Agreement analysis of sleep patterns between self-reported questionnaires and actigraphy in adults

Purpose

To investigate the agreement in sleep pattern recording by self-reported sleep questionnaires and actigraphy in adults.

Methods

This is a cross-sectional study. Men and women who met inclusion criteria were recruited for this study. The inclusion criteria were apparently healthy Omani nationals ages 19 to 50 years. Sleep questionnaires were randomly distributed in Muscat either directly or via electronic and paper announcements. Data were collected from the participants using the self-reported questionnaires with four piloted questions for sleep pattern identification and through the actigraphy wristband given to subjects to wear for a week. Cohen’s kappa test was performed for agreement analysis.

Results

A total of 964 Omani subjects between ages 18 and 59 years of both genders were recruited and completed the questionnaires successfully. Out of these, only 321 subjects wore the actigraphy wristband for 1 week (response rate = 33%). Agreement analysis reported a mild level of agreement for the monophasic (41%), moderate level for biphasic (59%), and good level for polyphasic (70%) sleep patterns. The overall agreement level of sleep patterns between the two methods was 57%. There is a low specificity of self-reported assessment in reporting sleep pattern.

Conclusion

The average agreement level of subjective versus objective assessments of sleep patterns was moderate at 57% and self-reported sleep pattern is not specific. The study recommends the use of actigraphy along with sleep questionnaires for accurate assessment of sleep patterns in cohort studies.

     

Molecular Evidence of Helicobacter Pylori Infection in Prostate Tumors

Objectives

To determine whether Helicobacter pylori (H. pylori) is detectable in both benign prostatic hyperplasia (BPH) and prostate cancer (PCa). Epidemiological studies have shown significant associations between infective chronic prostatitis and prostatic carcinoma. Many bacteria have been found in the prostate of patients with chronic prostatitis, BPH, and PCa.

Methods

One hundred consecutive patients with prostate diseases were enrolled in the study. Detection of H. pylori DNA in prostate tissue from patients with BPH and PCa was performed using both immunohistochemistry and PCR, and the results were confirmed by DNA sequencing. Odds ratios and the Fisher Exact test were used for the analysis of the associations between the variables.

Results

Among the patients, 78% had BPH and 19% had PCa. While immunohistochemistry showed no positive sample for H. pylori, PCR combined with sequencing detected H. pylori DNA in prostate tissue samples from 5 patients. However, statistical analysis of the data showed that BPH and PCa are not significantly associated with the presence of H. pylori DNA in prostate tissue (odds ratio = 0.94, 95% confidence interval = 0.09–23.34, one-tailed Chi-square value = 0.660, p > 0.05). The limitation of this study was the small number of PCa patients.

Conclusions

This study provides, for the first time, molecular evidence of the presence of H. pylori DNA in prostatic tissue of patients with BPH and PCa. It paves the way for further comprehensive studies to examine the association of H. pylori infection with BPH and PCa.Key Words: Helicobacter pylori infection, Prostate cancer, Benign prostate hyperplasia, PCR     

Sleep deprivation alters neutrophil functions and levels of Th1-related chemokines and CD4+ T cells in the blood

Sleep and Breathing - The state of knowledge about the effect of sleep deprivation on the immune system is scarce and conflicting. It would therefore be useful to investigate the consequences of...     

Acute simvastatin increases endothelial nitric oxide synthase phosphorylation via AMP-activated protein kinase and reduces contractility of isolated rat mesenteric resistance arteries

