Sample records for african sleeping sickness

  1. The continuing problem of human African trypanosomiasis (sleeping sickness). (United States)

    Kennedy, Peter G E


    Human African trypanosomiasis, also known as sleeping sickness, is a neglected disease, and it continues to pose a major threat to 60 million people in 36 countries in sub-Saharan Africa. Transmitted by the bite of the tsetse fly, the disease is caused by protozoan parasites of the genus Trypanosoma and comes in two types: East African human African trypanosomiasis caused by Trypanosoma brucei rhodesiense and the West African form caused by Trypanosoma brucei gambiense. There is an early or hemolymphatic stage and a late or encephalitic stage, when the parasites cross the blood-brain barrier to invade the central nervous system. Two critical current issues are disease staging and drug therapy, especially for late-stage disease. Lumbar puncture to analyze cerebrospinal fluid will remain the only method of disease staging until reliable noninvasive methods are developed, but there is no widespread consensus as to what exactly defines biologically central nervous system disease or what specific cerebrospinal fluid findings should justify drug therapy for late-stage involvement. All four main drugs used for human African trypanosomiasis are toxic, and melarsoprol, the only drug that is effective for both types of central nervous system disease, is so toxic that it kills 5% of patients who receive it. Eflornithine, alone or combined with nifurtimox, is being used increasingly as first-line therapy for gambiense disease. There is a pressing need for an effective, safe oral drug for both stages of the disease, but this will require a significant increase in investment for new drug discovery from Western governments and the pharmaceutical industry.

  2. Clinical features, diagnosis, and treatment of human African trypanosomiasis (sleeping sickness). (United States)

    Kennedy, Peter Ge


    Human African trypanosomiasis, or sleeping sickness, is caused by infection with parasites of the genus Trypanosoma, transmitted by the tsetse fly. The disease has two forms, Trypanosoma brucei (T b) rhodesiense and T b gambiense; and is almost always fatal if untreated. Despite a recent reduction in the number of reported cases, patients with African trypanosomiasis continue to present major challenges to clinicians. Because treatment for CNS-stage disease can be very toxic, diagnostic staging to distinguish early-stage from late-stage disease when the CNS in invaded is crucial but remains problematic. Melarsoprol is the only available treatment for late-stage T b rhodesiense infection, but can be lethal to 5% of patients owing to post-treatment reactive encephalopathy. Eflornithine combined with nifurtimox is the first-line treatment for late-stage T b gambiense. New drugs are in the pipeline for treatment of CNS human African trypanosomiasis, giving rise to cautious optimism.

  3. Population genetics of Glossina palpalis palpalis from central African sleeping sickness foci

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    Solano Philippe


    Full Text Available Abstract Background Glossina palpalis palpalis (Diptera: Glossinidae is widespread in west Africa, and is the main vector of sleeping sickness in Cameroon as well as in the Bas Congo Province of the Democratic Republic of Congo. However, little is known on the structure of its populations. We investigated G. p. palpalis population genetic structure in five sleeping sickness foci (four in Cameroon, one in Democratic Republic of Congo using eight microsatellite DNA markers. Results A strong isolation by distance explains most of the population structure observed in our sampling sites of Cameroon and DRC. The populations here are composed of panmictic subpopulations occupying fairly wide zones with a very strong isolation by distance. Effective population sizes are probably between 20 and 300 individuals and if we assume densities between 120 and 2000 individuals per km2, dispersal distance between reproducing adults and their parents extends between 60 and 300 meters. Conclusions This first investigation of population genetic structure of G. p. palpalis in Central Africa has evidenced random mating subpopulations over fairly large areas and is thus at variance with that found in West African populations of G. p. palpalis. This study brings new information on the isolation by distance at a macrogeographic scale which in turn brings useful information on how to organise regional tsetse control. Future investigations should be directed at temporal sampling to have more accurate measures of demographic parameters in order to help vector control decision.

  4. Gene fusion analysis in the battle against the African endemic sleeping sickness.

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    Philip Trimpalis

    Full Text Available The protozoan Trypanosoma brucei causes African Trypanosomiasis or sleeping sickness in humans, which can be lethal if untreated. Most available pharmacological treatments for the disease have severe side-effects. The purpose of this analysis was to detect novel protein-protein interactions (PPIs, vital for the parasite, which could lead to the development of drugs against this disease to block the specific interactions. In this work, the Domain Fusion Analysis (Rosetta Stone method was used to identify novel PPIs, by comparing T. brucei to 19 organisms covering all major lineages of the tree of life. Overall, 49 possible protein-protein interactions were detected, and classified based on (a statistical significance (BLAST e-value, domain length etc., (b their involvement in crucial metabolic pathways, and (c their evolutionary history, particularly focusing on whether a protein pair is split in T. brucei and fused in the human host. We also evaluated fusion events including hypothetical proteins, and suggest a possible molecular function or involvement in a certain biological process. This work has produced valuable results which could be further studied through structural biology or other experimental approaches so as to validate the protein-protein interactions proposed here. The evolutionary analysis of the proteins involved showed that, gene fusion or gene fission events can happen in all organisms, while some protein domains are more prone to fusion and fission events and present complex evolutionary patterns.

  5. Spatial predictions of Rhodesian Human African Trypanosomiasis (sleeping sickness prevalence in Kaberamaido and Dokolo, two newly affected districts of Uganda.

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    Nicola A Batchelor

    Full Text Available The continued northwards spread of Rhodesian sleeping sickness or Human African Trypanosomiasis (HAT within Uganda is raising concerns of overlap with the Gambian form of the disease. Disease convergence would result in compromised diagnosis and treatment for HAT. Spatial determinants for HAT are poorly understood across small areas. This study examines the relationships between Rhodesian HAT and several environmental, climatic and social factors in two newly affected districts, Kaberamaido and Dokolo. A one-step logistic regression analysis of HAT prevalence and a two-step logistic regression method permitted separate analysis of both HAT occurrence and HAT prevalence. Both the occurrence and prevalence of HAT were negatively correlated with distance to the closest livestock market in all models. The significance of distance to the closest livestock market strongly indicates that HAT may have been introduced to this previously unaffected area via the movement of infected, untreated livestock from endemic areas. This illustrates the importance of the animal reservoir in disease transmission, and highlights the need for trypanosomiasis control in livestock and the stringent implementation of regulations requiring the treatment of cattle prior to sale at livestock markets to prevent any further spread of Rhodesian HAT within Uganda.

  6. Spatial predictions of Rhodesian Human African Trypanosomiasis (sleeping sickness) prevalence in Kaberamaido and Dokolo, two newly affected districts of Uganda. (United States)

    Batchelor, Nicola A; Atkinson, Peter M; Gething, Peter W; Picozzi, Kim; Fèvre, Eric M; Kakembo, Abbas S L; Welburn, Susan C


    The continued northwards spread of Rhodesian sleeping sickness or Human African Trypanosomiasis (HAT) within Uganda is raising concerns of overlap with the Gambian form of the disease. Disease convergence would result in compromised diagnosis and treatment for HAT. Spatial determinants for HAT are poorly understood across small areas. This study examines the relationships between Rhodesian HAT and several environmental, climatic and social factors in two newly affected districts, Kaberamaido and Dokolo. A one-step logistic regression analysis of HAT prevalence and a two-step logistic regression method permitted separate analysis of both HAT occurrence and HAT prevalence. Both the occurrence and prevalence of HAT were negatively correlated with distance to the closest livestock market in all models. The significance of distance to the closest livestock market strongly indicates that HAT may have been introduced to this previously unaffected area via the movement of infected, untreated livestock from endemic areas. This illustrates the importance of the animal reservoir in disease transmission, and highlights the need for trypanosomiasis control in livestock and the stringent implementation of regulations requiring the treatment of cattle prior to sale at livestock markets to prevent any further spread of Rhodesian HAT within Uganda.

  7. African horse sickness. (United States)

    Mellor, Philip Scott; Hamblin, Christopher


    African horse sickness virus (AHSV) causes a non-contagious, infectious insect-borne disease of equids and is endemic in many areas of sub-Saharan Africa and possibly Yemen in the Arabian Peninsula. However, periodically the virus makes excursions beyond its endemic areas and has at times extended as far as India and Pakistan in the east and Spain and Portugal in the west. The vectors are certain species of Culicoides biting midge the most important of which is the Afro-Asiatic species C. imicola. This paper describes the effects that AHSV has on its equid hosts, aspects of its epidemiology, and present and future prospects for control. The distribution of AHSV seems to be governed by a number of factors including the efficiency of control measures, the presence or absence of a long term vertebrate reservoir and, most importantly, the prevalence and seasonal incidence of the major vector which is controlled by climate. However, with the advent of climate-change the major vector, C. imicola, has now significantly extended its range northwards to include much of Portugal, Spain, Italy and Greece and has even been recorded from southern Switzerland. Furthermore, in many of these new locations the insect is present and active throughout the entire year. With the related bluetongue virus, which utilises the same vector species of Culicoides this has, since 1998, precipitated the worst outbreaks of bluetongue disease ever recorded with the virus extending further north in Europe than ever before and apparently becoming endemic in that continent. The prospects for similar changes in the epidemiology and distribution of AHSV are discussed.

  8. A literature review of economic evaluations for a neglected tropical disease: human African trypanosomiasis ("sleeping sickness"). (United States)

    Sutherland, C Simone; Yukich, Joshua; Goeree, Ron; Tediosi, Fabrizio


    Human African trypanosomiasis (HAT) is a disease caused by infection with the parasite Trypanosoma brucei gambiense or T. b. rhodesiense. It is transmitted to humans via the tsetse fly. Approximately 70 million people worldwide were at risk of infection in 1995, and approximately 20,000 people across Africa are infected with HAT. The objective of this review was to identify existing economic evaluations in order to summarise cost-effective interventions to reduce, control, or eliminate the burden of HAT. The studies included in the review were compared and critically appraised in order to determine if there were existing standardised methods that could be used for economic evaluation of HAT interventions or if innovative methodological approaches are warranted. A search strategy was developed using keywords and was implemented in January 2014 in several databases. The search returned a total of 2,283 articles. After two levels of screening, a total of seven economic evaluations were included and underwent critical appraisal using the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist 6: Economic Evaluations. Results from the existing studies focused on the cost-effectiveness of interventions for the control and reduction of disease transmission. Modelling was a common method to forecast long-term results, and publications focused on interventions by category, such as case detection, diagnostics, drug treatments, and vector control. Most interventions were considered cost-effective based on the thresholds described; however, the current treatment, nifurtomix-eflornithine combination therapy (NECT), has not been evaluated for cost-effectiveness, and considerations for cost-effective strategies for elimination have yet to be completed. Overall, the current evidence highlights the main components that play a role in control; however, economic evaluations of HAT elimination strategies are needed to assist national decision makers, stakeholders, and

  9. Late stage infection in sleeping sickness.

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    Hartwig Wolburg

    Full Text Available At the turn of the 19(th century, trypanosomes were identified as the causative agent of sleeping sickness and their presence within the cerebrospinal fluid of late stage sleeping sickness patients was described. However, no definitive proof of how the parasites reach the brain has been presented so far. Analyzing electron micrographs prepared from rodent brains more than 20 days after infection, we present here conclusive evidence that the parasites first enter the brain via the choroid plexus from where they penetrate the epithelial cell layer to reach the ventricular system. Adversely, no trypanosomes were observed within the parenchyma outside blood vessels. We also show that brain infection depends on the formation of long slender trypanosomes and that the cerebrospinal fluid as well as the stroma of the choroid plexus is a hostile environment for the survival of trypanosomes, which enter the pial space including the Virchow-Robin space via the subarachnoid space to escape degradation. Our data suggest that trypanosomes do not intend to colonize the brain but reside near or within the glia limitans, from where they can re-populate blood vessels and disrupt the sleep wake cycles.

  10. Tsetse elimination: its interest and feasibility in the historical sleeping sickness focus of Loos islands, Guinea

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    Kagbadouno M.


    Full Text Available Guinea is the West African country which is currently the most prevalent for sleeping sickness. The littoral area is the region where most of the recent sleeping sickness cases have been described, especially the mangrove sleeping sickness foci of Dubreka and Boffa where Glossina palpalis gambiensis is the vector. Loos islands constitute a small archipelago 5 km apart from the capital, Conakry. Medical, animal, and entomological surveys were implemented in these islands in Oct-Nov 2006. No pathogenic trypanosomes were found in these surveys. The locally very high tsetse densities (up to more than 100 tsetse/trap/day linked to pig rearing, constitute a high potential risk for humans (taking into account populations movements with neighboring active sleeping sickness foci of the Guinea littoral, and the history of sleeping sickness on these islands, and for the economically important pig rearing, as well as a danger for tourism. This situation, associated to the possibility of elimination of these tsetse populations due to low possibility of reinvasion, led the National Control Program to launch a tsetse elimination project following an “area wide” strategy for the first time in West Africa, which participates in the global objective of the PATTEC (Pan African Tsetse and Trypanosomosis Eradication Campaign.

  11. The development of drugs for treatment of sleeping sickness: a historical review

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    Steverding Dietmar


    Full Text Available Abstract Only four drugs are available for the chemotherapy of human African trypanosomiasis or sleeping sickness; Suramin, pentamidine, melarsoprol and eflornithine. The history of the development of these drugs is well known and documented. suramin, pentamidine and melarsoprol were developed in the first half of the last century by the then recently established methods of medicinal chemistry. Eflornithine, originally developed in the 1970s as an anti-cancer drug, became a treatment of sleeping sickness largely by accident. This review summarises the developmental processes which led to these chemotherapies from the discovery of the first bioactive lead compounds to the identification of the final drugs.

  12. We Remember… Elders' Memories and Perceptions of Sleeping Sickness Control Interventions in West Nile, Uganda.

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    Vanja Kovacic


    Full Text Available The traditional role of African elders and their connection with the community make them important stakeholders in community-based disease control programmes. We explored elders' memories related to interventions against sleeping sickness to assess whether or not past interventions created any trauma which might hamper future control operations. Using a qualitative research framework, we conducted and analysed twenty-four in-depth interviews with Lugbara elders from north-western Uganda. Participants were selected from the villages inside and outside known historical sleeping sickness foci. Elders' memories ranged from examinations of lymph nodes conducted in colonial times to more recent active screening and treatment campaigns. Some negative memories dating from the 1990s were associated with diagnostic procedures, treatment duration and treatment side effects, and were combined with memories of negative impacts related to sleeping sickness epidemics particularly in HAT foci. More positive observations from the recent treatment campaigns were reported, especially improvements in treatment. Sleeping sickness interventions in our research area did not create any permanent traumatic memories, but memories remained flexible and open to change. This study however identified that details related to medical procedures can remain captured in a community's collective memory for decades. We recommend more emphasis on communication between disease control programme planners and communities using detailed and transparent information distribution, which is not one directional but rather a dialogue between both parties.

  13. Sleeping sickness in travelers - do they really sleep?

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    Karin Urech


    Full Text Available The number of imported Human African Trypanosomiasis (HAT cases in non-endemic countries has increased over the last years. The objective of this analysis is to describe the clinical presentation of HAT in Caucasian travelers. Literature was screened (MEDLINE, Pubmed using the terms "Human African Trypanosomiasis", "travelers" and "expatriates"; all European languages except Slavic ones were included. Publications without clinical description of patients were only included in the epidemiological analysis. Forty-five reports on Caucasians with T.b. rhodesiense and 15 with T.b. gambiense infections were included in the analysis of the clinical parameters. Both species have presented with fever (T.b. rhodesiense 97.8% and T.b. gambiense 93.3%, headache (50% each and a trypanosomal chancre (T.b. rhodesiense 84.4%, T.b. gambiense 46.7%. While sleeping disorders dominate the clinical presentation of HAT in endemic regions, there have been only rare reports in travelers: insomnia (T.b. rhodesiense 7.1%, T.b. gambiense 21.4%, diurnal somnolence (T.b. rhodesiense 4.8%, T.b. gambiense none. Surprisingly, jaundice has been seen in 24.2% of the Caucasian T.b. rhodesiense patients, but has never been described in HAT patients in endemic regions. These results contrast to the clinical presentation of T.b. gambiense and T.b. rhodesiense HAT in Africans in endemic regions, where the presentation of chronic T.b. gambiense and acute T.b. rhodesiense HAT is different. The analysis of 14 reports on T.b. gambiense HAT in Africans living in a non-endemic country shows that neurological symptoms such as somnolence (46.2%, motor deficit (64.3% and reflex anomalies (14.3% as well as psychiatric symptoms such as hallucinations (21.4% or depression (21.4% may dominate the clinical picture. Often, the diagnosis has been missed initially: some patients have even been hospitalized in psychiatric clinics. In travelers T.b. rhodesiense and gambiense present as acute illnesses

  14. Tsetse Control and Gambian Sleeping Sickness; Implications for Control Strategy.

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    Inaki Tirados

    Full Text Available Gambian sleeping sickness (human African trypanosomiasis, HAT outbreaks are brought under control by case detection and treatment although it is recognised that this typically only reaches about 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because it is considered too expensive and difficult to organise in resource-poor settings. We conducted a full scale field trial of a refined vector control technology to determine its utility in control of Gambian HAT.The major vector of Gambian HAT is the tsetse fly Glossina fuscipes which lives in the humid zone immediately adjacent to water bodies. From a series of preliminary trials we determined the number of tiny targets required to reduce G. fuscipes populations by more than 90%. Using these data for model calibration we predicted we needed a target density of 20 per linear km of river in riverine savannah to achieve >90% tsetse control. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda to determine the efficacy of tiny targets (overall target density 5.7/km2. In 12 months, tsetse populations declined by more than 90%. As a guide we used a published HAT transmission model and calculated that a 72% reduction in tsetse population is required to stop transmission in those settings.The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment, covering 80% of the population, is US$433,333 (WHO figures. One year of vector control organised within the country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this method of vector control to case detection and treatment is strong. We outline how such a component could be organised.

  15. N-myristoyltransferase inhibitors as new leads to treat sleeping sickness

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    Frearson, Julie A.; Brand, Stephen; McElroy, Stuart P.; Cleghorn, Laura A.T.; Smid, Ondrej; Stojanovski, Laste; Price, Helen P.; Guther, M. Lucia S.; Torrie, Leah S.; Robinson, David A.; Hallyburton, Irene; Mpamhanga, Chidochangu P.; Brannigan, James A.; Wilkinson, Anthony J.; Hodgkinson, Michael; Hui, Raymond; Qiu, Wei; Raimi, Olawale G.; van Aalten, Daan M.F.; Brenk, Ruth; Gilbert, Ian H.; Read, Kevin D.; Fairlamb, Alan H.; Ferguson, Michael A.J.; Smith, Deborah F.; Wyatt, Paul G. (York); (Toronto); (Dundee)


    African sleeping sickness or human African trypanosomiasis, caused by Trypanosoma brucei spp., is responsible for {approx}30,000 deaths each year. Available treatments for this disease are poor, with unacceptable efficacy and safety profiles, particularly in the late stage of the disease when the parasite has infected the central nervous system. Here we report the validation of a molecular target and the discovery of associated lead compounds with the potential to address this lack of suitable treatments. Inhibition of this target - T. brucei N-myristoyltransferase - leads to rapid killing of trypanosomes both in vitro and in vivo and cures trypanosomiasis in mice. These high-affinity inhibitors bind into the peptide substrate pocket of the enzyme and inhibit protein N-myristoylation in trypanosomes. The compounds identified have promising pharmaceutical properties and represent an opportunity to develop oral drugs to treat this devastating disease. Our studies validate T. brucei N-myristoyltransferase as a promising therapeutic target for human African trypanosomiasis.

  16. Should I Get Screened for Sleeping Sickness? A Qualitative Study in Kasai Province, Democratic Republic of Congo


    Alain Mpanya; David Hendrickx; Mimy Vuna; Albert Kanyinda; Crispin Lumbala; Valéry Tshilombo; Patrick Mitashi; Oscar Luboya; Victor Kande; Marleen Boelaert; Pierre Lefèvre; Pascal Lutumba


    BACKGROUND: Control of human African trypanosomiasis (sleeping sickness) in the Democratic Republic of Congo is based on mass population active screening by mobile teams. Although generally considered a successful strategy, the community participation rates in these screening activities and ensuing treatment remain low in the Kasai-Oriental province. A better understanding of the reasons behind this observation is necessary to improve regional control activities. METHODS: Thirteen focus group...

  17. African horse sickness in naturally infected, immunised horses. (United States)

    Weyer, C T; Quan, M; Joone, C; Lourens, C W; MacLachlan, N J; Guthrie, A J


    To determine whether subclinical cases, together with clinical cases, of African horse sickness (AHS) occur in immunised horses in field conditions, whole blood samples were collected and rectal temperatures recorded weekly from 50 Nooitgedacht ponies resident in open camps at the Faculty of Veterinary Science, University of Pretoria, Onderstepoort, during 2008-2010. The samples were tested for the presence of African horse sickness virus (AHSV) RNA by a recently developed real-time RT-PCR. It was shown that 16% of immunised horses in an AHS endemic area were infected with AHSV over a 2 year period, with half of these (8%) being subclinically infected. The potential impact of such cases on the epidemiology of AHS warrants further investigation.

  18. Mapping sleeping sickness in Western Africa in a context of demographic transition and climate change

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    Cecchi G.


    Full Text Available Human population growth, climate change and economic development are causing major environmental modifications in Western Africa, which will have important repercussions on the epidemiology of sleeping sickness. A new initiative, the Atlas of human African trypanosomiasis (HAT, aims at assembling and geo-referencing all epidemiological data derived from both active screening activities and passive surveillance. A geographic database enables to generate up-to-date disease maps at a range of scales and of unprecedented spatial accuracy. We present preliminary results for seven West African countries (Benin, Burkina Faso, Côte d’Ivoire, Ghana, Guinea, Mali and Togo and briefly discuss the relevance of the Atlas for future monitoring, control and research activities.

  19. Should I get screened for sleeping sickness? A qualitative study in Kasai province, Democratic Republic of Congo.

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    Alain Mpanya


    Full Text Available BACKGROUND: Control of human African trypanosomiasis (sleeping sickness in the Democratic Republic of Congo is based on mass population active screening by mobile teams. Although generally considered a successful strategy, the community participation rates in these screening activities and ensuing treatment remain low in the Kasai-Oriental province. A better understanding of the reasons behind this observation is necessary to improve regional control activities. METHODS: Thirteen focus group discussions were held in five health zones of the Kasai-Oriental province to gain insights in the regional perceptions regarding sleeping sickness and the national control programme's activities. PRINCIPAL FINDINGS: Sleeping sickness is well known among the population and is considered a serious and life-threatening disease. The disease is acknowledged to have severe implications for the individual (e.g., persistence of manic periods and trembling hands, even after treatment, at the family level (e.g., income loss, conflicts, separations and for communities (e.g., disruption of community life and activities. Several important barriers to screening and treatment were identified. Fear of drug toxicity, lack of confidentiality during screening procedures, financial barriers and a lack of communication between the mobile teams and local communities were described. Additionally, a number of regionally accepted prohibitions related to sleeping sickness treatment were described that were found to be a strong impediment to disease screening and treatment. These prohibitions, which do not seem to have a rational basis, have far-reaching socio-economic repercussions and severely restrict the participation in day-to-day life. CONCLUSIONS/SIGNIFICANCE: A mobile screening calendar more adapted to the local conditions with more respect for privacy, the use of less toxic drugs, and a better understanding of the origin as well as better communication about the prohibitions

  20. Agrochemicals against malaria, sleeping sickness, leishmaniasis and Chagas disease.

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    Matthias Witschel

    Full Text Available In tropical regions, protozoan parasites can cause severe diseases with malaria, leishmaniasis, sleeping sickness, and Chagas disease standing in the forefront. Many of the drugs currently being used to treat these diseases have been developed more than 50 years ago and can cause severe adverse effects. Above all, resistance to existing drugs is widespread and has become a serious problem threatening the success of control measures. In order to identify new antiprotozoal agents, more than 600 commercial agrochemicals have been tested on the pathogens causing the above mentioned diseases. For all of the pathogens, compounds were identified with similar or even higher activities than the currently used drugs in applied in vitro assays. Furthermore, in vivo activity was observed for the fungicide/oomyceticide azoxystrobin, and the insecticide hydramethylnon in the Plasmodium berghei mouse model, and for the oomyceticide zoxamide in the Trypanosoma brucei rhodesiense STIB900 mouse model, respectively.

  1. The natural progression of Gambiense sleeping sickness: what is the evidence?

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    Francesco Checchi

    Full Text Available Gambiense human African trypanosomiasis (HAT, sleeping sickness is widely assumed to be 100% pathogenic and fatal. However, reports to the contrary exist, and human trypano-tolerance has been postulated. Furthermore, there is uncertainty about the actual duration of both stage 1 and stage 2 infection, particularly with respect to how long a patient remains infectious. Understanding such basic parameters of HAT infection is essential for optimising control strategies based on case detection. We considered the potential existence and relevance of human trypano-tolerance, and explored the duration of infectiousness, through a review of published evidence on the natural progression of gambiense HAT in the absence of treatment, and biological considerations. Published reports indicate that most gambiense HAT cases are fatal if untreated. Self-resolving and asymptomatic chronic infections probably constitute a minority if they do indeed exist. Chronic carriage, however, deserves further study, as it could seed renewed epidemics after control programmes cease.

  2. Civil conflict and sleeping sickness in Africa in general and Uganda in particular

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    Berrang Ford Lea


    Full Text Available Abstract Conflict and war have long been recognized as determinants of infectious disease risk. Re-emergence of epidemic sleeping sickness in sub-Saharan Africa since the 1970s has coincided with extensive civil conflict in affected regions. Sleeping sickness incidence has placed increasing pressure on the health resources of countries already burdened by malaria, HIV/AIDS, and tuberculosis. In areas of Sudan, the Democratic Republic of the Congo, and Angola, sleeping sickness occurs in epidemic proportions, and is the first or second greatest cause of mortality in some areas, ahead of HIV/AIDS. In Uganda, there is evidence of increasing spread and establishment of new foci in central districts. Conflict is an important determinant of sleeping sickness outbreaks, and has contributed to disease resurgence. This paper presents a review and characterization of the processes by which conflict has contributed to the occurrence of sleeping sickness in Africa. Conflict contributes to disease risk by affecting the transmission potential of sleeping sickness via economic impacts, degradation of health systems and services, internal displacement of populations, regional insecurity, and reduced access for humanitarian support. Particular focus is given to the case of sleeping sickness in south-eastern Uganda, where incidence increase is expected to continue. Disease intervention is constrained in regions with high insecurity; in these areas, political stabilization, localized deployment of health resources, increased administrative integration and national capacity are required to mitigate incidence. Conflict-related variables should be explicitly integrated into risk mapping and prioritization of targeted sleeping sickness research and mitigation initiatives.

  3. Civil conflict and sleeping sickness in Africa in general and Uganda in particular. (United States)

    Berrang Ford, Lea


    Conflict and war have long been recognized as determinants of infectious disease risk. Re-emergence of epidemic sleeping sickness in sub-Saharan Africa since the 1970s has coincided with extensive civil conflict in affected regions. Sleeping sickness incidence has placed increasing pressure on the health resources of countries already burdened by malaria, HIV/AIDS, and tuberculosis. In areas of Sudan, the Democratic Republic of the Congo, and Angola, sleeping sickness occurs in epidemic proportions, and is the first or second greatest cause of mortality in some areas, ahead of HIV/AIDS. In Uganda, there is evidence of increasing spread and establishment of new foci in central districts. Conflict is an important determinant of sleeping sickness outbreaks, and has contributed to disease resurgence. This paper presents a review and characterization of the processes by which conflict has contributed to the occurrence of sleeping sickness in Africa. Conflict contributes to disease risk by affecting the transmission potential of sleeping sickness via economic impacts, degradation of health systems and services, internal displacement of populations, regional insecurity, and reduced access for humanitarian support. Particular focus is given to the case of sleeping sickness in south-eastern Uganda, where incidence increase is expected to continue. Disease intervention is constrained in regions with high insecurity; in these areas, political stabilization, localized deployment of health resources, increased administrative integration and national capacity are required to mitigate incidence. Conflict-related variables should be explicitly integrated into risk mapping and prioritization of targeted sleeping sickness research and mitigation initiatives.

  4. [Ivory Coast uprising and returning Burkinabe immigrants: evaluation of the risk for reemergence of sleeping sickness in Burkina Faso]. (United States)

    Courtin, F; Jamonneau, V; Kambiré, R; Solano, P


    Following the sociopolitical unrest that occurred in Ivory Coast in 2002, 360,000 Burkinabe immigrants returned to Burkina Faso that was the epicenter of sleeping sickness last century and is now thought to be free of autochthonous transmission. The purpose of this study was to determine if the massive return of immigrants from human African trypanosomiasis (HAT) endemic areas of Ivory Coast to areas in Burkina Faso where the vector (tsetse fly) is currently present could lead to re-emergence of the disease. Risk areas for re-emergence were identified taking into account the number of returning immigrants, history of the disease, and presence of tsetse flies. Based on these criteria, study was focused on two villages, i.e., Folonzo and Gbalara, located in southern Burkina Faso near the Ivory Coast border. Study in these two villages consisted of characterization of the population (repatriates or not, origin, ...) and medical surveys to assess the presence/absence of the disease. Departure of some returning immigrants from areas including sleeping sickness foci in Ivory Coast (e.g. center west) confirmed the potential risk of re-emergence of the disease. Although no case of sleeping sickness was diagnosed, several serologically positive people were identified and will be followed up. This study failed to demonstrate a clear-cut correlation between massive population movements due to war and reemergence of sleeping sickness. However, this study may have been timed too soon after the return of immigrants to detect reemergence of HAT that could require several years.

  5. Prevalence and Types of Coinfections in Sleeping Sickness Patients in Kenya (2000/2009

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    J. M. Kagira


    Full Text Available The occurrence of coinfections in human African trypanosomiasis (HAT patients was investigated using a retrospective data of hospital records at the National Sleeping Sickness Referral Hospital in Alupe, Kenya. A total of 31 patients, 19 males and 12 females, were diagnosed with HAT between the years 2000 and 2009. The observed co-infections included malaria (100%, helminthosis (64.5%, typhoid (22.5%, urinary tract infections (16.1%, HIV (12.9%, and tuberculosis (3.2%. The species of helminthes observed included Ancylostoma duodenale (38.7%, Ascaris lumbricoides (45.7%, Strongyloides stercoralis (9.7%, and Taenia spp. (3.2%. The patients were also infected with Entamoeba spp. (32.3% and Trichomonas hominis (22.6% protozoan parasites. The main clinical signs observed at the point of admission included headache (74.2%, fever (48.4%, sleep disorders (45.2%, and general body pain (41.9%. The HAT patients were treated with suramin (early stage, 9/31 and melarsoprol (late stage, 22/31. In conclusion, the study has shown that HAT patients have multiple co-infections which may influence the disease pathogenesis and complicate management of HAT.

  6. Joint association of sleep problems and psychosocial working conditions with registered long-term sickness absence

    DEFF Research Database (Denmark)

    Madsen, Ida E. H.; Larsen, Ann D.; Thorsen, Sannie V.


    questionnaire response. We defined sleep problems by self-reported symptoms and/or register data on hypnotics purchases of hypnotics. Psychosocial working conditions included quantitative and emotional demands, influence, supervisor recognition and social support, leadership quality, and social support from......Objectives: Sleep problems and adverse psychosocial working conditions are associated with increased risk of long-term sickness absence. Because sleep problems affect role functioning they may also exacerbate any effects of psychosocial working conditions and vice versa. We examined whether sleep...... problems and psychosocial working conditions interact in their associations with long-term sickness absence. Methods: We linked questionnaire data from participants to two surveys of random samples of the Danish working population (N=10 752) with registries on long-term sick leave during five years after...

  7. Simulating the elimination of sleeping sickness with an agent-based model (United States)

    Grébaut, Pascal; Girardin, Killian; Fédérico, Valentine; Bousquet, François


    Although Human African Trypanosomiasis is largely considered to be in the process of extinction today, the persistence of human and animal reservoirs, as well as the vector, necessitates a laborious elimination process. In this context, modeling could be an effective tool to evaluate the ability of different public health interventions to control the disease. Using the Cormas® system, we developed HATSim, an agent-based model capable of simulating the possible endemic evolutions of sleeping sickness and the ability of National Control Programs to eliminate the disease. This model takes into account the analysis of epidemiological, entomological, and ecological data from field studies conducted during the last decade, making it possible to predict the evolution of the disease within this area over a 5-year span. In this article, we first present HATSim according to the Overview, Design concepts, and Details (ODD) protocol that is classically used to describe agent-based models, then, in a second part, we present predictive results concerning the evolution of Human African Trypanosomiasis in the village of Lambi (Cameroon), in order to illustrate the interest of such a tool. Our results are consistent with what was observed in the field by the Cameroonian National Control Program (CNCP). Our simulations also revealed that regular screening can be sufficient, although vector control applied to all areas with human activities could be significantly more efficient. Our results indicate that the current model can already help decision-makers in planning the elimination of the disease in foci. PMID:28008825

  8. Simulating the elimination of sleeping sickness with an agent-based model

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    Grébaut Pascal


    Full Text Available Although Human African Trypanosomiasis is largely considered to be in the process of extinction today, the persistence of human and animal reservoirs, as well as the vector, necessitates a laborious elimination process. In this context, modeling could be an effective tool to evaluate the ability of different public health interventions to control the disease. Using the Cormas® system, we developed HATSim, an agent-based model capable of simulating the possible endemic evolutions of sleeping sickness and the ability of National Control Programs to eliminate the disease. This model takes into account the analysis of epidemiological, entomological, and ecological data from field studies conducted during the last decade, making it possible to predict the evolution of the disease within this area over a 5-year span. In this article, we first present HATSim according to the Overview, Design concepts, and Details (ODD protocol that is classically used to describe agent-based models, then, in a second part, we present predictive results concerning the evolution of Human African Trypanosomiasis in the village of Lambi (Cameroon, in order to illustrate the interest of such a tool. Our results are consistent with what was observed in the field by the Cameroonian National Control Program (CNCP. Our simulations also revealed that regular screening can be sufficient, although vector control applied to all areas with human activities could be significantly more efficient. Our results indicate that the current model can already help decision-makers in planning the elimination of the disease in foci.

  9. Skimp on Sleep and You Just May Wind Up Sick (United States)

    ... We don't know why sleep is so critical for maintaining health and immune function," said Broussard, who was not involved with the study. "Sleep remains somewhat of a mystery, even though we all sleep and chronic insufficient ...

  10. Carbohydrate-Binding Non-Peptidic Pradimicins for the Treatment of Acute Sleeping Sickness in Murine Models (United States)

    Castillo-Acosta, Víctor M.; Ruiz-Pérez, Luis M.; Reichardt, Niels C.; Igarashi, Yasuhiro; Liekens, Sandra; Balzarini, Jan


    Current treatments available for African sleeping sickness or human African trypanosomiasis (HAT) are limited, with poor efficacy and unacceptable safety profiles. Here, we report a new approach to address treatment of this disease based on the use of compounds that bind to parasite surface glycans leading to rapid killing of trypanosomes. Pradimicin and its derivatives are non-peptidic carbohydrate-binding agents that adhere to the carbohydrate moiety of the parasite surface glycoproteins inducing parasite lysis in vitro. Notably, pradimicin S has good pharmaceutical properties and enables cure of an acute form of the disease in mice. By inducing resistance in vitro we have established that the composition of the sugars attached to the variant surface glycoproteins are critical to the mode of action of pradimicins and play an important role in infectivity. The compounds identified represent a novel approach to develop drugs to treat HAT. PMID:27662652

  11. Survey on Trypanosoma spp. infection of dogs in Gabon and its epidemiological implications for sleeping sickness. (United States)

    Watier-Grillot, S; Herder, S; Marié, J-L; Bourry, O; Cuny, G; Davoust, B


    This survey screened native dogs (Canis familiaris) in Gabon (Africa) for trypanosome infection. A total of 376 apparently healthy dogs, divided into two populations, were examined. The first group included 252 semi-domesticated dogs inhabiting 16 villages of the Ogooué-Ivindo Province, a rural inland area in northeast Gabon, and the second group 124 dogs belonging to protection companies or families from Libreville (n = 113) and Port-Gentil (n = 11), in the coastal area of Gabon. Both study areas include active or former foci of sleeping sickness in Gabon. Molecular testing (polymerase chain reaction) was performed on blood samples from dogs in both groups. All dogs were negative for T. congolense ("savanna type" and "forest type"). Eighteen dogs (4.7%), however, tested positive for T. brucei s.l.: 3% (8/252) were from the Ogooué-Ivindo Province, and 8% (10/124) from the coastal area. These animals may be potential reservoirs of the parasite T. brucei gambiense, responsible for human African trypanosomiasis. This hypothesis, as well as the role of the dog as a sentinel of human infection by T. brucei gambiense, should be investigated in further studies.

  12. A review of African horse sickness and its implications for Ireland

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    Thompson Geoffrey M


    Full Text Available Abstract African horse sickness is an economically highly important non-contagious but infectious Orbivirus disease that is transmitted by various species of Culicoides midges. The equids most severely affected by the virus are horses, ponies, and European donkeys; mules are somewhat less susceptible, and African donkeys and zebra are refractory to the devastating consequences of infection. In recent years, Bluetongue virus, an Orbivirus similar to African horse sickness, which also utilises Culicoides spp. as its vector, has drastically increased its range into previously unaffected regions in northern Europe, utilising indigenous vector species, and causing widespread economic damage to the agricultural sector. Considering these events, the current review outlines the history of African horse sickness, including information concerning virus structure, transmission, viraemia, overwintering ability, and the potential implications that an outbreak would have for Ireland. While the current risk for the introduction of African horse sickness to Ireland is considered at worst ‘very low’, it is important to note that prior to the 2006 outbreak of Bluetongue in northern Europe, both diseases were considered to be of equal risk to the United Kingdom (‘medium-risk’. It is therefore likely that any outbreak of this disease would have serious socio-economic consequences for Ireland due to the high density of vulnerable equids and the prevalence of Culicoides species, potentially capable of vectoring the virus.

  13. Occurrence of African horse sickness in a domestic dog without apparent ingestion of horse meat

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    Sybrand J. van Sittert


    Full Text Available This is the first case of African horse sickness (AHS in a dog where there was no apparent ingestion of horse meat. Significantly, the dog was part of a colony that resides in a Good Clinical Practice and Good Laboratory Practice accredited facility where complete history, weather and feeding records are maintained. The dog died after a week-long illness despite therapy. The principal post-mortem findings were severe hydrothorax and pulmonary consolidation (red hepatisation of the lungs. Histopathology revealed severe oedema and congestion of the lungs, hyaline degeneration of the myocardium and congestion of the liver sinusoids. Immunohistochemistry detected AHS-positive staining granules in the myocardium, whilst a real-time reverse transcription quantitative Polymerase chain reaction assay of tissue samples was strongly positive for African horse sickness virus nucleic acid. Other dogs on the property showed a 43%seroconversion rate to AHS.

  14. [History of an epidemiological route between Ivory Coast and Burkina Faso: the case of the Koudougou sleeping sickness foci]. (United States)

    Kiendrébéogo, D; Kambiré, R; Jamonneau, V; Lingué, K; Solano, P; Courtin, F


    In the first half of the XXth century, while Upper-Volta (now Burkina Faso) was suffering a terrible epidemic of sleeping sickness, the French colonial administration encouraged the movement of people from Upper-Volta to Ivory Coast to meet their demands for labour. This led to the establishment of Mossi villages, such as those of Koudougou, in the Ivorian forest with populations originating from areas of Upper-Volta that were not only densely populated but also severely affected by sleeping sickness. Since 2000, most cases of sleeping sickness in the Koudougou district of Burkina Faso have been in people originally from Ivory Coast. Who are they? Where did they settle in Burkina Faso? Where do they come from in Ivory Coast? After having retraced the epidemiological history of Koudougou villages in Burkina Faso and Ivory Coast, the history of ten cases of sleeping sickness detected passively at Koudougou hospital since 2000 were analysed. All cases originated from the forest area of Ivory Coast. Understanding the spread of sleeping sickness between Burkina Faso and Ivory Coast will assist in the identification of areas of disease risk.

  15. Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda

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    Coleman Paul G


    Full Text Available Abstract Background Zoonotic sleeping sickness, or HAT (Human African Trypanosomiasis, caused by infection with Trypanosoma brucei rhodesiense, is an under-reported and neglected tropical disease. Previous assessments of the disease burden expressed as Disability-Adjusted Life Years (DALYs for this infection have not distinguished T.b. rhodesiense from infection with the related, but clinically distinct Trypanosoma brucei gambiense form. T.b. rhodesiense occurs focally, and it is important to assess the burden at the scale at which resource-allocation decisions are made. Methods The burden of T.b. rhodesiense was estimated during an outbreak of HAT in Serere, Uganda. We identified the unique characteristics affecting the burden of rhodesiense HAT such as age, severity, level of under-reporting and duration of hospitalisation, and use field data and empirical estimates of these to model the burden imposed by this and other important diseases in this study population. While we modelled DALYs using standard methods, we also modelled uncertainty of our parameter estimates through a simulation approach. We distinguish between early and late stage HAT morbidity, and used disability weightings appropriate for the T.b. rhodesiense form of HAT. We also use a model of under-reporting of HAT to estimate the contribution of un-reported mortality to the overall disease burden in this community, and estimate the cost-effectiveness of hospital-based HAT control. Results Under-reporting accounts for 93% of the DALY estimate of rhodesiense HAT. The ratio of reported malaria cases to reported HAT cases in the same health unit was 133:1, however, the ratio of DALYs was 3:1. The age productive function curve had a close correspondence with the HAT case distribution, and HAT cases occupied more patient admission time in Serere during 1999 than all other infectious diseases other than malaria. The DALY estimate for HAT in Serere shows that the burden is much greater

  16. Serological survey of African horse sickness in selected districts of Jimma zone, Southwestern Ethiopia. (United States)

    Bitew, Molalegne; Andargie, Ashenafi; Bekele, Mihreteab; Jenberie, Shiferaw; Ayelet, Gelagay; Gelaye, Esayas


    A cross-sectional serological survey was undertaken in selected districts of different agro-ecology of Jimma zone (Dedo, Yebu, Seka, Serbo, and Jimma town) from November 2009 to February 2010 to determine the seroprevalence of African horse sickness virus and associated risk factors of the disease. Two hundred seventy-four equids (189 horses, 43 mules, and 47 donkeys) with a history of non-vaccination for at least 2 years were selected randomly from the above areas. Sera samples were collected and assayed for the presence of specific antibody against African horse sickness virus using blocking ELISA. An overall seroprevalence of 89 (32.5%) was found and it was 24 (51.1%) for donkeys, 13 (30.2%) for mules, and 52(28.3%) for horses. Seroprevalence was significantly (X(2) = 11.05, P 0.05 and X(2) = 3.38, P > 0.05, respectively) associated with seroprevalence of AHSV. The present study showed that African horse sickness (AHS) is highly prevalent disease for the horses followed by mules and then donkeys in Jimma zone explained by lower seroconversion rate. Therefore, control strategy against AHS should target at high risk species of all age and sex in their locality in the initial stage for better containment of the disease.

  17. Plasma soluble erythropoietin receptor is decreased during sleep in Andean highlanders with Chronic Mountain Sickness


    Villafuerte, Francisco C.; Corante, Noemí; Anza-Ramírez, Cecilia; Figueroa-Mujíca, Rómulo; Vizcardo-Galindo, Gustavo; Mercado, Andy; Macarlupú, José Luis; León-Velarde, Fabiola


    Excessive erythrocytosis (EE) is the main sign of Chronic Mountain Sickness (CMS), a highly prevalent syndrome in Andean highlanders. Low pulse O2 saturation (SpO2) during sleep and serum androgens have been suggested to contribute to EE in CMS patients. However, whether these factors have a significant impact on the erythropoietin (Epo) system leading to EE is still unclear. We have recently shown that morning soluble Epo receptor (sEpoR), an endogenous Epo antagonist, is decreased in CMS pa...

  18. ["African sickness" and the heart: the mystery of endomyocardial fibrosis]. (United States)

    Grimaldi, Antonio; Alfieri, Ottavio; Camici, Paolo G; La Canna, Giovanni; Zoppei, Gianna; Olivotto, Iacopo


    The epidemic of cardiovascular disease is a global phenomenon and the magnitude of its increase in incidence and prevalence in low-income countries has potentially major implications for those high-income countries that characterize the developed world. The "epidemiologic transition" provides a useful framework for understanding changes in the patterns of disease as a result of socioeconomic and demographic developments. According to the migratory flow, the burden of African immigrants in Italy is rising, and there is a need to re-assess the clinical management of anything but obsolete western cardiovascular disorders also delving into the rare tropical neglected diseases. Rheumatic fever and tropical cardiac diseases, such as endomyocardial fibrosis in Africa and Chagas disease in Latin America, require a human resource framework to direct into research and intervention programs. This review will focus upon endomyocardial fibrosis, by far the most common type of restrictive cardiomyopathy worldwide, still an unsolved puzzle from a pathophysiological point of view and in need of more attention from the international community of cardiologists. In this paper the data from the literature are implemented by our personal experience at the St. Raphael of St. Francis Hospital-Nsambya and the Ugandan Heart Institute of Kampala, the capital town of Uganda.

  19. Sleeping sickness (United States)

    ... include: Eflornithine (for T. b. gambiense only) Melarsoprol Pentamidine (for T. b. gambiense only) Suramin (Antrypol) Some ... Pentamidine injections protect against T. b. gambiense, but not against T. b. rhodesiense . Because this medicine is ...

  20. Ventilation, autonomic function, sleep and erythropoietin. Chronic mountain sickness of Andean natives. (United States)

    Bernardi, Luciano; Roach, Robert C; Keyl, Cornelius; Spicuzza, Lucia; Passino, Claudio; Bonfichi, Maurizio; Gamboa, Alfredo; Gamboa, Jorge; Malcovati, Luca; Schneider, Annette; Casiraghi, Nadia; Mori, Antonio; Leon-Velarde, Fabiola


    Polycythemia is one of the key factors involved in the chronic mountain sickness syndrome, a condition frequent in Andean natives but whose causes still remain unclear. In theory, polycythemia may be secondary to abnormalities in ventilation, occurring during day or night (e.g. due to sleep abnormalities) stimulating excessive erythropoietin (Epo) production, or else it may result from either autogenous production, or from co-factors like cobalt. To assess the importance of these points, we studied subjects with or without polycythemia, born and living in Cerro de Pasco (Peru, 4330m asl, CP) and evaluated the relationship between Epo and respiratory variables both in CP and sea level. We also assessed the relationship between sleep abnormalities and the circadian rhythm of Epo. Polycythemic subjects showed higher Epo in all conditions, lower SaO2 and hypoxic ventilatory response, higher physiological dead space and higher CO2, suggesting ventilatory inefficiency. Epo levels could be highly modified by the level of oxygenation, and were related to similar directional changes in SaO2. Cobalt levels were normal in all subjects and correlated poorly with hematologic variables. The diurnal variations in Epo were grossly abnormal in polycythemic subjects, with complete loss of the circadian rhythm. These abnormalities correlated with the levels of hypoxemia during the night, but not with sleep abnormalities, which were only minor even in polycythemic subjects. The increased Epo production is mainly related to a greater ventilatory inefficiency, and not to altered sensitivity to hypoxia, cobalt or sleep abnormalities. Improving oxygenation can represent a possible therapeutic option for this syndrome.

  1. Plasma soluble erythropoietin receptor is decreased during sleep in Andean highlanders with Chronic Mountain Sickness. (United States)

    Villafuerte, Francisco C; Corante, Noemí; Anza-Ramírez, Cecilia; Figueroa-Mujíca, Rómulo; Vizcardo-Galindo, Gustavo; Mercado, Andy; Macarlupú, José Luis; León-Velarde, Fabiola


    Excessive erythrocytosis (EE) is the main sign of Chronic Mountain Sickness (CMS), a highly prevalent syndrome in Andean highlanders. Low pulse O2 saturation (SpO2) during sleep and serum androgens have been suggested to contribute to EE in CMS patients. However, whether these factors have a significant impact on the erythropoietin (Epo) system leading to EE is still unclear. We have recently shown that morning soluble Epo receptor (sEpoR), an endogenous Epo antagonist, is decreased in CMS patients suggesting increased Epo availability (increased Epo/sEpoR). The present study aimed to characterize the nocturnal concentration profile of sEpoR and Epo and their relationship with SpO2, Hct, and serum testosterone in healthy highlanders (HH) and CMS patients. Epo and sEpoR concentrations were evaluated every 4 h (6 PM to 6 AM) and nighttime SpO2 was continuously monitored (10 PM to 6 AM) in 39 male participants (CMS, n = 23; HH, n = 16) aged 21-65 yr from Cerro de Pasco, Peru (4,340 m). CMS patients showed higher serum Epo concentrations throughout the night and lower sEpoR from 10 PM to 6 AM. Consequently, Epo/sEpoR was significantly higher in the CMS group at every time point. Mean sleep-time SpO2 was lower in CMS patients compared with HH, while the percentage of sleep time spent with SpO2 < 80% was higher. Multiple-regression analysis showed mean sleep-time SpO2 and Epo/sEpoR as significant predictors of hematocrit corrected for potential confounders (age, body mass index, and testosterone). Testosterone levels were associated neither with Hct nor with erythropoietic factors. In conclusion, our results show sustained erythropoietic stimulus driven by the Epo system in CMS patients, further enhanced by a continuous exposure to accentuated nocturnal hypoxemia.

  2. Validation of ELISA for the detection of African horse sickness virus antigens and antibodies. (United States)

    Rubio, C; Cubillo, M A; Hooghuis, H; Sanchez-Vizcaino, J M; Diaz-Laviada, M; Plateau, E; Zientara, S; Crucière, C; Hamblin, C


    The mortality rate in susceptible populations of horses during an epizootic of African horse sickness (AHS) may be in excess of 90%. Rapid and reliable assays are therefore essential for the confirmation of clinical diagnoses and to enable control strategies to be implemented without undue delay. One of the major objectives of a recent European Union funded project was the validation of newly developed diagnostic assays which are rapid, sensitive, highly reproducible and inexpensive, for the detection of African horse sickness virus (AHSV) antigens and antibodies. The Laboratorio de Sanidad y Produccion Animal (LSPA) in Algete, Spain was charged with the responsibility of co-ordinating and supplying samples of viruses and antisera to the participating laboratories in Spain, France and the United Kingdom. The panels comprised 76 antigen samples for assay by indirect sandwich ELISAs and 53 serum samples for antibody detection by either indirect or competitive ELISAs. Results generated by ELISA for each laboratory were analysed in LSPA in terms of their relative sensitivities and specificities. There was a good agreement between the ELISAs used for either antigen or antibody detection. The participating groups agreed that any field sample giving a doubtful result would always be retested by ELISA and an alternative assay.

  3. Identification of different trypanosome species in the mid-guts of tsetse flies of the Malanga (Kimpese sleeping sickness focus of the Democratic Republic of Congo

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    Simo Gustave


    Full Text Available Abstract Background The Malanga sleeping sickness focus of the Democratic Republic of Congo has shown an epidemic evolution of disease during the last century. However, following case detection and treatment, the prevalence of the disease decreased considerably. No active survey has been undertaken in this focus for a couple of years. To understand the current epidemiological status of sleeping sickness as well as the animal African trypanosomiasis in the Malanga focus, we undertook the identification of tsetse blood meals as well as different trypanosome species in flies trapped in this focus. Methods Pyramidal traps were use to trap tsetse flies. All flies caught were identified and live flies were dissected and their mid-guts collected. Fly mid-gut was used for the molecular identification of the blood meal source, as well as for the presence of different trypanosome species. Results About 949 Glossina palpalis palpalis were trapped; 296 (31.2% of which were dissected, 60 (20.3% blood meals collected and 57 (19.3% trypanosome infections identified. The infection rates were 13.4%, 5.1%, 3.5% and 0.4% for Trypanosoma congolense savannah type, Trypanosoma brucei s.l., Trypanosoma congolense forest type and Trypanosoma vivax, respectively. Three mixed infections including Trypanosoma brucei s.l. and Trypanosoma congolense savannah type, and one mixed infection of Trypanosoma vivax and Trypanosoma congolense savannah type were identified. Eleven Trypanosoma brucei gambiense infections were identified; indicating an active circulation of this trypanosome subspecies. Of all the identified blood meals, about 58.3% were identified as being taken on pigs, while 33.3% and 8.3% were from man and other mammals, respectively. Conclusion The presence of Trypanosoma brucei in tsetse mid-guts associated with human blood meals is indicative of an active transmission of this parasite between tsetse and man. The considerable number of pig blood meals combined

  4. Fexinidazole--a new oral nitroimidazole drug candidate entering clinical development for the treatment of sleeping sickness.

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    Els Torreele

    Full Text Available BACKGROUND: Human African trypanosomiasis (HAT, also known as sleeping sickness, is a fatal parasitic disease caused by trypanosomes. Current treatment options for HAT are scarce, toxic, no longer effective, or very difficult to administer, in particular for the advanced, fatal stage of the disease (stage 2, chronic HAT. New safe, effective and easy-to-use treatments are urgently needed. Here it is shown that fexinidazole, a 2-substituted 5-nitroimidazole rediscovered by the Drugs for Neglected Diseases initiative (DNDi after extensive compound mining efforts of more than 700 new and existing nitroheterocycles, could be a short-course, safe and effective oral treatment curing both acute and chronic HAT and that could be implemented at the primary health care level. To complete the preclinical development and meet the regulatory requirements before initiating human trials, the anti-parasitic properties and the pharmacokinetic, metabolic and toxicological profile of fexinidazole have been assessed. METHODS AND FINDINGS: Standard in vitro and in vivo anti-parasitic activity assays were conducted to assess drug efficacy in experimental models for HAT. In parallel, a full range of preclinical pharmacology and safety studies, as required by international regulatory guidelines before initiating human studies, have been conducted. Fexinidazole is moderately active in vitro against African trypanosomes (IC₅₀ against laboratory strains and recent clinical isolates ranged between 0.16 and 0.93 µg/mL and oral administration of fexinidazole at doses of 100 mg/kg/day for 4 days or 200 mg/kg/day for 5 days cured mice with acute and chronic infection respectively, the latter being a model for the advanced and fatal stage of the disease when parasites have disseminated into the brain. In laboratory animals, fexinidazole is well absorbed after oral administration and readily distributes throughout the body, including the brain. The absolute bioavailability

  5. Towards an early warning system for Rhodesian sleeping sickness in savannah areas: man-like traps for tsetse flies.

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    Glyn A Vale

    Full Text Available BACKGROUND: In the savannahs of East and Southern Africa, tsetse flies (Glossina spp. transmit Trypanosoma brucei rhodesiense which causes Rhodesian sleeping sickness, the zoonotic form of human African trypanosomiasis. The flies feed mainly on wild and domestic animals and are usually repelled by humans. However, this innate aversion to humans can be undermined by environmental stresses on tsetse populations, so increasing disease risk. To monitor changes in risk, we need traps designed specifically to quantify the responsiveness of savannah tsetse to humans, but the traps currently available are designed to simulate other hosts. METHODOLOGY/PRINCIPAL FINDINGS: In Zimbabwe, two approaches were made towards developing a man-like trap for savannah tsetse: either modifying an ox-like trap or creating new designs. Tsetse catches from a standard ox-like trap used with and without artificial ox odor were reduced by two men standing nearby, by an average of 34% for Glossina morsitans morsitans and 56% for G. pallidipes, thus giving catches more like those made by hand-nets from men. Sampling by electrocuting devices suggested that the men stopped flies arriving near the trap and discouraged trap-entering responses. Most of human repellence was olfactory, as evidenced by the reduction in catches when the trap was used with the odor of hidden men. Geranyl acetone, known to occur in human odor, and dispensed at 0.2 mg/h, was about as repellent as human odor but not as powerfully repellent as wood smoke. New traps looking and smelling like men gave catches like those from men. CONCLUSION/SIGNIFICANCE: Catches from the completely new man-like traps seem too small to give reliable indices of human repellence. Better indications would be provided by comparing the catches of an ox-like trap either with or without artificial human odor. The chemistry and practical applications of the repellence of human odor and smoke deserve further study.

