Magnesium—A Potential Key Player in Inflammatory Bowel Diseases?

The altered magnesium status in inflammatory bowel disease (IBD) patients may have a significant clinical imprint considering its role in cell signaling and genomic stability, as well as its involvement in IBD patients’ fatigue. Our study pioneers the investigation of magnesium hair concentration patterns in an adult population of IBD patients. The hair magnesium concentration in IBD patients is compared to healthy controls in order to identify correlations between the magnesium status and relevant parameters related to disease activity, psychological status, and sleep quality. We report a significantly lower hair magnesium concentration within the IBD group compared to healthy controls (95%CI: 0.006–0.062; p = 0.017) and lower levels in CD compared to UC (95%CI: −0.061–−0.002; p = 0.038). We identified a borderline statistical significance between the hair magnesium concentration and UC disease activity (95%CI; −0.679–0.008; p = 0.055) and a significantly lower magnesium concentration in patients who reported increased sleep latency (95%CI −0.65–−0.102; p = 0.011) or decreased sleep duration (95%CI −0.613–−0.041; p = 0.028). Our results advance several hypotheses with substantial clinical impact to be confirmed in future studies. Magnesium levels appear to be modified in IBD patients, which suggests it either plays a primary role in disease pathophysiology or a is result of the disease’s evolution. Magnesium could be used in predictive models for clinical/subclinical disease activity. Moreover, magnesium supplementation may improve IBD evolution and sleep quality for patients with a deficit of this mineral. However, confirmatory evidence-based studies are needed to generate specific dosing, time of supplementation, and optimum monitoring of magnesium status in IBD patients.     

寒区集训新兵睡眠质量影响因素研究

目的探讨寒区新兵睡眠质量的影响因素。方法以匹兹堡睡眠质量指数（PSQ I）测试寒区集训期新兵1 000人并分析其影响因素。结果（1）有效问卷892份,吸烟、饮酒者PSQ I及除催眠药物使用外的其他各项因子分高于无烟酒饮用习惯者。（2）县城来源新兵入睡时间明显高于省城来源新兵,乡镇来源新兵PSQ I及多项因子分低于省城和县城来源新兵。（3）回归分析显示：寒区新兵睡眠质量的主要影响因素依次为吸烟、饮酒及家庭住址。结论寒区新兵睡眠质量的影响因素为吸烟、饮酒及家庭住址。     

鼻腔扩容术加腭咽成形术对阻塞睡眠呼吸暂停综合征的疗效分析

目的：研究分析临床应用鼻腔扩容术加腭咽成形术治疗阻塞睡眠呼吸暂停综合征的疗效。方法：选取2011年5月-2012年5月本院收治的15例阻塞睡眠呼吸暂停综合征患者,给予鼻腔扩容术加腭咽成形术联合治疗,分析其治疗后的临床疗效及并发症发生情况。结果：术后随访观察,6个月时治疗总有效率保持为100%,1年时治疗总有效率为93.3%,患者的AHI指数及LSaO2均较术前有明显改善,总体疗效满意;术后并发症发生率为46.7%,给予相应的对症治疗后症状消失,无实质性损害。结论：鼻腔扩容术联合腭咽成形术治疗阻塞睡眠呼吸暂停综合征近远期疗效均较满意,但术后并发症发生情况需进一步改善。     

睡眠-觉醒的神经调节机制

睡眠-觉醒是一个涉及多系统、多中枢的生理过程，具有复杂的神经调节机制。促进觉醒的系统大部分起源于一系列明确的细胞群，并且这些细胞群与各自明确的神经递质相关联。促进睡眠的系统主要与大脑中抑制性神经递质γ氨基丁酸（GABA）有关，脑中不同部位的GABA神经元共同起到了促进睡眠的作用。为了更好地理解睡眠 觉醒的神经调节机制以及为新药的开发提供线索，本文对促进觉醒的系统和促进睡眠的系统的功能及其有关的神经递质进行了系统描述。     

A cross-sectional study of obstructive sleep apnea in patients with colorectal cancer

