Sample records for nocturnal enuresis

  1. Prevalence of Nocturnal Enuresis and Its Associated Factors in Primary School and Preschool Children of Khorramabad in 2013

    PubMed Central

    Bakhtiar, Katayoun; Pournia, Yadollah; Ebrahimzadeh, Farzad; Farhadi, Ali; Shafizadeh, Fathollah; Hosseinabadi, Reza

    2014-01-01

    Background. Nocturnal enuresis refers to an inability to control urination during sleep. This study aimed to determine the prevalence of nocturnal enuresis and its associated factors in children in the city of Khorramabad. Materials and Methods. In this descriptive-analytic, cross-sectional study, 710 male and female children were divided into two groups with equal numbers. The samples were selected from the schools of Khorramabad using the multistage cluster and stratified random sampling methods based on the diagnostic criteria of DSM-IV. The data was analyzed using the logistic regression. Results. The results showed that 8% of the children had nocturnal enuresis, including 5.2% of primary nocturnal enuresis and 2.8% of secondary nocturnal enuresis. The prevalence of nocturnal enuresis in the boys (10.7%) was higher compared with that in the girls (5.4%) (P = 0.009). There were statistically significant relationships between nocturnal enuresis and history of nocturnal enuresis in siblings (P = 0.023), respiratory infections (P = 0.036), deep sleep (P = 0.007), corporal punishment at school (P = 0.036), anal itching (P = 0.043), and history of seizures (P = 0.043). Conclusion. This study showed that the prevalence of nocturnal enuresis in the boys was higher compared with that in the girls. PMID:25374608

  2. Circadian Rhythm of Glomerular Filtration and Solute Handling Related to Nocturnal Enuresis.

    PubMed

    Dossche, L; Raes, A; Hoebeke, P; De Bruyne, P; Vande Walle, J

    2016-01-01

    Although nocturnal polyuria in patients with monosymptomatic enuresis can largely be explained by the decreased nocturnal vasopressin secretion hypothesis, other circadian rhythms in the kidney also seem to have a role. We recently documented an absent day/night rhythm in a subgroup of desmopressin refractory cases. We explore the importance of abnormal circadian rhythm of glomerular filtration and tubular (sodium, potassium) parameters in patients with monosymptomatic enuresis. In this retrospective study of a tertiary enuresis population we collected data subsequent to a standardized screening (International Children's Continence Society questionnaire), 14-day diary for nocturnal enuresis and diuresis, and 24-hour concentration profile. The study population consisted of 139 children with nocturnal enuresis who were 5 years or older. Children with nonmonosymptomatic nocturnal enuresis were used as controls. There was a maintained circadian rhythm of glomerular filtration, sodium, osmotic excretion and diuresis rate in children with monosymptomatic and nonmonosymptomatic nocturnal enuresis, and there was no difference between the 2 groups. Secondary analysis revealed that in patients with nocturnal polyuria (with monosymptomatic or nonmonosymptomatic nocturnal enuresis) circadian rhythm of glomerular filtration, sodium and osmotic excretion, and diuresis rate was diminished in contrast to those without nocturnal polyuria (p <0.001). Circadian rhythm of the kidney does not differ between patients with nonmonosymptomatic and monosymptomatic enuresis. However, the subgroup with enuresis and nocturnal polyuria has a diminished circadian rhythm of nocturnal diuresis, sodium excretion and glomerular filtration in contrast to children without nocturnal polyuria. This observation cannot be explained by the vasopressin theory alone. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. The Effect of Breathing Exercises on the Nocturnal Enuresis in the Children with the Sleep-Disordered Breathing

    PubMed Central

    Khaleghipour, Shahnaz; Masjedi, Mohsen; Kelishadi, Roya

    2013-01-01

    Background The nocturnal enuresis is one of the most common complaints of childhood. Upper airway obstruction and nocturnal snoring affect the nocturnal enuresis in children. Objectives The aim of this study was to investigate the effects of breathing exercises on the nocturnal enuresis in the children with the sleep-disordered breathing. Patients and Methods This study was conducted in year of 2011 by a semi-experimental design with the control group among 40 children, aged 6 - 12 years, who had the nocturnal enuresis. Participants were examined based on the criteria of nocturnal enuresis, oral breathing, and nocturnal snoring. Subsequently, they were randomly assigned to the case and control groups. In the case group, the breathing exercises were performed for 45 minutes, and were pursued for four weeks in the morning following and prior to sleeping, and subsequently the arterial blood gases were measured and the frequency of enuresis and the respiratory rates (RR) were recorded. Results After intervention the means of PaCO2 and RR in the control group were significantly higher than the case group (P < 0.0001). Likewise, O2sat, PaO2 in the case group were higher than the control group (P < 0.0001). The nocturnal enuresis decreased significantly in the case group, compared to the control group (P < 0.0001). Conclusions This study suggests that the breathing exercises may reduce the frequency of nocturnal enuresis in the patients with the oral breathing and nocturnal snore. The clinical implications of these findings should be verified in the future longitudinal studies. PMID:24719691

  4. Multi-Modal Treatment of Nocturnal Enuresis.

    ERIC Educational Resources Information Center

    Mohr, Caroline; Sharpley, Christopher F.

    1988-01-01

    The article reports a multimodal treatment of nocturnal enuresis and anxious behavior in a mildly mentally retarded woman. Behavioral treatment and removal of caffeine from the subject's diet eliminated both nocturnal enuresis and anxious behavior. (Author/DB)

  5. The pathophysiology of monosymptomatic nocturnal enuresis with special emphasis on the circadian rhythm of renal physiology.

    PubMed

    Dossche, L; Walle, J Vande; Van Herzeele, C

    2016-06-01

    Nocturnal polyuria in monosymptomatic nocturnal enuresis (MNE) has so far mainly been attributed to a disturbed circadian rhythm of renal water handling. Low vasopressin levels overnight correlate with absent maximal concentrating activity, resulting in an increased nocturnal diuresis with low urinary osmolality. Therefore, treatment with desmopressin is a rational choice. Unfortunately, 20 to 60 % of children with monosymptomatic enuresis are desmopressin-resistant. There is increasing evidence that other disturbed circadian rhythms might play a role in nocturnal polyuria. This review focuses on renal aspects in the pathophysiology of nocturnal polyuria in MNE, with special emphasis on circadian rhythms. Articles related to renal circadian rhythms and enuresis were searched through the PubMed library with the goal of providing a concise review. Nocturnal polyuria can only partially be explained by blunted circadian rhythm of vasopressin secretion. Other alterations in the intrinsic renal circadian clock system also seem to be involved, especially in desmopressin-resistant enuresis. • Disturbance in the circadian rhythm of arginine vasopressin secretion is related to nocturnal polyuria in children with enuresis. • Desmopressin is recommended as a treatment for monosymptomatic nocturnal enuresis, working as a vasopressin analogue acting on V2 receptors in the collecting ducts of the kidney. What is New: • Other renal circadian rhythms might play a role in nocturnal polyuria, especially in desmopressin-resistant case.

  6. Transcutaneous Electrical Nerve Stimulation in Children with Monosymptomatic Nocturnal Enuresis: A Randomized, Double-Blind, Placebo Controlled Study.

    PubMed

    Jørgensen, Cecilie Siggaard; Kamperis, Konstantinos; Borch, Luise; Borg, Britt; Rittig, Søren

    2017-09-01

    In a third of all children with monosymptomatic nocturnal enuresis their condition is refractory to first line treatments. Transcutaneous electrical nerve stimulation has been documented to be efficacious in children with daytime incontinence. We investigated the effect of transcutaneous electrical nerve stimulation in children with monosymptomatic nocturnal enuresis without nocturnal polyuria. Children with monosymptomatic nocturnal enuresis (3 or more wet nights per week) and no nocturnal polyuria were randomized to treatment with active or sham transcutaneous electrical nerve stimulation involving 1-hour sessions twice daily for 10 weeks in a double-blind design. Of the 52 children with monosymptomatic nocturnal enuresis included in the study 47 completed treatment (mean age 9.5 ± 2.1 years, 38 males). None of the children experienced a full response with complete remission of enuresis. Treatment with transcutaneous electrical nerve stimulation did not lead to significant changes in number of wet nights, nocturnal urine production on wet or dry nights, maximum voided volume with and without first morning voided volume, or voiding frequency when comparing parameters before and after treatment. The present study demonstrates no anti-enuretic effect of transcutaneous electrical nerve stimulation in children with monosymptomatic nocturnal enuresis without nocturnal polyuria. Nocturnal urine production and bladder capacity remained unchanged during and after treatment with transcutaneous electrical nerve stimulation. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. Effect of indomethacin on desmopressin resistant nocturnal polyuria and nocturnal enuresis.

    PubMed

    Kamperis, Konstantinos; Rittig, Søren; Bower, Wendy F; Djurhuus, Jens C

    2012-11-01

    We evaluated the acute effect of indomethacin on renal water and solute handling in children with coexisting monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria, and in healthy controls. A total of 23 subjects were recruited, consisting of 12 children with monosymptomatic nocturnal enuresis and nocturnal polyuria with partial or no response to desmopressin, and 11 age matched controls. Children completed a 48-hour inpatient study protocol consisting of fractional urine collections and blood samples. Sodium and water intake were standardized. During the second night a dose of 50 mg indomethacin was administered orally before bedtime. Diuresis, urine osmolalities, clearances and fractional excretions were calculated for sodium, potassium, urea, osmoles and solute-free water. Renin, angiotensin II, aldosterone and atrial natriuretic peptide were measured in plasma. Prostaglandin E(2) was measured in urine. Indomethacin markedly decreased the nocturnal sodium, urea and osmotic excretion in children with enuresis and controls. The overall effect on nocturnal urine output was inconsistent in the group with enuresis. Subjects in whom nocturnal diuresis was decreased following administration of indomethacin remained dry. Prostaglandin inhibition leads to antidiuresis, reducing the amount of sodium, urea and osmotic excretion in children with monosymptomatic nocturnal enuresis and desmopressin resistant nocturnal polyuria. The sodium regulating hormones do not seem to mediate these processes. The overall effect in desmopressin nonresponders with nocturnal polyuria is variable. The extent to which indomethacin can be applied in the treatment of enuresis needs further evaluation. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Nocturnal enuresis in children in Kinshasa, Democratic Republic of Congo.

    PubMed

    Aloni, Michel N; Ekila, Mathilde B; Ekulu, Pépé M; Aloni, Muriel L; Magoga, Kumbundu

    2012-10-01

      To determine the prevalence of nocturnal enuresis in children of Kinshasa in Democratic Republic of Congo.   In all, 506 questionnaires were sent to parents of children aged 6-12 years randomly selected from four primary schools in Kinshasa, Democratic Republic of Congo. The questionnaire was designed to collect information about prevalence and factors associated with nocturnal enuresis.   A total of 415 (82.0%) were correctly completed. In this series, 109 children were identified as nocturnal enuresis in which 50 boys and 56 girls (p > 0.05). Factors associated with nocturnal enuresis were deep sleep, young age and familial history of enuresis (p < 0.05). Only 11% of patients have been consulted by doctors. Twelve children (11.0%) were treated by healers traditional. In the other part, 43 children (39.4%) were frequently punished by their parents. The common self-help strategies were 79 children (72.5%) were submitted to fluid restrictions before going to sleep and 68 (62.4%) were waking the child at night to void.   In Kinshasa, the prevalence of nocturnal enuresis was high to those reported in Asian and Western countries. Nocturnal enuresis remains an important clinical problem in children but only a small percentage of parents seek medical help. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

  9. Behavioral Treatment for Nocturnal Enuresis

    ERIC Educational Resources Information Center

    Friman, Patrick C.; Jones, Kevin M.

    2005-01-01

    Nocturnal enuresis is one of the most prevalent and distressing of all childhood problems. The treatment of nocturnal enuresis has shifted in the past few decades from a strictly psychopathological perspective to a biobehavioral perspective. Although the primary clinical features of this disorder are medical/organic, there is currently strong…

  10. Hypnotherapy as a Treatment for Enuresis.

    ERIC Educational Resources Information Center

    Edwards, S. D.; Van Der Spuy, H. I. J.

    1985-01-01

    Assesses the efficacy of hypnotherapy in the treatment of nocturnal enuresis in boys aged 8 to 13 years. Treatment consisted of six weekly standardized sessions. Results indicated that hypnotherapy was significantly effective over 6 months in decreasing nocturnal enuresis, compared with both pretreatment enuresis frequency and no-treatment…

  11. Association of Obstructive Sleep Apnea Risk Factors with Nocturnal Enuresis in Postmenopausal Women

    PubMed Central

    Koo, Patrick; McCool, F. Dennis; Hale, Lauren; Stone, Katie; Eaton, Charles B.

    2015-01-01

    Objective The prevalence of obstructive sleep apnea (OSA) in women increases significantly after menopause. However, identifying at-risk women in this population is difficult because they tend to underreport symptoms and their complaints may differ from those traditionally associated with OSA. We investigated whether OSA risk factors are associated with the presence of a “non-traditional” complaint such as nocturnal enuresis in postmenopausal women. Methods A cross-sectional study of postmenopausal women ages 50–79, who participated in the Women Health Initiative Observational and Clinical Trial Studies (1993–2005) at 40 Clinical Centers in the United States, was performed. Multiple variable logistic regression analysis was employed to determine the association of OSA risk factors with nocturnal enuresis. Results A cohort of 2,789 women (1.7%) reported having nocturnal enuresis. Obesity (Odds ratio (OR)=2.29, 95% Confidence Interval (CI) 2.00–2.62), snoring (OR=2.01, 95% CI 1.74–2.32), poor sleep quality (OR=1.70, 95% CI 1.52–1.91), sleep fragmentation (OR=2.44, 95% CI 2.14–2.79), daytime sleepiness (OR=1.50, 95% CI 1.33–1.68), and hypertension (OR=1.13, 95% CI 1.01–1.26) were associated with nocturnal enuresis. Each additional OSA risk factor in a predefined OSA score significantly increased the odds of having nocturnal enuresis in a dose-response fashion (OR=1.38, 2.00, 2.80, 3.87, 5.10, and 7.02 for scores of 1–6, respectively) compared to no risk factors. Conclusion OSA risk factors are associated with nocturnal enuresis in postmenopausal women. Mechanisms relating nocturnal enuresis to OSA may include apnea-associated changes of intra-thoracic pressure leading to increased urine output. Questioning at-risk postmenopausal women presenting with nocturnal enuresis about other OSA risk factors should be considered. PMID:26325085

  12. Nocturnal polyuria is related to absent circadian rhythm of glomerular filtration rate.

    PubMed

    De Guchtenaere, A; Vande Walle, C; Van Sintjan, P; Raes, A; Donckerwolcke, R; Van Laecke, E; Hoebeke, P; Vande Walle, J

    2007-12-01

    Monosymptomatic nocturnal enuresis is frequently associated with nocturnal polyuria and low urinary osmolality during the night. Initial studies found decreased vasopressin levels associated with low urinary osmolality overnight. Together with the documented desmopressin response, this was suggestive of a primary role for vasopressin in the pathogenesis of enuresis in the absence of bladder dysfunction. Recent studies no longer confirm this primary role of vasopressin. Other pathogenetic factors such as disordered renal sodium handling, hypercalciuria, increased prostaglandins and/or osmotic excretion might have a role. So far, little attention has been given to abnormalities in the circadian rhythm of glomerular filtration rate. We evaluated the circadian rhythm of glomerular filtration rate and diuresis in children with desmopressin resistant monosymptomatic nocturnal enuresis and nocturnal polyuria. We evaluated 15 children (9 boys) 9 to 14 years old with monosymptomatic nocturnal enuresis and nocturnal polyuria resistant to desmopressin treatment. The control group consisted of 25 children (12 boys) 9 to 16 years old with monosymptomatic nocturnal enuresis without nocturnal polyuria. Compared to the control population, children with nocturnal polyuria lost their circadian rhythm not only for diuresis and sodium excretion but also for glomerular filtration rate. Patients with monosymptomatic nocturnal enuresis and nocturnal polyuria lack a normal circadian rhythm for diuresis and sodium excretion, and the circadian rhythm of glomerular filtration rate is absent. This absence of circadian rhythm of glomerular filtration rate and/or sodium handling cannot be explained by a primary role of vasopressin, but rather by a disorder in circadian rhythm of renal glomerular and/or tubular functions.

  13. Primary nocturnal enuresis is associated with lower intelligence quotient scores in boys from poorer socioeconomic status families.

    PubMed

    Basiri, Abbas; Bahrainian, Seyed Abdolmajid; Khoshdel, Alireza; Jalaly, Niloofar; Golshan, Shabnam; Pakmanesh, Hamid

    2017-03-01

    To explore intelligence quotient in boys with primary nocturnal enuresis compared with normal boys considering their socioeconomic status. A total of 152 school-aged boys (including 55 boys with primary nocturnal enuresis and 97 matched normal controls) were assessed. Boys with a history of any neurological or urological disease were excluded. Two different districts of Tehran: Khani-Abad (a poor district) and Pirouzi (a middle class district) districts were enrolled according to socioeconomic status data reported by the World Health Organization. Intelligence tests were carried out using a validated Iranian translation of the Wechsler Intelligence Scale for Children Revised. Total, as well as performance intelligence quotient and verbal intelligence quotient scores and verbal-performance discrepancy (the difference between verbal and performance intelligence quotient scores for each individual) were compared using a t-test between boys with primary nocturnal enuresis in each district and their matched controls. Considering each district separately, the total intelligence quotient score was lower in primary nocturnal enuresis cases than controls only in the lower income district (90.7 ± 23.3 vs 104.8 ± 14.7, P = 0.002). Similarly, boys with primary nocturnal enuresis ranked lower in verbal intelligence quotient (P = 0.002) and performance intelligence quotient (P = 0.004) compared with their matched normal controls only in lower income district, whereas in the higher income district, boys with primary nocturnal enuresis ranked similar in total intelligence quotient to their matched controls. Boys with primary nocturnal enuresis had a lower intelligence quotient compared with the control participants only in low-income district. It seems important to adjust the results of the intelligence quotient assessment in these children according to their socioeconomic status. © 2017 The Japanese Urological Association.

  14. The Behavioral Treatment of Childhood Nocturnal Enuresis.

    ERIC Educational Resources Information Center

    Wagner, William G.

    1987-01-01

    Notes that of the treatments attempted for nocturnal enuresis, pharmacotherapy, individual psychotherapy, and behavioral conditioning, the most effective is behavioral conditioning with a urine alarm. Reviews the enuresis literature and provides recommendations for use of the urine alarm approach. (Author/ABB)

  15. Management of nocturnal enuresis - myths and facts

    PubMed Central

    Sinha, Rajiv; Raut, Sumantra

    2016-01-01

    Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of treatment. PMID:27458562

  16. Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep.

    PubMed

    Van Herzeele, Charlotte; Dhondt, Karlien; Roels, Sanne P; Raes, Ann; Hoebeke, Piet; Groen, Luitzen-Albert; Vande Walle, Johan

    2016-09-01

    There is a high comorbidity between nocturnal enuresis, sleep disorders and psychological problems. The aim of this study was to investigate whether a decrease in nocturnal diuresis volume not only improves enuresis but also ameliorates disrupted sleep and (neuro)psychological dysfunction, the major comorbidities of this disorder. In this open-label, prospective phase IV study, 30 children with monosymptomatic nocturnal enuresis (MNE) underwent standardized video-polysomnographic testing and multi-informant (neuro)psychological testing at baseline and 6 months after the start of desmopressin treatment in the University Hospital Ghent, Belgium. Primary endpoints were the effect on sleep and (neuro)psychological functioning. The secondary endpoint was the change in the first undisturbed sleep period or the time to the first void. Thirty children aged between 6 and 16 (mean 10.43, standard deviation 3.08) years completed the study. The results demonstrated a significant decrease in periodic limb movements during sleep (PLMS) and a prolonged first undisturbed sleep period. Additionally, (neuro)psychological functioning was improved on several domains. The study demonstrates that the degree of comorbidity symptoms is at least aggravated by enuresis (and/or high nocturnal diuresis rate) since sleep and (neuro)psychological functioning were significantly ameliorated by treatment of enuresis. These results indicate that enuresis is not such a benign condition as has previously been assumed.

  17. Evaluation and treatment of enuresis.

    PubMed

    Ramakrishnan, Kalyanakrishnan

    2008-08-15

    Enuresis is defined as repeated, spontaneous voiding of urine during sleep in a child five years or older. It affects 5 to 7 million children in the United States. Primary nocturnal enuresis is caused by a disparity between bladder capacity and nocturnal urine production and failure of the child to awaken in response to a full bladder. Less commonly, enuresis is secondary to a medical, psychological, or behavioral problem. A diagnosis usually can be made with a history focusing on enuresis and a physical examination followed by urinalysis. Imaging and urodynamic studies generally are not needed unless specifically indicated (e.g., to exclude suspected neurologic or urologic disease). Primary nocturnal enuresis almost always resolves spontaneously over time. Treatment should be delayed until the child is able and willing to adhere to the treatment program; medications are rarely indicated in children younger than seven years. If the condition is not distressing to the child, treatment is not needed. However, parents should be reassured about their child's physical and emotional health and counseled about eliminating guilt, shame, and punishment. Enuresis alarms are effective in children with primary nocturnal enuresis and should be considered for older, motivated children from cooperative families when behavioral measures are unsuccessful. Desmopressin is most effective in children with nocturnal polyuria and normal bladder capacity. Patients respond to desmopressin more quickly than to alarm systems. Combined treatment is effective for resistant cases.

  18. NOCTURNAL ENURESIS AS A RISK FACTOR FOR FALLS IN OLDER COMMUNITY-DWELLING WOMEN WITH URINARY INCONTINENCE

    PubMed Central

    Pahwa, Avita K.; Andy, Uduak U.; Newman, Diane K.; Stambakio, Hanna; Schmitz, Kathryn H.; Arya, Lily A.

    2016-01-01

    Purpose To determine the association between urinary symptoms, fall risk and physical limitations in older community-dwelling women with urinary incontinence (UI). Materials and Methods In-depth assessment of day and nighttime urinary symptoms, fall risk, physical function, physical performance tests and mental function in older community-dwelling women with UI and who had not sought care for their urinary symptoms. All assessments were performed in the participants’ homes. We used univariable and multivariable linear regression to examine the relationship of urinary symptoms with fall risk, physical function, and physical performance. Results In 37 women with UI (mean age 74 ± 8.4 years), 48% were at high risk for falls. Nocturnal enuresis was reported by 50%. Increased fall risk was associated with increasing frequency of nocturnal enuresis (p=0.04), worse lower limb (p<0.001) and worse upper limb (p<0.0001) function and worse performance on a composite physical performance test of strength, gait and balance (p=0.02). Women with nocturnal enuresis had significantly lower median physical performance test scores (7, range 0, 11) than women without nocturnal enuresis (median 9, range 1, 12, p=0.04). In a multivariable regression model that included age, nocturnal enuresis episodes and physical function, only physical function was associated with increased fall risk (p<0.0001). Conclusion Nocturnal enuresis is common in older community-dwelling women with UI and may serve as a marker for fall risk even in women not seeking care for their urinary symptoms. Interventions targeting upper and lower body physical function could potentially reduce risk of falls in older women with UI. PMID:26626218

  19. Desmopressin resistant nocturnal polyuria secondary to increased nocturnal osmotic excretion.

    PubMed

    Dehoorne, Jo L; Raes, Ann M; van Laecke, Erik; Hoebeke, Piet; Vande Walle, Johan G

    2006-08-01

    We investigated the role of increased solute excretion in children with desmopressin resistant nocturnal enuresis and nocturnal polyuria. A total of 42 children with monosymptomatic nocturnal enuresis and significant nocturnal polyuria with high nocturnal urinary osmolality (more than 850 mmol/l) were not responding to desmopressin. A 24-hour urinary concentration profile was obtained with measurement of urine volume, osmolality, osmotic excretion and creatinine. The control group consisted of 100 children without enuresis. Based on osmotic excretion patients were classified into 3 groups. Group 1 had 24-hour increased osmotic excretion, most likely secondary to a high renal osmotic load. This was probably diet related since 11 of these 12 patients were obese. Group 2 had increased osmotic excretion in the evening and night, probably due to a high renal osmotic load caused by the diet characteristics of the evening meal. Group 3 had deficient osmotic excretion during the day, secondary to extremely low fluid intake to compensate for small bladder capacity. Nocturnal polyuria with high urinary osmolality in our patients with desmopressin resistant monosymptomatic nocturnal enuresis is related to abnormal increased osmotic excretion. This may be explained by their fluid and diet habits, eg daytime fluid restriction, and high protein and salt intake.

  20. Successful Use of the Nocturnal Urine Alarm for Diurnal Enuresis.

    ERIC Educational Resources Information Center

    Friman, Patrick C.; Vollmer, Dennis

    1995-01-01

    A urine alarm, typically used to treat nocturnal enuresis, was effectively used to treat diurnal enuresis in a 15-year-old female with depression, attention deficit hyperactivity disorder, and conduct disorder. The study indicated that the alarm eliminated wetting in both treatment phases and that continence was maintained at three-month and…

  1. Understanding nocturnal enuresis and its treatments.

    PubMed

    Potter, D C; Wogoman, H A; Nietch, P

    1999-09-01

    Nocturnal enuresis is a condition that touches the lives of many children around the world. Affected children and their parents may experience feelings of guilt, frustration, and anxiety because of their lack of control over the situation. Nurses can play an important role in providing education to families in regards to the causes and treatment of enuresis. It is important for nurses to understand the problem of bedwetting thoroughly so they can assist the family in making an informed decision about the various options currently available. Nocturnal enuresis (bedwetting) is a common disorder that frequently results in frustration and stress on not only the children that experience it, but their parents as well. Scharf, Pravda, Jennings, Kauffman, and Ringel (1987) note that an estimated five to seven million children in America experience enuresis. Enuresis has family and psychosocial aspects, along with financial concerns. Therefore, it is important for nurses to be aware of the causes of enuresis, how it affects the family, and the current treatments that are available.

  2. Increased nocturnal blood pressure in enuretic children with polyuria.

    PubMed

    Kruse, Anne; Mahler, Birgitte; Rittig, Soren; Djurhuus, Jens Christian

    2009-10-01

    We investigated the association between nocturnal blood pressure and urine production in children with enuresis. A total of 39 consecutive children with a mean age of 9.8 years (range 6.2 to 14.9) with monosymptomatic nocturnal enuresis completed a bladder diary, including 2 weeks of basic documentation and 2 with desmopressin titration from 120 to 240 microg sublingually. Arterial blood pressure was measured every 30 minutes during 24 hours and during 4 additional nights using an ambulatory blood pressure monitor. Furthermore, 10 healthy children were recruited into the study who completed a bladder diary for 5 days while measuring arterial blood pressures with documentation of all intake and voided volumes. Patients with nocturnal polyuria had significantly higher nocturnal mean arterial pressure than patients without polyuria and controls (p <0.05). Furthermore, a positive correlation was seen between nocturnal urine output and nocturnal mean arterial pressure (r = 0.32, p <0.001). Nocturnal urine output was significantly higher during wet nights than dry nights (p <0.001). However, no significant difference was found in mean arterial pressure between wet and dry nights. Nocturnal mean arterial pressure was significantly higher in children with enuresis with polyuria than in children without polyuria. There was a significant positive correlation between average nocturnal mean arterial pressure and nocturnal urine volume in the whole study. The association between nocturnal blood pressure and urine volume, and the role of blood pressure should be investigated in a larger group of children with enuresis who have nocturnal polyuria.

  3. The Relationship Between Child Anxiety Related Disorders and Primary Nocturnal Enuresis.

    PubMed

    Salehi, Bahman; Yousefichaijan, Parsa; Rafeei, Mohammad; Mostajeran, Mahssa

    2016-06-01

    Nocturnal enuresis, often called bedwetting or sleep wetting, is a common problem in children after the age of five and may lead to symptoms such as infection, incontinence and frequent urination. This problem refers to a state in which children after the age of five have no control of their urine for six continuous months and it cannot be attributed to any organic factors or drug use. In this study we aimed to study generalized anxiety disorder as one of the possible causes of primary nocturnal enuresis. In this case-control study 180 children with primary nocturnal enuresis and same number of healthy children with a mean age of 7 - 17 years old with the same demographic characteristics were selected. The study took place at Amir Kabir hospital of Arak, Iran during year 2014. After collecting the information, diagnosis was verified based on the diagnostic and statistical manual of mental disorders (DSM) IV-TR criteria. Results were analyzed using the SPSS software (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, version 20.0. Armonk, NY: IBM Corp.). Frequency of generalized anxiety disorder, panic disorder, school phobia, social anxiety, separation anxiety, history of anxiety in mother, history of primary nocturnal enuresis in parent's family and body mass index had a significant difference between the two groups (P = 0.005). With the results obtained from this study we could say that there was a clear significant difference between the two control and patient groups for all subgroups of anxiety disorders such as generalized anxiety disorder and their relationship with primary nocturnal enuresis. Given the higher prevalence of generalized anxiety disorder, panic disorder, school phobia, social anxiety, separation anxiety and comparison with healthy children, it is recommended for all children with primary nocturnal enuresis to be investigated and treated for generalized anxiety disorder.

  4. Prevalence of Nocturnal Enuresis and Related Factors in Children Aged 5-13 in Istanbul

    PubMed Central

    Dolgun, Gulumser; Savaser, Sevim; Balci, Serap; Yazici, Saadet

    2012-01-01

    Objective Enuresis is a health problem frequently encountered in childhood. This study was carried out in two socio-demographically different districts of the province of Istanbul, for the purpose of determining the relationship between the prevalence of primary nocturnal enuresis and certain demographic characteristics. Methods The study design is a cross-sectional carried out on 420 children (5 to 13 yr old) through random sampling. The research was conducted at two health centers in two different districts in the province of Istanbul. Data was collected with a questionnaire created by the researchers. Diagnosis of enuresis considered nocturnal voiding twice a week for at least three consecutive months. Findings Enuresis was a complaint expressed by 16.2% of the cases in the study group; 8.3% reported intermittent bedwetting. The data collected in the two districts pointed to a significant difference in terms of the frequency of enuresis in favor of the district where socio-demographic features were inferior (P<0.005). When family histories were explored in cases of children with enuresis, it was found that the mothers of 76.2% had the problem of enuresis while 14.9% had enuretic fathers. Thus statistically, the presence of enuresis in the family history was seen to have had a markedly significant impact on the occurrence of enuresis in the child (P<0.001). Conclusion It was concluded that familial predisposition to the condition constituted a more significant risk factor for enuresis compared to socio-demographic or economic characteristics. PMID:23056887

  5. Prevalence of nocturnal enuresis in school aged children: the role of personal and parents related socio-economic and educational factors.

    PubMed

    Hashem, Mahmoodzadeh; Morteza, Amestejani; Mohammad, Karamyar; Ahmad-Ali, Nikibakhsh

    2013-02-01

    Nocturnal enuresis is a common psychosocial concern for both parents and children. In the present study we have determined the prevalence of nocturnal enuresis in Urmia, Iran children and associated personal and familial factors with this problem. A cross sectional epidemiological study for detection of nocturnal enuresis prevalence rate and evaluation of associated familial and personal factors in elementary school children (7-11 years old) from Urmia were investigated. The subjects were selected by cluster sampling method. Chi square test and logistic regression were used in univariate and multivariate respectively. Of the 1600 questionnaires distributed, 918 (57%) were completed and included in the final analysis. The rest, which were not filled by parents and also those out of our study age range were excluded. Gender of the subjects was almost equally distributed (48.6% males and 51.4% females). Prevalence of nocturnal enuresis was 18.7% (n = 172) and prevalence of day time incontinence was 5.5% (n=51). There was no significant gender difference between these two groups. Enuretics had crowded families, positive family history, low educational level of parents, jobless father, working mother, single parent, poor school performance, positive history of urinary tract infection (UTI). Our results with enuresis prevalence and associated factors were comparable to other epidemiological studies from various countries. We found that Iranian families do not pay sufficient attention to their enuretic children.

  6. Evaluation of cerebral maturation by visual and quantitative analysis of resting electroencephalography in children with primary nocturnal enuresis.

    PubMed

    Hallioğlu, O; Ozge, A; Comelekoglu, U; Topaloglu, A K; Kanik, A; Duzovali, O; Yilgor, E

    2001-10-01

    This study was undertaken to evaluate resting electroencephalographic (EEG) changes and their relations to cerebral maturation in children with primary nocturnal enuresis. Cerebral maturation is known to be important in the pathogenesis of this disorder. Twenty-five right-handed patients with primary nocturnal enuresis, aged 6 to 14 years, and 23 age- and sex-matched healthy children were included in this cross-sectional case-control study. The abnormalities detected using such techniques as hemispheral asymmetry, regional differences, and hyperventilation response in addition to visual and quantitative EEG analysis were examined statistically by multivariate analysis. A decrease in alpha activity in the left (dominant hemisphere) temporal lobe and in the frontal lobes bilaterally and an increase in delta activity in the right temporal region were observed. We concluded that insufficient cerebral maturation is an important factor in the pathogenesis of primary nocturnal enuresis, and EEG, as a noninvasive and inexpensive method, could be used in evaluating cerebral maturation.

  7. Anterior urethral valve in an adolescent with nocturnal enuresis.

    PubMed

    Wu, Chia Chang; Yang, Stephen Shei Dei; Tsai, Yao Chou

    2007-11-01

    The anterior urethral valve (AUV) is a rare congenital urethral anomaly that can lead to variable urinary tract symptoms. We report on a 13-year-old boy with AUV who was referred from a primary care physician for nocturnal enuresis. AUV was disclosed by videourodynamic study and confirmed by simultaneous retrograde cystourethroscopy and antegrade urethroscopy. The AUV was ablated by neodymium:yttrium-aluminum-garnet contact laser at the 5-o'clock and 7-o'clock directions. A postoperative videourodynamic study depicted a patent urethra, a good maximal flow rate, and improved bladder capacity. His nocturnal enuresis had completely subsided at a follow-up period of longer than 24 months.

  8. Mono-symptomatic nocturnal enuresis in lebanese children: prevalence, relation with obesity, and psychological effect.

    PubMed

    Merhi, Bassem Abu; Hammoud, Ahmad; Ziade, Fouad; Kamel, Raymond; Rajab, Mariam

    2014-01-01

    Nocturnal enuresis is involuntary urination while sleeping after a certain age, usually five years, when children should have established bladder control. The prevalence has been found to be up to 20% in five year old children, and it is considered the most common urological childhood complication. This study was conducted on Makassed School children aged 5-18 years. This was a two-step study, the first step was a questionnaire distributed to the children to be answered by their parents. The second step included individually meeting with every child who met the inclusion criteria and his/her parents and physically examining the child. 11,440 questionnaires were distributed to school children aged 5-18 years, to be answered by their parents. Of the 7270 parents who responded back, 6620 reported no enuresis, 90 (1.25%) reported only diurnal enuresis, 107 (1.5%) reported diurnal and nocturnal enuresis, and 453 parents reported their child having nocturnal enuresis only. The data collected was analyzed according to age, sex, area, body mass index (BMI), and the PMQOL-SF score. The prevalence of mono-symptomatic nocturnal enuresis (MNE) in Lebanon was found to be 5.3%. The results showed that the prevalence of MNE is inversely proportional to age. The prevalence of male to female ratio was 1.4:1. As for the prevalence according to different geographic areas, the results have shown that the North had the majority of cases with 7.6% prevalence. Results showed that 82.4% of children had a score more than 50, and only 28% of parents had a score above 50. The prevalence of nocturnal enuresis in Lebanon is lower than that in neighboring countries such as Turkey8 and Saudi Arabia,9 but higher than that in Italy10 and Hong Kong. Our study has managed to show the same results, with a peak in incidence at seven years then dropping back to 0% at the age of 16. Our study has shown a male to female predominance but the male to female ratio was 1.4:1, a value lower than that described in earlier studies. Our study has shown that more than 80% of children were psychologically affected whereas only less than 30% of parents were affected. To our knowledge, this was the first study in Lebanon conducted to determine the prevalence of MNE. The relatively low prevalence rate found may be because of differences in genetic predisposition, psychosocial or environmental conditions, and traditional and cultural backgrounds. No relation was found between obesity and nocturnal enuresis. The psychological impact on children is significant but that on the parents is minimal.

  9. Mono-Symptomatic Nocturnal Enuresis in Lebanese Children: Prevalence, Relation with Obesity, and Psychological Effect

    PubMed Central

    Merhi, Bassem Abu; Hammoud, Ahmad; Ziade, Fouad; Kamel, Raymond; Rajab, Mariam

    2014-01-01

    INTRODUCTION Nocturnal enuresis is involuntary urination while sleeping after a certain age, usually five years, when children should have established bladder control. The prevalence has been found to be up to 20% in five year old children, and it is considered the most common urological childhood complication. MATERIAL AND METHODS This study was conducted on Makassed School children aged 5–18 years. This was a two-step study, the first step was a questionnaire distributed to the children to be answered by their parents. The second step included individually meeting with every child who met the inclusion criteria and his/her parents and physically examining the child. RESULTS 11,440 questionnaires were distributed to school children aged 5–18 years, to be answered by their parents. Of the 7270 parents who responded back, 6620 reported no enuresis, 90 (1.25%) reported only diurnal enuresis, 107 (1.5%) reported diurnal and nocturnal enuresis, and 453 parents reported their child having nocturnal enuresis only. The data collected was analyzed according to age, sex, area, body mass index (BMI), and the PMQOL-SF score. The prevalence of mono-symptomatic nocturnal enuresis (MNE) in Lebanon was found to be 5.3%. The results showed that the prevalence of MNE is inversely proportional to age. The prevalence of male to female ratio was 1.4:1. As for the prevalence according to different geographic areas, the results have shown that the North had the majority of cases with 7.6% prevalence. Results showed that 82.4% of children had a score more than 50, and only 28% of parents had a score above 50. DISCUSSION The prevalence of nocturnal enuresis in Lebanon is lower than that in neighboring countries such as Turkey8 and Saudi Arabia,9 but higher than that in Italy10 and Hong Kong. Our study has managed to show the same results, with a peak in incidence at seven years then dropping back to 0% at the age of 16. Our study has shown a male to female predominance but the male to female ratio was 1.4:1, a value lower than that described in earlier studies. Our study has shown that more than 80% of children were psychologically affected whereas only less than 30% of parents were affected. CONCLUSION To our knowledge, this was the first study in Lebanon conducted to determine the prevalence of MNE. The relatively low prevalence rate found may be because of differences in genetic predisposition, psychosocial or environmental conditions, and traditional and cultural backgrounds. No relation was found between obesity and nocturnal enuresis. The psychological impact on children is significant but that on the parents is minimal. PMID:24653655

  10. Using multimedia for patient information--a program about nocturnal enuresis.

    PubMed

    Evans, J H; Collier, J; Crook, I; Garrud, P; Harris, P; MacKinlay, D R; Redsell, S A

    1998-05-01

    To identify the information needs of children with nocturnal enuresis, and to design, produce and evaluate an interactive computer program to provide this information. The program was developed over an 18-month period using information provided by children, parents and professionals, and was evaluated in a hospital-based enuresis clinic in 65 children. Usability and knowledge gained were also evaluated in 43 healthy children aged 8-10 years attending a local inner-city primary school. An interactive program about nocturnal enuresis was developed, which runs on a personal computer and uses sound, voice, cartoon drawings and animation in a modular design. Knowledge scores increased in clinic attendees and in schoolchildren after using the program (Wilcoxon matched pairs test, P < 0.001). This improvement was maintained when the program was re-tested 6-10 months later. This interactive computer program holds children's attention and increases their understanding of enuresis. Interactive multimedia may be useful to complement the information provided by health professionals. This method of communication may be particularly useful for children with a low level of literacy.

  11. Children Treated for Nocturnal Enuresis: Characteristics and Trends over a 15-Year Period

    ERIC Educational Resources Information Center

    Kushnir, Jonathan; Kushnir, Baruch; Sadeh, Avi

    2013-01-01

    Background: Nocturnal Enuresis (NE) is one of the most prevalent childhood disorders and has significant negative psychosocial impact on the child and family. Objective: To assess the characteristics of children with NE and trends over a 15-year period. Methods: The study included 18,677 children [11,205 (60%) boys and 7,472 (40%) girls] referred…

  12. The Effects of a Contingency Contracting Program on the Nocturnal Enuresis of Three Children

    ERIC Educational Resources Information Center

    Stover, Anthony C.; Dunlap, Glen; Neff, Bryon

    2008-01-01

    Objective: This study was conducted to evaluate the effects of a contingency contracting program to eliminate nocturnal enuresis of three children ages 5 to 12. Methods: The program was implemented by the children's primary caregivers, two of whom were foster parents and the third a case worker in the foster care system. The program was a package…

  13. Topical use of Matricaria recutita L (Chamomile) Oil in the Treatment of Monosymptomatic Enuresis in Children

    PubMed Central

    Sharifi, Hosein; Minaie, Mohammad Bagher; Qasemzadeh, Mohammad Javad; Ataei, Nematollah; Gharehbeglou, Mohammad; Heydari, Mojtaba

    2015-01-01

    Aim. To evaluate the efficacy of topical use of Matricaria recutita L oil in the treatment of enuresis in children. Methods. Eighty patients diagnosed as monosymptomatic nocturnal or daytime enuresis were allocated to receive Matricaria recutita L (chamomile) oil or placebo topically for 6 weeks in a double-blind randomized placebo-controlled trial with a parallel design. Patients were evaluated prior to and following 8 weeks of the intervention in terms of frequency of enuresis and any observed adverse events. Results. The mean frequency of enuresis at the first, second, and third 2 weeks was lower in the intervention group compared with the placebo group, and the differences were statistically significant (P < .001, P = .03, and P < .001, respectively). There was no report of any adverse event in the study groups. Conclusion. The findings of this study showed that the topical use of (chamomile) oil can decrease the frequency of nocturia in children with monosymptomatic nocturnal or daytime enuresis. PMID:26427789

  14. Nocturnal Enuresis Is Associated with Attention Deficit Hyperactivity Disorder and Conduct Problems

    PubMed Central

    Park, Subin; Kim, Jae-Won; Hong, Soon-Beom; Shin, Min-Sup; Yoo, Hee Jeong; Cho, Soo-Churl

    2013-01-01

    Objective There are no published prevalence estimates of elimination disorders and their association with disruptive-behavior disorders among children in the Asian region using standardized diagnostic interviews. This study was conducted to determine the prevalence of elimination disorders and its association with disruptive-behavior disorders in a representative sample of children in Seoul, Korea. Methods The diagnosis of enuresis and encopresis was derived from parent-reported data for "enuresis and encopresis," collected using the Diagnostic Interview Schedule for Children, from a representative sample of 6- to 12-year-old children (n=1,645) who participated in the 2005 Seoul Child and Adolescent Mental Health Survey. Prevalence data for attention deficit and disruptive-behavior disorders were collected from the same sample. Results The overall 12-month prevalence of nocturnal enuresis and encopresis was 1.8% and 0.6%, respectively. Enuresis and encopresis prevalence in boys was significantly greater than that in girls. Enuresis and encopresis was most common at 7 to 9 years of age. Enuresis was significantly associated with ADHD (OR 2.6, 95% CI 1.0-6.9) and conduct disorder (CD; OR 4.7, 95% CI 1.0-22.4). Conclusion Enuresis is significantly associated with ADHD and CD, so these conditions must be assessed together during the evaluation of children with enuresis. PMID:24302948

  15. Incidence of obsessive-compulsive disorder in children with nonmonosymptomatic primary nocturnal enuresis.

    PubMed

    Yousefichaijan, Parsa; Khosrobeigi, Ali; Salehi, Bahman; Taherahmadi, Hassan; Shariatmadari, Fakhreddin; Ghandi, Yazdan; Alinejad, Saeed; Farhadiruzbahani, Fateme

    2016-01-01

    Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 years of age. The behavior is not due exclusively to the direct physiologic effect of a substance or a general medical condition. Diurnal enuresis defines wetting, whereas awake and nocturnal enuresis refers to voiding during sleep. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers the resumption of wetting after at least 6 months of dryness. Monosymptomatic enuresis has no associated daytime symptoms, and nonmonosymptomatic enuresis, which is more common, often has at least one subtle daytime symptom. Monosymptomatic enuresis is rarely associated with significant organic underlying abnormalities. Obsessive-compulsive disorder (OCD) is a chronic disabling illness characterized by repetitive, ritualistic behaviors over which the patients have little or no control. The purpose of this study was to investigate the relationship between OCD and nonmonosymptomatic nocturnal enuresis (NMNE). In this case-control study, we evaluated 186 children aged 6-17 years old who were visited in the pediatric clinics of Amir Kabir Hospital, Arak, Iran. The control group included 93 healthy children, and the case group included 93 age- and sex-matched children with stage 1-3 chronic kidney disease (CKD). Then, the children's behavioral status was evaluated using the Children's Yale-Brown Obsessive-Compulsive Scale. The difference in compulsion was significant ( P = 0.021), whereas the difference in obsession was significant between the two groups ( P = 0.013). The most common symptom in CKD children with compulsion was silent repetition of words. Compulsive and obsessive are more common in NMNE versus healthy children. The observed correlation between compulsive-obsessive and NMNE makes psychological counseling mandatory in children with NMNE.

  16. Incidence of obsessive–compulsive disorder in children with nonmonosymptomatic primary nocturnal enuresis

    PubMed Central

    Yousefichaijan, Parsa; Khosrobeigi, Ali; Salehi, Bahman; Taherahmadi, Hassan; Shariatmadari, Fakhreddin; Ghandi, Yazdan; Alinejad, Saeed; Farhadiruzbahani, Fateme

    2016-01-01

    Introduction: Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 years of age. The behavior is not due exclusively to the direct physiologic effect of a substance or a general medical condition. Diurnal enuresis defines wetting, whereas awake and nocturnal enuresis refers to voiding during sleep. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers the resumption of wetting after at least 6 months of dryness. Monosymptomatic enuresis has no associated daytime symptoms, and nonmonosymptomatic enuresis, which is more common, often has at least one subtle daytime symptom. Monosymptomatic enuresis is rarely associated with significant organic underlying abnormalities. Obsessive–compulsive disorder (OCD) is a chronic disabling illness characterized by repetitive, ritualistic behaviors over which the patients have little or no control. The purpose of this study was to investigate the relationship between OCD and nonmonosymptomatic nocturnal enuresis (NMNE). Materials and Methods: In this case–control study, we evaluated 186 children aged 6–17 years old who were visited in the pediatric clinics of Amir Kabir Hospital, Arak, Iran. The control group included 93 healthy children, and the case group included 93 age- and sex-matched children with stage 1–3 chronic kidney disease (CKD). Then, the children's behavioral status was evaluated using the Children's Yale-Brown Obsessive–Compulsive Scale. Results: The difference in compulsion was significant (P = 0.021), whereas the difference in obsession was significant between the two groups (P = 0.013). The most common symptom in CKD children with compulsion was silent repetition of words. Conclusion: Compulsive and obsessive are more common in NMNE versus healthy children. The observed correlation between compulsive-obsessive and NMNE makes psychological counseling mandatory in children with NMNE. PMID:27857786

  17. Bedwetting (Nocturnal Enuresis)

    MedlinePlus

    ... expands (gets bigger) as urine enters and then contracts (gets smaller) to push the urine out. In ... a role in enuresis, although this is rare. Psychological problems. Some experts believe that stress can be ...

  18. Neuropsychological functioning related to specific characteristics of nocturnal enuresis.

    PubMed

    Van Herzeele, C; Dhondt, K; Roels, S P; Raes, A; Groen, L-A; Hoebeke, P; Walle, J Vande

    2015-08-01

    There is a high comorbidity demonstrated in the literature between nocturnal enuresis and several neuropsychological dysfunctions, with special emphasis on attention deficit hyperactivity disorder (ADHD). However, the majority of the psychological studies did not include full non-invasive screening and failed to differentiate between monosymptomatic nocturnal enuresis (MNE) and non-MNE patients. The present study primarily aimed to investigate the association between nocturnal enuresis and (neuro)psychological functioning in a selective homogeneous patient group, namely: children with MNE and associated nocturnal polyuria (NP). Secondly, the study investigated the association between specific characteristics of nocturnal enuresis (maximum voided volume, number of wet nights and number of nights with NP) and ADHD-inattentive symptoms, executive functioning and quality of life. The psychological measurements were multi-informant (parents, children and teachers) and multi-method (questionnaires, clinical interviews and neuropsychological testing). Thirty children aged 6-16 years (mean 10.43 years, SD 3.08) were included. Of them, 80% had at least one psychological, motor or neurological difficulty. The comorbid diagnosis of ADHD, especially the predominantly inattentive presentation, was most common. According to the teachers, a low maximum voided volume (corrected for age) was associated with more attention problems, and a high number of nights with NP was associated with more behaviour-regulation problems. No significant correlations were found between specific characteristics of enuresis and quality of life. Details are demonstrated in Table. The children were recruited from a tertiary referral centre, which resulted in selection bias. Moreover, NP was defined as a urine output exceeding 100% of the expected bladder capacity for age (EBC), and not according to the expert-opinion-based International Children's Continence Society norm of 130% of EBC. The definition for NP of a urine output exceeding 100% of the EBC is more in line with the recent findings of the Aarhus group. For children with MNE and associated NP, a high comorbidity with the predominantly inattentive presentation of ADHD was demonstrated. Children experienced problems with daytime functioning in relation to their wetting problem at night. According to the teachers, a low maximum voided volume was associated with more attention problems, and a high number of nights with NP was associated with more behaviour-regulation problems. Although comorbidity is still the appropriate word to use, the observation favours a more complex pathogenesis of enuresis with a common pathway in the central nervous system, including: neurotransmitters, influencing neuropsychological functioning as well as sleep, circadian rhythm of diuresis and bladder function control. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  19. Noninvasive imaging of brain oxygen metabolism in children with primary nocturnal enuresis during natural sleep.

    PubMed

    Yu, Bing; Huang, Mingzhu; Zhang, Xu; Ma, Hongwei; Peng, Miao; Guo, Qiyong

    2017-05-01

    A series of studies have revealed that nocturnal enuresis is closely related to hypoxia in children with primary nocturnal enuresis (PNE). However, brain oxygen metabolism of PNE children has not been investigated before. The purpose of this study was to investigate changes in whole-brain cerebral metabolic rate of oxygen (CMRO 2 ), cerebral blood flow (CBF), and oxygen extraction fraction (OEF) in children suffering from PNE. We used the newly developed T2-relaxation-under-spin-tagging (TRUST) magnetic resonance imaging technique. Neurological evaluation, structural imaging, phase-contrast, and the TRUST imaging method were applied in children with PNE (n = 37) and healthy age- and sex-matched control volunteers (n = 39) during natural sleep to assess whole-brain CMRO 2 , CBF, OEF, and arousal from sleep scores. Results showed that whole-brain CMRO 2 and OEF values of PNE children were higher in controls, while there was no significant difference in CBF. Consequently, OEF levels of PNE children were increased to maintain oxygen supply. The elevation of OEF was positively correlated with the difficulty of arousal. Our results provide the first evidence that high oxygen consumption and high OEF values could make PNE children more susceptible to hypoxia, which may induce cumulative arousal deficits and make them more prone to nocturnal enuresis. Hum Brain Mapp 38:2532-2539, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  20. The enuretic episode--a complete micturition from a bladder with normal capacity? A critical reappraisal of the definition.

    PubMed

    Rasmussen, P V; Kirk, J; Rittig, S; Djurhuus, J C

    1997-01-01

    Fifty-five normal children, aged between 7 and 12 years, were hospitalised for four consecutive nights. On three of these nights, the subjects received 25 ml/kg body weight of fluid prior to bedtime. Such fluid-loading provoked 28 enuresis-like episodes in 17 children, most of which occurred during the first few hours of sleep. The incidence of these enuretic events decreased with increasing age, more boys than girls were affected, there was a statistically significant correlation between total enuresis volume and nocturia volume, and the micturition was frequently incomplete, leaving large volumes of residual urine in the bladder. It was concluded that if nocturnal urine production exceeds bladder capacity, enuresis may be provoked, even in children who do not normally wet the bed. Furthermore, the definition of nocturnal enuresis as a complete emptying of the bladder during sleep may need revision.

  1. Primary nocturnal enuresis in children. Background and treatment.

    PubMed

    Wille, S

    1994-01-01

    The aim of the present studies was to investigate background factors and treatment in children with monosymptomatic primary nocturnal enuresis. The study material comprised enuretics, former enuretics and controls from the municipal community of Falkenberg on the west coast of Sweden. Whenever possible all investigations were made with the children staying in their own home environment. Different background factors have been suspected as being causative: sleep disturbances, behavioural or psychological disturbances, small bladder capacity, increased night diuresis and an insufficient production of the antidiuretic hormone during sleep. These factors have been investigated in these studies. The treatment of enuresis has been dominated by the alarm and antidiuretic treatment with DDAVP. Primary nocturnal monosymptomatic enuresis is a common problem in childhood. In this study the prevalence among 392 seven year old children was 7.3%. A prior history of enuresis was found in 65% of families of the enuretics compared to 25% in controls. The enuretic children showed no statistically significant differences in behavioural or psychological problems compared to non-enuretic children. Enuretic children were described as heavy sleepers by their parents and a wake-up test performed at home showed that they were statistically significantly harder to arouse than the controls. Children with nocturnal enuresis, former enuretics and controls did not differ in social or behavioural traits in an interview study. No signs of symptom substitution was found when enuresis was resolved. Enuretic children had a normal bladder capacity and no statistically significant difference was found compared to controls and former enuretics. The enuretic children showed a normal calcium-creatinine quota in the urine. Former enuretic children showed a significantly enhanced calcium/creatinine quota compared to enuretics and controls. Enuretic children had a statistically significant lower morning plasma level of the anti diuretic hormone vasopressin than non-enuretic children. Enuretic children were treated for 12 weeks with DDAVP or the alarm. DDAVP treated patients had a more rapid effect compared with alarm treated patients. Alarm treated children had a lower relapse frequency. Enuretic children were treated in a randomised, double blind, double dummy, cross over, placebo-controlled study with DDAVP 20 micrograms intranasally by a single dose pipette or 200 micrograms orally as a tablet. Both methods were equally effective in controlling enuresis, but significantly superior to placebo. Enuretic children are normal, well adjusted children with a normal bladder capacity, a high level of arousal threshold, and a low morning level of plasma vasopressin. The alarm and DDAVP are equally effective in treating enuresis.(ABSTRACT TRUNCATED AT 400 WORDS)

  2. Secondary nocturnal enuresis related to central diabetes insipidus as an early manifestation of intracranial germinomatous germ cell tumors in a series of male youngsters.

    PubMed

    Papaefthimiou, Apostolos; Kyrgios, Ioannis; Kotanidou, Eleni P; Maggana, Ioanna; Mouzaki, Konstantina; Galli-Tsinopoulou, Assimina

    2015-02-01

    Nocturnal enuresis is a common symptom in children. It is usually attributed to benign causes and diagnostic evaluation is not carried out. We report three male young patients initially presenting with short stature and nocturnal enuresis, related to diabetes insipidus, caused by intracranial germinomatous germ cell tumors. In all three cases, water deprivation tests confirmed diabetes insipidus. Extensive endocrinological investigation also showed further hormone deficiencies. Magnetic resonance imaging of the brain revealed the presence of a central nervous system lesion and histology confirmed the final diagnosis. Surgery, radiation with or without chemotherapy was conducted and the patients were treated with hormone replacement therapies. The patients after a long follow-up were free of disease. We present these cases to alert clinicians to bear in mind that the presence of an intracranial germinomatous germ cell tumor should at least be considered in a child presenting with bed wetting, especially if additional symptoms and signs, including late onset puberty and growth delay or morning hypernatremia, may coexist. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Task positive and default mode networks during a working memory in children with primary monosymptomatic nocturnal enuresis and healthy controls.

    PubMed

    Zhang, Kaihua; Ma, Jun; Lei, Du; Wang, Mengxing; Zhang, Jilei; Du, Xiaoxia

    2015-10-01

    Nocturnal enuresis is a common developmental disorder in children, and primary monosymptomatic nocturnal enuresis (PMNE) is the dominant subtype. This study investigated brain functional abnormalities that are specifically related to working memory in children with PMNE using function magnetic resonance imaging (fMRI) in combination with an n-back task. Twenty children with PMNE and 20 healthy children, group-matched for age and sex, participated in this experiment. Several brain regions exhibited reduced activation during the n-back task in children with PMNE, including the right precentral gyrus and the right inferior parietal lobule extending to the postcentral gyrus. Children with PMNE exhibited decreased cerebral activation in the task-positive network, increased task-related cerebral deactivation during a working memory task, and longer response times. Patients exhibited different brain response patterns to different levels of working memory and tended to compensate by greater default mode network deactivation to sustain normal working memory function. Our results suggest that children with PMNE have potential working memory dysfunction.

  4. Effectiveness of Psychological and Pharmacological Treatments for Nocturnal Enuresis.

    ERIC Educational Resources Information Center

    Houts, Arthur C.; And Others

    1994-01-01

    Assesses overall effectiveness of psychological and pharmacological treatments, relative effectiveness of specific treatments, and moderators of treatment effectiveness for nocturnal enuretic children via quantitative integration of research. Findings confirm that more children benefit from psychological than from pharmacological interventions and…

  5. [Nocturnal enuresis in children].

    PubMed

    Hjälmås, K

    1998-01-01

    After allergic disorders, nocturnal enuresis is the most common chronic childhood condition. Recent research has yielded abundant new knowledge about the condition, especially about its aetiology and pathophysiology, and the psychological consequences. A hereditary background has been substantiated by the identification in genetic linkage studies of areas in chromosomes 12 and 13 that are manifestly associated with bedwetting, though genotype expression in the phenotype appears to be complex and heterogeneous. Pathophysiologically, findings in current intensive research suggest three interactive factors to be involved: (i) relative nocturnal polyuria, due to insufficient antidiuretic hormone release during sleep in pre-teenagers, and due to renal tubular dysfunction in adolescents and adults; (ii) reduced nocturnal bladder capacity, especially in the 33 per cent of cases which do not respond to desmopressin treatment; and (iii) the patient's inability to waken in response to signals from a full bladder. Recent findings have also confirmed previous reports that with very few exceptions bedwetting is not caused by psychological factors. On the contrary, the condition causes psychological problems manifested in reduced self-esteem, shame and guilt, though self-esteem is restored by successful treatment. Active treatment should be started as soon as the child is ready to receive it, the main options being an enuresis alarm, desmopressin, or a combination of the two. If reduced bladder capacity is suspected, treatment with a detrusor relaxant should be included.

  6. A preliminary investigation of three issues pertaining to a common behavioral treatment for nocturnal enuresis.

    PubMed

    Mace, F C; Parrish, J M

    1984-09-01

    Two adolescent brothers exhibiting nocturnal enuresis since birth participated in this multiple case study examining the successful application of a modified alarm and pad procedure with a deaf youth and the generalization of effects to an initially untreated, non-hearing impaired sibling. A description of the treatment program and the explicit statement of an avoidance contingency prior to intervention resulted in a rapid and marked increase in percentage of dry nights in both cases, with further increases observed following implementation of an alarm and pad plus accident correction procedure in conjunction with self-monitoring. Treatment gains were maintained at a 10-month follow-up.

  7. Predictors of outcome in children and adolescents with overactive bladder treated with parasacral transcutaneous electrical nerve stimulation.

    PubMed

    Hoffmann, Anselmo; Sampaio, Clara; Nascimento, Ana Aparecida; Veiga, Maria Luiza; Barroso, Ubirajara

    2018-02-01

    Parasacral transcutaneous electrical nerve stimulation (TENS) has emerged as an effective treatment for overactive bladder (OAB) in view of its high success rates in improving lower urinary tract symptoms and constipation, with no direct side effects. However, the clinical characteristics associated with the outcomes remain to be established. The aim of this study was to evaluate potential predictors of outcome in children with OAB treated using parasacral TENS. This was a prospective study of children with symptoms of isolated OAB, enrolled consecutively to the study and treated with parasacral TENS (figure). Isolated OAB was defined as the presence of urinary urgency with no signs of dysfunctional voiding. The symptoms were considered completely resolved when a patient's parents/guardians or the patients themselves reported a 100% improvement. Parasacral TENS was performed twice weekly for a total of 20 sessions of 20 min each at 10 Hz. The potential predictive factors evaluated were: sex, age, daytime incontinence, nocturia, a prior history of urinary tract infection, the presence of nocturnal enuresis, constipation and holding maneuvers. Eighty-three patients with a mean age of 7.8 ± 2.8 years were included in the study. Complete resolution of symptoms was achieved in 47 (56.6%). Following parasacral TENS treatment, a significant response was reported in 96.4% of cases. Of the 55 patients with nocturnal enuresis, partial resolution was achieved in 30 cases (54.5%), with a statistically significant association between nocturnal enuresis and the patient's response to treatment (p < 0.004; OR = 4.4, 95% CI 1.5-12.5). No other factor was associated with response to treatment. To the best of our knowledge, this association between nocturnal enuresis and failure to respond to parasacral TENS treatment for lower urinary tract dysfunction has not previously been reported. The identification of factors capable of predicting therapeutic failure may allow professionals to select those specific patients who would benefit from a multimodal approach in the treatment of this pathology, which has such a significant impact on the quality of life of affected patients. Nocturnal enuresis was the only symptom associated with a poor outcome following parasacral TENS treatment in children with OAB. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  8. Evidence of reduced bladder capacity during nighttime in children with monosymptomatic nocturnal enuresis.

    PubMed

    Borg, B; Kamperis, K; Olsen, L H; Rittig, S

    2018-04-01

    Bladder capacity in children with nocturnal enuresis is assessed by maximal voided volumes (MVV) obtained through daytime frequency volume (FV) charts. Although a degree of association has been demonstrated, daytime MVV does not consistently correspond with the nocturnal bladder capacity (NBC) in monosymptomatic nocturnal enuresis (MNE). It was hypothesized that isolated reduced NBC is a common phenomenon in children with nocturnal enuresis, despite normal daytime bladder function. The aim of this study was to evaluate NBC in children with MNE and normal daytime voided volumes. Specifically, it aimed to determine the prevalence and degree of reduced NBC when using nocturnal urine production (NUP) during wet nights as a surrogate estimate of NBC. Furthermore, it aimed to investigate the relationship between NBC and desmopressin response. Data from 103 children aged 5-15 years consecutively treated for MNE in a tertiary referral centre and with normal MVV on daytime FV charts were collected for this cohort study. Home recordings were completed for 2 weeks at baseline and during desmopressin dose titration. Estimated nocturnal bladder capacity (eNBC) was assessed separately each night as the total NUP causing a wet night. If NUP during a wet night was less than MVV, it was considered to be reduced eNBC during that particular night. Surprisingly, 82% (n = 84) of the children with MNE and normal daytime MVV experienced at least one wet night, with NUP below the daytime MVV indicative of a reduced eNBC. For 84 patients, mean percentage of wet nights with reduced eNBC (NUP below MVV) was 49% (SD ± 31). A total of 11% of children with frequently reduced eNBC (>40% of wet nights with reduced eNBC) responded to desmopressin (Summary Fig.). Of the children with frequently reduced NBC, 91% experienced wet nights, with NUP <65% of expected bladder capacity (EBC). A significant proportion of children with MNE and normal MVV during the daytime frequently experienced wet nights, with a NUP well below their MVV and even <65% of EBC. This indicated that bladder reservoir dysfunction during sleep is relatively common in MNE. This abnormality was not reflected on daytime recordings, and thus nighttime data with NUP must be collected. This phenomenon may explain treatment failure to desmopressin, despite adequate antidiuretic response. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  9. Nocturnal enuresis in a longitudinal perspective. A primary problem of maturity and/or a secondary environmental reaction?

    PubMed

    Klackenberg, G

    1981-07-01

    The study is part of a prospective longitudinal investigation, involving annual somatic, psychological and social check-ups in a random sample of 212 children. Data are presented on the gradual achievement of bladder control, with relapses into wetting. Information is provided on relationships with training, with behavioural variables, with emotional maturity (Rorschach) and with sleep. It seems probable that primary enuresis usually ceases by the age of 8 at the latest and that enuresis in older children is a secondary emotional disorder which may, however, have started at an earlier age. The 6-year-old enuretic shows signs of delayed emotional maturity. The relation with somnambulism is ambiguous. Enuresis is not significantly related to training. None of the data obtained in this study conflict with the theory that primary enuresis is chiefly a maturity problem, the nature of which can be emotional. The neurophysiological aspect has not been investigated.

  10. Why does adenotonsillectomy not correct enuresis in all children with sleep disordered breathing?

    PubMed

    Kovacevic, Larisa; Wolfe-Christensen, Cortney; Lu, Hong; Toton, Monika; Mirkovic, Jelena; Thottam, Prasad J; Abdulhamid, Ibrahim; Madgy, David; Lakshmanan, Yegappan

    2014-05-01

    We analyzed the outcome of nocturnal enuresis after adenotonsillectomy in children with sleep disordered breathing. We also evaluated differences in demographic, clinical, laboratory and polysomnography parameters between responders and nonresponders after adenotonsillectomy. We prospectively evaluated children 5 to 18 years old diagnosed with sleep disordered breathing (snoring or obstructive sleep apnea syndrome) on polysomnography and monosymptomatic primary nocturnal enuresis requiring adenotonsillectomy to release upper airway obstruction. Plasma antidiuretic hormone and brain natriuretic peptide were measured preoperatively and 1 month postoperatively. Sleep studies were done in 46 children and 32 also underwent blood testing preoperatively and postoperatively. Mean ± SD patient age was 8.79 ± 2.41 years and the mean number of wet nights weekly was 6.39 ± 1.26. Polysomnography revealed obstructive sleep apnea syndrome in 71.7% of patients and snoring in 28.3%. After adenotonsillectomy 43.5% of patients became dry. Preoperative polysomnography findings indicated that responders, who were dry, had significantly more arousals and obstructive apnea episodes but fewer awakenings than nonresponders, who were wet. Significant increases in plasma antidiuretic hormone and significant decreases in plasma brain natriuretic peptide were seen in all children with no difference between responders and nonresponders. No difference between the groups was noted in age, gender, race, body mass index, constipation, preoperative number of wet nights weekly or type of sleep disordered breathing. Nocturnal enuresis resolved after adenotonsillectomy in almost half of the children with sleep disordered breathing. Those who became dry had more frequent arousal episodes caused by apnea events than those who remained wet. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  11. An epidemiological study of enuresis in Korean children.

    PubMed

    Lee, S D; Sohn, D W; Lee, J Z; Park, N C; Chung, M K

    2000-05-01

    To estimate the prevalence of enuresis in children of elementary school age, to evaluate the impact of enuresis on these children and their parents, and to identify the methods and effectiveness of managing enuresis. Subjects and methods A randomly selected cross-sectional study was conducted in one elementary school in each urban ward (nine schools) in Pusan, Korea. The parents of these 12 570 children aged 7-12 years were asked to complete questionnaires which included items about the presence and frequency of enuresis, its perceived impact and management. Enuresis was defined as an episode of wetting occurring at least once per month. The overall response rate to the questionnaire was 55.8% (girls 28.2%, boys 27.6%). The prevalence of nocturnal, diurnal and combined enuresis was 9.2%, 2.2% and 1.4%, respectively. The overall prevalence of enuresis declined with age from 20.4% at 7 years old to 5.6% at 12 years old; 342 (57.0%) parents and 318 (55. 6%) children were concerned about enuresis. The common self-help strategies were waking the child at night to void (38.1%) and restriction of water intake (25.7%). Of the enuretic children, only 13.7% had consulted a health worker. The prevalence rates for enuresis in Pusan are similar to those reported from European countries. Enuretic children and their parents were moderately concerned about enuresis and the parents primarily used self-management within the family.

  12. Risperidone-induced enuresis in two children with autistic disorder.

    PubMed

    Hergüner, Sabri; Mukaddes, Nahit Motavalli

    2007-08-01

    Risperidone appears to be effective in treating behavioral problems in children with autistic disorder. Although increased appetite, weight gain, and sedation are among the most common side effects, risperidone-induced enuresis is rarely reported. We will present two cases with risperidone-induced enuresis, and discuss our findings in the context of current literature. Two children aged 11 and 10 years, diagnosed with autism and mental retardation, have developed new-onset diurnal and nocturnal enuresis respectively on their first and second weeks of risperidone monotherapy (1.5 and 1 mg/day). They did not experience sedation, and their medical history and workup were unremarkable. As enuresis did not resolve spontaneously, we decided to substitute risperidone with olanzapine. Enuresis ceased rapidly after discontinuation of risperidone with no emergence when patients were treated with olanzapine 5 mg/day for a period of 6 months and 1 year, respectively. Although the pathophysiology of antipsychotic-induced enuresis remains unclear, a number of mechanisms including alpha(1)-adrenergic blockade, dopamine blockade, and antimuscarinic effects has been proposed. Olanzapine has lower alpha(1)-adrenergic and dopaminergic blockade properties, thus changing risperidone to olanzapine may be an alternative modality in risperidone-induced enuresis when antipsychotic treatment is crucial. Clinicians should be more vigilant about screening for this side effect, especially in younger population with developmental disabilities.

  13. Secondary Nocturnal Enuresis

    MedlinePlus

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  14. Evidence-Based Psychosocial Treatments for Pediatric Elimination Disorders.

    PubMed

    Shepard, Jaclyn A; Poler, Joseph E; Grabman, Jesse H

    2017-01-01

    Pediatric elimination disorders are common in childhood, yet psychosocial correlates are generally unclear. Given the physiological concomitants of both enuresis and encopresis, and the fact that many children with elimination disorders are initially brought to their primary care physician for treatment, medical evaluation and management are crucial and may serve as the first-line treatment approach. Scientific investigation on psychological and behavioral interventions has progressed over the past couple of decades, resulting in the identification of effective treatments for enuresis and encopresis. However, the body of literature has inherent challenges, particularly given the multicomponent nature of many of the treatment packages. This review identified 25 intervention studies-18 for nocturnal enuresis and 7 for encopresis-over the past 15 years and classified them according to the guidelines set forth by the Task Force on the Promotion and Dissemination of Psychological Procedures. For nocturnal enuresis, the urine alarm and dry-bed training were identified as well-established treatments, Full Spectrum Home Therapy was probably efficacious, lifting was possibly efficacious, and hypnotherapy and retention control training were classified as treatments of questionable efficacy. For encopresis, only two probably efficacious treatments were identified: biofeedback and enhanced toilet training (ETT). Best practice recommendations and suggestions for future research are provided to address existing limitations, including heterogeneity and the multicomponent nature of many of the interventions for pediatric elimination disorders.

  15. Comparison between imipramine and imipramine combined with pseudoephedrine in 5-12-year-old children with uncomplicated enuresis: a double-blind clinical trial.

    PubMed

    Abedin Zadeh, Mehdi; Moslemi, Mohammad Kazem; Kholaseh Zadeh, Golrasteh

    2011-02-01

    Monosymptomatic nocturnal enuresis is a common entity, with a prevalence of 10% at the age of 7 years. For its primary treatment, we compared the effect of combination medical therapy (imipramine with pseudoephedrine) with imipramine alone. In this one-center prospective double-blind clinical trial, 100 school-age children (age range 5-12 years) were enrolled. They were divided into two groups, comparable in terms of age and other demographic factors: (A) adjusted doses of a combination of imipramine with pseudoephedrine, and (B) imipramine with placebo were administered. Improvement was defined as less than 2 wet nights per week. Four weeks after drug withdrawal, the response rate was 74% in group A in comparison to 52% in group B, this difference being statistically significant. There was a recurrence of enuresis in both groups during the 4 weeks after treatment was discontinued (10% increase in group A and 8% increase in group B). The additive pharmacologic effects of imipramine with pseudoephedrine for the treatment of monosymptomatic nocturnal enuresis in children were well tolerated, and gave significantly faster results than single drug therapy using imipramine. The moderate-to-high recurrence rate following discontinuation of medical treatment indicates the need for a longer term study involving more cases. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  16. Five years of experience in nocturnal enuresis and urinary incontinence in children: where we are and where we are going.

    PubMed

    Ferrara, P; Ianniello, F; Romani, L; Fabrizio, G C; Gatto, A; Chiaretti, A

    2014-01-01

    Nocturnal enuresis (NE) is a very common pediatric disorder. The aim of this study was to evaluate the characteristics of patients with NE or urinary incontinence (UI) during a period of 5 years to increase the knowledge on these conditions and optimize their diagnosis and treatment. We enrolled 278 children with NE or UI referred to the pediatric nephrology ambulatory, 'A. Gemelli' University Hospital of Rome, from December 2006 to December 2011. We observed that heredity, parasomnias, left-handedness, polythelia and constipation are correlated to NE and UI. We wanted to clarify the definition of NE and UI and describe our experience on the main characteristics of these conditions by referring to the latest knowledge reported in the literature. 2013 S. Karger AG, Basel.

  17. A consultant paediatrician led and public health nurse (PHN) provided Community Enuresis Clinic as a model of care.

    PubMed

    Noone, D; van der Spek, N; Waldron, M

    2011-02-01

    A dedicated Community Enuresis Clinic was established in 2004 in Cavan and Monaghan. The service was audited using ERIC (Education and Resources for Improving Childhood Continence) guidelines. There were 106 males and 47 females, giving an M: F ratio of 2.3:1. Monosymptomatic Nocturnal Enuresis (MNE) accounted for 127 (83%). Adequate follow-up was available for 108 children with MNE and in this group Initial Success was 49% (ERIC target 50%). 71% were dry at 1 year. There was a dropout rate of 20% in the MNE group (ERIC minimum standard < 25%). We believe the structure of this community based clinic and its approach to MNE management has been successful.

  18. Association among nocturnal enuresis, body weight and obstructive sleep apnea in children of south Italy: an observational study.

    PubMed

    Ferrara, Pietro; Fabrizio, Giovanna C; Franco, Daniele; Spina, Giulia; Ianniello, Francesca; Sbordone, Annamaria; Vitelli, Ottavio; Quintarelli, Fabio; Verrotti, Alberto; Saggese, Giuseppe

    2016-04-14

    To evaluate the rate of nocturnal enuresis (NE), body weight and obstructive sleep apnea in children 5 to 10 years of age in South Italy and the possible association among these disorders. We have administered 1.100 validated questionnaires, in Italian language, to parents and we have analyzed data with a logistic regression. Forty-two percent of children had a BMI ≥ 85th (group 1) vs 58.0% normal weight children at the same age (group 2). There is a higher number of overweight males compared to females without statistically differences. In group 1 there were a higher number of children with NE and obstructive sleep disorders and exists in some children the association among these three disorders. There are no statistically differences between two study groups for the association body weight-NE, body weight-NE-obstructive sleep disorders.

  19. Focus on desmopressin and enuresis: a review of literature.

    PubMed

    Ferrara, Pietro; Vena, Flaminia; Basile, Maria C; Ianniello, Francesca; Gatto, Antonio

    2016-02-01

    Nocturnal enuresis (NE) is a common disorder in children. Choice of treatment depends on the frequency and severity of symptoms, the child's age and motivation. Treatment options for NE are alarm, desmopressin and imipramine. In particular, the main desmopressin therapeutical effect is the antidiuretic activity. The different formulations of desmopressin are an injectable solution, an oral tablet formulation and the recent oral lyophilisate (MELT). MELT with its higher biodisponibility guarantees the same therapy response of other formulations with a lower doses and it represents the first line and safety treatment for the NE.

  20. Hyponatraemic convulsion secondary to desmopressin treatment for primary enuresis.

    PubMed

    Apakama, D C; Bleetman, A

    1999-05-01

    The case of a 6 year old child who presented with convulsions and coma after unsupervised self administration of intranasal desmopressin (DDAVP) for nocturnal enuresis is presented. Children with enuresis can be embarassed by their condition and may believe that multiple doses of their nasal spray may bring about a rapid resolution. Water intoxication is an uncommon but serious adverse effect of treatment with intranasal DDAVP. These patients may present with seizure, mental state changes, or both. Basic management consists of stopping the drug, fluid restriction, and suppressive treatment for seizures. Recovery is usually rapid and complete. Administration of the nasal spray in children should be supervised by parents to prevent highly motivated children from accidental overdose. The risks of high fluid intake need to be carefully explained to both parents and children.

  1. [Optimization of enuresis therapy in children using transcranial magnetotherapy].

    PubMed

    Otpushchennikova, T V; Kazanskaia, I V; Volkov, S V; Raĭgorodskaia, Iu M

    2010-01-01

    A total of 58 children (age from 6 to 14 years) suffering from nocturnal enuresis (NE) were divided into two groups. The study group received basic therapy (driptan dose was reduced to 2.5 mg twice a day) in combination with transcranial bitemporal magnetotherapy (TcMT). The control group received placebo TcMT and basic therapy. It is shown that addition of TcMT to reduced basic therapy lowered the score of imperative voiding symptoms 1.3-fold, number of enuresis patients 1.7-fold, volume of the bladder 6.8 months after the treatment 1.9-fold, corrected vegetative status and activity of the subcortical nervous center in 24% children according to cardiointervalography versus the controls. Thus, TcMT improves clinical effect in NE patients in 2-fold reduction of pharmacological burden.

  2. Novel AVPR2 mutation causing partial nephrogenic diabetes insipidus in a Japanese family.

    PubMed

    Yamashita, Sumie; Hata, Astuko; Usui, Takeshi; Oda, Hirotsugu; Hijikata, Atsushi; Shirai, Tsuyoshi; Kaneko, Naoto; Hata, Daisuke

    2016-05-01

    X-linked recessive congenital nephrogenic diabetes insipidus (NDI) is caused by mutations of the arginine vasopressin type 2 receptor gene (AVPR2). More than 200 mutations of the AVPR2 gene with complete NDI have been reported although only 15 mutations with partial NDI has been reported to date. We herein report a Japanese kindred with partial NDI. The proband is an 8-year-old boy who was referred to our hospital for nocturnal enuresis. Water deprivation test and hypertonic saline test suggested partial renal antidiuretic hormone arginine vasopressin (AVP) resistance. Analysis of genomic DNA revealed a novel missense mutation (p.L161P) in the patient. The patient's mother was heterozygous for the mutation. Three-dimensional (3-D) modeling study showed that L161P possibly destabilizes the transmembrane domain of the V2 receptor, resulting in its misfolding or mislocalization. Distinguishing partial NDI from nocturnal enuresis is important. A clinical clue for diagnosis of partial NDI is an incompatibly high level of AVP despite normal serum osmolality.

  3. Parental perception and factors associated with treatment strategies for primary nocturnal enuresis.

    PubMed

    Tai, Thomson T; Tai, Brent T; Chang, Yu-Jun; Huang, Kuo-Hsuan

    2017-06-01

    The aim was to investigate the factors influencing parents seeking reasonable managements for their child and their overall outlook toward primary nocturnal enuresis (PNE). We recruited 93 children with PNE from enuresis clinics and requested their parents to complete questionnaires regarding their child's medical history and behavior, their methods for coping with PNE, and their perception of enuresis. Logistic regression models were applied to investigate factors influencing the parents to adopt a positive approach toward enuresis and to subsequently seek a medical consultation. One-third of the parents had an encouraging attitude toward children with PNE, whereas slightly less than half reacted with anger. The more educated the father or the younger the child with NE, the larger the possibility of the parents utilizing a positive approach, such as encouragement, for coping with NE. Factors that influenced parents to seek medical consultation for NE were socioeconomic status, maternal educational level, and the age and birth order of their child. From our results, angry and frustrated parents (43.0%) were significantly more likely to punish their child for bedwetting than were parents who approached NE positively (comfort and encouragement; 33.3%). A lack of encouragement may negatively affect the self-esteem of children with NE. Moreover, an individual's self-esteem or confidence, both of which can help them eliminate NE, determines the person's behavioral response to bedwetting. In our study, approximately 50% of the parents who approached NE positively (comfort and encouragement) or inconsistently (ambivalence) reported that they comforted their child after bedwetting. Nearly half the parents reacted angrily to children with NE, and some parents even punished their child. The parents' socioeconomic background, education, and the age and birth order of the child were the factors associated with their seeking active treatment for NE. A father's education and young age of the child were factors that influenced parents who preferred positive approaches, such as encouragement, for coping with NE. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  4. [Intelligence level and intelligence structure of children with primary nocturnal enuresis].

    PubMed

    Dai, Xiao-Mei; Ma, Hong-Wei; Pan, Xue-Xia

    2007-10-01

    Some research has shown that there may be memory/caution (M/C) defects in children with primary nocturnal enuresis (PNE). This study aimed to investigate whether the defects affect the intelligence level and the intelligence structure in PNE children. Intelligence tests were performed by means of Wechsler Young Children Scales of Intelligence (C-WISC) in 40 children with PNE and 40 age-matched normal children. The full intelligence quotient (FIQ), verbal IQ (VIQ) and performances IQ (PIQ) in the PNE group were in a normal range and did not different from the control group. There were significant differences in the scores for digit extent, decipher, knowledge and arithmetics between the PNE and the control groups (P < 0.05). M/C factor in the PNE group was statistically lower than in the control group (93.44 +/-11.27 vs 100.03 +/-11.79; P < 0.05). The total intelligence level of children with PNE was normal, but the M/C factor in the intelligence structure had some defects, suggesting that PNE may be related to the abnormity of executive function in the frontal lobe.

  5. Incontinence in persons with Down Syndrome.

    PubMed

    Niemczyk, Justine; von Gontard, Alexander; Equit, Monika; Medoff, David; Wagner, Catharina; Curfs, Leopold

    2017-08-01

    To assess the rates of incontinence and associated psychological problems in children, adolescents and adults with Down Syndrome, a genetic syndrome caused by partial or complete triplication (trisomy) of chromosome 21 and characterized by typical facial features, a physical growth delay and mild or moderate intellectual disability. Three hundred and seventeen persons with Down Syndrome (4-51 years) were recruited through a German parent support group (59.6% male, mean age 19.2 years). The Parental Questionnaire: Enuresis/Urinary Incontinence, the Incontinence Questionnaire-Pediatric Lower Urinary Tract Symptoms, as well as the Developmental Behavior Checklist (DBC) for parents or for adults were filled out by parents or care-givers. 17.2% of the sample had nocturnal enuresis, 15.9% had daytime urinary incontinence, and 14.2% had fecal incontinence. Incontinence was present in 64.0% of young children (4-12 years), 10.3% of teens (13-17 years), 12.8% of young adults (18-30 years) and in 22.4% of older adults (>30 years). 13.6% of children and 8.4% of adults had a DBC score in the clinical range. 19.5% of children and 27.8% of adults with incontinence had behavioral problems. There was a significant association between nocturnal enuresis, daytime urinary incontinence and clinical DBC scores in adults. Incontinence in Down Syndrome is mainly present in young children and increases in older adults. Behavioral comorbidity is associated with incontinence only in adults with Down Syndrome. Screening and treatment of incontinence in individuals with Down Syndrome is recommended. © 2016 Wiley Periodicals, Inc.

  6. Impact of enuresis nocturna on health-related quality of life in children and their mothers.

    PubMed

    Kilicoglu, A G; Mutlu, C; Bahali, M K; Adaletli, H; Gunes, H; Duman, H Metin; Toz, H Ipek; Uneri, O S

    2014-12-01

    Nocturnal enuresis (NE) is a common childhood disorder. As children age and NE persists, it may become more stressful for both them and their caregivers. The aim of the present study was to assess the impact of NE on the quality of life of children who were diagnosed with NE, and their mothers, and to compare the results with a healthy control group. Eighty-two children with NE, and their mothers, and 93 healthy children and their mothers were enrolled in the study. The sociodemographic data were evaluated. The Pediatric Quality of Life Inventory 4.0 Scales (PedsQL 4.0) were used to assess the children's health-related quality of life (HRQoL); and the World Health Organization Quality of Life Instrument; short form (WHOQOL-BREF) was used for the mothers' HRQoL. The PedsQL 4.0 mean scores for the children with NE group were as follows: total score, 68.74; physical health score, 72.79; psychosocial health score, 66.56. The scores for the children in the control group were as follows: total score, 80.98; physical health score, 81.11; psychosocial health score, 80.88. The WHOQOL-BREF scores for the mothers of the children with NE were as follows: physical health score, 67.90; psychosocial health score, 62.66; social relationships score, 60.90; environmental area score, 61.04. The WHOQOL-BREF scores for the mothers in the control group were as follows: physical health score, 75.96; psychosocial health score, 72.39; social relationships score, 72.18; environmental area score, 67.44. Nocturnal enuresis negatively affects the quality of life of both children and their mothers. Therefore, when physicians see children with enuresis, they should also be aware of the effect of NE on the mothers' quality of life. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  7. Atomoxetine ameliorates nocturnal enuresis with subclinical attention-deficit/hyperactivity disorder.

    PubMed

    Ohtomo, Yoshiyuki

    2017-02-01

    Recent studies have shown that incontinence and attention-deficit/hyperactivity disorder (ADHD) coexist and there is an interaction between them. The treatment for nocturnal enuresis (NE) and ADHD, however, has not been established. At the first visit to the outpatient clinic, physical examination and history taking were carried out in 265 new patients with NE. After excluding the possibility of comorbid ADHD and related disorders, patients with monosymptomatic NE (MNE) were treated with desmopressin and/or alarm, and those with non-monosymptomatic NE (NMNE) were treated with anti-cholinergics and/or alarm. This 12 week treatment did not work in 65 patients, and they were re-assessed for comorbid ADHD. A total of 24 were diagnosed with ADHD, and they were treated with atomoxetine (1.8 mg/kg/day) in addition to ongoing therapy for NE. After 8 weeks of atomoxetine, the average wet nights per months was significantly decreased: 18.5-4.6 in the MNE group (P = 0.001), and 22.1-12.4 in the NMNE group (P = 0.0251). Overall, atomoxetine was beneficial in 19 of 24 patients. Atomoxetine may be a suitable option for refractory NE with comorbid ADHD. © 2016 Japan Pediatric Society.