  6. Seasonal Changes in Sleep Duration in African American and African College Students Living In Washington, D.C.

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    Janna Volkov


    Full Text Available Duration of nocturnal melatonin secretion, a marker of “biological night” that relates to sleep duration, is longer in winter than in summer in patients with seasonal affective disorder (SAD, but not in healthy controls. In this study of African and African American college students, we hypothesized that students who met criteria for winter SAD or subsyndromal SAD (S-SAD would report sleeping longer in winter than in summer. In addition, based on our previous observation that Africans report more “problems” with change in seasons than African Americans, we expected that the seasonal changes in sleep duration would be greater in African students than in African American students. Based on Seasonal Pattern Assessment Questionnaire (SPAQ responses, African American and African college students in Washington, D.C. (N = 575 were grouped into a winter SAD/S-SAD group or a no winter diagnosis group, and winter and summer sleep length were determined. We conducted a 2 (season × 2 (sex × 2 (ethnicity × 2 (winter diagnosis group ANCOVA on reported sleep duration, controlling for age. Contrary to our hypothesis, we found that African and African American students with winter SAD/S-SAD report sleeping longer in the summer than in the winter. No differences in seasonality of sleep were found between African and African American students. Students with winter SAD or S-SAD may need to sacrifice sleep duration in the winter, when their academic functioning/efficiency may be impaired by syndromal or subsyndromal depression, in order to meet seasonally increased academic demands.

  7. The colony as laboratory: German sleeping sickness campaigns in German East Africa and in Togo, 1900-1914. (United States)

    Eckart, Wolfgang U


    This paper is on dangerous human experimentations with drugs against trypanosimiasis carried out in the former German colonies of German East Africa and Togo. Victory over trypanosomiasis could not be achieved in Berlin because animals were thought to be unsuitable for therapeutic laboratory research in the field of trypanosomiasis. The colonies themselves were necessarily chosen as laboratories and the patients with sleeping sickness became the objects of therapeutical and pharmacological research. The paper first outlines Robert Koch's trypanosomiasis research in the large sleeping sickness laboratory of German East Africa and then focuses on the escalating human experiments on trypanosomiasis in the German Musterkolonie Togo, which must be interpreted as a reaction to the starting signal given by Robert Koch in East Africa.

  8. African horse sickness in The Gambia: circulation of a live-attenuated vaccine-derived strain. (United States)

    Oura, C A L; Ivens, P A S; Bachanek-Bankowska, K; Bin-Tarif, A; Jallow, D B; Sailleau, C; Maan, S; Mertens, P C; Batten, C A


    African horse sickness virus serotype 9 (AHSV-9) has been known for some time to be circulating amongst equids in West Africa without causing any clinical disease in indigenous horse populations. Whether this is due to local breeds of horses being resistant to disease or whether the AHSV-9 strains circulating are avirulent is currently unknown. This study shows that the majority (96%) of horses and donkeys sampled across The Gambia were seropositive for AHS, despite most being unvaccinated and having no previous history of showing clinical signs of AHS. Most young horses (horses. Sequence analysis revealed the presence of an AHSV-9 strain showing 100% identity to Seg-2 of the AHSV-9 reference strain, indicating that the virus circulating in The Gambia was highly likely to have been derived from a live-attenuated AHSV-9 vaccine strain.

  9. Trypanosoma brucei Invasion and T-Cell Infiltration of the Brain Parenchyma in Experimental Sleeping Sickness: Timing and Correlation with Functional Changes (United States)

    Laperchia, Claudia; Palomba, Maria; Seke Etet, Paul F.; Rodgers, Jean; Bradley, Barbara; Montague, Paul; Grassi-Zucconi, Gigliola; Bentivoglio, Marina


    Background The timing of Trypanosoma brucei entry into the brain parenchyma to initiate the second, meningoencephalitic stage of human African trypanosomiasis or sleeping sickness is currently debated and even parasite invasion of the neuropil has been recently questioned. Furthermore, the relationship between neurological features and disease stage are unclear, despite the important diagnostic and therapeutic implications. Methodology Using a rat model of chronic Trypanosoma brucei brucei infection we determined the timing of parasite and T-cell neuropil infiltration and its correlation with functional changes. Parasite DNA was detected using trypanosome-specific PCR. Body weight and sleep structure alterations represented by sleep-onset rapid eye movement (SOREM) periods, reported in human and experimental African trypanosomiasis, were monitored. The presence of parasites, as well as CD4+ and CD8+ T-cells in the neuropil was assessed over time in the brain of the same animals by immunocytochemistry and quantitative analyses. Principal findings Trypanosome DNA was present in the brain at day 6 post-infection and increased more than 15-fold by day 21. Parasites and T-cells were observed in the parenchyma from day 9 onwards. Parasites traversing blood vessel walls were observed in the hypothalamus and other brain regions. Body weight gain was reduced from day 7 onwards. SOREM episodes started in most cases early after infection, with an increase in number and duration after parasite neuroinvasion. Conclusion These findings demonstrate invasion of the neuropil over time, after an initial interval, by parasites and lymphocytes crossing the blood-brain barrier, and show that neurological features can precede this event. The data thus challenge the current clinical and cerebrospinal fluid criteria of disease staging. PMID:28002454

  10. Framing tropical disease in London: Patrick Manson, Filaria perstans, and the Uganda sleeping sickness epidemic, 1891-1902. (United States)

    Haynes, D M


    Much of the historical literature on tropical medicine represents the periphery as the chief site for the production of western knowledge about disease in the British empire. This study on the Filaria perstans-sleeping sickness hypothesis revises this perspective by showing how the imperial metropole functioned as a culture space for the construction of knowledge about the empire. Beginning in 1891, Patrick Manson used the publicity resources of London to generate a rhetorical imperative for the confirmation of his hypothesis without ever leaving Britain. Later, while he was medical adviser to the imperial state, the 1900 sleeping sickness epidemic in Uganda presented Manson with a unique opportunity to determine the validity of his hypothesis. By exaggerating the possible spread of the epidemic privately among Foreign Office personnel and publicly in the medical press, he succeeded in mobilizing the first Royal Society sleeping sickness research expedition to Africa in 1902. While this expedition ultimately disproved Manson's hypothesis, this outcome ironically created the very conditions for the identification of the actual causal agent (Trypanosoma gambiense) and its vector (tsetse fly) by Aldo Castellani and David Bruce respectively.

  11. The role of poor sleep in the relation between workplace bullying/unwanted sexual attention and long‑term sickness absence

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Grynderup, Matias Brødsgaard; Lange, Theis;


    Purpose While exposure to bullying and unwanted sexual attention was previously found to increase the risk of sickness absence, the underlying mechanisms are largely unknown. Poor sleep can be a consequence of stressful exposures and a cause of poor health, and poor sleep is also a determinant...... of insufficient recovery. Therefore, the present study investigated whether poor sleep mediates and/or moderates the association between bullying and unwanted sexual attention, on the one hand, and long-term sickness absence (LTSA), on the other hand. Methods We used questionnaire data from 7650 individuals...... contributing with 15,040 2-year observation periods. Workplace bullying, unwanted sexual attention, disturbed sleep, and difficulties awakening were measured at three time points, and participants were followed in registers to measure the occurrence of LTSA, defined as ≥30 consecutive days of sickness absence...

  12. Immunogenicity of two adjuvant formulations of an inactivated African horse sickness vaccine in guinea-pigs and target animals

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    Gaetano Federico Ronchi


    Full Text Available Monovalent, inactivated and adjuvanted vaccines against African horse sickness, prepared with serotypes 5 and 9, were tested on guinea-pigs to select the formulation that offered the greatest immunity. The final formulation of the vaccines took into account the immune response in the guinea-pig and the inflammatory properties of two types of adjuvant previously tested on target animals. A pilot study was subsequently conducted on horses using a vaccine prepared with serotype 9. The vaccine stimulated neutralising antibodies from the first administration and, after the booster dose, 28 days later; high antibody levels were recorded for at least 10 months. The guinea-pig appears to be a useful laboratory model for the evaluation of the antigenic properties of African horse sickness vaccines.

  13. Temporal and spatial epidemiology of sleeping sickness and use of geographical information system (GIS in Kenya

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    Jane Jemeli Rutto


    Full Text Available Background & objectives: In Kenya, sleeping sickness (SS caused by Trypanosoma brucei rhodesiense is confined to the Nyanza and Western Provinces tsetse belts. Over the last two decades, the disease has exhibited great spatial variability in its spread and distribution. The objectives of the study were to map the spatial and temporal distribution of SS and determine possible risk factors associated with the disease in western Kenya. Methods: Geographical coordinates of villages were obtained using a Global Positioning System (GPS. SS data were analyzed retrospectively and the mapping of villages was done using MapInfo Software®. Epidemiological data of villages affected by SS were then correlated to human and cattle population. Results: SS has spread northwards affecting the western parts of Busia, Teso, and of Bungoma districts in the late 1990s. Most of the SS cases were reported between March and June. The mainly affected age groups were from 20 to 49 years. SS was highest in areas with low human population density, ranging from 0–340/km2 and high livestock population, ranging from 5000 to 10,000 cattle. Interpretation & conclusion: There was a shift of SS occurrence from the old foci into new foci occurring at low transmission levels and causing occasional epidemic outbreaks. The study concludes that seasons influenced disease incidences with higher numbers of SS cases being recorded during the wet seasons. Gender and age determined the disease occurrence with most productive age groups being at higher risk. Areas with high livestock populations had low human population densities and had higher SS cases.

  14. Trypanosoma vivax, T. congolense "forest type" and T. simiae: prevalence in domestic animals of sleeping sickness foci of Cameroon. (United States)

    Nimpaye, H; Njiokou, F; Njine, T; Njitchouang, G R; Cuny, G; Herder, S; Asonganyi, T; Simo, G


    In order to better understand the epidemiology of Human and Animal trypanosomiasis that occur together in sleeping sickness foci, a study of prevalences of animal parasites (Trypanosoma vivax, T. congolense "forest type", and T. simiae) infections was conducted on domestic animals to complete the previous work carried on T. brucei gambiense prevalence using the same animal sample. 875 domestic animals, including 307 pigs, 264 goats, 267 sheep and 37 dogs were sampled in the sleeping sickness foci of Bipindi, Campo, Doumé and Fontem in Cameroon. The polymerase chain reaction (PCR) based method was used to identify these trypanosome species. A total of 237 (27.08%) domestic animals were infected by at least one trypanosome species. The prevalence of T. vivax, T. congolense "forest type" and T. simiae were 20.91%, 11.42% and 0.34% respectively. The prevalences of 7 vivax and T. congolense "forest type" differed significantly between the animal species and between the foci (p < 0.0001); however, these two trypanosomes were found in all animal species as well as in all the foci subjected to the study. The high prevalences of 7 vivax and T congolense "forest type" in Bipindi and Fontem-Center indicate their intense transmission in these foci.

  15. The role of poor sleep in the relation between workplace bullying/unwanted sexual attention and long‑term sickness absence

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Grynderup, Matias Brødsgaard; Lange, Theis


    Purpose While exposure to bullying and unwanted sexual attention was previously found to increase the risk of sickness absence, the underlying mechanisms are largely unknown. Poor sleep can be a consequence of stressful exposures and a cause of poor health, and poor sleep is also a determinant...... contributing with 15,040 2-year observation periods. Workplace bullying, unwanted sexual attention, disturbed sleep, and difficulties awakening were measured at three time points, and participants were followed in registers to measure the occurrence of LTSA, defined as ≥30 consecutive days of sickness absence...... during the subsequent 2 years. Results The odds of LTSA were significantly increased by workplace bullying (OR 1.77; 95 % CI 1.50–2.12) and unwanted sexual attention (OR 1.55; 95 % CI 1.06–2.29). Together, disturbed sleep and difficulties awakening mediated 12.8 % (95 % CI 8.1–19.8) of the association...

  16. Quantitative Risk Assessment for African Horse Sickness in Live Horses Exported from South Africa. (United States)

    Sergeant, Evan S; Grewar, John D; Weyer, Camilla T; Guthrie, Alan J


    African horse sickness (AHS) is a severe, often fatal, arbovirus infection of horses, transmitted by Culicoides spp. midges. AHS occurs in most of sub-Saharan Africa and is a significant impediment to export of live horses from infected countries, such as South Africa. A stochastic risk model was developed to estimate the probability of exporting an undetected AHS-infected horse through a vector protected pre-export quarantine facility, in accordance with OIE recommendations for trade from an infected country. The model also allows for additional risk management measures, including multiple PCR tests prior to and during pre-export quarantine and optionally during post-arrival quarantine, as well as for comparison of risk associated with exports from a demonstrated low-risk area for AHS and an area where AHS is endemic. If 1 million horses were exported from the low-risk area with no post-arrival quarantine we estimate the median number of infected horses to be 5.4 (95% prediction interval 0.5 to 41). This equates to an annual probability of 0.0016 (95% PI: 0.00015 to 0.012) assuming 300 horses exported per year. An additional PCR test while in vector-protected post-arrival quarantine reduced these probabilities by approximately 12-fold. Probabilities for horses exported from an area where AHS is endemic were approximately 15 to 17 times higher than for horses exported from the low-risk area under comparable scenarios. The probability of undetected AHS infection in horses exported from an infected country can be minimised by appropriate risk management measures. The final choice of risk management measures depends on the level of risk acceptable to the importing country.

  17. Assembly of replication-incompetent African horse sickness virus particles: rational design of vaccines for all serotypes.


    Lulla, V.; Lulla, A; Wernike, K; Aebischer, A.; Beer, M.; Roy, P.


    UNLABELLED: African horse sickness virus (AHSV), an orbivirus in the Reoviridae family with nine different serotypes, causes devastating disease in equids. The virion particle is composed of seven proteins organized in three concentric layers, an outer layer made of VP2 and VP5, a middle layer made of VP7, and inner layer made of VP3 that encloses a replicase complex of VP1, VP4, and VP6 and a genome of 10 double-stranded RNA segments. In this study, we sought to develop highly efficacious ca...

  18. The history of African trypanosomiasis

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    Steverding Dietmar


    Full Text Available Abstract The prehistory of African trypanosomiasis indicates that the disease may have been an important selective factor in the evolution of hominids. Ancient history and medieval history reveal that African trypanosomiasis affected the lives of people living in sub-Saharan African at all times. Modern history of African trypanosomiasis revolves around the identification of the causative agents and the mode of transmission of the infection, and the development of drugs for treatment and methods for control of the disease. From the recent history of sleeping sickness we can learn that the disease can be controlled but probably not be eradicated. Current history of human African trypanosomiasis has shown that the production of anti-sleeping sickness drugs is not always guaranteed, and therefore, new, better and cheaper drugs are urgently required.

  19. Risk of introducing African horse sickness virus into the Netherlands by international equine movements. (United States)

    de Vos, C J; Hoek, C A; Nodelijk, G


    African horse sickness (AHS) is a vector-borne viral disease of equines that is transmitted by Culicoides spp. and can have severe consequences for the horse industry in affected territories. A study was performed to assess the risk of introducing AHS virus (AHSV) into the Netherlands (P_AHS) by international equine movements. The goal of this study was to provide more insight into (a) the regions and equine species that contribute most to this risk, (b) the seasonal variation in this risk, and (c) the effectiveness of measures to prevent introduction of AHSV. Countries worldwide were grouped into three risk regions: (1) high risk, i.e., those countries in which the virus is presumed to circulate, (2) low risk, i.e., those countries that have experienced outbreaks of AHS in the past and/or where the main vector of AHS, Culicoides imicola, is present, and (3) very low risk, i.e., all other countries. A risk model was constructed estimating P_AHS taking into account the probability of release of AHSV in the Netherlands and the probability that local vectors will subsequently transmit the virus to local hosts. Model calculations indicated that P_AHS is very low with a median value of 5.1×10(-4)/year. The risk is highest in July and August, while equine movements in the period October till March pose a negligible risk. High and low risk regions contribute most to P_AHS with 31% and 53%, respectively. Importations of donkeys and zebras constitute the highest risk of AHSV release from high risk regions, while international movements of competition horses constitute the highest risk of AHSV release from low and very low risk regions. Preventive measures currently applied reduce P_AHS by 46% if compared to a situation in which no preventive measures are applied. A prolonged and more effective quarantine period in high risk regions and more stringent import regulations for low risk regions could further reduce P_AHS. Large uncertainty was involved in estimating model input

  20. The influence of PTSD, sleep fears, and neighborhood stress on insomnia and short sleep duration in urban, young adult, African Americans. (United States)

    Hall Brown, Tyish; Mellman, Thomas A


    African Americans residing in stressful urban environments have high rates of insomnia and short sleep duration, both of which are associated with adverse health outcomes. However, limited data exist that explore factors influencing inadequate sleep in this high-risk population. This study sought to evaluate the contributions of demographics, trauma, posttraumatic stress disorder (PTSD) symptoms, sleep fears, and neighborhood stress to both insomnia and short sleep in urban African American young adults. Data were analyzed from self-report measures completed by 378 participants 18-35 years of age. PTSD symptom severity and sleep fears were independently associated with insomnia severity, and sleep fears was associated with sleep duration. Results have implications for preventative health intervention strategies for urban African American young adults.

  1. Assembly of Replication-Incompetent African Horse Sickness Virus Particles: Rational Design of Vaccines for All Serotypes (United States)

    Lulla, Valeria; Lulla, Aleksei; Wernike, Kerstin; Aebischer, Andrea; Beer, Martin


    ABSTRACT African horse sickness virus (AHSV), an orbivirus in the Reoviridae family with nine different serotypes, causes devastating disease in equids. The virion particle is composed of seven proteins organized in three concentric layers, an outer layer made of VP2 and VP5, a middle layer made of VP7, and inner layer made of VP3 that encloses a replicase complex of VP1, VP4, and VP6 and a genome of 10 double-stranded RNA segments. In this study, we sought to develop highly efficacious candidate vaccines against all AHSV serotypes, taking into account not only immunogenic and safety properties but also virus productivity and stability parameters, which are essential criteria for vaccine candidates. To achieve this goal, we first established a highly efficient reverse genetics (RG) system for AHSV serotype 1 (AHSV1) and, subsequently, a VP6-defective AHSV1 strain in combination with in trans complementation of VP6. This was then used to generate defective particles of all nine serotypes, which required the exchange of two to five RNA segments to achieve equivalent titers of particles. All reassortant-defective viruses could be amplified and propagated to high titers in cells complemented with VP6 but were totally incompetent in any other cells. Furthermore, these replication-incompetent AHSV particles were demonstrated to be highly protective against homologous virulent virus challenges in type I interferon receptor (IFNAR)-knockout mice. Thus, these defective viruses have the potential to be used for the development of safe and stable vaccine candidates. The RG system also provides a powerful tool for the study of the role of individual AHSV proteins in virus assembly, morphogenesis, and pathogenesis. IMPORTANCE African horse sickness virus is transmitted by biting midges and causes African horse sickness in equids, with mortality reaching up to 95% in naive horses. Therefore, the development of efficient vaccines is extremely important due to major economic

  2. Revisiting safe sleep recommendations for African-American infants: why current counseling is insufficient. (United States)

    Gaydos, Laura M; Blake, Sarah C; Gazmararian, Julie A; Woodruff, Whitney; Thompson, Winifred W; Dalmida, Safiya George


    The American Academy of Pediatrics recommends that children be placed in the supine position on firm bedding and not bed share with parents or other children. Health professionals increasingly understand that many African-American parents do not follow these recommendations, but little research exists on provider reactions to this non-compliance. This study was intended to better understand how low-income, African-American mothers understand and act upon safe sleep recommendations for newborns and how providers counsel these mothers. We conducted focus groups with 60 African-American, low-income, first-time mothers and telephone interviews with 20 providers serving these populations to explore provider counseling and patient decision making. The large majority of mothers reported understanding, but not following, the safe-sleeping recommendations. Key reasons for non-compliance included perceived safety, convenience, quality of infant sleep and conflicting information from family members. Mothers often take measures intended to mitigate risk associated with noncompliance, instead increasing SIDS risk. Providers recognize that many mothers are non-compliant and attribute non-compliance largely to cultural and familial influence. However, few provider attempts are made to mitigate SIDS risks from non-compliant behaviors. We suggest that counseling strategies should be adapted to: (1) provide greater detailed rationale for SIDS prevention recommendations; and (2) incorporate or acknowledge familial and cultural preferences. Ignoring the reasons for sleep decisions by African-American parents may perpetuate ongoing racial/ethnic disparities in SIDS.

  3. Sleeping Beauty Redefined: African American Girls in Transition. (United States)

    Kusimo, Patricia S.

    This paper examines the interests, perceptions, and participation of 16 African American girls in a program designed to improve girls' persistence in science, mathematics, and technology (SMT). The girls are among 33 African American and 73 total original participants in "Rural and Urban Images: Voices of Girls in Science, Mathematics, and…

  4. Breeding for trypanotolerance in African cattle

    NARCIS (Netherlands)

    Waaij, van der E.H.


    Trypanosomosis, or sleeping sickness, is one of the most important livestock diseases in Africa. Some West African cattle breeds show a degree of resistance to a trypanosome infection: they are trypanotolerant. At the International Livestock Research Institute (ILRI) in Nairobi, Kenya, an F2 experim

  5. Protective immunization of horses with a recombinant canarypox virus vectored vaccine co-expressing genes encoding the outer capsid proteins of African horse sickness virus. (United States)

    Guthrie, Alan J; Quan, Melvyn; Lourens, Carina W; Audonnet, Jean-Christophe; Minke, Jules M; Yao, Jiansheng; He, Ling; Nordgren, Robert; Gardner, Ian A; Maclachlan, N James


    We describe the development and preliminary characterization of a recombinant canarypox virus vectored (ALVAC) vaccine for protective immunization of equids against African horse sickness virus (AHSV) infection. Horses (n=8) immunized with either of two concentrations of recombinant canarypox virus vector (ALVAC-AHSV) co-expressing synthetic genes encoding the outer capsid proteins (VP2 and VP5) of AHSV serotype 4 (AHSV-4) developed variable titres (horse immunized with a commercial recombinant canarypox virus vectored vaccine expressing the haemagglutinin genes of two equine influenza H3N8 viruses was seronegative to AHSV and following infection with virulent AHSV-4 developed pyrexia, thrombocytopenia and marked oedema of the supraorbital fossae typical of the "dikkop" or cardiac form of African horse sickness. AHSV was detected by virus isolation and quantitative reverse transcriptase polymerase chain reaction in the blood of the control horse from 8 days onwards after challenge infection whereas AHSV was not detected at any time in the blood of the ALVAC-AHSV vaccinated horses. The control horse seroconverted to AHSV by 2 weeks after challenge infection as determined by both virus neutralization and ELISA assays, whereas six of eight of the ALVAC-AHSV vaccinated horses did not seroconvert by either assay following challenge infection with virulent AHSV-4. These data confirm that the ALVAC-AHSV vaccine will be useful for the protective immunization of equids against African horse sickness, and avoids many of the problems inherent to live-attenuated AHSV vaccines.

  6. Efficacy and Safety of Pafuramidine versus Pentamidine Maleate for Treatment of First Stage Sleeping Sickness in a Randomized, Comparator-Controlled, International Phase 3 Clinical Trial.

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    Gabriele Pohlig


    Full Text Available Sleeping sickness (human African trypanosomiasis [HAT] is a neglected tropical disease with limited treatment options that currently require parenteral administration. In previous studies, orally administered pafuramidine was well tolerated in healthy patients (for up to 21 days and stage 1 HAT patients (for up to 10 days, and demonstrated efficacy comparable to pentamidine.This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospitals in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included. The primary efficacy endpoint was the combined rate of clinical and parasitological cure at 12 months. The primary safety outcome was the frequency and severity of adverse events. The study was registered on the International Clinical Trials Registry Platform at with the number ISRCTN85534673.The overall cure rate at 12 months was 89% in the pafuramidine group and 95% in the pentamidine group; pafuramidine was non-inferior to pentamidine as the upper bound of the 95% confidence interval did not exceed 15%. The safety profile of pafuramidine was superior to pentamidine; however, 3 patients in the pafuramidine group had glomerulonephritis or nephropathy approximately 8 weeks post-treatment. Two of these events were judged as possibly related to

  7. Analysis of risk factors for T. brucei rhodesiense sleeping sickness within villages in south-east Uganda

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    Odiit Martin


    Full Text Available Abstract Background Sleeping sickness (HAT caused by T.b. rhodesiense is a major veterinary and human public health problem in Uganda. Previous studies have investigated spatial risk factors for T.b. rhodesiense at large geographic scales, but none have properly investigated such risk factors at small scales, i.e. within affected villages. In the present work, we use a case-control methodology to analyse both behavioural and spatial risk factors for HAT in an endemic area. Methods The present study investigates behavioural and occupational risk factors for infection with HAT within villages using a questionnaire-based case-control study conducted in 17 villages endemic for HAT in SE Uganda, and spatial risk factors in 4 high risk villages. For the spatial analysis, the location of homesteads with one or more cases of HAT up to three years prior to the beginning of the study was compared to all non-case homesteads. Analysing spatial associations with respect to irregularly shaped geographical objects required the development of a new approach to geographical analysis in combination with a logistic regression model. Results The study was able to identify, among other behavioural risk factors, having a family member with a history of HAT (p = 0.001 as well as proximity of a homestead to a nearby wetland area (p Conclusion Spatial risk factors for HAT are maintained across geographical scales; this consistency is useful in the design of decision support tools for intervention and prevention of the disease. Familial aggregation of cases was confirmed for T. b. rhodesiense HAT in the study and probably results from shared behavioural and spatial risk factors amongmembers of a household.

  8. Development of a Luminex-Based DIVA Assay for Serological Detection of African Horse Sickness Virus in Horses. (United States)

    Sánchez-Matamoros, A; Nieto-Pelegrín, E; Beck, C; Rivera-Arroyo, B; Lecollinet, S; Sailleau, C; Zientara, S; Sánchez-Vizcaíno, J M


    African horse sickness (AHS) is considered a fatal re-emergent vector-borne disease of horses. In the absence of any effective treatment for AHS, vaccination remains the most effective form of disease control. The new generation of vaccines, such as one based on purified, inactivated AHS virus (AHSV, serotype 4), which does not induce antibodies against non-structural protein 3 (NS3), enables the development of diagnostic methods that differentiate infected from vaccinated animals (DIVA assays). As detecting AHS in AHSV-free countries may lead to restrictions on international animal movements and thereby cause significant economic damage, these DIVA assays are crucial for reducing movement restrictions. In this article, we describe a Luminex-based multiplex assay for DIVA diagnosis of AHS, and we validate it in a duplex format to detect antibodies against structural protein 7 (VP7) and NS3 in serum samples from horses vaccinated with inactivated AHSV4 vaccine or infected with a live virus of the same serotype. Results of the Luminex-based assay for detecting anti-NS3 antibodies showed good positive correlation with results from an in-house enzyme-linked immunosorbent assay (ELISA). Thus, the Luminex-based technique described here may allow multiplex DIVA antibody detection in a single sample in less than 2 h, and it may prove adaptable for the development of robust, multiplex serological assays.

  9. An African horse sickness virus serotype 4 recombinant canarypox virus vaccine elicits specific cell-mediated immune responses in horses. (United States)

    El Garch, H; Crafford, J E; Amouyal, P; Durand, P Y; Edlund Toulemonde, C; Lemaitre, L; Cozette, V; Guthrie, A; Minke, J M


    A recombinant canarypox virus vectored vaccine co-expressing synthetic genes encoding outer capsid proteins, VP2 and VP5, of African horse sickness virus (AHSV) serotype 4 (ALVAC(®)-AHSV4) has been demonstrated to fully protect horses against homologous challenge with virulent field virus. Guthrie et al. (2009) detected weak and variable titres of neutralizing antibody (ranging from horses received two vaccinations twenty-eight days apart and three horses remained unvaccinated. The detection of VP2/VP5 specific IFN-γ responses was assessed by enzyme linked immune spot (ELISpot) assay and clearly demonstrated that all ALVAC(®)-AHSV4 vaccinated horses developed significant IFN-γ production compared to unvaccinated horses. More detailed immune responses obtained by flow cytometry demonstrated that ALVAC(®)-AHSV4 vaccinations induced immune cells, mainly CD8(+) T cells, able to recognize multiple T-epitopes through all VP2 and only the N-terminus sequence of VP5. Neither VP2 nor VP5 specific IFN-γ responses were detected in unvaccinated horses. Overall, our data demonstrated that an experimental recombinant canarypox based vaccine induced significant CMI specific for both VP2 and VP5 proteins of AHSV4.

  10. Accuracy of individual rapid tests for serodiagnosis of gambiense sleeping sickness in West Africa.

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    Vincent Jamonneau


    Full Text Available Individual rapid tests for serodiagnosis (RDT of human African trypanosomiasis (HAT are particularly suited for passive screening and surveillance. However, so far, no large scale evaluation of RDTs has been performed for diagnosis of Trypanosoma brucei gambiense HAT in West Africa. The objective of this study was to assess the diagnostic accuracy of 2 commercial HAT-RDTs on stored plasma samples from West Africa.SD Bioline HAT and HAT Sero-K-Set were performed on 722 plasma samples originating from Guinea and Côte d'Ivoire, including 231 parasitologically confirmed HAT patients, 257 healthy controls, and 234 unconfirmed individuals whose blood tested antibody positive in the card agglutination test but negative by parasitological tests. Immune trypanolysis was performed as a reference test for trypanosome specific antibody presence. Sensitivities in HAT patients were respectively 99.6% for SD Bioline HAT, and 99.1% for HAT Sero-K-Set, specificities in healthy controls were respectively 87.9% and 88.3%. Considering combined positivity in both RDTs, increased the specificity significantly (p ≤ 0.0003 to 93.4%, while 98.7% sensitivity was maintained. Specificities in controls were 98.7-99.6% for the combination of one or two RDTs with trypanolysis, maintaining a sensitivity of at least 98.1%.The observed specificity of the single RDTs was relatively low. Serial application of SD Bioline HAT and HAT Sero-K-Set might offer superior specificity compared to a single RDT, maintaining high sensitivity. The combination of one or two RDTs with trypanolysis seems promising for HAT surveillance.

  11. The unknown risk of vertical transmission in sleeping sickness--a literature review.

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    Andreas K Lindner

    Full Text Available BACKGROUND: Children with human African trypanosomiasis (HAT present with a range of generally non-specific symptoms. Late diagnosis is frequent with often tragic outcomes. Trypanosomes can infect the foetus by crossing the placenta. Unequivocal cases of congenital infection that have been reported include newborn babies of infected mothers who were diagnosed with HAT in the first 5 days of life and children of infected mothers who had never entered an endemic country themselves. METHODS: This review systematically summarizes the literature on the vertical transmission of HAT, to our knowledge for the first time. To approach the broader aspects of the subject, articles considering the epidemiology of childhood HAT and HAT in pregnancy were also included. The HAT guidelines and technical reports of the World Health Organisation, Médecins Sans Frontières, Institut de Recherche pour le Développement, and of one endemic country were reviewed. RESULTS: Publications describing congenital HAT are very limited and consist only of single case reports and small case series. Generally it is assumed to be a rare event, but it has never been systematically investigated. In two publications, it is hypothesized that congenital HAT occurs more often than suspected. Not all guidelines and not all HAT literature mention this transmission route. CONCLUSIONS: The risk of vertical transmission is unknown. Awareness of congenital HAT is insufficient, and as a result opportunities for an early diagnosis in newborns may be missed. All HAT guidelines and local HAT protocols should stress that in endemic areas pregnant women should be systematically checked for HAT and that newborns of HAT infected mothers should be assessed for the disease as soon as possible. Studies on the impact of HAT on fertility and pregnancy and studies on congenital HAT are long overdue.

  12. Domestic animals as potential reservoir hosts of Trypanosoma brucei gambiense in sleeping sickness foci in Cameroon

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    Njiokou F.


    Full Text Available An explanation of the endemic nature and/or the resurgence of Human African Trypanosomiasis (HAT in the historic foci in West and Central Africa may be the existence of an animal reservoir. In some HAT foci, pigs were found infected by Trypanosoma brucei gambiense but the implication of the other domestic animals was not quite evaluated. This study aims to determine the prevalence of T. b. gambiense in domestic animal species (goat, sheep, pig and dog commonly found in the four active HAT foci in Cameroon (Bipindi, Fontem, Campo and Doumé. Blood samples were collected from 307 pigs, 264 goats, 267 sheep and 37 dogs and used for parasitological (QBC, immunological (LiTat 1.3 CATT and molecular (PCR analyses. QBC detected trypanosomes in 3.88 % domestic animals while 22.7 % were sero-positive with LiTat 1.3 CATT tests. Of the 875 animals analysed, 174 (19.88 % harboured T. brucei s.l. DNA, found in each of the four types of animal and in the four localities. The infection rate significantly differed among the animal species (p < 0.0001 and localities (p < 0.0001. The PCR also revealed T. b. gambiense group 1 DNA in 27 (3.08 % domestic animals. The specific infection rates were as follows: sheep (6.74 %, goats (3.08 %, pigs (0.32 % and dogs (0 %. T. b. gambiense was found in 8 (3.92 % animals from Bipindi, 15 (4.83 % from Campo, 4 (2.59 % from Fontem-Center and none from Doumé. The infection rates significantly differed between the localities, and correlated with the intensity of HAT transmission in the foci.

  13. Exploring cultural beliefs about "that sickness": grandmothers' explanations of HIV in an urban South African context. (United States)

    Penn, Claire; Watermeyer, Jennifer


    The role of culture in community beliefs about HIV is important to understand, given poor adherence to treatment and the failure of prevention programs in some contexts. An exploration of such models may yield important insight into barriers to care, treatment-seeking paths, and intergenerational differences in cultural beliefs and practices. Our study aimed to understand South African grandmothers' traditional beliefs about HIV. Three focus groups were conducted with 15 grandmothers from different cultural backgrounds in an urban community. Results indicated a variety of cultural explanations for causes, treatments, and prevention strategies. The lack of coherence and fluidity in opinions in this group suggests ways in which grandmothers may have a bridging role in the clinic that may help to validate and alleviate uncertainty, harmonize the voices of medicine and the lifeworld, and provide greater insight into people's ideas about health and treatment seeking, also known as the healthworld.

  14. Trypanosoma vivax, T. congolense “forest type” and T. simiae: prevalence in domestic animals of sleeping sickness foci of Cameroon

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    Nimpaye H.


    Full Text Available In order to better understand the epidemiology of Human and Animal trypanosomiasis that occur together in sleeping sickness foci, a study of prevalences of animal parasites (Trypanosoma vivax, T. congolense “forest type”, and T. simiae infections was conducted on domestic animals to complete the previous work carried on T. brucei gambiense prevalence using the same animal sample. 875 domestic animals, including 307 pigs, 264 goats, 267 sheep and 37 dogs were sampled in the sleeping sickness foci of Bipindi, Campo, Doumé and Fontem in Cameroon. The polymerase chain reaction (PCR based method was used to identify these trypanosome species. A total of 237 (27.08% domestic animals were infected by at least one trypanosome species. The prevalence of T. vivax, T. congolense “forest type” and T. simiae were 20.91%, 11.42% and 0.34% respectively. The prevalences of T. vivax and T. congolense “forest type” differed significantly between the animal species and between the foci (p < 0.0001; however, these two trypanosomes were found in all animal species as well as in all the foci subjected to the study. The high prevalences of T. vivax and T. congolense “forest type” in Bipindi and Fontem-Center indicate their intense transmission in these foci.

  15. Induction of antibody responses to African horse sickness virus (AHSV in ponies after vaccination with recombinant modified vaccinia Ankara (MVA.

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    Rachael Chiam

    Full Text Available BACKGROUND: African horse sickness virus (AHSV causes a non-contagious, infectious disease in equids, with mortality rates that can exceed 90% in susceptible horse populations. AHSV vaccines play a crucial role in the control of the disease; however, there are concerns over the use of polyvalent live attenuated vaccines particularly in areas where AHSV is not endemic. Therefore, it is important to consider alternative approaches for AHSV vaccine development. We have carried out a pilot study to investigate the ability of recombinant modified vaccinia Ankara (MVA vaccines expressing VP2, VP7 or NS3 genes of AHSV to stimulate immune responses against AHSV antigens in the horse. METHODOLOGY/PRINCIPAL FINDINGS: VP2, VP7 and NS3 genes from AHSV-4/Madrid87 were cloned into the vaccinia transfer vector pSC11 and recombinant MVA viruses generated. Antigen expression or transcription of the AHSV genes from cells infected with the recombinant viruses was confirmed. Pairs of ponies were vaccinated with MVAVP2, MVAVP7 or MVANS3 and both MVA vector and AHSV antigen-specific antibody responses were analysed. Vaccination with MVAVP2 induced a strong AHSV neutralising antibody response (VN titre up to a value of 2. MVAVP7 also induced AHSV antigen-specific responses, detected by western blotting. NS3 specific antibody responses were not detected. CONCLUSIONS: This pilot study demonstrates the immunogenicity of recombinant MVA vectored AHSV vaccines, in particular MVAVP2, and indicates that further work to investigate whether these vaccines would confer protection from lethal AHSV challenge in the horse is justifiable.

  16. Culicoides species abundance and potential over-wintering of African horse sickness virus in the Onderstepoort area, Gauteng, South Africa

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    Gert J. Venter


    Full Text Available In South Africa, outbreaks of African horse sickness (AHS occur in summer; no cases are reported in winter, from July to September. The AHS virus (AHSV is transmitted almost exclusively by Culicoides midges (Diptera: Ceratopogonidae, of which Culicoides imicola is considered to be the most important vector. The over-wintering mechanism of AHSV is unknown. In this study, more than 500 000 Culicoides midges belonging to at least 26 species were collected in 88 light traps at weekly intervals between July 2010 and September 2011 near horses in the Onderstepoort area of South Africa. The dominant species was C. imicola. Despite relatively low temperatures and frost, at least 17 species, including C. imicola, were collected throughout winter (June–August. Although the mean number of midges per night fell from > 50 000 (March to < 100 (July and August, no midge-free periods were found. This study, using virus isolation on cell cultures and a reverse transcriptase polymerase chain reaction (RT-PCR assay, confirmed low infection prevalence in field midges and that the detection of virus correlated to high numbers. Although no virus was detected during this winter period, continuous adult activity indicated that transmission can potentially occur. The absence of AHSV in the midges during winter can be ascribed to the relatively low numbers collected coupled to low infection prevalence, low virus replication rates and low virus titres in the potentially infected midges. Cases of AHS in susceptible animals are likely to start as soon as Culicoides populations reach a critical level.

  17. Research Progress in Development of Vaccines against African Horse Sickness%非洲马瘟疫苗的研究进展

    Institute of Scientific and Technical Information of China (English)

    何宇乾; 吴海燕


    African horse sickness (AHS) is a non-contagious, insect-borne disease of equids, caused by African horse sickness viruses. This disease is included in the single Office International des Epizooties list of notifiable terrestrial animal diseases, and at present, is enzootic in such areas as sub-Saharan Africa. AHS is mainly transmitted by Culicoides midges, which grow and reproduce in the endemic areas, being responsible for the epidemiological status of this disease. The live attenuated vaccines and inactivated vaccines against AHS have been commercialized and been widely used. The new generation vaccines based on genetic engineering, such as subunit vaccines and viral vector vaccines, are being developed and will probably enter the vaccine marketplace in the future. In this review, we discussed the current status of vaccines against AHS in detail.%非洲马瘟(African horse sickness,AHS)由非洲马瘟病毒(African horse sickness virus,AHSV)感染马科动物而引起的一种非接触性传播的虫媒病毒病,为世界动物卫生组织法定报告的动物疫病,目前主要流行于亚撒哈拉非洲等地区.库蠓( Culicoides midges)是非洲马瘟的主要媒介昆虫,其在疫区的生长繁殖直接影响着该病的流行状况.非洲马瘟弱毒苗和灭活苗已经商品化并得到广泛地应用,新型基因工程疫苗,如亚单位疫苗、活病毒载体疫苗等,正在研发当中并有望将来进入疫苗市场,作者着重对ASH疫苗的研究现状进行了评述.

  18. Antigenic profile of African horse sickness virus serotype 4 VP5 and identification of a neutralizing epitope shared with bluetongue virus and epizootic hemorrhagic disease virus

    DEFF Research Database (Denmark)

    Martinez-Torrecuadrada, J.L.; Langeveld, J.P.M.; Venteo, A.;


    African horse sickness virus (AHSV) causes a fatal disease in horses. The virus capsid is composed of a double protein layer, the outermost of which is formed by two proteins: VP2 and VP5. VP2 is known to determine the serotype of the virus and to contain the neutralizing epitopes. The biological...... immunodominant region was found in the N-terminal 330 residues of VP5, defining two antigenic regions, I (residues 151-200) and II (residues 83-120). The epitopes were further defined by PEPSCAN analysis with 12mer peptides, which determined eight antigenic sites in the N-terminal half of the molecule...

  19. Efficacy, Safety, and Dose of Pafuramidine, a New Oral Drug for Treatment of First Stage Sleeping Sickness, in a Phase 2a Clinical Study and Phase 2b Randomized Clinical Studies.

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    Christian Burri


    Full Text Available Sleeping sickness (human African trypanosomiasis [HAT] is caused by protozoan parasites and characterized by a chronic progressive course, which may last up to several years before death. We conducted two Phase 2 studies to determine the efficacy and safety of oral pafuramidine in African patients with first stage HAT.The Phase 2a study was an open-label, non-controlled, proof-of-concept study where 32 patients were treated with 100 mg of pafuramidine orally twice a day (BID for 5 days at two trypanosomiasis reference centers (Angola and the Democratic Republic of the Congo [DRC] between August 2001 and November 2004. The Phase 2b study compared pafuramidine in 41 patients versus standard pentamidine therapy in 40 patients. The Phase 2b study was open-label, parallel-group, controlled, randomized, and conducted at two sites in the DRC between April 2003 and February 2007. The Phase 2b study was then amended to add an open-label sequence (Phase 2b-2, where 30 patients received pafuramidine for 10 days. The primary efficacy endpoint was parasitologic cure at 24 hours (Phase 2a or 3 months (Phase 2b after treatment completion. The primary safety outcome was the rate of occurrence of World Health Organization Toxicity Scale Grade 3 or higher adverse events. All subjects provided written informed consent.Pafuramidine for the treatment of first stage HAT was comparable in efficacy to pentamidine after 10 days of dosing. The cure rates 3 months post-treatment were 79% in the 5-day pafuramidine, 100% in the 7-day pentamidine, and 93% in the 10-day pafuramidine groups. In Phase 2b, the percentage of patients with at least 1 treatment-emergent adverse event was notably higher after pentamidine treatment (93% than pafuramidine treatment for 5 days (25% and 10 days (57%. These results support continuation of the development program for pafuramidine into Phase 3.

  20. Interaction of sleep quality and psychosocial stress on obesity in African Americans: the Cardiovascular Health Epidemiology Study (CHES

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    Meng Yuan-Xiang


    Full Text Available Abstract Background Compared with whites, sleep disturbance and sleep deprivation appear more prevalent in African Americans (AA. Long-term sleep deprivation may increase the risk of obesity through multiple metabolic and endocrine alterations. Previous studies have reported contradictory results on the association between habitual sleep duration and obesity. Accordingly, we aimed to assess whether sleep quality and duration are inversely associated with body mass index (BMI and obesity and test whether these associations are modified by psychosocial stress, known to influence sleep quality. Methods A sample of 1,515 AA residents of metropolitan Atlanta, aged 30-65 years, was recruited by a random-digit-dialing method in 2007-08. The outcome obesity was defined by BMI (kg/m2 continuously and categorically (BMI ≥ 30 versus BMI Results The mean (standard deviation age was 47.5 (17.0 years, and 1,096 (72% were women. GSQ score categorized into tertiles was associated with BMI. Among women, after multivariable adjustment that included age, gender, physical activity, smoking status, education, total family income, financial stress and history of hypertension, hypercholesterolemia, diabetes and myocardial infarction, obesity was associated with sleep quality as assessed by GSQ continuous score, [odds ratio, OR (95% C.I.: 1.08 (1.03 - 1.12], and with a worse sleep disturbance subcomponent score [OR (95% C.I.: 1.48 (1.16 - 1.89]. Among all participants, stress modified the association between obesity and sleep quality; there was an increased likelihood of obesity in the medium stress category, OR (95% C.I.: 1.09 (1.02 - 1.17. Conclusion Sleep quality was associated with obesity in women. The association of sleep quality with obesity was modified by perceived stress. Our results indicate the need for simultaneous assessment of sleep and stress.

  1. Comparative Risk Analysis of Two Culicoides-Borne Diseases in Horses: Equine Encephalosis More Likely to Enter France than African Horse Sickness

    DEFF Research Database (Denmark)

    Faverjon, C.; Leblond, A.; Lecollinet, S.;


    African horse sickness (AHS) and equine encephalosis (EE) are Culicoides-borne viral diseases that could have the potential to spread across Europe if introduced, thus being potential threats for the European equine industry. Both share similar epidemiology, transmission patterns and geographical...... and regional differences in virus entry probabilities were the same for both diseases. However, the probability of EE entry was much higher than the probability of AHS entry. Interestingly, the most likely entry route differed between AHS and EE: AHS has a higher probability to enter through an infected vector...... and EE has a higher probability to enter through an infectious host. Consequently, different effective protective measures were identified by ‘what-if’ scenarios for the two diseases. The implementation of vector protection on all animals (equine and bovine) coming from low-risk regions before...

  2. Sleep (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Sleep: Condition Information Skip sharing on social media links Share this: Page Content What is sleep? Sleep is a period of unconsciousness during which ...

  3. Melarsoprol sensitivity profile of Trypanosoma brucei gambiense isolates from cured and relapsed sleeping sickness patients from the Democratic Republic of the Congo.

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    Patient Pyana Pati


    Full Text Available Sleeping sickness caused by Trypanosoma brucei (T.b. gambiense constitutes a serious health problem in sub-Sahara Africa. In some foci, alarmingly high relapse rates were observed in patients treated with melarsoprol, which used to be the first line treatment for patients in the neurological disease stage. Particularly problematic was the situation in Mbuji-Mayi, East Kasai Province in the Democratic Republic of the Congo with a 57% relapse rate compared to a 5% relapse rate in Masi-Manimba, Bandundu Province. The present study aimed at investigating the mechanisms underlying the high relapse rate in Mbuji-Mayi using an extended collection of recently isolated T.b. gambiense strains from Mbuji-Mayi and from Masi-Manimba.Forty five T.b. gambiense strains were used. Forty one were isolated from patients that were cured or relapsed after melarsoprol treatment in Mbuji-Mayi. In vivo drug sensitivity tests provide evidence of reduced melarsoprol sensitivity in these strains. This reduced melarsoprol sensitivity was not attributable to mutations in TbAT1. However, in all these strains, irrespective of the patient treatment outcome, the two aquaglyceroporin (AQP 2 and 3 genes are replaced by chimeric AQP2/3 genes that may be associated with resistance to pentamidine and melarsoprol. The 4 T.b. gambiense strains isolated in Masi-Manimba contain both wild-type AQP2 and a different chimeric AQP2/3. These findings suggest that the reduced in vivo melarsoprol sensitivity of the Mbuji-Mayi strains and the high relapse rates in that sleeping sickness focus are caused by mutations in the AQP2/AQP3 locus and not by mutations in TbAT1.We conclude that mutations in the TbAQP2/3 locus of the local T.b. gambiense strains may explain the high melarsoprol relapse rates in the Mbuji-Mayi focus but other factors must also be involved in the treatment outcome of individual patients.

  4. Risk factors for isolated sleep paralysis in an African American sample: a preliminary study. (United States)

    Ramsawh, Holly J; Raffa, Susan D; White, Kamila S; Barlow, David H


    Isolated sleep paralysis (ISP) is a temporary period of involuntary immobility that can occur at sleep onset or offset. It has previously been reported in association with both panic disorder (PD) and posttraumatic stress disorder (PTSD). The current study examined the association between ISP and several possible risk factors--anxiety sensitivity, trauma exposure, life stress, and paranormal beliefs--in a sample of African American participants with and without a history of ISP. Significant between-group differences were found for PD and PTSD diagnoses, anxiety sensitivity, life stress, and certain aspects of paranormal belief, with the ISP group being higher on all of these indices. No differences were found with regard to trauma exposure. Hierarchical regression analyses indicated that PD, anxiety sensitivity, and life stress each contributed unique variance to ISP cognitive symptoms, whereas PTSD and paranormal beliefs did not. These results provide preliminary support for an association between ISP and anxiety sensitivity and corroborate previous reports of ISP's association with PD and life stress. The current trauma/PTSD findings are mixed, however, and warrant future research.

  5. Inactivated and adjuvanted vaccine for the control of the African horse sickness virus serotype 9 infection: evaluation of efficacy in horses and guinea-pig model. (United States)

    Lelli, Rossella; Molini, Umberto; Ronchi, Gaetano Federico; Rossi, Emanuela; Franchi, Paola; Ulisse, Simonetta; Armillotta, Gisella; Capista, Sara; Khaiseb, Siegfried; Di Ventura, Mauro; Pini, Attilio


    African horse sickness (AHS) is a non-contagious viral disease of solipeds transmitted by Culicoides. The disease is endemic in most African countries. Past experience has shown that Italy is a country exposed to emerging infectious diseases endemic to Africa; an incursion of AHS virus together with the widespread presence of Culicoides vectors could be the cause of a serious epidemic emergency. A live attenuated vaccine containing seven of the nine viral serotypes, serotype 5 and 9 are excluded, is commercially available from Onderstepoort Biological Products. However, the use of live vaccines is a matter of endless disputes, and therefore inactivated or recombinant alternative products have been investigated over the years. Since research on AHS is hampered by the use of horses to evaluate vaccine potency, in a previous experiment serological response to serotypes 5 and 9 was assayed in guinea-pigs and horses. A durable and comparable serological response was observed in the two animal species. In the present study antibody response in horses and guinea-pigs, immunised with the inactivated-adjuvanted vaccine formulated with serotype 9, was tested over a period of 12 months. When immunity was challenged, horses were protected from infection and disease. Antibody response in horses and guinea-pigs compared favourably.

  6. How can molecular diagnostics contribute to the elimination of human African trypanosomiasis? (United States)

    Büscher, Philippe; Deborggraeve, Stijn


    A variety of molecular diagnostic tests for human African trypanosomiasis (HAT) (sleeping sickness) has been developed. Some are effectively used for research and confirmation diagnosis in travel medicine, usually following non-standardized protocols. Others have become commercially available as diagnostic kits. WHO aims to eliminate HAT as a public health problem by the year 2020, and zero transmission by the year 2030. This article gives an overview of the recent progress in molecular diagnostics for sleeping sickness, including the most recent data on test performances. Also discussed is how molecular diagnostics can play an important role in the process toward the elimination of HAT.

  7. Development of a Microsphere-based Immunoassay for Serological Detection of African Horse Sickness Virus and Comparison with Other Diagnostic Techniques. (United States)

    Sánchez-Matamoros, A; Beck, C; Kukielka, D; Lecollinet, S; Blaise-Boisseau, S; Garnier, A; Rueda, P; Zientara, S; Sánchez-Vizcaíno, J M


    African horse sickness (AHS) is a viral disease that causes high morbidity and mortality rates in susceptible Equidae and therefore significant economic losses. More rapid, sensitive and specific assays are required by diagnostic laboratories to support effective surveillance programmes. A novel microsphere-based immunoassay (Luminex assay) in which beads are coated with recombinant AHS virus (AHSV) structural protein 7 (VP7) has been developed for serological detection of antibodies against VP7 of any AHSV serotype. The performance of this assay was compared with that of a commercial enzyme-linked immunosorbent assay (ELISA) and commercial lateral flow assay (LFA) on a large panel of serum samples from uninfected horses (n = 92), from a reference library of all AHSV serotypes (n = 9), on samples from horses experimentally infected with AHSV (n = 114), and on samples from West African horses suspected of having AHS (n = 85). The Luminex assay gave the same negative results as ELISA when used to test the samples from uninfected horses. Both assays detected antibodies to all nine AHSV serotypes. In contrast, the Luminex assay detected a higher rate of anti-VP7 positivity in the West African field samples than did ELISA or LFA. The Luminex assay detected anti-VP7 positivity in experimentally infected horses at 7 days post-infection, compared to 13 days for ELISA. This novel immunoassay provides a platform for developing multiplex assays, in which the presence of antibodies against multiple ASHV antigens can be detected simultaneously. This would be useful for serotyping or for differentiating infected from vaccinated animals.

  8. Ns1 is a key protein in the vaccine composition to protect Ifnar(-/- mice against infection with multiple serotypes of African horse sickness virus.

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    Francisco de la Poza

    Full Text Available African horse sickness virus (AHSV belongs to the genus Orbivirus. We have now engineered naked DNAs and recombinant modified vaccinia virus Ankara (rMVA expressing VP2 and NS1 proteins from AHSV-4. IFNAR((-/- mice inoculated with DNA/rMVA-VP2,-NS1 from AHSV-4 in an heterologous prime-boost vaccination strategy generated significant levels of neutralizing antibodies specific of AHSV-4. In addition, vaccination stimulated specific T cell responses against the virus. The vaccine elicited partial protection against an homologous AHSV-4 infection and induced cross-protection against the heterologous AHSV-9. Similarly, IFNAR((-/- mice vaccinated with an homologous prime-boost strategy with rMVA-VP2-NS1 from AHSV-4 developed neutralizing antibodies and protective immunity against AHSV-4. Furthermore, the levels of immunity were very high since none of vaccinated animals presented viraemia when they were challenged against the homologous AHSV-4 and very low levels when they were challenged against the heterologous virus AHSV-9. These data suggest that the immunization with rMVA/rMVA was more efficient in protection against a virulent challenge with AHSV-4 and both strategies, DNA/rMVA and rMVA/rMVA, protected against the infection with AHSV-9. The inclusion of the protein NS1 in the vaccine formulations targeting AHSV generates promising multiserotype vaccines.

  9. Where are the horses? With the sheep or cows? Uncertain host location, vector-feeding preferences and the risk of African horse sickness transmission in Great Britain. (United States)

    Lo Iacono, Giovanni; Robin, Charlotte A; Newton, J Richard; Gubbins, Simon; Wood, James L N


    Understanding the influence of non-susceptible hosts on vector-borne disease transmission is an important epidemiological problem. However, investigation of its impact can be complicated by uncertainty in the location of the hosts. Estimating the risk of transmission of African horse sickness (AHS) in Great Britain (GB), a virus transmitted by Culicoides biting midges, provides an insightful example because: (i) the patterns of risk are expected to be influenced by the presence of non-susceptible vertebrate hosts (cattle and sheep) and (ii) incomplete information on the spatial distribution of horses is available because the GB National Equine Database records owner, rather than horse, locations. Here, we combine land-use data with available horse owner distributions and, using a Bayesian approach, infer a realistic distribution for the location of horses. We estimate the risk of an outbreak of AHS in GB, using the basic reproduction number (R0), and demonstrate that mapping owner addresses as a proxy for horse location significantly underestimates the risk. We clarify the role of non-susceptible vertebrate hosts by showing that the risk of disease in the presence of many hosts (susceptible and non-susceptible) can be ultimately reduced to two fundamental factors: first, the abundance of vectors and how this depends on host density, and, second, the differential feeding preference of vectors among animal species.

