scholarly journals Exaggerated postprandial GLP-1 secretion following esophagectomy is not associated with gastric emptying and intestinal transit

2020 ◽  
Author(s):  
C F Murphy ◽  
J A Elliott ◽  
N G Docherty ◽  
A A Mohamed ◽  
R P Vincent ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Gastrointestinal Transit ◽  
Symptom Burden ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Gastrointestinal Transit Time ◽  
Control Subjects ◽  
Proximal Small Intestine ◽  
Gut Hormone ◽  
Glucagon Like Peptide 1

Summary Esophagectomy causes postprandial symptoms associated with an exaggerated postprandial gut hormone response. This study aimed to compare the gastrointestinal transit time of patients 1 year after esophagectomy with unoperated controls, including its relation to satiety gut hormone release. In this cross-sectional study, consecutive, disease-free patients after esophagectomy with pyloroplasty were compared with unoperated control subjects to assess gastric emptying (GE) and cecal arrival time (CAT). Serial plasma samples were collected before, and for 300 minutes after, a mixed-meal challenge. Body composition was assessed, and symptom scores were calculated. Eleven patients 1 year post-esophagectomy (age: 62.6 ± 9.8, male: 82%) did not show a significantly different GE pattern compared with 10 control subjects (P = 0.245). Rather, patients could be categorized bimodally as exhibiting either rapid or slow GE relative to controls. Those with rapid GE trended toward a higher postprandial symptom burden (P = 0.084) without higher postprandial glucagon-like peptide-1 (GLP-1) secretion (P = 0.931). CAT was significantly shorter after esophagectomy (P = 0.043) but was not significantly associated with GE, GLP-1 secretion, or symptom burden. Neither early nutrient delivery to the proximal small intestine nor to the colon explains the exaggerated postprandial GLP-1 response after esophagectomy. GE varies significantly in these patients despite consistent pyloric management.

scholarly journals Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049967
Author(s):  
Karen Sól Saevarsdóttir ◽  
Hildur Ýr Hilmarsdóttir ◽  
Ingibjörg Magnúsdóttir ◽  
Arna Hauksdóttir ◽  
Edda Bjork Thordardottir ◽  
...  
Keyword(s):  
Severe Disease ◽  
Symptom Burden ◽  
Cross Sectional Study ◽  
Illness Severity ◽  
University Education ◽  
Adjusted Relative Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Increased Risk

ObjectiveTo test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity.DesignPopulation-based cross-sectional study.SettingIceland.ParticipantsA total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19.Main outcome measuresSymptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities.ResultsCompared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44).ConclusionsSevere disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19.

scholarly journals How do delirium motor subtypes differ in phenomenology and contributory aetiology? a cross-sectional, multisite study of liaison psychiatry and palliative care patients

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041214
Author(s):  
Kevin Glynn ◽  
Frank McKenna ◽  
Kevin Lally ◽  
Muireann O’Donnell ◽  
Sandeep Grover ◽  
...  
Keyword(s):  
Palliative Care ◽  
Rating Scale ◽  
Symptom Burden ◽  
Systemic Infection ◽  
International Study ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Liaison Psychiatry ◽  
Cross Sectional ◽  
Hypoactive Delirium

ObjectivesTo investigate whether delirium motor subtypes differ in terms of phenomenology and contributory aetiology.DesignCross-sectional study.SettingInternational study incorporating data from Ireland and India across palliative care, old age liaison psychiatry and general adult liaison psychiatry settings.Participants1757 patients diagnosed with delirium using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM IV).Primary and secondary outcome measuresHyperactive, mixed and hypoactive delirium subtypes were identified using the abbreviated version of the Delirium Motor Subtype Scale. Phenomenology was assessed using the Delirium Rating Scale Revised. Contributory aetiologies were assessed using the Delirium Aetiology Checklist (DEC), with a score >2 indicating that the aetiology was likely or definitely contributory.ResultsHypoactive delirium was associated with dementia, cerebrovascular and systemic infection aetiologies (p<0.001) and had a lower overall burden of delirium symptoms than the other motor subtypes. Hyperactive delirium was associated with younger age, drug withdrawal and the DEC category other systemic aetiologies (p<0.001). Mixed delirium showed the greatest symptom burden and was more often associated with drug intoxication and metabolic disturbance (p<0.001). All three delirium motor subtypes had similar levels of impairment in attention and visuospatial functioning but differed significantly when compared with no subtype (p<0.001).ConclusionsThis study indicates a pattern of aetiology and symptomatology of delirium motor subtypes across a large international sample that had previously been lacking. It serves to improve our understanding of this complex condition and has implications in terms of early detection and management of delirium.

scholarly journals Comparison between Widefield Optical Coherence Tomography Devices in Eyes with High Myopia

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 658
Author(s):  
Federico Corvi ◽  
Federico Zicarelli ◽  
Matteo Airaldi ◽  
Salvatore Parrulli ◽  
Mariano Cozzi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
High Myopia ◽  
Cross Sectional Study ◽  
Horizontal Line ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
Image Artifact ◽  
Control Subjects ◽  
And Control