  8. Physical Activity Patterns and Sedentary Behavior in Older Women With Urinary Incontinence: an Accelerometer-based Study.

    PubMed

    Chu, Christine M; Khanijow, Kavita D; Schmitz, Kathryn H; Newman, Diane K; Arya, Lily A; Harvie, Heidi S

    2018-01-10

    Objective physical activity data for women with urinary incontinence are lacking. We investigated the relationship between physical activity, sedentary behavior, and the severity of urinary symptoms in older community-dwelling women with urinary incontinence using accelerometers. This is a secondary analysis of a study that measured physical activity (step count, moderate-to-vigorous physical activity time) and sedentary behavior (percentage of sedentary time, number of sedentary bouts per day) using a triaxial accelerometer in older community-dwelling adult women not actively seeking treatment of their urinary symptoms. The relationship between urinary symptoms and physical activity variables was measured using linear regression. Our cohort of 35 community-dwelling women (median, age, 71 years) demonstrated low physical activity (median daily step count, 2168; range, 687-5205) and high sedentary behavior (median percentage of sedentary time, 74%; range, 54%-89%). Low step count was significantly associated with nocturia (P = 0.02). Shorter duration of moderate-to-vigorous physical activity time was significantly associated with nocturia (P = 0.001), nocturnal enuresis (P = 0.04), and greater use of incontinence products (P = 0.04). Greater percentage of time spent in sedentary behavior was also significantly associated with nocturia (P = 0.016). Low levels of physical activity are associated with greater nocturia and nocturnal enuresis. Sedentary behavior is a new construct that may be associated with lower urinary tract symptoms. Physical activity and sedentary behavior represent potential new targets for treating nocturnal urinary tract symptoms.

  9. Nocturnal enuresis: A topic review and institution experience

    PubMed Central

    DiBianco, John Michael; Morley, Chad; Al-Omar, Osama

    2014-01-01

    The objective is to provide a review of nocturnal enuresis (NE), including its epidemiology, etiology, pathophysiology, evaluation, and current management. We also set to provide further insight on the treatment of this condition from the experience derived from patients cared for at our tertiary-care institution. NE affects approximately 15% of all children at 5-year-old, affecting boys more frequently than girls. At our large university tertiary pediatric urology center, NE and incontinence, in general, is one the most common chief complaints prompting urologic care. In this review, we examine the condition in detail, highlighting specific goals of the initial evaluation and treatment. We contrast the commonly implemented treatment recommendations, available from the literature with strategies we have found valuable from our extensive experience in treating patients with this disorder. Using current urologic reference textbooks, book chapters, Medline, journal articles and reviews describing the many aspects of NE were reviewed in order to describe NE and the current practices at our institution. Although, this is not a systematic literature review, it includes relevant available research, institutional experience and urological expert opinion and current practices at a tertiary state health facility. The treatment of NE remains a challenge for many pediatricians and pediatric urologists. This likely stems from the multiple possible etiologies of the disorder. We have established a treatment algorithm at our institution, which we have found successful in the majority of our patients. This consists of starting patients on urotherapy, then offering both the enuresis alarm device and medication therapy as first line treatments, and finally adding anticholingerics for combination therapy. Our hope is with further research the treatment of NE will continue to improve. PMID:25506580

  10. Adolescents with nocturnal enuresis and daytime urinary incontinence-How can pediatric and adult care be improved-ICI-RS 2015?

    PubMed

    von Gontard, Alexander; Cardozo, Linda; Rantell, Angie; Djurhuus, Jens-Christian

    2017-04-01

    Nocturnal enuresis (NE) and daytime urinary incontinence (DUI) are common in adolescents. The aim of this paper was to review studies on prevalence, clinical symptoms and associated risk factors and to formulate recommendations for assessment and treatment. A systematic Scopus search was performed and relevant publications were selected. The topic was discussed during the ICI-RS meeting in 2015. One to two percent of older adolescents are affected by NE and 1% by DUI. NE and DUI are associated with multiple risk factors such as fecal incontinence and constipation, obesity, chronic illness, and psychological impairment. Chronic treatment-resistant, relapsing and new-onset cases can occur. Adolescent NE and DUI can be treated by a multidisciplinary team according to pediatric principles. Additional treatment components have been developed for adolescents. Transition from pediatric to adult services is frequently disorganized. Incontinence in adolescents is a neglected research topic and clinical care is often suboptimal. As adolescents are seen by both pediatric and adult services, alignment and harmonization of diagnostic and therapeutic principles is needed. Also, an organized transition process is recommended to improve care for adolescent patients. Neurourol. Urodynam. 36:843-849, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. Can recording only the day-time voided volumes predict bladder capacity?

    PubMed

    Cho, Won Yeol; Kim, Seong Cheol; Kim, Sun-Ouck; Park, Sungchan; Lee, Sang Don; Chung, Jae Min; Kim, Kyung Do; Moon, Du Geon; Kim, Young Sig; Kim, Jun Mo

    2018-05-01

    This study aimed to demonstrate a method to easily assess bladder capacity using knowledge of day-time voided volumes, which can be obtained even from patients with nocturnal enuresis where the first morning void cannot accurately predict the bladder capacity due to bladder emptying overnight. We evaluated 177 healthy children from 7 Korean medical centres entered the study between January 2008 and January 2009. Voided volumes measured for more than 48 hours were recorded in the frequency volume chart (FVC). Most voided volumes during day-time were showed between 30% and 80% of the maximal voided volume (MVV). The maximal voided volume during day-time (MVVDT) was significantly less than the MVV (179.5±71.1 mL vs. 227.0±79.2 mL, p<0.001). The correlation coefficients with the MVV were 0.801 for the estimated MVV using the MVVDT (MVVDT×1.25), which suggested a fairly strong relationship between the MVVDT×1.25 and the MVV. The MVV derived from the FVC excluding the FMV was less than if the FMV had been included. When an accurate first morning voided volume cannot be obtained, as in patients with nocturnal enuresis, calculating MVVDT×1.25 allows estimation of the bladder capacity in place of the MVV.

  12. Is there a correlation between intravaginal ejaculatory latency time and enuresis? An exploratory study

    PubMed Central

    Serefoglu, Ege Can; Karacay, Safak; Ozdemir, Ahmet Tunc; Kalkan, Mehmet; Yencilek, Faruk

    2014-01-01

    Introduction Premature ejaculation (PE) is the most common male sexual dysfunction. Monosymptomatic enuresis (ME) is nocturnal bed wetting, without any daytime symptoms. Recent clinical studies report an association between lifelong PE and ME. The purpose of this study was to compare the intravaginal ejaculatory time (IELT) between lifelong PE in men with and without ME. The goal was to determine if there is an association between the severity of ME and of IELT. Material and methods A total of 137 men with lifelong PE were included in this study. Subjects were asked if they had childhood ME. The characteristics and mean IELTs of patients with and without ME were compared using the student's t–test, and the correlation between severity of ME and IELT was assessed with trend test. Results Of the 137 lifelong PE patients, 57 reported ME. There was a strong negative correlation in patients with ME between the severity of enuresis and IELT, with IELT being shorter in patients with severe ME. Conclusions A strong correlation between IELT and the severity of ME suggests a common underlying mechanism. Further studies are required to confirm these findings and elucidate the exact pathophysiology. PMID:24982787

  13. Is there a correlation between intravaginal ejaculatory latency time and enuresis? An exploratory study.

    PubMed

    Koyuncu, Hakan; Serefoglu, Ege Can; Karacay, Safak; Ozdemir, Ahmet Tunc; Kalkan, Mehmet; Yencilek, Faruk

    2014-01-01

    Premature ejaculation (PE) is the most common male sexual dysfunction. Monosymptomatic enuresis (ME) is nocturnal bed wetting, without any daytime symptoms. Recent clinical studies report an association between lifelong PE and ME. The purpose of this study was to compare the intravaginal ejaculatory time (IELT) between lifelong PE in men with and without ME. The goal was to determine if there is an association between the severity of ME and of IELT. A total of 137 men with lifelong PE were included in this study. Subjects were asked if they had childhood ME. The characteristics and mean IELTs of patients with and without ME were compared using the student's t-test, and the correlation between severity of ME and IELT was assessed with trend test. Of the 137 lifelong PE patients, 57 reported ME. There was a strong negative correlation in patients with ME between the severity of enuresis and IELT, with IELT being shorter in patients with severe ME. A strong correlation between IELT and the severity of ME suggests a common underlying mechanism. Further studies are required to confirm these findings and elucidate the exact pathophysiology.

  14. Effects of Adenotonsillectomy on Neurocognitive Function in Pediatric Obstructive Sleep Apnea Syndrome

    PubMed Central

    Horiuchi, Fumie; Oka, Yasunori; Komori, Kenjiro; Tokui, Yasumasa; Matsumoto, Teruhisa; Ueno, Shu-ichi

    2014-01-01

    Obstructive sleep apnea syndrome (OSAS) in children does not only present with symptoms of sleep disturbances but also with associated symptoms such as growth failure, enuresis, academic learning difficulties, and behavioral problems, including attention deficit/hyperactivity disorder- (ADHD-) like symptoms. We evaluated neurocognitive functions before and after adenotonsillectomy in a patient with OSAS. An 11-year-old boy suspected of having ADHD with nocturnal enuresis was referred for evaluation. He was found to have adenotonsillar hypertrophy. Presence of snoring was evident only after detailed medical interview. Polysomnography confirmed the diagnosis of OSAS, which was subsequently treated by adenotonsillectomy. The apnea/hypopnea index decreased from 21.9 at baseline to 1.8 after surgery, and the frequency of enuresis fell from almost nightly to 2-3 times per month. Neurocognitive and behavioral assessment after the treatment of OSAS showed significant improvement in cognitive functions, especially attention capacity and considerable amelioration of behavioral problems including ADHD-like symptoms. As the most common cause of pediatric OSAS is adenotonsillar hypertrophy, medical interview and oropharyngeal examination should always be performed in children suspected of having ADHD. The necessity of sleep evaluation for children with ADHD-like symptoms was also emphasized. PMID:24971187

  15. Dysfunctional elimination symptoms in childhood and adulthood.

    PubMed

    Bower, W F; Yip, S K; Yeung, C K

    2005-10-01

    The dysfunctional elimination syndrome (DES) is rare in adulthood. We evaluate the natural history of DES to identify aspects of the disorder that may be carried into adulthood. A 2-part questionnaire was devised and self-administered to 191 consecutive women attending a urogynecological clinic (UG) and to 251 normal women. The first section asked for recall of childhood symptoms known to be associated with DES, while the lat-ter section explored current bladder and bowel problems. Data sets from the normal cohort (55) reporting current bladder problems were excluded. Descriptive statistics, chi-square and Mann-Whitney-U tests were used to compare variables. UG patients had significantly higher childhood DES scores than normal women. Overall 41.7% of UG patients could be labeled as having dysfunctional elimination as an adult. Symptoms reported significantly more often in childhood by UG patients than by control women were frequent urinary tract infection, vesicoureteral reflux, frequency, urge incontinence, slow and intermittent urine flow, small volume high urge voids, hospitalization for constipation, frequent fecal soiling and nocturnal enuresis. Higher DES scores correlated significantly with current adult urgency, urge leak, stress incontinence, incomplete emptying, post-void leak, hesitancy, nocturia and nocturnal enuresis. Constipation and fecal incontinence in adulthood also showed a significant association with high DES scores. Logistic regression revealed childhood urgency to be associated with adult DES. Childhood lower urinary tract dysfunction may have a negative impact on bladder and bowel function later life.

  16. Children with nocturnal enuresis have posture and balance disorders.

    PubMed

    Pavione Rodrigues Pereira, R; Nascimento Fagundes, S; Surry Lebl, A; Azevedo Soster, L; Machado, M G; Koch, V H; Tanaka, C

    2016-08-01

    Integration of the neuromuscular system is required for maintaining balance and adequate voiding function. Children with enuresis have delayed maturation of the motor cortex, with changes in the sensory and motor systems. Along with various alterations, including the genetic, hormonal, behavioral, and sleep disturbances, and neuromotor and sensory deficits associated with nocturnal enuresis (NE) in children and adults, a consistent alteration in the posture of children with NE has been observed in the current practice. Because posture and the balance control system are strongly connected, this study aimed to investigate posture and balance in children and teenagers with NE. A total of 111 children with enuresis were recruited to the enuretic group (EG) and 60 asymptomatic children made up the control group (CG). The participants were divided into two age subgroups: (A) 7-11 years old, N = 77 for EG/A, N = 38 for CG/A; and (B) 12-16 years old, N = 34 for EG/B, N = 22 for CG/B. Balance was assessed using an electronic force plate (100 Hz) to calculate the area of the center of pressure (COP) displacement. The COP is the point that results from the action of vertical forces projected onto the force plate. Sensory integration was analyzed using a 60-s trial with the subject standing under four conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; (4) eyes closed, unstable surface. Posture was assessed by placing reflective anatomical landmarks on the anterior superior iliac spine, the posterior superior iliac spine, the greater trochanter, and lateral malleolus. A photograph was taken while the subject stood quietly. The angles were obtained from landmark connections using software to assess the following posture variables: pelvic ante/retroversion and pelvic ante/retropulsion. The EG showed a greater area of COP displacement compared with the CG under all four sensory conditions and both subgroups, except for EG/B in condition 3. Regarding posture, EG showed higher pelvic anteversion angles than CG. Enuretic children showed forward inclination of the pelvis and had worse balance compared with control children. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  17. Sleep fragmentation and periodic limb movements in children with monosymptomatic nocturnal enuresis and polyuria.

    PubMed

    Dhondt, Karlien; Van Herzeele, Charlotte; Roels, Sanne Patrick; Raes, Ann; Groen, Luitzen-Albert; Hoebeke, Piet; Walle, Johan Vande

    2015-07-01

    Children with nocturnal enuresis (NE) have been found to have sleep fragmentation and a high incidence of periodic limb movements in sleep (PLMS). This study explored the association of monosymptomatic NE and polyuria in relation to fluid intake, bladder volume, number of wet nights, and number of nights with polyuria to the frequency of PLMS and cortical arousals during sleep. Thirty children with monosymptomatic NE and polyuria were enrolled in the study. Enuretic parameters were determined by diaries, forced drinking, uroflow, and ultrasound examination. All subjects participated in one polysomnographic study. The number of cortical arousals and PLMS were compared with those recorded in a former pilot study which included only children with refractory NE. Of the 30 children who participated in the study, the mean age was 10.43 ± 3.08 (range 6-16) years, and 23 were boys. The PLMS index was positively associated with the arousal index and the awakening index (p < 0.001). No significant association between the sleep and the enuretic parameters was found. Children with refractory NE showed a significantly higher PLMS index (p < 0.001). We found that PLMS and cortical arousals in sleep were increased in children with monosymptomatic NE and polyuria, without a significant association with the enuretic parameters. These observations suggest the presence of a comorbid mechanism driven by a common, independent pacemaker. We hypothesize the autonomic system, its sympathetic branch, and the dopaminergic system as candidates for this pacemaker.

  18. Voiding school as a treatment for daytime incontinence or enuresis: Assessing the effectiveness of intervention by measuring changes in wetting episodes.

    PubMed

    Saarikoski, A; Koppeli, R; Taskinen, S; Axelin, A

    2018-06-01

    Most urotherapy interventions are planned for children with daytime incontinence or symptoms, and are based on individual education. This study conducted a voiding school (VS) program with groups of 4-6 children with daytime incontinence or enuresis with or without daytime symptoms. The aim of this quasi-experimental study with a one-group pretest-posttest design was to assess the effectiveness of the VS intervention for treating children's daytime incontinence or enuresis. Sixty-nine 6-12-year-old children with incontinence classified as treatment resistant participated in the VS at an outpatient clinic. Based on a power analysis, a sample of 52 participants was required. The VS involved two whole-day group visits 2 months apart. The educational content of the intervention was based on the International Children's Continence Society's standards for urotherapy, and was delivered with child-oriented teaching methods, including group discussions with peers. The primary outcome measure was the number of dry days and nights. The amount of wetting was also estimated, and the frequency of voiding measured. Data were collected with 1-week voiding diaries before and after each visit. Changes in dependent variables between four measurement points was measured by using repeated measures variance analysis. The long-term effectiveness was evaluated from patient records concerning 3-month follow-up phone calls or other contacts 8-18 months after the VS. Fifty-eight children, 34 girls and 24 boys, completed the study. Twelve children had daytime incontinence, 18 had enuresis, and 28 had both. The number of dry days increased from a mean of 3.5-5.3 (P < 0.001), and the number of dry nights increased from a mean of 2.4-3.9 (P < 0.001) (Summary table). Thirteen (22%) children became completely dry. Three of them had daytime incontinence, five enuresis, and five both. Twenty-four out of 40 (60%) children with daytime incontinence, and 23 out of 46 (50%) children with enuresis showed ≥50% decrease in wetting episodes. The amount of wetting reduced, but the voiding frequency remained unchanged based on the voiding diaries. Twenty-two (45%) of the children were completely dry (six had daytime incontinence, nine enuresis, and seven both), and 16 (39%) showed further improvement, but eight (16%) children remained unchanged 8-18 months after the VS. Voiding school (VS) was an effective intervention for treating both daytime incontinence and nocturnal enuresis in children who had not benefited from standard treatment and were classified as treatment resistant. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  19. Constipation and Lower Urinary Tract Dysfunction in Children and Adolescents: A Population-Based Study.

    PubMed

    Sampaio, Clara; Sousa, Ariane Sampaio; Fraga, Luis Gustavo A; Veiga, Maria Luiza; Bastos Netto, José Murillo; Barroso, Ubirajara

    2016-01-01

    To evaluate the correlation between constipation and lower urinary tract dysfunction (LUTD) and nocturnal enuresis in a population-based study. This is a cross-sectional study. The criteria for inclusion were children and adolescents of between 5 and 17 years and who agreed to sign the informed consent form. The study excluded students with neurological problems or who had documented abnormalities of the urinary tract. To identify the presence and severity of LUTD, we used the Voiding Dysfunction Symptom Score (DVSS). To evaluate the presence of constipation, Rome III questionnaire was used. We interviewed 829 children and adolescents, of which 416 (50.18%) were male. The mean (SD) age was 9.1 (±2.9) years. The overall prevalence of LUTD was 9.1%, predominantly in girls (15 versus 3.1%, p  < 0.001). Constipation was found in 9.4% of boys and 12.4% of girls ( p  = 0.169). Constipated children were 6.8 times more likely to have LUTD than those not constipated ( p  < 0.001, coefficient and correlation of 0.411). Constipation was found in 8.2% of children without LUTD and in 35.2% of children with LUTD. We performed multivariate analysis to identify urinary symptoms that are independent predictors of the presence of constipation. The presence of infrequent urination ( p  = 0.004) and holding maneuvers ( p  < 0.001) were independent predictors. It was noted also noted that constipated children, according to the Rome III criteria, possess a worse DVSS ( p  < 0.001). Regarding the presence of nocturnal enuresis, 12.6% of children and adolescents had constipation in association with this symptom. However, this relationship was not statistically significant ( p  = 0.483). Constipated children were 6.8 times more likely to have LUTD than those not constipated. Among the urinary symptoms, infrequent voiding and holding maneuvers are independent factors of urinary expressions in constipated children. Children with more severe constipation have more prominent urinary symptoms. The presence of enuresis was not associated with constipation.

  20. Association between allergic disease, sleep-disordered breathing, and childhood nocturnal enuresis: a population-based case-control study.

    PubMed

    Tsai, Jeng-Dau; Chen, Hsuan-Ju; Ku, Min-Sho; Chen, Shan-Ming; Hsu, Chih-Chuan; Tung, Min-Che; Lin, Che-Chen; Chang, Hsing-Yi; Sheu, Ji-Nan

    2017-12-01

    Little is known about the associations between allergic disease, sleep-disordered breathing (SDB), and childhood nocturnal enuresis (NE). We examined whether allergic disease and SDB were associated with childhood NE. Data were assessed from the 2007-2012 Taiwan National Health Insurance Research Database. We enrolled 4308 children aged 5-18 years having NE diagnosis and age- and sex-matched 4308 children as the control group. The odds ratios of NE were calculated to determine an association with preexisting allergic disease and SDB. A total of 8616 children were included in the analysis. Prevalence of allergic diseases and SDB was significantly higher for the NE group than the control group (all p < 0.001). After adjusting odds ratios for potential confounding factors, except asthma, children with allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and obstructive sleep apnea (OSA) had significantly higher odds of NE compared with children never diagnosed. With stratification for sex, girls with allergic rhinitis, atopic dermatitis, allergic conjunctivitis, OSA, and snoring had significantly higher odds of NE, compared with girls never diagnosed. Only boys with allergic rhinitis and OSA were associated with increased odds of NE. With stratification for age, children aged 5-12 years with allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and OSA had significantly higher odds of NE compared with those never diagnosed. Odds of NE increased with the number of comorbid allergic diseases. Allergic diseases and SDB are associated with increased odds of childhood NE. The odds of NE increased with the number of comorbid allergic diseases present.

  1. Lower Urinary Tract Urological Abnormalities and Urodynamic Findings of Physiological Urinary Incontinence Versus Non-mono Symptomatic Nocturnal Enuresis in Children.

    PubMed

    Naseri, Mitra

    2014-03-01

    Although 98% of children attain daytime bladder control by three years of age, urinary incontinence is regarded physiological up to the fifth year of life. This study aimed to assess whether lower urinary tract urological abnormalities and abnormal urodynamic findings are infrequent in children with physiological urinary incontinence in contrast to those with non-monosymptomatic nocturnal enuresis (NMNE). During a three-year period (2007-2009), 66 neurologically normal children including 51 children (34 girls, 17 boys) older than five years of age with NMNE and intermittent daytime incontinence, and 15 children with physiological urinary incontinence (eight girls and seven boys) aged four to five years of age without any known urological abnormalities were enrolled in the study. Patients with neurologic deficits or known urological anomalies were excluded from the study. Kidney-bladder ultrasonography, voiding cystourethrography (VCUG), and urodynamic studies were performed to evaluate the anatomy of urinary tract and bladder function. Urinary tract infection was found in 23 (34.8%) children, 17 (33.3%) and 6 (40%) patients with NMNE and physiological urinary incontinence, respectively. Out of 48 patients who underwent VCUG, vesicoureteral reflux (VUR) was found in seven and eight children younger and older than five years of age, respectively. Abnormal urodynamic findings were reported in 5 (62.5%) of eight children younger than five-year-old, and 14 (63.6%) of 22 patients older than 5-year-old. VUR might be more frequent in children with physiological urinary incontinence than the normal population, and might be as common as NMNE with intermittent daytime incontinence.

  2. Obstructive Sleep Apnea in a Danish Population of Men and Women Aged 60-80 Years with Nocturia

    PubMed Central

    Bing, Mette Hornum; Jennum, Poul; Moller, Lars Alling; Mortensen, Svend; Lose, Gunnar

    2012-01-01

    Introduction and Hypothesis: The aim of the present study was in a case-control design to evaluate the association between nocturia and obstructive sleep apnea, in men and women who had nocturia ≥ 2 per night (nocturics) compared to those without nocturia (controls). Methods: Participants were randomly selected among respondents in a population study of 4000 elderly individuals. Nocturia was assessed using the validated Nocturia, Nocturnal Enuresis, and Sleep-interruption Questionnaire (NNES-Q). Nocturia (≥ 2 voids/night) or control (< 1 void/night) status was assessed by a 3-day frequency volume chart (FVC). Furthermore, all participants completed an overnight ambulatory polygraphic recording to identify obstructive sleep apnea (OSA). Results: Of 1111 eligible individuals, a total of 75 nocturics and 75 controls (13.5%) were included. Overall, the prevalence and severity of OSA among nocturics and controls was not significantly different. In a sub-analysis we found that 22 nocturics with OSA (69%) had nocturnal polyuria. This led to a significantly increased risk of having OSA (OR 2.8, 95% CI: 1.1-7.3, p < 0.05) when having nocturnal polyuria compared to other pathophysiological causes of nocturia (polyuria, low bladder capacity, a combination of nocturnal polyuria/low bladder capacity, and neither nocturnal polyuria/low bladder capacity). Conclusions: Nocturia twice or more was not significantly associated with OSA. However, nocturics with nocturnal polyuria had a significantly higher risk of having OSA than nocturics with other pathophysiologies. Citation: Bing MH; Jennum P; Moller LA; Mortensen S; Lose G. Obstructive sleep apnea in a danish population of men and women aged 60-80 years with nocturia. J Clin Sleep Med 2012;8(5):515-520. PMID:23066362

  3. Prevalence of nocturnal enuresis and related risk factors in school-age children in Egypt: an epidemiological study.

    PubMed

    Hamed, Ahmed; Yousf, Fouad; Hussein, Mohamed M

    2017-03-01

    To determine the prevalence of mono-symptomatic nocturnal enuresis (MNE) and its risk factors among school-age children in our community. A cross-sectional study included school-age children from two governorates in south of Egypt. A questionnaire was presented to randomly selected students. It consisted of 3 domains: Domain 1 included questions about MNE, domain 2 was about risk factors for MNE, and domain 3 was about management of MNE. The study included 4652 students (9 ± 2 years) from 12 primary schools (51 % males and 49 % females). Of 4652 students, 834 (18 %) had NE, with no significant difference between rural and urban areas (17.5 vs. 18.4 %, p = 0.4). Younger age categories showed higher prevalence of MNE than in older children. MNE caused moderate-to-severe bother for 44.5 and 87.8 % of students and parents, respectively. Urinary tract infection, pinworm infestation, constipation, and caffeine over-consumption significantly associated with MNE. Family history of MNE was positive in 84.7 %. Daytime incontinence coexisted in 16 % of cases. Children with ≥4 siblings and birth order ≥3 had more prevalent MNE. Deep sleepers and exposure to problems/violence correlated positively with occurrence of MNE. Father's level of education and work status, mother education, number of children per room, and socioeconomic status significantly associated with occurrence of MNE. There was no significant correlation between gender and prevalence of MNE. No treatment was used in 53.2 % of cases. In the Egyptian community, pinworm infestation, UTI, constipation, and overconsumption of caffeine-containing beverages are potential reversible risk factors for MNE in school-age children.

  4. Self-esteem in 6- to 16-year-olds with monosymptomatic nocturnal enuresis.

    PubMed

    Kanaheswari, Yoganathan; Poulsaeman, Veronica; Chandran, Vijayalakshmi

    2012-10-01

    Childhood nocturnal enuresis (NE) and incontinence has been shown to be associated with increased behavioural problems and reduced self-esteem (SE) in Western populations. The impact on Asian children, however, is not known. This study investigates the relationship between SE and monosymptomatic NE in Malaysian children aged 6 to 16 years. Children with wetting frequency of at least 4 out of 14 nights were recruited with controls matched for age, gender and race. SE scores were obtained using the 'I Think I Am' questionnaire for five domains: body image, talents and skills, psychological well-being, relationship with family and relationship with others. A total of 126 children were recruited; 22 enuretics aged 6-9 years and their matched controls (Group1) and 41 enuretics aged 10-16 years and their matched controls (Group 2). SE scores were similar between the enuretic and controls in Group 1, whereas in Group 2, enuretics had significantly lower scores (P < 0.05) in 'body image', 'relationship with others' and total SE scores. This difference was more pronounced among girls, adolescents and those who wet more than 10/14 nights. The SE of Malaysian children with monosymptomatic NE aged 10 years and above is significantly lower than their peers. This effect is seen particularly among girls, adolescents and those with frequent wetting. In the light of these findings, the 'wait and see' approach by the Malaysian medical profession is no longer appropriate. Treatment should begin before the age of 10 years. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  5. Correlation between clinical manifestations of nocturnal enuresis and attentional performance in children with attention deficit hyperactivity disorder (ADHD).

    PubMed

    Yang, Teng-Kai; Huang, Kuo-How; Chen, Shyh-Chyan; Chang, Hong-Chiang; Yang, Hung-Ju; Guo, Ya-Jun

    2013-01-01

    Children with attention deficit hyperactivity disorder (ADHD) tend to be more vulnerable to various forms of voiding dysfunction and nocturnal enuresis (NE). We attempt to compare the clinical manifestations and attentional performance between ADHD children with NE and those without NE. We consecutively enrolled children diagnosed with ADHD in child and adolescent psychiatric clinics. The questionnaires for evaluation of ADHD symptoms and voiding dysfunction symptoms were administered to all study participants. All participants also received the Test Battery for Attention Performance (TAP) for assessment of attentional function. A total of 53 children were enrolled in this study, comprising 47 boys and six girls. The prevalence rate of NE was 28.3%. Children in the NE group had statistically significant higher dysfunctional voiding symptom score (5.40 ± 3.66 vs.3.16 ± 2.74; p = 0.018) and two subscales of "When I wet myself, my underwear is soaked" (p < 0.001) and "I miss having a bowel movement every day" (p = 0.047). There were no significant differences with regard to all psychiatric evaluations between the NE and non-NE groups. In the TAP test, the NE group showed a significantly shorter reaction time in the domain of inhibitory control, working memory, and auditory sustained attention than the non-NE group. Children with ADHD have a high prevalence of NE. ADHD children with NE had a significantly higher dysfunctional voiding symptom score and shorter reaction time in most domains of the TAP test. Further study is needed to discern the impact of NE on the neuropsychological function of ADHD children. Copyright © 2012. Published by Elsevier B.V.

  6. Bladder control training in girls with lower urinary tract dysfunction.

    PubMed

    Amira, Peco-Antić; Dušan, Paripović; Gordana, Miloševski-Lomić; Sandra, Trojanović; Ivaniševic, Ivana

    2013-01-01

    To evaluate the efficacy of standard and biofeedback bladder control training (BCT) on the resolution of dysfunctional elimination syndrome (primary outcome), and on the reduction of urinary tract infections (UTI) and the use of medications such as antibacterial prophylaxis and/or anticholinergic/alpha-blockers (secondary outcome) in girls older than aged least 5 years. 72 girls, median age of 8 years (interquartile range, IQR 7-10) were subjected to standard BCT (cognitive, behavioural and constipation treatment) and 12 one-hour sessions of animated biofeedback using interactive computer games within 8 weeks. Fifty patients were reevaluated after median 11 (IQR, 6-17) months. Effectiveness of BCT was determined by reduction of dysfunctional voiding score (DVS), daytime urinary incontinence (DUI), constipation, UTI, nocturnal enuresis (NE), post void residual (PVR), and improvements in bladder capacity and uroflow/EMG patterns. BCT resulted in significant normalization of DUI, NE, constipation, bladder capacity, uroflow/EMG, while decrease of PVR didn't reach statistical significance. In addition, the incidence of UTI, antibacterial prophylaxis and medical urotherapy significantly decreased. There were no significant differences in DVS, DVI, NE, bladder capacity and voiding pattern at the end of the BCT and at the time of reevaluation. The success on BCT was supported by parenteral perception of the treatment response in 63.9% and full response in additional 15.3% of the patients. Combination of standard and biofeedback BCT improved dysfunctional elimination syndrome and decreased UTI with discontinuation of antibacterial prophylaxis and/or anticholinergic/alpha-blockers in the majority of the patients. Better training results are expected in patients with higher bladder wall thickness as well as in those with vesicoureteral reflux, while presence of nocturnal enuresis may be a negative predictor of the training effect.

  7. Incontinence in children with treated attention-deficit/hyperactivity disorder.

    PubMed

    Niemczyk, J; Equit, M; Hoffmann, L; von Gontard, A

    2015-06-01

    Attention-deficit/hyperactivity disorder (ADHD) and incontinence (nocturnal enuresis, daytime urinary incontinence and fecal incontinence) are common disorders in childhood. Both disorders are strongly associated with each other. ADHD can affect compliance to incontinence therapy in a negative way; it can also affect outcome. The aim of the present study was to assess the prevalence of incontinence, age of bladder and bowel control, and psychological symptoms in children having treatment for ADHD compared to a control group. Forty children having treatment for ADHD (75% boys, mean age 11.4 years) and 43 matched controls (60.5% boys, mean age 10.7 years) were assessed. Their parents filled out questionnaires to assess: child psychopathology (Child Behavior Checklist), incontinence (Parental Questionnaire: Enuresis/Urinary Incontinence; Encopresis Questionnaire - Screening Version) and symptoms of the lower urinary tract (International-Consultation-on-Incontinence-Questionnaire - Pediatric Lower Urinary Tract Symptoms). The ICD-10 diagnoses and children's IQ were measured by standardized instruments (Kinder-DIPS, Coloured Progressive Matrices/Standard Progressive Matrices). Rates of incontinence in the ADHD group (5% nocturnal enuresis, 5% daytime urinary incontinence, 2.5% fecal incontinence) did not differ significantly from incontinence rates in the control group (4.7% daytime urinary incontinence). More children in the ADHD group had Child Behavior Checklist scores in the clinical range. Further ICD-10 disorders were present in eight children with ADHD and in one control child. More children with ADHD had delayed daytime and nighttime bladder control, as well as delayed bowel control, than the controls. The present study showed that if children are treated for their ADHD, according to standard practice guidelines, incontinence rates are similar to those without ADHD. More children with ADHD reached continence at a later age than the controls, which could be an indicator of maturational deficits in the central nervous system. Additionally, children with ADHD showed higher rates of clinically relevant psychological symptoms. This study provides further information of the association between ADHD and incontinence. Treatment of ADHD may be associated with positive effects on incontinence outcomes. Therefore, children with ADHD should always be screened for incontinence problems and children with incontinence problems should also be screened for ADHD if symptoms of hyperactivity, inattention and/or impulsivity are also present. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  8. Obstructive sleep apnea syndrome and nocturnal epilepsy with tonic seizures.

    PubMed

    Bialasiewicz, Piotr; Nowak, Dariusz

    2009-12-01

    Some ambiguous symptoms may delay or lead to an erroneous diagnosis. We present a case of pure sleep, generalized tonic seizures in a patient with concomitant sleep apnea syndrome. The prolonged apneic periods with tonic muscle contracture lasting minutes and occurring exclusively at night with ensuing confusional state posed diagnostic difficulties because of the negative EEG at the beginning of the workup and the absence of other epilepsy symptoms (i.e. clonic phase, tongue biting, enuresis, seizures while awake). Numerous apneas on polysomnography led to the diagnosis of sleep apnea syndrome. No effect of continuous positive airways pressure (CPAP) treatment on frequency of the nocturnal tonic epileptic fits and the repetitive character of the clinical presentation combined with the typical pathologic changes on subsequent EEGs permitted to suggest the epileptic nature of the paroxysmal events. Episodes stopped following administration of clonazepam. However, spontaneous, coincidental remission of seizures cannot be excluded since the patient remained seizure free even after discontinuation of the drug.

  9. Chronobiology of micturition: putative role of the circadian clock.

    PubMed

    Negoro, Hiromitsu; Kanematsu, Akihiro; Yoshimura, Koji; Ogawa, Osamu

    2013-09-01

    Mammals urinate less frequently during the sleep period than the awake period. This is modulated by a triad of factors, including decreased arousal in the brain, a decreased urine production rate in the kidneys and increased functional bladder capacity during sleep. The circadian clock is genetic transcription-translation feedback machinery. It exists in most organs and cells, termed the peripheral clock, which is orchestrated by the central clock in the suprachiasmatic nucleus of the brain. We discuss the linkage between the day and night change in micturition frequency and the genetic rhythm maintained by the circadian clock system, focusing on the brain, kidney and bladder. We performed an inclusive review of the literature on the diurnal change in micturition frequency, urine volume, functional bladder capacity and urodynamics in humans and rodents, relating this to recent basic biological findings about the circadian clock. In humans various behavioral studies demonstrated a diurnal functional change in the kidney and bladder. Conversely, patients with nocturnal enuresis and nocturia showed impairment in this triad of factors. Rats and mice, which are nocturnal animals, also have a micturition frequency rhythm that is decreased during the day, which is the sleep phase for them. Mice with a genetically defective circadian clock system show impaired physiological rhythms in the triad of factors. The existence of the circadian clock has been proven in the brain, kidney and bladder, in which thousands of circadian oscillating genes exist. In the kidney they include genes involved in the regulation of water and major electrolytes. In the bladder they include connexin 43, a gene associated with the regulation of bladder capacity. Recent progress in molecular biology about the circadian clock provides an opportunity to investigate the genetic basis of the micturition rhythm or impairment of the rhythm in nocturnal enuresis and nocturia. If this approach is to be translated clinically, a strategy is to analyze and treat the triad of micturition factors as separate parts of 1 problem. The other way could be to cope with this triad of problems simultaneously, if possible, by treating the circadian physiological rhythm itself. The discoveries reviewed point toward further investigation of the micturition rhythm by basic and translational chronobiology. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. A Possible Pathogenic Linkage Among Headache, Migraine, and Nocturnal Enuresis in Children

    PubMed Central

    Dell’Aquila, Livia; Perrone, Giacomo; Spina, Giulia; Miconi, Francesco; Rapaccini, Valentina; Del Vescovo, Ester; Di Lazzaro, Vincenzo; Verrotti, Alberto

    2016-01-01

    Purpose This study aims to evaluate the prevalence of headaches and migraine in children with nocturnal enuresis (NE) and to improve knowledge on these conditions. In particular, for this purpose, a possible pathogenic relationship linking both conditions and the impact of headaches and migraine on NE persistence was evaluated. Methods Researchers enrolled 123 children with NE, aged between 5 and 15 years, referred to the Service of Pediatrics, Campus Bio-Medico University Hospital of Rome between January 2014 and January 2015. Parents of all children enrolled in the study were invited to complete a self-reported questionnaire. The study protocol was approved by the Human Research Ethics Committee of Campus-Bio-Medico University. The NE group data was compared with the data of a control group (107 children). Results Of the eligible patients, 7.8% suffer from headaches/migraine (mean age, 9.63 years; interquartile range [IQR], 3.5 years) and 47.1% have a family history of headaches (mean age, 8.46 years; IQR, 3.75 years). Of the 8 patients with headaches, all are male, 3 have tension-type headaches (2 of them have maternal family history) and 5 have migraine (3 of them have maternal family history). Of the 35.3% with a migraine family history (mean age, 8.36 years; IQR, 3.5 years), 22 are male, and 14 are female. Three of these patients have migraine. A total of 92.2% suffer from NE but not from headaches (mean age, 8.43 years; IQR, 3 years). Of these patients, 33 are female (35.1%), and 61 are male (64.9%). In the control group, 4.7% (5 out of 107) of the children suffer from headaches, and of these, 4 are affected by nonmigraine headaches and 1 by migraine. Conclusions In conclusion, according to the hypothesis, NE and headaches/migraine could be linked by several similarities. PMID:28043109

  11. [Isolated primary nocturnal enuresis: international evidence based management. Consensus recommendations by French expert group].

    PubMed

    Aubert, D; Berard, E; Blanc, J-P; Lenoir, G; Liard, F; Lottmann, H

    2010-05-01

    The causes and treatment of isolated primary nocturnal enuresis (PNE) are the subject of ongoing controversy. We are proposing consensus practical recommendations, based on a formalised analysis of the literature and validated by a large panel of experts. A task force of six experts based its work on the guide for literature analysis and recommendations and recommendation grading of the French Haute Autorité de Santé (formalized consensus process methodological guidelines) to evaluate the level of scientific proof (grade of 1 to 4) and the strength of the recommendations (grade A, B, C) of the publications on PNE. As a result of this, 223 articles from 2003 on were identified, of which only 127 (57 %) have an evaluable level of proof. This evaluation was then reviewed by a 19-member rating group. Several recommendations, poorly defined by the literature, had to be proposed by a professional agreement resulting from a consultation between the members of the task force and those of the rating group. For its final validation, the document was submitted to a reading group of 21 members working in a wide range of specialist areas and practices but all involved in PNE. The definition of PNE is very specific: intermittent incontinence during sleep, from the age of 5, with no continuous period of continence longer than 6 months, with no other associated symptom, particularly during the day. Its diagnosis is clinical by the exclusion of all other urinary pathologies. Two factors must be identified during the consultation: nocturnal polyuria promoted by excessive fluid intake, inverse secretion of vasopressin, snoring and sleep apnoea. It is sensitive to desmopressin; small bladder capacity evaluated according to a voiding diary and the ICCS formula. It may be associated with diurnal hyperactivity of the detrusor (30 %). It is resistant to desmopressin. Problems associated with PNE are: abnormal arousal threshold, attention deficit hyperactivity disorder (ADHD) (10 %), low self-esteem. The psychological component is not very significant. PNE is not psychological in origin. The management of this condition includes: evaluating the intrafamilial tolerance and the child's motivation, evaluating the rate, the volume of urine and wet nights using a diurnal and nocturnal diary; education (sufficient fluid intake at the start of the day, decrease in hyperosmolar intake in the evening, regular and complete urination); specific treatments: desmopressin for polyuric forms (expected success rate of 60-70 %), alarms for forms involving small bladder capacity (expected success rate of 60-80 %); alternative treatments and/or treatments combined with the preceding ones, for refractory forms: oxybutinin, tricyclic antidepressants (risk). Results obtained with hypnosis, psychotherapy, acupuncture, homoeopathy or chiropractic are not currently validated (insufficient level of proof). Copyright (c) 2009 Elsevier Masson SAS. All rights reserved.

  12. Urinary incontinence in persons with Prader-Willi Syndrome.

    PubMed

    Von Gontard, Alexander; Didden, Robert; Sinnema, Margje; Curfs, Leopold

    2010-12-01

    To assess and identify the frequency and type of urinary incontinence (UI), as well as associated symptoms in persons with Prader-Willi syndrome (PWS). PWS is characterized by mental retardation, short stature, obesity and hypogonadism. The behavioural phenotype includes eating problems, temper outbursts, affective disorders, stereotypies and speech abnormalities. UI is common in children with mental retardation in general, but has not been reported systematically in children with PWS so far. The Dutch version of the 'Parental Questionnaire: Enuresis/Urinary Incontinence' was completed by 118 parents of children with PWS. This questionnaire includes items referring to day- and night-time wetting, toilet habits, observable voiding behaviours and reactions, urinary tract infections, stool habits and behavioural symptoms. The rate of nocturnal enuresis in persons with PWS was 13.6% (16) at a mean age of 15.1 years. 3.8% (5) had additional daytime urinary incontinence, and 3.3% (4) had faecal incontinence. Lower urinary tract symptoms were commonly indicative of overactive bladder, dysfunctional voiding and postponement. Also, the rate of internalizing and externalizing behavioural problems was high. Urinary incontinence is more common in persons with PWS than in typically developing children, adolescents and adults. As lower urinary tract symptoms are common, detailed assessment and specific treatment of UI should be part of the care of all persons with PWS. © 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.

  13. Co-sleeping and childhood enuresis in China.

    PubMed

    Ma, Jun; Li, Shenghui; Jiang, Fan; Jin, Xingming; Shen, Xiaoming; Li, Fei

    2014-01-01

    Co-sleeping is associated with disturbance of the natural sleep pattern, including sleep fragmentation and daytime sleepiness. Nocturnal enuresis (NE) or bed-wetting, although benign, is a significant cause of distress to affected children and their caregiver(s). This study investigated the relationship between co-sleeping and NE in primary school children from China. Data from a previous sleep study of primary school children from 8 cities across China were analyzed. Multivariable regression analysis was performed to assess the relationship between co-sleeping and NE while controlling for a number of confounding factors. The prevalence of NE in co-sleeping and non-co-sleeping children in different age groups was evaluated. The prevalence of co-sleeping and NE in children aged 5 to 12 years was 22.8% and 4.6%, respectively. Co-sleeping was associated with a higher prevalence of NE in primary school age children (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.27-1.77; p < .001) after adjusting for confounding factors. The differences in the prevalence of NE between co-sleepers and non-co-sleepers were significant in the 9-year age group (OR, 1.49; 95% CI, 1.06-2.11; p = .025) and 11- to 12-year age group (OR, 3.16; 95% CI, 2.19-4.57; p < .001). Co-sleeping may increase the risk of NE in primary school children, particularly in those aged 11 to 12 years.

  14. Enuresis Is a Common and Persistent Problem Among Children and Young Adults with Sickle Cell Anemia

    PubMed Central

    Field, Joshua J.; Austin, Paul F.; An, Ping; Yan, Yan; DeBaun, Michael R.

    2013-01-01

    OBJECTIVES Enuresis and nocturia are common among children with sickle cell anemia (SCA). The objectives of this study were to describe the prevalence of enuresis and nocturia among children and young adults with SCA and determine the relationship, if any, between these symptoms and SCA-related morbidity. METHODS A prospective infant cohort of African-American children with SCA was previously established from the Cooperative Study for Sickle Cell Disease. Included in this cohort were children with SCA enrolled before 6 months of age for whom questions about enuresis and nocturia had been completed. RESULTS A total of 213 participants were included in this analysis. Sixty-nine individuals (33%) experienced enuresis over the course of the study. No children under 6 years of age were asked about enuresis. Thereafter, enuresis was most prevalent between the ages of 6 and 8 years (42%) and continued to be common in young adults ages 18 to 20 years (9%). Seventy-nine percent of individuals reported a history of nocturia. There was no association between enuresis or nocturia and an increased rate of pain or acute chest syndrome (ACS) episodes. CONCLUSIONS Enuresis and nocturia are common in children with SCA. Among adults with SCA, enuresis and nocturia are more persistent compared with adults in the general population. Enuresis and nocturia are not associated with an increased rate of pain or ACS. PMID:18384865

  15. 21 CFR 876.2040 - Enuresis alarm.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Enuresis alarm. 876.2040 Section 876.2040 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Monitoring Devices § 876.2040 Enuresis alarm. (a) Identification. An enuresis...

  16. Management of bedwetting in children.

    PubMed

    2004-05-01

    Bedwetting (nocturnal enuresis) is common among school-aged children, with around one in six 5-year-olds, and at least one in fifty 7-year-old boys and one in a hundred 7-year-old girls, wetting the bed more than once a week. Moreover, in some children, the problem can persist, with around 0.8% of girls and 1.6% of boys aged 15-16 years wetting at least once every 3 months. The condition can affect the child's self-esteem, and may lead to teasing or bullying, reduced social interactions and behavioural problems. The frequent changing and washing of bedding and night-clothes can place an additional workload and financial burden on the family. Parents may become intolerant of the situation, and this may even lead to physical punishment of the child. Here we review the primary-care management of children with bedwetting.

  17. Comorbidity of Enuresis in Children with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Ghanizadeh, Ahmad

    2010-01-01

    Objective: To compare parental psychopathology and psychiatric disorders in ADHD children with and those without enuresis. Method: The participants of the clinical sample interviewed according to "DSM-IV" diagnostic criteria were 35 children with ADHD and enuresis, 153 ADHD children without enuresis, 115 fathers, and 172 mothers. Results: Only ODD…

  18. Controlled Study of Encopresis and Enuresis in Children with a Prepubertal and Early Adolescent Bipolar-I Disorder Phenotype

    ERIC Educational Resources Information Center

    Klages, Tricia; Geller, Barbara; Tillman, Rebecca; Bolhofner, Kristine; Zimerman, Betsy

    2005-01-01

    Objective: To examine the prevalence of encopresis/enuresis, relationship between maternal hostility and encopresis, parent-child concordance of reporting encopresis/enuresis, and familial aggregation of enuresis in subjects with a prepubertal and early adolescent bipolar-I disorder phenotype (PEA-BP), attention-deficit/hyperactivity disorder…

  19. Aripiprazole-Related Diurnal Enuresis in Children: 2 Cases (Aripiprazole-Related Enuresis).

    PubMed

    Gunes, Serkan

    Aripiprazole is an atypical antipsychotic with dopaminergic and serotonergic effects. Enuresis as an adverse effect has been reported with aripiprazole use in children with autism spectrum disorders. Here, we report 2 cases without autism spectrum disorders who developed diurnal enuresis after starting aripiprazole and ceased after discontinuation of the medication.

  20. Punishment for bedwetting is associated with child depression and reduced quality of life.

    PubMed

    Al-Zaben, Faten Nabeel; Sehlo, Mohammad Gamal

    2015-05-01

    This study assessed the relationship between parental punishment and depression as well as quality of life in children with primary monosymptomatic nocturnal enuresis (PMNE). A consecutive sample of 65 children (7-13 years) with PMNE and 40 healthy children, selected as controls (Group III), were included in the study. The children with PMNE were further sub-classified into two groups: Group I, which included children who received parental punishment for enuresis and Group II, which comprised children who were not punished for bedwetting. Depression and health-related quality of life (HRQL) were assessed among the three groups. The number of wet nights per week was significantly increased in Group I compared with Group II (P<.001). In addition, the severity of depressive symptoms increased in Group I as compared to the other two groups (P<.001). Similarly, the psychosocial HRQL lower in Group compared to the control group (Group III) (P<.001). Prior parental discipline, including corporal punishment (B=0.55, P=.008), as well as the frequency (B=0.73, P<.001) and duration of punishment (B=0.33, P=.02) were strong predictors of increased depressive symptom severity. It was also found that prior punishment (B=-0.42, P=.01) and the frequency (B=-0.62, P<.001) and duration of punishment (B=-0.34, P=.02) were strong predictors for poor psychosocial HRQL. Overall, parental punishment has a poor outcome in children with PMNE. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Enuresis and encopresis in a south Indian population of children.

    PubMed

    Hackett, R; Hackett, L; Bhakta, P; Gowers, S

    2001-01-01

    Though bladder and bowel control are important developmental milestones in all cultures, the prevalence of enuresis and encopresis has rarely been studied in developing countries despite there being factors in these countries that could affect it. This study reports the prevalence and associations of enuresis and encopresis in children in Kerala, India. The parents of 1403 randomly selected 8-12-year-old children were interviewed. The prevalence of enuresis and encopresis was ascertained using Rutter's A2 scale. Subsamples of children underwent psychiatric, physical and psychometric evaluations. Of the children, 18.6% had had an episode of enuresis in the past year and 4.3% in the past week. Four per cent had had an episode of encopresis in the past year. Enuresis was associated with parents' education, physical and psychiatric symptoms in the child, poor academic achievement and lax parental attitudes to toilet training. Encopresis was associated with male sex, physical and psychiatric symptoms, poor academic achievement, early separation and not having a toilet. The prevalence of enuresis compares with western countries, but encopresis is commoner. The associations of enuresis suggested a multifactorial model in which parental competence was prominent. This study de-emphasized the importance of neurodevelopmental factors in enuresis and encopresis in this age group.

  2. Controlled study of encopresis and enuresis in children with a prepubertal and early adolescent bipolar-I disorder phenotype.

    PubMed

    Klages, Tricia; Geller, Barbara; Tillman, Rebecca; Bolhofner, Kristine; Zimerman, Betsy

    2005-10-01

    To examine the prevalence of encopresis/enuresis, relationship between maternal hostility and encopresis, parent-child concordance of reporting encopresis/enuresis, and familial aggregation of enuresis in subjects with a prepubertal and early adolescent bipolar-I disorder phenotype (PEA-BP), attention-deficit/hyperactivity disorder (ADHD), and healthy controls (HC). There were 268 consecutively ascertained subjects (93 PEA-BP, 81 ADHD, and 94 HC). PEA-BP was defined as DSM-IV BP-I (manic or mixed phase) with elation and/or grandiosity. The WASH-U-KSADS and Psychosocial Schedule for School-Age Children-Revised were administered to parents about their children and separately to children about themselves. Encopresis was more prevalent in PEA-BP versus HC subjects (15.1% versus 3.2%, chi2 = 6.4, p = .012). Enuresis was more common in PEA-BP versus HC (21.5% versus 6.4%, chi2 = 7.8, p = .005) and ADHD versus HC (22.2% versus 6.4%, chi2 = 6.1, p = .014) subjects. All enuresis onset in subjects not receiving lithium. Most encopresis (81.8%) and enuresis (75.0%) onset before mania. Familial aggregation of enuresis was more frequent in enuretics than nonenuretics (47.7% versus 5.4%, chi2 = 41.2, p < .0001). Maternal hostility was more prevalent in encopretic versus nonencopretic subjects (91.7% versus 55.6%, chi2 = 8.3, p = .004). Parent-child concordance on reporting encopresis and enuresis was poor to fair. Children with PEA-BP need to be evaluated for encopresis, enuresis, and mother-child relationships.

  3. Predictors and Outcomes of Childhood Primary Enuresis

    PubMed Central

    Kessel, Ellen M.; Allmann, Anna E. S.; Goldstein, Brandon; Finsaas, Megan; Dougherty, Lea R.; Bufferd, Sara J.; Carlson, Gabrielle A.; Klein, Daniel N.

    2017-01-01

    Objective Although enuresis is relatively common in early childhood, research exploring its antecedents and implications is surprisingly limited, perhaps because the condition typically remits in middle childhood. Method We examined the prevalence, predictors, prognostic factors, and outcomes of primary enuresis in a large (N = 559) multi-method, multi-informant prospective study with a community-based sample of children followed from age 3 to age 9. Results We found that 12.7% of our sample met criteria for lifetime enuresis, suggesting that it is a commonly occurring childhood disorder. Males were over twice as likely to have a lifetime diagnosis than females. Significant age 3 predictors of developing primary enuresis at age 9 included child anxiety and low positive affectivity, maternal history of anxiety, and low authoritative parenting. In addition, poorer global functioning and more depressive and anxiety symptoms at age 3 predicted a greater likelihood of persistence through age 9. By age 9, 77% of children who had received a diagnosis of primary enuresis were in remission and continent. However, children who had remitted exhibited a higher rate of ADHD and greater ADHD and depressive symptoms at age 9 compared to children with no lifetime history of enuresis. Conclusions Results of the present study underscore the clinical significance of primary enuresis and demonstrate that it shows both strong antecedent and prospective associations with psychopathology. The findings also highlight the possible role of parenting in the development of enuresis. PMID:28219491

  4. Increased Risk of Physical Punishment among Enuretic Children with Family History of Enuresis.

    PubMed

    Sá, Cacilda Andrade; Gusmão Paiva, Ana Carolina; de Menezes, Maria Clotilde Lima Bezerra; de Oliveira, Liliana Fajardo; Gomes, Carlos Augusto; de Figueiredo, André Avarese; de Bessa, José; Netto, José Murillo B

    2016-04-01

    Some parents blame their children for bedwetting and, therefore, punish them. This study aimed to assess the rate of punishment experienced by enuretic children and associated causative factors. A total of 87 children 6 to 15 years old with monosymptomatic enuresis were assessed individually. Parents answered the questions in the tolerance scale. The forms of punishment were classified as verbal, chastisement and physical aggression. Family history of enuresis was considered only when 1 or both parents had experienced enuresis. Of the 35 girls and 52 boys with a mean ± SD age of 9.3 ± 2.3 years 67 had a family history of enuresis. Of the 67 parents 57 (85.0%) had a history of being punished due to enuresis. All children experienced some sort of verbal punishment. Children who had a family history of enuresis were more prone to being punished by physical aggression than those without such a family history (32 of 67 or 47.8% vs 4 of 20 or 20%, OR 3.7, 95% CI 1.1-12.1, p = 0.03). Punishment was found 3 times more frequently in girls than in boys (20 of 35 or 57.1% vs 16 of 52 or 30.8%, OR 3.0, 95% CI 1.2-7.3). Parents of 79 of the 87 children (90.8%) had high scores on the tolerance scale regardless of the history of enuresis. Enuretic children are at a high risk for experiencing some kind of punishment. Children whose parents had enuresis are at risk for being physically punished. Parents should be taught about the involuntary nature of enuresis and the fact that no punishment would help improve the condition. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Enuresis (Bed-Wetting)

    MedlinePlus

    ... in their development. Bedwetting is more common among boys than girls. Symptoms of enuresis Enuresis is when an older ... valves in boys or in the ureter in girls or boys. Abnormalities in the spinal cord. A small bladder. ...

  6. Epidemiology of autistic disorder in Bahrain: prevalence and obstetric and familial characteristics.

    PubMed

    Al-Ansari, A M; Ahmed, M M

    2013-09-01

    European and North American studies show that the prevalence of autistic disorder is inccreasing. This study was performed to identify the prevalence of autistic disorder in Bahrain, and determine some of the demographic and family characteristics. Using a case-control design, 100 children who received a diagnosis of autistic disorder according to DSM-IV-TR during the period 2000-2010 were selected. An equal numberofcontrols who had received a diagnosis of nocturnal enuresis and no psychopathology were selected, matched for sex and age group. The prevalence of autistic disorder was estimated as 4.3 per 10,000 population, with a male:female sex ratio of 4:1. Significantly more cases than controls were delivered by caesarean section and had mothers who suffered prenatal complications. The prevalence estimate in Bahrain is comparable to previous reports using similar methods. Obstetric complications and caesarean section delivery may be associated with autistic disorder.

  7. Penile strangulation by hair.

    PubMed

    Acimi, Smail

    2014-07-01

    To know the causes and results of treatment of complications from a penile strangulation by hair in seven boys. From April 2000 to December 2012, seven boys presenting serious penile complications by hair strangulation have been operated in two centers. All seven boys had transection of the urethra at the coronal level. And none of our patients were at the stage of necrosis or amputation of the glans. The age of the patients at surgery ranged from 34 to 134 months (mean 96 months). Four children presented urethrocutaneous fistulas (57% of cases), and the innervation and vascularization of the glans remained poor after repair in three patients. The penile strangulation by hair was due to a simple accident. However, several predisposing factors were discovered in our patients: lack of cleanliness; a moist environment with nocturnal enuresis; the presence of pubic hair in young children reported in the four children, and a coronal sulcus not covered by the foreskin in circumcised children.

  8. Predictors and Outcomes of Childhood Primary Enuresis.

    PubMed

    Kessel, Ellen M; Allmann, Anna E S; Goldstein, Brandon L; Finsaas, Megan; Dougherty, Lea R; Bufferd, Sara J; Carlson, Gabrielle A; Klein, Daniel N

    2017-03-01

    Although enuresis is relatively common in early childhood, research exploring its antecedents and implications is surprisingly limited, perhaps because the condition typically remits in middle childhood. We examined the prevalence, predictors, prognostic factors, and outcomes of primary enuresis in a large (N = 559) multi-method, multi-informant prospective study with a community-based sample of children followed from age 3 years to age 9 years. We found that 12.7% of our sample met criteria for lifetime enuresis, suggesting that it is a commonly occurring childhood disorder. Males were more than twice as likely as females to have a lifetime diagnosis. Significant age 3 predictors of developing primary enuresis by age 9 included child anxiety and low positive affectivity, maternal history of anxiety, and low authoritative parenting. In addition, poorer global functioning and more depressive and anxiety symptoms at age 3 years predicted a greater likelihood of persistence through age 9. By age 9 years, 77% of children who had received a diagnosis of primary enuresis were in remission and continent. However, children who had remitted exhibited a higher rate of attention-deficit/hyperactivity disorder (ADHD) and greater ADHD and depressive symptoms at age 9 compared to children with no lifetime history of enuresis. Results of the present study underscore the clinical significance of primary enuresis and demonstrate that it shows both strong antecedent and prospective associations with psychopathology. The findings also highlight the possible role of parenting in the development of enuresis. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  9. [Enuresis].

    PubMed

    Bruézière, J

    1992-01-01

    The word "enuresis" is the greek word for incontinence. Enuresis has to be considered as a symptom and not as a disease. We have to keep in mind that urine leaking may be due to an anatomical anomaly (epispadias, ectopic ureter, spinal coral lesion, urethral obstacle) in which case treatment of the underlying disease constitutes treatment of enuresis. Nevertheless, enuresis is isolated in 95% of cases. Three groups are defined depending on whether the bladder is normal, hyperactive or retentionnist with bladder-sphincter dyssynergia. We emphasize the frequency of coexistence of these three aspects and the gravity of a wrong diagnosis. The onset or presence of bladder-sphincter dyssynergia is a major concern for the pediatric urologist due to its severity and the difficulties of treatment.

  10. The concept of outcome.

    PubMed

    Hunt, S

    1997-01-01

    The Enuresis Resource and Information Centre in the UK has recently launched a second edition of Guidelines on Minimum Standards of Practice in the Treatment of Enuresis. The purpose of the Guidelines is to provide a blueprint for service delivery in the UK, leading to enuresis services that offer effective, accessible and dependable treatment. In particular, these Guidelines propose minimum and target standards that enuresis services should aim to achieve, relating to referral, assessment and treatment, as well as catchment area appointments, research and referral. In addition, the Guidelines may be used to provide a framework within which enuresis services can be audited and evaluated. Successive cycles of observation, appraisal and action should encourage a continual improvement process in each clinic, resulting in a progressive development of the service offered.

  11. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Enuresis

    ERIC Educational Resources Information Center

    Fritz, Gregory; Rockney, Randy

    2004-01-01

    Enuresis is a symptom that is frequently encountered in child psychiatric evaluations. Careful assessment is required to identify specific urologic, developmental, psychosocial, and sleep-related etiologies. For most children with enuresis, however, a specific etiology cannot be determined. Treatment then involves supportive approaches,…

  12. Summary of the Practice Parameter for the Assessment and Treatment of Children and Adolescents with Enuresis

    ERIC Educational Resources Information Center

    Fritz, Gregory; Rockney, Randy

    2004-01-01

    Enuresis is a symptom that is frequently encountered in child psychiatric evaluations. Careful assessment is required to identify specific urologic, developmental, psychosocial, and sleep-related etiologies. For most children with enuresis, however, a specific etiology cannot be determined. Treatment then involves supportive approaches,…

  13. Therapeutic Treatment Protocol for Enuresis Using an Enuresis Alarm

    ERIC Educational Resources Information Center

    Shapira, Bettina E.; Dahlen, Penny

    2010-01-01

    Enuresis, one of the most prevalent and chronic childhood disorders, imposes serious financial, physical, and emotional burdens on the child and the family affected by it. This article provides counselors with an overview of the complex etiologies, diagnostic criteria, and current treatment options for the disorder, as well as assessment tools and…

  14. Oral language disorders and enuresis in children.

    PubMed

    Birenbaum, Thelma Kilinsky; Cunha, Maria Claudia

    2010-01-01

    Co-occurrence of oral language disorders and enuresis in children. To identify and analyze the relationship between instances of oral language disorders and enuresis in children. Clinical, quantitative and qualitative study, with a descriptive/interpretative outline, presented through two distinct situations. "Situation 1" refers to a group of 120 children between 3:0 and 10:0 years old, independently of gender and age, from a philanthropic Institution in Greater São Paulo. "Situation 2" refers specifically to the evaluation of children who have oral language disorders and enuresis. Results indicated that enuretic children present a higher percentage of oral language disorders when compared to non-enuretic children, especially phonological disorders and talking very little. These results support the studies on co-occurrence of enuresis and oral language disorders, presented in papers that attribute a bio-psychic etiology to this co-morbidity. Results indicated a relationship between enuresis and oral language disorders. Considering the interactions among language, body and psyche, it is suggested that speech therapists, when dealing with oral language disorders in children, also investigate the acquisition of their bladder sphincter control, in a bio-psychical approach.

  15. The post-treatment effects of enterobiasis on the occurrence of enuresis among children in Calabar, Nigeria.

    PubMed

    Otu-Bassey, Iquo B; Useh, Monday F; Alaribe, Anyanwu A

    2011-04-01

    To investigate the relationship between enterobiasis and enuresis before and after albendazole therapy among 632 children, aged, 5-14 years, in Calabar, Nigeria. The scotch tape (cellotape) technique was used for the detection of eggs of Enterobius vermicularis (E. vermicularis) while questionnaire-based interviews were used for screening for anal itching and/or enuresis among study participants. All subjects found positive for Enterobius infection as confirmed by the presence of eggs and those with persistent anal itching (both enuretic and non-enuretic) were treated with 400 mg of albendazole given as a single dose. The treated subjects were re-assessed post-treatment to ascertain whether they were cured and also to determine their enuretic status (for the enuretics). The overall prevalences of Enterobius infection, anal itching, and enuresis prior to albendazole therapy were 6.8%, 42.9%, and 35.6% respectively. There was no statistically significant difference in the prevalence of these parameters by the socio-economic class of subjects (P = 0.462, P = 0.647, and P = 0.610, respectively). The pre-treatment prevalences of enuresis among Enterobius and anal itching-positive subjects were 53.5% and 49.8%, respectively versus 34.3% and 24.9%, respectively among their negative counterpart (P = 0.012 and P < 0.001, respectively). Four (20%) out of the 20 enuretic children found Enterobius egg-negative after albendazole therapy were equally cured while 8(40%) had reduction of their enuresis, thus giving a total resolution rate of 60%. Similarly, 64.2% resolution (25% cure and 32.8% reduction) of enuresis was observed amongst 120 anal itching-cured/enuretic children. Enuretic status of the Enterobius-/anal itching-uncured subjects, on the other hand, remained unchanged post-treatment. This study is suggestive of the involvement of E. vermicularis in the aetiology of enuresis in Calabar. Children presenting with, especially, uncomplicated enuresis should be screened for enterobiasis. Copyright © 2011 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  16. Enuresis, firesetting, and cruelty to animals: does the ego triad show predictive validity?

    PubMed

    Slavkin, M L

    2001-01-01

    The hypothesis tested in this study was that the presence of enuresis and cruelty to animals in juvenile firesetters would be significantly related to recidivistic firesetting. This hypothesis was related to Yarnell's belief in an ego triad among juvenile firesetters, which linked the occurrence of enuresis, cruelty to animals and others, and firesetting. No relationship was found between groups for firesetting recidivism and enuresis. However, juveniles who were identified as being cruel to animals were more likely than those who were not cruel to animals to engage in recidivistic firesetting behaviors.

  17. Enuresis, Firesetting, and Cruelty to Animals: Does the Ego Triad Show Predictive Validity?

    ERIC Educational Resources Information Center

    Slavkin, Michael Lawrence

    2001-01-01

    The hypothesis tested in this study was that the presence of enuresis and cruelty to animals in juvenile firesetters would be significantly related to recidivistic firesetting. No relationship was found between firesetting recidivism and enuresis. However, juveniles who were identified as being cruel to animals were more likely to engage in…

  18. Incontinence in children, adolescents and adults with Williams syndrome.

    PubMed

    von Gontard, Alexander; Niemczyk, Justine; Borggrefe-Moussavian, Sorina; Wagner, Catharina; Curfs, Leopold; Equit, Monika

    2016-11-01

    Williams Syndrome (WS) is a microdeletion syndrome (chromosome 7q11.23) characterized by typical facial features, cardiovascular disease, behavioural symptoms, and mild intellectual disability (ID). The aim of this study was to assess the rates of incontinence and psychological problems in persons with WS. 231 individuals with WS were recruited through the German parent support group (52.0% male, mean age 19.4 years). Faecal incontinence (FI) was diagnosed from the age of 4 years and nocturnal enuresis (NE) and daytime urinary incontinence (DUI) of 5 years onwards. The Parental Questionnaire: Enuresis/Urinary Incontinence, the International-Consultation-on-Incontinence-Questionnaire-Pediatric LUTS (ICIQ-CLUTS), as well as the Developmental Behavior Checklist for parents (DBC-P) or for adults (DBC-A) were filled out by parents or caregivers. 17.8% of the sample had NE, 5.9% DUI and 7.6% FI. NE was present in 44.9% of children (4-12 years), 13.5% of teens (13-17y), 3.3% of young adults (18-30y) and in 3.6% of adults (> 30y). DUI (and FI) decreased from 17.9% (21.4%) in children to 0% in adults. 3.5% of the sample had an ICIQ-CLUTS score in the clinical range. 30.5% of children and 22.1% of adults had a clinical DBC score. Children and teens with clinically relevant DBC-P-scores had significantly higher DUI rates. Children with WS have high rates of incontinence and LUTS, which decrease with age. Most adults are continent. NE is the most common subtype. Except for DUI in children, incontinence is not associated with behavioural problems. Screening, assessment and treatment of incontinence in individuals with WS is recommended. Neurourol. Urodynam. 35:1000-1005, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  19. Preoperative distraction in children: hand-held videogames vs clown therapy.

    PubMed

    Messina, M; Molinaro, F; Meucci, D; Angotti, R; Giuntini, L; Cerchia, E; Bulotta, A L; Brandigi, E

    2014-12-30

    Anxiety in children undergoing surgery is characterized by feelings of tension, apprehension, nervousness and fear which may manifest differently. Postoperative behavioural changes such as nocturnal enuresis, feeding disorders, apathy, and sleep disturbances may stem from postoperative anxiety. Some Authors pointed out that over 60% of children undergoing surgery are prone to developing behavioural alterations 2 weeks after surgery. Variables such as age, temperament and anxiety both in children and parents are considered predictors of such changes.1 Studies were published describing how psycho-behavioural interventions based on play, learning and entertainment in preparing children for surgery, may reduce preoperative anxiety. Clown-therapy is applied in the most important paediatric facilities and has proved to diminish children's emotional distress and sufferance, as well as consumption of both analgesics and sedatives and to facilitate the achievement of therapeutic goals. The aim of our study was to evaluate the efficacy of clown-therapy during the child's hospital stay, with a view to optimizing treatment and care, preventing behavioural alterations and enhancing the child's overall life quality.

  20. Navy Recruit Optimization, Post-1980: Separation Process.

    DTIC Science & Technology

    1981-04-01

    3850260 RGC Death 5030420 RGD Pregnancy 3850220.2 RGE Enuresis 3850220.1m RGF Sleepwalking 3850220.1m F. OTHER RXA Miscellaneous Reasons not covered by...codes--Erroneous Enlistment (RGA), Minority (RGB), Death (RGC), Pregnancy (RGD), Enuresis (RGE), Sleepwalking (RGF)--exhibit a high degree of...difficult to diagnose precisely as medical or mental; e.g., enuresis, sleepwalking . TABLE 6. COMPARISON OF MEDICAL/PSYCHOLOGICAL SEPARATIONS ACROSS RTCs

  1. Mobile phone applications in management of enuresis: The good, the bad, and the unreliable!

    PubMed

    Myint, Michael; Adam, Ahmed; Herath, Sampath; Smith, Grahame

    2016-04-01

    The proliferation of medical-type applications or 'apps' on smartphones is a typical example of the impact technology has had on medical practice. Maintaining a bladder diary is a recommended part of evaluating the effect of interventions for patients suffering from enuresis. Traditional pen-and-paper bladder diaries have poor completion rates, inconsistent patterns in data entry, and are deficient in validation. Electronic bladder diaries have been proposed to overcome these obstacles. With increasing numbers of smartphone apps available to the general public, it is important to distinguish well-designed apps for childhood enuresis. To identify, evaluate, and rank all available mobile-phone apps for the management of childhood enuresis. On August 21, 2014, a search was conducted on iTunes, Android Play Store, and BlackBerry World for smartphone apps using the following search terms: bladder, bedwetting, bladder diary, enuresis, incontinence, and wetting. Apps that did not have a bladder diary function and that were unrelated to the investigation, follow-up, and treatment of childhood enuresis were excluded. Apps were rated by a paediatric urology consultant, fellow, registrar, and resident medical officer using standardised criteria including: design; ease of use; languages; quality of instructions; security; accordance with ICCS definition of enuresis; and ability to store histories; record bowel habits; transfer data to other devices; and print data. Across all three search platforms, a total of 1041 apps were identified. Only 24 were included and reviewed based on exclusion criteria. Average ratings for apps ranged from 10 to 30.75 out of 50 based on standardised criteria. Smartphone apps are playing an increasingly significant role in the management of enuresis in place of pen-and-paper bladder diaries. Apps available to the general public vary in quality and it can be difficult for patients to identify one appropriate for use. We found apps with higher ratings consistently had engaging interfaces, were easy to use, and defined the primary purpose clearly. Lower ratings and performance often was caused by poor quality of experience through "freezing"/"crashing." Bladder diary apps can eliminate disadvantages of pen-and-paper diaries in the management of enuresis. Currently, apps available vary in quality. The three best-rated apps currently available are My Dryness Tracker, Bedwetting Tracker, and HapPee Time. There is room for medical associations to collaborate with developers for further app development. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  2. Snoring and obstructive sleep apnoea in children: why should we treat?

    PubMed

    Gozal, David; O'Brien, Louise M

    2004-01-01

    Frequent and loud snoring is a very frequent condition in prepubertal children affecting approximately 10% of all 2-8 year old children. If polysomnographical evaluations are performed in these snoring children, approximately 10% will be diagnosed with obstructive sleep apnoea (OSA). The pathophysiology of OSA in children is still poorly understood. Indeed, while adenotonsillar hypertrophy is certainly a major contributor to OSA, other factors need to be implicated for OSA to develop. In recent years, it has become apparent that OSA and snoring are not as innocuous as previously thought. Indeed, epidemiological and pre-post treatment analyses have identified substantial morbidities that primarily affect cardiovascular and neurobehavioural systems, namely pulmonary hypertension, systemic elevation of arterial blood pressure, nocturnal enuresis, reduced somatic growth, behavioural problems that resemble attention deficit-hyperactivity disorder, as well as learning and cognitive deficits. These problems are associated with marked increases in healthcare-related costs. More importantly, if timely diagnosis and intervention are not implemented, some of these morbid complications may not be completely reversible, leading to long-lasting residual consequences.

  3. Controlled trial of standard pad and bell alarm against mini alarm for nocturnal enuresis.

    PubMed Central

    Fordham, K E; Meadow, S R

    1989-01-01

    Fifty six children aged from 6-16 years who wet their beds at night were entered into a controlled trial of two alarm devices: a traditional alarm using a wet sensor mat on the bed attached to an alarm bell out of reach of the child, and a mini alarm system incorporating a tiny perineal wet sensor attached to a small alarm worn on the child's clothing. A quota allocation system ensured comparability between the two treatment groups. The children were encouraged to use the alarm for four months. Both alarms were equally effective in helping children to become dry. There was no significant difference between the number of children unable to comply with treatment or to be helped by each alarm. The rate of acquisition of dryness was similar for the two groups. The traditional standard alarm was sturdier, more dependable, and easier to maintain, but the mini alarm had some advantages, particularly for girls. Both types of alarm are recommended for general use. Images Fig 1 Fig 2 PMID:2658853

  4. Enuresis: An Historical, Cultural, and Contemporary Account of Etiology and Treatment

    ERIC Educational Resources Information Center

    McDonald, James E.; Trepper, Terry

    1977-01-01

    The authors discuss the cultural relativism of enuresis and the subsequent notion that urinary incontinence may not be a disease or psychopathy, but, rather, a problem associated with social expectations and developmental delays. (Author)

  5. Behavioural problems in children with enuresis

    PubMed Central

    Birdal, Seval; Doğangün, Burak

    2016-01-01

    Aim: Enuresis is defined as involuntary or intentional repeated voiding of urine into clothes or bed at least twice a week for a period of three consecutive months in children older than five years old. It is one of the most frequent chronic childhood disorders. The aim of this study was to investigate the frequency of behavioural problems in children with enuresis. Material and Methods: The research compared 30 children aged between 7 and 11 years who had consulted to Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Training and Research Hospital, Child and Adolescent Psychiatry Clinics and diagnosed with enuresis with their 30 peers who were randomly selected from a state elementary school. The Child Behaviour Checklist was applied to both groups. Results: The subdimension scores of both groups were compared, it was observed that children with enuresis had higher scores compared to their peers in all sub-tests except for the Sluggish Cognitive Tempo, Anxiety Disorders, and Obsessive Compulsive Disorder sub-tests. Enuretic children had higher scores in externalizing (p<0.001), internalizing (p=0.001) and total problem (p<0.001) scales. Conclusion: The results of this study indicate that children with enuresis exhibit behavioral problems with a higher rate compared to their healthy peers. The results are in line with the literature. Moreover, compered to the results of the studies conducted in different countries, significantly higher scores in internalizing problems were obtained. It was thought is possible that this might be related with cultural factors. However, these findings need to be verified with data from larger scale studies. PMID:27738398

  6. A non-urologic cause of nocturia and enuresis--obstructive sleep apnea syndrome (OSAS).

    PubMed

    Ulfberg, J; Thuman, R

    1996-04-01

    Three case reports describe nocturia and enuresis as complications of the obstructive sleep apnea syndrome (OSAS). It is important to recognize the causal relationship since these troublesome symptoms are easily treated by treating the sleep apnea.

  7. [Classification of enuresis/encopresis according to DSM-5].

    PubMed

    von Gontard, Alexander

    2014-03-01

    Elimination disorders are common in childhood and adolescence. Enuresis is traditionally defined as wetting from the age of 5 years and encopresis as soiling from 4 years onwards - after all organic causes have been excluded. In the past decades, many subtypes of elimination disorders have been identified with different symptoms, etiologies, and specific treatment options. Unfortunately, the DSM-5 criteria did not integrate these new approaches. In contrast, classification systems of the International Children's Incontinence Society (ICCS) for enuresis and urinary incontinence as well as the ROME-III criteria for fecal incontinence offer new and relevant suggestions for both clinical and research purposes.

  8. Incidence of Enuresis and Encopresis Among Children with Attention Deficit Hyperactivity Disorder in a Population-Based Birth Cohort

    PubMed Central

    Mellon, Michael W.; Natchev, Brooke E.; Katusic, Slavica K.; Colligan, Robert C.; Weaver, Amy L.; Voigt, Robert G.; Barbaresi, William J.

    2013-01-01

    OBJECTIVE This study reports the incidence of enuresis and encopresis among children with attention-deficit/hyperactivity disorder (AD/HD) versus those without AD/HD. METHOD Subjects included 358 (74.5% male) children with research-identified AD/HD from a 1976-1982 population-based birth cohort (N = 5718) and 729 (75.2% male) non-AD/HD control subjects from the same birth cohort, matched by gender and age. All subjects were retrospectively followed from birth until a diagnosis of enuresis or encopresis was made or last follow-up prior to 18 years of age. The complete medical record for each subject was reviewed to obtain information on age of initial diagnosis of an elimination disorder, frequency and duration of symptoms, identification of exclusionary criteria specified by DSM-IV, with confirmation of the diagnosis by expert consensus. RESULTS Children with AD/HD were 2.1 (95% CI, 1.3-3.4; p = 0.002) times more likely to meet DSM-IV criteria for enuresis than non-AD/HD controls; they were 1.8 (95% CI, 1.2 – 2.7; p = 0.006) times more likely to do so than non-AD/HD controls when less stringent criteria for a diagnosis of enuresis were employed. Though not significant, children with AD/HD were 1.8 (95% CI, 0.7-4.6; p = 0.23) times more likely to meet criteria for encopresis than non-AD/HD controls. The relative risk was 2.0 (95% CI, 1.0-4.1; p = 0.05) when a less stringent definition for encopresis was utilized. CONCLUSIONS The results of this population-based study demonstrate that children with AD/HD are more likely than their peers without AD/HD to develop enuresis with a similar trend for encopresis. PMID:23680296

  9. Incidence of enuresis and encopresis among children with attention-deficit/hyperactivity disorder in a population-based birth cohort.

    PubMed

    Mellon, Michael W; Natchev, Brooke E; Katusic, Slavica K; Colligan, Robert C; Weaver, Amy L; Voigt, Robert G; Barbaresi, William J

    2013-01-01

    This study reports the incidence of enuresis and encopresis among children with attention-deficit/hyperactivity disorder (ADHD) versus those without ADHD. Subjects included 358 children (74.5% boys) with research-identified ADHD from a 1976 to 1982 population-based birth cohort (n = 5718) and 729 (75.2% boys) non-ADHD control subjects from the same birth cohort, matched by gender and age. All subjects were retrospectively followed from birth until a diagnosis of enuresis or encopresis was made or last follow-up before 18 years of age. The complete medical record for each subject was reviewed to obtain information on age of initial diagnosis of an elimination disorder, frequency and duration of symptoms, and identification of exclusionary criteria specified by DSM-IV, with confirmation of the diagnosis by expert consensus. Children with ADHD were 2.1 (95% confidence interval [CI], 1.3-3.4; P = .002) times more likely to meet DSM-IV criteria for enuresis than non-ADHD controls; they were 1.8 (95% CI, 1.2-2.7; P = .006) times more likely to do so than non-ADHD controls when less stringent criteria for a diagnosis of enuresis were employed. Though not significant, children with ADHD were 1.8 (95% CI, 0.7-4.6; P = .23) times more likely to meet criteria for encopresis than non-ADHD controls. The relative risk was 2.0 (95% CI, 1.0-4.1; P = .05) when a less stringent definition for encopresis was utilized. Children with ADHD are more likely than their peers without ADHD to develop enuresis with a similar trend for encopresis. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  10. Enuresis as a Premorbid Developmental Marker of Schizophrenia

    ERIC Educational Resources Information Center

    Hyde, Thomas M.; Deep-Soboslay, Amy; Iglesias, Bianca; Callicott, Joseph H.; Gold, James M.; Meyer-Lindenberg, Andreas; Honea, Robyn A.; Bigelow, Llewellyn B.; Egan, Michael F.; Emsellem, Esther M.; Weinberger, Daniel R.

    2008-01-01

    There is comparatively little information about premorbid maturational brain abnormalities in schizophrenia (SCZ). We investigated whether a history of childhood enuresis, a well-established marker of neurodevelopmental delay, is associated with SCZ and with measures of brain abnormalities also associated with SCZ. A Diagnostic and Statistical…

  11. Pharmacotherapy in the Management of Voiding and Storage Disorders, Including Enuresis and Encopresis

    ERIC Educational Resources Information Center

    Reiner, William G.

    2008-01-01

    Enuresis and encopresis are disorders of the bladder and rectum, and this article helps in understanding the neurobiology of lower urinary tract and anorectal function to help in the treatment of these disorders. Treatment for children with these disorders emphasizes either a psychological or pharmacological approach.

  12. A Case Study Using Child-Centered Play Therapy Approach to Treat Enuresis and Encopresis.

    ERIC Educational Resources Information Center

    Cuddy-Casey, Maria

    1997-01-01

    Demonstrates an alternative method (nondirective child-centered therapy) in treating enuresis and encopresis resulting from emotional disturbances. Examines various etiologies and approaches to treating these conditions. Provides a case study example. Claims that professionals must differentiate between primary and secondary occurrences of these…

  13. Color Vision Deficiency and Functional Disorders Among Israeli Male Adolescents Between 2007 and 2013.

    PubMed

    Berger, Assaf; Findler, Michael; Maymon, Dror; Korach, Tzfanya; Yativ, Oshrat Fono; Gronovich, Yoav; Hassidim, Ayal

    2016-09-01

    Color vision deficiency has been associated with educational difficulties among male children, as well as attention-deficit hyperactivity disorder (ADHD). We examined the association of color vision deficiency with functional conditions, including ADHD, irritable bowel syndrome, enuresis and somatoform disorders, in a large population of male adolescents. We included all Israeli male adolescents that underwent medical and cognitive examinations during conscription between the years 2007 and 2013. The prevalence of ADHD, irritable bowel syndrome, enuresis, and somatoform disorders among color vision deficiency patients was compared to a control group. The study included 305 964 males aging 17 ± 0.6, of which 7584 (2.5%) had color vision deficiency. Using a multivariable analysis, the probability for irritable bowel syndrome, enuresis, and somatoform disorders among color vision deficiency patients was increased by 1.41, 1.94, and 3.87, respectively (P < .05). No significant association was found between ADHD and color vision deficiency. Color vision abnormalities are associated with functional disorders in male adolescents, including irritable bowel syndrome, enuresis, and somatoform disorders. © The Author(s) 2016.

  14. Disturbed skin barrier in children with chronic kidney disease.

    PubMed

    Wojtowicz-Prus, Elzbieta; Kilis-Pstrusinska, Katarzyna; Reich, Adam; Zachwieja, Katarzyna; Miklaszewska, Monika; Szczepanska, Maria; Szepietowski, Jacek C

    2015-02-01

    There are limited data on skin lesions in children with end-stage renal failure. The aim of the study was an evaluation of the skin barrier in children with different stages of chronic kidney disease (CKD). The prevalence of xerosis, its severity, as well as its link selected demographic factors, were examined. The study included 103 children: 72 with CKD stages 3-5 (38 on conservative treatment and 34 on dialysis) and 31 patients with primary monosymptomatic nocturnal enuresis as a control group. Initially, the study subjects described the localisation and severity of dry skin by themselves. Next, clinical evaluation of xerosis, non-invasive corneometric assessment of epidermis moisturising and the measurement of transepidermal water loss were performed. Most CKD children reported dry skin. The problem of xerosis was identified more frequently in patients on dialysis (67.6 %) than on conservative treatment (42.1 %) (p = 0.01). CKD patients divided according to skin dryness did not differ with regards to age, sex, initial kidney disease and CKD duration. Disturbed skin barrier is an important concern of children with CKD, intensifying as the disease progresses. This symptom occurs on early stages of CKD and it should be taken into consideration in the CKD management.

  15. A comparative study of axis I antecedents before age 18 of unipolar depression, bipolar disorder and schizophrenia.

    PubMed

    Rubino, I Alex; Frank, Ellen; Croce Nanni, Roberta; Pozzi, Daniela; Lanza di Scalea, Teresa; Siracusano, Alberto

    2009-01-01

    Despite a large scientific literature on early clinical precursors of schizophrenia, bipolar disorder and unipolar depression, few data are available on axis I disorders preceding the adult onset of these illnesses. Disorders before the age of 18 years were retrospectively assessed with a structured interview in 3 groups of consecutive adult inpatients with DSM-IV diagnoses of schizophrenia (n = 197), major depressive disorder (n = 287) and bipolar disorder (n = 132). Only patients with adult onset of schizophrenia and of mania/hypomania were included. A sample of the general population served as control group (n = 300). The clinical groups significantly outnumbered the control sample on the majority of early axis I diagnoses. Schizophrenia was significantly associated (1) with attention deficit hyperactivity disorder (ADHD), ADHD inattentive subtype, ADHD hyperactive subtype and primary nocturnal enuresis, compared to unipolar depression, and (2) with social phobia and ADHD inattentive subtype, compared to bipolar disorder. Oppositional defiant disorder was significantly associated with bipolar disorder, compared to the other clinical and control groups. The ADHD hyperactive subtype predicted the adult onset of bipolar disorder compared to unipolar depression. Externalizing disorders seem of special importance as regards the clinical pathways toward schizophrenia.

