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Anomalous Bodily Maps of #Emotions in #Schizophrenia
https://academic.oup.com/schizophreniabulletin/advance-article-abstract/doi/10.1093/schbul/sby179/5245815?redirectedFrom=fulltext
Embodied emotions arise from interoceptive and somatosensory processes, and are essential to the development of a stable sense of self. Emotional embodiment is therefore inherently interwoven with our sense of bodily self-awareness, and allows us to navigate complex social situations. Given that the core feature of schizophrenia (SZ) is characterized by the presence of bodily self-disturbances and social-emotional deficits, we hypothesized that embodiment of emotion would be disrupted in SZ
Bodily maps of emotions were anomalous in SZ as indicated by indistinguishable maps across different emotions. Relative to the control group, patients reported less discrete and less clear bodily sensations across emotions. In particular, bodily maps for low-arousal emotions were atypical in comparison with healthy controls.
Conclusions
Anomalous and undifferentiated mapping of embodied emotions in SZ could lead to deficits in linking bodily sensations to conceptual categories of emotions. Disrupted emotional embodiment could also contribute to poor social functioning. Abnormal bodily sensations of emotions might therefore be a promising target for future psychosocial interventions.
Anomalous Bodily Maps of #Emotions in #Schizophrenia
https://academic.oup.com/schizophreniabulletin/advance-article-abstract/doi/10.1093/schbul/sby179/5245815?redirectedFrom=fulltext
Embodied emotions arise from interoceptive and somatosensory processes, and are essential to the development of a stable sense of self. Emotional embodiment is therefore inherently interwoven with our sense of bodily self-awareness, and allows us to navigate complex social situations. Given that the core feature of schizophrenia (SZ) is characterized by the presence of bodily self-disturbances and social-emotional deficits, we hypothesized that embodiment of emotion would be disrupted in SZ
Bodily maps of emotions were anomalous in SZ as indicated by indistinguishable maps across different emotions. Relative to the control group, patients reported less discrete and less clear bodily sensations across emotions. In particular, bodily maps for low-arousal emotions were atypical in comparison with healthy controls.
Conclusions
Anomalous and undifferentiated mapping of embodied emotions in SZ could lead to deficits in linking bodily sensations to conceptual categories of emotions. Disrupted emotional embodiment could also contribute to poor social functioning. Abnormal bodily sensations of emotions might therefore be a promising target for future psychosocial interventions.
OUP Academic
Anomalous Bodily Maps of Emotions in Schizophrenia
AbstractObjective. Embodied emotions arise from interoceptive and somatosensory processes, and are essential to the development of a stable sense of self. Emoti
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Inhibition of #Mevalonate Pathway Prevents Adipocyte #Browning in Mice and Men by Affecting Protein Prenylation
https://www.sciencedirect.com/science/article/pii/S1550413118307368?via%3Dihub
Highlights
• The mevalonate pathway is important for adipose tissue browning in mouse and human
• Statin use is inversely correlated with brown fat activity in humans
• Geranylgeranylation of small GTP-binding proteins promotes adipocyte browning
• Small GTP-binding proteins regulate F-actin formation and YAP1/TAZ stability
Inhibition of #Mevalonate Pathway Prevents Adipocyte #Browning in Mice and Men by Affecting Protein Prenylation
https://www.sciencedirect.com/science/article/pii/S1550413118307368?via%3Dihub
Highlights
• The mevalonate pathway is important for adipose tissue browning in mouse and human
• Statin use is inversely correlated with brown fat activity in humans
• Geranylgeranylation of small GTP-binding proteins promotes adipocyte browning
• Small GTP-binding proteins regulate F-actin formation and YAP1/TAZ stability
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Development and Validation of a Prediction Model for Mortality and Adverse Outcomes Among Patients With Peripheral #Eosinopenia on Admission for #Clostridium difficile Infection
https://jamanetwork.com/journals/jamasurgery/article-abstract/2698956
Those with an undetectable eosinophil count at admission had increased in-hospital mortality in both the training (odds ratio OR, 2.01; 95% CI, 1.08-3.73; P = .03) and validation (OR, 2.26; 95% CI, 1.33-3.83; P = .002) cohorts in both univariable and multivariable analysis. Undetectable eosinophil counts were also associated with indicators of severe sepsis, such as admission to monitored care settings (OR, 1.40; 95% CI, 1.06-1.86), the need for vasopressors (OR, 2.08; 95% CI, 1.32-3.28), and emergency total colectomy (OR, 2.56; 95% CI, 1.12-5.87). Other significant predictors of mortality at admission included increasing comorbidity burden (for each 1-unit increase: OR, 1.13; 95% CI, 1.05-1.22) and lower systolic blood pressures (for each 1-mm Hg increase: OR, 0.99; 95% CI, 0.98-1.00). In a subgroup analysis of patients presenting without initial tachycardia or hypotension, only patients with undetectable admission eosinophil counts, but not those with an elevated white blood cell count, had significantly increased odds of inpatient mortality (OR, 5.76; 95% CI, 1.99-16.64).
Conclusions and Relevance This study describes a simple, widely available, inexpensive model predicting CDI severity and mortality to identify at-risk patients at the time of admission.
