Kuskbertram4392

There are currently no established cutoff levels for thyrotropin (TSH) within the reference intervals associated with carotid atherosclerosis to prevent the onset of cardiovascular diseases. The present study aimed to determine the TSH cutoff level associated with carotid maximum intima-media thickness (max IMT) in euthyroid premenopausal, perimenopausal and postmenopausal women.

We conducted a cross-sectional study of 468 euthyroid women who had not been treated for or diagnosed with cardiovascular diseases and/or metabolic disorders among 1221 Japanese women who participated in a comprehensive medical examination at the Hidaka Hospital, Japan. Participants' weight, blood pressure, plasma glucose, serum lipoprotein, free thyroxine and TSH were measured and an interview about menstruation was conducted. Carotid ultrasonography was performed to determine max IMT.

Max IMT significantly increased stepwise as menopausal status progressed (p < 0.001). Serum TSH levels were significantly higher in participants with carotid plaques, defined as max IMT ≥1.1 mm (p = 0.038), and were independently associated with the presence of carotid plaque using multivariate logistic regression analysis (β =1.218, p = 0.036). In postmenopausal women, significantly higher carotid max IMT values were observed in women with serum TSH ≥2.5 μIU/mL compared with women with concentrations <2.5 μIU/mL (p = 0.018) without elevated total cholesterol and low-density lipoprotein cholesterol concentrations. These differences were not observed in premenopausal women.

Laboratory finding of serum TSH concentration ≥2.5 μIU/mL may be useful to assess risk of atherosclerosis, especially in postmenopausal women.

Laboratory finding of serum TSH concentration ≥2.5 μIU/mL may be useful to assess risk of atherosclerosis, especially in postmenopausal women.Older adults who fall recurrently (i.e., 2 or more falls/year) are at risk of functional decline and mortality. Understanding which risk factors for recurrent falls are most important will inform secondary fall prevention strategies that can reduce recurrent falls risk. Thus, we conducted a systematic review with meta-analysis to determine the relative risk of recurrent falls for different types of falls risk factors. MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched on April 25, 2019 (Prospero Registration CRD42019118888). We included peer-reviewed prospective studies which examined risk factors that contributed to recurrent falls in adults aged ≥ 60 years. Using the falls risk classification system of Lord and colleagues, we classified each risk factor into one of the following domains 1) balance and mobility; 2) environmental; 3) psychological; 4) medical; 5) medication; 6) sensory and neuromuscular; or 7) sociodemographic. We calculated the summary relative risk (RR) for each domain and evaluated the risk of bias and quality of reporting. Twenty-two studies were included in this systematic review and meta-analysis. Four domains predicted recurrent falls balance and mobility (RR1.32;95 % CI[1.10, 1.59]), medication (RR1.53;95 % CI[1.11, 2.10]), psychological (RR1.35;95 % CI[1.03, 1.78]), and sensory and neuromuscular (RR1.51;95 % CI[1.18, 1.92]). Each of these four domains can be viewed as a marker of frailty. The risk of bias was low, and the study quality was high (minimum19/22). Older adults with markers of frailty are up to 53 % more likely to experience recurrent falls. Buparlisib order Strategies that identify and resolve frailty markers should be a frontline approach to preventing recurrent falls.

To investigate the effect of a social robot intervention on sleep and motor activity in nursing home residents living with dementia and chronic pain.

A pilot randomized controlled trial was conducted with 41 residents from three Australian nursing homes. People living with dementia and chronic pain were randomized into either a 30-minute daily social robot (PARO) condition or a usual care condition for six weeks. Sleep and motor activity were assessed by actigraphy at four-time points week 0 at baseline, week one, week six, and after the intervention. Data were reduced into daytime (800am - 759pm) and night-time (800pm - 759am) summaries. Change scores for each time point compared with baseline were computed for data analysis and the generalized estimating equation model with imbalanced baseline values added as covariates were performed.

At week one, residents in the PARO group had a greater increase in the night sleep period (1.81, 95 % CI 0.22-3.84, p = 0.030, Cohen's d = 0.570). At week six, residents in the PARO group showed a greater increase in daytime wakefulness (1.91, 95 % CI 0.09-3.73, p = 0.042, Cohen's d = 0.655) and a greater reduction in daytime sleep (-1.35, 95 % CI -2.65 to -0.05, p = 0.040, Cohen's d = 0.664). No significant results were found for motor activity.

PARO could improve sleep patterns for nursing home residents living with dementia and chronic pain, but the effect of PARO on motor activity needs further research. Australian New Zealand Clinical Trials Registry (ACTRN12618000082202).