BackgroundThe association between colorectal cancer (CRC) and obstructive sleep apnoea (OSA) has been attracting increasing attention. several studies had confirmed that OSA increases the risk of CRC onset. However, the findings of studies on the morbidity of OSA in patients with CRC were unclear. Therefore, this study aimed to investigate the morbidity of OSA in patients with CRC as well as the association between the clinicopathological characteristics of OSA and CRC.MethodsA total of 414 patients with a pathological diagnosis of CRC from 1 January, 2020 to 30 December, 2020 were included in this study. Demographic characteristics, clinical information, and tumor characteristics of participants were collected; sleep was monitored using a wearable oximeter and via sleep quality questionnaire. The oxygen desaturation index (ODI) was used to classify OSA severity so that the diagnostic criteria for OSA were set based on the ODI as 0–5 (normal) and ≥5 (abnormal). After correcting for confounding factors, a logistic regression analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the factors affecting the tumor lymph node stage (N stage).ResultsA total of 402 patients with CRC were included in this study, including 225 (55.97%) men and 177 (44.03%) women. The mean ODI value of participants was 3.40±8.17. The morbidity of OSA among the patients with CRC having ODI ≥5 was 16.17%. A comparison between the normal and abnormal ODI value groups revealed that the high proportion of abnormal ODI was related to higher N stage (P<0.05). Logistic regression analysis revealed a correlation of ODI values and age to the N stage. Specifically, CRC patients with an abnormal ODI had a higher risk of lymph node metastasis compared to those with normal ODI (OR =1.915, 95% CI: 1.025 to 3.579). Moreover, patients with CRC aged ≥65 years had a higher risk of lymph node metastasis compared to those aged <65 years (OR =2.190, 95% CI: 1.163 to 4.125).ConclusionsCRC patients with abnormal ODI are susceptible to OSA. Additionally, abnormal ODI and age ≥65 years are relevant factors for the N2 stage.     

Obstructive sleep apnea syndrome (OSAS) and hypertension: Pathogenic mechanisms and possible therapeutic approaches

Obstructive sleep apnea syndrome (OSAS), a chronic condition characterized by collapse of the pharynx during sleep, has been increasingly recognized as a health issue of growing importance over the last decade. Recently emerging evidence suggests that there is a causal link between OSAS and hypertension, and hypertension represents an independent risk factor in OSAS patients. However, the pathophysiological basis for patients with OSAS having an increased risk for hypertension remains to be elucidated. The main acute physiological outcomes of OSAS are intermittent hypoxia, intrapleural pressure changes, and arousal from sleep, which might induce endothelial dysfunction, sympathetic activation, renin–angiotensin–aldosterone system activation, lipid metabolism dysfunction, and increased oxidative stress. This brief review focuses on the current understanding of the complex association between OSAS and hypertension.     

Effect of Lavender cream with or without footbath on sleep quality and fatigue in pregnancy and postpartum: a randomized controlled trial

Sleep disturbance and fatigue are frequent complaints during pregnancy and postpartum. We assessed the effectiveness of Lavender cream and footbath on sleep quality and fatigue in pregnancy and postpartum. In this trial, 141 women with sleep disturbance at 25–28 weeks gestation were recruited from public health centers in Tabriz, Iran, from May 2013 until January 2014 and randomized into one of three groups receiving: Lavender and footbath, Lavender alone, or placebo cream. Sleep quality was assessed using the Pittsburgh sleep quality index at the 4th and 8th weeks after intervention and the 6th week postpartum. Fatigue was assessed with the multidimensional assessment of fatigue scale at the 6th week after intervention and the 6th week postpartum. Repeated measures ANOVA and ANCOVA were used. Compared with the placebo group, the global sleep quality score post-intervention in pregnancy and the postpartum were significantly lower in the Lavender and footbath and the Lavender cream only groups. Fatigue in both intervention groups was significantly improved only at the 6th week postpartum. No statistically significant differences were observed between the two intervention groups. Lavender cream with or without footbath may improve sleep quality in pregnancy and postpartum.     

Investigation and Treatment of Ovulatory Failure

After gonadal dysgenesis or developmental failure have been ruled out and therapy initiated for secondary amenorrhea in appropriate cases, there remains a group of women in whom measures to overcome infertility can be undertaken with reasonable expectation of success. The first need is to determine if ovulation is occurring; if it is not, a variety of means is now available to induce it.     

Pseudoventricular Tachycardia

This program is acceptable for 24 hours of Prescribed credit by the American Academy of Family Physicians and 24 hours of Category 1 credit toward the Physician's Recognition Award of the American Medical Association. If movies are viewed, additional credits are available. Further information and registration and hotel reservation forms can be secured by writing to: Interstate Postgraduate Medical Association, PO Box 1109, Madison, WI 53701.