scholarly journals Smoking Prevalence and Its Clinical Correlations in Patients with Narcolepsy-cataplexy

2016 ◽  
Vol 117 (2-3) ◽  
pp. 81-89 ◽  
Author(s):  
Pavla Peřinová ◽  
Eva Feketeová ◽  
David Kemlink ◽  
Petra Kovalská ◽  
Karolína Chlebušová ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Neurological Disease ◽  
Smoking Prevalence ◽  
Sleep Latency ◽  
Clinical Parameters ◽  
Smoking Duration ◽  
Former Smokers ◽  
Clinical Correlations ◽  
The Mean ◽  
Multiple Sleep Latency

Narcolepsy-cataplexy (NC) is a chronic neurological disease with suggested autoimmune etiopathogenesis. Nicotine stimulates central nervous system and smoking increases the risk of autoimmune diseases. Assessment of smoking habits and its correlation to clinical parameters among 87 adult NC patients (38 male, 49 female) included night polysomnography and multiple sleep latency test. In our sample, 43.7% NC patients were regular smokers, and 19.5% former smokers compared to 22.2%, and 12.6%, respectively, in the general population. Patients started to smoke in the mean age of 20.0 (SD ±6.0) years. 72.2% of NC smokers started to smoke before the onset of NC and the mean of the delay between smoking onset and NC onset was 9.1 (±5.8) years. We found a direct correlation between smoking duration and the number of awakenings, duration of N1 sleep, REM sleep latency, and apnoea/hypopnoea index (AHI), and, on the contrary, indirect correlation between smoking duration and N3 sleep duration, showing that smoking duration consistently correlates with sleep macrostructure. Smoking is highly prevalent in NC and has relationship with clinical features of NC.

scholarly journals Midazolam daytime residual effect evaluated by the multiple sleep latency test

1993 ◽  
Vol 51 (2) ◽  
pp. 165-168
Author(s):  
Rubens Reimão
Keyword(s):  
Clinical Evaluation ◽  
Sleep Latency ◽  
Residual Effect ◽  
Subjective Symptom ◽  
Multiple Sleep Latency Test ◽  
Double Blind ◽  
Weight Distributions ◽  
The Mean ◽  
Double Blind Design ◽  
Multiple Sleep Latency

Daytime sleepiness after ingestion of midazolam as a hypnotic was quantitatively studied employing the Multiple Sleep Latency Test (MSLT). We evaluated 20 healthy volunteers, 10 of which received a single oral dose of midazolam (15 mg, one tablet) and 10 of which received placebo, in a double-blind design. Tablets were administered at 2200 h, bedtime. On the following day, all subjects were submitted to a clinical evaluation, a subjective checklist and the MSLT. The mean age was 34.7 + 8.9 years in the midazolam and 38.0+10.6 years in the placebo groups (n.s.). Sex and weight distributions were similar in both groups (n.s.). Clinical evaluation and subjective symptom checklist did not make evident significant differences between midazolam and placebo groups (n.s.). The MSTL was performed at 0900, 1100, 1300, 1500 and 1700 h. Mean sleep latencies were 12.0, 12.7, 8.0, 13.5, 17.0 min in the midazolam group; mean sleep latencies were 13.8, 9.0, 6.9, 9.5, 13.6 min in the placebo group (n.s.). In the single dose, double-blind design here evaluated, midazolam did not show differences in relation to placebo on the following day, detectable by the MSLT.

scholarly journals POS0853 DECREASE IN ANTI-TOPOISOMERASE-1 ANTIBODY TITER IN PATIENTS WITH SYSTEMIC SCLEROSIS DURING LONG-TERM RITUXIMAB THERAPY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 681.1-681
Author(s):  
L. Garzanova ◽  
L. P. Ananyeva ◽  
O. Koneva ◽  
O. Desinova ◽  
O. Ovsyannikova ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
B Lymphocytes ◽  
Vital Capacity ◽  
Clinical Parameters ◽  
Diffusion Capacity ◽  
Positive Group ◽  
Topoisomerase 1 ◽  
The Mean