  10. Vaccination of horses with a recombinant modified vaccinia Ankara virus (MVA) expressing African horse sickness (AHS) virus major capsid protein VP2 provides complete clinical protection against challenge. (United States)

    Alberca, Berta; Bachanek-Bankowska, Katarzyna; Cabana, Marta; Calvo-Pinilla, Eva; Viaplana, Elisenda; Frost, Lorraine; Gubbins, Simon; Urniza, Alicia; Mertens, Peter; Castillo-Olivares, Javier


    African horse sickness virus (AHSV) is an arthropod-borne pathogen that infects all species of equidae and causes high mortality in horses. Previously, a recombinant modified vaccinia Ankara (MVA) virus expressing the protein VP2 of AHSV serotype 4 was shown to induce virus neutralising antibodies in horses and protected interferon alpha receptor gene knock-out mice (IFNAR -/-) against virulent AHSV challenge. This study builds on the previous work, examining the protective efficacy of MVA-VP2 vaccination in the natural host of AHSV infection. A study group of 4 horses was vaccinated twice with a recombinant MVA virus expressing the major capsid protein (VP2) of AHSV serotype 9. Vaccinated animals and a control group of unvaccinated horses were then challenged with a virulent strain of AHSV-9. The vaccinated animals were completely protected against clinical disease and also against viraemia as measured by standard end-point dilution assays. In contrast, all control horses presented viraemia after challenge and succumbed to the infection. These results demonstrate the potential of recombinant MVA viruses expressing the outer capsid VP2 of AHSV as a protective vaccine against AHSV infection in the field.

  11. Data-driven models to predict the elimination of sleeping sickness in former Equateur province of DRC. (United States)

    Rock, K S; Pandey, A; Ndeffo-Mbah, M L; Atkins, K E; Lumbala, C; Galvani, A; Keeling, M J


    Approaching disease elimination, it is crucial to be able to assess progress towards key objectives using quantitative tools. For Gambian human African trypanosomiasis (HAT), the ultimate goal is to stop transmission by 2030, while intermediary targets include elimination as a public health problem - defined as <1 new case per 10,000 inhabitants in 90% of foci, and <2000 reported cases by 2020. Using two independent mathematical models, this study assessed the achievability of these goals in the former Equateur province of the Democratic Republic of Congo, which historically had endemic levels of disease. The two deterministic models used different assumptions on disease progression, risk of infection and non-participation in screening, reflecting biological uncertainty. To validate the models a censor-fit-uncensor procedure was used to fit to health-zone level data from 2000 to 2012; initially the last six years were censored, then three and the final step utilised all data. The different model projections were used to evaluate the expected transmission and reporting for each health zone within each province under six intervention strategies using currently available tools. In 2012 there were 197 reported HAT cases in former Equateur reduced from 6828 in 2000, however this reflects lower active testing for HAT (1.3% of the population compared to 7.2%). Modelling results indicate that there are likely to be <300 reported cases in former Equateur in 2020 if screening continues at the mean level for 2000-2012 (6.2%), and <120 cases if vector control is introduced. Some health zones may fail to achieve <1 new case per 10,000 by 2020 without vector control, although most appear on track for this target using medical interventions alone. The full elimination goal will be harder to reach; between 39 and 54% of health zones analysed may have to improve their current medical-only strategy to stop transmission completely by 2030.

  12. Sleep paralysis and trauma, psychiatric symptoms and disorders in an adult African American population attending primary medical care. (United States)

    Mellman, Thomas A; Aigbogun, Notalelomwan; Graves, Ruth Elaine; Lawson, William B; Alim, Tanya N


    The occurrence of sleep paralysis (SP) absent narcolepsy appears to not be uncommon in African Americans and probably other non-European groups. Prior research has linked SP to trauma and psychiatric disorders and suggested a specific relationship to panic disorder in African Americans. The objective of our study was to evaluate relationships of SP with trauma, concurrent psychiatric symptoms and lifetime psychiatric diagnoses in an adult African American population recruited from primary care. Cross sectional study with surveys and diagnostic interviews; Patients attending primary care clinics filled out a survey that determined the 6 month prevalence and associated features of SP, a panic disorder screen, the self-rated Hamilton Depression Scale, and an inventory of trauma exposure. A subset of trauma-exposed participants (N = 142) received comprehensive diagnostic interviews that incorporated the Structured Clinical Interview for DSM-IV and the Clinician Assessed PTSD Scale. Four hundred and forty-one adults participated (mean age-40.0 SD = 13.3, 68% female, 95% African American). Fourteen percent endorsed recent SP. In approximately 1/3 of those with SP, episodes also featured panic symptoms. SP was strongly associated with trauma history, and concurrent anxiety and mood symptoms. SP was not associated with specific psychiatric disorders other than lifetime (but not current) alcohol or substance use disorders. Our findings suggest that SP is not uncommon in adult African Americans and is associated with trauma and concurrent distress but not with a specific psychiatric diagnosis.

  13. Clinical presentation of T.b. rhodesiense sleeping sickness in second stage patients from Tanzania and Uganda.

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    Irene Kuepfer

    Full Text Available BACKGROUND: A wide spectrum of disease severity has been described for Human African Trypanosomiasis (HAT due to Trypanosoma brucei rhodesiense (T.b. rhodesiense, ranging from chronic disease patterns in southern countries of East Africa to an increase in virulence towards the north. However, only limited data on the clinical presentation of T.b. rhodesiense HAT is available. From 2006-2009 we conducted the first clinical trial program (Impamel III in T.b. rhodesiense endemic areas of Tanzania and Uganda in accordance with international standards (ICH-GCP. The primary and secondary outcome measures were safety and efficacy of an abridged melarsoprol schedule for treatment of second stage disease. Based on diagnostic findings and clinical examinations at baseline we describe the clinical presentation of T.b. rhodesiense HAT in second stage patients from two distinct geographical settings in East Africa. METHODOLOGY/PRINCIPAL FINDINGS: 138 second stage patients from Tanzania and Uganda were enrolled. Blood samples were collected for diagnosis and molecular identification of the infective trypanosomes, and T.b. rhodesiense infection was confirmed in all trial subjects. Significant differences in diagnostic parameters and clinical signs and symptoms were observed: the median white blood cell (WBC count in the cerebrospinal fluid (CSF was significantly higher in Tanzania (134 cells/mm(3 than in Uganda (20 cells/mm(3; p<0.0001. Unspecific signs of infection were more commonly seen in Uganda, whereas neurological signs and symptoms specific for HAT dominated the clinical presentation of the disease in Tanzania. Co-infections with malaria and HIV did not influence the clinical presentation nor treatment outcomes in the Tanzanian study population. CONCLUSIONS/SIGNIFICANCE: We describe a different clinical presentation of second stage T.b. rhodesiense HAT in two distinct geographical settings in East Africa. In the ongoing absence of sensitive diagnostic

  14. Serum sickness (United States)

    ... the problem should be stopped. Avoid using that medicine or antiserum in the future. ... Call your provider if you received medicine or antiserum in the last 4 weeks and have symptoms of serum sickness.

  15. A web-based survey of horse owners' perceptions and network analysis of horse movements relating to African horse sickness distribution in Namibia and South Africa. (United States)

    Liebenberg, Danica; Piketh, Stuart; van Hamburg, Huib


    Africa horse sickness (AHS) is the most lethal infectious non-contagious horse disease and has accordingly been declared notifiable by the World Organisation for Animal Health. AHS is endemic to sub-Saharan Africa and causes considerable losses to the equestrian industry. The effect of diseases in livestock on socio-economic factors is well researched, but the effect of anthropogenic factors on the distribution of a disease is poorly understood. The purpose of the study was to assess Namibian and South African horse owners' perceptions and the effect of horse movement on AHS distribution. A cross-sectional study was conducted to collect information from horse owners in Namibia and South Africa. To that end 'Fluid survey' was used for survey development. The survey was launched on Facebook and the link shared to horse related focus groups in Namibia and South Africa. A total of 508 responses were collected during the survey period. Of the 417 completed questionnaires received, 22% were from Namibia and 78% from South Africa. The participants comprised of 71% social and 29% professional riders. The most popular precautionary measures used, in addition to vaccination, were chemical repellents (64%) and stabling of horses during dusk and dawn (59%). A network analysis was performed in Gephi 0.8.2.B to illustrate the movement of horses between countries and districts/provinces. Network analysis results indicate that areas with the highest movement of horses corresponded to the areas with a high occurrence of AHS. Although 93% of the participants were aware that AHS is a notifiable and controlled disease, the process and efficiency of reporting is mostly unknown. With this snapshot of horse owners' perceptions and the effect of horse movement on the distribution of AHS, it is clear that a more holistic approach is needed. To that end, all environmental and social factors must be taken into account in effective management strategies.

  16. Exploring the link between nocturnal heart rate, sleep apnea and cardiovascular function in African and Caucasian men : the SABPA study / Y. van Rooyen.


    Van Rooyen, Yolandi


    Motivation: There is a rapid escalation in urbanization amongst South Africans and it is known that urbanized South Africans are subjected to lifestyle factors conducive to an increase in the risk for cardiovascular disease (CVD). Obstructive sleep apnea (OSA) has been described as an independent risk factor for CVD, especially hypertension. OSA has also been associated with insomnia, and plays a contributory role in the co-morbidity of this disorder. The mechanisms employed by OSA, which pro...

  17. Human African trypanosomiasis. (United States)

    Lejon, Veerle; Bentivoglio, Marina; Franco, José Ramon


    Human African trypanosomiasis or sleeping sickness is a neglected tropical disease that affects populations in sub-Saharan Africa. The disease is caused by infection with the gambiense and rhodesiense subspecies of the extracellular parasite Trypanosoma brucei, and is transmitted to humans by bites of infected tsetse flies. The disease evolves in two stages, the hemolymphatic and meningoencephalitic stages, the latter being defined by central nervous system infection after trypanosomal traversal of the blood-brain barrier. African trypanosomiasis, which leads to severe neuroinflammation, is fatal without treatment, but the available drugs are toxic and complicated to administer. The choice of medication is determined by the infecting parasite subspecies and disease stage. Clinical features include a constellation of nonspecific symptoms and signs with evolving neurological and psychiatric alterations and characteristic sleep-wake disturbances. Because of the clinical profile variability and insidiously progressive central nervous system involvement, disease staging is currently based on cerebrospinal fluid examination, which is usually performed after the finding of trypanosomes in blood or other body fluids. No vaccine being available, control of human African trypanosomiasis relies on diagnosis and treatment of infected patients, assisted by vector control. Better diagnostic tools and safer, easy to use drugs are needed to facilitate elimination of the disease.

  18. Drug resistance in African trypanosomiasis: the melarsoprol and pentamidine story. (United States)

    Baker, Nicola; de Koning, Harry P; Mäser, Pascal; Horn, David


    Melarsoprol and pentamidine represent the two main classes of drugs, the arsenicals and diamidines, historically used to treat the diseases caused by African trypanosomes: sleeping sickness in humans and Nagana in livestock. Cross-resistance to these drugs was first observed over 60 years ago and remains the only example of cross-resistance among sleeping sickness therapies. A Trypanosoma brucei adenosine transporter is well known for its role in the uptake of both drugs. More recently, aquaglyceroporin 2 (AQP2) loss of function was linked to melarsoprol-pentamidine cross-resistance. AQP2, a channel that appears to facilitate drug accumulation, may also be linked to clinical cases of resistance. Here, we review these findings and consider some new questions as well as future prospects for tackling the devastating diseases caused by these parasites.

  19. Association of genetic loci with sleep apnea in European Americans and African-Americans: the Candidate Gene Association Resource (CARe.

    Directory of Open Access Journals (Sweden)

    Sanjay R Patel

    Full Text Available Although obstructive sleep apnea (OSA is known to have a strong familial basis, no genetic polymorphisms influencing apnea risk have been identified in cross-cohort analyses. We utilized the National Heart, Lung, and Blood Institute (NHLBI Candidate Gene Association Resource (CARe to identify sleep apnea susceptibility loci. Using a panel of 46,449 polymorphisms from roughly 2,100 candidate genes on a customized Illumina iSelect chip, we tested for association with the apnea hypopnea index (AHI as well as moderate to severe OSA (AHI≥15 in 3,551 participants of the Cleveland Family Study and two cohorts participating in the Sleep Heart Health Study.Among 647 African-Americans, rs11126184 in the pleckstrin (PLEK gene was associated with OSA while rs7030789 in the lysophosphatidic acid receptor 1 (LPAR1 gene was associated with AHI using a chip-wide significance threshold of p-value<2×10(-6. Among 2,904 individuals of European ancestry, rs1409986 in the prostaglandin E2 receptor (PTGER3 gene was significantly associated with OSA. Consistency of effects between rs7030789 and rs1409986 in LPAR1 and PTGER3 and apnea phenotypes were observed in independent clinic-based cohorts.Novel genetic loci for apnea phenotypes were identified through the use of customized gene chips and meta-analyses of cohort data with replication in clinic-based samples. The identified SNPs all lie in genes associated with inflammation suggesting inflammation may play a role in OSA pathogenesis.

  20. Acute mountain sickness (United States)

    High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema ... Acute mountain sickness is caused by reduced air pressure and lower oxygen levels at high altitudes. The faster you ...

  1. Challenges facing the elimination of sleeping sickness in west and central Africa: sustainable control of animal trypanosomiasis as an indispensable approach to achieve the goal. (United States)

    Simo, Gustave; Rayaisse, Jean Baptiste


    African trypanosomiases are infectious diseases caused by trypanosomes. African animal trypanosomiasis (AAT) remains an important threat for livestock production in some affected areas whereas human African trypanosomiasis (HAT) is targeted for elimination in 2020. In West and Central Africa, it has been shown that the parasites causing these diseases can coexist in the same tsetse fly or the same animal. In such complex settings, the control of these diseases must be put in the general context of trypanosomiasis control or "one health" concept where the coordination of control operations will be beneficial for both diseases. In this context, implementing control activities on AAT will help to sustain HAT control. It will also have a positive impact on animal health and economic development of the regions. The training of inhabitants on how to implement and sustain vector control tools will enable a long-term sustainability of control operations that will lead to the elimination of HAT and AAT.

  2. Human African trypanosomiasis in non-endemic countries. (United States)

    Sudarshi, Darshan; Brown, Mike


    Human African trypanosomiasis (HAT) or sleeping sickness is a parasitic disease, acquired by the bite of an infected tsetse fly. In non-endemic countries HAT is rare, and therefore the diagnosis may be delayed leading to potentially fatal consequences. In this article the clinical presentation, diagnosis and treatment of the two forms of HAT are outlined. Rhodesiense HAT is an acute illness that presents in tourists who have recently visited game parks in Eastern or Southern Africa, whereas Gambiense HAT has a more chronic clinical course, in individuals from West or Central Africa.

  3. Dizziness and Motion Sickness (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Dizziness and Motion Sickness Dizziness and Motion Sickness Patient ... vision or speech, or hearing loss. What is dizziness? Dizziness can be described in many ways, such ...

  4. Morning sickness (image) (United States)

    Morning sickness usually begins during the first month of pregnancy and continues until the 14th to 16th week. ... have nausea and vomiting through their entire pregnancy. Morning sickness is very common and does not hurt the ...

  5. Virus-specific CD8⁺ T-cells detected in PBMC from horses vaccinated against African horse sickness virus. (United States)

    Pretorius, Alri; Van Kleef, Mirinda; Van Wyngaardt, Wouter; Heath, Jeanette


    African horsesickness (AHS) is an infectious but noncontagious viral disease affecting all species of Equidae. The recall immune response of AHSV naïve horses immunised with an attenuated African horsesickness virus serotype 4 (AHSV4) was characterised using immune assays including ELISPOT, real-time PCR (qPCR) and flow cytometry. The recall immune response detected in PBMC isolated from three inoculated horses showed an upregulation of circulating B lymphocytes that correlated with elevated IL-4 mRNA expression indicative of humoral immunity, but reduced frequency of CD4⁺ cells. In addition to the expected antibody response, an increase in CD8⁺ cells was also detected. Although these CD8⁺ cells may be CTL, the role of these cells in immunity against AHSV still has to be determined.

  6. A targeted door-to-door strategy for sleeping sickness detection in low-prevalence settings in Côte d’Ivoire

    Directory of Open Access Journals (Sweden)

    Koffi Mathurin


    Full Text Available Significant efforts to control human African trypanosomiasis (HAT over the three past decades have resulted in drastic reductions of disease prevalence in Côte d’Ivoire. In this context, the costly and labor-intensive active mass screening strategy is no longer efficient. In addition to a more cost-effective passive surveillance system being implemented in this low-prevalence context, our aim was to develop an alternative targeted active screening strategy. In 2012, we carried out a targeted door-to-door (TDD survey focused on the immediate vicinities of former HAT patients detected in the HAT focus of Bonon and compared the results to those obtained during classical active mass screening (AMS surveys conducted from 2000 to 2012 in the same area. The TDD that provides a friendlier environment, inviting inhabitants to participate and gain awareness of the disease, detected significantly more HAT cases than the AMS. These results suggest that the TDD is an efficient and useful strategy in low-prevalence settings where very localized transmission cycles may persist and, in combination with passive surveillance, could help in eliminating HAT.

  7. A targeted door-to-door strategy for sleeping sickness detection in low-prevalence settings in Côte d’Ivoire (United States)

    Koffi, Mathurin; N’Djetchi, Martial; Ilboudo, Hamidou; Kaba, Dramane; Coulibaly, Bamoro; N’Gouan, Emmanuel; Kouakou, Lingué; Bucheton, Bruno; Solano, Philippe; Courtin, Fabrice; Ehrhardt, Stephan; Jamonneau, Vincent


    Significant efforts to control human African trypanosomiasis (HAT) over the three past decades have resulted in drastic reductions of disease prevalence in Côte d’Ivoire. In this context, the costly and labor-intensive active mass screening strategy is no longer efficient. In addition to a more cost-effective passive surveillance system being implemented in this low-prevalence context, our aim was to develop an alternative targeted active screening strategy. In 2012, we carried out a targeted door-to-door (TDD) survey focused on the immediate vicinities of former HAT patients detected in the HAT focus of Bonon and compared the results to those obtained during classical active mass screening (AMS) surveys conducted from 2000 to 2012 in the same area. The TDD that provides a friendlier environment, inviting inhabitants to participate and gain awareness of the disease, detected significantly more HAT cases than the AMS. These results suggest that the TDD is an efficient and useful strategy in low-prevalence settings where very localized transmission cycles may persist and, in combination with passive surveillance, could help in eliminating HAT. PMID:27849517

  8. Loop-Mediated Isothermal Amplification Test for Trypanosoma gambiense Group 1 with Stem Primers: A Molecular Xenomonitoring Test for Sleeping Sickness (United States)

    Mburugu, Gitonga N.


    The World Health Organization has targeted Human African Trypanosomiasis (HAT) for elimination by 2020 with zero incidence by 2030. To achieve and sustain this goal, accurate and easy-to-deploy diagnostic tests for Gambian trypanosomiasis which accounts for over 98% of reported cases will play a crucial role. Most needed will be tools for surveillance of pathogen in vectors (xenomonitoring) since population screening tests are readily available. The development of new tests is expensive and takes a long time while incremental improvement of existing technologies that have potential for xenomonitoring may offer a shorter pathway to tools for HAT surveillance. We have investigated the effect of including a second set of reaction accelerating primers (stem primers) to the standard T. brucei gambiense LAMP test format. The new test format was analyzed with and without outer primers. Amplification was carried out using Rotorgene 6000 and the portable ESE Quant amplification unit capable of real-time data output. The stem LAMP formats indicated shorter time to results (~8 min), were 10–100-fold more sensitive, and indicated higher diagnostic sensitivity and accuracy compared to the standard LAMP test. It was possible to confirm the predicted product using ESE melt curves demonstrating the potential of combining LAMP and real-time technologies as possible tool for HAT molecular xenomonitoring.

  9. Loop-Mediated Isothermal Amplification Test for Trypanosoma gambiense Group 1 with Stem Primers: A Molecular Xenomonitoring Test for Sleeping Sickness

    Directory of Open Access Journals (Sweden)

    Zablon K. Njiru


    Full Text Available The World Health Organization has targeted Human African Trypanosomiasis (HAT for elimination by 2020 with zero incidence by 2030. To achieve and sustain this goal, accurate and easy-to-deploy diagnostic tests for Gambian trypanosomiasis which accounts for over 98% of reported cases will play a crucial role. Most needed will be tools for surveillance of pathogen in vectors (xenomonitoring since population screening tests are readily available. The development of new tests is expensive and takes a long time while incremental improvement of existing technologies that have potential for xenomonitoring may offer a shorter pathway to tools for HAT surveillance. We have investigated the effect of including a second set of reaction accelerating primers (stem primers to the standard T. brucei gambiense LAMP test format. The new test format was analyzed with and without outer primers. Amplification was carried out using Rotorgene 6000 and the portable ESE Quant amplification unit capable of real-time data output. The stem LAMP formats indicated shorter time to results (~8 min, were 10–100-fold more sensitive, and indicated higher diagnostic sensitivity and accuracy compared to the standard LAMP test. It was possible to confirm the predicted product using ESE melt curves demonstrating the potential of combining LAMP and real-time technologies as possible tool for HAT molecular xenomonitoring.

  10. Predicting the Impact of Intervention Strategies for Sleeping Sickness in Two High-Endemicity Health Zones of the Democratic Republic of Congo (United States)

    Torr, Steve J.; Lumbala, Crispin; Keeling, Matt J.


    Two goals have been set for Gambian human African trypanosomiasis (HAT), the first is to achieve elimination as a public health problem in 90% of foci by 2020, and the second is to achieve zero transmission globally by 2030. It remains unclear if certain HAT hotspots could achieve elimination as a public health problem by 2020 and, of greater concern, it appears that current interventions to control HAT in these areas may not be sufficient to achieve zero transmission by 2030. A mathematical model of disease dynamics was used to assess the potential impact of changing the intervention strategy in two high-endemicity health zones of Kwilu province, Democratic Republic of Congo. Six key strategies and twelve variations were considered which covered a range of recruitment strategies for screening and vector control. It was found that effectiveness of HAT screening could be improved by increasing effort to recruit high-risk groups for screening. Furthermore, seven proposed strategies which included vector control were predicted to be sufficient to achieve an incidence of less than 1 reported case per 10,000 people by 2020 in the study region. All vector control strategies simulated reduced transmission enough to meet the 2030 goal, even if vector control was only moderately effective (60% tsetse population reduction). At this level of control the full elimination threshold was expected to be met within six years following the start of the change in strategy and over 6000 additional cases would be averted between 2017 and 2030 compared to current screening alone. It is recommended that a two-pronged strategy including both enhanced active screening and tsetse control is implemented in this region and in other persistent HAT foci to ensure the success of the control programme and meet the 2030 elimination goal for HAT. PMID:28056016

  11. Cerebral and peripheral changes occurring in nitric oxide (NO synthesis in a rat model of sleeping sickness: identification of brain iNOS expressing cells.

    Directory of Open Access Journals (Sweden)

    Donia Amrouni

    Full Text Available BACKGROUND: The implication of nitric oxide (NO in the development of human African trypanosomiasis (HAT using an animal model, was examined. The manner by which the trypanocidal activity of NO is impaired in the periphery and in the brain of rats infected with Trypanosoma brucei brucei (T. b. brucei was analyzed through: (i the changes occurring in NO concentration in both peripheral (blood and cerebral compartments; (ii the activity of nNOS and iNOS enzymes; (iii identification of the brain cell types in which the NO-pathways are particularly active during the time-course of the infection. METHODOLOGY/PRINCIPAL FINDINGS: NO concentration (direct measures by voltammetry was determined in central (brain and peripheral (blood compartments in healthy and infected animals at various days post-infection: D5, D10, D16 and D22. Opposite changes were observed in the two compartments. NO production increased in the brain (hypothalamus from D10 (+32% to D16 (+71%, but decreased in the blood from D10 (-22% to D16 (-46% and D22 (-60%. In parallel with NO measures, cerebral iNOS activity increased and peaked significantly at D16 (up to +700%. However, nNOS activity did not vary. Immunohistochemical staining confirmed iNOS activation in several brain regions, particularly in the hypothalamus. In peritoneal macrophages, iNOS activity decreased from D10 (-83% to D16 (-65% and D22 (-74% similarly to circulating NO. CONCLUSION/SIGNIFICANCE: The NO changes observed in our rat model were dependent on iNOS activity in both peripheral and central compartments. In the periphery, the NO production decrease may reflect an arginase-mediated synthesis of polyamines necessary to trypanosome growth. In the brain, the increased NO concentration may result from an enhanced activity of iNOS present in neurons and glial cells. It may be regarded as a marker of deleterious inflammatory reactions.

  12. Structures of Trypanosoma brucei methionyl-tRNA synthetase with urea-based inhibitors provide guidance for drug design against sleeping sickness.

    Directory of Open Access Journals (Sweden)

    Cho Yeow Koh


    Full Text Available Methionyl-tRNA synthetase of Trypanosoma brucei (TbMetRS is an important target in the development of new antitrypanosomal drugs. The enzyme is essential, highly flexible and displaying a large degree of changes in protein domains and binding pockets in the presence of substrate, product and inhibitors. Targeting this protein will benefit from a profound understanding of how its structure adapts to ligand binding. A series of urea-based inhibitors (UBIs has been developed with IC50 values as low as 19 nM against the enzyme. The UBIs were shown to be orally available and permeable through the blood-brain barrier, and are therefore candidates for development of drugs for the treatment of late stage human African trypanosomiasis. Here, we expand the structural diversity of inhibitors from the previously reported collection and tested for their inhibitory effect on TbMetRS and on the growth of T. brucei cells. The binding modes and binding pockets of 14 UBIs are revealed by determination of their crystal structures in complex with TbMetRS at resolutions between 2.2 Å to 2.9 Å. The structures show binding of the UBIs through conformational selection, including occupancy of the enlarged methionine pocket and the auxiliary pocket. General principles underlying the affinity of UBIs for TbMetRS are derived from these structures, in particular the optimum way to fill the two binding pockets. The conserved auxiliary pocket might play a role in binding tRNA. In addition, a crystal structure of a ternary TbMetRS•inhibitor•AMPPCP complex indicates that the UBIs are not competing with ATP for binding, instead are interacting with ATP through hydrogen bond. This suggests a possibility that a general 'ATP-engaging' binding mode can be utilized for the design and development of inhibitors targeting tRNA synthetases of other disease-causing pathogen.

  13. Is There an Association between Sleeping Patterns and Other Environmental Factors with Obesity and Blood Pressure in an Urban African Population?

    Directory of Open Access Journals (Sweden)

    Sandra Pretorius

    Full Text Available Beyond changing dietary patterns, there is a paucity of data to fully explain the high prevalence of obesity and hypertension in urban African populations. The aim of this study was to determine whether other environmental factors (including sleep duration, smoking and physical activity are related to body anthropometry and blood pressure (BP. Data were collected on 1311 subjects, attending two primary health care clinics in Soweto, South Africa. Questionnaires were used to obtain data on education, employment, exercise, smoking and sleep duration. Anthropometric and BP measurements were taken. Subjects comprised 862 women (mean age 41 ± 16 years and mean BMI 29.9 ± 9.2 kg/m² and 449 men (38 ± 14 years and 24.8 ± 8.3 kg/m². In females, ANOVA showed that former smokers had a higher BMI (p 30 minutes was related to a lower BMI (β = -0.04, p30 minutes/day was related to lower systolic (β = -0.02, p<0.05 and lower diastolic BP (β = -0.02, p = 0.05. Longer night time sleep duration was associated with higher diastolic (β = 0.005, p<0.01 and systolic BP (β = 0.003, p<0.05 in females. No health benefits were noted for physical activity. These data suggest that environmental factors rarely collected in African populations are related, in gender-specific ways, to body anthropometry and blood pressure. Further research is required to fully elucidate these associations and how they might be translated into public health programs to combat high levels of obesity and hypertension.

  14. Sleep Sleeping Patch

    Institute of Scientific and Technical Information of China (English)


    The Sleep Sleeping Patch is a new kind of external patch based on modern sleep medicine research achievements, which uses the internationally advanced transdermal therapeutic system (TTS). The Sleep Sleeping Patch transmits natural sleep inducers such as peppermint and liquorice extracts and melatonin through the skin to induce sleep. Clinical research proves that the Sleep Sleeping Patch can effectively improve insomnia and the quality of sleep. Highly effective: With the modern TTS therapy,

  15. Human African trypanosomiasis in endemic populations and travellers. (United States)

    Blum, J A; Neumayr, A L; Hatz, C F


    Human African trypanosomiasis (HAT) or sleeping sickness is caused by the protozoan parasites Trypanosoma brucei (T.b.) gambiense (West African form) and T.b. rhodesiense (East African form) that are transmitted by the bite of the tsetse fly, Glossina spp.. Whereas most patients in endemic populations are infected with T.b. gambiense, most tourists are infected with T.b. rhodesiense. In endemic populations, T.b. gambiense HAT is characterized by chronic and intermittent fever, headache, pruritus, and lymphadenopathy in the first stage and by sleep disturbances and neuro-psychiatric disorders in the second stage. Recent descriptions of the clinical presentation of T.b. rhodesiense in endemic populations show a high variability in different foci. The symptomatology of travellers is markedly different from the usual textbook descriptions of African HAT patients. The onset of both infections is almost invariably an acute and febrile disease. Diagnosis and treatment are difficult and rely mostly on old methods and drugs. However, new molecular diagnostic technologies are under development. A promising new drug combination is currently evaluated in a phase 3 b study and further new drugs are under evaluation.

  16. Through the dark continent: African trypanosome developments in the tsetse fly

    Directory of Open Access Journals (Sweden)

    Brice eROTUREAU


    Full Text Available African trypanosomes are unicellular flagellated parasites causing trypanosomiases in Africa, a group of severe diseases also known as sleeping sickness in human and nagana in cattle. These parasites are almost exclusively transmitted by the bite of the tsetse fly. In this review, we describe and compare the three development programs of the main trypanosome species impacting human and animal health, with focus on the most recent observations. From here, some reflections on research issues on the trypanosome developmental biology in the tsetse fly to be addressed in the future are given.

  17. Mathematical models of human african trypanosomiasis epidemiology. (United States)

    Rock, Kat S; Stone, Chris M; Hastings, Ian M; Keeling, Matt J; Torr, Steve J; Chitnis, Nakul


    Human African trypanosomiasis (HAT), commonly called sleeping sickness, is caused by Trypanosoma spp. and transmitted by tsetse flies (Glossina spp.). HAT is usually fatal if untreated and transmission occurs in foci across sub-Saharan Africa. Mathematical modelling of HAT began in the 1980s with extensions of the Ross-Macdonald malaria model and has since consisted, with a few exceptions, of similar deterministic compartmental models. These models have captured the main features of HAT epidemiology and provided insight on the effectiveness of the two main control interventions (treatment of humans and tsetse fly control) in eliminating transmission. However, most existing models have overestimated prevalence of infection and ignored transient dynamics. There is a need for properly validated models, evolving with improved data collection, that can provide quantitative predictions to help guide control and elimination strategies for HAT.

  18. Towards the Atlas of human African trypanosomiasis

    Directory of Open Access Journals (Sweden)

    Mattioli Raffaele C


    Full Text Available Abstract Background Updated, accurate and comprehensive information on the distribution of human African trypanosomiasis (HAT, also known as sleeping sickness, is critically important to plan and monitor control activities. We describe input data, methodology, preliminary results and future prospects of the HAT Atlas initiative, which will allow major improvements in the understanding of the spatial distribution of the disease. Methods Up-to-date as well as historical data collected by national sleeping sickness control programmes, non-governmental organizations and research institutes have been collated over many years by the HAT Control and Surveillance Programme of the World Health Organization. This body of information, unpublished for the most part, is now being screened, harmonized, and analysed by means of database management systems and geographical information systems (GIS. The number of new HAT cases and the number of people screened within a defined geographical entity were chosen as the key variables to map disease distribution in sub-Saharan Africa. Results At the time of writing, over 600 epidemiological reports and files from seventeen countries were collated and included in the data repository. The reports contain information on approximately 20,000 HAT cases, associated to over 7,000 different geographical entities. The oldest epidemiological records considered so far date back to 1985, the most recent having been gathered in 2008. Data from Cameroon, Central African Republic, Chad, Congo, Equatorial Guinea and Gabon from the year 2000 onwards were fully processed and the preliminary regional map of HAT distribution is presented. Conclusion The use of GIS tools and geo-referenced, village-level epidemiological data allow the production of maps that substantially improve on the spatial quality of previous cartographic products of similar scope. The significant differences between our preliminary outputs and earlier maps of HAT

  19. Sick from Freedom: An Unusual Perspective on the Civil War and Reconstruction

    Directory of Open Access Journals (Sweden)

    Elisabeth Davis Elder


    Full Text Available Review of: Sick from Freedom: African-American Illness and Suffering during the Civil War and Reconstruction; Jim Downs; (2012. Oxford University Press, Oxford, England. 280 pages.

  20. Sick of Taxes?

    DEFF Research Database (Denmark)

    Ljunge, Jan Martin

    I estimate a price elasticity of sickness absence. Sick leave is an intensive margin of labor supply where individuals are free to adjust. I exploit variation in tax rates over two decades, which provide thousands of differential incentives across time and space, to estimate the price...... responsiveness. High taxes provide an incentive to take more sick leave, as less after tax income is lost when taxes are high. The panel data, which is representative of the Swedish population, allow for extensive controls including unobserved individual characteristics. I find a substantial price elasticity...... of sick leave, -0.7, with respect to the net of tax rate. Though large relative to traditional labor supply elasticities, Swedes are half as price elastic as bike messengers, and just as elastic as stadium vendors on the margin which they can adjust freely....

  1. Got a Sick Fish? (United States)

    ... Welfare Veterinary Careers Public Health Got a sick fish? Fish with disease can show a variety of signs. If you notice your pet fish having any unusual disease signs, contact your veterinarian ...

  2. Sick building syndrome

    Directory of Open Access Journals (Sweden)

    Tjandra Y. Aditama


    Full Text Available Sick building syndrome describes a number of mostly unspesific complaints of some occupants of the building. The exact pathophysiological mechanism remains elusive. It is a multi factorial event which may include physical, chemical, biological as well as psycological factors. In many cases it is due to insufficient maintenance of the HVAC (heating, ventilation, air conditioning system in the building. Sign and symptoms can be uncomfortable and even disabling, which may include mucus membrane irritation, neurotoxic symptoms, asthma like symptoms, skin complaints, gastrointestinal symptoms and other related symptoms. There are various investigation methods to diagnose sick building syndrome, and on site assessment of the building is extremely useful. Prevention through a proactive air quality monitoring program is far more desirable than dealing with an actual sick building. Indoor air and the sick building symdrome serves as a paradigm of modern occupational and environmental medicine. (Med J Indones 2002; 11:124-31Keywords: indoor air pollution, sick building syndrome, building related illness

  3. General introduction to altitude adaptation and mountain sickness

    DEFF Research Database (Denmark)

    Bartsch, P.; Saltin, B.


    . The alteration at the muscle level at altitude is minor and so is the effect on the metabolism, although it is debated whether a possible reduction in blood lactate accumulation occurs during exercise at altitude. Transient acute mountain sickness (headache, anorexia, and nausea) is present in 10-30% of subjects...... ascent (average ascent rate 300 m/day above 2000 m a.s.l.), primarily in order to sleep and feel well, and minimize the risk of mountain sickness. A new classification of altitude levels based on the effects on performance and well-being is proposed and an overview given over the various modalities using...

  4. [Serum sickness in diphtheria]. (United States)

    Vozianova, Zh I; Chepilko, K I


    As many as 2247 patients with different clinical forms of diphtheria were examined. Antidiphtheric serum (ADS) was administered in 1556 children, the dosage being determined by condition of the patient. Serum sickness developed at day 7 to 9 in 24 (1.5%); 10 patients were found to run a mild course, 14--moderately severe. 6 patients had allergic reactions: 3--to antibiotic (penicillin), urticaria type, 1--to pertussoid-tetanic anatoxin, 2 had pollinosis-type reaction. Thus, serum sickness has practical value, which fact requires a detailed allergic history together with skin tests to be performed before the administration of ADS.

  5. Social inequalities in "sickness"

    DEFF Research Database (Denmark)

    van der Wel, Kjetil A; Dahl, Espen; Thielen, Karsten


    -employment were particularly high in the Anglo-Saxon and Eastern welfare regimes, and lowest in the Scandinavian regime. For men, absolute and relative social inequalities in sickness were lowest in the Southern regime; for women, inequalities were lowest in the Scandinavian regime. The authors conclude......In comparative studies of health inequalities, public health researchers have usually studied only disease and illness. Recent studies have also examined the sickness dimension of health, that is, the extent to which ill health is accompanied by joblessness, and how this association varies...

  6. Sickness and love: an introduction

    NARCIS (Netherlands)

    S. van der Geest; S. Vandamme


    Love is a neglected topic in anthropology, for good reasons: it has always resisted scientific definition and analysis. By associating love with sickness seven authors attempt to capture various meanings and experiences of love. Two broad concepts arise: love as sickness and love in response to sick

  7. Main: MPA5 [TP Atlas

    Lifescience Database Archive (English)

    Full Text Available ion people suffer from African trypanosomiasis, sleeping sickness, caused by Tryp...rasitic protozoan trypanosomes. A half million people suffer from African trypanosomiasis, sleep

  8. Sleep Quiz (United States)

    ... suffer from sleep disorders, including sleep apnea, insomnia, narcolepsy, and restless legs syndrome. An untreated sleep disorder ... accidents each year--claiming over 1,500 lives. Narcolepsy is a sleep disorder marked by "sleep attacks." ...

  9. Therapeutic evaluation of Acacia nilotica (Linn stem bark extract in experimental African trypanosomiasis

    Directory of Open Access Journals (Sweden)

    E O Ogbadoyi


    Full Text Available Summary: Chemotherapy of African trypanosomiasis still remains far from being satisfactory, being severely limited by a number of factors including unacceptable toxicity, increasing parasite resistance, high cost and unavailability. There is an urgent need for therapeutic agents that are effective, affordable and accessible to the rural poor in Africa who bear most of the disease burden. The objective of this study was to evaluate the therapeutic effects of Acacia nilotica in experimental Trypanosoma brucei brucei infection in mice.  Methanol extract of stem bark of the plant was investigated for its therapeutic effects in experimental African trypanosomiasis. Acute toxicity studies were also conducted. Crude extract of 70% v/v (Methanol/Water at a dose of 400mg kg-1 body weight per day completely cured the experimental T.b. brucei infection in mice, while doses of 50, 100, 200, 300, and 400mgkg-1 body weight per day of the partially purified extract completely cured the experimental infection in mice within two days.  Sub inoculation of blood and cerebrospinal fluid drawn from the cured mice into healthy mice failed to produce any infection within 28 days of post inoculation. Phytochemical analysis showed the presence of carbohydrates, saponin, tannin and cardiac glycoside. LD50 of the partially purified extract was found to be 2000mg/kg body weight, the extract being acutely toxic at a dose of 1600mgkg-1 body weight. It is concluded that methanol extract of stem bark of A. nilotica cures experimental T. b. brucei infection in mice.   Industrial relevance: The findings in this study provide very useful clue for biopharmaceutical industries and drug manufacturers for the development of phytotherapeutic agents from this plant, not only for therapeutic intervention in the control of African trypanosomiasis but also for the treatment of cancer. This is because of the strong link between Chemotherapy of human African trypanosomiasis (sleeping

  10. Sickness: From the focus on cytokines, prostaglandins, and complement factors to the perspectives of neurons. (United States)

    Poon, David Chun-Hei; Ho, Yuen-Shan; Chiu, Kin; Wong, Hoi-Lam; Chang, Raymond Chuen-Chung


    Systemic inflammation leads to a variety of physiological (e.g. fever) and behavioral (e.g. anorexia, immobility, social withdrawal, depressed mood, disturbed sleep) responses that are collectively known as sickness. While these phenomena have been studied for the past few decades, the neurobiological mechanisms by which sickness occurs remain unclear. In this review, we first revisit how the body senses and responds to infections and injuries by eliciting systemic inflammation. Next, we focus on how peripheral inflammatory molecules such as cytokines, prostaglandins, and activated complement factors communicate with the brain to trigger neuroinflammation and sickness. Since depression also involves inflammation, we further elaborate on the interrelationship between sickness and depression. Finally, we discuss how immune activation can modulate neurons in the brain, and suggest future perspectives to help unravel how changes in neuronal functions relate to sickness responses.

  11. Female sickness absenteeism in Poland. (United States)

    Indulski, J A; Szubert, Z


    It is observed that the working activity period has recently been decreasing in Poland; this applies to both the male and female populations. Since women constitute 48% of all workers employed in the national economy, this tendency may pose an important problem for the community and public health. The main information source for the absenteeism analysis are medical certificates which in Poland obligatorily document every instance of a sick-leave from work, irrespective of the length of sickness. A 15% random sample of all sickness certificates constitutes a database for the monitoring system of sickness absence. The lost time rate is the main parameter analysed by the system. In 1994 the rate of female sickness absence in Poland amounted to 25.1 days per one employee. In Poland the main causes of female sickness absence are: respiratory diseases--18% of all sickness absence (in the 16-19 age group--49%), and disorders of female genital tract and complications of pregnancy, childbirth and puerperium (17% of all sickness absence and 48% in the 20-29 age group). The most important chronic diseases that substantially contribute to the level of sickness absence include: musculoskeletal diseases (15%), diseases of the circulatory system (15%) and the nervous system and sense organs (11%). Over the period of 1990-1994 the highest rate of the female sickness absence related to gynecological diseases and pregnancy complications (mean annual increase--22%), and the musculoskeletal diseases (mean annual increase--10%).

  12. Human African trypanosomiasis in South Sudan: how can we prevent a new epidemic?

    Directory of Open Access Journals (Sweden)

    José A Ruiz-Postigo

    Full Text Available Human African trypanosomiasis (HAT has been a major public health problem in South Sudan for the last century. Recurrent outbreaks with a repetitive pattern of responding-scaling down activities have been observed. Control measures for outbreak response were reduced when the prevalence decreased and/or socio-political crisis erupted, leading to a new increase in the number of cases. This paper aims to raise international awareness of the threat of another outbreak of sleeping sickness in South Sudan. It is a review of the available data, interventions over time, and current reports on the status of HAT in South Sudan. Since 2006, control interventions and treatments providing services for sleeping sickness have been reduced. Access to HAT diagnosis and treatment has been considerably diminished. The current status of control activities for HAT in South Sudan could lead to a new outbreak of the disease unless 1 the remaining competent personnel are used to train younger staff to resume surveillance and treatment in the centers where HAT activities have stopped, and 2 control of HAT continues to be given priority even when the number of cases has been substantially reduced. Failure to implement an effective and sustainable system for HAT control and surveillance will increase the risk of a new epidemic. That would cause considerable suffering for the affected population and would be an impediment to the socioeconomic development of South Sudan.

  13. Sleep Disorders (United States)

    ... the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are Insomnia - a hard time falling or staying asleep Sleep apnea - breathing interruptions during sleep Restless legs syndrome - ...

  14. Sleep Problems (United States)

    ... For Consumers Consumer Information by Audience For Women Sleep Problems Share Tweet Linkedin Pin it More sharing ... PDF 474KB) En Español Medicines to Help You Sleep Tips for Better Sleep Basic Facts about Sleep ...

  15. Sick as a Dog

    Institute of Scientific and Technical Information of China (English)


    当形容一个人病得很重时,英语中有这样的说法:Sick as a dog,为什么人们会用"狗"来表示"生病"的意思呢?原来,英语中dog一词有时含有贬义,比如:俚语going to the dogs,表示"糟糕透顶";dog in the manger,表示"犬占马槽、自私自利"的意思。

  16. Construct validity and factor structure of the pittsburgh sleep quality index and epworth sleepiness scale in a multi-national study of African, South East Asian and South American college students.

    Directory of Open Access Journals (Sweden)

    Bizu Gelaye

    Full Text Available The Pittsburgh Sleep Quality Index (PSQI and the Epworth Sleepiness Scale (ESS are questionnaires used to assess sleep quality and excessive daytime sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand.A cross-sectional study was conducted among 8,481 undergraduate students. Students were invited to complete a self-administered questionnaire that collected information about lifestyle, demographic, and sleep characteristics. In each country, the construct validity and factorial structures of PSQI and ESS questionnaires were tested through exploratory and confirmatory factor analyses (EFA and CFA.The largest component-total correlation coefficient for sleep quality as assessed using PSQI was noted in Chile (r = 0.71 while the smallest component-total correlation coefficient was noted for sleep medication use in Peru (r = 0.28. The largest component-total correlation coefficient for excessive daytime sleepiness as assessed using ESS was found for item 1 (sitting/reading in Chile (r = 0.65 while the lowest item-total correlation was observed for item 6 (sitting and talking to someone in Thailand (r = 0.35. Using both EFA and CFA a two-factor model was found for PSQI questionnaire in Chile, Ethiopia and Thailand while a three-factor model was found for Peru. For the ESS questionnaire, we noted two factors for all four countries.Overall, we documented cross-cultural comparability of sleep quality and excessive daytime sleepiness measures using the PSQI and ESS questionnaires among Asian, South American and African young adults. Although both the PSQI and ESS were originally developed as single-factor questionnaires, the results of our EFA and CFA revealed the multi- dimensionality of the scales suggesting limited usefulness of the global PSQI and ESS




    Healing in African indigenous cultures is a corporate matter involving the totality of the person, family and community. Healing presupposes sickness; its practice is therefore interlocked with a people’s conception of sickness and diseases. In Africa, sickness is an attestation to the fact that an individual is out of tune with nature and the supernatural, which is represented by the various deities. The physical signs are therefore a part of the story and not the whole story. Similarly, the...

  18. Cinerama sickness and postural instability

    NARCIS (Netherlands)

    Bos, J.E.; Ledegang, W.D.; Lubeck, A.J.A.; Stins, J.F.


    Motion sickness symptoms and increased postural instability induced by motion pictures have been reported in a laboratory, but not in a real cinema. We, therefore, carried out an observational study recording sickness severity and postural instability in 19 subjects before, immediately and 45 min af

  19. Network analysis reveals distinct clinical syndromes underlying acute mountain sickness.

    Directory of Open Access Journals (Sweden)

    David P Hall

    Full Text Available Acute mountain sickness (AMS is a common problem among visitors at high altitude, and may progress to life-threatening pulmonary and cerebral oedema in a minority of cases. International consensus defines AMS as a constellation of subjective, non-specific symptoms. Specifically, headache, sleep disturbance, fatigue and dizziness are given equal diagnostic weighting. Different pathophysiological mechanisms are now thought to underlie headache and sleep disturbance during acute exposure to high altitude. Hence, these symptoms may not belong together as a single syndrome. Using a novel visual analogue scale (VAS, we sought to undertake a systematic exploration of the symptomatology of AMS using an unbiased, data-driven approach originally designed for analysis of gene expression. Symptom scores were collected from 292 subjects during 1110 subject-days at altitudes between 3650 m and 5200 m on Apex expeditions to Bolivia and Kilimanjaro. Three distinct patterns of symptoms were consistently identified. Although fatigue is a ubiquitous finding, sleep disturbance and headache are each commonly reported without the other. The commonest pattern of symptoms was sleep disturbance and fatigue, with little or no headache. In subjects reporting severe headache, 40% did not report sleep disturbance. Sleep disturbance correlates poorly with other symptoms of AMS (Mean Spearman correlation 0.25. These results challenge the accepted paradigm that AMS is a single disease process and describe at least two distinct syndromes following acute ascent to high altitude. This approach to analysing symptom patterns has potential utility in other clinical syndromes.

  20. Racial differences in sleep architecture: the role of ethnic discrimination. (United States)

    Tomfohr, Lianne; Pung, Meredith A; Edwards, Kate M; Dimsdale, Joel E


    African Americans have been consistently shown to have less deep (slow wave sleep; SWS) and more light (Stages 1 and 2) sleep than Caucasian Americans. This paper explored whether discrimination, a stressor that uniquely impacts certain ethnic groups, contributes to differences in sleep architecture. The sleep of 164 African and Caucasian Americans was examined with laboratory based polysomnography (PSG). Experiences of perceived discrimination (The Scale of Ethnic Experience) and sociodemographic factors were also assessed. After adjusting for age, body mass index (BMI), socioeconomic status (SES) and smoking status, African Americans slept approximately 4.5% more total sleep time (TST) in Stage 2 sleep and 4.7% less TST in SWS than Caucasian Americans (psdiscrimination was a partial mediator of ethnic differences in sleep architecture. Individuals who reported experiencing more discrimination slept more time in Stage 2 and less time in SWS (psethnic group membership plays a part in explaining differences in sleep architecture.


    Directory of Open Access Journals (Sweden)

    S. Y. Nikulina


    Full Text Available Aim. To evaluate changes in hereditary burden of sick sinus syndrome (SSS in families of patients with SSS and assess heart rate variability (HRV in patients with SSS.Results. 33 families of patients with SSS were examined. Clinical study, ECG-Holter monitoring, atropine test, transesophageal left atrial stimulation, echocardiography, veloergometry were fulfilled in all probands and their relatives in 1990 and 2005-2006. Cardiorhythmography was done in patients with SSS only in 2005-2006.Results. Increase in hereditary burden with SSS from 31 to 35% is registered during 15 years. Significant growth of patients with SSS was observed among daughters (from 50 to 71%, nephews (from 33 to 50% and nieces (from 0 to 20%. HRV analysis shows prevalence of sympathetic system activity in patients with SSS.Conclusion. Growth of hereditary burden with SSS especially among female relatives is shown. HRV analysis can be used for SSS diagnostics.

  2. Social inequalities in 'sickness'

    DEFF Research Database (Denmark)

    Wel, Kjetil A. van der; Dahl, Espen; Thielen, Karsten


    The aim of this paper is to examine educational inequalities in the risk of non-employment among people with illnesses and how they vary between European countries with different welfare state characteristics. In doing so, the paper adds to the growing literature on welfare states and social...... from Eurostat and OECD that include spending on active labour market policies, benefit generosity, income inequality, and employment protection. Using multilevel techniques we find that comprehensive welfare states have lower absolute and relative social inequalities in sickness, as well as more...... inequalities in health by studying the often overlooked ‘sickness’-dimension of health, namely employment behaviour among people with illnesses. We use European Union Statistics on Income and Living Conditions (EU-SILC) data from 2005 covering 26 European countries linked to country characteristics derived...

  3. Bacteriotherapy of acute radiation sickness

    Energy Technology Data Exchange (ETDEWEB)

    Mal' tsev, V.N.; Korshunov, V.M.; Strel' nikov, V.A.; Ikonnikova, T.B.; Kissina, E.V.; Lyannaya, A.M.; Goncharova, G.I.; Pinegin, B.V.


    Acute sickness is associated with intestinal dysbacteriosis; there is a radical decrease in number of microorganisms of lactic fermentation (bifidobacterium, lactobacillus) and an increase in E. coli proteus, enterococcus, and clostridium. Extensive use is made of live microorganisms in the treatment of various diseases associated with intestinal dysbacteriosis; in the case of acute radiation sickness, yeast, colibacterin, and E. coli have been used. In a number of cases, such therapy increased survival and life expectancy of irradiated animals. In this study, microorganisms of lactic fermentation (lactobacillus, bifidobacterium) and colibacterin were used for treatment of acute radiation sickness.

  4. Actigraphy in human African trypanosomiasis as a tool for objective clinical evaluation and monitoring: a pilot study.

    Directory of Open Access Journals (Sweden)

    Alfred K Njamnshi

    Full Text Available BACKGROUND: Human African trypanosomiasis (HAT or sleeping sickness leads to a complex neuropsychiatric syndrome with characteristic sleep alterations. Current division into a first, hemolymphatic stage and second, meningoencephalitic stage is primarily based on the detection of white blood cells and/or trypanosomes in the cerebrospinal fluid. The validity of this criterion is, however, debated, and novel laboratory biomarkers are under study. Objective clinical HAT evaluation and monitoring is therefore needed. Polysomnography has effectively documented sleep-wake disturbances during HAT, but could be difficult to apply as routine technology in field work. The non-invasive, cost-effective technique of actigraphy has been widely validated as a tool for the ambulatory evaluation of sleep disturbances. In this pilot study, actigraphy was applied to the clinical assessment of HAT patients. METHODS/PRINCIPAL FINDINGS: Actigraphy was recorded in patients infected by Trypanosoma brucei gambiense, and age- and sex-matched control subjects. Simultaneous nocturnal polysomnography was also performed in the patients. Nine patients, including one child, were analyzed at admission and two of them also during specific treatment. Parameters, analyzed with user-friendly software, included sleep time evaluated from rest-activity signals, rest-activity rhythm waveform and characteristics. The findings showed sleep-wake alterations of various degrees of severity, which in some patients did not parallel white blood cell counts in the cerebrospinal fluid. Actigraphic recording also showed improvement of the analyzed parameters after treatment initiation. Nocturnal polysomnography showed alterations of sleep time closely corresponding to those derived from actigraphy. CONCLUSIONS/SIGNIFICANCE: The data indicate that actigraphy can be an interesting tool for HAT evaluation, providing valuable clinical information through simple technology, well suited also for long

  5. Man-fly contact in the Gambian trypanosomiasis focus of Nola-Bilolo (Central African Republic). (United States)

    Gouteux, J P; Kounda Gboumbi, J C; Noutoua, L; D'Amico, F; Bailly, C; Roungou, J B


    A study using bipyramid tetse fly traps in the Nola-Bilolo sleeping sickness focus (Central African Republic) reveals ecological and behavioural differences between two vectors, Glossina palpalis palpalis and G. fuscipes fuscipes. The latter species inhabits mainly open water sites and surrounding forest, whereas G. p. palpalis occurs mainly in coffe plantations near villages. Consequently, the man-fly contact differs considerably according to the species. The intensity of trypanosomiasis transmission, estimated by the probable distribution of cases, showed significant positive correlation with the density of the flies. Analysis of the fly blood meals in two villages show that, unlike G. g. palpalis, G. f. fuscipes feeds on men more than on pigs. Trypanosoma vivax infection was observed only in G. fuscipes fuscipes. The differences in occupation of the environment between the two vectors must be taken in account in trapping programmes which may modify this distribution.

  6. African trypanosomiasis with special reference to Egyptian Trypanosoma evansi: is it a neglected zoonosis? (United States)

    El-Bahnasawy, Mamdouh M M; Khater, Mai Kh A; Morsy, Tosson A


    Trypanosomes (including humans) are blood and sometimes tissue parasites of the order Kinetoplastida, family Trypanosomatidae, genus Trypanosoma, principally transmitted by biting insects where most of them undergo a biological cycle. They are divided into Stercoraria with the posterior station inoculation, including T. cruzi, both an extra- and intracellular parasite that causes Chagas disease, a major human disease affecting 15 million people and threatening 100 million people in Latin America, and the Salivaria with the anterior station inoculation, mainly African livestock pathogenic trypanosomes, including the agents of sleeping sickness, a major human disease affecting around half a million people and threatening 60 million people in Africa. Now, T. evansi was reported in man is it required to investigate its zoonotic potential?

