Clustering of Metabolic Risk Factors Is Associated with High-Normal Levels of Liver Enzymes Among 6- to 8-Year-Old Children: The PANIC Study

Abstract Background: We studied the associations of clustering of metabolic risk factors with plasma levels of alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) in healthy prepubertal children. Methods: The subjects were a representative population sample of 492 children 6-8 years of age. We assessed body fat percentage (dual-energy X-ray absorptiometry), body mass index, waist circumference, systolic and diastolic blood pressure, glucose, insulin, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, ALT, GGT, and high-sensitivity C-reactive protein (hsCRP) and calculated a continuous metabolic syndrome score variable. We also used factor analysis to examine whether high-normal liver enzymes are a feature of metabolic syndrome among children. Results: Children with overweight or obesity, defined by International Obesity Task Force (IOTF) criteria, had a 2.1-times higher risk of having ALT and a 4.5-times higher risk of having GGT in the highest fifth of its distribution than normal weight children. Children in the highest sex-specific third of metabolic syndrome score, body fat percentage, waist circumference, and insulin had a two to three times higher risk of being in the highest fifth of ALT and GGT. Moreover, children in the highest third of glucose and hsCRP had a 2.5-fold risk of being in the highest fifth of GGT. First-order factor analysis yielded three factors; the first included insulin, glucose, and triglycerides; the second waist circumference, insulin, GGT, and hsCRP; and the third HDL-C, triglycerides, waist circumference, and insulin. Second-order factor analysis yielded a single metabolic syndrome factor, explaining 64.1% of the variance. Conclusions: Clustering of metabolic risk factors, particularly excess body fat, is associated with high-normal levels of ALT and GGT in prepubertal children. High-normal levels of liver enzymes, especially GGT, and systemic low-grade inflammation could be considered features of metabolic syndrome among children. Subtle changes in liver function may play an important role in the pathogenesis of metabolic syndrome beginning in childhood.     

EEG burst recovery is predictive of brain injury after experimental hypothermic circulatory arrest

Objective--To evaluate whether electroencephalography (EEG) recovery could be considered a reliable marker of brain injury after experimental hypothermic circulatory arrest (HCA). Design--Cortical electrical activity was registered before and after a 75-min period of HCA in 27 pigs that survived 7 days after the experiment. The sum of EEG bursts was counted as a percentage of the sum of artifact-free bursts and suppressions, and this percentage was used as a measure of EEG activity in the analysis. Results--Brain infarction developed in 13 animals (48.1%), in 12 cases (44.4%) having involved the cortex, in 1 case the thalamus (3.7%) and in another the hippocampus (3.7%). The mean EEG burst percentage significantly correlated with the total brain histopathological score (ρ?=??0.588, P?=?0.001). EEG burst percentage from the 2?h 20?min to the 7?h 20?min interval correlated with the total brain histopathological score and with the cortex, brainstem and cerebellum scores. The mean EEG burst percentage rate was higher, but not significantly, among the animals without brain infarction (38.5% vs 32.4%), but such a difference was significant at the 3?h 20?min postoperative interval (P?=?0.02). The mean EEG burst percentage significantly correlated with brain glucose concentration at the 1?h interval (ρ?=?0.387; P?=?0.046), brain lactate concentration at the 2?h interval (ρ?=??0.431; P?=?0.025), and the brain lactate/glucose ratio at the 1?h 30?min interval from the start of rewarming (ρ?=??0.433; P?=?0.024). Conclusion--A decreased EEG burst percentage seems to be associated with an increased risk of developing histologically evident brain ischemic injury in the cortex, brainstem and cerebellum after experimental HCA.     

