H ποιότητα του ύπνου μετά από λοίμωξη από COVID-19

Εισαγωγή - Σκοπός μελέτης: Ο ύπνος αποτελεί μια βασική ανάγκη του οργανισμού, και είναι ζωτικής σημασίας. Η πανδημία του COVID-19 είχε ως αποτέλεσμα να αλλάξει την καθημερινότητα των ανθρώπων, καθώς επίσης και την ποιότητα του ύπνου τους. Αρκετές μελέτες έχουν δείξει ότι η επίπτωση των διαταραχών ύπνου και νευρο-ψυχιατρικών συμπτωμάτων είναι ιδιαίτερα υψηλή σε ασθενείς με COVID-19. Λίγα είναι τα δεδομένα όσο αφορά τον ύπνο μετά την ανάρρωση ασθενών με COVID-19. Σκοπός της μελέτης αυτής είναι να διερευνηθεί η ποιότητα του ύπνου ένα μήνα μετά από νοσηλεία σε ασθενείς που νόσησαν με COVID-19. Μέθοδοι: Πρόκειται για μία μελέτη παρατήρησης, ασθενών-μαρτύρων. Στη μελέτη αυτή συμμετείχαν 87 ασθενείς με μέτρια ή σοβαρή λοίμωξη από COVID-19, που έχρηζαν νοσηλείας. Οι ασθενείς αυτοί εξετάσθηκαν στα εξωτερικά ιατρεία του νοσοκομείου ένα μήνα μετά την έξοδό τους από το νοσοκομείο, και συμπλήρωσαν ερωτηματολόγια για την κατάθλιψη, το άγχος, την κατάσταση της υγείας τους και της ποιότητας του ύπνου τους. Ως ομάδα ελέγχου χρησιμοποιήθηκαν 87 εθελοντές, εργαζόμενοι του τομέα υγείας που δεν είχαν νοσήσει από COVID-19. Αποτελέσματα: Η ποιότητα ύπνου συσχετιζόταν με τον χρόνο επέλευσης του ύπνου (r=0,629, p=0.0001), με την κλίμακα υγείας (r=-0,448, p=0,0001), την σωματική υποκατηγορία (r=-0,373, p=0,0001), και με την πνευματική υποκατηγορία (r=-0,456, p=0,0001). H ποιότητα ύπνου συσχετίστηκε επίσης με το επίπεδο άγχους (r=0,344, p=0,001), και με την κλίμακα κατάθλιψης (r=0,266, p=0,013). Από τους αιματολογικούς δείκτες, συσχετίστηκε με τον αιματοκρίτη (r=-0,314, p=0,030) και την αιμοσφαιρίνη (r=-0,373, p=0,009), τα αιμοπετάλια (r=0,341, p=0,034) και με τα επίπεδα της CRP (r=-0,685, p=0,042). Στο πολυπαραγοντικό μοντέλο, παρέμεινε στατιστικά σημαντική η σχέση της ποιότητας ύπνου με την κλίμακα υγείας. Η ποιότητα ύπνου δεν διέφερε στις δύο ομάδες (p=0,129). Διαφορές δεν παρατηρήθηκαν μεταξύ των δύο ομάδων ούτε και στον χρόνο επέλευσης ύπνου, το οποίο είναι δείκτης εμφάνισης αυπνίας (p=0,281). Συμπεράσματα: Η μελέτη αυτή δεν κατάφερε να αποδείξει χαμηλότερη ποιότητα ύπνου ένα μήνα μετά τη λοίμωξη από Covid-19, σε σύγκριση με άτομα ελέγχου που δεν νόσησαν. Στο αποτέλεσμα αυτό ίσως επιδρά το γεγονός ότι η ομάδα ελέγχου που χρησιμοποιήθηκε αποτελούταν από επαγγελματίες υγείας, μια ομάδα με υψηλά ποσοστά άγχους, κατάθλιψης και μη αποδοτικού ύπνου.Background-Aim of the Study: Sleep is an essential function and plays a vital role, for a person's health and wellbeing. The COVID-19 pandemic brought important implications on daily life and sleep quality. There are several studies that point out the high prevalence of sleep disruption and psychological disorders in patients with COVID-19 infection. However, little is known about sleep after the recovery of COVID-19 infection. The aim of this study was to investigate sleep quality in patients, one month after hospital admission for COVID-19 infection. possible associations between regular sleep disruption and immunity response after vaccination for COVID-19. Methods: This is an observational study (a case-control study). Eighty-seven patients suffering from moderate or severe infection of COVID-19 and needed an admission at the hospital were enrolled in this study. Patients had a follow-up examination one month after their discharge from the hospital, and they were asked to complete questionnaires for depression, stress, physical and mental health status, and sleep quality. Eighty-seven healthcare workers, with no previous history of COVID-19 infection were enrolled as a control group. Results: Sleep quality was associated with sleep latency (r=0.629, p=0.0001), with total health status, (r=-0.448, p=0.0001), with physical status (r=-0.373, p=0.0001), and with mental status (r=-0.456, p=0.0001). Sleep quality was also associated with stress (r=0.344, p=0.001), and depression (r=0.266, p=0.013). Sleep quality was associated and with biochemical factors, such as hematocrit (r=-0.314, p=0.030), hemoglobin (r=-0.373, p=0.009), platelets count (r=0.341, p=0.034) and levels of C-reactive protein (CRP) (r=-0.685, p=0.042). After multivariate analysis, the relationship between sleep quality and health status remained, after adjusting for confounders factors. Sleep quality did not differ between the two groups (p=0.129). There were no differences between the two groups in sleep latency, which is an indicator of insomnia (p=0.281). Conclusions: Our observations did not demonstrate sleep quality differences between the group of COVID-19 sufferers and the control group. This conclusion is limited by the fact that healthcare professionals, that were used as a control group, often experience a chronic circadian disruption, and they have increased prevalence of stress and depression, compared to general population