Development and Validation of a Prediction Model for Mortality and Adverse Outcomes Among Patients With Peripheral #Eosinopenia on Admission for #Clostridium difficile Infection
https://jamanetwork.com/journals/jamasurgery/article-abstract/2698956
Those with an undetectable eosinophil count at admission had increased in-hospital mortality in both the training (odds ratio OR, 2.01; 95% CI, 1.08-3.73; P = .03) and validation (OR, 2.26; 95% CI, 1.33-3.83; P = .002) cohorts in both univariable and multivariable analysis. Undetectable eosinophil counts were also associated with indicators of severe sepsis, such as admission to monitored care settings (OR, 1.40; 95% CI, 1.06-1.86), the need for vasopressors (OR, 2.08; 95% CI, 1.32-3.28), and emergency total colectomy (OR, 2.56; 95% CI, 1.12-5.87). Other significant predictors of mortality at admission included increasing comorbidity burden (for each 1-unit increase: OR, 1.13; 95% CI, 1.05-1.22) and lower systolic blood pressures (for each 1-mm Hg increase: OR, 0.99; 95% CI, 0.98-1.00). In a subgroup analysis of patients presenting without initial tachycardia or hypotension, only patients with undetectable admission eosinophil counts, but not those with an elevated white blood cell count, had significantly increased odds of inpatient mortality (OR, 5.76; 95% CI, 1.99-16.64).
Conclusions and Relevance This study describes a simple, widely available, inexpensive model predicting CDI severity and mortality to identify at-risk patients at the time of admission.
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Effect of #Resveratrol on Blood #Lipid Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta‐Analysis
https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22348?af=R
Ten randomized controlled trials involving a total of 363 patients with type 2 diabetes were included in the analysis. The results show that longer resveratrol intervention time (≥6 months) can reduce TG levels. But resveratrol increased total cholesterol in patients within obesity range. In type 2 diabetes patients with obesity and in those who took lipid‐lowering drugs, resveratrol increased low‐density lipoprotein levels.
Conclusions
Resveratrol can improve TG in patients with type 2 diabetes
Effect of #Resveratrol on Blood #Lipid Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta‐Analysis
https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22348?af=R
Ten randomized controlled trials involving a total of 363 patients with type 2 diabetes were included in the analysis. The results show that longer resveratrol intervention time (≥6 months) can reduce TG levels. But resveratrol increased total cholesterol in patients within obesity range. In type 2 diabetes patients with obesity and in those who took lipid‐lowering drugs, resveratrol increased low‐density lipoprotein levels.
Conclusions
Resveratrol can improve TG in patients with type 2 diabetes
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#Mindfulness Training Enhances Self-Regulation and Facilitates #Health Behavior Change for Primary Care Patients: a Randomized Controlled Trial
https://link.springer.com/article/10.1007/s11606-018-4739-5
Mindfulness Training for Primary Care (MTPC) is an 8-week, referral-based, insurance-reimbursable program integrated into safety-net health system patient-centered medical homes. We hypothesized that MTPC would be more effective for catalyzing chronic disease self-management action plan initiation within 2 weeks, versus a low-dose comparator (LDC) consisting of a 60-min mindfulness introduction, referral to community and digital resources, and addition to a 6-month waitlist for MTPC.
Participants randomized to MTPC, relative to LDC, had significantly higher adjusted odds of self-management action plan initiation in an intention-to-treat analysis (OR = 2.28; 95% CI = 1.02 to 5.06, p = 0.025).
Conclusions
An 8-week dose of mindfulness training is more effective than a low-dose mindfulness comparator in facilitating chronic disease self-management behavior change among primary care patients.
#Mindfulness Training Enhances Self-Regulation and Facilitates #Health Behavior Change for Primary Care Patients: a Randomized Controlled Trial
https://link.springer.com/article/10.1007/s11606-018-4739-5
Mindfulness Training for Primary Care (MTPC) is an 8-week, referral-based, insurance-reimbursable program integrated into safety-net health system patient-centered medical homes. We hypothesized that MTPC would be more effective for catalyzing chronic disease self-management action plan initiation within 2 weeks, versus a low-dose comparator (LDC) consisting of a 60-min mindfulness introduction, referral to community and digital resources, and addition to a 6-month waitlist for MTPC.
Participants randomized to MTPC, relative to LDC, had significantly higher adjusted odds of self-management action plan initiation in an intention-to-treat analysis (OR = 2.28; 95% CI = 1.02 to 5.06, p = 0.025).
Conclusions
An 8-week dose of mindfulness training is more effective than a low-dose mindfulness comparator in facilitating chronic disease self-management behavior change among primary care patients.
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High Patient #Activation Is Associated With Remission in Patients With Inflammatory #Bowel Disease
https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izy378/5257738?redirectedFrom=fulltext
High levels of patient activation (having the knowledge, skills, and confidence to effectively manage one’s care), have been associated with improved outcomes in many chronic conditions. There have been few studies of the effects of activation in patients with inflammatory bowel disease (IBD). We performed a large, prospective Internet-based study to assess the relationship between patient activation level and clinical remission in patients with Crohn’s disease or ulcerative colitis.
Higher anxiety (adjusted odds ratio aOR, 0.32; 95% confidence interval CI, 0.29–0.36) and depression scores were associated with a decreased odds of high patient activation. After we adjusted for education status, smoking, medication use, and other confounders, we found that patients with high activation at baseline were more likely to be in clinical remission during the follow-up period.
In a large, prospective Internet-based cohort of patients with IBD, we found a strong association between patient activation and clinical remission. These findings suggest that patient activation affects disease outcomes.
