Tag: pubmed

J Clin Sleep Med. 2023 Feb 17. doi: 10.5664/jcsm.10514. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Several studies have shown that patients with short sleep duration show a poor response to cognitive behavioral therapy for insomnia (CBT-I) but such studies have not included patients with comorbid conditions. The current study was conducted to determine whether pre-treatment sleep duration moderates the response of patients with major depression (MDD) and insomnia (ID) disorders to a combined CBT-I and antidepressant medication treatment.

METHODS: This study comprised a secondary analysis of a larger randomized trial that tested combined CBT-I/antidepressant medication treatment of patients with MDD and ID. Participants (N=99; 70 women; M_age = 47.712.4 yrs.) completed pre-treatment polysomnography and then were randomly assigned to a 12-week treatment with antidepressant medication combined with CBT-I or a sham therapy (CTRL). Short and longer sleepers were defined using total sleep time cutoffs of <5, <6 and <7 hours for short sleep. Insomnia and depression remission ascertained respectively from the Insomnia Severity Index and Hamilton Rating Scale for Depression were used to compare treatment responses of short and longer sleepers defined by the cutoffs mentioned.

RESULTS: Logistic regression analyses showed that statistically significant results were obtained only when the cutoff of <5 hours of sleep was used to define “short sleep.” Both the CBT-I recipients with < 5 hours of sleep (OR = 0.053; 95% CI = 0.006 – 0.499) and the CTRL group with ≥ 5 hours of sleep (OR = 0.149; 95% CI = 0.045 – 0.493) were significantly less likely to achieve insomnia remission than were CBT-I recipients with ≥ 5 hours of sleep. The shorter sleeping CBT-I group (OR = 0.118; 95% CI = 0.020 – 0.714) and longer sleeping CTRL group (OR = 0.321; 95% CI = 0.105 – 0.983) were also less likely to achieve insomnia and/or depression remission than was the longer sleeping CBT-I group with ≥ 5 hours of sleep.

CONCLUSIONS: Sleeping <5 hours may dispose comorbid MDD/ID patients to a poor response to combined CBT-I/medication treatments for their insomnia and depression. Future studies to replicate these findings and explore mechanisms of treatment response seem warranted.

CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Title: Treatment of Insomnia and Depression (TRIAD); Identifier: NCT00767624; URL: https://clinicaltrials.gov/ct2/show/results/NCT00767624.

PMID:36798983 | DOI:10.5664/jcsm.10514

J Clin Sleep Med. 2023 Feb 17. doi: 10.5664/jcsm.10516. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Chronic noncancer pain (CP) commonly co-occurs with obstructive sleep apnea (OSA) and may contribute to greater symptom burden. The study aims were to (1) characterize CP among veterans with OSA; and (2) examine differences in sleepiness (Epworth Sleepiness Scale, ESS), insomnia symptoms (Insomnia Severity Index [ISI]), and quality of life (Short Form Health Survey 20, SF-20) in veterans with OSA with or without pre-existing CP.

METHODS: An observational, cross-sectional, study of 111 veterans with newly diagnosed, untreated OSA was conducted. Descriptive statistics characterized the sample and comorbid CP outcomes. Regression analyses were performed to investigate associations between self-reported CP and sleep-related symptoms or quality of life while controlling for potential confounders.

RESULTS: CP was reported by 69.5% (95% CI: 61.8, 76.2) of participants. Having CP was associated with increased ESS (12.7 ± 5.5 vs 10.2 ± 5.2; p = 0.021) and ISI scores (18.1 ± 6.2 vs. 13.7 ± 7.4; p = 0.002), and worse quality of life across all SF-20 domains.

CONCLUSIONS: There is a high prevalence of CP among veterans with OSA and symptom burden is higher in patients with OSA and CP. Future investigations should address symptom response and burden to OSA treatment in comorbid OSA and CP to guide outcome expectancies and residual OSA symptom treatment plans.

PMID:36798982 | DOI:10.5664/jcsm.10516

Oral Dis. 2023 Feb 16. doi: 10.1111/odi.14543. Online ahead of print.

ABSTRACT

OBJECTIVE: The possible association between hypertension and periodontitis and the effect of hypertension on periodontal treatment were investigated by evaluating salivary and gingival crevicular fluid (GCF) interleukin (IL)-6 and C reactive protein (CRP) levels.

METHODS: Forty-two healthy individuals without any previously diagnosed systemic disease [10 periodontally healthy (control) and 10 periodontitis (CP)] and subjects with hypertension [13 periodontally healthy (HP) and 9 with periodontitis (CP + HP)] participated in the study. GCF and saliva samples were obtained at baseline and four weeks after Phase I periodontal treatment. Biochemical parameters were analyzed using ELISA.

