Neuro endocrinology letters最新文献

Objective: The article examines the concept and methods of positive schema therapy. It is based on the theory of schema therapy and adaptive schemas, which enrich the perspectives of positive psychology, positive CBT and strengths-based CBT. Based on case vignettes, show practical methods associated with this approach.

Methods: A literature review was conducted on adaptive schemas, their measurement using the Young Positive Schema Questionnaire (YPSQ) and therapeutic interventions supporting the development of the Healthy Adult and Kind Parent modes. In addition, special attention was paid to integrating schema therapy methods within therapeutic interventions of positive psychology and CBT based on resources. Selected case studies of various psychological problems and disorders are presented as examples of therapeutic work using positive schema therapy methods.

Results: Positive schema therapy has been shown in additional studies to be an effective tool for increasing emotional resilience, coping with stressful situations, and improving emotional regulation and the overall quality of life. Adaptive schemas such as self-compassion, social belonging, and emotional openness significantly support the development of the Healthy Adult mode.

Conclusion: Positive schema therapy is an innovative approach in psychotherapeutic practice, expanding clinical methods of schema therapy work. Despite limited empirical support, it has the potential to develop further, introducing new procedures to strengthen the positive aspects of client´s experiences and behaviour when dealing with psychological problems.

Objectives: This study aims to evaluate the prevalence and characteristics of scoliosis in asthenic children diagnosed with mitral valve prolapse (MVP).

Material and methods: This study aims to characterize scoliosis prevalence and examine relationships with mitral valve morphology, regurgitation severity, and skeletal phenotypes (pectus excavatum, hypermobility, skin laxity) in asthenic children with primary MVP based on echocardiographic findings. Individuals with known systemic connective tissue disorders were excluded. Scoliosis was assessed radiographically using Cobb angle measurements with a threshold of ≥10° for diagnosis. Statistical analysis was performed using SPSS 26.0.

Results: The study included 49 asthenic children (25 females, 24 males) aged 9 to 17 years who were diagnosed MVP. The mean age of participants was 13.2 ± 2.2 years. Physical examination revealed pectus excavatum in 46.9%, joint hypermobility in 39%, and skin laxity in 16.3% of patients. Scoliosis (Cobb ≥10°): 47% (23/49, [95% CI: 33-61%]); potential scoliosis (5-10°): 27% (13/49, [95% CI: 16-40%]); any abnormal curvature: 73% (36/49, [95% CI: 59-84%]). Valve morphology: diffuse thickening 61% (30/49); localized elongation 39% (19/49). No significant association between scoliosis and valve morphology (p > 0.05) or MR severity (p > 0.05). Pectus excavatum significantly associated with elongated valve structure (p = 0.001). Pectus excavatum was significantly more common in patients with an elongated, straight valve structure (p = 0.001).

Conclusions: High scoliosis prevalence (47%) in asthenic MVP children is independent of cardiac severity, suggesting intrinsic skeletal tissue vulnerability. Neuroendocrine and immune mechanistic investigation warranted.

Objective: To delve into the potential association between the dietary sodium-potassium ratio and stroke in the low-sodium diet population.

Methods: Cross-sectional analysis was done utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 7 cycles from 2003 to 2016. 7141 samples were selected. Participants were categorized into stroke and non-stroke groups following population characteristics, and the association between dietary sodium-potassium ratio and stroke was analyzed across various categorical variables. Stratification of the dietary sodium-potassium ratio was done using quartiles. Weighted logistic regression models were constructed by adjusting various confounders to examine the sodium-potassium ratio's relationship with stroke. ubgroup analyses stratified by BMI were performed; interaction terms were evaluated with significance threshold p < 0.1. The relation between the sodium-potassium ratio and stroke risk was explored by Restricted Cubic Splines (RCS).

