Association between Type-D Personality and Affective (Anxiety, Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study

Background: Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients. Objective: The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up). Aims: The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients. Methods: 145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1. Results: One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of TypeD personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1. Conclusion: Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Insulin receptor-related receptor in the pancreas and in a β-cell line

Insulin receptor-related receptor (IRR) belongs to the family of the insulin receptor (IR) along with the IR itself and the insulin-like growth factor receptor. Whereas the ligands of the latter receptors are known, identification of an IRR ligand has eluded investigations so that IRR has been considered an orphan receptor. A recent breakthrough in the understanding of IRR functional role came from the finding that IRR can be activated by mildly alkali media in absence of any protein agonist [1]. IRR shows highly specific tissue distribution, with highest concentration in kidney intercalated cells. However, significant amounts of the receptor are also found in the stomach and in α- and β-cells of the islets of Langerhans. Recent reports indicate that the pancreatic duct system is frequently associated with islet cells. Here, we show that those islet cells that are in contact with the excretory ducts are also IRR-expressing cells. Thus, when the exocrine pancreas is in an active state of secretion duct-associated islet cell behavior is potentially influenced by an IRR-mediated alkaline-induced signalling pathway. To explore this issue, we analyzed the effects of alkaline media on the pancreatic β-cell line MIN6. Activation of endogenous IRR was detected and could be inhibited with linsitinib, a synthetic inhibitor of the IR family of receptors. IRR autophosphorylation correlated with pH-dependent linsitinib-sensitive activation of IR substrate 1 (IRS-1). In contrast to insulin stimulation, no protein kinase B (Akt/PKB) phosphorylation was detected as a result of the alkali treatment. The alkaline medium but not insulin also triggered actin cytoskeleton remodeling in MIN6 cells that was blocked by pre-incubation with linsitinib. We propose that the activation of IRR by alkali is a component of a local loop of signaling between the exocrine and endocrine parts of the pancreas

Hostility in cancer patients as an underexplored facet of distress

ObjectiveIn the present study, we aimed to assess hostility and to examine its association with formal psychiatric diagnosis, coping, cancer worries, and quality of life in cancer patients.MethodsThe World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) to make an ICD‐10 (International Classification of Disease) psychiatric diagnosis was applied to 516 cancer outpatients. The patients also completed the Brief Symptom Inventory‐53 to assess hostility (BSI‐HOS), and the Mini‐Mental Adjustment to cancer scale (Mini‐MAC). A subset of patients completed the Cancer Worries Inventory (CWI), the Openness Scale, and the Quality of Life Index.ResultsBy analyzing the distribution of the responses 25% of the patients had moderate and 11% high levels of hostility, with about 20% being BSI‐HOS “cases.” Hostility was higher in patients with a formal ICD‐10 psychiatric diagnosis (mainly major depression, other depressive disorders, anxiety disorders) than patients without ICD‐10 diagnosis. However, about 25% of ICD‐10‐non cases also had moderate‐to‐high hostility levels. Hostility was associated with Mini‐MAC hopelessness and anxious preoccupation, poorer quality of life, worries (mainly problems sin interpersonal relationships), and inability to openly discuss these problems within the family.ConclusionsHostility and its components should be considered as dimensions to be more carefully explored in screening for distress in cancer clinical settings for its implications in negatively impacting on quality of life, coping and relationships with the family, and possibly the health care system.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167492/1/pon5594_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167492/2/pon5594.pd

Post-traumatic Stress Symptoms and Serotonin Transporter (5-HTTLPR) Polymorphism in Breast Cancer Patients