Background: To compare four different optical coherence tomography (OCT) devices for visualization of retinal and subretinal layers in highly myopic eyes. Methods: In this prospective, observational, cross-sectional study, consecutive patients with high myopia and control subjects were imaged by four OCT devices: Spectralis OCT2, PlexElite 2.0 100 kHz, PlexElite 2.0 200 kHz and the Canon Xephilio OCT-S1. The acquisition protocol for comparison consisted of single vertical and horizontal line scans centered on the fovea. Comparison between the devices in the extent of visible retina, presence of conjugate image or mirror artifacts, visibility of the sclerochoroidal interface and retrobulbar tissue. Results: 30 eyes with high myopia and 30 control subjects were analyzed. The visualized RPE length was significantly different between the OCT devices with Xephilio OCT-S1 imaging the largest extent (p < 0.0001). The proportion of eyes with conjugate image artifact was significantly higher with the Spectralis OCT (p < 0.0001), and lower with the PlexElite 200 kHz (p < 0.0001). No difference in visibility of the sclerochoroidal interface was noted among instruments. The retrobulbar tissue was visible in a higher proportion of eyes using swept-source PlexElite 100 kHz and 200 kHz (p < 0.007) compared to the other devices. Conclusions: In highly myopic eyes, the four OCT devices demonstrated significant differences in the extent of the retina imaged, in the prevalence of conjugate image artifact, and in the visualization of the retrobulbar tissue.

scholarly journals Health hazards and risks for musculoskeletal problems among child labourers in the brickfield sector of West Bengal, India

2018 ◽  
Vol 11 (4) ◽  
pp. 250-257 ◽  
Author(s):  
Banibrata Das
Keyword(s):  
Heart Rate ◽  
Occupational Health ◽  
Respiratory Health ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Health Hazards ◽  
Cross Sectional ◽  
Control Subjects ◽  
Strenuous Activity ◽  
Musculoskeletal Problems

Abstract Aims The purpose of this study was to describe the health hazards among child labourers in brickfields, and to assess occupational health problems, together with physiological and respiratory stress, compared with child control subjects. Methods A cross-sectional study was conducted on 112 child brickfield workers and 120 control subjects, and a modified Nordic Questionnaire was applied to assess the discomfort felt among both groups of workers. Physiological assessment of the workload was carried out by the measurement of heart rate, blood pressure and spirometry of the workers. Results Child brickfield workers suffer from pain, especially in the lower back (97%), shoulder (88%), hands (82%), wrist (76%), neck (73%) and ankle (71%). The post-activity heart rate of the child brickfield workers was 166.5 beats/min, whereas the systolic and diastolic blood pressures were 132.2 and 67.2 mm/Hg, respectively. The forced vital capacity value of child brickfield workers was 2.04, and in the case of the controls it was 2.18, which was significantly different. The forced expiratory volumes in 1 s of experimental and control subjects were 1.82 and 1.92, respectively. The peak expiratory flow rate was significantly different between the two groups. Conclusions Most of the brick-making activities were strenuous ones that affected the children. The cardiovascular and respiratory health of the child brickfield workers has changed markedly due to strenuous activity. The child brickfield workers also experienced other occupational health problems and severe musculoskeletal pain.

scholarly journals Correlation between Corneal Elevation Topography and Perimetric Changes in Patients with Primary Open Angle Glaucoma

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Visual Field ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Cross Sectional Study ◽  
Visual Field Examination ◽  
Cross Sectional ◽  
Control Subjects ◽  
Scheimpflug Imaging ◽  
Average Maximum ◽  
Grading Scale

Aim: The aim of this study is to assess Scheimpflug topographic elevation maps in patients with POAG and correlate the results with their perimetric changes. Methods: This was an analytical observational cross-sectional study. The study included 130 eyes of 70 subjects which were divided into 78 eyes of 44 patients diagnosed with POAG and 52 eyes of 26 control subjects. Measurement of IOP, visual field examination in patients with POAG using Humphrey Field Analyzer (2003 Carl Zeiss Meditec), Germany were done. Subjects were scanned using TMS-5 topographer (Topographic Modeling System, version 5. Tomey Corp. Nagoya, Japan) to measure central corneal thickness, mean anterior keratometry, maximum anterior and posterior topographic elevation maps in the central 3, 5, and 7 mm. Results: 78 patients with POAG classified according to visual field deterioration using Hodapp-Anderson-Parrish grading scale into mild glaucoma 33 eyes, moderate glaucoma 19 eyes, severe glaucoma 26 eyes, and 52 eyes control were included in the study. The mean age of the patients with POAG was 57.82 ± 7.78 years; 22 eyes (50%) were male and 22 eyes (50%) were female. The average age of control subjects was 56.62 ± 8.48 years; 12 eyes (46.2%) were male and 14 eyes (53.8%) were female, average CCT was 530.3 ± 23.58 µm, average mean anterior keratometry (MAK) was 42.97 ± 1.42 D, average maximum anterior elevation (MAE) in 3,5 and 7mm zone was 5.31 ± 2.28, 12.10 ± 6.94 and 44.04 ± 21.99 µm respectively and average maximum posterior elevation (MPE) in 3,5 and 7mm zone was 8.46 ± 2.10, 19.90 ± 9.39 and 62.72 ± 28.82 µm respectively in patients with POAG, whereas average CCT was 543.0 ± 31.02µm, average MAK was 43.11 ± 1.73 D, average MAE in 3,5 and 7mm zone was 4.52 ± 1.97, 5.90 ± 2.71 and 27.19 ± 8.55 µm respectively. Conclusion: Evaluation of corneal elevation topography by scheimpflug imaging showed forward shifting of the anterior and posterior corneal surfaces in POAG.

