Individual responses in biomarkers of health after marathon and half-marathon running: is age a factor in troponin changes?

Although strenuous physical activity is known to cause notable perturbations in blood chemistries, only few studies exist observing exercise-induced simultaneous changes in biomarkers of health status. We compared markers of muscle, cardiovascular, renal, hepatic and inflammatory status at baseline and at 3-h and at 48-h postrace in recreational runners who successfully completed either a marathon (mean age 27?±?13 years, finishing time 199?±?8?min, n?=?4) or half-marathon (mean age 38?±?13 years, finishing time 131?±?6?min, n?=?6) race. Significant postrace changes occurred in myoglobin (p?p?p?p?p?p?p?p?p?p?p?p?p?p?p?相似文献   

Clinical and genetic determinants of chronic visual pathway changes after methanol - induced optic neuropathy: four-year follow-up study

Context: Methanol poisoning induces acute optic neuropathy with possible long-term visual damage.

Objective: To study the dynamics and key determinants of visual pathway functional changes during 4 years after acute methanol poisoning.

Methods: A total of 42 patients with confirmed methanol poisoning (mean age 45.7?±?4.4 years) were examined 4.9?±?0.6, 25.0?±?0.6, and 49.9?±?0.5 months after discharge. The following tests were performed: visual evoked potential (VEP), retinal nerve fiber layer (RNFL) measurement, brain magnetic resonance imaging (MRI), complete ocular examination, biochemical tests, and apolipoprotein E (ApoE) genotyping.

Results: Abnormal VEP P1 latency was registered in 18/42 right eyes (OD) and 21/42 left eyes (OS), abnormal N1P1 amplitude in 10/42 OD and OS. Mean P1 latency shortening during the follow-up was 15.0?±?2.0?ms for 36/42 (86%) OD and 14.9?±?2.4?ms for 35/42 (83%) OS, with maximum shortening up to 35.0?ms. No significant change of mean N1P1 amplitude was registered during follow-up.

A further decrease in N1P1 amplitude ≥1.0 mcV in at least one eye was observed in 17 of 36 patients (47%) with measurable amplitude (mean decrease ?1.11?±?0.83 (OD)/?2.37?±?0.66 (OS) mcV versus ?0.06?±?0.56 (OD)/?0.83?±?0.64 (OS) mcV in the study population; both p?ApoE4 allele carriers had lower global and temporal RNFL thickness and longer initial P1 latency compared to the non-carriers (all p?p?r?=?0.384; p?=?.013) and brain hemorrhages (r?=?0.395; p?=?.011).

Conclusions: Improvement of optic nerve conductivity occurred in more than 80% of patients, but evoked potential amplitude tended to decrease during the 4 years of observation. ApoE4 allele carriers demonstrated lower RNFL thickness, longer P1 latency, and more frequent methanol-induced brain damage compared to non-carriers.     

Influence of patient related factors on number of mesenchymal stromal cells reached after in vitro culture expansion for clinical treatment

Background: Number of stromal cells injected in patients with ischaemic heart disease (IHD) may be of importance for the treatment efficacy, which in turn may be influenced by various patient-related factors. In this study, we investigate whether patient-related factors influence the number of autologous stromal cells reached after in vitro culture expansion for clinical therapy.

Methods: Culture expansion data from 111 patients with IHD treated with autologous stromal cells in three clinical trials were used. We correlated the final cell count after two passages of cultivation with different patient factors.

Results: There was a significant relation between body mass index (BMI) and the number of adipose derived stromal cells (ASCs) reached after culture expansion and for all patients included into the three studies (r?=?0.375, p?=?.019 and r?=?0.200, p?=?.036, respectively). Moreover, there was a significantly higher number of ASCs reached in patients with hypertension compared to those without hypertension and for all patients overall (68.8?±?39.6?×?10⁶ vs. 39.1?±?23.6?×?10⁶, p?=?.020 and 62.0?±?55.0?×?10⁶ vs. 29.0?±?19.3?×?10⁶, p?<?.001, respectively). The same tendency was seen with bone marrow derived mesenchymal stromal cells (MSCs) in patients with hypertension compared to those without hypertension (58.4?±?61.8?×?10⁶ vs. 22.6?±?13.3?×?10⁶, p?<?.001) and in males compared to females (56.4?±?61.5?×?10⁶ vs. 30.9?±?27.9?×?10⁶, p?=?.041). Moreover, a significant negative correlation between left ventricular ejection fraction and number of MSCs was found (r?=??0.287, p?=?.017).

