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  • Albertsen Macdonald heeft een update geplaatst 2 maanden, 2 weken geleden

    Most studies reported increased survival in the tourniquet group, but few had relevant comparators, and the survival benefit was difficult to estimate. Most studies reported a reduced need for blood transfusion, with few and mainly transient adverse effects from tourniquet use.

    Despite relatively low evidence, the studies consistently suggested that the use of commercial tourniquets in a civilian setting to control life-threatening extremity hemorrhage seemed to be associated with improved survival, reduced need for blood transfusion, and few and transient adverse effects.

    Despite relatively low evidence, the studies consistently suggested that the use of commercial tourniquets in a civilian setting to control life-threatening extremity hemorrhage seemed to be associated with improved survival, reduced need for blood transfusion, and few and transient adverse effects.Life expectancy in most developed countries has been rising over the past century. In the UK alone, there are about 12 million people over 65 years old and centenarians have increased by 85% in the past 15 years. ONO-AE3-208 As a result of the ageing population, which is due mainly to improvements in medical treatments, public health, improved housing and lifestyle choices, there is an associated increase in the prevalence of pathological conditions, such as metabolic disorders, type 2 diabetes, cardiovascular and neurodegenerative diseases, many types of cancer and others. Statistics suggest that nearly 54% of elderly people in the UK live with at least two chronic conditions, revealing the urgency for identifying interventions that can prevent and/or treat such disorders. Non-pharmacological, dietary interventions such as energetic restriction (ER) and methionine restriction (MR) have revealed promising outcomes in increasing longevity and preventing and/or reversing the development of ageing-associated disorders. In this review, we discuss the evidence and mechanisms that are involved in these processes. Fibroblast growth factor 1 and hydrogen sulphide are important molecules involved in the effects of ER and MR in the extension of life span. Their role is also associated with the prevention of metabolic and cognitive disorders, highlighting these interventions as promising modulators for improvement of health span.The objective was to verify the association between body dissatisfaction (BD) – constituted by the desire to lose weight – with family and personal aspects related to the shape of the body and weight control practices in female adolescents. Cross-sectional observational epidemiological study with adolescents aged 12 to 19 years, enrolled in classes of the 8th and 9th years of public schools belonging to the urban area of the city of Caxias do Sul/RS, Brazil. A self-applicable questionnaire was used. BD was assessed using a Silhouettes Scale. Multivariate regression was performed using Poisson regression with robust variation, hierarchically using a pre-established conceptual model, using the prevalence ratio (PR) adjusted with 95% confidence intervals (95% CI) as a measure of effect. A significance level of 5% (p≤0.05) was considered. Among the 685 female students, 77.2% had BD. The father’s incentive to diet sometimes (PR 1.20; 95% CI 1.08-1.22; p≤0.001) and always (PR 1.15; 95% CI 1.03-1.28; p≤0.001), trying to lose weight (PR 1.64; 95% CI 1.34-2.01; p≤0.0001), dieting five times or more (PR 1.21; 95% CI 1.08-1.35; p=0.002) and skipping meals less than once a week (PR 1.16; 95% CI 1.04-1.29; p=0.026), increased the chances of having BD. In conclusion, among the investigated parents’ behaviors, only the father’s incentive to go on a diet was associated with BD. Adolescent weight control practices increased the chances of having BD. Thus, it facilitates the identification of this condition at an early stage, enabling adequate treatment and prevention of health complications.

    Cognitive theories of obsessive-compulsive disorder (OCD) stress the importance of dysfunctional beliefs in the development and maintenance of the disorder. However, a neurobiological understanding of these cognitive models, including thought-action fusion (TAF), is surprisingly lacking. Thus, this functional magnetic resonance imaging study aimed to investigate whether altered functional connectivity (FC) is associated with the TAF paradigm in OCD patients.

    Forty-one OCD patients and 47 healthy controls (HCs) participated in a functional magnetic resonance imaging study using a TAF task, in which they were asked to read the name of a close or a neutral person in association with positive and negative statements.

    The conventional TAF condition (negative statements/close person) induced significant FC between the regions of interest (ROIs) identified using multivoxel pattern analysis and the visual association areas, default mode network subregions, affective processing, and several subcortical regions ihe underlying neurobiological mechanisms of OCD at the circuit-based level.

    The Patient Health Questionnaire (PHQ-9), the Beck Depression Inventory (BDI-II) and the Generalised Anxiety Disorder Assessment (GAD-7) are widely used in the evaluation of interventions for depression and anxiety. The smallest reduction in depressive symptoms that matter to patients is known as the Minimum Clinically Important Difference (MCID). Little empirical study of the MCID for these scales exists.

    A prospective cohort of 400 patients in UK primary care were interviewed on four occasions, 2 weeks apart. At each time point, participants completed all three questionnaires and a ‘global rating of change’ scale (GRS). MCID estimation relied on estimated changes in symptoms according to reported improvement on the GRS scale, stratified by baseline severity on the Clinical Interview Schedule (CIS-R).

    For moderate baseline severity, those who reported improvement on the GRS had a reduction of 21% (95% confidence interval (CI) -26.7 to -14.9) on the PHQ-9; 23% (95% CI -27.8 to -18.0) on the BDI-II and 26.8% (95% CI -33.5 to -20.1) on the GAD-7. The corresponding threshold scores below which participants were more likely to report improvement were -1.7, -3.5 and -1.5 points on the PHQ-9, BDI-II and GAD-7, respectively. Patients with milder symptoms require much larger reductions as percentage of their baseline to endorse improvement.

    An MCID representing 20% reduction of scores in these scales, is a useful guide for patients with moderately severe symptoms. If treatment had the same effect on patients irrespective of baseline severity, those with low symptoms are unlikely to notice a benefit.

    Funding. National Institute for Health Research.

    Funding. National Institute for Health Research.

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