A-141 Vindicated by Awareness: Acting with Awareness May Compensate for Inhibitory Deficits in ADHD Symptom Burden

2021 ◽  
Vol 36 (6) ◽  
pp. 1194-1194
Author(s):  
Maria E Dragulin ◽  
Claudia Jacova
Keyword(s):  
Inhibitory Control ◽  
Adhd Symptom ◽  
Rating Scale ◽  
Symptom Burden ◽  
Cross Sectional Study ◽  
Trait Mindfulness ◽  
Five Facet Mindfulness Questionnaire ◽  
Cross Sectional ◽  
Interference Test ◽  
Acting With Awareness

Abstract Objective To understand the role of trait mindfulness acting-with-awareness in the relationship between inhibitory control and ADHD symptom burden. Method We conducted a cross-sectional study with 103 adults, aged 18 to 86, mean age = 46, mean education = 15 years, 46% male. Participants were recruited in North Western Oregon counties. Eligible individuals were aged &gt;18, fluent in English, and with normal global cognition (Montreal Cognitive Assessment, MoCA&gt;22). The presence of ADHD diagnoses/symptoms was not required. Participants were administered the Adult Investigator Symptom Rating Scale (AISRS), the Five Facet Mindfulness Questionnaire (FFMQ) Acting with Awareness, and the DKEFS Color-Word Interference Test (CWIT). We examined the contribution of CWIT (time/sec), acting-with-awareness (AA), and their interaction in age-adjusted multiple regression predicting AISRS total score. Results Descriptives for the measures of interest were AISRS (M = 19.21, SD = 12.72), CWIT (M = 55.66, SD = 15.27), and FFMQ-AA (M = 25.10, SD = 7.17). Both CWIT and FFMQ-AA predicted AISRS when analyzed independently (B = 0.274, p = 0.14, R2 = 0.13 and B = -0.633, p &lt; 0.001, R2 = 0.45). In the combined model, FFMQ-AA (B = -1.06, p = 0.000) but not CWIT predicted AISRS, R2 = 0.47. The interaction was not significant, p = 0.55. Conclusion AA is a powerful predictor of ADHD symptom burden: it accounts for almost half of the variance, and removes any contribution from inhibitory control. Our finding suggests that trait mindfulness has a more important role in shaping ADHD than cognition.

scholarly journals Trimethylamine N-oxide and the reverse cholesterol transport in cardiovascular disease: a cross-sectional study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Laura Bordoni ◽  
Joanna J. Samulak ◽  
Angelika K. Sawicka ◽  
Iwona Pelikant-Malecka ◽  
Adrianna Radulska ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Transfer Protein ◽  
Control Subjects ◽  
Atherosclerotic Lesions ◽  
Complex Picture ◽  
Artery Disease ◽  
Genetically Determined ◽  
And Control

Abstract The early atherosclerotic lesions develop by the accumulation of arterial foam cells derived mainly from cholesterol-loaded macrophages. Therefore, cholesterol and cholesteryl ester transfer protein (CETP) have been considered as causative in atherosclerosis. Moreover, recent studies indicate the role of trimethylamine N-oxide (TMAO) in development of cardiovascular disease (CVD). The current study aimed to investigate the association between TMAO and CETP polymorphisms (rs12720922 and rs247616), previously identified as a genetic determinant of circulating CETP, in a population of coronary artery disease (CAD) patients (n = 394) and control subjects (n = 153). We also considered age, sex, trimethylamine (TMA) levels and glomerular filtration rate (GFR) as other factors that can potentially play a role in this complex picture. We found no association of TMAO with genetically determined CETP in a population of CAD patients and control subjects. Moreover, we noticed no differences between CAD patients and control subjects in plasma TMAO levels. On the contrary, lower levels of TMA in CAD patients respect to controls were observed. Our results indicated a significant correlation between GFR and TMAO, but not TMA. The debate whether TMAO can be a harmful, diagnostic or protective marker in CVD needs to be continued.

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