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Background: Emerging research suggests that attention-deficit/hyperactivity disorder (ADHD) increases the risk for cardiovascular (CVDs) and metabolic disorders (i.e., cardiometabolic disorders) in adulthood. Yet, available studies are scarce and have mainly been focused on individuals receiving clinical ADHD diagnoses. We aimed to investigate the prospective associations of ADHD symptoms in young and mid-adulthood with subsequent cardiometabolic disorders and the underlying mechanisms. Methods: We studied 10,394 twins from the Swedish Twin Registry (STR), born between 1958 and 1985 without previous medical history of cardiometabolic disorders. They provided self-assessment of ADHD symptoms (score range 0–36) via a validated, DSM-IV-based scale in a web-based questionnaire/telephone interview within the Study of Twin Adults: Genes and Environment (STAGE), in 2005–2006 (aged 19–47 years), and were followed until the end of 2018 (33–59 years) to identify incident clinical diagnoses/medication prescriptions for cardiometabolic disorders acquired from Swedish national registers. We used Cox regression models to investigate the associations between ADHD symptoms score and cardiometabolic outcomes, with and without adjustment for relevant covariates, and a co-twin control design to study familial confounding. Results: A one-unit increase in the level of ADHD symptoms was associated with a 2% increase in the rate of CVDs (hazard ratio [HR] = 1.02, 95% confidence interval 1.01–1.04) and a 3% increase in the rate of metabolic disorders (HR = 1.03, 1.02–1.05), after adjusting for birth year and sex. The associations were no longer significant after adjusting for educational attainment, lifestyle factors, and comorbid psychiatric disorders. The associations remained significant after adjusting for familial factors shared by dizygotic twin pairs but became nonsignificant after adjusting for factors shared by monozygotic twin pairs. However, the strength of the associations attenuated significantly in monozygotic twins compared to dizygotic twins for CVDs only, suggesting genetic confounding. Conclusions: ADHD symptom score is associated with a higher risk for cardiometabolic disorders, which may be explained by lower educational attainment, adverse lifestyle factors, and psychiatric comorbidities. Moreover, the associations appear to be partly confounded by shared genetic factors, especially for CVDs. Further research is needed to investigate the identified associations at the level of individual cardiometabolic disorders and to follow-up participants until a more advanced older age. [ABSTRACT FROM AUTHOR]

Background: The third-generation streamlined liner of the pharynx airway (SLIPA-3G) is a new-generation supraglottic airway device (SAD) that is non-cuffed and disposable, with a sealing pressure that varies dynamically with the airway pressure. This study compared the SLIPA-3G with the laryngeal mask airway supreme (LMAS) in patients undergoing laparoscopic cholecystectomy. Methods: Two hundred and twenty patients scheduled for laparoscopic cholecystectomy were randomly allocated to either the SLIPA-3G group or the LMAS group. Data were collected on the patients' hemodynamic parameters at different time points, ease of insertion, fiberoptic view, oropharyngeal leak pressure (OLP) at different time points and SAD-related complications. Results: The mean OLP immediately after device placement in the LMAS group was significantly higher than that of the SLIPA-3G group (31.34 ± 6.99 cmH2O vs.28.94 ± 6.01 cmH2O, P = 0.008, 95% CI 0.62–4.17). The OLPs of the two groups were not significantly different after the induction of a pneumoperitoneum until the end of surgery. The OLP increased gradually through the course of the operation in the SLIPA-3G group (P value = 0.035) but not in the LMAS group (P value = 0.945). There was no significant difference between the two groups in hemodynamic parameters, insertion time and success rate, fiberoptic view and complication rate. Conclusions: The SLIPA-3G and LMAS were associated with comparable OLPs, hemodynamic parameters, ease of insertion, fiberoptic views and complication rates when used during laparoscopic cholecystectomy. The SLIPA-3G can be used as an effective alternative to the LMAS in patients undergoing laparoscopic surgeries. [ABSTRACT FROM AUTHOR]

Background: To investigate whether respectively radial extracoporeal shock wave therapy (rESWT) or a combination of rESWT, celecoxib and eperisone (rESWT + C + E) are superior in reducing pain in patients with chronic nonspecific low back pain (cnsLBP) compared to C + E alone (a standard treatment of this condition in China). Methods: 140 patients with cnsLBP were randomly allocated to rESWT (n = 47), rESWT + C + E (n = 45) or C + E alone (n = 48) for four weeks between November 2017 and March 2019. Outcome was evaluated using the Pain Self-Efficacy Questionnaire (PSEQ), Numerical Rating Scale (NRS), Oswestry Low Back Pain Disability Questionnaire and Patient Health Questionnaire 9, collected at baseline as well as one week (W1), W2, W3, W4 and W12 after baseline. Results: All scores showed a statistically significant improvement over time. The PSEQ and NRS scores showed a significant Time × Treatment effect. Patients treated with rESWT had significantly lower mean NRS values than patients treated with rESWT + C + E at W1 and W3, as well as than patients treated with C + E alone at W3 and W4. No severe adverse events were observed. Conclusions: rESWT may not be inferior to respectively rESWT + C + E or C + E alone in reducing pain in patients with cnsLBP. Level of Evidence: Level I, prospective, randomized, active-controlled trial. Trial registration: Clinicaltrials.gov Identifier NCT03337607. Registered November 09, 2017, https://www.clinicaltrials.gov/ct2/show/NCT03337607. Level of evidence: Level I; prospective, randomized, controlled trial. [ABSTRACT FROM AUTHOR]

Background: Active tuberculosis (ATB) originates from primary Mycobacterium tuberculosis (MTB) infection or reactivation of latent tuberculosis. Besides bacteriological examination, MTB-reactive immunocytes detection can be an alternative testing for discrimination of active tuberculosis. The purpose of this study is to investigate the accuracy of peripheral blood CD27-CD38+IFN-γ+CD4+T cells in ATB diagnosis.Methods: This prospective diagnostic accuracy study was conducted at Shanghai Pulmonary Hospital between January 2019 and December 2021. Patients with ATB, non-tuberculosis mycobacterium infection (NTM), latent tuberculosis infection (LTBI), other respiratory diseases (OD), and healthy individuals (HC) were enrolled. The accuracy of CD27-CD38+IFN-γ+CD4+/CD4+ and other phenotypic markers for ATB diagnosis was assessed.Results: A total of 376 patients (237 ATB, 38 LTBI, 8 NTM, 50 OD, and 43 HC) were enrolled. The ratios of CD4+IFN-γ+CD27- and CD4+IFN-γ+CD27-CD38+ profiles in CD4+IFN-γ+ cells and the ratios of CD4+IFN-γ+CD38+, CD4+IFN-γ+CD27-, and CD4+IFN-γ+CD38+CD27- profiles in CD4+ cells in the ATB group were significantly higher than in the other groups. The area under the curve (AUC) of CD27-CD38+IFN-γ+CD4+/CD4+ for the diagnosis of ATB was the highest, with a value of 0.890. With the optimal cutoff value of 1.34 × 10-4, the sensitivity and specificity of CD27-CD38+IFN-γ+CD4+/CD4+ for ATB diagnosis was 0.869 and 0.849, respectively.Conclusion: CD27-CD38+IFN-γ+CD4+/CD4+ might be a potential biomarker for active tuberculosis diagnosis. [ABSTRACT FROM AUTHOR]