Conclusions: Patient related factors such as BMI, hypertension and gender may influence the number of MSCs reached after in vitro culture expansion.     

Evaluation of Clostridium difficile Infection with PET/CT Imaging in a Mouse Model

Purpose

Existing clinical or microbiological scores are not sensitive enough to obtain prompt identification of patients at risk of complicated Clostridium difficile infection (CDI). Our aim was to use a CDI animal model to evaluate 2-deoxy-2-[¹⁸F]fluoro-D-glucose positron emission tomography ([¹⁸F]FDG-PET) as a marker of severe course of infection.

Procedures

CDI was induced with cefoperazone for 10 days followed by clindamycin 1 day before C. difficile inoculation. Mice were divided into wild type (n?=?6), antibiotic without infection (AC n?=?4), h001-infected (n?=?5, ribotype 001), and h027-infected (n?=?5, ribotype 027). Two days after inoculation, [¹⁸F]FDG-PET was acquired. Weight, general animal condition, and survival were monitored daily for 9 days.

Results

h001 group showed symptoms for 4 days with 0 % mortality and a similar colon uptake than control animals (h001 0.52?±?0.20, WT 0.42?±?0.07, and AC 0.36?±?0.06). The h027 group showed symptoms up to 7 days, with 66.7 % of mortality 4 days after infection, and significantly higher colon uptake (0.93?±?0.38, p?<?0.05). Clinical score was associated to colon and cecum uptake (rho?=?0.78, p?=?0.0001) (rho?=?0.73, p?=?0.0003).

Conclusion

High toxin producer ribotype 027 induced more severe CDI infections, correlating with higher colon and cecum [¹⁸F]FDG uptake. Colon uptake may purportedly serve as early predictor of CDI severity.

     

Serum level of interleukin-6 (IL-6) and N-terminal propeptide of procollagen type I (PINP) in patients with liver diseases

Introduction: The aim of this study was to evaluate the concentration of interleukin-6 and N-terminal propeptide of procollagen type I and their relationship in liver diseases of different etiologies.

Material and methods: Serum samples were obtained from 30 healthy volunteers and patients suffering from alcoholic cirrhosis (AC) – 31, non-alcoholic cirrhosis (NAC) – 28 and toxic hepatitis (HT) – 23 patients. Cirrhotic patients were classified according to Child–Pugh score. IL-6 and PINP concentrations were determined according to the electrochemiluminescence immunoassay.

Results: The mean serum IL-6 concentration was significantly higher in AC (mean?±?SD:21.52?± 15.01?pg/mL), NAC (20.07?±?32.12?pg/mL) and HT (15.14?±?17.18?pg/mL) when compared to the control group (C) (1.67?±?0.42?pg/mL) (Mann–Whitney U test: p?p?p?=?.020 and p?p?p?=?.022, respectively). IL-6 and PINP concentrations appeared to vary depending on the severity of liver damage (p?p?p?Conclusions: We conclude that serum concentrations of IL-6 and PINP change in liver diseases, and those changes reflect the severity of liver disease.     

Efficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning

Context: Acidemia is a marker of prognosis in methanol poisoning, as well as compounding formate-induced cytotoxicity. Prompt correction of acidemia is a key treatment of methanol toxicity and methods to optimize this are poorly defined.

Objective: We studied the efficiency of acidemia correction by intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) in a mass outbreak of methanol poisoning.

Methods: The study was designed as observational cohort study. The mean time for an increase of 1?mmol/L HCO₃^–, 0.01 unit arterial blood pH, and the total time for correction of HCO₃^– were determined in IHD- and CRRT-treated patients.

