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Corace K, Baysarowich R, Willows M, Baddeley A, Schubert N, Knott V. Resting State EEG Activity Related to Impulsivity in People with Prescription Opioid Use Disorder. Psychiatry Res Neuroimaging 2022; 321:111447. [PMID: 35149322 DOI: 10.1016/j.pscychresns.2022.111447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 12/08/2021] [Accepted: 01/22/2022] [Indexed: 11/23/2022]
Abstract
Previous studies on EEG activity in prescription opioid use disorder (OUD) have reported neuronal dysfunction related to heroin use, most consistently reflected by increases in β-brain oscillations. As similar research has yet to examine EEG associated with non-medical use of prescription opioid and as inhibitory deficits are associated with OUD, this pilot study compared quantitative EEGs of 18 patients with prescription OUD and 18 healthy volunteers and assessed relationships between oscillatory activity and impulsivity with the Barratt Impulsiveness Scale (BIS-11). Spectral EEGs showed greater amplitude density in β1, β2, and β3 frequencies across frontal, temporal-central and posterior recording areas in patients. Similar abnormal amplitude density increases were seen in δ but not in θ or α frequency bands. Patients exhibited greater scores (impaired impulse control) on BIS-11 subscales (attention, motor, self-control) and impairment of these impulsive subtypes was associated with increases in β and δ oscillations. In patients, β1, β2, and δ activity was positively associated with disorder severity. Taken together, the results suggest that altered brain oscillations in persons with prescription OUD show some similarities with reported oscillatory changes in heroin use and may indicate a chronic state of imbalance in neuronal networks regulating impulsive and inhibitory control systems.
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Affiliation(s)
- Kim Corace
- Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Institute of Mental Health Research, Ottawa, ON, Canada
| | - Renee Baysarowich
- Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Melanie Willows
- Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Institute of Mental Health Research, Ottawa, ON, Canada
| | - Ashley Baddeley
- Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Nick Schubert
- Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Verner Knott
- Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Institute of Mental Health Research, Ottawa, ON, Canada; Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
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Obeid N, Flament MF, Buchholz A, Henderson KA, Schubert N, Tasca G, Thai H, Goldfield G. Examining Shared Pathways for Eating Disorders and Obesity in a Community Sample of Adolescents: The REAL Study. Front Psychol 2022; 13:805596. [PMID: 35432146 PMCID: PMC9008728 DOI: 10.3389/fpsyg.2022.805596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 02/16/2022] [Indexed: 11/21/2022] Open
Abstract
Several psychosocial models have been proposed to explain the etiology of eating disorders (EDs) and obesity separately despite research suggesting they should be conceptualized within a shared theoretical framework. The objective of the current study was to test an integrated comprehensive model consisting of a host of common risk and protective factors (socio-environmental, psychological, and behavioral) expected to explain both eating and weight disorders simultaneously in a large school-based sample of adolescents. Data were collected from 3,043 youth (60% female, 14.00 ± 1.61) from 41 schools in the Ottawa region, Canada. Working with interested school staff, validated self-report scales in the form of a questionnaire booklet were administered to participating students to assess several understood risk and protective factors common to both eating disorders and obesity. Anthropometric measurements of weight and height were taken at the end of the questionnaire administration period by trained research staff. Structural equation modeling with cross-validation was used to test the hypothesized model. Findings demonstrated that dysregulated eating was associated with both eating disorder and weight status with diet culture and emotion dysregulation directly associated with some of these disordered eating patterns. It equally pointed to how lifestyle made up of high sedentary behaviors, low vigorous exercise and varied eating patterns contributed to both emotion dysregulation and poor body image which subsequently affected eating issues and weight status simultaneously, signaling the complex interplay of psychosocial factors that underlie these concerns. This study provides evidence for an integrated psychosocial model consisting of socio-environmental, psychological, and behavioral factors may best explain the complex interplay of risk and protective factors influencing eating disorders and obesity. It equally highlights understanding the direct and indirect effects of some of the most salient risk factors involved in eating and weight-related concerns, including the strong effects of diet culture and stressors such as weight-based teasing, providing interventionalists evidence of important risk factors to consider targeting in eating disorder and weight-based prevention efforts.
