Menopause is associated with decreased postprandial ghrelin, while a history of anorexia nervosa is associated with increased total ghrelin

Abstract

Introduction

Middle age has been linked with various dysfunctional eating patterns in women. The hormone ghrelin is related to food intake, with plasma levels rising before eating and decreasing immediately afterwards. Animal research has shown that estradiol is an antagonist of ghrelin. Given that both menopause and anorexia nervosa (AN) are states characterised by reduced estradiol, the goal of the present study was to investigate for the first time whether menopausal status and a history of AN are linked with altered ghrelin levels in middle‐aged women. Based on previous research, we hypothesised that a) post‐menopausal women would demonstrate comparably increased ghrelin after food intake and b) women with a history of AN would exhibit increased total ghrelin levels.

Methods

Healthy, middle‐aged women (N=57) were recruited. N=31 were post‐menopausal and n=27 had a history of AN. Plasma was repeatedly collected before and after a meal standardised in terms of caloric content. Areas under the curves were calculated to indicate total (AUCg) and postprandial ghrelin (AUCi).

Results

Menopausal status was linked with postprandial ghrelin (AUCi ‐1.6±2.2 vs. ‐2.9±2.6; p=.058), while a history of AN was linked with total ghrelin (AUCg 36.2±5.6 vs. 39.0±3.7; p=.050). There were no interaction effects (both p>.466). A closer examination of the effects revealed that post‐menopausal women showed marginally greater decreases in ghrelin immediately after food intake (p=.064) and marginally greater re‐increases after 60 min (p=.084) when compared to pre‐menopausal women. Women with a history of AN had significantly higher total ghrelin when compared to women without a history of AN (p=.042).

Discussion

Post‐menopause was linked with higher sensitivity of ghrelin to food intake (trend), while a history of AN was related to greater total ghrelin. Future research should investigate to what extent the observed alterations in ghrelin may affect dysfunctional eating behaviour during middle age.

This article is protected by copyright. All rights reserved.

https://ift.tt/2RUgWHq

Possible hints and pitfalls in diagnosing Peutz-Jeghers syndrome

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2PxoN17

Dysregulated glucose homeostasis in congenital central hypoventilation syndrome

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2QWlIV6

Targeted next generation sequencing in patients with maturity-onset diabetes of the young (MODY)

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2PCzmA0

Cryosurgery combined with topical interventions for actinic keratosis: A systematic review and meta‐analysis

Summary

Background

Actinic keratoses (AK) are early in situ carcinomas of the skin due to cumulative sun exposure. Cryosurgery is an easy and practicable lesion‐directed approach for isolated lesions.

Objectives

To investigate if an upfront combination of cryosurgery with a topical intervention is superior to cryosurgery alone for AK.

Methods

We performed a systematic literature research in Medline, Embase, and CENTRAL and hand‐searched pertinent trial registers for eligible randomized controlled trials until 17 July 2018. Results from individual studies were pooled using a random‐effects model. The risk of bias was estimated with the Cochrane Risk of Bias Tool and the quality of evidence of the outcomes with the GRADE approach.

Results

Out of 1,758 records initially identified, 9 studies with a sample size of 1,644 patients were included. Cryosurgery in combination with a topical approach showed significantly higher participant complete clearance rates compared to monotherapy (RR 1·74, 95% CI 1·25‐2·43, I²=73%, 8 studies. The participant partial clearance rate was not statistically different (RR 1·64, 95% CI 0·88‐3·03, I²=77%, 3 studies). The number of patients who completed the study protocol and did not withdraw due to adverse events was equal in both groups (RR 0·98, 95% CI 0·95‐1·01, I²=75%, 7 studies). The studies were estimated at high risk for selective reporting bias.

Conclusions

Our results suggest superiority of a combination regimen regarding AK clearance with equal tolerability. This study highlights the importance of a field‐directed approach in patients with multiple AK or field‐cancerization.

