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Parenting is a challenging life-cycle transition, particularly for lesbian, gay, and bisexual (LGB) persons who have to deal with prejudice and discrimination. Considering this position of social disadvantage and the potential protective role of social support, our aim in this work was to systematize existing knowledge about the role of social support (i.e., social support, family support, community support, LGBT support, support, and engagement) in the transition to parenthood among LGB persons. Through a systematic review process conducted in May 2019 using PRISMA guidelines, the present study identified 22 manuscripts which accomplished all inclusion criteria. Our results suggested closer relationships to the family of origin and a detachment from the LGBT community in this stage of life cycle. Furthermore, the social support received in the transition to parenthood seems to influence not only the psychological well-being of these parents and prospective parents but also the quality of their relationships with different support networks. Thus, we understand that inclusive clinical and human professional interventions aimed at improving the available social support networks of LGB persons and, consequently, enhance their psychosocial well-being and family relations during this life transition. [ABSTRACT FROM AUTHOR]

Background: It has been speculated for several years that trans identity and parenthood could be incompatible. However, studies investigating the parental intentions of trans individuals stress that they have motivations and parental intentions similar to cis people. Fertility preservation is a way for trans people to achieve parenthood; still, information about these procedures is not always provided, and implications on trans people well-being are not always discussed with health professionals. Methods: In this exploratory study, we looked at the parenthood intentions of 14 Portuguese trans and non-binary people and their experiences with health services. We conducted four focus groups and used thematic analysis to analyze the participants' speeches. Results: Half of the participants wanted to be parents, especially through adoption. Most of the remaining were undecided on the subject. Mixed experiences with the health services were reported, and only a few participants were informed by health providers about fertility preservation options. Conclusions: Trans individuals need to receive clear information about parenthood possibilities in order to make informed decisions about their future. [ABSTRACT FROM AUTHOR]

Chronic inflammation plays an important role in the progression and outcome of chronic kidney disease (CKD). The circulating levels of the inflammatory biomarkers interleukin 6 (IL6) and pentraxin 3 (PTX3) are enhanced in CKD patients, and are associated with the progression of the disease and with higher risk for cardiovascular events, the major cause of death in CKD patients. Our aim was to study how specific polymorphisms of IL6 and PTX3 encoding genes affect the inflammatory response and outcome of end-stage renal disease (ESRD) patients on dialysis. Methodology included the analysis of two single nucleotide polymorphisms (SNP), namely the IL6 (rs1800795) polymorphism in the promoter region (-174G > C), and the PTX3 (rs2305619) polymorphism in the intron 1 (+ 281A > G), which were analyzed in ESRD patients on dialysis and in a group of heathy individuals. The allelic frequencies, genotype distribution and their association with circulating levels of the inflammatory markers C-reactive protein (CRP), IL6, growth differentiation factor 15 (GDF15) and PTX3, were determined in ESRD patients. Events of death were recorded along one year, to assess the association of the studied SNPs with all-cause mortality and the inflammatory biomarkers, in ESRD patients. Results showed that the allelic frequencies and genotype distribution for IL6 and PTX3 SNPs in the control group and ESRD patients were similar and in agreement with other European reports. For the IL6 polymorphism, we found a trend towards higher levels of high-sensitivity (hs) CRP, IL6 and PTX3 in the homozygous genotypes; the CC genotype also showed the highest levels of GDF15. The mortality rate after the 1-year follow-up was 10.4%. The CC genotype (IL6 SNP) was associated to a higher risk of mortality and deceased patients carrying this genotype also showed the highest levels of hsCRP. Regarding the studied PTX3 SNP, the AA genotype was linked to an enhanced inflammatory response, showing the highest values of hsCRP and IL6. Nevertheless, this genotype had no significant impact on the mortality rate. In conclusion, both studied SNPs seem to modulate the inflammatory response in ESRD and may, therefore, be determinant on disease progression and patients' outcome. Our data also highlights the importance of research on genetic variants that, although less frequent, may have significant biological value. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies on the life satisfaction in children and young people have investigated its association with vulnerability, discrimination, the individual's school environment and network of relationships, and mental health. The growing interest in the area demands instruments with good psychometric properties. Aim: The aim of this study is to study the psychometric properties of the Multidimensional Life Satisfaction Scale for Children (MLSS-C). Method: The participants were 379 elementary schoolchildren aged 9 to 14 ( M = 10.5 years), enrolled in public schools in a city in the state of São Paulo, Brazil. The instruments used were the MLSS-C, the Self-Description Assessment Questionnaire 1 (SDQ1), the Social Skills Rating System (SSRS), and the Childhood Stress Scale (CSS). Two data collections were made, one in the fifth year of elementary school and one in the sixth. Confirmatory factor analysis (CFA) was carried out to assess the structural model's goodness of fit. The internal consistency (Cronbach's alpha and composite reliability), test-retest reliability and the discriminant, convergent, and divergent validity were also assessed. Results: Regarding CFA, after removing items with saturation values below .50, six dimensions proposed by the authors remained, five of them with alpha values above .70. The construct validity was confirmed by finding moderate and positive correlations between life satisfaction and self-concept and social skills (convergent validity) and lower and negative correlation with childhood stress (divergent validity). Conclusion: Together, the reported results provide preliminary evidence of the reliability and validity of this scale. It is suggested, therefore, that this scale is suitable for both research and practice with Brazilian schoolchildren. [ABSTRACT FROM AUTHOR]

