Search

Bipolar affective disorder (BAD) is one of the actual problems in modern psychiatry. The aim of the study is to investigate dyssomnia in patients with primary episode of BAD, taking into account, the sex and clinical features of the diseases debut. We have clinically examined 65 men and 88 women diagnosed with bipolar affective disorder in the period 2015–2019. It was found that dyssomnia is present in 98.3% of all patients, in 97.7% of men and in 98.7% of women with depressive variant of the primary episode of BAD, accordingly in 30.4%, 26.7% and 37.5% of patients with manic variant and at 100,0% of patients with mixed variant. The structure of sleep disorders varies significantly depending on the variant of the primary episode: with depressive, prevail night and early awakenings (100.0%), sleep disturbance (75.6%, 70.5%, and 78.7%), unstable sleep (47.9%, 59.1% and 41.3%, p

We report a patient who presented with paraplegia after ascending aorta and arch replacement using the frozen elephant trunk technique. Immediate postoperatively cerebrospinal fluid drainage allowed successful reversal of spinal chord injury. Early awakening of patients following a frozen elephant technique is mandatory because it allows recognition and treatment of this complication by prompt cerebrospinal liquor drainage.

Objectives Evaluate an enhanced recovery after surgery (ERAS)–based free flap management protocol implemented at our center. Study Design Prospective cohort study of patients after implementation of an ERAS-based perioperative care protocol for patients undergoing free flap reconstruction of the head and neck as compared with a historical control group. Setting Tertiary care academic medical center. Participants and Methods All patients undergoing free flap reconstruction were prospectively enrolled in the ERAS protocol group. A retrospective control group was identified by randomly selecting an equivalent number of patients from a records search of those undergoing free flap surgery between 2009 and 2015. Blood transfusion, complications, 30-day readmission rates, intensive care unit (ICU) and hospital length of stay, and costs of hospitalization were compared. Results Sixty-one patients were included in each group. Patients in the ERAS group underwent less frequent flap monitoring by physicians and had lower rates of intraoperative (70.5% vs 86.8%, P = .04) and postoperative (49.2% vs 27.2%, P = .026) blood transfusion, were more likely to be off vasopressors (98.3% vs 50.8%, P < .01) and ventilator support (63.9% vs 9.8%, P < .01) at the conclusion of surgery, and had shorter ICU stays (2.11 vs 3.39 days, P = .017). Length of stay, readmissions, and complication rates did not significantly differ between groups. Conclusion ERAS-based perioperative practices for head and neck free flap reconstruction can reduce time on the ventilator and in the ICU and the need for vasopressors, blood transfusions, and labor-intensive flap monitoring, without adverse effects on outcomes.

The present study examined the effect of partial sleep deprivation (PSD) and racial variation on muscle power and fatigue during a 30-s Wingate test. In randomized order, 36 healthy football players – 12 black Tunisians (BT), 12 white Tunisians (WT) and 12 South Africans (SA) were asked to perform a 30-s Wingate test during which the peak (PP) and mean (MP) powers and the fatigue index (FI) were assessed. Measurements were performed in the afternoon after two nocturnal regimens: (i) a reference normal sleep night (RN) and (ii) 4-h of PSD caused by an early awakening (bed time: from 22:30 to 03:00 h). Our results showed that PP and MP were higher in SA than WT and BT during the RN control. Likewise, compared to this control, PP and MP were affected by PSD during the following afternoon in SA. There was a significantly greater decrease in PP and MP (p

The development of Science was a part of God’s revelation which was revealed to His Prophets at the early awakening of human civilization on the earth. This Science then was spread by their followers to make people understand, apply and develop it as a means in running their duty as caliphs. However, after the death of the prophets, people tended to misuse science development. As a result, beside giving some advantages and ease for human activities, it also creates negative effects.