This article is protected by copyright. All rights reserved.

https://ift.tt/2DqMvos

Efficacy of nivolumab monotherapy against acral lentiginous melanoma and mucosal melanoma in Asian patients

Abstract

Early clinical trials showed that treatment with anti‐programmed death‐1 (anti‐PD‐1) agents, such as nivolumab and pembrolizumab, led to marked improvements in the prognosis of advanced melanoma patients. However, most of the large‐scale studies of such treatment mainly analyzed the efficacy of anti‐PD‐1 agents in Caucasian populations. Since the clinical subtypes of melanoma differ widely among populations, and the response to anti‐PD‐1 agents is known to vary among the clinical subtypes of the disease, the efficacy of anti‐PD‐1 agents in Asian populations remains unclear.

This article is protected by copyright. All rights reserved.

https://ift.tt/2Q6aQqe

Sex‐related differences in response to zinc pyrithione shampoo versus non‐anti‐dandruff shampoo

Abstract

Objective

Sex‐related differences in skin properties may be expected to impact on dandruff formation and treatment. A meta‐analysis approach was undertaken to investigate potential differences between males and females in response to zinc pyrithione (ZnPT) treatment versus non‐anti‐dandruff (AD) shampoo. A separate pooled statistical analysis of ceramide and total protein loss endpoints was also undertaken to assess potential sex‐related differences in stratum corneum properties that might influence response to ZnPT versus non‐AD shampoo in subjects with dandruff.

Methods

The meta‐analysis approach included data from 17 half‐head, double‐blind, randomized studies (N=2088) undertaken in Asia to assess the effectiveness of 1% ZnPT shampoo and/or non‐AD shampoo in reducing dandruff severity, as assessed by Total Weighted Head Score Adherent Flake (TWHS‐AF) methodology. Treatment duration was 4 weeks, with TWHS‐AF measured at weekly intervals. Data from an additional three studies (N=143) conducted in Asia were included in the pooled analysis of ceramide levels and protein loss from scalp skin of subjects with dandruff.

Results

Response to 1% ZnPT versus non‐AD shampoo was greater in males than in females at all time points; after 4 weeks, the between‐treatment difference in TWHS‐AF was −17.5 (95% confidence interval [CI] −19.5, −15.5) in males and −11.1 (−13.2, −8.9) in females. Sex‐related differences were observed between males and females in response to both 1% ZnPT and non‐AD shampoos. Males had a stronger response than females to treatment with 1% ZnPT shampoo, while dandruff decreased to a greater extent in females than in males when using non‐AD shampoo. Statistically significant sex‐related differences in ceramide levels and total protein loss were observed (both P<0.01). Ceramide levels were 0.76 times lower (95% CI 0.60, 0.97) in males than in females, while total protein loss was 1.4 times greater (95% CI 1.1, 1.9) in males than in females.

Conclusion

Males show a greater response than females to 1% ZnPT shampoo, while females show a greater response than males to non‐AD shampoo. These findings may in part be explained by the sex‐related differences observed in stratum corneum properties, which may make males more prone to dandruff than females.

This article is protected by copyright. All rights reserved.

https://ift.tt/2FC1NJU

The cortical face network of the prosopagnosic patient PS with fast periodic stimulation in fMRI