High Patient #Activation Is Associated With Remission in Patients With Inflammatory #Bowel Disease
https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izy378/5257738?redirectedFrom=fulltext
High levels of patient activation (having the knowledge, skills, and confidence to effectively manage one’s care), have been associated with improved outcomes in many chronic conditions. There have been few studies of the effects of activation in patients with inflammatory bowel disease (IBD). We performed a large, prospective Internet-based study to assess the relationship between patient activation level and clinical remission in patients with Crohn’s disease or ulcerative colitis.
Higher anxiety (adjusted odds ratio aOR, 0.32; 95% confidence interval CI, 0.29–0.36) and depression scores were associated with a decreased odds of high patient activation. After we adjusted for education status, smoking, medication use, and other confounders, we found that patients with high activation at baseline were more likely to be in clinical remission during the follow-up period.
In a large, prospective Internet-based cohort of patients with IBD, we found a strong association between patient activation and clinical remission. These findings suggest that patient activation affects disease outcomes.
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Association of Pharmacological #Treatments With Long-term Pain Control in Patients With Knee #Osteoarthritis
A Systematic Review and Meta-analysis
https://jamanetwork.com/journals/jama/article-abstract/2719308
Associations with decreases in pain were found for the nonsteroidal anti-inflammatory drug celecoxib (SMD, −0.18 [95% CrI, −0.35 to −0.01]) and the symptomatic slow-acting drug in osteoarthritis glucosamine sulfate (SMD, −0.29 [95% CrI, −0.49 to −0.09]), but there was large uncertainty for all estimates vs placebo. The association with pain improvement remained significant only for glucosamine sulfate when data were analyzed using the mean difference on a scale from 0 to 100 and when trials at high risk of bias were excluded. Associations with improvement in joint space narrowing were found for glucosamine sulfate (SMD, −0.42 [95% CrI, −0.65 to −0.19]), chondroitin sulfate (SMD, −0.20 [95% CrI, −0.31 to −0.07]), and strontium ranelate (SMD, −0.20 [95% CrI, −0.36 to −0.05]).
Conclusions and Relevance In this systematic review and network meta-analysis of studies of patients with knee osteoarthritis and at least 12 months of follow-up, there was uncertainty around the estimates of effect size for change in pain for all comparisons with placebo. Larger RCTs are needed to resolve the uncertainty around efficacy of medications for knee osteoarthritis
Association of Pharmacological #Treatments With Long-term Pain Control in Patients With Knee #Osteoarthritis
A Systematic Review and Meta-analysis
https://jamanetwork.com/journals/jama/article-abstract/2719308
Associations with decreases in pain were found for the nonsteroidal anti-inflammatory drug celecoxib (SMD, −0.18 [95% CrI, −0.35 to −0.01]) and the symptomatic slow-acting drug in osteoarthritis glucosamine sulfate (SMD, −0.29 [95% CrI, −0.49 to −0.09]), but there was large uncertainty for all estimates vs placebo. The association with pain improvement remained significant only for glucosamine sulfate when data were analyzed using the mean difference on a scale from 0 to 100 and when trials at high risk of bias were excluded. Associations with improvement in joint space narrowing were found for glucosamine sulfate (SMD, −0.42 [95% CrI, −0.65 to −0.19]), chondroitin sulfate (SMD, −0.20 [95% CrI, −0.31 to −0.07]), and strontium ranelate (SMD, −0.20 [95% CrI, −0.36 to −0.05]).
Conclusions and Relevance In this systematic review and network meta-analysis of studies of patients with knee osteoarthritis and at least 12 months of follow-up, there was uncertainty around the estimates of effect size for change in pain for all comparisons with placebo. Larger RCTs are needed to resolve the uncertainty around efficacy of medications for knee osteoarthritis
Jamanetwork
Pharmacological Treatments for Pain Control in Knee Osteoarthritis
This network meta-analysis of randomized clinical trials estimates the effects of analgesics, vitamin E, bone-acting agents like bisphosphonates and calcitonin, nonsteroidal anti-inflammatory drugs, intra-articular hyaluronic acid and corticosteroids, chondroitin…
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#Work Loss Before and After Diagnosis of #Crohn’s Disease
https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izy382/5247639?redirectedFrom=fulltext
Among the 2015 incident Crohn’s disease patients (median age, 35 years; 50% women), both the proportion with work loss and the mean annual number of lost workdays were larger 5 years before diagnosis (25%; mean, 45 days) than in the 10,067 comparators (17%; mean, 29 days). Increased work loss was seen during the year of diagnosis, after which it declined to levels similar to before diagnosis. Of all patients, 75% had no work loss 24–12 months before diagnosis. Of them, 84% had full work ability also 12–24 months after diagnosis. In patients with total work loss (8.3% of all) before diagnosis, 83% did not work after. Among those with full work ability before diagnosis, the absolute risk of having total work loss after diagnosis was 1.4% (0.43% in the comparators). Our results were consistent across several sensitivity analyses using alternative definitions for date of diagnosis.
Conclusions
Patients with Crohn’s disease had increased work loss several years before diagnosis, possibly explained by comorbidity or by diagnostic delay
#Work Loss Before and After Diagnosis of #Crohn’s Disease
https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izy382/5247639?redirectedFrom=fulltext
Among the 2015 incident Crohn’s disease patients (median age, 35 years; 50% women), both the proportion with work loss and the mean annual number of lost workdays were larger 5 years before diagnosis (25%; mean, 45 days) than in the 10,067 comparators (17%; mean, 29 days). Increased work loss was seen during the year of diagnosis, after which it declined to levels similar to before diagnosis. Of all patients, 75% had no work loss 24–12 months before diagnosis. Of them, 84% had full work ability also 12–24 months after diagnosis. In patients with total work loss (8.3% of all) before diagnosis, 83% did not work after. Among those with full work ability before diagnosis, the absolute risk of having total work loss after diagnosis was 1.4% (0.43% in the comparators). Our results were consistent across several sensitivity analyses using alternative definitions for date of diagnosis.
