Search Results (390)

Numerous investigations have revealed elevated rates of post-traumatic stress symptoms (PTSS) following COVID-19 infection. This study examined the relation between illness-related and psychosocial variables in the severity of PTSS in individuals previously infected with COVID-19. The study sample included 381 individuals who had been infected with COVID-19 within the previous 4 months. Participants completed online measures of infection symptom severity, ongoing COVID-19 symptom burden, fear of dying and catastrophic thinking. Age, infection severity, ongoing COVID-19 symptom burden, and fear of dying and catastrophic thinking were significant correlates of the severity of PTSS. Hierarchical regression analysis revealed that age, gender, ongoing COVID-19 symptom burden, fear of dying and catastrophic thinking each made unique significant contributions to the prediction of the severity of PTSS. The results of the present study suggest that fear of dying and catastrophic thinking about COVID-19 symptoms might contribute to the development of PTSS following COVID-19 infection. Interventions aimed at reducing death fears and modifying negative and alarmist appraisals of COVID-19 symptoms might contribute to more positive recovery outcomes in individuals who are infected with COVID-19. The cross-sectional design of this study precludes statements about causality, and conclusions about temporal relations among variables must await replication in a longitudinal design. Full article

Background/Objectives: Ulcerative colitis (UC) and Crohn’s disease (CD) are two forms of inflammatory bowel disease (IBD), which, despite their shared inflammatory nature, differ markedly in clinical presentation and disease course. In this study, we aimed to explore whether these clinical differences are also reflected at the psychological level. Specifically, we sought to delineate the personality characteristics of a sample of patients with IBD and to investigate psychological and psychopathological differences between individuals with UC and CD. Methods: We enrolled 29 (44.61%) UC patients and 36 (55.39%) CD patients, all aged 18 years or older. Each participant completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), which was subsequently scored and interpreted by trained psychologists. The MMPI-2 is a 567-item inventory with dichotomous answers (true/false), providing measures of a wide range of symptoms, beliefs, attitudes, and personality traits. Results: The total sample showed clinically significant elevations on hypochondriasis (Hs), health concerns (HEA), general health concerns (HEA₃), and physical malfunctioning (D₃) scales. UC patients had statistically significant higher scores on hypomania (p = 0.043), lack of ego mastery—defective inhibition (p = 0.006), and fears (p = 0.038) scales than CD patients. On the other hand, CD patients showed statistically significant higher scores on the Overcontrolled Hostility scale (p = 0.043). Conclusions: Both groups of patients experience emotional difficulties related to their clinical conditions, leading to an increased preoccupation with bodily symptoms and illness. These aspects appear to be accompanied by shifts in mood towards a more depressive state. Notably, the UC group demonstrates a greater degree of impairment compared to the CD group, with experiences of anxiety, stress, difficulties in emotional control, and emerging relational challenges. Full article

For centuries, traditional medical systems have utilized Cistus leaf infusions, extracts, and essential oils in the treatment of inflammatory conditions, respiratory infections, febrile illnesses, and gastrointestinal disorders. Contemporary research has increasingly focused on the identification and characterization of biologically active constituents—particularly polyphenols and other antioxidants—that may modulate key physiological and cellular processes in the human body. These include mechanisms related to oxidative stress, inflammation, aging, and carcinogenesis. The therapeutic relevance of Cistus-derived compounds is further supported by their generally favorable safety profile and high tolerability, which distinguishes them from many synthetic pharmaceuticals. Moreover, the accessibility of Cistus preparations as dietary supplements or herbal infusions allows for their regular consumption without the need for complex therapeutic regimens. This positions Cistus as a promising candidate for integrative health strategies aimed at disease prevention and health maintenance. This review provides a comprehensive overview of the pharmacological potential and therapeutic applications of Cistus extracts, with particular emphasis on their antioxidant and bioactive properties. Full article

