Sleep pattern is associated with adipokine levels and nutritional markers in resident physicians

Shift work and long hours of work are common in medical training and have been associated with a higher propensity for developing nutritional problems and obesity. Changes in leptin and ghrelin concentrations – two hormones that contribute importantly to the central regulation of food intake – are poorly described in this population. The aim of this study was to identify possible negative associations between sleep patterns, nutritional status and serum levels of adipokines. The study included 72 resident physicians (52 women and 20 men) who underwent the following assessments: nutritional assessment (3-day dietary recall evaluated by the Adapted Healthy Eating Index), anthropometric variables, fasting metabolism, physical activity level, sleep quality and sleepiness. Resident physicians with poor sleep quality reported greater weight gain after the beginning of residency (5.1 and 3.0?kg, respectively; p?=?0.01) and higher frequency of abnormal waist circumference (44.2 and 17.6%, respectively; p?=?0.04) than those with better sleep quality. Mean ghrelin concentration was greater in volunteers with poor sleep quality (64.6?±?67.8 and 26.2?±?25.0?pg/mL, respectively; p?=?0.04). Women identified as having excessive daytime sleepiness had lower levels of leptin (9.57?±?10.4?ng/mL versus 16.49?±?11.4?ng/mL, respectively; p?=?0.03) than those without excessive sleepiness. Furthermore, correlations were found between hours of additional work per week and: intake of cereals, bread and pasta (r?=?0.22, p?=?0.01); intake of servings of fruits (r?=??0.20; p?=?0.02) and beans (r?=??0.21; p?=?0.01); and global score for Adapted Healthy Eating Index (r?=??0.23; p?=?0.008; Table 3). The sleep quality total score correlated with servings of beans (r?=??0.22; p?=?0.01) and servings of oils (r?=?0.23; p?=?0.008). Significant correlations were found between mean of time of sleep and servings of cereals, bread and pasta (r?=?0.20; p?=?0.02), servings of meat (r?=??0.29; p?=?0.02) and cholesterol levels (r?=?0.27; p?=?0.03). These observations indicate that sleep patterns and long working hours of resident physicians are negatively associated with biological markers related to central food control, the lipid profile, cholesterol levels and eating healthy foods. These factors may predispose these shift workers to become overweight and develop metabolic disorders.     

Circulating biomarkers of hypertrophy and fibrosis in patients with hypertrophic cardiomyopathy assessed by cardiac magnetic resonance

Abstract

Background: Myocardial fibrosis in hypertrophic cardiomyopathy (HCM) is associated with worse clinical outcomes. The availability of circulating biomarkers of myocardial fibrosis and hypertrophy would be helpful in clinical practice.

Objective: The aim of this study was to evaluate usefulness of various biomarkers of myocardial fibrosis and hypertrophy in HCM.

Methods: Levels of biomarkers: soluble ST2 (sST2), galectin-3 (Gal-3), growth differentiation factor-15 (GDF-15), NT-proBNP and high-sensitivity cardiac troponin T (hs-cTnT) were measured in 60 patients with HCM. All patients underwent cardiac magnetic resonance imaging to calculate parameters of hypertrophy and fibrosis.

Results: We observed positive correlations among sST2 levels and left ventricular mass (LVM) (r?=?0.32, p?=?0.012), LV mass indexed for the body surface area (LVMI) (r?=?0.27, p?=?0.036) and maximal wall thickness (MWT) (r?=?0.31, p?=?0.015). No correlation was found between Gal-3 and GDF-15 levels and hypertrophy and fibrosis parameters. We observed positive correlations among hs-cTnT levels and LVM (r?=?0.58, p?<?0.0001), LVMI (r?=?0.48, p?=?0.0001), MWT (r?=?0.31, p?=?0.015) and late gadolinium enhancement (LGE) mass (r?=?0.37, p?=?0.003). There were positive correlations between NT-proBNP levels and LVM (r?=?0.33, p?=?0.01), LVMI (r?=?0.41, p?=?0.001), MWT (r?=?0.42, p?<?0.001) and LGE mass (r?=?0.44, p?<?0.001).

