Asociación entre cronotipo y síntomas depresivos: un estudio exploratorio / Association between chronotype and depressive symptoms: an exploratory study

Introducción: el cronotipo es la predisposición natural de cada individuo a experimentar picos de energía o momentos de descanso en función de su ritmo circadiano. Los individuos pueden tener cronotipos matutinos, vespertinos o intermedios, que pueden tener relación con el desarrollo de depresión. Objetivo: determinar la existencia de asociación entre el cronotipo y la sintomatología depresiva en una muestra de adultos. Metodología: este estudio observacional, descriptivo y exploratorio se realizó en agosto de 2023. Se incluyeron en este estudio adultos de ambos sexos. Se recolectaron datos sociodemográficos, y los participantes respondieron el Morningness-Eveningness Questionnaire de Horne y Östberg para evaluar el cronotipo, y el Patient Health Questionnaire de 2 ítems (PHQ-2) para evaluar los síntomas depresivos. Se utilizaron estadísticas descriptivas para todas las variables. Para la estadística inferencial, se utilizó la prueba de chi-cuadrado con un nivel de confianza del 95 %. Se utilizó odds ratio para cuantificar las relaciones. Resultados: un total de 105 personas participaron en el estudio, de las cuales el 58 % eran mujeres. La edad media de la muestra era de 29,4 ± 11,6 años. El 69 % de la muestra presentaba el cronotipo matutino, mientras que el 31 % presentaba el cronotipo vespertino. Se observó que el 31 % de los participantes puntuaba positivamente para depresión (PHQ-2 ≥ 3). Se encontró una relación entre el cronotipo y los puntos de corte del PHQ-2 (p=0,036). Se halló una OR=2,5 (IC 95%: 1,05-5,95) a favor del cronotipo vespertino para el desarrollo de depresión. Conclusión: casi siete de cada diez participantes tenían un cronotipo matutino, mientras que tres de cada diez dieron positivo en depresión. Los individuos con cronotipos vespertinos son más propensos a desarrollar síntomas depresivos que aquellos con cronotipos matutinos.

Introduction: chronotype is the natural predisposition of each individual to experience peaks of energy or moments of rest according to their circadian rhythm. Individuals may have morning, evening, or intermediate chronotypes that may be related to the development of depression. Objective: to determine the existence of an association between chronotype and depressive symptomatology in a sample of adults. Methodology: this observational, descriptive, and exploratory study was conducted in August 2023. Adults of both sexes were included in this study. Sociodemographic data were collected, and participants answered the Morningness-Eveningness Questionnaire by Horne and Östberg to assess chronotype, and the 2-item Patient Health Questionnaire (PHQ-2) to assess depressive symptoms. Descriptive statistics were used for all the variables. For inferential statistics, the chi-squared test was used with a confidence level of 95 %. Odds ratio was used to quantify the relationships. Results: a total of 105 people participated in the study, 58 % of whom were women. The mean age of the sample was 29.4 ± 11.6 years. Sixty-nine percent of the sample presented the morning chronotype, while 31 % presented the evening chronotype. It was found that 31 % of the participants scored positively for depression (PHQ-2 ≥ 3). A relationship was found between chronotype and PHQ-2 cutoff points (p=0.036). An OR=2.5 (95 % CI 1.05-5.95) was found in favor of the evening chronotype for the development of depression. Conclusion: almost seven out of ten participants had a morning chronotype, whereas three out of ten were positive for depression. Individuals with evening chronotypes are more likely to develop depressive symptoms than those with morning chronotypes.

Asociación entre cronotipo y síntomas depresivos: un estudio exploratorio

Introducción: el cronotipo es la predisposición natural de cada individuo a experimentar picos de energía o momentos de descanso en función de su ritmo circadiano. Los individuos pueden tener cronotipos matutinos, vespertinos o intermedios, que pueden tener relación con el desarrollo de depresión. Objetivo: determinar la existencia de asociación entre el cronotipo y la sintomatología depresiva en una muestra de adultos. Metodología: este estudio observacional, descriptivo y exploratorio se realizó en agosto de 2023. Se incluyeron en este estudio adultos de ambos sexos. Se recolectaron datos sociodemográficos, y los participantes respondieron el Morningness-Eveningness Questionnaire de Horne y Östberg para evaluar el cronotipo, y el Patient Health Questionnaire de 2 ítems (PHQ-2) para evaluar los síntomas depresivos. Se utilizaron estadísticas descriptivas para todas las variables. Para la estadística inferencial, se utilizó la prueba de chi-cuadrado con un nivel de confianza del 95 %. Se utilizó odds ratio para cuantificar las relaciones. Resultados: un total de 105 personas participaron en el estudio, de las cuales el 58 % eran mujeres. La edad media de la muestra era de 29,4 ± 11,6 años. El 69 % de la muestra presentaba el cronotipo matutino, mientras que el 31 % presentaba el cronotipo vespertino. Se observó que el 31 % de los participantes puntuaba positivamente para depresión (PHQ-2 ≥ 3). Se encontró una relación entre el cronotipo y los puntos de corte del PHQ-2 (p=0,036). Se halló una OR=2,5 (IC 95%: 1,05-5,95) a favor del cronotipo vespertino para el desarrollo de depresión. Conclusión: casi siete de cada diez participantes tenían un cronotipo matutino, mientras que tres de cada diez dieron positivo en depresión. Los individuos con cronotipos vespertinos son más propensos a desarrollar síntomas depresivos que aquellos con cronotipos matutinos.

Introduction: chronotype is the natural predisposition of each individual to experience peaks of energy or moments of rest according to their circadian rhythm. Individuals may have morning, evening, or intermediate chronotypes that may be related to the development of depression. Objective: to determine the existence of an association between chronotype and depressive symptomatology in a sample of adults. Methodology: this observational, descriptive, and exploratory study was conducted in August 2023. Adults of both sexes were included in this study. Sociodemographic data were collected, and participants answered the Morningness-Eveningness Questionnaire by Horne and Östberg to assess chronotype, and the 2-item Patient Health Questionnaire (PHQ-2) to assess depressive symptoms. Descriptive statistics were used for all the variables. For inferential statistics, the chi-squared test was used with a confidence level of 95 %. Odds ratio was used to quantify the relationships. Results: a total of 105 people participated in the study, 58 % of whom were women. The mean age of the sample was 29.4 ± 11.6 years. Sixty-nine percent of the sample presented the morning chronotype, while 31 % presented the evening chronotype. It was found that 31 % of the participants scored positively for depression (PHQ-2 ≥ 3). A relationship was found between chronotype and PHQ-2 cutoff points (p=0.036). An OR=2.5 (95 % CI 1.05-5.95) was found in favor of the evening chronotype for the development of depression. Conclusion: almost seven out of ten participants had a morning chronotype, whereas three out of ten were positive for depression. Individuals with evening chronotypes are more likely to develop depressive symptoms than those with morning chronotypes.

