Search Results (6)

Functional somatic symptoms (FSSs) in children—such as headaches, stomachaches, and muscle pain without clear medical explanations—pose a significant clinical challenge, often leading to repeated healthcare visits and impairments in daily functioning. While the role of parental psychological factors in shaping children’s FSSs has been suggested, empirical evidence remains limited and fragmented. This study addresses this gap by systematically examining the associations between parents’ reflective functioning, emotion regulation, alexithymia, and physical and mental health, and the frequency and severity of children’s FSSs. A total of 339 parents of children aged 6–12 completed surveys assessing their capacity to understand mental states, regulate emotions, and identify or describe feelings, as well as their self-reported physical and mental health. They also indicated whether their child experienced FSSs (e.g., headaches, stomachaches) more than once per week. Results revealed that parents of children with FSSs reported significantly lower levels of reflective functioning (lower certainty, higher uncertainty), higher alexithymic traits, and greater emotion regulation difficulties, alongside poorer physical and mental health indices. Logistic regression analyses demonstrated that emotion regulation difficulties and poorer mental health significantly increased the likelihood of a child exhibiting FSSs, while lower reflective functioning also emerged as a significant predictor. Furthermore, multiple linear regression indicated that emotion regulation challenges and poor mental health predicted greater severity of FSSs. These findings offer novel insights into how parents’ psychological and health characteristics can shape children’s somatic symptom expression, highlighting the need for family-focused interventions. By identifying and addressing parental emotional and cognitive difficulties, clinicians may be able to mitigate the intergenerational transmission of maladaptive stress responses, ultimately reducing the burden of FSSs in children. Full article

Background/Objectives: Evidence suggests that older adults who survived COVID-19 were exposed to greater functional dependence in their daily living activities. This study aims to examine the prevalence of functional dependence and associated factors among Brazilian older people with functional dependence 12 months after COVID-19 infection. Methods: A cross-sectional study was carried out involving people aged 60 years or older in the state of Paraná, Brazil. One year after notification or hospital discharge due to COVID-19, between June 2021 and March 2022, participants responded to a questionnaire via telephone call about sociodemographic data and data on functionality using the Measure of Functional Independence (FIM). The outcome variable “assessment of functional capacity” was divided into functional dependence (FIM Total < 104) and functional independence (FIM Total ≥ 104). Results: A total of 768 older adults participated, with an average age of 68.03 ± 6.8 years (range between 60 and 100). A majority of them were female (50.3%), white (46%), with low education (37.4%), had a partner (56.3%), did not live alone (72.4%), and had their own home (52.2%). The prevalence of functional dependence was 7.2%. On average, participants scored 5.4 points lower on FIM one year after COVID-19 infection compared with those in the acute phase of COVID-19 (125.5 vs. 120.1; p < 0.001). Functional dependence was higher (p < 0.05) among women when compared to men (aOR = 2.28); in people who changed their work situation due to COVID-19 when compared to those with no change (aOR = 5.27); in people with fair/poor/bad self-reported health compared to those with excellent/good health (aOR = 2.97); in people with cardiovascular symptoms compared to those without cardiovascular symptoms (aOR = 3.37); and among the most severe cases of the disease (treatment in ICU) compared to mild cases (outpatient treatment) (aOR = 10.5). Conclusions: Most participants presented functional independence 12 months after COVID-19 infection. Cases of functional dependence were influenced by multidimensional factors, including physical health, economic, and psychosocial aspects. Full article

Background: This prospective study aims to determine whether preoperative stair-climbing tests (SCT) predict postoperative pulmonary complications (PPC) better than self-reported poor functional capacity (SR_PFC) in patients with known or suspected COPD. Methods: A total of 320 patients undergoing scheduled for major non-cardiac surgery, 240 with verified COPD and 80 with GOLD key indicators but disproved COPD, underwent preoperative SR_PFC and SCT and were analyzed. Least absolute shrinkage and selection operator (LASSO) regression was used for variable selection. Two multivariable regression models were fitted, the SR_PFC model (baseline variables such as sociodemographic, surgical and procedural characteristics, medical preconditions, and GOLD key indicators plus SR_PFC) and the SCT model (baseline variables plus SCT_PFC). Results: Within all stair-climbing variables, LASSO exclusively selected self-reported poor functional capacity. The cross-validated area under the receiver operating characteristic curve with bias-corrected bootstrapping 95% confidence interval (95% CI) did not differ between the SR_PFC and SCT models (0.71; 0.65–0.77 for both models). SR_PFC was an independent risk factor (adjusted odds ratio (OR) 5.45; 95% CI 1.04–28.60; p = 0.045 in the SR_PFC model) but SCT_PFC was not (adjusted OR 3.78; 95% CI 0.87–16.34; p = 0.075 in the SCT model). Conclusions: Our findings indicate that preoperative SR_PFC adequately predicts PPC while additional preoperative SCTs are dispensable in patients with known or suspected COPD. Full article

