Diabetic Nephropathy: Update on Pillars of Therapy Slowing Progression.

Management of diabetic kidney disease (DKD) has evolved in parallel with our growing understanding of the multiple interrelated pathophysiological mechanisms that involve hemodynamic, metabolic, and inflammatory pathways. These pathways and others play a vital role in the initiation and progression of DKD. Since its initial discovery, the blockade of the renin-angiotensin system has remained a cornerstone of DKD management, leaving a large component of residual risk to be dealt with.

The development of a home-based technology to improve gait in people with Parkinson's disease: a feasibility study.

Background: People with Parkinson's disease (PwP) may experience gait impairment and freezing of gait (FOG), a major cause of falls. External cueing, including visual (e.g.

Cardiovascular Autonomic Neuropathy Is Associated With Increased Glucose Variability in People With Type 1 Diabetes.

Objective: We investigated the association between the cardiovascular autonomic neuropathy (CAN) diagnosis and glucose variability (GV) in type 1 diabetes (T1D), as autonomic dysfunction previously has been associated with increased GV.

Research Design And Methods: CAN was assessed by three recommended cardiovascular reflex tests (CARTs). Glucose metrics were obtained from 10-day blinded continuous glucose monitoring (CGM).

Obesity and Breast Cancer Risk: The Oncogenic Implications of Metabolic Dysregulation.

Context: Breast cancer is increasing in prevalence in parallel with rising rates of obesity worldwide. Obesity is recognized as a leading modifiable risk factor for the development of breast cancer; however, this association varies considerably by clinicopathologic features, and the underlying mechanisms are complex.

Evidence Acquisition: Pubmed literature search using combinations of "obesity," "breast cancer risk," "diet," "exercise," "weight gain," "weight loss," "adipose tissue inflammation," "crown-like structure," "immune markers," "metformin," "gliflozins," "SGLT-2i," "GLP1-RA," and related terms.

The evolving role of the Women's Health Specialist in cancer prevention and survivorship.

Importance And Objective: This review provides a framework for primary care physicians, internists, family doctors, NP's, PA's, and oncologists caring for women-henceforth referred to as Women's Health Specialists-to identify and screen patients who may be at high risk for inherited cancer syndromes; an intervention referred to as previvorship care. For women who undergo risk-reducing oophorectomy, survivorship care is critical to optimizing quality of life thereafter. In this paper, we review management of the unique survivorship needs and management options for women at risk for or with a cancer diagnosis, highlighting the importance of interdisciplinary care.

Denosumab Discontinuation in Patients Treated for Low Bone Density and Osteoporosis.

Denosumab (DMAB) is a potent antiresorptive treatment used for treatment of osteoporosis and low bone mineral density (BMD) in those at high risk for fracture. In postmenopausal women with osteoporosis, DMAB treatment for 10 years has been studied, with results showing continued gains in BMD, sustained fracture risk reduction, and low risk of adverse events. However, upon discontinuation of DMAB, there is a rapid reversal of effect, with increase in bone turnover, loss of BMD, and in a subset of patients, a greater risk for multiple vertebral fractures.

Laminar Distribution of Phase-Amplitude Coupling of Spontaneous Current Sources and Sinks.

Although resting-state functional connectivity is a commonly used neuroimaging paradigm, the underlying mechanisms remain unknown. Thalamo-cortical and cortico-cortical circuits generate oscillations at different frequencies during spontaneous activity. However, it remains unclear how the various rhythms interact and whether their interactions are lamina-specific.

Imaging the Dynamics of Mammalian Neocortical Population Activity In-Vivo.

Neural computations underlying sensory perception, cognition and motor control are performed by populations of neurons at different anatomical and temporal scales. Few techniques are currently available for exploring dynamics of local and large range populations. Voltage-sensitive dye imaging (VSDI) reveals neural population activity in areas ranging from a few tens of microns to a couple of centimeters, or two areas up to ~10 cm apart.

Chronic idiopathic urticaria: treatment with omalizumab.

