The caffeine dilemma: unraveling the intricate relationship between caffeine use disorder, caffeine withdrawal symptoms and mental well-being in adults.

OBJECTIVE: This study aimed to explore the relationship between caffeine use disorder (CUD), caffeine withdrawal symptoms and the prevalence of depression, anxiety and stress (DASS) in adults. DESIGN: The study utilised a cross-sectional design to assess the relationships between CUD, caffeine withdrawal symptoms and DASS. SETTING: Participants' CUD was evaluated through the Caffeine Use Disorder Questionnaire (CUDQ), while the Depression Anxiety Stress Scale-21 (DASS-21) measured DASS levels. Caffeine withdrawal symptoms and total caffeine intake were calculated based on self-reported consumption of caffeine-rich products. PARTICIPANTS: The study involved 618 participants with an average age of 27·8 (sd 7·8) years. RESULTS: Participants consumed an average of 461·21 (sd 11·09) mg/d of caffeine, showing a positive correlation between CUD and total caffeine intake. The risk of CUD increased alongside levels of DASS. Individuals with caffeine withdrawal symptoms had higher CUDQ and DASS scores. A multiple linear regression model revealed significant associations between total caffeine intake (P < 0·001) and DASS-21 score (P < 0·001) with CUDQ score. CONCLUSIONS: The study concluded that caffeine, while recognised for its potential health benefits, also exhibits properties that may lead to addiction. The development of caffeine use disorder and cessation of caffeine intake can increase DASS levels in adults, indicating the need for awareness and appropriate interventions in public health nutrition.

Effects of hemoglobin concentration on retinochoroidal vascular plexuses: an optical coherence tomography angiography study.

PURPOSE: To evaluate retinal and choroidal microvascular structures using optical coherence tomography angiography (OCTA) in patients with anemia and polycythemia vera (PV). METHODS: In this prospective study, 142 patients (142 eyes) were enrolled and divided into 3 groups: the anemia (n = 56), PV (n = 46), and healthy groups (n = 40, controls). For each patient, 6- × 6-mm macular angiography images were taken using an OCTA system (optovue, Inc., Fremont). For each eye analyzed, the software automatically measured vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP; superior, nasal, temporal, and inferior quadrants), choriocapillaris (CC), and foveal avascular zone (FAZ). RESULTS: The OCTA analysis revealed that the VD of the DCP was significantly decreased in the superior and inferior hemispheres of the whole area, multiple quadrants of the perifovea, and CC with a 1-mm2 flow area in the anemia group compared with the PV group (p < 0.017), but the VD of the SCP did not show any significant difference in any quadrant between the two groups (p > 0.017). When compared with the healthy group, the anemia and PV groups showed a significant difference in multiple quadrants of the parafovea and temporal quadrant of the perifovea in the VD of the SCP and CC with a 2-mm2 flow area (p < 0.017). The FAZ and non-flow area did not manifest any significant difference between the groups (p > 0.017). The hemoglobin concentrations in the anemia, PV, and healthy groups were 8.11 ± 1.33, 17.5 ± 1.2, and 15.6 ± 0.73 g/dL, respectively, indicating statistically significant differences between the groups (p < 0.001). CONCLUSION: In this study, quantitative OCTA analysis revealed a higher tendency for retinal and choroidal microvascular morphological changes in patients with anemia and PV. The outcomes of the current investigation can provide new insights into the retinal and choroidal pathophysiologies found in patients with hemoglobin abnormalities.

Effect of perfluoropropane (C3F8) versus sulfurhexafluoride (SF6) tamponades on the retinal microvasculature after macular hole surgery.

PURPOSE: To determine the effects of C3F8 and SF6 gasses by using optical coherence tomography angiography (OCTA) in patients with surgically closed idiopathic full-thickness macular holes (FTMH). METHODS: A prospective, comparative study, in which 38 eyes of 38 patients with an idiopathic FTMH were studied. Twenty patients were randomized to the C3F8 group and 18 patients to the SF6 group. All patients underwent pars plana vitrectomy, internal limiting membrane peeling with 14 % C3F8 or 20 % SF6 gasses. The superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel densities (VD), foveal avascular zone (FAZ) area in SCP, the choriocapillaris flow area; and subfoveal choroidal thickness (SFCT) were examined at preoperative and postoperative first- and third-month controls using OCTA. RESULTS: When the changes in the FAZ, SFCT, SCP and DCP VDs were compared, no significant differences were found between the groups (p>0.05 for all). It was determined that the 1-mm radius flow area increases in the C3F8 group at the first and third months after the surgery were significantly higher than in the SF6 group (p<0.05). A significant gain was observed in the BCVA values compared to their preoperative values for both groups; however any differences between the C3F8 and SF6 groups in terms of BCVA were not detected in this study. CONCLUSION: This is the first report to compare the effects of C3F8 and SF6 gasses on idiopathic FTMH surgery by using OCTA. C3F8 and SF6 gasses may have similar effect on the remodeling process of vascular tissues.