Evaluation of the association between self-reported sleep bruxism and chronotype and sleep quality among dental students / Avaliação da associação entre cronotipo, qualidade do sono e autorrelato de bruxismo do sono entre estudantes universitários de Odontologia

ABSTRACT Background Sleep bruxism (BS) is defined as involuntary jaw movements characterized by grinding and clenching teeth. Objective To verify the association between chronotype, sleep quality, and self-reporting of BS in dental students. Method A cross-sectional study was conducted with 214 undergraduate dental students at a public university in northeast Brazil. The participants answered the Munich Chronotype Questionnaire for the identification of chronotype and another questionnaire regarding daily aspects to collect information about sleep quality, self-reported sleep bruxism, the use of sleeping pills, snoring, concentration during daily activities and energy upon waking. Results The prevalence of self-reported sleep bruxism was 11.0%. In the final model, the eveningness chronotype (OR = 23.00; 95% CI: 2.36-223.84, p = 0.007), habitual snoring (OR = 3.12; 95% CI: 1.31-7.39, p = 0.01) and low energy upon waking in the morning (OR = 2.37; 95% CI: 1.96-5.58, p = 0.040) were associated with self-reported sleep bruxism. Conclusion The evening chronotype, presence of snoring, and low energy when waking up in the morning influenced self-reporting of sleep bruxism among undergraduate dental students.

RESUMO Introdução O bruxismo do sono (BS) é definido como movimentos involuntários da mandíbula caracterizados por ranger e apertar os dentes. Objetivo Verificar se o cronotipo e a qualidade do sono estão associados ao autorrelato de BS em graduandos de Odontologia. Método Um estudo transversal com 214 estudantes de uma universidade pública do Nordeste do Brasil. Os participantes responderam ao Morningness-Eveningness Questionnaire para identificar os cronotipos e outro questionário sobre aspectos diários em que foram coletadas informações sobre qualidade do sono, autorrelato de bruxismo do sono, uso de pílulas para dormir, ronco, concentração nas atividades diárias, energia ao acordar. Resultados A prevalência de autorrelato do bruxismo do sono foi de 11,0%. No modelo final, o cronotipo noturno (OR = 23,00; 95% IC: 2.36-223.84, p = 0,007), o hábito de roncar (OR = 3,12; 95% IC: 1.31-7.39, p = 0,01) e o baixo nível de energia ao acordar pela manhã (OR = 2,37; 95% IC: 1.96-5.58, p = 0,04) estiveram associados com o autorrelato de BS. Conclusão O cronotipo noturno, a presença do ronco e a baixa energia ao se levantar pela manhã influenciaram o autorrelato de bruxismo do sono entre os estudantes de graduação em Odontologia.

Adaptation and validation of the Mood Rhythm Instrument for use in Brazilian adolescents

Objective: Adapt and validate the Mood Rhythm Instrument (MRhI), a self-reported questionnaire that assesses self-perceived rhythmicity of mood-related symptoms in adults, into a version that assesses and evaluates perceived mood-related symptoms in adolescents (MRhI-Y). Methods: Adaptation of the Brazilian Portuguese version of the MRhI for an adolescent population followed three steps: review by consultants, analysis by experts, and pilot testing through a visual analogue scale (VAS). The final questionnaire (MRhI-Y) was applied to 171 adolescents aged 12-17 years. Internal consistency was calculated using Cronbach's alpha and McDonald's omega. The psychometric properties of the MRhI-Y were evaluated using exploratory factor analysis (EFA). Results: The MRhI-Y was designed to use wording more appropriate for adolescents than that of the MRhI. Expert agreement about item quality ranged between 82 and 100%. Adolescents' VAS ratings indicated good comprehension of the items. Cronbach's alpha and McDonalds' omega coefficients were 0.71 and 0.74. The EFA resulted in a three-factor solution (affective, cognitive, and somatic). Younger adolescents (ages 12 to 13) reported lower rhythmicity scores than older groups (ages 14 to 15 and 16 to 17), even controlling for chronotype. Conclusions: The Brazilian Portuguese version of the MRhI-Y presented adequate comprehension by adolescents and good internal consistency. The MRhI-Y is a promising tool to improve our understanding of the underlying characteristics of mood fluctuation in adolescence.

Alteraciones metabólicas y circadianas en personal de enfermería de un hospital público del noroeste de México / Circadian and metabolic alterations among nursing personnel in a northeastern public hospital in Mexico / Alterações metabólicas e circadianas na equipe de enfermagem de um hospital público no noroeste do México

RESUMEN Introducción Las alteraciones metabólicas se vinculan a los ritmos biológicos, dado que es tos sistemas controlan aspectos fisiológicos como patrones de sueño/vigilia, temperatura corporal, presión arterial y liberación de hormonas endocrinas. Objetivo Identificar la relación entre los componentes del síndrome metabólico y disincro nía circadiana en personal de enfermería de un hospital público. Métodos Estudio correlacional. Muestra censal de 30 profesionales de enfermería de dos turnos. Para la recolección de datos se utilizaron tres cédulas: a) antecedentes biosociode mográficos y laborales; b) síndrome metabólico; c) ciclo circadiano. En el procesamiento de datos se utilizó pruebas Chi-cuadrada, R de Pearson y Rho de Spearman, se verificó el su puesto de normalidad con Shapiro-Wilk. Se contó con autorización del Comité de Ética de la institución de salud y con el consentimiento informado de participantes. Resultados 43.3 % del personal de enfermería cumplió con criterios diagnósticos de síndro me metabólico, 100 % del turno nocturno presentó disincronía circadiana con base en el indicador patrón de sueño. El consumo de alcohol y nivel alto de triglicéridos, mostraron relación positiva estadísticamente significativa con la presencia de insomnio (p ≤ 0.001; p ≤ 0.05). Conclusión El síndrome metabólico es un problema de salud con alta prevalencia entre el personal de enfermería, independientemente del nivel académico o del turno laboral. El peso y los triglicéridos fueron indicadores que mostraron relación con patrones de sueño afectados. Esto enfatiza la importancia de incidir en la prevención y tratamiento del sín drome metabólico como una prioridad en el personal de enfermería, desde la salud laboral.

ABSTRACT Introduction Metabolic alterations are linked to biologic rhythms because these cycles control physiologic patterns including sleep/awake, body temperature, blood pressure, and hormones release. Objective To identify the relationship between the metabolic syndrome components and the circadian alterations among nursing personnel in a public hospital in Mexico. Method This is a correlational study. The sample was constituted of 30 nursing professio nals working in 2 shifts. Data were collected using three registers: a) bio socio-demographic and labor-related backgrounds; b) metabolic syndrome; c) circadian cycle. Chi-square, Pearson's R, Spearman's Rho, and Shapiro-Wilk normality test were calculated. The study approval was granted by the Ethics Committee of the Health Institution. The corresponding informed consent was obtained from all participants. Results 43.3 % of the nursing personnel qualified for the metabolic syndrome diagnostic criteria. 100 % of the nurses working the night shift showed circadian alterations in terms of sleep patterns. Alcohol consumption and high levels of triglycerides were positively and significantly related to insomnia (p ≤ 0.001; p ≤ 0.05). Conclusion The metabolic syndrome is a health problem with a high prevalence in all kinds of nursing personnel. Bodyweight and triglyceride levels were indicators suggesting altered sleep patterns. This situation highlights the importance of designing and implementing strategies aimed at preventing and addressing metabolic syndrome among nursing person nel as a labor health priority.

