Posttreatment surveillance after paraaortic radiotherapy for stage I seminoma: a systematic analysis

Context  

The extent and duration of routine follow-up after paraaortic (PA) radiotherapy for stage I seminoma remain controversial in terms of efficacy, costs of technical investigations and long-term morbidity.     

Effects of positive affect on risk perceptions in adolescence and young adulthood

Affective influences may play a key role in adolescent risk taking, but have rarely been studied. Using an audiovisual method of affect induction, two experimental studies examined the effect of positive affect on risk perceptions in adolescence and young adulthood. Outcomes were risk perceptions regarding drinking alcohol, smoking a cigarette, riding in a car with a drunk driver, getting into a fight, and having unprotected sexual intercourse. Study 1 showed that positive affect led to lower risk perceptions than neutral affect for young adults (mean age 23). Study 2 replicated the effect for early adolescents (mean age 13), mid-adolescents (mean age 17), and young adults (mean age 23). Moreover, Study 2 showed that the effect was most pronounced at high levels of impulsiveness. Adolescents and young adults may be more risk averse in contexts that do not give rise to emotions, but have markedly lower risk perceptions under positive affect.     

Regression of left atrial diameter after kidney transplantation is associated with prolonged survival: an observational study

Renal transplantation reduces the dramatically elevated risk of cardiovascular death in dialysis patients. We previously showed that left atrial diameter before transplantation predicts cardiovascular and overall mortality. Now, we investigated the association of changes in cardiac morphology after transplantation and mortality. We retrospectively analyzed data from the Austrian transplant repository using multivariable Cox and competing risk models and multivariable logistic regression for the prediction of changes in cardiac morphology. We identified 414 patients with a median follow‐up of 8 years and observed a significant progression of mean diameter of left atrium (LA), right atrium and right ventricle and a significant regression of left ventricle. Complete case analysis of 243 patients with a regression of initially enlarged LA diameter had a significantly lower risk of adjusted overall and cardiovascular mortality; hazard ratio (HR 0.45, 95% CI 0.30–0.69, P < 0.001, 124 deaths), and HR of 0.43 [95% CI 0.21–0.92, P = 0.029, 48 cardiovascular (CV) deaths], respectively. Only age at transplantation was significantly associated with regression of LA (OR 0.75, 95% CI 0.60–0.93, P = 0.007). Patients with regression of LA after kidney transplantation exhibited a lower overall and CV mortality risk. Besides age, peritoneal dialysis and antihypertensive therapy were mediators of LA regression.     

Exercise Training and Endothelial Function

Vascular endothelium is a key determinant of circulatory homeostasis because it coordinates tissue perfusion and modulates arterial compliance. Endothelial dysfunction is considered to be a very early indication of atherosclerosis, being detectable even in childhood. Later on in life, endothelial dysfunction in large conduit arteries has been consistently shown to be a significant predictor of cardiovascular events. Elegantly conducted innovative studies have demonstrated the efficacy of physical exercise in improving endothelial dysfunction. Randomized controlled trials with parallel group design with adequate statistical power have consistently shown the therapeutic efficacy of both aerobic and resistance exercise training as physiologic means to improve, and even normalize, vascular endothelial function in patients with cardiovascular diseases. On the contrary, few data of comparable quality are available from randomized controlled trials among asymptomatic subjects or in those with metabolic disturbances. In addition, female participants are clearly under-represented in exercise training studies with vascular function as the key outcome measure.