Assessment of sleep quality in patients with orofacial pain and headache complaints: A polysomnographic study.

BACKGROUND: Sleep is a physiological function essential for survival, recovery, tissue repair, memory consolidation, and brain function. Pain is also an indispensable aspect of human life. The coexistence of sleep disorders and pain is often described in the literature, yet it is critical to define sleep not only subjectively but also using objective instrumental methods, such as polysomnography, that provide data on sleep quality. OBJECTIVES: The aim of the study was to determine the relationship between orofacial pain (OFP), headache (HA) and sleep quality using subjective and objective sleep quality assessment methods. Additionally, we aimed to explore whether poor sleep quality was related to OFP and HA alone or was influenced by the coexistence of psycho-emotional factors such as depression, anxiety and stress. MATERIAL AND METHODS: A single-night video-polysomnography was performed on patients from the Outpatient Clinic for Temporomandibular Disorders at Wroclaw Medical University, Poland, who had been diagnosed with OFP and HA. Additionally, questionnaires were employed to assess sleep quality, pain, HA, and the psycho-emotional state. RESULTS: There was no statistically significant relationship between the severity of OFP and HA and polysomnographic sleep quality parameters. On the other hand, the quality of sleep as determined by questionnaire studies correlated markedly with the severity of experienced pain. The severity of pain was found to be significantly correlated with depression, anxiety and perceived stress scores. CONCLUSIONS: The psycho-emotional aspects are of critical importance in the perception of OFP and HA. They can be associated with worsened subjective sleep quality, insomnia or daytime sleepiness. Therefore, the treatment of such patients must be preceded by a comprehensive assessment of their psychoemotional state, as anxiety, stress and depression can significantly influence the course of the disease and the response to treatment procedures.

Relationship between pain severity, satisfaction with life and the quality of sleep in Polish adults with temporomandibular disorders.

BACKGROUND: Temporomandibular disorders (TMD) pose a serious health problem that can have a negative effect on patients' lives, impair work performance, and result in work absences and restrictions in daily activities. OBJECTIVES: The aim of this observational, cross-sectional study was to evaluate the level of satisfaction with life among Polish patients with TMD and to assess the influence of pain severity on this parameter. A secondary goal was to investigate sleep quality within this patient group and explore its relationship with pain. MATERIAL AND METHODS: A total of 219 patients from the Outpatient Clinic for Temporomandibular Disorders at the University Dental Polyclinic in Wroclaw, Poland, participated in this study. These individuals underwent a clinical examination using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol and completed 2 validated questionnaires, namely the Satisfaction With Life Scale (SWLS) and the Pittsburgh Sleep Quality Index (PSQI). Furthermore, the patients were assessed for the severity of masseter muscle pain (MMP) and temporal muscle pain (TMP), and the average pain in these muscles (AMP) was calculated. Subsequently, a statistical analysis was performed on the collected data. RESULTS: The group of patients with average satisfaction with life exhibited significantly higher levels of MMP (p = 0.025) and AMP (p = 0.044) as compared to the high-satisfaction group. Regarding sleep quality, 50.23% of the patients experienced poor sleep quality. Poor sleep quality was found to be statistically associated with higher levels of TMP (p = 0.032) and AMP (p = 0.028). Moreover, women demonstrated significantly worse sleep quality as compared to men (p = 0.002). The findings indicate that PSQI has a greater impact on SWLS than vice versa. CONCLUSIONS: Due to a large number of TMD patients experiencing poor sleep quality and the associated reduced life satisfaction, these parameters should be considered as influential factors that modify the management of patients with TMD.

A High-Quality Diet, as Measured by the DASH Score, Is Associated with a Lower Risk of Metabolic Syndrome and Visceral Obesity.

