Fatigue fracture of the sacrum related to pregnancy

Pregnancy is the period when, due to hormonal and structural changes connected with fetal growth, temporary musculoskeletal dysfunctions occur. Pregnancy-related fatigue fractures may be a rare cause of persistent or increasing pain in the sacrum region

Carbohydrate metabolism and lipid profile in patients with Parkinson’s disease with subthalamic deep brain stimulation

Aim of the study. Assessment of potential effect of subthalamic nucleus deep brain stimulation (STN-DBS) on glucose metabolism in patients with Parkinson’s disease (PD). Clinical rationale for the study. Although a valuable alternative to pharmacotherapy in advanced PD, STN-DBS is thought to negatively affect the cardiometabolic profile of patients (including body mass, lipid profile). Exacerbation of glucose metabolism dysregulation after DBS could therefore be assumed. Material and methods. Two groups of patients with Parkinson’s disease were included: 20 treated pharmacologically (PHT) and 20 newly qualified for STN-DBS (DBS) — with the first assessment prior to surgery, and the second 11 months after surgery on average. Body mass index (BMI), plasma concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and glucose levels during a three-point oral glucose tolerance test were measured three times (median intervals between visits 12 and 14 months respectively). Results. Significant differences between the two groups were noted with respect to changes in BMI, and serum concentration of TG and HDL-C over the course of the study. In the DBS group, a significant increase in BMI (26.42 vs. 27.24 kg/m2, p = 0.03) and TG level (103.8 vs. 142.8 mg/dL, p < 0.001) with a simultaneous decrease in HDL-C level (54.4 vs. 46 mg/dL, p < 0.01) was observed. Mean glucose level after oral glucose administration was lower in the DBS than in the PHT group (147.4 vs. 120.2 mg/dL, p = 0.03 after one hour and 109.9 vs. 82.3 mg/dL, p < 0.01 after two hours) during the second visit. Also inter-visit changes in fasting glucose levels (8.4 mg/dL in the PHT group and –5.8 mg/dL in the DBS group, p = 0.02) differed over the study duration. Conclusions. Our observations are similar to previous ones indicating less favourable changes in BMI and some lipid fractions in patients treated surgically. Interestingly, such a trend was not observed for glucose metabolism parameters, suggesting that mechanisms other than simple body mass changes are involved in early biochemical changes after STN-DBS in PD patients. Clinical implications. The metabolic consequences of DBS require further investigation as an additional factor potentially affecting the outcome of therapy, and routine patient follow-up should not be limited to neurological and psychological assessments

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

Dual-time-point PET/CT study protocol can improve the larynx cancer diagnosis

AimTo evaluate whether the sequential dual-time-point fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (DTP 18F-FDG PET/CT) study improves the differential diagnosis in the larynx.BackgroundIn some cases, the clinical and metabolic similarity of laryngitis and larynx cancer make differential diagnostics difficult when performing standard 18F-FDG PET/CT examinations; therefore, an additional study protocol performance seems to be of reasonable value.Materials and methods90 patients (mean age: 61±11 years, range: 41–84 years): 23 women (mean age: 63±10 years, range: 51–84 years) and 67 men (mean age: 61±11 years, range: 41–80 years) underwent delayed 18F-FDG PET/CT examinations at 60 and 90min post intravenous injection (p.i.) of the radiopharmaceutical 18F-FDG. We compared the metabolic activity of 90 structures divided into following groups: normal larynx (30 patients), laryngitis (30 lesions) and larynx cancer (30 tumors) with maximal and mean standardized uptake value (SUVmax, SUVmean) and the retention index (RI-SUVmax). We used the receiver operating characteristics (ROC) curve to evaluate the SUVmax cut-off values.ResultsThe SUVmax cut-off value at 60 and 90min p.i. of 2.3 (sensitivity/specificity: 96.4%/100%) and 2.4 (94.2%/100%), respectively, distinguished normal and abnormal metabolic activity in the larynx. When laryngitis and tumors were compared, the SUVmax cut-off values obtained after initial and delayed imaging were 3.6 (87.5%/52.0%) and 6.1 (58.3%/84%), respectively. The RI-SUVmax of 1.3% (71.4%/88.1%) suggested abnormality, while RI-SUVmax of 6.6%, malignant etiology (75.0%/80.0%).ConclusionsIn this study, the sequential DTP scanning protocol improved the sensitivity and specificity of the PET/CT method in terms of differential diagnosis within the larynx