Publication date: Available online 17 November 2018

Source: Cortex

Author(s): Xiaoqing Gao, Quoc C. Vuong, Bruno Rossion

Abstract

Following brain damage, the patient PS suffers from selective impairment in recognizing individuals by their faces, i.e. prosopagnosia. Her case has been documented in more than 30 publications to date, informing about the nature of individual face recognition and its neural basis. Here we report new functional neuroimaging data obtained on PS with a recently developed fast periodic stimulation functional imaging (FPS-fMRI) paradigm combining high sensitivity, specificity and reliability in identifying the cortical face-selective network (Gao et al., 2018). We define the extent of the large and reliable face-selective activation in the lateral section of the right middle fusiform gyrus, i.e. right FFA, which forms a single cluster of activation lying at the anterior border of the patient's main lesion in the inferior occipital gyrus. The contribution of posterior face-selective responses in the right or left inferior occipital gyrus is ruled out, strongly supporting the view that face-selective activity emerges in the right middle fusiform gyrus of the patient's brain from non-face-selective inputs from early visual areas. Despite this, low-level visual cues, i.e. amplitude spectrum of images, do not contribute to neural face-selective responses anywhere in the patient's cortical face network. This sensitive face-localizer approach also reveals an intact face-selective network anterior to the fusiform gyrus, including clusters in the ventral anterior temporal lobe (occipito-temporal sulcus and temporal pole) and the inferior frontal gyrus, with a right hemispheric dominance. Overall, with the exception of the left inferior occipital gyrus, the cortical face network of the prosopagnosic patient PS appears remarkably similar to typical individuals in non-brain damaged regions. However, unlike in neurotypical adults tested in the present study, including age-matched controls, a novel paradigm based on FPS-FMRI confirms that the patient's face network is insensitive to differences between rapidly presented pictures of unfamiliar individual faces, in line with her prosopagnosia.

https://ift.tt/2qQJQNl

Covert Attention Beyond the Range of Eye-movements: Evidence for a Dissociation between Exogenous and Endogenous orienting

Publication date: Available online 17 November 2018

Source: Cortex

Author(s): Soazig Casteau, Daniel T. Smith

Abstract

The relationship between covert shift of attention and the oculomotor system has been the subject of numerous studies. A widely held view, known as Premotor Theory, is that covert attention depends upon activation of the oculomotor system. However, recent work has argued that Premotor Theory is only true for covert, exogenous orienting of attention and that covert endogenous orienting is largely independent of the oculomotor system. To address this issue we examined how endogenous and exogenous covert orienting of attention was affected when stimuli were presented at a location outside the range of saccadic eye movements. Results from Experiment 1 showed that exogenous covert orienting was abolished when stimuli were presented beyond the range of saccadic eye movements, but preserved when stimuli were presented within this range. In contrast, in Experiment 2 endogenous covert orienting was preserved when stimuli appeared beyond the saccadic range. Finally, Experiment 3 confirmed the observations of Exp.1 and 2. Our results demonstrate that exogenous, covert orienting is limited to the range of overt saccadic eye movements, whereas covert endogenous orienting is not. These results are consistent with a weak, exogenous-only version of Premotor Theory.

https://ift.tt/2FttYKI

Mapping Whole Brain Connectivity Changes: The Potential Impact of Different Surgical Resection Approaches for Temporal Lobe Epilepsy

Publication date: Available online 17 November 2018

Source: Cortex

Author(s): Natalie Busby, Ajay D. Halai, Geoffrey J.M. Parker, David J. Coope, Matthew A. Lambon Ralph

