Nocturia in sleep-disordered breathing

Background and purpose: Nocturia is a common complaint in sleep-disordered breathing (SDB), but there is no study demonstrating the prevalence and frequency of nocturnal urination in a large number of SDB patients. To determine the prevalence and frequency of nocturnal urination among patients with SDB of different severities and to discover the factors related to nocturia

Neuropathy and Dysautonomia in Patients with Obstructive Sleep Apnea Syndrome

WOS: 000351851100006PubMed ID: 28360671Introduction: The aim of our study is to search for the existence of neuropathy, dysautonomia and to identify the correlations of sickness level of patients with Obstructive Sleep Apnea Syndrome (OSAS). Methods: The research is based on the real cases at Dokuz Eylul University of Medicine Sleep and Epilepsy Center, observed during September 2008-May 2009. The patients were selected by polysomnography samples based on 20 persons at same ages with following criteria; high leveled OSAS (AHI >= 30), low OSAS (5 <= AHI<30) and healthy participants. Classical ENMG protocol, symphatic skin response and R-R interval variation test were performed on these samples. Results: High and low leveled OSAS patients had a statistically significant (p<0.05) decrease in the average velocity of motor conduction in right tibialis posterior when compared to the control group. Besides we observed an statistically significant (p<0.05) increase in the average amplitud of symphatic skin responses in high leveled OSAS patients than control group. Conclusion: OSAS indicates a risk of possible peripheral neuropathy and autonomic dysfunction risk increases in positive correlation with level of OSAS

Normalized Theta but Increased Gamma Activity after Acetylcholinesterase Inhibitor Treatment in Alzheimer's Disease: Preliminary qEEG Study

Acetylcholinesterase inhibitors (AChE-I) are the core treatment of mild to severe Alzheimer's disease (AD). However, the efficacy of AChE-I treatment on electroencephalography (EEG) and cognition remains unclear. We aimed to investigate the EEG power and coherence changes, in addition to neuropsychological performance, following a one-year treatment. Nine de-novo AD patients and demographically-matched healthy controls (HC) were included. After baseline assessments, all AD participants started cholinergic therapy. We found that baseline and follow-up gamma power analyzes were similar between groups. Yet, within the AD group after AChE-I intake, individuals with AD displayed higher gamma power compared to their baselines (P < .039). Also, baseline gamma coherence analysis showed lower values in the AD than in HC (P < .048), while these differences disappeared with increased gamma values of AD patients at the follow-up. Within the AD group after AChE-I intake, individuals with AD displayed higher theta and alpha coherence compared to their baselines (all, P < .039). These increased results within the AD group may result from a subclinical epileptiform activity. Even though AChE-I is associated with lower mortality, our results showed a significant effect on EEG power yet can increase the subclinical epileptiform activity. It is essential to be conscious of the seizure risk that treatment may cause

Neuralgic amyotrophy as the primary cause of shoulder pain in a patient with rotator cuff tear

A 66-year-old woman with no history of trauma presented with severe shoulder pain. Magnetic resonance imaging revealed rupture of the supraspinatus tendon, for which surgical treatment was considered. However, it was noted that shoulder pain was accompanied by weakness in the shoulder muscles, and the patient underwent electroneuromyographic examination, which revealed neuralgic amyotrophy. Following physical therapy and rehabilitation combined with appropriate medical therapy, her symptoms significantly improved. In cases with severe shoulder pain without a trauma history, characteristics of pain should be thoroughly analyzed and neuralgic amyotrophy considered in the differential diagnosis

The reliability of P300 and the influence of age, gender and education variables in a 50 years and older normative sample

Objectives: The present study aims to investigate the effects of age, gender, and level of education on P300 in a healthy population, aged 50 years and over; and determine the reliability metrics for different conditions and measurement methods.Method: Auditory and visual oddball recordings of 171 healthy adults were investigated. A fully automated preprocessing was applied to elicit ERP P300. Maximum peak amplitude, latency and mean amplitudes were measured. Data were stratified by age, gender, and education to determine group-level differences by using repeat measures of ANOVA. The internal consistency of P300 was calculated by a split-half method using odd-even segments. Test-retest reliability was assessed by calculating the intraclass correlation coefficient (ICC).Results: Maximum peak P300 amplitudes were higher in the 50-64 years age group compared to the >65 years age group; and females showed increased P300 amplitudes compared to males. P300 measures showed fair to good internal consistency and poor to good test-retest reliability.Conclusion: Age and gender should be taken into account when designing ERP studies with elderly individuals. P300 showed good internal consistency in general, between gender groups and age groups. Long-term test-retest reliability was lower but acceptable. These findings can be interpreted as the strength of P300 by being an objective and reliable method independent of cultural differences. Here we underline several factors that may affect P300 measures and discuss other possible factors that should be standardized for P300 to be used in clinical settings

Identification of the Variations in the CPT1B and CHKB Genes Along with the HLA-DQB1*06:02 Allele in Turkish Narcolepsy Patients and Healthy Persons

