Brownebishop8454
Thyrotropin stimulating hormone (TSH) suppression in patients with differentiated thyroid cancer (DTC) aims to decrease the growth and proliferation of thyroid cancer cells. However, the effect of TSH-suppressive therapy on bone microarchitecture remains undefined.
Cross-sectional study including 43 women with DTC undergoing TSH-suppressive therapy (sTSH) compared to 20 women also on levothyroxine (LT4) therapy but with TSH in the low-normal range (nTSH) since the thyroid surgery. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA), and trabecular bone score (TBS) was evaluated using the TBS iNsigth software. Fracture risk assessed by FRAX, with and without TBS, was calculated. The relationship between suppressive therapy-related parameters and bone parameters was investigated.
The TBS mean values were not significantly different in the sTSH and nTSH groups (1.273 ± 0.12 vs 1.307 ± 0.14, p = 0.7197). In both groups, postmenopausal women had degraded microarchitecture (TBS 1and those on LT4 replacement therapy aiming at a TSH level within the low-normal reference range. Low TBS values were observed in postmenopausal women of both groups, suggesting that not only suppressed TSH levels but also a low-normal TSH is associated with deteriorated bone microarchitecture in postmenopausal women following total thyroidectomy.
Test anxiety may be better thought of as a biopsychosocial process affecting academic performance during the days leading up to an exam, rather than a static appraisal of attitudes related to test taking. This was a passive observational study following students 2 days before a midterm exam and was designed to test the Sleep Anxiety Performance Process (SAPP) model in the context of a psychology statistics exam.
Undergraduates (N=167) enrolled in a statistics class, January-November 2015. Participants completed an electronic battery of measures and Sleep Mood Study Diaries (SMS) during the mornings, 2 days before a statistics exam. Instructors confirmed exam scores.
A path model showed a reciprocal bi-directional relationship between Sleep Quality and restfulness (Q&R) and test anxiety 2 days before a scheduled exam, with test anxiety measured in the morning, before the exam predicting exam performance. Prior exam performance, being a non-native English speaker (ESL), and class performance motivation also predicted exam performance.
These data support the SAPP model's premise that that sleep and anxiety feed one another, as a reciprocal process, that collectively impairs academic performance, with direct effects on academic performance, but with implications for overall student health.
These data support the SAPP model's premise that that sleep and anxiety feed one another, as a reciprocal process, that collectively impairs academic performance, with direct effects on academic performance, but with implications for overall student health.
Image evaluation of contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) and additional time-intensity curve (TIC) analysis enable qualitative and quantitative analyses of pancreatic tumor based on real-time perfusion imaging.
To evaluate the efficacy of CEH-EUS with a combination of qualitative and quantitative analyses of pancreatic solid tumors.
Patients were scheduled to undergo EUS-guided fine needle aspiration (FNA) for pancreatic solid tumors were prospectively enrolled between 11/2016 and 12/2018 and underwent CEH-EUS. The vascular and enhancement patterns were qualitatively evaluated and heterogeneous enhancement was defined to be indicative of malignancy. The echo intensity change during 60s in the tumor was quantitatively evaluated by time intensity curve analysis.
In total, 100 patients were enrolled in this study. The final diagnoses were malignant lesions in 87 patients and benign legions in 13 patients. There were four categories of enhancement and patterns hypovascular with heterogeneous, hypovascular with homogeneous, hypervascular heterogeneous, and hypervascular homogeneous enhancement. The diagnostic capability of qualitative analysis was the sensitivity, specificity, and accuracy of 89%, 62%, and 85%, respectively. With respect to time intensity curve analysis, the time to peak of malignant lesions was significantly shorter than those of benign lesions (P = 0.0009) with an optimal cutoff value of 12.81s on the receiver operating characteristic curve analysis. Elimusertib With the combination of qualitative and quantitative analyses, the sensitivity, specificity, and accuracy were improved to 100%, 54%, and 94%, respectively.
CEH-EUS with combined qualitative and quantitative analyses for pancreatic tumors might be useful as a complement for EUS-FNA. The UMIN Clinical Trials Registry (UMIN000025192).
CEH-EUS with combined qualitative and quantitative analyses for pancreatic tumors might be useful as a complement for EUS-FNA. The UMIN Clinical Trials Registry (UMIN000025192).
Lower exercise tolerance is an important component of asthma and the possible effects of non-invasive ventilation on exercise capacity in individuals with severe therapy-resistant asthma (STRA) are unknown. This study aimed to evaluate the immediate effect of continuous positive airway pressure (CPAP) on exercise tolerance in children with STRA.
We performed a controlled, randomized, crossover clinical trial including subjects aged 6 to 18years old diagnosed with STRA. Clinical, anthropometric and lung function data were collected. The participants in the intervention group (IG) used CPAP (PEEP 10cmH
O and FiO
0.21) for a period of 40min. Subjects in the control group (CG) used CPAP with minimum PEEP at 1 cmH
0 also for 40min. Afterwards, subjects from both groups underwent cardiopulmonary exercise testing (CPET). After a 15-day washout period, on a subsequent visit, subjects participated in the opposite group to the initial one.