RESUMO Introdução As alterações metabólicas estão ligadas aos ritmos biológicos, pois esses siste mas controlam aspectos fisiológicos como padrões de sono/vigília, temperatura corporal, pressão arterial e liberação de hormônios endócrinos. Objetivo Identificar a relação entre os componentes da síndrome metabólica e a dissincro nia circadiana na equipe de enfermagem de um hospital público. Métodos Estudo correlacional. Amostra censitária de 30 profissionais de enfermagem com dois turnos. Para a coleta de dados foram utilizados três cartões: a) antecedentes biossociodemográficos e laborais; b) síndrome metabólica; c) ciclo circadiano. No processa mento dos dados foram utilizados os testes Qui-quadrado, R de Pearson e Rho de Spearman, a suposição de normalidade foi verificada com Shapiro-Wilk. Contou-se com a autorização do Comitê de Ética da instituição de saúde e o termo de consentimento informado dos participantes. Resultados 43.3 % da equipe de enfermagem atendeu aos critérios diagnósticos para sín drome metabólica, 100 % do plantão noturno apresentou dissincronia circadiana com base no indicador padrão de sono. O consumo de álcool e o nível elevado de triglicerídeos mos traram relação positiva estatisticamente significativa com a presença de insônia (p ≤ 0.001; p ≤ 0.05). Conclusão A síndrome metabólica é um problema de saúde de alta prevalência entre a equipe de enfermagem, independentemente do nível acadêmico ou turno de trabalho. O peso e os triglicerídeos foram indicadores que mostraram relação com os padrões de sono afetados. Isto ressalta a importância de influenciar a prevenção e o tratamento da síndrome metabólica como prioridade na equipe de enfermagem, desde a saúde do trabalhador.

Women amateur street runners have a higher level of chronotype self- perception than men

Abstract Aim: The aims of the present study were to verify the self-perception level of the chronotype of amateur street runners and to test the association between the chronotype, gender, age, and preferred training time. Methods: A total of 166 amateur street runners were included (♀ = 89, age 38.9 ± 11.2 years; ♂ = 77, age 38.0 ± 9.7 years). The Brazilian version of the Horne & östberg questionnaire was used to assess chronotypes and the preferred training time was determined through a multiple choice question. Based on chronotype definitions that suggest that when free to choose, morning-types (MT) would prefer training in the morning, evening-types (ET) in the evening and neither-types (NT) would not have a predilection for any specific time. The corroboration of this hypothesis was assumed as self-perception level of the chronotypes. Results: Women showed higher self-perception levels of their chronotype compared to men (58.4% vs. 41.6%; χ2 = 4.699; p = 0.030). By chronotypes, MT, NT, and ET self-perception levels were 73.9%, 15.9%, 88.9%, respectively (χ2 = 57.489; p < 0.001). The most observed women circadian typology was MT, while in men it was NT (χ2 = 8.951; p = 0.011). However, there was no significant association between gender and preferred training time (χ2 = 2.654; p = 0.265). Age, female gender and preference to exercise during the day are associated with MT. Conclusion: Women runners showed a greater perception of their circadian traits than men, despite there was no association between gender and preferred training time.

Evaluation of seasonal breeding of the domestic canary (Serinus canaria) in an artificial environment / Avaliação da reprodução sazonal no canário doméstico (Serinus canaria) em ambiente artificial

ABSTRACT: The domestic canary (Serinus canaria) has been bred for hundreds of years to improve the quality of its plumage and its song. Reproduction in this species occurs seasonally, stimulated by a gradual increase in day length. Although, the occurrence of seasonal breeding in canaries is well known, whether canary reproduction can be manipulated remains unknown. Our objective was to determine whether the conditions of captivity (photoperiod and temperature) can be adjusted to enable canaries to reproduce outside of their natural breeding season. Thirty days before the natural breeding season, canary pairs were assigned and separated into three different groups: External Control (housed outdoors under ambient conditions), Artificial Control (housed artificially indoors under conditions similar to the external conditions), and Artificial Altered (housed artificially indoors for five months, with the photoperiod gradually manipulated to simulate that of the natural breeding season) groups. The number of clutches laid was greater in the Artificial Control than in External Control; however, more birds hatched in the External Control. In the Artificial Altered group, the beginning of the breeding season was delayed when the same parameters were used. Although, further research is needed, this study presents new data to assist in the development of protocols that entail gradual changes in environmental conditions to try to reduce the impacts of the processes on animal welfare.

RESUMO: O canário doméstico (Serinus canaria) tem sido criado há centenas de anos para melhorar a qualidade da plumagem e do canto. A reprodução nesta espécie é sazonal, sendo estimulada por um aumento gradual da duração do dia. Embora a reprodução sazonal de canários seja bem conhecida, ainda não se sabe se a reprodução dos canários pode ser manipulada. O objetivo foi determinar se as condições em cativeiro (fotoperíodo e temperatura) podem ser ajustadas para permitir que os canários se reproduzam fora de sua estação natural de reprodução. Trinta dias antes da estação natural de reprodução, os pares foram designados e separados em grupos: Controle Externo (alojado em gaiolas sob condições ambientais externas); Controle Artificial (alojado em gaiolas mantidas em condições artificiais semelhantes ao lado externo); e Alterado Artificial (alojado em gaiolas mantidas em condições artificiais constantes por cinco meses, após o fotoperíodo foi gradualmente manipulado para simular o da estação natural de reprodução). O número de posturas foi maior no grupo Controle Artificial do que no Controle Externo; entretanto, mais aves eclodiram no Controle Externo. No grupo Alterado Artificial, o início do período reprodutivo foi atrasado considerando os mesmos parâmetros reprodutivos. Embora mais pesquisas sejam necessárias, este estudo apresenta novos dados para auxiliar no desenvolvimento de protocolos que promovam mudanças graduais das condições ambientais visando reduzir os impactos no bem-estar animal.