Conclusions: Although no correlation between sST2 levels and myocardial fibrosis was found, sST2 may provide some additional information about hypertrophy extension. NT-proBNP and hs-cTnT are useful biomarkers in assessment of hypertrophy and fibrosis in HCM.     

Oxidative stress is associated with decreased heart rate variability in patients with chronic kidney disease

Objectives: Elevated oxidative stress and reduced heart rate variability (HRV) is prevalent in patients with chronic kidney disease (CKD) and is associated with increased morbidity and mortality. Previous studies have identified a positive association between elevated oxidative stress and autonomic dysfunction, however this relationship has not yet been investigated in the CKD population.

Methods: Plasma was collected from 78 patients with stage 3–4 CKD (estimated glomerular filtration rate 25–60?ml/min/1.73?m²) for the assessment of oxidative stress, including plasma total F2-isoprostanes, glutathione peroxidase activity and total antioxidant capacity. Time and frequency HRV parameters were measured from a three lead electrocardiogram.

Results: Participants with elevated F2-isoprostanes had reduced HRV compared to patients with normal levels of F2-isoprostanes. A number of HRV parameters were found to be inversely correlated with F2-isoprostanes in all CKD patients, including SDNN (r?=??0.337; P?r?=??0.281, P?=?0.01), LF (r?=??0.315, P?r?=??0.288, P?=?0.01). Multiple linear regression found F2-isoprostanes to be an independent predictor of SDNN (r²?=?0.287, β?=??0.272, P?=?0.01).

Discussion: Oxidative stress is significantly and independently associated with HRV in patients with CKD. Identifying oxidative stress in the pathogenesis of autonomic dysfunction may help target therapeutic strategies.     

Assessment of Treg/Th17 axis role in immunopathogenesis of chronic injuries of mustard lung disease

Purpose: Sulfur mustard (SM) lung is a heterogeneous disease associated with abnormal inflammatory immune responses. The Th17/Treg axis imbalance is associated with the pathogenesis of chronic inflammatory pulmonary disease. We aimed to determine the distribution of different Th17 and Treg cells in patients with SM lung and chronic obstructive pulmonary disease (COPD) and evaluate the clinical implications in this homeostasis. Methods: In this analytical cross-sectional study, CD4?⁺?Foxp3^+?Treg and CD4⁺?IL-17^+?Th17 cells were measured in peripheral blood mononuclear cells (PBMCs) and transbronchial biopsy (TBB) samples of 15 SM-exposed patients, 12 COPD and 13 healthy controls (HCs). The potential correlation between the ratio of Th17/Tregs and lung function was evaluated with multivariate logistic regression (MLR) analysis. Results: The frequency of CD4?⁺?FoxP3⁺?Tregs and CD4?⁺?IL-17⁺?Th17 was increased ～1.7-fold (8.71/4.95) and ～2.7-fold (1.028/0.371) respectively, in the PBMC of SM patients compared with the health controls (p?<?0.001). The results indicated that there were increases in the frequency of Th17 and Tregs cells in the patients with COPD versus the HC, that is, ～2.6-fold (0.987/0.371) and ～1.4-fold (7.12/4.95), respectively; but they did not reach to SM level (p?≥?0.05). Moreover, in the TBB samples, the CD4?⁺?IL-17^+?Th17 and CD4⁺?FoxP3^+?Tregs numbers were significantly higher in SM and COPD patients than HC (p?<?0.05). The Th17 and Treg cells were inversely correlated with forced expiratory volume in 1s (FEV1%) (r?=??0.351, p =?0.001; r?=??0.344, p?=?0.021) and FEV1/FVC (r?=??0.44, p?=?0.001; r?=??0.302, p?=?0.011), respectively. Instead, positive correlations were found between Treg/Th17 ratios and forced FEV1%pred (r?=?0.156, p?=?0.007), as well as FEV1/FVC ratio (r?=?0.334, p?=?0.006). Conclusions: The imbalance of Th17/Treg has a key role in immunopathogenesis of chronic phase of mustard lung disease.     

