Obstructive sleep apnea syndrome and hypothyroidism — merely concurrence or causal association?

The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients.The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients

The -463G/A and -129G/A myeloperoxidase-encoding gene polymorphism in chronic obstructive pulmonary disease

Introduction: Neutrophils are involved in the pathogenesis of chronic obstructive pulmonary disease (COPD). Myeloperoxidase is an important bactericidal granulocytic enzyme. It is of interest to question whether or not the polymorphic variants of the myeloperoxidase-encoding gene are associated with the risk of developing COPD. Material and methods: The study determined the risk of COPD development in 186 COPD patients and 220 healthy subjects in the context of two selected polymorphic sites of the promoter region of the myeloperoxidase-encoding gene. Results: It has been demonstrated that the AA genotype of locus -463 in the myeloperoxidase-encoding gene increases the risk of developing COPD (OR: 2.87; CI: 1.651–4.997). This genotype also correlates with a higher gene expression in patients (0.56  ± 0.12 vs 0.31 ± 0.18 in patients with AG genotype and 0.29 ± 0.17, p < 0.01 in those with GG genotype). In healthy indivi-duals, the AA genotype was also characterized by increased expression of the myeloperoxidase-encoding gene (0.41 ± 0.16 vs 0.29 ± 0.15 for AG genotype, p < 0.01 and 0.25 ± 0.16 for GG genotype p < 0.01). Patients with the AA genotype had  a significantly higher gene expression than healthy subjects with this genotype. Conclusions: The polymorphic site -129 of the myeloperoxidase-encoding gene was unrelated to the development of COPD. The gene expression did not differ for the individual genotypes. Our studies indicate that the polymorphism of the myeloperoxidase--encoding gene may be related to chronic obstructive pulmonary disease

The utility of selected questionnaires in the assessment of fatigue, depression and health quality in post-sarcoidosis fatigue syndrome

Introduction: The nature of post-sarcoidosis fatigue syndrome (PSFS) is unknown and tools for the assessment of health quality (HQ) in these patients have not been fully assessed. The aim was to validate the Polish version of sarcoidosis health questionnaire (SHQ) and verify the association of HQ with fatigue and depressive symptoms among Polish patients with PSFS. Material and methods: 71 patients with sarcoidosis (34 women, the mean age 47) were divided to: PSFS (n = 21), active sarcoidosis (S-A, n = 27) and sarcoidosis with complete remission (S-R, n = 23) groups. Fatigue Assessment Scale (FAS) was used to define significant fatigue (≥ 22 points). Polish version of SHQ was prepared by the authors and validated. Beck Depression Index (BDI) and Patient Health Questionnaire 9 (PHQ-9) were used to evaluate self-reported depressive symptoms. Results: Polish version of SHQ was proved reliable and valid. HQ was worse and depressive symptoms were more frequent in PSFS and S-A when compared with S-R group. SHQ total score correlated negatively with depressive symptoms (r = -0.787 for BDI and r = -0,755 for PHQ-9, p < 0.01). A negative correlation between SHQ and FAS score was found (r = –0.784, p < 0.01). FAS score correlated with depressive symptoms (r = 0.726 for BDI and r = 0.755 for PHQ-9, p < 0.01). Conclusion: Polish version of SHQ is a valuable tool for the assessment of HQ in sarcoidosis. HQ is impaired in PSFS comparing to patients with complete remission, but is comparable to active sarcoidosis. Depressive symptoms impact HQ and may influence perception of fatigue. Both fatigue and depression have a negative impact on HQ in sarcoidosis

Zespół obturacyjnego bezdechu sennego i niedoczynność tarczycy — przypadkowa zbieżność czy związek przyczynowo-skutkowy?

