Mapping of predictors of the disengagement of the descending inhibitory pain modulation system in fibromyalgia: an exploratory study

Background: The main symptoms of fibromyalgia comprise diffuse pain, disability, depressive symptoms, catastrophizing, sleep disruption and fatigue, associated with dysfunction of the descending pain-modulating system (DPMS). Objectives: We aimed to identify patterns of main symptoms of fibromyalgia and neuroplasticity biomarkers (i.e. brain-derived neurotrophic factor (BDNF) and S100B protein) in non-responders to the conditioned pain modulation task (CPM-task) induced by immersion of hand in cold water (0–1°C). Furthermore, we evaluated if these patterns predict responsiveness to CPM-task. Methods: This cross-sectional study included 117 women with fibromyalgia (( n = 60) non-responders and ( n = 57) responders), with age ranging from 30 to 65 years old. We analysed changes in numerical pain scale (NPS-10) during the CPM-task using a standardized protocol. Results: A hierarchical multivariate logistic regression analysis was used to construct a propensity score-adjusted index to identify non-responders compared to responders to CPM-task. The following variables were retained in the models: analgesic use four or more times per week, heat pain threshold (HPT), poor sleep quality, pain catastrophizing, serum levels of BDNF, number of psychiatric diagnoses and the impact of symptoms of fibromyalgia on quality of life. Receiver operator characteristics (ROC) analysis showed non-responders can be discriminated from responders by a composite index of more frequent symptoms of fibromyalgia and neuroplasticity markers (area under the curve (AUC) = 0.83, sensitivity = 100% and specificity = 98%). Conclusion: Patterns of fibromyalgia symptoms and neuroplasticity markers may be helpful to predict responsiveness to the CPM-task which might help personalize treatment and thereby contribute to the care of patients with fibromyalgia.

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Abstract WP5: Outcomes Are Not Different Between Patients With Intermediate and High Dwi-aspects After Stent-retriever Thrombectomy

Stroke ◽

10.1161/str.47.suppl_1.wp5 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Woong Yoon ◽

Seul Kee Kim ◽

Tae Wook Heo ◽

Byung Hyun Baek ◽

Jaechan Park

Keyword(s):

Functional Outcome ◽

Time Window ◽

Multivariate Logistic Regression Analysis ◽

Area Under The Curve ◽

Stent Retriever ◽

Operating Characteristics ◽

Anterior Circulation ◽

Good Outcome ◽

Characteristics Analysis ◽

The Impact

Introduction: Few studies have investigated the association between pretreatment DWI-ASPECTS and functional outcome after stent-retriever thrombectomy in patients with acute anterior circulation stroke. Hypothesis: Patients with acute stroke and DWI-ASPECTS <7 might have a similar chance of a good outcome compared to those with a higher DWI-ASPECTS, if they are treated with a stent-retriever thrombectomy in a short time window. However, this hypothesis has not been tested. Thus, this study aimed to investigate the impact of DWI-ASPECTS on functional outcome in patients with acute anterior circulation stroke who received a stent-retriever thrombectomy. Methods: We retrospectively analyzed the clinical and DWI data from 171 patients with acute anterior circulation stroke who were treated with stent-retriever thrombectomy within 6 hours of symptom onset. The DWI-ASPECTS was assessed by two readers. A good outcome was defined as a modified Rankin Scale score of 0-2 at 3 months. Results: The median DWI-ASPECTS was 7 (interquartile range, 6-8). Receiver operating characteristics analysis revealed an ASPECTS ≥ 7 was the optimal cut-off to predict a good outcome at 3 months (area under the curve=0.57; sensitivity, 75.3%; specificity, 34.4%). The rates of good outcome, symptomatic hemorrhage, and mortality were not different between high DWI-ASPECTS (scores of 7-10) and intermediate (scores of 4-6) groups. In patients with an intermediate DWI-ASPECTS, good outcome was achieved in 46.5% (20/43) of patients with successful revascularization (modified TICI 2b or 3), whereas no patients without successful revascularization had a good outcome ( P =0.016). In multivariate logistic regression analysis, independent predictors of good outcome were age and successful revascularization. Conclusions: Our study suggested that treatment outcomes were not different between patients with a high DWI-ASPECTS and those with an intermediate DWI-ASPECTS who underwent stent-retriever thrombectomy for acute anterior circulation stroke. Thus, patients with an intermediate DWI-ASPECTS otherwise eligible for endovascular therapy should not be excluded for stent-retriever thrombectomy or stroke trials.

