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Naunyn-Schmiedeberg's Archives of... Sep 2023Treatment with mirtazapine, a widely prescribed antidepressant, has been linked to weight gain and dyslipidemia. Whether dyslipidemia occurs secondary to increased...
Treatment with mirtazapine, a widely prescribed antidepressant, has been linked to weight gain and dyslipidemia. Whether dyslipidemia occurs secondary to increased appetite due to antidepressant treatment, or due to direct pharmacological effects of mirtazapine is unknown. The aim of this analysis is to complement our previously published results of the effect of mirtazapine on metabolism and energy substrate partitioning from a proof-of-concept, open-label clinical study (ClinicalTrials.gov NCT00878540) in 12 healthy males (20-25 years). We report the effect of a seven-day administration of mirtazapine 30 mg per day on weight and lipid metabolism in healthy men under highly standardized conditions with respect to diet, physical activity and day-night-rhythm and under continuous clinical observation. After a 7-day administration of mirtazapine 30 mg, we observed a statistically significant increase in triglyceride levels (mean change + 4.4 mg/dl; 95% CI [- 11.4; 2.6]; p = 0.044) as well as TG/HDL-C ratio (mean change + 0.2; 95% CI [- 0.4; 0.1]; p = 0.019) and a decrease in HDL-cholesterol (mean change - 4.3 mg/dl; 95% CI [2.1; 6.5]; p = 0.004), LDL-cholesterol (mean change - 8.7 mg/dl; 95% CI [3.8; 13.5]; p = 0.008), total cholesterol (mean change - 12.3 mg/dl; 95% CI [5.4; 19.1]; p = 0.005), and non-HDL-C (mean change - 8.0 mg/dl; 95% CI [1.9; 14.0]; p = 0.023). Notably, weight (mean change - 0.6 kg; 95% CI [0.4; 0.8]; p = 0.002) and BMI (mean change - 0.2; 95% CI [0.1; 0.2]; p = 0.002) significantly decreased. No change in waist circumference (mean change - 0.4 cm; 95% CI [- 2.1; 2.9]; p = 0.838) or waist-to-hip-ratio (mean change 0.0; 95% CI [- 0.0; 0.0]; p = 0.814) was observed. This is the first study showing unfavorable changes in lipid metabolism under mirtazapine in healthy individuals despite highly standardized conditions including dietary restriction, and despite the observation of a decrease of weight. Our findings support the hypothesis that mirtazapine has direct pharmacological effects on lipid metabolism. ClinicalTrials.gov: NCT00878540.
Topics: Humans; Male; Antidepressive Agents; Cholesterol, HDL; Dyslipidemias; Fasting; Mirtazapine; Triglycerides; Weight Gain
PubMed: 36890393
DOI: 10.1007/s00210-023-02448-y -
Journal of Cancer Research and... Dec 2022The aim was to assess the potential reduction in the doses to organs at risk (OARs) and target organ volume by doing replanning on repeat computed tomography (CT) scan...
AIM OF STUDY
The aim was to assess the potential reduction in the doses to organs at risk (OARs) and target organ volume by doing replanning on repeat computed tomography (CT) scan during the 4 week of radiation therapy (RT).
MATERIALS AND METHODS
Twenty-four histologically proven patients of inoperable esophagus carcinoma were studied. All patients received induction chemotherapy followed by concurrent chemotherapy and radiotherapy. CT simulation with proper immobilization was done, and images were transferred to the treatment planning system. Delineation of target volumes and OARs was done, and two plans were generated for 60 Gy in 30 fractions and 40 Gy in 20 fractions with intensity-modulated RT keeping the doses to OARs within the tolerance limits. Replanning for 20 Gy in 10 fractions was done on repeat CT scan during the 4 week of radiotherapy treatment, and potential reduction in doses to OARs and target organ volume was assessed.