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Affiliation(s)
- Nicole Obeid
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- *Correspondence: Nicole Obeid,
| | | | - Annick Buchholz
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Centre for Healthy Active Living, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Katherine A. Henderson
- Department of Psychology, Carleton University, Ottawa, ON, Canada
- Anchor Psychological Services, Ottawa, ON, Canada
| | - Nick Schubert
- Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Giorgio Tasca
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Helen Thai
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Gary Goldfield
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Psychology, Carleton University, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
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Nasri Sissini M, Berchez F, Hall-Spencer J, Ghilardi-Lopes N, Carvalho VF, Schubert N, Koerich G, Diaz-Pulido G, Silva J, Serrão E, Assis J, Santos R, Floeter SR, Rörig L, Barufi JB, Bernardino AF, Francini-Filho R, Turra A, Hofmann LC, Aguirre J, Le Gall L, Peña V, Nash MC, Rossi S, Soares M, Pereira-Filho G, Tâmega F, Horta PA. Brazil oil spill response: Protect rhodolith beds. Science 2020; 367:156. [PMID: 31919215 DOI: 10.1126/science.aba2582] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M Nasri Sissini
- Laboratório de Ficologia, Departamento de Botânica, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil.,Programa de Pós-Graduação em Ecologia, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil
| | - F Berchez
- CienTec Park and Instituto de Biociências, Universidade de São Paulo, 05422-970, São Paulo, Brazil
| | - J Hall-Spencer
- Marine Biology and Ecology Research Centre, University of Plymouth, Plymouth PL4 8AA, UK
| | - N Ghilardi-Lopes
- Center for Natural and Human Sciences, Federal University of do ABC, 09210-170, Santo André, São Paulo, Brazil
| | - V F Carvalho
- Laboratório de Ficologia, Departamento de Botânica, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil.,Programa de Pós-Graduação em Ecologia, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil
| | - N Schubert
- Laboratório de Ficologia, Departamento de Botânica, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil.,Centre of Marine Sciences, University of Algarve, Campus Gambelas, 8005-139 Faro, Portugal
| | - G Koerich
- Laboratório de Ficologia, Departamento de Botânica, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil.,Programa de Pós-Graduação em Ecologia, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil
| | - G Diaz-Pulido
- School of Environment and Science, and Australian Rivers Institute-Coasts & Estuaries, Griffith University, QLD 4111, Australia
| | - J Silva
- Centre of Marine Sciences, University of Algarve, Campus Gambelas, 8005-139 Faro, Portugal
| | - E Serrão
- Centre of Marine Sciences, University of Algarve, Campus Gambelas, 8005-139 Faro, Portugal
| | - J Assis
- Centre of Marine Sciences, University of Algarve, Campus Gambelas, 8005-139 Faro, Portugal
| | - R Santos
- Centre of Marine Sciences, University of Algarve, Campus Gambelas, 8005-139 Faro, Portugal
| | - S R Floeter
- Laboratório de Ficologia, Departamento de Botânica, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil.,Programa de Pós-Graduação em Ecologia, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil
| | - L Rörig
- Laboratório de Ficologia, Departamento de Botânica, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil
| | - J B Barufi
- Laboratório de Ficologia, Departamento de Botânica, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil
| | - A F Bernardino
- Departamento de Oceanografia e Ecologia, Universidade Federal do Espírito Santo, 29075-910, Vitória, Espírito Santo, Brazil
| | - R Francini-Filho
- Centro de Ciências Aplicadas e Educação, Universidade Federal da Paraíba, 58297-000, Rio Tinto, Paraíba, Brazil
| | - A Turra
- Departamento de Oceanografia Biológica, Instituto Oceanográfico, Universidade de São Paulo, 05508-900, São Paulo, Brazil
| | - L C Hofmann
- Alfred Wegener Institute Helmholtz Center for Polar and Marine Research, 27570 Bremerhaven, Germany