Results: Among the 7,141 participants with a dietary sodium intake ≤ 2,300 mg, the dietary sodium-to-potassium ratio was significantly higher in those who had experienced a stroke (ratio = 1.19 (0.51)) compared to those who had not (ratio = 1.11 (0.52)) (p < 0.05). An increased sodium-to-potassium ratio was associated with a higher risk of stroke in the following subgroups: women (Odds Ratio (OR) = 1.31, 95% CI: 1.05-1.62, p = 0.013), individuals with a BMI of 25-30 kg/m² (OR = 2.02, 95% CI: 1.40-2.91, p < 0.001), those with a history of smoking (OR = 1.79, 95% CI: 1.20-2.67, p = 0.004), alcohol consumers (OR = 1.29, 95% CI: 1.00-1.67, p = 0.047), those without coronary heart disease (OR = 1.33, 95% CI: 1.10-1.62, p = 0.003) or diabetes (OR = 1.33, 95% CI: 1.08-1.63, p = 0.006), but with hypertension (OR = 1.28, 95% CI: 1.03-1.59, p = 0.022). Stratified analysis by BMI indicated that the association between the sodium-to-potassium ratio and stroke was strongest and most consistent among overweight individuals (BMI 25-30 kg/m²), with all ORs exceeding 2 and p < 0.001. Additionally, a U-shaped relationship was observed between the dietary sodium-to-potassium ratio and stroke risk. A ratio within the range of 0.46-1.00 was associated with a reduced risk of stroke, with the lowest risk observed at a ratio of 0.76.

Conclusion: In low-sodium diet population, association between dietary sodium-potassium ratio and stroke risk follows a "U" shaped correlation. However, prospective investigations are warranted to provide additional evidence to support findings.

Purpose: To evaluate whether middle cerebral artery (MCA) Doppler flow parameters measured in the first week of life are associated with intraventricular hemorrhage (IVH) in preterm infants.

Methods: A prospective cohort study was conducted in a level 4A neonatal intensive care unit (NICU) at Adana City Training and Research Hospital between March 2022 and April 2023. Preterm infants born weighing ≤1250 g and ≥500 g were included. MCA flow parameters, including peak systolic velocity (PSV), peak diastolic velocity (PDV), pulsatility index (PI), resistivity index (RI) and time-averaged maximum velocity (TAMAX) were measured via transfontanel Doppler ultrasonography within the first five days of life every day. The association between MCA Doppler parameters and IVH development was analyzed.

Results: Ninety-two preterm infants were included. IVH was detected in 34.7% (n = 32). Infants with IVH had lower gestational age and birth weight. Logistic regression revealed that lower birth weight, the presence of PDA, and early-onset sepsis increased IVH risk. Both increased and decreased MCA Doppler parameters (PSV, PDV, PI and TAMAX) preceded IVH.

Conclusion: MCA Doppler flow fluctuations were associated with IVH in preterm infants. These associations warrant further investigation to determine whether MCA Doppler measurements can prospectively identify infants at risk for IVH.

What is known: Cerebral autoregulation is a developmental process that can be disrupted in neonates with congenital heart disease, hypoxic-ischemic encephalopathy, and those born preterm.

What is new: Novel methods to assess cerebral autoregulation in these populations can be used to target patient-specific hemodynamic parameters.

Our review study addresses chronic periodontitis and its potential complications in the distal segments of the intestine and rectum. Subgingival colonization by gram-negative anaerobic bacteria such as Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Eikenella corrodens, and Fusobacterium nucleatum may, through haematogenous dissemination into non-oral tissues and organs, cause severe systemic diseases. In connection with colorectal carcinoma, the third most frequently diagnosed malignant tumor, special attention has been focused on the anaerobic rod Fusobacterium nucleatum, one of the key periodontal pathogens involved in periodontal pocket infections. A growing amount of direct and indirect evidence supports its role in the development, progression, and persistence of colorectal carcinoma in the distal colon and rectum. F. nucleatum possesses numerous virulence factors that underlie its remarkable infectious potential, not only within the oral cavity but also in the colonic environment, where they facilitate its integration into the dysbiotic microbiome and directly contribute to carcinogenesis in this region. Disruption of the physiological microbiota and colonization by F. nucleatum are now considered major drivers of malignant tumorigenesis in the distal colon. Several studies confirm the oral origin of F. nucleatum and its potential haematogenous spread into the intestinal microenvironment. Eradication of F. nucleatum from the colon is regarded as a crucial factor in achieving successful treatment outcomes for colorectal cancer (CRC). However, systemic administration of broad spectrum antibiotics adversely affects the composition of the normal gut microbiome, leading to microbial imbalance. For this reason, the elimination of F. nucleatum in the colon and rectum relies on a whole range of antibacterial agents that minimally disrupt the gut microbiota. Our eradication strategy for F. nucleatum emphasizes close cooperation between dentists or periodontologists and gastroenterologists or oncologists, targeting high-risk populations: patients with IBD, colorectal adenomas ≥1 cm, multiple polyps, or first-degree relatives with CRC diagnosed before age 60. These at risk patients undergo dental evaluation for periodontitis and gingivitis by collaborating dentists. Identified cases are treated using localized, comprehensive, and early eradication strategies targeting F. nucleatum and other periodontal pathogens within the periodontal pocket microenvironment. The primary objective of early interdisciplinary cooperation is to detect early stages of periodontitis with periodontal pocket depths of up to 4 mm. In such early forms of periodontitis, elimination of infection can be achieved through local approaches including scaling, deep scaling, and curettage, combined with the application of antibacterial solutions, varnishes, antimicrobial impregnated fibers, and, where appropriate, the use of periodontal lasers.

