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1.
Rev. bras. neurol ; 57(4): 23-30, out.-dez. 2021. ilus
Article in English | LILACS-Express | LILACS | ID: biblio-1359223

ABSTRACT

There is a close association between sleep and epilepsy, and this literature review aims to raise issues regarding sleep time control, circadian and ultradian rhythms, epilepsy and its interaction with sleep and circadian rhythm, epilepsy and sleep disorders, and finally epilepsy management and medications. It is mentioned that sleep may provide a hypersynchronous state, as occurs in non-rapid eye movement sleep (NREM), and hyperexcitability, in cyclic alternating pattern (CAP), allowing more frequent interictal epileptiform abnormalities and seizures. In some epilepsy syndromes, seizures occur broadly / or entirely during sleep or on awakening, mainly in childhood, and maybe exacerbated in adults during the sleep or sleep-deprived, and there are the so-called Sleep-related epilepsies that are divided as sleep-associated, sleep-accentuated and arousal/awakening related. Sleep quality may be reduced in patients with epilepsy also due to nocturnal seizures or concomitant sleep disorders. Sleep disorders are common in patients with epilepsy and treatment of them mainly sleep-disordered breathing may improve seizure control. Besides, some parasomnias may mimic seizures, and also they can adversely affect the quality and quantity of sleep whereas antiepileptic therapy can have a negative or positive effect on sleep. Nocturnal epileptic seizures may be challenging to discern from parasomnias, in particular NREM parasomnias such as night terrors, sleepwalking and confusional arousals.


Há uma estreita associação entre sono e epilepsia, e esta revisão de literatura tem como objetivo levantar questões relacionadas ao controle do tempo do sono, ritmos circadianos e ultradianos, epilepsia e sua interação com sono e ritmo circadiano, epilepsia e transtornos do sono e, finalmente, o tratamento e medicamentos para epilepsia. Menciona-se que o sono pode proporcionar um estado hipersincrônico, como ocorre no sono "non-rapid eye movement" (NREM), e hiperexcitabilidade, no "cyclic alternating pattern" (CAP), permitindo anormalidades epileptiformes interictais e crises epilépticas mais frequentes. Em algumas síndromes epilépticas, as crises ocorrem ampla / ou inteiramente durante o sono ou despertar, principalmente na infância, e podem ser exacerbadas em adultos durante o sono ou privação de sono, e as chamadas epilepsias relacionadas ao sono se dividem em sono associadas, sono acentuadas e relacionadas com o despertar. A qualidade do sono pode ser reduzida em pacientes com epilepsia também devido a crises epilépticas noturnas ou transtornos do sono concomitantes. Esses são comuns em pacientes com epilepsia e o seu tratamento, principalmente dos transtornos respiratórios do sono, pode melhorar o controle das crises epilépticas. Além disso, algumas parassonias podem mimetizar crises epilépticas, e também elas podem afetar adversamente a qualidade e a quantidade do sono, enquanto a terapia antiepiléptica pode ter um efeito negativo ou positivo sobre o sono. Pode ser difícil discernir as crises epilépticas noturnas das parassonias, em particular das parassonias NREM, como terrores noturnos, crises de sonambulismo e despertares confusionais.


Subject(s)
Humans , Child , Adult , Sleep Deprivation , Sleep Wake Disorders/etiology , Epilepsy/complications , Epilepsy/diagnosis , Seizures/etiology , Sleep Wake Disorders/complications , Circadian Rhythm , Epilepsy/drug therapy
3.
Ciênc. Saúde Colet ; 26(8): 2997-3004, ago. 2021. tab, graf
Article in English | LILACS | ID: biblio-1285971

ABSTRACT

Abstract Blood pressure measurements taken in a clinical setting are subject to errors, therefore there are advantages to monitoring blood pressure at home, especially in in patients diagnosed with hypertension. The study describes the feasibility of home monitoring to assess blood pressure in primary care and compares blood pressure measured at home and during a medical consultation. This cross-sectional study was carried out with patients whose used home blood pressure in the morning and evening, thrice for seven consecutive day sat home. Participants included patients older than 18 years with suspected whitecoat hypertension, taking antihypertensives, or those intolerant of ambulatory blood pressure monitoring, and excluded patients who did not follow the protocol, suffered from an irregular heart rate, and pregnant women. Of the 134 patients who participated in the study, 63.3% had altered blood pressure when measured at health facilities and 48% had higher blood pressure at home. The mean difference between the methods was 10.1 mmHg for systolic and 4.3 mmHg for diastolic. The prevalence of whitecoat hypertension was 19.4%. Blood pressure monitoring at home is a practicable strategy in the Brazilian healthcare system.


Resumo A medição da pressão arterial no consultório está sujeita a erros; assim, a monitorização residencial da pressão arterial é utilizada para o monitoramento e diagnóstico da hipertensão. Descrever a viabilidade da monitorização residencial para avaliar a pressão arterial na atenção primária e comparar os valores da pressão arterial através da monitorização residencial e medida de consultório. Estudo transversal realizado com pacientes que utilizaram a monitorização residencial pela manhã e pela noite, em triplicata por sete dias consecutivos em domicílio. Foram incluídos pacientes maiores de 18 anos, com suspeita de hipertensão do avental branco, utilizando anti-hipertensivos ou intolerantes a monitorização ambulatorial. Foram excluídos pacientes que não seguiram o protocolo, aqueles que apresentavam ritmo cardíaco irregular ou mulheres grávidas. 134 pacientes participaram do estudo, 63,3% apresentaram pressão arterial alteradas em consultório e 48% pela monitorização residencial. A diferença média dos métodos foi de 10,1 mmHg para sistólica e 4,3 mmHg para diastólica. A prevalência de hipertensão do avental branco foi 19,4%. A monitorização residencial da pressão arterial no sistema de saúde brasileiro provou ser uma estratégia viável.