Presenteeism, characterized by going to work sick, has become increasingly prevalent in nursing, a profession with high social and interpersonal demands. It is associated with a deterioration of the health of nurses, a reduction in the excellence of care, and a decrease in safety for users. Burnout is related to stress and mental overload and is characterized by exhaustion and fatigue. Objective: To map the evidence on the relationship between presenteeism and burnout in nurses. Methods: A literature review was carried out using the EBSCOHost Research search engine in various databases. Eight studies were selected and analyzed. Results: The studies identify a consistent relationship between burnout and presenteeism in nurses. Emotional exhaustion, resulting from burnout, can lead nurses to go to work despite being ill, due to a sense of responsibility, ethical duty, or organizational pressures. Most studies are cross-sectional, which limits the ability to establish causal relationships and identify specific interventions to reduce burnout-related presenteeism in nursing. Conclusions: It is essential to invest in health management policies for nurses to reduce burnout and minimize the consequences of presenteeism. Full article

Background/Objectives: Adolescents with chronic physical health conditions (CHCs) use specific coping strategies to respond to condition-related stressors. However, most studies of CHC-related stress and coping focus on a single condition. The objective of this study was to measure CHC-related stress and identify associated coping strategies in adolescents with a variety of CHCs. A secondary objective was to examine the relationship between CHC-related stress, coping strategies, health-related quality of life, and perceived severity of chronic illness. Methods: Teens (n = 38, 68.42% female, mean age 17.9 years) with CHCs completed the Responses to Stress Questionnaire (RSQ) for CHC-related stress, the PedsQL to assess health-related quality of life, and the Perceptions of the Severity of Chronic Illness (PSCI) measure. The most frequently reported conditions were asthma, food allergies, and multiple conditions. We used fuzzy cluster analysis to identify two clusters, high stress and low stress, based on ratings of CHC-related stressors. Relationships between coping strategies and the PedsQL and PSCI, and between the PSCI and PedsQL, were assessed using Pearson partial correlations. Relationships between the PSCI, PedsQL, and coping strategies for the two clusters were assessed using adjusted mean differences. We adjusted for multiple comparisons by controlling the false discovery rate. Significance was set at p < 0.05. Results: Teens were most likely to use secondary control engagement coping and involuntary engagement to respond to CHC-related stressors. Teens in the two clusters differed on health-related quality of life but not coping strategies or perceived condition severity. CHC diagnosis category was associated with cluster membership. Conclusions: This exploratory study highlighted relationships among quality of life, coping strategies, and CHC diagnosis category that should be explored in future studies. Improved understanding of CHC-related stress and coping strategies in teens with CHCs could have an impact on their quality of life and well-being. Full article

Background/Objectives: Child abuse is a pervasive global issue with significant implications for the physical, emotional, and psychological well-being of victims. This review highlights the clinical, molecular, and therapeutic dimensions of child abuse, emphasizing its long-term impact and the need for interdisciplinary approaches. Early exposure to abuse activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to chronic cortisol release and subsequent neuroplastic changes in brain regions such as the hippocampus, amygdala, and prefrontal cortex. These molecular alterations, including epigenetic modifications and inflammatory responses, contribute to the heightened risk of psychiatric disorders and chronic illnesses in survivors. Clinically, child abuse presents with diverse manifestations ranging from physical injuries to psychological and developmental disorders, making timely diagnosis challenging. Methods: A multidisciplinary approach involving thorough clinical evaluation, detailed histories, and collaboration with child protection services is essential for accurate diagnosis and effective intervention. Results: Recent advances in molecular biology have identified biomarkers, such as stress-related hormones and epigenetic changes, which provide novel insights into the physiological impact of abuse and potential targets for therapeutic intervention. Current treatment strategies prioritize the child’s safety, psychological well-being, and prevention of further abuse. Trauma-focused cognitive behavioral therapy and family-centered interventions are pivotal in promoting recovery and resilience. Conclusions: Emerging research focuses on integrating molecular findings with clinical practice, utilizing digital health tools, and leveraging big data to develop predictive models and personalized treatments. Interdisciplinary collaboration remains crucial to translating research into policy and practice, ultimately aiming to mitigate the impact of child abuse and improve outcomes for survivors. Full article