Introduction: Borderline personality disorder (BPD) is associated with significant difficulties in emotional regulation and a higher prevalence of nightmares, which increase emotional instability and decrease quality of life. Dreams represent valuable therapeutic material that can reveal internal conflicts and support self-awareness.

Objective: This article explores dreamwork in group schema therapy (GST) aimed at the early maladaptive schemas (EMS) and modes. The ultimate goal of these approaches is to support the Healthy Adult mode in processing the emotional needs of patients with BPD.

Methods: TThe article presents the theoretical foundations and therapeutic techniques, including imagery, dream rescripting, chairwork, and amplification of dream images. Case vignettes illustrate how dreamwork can help recognise and process a patient's internal conflicts and thus aid the therapy process.

Results: Dreamwork in GST helps patients better understand their emotional needs and schemas. The increased awareness helps to modify dysfunctional behaviour and improve emotional stability. The group therapy format allows patients to share their experiences and receive support from others, which increases the feeling of belonging and security.

Discussion: Dreamwork in GST creates a safe space for processing internal conflicts related to EMS and connections with real possibilities in the patient's life. Dreamwork also brings challenges, such as the risk of slipping into intellectualisation or being overwhelmed by strong emotions and unable to resolve impactful dreams. Dedicated courses and research are needed to warrant effective implementation and elaboration of these methods.

Conclusion: Dreamwork in GST might be an effective tool for promoting self-awareness, processing emotional conflicts, and strengthening the Healthy Adult and Kind Parent modes.

Background: Nutraceutical combinations represent a potential strategy for managing mild hypercholesterolemia in patients who cannot tolerate or do not require statin therapy. In this two-group prospective comparative study, we evaluated the effects of a nutraceutical formulation containing berberine (500 mg), bergamot extract (200 mg), and Amaranthus cruentus extract (30 mg) on lipid, inflammatory, and neurotrophic parameters in low-risk subjects with mild-to-moderate hypercholesterolemia.

Methods: Sixty subjects with low-density-lipoprotein cholesterol (LDL-C) 115-180 mg/dL, total cholesterol (TC) 200-260 mg/dL, triglycerides <250 mg/dL, and cardiovascular risk < 20% received either one tablet daily (Group 1, n = 30) or two tablets daily (Group 2, n = 30) of the study supplement for 8 weeks. Primary outcomes included TC, LDL-C, oxidized LDL (oxLDL), and high-density-lipoprotein cholesterol (HDL-C). Secondary outcomes were triglycerides, high-sensitivity C-reactive protein (hs-CRP), and serum brain-derived neurotrophic factor (BDNF).

Results: Both regimens significantly reduced TC and LDL-C at 8 weeks. Group 2 demonstrated superior reductions in LDL-C (-25.2% versus -14.5%, p < 0.05), oxLDL (-23.1% versus -11.8%, p < 0.05), and hs-CRP (-31.3% versus -6.7%, p < 0.001) compared with Group 1. Group 2 also showed significant increases in HDL-C (+14.9% versus +2.2%, p < 0.05) and BDNF levels (+16.3% versus +2.7%, p<0.001). Both regimens were well-tolerated with no adverse events or hepatic/muscular parameter changes.