RESULTS: Before the periodontal treatment, significantly higher GCF IL-6 and CRP levels were detected in CP+HP and CP groups compared to HP and control groups (p<0.01). Salivary CRP level in CP+HP group was found to be higher than the control group (p<0.05). Statistically significant gingival and plaque index measurements (p<0.01) might suggest a possible effect of hypertension on periodontal status. Periodontal treatment significantly improved the clinical indices, however biochemical parameters did not change after the treatment.

CONCLUSION: The association of hypertension with periodontitis through local salivary and GCF inflammatory mediators might be possible in disease process.

PMID:36798972 | DOI:10.1111/odi.14543

Hum Vaccin Immunother. 2023 Feb 16:2176643. doi: 10.1080/21645515.2023.2176643. Online ahead of print.

ABSTRACT

Many countries have initiated a booster dose for COVID-19 vaccination. However, little is known about the association between adverse events to vaccination and individual psychological status and willingness to receive the booster dose. From December 1, 2021 to February 1, 2022, 474 participants answered a questionnaire in a university town in China, and information about previous adverse events, anxiety status, and vaccination intention were collected. Chi-square test and logistic regression models were used to analyze the factors associated with willingness to receive booster dose of vaccine. Previous adverse events, such as pain at the injection site, fatigue, muscle pain and headache were associated with anxiety of the participants. About 76.2% of the participants were willing to receive booster dose of vaccine. However, adverse event was not associated with their willingness to receive the booster dose. Participants with age ≤25 were less willing to receive the booster dose, although the association was not statistically significant in the multivariable model. In conclusion, the adverse events of COVID-19 vaccination were associated with psychology status of the vaccinated people. It is still necessary to strengthen the public education on COVID-19 vaccination to improve the vaccination willingness of people, especially among the young people.

PMID:36798968 | DOI:10.1080/21645515.2023.2176643

J Bone Miner Res. 2023 Feb 16. doi: 10.1002/jbmr.4789. Online ahead of print.

ABSTRACT

We examine the hypothesis that DXA structural variables measured at the femoral neck and trochanter cross sections will improve prediction of fractures at these sites in addition to areal BMD (aBMD). We present an analysis of the internal distribution of bone at the site of these fractures using baseline hip DXA measurement of 1,151 participants, mean age (SD) 75 (3), in the 15-year Perth Longitudinal Study of Aging in Women. Structural differences at the femoral neck (FN) and trochanter (TR) cross sections were compared in 69 participants who went on to sustain femoral neck fracture (FNF) and 59 participants who went on to sustain trochanter fracture (TRF), on average ten years later, to those who did not fracture. The new structural variables, in addition to aBMD and bone width (W), were Sigma (distribution of bone within scanned area) and Delta (distance between centre-of-mineral mass and geometric centre). At baseline, compared to Non-fracture cases, FNF cases had a FNaBMD 7% lower, a FNWidth 3% higher and a FNDelta 29% higher, associated with bone loss in superior segment. In Cox proportional hazard analysis for FNF, age (HR 1.39), THaBMD (0.79) and Delta (1.70) were significant. Addition of FN Delta to the base case of THaBMD and age improved the C statistic from 0.62 to 0.69, P =0.01. At baseline, TRF cases had a 15% reduction in TRaBMD with minor increases in Sigma (1%) and Width (2%). In Cox analysis for TRF neither addition of Sigma nor Width improved age and THaBMD as predictors and did not alter the C- statistic of 0.81. Adding measurement of FN Delta, which is an assessment of superior sector bone loss, to hip aBMD and age substantially improves clinical FNF prediction in older women. This article is protected by copyright. All rights reserved.

PMID:36798967 | DOI:10.1002/jbmr.4789

Transl Pediatr. 2023 Jan 31;12(1):1-12. doi: 10.21037/tp-22-280. Epub 2023 Jan 16.

ABSTRACT

BACKGROUND: There is known to be significant genetic involvement in persistent pulmonary hypertension of the newborn (PPHN), but to date there is not a clear understanding of this situation, and clarifying that involvement would be of considerable assistance in devising effective treatments for the disease. This case-control study was undertaken to search for genetic variants associated with PPHN in the Thai population using a genome-wide association study (GWAS).