The aim of this study was the adaptation of the Everyday Discrimination Scale to Portuguese youth. Scale items were subject to translation and adaptation, and two items were incorporated into the scale to increase construct validity. After establishing face validity, data from 2996 high school students were subject to Exploratory Factorial Analysis (EFA) and Confirmatory Factor Analysis (CFA). The EFA results portrayed a two-factor solution - Unfair Treatment and Personal Rejection - with four items each (seven items of the original scale and one prepared to this study). The CFA validated a hierarchical model in which the two factors observed in the EFA are subordinated to a second order latent factor, the Perception of Discrimination. The instrument was able to distinguish the perceptions of discrimination felt by prejudiced groups, since significant differences were observed between black and white participants, and between lesbian, gay and bisexual participants and their heterosexual counterparts. The instrument partially explains variations in mental health levels, given the observation of a negative correlation between perceived discrimination and mental health. The study concludes that this adapted version of the scale is a proper resource to the measurement and comparison of the perceptions of discrimination felt by the young. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular risk factors are found with significantly high frequency in psoriatic patients. Periods of remission and reactivation of lesions are common in psoriasis. Objective: Considering the association of chronic inflammation with the atherogenic process, we aimed to search for a possible relationship between the lipid profile, adipokine levels and body mass index (BMI) at the end of a successful treatment for psoriasis, and the length of remission of psoriasis. Methods: Forty-three patients were clinically and analytically studied after a successful treatment [as shown by Psoriasis Area and Severity Index (PASI)]-nine treated with topical agents, 17 with narrow-band UV light B (NB-UVB) and 17 with psoralen plus UVA-and were followed to record the length of remission. Results: The length of psoriasis remission correlated negatively and significantly with cholesterol levels, which correlated significantly and positively with C-reactive protein (CRP). In multiple linear regression analysis, cholesterol, CRP, PASI and BMI were associated with the length of remission. Patients with cholesterol levels <200 mg/dL ( n = 13) presented a significantly longer remission, lower BMI and triglycerides values, and a trend towards lower PASI and CRP values than those with high cholesterol ( n = 30). Considering patients according to the treatment used, cholesterol was also associated with length of remission, especially for patients treated with NB-UVB and topical therapy. Conclusion: Psoriasis patients with the highest cholesterol levels presented higher BMIs, triglycerides levels and shorter remission periods. Our data suggest that the identification of potentially treatable conditions, such as dyslipidaemia and obesity, and their adequate treatment may benefit psoriasis patients by increasing the length of remission of the disease. [ABSTRACT FROM AUTHOR]

Background Periods of remission and of exacerbation of psoriatic lesions are common in psoriasis. We recently reported C-reactive protein (CRP) as a marker of psoriasis severity and that some patients still presented with a residual inflammation after treatment. We wondered if this residual inflammation could underlie an earlier exacerbation of psoriasis. Objective The purpose of our study was to evaluate if there is a relationship between CRP levels, Psoriasis Area and Severity Index (PASI), and body mass index (BMI), at the end of psoriasis treatment, with the length of psoriasis remission. Methods We followed 46 patients studied at the end of treatment, to record the length of remission; 9 of the patients were treated with topical agents, 17 with narrow-band UVB (NB-UVB), and 20 with psoralen plus UVA (PUVA). Results We found that the length of remission correlated with the values for PASI and CRP at the end of therapy. By performing a multiple linear regression analysis, CRP, PASI, and BMI were each significantly associated with length of remission. Patients with residual inflammation at the end of treatment presented with a significantly shorter length of remission. When considering patients grouped according to the used therapies, CRP and PASI also emerged as potential determinants of length of remission, especially in the case of patients treated with NB-UVB and topical therapy. Conclusion Our data suggest that CRP and PASI are important determinants of length of psoriasis remission for patients treated with phototherapy or topical therapy. Further studies with larger groups of patients are warranted to test this hypothesis. Moreover, we propose that, by the end of the treatment, the evaluation of CRP and PASI could be important to decide, when possible, if the treatment should be continued to achieve lower CRP values and longer periods of remission. [ABSTRACT FROM AUTHOR]