  16. Urinary incontinence in familial dysautonomia.

    PubMed

    Saini, J; Axelrod, F B; Maayan, C; Stringer, J; Smilen, S W

    2003-08-01

    The aim of this study was to determine the prevalence of urinary incontinence in women with familial dysautonomia (FD). A telephone survey was conducted on 68 known surviving female FD patients over 13 years of age registered with the Dysautonomia Centers in the USA and Israel. The mean age of the surveyed group was 27.1+/-9.8 years and 99% of the patients were nulliparous. The overall reported prevalence of urinary incontinence was 82% (n=56). Of the patients with incontinence, 59% (n=33) reported stress incontinence, 11% (n=6) reported urge incontinence, and 30% (n=17) reported symptoms of both, or mixed incontinence. In most women urinary loss was both small and infrequent, but 36% of women (n=20) with incontinence experienced a loss sufficient to necessitate the use of protection (panty liners, pads or diapers); in 7% (n=4) such loss occurred daily. Twelve per cent of all women with FD surveyed experienced primary nocturnal enuresis and 26% experienced nocturia. The prevalence of urinary incontinence is high in young female patients with familial dysautonomia. Neurophysiologic testing in this population may provide a better understanding of the role of the autonomic nervous system in urinary incontinence.

  17. A Novel Enuresis Alarm for Toilet Training Students with Intellectual Disability: An Initial Evaluation in a School Setting

    ERIC Educational Resources Information Center

    Mruzek, Daniel W.; McAleavey, Stephen; Engel, Suzanne; Smith, Tristram

    2016-01-01

    In this study, a novel enuresis alarm device using a miniaturized radio frequency module and disposable sensors made with inexpensive conductive ink was used to teach toilet use for urination with three participants with severe intellectual disability (two males and one female; aged 7-15 years) in a private special education school setting. At…

  18. Childhood Enuresis: Current Diagnostic Formulations, Salient Findings, and Effective Treatment Modalities.

    PubMed

    Thurber, Steven

    2017-06-01

    Enuresis constitutes a frequently encountered problem area for children that may adversely affect social and emotional adjustment. This type of incontinence has been of concern to the human family for centuries. A brief history of enuresis is presented followed by current conceptualizations, diagnostic criteria, prevalence rates and psychiatric comorbidities. Historic notions of causation together with ineffective, sometimes barbaric treatments are then discussed, ending with a presentation of evidence-based treatment modalities, with the urine alarm being an essential element of effective treatment. An intervention termed dry bed training combines the urine alarm with a series of procedures designed in part to reduce relapse potential and should be a primary consideration for implementation by treatment professionals. Finally, a brief case study is presented illustrating special etiological and treatment considerations with juvenile psychiatric patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Enuresis and encopresis: ten years of progress.

    PubMed

    Mikkelsen, E J

    2001-10-01

    To review the progress made over the past decade with regard to the treatment of enuresis and encopresis, as well as advances in the understanding of etiological mechanisms. Separate computerized literature (English language only) searches of Medline and PsycINFO databases were conducted under the parameter of enuresis and children-adolescents, as well as encopresis and children-adolescents. There has been a substantial decrease in published research concerning the use of imipramine to treat enuresis compared with the prior two decades, accompanied by a corresponding increase in the number of papers concerning desmopressin acetate (DDAVP), which has become the primary pharmacological treatment. Genetic studies of large pedigrees have further confirmed the importance of heritable factors. With regard to encopresis, the research has focused primarily on pathophysiological factors related to the colon and anal sphincter. The widespread use of DDAVP has been the primary addition to treatment strategies over the past decade. The bell-and-pad method of conditioning, the only major treatment that has enduring benefit after being withdrawn, is the most cost-effective and appears to be underutilized. Research into etiological mechanisms has focused primarily on the mechanism of action of DDAVP and advances in the understanding of genetic factors. Advances in the treatment and etiological understanding of encopresis have been less impressive.

  20. The prevalence of abnormal genital findings, vulvovaginitis, enuresis and encopresis in children who present with allegations of sexual abuse.

    PubMed

    Anderson, B; Thimmesch, I; Aardsma, N; Ed D, M Terrell; Carstater, S; Schober, J

    2014-12-01

    To assess the prevalence of vulvovaginitis, enuresis and encopresis in children who were referred for allegations of sexual abuse. A retrospective chart review of 1280 children presenting for non-acute examination after allegations of sexual abuse during a 15-year time span. Interview documentation, physical examination documentation, urinalysis, urine and vaginal cultures were reviewed. Of the 1280 children, 73.3% were female and 26.7% male. The ages of the children ranged from 6 months to 18 years (median age was 6 years). Interviews revealed that fondling contact was the most common allegation, followed by oral, vaginal, and anal penetration. Interviews also disclosed lower urinary tract symptoms, UTI, constipation, encopresis and enuresis. Physical examination revealed no abnormal genital findings in 44.7% of cases. Examinations of the vagina noted: erythema (18.1%); hymenal notching (posterior 16.8%, anterior 4.4%); vuvlovaginitis (14.0%); laceration or transection (0.6%); and bruising (0.4%). Examination of the anus noted: anal fissure/tear (14.9%); loss of anal tone (10.6%); reflex anal dilatation (9.2%); venous congestion (3.8%); and proctitis (0.9%). Vulvovaginitis was noted in 14% (131/936) and encopresis in 2.3% (21/936). Enuresis according to age was reported in 13% of 5-9 year olds, 14.7% of 10-16 year olds and 18.2% of 17-18 year olds suspected of being abused. Prevalence of vulvovaginitis and enuresis were increased, and encopresis was decreased in children with allegations of sexual abuse when compared to the general pediatric population. Physicians should continue to be aware of the possibility of the presence of these conditions in children who have been sexually abused, and offer appropriate treatment. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  1. [Enuresis aetological approaches and therapeutic strategies (author's transl)].

    PubMed

    Holm-Hadulla, M

    1980-06-01

    Enuresis is a frequent disease in childhood--entailing personal misery, shame, and discredit for the children concerned as well as irritation and a bigger workload for the responsible adults. Parents and teachers often tend to react to this uncontrolled urinating as to a personal provocation. The following study is meant to summarize different aetiological approaches from which therapeutic strategies are derived and classified according to pragmatic considerations. By resorting to common psychotherapeutic methods pediatricians can successfully treat 2/3--3/4 of all cases.

  2. Medical Comorbidity of Attention-Deficit/Hyperactivity Disorder in US Adolescents.

    PubMed

    Jameson, Nicole D; Sheppard, Brooke K; Lateef, Tarannum M; Vande Voort, Jennifer L; He, Jian-Ping; Merikangas, Kathleen Ries

    2016-10-01

    Understanding patterns of medical comorbidity in attention-deficit/hyperactivity disorder (ADHD) may lead to better treatment of affected individuals as well as aid in etiologic study of disease. This article provides the first systematic evaluation on the medical comorbidity of ADHD in a nationally representative sample (National Comorbidity Replication Survey-Adolescent Supplement; N = 6483) using formal diagnostic criteria. Survey-weighted odds ratios adjusted for demographics, additional medical, and mental disorders were calculated for associations between ADHD and medical conditions. Models adjusted for demographics revealed significantly increased odds of allergy, asthma, enuresis, headache/migraine, and serious stomach or bowel problems. After adjusting for comorbidity, across the medical conditions, enuresis and serious stomach problems were the strongest correlates of ADHD. These findings confirm the pervasive medical comorbidity of ADHD reported in previous clinical and community-based studies. The intriguing salience of enuresis and serious stomach or bowel conditions may also provide an important clue to multisystem involvement in ADHD. © The Author(s) 2016.

  3. How do we recognize the child with OSAS?

    PubMed

    Joosten, Koen F; Larramona, Helena; Miano, Silvia; Van Waardenburg, Dick; Kaditis, Athanasios G; Vandenbussche, Nele; Ersu, Refika

    2017-02-01

    Obstructive sleep-disordered breathing includes a spectrum of clinical entities with variable severity ranging from primary snoring to obstructive sleep apnea syndrome (OSAS). The clinical suspicion for OSAS is most often raised by parental report of specific symptoms and/or abnormalities identified by the physical examination which predispose to upper airway obstruction (e.g., adenotonsillar hypertrophy, obesity, craniofacial abnormalities, neuromuscular disorders). Symptoms and signs of OSAS are classified into those directly related to the intermittent pharyngeal airway obstruction (e.g., parental report of snoring, apneic events) and into morbidity resulting from the upper airway obstruction (e.g., increased daytime sleepiness, hyperactivity, poor school performance, inadequate somatic growth rate or enuresis). History of premature birth and a family history of OSAS as well as obesity and African American ethnicity are associated with increased risk of sleep-disordered breathing in childhood. Polysomnography is the gold standard method for the diagnosis of OSAS but may not be always feasible, especially in low-income countries or non-tertiary hospitals. Nocturnal oximetry and/or sleep questionnaires may be used to identify the child at high risk of OSAS when polysomnography is not an option. Endoscopy and MRI of the upper airway may help to identify the level(s) of upper airway obstruction and to evaluate the dynamic mechanics of the upper airway, especially in children with combined abnormalities. Pediatr Pulmonol. 2017;52:260-271. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. The adverse effects of oral desmopressin lyophilisate (MELT): personal experience on enuretic children

    PubMed Central

    Franceschini, Giulia; Mercurio, Serena; Del Vescovo, Ester; Ianniello, Francesca; Petitti, Tommasangelo

    2018-01-01

    Objective The aim of this study was to evaluate adverse effects of oral desmopressin lyophilisate (MELT) in enuretic children. Material and methods We enrolled 260 children with nocturnal enuresis (NE) referred to the Pediatric Service, ‘Campus Bio-Medico’ University of Rome, from April 2014 to April 2017 in the study, of these 23 were excluded. The study was characterized by 2 phases. During Phase 1 a careful patient’s medical history was obtained and physical examination was performed. After 3 months of treatment with MELT (Minirin/DDAVP®) at the dose of 120 mcg a day, a micturition diary was kept, adherence to therapy and any possible adverse effects were checked during the Phase 2. The study was carried out in compliance with the Helsinki Declaration. Results Among 237 patients included in the study 11 male and 6 female (n=17; 7.2%) patients with a mean age 10.06±2.49 years, reported 22 adverse effects, with an absolute risk of 7.17%. In particular, 5 neurological symptoms, 3 gastrointestinal effects, 4 sleep disturbances, 8 psycho-behavioral disorders, 2 symptoms of fatigue were reported. Conclusion In our study MELT with its higher bioavailability guaranteed lower frequency of adverse effects which resolved spontaneously and rapidly. The MELT formulation actually represents the first line and safe treatment for the NE. PMID:29484228

  5. Diurnal and twenty-four hour patterning of human diseases: acute and chronic common and uncommon medical conditions.

    PubMed

    Smolensky, Michael H; Portaluppi, Francesco; Manfredini, Roberto; Hermida, Ramon C; Tiseo, Ruana; Sackett-Lundeen, Linda L; Haus, Erhard L

    2015-06-01

    The symptom intensity and mortality of human diseases, conditions, and syndromes exhibit diurnal or 24 h patterning, e.g., skin: atopic dermatitis, urticaria, psoriasis, and palmar hyperhidrosis; gastrointestinal: esophageal reflux, peptic ulcer (including perforation and hemorrhage), cyclic vomiting syndrome, biliary colic, hepatic variceal hemorrhage, and proctalgia fugax; infection: susceptibility, fever, and mortality; neural: frontal, parietal, temporal, and occipital lobe seizures, Parkinson's and Alzheimer's disease, hereditary progressive dystonia, and pain (cancer, post-surgical, diabetic neuropathic and foot ulcer, tooth caries, burning mouth and temporomandibular syndromes, fibromyalgia, sciatica, intervertebral vacuum phenomenon, multiple sclerosis muscle spasm, and migraine, tension, cluster, hypnic, and paroxysmal hemicranial headache); renal: colic and nocturnal enuresis and polyuria; ocular: bulbar conjunctival redness, keratoconjunctivitis sicca, intraocular pressure and anterior ischemic optic neuropathy, and recurrent corneal erosion syndrome; psychiatric/behavioral: major and seasonal affective depressive disorders, bipolar disorder, parasuicide and suicide, dementia-associated agitation, and addictive alcohol, tobacco, and heroin cravings and withdrawal phenomena; plus autoimmune and musculoskeletal: rheumatoid arthritis, osteoarthritis, axial spondylarthritis, gout, Sjögren's syndrome, and systemic lupus erythematosus. Knowledge of these and other 24 h patterns of human pathophysiology informs research of their underlying circadian and other endogenous mechanisms, external temporal triggers, and more effective patient care entailing clinical chronopreventive and chronotherapeutic strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Controlled outcome studies of child clinical hypnosis.

    PubMed

    Adinolfi, Barbara; Gava, Nicoletta

    2013-09-01

    Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem.

  7. Sleep disturbances in Angelman syndrome: a questionnaire study.

    PubMed

    Bruni, Oliviero; Ferri, Raffaele; D'Agostino, Gaetana; Miano, Silvia; Roccella, Michele; Elia, Maurizio

    2004-06-01

    Only few studies are available on sleep disorders in Angelman syndrome (AS), a neurodevelopmental disorder with several behavior disturbances. The aim of this study was to determine the prevalence of sleep disorders in a relatively large group of AS subjects, compared to that of age-matched controls. Forty-nine consecutive parents of patients with AS (26 males and 23 females aged 2.3-26.2 years) were interviewed and filled out a comprehensive sleep questionnaire. Based on their genetic etiology, four groups were defined: deletion of chromosome 15q11-13 (25 subjects); methylation imprinting mutation (six subjects), UBE3A mutations (seven subjects) and paternal uniparental disomy (five subjects). In the remaining cases genetic testings were negative. A significantly high frequency of disorders of initiating and maintaining sleep, prolonged sleep latency, prolonged wakefulness after sleep onset, high number of night awakenings and reduced total sleep time were found in our AS patients, as compared to age-matched controls. We also found other types of sleep disorders, never reported before, such as enuresis, bruxism, sleep terrors, somnambulism, nocturnal hyperkinesia, and snoring. No differences were found between the four genetic aetiology groups. Moreover, we did not find important improvement of sleep disturbances from pre-pubertal to post-pubertal ages. Our data confirm the significant presence of sleep/wake rhythms fragmentation, peculiar of AS, and also demonstrate the presence of several other types of sleep disturbances in this syndrome.

  8. Abdominal pain symptoms are associated with anxiety and depression in young children.

    PubMed

    von Gontard, Alexander; Moritz, Anne-Michaela; Thome-Granz, Sigrid; Equit, Monika

    2015-11-01

    Abdominal pain symptoms and incontinence are common in childhood. The aim of this study was to analyse abdominal pain symptoms and their associations with incontinence and symptoms of anxiety and depression in young children. We examined 1130 children during the school entry check-up (mean age 6.2 years) and 951 participated in the study. Parents completed a questionnaire contained 11 items regarding Rome-III functional gastrointestinal disorders (FGIDs) and incontinence and 14 items from the anxious/depressed scale of the Child Behavior Checklist (CBCL). Of the 951 children (55.6% boys) we recruited, 30.1% had experienced abdominal pain symptoms in the past two months and 14% had complained of them at least once a week. In addition, 2.6% had irritable bowel syndrome, 11.3% had childhood functional abdominal pain, 2.4% were affected by faecal incontinence, 2.1% were affected by daytime urinary incontinence, and 5.5% were affected by nocturnal enuresis. One in ten (10.6%) had symptoms of anxiety and depression, and these were significantly higher in the children with FGIDs, particularly if they were also incontinent. Nearly a third of the children (30.1%) had abdominal pain symptoms, and FGIDs were associated with significantly higher symptoms of anxiety and depression, especially if children were also incontinent. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  9. Parasomnias and isolated sleep symptoms in Parkinson's disease: a questionnaire study on 661 patients.

    PubMed

    Ylikoski, Ari; Martikainen, Kirsti; Partinen, Markku

    2014-11-15

    Sleep disorders are among the most common non-motor symptoms in Parkinson's disease. The prevalence of parasomnias and their association with other symptoms were studied in a questionnaire study among 1447 randomly selected Parkinson patients, aged 43 to 89 years. The response rate was 59.0% and of these 77% had answered to all questions that were used in the analyses (N = 661). The prevalence of REM sleep behavior disorder (RBD) evaluated by the RBDSQ ≥ 6 was 39.0%. The occurrences of other parasomnias (≥ 1/week) in patients with PD were: nightmares 17.2%, night terrors 3.9%, sleepwalking 1.8%, enuresis 21.0%, and hallucinations 15.3%. Occurrences (≥ 1/week) of the isolated sleep symptoms were: nocturnal sweating 28.8%, bruxism 4.7%, and sleep talking 21.7%. Association of RBD with sleepwalking (parasomnia overlap disorder) was found in 1.7% of all PD patients. Adjusted logistic regression analysis showed that weekly nightmares (OR 12.5; 95% CI 5.3 to 29.7), hallucinations (OR 5.1; 2.1 to 12.4), sleep talking (OR 11.6; 5.9 to 22.8), male gender (OR 1.9; 1.1 to 3.1), and restless legs syndrome (OR 4.7; 1.7 to 13.2) associated with the presence of RBD. Parkinson patients with RBD have often also other parasomnias and/or isolated sleep symptoms. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. A 20-year study of persistence of lower urinary tract symptoms and urinary incontinence in young women treated in childhood.

    PubMed

    Petrangeli, F; Capitanucci, M L; Marciano, A; Mosiello, G; Alvaro, R; Zaccara, A; Finazzi-Agro, E; De Gennaro, M

    2014-06-01

    To determine whether urinary incontinence (UI) and lower urinary tract symptoms (LUTS) persist over years, patients treated for UI and LUTS in childhood were re-evaluated in adulthood. Forty-seven women (cases) treated in childhood for daytime UI/LUTS (group A) and nocturnal enuresis (group B) self-completed (average age: 24.89 ± 3.5 years) the International Consultation on Incontinence Questionnaire for Female with LUTS (ICIQ-FLUTS). ICIQ-FLUTS was self-administered to 111 healthy women (average age: 23 ± 5.1 years) from a nursing school as a control group. Data obtained from ICIQ-FLUTS and quality of life (QoL) score (0-10) were compared (Fisher's exact test) between patients and controls, and between group A (n = 28) and group B (n = 19). Prevalence of LUTS was higher in patients than in controls. The difference between patients and controls was statistically significant (p = 0.0001) for UI (34% vs. 7%) and feeling of incomplete bladder emptying (49% vs. 28%). QoL score was >5 in 59% of patients and 1% of controls (p = 0.0001). No significant differences were found between groups A and B. UI and LUTS are confirmed in young women who suffered for the same condition in childhood. Longitudinal studies are needed to assess if these symptoms persist or are newly onset. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  11. Basic or extended urine sampling to analyse urine production?

    PubMed

    Denys, Marie-Astrid; Kapila, Vansh; Weiss, Jeffrey; Goessaert, An-Sofie; Everaert, Karel

    2017-09-01

    Frequency volume charts are valuable tools to objectify urine production in patients with nocturia, enuresis or nocturnal incontinence. Analyses of daytime and nighttime urine (=basic collection) or analyses of urine samples collected every 3 h (=extended collection) extend this evaluation by describing circadian patterns of water and solute diuresis (=renal function profiles). To assess intra-individual correlation and agreement between renal function profiles provided using basic and extended urine collections, and using two extended urine collections. To create a short-form of the extended collection. This prospective observational study was executed at Ghent University Hospital, Belgium. Study participation was open for anyone visiting the hospital. Participants collected one basic and two extended 24-h urine collections. Urinary levels of osmolality, sodium and creatinine were determined. There was a moderate to strong correlation between results of basic and extended urinalyses. Comparing both extended urinalyses showed a moderate correlation between the eight individual samples and a weak to strong correlation between the mean daytime and nighttime values of renal functions. Different samples could be considered as most representative for mean daytime values, while all samples collected between 03 and 05am showed the highest agreement with mean nighttime values of renal function. Since there is a good correlation and agreement between basic and extended urine collections to study the mechanisms underlying urine production, the choice of urine sampling method to evaluate urine production depends on the purpose. A nighttime-only urine sample collected between 03 and 05am may be the most practical approach. © 2017 Wiley Periodicals, Inc.

  12. Sleepwalking (For Parents)

    MedlinePlus

    ... pauses in breathing while sleeping) bedwetting (enuresis) night terrors Is Sleepwalking Harmful? Sleepwalking itself is not harmful. ... on this topic for: Parents Kids Teens Night Terrors Nightmares Sleep Problems in Teens All About Sleep ...

  13. Hypnosis and the Child.

    ERIC Educational Resources Information Center

    Place, Maurice

    1984-01-01

    Discusses the nature and value of hypnosis; rating scales and their clinical relevance; the role of self-hypnosis; and clinical studies related to anxiety, hysteria, enuresis, asthma, and pain and painful procedures. (RH)

  14. Bladder and Bowel Control in Children with Cerebral Palsy: Case-Control Study

    PubMed Central

    Ozturk, Mustafa; Oktem, Faruk; Kisioglu, Nesimi; Demirci, Mustafa; Altuntas, Irfan; Kutluhan, Suleyman; Dogan, Malik

    2006-01-01

    Aim To determine the age of development of bladder and bowel control and the frequency of enuresis, encopresis, and urinary infections in children with cerebral palsy. Methods The study included 45 children with cerebral palsy who regularly attended a rehabilitation center in Isparta, Turkey, and two groups of age- and sex-matched children, 37 siblings of the children with cerebral palsy and 37 healthy children. Demographic data and information on the age of development of total bladder and bowel control and presence of possible urinary symptoms in children were collected from their caregivers by use of a questionnaire. Frequency of enuresis and encopresis was estimated among the children aged ≥5 years. A mid-way urinary sample was obtained from 40, 22, and 21 children in the cerebral palsy, siblings, and healthy children, respectively. Results The mean age of nighttime bladder and bowel control development was 47 months (95% confidence interval [CI], 35-58) and 45 (36-55) months, respectively, for the children with cerebral palsy, 35 months (95% CI, 24-46) and 26 months (95% CI, 24-28), respectively, for their siblings, and 27 months (95% CI, 22-33) and 25 months (95% CI, 23-27) months, respectively, for the healthy children. Among the children aged ≥5 years, enuresis was present in 11 of 34 children with cerebral palsy, 7 of 30 siblings, and 4 of 30 healthy children (P = 0.200), whereas encopresis was present in 5 children with cerebral palsy, one sibling, and one healthy child. Constipation was significantly more present in chidlren with cerebral palsy than in other two groups (P<0.001). Urine culture was positive in 13 children with cerebral palsy, 1 sibling, and 2 healthy chidlren (P = 0.024). There were no significant differences in other urinary symptoms and laboratory findings among the three groups. Conclusion The children with cerebral palsy gained bladder and bowel control at older age in comparison with their siblings and healthy children. They also had more frequent enuresis and urinary infections. PMID:16625691

  15. Pathophysiology of nocturnal lower urinary tract symptoms in older patients with urinary incontinence.

    PubMed

    Denys, Marie-Astrid; Decalf, Veerle; Kumps, Candy; Petrovic, Mirko; Goessaert, An-Sofie; Everaert, Karel

    2017-11-01

    To explore the mismatch between functional bladder capacity and nocturnal urine production, and to study the pathophysiology of an increased nocturnal urine production in older patients with urinary incontinence. The present prospective observational study included adults aged ≥65 years with urinary incontinence. Participants completed questionnaires, frequency volume charts and renal function profiles. The nocturnal lower urinary tract symptom index was defined as nocturnal urine output/maximum voided volume; the nocturnal polyuria index as nocturnal/24 h urine output. The median age (n = 95) was 74 years (69-79), 87% were women and 73% had nocturnal lower urinary tract symptoms (nocturnal urinary incontinence or nocturia ≥2). Participants with nocturnal lower urinary tract symptoms had a significantly higher nocturnal urine output (809 mL vs 650 mL; P = 0.001) and no significant difference in maximum voided volume (350 mL vs 437 mL; P = 0.079) compared with participants without nocturnal lower urinary tract symptoms. Participants (nocturnal polyuria index >33% [n = 56], nocturnal polyuria index >40% [n = 42], nocturnal lower urinary tract symptom index >1.87 [n = 51]) showed higher night-time diuresis rates, free water and sodium clearance compared with during the daytime. Controls (nocturnal polyuria index ≤33% [n = 26], nocturnal polyuria index ≤40% [n = 40], nocturnal lower urinary tract symptom index ≤1.87 [n = 44]) had no circadian rhythm in their diuresis rate or sodium clearance, but more nocturnal free water clearance compared with during the daytime. The majority of older adults with urinary incontinence present nocturnal lower urinary tract symptoms. An increased nocturnal sodium diuresis seems to be the only mechanism differentiating patients with nocturnal lower urinary tract symptoms from controls. © 2017 The Japanese Urological Association.

  16. Products for Children with Enuresis and Daytime Urinary Incontinence

    MedlinePlus

    ... NKF Online Communities Featured Story Want to save money on your prescriptions? Introducing a new discount card ... Events and Galas Spring Clinical Meetings KEEP Healthy - Free Kidney Health checks Your Kidneys and You Meetings ...

  17. Clinical Study of An Ayurvedic Compound (Divyadi Yoga) in the Management of Shayyamutrata (enuresis)

    PubMed Central

    Jain, C. M.; Gupta, Anju

    2010-01-01

    Child health has assumed great significance in all over world. Its importance is being realized more and more by pediatricians and general public in developing as well as developed countries. Enuresis is defined as the voluntary or involuntary repeated discharge of urine into clothes or bed after a developmental age when bladder control should be established. The present clinical study was planned to evaluate the effect of Divyadi Yoga along with counseling in the management of Shayyamutra. Total 40 selected cases were divided into two groups, i.e. 20 in each group. One group of children were given the trial drug Divyadi Yoga (D1) with counseling and other group of children were given placebo Divyadi Yoga (D2) with counseling. Divyadi Yoga was given in the dose of 3-6 gms. twice a day with luke warm water. The result of the study showed that groups provided a highly significant. PMID:22131688

  18. Comparative Effects of an Angiotensin II Receptor Blocker (ARB)/Diuretic vs. ARB/Calcium-Channel Blocker Combination on Uncontrolled Nocturnal Hypertension Evaluated by Information and Communication Technology-Based Nocturnal Home Blood Pressure Monitoring - The NOCTURNE Study.

    PubMed

    Kario, Kazuomi; Tomitani, Naoko; Kanegae, Hiroshi; Ishii, Hajime; Uchiyama, Kazuaki; Yamagiwa, Kayo; Shiraiwa, Toshihiko; Katsuya, Tomohiro; Yoshida, Tetsuro; Kanda, Kiyomi; Hasegawa, Shinji; Hoshide, Satoshi

    2017-06-23

    Nocturnal blood pressure (BP) is an independent risk factor of cardiovascular events. The NOCTURNE study, a multicenter, randomized controlled trial (RCT) using our recently developed information and communication technology (ICT) nocturnal home BP monitoring (HBPM) device, was performed to compare the nocturnal HBP-lowering effects of differential ARB-based combination therapies in 411 Japanese patients with nocturnal hypertension (HT).Methods and Results:Patients with nocturnal BP ≥120/70 mmHg at baseline even under ARB therapy (100 mg irbesartan daily) were enrolled. The ARB/CCB combination therapy (irbesartan 100 mg+amlodipine 5 mg) achieved a significantly greater reduction in nocturnal home systolic BP (primary endpoint) than the ARB/diuretic combination (daily irbesartan 100 mg+trichlormethiazide 1 mg) (-14.4 vs. -10.5 mmHg, P<0.0001), independently of urinary sodium excretion and/or nocturnal BP dipping status. However, the change in nocturnal home systolic BP was comparable among the post-hoc subgroups with higher salt sensitivity (diabetes, chronic kidney disease, and elderly patients). This is the first RCT demonstrating the feasibility of clinical assessment of nocturnal BP by ICT-nocturnal HBPM. The ARB/CCB combination was shown to be superior to ARB/diuretic in patients with uncontrolled nocturnal HT independently of sodium intake, despite the similar impact of the 2 combinations in patients with higher salt sensitivity.

  19. Association of pediatric obstructive sleep apnea with poor academic performance: A school-based study from India

    PubMed Central

    Goyal, Abhishek; Pakhare, Abhijit P; Bhatt, Girish C; Choudhary, Bharat; Patil, Rajesh

    2018-01-01

    Background: Pediatric obstructive sleep apnea (OSA) is a highly prevalent but often neglected disorder. There is paucity of reports on the prevalence of pediatric OSA from India. This study was done to estimate the prevalence of OSA in school children aged 5–10 years and its association with academic performance. Methodology: This school-based cross-sectional epidemiological study was conducted from July 2015 to November 2015. A questionnaire seeking information on sociodemographic variables, school performance, sleeping pattern, and a validated 22-item pediatrics sleep-related breathing disorder (SRBD) scale was distributed to 1820 pupils in three primary schools. The prevalence of OSA (defined as SRBD score >33%) was reported as proportion and its 95% confidence interval (CI). Results: We received 1520 questionnaires out of 1820 distributed and of which 1346 were complete and were analyzed. The prevalence of OSA among children in our study was 9.6% (95% CI: 8.1%–11.7%). On multivariate analysis, working mother (adjusted odds ratio [OR]: 1.8; 95% CI: 1.2–2.7), sleep bruxism (adjusted OR: 1.7; 95% CI: 1.1–2.6), and sleep talking (adjusted OR: 3.0; 95% CI: 1.9–4.7) were found to be independently associated with OSA. Students with positive SRBD were more prone to nocturnal enuresis (NE) (OR 3.48; 95% CI 2.27–5.26) and poor academic performance in all subjects. Conclusion: OSA is highly prevalent (9.6%) in Indian children. OSA is associated with NE and poor academic performance in all subjects. This study found association of maternal occupation and OSA which needs to be confirmed in larger studies. PMID:29487248

  20. Effects of Food and Pharmaceutical Formulation on Desmopressin Pharmacokinetics in Children.

    PubMed

    Michelet, Robin; Dossche, Lien; De Bruyne, Pauline; Colin, Pieter; Boussery, Koen; Vande Walle, Johan; Van Bocxlaer, Jan; Vermeulen, An

    2016-09-01

    Desmopressin is used for treatment of nocturnal enuresis in children. In this study, we investigated the pharmacokinetics of two formulations-a tablet and a lyophilisate-in both fasted and fed children. Previously published data from two studies (one in 22 children aged 6-16 years, and the other in 25 children aged 6-13 years) were analyzed using population pharmacokinetic modeling. A one-compartment model with first-order absorption was fitted to the data. Covariates were selected using a forward selection procedure. The final model was evaluated, and sensitivity analysis was performed to improve future sampling designs. Simulations were subsequently performed to further explore the relative bioavailability of both formulations and the food effect. The final model described the plasma desmopressin concentrations adequately. The formulation and the fed state were included as covariates on the relative bioavailability. The lyophilisate was, on average, 32.1 % more available than the tablet, and fasted children exhibited an average increase in the relative bioavailability of 101 % in comparison with fed children. Body weight was included as a covariate on distribution volume, using a power function with an exponent of 0.402. Simulations suggested that both the formulation and the food effect were clinically relevant. Bioequivalence data on two formulations of the same drug in adults cannot be readily extrapolated to children. This was the first study in children suggesting that the two desmopressin formulations are not bioequivalent in children at the currently approved dose levels. Furthermore, the effect of food intake was found to be clinically relevant. Sampling times for a future study were suggested. This sampling design should result in more informative data and consequently generate a more robust model.

  1. Clinical course of a cohort of children with non-neurogenic daytime urinary incontinence symptoms followed at a tertiary center.

    PubMed

    Lebl, Adrienne; Fagundes, Simone Nascimento; Koch, Vera Hermina Kalika

    2016-01-01

    To characterize a cohort of children with non-neurogenic daytime urinary incontinence followed-up in a tertiary center. Retrospective analysis of 50 medical records of children who had attained bladder control or minimum age of 5 years, using a structured protocol that included lower urinary tract dysfunction symptoms, comorbidities, associated manifestations, physical examination, voiding diary, complementary tests, therapeutic options, and clinical outcome, in accordance with the 2006 and 2014 International Children's Continence Society standardizations. Female patients represented 86.0% of this sample. Mean age was 7.9 years and mean follow-up was 4.7 years. Urgency (56.0%), urgency incontinence (56.0%), urinary retention (8.0%), nocturnal enuresis (70.0%), urinary tract infections (62.0%), constipation (62.0%), and fecal incontinence (16.0%) were the most prevalent symptoms and comorbidities. Ultrasound examinations showed alterations in 53.0% of the cases; the urodynamic study showed alterations in 94.7%. At the last follow-up, 32.0% of patients persisted with urinary incontinence. When assessing the diagnostic methods, 85% concordance was observed between the predictive diagnosis of overactive bladder attained through medical history plus non-invasive exams and the diagnosis of detrusor overactivity achieved through the invasive urodynamic study. This subgroup of patients with clinical characteristics of an overactive bladder, with no history of urinary tract infection, and normal urinary tract ultrasound and uroflowmetry, could start treatment without invasive studies even at a tertiary center. Approximately one-third of the patients treated at the tertiary level remained refractory to treatment. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  2. Association of pediatric obstructive sleep apnea with poor academic performance: A school-based study from India.

    PubMed

    Goyal, Abhishek; Pakhare, Abhijit P; Bhatt, Girish C; Choudhary, Bharat; Patil, Rajesh

    2018-01-01

    Pediatric obstructive sleep apnea (OSA) is a highly prevalent but often neglected disorder. There is paucity of reports on the prevalence of pediatric OSA from India. This study was done to estimate the prevalence of OSA in school children aged 5-10 years and its association with academic performance. This school-based cross-sectional epidemiological study was conducted from July 2015 to November 2015. A questionnaire seeking information on sociodemographic variables, school performance, sleeping pattern, and a validated 22-item pediatrics sleep-related breathing disorder (SRBD) scale was distributed to 1820 pupils in three primary schools. The prevalence of OSA (defined as SRBD score >33%) was reported as proportion and its 95% confidence interval (CI). We received 1520 questionnaires out of 1820 distributed and of which 1346 were complete and were analyzed. The prevalence of OSA among children in our study was 9.6% (95% CI: 8.1%-11.7%). On multivariate analysis, working mother (adjusted odds ratio [OR]: 1.8; 95% CI: 1.2-2.7), sleep bruxism (adjusted OR: 1.7; 95% CI: 1.1-2.6), and sleep talking (adjusted OR: 3.0; 95% CI: 1.9-4.7) were found to be independently associated with OSA. Students with positive SRBD were more prone to nocturnal enuresis (NE) (OR 3.48; 95% CI 2.27-5.26) and poor academic performance in all subjects. OSA is highly prevalent (9.6%) in Indian children. OSA is associated with NE and poor academic performance in all subjects. This study found association of maternal occupation and OSA which needs to be confirmed in larger studies.

  3. Nocturnal light environments and species ecology: implications for nocturnal color vision in forests.

    PubMed

    Veilleux, Carrie C; Cummings, Molly E

    2012-12-01

    Although variation in the color of light in terrestrial diurnal and twilight environments has been well documented, relatively little work has examined the color of light in nocturnal habitats. Understanding the range and sources of variation in nocturnal light environments has important implications for nocturnal vision, particularly following recent discoveries of nocturnal color vision. In this study, we measured nocturnal irradiance in a dry forest/woodland and a rainforest in Madagascar over 34 nights. We found that a simple linear model including the additive effects of lunar altitude, lunar phase and canopy openness successfully predicted total irradiance flux measurements across 242 clear sky measurements (r=0.85, P<0.0001). However, the relationship between these variables and spectral irradiance was more complex, as interactions between lunar altitude, lunar phase and canopy openness were also important predictors of spectral variation. Further, in contrast to diurnal conditions, nocturnal forests and woodlands share a yellow-green-dominant light environment with peak flux at 560 nm. To explore how nocturnal light environments influence nocturnal vision, we compared photoreceptor spectral tuning, habitat preference and diet in 32 nocturnal mammals. In many species, long-wavelength-sensitive cone spectral sensitivity matched the peak flux present in nocturnal forests and woodlands, suggesting a possible adaptation to maximize photon absorption at night. Further, controlling for phylogeny, we found that fruit/flower consumption significantly predicted short-wavelength-sensitive cone spectral tuning in nocturnal mammals (P=0.002). These results suggest that variation in nocturnal light environments and species ecology together influence cone spectral tuning and color vision in nocturnal mammals.

  4. The relationship between nocturnal polyuria and the distribution of body fluid: assessment by bioelectric impedance analysis.

    PubMed

    Torimoto, Kazumasa; Hirayama, Akihide; Samma, Shoji; Yoshida, Katsunori; Fujimoto, Kiyohide; Hirao, Yoshihiko

    2009-01-01

    Increased nocturnal urinary volume is closely associated with nocturia. We investigated the relationship between nocturnal polyuria and the variation of body fluid distribution during the daytime using bioelectric impedance analysis. A total of 34 men older than 60 years were enrolled in this study. A frequency volume chart was recorded. Nocturnal polyuria was defined as a nocturnal urine volume per 24-hour production of greater than 0.35 (the nocturnal polyuria index). Bioelectric impedance analysis was performed 4 times daily at 8 and 11 a.m., and 5 and 9 p.m. using an InBody S20 body composition analyzer (BioSpace, Seoul, Korea). A significant difference was found in mean +/- SEM 24-hour urine production per fat-free mass between the groups with and without nocturnal polyuria (17.8 +/- 1.4 vs 7.7 +/- 0.9 ml/kg). The increase in fluid in the legs compared with the volume at 8 a.m. was significantly larger at 5 p.m., while there was no difference in the arms or trunk. Nocturnal urine volume significantly correlated with the difference in fluid volume in the legs (r = 0.527, p = 0.0019) and extracellular fluid volume (r = 0.3844, p = 0.0248) between the volumes at 8 a.m. and 9 p.m. Overproduction of urine per fat-free mass leads to nocturnal polyuria. Extracellular fluid accumulates as edema in the legs during the day in patients with nocturnal polyuria. The volume of accumulated extracellular fluid correlates with nocturnal urine volume. We suggest that leg edema is the source of nocturnal urine volume and decreasing edema may cure nocturnal polyuria.

  5. Does the Age of Donor Kidneys Affect Nocturnal Polyuria in Patients With Successful Real Transplantation?

    PubMed

    Mitsui, T; Morita, K; Iwami, D; Kitta, T; Kanno, Y; Moriya, K; Takeda, M; Shinohara, N

    We investigated whether the age of donor kidneys influences the incidence of nocturnal polyuria in patients with successful renal transplantation (RTX). Eighty-five patients (45 men and 40 women) undergoing RTX (median age, 47 years) were included in this study. Twenty-four-hour bladder diaries were kept for 3 days, and nocturnal polyuria was defined as a nocturnal polyuria index (nocturnal urine volume/24-hour urine volume) of >0.33. Risk factors for nocturnal polyuria were analyzed in patients with RTX by means of the Mann-Whitney U test, χ 2 test, and a logistic regression analysis. End-stage renal disease (ESRD) developed from diabetes mellitus in 16 patients (19%). Sixty-five patients (76%) received pre-transplant dialysis, with a median duration of 5 years. The median serum creatinine level and body mass index at the most recent visit were 1.2 mg/dL and 21.2 kg/m 2 , respectively. On the basis of the 24-hour bladder diaries, nocturnal polyuria was identified in 48 patients (56%). A logistic regression analysis revealed that diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria (odds ratio, 8.95; 95% confidence interval, 2.01-65.3; P = .0028). The age of donor kidneys at examination did not affect the incidence of nocturnal polyuria (P = .9402). Nocturnal polyuria was not uncommon in patients with successful RTX. Diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria, whereas the age of donor kidneys at examination did not affect the incidence of nocturnal polyuria. Thus, nocturnal polyuria is caused by recipient factors but not donor factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Nocturnal Polyuria in Older Women with Urge Urinary Incontinence: Role of Sleep Quality, Time in Bed and Medications Used.

    PubMed

    Tyagi, Shachi; Perera, Subashan; Clarkson, Becky D; Tadic, Stasa D; Resnick, Neil M

    2017-03-01

    Nocturia is common and bothersome in older adults, especially those who are also incontinent. Since nocturnal polyuria is a major contributor, we examined factors associated with nocturnal polyuria in this population to identify those possibly amenable to intervention. We analyzed baseline data from 2 previously completed studies of urge urinary incontinence. The studies involved 284 women (mean age ± SD 72.9 ± 7.9 years) who also completed 3-day voiding diaries. Participants with a nocturnal polyuria index greater than 33% were categorized as having nocturnal polyuria (nocturnal polyuria index = nocturnal urinary volume per 24-hour urine volume). Associations between nocturnal polyuria and various demographic, clinical and sleep related parameters were determined. Overall 55% of the participants had nocturnal polyuria. Multivariable regression analysis revealed that age, body mass index, use of angiotensin converting enzyme inhibitor/angiotensin receptor blocker, time spent in bed and duration of first uninterrupted sleep were independent correlates of nocturnal polyuria. Participants with a larger nocturnal excretion reported a shorter duration of uninterrupted sleep before first awakening to void and worse sleep quality despite spending similar time in bed. Body mass index, use of angiotensin converting enzyme inhibitor/angiotensin receptor blockers, time in bed and duration of uninterrupted sleep before first awakening to void are independently associated with nocturnal polyuria in older women with urge urinary incontinence, and are potentially modifiable. These findings also confirm the association between sleep and nocturnal polyuria. Further studies should explore whether interventions to reduce nocturnal polyuria and/or increase the duration of uninterrupted sleep before first awakening to void would help to improve sleep quality in this population and thereby reduce or eliminate the need for sedative hypnotics. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. A cutoff value based on analysis of a reference population decreases overestimation of the prevalence of nocturnal polyuria.

    PubMed

    van Haarst, Ernst P; Bosch, J L H Ruud

    2012-09-01

    We sought criteria for nocturnal polyuria in asymptomatic, nonurological adults of all ages by reporting reference values of the ratio of daytime and nighttime urine volumes, and finding nocturia predictors. Data from a database of frequency-volume charts from a reference population of 894 nonurological, asymptomatic volunteers of all age groups were analyzed. The nocturnal polyuria index and the nocturia index were calculated and factors influencing these values were determined by multivariate analysis. The nocturnal polyuria index had wide variation but a normal distribution with a mean ± SD of 30% ± 12%. The 95th percentile of the values was 53%. Above this cutoff a patient had nocturnal polyuria. This value contrasts with the International Continence Society definition of 33% but agrees with several other reports. On multivariate regression analysis with the nocturnal polyuria index as the dependent variable sleeping time, maximum voided volume and age were the covariates. However, the increase in the nocturnal polyuria index by age was small. Excluding polyuria and nocturia from analysis did not alter the results in a relevant way. The nocturnal voiding frequency depended on sleeping time and maximum voided volume but most of all on the nocturia index. The prevalence of nocturnal polyuria is overestimated. We suggest a new cutoff value for the nocturnal polyuria index, that is nocturnal polyuria exists when the nocturnal polyuria index exceeds 53%. The nocturia index is the best predictor of nocturia. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Analysis of nocturia with 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration: concept for effective treatment modality.

    PubMed

    Udo, Yukihiro; Nakao, Masahiro; Honjo, Hisashi; Ukimura, Osamu; Kawauchi, Akihiro; Kitakoji, Hiroshi; Miki, Tsuneharu

    2011-03-01

    • To determine the relationship between the number of nocturia and 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration as well as to assess the significance of these factors with respect to eliminating nocturnal voidings in individual patients with nocturia. • Among 532 participants who completed a 3-day bladder diary between April 2005 and December 2006, the diaries of 450 participants without 24-h polyuria were analyzed. • Clinical variables such as the number of daytime and night-time voids, 24-h urine volume, nocturnal polyuria index, daytime and night-time maximum voided volumes (MVV), night/day MVV ratio, sleep duration and proportion of night/day urine production rates were obtained from each diary. • Participants were classified into eight groups according to values of three factors: nocturnal MVV, proportion of night/day urine production rates and length of sleep duration. • Each group was divided into three subgroups: non-nocturics (number of nocturnal voidings is zero), mild nocturics (number of nocturnal voidings is one) and severe nocturics (number of nocturnal voidings is two or more). • The data from non-nocturics with three normal factors were regarded as the normal control and compared with the variables of the other subgroups using Dunnett's method. • Variables that form the basis of classifying participants into eight groups and corresponding to abnormal factors of each group were statistically significant in all the subgroups of each group. • Furthermore, a significantly increased 24-h urine volume was found in severe nocturics of the group with three normal factors. • A significantly decreased 24-h urine volume was found in non-nocturics of groups with nocturnal polyuria, decreased bladder capacity and both long sleep duration and nocturnal polyuria. • A significantly increased nocturnal MVV and night/day MVV ratio were shown in non-nocturics and mild nocturics of the groups with nocturnal polyuria and both long sleep duration and nocturnal polyuria. • Because nocturia is a multifactorial disorder and closely related to four factors (i.e. 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration), the evaluation of all these factors appears to be clinically useful for determining the main contributing factor in patients with nocturia as well as the suitable treatment modality on an individual basis. • Physicians should take all these factors into consideration in the evaluation and treatment of nocturia. © 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.

  9. Identification of the Gifted: A Prospective View.

    ERIC Educational Resources Information Center

    Salles, Jose Ferraz

    1987-01-01

    A psychiatrist describes causative factors (e.g., difficult childbirth, cerebral hypoxemy), behaviors (e.g., motor instability, irritability, enuresis), and abilities (e.g., extrasensory perception, telepathy) that he has associated with giftedness but that are not widely recognized. He also advocates the use of ambidextrous training and Losanov…

  10. Analysis of Navy Delayed Entry Program and Recruit Training Center Attrition

    DTIC Science & Technology

    1998-06-01

    training which are not consistent with military service (e.g., sleepwalking , suicidal behavior, bedwetting). "Screen" encompasses the prior problems...Non-Academic Psych-Personality Disorder I Behavior 193 Non-Academic Psych-Enuresis I Behavior 194 Non-Academic Psych- Sleepwalk I Behavior 43

  11. Patterns and Processes in Nocturnal and Crepuscular Pollination Services.

    PubMed

    Borges, Renee M; Somanathan, Hema; Kelber, Almut

    2016-12-01

    Night, dawn, and dusk have abiotic features that differ from the day. Illumination, wind speeds, turbulence, and temperatures are lower while humidity may be higher at night. Nocturnal pollination occurred in 30% of angiosperm families across 68% of orders, 97% of families with C3, two-thirds of families with crassulacean acid metabolism (CAM), and 71% dicot families with C4 photosynthesis. Despite its widespread occurence, nocturnal pollination occurs in more families with xerophytic adaptations than helophytes or mesophytes, suggesting that nocturnal flowering is primarily an adaptation to water stress since flowering is a water-intensive process. We propose the arid or water stress hypothesis for nocturnal flowering suggesting that plants facing water stress in a habitat (e.g., deserts) or a habitat stratum (e.g., upper canopy for epiphytes) gain a selective advantage by nocturnal flowering by reducing water loss through evapotranspiration, leading to larger flowers that provide more nectar or other resources, to support pollinators with higher rewards. Contrary to the wide taxonomic occurrence of nocturnal flowering, few animal taxa serve as nocturnal pollinators. We discuss the sensory and physiological abilities that enable pollinator movement, navigation, and detection of flowers within the nocturnal temporal niche and present a unified framework for investigation of nocturnal flowering and pollination.

  12. Nocturnal Blood Pressure in Young Adults and Cognitive Function in Midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

    PubMed Central

    Ning, Hongyan; Muntner, Paul; Reis, Jared P.; Calhoun, David A.; Viera, Anthony J.; Levine, Deborah A.; Jacobs, David R.; Shimbo, Daichi; Liu, Kiang; Greenland, Philip; Lloyd-Jones, Donald

    2015-01-01

    BACKGROUND Nocturnal blood pressure (BP) is associated with risk for cardiovascular events. However, the relationship between nocturnal BP in young adults and cognitive function in midlife remains unclear. METHODS We used data from the ambulatory BP monitoring substudy of the Coronary Artery Risk Development in Young Adults Study, including 224 participants (mean age 30 years, 45% men, 63% African Americans). At the 20-year follow-up, the Stroop test (executive function), Digit Symbol Substitution Test (psychomotor speed), and Rey Auditory Verbal Learning Test (verbal memory) were assessed. RESULTS Baseline mean office, daytime, and nocturnal BP were 109/73, 120/74, and 107/59mm Hg, respectively. Nocturnal BP dipping, calculated as (nocturnal systolic BP [SBP] − daytime SBP) × 100/daytime SBP, was divided into quartiles (Q1: −39.3% to −16.9%; Q2: −16.8% to −13.2%, Q3 [reference]: −13.1% to −7.8%, and Q4: −7.7% to +56.4%). In multiple regression analyses, the least nocturnal SBP dipping (Q4 vs. reference) and higher nocturnal diastolic BP level were associated with worse Stroop scores, with adjustments for demographic and clinical characteristics, and cumulative exposure to office BP during follow-up (β [standard error]: 0.37 [0.18] and 0.19 [0.07], respectively; all P < 0.05). Digit Symbol Substitution Test and Rey Auditory Verbal Learning Test were not significantly associated with nocturnal SBP dipping or nocturnal SBP/diastolic BP levels. CONCLUSIONS Among healthy young adults, less nocturnal SBP dipping and higher nocturnal diastolic BP levels were associated with lower executive function in midlife, independent of multiple measures of office BP during long-term follow-up. PMID:25783740

  13. The association between nocturia and nocturnal polyuria in clinical and epidemiological studies: a systematic review and meta-analyses.

    PubMed

    Hofmeester, Ilse; Kollen, Boudewijn J; Steffens, Martijn G; Bosch, J L H Ruud; Drake, Marcus J; Weiss, Jeffrey P; Blanker, Marco H

    2014-04-01

    We determined the relationship between nocturia and nocturnal polyuria. The PubMed® and Embase® databases were searched for studies written in English, German, French or Dutch with original data on adult participants in an investigation of the relationship between nocturia and nocturnal polyuria. A meta-analysis of the difference in mean nocturnal voiding frequencies between patients with and without nocturnal polyuria was conducted. Nocturnal polyuria risk was compared between participants with and without nocturia, and the resulting odds ratio was subsequently converted to relative risk with 95% CIs. From 511 references identified we selected 78 publications of 66 studies, 15 of which met the inclusion criteria for this study. Quality scores of studies were generally high for internal validity but low for external validity. In 7 studies (1,416 participants) we estimated a standardized mean difference of 0.59 (95% CI 0.29-0.89) for nocturnal voids between nocturnal polyuria and nonnocturnal polyuria cases. In 8 other studies (with 2,320 participants) we calculated a pooled OR of 4.99 (3.92-6.37) for nocturnal polyuria in individuals with nocturia. The corresponding RR, based on a nocturnal polyuria risk in the pooled population of 63.8%, was 1.41 (1.37-1.44). The association between nocturia and nocturnal polyuria is apparent and robust. However, the clinical importance of the association appears to be less obvious than previously suggested based on single studies. The observed high prevalence of nocturnal polyuria, as a result of the applied International Continence Society definition, may be responsible for this discrepancy. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. Pediatric Psychology: Applications to the Schools Needs of Children with Health Disorders.

    ERIC Educational Resources Information Center

    Perry, Joseph D.; Flanagan, William K.

    1986-01-01

    A review of pediatric psychology considers interventions by school personnel to promote the school adjustment of children with serious medical illness. Psychosocial and educational impacts of cancer, spina bifida, enuresis, and encopresis are discussed; and suggestions for managing children with chronic health disorders, serious illness, and…

  15. Collaborative Assessment and Treatment of Children with Enuresis and Encopresis.

    ERIC Educational Resources Information Center

    Geroski, Anne M.; Rodgers, Kevin A.

    1998-01-01

    Signs, symptoms, and definitions that distinguish occasional incontinence of urine or bowel from more serious problems are reviewed, and interventions that may help are discussed. The importance of medical involvement is stressed. A case study involving a school counselor is presented for each type of incontinence. (EMK)

  16. Nocturnal Oviposition Behavior of Forensically Important Diptera in Central England.

    PubMed

    Barnes, Kate M; Grace, Karon A; Bulling, Mark T

    2015-11-01

    Timing of oviposition on a corpse is a key factor in entomologically based minimum postmortem interval (mPMI) calculations. However, there is considerable variation in nocturnal oviposition behavior of blow flies reported in the research literature. This study investigated nocturnal oviposition in central England for the first time, over 25 trials from 2011 to 2013. Liver-baited traps were placed in an urban location during control (diurnal), and nocturnal periods and environmental conditions were recorded during each 5-h trial. No nocturnal activity or oviposition was observed during the course of the study indicating that nocturnal oviposition is highly unlikely in central England. © 2015 American Academy of Forensic Sciences.

  17. Nocturnal Eating: Association with Binge Eating, Obesity, and Psychological Distress

    PubMed Central

    Striegel-Moore, Ruth H.; Rosselli, Francine; Wilson, G. Terence; Perrin, Nancy; Harvey, Kate; DeBar, Lynn

    2009-01-01

    Objective To examine clinical correlates of nocturnal eating, a core behavioral symptom of night eating syndrome. Method Data from 285 women who had participated in a two-stage screening for binge eating were utilized. Women (n = 41) who reported one or more nocturnal eating episodes in the past 28 days on the Eating Disorder Examination and women who did not report nocturnal eating (n =244) were compared on eating disorder symptomatology, Body Mass Index (BMI), and on measures of psychosocial adjustment. Results Nocturnal eaters were significantly more likely to report binge eating and differed significantly from non-nocturnal eaters (with responses indicating greater disturbance) on weight and shape concern, eating concern, self-esteem, depression, and functional impairment, but not on BMI or dietary restraint. Group differences remained significant in analyses adjusting for binge eating. Conclusions This study confirms the association between nocturnal eating and binge eating previously found in treatment seeking samples yet also suggests that the elevated eating disorder symptoms and decreased psychosocial adjustment observed in nocturnal eaters is not simply a function of binge eating. PMID:19708071

  18. Removal of nutrient limitations by long-term fertilization decreases nocturnal water loss in savanna trees.

    Treesearch

    F.G. Scholz; S.J. Bucci; G. Goldstein; F.C. Meinzer; A.C. Franco; F. Miralles-Wilhelm

    2007-01-01

    Under certain environmental conditions, nocturnal transpiration can be relatively high in temperate and tropical woody species. In nutrient-poor systems such as the Brazilian Cerrado, nocturnal transpiration may enhance delivery of nutrients to roots. We compared nocturnal transpiration of three dominant Cerrado tree species growing in unfertilized plots and plots to...

  19. Effect of daily sildenafil on patients with absent nocturnal erections due to pelvic fracture urethral disruption: a single-centre experience.

    PubMed

    Peng, J; Zhang, Z; Gao, B; Yuan, Y; Cui, W; Tang, Y; Song, W; Xin, Z

    2016-12-01

    Erectile dysfunction (ED) is a common sequel of pelvic fracture urethral disruption. Those patients with nocturnal erections may respond favourably to sildenafil; however, little is known about the response to sildenafil in patients with absent nocturnal erections. The aim was to evaluate the response to the treatment of sildenafil 50 mg taken once daily in the patients with absent nocturnal erections. From January 2008 to December 2011, a total of 28 patients with absent nocturnal erections were evaluated. We recorded nocturnal penile tumescence and rigidity with an erectometer. If nocturnal erections were absent for three nights, patients were administrated sildenafil 100 mg at bedtime and tested again at the fourth night. Penile duplex ultrasound with intracavernous injection was performed to define the cause of ED. All patients received a daily dose of sildenafil 50 mg for 12 weeks. Response to sildenafil treatment was defined as sustained erections allowing vaginal penetration and intercourse. Twenty-three (78%) patients completed the daily sildenafil treatment, and follow-up was available. The nocturnal erections at the fourth night in 13 patients (46.4%) were improved. About 61.5% (8/13) reported effective response to daily sildenafil. The improvement of nocturnal erections induced by sildenafil taken at bedtime might predict the response to sildenafil taken daily. © 2016 Blackwell Verlag GmbH.

  20. Nocturnal Hypoxia and Loss of Kidney Function

    PubMed Central

    Ahmed, Sofia B.; Ronksley, Paul E.; Hemmelgarn, Brenda R.; Tsai, Willis H.; Manns, Braden J.; Tonelli, Marcello; Klarenbach, Scott W.; Chin, Rick; Clement, Fiona M.; Hanly, Patrick J.

    2011-01-01

    Background Although obstructive sleep apnea (OSA) is more common in patients with kidney disease, whether nocturnal hypoxia affects kidney function is unknown. Methods We studied all adult subjects referred for diagnostic testing of sleep apnea between July 2005 and December 31 2007 who had serial measurement of their kidney function. Nocturnal hypoxia was defined as oxygen saturation (SaO2) below 90% for ≥12% of the nocturnal monitoring time. The primary outcome, accelerated loss of kidney function, was defined as a decline in estimated glomerular filtration rate (eGFR) ≥4 ml/min/1.73 m2 per year. Results 858 participants were included and followed for a mean study period of 2.1 years. Overall 374 (44%) had nocturnal hypoxia, and 49 (5.7%) had accelerated loss of kidney function. Compared to controls without hypoxia, patients with nocturnal hypoxia had a significant increase in the adjusted risk of accelerated kidney function loss (odds ratio (OR) 2.89, 95% confidence interval [CI] 1.25, 6.67). Conclusion Nocturnal hypoxia was independently associated with an increased risk of accelerated kidney function loss. Further studies are required to determine whether treatment and correction of nocturnal hypoxia reduces loss of kidney function. PMID:21559506

  1. [Nocturnal continuous subcutaneous insulin infusion--a therapeutic possibility in labile type I diabetes under exceptional conditions].

    PubMed

    Bruns, W; Steinborn, F; Menzel, R; Staritz, B; Bibergeil, H

    1990-03-15

    The whole-day continuous subcutaneous insulin infusion (CSII) with portable pumps in daily blood glucose autocontrol guarantees a more stabile and favourable glycaemia than multiple injections in labile type I diabetics. The success is mainly to be traced back to the continuous replacement of the basal secretion, particularly to the nocturnal fasting phase. In this study the effect on the glycaemia is investigated with exclusively nocturnal administration of the CSII under maintenance of multiple insulin injections during this day. In a group of 18 type I diabetics the nocturnal CSII in comparison to intermediate insulin administrations in the evening led to a significant improvement of glycaemia (p less than 0.01), in particular to the decrease of the fasting blood sugars (p less than 0.05). In two casuistic observations in comparison to all the other conventional methods for the compensation of the nocturnal glycaemia (depot insulin, nocturnal injection of normal insulin) the nocturnal CSII proved to be superior. Therefore, the nocturnal CSII is an--though more rarely to be used--alternative, which may be taken into consideration, of a whole-day CSII is temporarily unwished for.

  2. Recurrence of stroke caused by nocturnal hypoxia-induced blood pressure surge in a young adult male with severe obstructive sleep apnea syndrome.

    PubMed

    Yoshida, Tetsuro; Kuwabara, Mitsuo; Hoshide, Satoshi; Kario, Kazuomi

    2016-03-01

    Obstructive sleep apnea syndrome (OSAS) causes resistant hypertension and a hypopnea-related nocturnal blood pressure (BP) surge. This could lead to an increase of not only the nocturnal BP level but also nocturnal BP variability, both of which increase an individual's cardiovascular risk. We recently developed a trigger sleep BP monitoring method that initiates BP measurement when an individual's oxygen desaturation falls below a variable threshold, and we demonstrated that it can detect a BP surge during apnea episodes. We here report the case of a 36-year-old man with severe OSAS who experienced the recurrence of stroke due to nocturnal hypoxia and a nocturnal BP surge measured by this trigger sleep BP monitoring device. A nocturnal BP surge during sleep in OSAS patients could be a strong trigger of cardiovascular events. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  3. Impact of nocturnal heartburn on quality of life, sleep, and productivity: the SINERGE study.

    PubMed

    Calleja, José Luis; Bixquert, M; Maldonado, J

    2007-10-01

    The aim of the SINERGE study was to assess the impact of nocturnal heartburn on quality of life, sleep, and productivity. Ambulatory patients >/=18 years old and classified as defined cases of nocturnal heartburn (n=337), nonnocturnal heartburn (n=139), uncontrolled hypertension (n=198), and symptomatic depression (n=104) were included in this cross-sectional study. Information on age, gender, body mass index, and comorbidity was collected and the following validated questionnaires were applied: SF-12, Pittsburgh Sleep Quality Index, and Work Productivity and Activity Impairment questionnaire. The prevalence of primary care consultation for heartburn and nocturnal heartburn was 4.7% and 1.9%, respectively. Health-related quality of life, sleep, and productivity were significantly impaired in patients with frequent nocturnal heartburn symptoms as compared with those of the patients without nocturnal symptoms or patients with hypertension. Nocturnal heartburn poses a considerable burden for the sufferer because of the impact on quality of life, sleep, and daily activities.

  4. Nocturnal Asthma

    MedlinePlus

    ... caused by an upper airway obstruction Treatment and Management Treatment of any underlying causes of nocturnal asthma ... trials . Asthma Types Allergic Asthma Nocturnal Asthma Patients & Visitors Giving For Professionals About Us Treatment & Programs Health ...

  5. Comparing the effects of nocturnal sleep and daytime napping on declarative memory consolidation.

    PubMed

    Lo, June C; Dijk, Derk-Jan; Groeger, John A

    2014-01-01

    Nocturnal sleep and daytime napping facilitate memory consolidation for semantically related and unrelated word pairs. We contrasted forgetting of both kinds of materials across a 12-hour interval involving either nocturnal sleep or daytime wakefulness (experiment 1) and a 2-hour interval involving either daytime napping or wakefulness (experiment 2). Beneficial effects of post-learning nocturnal sleep and daytime napping were greater for unrelated word pairs (Cohen's d=0.71 and 0.68) than for related ones (Cohen's d=0.58 and 0.15). While the size of nocturnal sleep and daytime napping effects was similar for unrelated word pairs, for related pairs, the effect of nocturnal sleep was more prominent. Together, these findings suggest that sleep preferentially facilitates offline memory processing of materials that are more susceptible to forgetting.

  6. Technical advances in flow cytometry-based diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria

    PubMed Central

    Correia, Rodolfo Patussi; Bento, Laiz Cameirão; Bortolucci, Ana Carolina Apelle; Alexandre, Anderson Marega; Vaz, Andressa da Costa; Schimidell, Daniela; Pedro, Eduardo de Carvalho; Perin, Fabricio Simões; Nozawa, Sonia Tsukasa; Mendes, Cláudio Ernesto Albers; Barroso, Rodrigo de Souza; Bacal, Nydia Strachman

    2016-01-01

    ABSTRACT Objective: To discuss the implementation of technical advances in laboratory diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria for validation of high-sensitivity flow cytometry protocols. Methods: A retrospective study based on analysis of laboratory data from 745 patient samples submitted to flow cytometry for diagnosis and/or monitoring of paroxysmal nocturnal hemoglobinuria. Results: Implementation of technical advances reduced test costs and improved flow cytometry resolution for paroxysmal nocturnal hemoglobinuria clone detection. Conclusion: High-sensitivity flow cytometry allowed more sensitive determination of paroxysmal nocturnal hemoglobinuria clone type and size, particularly in samples with small clones. PMID:27759825

  7. Nocturnal bees are attracted by widespread floral scents.

    PubMed

    Carvalho, Airton Torres; Maia, Artur Campos Dalia; Ojima, Poliana Yumi; dos Santos, Adauto A; Schlindwein, Clemens

    2012-03-01

    Flower localization in darkness is a challenging task for nocturnal pollinators. Floral scents often play a crucial role in guiding them towards their hosts. Using common volatile compounds of floral scents, we trapped female nocturnal Megalopta-bees (Halictidae), thus uncovering olfactory cues involved in their search for floral resources. Applying a new sampling method hereby described, we offer novel perspectives on the investigation of nocturnal bees.

  8. Nocturnal intermittent hypoxia and C reactive protein among middle-aged community residents: a cross-sectional survey.

    PubMed

    Muraki, Isao; Tanigawa, Takeshi; Yamagishi, Kazumasa; Sakurai, Susumu; Ohira, Tetsuya; Imano, Hironori; Kitamura, Akihiko; Kiyama, Masahiko; Sato, Shinichi; Shimamoto, Takashi; Konishi, Masamitsu; Iso, Hiroyasu

    2010-06-01

    There are conflicting results for the association between obstructive sleep apnoea and raised C reactive protein (CRP) levels. A study was undertaken to investigate whether nocturnal intermittent hypoxia, a surrogate marker for obstructive sleep apnoea, was associated with CRP levels among a community-dwelling Japanese population. Among participants in the Circulatory Risk in Communities Study (CIRCS), 1422 male and 2466 female community residents aged 40-69 years were tested during sleep. No nocturnal intermittent hypoxia, mild nocturnal intermittent hypoxia and moderate to severe nocturnal intermittent hypoxia were defined using 3% oxygen desaturation index cut-off points at 5 and 15 events/h, respectively. High-sensitivity CRP levels were measured using a latex particle-enhanced immunonephelometric assay. Multivariate analysis was adjusted for age, sex, body mass index, smoking status, current alcohol intake, hypertension, hypercholesterolaemia, diabetes mellitus and menopausal status for women. Multivariable-adjusted mean CRP levels among men were 0.70 mg/l (95% CI 0.65 to 0.75) for no nocturnal intermittent hypoxia, 0.82 mg/l (95% CI 0.74 to 0.89) for mild nocturnal intermittent hypoxia and 0.84 mg/l (95% CI 0.70 to 1.00) for moderate to severe nocturnal intermittent hypoxia (p for trend=0.03). The values for women were 0.59 mg/l (95% CI 0.57 to 0.62), 0.66 mg/l (95% CI 0.59 to 0.73) and 0.82 mg/l (95% CI 0.62 to 1.03), respectively (p for trend=0.008). Compared with no nocturnal intermittent hypoxia, the prevalence of a high CRP level (>or=1.0 mg/l) was 1.4-1.7-fold higher for mild to severe nocturnal intermittent hypoxia in both sexes. Nocturnal intermittent hypoxia is associated with raised serum CRP levels among middle-aged Japanese subjects.

  9. Nocturnal and Circadian Rhythm of Blood Pressure Is Associated with Renal Structure Damage and Function in Patients with IgAN.

    PubMed

    Lin, Lirong; Zhang, Huhai; Yang, Jurong; Zhang, Jianguo; Li, Kailong; Huo, Bengang; Dai, Huanzi; Zhang, Weiwei; Yang, Jie; Tan, Wei; He, Yani

    2016-01-01

    Abnormal circadian rhythm of blood pressure (BP) is closely related to target organ damage in hypertension. However, the association between abnormal circadian rhythm of BP and renal injury is not clear. We investigated whether renal injury is associated with nocturnal BP and circadian rhythm of BP in Chinese IgAN patients. Clinic and 24 h ambulatory BP monitoring data were obtained from 330 Chinese IgAN patients with mean 24 h BP < 130/80 and mean daytime BP < 135/85 mmHg. Renal histopathological injury was determined according to the Oxford classification of IgAN. Among the 330 IgAN subjects, 35.8% suffered from nocturnal hypertension, 61.5% had abnormal circadian BP, and 27% had nocturnal hypertension with a nondipping pattern. Compared with nocturnal normotensive patients, patients with nocturnal hypertension had significantly higher levels of blood cystatin C, blood uric acid, and lower estimated glomerular filtration rate (eGFR), and significantly a higher mean renal tissue injury score. The nondipping hypertensive group had significantly higher nocturnal diastolic and systolic BP, blood uric acid, and glomerulosclerosis rates, whereas eGFR was lower. In nondipping hypertensive patients, urinary sodium excretion and renal tissue injury scores were significantly higher than dipping patients. Nocturnal hypertension and abnormal circadian BP correlated with renal tissue injury, renal interstitial fibrosis, and aortic arch atherosclerosis. Abnormal circadian rhythm of BP and nocturnal hypertension are common clinical manifestations in Chinese IgAN patients with normal mean 24 h BP. Abnormal circadian BP and nocturnal hypertension may accelerate IgAN progression by inducing renal dysfunction and histopathological damage. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

  10. The effect of dexlansoprazole MR on nocturnal heartburn and GERD-related sleep disturbances in patients with symptomatic GERD.

    PubMed

    Fass, Ronnie; Johnson, David A; Orr, William C; Han, Cong; Mody, Reema; Stern, Kathleen N; Pilmer, Betsy L; Perez, M Claudia

    2011-03-01

    Nocturnal heartburn and related sleep disturbances are common among patients with gastroesophageal reflux disease (GERD). This study evaluated the efficacy of dexlansoprazole MR 30 mg in relieving nocturnal heartburn and GERD-related sleep disturbances, improving work productivity, and decreasing nocturnal symptom severity in patients with symptomatic GERD. Patients (N=305) with frequent, moderate-to-very severe nocturnal heartburn and associated sleep disturbances were randomized 1:1 in a double-blind fashion to receive dexlansoprazole MR or placebo once daily for 4 weeks. The primary end point was the percentage of nights without heartburn. Secondary end points were the percentage of patients with relief of nocturnal heartburn and of GERD-related sleep disturbances over the last 7 days of treatment. At baseline and week 4/final visit, patients completed questionnaires that assessed sleep quality, work productivity, and the severity and impact of nocturnal GERD symptoms. Dexlansoprazole MR 30 mg (n=152) was superior to placebo (n=153) in median percentage of nights without heartburn (73.1 vs. 35.7%, respectively; P<0.001). Dexlansoprazole MR was significantly better than placebo in percentage of patients with relief of nocturnal heartburn and GERD-related sleep disturbances (47.5 vs. 19.6%, 69.7 vs. 47.9%, respectively; P<0.001), and led to significantly greater improvements in sleep quality and work productivity and decreased nocturnal symptom severity. Adverse events were similar across treatment groups. In patients with symptomatic GERD, dexlansoprazole MR 30 mg is significantly more efficacious than placebo in providing relief from nocturnal heartburn, in reducing GERD-related sleep disturbances and the consequent impairments in work productivity, and in improving sleep quality/quality of life.

  11. Comparing the Effects of Nocturnal Sleep and Daytime Napping on Declarative Memory Consolidation

    PubMed Central

    Lo, June C.; Dijk, Derk-Jan; Groeger, John A.

    2014-01-01

    Nocturnal sleep and daytime napping facilitate memory consolidation for semantically related and unrelated word pairs. We contrasted forgetting of both kinds of materials across a 12-hour interval involving either nocturnal sleep or daytime wakefulness (experiment 1) and a 2-hour interval involving either daytime napping or wakefulness (experiment 2). Beneficial effects of post-learning nocturnal sleep and daytime napping were greater for unrelated word pairs (Cohen’s d = 0.71 and 0.68) than for related ones (Cohen’s d = 0.58 and 0.15). While the size of nocturnal sleep and daytime napping effects was similar for unrelated word pairs, for related pairs, the effect of nocturnal sleep was more prominent. Together, these findings suggest that sleep preferentially facilitates offline memory processing of materials that are more susceptible to forgetting. PMID:25229457

  12. The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial

    PubMed Central

    Rocco, Michael V.; Lockridge, Robert S.; Beck, Gerald J.; Eggers, Paul W.; Gassman, Jennifer J.; Greene, Tom; Larive, Brett; Chan, Christopher T.; Chertow, Glenn M.; Copland, Michael; Hoy, Christopher D.; Lindsay, Robert M.; Levin, Nathan W.; Ornt, Daniel B.; Pierratos, Andreas; Pipkin, Mary F.; Rajagopalan, Sanjay; Stokes, John B.; Unruh, Mark L.; Star, Robert A.; Kliger, Alan S.

    2013-01-01

    Prior small studies have shown multiple benefits of frequent nocturnal hemodialysis compared to conventional three times per week treatments. To study this further, we randomized 87 patients to three times per week conventional hemodialysis or to nocturnal hemodialysis six times per week, all with single-use high-flux dialyzers. The 45 patients in the frequent nocturnal arm had a 1.82-fold higher mean weekly stdKt/Vurea, a 1.74-fold higher average number of treatments per week, and a 2.45-fold higher average weekly treatment time than the 42 patients in the conventional arm. We did not find a significant effect of nocturnal hemodialysis for either of the two coprimary outcomes (death or left ventricular mass (measured by MRI) with a hazard ratio of 0.68, or of death or RAND Physical Health Composite with a hazard ratio of 0.91). Possible explanations for the left ventricular mass result include limited sample size and patient characteristics. Secondary outcomes included cognitive performance, self-reported depression, laboratory markers of nutrition, mineral metabolism and anemia, blood pressure and rates of hospitalization, and vascular access interventions. Patients in the nocturnal arm had improved control of hyperphosphatemia and hypertension, but no significant benefit among the other main secondary outcomes. There was a trend for increased vascular access events in the nocturnal arm. Thus, we were unable to demonstrate a definitive benefit of more frequent nocturnal hemodialysis for either coprimary outcome. PMID:21775973

  13. Heavy rainfall triggers increased nocturnal flight in desert populations of the Pacific black duck (Anas superciliosa).

    PubMed

    McEvoy, J F; Ribot, R F H; Wingfield, J C; Bennett, A T D

    2017-12-14

    Understanding of avian nocturnal flight comes mainly from northern hemisphere species in seasonal temperate ecosystems where nocturnal flight is often precisely timed and entrained by annual photoperiod. Here we investigate patterns of nocturnal flight in waterbirds of Australian desert ecosystems that fly considerable distances to find temporary water bodies formed from rainfall which is highly unpredictable seasonally and spatially, and when there is sufficient water, they then breed. How they perform these feats of navigation and physiology remain poorly known. Using GPS tracking of 38 satellite tagged Pacific black ducks (Anas superciliosa) in two contrasting ecosystems, before and after heavy rainfall we revealed a key role for facultative nocturnal flight in the movement ecology of this species. After large rainfall events, birds rapidly increased nocturnal flight activity in the arid aseasonal ecosystem, but not in the mesic seasonal one. Nocturnal flights occurred throughout the night in both ecosystems. Long range flights (>50 km in 2 hours) occurred almost exclusively at night; at night the distance flown was higher than during the day, birds visited more locations, and the locations were more widely dispersed. Our work reveals that heavy rainfall triggers increased nocturnal flight activity in desert populations of waterbirds.

  14. Nocturnal Gastroesophageal Reflux Revisited by Impedance-pH Monitoring

    PubMed Central

    Blondeau, Kathleen; Mertens, Veerle; Tack, Jan; Sifrim, Daniel

    2011-01-01

    Background/Aims Impedance-pH monitoring allows detailed characterization of gastroesophageal reflux and esophageal activity associated with reflux. We assessed the characteristics of nocturnal reflux and esophageal activity preceding and following reflux. Methods Impedance-pH tracings from 11 healthy subjects and 76 patients with gastroesophageal reflux disease off acid-suppressive therapy were analyzed. Characteristics of nocturnal supine reflux, time distribution and esophageal activity seen on impedance at 2 minute intervals preceding and following reflux were described. Results Patients had more nocturnal reflux events than healthy subjects (8 [4-12] vs 2 [1-5], P = 0.002), with lower proportion of weakly acidic reflux (57% [35-78] vs 80% [60-100], P = 0.044). Nocturnal reflux was mainly liquid (80%) and reached the proximal esophagus more often in patients (6% vs 0%, P = 0.047). Acid reflux predominated in the first 2 hours (66%) and weakly acidic reflux in the last 3 hours (70%) of the night. Most nocturnal reflux was preceded by aboral flows and cleared by short lasting volume clearance. In patients, prolonged chemical clearance was associated with less esophageal activity. Conclusions Nocturnal weakly acidic reflux is as common as acid reflux in patients with gastroesophageal reflux disease, and predominates later in the night. Impedance-pH can predict prolonged chemical clearance after nocturnal acid reflux. PMID:21602991

  15. Antidiuretic effects of a nonpeptide vasopressin V(2)-receptor agonist, OPC-51803, administered orally to rats.

    PubMed

    Nakamura, S; Hirano, T; Tsujimae, K; Aoyama, M; Kondo, K; Yamamura, Y; Mori, T; Tominaga, M

    2000-12-01

    OPC-51803 is the first nonpeptide vasopressin (AVP) V(2)-receptor-selective agonist. Its pharmacological profile, including antidiuretic action and receptor binding, was characterized using conscious Brattleboro rats with hereditary diabetes insipidus and Sprague-Dawley rats. In membrane preparations from the liver and kidney, OPC-51803 displaced the [(3)H]AVP binding to V(2)-receptors (K(i) = 49.8 +/- 8.1 nM) more greatly than that to V(1a)-receptors (K(i) = 1061 +/- 60 nM), showing a 21 times higher affinity for V(2)-receptors. At single oral doses of 0.003 to 0.3 mg/kg in female Brattleboro rats, OPC-51803 decreased urine volume (from 10.8 +/- 1.1 to 0.5 +/- 0.2 ml during 0-2 h postdosing) and increased urinary osmolality (from 114 +/- 9 to 432 +/- 114 mOsm/kg) in a dose-dependent manner. During the period of 4-week treatment with OPC-51803, significant and constant antidiuresis was observed. In male Sprague-Dawley rats with normal plasma AVP levels, OPC-51803 at 0.03 to 0.3 mg/kg also produced a dose-dependent antidiuretic action (urine volume: from 2.6 +/- 0.6 to 1.1 +/- 0.2 ml at 0-4 h postdosing). Few changes in urinary parameters, serum parameters, or plasma hormone levels were observed. OPC-51803 did not change blood pressure or heart rate, or inhibit AVP-induced pressor response even at 30 mg/kg p.o. These results demonstrate that OPC-51803 is a V(2)-selective agonist that produces a significant antidiuretic action after single and multiple oral dosing in AVP-deficient and normal AVP states. The data suggest that OPC-51803 is a useful therapeutic drug in the treatment of hypothalamic diabetes insipidus, nocturnal enuresis, and some kinds of urinary incontinence.

  16. Efficacy of a Mandibular Advancement Appliance on Sleep Disordered Breathing in Children: A Study Protocol of a Crossover Randomized Controlled Trial.

    PubMed

    Idris, Ghassan; Galland, Barbara; Robertson, Christopher J; Farella, Mauro

    2016-01-01

    Sleep-Disordered Breathing (SDB) varies from habitual snoring to partial or complete obstruction of the upper airway and can be found in up to 10% of children. SDB can significantly affect children's wellbeing, as it can cause growth disorders, educational and behavioral problems, and even life-threatening conditions, such as cardiorespiratory failure. Adenotonsillectomy represents the primary treatment for pediatric SDB where adeno-tonsillar hypertrophy is indicated. For those with craniofacial anomalies, or for whom adenotonsillectomy or other treatment modalities have failed, or surgery is contra-indicated, mandibular advancement splints (MAS) may represent a viable treatment option. Whilst the efficacy of these appliances has been consistently demonstrated in adults, there is little information about their effectiveness in children. To determine the efficacy of mandibular advancement appliances for the management of SDB and related health problems in children. The study will be designed as a single-blind crossover randomized controlled trial with administration of both an "Active MAS" (Twin-block) and a "Sham MAS." Eligible participants will be children aged 8-12 years whose parents report they snore ≥3 nights per week. Sixteen children will enter the full study after confirming other inclusion criteria, particularly Skeletal class I or class II confirmed by lateral cephalometric radiograph. Each child will be randomly assigned to either a treatment sequence starting with the Active or the Sham MAS. Participants will wear the appliances for 3 weeks separated by a 2-week washout period. For each participant, home-based polysomnographic data will be collected four times; once before and once after each treatment period. The Apnea Hypopnea Index (AHI) will represent the main outcome variable. Secondary outcomes will include, snoring frequency, masseter muscle activity, sleep symptoms, quality of life, daytime sleepiness, children behavior, and nocturnal enuresis. In addition, blood samples will be collected to assess growth hormone changes. This study was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR): [ACTRN12614001013651].

  17. [Autoimmune neuropsychiatric disorders associated to infection by streptococcus in the paediatric age: PANDAS].

    PubMed

    Betancourt, Y M; Jiménez-León, J C; Jiménez-Betancourt, C S; Castillo, V E

    2003-02-01

    The acronym PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus) describes the neuropsychiatric disorders resulting from an autoimmune response to an infection by streptococcus in children. The aim of this study was to clinically analyse 38 patients under the age of 16 with tics, Tourette syndrome (TS) or obsessive compulsive disorder (OCD) and their possible association to an infection caused by group A beta-haemolytic streptococcus (GABHS). We reviewed the medical records at the Instituto Neurológico in Valencia (Venezuela) over a 12 year period (1988-2000). All the patients met the inclusion criteria set out by the National Institute of Mental Health in Bethesda (1997) and the DSM-IV. Onset of the symptoms was higher in the group of schoolchildren (n=24), followed by the group of preschool children (n=8) and adolescents (n=6). Males were predominant (n=33) (86.8%). 17 patients presented chronic tics (44.7%), 13 had transitory tics (34.2%) and there were eight cases of TS (21.1%). The most frequently related comorbid disorders were: difficulties in learning (n=30) (78.9%), ADHD (n=27) (71.1%), OCD 14 (36.8%), sleep disorders (n=14) (36.8%), behavioural disorders (n=12) (31.6%), language disorders (n=11) (28.9%), psychomotor disorders (n=10) (26.3%) and nocturnal enuresis (n=7) (18.4%). Electroencephalogram patterns were abnormal in 72.4% (n=12), and the disorganised pattern was the most frequently observed (n=12) (41.4%), followed by a slow diffuse pattern (n= 7) (24.1%) and the left centro-parieto-temporal focal paroxysmal specific pattern (n=7) (24.1%). Less frequently we found unspecific generalised paroxysmal patterns, in four cases (13.8%), and asymmetrical patterns (n=1) (3.4%). The association with an infection by streptococcus was shown in two cases, which amounted to 5.2% of the sample. The obtained are similar to those reported in the literature. Only 5.2% of the cases were linked to a prior streptococcus infection.

  18. Visual reliability and information rate in the retina of a nocturnal bee.

    PubMed

    Frederiksen, Rikard; Wcislo, William T; Warrant, Eric J

    2008-03-11

    Nocturnal animals relying on vision typically have eyes that are optically and morphologically adapted for both increased sensitivity and greater information capacity in dim light. Here, we investigate whether adaptations for increased sensitivity also are found in their photoreceptors by using closely related and fast-flying nocturnal and diurnal bees as model animals. The nocturnal bee Megalopta genalis is capable of foraging and homing by using visually discriminated landmarks at starlight intensities. Megalopta's near relative, Lasioglossum leucozonium, performs these tasks only in bright sunshine. By recording intracellular responses to Gaussian white-noise stimuli, we show that photoreceptors in Megalopta actually code less information at most light levels than those in Lasioglossum. However, as in several other nocturnal arthropods, Megalopta's photoreceptors possess a much greater gain of transduction, indicating that nocturnal photoreceptors trade information capacity for sensitivity. By sacrificing photoreceptor signal-to-noise ratio and information capacity in dim light for an increased gain and, thus, an increased sensitivity, this strategy can benefit nocturnal insects that use neural summation to improve visual reliability at night.

  19. Effects of moderate and heavy endurance exercise on nocturnal HRV.

    PubMed

    Hynynen, E; Vesterinen, V; Rusko, H; Nummela, A

    2010-06-01

    This study examined the effects of endurance exercise on nocturnal autonomic modulation. Nocturnal R-R intervals were collected after a rest day, after a moderate endurance exercise and after a marathon run in ten healthy, physically active men. Heart rate variability (HRV) was analyzed as a continuous four-hour period starting 30 min after going to bed for sleep. In relation to average nocturnal heart rate after rest day, increases to 109+/-6% and 130+/-11% of baseline were found after moderate endurance exercise and marathon, respectively. Standard deviation of R-R intervals decreased to 90+/-9% and 64+/-10%, root-mean-square of differences between adjacent R-R intervals to 87+/-10% and 55+/-16%, and high frequency power to 77+/-19% and 34+/-19% of baseline after moderate endurance exercise and marathon, respectively. Also nocturnal low frequency power decreased to 56+/-26% of baseline after the marathon. Changes in nocturnal heart rate and HRV suggest prolonged dose-response effects on autonomic modulation after exercises, which may give useful information on the extent of exercise-induced nocturnal autonomic modulation and disturbance to the homeostasis.

  20. A clinical investigation of the mechanism of loxoprofen, a non-steroidal anti-inflammatory drug, for patients with nocturia.

    PubMed

    Araki, Tohru; Yokoyama, Teruhiko; Araki, Motoo; Furuya, Seiji

    2008-12-01

    We previously reported the effectiveness of loxoprofen sodium (loxoprofen), a non-steroidal anti-inflammatory drug, for patients with lower urinary tract symptoms (LUTS) complaining of nocturia. In this study, we explored the mechanism of loxoprofen in the treatment of nocturia. Fifty-six patients complaining of nocturia were enrolled. They took a single 60-mg tablet of loxoprofen at bedtime for 14 days. The effects of this treatment were assessed by bladder diaries. Nocturia improved (nocturia decreased >or=1 void/night) in 40 patients (71.4%). Nocturnal urine volume was reduced in 31 of 40 (77.5%) without nocturnal single-void volume increase. Nocturnal single-void volume increased in 4 of 40 (10.0%) without nocturnal urine volume reduction. Two of 40 (5.0%) demonstrated both nocturnal urine volume reduction and nocturnal single-void volume increase. Three (7.5%) were exceptions to the above. In conclusion, the main mechanism of loxoprofen is the reduction of nocturnal urine volume for the treatment of nocturia and the second mechanism is the increased bladder capacity.