Chronic idiopathic urticaria (CIU) is a common autoimmune skin condition characterized by spontaneously recurring hives for 6 weeks or longer. The new terminology used for CIU in most countries including Canada is chronic spontaneous urticaria (CSU). CSU is associated with significant psychosocial morbidity with a markedly negative impact on overall quality of life.

Embedding of cortical representations by the superficial patch system.

Pyramidal cells in layers 2 and 3 of the neocortex of many species collectively form a clustered system of lateral axonal projections (the superficial patch system--Lund JS, Angelucci A, Bressloff PC. 2003. Anatomical substrates for functional columns in macaque monkey primary visual cortex.

Coping with early breast cancer: couple adjustment processes and couple-based intervention.

Early breast cancer affects one in every nine women along with their families. Advances in screening and biomedical interventions have changed the face of breast cancer from a terminal condition to a chronic disease with biopsychosocial features. The present review surveyed the nature and extent of psychological morbidity experienced by the breast cancer survivor and her spouse during the post-treatment phase, with particular focus on the impact of disease on the marital relationship.

Status of psychological trials in breast cancer patients: a report of three meta-analyses.

This systematic review reports the results of three meta-analyses addressing the clinical efficacy of psychological interventions in breast cancer patients. Three outcome variables were examined: anxiety, depression and quality of life. Several moderator variables were found to both account for inter-trial heterogeneity and interact with treatment efficacy; methodological quality, prognosis, treatment type, orientation and duration.

Removal of spatial biological artifacts in functional maps by local similarity minimization.

Functional maps obtained by various technologies, including optical imaging techniques, f-MRI, PET, and others, may be contaminated with biological artifacts such as vascular patterns or large patches of parenchyma. These artifacts originate mostly from changes in the microcirculation that result from either activity-dependent changes in volume or from oximetric changes that do not co-localize with neuronal activity per se. Standard methods do not always suffice to reduce such artifacts, in which case conspicuous spatial artifacts mask details of the underlying activity patterns.

Cortical response field dynamics in cat visual cortex.

Little is known about the "inverse" of the receptive field--the region of cortical space whose spatiotemporal pattern of electrical activity is influenced by a given sensory stimulus. We refer to this activated area as the cortical response field, the properties of which remain unexplored. Here, the dynamics of cortical response fields evoked in visual cortex by small, local drifting-oriented gratings were explored using voltage-sensitive dyes.

Staphylococcal infections in PD: monitoring, screening and prevention.

Peritonitis and catheter infections remain a major complication of peritoneal dialysis, accounting for much of the morbidity associated with the technique. The most common source of infection is contamination with predominantly Gram positive skin flora, Staphylococcus (S) epidermidis and S. aureus.

Treating attachment injured couples with emotionally focused therapy: a case study approach.

This paper compared the attachment injury resolution process in two distressed couples undergoing ten sessions of Emotional Focused Therapy (EFT), a short-term empirically validated treatment for relational distress. An attachment injury is a newly coined clinical construct that denotes a specific type of betrayal within the couple's relationship. The incident is so potent that it calls into question assumptions about the safety of the relationship.

Imaging cortical correlates of illusion in early visual cortex.

Exploring visual illusions reveals fundamental principles of cortical processing. Illusory motion perception of non-moving stimuli was described almost a century ago by Gestalt psychologists. However, the underlying neuronal mechanisms remain unknown.

Minimizing discomfort with surface neuromuscular stimulation.

The purpose of this study was to evaluate the effects of stimulus parameters, electrode types, and electrode positions on the perception of discomfort during lower extremity surface neuromuscular stimulation. Ten normal and eight neurologically impaired (four incomplete spinal cord and four stroke) subjects were enrolled. Neurologically impaired subjects had some sensation, although it was often reduced.

Multicenter evaluation of electrical stimulation systems for walking.

Objective: To test the long-term benefits of several noninvasive systems for functional electrical stimulation (FES) during walking.

Design: Forty subjects (average years since injury, 5.4) were studied in four centers for an average time of 1 year.