Risk of Developing Metabolic Syndrome Is Affected by Length of Daily Siesta: Results from a Prospective Cohort Study

Background: Siesta has been associated with increased incidence of cardiovascular disease but the mechanism remains unclear. New studies into the relationship between siesta and metabolic syndrome have identified siesta length as a crucial differential, suggesting that siesta less than 40 min is associated with decreased risk of metabolic syndrome, while longer siesta is associated with increased risk. We aimed to investigate the effect of siesta duration on development of metabolic syndrome in a Mediterranean population using a prospective cohort study design. Methods: Our sample consisted of 9161 participants of the SUN cohort without components of metabolic syndrome at baseline. Siesta exposure was assessed at baseline and the development of metabolic syndrome components was assessed after an average 6.8 years of follow-up. We estimated odds ratios and fitted logistic regression models to adjust for potential cofounders including night-time sleep duration and quality, as well as other diet, health, and lifestyle factors. Results: We observed a positive association between average daily siesta >30 min and development of metabolic syndrome (aOR = 1.39 CI: 1.03–1.88). We found no significant difference in risk of developing metabolic syndrome between the group averaging ≤30 min of daily siesta and the group not taking siesta (aOR = 1.07 CI: 0.83–1.37). Further analysis suggested that average daily siesta <15 min may reduce risk of metabolic syndrome. Conclusions: Our study supports the J-curve model of the association between siesta and risk of metabolic syndrome, but suggests the protective effect is limited to a shorter range of siesta length than previously proposed.     

Primary aldosteronism in patients with adrenal incidentaloma: Is screening appropriate for everyone?

Primary aldosteronism (PA) is a common form of secondary hypertension. Several guidelines recommend that patients with adrenal incidentaloma have a high probability of suffering from PA. We conducted a prospective study of 269 consecutive adults with adrenal incidentaloma to investigate the prevalence and clinical characteristics of PA. In total, 9 participants were detected with PA, suggesting a prevalence of 3.35% among the study population. PA participants had a higher blood pressure level by 14/20.8 mm Hg and a lower serum potassium level by 0.8 mmol/L (P < .05). Importantly, all patients with PA presented with concurrent indications (hypertension with or without hypokalemia) for screening of the disease, but they have not undergone relative screening by the referring physician, thus casting doubts about the appropriate implementation of current guidelines in real‐life practice. Intense efforts are needed to familiarize physicians with recommendations for PA to minimize undiagnosed cases and the detrimental sequelae of this endocrine form of hypertension.     

Estimating progression-free survival in patients with glioblastoma using routinely collected data

Journal of Neuro-Oncology - Glioblastoma (GBM) represents 80% of all primary malignant brain tumours in adults. Prognosis is poor, and there is a clear correlation between disease progression and...     

Large olfactory neuroblastoma (esthesioneuroblastoma) surgically treated with an Altemir technique modification: a case report

Introduction

Olfactory neuroblastomas are rare malignant tumors that usually occur in the upper nasal cavity. The purpose of this paper is to present a case of a large olfactory neuroblastoma filling the entire nasal cavity, treated with an Altemir technique modification.

Methods

A 39-year-old woman presented with a large tumor of the nasal cavity. After the laboratory examinations, the tumor was classified as a Kadish stage A olfactory neuroblastoma. The selected treatment was the surgical excision after an Altemir technique modification combined with midfacial degloving and additional radiotherapy.

Results

Histopathology revealed a Hyams grade III olfactory neuroblastoma completely removed. Although the patient refused the additional radiotherapy, 18 months postoperatively, there were no signs of recurrence, and the patient shows big improvement on her sense of smell.

Conclusions

Large olfactory neuroblastomas filling the entire nasal cavity extending back to the postnasal space can be completely removed using a transfacial approach as the Altemir technique modification is.