  7. The Atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases

    Directory of Open Access Journals (Sweden)

    Courtin Fabrice


    Full Text Available Abstract Background Following World Health Assembly resolutions 50.36 in 1997 and 56.7 in 2003, the World Health Organization (WHO committed itself to supporting human African trypanosomiasis (HAT-endemic countries in their efforts to remove the disease as a public health problem. Mapping the distribution of HAT in time and space has a pivotal role to play if this objective is to be met. For this reason WHO launched the HAT Atlas initiative, jointly implemented with the Food and Agriculture Organization of the United Nations, in the framework of the Programme Against African Trypanosomosis. Results The distribution of HAT is presented for 23 out of 25 sub-Saharan countries having reported on the status of sleeping sickness in the period 2000 - 2009. For the two remaining countries, i.e. Angola and the Democratic Republic of the Congo, data processing is ongoing. Reports by National Sleeping Sickness Control Programmes (NSSCPs, Non-Governmental Organizations (NGOs and Research Institutes were collated and the relevant epidemiological data were entered in a database, thus incorporating (i the results of active screening of over 2.2 million people, and (ii cases detected in health care facilities engaged in passive surveillance. A total of over 42 000 cases of HAT and 6 000 different localities were included in the database. Various sources of geographic coordinates were used to locate the villages of epidemiological interest. The resulting average mapping accuracy is estimated at 900 m. Conclusions Full involvement of NSSCPs, NGOs and Research Institutes in building the Atlas of HAT contributes to the efficiency of the mapping process and it assures both the quality of the collated information and the accuracy of the outputs. Although efforts are still needed to reduce the number of undetected and unreported cases, the comprehensive, village-level mapping of HAT control activities over a ten-year period ensures a detailed and reliable

  8. Sleep Quiz (United States)

    Skip Navigation Bar Home Current Issue Past Issues Sleep Quiz Past Issues / Summer 2007 Table of Contents ... on. Photo: iStock Take the National Center on Sleep Disorders Research Sleep Quiz TRUE OR FALSE ? _____1. ...

  9. The cost of sickness: on the effect of the duration of sick leave on post-sick leave earnings. (United States)

    Andersen, Signe Hald


    Studies analysing the effect of the duration of sick leave on subsequent labour market outcomes do not consider the potential endogenous relationship between duration and labour market outcomes. This paper deals with this shortcoming by using a consistent estimator attained through Instrumental Variables methods for estimating the effect of the duration of a sick leave spell on post-sick leave earnings. I use Danish administrative data and a major 2001 reform of the sick leave system as the instrument for duration. I find that the duration of a sick leave spell has both short and long term effects on post-sick leave earnings.

  10. Sick Leave and Subjective Health Complaints


    Tveito, Torill Helene


    The aims of this thesis were to identify risk factors for high levels of sick leave and investigate what – if anything – can be done to reduce sick leave. What is the role of “subjective health complaints”, coping, and psychosocial work factors in relation to sick leave, and to what extent do these factors and the sick leave relate to quality of life? Are there any interventions with a documented effect on sick leave in the literature? Is it possible to influence sick leave thr...

  11. Sleep Disorders

    DEFF Research Database (Denmark)

    Rahbek Kornum, Birgitte; Mignot, Emmanuel


    Mammalian sleep has evolved under the influence of the day-night cycle and in response to reproductive needs, food seeking, and predator avoidance, resulting in circadian (predictive) and homeostatic (reactive) regulation. A molecular clock characterized by transcription/translation feedback loops...... mediates circadian regulation of sleep. Misalignment with the rhythm of the sun results in circadian disorders and jet lag. The molecular basis of homeostatic sleep regulation is mostly unknown. A network of mutually inhibitory brain nuclei regulates sleep states and sleep-wake transitions. Abnormalities...... in these networks create sleep disorders, including rapid eye movement sleep behavior disorder, sleep walking, and narcolepsy. Physiological changes associated with sleep can be imbalanced, resulting in excess movements such as periodic leg movements during sleep or abnormal breathing in obstructive sleep apneas...

  12. Sick sinus syndrome: a review. (United States)

    Semelka, Michael; Gera, Jerome; Usman, Saif


    Sick sinus syndrome refers to a collection of disorders marked by the heart's inability to perform its pacemaking function. Predominantly affecting older adults, sick sinus syndrome comprises various arrhythmias, including bradyarrhythmias with or without accompanying tachyarrhythmias. At least 50 percent of patients with sick sinus syndrome develop alternating bradycardia and tachycardia, also known as tachy-brady syndrome. Sick sinus syndrome results from intrinsic causes, or may be exacerbated or mimicked by extrinsic factors. Intrinsic causes include degenerative fibrosis, ion channel dysfunction, and remodeling of the sinoatrial node. Extrinsic factors can be pharmacologic, metabolic, or autonomic. Signs and symptoms are often subtle early on and become more obvious as the disease progresses. They are commonly related to end-organ hypoperfusion. Cerebral hypoperfusion is most common, with syncope or near-fainting occurring in about one-half of patients. Diagnosis may be challenging, and is ultimately made by electrocardiographic identification of the arrhythmia in conjunction with the presence of symptoms. If electrocardiography does not yield a diagnosis, inpatient telemetry monitoring, outpatient Holter monitoring, event monitoring, or loop monitoring may be used. Electrophysiologic studies also may be used but are not routinely needed. Treatment of sick sinus syndrome includes removing extrinsic factors, when possible, and pacemaker placement. Pacemakers do not reduce mortality, but they can decrease symptoms and improve quality of life.

  13. Sleep apneas and high altitude newcomers. (United States)

    Goldenberg, F; Richalet, J P; Onnen, I; Antezana, A M


    Sleep and respiration data from two French medical high altitude expeditions (Annapurna 4,800 m and Mt Sajama 6,542 m) are presented. Difficulties in maintaining sleep and a SWS decrease were found with periodic breathing (PB) during both non-REM and REM sleep. Extent of PB varied considerably among subjects and was not correlated to the number of arousals but to the intercurrent wakefulness duration. There was a positive correlation between the time spent in PB and the individual hypoxic ventilatory drive. The relation between PB, nocturnal desaturation, and mountain sickness intensity are discussed. Acclimatization decreased the latency toward PB and improved sleep. Hypnotic benzodiazepine intake (loprazolam 1 mg) did not worsen either SWS depression or apneas and allowed normal sleep reappearance after acclimatization.

  14. Human African trypanosomiasis with 7-year incubation period: clinical, laboratory and neuroimaging findings. (United States)

    Wengert, Oliver; Kopp, Marcel; Siebert, Eberhard; Stenzel, Werner; Hegasy, Guido; Suttorp, Norbert; Stich, August; Zoller, Thomas


    Human African trypanosomiasis (HAT), also referred to as "sleeping sickness", is caused by the parasite Trypanosoma brucei. Diagnosing imported HAT outside endemic areas is difficult and diagnosis is often delayed. We report a case of imported human African trypanosomiasis caused by Trypanosoma brucei gambiense with an unusually long incubation period of at least 7 years. A 33 year old male African patient, a former resident of Cameroon, presented with a 4-month history of progressive personality changes. A few weeks before presentation the patient had first been admitted to a psychiatric ward and received antidepressant treatment, until a lumbar puncture showed pleocytosis and then antibiotic treatment for suspected neuroborreliosis was initiated. The patient continued to deteriorate during antibiotic treatment and became increasingly lethargic. Under antiparasitic and anti-inflammatory treatment, the condition of the patient gradually improved over the following months and he recovered completely after 24 months of follow-up. This well-documented case illustrates typical difficulties in establishing the correct diagnosis outside endemic areas and provides an overview of typical clinical, neuropathological and neuroimaging findings in T. b. gambiense trypanosomiasis, guiding the clinician in establishing the correct diagnosis in this rare disease.

  15. Hyperventilation in a motion sickness desensitization program

    NARCIS (Netherlands)

    Mert, A.; Bles, W.; Nooij, S.A.E.


    Introduction: In motion sickness desensitization programs, the motion sickness provocative stimulus is often a forward bending of the trunk on a rotating chair, inducing Coriolis effects. Since respiratory relaxation techniques are applied successfully in these courses, we investigated whether these

  16. Ecologies of complexity: Tropical environments, African trypanosomiasis, and the science of disease control in British colonial Africa, 1900-1940. (United States)

    Tilley, Helen


    Tropical Africa was one of the last regions of the world to experience formal European colonialism, a process that coincided with the advent of a range of new scientific specialties and research methods. The history of British attempts to understand and control African trypanosomiasis (sleeping sickness in humans and nagana in cattle), following the intense human epidemics that broke out between 1895 and 1910, reveals hitherto ignored scientific research in the fields of ecology, epidemiology, and tropical medicine that helped produce a new understanding of the "ecology of disease." Often generated within a transnational and inter-disciplinary context, this knowledge increasingly assumed that vector-borne diseases in tropical environments were highly complex, dynamic, and interrelated phenomena. Thus while many people continued to hope that trypanosomiasis could be eradicated, research results made this prospect seem unlikely, if not impossible.

  17. The detection and treatment of human African trypanosomiasis

    Directory of Open Access Journals (Sweden)

    Bouteille B


    Full Text Available Bernard Bouteille,1 Alain Buguet21Laboratory of Parasitology, Dupuytren University Hospital of Limoges, France; 2Polyclinic Marie-Louise Poto-Djembo, Pointe-Noire, CongoAbstract: Human African trypanosomiasis (HAT is caused by the injection of Trypanosoma brucei (T. b. gambiense or T. b. rhodesiense by Glossina, the tsetse fly. Three historical eras followed the exclusive clinical approach of the 19th century. At the turn of the century, the “initial research” era was initiated because of the dramatic spread of HAT throughout intertropical Africa, and scientists discovered the agent and its vector. Two entities, recurrent fever and sleeping sickness, were then considered a continuum between hemolymphatic stage 1 and meningoencephalitic stage 2. Treatments were developed. Soon after World War I, specific services and mobile teams were created, initiating the “epidemiological” era, during which populations were visited, screened, and treated. As a result, by 1960, annual new cases were rare. New mass screening and staging tools were then developed in a third, “modern” era, especially to counter a new epidemic wave. Currently, diagnosis still relies on microscopic detection of trypanosomes without (wet and thick blood films or with concentration techniques (capillary tube centrifugation, miniature anion-exchange centrifugation technique. Staging is a vital step.Stage 1 patients are treated on site with pentamidine or suramin. However, stage 2 patients are treated in specialized facilities, using drugs that are highly toxic and/or that require complex administration procedures (melarsoprol, eflornithine, or nifurtimox-eflornithine combination therapy. Suramin and melarsoprol are the only medications active against Rhodesian HAT. Staging still relies on cerebrospinal fluid examination for trypanosome detection and white blood cell counts: stage 1, absence of trypanosomes, white blood cell counts ≤ 5/µL; stage 2, presence of

  18. Acute mountain sickness: controversies and advances. (United States)

    Bartsch, Peter; Bailey, Damian M; Berger, Marc M; Knauth, Michael; Baumgartner, Ralf W


    This review discusses the impact of recent publications on pathophysiologic concepts and on practical aspects of acute mountain sickness (AMS). Magnetic resonance imaging studies do not provide evidence of total brain volume increase nor edema within the first 6 to 10 h of exposure to hypoxia despite symptoms of AMS. After 16 to 32 h at about 4500 m, brain volume increases by 0.8% to 2.7%, but morphological changes do not clearly correlate with symptoms of AMS, and lumbar cerebrospinal fluid pressure was unchanged from normoxic values in individuals with AMS. These data do not support the prevailing hypothesis that AMS is caused by cerebral edema and increased intracranial pressure. Direct measurement of increased oxygen radicals in hypoxia and a first study reducing AMS when lowering oxygen radicals by antioxidants suggest that oxidative stress is involved in the pathophysiology of AMS. Placebo-controlled trials demonstrate that theophylline significantly attenuates periodic breathing without improving arterial oxygen saturation during sleep. Its effects on AMS are marginal and clearly inferior to acetazolamide. A most recent large trial with Ginkgo biloba clearly showed that this drug does not prevent AMS in a low-risk setting in which acetazolamide in a low dose of 2 x 125 mg was effective. Therefore, acetazolamide remains the drug of choice for prevention and the recommended dose remains 2 x 250 mg daily until a lower dose has been tested in a high-risk setting and larger clinical trials with antioxidants have been performed.

  19. Identifying Darwinian selection acting on different human APOL1 variants among diverse African populations. (United States)

    Ko, Wen-Ya; Rajan, Prianka; Gomez, Felicia; Scheinfeldt, Laura; An, Ping; Winkler, Cheryl A; Froment, Alain; Nyambo, Thomas B; Omar, Sabah A; Wambebe, Charles; Ranciaro, Alessia; Hirbo, Jibril B; Tishkoff, Sarah A


    Disease susceptibility can arise as a consequence of adaptation to infectious disease. Recent findings have suggested that higher rates of chronic kidney disease (CKD) in individuals with recent African ancestry might be attributed to two risk alleles (G1 and G2) at the serum-resistance-associated (SRA)-interacting-domain-encoding region of APOL1. These two alleles appear to have arisen adaptively, possibly as a result of their protective effects against human African trypanosomiasis (HAT), or African sleeping sickness. In order to explore the distribution of potential functional variation at APOL1, we studied nucleotide variation in 187 individuals across ten geographically and genetically diverse African ethnic groups with exposure to two Trypanosoma brucei subspecies that cause HAT. We observed unusually high levels of nonsynonymous polymorphism in the regions encoding the functional domains that are required for lysing parasites. Whereas allele frequencies of G2 were similar across all populations (3%-8%), the G1 allele was only common in the Yoruba (39%). Additionally, we identified a haplotype (termed G3) that contains a nonsynonymous change at the membrane-addressing-domain-encoding region of APOL1 and is present in all populations except for the Yoruba. Analyses of long-range patterns of linkage disequilibrium indicate evidence of recent selection acting on the G3 haplotype in Fulani from Cameroon. Our results indicate that the G1 and G2 variants in APOL1 are geographically restricted and that there might be other functional variants that could play a role in HAT resistance and CKD risk in African populations.

  20. Absence and leave; sick leave. Final rule. (United States)


    The U.S. Office of Personnel Management is issuing final regulations on the use of sick leave and advanced sick leave for serious communicable diseases, including pandemic influenza when appropriate. We are also permitting employees to substitute up to 26 weeks of accrued or accumulated sick leave for unpaid Family and Medical Leave Act (FMLA) leave to care for a seriously injured or ill covered servicemember, as authorized under the National Defense Authorization Act for Fiscal Year 2008, including up to 30 days of advanced sick leave for this purpose. Finally, we are reorganizing the existing sick leave regulations to enhance reader understanding and administration of the program.

  1. Parenthood, gender and sickness absence. (United States)

    Mastekaasa, A


    It is well documented that women have generally higher morbidity rates than men. In line with this women are also more absent from work due to sickness. This paper considers one popular explanation of the morbidity difference in general and of the difference in sickness absence in particular, viz. that women to a greater extent than men are exposed to the 'double burden' of combining paid work with family obligations. We discuss theories of role overload and role conflict, which both assume that the combination of multiple roles may have negative health effects, as well theories of role enhancement, which assume positive health effects of multiple roles. Using two large Norwegian data sets, the relationship between the number of and the age of children on the one hand and sickness absence on the other is examined separately for men and women and for a number of theoretically interesting subpopulations of women defined in terms of marital status (also taking account of unmarried cohabitation), level of education, and working hours. Generally speaking the association between children and sickness absence is weak, particularly for married people of both genders. To the extent that married persons with children are more absent than married persons without children, this is largely due to respiratory conditions. The relationship between children and sickness absence is somewhat stronger for single, never married mothers, but not for single mothers who have been previously married or for women living in unmarried cohabitation. The findings thus provide little support for either role overload/conflict or role enhancement theories. The possibility that these effects are both present and counterbalancing each other or that they are confounded with uncontrolled selection effects can not, however, be ruled out.

  2. Healthy Sleep Habits (United States)

    ... Sleep Apnea Testing CPAP Healthy Sleep Habits Healthy Sleep Habits Your behaviors during the day, and especially ... team at an AASM accredited sleep center . Quick Sleep Tips Follow these tips to establish healthy sleep ...

  3. What Are Sleep Studies? (United States)

    ... Share this page from the NHLBI on Twitter. Sleep Studies Also known as polysomnography. Sleep studies are ... Sleep Rate This Content: Updated: December 9, 2016 Sleep Infographic Sleep Disorders & Insufficient Sleep: Improving Health through ...

  4. Simulator sickness and its measurement with Simulator Sickness Questionnaire (SSQ

    Directory of Open Access Journals (Sweden)

    Marcin P. Biernacki


    Full Text Available One of the most common methods for studying the simulator sickness issue is the Simulator Sickness Questionnaire (SSQ (Kennedy et al., 1993. Despite the undoubted popularity of the SSQ, this questionnaire has not as yet been standardized and translated, which could allow us to use it in Poland for research purposes. The aim of our article is to introduce the SSQ to Polish readers, both researchers and practitioners. In the first part of this paper, the studies using the SSQ are discussed, whereas the second part consists of the description of the SSQ test procedure and the calculation method of sample results. Med Pr 2016;67(4:545–555

  5. Sleep Apnea (United States)

    Sleep apnea is a common disorder that causes your breathing to stop or get very shallow. Breathing ... an hour. The most common type is obstructive sleep apnea. It causes your airway to collapse or ...

  6. Sick, the spectroscopic inference crank

    CERN Document Server

    Casey, Andrew R


    There exists an inordinate amount of spectral data in both public and private astronomical archives which remain severely under-utilised. The lack of reliable open-source tools for analysing large volumes of spectra contributes to this situation, which is poised to worsen as large surveys successively release orders of magnitude more spectra. In this Article I introduce sick, the spectroscopic inference crank, a flexible and fast Bayesian tool for inferring astrophysical parameters from spectra. sick can be used to provide a nearest-neighbour estimate of model parameters, a numerically optimised point estimate, or full Markov Chain Monte Carlo sampling of the posterior probability distributions. This generality empowers any astronomer to capitalise on the plethora of published synthetic and observed spectra, and make precise inferences for a host of astrophysical (and nuisance) quantities. Model intensities can be reliably approximated from existing grids of synthetic or observed spectra using linear multi-di...

  7. Sickness Behavior in Honey Bees (United States)

    Kazlauskas, Nadia; Klappenbach, Martín; Depino, Amaicha M.; Locatelli, Fernando F.


    During an infection, animals suffer several changes in their normal physiology and behavior which may include lethargy, appetite loss, and reduction in grooming and general movements. This set of alterations is known as sickness behavior and although it has been extensively believed to be orchestrated primarily by the immune system, a relevant role for the central nervous system has also been established. The aim of the present work is to develop a simple animal model to allow studying how the immune and the nervous systems interact coordinately during an infection. We administered a bacterial lipopolysaccharide (LPS) into the thorax of honey bees to mimic a bacterial infection, and then we evaluated a set of stereotyped behaviors of the animals that might be indicative of sickness behavior. First, we show that this immune challenge reduces the locomotor activity of the animals in a narrow time window after LPS injection. Furthermore, bees exhibit a loss of appetite 60 and 90 min after injection, but not 15 h later. We also demonstrate that LPS injection reduces spontaneous antennal movements in harnessed animals, which suggests a reduction in the motivational state of the bees. Finally, we show that the LPS injection diminishes the interaction between animals, a crucial behavior in social insects. To our knowledge these results represent the first systematic description of sickness behavior in honey bees and provide important groundwork for the study of the interaction between the immune and the neural systems in an insect model. PMID:27445851

  8. Sleep health in U.S. Hispanic population. (United States)

    Loredo, Jose S; Soler, Xavier; Bardwell, Wayne; Ancoli-Israel, Sonia; Dimsdale, Joel E; Palinkas, Lawrence A


    The importance of sleep on health has only been recently recognized, and the general public and the medical community are not yet fully knowledgeable about this issue. The great majority of sleep research has been performed in whites of European descent and to a lesser extent in African Americans, making generalization of the findings to other ethnic and racial groups difficult. Very little sleep research has been done in U.S. Hispanics. However, based on the available literature and the high prevalence of risk factors in Hispanics, such as obesity, diabetes, living in the inner city, and use of alcohol, the prevalence of such important sleep disorders such as obstructive sleep apnea and sleep habits such as poor sleep hygiene are suspected to be high. There is also some evidence that acculturation to the U.S. life style may lead to worse sleep habits in Hispanics, including fewer hours of sleep. Two current large NIH sponsored studies of sleep in U.S. Hispanics promise to significantly add to the literature on various sleep disorders such as sleep disordered breathing, insomnia, restless legs syndrome, periodic limb movement disorder, and sleep habits such as short sleep duration and sleep hygiene.

  9. Animal models in motion sickness research (United States)

    Daunton, Nancy G.


    Practical information on candidate animal models for motion sickness research and on methods used to elicit and detect motion sickness in these models is provided. Four good potential models for use in motion sickness experiments include the dog, cat, squirrel monkey, and rat. It is concluded that the appropriate use of the animal models, combined with exploitation of state-of-the-art biomedical techniques, should generate a great step forward in the understanding of motion sickness mechanisms and in the development of efficient and effective approaches to its prevention and treatment in humans.

  10. Control and surveillance of human African trypanosomiasis. (United States)


    In the 1960s, it appeared that human African trypanosomiasis (HAT) could be effectively controlled, but by the beginning of the twenty-first century several decades of neglect had led to alarming numbers of reported new cases, with an estimated 300 000 people infected. The World Health Organization (WHO) responded with a series of initiatives aimed at bringing HAT under control again. Since 2001, the pharmaceutical companies that produce drugs for HAT have committed themselves to providing them free of charge to WHO for distribution for the treatment of patients. In addition, funds have been provided to WHO to support national sleeping sickness control programmes to boost control and surveillance of the disease. That, coupled with bilateral cooperation and the work of nongovernmental organizations, helped reverse the upward trend in HAT prevalence. By 2012, the number of reported cases was fewer than 8000. This success in bringing HAT under control led to its inclusion in the WHO Roadmap for eradication, elimination and control of neglected tropical diseases, with a target set to eliminate the disease as a public health problem by 2020. A further target has been set, by countries in which HAT is endemic, to eliminate gambiense HAT by reducing the incidence of infection to zero in a defined geographical area. This report provides information about new diagnostic approaches, new therapeutic regimens and better understanding of the distribution of the disease with high-quality mapping. The roles of human and animal reservoirs and the tsetse fly vectors that transmit the parasites are emphasized. The new information has formed the basis for an integrated strategy with which it is hoped that elimination of gambiense HAT will be achieved. The report also contains recommendations on the approaches that will lead to elimination of the disease.

  11. Total sleep deprivation, chronic sleep restriction and sleep disruption. (United States)

    Reynolds, Amy C; Banks, Siobhan


    Sleep loss may result from total sleep deprivation (such as a shift worker might experience), chronic sleep restriction (due to work, medical conditions or lifestyle) or sleep disruption (which is common in sleep disorders such as sleep apnea or restless legs syndrome). Total sleep deprivation has been widely researched, and its effects have been well described. Chronic sleep restriction and sleep disruption (also known as sleep fragmentation) have received less experimental attention. Recently, there has been increasing interest in sleep restriction and disruption as it has been recognized that they have a similar impact on cognitive functioning as a period of total sleep deprivation. Sleep loss causes impairments in cognitive performance and simulated driving and induces sleepiness, fatigue and mood changes. This review examines recent research on the effects of sleep deprivation, restriction and disruption on cognition and neurophysiologic functioning in healthy adults, and contrasts the similarities and differences between these three modalities of sleep loss.

  12. Predicting the effect of climate change on African trypanosomiasis: integrating epidemiology with parasite and vector biology. (United States)

    Moore, Sean; Shrestha, Sourya; Tomlinson, Kyle W; Vuong, Holly


    Climate warming over the next century is expected to have a large impact on the interactions between pathogens and their animal and human hosts. Vector-borne diseases are particularly sensitive to warming because temperature changes can alter vector development rates, shift their geographical distribution and alter transmission dynamics. For this reason, African trypanosomiasis (sleeping sickness), a vector-borne disease of humans and animals, was recently identified as one of the 12 infectious diseases likely to spread owing to climate change. We combine a variety of direct effects of temperature on vector ecology, vector biology and vector-parasite interactions via a disease transmission model and extrapolate the potential compounding effects of projected warming on the epidemiology of African trypanosomiasis. The model predicts that epidemics can occur when mean temperatures are between 20.7°C and 26.1°C. Our model does not predict a large-range expansion, but rather a large shift of up to 60 per cent in the geographical extent of the range. The model also predicts that 46-77 million additional people may be at risk of exposure by 2090. Future research could expand our analysis to include other environmental factors that influence tsetse populations and disease transmission such as humidity, as well as changes to human, livestock and wildlife distributions. The modelling approach presented here provides a framework for using the climate-sensitive aspects of vector and pathogen biology to predict changes in disease prevalence and risk owing to climate change.

  13. Mammalian sleep (United States)

    Staunton, Hugh


    This review examines the biological background to the development of ideas on rapid eye movement sleep (REM sleep), so-called paradoxical sleep (PS), and its relation to dreaming. Aspects of the phenomenon which are discussed include physiological changes and their anatomical location, the effects of total and selective sleep deprivation in the human and animal, and REM sleep behavior disorder, the latter with its clinical manifestations in the human. Although dreaming also occurs in other sleep phases (non-REM or NREM sleep), in the human, there is a contingent relation between REM sleep and dreaming. Thus, REM is taken as a marker for dreaming and as REM is distributed ubiquitously throughout the mammalian class, it is suggested that other mammals also dream. It is suggested that the overall function of REM sleep/dreaming is more important than the content of the individual dream; its function is to place the dreamer protagonist/observer on the topographical world. This has importance for the developing infant who needs to develop a sense of self and separateness from the world which it requires to navigate and from which it is separated for long periods in sleep. Dreaming may also serve to maintain a sense of ‘I’ness or “self” in the adult, in whom a fragility of this faculty is revealed in neurological disorders.

  14. Sleep Problems Under-Reported by Parents in Iranian Children


    Shahla Afsharpaiman; Ali Bagheri Hagh; Mohammad Kolbadi Nejad; Susan Amirsalari; Mohammad Torkaman


    Sleep problems are common in childhood, but there are limited studies regarding that in Iranian children and awareness of the sleep problems and their complication in Iranian parents. We arranged this study in which parents of children attending for a sick visit or routine growth control to assess whether sleep problems are under-reported at general pediatric visits. In a cross - a sectional study from April 2010 to April 2011 in 301 children aged 2-14 years old attending to pediatric clinics...

  15. Sleep and Women (United States)

    ... hygiene sleep length Sleep Movement Disorders Sleep Need Sleep talking Sleeping Pills sleepwalking Snoring stress Stroke Suicide Supplements surgery Technology Teens Telemedicine television The internet Time change Transportation trauma travel Treatments ...

  16. Sleep disorders - overview (United States)

    Insomnia; Narcolepsy; Hypersomina; Daytime sleepiness; Sleep rhythm; Sleep disruptive behaviors; Jet lag ... excessive daytime sleepiness) Problems sticking to a regular sleep schedule (sleep rhythm problem) Unusual behaviors during sleep ( ...

  17. American Sleep Association (United States)

    ... Sleep Disorders Book Join ASA Press Room American Sleep Association Improving public health by increasing awareness about ... Members Username or Email Password Remember Me Register Sleep Blog Changing Bad Sleep Habits Asthma and Sleep ...

  18. Sleep and Chronic Disease (United States)

    ... message, please visit this page: About . Sleep About Us About Sleep Key Sleep Disorders Sleep ... Sheets Data & Statistics Projects and Partners Resources Events Sleep and Chronic Disease Recommend on Facebook Tweet Share ...


    Energy Technology Data Exchange (ETDEWEB)

    Casey, Andrew R., E-mail: [Institute of Astronomy, University of Cambridge, Madingley Road, Cambdridge, CB3 0HA (United Kingdom)


    There exists an inordinate amount of spectral data in both public and private astronomical archives that remain severely under-utilized. The lack of reliable open-source tools for analyzing large volumes of spectra contributes to this situation, which is poised to worsen as large surveys successively release orders of magnitude more spectra. In this article I introduce sick, the spectroscopic inference crank, a flexible and fast Bayesian tool for inferring astrophysical parameters from spectra. sick is agnostic to the wavelength coverage, resolving power, or general data format, allowing any user to easily construct a generative model for their data, regardless of its source. sick can be used to provide a nearest-neighbor estimate of model parameters, a numerically optimized point estimate, or full Markov Chain Monte Carlo sampling of the posterior probability distributions. This generality empowers any astronomer to capitalize on the plethora of published synthetic and observed spectra, and make precise inferences for a host of astrophysical (and nuisance) quantities. Model intensities can be reliably approximated from existing grids of synthetic or observed spectra using linear multi-dimensional interpolation, or a Cannon-based model. Additional phenomena that transform the data (e.g., redshift, rotational broadening, continuum, spectral resolution) are incorporated as free parameters and can be marginalized away. Outlier pixels (e.g., cosmic rays or poorly modeled regimes) can be treated with a Gaussian mixture model, and a noise model is included to account for systematically underestimated variance. Combining these phenomena into a scalar-justified, quantitative model permits precise inferences with credible uncertainties on noisy data. I describe the common model features, the implementation details, and the default behavior, which is balanced to be suitable for most astronomical applications. Using a forward model on low-resolution, high signal


    Directory of Open Access Journals (Sweden)

    A. A. Chernova


    Full Text Available Published data demonstrating genetic determination of sick sinus syndrome is presented. The definition of this pathology is presented; the main symptoms are described, as well as genes that influence the development of idiopathic sick sinus syndrome, their polymorphisms and role in disorders of the cardiovascular system.

  1. Job demands, health perception and sickness absence

    NARCIS (Netherlands)

    Roelen, C.A.; Koopmans, P.C.; de Graaf, J.H.; van Zandbergen, J.W.; Groothoff, J.W.


    Background Investigation of the relations between job demands, health and sickness absence is required to design a strategy for the prevention of absence and disability. Aim To study the relationships between (physical and psychological) job demands, health perception and sickness absence. Methods P

  2. Predicting motion sickness during parabolic flight (United States)

    Harm, Deborah L.; Schlegel, Todd T.


    BACKGROUND: There are large individual differences in susceptibility to motion sickness. Attempts to predict who will become motion sick have had limited success. In the present study, we examined gender differences in resting levels of salivary amylase and total protein, cardiac interbeat intervals (R-R intervals), and a sympathovagal index and evaluated their potential to correctly classify individuals into two motion sickness severity groups. METHODS: Sixteen subjects (10 men and 6 women) flew four sets of 10 parabolas aboard NASA's KC-135 aircraft. Saliva samples for amylase and total protein were collected preflight on the day of the flight and motion sickness symptoms were recorded during each parabola. Cardiovascular parameters were collected in the supine position 1-5 days before the flight. RESULTS: There were no significant gender differences in sickness severity or any of the other variables mentioned above. Discriminant analysis using salivary amylase, R-R intervals and the sympathovagal index produced a significant Wilks' lambda coefficient of 0.36, p=0.006. The analysis correctly classified 87% of the subjects into the none-mild sickness or the moderate-severe sickness group. CONCLUSIONS: The linear combination of resting levels of salivary amylase, high-frequency R-R interval levels, and a sympathovagal index may be useful in predicting motion sickness severity.

  3. Motion Sickness Induced by Optokinetic Drums

    NARCIS (Netherlands)

    Bos, J.E.; Bles, W.


    Motion sickness is not only elicited by certain kinds of self-motion, but also by motion of a visual scene. In case of the latter, optokinetic drums are often used and a visual-vestibular conflict is assumed to cause the sickness. When the rotation axis is Earth vertical however, different studies s

  4. Girl Babies Make Mothers Sick

    Institute of Scientific and Technical Information of China (English)



    已经或是将要做母亲的女性阅读此文一定兴味盎然。本文告诉我们: …women suffering from extreme morning sickness during the first three months of pregnancy are more likely to be carrying a daughter than a son. 这个结论不是凭空想象出来的,其调查的对象人数多达百万,令人吃惊: Askling and his team compared more than a million births in Sweden with records of women admitted to hospital for extreme morning sickness. 更令人吃惊的是,除了现代的调查之外,研究人员还引用了古希腊名医希波克拉底的观点: …female fetuses gave the mother a pale face, whereas a mother carrying a male fetus has a healthier tone(气色)to her skin.】

  5. Genetic aspects of sick sinus syndrome

    Directory of Open Access Journals (Sweden)

    Chernova A.A.


    consistent with that of the genotypes of the above genes in the general population of primary sick sinus syndrome patients. The allelic variants of the above genes were not found to be associated with ompensated sick sinus syndrome. Conclusion. The genetic predictors of idiopathic sick sinus syndrome are heterozygous genotypes 44 GA and 4a/4b genes Cx 40 and NOS3 as well as homozygous genotypes in rare allele DD and GG genes ADRA2B and SCN5A. Polymorphic allelic variant 2161C > T (Arg721Trp of MYH6 gene was not revealed in the examined cohort of Krasnoyarsk population. The distribution of the genotypes of the investigated genes in latent sick sinus syndrome patients was found to be consistent with that of the genotypes in the general population of primary sick sinus syndrome patients.

  6. Archives, libraries and museums: containers often sick, sometimes seriously sick

    Directory of Open Access Journals (Sweden)

    Roberto Nicolucci


    Full Text Available As far as the feeling of quietness and peace that they often convey, archives, museums and libraries also hide dangers that you may not imagine, either for visitors or especially for the members of the staff. Indeed the poor microclimatic conditions – often the consequences of materials and construction or building technologies that appear definitely obsolete – often arouse suspicion and worry among the staff. Wrong Thermo hygrometric parameters, the presence of volatile organic elements, mineral fibers, biocides, radon gas, aerial dispersive molecules, are among others some of the chemical physical polluters of major influence that may contribute to giving life to the so-called Sick Building Syndrome. But such spaces also bear biological polluters that can provoke pathologies of various types and importance, among which the feared Illness of Legionnaire. The presence of electromagnetic fields, but above all wrong lighting and wrong ergonomic working positions represent some risk factors for members of staff and visitors.

  7. Sleep Disturbances (United States)

    ... get up in the middle of the night. Sleep in a cool dark place and use the bed only for sleeping and sexual activity. Do not read or watch television in bed. Avoid “screen time” — television, phones, tablets ...

  8. Ancestral sleep. (United States)

    de la Iglesia, Horacio O; Moreno, Claudia; Lowden, Arne; Louzada, Fernando; Marqueze, Elaine; Levandovski, Rosa; Pilz, Luisa K; Valeggia, Claudia; Fernandez-Duque, Eduardo; Golombek, Diego A; Czeisler, Charles A; Skene, Debra J; Duffy, Jeanne F; Roenneberg, Till


    While we do not yet understand all the functions of sleep, its critical role for normal physiology and behaviour is evident. Its amount and temporal pattern depend on species and condition. Humans sleep about a third of the day with the longest, consolidated episode during the night. The change in lifestyle from hunter-gatherers via agricultural communities to densely populated industrialized centres has certainly affected sleep, and a major concern in the medical community is the impact of insufficient sleep on health [1,2]. One of the causal mechanisms leading to insufficient sleep is altered exposure to the natural light-dark cycle. This includes the wide availability of electric light, attenuated exposure to daylight within buildings, and evening use of light-emitting devices, all of which decrease the strength of natural light-dark signals that entrain circadian systems [3].


    Institute of Scientific and Technical Information of China (English)

    Fabiola León-Velarde


    @@ Chronic Mountain Sickness (CMS) is a multifactorial disease caused by a limited capacity to achieve complete adaptation to life under chronic hypoxic conditions. It is accompanied by excessive erythrocitosis (levels of erythrocytes above the normal value set for each altitude), and in advances cases also by pulmonary hypertension. The hypoxemia, caused by central or peripheral respiratory disorders and/or associated to diverse risk factors, produces the excessive erythrocytosis. The most common symptoms are headaches, dizziness, breathlessness, sleep disturbances, tinnitus, physical and mental fatigue, anorexia, and bone and muscle pain. The most common signs are an intermittent or permanent cyanosis, hyperemia and venous dilatation in hands or feet (Monge-M et al., 1928; Winslow and Monge-C, 1987). Aging, respiratory diseases, sleep, menopause, and overweight has proved to be additional risk factors in the development of CMS (Kryger et al., 1978; León-Velarde et al., 1993; Sime et al., 1975; León-Velarde et al., 1997; León-Velarde et al., 2001; Monge-C et al., 1992; Normand et al., 1992)

  10. Motion sickness: a negative reinforcement model. (United States)

    Bowins, Brad


    Theories pertaining to the "why" of motion sickness are in short supply relative to those detailing the "how." Considering the profoundly disturbing and dysfunctional symptoms of motion sickness, it is difficult to conceive of why this condition is so strongly biologically based in humans and most other mammalian and primate species. It is posited that motion sickness evolved as a potent negative reinforcement system designed to terminate motion involving sensory conflict or postural instability. During our evolution and that of many other species, motion of this type would have impaired evolutionary fitness via injury and/or signaling weakness and vulnerability to predators. The symptoms of motion sickness strongly motivate the individual to terminate the offending motion by early avoidance, cessation of movement, or removal of oneself from the source. The motion sickness negative reinforcement mechanism functions much like pain to strongly motivate evolutionary fitness preserving behavior. Alternative why theories focusing on the elimination of neurotoxins and the discouragement of motion programs yielding vestibular conflict suffer from several problems, foremost that neither can account for the rarity of motion sickness in infants and toddlers. The negative reinforcement model proposed here readily accounts for the absence of motion sickness in infants and toddlers, in that providing strong motivation to terminate aberrant motion does not make sense until a child is old enough to act on this motivation.

  11. Workplace bullying and sickness presenteeism

    DEFF Research Database (Denmark)

    Conway, Paul Maurice; Clausen, Thomas; Hansen, Åse Marie


    Purpose: The aim of this study is to investigate exposure to workplace bullying as a potential risk factor for sickness presenteeism (SP), i.e., working while ill. Methods: This study is based on data collected through self-reported questionnaires in a 2-year prospective study on employees...... with missing values, the final samples were composed of 2,865 and 1,331participants in the cross-sectional and prospective analyses, respectively. Results: Modified poisson regression analyses showed that frequent (i.e., daily or weekly) exposure to workplace bullying was associated with reporting 8 or more...... indications of a significant relationship between exposure to frequent workplace bullying and SP, although causal connections could not be established. Methodological and theoretical considerations about study findings are provided, which could be of benefit to future studies examining the impact of being...

  12. Medicines for sleep (United States)

    Benzodiazepines; Sedatives; Hypnotics; Sleeping pills; Insomnia - medicines; Sleep disorder - medicines ... are commonly used to treat allergies. While these sleep aids are not addictive, your body becomes used ...

  13. [Sleep disorders among physicians on shift work]. (United States)

    Schlafer, O; Wenzel, V; Högl, B


    Sleep disorders in physicians who perform shift work can result in increased risks of health problems that negatively impact performance and patient safety. Even those who cope well with shift work are likely to suffer from sleep disorders. The aim of this manuscript is to discuss possible causes, contributing factors and consequences of sleep disorders in physicians and to identify measures that can improve adaptation to shift work and treatment strategies for shift work-associated sleep disorders. The risk factors that influence the development of sleep disorders in physicians are numerous and include genetic factors (15 % of the population), age (> 50 years), undiagnosed sleep apnea,, alcohol abuse as well as multiple stress factors inherent in clinical duties (including shift work), research, teaching and family obligations. Several studies have reported an increased risk for medical errors in sleep-deprived physicians. Shift workers have an increased risk for psychiatric and cardiovascular diseases and shift work may also be a contributing factor to cancer. A relationship has been reported not only with sleep deprivation and changes in food intake but also with diabetes mellitus, obesity, hypertension and coronary heart disease. Nicotine and alcohol consumption are more frequent among shift workers. Increased sickness and accident rates among physicians when commuting (especially after night shifts) have a socioeconomic impact. In order to reduce fatigue and to improve performance, short naps during shiftwork or naps plus caffeine, have been proposed as coping strategies; however, napping during adverse circadian phases is less effective, if not impossible when unable to fall asleep. Bright and blue light supports alertness during a night shift. After shiftwork, direct sunlight exposure to the retina can be avoided by using dark sunglasses or glasses with orange lenses for commuting home. The home environment for daytime sleeping after a night shift should be

  14. Metals: In Sickness and in Health (United States)

    ... All Articles | Inside Life Science Home Page Metals: In Sickness and in Health By Stephanie Dutchen Posted February 1, 2012 ... only strengthens bones but also plays a role in muscle, nerve function and blood clotting. Sodium and ...

  15. Evidence Report: Risk of Decompression Sickness (DCS) (United States)

    Conkin, Johnny; Norcross, Jason R.; Wessel, James H., III; Klein, Jill S.; Dervay, Joseph P.; Gernhardt, Michael L.


    Given that tissue inert gas partial pressure is often greater than ambient pressure during phases of a mission, primarily during extravehicular activity (EVA), there is a possibility of decompression sickness (DCS).

  16. P6 acupressure reduces morning sickness. (United States)

    Dundee, J W; Sourial, F B; Ghaly, R G; Bell, P F


    A prospective study was designed to test the efficacy of pressure at the P6 (Neiguan) acupuncture point, in preventing morning sickness. Three groups of patients in early pregnancy recorded the severity and frequency of sickness over a period of 4 consecutive days following daily pressure at P6 point, pressure at a point near the right elbow and with no treatment. Troublesome sickness was significantly less in both the genuine (23/119) and dummy (41/112) pressure groups as compared with the control series (67/119). When the data are adversely 'weighted' to compensate for the lower incidence of fully completed returns in the active treatment groups, only the P6 group show a significant reduction in sickness. No side effects occurred in either group and while anticipation of benefit may offer a partial explanation for the findings, pressure at the Neiguan point appears to have a specific therapeutic effect.

  17. Genetics Home Reference: sick sinus syndrome (United States)

    ... the structure of myosin, which can affect cardiac muscle contraction and increase the likelihood of developing an abnormal heartbeat. More commonly, sick sinus syndrome is caused by other ... such as muscular dystrophy, abnormal inflammation, or a shortage of oxygen ( ...

  18. Motion sickness, stress and the endocannabinoid system.

    Directory of Open Access Journals (Sweden)

    Alexander Choukèr

    Full Text Available BACKGROUND: A substantial number of individuals are at risk for the development of motion sickness induced nausea and vomiting (N&V during road, air or sea travel. Motion sickness can be extremely stressful but the neurobiologic mechanisms leading to motion sickness are not clear. The endocannabinoid system (ECS represents an important neuromodulator of stress and N&V. Inhibitory effects of the ECS on N&V are mediated by endocannabinoid-receptor activation. METHODOLOGY/PRINCIPAL FINDINGS: We studied the activity of the ECS in human volunteers (n = 21 during parabolic flight maneuvers (PFs. During PFs, microgravity conditions (<10(-2 g are generated for approximately 22 s which results in a profound kinetic stimulus. Blood endocannabinoids (anandamide and 2-arachidonoylglycerol, 2-AG were measured from blood samples taken in-flight before start of the parabolic maneuvers, after 10, 20, and 30 parabolas, in-flight after termination of PFs and 24 h later. Volunteers who developed acute motion sickness (n = 7 showed significantly higher stress scores but lower endocannabinoid levels during PFs. After 20 parabolas, blood anandamide levels had dropped significantly in volunteers with motion sickness (from 0.39+/-0.40 to 0.22+/-0.25 ng/ml but increased in participants without the condition (from 0.43+/-0.23 to 0.60+/-0.38 ng/ml resulting in significantly higher anandamide levels in participants without motion sickness (p = 0.02. 2-AG levels in individuals with motion sickness were low and almost unchanged throughout the experiment but showed a robust increase in participants without motion sickness. Cannabinoid-receptor 1 (CB1 but not cannabinoid-receptor 2 (CB2 mRNA expression in leucocytes 4 h after the experiment was significantly lower in volunteers with motion sickness than in participants without N&V. CONCLUSIONS/SIGNIFICANCE: These findings demonstrate that stress and motion sickness in humans are associated with impaired endocannabinoid

  19. Problems sleeping during pregnancy (United States)

    ... sleeping References Balserak BI, Lee KA. Sleep and sleep disorders associated with pregnancy. In: Kryger M, Roth T, ... Elsevier; 2017:chap 156. Ibrahim S, Foldvary-Shaefer N. Sleep disorders in pregnancy: implications, evaluation, and treatment. Neurologic Clinics . ...

  20. Sleep Terrors (Night Terrors) (United States)

    ... sleepwalking. Like sleepwalking, sleep terrors are considered a parasomnia — an undesired occurrence during sleep. Although sleep terrors are more common in children, they can also affect adults. A sleep terror ...

  1. American Sleep Apnea Association (United States)

    American Sleep Apnea Association Learn About the CPAP Assistance Program About ASAA News about ASAA Who we are Leadership Team Supporting the ASAA Financials Learn Healthy sleep Sleep apnea Other sleep disorders Personal stories Treat Test Yourself ...

  2. Pediatric sleep apnea (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... During sleep, all of the muscles in the body become more relaxed. This includes the muscles that help keep ...

  3. Sleep and Aging (United States)

    ... version of this page please turn Javascript on. Sleep and Aging About Sleep We all look forward to a good night's ... health and quality of life. Two Types of Sleep There are two types of sleep: non-rapid ...

  4. Obstructive sleep apnea - adults (United States)

    Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults ... When you sleep, all of the muscles in your body become more relaxed. This includes the muscles that help keep your ...

  5. Sleep Apnea (For Parents) (United States)

    ... Feeding Your 1- to 2-Year-Old Obstructive Sleep Apnea KidsHealth > For Parents > Obstructive Sleep Apnea Print ... kids and teens can develop it, too. About Sleep Apnea Sleep apnea happens when a person stops ...

  6. Sleep aspnea

    Institute of Scientific and Technical Information of China (English)


    2008057 A multi-center study on the association between sleep apnea and prevalence of hypertension. CHEN Baoyuan(陈宝元), et al. Dept Respir Med, Tianjin Med Univ General Hosp, Tianjin 300052. Chin J Tuberc Respir Dis, 2007;30(12):894-897. Objective To investigate the prevalence of hypertension among sleep apnea patients and the associated factors. Methods A total of 2297 patients (male 1310, female 211) from 20 teaching hospita

  7. African Literature


    Recek, Denis


    The topic of this diploma is the formation and shaping of African literature. The first chapter is about the beginning of African literature. It describes oral literature and its transmission into written literature. Written African literature had great problems in becoming a part of world literature because of its diversity of languages and dialects. Christianity and Islam are mentioned as two religions which had a great impact on African literature. Colonialism is broadly described as an es...

  8. Sleep Tips: 7 Steps to Better Sleep (United States)

    ... turn every night. Consider simple tips for better sleep, from setting a sleep schedule to including physical activity in your daily ... simply worn out? Perhaps the solution is better sleep. Think about all the factors that can interfere ...

  9. Benefiting Africans

    Institute of Scientific and Technical Information of China (English)


    Along with thriving Sino-African economic and trade ties,Chinese companies have attached greater importance to their social responsibility to Africans.More than 2,000 sweaters woven by Chinese mothers were sent to orphans and disabled children in Kenya and four other African countries in September. This activity was launched by Hengyuanxiang,aleading Chinese wool manufacturer.

  10. Benefiting Africans

    Institute of Scientific and Technical Information of China (English)



    Along with thriving Sino-African economic and trade ties,Chinese companies have attached greater importance to their social responsibility to Africans.More than 2,000 sweaters woven by Chinese mothers were sent to orphans and disabled children in Kenya and four other African countries in September.This activity was launched by Hengyuanxiang,a leading Chinese wool manufacturer.

  11. European EVA decompression sickness risks (United States)

    Vogt, Lorenz; Wenzel, Jürgen; Skoog, A. I.; Luck, S.; Svensson, Bengt

    For the first manned flight of Hermes there will be a capability of performing EVA. The European EVA Space Suit will be an anthropomorphic system with an internal pressure of 500 hPa of pure oxygen. The pressure reduction from the Hermes cabin pressure of 1013 hPa will induce a risk for Decompression Sickness (DCS) for the EVA crewmember if no adequate protective procedures are implemented. Specific decompression procedures have to be developed. From a critical review of the literature and by using knowledge gained from research conducted in the past in the fields of diving and aerospace medicine safe protective procedures are proposed for the European EVA scenario. An R factor of 1.2 and a tissue half-time ( t1/2) of 360 minutes in a single-tissue model have been identified as appropriate operational values. On the basis of an acceptable risk level of approximately 1%, oxygen prebreathing times are proposed for (a) direct pressure reduction from 1013 hPa to a suit pressure of 500 hPa, and (b) staged decompression using a 700 hPa intermediate stage in the spacecraft cabin. In addition, factors which influence individual susceptibility to DCS are identified. Recommendations are also given in the areas of crew selection and medical monitoring requirements together with therapeutic measures that can be implemented in the Hermes scenario. A method for demonstration of the validity of proposed risks and procedures is proposed.

  12. Sleep Problems Under-Reported by Parents in Iranian Children

    Directory of Open Access Journals (Sweden)

    Shahla Afsharpaiman


    Full Text Available Sleep problems are common in childhood, but there are limited studies regarding that in Iranian children and awareness of the sleep problems and their complication in Iranian parents. We arranged this study in which parents of children attending for a sick visit or routine growth control to assess whether sleep problems are under-reported at general pediatric visits. In a cross - a sectional study from April 2010 to April 2011 in 301 children aged 2-14 years old attending to pediatric clinics were enrolled. To investigate the general orientation of parents about their child sleep problem we asked them a global question at first regarding sleep of their child. After that, the Persian version of BEARS questionnaire was completed by them. Only 30 (9.9% parents reported sleep problems in their children in response to primary global question but by collecting the data from BEARS questionnaire it was revealed 45.18% (136/301 of children had one or more of sleep disorders at all. As mentioned 136 (45.18% children had slept problems of which the most frequent complaint (15.28% was related to bedtime problems. The second complaint (11.96% was awakening during the night children. A significant association between sleep problems and child gender was not found. Co-sleeping with parents was found in 55.48% of all children in this study. Despite the high prevalence and adverse effects of sleep disorders, the present study suggests that parents underreport sleep problems at consultation. We suggest children should be assessed for sleep disorders in monitoring and health screening visits.

  13. Sleep Problems Under-Reported by Parents in Iranian Children. (United States)

    Afsharpaiman, Shahla; Bagheri Hagh, Ali; Kolbadi Nejad, Mohammad; Amirsalari, Susan; Torkaman, Mohammad


    Sleep problems are common in childhood, but there are limited studies regarding that in Iranian children and awareness of the sleep problems and their complication in Iranian parents. We arranged this study in which parents of children attending for a sick visit or routine growth control to assess whether sleep problems are under-reported at general pediatric visits. In a cross-sectional study from April 2010 to April 2011 in 301 children aged 2-14 years old attending to pediatric clinics were enrolled. To investigate the general orientation of parents about their child sleep problem we asked them a global question at first regarding sleep of their child. After that, the Persian version of BEARS questionnaire was completed by them. Only 30 (9.9%) parents reported sleep problems in their children in response to primary global question but by collecting the data from BEARS questionnaire it was revealed 45.18% (136/301) of children had one or more of sleep disorders at all. As mentioned 136 (45.18%) children had slept problems of which the most frequent complaint (15.28%) was related to bedtime problems. The second complaint (11.96%) was awakening during the night children. A significant association between sleep problems and child gender was not found. Co-sleeping with parents was found in 55.48% of all children in this study. Despite the high prevalence and adverse effects of sleep disorders, the present study suggests that parents underreport sleep problems at consultation. We suggest children should be assessed for sleep disorders in monitoring and health screening visits.

  14. Disease: H00357 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00357 African trypanosomiasis; Sleeping sickness African trypanosomiasis is a has been shown to induce apoptosis in human brain. Infectious disease hsa05143 African trypanosomiasis

  15. 非洲马瘟病毒VP7和NS2双重荧光RT-PCR检测技术的建立与应用%Development and Application of Duplex Real-time RT-PCR Assay for the Detection of VP7 and NS2 of African Horse Sickness Virus

    Institute of Scientific and Technical Information of China (English)

    高志强; 张鹤晓; 乔彩霞; 蒲静; 张伟; 谷强; 刘环; 张利峰; 马贵平


      Nucleic acid sequences of representative strains of different genotypes of African horse sickness viruses(AHSV)were aligned with the DNAMAN software. The two highly conservative NS2 and VP7 regions were then subjected to design primers and probes. The artificially synthesized nucleic acid fragments including amplification regions were used to prepare double strand RNA (dsRNA)by in vitro transcription in two directions(T7 and SP6). A duplex real-time TaqMan RT-PCR assay was developed to detect and quantify AHSV by optimization of reaction conditions using prepared dsRNA. The developed assay was used to detect a set of extracted pathogen RNA/DNA including those of AHSV,Eastern and Western equine encephalomyelitis virus(EEEV and WEEV), equine arteritis virus(EAV),equine influenza virus subtype H3N8(EIV H3N8),Salmonella abortus equi,Streptococcus equi subsp. zooepidimicus resulting in positive only for AHSV RNA,but negative for other virus nucleic acids,suggesting that the developed assay was specific and reliable. The detection limit of the real-time RT-PCR was 1.0×102copies per reaction,10 times more sensitive than that of the conventional RT–PCR based on gel electrophoresis. Also the double gene design could ensure the reliability, and efficiently reduce false negative results. By testing 248 clinical samples,it is confirmed that this assay was rapid,sensitive and repeatable,meeting the requirements for rapid diagnosis of AHSV.%  利用DNAMAN软件对非洲马瘟病毒不同基因型代表株的序列进行分析,选择其高度保守的VP7和NS2基因设计合成引物和探针。人工分别合成包含有扩增区域的VP7和NS2核苷酸片段进行双向(T7和SP6)体外转录制备双链RNA(dsRNA)。使用制备的dsRNA在对荧光定量RT-PCR的反应条件优化的基础上,建立了适用于非洲马瘟病毒检测的双重通用荧光定量RT-PCR检测技术。应用建立的方法对非洲马瘟病毒核酸,马流感病毒核酸

  16. Neuroimmunologic aspects of sleep and sleep loss (United States)

    Rogers, N. L.; Szuba, M. P.; Staab, J. P.; Evans, D. L.; Dinges, D. F.


    The complex and intimate interactions between the sleep and immune systems have been the focus of study for several years. Immune factors, particularly the interleukins, regulate sleep and in turn are altered by sleep and sleep deprivation. The sleep-wake cycle likewise regulates normal functioning of the immune system. Although a large number of studies have focused on the relationship between the immune system and sleep, relatively few studies have examined the effects of sleep deprivation on immune parameters. Studies of sleep deprivation's effects are important for several reasons. First, in the 21st century, various societal pressures require humans to work longer and sleep less. Sleep deprivation is becoming an occupational hazard in many industries. Second, to garner a greater understanding of the regulatory effects of sleep on the immune system, one must understand the consequences of sleep deprivation on the immune system. Significant detrimental effects on immune functioning can be seen after a few days of total sleep deprivation or even several days of partial sleep deprivation. Interestingly, not all of the changes in immune physiology that occur as a result of sleep deprivation appear to be negative. Numerous medical disorders involving the immune system are associated with changes in the sleep-wake physiology--either being caused by sleep dysfunction or being exacerbated by sleep disruption. These disorders include infectious diseases, fibromyalgia, cancers, and major depressive disorder. In this article, we will describe the relationships between sleep physiology and the immune system, in states of health and disease. Interspersed will be proposals for future research that may illuminate the clinical relevance of the relationships between sleeping, sleep loss and immune function in humans. Copyright 2001 by W.B. Saunders Company.