Introduction: Post-traumatic Symptoms (PTSS) and Post-traumatic Stress Disorder (PTSD) have been reported to affect a quite significant proportion of cancer patients. No study has examined the relationship between serotonin transporter gene-linked polymorphic region (5-HTTLPR) and cancer, including Gene-Environment interactions between this polymorphism and specific causes of distress, such as cancer related problems (CRP) or life stressful events (SLE). Methods: One hundred and forty five breast cancer outpatients participated in the study and were assessed using the Impact of Event Scale (IES), the Problem List (PL) developed by the National Comprehensive Cancer Network (NCCN) Distress Management Guidelines and the Paykel's Life Events Interview to evaluate the exposure to SLE during the year before the cancer diagnosis. Each patient was genotyped for 5-HTTLPR polymorphism by analyzing genomic DNA obtained from whole blood cells. Gene-Environment interactions were tested through moderation analysis. Results: Twenty-six patients (17.7%) were classified as PTSS cases using the IES. Genotype and phenotype distributions did not differ across individuals with/without PTSS (genotype: χ2 = 1.5; df = 2; p = 0.3; phenotype χ2 = 0.9; df = 1; p = 0.2). For both the genotype and phenotype model, using CRP as a predictor showed significant gene-environment interactions with IES total score (p = 0.020 and p = 0.004, respectively), with individuals carrying the l/l allele showing a greater probability of experiencing PTSS. No interaction was found in relationship to SLE (p = 0.750). Conclusion: This study showed a significant GEI between CRP and PTSS in breast cancer patients, with carriers of the l/l allele showing indicators consistent with greater sensitivity to stress

Imigrantes russos no Brasil: para entender, para ser compreendido

While L2 acquisition by Brazilians has been studied for different languages, the acquisition of Brazilian Portuguese by foreigners has been poorly explored. Recent studies of non-native accented speech in other languages have shown that a foreign accent could largely influence the perception of personal qualities of speakers, and this issue presents a large interest for intercultural research projects. Our research project is focused on Russophone immigrants living in Brazil, bilingual speakers of Russian and Portuguese. The specific aim of the current work is to describe a database containing information about 40 native Russian speakers living in São Paulo for at least six months. Their linguistic and sociocultural profiles are presented, and the experimental protocol of the data collection is described. The protocol included recording speech samples in Russian and in Portuguese and video recordings for further facial expression analysis of bilinguals by the program FaceReader 7.0. The analysis of the sociocultural profiles of the Russophones, presented in the current work, provides a strong basis for the enrichment of the phonetic, sociolinguistic, and nonverbal behavior analysis of these speakers.A aquisição de L2 por brasileiros tem sido foco de um grande número de estudos. No entanto, a aquisição de português brasileiro por falantes de outras línguas tem sido pouco explorada. Pesquisas recentes sobre o sotaque estrangeiro mostram que este pode exercer forte influência na percepção de características pessoais de falantes, fator este que se reveste de grande interesse em projetos de pesquisa de natureza intercultural. O nosso projeto de pesquisa tem como foco imigrantes russófonos que moram no Brasil, falantes bilíngues de russo e português. O objetivo específico deste trabalho é descrever um banco de dados que contém informação sobre 40 falantes nativos de russo que moram em São Paulo há pelo menos 6 meses. Descrevemos seus perfis linguísticos e socioculturais, e apresentamos o protocolo de coleta de dados desenvolvido. O protocolo inclui a gravação de amostras de fala em russo e em português, e também a gravação em vídeo para futura análise de expressões faciais em bilingues, utilizando o programa FaceReader 7.0. A análise de perfis socioculturais de russófonos, apresentada no presente trabalho, fornece subsídios para enriquecer as análises fonéticas, sociolinguísticas e de comportamento não-verbal desses falantes

A comparison of Dignity Therapy narratives among people with severe mental illness and people with cancer

Objective: To examine Dignity Therapy (DT) narratives in patients with severe mental illness (SMI) and a control group of cancer patients. Methods: 12 patients with SMI (schizophrenia, bipolar disorders, sever personality disorders) and 12 patients with non-advanced cancer individually participated to DT interviews. DT was tape-recorded, transcribed verbatim and shaped into a narrative through a preliminary editing process. A session was dedicated to the final editing process along with the participant, with a final written legacy (generativity document) provided to the participant. Interpretative Phenomenological Analysis was used to qualitatively analyze the generativity documents. Results: Patients with SMI and patients with cancer presented similar main narrative categories relative to dignity, such as "Meaning making", "Resources", "Legacy", "Dignity"; in addition, inpatients with SMI "Stigma" and inpatients with cancer "Injustice" emerged as separate categories. Patients in both groups strongly appreciated DT as an opportunity to reflect on their life story and legacy. Conclusions: The study showed that DT is a valuable intervention for people with SMI, grounded in a practical, person-centered approach. All patients found DT as an opportunity to describe their past and present, highlighting changes in the way they relate to themselves and others. These results can guide implementation of DT in mental health settings for people with SMI, as it is for people with cancer