Statins can have beneficial cholesterol-independent effects on vascular contractility, which may involve increases in the bioavailability of NO (nitric oxide) as a result of phosphorylation of eNOS (endothelial NO synthase). Although this has been attributed to phosphorylation of Akt (also known as protein kinase B), studies in cultured cells have shown that statins can phosphorylate AMPK (AMP-activated protein kinase); it is unknown whether this has functional effects in intact arteries. Thus we investigated the acute effects of simvastatin on resistance arterial contractile function, evaluating the involvement of NO, Akt and AMPK. Isolated rat mesenteric resistance arteries were mounted on a wire myograph. The effects of incubation (1 and 2?h) with simvastatin (0.1 or 1?μM) on contractile responses were examined in the presence and absence of L-NNA (N-nitro-L-arginine; 10?μM) or mevalonate (1?mM). Effects on eNOS, phospho-eNOS (Ser1177), and total and phospho-Akt and -AMPK protein expression were investigated using Western blotting. The effect of AMPK inhibition (compound C, 10?μM) on eNOS phosphorylation and contractile responses were also studied. Simvastatin (1?μM, 2?h) significantly reduced constriction to U46619 and phenylephrine and enhanced dilations to ACh (acetylcholine) in depolarized, but not in U46619-pre-constricted arteries. These effects were completely and partially prevented by L-NNA and mevalonate respectively. Simvastatin increased eNOS and AMPKα phosphorylation, but had no effect on Akt protein expression and phosphorylation after 2?h incubation. Compound C prevented the effects of simvastatin on eNOS phosphorylation and contractility. Thus simvastain can acutely modulate resistance arterial contractile function via mechanisms that involve the AMPK/phospho-eNOS (Ser1177)/NO-dependent pathway.     

Reference values for arterial stiffness indices in an Omani Arab population

Objectives:

To determine the reference values of arterial stiffness indices, particularly augmentation index (AIx) and pulse wave velocity (PWV) using applanation tonometry in a healthy Omani Arab population.

Methods:

This prospective study was carried out in the Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman over a 2-year period from June 2011 to June 2013. The central AIx, aortic PWV (AoPWV), and central pulse pressure (CPP) were recorded from 120 healthy subjects recruited randomly from a normal population using a SphygmoCor device. The 2.5th and 97.5th percentiles were used to determine the reference ranges for men and women separately. Analyses were performed using univariate statistics.

Results:

The mean age of the cohort was 38 years for men, and 35 years for women, with the ages ranging from 20-53 years. The overall mean central AIx was 13±11%, and for AoPWV was 6.7±1.6 m/s. The central AIx was higher in women (17 versus 10%; p<0.001), whereas the AoPWV was higher in men (7.1 versus 6.3 m/s; p=0.003). Subjects were categorized according to the gender and age decade, and reference values for CPP, central AIx, and AoPWV were obtained.

Conclusion:

This study reports the reference values for arterial stiffness indices from an Omani Arab population; the results of which should be interpreted in the context of its limitations.Cardiovascular disease is the leading cause of mortality and morbidity worldwide.1 High central pulse pressure (CPP) and increased aortic pulse wave velocity (AoPWV) resulting from stiffness of large arteries have been recognized as an independent risk factor for cardiovascular disease.2-5 The European Hypertension Society guidelines recommended the pulse wave velocity (PWV) to be used for risk assessment stratification of hypertensive patients.6 Several non-invasive techniques have been developed to assess arterial stiffness parameters.7,8 Applanation tonometry developed by O’Rourke and other investigators9-12 is a simple, reproducible, and validated method used to assess arterial stiffness indices in healthy subjects and in subjects with various cardiovascular diseases. In addition to direct analysis of peripheral pulse wave forms to determine peripheral augmentation indices, this method can also be used to calculate central (aortic) augmentation indices and central blood pressure by using validated algorithms.12 A large number of studies from different European populations, African, and Asian nations have assessed reference ranges and correlates of arterial stiffness using applanation tonometry.13-16 However, studies on reference values of arterial stiffness in Arab populations are scant. Considering variations in genetic and environmental factors between populations, differences in arterial stiffness values in health and cardiovascular disease individuals are expected. There is a lack of previous studies on normal arterial stiffness indices in an Omani Arab population. Normal reference values from healthy subjects are particularly pertinent for proper clinical applications. Therefore, this study aimed to determine the reference values of arterial stiffness indices particularly augmentation index (AIx) and PWV using applanation tonometry in a healthy Omani Arab population.