Personality, cognitive appraisal and labor pain

Background The theories focusing on the central neural mechanisms also pointed to the role of psychological factors in shaping painful sensations. The aim of the study was to explore direct and indirect effects of personality and cognitive appraisal of childbirth on experienced labor pain. Participants and procedure Labor pain was assessed twice by forty-five childbearing women aged 18-45 (M = 28.31, SD = 5.20; 23 participants were primiparous): on admission to the obstetrics clinic and two days postpartum. On the first occasion, experienced and anticipated pain (VAS) and cognitive appraisal of labor (KOS) were measured, while the second assessment included rating of pain in the second stage of labor (VAS) and personality traits (NEO-FFI). Results Mediation analyses indicated indirect effects of conscientiousness on pain at the first stage of labor via challenge appraisal and of neuroticism and conscientiousness on recalled second stage labor pain intensity via threat/loss appraisal. Irrespective of personality traits, correlations were found between pain and cognitive appraisal in terms of threat/loss and challenge. Conclusions The findings showed the importance of conscientiousness and positive appraisal of labor for diminishing the experienced and memory for labor pain. Such positive appraisals can be reinforced in prenatal classes or trained with the support of close persons

Molecular Investigation of the Fatal Bloodstream <i>Candida orthopsilosis</i> Infection Case following Gastrectomy

Candida orthopsilosis represents a closely related cryptic genospecies of Candida parapsilosis complex-misidentified in routine diagnostic assays. This is emerging in settings where central venous catheters, invasive medical interventions, and echinocandin treatments are most likely to be used. A 59-year-old, non-neutropenic male patient, was admitted to an intensive care unit (ICU) due to respiratory distress syndrome, following a partial gastrectomy. As a result of duodenal stump leakage, re-laparotomy was required, abdominal drains were provided and central line catheters were exchanged. Multiple isolates of Candida orthopsilosis drawn from consecutive blood cultures were identified, despite ongoing echinocandin therapy and confirmed in vitro echinocandins susceptibility of the isolated strain. Species identification was verified via ITS region sequencing. Herein, we report the well-documented—per clinical data and relevant laboratory diagnosis—first case of a bloodstream infection caused by Candida orthopsilosis in Poland

A Common Profile of Disordered Angiogenic Factor Production and the Exacerbation of Inflammation in Early Preeclampsia, Late Preeclampsia, and Intrauterine Growth Restriction

<div><p>Preeclampsia and intrauterine growth restriction are two separate disease entities that, according to numerous reports, share the same pathogenesis. In both, angiogenesis disorders and generalized inflammation are the dominant symptoms. In this study, we hypothesized that both diseases demonstrate the same profile in early preeclampsia, late preeclampsia, and intrauterine growth restriction patients, with the only difference being the degree of exacerbation of lesions. One hundred sixty-seven patients were enrolled in the study and divided into four groups: early preeclampsia, late preeclampsia, and intrauterine growth restriction groups, and one control group. Concentrations of the angiogenesis and inflammatory markers soluble fms-like tyrosine kinase receptor 1, placental growth factor, high-sensitivity C-reactive protein, and interleukin-6 were determined, and the behavior of these markers and correlations among them were studied. Higher concentrations of soluble fms-like tyrosine kinase receptor 1, high-sensitivity C-reactive protein, and interleukin-6 and a lower concentration of placental growth factor were observed in the study groups compared with the control group. No differences in concentrations of the studied markers were found among the study groups but significant correlations were observed. The higher values for the angiogenesis and inflammatory markers both in preeclampsia patients and patients with intrauterine growth restriction of placental origin compared with the control group suggest the existence of the same underlying disorders in the development of these pathologies. The observed mutual correlations for disordered angiogenesis and inflammatory markers are suggestive of a mutual relationship between these processes in the development of pathologies evolving secondary to placental ischemia. The same lesion profile was observed for both preeclampsia and ‘placental’ intrauterine growth restriction patients, which could be used in developing common diagnostic criteria for pregnant patients.</p></div

Characteristics and a statistical analysis of routine diagnostics of the study groups (Mann-Whitney U-test).

<p>Characteristics and a statistical analysis of routine diagnostics of the study groups (Mann-Whitney U-test).</p

Analysis of variance of soluble fms-like tyrosine kinase receptor 1 (sFlt-1) in the study groups.

<p>The difference between sFlt-1 concentrations of the study groups with a 95% confidence interval was p<0.0001 and F = 55.624. Interactions between groups for sFlt-1 usingTukey’s test (examining statistically significant differences) were: intrauterine growth restriction (IUGR)/control (p<0.0001); early/control (p<0.0001); and late/control (p<0.0001). log sFlt-1, log sFlt-1 concentration in plasma; early, early-onset preeclampsia; late, late-onset preeclampsia.</p

Correlation between high-sensitivity C-reactive protein (hsCRP) and fms-like tyrosine kinase receptor 1 (sFlt-1).

<p>A positive correlation between sFlt-1 and hsCRP was observed in the study population (r = 0.47, p<0,001) using Spearman’s correlation analysis.</p

Analysis of variance for high-sensitivity C-reactive protein (hsCRP) in the study groups.

<p>The differences between hsCRP concentrations in the study groups with a 95% confidence interval was p<0.0001, F = 134.29. Interactions between groups for hsCRP using Tukey’s test (examining statistically significant differences) were: intrauterine growth restriction (IUGR)/control (p<0.0001); early/control (p<0.0001); late/control (p<0.0001). log hsCRP, log hsCRP concentration in plasma; early, early-onset preeclampsia; late, late-onset preeclampsia.</p

Analysis of variance for the soluble fms-like tyrosine kinase receptor 1 (sFlt-1) and placental growth factor (PlGF) ratio in the study groups.

<p>The difference between the sFlt-1/PlGF ratio in the study groups with a 95% confidence interval was p<0.0001, F = 133.57. Interactions between groups for the sFlt-1/PlGF ratio using Tukey’s test (examining statistically significant differences) were: intrauterine growth restriction (IUGR)/control (p<0.0001); early/control (p<0.0001); late/control (p<0.0001). log sFlt-1/PlGF, log sFlt-1/PlGF ratio; early, early-onset preeclampsia; late, late-onset preeclampsia.</p

Analysis of variance for placental growth factor (PlGF) in the study groups.

<p>The difference between PlGF concentrations in the study groups with a 95% confidence interval was p<0.0001, F = 98.339. Interactions between groups for PlGF using Tukey’s test (examining statistically significant differences) were: intrauterine growth restriction (IUGR)/control (p<0.0001); early/control (p<0.0001); late/control (p<0.0001). log PlGF, log PlGF concentration in plasma; early, early-onset preeclampsia; late, late-onset preeclampsia.</p