The role of the Syndrome X in the pathophysiology of sleep-apnea syndrome

Objective: Syndrome X or microvascular angina pectoris is defined as angina pectoris due to coronary microvascular dysfunction in patients with non-stenotik epicardial arteries. The aim of his study was to investigate the relationship between obstructive sleep apnea syndrome (OSAS) and syndrome X.Materials and methods: Twenty patients (11 male, 9 female) with the complaint of chest pain who referred to Cardiology Clinics of Dicle University were enrolled in the study as Group 1. All of the patients’ exercise tests were positive, epicardial coronary arteries were normal and coronary flows were slow in Group 1. Thirty healthy person were enrolled in the study as group 2. Polysomnography (PSG) and echocardiography (ECHO) was performed in all patients.Results: In Group 1, 11 (55%) patients had obstructive sleep apnea. In Group 2, three patients (10%) had OSAS. There were significant differences in terms of OSAS frequency among groups. There were no significant differences in terms of left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), stroke volume, deceleration time (DT) , ejection time (ET) and the left atrium (LA) diameter between Syndrome X and control groups according to echocardiographic examination (p>0.05). However, IVRT, RA diameter, the myocardial performance index (MPI), PAP, and MEV / mav rates were significantly different (p <0.05).Conclusion: OSAS -also known to cause cardiovascular complications- incidence was significantly higher in patients with syndrome X than the healthy subjects. In OSAS patients, apnea hypopnea index, cardiovascular risk factors such as hypertension and dyslipidemia were more common than healthy subjects. Therefore, these patients should be followed up closely and be treated properly

Serum YKL-40 levels as a novel marker of inflammation and endothelial dysfunction in patients with pseudoexfoliation syndrome

WOS: 000321700800013PubMed: 23661157Purpose To evaluate serum levels of YKL-40 in patients with pseudoexfoliation syndrome (PEX) in comparison with those of age-and sex-matched healthy subjects. Methods Forty patients with PEX (PEX group) and 40 age- and sex-matched control subjects (control group) were enrolled in the study. An enzyme immunoassay method using the commercially available test MicroVue YKL-40 was used to measure serum YKL-40 concentration. Systolic and diastolic blood pressures, serum levels of high sensitivity C-reactive protein (hsCRP), total cholesterol, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglycerides were also examined. Results the mean age was 54.4 +/- 7.6 (ranging 41-65) years in each group. the mean serum YKL-40 level of the PEX group was significantly higher than that of the control group (P<0.001). in addition, the mean serum HsCRP, total cholesterol, LDL, and triglycerides levels were significantly higher, and mean serum HDL level was significantly lower in the PEX group than in the control group (all P<0.001, excluding both P = 0.002 for triglycerides and HDL levels). Further, the mean systolic and diastolic blood pressures were significantly higher in the PEX group than in the control group (P-1 = 0.001 and P-2 = 0.01, respectively). Conclusion We have shown a relationship between PEX and elevated serum levels of YKL-40. We imply that a better understanding of the role of YKL-40 in the pathogenesis of endothelial dysfunction and atherosclerosis is necessary to develop new therapies for preventing or treating PEX. Further studies are warranted to clarify the clinical relevance of these findings

Assessment of the sleep parameters in patients with obstructive sleep apnea syndrome with a

Objective: In this study, traffic accident with a history ofobstructive sleep apnea syndrome (OSAS) in patientswith polysomnographic parameters was investigated.Methods: A total of 77 OSAS patients were included inthe study. All-night polysomnographic recordings obtainedfrom patients with enuresis parameters and thepresence of traffic accidents recorded in standard form.Results: The mean age of patients was 45.15 ± 11.53years. 53% of the patients were male and 47% female.The mean apnea hypopnea index (AHI) in patients was13.54 events/h. History of traffic accidents was found in12% patients. Apnea hypopnea index, supine AHI, arousalindex and oxygen desaturation index were found significantlydifferent parameters between history of trafficaccidents group and non-history of traffic accidents group(p <0.05).Conclusion: In this study, patients with OSAS severity ofthe disease with a history of traffic accidents were associatedthe relationship between the parameters. This relationshipwith the severity of the disease might be due tothe negative effects on attention. J Clin Exp Invest 2013;4 (2): 204-207Key words: OSAS, traffic accident, AH

