Sleep quality of patients with papillary thyroid carcinoma: a prospective longitudinal study with 5-year follow-up.

We evaluated the pre- and postoperative sleep quality of patients with newly diagnosed papillary thyroid carcinoma (PTC) who underwent thyroid surgery, and investigated the factors associated with persistent poor sleep quality. The Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale, and Stanford sleepiness scale were used to estimate sleep quality and daytime sleepiness. Face-to-face surveys were conducted preoperatively, and 1, 4, and 10 months after thyroid surgery. The PSQI was administered during a telephone interview about after 5 years after surgery. Forty-six patients (mean age 47.3 ± 10.1 years) with PTC (11 males, 35 females) were included in this study. Twenty-one participants underwent lobectomy and 25 underwent total thyroidectomy. Preoperatively, 35 (76.1%) patients showed poor sleep quality. PSQI scores at postoperative 1, 4, and 10 months were significantly lower than preoperative scores (p < 0.001). Postoperative 5-year PSQI scores decreased significantly compared to the preoperative scores (p < 0.001). Patients newly diagnosed with PTC suffered from sleep disturbance before and after surgery for at least 10 months, recovering to a comparable rate of sleep disturbance with the general population by 5 years after surgery. Higher preoperative PSQI score was at risk for prolonged poor sleep quality in patients with PTC.

Automated Detection of Sleep Apnea-Hypopnea Events Based on 60 GHz Frequency-Modulated Continuous-Wave Radar Using Convolutional Recurrent Neural Networks: A Preliminary Report of a Prospective Cohort Study.

Radar is a promising non-contact sensor for overnight polysomnography (PSG), the gold standard for diagnosing obstructive sleep apnea (OSA). This preliminary study aimed to demonstrate the feasibility of the automated detection of apnea-hypopnea events for OSA diagnosis based on 60 GHz frequency-modulated continuous-wave radar using convolutional recurrent neural networks. The dataset comprised 44 participants from an ongoing OSA cohort, recruited from July 2021 to April 2022, who underwent overnight PSG with a radar sensor. All PSG recordings, including sleep and wakefulness, were included in the dataset. Model development and evaluation were based on a five-fold cross-validation. The area under the receiver operating characteristic curve for the classification of 1-min segments ranged from 0.796 to 0.859. Depending on OSA severity, the sensitivities for apnea-hypopnea events were 49.0-67.6%, and the number of false-positive detections per participant was 23.4-52.8. The estimated apnea-hypopnea index showed strong correlations (Pearson correlation coefficient = 0.805-0.949) and good to excellent agreement (intraclass correlation coefficient = 0.776-0.929) with the ground truth. There was substantial agreement between the estimated and ground truth OSA severity (kappa statistics = 0.648-0.736). The results demonstrate the potential of radar as a standalone screening tool for OSA.

A Case of Perampanel Overdose Presenting with Respiratory Failure.

Perampanel is a novel antiepileptic drug that has been used as an adjunctive treatment for focal-onset seizures. No reports to date have documented respiratory suppression as a side effect of perampanel in adults. Herein, we report a 51-year-old man with focal epilepsy presented with type 2 respiratory failure after accidently consuming of 66 mg of perampanel. Clinicians should consider the possibility of respiratory compromise whenever a high dose of perampanel needs to be administered to patients.

Ictal Swearing as a Lateralizing Value for the Dominant Hemisphere in Temporal Lobe Epilepsy.

Ictal swearing, as an epileptic manifestation, has rarely been reported. Despite its poor localization value and unclear mechanism, several previous studies have reported that it frequently originates from the temporal lobe and more often from the non-dominant hemisphere. Herein, we report a case of a 41-year-old right-handed man with a history of stereotypical manifestation of ictal swearing with a left (dominant) hemisphere origin, confirmed by video electroencephalography monitoring. Reasonable suspicion that repetitive swearing could be a manifestation of seizures is important for clinicians not to misdiagnose the disease.

Potentiation of Fas- and TRAIL-mediated apoptosis by IFN-gamma in A549 lung epithelial cells: enhancement of caspase-8 expression through IFN-response element.

Epithelial cell apoptosis triggered cooperatively by multiple cytokines contributes to the injury induced by inflammatory responses in the lung and elsewhere. Here we show that interferon-gamma (IFN-gamma) sensitizes A549 cells, human lung epithelial cells, to cytokine-mediated apoptosis by upregulating caspase-8 expression. Pretreating the cells with IFN-gamma potentiated Fas- and TNF-related apoptosis inducing ligand (TRAIL)-induced cell death, but other forms of apoptosis, not mediated via receptors, were unaffected. Western blotting and inhibitor assays showed that IFN-gamma selectively increased expression of caspases-7 and -8, but not caspases-2, -3, -9, or -10, as a necessary step leading to apoptosis. Assaying promoter activity using a luciferase reporter gene indicated that an IFN-gamma response element was located in the 5'-flanking region of the caspase-8 gene, spanning positions -227 to -219. Taken together, these findings suggest that IFN-gamma potentiates Fas- and TRAIL-mediated apoptosis by increasing caspase-8 expression via an IFN-gamma response element in A549 cells.