Validation of the Turkish version of the Orthorexia Nervosa Inventory (ONI) in an adult population: its association with psychometric properties.

PURPOSE: To examine the reliability and validity of the Turkish version of the Orthorexia Nervosa Inventory (ONI) in a large adult population. METHODS: Included in this cross-sectional study, were 710 individuals living in Turkey who were between 18 and 65 years of age. The individuals were reached via an online questionnaire that included their sociodemographic characteristics and the ONI and Eating Attitude Test-26 (EAT-26). Confirmatory factor analysis (CFA) was used to test the validity of the ONI. The ONI contains three sub-factors (behaviors, emotions, and impairments). Analyses were conducted using LISREL 8.80 for Windows and IBM SPSS Statistics for Windows 22.0. RESULTS: The Cronbach's alpha coefficient was 0.91 for the ONI total factor scores and Cronbach alpha values for behaviors, impairments, and emotions were found to be 0.82, 0.84, and 0.81, respectively. The CFA performed supported the three-factor structure of the ONI obtained in the first sample. The minimum discrepancy per degree of freedom = 5.65 and the model generally fit well to the structure (RMSEA = 0.08, CFI = 0.94, NFI = 0.93, SRMR = 0.07, IFI = 0.94). A positive and moderate relationship (r = 0.42) was found between the ONI and EAT-26. A positive and low level (r = 0.16) correlation was found between the ONI and body mass index. There was no statistically significant difference between the ONI scores according to gender (p = 0.22). CONCLUSION: The findings suggested that the Turkish version of the ONI is a valid and reliable scale for determining the tendency for ON in a Turkish adult population. LEVEL OF EVIDENCE: Level V, descriptive cross-sectional study.

Evaluation of the relationship between anxiety and nutritional habits in Turkish patients with multiple sclerosis during the Covid-19 outbreak / Avaliação da relação entre ansiedade e hábitos nutricionais em pacientes turcos com esclerose múltipla durante o surto da Covid-19

ABSTRACT Objective The Coronavirus disease 2019 is a global public health problem that has led to psychological disorders (depression, anxiety, etc.), especially in fragile individuals such as those affected by multiple sclerosis. This study investigated the relationship between anxiety and nutritional habits during the Coronavirus disease 2019 outbreak in multiple sclerosis patients. Methods This cross-sectional study was an online survey of multiple sclerosis patients living in Turkey. The total sample consisted of 294 multiple sclerosis patients. A questionnaire containing general demographic data, the Beck Anxiety Inventory, and nutritional attitudes and habits was applied to multiple sclerosis patients. Results Moderate or severe anxiety scores were found in 42.2% of multiple sclerosis patients. Weight gain was reported in 40.5% of them during the outbreak. A statistically significant difference was found in the distribution of individuals' Beck Anxiety Inventory scores for consumption of nuts/seeds, rice/pasta, cake/cookies, and water. A 1-unit increase in Beck Anxiety Inventory scores led to a 1.04 times increased consumption of bread and rice/pasta and a 1.05 times increased consumption of cake/cookies either before or after controlling for potential confounders. A 1-unit increase in Beck Anxiety Inventory scores led to a 1.06 times decreased consumption of water and a 1.04 times decreased consumption of meat and poultry, fruit (fresh), and rice/pasta, either before or after controlling for potential confounders. Conclusion During the Coronavirus disease 2019 outbreak, anxiety led to changes in multiple sclerosis patients' nutritional habits and food preferences. The continuous surveillance of psychological consequences and nutritional counseling during outbreaks should become routine as part of preparedness efforts worldwide.