Results: Data were obtained from 18 patients treated with IHD and 13 patients treated with CRRT. At baseline, CRRT group was more acidemic than IHD group (mean arterial pH 6.79?±?0.10 versus 7.05?±?0.10; p?=?0.001). No association was found between the rate of acidemia correction and age, weight, serum methanol, lactate, formate, and glucose on admission. The time to HCO₃^– correction correlated with arterial blood pH (r=??0.511; p?=?0.003) and creatinine (r?=?0.415; p?=?0.020). There was association between the time to HCO₃^– correction and dialysate/effluent and blood flow rates (r=??0.738; p?r=??0.602; p?The mean time for HCO₃^– to increase by 1?mmol/L was 12?±?2?min for IHD versus 34?±?8?min for CRRT (p?p?=?0.024). The mean increase in HCO₃^– was 5.67?±?0.90?mmol/L/h for IHD versus 2.17?±?0.74?mmol/L/h for CRRT (p?Conclusions: Our study supports the superiority of IHD over CRRT in terms of the rate of acidemia correction.     

Tympanic membrane temperature decreases during head up tilt: relation to frontal lobe oxygenation and middle cerebral artery mean blood flow velocity

Introduction: Changes in blood flow influence temperature of surrounding tissues. Since the internal carotid artery (ICA) and internal jugular vein (IJV) neighbor the tympanic membrane, changes in their blood flow most likely determine changes in tympanic membrane temperature (TMT). We sought to evaluate the relationship between changes during a head-up tilt (HUT) induced reduction in cerebral blood flow (CBF) and TMT.

Methods: Ten male subjects (age 19–28 years) underwent 50° HUT until presyncope. A non-contact infrared sensor in the ear canal targeted the tympanic membrane. Changes in CBF were monitored by transcranial Doppler which determined the mean blood flow velocity in the middle cerebral artery (MCA V_mean) and by near infrared spectroscopy assessed frontal lobe oxygenation (S_cO₂), while skin blood flow (SkBF) was evaluated by laser Doppler flowmetry.

Results: During HUT, TMT decreased by 0.6?°C (median; range 0.2 to 1.6?°C) related to a decrease in MCA V_mean (51.0?±?6.7 to 34.3?±?5.8?cm/sec (mean?±?SD); r?=?0.518, p?=?.002) and S_cO₂ (78.6?±?5.4% to 69.0?±?5.7%; r?=?0.352, p?=?.043), but not to SkBF (120?±?78 to 69?±?37 PU; r?=?0.245, p?=?.142).

Conclusion: During an orthostatic challenge TMT decreases and the decrease is related to a reduction in CBF as indicated by MCA V_mean and S_cO₂, but not to SkBF. We consider TMT holds potential for non-invasive assessment of changes in cerebral perfusion.     

Kinesiologic taping reduces morbidity after oral and maxillofacial surgery: a pooled analysis

Abstract

Background: Postoperative morbidity is a major disadvantage after oral and maxillofacial (OMF) surgery, often caused by pain, trismus and swelling affecting patients’ quality of life. The goal of this study was to examine the effect of kinesiologic taping (KT) on swelling, pain, trismus and patients’ satisfaction after OMF surgery. Materials and methods: Performing a pooled analysis of 96 patients that were assigned for maxillofacial treatment (midface fractures n?=?30, mandibular fractures n?=?26, wisdom tooth removal n?=?40) divided into treatment either with or without kinesiologic tape application. Tape was applied directly after surgery and maintained for at least 5?d postoperatively. Facial swelling was quantified at six specific points in time using a five-line measurement. Pain and degree of mouth opening was measured. Patients’ objective feeling and satisfaction was queried. Results: Application of KT after OMF surgery has a significant influence on the reduction of swelling decreasing the turgidity for 60% during the first 2?d after surgery. Evaluating all patients swelling was significantly lower in the KT treatment group (T2: 63.5?cm?±?4.3; T3: 62.5?cm?±?4.2; T4: 61.6?cm?±?4.2) than in the no-KT group (T2: 67.6?cm?±?5.0; T3: 67.0?cm?±?5.0; T4: 64.8?cm?±?4.8) at T2 (p?<?0.001), T3 (p?<?0.001), and T4 (p?=?0.001). VAS Pain values were scored significantly lower for the KT group (T1: 2.5?±?2.0 (p?=?0.006); T2: 1.7?±?2.0 (p?<?0.001); T3: 1.5?±?2.3 (p?=?0.004); T4: 0.6?±?1.1 (p?=?0.001) compared to the no-KT group (T1: 3.8?±?2.5; T2: 3.5?±?2.7; T3: 2.9?±?2.2; T4: 1.6?±?1.7). A statistically significant amelioration in mean mouth opening ability was observed in the KT group (T1-BL: ?0.08?cm?±?0.49 (p?=?0.025); T2-BL: 0.07?cm?±?0.59 (p?=?0.012); T3-BL: 0.20?±?0.63 (p?=?0.013); T4-BL: 0.42?±?0.59 (p?=?0.003)) compared to the no-KT group (T1-BL: ?0.47?cm?±?0.86; T2-BL: ?0.39?cm?±?0.84; T3-BL: ?0.24?±?0.89; T4-BL: ?0.13?±?1.02). Conclusion: KT after OMF surgery is a promising, simple, less traumatic, economical approach free from systemic adverse reaction upgrading patients’ quality of life.     