The current study was designed to examine the relationship between diet quality, as measured by the Dietary Approaches to Stop Hypertension (DASH) score, and the prevalence of metabolic syndrome (MetS) and its components. The study was cross-sectional in design and enrolled 535 people, including 215 with MetS and 320 without MetS. Using a validated food frequency questionnaire, the DASH diet quality score was counted. The mean age of the MetS group and control subjects was 58.48 ± 14.65 and 58.33 ± 9.26 years, respectively. The study showed that the MetS group had a significantly lower mean total DASH score than the control group (23.13 ± 5.44 vs. 24.62 ± 5.07, p = 0.0023). In addition, it was found that an increase in the total DASH score was associated with a lower risk of MetS (odds ratio [OR] = 0.95, 95% confidence interval [CI] = 0.91-0.99, p = 0.009). In the correlation analysis of the total population, a better-quality diet (higher DASH score) was positively correlated with high-density lipoprotein cholesterol (HDL-c), and negatively correlated with triglyceride (TG) concentration and waist circumference. It was also found that an increase in the total DASH score was associated with a lower risk of abdominal obesity (OR = 0.93, 95% CI = 0.88-0.99, p = 0.017). The results from the analyzed data highlight the potential benefits of following a healthy diet such as DASH.

Assessment of Clinical Indicators Registered on Admission to the Hospital Related to Mortality Risk in Cancer Patients with COVID-19.

BACKGROUND: Oncology patients are a particularly vulnerable group to the severe course of COVID-19 due to, e.g., the suppression of the immune system. The study aimed to find links between parameters registered on admission to the hospital and the risk of later death in cancer patients with COVID-19. METHODS: The study included patients with a reported history of malignant tumor (n = 151) and a control group with no history of cancer (n = 151) hospitalized due to COVID-19 between March 2020 and August 2021. The variables registered on admission were divided into categories for which we calculated the multivariate Cox proportional hazards models. RESULTS: Multivariate Cox proportional hazards models were successfully obtained for the following categories: Patient data, Comorbidities, Signs recorded on admission, Medications used before hospitalization and Laboratory results recorded on admission. With the models developed for oncology patients, we identified the following variables that registered on patients' admission were linked to significantly increased risk of death. They are: male sex, presence of metastases in neoplastic disease, impaired consciousness (somnolence or confusion), wheezes/rhonchi, the levels of white blood cells and neutrophils. CONCLUSION: Early identification of the indicators of a poorer prognosis may serve clinicians in better tailoring surveillance or treatment among cancer patients with COVID-19.

Metabolic Syndrome Is Associated with Low Diet Quality Assessed by the Healthy Eating Index-2015 (HEI-2015) and Low Concentrations of High-Density Lipoprotein Cholesterol.

Presenting diet quality of patients with metabolic syndrome (MetS), using a holistic approach is more useful than investigating dietary individual components, but there is still a small amount of research in this area. The aim of this study assessed the diet quality, as measured by the HEI-2015, of MetS patients compared to healthy individuals. The study and control group consisted of 215 patients with MetS and 320 people without MetS, respectively. A nutritional analysis using a semi-quantitative food frequency questionnaire was used to evaluate the nutritional habits in the study and control group. Total HEI-2015 scores were significantly lower in MetS subjects than in those in the control group (65.04 ± 9.71 vs. 66.75 ± 8.88) and the quality of women's diets was better than the quality of men's diet (66.83 ± 8.99 vs. 64.75 ± 9.57). We also observed that low HDL-c concentration increased the risk of MetS in the general population the most. Across the population, there was a weak positive correlation between HDL-c concentrations and total HEI-2015 scores and a weak negative correlation between mean waist circumference values and total HEI-2015 scores. HDL-c concentrations may be a key factor in the prevention of MetS and appropriate therapeutic management to increase HDL-c levels may be of key importance in patients diagnosed with MetS.

All-Cause Mortality and Trimethylamine N-Oxide Levels in Patients with Cardiovascular Disease.