  17. Neuroimaging of sleep and sleep disorders. (United States)

    Nofzinger, Eric A


    Herein are presented the results of research in the area of sleep neuroimaging over the past year. Significant work has been performed to clarify the basic mechanisms of sleep in humans. New studies also extend prior observations regarding altered brain activation in response to sleep deprivation by adding information regarding vulnerability to sleep deprivation and regarding the influence of task difficulty on aberrant responses. Studies in sleep disorder medicine have yielded significant findings in insomnia, depression, and restless legs syndrome. Extensive advances have been made in the area of sleep apnea where physiologic challenges have been used to probe brain activity in the pathophysiology of sleep apnea syndrome.

  18. Coriolis effects and motion sickness modelling. (United States)

    Bles, W


    Coriolis effects are notorious in relation to disorientation and motion sickness in aircrew. A review is provided of experimental data on these Coriolis effects, including the modulatory effects of adding visual or somatosensory rotatory motion information. A vector analysis of the consequences of head movements during somatosensory, visual and/or vestibular rotatory motion stimulation revealed that the more the sensed angular velocity vector after the head movements is aligned with the gravitoinertial force vector, the less nauseating effects are experienced. It is demonstrated that this is a special case of the subjective vertical conflict theory on motion sickness that assumes that motion sickness may be provoked if a discrepancy is detected between the subjective vertical and the sensed vertical as determined on the basis of incoming sensory information.


    Directory of Open Access Journals (Sweden)

    N. A. Abramova


    Full Text Available 143 children and 376 of their family members were examined for the study of intrafamilial infection. The study revealed that in the families of the studied sickly children (SC 100% of mothers, 83,3% of fathers, 100% of siblings and 100% of nannies were infected. Herpes viruses: EBV (55,8%, CMV (50,8%, HHV VI (21,7% in combination with intracellular pathogens (Chlamydia and Mycoplasma were prevalent in the sickly children. Examination of the family members revealed presence of the same pathogens. Control group differed significantly and reliably from the group of sickly children. There were not many infected children, no acute forms of diseases; monoinfection predominated. 

  20. Delivery of antihuman African trypanosomiasis drugs across the blood-brain and blood-CSF barriers. (United States)

    Sekhar, Gayathri N; Watson, Christopher P; Fidanboylu, Mehmet; Sanderson, Lisa; Thomas, Sarah A


    Human African trypanosomiasis (HAT or sleeping sickness) is a potentially fatal disease caused by the parasite, Trypanosoma brucei sp. The parasites are transmitted by the bite of insect vectors belonging to the genus Glossina (tsetse flies) and display a life cycle strategy that is equally spread between human and insect hosts. T.b. gambiense is found in western and central Africa whereas, T.b. rhodesiense is found in eastern and southern Africa. The disease has two clinical stages: a blood stage after the bite of an infected tsetse fly, followed by a central nervous system (CNS) stage where the parasite penetrates the brain; causing death if left untreated. The blood-brain barrier (BBB) makes the CNS stage difficult to treat because it prevents 98% of all known compounds from entering the brain, including some anti-HAT drugs. Those that do enter the brain are toxic compounds in their own right and have serious side effects. There are only a few drugs available to treat HAT and those that do are stage specific. This review summarizes the incidence, diagnosis, and treatment of HAT and provides a close examination of the BBB transport of anti-HAT drugs and an overview of the latest drugs in development.

  1. Assembling the components of the quorum sensing pathway in African trypanosomes. (United States)

    Mony, Binny M; Matthews, Keith R


    African trypanosomes, parasites that cause human sleeping sickness, undergo a density-dependent differentiation in the bloodstream of their mammalian hosts. This process is driven by a released parasite-derived factor that causes parasites to accumulate in G1 and become quiescent. This is accompanied by morphological transformation to 'stumpy' forms that are adapted to survival and further development when taken up in the blood meal of tsetse flies, the vector for trypanosomiasis. Although the soluble signal driving differentiation to stumpy forms is unidentified, a recent genome-wide RNAi screen identified many of the intracellular signalling and effector molecules required for the response to this signal. These resemble components of nutritional starvation and quiescence pathways in other eukaryotes, suggesting that parasite development shares similarities with the adaptive quiescence of organisms such as yeasts and Dictyostelium in response to nutritional starvation and stress. Here, the trypanosome signalling pathway is discussed in the context of these conserved pathways and the possible contributions of opposing 'slender retainer' and 'stumpy inducer' arms described. As evolutionarily highly divergent eukaryotes, the organisation and conservation of this developmental pathway can provide insight into the developmental cycle of other protozoan parasites, as well as the adaptive and programmed developmental responses of all eukaryotic cells.

  2. Aquaglyceroporin 2 controls susceptibility to melarsoprol and pentamidine in African trypanosomes. (United States)

    Baker, Nicola; Glover, Lucy; Munday, Jane C; Aguinaga Andrés, David; Barrett, Michael P; de Koning, Harry P; Horn, David


    African trypanosomes cause sleeping sickness in humans, a disease that is typically fatal without chemotherapy. Unfortunately, drug resistance is common and melarsoprol-resistant trypanosomes often display cross-resistance to pentamidine. Although melarsoprol/pentamidine cross-resistance (MPXR) has been an area of intense interest for several decades, our understanding of the underlying mechanisms remains incomplete. Recently, a locus encoding two closely related aquaglyceroporins, AQP2 and AQP3, was linked to MPXR in a high-throughput loss-of-function screen. Here, we show that AQP2 has an unconventional "selectivity filter." AQP2-specific gene knockout generated MPXR trypanosomes but did not affect resistance to a lipophilic arsenical, whereas recombinant AQP2 reversed MPXR in cells lacking native AQP2 and AQP3. AQP2 was also shown to be disrupted in a laboratory-selected MPXR strain. Both AQP2 and AQP3 gained access to the surface plasma membrane in insect life-cycle-stage trypanosomes but, remarkably, AQP2 was specifically restricted to the flagellar pocket in the bloodstream stage. We conclude that the unconventional aquaglyceroporin, AQP2, renders cells sensitive to both melarsoprol and pentamidine and that loss of AQP2 function could explain cases of innate and acquired MPXR.

  3. Early invasion of brain parenchyma by African trypanosomes.

    Directory of Open Access Journals (Sweden)

    Ute Frevert

    Full Text Available Human African trypanosomiasis or sleeping sickness is a vector-borne parasitic disease that has a major impact on human health and welfare in sub-Saharan countries. Based mostly on data from animal models, it is currently thought that trypanosome entry into the brain occurs by initial infection of the choroid plexus and the circumventricular organs followed days to weeks later by entry into the brain parenchyma. However, Trypanosoma brucei bloodstream forms rapidly cross human brain microvascular endothelial cells in vitro and appear to be able to enter the murine brain without inflicting cerebral injury. Using a murine model and intravital brain imaging, we show that bloodstream forms of T. b. brucei and T. b. rhodesiense enter the brain parenchyma within hours, before a significant level of microvascular inflammation is detectable. Extravascular bloodstream forms were viable as indicated by motility and cell division, and remained detectable for at least 3 days post infection suggesting the potential for parasite survival in the brain parenchyma. Vascular inflammation, as reflected by leukocyte recruitment and emigration from cortical microvessels, became apparent only with increasing parasitemia at later stages of the infection, but was not associated with neurological signs. Extravascular trypanosomes were predominantly associated with postcapillary venules suggesting that early brain infection occurs by parasite passage across the neuroimmunological blood brain barrier. Thus, trypanosomes can invade the murine brain parenchyma during the early stages of the disease before meningoencephalitis is fully established. Whether individual trypanosomes can act alone or require the interaction from a quorum of parasites remains to be shown. The significance of these findings for disease development is now testable.

  4. Sleep Apnea (United States)

    ... of other risk factors linked to a higher risk of heart disease. The conditions that make up metabolic syndrome include high blood pressure, abnormal cholesterol, high blood sugar and an increased waist circumference. Complications with medications and surgery. Obstructive sleep apnea ...

  5. Genetic aspects of sick sinus syndrome


    Chernova A.A.; Nikulina S.Yu.; Tret’yakova S.S.; Voyevoda M.I.; Maksimov V.N.; Chernov V.N.


    Aim. To study the association between polymorphic allelic variants of the alpha-2В-adrenoreceptor gene (ADRA2B), endothelial nitric oxide synthase gene (NOS3), connexin protein gene 40 (Cx40), cardiac myosin heavy chain gene (MYH6), and voltage-gated sodium channels gene (SCN5A) and development of the idiopathic sick sinus syndrome. Methods. 14 probands with primary symptoms of sick sinus syndrome and their 110 relatives of the I–III degree kinship were examined. At the Berzon City Clinical H...

  6. Trends in sickness absence in Denmark

    DEFF Research Database (Denmark)

    Johansen, Kristina; Bihrmann, Kristine; Mikkelsen, Sigurd


    a linear regression analysis to analyze time trends in sickness absence based on datasets from the Danish Employers Confederation, the State Employer's Authority, the Labour Force Survey, and Statistics Denmark. RESULTS: The findings from the Confederation of Danish Employers, the State Employer......'s Authority, and the Labor Force Survey indicated a stable and largely unaltered pattern of sickness absence during the last 20 years. Findings from Statistics Denmark showed an increase in the cumulative incidence proportion from 6.6 to 7.5% among employed people between 2000 and 2007. CONCLUSION: Our data...

  7. Do lower vertebrates suffer from motion sickness? (United States)

    Lychakov, Dmitri

    The poster presents literature data and results of the author’s studies with the goal to find out whether the lower animals are susceptible to motion sickness (Lychakov, 2012). In our studies, fish and amphibians were tested for 2 h and more by using a rotating device (f = 0.24 Hz, a _{centrifugal} = 0.144 g) and a parallel swing (f = 0.2 Hz, a _{horizontal} = 0.059 g). The performed studies did not revealed in 4 fish species and in toads any characteristic reactions of the motion sickness (sopite syndrome, prodromal preparatory behavior, vomiting). At the same time, in toads there appeared characteristic stress reactions (escape response, an increase of the number of urinations, inhibition of appetite), as well as some other reactions not associated with motion sickness (regular head movements, eye retractions). In trout fry the used stimulation promoted division of the individuals into the groups differing by locomotor reaction to stress, as well as the individuals with the well-expressed compensatory reaction that we called the otolithotropic reaction. Analysis of results obtained by other authors confirms our conclusions. Thus, the lower vertebrates, unlike mammals, are immune to motion sickness either under the land conditions or under conditions of weightlessness. On the basis of available experimental data and theoretical concepts of mechanisms of development the motion sickness, formulated in several hypotheses (mismatch hypothesis, Traisman‘ s hypothesis, resonance hypothesis), there presented the synthetic hypothesis of motion sickness that has the conceptual significance. According to the hypothesis, the unusual stimulation producing sensor-motor or sensor-sensor conflict or an action of vestibular and visual stimuli of frequency of about 0.2 Hz is perceived by CNS as poisoning and causes the corresponding reactions. The motion sickness actually is a byproduct of technical evolution. It is suggested that in the lower vertebrates, unlike mammals

  8. The effects on sick leave of changes in the sickness insurance system


    Henrekson, Magnus; Persson, Mats


    In order to get a more complete picture of how labor supply is affected by economic incentives, the effects on absenteeism and not just on contracted hours should be taken into account. In particular, the effects on absenteeism due to sick leave can be considerable. In this paper we examine whether the level of sick leave compensation affects sick leave behavior. Using time-series data for Sweden spanning a long period (1955-99) with numerous changes of the compensation level, we generally fi...

  9. Diagnosing Sleep Disorders (United States)

    ... of this page please turn JavaScript on. Feature: Sleep Disorders Diagnosing Sleep Disorders Past Issues / Summer 2015 Table of Contents Depending ... several possible tests when trying to diagnose a sleep disorder: Sleep history and sleep log If you believe ...

  10. Sleep Deprivation and Deficiency (United States)

    ... page from the NHLBI on Twitter. What Are Sleep Deprivation and Deficiency? Sleep deprivation (DEP-rih-VA-shun) is a condition that ... the following: You don't get enough sleep (sleep deprivation) You sleep at the wrong time of day ( ...

  11. 'Biracial'-Looking Twins: A New Twin Type?/Twin Research: Twins with Cystic Teratomas; Sleep Quality and Body Mass Index; Previable Membrane Rupture/Print and Online Reports: Twins Born to a Sister Surrogate; NASA Twin Study; African-Cosmopolitan Twin Fashion Inspirations; Triplet Hockey Stars. (United States)

    Segal, Nancy L


    Dizygotic (DZ) co-twins born to mothers and fathers from different racial or ethnic backgrounds often resemble one parent much more than the other. As such, these pairs comprise a unique subset of twins for investigating how others' responses to their different looks may affect their personalities and self-esteem. This article describes some of these twin pairs and some challenges of raising them, and suggests ways they may be used in research. Next, recent twin research on cystic teratomas, relations between sleep quality and body mass index, and previable membrane rupture is described. The final section concerns twins, twin studies, and related events in the media, namely: twins born to a sister surrogate, the NASA twin investigation, inspiring African-Cosmopolitan twins in fashion, and triplet Hockey Stars.

  12. Discovery and verification of osteopontin and Beta-2-microglobulin as promising markers for staging human African trypanosomiasis. (United States)

    Tiberti, Natalia; Hainard, Alexandre; Lejon, Veerle; Robin, Xavier; Ngoyi, Dieudonné Mumba; Turck, Natacha; Matovu, Enock; Enyaru, John; Ndung'u, Joseph Mathu; Scherl, Alexander; Dayon, Loïc; Sanchez, Jean-Charles


    Human African trypanosomiasis, or sleeping sickness, is a parasitic disease endemic in sub-Saharan Africa, transmitted to humans through the bite of a tsetse fly. The first or hemolymphatic stage of the disease is associated with presence of parasites in the bloodstream, lymphatic system, and body tissues. If patients are left untreated, parasites cross the blood-brain barrier and invade the cerebrospinal fluid and the brain parenchyma, giving rise to the second or meningoencephalitic stage. Stage determination is a crucial step in guiding the choice of treatment, as drugs used for S2 are potentially dangerous. Current staging methods, based on counting white blood cells and demonstrating trypanosomes in cerebrospinal fluid, lack specificity and/or sensitivity. In the present study, we used several proteomic strategies to discover new markers with potential for staging human African trypanosomiasis. Cerebrospinal fluid (CSF) samples were collected from patients infected with Trypanosoma brucei gambiense in the Democratic Republic of Congo. The stage was determined following the guidelines of the national control program. The proteome of the samples was analyzed by two-dimensional gel electrophoresis (n = 9), and by sixplex tandem mass tag (TMT) isobaric labeling (n = 6) quantitative mass spectrometry. Overall, 73 proteins were overexpressed in patients presenting the second stage of the disease. Two of these, osteopontin and β-2-microglobulin, were confirmed to be potential markers for staging human African trypanosomiasis (HAT) by Western blot and ELISA. The two proteins significantly discriminated between S1 and S2 patients with high sensitivity (68% and 78%, respectively) for 100% specificity, and a combination of both improved the sensitivity to 91%. The levels of osteopontin and β-2-microglobulin in CSF of S2 patients (μg/ml range), as well as the fold increased concentration in S2 compared with S1 (3.8 and 5.5 respectively) make the two markers good

  13. Job satisfaction and sickness absence : a questionnaire survey

    NARCIS (Netherlands)

    Roelen, C.A.; Koopmans, P.C.; Notenbomer, A.; Groothoff, J.W.


    Background When dissatisfaction with work precedes sickness absence, screening for satisfaction levels might usefully detect workers at risk of sickness absence. Aim To investigate whether job satisfaction was associated with subsequent sickness absence days or episodes. Methods A sample of workers

  14. 5 CFR 630.401 - Granting sick leave. (United States)


    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Granting sick leave. 630.401 Section 630.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Sick Leave § 630.401 Granting sick leave. (a) Subject to paragraphs (b) through (e) of...

  15. 5 CFR 630.402 - Requesting sick leave. (United States)


    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Requesting sick leave. 630.402 Section 630.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Sick Leave § 630.402 Requesting sick leave. An employee must file an application—written, oral,...

  16. Survey of acute mountain sickness on Mauna Kea. (United States)

    Onopa, Janet; Haley, Amanda; Yeow, Mei Ean


    Although thousands of people ascend 4205 m to visit the summit of Mauna Kea each year, there has been no information on the rate of altitude illness triggered by such visits. Two surveys were used: one for tourists driving up to the summit and the other for summit astronomy workers staying at lodging facilities at intermediate altitude. The surveys included the standardized Lake Louise Self-report Acute Mountain Sickness (AMS) Questionnaire that, when scored, gave the Lake Louise Symptoms Score (LLSS). Thirty percent of surveyed day visitors and 69% of surveyed professional astronomy staff had AMS, defined as a LLSS score of 3 or greater, with headache. Nine participants reported "disorientation/confusion" or greater consciousness changes. A majority of astronomy professionals reported fatigue, disturbed sleep, reduced activity, and mental status changes. Few took any AMS medications. The incidence of AMS in visitors to Mauna Kea's summit warrants increased education and increased availability of supplemental oxygen at the summit. The absence of reported serious altitude illness in the community is probably due to the rapid descent available on Mauna Kea, with prompt reversibility of adverse effects.

  17. Hypoventilation in chronic mountain sickness: a mechanism to preserve energy. (United States)

    Zubieta-Calleja, G R; Paulev, P-E; Zubieta-Calleja, L; Zubieta-Calleja, N; Zubieta-Castillo, G


    Chronic Mountain Sickness (CMS) patients have repeatedly been found to hypoventilate. Low saturation in CMS is attributed to hypoventilation. Although this observation seems logical, a further understanding of the exact mechanism of hypoxia is mandatory. An exercise study using the Bruce Protocol in CMS (n = 13) compared to normals N (n = 17), measuring ventilation (VE), pulse (P), and saturation by pulse oximetry (SaO(2)) was performed. Ventilation at rest while standing, prior to exercise in a treadmill was indeed lower in CMS (8.37 l/min compared with 9.54 l/min in N). However, during exercise, stage one through four, ventilation and cardiac frequency both remained higher than in N. In spite of this, SaO(2) gradually decreased. Although CMS subjects increased ventilation and heart rate more than N, saturation was not sustained, suggesting respiratory insufficiency. The degree of veno-arterial shunting of blood is obviously higher in the CMS patients both at rest and during exercise as judged from the SaO(2) values. The higher shunt fraction is due probably to a larger degree of trapped air in the lungs with uneven ventilation of the CMS patients. One can infer that hypoventilation at rest is an energy saving mechanism of the pneumo-dynamic and hemo-dynamic pumps. Increased ventilation would achieve an unnecessary high SaO(2) at rest (low metabolism). This is particularly true during sleep.

  18. Controlling sickness absence: a study of changes in the Danish sickness absence legislation since 1973

    DEFF Research Database (Denmark)

    Johansen, Kristina; Andersen, John Sahl; Mikkelsen, Sigurd


    OBJECTIVES: To outline the principles underlying changes overtime in entitlement to sickness absence benefit in Denmark. METHODS: The Danish sickness benefit scheme during the past 30 years has been studied based on a comprehensive review of the Sickness Benefit Act from 1973, and all later...... amendments to the act. RESULTS: Entitlement to sickness benefit in Denmark has undergone considerable changes during the past 30 years. The guiding principles of the reforms have been financial savings in combination with an assumption that human behaviour can be controlled through bureaucratic......'s policy is to some extent a return to the biopsychosocial approach in the sense that the citizen is not regarded a passive victim of disease but an active player in influencing own working capacity. Added to this is, however, a new element of much tighter control leaving less room for autonomy....

  19. Serum sickness-like reaction with clarithromycin. (United States)

    Sohail, Muhammad Adnan; Nasir, Junaid; Ikram, Umaira; Genese, Thomas


    Serum sickness-like reaction is a rare immunological condition which may develop following exposure to certain drugs such as penicillins, cephalosporins, and trimethoprim-sulfamethoxazole, among many others. It is described classically as a type III hypersensitivity response to heterologous proteins. Its true mechanism is still unclear. We present a case of serum sickness-like reaction to clarithromycin, a commonly prescribed drug for the treatment of respiratory tract infections. The patient had been taking this drug for 3 days when she experienced generalized body aches, rash, arthralgia, and shortness of breath, prompting presentation to the emergency department. Laboratory studies showed decreased C4 and total complement with a slightly elevated sedimentation rate. After exclusion of other possible causes, the diagnosis of serum sickness-like reaction was made. The patient responded well to nonsteroidal antiinflammatory medication, antihistamines, and a short, tapering dose of steroids. To our knowledge, serum sickness-like reaction to clarithromycin has never been reported previously. This case emphasizes the need for increased clinical awareness of such an adverse outcome to clarithromycin use.

  20. Do junior doctors take sick leave? (United States)

    Perkin, M R; Higton, A; Witcomb, M


    Nosocomial infections place a heavy burden on overstretched health services. An audit of junior doctors' sick leave behaviour was undertaken in 1993 and again in 2001. The object was to ascertain the level of common infectious illness and to investigate whether junior doctors were remaining at work inappropriately. The doctors were asked if any factors had influenced their decision to take sick leave or not. Between the two audits several initiatives have been introduced to improve the working conditions of junior doctors, including the New Deal to reduce hours of work. Eighty one junior doctors in a large teaching hospital participated in 1993 and 110 in 2001. The number reporting an infectious illness in the previous six months was similar (61.7% in 1993, 68.2% in 2001). There had been a significant increase in the percentage of infectious illness episodes for which the doctors took sick leave (15.1% in 1993, 36.8% in 2001, p work (72% in 1993, 68% in 2001). Consultant pressure was cited by 26% (1993) and 20% (2001). Use of the staff occupational health unit was minimal, with none of the ill doctors contacting the department in 1993 and only three in 2001. Overall, despite the reduction in the number of infectious doctors not taking sick leave, the majority remained at work. Fundamental changes are needed if potentially infected doctors are not to present a risk of iatrogenic infection.

  1. Cerebral blood flow in acute mountain sickness

    DEFF Research Database (Denmark)

    Jensen, J B; Wright, Anne; Lassen, N A


    Changes in cerebral blood flow (CBF) were measured using the radioactive xenon technique and were related to the development of acute mountain sickness (AMS). In 12 subjects, ascending from 150 to 3,475 m, CBF was 24% increased at 24 h [45.1 to 55.9 initial slope index (ISI) units] and 4% increased...

  2. The Negotiation of the Sick Role

    DEFF Research Database (Denmark)

    Mik-Meyer, Nanna; Roelsgaard Obling, Anne


    In encounters between general practitioners (GPs) and patients with medically unexplained symptoms (MUS), the negotiation of the sick role is a social process. In this process, GPs not only use traditional biomedical diagnostic tools but also rely on their own opinions and evaluations of a patient...

  3. Advances in Sleep Studies (United States)

    ... of this page please turn JavaScript on. Feature: Sleep Disorders Advances in Sleep Studies Past Issues / Summer 2015 ... is the director of the National Center on Sleep Disorders Research (NCSDR) in the NIH's National Heart, Lung, ...

  4. Sleep Disorders (PDQ) (United States)

    ... to sleep and wake at the right times. Parasomnia : Acting in unusual ways while falling asleep, sleeping, ... will suggest a sleep disorder clinic for treatment. Children with Somnolence Syndrome Somnolence syndrome (SS) is a side ...

  5. Employees with Sleep Disorders (United States)

    ... Cataplexy (a weakness or paralysis of the muscles), sleep paralysis, and hallucinations are common symptoms of narcolepsy (Neurology Channel, 2005). Hypersomnia: Hypersomnia’s symptoms include excessive ... by extended sleep episodes or by daytime sleep episodes that occur ...

  6. Isolated sleep paralysis (United States)

    Sleep paralysis - isolated; Parasomnia - isolated sleep paralysis ... Episodes of isolated sleep paralysis last from a few seconds to 1 or 2 minutes. During these episodes the person is unable to move ...

  7. Sleep Apnea Information Page (United States)

    ... Page You are here Home » Disorders » All Disorders Sleep Apnea Information Page Sleep Apnea Information Page Search Disorders Search NINDS SEARCH ... Institutes of Health (NIH) conduct research related to sleep apnea in laboratories at the NIH, and also ...

  8. Sleep and your health (United States)

    ... this page: // Sleep and your health To use the sharing features ... in a number of ways. Why You Need Sleep Sleep gives your body and brain time to ...

  9. Sleep Issues and Sundowning (United States)

    ... We will not sell or share your name. Sleep Issues and Sundowning Tweet Bookmark this page | Email | ... Sleep Changes Back to top Coping strategies for sleep issues and sundowning If the person is awake ...

  10. GPs' negotiation strategies regarding sick leave for subjective health complaints

    DEFF Research Database (Denmark)

    Nilsen, Stein Tore; Malterud, Kirsti; Werner, Erik L.


    Objectives: To explore general practitioners ’(GPs’) specific negotiation strategies regarding sick-leave issues with patientssuffering from subjective health complaints. Design: Focus-group study. Setting: Nine focus-group interviews in three citiesin different regions of Norway. Participants: 48...... to sick leave. Conclusions and implications: GPs seem to have a conscious approach to negotiations of sickness certification, as they report applying specific strategies to limit the duration of sick leave due to subjective health complaints. This give-and-take way of handling sick leave negotiations has...

  11. Sleep Eduction: Treatment & Therapy (United States)

    ... Overview Testing Process & Results CPAP Overview Benefits Side Effects Variations Tips Healthy Sleep Habits Sleep Disorders by Category Insomnias Insomnia Child Insomnia Short Sleeper Hypersomnias Narcolepsy Insufficient ...

  12. Sleep Talking (Somniloquy) (United States)

    ... Overview Testing Process & Results CPAP Overview Benefits Side Effects Variations Tips Healthy Sleep Habits Sleep Disorders by Category Insomnias Insomnia Child Insomnia Short Sleeper Hypersomnias Narcolepsy Insufficient ...

  13. Growth in Body Mass Index from Childhood into Adolescence: The Role of Sleep Duration and Quality (United States)

    El-Sheikh, Mona; Bagley, Erika J.; Keiley, Margaret K.; Erath, Stephen A.


    This study examined longitudinal relations between sleep and body mass index (BMI) from late childhood ([X-bar] age = 9.44 at T1) to early adolescence ([X-bar] age = 11.36 at T3) with a relatively large (n = 273 at T1) and diverse (35% African Americans) sample. Sleep was assessed with actigraphy-based sleep minutes and self-reported sleep…

  14. Sleep problems in children. (United States)

    Baweja, R; Calhoun, S; Baweja, R; Singareddy, R


    Sleep complaints and sleep disorders are common during childhood and adolescence. The impact of not getting enough sleep may affect children's' physical health as well emotional, cognitive and social development. Insomnia, sleep-disordered breathing, parasomnias and sleep disturbances associated with medical and psychiatric disorders are some of the commonly encountered sleep disorders in this age group. Changes in sleep architecture and the amount of sleep requirement associated with each stage of development should be considered during an evaluation of sleep disorders in children. Behavioral treatments should be used initially wherever possible especially considering that most pharmacologic agents used to treat pediatric sleep disorders are off-label. In this review we address the most common sleep problems in children/adolescents as they relate to prevalence, presentation and symptoms, evaluation and management.


    Institute of Scientific and Technical Information of China (English)



    @@Sleep is the natural suspension of consciousness during which the powers of the body are restored Sleep recurs with remarkable periodicity in alliance with the geocosmic cycle and in compliance with the circadian rhythms of the body.

  16. Sleep for cognitive enhancement

    Directory of Open Access Journals (Sweden)

    Susanne eDiekelmann


    Full Text Available Sleep is essential for effective cognitive functioning. Loosing even a few hours of sleep can have detrimental effects on a wide variety of cognitive processes such as attention, language, reasoning, decision making, learning and memory. While sleep is necessary to ensure normal healthy cognitive functioning, it can also enhance performance beyond the boundaries of the normal condition. This article discusses the enhancing potential of sleep, mainly focusing on the domain of learning and memory. Sleep is known to facilitate the consolidation of memories learned before sleep as well as the acquisition of new memories to be learned after sleep. According to a widely held model this beneficial effect of sleep relies on the neuronal reactivation of memories during sleep that is associated with sleep-specific brain oscillations (slow oscillations, spindles, ripples as well as a characteristic neurotransmitter milieu. Recent research indicates that memory processing during sleep can be boosted by (i cueing memory reactivation during sleep, (ii stimulating sleep-specific brain oscillations, and (iii targeting specific neurotransmitter systems pharmacologically. Olfactory and auditory cues can be used, for example, to increase reactivation of associated memories during post-learning sleep. Intensifying neocortical slow oscillations (the hallmark of slow wave sleep by electrical or auditory stimulation and modulating specific neurotransmitters such as noradrenaline and glutamate likewise facilitates memory processing during sleep. With this evidence in mind, this article concludes by discussing different methodological caveats and ethical issues that should be considered when thinking about using sleep for cognitive enhancement in everyday applications.

  17. Changes in sickness absenteeism following the introduction of a qualifying day for sickness benefit--findings from Sweden Post

    DEFF Research Database (Denmark)

    Voss, M; Floderus, B; Diderichsen, F


    AIMS: In 1993, a qualifying day without sickness benefit was introduced to the Swedish sickness benefit system. The aim of the present study is to investigate sickness absenteeism before and after the introduction of the qualifying day, in the light of conditions inside and outside working life....... METHODS: The study was based on 1,952 female and 2,229 male employees of Sweden Post. Sickness absence was measured by sickness incidence one year before and one year after the introduction of the qualifying day (sick-leave events/person days at risk). Information about explanatory factors was collected...... lifting at work more often showed an increase in incidence compared to men without heavy lifting, and the same tendency was found for women. CONCLUSION: The reduction in sickness incidence following the introduction of the qualifying day was fairly independent of different work-related and non-work...

  18. Kynurenine pathway inhibition reduces central nervous system inflammation in a model of human African trypanosomiasis. (United States)

    Rodgers, Jean; Stone, Trevor W; Barrett, Michael P; Bradley, Barbara; Kennedy, Peter G E


    Human African trypanosomiasis, or sleeping sickness, is caused by the protozoan parasites Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense, and is a major cause of systemic and neurological disability throughout sub-Saharan Africa. Following early-stage disease, the trypanosomes cross the blood-brain barrier to invade the central nervous system leading to the encephalitic, or late stage, infection. Treatment of human African trypanosomiasis currently relies on a limited number of highly toxic drugs, but untreated, is invariably fatal. Melarsoprol, a trivalent arsenical, is the only drug that can be used to cure both forms of the infection once the central nervous system has become involved, but unfortunately, this drug induces an extremely severe post-treatment reactive encephalopathy (PTRE) in up to 10% of treated patients, half of whom die from this complication. Since it is unlikely that any new and less toxic drug will be developed for treatment of human African trypanosomiasis in the near future, increasing attention is now being focussed on the potential use of existing compounds, either alone or in combination chemotherapy, for improved efficacy and safety. The kynurenine pathway is the major pathway in the metabolism of tryptophan. A number of the catabolites produced along this pathway show neurotoxic or neuroprotective activities, and their role in the generation of central nervous system inflammation is well documented. In the current study, Ro-61-8048, a high affinity kynurenine-3-monooxygenase inhibitor, was used to determine the effect of manipulating the kynurenine pathway in a highly reproducible mouse model of human African trypanosomiasis. It was found that Ro-61-8048 treatment had no significant effect (P = 0.4445) on the severity of the neuroinflammatory pathology in mice during the early central nervous system stage of the disease when only a low level of inflammation was present. However, a significant (P = 0.0284) reduction in

  19. Alcohol disrupts sleep homeostasis. (United States)

    Thakkar, Mahesh M; Sharma, Rishi; Sahota, Pradeep


    Alcohol is a potent somnogen and one of the most commonly used "over the counter" sleep aids. In healthy non-alcoholics, acute alcohol decreases sleep latency, consolidates and increases the quality (delta power) and quantity of NREM sleep during the first half of the night. However, sleep is disrupted during the second half. Alcoholics, both during drinking periods and during abstinences, suffer from a multitude of sleep disruptions manifested by profound insomnia, excessive daytime sleepiness, and altered sleep architecture. Furthermore, subjective and objective indicators of sleep disturbances are predictors of relapse. Finally, within the USA, it is estimated that societal costs of alcohol-related sleep disorders exceeds $18 billion. Thus, although alcohol-associated sleep problems have significant economic and clinical consequences, very little is known about how and where alcohol acts to affect sleep. In this review, we have described our attempts to unravel the mechanism of alcohol-induced sleep disruptions. We have conducted a series of experiments using two different species, rats and mice, as animal models. We performed microdialysis, immunohistochemical, pharmacological, sleep deprivation and lesion studies which suggest that the sleep-promoting effects of alcohol may be mediated via alcohol's action on the mediators of sleep homeostasis: adenosine (AD) and the wake-promoting cholinergic neurons of the basal forebrain (BF). Alcohol, via its action on AD uptake, increases extracellular AD resulting in the inhibition of BF wake-promoting neurons. Since binge alcohol consumption is a highly prevalent pattern of alcohol consumption and disrupts sleep, we examined the effects of binge drinking on sleep-wakefulness. Our results suggest that disrupted sleep homeostasis may be the primary cause of sleep disruption observed following binge drinking. Finally, we have also shown that sleep disruptions observed during acute withdrawal, are caused due to impaired

  20. Perceived discrimination and youths' adjustment: sleep as a moderator. (United States)

    Caldas, Mona; Tu, Kelly M; Saini, Ekjyot K; Fuller-Rowell, Thomas E; Buckhalt, Joseph A


    Adolescents' sleep duration was examined as a moderator of the association between perceived discrimination and internalizing (anxiety, depression) and externalizing symptoms. Participants were 252 adolescents (mean: 15.79 years; 66% European American, 34% African American) who reported on their perceived discrimination (racial and general) and adjustment. Sleep duration was measured using actigraphy. Moderation effects were evident. The lowest levels of internalizing symptoms were observed for adolescents with longer sleep duration in conjunction with lower levels of perceived racial discrimination. Further, general perceived discrimination was associated more strongly with externalizing behaviours for youth with shorter versus longer sleep. Findings highlight the importance of sleep as a bioregulatory system that can ameliorate or exacerbate the effects of discrimination on youths' adjustment.

  1. Adolescents' Sleep Behaviors and Perceptions of Sleep (United States)

    Noland, Heather; Price, James H.; Dake, Joseph; Telljohann, Susan K.


    Background: Sleep duration affects the health of children and adolescents. Shorter sleep durations have been associated with poorer academic performance, unintentional injuries, and obesity in adolescents. This study extends our understanding of how adolescents perceive and deal with their sleep issues. Methods: General education classes were…

  2. Catechol-O-methyltransferase Val158Met polymorphism associates with individual differences in sleep physiologic responses to chronic sleep loss.

    Directory of Open Access Journals (Sweden)

    Namni Goel

    Full Text Available BACKGROUND: The COMT Val158Met polymorphism modulates cortical dopaminergic catabolism, and predicts individual differences in prefrontal executive functioning in healthy adults and schizophrenic patients, and associates with EEG differences during sleep loss. We assessed whether the COMT Val158Met polymorphism was a novel marker in healthy adults of differential vulnerability to chronic partial sleep deprivation (PSD, a condition distinct from total sleep loss and one experienced by millions on a daily and persistent basis. METHODOLOGY/PRINCIPAL FINDINGS: 20 Met/Met, 64 Val/Met, and 45 Val/Val subjects participated in a protocol of two baseline 10h time in bed (TIB nights followed by five consecutive 4 h TIB nights. Met/Met subjects showed differentially steeper declines in non-REM EEG slow-wave energy (SWE-the putative homeostatic marker of sleep drive-during PSD, despite comparable baseline SWE declines. Val/Val subjects showed differentially smaller increases in slow-wave sleep and smaller reductions in stage 2 sleep during PSD, and had more stage 1 sleep across nights and a shorter baseline REM sleep latency. The genotypes, however, did not differ in performance across various executive function and cognitive tasks and showed comparable increases in subjective and physiological sleepiness in response to chronic sleep loss. Met/Met genotypic and Met allelic frequencies were higher in whites than African Americans. CONCLUSIONS/SIGNIFICANCE: The COMT Val158Met polymorphism may be a genetic biomarker for predicting individual differences in sleep physiology-but not in cognitive and executive functioning-resulting from sleep loss in a healthy, racially-diverse adult population of men and women. Beyond healthy sleepers, our results may also provide insight for predicting sleep loss responses in patients with schizophrenia and other psychiatric disorders, since these groups repeatedly experience chronically-curtailed sleep and demonstrate COMT

  3. Study on experimental motion sickness in children. (United States)

    Takahashi, M; Toriyabe, I; Takei, Y; Kanzaki, J


    To clarify the characteristics of motion sickness in children we investigated autonomic nervous symptoms and instability evoked by walking while wearing horizontally reversing goggles in 90 children aged 4 to 15 years. Kindergarten children had hardly any autonomic nervous symptoms except headache; however, they often fell, could not stand up or move, and exhibited a to-and-fro deviation gait. Although the frequency and severity of sickness gradually increased during growth, the severity of gait disorder became milder as age increased. On the basis of these findings it seems likely that functions which perceive disorder of spatial orientation and action are immature in young children, and once spatial orientation is impaired, instability becomes very severe, since inadequate control is not stopped by an alarm function against disorientation.

  4. Sleeping with an Android (United States)


    Sleep quality and duration are strong indicators of an individual’s health and quality of lifebut they are difficult to track in everyday life. Mobile apps such as Sleep as Android leverage smartphone sensors to track sleep patterns and make recommendations to improve sleeping habits. PMID:28293622

  5. Sleep and Infant Learning (United States)

    Tarullo, Amanda R.; Balsam, Peter D.; Fifer, William P.


    Human neonates spend the majority of their time sleeping. Despite the limited waking hours available for environmental exploration, the first few months of life are a time of rapid learning about the environment. The organization of neonate sleep differs qualitatively from adult sleep, and the unique characteristics of neonatal sleep may promote…

  6. [Genetic predictors of sick sinus node syndrome]. (United States)

    Chernova, A A; Nikulina, S Iu; Tret'iakova, S S


    The article is devoted to the role of heredity in development of the sick sinus node syndrome (SSNS). We have examined 14 probands and 110 their relatives from families with idiopathic SSNS and established the role in development of hereditary SSNS of polymorphisms of the following genes: -2-adrenoreceptor, enzyme endothelial NO synthase, protein connexin 40, voltage dependent cardiac sodium channels, cardiac myosin heavy chains. We also revealed associations of clinical variants of idiopathic SSNS with genotypes of the studied genes.

  7. Sick sinus syndrome: a family study. (United States)

    Rogińska, Natalia; Bieganowska, Katarzyna


    A case of related individuals affected by sick sinus syndrome is presented in this study. The clinical and electrocardiographic signs of sinus node dysfunction and the most common causes of this disease are presented. Subsequently, the article includes descriptions of sinus node disease in three related children as well as details of the disease in their relatives. A literature review of the genetics of familial sinus node dysfunction concludes the study.

  8. Sleep and Stroke. (United States)

    Mims, Kimberly Nicole; Kirsch, Douglas


    Evidence increasingly suggests sleep disorders are associated with higher risk of cardiovascular events, including stroke. Strong data correlate untreated sleep apnea with poorer stroke outcomes and more recent evidence implicates sleep disruption as a possible etiology for increased cerebrovascular events. Also, sleep duration may affect incidence of cardiovascular events. In addition, sleep-disordered breathing, insomnia, restless legs syndrome, and parasomnias can occur as a result of cerebrovascular events. Treatment of sleep disorders improve sleep-related symptoms and may also improve stroke recovery and risk of future events.

  9. Movement disorders and sleep. (United States)

    Driver-Dunckley, Erika D; Adler, Charles H


    This article summarizes what is currently known about sleep disturbances in several movement disorders including Parkinson disease, essential tremor, parkinsonism, dystonia, Huntington disease, myoclonus, and ataxias. There is an association between movement disorders and sleep. In some cases the prevalence of sleep disorders is much higher in patients with movement disorder, such as rapid eye movement sleep behavior disorder in Parkinson disease. In other cases, sleep difficulties worsen the involuntary movements. In many cases the medications used to treat patients with movement disorder disturb sleep or cause daytime sleepiness. The importance of discussing sleep issues in patients with movement disorders cannot be underestimated.

  10. Identifying transmission cycles at the human-animal interface: the role of animal reservoirs in maintaining gambiense human african trypanosomiasis.

    Directory of Open Access Journals (Sweden)

    Sebastian Funk

    Full Text Available Many infections can be transmitted between animals and humans. The epidemiological roles of different species can vary from important reservoirs to dead-end hosts. Here, we present a method to identify transmission cycles in different combinations of species from field data. We used this method to synthesise epidemiological and ecological data from Bipindi, Cameroon, a historical focus of gambiense Human African Trypanosomiasis (HAT, sleeping sickness, a disease that has often been considered to be maintained mainly by humans. We estimated the basic reproduction number [Formula: see text] of gambiense HAT in Bipindi and evaluated the potential for transmission in the absence of human cases. We found that under the assumption of random mixing between vectors and hosts, gambiense HAT could not be maintained in this focus without the contribution of animals. This result remains robust under extensive sensitivity analysis. When using the distributions of species among habitats to estimate the amount of mixing between those species, we found indications for an independent transmission cycle in wild animals. Stochastic simulation of the system confirmed that unless vectors moved between species very rarely, reintroduction would usually occur shortly after elimination of the infection from human populations. This suggests that elimination strategies may have to be reconsidered as targeting human cases alone would be insufficient for control, and reintroduction from animal reservoirs would remain a threat. Our approach is broadly applicable and could reveal animal reservoirs critical to the control of other infectious diseases.

  11. Childhood serum sickness: a case report. (United States)

    Chao, Y K; Shyur, S D; Wu, C Y; Wang, C Y


    Childhood serum sickness is a rare allergic disease that follows the administration of a foreign antigenic material, most commonly caused by injecting a protein or haptenic drug. The disease is a type III hypersensitivity reaction mediated by deposits of circulating immune complexes in small vessels, which leads to complement activation and subsequent inflammation. The clinical features are fever, cutaneous eruptions, lymphadenopathy, arthralgias, albuminuria, and nephritis. Serum sickness is an acute self-limited disease. We report a 3-year-old child who presented with fever and a rash; an invasive bacterial infection was strongly suspected. He was therefore given penicillin and gentamicin and responded well. At day 4 after admission, he developed a serum sickness reaction and showed symptoms of arthralgias, generalized edema, purpura, and gross hematuria. The white blood cell count was 12 190/mm3 with 7% eosinophils. Urinalysis revealed red blood cell above 100 per high power field, white blood cell 10 to 15 per high power field, and proteinuria. The antibiotics were discontinued and hydrocortisone (20 mg/kg/d), diphenhydramine HCl (4 mg/kg/d), aspirin (66 mg/kg/d) was administered, plus 1 dose of epinephrine (0.01 mL/kg) administered intramuscularly. On day 7, the 3rd day after withholding antibiotics, his condition dramatically improved. The clinical symptoms resolved progressively and his urinalysis returned to normal.

  12. Isolated sleep paralysis elicited by sleep interruption. (United States)

    Takeuchi, T; Miyasita, A; Sasaki, Y; Inugami, M; Fukuda, K


    We elicited isolated sleep paralysis (ISP) from normal subjects by a nocturnal sleep interruption schedule. On four experimental nights, 16 subjects had their sleep interrupted for 60 minutes by forced awakening at the time when 40 minutes of nonrapid eye movement (NREM) sleep had elapsed from the termination of rapid eye movement (REM) sleep in the first or third sleep cycle. This schedule produced a sleep onset REM period (SOREMP) after the interruption at a high rate of 71.9%. We succeeded in eliciting six episodes of ISP in the sleep interruptions performed (9.4%). All episodes of ISP except one occurred from SOREMP, indicating a close correlation between ISP and SOREMP. We recorded verbal reports about ISP experiences and recorded the polysomnogram (PSG) during ISP. All of the subjects with ISP experienced inability to move and were simultaneously aware of lying in the laboratory. All but one reported auditory/visual hallucinations and unpleasant emotions. PSG recordings during ISP were characterized by a REM/W stage dissociated state, i.e. abundant alpha electroencephalographs and persistence of muscle atonia shown by the tonic electromyogram. Judging from the PSG recordings, ISP differs from other dissociated states such as lucid dreaming, nocturnal panic attacks and REM sleep behavior disorders. We compare some of the sleep variables between ISP and non-ISP nights. We also discuss the similarities and differences between ISP and sleep paralysis in narcolepsy.

  13. Sleep, sleep disturbance, and fertility in women. (United States)

    Kloss, Jacqueline D; Perlis, Michael L; Zamzow, Jessica A; Culnan, Elizabeth J; Gracia, Clarisa R


    Sleep and sleep disturbances are increasingly recognized as determinants of women's health and well-being, particularly in the context of the menstrual cycle, pregnancy, and menopause. At present, however, little is known about whether fertility is affected by sleep quantity and quality. That is, to what degree, and by what mechanisms, do sleep and/or its disturbances affect fertility? The purpose of this review is to synthesize what is known about sleep disturbances in relation to reproductive capacity. A model is provided, whereby stress, sleep dysregulation, and circadian misalignment are delineated for their potential relevance to infertility. Ultimately, if it is the case that sleep disturbance is associated with infertility, new avenues for clinical intervention may be possible.

  14. Childhood epilepsy and sleep


    Al-Biltagi, Mohammed A


    Sleep and epilepsy are two well recognized conditions that interact with each other in a complex bi-directional way. Some types of epilepsies have increased activity during sleep disturbing it; while sleep deprivation aggravates epilepsy due to decreased seizure threshold. Epilepsy can deteriorate the sleep-related disorders and at the same time; the parasomnias can worsen the epilepsy. The secretion of sleep-related hormones can also be affected by the occurrence of seizures and supplementat...

  15. Functional neuroimaging of sleep. (United States)

    Nofzinger, Eric A


    Sleep and sleep disorders have traditionally been viewed from a polysomnographic perspective. Although these methods provide information on the timing of various stages of sleep and wakefulness, they do not provide information regarding function in brain structures that have been implicated in the generation of sleep and that may be abnormal in different sleep disorders. Functional neuroimaging methods provide information regarding changes in brain function across the sleep-wake cycle that provides information for models of sleep dysregulation in a variety of sleep disorders. Early studies show reliable increases in function in limbic and anterior paralimbic cortex in rapid eye movement (REM) sleep and decreases in function in higher-order cortical regions in known thalamocortical networks during non-REM sleep. Although most of the early work in this area has been devoted to the study of normal sleep mechanisms, a collection of studies in diverse sleep disorders such as sleep deprivation, depression, insomnia, dyssomnias, narcolepsy, and sleep apnea suggest that functional neuroimaging methods have the potential to clarify the pathophysiology of sleep disorders and to guide treatment strategies.

  16. Severe serum sickness reaction to oral and intramuscular penicillin. (United States)

    Clark, Brychan M; Kotti, George H; Shah, Anand D; Conger, Nicholas G


    Serum sickness is a type III hypersensitivity reaction mediated by immune complex deposition with subsequent complement activation, small-vessel vasculitis, and tissue inflammation. Although the overall incidence of serum sickness is declining because of decreased use of heterologous sera and improved vaccinations, rare sporadic cases of serum sickness from nonprotein drugs such as penicillins continue to occur. Drug-induced serum sickness is usually self-limited, with symptoms lasting only 1-2 weeks before resolving. We report an unusual case of a severe and prolonged serum sickness reaction that occurred after exposure to an intramuscular penicillin depot injection (probable relationship by Naranjo score) and discuss how pharmacokinetics may have played a role. Clinicians should be familiar with serum sickness reactions particularly as they relate to long-acting penicillin preparations. Accurate diagnosis in conjunction with cessation of drug exposure and prompt initiation of antiinflammatory treatment with corticosteroids can produce complete recovery

  17. Rizatriptan reduces vestibular-induced motion sickness in migraineurs. (United States)

    Furman, Joseph M; Marcus, Dawn A; Balaban, Carey D


    A previous pilot study suggested that rizatriptan reduces motion sickness induced by complex vestibular stimulation. In this double-blind, randomized, placebo-controlled study we measured motion sickness in response to a complex vestibular stimulus following pretreatment with either rizatriptan or a placebo. Subjects included 25 migraineurs with or without migraine-related dizziness (23 females) aged 21-45 years (31.0 ± 7.8 years). Motion sickness was induced by off-vertical axis rotation in darkness, which stimulates both the semicircular canals and otolith organs of the vestibular apparatus. Results indicated that of the 15 subjects who experienced vestibular-induced motion sickness when pretreated with placebo, 13 showed a decrease in motion sickness following pretreatment with rizatriptan as compared to pretreatment with placebo (P rizatriptan, reduces vestibular-induced motion sickness by influencing serotonergic vestibular-autonomic projections.

  18. Morning sickness and vitamin B6 status of pregnant women. (United States)

    Schuster, K; Bailey, L B; Dimperio, D; Mahan, C S


    The relationship between the vitamin B6 status of 180 pregnant women and the incidence and degree of morning sickness experienced during the first trimester was investigated. There were no significant differences in plasma pyridoxal 5'-phosphate (PLP), erythrocyte aspartate aminotransferase (AspAT) activity, and stimulation of erythrocyte AspAT activity by exogenous PLP between subjects who experienced morning sickness and those who did not. No relationship was found between these indicators of vitamin B6 status and the degree of morning sickness experienced by this group during early pregnancy. There were no differences in the number of women who experienced morning sickness or in the number with different degrees of sickness when plasma levels of PLP, erythrocyte AspAT activity or stimulation by PLP were divided into upper and lower 50th percentile groups and compared. Therefore these data show no relationship between vitamin B6 status and the incidence or degree of morning sickness.

  19. Serum levels of eleven steroid hormones following motion sickness. (United States)

    Stalla, G K; Doerr, H G; Bidlingmaier, F; Sippel, W G; von Restorff, W


    In order to grade motion sickness objectively, the following 11 adrenal hormones were investigated in subjects with different motion sickness susceptibility: Aldosterone, corticosterone, 11-deoxycorticosterone, progesterone, 17-OH-progesterone, 11-deoxycortisol, cortisol, cortisone, testosterone, androstendione, dehydroepiandrosterone sulfate. Motion sickness was induced by the coriolis effect on a rotary chair. Both severe kinetosis after short rotation time and mild motion sickness after 30 min of rotation occurred together with small hormonal changes. Androstendione and 11-deoxycortisol appear to be sensitive indicators of motion sickness if the rotation time is taken into consideration. A significant increase of all hormones except progesterone, cortisone, testosterone, and dehydroepiandrosterone sulfate was observed when pronounced malaise had come after a long rotation stress (24.6 min). The changes in plasma aldosterone concentration appeared to correlate with time only. The present study demonstrates that hormonal analysis can be helpful in estimating the degree of motion sickness.

  20. Health problems and disability in long-term sickness absence: ICF coding of medical certificates

    Directory of Open Access Journals (Sweden)

    Morgell Roland


    Full Text Available Abstract Background The purpose of this study was to test the feasibility of International Classification of Functioning, Disability and Health (ICF and to explore the distribution, including gender differences, of health problems and disabilities as reflected in long-term sickness absence certificates. Methods A total of 433 patients with long sick-listing periods, 267 women and 166 men, were included in the study. All certificates exceeding 28 days of sick-listing sent to the local office of the Swedish Social Insurance Administration of a municipality in the Stockholm area were collected during four weeks in 2004-2005. ICD-10 medical diagnosis codes in the certificates were retrieved and free text information on disabilities in body function, body structure or activity and participation were coded according to ICF short version. Results In 89.8% of the certificates there were descriptions of disabilities that readily could be classified according to ICF. In a reliability test 123/131 (94% items of randomly chosen free text information were identically classified by two of the authors. On average 2.4 disability categories (range 0-9 were found per patient; the most frequent were 'Sensation of pain' (35.1% of the patients, 'Emotional functions' (34.1%, 'Energy and drive functions' (22.4%, and 'Sleep functions' (16.9%. The dominating ICD-10 diagnostic groups were 'Mental and behavioural disorders' (34.4% and 'Diseases of the musculoskeletal system and connective tissue' (32.8%. 'Reaction to severe stress and adjustment disorders' (14.7%, and 'Depressive episode' (11.5% were the most frequent diagnostic codes. Disabilities in mental functions and activity/participation were more commonly described among women, while disabilities related to the musculoskeletal system were more frequent among men. Conclusions Both ICD-10 diagnoses and ICF categories were dominated by mental and musculoskeletal health problems, but there seems to be gender

  1. Serum sickness-like illness associated with ciprofloxacin. (United States)

    Slama, T G


    Serum sickness is a systemic hypersensitivity reaction initially reported in children receiving horse serum. Drugs such as penicillins, cephalosporins, and sulfonamides are now noted to be the most common etiologic agents of serum sickness-like reactions. This case report describes a serum sickness-like reaction temporally related to ciprofloxacin, a previously unreported adverse effect of this drug or any of the other quinolones.


    Directory of Open Access Journals (Sweden)

    Oyeronke Olademo


    Full Text Available Healing in African indigenous cultures is a corporate matter involving the totality of the person, family and community. Healing presupposes sickness; its practice is therefore interlocked with a people’s conception of sickness and diseases. In Africa, sickness is an attestation to the fact that an individual is out of tune with nature and the supernatural, which is represented by the various deities. The physical signs are therefore a part of the story and not the whole story. Similarly, the Christian conception of disease and healing is intertwined with the individual’s relationship with the supernatural and the physical signs are but part of the story. Diagnosis and prescription for treatment and healing take into cognizance all these facts and this is where the healer comes in. The healer constitutes an integral part of the patient’s healing in Yoruba religion as well as in African Christianity. There are female and male healers in both religions but whereas these specialists are designated as healers/diviners/custodians of tradition in Yoruba religion, in African Christianity, they are known as prophetesses/prophets/deliverance ministers. This paper seeks to evaluate the position of the healer among the Yoruba of Nigeria. A second objective is to analyze contemporary postures on healing activities in Yoruba religion and Christianity and how women feature in these processes.

  3. Relations Between Toddler Sleep Characteristics, Sleep Problems, and Temperament


    Molfese, Victoria J.; Rudasill, Kathleen M.; Prokasky, Amanda; Champagne, Carly; Holmes, Molly; Molfese, Dennis; Bates, Jack


    Two sources of information (parent reported sleep diaries and actigraph records) were used to investigate how toddler sleep characteristics (bed time/sleep onset, wake time/sleep offset, total nighttime sleep and total sleep time) are related to sleep problems and temperament. There were 64 toddler participants in the study. Consistent with studies of older children, parent reports differed from actigraph based records. The findings that parent reported and actigraph recorded sleep characteri...

  4. Sleep and the endocrine system. (United States)

    Morgan, Dionne; Tsai, Sheila C


    In this article, the effect of sleep and sleep disorders on endocrine function and the influence of endocrine abnormalities on sleep are discussed. Sleep disruption and its associated endocrine consequences in the critically ill patient are also reviewed.

  5. Are You Getting Enough Sleep? (United States)

    ... Past Emails CDC Features Are you getting enough sleep? Recommend on Facebook Tweet Share Compartir Sleep is ... sleep guidelines for different age groups. How much sleep do you need? Newborns 16-18 hours Preschool- ...