RESULTS
A total of 24 cases were analyzed for the adaptive plan with the coverage of the 95% prescription isodose for planning target volume. Statistical analysis was done by t-test. The difference in the doses received by the OARs was analyzed and was seen that due to re CT scan, the doses were reduced to the left lung V (mean 19.23 Gy vs. 17.35 Gy) and D (mean 16.03 Gy vs. 14.25 Gy), right lung V (mean 18.38 Gy vs. 16.66 Gy) and D (mean 15.70 Gy vs. 13.97 Gy), heart V (mean 38.72 Gy vs. 35.32 Gy) and D (mean 26.40 Gy vs. 22.74 Gy), and spine 1% volume (mean 36.54 Gy vs. 33.39 Gy) and D (mean 39.81 Gy vs. 34.34 Gy), gross tumor volume (GTV) (mean 67.37 cm vs. 24.58 cm ) and were all significantly smaller for the adaptive plan.
CONCLUSION
By doing adaptive radiotherapy in the 4 week of treatment using repeat CT scan, along with the response evaluation, there is a significant reduction in the volume of GTV, and replanning of treatment on repeat CT scan also helps us in reducing doses to the OARs resulting in reduced toxicity.
Topics: Humans; Radiotherapy Planning, Computer-Assisted; Radiotherapy Dosage; Radiotherapy, Intensity-Modulated; Organs at Risk; Tomography, X-Ray Computed; Carcinoma; Lung Neoplasms
PubMed: 36510979
DOI: 10.4103/jcrt.JCRT_162_20 -
Bulletin of the National Research Centre 2023The stay-at-home conditions due to the COVID-19 pandemic significantly alter the Malaysian lifestyle, and all Malaysians faced difficulties adopting the new lifestyle. A...
BACKGROUND
The stay-at-home conditions due to the COVID-19 pandemic significantly alter the Malaysian lifestyle, and all Malaysians faced difficulties adopting the new lifestyle. A hypothetico-deductive technique has been conducted in this study, to find out what kind of changes the COVID-19 has brought about in the behavior of Malaysians and how they are coping with the changing lifestyles. According to G* Power 3.1 sample size determination in Malaysia, the entire sample of 112 was sufficient to provide the value for the medium effect size for the computation of the F-tests and the findings were reliable (The Cronbach's alpha values were all above 0.70.). To calculate the mean of the lifestyle during COVID-19, the mean scores range between 1.00 and 5.00 marks indicating much reduced to much increased.
RESULTS
It seemed that the jobs traveling (mean 1.80) and outdoor sports time (mean = 1.94) were somewhat reduced. In contrast, indoor sports activities (mean = 3.01), online games (mean = 2.76), physical exercises (mean = 2.63), and the number of staycations (mean = 2.46) during the pandemic stayed the same. However, religious activities (mean = 3.73), body mass index (mean = 3.54), online shopping (mean = 3.90), sleeping time (mean = 3.43), amount of anxiety (mean = 3.38), amount of caffeine (mean = 3.15), medical consumption (mean = 3.10), watching movies (mean = 3.26), and watching drama series (mean = 3.37) during COVID-19 were somewhat increased. In addition, respondents' time spent on social media (mean = 4.27) and online meetings (mean = 4.37) during COVID-19 were much increased. We found no significant differences in the means of the dependent variables (lifestyle of COVID-19) among all demographic characteristics except age and employment status.
CONCLUSIONS
New behavioral changes bring new challenges. Malaysians should need to adopt some precautions to minimize the negative effect of new behavioral changes in post-COVID-19 life. The results will help policymakers to make the right decisions about improving the quality of life after COVID-19.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s42269-023-00979-1.
PubMed: 36624728
DOI: 10.1186/s42269-023-00979-1 -
Clinical Oral Implants Research Oct 2018The aim of this critical review was to evaluate whether commonly used biologic diagnostic parameters correspond to implant survival and peri-implantitis prevalence. (Review)
Review
OBJECTIVES
The aim of this critical review was to evaluate whether commonly used biologic diagnostic parameters correspond to implant survival and peri-implantitis prevalence.