Subject(s)
Humans , Female , Pregnancy , Blood Pressure Monitoring, Ambulatory , Hypertension/diagnosis , Hypertension/epidemiology , Primary Health Care , Blood Pressure , Feasibility Studies , Cross-Sectional Studies , Circadian Rhythm
4.
Rev. cienc. salud ; 19(2): 39-54, mayo-ago. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1347309

ABSTRACT

Resumen Introducción: alteraciones en el cronotipo y la calidad del sueño se han asociado con la desincronización del reloj circadiano, estudiadas como posible causa de la aparición de enfermedades crónicas. El objetivo fue identificar la asociación entre indicadores antropométricos, porcentaje de grasa corporal y consumo alimentario con el turno laboral, cronotipo y calidad del sueño en el personal de salud de un hospital de segundo nivel de atención. Materiales y métodos: se tomaron medidas antropométricas para determinar el índice de masa corporal y el porcentaje de grasa corporal total. Se aplicó el Cuestionario de Cronotipo de Munich y el Índice de Calidad del Sueño de Pittsburg. Resultados: participaron 60 trabajadores, y el cronotipo nocturno fue el predominante (53 %). El 80 % de los participantes tiene una moderada calidad del sueño. Un 55 % de los participantes tenía sobrepeso y obesidad, y solo el 8.3 % presentaba un porcen taje de grasa corporal normal. En el turno nocturno destacó la mala calidad de dormición (p = 0.03) y adaptación de los cronotipos vespertino y nocturno (p = 0.03). Los participantes de cronotipo vespertino mostraron los mayores valores de peso corporal (p = 0.04). La calidad del sueño no mostró asociación sig nificativa con los cambios en el peso o el porcentaje de grasa corporal. Discusión: los ritmos circadianos alterados incrementan el riesgo de obesidad y otros problemas de salud. Se observa una adaptación del cronotipo al turno en que laboran, moderada calidad del sueño y hábitos de alimentación inadecuada, considerados sincronizadores de los ciclos circadianos, ubicándolos como factores para evitar enferme dades futuras.


Abstract Introduction: Chronotype and sleep-quality changes have been associated with the desynchronization of the circadian clock, which has been studied as the possible cause of the appearance of chronic dis eases, such as obesity. The objective of the present study was to identify the association between anthro pometric indicators, such as body fat percentage and food consumption, in sync with the work shift, chronotype, and sleep quality of the health personnels of a hospital providing secondary level of care. Materials and methods: Anthropometric measurements (i.e., weight, height, waist circumference, and skinfolds) were recorded to determine the body mass index and total body fat percentage using the Munich Chronotype Questionnaire and Pittsburg Sleep Quality Index. Results: A total of 60 workers participated in the survey, who predominantly recorded night chronotype (53%), 80% of the participants had a moderate quality of sleep, 55% were overweight and obese, and only 8.3% presented with normal body fat. In the night shift, poor sleep quality (p = 0.03) and adaptation to the evening and night chronotypes (p = 0.03) were prominent. Evening-chronotype participants showed the highest body weight values (p = 0.04). Sleep quality showed no significant association with the weight or body fat percentage changes. Discussion: Altered circadian rhythms increase the risk of obesity and other health issues. There was an adaptation of the chronotype to the shift in which the patients worked, moderate quality of sleep, and inappropriate eating habits, which are consid ered as the synchronizers of the circadian cycles, placing them as factors to be taken into account to avoid future diseases.


Resumo Introdução: Alterações no cronótipo e na qualidade do sono têm sido associadas à dessincronização do relógio circadiano; estudada como possível causa do aparecimento de doenças crônicas como a obesi dade. O objetivo foi identificar a associação entre os indicadores antropométricos, percentual de gordura corporal e consumo alimentar com o turno de trabalho, cronótipo e qualidade do sono de profissionais de saúde de um Hospital de segundo nível de atenção. Materiais e métodos: As medidas antropométricas (peso, altura, circunferência da cintura e dobras cutâneas) foram realizadas para determinar o IMC e o percentual de gordura corporal total. Foram aplicados o questionário de cronótipo de Munich e o índice de qualidade de sono de Pittsburg. Resultados: Participaram 60 trabalhadores, sendo o cronótipo noturno o predominante (53%). 80% dos participantes têm uma qualidade de sono moderada. 55% dos participantes estavam com sobrepeso e obesidade e apenas 8,3% tinham um percentual de gordura corporal normal. No plantão noturno, destacaram-se a má qualidade do sono (p = 0.03) e a adaptação dos cronótipos vespertino e noturno (p = 0.03). Os participantes do cronótipo vespertino apresentaram os maiores valores de peso corporal (p = 0.04). A qualidade do sono não mostrou associação significativa com mudanças no peso ou percentual de gordura corporal. Discussão: Ritmos circadianos alterados aumentam o risco de obesidade e outros problemas de saúde. Observa-se uma adaptação do cronótipo ao turno em que trabalham, qualidade de sono moderada e hábitos alimentares inadequados, conside rados sincronizadores dos ciclos circadianos, colocando-os como fatores a serem levados em considera ção para evitar doenças futuras.


Subject(s)
Humans , Male , Female , Body Mass Index , Circadian Rhythm , Body Composition/physiology
5.
Arq. bras. cardiol ; 116(2): 295-302, fev. 2021. tab
Article in Portuguese | LILACS | ID: biblio-1152994

