Activity

PURPOSE The primary objective of this study was to examine the relationship of longitudinal changes in autonomic symptom burden and longitudinal changes in activities of daily living (ADLs); a secondary analysis examined the impact of depressive symptoms in this relationship. METHODS Data were retrieved from the Parkinson’s Progression Markers Initiative (PPMI), a dataset documenting the natural history of newly diagnosed Parkinson’s disease (PD). The analysis focused on data from baseline, visit 6 (24 months after enrollment), and visit 12 (60 months after enrollment). The impact of longitudinal changes in autonomic symptom burden on longitudinal changes in ADLs function was examined. A secondary mediation analysis was performed to investigate whether longitudinal changes in depressive symptoms mediate the relationship between longitudinal changes in autonomic symptom burden and ADLs function. RESULTS Changes in autonomic symptom burden, cognitive function, depressive symptoms, and motor function all correlated with ADLs. Only changes in ADLs and depression were found to be associated with changes in autonomic symptom burden. We found that longitudinal change in autonomic symptoms was a significant predictor of change in ADLs at 24 and 60 months after enrollment, with the cardiovascular subscore being a major driver of this association. Mediation analysis revealed that the association between autonomic symptoms and ADLs is partially mediated by depressive symptoms. CONCLUSIONS Longitudinal changes in autonomic symptoms impact ADLs function in patients with early signs of PD, both directly and indirectly through their impact on depressive symptoms. Future investigation into the influence of treatment of these symptoms on outcomes in PD is warranted.PURPOSE The aim of the study was to explore a potential dose effect of water on heart rate responses and markers of vagal tone modulation. METHODS This was a randomized crossover study involving eight men whose heart rate and heart rate variability parameters were continuously measured following ingestion of different volumes of still mineral water (200, 400, 600, and 800 mL). RESULTS A significant volume by time effect for heart rate (p  less then  0.005) was observed. Ingestion of all volumes of drink water of more 200 mL significantly decreased the heart rate. Significant time effects for heart rate variability parameters were observed. CONCLUSION Ingestion of a mineral water drink affected the heart rate in men in a time-dependent manner, possibly by changes in cardiac vagal modulation.Few studies provide information about the clinical correlates of economic costs in pediatric anxiety disorders. This study uses baseline data from a randomized trial involving 209 children and adolescents with clinical anxiety to examine clinical and demographic correlates of direct and indirect costs. Measured costs included the direct costs of mental health services and the indirect costs resulting from children’s missed school and parents’ missed work. Validated measures of anxiety and depression severity and of internalizing and externalizing behaviors were reported by youth, their parents, and independent evaluators. Selleck Memantine Seventy-two percent of youth (n = 150) had positive costs. Among these youth, the mean annual total cost was $6405 (sd = $11,674), of which $5890 represented direct cost and $4658 represented indirect cost. Higher average costs were correlated with greater child anxiety and depression severity (p  less then  0.001). Most pediatric anxiety disorders result in substantial individual and family costs, and costs may increase rapidly with elevated anxiety severity and depressed mood.INTRODUCTION Hill’s classification provides a reproducible endoscopic grading system for esophagogastric junction morphology and competence, specifically whether the gastroesophageal flap valve (GEFV) is normal (grade I/II) or abnormal (grades III/IV). However, it is not routinely used in clinical practice. We report a systematic review and meta-analysis to determine association between abnormal GEFV and gastroesophageal reflux disorder (GERD). METHODS A comprehensive literature search of MEDLINE and Scopus databases was conducted to identify studies that reported the association between abnormal GEFV and GERD. The search and quality assessment were performed independently by two authors. Fixed- and random-effects meta-analyses were conducted using symptomatic GERD and erosive esophagitis as outcomes. RESULTS A total of 11 studies met inclusion criteria that included a total of 5054 patients. In the general population, patients with abnormal GEFV had greater risk of symptomatic GERD compared to patients with a normal GEFV (risk ratio [RR] 1.88, 95% CI 1.57-2.24). Further, in patients with symptomatic GERD, patients with abnormal GEFV had greater risk of erosive esophagitis compared to patients with normal GEFV (RR 2.17, 95% CI 1.40-3.36). Finally, the specificity of abnormal GEFV for symptomatic GERD was 73.3% (95% CI 69.3-77.0%) and 75.7% (95% CI 65.9-83.4%) for erosive esophagitis in symptomatic GERD. CONCLUSION Our systematic review and meta-analysis showed consistent association between abnormal GEFV indicated by Hill’s classification III/IV and symptomatic GERD and erosive esophagitis. Our recommendation is to include Hill’s classification in routine endoscopy reports and workup for GERD.BACKGROUND The specific and accurate pathogenesis of diarrhea-type irritable bowel syndrome is still unclear. AIMS We explored the mechanism of heat shock protein 27 (HSP27) in diarrhea-type irritable bowel syndrome to identify the key targets for the disease. METHODS The human colonic epithelial cell lines Caco-2 and NCM460 were pretreated with KRIBB3 (a phosphorylation inhibitor of HSP27) and then stimulated with lipopolysaccharide for different times. The apoptosis ratios of Caco-2 and NCM460 cells were examined with Annexin V/PI assays. Cell growth was determined using the cell counting kit-8 assay, and the expression levels of IL-1β and IL-6 in the cell supernatant were analyzed by ELISA. In addition, the expression levels of HSP27 and the nuclear factor-κB (NF-κB) signaling pathway were examined by Western blot assay. RESULTS Stimulation with lipopolysaccharide promoted the expression of HSP27 in colonic epithelial cells. HSP27 was phosphorylated at serine 78 and 82 after exposure to LPS. Apoptosis, growth inhibition, and inflammatory factor expression of lipopolysaccharide-induced colonic epithelial cells were greatly exacerbated by KRIBB3 treatment.