How do care partners of people with rare dementia use language in online peer support groups? A quantitative text analysis study

We used quantitative text analysis to examine conversations in a series of online support groups attended by care partners of people living with rare dementias (PLWRD). We used transcripts of 14 sessions (>100,000 words) to explore patterns of communication in trained facilitators’ (n = 2) and participants’ (n = 11) speech and to investigate the impact of session agenda on language use. We investigated the features of their communication via Poisson regression and a clustering algorithm. We also compared their speech with a natural speech corpus. We found that differences to natural speech emerged, notably in emotional tone (d = −3.2, p < 0.001) and cognitive processes (d = 2.8, p < 0.001). We observed further differences between facilitators and participants and between sessions based on agenda. The clustering algorithm categorised participants’ contributions into three groups: sharing experience, self-reflection, and group processes. We discuss the findings in the context of Social Comparison Theory. We argue that dedicated online spaces have a positive impact on care partners in combatting isolation and stress via affiliation with peers. We then discuss the linguistic mechanisms by which social support was experienced in the group. The present paper has implications for any services seeking insight into how peer support is designed, delivered, and experienced by participants

Effect of inhaled corticosteroid particle size on asthma efficacy and safety outcomes: a systematic literature review and meta-analysis

BACKGROUND: Inhaled corticosteroids (ICS) are the primary treatment for persistent asthma. Currently available ICS have differing particle size due to both formulation and propellant, and it has been postulated that this may impact patient outcomes. This structured literature review and meta-analysis compared the effect of small and standard particle size ICS on lung function, symptoms, rescue use (when available) and safety in patients with asthma as assessed in head-to-head randomized controlled trials (RCTs). METHODS: A systematic literature search of MEDLINE was performed to identify RCTs (1998-2014) evaluating standard size (fluticasone propionate-containing medications) versus small particle size ICS medication in adults and children with asthma. Efficacy outcomes included forced expiratory volume in 1 s (FEV1), morning peak expiratory flow (PEF), symptom scores, % predicted forced expiratory flow between 25 and 75% of forced vital capacity (FEF25-75%), and rescue medication use. Safety outcomes were also evaluated when available. RESULTS: Twenty-three independent trials that met the eligibility criteria were identified. Benefit-risk plots did not demonstrate any clinically meaningful differences across the five efficacy endpoints considered and no appreciable differences were noted for most safety endpoints. Meta-analysis results, using a random-effects model, demonstrated no significant difference between standard and small size particle ICS medications in terms of effects on mean change from baseline FEV1 (L) (-0.011, 95% confidence interval [CI]: -0.037, 0.014 [N = 3524]), morning PEF (L/min) (medium/low doses: -3.874, 95% CI: -10.915, 3.166 [N = 1911]; high/high-medium doses: 5.551, 95% CI: -1.948, 13.049 [N = 749]) and FEF25-75% predicted (-2.418, 95% CI: -6.400; 1.564 [N = 115]). CONCLUSIONS: Based on the available literature, no clinically significant differences in efficacy or safety were observed comparing small and standard particle size ICS medications for the treatment of asthma. TRIAL REGISTRATION: GSK Clinical Study Register No: 202012

