Sleep deprivation of rats: The hyperphagic response is real

Study Objectives: Chronic sleep deprivation of rats causes hyperphagia without body weight gain. Sleep deprivation hyperphagia is prompted by changes in pathways governing food intake; hyperphagia may be adaptive to sleep deprivation hypermetabolism. A recent paper suggested that sleep deprivation might inhibit ability of rats to increase food intake and that hyperphagia may be an artifact of uncorrected chow spillage. To resolve this, a palatable liquid diet (Ensure) was used where spillage is insignificant. Design: Sleep deprivation of male Sprague Dawley rats was enforced for 10 days by the flowerpot/platform paradigm. Daily food intake and body weight were measured. On day 10, rats were transcardially perfused for analysis of hypothalamic mRNA expression of the orexigen, neuropeptide Y (NPY). Setting: Morgan State University, sleep deprivation and transcardial perfusion; University of Maryland, NPY in situ hybridization and analysis. Measurements and Results: Using a liquid diet for accurate daily measurements, there was no change in food intake in the first 5 days of sleep deprivation. Importantly, from days 6-10 it increased significantly, peaking at 29% above baseline. Control rats steadily gained weight but sleep-deprived rats did not. Hypothalamic NPY mRNA levels were positively correlated to stimulation of food intake and negatively correlated with changes in body weight. Conclusion: Sleep deprivation hyperphagia may not be apparent over the short term (i.e., <= 5 days), but when extended beyond 6 days, it is readily observed. The timing of changes in body weight and food intake suggests that the negative energy balance induced by sleep deprivation prompts the neural changes that evoke hyperphagia.

Effect of Age on Outcome of Reduced-Intensity Hematopoietic Cell Transplantation for Older Patients With Acute Myeloid Leukemia in First Complete Remission or With Myelodysplastic Syndrome

Purpose Acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) primarily afflict older individuals. Hematopoietic cell transplantation (HCT) is generally not offered because of concerns of excess morbidity and mortality. Reduced-intensity conditioning (RIC) regimens allow increased use of allogeneic HCT for older patients. To define prognostic factors impacting long-term outcomes of RIC regimens in patients older than age 40 years with AML in first complete remission or MDS and to determine the impact of age, we analyzed data from the Center for International Blood and Marrow Transplant Research (CIBMTR). Patients and Methods We reviewed data reported to the CIBMTR (1995 to 2005) on 1,080 patients undergoing RIC HCT. Outcomes analyzed included neutrophil recovery, incidence of acute or chronic graft-versus-host disease (GVHD), nonrelapse mortality (NRM), relapse, disease-free survival (DFS), and overall survival (OS). Results Univariate analyses demonstrated no age group differences in NRM, grade 2 to 4 acute GVHD, chronic GVHD, or relapse. Patients age 40 to 54, 55 to 59, 60 to 64, and >= 65 years had 2-year survival rates as follows: 44% (95% Cl, 37% to 52%), 50% (95% Cl, 41% to 59%), 34% (95% Cl, 25% to 43%), and 36% (95% Cl, 24% to 49%), respectively, for patients with AML (P = .06); and 42% (95% Cl, 35% to 49%), 35% (95% Cl, 27% to 43%), 45% (95% Cl, 36% to 54%), and 38% (95% Cl, 25% to 51%), respectively, for patients with MDS (P = .37). Multivariate analysis revealed no significant impact of age on NRM, relapse, DFS, or OS (all P>.3). Greater HLA disparity adversely affected 2-year NRM, DFS, and OS. Unfavorable cytogenetics adversely impacted relapse, DFS, and OS. Better pre-HCT performance status predicted improved 2-year OS. Conclusion With these similar outcomes observed in older patients, we conclude that older age alone should not be considered a contraindication to HCT.

