Assessment of sleep quality in patients with orofacial pain and headache complaints: A polysomnographic study.

BACKGROUND: Sleep is a physiological function essential for survival, recovery, tissue repair, memory consolidation, and brain function. Pain is also an indispensable aspect of human life. The coexistence of sleep disorders and pain is often described in the literature, yet it is critical to define sleep not only subjectively but also using objective instrumental methods, such as polysomnography, that provide data on sleep quality. OBJECTIVES: The aim of the study was to determine the relationship between orofacial pain (OFP), headache (HA) and sleep quality using subjective and objective sleep quality assessment methods. Additionally, we aimed to explore whether poor sleep quality was related to OFP and HA alone or was influenced by the coexistence of psycho-emotional factors such as depression, anxiety and stress. MATERIAL AND METHODS: A single-night video-polysomnography was performed on patients from the Outpatient Clinic for Temporomandibular Disorders at Wroclaw Medical University, Poland, who had been diagnosed with OFP and HA. Additionally, questionnaires were employed to assess sleep quality, pain, HA, and the psycho-emotional state. RESULTS: There was no statistically significant relationship between the severity of OFP and HA and polysomnographic sleep quality parameters. On the other hand, the quality of sleep as determined by questionnaire studies correlated markedly with the severity of experienced pain. The severity of pain was found to be significantly correlated with depression, anxiety and perceived stress scores. CONCLUSIONS: The psycho-emotional aspects are of critical importance in the perception of OFP and HA. They can be associated with worsened subjective sleep quality, insomnia or daytime sleepiness. Therefore, the treatment of such patients must be preceded by a comprehensive assessment of their psychoemotional state, as anxiety, stress and depression can significantly influence the course of the disease and the response to treatment procedures.

Polysomnographic Assessment of Effects of Tobacco Smoking and Alcohol Consumption on Sleep Bruxism Intensity.

Background: Sleep bruxism (SB) is a common sleep-related movement behavior with a complex etiology. A recent hypothesis suggests psychoactive substance usage, tobacco smoking, and alcohol intake are risk factors for SB. This study aimed to evaluate SB intensity in tobacco smokers and alcohol drinkers. Methods: A total of 133 adults underwent full-night audio- and video-polysomnography, and the polysomnograms were evaluated using the American Academy of Sleep Medicine guidelines. The study group was divided into smoker and nonsmoker groups as well as drinker and non-drinker groups. Results: The results of the polysomnographic analysis confirmed that tobacco smoking has a significant effects on SB. Tobacco smokers showed increased bruxism intensity (5.50 ± 4.71 vs. 3.83 ± 3.26, p < 0.05), especially the mixed phenotype (0.93 ± 1.00 vs. 0.59 ± 0.59, p < 0.05), in the N1 sleep stage (22.84 ± 20.45 vs. 15.66 ± 13.60, p < 0.05) and the nonsupine position (4.93 ± 5.56 vs. 2.50 ± 2.31, p < 0.05). They also showed a higher number of bruxism episodes with arousal compared with nonsmokers (2.91 ± 2.83 vs. 1.61 ± 1.49, p < 0.05), indicating increased sleep fragmentation. However, no significant effect of alcohol on SB intensity was observed, and the bruxism episode index was similar in alcohol drinkers and nondrinkers. In addition, electrolyte disturbances and lipid disorders were evaluated. Compared with nonsmokers, tobacco smokers showed a higher concentration of plasma triglycerides (177.67 ± 106.9 vs. 129.18 ± 65.61) and lower levels of iron and magnesium (96.68 ± 43.58 vs. 123.83 ± 52.36 and 1.85 ± 0.22 vs. 1.96 ± 0.21, respectively). Conclusions: In summary, this study showed that tobacco smoking, but not alcohol consumption, is related to bruxism intensity and lipid and electrolyte disturbances in individuals with sleep disorders.

Correction: Agrawal et al. The Assessment of Fear of COVID-19 among the Elderly Population: A Cross-Sectional Study. J. Clin. Med. 2021, 10, 5537.

In the original publication [...].

Telemetric Assessment of Continuous Positive Airways Pressure (CPAP) Effectiveness and Adherence in Obstructive Sleep Apnea during COVID-19 Pandemic.

Obstructive sleep apnea is the most common sleep-related breathing disorder. In the pandemic times of the new coronavirus SARS-CoV-2, CPAP (Continuous Positive Airway Pressure) therapy of obstructive sleep apnea became even more challenging. After the pandemic outbreak in March 2020, most CPAP treatment recommendations changed because of rising concerns about CPAP usage safety for patients and their families. Therefore, we examined the effectiveness of CPAP and adherence to the therapy of 149 adults with obstructive sleep apnea in the period of two years from 4 March 2019 to 3 March 2021 (before pandemic breakout and during the first year of pandemic). Data on CPAP parameters and adherence to therapy were obtained via a telemetric system. Together, our results demonstrated that the COVID-19 pandemic had no significant impact on CPAP therapy parameters and adherence in whole study group. However, detailed analysis acknowledged that some demographic and clinical features influenced CPAP therapy. The results showed that across subgroups of patients differentiated on the basis of age, gender, co-existing diabetes mellitus, or hypertension, the COVID-19 pandemic seemed to affect CPAP effectiveness. Our results provide a good starting point for discussion on CPAP therapy recommendations during pandemic times.