ABSTRACT

Resumo Fundamento O padrão pressórico não-dipper é definido por uma redução inferior a 10% na pressão arterial noturna e está associado a doenças cardiovasculares. Acredita-se que a inflamação desempenhe um papel na patogênese da doença pulmonar obstrutiva crônica (DPOC) e no padrão pressórico não-dipper e ambas as doenças estão associadas a uma qualidade de vida mais baixa. Objetivo O objetivo deste estudo foi o de investigar os efeitos do padrão pressórico não-dipper em pacientes com DPOC. Métodos Foi realizado um estudo transversal incluindo 142 pacientes com DPOC. O Questionário Respiratório de Saint George e a Escala de Qualidade de Vida Euro foram utilizados para a coleta de dados. Para entender a rigidez arterial, o índice de aumento e a velocidade da onda de pulso foram medidos; subsequentemente, foi realizada a monitorização ambulatorial da pressão arterial de 24 horas. Foi aplicado um modelo de regressão logística multivariável para entender a relação entre as diferentes variáveis independentes e o padrão pressórico. Foram considerados estatisticamente significativos valores de p inferiores a 0,05. Resultados Como resultado, 76,1% (n = 108) dos pacientes apresentaram o padrão pressórico não-dipper. Os pacientes com padrão não-dipper apresentaram valores mais altos de proteína C reativa (OR: 1,123; IC 95%: 1,016;1,242), índice de aumento (OR: 1,057; IC 95%: 1,011;1,105) e pontuação total no Questionário Respiratório de Saint George (OR: 1,021; IC 95%: 1,001;1,042), em comparação com os pacientes com padrão dipper. Adicionalmente, com o aumento do número de pessoas que habitavam o domicílio, verificou-se que o padrão pressórico não-dipper era mais frequente (OR: 1,339; IC 95%:1,009;1,777). Conclusão O padrão pressórico não-dipper pode aumentar o risco cardiovascular ao desencadear a inflamação e pode afetar adversamente o prognóstico da DPOC diminuindo a qualidade de vida relacionada à doença. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)


Abstract Background Non-dipper blood pressure is defined by less than a 10% reduction in nighttime blood pressure, and it is associated with cardiovascular disease. Inflammation is thought to play a role in the pathogenesis of both chronic obstructive pulmonary disease (COPD) and non-dipper blood pressure pattern, and both diseases are associated with lower quality of life. Objective The aim of this study was to investigate the effects of non-dipper blood pressure pattern in patients with COPD. Methods A cross-sectional study was carried out with 142 patients with COPD. The Saint George Respiratory Questionnaire and the Euro Quality of Life Scale were used to collect data. To understand arterial stiffness, the augmentation index and pulse wave velocity were measured, and 24-hour ambulatory blood pressure monitoring was subsequently performed. A multivariable logistic regression model was used to understand the relationship between different independent variables and blood pressure pattern. P values lower than 0.05 were considered statistically significant. Results As a result, 76.1% (n = 108) of the patients had non-dipper blood pressure pattern. Non-dipper patients had higher C-reactive protein (OR:1.123; 95% CI:1.016;1.242), augmentation index (OR: 1.057; 95% CI: 1.011;1.105) and Saint George Respiratory Questionnaire total score (OR: 1.021; 95% CI: 1.001;1.042) than dipper patients. Also, as the number of people living at home increased, non-dipper blood pressure pattern was found to be more frequent (OR: 1.339; 95% CI: 1.009;1.777). Conclusion Non-dipper blood pressure pattern may increase cardiovascular risk by triggering inflammation and may adversely affect the prognosis of COPD by lowering the disease-related quality of life. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)


Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive , Hypertension , Quality of Life , Blood Pressure , Cross-Sectional Studies , Circadian Rhythm , Blood Pressure Monitoring, Ambulatory , Pulse Wave Analysis
6.
Article in English | WPRIM | ID: wpr-922197

ABSTRACT

BACKGROUND@#Exposure to the ionizing radiation (IR) encountered outside the magnetic field of the Earth poses a persistent threat to the reproductive functions of astronauts. The potential effects of space IR on the circadian rhythms of male reproductive functions have not been well characterized so far.@*METHODS@#Here, we investigated the circadian effects of IR exposure (3 Gy X-rays) on reproductive functional markers in mouse testicular tissue and epididymis at regular intervals over a 24-h day. For each animal, epididymis was tested for sperm motility, and the testis tissue was used for daily sperm production (DSP), testosterone levels, and activities of testicular enzymes (glucose-6-phosphate dehydrogenase (G6PDH), sorbitol dehydrogenase (SDH), lactic dehydrogenase (LDH), and acid phosphatase (ACP)), and the clock genes mRNA expression such as Clock, Bmal1, Ror-α, Ror-β, or Ror-γ.@*RESULTS@#Mice exposed to IR exhibited a disruption in circadian rhythms of reproductive markers, as indicated by decreased sperm motility, increased daily sperm production (DSP), and reduced activities of testis enzymes such as G6PDH, SDH, LDH, and ACP. Moreover, IR exposure also decreased mRNA expression of five clock genes (Clock, Bmal1, Ror-α, Ror-β, or Ror-γ) in testis, with alteration in the rhythm parameters.@*CONCLUSION@#These findings suggested potential health effects of IR exposure on reproductive functions of male astronauts, in terms of both the daily overall level as well as the circadian rhythmicity.


Subject(s)
ARNTL Transcription Factors/genetics , Acid Phosphatase , Animals , CLOCK Proteins/genetics , Circadian Rhythm/radiation effects , Epididymis/radiation effects , Gene Expression/radiation effects , Genitalia, Male/radiation effects , Glucosephosphate Dehydrogenase , L-Iditol 2-Dehydrogenase , L-Lactate Dehydrogenase , Male , Mice , Mice, Inbred C57BL , Models, Animal , Nuclear Receptor Subfamily 1, Group F, Member 1/genetics , Nuclear Receptor Subfamily 1, Group F, Member 2/genetics , Nuclear Receptor Subfamily 1, Group F, Member 3/genetics , RNA, Messenger/genetics , Radiation Exposure , Radiation, Ionizing , Reproductive Physiological Phenomena/radiation effects , Sperm Motility/radiation effects , Spermatozoa/radiation effects , Testis/radiation effects
7.
Article in Chinese | WPRIM | ID: wpr-922038

ABSTRACT

Smith-Magenis syndrome (SMS) (OMIM #182290) is a rare genetic disorder with a prevalence of 1 in 25 000 live births. Approximately 90% of SMS patients have harbored a 3.7 Mb interstitial 17p11.2 deletion involving the RAI1 gene, while 10% of cases have carried pathogenic variants of the RAI1 gene. SMS is characterized by sleep disturbance, intellectual impairment, developmental delay, craniofacial and cardiovascular anomalies, obesity, self injury, aggressive and autistic-like behaviors. Most SMS patients have sleep disorders such as short total sleep time, frequent night waking, short sleep onset, and early morning waking. The sleep disturbance may aggravate with age and persist throughout life. Three mechanisms have been delineated. The first concern was the abnormal secretion of melatonin, with high levels during daytime and low levels at night. Evaluation of the integrity of the intrinsically photosensitive retinal ganglion cell (ipRGC)/melanopsin system has found that SMS patients showed dysfunction in the sustained component of the pupillary light responses to blue light. Synchronization of daily melatonin profile and its photoinhibition are dependent on the activation of melanopsin. Dysfunction of the retina-melanin system may be one of the causes of melatonin spectrum disorders. Secondly, dysregulation of circadian rhythm gene expression has also been noted in mice and SMS patients. Finally, there may be association between sleep deprivation symptoms and DNA methylation patterns, which has provided new insights for SMS-associated sleep disorders and symptoms alike. Treatment for SMS-related sleep disorders is administered primarily through medications like melatonin tablets, which can alleviate insomnia-related sleep difficulties, in particular externalizing behavior in children. Researchers are also actively exploring other treatments for SMS currently.


