The Implication of Misinformation and Stigma in Age-Related Quality of Life, Depression, and Coping Mechanisms of Adult Patients with Psoriasis.

Background and Objectives: Stigma and lack of acceptance in society might have detrimental effects on the quality of life of patients with psoriasis, sometimes being comparable with other chronic diseases and conditions that affect the appearance of a patient, such as burns. Therefore, we surveyed our patients diagnosed with psoriasis to determine the implications of misinformation and stigma for their quality of life, depression, and coping strategies stratified by different age categories. Materials and Methods: A cross-sectional study was designed for a sample size of a minimum of 45 patients considering a prevalence of psoriasis of 2-3% in the general population. The study participants (patients and controls) were given both a paper-based unstandardized questionnaire and an online version of three standardized surveys. The cohort of patients was further split into three age groups to determine their age-related quality of life and coping mechanisms. Results: The proportion of patients with a history of depression and depressive symptoms among patients with psoriasis was significantly higher. Multiple discrepancies were observed between patients and controls regarding questions that targeted stigma and misinformation. On the Coping Orientation to Problems Experienced Inventory (COPE-60) questionnaire, older patients were more likely to use positive coping mechanisms such as engagement and problem-focused coping, while the young patients were using more emotion-focused coping mechanisms. However, patients in the 30-50 age range group scored the highest on physical and mental health among all participants who filled the 12-Item Short Form Survey (SF-12) survey. The Dermatology Life Quality Index (DLQI) results showed significantly more patients answering "a lot and very much" concerning embarrassment and social activities, while sexual difficulties affected the older patients. The strongest correlations with depression were observed in the young patient group, who believed that psoriasis can cause skin cancer (rho = 0.418) and who had sexual difficulties (rho = 0.414) and embarrassment (rho = 0.359) as evaluated by the DLQI survey. In the 30- to 50-year-old group, the strongest correlations were with the feeling of being stigmatized (rho = 0.376), having sexual difficulties (rho = 0.367) and disengagement coping style (rho = 273). Conclusions: While the respondents are reasonably well-informed regarding psoriasis, a degree of stigma remains, likely due to involuntary emotional responses such as repulsion and embarrassment. It is essential to establish initiatives aimed at educating the general public, raising awareness, and establishing a more tolerant social environment for psoriasis patients.

Altered nutritional status, inflammation and systemic vulnerability in patients with acute myocardial infarction undergoing percutaneous coronary revascularisation: A prospective study in a level 3 cardiac critical care unit.

AIM: The aim of the present study was to assess the influence of nutritional status, as expressed by Controlling Nutritional Status (CONUT) and Geriatric Nutritional Risk Index (GNRI) scores, on the inflammatory response following acute myocardial infarction (AMI) and the impact of an altered nutritional status and increased systemic inflammation on immediate evolution following AMI. METHODS: This was an observational prospective study in which we used the CONUT score and GNRI on 86 consecutive patients with AMI receiving primary revascularisation, divided into a well-nourished group (CONUT score 0-2, n = 68) and moderate-to-severe nutritional deficit group (CONUT score ≥ 3, n = 18). Inflammatory status was assessed on the basis of highly sensitive C-reactive protein (hs-CRP) at baseline and on day 5. RESULTS: Malnourished patients presented significantly higher levels of serum hs-CRP at baseline (33.6 ± 35.02 mg/dL vs 10.26 ± 25.93 mg/dL, P < 0.0001) and day 5 (52.8 ± 46.25 mg/dL vs 17.04 ± 24.78 mg/dL, P < 0.0001). GNRI values showed a weak but significant correlation with serum hs-CRP at baseline (r = -0.26, P = 0.01) and day 5 (r = -0.44, P < 0.0001). Patients with altered nutritional status presented more frequent deterioration of their haemodynamical status, requiring inotropic support (P = 0.002) and longer hospitalisation in the acute cardiac care unit (4.27 ± 2.60 vs 2.85 ± 0.73 days, P = 0.005). Patients requiring intravenous inotropics had a higher CONUT score (2.31 ± 1.7 vs 1.17 ± 1.27, P = 0.01), lower GNRI (102.0 ± 5.31 vs 98.56 ± 5.2, P = 0.02) and higher hs-CRP levels at baseline and day 5 (31.40 ± 46.57 vs 18.52 ± 32.98, P = 0.04 and 46.04 ± 51.50 vs 19.60 ± 46.05, P = 0.006). CONCLUSIONS: Malnourished patients with AMI had more expressed inflammation, increased blood vulnerability and worse outcomes.

Population preferences for sources that offers information about dietary fibres health effects - an international cross-sectional survey.

OBJECTIVE: To investigate the perceived importance of information about dietary fibre with regard top opulation socio - demographic characteristics and consumption patterns. METHODS: The cross-sectional study was conducted from September to November, 2016, in six different counties and 57 cities across Romania, and was part of a larger project that had nine other countries as well. Data of the Romanian subjects was collected using a validated questionnaire that was disseminated across the 10 countries at the same time. Knowledge about dietary fibre was explored through 10 questions, and the respondents were asked to answer on a 5-point Likert scale varying from 1 (totally disagree) to 5 (totally agree). SPSS 22 was used for data anaylsis. RESULTS: Of the 670 subjects, 358 (53.4%) were females, and the overall mean age was 35.81±15.61 years (range: 18-89 years). There were 298 (44.5%) subjects with a university degree, 314(46.9%) had completed high school and 57 (8.5%) had done primary school. Besides, 568 (84.8%) participants lived in an urban environment. Internet was the main source of getting information for 368(54.9%) subjects, while the lowest was hospitals 122 (18.2%). The percentage of correct answers regarding knowledge about health effects of dietary fibre was 23.12%. Most accurate answers were related to deficiency of vitamins and minerals 370 (55.5%), breast cancer 202(30.3%), vision problems 202(30.3%) and diabetes 168 (25.2%). The question with least accurate answer was the one about general preventive characteristics of dietary fibres 65 (9.7%). CONCLUSION: A proper and friendly way to transmit information about the importance of dietary fibre consumption is critical in promoting healthy diet patterns and in preventing non-transmissible diseases.

Wellness integrative profile 10 (WIP10) - an integrative educational tool of nutrition, fitness and health.

OBJECTIVE: To assess the educational impact and satisfaction of using Wellness Integrative Profile 10 both by specialists and clients in nutrition, health and fitness centres. METHODS: This cross-sectional study was conducted at 42 wellness centres in Romania during March-November 2016, where Wellness Integrative Profile 10 was implemented with no less than 3 months before the beginning of the study. Data was gathered through a 15-item questionnaire related to the educational impact of integrating 10 parameters regarding the level of health, nutrition and fitness of the subjects.. RESULTS: The questionnaire had a reliability Cronbach score of 0.777 for specialists and 0.705 for clients. The number of subjects who rated the satisfaction questionnaire WIP10 with maximum grade (5) were: 181.93(61.88%) specialists and 1,309.40(65.88%) clients. CONCLUSIONS: The implementation of Wellness Integrative Profile 10 will allow in the future to design customised and specialised programmes for health.