Conclusions
Patients with Crohn’s disease had increased work loss several years before diagnosis, possibly explained by comorbidity or by diagnostic delay
OUP Academic
Work Loss Before and After Diagnosis of Crohn’s Disease
AbstractBackground. The aim of this study was to examine work loss in patients with Crohn’s disease.Methods. Using nationwide registers, we identified inciden
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The Impact of Autoimmune #Hepatitis and Its Treatment on #Health Utility
https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.30031
Patient reporting suggests that the physical and psychological effects of autoimmune hepatitis (AIH) can be substantial. However, health‐related quality of life (HRQOL) in patients with AIH remains incompletely characterized, and health utility remains to be explored.
HRQOL, measured by the EQ‐5D‐5L utility index, is shown to be significantly impaired in our cohort of AIH patients compared with population norms. Within the AIH cohort, corticosteroid use was found to be significantly associated with impaired HRQOL, even when controlling for biochemical disease activity status. Conclusion: Our data show evidence of HRQOL impairment in a large cohort of AIH patients compared with the general population. Furthermore, corticosteroid use is strongly associated with decreased HRQOL, independent of remission status. This highlights the need for better corticosteroid‐free therapy approaches and it emphasizes the need for future novel therapeutic trials in AIH.
The Impact of Autoimmune #Hepatitis and Its Treatment on #Health Utility
https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.30031
Patient reporting suggests that the physical and psychological effects of autoimmune hepatitis (AIH) can be substantial. However, health‐related quality of life (HRQOL) in patients with AIH remains incompletely characterized, and health utility remains to be explored.
HRQOL, measured by the EQ‐5D‐5L utility index, is shown to be significantly impaired in our cohort of AIH patients compared with population norms. Within the AIH cohort, corticosteroid use was found to be significantly associated with impaired HRQOL, even when controlling for biochemical disease activity status. Conclusion: Our data show evidence of HRQOL impairment in a large cohort of AIH patients compared with the general population. Furthermore, corticosteroid use is strongly associated with decreased HRQOL, independent of remission status. This highlights the need for better corticosteroid‐free therapy approaches and it emphasizes the need for future novel therapeutic trials in AIH.
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#Alcohol consumption and #hospitalization burden in anadult Italian population: prospective results from theMoli-sani study
https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.14490
During a median follow-up of 6.3 y ears, 12 996 multiple hospital admissions occurred.In multi va ria ble analy ses, life-time ab stainers and former drink ers had higher rates of all-cause hospitalizations compared with light alcohol consumers. Alcohol consumption > 48 g/da y was associated with a higher rate of hospitalization for both alcohol-related diseases (IRR = 1.74,95% CI = 1.32–2.29) and cancer (IRR = 1.36, 95% CI = 1.12–1.65). The magnitude of the association betw een heavieralcohol intak e and hospitalization tended to be greater in smok ers than non-smokers. No associations w ere observed withhospitalization for trauma or neurodeg enerative diseases.
Conclusio ns Moderate alcohol consumption appears to ha ve amodest but complex impact on global hospitalization burden. Hea vier drink ers hav e a higher rate of hospitalization for allcauses, including alcohol-related diseases and cancer, a risk that appears to be further magnified b y concurrent smoking.
#Alcohol consumption and #hospitalization burden in anadult Italian population: prospective results from theMoli-sani study
https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.14490
During a median follow-up of 6.3 y ears, 12 996 multiple hospital admissions occurred.In multi va ria ble analy ses, life-time ab stainers and former drink ers had higher rates of all-cause hospitalizations compared with light alcohol consumers. Alcohol consumption > 48 g/da y was associated with a higher rate of hospitalization for both alcohol-related diseases (IRR = 1.74,95% CI = 1.32–2.29) and cancer (IRR = 1.36, 95% CI = 1.12–1.65). The magnitude of the association betw een heavieralcohol intak e and hospitalization tended to be greater in smok ers than non-smokers. No associations w ere observed withhospitalization for trauma or neurodeg enerative diseases.
Conclusio ns Moderate alcohol consumption appears to ha ve amodest but complex impact on global hospitalization burden. Hea vier drink ers hav e a higher rate of hospitalization for allcauses, including alcohol-related diseases and cancer, a risk that appears to be further magnified b y concurrent smoking.
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Association of #Alcohol Consumption After Development of #Heart Failure With Survival Among Older Adults in the Cardiovascular Health Study
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2719576
After controlling for other factors, consumption of 7 or fewer alcoholic drinks per week was associated with additional mean survival of 383 days (95% CI, 17-748 days; P = .04) compared with abstinence from alcohol. Although the robustness was limited by the small number of individuals who consumed more than 7 drinks per week, a significant inverted U-shaped association between alcohol consumption and survival was observed. Multivariable model estimates of mean time from heart failure diagnosis to death were 2640 days (95% CI, 1967-3313 days) for never drinkers, 3046 days (95% CI, 2372-3719 days) for consumers of 0 to 7 drinks per week, and 2806 (95% CI, 1879-3734 days) for consumers of more than 7 drinks per week (P = .02). Consumption of 10 drinks per week was associated with the longest survival, a mean of 3381 days (95% CI, 2806-3956 days) after heart failure diagnosis.
