To use the pupillary light reflex and polysomnography to evaluate the function of intrinsically photosensitive retinal ganglion cells (ipRGCs) and to correlate this function with structural damage in ...glaucoma.
Cross-sectional study.
A study was conducted on both eyes of 45 participants (32 patients with glaucoma and 13 healthy subjects).
For the pupillary reflex evaluation, patients were tested in the dark using a Ganzfeld system (RETIport; Roland Consult, Brandenburg, Germany); pupil diameter was measured with an eye tracker system. To preferentially stimulate ipRGCs, we used a 1-second 470-nm flash with a luminance of 250 cd/m(2). To stimulate different retinal photoreceptors, we used a 1-second 640-nm flash with a luminance of 250 cd/m(2). All of the subjects underwent polysomnography. Subjects underwent standard automated perimetry and optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec Inc, Dublin, CA).
Correlations between ipRGC activity, as measured by the pupillary light reflex, and polysomnography parameters, and correlations between retinal nerve fiber layer (RNFL) thickness and the pupillary light reflex and polysomnography parameters.
The mean patient ages in the healthy and glaucoma groups were 56.8±7.8 years and 61.5±11.6 years, respectively (P = 0.174). Patients with glaucoma had significantly lower average total sleep time, sleep efficiency, and minimum oxyhemoglobin saturation compared with the healthy subjects (P = 0.008, P = 0.002, and P = 0.028, respectively). Patients with glaucoma had significantly higher arousal durations after falling asleep and more periodic limb movements (P = 0.002 and P = 0.045, respectively). There was an inverse correlation between the rapid eye movement latency and the peak of the pupillary response to the blue flash (P = 0.004). The total arousals were inversely correlated with the sustained blue flash response (P = 0.029). The RNFL thickness was associated with the peak and sustained responses to the blue flash (P < 0.001 for both comparisons); however, RNFL thickness was only associated with the mean oxygen desaturation index among the polysomnography parameters (P = 0.023).
This study demonstrated that decreased ipRGC function caused by glaucoma affected pupillary response and sleep quality.
Background Although mood-congruent memory (MCM), or the tendency to recall information consistent with one’s mood, is a robust phenomenon in human depression, to our knowledge, it has never been ...demonstrated in animals. Methods Mice were subjected to social isolation (SI) or crowding for 12 hours and had their depressive-like behaviour (evaluated by the forced swim, tail suspension, sucrose preference and splash tests) or their serum corticosterone concentrations evaluated. In addition, we determined the temporal forgetting curve of the plus-maze discriminative avoidance task (PM-DAT) and examined the effects of SI or crowding on memory retrieval in the PM-DAT. Finally, we verified the effects of metyrapone pretreatment on reinstatement of memory retrieval or on the increase of corticosterone levels induced by SI. Results Twelve hours of SI produced depressive-like behaviour, enhanced corticosterone concentration and reinstated retrieval of a forgotten discriminative aversive (i.e., negatively valenced) task. Depressive-like behaviour was critical for this facilitative effect of SI because 12 hours of crowding neither induced depressive-like behaviour nor enhanced retrieval, although it increased corticosterone levels at the same magnitude as SI. However, corticosterone increase was a necessary condition for MCM in mice, in that the corticosterone synthesis inhibitor metyrapone abolished SI-induced retrieval reinstatement. Limitations Our study did not investigate the effects of the social manipulations proposed here in a positively valenced task. Conclusion To our knowledge, the present paper provides the first evidence of MCM in animal models.
Lack of sleep can jeopardize vaccine effectiveness Polesel, Daniel Ninello, PhD; Nozoe, Karen Tieme, PhD; Tufik, Sergio, MD, PhD ...
American journal of infection control,
01/2017, Letnik:
45, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Recently, Lee et al presented an innovative article that evaluated the knowledge, attitudes, and opinions of health care workers and the factors associated with influenza vaccination. We would also ...like to note that the main consequence of effective vaccination is a lower occupation of hospital beds by patients affected by diseases due to a nonefficient vaccination or lack thereof.
The pandemic unleashed by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 500 million people worldwide and caused more than 6 million deaths. Cellular and humoral ...immunity induced by infection or immunization are key factors in controlling the viral burden and avoiding the recurrence of coronavirus disease. The duration and effectiveness of immunity after infection is relevant to pandemic policy interventions, including the timing of vaccine boosters.
We sought to evaluate longitudinal binding and functional antibodies against SARS-CoV-2 receptor-binding domain in police officers and health care workers with a history of coronavirus disease 2019 and compare with SARS-CoV-2–naive individuals after vaccination with adenovirus-based ChAdOx1 nCoV-19 (AstraZeneca-Fiocruz) or the inactivated CoronaVac vaccine (Sinovac-Butantan Institute).
A total of 208 participants were vaccinated. Of these, 126 (60.57%) received the ChAdOx1 nCoV-19 vaccine and 82 (39.42%) received the CoronaVac vaccine. Prevaccination and postvaccination blood was collected, and the amount of anti–SARS-CoV-2 IgG and the neutralizing ability of the antibodies to block the interaction between angiotensin-converting enzyme 2 and receptor-binding domain were determined.
Subjects with preexisting SARS-CoV-2 immunity and who received a single dose of ChAdOx1 nCoV-19 or CoronaVac have similar or superior antibody levels when compared with levels in seronegative individuals even after 2 doses of the vaccine. Neutralizing antibody titers of seropositive individuals were higher with a single dose of either ChAdOx1 nCoV-19 or CoronaVac compared with those of seronegative individuals. After 2 doses, both groups reached a plateau response.