The pretrial process of discovery governed by Federal and Maine Rule of Civil Procedure 26 enables plaintiffs in product liability actions to delve where few people have delved before—into a corporation\u27s internal memoranda, competitive practices, and secret product or design information as well as other less sensitive information in a company\u27s possession. Discovery, in this context as in others, is a powerful tool determined by the courts to be necessary for the just litigation of claims. As a balance to the leeway given parties to compel production of information in discovery, federal and Maine courts have the authority under Federal and Maine Rule 26(c) to protect parties and witnesses from the harm that can result from a disclosure of confidential information. The court may enter a protective order, sometimes called a confidentiality order, restricting a party receiving the information from disseminating it or from making any use of the information other than for purposes of the specific litigation. In addition, public access to information after its use in the litigation often is barred by such orders. Irrespective of the legal interests of the parties involved in the case, however, the public outside the legal community may have an interest in the information, and the receiving party may wish to disclose it. This point is brought into focus by the occasional case in which confidential information raises dramatic health issues, such as the recent reports of potential health risks from silicone breast implants. Judicial use of Rule 26(c) to restrict dissemination of discovered information predictably has invited First Amendment claims of free speech. Maine courts are empowered and exhorted by Maine Rule 26(c) to issue protective orders. Unlike the Federal Rule, Maine Rule 26(c) includes an admonition for the courts to exercise their powers to grant a protective order and other controls over discovery “with liberality . . . to protect parties and witnesses.” Whether conscious of the admonition or not, state courts in product liability cases have issued broadly constructed protective orders restricting plaintiffs, their attorneys and their witnesses from revealing information. The risk for all trial courts, confronted with the potential magnitude of discovery problems and hesitant to spend their limited time on this one procedural issue, is that the power to grant protective orders will degenerate into a perfunctory granting of most or even all such requests. The decision to grant such an order becomes perfunctory when the court does so without an appropriate “good cause” determination and without a careful fashioning of the order to minimize its impact on the affected parties. In Maine\u27s courts, despite the admonition to use the protective-order power liberally, the same considerations apply as fully as in federal courts to a determination of whether a protective order is justified. This Comment examines these considerations and concludes that trial courts must guard against exercising too freely their power to issue protective orders. Such an overly broad exercise of the power relieves movants of their burden to articulate with some specificity the potential harm constituting good cause for restricting parties\u27 and witnesses\u27 First Amendment interests. An understanding of the implications of protective orders should encourage courts to fashion such orders in a way that minimizes the effect on the parties and witnesses without sacrificing the protective purpose of the order

Scanning of obstructive sleep apnea syndrome using smartwatch: A comparison of smartwatch and polysomnography

BACKGROUND: Obstructive Sleep Apnea Syndrome (OSAS), which significantly impairs nighttime sleep quality and causes excessive daytime sleepiness, not only reduces the quality of life of patients, but also increases the social and socioeconomic burden. Wearable-noninvasive devices can provide faster OSAS screening and follow-up. Smartwatches as an objective, non-invasive, practical and relatively inexpensive method, they are attractive candidates for pre-evaluation of OSAS and referral to a physician. In this study, it was aimed to evaluate the effectiveness of a smart watch in detecting OSAS findings compared to the gold standard polysomnograhy (PSG). METHODS: PSG data of the study group were compared with data such as SpO2, heart rate and saturation obtained by smartwatch from both sides, and the Cohen's kappa was used to measure for two methods and predictive values were evaluated. RESULTS: A total of 115 participants [44 female (38.3%), mean age (SD): 49.24 (11.39)] were enrolled. 75 (65.22%) of the participants were diagnosed with OSAS, of which 29 (25.22%) participants have severe OSAS. The smartwatch showed good sensitivity (75% to 96%), specificity (79% to 91%), and diagnostic accuracy (AUC: 0.84 to 0.93) in predicting apnea and severe apnea, respectively. The highest agreement between PSG and smartwatch and the diagnostic ability of smartwatch were found in persons with severe OSAS. CONCLUSION: The high PPV-NPV values in our study and the good compatibility coefficient of the smart watch with the PSG device can contribute to the expansion of the usage areas of smart watches that come into the lives of many people in daily practice

Identification of the Variations in the CPT1B

Background: The HLA-DQB1*06:02 allele across all ethnic groups and the rs5770917 variation between CPT1B and CHKB genes in Japanese and Koreans are common genetic susceptibility factors for narcolepsy. This comprehensive genetic study sought to assess variations in CHKB and CPT1B susceptibility genes and HLA-DQB1*06:02 allele status in Turkish patients with narcolepsy and healthy persons. Methods: CHKB/CPT1B genes were sequenced in patients with narcolepsy (n=37) and healthy persons (n=100) to detect variations. The HLA-DQB1*06:02 allele status was determined by sequence specific polymerase chain reaction. Results: The HLA-DQB1*06:02 allele was significantly more frequent in narcoleptic patients than in healthy persons (p=2×10(−7)) and in patients with narcolepsy and cataplexy than in those without (p=0.018). The mean of the multiple sleep latency test, sleep-onset rapid eye movement periods, and frequency of sleep paralysis significantly differed in the HLA-DQB1*06:02–positive patients. rs5770917, rs5770911, rs2269381, and rs2269382 were detected together as a haplotype in three patients and 11 healthy persons. In addition to this haplotype, the indel variation (rs144647670) was detected in the 5′ upstream region of the human CHKB gene in the patients and healthy persons carrying four variants together. Conclusion: This study identified a novel haplotype consisting of the indel variation, which had not been detected in previous studies in Japanese and Korean populations, and observed four single-nucleotide polymorphisms in CHKB/CPT1B. The study confirmed the association of the HLA-DQB1*06:02 allele with narcolepsy and cataplexy susceptibility. The findings suggest that the presence of HLA-DQB1*06:02 may be a predictor of cataplexy in narcoleptic patients and could therefore be used as an additional diagnostic marker alongside hypocretin