Adverse childhood experiences are associated with an increased risk of obesity in early adolescence: a population-based prospective cohort study.

OBJECTIVE: To determine whether adverse childhood experiences were associated with weight gain and obesity risk in adolescence. METHODS: We analyzed data from 6942 adolescents followed between 9 and 13 years of age in the Growing Up in Ireland cohort study. The main exposures were 14 adverse childhood experiences, 4 of which were included in the Adverse Childhood Experience (ACE) study. The primary outcome was incident overweight and obesity at 13 years. Secondary outcomes included prevalent overweight/obesity and weight gain. RESULTS: More than 75% of the youth experienced an adverse experience and 17% experienced an ACE-specific experience before 9 years. At 13 years, 48% were female and 31.4% were overweight or obese. After adjusting for confounding, exposure to any adverse experience was associated with prevalent overweight/obesity (aOR: 1.56; 1.19-2.05) and incident overweight/obesity (adjusted IRR: 2.15; 95% CI: 1.37-3.39), while exposure to an ACE-specific exposure was associated weight gain (BMI Z score change = 0.202; 95% CI: 0.100-0.303). A significant interaction between income and adverse childhood experiences was observed for both incident overweight/obesity and weight gain (BMI Z change: -0.046; 95% CI: -0.092 to 0.000). CONCLUSIONS: Adverse childhood experiences and low income interact and independently predict obesity risk in early adolescence.

Balancing benefits and risks of exercise in pregnancy: a qualitative analysis of social media discussion.

Exercise improves pregnancy outcomes, but few pregnant individuals meet physical activity guidelines. The main objective of this study was to explore the perception of exercise during pregnancy using posts and comments on Reddit, a large social media platform. Relevant user-generated posts and comments were identified on Reddit by searching systematically for a combination of keywords related to pregnancy and exercise. A dataset of 120 posts and 2892 comments was randomly selected for reflexive thematic analysis. Three themes relating to perceptions of benefits and risks to exercise in pregnancy and how they influence decision-making were generated: (1) perceived benefits of exercise: 'We all know that exercise is good for us'; (2) perceived risks of exercise: Exercise as 'off limits'; and (3) information seeking and decision-making: 'I'm kinda stumped on exercise'. While the benefits of exercise during pregnancy are well recognised among Reddit users, perceived risks significantly influence their decisions to start, continue, adjust or stop exercising. Healthcare providers play a crucial role in guiding these exercise choices, emphasising the need for them to provide evidence-based advice and support pregnant individuals in achieving optimal physical activity levels. Addressing misinformation and providing supportive counselling can help pregnant individuals navigate the complexities of exercise during this critical period.

SREAT presenting as decades of intractable seizures and isolated delusional episodes with clinical, laboratory, and EEG confirmation of treatment response.

We report a case of a 60-year-old woman with a history of intractable seizures and isolated delusional psychosis who was later diagnosed with steroid-responsive encephalopathy associated with autoimmune thyroiditis. The patient underwent right temporal lobectomy (epilepsy surgery) 15 years before coming to this clinic, but continued to have focal seizures, resulting in frequent emergency room visits thereafter. After admission for intensive inpatient video electroencephalogram monitoring and subsequent 7 months of close follow-up, both the electroencephalogram abnormalities and isolated delusional psychosis were found to be responsive to immunotherapy. This suggests that her epilepsy may be autoimmune in nature. Steroid-responsive encephalopathy associated with autoimmune thyroiditis was diagnosed after 26 years since the onset of seizures. Performing invasive epilepsy surgery in patients with autoimmune epilepsy cannot reverse the inflammatory process; therefore, it is reasonable to test for autoimmune etiologies before excision surgery on patients with medically intractable epilepsy. This case demonstrates the clinical use of quantitative electroencephalogram in assisting with the diagnosis of steroid-responsive encephalopathy associated with autoimmune thyroiditis and supports that it is a spectrum disorder with protean manifestations.

Correlations of Clusters of Non-Convulsive Seizure and Magnetic Resonance Imaging in a Case With GAD65-Positive Autoimmune Limbic Encephalitis.

With the increased availability of laboratory tests, glutamic acid decarboxylase (GAD) antibody-positive limbic encephalitis has become an emerging diagnosis. The myriad symptoms of limbic encephalitis make the diagnosis challenging. Symptoms range from seizures, memory loss, dementia, confusion, to psychosis. We present a case of a 21-year-old female with GAD65 antibody-positive limbic encephalitis. The case is unique because the clinical course suggests that non-convulsive seizures are the major cause of this patient's clinical manifestations. The following is the thesis: systemic autoimmune disease, associated with the GAD65 antibody, gives rise to seizures, in particular, non-convulsive seizures. Temporal lobes happen to be the most susceptible sites to develop seizures. The greater part of these seizures can be non-convulsive and hard to recognize without electroencephalogram (EEG) monitoring. The variable symptoms mirror the severity and locations of these seizures. The magnetic resonance imaging (MRI) signal abnormities in the bilateral hippocampus, fornix, and mammillary body correlate with the density of these seizures in the similar manner, which suggests it is secondary to post-ictal edema.