Development of a family-based pulmonary rehabilitation programme: an exploratory study

Abstract

Purpose: This study explored the expectations of patients with chronic obstructive pulmonary disease (COPD) and family members about a family-based pulmonary rehabilitation (PR) programme; developed and implemented a family-based PR programme and explored the impacts of the intervention on patients and family members. Method: Patients with COPD and family members were interviewed. A family-based PR programme was designed. Patients' breathlessness, muscle strength, exercise tolerance, functional balance and health-related quality of life were collected pre/post-programme. Family coping and adjustment to illness were measured in patients and family members. Focus groups were conducted after the programme. Results: Patients (n?=?35; 69?±?10 years; FEV₁ 62?±?15% predicted) and family members (n?=?35; 57?±?12 years) had similar expectations/needs about a PR programme. Nine dyads participated. Patients' quadriceps strength, exercise tolerance and functional balance improved significantly (all p values?<?0.023). Patients and family members seem to use more positive coping behaviours (p?=?0.026; p?=?0.011). Patients (n?=?7; 78%) and family members (n?=?8; 89%) considered having more knowledge about COPD and its management. Patients felt more functional (n?=?9; 100%) and reported their family members to be more active (n?=?3; 38%). In family members' perspective, their relationship with the care receiver was enhanced (n?=?2; 22%). Conclusions: PR programmes, if inclusive of family members, may enhance the skills of the whole family to manage COPD.

• Implications for Rehabilitation

• Patients with chronic obstructive pulmonary disease (COPD) and their family members have similar expectations and needs about a family-based pulmonary rehabilitation (PR) programme.

• A family-based PR programme is feasible to implement within primary care.

• PR programmes, if inclusive of family members, may enhance the skills of the whole family to manage COPD.

     

Wide-range CRP versus high-sensitivity CRP on Roche analyzers: focus on low-grade inflammation ranges and high-sensitivity cardiac troponin T levels

Abstract

Wide-range C-reactive protein (wr-CRP) has been proposed as an economical alternative to high-sensitivity C-reactive protein (hs-CRP) for the evaluation of low-grade inflammation-associated cardiovascular risk (LGI-CVR). Concomitant values of serum hs-CRP and plasma wr-CRP ≤5?mg/L, and high-sensitivity cardiac troponin T (hs-cTnT), all assayed on Roche Diagnostics analyzers over a 1.8-year period, were extracted from a hospital laboratory database. Hs-CRP and wr-CRP values were compared (Bland–Altman method; Deming’s correlation), then separately classified into low (<1?mg/L), moderate (1–3?mg/L) and high (>3?mg/L) LGI-CVR ranges for agreement test (κ), assessed before and after Deming’s regression-based adjustment of wr-CRP (Adj-wr-CRP). Wr-CRP and hs-CRP values were strongly correlated, with linearity, whether below 5?mg/L (n?=?744; τ?=?0.933; p?n?=?283; τ?=?0.823; p?p?相似文献   

