Notes

Atypical Antipsychotics as well as Metabolism Symptoms: From Molecular Systems in order to Specialized medical Variations.
Second trimester screening and management for preterm birth, intrauterine selective growth restriction (sFGR), classification of monochorial twins with sFGR, and management of the surviving twin after the death of the co-twin are described.Complications exclusively affecting MC twins include Twin to Twin Transfusion Syndrome (TTTS) with the important topics screening, prognosis, complications of laser therapy, timing of delivery, risks for brain abnormalities and delayed neurological development, Twin Anemia-Polycythemia Sequence (TAPS) and Twin Reversed Arterial Perfusion (TRAP) Sequence. This also includes MC MA twins as well as conjoined twins.Finally, the birth mode and time for DC and MC twin pregnancies are described.The information is summarized in 62 recommendations for action, 4 tables and 8 illustrations with comprehensive background texts.The guideline is an international guideline adaptation (ISUOG, NICE) as well as a systematic literature search and is up-to-date.
Intermittent fasting (IF) is an effective strategy to improve cardiometabolic health.

The objective of this work is to examine the effects of IF on cardiometabolic risk factors and the gut microbiota in patients with metabolic syndrome (MS).

A randomized clinical trial was conducted at a community health service center.

Participants included adults with MS, age 30 to 50 years.

Intervention consisted of 8 weeks of "2-day" modified IF.

Cardiometabolic risk factors including body composition, oxidative stress, inflammatory cytokines, and endothelial function were assessed at baseline and at 8 weeks. The diversity, composition, and functional pathways of the gut microbiota, as well as circulating gut-derived metabolites, were measured.

Thirty-nine patients with MS were included 21 in the IF group and 18 in the control group. On fasting days, participants in the IF group reduced 69% of their calorie intake compared to nonfasting days. The 8-week IF significantly reduced fat mass, ameliorated oxidativ associated with MS.
Cushing's syndrome frequently causes mental health impairment. Data in patients with adrenal incidentaloma (AI) are lacking.

We aimed to evaluate psychiatric and neurocognitive functions in AI patients, in relation to the presence of subclinical hypercortisolism (SH), and the effect of adrenalectomy on mental health.

We enrolled 62 AI patients (64.8 ± 8.9 years) referred to our centers. Subclinical hypercortisolism was diagnosed when cortisol after 1mg-dexamethasone suppression test was >50 nmol/L, in the absence of signs of overt hypercortisolism, in 43 patients (SH+).

The structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders-5, and 5 psychiatric scales were performed. The Brief Assessment of Cognition in Schizophrenia (Verbal and Working Memory, Token and Symbol Task, Verbal Fluency, Tower of London) was explored in 26 patients (≤65 years).

The prevalence of psychiatric disorders was 27.4% (SH+ 30.2% vs SH- 21.1%, P = 0.45). SH+ showed a higher prevalence of middle insomnia (by the Hamilton Depression Rating Scale) compared with SH- (51% vs 22%, P = 0.039). Considering the Sheehan Disability Scale, SH+ showed a higher disability score (7 vs 3, P = 0.019), higher perceived stress (4.2 ± 1.9 vs 2.9 ± 1.9, P = 0.015), and lower perceived social support (75 vs 80, P = 0.036) than SH-. High perceived stress was independently associated with SH (odds ratio [OR] = 5.46, confidence interval 95% 1.4-21.8, P = 0.016). Interestingly, SH+ performed better in verbal fluency (49.5 ± 38.9 vs 38.9 ± 9.0, P = 0.012), symbol coding (54.1 ± 6.7 vs 42.3 ± 15.5, P = 0.013), and Tower of London (15.1 vs 10.9, P = 0.009) than SH-. In 8 operated SH+, no significant changes were found.

Subclinical hypercortisolism may influence patients' mental health and cognitive performances, requiring an integrated treatment.
Subclinical hypercortisolism may influence patients' mental health and cognitive performances, requiring an integrated treatment.
As the use of electronic cigarettes (EC) continues to rise in the United States, especially among adolescents and young adults, it is necessary to better understand factors associated with EC initiation. Specifically, it is unclear how genetic and environmental contributions influence the initiation of EC. Further, the degree to which genetic and environmental influences are shared between EC initiation and conventional cigarette (CC) initiation is unknown.

A sample of young adult twins ages 15-20 (N = 858 individuals; 421 complete twin pairs) was used to estimate the genetic and environmental influences on the liability of initiation unique to EC and CC as well as the degree to which these factors are shared between the two. Approximately 24% of participants initiated use of EC, 19% initiated use of CC, and 11% initiated dual use.

Combined contributions of additive genetic and shared environmental influences were significant for CC (ACC = 0.19 [95% CI = 0-0.79], p = 0.57; CCC = 0.42 [95% CI = 0-0.70], irst to use a sample of twin to estimate the contributions of genetic and environmental influences toward EC initiation and estimate the potential for overlapping influences with CC initiation. This study has implications for future debate about the etiology of EC and CC use with respect to potential overlapping genetic and environmental influences.
The association between depression and fall risk in older adults is recognized, yet the mechanisms underlying this association are unclear. This study estimated the mediating role of antidepressant use in the association between depression and falls and fall injuries.

Longitudinal data from the Health and Retirement Study (HRS; 2004-2006) were linked with medication data from the Prescription Drug Study (PDS; 2005). The sample included community-dwelling adults age ≥ 65 with data on depression and medication use (n=3,565). Depression was measured using two independent survey tools Composite International Diagnostic Interview for depression short form and an 8-item version of the Centers for Epidemiologic Studies Depression scale. ABT-199 inhibitor We used causal mediation analysis to estimate and compare the direct and indirect (mediated by antidepressant use) effects of depression on falls and fall injuries.

Individuals with major depressive disorder (MDD) were significantly more likely to experience a fall (OR 1.92; 95% CI 1.
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