Restless legs syndrome - en beskrivning av dess inverkan på individens sömn, livskvalitet samt olika behandlingsformer : En systematisk litteraturstudie

Syftet med denna systematiska litteraturstudie var att beskriva hur restless legs inverkar på individens sömn och livskvalitet. Syftet var även att granska vilka olika former av behandlingar som finns att tillgå vid restless legs. För att finna information om detta ämne har endast vetenskapliga artiklar använts. Datainsamlingen har skett via databaser, internet samt Högskolans bibliotek, och artiklar från år 1995 och framåt har valts ut. Inklusionskriterier för denna studie var att de valda artiklarna skulle vara internationella vetenskapliga artiklar i fulltext. De funna artiklarna granskades med avseende på vetenskaplig kvalitet och poängsattes utifrån för ändamålet avsedda granskningsmallar. Denna bedömning resulterade i 21 artiklar. Resultatet visade att restless legs patienter upplever sömnbristen som det största problemet. För flertalet individer som drabbas av restless legs försämrades livskvaliteten och patienterna drabbades vanligtvis av psykologiska och fysiologiska besvär. Det vanligaste sättet att behandla restless legs var att använda dopaminerga läkemedel samt bensodiazepiner, antiepileptika och opioider. Andra former av behandlingar var järn, homeopatiska läkemedel, hypnos samt fysisk aktivitet. Det förekom även att restless legs patienter på eget initiativ använde hasch eftersom det ansågs lindra symtomen.

Seguimento clinoceletrográfico de criançcas e adolescentes com crise epiléptica única não-provocada

Os fenômenos convulsivos despertaram o interesse de estudiosos e pensadores já na Antigüidade, quando aspectos mágicos e sobrenaturais eram a eles associados. No século XIX foram lançadas as bases dos conceitos atuais sobre a desestruturação funcional cerebral na epilepsia, e Berger, em 1929, marcou definitivamente a história com a descoberta dos ritmos cerebrais. Crise epiléptica e epilepsia não são sinônimos, já que o último termo refere-se a crises recorrentes espontâneas. Ela costuma iniciar na infância, daí a preocupação com o risco de repetição do primeiro episódio e com a decisão de instituir tratamento medicamentoso. Fatores prognósticos são apontados, mas não há consenso. No Brasil existem poucas pesquisas nesta linha, tanto de prevalência da epilepsia como de fatores envolvidos na recorrência de crises. Este estudo teve como objetivo geral avaliar aspectos clinicoeletrográficos capazes de auxiliar no prognóstico e no manejo da epilepsia da criança e do adolescente. Foram objetivos específicos determinar a incidência de crise epiléptica não provocada recorrente; identificar fatores remotos implicados na ocorrência de crise epiléptica; relacionar tipo de crise com achados eletrencefalográficos; relacionar tipo de crise, duração da crise, estado vigília/sono no momento da crise e achados eletrencefalográficos com possibilidade de recorrência; e identificar os fatores de risco para epilepsia. Foram acompanhados 109 pacientes com idades entre 1 mês e 16 anos, com primeira crise não-provocada, em média por 24 meses, a intervalos trimestrais, no Hospital de Clínicas de Porto Alegre (HCPA). Foram realizados eletrencefalogramas (EEG) após a primeira crise; depois, solicitados anualmente. Não foram incluídos casos com epilepsia ou síndrome epiléptica bem definida, ou que fizeram uso prévio de drogas antiepilépticas. A média de idade foi 6 anos, com predomínio da faixa etária de 6 a 12 anos. Setenta eram meninos e 39, meninas. Os indivíduos brancos eram 92, e os não-brancos, 17. O nível de escolaridade dos casos esteve de acordo com a distribuição da idade e, entre os responsáveis, predominaram 8 anos de escolaridade. Foi possível concluir que as crises únicas não-provocadas mais freqüentes foram generalizadas, e sem predomínio significativo do tipo de EEG. A incidência de crise não-provocada recorrente foi 51,4%. História de intercorrências pré-natais maternas aumentou em 2 vezes o risco de repetição de crises. Via de nascimento, escore de Apgar no 5º minuto, relação peso ao nascer/idade gestacional, intercorrências no período pós-natal imediato e desenvolvimento neuropsicomotor não tiveram influência na recorrência. História familiar de crises mostrou tendência à significância estatística para repetição dos episódios, com risco de 1,7. Não foi encontrada associação entre tipo de crise e achado eletrencefalográfico. A maioria das crises foi de curta duração (até 5 minutos), mas este dado não esteve relacionado com a recorrência. Estado de vigília teve efeito protetor na recorrência. Se a primeira crise foi parcial, o risco de repetição foi 1,62, com tendência à significância. Quando o primeiro EEG foi alterado, houve relação significativa com primeira crise tanto generalizada como parcial. O primeiro EEG com alterações paroxísticas focais apontou risco de repetição de 2,90. Quando as variáveis envolvidas na repetição de crises foram ajustadas pelo modelo de regressão de Cox, EEG alterado mostrou risco de 2,48, com riscos acumulados de 50%, 60%, 62% e 68%; com EEG normal, os riscos foram 26%, 32%, 34% e 36% em 6, 12, 18 e 24 meses respectivamente.