To investigate the prevalence of restless legs syndrome (RLS) during pregnancy and to evaluate factors associated with RLS in a population of Iranian pregnant women.In the present cross-sectional study, 443 consecutive pregnant women admitted for delivery underwent an interview within 2 days of parturition. The diagnosis of RLS was established by the 4 criteria of the International Restless Legs Syndrome Study Group (IRLSSG). The severity of RLS was assessed through the IRLSSG Rating Scale.Seventy-nine (17.8%) women met the RLS diagnostic criteria, with most (74.7%) having RLS of moderate severity. The mean RLS duration before delivery was 3.1 ± 2.1 months among 69 (87.3%) women; 10 (12.7%) had RLS onset before pregnancy. Sleep disturbances including insomnia and early awakening were significantly more common among women with RLS than among those without (P0.001), and the frequency of cesarean delivery was also significantly higher (58.2% versus 44.5%, P = 0.027; odds ratio 2.4). There were no significant differences between the 2 groups in terms of age, number of pregnancies, folate and iron supplementation, hemoglobin level, and neonatal anthropometric data.Restless legs syndrome is common during pregnancy and is associated with poor sleep and an increased risk of cesarean delivery.

Summary Objective: We assessed the hypnotic effects of and patient satisfaction with three types of hypnotics prescribed empirically: ultra-short-acting (US-a), short-acting (S-a), and intermediate- and long-acting (IL-a) agents. Methods: We studied 310 insomniac patients (age 60·5 ± 15·0 years) treated with US-a (n = 124), S-a (n = 149) or IL-a (n = 37) agents. Patients were interviewed to evaluate individual satisfaction and drug efficacy. Efficacy, as assessed by total sleep time (TST) and sleep latency time (SLT), was compared between satisfied and dissatisfied patient groups. Nocturnal awaking curve for each hypnotic was used for comparing the effects between satisfied and dissatisfied patient groups in each type of hypnotics. Results: Thirty-two patients (25·8%) were dissatisfied with US-a, 35 (23·5%) with S-a and 11 (29·7%) with IL-a. TST differed significantly between satisfied and dissatisfied groups: 424 ± 88 vs. 345 ± 101 min for US-a (P

Critics have long recognized a kinship between the works of Friedrich Schiller and Franz Grillparzer. As early as 1902, 0. E. Lessing made the most thorough assessment to date of the specific nature of the relationship between the two dramatists in his study Schillers Einflus auf Grillparzer. Only three years later, to mark the occas ion of the one hundredth anniversary of Schiller's death, Robert F. A rnold wrote an article for the Jahrbuch der Grillparzer-Gesellschaft entitled "Schiller und Grillparzer," in which he maintains, "Also schon 1855 und 1859 [...] konnte die Nation Schillers Andenken nicht festlich begehen, ohne in Grillparzer gleichsam den geistigen Erben, ja Haupterben des Gefeierten zu ehren" (133). To justify this claim, Arnold proceeds to catalogue the "Ubereinstimmungen des auseren Lebens" (149) such as a strict, sober father or the early awakening of their respective poetic talents, and compares their art in the broadest of terms. In 1972 Robert Pichl again brought the two names into close proximity in his study Dualismus und Ambivalenz. Die Dramenschlusse Schillers und Grillparzers als Indizien individueller Vorgangsgestaltung. One might expect Pichl's study to deal with the analogies between the conclusions of Maria Stuart and Sappho, but he chooses instead to focus on establishing "ein geschlossenes Analysensystem, in dem sich die kunstlerische Eigenart der Schlusgestaltung beider Dichter aufrollen last" (3). From approximately 1806 to 1810, Schiller's influence dominated the teenage Grillparzer as Lessing has fully documented and as the dramatist himself acknowledged: "Schiller war mein Idol, mein Vorbild, und mein Gefuhl (viel

A vast literature review on the insomnia epidemiology, the most common sleep disorder, using MEDLINE and LILACS last 30 years of data, was performed from January 2002 to November 2003. The key-words were: sleep initiation disorders, sleep maintenance disorders, early awakening disorder, insomnia, sleep disorders, insomnia prevalence, insomnia consequences. Several insomnia definition criteria and epidemiology researches methods, with data comparison difficulties, were noticed. In the future it will be necessary similar insomnia definition and epidemiology studies criteria.

