The Burden of Narcolepsy in Adults: A Population Sampling Study Using Personal Media.

OBJECTIVE: To obtain insight in the spectrum of narcolepsy symptoms and associated burden in a large cohort of patients. METHODS: We used the Narcolepsy Monitor, a mobile app, to easily rate the presence and burden of 20 narcolepsy symptoms. Baseline measures were obtained and analyzed from 746 users aged between 18 and 75 years with a reported diagnosis of narcolepsy. RESULTS: Median age was 33.0 years (IQR 25.0-43.0), median Ullanlinna Narcolepsy Scale 19 (IQR 14.0-26.0), 78% reported using narcolepsy pharmacotherapy. Excessive daytime sleepiness (97.2%) and lack of energy were most often present (95.0%) and most often caused a high burden (79.7% and 76.1% respectively). Cognitive symptoms (concentration 93.0%, memory 91.4%) and psychiatric symptoms (mood 76.8%, anxiety/panic 76.4%) were relatively often reported to be present and burdensome. Conversely, sleep paralysis and cataplexy were least often reported as highly bothersome. Females experienced a higher burden for anxiety/panic, memory, and lack of energy. CONCLUSIONS: This study supports the notion of an elaborate narcolepsy symptom spectrum. Each symptom's contribution to the experienced burden varied, but lesser-known symptoms did significantly add to this as well. This emphasizes the need to not only focus treatment on the classical core symptoms of narcolepsy.

Determinants of perceived sleep quality in normal sleepers.

Objective: This study aimed to establish the determinants of perceived sleep quality over a longer period of time, taking into account the separate contributions of actigraphy-based sleep measures and self-reported sleep indices. Methods: Fifty participants (52 ± 6.6 years; 27 females) completed two consecutive weeks of home monitoring, during which they kept a sleep-wake diary while their sleep was monitored using a wrist-worn actigraph. The diary included questions on perceived sleep quality, sleep-wake information, and additional factors such as well-being and stress. The data were analyzed using multilevel models to compare a model that included only actigraphy-based sleep measures (model Acti) to a model that included only self-reported sleep measures to explain perceived sleep quality (model Self). In addition, a model based on the self-reported sleep measures and extended with nonsleep-related factors was analyzed to find the most significant determinants of perceived sleep quality (model Extended). Results: Self-reported sleep measures (model Self) explained 61% of the total variance, while actigraphy-based sleep measures (model Acti) only accounted for 41% of the perceived sleep quality. The main predictors in the self-reported model were number of awakenings during the night, sleep onset latency, and wake time after sleep onset. In the extended model, the number of awakenings during the night and total sleep time of the previous night were the strongest determinants of perceived sleep quality, with 64% of the variance explained. Conclusion: In our cohort, perceived sleep quality was mainly determined by self-reported sleep measures and less by actigraphy-based sleep indices. These data further stress the importance of taking multiple nights into account when trying to understand perceived sleep quality.

Smart Rehabilitation Garment for posture monitoring.

Posture monitoring and correction technologies can support prevention and treatment of spinal pain or can help detect and avoid compensatory movements during the neurological rehabilitation of upper extremities, which can be very important to ensure their effectiveness. We describe the design and development of Smart Rehabilitation Garment (SRG) a wearable system designed to support posture correction. The SRG combines a number of inertial measurement units (IMUs), controlled by an Arduino processor. It provides feedback with vibration on the garment, audible alarm signals and visual instruction through a Bluetooth connected smartphone. We discuss the placement of sensing modules, the garment design, the feedback design and the integration of smart textiles and wearable electronics which aimed at achieving wearability and ease of use. We report on the system's accuracy as compared to optical tracker method.

Effect of homologous PRP on proliferation of human periodontally affected osteoblasts. In vitro preliminary study. Report of a case.

OBJECTIVE: The purpose of this in vitro study was to evaluate the effect of two concentrations of homologous platelet-rich plasma (PRP) on the proliferative response of osteoblasts derived from a patient with aggressive periodontitis. METHODS: 8.5 ml of venous blood were taken from 1 healthy and non-smoker volunteer. PRP was prepared following the protocol of Curasan. Osteoblasts were derived from alveolar bone chips obtained from a patient with aggressive periodontitis during conventional periodontal surgery and a clinically healthy person during crown lengthening surgical procedure. Cells were grown in 24-well dishes and on day 2 of quiescence were treated with 1% and 5% (v/v) of PRP. The effect on cell proliferation was estimated by measuring [3H] thymidine incorporation. After 48h of incubation, cells were processed to subject to scintillation counting. Counts per minute were determined for each sample. RESULTS: The addition of 1% and 5% of PRP provoked a statistical significant (p<0.05) increase in cell growth. CONCLUSIONS: Data revealed significant enhancement of proliferative response of osteoblasts in the presence of PRP, which might serve as a source of growth factors promoting periodontal repair by modulating cell response and activities.

Study of the activity of lymphocyte adenosine deaminase in chronic renal failure.

The activity of lymphocyte adenosine deaminase was studied in 28 undialysed uremic patients, 19 patients on maintenance hemodialysis and 32 normal subjects. A statistically significant decrease of the enzyme activity was found both for the undialysed and dialysed patients.