Sit less and move more! A cross-sectional study of the associations between physical activity and sedentary behaviors with inhibitory control in Brazilian adults.

OBJECTIVE: To investigate the independent and joint associations between sedentary behaviors (SB) and physical activity (PA) with inhibitory control (IC) in adults. METHODS: A total of 111 participants (median age = 30 years; 60% women), completed the Stroop Color-Words test to assess IC. They also wore accelerometers for seven days to measure SB, light PA, moderate-to-vigorous PA (MVPA), and daily steps. We previously set cutoff points for SB and PA measurements and tested them to determine their association with IC. All analyses were adjusted for potential confounding factors including age, gender, post-secondary education, income, body mass index, and accelerometer wear time. RESULTS: Low SB, high MVPA, and high daily steps were independently associated with a better IC compared to their respective counterparts. Adults with low levels of SB and light PA demonstrated better IC performance (ß = -227.67, 95%CI = -434.14 to -21.20) compared to those with high SB and low light PA. Conversely, individuals with high SB and high light PA exhibited worse performance (ß = 126.80, 95%CI = 2.11 to 251.50) than those in the high SB and low light PA group. Furthermore, the joint association of low SB with high MVPA (ß = -491.12, 95%CI = -689.23 to -293.01) or low SB with high daily steps (ß = -254.29, 95%CI = -416.41 to -92.16) demonstrated better IC performance compared to those with high SB and low MVPA or low daily steps. CONCLUSION: Our findings highlight independent and joint associations between low SB, high MVPA, and high daily steps with enhanced IC in adults.

Conquering pressure! The effects of mild-anxiety training on motor performance under pressure during early motor learning.

We conceptually replicated the one previous study (see record 2009-13549-001) revealing that individuals who practice a motor skill under psychological pressure (anxiety training-AT) avoid performance deterioration when exposed to higher levels of pressure. We used a >3× larger sample size than the original study and attempted to shed light on mechanisms whereby AT may promote performance under pressure by measuring variables related to three theories of choking under pressure: attentional control theory (ACT), reinvestment theory, and the biopsychosocial model (BPSM) of challenge and threat. Eighty-four participants practiced 300 golf putts over 2 days with mild psychological pressure manipulations (AT group) or no pressure manipulations (control group). On the third day, all participants completed putting posttests with no pressure manipulations, mild pressure manipulations, or high-pressure manipulations. We had participants report their mental effort, movement reinvestment, and perceived challenge/threat after each posttest to investigate ACT, reinvestment theory, and the BPSM of challenge and threat, respectively. Results showed the AT group maintained their performance across posttests, whereas the control group performed worse under pressure. Additionally, results indicated that AT moderated changes in mental effort and movement reinvestment during pressure, although neither mechanism mediated the relationship between AT and performance under pressure. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An overlooked relationship in recovery from substance use disorders: Associations between body mass index and negative emotional states.

Recovery from substance use disorders (SUD) is multifactorial. Being overweight could negatively impact physiological and psychological health-related parameters. Using model selection, we examined associations between body mass index (BMI) and negative emotional states (NES; e.g., stress, anxiety, depression) in 54 men with SUD and under treatment in five different therapeutic recovery centers. We found that BMI was positively associated with stress (p < .001), anxiety (p < .001), and depression (p = .002). Therefore, our findings suggest that decreasing the accumulation of body fat might contribute to improving mental health in individuals with SUD during recovery.

Extracorporeal life support use in limited lung function: a narrative review.