Conclusions and Relevance These findings suggest that limited alcohol consumption among older adults with incident heart failure is associated with survival benefit compared with long-term abstinence. These findings suggest that older adults who develop heart failure may not need to abstain from moderate levels of alcohol consumption.
Association of #Alcohol Consumption After Development of #Heart Failure With Survival Among Older Adults in the Cardiovascular Health Study
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2719576
After controlling for other factors, consumption of 7 or fewer alcoholic drinks per week was associated with additional mean survival of 383 days (95% CI, 17-748 days; P = .04) compared with abstinence from alcohol. Although the robustness was limited by the small number of individuals who consumed more than 7 drinks per week, a significant inverted U-shaped association between alcohol consumption and survival was observed. Multivariable model estimates of mean time from heart failure diagnosis to death were 2640 days (95% CI, 1967-3313 days) for never drinkers, 3046 days (95% CI, 2372-3719 days) for consumers of 0 to 7 drinks per week, and 2806 (95% CI, 1879-3734 days) for consumers of more than 7 drinks per week (P = .02). Consumption of 10 drinks per week was associated with the longest survival, a mean of 3381 days (95% CI, 2806-3956 days) after heart failure diagnosis.
Conclusions and Relevance These findings suggest that limited alcohol consumption among older adults with incident heart failure is associated with survival benefit compared with long-term abstinence. These findings suggest that older adults who develop heart failure may not need to abstain from moderate levels of alcohol consumption.
Jamanetwork
Association of Alcohol Use After Heart Failure Diagnosis With Survival Among Older Adults
This cohort study investigates whether the consumption of alcohol after the diagnosis of heart failure among older adults who participated in the Cardiovascular Health Study was associated with increased survival compared with abstinence.
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#Magnesium status and supplementation influence vitamin #D status and metabolism: results from a randomized trial
https://academic.oup.com/ajcn/article-abstract/108/6/1249/5239886?redirectedFrom=fulltext
Previous in vitro and in vivo studies indicate that enzymes that synthesize and metabolize vitamin D are magnesium dependent. Recent observational studies found that magnesium intake significantly interacted with vitamin D in relation to vitamin D status and risk of mortality. According to NHANES, 79% of US adults do not meet their Recommended Dietary Allowance of magnesium.
The relations between magnesium treatment and plasma concentrations of 25(OH)D3, 25(OH)D2, and 24,25(OH)2D3 were significantly different dependent on the baseline concentrations of 25(OH)D, and significant interactions persisted after Bonferroni corrections. Magnesium supplementation increased the 25(OH)D3 concentration when baseline 25(OH)D concentrations were close to 30 ng/mL, but decreased it when baseline 25(OH)D was higher (from ∼30 to 50 ng/mL). Magnesium treatment significantly affected 24,25(OH)2D3 concentration when baseline 25(OH)D concentration was 50 ng/mL but not 30 ng/mL. On the other hand, magnesium treatment increased 25(OH)D2 as baseline 25(OH)D increased.
Conclusion
Our findings suggest that optimal magnesium status may be important for optimizing 25(OH)D status.
#Magnesium status and supplementation influence vitamin #D status and metabolism: results from a randomized trial
https://academic.oup.com/ajcn/article-abstract/108/6/1249/5239886?redirectedFrom=fulltext
Previous in vitro and in vivo studies indicate that enzymes that synthesize and metabolize vitamin D are magnesium dependent. Recent observational studies found that magnesium intake significantly interacted with vitamin D in relation to vitamin D status and risk of mortality. According to NHANES, 79% of US adults do not meet their Recommended Dietary Allowance of magnesium.
The relations between magnesium treatment and plasma concentrations of 25(OH)D3, 25(OH)D2, and 24,25(OH)2D3 were significantly different dependent on the baseline concentrations of 25(OH)D, and significant interactions persisted after Bonferroni corrections. Magnesium supplementation increased the 25(OH)D3 concentration when baseline 25(OH)D concentrations were close to 30 ng/mL, but decreased it when baseline 25(OH)D was higher (from ∼30 to 50 ng/mL). Magnesium treatment significantly affected 24,25(OH)2D3 concentration when baseline 25(OH)D concentration was 50 ng/mL but not 30 ng/mL. On the other hand, magnesium treatment increased 25(OH)D2 as baseline 25(OH)D increased.
Conclusion
Our findings suggest that optimal magnesium status may be important for optimizing 25(OH)D status.
OUP Academic
Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial
ABSTRACTBackground. Previous in vitro and in vivo studies indicate that enzymes that synthesize and metabolize vitamin D are magnesium dependent. Recent observa
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How does #exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood #pressure
https://bjsm.bmj.com/content/early/2018/12/05/bjsports-2018-099921
In analyses that combined all populations, antihypertensive medications achieved higher reductions in baseline SBP compared with exercise interventions (mean difference −3.96 mmHg, 95% CrI −5.02 to −2.91). Compared with control, all types of exercise (including combination of endurance and resistance) and all classes of antihypertensive medications were effective in lowering baseline SBP. Among hypertensive populations, there were no detectable differences in the SBP-lowering effects of ACE-I, ARB, β-blocker and diuretic medications when compared with endurance or dynamic resistance exercise. There was no detectable inconsistency between direct and indirect comparisons. Although there was evidence of small-study effects, this affected both medication and exercise trials.