| | - J Aguirre
- Departamento Estratigrafıa y Paleontologia, Universidad de Granada, 18001 Granada, Spain
| | - L Le Gall
- Muséum National d'Histoire Naturelle-Institut de Systématique, Evolution, Biodiversité, 75231 Paris, Cedex 05, France
| | - V Peña
- BioCost Research Group, Universidade da Coruña, 15071, Coruña, Spain
| | - M C Nash
- Research School of Earth Sciences, Australian National University, Canberra, ACT, Australia
| | - S Rossi
- Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, DiSTeBA, University of Salento, Lecce, Italy.,Instituto de Ciências do Mar (Labomar), Universidade Federal do Ceará, 60165-081, Fortaleza, Ceará, Brazil
| | - M Soares
- Instituto de Ciências do Mar (Labomar), Universidade Federal do Ceará, 60165-081, Fortaleza, Ceará, Brazil
| | - G Pereira-Filho
- Departamento de Ciências do Mar, Universidade Federal de São Paulo, 11070-100, Santos, São Paulo, Brazil
| | - F Tâmega
- Programa de Pós-Graduação em Oceanografia, Instituto de Oceanografia, Universidade Federal do Rio Grande, 96203-900, Rio Grande, Rio Grande do Sul, Brazil
| | - P A Horta
- Laboratório de Ficologia, Departamento de Botânica, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil. .,Programa de Pós-Graduação em Ecologia, Universidade Federal de Santa Catarina, 88040-970, Florianópolis, Santa Catarina, Brazil
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Schubert N, Salazar VW, Rich WA, Vivanco Bercovich M, Almeida Saá AC, Fadigas SD, Silva J, Horta PA. Rhodolith primary and carbonate production in a changing ocean: The interplay of warming and nutrients. Sci Total Environ 2019; 676:455-468. [PMID: 31048175 DOI: 10.1016/j.scitotenv.2019.04.280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 04/13/2019] [Accepted: 04/18/2019] [Indexed: 06/09/2023]
Abstract
Rhodolith beds, like many other marine ecosystems, are affected by climate change that is causing an increase in the magnitude and frequency of extreme high temperature events (heat waves). Unfortunately, this does not represent the sole peril for these communities, as coastal urbanization in conjunction with altered precipitation patterns can increase terrestrial-derived nutrient input. In Brazil, rhodolith beds are among the most extensive coastal benthic ecosystems, but despite their vast distribution and great ecological and economic importance, studies on the productivity of these communities and the impact of changing environmental conditions are almost non-existent. This study addressed the individual and combined effects of increases in temperature and nutrient concentration on the physiological performance of two widely distributed rhodolith species, Lithothamnion crispatum and Melyvonnea erubescens. The results showed species-specific responses in net photosynthetic performance, with no response in L. crispatum, while M. erubescens responded negatively to both increase in temperature and nutrients. In contrast, calcification in both species showed a significant decline at high temperature. No interactive effects were found between temperature and nutrients, yet their combined negative effects were additive, resulting in negative daily-integrated net productivity and a large decline in daily carbonate production in both species. This has strong implications for rhodolith bed primary productivity and carbonate production, as heat waves may potentially cause a strong decline in carbonate production (ca. 50% loss), accompanied by a severe drop in primary productivity that will be even more pronounced under high-nutrient conditions. Also, the species-specific responses to changes in temperature and nutrient concentration suggest that the magnitude of impact of these factors on rhodolith bed productivity will depend on the species dominating the community and may finally result in changes in rhodolith community composition.
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Affiliation(s)
- N Schubert
- Programa de Pós-graduação em Oceanografia, Centro de Ciências Físicas e Matemáticas, Universidade Federal de Santa Catarina, Campus Trindade, Florianopolis, Brazil; Laboratório de Ficologia, Departamento de Botânica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianopolis, Brazil.