Assessment of Telomerase Reverse Transcriptase Single Nucleotide Polymorphism in Sleep Bruxism.

INTRODUCTION: Sleep bruxism (SB) is a widespread masticatory muscle activity during sleep and affects approximately 13.2% of the general population. Telomerase reverse transcriptase (TERT) plays a role in preventing the shortening of the telomere. This prospective, observational study aimed to investigate the relationship between single nucleotide polymorphism (SNP) of TERT and the severity of SB and to identify the independent risk factors for SB. METHODS: A total of 112 patients were diagnosed by performing one-night polysomnography based on the guidelines of the American Academy of Sleep Medicine. TERT SNP was detected by real-time quantitative polymerase chain reaction (qPCR). RESULTS: Statistical analysis showed the lack of relationship between the rs2853669 polymorphism of TERT and severity of SB (p > 0.05). However, the study showed that patients with allele T in the 2736100 polymorphism of TERT had a lower score on the phasic bruxism episode index (BEI). Based on the receiver operating characteristic (ROC) curve, the value of phasic BEI was 0.8 for the differential prediction for the presence of allele T in the locus. The sensitivity and specificity were 0.328 and 0.893, respectively. The regression analysis showed that lack of TERT rs2736100 T allele, male gender, and arterial hypertension are the risk factors for the higher value of phasic BEI. CONCLUSION: The SNP of the TERT gene affects phasic SB intensity. The absence of TERT rs2736100 T allele, male sex, and arterial hypertension are independent risk factors for phasic SB.

The Assessment of Fear of COVID-19 among the Elderly Population: A Cross-Sectional Study.

The prevailing COVID-19 pandemic has dramatically affected the mental health and well-being of individuals. This cross-sectional study aimed to assess the perceived fear of COVID-19 among older adults in Poland and identify subpopulations with the highest risk of potential mental health disorders. The study was conducted in November-December 2020 on 500 people aged ≥60 years (mean M = 67.9, standard deviation SD = 4.2). In order to collect information on participants' characteristics and COVID-19-related information, they were asked to complete a questionnaire based on recorded telephone calls. Perceived fear of COVID-19 was measured using Fear of COVID-19 Scale (FCV-19S), which ranges from 7 to 35. Multiple linear regression was performed to identify factors associated with the perceived fear of COVID-19. Our results showed that the highest level of fear of COVID-19 infection was observed among women (p = 0.025) and patients taking anticoagulants (p = 0.004). Moreover, older adults with higher anxiety levels were more likely to be fearful of COVID-19 (according to the GAS-10 scale; p < 0.001). These findings may help policy makers and healthcare workers to adapt and implement better mental health strategies to help the elderly fight fear and anxiety during the prevailing pandemic.

The Total Antioxidant Status, Serum Selenium Concentrations and the Ultrasound Assessment Carotid Intima Media Thickness in Patients with Arterial Hypertension.

The objective of the study was to establish the correlation between serum selenium concentrations, total antioxidant status, and the carotid intima media thickness in ultrasound assessment in patients with arterial hypertension. A group of 76 people suffering from arterial hypertension was qualified to participate in the study. The mean age of the respondents was 53.48 ± 12.78. Serum selenium concentrations (Se-S) and total antioxidant status (TAS) were determined in all respondents. Se-S were determined by hydride generation atomic absorption spectroscopy (HGAAS). The antioxidant status was assessed by the enzyme-linked immunosorbent assay (ELISA). In addition, an ultrasound exam of the carotid arteries was performed, and the intima media thickness (cIMT) was measured. In the study group, Se-S and TAS were 89.73 ± 18.99 µg/L and 1.18 ± 0.35 mM. However, the cIMT measured using ultrasound was 0.68 ± 0.15 mm. cIMT was significantly greater in patients with arterial hypertension with Se-S < median in comparison to patients with arterial hypertension with Se-S ≥ median (0.73 ± 0.19 mm vs. 0.65 ± 0.10 mm, p < 0.05), as well as in patients with arterial hypertension with TAS < median than in patients with arterial hypertension with TAS ≥ median (0.79 ± 0.18 mm vs. 0.56 ± 0.13 mm, p < 0.05). In regression analysis, older age, higher BMI, smoking, and lower serum selenium concentrations were independently correlated with the greater cIMT. Higher BMI and smoking were independent risk factors for the lower TAS, and the use of ACE inhibitors, ß-blockers, and higher Se-S were independent factors of protection against the lower TAS. In patients with arterial hypertension, the lower total antioxidant status due to lower serum selenium concentrations may be correlated with an increase of the carotid intima media thickness measured using ultrasound.