Background and Objective: In thoracic surgery, different modalities of extracorporeal life support (ECLS) can be used for cardiorespiratory support in complex scenarios. Decades of learning in clinical practice and physiology associated with technological development led to a great variety of ECLS technologies available. Thoracic surgery procedures with difficult or impossible single lung ventilation may still be performed using different ECLS modalities. The aim of this review is to describe the use of ECLS, with its different modalities, as a solution to perform complex surgeries in a patient with difficult or impossible single lung ventilation. Methods: A literature review was conducted using the terms "extracorporeal life support pulmonary resection" and "extracorporeal life support thoracic surgery", and articles were selected according to defined criteria. Key Content and Findings: To support lung function during thoracic surgery, the most efficient and popular variety of ECLS is venovenous extracorporeal membrane oxygenation. Lung resection on a single lung after pneumonectomy, surgery in a patient with severe hypercapnia and/or low respiratory reserve, carinal and airway surgery, and severe thoracic trauma are the main examples of situations where ECLS may be the solution to provide a safe surgical environment in patients who cannot tolerate single lung ventilation. Multidisciplinarity, selection of patients and careful surgical planning are cornerstones in defining the situations that may benefit from ECLS support. Conclusions: Knowledge on techniques of ECLS are essential for every thoracic surgeon. Although rarely used, these techniques of cardiorespiratory support should be considered when planning complex cases with difficulties in ventilation and emergent situations.

Does learning a skill with the expectation of teaching it impair the skill's execution under psychological pressure if the skill is learned with analogy instructions?

OBJECTIVE: Having learners practice a motor skill with the expectation of teaching it (versus an expectation of being tested on it) has been revealed to enhance skill learning. However, this improvement in skill performance is lost when the skill must be performed under psychological pressure due to 'choking under pressure.' The present study investigated whether this choking effect is caused by an accrual of declarative knowledge during skill practice and could be prevented if a technique (analogy instructions) to minimize the accrual of declarative knowledge during practice is employed. DESIGN: We used a 2 (Expectation: teach/test) x 2 (Instructions: analogy/explicit) x 2 (Posttest: low-pressure/high-pressure) mixed-factor design, with repeated measures on the last factor. METHODS: One-hundred fifty-six participants were quasi-randomly assigned (based on sex) to one of four groups. Participants in the teach/analogy and teach/explicit groups practiced golf putting with the expectation of teaching putting to another participant, and analogy instructions or explicit instructions, respectively. Participants in the test/analogy and test/explicit groups practiced golf putting with the expectation of being tested on their putting, and analogy instructions or explicit instructions, respectively. The next day all participants completed low- and high-pressure putting posttests, with their putting accuracy serving as the dependent variable. RESULTS: We observed an Expectation x Instructions × Posttest interaction, such that a main effect of expectation was found in the low-pressure posttest, with the teach group exhibiting superior accuracy, and an Expectation × Instructions interaction was revealed for the high-pressure posttest. This interaction resulted from the teach group showing greater accuracy than the test group exclusively when receiving analogy instructions. CONCLUSION: Results show that participants who practiced with the expectation of teaching exhibited superior learning and indicate that they choked under pressure likely due to their accrual of declarative knowledge during practice, since the choking effect was prevented by having them practice with analogy instructions. Accordingly, having learners practice with the expectation of teaching and techniques that minimize the accrual of declarative knowledge is recommended.

That looks easy! Evidence against the benefits of an easier criterion of success for enhancing motor learning.

OPTIMAL theory predicts providing learners with a relatively easier criterion of success during practice enhances motor learning through increased self-efficacy, perceptions of competence, and intrinsic motivation. However, mixed results in the literature suggest this enhancement effect may be moderated by the number of successes achieved by learners practicing with the difficult criterion. To investigate this possibility, we manipulated quantity of practice to affect the absolute number of successes achieved by learners practicing with different success criteria. Eighty participants were divided into four groups and performed 50 or 100 trials of a mini-shuffleboard task. Groups practiced with either a large or a small zone of success surrounding the target. Learning was assessed 24 h after acquisition with retention and transfer tests. In terms of endpoint accuracy and precision, there were no learning or practice performance benefits of practicing with an easier criterion of success, regardless of the number of trials. This absence of a criterion of success effect was despite the efficacy of our manipulation in increasing the number of trials stopping within the zone of success, self-efficacy, perceptions of competence, and, for participants with 100 trials, intrinsic motivation. An equivalence test indicated that the effect of criterion of success was small, if existent. Moreover, at the individual level, intrinsic motivation did not predict posttest or acquisition performance. There were no benefits of easing the criterion of success on pressure, effort, accrual of explicit knowledge, or conscious processing. These data challenge key tenets of OPTIMAL theory and question the efficacy of easing criterion of success for motor learning.