The insomnia prevalence in general population was determined by means of 408 home interviews of adults, in a representative sample of Campo Grande city, Brazil. The random sample was stratified by sex, age and economic social status. Insomnia subtypes evaluated were the disorders of sleep initiation (DSI), sleep maintenance (DSM) and early awakening (DEA). A structured questionnaire was used with the consent from the interviewed subjects. Statistics used chi-square, and Fisher tests; and inferences based on binomial distribution parameters; the significance level was 5% and confidence interval (CI) was 95%.The general prevalence of insomnia was 19.1% (sd=2.0%), mostly women (p=0.0015), and people of less years of schooling (p=0.0317), subtype DSI (14.2%, p=0.0043), and chronic (p=0.7022). Hypnotic drugs were used by 6.9%(sd=1.3%) in the last month. Use in the last 2 years, 70.3% mostly insomniacs (p

Summary The effects of age and shiftwork experience (never, past, present) on sleep were studied in a sample of 3236 wage earners and retired workers by means of a questionnaire. The sample was composed of 32-, 42-, 52-, and 62-year-old subjects, and included both sexes and various occupational statuses. Age resulted in a continuously increasing frequency of sleep disturbances and hypnotic use, except for difficulty getting back to sleep and early awakening, which peaked at 52 years and then decreased at 62 years, thus suggesting a ‘retirement effect’. Current and past shiftworkers reported more problems with falling asleep and early awakening than subjects who had never worked on shifts. This is a likely explanation of why the effect of age was massive in the latter group and much less pronounced in the former groups. There were no clear effects of the length or recency of shiftwork experience. This finding does not support the hypothesized permanent effect of shiftwork experience on subsequent sleep. Females had higher complaint rates at every age. There was little interaction between age and sex, but women were affected more by shiftwork as they got older, particularly as to hypnotic consumption. Some of the results support the hypothesis that a selection process excludes workers who are no longer able to cope with the demands of shiftwork.

Introduction – Given the high morbidity and mortality associated with intracerebral hemorrhage (ICH), family members and healthcare providers base early supportive management decisions, at least in part, on expected prognosis. In the comatose patient with ICH, this short-term prognosis is most overtly characterized by regaining of consciousness.Methods – A retrospective consecutive cohort of 51 patients admitted to a neuroICU with ICH and admission Glasgow Coma Scale score ≤ 8 was identified. Logistic regression was performed to assess the association of baseline characteristics and treatment parameters associated with awakening.Results – Awakening from coma was observed in 53% of ICH patients: 83% with an initial GCS score of 7-8, 43% with an initial score of 5-6, and 20% with an initial score of 3-4. Awakening from coma in the cohort of 27 patients who regained consciousness occurred in 59% of patients by day 2, 89% by day 7, and 96% by day 9. In multivariable analysis, only higher admission GCS score was associated with a greater likelihood of awakening from coma (OR 4.9 [95%CI 1.9–13] per 2-point category, p=0.001). DNR status during the first 24 hours was not associated with awakening but was at later time points.Conclusion – GCS score is the predominant initial predictor of early awakening in patients who present in coma after ICH. Patients who regained consciousness typically did so within the first 9 days of hospital admission.

Insomnia generally is defined as a subjective report of difficulty falling sleep, difficulty staying asleep, early awakening, or nonrestorative sleep. It is one of the most common health complaints among the general population. in this paper we try to find relationships between different insomnia cases and predisposing, precipitating, and perpetuating factors following by pharmacological treatment.

Discoveries via self-experimentation about effects of breakfast on sleep, morning faces on mood, standing on sleep, and sugar water on weight. Eating breakfast increases early awakening. Seeing faces in the morning improves mood the next day. Standing at least 8 hours per day reduces early awakening. During fructose water causes easy weight loss.