  Częstość występowania zespołu obturacyjnego bezdechu sennego (OBS) waha się od 4 do 7% u mężczyzn i od 2 do 5% u kobiet. Jest on przyczyną wielu poważnych następstw, takich jak: wypadki drogowe, powikłania sercowo-naczyniowe, a rosnąca zachorowalność i śmiertelność, sprawiają, że staje się jednym z głównych problemów zdrowotnych. Oprócz otyłości (głównego czynnika ryzyka dla OBS) ujawnieniu tego fenotypu sprzyja niedoczynność tarczycy. Mimo że wydaje się ona uznanym czynnikiem ryzyka OBS, niektórzy autorzy sugerują brak klinicznie istotnego związku. Zaobserwowano jednak zwiększoną częstość występowania niedoczynności tarczycy u pacjentów z OBS, ale dane epidemiologiczne są ograniczone. Zdecydowanie mniej wiadomo o subklinicznej niedoczynności tarczycy u pacjentów z OBS. Jeśli jawna i subkliniczna niedoczynność tarczycy w tej grupie pacjentów jest co najmniej tak samo częsta, jak w populacji ogólnej, zasadne wydaje się badanie pacjentów w kierunku niedoczynności tarczycy, ponieważ skuteczne leczenie może zmniejszyć zaburzenia oddychania podczas snu. Niestety, ten korzystny efekt stwierdzono tylko w kilku badaniach na niewielkiej liczbie pacjentów z niedoczynnością tarczycy. Mimo braku międzynarodowych wytycznych oraz dużych, wieloośrodkowych badań, autorzy niniejszej pracy uważają jednak, że przesiewowe badania TSH mogą się okazać korzystne dla sporej grupy pacjentów z OBS.

Clinical presentation, sexual function and quality of life as predictors of sexual satisfaction among women with urinary incontinence before a vaginal revitalization procedure

Purpose: Urinary incontinence (UI) is a common condition among women that affects quality of life, depressive symptoms and sexual function. The aim of the study was to verify whether clinical data, sexual dysfunction and quality of life may be independent predictors of life satisfaction of women with UI. Methods: The study group included 76 patients who reported to a gynaecological clinic for vaginal revitalisation due to symptoms typical of UI. The patients completed: Life Satisfaction Questionnaire (FLZ), Female Sexual Function Index (FSFI), Incontinence Quality of Life Questionnaire (I-QOL) and Beck Depression Inventory (BDI). Results: The UI patients presented a lower mean score regarding satisfaction with sex than a comparable healthy population. A high score on the FLZ-sex scale was predicted by lack of labour complications, a high score on the FLZ-health and FLZ-relationships scales, and FSFI arousal scale. Conclusions: UI appears to be linked particularly strongly to low satisfaction with sex as a dimension of life satisfaction. Memory of labour complications was associated to dissatisfaction with sex. On the other hand, no link between satisfaction with sex and episiotomy, caesarean section or natural childbirth was found. High satisfaction with sex was linked to high satisfaction with general health and relationship, as well as high arousal as a sexual function

The Association between Temperament, Chronotype, Depressive Symptoms, and Disease Activity among Patients with Inflammatory Bowel Disease&mdash;A Cross-Sectional Pilot Study

The psychological aspect may play an important role in ulcerative colitis (UC) and Crohn&rsquo;s disease (CD). The aims of this study were to explore the differences between patients with UC and CD regarding chronotype, temperament and depression, and to assess the psychological factors mentioned as predictors of disease activity. In total, n = 37 patients with UC and n = 47 patients with CD were included in the study. They underwent a clinical assessment, including the Mayo score or Crohn Disease Activity Index (CDAI), and completed questionnaires: a sociodemographic survey, Formal Characteristics of Behavior&ndash;Temperament Inventory (FCB-TI), Chronotype Questionnaire (CQ), and the Beck Depression Index II (BDI). The Sensory Sensitivity score was higher among patients with CD than UC (p = 0.04). The emotional reactivity and endurance scores were higher among women than men with CD (p = 0.028 and p = 0.012 respectively). CQ Morningness&ndash;Eveningness (ME) correlated with Endurance (p = 0.041), Emotional Reactivity (p = 0.016), and Activity (p = 0.004). ME correlated with Rhythmicity among CD patients (p = 0.002). The Mayo score was predicted by Perseverance. The CDAI score was predicted by the BDI score. The pattern of the relationship between chronotype and temperament may differentiate patients with UC and CD. Personal disposition may play a role in the clinical assessment of patients with IBD

Who Benefits from Fermented Food Consumption? A Comparative Analysis between Psychiatrically Ill and Psychiatrically Healthy Medical Students