Relationship between reward-related brain activity and opportunities to sit.

The present study tested whether energy-minimizing behaviors evoke reward-related brain activity that promotes the repetition of these behaviors via reinforcement learning processes. Fifty-eight healthy young adults in a standing position performed a task where they could earn a reward either by sitting down or squatting while undergoing electroencephalographic (EEG) recording. Reward-prediction errors were quantified as the amplitude of the EEG-derived reward positivity. Results showed that reward positivity was larger on reward versus no reward trials, confirming the validity of our paradigm to measure evoked reward-related brain activity. However, results showed no evidence that sitting (versus standing and squatting) trials led to larger reward positivity. Moreover, we found no evidence suggesting that this effect was moderated by typical physical activity, physical activity on the day of the study, or energy expenditure during the experiment. However, at the behavioral level, results showed that the probability of choosing the stimulus more likely to lead to sitting than standing increased as the number of trials increased. In addition, results revealed that the probability of changing the selected stimulus was higher when the previous trial was a stand trial relative to a sit trial. In sum, neural results showed no evidence supporting the theory that opportunities to minimize energy expenditure are rewarding. However, behavioral findings suggested participants tend to choose the less effortful behavioral alternative and were therefore consistent with the theory of effort minimization (TEMPA).

Extralobar Pulmonary Sequestration.

Male, 71 year-old, asymptomatic, former smoker and previous history of lung tuberculosis. Referred to outpatient clinic due to left lower lobe consolidation diagnosed on non-contrasted CT scan, with increased uptake on PET-CT. Then, a contrast-enhanced CT scan revealed extralobar pulmonary sequestration with venous drainage to the left azygos vein (Blue arrow) and a double branch arterial supply from the thoracic aorta (Red arrow).

Innovative 3d-Printed Prosthesis In A Rare Case Of A Huge Mass Of Anterior Thoracic Wall - Low Grade Fibromyxoid Sarcoma (Lgfms).

The need for complete resection of chest wall tumors creates a huge challenge in terms of reconstructing the complex dynamics of the thorax. We are reporting a case of a low-grade fibromyxoid sarcoma (LGFMS) diagnosed in a young male, where the complete resection of the mass, sternum and parcially the pericardium was performed. Subsequently, a composite porous high-density polyethylene StarPore® prosthesis of the sternum and costal arches was used and the latissimus dorsi muscle free flap with skin graft was implanted over the sternum.

An Unusual Location for a Lymph Node.

We report a case of a 67-years old non-smoking female diagnosed with hypertension when 24-years-old and complicated with chronic kidney and hypertensive heart diseases. On CT-Chest an incidental discovery of a lesion (16x14x23mm) adjacent to the abdominal aorta was made. Initially suspected to be paraganglioma, a hypothesis which the subsequent MRI did not exclude. Urine analysis showed normal Metanephrine with slightly elevated Chromogranin-A levels. During VATs-procedure "bulging" below the adventitial layer of the descending aorta at the level of the diaphragmatic gutter was identified. By opening the adventitia, a lipomatous lesion with a nodular, consistent center was identified and excised. Final histopathological report confirmed the diagnosis of lymph node not suggestive of neoplasia. Currently, 12 months after the surgery, the patient's condition is good being under surveillance in the Thoracosurgical Outpatient Clinic. Despite not having identified any neuroendocrine component, the patient had clinical signs of clear improvement of arterial hypertension.

Insular cortex activity during food-specific inhibitory control is associated with academic achievement in children.