Relationship of troponin to incident atrial fibrillation occurrence,recurrence after radiofrequency ablation and prognosis: a systematic review,meta-analysis and meta-regression

Objective: To explore the association between the levels of troponin (Tn) and incident atrial fibrillation (AF) occurrence, AF recurrence after radiofrequency ablation (RFA), and the risk trend of AF related prognosis (stroke, major bleeding and mortality).

Methods: Twenty-seven studies were included after a systematic search in PubMed from 2005 to 2017, including 13 associated with incident AF occurrence, 8 associated with AF recurrence after RFA and 6 studies evaluating the risk trend of AF-related prognosis with increased Tn levels.

Results: Compared with ‘no incident AF occurrence’ patients, the incident AF occurrence group had similar baseline troponin I (TnI) levels (standardized mean differences [SMD]?=?0.42, 95% CI: ?0.02–0.86, p?=?0.06; I²?=?87.0%, N?=?6), but higher troponin T (TnT) levels (SMD?=?3.77, 2.13–5.42, p?<0.001; I²=99.7%, N?=?8). AF recurrence patients had similar peri-ablation TnI levels, but higher peri-ablation TnT levels compared to the ‘no AF recurrence’ group with pooled SMD. (TnI: SMD: ?0.61, ?1.22to 0, p?=?0.049; I²?=?87.1%; TnT: 0.38, 0.14–0.62, p?=?0.002; I²?=?64.7%). On meta-regression, there was an increased risk trend for stroke/systemic embolism (SE) (r²?=?0.93, p?=?0.04) or major bleeding (r²?=?0.99, p?r²?=?0.09, p?=?0.25) or TnT (r²?=?0.20, p?=?0.31), and stroke/SE (r²?=?0.02, p?=?0.74) or major bleeding (r²?=?0.002, p?=?0.92) was non-significantly related to increasing TnI levels.

Conclusions: In our systematic review, meta-analysis and meta-regression, TnT was associated with both incident AF occurrence and AF recurrence after RFA, as well as stroke/SE and major bleeding. In contrast, TnI was not associated with incident AF occurrence, AF recurrence after RFA or prognosis (stroke/SE, major bleeding).     

Evaluation of mediators of oxidative stress and inflammation in patients with acute appendicitis

Context: This study aims to explore the potential of new inflammatory markers for improving the challenging diagnosis of acute appendicitis (AA).

Methods: Levels of IL-1, IL-6, IL-8, IL-10, CRP, INF-γ, and TNF-α in serum were measured in 73 patients with AA. Oxidative stress and antioxidant enzymes were analyzed.

Results: Serum levels of interleukins, TNF-α, and INF-γ were significantly elevated in patients with appendicitis (p?<?0.0001), except for IL-10, which presented decreased levels. There were no significant differences in SOD (p?=?0.29), CAT (p?=?0.19), or TBARS levels (p?=?0.18), whereas protein carbonyls presented significant increase (p?<?0.0001).

Conclusion: Evaluating these biomarkers could aid in diagnosing AA.     

Seasonality of dizziness and vertigo in a tropical region

Vertigo and dizziness are among the most common medical complaints in the emergency room, and are associated with a considerable personal and health care burden. Scarce and conflicting reports indicate those symptoms may present a seasonal distribution. This study aimed at investigating the existence of a seasonal distribution of vertigo/dizziness in a tropical region, and the correlations of these findings with climatic variables. The charts of all patients consecutively admitted between 2009 and 2012 in the emergency room of a Brazilian general hospital were reviewed. A total of 4920 cases containing these terms were sorted from a sample of 276?076 emergency records. Seasonality was assessed using Cosinor Analysis. Pearson's correlations were performed between the incidence of consultations, considering separately dizziness and vertigo and each of the predictor climatic variables of that index month. Significant seasonal patterns were observed for dizziness and vertigo in the emergency room. Vertigo was more frequent in late winter–spring, negatively correlating to humidity (r?=??0.374; p?=?0.013) and rainfall (r?=??0.334; p?=?0.020). Dizziness peaked on summer months, and positively correlated to average temperatures (r?=?0.520; p?<?0.001) and rainfall (r?=?0.297; p?=?0.040), but negatively to atmospheric pressure (r?=??0.424; p?=?0.003). The different seasonal patterns evidenced for dizziness and vertigo indicate possible distinct underlying mechanisms of how seasons may influence the occurrence of those symptoms.     

