Management of Adults With Acute #Migraine in the #Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies.
http://onlinelibrary.wiley.com/doi/10.1111/head.12835/abstract

The search identified 68 unique randomized controlled trials utilizing 28 injectable medications. Of these, 19 were rated class 1 (low risk of bias), 21 were rated class 2 (higher risk of bias), and 28 were rated class 3 (highest risk of bias). Metoclopramide, prochlorperazine, and sumatriptan each had multiple class 1 studies supporting acute efficacy, as did dexamethasone for prevention of headache recurrence. All other medications had lower levels of evidence.
Recommendations

Intravenous metoclopramide and prochlorperazine, and subcutaneous sumatriptan should be offered to eligible adults who present to an ED with acute migraine (Should offer—Level B). Dexamethasone should be offered to these patients to prevent recurrence of headache (Should offer—Level B). Because of lack of evidence demonstrating efficacy and concern about sub-acute or long-term sequelae, injectable morphine and hydromorphone are best avoided as first-line therapy (May avoid–Level C).

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Screening for #Obesity in #Children and #Adolescents
US Preventive Services Task Force Recommendation Statement
http://jamanetwork.com/journals/jama/fullarticle/2632511

Based on year 2000 Centers for Disease Control and Prevention growth charts, approximately 17% of children and adolescents aged 2 to 19 years in the United States have obesity, and almost 32% of children and adolescents are overweight or have obesity. Obesity in children and adolescents is associated with morbidity such as mental health and psychological issues, asthma, obstructive sleep apnea, orthopedic problems, and adverse cardiovascular and metabolic outcomes (eg, high blood pressure, abnormal lipid levels, and insulin resistance). Children and adolescents may also experience teasing and bullying behaviors based on their weight. Obesity in childhood and adolescence may continue into adulthood and lead to adverse cardiovascular outcomes or other obesity-related morbidity, such as type 2 diabetes.

Conclusions and Recommendation The USPSTF recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)

Inflammation in the Neurocircuitry of Obsessive-Compulsive Disorder
http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2631893

Importance For a small percentage of obsessive-compulsive disorder (OCD) cases exhibiting additional neuropsychiatric symptoms, it was proposed that neuroinflammation occurs in the basal ganglia as an autoimmune response to infections. However, it is possible that elevated neuroinflammation, inducible by a diverse range of mechanisms, is important throughout the cortico-striato-thalamo-cortical circuit of OCD. Identifying brain inflammation is possible with the recent advance in positron emission tomography (PET) radioligands that bind to the translocator protein (TSPO). Translocator protein density increases when microglia are activated during neuroinflammation and the TSPO distribution volume (VT) is an index of TSPO density.

Conclusions and Relevance To our knowledge, this is the first study demonstrating inflammation within the neurocircuitry of OCD. The regional distribution of elevated TSPO VT argues that the autoimmune/neuroinflammatory theories of OCD should extend beyond the basal ganglia to include the cortico-striato-thalamo-cortical circuit. Immunomodulatory therapies should be investigated in adult OCD, rather than solely childhood OCD, particularly in cases with prominent distress when preventing compulsions.

The impact of #marriage and parenthood on male #BMI body mass index: Static and dynamic effects
http://www.sciencedirect.com/science/article/pii/S0277953617303349?via%3Dihub

Results
The study showed that married men have higher BMI, but marital status changes largely drove this static effect, namely, an increase in BMI in the period following marriage, and a decrease in BMI preceding and following divorce.

Conclusions
Thus, this study found marked evidence in support of the marriage market and social obligation theories' predictions about male BMI, and supports neither marriage protection theory nor marriage selection theory. Wives’ pregnancies had no significant effect on BMI; instead, men tend to have higher BMI in the periods following childbirth. Finally, analyses showed marked contemporaneous correlations between husband and wife BMI over the course of marriage.

#Proton Pump Inhibitors and Risk of Mild #Cognitive Impairment and #Dementia
http://onlinelibrary.wiley.com/doi/10.1111/jgs.14956/abstract


Continuous (always vs never) PPI use was associated with lower risk of decline in cognitive function (hazard ratio (HR) = 0.78, 95% confidence interval (CI) =0.66–0.93, P = .005) and lower risk of conversion to MCI or AD (HR = 0.82, 95% CI = 0.69–0.98, P = .03). Intermittent use was also associated with lower risk of decline in cognitive function (HR = 0.84, 95% CI = 0.76–0.93, P = .001) and risk of conversion to MCI or AD (HR = 0.82, 95% CI = 0.74–0.91, P = .001). This lower risk was found for persons with normal cognition or MCI.
Conclusion

Proton pump inhibitors were not associated with greater risk of dementia or of AD, in contrast to recent reports. Study limitations include reliance on self-reported PPI use and lack of dispensing data. Prospective studies are needed to confirm these results to guide empirically based clinical treatment recommendations.