Psychometric evaluation of the Polish version of the Arrhythmia­Specific Questionnaire in Tachycardia and Arrhythmia: a new tool for symptom and health­related quality of life assessment.

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia resulting in hospitalization. The assessment of symptoms and health­related quality of life (HRQoL) can provide valuable information before, during, and after health care interventions for AF. AIMS: We aimed to perform a translation and cultural adaptation of the Arrhythmia­Specific Questionnaire in Tachycardia and Arrhythmia (ASTA), and to evaluate the reliability and validity of its Polish version. METHODS: The standard forward­backward translation procedure to translate the ASTA questionnaire into Polish was used. A total of 244 patients with AF at a mean (SD) age of 70.7 (10.7) years completed the questionnaire and were included in the study. Reliability was tested using internal consistency (Cronbach α) and validity with an item­total correlation, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). RESULTS: The ASTA symptom scale had satisfactory psychometric properties (α = 0.718), and the corrected item­total correlation was sufficient for most items (0.361-0.506), except for cold sweats (0.156). The ASTA HRQoL scale showed good psychometric properties (α = 0.855). Initial CFA analyses showed that the 1- and 2­factor models had similar properties, with strong factor loadings and satisfactory goodness­of­fit values according to the comparative fit index (0.947 for the 1­factor model vs 0.988 for the 2­factor model). A comparison of the 1­and 2­factor models showed that the close fit for the root­mean­square error of approximation was better for the 2­factor model (0.387 vs 0.193). A 2­factor EFA model was produced, and for factor 1 (physical scale), the varimax low ranged between 0.470 and 0.804, and for factor 2 (the mental scale), it ranged between 0.597 and 0.873. CONCLUSIONS: The psychometric properties of the Polish version of the ASTA questionnaire were overall found to be satisfactory.

Echocardiographic assessment of myocardial function in workers occupationally exposed to lead without clinically evident heart disease.

PURPOSE: The aim of the study was to evaluate echocardiographic changes in workers occupationally exposed to low doses of lead. METHODS: We enrolled 63 men occupationally exposed to lead into the study (group I). Unexposed group consisted of 49 healthy men (group II). Blood lead concentration (Pb-B) and blood zinc protoporphyrin concentration (ZnPP) were determined. Transthoracic echocardiographic examination was performed. RESULTS: In the studied groups, selected on the criterion of occupational exposure to lead, comparative analysis of echocardiographic parameters indicated statistically significant differences. A negative linear correlations between ZnPP and E' was observed in group I. It was proved that a higher concentration of ZnPP is independent risk factor of lowering the E' mean value in group I. CONCLUSIONS: Occupational exposure to low doses of lead is associated with the occurrence of discreet morphological and functional heart changes that in the future may predispose to disclosed pathology of heart.

[Assessment of hematopoiesis regeneration in patients with solid tumors after radiotherapy]. / Ocena regeneracji ukladu krwiotwórczego u chorych na nowotwory lite leczonych promieniowaniem jonizujacym.

The myelotoxicity is one of the most severe adverse events of radiotherapy. Increase of CD34+ cells level in peripheral blood as result of raised output of granulocyte colony stimulating factor (G-CSF) can be result of hematopoiesis regeneration after radiotherapy. The aim of this study was to determine the hematopoiesis regeneration using analysis of CD34+ cells level in peripheral blood and serum concentration of G-CSF in patients treated with radiotherapy according to irradiated body region and irradiation field size. Two groups of irradiated patients were examined. Group I consisted of 11 patients (mean age 56) with gynecological malignancies (teletherapy dose 40-50 Gy for pelvic area and brachytherapy with Cs). Group II consisted of 10 patients (mean age 58) with head and neck malignancies (teletherapy only 50-70 Gy). Every patient was evaluated 3 times: before radiotherapy, in the day of ending and 14 days after therapy. 3 ml of blood for CD34 and serum for G-CSF estimation were collected. Blood cells were stained with monoclonal antibody specific for CD34 antigen and analysed by flow cytometry. G-CSF level was estimated by ELISA. After radiotherapy in both groups statistically significant leukopenia (p < 0.001) was observed. There was no difference between two groups in levels of CD34+ cells before and in the last day of therapy but there was significant increase of CD34+ cells in group I compared with group II 14 days after treatment (p < 0.01). Decrease of CD34+ cells during radiotherapy and after its ending in all patients was observed but only in group II was statistically significant. Positive correlation between amount of leukocytes and CD34+ cells percentage was stated. There were no statistically significant differences in serum G-CSF concentration within particular groups and between group I and II. Our results indicate that evaluation of CD34+ cells level in peripheral blood is useful in prediction of hematopoiesis regeneration after radiotherapy. G-CSF serum concentration is not prognostic factor in these groups of patients.