The influence of age, gender, ethnicity, and insomnia on Epworth sleepiness scores: a normative US population.

Background And Purpose: This study explored the distribution of Epworth Sleepiness Scale (ESS) scores in a randomly sampled, community population and provided percentile scores that will assist in decision-making in both research and clinical settings.

Patients And Methods: Participants included 703 individuals between the ages of 20 and 98, with 116 people with insomnia (PWI) and 587 people not having insomnia (PNI). Analyses produced main effects for sleep status and ethnicity.

The comparison and validity of troponin I assay systems in diagnosing myocardial ischemic injury after surgical coronary revascularization.

Objective: A prospective observational study was conducted to test the agreement between 2 commercially available automated cardiac troponin-I immunoassay systems (Opus Plus, Behring Diagnostics UK Ltd, Hounslow, UK; AxSYM, Abbott Laboratories, Abbott Park, IL) and to determine a normal reference range and threshold value indicative of perioperative myocardial infarction (PMI) after elective coronary artery bypass graft (CABG) surgery for the Opus Plus system.

Design: Prospective, observational study. Setting : Single institution, cardiothoracic specialty hospital.

Potential therapeutic applications of fructose-1,6-diphosphate.

Ischaemia-related tissue injury is the leading cause of death in developed countries. Drugs that can reduce ischaemic injury would be beneficial in treatment of myocardial infarction (MI), surgical trauma and stroke. Fructose-1,6-diphosphate (FDP) is a key intermediate in anaerobic glycolysis and is the product of the major regulatory enzyme in the pathway (phosphofructokinase).

Auditory sequence learning: differential sensitivity to task relevant and task irrelevant sequences.

Using a serial reaction time task, this study examines whether learning of auditory sequences is possible without a corresponding motor response, i.e., by listening alone.

Transcriptional responses of rat skeletal muscle following hypoxia-reoxygenation and near ischaemia-reperfusion.

Aim: The effect of ischaemia/reperfusion or hypoxia/reoxygenation on gene expression has not been extensively studied. We hypothesized that in skeletal muscle, tissue hypoxia of similar magnitude but induced by different mechanisms would lead to different transcriptional responses.

Methods: Muscle gene transcription was assessed using microarray analysis and reverse transcriptase polymerase chain reaction in 18 rats exposed to regional hind limb near ischaemia/reperfusion (n = 6), hypoxia/reoxygenation (n = 6) or sham operation (n = 6).

Socioeconomic status and insomnia.

This investigation compared the likelihood of insomnia and insomnia-related health consequences among individuals of different socioeconomic status. A random-digit dialing procedure was used to recruit at least 50 men and 50 women in each age decade from 20 to 80+ years old. Participants completed 2 weeks of sleep diaries as well as questionnaires related to fatigue, sleepiness, and psychological distress.

Thyroid hormone inhibits slow skeletal TnI expression in cardiac TnI-null myocardial cells.

A cardiac troponin I (cTnI) gene knockout mouse model has been created and the phenotype of the cTnI null mice is an acute heart failure resulting from the deficiency of TnI and a diastolic dysfunction. Two isoforms of TnI (the fetal form ssTnI and the adult form cTnI) are mainly expressed in the heart under a developmentally regulated program. In our previous studies, we demonstrated that thyroid hormone could alter the time course of ssTnI gene expression in the heart.

The relation between smoking and sleep: the influence of smoking level, health, and psychological variables.

The relation between smoking and sleep was examined in a randomly selected sample of 769 individuals (379 men and 390 women, ages 20 to 98). Participants completed 2 weeks of sleep diaries, provided a global report on their sleep, indicated the number of cigarettes smoked per day, and supplied information on health, depressive symptoms, anxiety, and caffeine and alcohol use. After controlling for demographic, health, psychological, and behavioral variables, light smoking (< 15 cigarettes per day), but not heavier smoking, was associated with self-reported chronic insomnia and reduced sleep diary total sleep time and time in bed.

Myocardial protection using fructose-1,6-diphosphate during coronary artery bypass graft surgery: a randomized, placebo-controlled clinical trial.

Unlabelled: In vitro and in vivo studies suggest that fructose-1,6-diphosphate (FDP), an intermediary glycolytic pathway metabolite, ameliorates ischemic tissue injury through increased high-energy phosphate levels and may therefore have cardioprotective properties in patients undergoing coronary artery bypass graft (CABG) surgery. We designed a randomized, placebo-controlled, double-blinded, sequential-cohort, dose-ranging safety study to test 5 FDP dosage regimens in patients (n = 120; 60 FDP, 60 control) undergoing CABG surgery. Of these dosage regimens, 3 produced no benefit, 1 produced improved cardiac function, and 1 required adjustment as a result of metabolic acidosis.