Background: A few studies in psoriasis vulgaris patients have reported changes suggesting red blood cell (RBC) damage is linked to neutrophil activation, oxidative stress, and psoriasis worsening. Objective: The aim of this study was to evaluate erythroid disturbances in Portuguese psoriasis vulgaris patients, before, during, and after treatment. Methods: A cross-sectional study (n = 73 patients vs 40 healthy control subjects) followed by a longitudinal study (n = 47 patients) was performed, with assessments before, and at 3,6, and 12 weeks of therapy (10 patients started topical treatment, 17 narrow-band UVB, and 20 photochemotherapy [psoralen plus UVA; PUVA]). Evaluations included hematologic data, total bilirubin levels, membrane-bound hemoglobin (MBH), membrane protein band 3 profile, total plasma antioxidant status (TAS), lipid peroxidation (thiobarbituric acid [TBA] assay), elastase, lactoferrin, and C-reactive protein (CRP). Results: Before treatment, patients presented with higher leukocyte/neutrophil and reticulocyte counts, elastase, lactoferrin, TBA, TBA/TAS, reticulocyte production index, total bilirubin and MBH values, lower RBC and hematocrit, higher percentages of high-molecular-weight aggregates, and lower percentages of band 3 monomer. After treatment, we observed a reversal in most of the parameters. However, patients still presented with values suggestive of accelerated RBC damage, removal, and production, as most of the parameters were still higher than those in the control group; the same occurred with CRP. Conclusion: Our data suggest that psoriasis vulgaris triggers an inflammatory response, with release of acutephase reactants, reactive oxygen species, cationic proteins, and proteases, leading to enhanced RBC damage! aging and, ultimately, to enhanced RBC removal. These assumptions were strengthened by the observation that, with treatment, all of these changes were reversed, the inflammation was reduced, the production of reticulocytes was increased, and the RBCs presented changes usually observed in younger/less damaged RBCs. These erythroid changes were enhanced with PUVA therapy, probably due to the more pronounced clearing of the lesions, as suggested by Psoriasis Area and Severity Index (PASI) scores. Finally, after treatment, a residual inflammation still persisted that might contribute to the observed erythroid disturbances. [ABSTRACT FROM AUTHOR]

Background: Psoriatic patients present with an increased frequency of cardiovascular events. Objective: To study the impact of psoriasis duration and therapy on traditional and new cardiovascular risk factors. Study Design: A longitudinal study performed between 2005 and the first trimester of 2008. Each patient was followed up for 12 weeks, and was observed before and 3, 6, and 12 weeks after starting therapy. Setting: Patients attending the Dermatology Service, University Hospital of Coimbra, Coimbra, Portugal were enrolled. Subjects: Thirty-four patients with psoriasis vulgaris and 37 healthy volunteers as controls. Main Outcome Measures: Psoriasis Area and Severity Index (PASI); lipid profile, oxidized low-density lipoprotein (oxLDL), oxLDL/low-density lipoprotein (LDL), total antioxidant status, lipid peroxidation, C-reactive protein (CRP), and circulating levels of adiponectin. Intervention: Ten patients started therapy with topical treatment, 11 with narrow-band UVB radiation (NB-UVB), and 13 with pso aren plus UVA (PUVA). Results: Before starting therapy, psoriatic patients presented with several risk changes in their lipid profiles, and significantly higher CRP, oxLDL, and oxLDL/LDL, and lower adiponectin levels (vs control subjects), which may further contribute to inflammation and atherogenesis. After treatment of the patients, although no significant differences were observed in the lipid profile compared with baseline, some changes suggested that the treatment could somehow alter lipid metabolism, as the reduction in high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A and the increase in the atherogenic index cholesterol/HDL-C maintained an even higher significance (as shown by p-values) when compared with the control group. After topical therapy, there was a significant reduction in thiobarbituric acid reactivity only, suggesting that the reduction in the hyperproliferative process within the lesions is important for lipid peroxidation. After NB-UVB therapy, oxLDL/LDL, cholesterol/HDL-C, lipoprotein (a) [Lp(a)], and CRP remained higher than in the control subjects, reflecting persistent inflammation and atherogenic risk. After PUVA treatment, there was a significant reduction in Lp(a), associated with an almost significant increase in apolipoprotein-B (p = 0.054); these changes were not observed after NB-UVB treatment. However, after PUVA and NB-UVB treatment, CRP and, in the NB-UVB group, oxLDL/LDL were persistently higher than controls. Conclusion: Our data show that psoriatic patients present with several lipid profile changes that seem to be related to the severity of the disease and/or the treatment used. Mild psoriasis patients receiving topical treatment presented before starting therapy with a lipid profile similar to controls, whereas those undergoing NB-UVB and PUVA, who had higher PASI scores, presented with several risk factors. Moreover, PUVA therapy seems to interact in a different way with lipids that might result from an interaction of psoralen with plasma lipids, namely Lp(a). Inflammation, a hallmark of psoriasis, also seems to be related to psoriasis severity. Both NB-UVB and PUVA were effective, as shown by the reduction in PASI score, as well as in the oxidative and inflammatory stress markers. However, after NB-UVB and PUVA, a low-grade inflammatory process still persisted, which might be related to the duration of remission of the disease. [ABSTRACT FROM AUTHOR]