Improved assessment of arterial stiffness using corrected cardio-ankle vascular index (CAVI0) in overweight adolescents with white-coat and essential hypertension

Arterial stiffness is a marker of vascular damage. Although adiposity increases cardiovascular risk, the relationship between paediatric overweight and arterial stiffness is unclear. The study aimed to evaluate the simultaneous effect of hypertension and overweight on arterial stiffness using cardio-ankle vascular index (CAVI) and related novel, theoretically blood pressure (BP)-independent, index CAVI₀. CAVI and CAVI₀ were measured in 140 adolescent boys (16.0?±?1.9?years) divided into age-matched groups: normal-weight normotensives, overweight normotensives, overweight white-coat hypertensives, and overweight essential hypertensives. Overweight normotensives had significantly lower CAVI and CAVI₀ compared to normal-weight normotensives (4.81?±?0.64 vs. 5.33?±?0.66, p?<?.01; 7.10?±?0.99 vs. 7.81?±?1.00, p?<?.01, respectively). CAVI and CAVI₀ in overweight essential hypertensives showed no significant difference compared to normal-weight normotensives and were significantly higher compared to overweight normotensives (5.32?±?0.77 vs. 4.81?±?0.64, p?<?.01; 7.77?±?1.19 vs. 7.10?±?0.99, p?<?.01, respectively). CAVI, but not CAVI₀, was associated positively with diastolic pressure (0.022?mmHg^?1, p?=?.002) and negatively with pulse pressure (?0.022?mmHg^?1, p?=?.001), and it was significantly higher in overweight white-coat hypertensives compared to overweight normotensives (5.20?±?0.63 vs. 4.81?±?0.64, p?<?.05). The lowering effect of overweight on arterial stiffness indexed by CAVI and CAVI₀ in hypertensive adolescents seems to counterbalance the early arteriosclerotic effect of essential hypertension. The increase in CAVI, but not CAVI₀, in overweight white-coat hypertensives could be attributable to residual BP dependence of CAVI, which is not present in CAVI₀. Under certain conditions, CAVI₀ may offer a clinically relevant improved assessment of arterial stiffness superior to CAVI.     

Urine liver fatty acid binding protein and chronic kidney disease progression

Excretion of the tubular protein liver fatty acid binding protein (L-FABP) is a potential novel biomarker of renal dysfunction. We examined whether urine L-FABP excretion adds prognostic information to the well-established risk markers, blood pressure (BP), albumin excretion and baseline GFR, regarding progression of chronic kidney disease (CKD). In a prospective study design a cohort of 74 stage 3-4 CKD patients (age 61?±?13 years) were included. Glomerular filtration ratio (GFR, ⁵¹Cr-EDTA-clearance), 24-hour ambulatory BP, 24-hour urinary albumin/creatinine ratio (UAC) and urinary L-FABP/creatinine ratio (U-L-FABP/C) were determined at baseline and after 18 months of follow-up. For comparison 25 age-matched healthy controls were included. The U-L-FABP/C was elevated in CKD patients when compared to controls (mean U-L-FABP/C 2.3 [95% CI 1.7–2.9] μg/mmol vs 0.6 [0.5–0.7] μg/mmol, p?<?.001). In CKD patients, log U-L-FABP/C at baseline and at follow-up were positively associated (Pearson correlation coefficient r?=?0.74, p?<?.001). Baseline log U-L-FABP/C was negatively correlated with baseline GFR (r?=??0.32, p?<?.001) and directly correlated with UAC (r?=?0.67, p?<?.001). The relative change in GFR from baseline to follow-up correlated with baseline UAC (p?<?.001), 24-hour systolic BP (p?=?0.05) and log U-L-FABP/C (p?<?.001). Using multiple regression analysis adjusting for baseline GFR, UAC, BP, age and gender, baseline log U-L-FABP/C was associated with a decline in GFR only in patients with UAC <3?mg/mmol (n?=?29, p?=?0.001) and not in patients with UAC ≥3?mg/mmol (n?=?44, p?=?0.21). In conclusion urine L-FABP/C is permanently elevated in CKD patients, but only associated with GFR decline in those without albuminuria.     