BACKGROUND/OBJECTIVES: Inhibitory control (IC) is usually poorer in children with overweight and obesity and has been associated with unhealthy eating behaviors and lower academic achievement. Food-specific IC tasks depicting salient unhealthy foods may be more sensitive to predicting fat accumulation and unhealthy behaviors than traditional IC tasks. However, the neural activation patterns in response to food-specific IC remain unclear, especially in developing children`s brains. Here, we investigated brain activity associated with food-specific IC in children with accumulated fat mass. SUBJECTS/METHODS: 36 children with overweight and obesity performed a food-specific Go/No-Go task in an MRI scanner. We assessed the children's body composition with dual-energy x-ray absorptiometry, academic achievement, somatic maturation, and cardiorespiratory fitness. RESULTS: The left insular cortex was significantly activated during successful inhibition of palatable food cues and was associated with higher academic achievement. Also, linear regression showed that academic achievement correlated with insular cortex activation even when controlling for somatic maturation, cognitive performance, and cardiorespiratory fitness. CONCLUSION: Our results indicate that insular cortex activation, an area known for rational and emotional processing, is associated with successful inhibitory control in response to food images in children with overweight and obesity, while academic performance seems to play a role in the magnitude of this activation.

Associação entre Bloqueio Atrioventricular e Mortalidade em Pacientes de Atenção Primária: O Estudo CODE / Association between Atrioventricular Block and Mortality in Primary Care Patients: The CODE Study

Resumo Fundamento O bloqueio atrioventricular (BAV) descreve um comprometimento na condução dos átrios para os ventrículos. Embora o curso clínico do BAV tenha sido avaliado, os achados são de países de alta renda e, portanto, não podem ser extrapolados para a população latina. Objetivo Avaliar a associação entre BAV e mortalidade. Métodos Foram incluídos pacientes do estudo CODE (Clinical Outcomes in Digital Electrocardiology), maiores de 16 anos que realizaram eletrocardiograma (ECG) digital de 2010 a 2017. Os ECGs foram relatados por cardiologistas e por software automatizado. Para avaliar a relação entre BAV e mortalidade, foram utilizados o modelo log-normal e as curvas de Kaplan-Meier com valores de p bicaudais < 0,05 considerados estatisticamente significativos. Resultados O estudo incluiu 1.557.901 pacientes; 40,23% eram homens e a média de idade foi de 51,7 (DP ± 17,6) anos. Durante um seguimento médio de 3,7 anos, a mortalidade foi de 3,35%. A prevalência de BAV foi de 1,38% (21.538). Os pacientes com BAV de primeiro, segundo e terceiro graus foram associados a uma taxa de sobrevida 24% (taxa de sobrevida relativa [RS] = 0,76; intervalo de confiança [IC] de 95%: 0,71 a 0,81; p < 0,001), 55% (RS = 0,45; IC de 95%: 0,27 a 0,77; p = 0,01) e 64% (RS = 0,36; IC de 95%: 0,26 a 0,49; p < 0,001) menor quando comparados ao grupo controle, respectivamente. Os pacientes com BAV 2:1 tiveram 79% (RS = 0,21; IC de 95%: 0,08 a 0,52; p = 0,005) menor taxa de sobrevida do que o grupo controle. Apenas Mobitz tipo I não foi associado a maior mortalidade (p = 0,27). Conclusão BAV foi um fator de risco independente para mortalidade geral, com exceção do BAV Mobitz tipo I.

Abstract Background Atrioventricular block (AVB) describes an impairment of conduction from the atria to the ventricles. Although the clinical course of AVB has been evaluated, the findings are from high-income countries and, therefore, cannot be extrapolated to the Latinx population. Objective Evaluate the association between AVB and mortality. Methods Patients from the CODE (Clinical Outcomes in Digital Electrocardiology) study, older than 16 years who underwent digital electrocardiogram (ECG) from 2010 to 2017 were included. ECGs were reported by cardiologists and by automated software. To assess the relationship between AVB and mortality, the log-normal model and the Kaplan-Meier curves were used with two-tailed p-values < 0.05 considered statistically significant. Results The study included 1,557,901 patients; 40.2% were men, and mean age was 51.7 (standard deviation ± 17.6) years. In a mean follow-up of 3.7 years, the mortality rate was 3.35%. The AVB prevalence was 1.38% (21,538). Patients with first-, second-, and third-degree AVB were associated with 24% (relative survival rate [RS] = 0.76; 95% confidence interval [CI]: 0.71-0.81; p < 0.001), 55% (RS = 0.45; 95% CI: 0.27-0.77; p = 0.01), and 64% (RS = 0.36; 95% CI: 0.26-0.49; p < 0.001) lower survival rate when compared to the control group, respectively. Patients with 2:1 AVB had 79% (RS = 0.21; 95% CI: 0.08-0.52; p = 0.005) lower survival rate than the control group. Only Mobitz type I was not associated with higher mortality (p = 0.27). Conclusion AVB was an independent risk factor for overall mortality, with the exception of Mobitz type I.