"Start to stop": results of a randomised controlled trial of a smoking cessation programme for teens.

Objective: To examine the feasibility, acceptability, and effectiveness of a school based smoking cessation programme among students caught smoking at school.

Design: A randomised controlled trial comparing cessation rates among students in a behavioural cessation programme and those receiving self help materials only.

Setting: Eighteen schools in the Memphis, Tennessee area.

Sequence learning by action and observation: evidence for separate mechanisms.

In the Serial Reaction Time (SRT) task, participants respond to a set of stimuli the order of which is apparently random, but which consists of repeating sub-sequences. Participants can become sensitive to this regularity, as measured by an indirect test of reaction time, but can remain apparently unaware of the sequence, as measured by direct tests of prediction or recognition. Some researchers have claimed that this learning may take place by observation alone.

The reliability and predictive value of adolescents' reports of initial reactions to smoking.

A sample of 372 adolescents completed annual surveys regarding their initial reactions to smoking (IRTS) and their current smoking status. Each annual survey asked participants if they had the following five reactions the first time they smoked a cigarette: coughing, or feeling dizzy, sick, high, or relaxed. Time 1 IRTS data were collected within 1 year of the reported initial smoking experience, and Time 2 IRTS data were collected 1 year later.

Integrated approach to off-pump coronary artery bypass surgery.

Background: The Off-Pump Coronary Artery Bypass (OPCAB) technique is becoming more popular in many cardiac units throughout the world. This relatively new technique has prompted surgeons and anaesthetists to review and modify the routine approach to Coronary Artery Bypass Surgery (CABG). In this study we reviewed and analysed the outcome of an integrated anaesthetic and surgical peri-operative approach that allowed routine use of OPCAB and avoided the use of cardiopulmonary bypass (CPB).

Venous thromboembolism in the intensive care unit.

Most ICU patients have a significant number of risk factors for VTE. The high incidence of DVT in the ICU population and the recognition of a high incidence of PE at autopsy confirm this. We have alluded to the difficulty of clinical diagnosis of VTE and the need for diagnostic investigations.

Quantitative criteria for insomnia.

Formal diagnostic systems (DSM-IV, ICSD, and ICD-10) do not provide adequate quantitative criteria to diagnose insomnia. This may not present a serious problem in clinical settings where extensive interviews determine the need for clinical management. However, lack of standard criteria introduce disruptive variability into the insomnia research domain.

Insomnia and daytime functioning.

Results from the present review challenge the assumption that daytime functioning deficits are associated with insomnia. Objectively-measured daytime sleepiness is not elevated in people with insomnia, and most cognitive/psychomotor tasks do not indicate deficits in people with insomnia. In contrast, a number of studies have found that people with insomnia self-report daytime symptoms such as elevated fatigue, mood disturbance and reduced quality of life.

Ethnic differences in smoking withdrawal effects among adolescents.

Smoking withdrawal effect information was collected from 75 adolescents (54 males and 21 females) making a quit attempt during a school-based smoking cessation program. A strong need to smoke was the most common withdrawal effect (60%), followed by irritability (51%), and difficulty concentrating (41%). Most (61%) participants experienced two or more withdrawal effects during the quit attempt, and withdrawal effects were evident in those smoking less than daily.

'Young old' and 'old old' poor sleepers with and without insomnia complaints.

Objective: Sleep, psychological adjustment, health and insomnia complaints were examined in 277 community-dwelling seniors in order to identify characteristics that distinguish poor sleepers with complaints (likely to seek treatment) and those without complaints (unlikely to seek treatment).

Methods: Two weeks of sleep diaries and other sleep-related measures were collected. Young old (65-74 years) and old old (75+) participants were categorized as: good sleepers, poor sleepers with complaints (complainers), and poor sleepers without complaints (noncomplainers).

Characteristics of adolescents caught with cigarettes at school: implications for developing smoking cessation programs.

A potential method of recruiting adolescents for smoking cessation interventions is to offer treatment to students who have been caught with cigarettes at school. The present investigation surveyed 110 adolescents after they were caught with cigarettes at school. The majority of participants were daily smokers (65%) and 17% of the sample scored > or =6 on a version of the Fagerström Tolerance Questionnaire.