Up-Regulation of PARP1 Expression Significantly Correlated with Poor Survival in Mucosal Melanomas

Introduction: Mucosal melanoma is rare and associated with poorer prognosis in comparison to conventional melanoma subtypes. Little is known about the prognostic significance as well as possible associations between PARP1 and immunologic response in mucosal melanoma. Methods: PARP1, PD-L1 and IDO1 immunostains were performed on 192 mucosal melanomas including 86 vulvar, 89 sinonasal, and 17 anorectal melanomas. Results: By Kaplan–Meier analyses, high PARP1 expression correlated with worse overall and melanoma-specific survival (log-rank p values = 0.026 and 0.047, respectively). Tumors with combined PARP1 and IDO1 high expression correlated with worse overall and melanoma-specific survival (p = 0.015, 0.0034 respectively). By multivariate analyses, high PARP1 expression remained a predictor of worse survival independent of stage. By Fisher’s exact test, high PARP1 expression correlated with highly mitogenic tumors (p = 0.02). High tumoral PD-L1 and IDO1 expression were associated with ulcerated primary tumors (p = 0.019, 0.0019, respectively). By linear regression analyses, correlations between PARP1 expression versus IDO1 expression (p = 0.0001) and mitotic index (p = 0.0052) were observed. Conclusion: Increased expression of PARP1 is an independent negative prognostic marker in mucosal melanomas. The association between PARP1 and IDO1 and their combined adverse prognostic role raise the potential of combined therapy in mucosal melanoma

Does the Mesenchymal Stem Cell Source Influence Smooth Muscle Regeneration in Tissue-Engineered Urinary Bladders?

A variety of tissue engineering techniques utilizing different cells and biomaterials are currently being explored to construct urinary bladder walls de novo, but so far no approach is clearly superior. The aim of this study was to determine whether mesenchymal stem cells (MSCs) isolated from different sources, (bone marrow [BM-MSCs] and adipose tissue [ADSCs]), differ in their potential to regenerate smooth muscles in tissue-engineered urinary bladders and to determine an optimal number of MSCs for urinary bladder smooth muscle regeneration. Forty-eight rats underwent hemicystectomy and bladder augmentation with approximately 0.8 cm graft. In the first and second groups, urinary bladders were reconstructed with small intestinal submucosa (SIS) seeded with 10 × 10 or 4 × 10 ADSCs/cm , respectively. In the third and fourth groups, urinary bladders were augmented with SIS seeded with 10 × 10 or 4 × 10 BM-MSCs/cm , respectively. In the fifth group, urinary bladders were augmented with SIS without cells. The sixth group (control) was left intact. Smooth muscle regeneration was evaluated by real-time polymerase chain reaction (RT-PCR) and histological examinations. Histologically, there were no significant differences between urinary bladders augmented with ADSCs and BM-MSCs, but there was a marked increase in smooth muscle formation in bladders augmented with grafts seeded with MSCs in higher density (10 × 10 /cm ) compared to lower density (4 × 10 /cm ). Molecular analysis revealed that bladders reconstructed with ADSC-seeded grafts expressed higher levels of smooth muscle myosin heavy chain, caldesmon, and vinculin. Bladders augmented with unseeded SIS were fibrotic and devoid of smooth muscles. ADSCs and BM-MSCs have comparable smooth muscle regenerative potential, but the number of MSCs used for graft preparation significantly affects the smooth muscle content in tissue-engineered urinary bladders