Our data reinforce the importance of vaccine boosters to increase specific binding and neutralizing SARS-CoV-2 antibodies.
Studies have suggested that obstructive sleep apnea (OSA) contributes to the deterioration of left ventricular diastolic function. This may lead to atrial myocardial overstretching and enlargement, ...which could be associated with increased cardiovascular risk. The aim of this study was to evaluate left atrial (LA) volume and function in patients with OSA compared with controls without OSA and their associations with any left ventricular diastolic abnormalities using real-time 3-dimensional echocardiography (RT3DE).
Fifty-six patients with mild to severe OSA and 50 controls of similar age and with similar body mass indexes, blood pressure, and frequency of hypertension were analyzed. All subjects underwent polysomnography and RT3DE.
A larger 3-dimensional maximum LA volume indexed for body surface area, larger volume before atrial contraction, and higher active atrial ejection fraction were found in patients with OSA (P < .01 for all). Mitral annular early diastolic velocity (E') was reduced in patients with OSA (P = .03), whereas late diastolic velocity (A') and the ratio of mitral valve early diastolic velocity to mitral annular early diastolic velocity (E/E') were increased in the same group (P < .05 for both). In addition, a lower E'/A' ratio was also found in the OSA group (P = .02). An increase in 3-dimensional maximum LA volume indexed for body surface area was observed, depending on OSA severity. The apnea-hypopnea index and E/E' ratio were independent predictors of an increase in 3-dimensional maximum LA volume in a multiple regression model.
Using RT3DE, this study demonstrates that OSA induces a functional burden on the left atrium, resulting in remodeling. These functional and structural changes are related to the impairment of diastolic function in this population.
Diagnosis of sleep-disordered breathing requires overnight recordings, such as polygraphy or polysomnography. Considering the cost and low availability of these procedures, preselection of patients ...at high risk is recommended. We aimed to develop a screening tool allowing identification of individuals at risk of sleep-disordered breathing.
We used the participants from the population-based HypnoLaus cohort in Lausanne, Switzerland, who had a clinical assessment and polysomnography at home, to build a clinical score (the NoSAS score) using multiple factor analysis and logistic regression to identify people likely to have clinically significant sleep-disordered breathing. The NoSAS score was externally validated in an independent sleep cohort (EPISONO). We compared its performance to existing screening scores (STOP-Bang and Berlin scores).
We used the 2121 participants from the HypnoLaus cohort who were assessed between Sept 1, 2009, and June 30, 2013. The NoSAS score, which ranges from 0 to 17, allocates 4 points for having a neck circumference of more than 40 cm, 3 points for having a body-mass index of 25 kg/m(2) to less than 30 kg/m(2) or 5 points for having a body-mass index of 30 kg/m(2) or more, 2 points for snoring, 4 points for being older than 55 years of age, and 2 points for being male. Using a threshold of 8 points or more, the NoSAS score identified individuals at risk of clinically significant sleep-disordered breathing, with an area under the curve (AUC) of 0·74 (95% CI 0·72-0·76). It showed an even higher performance in the EPISONO cohort, with an AUC of 0·81 (0·77-0·85). The NoSAS score performed significantly better than did the STOP-Bang (AUC 0·67 95% CI 0·65-0·69; p<0·0001) and Berlin (0·63 0·61-0·66; p<0·0001) scores.
The NoSAS score is a simple, efficient, and easy to implement score enabling identification of individuals at risk of sleep-disordered breathing. Because of its high discrimination power, the NoSAS score can help clinicians to decide which patients to further investigate with a nocturnal recording.
Faculty of Biology and Medicine of the University of Lausanne, Lausanne University Hospital, Swiss National Science Foundation, Leenaards Foundation, GlaxoSmithKline, and Vaud Pulmonary League.
Although there is anatomopathologic evidence of atrial involvement in Chagas cardiomyopathy (CCM), the impact in left atrial (LA) function is unknown. The aim of this study was to evaluate LA ...function in patients with CCM with real-time three-dimensional echocardiography (RT3DE) and to compare it with patients with idiopathic dilated cardiomyopathy (DCM).
A total of 30 patients with CCM, 30 patients with DCM, and 20 normal subjects used as the control group were studied. With the use of RT3DE, we measured LA maximum (maxLAV), minimum, and pre-atrial contraction volumes and calculated total and active LA emptying fractions.
Left ventricular ejection fraction and mitral regurgitation were similar in both groups. MaxLAV/m(2) was larger in the CCM group than in the DCM group (76.9 ± 21.9 mL vs. 59.1 ± 26.0 mL; P < .01), and both were significantly larger than in the control group (P < .01). Total LA emptying fraction was lower in the CCM group than in the DCM group (0.30 ± 0.10 vs. 0.40 ± 0.12; P < .01), and both were lower than in the control group (P = .01). Active LA emptying fraction was also lower in the CCM group than in the DCM group (0.22 ± 0.09 vs. 0.28 ± 0.11; P < .01), and both were lower than in the control group (P = .01). The E/e' ratio was higher in the CCM group than in the DCM group (21 ± 10 vs. 15 ± 6; P < .01), and both were greater than in the control group (P < .01). In a multiple regression model, the E/e' ratio was the only independent predictor of a worsening active LA emptying fraction.
LA function is more compromised in patients with CCM than in patients with DCM. This finding indicates a more diffuse and severe myocardial impairment in Chagas disease that is probably related to increased left ventricular filling pressures and atrial myopathy.
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