Abstract

In neurosurgery there are several situations that require transgression of the temporal cortex. For example, a subset of patients with temporal lobe epilepsy require surgical resection (most typically, en-bloc anterior temporal lobectomy). This procedure is the gold standard to alleviate seizures but is associated with chronic cognitive deficits. In recent years there have been multiple attempts to find the optimum balance between minimising the size of resection in order to preserve cognitive function, while still ensuring seizure freedom. Some attempts involve reducing the distance that the resection stretches back from the temporal pole, whilst others try to preserve one or more of the temporal gyri. More recent advanced surgical techniques (selective amygdalo-hippocamptectomies) try to remove the least amount of tissue by going under (sub-temporal), over (trans-Sylvian) or through the temporal lobe (middle-temporal), which have been related to better cognitive outcomes. Previous comparisons of these surgical techniques focus on comparing seizure freedom or behaviour post-surgery, however there have been no systematic studies showing the effect of surgery on white matter connectivity. The main aim of this study, therefore, was to perform systematic 'pseudo-neurosurgery' based on existing resection methods on healthy neuroimaging data and measuring the effect on long-range connectivity. We use anatomical connectivity maps (ACM) to determine long-range disconnection, which is complementary to existing measures of local integrity such as fractional anisotropy or mean diffusivity. ACMs were generated for each diffusion scan in order to compare whole-brain connectivity with an 'ideal resection', nine anterior temporal lobectomy and three selective approaches. For en-bloc resections, as distance from the temporal pole increased, reduction in connectivity was evident within the arcuate fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and the uncinate fasciculus. Increasing the height of resections dorsally reduced connectivity within the uncinate fasciculus. Sub-temporal amygdalohippocampectomy resections were associated with connectivity patterns most similar to the 'ideal' baseline resection, compared to trans-Sylvian and middle-temporal approaches. In conclusion, we showed the utility of ACM in assessing long-range disconnections/disruptions during temporal lobe resections, where we identified the sub-temporal resection as the least disruptive to long-range connectivity which may explain its better cognitive outcome. These results have a direct impact on understanding the amount and/or type of cognitive deficit post-surgery, which may not be obtainable using local measures of white matter integrity.

https://ift.tt/2qSNFle

Brain activity in struggling readers before intervention relates to future reading gains

Publication date: Available online 16 November 2018

Source: Cortex

Author(s): Tehila Nugiel, Mary Abbe Roe, W.Patrick Taylor, Paul T. Cirino, Sharon R. Vaughn, Jack M. Fletcher, Jenifer Juranek, Jessica A. Church

Abstract

Neural markers for reading-related changes in in response to intervention may represent biomarkers that could inform intervention plans as a potential index of the malleability of the reading network in struggling readers. Particularly interesting is the role of activation outside the reading network, especially in executive control networks important for reading comprehension. However, it is unclear whether any intervention-related executive control changes in the brain are specific to reading tasks or reflect more domain general changes. Brain changes associated with reading gains over time were compared for a sentence comprehension task as well as for a non-lexical executive control task (a behavioral inhibition task) in upper-elementary struggling readers, and in grade-matched non-struggling readers. Functional MRI scans were conducted before and after 16 weeks of reading intervention. Participants were grouped as improvers and non-improvers based on the consistency and size of post-intervention gains across multiple post-test measures. Engagement of the right fusiform during the reading task, both before and after intervention, was related to gains from remediation. Additionally, pre-intervention activation in regions that are part of the default-mode network (precuneus) and the fronto-parietal network (right posterior middle temporal gyrus) separated improvers and non-improvers from non-struggling readers. None of these differences were observed during the non-lexical inhibitory control task, indicating that the brain changes seen related to intervention outcome in struggling readers were specific to the reading process.

https://ift.tt/2FsjnQm

A simple technique to increase field of view (FOV) of a USB dematoscope

Publication date: Available online 16 November 2018

Source: Journal of the American Academy of Dermatology

Author(s): Deepak Jakhar, Ishmeet Kaur

https://ift.tt/2FpoCQN

Skin Diseases of the Breast and Nipple Part 2: Inflammatory and Infectious Diseases

Publication date: Available online 16 November 2018

Source: Journal of the American Academy of Dermatology

Author(s): Reid A. Waldman, Justin Finch, Jane M. Grant-Kels, Diane Whitaker-Worth

Abstract

Certain dermatologic conditions are unique to the breast and nipple, whereas others may incidentally involve these structures. All require a nuanced approach to diagnosis and treatment due to the functional, sexual and aesthetic importance of this area. The lactating patient requires special management since certain treatment options are contraindicated. All dermatologic conditions involving the breast and nipple require careful evaluation since breast malignancy can be mistaken for a benign condition or may trigger the development of certain dermatologic conditions. This article reviews common and uncommon inflammatory and infectious conditions of the breast and nipple and provides insight into diagnosis and treatment of this heterogeneous group of diseases. For the purposes of this article, these conditions are divided into 4 distinct categories: 1) Dermatitis; 2) Radiation-induced Changes; 3) Mastitis; and 4) miscellaneous dermatologic conditions of the breast and nipple.