| | - V W Salazar
- Curso de Graduação em Ciências Biológicas, Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - W A Rich
- Laboratório de Ficologia, Departamento de Botânica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianopolis, Brazil; Programa de Pós-Graduação em Ecologia, Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - M Vivanco Bercovich
- Programa de Pós-graduação em Oceanografia, Centro de Ciências Físicas e Matemáticas, Universidade Federal de Santa Catarina, Campus Trindade, Florianopolis, Brazil; Laboratório de Ficologia, Departamento de Botânica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - A C Almeida Saá
- Programa de Pós-graduação em Oceanografia, Centro de Ciências Físicas e Matemáticas, Universidade Federal de Santa Catarina, Campus Trindade, Florianopolis, Brazil; Laboratório de Ficologia, Departamento de Botânica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - S D Fadigas
- Programa de Pós-graduação em Oceanografia, Centro de Ciências Físicas e Matemáticas, Universidade Federal de Santa Catarina, Campus Trindade, Florianopolis, Brazil; Laboratório de Ficologia, Departamento de Botânica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - J Silva
- CCMAR - Centre of Marine Sciences, University of Algarve, Campus Gambelas, 8005-139 Faro, Portugal
| | - P A Horta
- Laboratório de Ficologia, Departamento de Botânica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianopolis, Brazil
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Berthold T, Schubert N, Muschter S, Rohr M, Wesche J, Reil A, Bux J, Bakchoul T, Greinacher A. HNA antibody-mediated neutrophil aggregation is dependent on serine protease activity. Vox Sang 2015; 109:366-74. [PMID: 26084778 DOI: 10.1111/vox.12292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/31/2015] [Accepted: 04/01/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Transfusion-related acute lung injury (TRALI) is often caused by antibodies against human neutrophil alloantigen-2 (HNA-2) and HNA-3a. Neutrophil aggregation is considered as a major cause of TRALI, but little is known about how HNA antibodies initiate this process. We explored mechanisms involved in neutrophil aggregation induced by HNA-2 and HNA-3a antibodies. MATERIALS AND METHODS Isolated neutrophils were pretreated with broad-spectrum or specific inhibitors against different cell functions or proteases. Granulocyte agglutination test (GAT) was performed with serially diluted anti-HNA-2 and anti-HNA-3a plasmas or control plasma, and reactivity was evaluated microscopically. Reactive oxygen species (ROS) production in neutrophils was investigated using a lucigenin-based chemiluminescence assay. RESULTS HNA-2 and HNA-3a antibody-mediated neutrophil aggregation was inhibited by pretreatment with formaldehyde, iodoacetamide and the serine protease inhibitors Pefabloc-SC, N-p-tosyl-L-phenylalanine chloromethyl ketone (TPCK) and Nα-tosyl-L-lysine chloromethyl ketone hydrochloride (TLCK). In contrast, inhibition of actin polymerization, respiratory burst, cysteine proteases, metalloproteases or aspartic proteases did not affect neutrophil aggregation. Furthermore, HNA-3a antibodies did not directly cause ROS production in neutrophils. CONCLUSION Aggregation of neutrophils induced by HNA-2 and HNA-3a antibodies is an active process and depends on trypsin- or chymotrypsin-like serine proteases but is not dependent on the production of ROS. These findings may open new prospects for the pharmacologic prevention of neutrophil-associated acute lung injury.
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Affiliation(s)
- T Berthold
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - N Schubert
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - S Muschter
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - M Rohr
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - J Wesche
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - A Reil
- Deutsches Rotes Kreuz - Blutspendedienst West, Hagen, Germany
| | - J Bux
- Ruhr Universität Bochum, Bochum, Germany
| | - T Bakchoul
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - A Greinacher
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
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Flament MF, Buchholz A, Henderson K, Obeid N, Maras D, Schubert N, Paterniti S, Goldfield G. Comparative distribution and validity of DSM-IV and DSM-5 diagnoses of eating disorders in adolescents from the community. Eur Eat Disord Rev 2014; 23:100-10. [PMID: 25524758 DOI: 10.1002/erv.2339] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 11/20/2014] [Accepted: 11/22/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVES DSM-5 changes for eating disorders (EDs) aimed to reduce preponderance of non-specified cases and increase validity of specific diagnoses. The objectives were to estimate the combined effect of changes on prevalence of EDs in adolescents and examine validity of diagnostic groupings. METHOD A total of 3043 adolescents (1254 boys and 1789 girls, Mage = 14.19 years, SD = 1.61) completed self-report questionnaires including the Eating Disorder Diagnostic Scale. RESULTS Prevalence of full-threshold EDs increased from 1.8% (DSM-IV) to 3.7% (DSM-5), with a higher prevalence of bulimia nervosa (1.6%) and the addition of the diagnosis of purging disorder (1.4%); prevalence of binge eating disorder was unchanged (0.5%), and non-specified cases decreased from 5.1% (DSM-IV) to 3.4% (DSM-5). Validation analyses demonstrated that DSM-5 ED subgroups better captured variance in psychopathology than DSM-IV subgroups. DISCUSSION Findings extend results from previous prevalence and validation studies into the adolescent age range. Improved diagnostic categories should facilitate identification of EDs and indicate targeted treatments.