Subject(s)
Animals , Circadian Rhythm , Humans , Melatonin , Mice , Sleep , Sleep Wake Disorders/genetics , Smith-Magenis Syndrome/genetics
8.
Acta Physiologica Sinica ; (6): 734-744, 2021.
Article in Chinese | WPRIM | ID: wpr-921276

ABSTRACT

Circadian clock is an internal autonomous time-keeping system, including central clocks located in the suprachiasmatic nucleus (SCN) and peripheral clocks. The molecular circadian clock consists of a set of interlocking transcriptional-translational feedback loops that take the clock-controlled genes 24 h to oscillate. The core mechanism of molecular circadian clock is that CLOCK/BMAL1 dimer activates the transcription of cryptochromes (CRYs) and Periods (PERs), which act as transcriptional repressors of further CLOCK/BMAL1-mediated transcription. In addition to this basic clock, there is an additional sub-loop of REV-ERBα and RORα regulating the transcription of BMAL1. Approximately 80% protein-coding genes demonstrate significant rhythmicity. The earth rotation is responsible for the generation of the daily circadian rhythms. To coordinate metabolic balance and energy availability, almost all organisms adapt to the rhythm. Studies have shown that circadian clock integrating with metabolic homeostasis increases the efficiency of energy usage and coordinates with different organs in order to adapt to internal physiology and external environment soon. As the central organ of metabolism, the liver performs various physiological activities nearly all controlled by the circadian clock. There are multiple interactive regulation mechanisms between the circadian clock and the regulation of liver metabolism. The misalignment of metabolism with tissue circadian is identified as a high-risk factor of metabolic diseases. This article reviews the recent studies on circadian physiological regulation of liver glucose, lipid and protein metabolism and emphasizes oscillation of mitochondrial function. We also take an outlook for new methods and application of circadian clock research in the future.


Subject(s)
CLOCK Proteins , Circadian Clocks/genetics , Circadian Rhythm , Liver , Suprachiasmatic Nucleus
9.
Article in Chinese | WPRIM | ID: wpr-887973

ABSTRACT

Circadian rhythm disorder is a common society issue caused by jet lag,shift work,sleep disruption and changes in food consumption. Light is the major factor affecting the circadian rhythm system. Disruption of the circadian rhythm system can cause damage to the body,leading to some diseases. Maintaining a normal circadian system is of great importance for good health. Ideal therapeutic effect can not only alleviate symptoms of the diseases,but also recovery the disturbed circadian rhythm to normal. The paper summarizes the modeling methods of animal circadian rhythm disorder,diseases of circadian rhythm abnormality,regulation of circadian clock genes and medicine which are related to circadian rhythm to diseases of circadian rhythm disorder.


Subject(s)
Animals , Circadian Rhythm/genetics , Humans , Jet Lag Syndrome/genetics , Sleep , Sleep Disorders, Circadian Rhythm
10.
Chinese Medical Journal ; (24): 539-545, 2021.
Article in English | WPRIM | ID: wpr-878022

ABSTRACT

BACKGROUND@#The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels. The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion, possibly due to the circadian rhythm in urinary excretion. This study aimed to explore the circadian rhythm, characteristics, and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.@*METHODS@#Eighty-five participants (mean age 32.4 years) completed the 24-h urine collection by successively collecting each of the single-voided specimens within 24 h. The concentrations of the urinary sodium, potassium, and creatinine for each voided specimen were measured. Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium, potassium, and creatinine excretion. The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.@*RESULTS@#The metabolism of urinary sodium, potassium, and creatinine showed different patterns of circadian rhythm, although the urinary sodium excretion showed non-significant parameters in the cosinor model. A significant circadian rhythm of urinary creatinine excretion was observed, while the circadian rhythm of sodium was less significant than that of potassium. The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent, which had a nocturnal peak and fell to the lowest around noon to afternoon. In contrast, the peak of potassium was observed in the morning and dropped to the lowest point in the evening. The hourly urinary excretion followed a similar circadian rhythm.@*CONCLUSION@#It is necessary to consider the circadian rhythm of urinary sodium, potassium, and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.


Subject(s)
Adult , China , Circadian Rhythm , Creatinine , Humans , Potassium , Sodium , Urine Specimen Collection , Young Adult
11.
Article in Chinese | WPRIM | ID: wpr-880839

ABSTRACT

OBJECTIVE@#To evaluate the effect of general anesthesia on postoperative melatonin secretion in 4-to 6-year-old children with snoring.@*METHODS@#Twenty children with snoring aged 4-6 years of either gender (ASA grade Ⅰ and Ⅱ) were selected for adenoidectomy.Before, during and 3 days after the operation, salivary melatonin levels of the children were measured at 11 selected time points (T1-T11).The illumination intensity and body temperature of the children were recorded at each time point of measurement.The sleep time of the children in 3 days after the operation was recorded, and postoperative pain scores (FLACC) and Riker and Rehabilitation Quality Rating Scale-15(QoR-15) scores were assessed.Sleep Apnea Life Quality Evaluation Questionnaire (OSA-18) was used to evaluate postoperative recovery of the children at 28 days after the operation.The incidence of major adverse events of the children during hospitalization was recorded.@*RESULTS@#No significant difference was found in baseline salivary melatonin level among the 20 children before the operation.Salivary melatonin level at 7 am after the operation (T8) was significantly lowered as compared with that before the surgery (T4)(@*CONCLUSIONS@#In preschool children with snoring, general anesthesia affects but does not inhibit melatonin secretion on the first night after surgery, and minor surgeries under general anesthesia in the morning do not cause significant changes in melatonin secretion to cause disturbance of the circadian rhythm in these children.