Background:Rituximab (RTX) is a new option in the treatment of systemic sclerosis (SSc) [1]. There is not enough data on changes in the level of autoantibodies and their clinical significance during RTM therapy. There are only a few reports on the higher efficiency of RTX in patients (pts) with SSc positive for anti-topoisomerase-1 antibodies (a-Topo-1), therefore the study of this issue might be interested.Objectives:To compare clinical parameters and B-lymphocytes (B-lymph) level in SSc pts depending on the presence or absence of a-Topo-1 during RTX therapy with prospective long-term follow-up.Methods:This study included 88 pts with SSc. The mean follow-up period was 26,3±10,7 months. The mean age was 47years (17-71), female-73 pts (83%), the diffuse cutaneous subset of the disease had 50 pts (57%). Symptoms of the interstitial lung disease (ILD) were observed in 70 pts (80%). The mean disease duration was 5,9±4,8 years. The cumulative mean dose of RTX was 2,9±1,1 grams. All patients received prednisone at a dose of 11,7±4,4 mg, immunosuppressants received 42% of them. There were 63 pts positive for a-Topo-1 and 25 pts - negative. The pts of the compared groups did not differ in the main demographic and clinical parameters, excepting lung involvement. In a-Topo-1 positive group 55 (87%) pts had ILD and only 15 (60%) – in a-Topo-1-negative group (p=0,02). The results at baseline and at the end of the follow up are presented in the form of mean values and changes in parameters (delta).Results:Considering the entire cohort, an improvement of almost all outcome parameters was found. When a-Topo-1 positive and a-Topo-1-negative pts were analyzed separately, we observed a significantly higher decrease in the activity score, depletion of B-lymph, an increase in forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) in a-Topo-1 positive group of pts (table 1).Table 1.Changes of the main outcome parameters depending on the presence of a-Topo-1 on RTX therapy.Parametersa-Topo-1positive ptsa-Topo-1negative ptsPDelta Activity score (EScSG-AI)1,790,90,001Delta Rodnan skin score (mRSS)4,95,2NSDelta B-lymphocytes (absolute count)0,2120,1930,001Delta FVC*, %8,646,460,001Delta DLCO**, %2,860,0320,001*FVC - forced vital capacity % predicted, **DLCO - diffusion capacity for carbon monoxide % predictedThe a-Тopo-1 level decreased from 174,2±50,1 to 148,1±66,1 units/ml (p=0,0009). In this group, a-Тopo-1 became negative in 5 pts (7,9%). The disappearance of a-Topo-1 positivity was accompanied by a more pronounced decrease in mRSS (delta mRSS=7,4) and a higher depletion of B-lymph. There was a higher cumulative dose of RTX (4±1,4grams) in this 5 pts compared with the pts who sustained a-Topo-1 positivity. There was a moderate negative statistically significant correlation between the a-Topo-1 and the total dose of RTX (r=-0,298, p=0,017). A moderate negative statistically significant correlation was found between the a-Topo-1 and FVC (r=-0,322, p=0,009).Conclusion:In our study, the a-Topo-1 level significantly decreased during RTX therapy in Russian pts. The decrease in a-Topo-1 titers correlated with the total dose of RTX and was accompanied by a decrease in mRSS, disease activity index and an increase in FVC and DLCO. A higher efficacy of RTX in the a-Topo-1 positive group with prevalence of ILD was revealed, therefore a-Topo-1 positivity could be considered as a predictor of a better response to RTX therapy.References:[1]Jordan S, et al. Effects and safety of rituximab in systemic sclerosis: an analysis from the European Scleroderma Trial and Research (EUSTAR) group. Ann Rheum Dis.2015;74:1188–94.Doi:10.1136/annrheumdis-2013-204522.[2]Ebata S, Yoshizaki A, et.al. Rituximab therapy is more effective than cyclophosphamide therapy for Japanese patients with anti-topoisomerase I-positive systemic sclerosis-associated interstitial lung disease. J Dermatol.2019.Nov;46(11):1006-1013.doi:10.1111/1346-8138.15079.Disclosure of Interests:None declared

scholarly journals Late-Onset Narcolepsy: A Case Report with Brief Review of the Literature