  1. The risks of nocturnal hypoglycaemia in insulin-treated diabetes.

    PubMed

    Graveling, Alex J; Frier, Brian M

    2017-11-01

    Over half of all episodes of severe hypoglycaemia (requiring external help) occur during sleep, but nocturnal hypoglycaemia is often asymptomatic and unrecognised. The precise incidence of nocturnal hypoglycaemia is difficult to determine with no agreed definition, but continuous glucose monitoring has shown that it occurs frequently in people taking insulin. Attenuation of the counter-regulatory responses to hypoglycaemia during sleep may explain why some episodes are undetected and more prolonged, and modifies cardiovascular responses. The morbidity and mortality associated with nocturnal hypoglycaemia is probably much greater than realised, causing seizures, coma and cardiovascular events and affecting quality of life, mood and work performance the following day. It may induce impaired awareness of hypoglycaemia. Cardiac arrhythmias that occur during nocturnal hypoglycaemia include bradycardia and ectopics that may provoke dangerous arrhythmias. Treatment strategies are discussed that may help to minimise the frequency of nocturnal hypoglycaemia. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Associations of Sleep Quality and Awake Physical Activity with Fluctuations in Nocturnal Blood Pressure in Patients with Cardiovascular Risk Factors

    PubMed Central

    Kadoya, Manabu; Koyama, Hidenori; Kurajoh, Masafumi; Naka, Mariko; Miyoshi, Akio; Kanzaki, Akinori; Kakutani, Miki; Shoji, Takuhito; Moriwaki, Yuji; Yamamoto, Tetsuya; Inaba, Masaaki; Namba, Mitsuyoshi

    2016-01-01

    Background Sleep quality and awake physical activity are important behavioral factors involved in the occurrence of cardiovascular diseases, potentially through nocturnal blood pressure (BP) changes. However, the impacts of quantitatively measured sleep quality and awake physical activity on BP fluctuation, and their relationships with several candidate causal factors for nocturnal hypertension are not well elucidated. Methods This cross-sectional study included 303 patients registered in the HSCAA study. Measurements included quantitatively determined sleep quality parameters and awake physical activity obtained by actigraph, nocturnal systolic BP (SBP) fall [100 × (1- sleep SBP/awake SBP ratio)], apnea hypopnea index, urinary sodium and cortisol secretion, plasma aldosterone concentration and renin activity, insulin resistance index, parameters of heart rate variability (HRV), and plasma brain-derived neurotrophic factor (BDNF). Results Simple regression analysis showed that time awake after sleep onset (r = -0.150), a parameter of sleep quality, and awake physical activity (r = 0.164) were significantly correlated with nocturnal SBP fall. Among those, time awake after sleep onset (β = -0.179) and awake physical activity (β = 0.190) were significantly and independently associated with nocturnal SBP fall in multiple regression analysis. In a subgroup of patients without taking anti-hypertensive medications, both time awake after sleep onset (β = -0.336) and awake physical activity (β = 0.489) were more strongly and independently associated with nocturnal SBP falls. Conclusion Sleep quality and awake physical activity were found to be significantly associated with nocturnal SBP fall, and that relationship was not necessarily confounded by candidate causal factors for nocturnal hypertension. PMID:27166822

  3. Evaluation of the occurrence and diagnose definitions for Nocturnal Polyuria in Spinal Cord Injured patients during rehabilitation.

    PubMed

    Viaene, Annick; Denys, Marie-Astrid; Goessaert, An-Sofie; Claeys, Jana; Raes, Ann; Roggeman, Saskia; Everaert, Karel

    2017-11-03

    Little is known about the occurrence of nocturnal polyuria in spinal cord injured (SCI) patients and the definitions which are preferable in this population. To determine the occurrence of nocturnal polyuria (NP) in spinal cord injured patients during in-patient rehabilitation in the Ghent University Hospital. To study the influence of different time periods (daytime, bed rest and sleep) on the accuracy of the existing diagnose definitions for NP specifically for this type of patients. Retrospective study using patient records. SCI patients during hospital based rehabilitation between 2011 and 2014. Seventy-four SCI patients were selected and their records of frequency-volume charts were examined, after exclusion of unreliable data, forty-seven patients were retained for the current study. Retrospective study using data from frequency-volume charts of either two or three days from patients with SCI. Nocturnal urine production (NUP) and nocturnal polyuria index (NPi) were calculated. There was a significant increase in diuresis, calculated as urine production, between day time and bed rest (p=0.008) and between day time and sleep (p=0.001). All patients showed nocturnal polyuria during a 12-hour night time period (including both bed rest and sleep) and 39 patients showed nocturnal polyuria during the 8 hour period of sleep. There was no significant difference in mean urine production between bed rest and sleep. Prevalence of NP did not significantly differ between the complete or incomplete SCI patients or between patients with higher and lower SCI levels. This study showed that the occurrence of nocturnal polyuria in patients with SCI is high and that it is important to consider which definitions of NP are used for diagnosis. Increase in diuresis is observed during bed rest and sleep and the diagnose is correctly estimated when nocturnal urine production definitions are used in both time periods. In accordance with what was expected, diagnose of NP was overestimated when nocturnal polyuria index type definitions were used. It is important to be aware of the frequent occurrence of nocturnal polyuria in spinal cord injury patients and the impact of their daily routine to the accuracy of the diagnosis of NP. More knowledge about this topic can help to avoid incontinence caused by nocturnal polyuria.

  4. Elevated nocturnal NEFA are an early signal for hyperinsulinaemic compensation during diet-induced insulin resistance in dogs.

    PubMed

    Broussard, Josiane L; Kolka, Cathryn M; Castro, Ana V B; Asare Bediako, Isaac; Paszkiewicz, Rebecca L; Szczepaniak, Edward W; Szczepaniak, Lidia S; Knutson, Kristen L; Kim, Stella P; Bergman, Richard N

    2015-11-01

    A normal consequence of increased energy intake and insulin resistance is compensatory hyperinsulinaemia through increased insulin secretion and/or reduced insulin clearance. Failure of compensatory mechanisms plays a central role in the pathogenesis of type 2 diabetes mellitus; consequently, it is critical to identify in vivo signal(s) involved in hyperinsulinaemic compensation. We have previously reported that high-fat feeding leads to an increase in nocturnal NEFA concentration. We therefore designed this study to test the hypothesis that elevated nocturnal NEFA are an early signal for hyperinsulinaemic compensation for insulin resistance. Blood sampling was conducted in male dogs to determine 24 h profiles of NEFA at baseline and during high-fat feeding with and without acute nocturnal NEFA suppression using a partial A1 adenosine receptor agonist. High-fat feeding increased nocturnal NEFA and reduced insulin sensitivity, effects countered by an increase in acute insulin response to glucose (AIR(g)). Pharmacological NEFA inhibition after 8 weeks of high-fat feeding lowered NEFA to baseline levels and reduced AIR(g) with no effect on insulin sensitivity. A significant relationship emerged between nocturnal NEFA levels and AIR(g). This relationship indicates that the hyperinsulinaemic compensation induced in response to high-fat feeding was prevented when the nocturnal NEFA pattern was returned to baseline. Elevated nocturnal NEFA are an important signal for hyperinsulinaemic compensation during diet-induced insulin resistance.

  5. Effects of exercise intensity and duration on nocturnal heart rate variability and sleep quality.

    PubMed

    Myllymäki, Tero; Rusko, Heikki; Syväoja, Heidi; Juuti, Tanja; Kinnunen, Marja-Liisa; Kyröläinen, Heikki

    2012-03-01

    Acute physical exercise may affect cardiac autonomic modulation hours or even days during the recovery phase. Although sleep is an essential recovery period, the information on nocturnal autonomic modulation indicated by heart rate variability (HRV) after different exercises is mostly lacking. Therefore, this study investigated the effects of exercise intensity and duration on nocturnal HR, HRV, HR, and HRV-based relaxation, as well as on actigraphic and subjective sleep quality. Fourteen healthy male subjects (age 36 ± 4 years, maximal oxygen uptake 49 ± 4 ml/kg/min) performed five different running exercises on separate occasions starting at 6 p.m. with HR guidance at home. The effect of intensity was studied with 30 min of exercises at intensities corresponding to HR level at 45% (easy), 60% (moderate) and 75% (vigorous) of their maximal oxygen uptake. The effect of duration was studied with 30, 60, and 90 min of moderate exercises. Increased exercise intensity elevated nocturnal HR compared to control day (p < 0.001), but it did not affect nocturnal HRV. Nocturnal HR was greater after the day with 90- than 30- or 60-min exercises (p < 0.01) or control day (p < 0.001). Nocturnal HRV was lower after the 90-min exercise day compared to control day (p < 0.01). Neither exercise intensity nor duration had any impact on actigraphic or subjective sleep quality. The results suggest that increased exercise intensity and/or duration cause delayed recovery of nocturnal cardiac autonomic modulation, although long exercise duration was needed to induce changes in nocturnal HRV. Increased exercise intensity or duration does not seem to disrupt sleep quality.

  6. Self-Reported Sleep Bruxism and Nocturnal Gastroesophageal Reflux Disease in Patients with Obstructive Sleep Apnea: Relationship to Gender and Ethnicity§

    PubMed Central

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

    2014-01-01

    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

  7. Self-reported sleep bruxism and nocturnal gastroesophageal reflux disease in patients with obstructive sleep apnea: relationship to gender and ethnicity.

    PubMed

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

    2014-01-01

    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. 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. 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. 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.

  8. The effect of first nocturnal ejaculation timing on risk and sexual behaviors of Korean male adolescents

    PubMed Central

    Lee, Mi-Ji; Yang, Go-Eun; Chueh, Hee Won; Park, Jae Hong

    2017-01-01

    Purpose This study evaluated the effect of first nocturnal ejaculation timing on risk and sexual behaviors of Korean male adolescents. Methods We analyzed data from the 10th edition of the Korea Youth Risk Behavior Web-based survey that was conducted with male high school adolescents in grades 10–12. The survey included 17,907 adolescents, and 10,326 responded their experience of first nocturnal ejaculation. Of these, 595 had their first nocturnal ejaculation in ≤grade 4 (“early puberty”) and 9,731 had their first nocturnal ejaculation in ≥grade 5 (“normal puberty”). We analyzed differences between these 2 groups in risk and sexual behaviors. Results Early first nocturnal ejaculation showed a positive association with sexual intercourse (odds ratio [OR], 3.27; 95% confidence interval [CI], 2.56–4.17), sexual debut at elementary school age (OR, 7.45; 95% CI, 5.00–11.10), and having had a sexually transmitted disease (OR, 6.60; 95% CI, 3.94–11.08). After a multiple logistic regression to adjust for socio-demographic variables, early first nocturnal ejaculation was still positively associated with sexual intercourse (OR, 2.73; 95% CI, 2.03–3.69), sexual debut at elementary school age (OR, 5.96; 95% CI, 3.47–10.22), and having had a sexually transmitted disease (OR, 5.17; 95% CI, 2.52–10.20). Early first nocturnal ejaculation was positively associated with alcohol consumption, smoking, and substance use. However, this was not statistically significant after adjusting for several socio-demographic variables. Conclusion There is a positive association between early nocturnal ejaculation and sexual behaviors in male adolescents. Proactive education about sexual behaviors is required for adolescents who reach sexual maturity early. PMID:28443258

  9. Pollination of Campomanesia phaea (Myrtaceae) by night-active bees: a new nocturnal pollination system mediated by floral scent.

    PubMed

    Cordeiro, G D; Pinheiro, M; Dötterl, S; Alves-Dos-Santos, I

    2017-03-01

    Bees are the most important diurnal pollinators of angiosperms. In several groups of bees a nocturnal/crepuscular habit developed, yet little is known about their role in pollination and whether some plants are adapted specifically to these bees. We used a multidisciplinary approach to investigate the reproductive biology and to understand the role of nocturnal/crepuscular bees in pollination of Campomanesia phaea (Myrtaceae), popularly named cambuci. We studied the floral biology and breeding system of C. phaea. We collected the floral visitors and tested the pollinators' effectiveness. We also determined the floral scents released at night and during daytime, and studied behavioural responses of crepuscular/nocturnal bees towards these scents. The flowers of cambuci were self-incompatible and had pollen as the only resource for flower visitors. Anthesis lasted around 14 h, beginning at 04:30 h at night. The flowers released 14 volatile compounds, mainly aliphatic and aromatic compounds. We collected 52 species of floral visitors, mainly bees. Nocturnal and crepuscular bees (four species) were among the most frequent species and the only effective pollinators. In field bioassays performed at night, nocturnal/crepuscular bees were attracted by a synthetic scent blend consisting of the six most abundant compounds. This study describes the first scent-mediated pollination system between a plant and its nocturnal bee pollinators. Further, C. phaea has several floral traits that do not allow classification into other nocturnal pollination syndromes (e.g. pollinator attraction already before sunrise, with pollen as the only reward), instead it is a plant specifically adapted to nocturnal bees. © 2016 German Botanical Society and The Royal Botanical Society of the Netherlands.

  10. Most nocturnal asthma symptoms occur outside of exacerbations and associate with morbidity.

    PubMed

    Horner, Caroline C; Mauger, David; Strunk, Robert C; Graber, Nora J; Lemanske, Robert F; Sorkness, Christine A; Szefler, Stanley J; Zeiger, Robert S; Taussig, Lynn M; Bacharier, Leonard B

    2011-11-01

    Although nocturnal awakenings help categorize asthma severity and control, their clinical significance has not been thoroughly studied. We sought to determine the clinical consequences of nocturnal asthma symptoms requiring albuterol (NASRAs) in children with mild-to-moderate persistent asthma outside of periods when oral corticosteroids were used for worsening asthma symptoms. Two hundred eighty-five children aged 6 to 14 years with mild-to-moderate persistent asthma were randomized to receive one of 3 controller regimens and completed daily symptom diaries for 48 weeks. Diary responses were analyzed for the frequency and consequences of NASRAs. NASRAs occurred in 72.2% of participants at least once, and in 24.3% of participants, they occurred 13 or more times. The majority (81.3%) of nocturnal symptoms occurred outside of exacerbation periods and were associated the next day with the following events: albuterol use (56.9% of days preceded by nocturnal symptoms vs 18.1% of days not preceded by nocturnal symptoms; relative risk [RR], 2.3; 95% CI, 2.2-2.4), school absence (5.0% vs 0.3%; RR, 10.6; 95% CI, 7.8-14.4), and doctor contact (3.7% vs 0.2%; RR, 8.8; 95% CI, 6.1-12.5). Similar findings were noted during exacerbation periods (RRs of 1.7 for albuterol use, 5.5 for school absence, and 4.9 for doctor contacts). Nocturnal symptoms did not predict the onset of exacerbations. Nocturnal symptoms requiring albuterol in children with mild-to-moderate persistent asthma receiving controller therapy occurred predominantly outside of exacerbation periods. Despite being poor predictors of exacerbations, they were associated with increases in albuterol use, school absences, and doctor contacts the day after nocturnal symptom occurrences. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  11. Temporal Relationships Between Napping and Nocturnal Sleep in Healthy Adolescents.

    PubMed

    Jakubowski, Karen P; Hall, Martica H; Lee, Laisze; Matthews, Karen A

    2017-01-01

    Many adolescents do not achieve the recommended 9 hr of sleep per night and report daytime napping, perhaps because it makes up for short nocturnal sleep. This article tests temporal relationships between daytime naps and nighttime sleep as measured by actigraphy and diary among 236 healthy high school students during one school week. Mixed model analyses adjusted for age, race, and gender demonstrated that shorter actigraphy-assessed nocturnal sleep duration predicted longer napping (measured by actigraphy and diary) the next day. Napping (by actigraphy and diary) predicted shorter nocturnal sleep duration and worse sleep efficiency that night measured by actigraphy. Diary-reported napping also predicted poorer self-reported sleep quality that night. Frequent napping may interfere with nocturnal sleep during adolescence.

  12. Nocturnal hypoglycaemia in Type 1 diabetic patients, assessed with continuous glucose monitoring: frequency, duration and associations.

    PubMed

    Wentholt, I M E; Maran, A; Masurel, N; Heine, R J; Hoekstra, J B L; DeVries, J H

    2007-05-01

    We quantified the occurrence and duration of nocturnal hypoglycaemia in individuals with Type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) or multiple-injection therapy (MIT) using a continuous subcutaneous glucose sensor. A microdialysis sensor was worn at home by 24 patients on CSII (mean HbA(1c) 7.8 +/- 0.9%) and 33 patients on MIT (HbA(1c) 8.7 +/- 1.3%) for 48 h. Occurrence and duration of nocturnal hypoglycaemia were assessed and using multivariate regression analysis, the association between HbA(1c), diabetes duration, treatment type (CSII vs. MIT), fasting and bedtime blood glucose values, total daily insulin dose and mean nocturnal glucose concentrations, and hypoglycaemia occurrence and duration was investigated. Nocturnal hypoglycaemia < or = 3.9 mmol/l occurred in 33.3% of both the CSII- (8/24) and MIT-treated patients (11/33). Mean (+/- sd; median, interquartile range) duration of hypoglycaemia < or = 3.9 mmol/l was 78 (+/- 76; 57, 23-120) min per night for the CSII- and 98 (+/- 80; 81, 32-158) min per night for the MIT-treated group. Multivariate regression analysis showed that bedtime glucose value had the strongest association with the occurrence (P = 0.026) and duration (P = 0.032) of nocturnal hypoglycaemia. Microdialysis continuous glucose monitoring has enabled more precise quantification of nocturnal hypoglycaemia occurrence and duration in Type 1 diabetic patients. Occurrence and duration of nocturnal hypoglycaemia were mainly associated with bedtime glucose value.

  13. Sleep Apnea and Circadian Extracellular Fluid Change as Independent Factors for Nocturnal Polyuria.

    PubMed

    Niimi, Aya; Suzuki, Motofumi; Yamaguchi, Yasuhiro; Ishii, Masaki; Fujimura, Tetsuya; Nakagawa, Tohru; Fukuhara, Hiroshi; Kume, Haruki; Igawa, Yasuhiko; Akishita, Masahiro; Homma, Yukio

    2016-10-01

    We investigated the relationships among nocturnal polyuria, sleep apnea and body fluid volume to elucidate the pathophysiology of nocturia in sleep apnea syndrome. We enrolled 104 consecutive patients who underwent polysomnography for suspected sleep apnea syndrome. Self-assessed symptom questionnaires were administered to evaluate sleep disorder and lower urinary tract symptoms, including nocturia. Voiding frequency and voided volume were recorded using a 24-hour frequency-volume chart. Body fluid composition was estimated in the morning and at night using bioelectric impedance analysis. Frequency-volume chart data were analyzed in 22 patients after continuous positive airway pressure therapy. Patients with nocturnal polyuria showed a higher apnea-hypopnea index (33.9 vs 24.2, p = 0.03) and a larger circadian change in extracellular fluid adjusted to lean body mass (0.22 vs -0.19, p = 0.019) than those without nocturnal polyuria. These relations were more evident in patients 65 years old or older than in those 64 years or younger. A multivariate linear regression model showed an independent relationship of nocturnal polyuria with the apnea-hypopnea index and the circadian change in extracellular fluid adjusted to lean body mass (p = 0.0012 and 0.022, respectively). Continuous positive airway pressure therapy significantly improved nocturnal polyuria and nocturia only in patients with nocturnal polyuria. This study identified sleep apnea and the circadian change in extracellular fluid as independent factors for nocturnal polyuria. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. Survival with Three-Times Weekly In-Center Nocturnal Versus Conventional Hemodialysis

    PubMed Central

    Xu, Jianglin; Suri, Rita S.; Nesrallah, Gihad; Lindsay, Robert; Garg, Amit X.; Lester, Keith; Ofsthun, Norma; Lazarus, Michael; Hakim, Raymond M.

    2012-01-01

    Whether the duration of hemodialysis treatments improves outcomes remains controversial. Here, we evaluated survival and clinical changes associated with converting from conventional hemodialysis (mean=3.75 h/treatment) to in-center nocturnal hemodialysis (mean=7.85 h/treatment). All 959 consecutive patients who initiated nocturnal hemodialysis for the first time in 77 Fresenius Medical Care facilities during 2006 and 2007 were eligible. We used Cox models to compare risk for mortality during 2 years of follow-up in a 1:3 propensity score–matched cohort of 746 nocturnal and 2062 control patients on conventional hemodialysis. Two-year mortality was 19% among nocturnal hemodialysis patients compared with 27% among conventional patients. Nocturnal hemodialysis associated with a 25% reduction in the risk for death after adjustment for age, body mass index, and dialysis vintage (hazard ratio=0.75, 95% confidence interval=0.61–0.91, P=0.004). With respect to clinical features, interdialytic weight gain, albumin, hemoglobin, dialysis dose, and calcium increased on nocturnal therapy, whereas postdialysis weight, predialysis systolic blood pressure, ultrafiltration rate, phosphorus, and white blood cell count declined (all P<0.001). In summary, notwithstanding the possibility of residual selection bias, conversion to treatment with nocturnal hemodialysis associates with favorable clinical features, laboratory biomarkers, and improved survival compared with propensity score–matched controls. The potential impact of extended treatment time on clinical outcomes while maintaining a three times per week hemodialysis schedule requires evaluation in future clinical trials. PMID:22362905

  15. Getting a good night sleep? The importance of recognizing and treating nocturnal hypokinesia in Parkinson's disease.

    PubMed

    Bhidayasiri, Roongroj; Trenkwalder, Claudia

    2018-05-01

    When Parkinson's disease (PD) patients are asked about the quality of their sleep, their answers are dominated by difficulties associated with impaired mobility in bed, medically referred to as nocturnal hypokinesia. Nocturnal hypokinesia is symptomatic from the mid-stage of the disease, affecting up to 70% of PD patients, and contributes to poor sleep quality, and increased carer burden. Here we explore four areas of nocturnal hypokinesia that are relevant to clinical practice, namely: manifestations and definition; clinical assessment and objective monitoring; etiologies and contributing factors; and evidence-based therapeutic approaches. In addition, we provide an operational definition of what constitutes nocturnal hypokinesia and outline different methods of assessment, ranging from clinical interviews and rating scales to objective night-time monitoring with inertial sensors. Optimal management of nocturnal hypokinesia in PD begins with recognizing its manifestation by inquiring about cardinal symptoms and contributing factors from, not only patients, but also carers, followed by formal assessment, and the application of individualized evidence-based treatment. Night-time dopaminergic treatment is the primary therapy; however, careful clinical judgment is required to balance the benefits with the potential adverse events related to nocturnal dopaminergic stimulation. Future studies are needed to explore the practicality of home-based objective assessment of nocturnal hypokinesia, new therapeutic options not limited to dopaminergic medications, and non-pharmacologic approaches, including training on compensatory strategies and bedroom adaptations. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Light pollution modifies the expression of daily rhythms and behavior patterns in a nocturnal primate.

    PubMed

    Le Tallec, Thomas; Perret, Martine; Théry, Marc

    2013-01-01

    Among anthropogenic pressures, light pollution altering light/dark cycles and changing the nocturnal component of the environment constitutes a threat for biodiversity. Light pollution is widely spread across the world and continuously growing. However, despite the efforts realized to describe and understand the effects of artificial lighting on fauna, few studies have documented its consequences on biological rhythms, behavioral and physiological functions in nocturnal mammals. To determine the impacts of light pollution on nocturnal mammals an experimental study was conducted on a nocturnal primate, the grey mouse lemur Microcebus murinus. Male mouse lemurs (N = 8) were exposed 14 nights to moonlight treatment and then exposed 14 nights to light pollution treatment. For both treatments, chronobiological parameters related to locomotor activity and core temperature were recorded using telemetric transmitters. In addition, at the end of each treatment, the 14(th) night, nocturnal and feeding behaviors were explored using an infrared camera. Finally, throughout the study, body mass and daily caloric food intake were recorded. For the first time in a nocturnal primate, light pollution was demonstrated to modify daily rhythms of locomotor activity and core temperature especially through phase delays and increases in core temperature. Moreover, nocturnal activity and feeding behaviors patterns were modified negatively. This study suggests that light pollution induces daily desynchronization of biological rhythms and could lead to seasonal desynchronization with potential deleterious consequences for animals in terms of adaptation and anticipation of environmental changes.

  17. Light Pollution Modifies the Expression of Daily Rhythms and Behavior Patterns in a Nocturnal Primate

    PubMed Central

    Le Tallec, Thomas; Perret, Martine; Théry, Marc

    2013-01-01

    Among anthropogenic pressures, light pollution altering light/dark cycles and changing the nocturnal component of the environment constitutes a threat for biodiversity. Light pollution is widely spread across the world and continuously growing. However, despite the efforts realized to describe and understand the effects of artificial lighting on fauna, few studies have documented its consequences on biological rhythms, behavioral and physiological functions in nocturnal mammals. To determine the impacts of light pollution on nocturnal mammals an experimental study was conducted on a nocturnal primate, the grey mouse lemur Microcebus murinus. Male mouse lemurs (N = 8) were exposed 14 nights to moonlight treatment and then exposed 14 nights to light pollution treatment. For both treatments, chronobiological parameters related to locomotor activity and core temperature were recorded using telemetric transmitters. In addition, at the end of each treatment, the 14th night, nocturnal and feeding behaviors were explored using an infrared camera. Finally, throughout the study, body mass and daily caloric food intake were recorded. For the first time in a nocturnal primate, light pollution was demonstrated to modify daily rhythms of locomotor activity and core temperature especially through phase delays and increases in core temperature. Moreover, nocturnal activity and feeding behaviors patterns were modified negatively. This study suggests that light pollution induces daily desynchronization of biological rhythms and could lead to seasonal desynchronization with potential deleterious consequences for animals in terms of adaptation and anticipation of environmental changes. PMID:24236115

  18. Nocturnal awakenings and pediatric injury risk.

    PubMed

    Schwebel, David C; Brezausek, Carl M

    2008-04-01

    This study was designed to examine relations between nocturnal awakenings and unintentional injury risk among toddlers. A nationally representative sample of 799 children was followed longitudinally from birth through 36 months. Patterns of nocturnal awakening were assessed by parent-report at ages 6, 15, 24 and 36 months, and injury events were reported at quarterly intervals over the same time period. A range of external covariates, including positive and negative affect and externalizing behavior; maternal stress, maternal depression, and parenting style; and family socioeconomic status were measured. A persistent pattern of very mild nocturnal awakening was related to increased risk of injury during the toddler years, and that relation held after controlling for a range of potential covariates. A pattern of persistent nocturnal awakening appears to be related to unintentional injury risk in toddlers.

  19. Low-level nocturnal wind maximum over the Central Amazon Basin

    NASA Technical Reports Server (NTRS)

    Greco, Steven; Ulanski, Stanley; Garstang, Michael; Houston, Samuel

    1992-01-01

    A low-level nocturnal wind maximum is shown to exist over extensive and nearly undisturbed rainforest near the central Amazon city of Manaus. Meteorological data indicate the presence of this nocturnal wind maximum during both the wet and dry seasons of the Central Amazon Basin. Daytime wind speeds which are characteristically 3-7 m/s between 300 and 1000 m increase to 10-15 m/s shortly after sunset. The wind-speed maximum is reached in the early evening, with wind speeds remaining high until several hours after sunrise. The nocturnal wind maximum is closely linked to a strong low-level inversion formed by radiational cooling of the rainforest canopy. Surface and low-level pressure gradients between the undisturbed forest and the large Amazon river system and the city of Manaus are shown to be responsible for much of the nocturnal wind increase. The pressure gradients are interpreted as a function of the thermal differences between undisturbed forest and the river/city. The importance of both the frictional decoupling and the horizontal pressure gradient suggest that the nocturnal wind maximum does not occur uniformly over all Amazonia. Low-level winds are thought to be pervasive under clear skies and strong surface cooling and that, in many places (i.e., near rivers), local pressure gradients enhance the low-level nocturnal winds.

  20. Nocturnal myoclonus: treatment efficacy of clonazepam and temazepam.

    PubMed

    Mitler, M M; Browman, C P; Menn, S J; Gujavarty, K; Timms, R M

    1986-01-01

    Clonazepam (1 mg h.s.) and temazepam (30 mg h.s.) were studied in 10 patients diagnosed as having insomnia with nocturnal myoclonus. Each subject underwent two nocturnal polysomnographic recordings while drug-free, two during treatment with clonazepam, and two during treatment with temazepam. Treatment sessions were 7 days long, and recordings were done on nights 6 and 7 of the treatment sessions. A 14-day washout period separated the treatment sessions. The order of drugs used in the first and second treatment sessions was randomized. Objective and subjective sleep laboratory data showed that both drugs improved the sleep of patients with insomnia in association with nocturnal myoclonus. Neither drug significantly reduced the number of nocturnal myoclonic events. Sleep changes were consistent with those produced by sedative benzodiazepines in general. Thus, the data support clinical reports that clonazepam, a benzodiazepine marketed for the indication of seizure, is useful in improving sleep disturbances associated with nocturnal myoclonus. Temazepam, a benzodiazepine marketed for the indication of insomnia, was found to be a suitable alternative to clonazepam in the treatment of insomnia associated with nocturnal myoclonus. The present data and other studies suggest the need for a model that explains why leg movements and sleep disturbances may wax and wane independently.

  1. Ecomorphology of orbit orientation and the adaptive significance of binocular vision in primates and other mammals.

    PubMed

    Heesy, Christopher P

    2008-01-01

    Primates are characterized by forward-facing, or convergent, orbits and associated binocular field overlap. Hypotheses explaining the adaptive significance of these traits often relate to ecological factors, such as arboreality, nocturnal visual predation, or saltatory locomotion in a complex nocturnal, arboreal environment. This study re-examines the ecological factors that are associated with high orbit convergence in mammals. Orbit orientation data were collected for 321 extant taxa from sixteen orders of metatherian (marsupial) and eutherian mammals. These taxa were coded for activity pattern, degree of faunivory, and substrate preference. Results demonstrate that nocturnal and cathemeral mammals have significantly more convergent orbits than diurnal taxa, both within and across orders. Faunivorous eutherians (both nocturnal and diurnal) have higher mean orbit convergence than opportunistically foraging or non-faunivorous taxa. However, substrate preference is not associated with higher orbit convergence and, by extension, greater binocular visual field overlap. These results are consistent with the hypothesis that mammalian predators evolved higher orbit convergence, binocular vision, and stereopsis to counter camouflage in prey inhabiting a nocturnal environment. Strepsirhine primates have a range of orbit convergence values similar to nocturnal or cathemeral predatory non-primate mammals. These data are entirely consistent with the nocturnal visual predation hypothesis of primate origins. (c) 2007 S. Karger AG, Basel.

  2. Do high fasting glucose levels suggest nocturnal hypoglycaemia? The Somogyi effect-more fiction than fact?

    PubMed

    Choudhary, P; Davies, C; Emery, C J; Heller, S R

    2013-08-01

    The Somogyi effect postulates that nocturnal hypoglycaemia causes fasting hyperglycaemia attributable to counter-regulatory hormone release. Although most published evidence has failed to support this hypothesis, this concept remains firmly embedded in clinical practice and often prevents patients and professionals from optimizing overnight insulin. Previous observational data found lower fasting glucose was associated with nocturnal hypoglycaemia, but did not assess the probability of infrequent individual episodes of rebound hypoglycaemia. We analysed continuous glucose monitoring data to explore its prevalence. We analysed data from 89 patients with Type 1 diabetes who participated in the UK Hypoglycaemia study. We compared fasting capillary glucose following nights with and without nocturnal hypoglycaemia (sensor glucose < 3.5 mmol/l). Fasting capillary blood glucose was lower after nights with hypoglycaemia than without [5.5 (3.0) vs. 14.5 (4.5) mmol/l, P < 0.0001], and was lower on nights with more severe nocturnal hypoglycaemia [5.5 (3.0) vs. 8.2 (2.3) mmol/l; P = 0.018 on nights with nadir sensor glucose of < 2.2 mmol/l vs. 3.5 mmol/l]. There were only two instances of fasting capillary blood glucose > 10 mmol/l after nocturnal hypoglycaemia, both after likely treatment of the episode. When fasting capillary blood glucose is < 5 mmol/l, there was evidence of nocturnal hypoglycaemia on 94% of nights. Our data indicate that, in clinical practice, the Somogyi effect is rare. Fasting capillary blood glucose ≤ 5 mmol/l appears an important indicator of preceding silent nocturnal hypoglycaemia. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  3. Oxygen Desaturation Index Estimation through Unconstrained Cardiac Sympathetic Activity Assessment Using Three Ballistocardiographic Systems.

    PubMed

    Jung, Da Woon; Hwang, Su Hwan; Lee, Yu Jin; Jeong, Do-Un; Park, Kwang Suk

    2016-01-01

    Nocturnal hypoxemia, characterized by abnormally low oxygen saturation levels in arterial blood during sleep, is a significant feature of various pathological conditions. The oxygen desaturation index, commonly used to evaluate the nocturnal hypoxemia severity, is acquired using nocturnal pulse oximetry that requires the overnight wear of a pulse oximeter probe. This study aimed to suggest a method for the unconstrained estimation of the oxygen desaturation index. We hypothesized that the severity of nocturnal hypoxemia would be positively associated with cardiac sympathetic activation during sleep. Unconstrained heart rate variability monitoring was conducted using three different ballistocardiographic systems to assess cardiac sympathetic activity. Overnight polysomnographic and ballistocardiographic recording pairs were collected from the 20 non-nocturnal hypoxemia (oxygen desaturation index <5 events/h) subjects and the 76 nocturnal hypoxemia patients. Among the 96 recording pairs, 48 were used as training data and the remaining 48 as test data. The regression analysis, performed using the low-frequency component of heart rate variability, exhibited a root mean square error of 3.33 events/h between the estimates and the reference values of the oxygen desaturation index. The nocturnal hypoxemia diagnostic performance produced by our method was presented with an average accuracy of 96.5% at oxygen desaturation index cutoffs of ≥5, 15, and 30 events/h. Our method has the potential to serve as a complementary measure against the accidental slip-out of a pulse oximeter probe during nocturnal pulse oximetry. The independent application of our method could facilitate home-based long-term oxygen desaturation index monitoring. © 2016 S. Karger AG, Basel.

  4. Nocturnal vision and landmark orientation in a tropical halictid bee.

    PubMed

    Warrant, Eric J; Kelber, Almut; Gislén, Anna; Greiner, Birgit; Ribi, Willi; Wcislo, William T

    2004-08-10

    Some bees and wasps have evolved nocturnal behavior, presumably to exploit night-flowering plants or avoid predators. Like their day-active relatives, they have apposition compound eyes, a design usually found in diurnal insects. The insensitive optics of apposition eyes are not well suited for nocturnal vision. How well then do nocturnal bees and wasps see? What optical and neural adaptations have they evolved for nocturnal vision? We studied female tropical nocturnal sweat bees (Megalopta genalis) and discovered that they are able to learn landmarks around their nest entrance prior to nocturnal foraging trips and to use them to locate the nest upon return. The morphology and optics of the eye, and the physiological properties of the photoreceptors, have evolved to give Megalopta's eyes almost 30 times greater sensitivity to light than the eyes of diurnal worker honeybees, but this alone does not explain their nocturnal visual behavior. This implies that sensitivity is improved by a strategy of photon summation in time and in space, the latter of which requires the presence of specialized cells that laterally connect ommatidia into groups. First-order interneurons, with significantly wider lateral branching than those found in diurnal bees, have been identified in the first optic ganglion (the lamina ganglionaris) of Megalopta's optic lobe. We believe that these cells have the potential to mediate spatial summation. Despite the scarcity of photons, Megalopta is able to visually orient to landmarks at night in a dark forest understory, an ability permitted by unusually sensitive apposition eyes and neural photon summation.

  5. Nocturnal Hypoglycemia: Answering the Challenge With Long-acting Insulin Analogs

    PubMed Central

    Brunton, Stephen A.

    2007-01-01

    Background Nocturnal hypoglycemia may be the most common type of hypoglycemia in individuals with diabetes using insulin and is particularly worrisome because it often goes undetected and may lead to unconsciousness and even death in severe cases. Objectives The prevalence, causes, and consequences of nocturnal hypoglycemia as well as detection and prevention strategies are reviewed, including the use of long-acting insulin analogs, which offer more physiologic and predictable time-action profiles than traditional human basal insulin. Data Sources A total of 307 publications (151 PubMed; 104 Adis; 52 BIOSIS) were reviewed. Review Methods Relevant trials were found by searching for “(detemir OR glargine) AND nocturnal AND (hypoglycemia OR hypoglycaemia) AND diabetes.” To capture trials that may not have specified “nocturnal” in the title or abstract text but still reported nocturnal hypoglycemia data, a supplemental search of PubMed using “(detemir OR glargine) AND (nocturnal OR hypoglycemia OR hypoglycaemia) AND diabetes” was undertaken. Results A review of these trials found that patients with type 1 and type 2 diabetes mellitus have a lower risk for nocturnal hypoglycemia when receiving long-acting insulin analogs (insulin detemir or insulin glargine), provided that glycemic control is comparable to that provided by traditional human basal insulin. Long-acting insulin analogs may be the best option to provide basal insulin coverage in patients who do not choose or require continuous subcutaneous insulin infusion. Conclusions Randomized clinical trials suggest that the long-acting insulin analogs are associated with a lower risk for nocturnal hypoglycemia than neutral protamine Hagedorn without sacrificing glycemic control. PMID:17955093

  6. Diurnal and nocturnal pollination of Marginatocereus marginatus (Pachycereeae: Cactaceae) in Central Mexico.

    PubMed

    Dar, Saleem; del Coro Arizmendi, Ma; Valiente-Banuet, Alfonso

    2006-03-01

    Chiropterophillous and ornithophillous characteristics can form part of a single reproductive strategy in plants that have flowers with diurnal and nocturnal anthesis. This broader pollination strategy can ensure seed set when pollinators are scarce or unpredictable. This appears to be true of hummingbirds, which presumably pollinate Marginatocereus marginatus, a columnar cactus with red nocturnal and diurnal flowers growing as part of dense bat-pollinated columnar cacti forests in arid regions of central Mexico. The aim of this study was to study the floral biology of M. marginatus, and evaluate the effectiveness of nocturnal vs. diurnal pollinators and the contribution of each pollinator group to overall plant fitness. Individual flower buds were marked and followed to evaluate flower phenology and anthesis time. Flowers and nectar production were measured. An exclusion experiment was conducted to measure the relative contribution of nocturnal and diurnal pollinators to seed set. Marginatocereus marginatus has red hermaphroditic flowers with nocturnal and diurnal anthesis. The plant cannot produce seeds by selfing and was pollinated during the day by hummingbirds and during the night by bats, demonstrating that both pollinator groups were important for plant reproduction. Strong pollen limitation was found in the absence of one of the pollinator guilds. Marginatocereus marginatus has an open pollination system in which both diurnal and nocturnal pollinators are needed to set seeds. This represents a fail-safe pollination system that can ensure both pollination, in a situation of low abundance of one of the pollinator groups (hummingbirds), and high competition for nocturnal pollinators with other columnar cacti that bloom synchronously with M. marginatus in the Tehuacan Valley, Mexico.

  7. Pulsed magnetotherapy in Czechoslovakia--a review.

    PubMed

    Jerabek, J

    1994-01-01

    Pulsed magnetotherapy has been used in Czechoslovakia for more than one decade. It has been proved that this type of physical therapy is very efficient mainly in rheumatic diseases, in paediatrics (sinusitis, enuresis), and in balneological care of patients suffering from ischaemic disorders of lower extremities. Promising results have also been obtained in neurological diseases (multiple sclerosis, spastic conditions) and in ophthalmology, in degenerative diseases of the retina.

  8. Interactive influences of ethnicity, endothelin-1 gene, and everyday discrimination upon nocturnal ambulatory blood pressure.

    PubMed

    Gregoski, Mathew J; Buxbaum, Sarah G; Kapuku, Gaston; Dong, Yanbin; Zhu, Haidong; Davis, Mary; Gonto, Kelsey; Treiber, Frank A

    2013-06-01

    Everyday discrimination scale scores are associated with increased ambulatory blood pressure (BP) and reduced nocturnal dipping, and the endothelin-1 (ET-1)/Lys198Asn polymorphism is associated with increased resting BP and exaggerated BP reactivity among African Americans compared to European Americans. Combined influences of these factors on BP control are unknown. This study tested the hypothesis of a three-way interaction between ethnicity, ET-1 carrier status, and everyday discrimination upon ambulatory BP and nocturnal dipping. Baseline laboratory anthropometrics and the everyday discrimination scale were completed by 352 (175 African American) young adult normotensives, followed by 24-h ambulatory BP monitoring. For nocturnal dipping, multiple regression models controlling for age, sex, ethnicity, and body mass index revealed significant three-way ET-1 × everyday discrimination × ethnicity interactions. Specifically, among African American ET-1 T-allele carriers, increases in everyday discrimination led to reduced nocturnal dipping. African Americans that carry the ET-1/Lys198Asn T-allele and report higher everyday discrimination scores may be at particular risk for reduced nocturnal dipping.

  9. Interactive Influences of Ethnicity, Endothelin-1 Gene, and Everyday Discrimination Upon Nocturnal Ambulatory Blood Pressure

    PubMed Central

    Gregoski, Mathew J.; Buxbaum, Sarah G.; Kapuku, Gaston; Dong, Yanbin; Zhu, Haidong; Davis, Mary; Gonto, Kelsey; Treiber, Frank A.

    2013-01-01

    Background Everyday discrimination scale scores are associated with increased ambulatory blood pressure (BP), and reduced nocturnal dipping, and the ET-1/Lys198Asn polymorphism is associated with increased resting BP and exaggerated BP reactivity among African Americans compared to European Americans. Combined influences of these factors on BP control are unknown. Purpose This study tested the hypothesis of a three-way interaction between ethnicity, ET-1 carrier status and everyday discrimination upon ambulatory BP and nocturnal dipping. Methods Baseline laboratory anthropometrics and the everyday discrimination scale were completed by 351 (175 African American) young adult normotensives; followed by 24-hour ambulatory BP monitoring. Results For nocturnal dipping, multiple regression models controlling for age, sex, race, and BMI revealed significant three-way ET-1 x everyday discrimination x ethnicity interactions. Specifically, among African American ET-1 T-allele carriers, increases in everyday discrimination led to reduced nocturnal dipping. Conclusions African Americans that carry the ET1/Lys198Asn T-allele and report higher everyday discrimination scores may be at particular risk for reduced nocturnal dipping. PMID:23436272

  10. Effects of acute ethanol administration on nocturnal pineal serotonin N-acetyltransferase activity

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Creighton, J.A.; Rudeen, P.K.

    The effect of acute ethanol administration on pineal serotonin N-acetyltransferase (NAT) activity, norepinephrine and indoleamine content was examined in male rats. When ethanol was administered in two equal doses (2 g/kg body weight) over a 4 hour period during the light phase, the nocturnal rise in NAT activity was delayed by seven hours. The nocturnal pineal norepinephrine content was not altered by ethanol except for a delay in the reduction of NE with the onset of the following light phase. Although ethanol treatment led to a significant reduction in nocturnal levels of pineal serotonin content, there was no significant effectmore » upon pineal content of 5-hydroxyindoleacetic acid (5-HIAA). The data indicate that ethanol delays the onset of the rise of nocturnal pineal NAT activity.« less

  11. The relative importance of olfaction and vision in a diurnal and a nocturnal hawkmoth.

    PubMed

    Balkenius, Anna; Rosén, Wenqi; Kelber, Almut

    2006-04-01

    Nectar-feeding animals can use vision and olfaction to find rewarding flowers and different species may give different weight to the two sensory modalities. We have studied how a diurnal or nocturnal lifestyle affects the weight given to vision and olfaction. We tested naïve hawkmoths of two species in a wind tunnel, presenting an odour source and a visual stimulus. Although the two species belong to the same subfamily of sphingids, the Macroglossinae, their behaviour was quite different. The nocturnal Deilephila elpenor responded preferably to the odour while the diurnal Macroglossum stellatarum strongly favoured the visual stimulus. Since a nocturnal lifestyle is ancestral for sphingids, the diurnal species, M. stellatarum, has evolved from nocturnal moths that primarily used olfaction. During bright daylight visual cues may have became more important than odour.

  12. The effect of lateral decubitus position on nocturnal intraocular pressure over a habitual 24-hour period in healthy adults.

    PubMed

    Hao, Jie; Zhen, Yi; Wang, Hao; Yang, Diya; Wang, Ningli

    2014-01-01

    To investigate the effect of lateral decubitus position (LDP) on nocturnal intraocular pressure (IOP) and the effect of LDP on 24-hour habitual IOP pattern in healthy subjects. Intraocular pressure was measured every 2-hours using an Accupen Applanation Tonometer (Accutome, USA). During the diurnal period (7:30 am, 9:30 am, 11:30 am, 1:30 pm, 3:30 pm, 5:30 pm, 7:30 pm, and 9:30 pm), IOP was measured in the sitting position under bright light (500-1000 lux) after the subjects had been seated for 5 min. The nocturnal IOP was measured in the supine position, right LDP, and left LDP, with randomized sequences, under dim light (<10 lux) at 11:30 pm, 1:30 am, 3:30 am, and 5:30 am. The subjects were awakened and maintained each position for 5 min before the measurement. The 24-hour habitual IOP patterns were obtained according to the nocturnal position (supine, right LDP and left LDP) for either eye. P<0.05 was considered to be significant. Nineteen healthy subjects were included with a mean age of 51.3±5.8 years. During the nocturnal period, a significant IOP difference was found between the dependent eye (the eye on the lower side) of LDP and the supine position, but not for all the nocturnal time points. Over a 24-hour period, the effect of LDP on habitual IOP pattern was not statistically significant, although the mean nocturnal IOP and the diurnal-nocturnal IOP change for the right and the left eye in the LDP pattern was slightly higher than that in the sitting-supine pattern. Significant nocturnal IOP differences existed between the dependent eye and the supine, but did not occur consistently for all time points. Over a 24-hour period, the effect of LDP on habitual IOP pattern was not statistically significant in healthy subjects.

  13. Detection of paroxysmal nocturnal hemoglobinuria clones in patients with myelodysplastic syndromes and related bone marrow diseases, with emphasis on diagnostic pitfalls and caveats

    PubMed Central

    Wang, Sa A.; Pozdnyakova, Olga; Jorgensen, Jeffrey L.; Medeiros, L. Jeffrey; Stachurski, Dariusz; Anderson, Mary; Raza, Azra; Woda, Bruce A.

    2009-01-01

    Background The presence of paroxysmal nocturnal hemoglobinuria clones in the setting of aplastic anemia or myelodysplastic syndrome has been shown to have prognostic and therapeutic implications. However, the status of paroxysmal nocturnal hemoglobinuria clones in various categories of myelodysplastic syndrome and in other bone marrow disorders is not well-studied. Design and Methods By using multiparameter flow cytometry immunophenotypic analysis with antibodies specific for four glycosylphosphatidylinositol-anchored proteins (CD55, CD59, CD16, CD66b) and performing an aerolysin lysis confirmatory test in representative cases, we assessed the paroxysmal nocturnal hemoglobinuria-phenotype granulocytes in 110 patients with myelodysplastic syndrome, 15 with myelodysplastic/myeloproliferative disease, 5 with idiopathic myelofibrosis and 6 with acute myeloid leukemia. Results Paroxysmal nocturnal hemoglobinuria-phenotype granulocytes were detected in nine patients with low grade myelodysplastic syndrome who showed clinicopathological features of bone marrow failure, similar to aplastic anemia. All paroxysmal nocturnal hemoglobinuria-positive cases demonstrated loss of the four glycosylphosphatidylinositol-anchored proteins, with CD16−CD66b− clones being larger than those of CD55−CD59− (p<0.05). Altered glycosylphosphatidylinositol-anchored protein expression secondary to granulocytic hypogranulation, immaturity, and/or immunophenotypic abnormalities was present in a substantial number of cases and diagnostically challenging. Conclusions These results show that routine screening for paroxysmal nocturnal hemoglobinuria clones in patients with an intrinsic bone marrow disease who show no clinical evidence of hemolysis has an appreciable yield in patients with low grade myelodysplastic syndromes. The recognition of diagnostic caveats and pitfalls associated with the underlying intrinsic bone marrow disease is essential in interpreting paroxysmal nocturnal hemoglobinuria testing correctly. In our experience, the CD16/CD66b antibody combination is superior to CD55/CD59 in screening for subclinical paroxysmal nocturnal hemoglobinuria because it detects a large clone size and is less subject to analytical interference. PMID:19001281

  14. Detection of paroxysmal nocturnal hemoglobinuria clones in patients with myelodysplastic syndromes and related bone marrow diseases, with emphasis on diagnostic pitfalls and caveats.

    PubMed

    Wang, Sa A; Pozdnyakova, Olga; Jorgensen, Jeffrey L; Medeiros, L Jeffrey; Stachurski, Dariusz; Anderson, Mary; Raza, Azra; Woda, Bruce A

    2009-01-01

    The presence of paroxysmal nocturnal hemoglobinuria clones in the setting of aplastic anemia or myelodysplastic syndrome has been shown to have prognostic and therapeutic implications. However, the status of paroxysmal nocturnal hemoglobinuria clones in various categories of myelodysplastic syndrome and in other bone marrow disorders is not well-studied. By using multiparameter flow cytometry immunophenotypic analysis with antibodies specific for four glycosylphosphatidylinositol-anchored proteins (CD55, CD59, CD16, CD66b) and performing an aerolysin lysis confirmatory test in representative cases, we assessed the paroxysmal nocturnal hemoglobinuria-phenotype granulocytes in 110 patients with myelodysplastic syndrome, 15 with myelodysplastic/myeloproliferative disease, 5 with idiopathic myelofibrosis and 6 with acute myeloid leukemia. Paroxysmal nocturnal hemoglobinuria-phenotype granulocytes were detected in nine patients with low grade myelodysplastic syndrome who showed clinicopathological features of bone marrow failure, similar to aplastic anemia. All paroxysmal nocturnal hemoglobinuria-positive cases demonstrated loss of the four glycosylphosphatidylinositol-anchored proteins, with CD16(-)CD66b(-) clones being larger than those of CD55(-)CD59(-) (p<0.05). Altered glycosylphosphatidylinositol-anchored protein expression secondary to granulocytic hypogranulation, immaturity, and/or immunophenotypic abnormalities was present in a substantial number of cases and diagnostically challenging. These results show that routine screening for paroxysmal nocturnal hemoglobinuria clones in patients with an intrinsic bone marrow disease who show no clinical evidence of hemolysis has an appreciable yield in patients with low grade myelodysplastic syndromes. The recognition of diagnostic caveats and pitfalls associated with the underlying intrinsic bone marrow disease is essential in interpreting paroxysmal nocturnal hemoglobinuria testing correctly. In our experience, the CD16/CD66b antibody combination is superior to CD55/CD59 in screening for subclinical paroxysmal nocturnal hemoglobinuria because it detects a large clone size and is less subject to analytical interference.

  15. Simple model for estimating dry deposition velocity of ozone and its destruction in a polluted nocturnal boundary layer

    NASA Astrophysics Data System (ADS)

    Lin, Ching-Ho; Lai, Chin-Hsing; Wu, Yee-Lin; Chen, Ming-Jen

    2010-11-01

    Determining the destructions of both ozone and odd oxygen, O x, in the nocturnal boundary layer (NBL) is important to evaluate the regional ozone budget and overnight ozone accumulation. This work develops a simple method to determine the dry deposition velocity of ozone and its destruction at a polluted nocturnal boundary layer. The destruction of O x can also be determined simultaneously. The method is based on O 3 and NO 2 profiles and their surface measurements. Linkages between the dry deposition velocities of O 3 and NO 2 and between the dry deposition loss of O x and its chemical loss are constructed and used. Field measurements are made at an agricultural site to demonstrate the application of the model. The model estimated nocturnal O 3 dry deposition velocities from 0.13 to 0.19 cm s -1, very close to those previously obtained for similar land types. Additionally, dry deposition and chemical reactions account for 60 and 40% of the overall nocturnal ozone loss, respectively; ozone dry deposition accounts for 50% of the overall nocturnal loss of O x, dry deposition of NO 2 accounts for another 20%, and chemical reactions account for the remaining 30%. The proposed method enables the use of measurements made in typical ozone field studies to evaluate various nocturnal destructions of O 3 and O x in a polluted environment.

  16. A preliminary investigation of the nocturnal temperature structure above the city of Edmonton, Alberta

    Treesearch

    D. Yap

    1977-01-01

    Information about the nocturnal temperature structure over Edmonton, Alberta. Observations of the temperature fields, including two- and three-dimensional forms of the nocturnal heat island, were obtained from minisonde ascents, an instrumented helicopter, and towers during a 3-week urban air-pollution field study. Results show that urban-induced temperature...

  17. Effects of frequent hemodialysis on perceived caregiver burden in the Frequent Hemodialysis Network trials.

    PubMed

    Suri, Rita S; Larive, Brett; Hall, Yoshio; Kimmel, Paul L; Kliger, Alan S; Levin, Nathan; Tamura, Manjula Kurella; Chertow, Glenn M

    2014-05-01

    Patients receiving hemodialysis often perceive their caregivers are overburdened. We hypothesize that increasing hemodialysis frequency would result in higher patient perceptions of burden on their unpaid caregivers. In two separate trials, 245 patients were randomized to receive in-center daily hemodialysis (6 days/week) or conventional hemodialysis (3 days/week) while 87 patients were randomized to receive home nocturnal hemodialysis (6 nights/week) or home conventional hemodialysis for 12 months. Changes in overall mean scores over time in the 10-question Cousineau perceived burden scale were compared. In total, 173 of 245 (70%) and 80 of 87 (92%) randomized patients in the Daily and Nocturnal Trials, respectively, reported having an unpaid caregiver at baseline or during follow-up. Relative to in-center conventional dialysis, the 12-month change in mean perceived burden score with in-center daily hemodialysis was -2.1 (95% confidence interval, -9.4 to +5.3; P=0.58). Relative to home conventional dialysis, the 12-month change in mean perceived burden score with home nocturnal dialysis was +6.1 (95% confidence interval, -0.8 to +13.1; P=0.08). After multiple imputation for missing data in the Nocturnal Trial, the relative difference between home nocturnal and home conventional hemodialysis was +9.4 (95% confidence interval, +0.55 to +18.3; P=0.04). In the Nocturnal Trial, changes in perceived burden were inversely correlated with adherence to dialysis treatments (Pearson r=-0.35; P=0.02). Relative to conventional hemodialysis, in-center daily hemodialysis did not result in higher perceptions of caregiver burden. There was a trend to higher perceived caregiver burden among patients randomized to home nocturnal hemodialysis. These findings may have implications for the adoption of and adherence to frequent nocturnal hemodialysis.

  18. Comparing effects of insulin analogues and human insulin on nocturnal glycaemia in hypoglycaemia-prone people with Type 1 diabetes.

    PubMed

    Kristensen, P L; Tarnow, L; Bay, C; Nørgaard, K; Jensen, T; Parving, H-H; Perrild, H; Beck-Nielsen, H; Christiansen, J S; Thorsteinsson, B; Pedersen-Bjergaard, U

    2017-05-01

    To assess the difference between analogue and human insulin with regard to nocturnal glucose profiles and risk of hypoglycaemia in people with recurrent severe hypoglycaemia. A total of 72 people [46 men, mean ± sd age 54 ± 12 years, mean ± sd HbA 1c 65 ± 12 mmol/mol (8.1 ± 1.1%), mean ± sd duration of diabetes 30 ± 14 years], who participated in a 2-year randomized, crossover trial of basal-bolus therapy with insulin detemir/insulin aspart or human NPH insulin/human regular insulin (the HypoAna trial) were studied for 2 nights during each treatment. Venous blood was drawn hourly during sleep. Primary endpoints were nocturnal glucose profiles and occurrence of hypoglycaemia (blood glucose ≤ 3.9 mmol/l). During insulin analogue treatment, the mean nocturnal plasma glucose level was significantly higher than during treatment with human insulin (10.6 vs 8.1 mmol/l). The fasting plasma glucose level was similar between the treatments. Nocturnal hypoglycaemia was registered during 41/101 nights (41%) in the human insulin arm and 19/117 nights (16%) in the insulin analogue arm, corresponding to a hazard ratio of 0.26 (95% CI 0.14 to 0.45; P < 0.0001) with insulin analogue. Treatment with insulin analogue reduces the occurrence of nocturnal hypoglycaemia assessed by nocturnal glucose profiles in people with Type 1 diabetes prone to severe hypoglycaemia. Nocturnal glucose profiles provide a more comprehensive assessment of clinical benefit of insulin regimens as compared to conventional recording of hypoglycaemia. © 2017 Diabetes UK.

  19. Factors Associated with Nocturnal Hypoglycemia in At-Risk Adolescents and Young Adults with Type 1 Diabetes

    PubMed Central

    Wilson, Darrell M.; Calhoun, Peter M.; Maahs, David M.; Chase, H. Peter; Messer, Laurel; Buckingham, Bruce A.; Aye, Tandy; Clinton, Paula K.; Hramiak, Irene; Kollman, Craig

    2015-01-01

    Abstract Background: Hypoglycemia remains an impediment to good glycemic control, with nocturnal hypoglycemia being particularly dangerous. Information on major contributors to nocturnal hypoglycemia remains critical for understanding and mitigating risk. Materials and Methods: Continuous glucose monitoring (CGM) data for 855 nights were studied, generated by 45 subjects 15–45 years of age with hemoglobin A1c (HbA1c) levels of ≤8.0% who participated in a larger randomized study. Factors assessed for potential association with nocturnal hypoglycemia (CGM measurement of <60 mg/dL for ≥30 min) included bedtime blood glucose (BG), exercise intensity, bedtime snack, insulin on board, day of the week, previous daytime hypoglycemia, age, gender, HbA1c level, diabetes duration, daily basal insulin, and daily insulin dose. Results: Hypoglycemia occurred during 221 of 885 (25%) nights and was more frequent with younger age (P<0.001), lower HbA1c levels (P=0.006), medium/high-intensity exercise during the preceding day (P=0.003), and the occurrence of antecedent daytime hypoglycemia (P=0.001). There was a trend for lower bedtime BG levels to be associated with more frequent nocturnal hypoglycemia (P=0.10). Bedtime snack, before bedtime insulin bolus, weekend versus weekday, gender, and daily basal and bolus insulin were not associated with nocturnal hypoglycemia. Conclusions: Awareness that HbA1c level, exercise, bedtime BG level, and daytime hypoglycemia are all modifiable factors associated with nocturnal hypoglycemia may help patients and providers decrease the risk of hypoglycemia at night. Risk for nocturnal hypoglycemia increased in a linear fashion across the range of variables, with no clear-cut thresholds to guide clinicians or patients for any particular night. PMID:25761202

  20. Anatomical Specializations for Nocturnality in a Critically Endangered Parrot, the Kakapo (Strigops habroptilus)

    PubMed Central

    Corfield, Jeremy R.; Gsell, Anna C.; Brunton, Dianne; Heesy, Christopher P.; Hall, Margaret I.; Acosta, Monica L.; Iwaniuk, Andrew N.

    2011-01-01

    The shift from a diurnal to nocturnal lifestyle in vertebrates is generally associated with either enhanced visual sensitivity or a decreased reliance on vision. Within birds, most studies have focused on differences in the visual system across all birds with respect to nocturnality-diurnality. The critically endangered Kakapo (Strigops habroptilus), a parrot endemic to New Zealand, is an example of a species that has evolved a nocturnal lifestyle in an otherwise diurnal lineage, but nothing is known about its' visual system. Here, we provide a detailed morphological analysis of the orbits, brain, eye, and retina of the Kakapo and comparisons with other birds. Morphometric analyses revealed that the Kakapo's orbits are significantly more convergent than other parrots, suggesting an increased binocular overlap in the visual field. The Kakapo exhibits an eye shape that is consistent with other nocturnal birds, including owls and nightjars, but is also within the range of the diurnal parrots. With respect to the brain, the Kakapo has a significantly smaller optic nerve and tectofugal visual pathway. Specifically, the optic tectum, nucleus rotundus and entopallium were significantly reduced in relative size compared to other parrots. There was no apparent reduction to the thalamofugal visual pathway. Finally, the retinal morphology of the Kakapo is similar to that of both diurnal and nocturnal birds, suggesting a retina that is specialised for a crepuscular niche. Overall, this suggests that the Kakapo has enhanced light sensitivity, poor visual acuity and a larger binocular field than other parrots. We conclude that the Kakapo possesses a visual system unlike that of either strictly nocturnal or diurnal birds and therefore does not adhere to the traditional view of the evolution of nocturnality in birds. PMID:21860663

  1. Factors associated with nocturnal hypoglycemia in at-risk adolescents and young adults with type 1 diabetes.

    PubMed

    Wilson, Darrell M; Calhoun, Peter M; Maahs, David M; Chase, H Peter; Messer, Laurel; Buckingham, Bruce A; Aye, Tandy; Clinton, Paula K; Hramiak, Irene; Kollman, Craig; Beck, Roy W

    2015-06-01

    Hypoglycemia remains an impediment to good glycemic control, with nocturnal hypoglycemia being particularly dangerous. Information on major contributors to nocturnal hypoglycemia remains critical for understanding and mitigating risk. Continuous glucose monitoring (CGM) data for 855 nights were studied, generated by 45 subjects 15-45 years of age with hemoglobin A1c (HbA1c) levels of ≤8.0% who participated in a larger randomized study. Factors assessed for potential association with nocturnal hypoglycemia (CGM measurement of <60 mg/dL for ≥30 min) included bedtime blood glucose (BG), exercise intensity, bedtime snack, insulin on board, day of the week, previous daytime hypoglycemia, age, gender, HbA1c level, diabetes duration, daily basal insulin, and daily insulin dose. Hypoglycemia occurred during 221 of 885 (25%) nights and was more frequent with younger age (P<0.001), lower HbA1c levels (P=0.006), medium/high-intensity exercise during the preceding day (P=0.003), and the occurrence of antecedent daytime hypoglycemia (P=0.001). There was a trend for lower bedtime BG levels to be associated with more frequent nocturnal hypoglycemia (P=0.10). Bedtime snack, before bedtime insulin bolus, weekend versus weekday, gender, and daily basal and bolus insulin were not associated with nocturnal hypoglycemia. Awareness that HbA1c level, exercise, bedtime BG level, and daytime hypoglycemia are all modifiable factors associated with nocturnal hypoglycemia may help patients and providers decrease the risk of hypoglycemia at night. Risk for nocturnal hypoglycemia increased in a linear fashion across the range of variables, with no clear-cut thresholds to guide clinicians or patients for any particular night.

  2. Paroxysmal nocturnal hemoglobinuria and telomere length predicts response to immunosuppressive therapy in pediatric aplastic anemia

    PubMed Central

    Narita, Atsushi; Muramatsu, Hideki; Sekiya, Yuko; Okuno, Yusuke; Sakaguchi, Hirotoshi; Nishio, Nobuhiro; Yoshida, Nao; Wang, Xinan; Xu, Yinyan; Kawashima, Nozomu; Doisaki, Sayoko; Hama, Asahito; Takahashi, Yoshiyuki; Kudo, Kazuko; Moritake, Hiroshi; Kobayashi, Masao; Kobayashi, Ryoji; Ito, Etsuro; Yabe, Hiromasa; Ohga, Shouichi; Ohara, Akira; Kojima, Seiji

    2015-01-01

    Acquired aplastic anemia is an immune-mediated disease characterized by severe defects in stem cell number resulting in hypocellular marrow and peripheral blood cytopenias. Minor paroxysmal nocturnal hemoglobinuria populations and a short telomere length were identified as predictive biomarkers of immunosuppressive therapy responsiveness in aplastic anemia. We enrolled 113 aplastic anemia patients (63 boys and 50 girls) in this study to evaluate their response to immunosuppressive therapy. The paroxysmal nocturnal hemoglobinuria populations and telomere length were detected by flow cytometry. Forty-seven patients (42%) carried a minor paroxysmal nocturnal hemoglobinuria population. The median telomere length of aplastic anemia patients was −0.99 standard deviation (SD) (range −4.01–+3.01 SD). Overall, 60 patients (53%) responded to immunosuppressive therapy after six months. Multivariate logistic regression analysis identified the absence of a paroxysmal nocturnal hemoglobinuria population and a shorter telomere length as independent unfavorable predictors of immunosuppressive therapy response at six months. The cohort was stratified into a group of poor prognosis (paroxysmal nocturnal hemoglobinuria negative and shorter telomere length; 37 patients) and good prognosis (paroxysmal nocturnal hemoglobinuria positive and/or longer telomere length; 76 patients), respectively. The response rates of the poor prognosis and good prognosis groups at six months were 19% and 70%, respectively (P<0.001). The combined absence of a minor paroxysmal nocturnal hemoglobinuria population and a short telomere length is an efficient predictor of poor immunosuppressive therapy response, which should be considered while deciding treatment options: immunosuppressive therapy or first-line hematopoietic stem cell transplantation. The trial was registered in www.umin.ac.jp with number UMIN000017972. PMID:26315930

  3. Paroxysmal nocturnal hemoglobinuria and telomere length predicts response to immunosuppressive therapy in pediatric aplastic anemia.

    PubMed

    Narita, Atsushi; Muramatsu, Hideki; Sekiya, Yuko; Okuno, Yusuke; Sakaguchi, Hirotoshi; Nishio, Nobuhiro; Yoshida, Nao; Wang, Xinan; Xu, Yinyan; Kawashima, Nozomu; Doisaki, Sayoko; Hama, Asahito; Takahashi, Yoshiyuki; Kudo, Kazuko; Moritake, Hiroshi; Kobayashi, Masao; Kobayashi, Ryoji; Ito, Etsuro; Yabe, Hiromasa; Ohga, Shouichi; Ohara, Akira; Kojima, Seiji

    2015-12-01

    Acquired aplastic anemia is an immune-mediated disease characterized by severe defects in stem cell number resulting in hypocellular marrow and peripheral blood cytopenias. Minor paroxysmal nocturnal hemoglobinuria populations and a short telomere length were identified as predictive biomarkers of immunosuppressive therapy responsiveness in aplastic anemia. We enrolled 113 aplastic anemia patients (63 boys and 50 girls) in this study to evaluate their response to immunosuppressive therapy. The paroxysmal nocturnal hemoglobinuria populations and telomere length were detected by flow cytometry. Forty-seven patients (42%) carried a minor paroxysmal nocturnal hemoglobinuria population. The median telomere length of aplastic anemia patients was -0.99 standard deviation (SD) (range -4.01-+3.01 SD). Overall, 60 patients (53%) responded to immunosuppressive therapy after six months. Multivariate logistic regression analysis identified the absence of a paroxysmal nocturnal hemoglobinuria population and a shorter telomere length as independent unfavorable predictors of immunosuppressive therapy response at six months. The cohort was stratified into a group of poor prognosis (paroxysmal nocturnal hemoglobinuria negative and shorter telomere length; 37 patients) and good prognosis (paroxysmal nocturnal hemoglobinuria positive and/or longer telomere length; 76 patients), respectively. The response rates of the poor prognosis and good prognosis groups at six months were 19% and 70%, respectively (P<0.001). The combined absence of a minor paroxysmal nocturnal hemoglobinuria population and a short telomere length is an efficient predictor of poor immunosuppressive therapy response, which should be considered while deciding treatment options: immunosuppressive therapy or first-line hematopoietic stem cell transplantation. The trial was registered in www.umin.ac.jp with number UMIN000017972. Copyright© Ferrata Storti Foundation.

  4. Diurnal and Nocturnal Pollination of Marginatocereus marginatus (Pachycereeae: Cactaceae) in Central Mexico

    PubMed Central

    DAR, SALEEM; ARIZMENDI, Ma. del CORO; VALIENTE-BANUET, ALFONSO

    2006-01-01

    • Background and Aims Chiropterophillous and ornithophillous characteristics can form part of a single reproductive strategy in plants that have flowers with diurnal and nocturnal anthesis. This broader pollination strategy can ensure seed set when pollinators are scarce or unpredictable. This appears to be true of hummingbirds, which presumably pollinate Marginatocereus marginatus, a columnar cactus with red nocturnal and diurnal flowers growing as part of dense bat-pollinated columnar cacti forests in arid regions of central Mexico. The aim of this study was to study the floral biology of M. marginatus, and evaluate the effectiveness of nocturnal vs. diurnal pollinators and the contribution of each pollinator group to overall plant fitness. • Methods Individual flower buds were marked and followed to evaluate flower phenology and anthesis time. Flowers and nectar production were measured. An exclusion experiment was conducted to measure the relative contribution of nocturnal and diurnal pollinators to seed set. • Key Results Marginatocereus marginatus has red hermaphroditic flowers with nocturnal and diurnal anthesis. The plant cannot produce seeds by selfing and was pollinated during the day by hummingbirds and during the night by bats, demonstrating that both pollinator groups were important for plant reproduction. Strong pollen limitation was found in the absence of one of the pollinator guilds. • Conclusions Marginatocereus marginatus has an open pollination system in which both diurnal and nocturnal pollinators are needed to set seeds. This represents a fail-safe pollination system that can ensure both pollination, in a situation of low abundance of one of the pollinator groups (hummingbirds), and high competition for nocturnal pollinators with other columnar cacti that bloom synchronously with M. marginatus in the Tehuacan Valley, Mexico. PMID:16394025

  5. Nocturnal colonization behavior of blowflies (Diptera: Calliphoridae) in southeastern Australia.

    PubMed

    George, Kelly A; Archer, Melanie S; Toop, Tes

    2013-01-01

    Worldwide research into nocturnal colonization by blowflies has produced many contradictory findings, prompting investigation specific to southeastern Australia. Initial experiments showed that blowfly colonization begins shortly after sunrise and continues until sunset; nocturnal colonization never occurred. Colonization peaks occurred at mid-morning, midday, and in the hours preceding sunset. In an additional experiment, wild blowflies were captured and placed in cages with colonization medium supplied nocturnally. Colonization occurred on four of five nights, and Calliphora augur (Fabricius) (Diptera: Calliphoridae) was the main species colonizing baits nocturnally. Results suggest that colonization is most likely to occur during warm weather and when flies are able to walk or crawl to bait. In particular, blowflies trapped within a confined space (such as a room or car) with warmer-than-ambient temperature may be stimulated to colonize nearby remains. Entomologists should consider these findings when estimating minimum postmortem interval under these environmental conditions. © 2012 American Academy of Forensic Sciences.

  6. Lack of nocturnal blood pressure fall in elderly bedridden hypertensive patients with cerebrovascular disease.

    PubMed

    Sasaki, Masato; Ando, Hitoshi; Fujimura, Akio

    2012-02-01

    To prevent recurrence of cerebrovascular disease (CVD), adequate control of blood pressure (BP) is extremely important for the treatment of hypertensive CVD patients. As absence of the nocturnal fall of BP by the expected 10-20% from daytime levels is reported to exaggerate target organ injury, 24-h ambulatory blood pressure monitoring (ABPM) was conducted, especially to obtain data during nighttime sleep. Forty-eight elderly bedridden chronic phase CVD hypertensive patients (assessed 1-3 mo after CVD accident) participated. As a group, nocturnal BP was higher than diurnal BP, whereas nocturnal pulse rate was lower than diurnal pulse rate. The nocturnal BP fall was blunted in most (∼90%) of the patients. These results suggest that to perform a rational drug treatment, it is essential to do 24-h ABPM before initiation of antihypertensive therapy in elderly bedridden hypertensive CVD patients.

  7. Do wintering Harlequin Ducks forage nocturnally at high latitudes?

    USGS Publications Warehouse

    Rizzolo, D.J.; Esler, Daniel N.; Roby, D.D.; Jarvis, R.L.

    2005-01-01

    We monitored radio-tagged Harlequin Ducks (Histrionicus histrionicus) to determine whether nocturnal feeding was part of their foraging strategy during winter in south-central Alaska. Despite attributes of our study site (low ambient temperatures, harsh weather, short day length) and study species (small body size, high daytime foraging rates) that would be expected to favor nocturnal foraging, we found no evidence of nocturnal dive-feeding. Signals from eight radio-tagged Harlequin Ducks never exhibited signal loss due to diving during a total of 780 minutes of nocturnal monitoring. In contrast, the same eight birds exhibited signal loss during 62 ± 7% (SE) of 5-minute diurnal monitoring periods (total of 365 minutes of monitoring). Our results suggest that Harlequin Ducks in south-central Alaska face a stringent time constraint on daytime foraging during midwinter. Harlequin Ducks wintering at high latitudes, therefore, may be particularly sensitive to factors that increase foraging requirements or decrease foraging efficiency.

  8. A model for nocturnal frost formation on a wing section: Aircraft takeoff performance penalties

    NASA Technical Reports Server (NTRS)

    Dietenberger, M. A.

    1983-01-01

    The nocturnal frost formation on a wing section, to explain the hazard associated with frost during takeoff was investigated. A model of nocturnal frost formation on a wing section which predicts when the nocturnal frost will form and also its thickness and density as a function of time was developed. The aerodynamic penalities as related to the nocturnal frost formation properties were analyzed to determine how much the takeoff performance would be degraded by a specific frost layer. With an aircraft takeoff assuming equations representing a steady climbing flight, it is determined that a reduction in the maximum gross weight or a partial frost clearance and a reduction in the takeoff angle of attack is needed to neutralize drag and life penalities which are due to frost. Atmospheric conditions which produce the most hazardous frost buildup are determined.

  9. Rumination in a 7-year-old child.

    PubMed

    Griffin, J B

    1977-02-01

    Regurgitation of food by rumination has rarely been reported in latency-age children. A 7-year-old boy had symptoms of rumination, gagging, bruxism, and enuresis. During the oppositional stage of development many unresolved conflicts had developed between the patient and his parents. Short-term psychotherapy which focused on resolution of the power struggles produced rapid remission of the symptoms. A two-year follow-up showed no recurrence of difficulty.

  10. Paroxysmal arousal in epilepsy associated with cingulate hyperperfusion.

    PubMed

    Vetrugno, R; Mascalchi, M; Vella, A; Della Nave, R; Provini, F; Plazzi, G; Volterrani, D; Bertelli, P; Vattimo, A; Lugaresi, E; Montagna, P

    2005-01-25

    A patient with nocturnal frontal lobe epilepsy characterized by paroxysmal motor attacks during sleep had brief paroxysmal arousals (PAs), complex episodes of nocturnal paroxysmal dystonia, and epileptic nocturnal wandering since childhood. Ictal SPECT during an episode of PA demonstrated increased blood flow in the right anterior cingulate gyrus and cerebellar cortex with hypoperfusion in the right temporal and frontal associative cortices.

  11. Report on the nocturnal raptor monitoring workshop

    Treesearch

    Geoffrey L. Holroyd; Lisa Takats

    1997-01-01

    The goal of this workshop was to discuss the development of a strategy to determine the status and assess trends of nocturnal raptor species (i.e., nocturnal owls) in Canada and the USA. A strategy for diurnal raptor species was initiated at a workshop in Boise, Idaho in August 1996. The results of these workshops will form the basis for developing the North American...

  12. Eye shape and the nocturnal bottleneck of mammals.

    PubMed

    Hall, Margaret I; Kamilar, Jason M; Kirk, E Christopher

    2012-12-22

    Most vertebrate groups exhibit eye shapes that vary predictably with activity pattern. Nocturnal vertebrates typically have large corneas relative to eye size as an adaptation for increased visual sensitivity. Conversely, diurnal vertebrates generally demonstrate smaller corneas relative to eye size as an adaptation for increased visual acuity. By contrast, several studies have concluded that many mammals exhibit typical nocturnal eye shapes, regardless of activity pattern. However, a recent study has argued that new statistical methods allow eye shape to accurately predict activity patterns of mammals, including cathemeral species (animals that are equally likely to be awake and active at any time of day or night). Here, we conduct a detailed analysis of eye shape and activity pattern in mammals, using a broad comparative sample of 266 species. We find that the eye shapes of cathemeral mammals completely overlap with nocturnal and diurnal species. Additionally, most diurnal and cathemeral mammals have eye shapes that are most similar to those of nocturnal birds and lizards. The only mammalian clade that diverges from this pattern is anthropoids, which have convergently evolved eye shapes similar to those of diurnal birds and lizards. Our results provide additional evidence for a nocturnal 'bottleneck' in the early evolution of crown mammals.

  13. Adaptive genomic evolution of opsins reveals that early mammals flourished in nocturnal environments.

    PubMed

    Borges, Rui; Johnson, Warren E; O'Brien, Stephen J; Gomes, Cidália; Heesy, Christopher P; Antunes, Agostinho

    2018-02-05

    Based on evolutionary patterns of the vertebrate eye, Walls (1942) hypothesized that early placental mammals evolved primarily in nocturnal habitats. However, not only Eutheria, but all mammals show photic characteristics (i.e. dichromatic vision, rod-dominated retina) suggestive of a scotopic eye design. Here, we used integrative comparative genomic and phylogenetic methodologies employing the photoreceptive opsin gene family in 154 mammals to test the likelihood of a nocturnal period in the emergence of all mammals. We showed that mammals possess genomic patterns concordant with a nocturnal ancestry. The loss of the RH2, VA, PARA, PARIE and OPN4x opsins in all mammals led us to advance a probable and most-parsimonious hypothesis of a global nocturnal bottleneck that explains the loss of these genes in the emerging lineage (> > 215.5 million years ago). In addition, ancestral character reconstruction analyses provided strong evidence that ancestral mammals possessed a nocturnal lifestyle, ultra-violet-sensitive vision, low visual acuity and low orbit convergence (i.e. panoramic vision). Overall, this study provides insight into the evolutionary history of the mammalian eye while discussing important ecological aspects of the photic paleo-environments ancestral mammals have occupied.

  14. Frequency of paroxysmal nocturnal hemoglobinuria in patients attended in Belém, Pará, Brazil

    PubMed Central

    de Brito Junior, Lacy Cardoso; Cardoso, Maria do Socorro de Oliveira; Rocha, Euzamar Gaby; Anijar, Herika; Cunha, Mariana; Saraiva, João Carlos Pina

    2011-01-01

    Background Paroxysmal nocturnal hemoglobinuria is a hematological disease with complex physiopathology. It is genetically characterized by a somatic mutation in the PIG-A gene (phosphatidylinositol glycan anchor biosynthesis, class A), in which the best known antigens are DAF (decay accelerating factor or CD55) and MIRL (membrane inhibitor of reactive lysis or CD59). Objective To determine the frequency of paroxysmal nocturnal hemoglobinuria in patients attended at the HEMOPA foundation from November 2008 to July 2009. Method Thirty patients, with ages ranging from two to 79 years old and suspected of having paroxysmal nocturnal hemoglobinuria were examined. All patients were immunophenotyped by flow cytometry for the CD5, CD59, CD16 and CD45 antigens. Results Paroxysmal nocturnal hemoglobinuria was identified in nine of the thirty patients investigated. Another 3 cases had inconclusive results with CD59-negative labeling only for neutrophils. The highest frequency of paroxysmal nocturnal hemoglobinuria patients (7/9) and inconclusive cases (2/3) were between 19 years old and 48 years old, with a median of 28 years. Conclusion These results show the importance of flow cytometry to identify cases in which patients are deficient in only one antigen (CD59). PMID:23284241

  15. Interrupted breeding in a songbird migrant triggers development of nocturnal locomotor activity.

    PubMed

    Mukhin, Andrey; Kobylkov, Dmitry; Kishkinev, Dmitry; Grinkevich, Vitaly

    2018-04-03

    Long-distance avian migrants, e.g. Eurasian reed warblers (Acrocephalus scirpaceus), can precisely schedule events of their annual cycle. However, the proximate mechanisms controlling annual cycle and their interplay with environmental factors are poorly understood. We artificially interrupted breeding in reed warblers by bringing them into captivity and recording birds' locomotor activity for 5-7 days. Over this time, most of the captive birds gradually developed nocturnal locomotor activity not observed in breeding birds. When the birds were later released and radio-tracked, the individuals with highly developed caged activity performed nocturnal flights. We also found that reed warblers kept indoors without access to local cues developed a higher level of nocturnal activity compared to the birds kept outdoors with an access to the familiar environment. Also, birds translocated from a distant site (21 km) had a higher motivation to fly at night-time after release compared to the birds captured within 1 km of a study site. Our study suggests that an interrupted breeding triggers development of nocturnal locomotor activity in cages, and the level of activity is correlated with motivation to perform nocturnal flights in the wild, which can be restrained by familiar environment.

  16. Invasion of Ancestral Mammals into Dim-light Environments Inferred from Adaptive Evolution of the Phototransduction Genes.

    PubMed

    Wu, Yonghua; Wang, Haifeng; Hadly, Elizabeth A

    2017-04-20

    Nocturnality is a key evolutionary innovation of mammals that enables mammals to occupy relatively empty nocturnal niches. Invasion of ancestral mammals into nocturnality has long been inferred from the phylogenetic relationships of crown Mammalia, which is primarily nocturnal, and crown Reptilia, which is primarily diurnal, although molecular evidence for this is lacking. Here we used phylogenetic analyses of the vision genes involved in the phototransduction pathway to predict the diel activity patterns of ancestral mammals and reptiles. Our results demonstrated that the common ancestor of the extant Mammalia was dominated by positive selection for dim-light vision, supporting the predominate nocturnality of the ancestral mammals. Further analyses showed that the nocturnality of the ancestral mammals was probably derived from the predominate diurnality of the ancestral amniotes, which featured strong positive selection for bright-light vision. Like the ancestral amniotes, the common ancestor of the extant reptiles and various taxa in Squamata, one of the main competitors of the temporal niches of the ancestral mammals, were found to be predominate diurnality as well. Despite this relatively apparent temporal niche partitioning between ancestral mammals and the relevant reptiles, our results suggested partial overlap of their temporal niches during crepuscular periods.

  17. [Nocturia in elderly patients].

    PubMed

    Kurenkov, A V; Petrov, S B

    2010-01-01

    This study demonstrates a comparative assessment of the causes of nocturia in young and elderly patients with overactive bladder (OAB). We used the database of 245 patients over 18 years (117 men, 128 women) with OAB (more than 8 micturition per day), with presence or absence of urgent urinary incontinence and nocturia (an average of 2.5 episodes per night). All the patients had to complete a diary within 3 days indicating the time of the urge to urinate, urine volume per micturition and sleep time (when the patient is actually asleep before waking time). These patients were divided by sex and also into three age groups: younger than 60 years, 61-69 years and over 70 years. A diary was used to determine the nocturia index, nocturnal polyuria index, index of nocturnal bladder capacity. The most obvious reason for nocturia in patients with OAB was the polyuria and reduced nocturnal bladder capacity, which are not dependent on age. In young patients (< or = 60 years) nocturia was the result of the decrease of nocturnal bladder capacity and was evaluated by IBC. For the patients older than 70 years, the most common cause of nocturia was nocturnal polyuria, which was estimated by the index of nocturnal polyuria.

  18. Eye shape and the nocturnal bottleneck of mammals

    PubMed Central

    Hall, Margaret I.; Kamilar, Jason M.; Kirk, E. Christopher

    2012-01-01

    Most vertebrate groups exhibit eye shapes that vary predictably with activity pattern. Nocturnal vertebrates typically have large corneas relative to eye size as an adaptation for increased visual sensitivity. Conversely, diurnal vertebrates generally demonstrate smaller corneas relative to eye size as an adaptation for increased visual acuity. By contrast, several studies have concluded that many mammals exhibit typical nocturnal eye shapes, regardless of activity pattern. However, a recent study has argued that new statistical methods allow eye shape to accurately predict activity patterns of mammals, including cathemeral species (animals that are equally likely to be awake and active at any time of day or night). Here, we conduct a detailed analysis of eye shape and activity pattern in mammals, using a broad comparative sample of 266 species. We find that the eye shapes of cathemeral mammals completely overlap with nocturnal and diurnal species. Additionally, most diurnal and cathemeral mammals have eye shapes that are most similar to those of nocturnal birds and lizards. The only mammalian clade that diverges from this pattern is anthropoids, which have convergently evolved eye shapes similar to those of diurnal birds and lizards. Our results provide additional evidence for a nocturnal ‘bottleneck’ in the early evolution of crown mammals. PMID:23097513

  19. Nocturnal Polyuria: Excess of Nocturnal Urine Production, Excess of Definitions-Influence on Renal Function Profile.

    PubMed

    Goessaert, An-Sofie; Walle, Johan Vande; Bosch, Ruud; Hoebeke, Piet; Everaert, Karel

    2016-03-01

    This study aimed to identify important differences in renal function profile, and potential water and sodium diuresis cutoffs among participants with nocturnal polyuria according to nocturnal polyuria definitions. This post hoc analysis was based on a prospective study in which participants completed a bladder diary, collected urine and provided a blood sample. With an age dependent nocturnal polyuria index greater than 20% to 33% as the referent 4 definitions of nocturnal polyuria were compared, including 1) nocturnal polyuria index greater than 33%, 2) nocturnal urine production greater than 90 ml per hour and 3) greater than 10 ml/kg, and 4) nocturia index greater than 1.5. In 112 male and female participants significant differences in baseline characteristics and bladder diary parameters were found according to definition. Diuresis rate, free water clearance and sodium clearance had similar 24-hour courses in the subgroups with and without polyuria by each definition. The range varied more in the subgroup with vs without polyuria, especially at night for diuresis rate and free water clearance. At night the latter decreased in the polyuria subgroup based on each definition (p <0.001 to 0.045). A significant difference vs the no polyuria subgroups was found only for urine production greater than 90 ml per hour and polyuria index greater than 20% to 33%. For each definition sodium clearance remained high in the polyuria subgroup, which differed significantly from the no polyuria subgroups (p <0.001 to 0.030). Free water and sodium clearance cutoffs ranged from -0.65 to -0.85 ml per minute between 12 and 2 a.m., and 0.65 to 0.77 ml per minute between 3 and 5 a.m., respectively, with large sensitivity and specificity differences according to definition. There were important differences when comparing participants with vs without nocturnal polyuria by definition. The renal function profile indicating the pathophysiological mechanism of nocturnal polyuria did not seem to be influenced by definition but free water clearance and sodium clearance cutoff sensitivity differed substantially. These results must be confirmed in a larger homogeneous sample. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. Nocturnal Light Exposure Alters Hepatic Pai-1 Expression by Stimulating the Adrenal Pathway in C3H Mice

    PubMed Central

    Aoshima, Yoshiki; Sakakibara, Hiroyuki; Suzuki, Taka-aki; Yamazaki, Shunsuke; Shimoi, Kayoko

    2014-01-01

    Recent studies have suggested the possibility that nocturnal light exposure affects many biological processes in rodents, especially the circadian rhythm, an endogenous oscillation of approximately 24 h. However, there is still insufficient information about the physiological effects of nocturnal light exposure. In this study, we examined the changes in gene expression and serum levels of plasminogen activator inhibitor-1 (PAI-1), a major component of the fibrinolytic system that shows typical circadian rhythmicity, in C3H/He mice. Zeitgeber time (ZT) was assessed with reference to the onset of light period (ZT0). Exposure to fluorescent light (70 lux) for 1 h in the dark period (ZT14) caused a significant increase in hepatic Pai-1 gene expression at ZT16. Serum PAI-1 levels also tended to increase, albeit not significantly. Expression levels of the typical clock genes Bmal1, Clock, and Per1 were significantly increased at ZT21, ZT16, and ZT18, respectively. Exposure to nocturnal light significantly increased plasma adrenalin levels. The effects of nocturnal light exposure on Pai-1 expression disappeared in adrenalectomized mice, although the changes in clock genes were still apparent. In conclusion, our results suggest that nocturnal light exposure, even for 1 h, alters hepatic Pai-1 gene expression by stimulating the adrenal pathway. Adrenalin secreted from the adrenal gland may be an important signaling mediator of the change in Pai-1 expression in response to nocturnal light exposure. PMID:25077763

  1. Signatures of functional constraint at aye-aye opsin genes: the potential of adaptive color vision in a nocturnal primate.