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The Effect of Shift Fluctuations on Sleep Quality among Nurses Working in the Emergency Room in Amman, Jordan

International Journal of Occupational Safety and Health ◽

10.3126/ijosh.v10i1.29877 ◽

2020 ◽

Vol 10 (1) ◽

pp. 11-17

Author(s):

Khaled Suleiman ◽

Tarek Al-Khaleeb ◽

Mahmoud Al-Kaladeh ◽

Loai Abu Sharour

Keyword(s):

Sleep Quality ◽

Emergency Room ◽

Work Performance ◽

Poor Sleep ◽

Emergency Rooms ◽

Poor Sleep Quality ◽

Cross Sectional ◽

Public And Private ◽

Work Related ◽

The Impact

Introduction: Sleep Quality disturbances are common among nurses especially those working in stressful situations such as emergency room. Additionally, sleep quality disturbances were found to interfere with nurses’ quality of life and work performance. No studies have found the effect of fluctuated shifts on sleep quality among nurses. Objectives: To examine the impact of shift fluctuations on sleep quality among nurses working in the emergency room. Methods: A cross-sectional, descriptive design was employed. Five emergency rooms were selected from public and private hospitals located in Amman, Jordan. The selected hospitals were also referral sites with capacity of more than 200 beds. A convenient sample of nurses who had a minimum of six months experience in the emergency room and working on rotating shifts were eligible for participation. Nurses with known chronic respiratory problems and sleep apnea were excluded. A self-administered questionnaire including a demographic and work-related questions, and the Arabic version of the Pittsburgh Sleep Quality Index were provided. Shift fluctuations were clustered based on interchanging between morning, evening and night shifts. Results: A total of 179 emergency nurses working in rotating shifts participated in the study. The majority of the nurses were poor sleepers. The study found no significant differences between different shifts interchange and sleep quality. However, interchange between morning and evening shift reported the highest sleep disturbance. Sleep quality was positively correlated with the length of experience, while negatively correlated with the age and the number of monthly shifts. Nurses who declared higher satisfaction and ability to work under pressure revealed better sleep quality. Conclusion: Emergency room nurses showed poor sleep quality. While there was no specific shift interchange cluster inducing poor sleep quality, some demographical and work-related characteristics indicated their influence on sleep quality.

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Sex Differences in the Influence of Sleep on Body Mass Index and Risk of Metabolic Syndrome in Middle-Aged Adults

Healthcare ◽

10.3390/healthcare8040561 ◽

2020 ◽

Vol 8 (4) ◽

pp. 561

Author(s):

Hyun-E Yeom ◽

Jungmin Lee

Keyword(s):

Metabolic Syndrome ◽

Body Mass Index ◽

Body Mass ◽

Cross Sectional Study ◽

Poor Sleep ◽

Middle Aged ◽

Cross Sectional ◽

Aged People ◽

Middle Aged Adults ◽

The Impact

Poor sleep and obesity are intimately related to cardiovascular diseases. We aimed to examine whether the influence of sleep and body mass index (BMI) on the risk of metabolic syndrome (MetS) differed by sex in middle-aged people. It is a cross-sectional study of 458 Korean participants who completed self-administered surveys; the data were analyzed using the PROCESS macro for SPSS. We found that both sleep and BMI were significant predictors of MetS risk in women, particularly by the role of BMI connecting the impact of sleep to MetS risk. However, the association was not found in men, showing that BMI, but not sleep, was a significant predictor of MetS. This sex-related difference was due to different relationships between sleep and BMI, indicating that BMI was more dependent on sleep quality for women than for men. Therefore, a sex-specific approach to decrease the risk of MetS is warranted.