  6. Shift Work: Improving Daytime Sleep (United States)

    ... sleeping during the day. Do you have any sleep tips for shift workers? Answers from Timothy Morgenthaler, ... to be awake during the day and to sleep at night. Good daytime sleep is possible, though, ...

  7. The Phenomenon of Sleep Paralysis (United States)

    ... of sleep where vivid dreams occur (known as REM sleep), your arms and legs are temporarily paralyzed so ... alien abductions." Since breathing can be irregular during REM sleep, those experiencing sleep paralysis may feel like they' ...

  8. Sleep from an Islamic perspective


    BaHammam, Ahmed S.


    Sleep medicine is a relatively new scientific specialty. Sleep is an important topic in Islamic literature, and the Quran and Hadith discuss types of sleep, the importance of sleep, and good sleep practices. Islam considers sleep as one of the signs of the greatness of Allβh (God) and encourages followers to explore this important sign. The Quran describes different types of sleep, and these correspond with sleep stages identified by modern science. The Quran discusses the beneficial effects ...

  9. Income, ethnicity, and sleep: coping as a moderator. (United States)

    El-Sheikh, Mona; Kelly, Ryan J; Sadeh, Avi; Buckhalt, Joseph A


    Toward identifying variables that may protect children against sleep problems otherwise associated with ethnic minority status and economic adversity, support coping was examined as a moderator. Participants were 235 children (113 boys, 122 girls; M age = 11.33 years, SD = 8.03 months), 64% European American and 36% African American. Children's sleep duration (minutes) and continuity (efficiency) were assessed through actigraphs worn for 1 week. Mothers reported on the family's monetary resources (income-to-needs ratio) and children reported on their support coping strategies. For children from lower income homes and African Americans, a higher level of support coping was a protective factor against fewer sleep minutes and reduced sleep efficiency, otherwise associated with economic adversity. Children from more economically advantaged homes had good sleep parameters regardless of their coping. The results build on the existing small body of work by demonstrating that children's support coping strategies have a protective role against sleep problems otherwise associated with ethnic minority status and economic adversity and present potential targets for intervention that may help reduce health disparities in an important health domain.

  10. [Actigraphy in sleep medicine and sleep research]. (United States)

    Tamura, Yoshiyuki; Matsuda, Mika; Chiba, Shigeru


    Actigraphy is a method that utilizes a miniaturized computerized wristwatch-like device to monitor and collect data generated by body movements over extended periods of time. It allows estimation of sleep and wakefulness based on motor activity. It provides a noninvasive, objective, and longitudinal method for the diagnostic and post-treatment evaluation of patients with sleep disorders in the ambulatory setting. It has been used for researchers to study sleep disturbances in a variety of populations, most frequently for the evaluation of insomnia, paradoxical insomnia, and circadian rhythm sleep disorders. In addition, it is particularly useful in populations where polysomnography would be difficult to record, such as in patients with dementia and delirium. Actigraphy should be extensively carried out in sleep medicine as well as sleep research.

  11. Sleep and sleep disorders in Don Quixote. (United States)

    Iranzo, Alex; Santamaria, Joan; de Riquer, Martín


    In Don Quijote de la Mancha, Miguel de Cervantes presents Don Quixote as an amazing character of the 17th century who suffers from delusions and illusions, believing himself to be a medieval knight errant. Besides this neuropsychiatric condition, Cervantes included masterful descriptions of several sleep disorders such as insomnia, sleep deprivation, disruptive loud snoring and rapid eye movement sleep behaviour disorder. In addition, he described the occurrence of physiological, vivid dreams and habitual, post-prandial sleepiness--the siesta. Cervantes' concept of sleep as a passive state where all cerebral activities are almost absent is in conflict with his description of abnormal behaviours during sleep and vivid, fantastic dreams. His concept of sleep was shared by his contemporary, Shakespeare, and could have been influenced by the reading of the classical Spanish book of psychiatry Examen de Ingenios (1575).

  12. Alphabetical Index of Parasitic Diseases (United States)

    ... T U V W X Y Z A Acanthamoeba Infection Acanthamoeba Keratitis Infection African Sleeping Sickness (African trypanosomiasis) Alveolar ... Top K Kala-azar (Leishmaniasis, Leishmania Infection) Keratitis ( Acanthamoeba Infection) Back To Top L Leishmaniasis (Kala-azar, ...

  13. Pain and sickness behavior associated with corneal lesions in dairy calves [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Brandon J. Woods


    Full Text Available Infectious bovine keratoconjunctivitis (IBK is a common corneal disease of calves that adversely affects animal welfare by causing pain and weight loss. Identifying behavioral indicators of pain and sickness in calves with IBK is necessary for designing studies that aim to identify effective means of pain mitigation. Consistent with principles of the 3Rs for animal use in research, data from a randomized blinded challenge study was used to identify and describe variation of behaviors that could serve as reliable indicators of pain and sickness in calves with corneal injuries. Behavioral observations were collected from 29 Holstein calves 8 to 12 weeks of age randomly allocated to one of three treatments: (1 corneal scarification only, (2 corneal scarification with inoculation with Moraxella bovoculi and (3 corneal scarification with inoculation with Moraxella bovis. Behavior was continuously observed between time 1230 - 1730 h on day -1 (baseline time period and day 0 (scarification time period. Corneal scarification and inoculation occurred between 0800 - 1000 h on day 0. Frequency of head-directed behaviors (head shaking, head rubbing, head scratching and durations of head rubbing, feeding, standing with head lifted, lying with head lifted and sleeping were compared between study days and groups. Following scarification, the frequency of head-directed behavior significantly increased (p = 0.0001, as did duration of head rubbing (p=0.02. There was no significant effect of trial, trial day, treatment or treatment-day interaction on other behaviors studied. Our study demonstrated that head-directed behavior, such as head shaking, rubbing and scratching, was associated with scarification of eyes using an IBK challenge model, but sickness behavior was not observed.

  14. Sick sinus syndrome secondary to primary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Osman Beton


    Full Text Available The effects of hypercalcemia on the heart and the resulting alternations of the electrocardiogram have been well established. However, there are only limited number of reports in the literature on primary hyperparathyroidism leading to clinically significant arrhythmias. We present a patient who was diagnosed with symptomatic sick sinus syndrome in the setting of moderate hyper-calcemia secondary to primary hyperparathyroidism in this case report. After the surgical opera-tion for primary hyperparathyroidism, serum calcium level returned to normal range and patient’s complaints and arrhytmic findings recovered. The patient was asymptomatic for the following 13 years.

  15. Effect of lipopolysaccharide on sickness behaviour in hens kept in cage and free range environments. (United States)

    Gregory, N G; Payne, S R; Devine, C D; Cook, C J


    The aim of this study was to assess whether environmental enrichment and environmental conditions can influence the expression of sickness behaviour. The behaviour in response to injection of lipopolysaccharide or saline was examined in a total of 96 62-weeks old hatchmate hens kept in a free range or cage environment. There were eight experimental treatments, each with 12 birds. Half the birds were sourced from a commercial cage layer unit (C/-) and half from a commercial free range unit (FR/-). After intraperitoneal injection with either lipopolysaccharide or saline (as a control), the hens were placed in either a cage (-/C) or free range (-/FR) environment. Lipopolysaccharide caused greater suppression of activity in free range (FR/FR) than in caged hens, including less walking (53% reduction), roosting (-86%) and preening (-60%) (pcaged birds released into free range, nor in free range birds introduced to cages, suggesting that both the presence of and the familiarity with an environment affected sickness behaviour patterns. Increased sleeping was the most consistent response (+147%; pcaged hens, and this may make it more difficult to recognise disease expression in the caged environment.

  16. African America. (United States)

    Brodie, Carolyn S.; Brown, Gloria


    Presents an annotated bibliography of quality materials by and about African Americans in the areas of poetry, music, folklore, women, picture books, history/collective biography, authors, and professional materials. Activities are suggested in each area for Black History Month. (LRW)

  17. PER3 polymorphism predicts cumulative sleep homeostatic but not neurobehavioral changes to chronic partial sleep deprivation.

    Directory of Open Access Journals (Sweden)

    Namni Goel

    Full Text Available BACKGROUND: The variable number tandem repeat (VNTR polymorphism 5-repeat allele of the circadian gene PERIOD3 (PER3(5/5 has been associated with cognitive decline at a specific circadian phase in response to a night of total sleep deprivation (TSD, relative to the 4-repeat allele (PER3(4/4. PER3(5/5 has also been related to higher sleep homeostasis, which is thought to underlie this cognitive vulnerability. To date, no study has used a candidate gene approach to investigate the response to chronic partial sleep deprivation (PSD, a condition distinct from TSD and one commonly experienced by millions of people on a daily and persistent basis. We evaluated whether the PER3 VNTR polymorphism contributed to cumulative neurobehavioral deficits and sleep homeostatic responses during PSD. METHODOLOGY/PRINCIPAL FINDINGS: PER3(5/5 (n = 14, PER3(4/5 (n = 63 and PER3(4/4 (n = 52 healthy adults (aged 22-45 y demonstrated large, but equivalent cumulative decreases in cognitive performance and physiological alertness, and cumulative increases in sleepiness across 5 nights of sleep restricted to 4 h per night. Such effects were accompanied by increasing daily inter-subject variability in all groups. The PER3 genotypes did not differ significantly at baseline in habitual sleep, physiological sleep structure, circadian phase, physiological sleepiness, cognitive performance, or subjective sleepiness, although during PSD, PER3(5/5 subjects had slightly but reliably elevated sleep homeostatic pressure as measured physiologically by EEG slow-wave energy in non-rapid eye movement sleep compared with PER3(4/4 subjects. PER3 genotypic and allelic frequencies did not differ significantly between Caucasians and African Americans. CONCLUSIONS/SIGNIFICANCE: The PER3 VNTR polymorphism was not associated with individual differences in neurobehavioral responses to PSD, although it was related to one marker of sleep homoeostatic response during PSD. The comparability of PER3

  18. Sleep disturbances in Parkinsonism. (United States)

    Askenasy, J J M


    The present article is meant to suggest an approach to the guidelines for the therapy of sleep disturbances in Parkinson's Disease (PD) patients.The factors affecting the quality of life in PD patients are depression, sleep disturbances and dependence. A large review of the literature on sleep disturbances in PD patients, provided the basis for the following classification of the sleep-arousal disturbances in PD patients. We suggest a model based on 3 steps in the treatment of sleep disturbances in PD patients. This model allowing the patient, the spouse or the caregiver a quiet sleep at night, may postpone the retirement and the institutionalization of the PD patient. I. Correct diagnosis of sleep disorders based on detailed anamnesis of the patient and of the spouse or of the caregiver. One week recording on a symptom diary (log) by the patient or the caregiver. Correct diagnosis of sleep disorders co morbidities. Selection of the most appropriate sleep test among: polysomnography (PSG), multiple sleep latency test (MSLT), multiple wake latency test (MWLT), Epworth Sleepiness Scale, actigraphy or video-PSG. II. The nonspecific therapeutic approach consists in: a) Checking the sleep effect on motor performance, is it beneficial, worse or neutral. b) Psycho-physical assistance. c) Dopaminergic adjustment is necessary owing to the progression of the nigrostriatal degeneration and the increased sensitivity of the terminals, which alter the normal modulator mechanisms of the motor centers in PD patients. Among the many neurotransmitters of the nigro-striatal pathway one can distinguish two with a major influence on REM and NonREM sleep. REM sleep corresponds to an increased cholinergic receptor activity and a decreased dopaminergic activity. This is the reason why REM sleep deprivation by suppressing cholinergic receptor activity ameliorates PD motor symptoms. L-Dopa and its agonists by suppressing cholinergic receptors suppress REM sleep. The permanent adjustment

  19. Short-term sick leave and future risk of sickness absence and unemployment - the impact of health status

    Directory of Open Access Journals (Sweden)

    Hultin Hanna


    Full Text Available Abstract Background In previous studies the authors have found sick leave to be a predictor of future sick leave, unemployment and disability pension. Although sick leave reflects underlying health problems, some studies have suggested that sick leave may have consequences beyond the consequences of the underlying illness. However, few studies have aimed at studying consequences of sick leave while adjusting for ill health. This study aims to explore whether short-term sick leave increases the risk of future long-term sick leave, disability pension, and unemployment. Furthermore, we aim to control for the potentially confounding effects of physical and mental health status. Methods Data were gathered from the Stockholm Public Health Cohort (SPHC, restricted to 11,156 employed individuals (48.6% men aged 18–59, without long-term sick leave, disability pension or in-patient care the year before inclusion (2002. These were followed-up with regard to unemployment, long-term sick leave, and disability pension in 2006 and 2007. Odds ratios (OR with corresponding 95% confidence intervals (CI were estimated by logistic regression, controlling for six different measures of health status (limiting long-standing illness, self-rated health, mental health, somatic disease, musculoskeletal pain and in-patient care and socio-demographic factors. Results Results from the unadjusted analyses indicated increased risks of long-term sick leave (OR 2.00; CI 1.62-2.46 and short-term unemployment (OR 1.76; CI 1.35-2.29 for individuals exposed to more than one short-term sick-leave spell. There were no increased odds of long-term unemployment (OR 0.54; CI 0.28-1.04 or disability pension (OR 0.72; CI 0.42-1.24. After adjusting for the different measures of health status the odds ratio for short-term unemployment was not statistically significant (OR 1.29; CI 0.97-1.74. The odds ratios for the other outcomes slightly increased after adjustment for the used measures of

  20. Nuancing the relationship between motion sickness and postural stability

    NARCIS (Netherlands)

    Bos, J.E.


    The most cited theory on motion sickness is the conflict theory by Reason and Brand (1975) [1], stating that motion sickness occurs due to a conflict between the senses and stored patterns of motion. In addition, there seems to be evidence for another theory stating that postural instability is a ne

  1. Recurrence of sickness absence due to common mental disorders

    NARCIS (Netherlands)

    Koopmans, P.C.; Bultmann, U.; Roelen, C.A.; Hoedeman, R.; van der Klink, J.J.; Groothoff, J.W.


    PURPOSE: Common mental disorders (CMDs) are an important cause of work disability. Although CMDs are known to have high recurrence rates, little is known about the recurrence of sickness absence due to CMDs. This study examines the recurrence risk of sickness absence due to CMDs. METHODS: A cohort o

  2. Parametric hazard rate models for long-term sickness absence

    NARCIS (Netherlands)

    Koopmans, Petra C.; Roelen, Corne A. M.; Groothoff, Johan W.


    In research on the time to onset of sickness absence and the duration of sickness absence episodes, Cox proportional hazard models are in common use. However, parametric models are to be preferred when time in itself is considered as independent variable. This study compares parametric hazard rate m

  3. Identifying workers at risk of sickness absence by questionnaire

    NARCIS (Netherlands)

    Roelen, Corne A. M.; van der Pol, Tjepke R.; Koopmans, Petra C.; Groothoff, Johan W.


    Background Sickness absence is an important economic problem, because of high costs and lost productivity. Determining factors associated with increased risk of sickness absence may lead to the development of preventive measures. Aims To determine whether self-report questionnaires can identify thos

  4. 5 CFR 630.502 - Sick leave recredit. (United States)


    ... different leave systems under section 6308 of title 5, United States Code, 7 calendar days of sick leave are... leave system to which he or she can transfer only a part of his or her sick leave is entitled to a... employee returns to the leave system under which it was earned on or after December 2, 1994. (f)...

  5. 5 CFR 831.302 - Unused sick leave. (United States)


    ... annuity is increased by the days of unused sick leave to his credit under a formal leave system. (b) An...) A formal leave system is one which is provided by law or regulation or operates under written rules... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Unused sick leave. 831.302 Section...

  6. Sick leave analysis among self-employed Dutch farmers

    NARCIS (Netherlands)

    Hartman, E.; Oude Vrielink, H.H.E.; Huirne, R.B.M.; Metz, J.H.M.


    Background Agriculture is one of the most physically demanding and risky industries. Aim The objective of this study was to provide baseline data on the diagnoses, occurrence and duration of sick leave of self-employed Dutch farmers. Method A database of 22807 sick leave claims of 12627 farmers duri

  7. Identifying employees at risk for job loss during sick leave

    NARCIS (Netherlands)

    Flach, Peter A.; Groothoff, Johan W.; Bultmann, Ute


    Purpose: To examine the associations between medical, work-related, organizational and sociodemographic factors and job loss during sick leave in a Dutch population of 4132 employees on sick leave. Methods: Data were assessed by occupational health physicians (OHPs) on sociodemographic, medical, wor

  8. Does muscle strength predict future musculoskeletal disorders and sickness absence?

    DEFF Research Database (Denmark)

    Faber, A; Sell, L; Hansen, J V;


    High muscle strength is considered relevant for preventing musculoskeletal disorders and long-term sickness absence. However, prospective studies on the association between muscle strength and future musculoskeletal disorders and long-term sickness absence are few and show contrasting results....

  9. Return to work following sickness absence due to infectious mononucleosis

    NARCIS (Netherlands)

    Koopmans, P.C.; Bakhtali, R.; Katan, A.A.; Groothoff, J.W.; Roelen, C.A.


    BACKGROUND: Epstein-Barr virus infectious mononucleosis among adults is notorious because of the prolonged incapacitating fatigue it causes. AIMS: To investigate the duration of sickness absence and return to work following infectious mononucleosis. METHODS: Episodes of sickness absence due to infec

  10. Less sickness with more motion and/or mental distraction

    NARCIS (Netherlands)

    Bos, J.E.


    BACKGROUND: Motion sickness may reduce passenger comfort and crew performance. Countermeasures are dominated by medication with specific and often undesirable side effects. OBJECTIVE: To shown that sickness due to motion can be reduced by adding an inherent non-sickening vibration and by mental dist

  11. Sleep and Newborns (United States)

    ... AAP introduced this recommendation in 1992. Use a firm sleep surface. Cover the mattress with a sheet ... Sleep and Your 1- to 2-Year-Old Communication and Your Newborn Medical Care and Your Newborn ...

  12. Sleep and Eating Disorders. (United States)

    Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M


    Insomnia is related to an increased risk of eating disorders, while eating disorders are related to more disrupted sleep. Insomnia is also linked to poorer treatment outcomes for eating disorders. However, over the last decade, studies examining sleep and eating disorders have relied on surveys, with no objective measures of sleep for anorexia nervosa or bulimia nervosa, and only actigraphy data for binge eating disorder. Sleep disturbance is better defined for night eating syndrome, where sleep efficiency is reduced and melatonin release is delayed. Studies that include objectively measured sleep and metabolic parameters combined with psychiatric comorbidity data would help identify under what circumstances eating disorders and sleep disturbance produce an additive effect for symptom severity and for whom poor sleep would increase risk for an eating disorder. Cognitive behavior therapy for insomnia may be a helpful addition to treatment of those with both eating disorder and insomnia.

  13. Central sleep apnea (United States)

    ... diagnose an underlying medical condition. A sleep study (polysomnography) can confirm sleep apnea. Other tests that may ... MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow us Disclaimers Copyright Privacy ...

  14. Polysomnography (Sleep Study) (United States)

    ... make symptoms of some sleep disorders worse. During polysomnography You arrive at the sleep center in the ... t required to obtain accurate polysomnography results. After polysomnography In the morning, the sensors are removed, and ...

  15. Sleep in postmenopausal women. (United States)

    Vigeta, Sônia Maria Garcia; Hachul, Helena; Tufik, Sergio; de Oliveira, Eleonora Menicucci


    The aim of this study was to identify factors that most influence the perception of sleep quality in postmenopausal women. We used the methodological strategy of the Collective Subject Discourse (CSD), which is based on a theoretical framework of social representations theory. We obtained the data by interviewing 22 postmenopausal Brazilian women who were experiencing insomnia. The women gave accounts of their difficulties with sleep; a variety of dimensions were identified within the data. The onset of sleep disorders might have occurred during childhood or in situations considered to be stressful, and were not necessarily associated with menopause. We found that hormonal alterations occurring during menopause, psychosocial factors, and sleep-breathing disorders triggered occasional sleep disturbances during this time of life. Participants were aware of the consequences of sleep deprivation. In addition, inadequate sleep hygiene habits figured prominently as determinants in the persistence of sleep disturbances.

  16. Metformin and sleep disorders



    Metformin is a widely used anti-diabetic drug. Deterioration of sleep is an important unwanted side effect of metformin. Here, the authors review and present the details on metformin and sleep problem.

  17. Teenagers and sleep (United States)

    ... and with their health , including: Depression and low self esteem Sleepiness and trouble concentrating Decline in school performance ... associated with improved sleep and daytime functioning in adolescents. Sleep . 2011;34(6):797-800. PMID: 21629368 ...

  18. Sleep and Newborns (United States)

    ... 12-Month-Old Bed-Sharing All About Sleep Sleep and Your 1- to 2-Year-Old Communication and Your Newborn Medical Care and Your Newborn Your Newborn's Growth Choosing Safe Baby Products: Cribs Flat Head Syndrome ( ...

  19. Morning sickness: impact on offspring salt preference. (United States)

    Crystal, S R; Bernstein, I L


    These studies examined the relationship between salt preference of adult offspring and their mothers' symptoms of morning sickness during pregnancy. College students who could provide information about their mothers' symptoms of morning sickness completed a survey about their dietary salt intake (study 1; n = 169) or rated and consumed ten snack foods (study 2; n = 66). In study 1 a salt-use score was calculated based on responses to the Salt Intake Questionnaire; offspring of women with moderate or severe vomiting reported a significantly higher level of salt use (p < 0.01) than those whose mothers report little or no symptoms. In study 2 saltiness and pleasantness ratings of high-salt foods, intake of those foods and total sodium intake were the focus of analysis. Offspring of women reporting moderate or severe vomiting showed a significantly greater preference for the snack food subjects rated as saltiest than those whose mothers reported no or mild vomiting. They also ate more of that food and consumed more total sodium during the test session. Effects were stronger in Caucasian than Asian subjects. These studies suggest that moderate to severe vomiting during pregnancy can be associated with significantly higher salt intake in offspring. Thus, a gestational event may be an important determinant of salt intake and preference in adulthood.

  20. Predictors of sickness absence in pregnancy

    DEFF Research Database (Denmark)

    Hansen, Mette Lausten; Thulstrup, Ane Marie; Juhl, Mette


    OBJECTIVE: The aim of this cohort study was to investigate associations between parity, pre-pregnancy body mass index (BMI), assisted reproductive therapy (ART), time to pregnancy (TTP), and engagement in physical exercise and the risk of sickness absence in pregnancy from 10-29 completed pregnancy...... weeks. METHODS: Data from 51 874 pregnancies in the Danish National Birth Cohort collected from 1996 until 2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on questionnaires. Hazard ratios (HR) with 95% confidence intervals (95% CI) were...... calculated by Cox regression, using time of first episode of sickness absence as the primary outcome. RESULTS: Multiparity 1.26 (95% CI 1.10-1.45), overweight 1.13 (95% CI 1.08-1.18), obesity 1.23 (95% CI 1.15-1.31), ART 1.10 (95% CI 1.01-1.20), and TTP >12 months 1.06 (95% CI 0.99-1.13) were associated...

  1. Sleep hygiene and sleep quality in Italian and American adolescents. (United States)

    LeBourgeois, Monique K; Giannotti, Flavia; Cortesi, Flavia; Wolfson, Amy; Harsh, John


    This study investigated cross-cultural differences in adolescent sleep hygiene and sleep quality. Participants were 1348 students (655 males; 693 females) aged 12-17 years from public school systems in Rome, Italy (n = 776) and Southern Mississippi (n = 572). Participants completed the Adolescent Sleep-Wake Scale and the Adolescent Sleep Hygiene Scale. Reported sleep hygiene and sleep quality were significantly better for Italian than American adolescents. A moderate linear relationship was observed between sleep hygiene and sleep quality in both samples (Italians: R =.40; Americans: R =.46). Separate hierarchical multiple regression analyses showed that sleep hygiene accounted for significant variance in sleep quality, even after controlling for demographic and health variables (Italians: R(2) =.38; Americans: R(2) =.44). The results of this study suggest that there are cultural differences in sleep quality and sleep hygiene practices, and that sleep hygiene practices are importantly related to adolescent sleep quality.

  2. The impact of downsizing on remaining workers' sickness absence. (United States)

    Østhus, Ståle; Mastekaasa, Arne


    It is generally assumed that organizational downsizing has considerable negative consequences, not only for workers that are laid off, but also for those who remain employed. The empirical evidence with regard to effects on sickness absence is, however, inconsistent. This study employs register data covering a major part of the total workforce in Norway over the period 2000-2003. The number of sickness absence episodes and the number of sickness absence days are analysed by means of Poisson regression. To control for both observed and unobserved stable individual characteristics, we use conditional (fixed effects) estimation. The analyses provide some weak indications that downsizing may lead to slightly less sickness absence, but the overall impression is that downsizing has few if any effects on the sickness absence of the remaining employees.

  3. Undetected common mental disorders in long-term sickness absence

    DEFF Research Database (Denmark)

    Søgaard, Hans Jørgen


    Background. Undetected Common Mental Disorders (CMDs) amongst people on sick leave complicate rehabilitation and return to work because appropriate treatments are not initiated. Aims. The aim of this study is to estimate (1) the frequencies of CMD, (2) the predictors of undetected CMD, and (3......) the rate of return to work among sick listed individuals without a psychiatric disorder, who are registered on long-term sickness absence (LSA). Methods. A total of 2,414 incident individuals on LSA with a response rate of 46.4%, were identified for a two-phase study. The subsample of this study involved...... individuals registered on LSA who were sick-listed without a psychiatric sick leave diagnosis. In this respect, Phase 1 included 831 individuals, who were screened for mental disorders. In Phase 2, following the screening of Phase 1, 227 individuals were thoroughly examined by a psychiatrist applying Present...

  4. Sleep hygiene and actigraphically evaluated sleep characteristics in children with ADHD and chronic sleep onset insomnia. (United States)

    van der Heijden, Kristiaan B; Smits, Marcel G; Gunning, W Boudewijn


    In the present study we investigated sleep hygiene and actigraphically evaluated sleep in 74 medication-naïve children, aged 6-12 years, with rigorously diagnosed attention-deficit/hyperactivity disorder (ADHD) and chronic sleep onset insomnia (ADHD-SOI) and 23 ADHD controls without insomnia (ADHD-noSOI). Between-group differences were analysed for lights out (sleep log), actigraphically evaluated sleep onset, sleep latency, total sleep duration, actual sleep time and sleep hygiene as measured with the Children's Sleep Hygiene Scale. We found a significant difference (P sleep hygiene score between the ADHD-SOI (56.4 +/- 10.5) and ADHD-noSOI groups (53.0 +/- 10.6). We conclude that there were differences in sleep onset and sleep latency in ADHD children with chronic SOI and those without insomnia; however, sleep hygiene practices were similar and did not relate to sleep characteristics.

  5. Sleep and Metabolism: An Overview

    Directory of Open Access Journals (Sweden)

    Sunil Sharma


    Full Text Available Sleep and its disorders are increasingly becoming important in our sleep deprived society. Sleep is intricately connected to various hormonal and metabolic processes in the body and is important in maintaining metabolic homeostasis. Research shows that sleep deprivation and sleep disorders may have profound metabolic and cardiovascular implications. Sleep deprivation, sleep disordered breathing, and circadian misalignment are believed to cause metabolic dysregulation through myriad pathways involving sympathetic overstimulation, hormonal imbalance, and subclinical inflammation. This paper reviews sleep and metabolism, and how sleep deprivation and sleep disorders may be altering human metabolism.

  6. African American College Students: Literacy of Depression and Help Seeking (United States)

    Stansbury, Kim L.; Wimsatt, Maureen; Simpson, Gaynell Marie; Martin, Fayetta; Nelson, Nancy


    Depression is a serious public health concern in the United States affecting almost 18.8 million adults. It is a common mental disorder in college students, with estimates of 1 in 4 "experiencing an episode by age 24." African American college students are at an elevated risk for depression due to racism, stress, sleep deprivation, and lack of…

  7. Treatments for Sleep Changes (United States)

    ... use the bed only for sleep Discourage watching television during periods of wakefulness Medications for sleep changes In some cases, non-drug approaches fail to work or the sleep changes are accompanied by disruptive nighttime behaviors. For those individuals who do require medication, experts ...

  8. Physiology of Sleep. (United States)

    Carley, David W; Farabi, Sarah S


    IN BRIEF Far from a simple absence of wakefulness, sleep is an active, regulated, and metabolically distinct state, essential for health and well-being. In this article, the authors review the fundamental anatomy and physiology of sleep and its regulation, with an eye toward interactions between sleep and metabolism.

  9. Snoring and Sleep Apnea (United States)

    ... relations staff at . Insight into sleeping disorders and sleep apnea Forty-five percent of normal adults snore ... Witnessed episodes of breath pauses or apnea during sleep • Daytime sleepiness or fatigue • High ... disease • History of a stroke What treatments are available? ...

  10. Sleep and Your Preschooler (United States)

    ... Old Feeding Your 1- to 2-Year-Old Sleep and Your Preschooler KidsHealth > For Parents > Sleep and Your Preschooler Print A A A What's ... Preschoolers need about 11 to 12 hours of sleep each day, which can include a nap. There's ...

  11. Neuroimaging and sleep medicine. (United States)

    Nofzinger, Eric A


    In sleep medicine, patients with sleep disorders are evaluated and treated. The primary assessment tool of the field has traditionally been polysomnography. While polysomnography has been helpful in the evaluation of some sleep disorders, such as sleep apnea syndrome and periodic limb movement disorder, it has been less helpful in others, such as the insomnias, or sleep disorders secondary to mental disorders. These disorders are presumed to stem from some alteration in brain function that disrupts sleep. The development of functional neuroimaging methods provides a means to understand brain function in patients with sleep disorders in a manner not accessible to polysomnography. This paper summarizes functional neuroimaging findings during healthy sleep, then, reviews available studies in sleep disorders patients, and studies addressing the pharmacology of sleep and sleep disorders. Areas in which functional neuroimaging methods may be helpful in sleep medicine, and in which future development is advised, include: (1) clarification of pathophysiology; (2) aid in differential diagnosis; (3) assessment of treatment response; (4) guiding new drug development; and (5) monitoring treatment response.

  12. The Functions of Sleep

    Directory of Open Access Journals (Sweden)

    Samson Z Assefa


    Full Text Available Sleep is a ubiquitous component of animal life including birds and mammals. The exact function of sleep has been one of the mysteries of biology. A considerable number of theories have been put forward to explain the reason(s for the necessity of sleep. To date, while a great deal is known about what happens when animals sleep, there is no definitive comprehensive explanation as to the reason that sleep is an inevitable part of animal functioning. It is well known that sleep is a homeostatically regulated body process, and that prolonged sleep deprivation is fatal in animals. In this paper, we present some of the theories as to the functions of sleep and provide a review of some hypotheses as to the overall physiologic function of sleep. To better understand the purpose for sleeping, we review the effects of sleep deprivation on physical, neurocognitive and psychic function. A better understanding of the purpose for sleeping will be a great advance in our understanding of the nature of the animal kingdom, including our own.

  13. What Is Sleep Apnea? (United States)

    ... page from the NHLBI on Twitter. What Is Sleep Apnea? Español Sleep apnea (AP-ne-ah) is ... many people. Rate This Content: NEXT >> Featured Video Sleep Apnea Research: The HeartBeat Study 06/07/2012 ...

  14. African-American Biography. (United States)

    Martin, Ron


    Suggests sources of information for African American History Month for library media specialists who work with students in grades four through eight. Gale Research's "African-American Reference Library," which includes "African-America Biography,""African-American Chronology," and "African-American Almanac,"…

  15. Sleep as a support for social competence, peer relations, and cognitive functioning in preschool children. (United States)

    Vaughn, Brian E; Elmore-Staton, Lori; Shin, Nana; El-Sheikh, Mona


    Evidence that sleep influences social and cognitive adaptation for school-age children and adolescents is accumulating rapidly, but less research focuses on the role of sleep for adaptive functioning during early childhood. We addressed these questions using actigraphy to assess sleep duration, sleep quality, and variability in sleep schedules in relation to a range of social/emotional and cognitive measures, including receptive vocabulary, emotion understanding, peer acceptance, social skills, social engagement, and temperament. Children in a convenience sample (N = 62, 40 boys, mean age = 4.15 yrs, 67% European American) wore actigraphs for 4-7 days, with sleep and wake states determined using Sadeh's scoring algorithm. Older children spent less time in bed at night and ethnic minority children (mostly African Americans) slept less at night and had lower sleep efficiency than did European American ethnic status children. Bivariate relations (controlling for sex, age, and ethnicity) between sleep variables and child adaptation scores showed that sleep duration was positively associated with peer acceptance, social skills, social engagement, receptive vocabulary, and understanding of the causes of emotions. Fewer variables were associated with nighttime sleep quality and variability and these tended to be related to outcome variables suggestive of behavioral and emotional regulation. Results suggest that sleep parameters are broadly implicated in the adjustment of preschool age children.

  16. Sleep and sleep disorders in menopausal women. (United States)

    Guidozzi, F


    Sleep disorders in the menopause are common. Although these disorders may be due to the menopause itself and/or the associated vasomotor symptoms, the etiology is multifactorial and includes a number of other associated conditions. They may simply arise as part of the aging process and not be specifically related to the decrease in estrogen levels or, alternatively, because of breathing or limb movement syndromes, depression, anxiety, co-morbid medical diseases, medication, pain and/or psychosocial factors. The most commonly encountered sleep disorders in menopausal women include insomnia, nocturnal breathing disturbances and the associated sleep disorders that accompany the restless leg syndrome, periodic leg movement syndrome, depression and anxiety. This review article addresses sleep and the sleep disorders associated with menopause and briefly the role that hormone therapy may play in alleviating these disorders.

  17. Menopause related sleep disorders. (United States)

    Eichling, Philip S; Sahni, Jyotsna


    Sleep difficulty is one of the hallmarks of menopause. Following recent studies showing no cardiac benefit and increased breast cancer, the question of indications for hormonal therapy has become even more pertinent. Three sets of sleep disorders are associated with menopause: insomnia/depression, sleep disordered breathing and fibromyalgia. The primary predictor of disturbed sleep architecture is the presence of vasomotor symptoms. This subset of women has lower sleep efficiency and more sleep complaints. The same group is at higher risk of insomnia and depression. The "domino theory" of sleep disruption leading to insomnia followed by depression has the most scientific support. Estrogen itself may also have an antidepressant as well as a direct sleep effect. Treatment of insomnia in responsive individuals may be a major remaining indication for hormone therapy. Sleep disordered breathing (SDB) increases markedly at menopause for reasons that include both weight gain and unclear hormonal mechanisms. Due to the general under-recognition of SDB, health care providers should not assume sleep complaints are due to vasomotor related insomnia/depression without considering SDB. Fibromyalgia has gender, age and probably hormonal associations. Sleep complaints are almost universal in FM. There are associated polysomnogram (PSG) findings. FM patients have increased central nervous system levels of the nociceptive neuropeptide substance P (SP) and lower serotonin levels resulting in a lower pain threshold to normal stimuli. High SP and low serotonin have significant potential to affect sleep and mood. Treatment of sleep itself seems to improve, if not resolve FM. Menopausal sleep disruption can exacerbate other pre-existing sleep disorders including RLS and circadian disorders.

  18. African Trypanosomiasis (United States)


    Histol. 1977;375:53- 70. 42. Poltera AA, Owor R, Cox JN. Pathological aspects of human African trypanosomiasis (HAT) in Uganda. A post - mortem survey of...nodular lesions , including anthrax or tick bite associated with Rickettsia conorii infection. The chancre is followed by a hemolymphatic stage, dur- ing...electrocardiograph- ic changes and, at times, terminal cardiac insufficiency.41 Pulmonary lesions specifically related to trypanosomiasis are not


    Directory of Open Access Journals (Sweden)

    Abdul Latif


    Full Text Available Small industrial units are the seedbed on industrial development in underdeveloped economy for its less capital involvement and more employment generation capability. But this sector cannot contribute expectedly for infection to sickness that ultimately prevents the entrepreneurial bases of economy. Sickness can be occurred in the inception period, in operation and /or in macro environment.There are various techniques to prevent sickness and to make the treatment of occurred sickness. In this study, the researchers selected 13 sick units of BSCIC industrial units and collected the information regarding the causes, stages and measures to prevent sickness. It is found that 07 are born to sick due to improper capital budgeting, 06 are made sick for managerial problems and no units are bound to be sick for environmental problems.

  20. [Sleep and sexuality]. (United States)

    Abraham, G; Vlatkovic, D


    Our knowledge about the multiple aspects of sleep functions are still insufficient. Concerning the relationship between sleep and sexuality there are four points of view to take into account. Two observations: a spontaneous sexual excitement during REM sleep and that some anxious dreams can produce also sexual arousal. Two hypotheses: the erotic pleasure could be easier to perceive in a sleeping or dreaming state than in a waking state and some sleeping troubles could have an important influence on the sexual life of a couple.

  1. The neurology of sleep. (United States)

    Swick, Todd J


    Neurology, by virtue of its study of the brain, is the primary medical science for the elucidation of the anatomy, physiology, pathology and, ultimately, the function of sleep. There has been nothing short of a revolution in the science of sleep over the past 50 years. From the discovery of REM sleep to the identification of Hypocretin/Orexin the basic science and clinical field of sleep medicine has blossomed. This article will explore the anatomy, physiology, biochemistry and, to a limited extent, pathophysiology of the sleep/wake centers of the brain. The field of chronobiology will also be touched upon.

  2. Melarsoprol cyclodextrin inclusion complexes as promising oral candidates for the treatment of human African trypanosomiasis.

    Directory of Open Access Journals (Sweden)

    Jean Rodgers


    Full Text Available Human African trypanosomiasis (HAT, or sleeping sickness, results from infection with the protozoan parasites Trypanosoma brucei (T. b. gambiense or T. b. rhodesiense and is invariably fatal if untreated. There are 60 million people at risk from the disease throughout sub-Saharan Africa. The infection progresses from the haemolymphatic stage where parasites invade the blood, lymphatics and peripheral organs, to the late encephalitic stage where they enter the central nervous system (CNS to cause serious neurological disease. The trivalent arsenical drug melarsoprol (Arsobal is the only currently available treatment for CNS-stage T. b. rhodesiense infection. However, it must be administered intravenously due to the presence of propylene glycol solvent and is associated with numerous adverse reactions. A severe post-treatment reactive encephalopathy occurs in about 10% of treated patients, half of whom die. Thus melarsoprol kills 5% of all patients receiving it. Cyclodextrins have been used to improve the solubility and reduce the toxicity of a wide variety of drugs. We therefore investigated two melarsoprol cyclodextrin inclusion complexes; melarsoprol hydroxypropyl-β-cyclodextrin and melarsoprol randomly-methylated-β-cyclodextrin. We found that these compounds retain trypanocidal properties in vitro and cure CNS-stage murine infections when delivered orally, once per day for 7-days, at a dosage of 0.05 mmol/kg. No overt signs of toxicity were detected. Parasite load within the brain was rapidly reduced following treatment onset and magnetic resonance imaging showed restoration of normal blood-brain barrier integrity on completion of chemotherapy. These findings strongly suggest that complexed melarsoprol could be employed as an oral treatment for CNS-stage HAT, delivering considerable improvements over current parenteral chemotherapy.

  3. Regulated expression of an essential allosteric activator of polyamine biosynthesis in African trypanosomes.

    Directory of Open Access Journals (Sweden)

    Erin K Willert


    Full Text Available Trypanosoma brucei is the causative agent of African sleeping sickness. The polyamine biosynthetic pathway has the distinction of being the target of the only clinically proven anti-trypanosomal drug with a known mechanism of action. Polyamines are essential for cell growth, and their metabolism is extensively regulated. However, trypanosomatids appear to lack the regulatory control mechanisms described in other eukaryotic cells. In T. brucei, S-adenosylmethionine decarboxylase (AdoMetDC and ornithine decarboxylase (ODC are required for the synthesis of polyamines and also for the unique redox-cofactor trypanothione. Further, trypanosomatid AdoMetDC is activated by heterodimer formation with a catalytically dead homolog termed prozyme, found only in these species. To study polyamine regulation in T. brucei, we generated inducible AdoMetDC RNAi and prozyme conditional knockouts in the mammalian blood form stage. Depletion of either protein led to a reduction in spermidine and trypanothione and to parasite death, demonstrating that prozyme activation of AdoMetDC is essential. Under typical growth conditions, prozyme concentration is limiting in comparison to AdoMetDC. However, both prozyme and ODC protein levels were significantly increased relative to stable transcript levels by knockdown of AdoMetDC or its chemical inhibition. Changes in protein stability do not appear to account for the increased steady-state protein levels, as both enzymes are stable in the presence of cycloheximide. These observations suggest that prozyme and ODC are translationally regulated in response to perturbations in the pathway. In conclusion, we describe the first evidence for regulation of polyamine biosynthesis in T. brucei and we demonstrate that the unique regulatory subunit of AdoMetDC is a key component of this regulation. The data support ODC and AdoMetDC as the key control points in the pathway and the likely rate-limiting steps in polyamine biosynthesis.

  4. Relationship of airflow limitation severity with work productivity reduction and sick leave in a Japanese working population

    Directory of Open Access Journals (Sweden)

    Onoue A


    Full Text Available Ayumi Onoue,1 Hisamitsu Omori,1 Takahiko Katoh,2 Kenichi Kubota,3 Yoshio Nonami,3 Yasuhiro Ogata,3 Hiromasa Inoue4 1Department of Biomedical Laboratory Sciences, 2Department of Public Health, Faculty of Life Sciences, Kumamoto University, 3Japanese Red Cross Kumamoto Health Care Center, Kumamoto, 4Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan Background: The aim of this study was to reveal the association between airflow limitation (AL severity and reduction with work productivity as well as use of sick leave among Japanese workers.Methods: This cross-sectional study included 1,378 workers who underwent a lung function test during a health checkup at the Japanese Red Cross Kumamoto Health Care Center. AL was defined as forced expiratory volume in 1 second/forced vital capacity of <0.7. Workers completed a questionnaire on productivity loss at work and sick leave. The quality and quantity of productivity loss at work were measured on a ten-point scale indicating how much work was actually performed on the previous workday. Participants were asked how many days in the past 12 months they were unable to work because of health problems. Logistic regression analysis was used to assess the associations between AL severity and the quality and quantity of productivity loss at work as well as use of sick leave.Results: Compared with workers without AL, workers with moderate-to-severe AL showed a significant productivity loss (quality: odds ratio [OR] =2.04, 95% confidence interval [CI]: 1.12–3.71, P=0.02 and quantity: OR =2.19, 95% CI: 1.20–4.00, P=0.011 and use of sick leave (OR =2.69, 95% CI: 1.33–5.44, P=0.006 after adjusting for sex, age, body mass index, smoking status, hypertension, hyperglycemia, dyslipidemia, sleep duration, work hours per day, and workplace smoking environment.Conclusion: AL severity was significantly associated with work productivity loss and use

  5. Obesity and African Americans (United States)

    ... Data > Minority Population Profiles > Black/African American > Obesity Obesity and African Americans African American women have the ... ss6304.pdf [PDF | 3.38MB] HEALTH IMPACT OF OBESITY More than 80 percent of people with type ...

  6. Autism and sleep disorders

    Directory of Open Access Journals (Sweden)

    Preeti A Devnani


    Full Text Available “Autism Spectrum Disorders” (ASDs are neurodevelopment disorders and are characterized by persistent impairments in reciprocal social interaction and communication. Sleep problems in ASD, are a prominent feature that have an impact on social interaction, day to day life, academic achievement, and have been correlated with increased maternal stress and parental sleep disruption. Polysomnography studies of ASD children showed most of their abnormalities related to rapid eye movement (REM sleep which included decreased quantity, increased undifferentiated sleep, immature organization of eye movements into discrete bursts, decreased time in bed, total sleep time, REM sleep latency, and increased proportion of stage 1 sleep. Implementation of nonpharmacotherapeutic measures such as bedtime routines and sleep-wise approach is the mainstay of behavioral management. Treatment strategies along with limited regulated pharmacotherapy can help improve the quality of life in ASD children and have a beneficial impact on the family. PubMed search was performed for English language articles from January 1995 to January 2015. Following key words: Autism spectrum disorder, sleep disorders and autism, REM sleep and autism, cognitive behavioral therapy, sleep-wise approach, melatonin and ASD were used. Only articles reporting primary data relevant to the above questions were included.

  7. Circadian rhythm sleep disorders

    Directory of Open Access Journals (Sweden)

    Morgenthaler TI


    Full Text Available Bhanu P Kolla,1,2 R Robert Auger,1,2 Timothy I Morgenthaler11Mayo Center for Sleep Medicine, 2Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USAAbstract: Misalignment between endogenous circadian rhythms and the light/dark cycle can result in pathological disturbances in the form of erratic sleep timing (irregular sleep–wake rhythm, complete dissociation from the light/dark cycle (circadian rhythm sleep disorder, free-running type, delayed sleep timing (delayed sleep phase disorder, or advanced sleep timing (advanced sleep phase disorder. Whereas these four conditions are thought to involve predominantly intrinsic mechanisms, circadian dysrhythmias can also be induced by exogenous challenges, such as those imposed by extreme work schedules or rapid transmeridian travel, which overwhelm the ability of the master clock to entrain with commensurate rapidity, and in turn impair approximation to a desired sleep schedule, as evidenced by the shift work and jet lag sleep disorders. This review will focus on etiological underpinnings, clinical assessments, and evidence-based treatment options for circadian rhythm sleep disorders. Topics are subcategorized when applicable, and if sufficient data exist. The length of text associated with each disorder reflects the abundance of associated literature, complexity of management, overlap of methods for assessment and treatment, and the expected prevalence of each condition within general medical practice.Keywords: circadian rhythm sleep disorders, assessment, treatment

  8. Family Disorganization, Sleep Hygiene, and Adolescent Sleep Disturbance (United States)

    Billows, Michael; Gradisar, Michael; Dohnt, Hayley; Johnston, Anna; McCappin, Stephanie; Hudson, Jennifer


    The link between sleep hygiene and adolescent sleep is well documented, though evidence suggests contributions from other factors, particularly the family environment. The present study examined whether sleep hygiene mediated the relationship between family disorganization and self-reported sleep onset latency, total sleep time, and daytime…

  9. Sleep and Sleep Problems: From Birth to 3 (United States)

    Du Mond, Courtney; Mindell, Jodi A.


    Sleep is an important aspect of a child's early development and is essential to family well-being. During their first 3 years, infants and toddlers spend more than 50% of their lives sleeping. However, concerns about sleep and sleep problems are among the most common issues brought to the attention of pediatricians. Although sleep is one of the…

  10. Sleep and Salivary Cortisol

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Karlson, Bernt; Hansen, Åse Marie


    The aim of the present chapter was to analyze whether measures of cortisol in saliva were associated with measures of sleep and to explore if divergent results were related to underlying differences in theoretic assumptions and methods. Measures of sleep quality included sleep duration, overall...... sleep quality, difficulty falling asleep, disturbed sleep, and sleep deprivation. Twenty-three papers were found to fulfill the inclusion criteria. Cortisol measures were grouped into single time points at different times during the day, deviations at different time periods during the day, reactivity...... and recovery after a standardized laboratory test, area under the curve and response to dexamethasone test. A large proportion of the studies included showed non-significant findings, which, in several cases, may be a result of low power. The most consistent results were a positive association between sleep...

  11. Motion sickness history, food neophobia, and sensation seeking. (United States)

    Alley, Thomas R; Willet, Kathleen A; Muth, Eric R


    Motion sickness is believed to be caused by conflicting sensory signals, a situation that mimics the effects of ingesting certain toxins. Thus, one might suspect that individuals who have experienced a relatively high frequency of motion sickness may be particularly vigilant about avoiding anything that produces nausea, induding potentially nauseating toxins. Consequently, they may be more resistant to trying new foods, i.e., be more food neophobic, since unfamiliar foods can have unexpected adverse effects due to toxins or allergens. Likewise, many highly stimulating experiences can trigger motion sickness, so individuals who are more susceptible may be more prone to avoid such experiences, i.e., be less sensation seeking. Finally, it was expected that food neophobia would be more frequent in individuals low on sensation seeking tendencies. Self-reported motion sickness history in 308 adults (M= 18.8 yr.; SD = 1.6) was correlated with scores on the Arnett Inventory of Sensation Seeking and the Food Neophobia Scale. As predicted, greater history of motion sickness was associated with lower Sensation Seeking scores. Food Neophobia was not correlated with motion sickness history but, as expected, was negatively correlated (r = -.42) with scores on Sensation Seeking. Further research is recommended that measures actual sensitivity to motion sickness.

  12. "Children get sick all the time"

    DEFF Research Database (Denmark)

    Østergaard, Lise Rosendal; Bjertrup, Pia Juul; Samuelsen, Helle


    Background: In Burkina Faso, the government has implemented various health sector reforms in order to overcome financial and geographical barriers to citizens' access to primary healthcare throughout the country. Despite these efforts, morbidity and mortality rates among children remain high...... facilities. Focusing on mothers as the primary caregivers, we follow their pathways from the onset of symptoms through their various attempts of providing treatment for their sick children. The overall objective is to discuss the interconnectedness of various factors, inside and outside of the primary health...... care services. Due to their accumulated vulnerabilities, mothers shift pragmatically from one treatment to another. However, the sporadic nature of their treatment-seeking hinders them in obtaining long-term solutions and the result is recurrent child illnesses and relapses over long periods of time...

  13. The Person in a State of Sickness. (United States)

    Árnason, Vilhjálmur; Hjörleifsson, Stefán


    In this article, we discuss the ideas of Eric J. Cassell about the patient-professional relationship. We argue that his approach combines in an interesting way features from the literature on patient autonomy and paternalistic practices. We suggest that these seemingly paternalistic features of practicing medicine, which are widely either ignored or condemned in bioethical discussion, are of vital significance in medical practice. In the first sections of the article, we describe the main features of Cassell's understanding of the sick person and his version of personalized medicine. We pay particular attention to his notion of information control and compare his ideas about conversation with patients to Hans-Georg Gadamer's analysis of patient-professional dialogue. In the latter part of the article, we explore through a couple of examples the implications these ideas have for medical practice.

  14. Sickness absence in Poland after socio-economic transformation

    Directory of Open Access Journals (Sweden)

    Zuzanna Szubert


    Full Text Available Background: The aim of the analysis was to determine the magnitude and causes of the sickness-related temporary incapacity for work in Poland, and to identify changes in sickness absence and its differences by the type of economic activity and region. Material and Methods: This analysis is based on the 2006-2012 data on sickness absence compiled from medical certificates of temporary incapacity for work and published by the Social Insurance Institution (Zakład Ubezpieczeń Społecznych. The sickness absence is described in terms of the number of sick leave days relative to the number of the employed or insured people. Results: In 2012, the number of days of disability per one employed was 14.5 (12.1 men, 17.4 women, representing 3.98% of the time lost due to illness. The main causes of absence were: complications of pregnancy and mother's diseases during pregnancy (33% of the sick leave days in women, injury and poisoning (men: 24%; women: 8%, diseases of the musculoskeletal system (men: 17%; woman: 11%. The highest level of sickness absence was noted in the łódzkie, śląskie and warmińsko-mazurskie provinces (38-19% higher than nationwide and in the administrative and support sectors (22.2 days per 1 employee, when analyzed by sectors of the national economy. Conclusions: The high increase in sickness absence over the recent 7 years due to cancer, mental and muscloskeletal disorders may be an important risk factor for early assessment of permanent incapacity for work. Another major problem is female sickness absence due to pregnancy complications and mother's diseases during pregnancy. Med Pr 2014;65(1:73–84

  15. Self-Reported Sleep Bruxism and Nocturnal Gastroesophageal Reflux Disease in Patients with Obstructive Sleep Apnea: Relationship to Gender and Ethnicity§ (United States)

    Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim


    Study Objectives : Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity. Methods : A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group. Results : In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians. Conclusion : Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups. PMID:25352924

  16. 5 CFR 630.403 - Supporting evidence for the use of sick leave. (United States)


    ... leave. 630.403 Section 630.403 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Sick Leave § 630.403 Supporting evidence for the use of sick leave. (a) An agency may grant sick leave only when the need for sick leave is supported by administratively...

  17. Pharmacological and neurophysiological aspects of space/motion sickness (United States)

    Lucot, James B.; Crampton, George H.


    A motorized motion testing device modeled after a Ferris wheel was constructed to perform motion sickness tests on cats. Details of the testing are presented, and some of the topics covered include the following: xylazine-induced emesis; analysis of the constituents of the cerebrospinal fluid (CSF) during motion sickness; evaluation of serotonin-1A (5-HT sub 1A) agonists; other 5HT receptors; antimuscarinic mechanisms; and antihistaminergic mechanisms. The ability of the following drugs to reduce motion sickness in the cats was examined: amphetamines, adenosinergic drugs, opioid antagonists, peptides, cannabinoids, cognitive enhancers (nootropics), dextromethorphan/sigma ligands, scopolamine, and diphenhydramine.

  18. Motion Sickness: A Study of Its Effects on Human Physiology. (United States)


    SICKNESS: A STUDY OF ITS EFFECTS ON HUMAN PHYSIOLOGY THESIS Pierre J. Gaudreault Captain, USAF AFIT/GE/ENG/87D- 2 0 TO STEC TEo VN;FB 1 0 1988...ENG/87D-20 MOTION SICKNESS: A STUDY OF ITS EFFECTS ON HUMAN PHYSIOLOGY THESIS Pierre J. Gaudreault Captain, USAF AFIT/GE/ENG/87D-20 Approved for public...SICKNESS: A STUDY OF ITS EFFECTS ON HUMAN PHYSIOLOGY THESIS Presented to the Faculty of the School of Engineering of the Air Force Institute of Technology

  19. Heart failure accompanied by sick euthyroid syndrome and exercise training. (United States)

    Psirropoulos, D; Lefkos, N; Boudonas, G; Efthimiadis, A; Vogas, V; Keskilidis, C; Tsapas, G


    Sick euthyroid syndrome is defined as the decrease of serum free triiodothyronine with normal free L-thyroxin and thyrotropin. Its appearance in patients with chronic heart failure is an indicator of severity. Exercise training through a wide variety of mechanisms reverses sick euthyroid syndrome (normalization of free triiodothyronine levels) and improves the ability to exercise. There is a connection during exercise among dyspnea, hyperventilation, fatigue, catecholamines, a decrease in the number and function of beta-blocker receptors, and elevation of serum free triiodothyronine. It is not known whether sick euthyroid syndrome contributes to the development of heart failure or is only an attendant syndrome.

  20. Sleep from an islamic perspective

    Directory of Open Access Journals (Sweden)

    Ahmed S BaHammam


    Full Text Available Sleep medicine is a relatively new scientific specialty. Sleep is an important topic in Islamic literature, and the Quran and Hadith discuss types of sleep, the importance of sleep, and good sleep practices. Islam considers sleep as one of the signs of the greatness of Allβh (God and encourages followers to explore this important sign. The Quran describes different types of sleep, and these correspond with sleep stages identified by modern science. The Quran discusses the beneficial effects of sleep and emphasizes the importance of maintaining a pattern of light and darkness. A mid-day nap is an important practice for Muslims, and the Prophet Muhammad peace be upon him (pbuh promoted naps as beneficial. In accordance with the practice and instructions of Muhammad (pbuh, Muslims have certain sleep habits and these sleep habits correspond to some of the sleep hygiene rules identified by modern science. Details during sleep include sleep position, like encouraging sleep on the right side and discouraging sleep in the prone position. Dream interpretation is an established science in the Islamic literature and Islamic scholars have made significant contributions to theories of dream interpretation. We suggest that sleep scientists examine religious literature in general and Islamic literature in particular, to understand the views, behaviors, and practices of ancient people about the sleep and sleep disorders. Such studies may help to answer some unresolved questions in sleep science or lead to new areas of inquiry.