Temporal changes in fecal microbiota of patients infected with COVID-19: a longitudinal cohort

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a multifaceted disease potentially responsible for various clinical manifestations including gastro-intestinal symptoms. Several evidences suggest that the intestine is a critical site of immune cell development, gut microbiota could therefore play a key role in lung immune response. We designed a monocentric longitudinal observational study to describe the gut microbiota profile in COVID-19 patients and compare it to a pre-existing cohort of ventilated non-COVID-19 patients. Methods From March to December 2020, we included patients admitted for COVID-19 in medicine (43 not ventilated) or intensive care unit (ICU) (14 ventilated) with a positive SARS-CoV-2 RT-PCR assay in a respiratory tract sample. 16S metagenomics was performed on rectal swabs from these 57 COVID-19 patients, 35 with one and 22 with multiple stool collections. Nineteen non-COVID-19 ICU controls were also enrolled, among which 14 developed ventilator-associated pneumonia (pneumonia group) and five remained without infection (control group). SARS-CoV-2 viral loads in fecal samples were measured by qPCR. Results Although similar at inclusion, Shannon alpha diversity appeared significantly lower in COVID-19 and pneumonia groups than in the control group at day 7. Furthermore, the microbiota composition became distinct between COVID-19 and non-COVID-19 groups. The fecal microbiota of COVID-19 patients was characterized by increased Bacteroides and the pneumonia group by Prevotella. In a distance-based redundancy analysis, only COVID-19 presented significant effects on the microbiota composition. Moreover, patients in ICU harbored increased Campylobacter and decreased butyrate-producing bacteria, such as Lachnospiraceae, Roseburia and Faecalibacterium as compared to patients in medicine. Both the stay in ICU and patient were significant factors affecting the microbiota composition. SARS-CoV-2 viral loads were higher in ICU than in non-ICU patients. Conclusions Overall, we identified distinct characteristics of the gut microbiota in COVID-19 patients compared to control groups. COVID-19 patients were primarily characterized by increased Bacteroides and decreased Prevotella. Moreover, disease severity showed a negative correlation with butyrate-producing bacteria. These features could offer valuable insights into potential targets for modulating the host response through the microbiota and contribute to a better understanding of the disease's pathophysiology. Trial registration CER-VD 2020–00755 (05.05.2020) & 2017–01820 (08.06.2018)

From Distress Screening to Uptake: An Italian Multicenter Study of Cancer Patients

Introduction: Little consideration is given to the referral and uptake of available supportive services after distress screening. However, identifying the reasons for accepting or refusing help is mandatory for implementing a screening policy. The present study explored the practical usefulness of and potential barriers to the application of distress management. Methods: 406 cancer patients were consecutively selected and asked to complete the Distress Thermometer (DT) and Problem Check List (PL). All patients with a DT score ≥6 were invited for a post-DT telephone interview with a trained psychologist. Results: The 112 patients who refused to take part were more often older, retired, at a more advanced stage of illness, and with no previous experience of psychological intervention with respect to those who accepted. Of the 78 patients with a score ≥6 who were referred to the Psycho-Oncology Service, 65.4% accepted the telephone interview. Twenty-two patients rejected the initial invitation immediately for various reasons including logistic difficulties, physical problems, and feeling embarrassed about opening up to a psychologist. Conclusions: Our study confirms that screening per sé is insufficient to deal with the problem of distress and that more emphasis should be placed on implementing referral and treatment

Additional file 1 of Temporal changes in fecal microbiota of patients infected with COVID-19: a longitudinal cohort

Additional file 1: Figure S1. Flow chart of the study. Figure S2. Alpha diversity changes over time in ventilated and non-ventilated groups. Figure S3. Jaccard beta-diversity of ventilated and non-ventilated patients at day 0 depicted on NMDS