Thioredoxin interacting protein expression in the urinary sediment associates with renal function decline in type 1 diabetes

Aims: Thioredoxin interacting protein (TXNIP), an inhibitor of antioxidant thioredoxin (Trx), is upregulated by hyperglycemia and implicated in pathogenesis of diabetes complications. We evaluated mRNA expressions of genes encoding TXNIP and Trx (TXN) in urinary sediment and peripheral blood mononuclear cells (PBMC) of type 1 diabetes (T1D) patients with different degrees of chronic complications. Methods: qPCR was employed to quantify target genes in urinary sediment (n?=?55) and PBMC (n?=?161) from patients sorted by presence or absence of diabetic nephropathy (DN), retinopathy, peripheral and cardiovascular neuropathy; 26 healthy controls and 13 patients presenting non-diabetic nephropathy (focal and segmental glomerulosclerosis, FSGS) were also included. Results: Regarding the urinary sediment, TXNIP (but not TXN) expression was higher in T1D (p?=?0.0023) and FSGS (p?=?0.0027) patients versus controls. Expressions of TXNIP and TXN were higher, respectively, in T1D patients with versus without DN (p?=?0.032) and in those with estimated glomerular filtration rate (eGFR)?<?60 versus?≥60 mL/min/1.73 m² (p?=?0.008). eGFR negatively correlated with TXNIP (p?=?0.04, r?=??0.28) and TXN (p?=?0.04, r?=??0.30) expressions. T1D patients who lost?≥5 mL/min/1.73 m² yearly of eGFR presented higher basal TXNIP expression than those who lost?<5 mL/min/1.73 m² yearly after median follow-up of 24 months. TXNIP (p?<?0.0001) and TXN (p?=?0.002) expressions in PBMC of T1D patients were significantly higher than in controls but no differences were observed between patients with or without chronic complications. Conclusions: TXNIP and TXN are upregulated in urinary sediment of T1D patients with diabetic kidney disease (DKD), but only TXNIP expression is associated with magnitude of eGFR decline.     

Resistin may be an independent predictor of subclinical atherosclerosis formale smokers

To investigate whether resistin is associated with early atherosclerosis in male smokers. The present study consecutively enrolled 50 male smokers. Their serum resistin contents were detected with enzyme linked immunosorbent assay (ELISA), and subclinical atherosclerosis indices, including carotid inner middle thickness (IMT) and arterial elasticity indices (C1 and C2), were measured. The association between serum resistin levels and IMT, C1 and C2 were respectively evaluated with the Pearson’s correlation coefficient method. The results showed that the serum resistin level had a positive association with IMT (r?=?0.307, p?=?.030), but were both inversely associated with C1 (r?=??0.440, p?=?.001) and C2 (r?=??0.381, p?=?.006). These associations remained significant even after adjustment for cardiovascular confounders. In conclusion, serum resistin concentration was independently associated with early atherosclerosis in male smokers.     

Characterization of soluble thrombomodulin levels in patients with stage 3–5 chronic kidney disease

Abstract

Objective: This study aims to test the serum levels of soluble thrombomodulin (TM) in patients with chronic kidney disease (CKD)3–5 and to assess their connection with the different stages and severity of disease.

Methods: Sixty-seven patients with CKD are included, disease severity was evaluated accordingly to CKD staging and clinical data is collected. Nineteen healthy volunteers served as healthy controls. Serum soluble TM is analyzed by ELISA.