Ingestion of bar soap may produce serious injury: clinical effects and risk factors

Introduction: Most household and body soaps have an alkaline pH (9–12). In addition to their foaming effect, they irritate the skin. This study aims to review soap exposure reported to the Angers Poison Control Centre.

Method: A retrospective study of accidental or deliberate oral exposure to solid soaps reported to the Angers Poison Control Centre between 1 January 2000 and 1 April 2015. Poisoning severity was reassessed for each case according to the Poisoning Severity Score (PSS).

Results: 553 cases of exposure were recorded. In more than 40% of cases (n?=?226), exposure occurred in community settings (retirement homes, nursing homes). Patients had a history of dementia in 220 cases (40%). The most common symptoms were labial oedema (28%, n?=?153), oropharyngeal irritation (10%, n?=?56), salivation (10%, n?=?53), vomiting (9%, n?=?48) and cough (8%, n?=?45). Among symptomatic patients (n?=?276), one patient died from aspiration pneumonia and one patient died from a cardiogenic shock following oropharyngeal oedema, vomiting, cough and bronchial obstruction. Patients with dementia were more often symptomatic (75% vs 34%, p?p?p?n?=?14), highly severe (PSS3, n?=?1) and fatal (PSS4, n?=?2) poisoning were observed only in patients with dementia.

Conclusion: Ingestion of soap bars is potentially serious, especially in patients with dementia. This type of soap should not be available to them in community settings and close monitoring should be considered in the event of oral exposure.     

CT fluoroscopy-guided percutaneous drainage: comparison of the one step and the Seldinger techniques

Objective: To evaluate the one step technique compared with the Seldinger technique in computed tomography (CT) fluoroscopy-guided percutaneous drainage of abdominal and pelvic abscess.

Material and methods: Seventy-six consecutive patients (49 men, 27 women; mean age 63.5 years, range 19–87 years) with abdominal and pelvic abscess were included in this study. Drainages were performed with the one step (n?=?46) and with the Seldinger (n?=?48) technique between September 2012 and June 2014.

Results: The technical success and clinical success rates were 95.8% and 93.5%, respectively, for the one step group, and 97.8% and 95.7%, respectively, for the Seldinger group. The mean procedure time was significantly shorter with the one step than with the Seldinger method (15.0?±?4.3?min, range 10–29?min vs. 21.0?±?9.5?min, range 13–54?min, p?Conclusion: The one step technique was easier and faster than the Seldinger technique. The effectiveness of both techniques was similar for the CT fluoroscopy-guided percutaneous drainage of abdominal and pelvic abscess.     

Five-year observation of the relationship between body mass index and glycated hemoglobin in children with Type 1 diabetes mellitus

Abstract

Background: Poor metabolic control is a well-recognized risk factor for cardiovascular disease. However, the relationship between such factor as body weight and metabolic control in children with diabetes mellitus type 1 (DM1) is unclear. The aim of this study was to examine the relationships between body weight, age, metabolic control, sex, and form of insulin therapy in children with DM1.

Methods: This was a retrospective study of children with DM1 treated at one diabetes center for a minimum of 5?years since diagnosis.

Results: Median body mass index standard deviation score (BMI-SDS) increased annually (p?=?.0042) on average 0.08?±?0.27 per year throughout the observation. As well HbA1c and daily dose insulin increased annually (p?p?p?=?.01895). No correlation between BMI-SDS and metabolic control (HbA1c) was found (R?=?0.09, p?=?.60).

Conclusions: Body weight appears to be more affected by non-diabetic factors (e.g. irregular eating and sedentary lifestyle) than by the clinical course of diabetes. Metabolic control and body weight must be maintained in all children with DM1 (males and females) to reduce their future risk of cardiovascular disease.     