É possível verificar relações entre baixa visão e padrões de sono por meio de actigrafia? Relato de caso de uma paratleta / Is it possible to verify relations bet ween low vision and sleep patterns through actigraphy? Case report of a para-athlete

Verificar se a actigrafia permite estabelecer relações entre baixa visão e distúrbios do sono em uma paratleta. Utilizamos questionários, diário do sono e actígrafo durante 30 dias. Mostrou-se indiferente para o perfil circadiano com preferência de treinos vespertinos e má qualidade subjetiva do sono. Periodograma com ritmo circadiano e actograma evidenciando irregularidades nos horários para dormir e acordar aos finais de semana, com períodos de repouso diurno ao longo da semana. Média de sono foi de 06h30m com seis despertares por noite. Verificamos que ambiente, hábitos e rotinas contribuíram para a má qualidade de sono. A actigrafia, quando aliada a outras metodologias, mostrou-se útil para estabelecer relações entre baixa visão, qualidade do sono, prática de exercícios e auto percepção, além de contribuir, neste estudo, para o direcionamento de ações de medidas de higiene do sono, permitindo a promoção de melhorias e ganho em qualidade de vida pessoal e profissional.

Verify if the actigraphy can set relations between low vision and sleep disorders in a para-athlete. Questionnaires, sleep diary and actigraph were used during 30 days. The participant presented an indifferent circadian profile, with preference for evening training and poor subjective sleep quality. Periodogram with circadian rhythm and actogram showing irregularities in the times to sleep and wake up on weekends, with periods of day rest throughout the week. The average sleep time was 06h30m with six awakenings per night. It was found that environment, habits and routines contributed to poor sleep quality. Actigraphy, when combined with other methodologies, proved to be useful for establishing relationships between low vision, sleep quality, exercise and self-perception. In addition to contributing, in this study, to directing sleep hygiene measures, allowing the promotion of improvements and gain in quality of personal and professional life.

Variable beige adipocyte morphology in obese rats by different times of melatonin administration / Variación de la morfología del adipocito beige en ratas obesas según los diferentes tiempos de administración de melatonina

This study aimed to evaluate changes in beige adipocytes at different times of melatonin administration, in the morning (ZT01) or in the evening (ZT11), at 30 mg/kg daily by gavage for 7 weeks or continuously with drinking water in the term of high-calorie diet-induced obesity (HCD). Melatonin received at ZT11 or with drinking water resulted in an increased area of the browning zone in the subcutaneous white adipose tissue (sWAT), even in rats with HCD (compared with Control or HCD, respectively). The beige adipocyte and lipid droplet area after melatonin use were reduced compared to those with HCD and Control, in all administration modes (group ZT01 showed smaller changes compared to ZT11 or with drinking water groups). The fibrosis level decreased and significantly differed in HCD ZT01, HCD ZT11, and HCD water compared to that in HCD; moreover, the lowest value determined in HCD water, reached the control parameters. Furthermore, the IL-1b and IL-8 level was decreased in the HCD groups under melatonin treatment at ZT11 or with drinking water compared to that in HCD. The obtained results suggest that melatonin promotes sWAT browning in rats with diet-induced obesity and influences morphological signs of normal rats depending on the time of administration. Different functional activity of beige adipocytes was observed after melatonin was used depending on the time of administration, resulting in heat production and lipolysis (the relative mass of visceral fat was likewise diminished). More rapid browning was observed when melatonin treatment was performed at 1 h before lights-off (ZT11) or continuously via drinking water. Melatonin acted on beige adipocytes of obese rats through changing some parameters such as the area of adipocytes and lipid drops, the number of lipid drops, the relative area browning of sWAT, and the level of tissue fibrosis.

Este estudio tuvo como objetivo evaluar los cambios en los adipocitos beige en diferentes momentos de la administración de melatonina, en la mañana (ZT01) o por la noche (ZT11). Se administraron 30 mg/kg diariamente por sonda durante 7 semanas o continuamente con agua potable durante el periodo de obesidad inducida por una dieta alta en calorías (HCD). La melatonina recibida en ZT11 o con agua potable resultó en un aumento de área dorada en tejido adiposo blanco subcutáneo (sWAT), incluso en ratas con HCD (en comparación con Control o HCD, respectivamente). El área de gotas de lípidos y adipocitos de color beige después del uso de melatonina se redujo en comparación con aquellos con HCD y Control, en todos los modos de administración (el grupo ZT01 mostró cambios más pequeños en comparación con ZT11 o con grupos de agua potable). El nivel de fibrosis disminuyó y difirió significativamente en HCD ZT01, HCD ZT11 y agua HCD, en comparación con el HCD; además, el valor más bajo determinado en agua HCD alcanzó los parámetros de control. Además, el nivel de IL-1b e IL-8 disminuyó en los grupos HCD bajo tratamiento con melatonina en ZT11 o con agua potable en comparación con el de HCD. Los resultados obtenidos sugieren que la melatonina promueve el dorado sWAT en ratas con obesidad inducida por la dieta e influye en los signos morfológicos de las ratas normales dependiendo del momento de la administración. Se observó una actividad funcional diferente de los adipocitos de color beige después de usar melatonina dependiendo del tiempo de administración, dando como resultado la producción de calor y lipólisis (la masa relativa de grasa visceral también disminuyó). Se observó un ennegrecimiento más rápido cuando el tratamiento con melatonina se realizó 1 h antes de apagar las luces (ZT11) o de forma continua en grupos de agua potable. La melatonina actuó en los adipocitos beige de ratas obesas al cambiar algunos parámetros, como el área de adipocitos y gotas de lípidos, el número de gotas de lípidos, el área relativa de ennegrecimiento de sWAT y el nivel de fibrosis tisular.

Duration and quality of sleep in sprint and recovery performances among elite swimmers / Duração e qualidade de sono no desempenho do sprint e na recuperação de nadadores de elite / Duración y calidad del sueño en el desempeño en el sprint y recuperación d nadadores de élite

ABSTRACT Introduction: Circadian rhythms can impact athletes' sports performance, where the plateau occurs between 15 and 21 hours. Swimming is a peculiar case, as athletes perform training and final sessions in competitions at different times, as in the Rio2016 Olympic Games for example, where the semifinal and final competitions took place from ten o'clock at night. Objectives: (1) to present the protocol of an intervention performed with elite athletes of the Brazilian swimming team during the 2016 Olympic Games in Rio; (2) to find out whether the time at which the competitions were held affected the swimming performances of these athletes during the competition. Materials and Methods: Fourteen athletes of the Brazilian swimming team (males: n= 10; 71% and females: n= 4; 29%) participated in the study. They were followed up during two preparation periods (baseline and intervention) for the 2016 Olympic Games in Rio during June and July 2016. During the competition, we recorded the Reaction Time (RT) and Competition Time (CT) of each athlete in different modalities. The intervention strategies used were light therapy and sleep hygiene. The values of RT at the starting block and CT were registered and conferred with the official results. Results: The athletes showed a decrease in the total time awake (Δ = −13%; Effect size [ES] = 1.0) and sleep latency (Δ = −33%; ES = 0.7), and an increase in total sleep time (Δ = 13%; ES = 1.1; p = 0.04) between the baseline and the period of the intervention, pre-competition. We identified an improvement in the RT (Δ = −2.2% to −1.0%; ES = 0.2 to 0.5) during the competition only for the athletes who participated in the competition finals. Conclusion: We conclude that the intervention carried out was effective in mitigating any negative influence of competition time on the RT and CT of elite athletes of the Brazilian swimming team. Level of evidence II; Prospective comparative study.