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Impact of covid19 lockdown on sleep quality and acute psychiatric morbidity in medical students in Sudan.

10.21203/rs.3.rs-906805/v1 ◽

2021 ◽

Author(s):

Albashir A. Altayeb ◽

Batool A. altayeb ◽

Mohammed E. Ibrahim ◽

Amira Siddig Abdalgalil

Keyword(s):

Medical Students ◽

Sleep Quality ◽

Negative Impact ◽

Psychiatric Morbidity ◽

Systematic Sampling ◽

Poor Sleep ◽

Cross Sectional ◽

The Impact ◽

Junior Students ◽

Severe Anxiety

Abstract Introduction: The severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) is an emerging infection causing a widely spread pandemic of Coronavirus disease 2019 (COVID-19). The current COVID-19 pandemic is promoting fear of falling sick, dying, helplessness, and stigma. Urgent and timely understanding of sleep quality and mental health status is needed to help the community. Our investigation designed to assess the degree of sleep disturbance and psychological impact of the lockdown among medical students at university of Khartoum.Objectives: this study conducted to assess the impact of covid-19 lockdown on sleep quality and acute psychiatric morbidities among medical students at university of Khartoum.Method: Institutional based cross sectional study was conducted among 326 participants from Khartoum university, faculty of medicine. Study participants were determined by two steps, stratified sampling followed by systematic sampling techniques. Data was collected using standardized questionnaire, entered and analyzed using Statistical Package for Social Science (SPSS) software version 25.Results: out of the total 326 participants 211(64.7%0 were females, and 115(35.35) were males. 92 (28.2%) form the participants were good sleepers and 234 (71.8%) were poor sleepers, the prevalence of moderate to severe anxiety and depression in the participants was found 19.4%, 35.9% respectively. There was correlation between having poor sleep quality and depression among the participants.Conclusion: This study found that there is negative impact of the covid-19 lockdown on medical students, which we found that two thirds of the participants are poor sleepers with a predominance of the female gender among them, One third of the participants had moderate to severe depression which also affects the female more than the males and the junior students more than the seniors, Fifth of the participants had moderate to severe anxiety which affect both gender equally but it did affect the junior students more than the seniors.

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Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among hospital workers in a severely affected institution in Madrid, Spain: A surveillance cross-sectional study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1303 ◽

2020 ◽

pp. 1-7

Author(s):

Felipe Pérez-García ◽

Aurora Pérez-Zapata ◽

Naroa Arcos ◽

Manuel De la Mata ◽

María Ortiz ◽

...

Keyword(s):

Multivariate Logistic Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Previous Contact ◽

Polymerase Chain ◽

Asymptomatic Infections ◽

Secondary Hospital ◽

Respiratory Coronavirus ◽

The Impact

Abstract Objective: To analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic in workers of a hospital located in one of the most affected areas in Spain. Design, settings, and patients: Cross-sectional study performed between March and May 2020 over all workers of a secondary hospital in Madrid, Spain. Methods: We employed polymerase chain reaction (PCR, for symptomatic individuals) and serology (for both PCR-negative symptomatic workers and asymptomatic workers) as diagnostic tests for severe acute respiratory coronavirus virus 2 (SARS-CoV-2). We analyzed the prevalence of the virus in healthcare workers (HCWs) and nonhealthcare workers (nHCWs). We also collected information about the use of personal protective equipment (PPEs) and possible contacts prior to infection. Results: In total, 2,963 workers were included: 1,092 were symptomatic, and of these, 539 were positive by PCR (49.4% of symptomatic workers). From the remaining symptomatic workers, 197 (35.6%) were positive by serology. Regarding asymptomatic workers, 345 were positive by serology (31.9% of infected workers). In total, 1,081 (36.5%) presented a positive diagnostic test for SARS-CoV-2. Infection rates were different between HCWs (37.4%) and nHCWs (29.8%) (P = .006). In the multivariate logistic regression analysis, the use of PPE (protective: OR, 0.56; 95% CI, 0.44–0.72; P < .001) and previous contact with COVID-19 patients (risk factor: OR, 1.69; 95% CI, 1.28–2.24; P < .001) were independent factors that were associated with SAS-CoV-2 infection. Conclusions: Overall, >36% of our workers became infected with SARS-CoV-2, and the rate of asymptomatic infections accounted for almost 32% of all SARS-CoV-2 infections. We detected differences in the rates of infection between HCWs and nHCWs. The use of PPE and previous contact with COVID-19 patients were associated with SARS-CoV-2 infection.