Background: Somatic symptom disorder (SSD) in children may be influenced by stress reactivity and psychosocial factors. The glucocorticoid receptor (GR), encoded by NR3C1, is a key mediator of stress responses. However, the relationship between NR3C1 methylation and SSD remains unclear. Methods: We analyzed NR3C1 exon 1F methylation in cell-free DNA from saliva in 34 children with SSD and 29 age- and sex-matched controls using bisulfite amplicon sequencing. Psychological assessments included the Beck Depression Inventory-II (BDI-II) and KINDL questionnaires to evaluate associations with methylation patterns. Results: Methylation levels showed age-related differences. In children under 13, CpG sites displayed mixed methylation, and specific sites correlated with KINDL and BDI-II scores. KINDL physical and total well-being scores negatively correlated with CpG30 and positively with CpG35; BDI-II scores negatively correlated with CpG32 and CpG35. In children aged 13 or older, CpG sites showed uniformly high methylation with no correlation to psychological measures. The SSD group showed significantly higher average methylation across the exon 1F region than controls in the older age group. These children also had more cases of orthostatic dysregulation and longer illness duration. Conclusions: This study suggests age-dependent epigenetic regulation of NR3C1 in SSD. While younger children showed CpG-specific correlations with psychological symptoms, older children demonstrated uniformly high methylation and potentially reduced gene expression, potentially reflecting cumulative stress, autonomic dysfunction, and internalizing disorders such as anxiety and depression. Full article

Hypoxia leads to endothelial dysfunction and increased blood–brain barrier (BBB) permeability, promoting the incidence of diseases such as stroke and acute high-altitude illness. Brain microvascular endothelial cells (BMECs) are important structural and functional components of the BBB; however, the molecular changes that occur in BMECs during hypoxia remain unknown. We reported the molecular and functional changes in BMECs under hypoxia through whole-transcriptome sequencing, small RNA microarray, TMT quantitative proteomic, and untargeted metabolomic analyses. We found that hypoxia affected pathways such as ncRNA processing, the HIF-1 signaling pathway, the cell cycle, DNA replication, glucose metabolism, protein synthesis, and inflammation pathways. ncRNA processing was significantly downregulated. However, the levels of some miRNAs, tRNAs, tsRNAs, snoRNAs, lncRNAs, and circRNAs were significantly upregulated under hypoxia. These results suggest that ncRNAs may play an important role in oxidative stress and cellular adaptation to hypoxia, helping us understand the pathological process of BBB injury and providing potential targets for the treatment of BBB-related cerebrovascular diseases. Full article

Oligodendrocyte precursor cells (OPCs) are a dynamic and heterogeneous population of glial cells essential for brain development and myelination. Beyond their well-established role in oligodendrogenesis, emerging evidence suggests that OPCs contribute to synaptic regulation, neuronal communication, and brain plasticity. Recent studies have increasingly implicated OPC dysfunction in the pathophysiology of psychiatric disorders, particularly schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD). This narrative review integrates clinical, genetic, transcriptomic, and histological findings to examine the role of OPC alterations in mental illnesses. In SCZ, OPC abnormalities predominantly affect myelination, but recent data also suggest deficits in non-canonical functions, including neuron–OPC communication. Findings in BD largely mirror those in SCZ, implying shared OPC-related mechanisms across these disorders. In contrast, OPC involvement in MDD appears more complex, with evidence supporting both myelination deficits and non-canonical dysfunctions, such as impaired neuro–glial interactions and perineuronal network alterations. The developmental timing of OPC dysfunction may represent a common denominator underlying psychiatric disorders, as early-life stress and neurodevelopmental disturbances have been linked to OPC impairments. Moreover, given the shared developmental origins of OPCs and parvalbumin-positive interneurons, disruptions in their mutual interactions may contribute to broader neural network dysregulation. Despite these insights, the field remains in its infancy. Future studies integrating independent human cohorts with robust preclinical models are needed to clarify the extent of OPC involvement in psychiatric pathophysiology. Understanding OPC dysfunction may reveal novel biomarkers and open new avenues for individualized therapeutic interventions and preventive strategies in mental health. Full article