METHODS: A 659,184 single nucleotide polymorphisms from 387 participants (54 PPHN cases and 333 healthy participants) were genotyped across the human genome using an Illumina Asian Screening Array-24 v1.0 BeadChip Array. After quality control, we obtained 443,063 autosomal SNPs for the GWAS analysis. The FaST-LMM and R packages were used for all statistical analyses.

RESULTS: For the case-control analysis, the genomic inflation factor (λ) was 1.016, rs149768622 T>C in the first intron of WWC2 gene showed the strongest association with a P value of 3.76E-08 and odds ratio (OR) of 13.24 (95% CI: 3.91-44.78). The variants at the LOC102723906/LOC105377599, CADM4, GPM6A, CIT, RIMBP2, LOC105374510, LOC105375193, PTPRN2, CDK14, and LCORL loci showed suggestive evidence of associations with PPHN (P<1E-05).

CONCLUSIONS: This GWAS found that rs149768622 T>C in the WWC2 gene was possibly associated with PPHN. However, replication and functional studies are needed to validate this association and further explore the role(s) of the WWC2 gene in PPHN.

PMID:36798934 | PMC:PMC9926135 | DOI:10.21037/tp-22-280

Tech Innov Patient Support Radiat Oncol. 2023 Jan 26;25:100201. doi: 10.1016/j.tipsro.2023.100201. eCollection 2023 Mar.

ABSTRACT

PURPOSE: To investigate the possibility to be able to offer left sided breast cancer patients, not suitable for DIBH, an organ at risk saving treatment.

MATERIALS AND METHODS: Twenty patients receiving radiotherapy for left breast cancer in DIBH were enrolled in the study. Planning CT scans were acquired in the same supine treatment position in FB and DIBH. 3DCRT_DIBH plans were designed and optimized using two parallel opposed tangent beams (with some additional segments) for the breast and chest wall and anterior-posterior fields for regional lymph nodes irradiation. Additionally, FB helical tomotherapy plans were optimized to minimize heart and lung dose. All forty plans were optimized with at least 95% of the total CTV covered by the 95% of prescribed dose of 50 Gy in 25 fractions.

RESULTS: HT_FB plans showed significantly better dose homogeneity and conformity compared to the 3DCRT_DIBH specially for regional nodal irradiation. The heart mean dose was almost comparable in 3DCRT_DIBH and HT_FB while the volume (%) of the heart receiving 25 Gy had a statistically significant reduction from 7.90 ± 3.33 in 3DCRT_DIBH to 0.88 ± 0.66 in HT_FB. HT_FB was also more effective in left descending artery (LAD) mean dose reduction about 100% from 30.83 ± 9.2 Gy to 9.7 ± 3.1. The ipsilateral lung volume receiving 20 Gy has a further reduction of 43 % in HT_FB compared with 3DCRT_DIBH. For low dose comparison, 3DCRT_DIBH was superior for contralateral organ sparing compared to the HT_FB due to the limited angle for dose delivery.

CONCLUSION: For patients who cannot be a candidate for DIBH for any reason, HT in free breathing may be a good alternative and provides heart and ipsilateral lung dose sparing, however with the cost of increased dose to contralateral breast and lung.

PMID:36798947 | PMC:PMC9926227 | DOI:10.1016/j.tipsro.2023.100201

Adv Biomed Res. 2022 Dec 26;11:116. doi: 10.4103/abr.abr_242_21. eCollection 2022.

ABSTRACT

BACKGROUND: Mortality of ST-elevation myocardial infarction (STEMI) patients is increasing in world. This study defines predictors of mortality in patients who have STEMI.

MATERIALS AND METHODS: This study was a part of the ST-elevated myocardial infarction cohort study in Isfahan conducted on 876 acute myocardial infarction (MI) followed for 2 years that 781 patient entered. The effect of predictors of mortality includes demographic, physiological, and clinical characterizes compared in two groups alive and died patients. MACE was defined as nonfatal MI, nonfatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Univariate and multiple logistic regression analyses were performed. All analyses performed using SPSS 20.0. P < 0.05 considered statistically significant.

RESULTS: A total 781 patients, 117 (13%) that 72 (8.5%) was in-hospital died. The mean (standard deviation) age of the patients was 60.92 (12.77) years and 705 (81.3%) patients were males. Significant factors that affected mortality on analysis of demographic and physiological parameters were age (P < 0.001), sex (P = 0.004), transfusion (P = 0.010), STEMI type (P < 0.001), number epicardial territories >50% (P = 0.001), ventilation options (P < 0.001), smoker (P = 0.003), and diabetes (P = 0.026). Significant clinical factors affected mortality were ejection fraction (EF) (P < 0.001), creatinine (P < 0.001), hemoglobin (P < 0.001), low-density lipoprotein-cholesterol (LDL-C) (P = 0.019), and systolic blood pressure (P < 0.001). Multiple logistics regression model definition significant predictors for mortality were age (P < 0.001), heart rate (HR) (P = 0.007), EF (0.039), LDL-C (P = 0.002), and preangia (P = 0.022).