INTRODUCTION: Trimethylamine N-oxide (TMAO) is an organic compound with a well-established involvement in the pathogenesis of cardiovascular disease (CVD). However, data on the links between TMAO levels and cardiovascular mortality in Polish patients are lacking. OBJECTIVES: We aimed to assess the relationship between serum TMAO levels and 5-year mortality in Polish patients with CVD. PATIENTS AND METHODS: We retrospectively assessed serum TMAO levels in 1,036 consecutive patients (median age, 62 years; men, 61%) hospitalized between 2013 and 2015. Correlations between TMAO levels and 5-year mortality as well as anthropometric and biochemical parameters were assessed for the whole population and the subgroups of patients with acute coronary syndrome, stable coronary syndrome (SCS), chronic heart failure (HF), and atrial fibrillation (AF). RESULTS: In the univariate analysis, increased TMAO levels predicted 5-year mortality without clinically significant power (hazard ratio [HR], 1.01; 95% CI: 1.006-1.018; p < 0.0001). However, even this weak effect was lost in the multivariate analysis after adjustment for age, sex, comorbidities, and laboratory parameters. In the whole study group, TMAO levels in the fourth quartile of concentration (>6.01 µM) predicted 5-year mortality only in the univariate analysis (HR: 1.55; 95% CI: 1.34-1.79; p < 0.0001). In subgroup univariate analysis, TMAO levels predicted 5-year mortality in patients with SCS, chronic HF, and AF. CONCLUSIONS: Despite the promising results of previous studies, our study shows that the level of TMAO has at most moderate value in predicting all-cause mortality. TMAO levels depend on other clinical variables, which limits the use of TMAO as an independent predictor of mortality in these patients.

Citrulline and long-term mortality in patients with cardiovascular disease.

BACKGROUND: Cardiovascular disease (CVD) is associated with intestinal barrier dysfunction and increased intestinal permeability. Increased intestinal permeability to gut microbial metabolites may accelerate the progression of CVD. Plasma citrulline levels are a marker of functional enterocyte mass, and reduced citrulline levels indicate intestinal epithelial damage. Citrulline was reported as a useful prognostic marker in critically ill patients. However, data are lacking on the association of citrulline with long-term mortality in patients with CVD and with the levels of trimethylamine N-oxide (TMAO), a microbiota-derived metabolite which has been implicated in the pathogenesis of CVD. OBJECTIVES: To assess the effect of citrulline levels, a marker of intestinal barrier disruption, on long-term mortality in patients with CVD. Moreover, the relationship between the concentrations of 2 biomarkers - citrulline and TMAO - was assessed. MATERIAL AND METHODS: Serum citrulline levels were retrospectively assessed in 1036 consecutive patients with CVD (median age: 62 years; 61% men) hospitalized between 2013 and 2015. Associations of citrulline levels with 5-year mortality rates as well as anthropometric and biochemical parameters were evaluated for the entire study group and in subgroups of patients with acute coronary syndrome (ACS), chronic coronary syndrome, chronic heart failure (chronic HF), and atrial fibrillation (AF). Correlations between serum citrulline and TMAO levels were assessed. RESULTS: The median citrulline level in the study population was 22.5 µM (interquartile range (IQR): 17.8-27.9). Citrulline levels were not associated with 5-year mortality in patients with CVD (hazard ratio (HR) = 0.99; 95% confidence interval (95% CI): 0.97-1.00; p = 0.49). Median citrulline levels differed significantly between deceased patients and survivors at 5 years in patients with ACS (p = 0.025). There were no significant correlations between citrulline and TMAO levels (Kendall's tau = 0.027). CONCLUSIONS: Decreasing citrulline levels do not predict long-term mortality of hospitalized patients with CVD. Moreover, they are not associated with the serum levels of TMAO in these patients.

Anticoagulation Prior to COVID-19 Infection Has No Impact on 6 Months Mortality: A Propensity Score-Matched Cohort Study.

The coronavirus disease 2019 (COVID-19) shows high incidence of thromboembolic events in humans. In the present study, we aimed to evaluate if anticoagulation prior to COVID-19 infection may impact clinical profile, as well as mortality rate among patients hospitalized with COVID-19. The study was based on retrospective analysis of medical records of patients with laboratory confirmed SARS-CoV-2 infection. After propensity score matching (PSM), a group of 236 patients receiving any anticoagulant treatment prior to COVID-19 infection (AT group) was compared to 236 patients without previous anticoagulation (no AT group). In 180 days, the observation we noted comparable mortality rate in AT and no AT groups (38.5% vs. 41.1%, p = 0.51). Similarly, we did not observe any statistically significant differences in admission in the intensive care unit (14.1% vs. 9.6%, p = 0.20), intubation and mechanical ventilation (15.0% vs. 11.6%, p = 0.38), catecholamines usage (14.3% vs. 13.8%, p = 0.86), and bleeding rate (6.3% vs. 8.9%, p = 0.37) in both groups. Our results suggest that antithrombotic treatment prior to COVID-19 infection is unlikely to be protective for morbidity and mortality in patients hospitalized with COVID-19.