Anti-#diabetic action of all-trans #retinoic acid and the orphan G protein coupled receptor GPRC5C in pancreatic β-cells
https://www.jstage.jst.go.jp/article/endocrj/64/3/64EJ16-0338/article

Pancreatic islets express high levels of the orphan G-protein coupled receptor C5C (GPRC5C), the function of which remains to be established. Here we have examined the role of GPRC5C in the regulation of insulin secretion and β-cell survival and proliferation using human and mouse pancreatic islets RNA sequencing in human islets revealed GPRC5C expression correlated with the expression of genes controlling apoptosis, cell survival and proliferation. A reduction in Gprc5c mRNA and protein expression was observed in islets isolated from old mice (>46 weeks of age) compared to that in islets from newborn (<3 weeks) mice Potentiation of glucose-stimulated insulin secretion concomitant with enhanced islet cAMP level by all-trans retinoic acid (ATRA) was attenuated upon Gprc5c-KD.

Our results demonstrate that agents activating GPRC5C represent a novel modality for the treatment and/or prevention of diabetes by restoring and/or maintaining functional β-cell mass.

I’ll Show You the Way: Risky #Driver #Behavior When “Following a Friend”
http://journal.frontiersin.org/article/10.3389/fpsyg.2017.00705/full

Previous research examining social influences on driving behavior has primarily focused on the effects of passengers and surrounding vehicles (e.g., speed contagion). Of current interest was the interaction between drivers that occurs in a “following a friend” scenario, i.e., the driver of one vehicle (the leader) knows how to get to the desired destination while the driver of a second vehicle (the follower) does not.

In the follow a friend condition, drivers engaged in significantly more risky behaviors (in comparison to the other conditions) such as making more erratic and higher speed turns and lane changes, maintaining overall higher speed, as well as maintaining a shorter time headway when following a lead vehicle. These effects suggest a relationship to time pressure caused by a fear of getting lost.

Association of Upper Eyelid #Ptosis Repair and #Blepharoplasty With #Headache-Related Quality of Life
http://jamanetwork.com/journals/jamafacialplasticsurgery/article-abstract/2605435

Headache can be a functional indication for ptosis repair and blepharoplasty.

a prospective cohort study was conducted among 108 patients who underwent standard upper eyelid blepharoplasty and 44 patients who underwent ptosis repair (levator resection, Müller muscle resection, or frontalis suspension) for obscuration of the superior visual field at an ophthalmology clinic’s oculoplastic department from September 1, 2014, to September 1, 2015. A validated headache-related quality-of-life survey, the Headache Impact Test-6 (HIT), was administered preoperatively and postoperatively to patients who had tension-type headache. The minimum time interval after the operation was 3 months (mean, 13.5 weeks; range, 12-17 weeks).

Conclusions and Relevance The operations for ptosis and blepharoptosis provide significant relief for tension-type headache and result in improved headache-related quality of life. As a result, tension-type headache can be a functional indication for upper eyelid blepharoplasty and ptosis repair, especially for patients with lower results on the marginal reflex distance test 1.

#Semaglutide #weight loss in phase 2 trial

https://globenewswire.com/news-release/2017/06/23/1028468/0/en/Novo-Nordisk-reports-up-to-13-8-weight-loss-in-people-with-obesity-receiving-semaglutide-in-phase-2-trial.html

In the trial, 957 people with obesity were randomised to treatment with doses of semaglutide between 0.05 to 0.4 mg/day or placebo. Liraglutide 3.0 mg/day was included for comparison. Approximately 100 people were included in each active treatment arm in combination with diet and exercise. All people in the trial were treated for 52 weeks followed by a 7-week follow-up period.

From a mean baseline weight of around 111 kg and a body mass index of approximately 39 kg/m2, a weight loss up to 17.8 kg was observed after 52 weeks of treatment with semaglutide. This corresponded to an estimated 13.8% weight loss compared to the weight loss of 2.3% achieved by diet, exercise and placebo alone, with all treatment arms adjusted for people discontinuing treatment in the study. The results from the liraglutide 3.0 mg treatment arm were broadly in line with previously reported data.

Once-daily semaglutide had a well-tolerated safety profile, with the most common adverse events being gastrointestinal side effects.