CONCLUSION: The set of factors can increase or decrease mortality in these patients. Significant predictors of mortality STEMI patients by 2-year follow up were age, HR, EF, LDL-C, and preangia. It seems that more articles need to be done in different parts of Iran to confirm the results.

PMID:36798920 | PMC:PMC9926029 | DOI:10.4103/abr.abr_242_21

Adv Biomed Res. 2022 Dec 26;11:124. doi: 10.4103/abr.abr_15_21. eCollection 2022.

ABSTRACT

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are recognized as two common health problems. Metabolic diseases, such as dyslipidemia, obesity, and hypertension are known risk factors for NAFLD. In addition to these risk factors, other risk factors have been recently suggested, such as thyroid dysfunction.

MATERIALS AND METHODS: In this study, adult patients with T2DM were recruited. Various clinical and biochemical parameters including thyroid function tests, liver function tests, and liver sonography in all participants were assessed and compared between with and without NAFLD groups.

RESULTS: Data from 926 diabetic patients were analyzed; of which, 744 (80.3%) had fatty liver. The prevalence of subclinical hypothyroidism (SCH) in patients with NAFLD was 11.6% and in patients without NAFLD was 6.0% (P = 0.029). Furthermore, the prevalence of overt hypothyroidism was higher in diabetic patients with NAFLD (3.9% vs. 1.6%); this difference was not statistically significant. In univariate logistic regression analysis, hemoglobin A1c (odds ratio [OR]: 8.13); history of insulin consumption (OR: 5.35); duration of diabetes (OR: 2.20); family history of diabetes (OR: 2.85); history of antihypertensive drug use (OR: 2.14) as well as SCH (OR: 2.03) were significant variables for NAFLD. According to the multivariate logistic model, after eliminating the confounding effect of age, sex, and body mass index; the chance of developing NAFLD in patients with SCH was 2.32 times higher than patients without SCH (P = 0.014).

CONCLUSION: NAFLD is extremely common in patients with T2DM. The relationship between hypothyroidism and NAFLD is independent of other risk factors.

PMID:36798918 | PMC:PMC9926038 | DOI:10.4103/abr.abr_15_21

Biomater Res. 2023 Feb 16;27(1):12. doi: 10.1186/s40824-023-00353-2.

ABSTRACT

BACKGROUND: Brain-derived exosomes released into the blood are considered a liquid biopsy to investigate the pathophysiological state, reflecting the aberrant heterogeneous pathways of pathological progression of the brain in neurological diseases. Brain-derived blood exosomes provide promising prospects for the diagnosis of neurological diseases, with exciting possibilities for the early and sensitive diagnosis of such diseases. However, the capability of traditional exosome isolation assays to specifically isolate blood exosomes and to characterize the brain-derived blood exosomal proteins by high-throughput proteomics for clinical specimens from patients with neurological diseases cannot be assured. We report a magnetic transferrin nanoparticles (MTNs) assay, which combined transferrin and magnetic nanoparticles to isolate brain-derived blood exosomes from clinical samples.

METHODS: The principle of the MTNs assay is a ligand-receptor interaction through transferrin on MTNs and transferrin receptor on exosomes, and electrostatic interaction via positively charged MTNs and negatively charged exosomes to isolate brain-derived blood exosomes. In addition, the MTNs assay is simple and rapid (< 35 min) and does not require any large instrument. We confirmed that the MTNs assay accurately and efficiently isolated exosomes from serum samples of humans with neurodegenerative diseases, such as dementia, Parkinson’s disease (PD), and multiple sclerosis (MS). Moreover, we isolated exosomes from serum samples of 30 patients with three distinct neurodegenerative diseases and performed unbiased proteomic analysis to explore the pilot value of brain-derived blood protein profiles as biomarkers.

RESULTS: Using comparative statistical analysis, we found 21 candidate protein biomarkers that were significantly different among three groups of neurodegenerative diseases.

CONCLUSION: The MTNs assay is a convenient approach for the specific and affordable isolation of extracellular vesicles from body fluids for minimally-invasive diagnosis of neurological diseases.

PMID:36797805 | DOI:10.1186/s40824-023-00353-2