2021 ◽  
Author(s):  
Jeny Jacob ◽  
Rajesh Venkataram ◽  
Nandakishore Baikunje ◽  
Rashmi Soori
Keyword(s):  
Older Adults ◽  
Case Report ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Late Onset ◽  
Sleep Latency ◽  
Early Adulthood ◽  
Review Of The Literature ◽  
Multiple Sleep Latency ◽  
Overnight Polysomnography

AbstractNarcolepsy, a sleep disorder, has its onset in childhood and early adulthood but rarely in older adults. This case report focuses on a man in his late fifties who was noticed to have excessive daytime sleepiness during his stay in our hospital for an unrelated medical ailment. He was further evaluated with overnight polysomnography and next day multiple sleep latency test which confirmed the diagnosis of narcolepsy.

scholarly journals 1253 Multiple sleep onset REM episodes in middle age woman with excessive daytime sleepiness – Is this automatically assumed narcolepsy?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A477-A477
Author(s):  
Kamal Patel ◽  
Bianca J Lang
Keyword(s):  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Multiple Sleep Latency Test ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Obstructive Sleep ◽  
Falling Asleep ◽  
Multiple Sleep Latency

Abstract Introduction Presence of sleep onset REM episodes often raises concerns of narcolepsy. However other conditions have shown to have presence of sleep on REM episodes which include but not limited to obstructive sleep apnea, sleep wake schedule disturbance, alcoholism, neurodegenerative disorders, depression and anxiety Report of Case Here we present a case of 30 year old female with history of asthma, patent foraman ovale, migraine headache, and anxiety who presented with daytime sleepiness, falling asleep while at work, occasional scheduled naps, non-restorative sleep, sleep paralysis, and hypnopompic hallucination. Pertinent physical exam included; mallampati score of 4/4, retrognathia, high arched hard palate, crowded posterior oropharynx. She had a score of 16 on Epworth sleepiness scale. Patient previously had multiple sleep latency test at outside facility which revealed 4/5 SOREM, with mean sleep onset latency of 11.5 minutes. She however was diagnosed with narcolepsy and tried on modafinil which she failed to tolerate. She was tried on sertraline as well which was discontinued due to lack of benefit. She had repeat multiple sleep latency test work up which revealed 2/5 SOREM, with mean sleep onset latency was 13.1 minutes. Her overnight polysomnogram prior to repeat MSLT showed SOREM with sleep onset latency of 10 minutes. Actigraphy showed consistent sleep pattern overall with sufficient sleep time but was taking hydroxyzine and herbal medication. Patient did not meet criteria for hypersomnolence disorder and sleep disordered breathing. Conclusion There is possibility her medication may have played pivotal role with her daytime symptoms. We also emphasize SOREMs can be present in other disorders such as anxiety in this case and not solely in narcolepsy

Abstract 14964: Sudden Cardiac Death in Current vs. Former Smokers

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kyndaron Reinier ◽  
Carmen Teodorescu ◽  
Audrey Uy-Evanado ◽  
Karen Gunson ◽  
Jonathan Jui ◽  
...  
Keyword(s):  
Risk Factor ◽  
Sudden Cardiac Death ◽  
Medical Records ◽  
Cardiac Death ◽  
Smoking Prevalence ◽  
Smoking History ◽  
Common Finding ◽  
Behavioral Risk ◽  
Community Based ◽  
Former Smokers