Conclusions The effect of exercise interventions on SBP remains under-studied, especially among hypertensive populations. Our findings confirm modest but consistent reductions in SBP in many studied exercise interventions across all populations but individuals receiving medications generally achieved greater reductions than those following structured exercise regimens. Assuming equally reliable estimates, the SBP-lowering effect of exercise among hypertensive populations appears similar to that of commonly used antihypertensive medications. Generalisability of these findings to real-world clinical settings should be further evaluated.
How does #exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood #pressure
https://bjsm.bmj.com/content/early/2018/12/05/bjsports-2018-099921
In analyses that combined all populations, antihypertensive medications achieved higher reductions in baseline SBP compared with exercise interventions (mean difference −3.96 mmHg, 95% CrI −5.02 to −2.91). Compared with control, all types of exercise (including combination of endurance and resistance) and all classes of antihypertensive medications were effective in lowering baseline SBP. Among hypertensive populations, there were no detectable differences in the SBP-lowering effects of ACE-I, ARB, β-blocker and diuretic medications when compared with endurance or dynamic resistance exercise. There was no detectable inconsistency between direct and indirect comparisons. Although there was evidence of small-study effects, this affected both medication and exercise trials.
Conclusions The effect of exercise interventions on SBP remains under-studied, especially among hypertensive populations. Our findings confirm modest but consistent reductions in SBP in many studied exercise interventions across all populations but individuals receiving medications generally achieved greater reductions than those following structured exercise regimens. Assuming equally reliable estimates, the SBP-lowering effect of exercise among hypertensive populations appears similar to that of commonly used antihypertensive medications. Generalisability of these findings to real-world clinical settings should be further evaluated.
British Journal of Sports Medicine
How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials…
Objective To compare the effect of exercise regimens and medications on systolic blood pressure (SBP).
Data sources Medline (via PubMed) and the Cochrane Library.
Eligibility criteria Randomised controlled trials (RCTs) of angiotensin-converting enzyme…
Data sources Medline (via PubMed) and the Cochrane Library.
Eligibility criteria Randomised controlled trials (RCTs) of angiotensin-converting enzyme…
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Application of #mindfulness in a tier 3 obesity service improves eating behaviour and facilitates successful #weight-loss
https://academic.oup.com/jcem/advance-article/doi/10.1210/jc.2018-00578/5167368
There were statistically significant improvements (p=0.009) in self-reported eating behaviour (driven by improvements in ‘fast-foodism’ [p=0.031]) and reduction in body-weight (3.06kg [SD 5.2kg], p=0.002) at 6-months following completion of the group sessions. This was statistically more (p=0.036) than 6-month weight loss in control group (0.21kg). Participants reported improved self-esteem and confidence in self-management of body-weight.
Conclusion
Application of mindfulness-based eating behaviour strategies, taught at group sessions within a tier 3 obesity service, resulted in significant improvement in eating behaviour, and facilitated subsequent weight-loss over 6-months. Such a novel strategy has potential for scalability to the wider obese population.
Application of #mindfulness in a tier 3 obesity service improves eating behaviour and facilitates successful #weight-loss
https://academic.oup.com/jcem/advance-article/doi/10.1210/jc.2018-00578/5167368
There were statistically significant improvements (p=0.009) in self-reported eating behaviour (driven by improvements in ‘fast-foodism’ [p=0.031]) and reduction in body-weight (3.06kg [SD 5.2kg], p=0.002) at 6-months following completion of the group sessions. This was statistically more (p=0.036) than 6-month weight loss in control group (0.21kg). Participants reported improved self-esteem and confidence in self-management of body-weight.
Conclusion
Application of mindfulness-based eating behaviour strategies, taught at group sessions within a tier 3 obesity service, resulted in significant improvement in eating behaviour, and facilitated subsequent weight-loss over 6-months. Such a novel strategy has potential for scalability to the wider obese population.