During late pregnancy, sleep deterioration is regularly observed. In concert with these observations, in previous studies by other researchers, a slight objective cognitive decline in pregnant women has been found. Sleep is essential for memory consolidation. The hypothesis of the study was that cognitive impairment could be related to sleep deterioration during pregnancy. The study included 19 pregnant women in their third trimester of pregnancy (28–40 weeks, median 33 weeks (IQR 32–37)) recruited at the Department of Gynecology and Obstetrics, Medical University of Warsaw, and 20 non-pregnant women as controls. The assessment was performed using the vocabulary subtest from the Wechsler Adult Intelligence Scale (WAIS), D2 Test of Attention, OSPAN task (Operational Span Task) to assess cognitive performance, actigraphy to examine sleep parameters, and a set of self-report instruments: Athens Insomnia Scale (AIS), Beck Depression Inventory (BDI), Ford Insomnia Response to Stress (FIRST), Regenstein Hyperarousal Scale (HS), and Epworth Sleepiness Scale (ESS). Although there were no differences between the groups in WAIS (p = 0.18), pregnant women had worse scores in working memory capacity (overall number of remembered letters: p = 0.012, WM span index: p = 0.004) and a significantly lower score in attention (p = 0.03). Pregnant women also had lower sleep efficiency (p = 0.001), more awakenings from sleep (p = 0.001), longer average awakenings (p < 0.0001), longer wake after sleep onset (WASO, p < 0.0001), and longer total time in bed (p < 0.0001). In psychological assessment, pregnant women had only a higher FIRST score (p = 0.02). Using mediation analysis, we found that frequent awakening might be the major factor contributing to deterioration in working memory performance, explaining almost 40% of the total effect. In conclusion, sleep fragmentation in the third trimester of pregnancy may impair working memory consolidation. Pregnant women often complain about poor daily performance as well as non-restorative sleep. In this study, we showed that there is a relationship between lower sleep quality in pregnancy and worse cognitive functioning. We can expect a cognitive decline in women with sleep disturbances in pregnancy. Therefore, we should pay more attention to the treatment of sleep disorders in pregnancy. Full article

AIM: Research evidence suggests that physical exercise can be part of standard care for breast cancer (BC) patients, contributing to the prevention or reduction of the adverse effects of both the disease and cancer therapies on physiological and quality of life (QoL) parameters. The purpose of this study was to assess QoL and physical activity (PA) levels of BC female patients under chemotherapy and compare them with healthy controls. MATERIAL & METHOD: 159 females were recruited, 94 BC patients [age, 57.25 ± 13.59 yrs; height, 1.61 ± 0.05 m; mass, 69.49 ± 12.67 kg; body mass index (BMI), 26.63 ± 5.36 kg/m²] and 65 healthy women [age, 49.60 ± 7.80 yrs; height, 1.65 ± 0.04 m; mass, 69.04 ± 5.25 kg; BMI, 25.30 ± 3.95 kg/m²]. Levels of PA were self-estimated using the International Physical Activity Questionnaire. QoL was self-reported by the BC and control groups using the EORTCQLQ-C30 and the SF-36 Health Survey, respectively. RESULTS: BC patients exhibited a total energy expenditure of 2,200 ± 1,187 MET-min/week, of which 1,384 ± 592 were spent in moderate PAs, 773 ± 436 in walking and 43.34 ± 159 in vigorous PAs. On the other hand, 49.30% and 50.70% of the controls participated in high-intensity and moderate-intensity PAs, respectively. Moreover, controls and BC patients were spending 2.34 ± 1.05 h/day and 4.62 ± 2.58 h/day sitting, respectively. BC patients scored their QoL with 63.43 ± 20.63 and physical functioning (PF) with 71.48 ± 23.35, while their fatigue, pain, and dyspnea scores were 42.28 ± 20.54, 19.44 ± 24.40, and 25.93 ± 28.85, respectively. Negative correlations were found between QoL and fatigue (p < 0.01), PF and pain (p < 0.01), fatigue (p < 0.01) and dyspnea (p < 0.05), while a positive correlation was found between QoL and PF (p < 0.01). Healthy participants evaluated their QoL as excellent (10.30%), very good (55.17%), average (29.30%), and poor (3.40%). CONCLUSION: This study revealed that BC patients represented moderate to high levels of functioning and QoL and preferred PAs of moderate intensity. Moreover, a positive association was found between PF and QoL in BC patients, while their QoL and functional capacity were compromised by pain, dyspnea, and fatigue. Although the BC group used to participate in PAs, they accumulated many hours seated, and they were overweight, further supporting the need for these patients to follow the specific exercise recommendations, so as to optimize their benefits from exercise. Full article

Triple-negative breast cancer (TNBC) is a highly aggressive form of breast cancer that lacks targeted therapy options, and patients diagnosed with TNBC have poorer outcomes than patients with other breast cancer subtypes. Emerging evidence suggests that breast cancer stem cells (BCSCs), which have tumor-initiating potential and possess self-renewal capacity, may be responsible for this poor outcome by promoting therapy resistance, metastasis, and recurrence. TNBC cells have been consistently reported to display cancer stem cell (CSC) signatures at functional, molecular, and transcriptional levels. In recent decades, CSC-targeting strategies have shown therapeutic effects on TNBC in multiple preclinical studies, and some of these strategies are currently being evaluated in clinical trials. Therefore, understanding CSC biology in TNBC has the potential to guide the discovery of novel therapeutic agents in the future. In this review, we focus on the self-renewal signaling pathways (SRSPs) that are aberrantly activated in TNBC cells and discuss the specific signaling components that are involved in the tumor-initiating potential of TNBC cells. Additionally, we describe the molecular mechanisms shared by both TNBC cells and CSCs, including metabolic plasticity, which enables TNBC cells to switch between metabolic pathways according to substrate availability to meet the energetic and biosynthetic demands for rapid growth and survival under harsh conditions. We highlight CSCs as potential key regulators driving the aggressiveness of TNBC. Thus, the manipulation of CSCs in TNBC can be a targeted therapeutic strategy for TNBC in the future. Full article