Results: The levels of soluble TM in all patients with CKD were significantly higher than those of healthy controls (p?<?0.001). CKD5 patients showed higher serum levels of soluble TM, in comparison to CKD4 patients (p?=?0.001), CKD3 patients (p?<?0.001), and healthy controls (p?<?0.001). The correlation analysis revealed significant correlation between serum soluble TM and disease severity (r?=?0.714, p?<?0.001). Serum soluble TM was found to be correlated with eGFR (r?=??0.766; p?<?0.001) and serum creatinine (r?=?0.778, p?<?0.001).

Conclusion: Soluble TM concentrations significantly increase in the CKD patients and are associated with the severity of the disease. Soluble TM may play critical roles in the development of CKD, as a biomarker of endothelial cells damage, anticoagulation and anti-inflammation.     

Relationships among sleep timing,sleep duration and glycemic control in Type 2 diabetes in Thailand

There is evidence that the sleep and circadian systems play a role in glucose metabolism. In addition to physiological factors, sleep is also affected by behavioral, environmental, cultural and social factors. In this study, we examined whether morning or evening preference, sleep timing and sleep duration are associated with glycemic control in patients with type 2 diabetes residing in Thailand. Two hundred and ten type 2 diabetes patients who were not shift workers completed an interview and questionnaires to collect information on diabetes history, habitual sleep duration and sleep timing. Chronotype, an individual’s tendency for being a “morning” or “evening” person, was assessed using the Composite Score of Morningness (CSM), which reflects an individual’s subjective preference for activities in the morning or evening, as well as mid-sleep time on weekend nights (MSF), which reflects their actual sleep behavior. Most recent hemoglobin A1c (HbA1c) values were retrieved from medical records. Evening preference (as indicated by lower CSM), later bedtime on weekends, and shorter sleep duration correlated with higher HbA1c (r?=??0.18, p?=?0.01; r?=?0.17, p?=?0.01 and r?=??0.17, p?=?0.01, respectively), while there was no association between MSF or wake up time and glycemic control. In addition, later bedtime on weekends significantly correlated with shorter sleep duration (r?=??0.34, p?<?0.001). Hierarchical regression analyses adjusting for age, sex, body mass index, insulin use and diabetes duration revealed that later bedtime on weekends was significantly associated with poorer glycemic control (B?=?0.018, p?=?0.02), while CSM was not. Mediation analysis revealed that this association was fully mediated by sleep duration. In summary, later bedtime on weekends was associated with shorter sleep duration and poorer glycemic control in patients with type 2 diabetes. It is likely that patients with later weekend bedtimes curtail their sleep by waking up earlier. Exploring the potential reasons for this phenomenon (e.g. cultural influences, metropolitan lifestyle, environmental factors, family and social obligations) specific to a Thai population may help identify behavioral modifications (i.e. earlier bedtime and/or sleep duration extension) that could possibly lead to improved glycemic control in this population.     

Enhancement of purinergic signalling by excessive endogenous ATP in resiniferatoxin (RTX) neuropathy

ATP is a ligand of P2X family purinoceptors, and exogenous ATP administration evokes pain behaviors. To date, there is a lack of systematic studies to address relationships between endogenous ATP and neuropathic pain. In this report, we took advantage of a mouse model of resiniferatoxin (RTX)-induced neuropathic pain to address the role of endogenous ATP in neuropathic pain. After RTX administration, endogenous ATP markedly increased in dorsal root ganglia (DRGs) (p?<?0.01) and skin tissues (p?<?0.001). The excessive endogenous ATP was removed by apyrase, an ATP hydrolyzing enzyme, administration via either a lumbar puncture route (p?<?0.001) or an intraplantar injection (p?<?0.001), which led to the normalization of neuropathic pain. In addition, intraplantar treatment with apyrase caused mechanical analgesia. Linear analyses showed that the densities of P2X3(+) neurons (r?=??0.72, p?<?0.0001) and P2X3(+) dermal nerves (r?=??0.72, p?<?0.0001) were inversely correlated with mechanical thresholds. Moreover, the contents of endogenous ATP in skin tissues were linearly correlated with P2X3(+) dermal nerves (r?=?0.80, p?<?0.0001) and mechanical thresholds (r?=??0.80, p?<?0.0001). In summary, this study demonstrated that enhanced purinergic signalling due to an increase in endogenous ATP after RTX-induced nerve injury contributed to the development of neuropathic pain. The data in this report provide a new therapeutic strategy for pain control by targeting the endogenous ligand of purinergic signalling.     