Introduction: Smoking is a well-established risk factor for cardiovascular disease, but its role in sudden cardiac death (SCD) specifically has not been as well investigated. We sought to describe smoking prevalence among cases that suffered SCD in the general population. Hypothesis: We hypothesized that smoking prevalence would be high among SCD cases. Methods: Cases of SCD from an ongoing multiple-source community-based study of SCD in the northwest US (pop. approx. 1 million) were included if they were age ≥18 with smoking history available from medical records. We describe the prevalence of smoking in the SCD population, as well as characteristics of smokers vs. non-smokers. Results: From 2002 -2012, 1833 (76%) of 2402 SCD cases had pre-SCD medical records available, and smoking history was available for 1241 (68%) of these. While 2007-8 community data (Behavioral Risk Factor Surveillance Study) indicated that 16% of Oregonian adults were current smokers, among the SCD cases, 40% were current smokers, 31% former smokers, and 29% non-smokers. Men were more likely than women to be current smokers (42% vs. 37%) or former smokers (35% vs. 23%); 40% of women and 24% of men were non-smokers (p<0.0001). Among SCD cases, current smokers were significantly younger at the time of their SCD (57.8 ± 13.2 yrs) than former smokers (70.0 ± 12.9 yrs) or non-smokers (66.6 ± 17.9 yrs; p<0.0001), despite a similar number of years smoked among the current and former smokers (33 vs 29 years, p=0.22). Former smokers were more likely to have a history of myocardial infarction and documented CAD than current smokers (p<0.0001). Conclusions: In this community-based study of SCD, current and former smoking was a common finding; current smokers suffered SCD at a younger age than former smokers, despite less documented CAD and MI at the time of their arrest.

scholarly journals Suppurative infectious diseases of the central nervous system in domestic ruminants

2017 ◽  
Vol 37 (8) ◽  
pp. 820-828 ◽  
Author(s):  
Guilherme Konradt ◽  
Daniele M. Bassuino ◽  
Klaus S. Prates ◽  
Matheus V. Bianchi ◽  
Gustavo G.M. Snel ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Infectious Diseases ◽  
Neurological Disease ◽  
Etiologic Agent ◽  
Domestic Ruminants ◽  
The Central Nervous System ◽  
Positive Immunostaining

ABSTRACT: This study describes suppurative infectious diseases of the central nervous system (CNS) in domestic ruminants of southern Brazil. Reports from 3.274 cattle, 596 sheep and 391 goats were reviewed, of which 219 cattle, 21 sheep and 7 goats were diagnosed with central nervous system inflammatory diseases. Suppurative infectious diseases of the CNS corresponded to 54 cases (28 cattle, 19 sheep and 7 goats). The conditions observed consisted of listerial meningoencephalitis (8 sheep, 5 goats and 4 cattle), suppurative leptomeningitis and meningoencephalitis (14 cattle, 2 goats and 1 sheep), cerebral (6 cattle and 2 sheep), and spinal cord (7 sheep) abscesses, and basilar empyema (4 cattle and 1 sheep). Bacterial culture identified Listeria monocytogenes (9/54 cases), Escherichia coli (7/54 cases), Trueperella pyogenes (6/54 cases) and Proteus mirabilis (1/54 cases). All cases diagnosed as listeriosis through histopathology yielded positive immunostaining on immunohistochemistry, while 12/17 of the cases of suppurative leptomeningitis and meningoencephalitis presented positive immunostaining for Escherichia coli. Meningoencephalitis by L. monocytogenes was the main neurological disease in sheep and goats, followed by spinal cord abscesses in sheep. In cattle, leptomeningitis and suppurative meningoencephalitis was the most frequent neurological disease for the species, and E. coli was the main cause of these lesions. Basilar empyema, mainly diagnosed in cattle, is related to traumatic injuries, mainly in the nasal cavity, and the main etiologic agent was T. pyogenes.

Impairment of Antipyrine Metabolism in Urinary Tract Cancer

1983 ◽  
Vol 69 (3) ◽  
pp. 221-222 ◽  
Author(s):  
Maura Ludovici ◽  
Piero Dolara ◽  
Alfiero Costantini ◽  
Guido Barbagli ◽  
Anna Calzolai ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Half Life ◽  
Clinical Parameters ◽  
Tract Cancer ◽  
Patients With Cancer ◽  
Control Subjects ◽  
Antipyrine Metabolism ◽  
Urinary Tract Cancer ◽  
The Mean ◽  
Age And Sex

The metabolism of antipyrine was studied in 13 patients with cancer and bladder papillomas and in 11 control subjects, matched for interfering factors like smoking, diet, age and sex. The mean antipyrine half-life was significantly longer in patients with urinary tract cancer (14.7 ± 1.32 h SE) than in control subjects (11 ± 0.55 h SE) (P < 0.025); other clinical parameters did not vary.

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