Experiences of combined visual training and arm activation in the rehabilitation of unilateral visual neglect: A clinical study

This study reports a rehabilitation training for unilateral visual neglect combining a visual training programme and arm activation. Four cases of left visual neglect are presented with differing arm use. Neglect impairment was assessed using seven neuropsychological tests at weekly intervals for nine weeks: three weeks before, during and after the treatment period. In addition, one patient was followed over a longer time period. The treatment consisted of both a visual training programme and simultaneous arm activation. Considerable improvement in three of the four patients was observed in article reading. Moreover, all patients showed some improvement on three cancellation tests, whereas there was no improvement on other tests. In particular, the patients who had full hand or shoulder movement showed improvement in their performance. These results point out the usefulness of combined visual training and arm activation in the rehabilitation of visual neglect.     

Characteristics of subjects with schizophrenia spectrum disorder with and without antipsychotic medication – A 10-year follow-up of the Northern Finland 1966 Birth Cohort study

ObjectiveTo estimate the prevalence of non-medicated subjects having schizophrenia spectrum disorder and to study how they differ from medicated subjects in terms of sociodemographic and illness-related variables. We also aim to find the predictors for successful antipsychotic withdrawal.MethodsData of 70 subjects with schizophrenic psychoses (mean duration of illness 10.4 years) from the Northern Finland 1966 Birth Cohort were gathered by interview at the age of 34 and from hospital records. The stability of remission was assessed by comparing hospitalization rates between non-medicated and medicated subjects over an 8.7-year additional follow-up period.ResultsTwenty-four (34%) subjects were currently not receiving medication. They were more often males, less often on a disability pension, more often in remission, and had better clinical outcomes. Relapses during the follow-up were equally frequent between non-medicated and medicated subjects (47% vs. 56%). Not having been hospitalised during previous 5 years before the interview predicted long-term successful antipsychotic withdrawal without relapse.ConclusionsDespite a lack of precise predictors, there might be subgroup of schizophrenia spectrum subjects who do not need permanent antipsychotic medication, and a fewer previous psychiatric treatments may indicate such a subgroup.     

The joint contribution of physical activity,insomnia symptoms,and smoking to the cost of short‐term sickness absence

Physical inactivity has been associated with both insomnia symptoms and smoking. Further, they are all independently associated with increased sickness absence (SA) from work. However, joint contribution of either physical activity (PA) with insomnia symptoms or with smoking to SA and, especially, their direct cost for the employer is poorly understood. Therefore, we aimed to examine these joint associations with short‐term (<15 days) SA cost. The Helsinki Health Study is a cohort of midlife employees of the City of Helsinki, Finland (baseline n = 8960, response rate 67%). During 2000‐2002, the participants were mailed a survey questionnaire that gathered information on health behavior and sociodemographic characteristics. SA, salary, and time of employment were followed up through the employer's personnel register between 2002 and 2016 for those with a written consent to the use of their register data (78% of the participants). Individual salary data were used to calculate the direct cost of short‐term SA. Data were analyzed with a two‐part model. Inactive participants with frequent insomnia symptoms had 2526€ (95% CI 1736€‐3915€) higher cost of short‐term SA than vigorously active participants without insomnia symptoms. Furthermore, inactive smokers had 4166€ (95% CI 2737€‐5595€) higher cost for the employer over the follow‐up than vigorously active non‐smokers. In conclusion, this study showed that PA and insomnia symptoms as well as PA and smoking are jointly associated with short‐term SA cost. The results emphasize encouraging employers to improve work environments so that they promote active lifestyle, good sleep, and non‐smoking in order to reduce the cost of SA.     

Penetrating Aortic Ulcer and Intramural Hematoma

CardioVascular and Interventional Radiology - Acute aortic syndromes include a variety of overlapping clinical and anatomic diseases. Penetrating aortic ulcer (PAU), intramural hematoma (IMH) and...     

Effectiveness of a Brief Group Intervention Program for Young Adults with Gaming-Related Problems

International Journal of Mental Health and Addiction - Excessive digital gaming can have unfavorable effects on gamers’ well-being and everyday functioning. The aims of this study were to...