RESUMO Introdução: Os ritmos circadianos podem exercer impacto no desempenho esportivo dos atletas, onde o platô ocorre entre as 15 e 21 horas. A natação é um caso peculiar, uma vez que os nadadores realizam sessões de treinamento e provas finais em competições em diferentes horários, como por exemplo, nos Jogos Olímpicos Rio2016, onde as competições semifinais e finais da natação ocorreram a partir das 22 horas. Objetivos: O presente estudo teve como objetivos: (1) apresentar o protocolo de uma intervenção realizada com atletas de elite da equipe de natação brasileira durante os Jogos Olímpicos Rio 2016; (2) identificar se o desempenho dos atletas de natação foi afetado devido aos horários das provas durante a competição. Materiais e Métodos: Participaram do estudo 14 atletas da equipe de natação brasileira (masculino: n= 10; 71% e feminino: n= 4; 29%). Foi realizado acompanhamento dos atletas durante dois períodos de preparação (baseline e intervenção) para os Jogos Olímpicos Rio2016 nos meses de junho e julho de 2016. Durante a competição, foi realizado o registro do Tempo de Reação (TR) e Tempo de Prova (TP) de cada atleta nas diferentes modalidades. As estratégias de intervenção utilizadas foram: terapia de luz e higiene do sono. Os valores de TR no bloco de partida e TP foram registrados e conferidos com os resultados oficiais. Resultados: Os atletas apresentaram decréscimo no tempo total de vigília (Δ = −13%; Tamanho do Efeito (TE) = 1,0) e latência de sono (Δ = −33%; TE = 0,7), e aumento do tempo total de sono (Δ = 13%; TE = 1,1; p = 0,04) entre o baseline e o período de intervenção pré-competição. Nós identificamos melhorias no TR (Δ = −2,2% à −1,0%; TE = 0,2 a 0,5) ao longo da competição somente para os atletas que participaram da fase final da competição. Conclusão: Concluímos que a intervenção realizada foi efetiva para minimizar qualquer influência negativa do horário da competição sobre o TR e TP dos atletas de elite da natação brasileira. Nível de evidência II; Estudo prospectivo comparativo.

RESUMEN Introducción: Los ritmos circadianos pueden ejercer impacto en el desempeño deportivo de los atletas, donde la meseta ocurre entre las 15h y las 21 horas. La natación es un caso peculiar, ya que los nadadores realizan sesiones de entrenamiento y pruebas finales en competiciones en diferentes horarios, como por ejemplo, en los Juegos Olímpicos Rio 2016, en donde las competiciones semifinales y finales de natación ocurrieron a partir de las 22 horas. Objetivos: El presente estudio tuvo como objetivos: (1) presentar el protocolo de una intervención realizada con atletas de élite del equipo de natación brasileño durante los Juegos Olímpicos Rio 2016; (2) identificar si el desempeño de los atletas de natación fue afectado debido a los horarios de las pruebas durante la competición. Materiales y Métodos: Participaron en el estudio 14 atletas del equipo de natación brasileño (masculino: n = 10; 71% y femenino: n= 4; 29%). Fue realizado acompañamiento de los atletas durante dos períodos de preparación (baseline e intervención) para los Juegos Olímpicos Rio 2016 en los meses de junio y julio de 2016. Durante la competición, se realizó el registro del Tiempo de Reacción (TR) y Tiempo de Prueba (TP) de cada atleta en las diferentes modalidades. Las estrategias de intervención utilizadas fueron: terapia de luz e higiene del sueño. Los valores de TR en el bloque de partida y TP fueron registrados y verificados con los resultados oficiales. Resultados: Los atletas presentaron disminución en el tiempo total de vigilia (Δ = −13%; Tamaño de efecto (TE) = 1,0), y latencia del sueño (Δ = −33%; TE = 0,7), y aumento del tiempo total de sueño (Δ = 13%; TE = 1,1; p = 0,04) entre baseline y el período de intervención precompetición. Identificamos mejoras en el TR (Δ = −2,2% a −1,0%; TE = 0,2 a 0,5) a lo largo de la competición sólo para los atletas que participaron en la fase final de la competición. Conclusión: Concluimos que la intervención realizada fue efectiva para minimizar cualquier influencia negativa del horario de la competición sobre el TR y TP de los atletas de élite de la natación brasileña. Nivel de evidencia II; Estudio prospectivo comparativo.

Tipologia circadiana de estudantes de psicologia: diferenças entre a qualidade de sono, sonolência excessiva e hábitos diários / Circadian typology of psychology students: differences between sleep quality, excessive sleepiness and daily habits / Tipología circadiana de estudiantes de psicología: diferencias entre la calidad de sono, somnolencia excesiva y hábitos diarios

A tipologia circadiana é uma dimensão comportamental associada a preferências de hábitos diários. Contudo, este estudo objetivou avaliar a qualidade de sono e a sonolência excessiva de acadêmicos de Psicologia. Participaram deste estudo quase-experimental 56 estudantes com idade entre 17 e 34 anos. Utilizaram-se como instrumentos o Índice de Qualidade de Sono de Pittsburgh (PSQI), o Questionário de Matutinidade e Vespertinidade, a Escala de Sonolência de Karolinska e a Escala de Ritmo Social Breve. Após avaliar o PSQI, todos os participantes responderam os instrumentos por um período de 14 dias consecutivos. A MANOVA mostrou diferença significativa para sonolência diária durante os dias úteis [λ=0.81; F(4;47)=451,53; p<0,05], especificamente para o horário das 21h [F(2;5)=3,03; p<0,05]. Conclui-se que os estudantes possuem qualidade de sono ruim e, geralmente, tentam compensar as faltas de noites de sono durante a semana nos finais de semana.

The circadian typology is a behavioral dimension associated with preferences of daily habits. Thus, this study aimed to evaluate the quality of sleep and excessive sleepiness of undergraduates in psychology. Fifty-five students aged between 17 and 34 years participated in this quasi-experimental study. The Pittsburgh Sleep Quality Index, the Morningness-Eveningness Questionnaire, the Karolinska Sleepiness Scale, and the Brief Social Rhythm Scale were used as instruments. After assessing the PSQI, all participants answered the instruments for a period of 14 consecutive days. MANOVA showed significant difference for daily sleepiness during the working days [λλ=.81; F(4.47)=451.53; p<.05], specifically for business hours of 21h [F(2;5)=3.03; p<.05]. It is concluded that students have poor sleep quality and generally try to compensate for the lack of nights of sleep during the week on weekends.

