Notes

Diet good quality as well as risk and severity of COVID-19: a prospective cohort study.
re how we can replace this practice with safer, more effective, and less burdensome regimens.The so-called Helsingborg Disease is an intestinal degenerative neuropathy discovered in a kindred in South Sweden. Affected subjects develop severe intestinal symptoms, the most common being chronic diarrhea, but abdominal pain, constipation and severe vomiting are common. Chronic intestinal pseudo-obstruction is the end-stage with high mortality from intestinal failure. Two families with affected members were shown by histopathology and genealogy to be one large kindred with the same underlying disease. Genetic analysis shows that this disease, having an autosomal dominant transmission, is strongly linked to a region in the short arm of chromosome 9 and a 1.2 Mb duplication in this region. The duplication includes 22 protein-coding genes, most of them are interferon genes. Family members not carrying the duplication have no increased prevalence of gut diseases. Genetic analysis including gene-dose array should be important for etiologic diagnosis and for genetic guidance in this kindred.
Baclofen is an effective treatment for spasticity. Abrupt cessation of intrathecal (IT) or oral baclofen risks the development of withdrawal symptoms; however, the magnitude of the problem is unknown.

The aims for this study were as follows (1) using an administrative claims database, estimate the number of patients in the United States on baclofen, and (2) estimate the annual percent hospitalized pediatric and adult populations consequently at risk for interruption of chronic baclofen therapy.

Using 2011-2014 data representing commercially insured individuals, patients were selected based on insurance coverage; evidence of a baclofen claim; and hospitalization. All patients hospitalized while receiving chronic baclofen were assumed to be at risk for baclofen discontinuation. Yearly counts were determined and then extrapolated to national estimates using census data.

Extrapolating from the claims database, oral or IT baclofen was prescribed annually to 33,061 or 1486 patients ≤ 18years, and 654,294 or 7084 patients 19-64years, respectively. The estimated national mean number of at-risk hospitalizations per year for patients aged 19-64years on chronic oral or IT baclofen was 31,116 and 3774, respectively; patients ≤ 18years numbered 4691 and 959, respectively. The mean percent of patients hospitalized per year was 42% in those ≤ 18 years receiving IT baclofen compared with 30% in adults, and 3-10% in the populations receiving oral baclofen.

Extrapolation from an administrative claims database was used to estimate the national number and demographics of hospitalized chronic baclofen users. Patients≤ 18 years receiving IT baclofen were at highest risk of withdrawal due to a high occurrence of hospitalization.
Extrapolation from an administrative claims database was used to estimate the national number and demographics of hospitalized chronic baclofen users. Patients ≤ 18 years receiving IT baclofen were at highest risk of withdrawal due to a high occurrence of hospitalization.The Joint Task Force for Clinical Trial Competency (JTF) conducted a global survey of clinical research professionals requesting respondents to self-assess their competencies in each of the eight domains of its Core Competency Framework version 3.1. The results were analyzed based upon role, years of experience, educational level, professional certification, institutional affiliation, and continuing education participation. Respondents with professional certification self-assessed their competencies in all domains at higher levels than those without professional certification. The survey demonstrated that irrespective of role, experience, or educational level, training curricula in both pre-professional and continuing professional education should include additional content relating to research methods, protocol design, medical product development and regulation, and data management and informatics. These results validate and extend the recommendations of a similar 2016 JTF and other surveys. We further recommend that clinical and translational research organizations and clinical sites assess training needs locally, using both subjective and objective measures of skill and knowledge.
Studies suggested that menopause is a period of vulnerability for disordered eating behaviors, but whether menopause could be linked to orthorexia nervosa (ON) remains unexplored.

A sample composed of 709 women aged between 30 and 71years (mean age = 43.08years, SD = 9.24) answered self-administered questionnaires assessing ON (Düsseldorfer Orthorexia Skala, DOS), body image, self-esteem, and psychopathological symptoms. The sample included a Premenopause group of 441 women reporting regular menses, a Perimenopause group of 94 women reporting the recent onset of amenorrhea or menstrual irregularities, and a Postmenopause group of 174 women reporting amenorrhea of natural onset for more than 12months.

Group comparison using analysis of covariance with age as covariate showed that ON scores were statistically higher in the two groups of participants dealing with menopause (Peri- and Postmenopause) when compared with women not yet concerned by menopause (Premenopause). A Kendall's tau-b correlation performed between the menopausal status (Pre, Peri, or Postmenopause) and DOS categories (No ON; At risk of ON; Presence of ON) showed a weak but statistically significant positive correlation between the menopausal group and DOS categories (tau-b = 0.136, p < 0.001). In addition, Fisher's exact tests indicated that the percentages of participants in the "At risk of ON" and "Presence of ON" categories were statistically higher in the Postmenopause group in comparison with the Premenopause group (p < 0.001). Depressive symptoms were statistically higher in the Peri- and Post-groups, while anxiety symptoms were stronger in the Peri-group when compared with the Pre-group.

This study shows an increase of ON in women concerned with menopause, suggesting the existence of a relationship between menopause and ON. Further studies are necessary to identify factors involved in this association.

