The relationship between opioid use and obstructive sleep apnea: A systematic review and meta-analysis.

We conducted a systematic review to address limited evidence suggesting that opioids may induce or aggravate obstructive sleep apnea (OSA). All clinical trials or observational studies on adults from 1946 to 2018 found through MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases were eligible. We assessed the quality of the studies using published guidelines. Fifteen studies (six clinical trials and nine observational) with only two of good quality were included. Fourteen studies investigated the impact of opioids on the presence or severity of OSA, four addressed the effects of treatment for OSA  in opioid users, and none explored the consequences of opioid use in individuals with OSA. Eight of 14 studies found no significant relationship between opioid use or dose and apnea-hypopnea index (AHI) or degree of nocturnal desaturation. A random-effects meta-analysis (n = 10) determined the pooled mean change in AHI associated with opioid use of 1.47/h (-2.63-5.57; I2 = 65%). Three of the four studies found that continuous positive airway pressure (CPAP) therapy reduced AHI by 17-30/h in opioid users with OSA. Bilevel therapy with a back-up rate and adaptive servo-ventilation (ASV) without mandatory pressure support successfully normalized AHI (≤5) in opioid users. Limited by a paucity of good-quality studies, our review did not show a significant relationship between opioid use and the severity of OSA. There was some evidence that CPAP, Bilevel therapy, and ASV alleviate OSA for opioid users, with higher failure rates observed in patients on CPAP in opioid users.

Quercetin modulates age-induced changes in the transcript levels of some apoptosis related genes in the skeletal muscles of male rats

Adverse changes occur gradually in the skeletal muscles with age via continuous exposure to oxidative stress. Quercetin, a member of the flavonoids family, possesses anti-oxidative and radical-scavenging activities. Therefore, this study investigated the role of quercetin to modulate age-induced changes in the transcript levels of some apoptosis-related genes in rat's gastrocnemius muscles, up to 15 months-old. Half of the rats at each age (1, 5, 10 and 15 months old) were given a vehicle and the other half was given 200 mg/kg quercetin for 2 weeks, respectively. With the increase of age, vehicle groups showed hyalinization of the muscle fibers and a decrease of the catalase and an increase of the malondialdehyde levels. Down-regulation of Bcl2 gene and up-regulation of both NF-κB and Bax genes were recorded. Interestingly, quercetin groups showed focal hyalinization of the muscle fibers at both 10th and 15th months old. An increase in the catalase and a decrease in malondialdehyde levels, up-regulation of Bcl2 gene and down-regulation of both NF-κB and Bax genes were recorded. In conclusion, quercetin minimized age-induced alteration in the morphological structure and the expression of the apoptosis-related genes via increasing the antioxidant defense in the gastrocnemius muscle.

Chronic Periodontitis Case Definitions and Confounders in Periodontal Research: A Systematic Assessment.

Case definitions and criteria of periodontal diseases are not yet consistent worldwide. This can affect the accuracy of any comparison made between two studies. This study determines which are the most common chronic periodontitis case definitions as well as confounding variables that have been reported worldwide in periodontal literature. A systematic assessment on periodontal disease classification and confounders was conducted using all publications in MEDLINE, EMBASE, SCOPUS, and Google Scholar between 1965 and October 2017. Screening of eligible studies and data extraction were conducted in duplicate and independently by two reviewers. The search protocol produced 4,218 articles. Out of these, 492 potentially relevant articles were selected for review. Only 351 studies fulfilled the selection criteria. Combination of probing depth and clinical attachment loss was the most common chronic periodontitis case definitions used (121, studies, 34.5%). CPI/CPITN was the most common classification used. Age was the most common confounder studied in periodontal research (303 studies, 86.3%), followed by gender (268 studies, 76.4%) and race (138 studies, 39.3%). Albumin and creatinine were the least common variables studied (1 or 2 studies each). Different case definitions affect the prevalence and treatment consequences of periodontitis. We need to standardize periodontitis case definitions worldwide to avoid difficulties in case diagnosis and prognosis. Further studies need to be done to assess the association between periodontitis and several potential confounders.

Water-soluble plasmonic nanosensors with synthetic receptors for label-free detection of folic acid.

We describe an original approach to graft molecularly imprinted polymers around gold nanorods by combining the diazonium salt chemistry and the iniferter method. This chemical strategy enables fine control of the imprinting process at the nanometer scale and provides water-soluble plasmonic nanosensors.

Functionalization of magnetic nanocrystals by oligo (ethylene oxide) chains carrying diazonium and iniferter end groups.

The water stability of iron oxide nanoparticles (NPs) is a major issue for biomedical and biological applications. This paper presents a versatile approach for preparing water-soluble iron oxide nanoparticles coated by bifunctional oligo(ethylene oxide) (OEO) chains, carrying on the one side a diazonium end group for covalent grafting at the NP surface and on the other side an iniferter group (diethyl dithiocarbamate) for initiating the growing of poly(methacrylic acid). The nanoparticles were synthesized by coprecipitation in basic media and functionalized in situ by adding the diazonium salt directly in the synthesis medium. Oligo(ethylene oxide) with various chain lengths (from one to three monomer units) was grafted at the NP surface using this approach. The length of the OEO spacer between the NP surface and the iniferter end group was found to be a critical parameter for controlling the colloidal stability of the hybrid NPs. The polymerization time was also shown to strongly influence their colloidal stability, emphasizing the interest to control the interfacial properties of the hybrids for obtaining stable dispersions in water.

Immunological changes in acute myocardial infarction.

OBJECTIVE: This study was undertaken to investigate troponin and lymphocyte subset changes in acute myocardial infarctions (AMI) and to correlate these changes with disease variables. METHODS: Forty-five patients with AMI admitted to the Coronary Care Unit, Jordan University Hospital and Queen Alia Heart Institute at King Hussein Medical Center, Amman, Jordan during the period November 1999 through to April 2000 were included in the study. Forty-five patients with non cardiac conditions were selected as a control group. Tests performed include; determination of the percentages of B-lymphocytes, T-lymphocytes and T-lymphocyte subsets by flow cytometry, measurements of serum cardiac troponin I (cTnI) by microparticle enzyme immunoassay and determination of minor blood groups by the gel test. RESULTS: A significant increase in the percentages of CD8+ and CD19+ cells combined with a significant decrease in the percentages of CD3+ and CD4+ cells as well as a decrease of CD4+/CD8+ ratio were documented in patients with AMI 24 hours after admission to the hospital. Except for CD19+ cells, all of cell types assayed for returned to their normal percentages before discharge of patients. Very low CD4+ cell percentages and CD4+/CD8+ ratio were found to be poor prognostic signs of AMI. Serum cTnI levels which were elevated in all patients correlate very well with the decreased CD4+ cell percentages, and the decreased CD4+/CD8+ cell ratio and they seem to correlate with the extensiveness of infarction. Troponin and lymphocyte subset changes, on the other hand, did not correlate with the number of vessels diseased or the risk factors for AMI. Finally, a statistically significant association was observed between the Le (a-b-) phenotype and AMI. CONCLUSION: Immunologic change seem to accompany or follow AMI and changes in T-lymphocyte subsets and cTnI can be regarded as prognostic markers in AMI but these changes are independent of risk factors and the number of vessels diseased.