La tipología circadiana es una dimensión comportamental asociada a preferencias de hábitos diarios. Sin embargo, este estudio tuvo como objetivo evaluar la calidad del sueño y la somnolencia excesiva de académicos de psicología. Participaron de este estúdio quase-experimental 56 estudiantes con edad entre 17 y 34 años. Se utilizaron como instrumentos o Índice de Calidad de Sono de Pittsburgh (PSQI), o Cuestionario de Matutinidad-Vespertinidad, la Escala de Somnolencia de Karolinska y Escala de Ritmo Social Breve. Aprobar la PSQI, todos los participantes respondan os instrumentos por un período de 14 días consecutivos. A MANOVA mostró una diferencia para somnolencia durante los días laborables [λ=0,81; F(4; 47)=451,53; p<0.05], específicamente para el horario de las 21h [F(2; 5)=3,03; p<0.05]. Las conclusiones de estos estudios tienen la cualidad de su ruina y de manera general como compensar las faltas de la noche durante la semana.

Caracterización de la tipología circadiana en estudiantes universitarios en relación con el tipo de carrera / Characterization of the circadian typology in university students in relation to the type of career

RESUMEN Fundamento: El cronotipo es un atributo de los seres humanos, que refleja su fase circadiana individual, y repercute en las funciones biológicas y psicológicas, tanto en la salud como en la enfermedad. Su estudio es particularmente valioso en escenarios educacionales. Objetivo: caracterizar el cronotipo de estudiantes universitarios en relación con el tipo de carrera que estudian. Métodos: e realizó un estudio analítico trasversal, en una serie de 273 estudiantes universitarios, seleccionados por muestreo aleatorio simple, estructurados en tres grupos bajo criterio de procedencia: 88 de Ciencias Técnicas, 88 de Ciencias Sociales y Humanísticas y 97 de Ciencias Médicas. Se exploró el cronotipo de cada sujeto por medio del Cuestionario de Matutinidad- Vespertinidad. Para cada grupo fueron calculadas las puntuaciones medias resultantes del cuestionario y las proporciones de individuos matutinos, intermedios y vespertinos. Resultados: las puntuaciones medias de los tres grupos estuvieron enmarcadas en el rango de cronotipo intermedio, y no se constaron diferencias estadísticamente significativas. El 67 % de los sujetos fueron clasificados como intermedios, el 23,8 % como matutinos y el 9,2 % como vespertinos; las proporciones de los cronotipos por grupos tampoco mostraron diferencias significativas. Conclusión: existió un claro predominio del cronotipo intermedio, seguido en frecuencia por el matutino y el vespertino. No se demostró que el tipo de carrera influyera en las puntuaciones, ni en las proporciones de las tipologías circadianas por grupos.

ABSTRACT Foundation: Chronotype is an attribute of human beings, which reflects its individual circadian phase, and affects biological and psychological functions, both in health and disease. Its study is particularly valuable in educational settings. Objective: to characterize the chronotype of university students in relation to the type of career they study. Methods: a cross-sectional analytical study was conducted in a series of 273 university students, selected by simple random sampling, structured in three groups based on provenance criteria: 88 from Technical Sciences, 88 from Social and Humanistic Sciences and 97 from Medical Sciences. The chronotype of each subject was explored through the Morningness and Eveningness Questionnaire. For each group the mean scores of the questionnaire and the proportions of morning, intermediate and evening individuals were calculated. Results: the mean scores of the three groups were framed in the intermediate chronotype range, and there were no statistically significant differences. Subjects were classified as 67% of as intermediate, 23.8% as morning and 9.2 % as evening; chronotype proportions by groups also showed no significant differences. Conclusion: there was a clear predominance of intermediate chronotype, followed in frequency by morning and evening. It was not demonstrated that the type of career influenced scores, nor in proportions of the circadian typologies by groups.

Spanish translation of the mood rhythm instrument: a novel approach to mood evaluation

Introduction: The Mood Rhythm Instrument (MRI) is a questionnaire developed to assess the circadian rhythm of mood-related behaviors. The aim of this study was to translate this instrument from Brazilian Portuguese into Spanish. Methods: The translation process consisted of forward translation, adjustment, back translation, back translation review and harmonization. Results: Comparing the initial Spanish translation and the final Spanish version, there were no semantic differences and the items were not changed. Conclusions: The Spanish version of the MRI is ready to be tested in a Spanish population. In the future, assessing and comparing mood-related behaviors in transcultural studies will be possible(AU)

Analysis of the onset time of acute aortic dissection and the influence of climate on acute aortic dissection occurrence in Urumqi city: a retrospective study of a single center / 中华危重病急救医学

Objective To observe the time characteristics of acute aortic dissection (AAD) in Urumqi and its peripheral areas in Xinjiang Uygur autonomous region, and to explore the effect of meteorological conditions on the onset of AAD.Methods Retrospective analysis of the related data of the adult AAD patients diagnosed by imaging examination, and admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2010 to July 2016 was performed. The onset time, the contemporaneous meteorological data, including daily minimum, average, and the highest temperature, daily average air pressure, daily average relative humidity, daily precipitation, daily average wind speed, daily maximum wind speed, and sunshine duration per day were collected. Analysis of concentrated distribution trend of the AAD onset was done by circular distribution statistics. Meteorological conditions were compared between the AAD day and no AAD day. The changes of air temperature 5 days before onset were observed.Results A total of 379 patients were enrolled, with 307 male and 72 female. The ratio of male to female was 4.19:1, the average age was 52.27±12.18; and the underlying diseases was hypertension (about 58.05%); the incidence sites were Urumqi and Changji city. ① The incidence of AAD in Urumqi and its peripheral areas had clear concentrated trend, and the peak period of AAD corresponded to January 1st to 2nd (homogeneity testr = 0.104,r0.05 = 0.009,P 20.4 ℃ groups, and each group had 104, 99, 98, 78 cases of AAD, respectively. The number of AAD in lowest temperature group was 1.33 times of the highest temperature group. In the 45-59 and 60-74 years, the number of AAD in lowest temperature group was higher than that in the highest temperature group (50 vs. 36, 26 vs. 13). In patients with hypertension, the number of AAD in lowest temperature group was higher than that in the highest temperature group (60 vs. 44). ⑤ The maximum air temperature, mean air temperature of the day from 5 days before to the onset day of AAD, and the lowest temperature from 3 days before to the onset day of AAD display slowly decrease trends, but there was no significant difference in daily temperature.Conclusions The incidence of AAD in Urumqi and its peripheral areas was concentrated from January 1st to 2nd of each year. When the temperature was lower than -5.2 ℃, AAD were more likely to attack. The 5 days changes of temperature and daily temperature before the attack were relevant with onset of AAD. It was speculated that the weather conditions such as air temperature may affect patient who has a past history of cardiovascular disease to attack AAD.