MATERIALS AND METHODS
Publications from 2011 to 2017 were selected by an electronic search using the Pubmed database of the US National Library of Medicine. Prospective and retrospective studies with a mean follow-up time of at least 5 years and reporting prevalence of peri-implantitis as well as mean bone loss and standard deviation were selected. The correlation between reported prevalence of peri-implantitis and reported implant survival, mean follow-up time, mean bone loss, mean probing depth, and mean bleeding on probing was calculated. Mean bone loss and standard deviation were used for estimation of proportion of implants with bone loss exceeding 1, 2, and 3 mm.
RESULTS
Full-text analysis was performed for 255 papers from 4,173 available ones, and 41 met all the inclusion criteria. The overall mean weighted survival rate was 96.9% (89.9%-100%) and the reported prevalence of peri-implantitis ranged between 0% and 39.7%, based on 15 different case definitions. The overall weighted bone loss was 1.1 mm based on 8,182 implants and an average mean loading time ranging from 5 to 20 years. No correlation was found between mean bone loss and the reported prevalence of peri-implantitis. The estimated prevalence of implants with bone loss above 2 mm was 23%. The overall weighted mean probing depth was 3.3 mm, and mean weighted bleeding was 52.2%. Only a weak correlation was found between survival and function time (r = -0.49). There was no relation between the probing depth or bleeding and the mean bone loss, mean follow-up time, and reported prevalence of peri-implantitis.
CONCLUSION
Biologic parameters mean probing depth and mean bleeding on probing do not correlate with mean bone loss and this irrespective of follow-up. Case definition for peri-implantitis varied significantly between studies indicating that an unambiguous definition based on a specified threshold for bone loss is not agreed upon in the literature.
Topics: Alveolar Bone Loss; Dental Implantation, Endosseous; Dental Restoration Failure; Humans; Peri-Implantitis; Periodontal Index
PubMed: 30306697
DOI: 10.1111/clr.13264 -
Acta Ortopedica Mexicana 2021The aim of the study was to evaluate the outcomes and complications in patients with myelomeningocele who have undergone spinal fusion for neuromuscular scoliosis.
OBJECTIVE
The aim of the study was to evaluate the outcomes and complications in patients with myelomeningocele who have undergone spinal fusion for neuromuscular scoliosis.
MATERIAL AND METHODS
Retrospective study of 40 consecutive patients with myelomeningocele with neuromuscular scoliosis who underwent spinal arthrodesis, treated at our center between July 1991 and July 2028.
RESULTS
Mean follow up was 10 years. There were 19 male and 21 females. The average age at operation was 13 years. The mean preoperative scoliosis curve was 90o. At last follow up, the mean scoliosis curve was 43o. Mean correction of 52%. The average of pelvic obliquity was 19o. At last follow up de obliquity was 9o. Mean correction of 53%. The mean preoperative coronal balance was 28.4 mm. At the last follow up it was 17 mm. Mean correction of 40%. The mean preoperative kyphosis was 50o. At the last follow up it was 41o. Mean correction of 18%. The mean preoperative sagittal balance was 63.3 mm. At the last follow up it was 38.3 mm. Mean correction of 40%. There were 13 complications (32.5%), with infection being the most frequently observed complication.
CONCLUSIONS
The goals of the spinal surgery in patients with MMC are to obtain a stable, balanced and painless spinal fusion. Although the surgical treatment of these patients remains difficult, it is associated with high complication rate.
Topics: Female; Humans; Male; Meningomyelocele; Neuromuscular Diseases; Retrospective Studies; Scoliosis; Spinal Fusion; Treatment Outcome
PubMed: 35451247
DOI: No ID Found -
World Journal of Radiology Nov 2016To find accompanying anomalies of typical and atypical Scheuermann's disease (SD) is reported in the present study.
AIM
To find accompanying anomalies of typical and atypical Scheuermann's disease (SD) is reported in the present study.
METHODS
Study included 20 patients (16 men and 4 women) who had radiological imaging radiography, magnetic resonance imaging (MRI) and computed tomography, if available, due to back pain, curved back and low back pain in November 2011-February 2016 period. Patients were categorized into typical and atypical patterns based on the region involved. Thoracic kyphosis values were measured using real Cobb angle. Accompanying disc degeneration, herniations and spinal cord pathologies were studied using MRI.