OUP Academic
Application of mindfulness in a tier 3 obesity service improves eating behaviour and facilitates successful weight-loss
AbstractContext. Mindfulness strategies may facilitate healthier eating behaviour but have not previously been studied in a UK-based tier 3 obesity service.Obj
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Diet #soft drink is associated with increased odds of proliferative diabetic #retinopathy
https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.13154
.Results:Of the 609 participants (mean age stan-dard deviation: 64.6 11.6 years; males = 210),285 (46.8%) and 190 (31.2%) consumed diet andregular soft drink, respectively. A total of230 (37.8%), 36 (5.9%), 154 (25.3%), 28 (4.6%)and 146 (24.0%) had no DR, mild non-proliferative DR (NPDR), moderate NPDR, severeNPDR and proliferative DR (PDR), respectively.High diet soft drink consumption was indepen-dently associated with increased likelihood ofhaving PDR (odds ratio = 2.51, 95% confidenceinterval = 1.05–5.98), compared to no consump-tion. In contrast, regular soft drink was not associ-ated with DR or DME.Conclusions and Relevance:Consuming >4 cans(1.5 L)/week of diet soft drink is associated with amore than twofold risk of having PDR in patientswith diabetes. Longitudinal studies are needed tofurther elucidate the association and its underpinning mechanism
Diet #soft drink is associated with increased odds of proliferative diabetic #retinopathy
https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.13154
.Results:Of the 609 participants (mean age stan-dard deviation: 64.6 11.6 years; males = 210),285 (46.8%) and 190 (31.2%) consumed diet andregular soft drink, respectively. A total of230 (37.8%), 36 (5.9%), 154 (25.3%), 28 (4.6%)and 146 (24.0%) had no DR, mild non-proliferative DR (NPDR), moderate NPDR, severeNPDR and proliferative DR (PDR), respectively.High diet soft drink consumption was indepen-dently associated with increased likelihood ofhaving PDR (odds ratio = 2.51, 95% confidenceinterval = 1.05–5.98), compared to no consump-tion. In contrast, regular soft drink was not associ-ated with DR or DME.Conclusions and Relevance:Consuming >4 cans(1.5 L)/week of diet soft drink is associated with amore than twofold risk of having PDR in patientswith diabetes. Longitudinal studies are needed tofurther elucidate the association and its underpinning mechanism
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#Fluoroquinolone Antibiotics: Safety Communication - Increased Risk of Ruptures or Tears in the #Aorta Blood Vessel in Certain Patients
https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm628960.htm
RECOMMENDATION:
Healthcare professionals should:
Avoid prescribing fluoroquinolone antibiotics to patients who have an aortic aneurysm or are at risk for an aortic aneurysm, such as patients with peripheral atherosclerotic vascular diseases, hypertension, certain genetic conditions such as Marfan syndrome and Ehlers-Danlos syndrome, and elderly patients.
Prescribe fluoroquinolones to these patients only when no other treatment options are available.
Advise all patients to seek immediate medical treatment for any symptoms associated with aortic aneurysm.
Stop fluoroquinolone treatment immediately if a patient reports side effects suggestive of aortic aneurysm or dissection.
#Fluoroquinolone Antibiotics: Safety Communication - Increased Risk of Ruptures or Tears in the #Aorta Blood Vessel in Certain Patients
https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm628960.htm
RECOMMENDATION:
Healthcare professionals should:
Avoid prescribing fluoroquinolone antibiotics to patients who have an aortic aneurysm or are at risk for an aortic aneurysm, such as patients with peripheral atherosclerotic vascular diseases, hypertension, certain genetic conditions such as Marfan syndrome and Ehlers-Danlos syndrome, and elderly patients.
Prescribe fluoroquinolones to these patients only when no other treatment options are available.
Advise all patients to seek immediate medical treatment for any symptoms associated with aortic aneurysm.
Stop fluoroquinolone treatment immediately if a patient reports side effects suggestive of aortic aneurysm or dissection.
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Persistent #fatigue induced by #interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome
https://www.sciencedirect.com/science/article/pii/S0306453018301963
Highlights
•Baseline fatigue is not associated with the development of persistent fatigue after IFN-α.
•IFN-α-induced persistent fatigue is associated with increased baseline IL-10.
•Patients who develop persistent fatigue experience greater increases in IL-6 and 10 in response to IFN-α.
•Persistently fatigued patients recover at a similar rate, but from a more severe acute response to the initial trigger.
•Once established, neither the persistent fatigue phenotype, nor CFS, are associated with peripheral immune activation.
Persistent #fatigue induced by #interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome
https://www.sciencedirect.com/science/article/pii/S0306453018301963
Highlights
•Baseline fatigue is not associated with the development of persistent fatigue after IFN-α.
•IFN-α-induced persistent fatigue is associated with increased baseline IL-10.
•Patients who develop persistent fatigue experience greater increases in IL-6 and 10 in response to IFN-α.
•Persistently fatigued patients recover at a similar rate, but from a more severe acute response to the initial trigger.
•Once established, neither the persistent fatigue phenotype, nor CFS, are associated with peripheral immune activation.
Sciencedirect
Persistent fatigue induced by interferon-alpha: a novel, inflammation-based, proxy model of chronic fatigue syndrome
The role of immune or infective triggers in the pathogenesis of Chronic Fatigue Syndrome (CFS) is not yet fully understood. Barriers to obtaining immu…
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Association Between #Antidepressant Drug Use and Hip #Fracture in Older People Before and After Treatment Initiation
https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2719274
Of the 408 144 people in the register who were included in the study, 257 486 (63.1%) were women, with a mean (SD) age of 80.1 (7.2) years. Antidepressant users sustained more than twice as many hip fractures than did nonusers in the year before and year after the initiation of therapy (2.8% vs 1.1% and 3.5% vs 1.3%, respectively, per actual incidence figures). In adjusted analyses, the odds ratios were highest for the associations between antidepressant use and hip fracture 16 to 30 days before the prescription was filled (odds ratio, 5.76; 95% CI, 4.73-7.01). In all separate analyses of age groups, of men and women, and of individual antidepressants, the highest odds ratios were seen 16 to 30 days before initiation of treatment, and no clear dose-response relationship was seen.
Conclusions and Relevance The present study found an association between antidepressant drug use and hip fracture before and after the initiation of therapy. This finding raises questions about the association that should be further investigated in treatment studies.
Association Between #Antidepressant Drug Use and Hip #Fracture in Older People Before and After Treatment Initiation
https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2719274
Of the 408 144 people in the register who were included in the study, 257 486 (63.1%) were women, with a mean (SD) age of 80.1 (7.2) years. Antidepressant users sustained more than twice as many hip fractures than did nonusers in the year before and year after the initiation of therapy (2.8% vs 1.1% and 3.5% vs 1.3%, respectively, per actual incidence figures). In adjusted analyses, the odds ratios were highest for the associations between antidepressant use and hip fracture 16 to 30 days before the prescription was filled (odds ratio, 5.76; 95% CI, 4.73-7.01). In all separate analyses of age groups, of men and women, and of individual antidepressants, the highest odds ratios were seen 16 to 30 days before initiation of treatment, and no clear dose-response relationship was seen.