Probiotic therapies and fermented food diets hold promise for improving mental health. Although in this regard psychiatric patients appear to benefit more than healthy individuals, no research has been performed to directly evaluate this hypothesis. The present study examined a cohort of medical students facing a stressful event, and some of the students reported suffering from chronic psychiatric diseases. The amount of fermented food consumption was calculated with the use of seven-day dietary records, while depressive and anxiety symptoms were assessed with the use of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively. In psychiatrically healthy medical students under psychological stress (n = 372), higher fermented food consumption was associated with more depressive and anxiety symptoms. In contrast, psychiatrically ill medical students (n = 25, 6.3% of all the participants) were found to present a negative association between the amount of fermented food consumed and the severity of depressive symptoms (adjusted &beta; &minus;0.52, 95% CI &minus;0.85 to &minus;0.19, p = 0.0042); however, this relationship was insignificant for anxiety symptoms (adjusted &beta; &minus;0.22, 95% CI &minus;0.59 to 0.15, p = 0.22). A significant interaction was found between the consumption of fermented food and psychiatric diagnosis in predicting depressive symptoms (p = 0.0001), and a borderline significant interaction for anxiety symptoms (p = 0.053). In conclusion, psychiatrically ill people, but not healthy ones, may benefit from fermented food consumption in terms of alleviation of depressive symptoms. Our findings require cautious interpretation and further investigation

Zespół obturacyjnego bezdechu sennego i niedoczynność tarczycy—Przypadkowa zbieżność czy związek przyczynowo-skutkowy?

Częstość występowania zespołu obturacyjnego bezdechu sennego (OBS) waha się od 4 do 7% u mężczyzn i od 2 do 5% u kobiet. Jest on przyczyną wielu poważnych następstw, takich jak: wypadki drogowe, powikłania sercowo-naczyniowe, a rosnąca zachorowalność i śmiertelność, sprawiają, że staje się jednym z głównych problemów zdrowotnych. Oprócz otyłości (głównego czynnika ryzyka dla OBS) ujawnieniu tego fenotypu sprzyja niedoczynność tarczycy. Mimo że wydaje się ona uznanym czynnikiem ryzyka OBS, niektórzy autorzy sugerują brak klinicznie istotnego związku. Zaobserwowano jednak zwiększoną częstość występowania niedoczynności tarczycy u pacjentów z OBS, ale dane epidemiologiczne są ograniczone. Zdecydowanie mniej wiadomo o subklinicznej niedoczynności tarczycy u pacjentów z OBS. Jeśli jawna i subkliniczna niedoczynność tarczycy w tej grupie pacjentów jest co najmniej tak samo częsta, jak w populacji ogólnej, zasadne wydaje się badanie pacjentów w kierunku niedoczynności tarczycy, ponieważ skuteczne leczenie może zmniejszyć zaburzenia oddychania podczas snu. Niestety, ten korzystny efekt stwierdzono tylko w kilku badaniach na niewielkiej liczbie pacjentów z niedoczynnością tarczycy. Mimo braku międzynarodowych wytycznych oraz dużych, wieloośrodkowych badań, autorzy niniejszej pracy uważają jednak, że przesiewowe badania TSH mogą się okazać korzystne dla sporej grupy pacjentów z OBS

Obstructive Sleep Apnea Syndrome and Hypothyroidism—Merely Concurrence or Causal Association?

The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients

Lonely in the City–Sociodemographic Status and Somatic Morbidities as Predictors of Loneliness and Depression among Seniors–Preliminary Results

Up to a third of the population of older adults has been estimated to suffer from feelings of loneliness, which is considered a risk factor of depression. The aim of this paper is to compare the perceived level of loneliness and depression in seniors living in the country and in the cities and assess somatic morbidity and sociodemographic status as predictors of loneliness and depressiveness. n = 92 older adults in primary care units filled out a set of questionnaires: authors’ survey on sociodemographic data and morbidities, Beck Depression Inventory II (BDI, to measure depressiveness) and De Jong Gierveld Loneliness Scale (DJGLS, to assess loneliness). There was a strong, positive and statistically significant correlation between the BDI and DJGLS scores (R = 0.855, p &lt; 0.001). City residents had on average higher BDI and DJGLS scores. Linear regression models were constructed to predict BDI and DJGLS scores. The set of statistically significant predictors were similar for BDI and DJGLS. Sociodemographic status and somatic morbidities accounted for around 90% of variance of depressiveness and loneliness scores in the studied group. Living alone was found to be the strongest relative predictor of both loneliness and depressiveness in the studied sample of the older adults. Our current results suggest that there might be a need to improve social support in the late adulthood as an intervention to diminish the sense of loneliness and depressiveness