Effects of sevoflurane on expression of Egr-1 and Egr-2 in suprachiasmatic nuclei of sleep-deprived rats / 中华麻醉学杂志

Objective To evaluate the effects of sevoflurane on the expression of early growth response gene 1 (Egr-1) and Egr-2 in the suprachiasmatic nuclei (SCN) of sleep-deprived rats.Methods Forty-eight pathogen-free healthy male Sprague-Dawley rats,were divided into 4 groups (n =12 each) using a random number table:control group (group C),sleep deprivation group (group SD),sevoflurane group (group SEV) and sleep deprivation plus sevoflurane group (group SD+SEV).The rats were subjected to sleep deprivation for 96 h in group SD.The rats inhaled 2.5％ sevoflurane for 3 h in group SEV.The rats inhaled 2.5％ sevoflurane for 3 h after being subjected to sleep deprivation for 96 h in group SD+SEV.The mechanical paw withdrawal threshold (MWT) was measured at 12 h,3 days and 7 days after emergence from anesthesia (T1-3).The animals were sacrificed after blood samples were obtained from the external carotid artery,and the cerebral SCN was removed for determination of Egr-1 and Egr-2 expression by Western blot.Results Compared with group C,the MWT was significantly decreased at T1-3 in SD,SEV and SD+SEV groups,the expression of Egr-1 and Egr-2 in SCN was significantly up-regulated at T1-3 in SD and SD+SEV groups,and the expression of Egr-1 in SCN was significantly up-regulated at T1-3,and the expression of Egr-2 in SCN was up-regulated at T1 in group SEV (P＜0.05).Compared with SD and SEV groups,the MWT was significantly decreased at T1-3 in group SD+SEV,and the expression of Egr-1 and Egr-2 in SCN was significantly up-regulated at T1-3 in group SD+SEV (P＜0.05).Conclusion The mechanism by which sevoflurane aggravates hyperalgesia is related to up-regulation of Egr-1 and Egr-2 expression in SCN of sleepdeprived rats.

Activity/rest rhythm of depressed adolescents undergoing therapy: case studies / Ritmo de atividade e repouso em adolescentes deprimidos durante terapia: estudos de caso

Abstract Introduction: Disorders of circadian rhythms have been reported in studies of both depressed children and of depressed adolescents. The aim of this study was to evaluate whether there is a relationship between the 24-hour spectral power (24h SP) of the activity/rest rhythm and the clinical course of depression in adolescents. Methods: Six 14 to 17-year-old adolescents were recruited for the study. They were all suffering from major depressive disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria, as identified by the Schedule for Affective Disorders and Schizophrenia for School Aged Children: Present and Lifetime Version (K-SADS-PL). Depressive symptoms were assessed using the Children's Depression Rating Scale - Revised (CDRS-R) and clinical evaluations. Locomotor activity was monitored over a period of 13 consecutive weeks. Activity was measured for 10-minute periods using wrist-worn activity monitors. All patients were prescribed sertraline from after the first week up until the end of the study. Results: We found a relationship between high CDRS values and low 24-hour spectral power. Conclusions: The 24h SP of the activity/rest rhythm correlated significantly (negatively) with the clinical ratings of depression.

Resumo Introdução: Distúrbios do ritmo circadiano têm sido relatados em estudos com crianças e adolescentes deprimidos. O objetivo deste estudo foi avaliar se existe relação entre a potência espectral de 24 horas do ritmo de atividade e repouso e sintomas clínicos de depressão em adolescentes. Métodos: Seis adolescentes com idade entre 14 e 17 anos foram recrutados para o estudo. Eles foram diagnosticados com depressão maior de acordo com os critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais, 4ª edição (DSM-IV), identificados utilizando-se o instrumento Schedule for Affective Disorders and Schizophrenia for School Aged Children: Present and Lifetime Version (K-SADS-PL). Os sintomas depressivos foram avaliados pelo questionário Children's Depression Rating Scale - Revised (CDRS-R) e por avaliações clínicas. A atividade motora foi monitorada por um período de 13 semanas consecutivas e registrada a cada 10 minutos utilizando-se monitores de atividades usados no pulso. Todos os pacientes utilizaram o antidepressivo sertralina começando após a primeira semana até o final do estudo. Resultados: Foi observada uma relação entre escores altos no CDRS-R e valores baixos de potência espectral de 24 horas no ritmo de atividade e repouso. Conclusão: A potência espectral de 24 horas do ritmo de atividade e repouso apresentou uma correlação significativa (negativa) com os sintomas clínicos de depressão.

Cronobiología del sistema inmune / Immune system chronobiology

La cronobiología es la disciplina que ha estudiado la organización temporal de los procesos que ocurren en los seres vivos, los mecanismos que las originan y sus alteraciones. En 1832, Agustín de Candolle demostró que bajo condiciones constantes el período de los ciclos de movimientos de las plantas duraba unas 24 horas, con lo que añadió una evidencia de la naturaleza endógena de los ritmos biológicos. En los mamíferos, se ha estimado que aproximadamente el 10 por ciento del genoma está bajo un control circadiano. Desde la década de los años 70´s se observó que la respuesta inmune dependía de la hora del día en la cual se analizaba y que la susceptibilidad a las infecciones dependía también de la hora en la cual el organismo fuera infectado. Recientemente se ha establecido una relación entre el ciclo circadiano y la respuesta inmune. Este trabajo trata las ventajas del conocimiento del ritmo circadiana de los mecanismos inmunitarios y la importancia del uso de la cronoterapia sobre los osciladores de las células del sistema inmune en los trastornos inmunitarios, lo cual pudiera evitar complicaciones en los pacientes(AU)

Chronobiology is the science that studies temporary organization of the processes that happen in organisms, the mechanisms that originate them and its disorders. Austin of Candolle demonstrated that under constant conditions the period of the cycles of the plants' movements it lasted some 24 hour, adding an evidence of the endogenous nature of the biological rhythms in 1832. In mammals, has been considered approximately 10 percent of genome under circadian control. Since decade of 70´s, was observed that immune response depends of day´s hours in which it was analyzed, and the susceptibility to infections also depends of the hour in which an organism is infected. It has begun to establish relationship between circadian cycle and immune response recently. This work intends to give us the advantages of the knowledge of circadian rhythms of immune mechanisms and the importance of the chronotherapy´s use on the oscillators of the immune system´s cells in immunity dysfunctions and it would avoid complications in the patients(AU)

Avaliação do reparo ósseo na interface osso/implante em ratos pinealectomizados: análise histológica, imunoistoquimica, histométrica, biomecânica e por microct / Bone repair evaluation in bone/implant interface in pinealectomized rats: histological, immunohistochemistry, histometric, biomechanics and microCT analysis