Serum levels of FAK and some of its effectors in adult AML: correlation with prognostic factors and survival

Focal adhesion kinase (FAK), human myofibrillogenesis regulator-1 (MR-1), ephrin receptor type A4 (EphA4), proto-oncogene tyrosine kinase Src (Src), and protein kinase C (PKC) are important markers in proliferation, survival, and migration in some cancers. However, the significance of each is still unclear in different malignancies, including acute myeloid leukemia (AML). Therefore, this study was conducted to investigate their serum levels in Egyptian adult de novo AML patients (n?=?70) against healthy volunteers (n?=?20). We managed to study the correlation between each pair and to investigate their association with diagnosis, prognosis, and survival. Serum levels were analyzed using enzyme-linked immunosorbent assay (ELISA). We found that FAK, MR-1, Src, and PKC serum levels were significantly higher in AML patients compared to control (p?<?0.0001), and this was associated with significantly lower EphA4 level (p?<?0.0001). Interestingly, we also observed a significant negative correlation of FAK (p?=?0.027), MR-1 (p?=?0.003), Src (p?=?0.038), and PKC (p?=?0.03) with patients’ overall survival (OS) while there was a positive significant correlation between EphA4 and OS (p?=?0.007). In conclusion, this study suggests that FAK, MR-1, EphA4, Src, and PKC may be used as early diagnostic and prognostic markers with high sensitivity and specificity in AML patients and thus may be incorporated into the patients’ early diagnostic and prognostic panels.

     

Diagnostic value of exercise-induced changes in circulating high sensitive troponin T in stable chest pain patients

Abstract

Objective: We investigated the diagnostic value of exercise-induced increase in cardiac Troponin T (cTnT) in stable chest pain subjects.

Methods: CTnT was measured before and 20?h after an exercise test in 157 subjects suspected of coronary artery disease (CAD).

Results: CAD subjects (n?=?41) had higher baseline cTnT levels compared to non-CAD subjects (n?=?116), 6.39?ng/l and 3.00?ng/l, respectively, p?<?0.0001, and were more likely to increase in cTnT (70.7% versus 27.6%, p?<?0.0001). Net Reclassification Index for the combined variable was 19%, p?=?0.02.

Conclusions: Exercise-induced increase in cTnT was found to be associated with CAD and cTnT measurements improved the diagnostic evaluation.     

The midpoint of sleep on working days: A measure for chronodisruption and its association to individuals’ well-being