The mediating role of inhibitory control in the relationship between prefrontal cortex hemodynamics and exercise performance in adults with overweight or obesity.

Physical inactivity has been suggested to impair physical performance, cognitive functions and facilitate weight gain. One hypothesis is that long periods of physical inactivity could impair oxygen delivery to the prefrontal cortex (PFC), impairing one's cognitive ability to inhibit unhealthy automated behaviors and, therefore, reduce exercise tolerance. The present study sought to further understand the relationship among PFC hemodynamics, inhibitory control, and exercise tolerance in individuals with low physical fitness levels who are overweight or obese. Thirty-four participants were asked to perform a series of inhibitory control tests (i.e., Stroop task) in one testing session and complete an incremental cycling exercise test with hemodynamic fluctuations of the PFC measured with functional near-infrared spectroscopy in another session. Our results indicate that exercise performance varied with PFC oxygenation. We also found that inhibitory control played a key role mediating the relationship between PFC oxygenation and exercise performance, suggesting that the cognitive ability to inhibit automated responses has an impact on exercise behavior in adults with overweight and obesity.

Association between Atrioventricular Block and Mortality in Primary Care Patients: The CODE Study. / Associação entre Bloqueio Atrioventricular e Mortalidade em Pacientes de Atenção Primária: O Estudo CODE.

BACKGROUND: Atrioventricular block (AVB) describes an impairment of conduction from the atria to the ventricles. Although the clinical course of AVB has been evaluated, the findings are from high-income countries and, therefore, cannot be extrapolated to the Latinx population. OBJECTIVE: Evaluate the association between AVB and mortality. METHODS: Patients from the CODE (Clinical Outcomes in Digital Electrocardiology) study, older than 16 years who underwent digital electrocardiogram (ECG) from 2010 to 2017 were included. ECGs were reported by cardiologists and by automated software. To assess the relationship between AVB and mortality, the log-normal model and the Kaplan-Meier curves were used with two-tailed p-values < 0.05 considered statistically significant. RESULTS: The study included 1,557,901 patients; 40.2% were men, and mean age was 51.7 (standard deviation ± 17.6) years. In a mean follow-up of 3.7 years, the mortality rate was 3.35%. The AVB prevalence was 1.38% (21,538). Patients with first-, second-, and third-degree AVB were associated with 24% (relative survival rate [RS] = 0.76; 95% confidence interval [CI]: 0.71-0.81; p < 0.001), 55% (RS = 0.45; 95% CI: 0.27-0.77; p = 0.01), and 64% (RS = 0.36; 95% CI: 0.26-0.49; p < 0.001) lower survival rate when compared to the control group, respectively. Patients with 2:1 AVB had 79% (RS = 0.21; 95% CI: 0.08-0.52; p = 0.005) lower survival rate than the control group. Only Mobitz type I was not associated with higher mortality (p = 0.27). CONCLUSION: AVB was an independent risk factor for overall mortality, with the exception of Mobitz type I.