Talassoterapia para pacientes com fibromialgia: ensaio clínico radômico

Fibromyalgia (FM) is a chronic rheumatic syndrome characterized by diffuse muscle-skeletal pain, and aerobic exercises represent a fundamental portion in therapeutic approach. Objective of this study was to evaluate the effectiveness of aerobic exercises accomplished in the water of the sea (thalassotherapy) for women with FM and to compare with exercises accomplished in the swimming pool, involving a multidisciplinary team, composed by rheumatologists, physical therapists, students of physical therapy and students of physical education. Forty six (46) women with age between 18 and 60 years with FM were randomized in 2 groups: a swimming pool group (23 patients) and a sea group (23 patients). 80th groups trained a week with the same program of aerobic conditioning 3 times (60 minutes each) for 12 weeks. Ali the patients were evaluated, before and immediately after treatment, with Visual Analogical Scale (VAS) for pain and fatigue, number of tending points, Fibromyalgia Impact Ouestionnaire (FIO), Short Form 36 Health Survey (SF-36), Pittsburgh Sleep Ouality Index (PSOI) and Beck Oepression Inventory (BOI). For statistical analysis, it was used paired-t test for analysis intra-group and non-paired test for inter-groups analysis, significance levei of p <0,05. Four patients, of each group, didn't complete the training programo Groups were homogeneous and they were compared in initial evaluation, except for BOI (p <0,05). Both groups presented statistically significant improvement for ali appraised parameters in the post-treatment compared with initial evaluation, there were reduction of intensity of pain and fatigue, number of tending points, better functional capacity (FIO), life quality (SF-36), quality of sleep (PSQI) and depression indexes (BOI). However, in comparison among the groups, group of sea (thalassotherapy) presented better results for ali parameters, however with statistically significant difference just only for depression indexes (BOI). At the end, it was observed that accomplishment of aerobic exercises in sea water or swimming pool was effective as part of treatment for patients with FM. However, exercise programs with thalassotherapy seems to bring more benefits, mainly related to emotional aspects, could be a therapeutic option of low cost for patients with FM in our area

Increasing trends of sleep complaints in the city of São Paulo, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Sono e síndrome da fragilidade em idosos residentes em instituições de longa permanência

Introduction: The aging process causes quantitative and qualitative changes in sleeping. Such changes affects more than half of the adults above 65 years old, that live in the community and 70% of the institutionalized, a great negative impact in their quality of life. One of the pathological displays of aging, that share some characteristics with sleeping disorders and predict similar results, is the Frailty Syndrome, that characterize the most weakened and vulnerable elderly. The way sleeping disorders play a role in the frailty pathogeneses remains uncertain. Objective: Evaluate the relation between the sleeping and the frailty syndrome on institutionalized elderly. Methodology: A transversal study was performed with 69 elderly in institutions in the city of João Pessoa PB. Were used the Pittsburgh Sleeping Quality Index and actigraphy to subjective and objective variables, respectively, and questionnaires and specific tests to frailty phenotype variant (Fried Frailty Criteria). In the statistic analysis were used the Pearson correlation test, Chi Square and One-way ANOVA test, with Tukey-Krammer posttest. Subsequently, a Simple Linear Regression model was built. On every statistical analysis were considered a confidence interval of 95% and a p < 0,05. Results: The sample was characterized by the prevalence of the frail (49,3%), women (62,3%), single (50,7%) and 77,52 (±7,82).The frail elderly obtained the worst sleeping quality 10,37 (±4,31) (f = 4,15, p = 0,02), when compared with the non-frail. The sleep latency influenced more the frailty (R2 = 0,13, β standard = 1,76, β = 0,41, p = 0,001). Weren t found differences between the standard resting-activity variable and the frailty phenotype categories. Conclusion: Sleeping alterations, including bad sleeping quality, prolonged sleep latency, low sleep efficiency and day drowsiness, influenced the frailty in institutionalized elderly