Background/Objectives: According to a diathesis–stress model for the development of mental illness, it is assumed that, in addition to pre-existing individual vulnerability, the occurrence of acute strains is an etiological factor. The SARS-CoV-2 pandemic was a collective massive stressor, which could predispose to a first manifestation of a mental disorder or the exacerbation of a pre-existing mental disorder. The aim of this study was to investigate the effects of the pandemic on the cohort of patients admitted to hospital during the first year of the pandemic. Methods: Patients admitted to inpatient treatment in a university psychiatric hospital in an urban region from April 2020 to March 2021 were interviewed using a systematic questionnaire assessing individual stress factors in the context of the pandemic. On the basis of the interview, clinical practitioners rated the influence of the pandemic on the admission. Results: Six hundred and forty-five patients were interviewed. Only 6.4% showed a strong influence of the pandemic on inpatient admission. This group was characterized by a comparatively high level of socioeconomic functioning. Additionally, the majority of this group had a pre-existing mental disorder. Conclusions: For the majority of patients, the pandemic had only a minor influence on their hospitalization; only for 6.4% was a high impact of the pandemic reported. We hypothesize that this group’s higher socioeconomic functioning in addition to a pre-existing mental disorder made them vulnerable to pandemic-associated limitations. These data confirm a complex diathesis–stress model for the development of mental illness in the context of an acute collective stressor. Full article

Background/Objectives: Persistent breathlessness impacts people living with advanced chronic obstructive pulmonary disease (COPD) and carers. Accessible services are limited. This translational pilot study evaluated the feasibility, impacts on patient and carer-reported outcomes, and hospital use of a home-based breathlessness intervention service (BLIS). Methods: People with stable COPD, ≥1 COPD-related hospital admissions in the previous year, and persistent breathlessness participated in a pre–post study. The BLIS program involved home visits/phone contacts by a nurse/physiotherapist (average 8 contacts, 7 weeks). Uptake, retention, and fidelity were recorded prospectively, and participant experience was explored (post-program interviews). Breathing discomfort (Multidimensional Dyspnea Profile A1 scale), threat (Brief Illness Perception Questionnaire), and carer stress/strain (Zarit Burden Interview) were compared pre- and post-program (week 9, 3 and 6 months) using mean difference and 95% confidence intervals (CIs). Hospital use for COPD-related causes in 12 months before/after participation was reported. Results: A total of 16/19 eligible people agreed to participate, and 15/16 completed the program. In participants with COPD (73 [9] years, FEV1%pred 42% [15], mean [SD]; a median of 3 COPD-related hospital admissions in the previous year) and carers (n = 6), BLIS was highly (in 95%) acceptable. Compared to pre-program, breathing discomfort was reduced in week 9 and 6 months; breathlessness threat was reduced in week 9 and 3 months; and carer burden was reduced at 6 months. Compared to the 12 months prior, hospital admissions decreased in the 12 months post-program. Conclusions: Translation of this service to the local setting was feasible, with high program uptake and retention. Post-program improvements in key patient- and carer-reported outcomes and a reduction in public hospital admissions support the implementation of the BLIS program for this cohort in this setting. Full article

Refeeding syndrome (RS) is defined as the spectrum of metabolic and biochemical disorders related to rapid nutritional replenishment after a prolonged period of fasting. It is caused by an abrupt shift in electrolytes and fluid among intra- and extracellular compartments, leading to metabolic disturbances like hypophosphatemia, vitamin deficiency, and fluid overload. RS often remains underdiagnosed due to variability in definition and diagnostic criteria adopted, overlapping clinical features with other complications and low awareness among clinicians. Critically ill individuals, particularly those admitted to intensive care units (ICUs), represent a cohort with peculiar features that may heighten RS risk due to their baseline frailty, frequent undernutrition, and the metabolic stress of acute illness. However, studies specifically conducted in ICU settings have yielded conflicting results regarding incidence rates, prognostic impact, and specific risk factors. Despite these differences, all evidence consistently highlights RS as a frequent and serious complication in critically ill patients. Early detection and prevention are essential, relying on prompt nutritional assessment at ICU admission, careful monitoring of serum electrolytes before and during refeeding, and a conservative caloric approach to nutrient reintroduction, alongside supportive therapy and electrolyte supplementation if RS manifestations occur. Clinicians should be aware of the significant prevalence and potential severity of RS in critically ill patients, along with the ongoing challenges related to its early recognition, prevention, and optimal nutritional management. This review aims to provide a comprehensive overview of the current knowledge on the incidence, prognostic impact, risk factors, clinical manifestations, and nutritional management of RS in critically ill patients while highlighting existing evidence gaps and key areas requiring clinical attention. Full article