RESULTS
Age of the patients ranged from 11.0 to 23.0 (mean 17.2 ± 3.0). Typical pattern of SD were detected in 15 patients while atypical pattern were detected in 5 patients. Cobb angle range was 40.2-67.2 (mean 55.5 ± 8.7) in typical Scheuermann's patients and 24.7-49.9 (mean 36.7 ± 10.8) in atypical ones. Intervertebral level was affected and had the measures of 3-8 (mean 5.3 ± 1.6) and 7-9 (mean 8.2 ± 0.8) in typical and atypical Scheuermann's patients, respectively. Level of degenerative disc disease in MRI was 1-7 discs (mean 4.1 ± 1.7) in typical patients and 5-10 discs (mean 7.6 ± 1.9) in atypical patients.
CONCLUSION
SD can be seen in typical and atypical patterns, typical being more frequent. Because degenerative disc diseases, herniations and cord pathologies such as syringomyelia can accompany SD (albeit more common in atypical pattern), it is necessary to evaluate these patients with plain radiography and MRI together.
PubMed: 27928471
DOI: 10.4329/wjr.v8.i11.895 -
Langenbeck's Archives of Surgery May 2023No randomised clinical trials (RCTs) have simultaneously compared the safety of open (OA), transperitoneal laparoscopic (TLA), posterior retroperitoneal (PRA), and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
No randomised clinical trials (RCTs) have simultaneously compared the safety of open (OA), transperitoneal laparoscopic (TLA), posterior retroperitoneal (PRA), and robotic adrenalectomy (RA) for resecting adrenal tumours.
AIM
To evaluate outcomes for OA, TLA, PRA, and RA from RCTs.
METHODS
A NMA was performed according to PRISMA-NMA guidelines. Analysis was performed using R packages and Shiny.
RESULTS
Eight RCTs with 488 patients were included (mean age: 48.9 years). Overall, 44.5% of patients underwent TLA (217/488), 37.3% underwent PRA (182/488), 16.4% underwent RA (80/488), and just 1.8% patients underwent OA (9/488). The mean tumour size was 35 mm in largest diameter with mean sizes of 44.3 mm for RA, 40.9 mm for OA, 35.5 mm for TLA, and 34.4 mm for PRA (P < 0.001). TLA had the lowest blood loss (mean: 50.6 ml), complication rates (12.4%, 14/113), and conversion to open rates (1.3%, 2/157), while PRA had the shortest intra-operative duration (mean: 94 min), length of hospital stay (mean: 3.7 days), lowest visual analogue scale pain scores post-operatively (mean: 3.7), and was most cost-effective (mean: 1728 euros per case). At NMA, there was a significant increase in blood loss for OA (mean difference (MD): 117.00 ml (95% confidence interval (CI): 1.41-230.00)) with similar blood loss observed for PRA (MD: - 10.50 (95% CI: - 83.40-65.90)) compared to TLA.
CONCLUSION
LTA and PRA are important contemporary options in achieving favourable outcomes following adrenalectomy. The next generation of RCTs may be more insightful for comparison surgical outcomes following RA, as this approach is likely to play a future role in minimally invasive adrenalectomy.
PROSPERO REGISTRATION
CRD42022301005.
Topics: Humans; Middle Aged; Adrenal Gland Neoplasms; Adrenalectomy; Laparoscopy; Length of Stay; Network Meta-Analysis; Retroperitoneal Space; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 37145303
DOI: 10.1007/s00423-023-02911-7 -
The Medical Journal of Malaysia Jul 2022The aim of this study was to compare temperature readings measured at the forehead and wrist against the tympanic temperature which is generally accepted as the standard.
BACKGROUND
The aim of this study was to compare temperature readings measured at the forehead and wrist against the tympanic temperature which is generally accepted as the standard.