Performance, incidence of metabolic disturbances and endocrine variables of food-restricted male broiler chickens

1. This experiment was carried out to evaluate the productive and physiological consequences of a slight but long term food restriction of male broiler chickens from 2 commercial strains.2. Cobb-500 and Ross chickens were submitted to a 20% food restriction from 8 to 21 d of age. Strain, food programme and their interactive effects were analysed in terms of consequences upon performance, mortality, incidence of sudden death syndrome (SDS) and ascites syndrome (AS), index of right cardiac hypertrophy and plasma concentrations of hormones related to metabolism and growth (T-3, T-4, T-3:T-4 ratio, IGF-I and GH).3. Although some catch-up growth was observed by refeeding previously restricted birds after 22 d of rearing, food restriction decreased (P less than or equal to 0.05) body weight at market age (42 d) irrespective of the strain, but improved (P less than or equal to 0.05) food conversion.4. The incidence of mortality was not high in non-restricted birds but SDS and AS caused more than 50% of deaths. Hypertrophic cardiac index was observed in chickens of both strains after 4 weeks of age and was higher in ad libitum fed birds.5. During the period of food restriction, plasma T-3 and IGF-I concentrations decreased whereas plasma T-4 and GH concentrations increased compared to those of the age-matched ad libitum fed counterparts. During the subsequent ad libitum feeding period, few differences in circulating hormone concentrations were observed, except for the higher mean CH litres in previously food-restricted chickens at 35 d of age.6. These results indicate that even a non-severe food restriction negatively affects body weight of 42-d-old male broilers but these are benefits with improved food efficiency and diminished mortality from metabolic disturbances. The hormone results suggest that the degree of food restriction applied was not severe because there was a very fast adaptive response with small and transient alterations in T-3, T-4 and GH plasma concentrations during the period of compensatory growth.

Angiotensin II-derived reactive oxygen species underpinning the processing of the cardiovascular reflexes in the medulla oblongata

The brainstem is a major site in the central nervous system involved in the processing of the cardiovascular reflexes such as the baroreflex and the peripheral chemoreflex. The nucleus tractus solitarius and the rostral ventrolateral medulla are 2 important brainstem nuclei, and they play pivotal roles in autonomic cardiovascular regulation. Angiotensin II is one of the neurotransmitters involved in the processing of the cardiovascular reflexes within the brainstem. It is well-known that one of the mechanisms by which angiotensin II exerts its effect is via the activation of pathways that generate reactive oxygen species (ROS). In the central nervous system, ROS are reported to be involved in several pathological diseases such as hypertension, heart failure and sleep apnea. However, little is known about the role of ROS in the processing of the cardiovascular reflexes within the brainstem. The present review mainly discussed some recent findings documenting a role for ROS in the processing of the baroreflex and the peripheral chemoreflex in the brainstem.

Physical activity attenuates neuropsychiatric disturbances and caregiver burden in patients with dementia

INTRODUCTION: A significant benefit from physical activity has recently been described in some patients who suffer from neurodegenerative diseases. OBJECTIVE: To assess the effects of physical activity on neuropsychiatric disturbances in demented patients and on the mental burden of their caregivers. METHODS: Assisted by a public geriatric psychiatry clinical unit, we studied 59 patients with dementia. Patients were divided into three groups according to their diagnosis and level of physical activity. Data were assessed through a semi-structured interview. Patients were evaluated with the Neuropsychiatric Inventory, the Mini-Sleep Questionnaire and the Baecke Questionnaire. The data were statistically analyzed using the Mann-Whitney U test and linear regression, with the level of significance set at 5%. RESULTS: Patients with Alzheimer's or vascular dementia who engaged in physical activity had fewer neuropsychiatric symptoms than those who did not. When compared to the control group, the caregivers of patients with vascular dementia who engaged in physical activity had a reduced burden. CONCLUSION: The regular practice of physical activity seems to contribute to a reduction in neuropsychiatric symptoms in dementia patients and to attenuate the burden of the caregivers of those patients.

