Is Chronic Inflammation a Possible Cause of Obesity-Related Depression?

Adult obesity has been associated with depression, especially in women. Whether depression leads to obesity or obesity causes depression is unclear. Chronic inflammation is observed in obesity and depression. In 63 obese women without additional diseases depression level was assessed with the Beck's questionnaire. After evaluation of depression level study group was divided into groups according to the mood status (A—without depression, B—mild depression, and C—severe depression), and serum concentration of TNF-α, sTNFs, leptin, and IL-6 were measured by ELISA. No differences in age, body mass, BMI, and body composition were observed in study groups. We did not observe differences of serum concentrations of TNF-α, sTNFRs, leptin, and IL-6 between subgroup A and subgroups B and C. It seems that circulating adipokines did not exert influence on depression levels in obese women

Optimizing Expectations via Mobile Apps: A New Approach for Examining and Enhancing Placebo Effects

There is growing interest in interventions that enhance placebo responses in clinical practice, given the possibility that this would lead to better patient health and more effective therapy outcomes. Previous studies suggest that placebo effects can be maximized by optimizing patients’ outcome expectations. However, expectancy interventions are difficult to validate because of methodological challenges, such as reliable blinding of the clinician providing the intervention. Here we propose a novel approach using mobile apps that can provide highly standardized expectancy interventions in a blinded manner, while at the same time assessing data in everyday life using experience sampling methodology (e.g., symptom severity, expectations) and data from smartphone sensors. Methodological advantages include: 1) full standardization; 2) reliable blinding and randomization; 3) disentangling expectation effects from other factors associated with face-to-face interventions; 4) assessing short-term (days), long-term (months), and cumulative effects of expectancy interventions; and 5) investigating possible mechanisms of change. Randomization and expectancy interventions can be realized by the app (e.g., after the clinic/lab visit). As a result, studies can be blinded without the possibility for the clinician to influence study outcomes. Possible app-based expectancy interventions include, for example, verbal suggestions and imagery exercises, although a large number of possible interventions (e.g., hypnosis) could be evaluated using this innovative approach

Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women?

Objectives: Determine whether introital pelvic floor sonography with transvaginal probe (PFS-TV) can be an independent method in the diagnosis of genuine stress urinary incontinence (SUI) and to create a ultrasonographic diagnostic model to objectify diagnostic process. Material and methods: The study involved 315 patients with a history of urinary incontinence problems. Based on the clinical examination and urodynamic examination, the final diagnosis was made. Patients were divided into two groups. Group I included women with SUI and Group II included patients without SUI (OAB and no-UI). Each patient underwent PFS-TV at rest and during straining. The groups were compared in terms of ultrasound parameters. Results: Patients from both groups differed statistically in a significant way (p < 0.05) in terms of mean distance between the lower edge of the pubic symphysis at rest 19 mm vs 22 mm (Group I vs Group II) and during straining (D1 and D2) 22 mm vs 26 mm, the average value of the γ angle (at rest (γ1) 37.5° vs 40° and during straining (γ2) and 66° vs 58.5°, average difference value of angle γ during straining and at rest (γ2−γ1) 29° vs 14°, and frequency of urethral funneling 89% vs 17%. Two parameters studied during PFS-TV were included in the logistic regression model used to exclude the stress component of urinary incontinence. Diagnostic test parameters of model were sensitivity 86.6%, specificity 90.4%, accuracy 93.1%. Conclusions: PFS-TV makes it possible to exclude the stress component of urinary incontinence. The developed logistic regression model allows for the objectification of the results of ultrasound examination in patients with urinary incontinence

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Marine Strategy Framework Directive - Descriptor 2, Non-Indigenous Species, Delivering solid recommendations for setting threshold values for non-indigenous species pressure on European seas

Marine Non-Indigenous Species (NIS) are animals and plants introduced accidently or deliberately into the European seas, originating from other seas of the globe. About 800 marine non-indigenous species (NIS) currently occur in the European Union national marine waters, several of which have negative impacts on marine ecosystem services and biodiversity. Under the Marine Strategy Framework Directive (MSFD) Descriptor 2 (D2), EU Member States (MSs) need to consider NIS in their marine management strategies. The Descriptor D2 includes one primary criterion (D2C1: new NIS introductions), and two secondary criteria (D2C2 and D2C3). The D2 implementation is characterized by a number of issues and uncertainties which can be applicable to the Descriptor level (e.g. geographical unit of assessment, assessment period, phytoplanktonic, parasitic, oligohaline NIS, etc.), to the primary criterion D2C1 level (e.g. threshold values, cryptogenic, questionable species, etc), and to the secondary criteria D2C2 and D2C3. The current report tackles these issues and provides practical recommendations aiming at a smoother and more efficient implementation of D2 and its criteria at EU level. They constitute a solid operational output which can result in more comparable D2 assessments among MSs and MSFD regions/subregions. When it comes to the policy-side, the current report calls for a number of different categories of NIS to be reported in D2 assessments, pointing the need for the species to be labelled/categorised appropriately in the MSFD reporting by the MSs. These suggestions are proposed to be communicated to the MSFD Working Group of Good Environmental Status (GES) and subsequently to the Marine Strategy Coordination Group (MSCG) of MSFD. Moreover, they can serve as an input for revising the Art. 8 Guidelines

Non-indigenous species refined national baseline inventories : A synthesis in the context of the European Union's Marine Strategy Framework Directive

Refined baseline inventories of non-indigenous species (NIS) are set per European Union Member State (MS), in the context of the Marine Strategy Framework Directive (MSFD). The inventories are based on the initial assessment of the MSFD (2012) and the updated data of the European Alien Species Information Network, in collaboration with NIS experts appointed by the MSs. The analysis revealed that a large number of NIS was not reported from the initial assessments. Moreover, several NIS initially listed are currently considered as native in Europe or were proven to be historical misreportings. The refined baseline inventories constitute a milestone for the MSFD Descriptor 2 implementation, providing an improved basis for reporting new NIS introductions, facilitating the MSFD D2 assessment. In addition, the inventories can help MSs in the establishment of monitoring systems of targeted NIS, and foster cooperation on monitoring of NIS across or within shared marine subregions. Highlights • Refined MSFD baseline inventories of non-indigenous species (NIS) are set in EU. • The inventories are given per EU Member State (MS) and MSFD subregion up to 2012. • The NIS lists provide a basis for reporting new NIS introductions in EU after 2012. • Our work constitutes a milestone for the MSFD Descriptor 2 implementation