    PubMed

    Perry, George H; Martin, Robert D; Verrelli, Brian C

    2007-09-01

    While color vision perception is thought to be adaptively correlated with foraging efficiency for diurnal mammals, those that forage exclusively at night may not need color vision nor have the capacity for it. Indeed, although the basic condition for mammals is dichromacy, diverse nocturnal mammals have only monochromatic vision, resulting from functional loss of the short-wavelength sensitive opsin gene. However, many nocturnal primates maintain intact two opsin genes and thus have dichromatic capacity. The evolutionary significance of this surprising observation has not yet been elucidated. We used a molecular population genetics approach to test evolutionary hypotheses for the two intact opsin genes of the fully nocturnal aye-aye (Daubentonia madagascariensis), a highly unusual and endangered Madagascar primate. No evidence of gene degradation in either opsin gene was observed for any of 8 aye-aye individuals examined. Furthermore, levels of nucleotide diversity for opsin gene functional sites were lower than those for 15 neutrally evolving intergenic regions (>25 kb in total), which is consistent with a history of purifying selection on aye-aye opsin genes. The most likely explanation for these findings is that dichromacy is advantageous for aye-ayes despite their nocturnal activity pattern. We speculate that dichromatic nocturnal primates may be able to perceive color while foraging under moonlight conditions, and suggest that behavioral and ecological comparisons among dichromatic and monochromatic nocturnal primates will help to elucidate the specific activities for which color vision perception is advantageous.

  2. Nocturnal polyuria and decreased serum testosterone: is there an association in men with lower urinary tract symptoms?

    PubMed

    Kim, Jin Wook; Oh, Mi Mi; Yoon, Cheol Yong; Bae, Jae Hyun; Kim, Je Jong; Moon, Du Geon

    2014-05-01

    To investigate the putative association between nocturia and decreased serum testosterone in men with lower urinary tract symptoms. Frequency volume charts and serum testosterone levels of patients visiting the outpatient clinic for lower urinary tract symptoms were collected and analyzed. Age, prostate volume, body mass index and the presence of comorbidities were accounted for. Frequency volume charts were analyzed for pathophysiological components of nocturnal polyuria, global polyuria, decreased nocturnal bladder capacity and increased frequency to identify associated risks. Frequency volume charts were also used to chart 8-h changes of volume, frequency and capacity to identify time diurnal interactions with risk factors based on serum testosterone levels. A total of 2180 patients were enrolled in the study. Multivariate analysis showed testosterone decreased 0.142 ng/mL for every increase in nocturia, independent of other factors. Logistic regression analysis showed a significant difference between pathophysiological components. Decreased testosterone was shown to carry a significant independent risk for overall nocturia (odds ratio 1.60, 95% confidence interval 1.013-2.527, P = 0.044), and particularly nocturnal polyuria (odds ratio 1.934, 95% confidence interval 1.001-3.737, P = 0.027). Repeated measurement models showed patients with serum testosterone below 2.50 ng/mL to have a paradoxical increase in nocturnal urine volume at night. Nocturia, especially nocturnal polyuria, is associated with decreased serum testosterone. Patients with low serum testosterone show increased nocturnal urine output. © 2013 The Japanese Urological Association.

  3. Superior visual performance in nocturnal insects: neural principles and bio-inspired technologies

    NASA Astrophysics Data System (ADS)

    Warrant, Eric J.

    2016-04-01

    At night, our visual capacities are severely reduced, with a complete loss in our ability to see colour and a dramatic loss in our ability to see fine spatial and temporal details. This is not the case for many nocturnal animals, notably insects. Our recent work, particularly on fast-flying moths and bees and on ball-rolling dung beetles, has shown that nocturnal animals are able to distinguish colours, to detect faint movements, to learn visual landmarks, to orient to the faint pattern of polarised light produced by the moon and to navigate using the stars. These impressive visual abilities are the result of exquisitely adapted eyes and visual systems, the product of millions of years of evolution. Nocturnal animals typically have highly sensitive eye designs and visual neural circuitry that is optimised for extracting reliable information from dim and noisy visual images. Even though we are only at the threshold of understanding the neural mechanisms responsible for reliable nocturnal vision, growing evidence suggests that the neural summation of photons in space and time is critically important: even though vision in dim light becomes necessarily coarser and slower, it also becomes significantly more reliable. We explored the benefits of spatiotemporal summation by creating a computer algorithm that mimicked nocturnal visual processing strategies. This algorithm dramatically increased the reliability of video collected in dim light, including the preservation of colour, strengthening evidence that summation strategies are essential for nocturnal vision.

  4. Nocturnal hypoglycaemia in type 1 diabetes--consequences and assessment.

    PubMed

    DeVries, J Hans; Wentholt, Iris M E; Masurel, Nathalie; Mantel, Itske; Poscia, Alessandro; Maran, Alberto; Heine, Robert J

    2004-01-01

    Hypoglycaemia is inevitable when striving for low HbA1c values. Nocturnal hypoglycaemia often occurs without symptoms, but results in diminished next day well-being and hypoglycaemia unawareness. Frequency of nocturnal hypoglycaemia was first assessed in research ward settings, but suffered from insufficient glucose sampling frequency. This may have resulted in overestimation of the duration of hypoglycaemic episodes. The advent of the first continuous glucose sensor, the needle-type MedtronicMiniMed Continuous Glucose Measurement System, revolutionized the assessment of glucose values. However, on scrutiny, the first version of this sensor showed a drift into the hypoglycaemic area and delayed recovery from hypoglycaemia. Using the microdialysis-based GlucoDay system, our group reported a lower frequency of nocturnal hypoglycaemia in type 1 diabetes patients using an insulin pump, than that expected from the existing literature. Today, more than 80 years after the introduction of insulin for the treatment of type 1 diabetes, the associated frequency of nocturnal hypoglycaemia still awaits its definitive assessment. Copyright 2004 John Wiley & Sons, Ltd.

  5. Effects of work stress on work-related rumination, restful sleep, and nocturnal heart rate variability experienced on workdays and weekends.

    PubMed

    Vahle-Hinz, Tim; Bamberg, Eva; Dettmers, Jan; Friedrich, Niklas; Keller, Monika

    2014-04-01

    The present study reports the lagged effects of work stress on work-related rumination, restful sleep, and nocturnal heart rate variability experienced during both workdays and weekends. Fifty employees participated in a diary study. Multilevel and regression analyses revealed a significant relationship between work stress measured at the end of a workday, work-related rumination measured during the evening, and restful sleep measured the following morning. Work stress, measured as the mean of 2 consecutive workdays, was substantially but not significantly related to restful sleep on weekends. Work stress was unrelated to nocturnal heart rate variability. Work-related rumination was related to restful sleep on weekends but not on workdays. Additionally, work-related rumination on weekends was positively related to nocturnal heart rate variability during the night between Saturday and Sunday. No mediation effects of work stress on restful sleep or nocturnal heart rate variability via work-related rumination were confirmed.

  6. The effect of the lunar cycle on fecal cortisol metabolite levels and foraging ecology of nocturnally and diurnally active spiny mice.

    PubMed

    Gutman, Roee; Dayan, Tamar; Levy, Ofir; Schubert, Iris; Kronfeld-Schor, Noga

    2011-01-01

    We studied stress hormones and foraging of nocturnal Acomys cahirinus and diurnal A. russatus in field populations as well as in two field enclosures populated by both species and two field enclosures with individuals of A. russatus alone. When alone, A. russatus individuals become also nocturnally active. We asked whether nocturnally active A. russatus will respond to moon phase and whether this response will be obtained also in diurnally active individuals. We studied giving-up densities (GUDs) in artificial foraging patches and fecal cortisol metabolite levels. Both species exhibited elevated fecal cortisol metabolite levels and foraged to higher GUDs in full moon nights; thus A. russatus retains physiological response and behavioral patterns that correlate with full moon conditions, as can be expected in nocturnal rodents, in spite of its diurnal activity. The endocrinological and behavioral response of this diurnal species to moon phase reflects its evolutionary heritage.

  7. Nocturnal motor activity in fibromyalgia patients with poor sleep quality.

    PubMed

    Hyyppä, M T; Kronholm, E

    1995-01-01

    Nocturnal motor activity was examined in long-term rehabilitation patients complaining of poor sleep and having fibromyalgia syndrome (N = 24) or other musculoskeletal disorders (N = 60) and compared with that in 91 healthy controls drawn from a random community sample. Self-reports on sleep complaints and habits were collected. The frequency of nocturnal body movements, the "apnoea" index and ratio of "quiet sleep" to total time in bed were measured using the Static Charge Sensitive Bed (SCSB) (BioMatt). As a group, patients with fibromyalgia syndrome did not differ from patients with other musculoskeletal disorders or from healthy controls in their nocturnal motor activity. The "apnoea" index was a little higher in the fibromyalgia group than in the healthy control group but did not differ from that of the group of other musculoskeletal patients. Further multivariate analyses adjusted for age, BMI, medication and "apnoea" index did not support the assumption that an increased nocturnal motor activity characterizes patients with fibromyalgia syndrome.

  8. The influence of periodic increases of human activity on crepuscular and nocturnal mammals: Testing the weekend effect.

    PubMed

    Nix, Joshua H; Howell, Ryan G; Hall, Lucas K; McMillan, Brock R

    2018-01-01

    Human recreation can negatively affect wildlife, particularly on weekends when human activity is highest (i.e., the weekend effect). Much of what we understand about the weekend effect is based on research conducted on diurnal species, which have greater temporal overlap with humans. Because nocturnal species generally avoid times when humans are active, they are likely less affected by anthropogenic activity on weekends. Our objective was to test the weekend effect in relation to the degree of nocturnality of mammals in a recreational area. We predicted that as nocturnality increased, the effect of human activity would decrease. To address our objective, we placed 50 remote cameras along the Diamond Fork River in Utah from January to June 2015. We found that three out of the four focal species supported our predictions. Mule deer (crepuscular) reduced activity throughout our entire study area during weekends and avoided campgrounds. Beavers and mountain lions (both nocturnal) did not negatively respond to increased human activity. Raccoons (nocturnal) reduced activity during weekends, but only within campground areas. Our findings indicate that as the temporal overlap increases between wildlife and humans, so does the influence that humans have on wildlife. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Invasion of Ancestral Mammals into Dim-light Environments Inferred from Adaptive Evolution of the Phototransduction Genes

    PubMed Central

    Wu, Yonghua; Wang, Haifeng; Hadly, Elizabeth A.

    2017-01-01

    Nocturnality is a key evolutionary innovation of mammals that enables mammals to occupy relatively empty nocturnal niches. Invasion of ancestral mammals into nocturnality has long been inferred from the phylogenetic relationships of crown Mammalia, which is primarily nocturnal, and crown Reptilia, which is primarily diurnal, although molecular evidence for this is lacking. Here we used phylogenetic analyses of the vision genes involved in the phototransduction pathway to predict the diel activity patterns of ancestral mammals and reptiles. Our results demonstrated that the common ancestor of the extant Mammalia was dominated by positive selection for dim-light vision, supporting the predominate nocturnality of the ancestral mammals. Further analyses showed that the nocturnality of the ancestral mammals was probably derived from the predominate diurnality of the ancestral amniotes, which featured strong positive selection for bright-light vision. Like the ancestral amniotes, the common ancestor of the extant reptiles and various taxa in Squamata, one of the main competitors of the temporal niches of the ancestral mammals, were found to be predominate diurnality as well. Despite this relatively apparent temporal niche partitioning between ancestral mammals and the relevant reptiles, our results suggested partial overlap of their temporal niches during crepuscular periods. PMID:28425474

  10. Salmeterol versus slow-release theophylline combined with ketotifen in nocturnal asthma: a multicentre trial. French Multicentre Study Group.

    PubMed

    Muir, J F; Bertin, L; Georges, D

    1992-11-01

    We wished to assess the efficacy of inhaled salmeterol (SML; 50 micrograms b.i.d.) compared to a combination of slow-release theophylline and ketotifen p.o. (TK; T 300 mg+K 1 mg b.i.d.) for the treatment of nocturnal asthma. Ninety six patients with nocturnal asthma, (forced expiratory volume in one second (FEV1) 60-90% of predicted value, reversibility > or = 15%, at least two nocturnal awakenings per week) were eligible for a multicentre, double-blind, double-dummy cross-over study (14-day run-in, two successive 28-day treatment periods). Efficacy was assessed as success/failure, success being defined as the complete disappearance of nocturnal symptoms/awakening during the last week of each treatment period. There was a statistically significant difference between SML and TK for this criterion: 46% and 39% success with SML during periods I (first 28-day period) and II (following the cross-over), compared to only 15% and 26% with TK, respectively (p < 0.01). SML was also significantly better for the other criteria (lung function, rescue salbutamol intake during day and night). Side-effects were five times less frequent in SML-treated patients (p < 0.004). Efficacy and tolerance of SML were obviously far better than those of TK in patients with nocturnal asthma.

  11. Separating selection by diurnal and nocturnal pollinators on floral display and spur length in Gymnadenia conopsea.

    PubMed

    Sletvold, Nina; Trunschke, Judith; Wimmergren, Carolina; Agren, Jon

    2012-08-01

    Most plants attract multiple flower visitors that may vary widely in their effectiveness as pollinators. Floral evolution is expected to reflect interactions with the most important pollinators, but few studies have quantified the contribution of different pollinators to current selection on floral traits. To compare selection mediated by diurnal and nocturnal pollinators on floral display and spur length in the rewarding orchid Gymnadenia conopsea, we manipulated the environment by conducting supplemental hand-pollinations and selective pollinator exclusions in two populations in central Norway. In both populations, the exclusion of diurnal pollinators significantly reduced seed production compared to open pollination, whereas the exclusion of nocturnal pollinators did not. There was significant selection on traits expected to influence pollinator attraction and pollination efficiency in both the diurnal and nocturnal pollination treatment. The relative strength of selection among plants exposed to diurnal and nocturnal visitors varied among traits and populations, but the direction of selection was consistent. The results suggest that diurnal pollinators are more important than nocturnal pollinators for seed production in the study populations, but that both categories contribute to selection on floral morphology. The study illustrates how experimental manipulations can link specific categories of pollinators to observed selection on floral traits, and thus improve our understanding of how species interactions shape patterns of selection.

  12. Total lactate dehydrogenase activity of tail muscle is not cold-adapted in nocturnal lizards from cool-temperate habitats.

    PubMed

    Hare, K M; Miller, J H; Clark, A G; Daugherty, C H

    2005-12-01

    The dependence of metabolic processes on temperature constrains the behavior, physiology and ecology of many ectothermic animals. The evolution of nocturnality in lizards, especially in temperate regions, requires adaptations for activity at low temperatures when optimal body temperatures are unlikely to be obtained. We examined whether nocturnal lizards have cold-adapted lactate dehydrogenase (LDH). LDH was chosen as a representative metabolic enzyme. We measured LDH activity of tail muscle in six lizard species (n=123: three nocturnal, two diurnal and one crepuscular) between 5 and 35 degrees C and found no differences in LDH-specific activity or thermal sensitivity among the species. Similarly, the specific activity and thermal sensitivity of LDH were similar between skinks and geckos. Similar enzyme activities among nocturnal and diurnal lizards indicate that there is no selection of temperature specific LDH enzyme activity at any temperature. As many nocturnal lizards actively thermoregulate during the day, LDH may be adapted for a broad range of temperatures rather than adapted specifically for the low temperatures encountered when the animals are active. The total activity of LDH in tropical and temperate lizards is not cold-adapted. More data are required on biochemical adaptations and whole animal thermal preferences before trends can be established.

  13. Effects of Night-Time Use of Rotigotine on Nocturnal Symptoms in Parkinson's Disease

    PubMed Central

    Vallderiola, Francesc; Compta, Yaroslau; Aparicio, Javier; Tarradellas, Jaume; Salazar, Gabriel; Oliver, Josep María; Callén, Antonio; Delgado, Tania; Nobbe, Fritz

    2015-01-01

    Objectives. This open-label study assessed the efficacy and safety of exclusive night-time administration of transdermal rotigotine in patients with nocturnal and early morning PD symptoms. Methods. Patients with PD and nocturnal and early morning symptoms received transdermal rotigotine patches (2–16 mg/24 h) applied in the evening and removed in the morning for 3 months. Sleep disturbance was assessed with modified Parkinson's Disease Sleep Scale (PDSS-2). Other outcomes included a pain visual analogue scale (VAS) and short-form Parkinson's Disease Questionnaire (PDQ-8) for quality of life. Results. 74 patients completed treatment in this study. At the end of treatment, PDSS-2 total score had improved by mean 10.9 points from baseline (p < 0.001). All three PDSS-2 domain scores (sleep disturbances, nocturnal motor symptoms, and nocturnal symptoms) were also significantly improved by 41%, 56%, and 48%, respectively (p < 0.001). VAS-pain score decreased from 3.2 to 2.3 (p < 0.001). PDQ-8 score decreased from 23.8 to 18.1 (p < 0.001). The most frequently reported adverse events included nausea (9%), anxiety (4%), and dizziness (4%). Conclusions. Night-time administration of transdermal rotigotine is an effective and well tolerated treatment for nocturnal symptoms in patients with PD. PMID:26576319

  14. REM Sleep Phase Preference in the Crepuscular Octodon degus Assessed by Selective REM Sleep Deprivation

    PubMed Central

    Ocampo-Garcés, Adrián; Hernández, Felipe; Palacios, Adrian G.

    2013-01-01

    Study Objectives: To determine rapid eye movement (REM) sleep phase preference in a crepuscular mammal (Octodon degus) by challenging the specific REM sleep homeostatic response during the diurnal and nocturnal anticrepuscular rest phases. Design: We have investigated REM sleep rebound, recovery, and documented REM sleep propensity measures during and after diurnal and nocturnal selective REM sleep deprivations. Subjects: Nine male wild-captured O. degus prepared for polysomnographic recordings Interventions: Animals were recorded during four consecutive baseline and two separate diurnal or nocturnal deprivation days, under a 12:12 light-dark schedule. Three-h selective REM sleep deprivations were performed, starting at midday (zeitgeber time 6) or midnight (zeitgeber time 18). Measurements and Results: Diurnal and nocturnal REM sleep deprivations provoked equivalent amounts of REM sleep debt, but a consistent REM sleep rebound was found only after nocturnal deprivation. The nocturnal rebound was characterized by a complete recovery of REM sleep associated with an augment in REM/total sleep time ratio and enhancement in REM sleep episode consolidation. Conclusions: Our results support the notion that the circadian system actively promotes REM sleep. We propose that the sleep-wake cycle of O. degus is modulated by a chorus of circadian oscillators with a bimodal crepuscular modulation of arousal and a unimodal promotion of nocturnal REM sleep. Citation: Ocampo-Garcés A; Hernández F; Palacios AG. REM sleep phase preference in the crepuscular Octodon degus assessed by selective REM sleep deprivation. SLEEP 2013;36(8):1247-1256. PMID:23904685

  15. Effects of desmopressin for the treatment of nocturnal polyuria in elderly women: impact on related sleep quality

    PubMed Central

    Mun, Jong-Hyeon; Kim, Sun-Ouck; Yu, Ho Song; Chung, Ho Suck; Kwon, Dongdeuk

    2015-01-01

    Introduction: We investigated the efficacy, safety, and impact of desmopressin on quality of sleep in treating nocturnal polyuria in elderly women. Methods: We recruited 60 women over 60 years old with lower urinary tract symptoms (LUTS), including nocturia, and with nocturnal polyuria. Nocturnal polyuria was defined as nighttime urine production exceeding 33% of the 24-hour total urine volume determined by a frequency volume (FV) chart. All patients failed to respond to treatment of their underlying disease and evening fluid restriction. Desmopressin 0.1 mg was administered orally at bedtime for 12 weeks. The participants completed a series of questionnaires on the Medical Outcomes Study (MOS) sleep scale and FV chart before and after treatment. Results: The patient population had a mean age of 69.2 ± 9.4 years (range: 61–81). The mean duration of symptoms was 61.2 ± 45.1 months. Significant decreases were evident after desmopressin treatment in the number of nocturia episodes (3.63 ± 1.61 to 2.00 ± 1.13, p = 0.01), nocturnal urine volume (p = 0.01), nocturnal polyuria index (NPI) (p = 0.01), and nocturia index (NI) p = 0.01). Among the categories of the MOS sleep scale, sleep index (p = 0.003), sleep disturbance (p = 0.001), snoring (p = 0.028), and shortness of breath (p = 0.036) significantly changed, with a decreased number of nocturia episodes. Adverse events were mild. Conclusions: Desmopressin is an effective treatment for nocturnal polyuria in elderly women, where conservative treatment has failed. Sleep quality is also improved. PMID:26600882

  16. ASPIRE In-Home: rationale, design, and methods of a study to evaluate the safety and efficacy of automatic insulin suspension for nocturnal hypoglycemia.

    PubMed

    Klonoff, David C; Bergenstal, Richard M; Garg, Satish K; Bode, Bruce W; Meredith, Melissa; Slover, Robert H; Ahmann, Andrew; Welsh, John B; Lee, Scott W

    2013-07-01

    Nocturnal hypoglycemia is a barrier to therapy intensification efforts in diabetes. The Paradigm® Veo™ system may mitigate nocturnal hypoglycemia by automatically suspending insulin when a prespecified sensor glucose threshold is reached. ASPIRE (Automation to Simulate Pancreatic Insulin REsponse) In-Home (NCT01497938) was a multicenter, randomized, parallel, adaptive study of subjects with type 1 diabetes. The control arm used sensor-augmented pump therapy. The treatment arm used sensor-augmented pump therapy with threshold suspend, which automatically suspends the insulin pump in response to a sensor glucose value at or below a prespecified threshold. To be randomized, subjects had to have demonstrated ≥2 episodes of nocturnal hypoglycemia, defined as >20 consecutive minutes of sensor glucose values ≤65 mg/dl starting between 10:00 PM and 8:00 AM in the 2-week run-in phase. The 3-month study phase evaluated safety by comparing changes in glycated hemoglobin (A1C) values and evaluated efficacy by comparing the mean area under the glucose concentration time curves for nocturnal hypoglycemia events in the two groups. Other outcomes included the rate of nocturnal hypoglycemia events and the distribution of sensor glucose values. Data from the ASPIRE In-Home study should provide evidence on the safety of the threshold suspend feature with respect to A1C and its efficacy with respect to severity and duration of nocturnal hypoglycemia when used at home over a 3-month period. © 2013 Diabetes Technology Society.

  17. Sensitivity of nocturnal boundary layer temperature to tropospheric aerosol surface radiative forcing under clear-sky conditions

    NASA Astrophysics Data System (ADS)

    Nair, Udaysankar S.; McNider, Richard; Patadia, Falguni; Christopher, Sundar A.; Fuller, Kirk

    2011-01-01

    Since the middle of the last century, global surface air temperature exhibits an increasing trend, with nocturnal temperatures increasing at a much higher rate. Proposed causative mechanisms include the radiative impact of atmospheric aerosols on the nocturnal boundary layer (NBL) where the temperature response is amplified due to shallow depth and its sensitivity to potential destabilization. A 1-D version of the Regional Atmospheric Modeling System is used to examine the sensitivity of the nocturnal boundary layer temperature to the surface longwave radiative forcing (SLWRF) from urban aerosol loading and doubled atmospheric carbon dioxide concentrations. The analysis is conducted for typical midlatitude nocturnal boundary layer case days from the CASES-99 field experiment and is further extended to urban sites in Pune and New Delhi, India. For the cases studied, locally, the nocturnal SLWRF from urban atmospheric aerosols (2.7-47 W m-2) is comparable or exceeds that caused by doubled atmospheric carbon dioxide (3 W m-2), with the surface temperature response ranging from a compensation for daytime cooling to an increase in the nocturnal minimum temperature. The sensitivity of the NBL to radiative forcing is approximately 4 times higher compared to the daytime boundary layer. Nighttime warming or cooling may occur depending on the nature of diurnal variations in aerosol optical depth. Soil moisture also modulates the magnitude of SLWRF, decreasing from 3 to 1 W m-2 when soil saturation increases from 37% to 70%. These results show the importance of aerosols on the radiative balance of the climate system.

  18. A meta-analysis of rate ratios for nocturnal confirmed hypoglycaemia with insulin degludec vs. insulin glargine using different definitions for hypoglycaemia.

    PubMed

    Heller, S; Mathieu, C; Kapur, R; Wolden, M L; Zinman, B

    2016-04-01

    A prospective meta-analysis of phase 3 trials showed lower rates of nocturnal hypoglycaemia with insulin degludec vs. insulin glargine. We investigated the consistency of the results across different definitions of hypoglycaemia. This post-hoc, patient-level meta-analysis included six randomized, controlled, 26- or 52-week phase 3a trials in insulin-naïve participants with Type 2 diabetes mellitus (Type 2 diabetesinsulin naïve ), participants with Type 2 diabetes mellitus using basal-bolus therapy (Type 2 diabetesBB ) and those with Type 1 diabetes mellitus. We used three definitions of hypoglycaemia and different timescales for the nocturnal period. Rates were analysed for the entire core trial period, the 'maintenance period' only, and the extension trial set population. Analyses utilized a negative binomial regression model. In Type 2 diabetesinsulin naïve participants, risk of nocturnal hypoglycaemia was significantly lower with insulin degludec vs. insulin glargine for all hypoglycaemia definitions and trial periods. Risk was also lower for the timescale 21.59-05.59, but not 00.01-07.59. For Type 2 diabetesBB , nocturnal hypoglycaemia rates were lower with insulin degludec vs. insulin glargine across all definitions, timescales and trial periods, with one exception. For individuals with Type 1 diabetes mellitus, nocturnal hypoglycaemia risk was significantly lower with insulin degludec during the maintenance period for the original definition (plasma glucose < 3.1 mmol/l, timescale 00.01-05.59) and in the extension trial set population for all hypoglycaemia definitions except for the nocturnal timescale 00.01-07.59. Compared with insulin glargine, insulin degludec is associated with lower rates of nocturnal hypoglycaemia in people with Type 2 diabetes mellitus, and similar or lower rates in Type 1 diabetes mellitus, across different definitions. © 2015 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  19. The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study.

    PubMed

    Kim, Young Won; Park, Jinsung; Chung, Hong; Kim, Hong-Wook; Kim, Hyung Joon; Jung, Jae Hung; Kim, Won Tae

    2015-09-01

    To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33), aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6%) completed the study according to the study protocol (per-protocol group), and 24 dropped out (dropout group). Of the 24 patients in the dropout group, 5 withdrew consent due to side effects or lack of efficacy, 7 were lost to follow-up at 4 weeks, 8 were lost to follow-up at 12 weeks, and 4 dropped out due to failure to complete 3-day frequency volume charts at 12 weeks. In the per-protocol group, there was significant improvement in the International Prostate Symptom Score (IPSS), especially question numbers 1, 3, 4, 5, 6, 7, and the quality of life question (P=0.001, P=0.007, P<0.001, P=0.003, P=0.049, P<0.001, and P<0.001, respectively). The Leeds sleep evaluation questionnaire (LSEQ) score for the sleep question improved from 64.36 to 70.43 (P=0.039). The NPi reduced from 0.4005 to 0.3573 (P=0.027); however, in many cases, there was no improvement in nocturnal polyuria itself. In intention-to-treat analysis, there were significant improvements in IPSS and LSEQ in 45 patients. In elderly nocturnal polyuria patients, silodosin monotherapy exhibits good efficacy in improving nocturia and nocturnal polyuria; however, the mean NPi was still >0.33. Considering the high dropout rate of our study due to no implementation of 3-day frequency volume charts, prospective and large-scale studies are needed to confirm our results.

  20. The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study

    PubMed Central

    Kim, Young Won; Park, Jinsung; Chung, Hong; Kim, Hong-Wook; Kim, Hyung Joon; Jung, Jae Hung; Kim, Won Tae

    2015-01-01

    Purpose: To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. Methods: This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33), aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6%) completed the study according to the study protocol (per-protocol group), and 24 dropped out (dropout group). Results: Of the 24 patients in the dropout group, 5 withdrew consent due to side effects or lack of efficacy, 7 were lost to follow-up at 4 weeks, 8 were lost to follow-up at 12 weeks, and 4 dropped out due to failure to complete 3-day frequency volume charts at 12 weeks. In the per-protocol group, there was significant improvement in the International Prostate Symptom Score (IPSS), especially question numbers 1, 3, 4, 5, 6, 7, and the quality of life question (P=0.001, P=0.007, P<0.001, P=0.003, P=0.049, P<0.001, and P<0.001, respectively). The Leeds sleep evaluation questionnaire (LSEQ) score for the sleep question improved from 64.36 to 70.43 (P=0.039). The NPi reduced from 0.4005 to 0.3573 (P=0.027); however, in many cases, there was no improvement in nocturnal polyuria itself. In intention-to-treat analysis, there were significant improvements in IPSS and LSEQ in 45 patients. Conclusions: In elderly nocturnal polyuria patients, silodosin monotherapy exhibits good efficacy in improving nocturia and nocturnal polyuria; however, the mean NPi was still >0.33. Considering the high dropout rate of our study due to no implementation of 3-day frequency volume charts, prospective and large-scale studies are needed to confirm our results. PMID:26620902

  1. Extended Duration Nocturnal Hemodialysis and Changes in Plasma Metabolite Profiles.

    PubMed

    Kalim, Sahir; Wald, Ron; Yan, Andrew T; Goldstein, Marc B; Kiaii, Mercedeh; Xu, Dihua; Berg, Anders H; Clish, Clary; Thadhani, Ravi; Rhee, Eugene P; Perl, Jeffrey

    2018-03-07

    In-center, extended duration nocturnal hemodialysis has been associated with variable clinical benefits, but the effect of extended duration hemodialysis on many established uremic solutes and other components of the metabolome is unknown. We determined the magnitude of change in metabolite profiles for patients on extended duration nocturnal hemodialysis. In a 52-week prospective, observational study, we followed 33 patients receiving conventional thrice weekly hemodialysis who converted to nocturnal hemodialysis (7-8 hours per session, three times per week). A separate group of 20 patients who remained on conventional hemodialysis (3-4 hours per session, three times per week) served as a control group. For both groups, we applied liquid chromatography-mass spectrometry-based metabolite profiling on stored plasma samples collected from all participants at baseline and after 1 year. We examined longitudinal changes in 164 metabolites among those who remained on conventional hemodialysis and those who converted to nocturnal hemodialysis using Wilcoxon rank sum tests adjusted for multiple comparisons (false discovery rate <0.05). On average, the nocturnal group had 9.6 hours more dialysis per week than the conventional group. Among 164 metabolites, none changed significantly from baseline to study end in the conventional group. Twenty-nine metabolites changed in the nocturnal group, 21 of which increased from baseline to study end (including all branched-chain amino acids). Eight metabolites decreased after conversion to nocturnal dialysis, including l-carnitine and acetylcarnitine. By contrast, several established uremic retention solutes, including p -cresol sulfate, indoxyl sulfate, and trimethylamine N -oxide, did not change with extended dialysis. Across a wide array of metabolites examined, extended duration hemodialysis was associated with modest changes in the plasma metabolome, with most differences relating to metabolite increases, despite increased dialysis time. Few metabolites showed reduction with more dialysis, and no change in several established uremic toxins was observed. Copyright © 2018 by the American Society of Nephrology.

  2. Nocturnal Polyuria and Hypertension in Patients with Lifestyle Related Diseases and Overactive Bladder.

    PubMed

    Yokoyama, Osamu; Nishizawa, Osamu; Homma, Yukio; Takeda, Masayuki; Gotoh, Momokazu; Kakizaki, Hidehiro; Akino, Hironobu; Hayashi, Koichi; Yonemoto, Koji

    2017-02-01

    The objective of this multicenter cross-sectional study was to investigate the relationship of nocturnal polyuria in patients with common lifestyle related diseases and overactive bladder, with special attention to hypertension. After baseline assessment, patients recorded 24-hour urinary frequency/volume, blood pressure and heart rate for 3 days. They were stratified into 4 groups based on mean blood pressure, including no hypertension, and controllable, untreated and uncontrolled hypertension, respectively. The 2,353 eligible patients, who had urinary urgency once or more per week and 1 or more nocturnal toilet visits, were enrolled from 543 sites in Japan. Of these patients complete data, including the 24-hour frequency volume chart, were collected from 1,271. Multivariable analyses showed a statistically significant association of nocturnal polyuria with increasing age (OR 1.04, 95% CI 1.02-1.05, p <0.001) and gender (women vs men OR 0.75, 95% CI 0.59-0.96, p = 0.02), and for controllable (OR 1.10, 95% CI 0.83-1.460), untreated (OR 2.62, 95% CI 1.55-4.45) and uncontrolled (OR 1.15, 95% CI 0.81-1.62) hypertension vs no hypertension (p = 0.005). However, when assessed separately in men and women, hypertension and heart rate were significantly associated with nocturnal polyuria in women alone (p = 0.01 and 0.03, respectively). Lower urinary tract symptoms suggestive of benign prostatic hyperplasia were significantly associated with nocturnal polyuria in men alone (p <0.001). The current study demonstrates that nocturnal polyuria was significantly associated with age, male gender, and untreated hypertension in patients with lifestyle related diseases and overactive bladder. The association between hypertension and nocturnal polyuria was significant in women alone. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Insects as unidentified flying objects.

    PubMed

    Callahan, P S; Mankin, R W

    1978-11-01

    Five species of insects were subjected to a large electric field. Each of the insects stimulated in this manner emitted visible glows of various colors and blacklight (uv). It is postulated that the Uintah Basin, Utah, nocturnal UFO display (1965-1968) was partially due to mass swarms of spruce budworms, Choristoneura fumiferana (Clemens), stimulated to emit this type of St. Elmo's fire by flying into high electric fields caused by thunderheads and high density particulate matter in the air. There was excellent time and spatial correlation between the 1965-1968 UFO nocturnal sightings and spruce budworm infestation. It is suggested that a correlation of nocturnal UFO sightings throughout the U.S. and Canada with spruce budworm infestations might give some insight into nocturnal insect flight patterns.

  4. Nocturnal bruxism and temporomandibular disorders.

    PubMed

    Rugh, J D; Harlan, J

    1988-01-01

    This chapter has discussed the important aspects of nocturnal bruxism and its relation to disorders of the masticatory system and headaches. Bruxism is believed to be a stress-related sleep disorder, occurring in both men and women, in children, and in adults. In most patients, bruxism results only in minor tooth wear; however, it can become extremely severe with damage occurring in essentially every part of the masticatory apparatus. Nocturnal bruxism should not be overlooked as an etiologic factor in muscular headaches. Short-term acute therapy may involve physical therapy, nocturnal electromyographic biofeedback, and medication to relieve anxiety and improve sleep. Long-term management usually includes some form of stress reduction, change in lifestyle, and an occlusal splint or nightguard to protect the teeth and masticatory system.

  5. Efficacy of a Mandibular Advancement Appliance on Sleep Disordered Breathing in Children: A Study Protocol of a Crossover Randomized Controlled Trial

    PubMed Central

    Idris, Ghassan; Galland, Barbara; Robertson, Christopher J.; Farella, Mauro

    2016-01-01

    Background: Sleep-Disordered Breathing (SDB) varies from habitual snoring to partial or complete obstruction of the upper airway and can be found in up to 10% of children. SDB can significantly affect children's wellbeing, as it can cause growth disorders, educational and behavioral problems, and even life-threatening conditions, such as cardiorespiratory failure. Adenotonsillectomy represents the primary treatment for pediatric SDB where adeno-tonsillar hypertrophy is indicated. For those with craniofacial anomalies, or for whom adenotonsillectomy or other treatment modalities have failed, or surgery is contra-indicated, mandibular advancement splints (MAS) may represent a viable treatment option. Whilst the efficacy of these appliances has been consistently demonstrated in adults, there is little information about their effectiveness in children. Aims: To determine the efficacy of mandibular advancement appliances for the management of SDB and related health problems in children. Methods/design: The study will be designed as a single-blind crossover randomized controlled trial with administration of both an “Active MAS” (Twin-block) and a “Sham MAS.” Eligible participants will be children aged 8–12 years whose parents report they snore ≥3 nights per week. Sixteen children will enter the full study after confirming other inclusion criteria, particularly Skeletal class I or class II confirmed by lateral cephalometric radiograph. Each child will be randomly assigned to either a treatment sequence starting with the Active or the Sham MAS. Participants will wear the appliances for 3 weeks separated by a 2-week washout period. For each participant, home-based polysomnographic data will be collected four times; once before and once after each treatment period. The Apnea Hypopnea Index (AHI) will represent the main outcome variable. Secondary outcomes will include, snoring frequency, masseter muscle activity, sleep symptoms, quality of life, daytime sleepiness, children behavior, and nocturnal enuresis. In addition, blood samples will be collected to assess growth hormone changes. Trial registration: This study was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR): [ACTRN12614001013651]. PMID:27594841

  6. Chronic complications and quality of life of patients living with sickle cell disease and receiving care in three hospitals in Cameroon: a cross-sectional study.

    PubMed

    Andong, Anne M; Ngouadjeu, Eveline D T; Bekolo, Cavin E; Verla, Vincent S; Nebongo, Daniel; Mboue-Djieka, Yannick; Choukem, Simeon-Pierre

    2017-01-01

    Sickle Cell Disease (SCD) is associated with chronic multisystem complications that significantly influence the quality of life (QOL) of patients early in their life. Although sub-Saharan Africa bears 75% of the global burden of SCD, there is a paucity of data on these complications and their effects on the QOL. We aimed to record these chronic complications, to estimate the QOL, and to identify the corresponding risk factors in patients with SCD receiving care in three hospitals in Cameroon. In this cross-sectional study, a questionnaire was used to collect data from consecutive consenting patients. Information recorded included data on the yearly frequency of painful crisis, the types of SCD, and the occurrence of chronic complications. A 36-Item Short Form (SF-36) standard questionnaire that examines the level of physical and mental well-being, was administered to all eligible participants. Data were analyzed with STATA® software. Of 175 participants included, 93 (53.1%) were female and 111 (aged ≥14 years) were eligible for QOL assessment. The median (interquartile range, IQR) age at diagnosis was 4.0 (2.0-8.0) years and the median (IQR) number of yearly painful crisis was 3.0 (1.0-7.0). The most frequent chronic complications reported were: nocturnal enuresis, chronic leg ulcers, osteomyelitis and priapism (30.9%, 24.6%, 19.4%, and 18.3% respectively). The prevalence of stroke and avascular necrosis of the hip were 8.0% and 13.1% respectively. The median (IQR) physical and mental scores were 47.3 (43.9-58.5) and 41.0 (38.8-44.6) respectively. Age and chronic complications such as stroke and avascular necrosis were independently associated with poor QOL. In this population of patients living with SCD, chronic complications are frequent and their QOL is consequently poor. Our results highlight the need for national guidelines for SCD control, which should include new-born screening programs and strategies to prevent chronic complications.

  7. Proximal tubule proteins are significantly elevated in bladder urine of patients with ureteropelvic junction obstruction and may represent novel biomarkers: A pilot study.

    PubMed

    Gerber, Claire; Harel, Miriam; Lynch, Miranda L; Herbst, Katherine W; Ferrer, Fernando A; Shapiro, Linda H

    2016-04-01

    Ureteropelvic junction obstruction (UPJO) is the major cause of hydronephrosis in children and may lead to renal injury and early renal dysfunction. However, diagnosis of the degree of obstruction and severity of renal injury relies on invasive and often inconclusive renal scans. Biomarkers from voided urine that detect early renal injury are highly desirable because of their noninvasive collection and their potential to assist in earlier and more reliable diagnosis of the severity of obstruction. Early in response to UPJO, increased intrarenal pressure directly impacts the proximal tubule brush border. We hypothesize that single-pass, apically expressed proximal tubule brush border proteins will be shed into the urine early and rapidly and will be reliable noninvasive urinary biomarkers, providing the tools for a more reliable stratification of UPJO patients. We performed a prospective cohort study at Connecticut Children's Medical Center. Bladder urine samples from 12 UPJO patients were obtained prior to surgical intervention. Control urine samples were collected from healthy pediatric patients presenting with primary nocturnal enuresis. We determined levels of NGAL, KIM-1 (previously identified biomarkers), CD10, CD13, and CD26 (potentially novel biomarkers) by ELISA in control and experimental urine samples. Urinary creatinine levels were used to normalize the urinary protein levels measured by ELISA. Each of the proximal tubule proteins outperformed the previously published biomarkers. No differences in urinary NGAL and KIM-1 levels were observed between control and obstructed patients (p = 0.932 and p = 0.799, respectively). However, levels of CD10, CD13, and CD26 were significantly higher in the voided urine of obstructed individuals when compared with controls (p = 0.002, p = 0.024, and p = 0.007, respectively) (Figure). Targeted identification of reliable, noninvasive biomarkers of renal injury is critical to aid in diagnosing patients at risk, guiding therapeutic decisions and monitoring treatment efficacy. Proximal tubule brush border proteins are reliably detected in the urine of obstructed patients and may be more effective at predicting UPJO. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  8. Prevalence, risk factors and the bother of lower urinary tract symptoms in China: a population-based survey.

    PubMed

    Wang, Yuliang; Hu, Hao; Xu, Kexin; Wang, Xiaofeng; Na, Yanqun; Kang, Xiaoping

    2015-06-01

    Lower urinary tract symptoms (LUTS) consist of storage, voiding and postmicturition symptoms and cause discomfort in approximately 15.8 to 82.0 % of adults worldwide. Despite the wide range in prevalence rates, certain potential risk factors for LUTS have been identified, advanced age being the most noted one. However, the true extent of symptom discomfort among the affected population may be underestimated because of the considerable underreporting of the problem. The objective of this study was to evaluate the prevalence, risk factors and discomfort caused by LUTS in China. This population-based, cross-sectional survey was conducted in five geographical regions of China. A stratified, clustered, systematic sample of individuals aged ≥18 years was selected to answer demographic questionnaires and the International Consultation on Incontinence Questionnaire Male/Female Lower Urinary Tract Symptoms Long Form. A total of 3,023 participants (1,551 men; 1,472 women) were included in this study, and 61.2 % (61.2 % men; 61.1 % women) reported at least one LUTS. The prevalence of storage symptoms (59.8 % men; 60.5 % women) was greater than that of voiding (23.6 % men; 8.8 % women) plus postmicturition symptoms (14.6 % men; 6.3 % women). Nocturia (58.2 % men; 56.9 % women) was the most common specific LUTS. Advanced age, alcohol consumption and smoking were risk factors for LUTS among participants of both sexes. Enlarged prostate, diabetes mellitus and lower education levels correlated positively with LUTS in men, whereas higher parity and hypertension correlated positively with LUTS in women. Subjects with LUTS had great discomfort. Nocturia was the least bothersome symptom in both sexes, whereas nocturnal enuresis and urge urinary incontinence were the most bothersome in men and women respectively. Lower urinary tract symptoms are highly prevalent in China and many known risk factors are associated with these bothersome symptoms. However, the perception of the extent of symptom discomfort differed between sexes, and it may not correspond with symptom prevalence. Thus, an appropriate symptom discomfort assessment tool is needed to identify the clinically relevant conditions that warrant treatment.

  9. Paroxysmal nocturnal hemoglobinuria clones in severe aplastic anemia patients treated with horse anti-thymocyte globulin plus cyclosporine

    PubMed Central

    Scheinberg, Phillip; Marte, Michael; Nunez, Olga; Young, Neal S.

    2010-01-01

    Background Clones of glycosylphosphatidylinositol-anchor protein-deficient cells are characteristic in paroxysmal nocturnal hemoglobinuria and are present in about 40–50% of patients with severe aplastic anemia. Flow cytometry has allowed for sensitive and precise measurement of glycosylphosphatidylinositol-anchor protein-deficient red blood cells and neutrophils in severe aplastic anemia. Design and Methods We conducted a retrospective analysis of paroxysmal nocturnal hemoglobinuria clones measured by flow cytometry in 207 consecutive severe aplastic anemia patients who received immunosuppressive therapy with a horse anti-thymocyte globulin plus cyclosporine regimen from 2000 to 2008. Results The presence of a glycosylphosphatidylinositol-anchor protein-deficient clone was detected in 83 (40%) patients pre-treatment, and the median clone size was 9.7% (interquartile range 3.5–29). In patients without a detectable clone pre-treatment, the appearance of a clone after immunosuppressive therapy was infrequent, and in most with a clone pre-treatment, clone size often decreased after immunosuppressive therapy. However, in 30 patients, an increase in clone size was observed after immunosuppressive therapy. The majority of patients with a paroxysmal nocturnal hemoglobinuria clone detected after immunosuppressive therapy did not have an elevated lactate dehydrogenase, nor did they experience hemolysis or thrombosis, and they did not require specific interventions with anticoagulation and/or eculizumab. Of the 7 patients who did require therapy for clinical paroxysmal nocturnal hemoglobinuria symptoms and signs, all had an elevated lactate dehydrogenase and a clone size greater than 50%. In all, 18 (8.6%) patients had a clone greater than 50% at any given time of sampling. Conclusions The presence of a paroxysmal nocturnal hemoglobinuria clone in severe aplastic anemia is associated with low morbidity and mortality, and specific measures to address clinical paroxysmal nocturnal hemoglobinuria are seldom required. PMID:20595102

  10. Nocturnal cough in children with stable cystic fibrosis.

    PubMed

    van der Giessen, Lianne; Loeve, Martine; de Jongste, Johan; Hop, Wim; Tiddens, Harm

    2009-09-01

    To date no studies have been published on nocturnal cough frequency in children with stable CF. Aim of the study was to assess nocturnal cough frequency in children with CF. In addition nocturnal cough frequency was correlated with parameters of disease severity. During two nights cough was recorded with a digital audio recorder in 25 patients (mean age 13 years; range 6-19) with clinically stable CF. In addition oxygen saturation was measured. The day following the recording spirometry was carried out. CT scores were obtained from the most recent routine CT scan. Cough was expressed in cough seconds (csec) and in cough seconds per hour (csec/hr). Data shown are median values and interquartile range (IQR). First night: 8 csec (IQR 3-52); 0.9 csec/hr (IQR 0.3-6.1) Second night: 6 csec (IQR 2-32); 0.6 csec/hr (IQR 0.1-3.4). Csec in the 1st night did not correlate significantly with csec in the 2nd night. Only for the 2nd night a strong correlation was found between csec/hr and the FEV1%pred (r(s) = -0.75, P < 0.001) and FEF(75) %pred (r(s) = -0.71, P < 0.001). Bronchiectasis score correlated borderline with the mean csec/hr of both nights (r(s) = 0.39, P = 0.08). During both nights cough was significantly higher in the first hour of sleep (P < or = 0.04). Frequency of nocturnal coughing in children with CF was higher than that described for normal children. Nocturnal cough tended to be more severe in children with more advanced CF lung disease. Nocturnal cough was more severe in the first hour of sleep and varied from night-to-night. Copyright 2009 Wiley-Liss, Inc.

  11. End-Tidal CO2 Tension Is Predictive of Effective Nocturnal Oxygen Therapy in Patients with Chronic Heart Failure and Central Sleep Apnea.

    PubMed

    Sugimura, Koichiro; Shinozaki, Tsuyoshi; Fukui, Shigefumi; Ogawa, Hiromasa; Shimokawa, Hiroaki

    2016-05-01

    Central sleep apnea (CSA) is characterized by recurring cycles of crescendo-decrescendo ventilation during sleep, and enhances sympathetic nerve activity. Thus CSA has a prognostic impact in patients with chronic heart failure (CHF). Although nocturnal oxygen (O2) therapy decreases frequency of CSA and improves functional exercise capacity, it is also known that some non-responders to the therapy exist. We thus aimed to identify predictors of responders to nocturnal O2 therapy in CHF patients with CSA. In 12 CHF patients with CSA hospitalized at our department, sleep study was performed at 2 consecutive nights. Patients nasally inhaled O2 at either the first or second night in a randomized manner. To predict the percentage reduction in apnea-hypopnea index (%ΔAHI) in response to the nocturnal O2 therapy, we performed multiple regression analysis with a stepwise method with variables including age, brain-natriuretic peptide, circulation time, baseline AHI, hypercapnic ventilatory response and end-tidal carbon dioxide tension (PETCO2). Nocturnal O2 therapy significantly decreased AHI (from 32 ± 13 /h to 12 ± 10 /h, P < 0.0001). Among the possible predictors, PETCO2 was the only variable that is predictive of % changes in AHI. Receiver operating characteristics analysis determined 4.25% as the optimal cutoff PETCO2 level to identify responder to nocturnal O2 therapy (> 50% reduction of AHI), with 88.9% of sensitivity and 66.7% of specificity. In conclusion, PETCO2 is useful to predict the efficacy of O2 therapy in CHF patients with CSA, providing important information to the current nocturnal O2 therapy.

  12. Small-molecule factor D inhibitors selectively block the alternative pathway of complement in paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome.

    PubMed

    Yuan, Xuan; Gavriilaki, Eleni; Thanassi, Jane A; Yang, Guangwei; Baines, Andrea C; Podos, Steven D; Huang, Yongqing; Huang, Mingjun; Brodsky, Robert A

    2017-03-01

    Paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome are diseases of excess activation of the alternative pathway of complement that are treated with eculizumab, a humanized monoclonal antibody against the terminal complement component C5. Eculizumab must be administered intravenously, and moreover some patients with paroxysmal nocturnal hemoglobinuria on eculizumab have symptomatic extravascular hemolysis, indicating an unmet need for additional therapeutic approaches. We report the activity of two novel small-molecule inhibitors of the alternative pathway component Factor D using in vitro correlates of both paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome. Both compounds bind human Factor D with high affinity and effectively inhibit its proteolytic activity against purified Factor B in complex with C3b. When tested using the traditional Ham test with cells from paroxysmal nocturnal hemoglobinuria patients, the Factor D inhibitors significantly reduced complement-mediated hemolysis at concentrations as low as 0.01 μM. Additionally the compound ACH-4471 significantly decreased C3 fragment deposition on paroxysmal nocturnal hemoglobinuria erythrocytes, indicating a reduced potential relative to eculizumab for extravascular hemolysis. Using the recently described modified Ham test with serum from patients with atypical hemolytic uremic syndrome, the compounds reduced the alternative pathway-mediated killing of PIGA -null reagent cells, thus establishing their potential utility for this disease of alternative pathway of complement dysregulation and validating the modified Ham test as a system for pre-clinical drug development for atypical hemolytic uremic syndrome. Finally, ACH-4471 blocked alternative pathway activity when administered orally to cynomolgus monkeys. In conclusion, the small-molecule Factor D inhibitors show potential as oral therapeutics for human diseases driven by the alternative pathway of complement, including paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome. Copyright© Ferrata Storti Foundation.

  13. Short daily-, nocturnal- and conventional-home hemodialysis have similar patient and treatment survival.

    PubMed

    Tennankore, Karthik K; Na, Yingbo; Wald, Ron; Chan, Christopher T; Perl, Jeffrey

    2018-01-01

    Home hemodialysis (HHD) has many benefits, but less is known about relative outcomes when comparing different home-based hemodialysis modalities. Here, we compare patient and treatment survival for patients receiving short daily HHD (2-3 hours/5 plus sessions per week), nocturnal HHD (6-8 hours/5 plus sessions per week) and conventional HHD (3-6 hours/2-4 sessions per week). A nationally representative cohort of Canadian HHD patients from 1996-2012 was studied. The primary outcome was death or treatment failure (defined as a permanent return to in-center hemodialysis or peritoneal dialysis) using an intention to treat analysis and death-censored treatment failure as a secondary outcome. The cohort consisted of 600, 508 and 202 patients receiving conventional, nocturnal, and short daily HHD, respectively. Conventional-HHD patients were more likely to use dialysis catheter access (43%) versus nocturnal or short daily HHD (32% and 31%, respectively). Although point estimates were in favor of both therapies, after multivariable adjustment for patient and center factors, there was no statistically significant reduction in the relative hazard for the death/treatment failure composite comparing nocturnal to conventional HHD (hazard ratio 0.83 [95% confidence interval 0.66-1.03]) or short daily to conventional HHD (0.84, 0.63-1.12). Among those with information on vascular access, patients receiving nocturnal HHD had a relative improvement in death-censored treatment survival (0.75, 0.57-0.98). Thus, in this national cohort of HHD patients, those receiving short daily and nocturnal HHD had similar patient/treatment survival compared with patients receiving conventional HHD. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  14. Leaf carbohydrates influence transcriptional and post-transcriptional regulation of nocturnal carboxylation and starch degradation in the facultative CAM plant, Mesembryanthemum crystallinum.

    PubMed

    Taybi, Tahar; Cushman, John C; Borland, Anne M

    2017-11-01

    Nocturnal degradation of transitory starch is a limiting factor for the optimal function of crassulacean acid metabolism and must be coordinated with phosphoenolypyruvate carboxylase (PEPC)-mediated CO 2 uptake to optimise carbon gain over the diel cycle. The aim of this study was to test the hypothesis that nocturnal carboxylation is coordinated with starch degradation in CAM via a mechanism whereby the products of these pathways regulate diel transcript abundance and enzyme activities for both processes. To test this hypothesis, a starch and CAM-deficient mutant of Mesembryanthemum crystallinum was compared with wild type plants under well-watered and saline (CAM-inducing) conditions. Exposure to salinity increased the transcript abundance of genes required for nocturnal carboxylation, starch and sucrose degradation in both wild type and mutant, but the transcript abundance of several of these genes was not sustained over the dark period in the low-carbohydrate, CAM-deficient mutant. The diel pattern of transcript abundance for PEPC mirrored that of PEPC protein, as did the transcripts, protein, and activity of chloroplastic starch phosphorylase in both wild type and mutant, suggesting robust diel coordination of these metabolic processes. Activities of several amylase isoforms were low or lacking in the mutant, whilst the activity of a cytosolic isoform of starch phosphorylase was significantly elevated, indicating contrasting modes of metabolic regulation for the hydrolytic and phosphorylytic routes of starch degradation. Externally supplied sucrose resulted in an increase in nocturnal transcript abundance of genes required for nocturnal carboxylation and starch degradation. These results demonstrate that carbohydrates impact on transcriptional and post-transcriptional regulation of nocturnal carboxylation and starch degradation in CAM. Copyright © 2017 Elsevier GmbH. All rights reserved.

  15. Water Relations, Diurnal Acidity Changes, and Productivity of a Cultivated Cactus, Opuntia ficus-indica.

    PubMed

    Acevedo, E; Badilla, I; Nobel, P S

    1983-07-01

    Physiological responses of the Crassulacean acid metabolism (CAM) plant Opuntia ficus-indica (Cactaceae) were studied on a commercial plantation in central Chile. Young cladodes (flattened stems) and flower buds exhibited daytime stomatal opening, whereas mature cladodes and fruit exhibited the nocturnal stomatal opening characteristic of CAM plants. Severe water stress suppressed the nocturnal stomatal opening by mature cladodes, but their high water vapor conductance occurring near dawn was not affected. Nocturnal acidity increases were not as sensitive to water stress as was the nocturnal stomatal opening. The magnitude of the nocturnal acidity increases depended on the total daily photosynthetically active radiation (PAR), being 90% PAR-saturated at 27 moles per square meter per day for a mean nighttime air temperature of 5 degrees C and at 20 moles per square meter per day for 18 degrees C. Inasmuch as the PAR received on unshaded vertical surfaces averaged about 21 moles per square meter per day, nocturnal acidity increases by the cladodes were on the verge of being PAR-limited in the field. The net assimilation rate, which was positive throughout the year, annually averaged 3.4 grams per square meter per day for 1.0- and 2.0-year-old plants. Plants that were 5.4 years old had 7.2 square meters of cladode surface area (both sides) and an annual dry weight productivity of 13 megagrams (metric tons) per hectare per year when their ground cover was 32%. This substantial productivity for a CAM plant was accompanied by the highest nocturnal acidity increase so far observed in the field, 0.78 mole H(+) per square meter.

  16. Water Relations, Diurnal Acidity Changes, and Productivity of a Cultivated Cactus, Opuntia ficus-indica1

    PubMed Central

    Acevedo, Edmundo; Badilla, Ignacio; Nobel, Park S.

    1983-01-01

    Physiological responses of the Crassulacean acid metabolism (CAM) plant Opuntia ficus-indica (Cactaceae) were studied on a commercial plantation in central Chile. Young cladodes (flattened stems) and flower buds exhibited daytime stomatal opening, whereas mature cladodes and fruit exhibited the nocturnal stomatal opening characteristic of CAM plants. Severe water stress suppressed the nocturnal stomatal opening by mature cladodes, but their high water vapor conductance occurring near dawn was not affected. Nocturnal acidity increases were not as sensitive to water stress as was the nocturnal stomatal opening. The magnitude of the nocturnal acidity increases depended on the total daily photosynthetically active radiation (PAR), being 90% PAR-saturated at 27 moles per square meter per day for a mean nighttime air temperature of 5°C and at 20 moles per square meter per day for 18°C. Inasmuch as the PAR received on unshaded vertical surfaces averaged about 21 moles per square meter per day, nocturnal acidity increases by the cladodes were on the verge of being PAR-limited in the field. The net assimilation rate, which was positive throughout the year, annually averaged 3.4 grams per square meter per day for 1.0- and 2.0-year-old plants. Plants that were 5.4 years old had 7.2 square meters of cladode surface area (both sides) and an annual dry weight productivity of 13 megagrams (metric tons) per hectare per year when their ground cover was 32%. This substantial productivity for a CAM plant was accompanied by the highest nocturnal acidity increase so far observed in the field, 0.78 mole H+ per square meter. PMID:16663084

  17. Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development.

    PubMed

    Hill, Catherine Mary; Baya, Ana; Gavlak, Johanna; Carroll, Annette; Heathcote, Kate; Dimitriou, Dagmara; L'Esperance, Veline; Webster, Rebecca; Holloway, John; Virues-Ortega, Javier; Kirkham, Fenella Jane; Bucks, Romola Starr; Hogan, Alexandra Marie

    2016-05-01

    Physiological adaptation to high altitude hypoxia may be impaired in Andeans with significant European ancestry. The respiratory 'burden' of sleep may challenge adaptation, leading to relative nocturnal hypoxia. Developmental aspects of sleep-related breathing in high-altitude native children have not previously been reported. We aimed to determine the influence of development on diurnal-nocturnal oxyhemoglobin differences in children living at high altitude. This was a cross-sectional, observational study. Seventy-five healthy Bolivian children aged 6 mo to 17 y, native to low altitude (500 m), moderate high altitude (2,500 m), and high altitude (3,700 m) were recruited. Daytime resting pulse oximetry was compared to overnight recordings using Masimo radical oximeters. Genetic ancestry was determined from DNA samples. Children had mixed European/Amerindian ancestry, with no significant differences between altitudes. Sixty-two participants had ≥ 5 h of nocturnal, artifact-free data. As predicted, diurnal mean oxyhemoglobin saturation decreased across altitudes (infants and children, both P < 0.001), with lowest diurnal values at high altitude in infants. At high altitude, there was a greater drop in nocturnal mean oxyhemoglobin saturation (infants, P < 0.001; children, P = 0.039) and an increase in variability (all P ≤ 0.001) compared to low altitude. Importantly, diurnal to nocturnal altitude differences diminished (P = 0.036), from infancy to childhood, with no further change during adolescence. Physiological adaptation to high-altitude living in native Andeans is unlikely to compensate for the significant differences we observed between diurnal and nocturnal oxyhemoglobin saturation, most marked in infancy. This vulnerability to sleep-related hypoxia in early childhood has potential lifespan implications. Future studies should characterize the sleep- related respiratory physiology underpinning our observations. © 2016 Associated Professional Sleep Societies, LLC.

  18. Circadian rhythm of a Silene species favours nocturnal pollination and constrains diurnal visitation

    PubMed Central

    Prieto-Benítez, Samuel; Dötterl, Stefan; Giménez-Benavides, Luis

    2016-01-01

    Background and Aims Traits related to flower advertisement and reward sometimes vary in a circadian way, reflecting phenotypic specialization. However, specialized flowers are not necessarily restricted to specialized pollinators. This is the case of most Silene species, typically associated with diurnal or nocturnal syndromes of pollination but usually showing complex suites of pollinators. Methods A Silene species with mixed floral features between diurnal and nocturnal syndromes was used to test how petal opening, nectar production, scent emission and pollination success correlate in a circadian rhythm, and whether this is influenced by environmental conditions. The effect of diurnal and nocturnal visitation rates on plant reproductive success is also explored in three populations, including the effect of the pollinating seed predator Hadena sancta. Key Results The result showed that repeated petal opening at dusk was correlated with nectar secretion and higher scent production during the night. However, depending on environmental conditions, petals remain opened for a while in the morning, when nectar and pollen still were available. Pollen deposition was similarly effective at night and in the morning, but less effective in the afternoon. These results were consistent with field studies. Conclusions The circadian rhythm regulating floral attractiveness and reward in S. colorata is predominantly adapted to nocturnal flower visitors. However, favourable environmental conditions lengthen the optimal daily period of flower attraction and pollination towards morning. This allows the complementarity of day and night pollination. Diurnal pollination may help to compensate the plant reproductive success when nocturnal pollinators are scarce and when the net outcome of H. sancta shifts from mutualism to parasitism. These results suggest a functional mechanism explaining why the supposed nocturnal syndrome of many Silene species does not successfully predict their pollinator guilds. PMID:27451986

  19. The health-related quality-of-life impact of nocturnal awakenings in the middle-aged and older Finnish population.

    PubMed

    Väätäinen, Saku; Tuomilehto, Henri; Saramies, Jouko; Tuomilehto, Jaakko; Uusitalo, Hannu; Hussi, Esko; Keinänen-Kiukaanniemi, Sirkka; Martikainen, Janne

    2013-12-01

    The aim of the study is to examine the health-related quality-of-life (HRQOL) impact of the nocturnal awakenings and the duration of the sleep in the Finnish middle-aged and older population. Cross-sectional sample consisted of 823 community-dwelling persons aged 55-75 living in a single municipality in a rural area of Eastern Finland. Frequency of the nocturnal awakenings was dichotomized as reporting "frequent," if the participant reported subjectively awakening "often" or "very often," and "infrequent" if the participant reported awakening "sometimes" or less frequently. HRQOL was measured with a preference-based HRQOL-index instrument, 15D. Analyses were adjusted for gender, BMI, morbidities, depression, employment and marital status, current smoking and drinking, exercise, recommendation to exercise from a health care professional, and subjective opinion about own exercise habits. Frequent nocturnal awakenings had statistically and clinically significant negative impact on HRQOL, the mean (SE) adjusted marginal HRQOL impact being -0.0416 (0.006). More than 10 and less than 6.5 h of daily sleep were associated with higher probability of having low HRQOL, adjusted odd ratios (95 % CI) being 2.65 (1.11-6.33) and 2.65 (1.55-4.52), respectively. However, the changes in daily sleep duration did not have noticeable influence on the significance or magnitude of the negative HRQOL impact of the frequent nocturnal awakenings. Nocturnal awakenings displayed a strong independent association with decreased HRQOL. The findings suggest that both clinicians and researchers should pay closer attention to nocturnal awakenings and other sleep problems in order to find ways to improve the quality of life in individuals with such conditions.

  20. Time for a strategy in night-time dopaminergic therapy? An objective sensor-based analysis of nocturnal hypokinesia and sleeping positions in Parkinson's disease.

    PubMed

    Sringean, Jirada; Anan, Chanawat; Thanawattano, Chusak; Bhidayasiri, Roongroj

    2017-02-15

    Nocturnal hypokinesia is a common night-time symptom in patients with Parkinson's disease (PD). However, there is still little understanding of the nature, and variations of severity of this symptom. To evaluate the severity of nocturnal hypokinesia and sleep positions in PD patients using multisite wearable sensors. Nocturnal parameters and sleep positions in 18 PD couples were assessed and compared using wearable sensors (limbs and trunk) for one night in their homes. Nocturnal parameters included number, velocity, acceleration, degree, limb movements and the number of times they got out of bed. PD patients had significantly fewer episodes of turns in bed than their spouses (p=0.043), which was associated with significantly slower speed (p=0.005), acceleration (p=0.005) and fewer degrees (p=0.017). When we split the night into the first and second half, significant findings were mainly demonstrated in the second half of the night, including significantly fewer turns (p=0.02) with smaller degrees (p=0.017), slower speed (p=0.005) and acceleration (p=0.007). No significant differences in these parameters were shown in the first half of the night except for smaller degrees of turn in bed in PD patients (p=0.028) and slower acceleration (p=0.037). In addition, PD patients spent significantly more time in a supine position compared to their spouses (p=0.031) with significantly less time in a prone position (p=0.041). Nocturnal hypokinesia gets worse as the night progresses. Treatment of nocturnal hypokinesia should aim at providing a continuous dopaminergic delivery that can achieve a sustained therapeutic level of dopamine throughout the night. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Overnight Changes of Immune Parameters and Catecholamines Are Associated With Mood and Stress

    PubMed Central

    Rief, Winfried; Mills, Paul J.; Ancoli-Israel, Sonia; Ziegler, Michael G.; Pung, Meredith A.; Dimsdale, Joel E.

    2011-01-01

    Objectives To test the hypothesis that a nocturnal decrease of secretion of inflammation markers and catecholamines would be associated with mood and stress variables even after controlling for objective sleep variables. Methods A total of 130 healthy volunteers participated in this study, spending 2 nights in the Gillin Laboratory of Sleep and Chronobiology at the University of California, San Diego, General Clinical Research Center. Blood samples were obtained before sleep (10:30 PM) and after awakening (6:30 AM) on the first day, and these samples were assayed for inflammatory biomarkers and catecholamines. On the second night, polysomnographic records were scored for objective sleep variables, e.g., total sleep time and wake after sleep onset. Self-rating scales for mood, stress, depression, and daily hassles were administered the second day. Results The nocturnal decrease in interleukin-6 was smaller in people who reported more negative mood or fatigue and greater in those who reported more uplift events (e.g., with Profile of Mood States fatigue rp = −.25 to −.30). People with high stress or high depression levels had smaller nocturnal decreases of epinephrine. That relationship was even stronger when partial correlations were used to control for morning level and sleep variables. The associations between nocturnal changes of C-reactive protein, soluble tumor necrosis factor-receptor I, and norepinephrine with psychological states were nonremarkable. Conclusions The analyses of nocturnal change scores (difference scores) add substantial information compared with the traditional analyses of morning levels of immune variables and catecholamines alone. Subjective well-being is significantly associated with a greater nocturnal decrease of interleukin-6 and epinephrine. More research on nocturnal adaptation processes is warranted. PMID:20841563

  2. Overnight changes of immune parameters and catecholamines are associated with mood and stress.

    PubMed

    Rief, Winfried; Mills, Paul J; Ancoli-Israel, Sonia; Ziegler, Michael G; Pung, Meredith A; Dimsdale, Joel E

    2010-10-01

    To test the hypothesis that a nocturnal decrease of secretion of inflammation markers and catecholamines would be associated with mood and stress variables even after controlling for objective sleep variables. A total of 130 healthy volunteers participated in this study, spending 2 nights in the Gillin Laboratory of Sleep and Chronobiology at the University of California, San Diego, General Clinical Research Center. Blood samples were obtained before sleep (10:30 PM) and after awakening (6:30 AM) on the first day, and these samples were assayed for inflammatory biomarkers and catecholamines. On the second night, polysomnographic records were scored for objective sleep variables, e.g., total sleep time and wake after sleep onset. Self-rating scales for mood, stress, depression, and daily hassles were administered the second day. The nocturnal decrease in interleukin-6 was smaller in people who reported more negative mood or fatigue and greater in those who reported more uplift events (e.g., with Profile of Mood States fatigue r(p) = -.25 to -.30). People with high stress or high depression levels had smaller nocturnal decreases of epinephrine. That relationship was even stronger when partial correlations were used to control for morning level and sleep variables. The associations between nocturnal changes of C-reactive protein, soluble tumor necrosis factor-receptor I, and norepinephrine with psychological states were nonremarkable. The analyses of nocturnal change scores (difference scores) add substantial information compared with the traditional analyses of morning levels of immune variables and catecholamines alone. Subjective well-being is significantly associated with a greater nocturnal decrease of interleukin-6 and epinephrine. More research on nocturnal adaptation processes is warranted.

  3. Structural Characteristics of Nocturnal Mesoscale Convective Systems in the U.S. Great Plains as Observed During the PECAN Field Campaign

    NASA Astrophysics Data System (ADS)

    Bodine, D. J.; Dougherty, E.; Rasmussen, K. L.; Torres, A. D.

    2015-12-01

    During the summer in the U.S. Great Plains, some of the heaviest precipitation falls from large thunderstorm complexes known as Mesoscale Convective Systems (MCSs). These frequently occurring MCSs are often nocturnal in nature, so the dynamics associated with these systems are more elusive than those in the daytime. The Plains Elevated Convection at Night (PECAN) field campaign was launched over a 7-week period as an endeavor to better understand nocturnal MCSs occurring in the Great Plains. PECAN featured a dense array of ground-based and airborne instruments to observe nocturnal MCS, including dual-polarization radars at multiple frequencies, mobile mesonets, and sounding units. Our role in PECAN involved deploying Ott Parsivel disdrometers to gain information on drop size distributions (DSDs) and fall speeds. Analysis of disdrometer data in conjunction with radar data presented using Contour Frequency by Altitude Diagrams (CFADs) and high-resolution radiosonde data allows for a structural comparison of PECAN MCS cases to previously identified MCS archetypes. Novel insights into the structural evolution of nocturnal MCSs in relation to their synoptic, mesoscale, and thermodynamic environments are presented, using data collected from dense and numerous observation platforms. Understanding the environmental conditions that result in different nocturnal MCS configurations is useful for gaining insight into precipitation distributions and potential severe weather and flooding hazards in the Great Plains.

  4. Desmopressin is an Effective Treatment for Mixed Nocturia with Nocturnal Polyuria and Decreased Nocturnal Bladder Capacity

    PubMed Central

    Lee, Hye Won; Choo, Myung-Soo; Lee, Jeong Gu; Park, Choal Hee; Paick, Jae-Seung; Lee, Jeong Zoo; Han, Deok Hyun; Park, Won Hee

    2010-01-01

    To investigate the efficacy and safety of desmopressin in patients with mixed nocturia, Patients aged ≥18 yr with mixed nocturia (≥2 voids/night and a nocturnal polyuria index [NPi] >33% and a nocturnal bladder capacity index [NBCi] >1) were recruited. The optimum dose of oral desmopressin was determined during a 3-week dose-titration period and the determined dose was maintained for 4 weeks. The efficacy was assessed by the frequency-volume charts and the sleep questionnaire. The primary endpoint was the proportion of patients with a 50% or greater reduction in the number of nocturnal voids (NV) compared with baseline. Among 103 patients enrolled, 94 (79 men and 15 women) were included in the analysis. The proportion of patients with a 50% or greater reduction in NV was 68 (72%). The mean number of NV decreased significantly (3.20 to 1.34) and the mean nocturnal urine volume, nocturia index, NPi, and NBCi decreased significantly. The mean duration of sleep until the first NV was prolonged from 118.4±44.1 to 220.3±90.7 min (P<0.001). The overall impression of patients about their quality of sleep improved. Adverse events occurred in 6 patients, including one asymptomatic hyponatremia. Desmopressin is an effective and well-tolerated treatment for mixed nocturia. PMID:21165296

  5. Desmopressin is an effective treatment for mixed nocturia with nocturnal polyuria and decreased nocturnal bladder capacity.

    PubMed

    Lee, Hye Won; Choo, Myung-Soo; Lee, Jeong Gu; Park, Choal Hee; Paick, Jae-Seung; Lee, Jeong Zoo; Han, Deok Hyun; Park, Won Hee; Lee, Kyu-Sung

    2010-12-01

    To investigate the efficacy and safety of desmopressin in patients with mixed nocturia, Patients aged ≥ 18 yr with mixed nocturia (≥ 2 voids/night and a nocturnal polyuria index [NPi] >33% and a nocturnal bladder capacity index [NBCi] >1) were recruited. The optimum dose of oral desmopressin was determined during a 3-week dose-titration period and the determined dose was maintained for 4 weeks. The efficacy was assessed by the frequency-volume charts and the sleep questionnaire. The primary endpoint was the proportion of patients with a 50% or greater reduction in the number of nocturnal voids (NV) compared with baseline. Among 103 patients enrolled, 94 (79 men and 15 women) were included in the analysis. The proportion of patients with a 50% or greater reduction in NV was 68 (72%). The mean number of NV decreased significantly (3.20 to 1.34) and the mean nocturnal urine volume, nocturia index, NPi, and NBCi decreased significantly. The mean duration of sleep until the first NV was prolonged from 118.4 ± 44.1 to 220.3 ± 90.7 min (P<0.001). The overall impression of patients about their quality of sleep improved. Adverse events occurred in 6 patients, including one asymptomatic hyponatremia. Desmopressin is an effective and well-tolerated treatment for mixed nocturia.

  6. The nocturnal bottleneck and the evolution of activity patterns in mammals.

    PubMed

    Gerkema, Menno P; Davies, Wayne I L; Foster, Russell G; Menaker, Michael; Hut, Roelof A

    2013-08-22

    In 1942, Walls described the concept of a 'nocturnal bottleneck' in placental mammals, where these species could survive only by avoiding daytime activity during times in which dinosaurs were the dominant taxon. Walls based this concept of a longer episode of nocturnality in early eutherian mammals by comparing the visual systems of reptiles, birds and all three extant taxa of the mammalian lineage, namely the monotremes, marsupials (now included in the metatherians) and placentals (included in the eutherians). This review describes the status of what has become known as the nocturnal bottleneck hypothesis, giving an overview of the chronobiological patterns of activity. We review the ecological plausibility that the activity patterns of (early) eutherian mammals were restricted to the night, based on arguments relating to endothermia, energy balance, foraging and predation, taking into account recent palaeontological information. We also assess genes, relating to light detection (visual and non-visual systems) and the photolyase DNA protection system that were lost in the eutherian mammalian lineage. Our conclusion presently is that arguments in favour of the nocturnal bottleneck hypothesis in eutherians prevail.

  7. Retinal and optical adaptations for nocturnal vision in the halictid bee Megalopta genalis.

    PubMed

    Greiner, Birgit; Ribi, Willi A; Warrant, Eric J

    2004-06-01

    The apposition compound eye of a nocturnal bee, the halictid Megalopta genalis, is described for the first time. Compared to the compound eye of the worker honeybee Apis mellifera and the diurnal halictid bee Lasioglossum leucozonium, the eye of M. genalis shows specific retinal and optical adaptations for vision in dim light. The major anatomical adaptations within the eye of the nocturnal bee are (1) nearly twofold larger ommatidial facets and (2) a 4-5 times wider rhabdom diameter than found in the diurnal bees studied. Optically, the apposition eye of M. genalis is 27 times more sensitive to light than the eyes of the diurnal bees. This increased optical sensitivity represents a clear optical adaptation to low light intensities. Although this unique nocturnal apposition eye has a greatly improved ability to catch light, a 27-fold increase in sensitivity alone cannot account for nocturnal vision at light intensities that are 8 log units dimmer than during daytime. New evidence suggests that additional neuronal spatial summation within the first optic ganglion, the lamina, is involved.

  8. Wild Chimpanzees on the Edge: Nocturnal Activities in Croplands

    PubMed Central

    Krief, Sabrina; Cibot, Marie; Bortolamiol, Sarah; Seguya, Andrew; Krief, Jean-Michel; Masi, Shelly

    2014-01-01

    In a rapidly changing landscape highly impacted by anthropogenic activities, the great apes are facing new challenges to coexist with humans. For chimpanzee communities inhabiting encroached territories, not bordered by rival conspecifics but by human agricultural fields, such boundaries are risky areas. To investigate the hypothesis that they use specific strategies for incursions out of the forest into maize fields to prevent the risk of detection by humans guarding their field, we carried out video recordings of chimpanzees at the edge of the forest bordered by a maize plantation in Kibale National Park, Uganda. Contrary to our expectations, large parties are engaged in crop-raids, including vulnerable individuals such as females with clinging infants. More surprisingly chimpanzees were crop-raiding during the night. They also stayed longer in the maize field and presented few signs of vigilance and anxiety during these nocturnal crop-raids. While nocturnal activities of chimpanzees have been reported during full moon periods, this is the first record of frequent and repeated nocturnal activities after twilight, in darkness. Habitat destruction may have promoted behavioural adjustments such as nocturnal exploitation of open croplands. PMID:25338066

  9. Diurnal and Nocturnal Flight Activity of Blow Flies (Diptera: Calliphoridae) in a Rainforest Fragment in Brazil: Implications for the Colonization of Homicide Victims.

    PubMed

    Soares, Thiago F; Vasconcelos, Simao D

    2016-11-01

    Nocturnal flight of blow flies (Diptera: Calliphoridae) is a controversial issue in forensic entomology. We performed two field experiments to investigate the diurnal and nocturnal activity of six blow fly species in a rainforest fragment in Brazil. Initially, nocturnal (17:30-05:30) versus diurnal (05:30-17:30) flight activity was investigated. Only 3.9% of adults were collected at night, mostly the native species Mesembrinella bicolor, and nocturnal oviposition did not occur. In the second experiment, collection of adults took place at the following intervals: 05:30-08:30, 08:30-11:30, 11:30-14:30, and 14:30-17:30. The proportions of adults did not differ significantly among the four diurnal intervals, except for Hemilucilia segmentaria, which was captured more frequently in the early morning. Calliphoridae has predominantly diurnal behavior, not laying eggs in darkness. The association of the native species M. bicolor, Hemilucilia semidiaphana, and H. segmentaria to forested areas reinforces the forensic relevance of data on their flight pattern. © 2016 American Academy of Forensic Sciences.

  10. The nocturnal bottleneck and the evolution of activity patterns in mammals

    PubMed Central

    Gerkema, Menno P.; Davies, Wayne I. L.; Foster, Russell G.; Menaker, Michael; Hut, Roelof A.

    2013-01-01

    In 1942, Walls described the concept of a ‘nocturnal bottleneck’ in placental mammals, where these species could survive only by avoiding daytime activity during times in which dinosaurs were the dominant taxon. Walls based this concept of a longer episode of nocturnality in early eutherian mammals by comparing the visual systems of reptiles, birds and all three extant taxa of the mammalian lineage, namely the monotremes, marsupials (now included in the metatherians) and placentals (included in the eutherians). This review describes the status of what has become known as the nocturnal bottleneck hypothesis, giving an overview of the chronobiological patterns of activity. We review the ecological plausibility that the activity patterns of (early) eutherian mammals were restricted to the night, based on arguments relating to endothermia, energy balance, foraging and predation, taking into account recent palaeontological information. We also assess genes, relating to light detection (visual and non-visual systems) and the photolyase DNA protection system that were lost in the eutherian mammalian lineage. Our conclusion presently is that arguments in favour of the nocturnal bottleneck hypothesis in eutherians prevail. PMID:23825205

  11. Summer behavior of adult radio-equipped woodcock in central Maine

    USGS Publications Warehouse

    Owen, R.B.; Morgan, J.W.

    1975-01-01

    The behavior of 26 adult American woodcock (Philohela minor) was studied in central Maine during the summers of 1971-73 using radiotelemetry. Adults used diurnal covers and nocturnal sites that were similar to those previously recorded for immature woodcock. The adults, however, were more active during the daylight hours and moved to nocturnal sites later in the evening. Adult woodcock seemed to be less susceptible than immatures to capture by banding crews at night, because adults walked more often between diurnal and nocturnal sites and remained close to the brushy edges at night. Adult birds occupied a smaller composite summer range than the immatures, did not move as far from their capture sites dunng the observation penods, and traveled shorter distances between diurnal and nocturnal sites.

  12. Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension.

    PubMed

    Kario, Kazuomi; Tomitani, Naoko; Matsumoto, Yuri; Hamasaki, Haruna; Okawara, Yukie; Kondo, Maiko; Nozue, Ryoko; Yamagata, Hiromi; Okura, Ayako; Hoshide, Satoshi

    2016-01-01

    Asians have specific characteristics of hypertension (HTN) and its relationship with cardiovascular disease. The morning surge in blood pressure (BP) in Asians is more extended, and the association slope between higher BP and the risk for cardiovascular events is steeper in this population than in whites. Thus, 24-hour BP control including at night and in the morning is especially important for Asian patients with HTN. There are 3 components of "perfect 24-hour BP control": the 24-hour BP level, adequate dipping of nocturnal BP (dipper type), and adequate BP variability such as the morning BP surge. The morning BP-guided approach using home BP monitoring (HBPM) is the first step toward perfect 24-hour BP control. After controlling morning HTN, nocturnal HTN is the second target. We have been developing HBPM that can measure nocturnal BP. First, we developed a semiautomatic HBPM device with the function of automatic fixed-interval BP measurement during sleep. In the J-HOP (Japan Morning Surge Home Blood Pressure) study, the largest nationwide home BP cohort, we successfully measured nocturnal home BP using this device with data memory, 3 times during sleep (2, 3, and 4 am), and found that nocturnal home BP is significantly correlated with organ damage independently of office and morning BP values. The second advance was the development of trigger nocturnal BP (TNP) monitoring with an added trigger function that initiates BP measurements when oxygen desaturation falls below a variable threshold continuously monitored by pulse oximetry. TNP can detect the specific nocturnal BP surges triggered by hypoxic episodes in patients with sleep apnea syndrome. We also added the lowest heart rate-trigger function to TNP to detect the "basal nocturnal BP," which is determined by the circulating volume and structural cardiovascular system without any increase in sympathetic tonus. This double TNP is a novel concept for evaluating the pathogenic pressor mechanism of nocturnal BP. These data are now collected using an information and communication technology (ICT)-based monitoring system. The BP variability includes different time-phase variability from the shortest beat-by-beat, positional, diurnal, day-by-day, visit-to-visit, seasonal, and the longest yearly changes. The synergistic resonance of each type of BP variability would produce great dynamic BP surges, which trigger cardiovascular events. Thus, in the future, the management of HTN based on the simultaneous assessment of the resonance of all of the BP variability phenotypes using a wearable "surge" BP monitoring device with an ICT-based data analysis system will contribute to the ultimate individualized medication for cardiovascular disease. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Outflow from a Nocturnal Thunderstorm.

    DTIC Science & Technology

    1980-11-01

    P AD-A093 796 ILLINOIS STATE WATER SURVEY URBANAF/ .2 OUTFLOW FROM A NOCTURNAL THUNDERSTORM. (U) NOV a0 R W SCOTT NSF-ATHN78-0a865 UNCLASSIFIED SWS...CR-242 ARO-15529.5-6S N I muuuuuuuuuuuu iDA0937 9 6 State Water Survey Division k istitute of METEOROLOGY SECTION 0 uJD AT THE UNIVERSITY OF ILLINOIS...SWS Contract Report 242 / F OUTFLOW FROM A NOCTURNAL THUNDERSTORM Robert W. Scott Meteorology Section Illinois State Water Survey -- DTIC ELECTE CD

  14. Neuroendocrine aspects of primary endogenous depression. XV: Mathematical modeling of nocturnal melatonin secretion in major depressives and normal controls.

