Achtsamkeit

Achtsamkeit ist das Bemühen, sich den Erfahrungen im Hier und Jetzt mit möglichst großer Bewusstheit und Offenheit zuzuwenden. Dieses ursprünglich aus dem Bereich östlicher Meditationsansätze stammende Prinzip wurde in den letzten Jahren vermehrt in die Behandlung von Depressionen und unterschiedlichen anderen psychischen und körperlichen Störungen integriert. Der Band gibt einen praxisorientierten Einblick in die Hintergründe und die Methoden achtsamkeitsbasierter therapeutischer Arbeit. Der Band stellt die Grundzüge achtsamkeitsbasierter Behandlungsverfahren wie Mindfulness-based Stress Reduction (MBSR) oder Mindfulness-based Cognitive Therapy (MBCT) sowie zentrale Modelle zur Wirkungsweise achtsamkeitsbasierter Verfahren dar. Weiterhin gibt er einen Überblick über wichtige Forschungsergebnisse zur Wirksamkeit von achtsamkeitsbasierten Verfahren. Neben der Anwendung in der Rückfallprophylaxe bei Depressionen wird auch auf die Integration von Achtsamkeit bei der Therapie anderer Störungsbilder und in unterschiedlichen therapeutischen Settings eingegangen. Der Schwerpunkt des Bandes liegt auf der konkreten Darstellung der Behandlungsmethoden. Dabei wird das Vorgehen bei einzelnen Achtsamkeitsübungen, wie z.B. beim Body-Scan oder bei der Sitzmeditation, beschrieben und der Umgang mit möglichen Schwierigkeiten thematisiert. Die Neuauflage referiert aktuelle Forschungsbefunde und stellt ausführlich die achtsamkeitsbasierte Arbeit im Einzelsetting vor. Zudem werden in der Neubearbeitung kritische Aspekte im Kontext von Achtsamkeit diskutiert, wie z.B. die Frage von „Nebenwirkungen“ von Achtsamkeitsübungen oder das Problem einer „Kommerzialisierung“ und „Verflachung“ von Achtsamkeit.

Developments of Adapted Clothing for Physically Disabled People with Scoliosis Using 3D Geometrical Model

Scoliosis is a deformity of the spine that causes disorders of the rib cage. This makes it difficult to design clothes for affected people without following the shape of the rib cage. This paper presents a new 3D clothing design method based on virtual reality for women with physical disabilities such as scoliosis. The current design method is a variation of the draping techniques commonly used by fashion designers to design clothes on a mannequin or human body. However, the current design process highly considers the skeleton and body scan of the person. The skeleton is used to detect the anthropometric points of the patient, while the body scan allows us to detect the morphological contours at the onset of scoliosis. Thus, both allow us to accurately track the patient’s morphology and atypical shape. The position of the morphological contours is indicated by reference marks that are closely associated with the skeleton. This helps to automatically adapt the garment to the evolution of the patient’s pathology over time. The process of creating the 3D garment was processed based on the 3D model of the thorax, which helps to easily determine the anthropometric points and the morphological curves. Using this data, the geometrical model of the garment could be created with 3D ease allowances. The 2D block pattern was then obtained by flattening the 3D patterns using flattening methods. Finally, various tests were performed considering the evolution of pathology to predict the future garment. These tests validate our geometrical model of the garment with 3D ease allowances by comparing the results with previous work.

Mindfulness Training Associated With Resting-State Electroencephalograms Dynamics in Novice Practitioners via Mindful Breathing and Body-Scan

Objectives: Mindfulness-based stress reduction has been proven to improve mental health and quality of life. This study examined how mindfulness training and various types of mindfulness practices altered brain activity.Methods: Specifically, the spectral powers of scalp electroencephalography of the mindfulness-based stress reduction (MBSR) group (n=17) who underwent an 8-week MBSR training—including mindful breathing and body-scan—were evaluated and compared with those of the waitlist controls (n=14).Results: Empirical results indicated that the post-intervention effect of MBSR significantly elevated the resting-state beta powers and reduced resting-state delta powers in both practices; such changes were not observed in the waitlist control. Compared with mindful breathing, body-scanning resulted in an overall decline in electroencephalograms (EEG) spectral powers at both delta and low-gamma bands among trained participants.Conclusion: Together with our preliminary data of expert mediators, the aforementioned spectral changes were salient after intervention, but mitigated along with expertise. Additionally, after receiving training, the MBSR group’s mindfulness and emotion regulation levels improved significantly, which were correlated with the EEG spectral changes in the theta, alpha, and low-beta bands. The results supported that MBSR might function as a unique internal processing tool that involves increased vigilant capability and induces alterations similar to other cognitive training.