Subject(s)
Anesthesia, General/adverse effects , Bodily Secretions , Child , Child, Preschool , Circadian Rhythm , Humans , Melatonin , Snoring
12.
Braz. j. med. biol. res ; 54(6): e10722, 2021. graf
Article in English | LILACS | ID: biblio-1285669

ABSTRACT

Continuous industrial productivity and modern societies have resulted in excess artificial light. The altered circadian rhythm causes many diseases. During intrauterine life, the mother's maternal melatonin rhythm has a major role in influencing organ development. The aim of this study was to investigate the effect of maternal exposure to constant light on the structure and ultrastructure of neonatal skin. Twenty pregnant New Zealand rabbits were divided into two groups (n=10 each): control group (12-h light/dark) and constant light group (24-h light). Plasma maternal melatonin and corticosterone during pregnancy were determined. At the end of the experiment, the dorsal skin of the neonates of both groups was collected and prepared for histological, morphometric, and transmission electron microscopic study. Histological and morphometric results of skin of neonates from the constant light group revealed statistically significantly reduced epidermal thickness, decreased number of hair follicle, increased surface area of collagen, and decreased proliferating cell nuclear antigen (PCNA) positive cells. Ultrastructural examination showed wide intercellular spaces and disrupted desmosomal junctions in the epidermis. Earlier stages of hair follicles were also observed with indented shrunken nuclei, vacuolization, and swollen mitochondria. Dermal fibroblasts with dilated cisternae of rough endoplasmic reticulum containing electron-dense material were detected. Maternal melatonin was significantly reduced in the constant light group while maternal corticosterone showed no significant difference between groups. Therefore, normal maternal circadian rhythm is a key factor for the integrity of neonatal skin structure.


Subject(s)
Animals , Female , Pregnancy , Rabbits , Skin , Melatonin , Circadian Rhythm , Microscopy, Electron, Transmission , Epidermis
13.
Rev. bras. educ. méd ; 45(1): e031, 2021. tab, graf
Article in English | LILACS | ID: biblio-1155912

ABSTRACT

Abstract: Introduction: Excessive daytime sleepiness (EDS) is characterized by an increased likelihood of initiating sleep at inappropriate times through involuntary naps and it negatively impacts performance in studies, work, family, and social relationships and increases the risk of accidents. Objective: This study evaluated the schedule and prevalence of EDS and its associated factors in medical students (using the PBL method), comparing it with students from other health courses (using the Traditional method). Methods: A cross-sectional study was carried out with 1152 university students who were attending courses in the health area. The presence of EDS was defined when scores >10 in the Epworth Sleepiness Scale (ESS) and the chronotype was assessed by means of the Morningness-Eveningness Questionnaire (MEQ). Using Stata 13.0 software, descriptive statistics, bivariate and multivariate analyses were performed, including interactions to fit the model. Results: The prevalence of EDS was 56.5% (95% CI, 53.6-59.4), and the mean ESS score was 11.1 (95% CI, 10.8-11.3). This value was lower among those who had morning chronotypes and was higher among medical students. 10.3% (n=119) of the students had a chronotype that was incompatible with the period of the course. The associated and independent factors for EDS were: female gender (PR, 1.14, 95% CI, 1.01-1.29), age between 16 and 19 years (PR, 1.20, 95% CI, 1.04-1.39), studying late at night and using cell phones before falling asleep (PR, 1.56, 95% CI, 1.02-2.38), not doing weekly physical activity (PR, 1.13, 95% CI, 1.02-1.25), and morning chronotype (PR, 0.87, 95% CI, 0.76-0.99). Not using cell phones before bedtime reduced the prevalence of EDS by 14%. Conclusions: This study demonstrated that the morning chronotype behaved as an independent protective factor for disorders of the circadian cycle. Performing weekly physical activity reduces EDS among students with intermediate and evening chronotypes.


Resumo: Introdução: A sonolência diurna excessiva (SDE) é caracterizada por uma maior probabilidade de o indivíduo iniciar o sono em horários inadequados por meio de cochilos involuntários, afeta negativamente o desempenho nos estudos, no trabalho e nas relações familiares e sociais, e aumenta o risco de acidentes. Objetivo: Este estudo teve como objetivo avaliar o cronotipo e a prevalência de SDE e seus fatores associados em estudantes de Medicina (método PBL). Para tanto, compararam-se os discentes de Medicina com os de outros cursos da área da saúde (método tradicional). Métodos: Trata-se de estudo transversal com 1.152 estudantes universitários matriculados em cursos de graduação da área da saúde. Definiu-se a presença de SDE quando se observaram escores > 10 na Epworth Sleepiness Scale (ESE), e o cronótipo foi avaliado por meio do instrumento Morningness-eveningness Questionnaire (MEQ). Por meio do software Stata 13.0, realizaram-se estatística descritiva e análises bivariadas e multivariadas, além de interações para que o estudo pudesse se ajustar ao modelo. Resultados: A prevalência de SDE foi de 56,5% (IC 95%, 53,6-59,4), e a pontuação média na ESE foi de 11,1 (IC 95%, 10,8-11,3). Esse valor foi menor entre os que apresentaram cronotipo matutino e maior entre os estudantes de Medicina. Dos alunos que participaram do estudo, 10,3% (n = 119) apresentaram um cronotipo incompatível com o período do curso. Os fatores associados e independentes para a SDE foram: sexo feminino (RP, 1,14, IC 95%, 1,01-1,29), idade entre 16 e 19 anos (RP, 1,20, IC 95%, 1,04-1,39), hábito de estudar de madrugada, uso de celular antes de dormir (RP, 1,56, IC 95%, 1,02-2,38), não praticar atividade física semanal (RP, 1,13, IC 95%, 1,02-1,25) e cronótipo matutino (RP, 0,87, IC 95%, 0,76-0,99). Não usar telefones celulares antes de dormir reduziu a prevalência de SDE em 14%. Conclusões: Este estudo demonstrou que o cronotipo matutino se comportou como um fator protetor independente para distúrbios do ciclo circadiano. A prática de atividade física semanal reduziu a prevalência SDE entre universitários com cronotipos intermediário e noturno.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Students, Health Occupations/statistics & numerical data , Students, Medical/statistics & numerical data , Circadian Rhythm , Disorders of Excessive Somnolence/epidemiology , Brazil/epidemiology , Exercise , Prevalence , Cross-Sectional Studies , Sleep Disorders, Circadian Rhythm/epidemiology
14.
Rev. bras. neurol ; 56(2): 30-34, abr.-jun. 2020. ilus
Article in English | LILACS | ID: biblio-1102909