  1. Sleep from an Islamic perspective. (United States)

    Bahammam, Ahmed S


    Sleep medicine is a relatively new scientific specialty. Sleep is an important topic in Islamic literature, and the Quran and Hadith discuss types of sleep, the importance of sleep, and good sleep practices. Islam considers sleep as one of the signs of the greatness of Allνh (God) and encourages followers to explore this important sign. The Quran describes different types of sleep, and these correspond with sleep stages identified by modern science. The Quran discusses the beneficial effects of sleep and emphasizes the importance of maintaining a pattern of light and darkness. A mid-day nap is an important practice for Muslims, and the Prophet Muhammad peace be upon him (pbuh) promoted naps as beneficial. In accordance with the practice and instructions of Muhammad (pbuh), Muslims have certain sleep habits and these sleep habits correspond to some of the sleep hygiene rules identified by modern science. Details during sleep include sleep position, like encouraging sleep on the right side and discouraging sleep in the prone position. Dream interpretation is an established science in the Islamic literature and Islamic scholars have made significant contributions to theories of dream interpretation. We suggest that sleep scientists examine religious literature in general and Islamic literature in particular, to understand the views, behaviors, and practices of ancient people about the sleep and sleep disorders. Such studies may help to answer some unresolved questions in sleep science or lead to new areas of inquiry.

  2. 0144 Sick leave patterns as predictors of disability pension or long-term sick leave

    DEFF Research Database (Denmark)

    Stapelfeldt, Christina; Vinther Nielsen, Claus; Trolle Andersen, Niels;


    OBJECTIVES: The public health care sector is challenged by high sick leave rates among home-care personnel. This group also has a high probability of being granted a disability pension. We studied whether a workplace-registered frequent short-term sick leave spell pattern was an early indicator...... of future disability pension or future long-term sick leave among eldercare workers. METHOD: 2774 employees' sick leave days were categorised: 0-2 and 3-17 short (1-7 days) spells, 2-13 mixed short and long (8+ days) spells, and long spells only. Disability pension and long-term sick leave were subsequently...... the pseudo values method adjusted for age, occupation and unfavourable work factors. RESULTS: A frequent short-term and a mixed sick leave pattern increased the RR of being granted a disability pension; the RR was 2.08 (95% CI: 1.00-4.35) and 2.61 (95% CI: 1.33-5.12). Inversely, the long-term sick leave...

  3. Cardiovascular physiology and sleep. (United States)

    Murali, Narayana S; Svatikova, Anna; Somers, Virend K


    Sleep is a natural periodic suspension of consciousness during which processes of rest and restoration occur. The cognitive, reparative and regenerative accompaniments of sleep appear to be essential for maintenance of health and homeostasis. This brief overview will examine the cardiovascular responses to normal and disordered sleep, and their physiologic and pathologic implications. In the past, sleep was believed to be a passive state. The tableau of sleep as it unfolds is anything but a passive process. The brain's activity is as complex as wakefulness, never "resting" during sleep. Following the demise of the 'passive theory of sleep' (the reticular activating system is fatigued during the waking day and hence becomes inactive), there arose the 'active theory of sleep' (sleep is due to an active general inhibition of the brain) (1). Hess demonstrated the active nature of sleep in cats, inducing "physiological sleep" with electrical stimulation of the diencephalon (2). Classical experiments of transection of the cat brainstem (3) at midpontine level inhibited sleep completely, implying that centers below this level were involved in the induction of sleep (1, 4). For the first time, measurement of sleep depth without awakening the sleeper using the electroencephalogram (EEG) was demonstrated in animals by Caton and in humans, by Berger (1). This was soon followed by discovery of the rapid eye movement sleep periods (REM) by Aserinski and Kleitman (5), demonstration of periodical sleep cycles and their association with REM sleep (6, 7). Multiple studies and steady discoveries (4) made polysomnography, with its ability to perform simultaneous whole night recordings of EEG, electromyogram (EMG), and electrooculogram (EOC), a major diagnostic tool in study of sleep disorders. This facility has been of further critical importance in allowing evaluation of the interaction between sleep and changes in hemodynamics and autonomic cardiovascular control. Consequently the

  4. A "Sleep 101" Program for College Students Improves Sleep Hygiene Knowledge and Reduces Maladaptive Beliefs about Sleep. (United States)

    Kloss, Jacqueline D; Nash, Christina O; Walsh, Colleen M; Culnan, Elizabeth; Horsey, Sarah; Sexton-Radek, Kathy


    Sensitizing young adults about sleep hygiene knowledge and helpful sleep attitudes may have the potential to instill long-lasting healthy sleep practices. Towards these ends, evaluation of psychoeducational program "Sleep 101" tailored to college students was undertaken. Following two weeks of sleep-log recordings, participants were randomly assigned to a Sleep 101 (experimental) condition or a sleep monitoring (control) condition. The Sleep 101 condition was comprised of two 90-minute workshops aimed to educate students about healthy sleep practices, helpful thoughts about sleep, and ways to improve sleep. The sleep monitoring group received a sleep hygiene handout and completed sleep logs for the study duration. Sleep 101 participants endorsed fewer maladaptive beliefs and attitudes about sleep, increased sleep hygiene knowledge, and reduced sleep onset latency compared to the sleep monitoring participants. Brief psychoeducational courses may be a cost-effective way to alleviate current, and/or prevent future, sleep problems in young adults.

  5. Sleep, Cognition and Dementia. (United States)

    Porter, Verna R; Buxton, William G; Avidan, Alon Y


    The older patient population is growing rapidly around the world and in the USA. Almost half of seniors over age 65 who live at home are dissatisfied with their sleep, and nearly two-thirds of those residing in nursing home facilities suffer from sleep disorders. Chronic and pervasive sleep complaints and disturbances are frequently associated with excessive daytime sleepiness and may result in impaired cognition, diminished intellect, poor memory, confusion, and psychomotor retardation all of which may be misinterpreted as dementia. The key sleep disorders impacting patients with dementia include insomnia, hypersomnolence, circadian rhythm misalignment, sleep disordered breathing, motor disturbances of sleep such as periodic leg movement disorder of sleep and restless leg syndrome, and parasomnias, mostly in the form of rapid eye movement (REM) sleep behavior disorder (RBD). RBD is a pre-clinical marker for a class of neurodegenerative diseases, the "synucleinopathies", and requires formal polysomnographic evaluation. Untreated sleep disorders may exacerbate cognitive and behavioral symptoms in patients with dementia and are a source of considerable stress for bed partners and family members. When left untreated, sleep disturbances may also increase the risk of injury at night, compromise health-related quality of life, and precipitate and accelerate social and economic burdens for caregivers.

  6. Sleep disturbances in adults with eczema are associated with impaired overall health: a US population-based study. (United States)

    Silverberg, Jonathan I; Garg, Nitin K; Paller, Amy S; Fishbein, Anna B; Zee, Phyllis C


    Sleep disturbances are associated with poor health outcomes in adults. However, little is known about the sleep disturbances that occur in adult eczema. We studied the association between adult eczema and sleep disturbance and their impact on overall health and health care utilization. We used the 2012 National Health Interview Survey, a cross-sectional questionnaire of 34,613 adults. Eczema was associated with higher odds of fatigue (odds ratio (95% confidence interval): 2.97 (2.65-3.34)), regular daytime sleepiness (2.66 (2.34-3.01)), and regular insomnia (2.36 (2.11-2.64)), even after controlling for sleep duration, history of allergic disease, sociodemographics, and body mass index. There were significant interactions between eczema and fatigue, sleepiness, and insomnia as predictors of poorer overall health status, number of sick days, and doctor visits, such that eczema and each of the sleep symptoms were associated with higher odds of poorer outcomes than either eczema or sleep symptoms alone. Latent class analysis was used and identified five classes of fatigue, sleep disturbances, and allergic disorders. Two classes had high probabilities of eczema: one with high probabilities of asthma, hay fever, food allergy, and multiple sleep symptoms and the other with intermediate probability of insomnia alone. Future studies are warranted to better characterize sleep loss in eczema and develop strategies for treatment and prevention.




    Delayed sleep phase syndrome (DSPS) is a circadian rhythm sleep disorder in which the timing of the sleep episode occurs later than desired and is associated with difficulty falling asleep, problems awakening on time (e.g., to meet work or school obligations), and daytime sleepiness. The phase relationship between the timing of sleep and endogenous circadian rhythms is critical to the initiation and maintenance of sleep, and significant alteration leads to impairment of sleep quality and dura...

  8. Association Between Sleep Hygiene and Sleep Quality in Medical Students



    The aim of this study was to determine whether subjective sleep quality was reduced in medical students, and whether demographics and sleep hygiene behaviors were associated with sleep quality. A Web-based survey was completed by 314 medical students, containing questions about demographics, sleep habits, exercise habits, caffeine, tobacco and alcohol use, and subjective sleep quality (using the Pittsburgh Sleep Quality Index). Correlation and regression analyses tested for associations among...

  9. Sleep Hygiene and Sleep Quality in Italian and American Adolescents



    This study investigated cross-cultural differences in adolescent sleep hygiene and sleep quality. Participants were 1348 students (655 males; 693 females) aged 12–17 years from public school systems in Rome, Italy (n = 776) and Southern Mississippi (n = 572). Participants completed the Adolescent Sleep-Wake Scale and the Adolescent Sleep Hygiene Scale. Reported sleep hygiene and sleep quality were significantly better for Italian than American adolescents. A moderate linear relationship was o...

  10. Inhibition of lipopolysaccharid-induced sickness behavior by a dry extract from the roots of Pelargonium sidoides (EPs 7630) in mice. (United States)

    Nöldner, M; Schötz, K


    The host response to infections comprise the synthesis and release of proinflammatory cytokines (e.g. IL-1ss, TNF-alpha, IL-6) which induce symptoms of sickness behavior characterised by anorexia, depressed activity, listlessness or malaise. In laboratory animals, sickness behavior can be induced by the administration of cytokines itself or by cytokine-inducers such as lipopolysaccharide (LPS), the active fragment of endotoxin from Gram-negative bacteria. Preparations from roots of Pelargonium sidoides have been traditionally used in South African folk medicine for the treatment of different diseases (e.g. diarrhea, dysmenorrhea, hepatic disorders and respiratory tract infections including tuberculosis). Today, aqueous ethanolic extracts of Pelargonium sidoides are marketed mainly for respiratory tract infections. We studied the effects of the extract EPs 7630 and different fractions separated by ultrafiltration in an animal model of sickness behavior. The results of this study demonstrate that the extract EPs 7630 and the high-molecular weight fraction (F3) alleviate the symptoms of sickness behavior.

  11. Sickness absence and psychosocial work conditions : a multilevel study

    NARCIS (Netherlands)

    Roelen, C.A.; Weites, S.H.; Koopmans, P.C.; van der Klink, J.J.; Groothoff, J.W.


    Background Psychosocial work conditions, particularly psychological job demands, are inconsistently associated with sickness absence rates. This might be the result of investigating the psychosocial work environment at the individual level, reflecting personal perceptions rather than actual demands.

  12. Psychosocial work conditions associated with sickness absence among hospital employees

    DEFF Research Database (Denmark)

    Suadicani, P; Olesen, K; Bonde, J P;


    BACKGROUND: Meaningfulness of the job, collaboration among colleagues, trustworthiness of the closest superior and bullying have previously been shown to be major covariates of intention to quit the job. AIMS: To test if these elements of the psychosocial work environment are also the most...... essential covariates of sickness absence. METHODS: A cross-sectional questionnaire study of hospital employees which sought information on elements of the psychosocial work environment, general health status, life style, age, gender and profession. Data on sickness absence were obtained from the employer...... high sickness absence and 29 psychosocial work elements were analysed, adjusting for relevant confounders. Following multiple logistic regression analysis, three elements had an independent statistically significant association with high sickness absence: no exposure to bullying (odds ratio (95...

  13. Diclectin for morning sickness: Long-term neurodevelopment. (United States)

    Nulman, Irena; Koren, Gideon


    Question A pregnant patient recently asked me whether using Diclectin for morning sickness might affect the development of her child. Answer Our recent large study does show such a trend, although the differences are not necessarily clinically significant.

  14. Acute Mountain Sickness and Hemoconcentration in Next Generation Spacecraft (United States)

    Conkin, Johnny


    This slide presentation reviews the threat astronauts face from acute mountain sickness (AMS). It includes information about the symptoms of AMS, the potential threat to astronauts, and future efforts to mitigate the AMS threat.

  15. Pathology of sleep, hormones and depression

    NARCIS (Netherlands)

    Steiger, A.; Dresler, M.; Kluge, M.; Schussler, P.


    In patients with depression, characteristic changes of sleep electroencephalogram and nocturnal hormone secretion occur including rapid eye movement (REM) sleep disinhibition, reduced non-REM sleep and impaired sleep continuity. Neuropeptides are common regulators of the sleep electroencephalogram (

  16. American Academy of Sleep Medicine (United States)

    ... the field of sleep medicine. Join the American Academy of Sleep Medicine to further your career and ... MD Sept. 21 - As president of the American Academy of Sleep Medicine, I am keenly aware of ...

  17. Common Sleep Problems (For Teens) (United States)

    ... sleep when a person has the most vivid dreams. Why Do Teens Have Trouble Sleeping? Research shows ... will look at your overall health and sleep habits. In addition to doing a physical examination, the ...

  18. Common Sleep Problems (For Teens) (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Common Sleep Problems KidsHealth > For Teens > Common Sleep Problems Print ... have emotional problems, like depression. What Happens During Sleep? You don't notice it, of course, but ...

  19. Sleep Changes in Older Adults (United States)

    ... of the chemicals and hormones that help us sleep well (growth hormone and melatonin).Some lifestyle habits (such as smoking and drinking alcohol or caffeinated drinks) can cause sleep problems.Sleep problems may be caused by illness, ...

  20. Iii. Sleep assessment methods. (United States)

    Sadeh, Avi


    Sleep is a complex phenomenon that could be understood and assessed at many levels. Sleep could be described at the behavioral level (relative lack of movements and awareness and responsiveness) and at the brain level (based on EEG activity). Sleep could be characterized by its duration, by its distribution during the 24-hr day period, and by its quality (e.g., consolidated versus fragmented). Different methods have been developed to assess various aspects of sleep. This chapter covers the most established and common methods used to assess sleep in infants and children. These methods include polysomnography, videosomnography, actigraphy, direct observations, sleep diaries, and questionnaires. The advantages and disadvantages of each method are highlighted.

  1. Sleep in cluster headache

    DEFF Research Database (Denmark)

    Barloese, M C J; Jennum, P J; Lund, N T


    BACKGROUND AND PURPOSE: Cluster headache (CH) is a primary headache disorder characterized by severe attacks of unilateral pain following a chronobiological pattern. There is a close connection with sleep as most attacks occur during sleep. Hypothalamic involvement and a particular association...... with rapid eye movement (REM) sleep have been suggested. Sleep in a large, well-characterized population of CH patients was investigated. METHODS: Polysomnography (PSG) was performed on two nights in 40 CH patients during active bout and one night in 25 age, sex and body mass index matched controls...... in hospital. Macrostructure and other features of sleep were analyzed and related to phenotype. Clinical headache characterization was obtained by semi-structured interview. RESULTS: Ninety-nine nights of PSG were analyzed. Findings included a reduced percentage of REM sleep (17.3% vs. 23.0%, P = 0...

  2. A Study of Motion Sickness: Mathematical Modeling and Data Analysis (United States)


    levels of motion sick- ness experienced by a test subject during the course of an experiment (21:97; 25:59; 27:84). In 1987, Drylie, Fix, and Gaudreault cedures. Drylie and Gaudreault reported additional conclusions concerning motion sickness trends (11; 17). Fix developed a new equation for...and Gaudreault also noted low frequency EEG signals in the 0.1 Hz range (17:28). However, only one of their subjects had EEG signals with an amplitude

  3. Focus Group Study Exploring Factors Related to Frequent Sickness Absence.

    Directory of Open Access Journals (Sweden)

    Annette Notenbomer

    Full Text Available Research investigating frequent sickness absence (3 or more episodes per year is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves.We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R model as theoretical framework.Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills were regarded as solutions to reduce frequent sickness absence.The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

  4. A Model for the Analysis of Sick Leave in Sweden


    David Edgerton; Curt Wells


    This paper addresses the question of how to model individual behavior in the face of changes in the set of rules that govern the social welfare system in Sweden. To this end, the Swedish sickness insurance provides an excellent study object, since the system has often been changed during the past decade. The question of employee compensation for sick leave is one the more widely discussed aspects of Swedish social welfare legislation, and it is therefore of interest to examine how individuals...

  5. Is Physics Sick? [In Praise of Classical Physics

    CERN Document Server

    Ghassib, Hisham


    In this paper, it is argued that theoretical physics is more akin to an organism than to a rigid structure.It is in this sense that the epithet, "sick", applies to it. It is argued that classical physics is a model of a healthy science, and the degree of sickness of modern physics is measured accordingly. The malady is located in the relationship between mathematics and physical meaning in physical theory.

  6. Biological Rhythms Modelisation of Vigilance and Sleep in Microgravity State with COSINOR and Volterra's Kernels Methods (United States)

    Gaudeua de Gerlicz, C.; Golding, J. G.; Bobola, Ph.; Moutarde, C.; Naji, S.


    The spaceflight under microgravity cause basically biological and physiological imbalance in human being. Lot of study has been yet release on this topic especially about sleep disturbances and on the circadian rhythms (alternation vigilance-sleep, body, temperature...). Factors like space motion sickness, noise, or excitement can cause severe sleep disturbances. For a stay of longer than four months in space, gradual increases in the planned duration of sleep were reported. [1] The average sleep in orbit was more than 1.5 hours shorter than the during control periods on earth, where sleep averaged 7.9 hours. [2] Alertness and calmness were unregistered yield clear circadian pattern of 24h but with a phase delay of 4h.The calmness showed a biphasic component (12h) mean sleep duration was 6.4 structured by 3-5 non REM/REM cycles. Modelisations of neurophysiologic mechanisms of stress and interactions between various physiological and psychological variables of rhythms have can be yet release with the COSINOR method. [3

  7. Perspective on Sleep and Aging


    Monjan, Andrew A.


    There is a strong body of data directly interrelating sleep problems with mood disorders. There is a growing data base directly associating sleep disorders with attention and memory problems. Motor disorders, especially involving the dopaminergic system, may produce sleep problems, including a possible association between disordered sleep and nocturnal falls. Sleep disorders may be causal conditions for metabolic diseases and increased risk for morbidity and mortality. Sleep and health ar...

  8. Perspective on Sleep and Aging


    Monjan, Andrew A.


    There is a strong body of data directly interrelating sleep problems with mood disorders. There is a growing data base directly associating sleep disorders with attention and memory problems. Motor disorders, especially involving the dopaminergic system, may produce sleep problems, including a possible association between disordered sleep and nocturnal falls. Sleep disorders may be causal conditions for metabolic diseases and increased risk for morbidity and mortality. Sleep and health are di...

  9. Sleep Deprivation and Neurobehavioral Dynamics


    Basner, Mathias; Rao, Hengyi; Goel, Namni; David F. Dinges


    Lifestyles involving sleep deprivation are common, despite mounting evidence that both acute total sleep deprivation and chronically restricted sleep degrade neurobehavioral functions associated with arousal, attention, memory and state stability. Current research suggests dynamic differences in the way the central nervous system responds to acute versus chronic sleep restriction, which is reflected in new models of sleep-wake regulation. Chronic sleep restriction likely induces long-term neu...

  10. Stress, Sleep, and Allergy


    Jernelöv, Susanna


    Allergic diseases have recently increased dramatically in the western world, now affecting about 30% of the Swedish population. The reasons for this increase are unclear, but some of the suspects are behavioral factors, such as stress and sleep. Problems with stress are also common today, and stress may change the set-points for the functioning of the body, for instance in the immune system. Sleep, on the other hand, is important for recuperation, and disturbed sleep acts a ...

  11. Isolated sleep paralysis


    Sawant, Neena S.; Parkar, Shubhangi R.; Tambe, Ravindra


    Sleep paralysis (SP) is a cardinal symptom of narcolepsy. However, little is available in the literature about isolated sleep paralysis. This report discusses the case of a patient with isolated sleep paralysis who progressed from mild to severe SP over 8 years. He also restarted drinking alcohol to be able to fall asleep and allay his anxiety symptoms. The patient was taught relaxation techniques and he showed complete remission of the symptoms of SP on follow up after 8 months.

  12. A New Measure of Decompression Sickness in the Rat

    Directory of Open Access Journals (Sweden)

    Peter Buzzacott


    Full Text Available In this study we assessed the reliability of a tilting-board grip score as a measure of decompression sickness in rats. In experiments using a hyperbaric compression/decompression protocol, rats were observed for signs of decompression sickness and their grip strength measured on a tilting particle board hinged to a metal frame. Angles at which rats lost grip were converted to gravitational vectors. Decreased mean grip scores following decompression were fitted to a logistic regression model with strain, age, and weight. Decrease in grip score was significantly associated with observed decompression sickness (P=0.0036. The log odds ratio for decompression sickness = 1.40 (decrease in grip score. In rats with no decrease in mean grip score there was a 50% probability of decompression sickness (pDCS. This increased steadily with decreases in mean grip score. A decrease of 0.3 had a 60% pDCS, a decrease of 0.6 had a 70% pDCS, and a decrease of 2.1 had a 95% pDCS. The tilting board grip score is a reliable measure of the probability of decompression sickness.

  13. Nonepileptic paroxysmal sleep disorders. (United States)

    Frenette, Eric; Guilleminault, Christian


    Events occurring during nighttime sleep in children can be easily mislabeled, as witnesses are usually not immediately available. Even when observers are present, description of the events can be sketchy, as these individuals are frequently aroused from their own sleep. Errors of perception are thus common and can lead to diagnosis of epilepsy where other sleep-related conditions are present, sometimes initiating unnecessary therapeutic interventions, especially with antiepileptic drugs. Often not acknowledged, paroxysmal nonepileptic behavioral and motor episodes in sleep are encountered much more frequently than their epileptic counterpart. The International Classification of Sleep Disorders (ICSD) 2nd edition displays an extensive list of such conditions that can be readily mistaken for epilepsy. The most prevalent ones are reviewed, such as nonrapid eye movement (NREM) sleep parasomnias, comprised of sleepwalking, confusional arousals and sleep terrors, periodic leg movements of sleep, repetitive movement disorders, benign neonatal myoclonus, and sleep starts. Apnea of prematurity is also briefly reviewed. Specific issues regarding management of these selected disorders, both for diagnostic consideration and for therapeutic intervention, are addressed.

  14. Association between sleep hygiene and sleep quality in medical students. (United States)

    Brick, Cameron A; Seely, Darbi L; Palermo, Tonya M


    The aim of this study was to determine whether subjective sleep quality was reduced in medical students, and whether demographics and sleep hygiene behaviors were associated with sleep quality. A Web-based survey was completed by 314 medical students, containing questions about demographics, sleep habits, exercise habits, caffeine, tobacco and alcohol use, and subjective sleep quality (using the Pittsburgh Sleep Quality Index). Correlation and regression analyses tested for associations among demographics, sleep hygiene behaviors, and sleep quality. As hypothesized, medical students' sleep quality was significantly worse than a healthy adult normative sample (t = 5.13, p sleep quality in medical students was predicted by several demographic and sleep hygiene variables, and future research directions are proposed.

  15. Countermeasures to Neurobehavioral Deficits from Cumulative Partial Sleep Deprivation During Space Flight (United States)

    Dinges, David F.


    This project is concerned with identifying ways to prevent neurobehavioral and physical deterioration due to inadequate sleep in astronauts during long-duration manned space flight. The performance capability of astronauts during extended-duration space flight depends heavily on achieving recovery through adequate sleep. Even with appropriate circadian alignment, sleep loss can erode fundamental elements of human performance capability including vigilance, cognitive speed and accuracy, working memory, reaction time, and physiological alertness. Adequate sleep is essential during manned space flight not only to ensure high levels of safe and effective human performance, but also as a basic regulatory biology critical to healthy human functioning. There is now extensive objective evidence that astronaut sleep is frequently restricted in space flight to averages between 4 hr and 6.5 hr/day. Chronic sleep restriction during manned space flight can occur in response to endogenous disturbances of sleep (motion sickness, stress, circadian rhythms), environmental disruptions of sleep (noise, temperature, light), and curtailment of sleep due to the work demands and other activities that accompany extended space flight operations. The mechanism through which this risk emerges is the development of cumulative homeostatic pressure for sleep across consecutive days of inadequate sleep. Research has shown that the physiological sleepiness and performance deficits engendered by sleep debt can progressively worsen (i.e., accumulate) over consecutive days of sleep restriction, and that sleep limited to levels commonly experienced by astronauts (i.e., 4 - 6 hr per night) for as little as 1 week, can result in increased lapses of attention, degradation of response times, deficits in complex problem solving, reduced learning, mood disturbance, disruption of essential neuroendocrine, metabolic, and neuroimmune responses, and in some vulnerable persons, the emergence of uncontrolled

  16. Does self-efficacy predict return-to-work after sickness absence? A prospective study among 930 employees with sickness absence for three weeks or more

    DEFF Research Database (Denmark)

    Labriola, Merete; Lund, Thomas; Christensen, Karl B;


    AIM: To compare levels of self-efficacy among the general working population and employees with sickness absence from work, and to examine if general self-efficacy measured before occurrence of sickness absence predicted subsequent onset of sickness absence and Return-to-Work. METHODS: The study...

  17. Infant salt preference and mother's morning sickness. (United States)

    Crystal, S R; Bernstein, I L


    Evidence for an association between early pregnancy sickness and offspring salt (NaCl) preference has been obtained from studying offspring as young adults. To determine whether effects on NaCl preference are expressed in infancy, the present study examined 16-week-old infants whose mothers reported either little or no vomiting (N = 15) or frequent moderate to severe vomiting (N = 14) during the first 14 weeks of their pregnancy. The infants' oral-motor facial reactions to each solution and their relative intakes of distilled water and 0.1m and 0.2m NaCl were used as measures of preference. Infants of mothers who reported no or mild symptoms had a significantly lower relative intake of salt solutions than infants whose mothers reported moderate to severe symptoms (p < 0.01). The former infants also showed a greater number of aversive facial responses when given 0.2m NaCl (p < 0.05). Taken together, these findings support the hypothesis that maternal dehydration, induced by moderate to severe vomiting during pregnancy, can lead to enhanced salt preference in offspring. They also provide a potential explanation for some of the variability encountered when human infants are tested for their salt preference.

  18. Occupational exposures and sick leave during pregnancy

    DEFF Research Database (Denmark)

    Hansen, Mette Lausten; Thulstrup, Ane Marie; Juhl, Mette


    OBJECTIVE: This study aimed to investigate associations between work postures, lifting at work, shift work, work hours, and job strain and the risk of sick leave during pregnancy from 10-29 completed pregnancy weeks in a large cohort of Danish pregnant women. METHODS: Data from 51 874 pregnancies...... in the Danish National Birth Cohort collected between 1996-2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on telephone interviews. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression analysis, using time of first.......73-2.09, HRnight 1.52, 95% CI 1.15-2.01), monthly night shifts HRtrend 1.12, 95% CI 1.11-1.14, increasing weekly work hours HRtrend 0.93, 95% CI 0.91-0.95 and high job strain HR 1.52, 95% CI 1.42-1.63. Some exposures influenced HR in either a positive or negative time-dependent way. CONCLUSION: Our results support...

  19. Chronic Mountain Sickness-Phobrang Type

    Directory of Open Access Journals (Sweden)

    C. S. Nath


    Full Text Available Clinical0 features of 27 cases of Chronic Mountain Sickness (CMS from the Himalayas are reported. They are compared with 75 native highlanders (NH. All CMS patients were immigrants to high altitude. Mean duration of stay at high altitude was seven years. Mean values for haematocrit and haemoglobin were 80% and 23 G% respectively for the CMS group and 40% and 17.9 G% respectively for the native highlande group. Mean QRS axis in the former was +118 and in the latter +76. Incidence and quantum of protienuria were significantly higher in the CMS group. Cardiac catheteri -sation studies done in eight CMS cases showed elevated Pulmonary Artery (PA pressures even after a mean of 14.2 days at sea level. The disease which has four diagnostic elements-hypoxemia and polycythemia, pulmonary hypertension, right ventricular enlargement and nephropathy with dense proteinuria-is a variant of 'Monge's Disease' and a name CMS Phobrang Type is suggested, along with a new approach to clinical classification which may help in diagnosis before cor pulmonale sets in. Limited therapeutic trials conducted at highaltitude seem to indicate that yogic deep breathing exercises, low-dose aspirin and diamox may be beneficial in the prevention and therapy of CMS Phobrang Type at high  altitude.

  20. To sleep or not to sleep: The ecology of sleep in artificial organisms


    Nunn Charles L; McNamara Patrick; Acerbi Alberto


    Abstract Background All animals thus far studied sleep, but little is known about the ecological factors that generate differences in sleep characteristics across species, such as total sleep duration or division of sleep into multiple bouts across the 24-hour period (i.e., monophasic or polyphasic sleep activity). Here we address these questions using an evolutionary agent-based model. The model is spatially explicit, with food and sleep sites distributed in two clusters on the landscape. Ag...

  1. Unihemispheric sleep and asymmetrical sleep: behavioral, neurophysiological, and functional perspectives

    Directory of Open Access Journals (Sweden)

    Mascetti GG


    Full Text Available Gian Gastone Mascetti Department of General Psychology, University of Padova, Padova, Italy Abstract: Sleep is a behavior characterized by a typical body posture, both eyes' closure, raised sensory threshold, distinctive electrographic signs, and a marked decrease of motor activity. In addition, sleep is a periodically necessary behavior and therefore, in the majority of animals, it involves the whole brain and body. However, certain marine mammals and species of birds show a different sleep behavior, in which one cerebral hemisphere sleeps while the other is awake. In dolphins, eared seals, and manatees, unihemispheric sleep allows them to have the benefits of sleep, breathing, thermoregulation, and vigilance. In birds, antipredation vigilance is the main function of unihemispheric sleep, but in domestic chicks, it is also associated with brain lateralization or dominance in the control of behavior. Compared to bihemispheric sleep, unihemispheric sleep would mean a reduction of the time spent sleeping and of the associated recovery processes. However, the behavior and health of aquatic mammals and birds does not seem at all impaired by the reduction of sleep. The neural mechanisms of unihemispheric sleep are unknown, but assuming that the neural structures involved in sleep in cetaceans, seals, and birds are similar to those of terrestrial mammals, it is suggested that they involve the interaction of structures of the hypothalamus, basal forebrain, and brain stem. The neural mechanisms promoting wakefulness dominate one side of the brain, while those promoting sleep predominates the other side. For cetaceans, unihemispheric sleep is the only way to sleep, while in seals and birds, unihemispheric sleep events are intermingled with bihemispheric and rapid eye movement sleep events. Electroencephalogram hemispheric asymmetries are also reported during bihemispheric sleep, at awakening, and at sleep onset, as well as being associated with a use

  2. The effect of part-time sick leave for employees with mental disorders

    DEFF Research Database (Denmark)

    Høgelund, Jan; Holm, Anders

    Previous studies find that part-time sick-listing it is an effective instrument for reducing sick leave durations for employees with musculoskeletal disorders and for sick-listed employees in general. This paper provides new evidence by studying whether the Danish part-time sick leave programme...... hours for employees with physical disorders. In contrast, we find that part-time sick-listing does not reduce durations for employees with mental disorders. The analyses also illustrate the importance of adjusting for unobserved differences between part-time sick-listed and full-time sick...... the employee is able to work regular hours. We use combined survey and register data about 226 long-term sick-listed employees with mental disorders and 638 employees with physical disorders. Our analyses show that part-time sick-listing significantly reduces the duration until returning to regular working...

  3. African Trypanosomiasis Detection using Dempster-Shafer Theory

    CERN Document Server

    Maseleno, Andino


    World Health Organization reports that African Trypanosomiasis affects mostly poor populations living in remote rural areas of Africa that can be fatal if properly not treated. This paper presents Dempster-Shafer Theory for the detection of African trypanosomiasis. Sustainable elimination of African trypanosomiasis as a public-health problem is feasible and requires continuous efforts and innovative approaches. In this research, we implement Dempster-Shafer theory for detecting African trypanosomiasis and displaying the result of detection process. We describe eleven symptoms as major symptoms which include fever, red urine, skin rash, paralysis, headache, bleeding around the bite, joint the paint, swollen lymph nodes, sleep disturbances, meningitis and arthritis. Dempster-Shafer theory to quantify the degree of belief, our approach uses Dempster-Shafer theory to combine beliefs under conditions of uncertainty and ignorance, and allows quantitative measurement of the belief and plausibility in our identificat...

  4. Unihemispheric sleep and asymmetrical sleep: behavioral, neurophysiological, and functional perspectives (United States)

    Mascetti, Gian Gastone


    Sleep is a behavior characterized by a typical body posture, both eyes’ closure, raised sensory threshold, distinctive electrographic signs, and a marked decrease of motor activity. In addition, sleep is a periodically necessary behavior and therefore, in the majority of animals, it involves the whole brain and body. However, certain marine mammals and species of birds show a different sleep behavior, in which one cerebral hemisphere sleeps while the other is awake. In dolphins, eared seals, and manatees, unihemispheric sleep allows them to have the benefits of sleep, breathing, thermoregulation, and vigilance. In birds, antipredation vigilance is the main function of unihemispheric sleep, but in domestic chicks, it is also associated with brain lateralization or dominance in the control of behavior. Compared to bihemispheric sleep, unihemispheric sleep would mean a reduction of the time spent sleeping and of the associated recovery processes. However, the behavior and health of aquatic mammals and birds does not seem at all impaired by the reduction of sleep. The neural mechanisms of unihemispheric sleep are unknown, but assuming that the neural structures involved in sleep in cetaceans, seals, and birds are similar to those of terrestrial mammals, it is suggested that they involve the interaction of structures of the hypothalamus, basal forebrain, and brain stem. The neural mechanisms promoting wakefulness dominate one side of the brain, while those promoting sleep predominates the other side. For cetaceans, unihemispheric sleep is the only way to sleep, while in seals and birds, unihemispheric sleep events are intermingled with bihemispheric and rapid eye movement sleep events. Electroencephalogram hemispheric asymmetries are also reported during bihemispheric sleep, at awakening, and at sleep onset, as well as being associated with a use-dependent process (local sleep). PMID:27471418

  5. BDNF in sleep, insomnia, and sleep deprivation. (United States)

    Schmitt, Karen; Holsboer-Trachsler, Edith; Eckert, Anne


    The protein brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family of growth factors involved in plasticity of neurons in several brain regions. There are numerous evidence that BDNF expression is decreased by experiencing psychological stress and that, accordingly, a lack of neurotrophic support causes major depression. Furthermore, disruption in sleep homeostatic processes results in higher stress vulnerability and is often associated with stress-related mental disorders. Recently, we reported, for the first time, a relationship between BDNF and insomnia and sleep deprivation (SD). Using a biphasic stress model as explanation approach, we discuss here the hypothesis that chronic stress might induce a deregulation of the hypothalamic-pituitary-adrenal system. In the long-term it leads to sleep disturbance and depression as well as decreased BDNF levels, whereas acute stress like SD can be used as therapeutic intervention in some insomniac or depressed patients as compensatory process to normalize BDNF levels. Indeed, partial SD (PSD) induced a fast increase in BDNF serum levels within hours after PSD which is similar to effects seen after ketamine infusion, another fast-acting antidepressant intervention, while traditional antidepressants are characterized by a major delay until treatment response as well as delayed BDNF level increase. Key messages Brain-derived neurotrophic factor (BDNF) plays a key role in the pathophysiology of stress-related mood disorders. The interplay of stress and sleep impacts on BDNF level. Partial sleep deprivation (PSD) shows a fast action on BDNF level increase.

  6. [The NHG guideline 'Sleep problems and sleeping pills'

    NARCIS (Netherlands)

    Damen-van Beek, Z.; Lucassen, P.L.; Gorgels, W.J.M.J.; Smelt, A.F.; Knuistingh Neven, A.; Bouma, M.


    - The Dutch College of General Practitioners' (NHG) guideline 'Sleep problems and sleeping pills' provides recommendations for the diagnosis and treatment of the most prevalent sleep problems and for the management of chronic users of sleeping pills.- The preferred approach for sleeplessness is not

  7. Testosterone treatment diminishes sickness behavior in male songbirds. (United States)

    Ashley, Noah T; Hays, Quentin R; Bentley, George E; Wingfield, John C


    Males of many vertebrate species are typically more prone to disease and infection than female conspecifics, and this sexual difference is partially influenced by the immunosuppressive properties of testosterone (T) in males. T-induced immunosuppression has traditionally been viewed as a pleiotropic handicap, rather than an adaptation. Recently, it has been hypothesized that suppression of sickness behavior, or the symptoms of infection, may have adaptive value if sickness interferes with the expression of T-mediated behaviors important for male reproductive success. We conduct a classic hormone replacement experiment to examine if T suppresses sickness behavior in a seasonally-breeding songbird, Gambel's white-crowned sparrow (Zonotrichia leucophrys gambelii). Triggered experimentally by bacterial lipopolysaccharide (LPS), sickness behavior includes decreased activity, anorexia, and weight loss. Gonadectomized (GDX) males that were treated with silastic implants filled with T exhibited suppression of behavioral and physiological responses to LPS compared to GDX and sham-GDX controls given empty implants. Sickness responses of control groups were statistically indistinguishable. T-implanted birds had significantly higher plasma T than control groups and levels were within the range associated with aggressive interactions during male-to-male contests. These findings imply that suppression of sickness behavior could occur when T is elevated to socially-modulated levels. Alternatively, it is possible that this suppressive effect is mediated through a stress-induced mechanism, as corticosterone levels were elevated in T-implanted subjects compared to controls. We propose that males wounded and infected during contests may gain a brief selective advantage by suppressing sickness responses that would otherwise impair competitive performance. The cost of immunosuppression would be manifested in males through an increased susceptibility to disease, which is presumably

  8. Brain Basics: Understanding Sleep (United States)

    ... their dreams – a rare, dangerous problem called REM sleep behavior disorder . A person dreaming about a ball game, ... bed awake : If you can't get to sleep, don't just lie in bed. Do something else, like reading, watching television, or listening to music, until you feel tired. ...

  9. Sleep, Exercise, and Nutrition. (United States)

    Harrelson, Orvis A.; And Others

    The first part of this booklet concerns why sleep and exercise are necessary. It includes a discussion of what occurs during sleep and what dreams are. It also deals with the benefits of exercise, fatigue, posture, and the correlation between exercise and personality. The second part concerns nutrition and the importance of food. This part covers…

  10. Sleep Terrors in Twins

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available In an attempt to clarify the genetic and environmental causes of sleep terrors in childhood, reasearchers in Canada followed 390 pairs of monozygotic and dizygotic twins by assessing the frequency of sleep terrors at 18 and 30 months of age using a questionnaire administered to the biological mothers.

  11. Obstructive sleep apnea therapy

    NARCIS (Netherlands)

    Hoekema, A.; Stegenga, B.; Wijkstra, P. J.; van der Hoeven, J. H.; Meinesz, A. F.; de Bont, L. G. M.


    In clinical practice, oral appliances are used primarily for obstructive sleep apnea patients who do not respond to continuous positive airway pressure (CPAP) therapy. We hypothesized that an oral appliance is not inferior to CPAP in treating obstructive sleep apnea effectively. We randomly assigned

  12. Adenosine and sleep

    Energy Technology Data Exchange (ETDEWEB)

    Yanik, G.M. Jr.


    Behavioral and biochemical approaches have been used to determine the relative contribution of endogenous adenosine and adenosine receptors to the sleep-wake cycle in the rat. Adenosine concentrations in specific areas of the rat brain were not affected by 24 hours of total sleep deprivation, or by 24 or 48 hours of REM sleep deprivation. In order to assess the effect of REM sleep deprivation on adenosine A/sub 1/ receptors, /sup 3/H-L-PIA binding was measured. The Bmax values for /sup 3/H-L-PIA binding to membrane preparations of the cortices and corpus striata from 48 hour REM sleep-deprived animals were increased 14.8% and 23%, respectively. These increases were not maintained following the cessation of sleep deprivation and recovered within 2 hours. The results of a 96 hour REM deprivation experiment were similar to those of the 48 hour REM sleep deprivation experiment. However, these increases were not evident in similar structures taken from stress control animals, and conclusively demonstrated that the changes in /sup 3/H-L-PIA binding resulted from REM sleep deprivation and not from stress.

  13. Stress, arousal, and sleep

    NARCIS (Netherlands)

    Sanford, Larry D.; Suchecki, Deborah; Meerlo, Peter; Meerlo, Peter; Benca, Ruth M.; Abel, Ted


    Stress is considered to be an important cause of disrupted sleep and insomnia. However, controlled and experimental studies in rodents indicate that effects of stress on sleep-wake regulation are complex and may strongly depend on the nature of the stressor. While most stressors are associated with

  14. Sleep deprivation and depression

    NARCIS (Netherlands)

    Elsenga, Simon


    The association between depression and sleep disturbances is perhaps as old as makind. In view of the longstanding experience with this association it is amazing that only some 20 years ago, a few depressed patients attracted attention to the fact that Total Sleep Deprivation (TSD) had antidepressan

  15. Social and behavioral determinants of perceived insufficient sleep: analysis of the behavioral risk factor surveillance system

    Directory of Open Access Journals (Sweden)

    Michael A Grandner


    Full Text Available Background: Insufficient sleep is associated with cardiometabolic disease and poor health. However, few studies have assessed its determinants in a nationally-representative sample. Methods: Data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS was used (N=323,047 adults. Insufficient sleep was assessed as insufficient rest/sleep over 30 days. This was evaluated relative to sociodemographics (age, sex, race/ethnicity, marital status, region, socioeconomics (education, income, employment, insurance, health behaviors (diet, exercise, smoking, alcohol, and health/functioning (emotional support, BMI, mental/physical health. Results: Overall, insufficient sleep was associated with being female, White or Black/African-American, unemployed, without health insurance, and not married; decreased age, income, education, physical activity; worse diet and overall health; and increased household size, alcohol, and smoking. Conclusion: These factors should be considered risk factors for insufficient sleep.

  16. Total sleep deprivation study in delayed sleep-phase syndrome

    Directory of Open Access Journals (Sweden)

    Md Dilshad Manzar


    Full Text Available Delayed sleep-phase syndrome (DSPS is characterized by delayed sleep onset against the desired clock time. It often presents with symptoms of sleep-onset insomnia or difficulty in awakening at the desired time. We report the finding of sleep studies after 24 h total sleep deprivation (TSD in a 28-year-old DSPS male patient. He had characteristics of mild chronic DSPS, which may have been precipitated by his frequent night shift assignments. The TSD improved the patients sleep latency and efficiency but all other sleep variables showed marked differences.

  17. Sleep debt and obesity. (United States)

    Bayon, Virginie; Leger, Damien; Gomez-Merino, Danielle; Vecchierini, Marie-Françoise; Chennaoui, Mounir


    Short sleep duration has been shown to be associated with elevated body mass index (BMI) in many epidemiological studies. Several pathways could link sleep deprivation to weight gain and obesity, including increased food intake, decreased energy expenditure, and changes in levels of appetite-regulating hormones, such as leptin and ghrelin. A relatively new factor that is contributing to sleep deprivation is the use of multimedia (e.g. television viewing, computer, and internet), which may aggravate sedentary behavior and increase caloric intake. In addition, shift-work, long working hours, and increased time commuting to and from work have also been hypothesized to favor weight gain and obesity-related metabolic disorders, because of their strong link to shorter sleep times. This article reviews the epidemiological, biological, and behavioral evidence linking sleep debt and obesity.

  18. Circadian Rhythm Sleep Disorders

    Directory of Open Access Journals (Sweden)

    Erhan Akinci


    Full Text Available The circadian rhythm sleep disorders define the clinical conditions where sleep and ndash;wake rhythm is disrupted despite optimum environmental and social conditions. They occur as a result of the changes in endogenous circadian hours or non-compatibility of environmental factors or social life with endogenous circadian rhythm. The sleep and ndash;wake rhythm is disrupted continuously or in repeating phases depending on lack of balance between internal and external cycles. This condition leads to functional impairments which cause insomnia, excessive sleepiness or both in people. Application of detailed sleep anamnesis and sleep diary with actigraphy record, if possible, will be sufficient for diagnosis. The treatment aims to align endogenous circadian rhythm with environmental conditions. The purpose of this article is to review pathology, clinical characteristics, diagnosis and treatment of circadian rhythm disorder. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 178-189

  19. Decompression sickness following breath-hold diving. (United States)

    Schipke, J D; Gams, E; Kallweit, Oliver


    Despite convincing evidence of a relationship between breath-hold diving and decompression sickness (DCS), the causal connection is only slowly being accepted. Only the more recent textbooks have acknowledged the risks of repetitive breath-hold diving. We compare four groups of breath-hold divers: (1) Japanese and Korean amas and other divers from the Pacific area, (2) instructors at naval training facilities, (3) spear fishers, and (4) free-dive athletes. While the number of amas is likely decreasing, and Scandinavian Navy training facilities recorded only a few accidents, the number of spear fishers suffering accidents is on the rise, in particular during championships or using scooters. Finally, national and international associations (e.g., International Association of Free Drives [IAFD] or Association Internationale pour Le Developpment De L'Apnee [AIDA]) promote free-diving championships including deep diving categories such as constant weight, variable weight, and no limit. A number of free-diving athletes, training for or participating in competitions, are increasingly accident prone as the world record is presently set at a depth of 171 m. This review presents data found after searching Medline and ISI Web of Science and using appropriate Internet search engines (e.g., Google). We report some 90 cases in which DCS occurred after repetitive breath-hold dives. Even today, the risk of suffering from DCS after repetitive breath-hold diving is often not acknowledged. We strongly suggest that breath-hold divers and their advisors and physicians be made aware of the possibility of DCS and of the appropriate therapeutic measures to be taken when DCS is suspected. Because the risk of suffering from DCS increases depending on depth, bottom time, rate of ascent, and duration of surface intervals, some approaches to assess the risks are presented. Regrettably, none of these approaches is widely accepted. We propose therefore the development of easily manageable

  20. Speech motor control and acute mountain sickness (United States)

    Cymerman, Allen; Lieberman, Philip; Hochstadt, Jesse; Rock, Paul B.; Butterfield, Gail E.; Moore, Lorna G.


    BACKGROUND: An objective method that accurately quantifies the severity of Acute Mountain Sickness (AMS) symptoms is needed to enable more reliable evaluation of altitude acclimatization and testing of potentially beneficial interventions. HYPOTHESIS: Changes in human articulation, as quantified by timed variations in acoustic waveforms of specific spoken words (voice onset time; VOT), are correlated with the severity of AMS. METHODS: Fifteen volunteers were exposed to a simulated altitude of 4300 m (446 mm Hg) in a hypobaric chamber for 48 h. Speech motor control was determined from digitally recorded and analyzed timing patterns of 30 different monosyllabic words characterized as voiced and unvoiced, and as labial, alveolar, or velar. The Environmental Symptoms Questionnaire (ESQ) was used to assess AMS. RESULTS: Significant AMS symptoms occurred after 4 h, peaked at 16 h, and returned toward baseline after 48 h. Labial VOTs were shorter after 4 and 39 h of exposure; velar VOTs were altered only after 4 h; and there were no changes in alveolar VOTs. The duration of vowel sounds was increased after 4 h of exposure and returned to normal thereafter. Only 1 of 15 subjects did not increase vowel time after 4 h of exposure. The 39-h labial (p = 0.009) and velar (p = 0.037) voiced-unvoiced timed separations consonants and the symptoms of AMS were significantly correlated. CONCLUSIONS: Two objective measures of speech production were affected by exposure to 4300 m altitude and correlated with AMS severity. Alterations in speech production may represent an objective measure of AMS and central vulnerability to hypoxia.

  1. Delayed recompression for decompression sickness: retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Amir Hadanny

    Full Text Available Most cases of decompression sickness (DCS occur soon after surfacing, with 98% within 24 hours. Recompression using hyperbaric chamber should be administrated as soon as feasible in order to decrease bubble size and avoid further tissue injury. Unfortunately, there may be a significant time delay from surfacing to recompression. The time beyond which hyperbaric treatment is non effective is unclear. The aims of the study were first to evaluate the effect of delayed hyperbaric treatment, initiated more than 48 h after surfacing for DCS and second, to evaluate the different treatment protocols.From January 2000 to February 2014, 76 divers had delayed hyperbaric treatment (≥48 h for DCS in the Sagol center for Hyperbaric medicine and Research, Assaf-Harofeh Medical Center, Israel. Data were collected from their medical records and compared to data of 128 patients treated earlier than 48 h after surfacing at the same hyperbaric institute.There was no significant difference, as to any of the baseline characteristics, between the delayed and early treatment groups. With respect to treatment results, at the delayed treatment divers, complete recovery was achieved in 76% of the divers, partial recovery in 17.1% and no improvement in 6.6%. Similar results were achieved when treatment started early, where 78% of the divers had complete recovery, 15.6% partial recovery and 6.2% no recovery. Delayed hyperbaric treatment using US Navy Table 6 protocol trended toward a better clinical outcome yet not statistically significant (OR=2.786, CI95%[0.896-8.66], p=0.07 compared to standard hyperbaric oxygen therapy of 90 minutes at 2 ATA, irrespective of the symptoms severity at presentation.Late recompression for DCS, 48 hours or more after surfacing, has clinical value and when applied can achieve complete recovery in 76% of the divers. It seems that the preferred hyperbaric treatment protocol should be based on US Navy Table 6.

  2. Decompression sickness ('the bends') in sea turtles. (United States)

    García-Párraga, D; Crespo-Picazo, J L; de Quirós, Y Bernaldo; Cervera, V; Martí-Bonmati, L; Díaz-Delgado, J; Arbelo, M; Moore, M J; Jepson, P D; Fernández, Antonio


    Decompression sickness (DCS), as clinically diagnosed by reversal of symptoms with recompression, has never been reported in aquatic breath-hold diving vertebrates despite the occurrence of tissue gas tensions sufficient for bubble formation and injury in terrestrial animals. Similarly to diving mammals, sea turtles manage gas exchange and decompression through anatomical, physiological, and behavioral adaptations. In the former group, DCS-like lesions have been observed on necropsies following behavioral disturbance such as high-powered acoustic sources (e.g. active sonar) and in bycaught animals. In sea turtles, in spite of abundant literature on diving physiology and bycatch interference, this is the first report of DCS-like symptoms and lesions. We diagnosed a clinico-pathological condition consistent with DCS in 29 gas-embolized loggerhead sea turtles Caretta caretta from a sample of 67. Fifty-nine were recovered alive and 8 had recently died following bycatch in trawls and gillnets of local fisheries from the east coast of Spain. Gas embolization and distribution in vital organs were evaluated through conventional radiography, computed tomography, and ultrasound. Additionally, positive response following repressurization was clinically observed in 2 live affected turtles. Gas embolism was also observed postmortem in carcasses and tissues as described in cetaceans and human divers. Compositional gas analysis of intravascular bubbles was consistent with DCS. Definitive diagnosis of DCS in sea turtles opens a new era for research in sea turtle diving physiology, conservation, and bycatch impact mitigation, as well as for comparative studies in other air-breathing marine vertebrates and human divers.

  3. The Neuroprotective Aspects of Sleep. (United States)

    Eugene, Andy R; Masiak, Jolanta


    Sleep is an important component of human life, yet many people do not understand the relationship between the brain and the process of sleeping. Sleep has been proven to improve memory recall, regulate metabolism, and reduce mental fatigue. A minimum of 7 hours of daily sleep seems to be necessary for proper cognitive and behavioral function. The emotional and mental handicaps associated with chronic sleep loss as well as the highly hazardous situations which can be contributed to the lack of sleep is a serious concern that people need to be aware of. When one sleeps, the brain reorganizes and recharges itself, and removes toxic waste byproducts which have accumulated throughout the day. This evidence demonstrates that sleeping can clear the brain and help maintain its normal functioning. Multiple studies have been done to determine the effects of total sleep deprivation; more recently some have been conducted to show the effects of sleep restriction, which is a much more common occurrence, have the same effects as total sleep deprivation. Each phase of the sleep cycle restores and rejuvenates the brain for optimal function. When sleep is deprived, the active process of the glymphatic system does not have time to perform that function, so toxins can build up, and the effects will become apparent in cognitive abilities, behavior, and judgment. As a background for this paper we have reviewed literature and research of sleep phases, effects of sleep deprivation, and the glymphatic system of the brain and its restorative effect during the sleep cycle.

  4. Models of human sleep regulation

    NARCIS (Netherlands)

    Beersma, Domien G.M.


    Non-REM sleep deprivation and REM sleep deprivation both lead to specific rebounds, suggesting that these states fulfil physiological needs. In view of impaired performance after sleep deprivation, a recovery function of sleep seems likely. The timing of this recovery is restricted to a narrow time

  5. Heart Disease and African Americans (United States)

    ... Minority Population Profiles > Black/African American > Heart Disease Heart Disease and African Americans Although African American adults are ... were 30 percent more likely to die from heart disease than non-Hispanic whites. African American women are ...

  6. Safety, pharmacokinetic, and efficacy studies of oral DB868 in a first stage vervet monkey model of human African trypanosomiasis.

    Directory of Open Access Journals (Sweden)

    John K Thuita

    Full Text Available There are no oral drugs for human African trypanosomiasis (HAT, sleeping sickness. A successful oral drug would have the potential to reduce or eliminate the need for patient hospitalization, thus reducing healthcare costs of HAT. The development of oral medications is a key objective of the Consortium for Parasitic Drug Development (CPDD. In this study, we investigated the safety, pharmacokinetics, and efficacy of a new orally administered CPDD diamidine prodrug, 2,5-bis[5-(N-methoxyamidino-2-pyridyl]furan (DB868; CPD-007-10, in the vervet monkey model of first stage HAT. DB868 was well tolerated at a dose up to 30 mg/kg/day for 10 days, a cumulative dose of 300 mg/kg. Mean plasma levels of biomarkers indicative of liver injury (alanine aminotransferase, aspartate aminotransferase were not significantly altered by drug administration. In addition, no kidney-mediated alterations in creatinine and urea concentrations were detected. Pharmacokinetic analysis of plasma confirmed that DB868 was orally available and was converted to the active compound DB829 in both uninfected and infected monkeys. Treatment of infected monkeys with DB868 began 7 days post-infection. In the infected monkeys, DB829 attained a median C(max (dosing regimen that was 12-fold (3 mg/kg/day for 7 days, 15-fold (10 mg/kg/day for 7 days, and 31-fold (20 mg/kg/day for 5 days greater than the IC50 (14 nmol/L against T. b. rhodesiense STIB900. DB868 cured all infected monkeys, even at the lowest dose tested. In conclusion, oral DB868 cured monkeys with first stage HAT at a cumulative dose 14-fold lower than the maximum tolerated dose and should be considered a lead preclinical candidate in efforts to develop a safe, short course (5-7 days, oral regimen for first stage HAT.