    PubMed

    Sekula, L K; Lucke, J F; Heist, E K; Czambel, R K; Rubin, R T

    1997-03-24

    We previously reported a trend toward a higher mean nocturnal serum melatonin (MEL) concentration, based on 30-min blood sampling over 24 h, in 23 female definite endogenous depressive compared to 23 matched normal female control subjects, and no significant difference in 15 male depressives compared to their controls (Rubin et al., 1992). In both groups of patients vs. their controls, there also were trends toward an earlier MEL rise time, by about 30 min, and a later MEL peak time, by about 90 min. Because the offset of MEL secretion was not estimated in that study, the total duration of MEL secretion could not be determined. To further delineate the nocturnal MEL secretion curve, we modeled the MEL data by a linear-Beta model, a four-parameter adaptation of the Beta function. One parameter accounted-for baseline (diurnal) MEL concentration, two accounted for the shapes of the ascending and descending phases of the nocturnal secretion curve, and the fourth accounted for the area under the curve. The model permitted estimation of the start, peak, and end times of nocturnal MEL secretion. There again was a trend toward a higher mean nocturnal MEL concentration in the female depressives compared to their matched controls. There were no significant patient-control differences in secretion onset or peak times in either the women or the men except for nocturnal MEL offset time: the female patients had a trend toward a later offset time, by about 40 min, than their controls; this difference was not present in the men. With women and men analyzed together, the difference in nocturnal MEL offset time between patients and controls just reached significance (P < 0.05). The linear-Beta model appears to satisfactorily fit the MEL data and provides estimators of the onset, peak, and offset times of the activation phase of MEL secretion. This model may be applicable to more severely skewed 24-h hormone secretion curves, such as ACTH and cortisol.

  15. Adaptation to Life in the High Andes: Nocturnal Oxyhemoglobin Saturation in Early Development

    PubMed Central

    Hill, Catherine Mary; Baya, Ana; Gavlak, Johanna; Carroll, Annette; Heathcote, Kate; Dimitriou, Dagmara; L'Esperance, Veline; Webster, Rebecca; Holloway, John; Virues-Ortega, Javier; Kirkham, Fenella Jane; Bucks, Romola Starr; Hogan, Alexandra Marie

    2016-01-01

    Study Objectives: Physiological adaptation to high altitude hypoxia may be impaired in Andeans with significant European ancestry. The respiratory ‘burden’ of sleep may challenge adaptation, leading to relative nocturnal hypoxia. Developmental aspects of sleep-related breathing in high-altitude native children have not previously been reported. We aimed to determine the influence of development on diurnal-nocturnal oxyhemoglobin differences in children living at high altitude. Methods: This was a cross-sectional, observational study. Seventy-five healthy Bolivian children aged 6 mo to 17 y, native to low altitude (500 m), moderate high altitude (2,500 m), and high altitude (3,700 m) were recruited. Daytime resting pulse oximetry was compared to overnight recordings using Masimo radical oximeters. Genetic ancestry was determined from DNA samples. Results: Children had mixed European/Amerindian ancestry, with no significant differences between altitudes. Sixty-two participants had ≥ 5 h of nocturnal, artifact-free data. As predicted, diurnal mean oxyhemoglobin saturation decreased across altitudes (infants and children, both P < 0.001), with lowest diurnal values at high altitude in infants. At high altitude, there was a greater drop in nocturnal mean oxyhemoglobin saturation (infants, P < 0.001; children, P = 0.039) and an increase in variability (all P ≤ 0.001) compared to low altitude. Importantly, diurnal to nocturnal altitude differences diminished (P = 0.036), from infancy to childhood, with no further change during adolescence. Conclusions: Physiological adaptation to high-altitude living in native Andeans is unlikely to compensate for the significant differences we observed between diurnal and nocturnal oxyhemoglobin saturation, most marked in infancy. This vulnerability to sleep-related hypoxia in early childhood has potential lifespan implications. Future studies should characterize the sleep- related respiratory physiology underpinning our observations. Citation: Hill CM, Baya A, Gavlak J, Carroll A, Heathcote K, Dimitriou D, L'Esperance V, Webster R, Holloway J, Virues-Ortega J, Kirkham FJ, Bucks RS, Hogan AM. Adaptation to life in the high andes: nocturnal oxyhemoglobin saturation in early development. SLEEP 2016;39(5):1001–1008. PMID:26951394

  16. Low levels of nitryl chloride at ground level: nocturnal nitrogen oxides in the Lower Fraser Valley of British Columbia

    NASA Astrophysics Data System (ADS)

    Osthoff, Hans D.; Odame-Ankrah, Charles A.; Taha, Youssef M.; Tokarek, Travis W.; Schiller, Corinne L.; Haga, Donna; Jones, Keith; Vingarzan, Roxanne

    2018-05-01

    The nocturnal nitrogen oxides, which include the nitrate radical (NO3), dinitrogen pentoxide (N2O5), and its uptake product on chloride containing aerosol, nitryl chloride (ClNO2), can have profound impacts on the lifetime of NOx ( = NO + NO2), radical budgets, and next-day photochemical ozone (O3) production, yet their abundances and chemistry are only sparsely constrained by ambient air measurements. Here, we present a measurement data set collected at a routine monitoring site near the Abbotsford International Airport (YXX) located approximately 30 km from the Pacific Ocean in the Lower Fraser Valley (LFV) on the west coast of British Columbia. Measurements were made from 20 July to 4 August 2012 and included mixing ratios of ClNO2, N2O5, NO, NO2, total odd nitrogen (NOy), O3, photolysis frequencies, and size distribution and composition of non-refractory submicron aerosol (PM1). At night, O3 was rapidly and often completely removed by dry deposition and by titration with NO of anthropogenic origin and unsaturated biogenic hydrocarbons in a shallow nocturnal inversion surface layer. The low nocturnal O3 mixing ratios and presence of strong chemical sinks for NO3 limited the extent of nocturnal nitrogen oxide chemistry at ground level. Consequently, mixing ratios of N2O5 and ClNO2 were low ( < 30 and < 100 parts-per-trillion by volume (pptv) and median nocturnal peak values of 7.8 and 7.9 pptv, respectively). Mixing ratios of ClNO2 frequently peaked 1-2 h after sunrise rationalized by more efficient formation of ClNO2 in the nocturnal residual layer aloft than at the surface and the breakup of the nocturnal boundary layer structure in the morning. When quantifiable, production of ClNO2 from N2O5 was efficient and likely occurred predominantly on unquantified supermicron-sized or refractory sea-salt-derived aerosol. After sunrise, production of Cl radicals from photolysis of ClNO2 was negligible compared to production of OH from the reaction of O(1D) + H2O except for a short period after sunrise.

  17. Treatment of carpal tunnel syndrome with polarized polychromatic noncoherent light (Bioptron light): a preliminary, prospective, open clinical trial.

    PubMed

    Stasinopoulos, D; Stasinopoulos, I; Johnson, M I

    2005-04-01

    Our aim was to assess the efficacy of polarized polychromatic noncoherent light (Bioptron light) in the treatment of idiopathic carpal tunnel syndrome. Carpal tunnel syndrome is the most common compression neuropathy, but no satisfactory conservative treatment is available at present. An uncontrolled experimental study was conducted in patients who visited our clinic from mid-2001 to mid-2002. A total of 25 patients (22 women and three men) with unilateral idiopathic carpal tunnel syndrome, mild to moderate nocturnal pain, and paraesthesia lasting >3 months participated in the study. The average age of the patients was 47.4 years and the average duration of patients' symptoms was 5.2 months. Polarized polychromatic noncoherent light (Bioptron light) was administered perpendicular to the carpal tunnel area. The irradiation time for each session was 6 min at an operating distance of 5-10 cm from the carpal tunnel area, three times weekly for 4 weeks. Outcome measures used were the participants' global assessments of nocturnal pain and paraesthesia, respectively, at 4 weeks and 6 months. At 4 weeks, two patients (8%) had no change in nocturnal pain, six (24%) were in slightly less nocturnal pain, 12 (48%) were much better in regard to nocturnal pain and five (20%) were pain-free. At 6 months, three patients (12%) were slightly better in regard to nocturnal pain, 13 (52%) were much better regarding nocturnal pain, and nine patients (36%) were pain-free. At 4 weeks, four patients (16%) had no change in paraesthesia, five (20%) were slightly better, 13 patients (52%) were much better, and three patients (12%) were without paraesthesia. At 6 months, two patients (8%) had no change in paraesthesia, two (8%) were slightly better, 14 (56%) were much better, and seven (28%) were without paraesthesia. Nocturnal pain and paraesthesia associated with idiopathic carpal tunnel syndrome improved during polarized polychromatic noncoherent light (Bioptron light) treatment. Controlled clinical trials are needed to establish the absolute and relative effectiveness of this intervention.

  18. Vision and visual navigation in nocturnal insects.

    PubMed

    Warrant, Eric; Dacke, Marie

    2011-01-01

    With their highly sensitive visual systems, nocturnal insects have evolved a remarkable capacity to discriminate colors, orient themselves using faint celestial cues, fly unimpeded through a complicated habitat, and navigate to and from a nest using learned visual landmarks. Even though the compound eyes of nocturnal insects are significantly more sensitive to light than those of their closely related diurnal relatives, their photoreceptors absorb photons at very low rates in dim light, even during demanding nocturnal visual tasks. To explain this apparent paradox, it is hypothesized that the necessary bridge between retinal signaling and visual behavior is a neural strategy of spatial and temporal summation at a higher level in the visual system. Exactly where in the visual system this summation takes place, and the nature of the neural circuitry that is involved, is currently unknown but provides a promising avenue for future research.

  19. Pineal melatonin and the innate immune response: the TNF-alpha increase after cesarean section suppresses nocturnal melatonin production.

    PubMed

    Pontes, Gerlândia N; Cardoso, Elaine C; Carneiro-Sampaio, Magda M S; Markus, Regina P

    2007-11-01

    The nocturnal surge of melatonin is the endocrine expression of the circadian system and is essential for organizing the timing of various endogenous processes. Previous works suggest that, in the beginning of a defense response, the increase in circulating tumor necrosis factor-alpha (TNF-alpha) leads to a transient block of nocturnal melatonin production and promotes a disruption of internal time organization. In the present paper, the concentration of melatonin and cytokines [TNF-alpha, interferon-gamma (IFN-gamma), interleukin (IL)-2, IL-4, IL-5, IL-10, IL-12] in the colostrum (postdelivery day 3) and in the milk (postdelivery days 10, 15, 20 and 30) obtained at midday and midnight from mothers who gave birth by vaginal or cesarean section were compared. The nocturnal melatonin surge observed 3 days after vaginal delivery was absent after cesarean section. IL-12 presented no daily variation in either case, while daily variations in IFN-gamma, IL-10, IL-4 and IL-5 were observed after vaginal delivery and cesarean section. On the other hand, the increase in TNF-alpha after cesarean section resulted in suppression of the nocturnal melatonin surge. Daily variation of IL-2 was only observed after recovery of the nocturnal melatonin surge, 30 days after cesarean section. The present paper supports the hypothesis of a cross-talk between the pineal gland and the immune system, which could represent a putative immune-pineal axis.

  20. Timing of pubertal maturation and the onset of sexual behavior among Zimbabwe school boys.

    PubMed

    Campbell, Benjamin C; Prossinger, Hermann; Mbzivo, Michael

    2005-10-01

    The relationship between reproductive maturation and the onset of sexual behavior in boys across cultures is unclear. To explore the relative timing of pubertal events and their relationship to the onset of sexual behavior, we used data collected from 442 Zimbabwe school boys aged 12-18 years. Measures of reproductive maturation included self-reported spontaneous nocturnal emission, secondary sexual characteristics, and salivary testosterone. Behavioral measures included age at first sexual fantasies, non-coital sexual behavior, and coitus. Sigmoid interpolation curve techniques indicated a median age of first erection at 10.75 +/- 0.11 years, first sexual fantasy at 12.66 +/- 0.03 years, first spontaneous nocturnal emission at 13.02 +/- 0.03 years, and adult levels of blood testosterone at 17.2 +/- 0.7 years. First reported spontaneous nocturnal emission was significantly related to all measures of sexual behavior. Multiple regression models indicated that first reported spontaneous nocturnal emission was a stronger predictor of sexual behavior than variation in secondary sexual characteristics. In addition, testosterone was a significant predictor of sexual fantasies and intercourse, independent of first reported spontaneous nocturnal emission. These results confirm earlier findings in other populations that self-reported spontaneous nocturnal emissions can be used as a marker of pubertal timing among adolescent boys. They also suggest that variation in testosterone plays a role in the onset of sexual behavior among boys, beyond its relationship to developmental timing. The behavioral mechanisms represented by the significant effects of testosterone reported here remain to be investigated.

  1. Reproductive biology of Echinopsis terscheckii (Cactaceae): the role of nocturnal and diurnal pollinators.

    PubMed

    Ortega-Baes, P; Saravia, M; Sühring, S; Godínez-Alvarez, H; Zamar, M

    2011-01-01

    The aim of this study was to analyse the reproductive biology of Echinopsis terscheckii, a species endemic to northwest Argentina that has nocturnal flowers. We expected that this species had a generalised pollination system, with moths and diurnal visitors as the primary pollinators. To test this, we studied the floral biology, breeding system and floral visitors of this species and the effectiveness of nocturnal and diurnal visitors. Floral biology was defined based on floral morphology, floral cycle and nectar production of the flowers. The breeding system and relative contributions of diurnal and nocturnal visitors to fruit and seed set were analysed through field experiments. E. terscheckii flowers opened at sunset and closed the following day. The peak of nectar production occurred at midnight. Flowers were determined to be self-incompatible. Moths, bees and birds were identified as floral visitors. Moths were the most frequent visitors at night, whereas bees were the most frequent visitors during the day. Fruit production by diurnal pollinators was less than that by nocturnal pollinators; among all floral visitors, moths were the most effective pollinators. We have demonstrated for the first time that moths are the primary pollinators of columnar cacti of the genus Echinopsis. Our results suggest that moths might be important pollinators of columnar cactus species with nocturnal flowers in the extra-tropical deserts of South America. © 2010 German Botanical Society and The Royal Botanical Society of the Netherlands.

  2. Evidence for increased olfactory receptor gene repertoire size in two nocturnal bird species with well-developed olfactory ability

    PubMed Central

    Steiger, Silke S; Fidler, Andrew E; Kempenaers, Bart

    2009-01-01

    Background In vertebrates, the molecular basis of the sense of smell is encoded by members of a large gene family, namely olfactory receptor (OR) genes. Both the total number of OR genes and the proportion of intact OR genes in a genome may indicate the importance of the sense of smell for an animal. There is behavioral, physiological, and anatomical evidence that some bird species, in particular nocturnal birds, have a well developed sense of smell. Therefore, we hypothesized that nocturnal birds with good olfactory abilities have evolved (i) more OR genes and (ii) more intact OR genes than closely related and presumably less 'olfaction-dependent' day-active avian taxa. Results We used both non-radioactive Southern hybridization and PCR with degenerate primers to investigate whether two nocturnal bird species that are known to rely on olfactory cues, the brown kiwi (Apteryx australis) and the kakapo (Strigops habroptilus), have evolved a larger OR gene repertoire than their day-active, closest living relatives (for kiwi the emu Dromaius novaehollandiae, rhea Rhea americana, and ostrich Struthio camelus and for kakapo the kaka Nestor meridionalis and kea Nestor notabilis). We show that the nocturnal birds did not have a significantly higher proportion of intact OR genes. However, the estimated total number of OR genes was larger in the two nocturnal birds than in their relatives. Conclusion Our results suggest that ecological niche adaptations such as daily activity patterns may have shaped avian OR gene repertoires. PMID:19467156

  3. Expression and Evolution of Short Wavelength Sensitive Opsins in Colugos: A Nocturnal Lineage That Informs Debate on Primate Origins.

    PubMed

    Moritz, Gillian L; Lim, Norman T-L; Neitz, Maureen; Peichl, Leo; Dominy, Nathaniel J

    2013-01-01

    A nocturnal activity pattern is central to almost all hypotheses on the adaptive origins of primates. This enduring view has been challenged in recent years on the basis of variation in the opsin genes of nocturnal primates. A correspondence between the opsin genes and activity patterns of species in Euarchonta-the superordinal group that includes the orders Primates, Dermoptera (colugos), and Scandentia (treeshrews)-could prove instructive, yet the basic biology of the dermopteran visual system is practically unknown. Here we show that the eye of the Sunda colugo ( Galeopterus variegatus ) lacks a tapetum lucidum and has an avascular retina, and we report on the expression and spectral sensitivity of cone photopigments. We found that Sunda colugos have intact short wavelength sensitive (S-) and long wavelength sensitive (L-) opsin genes, and that both opsins are expressed in cone photoreceptors of the retina. The inferred peak spectral sensitivities are 451 and 562 nm, respectively. In line with adaptation to nocturnal vision, cone densities are low. Surprisingly, a majority of S-cones coexpress some L-opsin. We also show that the ratio of rates of nonsynonymous to synonymous substitutions of exon 1 of the S-opsin gene is indicative of purifying selection. Taken together, our results suggest that natural selection has favored a functional S-opsin in a nocturnal lineage for at least 45 million years. Accordingly, a nocturnal activity pattern remains the most likely ancestral character state of euprimates.

  4. Detection of subtle nocturnal motor activity from 3-D accelerometry recordings in epilepsy patients.

    PubMed

    Nijsen, Tamara M E; Cluitmans, Pierre J M; Arends, Johan B A M; Griep, Paul A M

    2007-11-01

    This paper presents a first step towards reliable detection of nocturnal epileptic seizures based on 3-D accelerometry (ACM) recordings. The main goal is to distinguish between data with and without subtle nocturnal motor activity, thus reducing the amount of data that needs further (more complex) analysis for seizure detection. From 15 ACM signals (measured on five positions on the body), two features are computed, the variance and the jerk. In the resulting 2-D feature space, a linear threshold function is used for classification. For training and testing, the algorithm ACM data along with video data is used from nocturnal registrations in seven mentally retarded patients with severe epilepsy. Per patient, the algorithm detected 100% of the periods of motor activity that are marked in video recordings and the ACM signals by experts. From all the detections, 43%-89% was correct (mean =65%). We were able to reduce the amount of data that need to be analyzed considerably. The results show that our approach can be used for detection of subtle nocturnal motor activity. Furthermore, our results indicate that our algorithm is robust for fluctuations across patients. Consequently, there is no need for training the algorithm for each new patient.

  5. Resources of dark skies in German climatic health resorts.

    PubMed

    Gabriel, Katharina M A; Kuechly, Helga U; Falchi, Fabio; Wosniok, Werner; Hölker, Franz

    2017-01-01

    Illumination of nocturnal environments is increasing steadily worldwide. While there are some benefits for mankind, light at night affects animals, plants, and human health by blurring the natural distinction between day and night. International regulations exist to protect the environment for the maintenance of human health but nocturnal darkness is not considered. In Germany, cities and communities labeled as Climatic Health Resorts provide for high standards in air quality. However, their degree of nocturnal darkness is unexplored so far. In our study, we examined the degree of nocturnal darkness in German Climatic Health Resorts by two datasets based on georeferenced remote sensing data. The majority of Climatic Health Resorts (93.1 %) are able to offer a relative respite (≥ 20 mag/arcsec 2 ) from a degraded nocturnal environment, while only 3.4 % are able to offer a dark, if by no means pristine, night environment (≥ 21 mag/arcsec 2 ). Climatic Health Resorts emit less light as well as are less affected by night sky brightness compared to the average of non-classified communities. In combination with daytime requirements, the resorts provide conditions for a more distinct day-and-night-cycle than non-classified communities.

  6. Prognostic value of nocturnal pulse oximetry in patients with heart failure.

    PubMed

    Rivera-López, Ricardo; Jordán-Martínez, Laura; López-Fernández, Silvia; Rivera-Fernandez, Ricardo; Tercedor, Luis; Sáez-Roca, Germán

    2018-05-23

    To analyze the prognostic value of nocturnal hypoxemia measured with portable nocturnal pulse-oximetry in patients hospitalized due to heart failure and its relation to mortality and hospital readmission. We included 38 patients who were admitted consecutively to our unit with the diagnosis of decompensated heart failure. Pulse-oximetry was considered positive for hypoxemia when more than 10 desaturations per hour were recorded during sleep. Follow-up was performed for 30.3 (standard deviation [SD] 14.2) months, the main objective being a combined endpoint of all-cause mortality and hospital readmission due to heart failure. The average age was 70.7 (SD 10.7) years, 63.3% were males. Pulse-oximetry was considered positive for hypoxemia in 27 (71%) patients. Patients with positive pulse-oximetry had the most frequent endpoint (9.1% [1] vs. 61.5% [16], P = 0.003). After multivariate analysis, continuous nocturnal hypoxemia was related to the combined endpoint (HR = 8.37, 1.19-68.4, P = 0.03). Patients hospitalized for heart failure and nocturnal hypoxemia measured with portable pulse-oximeter have an increased risk of hospital readmission and death. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  7. Nocturnality in synapsids predates the origin of mammals by over 100 million years

    PubMed Central

    Angielczyk, K. D.; Schmitz, L.

    2014-01-01

    Nocturnality is widespread among extant mammals and often considered the ancestral behavioural pattern for all mammals. However, mammals are nested within a larger clade, Synapsida, and non-mammalian synapsids comprise a rich phylogenetic, morphological and ecological diversity. Even though non-mammalian synapsids potentially could elucidate the early evolution of diel activity patterns and enrich the understanding of synapsid palaeobiology, data on their diel activity are currently unavailable. Using scleral ring and orbit dimensions, we demonstrate that nocturnal activity was not an innovation unique to mammals but a character that appeared much earlier in synapsid history, possibly several times independently. The 24 Carboniferous to Jurassic non-mammalian synapsid species in our sample featured eye morphologies consistent with all major diel activity patterns, with examples of nocturnality as old as the Late Carboniferous (ca 300 Ma). Carnivores such as Sphenacodon ferox and Dimetrodon milleri, but also the herbivorous cynodont Tritylodon longaevus were likely nocturnal, whereas most of the anomodont herbivores are reconstructed as diurnal. Recognizing the complexity of diel activity patterns in non-mammalian synapsids is an important step towards a more nuanced picture of the evolutionary history of behaviour in the synapsid clade. PMID:25186003

  8. Genetics Home Reference: autosomal dominant nocturnal frontal lobe epilepsy

    MedlinePlus

    ... brain are involved in many critical functions, including reasoning, planning, judgment, and problem-solving. It is unclear ... E, Montagna P. Nocturnal frontal lobe epilepsy. A clinical and polygraphic overview of 100 consecutive cases. Brain. ...

  9. Wind Profiles in Gentle Terrains and Vegetative Canopies for a Three-Dimensional Wind Field (3DWF) Model

    DTIC Science & Technology

    2007-07-01

    terrain was probably related to the nocturnal low-level jet ( LLJ ). From data sets, CASEX 99 (17) and JU2003 (18, 19), we know the nocturnal LLJ is...common a phenomena in the clear, undisturbed night atmosphere. The data showed the nocturnal LLJ was observed in 9 out of 10 intensive observation...distinct character of the very stable boundary layer due to the LLJ . Figure 4 shows that the wind profiles are nearly linear above 2.5 m for open

  10. Associations of Nocturnal Blood Pressure With Cognition by Self-Identified Race in Middle-Aged and Older Adults: The GENOA (Genetic Epidemiology Network of Arteriopathy) Study.

    PubMed

    Yano, Yuichiro; Butler, Kenneth R; Hall, Michael E; Schwartz, Gary L; Knopman, David S; Lirette, Seth T; Jones, Daniel W; Wilson, James G; Hall, John E; Correa, Adolfo; Turner, Stephen T; Mosley, Thomas H

    2017-10-27

    Whether the association of blood pressure (BP) during sleep (nocturnal BP) with cognition differs by race is unknown. Participants in the GENOA (Genetic Epidemiology Network of Arteriopathy) Study underwent ambulatory BP measurements, brain magnetic resonance imaging, and cognitive function testing (the Rey Auditory Verbal Learning Test, the Digit Symbol Substitution Task, and the Trail Making Test Part B) between 2000 and 2007. We examined multivariable linear regression models of the nocturnal BP-cognition association. Among 755 participants (mean age, 63 years; 64% women; 42% self-identified black race; 76% taking antihypertensive medication), mean nocturnal systolic BP (SBP)/diastolic BP was 126/69 mm Hg, daytime SBP/diastolic BP level was 139/82 mm Hg, and mean reduction in SBP from day to night (dipping) was 9%. Among the entire sample, a race interaction was observed in Digit Symbol Substitution Task and Trail Making Test Part B (both P <0.15). Race-stratified analyses showed that a 1-SD increase in nocturnal SBP levels was associated with poorer Digit Symbol Substitution Task and log-transformed Trail Making Test Part B scores (unstandardized regression coefficient [95% confidence interval]: -1.98 [-3.28 to -0.69] and 0.06 [0.004-0.12]; both P< 0.05) in black but not white individuals. Additional adjustments for white matter hyperintensity volumes or brain atrophy, measured via brain magnetic resonance imaging, did not change the results. Results were similar when nocturnal SBP dipping was assessed as the exposure, yet daytime SBP levels yielded no association with cognition. Nocturnal SBP measurements may be useful in assessing the potential risk for lower cognitive function in middle-aged and older adults, particularly in black individuals. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  11. Ocellar optics in nocturnal and diurnal bees and wasps.

    PubMed

    Warrant, Eric J; Kelber, Almut; Wallén, Rita; Wcislo, William T

    2006-12-01

    Nocturnal bees, wasps and ants have considerably larger ocelli than their diurnal relatives, suggesting an active role in vision at night. In a first step to understanding what this role might be, the morphology and physiological optics of ocelli were investigated in three tropical rainforest species - the nocturnal sweat bee Megalopta genalis, the nocturnal paper wasp Apoica pallens and the diurnal paper wasp Polistes occidentalis - using hanging-drop techniques and standard histological methods. Ocellar image quality, in addition to lens focal length and back focal distance, was determined in all three species. During flight, the ocellar receptive fields of both nocturnal species are centred very dorsally, possibly in order to maximise sensitivity to the narrow dorsal field of light that enters through gaps in the rainforest canopy. Since all ocelli investigated had a slightly oval shape, images were found to be astigmatic: images formed by the major axis of the ocellus were located further from the proximal surface of the lens than images formed by the minor axis. Despite being astigmatic, images formed at either focal plane were reasonably sharp in all ocelli investigated. When compared to the position of the retina below the lens, measurements of back focal distance reveal that the ocelli of Megalopta are highly underfocused and unable to resolve spatial detail. This together with their very large and tightly packed rhabdoms suggests a role in making sensitive measurements of ambient light intensity. In contrast, the ocelli of the two wasps form images near the proximal boundary of the retina, suggesting the potential for modest resolving power. In light of these results, possible roles for ocelli in nocturnal bees and wasps are discussed, including the hypothesis that they might be involved in nocturnal homing and navigation, using two main cues: the spatial pattern of bright patches of daylight visible through the rainforest canopy, and compass information obtained from polarised skylight (from the setting sun or the moon) that penetrates these patches.

  12. A glucose model based on support vector regression for the prediction of hypoglycemic events under free-living conditions.

    PubMed

    Georga, Eleni I; Protopappas, Vasilios C; Ardigò, Diego; Polyzos, Demosthenes; Fotiadis, Dimitrios I

    2013-08-01

    The prevention of hypoglycemic events is of paramount importance in the daily management of insulin-treated diabetes. The use of short-term prediction algorithms of the subcutaneous (s.c.) glucose concentration may contribute significantly toward this direction. The literature suggests that, although the recent glucose profile is a prominent predictor of hypoglycemia, the overall patient's context greatly impacts its accurate estimation. The objective of this study is to evaluate the performance of a support vector for regression (SVR) s.c. glucose method on hypoglycemia prediction. We extend our SVR model to predict separately the nocturnal events during sleep and the non-nocturnal (i.e., diurnal) ones over 30-min and 60-min horizons using information on recent glucose profile, meals, insulin intake, and physical activities for a hypoglycemic threshold of 70 mg/dL. We also introduce herein additional variables accounting for recurrent nocturnal hypoglycemia due to antecedent hypoglycemia, exercise, and sleep. SVR predictions are compared with those from two other machine learning techniques. The method is assessed on a dataset of 15 patients with type 1 diabetes under free-living conditions. Nocturnal hypoglycemic events are predicted with 94% sensitivity for both horizons and with time lags of 5.43 min and 4.57 min, respectively. As concerns the diurnal events, when physical activities are not considered, the sensitivity is 92% and 96% for a 30-min and 60-min horizon, respectively, with both time lags being less than 5 min. However, when such information is introduced, the diurnal sensitivity decreases by 8% and 3%, respectively. Both nocturnal and diurnal predictions show a high (>90%) precision. Results suggest that hypoglycemia prediction using SVR can be accurate and performs better in most diurnal and nocturnal cases compared with other techniques. It is advised that the problem of hypoglycemia prediction should be handled differently for nocturnal and diurnal periods as regards input variables and interpretation of results.

  13. Classification and Analysis of Four Types of Elevated Nocturnal Convective Initiation During Summer 2015

    NASA Astrophysics Data System (ADS)

    Stelten, S. A.; Gallus, W. A., Jr.

    2015-12-01

    A large portion of precipitation seen in the Great Plains region of the United States falls from nocturnal convection. Quite often, nocturnally initiated convection may grow upscale into a Mesoscale Convective System (MCS) that in turn may cause high impact weather events such as severe wind, flooding, and even tornadoes. Thus, correctly predicting nocturnal convective initiation is an integral part of forecasting for the Great Plains. Unfortunately, it is also one of the most challenging aspects of forecasting for this region. Many forecasters familiar with the Great Plains region have noted that elevated nocturnal convective initiation seems to favor a few distinct and rather diverse modes, which pose varying degrees of forecasting difficulties. This study investigates four of these modes, including initiation caused by the interaction of the low level jet and a frontal feature, initiation at the nose of the low level jet without the presence of a frontal feature, linear features ahead of and perpendicular to a forward propagating MCS, and initiation occurring with no discernible large scale forcing mechanism. Improving elevated nocturnal convective initiation forecasts was one of the primary goals of the Plains Elevated Convection At Night (PECAN) field campaign that took place from June 1 to July 15, 2015, which collected a wealth of convective initiation data. To coincide with these data sets, nocturnal convective initiation episodes from the 2015 summer season were classified into each of the aforementioned groups. This allowed for a thorough investigation of the frequency of each type of initiation event, as well as identification of typical characteristics of the atmosphere (forcing mechanisms present, available instability, strength/location of low level jet, etc.) during each event type. Then, using archived model data and the vast data sets collected during the PECAN field campaign, model performance during PECAN for each convective initiation mode was compared to the high quality data sets in order to flesh out why certain convective initiation modes may be more difficult to forecast than others.

  14. B-type natriuretic peptide is a determinant of the nocturnal increase in blood pressure independently of arterial hypertrophy and hypoxia.

    PubMed

    Tabara, Yasuharu; Igase, Michiya; Miki, Tetsuro; Ohyagi, Yasumasa; Matsuda, Fumihiko; Kohara, Katsuhiko

    2016-12-01

    Loss of the nocturnal blood pressure (BP) drop is a risk factor for cardiovascular outcomes. However, clinical parameters that predispose to changes in nocturnal BP are currently uncertain. Given the possible involvement of salt sensitivity in nocturnal BP levels, we investigated a hypothesized association between plasma B-type natriuretic peptide (BNP) levels - a marker of body fluid retention - and nocturnal BP in a general population. Study participants were 1020 general individuals. Participants were divided into four groups (riser, nondipper, dipper, and extreme dipper) by their percentage changes in nocturnal SBP measured using an ambulatory BP monitor. Plasma BNP levels were positively associated with circadian BP change (β = 0.162, P < 0.001) independently of carotid hypertrophy (β = 0.133, P < 0.001), and awake heart rate (β = -0.102, P = 0.001) and SBP (β = -0.246, P < 0.001). Risers showed 1.6 times higher BNP levels than dippers, whereas oxygen desaturation during sleep was frequently observed in nondippers. Results of multinomial logistic regression analysis indicated that BNP level was a significant determinant for the riser pattern [odds ratio (OR) 1.27 (BNP 10 pg/ml), P < 0.001], whereas oxygen desaturation was specifically associated with the nondipping pattern (OR 1.04, P = 0.001). When participants were subdivided by BNP level, risers were more frequent in the high BNP subgroup (19.5%) than in the low BNP subgroup (6.7%) (OR 3.39, P < 0.001). A slight increase in plasma BNP level was independently associated with rising nocturnal BP. Our results may help to understand the pathophysiology of circadian BP variation, and be a clue to identify individuals who require careful BP monitoring.

  15. [Urodynamic changes in patients with obstructive sleep apnea-hypopnea syndrome and nocturnal polyuria].

    PubMed

    Hu, Ke; Tu, Zuo-sheng; Lü, Sheng-qi; Li, Qing-quan; Chen, Xue-qin

    2011-03-01

    To investigate the urodynamic changes in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and nocturnal polyuria. From Sept. 2002 to Jun. 2008, 23 patients with nocturnal polyuria were diagnosed as having OSAHS by polysomnography (PSG). The number and output of nocturia, the osmotic pressure and the excretion of Na(+) were recorded during both the PSG night and CPAP titrating night. Plasma levels of brain natriuretic peptide (BNP) and atrial natriuretic peptides (ANP) were also measured at 11PM in the 2 nights and 7AM in the next mornings. Urodynamic studies including urine flow, bladder pressure during filling, pressure-flow study during voiding and urethral pressure were carried out in these patients. Urodynamic studies were performed again after treatment with CPAP for 3 months. PSG showed that the patients with nocturnal polyuria had moderate to severe OSAHS, in which the apnea-hypopnea index (AHI) being 48 ± 15 events per hour. The number of nocturnal voiding during the PSG night was more than that during the CPAP titrating night. During the PSG night, the output of nocturia, the nocturia excretion of Na(+), ANP levels (at 7am in the next morning after PSG night) increased and the osmotic pressure of nocturia decreased. CPAP therapy could reverse these abnormalities. The main characteristics of urodynamics in these patients included weak detrusor contraction, hypoesthesia in filling cystometry, and decreased bladder compliance, and detrusor external sphincter dyssynergia. After 3 months of CPAP treatment, both the motility of the detrusor of bladder and the bladder compliance improved. CPAP therapy can effectively reverse the nocturnal polyuria in OSAHS patients. In OSAHS patients, the features of nocturia, including the changes of output, osmotic pressure and the excretion of Na(+), may be related to the secretion of high-level of ANP. During the course of chronic progressively OSAHS pathophysiology, detrusor function of bladder may be damaged. CPAP therapy could decrease the nocturnal excretion of ANP, and improve the motility of the detrusor of bladder.

  16. Nighttime Chemistry in the Polluted Boundary Layer (Invited)

    NASA Astrophysics Data System (ADS)

    Stutz, J.; Wong, K.; Tsai, C.; Pikelnaya, O.

    2009-12-01

    Chemistry in the urban nocturnal boundary layer (NBL) has received surprisingly little attention in the past. Surface observations often see low ozone and high NO levels, which lead to low nocturnal radical levels and consequently slow chemistry near the ground. Above the surface, however, ozone and radical levels, for example of NO3, are considerably higher, and more efficient chemical pathways for the removal of gaseous pollutants such as nitrogen oxides, ozone, and hydrocarbons, are active. The influence of nocturnal chemistry on aerosol composition is also largest aloft. These processes are poorly understood due to a lack of observations in the altitude range from 20 - 500m. The strong influence of vertical mixing and transport on the composition of the NBL poses an additional challenge, requiring the measurement of vertical concentration profiles and the use of chemical transport models for their interpretation. In addition, heterogeneous processes on the ground and on aerosol surfaces play an important role in the nocturnal atmosphere. In this presentation we will review our current understanding of nocturnal chemistry in the lowest 300m of the polluted atmosphere, with a focus on nitrogen compounds. A number of field experiments in recent years have given insight into the vertical distribution of some of the most important nocturnal trace gases in urban areas, such as ozone, NO2, NO3, N2O5, and HONO. In particular, two 6-week long experiments in Houston, TX, in 2006 and 2009, have shown the strong and persistent impact of vertical mixing on the distribution of all trace gases, as well as the chemistry in the lowest 300m of the atmosphere. These observations were accompanied by detailed meteorological observations and in-situ measurements of chemical species at 70m above the ground. The observations in Houston were interpreted with a 1D chemical transport model that allows quantification of chemistry and transport at night. Our results identify gaps in our understanding of the polluted nocturnal urban boundary layer will be discussed.

  17. Influence of atmospheric properties on detection of wood-warbler nocturnal flight calls

    NASA Astrophysics Data System (ADS)

    Horton, Kyle G.; Stepanian, Phillip M.; Wainwright, Charlotte E.; Tegeler, Amy K.

    2015-10-01

    Avian migration monitoring can take on many forms; however, monitoring active nocturnal migration of land birds is limited to a few techniques. Avian nocturnal flight calls are currently the only method for describing migrant composition at the species level. However, as this method develops, more information is needed to understand the sources of variation in call detection. Additionally, few studies examine how detection probabilities differ under varying atmospheric conditions. We use nocturnal flight call recordings from captive individuals to explore the dependence of flight call detection on atmospheric temperature and humidity. Height or distance from origin had the largest influence on call detection, while temperature and humidity also influenced detectability at higher altitudes. Because flight call detection varies with both atmospheric conditions and flight height, improved monitoring across time and space will require correction for these factors to generate standardized metrics of songbird migration.

  18. Nocturnal Propagating Thunderstorms May Favor Urban "Hot-Spots": A Model-Based Study over Minneapolis

    NASA Technical Reports Server (NTRS)

    Ganeshan, Manisha; Murtugudde, Raghu

    2015-01-01

    High-resolution WRF model sensitivity experiments are carried out (with and without urban land cover) to study urban impacts on nocturnal propagating thunderstorms over the city of Minneapolis. It is found that the storm spatial characteristics, especially the position of the storm cell, are appreciably altered by the presence of urban land cover. The most robust urban instability during stormy conditions is the enhanced surface convergence due to increased frictional drag. No urban impact is visible on the rainfall intensity simulated by the model. The frictional convergence, aided by the nocturnal Urban Heat Island (UHI), appears to be responsible for attracting propagating storms towards the urban center. Advanced modeling experiments are needed to quantify the mechanical and thermal influence along with similar studies in other cities to further investigate the urban impact on the frequency and trajectory of nocturnal propagating storms.

  19. Artificial light at night as a new threat to pollination.

    PubMed

    Knop, Eva; Zoller, Leana; Ryser, Remo; Gerpe, Christopher; Hörler, Maurin; Fontaine, Colin

    2017-08-10

    Pollinators are declining worldwide and this has raised concerns for a parallel decline in the essential pollination service they provide to both crops and wild plants. Anthropogenic drivers linked to this decline include habitat changes, intensive agriculture, pesticides, invasive alien species, spread of pathogens and climate change. Recently, the rapid global increase in artificial light at night has been proposed to be a new threat to terrestrial ecosystems; the consequences of this increase for ecosystem function are mostly unknown. Here we show that artificial light at night disrupts nocturnal pollination networks and has negative consequences for plant reproductive success. In artificially illuminated plant-pollinator communities, nocturnal visits to plants were reduced by 62% compared to dark areas. Notably, this resulted in an overall 13% reduction in fruit set of a focal plant even though the plant also received numerous visits by diurnal pollinators. Furthermore, by merging diurnal and nocturnal pollination sub-networks, we show that the structure of these combined networks tends to facilitate the spread of the negative consequences of disrupted nocturnal pollination to daytime pollinator communities. Our findings demonstrate that artificial light at night is a threat to pollination and that the negative effects of artificial light at night on nocturnal pollination are predicted to propagate to the diurnal community, thereby aggravating the decline of the diurnal community. We provide perspectives on the functioning of plant-pollinator communities, showing that nocturnal pollinators are not redundant to diurnal communities and increasing our understanding of the human-induced decline in pollinators and their ecosystem service.

  20. Dark Matters: Challenges of Nocturnal Communication Between Plants and Animals in Delivery of Pollination Services

    PubMed Central

    Borges, Renee M.

    2018-01-01

    The night is a special niche characterized by dim light, lower temperatures, and higher humidity compared to the day. Several animals have made the transition from the day into the night and have acquired unique adaptations to cope with the challenges of performing nocturnal activities. Several plant species have opted to bloom at night, possibly as a response to aridity to prevent excessive water loss through evapotranspiration since flowering is often a water-demanding process, or to protect pollen from heat stress. Nocturnal pollinators have visual adaptations to function under dim light conditions but may also trade off vision against olfaction when they are dependent on nectar-rewarding and scented flowers. Nocturnal pollinators may use CO2 and humidity cues emanating from freshly-opened flowers as indicators of nectar-rich resources. Some endothermic nocturnal insect pollinators are attracted to thermogenic flowers within which they remain to obtain heat as a reward to increase their energy budget. This review focuses on mechanisms that pollinators use to find flowers at night, and the signals that nocturnally blooming flowers may employ to attract pollinators under dim light conditions. It also indicates gaps in our knowledge. While millions of years of evolutionary time have given pollinators and plants solutions to the delivery of pollination services and to the offering of appropriate rewards, this history of successful evolution is being threatened by artificial light at night. Excessive and inappropriate illumination associated with anthropogenic activities has resulted in significant light pollution which serves to undermine life processes governed by dim light. PMID:29599655

  1. Effect of nocturnal sound reduction on the incidence of delirium in intensive care unit patients: An interrupted time series analysis.

    PubMed

    van de Pol, Ineke; van Iterson, Mat; Maaskant, Jolanda

    2017-08-01

    Delirium in critically-ill patients is a common multifactorial disorder that is associated with various negative outcomes. It is assumed that sleep disturbances can result in an increased risk of delirium. This study hypothesized that implementing a protocol that reduces overall nocturnal sound levels improves quality of sleep and reduces the incidence of delirium in Intensive Care Unit (ICU) patients. This interrupted time series study was performed in an adult mixed medical and surgical 24-bed ICU. A pre-intervention group of 211 patients was compared with a post-intervention group of 210 patients after implementation of a nocturnal sound-reduction protocol. Primary outcome measures were incidence of delirium, measured by the Intensive Care Delirium Screening Checklist (ICDSC) and quality of sleep, measured by the Richards-Campbell Sleep Questionnaire (RCSQ). Secondary outcome measures were use of sleep-inducing medication, delirium treatment medication, and patient-perceived nocturnal noise. A significant difference in slope in the percentage of delirium was observed between the pre- and post-intervention periods (-3.7% per time period, p=0.02). Quality of sleep was unaffected (0.3 per time period, p=0.85). The post-intervention group used significantly less sleep-inducing medication (p<0.001). Nocturnal noise rating improved after intervention (median: 65, IQR: 50-80 versus 70, IQR: 60-80, p=0.02). The incidence of delirium in ICU patients was significantly reduced after implementation of a nocturnal sound-reduction protocol. However, reported sleep quality did not improve. Copyright © 2017. Published by Elsevier Ltd.

  2. From dusk till dawn: nocturnal and diurnal pollination in the epiphyte Tillandsia heterophylla (Bromeliaceae).

    PubMed

    Aguilar-Rodríguez, P A; Krömer, T; García-Franco, J G; MacSwiney G, M C

    2016-01-01

    In order to compare the effectiveness of diurnal and nocturnal pollinators, we studied the reproductive biology and pollinators of Tillandsia heterophylla E. Morren, an epiphytic tank bromeliad endemic to southeastern Mexico. Since anthesis in T. heterophylla is predominantly nocturnal but lasts until the following day, we hypothesised that this bromeliad would receive visits from both diurnal and nocturnal visitors, but that nocturnal visitors would be the most effective pollinators, since they arrive first to the receptive flower, and that bats would be the most frequent nocturnal visitors, given the characteristics of the nectar. Flowering of T. heterophylla began in May and lasted until July. The species is fully self-compatible, with an anthesis that lasts for ca. 15-16 h. Mean volume of nectar produced per flower was 82.21 μl, with a mean sugar concentration of 6.33%. The highest volume and concentration of nectar were found at 20:00 h, with a subsequent decline in both to almost zero over the following 12-h period. T. heterophylla has a generalist pollination system, since at least four different morphospecies of visitors pollinate its flowers: bats, moths, hummingbirds and bees. Most of the pollinating visits corresponded to bats and took place in the early evening, when stigma receptivity had already begun; making bats the probable pollinator on most occasions. However, diurnal pollinators may be important as a 'fail-safe' system by which to guarantee the pollination of T. heterophylla. © 2015 German Botanical Society and The Royal Botanical Society of the Netherlands.

  3. Diel and seasonal variation of a molluscan taxocoenosis associated with a Zostera marina bed in southern Spain (Alboran Sea)

    NASA Astrophysics Data System (ADS)

    Rueda, Jose L.; Urra, Javier; Salas, Carmen

    2008-09-01

    The diel and seasonal variation of molluscs living in a Zostera marina bed (12-14 m depth) from southern Spain have been studied for one year using a small Agassiz trawl for collecting the samples (222 m2). The frequent and dominant species were very similar in both diurnal and nocturnal samples, including mainly gastropods such as Jujubinus striatus, Nassarius pygmaeus, Mitrella minor, Calliostoma planatum, Rissoa membranacea or Smaragdia viridis. Nevertheless, a significant increase of abundance of scavengers (e.g. Nassarius spp.) and carnivores (e.g. cephalopods) was registered in nocturnal samples. The abundance was maximal in spring and summer in diurnal and nocturnal samples and also in autumn for nocturnal ones, displaying significantly higher values in nocturnal samples. The species richness, diversity and evenness displayed a similar seasonal trend for diurnal and nocturnal samples, with maximum values during summer months. Monthly variation of the molluscan composition (species presence-absence data) was more acute than diel variation, according to the Cluster, MDS and ANOSIM results. Nevertheless, both monthly and diel changes in the structure (species abundance data) of the molluscan taxocoenosis were important throughout the year. Diel changes in the structure of the molluscan fauna are related to an increase of abundance of some species at nighttime due to vertical movements from the sediment to the shoots or along them (e.g. J. striatus, Nassarius spp.) or due to horizontal movements from adjacent habitats (e.g. cephalopods). Nevertheless, some species such as Rissoa spp. or Bittium spp. stay on the leaves of Z. marina during day as well as nighttime.

  4. Dark Matters: Challenges of Nocturnal Communication Between Plants and Animals in Delivery of Pollination Services.

    PubMed

    Borges, Renee M

    2018-03-01

    The night is a special niche characterized by dim light, lower temperatures, and higher humidity compared to the day. Several animals have made the transition from the day into the night and have acquired unique adaptations to cope with the challenges of performing nocturnal activities. Several plant species have opted to bloom at night, possibly as a response to aridity to prevent excessive water loss through evapotranspiration since flowering is often a water-demanding process, or to protect pollen from heat stress. Nocturnal pollinators have visual adaptations to function under dim light conditions but may also trade off vision against olfaction when they are dependent on nectar-rewarding and scented flowers. Nocturnal pollinators may use CO 2 and humidity cues emanating from freshly-opened flowers as indicators of nectar-rich resources. Some endothermic nocturnal insect pollinators are attracted to thermogenic flowers within which they remain to obtain heat as a reward to increase their energy budget. This review focuses on mechanisms that pollinators use to find flowers at night, and the signals that nocturnally blooming flowers may employ to attract pollinators under dim light conditions. It also indicates gaps in our knowledge. While millions of years of evolutionary time have given pollinators and plants solutions to the delivery of pollination services and to the offering of appropriate rewards, this history of successful evolution is being threatened by artificial light at night. Excessive and inappropriate illumination associated with anthropogenic activities has resulted in significant light pollution which serves to undermine life processes governed by dim light.

  5. Wide-field motion tuning in nocturnal hawkmoths

    PubMed Central

    Theobald, Jamie C.; Warrant, Eric J.; O'Carroll, David C.

    2010-01-01

    Nocturnal hawkmoths are known for impressive visually guided behaviours in dim light, such as hovering while feeding from nectar-bearing flowers. This requires tight visual feedback to estimate and counter relative motion. Discrimination of low velocities, as required for stable hovering flight, is fundamentally limited by spatial resolution, yet in the evolution of eyes for nocturnal vision, maintenance of high spatial acuity compromises absolute sensitivity. To investigate these trade-offs, we compared responses of wide-field motion-sensitive neurons in three species of hawkmoth: Manduca sexta (a crepuscular hoverer), Deilephila elpenor (a fully nocturnal hoverer) and Acherontia atropos (a fully nocturnal hawkmoth that does not hover as it feeds uniquely from honey in bees' nests). We show that despite smaller eyes, the motion pathway of D. elpenor is tuned to higher spatial frequencies and lower temporal frequencies than A. atropos, consistent with D. elpenor's need to detect low velocities for hovering. Acherontia atropos, however, presumably evolved low-light sensitivity without sacrificing temporal acuity. Manduca sexta, active at higher light levels, is tuned to the highest spatial frequencies of the three and temporal frequencies comparable with A. atropos. This yields similar tuning to low velocities as in D. elpenor, but with the advantage of shorter neural delays in processing motion. PMID:19906663

  6. Differential arousal regulation by prokineticin 2 signaling in the nocturnal mouse and the diurnal monkey.

    PubMed

    Zhou, Qun-Yong; Burton, Katherine J; Neal, Matthew L; Qiao, Yu; Kanthasamy, Anumantha G; Sun, Yanjun; Xu, Xiangmin; Ma, Yuanye; Li, Xiaohan

    2016-08-18

    The temporal organization of activity/rest or sleep/wake rhythms for mammals is regulated by the interaction of light/dark cycle and circadian clocks. The neural and molecular mechanisms that confine the active phase to either day or night period for the diurnal and the nocturnal mammals are unclear. Here we report that prokineticin 2, previously shown as a circadian clock output molecule, is expressed in the intrinsically photosensitive retinal ganglion cells, and the expression of prokineticin 2 in the intrinsically photosensitive retinal ganglion cells is oscillatory in a clock-dependent manner. We further show that the prokineticin 2 signaling is required for the activity and arousal suppression by light in the mouse. Between the nocturnal mouse and the diurnal monkey, a signaling receptor for prokineticin 2 is differentially expressed in the retinorecipient suprachiasmatic nucleus and the superior colliculus, brain projection targets of the intrinsically photosensitive retinal ganglion cells. Blockade with a selective antagonist reveals the respectively inhibitory and stimulatory effect of prokineticin 2 signaling on the arousal levels for the nocturnal mouse and the diurnal monkey. Thus, the mammalian diurnality or nocturnality is likely determined by the differential signaling of prokineticin 2 from the intrinsically photosensitive retinal ganglion cells onto their retinorecipient brain targets.

  7. Nocturnality in synapsids predates the origin of mammals by over 100 million years.

    PubMed

    Angielczyk, K D; Schmitz, L

    2014-10-22

    Nocturnality is widespread among extant mammals and often considered the ancestral behavioural pattern for all mammals. However, mammals are nested within a larger clade, Synapsida, and non-mammalian synapsids comprise a rich phylogenetic, morphological and ecological diversity. Even though non-mammalian synapsids potentially could elucidate the early evolution of diel activity patterns and enrich the understanding of synapsid palaeobiology, data on their diel activity are currently unavailable. Using scleral ring and orbit dimensions, we demonstrate that nocturnal activity was not an innovation unique to mammals but a character that appeared much earlier in synapsid history, possibly several times independently. The 24 Carboniferous to Jurassic non-mammalian synapsid species in our sample featured eye morphologies consistent with all major diel activity patterns, with examples of nocturnality as old as the Late Carboniferous (ca 300 Ma). Carnivores such as Sphenacodon ferox and Dimetrodon milleri, but also the herbivorous cynodont Tritylodon longaevus were likely nocturnal, whereas most of the anomodont herbivores are reconstructed as diurnal. Recognizing the complexity of diel activity patterns in non-mammalian synapsids is an important step towards a more nuanced picture of the evolutionary history of behaviour in the synapsid clade. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  8. The severity of nocturnal hypoxia but not abdominal adiposity is associated with insulin resistance in non-obese men with sleep apnea.

    PubMed

    Borel, Anne-Laure; Monneret, Denis; Tamisier, Renaud; Baguet, Jean-Philippe; Faure, Patrice; Levy, Patrick; Halimi, Serge; Pépin, Jean-Louis

    2013-01-01

    Beyond obesity, sleep apnea syndrome is frequently associated with excess abdominal adiposity that could contribute to the deteriorated cardiometabolic risk profile of apneic patients. The present study addressed the respective contribution of the severity of sleep apnea syndrome and excess abdominal adiposity to the cardiometabolic risk profile of 38 non obese men with polysomnography-diagnosed sleep apnea syndrome (apnea-hypopnea index >15 events/hour). These otherwise healthy men performed a 75g-oral glucose tolerance test (OGTT) with plasma lipid/inflammatory and redox profiles. Twenty-one apneic men with high-waist circumference (>94 cm) were compared to 17 apneic men with low-waist circumference. Apneic men with high-waist circumference had higher AUC glucose and AUC insulin than apneic men with low-waist circumference. Accordingly, apneic men with high-waist circumference had higher hepatic insulin resistance as reflected by higher HOMA-resistance index, and lower global insulin sensitivity as reflected by lower insulin sensitivity index of Matsuda (derived from OGTT). The sleep structure and the apnea-hypopnea index were not different between the two groups. However, apneic men with high-waist circumference presented with lower mean nocturnal oxyhemoglobin (SpO2). In the 38 men, waist circumference and mean nocturnal SpO2 were inversely correlated (r = -0.43, p = 0.011) and were both associated with plasma glucose/insulin homeostasis indices: the higher the waist circumference, the lower the mean nocturnal SpO2, the lower the insulin-sensitivity. Finally, in multivariable regression model, mean nocturnal SpO2 and not waist circumference was associated with insulin-resistance. Thus, excess abdominal adiposity in non obese apneic men was associated with a deteriorated insulin-sensitivity that could be driven by a more severe nocturnal hypoxemia.

  9. The effect of night illumination, red and infrared light, on locomotor activity, behaviour and melatonin of Senegalese sole (Solea senegalensis) broodstock.

    PubMed

    Carazo, I; Norambuena, F; Oliveira, C; Sánchez-Vázquez, F J; Duncan, N J

    2013-06-13

    The present study aimed to determine a non-invasive nocturnal lighting system for the behavioural observation of a highly light sensitive species, Senegalese sole (Solea senegalensis). Locomotor activity, four types of behaviour and plasma melatonin were analysed in groups of 12 adult Senegalese sole (Solea senegalensis) reared in captivity and held under four night illumination treatments: total darkness (control), high 50lux intensity red light (group RH), low 5lux intensity red light (group RL) and infrared light (group IR). All groups experienced the same conditions during the day (lights on from 07:00 to 19:00) with white lighting of 125lux. Clarity of video images taken at night for the observation of fish behaviour were ranked as follows: group RH>RL>IR>control. All treatments presented a daily rhythm in locomotor activity with high activity from 14:00 to 18:00 and low activity from 21:00 to 12:00. The sole exposed to the high intensity red light at night appeared to be disturbed as during the low nocturnal locomotor activity period group RH presented higher activity and significantly higher nocturnal behaviour related to escape or fear than was observed in the other groups. The groups control, RL and IR exhibited similar levels of nocturnal locomotor activity and nocturnal behaviour related to escape or fear. Plasma melatonin, at mid-dark was not significantly different between the control and groups RL and IR, while melatonin was significantly lower in group RH compared to the control. The authors recommended low intensity red night illumination for the non-invasive study of nocturnal behaviour of Senegalese sole adults. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Atmospheric stability effects on potential radiological releases at a nuclear research facility in Romania: Characterising the atmospheric mixing state.

    PubMed

    Chambers, Scott D; Galeriu, Dan; Williams, Alastair G; Melintescu, Anca; Griffiths, Alan D; Crawford, Jagoda; Dyer, Leisa; Duma, Marin; Zorila, Bogdan

    2016-04-01

    A radon-based nocturnal stability classification scheme is developed for a flat inland site near Bucharest, Romania, characterised by significant local surface roughness heterogeneity, and compared with traditional meteorologically-based techniques. Eight months of hourly meteorological and atmospheric radon observations from a 60 m tower at the IFIN-HH nuclear research facility are analysed. Heterogeneous surface roughness conditions in the 1 km radius exclusion zone around the site hinder accurate characterisation of nocturnal atmospheric mixing conditions using conventional meteorological techniques, so a radon-based scheme is trialled. When the nocturnal boundary layer is very stable, the Pasquill-Gifford "radiation" scheme overestimates the atmosphere's capacity to dilute pollutants with near-surface sources (such as tritiated water vapour) by 20% compared to the radon-based scheme. Under these conditions, near-surface wind speeds drop well below 1 m s(-1) and nocturnal mixing depths vary from ∼ 25 m to less than 10 m above ground level (a.g.l.). Combining nocturnal radon with daytime ceilometer data, we were able to reconstruct the full diurnal cycle of mixing depths. Average daytime mixing depths at this flat inland site range from 1200 to 1800 m a.g.l. in summer, and 500-900 m a.g.l. in winter. Using tower observations to constrain the nocturnal radon-derived effective mixing depth, we were able to estimate the seasonal range in the Bucharest regional radon flux as: 12 mBq m(-2) s(-1) in winter to 14 mBq m(-2) s(-1) in summer. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  11. Neural organisation in the first optic ganglion of the nocturnal bee Megalopta genalis.

    PubMed

    Greiner, Birgit; Ribi, Willi A; Wcislo, William T; Warrant, Eric J

    2004-11-01

    Each neural unit (cartridge) in the first optic ganglion (lamina) of the nocturnal bee Megalopta genalis contains nine receptor cell axons (6 short and 3 long visual fibres), and four different types of first-order interneurons, also known as L-fibres (L1 to L4) or lamina monopolar cells. The short visual fibres terminate within the lamina as three different types (svf 1, 2, 3). The three long visual fibres pass through the lamina without forming characteristic branching patterns and terminate in the second optic ganglion, the medulla. The lateral branching pattern of svf 2 into adjacent cartridges is unique for hymenopterans. In addition, all four types of L-fibres show dorso-ventrally arranged, wide, lateral branching in this nocturnal bee. This is in contrast to the diurnal bees Apis mellifera and Lasioglossum leucozonium, where only two out of four L-fibre types (L2 and L4) reach neighbouring cartridges. In M. genalis, L1 forms two sub-types, viz. L1-a and L1-b; L1-b in particular has the potential to contact several neighbouring cartridges. L2 and L4 in the nocturnal bee are similar to L2 and L4 in the diurnal bees but have dorso-ventral arborisations that are twice as wide. A new type of laterally spreading L3 has been discovered in the nocturnal bee. The extensive neural branching pattern of L-fibres in M. genalis indicates a potential role for these neurons in the spatial summation of photons from large groups of ommatidia. This specific adaptation in the nocturnal bee could significantly improve reliability of vision in dim light.

  12. Glaucomatous Optic Neuropathy Associated with Nocturnal Dip in Blood Pressure: Findings from the Maracaibo Aging Study.

    PubMed

    Melgarejo, Jesús D; Lee, Joseph H; Petitto, Michele; Yépez, Juan B; Murati, Felipe A; Jin, Zhezhen; Chávez, Carlos A; Pirela, Rosa V; Calmón, Gustavo E; Lee, Winston; Johnson, Matthew P; Mena, Luis J; Al-Aswad, Lama A; Terwilliger, Joseph D; Allikmets, Rando; Maestre, Gladys E; De Moraes, C Gustavo

    2018-06-01

    To determine which nocturnal blood pressure (BP) parameters (low levels or extreme dipper status) are associated with an increased risk of glaucomatous damage in Hispanics. Observational cross-sectional study. A subset (n = 93) of the participants from the Maracaibo Aging Study (MAS) who met the study eligibility criteria were included. These participants, who were at least 40 years of age, had measurements for optical tomography coherence, visual field (VF) tests, 24-hour BP, office BP, and intraocular pressure <22 mmHg. Univariate and multivariate logistic regression analyses under the generalized estimating equations (GEE) framework were used to examine the relationships between glaucomatous damage and BP parameters, with particular attention to decreases in nocturnal BP. Glaucomatous optic neuropathy (GON) based on the presence of optic nerve damage and VF defects. The mean age was 61.9 years, and 87.1% were women. Of 185 eyes evaluated, 19 (26.5%) had signs of GON. Individuals with GON had significantly lower 24-hour and nighttime diastolic BP levels than those without. However, results of the multivariate GEE models indicated that the glaucomatous damage was not related to the average systolic or diastolic BP levels measured over 24 hours, daytime, or nighttime. In contrast, extreme decreases in nighttime systolic and diastolic BP (>20% compared with daytime BP) were significant risk factors for glaucomatous damage (odds ratio, 19.78 and 5.55, respectively). In this population, the link between nocturnal BP and GON is determined by extreme dipping effects rather than low nocturnal BP levels alone. Further studies considering extreme decreases in nocturnal BP in individuals at high risk of glaucoma are warranted. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  13. Bright light exposure at night and light attenuation in the morning improve adaptation of night shift workers.

    PubMed

    Yoon, In-Young; Jeong, Do-Un; Kwon, Ki-Bum; Kang, Sang-Bum; Song, Byoung-Gun

    2002-05-01

    With practical applicability in mind, we wanted to observe whether nocturnal alertness, performance, and daytime sleep could be improved by light exposure of tolerable intensity and duration in a real work place. We also evaluated whether attenuating morning light was important in adaptation of real night shift workers. Twelve night shift nurses participated in this study. The study consisted of three different treatment procedures: Room Light (RL), Bright Light (BL), and Bright Light with Sunglasses (BL/S). In RL, room light exposure was given during the night shift and followed by 1 hr exposure to sunlight or 10,000 lux light the next morning (from 08:30 to 09:30). In BL, a 4-hour nocturnal light exposure of 4,000-6,000 lux (from 01:00 to 05:00) was applied and followed by the same morning light exposure as in RL. In BL/S, the same nocturnal light exposure as in BL was done with light attenuation in the morning. Each treatment procedure was continued for 4 days in a repeated measures, cross-over design. Nocturnal alertness was measured by a visual analog scale. Computerized performance tests were done. Daytime sleep was recorded with actigraphy. The most significant overall improvement of sleep was noted in BL/S. BL showed less improvement than BL/S but more than RL. Comparison of nocturnal alertness among the 3 treatments produced similar results: during BL/S, the subjects were most alert, followed by BL and then by RL. Real night shift workers can improve nocturnal alertness and daytime sleep by bright light exposure in their work place. These improvements can be maximized by attenuating morning light on the way home.

  14. Influences of obstructive sleep apnea on blood pressure variability might not be limited only nocturnally in middle-aged hypertensive males.

    PubMed

    Shao, Liang; Heizhati, Mulalibieke; Yao, Xiaoguang; Wang, Yingchun; Abulikemu, Suofeiya; Zhang, Delian; Zhou, Ling; Hong, Jing; Li, Nanfang

    2018-05-01

    In this cross-sectional study, we analyzed the potential association between sleep measures and blood pressure variability. Ninety-three middle-aged hypertensive males, who underwent polysomnography and 24-h ambulatory blood pressure monitoring, were enrolled. Blood pressure variability was assessed by blood pressure standard deviation. Obstructive sleep apnea (apnea hypopnea index ≥ 15) was diagnosed in 52 (55.91%) patients. Mean body mass index and age were 27.77 ± 3.11 kg/m 2 and 44.05 ± 8.07 years, respectively. Hypertensive males with obstructive sleep apnea showed significantly higher 24-h, diurnal, and nocturnal diastolic blood pressure variability, compared to those without obstructive sleep apnea. While total cohort was further divided into two groups using the median of oxygen desaturation index, another indicator for severity of OSA, significant differences were also observed in 24-h, diurnal, and nocturnal diastolic blood pressure variability between two groups with higher and lower oxygen desaturation index. While subjects were also divided into two groups via the mean of sleep stage 1, hypertensive males with sleep stage 1 ≥ 8.1% showed significantly higher diurnal diastolic blood pressure variability than those with sleep stage 1 < 8.1%. Apnea hypopnea index was independently associated with 24-h and nocturnal diastolic blood pressure variability; oxygen desaturation index of 3% with 24-h diastolic, diurnal, and nocturnal diastolic blood pressure; and sleep stage 1 was with 24-h and with diurnal diastolic blood pressure variability in all study subjects. Effects of obstructive sleep apnea on blood pressure variability may not be limited nocturnally.

  15. Differences in ocular parameters between diurnal and nocturnal raptors.

    PubMed

    Beckwith-Cohen, Billie; Horowitz, Igal; Bdolah-Abram, Tali; Lublin, Avishai; Ofri, Ron

    2015-01-01

    To establish and compare normal ocular parameters between and within diurnal and nocturnal raptor groups. Eighty-eight ophthalmically normal raptors of six nocturnal and 11 diurnal species were studied. Tear production was measured using Schirmer tear test (STT) and phenol red thread test (PRTT), and applanation tonometry was conducted. Ultrasonographic measurements of axial length (AL), mediolateral axis (ML), vitreous body (VB), and pecten length (PL) were recorded, and conjunctival cultures were obtained. A weak correlation (R = 0.312, P = 0.006) was found between PRTT and STT. Tear production was significantly lower in nocturnal species (P < 0.001), but no difference was observed in intraocular pressure (IOP). VB and PL were significantly longer in diurnals (P < 0.001 and P = 0.021, respectively), and no significant difference was observed in AL and ML. When comparing results within these groups, there was a significant difference between most species for all parameters except IOP. Fifty-one percent of the examined raptors were positive for mycology or bacteriology, either on culture or PCR. The most common infectious agent isolated was Staphylococcus spp. Phenol red thread test and STT are both valid methods to measure tear production; however, a separate baseline must be determined for each species using these methods, as the results of one method cannot be extrapolated to the other. Due to significant differences observed within diurnal and nocturnal species, it appears that a more intricate division should be used when comparing these parameters for raptors, and the classification of diurnal or nocturnal holds little significance in the baseline of these data. © 2013 American College of Veterinary Ophthalmologists.

  16. Nocturnal herbivore-induced plant volatiles attract the generalist predatory earwig Doru luteipes Scudder

    NASA Astrophysics Data System (ADS)

    Naranjo-Guevara, Natalia; Peñaflor, Maria Fernanda G. V.; Cabezas-Guerrero, Milton F.; Bento, José Maurício S.

    2017-10-01

    Numerous studies have demonstrated that entomophagous arthropods use herbivore-induced plant volatile (HIPV) blends to search for their prey or host. However, no study has yet focused on the response of nocturnal predators to volatile blends emitted by prey damaged plants. We investigated the olfactory behavioral responses of the night-active generalist predatory earwig Doru luteipes Scudder (Dermaptera: Forficulidae) to diurnal and nocturnal volatile blends emitted by maize plants ( Zea mays) attacked by either a stem borer ( Diatraea saccharalis) or a leaf-chewing caterpillar ( Spodoptera frugiperda), both suitable lepidopteran prey. Additionally, we examined whether the earwig preferred odors emitted from short- or long-term damaged maize. We first determined the earwig diel foraging rhythm and confirmed that D. luteipes is a nocturnal predator. Olfactometer assays showed that during the day, although the earwigs were walking actively, they did not discriminate the volatiles of undamaged maize plants from those of herbivore damaged maize plants. In contrast, at night, earwigs preferred volatiles emitted by maize plants attacked by D. saccharalis or S. frugiperda over undamaged plants and short- over long-term damaged maize. Our GC-MS analysis revealed that short-term damaged nocturnal plant volatile blends were comprised mainly of fatty acid derivatives (i.e., green leaf volatiles), while the long-term damaged plant volatile blend contained mostly terpenoids. We also observed distinct volatile blend composition emitted by maize damaged by the different caterpillars. Our results showed that D. luteipes innately uses nocturnal herbivore-induced plant volatiles to search for prey. Moreover, the attraction of the earwig to short-term damaged plants is likely mediated by fatty acid derivatives.

  17. Basal-Bolus Insulin Therapy with Gla-300 During Hospitalization Reduces Nocturnal Hypoglycemia in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study.

    PubMed

    Okajima, Fumitaka; Nakamura, Yuko; Yamaguchi, Yuji; Shuto, Yuki; Kato, Katsuhito; Sugihara, Hitoshi; Emoto, Naoya

    2018-04-04

    Although reduction in the incidence of nocturnal hypoglycemia, as estimated by symptom or self-monitored plasma glucose, was shown to be more pronounced with 300 units/mL insulin glargine (Gla-300) than with 100 units/mL insulin glargine (Gla-100) in type 2 diabetes patients, the exact frequency of nocturnal hypoglycemia estimated with continuous glucose monitoring (CGM) has not been reported. Forty patients with type 2 diabetes who were admitted for glycemic control with basal-bolus insulin therapy (BBT) were randomized into the Gla-100 and Gla-300 groups. Insulin doses were adjusted to maintain blood glucose levels within 100-120 mg/dL at each meal. Plasma glucose and C-peptide profiles were estimated serially after admission and before discharge. Daily CGM was also performed before discharge. In the Gla-100 and Gla-300 groups, the mean duration of hospitalization was 15 ± 2 and 15 ± 1 days, respectively, and the mean basal insulin dose before discharge was 13 ± 7 and 15 ± 10 units, respectively. The dose of meal-time insulin was not different between the two groups. Compared with the Gla-300 group, the Gla-100 group had significantly lower nocturnal profiles of plasma glucose and C-peptide, but significantly higher frequency of CGM-estimated nocturnal hypoglycemia (10.7% ± 18.4% versus 1.2% ± 3.6%, P = 0.033). In type 2 diabetic patients, reduction in the incidence of CGM-estimated nocturnal hypoglycemia by BBT under tightly controlled diet therapy was higher with Gla-300 than with Gla-100. UMIN clinical trials registry (UMIN000023360).

  18. The effect of nitrogen availability and water conditions on competition between a facultative CAM plant and an invasive grass.

    PubMed

    Yu, Kailiang; D'Odorico, Paolo; Carr, David E; Personius, Ashden; Collins, Scott L

    2017-10-01

    Plants with crassulacean acid metabolism (CAM) are increasing their abundance in drylands worldwide. The drivers and mechanisms underlying the increased dominance of CAM plants and CAM expression (i.e., nocturnal carboxylation) in facultative CAM plants, however, remain poorly understood. We investigated how nutrient and water availability affected competition between Mesembryanthemum crystallinum (a model facultative CAM species) and the invasive C 3 grass Bromus mollis that co-occur in California's coastal grasslands. Specifically we investigated the extent to which water stress, nutrients, and competition affect nocturnal carboxylation in M. crystallinum . High nutrient and low water conditions favored M. crystallinum over B. mollis , in contrast to high water conditions. While low water conditions induced nocturnal carboxylation in 9-week-old individuals of M. crystallinum , in these low water treatments, a 66% reduction in nutrient applied over the entire experiment did not further enhance nocturnal carboxylation. In high water conditions M. crystallinum both alone and in association with B. mollis did not perform nocturnal carboxylation, regardless of the nutrient levels. Thus, nocturnal carboxylation in M. crystallinum was restricted by strong competition with B. mollis in high water conditions. This study provides empirical evidence of the competitive advantage of facultative CAM plants over grasses in drought conditions and of the restricted ability of M. crystallinum to use their photosynthetic plasticity (i.e., ability to switch to CAM behavior) to compete with grasses in well-watered conditions. We suggest that a high drought tolerance could explain the increased dominance of facultative CAM plants in a future environment with increased drought and nitrogen deposition, while the potential of facultative CAM plants such as M. crystallinum to expand to wet environments is expected to be limited.

  19. Fixed-dose combination PRO 160/120 of sabal and urtica extracts improves nocturia in men with LUTS suggestive of BPH: re-evaluation of four controlled clinical studies.

    PubMed

    Oelke, Matthias; Berges, Richard; Schläfke, Sandra; Burkart, Martin

    2014-10-01

    To determine the effects of the herbal fixed-dose combination PRO 160/120 (extracts from saw palmetto fruits and stinging nettle roots) on nocturnal voiding frequency, as measured by question 7 of the IPSS questionnaire, in patients with moderate-to-severe LUTS/BPH after 24 weeks of treatment compared to placebo, to the α-blocker tamsulosin, or to the 5α-reductase inhibitor finasteride. The study is about post hoc evaluation of four published randomized, double-blind clinical trials on PRO 160/120, two compared with placebo, one with finasteride and one with tamsulosin. In addition, a pooled data analysis of the two placebo-controlled trials was conducted. We analyzed data from a total of 922 patients with a mean age of 66 years and a mean baseline nocturnal voiding frequency of 2.1. In the pooled analysis of placebo-controlled trials, nocturnal voids improved by 0.8 (29 %) with PRO 160/120 compared to 0.6 (18 %) with placebo (p = 0.015, Wilcoxon test, one-tailed). The 69 % responder rate to PRO 160/120 was significantly superior to the placebo response (52 %; p = 0.003, χ (2)-test, two-tailed). The majority of responders improved by 1 void/night. Absolute improvements and response rates were consistently higher with PRO 160/120 than with placebo over a range of baseline nocturnal voiding frequencies. There were no differences between PRO 160/120 and finasteride or tamsulosin regarding absolute improvement of nocturnal voids or responds rates. PRO 160/120 significantly improved nocturnal voiding frequency compared to placebo and similar to tamsulosin or finasteride.

  20. Influence of abiotic factors on cathemeral activity: the case of Eulemur fulvus collaris in the littoral forest of Madagascar.

    PubMed

    Donati, Giuseppe; Borgognini-Tarli, Silvana M

    2006-01-01

    The role environmental factors play in influencing circadian rhythms in natural habitats is still poorly described in primates, especially for those taxa with an activity cycle extended over the 24-hour cycle. In this paper, we elucidate the importance of abiotic factors in entraining the activity of cathemeral primates, focussing on results from a long-term study of Eulemur fulvus collaris (collared brown lemur) in south-eastern Malagasy littoral forest. Two groups of lemurs were followed for 60 whole-day and 59 whole-night observation periods over 14 months. Diurnal and nocturnal observations were equally distributed among moon phases and seasons. Temperature and humidity were recorded hourly by automatic data loggers. The littoral forest has a climatic environment where rainfall and humidity are uncorrelated with temperature and photoperiod. Diurnal and nocturnal activity varied seasonally, with the former increasing significantly with extended day length and the latter increasing significantly with shortened day length. Dusk seemed to act as a primary zeitgeber for these lemurs, coordinating the onset of evening activity throughout the entire year. Lunar phase and the nocturnal luminosity index correlated positively with the duration of nocturnal activity and negatively with the length of diurnal activity. Temperature was positively associated with diurnal activity but did not seem to influence lemur rhythms at night. Finally, lemur nocturnal activity significantly decreased when levels of humidity and rainfall were high. Cathemeral biorhythm is triggered by zeitgebers and influenced by masking factors. The activity of collared brown lemurs appears to be seasonally influenced by photoperiod and directly modulated by nocturnal ambient luminosity. These results are discussed by comparing data from other cathemeral species living in various climatic situations. Copyright (c) 2006 S. Karger AG, Basel.

  1. Circadian pattern of fibrillatory events in non-Brugada-type idiopathic ventricular fibrillation with a focus on J waves.

    PubMed

    Aizawa, Yoshiyasu; Sato, Masahito; Ohno, Seiko; Horie, Minoru; Takatsuki, Seiji; Fukuda, Keiichi; Chinushi, Masaomi; Usui, Tatsuya; Aonuma, Kazutaka; Hosaka, Yukio; Haissaguerre, Michel; Aizawa, Yoshifusa

    2014-12-01

    The circadian pattern of ventricular fibrillation (VF) episodes in patients with idiopathic ventricular fibrillation (IVF) is poorly understood. The purpose of this study was to assess the circadian pattern of VF occurrence in patients with IVF. Excluding Brugada syndrome and other primary electrical diseases, the circadian pattern of VF occurrence was determined in 64 patients with IVF. The clinical and electrocardiographic characteristics were compared among patients with nocturnal (midnight to 6:00 AM) VF and nonnocturnal VF in relation to J waves. A J wave was defined as either notching or a slur at the QRS terminal >0.1 mV above the isoelectric line in contiguous leads. The overall distribution pattern of VF occurrence showed 2 peaks at approximately 6:00 AM and around 8:00 PM. Nocturnal VF was observed in 20 patients (31.3%), and J waves were present in 14 of these 20 individuals (70.0%), whereas J waves were less frequent in the 44 nonnocturnal patients with VF: 16 (36.4%) (P = .0117). Among patients with J waves, nocturnal VF was observed in 46.7% with a peak at approximately 4:00 AM. Nocturnal VF was less common in patients without J waves, occurring in only 17.6% (P = .0124). Both the type and location of J waves and the pattern of the ST segment were similar between the nocturnal and nonnocturnal VF groups. J waves were associated with a VF storm and long-term arrhythmia recurrence. In IVF, the presence of J waves may characterize a higher nocturnal incidence of VF and a higher acute and chronic risk of recurrence. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  2. Circadian characteristics of urinary leukotriene E(4) in healthy subjects and nocturnal asthmatic patients.

    PubMed

    Kurokawa, K; Tanaka, H; Tanaka, S; Abe, S

    2001-12-01

    Circadian rhythmicity of cysteinyl leukotrienes (LTs) and thromboxane (TX)-A(2) in healthy subjects and nocturnal asthmatic patients remains a subject of controversy. The aim of this study was to investigate the contribution of these mediators to the pathogenesis of nocturnal asthma. We measured peak expiratory flow rate, urinary concentration of LTE(4), 11-dehydro-TXB(2), and creatinine eight times every 3 h in three groups: healthy control subjects (n = 5, group A), nocturnal asthmatic patients (n = 9, group B), and nonnocturnal asthmatic subjects (n = 9, group C). To evaluate the reproducibility of the measurement of urinary LTE(4), we measured urinary LTE(4) in group A for 3 separate days. The urinary LTE(4) concentrations from 3 to 6 AM were significantly (p < 0.05) higher than from 3 to 6 PM in both group A and group B, but not in group C. The mean levels of LTE(4) in group B and group C were significantly higher (p < 0.05) than those in group A. In group B, another small peak was observed from 6 to 9 PM. No significant day-to-day variation was observed in group A. Urinary 11-dehydro-TXB(2) values from 3 to 6 AM were significantly (p < 0.001) higher than those levels from 3 to 6 PM in all groups, and the mean levels in group B and group C were significantly higher than those in group A (p < 0.05). Circadian rhythmicity of urinary LTE(4) with a morning peak was found in healthy control subjects and nocturnal asthmatic subjects, but not in nonnocturnal asthmatic patients. It was suggested that cysteinyl LTs rather than TXA(2) might contribute to the nocturnal worsening of asthma.

  3. Cyclic nocturnal awakening: a warning sign of a cluster bout.

    PubMed

    Martins, Isabel Pavão

    2015-04-01

    Cluster headache is an excruciating unilateral headache with autonomic symptoms whose periodic nocturnal activity, which interrupts sleep, has been attributed to a hypothalamic generator. We describe a patient with a longstanding episodic cluster headache who experienced, on two occasions, a period of nocturnal awakenings without pain or autonomic symptoms, lasting one week before the onset of a cluster bout. Awakenings occurred twice/night at the same hours of impending cluster attacks and had no apparent trigger, being unusual for this patient who had no previous sleep disturbances. Neurological examination and brain imaging were normal. This case documents two new aspects of cluster headache. It suggests that repeated nocturnal awakenings can be a warning sign of an impending cluster period, a finding that may have therapeutic implications, and also that hypothalamic activation may begin several days before trigemino-autonomic symptoms, thus behaving as a true bout generator. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  4. Severe Nocturnal and Postexercise Hypoxia in Children and Adolescents with Sickle Cell Disease

    PubMed Central

    Halphen, Isabelle; Elie, Caroline; Brousse, Valentine; Le Bourgeois, Muriel; Allali, Slimane; Bonnet, Damien; de Montalembert, Mariane

    2014-01-01

    Hypoxia is a common feature in children with sickle cell disease (SCD) that is inconsistently associated with painful crises and acute chest syndrome. To assess the prevalence and risk factors of hypoxia, we recorded daytime, nocturnal, and postexercise pulse oximetry (SpO2) values in 39 SCD patients with a median age of 10.8 years. Median daytime SpO2 was 97% (range, 89%–100%), and 36% of patients had daytime hypoxia defined as SpO2<96%. Median nocturnal SpO2 was 94.7% (range, 87.7%–99.5%), 50% of patients had nocturnal hypoxia defined as SpO2≤93%, and 11(37%) patients spent more than 10% of their total sleep time with SpO2<90%. Median postexercise SpO2 was 94% (range, 72%–100%) and 44.7% of patients had postexercise hypoxia defined as an SpO2 decrease ≥3% after a 6-minute walk test. Among patients with normal daytime SpO2, 35% had nocturnal and 42% postexercise hypoxia. Compared to 9 patients without daytime, nocturnal, or postexercise hypoxia, 25 patients with hypoxia under at least one of these three conditions had greater anemia severity (P = 0.01), lower HbF levels (P = 0.04), and higher aspartate aminotransferase levels (P = 0.03). Males predominated among patients with postexercise hypoxia (P = 0.004). Hypoxia correlated neither with painful crises nor with acute chest syndrome. Of 32 evaluable patients, 6 (18.8%) had a tricuspid regurgitation velocity ≥2.6 m/s, and this feature was associated with anemia (P = 0.044). Median percentage of the predicted distance covered during a 6-minute walk test was 86% [46–120]; the distance was negatively associated with LDH (P = 0.044) and with a past history of acute chest syndrome (P = 0.009). In conclusion, severe episodes of nocturnal and postexercise hypoxia are common in children with SCD, even those with normal daytime SpO2. PMID:24878576

  5. Remotely-sensed, nocturnal, dew point correlates with malaria transmission in Southern Province, Zambia: a time-series study

    PubMed Central

    2014-01-01

    Background Plasmodium falciparum transmission has decreased significantly in Zambia in the last decade. The malaria transmission is influenced by environmental variables. Incorporation of environmental variables in models of malaria transmission likely improves model fit and predicts probable trends in malaria disease. This work is based on the hypothesis that remotely-sensed environmental factors, including nocturnal dew point, are associated with malaria transmission and sustain foci of transmission during the low transmission season in the Southern Province of Zambia. Methods Thirty-eight rural health centres in Southern Province, Zambia were divided into three zones based on transmission patterns. Correlations between weekly malaria cases and remotely-sensed nocturnal dew point, nocturnal land surface temperature as well as vegetation indices and rainfall were evaluated in time-series analyses from 2012 week 19 to 2013 week 36. Zonal as well as clinic-based, multivariate, autoregressive, integrated, moving average (ARIMAX) models implementing environmental variables were developed to model transmission in 2011 week 19 to 2012 week 18 and forecast transmission in 2013 week 37 to week 41. Results During the dry, low transmission season significantly higher vegetation indices, nocturnal land surface temperature and nocturnal dew point were associated with the areas of higher transmission. Environmental variables improved ARIMAX models. Dew point and normalized differentiated vegetation index were significant predictors and improved all zonal transmission models. In the high-transmission zone, this was also seen for land surface temperature. Clinic models were improved by adding dew point and land surface temperature as well as normalized differentiated vegetation index. The mean average error of prediction for ARIMAX models ranged from 0.7 to 33.5%. Forecasts of malaria incidence were valid for three out of five rural health centres; however, with poor results at the zonal level. Conclusions In this study, the fit of ARIMAX models improves when environmental variables are included. There is a significant association of remotely-sensed nocturnal dew point with malaria transmission. Interestingly, dew point might be one of the factors sustaining malaria transmission in areas of general aridity during the dry season. PMID:24927747

  6. Remotely-sensed, nocturnal, dew point correlates with malaria transmission in Southern Province, Zambia: a time-series study.

    PubMed

    Nygren, David; Stoyanov, Cristina; Lewold, Clemens; Månsson, Fredrik; Miller, John; Kamanga, Aniset; Shiff, Clive J

    2014-06-13

    Plasmodium falciparum transmission has decreased significantly in Zambia in the last decade. The malaria transmission is influenced by environmental variables. Incorporation of environmental variables in models of malaria transmission likely improves model fit and predicts probable trends in malaria disease. This work is based on the hypothesis that remotely-sensed environmental factors, including nocturnal dew point, are associated with malaria transmission and sustain foci of transmission during the low transmission season in the Southern Province of Zambia. Thirty-eight rural health centres in Southern Province, Zambia were divided into three zones based on transmission patterns. Correlations between weekly malaria cases and remotely-sensed nocturnal dew point, nocturnal land surface temperature as well as vegetation indices and rainfall were evaluated in time-series analyses from 2012 week 19 to 2013 week 36. Zonal as well as clinic-based, multivariate, autoregressive, integrated, moving average (ARIMAX) models implementing environmental variables were developed to model transmission in 2011 week 19 to 2012 week 18 and forecast transmission in 2013 week 37 to week 41. During the dry, low transmission season significantly higher vegetation indices, nocturnal land surface temperature and nocturnal dew point were associated with the areas of higher transmission. Environmental variables improved ARIMAX models. Dew point and normalized differentiated vegetation index were significant predictors and improved all zonal transmission models. In the high-transmission zone, this was also seen for land surface temperature. Clinic models were improved by adding dew point and land surface temperature as well as normalized differentiated vegetation index. The mean average error of prediction for ARIMAX models ranged from 0.7 to 33.5%. Forecasts of malaria incidence were valid for three out of five rural health centres; however, with poor results at the zonal level. In this study, the fit of ARIMAX models improves when environmental variables are included. There is a significant association of remotely-sensed nocturnal dew point with malaria transmission. Interestingly, dew point might be one of the factors sustaining malaria transmission in areas of general aridity during the dry season.

  7. Cryptic seedling herbivory by nocturnal introduced generalists impacts survival, performance of native and exotic plants.

