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Background: The extent of parathyroidectomy (PTX) recommendation in patients with lithium‐associated hyperparathyroidism (LAH) remains controversial. The primary objectives of this study were to analyze extent of surgery, complications, and long‐term outcomes. Methods: A population‐based study, including all primary hyperparathyroidism (PHPT) patients who underwent PTX in Sweden between 2008 and 2017. Data on exhibited lithium prescriptions, morbidity, surgical approach, and outcomes were collected from relevant national registers and the Scandinavian Quality Register of Thyroid, Parathyroid, and Adrenal Surgery. Patients with lithium exposure before PTX were defined as having LAH. Descriptive summary statistics and regression models were used to evaluate differences in comorbidities, surgical approach, and outcomes between LAH and PHPT not exposed to lithium (non‐LAH). Results: Lithium exposure was significantly more common among PHPT (n = 202, 2.3%) than in controls (n = 416, 0.5%); OR 5.0 (95% CI 4.2–5.9). The risk of LAH correlated to the length of lithium exposure. In the LAH‐group, the surgical procedures were more extensive and associated with a higher risk of postoperative bleeding, wound infections, persistent hypercalcemia, and hypocalcemia that remained after adjustment for the higher percentage of multiglandular disease. However, the cumulative risk of re‐admission for PHPT was similar the first years after PTX and primarily elevated for patients with >5 years duration of lithium exposure prior to surgery. Conclusions: The findings support the perception of LAH as a complex entity. We recommend a functionally oriented approach, aimed to obtain and maintain normocalcemia for as long as possible, minimizing the risk of permanent hypoparathyroidism, and accepting some risk of recurrence. [ABSTRACT FROM AUTHOR]

Background: Primary hyperparathyroidism (pHPT) can be associated with potentially reversible cognitive impairment, which is occasionally mistaken for natural ageing and dementia. The aim was to evaluate short-term medical normalization of hypercalcaemia in surgical decision-making for elderly patients with mild cognitive deficiency. Methods: Patients with pHPT were included in a prospective observational study. A test panel including the Montreal Cognitive Assessment (MoCA) and validated tools for estimation of psychological status (Hospital Anxiety and Depression Scale, HADS), and muscle strength (timed-stands test, TST) was applied at baseline, after 4 weeks of calcimimetic treatment, and after parathyroidectomy. Mild cognitive impairment was defined by a MoCA score below 26. A longitudinal increase in MoCA score of at least 2 points 6 months after surgery was considered clinically meaningful. Results: Of 110 patients who underwent testing, 35 aged 50 years or more were identified to have mild cognitive dysfunction, including 19 who were aged at least 70 years (median MoCA score 23, i.q.r. 21-24). Calcimimetic treatment resulted in normalization of calcium levels, and improvements in MoCA and HADS scores, and TST time. Normal MoCA scores (at least 26) were reached in 17 patients by 6 months after surgery, of whom 10 were aged 70 years or older. Long-term increase in MoCA score correlated with the decrease in ionized calcium concentration (r = -0.536, P = 0.022). Baseline calcium concentration and improvement in MoCA with calcimimetic treatment were identified as independent predictors of favourable outcome after parathyroidectomy. Conclusion: Medical normalization of hypercalcaemia can aid in predicting outcome after parathyroidectomy. [ABSTRACT FROM AUTHOR]

Objective: To examine the influence of positive affect and mood-management in the completion and success of an Internet-based smoking cessation intervention. Methods: Participants were recruited online (n = 1000) and randomized to 4 different interventions. Half of the participants received a mood-management tool. Results: Retention was predicted by positive affect at 3 and 12 months. There was a higher 12-month abstinence rate among those who were assigned to the mood-management intervention and had initial low positive affect. Conclusions: The study supports the inclusion of mood-management tools in smoking cessation interventions and indicates that positive affect increases persistence to quit smoking. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition of mindfulness and mindfulness training as a way to decrease stress and increase psychological functioning.Purpose: The aims of this study were to examine the effects of mindfulness stress reduction training on perceived stress and psychological well-being and to examine if changes in mindfulness mediate intervention effects on these outcomes.Methods: Seventy women and one man with a previous cancer diagnosis (mean age 51.8 years, standard deviation = 9.86) were randomized into an intervention group or a wait-list control group. The intervention consisted of an 8-week mindfulness training course.Results: Compared to participants in the control group, participants in the mindfulness training group had significantly decreased perceived stress and posttraumatic avoidance symptoms and increased positive states of mind. Those who participated in the intervention reported a significant increase in scores on the five-facet mindfulness questionnaire (FFMQ) when compared to controls. The increase in FFMQ score mediated the effects of the intervention on perceived stress, posttraumatic avoidance symptoms, and positive states of mind.Conclusions: This study indicates that the improvements in psychological well-being resulting from mindfulness stress reduction training can potentially be explained by increased levels of mindfulness as measured with the FFMQ. The importance of these findings for future research in the field of mindfulness is discussed. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine change in risk perception and optimistic bias concerning behavior-linked health threats and environmental health threats between adolescence and young adulthood and how these factors related to personal satisfaction. METHODS: In 1996 and 2002, 1624 adolescents responded to a mailed questionnaire. RESULTS: Adolescents showed strong positive optimistic bias concerning behaviorlinked risks, and this optimistic bias increased with age. Increase in optimistic bias over time predicted increase in personal satisfaction. CONCLUSIONS: The capacity to process and perceive potential threats in a positive manner might be a valuable human ability positively influencing personal satisfaction and well-being. [ABSTRACT FROM AUTHOR]

Aims/hypothesis. The ATP-regulated potassium (KATP) channel in the pancreatic beta cell couples the metabolic state to electrical activity. The primary regulator of the KATP channel is generally accepted to be changes in ATP/ADP ratio, where ATP inhibits and ADP activates channel activity. Recently, we showed that long-chain CoA (LC-CoA) esters form a new class of potent KATP channel activators in rodents, as studied in inside-out patches. Methods. In this study we have investigated the effects of LC-CoA esters in human pancreatic beta cells using the inside-out and whole-cell configurations of the patch clamp technique. Results. Human KATP channels were potently activated by acyl-CoA esters with a chain length exceeding 12 carbons. Activation by LC-CoA esters did not require the presence of Mg2+ or adenine nucleotides. A detailed characterization of the concentration-dependent relationship showed an EC50 of 0.7±0.1 µmol/l. Furthermore, in the presence of an ATP/ADP ratio of 10 (1.1 mmol/l total adenine nucleotides), whole-cell KATP channel currents increased approximately six-fold following addition of 1 µmol/l LC-CoA ester. The presence of 1 µmol/l LC-CoA in the recording pipette solution increased beta-cell input conductance, from 0.5±0.2 nS to 2.5±1.3 nS. Conclusion/interpretation. Taken together, these results show that LC-CoA esters are potent activators of the KATP channel in human pancreatic beta cells. The fact that LC-CoA esters also stimulate KATP channel activity recorded in the whole-cell configuration, points to the ability of these compounds to have an important modulatory role of human beta-cell electrical activity under both physiological and pathophysiological conditions. [ABSTRACT FROM AUTHOR]