  7. The menstrual cycle and susceptibility to coriolis-induced sickness. (United States)

    Cheung, B; Heskin, R; Hofer, K; Gagnon, M


    Survey studies on motion sickness susceptibility suggest that females tend to report greater severity in illness and higher incidence of vomiting than males. Menstruation is said to be a contributing factor. A recent study suggested that females were least susceptible to seasickness during ovulation in a "round the world" yacht race. Sixteen subjects (18-36 years old) were exposed to Coriolis cross-coupling stimulation in the laboratory. They were tested once during permenstruation (Day 1-5), ovulation (Day 12-15) and premenstruation (Day 24-28), based on a normalized 28-day cycle, in a randomised design. Physiological measurements of motion sickness included forearm and calf cutaneous blood flow. Subjective evaluation of sickness symptoms was based on Graybiel's diagnostic criteria and Golding's rating method. Our results indicated that under controlled laboratory conditions, different phases of the menstrual cycle appear to have no influence on subjective symptoms of motion sickness or on cutaneous blood flow increase in the forearm and calf. The lack of commonality between the types and levels of hormones that are released during motion sickness and those that are involved in different menstrual phases appears to support our findings.

  8. Pleasant music as a countermeasure against visually induced motion sickness. (United States)

    Keshavarz, Behrang; Hecht, Heiko


    Visually induced motion sickness (VIMS) is a well-known side-effect in virtual environments or simulators. However, effective behavioral countermeasures against VIMS are still sparse. In this study, we tested whether music can reduce the severity of VIMS. Ninety-three volunteers were immersed in an approximately 14-minute-long video taken during a bicycle ride. Participants were randomly assigned to one of four experimental groups, either including relaxing music, neutral music, stressful music, or no music. Sickness scores were collected using the Fast Motion Sickness Scale and the Simulator Sickness Questionnaire. Results showed an overall trend for relaxing music to reduce the severity of VIMS. When factoring in the subjective pleasantness of the music, a significant reduction of VIMS occurred only when the presented music was perceived as pleasant, regardless of the music type. In addition, we found a gender effect with women reporting more sickness than men. We assume that the presentation of pleasant music can be an effective, low-cost, and easy-to-administer method to reduce VIMS.

  9. Sleep Disturbances in Mood Disorders. (United States)

    Rumble, Meredith E; White, Kaitlin Hanley; Benca, Ruth M


    The article provides an overview of common and differentiating self-reported and objective sleep disturbances seen in mood-disordered populations. The importance of considering sleep disturbances in the context of mood disorders is emphasized, because a large body of evidence supports the notion that sleep disturbances are a risk factor for onset, exacerbation, and relapse of mood disorders. In addition, potential mechanisms for sleep disturbance in depression, other primary sleep disorders that often occur with mood disorders, effects of antidepressant and mood-stabilizing drugs on sleep, and the adjunctive effect of treating sleep in patients with mood disorders are discussed.

  10. Ecotype evolution in Glossina palpalis subspecies, major vectors of sleeping sickness.

    Directory of Open Access Journals (Sweden)

    Thierry De Meeûs


    Full Text Available BACKGROUND: The role of environmental factors in driving adaptive trajectories of living organisms is still being debated. This is even more important to understand when dealing with important neglected diseases and their vectors. METHODOLOGY/PRINCIPAL FINDINGS: In this paper, we analysed genetic divergence, computed from seven microsatellite loci, of 614 tsetse flies (Glossina palpalis gambiensis and Glossina palpalis palpalis, major vectors of animal and human trypanosomes from 28 sites of West and Central Africa. We found that the two subspecies are so divergent that they deserve the species status. Controlling for geographic and time distances that separate these samples, which have a significant effect, we found that G. p. gambiensis from different landscapes (Niayes of Senegal, savannah and coastal environments were significantly genetically different and thus represent different ecotypes or subspecies. We also confirm that G. p. palpalis from Ivory Coast, Cameroon and DRC are strongly divergent. CONCLUSIONS/SIGNIFICANCE: These results provide an opportunity to examine whether new tsetse fly ecotypes might display different behaviour, dispersal patterns, host preferences and vectorial capacities. This work also urges a revision of taxonomic status of Glossina palpalis subspecies and highlights again how fast ecological divergence can be, especially in host-parasite-vector systems.

  11. Functional neuroimaging of sleep disorders. (United States)

    Nofzinger, Eric A


    Functional neuroimaging methods provide a means to understand brain function in patients with sleep disorders. This paper summarizes functional neuroimaging findings in sleep disorders patients, and studies addressing the pharmacology of sleep and sleep disorders. Areas in which functional neuroimaging methods may be helpful in sleep medicine, and in which future development is advised, include: 1) clarification of pathophysiology; 2) aid in differential diagnosis; 3) assessment of treatment response; 4) guiding new drug development; and 5) monitoring treatment response.

  12. [Sleep disorders and their treatment]. (United States)

    Holsboer-Trachsler, E


    Disturbed or inadequate sleep is a frequent complaint, often with a chronic course, requiring adequate treatment. To choose an appropriate therapy it is necessary to develop a useful, reliable valid and specific diagnostic procedure. Primary care physicians can recognize and treat most sleep disorders. For special diagnostic cases sleep centers are recommended. Sleep disorders may be managed by adequate pharmacological as well as nonpharmacological treatments. Besides specific pharmacological interventions, education in sleep/wake hygiene and several psychotherapeutic strategies may be valuable.

  13. Insomnia and sleep misperception. (United States)

    Bastien, C H; Ceklic, T; St-Hilaire, P; Desmarais, F; Pérusse, A D; Lefrançois, J; Pedneault-Drolet, M


    Sleep misperception is often observed in insomnia individuals (INS). The extent of misperception varies between different types of INS. The following paper comprised sections which will be aimed at studying the sleep EEG and compares it to subjective reports of sleep in individuals suffering from either psychophysiological insomnia or paradoxical insomnia and good sleeper controls. The EEG can be studied without any intervention (thus using the raw data) via either PSG or fine quantitative EEG analyses (power spectral analysis [PSA]), identifying EEG patterns as in the case of cyclic alternating patterns (CAPs) or by decorticating the EEG while scoring the different transient or phasic events (K-Complexes or sleep spindles). One can also act on the on-going EEG by delivering stimuli so to study their impact on cortical measures as in the case of event-related potential studies (ERPs). From the paucity of studies available using these different techniques, a general conclusion can be reached: sleep misperception is not an easy phenomenon to quantify and its clinical value is not well recognized. Still, while none of the techniques or EEG measures defined in the paper is available and/or recommended to diagnose insomnia, ERPs might be the most indicated technique to study hyperarousal and sleep quality in different types of INS. More research shall also be dedicated to EEG patterns and transient phasic events as these EEG scoring techniques can offer a unique insight of sleep misperception.

  14. [Circadian rhythm sleep disorder]. (United States)

    Mishima, Kazuo


    Primary pathophysiology of circadian rhythm sleep disorders(CRSDs) is a misalignment between the endogenous circadian rhythm phase and the desired or socially required sleep-wake schedule, or dysfunction of the circadian pacemaker and its afferent/efferent pathways. CRSDs consist of delayed sleep phase type, advanced sleep phase type, free-running type, irregular sleep-wake type, shift work type and jet lag type. Chronotherapy using strong zeitgebers (time cues), such as bright light and melatonin/ melatonin type 2 receptor agonist, is effective when administered with proper timing. Bright light is the strongest entraining agent of circadian rhythms. Bright light therapy (appropriately-timed exposure to bright light) for CRSDs is an effective treatment option, and can shift the sleep-wake cycle to earlier or later times, in order to correct for misalignment between the circadian system and the desired sleep-wake schedule. Timed administration of melatonin, either alone or in combination with light therapy has also been shown to be useful in the treatment of CRSDs.

  15. Sleep, vigilance, and thermosensitivity. (United States)

    Romeijn, Nico; Raymann, Roy J E M; Møst, Els; Te Lindert, Bart; Van Der Meijden, Wisse P; Fronczek, Rolf; Gomez-Herrero, German; Van Someren, Eus J W


    The regulation of sleep and wakefulness is well modeled with two underlying processes: a circadian and a homeostatic one. So far, the parameters and mechanisms of additional sleep-permissive and wake-promoting conditions have been largely overlooked. The present overview focuses on one of these conditions: the effect of skin temperature on the onset and maintenance of sleep, and alertness. Skin temperature is quite well suited to provide the brain with information on sleep-permissive and wake-promoting conditions because it changes with most if not all of them. Skin temperature changes with environmental heat and cold, but also with posture, environmental light, danger, nutritional status, pain, and stress. Its effect on the brain may thus moderate the efficacy by which the clock and homeostat manage to initiate or maintain sleep or wakefulness. The review provides a brief overview of the neuroanatomical pathways and physiological mechanisms by which skin temperature can affect the regulation of sleep and vigilance. In addition, current pitfalls and possibilities of practical applications for sleep enhancement are discussed, including the recent finding of impaired thermal comfort perception in insomniacs.

  16. Multidimensional intervention and sickness absence in assistant nursing students

    DEFF Research Database (Denmark)

    Svensson, Annemarie Lyng; Strøyer, Jesper; Ebbehøj, Niels Erik;


    if a multidimensional prevention programme combining physical training, patient transfer technique and stress management prevents sickness absence and LBP in NA students. METHODS: The study was a 14-month cluster randomized controlled study. The participants were NA students from 37 randomly selected classes located...... at two schools of health and social care in Copenhagen, Denmark. The participants completed a comprehensive questionnaire regarding sickness absence, LBP and psychosocial factors on commencement and after completion of the study. RESULTS: Of 766 female NA students, 668 (87%) completed the baseline......BACKGROUND: When handling patients, nursing assistant (NA) students and nurse students are frequently exposed to risk factors for low back pain (LBP) including sudden loads and twisting and bending of the spine. Furthermore, LBP is a major cause of sickness absence. AIMS: To ascertain...

  17. Analyzing sickness absence with statistical models for survival data

    DEFF Research Database (Denmark)

    Christensen, Karl Bang; Andersen, Per Kragh; Smith-Hansen, Lars;


    absence data deal with events occurring over time, the use of statistical models for survival data has been reviewed, and the use of frailty models has been proposed for the analysis of such data. METHODS: Three methods for analyzing data on sickness absences were compared using a simulation study...... involving the following: (i) Poisson regression using a single outcome variable (number of sickness absences), (ii) analysis of time to first event using the Cox proportional hazards model, and (iii) frailty models, which are random effects proportional hazards models. Data from a study of the relation...... between the psychosocial work environment and sickness absence were used to illustrate the results. RESULTS: Standard methods were found to underestimate true effect sizes by approximately one-tenth [method i] and one-third [method ii] and to have lower statistical power than frailty models. CONCLUSIONS...

  18. Acupressure therapy for morning sickness. A controlled clinical trial. (United States)

    Hyde, E


    A prospective, controlled clinical trial examined the efficacy of acupressure therapy for morning sickness, using a two group, random assignment, crossover design. Subjects in Group 1 (N = 8) used acupressure wristbands for five days, followed by five days without therapy. Subjects in Group 2 (N = 8) had no therapy for five days, followed by five days use of wristbands. The Multiple Affect Adjective Checklist and Sickness Impact Profile were used, and extent of nausea was assessed at baseline, day five, and day ten. Use of acupressure wristbands relieved morning sickness for 12 of 16 subjects (chi 2 = 5.31 with Yates' correction factor, df = 1, p less than .025). Acupressure therapy resulted in statistically significant (p less than .05) reductions in anxiety, depression, behavioral dysfunction, and nausea. Limitations of the study and suggestions for future research are presented.

  19. Psychiatric disorders in long-term sickness absence

    DEFF Research Database (Denmark)

    Søgaard, Hans Jørgen; Bech, Per


    AIMS: The study estimates the incidence of psychiatric disorders in long-term sickness absence (LSA; more than eight weeks of continuous sickness absence) over one year. The study is the first accounting for everybody on LSA by linking a psychiatric assessment for all persons on LSA to public...... registers. METHODS: In a Danish population of 120,000 inhabitants all 2,414 incident persons on LSA within one year were posted a questionnaire, of whom 1,121 (46.4%) responded. In a two phase design the 1,121 sick-listed persons were screened for psychiatric disorders. Phase 2 consisted of 844 people...... examined persons in Phase 2 showed by binomial tests the following frequencies: any psychiatric disorder 57%, any depression 42%, and any anxiety 18%. In Phase 1, representative for everyone on LSA, the frequencies were 48% for any psychiatric disorder, 35% for any depression, 15% for any anxiety, and 7...

  20. Depression and African Americans (United States)

    ... You are here Home » Depression And African Americans Depression And African Americans Not “Just the Blues” Clinical ... or spiritual communities. Commonly Asked Questions about Clinical Depression How do I get help for clinical depression? ...

  1. Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. (United States)

    Brown, Franklin C; Buboltz, Walter C; Soper, Barlow


    College students are known for their variable sleep schedules. Such schedules, along with other common student practices (e.g., alcohol and caffeine consumption), are associated with poor sleep hygiene. Researchers have demonstrated in clinical populations that improving sleep hygiene knowledge and practices is an effective treatment for insomnia. However, researchers who have examined relationships between sleep hygiene and practices in nonclinical samples and overall sleep quality have produced inconsistent findings, perhaps because of questionable measures. In this study, the authors used psychometrically sound instruments to examine these variables and to counter the shortcomings in previous investigations. Their findings suggest that knowledge of sleep hygiene is related to sleep practices, which, in turn, is related to overall sleep quality. The data from their regression modeling indicated that variable sleep schedules, going to bed thirsty, environmental noise, and worrying while falling asleep contribute to poor sleep quality.

  2. Physical, psychosocial, and organisational factors relative to sickness absence: a study based on Sweden Post

    DEFF Research Database (Denmark)

    Voss, M; Floderus, B; Diderichsen, F


    OBJECTIVE: To analyse incidence of sickness for women and men relative to potential aetiological factors at work-physical, psychosocial, and organisational. METHODS: The study group comprised 1557 female and 1913 male employees of Sweden Post. Sickness absence was measured by incidence of sicknes......: Certain physical, psychosocial, and organisational factors were important determinants of incidence of sickness, independently of each other. Some of the associations were sex specific.......OBJECTIVE: To analyse incidence of sickness for women and men relative to potential aetiological factors at work-physical, psychosocial, and organisational. METHODS: The study group comprised 1557 female and 1913 male employees of Sweden Post. Sickness absence was measured by incidence of sickness...... (sick leave events and person-days at risk). Information on explanatory factors was obtained by a postal questionnaire, and incidence of sickness was based on administrative files of the company. RESULTS: Complaints about heavy lifting and monotonous movements were associated with increased risk of high...

  3. Sleep and Diabetes

    Directory of Open Access Journals (Sweden)

    Swetha Bopparaju


    Full Text Available Sleep apnea is clinically recognized as a heterogeneous group of disorders characterized by recurrent apnea and/or hypopnea. Its prevalence ranges from 4% to 24%. It has been implicated as an independent risk factor for several conditions such as hypertension, stroke, arrhythmia, and myocardial infarction. Recently data has been emerging which suggests an independent association of obstructive sleep apnea with several components of the metabolic syndrome, particularly insulin resistance and abnormalities in lipid metabolism. We hereby review the salient features of the association between sleep and diabetes.

  4. Obstructive Sleep Apnea


    Brass, Steven D.; Ho, Matthew L.


    Obstructive sleep apnea (OSA) affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because o...

  5. Certificated sickness absence in industrial employees threatened with redundancy. (United States)

    Beale, N; Nethercott, S


    The proposition that workers take less sick leave when threatened by redundancy was examined in a longitudinal, controlled study using information from case records in a general practice. The hypothesis was only partly supported--certificated sickness absence dropped only in employees under the age of 40. Workers fearing job loss reported more illness, and their periods of absence were significantly longer, especially for men and for workers who had previously consulted their general practitioner infrequently. This study provides further evidence that the fear of mass redundancy is stressful to workers so threatened and costly to a society experiencing rising unemployment.

  6. Morning sickness: a mechanism for protecting mother and embryo. (United States)

    Flaxman, S M; Sherman, P W


    Approximately two-thirds of women experience nausea or vomiting during the first trimester of pregnancy. These symptoms are commonly known as morning sickness. Hook (1976) and Profet (1988) hypothesized that morning sickness protects the embryo by causing pregnant women to physically expel and subsequently avoid foods that contain teratogenic and abortifacient chemicals, especially toxic chemicals in strong-tasting vegetables, caffeinated beverages and alcohol. We examined this hypothesis by comprehensively reviewing the relevant medical, psychological and anthropological literature. In its support, (i) symptoms peak when embryonic organogenesis is most susceptible to chemical disruption (weeks 6-18), (ii) women who experience morning sickness are significantly less likely to miscarry than women who do not (9 of 9 studies), (iii) women who vomit suffer fewer miscarriages than those who experience nausea alone, and (iv) many pregnant women have aversions to alcoholic and nonalcoholic (mostly caffeinated) beverages and strong-tasting vegetables, especially during the first trimester. Surprisingly, however, the greatest aversions are to meats, fish, poultry, and eggs. A cross-cultural analysis using the Human Relations Area Files revealed 20 traditional societies in which morning sickness has been observed and seven in which it has never been observed. The latter were significantly less likely to have animal products as dietary staples and significantly more likely to have only plants (primarily corn) as staples than the 20 societies in which morning sickness occurred. Animal products may be dangerous to pregnant women and their embryos because they often contain parasites and pathogens, especially when stored at room temperatures in warm climates. Avoiding foodborne microorganisms is particularly important to pregnant women because they are immunosuppressed, presumably to reduce the chances of rejecting tissues of their own offspring (Haig 1993). As a result

  7. Linguistic Imperialism: African Perspectives. (United States)

    Phillipson, Robert


    Responds to an article on aspects of African language policy and discusses the following issues: multilingualism and monolingualism, proposed changes in language policy from the Organization for African Unity and South African initiatives, the language of literature, bilingual education, and whose interests English-language teaching is serving.…

  8. Sleep deprivation attenuates endotoxin-induced cytokine gene expression independent of day length and circulating cortisol in male Siberian hamsters (Phodopus sungorus). (United States)

    Ashley, Noah T; Walton, James C; Haim, Achikam; Zhang, Ning; Prince, Laura A; Fruchey, Allison M; Lieberman, Rebecca A; Weil, Zachary M; Magalang, Ulysses J; Nelson, Randy J


    Sleep is restorative, whereas reduced sleep leads to negative health outcomes, such as increased susceptibility to disease. Sleep deprivation tends to attenuate inflammatory responses triggered by infection or exposure to endotoxin, such as bacterial lipopolysaccharide (LPS). Previous studies have demonstrated that Siberian hamsters (Phodopus sungorus), photoperiodic rodents, attenuate LPS-induced fever, sickness behavior and upstream pro-inflammatory gene expression when adapted to short day lengths. Here, we tested whether manipulation of photoperiod alters the suppressive effects of sleep deprivation upon cytokine gene expression after LPS challenge. Male Siberian hamsters were adapted to long (16 h:8 h light:dark) or short (8 h:16 h light:dark) photoperiods for >10 weeks, and were deprived of sleep for 24 h using the multiple platform method or remained in their home cage. Hamsters received an intraperitoneal injection of LPS or saline (control) 18 h after starting the protocol, and were killed 6 h later. LPS increased liver and hypothalamic interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF) gene expression compared with vehicle. Among LPS-challenged hamsters, sleep deprivation reduced IL-1 mRNA levels in liver and hypothalamus, but not TNF. IL-1 attenuation was independent of circulating baseline cortisol, which did not increase after sleep deprivation. Conversely, photoperiod altered baseline cortisol, but not pro-inflammatory gene expression in sleep-deprived hamsters. These results suggest that neither photoperiod nor glucocorticoids influence the suppressive effect of sleep deprivation upon LPS-induced inflammation.

  9. The determinants of sick leave durations of Dutch self-employed

    NARCIS (Netherlands)

    Spierdijk, Laura; van Lomwel, Gijsbert; Peppelman, Wilko


    This paper analyzes sickness absenteeism among self-employed in the Netherlands. Using a unique data set provided by a large Dutch private insurance company, we assess the determinants of sick leave durations. Our study suggests that several risk factors affect the sick leave durations of self-emplo

  10. 5 CFR 630.405 - Sick leave used in the computation of an annuity. (United States)


    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Sick leave used in the computation of an annuity. 630.405 Section 630.405 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Sick Leave § 630.405 Sick leave used in the computation of an annuity....

  11. 5 CFR 630.406 - Records on the use of sick leave. (United States)


    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Records on the use of sick leave. 630.406 Section 630.406 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Sick Leave § 630.406 Records on the use of sick leave. An agency must maintain records...

  12. 5 CFR 630.404 - Use of sick leave during annual leave. (United States)


    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Use of sick leave during annual leave. 630.404 Section 630.404 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Sick Leave § 630.404 Use of sick leave during annual leave. Subject to §...

  13. Functions and Mechanisms of Sleep

    Directory of Open Access Journals (Sweden)

    Mark R. Zielinski


    Full Text Available Sleep is a complex physiological process that is regulated globally, regionally, and locally by both cellular and molecular mechanisms. It occurs to some extent in all animals, although sleep expression in lower animals may be co-extensive with rest. Sleep regulation plays an intrinsic part in many behavioral and physiological functions. Currently, all researchers agree there is no single physiological role sleep serves. Nevertheless, it is quite evident that sleep is essential for many vital functions including development, energy conservation, brain waste clearance, modulation of immune responses, cognition, performance, vigilance, disease, and psychological state. This review details the physiological processes involved in sleep regulation and the possible functions that sleep may serve. This description of the brain circuitry, cell types, and molecules involved in sleep regulation is intended to further the reader’s understanding of the functions of sleep.

  14. Impaired sleep and allostatic load

    DEFF Research Database (Denmark)

    Clark, Alice Jessie; Dich, Nadya; Lange, Theis


    Objective: Understanding the mechanisms linking sleep impairment to morbidity and mortality is important for future prevention, but these mechanisms are far from elucidated. We aimed to determine the relation between impaired sleep, both in terms of duration and disturbed sleep, and allostatic load...... Biobank with comprehensive information on sleep duration, disturbed sleep, objective measures of an extensive range of biological risk markers, and physical conditions. Results: Long sleep (mean difference 0.23; 95% confidence interval, 0.13, 0.32) and disturbed sleep (0.14; 0.06, 0.22) were associated...... with higher AL as well as with high-risk levels of risk markers from the anthropometric, metabolic, and immune system. Sub-analyses suggested that the association between disturbed sleep and AL might be explained by underlying disorders. Whereas there was no association between short sleep and AL...

  15. National Sleep Foundation (United States)

    ... Hebrew Hindi Hungarian Icelandic Indonesian Irish Italian Japanese Korean Latvian Lithuanian Macedonian Malay Maltese Norwegian Persian Polish ... Test your knowledge, take our symptom screener, and learn more about narcolepsy. Sleep and Melatonin It can ...

  16. Sleep after laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Rosenberg-Adamsen, S; Skarbye, M; Wildschiødtz, G


    The sleep pattern and oxygenation of 10 patients undergoing laparoscopic cholecystectomy were studied on the night before operation and the first night after operation. Operations were performed during general anaesthesia and postoperative analgesia was achieved without the administration...... of opioids. There were no significant changes in the total time awake or the number of arousals on the postoperative night compared with the night before operation. During the postoperative night, we found a decrease (P = 0.02) in slow wave sleep (SWS) with a corresponding increase in stage 2 sleep (P = 0.......01). SWS was absent in four of the patients after operation, whereas in six patients it was within the normal range (5-20% of the night). The proportion of rapid eye movement (REM) sleep was not significantly changed after operation. There were no changes in arterial oxygen saturation on the postoperative...

  17. Sleep and Aging: Insomnia (United States)

    ... Aging Insomnia Insomnia is the most common sleep complaint at any age. It affects almost half of ... A-Z | videos A-Z | training | about us | Customer Support | site map National Institute on Aging | U.S. ...

  18. Exercise Effects on Sleep Physiology

    Directory of Open Access Journals (Sweden)

    Sunao eUchida


    Full Text Available This mini-review focuses on the effects of exercise on sleep. In its early days, sleep research largely focused on central nervous system (CNS physiology using standardized tabulations of several sleep-specific landmark electroencephalogram (EEG waveforms. Though coarse, this method has enabled the observation and inspection of numerous uninterrupted sleep phenomena. Thus, research on the effects of exercise on sleep began, in the 1960’s, with a focus primarily on sleep EEG (CNS sleep changes. Those early studies found only small effects of exercise on sleep. More recent sleep research has explored not only CNS functioning, but somatic physiology as well. As physical exercise mostly affects somatic functions, endocrine and autonomic nervous system (ANS changes that occur during sleep should be affected by daytime exercise. Since endocrinological, metabolic and autonomic changes can be measured during sleep, it should be possible to assess exercise effects on somatic physiology in addition to CNS sleep quality, building from standard polysomnographic (PSG techniques. Incorporating measures of somatic physiology in the quantitative assessment of sleep could further our understanding of sleep's function as an auto-regulatory, global phenomenon.

  19. Assessment of Evidence Base from Medical Debriefs Data on Space Motion Sickness Incidence and Treatment (United States)

    Younker, D.R.; Daniels, V.R.; Boyd, J.L.; Putcha, L.


    An objective of this data compilation and analysis project is to examine incidence and treatment efficacy of common patho-physiological disturbances during spaceflight. Analysis of medical debriefs data indicated that astronauts used medications to alleviate symptoms of four major ailments for which astronauts received treatment for sleep disturbances, space motion sickness (SMS), pain (headache, back pain) and sinus congestion. In the present data compilation and analysis project on SMS treatment during space missions, subject demographics (gender, age, first-time or repeat flyer), incidence and severity of SMS symptoms and subjective treatment efficacy from 317 crewmember debrief records were examined from STS-1 through STS-89. Preliminary analysis of data revealed that 50% of crew members reported SMS symptoms on at least one flight and 22% never experienced it. In addition, there were 387 medication dosing episodes reported, and promethazine was the most commonly used medication. Results of analysis of symptom check lists, medication use/efficacy and gender and flight record differences in incidence and treatment efficacy will be presented. Evidence gaps for treatment efficacy along with medication use trend analysis will be identified.

  20. Do Fish Sleep?

    Institute of Scientific and Technical Information of China (English)


    Most fish can’t shut their eyes, so it’s easy to think they don’t sleep. But that’s like assuming humans don’t sleep because we can’t shut our ears to drown out sound. In fact, many species of fish take time out during the day or (more often) at night to enter a sleeplike stage. Some of these fish float in place, others lie on the bottom。

  1. Sleep and psychoneuroimmunology. (United States)

    Opp, Mark R


    The brain uses a variety of mechanisms to survey the immune system constantly. Responses of the immune system to invading pathogens are detected by the central nervous system, which responds by orchestrating complex changes in behavior and physiology. Sleep is one of the behaviors altered in response to immune challenge. The role of cytokines as mediators of responses to infectious challenge and regulators and modulators of sleep is the focus of this article.

  2. Sleep Patterns in Children with Cystic Fibrosis


    Meltzer, Lisa J.; Beck, Suzanne E.


    This study examined sleep patterns and the association between sleep and perceived health for children with and without CF. Ninety families (45 CF) completed questionnaires about the child’s sleep and health. Significant group differences were found for sleep patterns (bedtime, wake time, total sleep time), symptoms of sleep disordered breathing, and sleep disturbances. Poorer perceived health was associated with sleep disturbances among children with CF, but not for children without CF. This...

  3. Obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Steven D. Brass


    Full Text Available Obstructive sleep apnea (OSA affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual’s risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  4. Obstructive sleep apnea. (United States)

    Ho, Matthew L; Brass, Steven D


    Obstructive sleep apnea (OSA) affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual's risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  5. Sleep Paralysis and Hallucinosis

    Directory of Open Access Journals (Sweden)

    Gregory Stores


    Full Text Available Background: Sleep paralysis is one of the many conditions of which visual hallucinations can be a part but has received relatively little attention. It can be associated with other dramatic symptoms of a psychotic nature likely to cause diagnostic uncertainty. Methods and results: These points are illustrated by the case of a young man with a severe bipolar affective disorder who independently developed terrifying visual, auditory and somatic hallucinatory episodes at sleep onset, associated with a sense of evil influence and presence. The episodes were not obviously related to his psychiatric disorder. Past diagnoses included nightmares and night terrors. Review provided no convincing evidence of various other sleep disorders nor physical conditions in which hallucinatory experiences can occur. A diagnosis of predormital isolated sleep paralysis was made and appropriate treatment recommended. Conclusions: Sleep paralysis, common in the general population, can be associated with dramatic auxiliary symptoms suggestive of a psychotic state. Less common forms are either part of the narcolepsy syndrome or (rarely they are familial in type. Interestingly, sleep paralysis (especially breathing difficulty features prominently in the folklore of various countries.

  6. Obstructive sleep apnea alters sleep stage transition dynamics.

    Directory of Open Access Journals (Sweden)

    Matt T Bianchi

    Full Text Available INTRODUCTION: Enhanced characterization of sleep architecture, compared with routine polysomnographic metrics such as stage percentages and sleep efficiency, may improve the predictive phenotyping of fragmented sleep. One approach involves using stage transition analysis to characterize sleep continuity. METHODS AND PRINCIPAL FINDINGS: We analyzed hypnograms from Sleep Heart Health Study (SHHS participants using the following stage designations: wake after sleep onset (WASO, non-rapid eye movement (NREM sleep, and REM sleep. We show that individual patient hypnograms contain insufficient number of bouts to adequately describe the transition kinetics, necessitating pooling of data. We compared a control group of individuals free of medications, obstructive sleep apnea (OSA, medical co-morbidities, or sleepiness (n = 374 with mild (n = 496 or severe OSA (n = 338. WASO, REM sleep, and NREM sleep bout durations exhibited multi-exponential temporal dynamics. The presence of OSA accelerated the "decay" rate of NREM and REM sleep bouts, resulting in instability manifesting as shorter bouts and increased number of stage transitions. For WASO bouts, previously attributed to a power law process, a multi-exponential decay described the data well. Simulations demonstrated that a multi-exponential process can mimic a power law distribution. CONCLUSION AND SIGNIFICANCE: OSA alters sleep architecture dynamics by decreasing the temporal stability of NREM and REM sleep bouts. Multi-exponential fitting is superior to routine mono-exponential fitting, and may thus provide improved predictive metrics of sleep continuity. However, because a single night of sleep contains insufficient transitions to characterize these dynamics, extended monitoring of sleep, probably at home, would be necessary for individualized clinical application.

  7. Perspective on Sleep and Aging

    Directory of Open Access Journals (Sweden)

    Andrew A Monjan


    Full Text Available There is a strong body of data directly interrelating sleep problems with mood disorders. There is a growing data base directly associating sleep disorders with attention and memory problems. Motor disorders, especially involving the dopaminergic system, may produce sleep problems, including a possible association between disordered sleep and nocturnal falls. Sleep disorders may be causal conditions for metabolic diseases and increased risk for morbidity and mortality. Sleep and health are directly interrelated. To further probe these issues, especially as related to the aging process, investigators need to utilize tools and concepts from genomics and epigenetics, proteomics, metabolomics, any future ...omics, molecular neuroimaging, and cognitive neuroscience.

  8. Adenosine, Energy Metabolism, and Sleep

    Directory of Open Access Journals (Sweden)

    Tarja Porkka-Heiskanen


    Full Text Available While the exact function of sleep remains unknown, it is evident that sleep was developed early in phylogenesis and represents an ancient and vital strategy for survival. Several pieces of evidence suggest that the function of sleep is associated with energy metabolism, saving of energy, and replenishment of energy stores. Prolonged wakefulness induces signs of energy depletion in the brain, while experimentally induced, local energy depletion induces increase in sleep, similarly as would a period of prolonged wakefulness. The key molecule in the induction of sleep appears to be adenosine, which induces sleep locally in the basal forebrain.

  9. Development of a neural net paradigm that predicts simulator sickness

    Energy Technology Data Exchange (ETDEWEB)

    Allgood, G.O.


    A disease exists that affects pilots and aircrew members who use Navy Operational Flight Training Systems. This malady, commonly referred to as simulator sickness and whose symptomatology closely aligns with that of motion sickness, can compromise the use of these systems because of a reduced utilization factor, negative transfer of training, and reduction in combat readiness. A report is submitted that develops an artificial neural network (ANN) and behavioral model that predicts the onset and level of simulator sickness in the pilots and aircrews who sue these systems. It is proposed that the paradigm could be implemented in real time as a biofeedback monitor to reduce the risk to users of these systems. The model captures the neurophysiological impact of use (human-machine interaction) by developing a structure that maps the associative and nonassociative behavioral patterns (learned expectations) and vestibular (otolith and semicircular canals of the inner ear) and tactile interaction, derived from system acceleration profiles, onto an abstract space that predicts simulator sickness for a given training flight.

  10. Occupational rewards relate to sickness absence frequency but not duration

    NARCIS (Netherlands)

    Roelen, C. A. M.; Koopmans, P. C.; Groothoff, J. W.


    Work stress is an important problem that shifted sickness absence research to the psychosocial work environment at the expense of physical or chemical hazards. Most studies investigated the psychosocial work environment using the Demand-Control model. However, this model does not consider coping sty

  11. Respiratory impact on motion sickness induced by linear motion

    NARCIS (Netherlands)

    Mert, A.; Klöpping-Ketelaars, I.; Bles, W.


    Motion sickness incidence (MSI) for vertical sinusoidal motion reaches a maximum at 0.167 Hz. Normal breathing frequency is close to this frequency. There is some evidence for synchronization of breathing with this stimulus frequency. If this enforced breathing takes place over a larger frequency ra

  12. The role of work group in individual sickness absence behavior. (United States)

    Väänänen, Ari; Tordera, Nuria; Kivimäki, Mika; Kouvonen, Anne; Pentti, Jaana; Linna, Anne; Vahtera, Jussi


    The purpose of our two-year follow-up study was to examine the effect of the social components of the work group, such as group absence norms and cohesion, on sickness absence behavior among individuals with varying attitudes toward work attendance. The social components were measured using a questionnaire survey and data on sickness absence behavior were collected from the employers' records. The study population consisted of 19,306 Finnish municipal employees working in 1,847 groups (78% women). Multilevel Poisson regression modeling was applied. The direct effects of work group characteristics on sickness absence were mostly insignificant. In contrast, both of the social components of a work group had an indirect impact: The more tolerant the group absence norms (at both individual- and cross-level) and the lower the group cohesion (at the individual level), the more the absence behavior of an individual was influenced by his or her attitude toward work attendance. We conclude that work group moderates the extent to which individuals with a liberal attitude toward work attendance actually engage in sickness absence behavior.

  13. The association between commuter cycling and sickness absence

    NARCIS (Netherlands)

    Hendriksen, I.J.M.; Simons, M.; Garre, F.G.; Hildebrandt, V.H.


    Objective: To study the association between commuter cycling and all-cause sickness absence, and the possible dose-response relationship between absenteeism and the distance, frequency and speed of commuter cycling. Method: Cross-sectional data about cycling in 1236 Dutch employees were collected us

  14. Management of Sick Leave due to Musculoskeletal Disorders

    NARCIS (Netherlands)

    E. Faber (Elske)


    textabstractMusculoskeletal disorders are a common problem that may lead to func-Ational limitations and (work) disability. It is not clear yet how improvement in Apain or functional limitations is related to return to work after an episode of sick Aleave. Furthermore, several physicians are involve

  15. What bothers the sick-listed employee with severe MUPS?

    NARCIS (Netherlands)

    Hoedeman, R.; Blankenstein, A. H.; Koopmans, P. C.; Groothoff, J. W.


    Aims: The aim of this study was to explore what employees with severe medically unexplained physical symptoms (MUPS) experience as causes of distress with regard to employees with mild or no MUPS. Methods: This study is an additional analysis of a cross-sectional study in which 486 sick-listed emplo

  16. Pathophysiology of acute mountain sickness and high altitude pulmonary oedema

    DEFF Research Database (Denmark)

    Sutton, J R; Lassen, N


    We review the evidence that acute mountain sickness (AMS) and high altitude pulmonary oedema (HAPO) occur together more often than is realized. We hypothesize that AMS and HAPO have a common pathophysiological basis: both are due to increased pressure and flow in the microcirculation, causing...

  17. Decrease in monocular sleep after sleep deprivation in the domestic chicken

    NARCIS (Netherlands)

    Boerema, AS; Riedstra, B; Strijkstra, AM


    We investigated the trade-off between sleep need and alertness, by challenging chickens to modify their monocular sleep. We sleep deprived domestic chickens (Gallus domesticus) to increase their sleep need. We found that in response to sleep deprivation the fraction of monocular sleep within sleep d

  18. General practitioners' management of the long-term sick role. (United States)

    Higgins, Angela; Porter, Sam; O'Halloran, Peter


    In this paper, we use qualitative research techniques to examine the role of general practitioners in the management of the long-term sickness absence. In order to uncover the perspectives of all the main agents affected by the actions of general practitioners, a case study approach focussing on one particular employment sector, the public health service, is adopted. The role of family physicians is viewed from the perspectives of health service managers, occupational health physicians, employees/patients, and general practitioners. Our argument is theoretically framed by Talcott Parsons's model of the medical contribution to the sick role, along with subsequent conceptualisations of the social role and position of physicians. Sixty one semi-structured interviews and three focus group interviews were conducted in three Health and Social Care Trusts in Northern Ireland between 2010 and 2012. There was a consensus among respondents that general practitioners put far more weight on the preferences and needs of their patients than they did on the requirements of employing organisations. This was explained by respondents in terms of the propinquity and longevity of relationships between doctors and their patients, and by the ideology of holistic care and patient advocacy that general practitioners viewed as providing the foundations of their approach to patients. The approach of general practitioners was viewed negatively by managers and occupational health physicians, and more positively by general practitioners and patients. However, there is some evidence that general practitioners would be prepared to forfeit their role as validators of sick leave. Given the imperatives of both state and capital to reduce the financial burden of long-term sickness, this preparedness puts into doubt the continued role of general practitioners as gatekeepers to legitimate long-term sickness absence.

  19. Altered sleep composition after traumatic brain injury does not affect declarative sleep-dependent memory consolidation


    Janna eMantua; Keenan M Mahan; Owen S Henry; Rebecca M. C. Spencer


    Individuals with a history of traumatic brain injury (TBI) often report sleep disturbances, which may be caused by changes in sleep architecture or reduced sleep quality (greater time awake after sleep onset, poorer sleep efficiency, and sleep stage proportion alterations). Sleep is beneficial for memory formation, and herein we examine whether altered sleep physiology following TBI has deleterious effects on sleep-dependent declarative memory consolidation. Participants learned a list of wor...

  20. Predictors of recurrent sickness absence among workers having returned to work after sickness absence due to common mental disorders

    NARCIS (Netherlands)

    Arends, Iris; van der Klink, Jac J. L.; van Rhenen, Willem; de Boer, Michiel R.; Bultmann, Ute


    Objective The aim of this study was to investigate whether sociodemographic, disease-related, personal, and work-related factors - measured at baseline - are predictors of recurrent sickness absence (SA) at 6 and 12 months follow-up among workers who returned to work after SA due to common mental di

  1. Sleep timing and circadian phase in delayed sleep phase syndrome. (United States)

    Chang, Anne-Marie; Reid, Kathryn J; Gourineni, Ramadevi; Zee, Phyllis C


    Delayed sleep phase syndrome (DSPS) is a circadian rhythm sleep disorder in which the timing of the sleep episode occurs later than desired and is associated with difficulty falling asleep, problems awakening on time (e.g., to meet work or school obligations), and daytime sleepiness. The phase relationship between the timing of sleep and endogenous circadian rhythms is critical to the initiation and maintenance of sleep, and significant alteration leads to impairment of sleep quality and duration. The aim of this retrospective study was to determine the phase relationship between sleep-wake times and physiological markers of circadian timing in clinic patients with DSPS. Objective and subjective measures of sleep timing and circadian phase markers (core body temperature and melatonin) were measured in patients with DSPS and compared with age-matched controls. As expected, significant delays in the timing of the major sleep episode and circadian phase of body temperature and melatonin rhythms were seen in the DSPS group when allowed to sleep at their own habitual schedules, but the phase relationship between sleep-wake times and circadian phase was similar between the 2 groups. These results suggest that the symptoms of insomnia and excessive daytime sleepiness in DSPS patients living under entrained real-life conditions cannot be explained by an alteration in the phase relationship between sleep-wake patterns and other physiological circadian rhythms.

  2. Allometric scaling of decompression sickness risk in terrestrial mammals; cardiac output explains risk of decompression sickness (United States)

    Fahlman, Andreas


    A probabilistic model was used to predict decompression sickness (DCS) outcome in pig (70 and 20 kg), hamster (100 g), rat (220 g) and mouse (20 g) following air saturation dives. The data set included 179 pig, 200 hamster, 360 rat, and 224 mouse exposures to saturation pressures ranging from 1.9–15.2 ATA and with varying decompression rates (0.9–156 ATA • min‑1). Single exponential kinetics described the tissue partial pressures (Ptiss) of N2: Ptiss =  ∫(Pamb – Ptiss) • τ‑1 dt, where Pamb is ambient N2 pressure and τ is a time constant. The probability of DCS [P(DCS)] was predicted from the risk function: P(DCS) = 1‑e‑r, where r = ∫(PtissN2 ‑ Thr ‑ Pamb) • Pamb–1 dt, and Thr is a threshold parameter. An equation that scaled τ with body mass included a constant (c) and an allometric scaling parameter (n), and the best model included n, Thr, and two c. The final model provided accurate predictions for 58 out of 61 dive profiles for pig, hamster, rat, and mouse. Thus, body mass helped improve the prediction of DCS risk in four mammalian species over a body mass range covering 3 orders of magnitude.

  3. Introduction to modern sleep technology

    CERN Document Server

    Chiang, Rayleigh Ping-Ying


    This book offers a wide range of up-to-date insight on current research in sleep technology, covering advances in sleep medicine, clinical psychology, engineering, industrial design and technology management, all with the aim of improving people's daily lives.

  4. Sleep deprivation and false memories. (United States)

    Frenda, Steven J; Patihis, Lawrence; Loftus, Elizabeth F; Lewis, Holly C; Fenn, Kimberly M


    Many studies have investigated factors that affect susceptibility to false memories. However, few have investigated the role of sleep deprivation in the formation of false memories, despite overwhelming evidence that sleep deprivation impairs cognitive function. We examined the relationship between self-reported sleep duration and false memories and the effect of 24 hr of total sleep deprivation on susceptibility to false memories. We found that under certain conditions, sleep deprivation can increase the risk of developing false memories. Specifically, sleep deprivation increased false memories in a misinformation task when participants were sleep deprived during event encoding, but did not have a significant effect when the deprivation occurred after event encoding. These experiments are the first to investigate the effect of sleep deprivation on susceptibility to false memories, which can have dire consequences.

  5. Rodent models of sleep apnea. (United States)

    Davis, Eric M; O'Donnell, Christopher P


    Rodent models of sleep apnea have long been used to provide novel insight into the generation and predisposition to apneas as well as to characterize the impact of sleep apnea on cardiovascular, metabolic, and psychological health in humans. Given the significant body of work utilizing rodent models in the field of sleep apnea, the aims of this review are three-fold: first, to review the use of rodents as natural models of sleep apnea; second, to provide an overview of the experimental interventions employed in rodents to simulate sleep apnea; third, to discuss the refinement of rodent models to further our understanding of breathing abnormalities that occur during sleep. Given mounting evidence that sleep apnea impairs cognitive function, reduces quality of life, and exacerbates the course of multiple chronic diseases, rodent models will remain a high priority as a tool to interrogate both the pathophysiology and sequelae of breathing related abnormalities during sleep and to improve approaches to diagnosis and therapy.

  6. Sleep in High Stress Occupations (United States)

    Flynn-Evans, Erin


    High stress occupations are associated with sleep restriction, circadian misalignment and demanding workload. This presentation will provide an overview of sleep duration, circadian misalignment and fatigue countermeasures and performance outcomes during spaceflight and commercial aviation.

  7. The Impact of Cultural Behaviours, Local Beliefs, and Practices on Emerging Parasitic Diseases in Tropical Africa (United States)

    Onwuliri, Celestine O. E.; Anosike, Jude C.; Oguoma, Chibuzor; Onwuliri, Viola A.; Nwoke, Betram E. B.; Dozie, Ikechukwu, N. S.; Iwuala, Moses O. E.


    The scourge of emerging parasitic diseases (e.g., urinary schistosomiasis, ascariasis, malaria, chagas disease, leishmaniasis, trachoma, trichiuriasis, taeniasis, dracunculiasis, sleeping sickness, filariasis) causes tremendous pain, suffering, and eventually death in tropical African communities. Patterns of transmission of these emerging…

  8. Sleep stages, memory and learning.


    Dotto, L


    Learning and memory can be impaired by sleep loss during specific vulnerable "windows" for several days after new tasks have been learned. Different types of tasks are differentially vulnerable to the loss of different stages of sleep. Memory required to perform cognitive procedural tasks is affected by the loss of rapid-eye-movement (REM) sleep on the first night after learning occurs and again on the third night after learning. REM-sleep deprivation on the second night after learning does n...

  9. Impact of acetazolamide and CPAP on cortical activity in obstructive sleep apnea patients.

    Directory of Open Access Journals (Sweden)

    Katrin Stadelmann

    Full Text Available STUDY OBJECTIVES: 1 To investigate the impact of acetazolamide, a drug commonly prescribed for altitude sickness, on cortical oscillations in patients with obstructive sleep apnea syndrome (OSAS. 2 To examine alterations in the sleep EEG after short-term discontinuation of continuous positive airway pressure (CPAP therapy. DESIGN: Data from two double-blind, placebo-controlled randomized cross-over design studies were analyzed. SETTING: Polysomnographic recordings in sleep laboratory at 490 m and at moderate altitudes in the Swiss Alps: 1630 or 1860 m and 2590 m. PATIENTS: Study 1: 39 OSAS patients. Study 2: 41 OSAS patients. INTERVENTIONS: Study 1: OSAS patients withdrawn from treatment with CPAP. Study 2: OSAS patients treated with autoCPAP. Treatment with acetazolamide (500-750 mg or placebo at moderate altitudes. MEASUREMENTS AND RESULTS: An evening dose of 500 mg acetazolamide reduced slow-wave activity (SWA; approximately 10% and increased spindle activity (approximately 10% during non-REM sleep. In addition, alpha activity during wake after lights out was increased. An evening dose of 250 mg did not affect these cortical oscillations. Discontinuation of CPAP therapy revealed a reduction in SWA (5-10% and increase in beta activity (approximately 25%. CONCLUSIONS: The higher evening dose of 500 mg acetazolamide showed the "spectral fingerprint" of Benzodiazepines, while 250 mg acetazolamide had no impact on cortical oscillations. However, both doses had beneficial effects on oxygen saturation and sleep quality.

  10. Sleep in thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    G R Sridhar


    Full Text Available Objective: Pattern of sleep in hyperthyroid state / thyrotoxicosis has not been systematically studied. It is being characterized as poor without further elaboration. We analyzed the pattern of sleep in a large sample of individuals with thyrotoxicosis who came to our endocrine center in southern India. Materials and Methods: We identified individuals with the diagnosis of ′thyrotoxicosis′ from our electronic medical record database, and evaluated clinical parameters and pattern of their sleep: difficulty in falling asleep (DFA, difficulty in maintaining sleep (DMS, excess daytime sleepiness. In the first phase, univariate analysis with logistic regression was performed. Multivariate logistic regression was performed in the next phase on variables with a P-value < 0.1: these were considered as potential categories/ variables. Results: In model response variable with DFA, multivariate logistic regression predicted that subjects with abnormal appetite (more 1.7 or less 2.2, change in bowel motion (loose 1.5 or constipation 2.8, in mood (easy loss of temper 3.4, change of voice -- hoarse 7.4 or moderately hoarse 3.1, tended to have higher chances of difficulty in falling asleep (DFA. Patients with tremor (yes = 5.4 had greater likelihood of difficulty in maintaining sleep (DMS. Conclusions: Individuals with hyperthyroidism/thyrotoxicosis principally had difficulty in falling asleep DFA, which was related to hyperkinetic features.

  11. [Sleep related eating disorder]. (United States)

    Inoue, Yuichi; Komada, Yoko


    Nighttime eating is categorized as either sleep-related eating disorder (SRED) or night eating syndrome (NES). Critical reviews of the literature on both disorders have suggested that they are situated at opposite poles of a disordered eating spectrum. The feeding behavior in SRED is characterized by recurrent episodes of eating after an arousal from nighttime sleep with amnesia. Conversely, NES could be considered as an abnormality in the circadian rhythm of meal timing with a normal circadian timing of sleep onset. Both conditions clearly concentrate to occur during young adulthood, and are often relentless and chronic. Misunderstanding and low awareness of SRED and NES have limited our ability to determine the exact prevalence of the two disorders. SRED is frequently associated with other sleep disorders, in particular parasomnias such as sleep walking. Cognitive-behavioral therapy is ineffective, but pharmacotherapy is very effective in controlling SRED. Especially, studies have shown that the anti-seizure medication topiramate may be an effective treatment for SRED.

  12. Starting a sleep center. (United States)

    Epstein, Lawrence J; Valentine, Paul S


    The demand for sleep medicine services has grown tremendously during the last decade and will likely continue. To date, growth in demand has been met by growth in the number of new sleep centers. The need for more new centers will be dependent on market drivers that include increasing regulatory requirements, personnel shortages, integration of home sleep testing, changes in reimbursement, a shift in emphasis from diagnostics to treatment, and an increased consumer focus on sleep. The decision to open a new center should be based on understanding the market dynamics, completing a market analysis, and developing a business plan. The business plan should include an overview of the facility, a personnel and organizational structure, an evaluation of the business environment, a financial plan, a description of services provided, and a strategy for obtaining, managing, and extending a referral base. Implementation of the business plan and successful operation require ongoing planning and monitoring of operational parameters. The need for new sleep centers will likely continue, but the shifting market dynamics indicate a greater need for understanding the marketplace and careful planning.

  13. Sustained sleep fragmentation induces sleep homeostasis in mice

    KAUST Repository

    Baud, Maxime O.


    Study Objectives: Sleep fragmentation (SF) is an integral feature of sleep apnea and other prevalent sleep disorders. Although the effect of repetitive arousals on cognitive performance is well documented, the effects of long-term SF on electroencephalography (EEG) and molecular markers of sleep homeostasis remain poorly investigated. To address this question, we developed a mouse model of chronic SF and characterized its effect on EEG spectral frequencies and the expression of genes previously linked to sleep homeostasis including clock genes, heat shock proteins, and plasticity-related genes. Design: N/A. Setting: Animal sleep research laboratory. Participants : Sixty-six C57BL6/J adult mice. Interventions: Instrumental sleep disruption at a rate of 60/h during 14 days Measurements and Results: Locomotor activity and EEG were recorded during 14 days of SF followed by recovery for 2 days. Despite a dramatic number of arousals and decreased sleep bout duration, SF minimally reduced total quantity of sleep and did not significantly alter its circadian distribution. Spectral analysis during SF revealed a homeostatic drive for slow wave activity (SWA; 1-4 Hz) and other frequencies as well (4-40 Hz). Recordings during recovery revealed slow wave sleep consolidation and a transient rebound in SWA, and paradoxical sleep duration. The expression of selected genes was not induced following chronic SF. Conclusions: Chronic sleep fragmentation (SF) increased sleep pressure confirming that altered quality with preserved quantity triggers core sleep homeostasis mechanisms. However, it did not induce the expression of genes induced by sleep loss, suggesting that these molecular pathways are not sustainably activated in chronic diseases involving SF.

  14. A therapeutic community as a relevant and efficient ecclesial model in African Christianity

    Directory of Open Access Journals (Sweden)

    Matsobane Manala


    Full Text Available This article sets forth the argument that Christian ministry in Africa must become socially and culturally informed and constructed or else it will not touch the African soul and thus remain superficial. Black African people aspire above everything else to experience fullness of life and wellbeing here and now, as demonstrated by their greetings that are actually an enquiry into each other’s health and an expression of the wish for the other’s good health and wellbeing. The mainline churches that operate in Africa should embrace the scripturally sound Christian healing ministry in obedience to Christ’s commission to preach the gospel and heal the sick, if they are to prosper. Hence, this article discusses the following eight points, namely, (1 good health and healing as Africans’ important aspiration, (2 healing as the work of God and thus of the church, (3 the imperative of serious consideration of and respect for the African worldview, (4 membership decline and mainline churches’ loss of influence, (5 rethinking church in African Christianity, (6 the need for the black African church to adopt a therapeutic or healing community ecclesial model in order to position itself strategically to cater for the holistic needs of African (South African church members and surrounding communities, (7 the rationale of the healing ministry in today’s Reformed Church in Africa and (8 the recommended healing ministry. The article closes with a few concluding statements and advice

  15. Colonialism, Biko and AIDS: reflections on the principle of beneficence in South African medical ethics. (United States)

    Braude, Hillel David


    This paper examines the principle of beneficence in the light of moral and epistemological concerns that have crystallized in the South African context around clinical care. Three examples from the South African experience affecting the development of bioethics are examined: medical colonialism, the death in detention of Steve Biko, and the HIV/AIDS epidemic. Michael Gelfand's book [(1948). The sick African: a clinical study. Cape Town: Stewart Printing Company.] on African medical conditions captures the ambiguous nature of colonial medicine that linked genuine medical treatment with the civilizing mission. Biko's death was a key historical event that deeply implicated the medical profession under apartheid. The present HIV/AIDS epidemic presents the gravest social and political crisis for South African society. All three experiences influence the meaning and relevance of beneficence as a bioethics principle in the South African context. This paper argues for a South African bioethics informed by a critical humanism that takes account of the colonial past, and that does not model itself on an "original wound" or negation, but on positive care-giving practices.

  16. [Evaluation of sleep apnea syndromes]. (United States)

    Poirrier, R


    The evaluation of sleep apnea syndrome is based on polysomnography. Different sensor and recording techniques are reported. Some widely used neurophysiological and cardiorespiratory analysis criteria are proposed. Many sleep laboratories develop ambulatory and automatized methods for screening breathing disorders associated with sleep. The main principles of these approaches are briefly reviewed.

  17. Type 1 Diabetes and Sleep. (United States)

    Farabi, Sarah S


    IN BRIEF In people with type 1 diabetes, sleep may be disrupted as a result of both behavioral and physiological aspects of diabetes and its management. This sleep disruption may negatively affect disease progression and development of complications. This review highlights key research findings regarding sleep in people with type 1 diabetes.

  18. Cutaneous warming promotes sleep onset.

    NARCIS (Netherlands)

    Raymann, R.J.E.M.; Swaab, D.F.; Someren, E.J.W. van


    Sleep occurs in close relation to changes in body temperature. Both the monophasic sleep period in humans and the polyphasic sleep periods in rodents tend to be initiated when core body temperature is declining. This decline is mainly due to an increase in skin blood flow and consequently skin warmi

  19. Sleep disturbances and glucose homeostasis

    NARCIS (Netherlands)

    Barf, R. Paulien; Scheurink, Anton J.W.


    Sleep disturbances, induced by either lifestyle, shift work or sleeping disorders, have become more prevalent in our 24/7 Western society. Sleep disturbances are associated with impaired health including metabolic diseases such as obesity and type 2 diabetes. The question remains whether there is a

  20. Sleep Disorders, Epilepsy, and Autism (United States)

    Malow, Beth A.


    The purpose of this review article is to describe the clinical data linking autism with sleep and epilepsy and to discuss the impact of treating sleep disorders in children with autism either with or without coexisting epileptic seizures. Studies are presented to support the view that sleep is abnormal in individuals with autistic spectrum…