Conclusion: This nutraceutical formulation effectively and safely reduced TC and LDL-C in low-risk subjects with mild hypercholesterolemia. The twice-daily regimen provided superior lipid improvements and increased HDL-C and BDNF levels, indicating additional antioxidant, anti-inflammatory, and neuroprotective properties warranting further investigation.

Objectives: The study investigated, whether the FT4 and TSH blood levels in euthyroid pregnant women correlate with neonatal Apgar score.

Material and methods: The study group included 102 euthyroid pregnant women and their newborns. All women underwent clinical assessment (including pregnancy and perinatal interview and physical examination) and laboratory tests involving TSH and FT4 blood concentrations measurements three times, in each trimester. The neonate's overall condition was assessed with the Apgar scale.

Results: A significant positive correlation was described between FT4 concentrations in the study group in the first and second trimester and the newborns' condition assessed on the Apgar scale at 1 minute (Spearman's Rs rank correlation, R = 0.2418; p = 0.014 for the first trimester, and R = 0.2015; p = 0.043 for the second trimester); FT4 concentrations in the first trimester and Apgar score at 3 minutes (Spearman's Rs rank correlation, R = 0.2066; p = 0.038) and between FT4 in the second trimester and the results of Apgar score in the 5th minute (Spearman's Rs rank correlation, R = 0.2231; p = 0.024). Otherwise, maternal TSH concentrations did not significantly correlate with neonatal Apgar score. Analysis of the correlation between the tested thyroid hormones and the birth weight of newborns, as well as delivery date, did not show any significant correlations CONCLUSION: Our study disclosed the impact of maternal FT4 concentration on neonatal outcome expressed by Apgar score. The results presented reveal potential clinically relevant benefits derived from profound thyroid screening during pregnancy.

Objectives: Our aim is to contribute to the literature by presenting pediatric titinopathy cases with different clinical and genetic profiles, including the newly identified homozygous TTN mutation.

Methods: We retrospectively evaluated five pediatric patients with genetically confirmed titinopathy who presented to the Cukurova University Pediatric Neurology Department between January 2015 and May 2025. Clinical features, pattern of muscle weakness, electromyography (EMG), creatine kinase (CK) levels, muscle biopsy findings, cardiac and respiratory involvement, and genetic analyses via next-generation sequencing (NGS) were documented.

Results: Five pediatric patients from three consanguineous families were diagnosed with titinopathy. Patients' median age was 14 years (30 months-17 years). The mean age of walking in the patients was 28.5 months. Four patients from two consanguineous families carried a novel homozygous c.15218-2A>G mutation in the TTN gene, not previously reported as pathogenic. These cases exhibited a wide spectrum of muscle involvement, variable facial, respiratory, and cardiac manifestations, and histopathological features of myotubular or centronuclear myopathy. One unrelated patient had a known pathogenic homozygous c.35296G>A mutation, associated with limb-girdle and facial muscle weakness and mild cardiomyopathy. Despite genetic similarities, phenotypic expression varied even within families. All CK levels were normal.

Conclusion: This study expands the clinical and molecular understanding of titinopathies by identifying a novel TTN mutation associated with marked phenotypic variability, even within the same family. The findings underscore the significant heterogeneity of TTN-related myopathies and reinforce the necessity of comprehensive clinical and genetic evaluations for accurate diagnosis and effective genetic counseling.

Objectives: Previous studies have shown that older people who usually walk faster have a lower risk of death. The present study investigated the effects of blood flow restriction training using the newly developed plural parallel cuff (multi-cuff training) on psychological and physiological parameters, aiming to improve walking function in older people.

Design, material and methods: Forty-two older adults participated in the present study. They were randomly allocated to two groups with the same average age: one group trained with a cuff wrapped on both legs (multi-cuff training) during strength training, and the second group trained without cuffs (control), with training protocols being similar for both groups. This study had a crossover design: after 3 weeks, the training was switched between the groups.

Results: Multi-cuff training significantly rejuvenated the estimated walking age compared to the control.

Conclusion: The multi-cuff training program improves the walking function of older people with no major problems.