There is consistent evidence suggesting a relationship between individuals’ sleep–wake rhythms and well-being. The indiscriminate demands from daily working routines, which do not respect this individual physiological rhythm, might be mediating this phenomenon. The aim of the present study was to evaluate the relationship between the characteristics of sleep routines during working days and psychological well-being. This was a cross-sectional study on 825 individuals from rural communities from southern Brazil. The study protocol included a questionnaire on demographic characteristics, working routines, health complaints, and habits; the Munich Chronotype Questionnaire for sleep–wake rhythm and; the WHO-Five well-being index. Since sex has been shown to affect sleep circadian rhythm and well-being, analysis was performed on men and women separately. In the proposed hierarchical regression models, different factors contributed to well-being according to sex. Among men, sleep–wake and work-related variables did not predict well-being scores. Among women, later midpoints of sleep on working days (B?=??1.243, SE B?=?0.315, β?=??0.220), working more days per week (B?=??1.507, SE B?=?0.494, β?=?0.150), having longer working journeys (B?=??0.293, SE B?=?0.105, β?=??0.166), earlier working journey midpoints (B?=?0.465, SE B?=?0.222, β?=?0.115), and being exposed to less sunlight (B?=?0.140, SE B?=?0.064, β?=?0.103) predicted worse well-being. For the subgroup of women with days free from work, we have found a correlation between later midpoints of sleep during the week with worse well-being (Pearson’s r?=??0.159, p?=?0.045) while the same relationship was not significantly observed with the midpoint of sleep on non-working days (Pearson’s r?=??0.153, p?=?0.054). Considering WHO-Five as categorical, based on proposed clinical cut-offs, among women working 7-d/week, those with worst well-being (WHO-Five?<?13) had the latest midpoint of sleep (F?=?4.514, p?=?0.012). Thus, the midpoint of sleep on working days represents the interaction between individuals’ sleep–wake behavior and working routines. It plays an important role as a stress factor and may be a useful alternative variable related to chronodisruption.     

Changes in resting motor threshold of the tongue with normal aging and stroke

Aim of study: To examine the resting motor threshold of the tongue in healthy adults and stroke survivors.

Methods: Thirty-five healthy adults were classified into three groups: Group 1 (19–38?years; n?=?11), Group 2 (50–64?years; n?=?12) and Group 3 (66–78?years; n?=?12). Six chronic stroke survivors (mean age =59?years, SD?=?9.1?years) were recruited (Group 4). The resting motor thresholds (RMTs) of the tongue were measured and compared (i) among the four groups and (ii) between stroke survivors and age-matched healthy adults.

Results: Group 3 showed significantly higher RMTs than Group 1 (p?=?.001) and 2 (p =?0.007). Group 4 showed significantly higher RMTs than Group 1 (p =?.003) and 2 (p?=?.001). The RMTs of Group 3 and 4 were not significantly different (p =?.385). The RMT was positively correlated with age (r?=?0.534; p =?.001). Group 4 showed significantly higher RMTs than the age-matched controls (U?= 2.5, p?=?.009, r?=?0.77).

Conclusions: The resting motor threshold of the tongue is significantly increased in adults aged above 65 and in stroke survivors when compared with healthy adults. The findings suggested that the cortical excitability of the tongue deteriorates in the elderly and the stroke population.     

Impact of unilateral spatial neglect on chronic patient's post-stroke quality of life

Abstract

Background: Unilateral spatial neglect (USN) is the prevalent feature in patients with right-sided stroke. It is diagnosed through the behavior inattention test (BIT) and has a negative impact on patients affecting both their functional capacity and quality of life.

Objective: Here, we aimed to evaluate the impact of USN on the quality of life of patients in the chronic phase of stroke.

Methods: This is a cross-sectional study with stroke patients with USN. After confirming the presence of stroke through neuroimaging examinations and of USN through the BIT, patients’ quality of life was evaluated by using the EUROQOL scale. Spearman’s correlation was used to validate the correlation between patients’ USN and quality of life, with a p?<?.05 representing significant results.

Results: Eighteen individuals were included. When correlating the value of each domain of the EUROQOL scale with the results of the BIT, we observed a negative correlation between mobility (r?=?–0.97; p?=?.000), self-care (r?=?–0.82; p?=?.013), usual activities (r?=?–0.87; p?=?.005); pain or discomfort (r?=?–0.88; p?=?.004), anxiety or depression (r?=?–0.97; p?=?.000), and EUROQOL total score (r?=?–0.97, p?=?.000).

Conclusion: After a correlation between the overall EUROQOL and BIT scores, we suggest that the higher the USN degree is in stroke patients, the worse their perceived quality of life tends to be.     

