Positive Airway Pressure Adherence in Patients with Obstructive Sleep Apnea with Schizophrenia

Introduction

To determine the 1-year and 3-year adherence rates with Positive Airway Pressure (PAP) therapy in patients with schizophrenia compared to matched controls.

Methods

A case–control retrospective analysis was performed in a Veterans Affairs hospital. All symptomatic patients with schizophrenia ever started on PAP therapy between 2007 and 2015 were compared with controls matched for severity of sleep apnea based on AHI, BMI, and age at the time of diagnosis.

Results

Total number of subjects in both groups was 39. Mean AHI among cases and controls was 27.63 ± 22.16 and 33.59 ± 44.04 (p = 0.32), mean BMI was 34.91 ± 5.87 and 33.92 ± 5.21 (p = 0.43), and mean age at diagnosis was 53.6 ± 11.75 and 55.97 ± 11.92 (p = 0.36), respectively. There was no statistically significant difference in PAP use between patients with schizophrenia and controls at 1-year (percent days device use > 4 h—36.43% ± 31.41 vs. 49.09% ± 38.76; p = 0.17) and 3-year (percent days device use > 4 h—42.43 ± 35.50 vs. 60.53 ± 38.56; p = 0.089) visits

Conclusions

PAP adherence and usage is not significantly different among patients with schizophrenia compared to matched controls. Therefore, schizophrenia does not appear to influence CPAP compliance.

     

Induction of Rabies Virus Infection in Mice Brain may Up and Down Regulate Type II Interferon gamma via epigenetic modifications

Metabolic Brain Disease - As feared and deadly human diseases globally, Rabies virus contrived mechanisms to escape early immune recognition via suppression of the interferon response. This study,...     

Prenatal diagnosis and postnatal outcome of fetal intracranial hemorrhage

Background

The aim of this study was to present our experience with six cases of fetal intracranial hemorrhage (ICH) in terms of prenatal diagnostic features, and postnatal outcome.

Methods

The database of prenatal diagnosis unit was searched for antenatally diagnosed ICH cases. Maternal characteristics, ultrasound (US), and magnetic resonance imaging (MRI) findings, clinical course, and postnatal outcome were noted.

Results

We evaluated six consecutive cases of fetal ICH. One case was terminated at 24 weeks, and remaining five cases were delivered between 34 and 38 weeks. Five cases (5/6) had intraventricular, and one (1/6) had intraparenchymal hemorrhage. Hemorrhages were right sided in five cases (5/6), left sided in one case (1/6). Dilated and echogenic ventricular wall were the common US findings. No predisposing factor was detected in four of the cases, and intrauterine growth restriction was an underlying factor in two fetuses. Intrauterine progression of the hydrocephaly, and parenchymal thinning was seen in four cases (4/6). In three of four cases (3/4) with progressive grade 3–4 hemorrhage and hydrocephaly, postnatal outcome were dismal, and one case had mild neurological impairment at three months. In one case which had non-progressive mild ventriculomegaly, the lesion regressed after 4 weeks, and had normal short-term outcome

Conclusion

Fetal ICH can be accurately identified and categorized by antenatal sonography, and fetal MRI. Although intrauterine regression or normal short-term postnatal outcome is possible, the outcome is usually poor for fetuses with high grade and/or progressive lesions. Therefore, further studies assessing long-term postnatal outcome are needed     

A longitudinal birth cohort study of early life conditions,psychosocial factors,and emerging adolescent sexual orientation

This study tested whether previously reported associations between early life factors and later adolescent sexual orientation could be replicated in another prospective birth cohort, the UK Millennium Cohort Study (MCS). We used data on 9,795 youth from the MCS. Emerging sexual orientation was assessed using measures of sexual attraction to males and females in separate items at 14 years. Factors including birthweight, breastfeeding, sibling composition, parental ages, maternal psychopathology, parent-child relationship, and contextual risks were separated into three developmental periods: prenatal (n = 5 factors), before 7 years (n = 6 factors), and after 7 years (n = 5 factors). We controlled for handedness as a putative marker of prenatal androgen exposure and the possibility of mischievous responding statistically. Girls with greater maternal psychological distress since age 7 and greater pubertal body mass index were more likely to be nonheterosexual but the effect sizes were very small. Among boys there were no significant associations between any early life conditions and later sexual orientation. However, focusing on effect sizes rather than significance levels, there were small associations between preterm birth and nonheterosexuality. The results offer further evidence that psychosocial influences in the development of adolescent sexual orientation are weak or non-existent.     