Correlation of Copeptin with N-terminal pro-brain natriuretic peptide in predicting the severity and prognosis of acute pulmonary embolism Copeptin in acute pulmonary embolism

Aim: In this study, we aimed to compare copeptin with N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I for predicting severity and 3-month mortality in acute PE in the emergency department (ED). Material and Methods: All ED patients older than 18 years who were confirmed to have acute PE within six hours of diagnostic work-up were enrolled and prospectively screened. Risk stratification was made according to the 2014 European Society of Cardiology guideline on PE. The study endpoints were defined as 3-month mortality, presence of non-low risk PE, and presence of right ventricular (RV) dysfunction. The Mann-Whitney Ll test was used for the comparison of medians. Receiver operating characteristic curves were generated and the area under the curve (AUC) was calculated to determine the best cut-off values of copeptin and NT-proBNP. A P value < 0.05 was considered statistically significant. Results: The study enrolled 82 patients. Twelve patients who died during 3 months had higher concentrations of NT-proBNP and copeptin, but not troponin I. The AUCs of NT-proBNP and copeptin to accurately predict the 3-month mortality were 0.73 +/- 0.09 (95% CI, 0.62 - 0.82; p = 0.013) and 0.78 +/- 0.09 (95% CI, 0.68 - 0.86; p = 0.003), respectively. Low-risk patients, according to Pulmonary Embolism Severity Index, had lower concentrations of copeptin and NT-proBNP compared to intermediate-high risk patients. All three markers discriminated the presence of RV dysfunction truly. Discussion: Copeptin correlates with NT-proBNP and appears beneficial for early risk stratification of acute pulmonary embolism in the ED

The Evaluation of Headache in Patients with Schizophrenia: A Case- Control Study

Amaç: Bu çalışmada şizofrenli hastalarda sağlıklı kontrol grubu ile karşılaştırarak baş ağrısı sıklığı ve hangi tip baş ağrılarının olduğunun araştırılması amaçlandı.Yöntem: Çalışmaya 101 hasta ve 89 sağlıklı kontrol grubu alındı. Hastalara araştırmacılar tarafından hazırlanan, hastanın sosyo-demografik özelliklerinin, hastalığı ile ilgili bilgilerin ve baş ağrısı ile ilgili soruların yer aldığı sosyodemografik veri formu, DSM-IV eksen 1 tanı ölçütlerine göre hazırlanmış yapılandırılmış bir klinik görüşme formu olan SCID-1 ve Pozitif ve Negatif Belirtileri Değerlendirme Ölçeği uygulandı. Şu anda ya da geçmişte baş ağrısı olduğunu ifade eden hastalar baş ağrısının değerlendirilmesi amacıyla nöroloji polikliniğine yönlendirildi. Bulgular: Şizofrenli hasta grubunun %38.6'sı baş ağrısı tanımlarken, kontrol grubunda bu oran %37.1 olarak bulundu. Her iki grupta da en fazla gerilim tipi baş ağrısı (GTBA) görülmesine rağmen (hasta grubu=%31.7, kontrol grubu=%18) şizofreni grubunda GTBA kontrol grubundan anlamlı olarak daha fazla bulundu. Migren tipi baş ağrısı ise kontrol grubunun %11.2'sinde görülürken, hasta grubunun %2'sinde görülmekteydi. Şizofrenili hasta grubu kontrol grubuna göre baş ağrısı yakınmasını daha az dile getirmekteydi.Sonuç: Bu çalışmada şizofrenili hastaların normal popülasyon kadar baş ağrısına maruz kaldığı, baş ağrısı yakınmasını normal topluma göre daha az dile getirdikleri sonucu elde edilmiştir. Bu konuda yapılacak geniş örneklemli çalışmalar ve oluşturulacak tedavi protokolleri şizofrenili hastaların yaşam kalitesinin artmasına da katkı sağlayabilirObjective: The aim of this study is to explore the frequency and the types of headache in patients with schizophrenia and to compare it with the healthy control group. Method: A hundred and one patients and eighty nine healthy subjects were included in this case-control study. Socio-demographic data form, structured clinical interview for DSM disorders type 1 (SCID-1), Scale for the Assessment of the Negative Symptoms (SANS) and of the Positive Symptoms (SAPS) were applied. The subjects with headache were consulted to the neurology clinic. Results: The prevalence of headache in the patient group was 38.6% whereas the prevalence of headache in the control group was 37.1%. Tension type headache (TTH) was the most prominent type in both group (31.7% of patients, 18.0% of controls) and the presence of TTH in patients with schizophrenia was found statistically significant. Migraine type headache was detected in 2.0% of patients and 11.2% of controls. The ratio of headache was lesser in patients than in the controls. Conclusion: Schizophrenic patients have headache as much as the healthy subjects but they complain less about their headache than the controls do. Further studies with larger samples in patients with schizophrenia would present the importance of the issue and improve the quality of life in patients with schizophrenia contributing the analgesi