Validation of an immunohistochemistry assay to detect turkey coronavirus: A rapid and simple screening tool for limited resource settings

The objective of the present study was to develop and apply the direct immunohistochemistry (D-IHC) assay to search for turkey coronavirus (TCoV) antigens in formalin-fixed embedded-paraffin tissues by the use of biotin-labeled polyclonal antibody. Twenty-eight-day-old embryonated turkey eggs (n = 50) were inoculated with TCoV-purified virus, and 3 d after inoculation, sections from ileum, ileum-cecal junction, and ceca were harvested, fixed in neutral formalin, and embedded in paraffin blocks and used as positive control. In addition, a total of 100 field samples from ileum, ileum-cecal junction, and ceca, collected from 30 to 45-d-old turkeys poults experiencing an outbreak of acute enteritis, were used to search for TCoV by the same D-IHC. All results were compared with those obtained by conventional RT-PCR and indirect fluorescent antibody assay (IFA) for all tested samples. Turkey coronavirus was detected in experimentally infected embryo tissues and also in field samples in 100% of ileum-cecal junction and ceca by the 3 detection procedures. With IFA as a reference assay, sensitivity and specificity of D-IHC were 98 and 58%, whereas sensitivity and specificity of reverse transcription-PCR were 96 and 66%, calculated from the total of tested samples from experimental infection. Each of the examined procedures was highly specific (D-IHC, 93%; RT-PCR, 90%), sensitive (D-IHC, 85%; RT-PCR, 86%), and agreement of both D-IHC and RT-PCR was 99 and 100%, respectively, compared with IFA results obtained from all the field samples. These findings demonstrated the utility of D-IHC for direct detection of TCoV from field samples and considering the sensitivity and specificity found here, can be used as an alternative technique.

Guanidine Affects Differentially the Twitch Response of Diaphragm, Extensor Digitorum Longus and Soleus Nerve-Muscle Preparations of Mice

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Sleep duration in elderly obese patients correlated negatively with intake fatty

Study objectives: The purpose of the present study was to evaluate the relationship between sleep duration and dietary habits in elderly obese patients treated at an institute of cardiology.Methods: The fifty-eight volunteers were elderly patients with obesity (classified as obese according to BMI) of both genders, between 60 and 80 years of age. All participants were subjected to assessments of food intake, anthropometry, level of physical activity, and duration of sleep.Results: The men had significantly greater weight, height, and waist circumference than women. Sleep durations were correlated with dietary nutrient compositions only in men. We found a negative association between short sleep and protein intake (r = -0.43; p = 0.02), short sleep and monounsaturated fatty acids intake (r = -0.40; p = 0.03), and short sleep and cholesterol dietary intake (r = -0.50; p = 0.01).Conclusions: We conclude that mainly in men, volunteers that had short sleep duration showed a preference for high energy-density as fatty food, at least in part, may explain the relationship between short sleep duration and the development of metabolic abnormalities.

Metabolic Disturbances in Male Broilers of Different Strains. 1. Performance, Mortality, and Right Ventricular Hypertrophy

Two trials were carried out to test the susceptibility for metabolic disturbances of different strains of male broilers. In Trial 1, 1,890 male chickens were allotted in a randomized block design with seven treatments (Arbor Acres, Avian Farms, Cobb-500, Hubbard-Peterson, ISA, Naked Neck, and Ross) and six blocks of 45 chickens. Trial 2 involved 2,184 male chickens of six strains (Arbor Acres, Avian Farms, Cobb 500, Hubbard-Peterson, ISA Naked Neck, and Ross) allotted in seven complete blocks of 52 birds. The same management system was adopted for all birds, reared up to 42 d in an open house during late winter (Trial 1) or late autumn (Trial 2). The most marked differences observed among the strains tested was the lower BW and higher feed conversion of Naked Neck broilers. Total percentage mortalities were high among the most productive broilers, being more than 50% due to sudden death (SDS) and ascites syndrome (AS). No Naked Neck birds died as a consequence of these disturbances and the total mortalities were significantly lower (P ≤ 0.05) than the other strains. The ratio of right ventricle weight to total ventricle weight of the dead birds was over 0.25, except for Naked Neck birds, which presented a nonhypertrophic ratio. The two trials confirmed the relationship between high productivity and high incidence of SDS and AS and indicated that Naked Neck male broilers are resistant to these metabolic disturbances.