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Association of Hypertension with Mild Cognitive Impairment in Population from Less-Developed Areas of Multiethnic Northwest China

Neuroepidemiology ◽

10.1159/000517956 ◽

2021 ◽

Vol 55 (5) ◽

pp. 407-415

Author(s):

Mulalibieke Heizhati ◽

Nanfang Li ◽

Lin Wang ◽

Jing Hong ◽

Mei Li ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Elderly Population ◽

Blood Pressure Measurement ◽

Multivariate Logistic Regression Analysis ◽

Northwest China ◽

Poor Sleep ◽

Middle Aged ◽

Cross Sectional ◽

Normotensive Subjects

Background: Relationship between hypertension and mild cognitive impairment (MCI) remains undetermined in population from less-developed regions. We aimed to explore whether hypertension is associated with MCI in this specific population. Methods: In this cross-sectional study, we enrolled subjects aged ≥18 years using multistage random sampling from Emin, China, in 2019. Participants underwent questionnaires and data collection including mini-mental state examination (MMSE) and blood pressure measurement. Results: Finally, 31,329 subjects were included, with 11,270 hypertensives. Compared with normotensive subjects, hypertensives were characterized by significantly older age (55.19 ± 12.25 vs. 43.26 ± 12.71), more men (52.5% vs. 42.9%), low education attainment (≤primary education: 42.4% vs. 26.3%), more abdominal obesity (39.7% vs. 19.1%), poor sleep quality (39.1% vs. 28.7%), and chronic kidney disease (6.6% vs. 3.4%, p for all <0.001). Prevalence of MCI in hypertensives was significantly higher than that of normotensive subjects (24.3% vs. 15.6%, p < 0.001). Multivariate logistic regression analysis showed in a fully adjusted model that the odds for MCI were significantly increased in hypertensives than in normotensive population (OR = 1.19, 95% CI: 1.09, 1.30, p < 0.001) and independent of all the parameters studied including age, education level, and stroke. In the age-stratified regression model, presence of hypertension significantly increased the odds of MCI by 1.17-fold (95% CI: 1.03, 1.33, p = 0.020) and by 1.22-fold (95% CI: 1.04, 1.44, p = 0.016) in middle-aged and elderly population. Sensitivity analysis of excluding those with stroke history showed that hypertension was still a risk factor for MCI in total, middle-aged, and elderly population. Conclusion: Hypertension is in independent negative association with MCI in middle-aged and elderly population from underdeveloped regions.

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Communal latrine utilization and associated factors in Addis Ababa, Ethiopia: a community-based cross-sectional study

Journal of Water Sanitation and Hygiene for Development ◽

10.2166/washdev.2018.098 ◽

2018 ◽

Vol 8 (2) ◽

pp. 319-324 ◽

Cited By ~ 2

Author(s):

Elzabeth Girma Kefeni ◽

Walelegn Worku Yallew

Keyword(s):

Population Growth ◽

Social Services ◽

Addis Ababa ◽

Behavioural Change ◽

Multivariate Logistic Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

The Impact

Abstract Despite the quick urban population growth increased volume of wastes, including human excreta, which demands an expanded need of infrastructure, solid institutional setup and communities' engagement for management of safe disposal of excreta, arrangement of such basic social services has not developed as per the rate of population growth. Mostly, communal latrines are inclined towards an absence of cleanliness, as they accommodate many people beyond their capacity, filling up septic tanks quickly. A community-based cross-sectional study conducted in 817 randomly selected communal latrine user households, five focus group discussions and four key informant interviews were analysed. Bivariate and multivariate logistic regression analysis was performed to discover the impact of different factors on the use of communal latrines. The findings revealed that the rate of communal latrine use in Addis Ababa was about 79.8%. Unhygienic conditions, latrine emptying challenges, extreme smell, number of family units sharing the same squats, and latrine designs for the aged and children were identified as barriers to latrine utilization. This study suggests that, in parallel with the continued investments to increase access to sanitary facilities in the city, the management and behavioural change part has likewise to be stressed for better use and sustainability.

