Obstructive sleep apnea screening in different age groups: performance of the Berlin, STOP-Bang questionnaires and Epworth Sleepiness Scale.

OBJECTIVE: To evaluate the performance of the Berlin Questionnaire, the STOP-Bang Questionnaire, and the Epworth Sleepiness Scale in screening for the disease in adults of different age groups by comparing them with polysomnography. METHODS: Cross-sectional study with prospective patient allocation, in which individuals underwent a medical interview, completion of the three screening instruments, and polysomnography. Individuals were categorized into three age groups: 18-39, 40-59, and ≥60 years. The results of the screening instruments were compared to the diagnostic criteria of the International Classification of Sleep Disorders-third edition. Performance was assessed using 2×2 contingency tables, estimating sensitivity, specificity, predictive value, likelihood ratio, and accuracy. Receiver Operating Characteristic curves were also constructed and the area under the curve was estimated for each instrument by age group. RESULTS: We obtained a sample with 321 individuals suitable for analysis. The mean age was 50 years, with a predominance of females (56%). The prevalence of the disease in the overall sample was 79%, more prevalent in males in any age group and more frequent in the middle age group. The analyzes revealed that STOP-Bang performed better, both for the overall sample and for all age groups, followed by Berlin Questionnaire and Epworth Sleepiness Scale. CONCLUSION: In an outpatient setting with individuals with characteristics similar to those in this study, it seems sensible to choose the STOP-Bang as a screening tool for the disease, regardless of age group. LEVEL OF EVIDENCE ACCORDING THE GUIDE FOR AUTHORS: level 2.

Obstructive sleep apnea screening in different age groups: performance of the Berlin, STOP-Bang questionnaires and Epworth Sleepiness Scale

Abstract Objective To evaluate the performance of the Berlin Questionnaire, the STOP-Bang Questionnaire, and the Epworth Sleepiness Scale in screening for the disease in adults of different age groups by comparing them with polysomnography. Methods Cross-sectional study with prospective patient allocation, in which individuals underwent a medical interview, completion of the three screening instruments, and polysomnography. Individuals were categorized into three age groups: 18-39, 40-59, and ≥60 years. The results of the screening instruments were compared to the diagnostic criteria of the International Classification of Sleep Disorders—third edition. Performance was assessed using 2 × 2 contingency tables, estimating sensitivity, specificity, predictive value, likelihood ratio, and accuracy. Receiver Operating Characteristic curves were also constructed and the area under the curve was estimated for each instrument by age group. Results We obtained a sample with 321 individuals suitable for analysis. The mean age was 50 years, with a predominance of females (56%). The prevalence of the disease in the overall sample was 79%, more prevalent in males in any age group and more frequent in the middle age group. The analyzes revealed that STOP-Bang performed better, both for the overall sample and for all age groups, followed by Berlin Questionnaire and Epworth Sleepiness Scale. Conclusion In an outpatient setting with individuals with characteristics similar to those in this study, it seems sensible to choose the STOP-Bang as a screening tool for the disease, regardless of age group. Level of evidence according the guide for authors: level 2.

Strength training improves insulin resistance and differently affects mitochondria in skeletal muscle and visceral adipose tissue in high-fat fed mice.

AIMS: Strength training (ST) improves insulin resistance and glucose tolerance by yet unknown mechanisms. The aims of this study were to investigate the effects of ST on mitochondrial adaptation in skeletal muscle and adipose tissue, on heat shock protein 72 (Hsp72) in skeletal muscle, and on visceral adipocyte size in mice with high-fat diet (HFD)-induced insulin resistance. MATERIALS AND METHODS: Male Balb/c mice were divided into sedentary control-chow (C-chow), strength trained-chow (ST-chow), sedentary control-HFD (C-HFD) and strength trained-HFD (ST-HFD). Diet was provided for 12 weeks, while ladder climbing ST was performed for the final six weeks of the study at a frequency of three days per week. KEY FINDINGS: Strength training led to increased strength, muscular endurance, and skeletal muscle hypertrophy. Compared to the C-HFD group, mice in the ST-HFD group decreased their whole-body insulin resistance, improved their glucose tolerance, and had higher activation of the insulin pathway in skeletal muscle. ST increased citrate synthase (CS) activity in skeletal muscle, but this increase was blunted in ST-HFD. Conversely, HFD reduced adipose tissue CS activity regardless of training status. Hsp72 content was reduced in C-HFD, but returned to control levels in ST-HFD. Finally, reduced epididymal adipocyte size was observed in ST-HFD. SIGNIFICANCE: These results suggest that the improvement in insulin resistance induced by ST is related to mitochondrial adaptation in skeletal muscle, but not in adipose tissue. Moreover, this improvement might be related to increased skeletal muscle Hsp72 and reduced epididymal adipocyte size.

Plant species diversity in a Neotropical wetland: patterns of similarity, effects of distance, and altitude

ABSTRACT The Brazilian Pantanal is an extensive wetland with heterogeneous habitats, primarily due to the river-floodplain system and plants with differential adaptations and reproductive strategies. Factors such as altitude, distance among plant formations, and flood pulse must be considered to better understand its diversity. Aiming to assess the influence of biogeographic patterns in this system, we analyzed the floristic composition of six areas along the Paraguay River, including residual relieves, verifying the pattern of similarity, and effects of distance and altitude. We recorded 356 species in 87 families, mostly perennial (75%), and some annuals (15%) and pluriannuals (5%). Herbaceous plants were the most represented (48%), followed by arboreal (23%), shrubby (15%) and epiphytic (14%) habits, only 12% being endemic to Brazil. The studied areas showed low floristic similarity, but higher resemblance of species between neighboring areas, and no relation with altitude. The upper Paraguay River is diverse, with high spatial variability of species, predominantly perennial. The river-floodplain connectivity may be a determinant factor in species richness and occurrence of endemic species.

Plant species diversity in a Neotropical wetland: patterns of similarity, effects of distance, and altitude.

The Brazilian Pantanal is an extensive wetland with heterogeneous habitats, primarily due to the river-floodplain system and plants with differential adaptations and reproductive strategies. Factors such as altitude, distance among plant formations, and flood pulse must be considered to better understand its diversity. Aiming to assess the influence of biogeographic patterns in this system, we analyzed the floristic composition of six areas along the Paraguay River, including residual relieves, verifying the pattern of similarity, and effects of distance and altitude. We recorded 356 species in 87 families, mostly perennial (75%), and some annuals (15%) and pluriannuals (5%). Herbaceous plants were the most represented (48%), followed by arboreal (23%), shrubby (15%) and epiphytic (14%) habits, only 12% being endemic to Brazil. The studied areas showed low floristic similarity, but higher resemblance of species between neighboring areas, and no relation with altitude. The upper Paraguay River is diverse, with high spatial variability of species, predominantly perennial. The river-floodplain connectivity may be a determinant factor in species richness and occurrence of endemic species.