OSA-related fatigue was strongly associated with serum testosterone, together with OSA severity.
BackgroundObstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by repeated breathing pauses during sleep and is closely associated with obesity. Body fat is known to be a predictive factor for OSAHS and its severity.AimTo study the correlation between the severity of OSAHS and body composition measurements.Methods30 patients with OSAHS (21 men, 9 women, mean age 45.1 years, mean apnea-hypopnea index = 29.6/hour) were included in the study after full polysomnography. They were divided into 3 groups according to the apnea-hypopnea index (AHI): mild OSAHS (mean AHI 10.9/h), moderate OSAHS (mean AHI 23.9/h) and severe OSAHS (mean AHI 53.9/h). Body composition (body fat, body water and dry lean mass) was assessed using bioelectric impedance assay (BIA). Other measurements included neck and abdominal circumferences and body mass index (BMI). Pearson's coefficient (r) was used to express correlations between AHI and the following parameters: BMI, neck and abdominal circumferences, body fat, dry lean mass, and body water. Wilcoxon Sum-of-Ranks (Mann-Whitney) test for comparing unmatched samples was used to compare anthropometric and body composition measurements between groups.ResultsThe correlation between AHI and BMI was weak (r = 0.38). AHI correlated moderately with neck circumference (r = 0.54), with neck circumference corrected by height (r = 0.60), and more strongly with body fat (r = 0.67), with body water (r = 0.69) and with abdominal circumference (r = 0.75). There was a strong negative correlation between AHI and dry lean mass (r = - 0.92). There were significant differences in body fat, body water, neck circumference corrected by height and abdominal circumference (Wilcoxon Sum-of-Ranks, p < 0.01), between mild and severe OSASH groups, but not in BMI (Wilcoxon Sumof-Ranks, W = 86.5; p = 0.17).ConclusionsIn our study, the severity of OSAHS correlated with body fat and with body water more strongly than with general and cervical obesity. Abdominal adiposity may predict OSAHS severity better than neck circumference.
Imaging techniques have continually evolved during the last few decades to improve diagnosis in obstetrics and gynecology. Developed more than 15 years ago, three-dimensional (3D) ultrasound has been widely used in clinical practice during the last decade, and its use continues to grow as researchers explore innovative new applications. High definition live (HDlive) ultrasound (US) is a novel ultrasound technology that improves both 3D and four-dimensional (4D) ultrasound images. This technology can mainly be used to study normal and pathologic embryonic and fetal development. HDlive could be important to perinatal research and could provide a better understanding of the development of the early embryo and fetus. Because of the natural pictures of the fetus that it provides, HDlive could be beneficial for increasing the fetal-maternal bonding, an important factor for healthy behavior during the pregnancy. In gynecology, HDlive could be useful in providing a better image of the adnexal pathology or coronal plane of the uterus. Although its advantages need to be further explored, in our opinion, HDlive is an innovative technique and a useful tool with applications both in obstetrics and gynecology.
Since the first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there have been challenges recognizing the clinical features of SARS-CoV-2 and identifying therapeutic options. This has been compounded by viral mutations that affect clinical response and primary epidemiological indicators. Multiple variants of SARS-CoV-2 have been identified and classified on the basis of nomenclature implemented by scientific organizations and the World Health Organisation (WHO). A total of five variants of concern (VOCs) have been identified to date. The present study aimed to analyse clinical and epidemiological features of each variant. Based on these characteristics, predictions were made about potential future evolution. Considering the time and location of SARS-CoV-2 VOC emergence, it was hypothesised that mutations were not due to pressure caused by the vaccines introduced in December 2020 but were dependent on natural characteristics of the virus. In the process of adapting to the human body, SARS-CoV-2 is expected to undergo evolution to become more contagious but less deadly. SARS-CoV-2 was hypothesized to continue spread through isolated epidemic outbreaks due to the unimmunized population, mostly unvaccinated children and adults, and for coronaviruses to continue to present a public health problem. Contents 1. Introduction 2. SARS-CoV-2 variant gene mutations and impact of clinical features on disease evolution 3. Discussion 4. Limitations
Objectives: SARS-CoV-2 virus detection on nasopharyngeal specimens to infected individuals has become a challenge for the COVID-19 pandemic outbreak. We aim at comparing the performance of antigenic detection of SARS-CoV-2 in nasopharyngeal samples via an immunochromatographic method to molecular detection via qRT-PCR. Materials and Methods: 47 nasopharyngeal exudates were collected from suspicious COVID-19 cases. The samples were performed both via the qualitative immuno-chromatographic method for S protein detection in the SARS-CoV-2 structure, using fluorescent labelled anti-protein S antibodies and via qRT-PCR test for the qualitative detection of the screening gene E and the specific ORF1ab region of the RNA-SARS-CoV-2. Results: There was a fair correlation between the positive antigen tests and the positive PCR assays measured through threshold cycle ORF1ab region (Ct orf). A better correlation was obtained between the antigen test results and the Ct orf when including patients with Ct orf below 25. Conclusions: Using antigen tests as screening tests is useful on symptomatic persons during the viral replication period, therefore during the contagious period. A positive test shows a high predictive value for infection, while a negative antigen test result via immuno-chromatography must be confirmed by a qRT-PCR test.