ABSTRACT

In times of social isolation, as it may occur due to the COVID-19 pandemic, there are problems such as those regarding lack of regular exercising, socializing outside the home, all that can lead to poor sleep quality. According to the circadian rhythm, behavioral and physiological processes occur at the ideal times of the day and in the correct time order. However, circadian rhythms misalignment, as can result in confinement situations, can result in inadequate times for sleeping. All these constraints may result in metabolic and cognitive-behavioral negative consequences, at least. Consequently, healthy sleep hygiene indoors is necessary to avoid risk factors for insomnia and physical/psychological disorders. Besides, stress should beavoided by reducing exposure to a large amount of information on COVID-19 and its related negative consequences. This paper raises issues about the circadian rhythms and their ideal alignment, besides insomnia risk factors related to the disrupted environment and personal characteristics. In the end, some tips are presented regarding sleep hygiene at social isolation time.


Em tempos de isolamento social, como pode ocorrer devido à pandemia do COVID-19, existem problemas como os relacionados à falta de exercícios regulares, socialização fora de casa, tudo isso pode levar à má qualidade do sono. De acordo com o ritmo circadiano, os processos comportamentais e fisiológicos ocorrem nos horários ideais do dia e na ordem correta do tempo. No entanto, o desalinhamento dos ritmos circadianos, como pode resultar em situações de confinamento, pode resultar em tempos aberrantes para dormir. Todas essas restrições podem resultar em conseqüências negativas metabólicas e cognitivo-comportamentais, pelo menos. Consequentemente, é necessária uma higiene saudável do sono em ambientes fechados para evitar fatores de risco para insônia e distúrbios distúrbios físicos/psicológicos. Além disso, o estresse deve ser evitado, ao reduzir a exposição à grande quantidade de informações sobre o COVID-19 e suas conseqüências negativas relacionadas. Este artigo levanta questões sobre os ritmos circadianos e seu ideal alinhamento, além de fatores de risco para insônia relacionados ao ambiente perturbado e às características pessoais. Ao final, são apresentadas algumas dicas sobre higiene do sono no momento do isolamento social.


Subject(s)
Humans , Female , Social Isolation/psychology , Circadian Rhythm , Sleep Hygiene , Stress, Psychological/psychology , Risk Factors , Coronavirus Infections/prevention & control , Pandemics , Sleep Initiation and Maintenance Disorders
15.
Arch. argent. pediatr ; 118(2): e143-e147, abr. 2020.
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1100319

ABSTRACT

El sueño es una función vital en la que transcurre un tercio de nuestras vidas. Su restricción puede provocar trastornos físicos y psíquicos a corto y largo plazo.La internación hospitalaria, sin tener en cuenta la enfermedad que la originó, no favorece un sueño reparador y suficiente. Los factores que interfieren son externos (luz, ruidos) e internos (procedimientos, fármacos, cuidados).La Unidad de Cuidados Intensivos es el lugar con mayor dificultad para la conciliación y el mantenimiento del sueño. Se suma la gravedad de la enfermedad y las características de su estructura y funcionamiento.El deterioro de la cantidad o calidad del sueño podría desencadenar un cuadro de confusión mental agudo que, con frecuencia, afecta a los niños internados, reconocido como delirium. Promover, en el medio institucional, un trabajo conjunto de todos los estamentos para proteger el sueño dentro de lo posible es una tarea por realizar.


Sleep is a key function that takes up one third of our lives. Sleep deprivation may lead to physical and psychological disorders in the short and long term.Hospitalization, regardless of its cause, does not favor good enough and restorative sleep. It is affected by both external (light, noise) and internal (procedures, drugs, care) factors.The intensive care unit is the place where falling asleep and maintaining sleep is more difficult. This is in addition to disease severity and the characteristics of its structure and functioning.A poor sleep quantity or quality may trigger an acute confusional state, which often affects hospitalized children, known as delirium. Promoting a joint effort among all sectors of the hospital setting targeted at protecting sleep as much as possible is the required task.


Subject(s)
Humans , Male , Female , Sleep , Sleep Wake Disorders , Child, Hospitalized , Circadian Rhythm , Environment
16.
Arq. bras. cardiol ; 114(4): 711-715, Abr. 2020. tab
Article in English, Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131197

ABSTRACT

Resumo Fundamento O acometimento do sistema nervoso autônomo é um dos mecanismos propostos para explicar a progressão da lesão miocárdica na doença de Chagas. Evidências indicam alterações do sistema nervoso simpático e parassimpático desde a fase aguda, e estudos são necessários para se entender os aspectos fisiopatológicos e o valor prognóstico dessas alterações. Objetivo Analisar o comportamento da pressão arterial pela monitorização ambulatorial da pressão arterial (MAPA) em pacientes normotensos com doença de Chagas aguda (DCA) sem envolvimento cardíaco aparente, e a influência da infecção no descenso fisiológico do sono. Métodos Foi realizado a MAPA em 54 pacientes com DCA e utilizado um grupo controle de 54 indivíduos normotensos, pareados para idade e sexo. O nível de significância adotado foi para um erro tipo I (alfa) de 5%. Resultados Em um total de 54 pacientes com DCA ocorreu ausência de descenso sistólico do sono em 74,0%*, ausência de descenso diastólico do sono em 53,7%*, e ausência de descenso sistólico e diastólico do sono (51,8%)*, (*p<0,05). Em 12,9% ocorreu ascensão sistólica da pressão no sono e em 18,5% ascensão diastólica (p<0,05). Conclusão Em pacientes com Doença de Chagas aguda, houve ausência significativa do descenso fisiológico da pressão arterial durante o sono, tanto da pressão arterial sistólica quanto a diastólica, e alguns pacientes apresentaram ascensão noturna desses parâmetros. Esses achados sugerem alterações autonômicas na doença de Chagas desde a fase aguda. (Arq Bras Cardiol. 2020; 114(4):711-715)