There is an exponential increase in the global prevalence of non-alcoholic fatty liver disease (NAFLD) in all populations. The objective of this review is to examine how different cultures and molecular entities influence the progression of NAFLD. Research databases, including PubMed, Scopus, the American Diabetes Association, the American Liver Foundation, and Diabetes UK, were used to retrieve information. Our data analysis showed that cultural norms shape the perceptions of health, illness, and mortality, thus influencing how individuals view themselves and express their experiences and may also affect decisions related to treatment and healthcare. Cultural competence, the ability to understand and navigate cultural differences, is essential for eliciting patient and practitioner perspectives and integrating this understanding into diagnostic and treatment plans. By acknowledging and respecting a patient’s cultural background, healthcare providers can foster trust, improve care quality, enhance acceptance of diagnoses, and boost treatment adherence. Although cultural factors play a crucial role in the progression of NAFLD, the disease is also shaped by genetic predispositions, molecular mechanisms, and comorbidities. Molecular pathways involved in the development and progression of NAFLD include alterations in lipid metabolism, insulin signaling, insulin resistance, oxidative stress, defective gut microbiome, and inflammation. This study concludes that a combination of cultural preferences and molecular factors has contributed to the worldwide exponential rise in the prevalence of NAFLD, which in turn has led to an increase in the prevalence of comorbidities such as cardiovascular diseases, diabetes mellitus, and metabolic syndrome. Full article

Coronavirus disease 2019 (COVID-19) has posed unprecedented challenges to global public health, highlighting the importance of prognostic biomarkers in critically ill patients. The oxidative stress developed in COVID-19 is associated with impairment in various human organs and systems, and it is related to erythrocyte injury, leading to an elevation in red cell distribution width (RDW) and systemic inflammation. This study aims to assess the prognostic value of erythrogram indicators and C-reactive protein (CRP) levels in 91 intensive care unit-admitted COVID-19 patients, categorized into survivor patients (discharge group) and non-survivor patients (death group). The results were presented using descriptive statistics and the Mann–Whitney test. The most severe cases of respiratory failure in which the patients did not survive showed higher red cell distribution width (RDW) and lower values of red blood cell count, hemoglobin, and hematocrit. RDW may be an important indicator of mortality, as demonstrated by the receiver operating characteristic (ROC) curve analysis. Furthermore, this increase in RDW is correlated with elevated CRP levels, another important clinical outcome for these patients. In conclusion, elevated RDW and CRP levels at admission may be reliable predictors of unfavorable outcomes, emphasizing the utility of these indicators in clinical assessments of COVID-19 patients. Full article

With accelerating surface warming trends in urban regions, cities like Algiers are increasingly exposed to extreme heat, contributing to a growing concern over heat-related illnesses. For a comprehensive long-term assessment (2001–2023) of heat-related risks in Algiers, multi-decade satellite, meteorological, and census data were used in this study to map and assess spatial patterns of the Heat Health Risk Index (HHRI) within the framework established by the Intergovernmental Panel on Climate Change (IPCC) incorporating hazard, exposure and vulnerability components. The Universal Thermal Climate Index (UTCI) was then calculated to assess thermal stress levels during the same period. Following this, the study addressed a critical research gap by coupling the HHRI and UTCI and identified hotspots using the Getis-Ord Gi* statistical analysis tool. Our findings reveal that the intensity of HHRI has increased over time since “very-low” risk areas had an outstanding decrease (93%) and a 6 °C UTCI rise over 23 years reaching the “very strong heat stress” level. The coupled index demonstrated greater and different risk areas compared to the HHRI alone, suggesting that the coupling of both indicators enhances the sensitivity of heat risk assessment. Finally, persistently identified hotspots in central and eastern regions call for localized, targeted interventions in those areas and highlight the value of remote sensing in informing policymakers and enhancing climate resilience. Full article