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Affiliation(s)
- Martine F Flament
- University of Ottawa Institute of Mental Health Research, Ottawa, Canada
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Buecking B, Struewer J, Waldermann A, Horstmann K, Schubert N, Balzer-Geldsetzer M, Dodel R, Bohl K, Ruchholtz S, Bliemel C. What determines health-related quality of life in hip fracture patients at the end of acute care?--a prospective observational study. Osteoporos Int 2014; 25:475-84. [PMID: 23783644 DOI: 10.1007/s00198-013-2415-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 06/03/2013] [Indexed: 12/30/2022]
Abstract
UNLABELLED Hip fractures are associated with reduced health-related quality of life (HrQoL). We found pre-existing need of care or limited function, cognitive impairment, and depression to be independent factors associated with lower HrQoL during the postsurgical period. In contrast, joint replacement was associated with better HrQoL compared to internal fixation. Patients' treatment should be focused on functional recovery and treatment of depression. INTRODUCTION The aim of the study was to identify independent factors that were correlated with health-related quality of life (HrQoL) after hip fracture. METHODS A total of 402 patients with a mean age of 81 years suffering from a hip fracture were included in this prospective, observational cohort study. HrQoL (determined by the EuroQol instrument) was measured at admission and at discharge from an acute care hospital. Independent factors correlated with HrQoL at discharge and changes from pre-fracture to discharge were determined using multivariate analyses. The influence of antidepressants was evaluated by an ANOVA with repeated measurements. RESULTS Need of care prior to fracture was the most important determinant of EQ-5D index at discharge (ß = -0.359, p = 0.003). Additionally, low Mini Mental Status Examination (MMSE) was associated with a lower EQ-5D index at discharge (MMSE 0-9: ß = -0.238, p <0.001; MMSE 10-19: ß = -0.294, p <0.001) and a greater decrease in EQ-5D during hospitalisation (MMSE 10-19: ß = 0.281, p <0.001), while joint replacement (compared to internal fixation) was associated with a higher EQ-5D index (ß = 0.188, p = 0.002) and a lower decrease in the index (ß = -0.216, p = 0.003). EQ VAS values at discharge were correlated with pre-fracture Barthel Index (ß = 0.253, p <0.001) and Geriatric Depression Scale scores (ß = -0.135, p = 0.026). Depressive patients on antidepressants demonstrated less of a decrease in the EQ-5D index compared to patients not receiving medication (F = 2.907, p = 0.090). CONCLUSIONS Acute care of hip fracture patients should be focused on functional recovery and treatment of depression. When the preferred surgical strategy is unclear, joint replacement should be considered.