    PubMed

    Strauss, Sharon Y; Stanton, Maureen L; Emery, Nancy C; Bradley, Carrie A; Carleton, Alexandra; Dittrich-Reed, Dylan R; Ervin, Olivia A; Gray, Levi N; Hamilton, Andrew M; Rogge, Jennifer Harrington; Harper, Skye D; Law, Kimberley Cook; Pham, Vinh Q; Putnam, Matthew E; Roth, Tara M; Theil, Jacob H; Wells, Lara M; Yoshizuka, Eric M

    2009-02-01

    Although much of the theory on the success of invasive species has been geared at escape from specialist enemies, the impact of introduced generalist invertebrate herbivores on both native and introduced plant species has been underappreciated. The role of nocturnal invertebrate herbivores in structuring plant communities has been examined extensively in Europe, but less so in North America. Many nocturnal generalists (slugs, snails, and earwigs) have been introduced to North America, and 96% of herbivores found during a night census at our California Central Valley site were introduced generalists. We explored the role of these herbivores in the distribution, survivorship, and growth of 12 native and introduced plant species from six families. We predicted that introduced species sharing an evolutionary history with these generalists might be less vulnerable than native plant species. We quantified plant and herbivore abundances within our heterogeneous site and also established herbivore removal experiments in 160 plots spanning the gamut of microhabitats. As 18 collaborators, we checked 2000 seedling sites every day for three weeks to assess nocturnal seedling predation. Laboratory feeding trials allowed us to quantify the palatability of plant species to the two dominant nocturnal herbivores at the site (slugs and earwigs) and allowed us to account for herbivore microhabitat preferences when analyzing attack rates on seedlings. The relationship between local slug abundance and percent cover of five common plant taxa at the field site was significantly negatively associated with the mean palatability of these taxa to slugs in laboratory trials. Moreover, seedling mortality of 12 species in open-field plots was positively correlated with mean palatability of these taxa to both slugs and earwigs in laboratory trials. Counter to expectations, seedlings of native species were neither more vulnerable nor more palatable to nocturnal generalists than those of introduced species. Growth comparison of plants within and outside herbivore exclosures also revealed no differences between native and introduced plant species, despite large impacts of herbivores on growth. Cryptic nocturnal predation on seedlings was common and had large effects on plant establishment at our site. Without intensive monitoring, such predation could easily be misconstrued as poor seedling emergence.

  8. Spectral sensitivity of the nocturnal mosquito, Culex quinquefasciatus

    USDA-ARS?s Scientific Manuscript database

    The nocturnal mosquito, Culex quinquefasciatus,as a vector of West Nile virus is the target of many surveillance and control efforts. Surveillance of this species primarily consists of light traps baited with a variety of chemical lures. While much research has focused on optimization of the olfa...

  9. EVOLUTION OF THE NOCTURNAL INVERSION LAYER AT AN URBAN AND NONURBAN LOCATION

    EPA Science Inventory

    The evolutionary cycle of the nocturnal radiation inversion layer from formation until dissipation under fair weather conditions was investigated by time-series analyses of observations of inversion base and top heights, and inversion strength at an urban and a nonurban site in S...

  10. Vision in the dimmest habitats on earth.

    PubMed

    Warrant, Eric

    2004-10-01

    A very large proportion of the world's animal species are active in dim light, either under the cover of night or in the depths of the sea. The worlds they see can be dim and extended, with light reaching the eyes from all directions at once, or they can be composed of bright point sources, like the multitudes of stars seen in a clear night sky or the rare sparks of bioluminescence that are visible in the deep sea. The eye designs of nocturnal and deep-sea animals have evolved in response to these two very different types of habitats, being optimised for maximum sensitivity to extended scenes, or to point sources, or to both. After describing the many visual adaptations that have evolved across the animal kingdom for maximising sensitivity to extended and point-source scenes, I then use case studies from the recent literature to show how these adaptations have endowed nocturnal animals with excellent vision. Nocturnal animals can see colour and negotiate dimly illuminated obstacles during flight. They can also navigate using learned terrestrial landmarks, the constellations of stars or the dim pattern of polarised light formed around the moon. The conclusion from these studies is clear: nocturnal habitats are just as rich in visual details as diurnal habitats are, and nocturnal animals have evolved visual systems capable of exploiting them. The same is certainly true of deep-sea animals, as future research will no doubt reveal.

  11. Nocturnal hypoxemia in children and adolescents with cystic fibrosis*

    PubMed Central

    Ramos, Regina Terse Trindade; Santana, Maria Angélica Pinheiro; Almeida, Priscila de Carvalho; Machado, Almério de Souza; Araújo-Filho, José Bouzas; Salles, Cristina

    2013-01-01

    OBJECTIVE: To determine the prevalence of nocturnal hypoxemia and its association with pulmonary function, nutritional status, sleep macrostructure, and obstructive respiratory events during sleep in a population of clinically stable children and adolescents with cystic fibrosis (CF). METHODS: This was a cross-sectional study involving 67 children and adolescents with CF between 2 and 14 years of age. All of the participants underwent polysomnography, and SpO2 was measured by pulse oximetry. We also evaluated the Shwachman-Kulczycki (S-K) scores, spirometry findings, and nutritional status of the patients. RESULTS: The study involved 67 patients. The mean age of the patients was 8 years. The S-K scores differed significantly between the patients with and without nocturnal hypoxemia, which was defined as an SpO2 < 90% for more than 5% of the total sleep time (73.75 ± 6.29 vs. 86.38 ± 8.70; p < 0.01). Nocturnal hypoxemia correlated with the severity of lung disease, FEV1 (rs = −0.42; p = 0.01), FVC (rs = −0.46; p = 0.01), microarousal index (rs = 0.32; p = 0.01), and apnea-hypopnea index (rs = 0.56; p = 0.01). CONCLUSIONS: In this sample of patients with CF and mild-to-moderate lung disease, nocturnal oxygenation correlated with the S-K score, spirometry variables, sleep macrostructure variables, and the apnea-hypopnea index. PMID:24473760

  12. Neural coding underlying the cue preference for celestial orientation

    PubMed Central

    el Jundi, Basil; Warrant, Eric J.; Byrne, Marcus J.; Khaldy, Lana; Baird, Emily; Smolka, Jochen; Dacke, Marie

    2015-01-01

    Diurnal and nocturnal African dung beetles use celestial cues, such as the sun, the moon, and the polarization pattern, to roll dung balls along straight paths across the savanna. Although nocturnal beetles move in the same manner through the same environment as their diurnal relatives, they do so when light conditions are at least 1 million-fold dimmer. Here, we show, for the first time to our knowledge, that the celestial cue preference differs between nocturnal and diurnal beetles in a manner that reflects their contrasting visual ecologies. We also demonstrate how these cue preferences are reflected in the activity of compass neurons in the brain. At night, polarized skylight is the dominant orientation cue for nocturnal beetles. However, if we coerce them to roll during the day, they instead use a celestial body (the sun) as their primary orientation cue. Diurnal beetles, however, persist in using a celestial body for their compass, day or night. Compass neurons in the central complex of diurnal beetles are tuned only to the sun, whereas the same neurons in the nocturnal species switch exclusively to polarized light at lunar light intensities. Thus, these neurons encode the preferences for particular celestial cues and alter their weighting according to ambient light conditions. This flexible encoding of celestial cue preferences relative to the prevailing visual scenery provides a simple, yet effective, mechanism for enabling visual orientation at any light intensity. PMID:26305929

  13. Neural coding underlying the cue preference for celestial orientation.

    PubMed

    el Jundi, Basil; Warrant, Eric J; Byrne, Marcus J; Khaldy, Lana; Baird, Emily; Smolka, Jochen; Dacke, Marie

    2015-09-08

    Diurnal and nocturnal African dung beetles use celestial cues, such as the sun, the moon, and the polarization pattern, to roll dung balls along straight paths across the savanna. Although nocturnal beetles move in the same manner through the same environment as their diurnal relatives, they do so when light conditions are at least 1 million-fold dimmer. Here, we show, for the first time to our knowledge, that the celestial cue preference differs between nocturnal and diurnal beetles in a manner that reflects their contrasting visual ecologies. We also demonstrate how these cue preferences are reflected in the activity of compass neurons in the brain. At night, polarized skylight is the dominant orientation cue for nocturnal beetles. However, if we coerce them to roll during the day, they instead use a celestial body (the sun) as their primary orientation cue. Diurnal beetles, however, persist in using a celestial body for their compass, day or night. Compass neurons in the central complex of diurnal beetles are tuned only to the sun, whereas the same neurons in the nocturnal species switch exclusively to polarized light at lunar light intensities. Thus, these neurons encode the preferences for particular celestial cues and alter their weighting according to ambient light conditions. This flexible encoding of celestial cue preferences relative to the prevailing visual scenery provides a simple, yet effective, mechanism for enabling visual orientation at any light intensity.

  14. Local Characteristics of the Nocturnal Boundary Layer in Response to External Pressure Forcing

    NASA Astrophysics Data System (ADS)

    van der Linden, Steven; Baas, Peter; van Hooft, Antoon; van Hooijdonk, Ivo; Bosveld, Fred; van de Wiel, Bas

    2017-04-01

    Geostrophic wind speed data, derived from pressure observations, are used in combination with tower measurements to investigate the nocturnal stable boundary layer at Cabauw, The Netherlands. Since the geostrophic wind speed is not directly influenced by local nocturnal stability, it may be regarded as an external forcing parameter of the nocturnal stable boundary layer. This is in contrast to local parameters such as in situ wind speed, the Monin-Obukhov stability parameter (z/L) or the local Richardson number. To characterize the stable boundary layer, ensemble averages of clear-sky nights with similar geostrophic wind speed are formed. In this manner, the mean dynamical behavior of near-surface turbulent characteristics, and composite profiles of wind and temperature is systematically investigated. We find that the classification results in a gradual ordering of the diagnosed variables in terms of the geostrophic wind speed. In an ensemble sense the transition from the weakly stable to very stable boundary layer is more gradual than expected. Interestingly, for very weak geostrophic winds turbulent activity is found to be negligibly small while the resulting boundary cooling stays finite. Realistic numerical simulations for those cases should therefore have a a solid description of other thermodynamic processes such as soil heat conduction and radiative transfer. This prerequisite poses a challenge for Large-Eddy Simulations of weak wind nocturnal boundary layers.

  15. The Association of Pediatric Obesity With Nocturnal Non-Dipping on 24-Hour Ambulatory Blood Pressure Monitoring.

    PubMed

    Macumber, Ian R; Weiss, Noel S; Halbach, Susan M; Hanevold, Coral D; Flynn, Joseph T

    2016-05-01

    Obesity has been linked with abnormal nocturnal dipping of blood pressure (BP) in adults, which in turn is associated with poor cardiovascular outcomes. There are few data regarding abnormal dipping status in the obese pediatric population. The goal of this study was to further describe the relationship between obesity and non-dipping status on ambulatory blood pressure monitor (ABPM) in children. We conducted a cross-sectional study using a database of patients aged 5-21 years who had undergone 24-hour ABPM at Seattle Children's Hospital from January 2008 through May 2014. Subjects were grouped by body mass index (BMI) into lean (BMI 15th-85th percentile) and obese (BMI >95th percentile) groups. Compared to lean subjects (n = 161), obese subjects (n = 247) had a prevalence ratio (PR) for non-dipping of 2.15, adjusted for race (95% confidence interval (CI) = 1.25-3.42). Increasing severity of obesity was not further associated with nocturnal non-dipping. Nocturnal non-dipping was not associated with left ventricular hypertrophy (PR = 1.01, 95% CI = 0.71-1.44). These results suggest that in children, just as in adults, obesity is related to a relatively decreased dipping in nocturnal BP. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Variants in angiopoietin-2 (ANGPT2) contribute to variation in nocturnal oxyhaemoglobin saturation level

    USDA-ARS?s Scientific Manuscript database

    Genetic determinants of sleep-disordered breathing (SDB), a common set of disorders that contribute to significant cardiovascular and neuropsychiatric morbidity, are not clear. Overnight nocturnal oxygen saturation (SaO2) is a clinically relevant and easily measured indicator of SDB severity but its...

  17. SPATIAL VARIATION OF THE EVOLUTION AND STRUCTURE OF THE URBAN BOUNDARY LAYER

    EPA Science Inventory

    The spatial variation of the nocturnal urban boundary layer structure and the time variation of the mixing height, the nocturnal inversion top and strength after sunrise are presented for urban sites located upwind, downwind, and near the center of the heat island and for upwind ...

  18. Two New Species of Nocturnal Bees of the Genus Megalopta (Hymenoptera: Halictidae) with Keys to Species

    USDA-ARS?s Scientific Manuscript database

    Two new species of the nocturnal bee genus Megalopta are described: M. (Megalopta) tetewana, n. sp., from Mexico and M. (Noctoraptor) huaoranii, n. sp., from Ecuador. Identification keys to the Mesoamerican species of Megalopta s. str. and the species of the cleptoparasitic subgenus Noctoraptor ar...

  19. Nocturnal Orgasm in College Women: Its Relation to Dreams and Anxiety Associated with Sexual Factors

    ERIC Educational Resources Information Center

    Henton, Comradge L.

    1976-01-01

    A total of 774 female undergraduates were administered a structured questionnaire and an anxiety scale. It was found that women do experience nocturnal orgasms during sleep. Differences were found according to year at school as well as a positive correlation between level of anxiety and sexual excitement. (MS)

  20. Feeding and survival of two nocturnal cursorial spiders on extrafloral nectar and honeydew sugars

    USDA-ARS?s Scientific Manuscript database

    Sugars in the form of extrafloral nectar and honeydews may be important resources for nocturnal cursorial spiders such as Cheiracanthium inclusum (Hentz) and Hibana futilis (Banks). C. inclusum spiderlings given only water survived an average of only 6.1 d. Feeding on cotton extrafloral nectar and m...

  1. Numerical simulation of the nocturnal turbulence characteristics over Rattlesnake Mountain

    Treesearch

    W.E. Heilman; E.S. Takle

    1991-01-01

    A two-dimensional second-order turbulence-closure model based on Mellor-Yamada level 3 is used to examine the nocturnal turbulence characteristics over Rattlesnake Mountain in Washington. Simulations of mean horizontal velocities and potential temperatures agree well with data. The equations for the components of the turbulent kinetic energy (TKE) show that anisotropy...

  2. Insulin delivery and nocturnal glucose control in children and adolescents with type 1 diabetes.

    PubMed

    Tauschmann, Martin; Hovorka, Roman

    2017-12-01

    Nocturnal glucose control remains challenging in children and adolescents with type 1 diabetes due to highly variable overnight insulin requirements. The issue may be addressed by glucose responsive insulin delivery based on real-time continuous glucose measurements. Areas covered: This review outlines recent developments of glucose responsive insulin delivery systems from a paediatric perspective. We cover threshold-based suspend application, predictive low glucose suspend, and more advanced single hormone and dual-hormone closed-loop systems. Approaches are evaluated in relation to nocturnal glucose control particularly during outpatient randomised controlled trials. Expert opinion: Significant progress translating research from controlled clinical centre settings to free-living unsupervised home studies have been achieved over the past decade. Nocturnal glycaemic control can be improved whilst reducing the risk of hypoglycaemia with closed-loop systems. Following the US regulatory approval of the first hybrid closed-loop system in non-paediatric population, large multinational closed-loop clinical trials and pivotal studies including paediatric populations are underway or in preparation to facilitate the use of closed-loop systems in clinical practice.

  3. Insulin pump therapy with automated insulin suspension in response to hypoglycemia: reduction in nocturnal hypoglycemia in those at greatest risk.

    PubMed

    Choudhary, Pratik; Shin, John; Wang, Yongyin; Evans, Mark L; Hammond, Peter J; Kerr, David; Shaw, James A M; Pickup, John C; Amiel, Stephanie A

    2011-09-01

    To evaluate a sensor-augmented insulin pump with a low glucose suspend (LGS) feature that automatically suspends basal insulin delivery for up to 2 h in response to sensor-detected hypoglycemia. The LGS feature of the Paradigm Veo insulin pump (Medtronic, Inc., Northridge, CA) was tested for 3 weeks in 31 adults with type 1 diabetes. There were 166 episodes of LGS: 66% of daytime LGS episodes were terminated within 10 min, and 20 episodes lasted the maximum 2 h. LGS use was associated with reduced nocturnal duration ≤2.2 mmol/L in those in the highest quartile of nocturnal hypoglycemia at baseline (median 46.2 vs. 1.8 min/day, P = 0.02 [LGS-OFF vs. LGS-ON]). Median sensor glucose was 3.9 mmol/L after 2-h LGS and 8.2 mmol/L at 2 h after basal restart. Use of an insulin pump with LGS was associated with reduced nocturnal hypoglycemia in those at greatest risk and was well accepted by patients.

  4. The Expression of Three Opsin Genes from the Compound Eye of Helicoverpa armigera (Lepidoptera: Noctuidae) Is Regulated by a Circadian Clock, Light Conditions and Nutritional Status

    PubMed Central

    Yan, Shuo; Zhu, Jialin; Zhu, Weilong; Zhang, Xinfang; Li, Zhen; Liu, Xiaoxia; Zhang, Qingwen

    2014-01-01

    Visual genes may become inactive in species that inhabit poor light environments, and the function and regulation of opsin components in nocturnal moths are interesting topics. In this study, we cloned the ultraviolet (UV), blue (BL) and long-wavelength-sensitive (LW) opsin genes from the compound eye of the cotton bollworm and then measured their mRNA levels using quantitative real-time PCR. The mRNA levels fluctuated over a daily cycle, which might be an adaptation of a nocturnal lifestyle, and were dependent on a circadian clock. Cycling of opsin mRNA levels was disturbed by constant light or constant darkness, and the UV opsin gene was up-regulated after light exposure. Furthermore, the opsin genes tended to be down-regulated upon starvation. Thus, this study illustrates that opsin gene expression is determined by multiple endogenous and exogenous factors and is adapted to the need for nocturnal vision, suggesting that color vision may play an important role in the sensory ecology of nocturnal moths. PMID:25353953

  5. Nocturnal insect availability in bottomland hardwood forests managed for wildlife in the Mississippi Alluvial Valley

    USGS Publications Warehouse

    Loraine Ketzler,; Christopher Comer,; Twedt, Daniel J.

    2017-01-01

    Silviculture used to alter forest structure and thereby enhance wildlife habitat has been advocated for bottomland hardwood forest management on public conservation lands in the Mississippi Alluvial Valley. Although some songbirds respond positively to these management actions to attain desired forest conditions for wildlife, the response of other species, is largely unknown. Nocturnal insects are a primary prey base for bats, thereby influencing trophic interactions within hardwood forests. To better understand how silviculture influences insect availability for bats, we conducted vegetation surveys and sampled insect biomass within silviculturally treated bottomland hardwood forest stands. We used passive blacklight traps to capture nocturnal flying insects in 64 treated and 64 untreated reference stands, located on 15 public conservation areas in Arkansas, Louisiana, and Mississippi. Dead wood and silvicultural treatments were positively associated with greater biomass of macro-Lepidoptera, macro-Coleoptera, and all insect taxa combined. Biomass of micro-Lepidoptera was negatively associated with silvicultural treatment but comprised only a small proportion of total biomass. Understanding the response of nocturnal insects to wildlife-forestry silviculture provides insight for prescribed silvicultural management affecting bat species.

  6. To compare the effect of dextromethorphan, promethazine and placebo on nocturnal cough in children aged 1-12 y with upper respiratory infections: a randomized controlled trial.

    PubMed

    Bhattacharya, Malobika; Joshi, Neha; Yadav, Sangita

    2013-11-01

    To evaluate whether promethazine and dextromethorphan reduce nocturnal cough and improve sleep quality in children aged 1-12 y with upper respiratory tract infection (URI). This randomised double-blinded placebo-controlled trial was conducted in Pediatric outpatient department of Lok Nayak Hospital, Delhi. After randomization into promethazine, dextromethorphan and placebo groups, parental assessment of 120 children with URI for nocturnal cough severity (child), post-tussive vomiting (child) and sleep quality (child and parent) on the night before enrolment and after 3 d of assigned medication was measured using an internally validated indigenously prepared ordinal scale. Entire cohort improved in all the study parameters after 3 d. However, no superior benefit was noted when individual parameters were compared in the promethazine and dextromethorphan groups with the placebo group. Adverse effects were more frequent in the dextromethorphan and promethazine groups although the difference was not statistically significant. Nocturnal cough in URI is self-resolving and dextromethorphan and promethazine prescribed for the same are not superior to placebo.

  7. Changes in Drosophila melanogaster Sleep-Wake Behavior Due to Lotus (Nelumbo nucifera) Seed and Hwang Jeong (Polygonatum sibiricum) Extracts

    PubMed Central

    Jo, Kyungae; Jeon, SangDuk; Ahn, Chang-Won; Han, Sung Hee; Suh, Hyung Joo

    2017-01-01

    We evaluated the sleep enhancement activity of the medicinal herbs valerian (Valeriana officinalis), jujube (Ziziphus jujube), lotus seed (Nelumbo nucifera), Gastrodia elata, Polygonatum sibiricum, and baekbokryung (Poria cocos), which can relieve insomnia in a Drosophila model. Locomotor activity was measured in the Drosophila model to evaluate the sleep activity of Korean medicinal herbs traditionally used as sleep aids. The group treated with lotus seed extract showed less nocturnal activity. Treatment with 10 or 20 mg/mL of P. sibiricum significantly reduced nocturnal activity compared to the control group (P<0.05). The activity and sleep bouts of fruit flies were significantly decreased by a high-dose treatment (10 mg/mL) of lotus or P. sibiricum extracts at night. Caffeine-treated Drosophila showed increased nocturnal activity and decreased total sleep time (P<0.05). Flies receiving the 10 mg-doses of lotus seed or P. sibiricum extract showed significantly different nocturnal locomotor activity and total sleep time compared to caffeine-treated Drosophila. Lotus seed and P. sibiricum extracts are attractive and valuable sleep-potentiating nutraceuticals. PMID:29333381

  8. Association between morphometric variables and nocturnal desaturation in sickle-cell anemia.

    PubMed

    Salles, Cristina; Bispo, Marcelo; Trindade-Ramos, Regina Terse

    2014-01-01

    to evaluate associations between morphometric variables, cervical circumference (CC), and abdominal circumference (AC) with the presence of nocturnal desaturation in children and adolescents with sickle-cell anemia. all patients were submitted to baseline polysomnography, oral cavity measurements (maxillary intermolar distance, mandibular intermolar distance, and overjet), and CC and AC measurements. a total of 85 patients were evaluated. A positive correlation was observed between the height/age Z-score and CC measurement (r = 0.233, p = 0.031). The presence of nocturnal desaturation was associated with CC (59.2± 9.3 vs. 67.5 ± 10.7, p = 0.006) and AC measurements (27.0 ± 2.0 vs. 29.0± 2.1, p = 0.028). There was a negative correlation between desaturation and maxillary intermolar distance (r = -0.365, p = 0.001) and mandibular intermolar distance (r = -0.233, p = 0.037). the morphometric variables of CC and AC may contribute to raise suspicion of nocturnal desaturation in children and adolescents with sickle-cell anemia. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  9. Nocturnal excretion of 6-sulphatoxymelatonin in children and adolescents with autistic disorder.

    PubMed

    Tordjman, Sylvie; Anderson, George M; Pichard, Nadège; Charbuy, Henriette; Touitou, Yvan

    2005-01-15

    Many studies in autistic disorder report sleep problems and altered circadian rhythms, suggesting abnormalities in melatonin physiology. Additionally, melatonin, a pineal gland hormone produced from serotonin, is of special interest in autistic disorder given reported alterations in central and peripheral serotonin neurobiology. Nocturnal urinary excretion of 6-sulphatoxymelatonin was measured by radioimmunoassay in groups of children and adolescents with autistic disorder (n = 49) and normal control individuals (n = 88) matched on age, sex, and Tanner stage of puberty. Nocturnal 6-sulphatoxymelatonin excretion rate was significantly and substantially lower in patients with autism than in normal controls (mean +/- SEM, .75 +/- .11 vs. 1.80 +/- .17 microg/hr, p =.0001), and was significantly negatively correlated with severity of autistic impairments in verbal communication and play (p < .05). These findings indicate clearly that nocturnal production of melatonin is reduced in autism. Further research is warranted in order to understand the mechanisms underlying the lower melatonin production, to assess the impact of altered melatonin on the pathophysiology and behavioral expression of autistic disorder, and to determine the utility of melatonin administration in individuals with autism.

  10. Treatment of chronic pain associated with nocturnal bruxism with botulinum toxin. A prospective and randomized clinical study

    PubMed Central

    Al-Wayli, Hessa

    2017-01-01

    Background To evaluate the role of botulinum toxin type A (BTX-A) in the treatment of pain associated with nocturnal bruxism. Material and Methods Fifty subjects reporting nocturnal bruxism were recruited for a randomized clinical trial. Twenty five bruxers were injected with botulinum toxin in both masseters, and twenty five were treated with traditional methods of treating bruxism. Patients were evaluated at 3rd week, 2nd and 6th month and one year after injection and then used to calculate bruxism events. Bruxism symptoms were investigated using questionnaires. Results Mean pain score due to Bruxism events in the masseter muscle decreased significantly in the botulinum toxin injection group A (P =0.000, highly significant). However, in the conventional treatment group, mean pain score does not show improvement with time (p>0.05). Conclusions Our results suggest that botulinum toxin injection reduced the mean pain score and number of bruxism events, most likely by decreasing the muscle activity of masseter rather than affecting the central nervous system. Key words:Temporomandibular pain, nocturnal bruxism, botulinum toxin. PMID:28149474

  11. Nocturnal to Diurnal Switches with Spontaneous Suppression of Wheel-Running Behavior in a Subterranean Rodent

    PubMed Central

    Tachinardi, Patricia; Tøien, Øivind; Valentinuzzi, Veronica S.; Buck, C. Loren; Oda, Gisele A.

    2015-01-01

    Several rodent species that are diurnal in the field become nocturnal in the lab. It has been suggested that the use of running-wheels in the lab might contribute to this timing switch. This proposition is based on studies that indicate feed-back of vigorous wheel-running on the period and phase of circadian clocks that time daily activity rhythms. Tuco-tucos (Ctenomys aff. knighti) are subterranean rodents that are diurnal in the field but are robustly nocturnal in laboratory, with or without access to running wheels. We assessed their energy metabolism by continuously and simultaneously monitoring rates of oxygen consumption, body temperature, general motor and wheel running activity for several days in the presence and absence of wheels. Surprisingly, some individuals spontaneously suppressed running-wheel activity and switched to diurnality in the respirometry chamber, whereas the remaining animals continued to be nocturnal even after wheel removal. This is the first report of timing switches that occur with spontaneous wheel-running suppression and which are not replicated by removal of the wheel. PMID:26460828

  12. Progress in pediatrics in 2015: choices in allergy, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, nephrology, neurology, nutrition, oncology and pulmonology.

    PubMed

    Caffarelli, Carlo; Santamaria, Francesca; Di Mauro, Dora; Mastrorilli, Carla; Mirra, Virginia; Bernasconi, Sergio

    2016-08-27

    This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature. Epidemiological studies have evidenced the high incidence of Graves' disease and Hashimoto's thyroiditis in patients with Down syndrome. Documentation of novel risk factors for celiac disease are of use to develop strategies for prevention in the population at-risk. Diagnostic criteria for non-celiac gluten sensitivity have been reported. Negative effect on nervous system development of the supernumerary X chromosome in Klinefelter syndrome has emerged. Improvements have been made in understanding rare diseases such as Rubinstein-Taybi syndrome. Eltrombopag is an effective therapy for immune trombocytopenia. Children with sickle-cell anemia are at risk for nocturnal enuresis. Invasive diseases caused by Streptococcus pyogenes are still common despite of vaccination. No difference in frequency of antibiotic prescriptions for acute otitis media between before the publication of the national guideline and after has been found. The importance of timing of iron administration in low birth weight infants, the effect of probiotics for preventing necrotising enterocolitis and perspectives for managing jaundice and cholestasis in neonates have been highlighted. New strategies have been developed to reduce the risk for relapse in nephrotic syndrome including prednisolone during upper respiratory infection. Insights into the pathophysiology of cerebral palsy, arterial ischemic stroke and acute encephalitis may drive advances in treatment. Recommendations on breastfeeding and complementary feeding have been updated. Novel treatments for rhabdomyosarcoma should be considered for paediatric patients. Control of risk factors for bronchiolitis and administration of pavilizumab for preventing respiratory syncytial virus infection may reduce hospitalization. Identification of risk factors for hospitalization in children with wheezing can improve the management of this disease. Deletions or mutations in genes encoding proteins for surfactant function may cause diffuse lung disease.

  13. Nocturnality constrains morphological and functional diversity in the eyes of reef fishes.

    PubMed

    Schmitz, Lars; Wainwright, Peter C

    2011-11-19

    Ambient light levels are often considered to drive the evolution of eye form and function. Diel activity pattern is the main mechanism controlling the visual environment of teleost reef fish, with day-active (diurnal) fish active in well-illuminated conditions, whereas night-active (nocturnal) fish cope with dim light. Physiological optics predicts several specific evolutionary responses to dim-light vision that should be reflected in visual performance features of the eye. We analyzed a large comparative dataset on morphological traits of the eyes in 265 species of teleost reef fish in 43 different families. The eye morphology of nocturnal reef teleosts is characterized by a syndrome that indicates better light sensitivity, including large relative eye size, high optical ratio and large, rounded pupils. Improved dim-light image formation comes at the cost of reduced depth of focus and reduction of potential accommodative lens movement. Diurnal teleost reef fish, released from the stringent functional requirements of dim-light vision have much higher morphological and optical diversity than nocturnal species, with large ranges of optical ratio, depth of focus, and lens accommodation. Physical characteristics of the environment are an important factor in the evolution and diversification of the vertebrate eye. Both teleost reef fish and terrestrial amniotes meet the functional requirements of dim-light vision with a similar evolutionary response of morphological and optical modifications. The trade-off between improved dim-light vision and reduced optical diversity may be a key factor in explaining the lower trophic diversity of nocturnal reef teleosts.

  14. Responses of photosynthetic O2 evolution to PPFD in the CAM epiphyte Tillandsia usneoides L. (Bromeliaceae).

    PubMed

    Martin, C E; McKee, J M; Schmitt, A K

    1989-09-01

    Past studies of the effects of varying levels of photosynthetic photon flux density (PPFD) on the morphology and physiology of the epiphytic Crassulacean acid metabolism (CAM) plant Tillandsia usneoides L. (Bromeliaceae) have resulted in two important findings: (1) CAM, measured as integrated nocturnal CO2 uptake or as nocturnal increases in tissue acidity, saturates at relatively low PPFD, and (2) this plant does not acclimate to different PPFD levels, these findings require substantiation using photosynthetic responses immediately attributable to different PPFD levels, e.g., O2 evolution, as opposed to the delayed, nocturnal responses (CO2 uptake and acid accumulation). In the present study, instantaneous responses of O2 evolution to PPFD level were measured using plants grown eight weeks at three PPFD (20-45, 200-350, and 750-800 μmol m(-2)s(-1)) in a growth chamber, and using shoots taken from the exposed upper portions (maximum PPFD of 800 μmol m(-2)s(-1)) and shaded lower portions (maximum PPFD of 140 μmol m(-2)s(-1)) of plants grown ten years in a greenhouse. In addition, nocturnal increases in acidity were measured in the growth chamber plants. Regardless of the PPFD levels during growth, O2 evolution rates saturated around 500 μmol m(-2)s(-1). Furthermore, nocturnal increases in tissue acidity saturated at much lower PPFD. Thus, previous results were confirmed: photosynthesis saturated at low PPFD, and this epiphyte does not acclimate to different levels of PPFD.

  15. Nocturnal Polyuria in Older Women with Urge Urinary Incontinence: Role of Sleep Quality, Time in Bed, and Medications Used

    PubMed Central

    Tyagi, Shachi; Perera, Subashan; Clarkson, Becky D.; Tadic, Stasa D; Resnick, Neil M

    2016-01-01

    Purpose Nocturia is common and bothersome in older adults especially those who are also incontinent. Since nocturnal polyuria (NP) is a major contributor, we examined factors associated with NP in this population to identify those possibly amenable to intervention. Method We analyzed baseline data from two previously-completed studies of urge urinary incontinence (UUI). The studies involved 284 women (mean 72.9 ±7.9 years) who also completed 3-day voiding diaries. Participants with nocturnal polyuria index (NPi) of > 33% were categorized as having NP (NPi= nocturnal urinary volume/24-hour urine volume). Associations between NP and various demographic, clinical, and sleep-related parameters were determined. Results Fifty-five percent of the participants had NP. Multivariable regression analysis revealed that age, body mass index (BMI), use of angiotensin-converting-enzyme inhibitor (ACE-I)/angiotensin receptor blocker (ARB), time spent in bed, and duration of first uninterrupted sleep (DUS) were independent correlates of NP. Participants with larger nocturnal excretion reported shorter DUS and worse sleep quality despite spending similar time in bed. Conclusion BMI, use of ACE-I/ARB, time in bed and DUS are independently associated with NP in older women with UUI, and are potentially modifiable. These findings also confirm the association between sleep and NP. Further studies should explore whether interventions to reduce NP and/or increase DUS help to improve sleep quality in this population and thereby reduce or eliminate the need for sedative hypnotics. PMID:27678299

  16. Nitroglycerin-mediated, but not flow-mediated vasodilation, is associated with blunted nocturnal blood pressure fall in patients with resistant hypertension.

    PubMed

    Fontes-Guerra, Priscila C A; Cardoso, Claudia R L; Muxfeldt, Elizabeth S; Salles, Gil F

    2015-08-01

    Endothelial function by flow-mediated (FMD) and nitroglycerin-mediated vasodilations (NMD) was scarcely investigated in resistant hypertension. We aimed to assess the independent correlates of FMD and NMD in resistant hypertensive patients, particularly their associations with ambulatory blood pressures (BP) and nocturnal BP fall patterns. In a cross-sectional study, 280 resistant hypertensive patients performed 24-h ambulatory BP monitoring, carotid-femoral pulse wave velocity, polysomnography, and brachial artery FMD and NMD by high-resolution ultrasonography. Independent correlates of FMD, NMD, and brachial artery diameter (BAD) were assessed by multiple linear and logistic regressions. Median (interquartile range) FMD was 0.75% (-0.6 to +4.4%) and NMD was 11.8% (7.1-18.4%). Baseline BAD and diabetes were independently associated with both FMD and NMD. Older age and prior cardiovascular diseases were associated with altered FMD, whereas higher night-time SBP and lower nocturnal SBP fall were associated with impaired NMD. Moreover, there was a significant gradient of impaired NMD according to blunted nocturnal BP decline patterns. BAD was independently associated with age, sex, BMI, albuminuria, and nocturnal SBP fall. Further adjustments to blood flow velocity, aortic stiffness, plasma aldosterone concentration, and sleep apnea did not change these relationships. NMD, but not FMD, is independently associated with unfavorable night-time BP levels and nondipping patterns, and may be a better cardiovascular risk marker in patients with resistant hypertension. BAD also may provide additional prognostic information.

  17. Lidar observations revealing transport of O3 in the presence of a nocturnal low-level jet: Regional implications for ;next-day; pollution

    NASA Astrophysics Data System (ADS)

    Sullivan, John T.; Rabenhorst, Scott D.; Dreessen, Joel; McGee, Thomas J.; Delgado, Ruben; Twigg, Laurence; Sumnicht, Grant

    2017-06-01

    Remotely sensed profiles of ozone (O3) and wind are presented continuously for the first time during a nocturnal low-level jet (NLLJ) event occurring after a severe O3 episode in the Baltimore-Washington D.C. (BW) urban corridor throughout 11-12 June 2015. High-resolution O3 lidar observations indicate a well-mixed and polluted daytime O3 reservoir, which decayed into a contaminated nocturnal residual layer (RL) with concentrations between 70 and 100 ppbv near 1 km above the surface. Observations indicate the onset of the NLLJ was responsible for transporting polluted O3 away from the region, while simultaneously affecting the height and location of the nocturnal residual layer. High-resolution modeling analyses and next-day (12 June) lidar, surface, and balloon-borne observations indicate the trajectory of the NLLJ and polluted residual layer corresponds with "next-day" high O3 at sites throughout the southern New England region (New York, Connecticut, Massachusetts). The novel O3 lidar observations are evidence of both nocturnal advection (via high NLLJ wind fields) and entrainment of the polluted residual layer in the presence of the "next-day" convectively growing boundary layer. In the greater context, the novel observational suite described in this work has shown that the chemical budget in areas downwind of major urban centers can be altered significantly overnight during transport events such as the NLLJ.

  18. Optimizing sleep/wake schedules in space: Sleep during chronic nocturnal sleep restriction with and without diurnal naps

    NASA Astrophysics Data System (ADS)

    Mollicone, Daniel J.; Van Dongen, Hans P. A.; Dinges, David F.

    2007-02-01

    Effective sleep/wake schedules for space operations must balance severe time constraints with allocating sufficient time for sleep in order to sustain high levels of neurobehavioral performance. Developing such schedules requires knowledge about the relationship between scheduled "time in bed" (TIB) and actual physiological sleep obtained. A ground-based laboratory study in N=93 healthy adult subjects was conducted to investigate physiological sleep obtained in a range of restricted sleep schedules. Eighteen different conditions with restricted nocturnal anchor sleep, with and without diurnal naps, were examined in a response surface mapping paradigm. Sleep efficiency was found to be a function of total TIB per 24 h regardless of how the sleep was divided among nocturnal anchor sleep and diurnal nap sleep periods. The amounts of sleep stages 1+2 and REM showed more complex relationships with the durations of the anchor and nap sleep periods, while slow-wave sleep was essentially preserved among the different conditions of the experiment. The results of the study indicated that when sleep was chronically restricted, sleep duration was largely unaffected by whether the sleep was placed nocturnally or split between nocturnal anchor sleep periods and daytime naps. Having thus assessed that split-sleep schedules are feasible in terms of obtaining physiological sleep, further research will reveal whether these schedules and the associated variations in the distribution of sleep stages may be advantageous in mitigating neurobehavioral performance impairment in the face of limited time for sleep.

  19. The Nightly Use of Sodium Oxybate Is Associated with a Reduction in Nocturnal Sleep Disruption: A Double-Blind, Placebo-Controlled Study in Patients with Narcolepsy

    PubMed Central

    Black, Jed; Pardi, Daniel; Hornfeldt, Carl S.; Inhaber, Neil

    2010-01-01

    Objective: To further explore the effects of sodium oxybate (SXB) administration on nocturnal sleep in narcolepsy patients during a double-blind, placebo-controlled, parallel group study conducted with 228 adult patients with narcolepsy/cataplexy in the United States, Canada, and Europe. Method: Patients were withdrawn from antidepressants and sedative/hypnotics, and then randomized to receive 4.5, 6, or 9 g SXB or placebo nightly for 8 weeks. Patients receiving 6 and 9 g/night doses were titrated to their final dose in weekly 1.5 g increments, while patients receiving placebo were randomized to undergo a similar mock dose titration. The use of stimulant therapy continued unchanged. Changes in sleep architecture were measured using centrally scored nocturnal polysomnograms. Daily diaries were used to record changes in narcolepsy symptoms and adverse events. Results: Following 8 weeks of SXB treatment, study patients demonstrated significant dose-related increases in the duration of stage 3 and 4 sleep, reaching a median increase of 52.5 minutes in patients receiving 9 g nightly. Compared to placebo-treated patients, delta power was significantly increased in all dose groups. Stage 1 sleep and the frequency of nocturnal awakenings were each significantly decreased at the 6 and 9 g/night doses. The changes in nocturnal sleep coincided with significant decreases in the severity and frequency of narcolepsy symptoms. Conclusions: The nightly administration of SXB to narcolepsy patients significantly impacts measures of slow wave sleep, wake after sleep onset, awakenings, total sleep time, and stage 1 sleep in a dose-related manner. The frequency and severity of narcolepsy symptoms decreased with treatment. Citation: Black J; Pardi D; Hornfeldt CS; Inhaber N. The nightly use of sodium oxybate is associated with a reduction in nocturnal sleep disruption: a double-blind, placebo-controlled study in patients with narcolepsy. J Clin Sleep Med 2010;6(6):596-602. PMID:21206549

  20. The Severity of Nocturnal Hypoxia but Not Abdominal Adiposity Is Associated with Insulin Resistance in Non-Obese Men with Sleep Apnea

    PubMed Central

    Borel, Anne-Laure; Monneret, Denis; Tamisier, Renaud; Baguet, Jean-Philippe; Faure, Patrice; Levy, Patrick; Halimi, Serge; Pépin, Jean-Louis

    2013-01-01

    Background Beyond obesity, sleep apnea syndrome is frequently associated with excess abdominal adiposity that could contribute to the deteriorated cardiometabolic risk profile of apneic patients. Methods The present study addressed the respective contribution of the severity of sleep apnea syndrome and excess abdominal adiposity to the cardiometabolic risk profile of 38 non obese men with polysomnography-diagnosed sleep apnea syndrome (apnea-hypopnea index >15 events/hour). These otherwise healthy men performed a 75g-oral glucose tolerance test (OGTT) with plasma lipid/inflammatory and redox profiles. Twenty-one apneic men with high-waist circumference (>94 cm) were compared to 17 apneic men with low-waist circumference. Results Apneic men with high-waist circumference had higher AUC glucose and AUC insulin than apneic men with low-waist circumference. Accordingly, apneic men with high-waist circumference had higher hepatic insulin resistance as reflected by higher HOMA-resistance index, and lower global insulin sensitivity as reflected by lower insulin sensitivity index of Matsuda (derived from OGTT). The sleep structure and the apnea-hypopnea index were not different between the two groups. However, apneic men with high-waist circumference presented with lower mean nocturnal oxyhemoglobin (SpO2). In the 38 men, waist circumference and mean nocturnal SpO2 were inversely correlated (r = −0.43, p = 0.011) and were both associated with plasma glucose/insulin homeostasis indices: the higher the waist circumference, the lower the mean nocturnal SpO2, the lower the insulin-sensitivity. Finally, in multivariable regression model, mean nocturnal SpO2 and not waist circumference was associated with insulin-resistance. Conclusion Thus, excess abdominal adiposity in non obese apneic men was associated with a deteriorated insulin-sensitivity that could be driven by a more severe nocturnal hypoxemia. PMID:23951064

  1. Nocturnal eating disturbs phosphorus excretion in young subjects: a randomized crossover trial.

    PubMed

    Sakuma, Masae; Noda, Saaya; Morimoto, Yuuka; Suzuki, Akitsu; Nishino, Kanaho; Ando, Sakiko; Umeda, Minako; Ishikawa, Makoto; Arai, Hidekazu

    2015-10-08

    Nocturnal eating have recently increased. Serum phosphorus levels and regulators of phosphorus have circadian variations, so it is suggested that the timing of eating may be important in controlling serum phosphorus levels. However, there have been no reports on the effects of nocturnal eating on phosphorus metabolism. The objective was to evaluate the effects of nocturnal eating on phosphorus metabolism. Fourteen healthy men participated in two experimental protocols with differing dinner times. The design of this study was a crossover study. The subjects were served test meals three times (breakfast; 07:30 h, lunch; 12:30 h, dinner; 17:30 or 22:30 h) a day. Blood and urine samples were collected to assess diurnal variation until the following morning. The following morning, fasting serum phosphorus levels in the late dinner group were markedly higher than those in the early dinner group (p < 0.001), although serum calcium levels were maintained at approximately constant levels throughout the day in both groups. Fluctuations in urinary calcium excretion were synchronized with the timing of dinner eating, however, fluctuations in urinary phosphorus excretion were not synchronized. Urinary phosphorus excretions at night were inhibited in the late dinner group. In the late dinner group, intact parathyroid hormone levels didn't decrease, and they were significantly higher in this group compared with the early dinner group at 20:00 h (p = 0.004). The following morning, fasting serum fibroblast growth factor 23 levels in the late dinner group had not changed, but those in the early dinner group were significantly increased (p = 0.003). Serum free fatty acid levels before dinner were significantly higher in the late dinner group compared with the early dinner group. Our results indicate that nocturnal eating inhibits phosphorus excretion. It is suggested that nocturnal eating should be abstained from to manage serum phosphorus levels to within an adequate range.

  2. Nocturnal movements of desert bighorn sheep in the Muddy Mountains, Nevada

    USGS Publications Warehouse

    Longshore, Kathleen M.; Lowrey, Chris E.; Jeffress, Matthew; Thompson, Daniel B.

    2009-01-01

    Adequate management of a species requires complete knowledge of its ecology, including both nocturnal and diurnal behavior. Knowledge of the movement behavior of bighorn sheep can provide insight for understanding spatial population processes as the combined result of individual behavior, physiological constraints, and fine-scale environmental influences. However, because of past difficulties in tracking radio-collared animals in the dark, little is known about nocturnal movements of many ungulates, including desert bighorn sheep (Ovis canadensis nelsoni). The use of GPS collars that supply sequential location records over a 24-hour period has provided new opportunities for recording movements of animals. We report findings from a preliminary analysis of data on nocturnal movements of desert bighorn sheep wearing GPS collars in the Muddy Mountains, Nevada. The study is part of a larger research project on movement patterns aimed at assessing the connectivity of bighorn sheep populations that comprise the metapopulation in southern Nevada. We recorded nighttime locations at 2100 and 0400 PST and calculated a total of 8,758 nocturnal movement distances for 12 ewes and 16 rams. Nocturnal movements were characteristic of all individuals. Bighorn sheep varied in the magnitude of movement from night to night and there were significant differences among individuals in the mean distance moved. Females had a greater proportion of short movement distances when compared to males; males had the greatest proportion of long distance movements. Movement distances were affected by sex, season, and percent of the moon’s surface illumination. Mean movement distances of males were greater than those of females. For both males and females, mean movement distances were shortest during the late spring months (April-June) and greatest during summer (July–September). Mean movement distances were greatest when the moon was brightest for all seasons except late spring, when movement distances for both sexes were shortest. We also describe movement distances >1 km (19% ewes, 81% rams) relative to movements within or between 50% core use areas, and nighttime intermountain and intra-mountain travel.

  3. ARM Support for the Plains Elevated Convection at Night (AS-PECAN) Field Campaign Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Turner, D. D.; Geerts, B.

    The Plains Elevated Convection at Night (PECAN) field campaign was a large multi-agency/multi-institutional experiment that targeted nighttime convection events in the central plains of the United States in order to better understand a range of processes that lead to the initiation and upscale growth of deep convection. Both weather and climate models struggle to properly represent the timing and intensity of precipitation in the central United States in their simulations. These models must be able to represent the interactions between the nocturnal stable boundary layer (SBL), the nocturnal low-level jet (LLJ), and a reservoir of convectively available potential energy (CAPE)more » that frequently exists above the SBL. Furthermore, a large fraction of the nocturnal precipitation is due to the organization of mesoscale convective systems (MCSs). In particular, there were four research foci for the PECAN campaign: •The initiation of elevated nocturnal convection focus seeks to elucidate the mesoscaleenvironmental characteristics and processes that lead to convection initiation (CI) and provide baseline data on the early evolution of mesoscale convective clusters. •The dynamics and internal structure and microphysics of nocturnal MCSs focus will investigatethe transition from surface-based to elevated storm structure, the interaction of cold pools generated by MCSs with the nocturnal stable boundary layer, and how the organization and evolution of elevated convection is influenced by the SBL and the vertical profile of wind and stability above the LLJ. •The bores and wave-like disturbances focus seeks to advance knowledge of the initiation of boredisturbances by convection, how the vertical profile of stability and winds modulate bore structure, the role of these disturbances in the initiation, maintenance, and organization of deep convection, and their impact on the LLJ and SBL. •The LLJ focus seeks to understand the processes that influence the spatial and temporal evolutionof the LLJ, how it affects the SBL, and the interaction between the LLJ and atmospheric boundaries in the development of CI.« less

  4. Crassulacean acid metabolism-cycling in Euphorbia milii.

    PubMed

    Herrera, Ana

    2013-01-01

    Crassulacean acid metabolism (CAM) occurs in many Euphorbiaceae, particularly Euphorbia, a genus with C3 and C4 species as well. With the aim of contributing to our knowledge of the evolution of CAM in this genus, this study examined the possible occurrence of CAM in Euphorbia milii, a species with leaf succulence and drought tolerance suggestive of this carbon fixation pathway. Leaf anatomy consisted of a palisade parenchyma, a spongy parenchyma and a bundle sheath with chloroplasts, which indicates the possible functioning of C2 photosynthesis. No evidence of nocturnal CO2 fixation was found in plants of E. milii either watered or under drought; watered plants had a low nocturnal respiration rate (R). After 12 days without watering, the photosynthetic rate (P N) decreased 85 % and nocturnal R was nearly zero. Nocturnal H(+) accumulation (ΔH(+)) in watered plants was 18 ± 2 (corresponding to malate) and 18 ± 4 (citrate) μmol H(+) (g fresh mass)(-1). Respiratory CO2 recycling through acid synthesis contributed to a night-time water saving of 2 and 86 % in watered plants and plants under drought, respectively. Carbon isotopic composition (δ(13)C) was -25.2 ± 0.7 ‰ in leaves and -24.7 ± 0.1 ‰ in stems. Evidence was found for the operation of weak CAM in E. milii, with statistically significant ΔH(+), no nocturnal CO2 uptake and values of δ(13)C intermediate between C3 and constitutive CAM plants; ΔH(+) was apparently attributable to both malate and citrate. The results suggest that daily malate accumulation results from recycling of part of the nocturnal respiratory CO2, which helps explain the occurrence of an intermediate value of leaf δ(13)C. Euphorbia milii can be considered as a CAM-cycling species. The significance of the operation of CAM-cycling in E. milii lies in water conservation, rather than carbon acquisition. The possible occurrence of C2 photosynthesis merits research.

  5. Comparison of nocturia response to desmopressin treatment in elderly men with and without nocturnal polyuria in real-life practice.

    PubMed

    Chen, S-L; Huang, Y-H; Hung, T-W; Ou, Y-C

    2016-05-01

    To evaluate the safety and efficacy of low-dose desmopressin in elderly men with and without nocturnal polyuria (NP) in real-life practice. Patients with lower urinary tract symptoms (LUTS)/ benign prostate hyperplasia (BPH) who were≧ 65 years old with refractory nocturia were enrolled in this study. We retrospectively analysed elderly men treated with adding desmopressin to current medications for nocturia according to category of the baseline nocturnal urine volume. The 48-h frequency volume chart (FVC), International Prostate Symptom Score (IPSS) and quality of life (QoL) were initially assessed and re-evaluated 12 weeks later. Serum sodium level was checked 1 week, 4 weeks, and 12 weeks after initiation of desmopressin therapy or suspected hyponatremia event. The mean change in numbers of nocturnal voids was evaluated for efficacy of treatment. A total of 136 patients were included with 55 in non-NP group and 81 in NP group. Hypertension was more common in NP group in regard of comorbidities. During treatment period, there were significant reductions of nocturnal voids from 4.22 ± 1.38 to 2.31 ± 0.98 (p < 0.001) in non-NP group and from 4.52 ± 1.23 to 2.07 ± 0.89 (p < 0.001) in NP group. The reduction in nocturnal voids was more significant in NP group (2.44 ± 1.15 vs. 1.91 ± 1.48, p = 0.003). The mean decrease in serum sodium levels were 3.89 ± 1.22 mmol/l (p < 0.001) in non-NP group and 4.69 ± 3.5 mmol/l (p < 0.001) in NP group at the extreme value. Long-term treatment with low-dose desmopressin is safe and effective for nocturia with or without NP in elderly patients with LUTS/BPH during real-life practice. Patients should be well informed about the disease and are closely followed. © 2016 John Wiley & Sons Ltd.

  6. Low dose oral desmopressin for nocturnal polyuria in patients with benign prostatic hyperplasia: a double-blind, placebo controlled, randomized study.

    PubMed

    Wang, Chung-Jing; Lin, Yu-Nan; Huang, Shi-Wei; Chang, Chien-Hsing

    2011-01-01

    We evaluated the long-term efficacy and safety of low dose oral desmopressin in elderly patients with benign prostatic hyperplasia with more than nocturnal voids and nocturnal polyuria more than 30% of total daily urine volume. Eligible patients with benign prostatic hyperplasia older than 65 years with nocturia, nocturnal polyuria and International Prostate Symptom Score 14 or greater were included in the study. All patients received placebo or 0.1 mg desmopressin orally at bedtime. Patients were required to visit the outpatient clinic from the first visit, and after 1, 3, 6 and 12 months of treatment. Patients maintained flow volume charts and used diaries to record voiding data throughout the study. During followup urinalysis, urine sodium, urine osmolality, serum electrolytes, prostate specific antigen, International Prostate Symptom Score, quality of life, transrectal ultrasonography of prostate, uroflowmetry and post-void residual urine volume were performed at each visit. A total of 115 patients were enrolled in the study and randomized as 58 in the placebo group and 57 in the desmopressin group. Desmopressin significantly decreased nocturnal urine output and the number of nocturia episodes, and prolonged the first sleep period (p < 0.01). Compared to before treatment desmopressin gradually decreased serum sodium and induced statistically but not clinically significant hyponatremia after 12 months of treatment. No serious systemic complications were found during medication. Low dose oral desmopressin is an effective and well tolerated treatment for nocturnal polyuria in the lower urinary tract symptoms of patients with benign prostatic hyperplasia. Long-term desmopressin therapy gradually decreases serum sodium and it might induce hyponatremia even in patients without initial hyponatremia. For long-term desmopressin administration serum sodium should be assessed carefully, at least at 1 week after treatment. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. Nocturnal Vertical Gradients of O3, NO2, NO3, HONO, HCHO, and SO2 in Los Angeles, CA, during CalNex 2010

    NASA Astrophysics Data System (ADS)

    Tsai, J.; Pikelnaya, O.; Hurlock, S. C.; Wong, K.; Cheung, R.; Haman, C. L.; Lefer, B. L.; Stutz, J.

    2010-12-01

    Nocturnal chemistry, through the conversion and removal of air pollutants, plays an important role in determining the initial condition for photochemistry during the following day. In the stable nocturnal boundary layer (NBL) the interplay between suppressed vertical mixing and surface emissions of NOx and VOCs can result in pronounced vertical trace gas profiles. The resulting altitude dependence of nocturnal chemistry makes the interpretation of ground observations challenging. In particular, the quantification of the nocturnal loss of NOx, due to NO3 and N2O5 chemistry, requires observations throughout the entire vertical extent of the NBL. The formation of daytime radical precursors, such as HONO, is also altitude dependent. An accurate assessment of their impact on daytime chemistry requires measurements of their profiles during the night and morning. Here we present observations from the CalNex-LA experiment, which took place from May 15 to June 15, 2010 on the east side of the Los Angeles Basin, CA. A Long-Path Differential Optical Absorption Spectrometer (LP-DOAS) was set up on the roof of the Millikan library (265 m asl, 35m agl) on the campus of the California Institute of Technology. Four retroreflector arrays were mounted about 5 -7 km North-East of the instrument at 310m, 353m, 487m and 788 m asl. The vertical profiles of NO3, HONO, NO2, O3, HCHO, and SO2 were retrieved at altitude intervals of 35-78m, 78-121m, 121-255m and 255-556m above the ground. During many nights vertical gradients were observed, with elevated NO2 and HONO concentrations near the surface and larger ozone and NO3 concentrations aloft. Simultaneous ceilometer observations of the NBL structure show the impact of meteorology on the vertical trace gas distributions. We will discuss the consequences of trace gases gradients on the nocturnal NOx budget.

  8. Antisuicidal Response Following Ketamine Infusion Is Associated With Decreased Nighttime Wakefulness in Major Depressive Disorder and Bipolar Disorder.

    PubMed

    Vande Voort, Jennifer L; Ballard, Elizabeth D; Luckenbaugh, David A; Bernert, Rebecca A; Richards, Erica M; Niciu, Mark J; Park, Lawrence T; Machado-Vieira, Rodrigo; Duncan, Wallace C; Zarate, Carlos A

    Insomnia and disrupted sleep are associated with increased risk of suicide. The N-methyl-d-aspartate antagonist ketamine has been associated with reduced suicidal thoughts, but the mechanism of action is unknown. This study sought to evaluate differences in nocturnal wakefulness in depressed individuals who did and did not have an antisuicidal response to ketamine. Thirty-four participants with baseline suicidal ideation diagnosed with either DSM-IV major depressive disorder (n = 23) or bipolar depression (n = 11) between 2006 and 2013 completed nighttime electroencephalography (EEG) the night before and the night after a single ketamine infusion (0.5 mg/kg over 40 minutes). Suicidal ideation was assessed at baseline and the morning after ketamine infusion via several measures, including the Hamilton Depression Rating Scale suicide item, the suicide item of the Montgomery-Asberg Depression Rating Scale, and the first 5 items of the Scale for Suicide Ideation. A generalized linear mixed model evaluated differences in nocturnal wakefulness, as verified by EEG, between those who had an antisuicidal response to ketamine and those who did not, controlling for baseline nocturnal wakefulness. Results were also compared to the sleep of healthy controls (n = 22). After analyses adjusted for baseline sleep, participants with an antisuicidal response to ketamine showed significantly reduced nocturnal wakefulness the night after ketamine infusion compared to those without an antisuicidal response (F₁,₂₂ = 5.04, P = .04). Level of nocturnal wakefulness after antisuicidal response to ketamine did not differ significantly from nocturnal wakefulness in the control sample but did differ at a trend level (F₁,₄₀ = 3.15, P = .08). Reductions in wakefulness following ketamine may point to a biological mechanism underlying the effect of ketamine on suicidal ideation. ClinicalTrials.gov identifier: NCT00088699. © Copyright 2016 Physicians Postgraduate Press, Inc.

  9. Estimation of nocturnal CO2 and N2O soil emissions from changes in surface boundary layer mass storage

    NASA Astrophysics Data System (ADS)

    Grant, Richard H.; Omonode, Rex A.

    2018-04-01

    Annual budgets of greenhouse and other trace gases require knowledge of the emissions throughout the year. Unfortunately, emissions into the surface boundary layer during stable, calm nocturnal periods are not measurable using most micrometeorological methods due to non-stationarity and uncoupled flow. However, during nocturnal periods with very light winds, carbon dioxide (CO2) and nitrous oxide (N2O) frequently accumulate near the surface and this mass accumulation can be used to determine emissions. Gas concentrations were measured at four heights (one within and three above canopy) and turbulence was measured at three heights above a mature 2.5 m maize canopy from 23 July to 10 September 2015. Nocturnal CO2 and N2O fluxes from the canopy were determined using the accumulation of mass within a 6.3 m control volume and out the top of the control volume within the nocturnal surface boundary layer. Diffusive fluxes were estimated by flux gradient method. The total accumulative and diffusive fluxes during near-calm nights (friction velocities < 0.05 ms-1) averaged 1.16 µmol m-2 s-1 CO2 and 0.53 nmol m-2 s-1 N2O. Fluxes were also measured using chambers. Daily mean CO2 fluxes determined by the accumulation method were 90 to 130 % of those determined using soil chambers. Daily mean N2O fluxes determined by the accumulation method were 60 to 80 % of that determined using soil chambers. The better signal-to-noise ratios of the chamber method for CO2 over N2O, non-stationary flow, assumed Schmidt numbers, and anemometer tilt were likely contributing reasons for the differences in chambers versus accumulated nocturnal mass flux estimates. Near-surface N2O accumulative flux measurements in more homogeneous regions and with greater depth are needed to confirm the conclusion that mass accumulation can be effectively used to estimate soil emissions during nearly calm nights.

  10. Rotigotine for nocturnal hypokinesia in Parkinson's disease: Quantitative analysis of efficacy from a randomized, placebo-controlled trial using an axial inertial sensor.

    PubMed

    Bhidayasiri, Roongroj; Sringean, Jirada; Chaiwong, Suchapit; Anan, Chanawat; Penkeaw, Nuntiwat; Leaknok, Amarinee; Boonpang, Kamolwan; Saksornchai, Karn; Rattanachaisit, Watchara; Thanawattano, Chusak; Jagota, Priya

    2017-11-01

    Nocturnal hypokinesia is a common symptom in Parkinson's disease (PD), negatively affecting quality of life of both patients and caregivers. However, evidence-based treatment strategies are limited. To evaluate the efficacy of rotigotine transdermal patch, using a wearable sensor, in the management of nocturnal immobility. 34 PD subjects with nocturnal immobility were randomized to receive rotigotine transdermal patch (mean ± SD of 10.46 ± 4.63 mg/24 h, n = 17) or placebo patch (n = 17). Treatment was titrated to an optimal dose over 1-8 weeks, then maintained for 4 weeks. Primary endpoints were objective parameters assessing axial rotation measured using an axial inertial sensor (the NIGHT-Recorder) over two nights at the patients' home. Scale-based assessments were also performed. There was a significant difference, in favor of rotigotine, in change from baseline score in the number of turns in bed (ANCOVA, p = 0.001), and degree of axial turn (p = 0.042). These objective improvements were mirrored by significantly greater improvements in clinical scale-based assessments, including the Unified Parkinson's Disease Rating Scale (UPDRS) total scores (p = 0.009), UPDRS-motor scores (p < 0.001), UPDRS-axial scores (p = 0.01), the Modified Parkinson's Disease Sleep Scale (p < 0.001), the Nocturnal Akinesia Dystonia and Cramp Scale (p = 0.003) and the eight-item PD Questionnaire (PDQ-8) scores (p = 0.01) from baseline to end of treatment in patients given rotigotine compared to placebo. We show that the rotigotine patch provides a significant improvement in nocturnal symptoms as assessed using both objective measures and clinical rating scales. The study demonstrates the feasibility of using wearable sensors to record objective outcomes in PD-related clinical trials. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Nocturnal and seasonal patterns of carbon isotope composition of leaf dark-respired carbon dioxide differ among dominant species in a semiarid savanna.

    PubMed

    Sun, Wei; Resco, Víctor; Williams, David G

    2010-10-01

    The C isotope composition of leaf dark-respired CO(2) (δ(13)C(l)) integrates short-term metabolic responses to environmental change and is potentially recorded in the isotopic signature of ecosystem-level respiration. Species differences in photosynthetic pathway, resource acquisition and allocation patterns, and associated isotopic fractionations at metabolic branch points can influence δ(13)C(l), and differences are likely to be modified by seasonal variation in drought intensity. We measured δ(13)C(l) in two deep-rooted C(3) trees (Prosopis velutina and Celtis reticulata), and two relatively shallow-rooted perennial herbs (a C(3) dicot Viguiera dentata and a C(4) grass Sporobolus wrightii) in a floodplain savanna ecosystem in southeastern Arizona, USA during the dry pre-monsoon and wet monsoon seasons. δ(13)C(l) decreased during the nighttime and reached minimum values at pre-dawn in all species. The magnitude of nocturnal shift in δ(13)C(l) differed among species and between pre-monsoon and monsoon seasons. During the pre-monsoon season, the magnitude of the nocturnal shift in δ(13)C(l) in the deep-rooted C(3) trees P. velutina (2.8 ± 0.4‰) and C. reticulata (2.9 ± 0.2‰) was greater than in the C(3) herb V. dentata (1.8 ± 0.4‰) and C(4) grass S. wrightii (2.2 ± 0.4‰). The nocturnal shift in δ(13)C(l) in V. dentata and S. wrightii increased to 3.2 ± 0.1‰ and 4.6 ± 0.6‰, respectively, during the monsoon season, but in C(3) trees did not change significantly from pre-monsoon values. Cumulative daytime net CO(2) uptake was positively correlated with the magnitude of the nocturnal decline in δ(13)C(l) across all species, suggesting that nocturnal δ(13)C(l) may be controlled by (13)C/(12)C fractionations associated with C substrate availability and C metabolite partitioning. Nocturnal patterns of δ(13)C(l) in dominant plant species in the semiarid savanna apparently have predictable responses to seasonal changes in water availability, which is important for interpreting and modeling the C isotope signature of ecosystem-respired CO(2).

  12. Multi-center, randomized, placebo-controlled trial of nocturnal oxygen therapy in chronic obstructive pulmonary disease: a study protocol for the INOX trial.

    PubMed

    Lacasse, Yves; Bernard, Sarah; Sériès, Frédéric; Nguyen, Van Hung; Bourbeau, Jean; Aaron, Shawn; Maltais, François

    2017-01-09

    Long-term oxygen therapy (LTOT) is the only component of the management of chronic obstructive pulmonary disease (COPD) that improves survival in patients with severe daytime hypoxemia. LTOT is usually provided by a stationary oxygen concentrator and is recommended to be used for at least 15-18 h a day. Several studies have demonstrated a deterioration in arterial blood gas pressures and oxygen saturation during sleep in patients with COPD, even in those not qualifying for LTOT. The suggestion has been made that the natural progression of COPD to its end stages of chronic pulmonary hypertension, severe hypoxemia, right heart failure, and death is dependent upon the severity of desaturation occurring during sleep. The primary objective of the International Nocturnal Oxygen (INOX) trial is to determine, in patients with COPD not qualifying for LTOT but who present significant nocturnal arterial oxygen desaturation, whether nocturnal oxygen provided for a period of 3 years decreases mortality or delay the prescription of LTOT. The INOX trial is a 3-year, multi-center, placebo-controlled, randomized trial of nocturnal oxygen therapy added to usual care. Eligible patients are those with a diagnosis of COPD supported by a history of past smoking and obstructive disease who fulfill our definition of significant nocturnal oxygen desaturation (i.e., ≥ 30% of the recording time with transcutaneous arterial oxygen saturation < 90% on either of two consecutive recordings). Patients allocated in the control group receive room air delivered by a concentrator modified to deliver 21% oxygen. The comparison is double blind. The primary outcome is a composite of mortality from all cause or requirement for LTOT. Secondary outcomes include quality of life and utility measures, costs from a societal perspective and compliance with oxygen therapy. The follow-up period is intended to last at least 3 years. The benefits of LTOT have been demonstrated whereas those of nocturnal oxygen therapy alone have not. The INOX trial will likely determine whether supplemental oxygen during sleep is effective in reducing mortality, delaying the need for LTOT and improving health-related quality of life in patients with COPD who desaturate overnight. Current Controlled Trials ISRCTN50085100 ; ClinicalTrials.gov NCT01044628 (date of registration: January 6, 2010).

  13. Nocturnal activity patterns of northern myotis (Myotis septentrionalis) during the maternity season in West Virginia (USA)

    Treesearch

    Joshua B. Johnson; John W. Edwards; W. Mark Ford

    2011-01-01

    Nocturnal activity patterns of northern myotis (Myotis septentrionalis) at diurnal roost trees remain largely uninvestigated. For example, the influence of reproductive status, weather, and roost tree and surrounding habitat characteristics on timing of emergence, intra-night activity, and entrance at their roost trees is poorly known. We examined...

  14. Processes preventing nocturnal equilibration between leaf and soil water potential in tropical savanna woody species.

    Treesearch

    Sandra Bucci; Fabian G. Scholz; Guillermo Goldstein; Frederick C. Meinzer; Jose A. Hinojosa; William A. Hoffman; Augusto C. Franco

    2004-01-01

    The impact of nocturnal water loss and recharge of stem water storage on predawn disequilibrium between leaf (ΨL) and soil (Ψ S) water potentials was studied in three dominant tropical savanna woody species in central Brazil (Cerrado). Sap flow continued throughout the night during the dry season and...

  15. Nocturnal faecal soiling and anal masturbation.

    PubMed Central

    Clark, A F; Tayler, P J; Bhate, S R

    1990-01-01

    Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised. PMID:2270946

  16. Crassulacean acid metabolism, CO2-recycling, and tissue desiccation in the Mexican epiphyte Tillandsia schiedeana Steud (Bromeliaceae).

    PubMed

    Martin, C E; Adams, W W

    1987-01-01

    After 23 days without water in a greenhouse, rates of nocturnal CO2 uptake in Tillandsia schiedeana decreased substantially and maximum rates occurred later in the dark period eventually coinciding with the onset of illumination. Nocturnal CO2 uptake accounted for less than half the total nighttime increase in acidity measured in well-watered plants. With increased tissue desiccation, only 11-12% of measured acid accumulation was attributable to atmospheric CO2 uptake. Plants desiccated for 30 days regained initial levels of nocturnal acid accumulation and CO2 uptake after rehydration for 10h. These results stress the importance of CO2 recycling via CAM in this epiphytic bromeliad, especially during droughts.

  17. The effect of desmopressin on nocturnal polyuria, overnight weight loss, and morning postural hypotension in patients with autonomic failure.

    PubMed Central

    Mathias, C J; Fosbraey, P; da Costa, D F; Thornley, A; Bannister, R

    1986-01-01

    Day and night urine volume, morning and evening body weight, and supine and sitting blood pressure were measured in five patients with chronic autonomic failure who were not receiving treatment with drugs. All had nocturnal polyuria, overnight weight loss, and a pronounced postural fall in blood pressure, with lowest levels in the morning. Desmopressin (2-4 micrograms given intramuscularly at 8 pm) reduced nocturnal polyuria, diminished overnight weight loss, raised supine blood pressure, and reduced the postural fall, especially in the morning, when patients were often at their worst. Desmopressin may be a useful alternative to, or may supplement, other forms of treatment in some patients with autonomic failure. PMID:3089519

  18. Radiation forcing by the atmospheric aerosols in the nocturnal boundary layer

    NASA Astrophysics Data System (ADS)

    Singh, D. K.; Ponnulakshami, V. K.; Mukund, V.; Subramanian, G.; Sreenivas, K. R.

    2013-05-01

    We have conducted experimental and theoretical studies on the radiation forcing due to suspended aerosols in the nocturnal boundary layer. We present radiative, conductive and convective equilibrium profile for different bottom boundaries where calculated Rayleigh number is higher than the critical Rayleigh number in laboratory conditions. The temperature profile can be fitted using an exponential distribution of aerosols concentration field. We also present the vertical temperature profiles in a nocturnal boundary in the presence of fog in the field. Our results show that during the presence of fog in the atmosphere, the ground temperature is greater than the dew-point temperature. The temperature profiles before and after the formation of fog are also observed to be different.

  19. A new method for measuring nocturnal tooth contacts.

    PubMed

    Yamashita, S; Ai, M; Mizutani, H

    1993-09-01

    A new portable system for measuring nocturnal tooth contacts has been devised. This system was suitable for patients to take home and record tooth contacts by themselves. A micro photo sensor using optical fibres was applied to detect tooth contacts. The sensor and the target were accurately fixed to opposed molars, respectively on the same side, with removable metal attachments. Patients were instructed to set the attachment to their tooth each experimental night. In the present study, data was assembled for four or five nights in three subjects who were free of masticatory pain and dysfunction. Each subject showed an individual tooth contact pattern. It is suggested that this new system is useful and convenient for measuring nocturnal tooth contacts.

  20. Research on antidepressants in India

    PubMed Central

    Avasthi, Ajit; Grover, Sandeep; Aggarwal, Munish

    2010-01-01

    Data suggests that antidepressants are useful in the management of depressive disorders, anxiety disorders, sexual dysfunction, eating disorders, impulse control disorders, enuresis, aggression and some personality disorders. Research focusing on the usefulness of antidepressants in India has more or less followed the trends seen in the West. Most of the studies conducted in India have evaluated various antidepressants in depression. In this article, we review studies conducted in India on various antidepressants. The data suggests that antidepressants have been evaluated mainly in the acute phase treatment and rare studies have evaluated the efficacy in continuation phase treatment. PMID:21836704

  1. Nocturnality constrains morphological and functional diversity in the eyes of reef fishes

    PubMed Central

    2011-01-01

    Background Ambient light levels are often considered to drive the evolution of eye form and function. Diel activity pattern is the main mechanism controlling the visual environment of teleost reef fish, with day-active (diurnal) fish active in well-illuminated conditions, whereas night-active (nocturnal) fish cope with dim light. Physiological optics predicts several specific evolutionary responses to dim-light vision that should be reflected in visual performance features of the eye. Results We analyzed a large comparative dataset on morphological traits of the eyes in 265 species of teleost reef fish in 43 different families. The eye morphology of nocturnal reef teleosts is characterized by a syndrome that indicates better light sensitivity, including large relative eye size, high optical ratio and large, rounded pupils. Improved dim-light image formation comes at the cost of reduced depth of focus and reduction of potential accommodative lens movement. Diurnal teleost reef fish, released from the stringent functional requirements of dim-light vision have much higher morphological and optical diversity than nocturnal species, with large ranges of optical ratio, depth of focus, and lens accommodation. Conclusions Physical characteristics of the environment are an important factor in the evolution and diversification of the vertebrate eye. Both teleost reef fish and terrestrial amniotes meet the functional requirements of dim-light vision with a similar evolutionary response of morphological and optical modifications. The trade-off between improved dim-light vision and reduced optical diversity may be a key factor in explaining the lower trophic diversity of nocturnal reef teleosts. PMID:22098687

  2. Quantifying the local influence at a tall tower site in nocturnal conditions

    DOE PAGES

    Werth, David; Buckley, Robert; Zhang, Gengsheng; ...

    2015-10-17

    The influence of the local terrestrial environment on nocturnal atmospheric CO 2 measurements at a 329-m television transmitter tower (and a component of a CO 2 monitoring network) was estimated in this paper with a tracer release experiment and a subsequent simulation of the releases. This was done to characterize the vertical transport of emissions from the surface to the uppermost tower level and how it is affected by atmospheric stability. The tracer release experiment was conducted over two nights in May of 2009 near the Department of Energy’s Savannah River Site (SRS) in South Carolina. Tracer was released onmore » two contrasting nights—slightly stable and moderately stable—from several upwind surface locations. Measurements at the 329-m level on both nights indicate that tracer was able to mix vertically within a relatively short (~24 km) distance, implying that nocturnal stable conditions do not necessarily prevent vertical dispersion in the boundary layer and that CO 2 measurements at the tower are at least partly influenced by nearby emissions. A simulation of the tracer release is used to calculate the tower footprint on the two nights to estimate the degree to which the local domain affects the tower readings. The effect of the nocturnal boundary layer on the area sampled by the tower can be seen clearly, as the footprints were affected by changes in stability. Finally, the contribution of local sources to the measurements at the tower was minimal, however, suggesting that nocturnal concentrations at upper levels are contributed mostly by regional sources.« less

  3. The anti-bat strategy of ultrasound absorption: the wings of nocturnal moths (Bombycoidea: Saturniidae) absorb more ultrasound than the wings of diurnal moths (Chalcosiinae: Zygaenoidea: Zygaenidae).

    PubMed

    Ntelezos, Athanasios; Guarato, Francesco; Windmill, James F C

    2017-01-15

    The selection pressure from echolocating bats has driven the development of a diverse range of anti-bat strategies in insects. For instance, several studies have proposed that the wings of some moths absorb a large portion of the sound energy contained in a bat's ultrasonic cry; as a result, the bat receives a dampened echo, and the moth becomes invisible to the bat. To test the hypothesis that greater exposure to bat predation drives the development of higher ultrasound absorbance, we used a small reverberation chamber to measure the ultrasound absorbance of the wings of nocturnal (Bombycoidea: Saturniidae) and diurnal moths (Chalcosiinae: Zygaenoidea: Zygaenidae). The absorption factor of the nocturnal saturniids peaks significantly higher than the absorption factor of the diurnal chalcosiines. However, the wings of the chalcosiines absorb more ultrasound than the wings of some diurnal butterflies. Following a phylogenetic analysis on the character state of diurnality/ nocturnality in the Zygaenidae, we propose that diurnality in the Chalcosiinae is plesiomorphic (retained); hence, the absorbance of their wings is probably not a vestigial trait from an ancestral, nocturnal form but an adaptation to bat activity that overlaps their own. On a within-species level, females of the saturniids Argema mittrei and Samia cynthia ricini have significantly higher absorption factors than the males. In the female S. c. ricini, the higher absorption factor corresponds to a detection distance by bats that is at best 20-30% shorter than that of the male. © 2017. Published by The Company of Biologists Ltd.

  4. Seeing in the dark: vision and visual behaviour in nocturnal bees and wasps.

    PubMed

    Warrant, Eric J

    2008-06-01

    In response to the pressures of predation, parasitism and competition for limited resources, several groups of (mainly) tropical bees and wasps have independently evolved a nocturnal lifestyle. Like their day-active (diurnal) relatives, these insects possess apposition compound eyes, a relatively light-insensitive eye design that is best suited to vision in bright light. Despite this, nocturnal bees and wasps are able to forage at night, with many species capable of flying through a dark and complex forest between the nest and a foraging site, a behaviour that relies heavily on vision and is limited by light intensity. In the two best-studied species - the Central American sweat bee Megalopta genalis (Halictidae) and the Indian carpenter bee Xylocopa tranquebarica (Apidae) - learned visual landmarks are used to guide foraging and homing. Their apposition eyes, however, have only around 30 times greater optical sensitivity than the eyes of their closest diurnal relatives, a fact that is apparently inconsistent with their remarkable nocturnal visual abilities. Moreover, signals generated in the photoreceptors, even though amplified by a high transduction gain, are too noisy and slow to transmit significant amounts of information in dim light. How have nocturnal bees and wasps resolved these paradoxes? Even though this question remains to be answered conclusively, a mounting body of theoretical and experimental evidence suggests that the slow and noisy visual signals generated by the photoreceptors are spatially summed by second-order monopolar cells in the lamina, a process that could dramatically improve visual reliability for the coarser and slower features of the visual world at night.

  5. Effect of bright light on EEG activities and subjective sleepiness to mental task during nocturnal sleep deprivation.

    PubMed

    Yokoi, Mari; Aoki, Ken; Shimomura, Yoshihiro; Iwanaga, Koichi; Katsuura, Tetsuo; Shiomura, Yoshihiro

    2003-11-01

    The purpose of this study was to investigate the effect of the exposure to bright light on EEG activity and subjective sleepiness at rest and at the mental task during nocturnal sleep deprivation. Eight male subjects lay awake in semi-supine in a reclining seat from 21:00 to 04:30 under the bright (BL; >2500 lux) or the dim (DL; <150 lux) light conditions. During the sleep deprivation, the mental task (Stroop color-word conflict test: CWT) was performed each 15 min in one hour. EEG, subjective sleepiness, rectal and mean skin temperatures and urinary melatonin concentrations were measured. The subjective sleepiness increased with time of sleep deprivation during both rest and CWT under the DL condition. The exposure to bright light delayed for 2 hours the increase in subjective sleepiness at rest and suppressed the increase in that during CWT. The bright light exposure also delayed the increase in the theta and alpha wave activities in EEG at rest. In contrast, the effect of the bright light exposure on the theta and alpha wave activities disappeared by CWT. Additionally, under the BL condition, the entire theta activity during CWT throughout nocturnal sleep deprivation increased significantly from that in a rest condition. Our results suggest that the exposure to bright light throughout nocturnal sleep deprivation influences the subjective sleepiness during the mental task and the EEG activity, as well as the subjective sleepiness at rest. However, the effect of the bright light exposure on the EEG activity at the mental task diminishes throughout nocturnal sleep deprivation.

  6. Using Nocturnal Flight Calls to Assess the Fall Migration of Warblers and Sparrows along a Coastal Ecological Barrier

    PubMed Central

    Smith, Adam D.; Paton, Peter W. C.; McWilliams, Scott R.

    2014-01-01

    Atmospheric conditions fundamentally influence the timing, intensity, energetics, and geography of avian migration. While radar is typically used to infer the influence of weather on the magnitude and spatiotemporal patterns of nocturnal bird migration, monitoring the flight calls produced by many bird species during nocturnal migration represents an alternative methodology and provides information regarding the species composition of nocturnal migration. We used nocturnal flight call (NFC) recordings of at least 22 migratory songbirds (14 warbler and 8 sparrow species) during fall migration from eight sites along the mainland and island coasts of Rhode Island to evaluate five hypotheses regarding NFC detections. Patterns of warbler and sparrow NFC detections largely supported our expectations in that (1) NFC detections associated positively and strongly with wind conditions that influence the intensity of coastal bird migration and negatively with regional precipitation; (2) NFCs increased during conditions with reduced visibility (e.g., high cloud cover); (3) NFCs decreased with higher wind speeds, presumably due mostly to increased ambient noise; and (4) coastal mainland sites recorded five to nine times more NFCs, on average, than coastal nearshore or offshore island sites. However, we found little evidence that (5) nightly or intra-night patterns of NFCs reflected the well-documented latitudinal patterns of migrant abundance on an offshore island. Despite some potential complications in inferring migration intensity and species composition from NFC data, the acoustic monitoring of NFCs provides a viable and complementary methodology for exploring the spatiotemporal patterns of songbird migration as well as evaluating the atmospheric conditions that shape these patterns. PMID:24643060

  7. Relationship between body mass index with dietary fiber intake and skinfolds--differences among bodybuilders who train during morning and nocturne period.

    PubMed

    Monteiro, J C V; Pimentel, G D; Sousa, M V

    2012-01-01

    The prevalence of overweight individuals has increased in recent years. Moreover, the importance of a healthy diet is associated with the practice of physical activity and attempt to verify the achievement of physical exercise influences on food choice. However, it relationship between food intake and physical activity have not been studied. To evaluate if the period in which the trainings are conducted, morning and nocturne, interfere qualitatively and quantitatively in food consumption as well as verify possible associations between anthropometric profiles and dietary habits. We collected data from 33 adult volunteers, between men and women, practitioners of bodybuilding. A total of 33 volunteers were interviewed (18 (54.5%) were men and 15 (45.5%) were women). Regarding anthropometric data, it turns out that that the volunteers of the two periods had similar characteristics, differentiating only weight. The consumption of nutritional supplements was observed in 30.77% of the practitioners in the morning period vs. 35% for the nocturne. Considering macronutrient intake, there was a significant difference in the consumption of protein between the periods. The consumption during nocturne period was greater (126 ± 5% of the daily requirement) than the morning period (115.7 ± 2%). As for micro-nutrients, calcium intake was greater among men when compared to women. There was a positive correlation between the BMI, and arm circumference for practitioners of the morning period. This study show that the practitioners who train in the morning have quietly better eating habits than those in the nocturne period, however both are inappropriate.

  8. Environmental enrichment for a mixed-species nocturnal mammal exhibit.

    PubMed

    Clark, Fay E; Melfi, Vicky A

    2012-01-01

    Environmental enrichment (EE) is an integral aspect of modern zoo animal management but, empirical evaluation of it is biased toward species housed in single-species groups. Nocturnal houses, where several nocturnal species are housed together, are particularly overlooked. This study investigated whether three species (nine-banded armadillos, Dasypus novemcinctus; Senegal bush babies, Galago senegalensis; two-toed sloths, Choloepus didactylus) in the nocturnal house at Paignton Zoo Environmental Park, UK could be enriched using food-based and sensory EE. Subjects were an adult male and female of each species. EE was deemed effective if it promoted target species-typical behaviors, behavioral diversity, and increased use of enriched exhibit zones. Results from generalized linear mixed models demonstrated that food-based EE elicited the most positive behavioral effects across species. One set of food-based EEs (Kong®, termite mound and hanging food) presented together was associated with a significant increase in species-typical behaviors, increased behavioral diversity, and increased use of enriched exhibit zones in armadillos and bush babies. Although one type of sensory EE (scented pine cones) increased overall exhibit use in all species, the other (rainforest sounds) was linked to a significant decrease in species-typical behavior in bush babies and sloths. There were no intra or interspecies conflicts over EE, and commensalism occurred between armadillos and bush babies. Our data demonstrate that simple food-based and sensory EE can promote positive behavioral changes in a mixed-species nocturnal mammal exhibit. We suggest that both food and sensory EE presented concurrently will maximize opportunities for naturalistic activity in all species. © 2011 Wiley Periodicals, Inc.

  9. The anti-bat strategy of ultrasound absorption: the wings of nocturnal moths (Bombycoidea: Saturniidae) absorb more ultrasound than the wings of diurnal moths (Chalcosiinae: Zygaenoidea: Zygaenidae)

    PubMed Central

    Guarato, Francesco; Windmill, James F. C.

    2017-01-01

    ABSTRACT The selection pressure from echolocating bats has driven the development of a diverse range of anti-bat strategies in insects. For instance, several studies have proposed that the wings of some moths absorb a large portion of the sound energy contained in a bat's ultrasonic cry; as a result, the bat receives a dampened echo, and the moth becomes invisible to the bat. To test the hypothesis that greater exposure to bat predation drives the development of higher ultrasound absorbance, we used a small reverberation chamber to measure the ultrasound absorbance of the wings of nocturnal (Bombycoidea: Saturniidae) and diurnal moths (Chalcosiinae: Zygaenoidea: Zygaenidae). The absorption factor of the nocturnal saturniids peaks significantly higher than the absorption factor of the diurnal chalcosiines. However, the wings of the chalcosiines absorb more ultrasound than the wings of some diurnal butterflies. Following a phylogenetic analysis on the character state of diurnality/ nocturnality in the Zygaenidae, we propose that diurnality in the Chalcosiinae is plesiomorphic (retained); hence, the absorbance of their wings is probably not a vestigial trait from an ancestral, nocturnal form but an adaptation to bat activity that overlaps their own. On a within-species level, females of the saturniids Argema mittrei and Samia cynthia ricini have significantly higher absorption factors than the males. In the female S. c. ricini, the higher absorption factor corresponds to a detection distance by bats that is at best 20-30% shorter than that of the male. PMID:27913454

  10. Nocturia in men is a chaotic condition dominated by nocturnal polyuria.

    PubMed

    Fujimura, Tetsuya; Yamada, Yuta; Sugihara, Toru; Azuma, Takeshi; Suzuki, Motofumi; Fukuhara, Hiroshi; Nakagawa, Tohru; Kume, Haruki; Igawa, Yasuhiko; Homma, Yukio

    2015-05-01

    To characterize nocturia in men based on frequency volume chart data and symptom profiles assessed using the Core Lower Urinary Tract Symptom Score and Athens Insomnia Scale questionnaires. The Core Lower Urinary Tract Symptom Score and Athens Insomnia Scale questionnaires were administered to 299 consecutive treatment naïve men with nocturia (≥one time per night). Frequency volume chart data were recorded for 2 days. Correlations between nocturia and clinical characteristics including symptom scores, clinical diagnosis, Charlson Comorbidity Index, estimated glomerular filtration rate, uroflowmetry and prostate volume were analyzed. Patients were divided into five groups: one time (n = 36), two times (n = 65), three times (n = 85), four times (n = 78) and five times (n = 34) of nocturia. Age, prevalence or severity of chronic kidney disease, hyperlipidemia, low bladder capacity, nocturnal polyuria, urgency, bladder pain and sleep disorders were significantly correlated with the severity of nocturia. The Spearman correlation analysis identified eight possible independent factors for nocturia: age, estimated glomerular filtration rate, urgency, bladder pain, sleep quality, sleepiness during the day, average voided volume and nocturnal volume divided by body weight. Logistic regression analysis showed that nocturnal volume divided by body weight was the strongest factor of nocturia, and ≥7, 9 and 9.7 mL/kg were practical cut-off values of three, four and five times per night of nocturia, respectively. Nocturia in men is a chaotic condition dominated by nocturnal polyuria, and related to multiple factors including age, renal function, urgency, bladder pain, insomnia and bladder volume. © 2015 The Japanese Urological Association.

