Rileybruce7598
Timing of eating relative to the dim light melatonin onset (DLMO) may serve as a modifiable risk factor for adverse cardiometabolic outcomes. The primary aim of this study was to examine whether the timing of eating relative to DLMO is associated with body mass index (BMI), body fat, and diet in healthy adults without the confound of sleep deprivation.
Healthy men and women (N=97), ages 18-50, with a habitual sleep duration of ≥6.5 hours and ≤8.5 hours completed 7 days of actigraphy and daily sleep and food diaries. Participants underwent a dual-energy X-ray absorptiometry scan and blood draws to assess DLMO in the clinical research unit.
A shorter duration between DLMO and the average clock time of the last meal (last meal-DLMO) was related to a higher number of meals consumed, b=0.25, SE
=0.06, P< .001, longer feeding duration, b=0.84, SE
=0.06, P< .001, greater carbohydrate intake, b=9.08, SE
= 3.55, P= .01, and greater sugar intake, b=4.73, SE
=1.83, P= .01. Last meal-DLMO was not associated with BMI in the full sample; however, among those with later DLMO (after 1030 PM) last meal-DLMO was related to higher BMI, b=0.92, SE
= 0.36, P= .02.
These results suggest that timing of last meal relative to DLMO may serve as a marker of circadian misalignment and that eating the last meal closer to DLMO may negatively impact dietary habits.
These results suggest that timing of last meal relative to DLMO may serve as a marker of circadian misalignment and that eating the last meal closer to DLMO may negatively impact dietary habits.
To compare values of haemoglobin concentration (SpHb), arterial haemoglobin saturation (SpO
) and calculated arterial oxygen content (SpOC), measured noninvasively with a pulse co-oximeter before and after invivo adjustment (via calibration of the device using a measured haemoglobin concentration) with those measured invasively using a spectrophotometric-based blood gas analyser in anaesthetized dogs.
Prospective observational clinical study.
A group of 39 adult dogs.
In all dogs after standard instrumentation, the dorsal metatarsal artery was catheterised for blood sampling, and a pulse co-oximeter probe was applied to the tongue for noninvasive measurements. Paired data for SpHb, SpO
and SpOC from the pulse co-oximeter and haemoglobin arterial oxygen saturation (SaO
) and arterial oxygen content (CaO
) from the blood gas analyser were obtained before and after invivo adjustment. Bland-Altman analysis for repeated measurements was used to evaluate the bias, precision and agreement between the pumetric-based blood gas analyser haemoglobin and CaO2 values. After in vivo adjustment, the accuracy, precision and LoA markedly improved. Therefore, in vivo adjustment is recommended when using this device to monitor SpHb in anaesthetised dogs.Two unrelated cystic fibrosis patients were co-infected with Mycobacterium abscessus smooth and rough phenotypes. Smooth M. abscessus is proposed as the infecting form, and the subsequent loss of glycopeptidolipids in the host leads to a rough phenotype. Whole-genome sequencing (WGS) diagnosed two different M. fMLP order abscessus strains in patient N°1 but only one strain in patient N°2. In patient N°1, rough isolate had novel mutations potentially involved in smooth-to-rough morphology changes. In patient N°2, four genes were present in only the smooth isolate. In addition, we obtained different susceptibility profiles in the four clinical isolates. We revealed a new paradigm describing a cystic fibrosis patient infected with two different clones, including a rough isolate, and identifying a rough M. abscessus clone that did not lose glycopeptidolipids. We propose WGS for the identification of heterogenic isolates and genetic determinants of antimicrobial resistance, which we believe will positively influence treatment prognosis.The use of antibiotics directly correlates with the increase in antimicrobial resistance (AMR). Targeting novel antibiotics to patients with multidrug-resistant (MDR) pathogens should enhance their durability and slow development of resistance. The discovery, development, and clinical adoption of pathogen-targeted antibiotics have been hampered by technical and regulatory challenges. Growing insights into bacterial physiology and mechanisms of resistance, innovative clinical trial designs, streamlined regulatory approval pathways, and availability of rapid bacterial diagnostics are recent developments that can help address those challenges. Pathogen-targeted antibiotics provide an opportunity to treat patients with the right drug at the right time, leading to improved patient outcomes and better antimicrobial stewardship. Patient-centered pricing and reimbursement reform is needed to incentivize innovation.
Triheptanoin provides long-chain fatty acid oxidation disorder (LC-FAOD) patients with an alternative to medium-even-chain triglycerides therapy.
Retrospective analysis of 18 French LC-FAOD patients benefiting from early access to triheptanoin treatment.
Eight female and 10 male patients with LC-FAOD (VLCAD, LCHAD, CACT, CPTII and MTP) were treated with triheptanoin for a median duration of 22months (range 9-228months). At last consultation, triheptanoin accounted for 15-35% of their daily caloric intake. In the year following the introduction of triheptanoin, patients reported a reduction of intermittent snacking and nocturnal meals. Three patients, including 1 adult, became free of severe hypoglycaemic events. Ten of 12 paediatric patients and 4 of 6 adult patients reported reduced fatigue with reductions in the number and severity of episodes of myalgia. Of 6 patients, including 1 adult, that had required the use of a wheelchair in the year prior to triheptanoin, all but one no longer required its use. The number of emergency hospitalizations decreased, and none were recorded for paediatric patients during these 12months. Cumulative annual days of emergency care in the home were reduced from 286 to 51days in the year before and after initiation, respectively, and 13 patients required no such interventions. Adverse events were limited to digestive issues that dissipated over time.
Our case-series suggests that long-term treatment of LC-FAOD paediatric and adult patients with triheptanoin is safe and leads to marked improvement of symptoms and an improved quality of life.
Our case-series suggests that long-term treatment of LC-FAOD paediatric and adult patients with triheptanoin is safe and leads to marked improvement of symptoms and an improved quality of life.