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Affiliation(s)
- B Buecking
- Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg GmbH, Baldingerstrasse, 35043, Marburg, Germany,
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Schubert N, Schneider M, Michealis A. The mechanism of anodic dissolution of cobalt in neutral and alkaline electrolyte at high current density. Electrochim Acta 2013. [DOI: 10.1016/j.electacta.2013.06.093] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bohl K, Buecking B, Struewer J, Waldermann A, Horstmann K, Schubert N, Balzer-Geldsetzer M, Dodel R, Ruchholtz S. Welche Faktoren beeinflussen die gesundheitsbezogene Lebensqualität bei Patienten mit Hüftfraktur während der Versorgung in der Akutklinik. Gesundheitswesen 2013. [DOI: 10.1055/s-0033-1354217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schneider M, Schubert N, Höhn S, Michaelis A. Anodic dissolution behaviour and surface texture development of cobalt under electrochemical machining conditions. Electrochim Acta 2013. [DOI: 10.1016/j.electacta.2013.05.070] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Schneider M, Schroth S, Richter S, Höhn S, Schubert N, Michaelis A. In-situ investigation of the interplay between microstructure and anodic copper dissolution under near-ECM conditions—Part 2: The transpassive state. Electrochim Acta 2012. [DOI: 10.1016/j.electacta.2012.03.066] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Schneider M, Schroth S, Richter S, Höhn S, Schubert N, Michaelis A. In-situ investigation of the interplay between microstructure and anodic copper dissolution under near-ECM conditions – Part 1: The active state. Electrochim Acta 2011. [DOI: 10.1016/j.electacta.2011.06.075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schwartz AR, O'Donnell CP, Baron J, Schubert N, Alam D, Samadi SD, Smith PL. The hypotonic upper airway in obstructive sleep apnea: role of structures and neuromuscular activity. Am J Respir Crit Care Med 1998; 157:1051-7. [PMID: 9563718 DOI: 10.1164/ajrccm.157.4.9706067] [Citation(s) in RCA: 151] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The structural properties of the upper airway determine its collapsibility during periods of muscle hypotonia. Both rapid-eye-movement (REM) sleep and increases in nasal pressure (PN) produce hypotonia, which persists even after nasal pressure is abruptly reduced. To determine the factors that influence the collapsibility of the hypotonic airway, the critical pressure (Pcrit) and nasal resistance upstream to the site of pharyngeal collapse (RN) were measured in the first three breaths after abrupt reductions in PN during non-REM and REM sleep. PN was reduced abruptly from 15.2+/-3.2 cm H2O (mean +/- SD) for three breaths in 19 apneic patients. Upper-airway pressure-flow relationships were analyzed to determine Pcrit for each breath in non-REM and REM sleep. We found that Pcrit rose (collapsibility increased, p < 0.001) and RN fell (p = 0.02) between the first and third breath after the decrease in PN, whereas no difference in Pcrit was detected between sleep stages. In six patients, genioglossus-muscle electromyograms (EMGs) were recorded. Peak phasic activity rose between the first and third breath (p = 0.03), but tonic and peak phasic EMG activity fell in REM as compared with non-REM sleep (p < 0.001). We conclude that the hypotonic upper airway becomes most collapsible by the third breath after an abrupt decrease in PN, regardless of sleep stage and despite an increase in genioglossus-muscle activity. Our findings suggest that predominantly mechanical rather than neuromuscular factors modulate the properties of the pharynx after abrupt reductions in nasal pressure.
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Affiliation(s)
- A R Schwartz
- Johns Hopkins Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA
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Schwartz AR, Schubert N, Rothman W, Godley F, Marsh B, Eisele D, Nadeau J, Permutt L, Gleadhill I, Smith PL. Effect of uvulopalatopharyngoplasty on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis 1992; 145:527-32. [PMID: 1546831 DOI: 10.1164/ajrccm/145.3.527] [Citation(s) in RCA: 129] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Previous investigators have demonstrated variable responses to uvulopalatopharyngoplasty (UPP) in patients with obstructive sleep apnea. We hypothesized that this variability is due to either (1) differences in baseline pharyngeal collapsibility preoperatively or (2) differences in magnitude of the decrease in pharyngeal collapsibility resulting from surgery. To determine the relationship between changes in collapsibility and the response to UPP surgery, we measured the upper airway critical pressure (Pcrit) before and after UPP in 13 patients with obstructive sleep apnea. During non-REM sleep, maximal inspiratory airflow (VImax) was quantitated by varying the level of nasal pressure (PN), and Pcrit was determined by the level of PN below which VImax ceased. A positive response to UPP