ZFP36L1 negatively regulates plasmacytoid differentiation of BCL1 cells by targeting BLIMP1 mRNA

The ZFP36/Tis11 family of zinc-finger proteins regulate cellular processes by binding to adenine uridine rich elements in the 3′ untranslated regions of various mRNAs and promoting their degradation. We show here that ZFP36L1 expression is largely extinguished during the transition from B cells to plasma cells, in a reciprocal pattern to that of ZFP36 and the plasma cell transcription factor, BLIMP1. Enforced expression of ZFP36L1 in the mouse BCL1 cell line blocked cytokine-induced differentiation while shRNA-mediated knock-down enhanced differentiation. Reconstruction of regulatory networks from microarray gene expression data using the ARACNe algorithm identified candidate mRNA targets for ZFP36L1 including BLIMP1. Genes that displayed down-regulation in plasma cells were significantly over-represented (P = <0.0001) in a set of previously validated ZFP36 targets suggesting that ZFP36L1 and ZFP36 target distinct sets of mRNAs during plasmacytoid differentiation. ShRNA-mediated knock-down of ZFP36L1 in BCL1 cells led to an increase in levels of BLIMP1 mRNA and protein, but not for mRNAs of other transcription factors that regulate plasmacytoid differentiation (xbp1, irf4, bcl6). Finally, ZFP36L1 significantly reduced the activity of a BLIMP1 3′ untranslated region-driven luciferase reporter. Taken together, these findings suggest that ZFP36L1 negatively regulates plasmacytoid differentiation, at least in part, by targeting the expression of BLIMP1

Psychological therapies for depression and cardiovascular risk: evidence from national healthcare records in England

Aims: People with depression are up to 72% more at risk to develop cardiovascular disease (CVD) in their lifetime. Evidence-based psychotherapies are first-line interventions for the treatment of depression and are delivered nationally in England through the National Health Service via the Improving Access to Psychological Therapy (IAPT) primary care programme. It is currently unknown whether positive therapy outcomes may be associated with cardiovascular risk reduction. This study aimed to examine the association between psychotherapy outcomes for depression and incident CVD. Methods and results: A cohort of 636 955 individuals who have completed a course of psychotherapy was built from linked electronic healthcare record databases of national coverage in England: the national IAPT database, the Hospital Episode Statistics (HES) database, and the HES–ONS (Office of National Statistics) mortality database. Multivariable Cox models adjusting for clinical and demographic covariates were run to estimate the association between reliable improvement from depression and the risk of subsequent incidence of cardiovascular events. After a median follow-up of 3.1 years, reliable improvement from depression symptoms was associated with a lower risk of new onset of any CVD [hazard ratio (HR): 0.88, 95% confidence interval (CI): 0.86, 0.89], coronary heart disease (HR: 0.89, 95% CI: 0.86, 0.92), stroke (HR: 0.88, 95% CI: 0.83, 0.94), and all-cause mortality (HR: 0.81, 95% CI: 0.78, 0.84). This association was stronger in the under 60 compared with the over 60 for all outcomes. Results were confirmed in sensitivity analyses. Conclusion: Management of depression through psychological interventions may be associated with reduced risk of CVD. More research is needed to understand the causality of these associations