Abstract Background The involvement of the autonomic nervous system is one of the mechanisms proposed to explain the progression of myocardial lesion in Chagas disease. Evidences have shown changes in sympathetic and parasympathetic nervous system since the acute phase of the disease, and studies to clarify the pathophysiological and prognostic value of these changes are needed. Objetives To assess blood pressure profile by ambulatory blood pressure monitoring (ABPM) in normotensive patients with acute Chagas disease (ACD) without apparent cardiac damage, and the influence of the infection on nocturnal blood pressure fall. Methods ABPM was performed with 54 patients with ACD and a control group composed of 54 age- and sex-matched normotensive individuals. The alpha level of significance (type I error rate) was set at 5%. Results In the total of 54 patients, 74.0% did not show nocturnal fall in systolic blood pressure, 53.7% did not show nocturnal fall in diastolic blood pressure, and lack of both nocturnal fall in SBP and DBP was observed in 51.8% (*p<0.05). In 12.9% of patients, there was an increase in SBP and in 18.5% increase in DBP (p<0.05). Conclusions In patients with acute Chagas disease, a significant absence of the physiological fall in both systolic and diastolic blood pressure was observed during sleep, and some of the patients showed nocturnal increase in these parameters. These findings suggest autonomic changes in the acute phase of Chagas disease. (Arq Bras Cardiol. 2020; 114(4):711-715)


Subject(s)
Humans , Chagas Disease , Blood Pressure , Blood Pressure Determination , Circadian Rhythm , Blood Pressure Monitoring, Ambulatory , Hypertension
17.
Rev. bras. neurol ; 56(1): 11-18, jan.-mar. 2020. ilus, graf, tab
Article in English | LILACS | ID: biblio-1095930

ABSTRACT

The sleep-wake cycle that is circadian rhythm may have different patterns according to sex, environment and genetics determinants. This chronological cycle type, chronotype, may be populational expressed by the extremes, early or later going to bed and waking up, in a continuum. The first, the Morning-type individuals (the lark) and the later, the Evening types (the owl). Between the two extremes, there is the majority of these chronotypes ­ the intermediate ones. These patterns may be classified according to the questionnaires such as Horne and Ostberg Morningness/ Eveningness Questionnaire (MEQ) and the Munich Chrono Type Questionnaire (MCTQ). The rural population tends to be Morning-type, as well as children and younger women, more than men. The Morning person tends to be more healthy than the Evening ones who are more prone to diseases, as depression and metabolic syndrome. This basic knowledge may be helpful to patient's counseling and management: to avoid mismatch of circadian physiology and social duties / sleep. This circadian desynchrony can increase the risk of diseases, consequently there is a need to chrono-medicine into current treatment strategies.


O ciclo sono-vigília, que é um ritmo circadiano, pode ter padrões diferentes de acordo com os determinantes sexuais, ambientais e genéticos. Esse tipo de ciclo cronológico, cronótipo, pode ser expresso em termos populacionais pelos extremos, indo cedo ou mais tarde para a cama ou saindo dela, em um continuum. O primeiro, os indivíduos do tipo Manhã (a cotovia) e o posterior, os tipos da Tarde (a coruja). Entre os dois extremos, há a maioria desses cronotipos - os intermediários. Esses padrões podem ser classificados de acordo com questionários como o Horne e Ostberg Morningness/Eveningness Questionnaire (MEQ) e o Munich Chrono Type Questionnaire (MCTQ). A população rural tende a ser do tipo matutino, assim como crianças e mulheres mais jovens, mais que os homens.A pessoa da manhã tende a ser mais saudável do que as da noite, mais propensa a doenças, como depressão e síndrome metabólica. Esse conhecimento básico pode ser útil para o aconselhamento e tratamento dos pacientes: para evitar incompatibilidade entre a fisiologia circadiana e os deveres sociais / sono. Essa dessincronia circadiana pode aumentar o risco de doenças, consequentemente, é necessário a cronomedicina nas atuais estratégias de tratamento.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Sleep/physiology , Biological Clocks , Circadian Rhythm/physiology , Sleep Stages , Sex Factors , Surveys and Questionnaires , Actigraphy , Circadian Clocks/physiology
18.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 68-71, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1055368

ABSTRACT

Objective: Circadian dysregulation plays an important role in the etiology of mood disorders. Evening chronotype is frequent in these patients. However, prospective studies about the influence of chronotype on mood symptoms have reached unclear conclusions in patients with bipolar disorder (BD). The objective of this study was to investigate relationship between chronotype and prognostic factors for BD. Methods: At the baseline, 80 euthymic BD patients answered a demographic questionnaire and clinical scales to evaluate anxiety, functioning and chronotype. Circadian preference was measured using the Morningness-Eveningness Questionnaire, in which lower scores indicate eveningness. Mood episodes and hospitalizations were evaluated monthly for 18 months. Results: Among the BD patients, 14 (17.5%) were definitely morning type, 35 (43.8%), moderately morning, 27 (33.7%) intermediate (neither) and 4 (5%) moderately evening. Eveningness was associated with obesity or overweight (p = 0.03), greater anxiety (p = 0.002) and better functioning (p = 0.01), as well as with mood episodes (p = 0.04), but not with psychiatric hospitalizations (p = 0.82). This group tended toward depressive episodes (p = 0.06), but not (hypo)mania (p = 0.56). Conclusion: This study indicated that evening chronotype predicts a poor prognostic for BD. It reinforces the relevance of treating rhythm disruptions even during euthymia to improve patient quality of life and prevent mood episodes.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Anxiety/physiopathology , Bipolar Disorder/physiopathology , Circadian Rhythm/physiology , Prognosis , Psychiatric Status Rating Scales , Quality of Life , Time Factors , Logistic Models , Prospective Studies , Surveys and Questionnaires , Statistics, Nonparametric , Chronobiology Disorders/physiopathology , Hospitalization/statistics & numerical data , Middle Aged
19.
Arq. bras. cardiol ; 114(1): 109-117, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1055081