https://ift.tt/2qQzxZy

Skin Diseases of the Breast and Nipple Part I: Benign and Malignant Tumors

Publication date: Available online 16 November 2018

Source: Journal of the American Academy of Dermatology

Author(s): Reid A. Waldman, Justin Finch, Jane M. Grant-Kels, Christina Stevenson, Diane Whitaker-Worth

Abstract

Evaluation and management of dermatologic diseases of the breast and nipple requires an understanding of the unique anatomy of the breast and nipple as well as an awareness of the significant emotional, cultural, and sexual considerations that may come into play when treating this anatomic area. Part I of this 2 Part CME Series reviews breast anatomy, congenital breast anomalies, and benign and malignant breast tumors. Specifically, an emphasis is placed on inflammatory breast cancer and breast cancer with non-inflammatory skin involvement as well as on cutaneous metastases to the breast and from breast cancer. Familiarity of the dermatologist with the cutaneous manifestations of breast cancer will facilitate the diagnosis of breast malignancy and assist with staging, prognostication, and evaluation for recurrence. This article also discusses genodermatoses that predispose to breast pathology and provides imaging recommendations for evaluating a palpable breast mass.

https://ift.tt/2FpoCAh

Scholar : Dramatherapy, Volume 39, Issue 3, July - November 2018 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content Dramatherapy, Volume 39, Issue 3, July - November 2018 is now available online on Taylor & Francis Online. Special Issue: LGBTQ+ Perspectives. Guest Editors: Ryan Campinho Valadas and Mandy Carr This new issue contains the following articles: Editorials Editorial Ryan Campinho Valadas & Mandy Carr Pages: 123-126 | DOI: 10.1080/02630672.2018.1526310 Articles Should a dramatherapist disclose their sexual orientation to their clients? Perhaps they should be prepared to Becky Sheppard Pages: 127-140 | DOI: 10.1080/02630672.2018.1510019 'Prove it' working with LBGTQ+ Asylum seekers who must prove their sexuality to stay in the UK Jason Ward Pages: 141-151 | DOI: 10.1080/02630672.2018.1524503 Dramatherapy and gender: shattering norms and unearthing possibilities Georgina Beth Wilkinson Pages: 152-162 | DOI: 10.1080/02630672.2018.1511815 From isolation towards intimacy: healing emotional wounds in HIV+ gay men Ryan Campinho Valadas Pages: 163-178 | DOI: 10.1080/02630672.2018.1526309 Clinical Comment Introduction to Clinical Comments Ryan Campinho Valadas & Mandy Carr Pages: 179-180 | DOI: 10.1080/02630672.2018.1526311 On being a gay therapist: a reflective memoir John Christey-Casson Pages: 181-182 | DOI: 10.1080/02630672.2018.1508604 I am such a woman: the complexities of being a bisexual dramatherapist Hayley Southern Pages: 183-185 | DOI: 10.1080/02630672.2018.1508603 Family dramatherapy (FDT) and LGBTQ+ Christian Dixon Pages: 186-191 | DOI: 10.1080/02630672.2018.1514062 JOIN US at the 2019 JCCAP Future Directions Forum June 28-29, 2019 - Professional development training in child and adolescent mental health: http://bit.ly/JCCAP-FDF-2019-EB To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Cluster analysis of autoimmune rheumatic diseases based on autoantibodies. New insights for polyautoimmunity

Publication date: Available online 17 November 2018

Source: Journal of Autoimmunity

Author(s): Nicolás Molano-González, Manuel Rojas, Diana M. Monsalve, Yovana Pacheco, Yeny Acosta-Ampudia, Yhojan Rodríguez, Monica Rodríguez-Jimenez, Carolina Ramírez-Santana, Juan-Manuel Anaya

