Risk factors associated with transmission of sporadic norovirus (NV; formerly Norwalk-like virus)/Mexico strain were identified in a seroepidemiological study conducted in rural Mexico. Acquisition of Mexico strain IgA antibodies was age-related; 34% of 1-4-year-olds were seropositive, compared with 81% of adults (P<.001). After 12 months, 42% of 1-4-year-olds showed a seroresponse to Mexico strain, compared with 27% of adults (P<.01). Personal and domestic hygiene measures, such as hand washing, general cleanliness of the mother's clothing, and the type of room assigned for cooking were significantly associated with odds of a seroresponse. For infants, having a dog in or near the home was a risk factor for seroresponse (P<.01), whereas, for older children, the mother's involvement in agricultural activities was a risk factor (P<.001). This study provides initial evidence of risk factors associated with sporadic NV infection. Data indicate some similarities to risk factors associated with outbreaks of NV infection.
Performance of sleep questionnaires for the diagnosis of obstructive sleep apnea syndrome Background: The diagnosis of obstructive sleep apnea syndrome (OSAS) is based on nocturnal records: polysomnography or respiratory polygraphy. However, their high costs limit their use. Aim: To examine the predictive value of three sleep questionnaires (STOP, STOP-Bang, Epworth Sleepiness Scale (ESS) in the screening of OSAS in Chilean adults. Material and Methods: During the National Health Survey 2016/17, 205 adults aged 50.7 ± 15.0 years (46% males) living in the Metropolitan Region answered sleep questionnaires and underwent an ambulatory respiratory polygraphy. The sensitivity, specificity, positive and negative predictive values and receiver operating characteristic curves of sleep questionnaires were calculated. Results: Fifty nine percent of participants had OSAS which was moderate to severe in 26%. The clinical variables associated with OSAS were age, male gender, hypertension, dyslipidemia, overweight, cervical and waist circumferences, history of regular snoring and witnessed apneas. Daytime somnolence, insomnia and unrefreshing sleep were not associated to OSAS risk. STOP, STOP-Bang and ESS questionnaires classified 64%, 71% and 12% of cases as high risk for OSAS, respectively. The STOP and STOP-Bang questionnaires had the highest sensitivity to predict OSAS (76% and 89%, respectively) while the ESS had the highest specificity (91%). Conclusions: The sleep questionnaires allowed to identify the subjects at high risk for OSAS in this sample of adults from the Metropolitan Region.
Higher levels of plasma urate were associated with a longer duration of RBD without converting to PD. Future prospective studies would be needed to confirm this finding. Disorder Society
Prevalence of obstructive sleep apnea syndrome in Chilean adults. A sub-study of the national health survey, 2016/17 Background: Obstructive sleep apnea syndrome (OSAS) affects approximately 10%-20% of adults and is associated with obesity, hypertension and metabolic syndrome. Aim: To assess the prevalence and risk factors associated with OSAS in Chilean adults. Material and Methods: A standardized sleep questionnaire and respiratory polygraphy at home were conducted on adults aged 18 years or more, residing in the Metropolitan Region and enrolled in the 2016/17 National Health Survey. Results: Two-hundred and five people between 18 and 84 years old (46% men, mean age 50 years) underwent overnight respiratory polygraphy at home. The estimated obstructive sleep apnea prevalence was 49% (62% men, 31% women) considering an apnea-hypopnea index ≥ 5 respiratory events/hour, and 16% (21% men, 13% women) considering an apnea-hypopnea index ≥ 15 respiratory events/hour. The prevalence of obstructive sleep apnea continuously increased along with age for men and women, with a later onset for women. Age, gender, body mass index, cervical and waist circumference, snoring, reporting of apnea by proxies, self-reported cardiovascular and metabolic diseases such as hypertension, diabetes and dyslipidemia, were significantly associated with OSAS. No association was found with insomnia and daytime sleepiness. Conclusions: The prevalence and risk factors associated to obstructive sleep apnea syndrome were high among these adults.
Background: The relationship between sleep bruxism and antidepressant drugs in patients remains unclear. Objective: In this study, we aimed to investigate the incidence rate of antidepressant-related bruxism, and to examine whether or not antidepressant use is associated with this side effect in the patients. Patients and methods: The study sample was gathered from 2 hospitals. A total of 807 patients who met the criteria of inclusion were included in the study. The sample was divided into 2 groups: antidepressant group (n = 506) and the control group (n = 301). The sleep bruxism was established with reports from the study participants on the basis of the International Classification of Sleep Disorders: Diagnosis and Coding Manual Second Edition. Results: The prevalence of bruxism was significantly higher in the antidepressant group (24.3%) than the control group (15.3%). The incidence of antidepressant-induced bruxism was 14.0%. The antidepressants most associated with bruxism were paroxetine, venlafaxine, and duloxetine. The patients experiencing antidepressant-induced bruxism had higher age compared to those who did not suffer from this side effect. Conclusions:The results of the present study suggest that bruxism are frequently observed in women taking antidepressants and that it appears to be associated with antidepressant use at least in some patients.Introduction: Neuroendocrine secretion is regulated by sleep. OSA can impair hormone secretion with a decrease in pituitary function and morning serum testosterone levels. This can affect negatively libido and fertility. There is a paucity of studies evaluating this. Methods: Ambulatory males (20 to 50 years-old) were consecutively recruited from a Sleep Disorder Clinic, between August and December 2012. All underwent a clinical and anthropometric evaluation, a Epworth Sleepiness Scale (ESS), and polysomnography (PSG). We selected subjects with OSA defined as an apnea-hypopnea index (AHI) ≥5/h. Subjects with diabetes; hypothyroidism; pituitary tumors; morbid obesity and on chronic steroid treatment were excluded. We included 31 subjects of which 8 (25.8%) completed the study. Six were treated with CPAP and two with oral appliances. Sex hormone binding globulin (SHBG) protein, total and free testosterone levels were measured at baseline and at three months of OSA treatment. Results: We studied 8 subjects of mean age 43. Mean BMI 31.3. Mean AHI 47.3, events/h. Hormone levels at baseline and follow up were: Total testosterone 228.1 ng/ml and 259.1 ng/ml (p = 0.012); free testosterone 7.4 pg/ml and 9.2 pg/ml (p = 0.012); SHBG 15.3 nmol/lt and 17.4 nmol/lt (p = 0.05). Baseline ESS was 15.2. On follow up ESS was 3.2 (p = 0.018). BMI did not change significantly (p = 0.553). Conclusion: A significant increase in SHBG protein, total and free testosterone levels was observed after 3 months of treatment of OSA. This suggests that the improvement on libido reported on subjects treated with CPAP could be related to the increase in serum hormone levels and decrease in subj...
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