Objectives: Various sleep and related daytime complaints are frequent in patients with rheumatoid arthritis [RA]- and fibromyalgia syndrome [FMS], but also in the general population. The aim of this study was to compare the prevalence of these symptoms in the two patient groups to a control population. Methods: Forty-four women with RA, 43 with FMS and 756 normal women [NC] completed a standardized questionnaire on various questions regarding sleep, musculoskeletal, cognitive and mood complaints. Data from the 2 patient groups were compared to the answers given by the normal subjects. Results: Difficulties falling asleep, frequent and early awakening and non-restorative sleep were prevalent in patients compared to NC. Eighty-three percent of FMS, 55% of RA patients and 19% of NC reported tiredness all day. Most patients took daytime naps, but only 14% of FMS and 38% of RA patients felt refreshed after these. Consumption of hypnotics was 33% in FMS and 15% in RA, compared to 6% of NC. More than 80% of pati...

The restless and crying children in the modern post-anaesthetic recovery room have been attributed to hypoxia during the anaesthetic and to psychological causes. There is no doubt that in the great majority of cases these little patients are suffering from the pain of acute recent trauma, the hypnotic effect of barbiturates, or residual curarization. The use of meperidine intravenously, as part of the anaesthetic, reduces the incidence of these unpleasant sequelae markedly, as well as providing smooth induction and maintenance and early awakening from anaesthesia.

Age-specific prevalences of early awakening and feeling worse in the morning than in the evening were studied in 6034 subjects (schoolchildren, students, and employees) aged 9 to 60 years. Early awakening was found to be significantly more prevalent in males at most ages. In both sexes, early awakening was least prevalent in subjects aged 13 to 26 years and feeling worse in the morning than in the evening was most prevalent in subjects in their 20s. In subjects older than 21 years, the age trend of early awakening was a uniform increase, while that of feeling worse in the morning than in the evening was a uniform decrease. These two symptoms show roughly opposite age trends. Increasing prevalence of early awakening with age in endogenous depressives can be viewed at least partly as a reflection of the normal aging process.

The development of the Vienna endogenomorphic schizophrenic and cyclothymic axial syndromes as research criteria for endogenous psychoses is based on the results of a follow-up study on paranoiac patients by Berner (1). He was able to demonstrate that part of these patients were suffering from a clear schizophrenic or manic-depressive disorder at the time of reexamination. Further catamnestic studies on paranoiac patients as part of the Lausanne Survey (2) gave rise to the formulation of criteria enabling an attribution to these two diagnoses. The term ‘axial syndromes’ for these criteria was derived from the term ‘axial symptoms’ coined by Hoche (3). They were called ‘endogenomorphic’ (the adjective used formerly, ‘endomorphic’ was abandoned to avoid confusion with Sheldon’s physical types), to emphasize their use as research criteria and not as nosological classifications. The criteria were defined in 1969 and underwent several modifications as a result of experience gained in their use.

An index sample of neurological patients diagnosed as clinically depressed (83) was compared with a "major depression" sample (43) and a "neurological sample" (44) who were free from psychiatric disorder. There was no difference in global Hamilton Scores between the index and the major depression sample. The latter, however, more often exhibited family and personal history of psychiatric illness, early awakening, guilt, suicidal ideas, shorter index episodes of depression, and better response to treatment. The three samples were followed up for a period of up to 5 years. The index sample did worse on follow-up than did the depressed and the neurological samples. The disease profiles of both the index and neurological samples were similar, but there were more cases of epilepsy in the former. The index sample responded badly to conventional antidepressant treatment. It is concluded that the presence of chronic affective disorder in the neurological patient has an adverse effect on prognosis.

A difference between arterial and hepatic venous thiopental concentrations of 6.6 and 15.1 per cent was found in dogs after 3 and 5 hours, respectively, following intravenous injection of 30 mg. thiopental per pound. This and similar data in man were used to predict, in an electrical analog, the effect of liver thiopental metabolism on the rate of fall of arterial thiopental concentration. Contrary to previous belief we found that metabolism is of major importance in the early rapid reduction of arterial levels and hence plays a major role in the early awakening seen with this anesthetic. Although uptake in muscle still plays the dominant role in the early fall of the arterial concentration, this was equalled by the additive effect of metabolism and uptake in fat.