Thirteen subjects with a mean age of 12.30 ± 1.7years were included. The variables of peak expiratory flow (PEF) and forced expiratory volume in the first second (FEV
) before using CPAP and after performing CPET did not show significant differences. Regarding CPET results, there was no significant difference (P = 0.59) between groups at peak exercise for oxygen consumption-VO
(CG 33.4 ± 6.3 and IG 34.5 ± 5.9, mLkg
min
). However, the IG (12.4 ± 2.1) presented a total test time (min) significantly (P = 0.01) longer than the CG (11.5 ± 1.3).
The results suggest that the use of CPAP before physical exercise increases exercise duration in children and adolescents with STRA.
The results suggest that the use of CPAP before physical exercise increases exercise duration in children and adolescents with STRA.
Post-operative loss-of-control (LOC)-eating is a negative prognostic indicator for long-term outcomes following bariatric surgery. Emerging research suggests that night eating might also be associated with poorer post-operative outcomes. This study examined the co-occurrence and clinical features of night eating in patients with LOC-eating following bariatric surgery.
Participants were 131 adults who sought treatment for eating/weight concerns 6months following sleeve gastrectomy. The Eating Disorder Examination (EDE) interview (Bariatric-Surgery-Version) assessed LOC-eating, regular night eating (at least weekly), and eating-disorder psychopathology. Participants completed the Night Eating Questionnaire (NEQ), Beck Depression Inventory (BDI-II), and the Pittsburgh Sleep Quality Index (PSQI).
Approximately, 15% met screening criteria for night-eating syndrome based on the NEQ. Greater NEQ scores were associated significantly with race, lower percent total weight loss (%TWL), and greater EDE, BDI-II, and PSQI scores. Similar results were observed when comparing groups with regular night eating (21.4%) versus without (78.6%); adjusting for race and %TWL revealed similar findings.
In post-bariatric patients with LOC-eating, 15% likely had night-eating syndrome and 21.4% engaged in regular night-eating behavior. The co-occurrence of LOC-eating and regular night eating following sleeve gastrectomy may represent a more severe subgroup with elevated psychopathology, poorer sleep and %TWL.
Level III, evidence obtained from well-designed cohort or case-control analytic studies.
Level III, evidence obtained from well-designed cohort or case-control analytic studies.The present study was aimed to investigate the phototherapy effect with low-level laser on human bronchial epithelial cells activated by cigarette smoke extract (CSE). Phototherapy has been reported to actuate positively for controlling the generation/release of anti-inflammatory and pro-inflammatory mediators from different cellular type activated by distinct stimuli. It is not known whether the IL-8 and IL-10 release from CSE-stimulated human bronchial epithelium (BEAS) cells can be influenced by phototherapy. Human bronchial epithelial cell (BEAS) line was cultured in a medium with CSE and irradiated (660 nm) at 9 J. Apoptosis index was standardized with Annexin V and the cellular viability was evaluated by MTT. IL-8, IL-10, cAMP, and NF-κB were measured by ELISA as well as the Sp1, JNK, ERK1/2, and p38MAPK. Phototherapy effect was studied in the presence of mithramycin or the inhibitors of JNK or ERK. The IL-8, cAMP, NF-κB, JNK, p38, and ERK1/2 were downregulated by phototherapy. Both the JNK and the ERK s well as ROS secretion, but on the other hand, the corticoid blocked the IL-10 secretion. Taking it into consideration, it is reasonable to suggest that the beneficial effect of laser therapy on lung diseases involves its action on unbalance between pro-inflammatory and anti-inflammatory mediators secreted by human bronchial epithelial cells through different signaling pathway.
The aim of this study is to summarize anthropometric and advanced methods used to assess body composition in adults diagnosed with type 2 diabetes (T2D) or at risk for T2D that provide clinically relevant information about T2D disease-related complications or risk factors.
Anthropometry is commonly used in clinical settings; however, provides unreliable estimates of fat mass, fat-free mass, and body fat distribution for metabolic health assessments compared to advanced techniques such as bioelectrical impedance analysis (BIA), dual-energy x-ray absorptiometry (DXA), computerized tomography (CT), and magnetic resonance imaging (MRI). Few studies report the clinical use of anthropometric and advanced body composition methods that identify T2D disease-related complications or T2D risk factors. Anthropometry, BIA, DXA, CT, and MRI were used to estimate body adiposity and distribution, visceral and subcutaneous adipose tissue depots, and skeletal muscle mass. Review findings indicate that these methods were ca muscle mass. Review findings indicate that these methods were capable of identifying clinically relevant T2D disease-related complications such as sarcopenia and T2D risk factors such as obesity or regional adiposity. However, estimates were often sex and race/ethnicity specific warranting cross-validation of these methods in broader populations with T2D or risk for T2D prior to clinical implementation.
