Mackhahn0610

7% were taking anxiolytics, with greater drug consumption in the insomnia group. In a multivariate analysis, GPs who personally consumed these medications prescribed significantly more of them to patients, whereas their insomnia status had less impact. Other factors such as gender and type of practice were not associated with a higher prescription rate. Our results indicate that GPs' personal drug consumption can have a significant impact on the management of their patients, therefore suggesting that actions towards GPs' health improvement may also benefit their patients and the public. © 2020 European Sleep Research Society.Different types of glycosides extract of fenugreek have shown androgenic and anabolic effect in male. The aim of the study was to evaluate the effect of fenugreek extract on total testosterone levels in male. Medline via PubMed, Scopus databases, Cochrane Library, Web of Science, and Google Scholar were searched up to November 2018 for randomized clinical trials comparing intake of fenugreek extract with control group. Data on change in serum total testosterone were pooled using random-effects models. A total of four trials were included. Fenugreek extract has a significant effect on total serum testosterone. Results from clinical trials suggest that fenugreek extract supplement has an effect on serum total testosterone levels in male. © 2020 John Wiley & Sons, Ltd.BACKGROUND The development of a terminology system is essential to allow uniformity in reporting serous fluid specimens. An important topic to cover is the issue of specimen adequacy. In the present study, we aimed to evaluate whether there is a correlation between number of mesothelial cells and overall test's improved sensitivity and adequacy control. METHODS Cases of negative pleural fluids with concomitant positive pleural biopsies were selected from two referral institutions, with observation of the number of mesothelial cells in 10 high power fields, comparing the results with a control group (cases with negative biopsies, i.e. true negatives). Comparisons were conducted using the nonparametric Mann-Whitney U test. Data were analyzed for sensitivity and specificity derived from the Receiver Operating Characteristics (ROC) curve. For the choice of an optimal cutoff of mesothelial cells, receiver-operating curve analysis was constructed and the Youden index was calculated. RESULTS A total of 112 pleural effusions with paired pleural biopsies were studied. There was no difference in distributions of the number of mesothelial cells between cases with a positive biopsy (false negatives) and the control group (median=39 vs. median=30, respectively, p-value=0.974). However, simple logistic regression found a cutoff of 750 cells per 10 HPF as an optimal number for improved sensitivity (72.7%), with fair discriminatory power. CONCLUSIONS Enumeration of mesothelial cells may improve the sensitivity of the cytologic diagnosis of MPE, serving as an internal quality control for the test's overall accuracy. This article is protected by copyright. All rights reserved.In the absence of vision, spatial representation may be altered. When asked to compare the relative distances between three sounds (i.e., auditory spatial bisection task), blind individuals demonstrate significant deficits and do not show an event-related potential response mimicking the visual C1 reported in sighted people. However, we have recently demonstrated that the spatial deficit disappears if coherent time and space cues are presented to blind people, suggesting that they may use time information to infer spatial maps. In this study, we examined whether the modification of temporal cues during space evaluation altered the recruitment of the visual and auditory cortices in blind individuals. We demonstrated that the early (50-90 ms) occipital response, mimicking the visual C1, is not elicited by the physical position of the sound, but by its virtual position suggested by its temporal delay. Even more impressively, in the same time window, the auditory cortex also showed this pattern and responded to temporal instead of spatial coordinates. © 2020 The Authors. Human Brain Mapping published by Wiley Periodicals, Inc.Resistant hypertension (RHT) is associated with obstructive sleep apnea (OSA) and increased aortic stiffness, measured by carotid-femoral pulse wave velocity (cf-PWV). We aimed to evaluate in a randomized controlled trial, the effect of Continuous positive airway pressure (CPAP) treatment on cf-PWV in comparison with a control group in patients with RHT and moderate-severe OSA. One-hundred and sixteen patients were randomized to 6-month CPAP treatment (56 patients) or no therapy (60 patients), while keeping their antihypertensive treatment unchanged. Carotid-femoral pulse wave velocity was performed at the beginning and end of the 6-month period. Intention-to-treat intergroup differences in cf-PWV changes were assessed by a generalized mixed-effects model with the allocation group as a fixed factor and adjusted for age, sex, changes in mean arterial pressure and the baseline cf-PWV values. Subgroup sensitivity analyses were performed, excluding patients with low CPAP adherence and low cf-PWV at baseline. CPAP and control groups had similar clinic-laboratorial characteristics. Patients had a mean cf-PWV of 9.4 ± 1.6 m/s and 33% presented cf-PWV > 10 m/s. During treatment, the control group had a mean increase in cf-PWV of +0.43 m/s (95% confidence interval [CI], +0.14 to +0.73 m/s; p = .005), whereas the CPAP group had a mean increase of +0.03 m/s (95% CI, -0.33 to +0.39 m/s; p = .87), resulting in a mean difference in changes between CPAP and control of -0.40 m/s (95% CI, -0.82 to +0.02 m/s; p = .059). Subgroup analyses did not change the results. In conclusion, a 6-month CPAP treatment did not reduce aortic stiffness, measured by cf-PWV, in patients with RHT and moderate/severe OSA, but treatment may prevent its progression, in contrast to no-CPAP therapy. © 2020 European Sleep Research Society.BACKGROUND Postoperative critical care management is an integral part of cardiac surgery that contributes directly to clinical outcomes. In the United States there remains considerable variability in the critical care infrastructure for cardiac surgical programs. There is little published data investigating the impact of a dedicated cardiac surgical intensive care service. METHODS A retrospective study examining postoperative outcomes in cardiac surgical patients before and after the implementation of a dedicated cardiac surgical intensive care service at a single academic institution. An institutional Society of Thoracic Surgeons database was queried for study variables. Primary endpoints were the postoperative length of stay, intensive care unit length of stay, and mechanical ventilation time. Secondary endpoints included mortality, readmission rates, and postoperative complications. The effect on outcomes based on procedure type was also analyzed. selleckchem RESULTS A total of 1703 patients were included in this study-914 in the control group (before dedicated intensive care service) and 789 in the study group (after dedicated intensive care service).