Abstract

Autoimmune diseases (ADs) are a chronic and clinically heterogeneous group of diseases characterized by share common immunopathogenic mechanisms and risk factors (i.e., the autoimmune tautology), which explain the fact that one AD may coexist with others (i.e., polyautoimmunity - PolyA). In the present exploratory study, a mixed-cluster analysis of the most common autoimmune rheumatic diseases (ARDs) was done. A total of 187 consecutive women with established systemic lupus erythematosus (n = 70), rheumatoid arthritis (n = 51), systemic sclerosis (n = 35) and Sjögren's syndrome (n = 31) were included. A comprehensive clinical, autoantibody and cytokine assessment was simultaneously done. Total PolyA was registered in 142 (75.9%) patients. Six clusters were obtained, built mainly on autoantibodies: PolyA-I to -VI. The PolyA-III cluster showed the highest frequency of overt PolyA (p = 0.01), and the PolyA-I, -III, and -IV clusters exhibited the highest positivity for IL-12/23p40 (p = 0.015). These results provide new insights into the pathophysiology of PolyA and warrant prospective validation to enable development of a more accurate taxonomy of ARDs.

https://ift.tt/2DrxKBL

A multi-epitope DNA vaccine enables a broad engagement of diabetogenic T cells for tolerance in Type 1 diabetes

Publication date: Available online 17 November 2018

Source: Journal of Autoimmunity

Author(s): Jorge Postigo-Fernandez, Rémi J. Creusot

Abstract

Type 1 diabetes (T1D) is caused by diabetogenic T cells that evaded tolerance mechanisms and react against multiple β-cell antigens. Antigen-specific therapy to reinstate tolerance (typically using a single β-cell antigen) has so far proved unsuccessful in T1D patients. Plasmid DNA (pDNA)-mediated expression of proinsulin has demonstrated transient protection in clinical trials, but long-lasting tolerance is yet to be achieved. We aimed to address whether pDNA delivery of multiple epitopes/mimotopes from several β-cell antigens efficiently presented to CD4⁺ and CD8⁺ T cells could also induce tolerance. This approach significantly delayed T1D development, while co-delivery of pDNA vectors expressing four full antigens protected more mice. Delivery of multiple epitopes resulted in a broad engagement of specific T cells, eliciting a response distinct from endogenous epitopes draining from islets. T-cell phenotypes also varied with antigen specificity. Unexpectedly, the repertoire of T cells reactive to the same epitope was highly polyclonal. Despite induction of some CD25⁺ Foxp3⁺ regulatory T cells, protection from disease did not persist after treatment discontinuation. These data demonstrate that epitope-based tolerogenic DNA vaccines constitute effective precision medicine tools to target a broad range of specific CD4⁺ and CD8⁺ diabetogenic T-cell populations for prevention or treatment of T1D.

https://ift.tt/2Dt83kr

Scholar : New articles have been published for Journal of Natural History, Volume 52, Issue 39-40

The online platform for Taylor & Francis Online content The following articles have been newly published in the issue Journal of Natural History, Volume 52, Issue 39-40 on Taylor & Francis Online: Articles New dietary data from Compsophis and Alluaudina species (Squamata: Lamprophiidae: Pseudoxyrhophiinae), and implications for their dietary complexity and evolution Carl Richard Hutter, Zo F. Andriampenomanana, Jary H. Razafindraibe, Dr. Andolalao Rakotoarison, Mark D. Scherz Pages: 2497-2510 | DOI: 10.1080/00222933.2018.1543732 The issue is in progress. To view all articles already published in this issue, please visit: https://www.tandfonline.com/toc/tnah20/52/39-40 Hoping to have your article read by anyone, anywhere and at any time? Find out more about publishing open access with Ecosystem Health and Sustainability. To update which email alerts you receive, manage your alerts within the My Account area. You can also unsubscribe from this alert with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.