Decrease by 50% of plasma IgA tissue transglutaminase antibody concentrations within 2 months after start of gluten-free diet in children with celiac disease used as a confirming diagnostic test

Background Histological examination of small bowel biopsies is normally the gold standard for the diagnosis of celiac disease (CD). The objective of this study was to investigate whether the rate of decreases in elevated plasma IgA tissue transglutaminase antibody (IgA-tTG) and/or IgG deamidated gliadin peptides antibody (IgG???DGP) concentrations could be used as a confirming test for CD in children on a gluten-free diet (GFD) when biopsy was omitted in the diagnostic process. Methods In this retrospective study we compared children (≤18 years old) with a CD-confirming biopsy (n?=?16) to children without a biopsy (n?=?18). After initiation of GFD the antibody half-life (the time (T_½) when the antibody concentration is 50% decreased) was determined in all children. Results Children with a biopsy (IgA-tTG, T_½?=?1.9 months; IgG???DGP, T_½?=?2.2 months) and children without a biopsy (IgA-tTG, T_½?=?1.6 months; IgG???DGP, T_½?=?2.7 months) had comparable T_½ (mean) results (p?Conclusions When biopsy was omitted a rapid rate of decrease in CD antibody concentrations confirmed the CD diagnosis in children on GFD. The half-lives (T_½) of IgA-tTG were less than 2 months in CD children.     

Effects of thyroid hormone withdrawal on natriuretic peptides during radioactive iodine therapy in female patients with differentiated thyroid cancer

Objective: We aimed to investigate the effects of thyroid hormone withdrawal on N-terminal prohormone forms of atrial natriuretic peptide (NT-proANP) and brain natriuretic peptide (NT-proBNP) during radioiodine therapy in female patients with differentiated thyroid cancer (DTC).

Methods: Serum concentrations of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), NT-proANP and NT-proBNP were measured in 51 female patients with DTC (48.7?±?4.2 years) at three time-points: day of radioiodine therapy (t1 – under acute hypothyroidism), 5 days after radioiodine (t2 – under acute hypothyroidism) and 3 months after radioiodine (t3 – under TSH suppression). Thirty healthy euthyroid women served as controls (42.8?±?5.6 years).

Results: At t1/t2/t3, median NT-proANP was 5.2/1.7/487?pmol/L vs. 297.7?pmol/L in control group (p?p?p?r?=?0.38, p?=?0.005), NT-proANP/NT-proBNP ratios (r?=?0.47, p?=?0.001), heart rate (r?=?0.39, p?=?0.005), and negatively with mean arterial blood pressure (r?=??0.58, p?Conclusions: Our results indicate that NT-proANP reflects more accurately direct thyroid hormone effects than NT-proBNP. Thyroid hormone-dependent hemodynamic effects seem to be overlapped on the direct stimulatory effect of thyroid hormones on NT-proANP secretion by cardiac myocytes.     

Change in the new psychoactive substances associated with Emergency Department acute toxicity presentations associated with the introduction of the UK 2016 Psychoactive Substances Act

Objectives: In May 2016, the Psychoactive Substances Act (PSA) came into effect in UK making it an offence to produce or supply new psychoactive substances (NPS). The aim of this study was to determine whether this was associated with a change in Emergency Department (ED) presentations with acute NPS toxicity.

Method: ED presentations to our inner-city hospital in London, UK, with acute NPS toxicity in the 12 months before and after the PSA introduction [June 2015–May 2016 (2015/2016) and June 2016–May 2017 (2016/2017)] were obtained from our database. The following data were extracted: (i) demographics; (ii) NPS(s) self-reported [categorized as synthetic cannabinoids (SC), cathinones, and “other NPS”)]; and (iii) month of presentation.

Results: There were 1884 presentations with recreational drug toxicity, 447 (23.7%) involved NPS. There was no difference in the overall proportion of presentations involving an NPS in 2015/2016 [n?=?196 (22.3%)] and 2016/2017 [251 (24.9%); (p?=?.48)]. There were a mean?±?SD of 16.3?±?3.7 NPS-related presentations per month in 2015/2016 and 20.9?±?9.2 in 2016/2017; there was no significant change in overall monthly NPS-related presentations between these periods (p?=?.15). However, mean?±?SD monthly SC-related presentations increased from 2015/2016 (5.9?±?2.5) to 2016/2017 (17?±?9.8); p?=?.004. Mean monthly cathinone-related presentations decreased from 2015/2016 (8.8?±?4.2) to 2016/2017 (3.8?±?2.7); p?=?.001. There was no significant change in monthly mean “other NPS” presentations from 2015/2016 (1.8?±?2.2) to 2016/2017 (0.5?±?0.8); p?=?.062. Between 2015/2016 and 2016/2017, SCs as a proportion of NPS-related presentations increased (r?=?.90) whilst cathinones decreased (r?=??0.82).