RESUMO Objetivo A doença do Coronavírus - 2019, causada pelo Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), é um problema de saúde pública global e tem levado os indivíduos desenvolverem distúrbios psicológicos (depressão, ansiedade, etc.), especialmente indivíduos frágeis, como aqueles afetados por esclerose múltipla. O objetivo deste trabalho foi investigar a relação entre ansiedade e hábitos nutricionais em pacientes com esclerose múltipla durante o surto de coronavírus. Métodos Este estudo transversal é resultado de uma pesquisa online com pacientes com esclerose múltipla que vivem na Turquia (n=294). Um formulário de questionário contendo dados demográficos gerais, o Inventário de Ansiedade de Beck e atitudes e hábitos nutricionais foi aplicado a pacientes com esclerose múltipla. Resultados Escores de ansiedade moderados ou graves foram encontrados em 42,2% dos pacientes com esclerose múltipla. O ganho de peso foi relatado em 40,5% durante o surto. Foi encontrada diferença estatisticamente significativa na distribuição dos escores do Inventário de Ansiedade de Beck dos indivíduos para o consumo de nozes/sementes, arroz/massa, bolo/biscoitos e água. Um aumento de uma unidade nas pontuações do Inventário de Ansiedade de Beck levou a um aumento de 1,04 vezes no consumo de pão e arroz/massa e 1,05 vezes no consumo de bolo/biscoitos antes ou depois de controlar possíveis fatores de confusão. Um aumento de uma unidade nas pontuações do Inventário de Ansiedade de Beck levou a uma redução de 1,06 vezes no consumo de água e 1,04 vezes no consumo de carnes e aves, frutas (frescas) e arroz/massa antes ou depois de controlar possíveis fatores de confusão. Conclusão Durante o surto de coronavírus, a ansiedade levou a mudanças nos hábitos nutricionais e nas preferências alimentares dos pacientes com esclerose múltipla. A vigilância contínua das consequências psicológicas e o aconselhamento nutricional para surtos devem se tornar rotina como parte dos esforços de preparação em todo o mundo.

Validation of the Turkish Version of the Caffeine Use Disorder Questionnaire in an Adult Population.

The aim of this study was to examine the reliability and validity of the Turkish version of the Caffeine Use Disorder Questionnaire (CUDQ) in an adult population. In this instrument validation study, a total of 310 individuals (253 female, 57 males), with a mean age of 25.96 ± 6.29 years were included. The questionnaire consisted of 4 parts, comprising the sociodemographic characteristics, CUDQ, caffeine withdrawal symptoms, and caffeine consumption. For the evaluation of the data, confirmatory factor analysis (CFA), descriptive statistics, and the t test were used. In the reliability analysis, the Cronbach alpha internal consistency coefficient was 0.86, and the intraclass correlation coefficient was 0.83 for CUDQ. The CMIN/df was 0.54, and the model generally fits well to the structure (RMSEA = 0.08, CFI = 1, NFI = 1, GFI = 0.99, AGFI = 0.99, TLI = 1, NNFI = 1, RFI = 0.98). The findings suggested that the CUDQ has validity of structure, internal consistency, and construct validity for assessing Caffeine Use Disorder the tendency in the Turkish adult population. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-021-00688-8.

Evaluation of effects of a modified asymmetric rapid maxillary expansion appliance on the upper airway volume by cone beam computed tomography.

BACKGROUND/PURPOSE: The rapid maxillary expansion is accepted as the gold standard for the treatment of unilateral posterior crossbite in growing children. This study used cone beam computed tomography (CBCT) to evaluate the effects of a modified asymmetric rapid maxillary expansion (ARME) appliance on the upper airway volumes. MATERIALS AND METHODS: A modified ARME appliance was used on 12 adolescent male patients (mean age: 13.92 ±â€¯0.82 years) with a class I skeletal relationship and posterior unilateral crossbite. Lateral cephalometric measurements and upper airway volume were evaluated using CBCT images. The posterior airway volumes of the oropharyngeal and nasopharyngeal airways were measured. RESULTS: Cephalometric measurements showed significant (P < 0.05) posterior rotation of the mandible. There was no significant movement of the maxilla according to the cranial base on the sagittal plane. Nasopharyngeal and oropharyngeal airway volumes increased significantly (P < 0.05). CONCLUSION: The results of this study demonstrate that treatment with the modified ARME has no significant effect on the maxilla but may increase the upper airway volume.

Evaluation of the effects of fear and anxiety on nutrition during the COVID-19 pandemic in Turkey.

