Search

There are particular conditions that may optimize the effects of drinking-water interventions on body weight change and risk of obesity. Strategic planning to create and sustain conditions for optimal effects of drinking water may maximize the impact of school-based interventions to reduce childhood obesity. This paper proposes questions about the target population, type of diet and activity level that will be maintained during the intervention, and planned intervention message(s). The proposed questions are motivated by conditions associated with significant effects of drinking water in randomized controlled trials. They are discussed in relation to conditions underlying the recently successful school-based drinking-water intervention in New York City. If conditions allow, school-based drinking-water interventions have the potential to efficiently benefit millions of children worldwide, who are at risk of becoming obese. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by epithelial inflammation and tissue eosinophilic infiltration. Interleukin-33 (IL-33) is a key inflammatory cytokine that mediates eosinophilic infiltration.Objective: The aim of our study was to investigate the expression and role of IL-33 in eosinophilic CRS with nasal polyps (ECRSwNP) and in noneosinophilic CRS with nasal polyps (nECRSwNP), and to analyze their correlation with clinical severity.Methods: The study enrolled 25 patients with ECRSwNP, 27 patients with nECRSwNP, and 12 control subjects, based on immunohistochemical staining. Protein and mRNA expressions of IL-33 in sinus mucosal samples were determined by immunohistochemistry and real-time polymerase chain reaction. Sino-Nasal Outcome Test-20 (SNOT-20) score, visual analog scale (VAS) score, endoscopy score, and computed tomography (CT) score were assessed preoperatively.Results: IL-33 expression levels in the CRSwNP group were significantly higher than those in the control group (p < 0.01), especially in the ECRSwNP group (p < 0.05). There were no significant differences between the ECRSwNP and nECRSwNP groups with respect to SNOT-20 score, VAS score, endoscopy score, or CT score. IL-33 mRNA expression showed a positive correlation with the number of eosinophils (p < 0.05) and endoscopy score (p < 0.05) but not with VAS score and CT score.Conclusion: IL-33 expression plays an important role in patients with CRSwNP. No significant differences were observed between the ECRSwNP and nECRSwNP groups with respect to SNOT-20 score, VAS score, endoscopy score, or CT score. IL-33 expression was correlated with eosinophil counts and endoscopy score. [ABSTRACT FROM AUTHOR]

Background: To test whether an integrated prolonged exposure (PE) approach could address posttraumatic stress disorder (PTSD) symptoms effectively in individuals with co-occurring substance use disorders (SUD), we compared concurrent treatment of PTSD and SUD using PE (COPE) to relapse prevention therapy (RPT) for SUD and an active monitoring control group (AMCG).Methods: We conducted a randomized 12-week trial with participants (n = 110; 64% males; 59% African Americans) who met Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision criteria for full or subthreshold PTSD and SUD. Participants were randomly assigned to COPE (n = 39), RPT (n = 43), or AMCG (n = 28).Results: At the end-of-treatment, COPE and RPT demonstrated greater reduction in PTSD symptom severity relative to AMCG (COPE-AMCG = -34.06, p < 0.001; RPT-AMCG = -22.58, p = 0.002). Although the difference between COPE and RPT was not significant in the complete sample, the subset of participants with full (vs. subthreshold) PTSD demonstrated significantly greater reduction of PTSD severity in COPE relative to RPT. Both treatments were superior to AMCG in reducing the days of primary substance use (COPE-AMCG = -0.97, p = 0.01; RPT-AMCG = -2.07, p < 0.001). Relative to COPE, RPT showed significantly more improvement in SUD outcome at end-of-treatment (RPT-COPE = -1.10, p = 0.047). At 3-month follow-up, COPE and RPT maintained their treatment gains and were not significantly different in PTSD severity or days of primary substance use.Conclusion: COPE and RPT reduced PTSD and SUD severity in participants with PTSD + SUD. Findings suggest that among those with full PTSD, COPE improves PTSD symptoms more than a SUD-only treatment. The use of PE for PTSD was associated with significant decreases in PTSD symptoms without worsening of substance use. [ABSTRACT FROM AUTHOR]