was defined by a greater than or equal to 50% fall in non-REM disordered breathing rate (DBR). In the entire group, UPP resulted in significant decreases in DBR from 71.1 +/- 22.4 to 44.7 +/- 38.4 episodes/h (p = 0.025) and in Pcrit from 0.2 +/- 2.4 to -3.1 +/- 5.4 cm H2O (p = 0.016). Moreover, the percent change in DBR was correlated significantly with the change in Pcrit (p = 0.001). Subgroup analysis of responders and nonresponders demonstrated that significant differences in Pcrit were confined to the responders. Specifically, responders demonstrated a significant fall in Pcrit from -0.8 +/- 3.0 to -7.3 +/- 4.9 cm H2O (p = 0.01), whereas no significant change in Pcrit was detected in the nonresponders (1.1 +/- 1.6 versus 0.6 +/- 2.0 cm H2O. No clinical, polysomnographic, or physiologic predictors of a favorable response were found preoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A R Schwartz
- Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland
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Schwartz AR, Gold AR, Schubert N, Stryzak A, Wise RA, Permutt S, Smith PL. Effect of weight loss on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis 1991; 144:494-8. [PMID: 1892285 DOI: 10.1164/ajrccm/144.3_pt_1.494] [Citation(s) in RCA: 270] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Previous investigators have demonstrated in patients with obstructive sleep apnea that weight reduction results in a decrease in apnea severity. Although the mechanism for this decrease is not clear, we hypothesize that decreases in upper airway collapsibility account for decreases in apnea severity with weight loss. To determine whether weight loss causes decreases in collapsibility, we measured the upper airway critical pressure (Pcrit) before and after a 17.4 +/- 3.4% (mean +/- SD) reduction in body mass index in 13 patients with obstructive sleep apnea. Thirteen weight-stable control subjects matched for age, body mass index, gender (all men), and non-REM disordered breathing rate (DBR) also were studied before and after usual care intervention. During non-REM sleep, maximal inspiratory airflow was measured by varying the level of nasal pressure and Pcrit was determined by the level of nasal pressure below which maximal inspiratory airflow ceased. In the weight loss group, a significant decrease in DBR from 83.3 +/- 31.0 to 32.5 +/- 35.9 episodes/h and in Pcrit from 3.1 +/- 4.2 to -2.4 +/- 4.4 cm H2O (p less than 0.00001) was demonstrated. Moreover, decreases in Pcrit were associated with nearly complete elimination of apnea in each patient whose Pcrit fell below -4 cm H2O. In contrast, no significant change in DBR and a minimal reduction in Pcrit from 5.2 +/- 2.3 to 4.2 +/- 1.8 cm H2O (p = 0.031) was observed in the "usual care" group. We conclude that (1) weight loss is associated with decreases in upper airway collapsibility in obstructive sleep apnea, and that (2) the resolution of sleep apnea depends on the absolute level to which Pcrit falls.
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Affiliation(s)
- A R Schwartz
- Department of Medicine, Johns Hopkins Asthma and Allergy Center, Francis Scott Key Medical Center, Baltimore, Maryland 21224
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Gleadhill IC, Schwartz AR, Schubert N, Wise RA, Permutt S, Smith PL. Upper airway collapsibility in snorers and in patients with obstructive hypopnea and apnea. Am Rev Respir Dis 1991; 143:1300-3. [PMID: 2048817 DOI: 10.1164/ajrccm/143.6.1300] [Citation(s) in RCA: 293] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
During sleep, mild reduction in inspiratory airflow is associated with snoring, whereas obstructive hypopneas and apneas are associated with more marked reductions in airflow. We determined whether the degree of inspiratory airflow reduction was associated with differences in the collapsibility of the upper airway during sleep. Upper airway collapsibility was defined by the critical pressure (Pcrit) derived from the relationship between maximal inspiratory airflow and nasal pressure. In 10 asymptomatic snorers, six patients with obstructive hypopneas, and 10 patients with obstructive apneas, during nonrapid eye movement sleep, Pcrit ranged from -6.5 +/- 2.7 cm H2O to -1.6 +/- 1.4 and 2.5 +/- 1.5 cm H2O, respectively (mean +/- SD, p less than 0.001). Moreover, higher levels of Pcrit were associated with lower levels of maximal inspiratory airflow during tidal breathing during sleep (p less than 0.005). We conclude that differences in upper airway collapsibility distinguish among groups of normal subjects who snore and patients with periodic hypopneas and apneas. Moreover, the findings suggest that small differences in collapsibility (Pcrit) along a continuum are associated with reduced airflow and altered changes in pattern of breathing.
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Affiliation(s)
- I C Gleadhill
- Johns Hopkins Sleep Disorders Center, Division of Pulmonary Medicine, Baltimore, Maryland
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