FUNDAMENTO: O bloqueio atrioventricular (BAV) descreve um comprometimento na condução dos átrios para os ventrículos. Embora o curso clínico do BAV tenha sido avaliado, os achados são de países de alta renda e, portanto, não podem ser extrapolados para a população latina. OBJETIVO: Avaliar a associação entre BAV e mortalidade. MÉTODOS: Foram incluídos pacientes do estudo CODE (Clinical Outcomes in Digital Electrocardiology), maiores de 16 anos que realizaram eletrocardiograma (ECG) digital de 2010 a 2017. Os ECGs foram relatados por cardiologistas e por software automatizado. Para avaliar a relação entre BAV e mortalidade, foram utilizados o modelo log-normal e as curvas de Kaplan-Meier com valores de p bicaudais < 0,05 considerados estatisticamente significativos. RESULTADOS: O estudo incluiu 1.557.901 pacientes; 40,23% eram homens e a média de idade foi de 51,7 (DP ± 17,6) anos. Durante um seguimento médio de 3,7 anos, a mortalidade foi de 3,35%. A prevalência de BAV foi de 1,38% (21.538). Os pacientes com BAV de primeiro, segundo e terceiro graus foram associados a uma taxa de sobrevida 24% (taxa de sobrevida relativa [RS] = 0,76; intervalo de confiança [IC] de 95%: 0,71 a 0,81; p < 0,001), 55% (RS = 0,45; IC de 95%: 0,27 a 0,77; p = 0,01) e 64% (RS = 0,36; IC de 95%: 0,26 a 0,49; p < 0,001) menor quando comparados ao grupo controle, respectivamente. Os pacientes com BAV 2:1 tiveram 79% (RS = 0,21; IC de 95%: 0,08 a 0,52; p = 0,005) menor taxa de sobrevida do que o grupo controle. Apenas Mobitz tipo I não foi associado a maior mortalidade (p = 0,27). CONCLUSÃO: BAV foi um fator de risco independente para mortalidade geral, com exceção do BAV Mobitz tipo I.

Rare case of low-grade fibromyxoid sarcoma of the thoracic wall with complete sternum reconstruction.

An 18-year-old boy presented with a giant midline mass with 9 years of evolution. The tumor was excised, and reconstruction made with a customized sternum implant and a free latissimus dorsi muscle flap with skin graft. Histological analysis was compatible with low-grade fibromyxoid sarcoma (LGFMS).

LUNG RESECTION FOR NON-SMALL-CELL LUNG CANCER - A NEW RISK SCORE TO PREDICT MAJOR PERIOPERATIVE COMPLICATIONS.

OBJECTIVES: Identify risk factors for major perioperative complications (MPC) after anatomical lung resection for NonSmall-Cell Lung Cancer (NSCLC) and establish a scoring system. METHODS: Single center retrospective study of all consecutive patients diagnosed with NSCLC submitted to anatomical lung resection from 2015 to 2019 (N=564). EXCLUSION CRITERIA: previous lung surgery, concomitant non-lung cancer related procedures, urgency surgery. STUDY POPULATION: 520 patients. PRIMARY END-POINT: MPC defined as a composite endpoint including at least one of the in-hospital complications. Univariable and Multivariable analyses were developed to identify predictors of perioperative complications and create a risk score. Discrimination was assessed using the C-statistic. Calibration was evaluated by Hosmer and Lemeshow test and internal validation was obtained by means of bootstrap replication. RESULTS: Mean age of 65 years and 327 (62.9%) were males. Mean hospital stay of 9 days after surgery. Overall MPC rate was 23.3%. Male gender, hypertension, FEV1<75%, thoracotomy, bilobectomy/pneumectomy and additional resection were independent predictors of MPC. A risk score based on the odds ratios was developed - Major Perioperative Complications of Lung Resection (MPCLR) scoring system - and ranged between 0 and 14 points. It was divided in 5 groups: 1-2 points (positive preditive value 15%); 3-4 (PPV 25%); 5-7 (PPV 35%); 8-9 (PPV 60%); >10 points (PPV 88%). The score showed rea- sonable discrimination (C-statistic=0.70), good calibration (P=.643) and it was internally validated (C-statistic=0,70 BCa95% CI,0.65-0.79). CONCLUSIONS: This study proposes a simple and daily-life risk score system that was able to predict the incidence of perioperative complications.

