No evidence of enhanced oxidant production in blood obtained from patients with obstructive sleep apnea

<p>Abstract</p> <p>Background</p> <p>Obstructive sleep apnea syndrome (OSAS) is a recognized risk factor for cardiovascular morbidity and mortality, perhaps due to causative exacerbations of systemic oxidative stress. Putative oxidative stress related to numerous episodes of intermittent hypoxia, may be an oxidants chief driving force in OSAS patients.</p> <p>Methods</p> <p>We assessed the resting and n-formyl-methionyl-leucyl-phenylalanine (fMLP)- induced whole blood chemiluminescence (as a measure of oxidant production by polymorphonuclear leukocytes and monocytes), ferric reducing ability of plasma (FRAP) and H₂O₂generation in the whole blood of 27 untreated OSAS patients, 22 subjects after a night of CPAP therapy and 11 controls without OSAS. All of them were matched to age, BMI (body mass index) and smoking habits. All parameters were measured before and after polysomnography-controlled sleep, individual results were obtained as a mean from duplicated experiments.</p> <p>Results</p> <p>No significant differences were distinguished between evening and morning blood chemiluminescence, H₂O₂activity and FRAP within and between all three study groups.</p> <p>For instance patients with untreated OSAS had similar morning and evening resting whole blood chemiluminescence (2.3 +/- 2.2 vs. 2.4 +/- 2.2 [aU·10^-4phagocytes]), total light emission after stimulation with fMLP (1790 +/- 1371 vs. 1939 +/- 1532 [aU·s·10^-4phagocytes]), as well as FRAP after 3 min. plasma incubation (602 +/- 202 vs. 671 +/- 221 [uM]). Although, in the subgroup of 11 patients with severe OSAS (apnea/hypopnea index 58 +/- 18/h and oxygen desaturation index 55 +/- 19/h), the morning vs. evening resting chemiluminescence and total light emission after stimulation with fMLP observed a propensity to elevate 2.5 +/- 2.7 vs. 1.9 +/- 1.8 [aU·10^-4phagocytes] and 1778 +/- 1442 vs. 1503 +/- 1391 [aU·s·10^-4phagocytes], respectively, these did not attain statistical significance (p > 0.05).</p> <p>Conclusion</p> <p>Our investigation exposed no evidence in the overproduction of oxidants via circulating phagocytes, once considered a culprit in the oxidative stress of OSAS patients.</p

Dysfunction and pain temporomandibular disorder caused by impeded eruption of third mandibular molars

Introduction. There are reports in literature which indicate the connection between impacted third molars and occurrence of symptoms of craniomandibular dysfunctions and headaches. Objectives. The aim of this study was evaluation of the outcome of patients who reported specific symptoms of craniomandibular dysfunction and had impacted mandibular third molars. Materials and method. The research material consisted of 10 women who reported to the Department of Craniomandibular Disfunctions of the Medical University in Lublin, Poland, with pain and acoustic symptoms in the Temporomandibular joint (TMJ) area. During preliminary therapy, the patients used a silicone occlusal device; ionotherapy was ordered and the patients were recommended to eliminate parafunctions. Results. Clicks before treatments were present in 6 patients, after treatment with silicone occlusal device and ionotherapy with Profenid gel in 5 patients, while two years after extraction of the impacted teeth the clicks were no longer present, and differences in the presence of clicks analyses by means of the Q-Cochran test were statistically significant between examinations 1m vs.3 (Q=10.33; p<0.01) and examinations 2 vs.3 (Q=8.40; p<0.05). Conclusions. The study showed that extraction of the mandibular third molars can cause regression of some symptoms of craniomandibular disorders

Fruit and vegetables liking among European elderly according to food preferences, attitudes towards food and dependency

As the population ages and dependency for food-related activities increases, it becomes crucial to better understand food expectations of elderly consumers. Fruit and vegetables (F&V) are generally appreciated by elderly people. However, few studies have investigated elderly peoples’ F&V liking, taking into account their dependency and countries’ specificities. The present study aims to identify the liking of F&V, eating styles and food selectivity depending on the country of residence and levels of dependency. A European survey was conducted with 420 elderly people delegating meal-related activities, living at home or in nursing homes. Based on general food preferences, three eating styles were identified. Results showed that F&V liking is a segmenting variable. Elderly people from the style 1 (n = 145) do not really appreciate fruits nor desserts. On the contrary, elderly people from style 2 (n = 121) are really fruit lovers. Finally, elderly people from style 3 (n = 126) liked desserts, fruits, and even more vegetables. Results showed that elderly people were nor selective towards F&V, even if there were some exceptions as exotic fruits (disliked by 19%) and fennel (disliked by 33%). Fruit and vegetables selectivity was significantly different between countries (p 0.05 in both cases). Selectivity for F&V was very variable and could reach 32 vegetables among 42 and 28 fruits among 34. The most selective participants were from Finland and the least ones, from the UK. These results can be used to design and/or adapt F&V-based products according to elderly consumers’ liking, taking into account their country of origin and their dependency

