Bedtime Procrastination as a Mediator in the Relationship Between Active Emotion Regulation Strategies and Insomnia

Objectives@#Bedtime procrastination (BP) is defined as the behavior of voluntarily postponing bedtime without having external reasons for doing so. According to previous studies, people with reduced use of active emotion regulation strategies may use BP to cope with negative emotions. However, research about the relationship among active emotional regulation strategies, BP, and insomnia is lacking. This study aimed to investigate the mediating effect of BP between active emotional regulation strategies and insomnia severity. @*Methods@#In total, 597 adults (female, 81.9%; mean age, 23.18±2.80 years) completed the Emotional Regulation Strategies Checklist, Insomnia Severity Index, and Bedtime Procrastination Scale. @*Results@#There was a significant association between active emotional regulation strategies and BP (r=-0.152, p<0.01), between BP and insomnia severity (r=0.259, p<0.01), and between active emotional regulation strategies and insomnia severity (r=-0.128, p<0.01). BP significantly mediated the relationship between active emotional regulation strategies and insomnia severity (B=-0.024; 95% confidence interval [CI], -0.04 to -0.01). @*Conclusions@#BP may be considered in the relationship between active emotional regulation strategies and insomnia severity. Understanding the mediating role of BP may help prevent insomnia.

Anaphylactic reaction with hydroxyethyl starch during anesthesia: A case report

BACKGROUND: Hydroxyethyl starch (HES), a class of synthetic colloid solutions, has been widely used to treat perioperative hypovolemia. The use of HES, however, is associated with the risk of allergic reactions.CASE: An 83-year-old man was scheduled to undergo an open reduction and internal fixation of a pertrochanteric fracture under spinal anesthesia. He had no history of allergy. Five minutes after HES administration, hypotension, agitation, and skin rash were developed. HES infusion was terminated due to a suspected anaphylactic reaction. The vital signs recovered following administration of phenylephrine, dexamethasone, and hydrocortisone. Serum tryptase and total immunoglobulin E levels were elevated in plasma samples collected following the commencement of the allergic reaction during surgery.CONCLUSIONS: In the present report, the risk of anaphylactic reaction with HES and the laboratory tests needed to support the diagnosis are highlighted.

Factors Affecting Coronary Arterial Calcification in Patients with Chronic Kidney Disease Who Did Not Undergo Treatment with Dialysis

PURPOSE@#To investigate risk factors of coronary arterial calcification in chronic kidney disease (CKD) patients who did not undergo hemodialysis or peritoneal dialysis.@*MATERIALS AND METHODS@#We enrolled 83 patients of normal renal function (Group I) and 112 patients of CKD [Group II (CKD stage 1–2) and Group III (CKD stage 3–5)], who were assessed coronary artery calcium score (CACS) with cardiac CT. CACS between the groups were compared. Risk factors for coronary artery calcification in patients with CKD including diabetes, hypertension, and smoking were identified as relevant to CACS using logistic regression analysis. Serologic data of electrolytes were analyzed to evaluate effect for coronary calcification in patients with CKD.@*RESULTS@#Group III showed significant increment of CACS compared to Group I at the CACS level over 400 [odds ratio (OR) = 7.581, p = 0.01]. The OR were decreased in non-diabetic patients group, increased in non-hypertensive patients group, no significant differences in non-current smoker group. Serum phosphorous level was the only factor which showed significant effect for increased CACS (OR of 2.649, p = 0.02).@*CONCLUSION@#In CKD patients, higher stage of CKD was associated with increased CACS. Diabetes mellitus and increased serum phosphorous level would be considered as factors influencing coronary arterial calcification in CKD patients.