Undetectable thyroglobulin makes 123I whole-body scan and stimulated thyroglobulin obsolete in follow-up care of differentiated thyroid cancer: a retrospective study

Background Differentiated thyroid cancer (DTC) is a common malignancy with increasing incidence. Follow-up care for DTC includes thyroglobulin (Tg) measurement and ultrasound (US) of the neck, combined with 131I remnant ablation when indicated. Diagnostic precision has evolved with the introduction of the new high-sensitive Tg-assays (sensitivity ≤0.1 ng/mL). The aim of the study was to determine the prognostic utility of high-sensitive Tg and the need for other diagnostic tests in DTC. Methods This was a retrospective, observational study. Patients with pathologically confirmed DTC, treated with total thyroidectomy and 131I remnant ablation, who had their complete follow-up care in our institution were selected (October 2013–December 2018). Subjects with possible thyroglobulin autoantibody interference were excluded. Statistical analysis was performed using the IBM SPSS® Statistics 24 software package. Results Forty patients were eligible for analysis. A total of 24 out of the 40 patients (60%) had an undetectable high-sensitive Tg 6 months after total thyroidectomy. None of these patients had a stimulated Tg above 1 ng/mL, or remnant on the 123I Whole-Body Scan (WBS) after 1 year of follow-up. Ultrasound of the neck, performed between 6 and 12 months postoperative, was negative in 21 out of the 24 patients. Conclusions This study shows that an undetectable high-sensitive Tg can change the management of patients with DTC and decrease the use and need of stimulated Tg and 123I WBS.

Median 10 years follow-up of patients with covert Cushing’s syndrome: a case series

Background Ectopic adrenocorticotropic hormone secretion syndrome occurs in 10% of all patients with adrenocorticotropic-hormone-dependent hypercortisolism. It is usually associated with overt malignancies or with occult and indolent tumors. This study aims to confirm the source of ectopic adrenocorticotropic hormone in four patients with ectopic Cushing’s syndrome over time. Case presentation A 38-year-old Iranian man with Cushing’s syndrome underwent bilateral adrenalectomy since the source of ectopic adrenocorticotropic hormone secretion was not localized and pituitary imaging was normal. A whole-body scan revealed a right-lung tumoral mass with mediastinal lymph node metastasis. The mass was assumed a lung carcinoid tumor with mediastinal adenopathy. Right-lung mid-zone lobectomy and mediastinal lymphadenectomy were done. In a 47-year-old Iranian man with Cushing’s syndrome, whole-body computed tomography scan revealed a pulmonary nodule in the posterior segment of the left lower lobe of the lung. The third case was a 25-year-old Iranian man who presented with symptoms and signs of Cushing’s syndrome. Pituitary magnetic resonance imaging revealed a microadenoma 5 × 9 mm. Whole-body scan showed abnormal focal somatostatin receptors analog avid lesion in the posterior aspect of inferior third of right lung, highly suggestive of ectopic adrenocorticotropic-hormone-producing tumor. The last case was a 43-year-old Iranian woman with Marfan syndrome with a history of mitral and aortic valve replacement and chronic dissection of the aorta, who presented with symptoms and signs of Cushing’s syndrome. She underwent bilateral adrenalectomy 1 year later owing to failure to locate ectopic adrenocorticotropic hormone syndrome. Whole-body scan showed abnormally increased radiotracer uptake in the midline of the skull base and posterior aspect of the middle zone of left hemithorax and bed of left lobe of thyroid. Conclusion The clinical spectrum of ectopic adrenocorticotropic hormone secretion syndrome is wide, and distinguishing Cushing’s disease from ectopic adrenocorticotropic hormone secretion syndrome is difficult. Initial failure to identify a tumor is common. Pulmonary carcinoid or occult source of ectopic adrenocorticotropic hormone secretion syndrome is usually the cause. In occult cases of ectopic adrenocorticotropic hormone in which the tumor cannot be localized, serial follow-up with serial computed tomography, magnetic resonance imaging, or scintigraphy is recommended for several years until the tumor can be localized and treated.