Background The unprecedented exodus in the history of the European Union of more than 6 million Ukrainian refugees (May 13, 2022) is a cause for concern and could lead to a new difficult situation in terms of infectious disease control. Following the SARS-CoV-2 pandemic, Europe is facing a new challenge that could lead to a new wave of COVID-19 and an increase in the number of cases of tuberculosis or eradicated diseases, such as polio. Aim The purpose of this analysis was to provide an overview of lung diseases and health risks that could be encountered in refugees from Ukraine and translated to European Union`countries. Methods A systematic review was conducted in PubMed, World Health Organization, the UN Refugee Agency and the government’s websites. Selected publications investigated the health problems arising from Ukrainian population migration from conflict areas and their impact on the public health system in the adoptive countries. The main potentially contagious diseases in Ukraine have also been reviewed. Results The population of Ukraine has serious public health problems such as SARS-CoV-2 infection, multidrug-resistant tuberculosis, high levels of drug resistance and difficulties with an effective vaccination program, so there are significant risks of developing epidemics in transit or host countries. The current crisis has major peculiarities because the migrants were not concentrated in the camps but there was a dispersion of them on large territories of European countries. Conclusion In order to meet the health needs of refugees, it is necessary to adapt health systems culturally and linguistically, to train health workers on the particularities of existing diseases in the countries of refugee origin, and to facilitate collection of medical data on migrants’ health.
Chronic obstructive pulmonary disease (COPD) is one of the most challenging chronic disease nowadays due to increased morbidity and mortality, despite the multiple new therapies included in the therapeutic scheme. A possible cause may be insufficient approach to thromboembolic risk in these patients, scientific data being so far insufficient and relatively controversial. Areas covered: anticoagulant therapy is used mainly during severe exacerbations. There are data that have shown that therapy with low weight heparins injectable anticoagulants causes not only a reduction in thromboembolic risk but also an improvement in respiratory function parameters. Expert opinion: a number of COPD phenotypes are more prone to procoagulant status and thrombus formation. A layered approach to COPD patients in terms of antithrombotic prophylaxis is needed. Although current published clinical data have not provided irrefutable evidence, possibly due to the relatively heterogeneous approach to inclusion criteria, the frequent identification of autopsy holes in patients with COPD suggests that the high risk of mortality is due to specific bronchopulmonary changes and pulmonary embolism.
Current state of knowledge on the impact of emotions and perceptions of the population towards the risk of infection with the SARS-CoV-2 should be the basis for disease control measures as well as for community awareness programs. Due to differences in perceptions, concerns, culture, beliefs, different populations may react differently to the same challenges. Ninety adults were interviewed, without symptoms suggestive of SARS-CoV-2 infection, using the Romanian version of the Fear of COVID-19 Scale. The emotional reactions expressed by various psychotic or mental disorders, the main actions are taken to protect against the SARS-CoV-2 infection, as well as the hypothetical illness behavior were investigated. The total score, as well as each item of the Fear of COVID-19 Scale, indicates a low-to-moderate emotional level regarding to the risk of coronavirus infection. The data are supported by the choice to be treated at home in case of illness. There are differences in perception between sexes and between professional categories (employees vs. retirees). Knowledge of social phenomena caused by major epidemiological crises such as SARS-CoV-2 infection should be the basis of education, disease prevention and control programs to avoid the occurrence of psychosocial risks in the population.
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