Conclusions and Relevance The present study found an association between antidepressant drug use and hip fracture before and after the initiation of therapy. This finding raises questions about the association that should be further investigated in treatment studies.
Jamanetwork
Association Between Antidepressant Drug Use and Hip Fracture in Older People
This population-based study examines the occurrence of hip fractures in elderly individuals before and after initiation of antidepressant medications.
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Association between intake of non-sugar #sweeteners and #health outcomes: systematic review and meta-analyses of randomised and non-randomised controlle
https://www.bmj.com/content/364/bmj.k4718
To assess the association between intake of non-sugar sweeteners (NSS) and important health outcomes in generally healthy or overweight/obese adults and children.
..For all other outcomes, no differences were detected between the use and non-use of NSSs, or between different doses of NSSs. No evidence of any effect of NSSs was seen on overweight or obese adults or children actively trying to lose weight (very low to moderate certainty). In children, a smaller increase in body mass index z score was observed with NSS intake compared with sugar intake (−0.15, −0.17 to −0.12; two, n=528, moderate certainty of evidence), but no significant differences were observed in body weight (−0.60 kg, −1.33 to 0.14; two, n=467, low certainty of evidence), or between different doses of NSSs (very low to moderate certainty).
Conclusions Most health outcomes did not seem to have differences between the NSS exposed and unexposed groups. Of the few studies identified for each outcome, most had few participants, were of short duration, and their methodological and reporting quality was limited; therefore, confidence in the reported results is limited. Future studies should assess the effects of NSSs with an appropriate intervention duration. Detailed descriptions of interventions, comparators, and outcomes should be included in all reports.
Association between intake of non-sugar #sweeteners and #health outcomes: systematic review and meta-analyses of randomised and non-randomised controlle
https://www.bmj.com/content/364/bmj.k4718
To assess the association between intake of non-sugar sweeteners (NSS) and important health outcomes in generally healthy or overweight/obese adults and children.
..For all other outcomes, no differences were detected between the use and non-use of NSSs, or between different doses of NSSs. No evidence of any effect of NSSs was seen on overweight or obese adults or children actively trying to lose weight (very low to moderate certainty). In children, a smaller increase in body mass index z score was observed with NSS intake compared with sugar intake (−0.15, −0.17 to −0.12; two, n=528, moderate certainty of evidence), but no significant differences were observed in body weight (−0.60 kg, −1.33 to 0.14; two, n=467, low certainty of evidence), or between different doses of NSSs (very low to moderate certainty).
Conclusions Most health outcomes did not seem to have differences between the NSS exposed and unexposed groups. Of the few studies identified for each outcome, most had few participants, were of short duration, and their methodological and reporting quality was limited; therefore, confidence in the reported results is limited. Future studies should assess the effects of NSSs with an appropriate intervention duration. Detailed descriptions of interventions, comparators, and outcomes should be included in all reports.
The BMJ
Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non…
Objective To assess the association between intake of non-sugar sweeteners (NSS) and important health outcomes in generally healthy or overweight/obese adults and children.
Design Systematic review following standard Cochrane review methodology.
Data sources…
Design Systematic review following standard Cochrane review methodology.
Data sources…
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Persistent #vasomotor symptoms and #breast cancer in the Women's Health Initiative
https://journals.lww.com/menopausejournal/Abstract/publishahead/Persistent_vasomotor_symptoms_and_breast_cancer_in.97437.aspx
Results: Through 17.9 years (median) follow-up, 1,399 incident breast cancers were seen. Women with persistent VMS (VMS median duration 10+ years) (n = 9,715), compared to women with never VMS (n = 15,784), had a higher breast cancer incidence (hazard ratio HR 1.13 95% confidence interval CI 1.02-1.27). While breast cancer-specific mortality was higher in women with persistent VMS (HR 1.33 95% CI 0.88-2.02), the difference was not statistically significant. Persistent VMS status had no influence on breast cancer overall survival (HR 1.02 95% CI 0.81-1.29).
Conclusion: Women with persistent VMS are more likely to be diagnosed with breast cancer than women who never experienced VMS, but not more likely to die from breast cancer.
Persistent #vasomotor symptoms and #breast cancer in the Women's Health Initiative
https://journals.lww.com/menopausejournal/Abstract/publishahead/Persistent_vasomotor_symptoms_and_breast_cancer_in.97437.aspx
Results: Through 17.9 years (median) follow-up, 1,399 incident breast cancers were seen. Women with persistent VMS (VMS median duration 10+ years) (n = 9,715), compared to women with never VMS (n = 15,784), had a higher breast cancer incidence (hazard ratio HR 1.13 95% confidence interval CI 1.02-1.27). While breast cancer-specific mortality was higher in women with persistent VMS (HR 1.33 95% CI 0.88-2.02), the difference was not statistically significant. Persistent VMS status had no influence on breast cancer overall survival (HR 1.02 95% CI 0.81-1.29).
Conclusion: Women with persistent VMS are more likely to be diagnosed with breast cancer than women who never experienced VMS, but not more likely to die from breast cancer.