Conclusion: NPS present front-line health services with unique challenges, and the PSA 2016 represents a major legislative effort in UK to limit their availability and supply. The burden of NPS use on this inner-city ED remains large 12 months after this legislation has come into force, with evolving patterns of NPS use.     

The influence of inspiratory muscle training on diaphragmatic mobility,pulmonary function and maximum respiratory pressures in morbidly obese individuals: a pilot study

Abstract

Purpose: To investigate whether 12 week inspiratory muscle training (IMT) has any impact on pulmonary function, maximum respiratory pressures and diaphragmatic mobility (DM) in morbidly obese subjects. Method: Thirty-one morbidly obese individuals were assessed. Volunteers were randomised into two groups. The IMT group (n?=?16) followed an IMT protocol for 12 weeks, with a training load of 30% of maximal inspiratory pressure (PImax). The control group (CG) (n?=?15) followed the same protocol but without inspiratory load. Results: A total of 14 subjects performed IMT for 12 weeks. Significant increases in PImax (?86.86?±??20.70?cmH₂O versus ?106.43?±??32.97?cmH₂O, p?<?0.05) and maximal voluntary ventilation (97.84?±?37.06?L/min versus 115.17?±?34.17?L/min, p?<?0.05) were observed in the IMT group when compared to baseline. However, only FIV₁ significantly differed between the IMT group and the CG after the 12 week protocol (3.35?±?0.96?L versus 2.22?±?1.07?L, respectively; p?<?0.05). No significant differences were found in DM after the IMT protocol was performed. Conclusion: IMT improved PImax and altered the FIV₁. These results suggest that the improvements in muscular respiratory efficiency were insufficient to mobilise the diaphragm and modify ventilation mechanics. Pre-operative IMT may be a valuable approach in obese patients for preventing post-operative pulmonary complications. http://clinicaltrials.org -- NCT01449643 -- The Influence of IMT on Diaphragmatic Mobility in Morbidly Obese.

• Implications for Rehabilitation Morbid Obesity

• Morbid obesity is a disabling condition that has a serious negative impact on lung function, respiratory muscle function and quality of life.

• Inspiratory Muscle Training (IMT) is a technique which aims to improve pulmonary expansion and to prevent post surgery complications on morbid obese individuals.

• This study shows significantly increased on maximal inspiratory pressure, maximal voluntary ventilation and promoted changes on spirometric variables after IMT.

     

Influence of videogames and musical instruments on performances at a simulator for robotic surgery

Objective: To assess if exposure to videogames, musical instrument playing, or both influence the psychomotor skills level, assessed by a virtual reality simulator for robot-assisted surgery (RAS).

Materials and methods: A cohort of 57 medical students were recruited: playing musical instruments (group 1), videogames (group 2), both (group 3), and no activity (group 4); all students executed four exercises on a virtual simulator for RAS.

Results: Subjects from group 3 achieved the best performances on overall score: 527.09?±?130.54 vs. 493.73?±?108.88 (group 2), 472.72?±?85.31 (group 1), and 403.13?±?99.83 (group 4). Statistically significant differences (p?p?=?.009) and for time of completion (p?=?.044). As regards experience with the piano, subjects from group 3 outperformed those from group 1 on overall score (496.98?±?122.71 vs. 470.25?±?92.31), but without statistically significant difference (p?=?.646).

Conclusions: The present study suggests that the level of psychomotor skills in subjects exposed to both musical instrument playing and videogames is higher than that in those practicing either one alone. The effect of videogames appears negligible in individuals playing the piano.