Descriptive (cross-sectional) study, level V.
Descriptive (cross-sectional) study, level V.
There is an emerging role for radiological evaluation of psoas muscle as a marker of sarcopenia in trauma patients. Older trauma patients are more likely to undergo cranial than abdomino-pelvic imaging. Identifying sarcopenia using masseter cross-sectional area (M-CSA) has shown correlation with mortality. We sought to determine the correlation between psoas lumbar vertebral index (PLVI) and the M-CSA, and their association with health outcomes.

Patients aged 65 or above, who presented as a trauma call over a 1-year period were included if they underwent cranial or abdominal CT imaging. Images were retrospectively analysed to obtain PLVI and mean M-CSA measurements. Electronic records were abstracted for outcomes. Logistic regression methods, log scale analyses, Cox regression model and Kaplan-Meier plots were used to determine association of sarcopenia with outcomes.

There were 155 eligible patients in the M-CSA group and 204 patients in the PLVI group. Sarcopenia was defined as the lowest quartile in each group. Pearson's correlation indicated a weakly positive linear relationship (r = 0.35, p < 0.001) between these. There was no statistical association between M-CSA sarcopenia status and any measured outcomes. Those with PLVI sarcopenia were more likely to die in hospital (adjusted OR 3.38, 95% CI 1.47-9.73, p = 0.006) and at 2years (adjusted HR 1.90, 95% CI 1.11-3.25, p = 0.02). Only 29% patients with PLVI sarcopenia were discharged home, compared with 58% without sarcopenia (p = 0.001).

Sarcopenia, defined by PLVI, is predictive of increased in-patient and 2-year mortality. Our study did not support prognostic relevance of M-CSA.
Sarcopenia, defined by PLVI, is predictive of increased in-patient and 2-year mortality. Our study did not support prognostic relevance of M-CSA.
Autosomal dominant polycystic kidney disease (ADPKD) causes about 10% of cases of end stage renal disease. Disease progression rateis heterogeneous. Tolvaptan is presentlythe only specific therapeutic option to slow kidney function decline in adults at risk of rapidly progressing ADPKD with chronic kidney disease (CKD) stages 1-4. Thus, a reliable evaluation of kidney function in patients with ADPKD is needed.

We evaluated the agreement between measured (mGFR) and estimated glomerular filtration rate (eGFR) by 61 formulas based on creatinine and/or cystatin-C (eGFR) in 226 ADPKD patients with diverse GFR values, from predialysis to glomerular hyperfiltration. Also, we evaluated whether incorrect categorization of CKD using eGFR may interfere with the indication and/or reimbursement of Tolvaptan treatment.

No formula showed acceptable agreement with mGFR. Total Deviation Index averaged about 50% for eGFR based on creatinine and/or cystatin-C, indicating that 90% of the estimations of GFR showed bounds ofFR is recommended.
To systematically evaluate the efficacy of Shengmai San in patients with cardiotoxicity of anthracyclines.

Randomized controlled trials (RCTs) were identified by searching China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), PubMed, Cochrane Library, and Embase Databases from the inceptions until December 2020. The Cochrane Handbook was used to evaluate the risk of bias in the included studies. Data analysis was conducted using RevMan 5.3 software.

Totally 19 RCTs with 2,331 participants were included in this review. Results showed that in improving arrhythmia (13 RCTs, n=1,877, RR=0.37, 95%CI 0.25 to 0.52, P<0.00001), the treatment group was superior to the control group. In terms of reducing left ventricular end-diastolic diameter (LVEDD, 2 RCTs, n=128, MD=-0.79, 95%CI -0.93 to -0.65, P<0.00001) and left ventricular end systolic diameter (LVESD, 2 RCTs, n=128, MD=-0.58, 95%CI -0.82 to -0.35, P<0.00001), the treatment group was also better than the control group. In reducing myocardial enzymes such as creatine kinase (CK) [(3 RCTs, n=256, SMD=-0.80, 95%CI -1.16 to -0.44, P<0.0001), (2 RCTs, n=126, SMD=-0.62, 95%CI -0.98 to -0.26, P=0.0007)], the treatment group was superior to the control group.

Shengmai San has a positive effect on the treatment of cardiotoxicity from anthracyclines. However, in the future, it is still necessary to conduct high-quality RCTs to verify its efficacy.
Shengmai San has a positive effect on the treatment of cardiotoxicity from anthracyclines. HOIPIN-8 cell line However, in the future, it is still necessary to conduct high-quality RCTs to verify its efficacy.Medical students and residents experience burnout at a high rate and encounter threats to their well-being throughout training. It may be helpful to consider a holistic model of education to create educational environments in which trainees flourish. As clinician educators, the biopsychosocial-spiritual model of patient care has helped shape the way we care for patients. Using the biopsychosocial-spiritual model of patient care as a framework, we examine the ways in which clinician educators can support the physical, psychological, social, and spiritual needs of their trainees. The current state of trainee well-being in each of these areas is reviewed. We discuss potential interventions and opportunities for further research to help clinician educators develop a contextualized, holistic approach to the formation of their trainees.
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