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Disease Features Associated with a low Disease Impact in Patients with Psoriatic Arthritis: Results of a Cross-Sectional Multicenter Study

10.21203/rs.2.19994/v1 ◽

2020 ◽

Author(s):

Rubén Queiro ◽

Juan D Cañete ◽

María Montoro ◽

Susana Gómez ◽

Ana Cábez

Keyword(s):

Psoriatic Arthritis ◽

Disease Activity ◽

Multicenter Study ◽

Health Assessment ◽

Multivariate Logistic Regression Analysis ◽

Joint Involvement ◽

Cross Sectional ◽

Patient Reported ◽

Disease Impact ◽

The Impact

Abstract Background Patient reported outcomes measures, such as those provided by the the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire, have been found to be a reliable indicator of change during treatment, predictive of long-term outcomes, and the impact of psoriatic arthritis (PsA) on patients’ lives. The objective of the study was to describe demographic and clinical characteristics of PsA patients with a low disease impact and to analyze predictive factors for that state.Methods Post-hoc analysis of a cross-sectional multicenter study that included 223 consecutive patients. The Psoriatic Arthritis Impact of Disease (PsAID) questionnaire was used to estimate disease impact. Patients with a PsAID < 4 were considered in low disease impact. Minimal Disease Activity (MDA) response and the Health Assessment Questionnaire (HAQ) were also assessed. The degree of agreement between the different outcomes was addressed by Cohen´s kappa index.Results One hundred and twenty-two (54.7%) patients reached a PsAID <4. Among them, 52.0% and 68.0% presented articular or skin remission, respectively. Almost 75% of patients were in MDA state and 85.2% presented a low disability state according to the HAQ. A moderate concordance between HAQ ≤ 0.5 and PsAID <4 (k=0.53), fair between MDA and PsAID <4 (k=0.36), and moderate between DAPSA remission and PsAID <4 (k= 0.46), was observed. Multivariate logistic regression analysis showed that patients with distal interphalangeal joint (DIP) disease (OR 0.40, 95%CI: 0.20-0.79, p=0.009), family history of PsA (OR 0.25, 95%CI: 0.09-0.72, p=0.010), and higher C-reactive protein (OR 0.92, 95%CI: 0.85-0.99, p=0.036) were significantly less likely to reach a PsAID < 4.Conclusions There is certain discrepancy between disease activity measures and a low impact of disease in PsA. Clinical features (DIP joint involvement), biologic activity, and genetic factors (familial history), seem to be associated with lower odds of reaching a low disease impact.

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Headache catastrophization and its relationship with disability, depression, anxiety, stress and sleep quality

Headache Medicine ◽

10.48208/headachemed.2021.22 ◽

2021 ◽

pp. 118-127

Author(s):

Erlene Roberta Ribeiro Ribeiro dos Santos ◽

Daniella Araújo de Oliveira ◽

Antonio Flaudiano Bem Leite ◽

Pedro Augusto Sampaio Rocha Filho ◽

Marcelo Moraes Valença

Keyword(s):