Evaluation of Anthropometric and Metabolic Parameters in Obstructive Sleep Apnea

Aims. Sleep disorders have recently become a significant public health problem worldwide and have deleterious health consequences. Obstructive sleep apnea (OSA) is the most common type of sleep-related breathing disorders. We aimed to evaluate anthropometric measurements, glucose metabolism, and cortisol levels in patients with obstructive sleep apnea (OSA). Materials and Methods. A total of 50 patients with a body mass index ≥30 and major OSA symptoms were included in this study. Anthropometric measurements of the patients were recorded and blood samples were drawn for laboratory analysis. A 24-hour urine sample was also collected from each subject for measurement of 24-hour cortisol excretion. Patients were divided equally into 2 groups according to polysomnography results: control group with an apnea-hypopnea index (AHI) <5 (n=25) and OSA group with an AHI ≥5 (n=25). Results. Neck and waist circumference, fasting plasma glucose, HbA1c, late-night serum cortisol, morning serum cortisol after 1 mg dexamethasone suppression test, and 24-hour urinary cortisol levels were significantly higher in OSA patients compared to control subjects. Newly diagnosed DM was more frequent in patients with OSA than control subjects (32% versus 8%, p=0.034). There was a significant positive correlation between AHI and neck circumference, glucose, and late-night serum cortisol. Conclusions. Our study indicates that increased waist and neck circumferences constitute a risk for OSA regardless of obesity status. In addition, OSA has adverse effects on endocrine function and glucose metabolism

Association between burnout, anxiety and insomnia in healthcare workers: A cross-sectional study Burnout, anxiety and insomnia in healthcare workers

All healthcare workers (HCWs) encounter stress during in their working lives, and are constantly exposed to adverse conditions. The present study evaluates the relationship between burnout syndrome, anxiety levels and insomnia severity among healthcare workers, who mostly work in shifts. The Maslach Burnout Inventory, the Insomnia Severity Index and the Beck Anxiety Inventory were used to measure burnout, insomnia severity and anxiety status, respectively. This cross sectional study included a total of 1,011 HCWs and 679 (67.2%) of the study respondents were women. The respondents were aged 20-72, with a mean age of 35.67 +/- 8.61 years. Fifty-eight percent (n = 589) of the participants were rotating shift workers. Working on-call led to a significant difference in all burnout parameters (for each, <0.001). Age and on-call duty were seen to lead to a significant difference in the severity of insomnia (p = 0.028, p < 0.001, respectively). The total ISI score was found to be statistically significant positively correlated with the MBI subscales and the total BAI score (for each, <0.001). An increased awareness of the impact of sleep deprivation, burnout and anxiety among HCWs and meaningful interventions promoting change within the healthcare system are needed