Salivary levels of mutans streptococci and Lactobacilli among Palestinian school children in East Jerusalem

Objectives

The aim of the present study was to investigate the distribution of oral cariogenic bacteria among 12-year-old Palestinian children attending schools in East Jerusalem.

Materials and methods

Salivary levels of mutans streptococci (MS) and Lactobacilli (LB) were examined by semi-quantitative commercial kits and then correlated to social–demographic parameters.

Results

Overall, 52.1 % of the examined children presented the highest possible ranking score categories for MS bacteria, with only 5.4 % in the lowest category. Only 12.6 % of the school children presented the highest LB score, while 25 % had the lowest ranking score. Salivary MS levels in children attending private schools were lower than those of children in government schools and United Nations Relief and Works Agency (UNRWA) schools. Conversely, levels of LB were lowest in children attending UNRWA schools compared to government and private schools. Girls had significantly higher amounts of MS and LB than boys (p?=?0.001). Lower MS levels were significantly related to the following socioeconomic variables: higher father’s education level (p?=?0.037), higher mother’s education level (p?=?0.063), mother’s employment status (p?=?0.012), and lower home density (p?=?0.001). For LB, the only significant socioeconomic variable was higher father’s employment level, which was related to lower LB level (p?=?0.025).

Conclusions

Levels of MS and LB were found to be strongly related with socioeconomic status among Palestinian children in East Jerusalem. The relatively high prevalence of cariogenic bacteria suggests that oral care prevention and treatment demands special attention from the health care institutions and authorities.     

Pregnancy outcome in patients with previous uterine rupture

BACKGROUND: To review the outcome of subsequent pregnancies in conservatively managed cases of uterine rupture. METHODS: Charts of patients with full thickness uterine rupture in the past 25 years were reviewed and information on subsequent pregnancies was extracted from maternal and neonatal charts. RESULTS: Thirty-seven patients with uterine rupture were identified; the uterus was scarred in 62.2%. Ruptures were repaired in 26 (70.3%). Twelve patients subsequently conceived (24 pregnancies), with recurrence in 8/24 (33.3%) pregnancies or 5/12 (41.7%) patients. Patients with recurrence had a shorter median interval from previous rupture (2 versus 5 years), a higher incidence of previous longitudinal ruptures (60.0% versus 0.0%), and the median gestational age at the preceding rupture was lower without reaching statistical significance (34 versus 38 weeks; p = 0.209). CONCLUSIONS: Longitudinal ruptures and short intervals between rupture and subsequent pregnancy predispose to recurrence of uterine rupture.     

Trends and Spatial Pattern Analysis of Dengue Cases in Northeast Malaysia

ObjectivesDengue remains hyperendemic in Malaysia despite extensive vector control activities. With dynamic changes in land use, urbanisation and population movement, periodic updates on dengue transmission patterns are crucial to ensure the implementation of effective control strategies. We sought to assess shifts in the trends and spatial patterns of dengue in Kelantan, a north-eastern state of Malaysia (5°15’N 102°0’E).MethodsThis study incorporated data from the national dengue monitoring system (eDengue system). Confirmed dengue cases registered in Kelantan with disease onset between January 1, 2016 and December 31, 2018 were included in the study. Yearly changes in dengue incidence were mapped by using ArcGIS. Hotspot analysis was performed using Getis-Ord Gi to track changes in the trends of dengue spatial clustering.ResultsA total of 10 645 dengue cases were recorded in Kelantan between 2016 and 2018, with an average of 10 dengue cases reported daily (standard deviation, 11.02). Areas with persistently high dengue incidence were seen mainly in the coastal region for the 3-year period. However, the hotspots shifted over time with a gradual dispersion of hotspots to their adjacent districts.ConclusionsA notable shift in the spatial patterns of dengue was observed. We were able to glimpse the shift of dengue from an urban to peri-urban disease with the possible effect of a state-wide population movement that affects dengue transmission.