PARO could improve sleep patterns for nursing home residents living with dementia and chronic pain, but the effect of PARO on motor activity needs further research. Australian New Zealand Clinical Trials Registry (ACTRN12618000082202).Endometrial cancer is currently one of the most common gynecological cancers. Reported incidence rates vary in Spain depending on the region. We estimated what the incidence and mortality of endometrial cancers in Catalonia will be by 2030 and compared the predictions with data from 2010. Bayesian autoregressive age-period-cohort models were employed to predict incidence and mortality rates for 2015-2030. The incidence of endometrial cancer for women younger than 65 years was predicted to be lower in 2030 than in 2010, whereas it was predicted to be higher for women aged 65-74 years. Moreover, mortality rates for women aged ≥65 in 2030 are likely to exceed the rates in 2010. Five-year relative survival for all ages was slightly higher in the period 2005-2009 (79.3 %, 95 %CI 75.8 %-82.9 %) compared with those in 1995-1999 (76.0 %, 95 %CI 72.1 %-80.2 %). This plausible new scenario might be useful to plan new clinical and preventive strategies in the near future.

Frailty and sarcopenia are age-related conditions with shared features and are both associated with adverse health outcomes. Relatively little is known about outcomes of these conditions in combination. The aim of this study was to examine the predictive ability of combined frailty and sarcopenia classification on mortality.

Frailty was measured in 716 community-dwelling adults aged ≥65 years from the North West Adelaide Health Study (mean age 74.1(6.1) years, 55.5 % female) using the frailty phenotype (FP) and sarcopenia using the revised consensus definition from the European Working Group on Sarcopenia. Participants were classified as neither frail nor sarcopenic, frail-only, sarcopenic-only, or both frail and sarcopenic. All participants had a minimum of 10 years of mortality follow-up.

We identified 2.8 % of participants as both frail and sarcopenic, 15.5 % as frail-only, and 3.5 % as sarcopenic-only. Classification as both frail and sarcopenic, in a multivariable model, resulted in significantly elevated mortality risk (HR = 3.52, p < .001), which was over three times that of those neither frail nor sarcopenic. Frail-only was also a significant mortality predictor (HR = 2.03, p = .001), while classification as sarcopenic-only was not a significant predictor of mortality (HR = 1.65, p = .141). There was no significant difference in severity of frailty (mean number of characteristics) or grip strength between frail-only and those with both conditions when stratified by sex.

Individuals identified as frail would benefit from screening and assessment for sarcopenia, and vice versa for those identified as sarcopenic, as the mortality risk for individuals with these conditions in combination is nearly double that of each separately.

Individuals identified as frail would benefit from screening and assessment for sarcopenia, and vice versa for those identified as sarcopenic, as the mortality risk for individuals with these conditions in combination is nearly double that of each separately.In the past decade, the leading international cardiology societies have released statements that emphasize the importance of sex-specific reporting of the findings of clinical trials in cardiovascular research. To find out whether this has led to improvement, we compared sex-specific reporting of efficacy and safety outcomes for trials of cardiovascular drug interventions presented at the major clinical trials sessions of the European Society of Cardiology (ESC), American Heart Association (AHA) and the American College of Cardiology (ACC) before and after publication of these statements. We found that sex-specific efficacy and safety outcomes of the most influential cardiovascular intervention trials are still not systematically presented.

Mutations in GNAO1 typically result in neurodevelopmental disorders, including involuntary movements. They may be improved using calcium-channel modulators.

The patient visited our hospital at age 2years because of moderate global developmental delay. Her intermittent, generalized involuntary movements started at age 8years. A de novo GNAO1 mutation, NM_020988.2c.626G>A, (p.Arg209Cys), was identified by whole exome sequencing. At age 9years, she experienced severe, intermittent involuntary movements, which led to rhabdomyolysis. She needed intensive care with administration of midazolam, dantrolene sodium hydrate, and plasma exchange. We started treating her with gabapentin (GBP), after which she recovered completely. At age 11years, she developed continuous, generalized involuntary movements. This prompted us to increase the GBP dose, which again resolved the involuntary movements completely.

In the case of movement disorders associated with GNAO1 mutations, GBP treatment may be attempted before more invasive procedures are performed.

In the case of movement disorders associated with GNAO1 mutations, GBP treatment may be attempted before more invasive procedures are performed.

The objective was to determine if surgical approach affects time to recurrence in early-stage high-intermediate risk endometrial cancer (HIR-EC) treated with adjuvant vaginal brachytherapy (VBT).

In this retrospective cohort study, HIR-EC patients treated with VBT between 2005 and 2017 were identified and those who received open or minimally invasive hysterectomies (MIS) were included. Clinical and surgical variables were analyzed and time to recurrence was compared between surgical groups.

We identified 494 patients, of which 363 had MIS hysterectomies, 92.5% had endometrioid histology, 45.7% were stage IA and 48.0% stage IB. Open hysterectomy patients had higher BMIs (p=0.007), lower rates of lymph node sampling (p<0.001) and lymphovascular space invasion (LVSI) (p=0.036), however in patients who recurred, no differences were noted between groups. Overall, 65 patients (13.2%) recurred, 14 in the open group (10.7%) and 51 in the MIS group (14.0%) (p=0.58), while vaginal recurrences were noted in 4.6% and 6.