Sleep Quality ◽

Functional Disability ◽

Pain Catastrophizing ◽

Final Analysis ◽

Cross Sectional Study ◽

Poor Sleep ◽

Primary Headaches ◽

Cross Sectional ◽

Migraine Group ◽

Clinical Conditions

IntroductionCross-sectional studies on headache have not yet explored the influence of pain catastrophizing and associations with other psychosomatic comorbidities. The migraine-affected group of individuals was frequently associated with other clinical conditions such as depression, anxiety, stress, and poor sleep quality. These conditions exert a significant influence on carrier’s coping with daily pain and helplessness, since disability hampers work and daily living activities and overly burden individual, their family, society and the health system. Identifying the elements that contribute to disability is crucial in assisting interventions that minimize these conditions.ObjectiveThe aim of this cross-sectional study was to evaluate how the combination of migraine and catastrophizing, associated with functional disability, depression, anxiety, stress, and sleep quality in college students, can influence the perception of pain.MethodsThe 340 participants were selected by drawing lots, in which individuals with primary headaches were assigned. Therefore, the final analysis sample consisted of 288 individuals. The sample was divided into Group with migraine and Group with other primary headaches, with the application of scales: HIT-6 and the scale of pain catastrophizing.ResultsOf the 360 participants, 20 losses were recorded due to inadequate completion of scales, leaving out 340 participants. Of these, 52/340 (15.25%) did not suffer from headaches. 288/340 (84.7%) participants that reported headaches were included in this study, of which 133/288 (46.2%) had migraine, and 155/288 (53.8%) had non-migraine headache. Women who had migraine attacks were those with the most intense anxious symptoms, worse sleep quality, and catastrophization. The odds ratio of catastrophizing was higher for the Migraine Group. Linear and multivariate logistic regression revealed that the greater the presence of catastrophizing, the greater the occurrence of migraine. Catastrophizing had a greater power of contribution related to the disability generated by the crises in the group of migrainous (β = 0.564). The migraine group has a greater perception of pain.ConclusionHigher catastrophization was also associated with a greater intensity of depressive and anxiety symptoms, higher perceived stress, and worse quality of sleep in headache-affected individuals in our study.

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The impact of sleep quality and duration on leptin, appetite, and obesity indices in adults

Medical Journal of Indonesia ◽

10.13181/mji.oa.203707 ◽

2020 ◽

Vol 29 (4) ◽

pp. 417-21

Author(s):

Harry Freitag Luglio Muhammad ◽

Satwika Arya Pratama ◽

Dian Caturini Sulistyoningrum ◽

Maya Nurfitriani Hartono ◽

Emy Huriyati ◽

...

Keyword(s):

Sleep Quality ◽

Dietary Intake ◽

Sleep Duration ◽

The Body ◽

Enzyme Linked Immunosorbent Assay ◽

Poor Sleep ◽

Anthropometric Measures ◽

Cross Sectional ◽

Obesity Indices ◽

The Impact

BACKGROUND Poor sleep duration and quality were previously reported to increase the risk of obesity. This study was aimed to evaluate the impact of sleep quality and duration on leptin, appetite, and adiposity in Indonesian adults. METHODS This cross-sectional study recruited adults in Yogyakarta, Indonesia, in 2016. Sleep quality was assessed using the Pittsburgh sleep quality index, appetite was evaluated using the community nutrition appetite questionnaire, and dietary intake was assessed by interviews using the semi-quantitative food frequency questionnaire. Sleep duration was also asked. Obesity indices were measured using the body mass index (BMI), waist-hip circumference, and percentage of body fat. Leptin was analyzed using the enzyme-linked immunosorbent assay. A Spearman analysis was done to evaluate the correlation between sleep quality, sleep duration, anthropometric measures, dietary intake, appetite, and leptin. RESULTS 244 adults participated in this study. This study showed that lower sleep quality and duration was significantly correlated with higher body weight (r = 0.129, p = 0.043 and r = −0.228, p<0.001), BMI (r = 0.176, p = 0.006 and r = −0.202, p = 0.001), and waist circumference (r = 0.179, p = 0.005 and r = −0.254, p<0.001). There was a correlation between poor sleep quality and higher leptin concentration (r = 0.186, p = 0.004). Sleep quality and duration were not associated with appetite (r = 0.109, p = 0.109 and r = −0.043, p = 0.500). CONCLUSIONS This study found that lower sleep quality was correlated with higher BMI, higher leptin concentration, but not appetite.

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