Comparison of three oxidative stress biomarkers in a sample of healthy adults

Oxidative stress is a potentially important aetiological factor for many chronic diseases, including cardiovascular disease, neurodegenerative disease and cancer, yet studies often find inconsistent results. The associations between three of the most widely used biomarkers of oxidative stress, i.e. F₂-isoprostanes for lipid peroxidation and 8-oxo-7,8-dihydro-2’-deoxyguanosine (8-oxo-dG) and the comet assay with FPG for oxidative DNA damage, were compared in a sample of 135 healthy African-American and white adults. Modest associations were observed between F₂-isoprostanes and the comet assay (r?=?0.22, p?=?0.01), but there were no significant correlations between 8-oxo-dG and the comet assay (r?=??0.09) or F₂-IsoP (r?=??0.04). These results are informative for researchers seeking to compare results pertaining to oxidative stress across studies and/or assessment methods in healthy disease-free populations. The development and use of oxidative stress biomarkers is a promising field; however, additional validation studies are necessary to establish accuracy and comparability across oxidative stress biomarkers.     

Reduced antioxidant capacity and increased subclinical inflammation markers in prepubescent obese children and their relationship with nutritional markers and metabolic parameters

Objective: There are associations between some inflammatory and oxidative markers and obesity in adults, but whether prepubescent children of different weights also have such markers has not been studied. We investigated multiple inflammatory markers and levels of erythrocyte oxidant/antioxidant enzymes in prepubescent children of different weights.

Methods: Children aged 2–11 years were divided into three groups: 80 were underweight, 90 were obese but otherwise healthy, and 80 were healthy age- and sex-matched children of normal-weight. We analyzed inflammatory markers and the total oxidant status, total antioxidant status (TAS), and total thiol level were also determined, and the oxidative stress index was calculated as an indicator of the degree of oxidative stress.

Results: The obese group exhibited higher levels of fasting glucose, insulin, total cholesterol, triglycerides, the homeostatic model assessment of insulin resistance (HOMA-IR), and the homeostatic model assessment of β-cell function (HOMA-β), C-reactive protein (CRP), neutrophils, and neutrophil/lymphocyte ratio (NLR), as well as lower TAS and total thiol levels than the other two groups (all P?<?0.001). Moreover, TAS and total thiols were negatively correlated with age in the obese group (r?=??0.212, P?=?0.001; r?=??0.231, P?<?0.001, respectively). CRP levels in plasma were positively correlated with the body mass index (BMI), insulin and glucose levels, HOMA-IR, HOMA-β, WBC and neutrophil counts, and the NLR, and were negatively correlated with TAS and total thiol levels in the overall studied population.

Discussion: The coexistence of increased obesity-related subclinical inflammation and decreased antioxidant capacity can be observed even in prepubescence, and may eventually increase the risk of long-term vascular damage.     

Altered expression of circadian clock genes during peripheral blood stem cell mobilization induced by granulocyte colony-stimulating factor

Circulating hematopoietic stem cells exhibit robust circadian fluctuations, which influence the mobilized cell yield, even during enforced stem cell mobilization. However, alterations in the expression of circadian clock genes during granulocyte colony-stimulating factor (G-CSF)-induced peripheral blood stem cell (PBSC) mobilization are not fully elucidated. Therefore, we measured the expression of these genes in human peripheral blood leukocytes from 21 healthy donors. While CRY1 mRNA expression significantly increased by 3.9-fold (p?<?0.01), the expression of PER3, CRY2 and BMAL1 mRNAs significantly decreased (by 0.2-fold, 0.2-fold, and 0.6-fold, respectively; p?<?0.001) after G-CSF administration. Moreover, CRY1 mRNA expression was inversely correlated with the plasma level of noradrenaline (r?=??0.36, p?<?0.05), while PER3, CRY2, and BMAL1 mRNA expression directly correlated with the plasma level of noradrenaline (r?=?0.55, r?=?0.66, and r?=?0.57, respectively; p?<?0.001). Thus, significant correlations between the levels of circadian clock gene mRNAs and the plasma level of noradrenaline, a sympathetic nervous system neurotransmitter, were established. The modulation of sympathetic activation and of the circadian clock may be novel therapeutic targets for increasing stem cell yields in PBSC donors.