METHOD
This is a cross-sectional study carried out on 325 people from the general population entering a private hospital for consultation or work. Forehead and wrist temperature was taken using the CEFC RoHS K3 model (China) and tympanic temperature using the Braun Thermoscan 7 Thermometer Irt6520 by the same investigator on consenting individuals.
RESULTS
There was no significant difference between the forehead (mean =36.6, standard deviation, SD=0.30) and tympanic (mean=36.6, SD=0.41), Z= -1.609, p=0.108. However, there was significant difference between the wrist (mean=36.4, SD= 0.28) and tympanic (mean=36.6, SD=0.41) temperature values, Z= -8.749, p<0.001, the former being lower. Temperature measured at forehead (mean=36.6, SD=0.30) was also significantly higher than the wrist (mean=36.4, SD=0.28), Z= -9.381, p<0.001. The wrist temperature values were lower than forehead and tympanic.
CONCLUSION
Forehead temperature values are better representatives of the core temperature (tympanic) and be the preferred site of measurement compared to the wrist.
Topics: Body Temperature; Cross-Sectional Studies; Forehead; Humans; Prospective Studies; Temperature
PubMed: 35902943
DOI: No ID Found -
Frontiers in Psychology 2021Individuals can perceive the mean emotion or mean identity of a group of faces. It has been considered that individual representations are discarded when extracting a...
Individuals can perceive the mean emotion or mean identity of a group of faces. It has been considered that individual representations are discarded when extracting a mean representation; for example, the "element-independent assumption" asserts that the extraction of a mean representation does not depend on recognizing or remembering individual items. The "element-dependent assumption" proposes that the extraction of a mean representation is closely connected to the processing of individual items. The processing mechanism of mean representations and individual representations remains unclear. The present study used a classic member-identification paradigm and manipulated the exposure time and set size to investigate the effect of attentional resources allocated to individual faces on the processing of both the mean emotion representation and individual representations in a set and the relationship between the two types of representations. The results showed that while the precision of individual representations was affected by attentional resources, the precision of the mean emotion representation did not change with it. Our results indicate that two different pathways may exist for extracting a mean emotion representation and individual representations and that the extraction of a mean emotion representation may have higher priority. Moreover, we found that individual faces in a group could be processed to a certain extent even under extremely short exposure time and that the precision of individual representations was relatively poor but individual representations were not discarded.
PubMed: 34671297
DOI: 10.3389/fpsyg.2021.713212 -
PloS One 2013To evaluate the quality of clinical practice guidelines (CPGs) for otorhinolaryngology in China. (Review)
Review
OBJECTIVE
To evaluate the quality of clinical practice guidelines (CPGs) for otorhinolaryngology in China.
MATERIALS AND METHODS
A systematic search of relevant literature databases (CBM, WANFANG, VIP, CNKI, China Guideline Clearinghouse) published between 1978 and March 2012 was undertaken to identify and select CPGs related to otorhinolaryngology. Four independent reviewers assessed the eligible guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Their degree of agreement was evaluated using the intraclass correlation coefficient (ICC).
RESULT
From 170 citations, 21 relevant guidelines were included. The overall agreement among reviewers was moderate (ICC = 0.87; 95% confidence interval [CI], 0.78-0.91). The scores for each of the AGREE domains were the following: "scope and purpose" (mean ± standard error [SE] = 45.4±4.4; ICC = 0.92), "stakeholder involvement" (mean ± SE = 30.4±3.1; ICC = 0.81), "rigor of development" (mean ± SE = 20.9±2.8; ICC = 0.87), "clarity of presentation" (mean ± SE = 48.8±3.7; ICC = 0.80), "applicability" (mean ± SE = 12.6±1.7; ICC = 0.72), and "editorial independence" (mean ± SE = 6.2±0.8; ICC = 0.76). Three guidelines (14%) mentioned updates, and the average update frequency was 7 years. None used the GRADE system.
CONCLUSION
The quality of otorhinolaryngology guidelines in China is low. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.
Topics: China; Humans; Otolaryngology; Practice Guidelines as Topic; Quality Control
PubMed: 23349719
DOI: 10.1371/journal.pone.0053566