Perception of Difficulties Encountered in Eating Process from European Elderlies' Perspective

To maintain wellbeing, independence and nourishment of elderly population, one promising strategy is to provide home care by delivering food using “meals on wheels” (MoW) system. Even when the food is home-delivered, the difficulties encountered by elderlies during the overall eating process can be a limiting factor. Hence, the objective of this self-reported study was to explore the difficulty perception in the entire eating process from opening up the package, reheating, hand manipulation and oral processing of the food to bolus swallowing in 405 elderly consumers from five European countries (Finland, France, Poland, Spain and United Kingdom) with three different levels of dependency (category 1: participants living at home with help needed for food purchasing; category 2: participants living at home who need help for meal preparation or meal delivery; category 3: participants living in nursing homes/sheltered accommodation). Frequencies of responses and cross tabulation test were calculated for the difficulties perceived. Results show that the most difficult package to open was the cap irrespective of country or dependency levels (at P < 0.05). Although, glass was the most preferred packaging material, category (P = 0.034) and country (P = 0.001) had significant influence. Self-feeding dependency was correlated with the eating difficulties perceived, category 1 participants did not perceive difficulties in the meal preparation and reported minimal difficulties in the hand manipulation and oral processing (<30%), whilst the difficulties perceived by categories 2 and 3 were significantly higher (∼60% of participants). The insights generated might be helpful for designing efficient MoW systems with appropriate user-friendly features

Estimating the Reduction in the Radiation Burden From Nuclear Cardiology Through Use of Stress-Only Imaging in the United States and Worldwide

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Current worldwide nuclear cardiology practices andradiationexposure: results from the 65 country IAEA nuclear cardiology protocols cross-sectional study (INCAPS)

Aims To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiationoptimizing 'best practices' worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. Methods and results We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March-April 2013. Eight 'best practices' relating to radiation exposurewere identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more 'best practices' had lower EDs Conclusion Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally

Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries

Purpose: Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis. Methods: In March 2013, the IAEA invited laboratories across the world to document all SPECT and PET studies performed in one week. The data included age, gender, weight, radiopharmaceuticals, injected activities, camera type, positioning, hardware and software. Radiation effective dose was calculated for each patient. A quality score was defined for each laboratory as the number followed of eight predefined best practices with a bearing on radiation exposure (range of quality score 0&nbsp;–&nbsp;8). The participating European countries were assigned to regions (North, East, South, and West). Comparisons were performed between the four European regions and between Europe and the rest-of-the-world (RoW). Results: Data on 2,381 European patients undergoing nuclear cardiology procedures in 102 laboratories in 27 countries were collected. A cardiac SPECT study was performed in 97.9&nbsp;% of the patients, and a PET study in 2.1&nbsp;%. The average effective dose of SPECT was 8.0 ± 3.4&nbsp;mSv (RoW 11.4 ± 4.3&nbsp;mSv; P &lt; 0.001) and of PET was 2.6 ± 1.5&nbsp;mSv (RoW 3.8 ± 2.5&nbsp;mSv; P &lt; 0.001). The mean effective doses of SPECT and PET differed between European regions (P &lt; 0.001 and P = 0.002, respectively). The mean quality score was 6.2 ± 1.2, which was higher than the RoW score (5.0 ± 1.1; P &lt; 0.001). Adherence to best practices did not differ significantly among the European regions (range 6 to 6.4; P = 0.73). Of the best practices, stress-only imaging and weight-adjusted dosing were the least commonly used. Conclusion: In Europe, the mean effective dose from nuclear cardiology is lower and the average quality score is higher than in the RoW. There is regional variation in effective dose in relation to the best practice quality score. A possible reason for the differences between Europe and the RoW could be the safety culture fostered by actions under the Euratom directives and the implementation of diagnostic reference levels. Stress-only imaging and weight-adjusted activity might be targets for optimization of European nuclear cardiology practice