LYMPH NODE UPSTAGING AFTER SURGERY IN PATIENTS WITH NEGATIVE MEDIASTINAL STAGING BY EBUS.

INTRODUCTION: Mediastinal staging is a hot topic in thoracic oncology. According to the guidelines, and besides other criteria, in the presence of a primary lung cancer with increased mediastinal lymph node uptake on PET-CT, a negative result after lymph node sampling by Endobronchial Ultrasound (EBUS) is not enough to rule out mediastinal lymph node involve- ment, demanding a cervical mediastinoscopy to vouch for the results. METHODS AND OBJECTIVES: In order to study the percentage of lymph node surgical upstaging in patients with neg- ative mediastinal node staging by EBUS and evaluate the role of mediastinoscopy in these patients, we conducted a search in our department's database using the key-word EBUS in the period concerned between January 2014 and August 2020. A total of 302 patients were found. After applying defined criteria, we obtained 42 cases. RESULTS: Lymph node surgical upstaging occurred in 11 (26%) patients, of which 8 were upstaged to N2 and 3 to N1. Most of the cases were single station. Only in 5 (12% of the total) of the 11 patients, the upstaging was related to lymph node stations previously sampled by EBUS. Upstaging was more frequent among males and lower lobe tumours. DISCUSSION AND CONCLUSIONS: Regarding the 8 upstage cases for N2, 5 were single station. Of these 8 cases, only 5 would be approachable by cervical mediastinoscopy. Furthermore, 2 of them were single station, eligible for upfront surgery. Then, only in 3 (7%) of the 42 cases cervical mediastinoscopy would be of foremost importance.

Extradural thoracic nerve root hemangioblastoma approached by a combined posterior thoracic spine and video-assisted thoracoscopic surgery: A case report.

BACKGROUND: Hemangioblastomas commonly occur in the posterior fossa and are typically attributed to sporadic or familial Von Hippel-Lindau disease. Spinal hemangioblastomas, found in 7-10% of patients, are usually located within the cord (i.e., intramedullary). Here, a 58-year-old male presented with a purely extradural hemangioblastoma involving a spinal root that was surgically excised. CASE DESCRIPTION: A 58-year-old male was admitted with a progressive paraparesis and incomplete sensory deficit. The magnetic resonance imaging documented a solid dumbbell-shaped lesion that extended through the left T3-T4 foramen resulting in nerve root and spinal cord compression. Following arterial embolization and lesion excision by both neurosurgeons and thoracic surgeons, the patient's deficits improved. The postoperative computed tomography scan documented complete tumor removal, and the neuropathology revealed a hemangioblastoma. CONCLUSION: Here, we describe a 58-year-old male with a purely extradural thoracic foraminal T3-T4 dumbbell-shaped hemangioblastoma successfully treated by both embolization and surgical excision.

Associations of objectively measured movement behavior and cardiorespiratory fitness with mental health and quality of life in older adults with hypertension: an exploratory analysis during the COVID-19 pandemic.

Objectives: Herein, we explored the associations of pre-pandemic COVID-19 physical activity (PA), sedentary behavior (SB) and cardiorespiratory fitness (CRF) with mental health and quality of life in older adults with hypertension.Method: Objectively measured PA and SB, perceived stress, depression symptoms, and quality of life were assessed before and during the pandemic in seventeen older adults with hypertension. CRF was assessed before the pandemic by cardiopulmonary exercise testing. Longitudinal and cross-sectional associations were analyzed using the mixed linear model.Results: Pre-pandemic light PA (positive association) and SB (negative association) were associated with quality of life during the pandemic. Higher pre-pandemic CRF was associated with less negative changes in perceived stress, depression symptoms, and quality of life during the pandemic.Conclusion: Our preliminary findings suggest that a healthier pre-pandemic movement behavior (more PA, less SB) and better CRF can mitigate the negative impact of the COVID-19 pandemic on mental health and quality of life in older adults with hypertension.