O presente estudo teve como objetivo investigar a interface osso / implante em ratos pinealectomizados tratados com melatonina. Métodos: 30 ratos, machos, adultos foram divididos em 3 grupos: controle (CO), pinealectomizados (PnX) e pinealectomizado com melatonina (PNXm). Após 30 dias da Pinealectomia, um implante foi instalado em cada tíbia e a eutanásia foi realizada aos 42 dias. As amostras foram submetidas a histomorfométrica (ELCOI e AON), biomecânica (de torque reverso), microtomografia e análise imunoistoquímica. Os dados quantitativos foram submetidos à análise estatística (P <0,05). Para os resultados histométricos, valores ELCOI para PNX foram menores quando comparados com PNXm (P = 0,0393), enquanto AON não mostrou diferença entre os grupos (P = 0,761). Os valores de torque reverso não mostraram diferença entre os grupos PNX e PNXm (P = 0,5000), e as interações CO vs PNXm, e CO vs PNX mostraram diferença significativa (P <0,05). Os parâmetros volumétricas BV/TV (P = 0,933); Tr.N (P = 0,933); Tb.Th (P = 0,933), Tb.Sp (P = 0,200) não apresentaram diferença estatística. A imunomarcação para OPG, RANKL, TRAP e osteocalcina mostrou similaridade entre os grupos, apesar da PNXm parece assemelhar-se às condições fisiológicas (CO). Portanto, a melatonina melhorou a remodelação óssea na região peri-implante em ratos pinealectomizados.

This study aimed to investigate the interface bone/implant in pinealectomized rats treated with melatonin. 30 rats, male, adults were divided into 3 groups: control (CO), pinealectomized (PNX) and pinealectomized with melatonin (PNXm). After 30 days of the pinealectomy, one implant was installed on each tibia and euthanasia was performed at 42 days. The samples were submitted to histometric (BIC and NB), biomechanical (reverse torque), microtomography and immunohistochemical analysis. The quantitative data were subjected to statistical analysis (P<0.05). For the histometric results, BIC values to PNX were lower when compared to PNXm (P=0.0393), whereas NB did not showed difference among the groups (P=0.761). Reverse torque did not show difference between the groups PNX and PNXm (P=0,5000), and the interactions CO vs PNXm, and CO vs PNX showed significantly difference (P<0.05). The volumetric parameters BV/TV (P=0.933); Tr.N (P=0.933); Tb.Th (P=0.933), Tb.Sp (P=0.200) did not present statistical difference. The immunolabeling for OPG, RANKL, TRAP and osteocalcin showed similarity among the groups, despite the PNXm it seems to resemble to physiological conditions (CO). Therefore, melatonin improved the bone turnover in peri-implant region in pinealectomized rats.

Circadian Rhythm of Hospital Death: Difference Between the Intensive Care Unit and General Room

BACKGROUND AND OBJECTIVES: The purpose was to record the time at which biological phenomena stop in different hospital wards and determine regular patterns in times of death, as well as any associated factors. SUBJECTS AND METHODS: A total of 6,517 inpatients at the Keimyung University Dongsan Medical Center who died between January 2006 and December 2012 were retrospectively enrolled. A comparative analysis was conducted for the mortality distribution between the intensive care unit (ICU) and general wards (GW). RESULTS: A total of 3,198 (49%) died in the ICU and 3,319 (51%) in the GW. The ICU showed an increase in mortality over the most recent 3 years. There was no difference in monthly or daily pattern. ICU mortality peaked at 14:00 to 16:00 hours (9.2%) and 20:00 to 22:00 hours (9.1%), and GW mortality peaked at 06:00 to 08:00 hours (9.6%) and 10:00 to 12:00 hours (9.4%), with a significant statistical difference between the two wards (p=0.03). Patients with diseases of the circulatory system died most often in the ICU (28.3%), whereas those with neoplasms had the highest mortality rate in the GW (77.7%) (p<0.01). CONCLUSIONS: Some differences between the ICU and GW may be accounted for by a preserved circadian rhythm that was affected by disease distribution, hospital room environment, and use of various drugs.

Suicidal ideation and chronotype assessment in nurses and police officers / Ideação suicida e avaliação de cronotipo em enfermeiras e policiais militares

BACKGROUND: Nurses and police officers are professionals that work in shifts and have jobs that require attention and responsibility. They work under conditions that can cause stress, anxiety and changes in sleep patterns. OBJECTIVE: This study aims to identify symptoms of anxiety and depression, chronotype and the presence of suicidal ideations in nurses and police officers in the city of Arapiraca/Alagoas, Brazil. METHODS: This is a descriptive and quantitative study. The interviews were conducted using (i) identification records and general data, (ii) the Beck Anxiety Inventory, (iii) the Center for Epidemiologic Studies Depression Scale and (iv) the Horne-Östberg Questionnaire. RESULTS: Fifty-three nurses and 111 police officers participated in the research. Nurses and police officers exhibited indifferent to moderate matutinal chronotypes. Most of the nurses and police officers reported minimal to light levels of anxiety. Nurses and police officers presented elevated risk for depression. Five nurses and six police officers had considered attempting suicide at the time of the research. There were no significant differences between the study groups with respect to anxiety and depression symptoms, chronotype and suicidal ideations. CONCLUSION: The nurses and police officers examined presented high risk for symptoms of anxiety and depression; a considerable number of nurses and officers had lifetime suicidal ideations. Implementation of preventive measures is necessary for the early diagnosis of anxiety and depressive disorders in order to prevent complications, including possible suicide.

INTRODUÇÃO: Enfermeiros e policiais militares são profissionais que trabalham em turnos e têm empregos que exigem atenção e responsabilidade. Eles trabalham sob condições que podem causar estresse, ansiedade e mudanças nos padrões de sono. OBJETIVO: Este estudo visa identificar sintomas de ansiedade e depressão, cronotipo e a presença de ideação suicida em enfermeiros e policiais militares de Arapiraca/Alagoas, Brasil. MÉTODO: Este é um estudo descritivo e quantitativo. As entrevistas foram realizadas usando registros de Identificação e Dados Gerais, o Inventário de Ansiedade de Beck, a Escala de Depressão do Centro de Estudos Epidemiológicos e o questionário cronotipo de Horne-Ostberg. RESULTADOS: Cinquenta e três enfermeiras e 111 policiais militares participaram do estudo. Militares e enfermeiras apresentaram cronotipo matutino indiferente e moderado. A maioria das enfermeiras e militares relatou níveis mínimos e leve de ansiedade. As enfermeiras e os policiais militares apresentaram um risco elevado para depressão. Cinco enfermeiras e seis policiais militares pensaram em tantar suicídio até o momento da pesquisa. Não houve diferenças significativas (p > 0,05) entre os grupos de estudo com relação aos sintomas de ansiedade e depressão, cronotipo e ideação suicida. CONCLUSÃO: As enfermeiras e policiais militares estudados apresentaram um alto risco de sintomas de ansiedade e depressão. Um número considerável de enfermeiras e policiais militares tiveram ideação suicida ao longo da vida. A implementação de medidas de prevenção é necessária para o diagnóstico precoce de ansiedade e transtornos depressivos para evitar complicações, dentre estas, o suicídio.