ABSTRACT

Abstract Background: Non-dipper blood pressure (NDBP) is one of the important causes of hypertension-related target organ damage and future cardiovascular events. Currently, there is no practical tool to predict NDBP pattern. Objectives: The aim of this study was to investigate the relationship between aortic arch calcification (AAC) on chest radiography and NDBP pattern. Methods: All patients referred for ambulatory BP monitoring test were approached for the study participation. NDBP was defined as the reduction of ≤10% in nighttime systolic BP as compared to the daytime values. AAC was evaluated with chest radiography and inter-observer agreement was analyzed by using kappa statistics. Univariate and multivariate logistic regression analysis was conducted to assess the association of AAC and NDBP pattern. A 2-tailed p-value < 0.05 was considered statistically significant. Results: A total of 406 patients (median age: 51.3) were included. Of these, 261(64%) had NDBP pattern. Overall, the prevalence of AAC was 230 (57%). Non-dipper group had significantly higher prevalence of AAC (70% vs. 33%, p < 0.0001) as compared to the dipper group. Presence of AAC was a strong and independent predictor of NDBP pattern (OR 3.919, 95%CI 2.39 to 6.42) in multivariate analysis. Conclusions: Presence of AAC on plain chest radiography is strongly and independently associated with the presence of NDBP pattern.


Resumo Fundamento: A pressão arterial não-dipper é uma das causas mais importantes de lesão de órgão-alvo da hipertensão e de eventos cardiovasculares futuros. Atualmente, não há uma ferramenta prática para prever o padrão não-dipper de pressão arterial. Objetivos: O objetivo deste estudo foi investigar a relação entre a calcificação no arco aórtico detectada no raio de tórax e o padrão não-dipper de pressão arterial. Métodos: Todos os pacientes encaminhados para monitorização ambulatorial da pressão arterial foram abordados para participação no estudo. A pressão arterial não-dipper foi definida como a redução de ≤10% da pressão arterial sistólica noturna quando comparada com os valores diários. A calcificação no arco aórtico foi avaliada através de radiografia do tórax e a concordância interobservador foi analisada utilizando a estatística kappa. Análises de regressão logística uni e multivariada foram realizadas para avaliar a associação entre a calcificação no AA e o padrão PADV. Valores de p bicaudais < 0,05 foram considerados estatisticamente significativos. Resultados: Ao todo, 406 pacientes (idade mediana: 51,3) foram incluídos. Desses, 261(64%) apresentavam padrão não-dipper de pressão arterial. De modo geral, a prevalência de calcificação no arco aórtico foi de 230 (57%). O grupo não-dipper apresentou prevalência significativamente maior de calcificação no arco aórtico (70% vs. 33%, p < 0,0001) em relação ao grupo dipper. A presença de calcificação no arco aórtico foi um preditor forte e independente de padrão não-dipper de pressão arterial (OR = 3,919; IC: 95% 2,39-6,42) em análise multivariada. Conclusões: A presença de calcificação no arco aórtico em raio-x de tórax simples está forte e independentemente associada à presença de padrão não-dipper de pressão arterial.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aortic Diseases/diagnostic imaging , Blood Pressure/physiology , Vascular Calcification/diagnostic imaging , Aortic Diseases/physiopathology , Severity of Illness Index , Radiography, Thoracic , Risk Factors , Circadian Rhythm , Blood Pressure Monitoring, Ambulatory , Vascular Calcification/physiopathology
20.
Rio de Janeiro; s.n; 2020. xv, 70 p. ilus.
Thesis in Portuguese | LILACS | ID: biblio-1128787

ABSTRACT

Envolvido na transmissão de diversos arbovírus, entre eles o vírus Zika, o Aedes aegypti é um vetor de grande importância médica. Os ritmos circadianos regulam diferentes comportamentos de insetos vetores que estão ligados a aspectos importantes da capacidade vetorial. O padrão de expressão dos principais genes de relógio que fazem parte do relógio circadiano central em mosquitos já foi descrito em cabeças de fêmeas. A partir desses dados, os efeitos de mudanças fisiológicas como a ingestão sanguínea e a infecção por arbovírus no comportamento do mosquito começaram a ser avaliados com relação a alterações naquele padrão de expressão. Ainda não se sabe como o relógio central e o relógio periférico se comunicam para estabelecer o comportamento do ritmo de oviposição, portanto, estudos da expressão dos genes de relógio nos ovários de mosquitos são necessários. Nesta dissertação, avaliamos o efeito da infecção pelo ZIKV em importantes aspectos da capacidade vetorial (fecundidade e fertilidade) e na expressão de genes do relógio. Vimos que a infecção pelo ZIKV não altera a fecundidade e fertilidade de ovos, mas a eficiência de postura de ovos cai no segundo ciclo gonotrófico.


Dos quatro genes de relógio analisados, tim, vri, cry2 e per, os três primeiros apresentaram arritmicidade tanto em ovários de fêmeas infectadas quanto na condição controle (sem infecção), diferente do perfil encontrado em cabeças do mosquito. O único gene que aparenta ter expressão cíclica comumente observada foi period, em ambas as condições. Observarmos que, independente do perfil rítmico ou arrítmico dos genes, a infecção pelo ZIKV parece não afetar o relógio periférico de fêmeas de Ae. aegypti, assim como a infecção não afeta os parâmetros fisiológicos analisados (fecundidade e fertilidade). Em conjunto, essas observações nos indicam que os genes de relógio não são modulados pela infecção pelo vírus Zika em ovários de Aedes aegypti. (AU)


Subject(s)
Animals , Circadian Rhythm , Aedes , Fertility , Zika Virus
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