OBJECTIVE: The aim of this study was to evaluate effects of fear and anxiety on nutrition during the COVID-19 pandemic. DESIGN: Participants were recruited by an online survey in this cross-sectional study. The questionnaire included general demographic characteristics, level of fear and anxiety, and nutritional habits. The Fear of COVID-19 Scale (FCV-19S) and Generalized Anxiety Disorder-7 test (GAD-7) were used to determine fear and anxiety. SETTING: Turkey. PARTICIPANTS: A total sample consisted of 1012 adults. RESULTS: In pandemic, fear and anxiety caused individuals to skip breakfast and snacks less, but more at lunch. A positive significant correlation was observed between the increased consumption of yoghurt, cheese and water and FCV-19S scores. There was a positive significant correlation between cheese, legume, nuts-seeds, cake-cookies, dessert and tea consumption and GAD-7 scores. A 1-unit increase in FCV-19S scores affected 1·04 times of increased consumption of yoghurt, kefir, cheese, nuts-seeds, fruit (dry) and rice-pasta. A 1-unit increase in GAD-7 scores affected 1·03 times of increased consumption of egg and fruit (fresh); 1·04 times of increased consumption of cheese and other vegetables; 1·05 times of increased consumption of milk, meat, poultry, fish, legume, nuts-seeds, fruit (dry), cake-cookies and tea; 1·07 times of increased consumption of rice-pasta and coffee and 1·08 times of increased consumption of bread and dessert. CONCLUSIONS: In pandemic, anxiety and fear led to changes in individuals' nutritional habits and food preferences. Continuous surveillance of psychological consequences for outbreaks should become routine as part of preparedness efforts worldwide. In addition, the effects of these psychological problems on nutrition should be evaluated.

The Effectiveness of New Adiposity Indices on Plasma Lipid Profile in Patients with Multiple Sclerosis: A Cross-Sectional Study with A Body Shape Index, Body Roundness Index, and Visceral Adiposity Index.

OBJECTIVE: This study aimed to determine the effectiveness of three different indices used to identify the effect of visceral adiposity on lipid profile markers in patients with multiple sclerosis. METHODS: The study consisted of a total of 152 patients with relapsing-remitting multiple sclerosis who were aged 18 years and older. High-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), total cholesterol (TC), and triglyceride (TG) were accessed from the patient system. Patients' height, body weight, waist circumference, and hip circumference measurements were also obtained. The effects of three different adiposity indices, including A Body Shape Index (ABSI), the Body Roundness Index (BRI), and the Visceral Adiposity Index (VAI), on plasma lipid profile in multiple sclerosis patients were evaluated. The data were analyzed using the R software and SPSS 21 statistical software package. RESULTS: HDL-c was impacted by ABSI and VAI in males and only VAI in females (p < 0.05). An increase of 0.01 units of ABSI in males led to an increase of 5.88 mg/dL in plasma HDL-c level. In male patients with multiple sclerosis, LDL-c was positively affected by BRI and VAI changes (p < 0.05). One unit increase in BRI in males increased LDL-c level by 5.56 mg/dL, whereas 1 unit increase in VAI increased LDL-c level by 3.52 mg/dL (p < 0.05). CONCLUSION: This study indicated that these three different indices employed to evaluate adiposity were associated with plasma lipid profile. The effect of VAI on plasma lipids is higher than that of the other indices. In patients with multiple sclerosis, the use of these practical and non-invasive indices will be useful in assessing plasma lipid profile.

Association of cadmium but not arsenic levels in lung cancer tumor tissue with smoking, histopathological type and stage.

BACKGROUND: To evaluate association of lung cancer with arsenic and cadmium levels measured in tumor tissue. MATERIALS AND METHODS: Ninety-five patients with lung cancer tumor tissue obtained surgically were included in this study. Arsenic and cadmium levels were measured and levels of metals were compared among types of lung cancer and with reference to patient data. RESULTS: The histopathologic diagnoses of the 95 cases were SCC, 49, adenocarcinoma, 28, large cell, 11 and SCLC, 1. Mean tumor arsenic and cadmium levels were 149.3±129.1µg/kg and 276.3±219.3µg/kg, respectively. Cadmium levels were significantly associated with smoking (p=0.02), histopathologic type (p=0.005), and TNM staging (r=0.325; p=0.001), although arsenic was not related to any parameter (p>0.05). There was no relation between metal levels and mortality (p>0.05). CONCLUSIONS: We found a significant association between tumor cadmium levels of patients with lung cancer and smoking, histopathologic type and staging, although there was no relation with arsenic levels.