  11. Systematic review of proposed definitions of nocturnal polyuria and population-based evidence of their diagnostic accuracy.

    PubMed

    Olesen, Tine Kold; Denys, Marie-Astrid; Vande Walle, Johan; Everaert, Karel

    2018-02-06

    Background Evidence of diagnostic accuracy for proposed definitions of nocturnal polyuria is currently unclear. Purpose Systematic review to determine population-based evidence of the diagnostic accuracy of proposed definitions of nocturnal polyuria based on data from frequency-volume charts. Methods Seventeen pre-specified search terms identified 351 unique investigations published from 1990 to 2016 in BIOSIS, Embase, Embase Alerts, International Pharmaceutical Abstract, Medline, and Cochrane. Thirteen original communications were included in this review based on pre-specified exclusion criteria. Data were extracted from each paper regarding subject age, sex, ethnicity, health status, sample size, data collection methods, and diagnostic discrimination of proposed definitions including sensitivity, specificity, positive and negative predictive value. Results The sample size of study cohorts, participant age, sex, ethnicity, and health status varied considerably in 13 studies reporting on the diagnostic performance of seven different definitions of nocturnal polyuria using frequency-volume chart data from 4968 participants. Most study cohorts were small, mono-ethnic, including only Caucasian males aged 50 or higher with primary or secondary polyuria that were compared to a control group of healthy men without nocturia in prospective or retrospective settings. Proposed definitions had poor discriminatory accuracy in evaluations based on data from subjects independent from the original study cohorts with findings being similar regarding the most widely evaluated definition endorsed by ICS. Conclusions Diagnostic performance characteristics for proposed definitions of nocturnal polyuria show poor to modest discrimination and are not based on sufficient level of evidence from representative, multi-ethnic population-based data from both females and males of all adult ages.

  12. Quantifying the local influence at a tall tower site in nocturnal conditions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Werth, David; Buckley, Robert; Zhang, Gengsheng

    The influence of the local terrestrial environment on nocturnal atmospheric CO 2 measurements at a 329-m television transmitter tower (and a component of a CO 2 monitoring network) was estimated with a tracer release experiment and a subsequent simulation of the releases. This was done to characterize the vertical transport of emissions from the surface to the uppermost tower level and how it is affected by atmospheric stability. The tracer release experiment was conducted over two nights in May of 2009 near the Department of Energy’s Savannah River Site (SRS) in South Carolina. Tracer was released on two contrasting nights—slightlymore » stable and moderately stable—from several upwind surface locations. Measurements at the 329-m level on both nights indicate that tracer was able to mix vertically within a relatively short (~24 km) distance, implying that nocturnal stable conditions do not necessarily prevent vertical dispersion in the boundary layer and that CO 2 measurements at the tower are at least partly influenced by nearby emissions. A simulation of the tracer release is used to calculate the tower footprint on the two nights to estimate the degree to which the local domain affects the tower readings. The effect of the nocturnal boundary layer on the area sampled by the tower can be seen clearly, as the footprints were affected by changes in stability. The contribution of local sources to the measurements at the tower was minimal, however, suggesting that nocturnal concentrations at upper levels are contributed mostly by regional sources.« less

  13. Quantifying the local influence at a tall tower site in nocturnal conditions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Werth, David; Buckley, Robert; Zhang, Gengsheng

    The influence of the local terrestrial environment on nocturnal atmospheric CO 2 measurements at a 329-m television transmitter tower (and a component of a CO 2 monitoring network) was estimated in this paper with a tracer release experiment and a subsequent simulation of the releases. This was done to characterize the vertical transport of emissions from the surface to the uppermost tower level and how it is affected by atmospheric stability. The tracer release experiment was conducted over two nights in May of 2009 near the Department of Energy’s Savannah River Site (SRS) in South Carolina. Tracer was released onmore » two contrasting nights—slightly stable and moderately stable—from several upwind surface locations. Measurements at the 329-m level on both nights indicate that tracer was able to mix vertically within a relatively short (~24 km) distance, implying that nocturnal stable conditions do not necessarily prevent vertical dispersion in the boundary layer and that CO 2 measurements at the tower are at least partly influenced by nearby emissions. A simulation of the tracer release is used to calculate the tower footprint on the two nights to estimate the degree to which the local domain affects the tower readings. The effect of the nocturnal boundary layer on the area sampled by the tower can be seen clearly, as the footprints were affected by changes in stability. Finally, the contribution of local sources to the measurements at the tower was minimal, however, suggesting that nocturnal concentrations at upper levels are contributed mostly by regional sources.« less

  14. Nocturnal levels of chemerin and progranulin in adolescents: influence of sex, body mass index, glucose metabolism and sleep.

    PubMed

    Daxer, Johann; Herttrich, Theresa; Zhao, Ying Y; Vogel, Mandy; Hiemisch, Andreas; Scheuermann, Kathrin; Körner, Antje; Kratzsch, Jürgen; Kiess, Wieland; Quante, Mirja

    2017-01-01

    Adipokines have been implicated in obesity, insulin resistance and sleep regulation. However, the role of chemerin and progranulin, two recently described adipokines, in the context of sleep remains unclear. The aim of this study was to compare nocturnal serum chemerin and progranulin levels between overweight/obese and normal-weight adolescents and to assess variations by sex, across different sleep stages and in relation to glucose metabolism. The study sample included 34 overweight/obese and 32 normal-weight adolescents from secondary schools and the Leipzig Research Center for Civilization Diseases (LIFE) Child study cohort. We obtained longitudinal serum adipokine levels during in-laboratory polysomnography followed by an oral glucose tolerance test. Overweight/obese adolescents had significantly higher mean nocturnal serum chemerin area under the curve (AUC) levels (348.2±133.3 vs. 241.7±67.7 vs. ng/mL×h, p<0.001) compared to normal-weight controls. In detail, higher chemerin AUC levels in obese/overweight subjects were exclusively due to increased levels in females. No overall difference for serum progranulin AUC was found between the groups. However, when assessing sex-specific levels, serum progranulin AUC levels were ~30% higher in overweight/obese males compared to overweight/obese females. Of note, nocturnal serum chemerin and progranulin AUC did not exhibit a correlation with markers of glucose metabolism or sleep stages. Collectively, we report a sexual dimorphism in nocturnal progranulin and chemerin levels, which may help explain underlying differences in energy balance and body composition between males and females in the context of obesity.

  15. Field studies of transport and dispersion of atmospheric tracers in nocturnal drainage flows

    Treesearch

    Paul H. Gudiksen; Gilbert J. Ferber; Malcolm M. Fowler; Wynn L. Eberhard; Michael A. Fosberg; William R. Knuth

    1984-01-01

    A series of tracer experiments were carried out as part of the Atmospheric Studies in Complex Terrain (ASCOT) program to evaluate pollutant transport and dispersion characteristics of nocturnal drainage flows within a valley in northern California. The results indicate that the degree of interaction of the drainage flows with the larger scale regional flows are...

  16. Chronic vs. Short-Term Acute O 3 Exposure Effects on Nocturnal Transpiration in Two Californian Oaks

    Treesearch

    Nancy Grulke; E. Paoletti; R. L. Heath

    2007-01-01

    We tested the effect of daytime chronic moderate ozone (O3) exposure, short-term acute exposure, and both chronic and acute O3 exposure combined on nocturnal transpiration in California black oak and blue oak seedlings. Chronic O3 exposure (70 ppb for 8 h/day) was implemented in open-top chambers for...

  17. An automated technique for monitoring nocturnal avian vocalizations

    Treesearch

    James B. Johnson; Daniel Saenz; D. Brent Burt; Richard N. Conner

    2002-01-01

    We used audio recording dataloggers known as Frogloggers to collect nocturnal bird vocalizations at eight different sites within the Davy Crockett National Forest and the Stephen F. Austin Experimental Forest in eastern Texas from 9 May 2000 to 31 June 2001. We programmed the dataloggers to record for one-minute intervals at the beginning of each hour starting at 2100...

  18. Empirical modeling of spatial and temporal variation in warm season nocturnal air temperatures in two North Idaho mountain ranges, USA

    Treesearch

    Zachery A. Holden; Michael A. Crimmins; Samuel A. Cushman; Jeremy S. Littell

    2010-01-01

    Accurate, fine spatial resolution predictions of surface air temperatures are critical for understanding many hydrologic and ecological processes. This study examines the spatial and temporal variability in nocturnal air temperatures across a mountainous region of Northern Idaho. Principal components analysis (PCA) was applied to a network of 70 Hobo temperature...

  19. The role of nocturnal vision in mate choice: females prefer conspicuous males in the European tree frog (Hyla arborea)

    PubMed Central

    Gomez, Doris; Richardson, Christina; Lengagne, Thierry; Plenet, Sandrine; Joly, Pierre; Léna, Jean-Paul; Théry, Marc

    2009-01-01

    Nocturnal frog species rely extensively on vocalization for reproduction. But recent studies provide evidence for an important, though long overlooked, role of visual communication. In many species, calling males exhibit a conspicuous pulsing vocal sac, a signal bearing visually important dynamic components. Here, we investigate female preference for male vocal sac coloration—a question hitherto unexplored—and male colour pattern in the European tree frog (Hyla arborea). Under nocturnal conditions, we conducted two-choice experiments involving video playbacks of calling males with identical calls and showing various naturally encountered colour signals, differing in their chromatic and brightness components. We adjusted video colours to match the frogs' visual perception, a crucial aspect not considered in previous experiments. Females prefer males with a colourful sac and a pronounced flank stripe. Both signals probably enhance male conspicuousness and facilitate detection and localization by females. This study provides the first experimental evidence of a preference for specific vocal sac spectral properties in a nocturnal anuran species. Vocal sac coloration is based on carotenoids and may convey information about male quality worthwhile for females to assess. The informative content of the flank stripe remains to be demonstrated. PMID:19324736

  20. Nocturnal hypoglycemia identified by a continuous glucose monitoring system in patients with primary adrenal insufficiency (Addison's Disease).

    PubMed

    Meyer, Gesine; Hackemann, Annika; Reusch, Juergen; Badenhoop, Klaus

    2012-05-01

    Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients. Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3-5 days. In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL. Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects.

  1. Sound imaging of nocturnal animal calls in their natural habitat.

    PubMed

    Mizumoto, Takeshi; Aihara, Ikkyu; Otsuka, Takuma; Takeda, Ryu; Aihara, Kazuyuki; Okuno, Hiroshi G

    2011-09-01

    We present a novel method for imaging acoustic communication between nocturnal animals. Investigating the spatio-temporal calling behavior of nocturnal animals, e.g., frogs and crickets, has been difficult because of the need to distinguish many animals' calls in noisy environments without being able to see them. Our method visualizes the spatial and temporal dynamics using dozens of sound-to-light conversion devices (called "Firefly") and an off-the-shelf video camera. The Firefly, which consists of a microphone and a light emitting diode, emits light when it captures nearby sound. Deploying dozens of Fireflies in a target area, we record calls of multiple individuals through the video camera. We conduct two experiments, one indoors and the other in the field, using Japanese tree frogs (Hyla japonica). The indoor experiment demonstrates that our method correctly visualizes Japanese tree frogs' calling behavior. It has confirmed the known behavior; two frogs call synchronously or in anti-phase synchronization. The field experiment (in a rice paddy where Japanese tree frogs live) also visualizes the same calling behavior to confirm anti-phase synchronization in the field. Experimental results confirm that our method can visualize the calling behavior of nocturnal animals in their natural habitat.

  2. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Turner, D; Parsons, D; Geerts, B

    The Plains Elevated Convection at Night (PECAN) experiment is a large field campaign that is being supported by the National Science Foundation (NSF) with contributions from the National Oceanic and Atmospheric Administration (NOAA), the National Atmospheric and Space Administration (NASA), and the U.S. Department of Energy (DOE). The overarching goal of the PECAN experiment is to improve the understanding and simulation of the processes that initiate and maintain convection and convective precipitation at night over the central portion of the Great Plains region of the United States (Parsons et al. 2013). These goals are important because (1) a large fractionmore » of the yearly precipitation in the Great Plains comes from nocturnal convection, (2) nocturnal convection in the Great Plains is most often decoupled from the ground and, thus, is forced by other phenomena aloft (e.g., propagating bores, frontal boundaries, low-level jets [LLJ], etc.), (3) there is a relative lack of understanding how these disturbances initiate and maintain nocturnal convection, and (4) this lack of understanding greatly hampers the ability of numerical weather and climate models to simulate nocturnal convection well. This leads to significant uncertainties in predicting the onset, location, frequency, and intensity of convective cloud systems and associated weather hazards over the Great Plains.« less

  3. Mobile Disdrometer Observations of Nocturnal Mesoscale Convective Systems During PECAN

    NASA Astrophysics Data System (ADS)

    Bodine, D. J.; Rasmussen, K. L.

    2015-12-01

    Understanding microphysical processes in nocturnal mesoscale convective systems (MCSs) is an important objective of the Plains Elevated Convection At Night (PECAN) experiment, which occurred from 1 June - 15 July 2015 in the central Great Plains region of the United States. Observations of MCSs were collected using a large array of mobile and fixed instrumentation, including ground-based radars, soundings, PECAN Integrated Sounding Arrays (PISAs), and aircraft. In addition to these observations, three mobile Parsivel disdrometers were deployed to obtain drop-size distribution (DSD) measurements to further explore microphysical processes in convective and stratiform regions of nocturnal MCSs. Disdrometers were deployed within close range of a multiple frequency network of mobile and fixed dual-polarization radars (5 - 30 km range), and near mobile sounding units and PISAs. Using mobile disdrometer and multiple-wavelength, dual-polarization radar data, microphysical properties of convective and stratiform regions of MCSs are investigated. The analysis will also examine coordinated Range-Height Indicator (RHI) scans over the disdrometers to elucidate vertical DSD structure. Analysis of dense observations obtained during PECAN in combination with mobile disdrometer DSD measurements contributes to a greater understanding of the structural characteristics and evolution of nocturnal MCSs.

  4. Processes driving nocturnal transpiration and implications for estimating land evapotranspiration.

    PubMed

    de Dios, Víctor Resco; Roy, Jacques; Ferrio, Juan Pedro; Alday, Josu G; Landais, Damien; Milcu, Alexandru; Gessler, Arthur

    2015-06-15

    Evapotranspiration is a major component of the water cycle, yet only daytime transpiration is currently considered in Earth system and agricultural sciences. This contrasts with physiological studies where 25% or more of water losses have been reported to occur occurring overnight at leaf and plant scales. This gap probably arose from limitations in techniques to measure nocturnal water fluxes at ecosystem scales, a gap we bridge here by using lysimeters under controlled environmental conditions. The magnitude of the nocturnal water losses (12-23% of daytime water losses) in row-crop monocultures of bean (annual herb) and cotton (woody shrub) would be globally an order of magnitude higher than documented responses of global evapotranspiration to climate change (51-98 vs. 7-8 mm yr(-1)). Contrary to daytime responses and to conventional wisdom, nocturnal transpiration was not affected by previous radiation loads or carbon uptake, and showed a temporal pattern independent of vapour pressure deficit or temperature, because of endogenous controls on stomatal conductance via circadian regulation. Our results have important implications from large-scale ecosystem modelling to crop production: homeostatic water losses justify simple empirical predictive functions, and circadian controls show a fine-tune control that minimizes water loss while potentially increasing posterior carbon uptake.

  5. Nitrogen Oxides in the Nocturnal Boundary Layer: Chemistry of Nitrous Acid (HONO) and the Nitrate Radical (N03)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jochen Stutz

    Summary Chemical processes occurring at night in the lowest part of the urban atmosphere, the so called nocturnal boundary layer (NBL), can influence the composition of the atmosphere during the night as well as the following day. They may impact the budgets of some of the most important pollutants, such as ozone and nitrogen oxides, as well as influence size and composition of particular matter. Few studies have thus far concentrated on the nocturnal chemistry of the urban NBL, most likely due to the strong influence of vertical transport and mixing, which requires the measurement of trace gas profiles insteadmore » of simple point observations. Motivated by our lack of observations and understanding of nocturnal chemistry, the focus of this project was the study of the vertical distribution of trace gases and the altitude dependence of nocturnal chemistry under polluted conditions through field observations and modeling studies. The analysis of three field experiments (TEXAQS, Houston, 2000; Phoenix Sunrise Ozone Experiment, 2001; NAPOX, Boston, 2002), two of which were performed in this project, showed that ozone concentrations typically increase with height in the lowest 150m, while NO2 typically decreases. NO3, the dominant nocturnal radical species, showed much higher concentrations in the upper part of the NBL, and was often not present at the ground. With the help of a one-dimensional chemical transport model, developed in this project, we found that the interaction of ground emissions of NOx and hydrocarbons, together with their vertical transport, is responsible for the vertical profiles. The dominant chemical reactions influencing ozone, NO2 and NO3 are the reaction of ozone and NO3 with freshly emitted NO. Sensitivity studies with our model showed that the magnitude of the trace gas gradients depend both on the emission rates and the vertical stability of the NBL. Observations and model analysis clearly show that nocturnal chemistry in urban areas is altitude dependent. Measurements at one altitude, for example at the ground, where most air quality monitoring stations are located, are not representative for the rest of the NBL. Our model also revealed that radical chemistry is, in general, altitude dependent at night. We distinguish three regions: an unreactive, NO rich, ground layer; an upper, O3 and NO3 dominated layer, and a reactive mixing layer, where RO2 radicals are mixed from aloft with NO from the ground. In this reactive layer an active radical chemistry and elevated OH radical levels can be found. The downward transport of N2O5 and HO2NO2, followed by their thermal decay, was also identified as a radical source in this layer. Our observations also gave insight into the formation of HONO in the NBL. Based on our field experiments we were able to show that the NO2 to HONO conversion was relative humidity dependent. While this fact was well known, we found that it is most likely the uptake of HONO onto surfaces which is R.H. dependent, rather than the NO2 to HONO conversion. This finding led to the proposal of a new NO2 to HONO conversion mechanism, which is based on solid physical chemical principles. Noteworthy is also the observation of enhanced NO2 to HONO conversion during a dust storm event in Phoenix. The final activity in our project investigated the influence of the urban canopy, i.e. building walls and surfaces, on nocturnal chemistry. For the first time the surface area of a city was determined based on a Geographical Information System database of the city of Santa Monica. The surface to volume areas found in this study showed that, in the 2 lower part of the NBL, buildings provide a much larger surface area than the aerosol. In addition, buildings take up a considerable amount of the volume near the ground. The expansion of our model and sensitivity studies based on the Santa Monica data revealed that the surface area of buildings considerably influences HONO levels in urban areas. The volume reduction leads to a decrease of O3 and an increase of NO2 near the ground due to the stronger impact of NO emissions. Our project shows that the urban canopy should be included in future air quality models to better represent nocturnal chemistry. This project has considerably advanced our understanding of the chemistry of the urban nocturnal boundary layer. The results of this project have implications for air quality studies in the urban nocturnal boundary layer. The study has also identified new questions on nocturnal processes, which we will continue to address through other projects.« less

  6. Racism and ambulatory blood pressure in a community sample.

    PubMed

    Brondolo, Elizabeth; Libby, Daniel J; Denton, Ellen-Ge; Thompson, Shola; Beatty, Danielle L; Schwartz, Joseph; Sweeney, Monica; Tobin, Jonathan N; Cassells, Andrea; Pickering, Thomas G; Gerin, William

    2008-01-01

    Racism has been identified as a psychosocial stressor that may contribute to disparities in the prevalence of cardiovascular disease. The goal of the present article was to investigate the relationship of perceived racism to ambulatory blood pressure (ABP) in a sample of American-born Blacks and Latinos. Participants included English-speaking Black or Latino(a) adults between the ages of 24 and 65. They completed daily mood diaries and measures of perceived racism, socioeconomic status, and hostility. Participants were outfitted with ABP monitors; 357 provided data on waking hours only, and 245 provided data on both waking and nocturnal ABP. Perceived racism was positively associated with nocturnal ABP even when controlling for personality factors and socioeconomic status. The results suggest that racism may influence cardiovascular disease risk through its effects on nocturnal BP recovery.

  7. Ogun Oru: a traditional explanation for nocturnal neuropsychiatric disturbances among the Yoruba of Southwest Nigeria.

    PubMed

    Aina, O F; Famuyiwa, O O

    2007-03-01

    This article describes three cases of ;ogun oru' (nocturnal warefare), a condition reported in southwest Nigeria involving an acute night-time disturbance that is culturally attributed to demonic infiltration of the body and psyche during dreaming. Ogun oru is characterized by its occurrence, a female preponderance, the perception of an underlying feud between the sufferer's earthly spouse and a ;spiritual' spouse, and the event of bewitchment through eating while dreaming. The condition is believed to be treatable through Christian prayers or elaborate traditional rituals designed to exorcise the imbibed demonic elements. Ogun oru may be a label applied to medical problems. The differential diagnosis includes mainly parasomnias, for example, sleep terror, sleepwalking and sleep paralysis and, to a lesser extent, nocturnal or sleep epilepsy.

  8. Contrasting activity patterns of two related octopus species, Octopus macropus and Octopus vulgaris.

    PubMed

    Meisel, Daniela V; Byrne, Ruth A; Kuba, Michael; Mather, Jennifer; Ploberger, Werner; Reschenhofer, Erhard

    2006-08-01

    Octopus macropus and Octopus vulgaris have overlapping habitats and are exposed to similar temporal changes. Whereas the former species is described as nocturnal in the field, there are conflicting reports about the activity time of the latter one. To compare activity patterns, the authors tested both species in the laboratory. Octopuses were exposed to a light-dark cycle and held under constant dim light for 7 days each. O. macropus showed nocturnal and light-cued activity. According to casual observations, O. vulgaris started out nocturnal but had switched to mostly diurnal when the experiment began. Individual variation of its activity was found. The different activity patterns of O. macropus and O. vulgaris might reflect their lifestyles, the latter species being more generalist. ((c) 2006 APA, all rights reserved).

  9. Threshold-based insulin-pump interruption for reduction of hypoglycemia.

    PubMed

    Bergenstal, Richard M; Klonoff, David C; Garg, Satish K; Bode, Bruce W; Meredith, Melissa; Slover, Robert H; Ahmann, Andrew J; Welsh, John B; Lee, Scott W; Kaufman, Francine R

    2013-07-18

    The threshold-suspend feature of sensor-augmented insulin pumps is designed to minimize the risk of hypoglycemia by interrupting insulin delivery at a preset sensor glucose value. We evaluated sensor-augmented insulin-pump therapy with and without the threshold-suspend feature in patients with nocturnal hypoglycemia. We randomly assigned patients with type 1 diabetes and documented nocturnal hypoglycemia to receive sensor-augmented insulin-pump therapy with or without the threshold-suspend feature for 3 months. The primary safety outcome was the change in the glycated hemoglobin level. The primary efficacy outcome was the area under the curve (AUC) for nocturnal hypoglycemic events. Two-hour threshold-suspend events were analyzed with respect to subsequent sensor glucose values. A total of 247 patients were randomly assigned to receive sensor-augmented insulin-pump therapy with the threshold-suspend feature (threshold-suspend group, 121 patients) or standard sensor-augmented insulin-pump therapy (control group, 126 patients). The changes in glycated hemoglobin values were similar in the two groups. The mean AUC for nocturnal hypoglycemic events was 37.5% lower in the threshold-suspend group than in the control group (980 ± 1200 mg per deciliter [54.4 ± 66.6 mmol per liter] × minutes vs. 1568 ± 1995 mg per deciliter [87.0 ± 110.7 mmol per liter] × minutes, P<0.001). Nocturnal hypoglycemic events occurred 31.8% less frequently in the threshold-suspend group than in the control group (1.5 ± 1.0 vs. 2.2 ± 1.3 per patient-week, P<0.001). The percentages of nocturnal sensor glucose values of less than 50 mg per deciliter (2.8 mmol per liter), 50 to less than 60 mg per deciliter (3.3 mmol per liter), and 60 to less than 70 mg per deciliter (3.9 mmol per liter) were significantly reduced in the threshold-suspend group (P<0.001 for each range). After 1438 instances at night in which the pump was stopped for 2 hours, the mean sensor glucose value was 92.6 ± 40.7 mg per deciliter (5.1 ± 2.3 mmol per liter). Four patients (all in the control group) had a severe hypoglycemic event; no patients had diabetic ketoacidosis. This study showed that over a 3-month period the use of sensor-augmented insulin-pump therapy with the threshold-suspend feature reduced nocturnal hypoglycemia, without increasing glycated hemoglobin values. (Funded by Medtronic MiniMed; ASPIRE ClinicalTrials.gov number, NCT01497938.).

  10. Impact of the International Continence Society (ICS) report on the standardisation of terminology in nocturia on the quality of reports on nocturia and nocturnal polyuria: a systematic review.

    PubMed

    Hofmeester, Ilse; Kollen, Boudewijn J; Steffens, Martijn G; Bosch, J L H Ruud; Drake, Marcus J; Weiss, Jeffrey P; Blanker, Marco H

    2015-04-01

    To systematically review and evaluate the impact of the International Continence Society (ICS)-2002 report on standardisation of terminology in nocturia, on publications reporting on nocturia and nocturnal polyuria (NP). In 2002, the ICS defined NP as a Nocturnal Polyuria Index (nocturnal urine volume/total 24-h urine volume) of >0.2-0.33, depending on age. In April 2013 the PubMed and Embase databases were searched for studies (in English, German, French or Dutch) based on original data and adult participants, investigating the relationship between nocturia and NP. A methodological quality assessment was performed, including scores on external validity, internal validity and informativeness. Quality scores of items were compared between studies published before and after the ICS-2002 report. The search yielded 78 publications based on 66 studies. Quality scores of studies were generally high for internal validity (median 5, interquartile range [IQR] 4-6) but low for external validity. After publication of the ICS-2002 report, external validity showed a significant change from 1 (IQR 1-2) to 2 (IQR 1-2.5; P = 0.019). Nocturia remained undefined in 12 studies. In all, 19 different definitions were used for NP, most often being the ICS (or similar) definition: this covered 52% (n = 11) of studies before and 66% (n = 27) after the ICS-2002 report. Clear definitions of both nocturia and NP were identified in 67% and 76% before, and in 88% and 88% of the studies after the ICS-2002 report, respectively. The ICS-2002 report on standardisation of terminology in nocturia appears to have had a beneficial impact on reporting definitions of nocturia and NP, enabling better interpretation of results and comparisons between research projects. Because the external validity of most of the 66 studies is considered a problem, the results of these studies may not be validly extrapolated to other populations. The ICS definition of NP is used most often. However, its discriminative value seems limited due to the estimated difference of 0.6 nocturnal voids between individuals with and without NP. Refinement of current definitions based on robust research is required. Based on pathophysiological reasoning, we argue that it may be more appropriate to define NP based on nocturnal urine production or nocturnal voided volumes, rather than on a diurnal urine production pattern. © 2014 The Authors. BJU International © 2014 BJU International.

  11. Prevalence and comorbidity of nocturnal wandering in the U.S. adult general population.

    PubMed

    Pressman, Mark R

    2013-01-08

    As noted by Ohayon et al., nocturnal wandering (NW) is not synonymous with sleepwalking. NW may also refer to wandering during the night due to epilepsy. Alcohol intoxication can also result in drunken behavior while awake, but this type of cognitive impairment may be undistinguishable from other forms of NW. Dementia and CNS drug effects can also result in NW.

  12. Seasonal and nocturnal periodicities in ant nuptial flights in the tropics (Hymenoptera: Formicidae)

    Treesearch

    J.A. Torres; R.R. Snelling; M. Canals

    2001-01-01

    Nocturnal nuptial flights of ants were studied at Guaynabo and Guanica in the tropical island of Puerto Rico. A great proportion of the species had a high frequency of flights during the year with little seasonality in the frequency of flights. Flights were less frequent during the dry season. Nuptlal flights at Guaynabo occurred mostly during the post-sunset (18:30-22...

  13. Joint Observational Research on Nocturnal Atmospheric Dispersion of Aerosols (JORNADA)

    DTIC Science & Technology

    2009-02-01

    physical processes in NBL . Research Progress: July 2008-January 2009 Objective 1. Analysis of the Stationarity of Mesoscale Turbulence in the...data allows for a more complete understanding of the nocturnal boundary layer ( NBL ). We have analyzed lidar measurements of plume meander and...dispersion and their relationship to the complexities of NBL structure. Plume Dispersion: Vertical plume dispersion parameters (σz) were derived

  14. Nocturnal Sleep Dynamics Identify Narcolepsy Type 1

    PubMed Central

    Pizza, Fabio; Vandi, Stefano; Iloti, Martina; Franceschini, Christian; Liguori, Rocco; Mignot, Emmanuel; Plazzi, Giuseppe

    2015-01-01

    Study Objectives: To evaluate the reliability of nocturnal sleep dynamics in the differential diagnosis of central disorders of hypersomnolence. Design: Cross-sectional. Setting: Sleep laboratory. Patients: One hundred seventy-five patients with hypocretin-deficient narcolepsy type 1 (NT1, n = 79), narcolepsy type 2 (NT2, n = 22), idiopathic hypersomnia (IH, n = 22), and “subjective” hypersomnolence (sHS, n = 52). Interventions: None. Methods: Polysomnographic (PSG) work-up included 48 h of continuous PSG recording. From nocturnal PSG conventional sleep macrostructure, occurrence of sleep onset rapid eye movement period (SOREMP), sleep stages distribution, and sleep stage transitions were calculated. Patient groups were compared, and receiver operating characteristic (ROC) curve analysis was used to test the diagnostic utility of nocturnal PSG data to identify NT1. Results: Sleep macrostructure was substantially stable in the 2 nights of each diagnostic group. NT1 and NT2 patients had lower latency to rapid eye movement (REM) sleep, and NT1 patients showed the highest number of awakenings, sleep stage transitions, and more time spent in N1 sleep, as well as most SOREMPs at daytime PSG and at multiple sleep latency test (MSLT) than all other groups. ROC curve analysis showed that nocturnal SOREMP (area under the curve of 0.724 ± 0.041, P < 0.0001), percent of total sleep time spent in N1 (0.896 ± 0.023, P < 0.0001), and the wakefulness-sleep transition index (0.796 ± 0.034, P < 0.0001) had a good sensitivity and specificity profile to identify NT1 sleep, especially when used in combination (0.903 ± 0.023, P < 0.0001), similarly to SOREMP number at continuous daytime PSG (0.899 ± 0.026, P < 0.0001) and at MSLT (0.956 ± 0.015, P < 0.0001). Conclusions: Sleep macrostructure (i.e. SOREMP, N1 timing) including stage transitions reliably identifies hypocretin-deficient narcolepsy type 1 among central disorders of hypersomnolence. Citation: Pizza F, Vandi S, Iloti M, Franceschini C, Liguori R, Mignot E, Plazzi G. Nocturnal sleep dynamics identify narcolepsy type 1. SLEEP 2015;38(8):1277–1284. PMID:25845690

  15. The Australian Bogong Moth Agrotis infusa: A Long-Distance Nocturnal Navigator

    PubMed Central

    Warrant, Eric; Frost, Barrie; Green, Ken; Mouritsen, Henrik; Dreyer, David; Adden, Andrea; Brauburger, Kristina; Heinze, Stanley

    2016-01-01

    The nocturnal Bogong moth (Agrotis infusa) is an iconic and well-known Australian insect that is also a remarkable nocturnal navigator. Like the Monarch butterflies of North America, Bogong moths make a yearly migration over enormous distances, from southern Queensland, western and northwestern New South Wales (NSW) and western Victoria, to the alpine regions of NSW and Victoria. After emerging from their pupae in early spring, adult Bogong moths embark on a long nocturnal journey towards the Australian Alps, a journey that can take many days or even weeks and cover over 1000 km. Once in the Alps (from the end of September), Bogong moths seek out the shelter of selected and isolated high ridge-top caves and rock crevices (typically at elevations above 1800 m). In hundreds of thousands, moths line the interior walls of these cool alpine caves where they “hibernate” over the summer months (referred to as “estivation”). Towards the end of the summer (February and March), the same individuals that arrived months earlier leave the caves and begin their long return trip to their breeding grounds. Once there, moths mate, lay eggs and die. The moths that hatch in the following spring then repeat the migratory cycle afresh. Despite having had no previous experience of the migratory route, these moths find their way to the Alps and locate their estivation caves that are dotted along the high alpine ridges of southeastern Australia. How naïve moths manage this remarkable migratory feat still remains a mystery, although there are many potential sensory cues along the migratory route that moths might rely on during their journey, including visual, olfactory, mechanical and magnetic cues. Here we review our current knowledge of the Bogong moth, including its natural history, its ecology, its cultural importance to the Australian Aborigines and what we understand about the sensory basis of its long-distance nocturnal migration. From this analysis it becomes clear that the Bogong moth represents a new and very promising model organism for understanding the sensory basis of nocturnal migration in insects. PMID:27147998

  16. Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: a population-based study of older individuals in Spain.

    PubMed

    Gijón-Conde, Teresa; Graciani, Auxiliadora; López-García, Esther; Guallar-Castillón, Pilar; García-Esquinas, Esther; Rodríguez-Artalejo, Fernando; Banegas, José R

    2017-06-01

    Blood pressure (BP) variability and nocturnal decline in blood pressure are associated with cardiovascular outcomes. However, little is known about whether these indexes are associated with white-coat and masked hypertension. We performed a cross-sectional analysis of 1047 community-dwelling individuals aged ⩾60 years in Spain in 2012. Three observer-measured home BPs and 24-h ambulatory blood pressure monitoring (ABPM) were performed under standardized conditions. BP variability was defined as BP s.d. and coefficient of variation. Differences in BP variability and nocturnal BP decrease between groups were adjusted for sociodemographic and clinical covariates using generalized linear models. Of the cohort, 21.7% had white-coat hypertension, 7.0% had masked hypertension, 21.4% had sustained hypertension, and 49.9% were normotensive. Twenty-four hour, daytime and night-time systolic BP s.d. and coefficients of variation were significantly higher in subjects with white-coat hypertension than those with normotension (P<0.05) and were similar to subjects with sustained hypertension. In untreated subjects, 24-h but not daytime or night-time BP variability indexes were significantly higher in subjects with white-coat hypertension than in those with normotension (P<0.05). Percentage decrease in nocturnal systolic and diastolic BP was greatest in the white-coat hypertension group and lowest in the masked hypertension group in all patients and untreated patients (P<0.05). Lack of nocturnal decline in systolic blood pressure was observed in 70.2% of subjects with normotension, 57.8% of subjects with white-coat hypertension, 78.1% of subjects with masked hypertension, and 72.2% of subjects with sustained hypertension (P<0.001). In conclusion, 24-h BP variability was higher in subjects with white-coat hypertension and blunted nocturnal BP decrease was observed more frequently in subjects with masked hypertension. These findings may help to explain the reports of increased cardiovascular risk in patients with white-coat hypertension and poor prognosis in those with masked hypertension, highlighting the importance of ABPM.

  17. Insulin degludec results in lower rates of nocturnal hypoglycaemia and fasting plasma glucose vs. insulin glargine: A meta-analysis of seven clinical trials.

    PubMed

    Russell-Jones, D; Gall, M-A; Niemeyer, M; Diamant, M; Del Prato, S

    2015-10-01

    Basal insulin analogues have a reduced risk of hypoglycaemia compared with NPH insulin, but hypoglycaemia still remains a major impediment to achieving recommended fasting plasma glucose (FPG) targets in patients with diabetes. Insulin degludec (IDeg) is a new basal insulin that forms soluble multihexamers after subcutaneous injection resulting in an ultra-long duration of action and stable glucose-lowering effect. The aim of this analysis was to compare the effect of IDeg on FPG and nocturnal confirmed hypoglycaemia as compared to insulin glargine (IGlar). Data were included from seven phase 3a, randomised, open-label, treat-to-target clinical trials in which once-daily IDeg was compared with once-daily IGlar. Two trials included a total of 957 patients with type 1 diabetes (T1D) and five trials included a total of 3360 patients with type 2 diabetes (T2D); all trials were 26 or 52 weeks in duration. Confirmed hypoglycaemia was defined as plasma glucose <3.1 mmol/L or severe episodes requiring assistance, and nocturnal hypoglycaemia occurred between 00:01 and 05:59. In all trials, the mean end-of-trial FPG was lower for IDeg than IGlar, reaching statistical significance in three trials. Similarly, IDeg was associated with a lower rate of nocturnal confirmed hypoglycaemia vs. IGlar, which was statistically significant in three trials, regardless of type of diabetes or background therapy. This analysis shows that the lower rate of nocturnal confirmed hypoglycaemia seen with IDeg relative to IGlar is accompanied by a reduced mean FPG, in particular in patients with T2D. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Habitat use by female mallards in the lower mississippi alluvial valley

    USGS Publications Warehouse

    Davis, B.E.; Afton, A.D.; Cox, R.R.

    2009-01-01

    Mallard (Anas platyrhynchos) populations in the lower Mississippi Alluvial Valley (LMAV), USA, historically averaged 1.6 million and represented the largest concentrations of wintering mallards in North America. Effective management of this wintering population requires current information on use of habitats. Accordingly, we employed radiotelemetry techniques to assess proportional use of habitats by female mallards during winters 20042005 and 20052006. We divided winters into 4 time periods defined by hunting seasons (FIRST, SPLIT, SECOND, and POST) and recorded diurnal and nocturnal locations. We examined variations in proportional use of habitats and use of areas closed to hunting due to effects of age (immature or ad), winter (20042005 or 20052006), time period (SECOND or POST), individual female, and all potential interactions of these effects, using locations recorded during the latter 2 time periods. We found that diurnal and nocturnal proportional use of habitats varied inconsistently among time periods and winters. Mean proportional use of forested wetlands ranged from 0.475 to 0.816 and from 0.428 to 0.764 during diurnal and nocturnal sampling periods, respectively. Diurnal proportional use of areas closed to hunting varied inconsistently among time periods and winters. Mean proportional use of areas closed to hunting ranged from 0.183 to 0.423 during diurnal sampling periods. Nocturnal use of areas closed to hunting varied inconsistently among female ages and time periods and among female ages and winters. Mean proportional use of areas closed to hunting ranged from 0.211 to 0.445 during nocturnal sampling periods. Our research suggests that forested wetlands in the LMAV provide important wintering habitats for female mallards; continued restoration and establishment of these habitats should benefit female mallards.

  19. Habitat use by female mallards in the lower Mississippi alluvial valley

    USGS Publications Warehouse

    Davis, Bruce E.; Afton, Alan D.; Cox, Robert R.

    2009-01-01

    Mallard (Anas platyrhynchos) populations in the lower Mississippi Alluvial Valley (LMAV), USA, historically averaged 1.6 million and represented the largest concentrations of wintering mallards in North America. Effective management of this wintering population requires current information on use of habitats. Accordingly, we employed radiotelemetry techniques to assess proportional use of habitats by female mallards during winters 2004-2005 and 2005-2006. We divided winters into 4 time periods defined by hunting seasons (FIRST, SPLIT, SECOND, and POST) and recorded diurnal and nocturnal locations. We examined variations in proportional use of habitats and use of areas closed to hunting due to effects of age (immature or ad), winter (2004-2005 or 2005-2006), time period (SECOND or POST), individual female, and all potential interactions of these effects, using locations recorded during the latter 2 time periods. We found that diurnal and nocturnal proportional use of habitats varied inconsistently among time periods and winters. Mean proportional use of forested wetlands ranged from 0.475 to 0.816 and from 0.428 to 0.764 during diurnal and nocturnal sampling periods, respectively. Diurnal proportional use of areas closed to hunting varied inconsistently among time periods and winters. Mean proportional use of areas closed to hunting ranged from 0.183 to 0.423 during diurnal sampling periods. Nocturnal use of areas closed to hunting varied inconsistently among female ages and time periods and among female ages and winters. Mean proportional use of areas closed to hunting ranged from 0.211 to 0.445 during nocturnal sampling periods. Our research suggests that forested wetlands in the LMAV provide important wintering habitats for female mallards; continued restoration and establishment of these habitats should benefit female mallards.

  20. α(1)-adrenoceptor blocker naftopidil improves sleep disturbance with reduction in nocturnal urine volume.

    PubMed

    Yokoyama, Osamu; Aoki, Yoshitaka; Tsujimura, Akira; Takao, Tetsuya; Namiki, Mikio; Okuyama, Akihiko

    2011-04-01

    To examine the mechanism underlying improvements in nocturia by α(1)-blockers, we investigated whether the α(1)-blocker naftopidil acts on nocturia with sleep disturbance using a frequency/volume chart (FVC). A total of 56 male patients with lower urinary tract symptoms were enrolled. The inclusion criteria were as follows: eight or more points on the I-PSS; three or more points on the I-PSS score for nocturia; and prostate volume larger than 20 ml. Patients received 50 mg of naftopidil once daily for 4 weeks, and non-responders received 75 mg for another 4 weeks. All patients were examined, and their data entered into FVC for 2 days before and after administration of naftopidil. Quality of sleep was also evaluated using modified Pittsburgh sleep quality index (PSQI). Patients with sleep quality scores of three or four were assigned to sleep disturbance group (n = 33), while those with scores of less than three were assigned to non-disturbance group (n = 23). After administration of naftopidil, total I-PSS decreased and nocturia score decreased from 3.5 to 2.6 (P < 0.01). Total mean score of modified PSQI in sleep disturbance group became significantly lower after administration of naftopidil (from 16.9 to 14.0; P < 0.01). Naftopidil significantly decreased nocturnal urine volume, resulting in a decrease in the nocturnal polyuria index in both sleep disturbance and non-disturbance groups. These results suggest that α(1)-blockers have the ability to normalize sleep disorders. Naftopidil improved nocturnal polyuria regardless of the presence of sleep disturbance, meaning that it might directly reduce nocturnal urine production.

  1. Innovative Visualizations Shed Light on Avian Nocturnal Migration

    PubMed Central

    Farnsworth, Andrew; Aelterman, Bart; Alves, Jose A.; Azijn, Kevin; Bernstein, Garrett; Branco, Sérgio; Desmet, Peter; Dokter, Adriaan M.; Horton, Kyle; Kelling, Steve; Kelly, Jeffrey F.; Leijnse, Hidde; Rong, Jingjing; Sheldon, Daniel; Van den Broeck, Wouter; Van Den Meersche, Jan Klaas; Van Doren, Benjamin Mark; van Gasteren, Hans

    2016-01-01

    Globally, billions of flying animals undergo seasonal migrations, many of which occur at night. The temporal and spatial scales at which migrations occur and our inability to directly observe these nocturnal movements makes monitoring and characterizing this critical period in migratory animals’ life cycles difficult. Remote sensing, therefore, has played an important role in our understanding of large-scale nocturnal bird migrations. Weather surveillance radar networks in Europe and North America have great potential for long-term low-cost monitoring of bird migration at scales that have previously been impossible to achieve. Such long-term monitoring, however, poses a number of challenges for the ornithological and ecological communities: how does one take advantage of this vast data resource, integrate information across multiple sensors and large spatial and temporal scales, and visually represent the data for interpretation and dissemination, considering the dynamic nature of migration? We assembled an interdisciplinary team of ecologists, meteorologists, computer scientists, and graphic designers to develop two different flow visualizations, which are interactive and open source, in order to create novel representations of broad-front nocturnal bird migration to address a primary impediment to long-term, large-scale nocturnal migration monitoring. We have applied these visualization techniques to mass bird migration events recorded by two different weather surveillance radar networks covering regions in Europe and North America. These applications show the flexibility and portability of such an approach. The visualizations provide an intuitive representation of the scale and dynamics of these complex systems, are easily accessible for a broad interest group, and are biologically insightful. Additionally, they facilitate fundamental ecological research, conservation, mitigation of human–wildlife conflicts, improvement of meteorological products, and public outreach, education, and engagement. PMID:27557096

  2. Characteristics of napping in community-dwelling insomnia patients.

    PubMed

    Jang, Kwang Ho; Lee, Jung Hie; Kim, Seong Jae; Kwon, Hyo Jeong

    2018-05-01

    We aimed to determine napping characteristics of community-dwelling patients with insomnia disorder (ID) compared to characteristics of normal controls (NC), and to examine the effect of napping on nocturnal sleep. Adult volunteers who were more than 18 years old were recruited from three rural public health centers in Korea. Data from actigraphy recording and a sleep diary filled out for seven days were obtained. Finally, 115 ID patients and 80 NC subjects were included in this study. Parameters and timing of nocturnal sleep and nap were compared between the ID and NC groups. Two-way analysis of covariance (ANCOVA) was performed to determine the effect of ID diagnosis and napping on sleep parameters. Sleep efficiency (SE) in the ID group was significantly lower (p = 0.010), and wake time after sleep onset (WASO) was significantly greater (p = 0.023), compared to the NC group. There was no significant difference in nocturnal sleep or nap timing between the two groups. Nap frequency in the ID group was significantly higher than that in the NC group (p = 0.025). Although ID diagnosis and napping had no independent effect on fragmentation index, their interaction had a significant effect on fragmentation index (p = 0.021). Nap frequency was positively correlated with PSQI score (r = 0.166, p = 0.033). Insomnia patients showed no significant difference in nap timing or nap duration compared to NC subjects. However, insomnia patients showed higher nap frequency. Frequent napping was associated with poorer subjective sleep quality. Therefore, although napping might not have a negative impact on nocturnal sleep maintenance in NC subjects, it did have an effect on nocturnal sleep in insomnia patients. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Hidden floral adaptation to nocturnal moths in an apparently bee-pollinated flower, Adenophora triphylla var. japonica (Campanulaceae).

    PubMed

    Funamoto, D; Ohashi, K

    2017-09-01

    The discrepancy between observed flower visitors and those predicted based on floral phenotype has often cast doubt on the pollination syndrome concept. Here we show that this paradox may be alleviated by gaining better knowledge of the contributions of different flower visitors to pollination and the effects of floral traits that cannot be readily perceived by humans in Adenophora triphylla var. japonica. The blue, bell-shaped and pendant flowers of A. triphylla appear to fit a bee pollination syndrome. In contrast to this expectation, recent studies show that these flowers are frequented by nocturnal moths. We compared the flower visitor fauna, their visitation frequency and their relative contributions to seed set between day and night in two field populations of A. triphylla in Japan. We also determined the floral traits associated with temporal changes in the visitor assemblage, i.e. the timing of anthesis, the timing of changes in the sexual phase and the diel pattern of nectar production. While A. triphylla flowers were visited by both diurnal and nocturnal insects, the results from pollination experiments demonstrate that their primary pollinators are nocturnal settling-moths. Moreover, the flowers opened just after sunset, changed from staminate to pistillate phase in successive evenings and produced nectar only during the night, which all conform to the activity of nocturnal/crepuscular moths. Our study illustrates that the tradition of stereotyping the pollinators of a flower based on its appearance can be misleading and that it should be improved with empirical evidence of pollination performance and sufficient trait matching. © 2017 German Botanical Society and The Royal Botanical Society of the Netherlands.

  4. Do patients with intake of drugs labelled as sleep disturbing really sleep worse? A population based assessment from the Heinz Nixdorf Recall Study

    PubMed Central

    Kowall, Bernd; Kuß, Oliver; Schmidt‐Pokrzywniak, Andrea; Weinreich, Gerhard; Dragano, Nico; Moebus, Susanne; Erbel, Raimund; Jöckel, Karl‐Heinz; Stang, Andreas

    2016-01-01

    Aim The sleep disturbing effect of many drugs is derived from clinical trials with highly selected patient collectives. However, the generalizability of such findings to the general population is questionable. Our aim was to assess the association between intake of drugs labelled as sleep disturbing and self‐reported nocturnal sleep disturbances in a population‐based study. Methods We used data of 4221 participants (50.0% male) aged 45 to 75 years from the baseline examination of the Heinz Nixdorf Recall Study in Germany. The interview provided information on difficulties falling asleep, difficulties maintaining sleep and early morning arousal. We used the summary of product characteristics (SPC) for each drug taken and assigned the probability of sleep disturbances. Thereafter, we calculated cumulative probabilities of sleep disturbances per subject to account for polypharmacy. We estimated prevalence ratios (PR) using log Poisson regression models with robust variance. Results The adjusted PRs of any regular nocturnal sleep disorder per additional sleep disturbing drug were 1.01 (95% confidence interval (CI) 0.97, 1.06) and 1.03 (95% CI 1.00, 1.07) for men and women, respectively. Estimates for each regular nocturnal sleep disturbance were similarly close to 1. PRs for regular nocturnal sleep disturbances did not increase with rising cumulative probability for drug‐related sleep disturbances. Conclusions SPC‐based probabilities of drug‐related sleep disturbances showed barely any association with self‐reported regular nocturnal sleep disturbances. We conclude that SPC‐based probability information may lack generalizability to the general population or may be of limited data quality. PMID:27279554

  5. Targeting nocturnal hypertension in type 2 diabetes mellitus.

    PubMed

    Rossen, Niklas Blach; Knudsen, Søren Tang; Fleischer, Jesper; Hvas, Anne-Mette; Ebbehøj, Eva; Poulsen, Per Løgstrup; Hansen, Klavs Würgler

    2014-11-01

    Several studies in different populations have suggested that nighttime blood pressure (BP) is a stronger predictor of cardiovascular events than daytime BP. Consequently, treatment strategies to target nighttime BP have come into focus. The aim of the present study was to investigate the effect of change of administration time of antihypertensive drugs. We included 41 patients with type 2 diabetes mellitus and nocturnal hypertension (nighttime systolic BP >120 mm Hg) in an open-label, crossover study. Patients were randomized to 8 weeks of either morning or bedtime administration of all of the individual's once-daily antihypertensive drugs, followed by 8 weeks of switched dosing regimen. Bedtime administration of antihypertensive drugs resulted in a significant reduction in nighttime (7.5 mm Hg; P<0.001) and 24-hour (3.1 mm Hg; P=0.014) systolic BP, with a nonsignificant reduction in daytime (1.3 mm Hg; P=0.336) systolic BP. We did not find morning BP surge to be different between dosing regimens. Levels of C-reactive protein were significantly lower with bedtime administration, which may indicate an effect on low-grade inflammation. We found no difference in urinary albumin excretion, regardless of albuminuria status. Urinary sodium/creatinine was significantly increased and urinary osmolality significantly reduced with bedtime administration, which can be interpreted as increased nocturnal natriuresis. In patients with type 2 diabetes mellitus and nocturnal hypertension, administration of once-daily antihypertensive drugs at bedtime may be favorable. The increased nocturnal natriuresis may reflect increased effect of bedtime-administered thiazides and renin-angiotensin system inhibitors, suggesting a potential mechanism of the observed effects on BP with chronotherapeutic intervention. © 2014 American Heart Association, Inc.

  6. Nocturnal hypoventilation in neuromuscular disease: prevalence according to different definitions issued from the literature.

    PubMed

    Ogna, Adam; Quera Salva, Maria-Antonia; Prigent, Helene; Mroue, Ghassane; Vaugier, Isabelle; Annane, Djillali; Lofaso, Frederic; Orlikowski, David

    2016-05-01

    Restrictive respiratory failure is a major cause of morbidity and mortality in neuromuscular diseases (NMD). Home mechanical ventilation (HMV) is used to treat hypoventilation, identified by daytime hypercapnia or nocturnal desaturation. Recently, transcutaneous measure of CO2 (TcCO2) has been increasingly used to detect hypoventilation, using different cut-offs. We aimed to compare the prevalence of hypoventilation in an unselected adult NMD population according to different definitions issued from the literature. All consecutive nocturnal capno-oximetries performed between 2010 and 2014 in unventilated adult NMD patients were analysed retrospectively. Concomitant blood gas analysis and lung function data were collected. Patients on oxygen therapy were excluded. Hypoventilation was defined according to eight criteria, based on daytime PaCO2, daytime base excess, nocturnal SpO2 or TcCO2. Data from 232 patients were analysed (mean age 43.1 ± 15.4 years; 50.0 % women; vital capacity 59.2 ± 24.2 % of predicted). The hypoventilation prevalence was 10.3 to 61.2 %, depending on the used definition. The different definitions showed 49.1 to 94.8 % concordance (Cohen's kappa for agreement 0.115 to 0.763). Overall agreement between the eight definitions was poor (Light's kappa 0.267), and agreement between definitions based on nocturnal SpO2 and those based on TcCO2 was even lower (Light's kappa 0.204). We found large differences in hypoventilation prevalence according to the used definition. This has practical consequences, as HMV indication relies upon hypoventilation detection. We believe that capno-oximetry should be included in the diagnostic tools used to detect hypoventilation but this requires an update of consensus guidelines to agree upon the best definition.

  7. Mediating effects of nocturnal blood pressure and morning surge on the contributions of arterial stiffness and sodium intake to morning blood pressure: A path analysis.

    PubMed

    Lee, Hyung Tak; Park, Jin-Kyu; Choi, Sung Yong; Choi, Bo Youl; Kim, Mi Kyung; Mori, Mari; Yamori, Yukio; Lim, Young Hyo; Shin, Jinho

    2016-01-01

    The aim of this study was to evaluate the mediating effects of nocturnal blood pressure (BP) and morning surge on the contribution of arterial stiffness and sodium intake to morning BP in a middle-aged general population. The study included 124 subjects aged 30-59 years, from rural Yeoju County, Gyeonggi Province, South Korea. Ambulatory BP monitoring, 24 h urinary sodium excretion (24 h UNa) and brachial-ankle pulse wave velocity (baPWV) measurements were performed in all subjects. The mean ± SD age was 48.1 ± 8.2 years and the proportion of male subjects was 41.1%. After adjusting for covariates, morning systolic blood pressure (SBP) was significantly correlated with morning surge [coefficient = 0.761, 95% confidence interval (CI) 0.651-0.872, p < 0.001], nocturnal SBP (coefficient = 0.576, 95% CI 0.454-0.698, p < 0.001) and baPWV (coefficient = 3.550, 95% CI 1.447-5.653, p = 0.001). Path analysis modeling revealed that baPWV had significant direct (0.035, p = 0.013) and indirect effects (0.042, p = 0.012) on morning SBP. The indirect effect mediated by nocturnal SBP was statistically significant (0.054, p = 0.005), but the indirect effect mediated by the morning surge was not significant. The 24 h UNa had no significant direct or indirect effects on morning SBP. baPWV had significant direct and indirect effects on morning SBP. The indirect effect was mediated by nocturnal SBP, but not by morning surge. The 24 h UNa had neither significant direct nor indirect effects on morning SBP.

  8. Shedding light on light: benefits of anthropogenic illumination to a nocturnally foraging shorebird.

    PubMed

    Dwyer, Ross G; Bearhop, Stuart; Campbell, Hamish A; Bryant, David M

    2013-03-01

    Intertidal habitats provide important feeding areas for migratory shorebirds. Anthropogenic developments along coasts can increase ambient light levels at night across adjacent inter-tidal zones. Here, we report the effects of elevated nocturnal light levels upon the foraging strategy of a migratory shorebird (common redshank Tringa totanus) overwintering on an industrialised estuary in Northern Europe. To monitor behaviour across the full intertidal area, individuals were located by day and night using VHF transmitters, and foraging behaviour was inferred from inbuilt posture sensors. Natural light was scored using moon-phase and cloud cover information and nocturnal artificial light levels were obtained using geo-referenced DMSP/OLS night-time satellite imagery at a 1-km resolution. Under high illumination levels, the commonest and apparently preferred foraging behaviour was sight-based. Conversely, birds feeding in areas with low levels of artificial light had an elevated foraging time and fed by touch, but switched to visual rather than tactile foraging behaviour on bright moonlit nights in the absence of cloud cover. Individuals occupying areas which were illuminated continuously by lighting from a large petrochemical complex invariably exhibited a visually based foraging behaviour independently of lunar phase and cloud cover. We show that ambient light levels affect the timing and distribution of foraging opportunities for redshank. We argue that light emitted from an industrial complex improved nocturnal visibility. This allowed sight-based foraging in place of tactile foraging, implying both a preference for sight-feeding and enhanced night-time foraging opportunities under these conditions. The study highlights the value of integrating remotely sensed data and telemetry techniques to assess the effect of anthropogenic change upon nocturnal behaviour and habitat use. © 2012 The Authors. Journal of Animal Ecology © 2012 British Ecological Society.

  9. Living alongside railway tracks: Long-term effects of nocturnal noise on sleep and cardiovascular reactivity as a function of age.

    PubMed

    Tassi, Patricia; Rohmer, Odile; Schimchowitsch, Sarah; Eschenlauer, Arnaud; Bonnefond, Anne; Margiocchi, Florence; Poisson, Franck; Muzet, Alain

    2010-10-01

    Very few studies were devoted to permanent effects of nocturnal railway noise on sleep and cardiovascular reactivity. We investigated the effects of nocturnal railway noise on sleep and cardiovascular response in young and middle-aged adults living for many years either near a railway track or in a quiet area. Forty subjects (50% males) divided into two age groups (juniors: 26.2+/-3.6 and seniors: 56.2+/-4.2) participated in this experiment. Half of them lived near a railway track (RW group: 2.6 to 19 years) and the other half in a quiet environment (QE group: 8.1 to 14.2 years). After an adaptation night, all subjects underwent two nights in the laboratory: one control night and one noisy night (30 by-passes of a freight train). Sleep and cardiovascular modifications were assessed in response to noise. Sleep fragmentation indices were lower in RW subjects compared to QE whatever their age. In response to noise, there was a higher cardiovascular response rate to noise in RW juniors and a lower cardiovascular response rate in RW seniors compared to their age-paired QE counterparts. In conclusion, permanent exposure to nocturnal railway noise leads to decreased sleep fragmentation and to cardiovascular habituation. It is suggested that during the initial period experienced by residents living near railway tracks, nocturnal railway noise could induce a sensitization process on the autonomic response to noise reflecting a startle/defense reflex due to its functional significance, which progressively turns to habituation in the long-term if no adverse effect is experienced. Copyright 2010 Elsevier Ltd. All rights reserved.

  10. Innovative Visualizations Shed Light on Avian Nocturnal Migration.

    PubMed

    Shamoun-Baranes, Judy; Farnsworth, Andrew; Aelterman, Bart; Alves, Jose A; Azijn, Kevin; Bernstein, Garrett; Branco, Sérgio; Desmet, Peter; Dokter, Adriaan M; Horton, Kyle; Kelling, Steve; Kelly, Jeffrey F; Leijnse, Hidde; Rong, Jingjing; Sheldon, Daniel; Van den Broeck, Wouter; Van Den Meersche, Jan Klaas; Van Doren, Benjamin Mark; van Gasteren, Hans

    2016-01-01

    Globally, billions of flying animals undergo seasonal migrations, many of which occur at night. The temporal and spatial scales at which migrations occur and our inability to directly observe these nocturnal movements makes monitoring and characterizing this critical period in migratory animals' life cycles difficult. Remote sensing, therefore, has played an important role in our understanding of large-scale nocturnal bird migrations. Weather surveillance radar networks in Europe and North America have great potential for long-term low-cost monitoring of bird migration at scales that have previously been impossible to achieve. Such long-term monitoring, however, poses a number of challenges for the ornithological and ecological communities: how does one take advantage of this vast data resource, integrate information across multiple sensors and large spatial and temporal scales, and visually represent the data for interpretation and dissemination, considering the dynamic nature of migration? We assembled an interdisciplinary team of ecologists, meteorologists, computer scientists, and graphic designers to develop two different flow visualizations, which are interactive and open source, in order to create novel representations of broad-front nocturnal bird migration to address a primary impediment to long-term, large-scale nocturnal migration monitoring. We have applied these visualization techniques to mass bird migration events recorded by two different weather surveillance radar networks covering regions in Europe and North America. These applications show the flexibility and portability of such an approach. The visualizations provide an intuitive representation of the scale and dynamics of these complex systems, are easily accessible for a broad interest group, and are biologically insightful. Additionally, they facilitate fundamental ecological research, conservation, mitigation of human-wildlife conflicts, improvement of meteorological products, and public outreach, education, and engagement.

  11. Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus.

    PubMed

    Cai, Shirong; Tan, Sara; Gluckman, Peter D; Godfrey, Keith M; Saw, Seang-Mei; Teoh, Oon Hoe; Chong, Yap-Seng; Meaney, Michael J; Kramer, Michael S; Gooley, Joshua J

    2017-02-01

    To examine the influence of maternal sleep quality and nocturnal sleep duration on risk of gestational diabetes mellitus (GDM) in a multiethnic Asian population. A cohort of 686 women (376 Chinese, 186 Malay, and 124 Indian) with a singleton pregnancy attended a clinic visit at 26-28 weeks of gestation as part of the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort study. Self-reported sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). GDM was diagnosed based on a 75-g oral glucose tolerance test administered after an overnight fast (1999 WHO criteria). Multiple logistic regression was used to model separately the associations of poor sleep quality (PSQI score > 5) and short nocturnal sleep duration (<6 h) with GDM, adjusting for age, ethnicity, maternal education, body mass index, previous history of GDM, and anxiety (State-Trait Anxiety Inventory score). In the cohort 296 women (43.1%) had poor sleep quality and 77 women (11.2%) were categorized as short sleepers; 131 women (19.1%) were diagnosed with GDM. Poor sleep quality and short nocturnal sleep duration were independently associated with increased risk of GDM (poor sleep, adjusted odds ratio [OR] = 1.75, 95% confidence interval [CI] 1.11 to 2.76; short sleep, adjusted OR = 1.96, 95% CI 1.05 to 3.66). During pregnancy, Asian women with poor sleep quality or short nocturnal sleep duration exhibited abnormal glucose regulation. Treating sleep problems and improving sleep behavior in pregnancy could potentially reduce the risk and burden of GDM. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  12. Perceived Discrimination and Nocturnal Blood Pressure Dipping Among Hispanics: The Influence of Social Support and Race.

    PubMed

    Rodriguez, Carlos Jose; Gwathmey, TanYa M; Jin, Zhezhen; Schwartz, Joseph; Beech, Bettina M; Sacco, Ralph L; Di Tullio, Marco R; Homma, Shunichi

    2016-09-01

    Little is known about the relationship of perceived racism to ambulatory blood pressure (ABP) in Hispanics. We explored possible associations between ABP nocturnal dipping and perceived racism in a Hispanic cohort. Participants included 180 community-dwelling Hispanics from the Northern Manhattan Study. Measures included perceived racism, socioeconomic status, social support, and ABP monitoring. Nocturnal ABP nondipping was defined as a less than 10% decline in the average asleep systolic blood pressure relative to the awake systolic blood pressure. Overall, 77.8% of participants reported some form of perceived racism (Perceived Ethnic Discrimination Questionnaire scores >1.0). Greater social support was associated with less perceived discrimination (Spearman r = -0.54, p < .001). Those with higher perceived discrimination scores reported more depressive symptoms (r = 0.25, p < .001). Those with higher Perceived Ethnic Discrimination Questionnaire scores were less likely to show nocturnal ABP nondipping in multivariate models (odds ratio = 0.40, confidence interval = 0.17-0.98, p = .045). Among those with low perceived racism, black Hispanic participants were more likely to have nocturnal ABP nondipping (82.6%) compared with white Hispanics (53.9%; p = .02). Among those with high perceived racism, no associations between race and the prevalence of ABP nondipping was found (black Hispanic = 61.5% versus white Hispanic = 51.4%, p = .39; p interaction = .89). Perceived racism is relatively common among US Hispanics and is associated with ABP. Nondipping of ABP, a potential cardiovascular risk factor, was more common in black Hispanic participants with low perceived racism. This finding may reflect different coping mechanisms between black versus white Hispanics and related blood pressure levels during daytime exposures to discrimination.

  13. Perceived Discrimination and Nocturnal Blood Pressure Dipping Among Hispanics: the Influence of Social Support and Race

    PubMed Central

    Rodriguez, Carlos J.; Gwathmey, TanYa M.; Jin, Zhezhen; Schwartz, Joseph; Beech, Bettina M.; Sacco, Ralph L.; Di Tullio, Marco R.; Homma, Shunichi

    2016-01-01

    Objective Little is known about the relationship of perceived racism to ambulatory blood pressure (ABP) in Hispanics. We explored possible associations between ABP nocturnal dipping and perceived racism in a Hispanic cohort. Methods Participants included 180 community-dwelling Hispanics from the Northern Manhattan Study. Measures included perceived racism, socioeconomic status, social support, and ABP monitoring. Nocturnal ABP non-dipping was defined as a less than 10% decline in the average asleep systolic BP (SBP) relative to the awake SBP. Results Overall, 77.8% of participants reported some form of perceived racism [Perceived Ethnic Discrimination Questionnaire (PEDQ) scores >1.0]. Greater social support was associated with less perceived discrimination (Spearman r =−0.54; p<0.001). Those with higher perceived discrimination scores reported more depressive symptoms (r =0.25; p<0.001). Those with higher PEDQ scores were less likely to show nocturnal ABP non-dipping in multivariate models (OR=0.40, CI=0.17–0.98; p=0.045). Among those with low perceived racism, black Hispanic participants were more likely to have nocturnal ABP non-dipping (82.6%) compared to white Hispanics (53.9%; p=0.02). Among those with high perceived racism, no associations between race and the prevalence of ABP non-dipping was found (black Hispanic=61.5% vs. white Hispanic=51.4%, p=0.39; p interaction=0.89). Conclusions Perceived racism is relatively common among US Hispanics and is associated with ABP. Non-dipping of ABP, a potential cardiovascular risk factor, was more common in black-Hispanic participants with low perceived racism. This finding may reflect different coping mechanisms between black versus white Hispanics and related blood pressure levels during daytime exposures to discrimination. PMID:27136505

  14. Postcorrective surgery improvement of nocturnal hypoxemia in a case of partial anomalous pulmonary venous connection and aberrant hepatic vein drainage.

    PubMed

    Agrawal, Abhinav; Palkar, Atul V; Sahni, Sonu; Vatsia, Sheel K; Shah, Rakesh D; Talwar, Arunabh

    2016-01-01

    Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital anomaly that leads to an anatomical left-to-right shunt. Termination of the intrahepatic inferior vena cava (IVC) with its azygos continuation associated with the hepatic venous connection to the left atrium (LA) is also a rare congenital anomaly that results in an anatomical right-to-left shunt. A 65-year-old male presented with severe dyspnea on exertion and pedal edema. He was further diagnosed at our clinic and was found to have both the aforementioned congenital abnormalities, creating a bidirectional shunt. On further investigation, he was found to have nocturnal hypoxemia on overnight oximetry. The patient was successfully treated via surgical corrections of the congenital anomalies leading to symptomatic improvement as well as the resolution of nocturnal hypoxemia.

  15. Limits of colour vision in dim light.

    PubMed

    Kelber, Almut; Lind, Olle

    2010-09-01

    Humans and most vertebrates have duplex retinae with multiple cone types for colour vision in bright light, and one single rod type for achromatic vision in dim light. Instead of comparing signals from multiple spectral types of photoreceptors, such species use one highly sensitive receptor type thus improving the signal-to-noise ratio at night. However, the nocturnal hawkmoth Deilephila elpenor, the nocturnal bee Xylocopa tranquebarica and the nocturnal gecko Tarentola chazaliae can discriminate colours at extremely dim light intensities. To be able to do so, they sacrifice spatial and temporal resolution in favour of colour vision. We review what is known about colour vision in dim light, and compare colour vision thresholds with the optical sensitivity of the photoreceptors in selected animal species with lens and compound eyes. © 2010 The Authors, Ophthalmic and Physiological Optics © 2010 The College of Optometrists.

  16. Visual Navigation in Nocturnal Insects.

    PubMed

    Warrant, Eric; Dacke, Marie

    2016-05-01

    Despite their tiny eyes and brains, nocturnal insects have evolved a remarkable capacity to visually navigate at night. Whereas some use moonlight or the stars as celestial compass cues to maintain a straight-line course, others use visual landmarks to navigate to and from their nest. These impressive abilities rely on highly sensitive compound eyes and specialized visual processing strategies in the brain. ©2016 Int. Union Physiol. Sci./Am. Physiol. Soc.

  17. Rapid eye movement sleep behaviour disorder symptomatic of a brain stem cavernoma.

    PubMed

    Felix, Sandra; Thobois, Stephane; Peter-Derex, Laure

    2016-04-01

    A 75-year-old man complained of excessive daytime sleepiness (EDS), difficulty falling asleep and nocturnal agitation during sleep. Restless legs syndrome (RLS) was diagnosed and treated. Because of persistent EDS, snoring and nycturia, a nocturnal polysomnography (PSG) was performed. PSG showed high sleep fragmentation related to a moderate to severe obstructive sleep apnea syndrome. Continuous positive airway pressure treatment (CPAP) was proposed. Because of the persistence of abnormal nocturnal behaviours, characterized by screaming, punching and falling out of bed, a video-PSG with CPAP treatment was performed. The recording showed typical chin electromyography (EMG) activity increase associated with violent movements during rapid eye movement (REM) sleep, suggesting REM sleep behaviour disorders (RBD). Clinical neurological examination found no parkinsonian syndrome, no dysautonomic sign and no neurological focal sign. Dopamine transporter imaging [123I-FP-CIT single photon emission computed tomography (SPECT)] did not find any presynaptic dopaminergic pathways degeneration. Brain magnetic resonance imaging showed a vascular lesion suggestive of cavernoma located in the pons. The present case illustrates the complexity of sleep disturbance diagnosis with a possible entanglement of aetiologies responsible for nocturnal agitation, and confirms that an isolated pons cavernoma should be considered among the rare causes of RBD. © 2016 European Sleep Research Society.

  18. Slow eye movements distribution during nocturnal sleep.

    PubMed

    Pizza, Fabio; Fabbri, Margherita; Magosso, Elisa; Ursino, Mauro; Provini, Federica; Ferri, Raffaele; Montagna, Pasquale

    2011-08-01

    To assess the distribution across nocturnal sleep of slow eye movements (SEMs). We evaluated SEMs distribution in the different sleep stages, and across sleep cycles in nocturnal recordings of 10 healthy women. Sleep was scored according to standard criteria, and the percentage of time occupied by the SEMs was automatically detected. SEMs were differently represented during sleep stages with the following order: wakefulness after sleep onset (WASO): 61%, NREM sleep stage 1: 54%, REM sleep: 43%, NREM sleep stage 2: 21%, NREM sleep stage 3: 7%, and NREM sleep stage 4: 3% (p<0.0001). There was no difference between phasic and tonic REM sleep. SEMs progressively decreased across the NREM sleep cycles (38%, 15%, 13% during NREM sleep stage 2 in the first three sleep cycles, p=0.006), whereas no significant difference was found for REM, NREM sleep stage 1, slow-wave sleep and WASO. Our findings confirm that SEMs are a phenomenon typical of the sleep onset period, but are also found in REM sleep. The nocturnal evolution of SEMs during NREM sleep stage 2 parallels the homeostatic process underlying slow-wave sleep. SEMs are a marker of sleepiness and, potentially, of sleep homeostasis. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Nocturnal Hypoglycemia Identified by a Continuous Glucose Monitoring System in Patients with Primary Adrenal Insufficiency (Addison's Disease)

    PubMed Central

    Hackemann, Annika; Reusch, Juergen; Badenhoop, Klaus

    2012-01-01

    Abstract Background Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients. Methods Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3–5 days. Results In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL. Conclusions Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects. PMID:22242902

  20. Navigational Efficiency of Nocturnal Myrmecia Ants Suffers at Low Light Levels

    PubMed Central

    Narendra, Ajay; Reid, Samuel F.; Raderschall, Chloé A.

    2013-01-01

    Insects face the challenge of navigating to specific goals in both bright sun-lit and dim-lit environments. Both diurnal and nocturnal insects use quite similar navigation strategies. This is despite the signal-to-noise ratio of the navigational cues being poor at low light conditions. To better understand the evolution of nocturnal life, we investigated the navigational efficiency of a nocturnal ant, Myrmecia pyriformis, at different light levels. Workers of M. pyriformis leave the nest individually in a narrow light-window in the evening twilight to forage on nest-specific Eucalyptus trees. The majority of foragers return to the nest in the morning twilight, while few attempt to return to the nest throughout the night. We found that as light levels dropped, ants paused for longer, walked more slowly, the success in finding the nest reduced and their paths became less straight. We found that in both bright and dark conditions ants relied predominantly on visual landmark information for navigation and that landmark guidance became less reliable at low light conditions. It is perhaps due to the poor navigational efficiency at low light levels that the majority of foragers restrict navigational tasks to the twilight periods, where sufficient navigational information is still available. PMID:23484052

  1. Lifestyle and oral facial disorders associated with sleep bruxism in children.

    PubMed

    Alencar, Nashalie Andrade de; Fernandes, Alline Birra Nolasco; Souza, Margareth Maria Gomes de; Luiz, Ronir Raggio; Fonseca-Gonçalves, Andréa; Maia, Lucianne Cople

    2017-05-01

    The aim of the study was to investigate the routine, sleep history, and orofacial disorders associated with children aged 3-7 years with nocturnal bruxism. Children (n = 66) were divided into groups of parent reported nocturnal bruxism (n = 34) and those without the disorder (n = 32). Data about the child's routine during the day, during sleep and awakening, headache frequency, temporomandibular joint (TMJ), and hearing impairments were obtained through interviews with parents/caregivers. Electromyography examination was used to assess the activity of facial muscles. Multiple logistic regression (MLR), chi-square test, and t-test analyses were performed. MLR revealed association of nightmares (p = 0.002; OR = 18.09) and snoring (p = 0.013; OR = 0.14) with bruxism. Variables related to awakening revealed an association with bruxism (p < 0.05). Parents of the main group (children with nocturnal bruxism) reported more complaints of orofacial pain, facial appearance, and headache occurrence (p < 0.05). Auditory and muscle disorders were not significant variables (p > 0.05). Nightmares and snoring are associated with nocturnal bruxism in children. Bruxism in children elicits consequences such as headache, orofacial pain, and pain related to awakening.

  2. [Update on the respiratory management of patients with chronic neuromuscular disease].

    PubMed

    Priou, P; Trzepizur, W; Meslier, N; Gagnadoux, F

    2017-12-01

    Neuromuscular diseases include a wide range of conditions that may involve potentially life-threatening respiratory complications (infection, respiratory failure). For patients with neuromuscular diseases, clinical assessment of respiratory function and regular pulmonary function tests are needed to screen for nocturnal respiratory disorders, weakness of the diaphragm and potential restrictive disorders and/or chronic hypercapnic respiratory insufficiency, possibly with couch deficiency. MANAGEMENT OF NOCTURNAL RESPIRATORY DISORDERS AND CHRONIC RESPIRATORY FAILURE: Nocturnal respiratory assistance is an important phase of care for nocturnal respiratory disorders and chronic respiratory failure. This may involve continuous positive airway pressure, adaptative servo-ventilation or non-invasive ventilation with a facial or nasal mask. As needed, diurnal assistance may be proposed by mouthpiece ventilation. Should non-invasive ventilation prove insufficient, or if significant swallowing disorders or recurrent bronchial obstruction develop, or in case of prolonged intubation, tracheotomy may be required. In case of lower airway infection with ineffective cough, physical therapy, associated with air stacking, intermittent positive pressure breathing or mechanical in-exsufflation may be proposed. Care for swallowing disorders, nutritional counseling (cachexia, obesity), vaccinations and therapeutic education are integral elements of patient-centered management aiming to prevent the negative impact of infection and to manage respiratory failure of chronic neuromuscular disease. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. A nocturnal decline of salivary pH associated with airway hyperresponsiveness in asthma.

    PubMed

    Watanabe, Masanari; Sano, Hiroyuki; Tomita, Katsuyuki; Yamasaki, Akira; Kurai, Jun; Hasegawa, Yasuyuki; Igishi, Tadashi; Okazaki, Ryota; Tohda, Yuji; Burioka, Naoto; Shimizu, Eiji

    2010-08-01

    Salivary pH is associated with esophageal acid reflux and neutralization of esophageal acid. In this study, we assessed the association between nocturnal decline of salivary pH and airway hyperresponsiveness. Salivary pH was serially assessed in 9 patients with mild asthma (7 men and 2 women; mean age 33.3 years; mean %predicted FEV(1.0) 89.4%) and 10 healthy volunteers (6 men and 4 women; mean age 31.2 years) using a pH indicator tape. The buffering capacity of saliva was defined as the median effective dose (ED(50)) for acidification of saliva with 0.01 N HCl, and airway responsiveness was defined as the dose of methacholine producing a 35% fall in Grs (PD(35)-Grs). There was a significant correlation between the values obtained from the pH indicator tape and those obtained from the electrometric pH meter. Using the indicator tape for sequential monitoring, we observed a nocturnal fall (ΔpH) in salivary pH in all subjects. A significant correlation was found between airway hyperresponsiveness (PD(35)-Grs) and either ΔpH or ED(50) in mildly asthmatic patients. Vagal reflux dysfunction might contribute to nocturnal salivary pH as well as to airway hyperresponsiveness in mild asthmatics.

  4. Participatory research to design a novel telehealth system to support the night-time needs of people with dementia: NOCTURNAL.

    PubMed

    Martin, Suzanne; Augusto, Juan Carlos; McCullagh, Paul; Carswell, William; Zheng, Huiru; Wang, Haiying; Wallace, Jonathan; Mulvenna, Maurice

    2013-12-04

    Strategies to support people living with dementia are broad in scope, proposing both pharmacological and non-pharmacological interventions as part of the care pathway. Assistive technologies form part of this offering as both stand-alone devices to support particular tasks and the more complex offering of the "smart home" to underpin ambient assisted living. This paper presents a technology-based system, which expands on the smart home architecture, orientated to support people with daily living. The system, NOCTURNAL, was developed by working directly with people who had dementia, and their carers using qualitative research methods. The research focused primarily on the nighttime needs of people living with dementia in real home settings. Eight people with dementia had the final prototype system installed for a three month evaluation at home. Disturbed sleep patterns, night-time wandering were a focus of this research not only in terms of detection by commercially available technology but also exploring if automated music, light and visual personalized photographs would be soothing to participants during the hours of darkness. The NOCTURNAL platform and associated services was informed by strong user engagement of people with dementia and the service providers who care for them. NOCTURNAL emerged as a holistic service offering a personalised therapeutic aspect with interactive capabilities.

  5. From nocturnal frontal lobe epilepsy to Sleep-Related Hypermotor Epilepsy: A 35-year diagnostic challenge.

    PubMed

    Tinuper, Paolo; Bisulli, Francesca

    2017-01-01

    Nocturnal frontal lobe epilepsy (NFLE) is a focal epilepsy with seizures arising mainly during sleep and characterized by complex, often bizarre, motor behavior or sustained dystonic posturing. First described in 1981, it was initially considered a motor disorder of sleep and was named nocturnal paroxysmal dystonia (NPD). The unusual seizure semiology, onset during sleep, and often uninformative scalp EEG and brain MRI make it difficult to distinguish NPD attacks from other non-epileptic nocturnal paroxysmal events, namely parasomnias. The long-debated epileptic origin of the condition was finally demonstrated in 1990 and the term NFLE introduced. Even though many aspects of parasomnias and NFLE have been clarified in the last two decades, the differential diagnosis remains a challenge for clinicians. To address controversial issues and define the diagnostic criteria for NFLE, a Consensus Conference was held in Bologna, Italy in 2014. Major points of agreement emerged on: (i) the relationship of the seizures with sleep and not with the circadian pattern of seizure occurrence; (ii) the possible extrafrontal origin of hypermotor seizures, without substantial differences in seizure semiology. In the wake of the Consensus, the syndrome was renamed Sleep-Related Hypermotor Epilepsy (SHE). Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  6. The diet of a nocturnal pelagic predator, the Bulwer's petrel, across the lunar cycle.

    PubMed

    Waap, S; Symondson, W O C; Granadeiro, J P; Alonso, H; Serra-Gonçalves, C; Dias, M P; Catry, P

    2017-05-03

    The lunar cycle is believed to strongly influence the vertical distribution of many oceanic taxa, with implications for the foraging behaviour of nocturnal marine predators. Most studies to date testing lunar effects on foraging have focused on predator activity at-sea, with some birds and marine mammals demonstrating contrasting behavioural patterns, depending on the lunar-phase. However, to date no study has focused on how the lunar cycle might actually affect predator-prey interactions in the upper layers of the ocean. Here, we tested whether the diet of the predominantly nocturnal pelagic predator, the Bulwer's petrel (Bulweria bulwerii) would change throughout the lunar cycle, using molecular analysis to augment detection and taxonomic resolution of prey collected from stomach-contents. We found no evidence of dietary shifts in species composition or diversity, with Bulwer's petrel always consuming a wide range of mesopelagic species. Other co-variables potentially affecting light availability at-sea, such as percentage of cloud cover, did not confound our results. Moreover, many of the species found are thought not to reach the sea-surface. Our findings reveal that nocturnal predators are probably more specialized than previously assumed, irrespective of ambient-light, but also reveal deficiencies in our current understanding of species vertical distribution and predation-dynamics at-sea.

  7. Processes driving nocturnal transpiration and implications for estimating land evapotranspiration

    PubMed Central

    de Dios, Víctor Resco; Roy, Jacques; Ferrio, Juan Pedro; Alday, Josu G.; Landais, Damien; Milcu, Alexandru; Gessler, Arthur

    2015-01-01

    Evapotranspiration is a major component of the water cycle, yet only daytime transpiration is currently considered in Earth system and agricultural sciences. This contrasts with physiological studies where 25% or more of water losses have been reported to occur occurring overnight at leaf and plant scales. This gap probably arose from limitations in techniques to measure nocturnal water fluxes at ecosystem scales, a gap we bridge here by using lysimeters under controlled environmental conditions. The magnitude of the nocturnal water losses (12–23% of daytime water losses) in row-crop monocultures of bean (annual herb) and cotton (woody shrub) would be globally an order of magnitude higher than documented responses of global evapotranspiration to climate change (51–98 vs. 7–8 mm yr−1). Contrary to daytime responses and to conventional wisdom, nocturnal transpiration was not affected by previous radiation loads or carbon uptake, and showed a temporal pattern independent of vapour pressure deficit or temperature, because of endogenous controls on stomatal conductance via circadian regulation. Our results have important implications from large-scale ecosystem modelling to crop production: homeostatic water losses justify simple empirical predictive functions, and circadian controls show a fine-tune control that minimizes water loss while potentially increasing posterior carbon uptake. PMID:26074373

  8. Nocturnal water loss in mature subalpine Eucalyptus delegatensis tall open forests and adjacent E. pauciflora woodlands

    PubMed Central

    Buckley, Thomas N; Turnbull, Tarryn L; Pfautsch, Sebastian; Adams, Mark A

    2011-01-01

    We measured sap flux (S) and environmental variables in four monospecific stands of alpine ash (Eucalyptus delegatensis R. Baker, AA) and snowgum (E. pauciflora Sieb. ex Spreng., SG) in Australia's Victorian Alps. Nocturnal S was 11.8 ± 0.8% of diel totals. We separated transpiration (E) and refilling components of S using a novel modeling approach based on refilling time constants. The nocturnal fraction of diel water loss (fn) averaged 8.6 ± 0.6% for AA and 9.8 ± 1.7% for SG; fn differed among sites but not species. Evaporative demand (D) was the strongest driver of nocturnal E (En). The ratio En/D (Gn) was positively correlated to soil moisture in most cases, whereas correlations between wind speed and Gn varied widely in sign and strength. Our results suggest (1) the large, mature trees at our subalpine sites have greater fn than the few Australian native tree species that have been studied at lower elevations, (2) AA and SG exhibit similar fn despite very different size and life history, and (3) fn may differ substantially among sites, so future work should be replicated across differing sites. Our novel approach to quantifying fn can be applied to S measurements obtained by any method. PMID:22393512

  9. A single wind-mediated mechanism explains high-altitude ‘non-goal oriented’ headings and layering of nocturnally migrating insects

    PubMed Central

    Reynolds, Andy M.; Reynolds, Don R.; Smith, Alan D.; Chapman, Jason W.

    2010-01-01

    Studies made with both entomological and meteorological radars over the last 40 years have frequently reported the occurrence of insect layers, and that the individuals forming these layers often show a considerable degree of uniformity in their headings—behaviour known as ‘common orientation’. The environmental cues used by nocturnal migrants to select and maintain common headings, while flying in low illumination levels at great heights above the ground, and the adaptive benefits of this behaviour have long remained a mystery. Here we show how a wind-mediated mechanism accounts for the common orientation patterns of ‘medium-sized’ nocturnal insects. Our theory posits a mechanism by which migrants are able to align themselves with the direction of the flow using a turbulence cue, thus adding their air speed to the wind speed and significantly increasing their migration distance. Our mechanism also predicts that insects flying in the Northern Hemisphere will typically be offset to the right of the mean wind line when the atmosphere is stably stratified, with the Ekman spiral in full effect. We report on the first evidence for such offsets, and show that they have significant implications for the accurate prediction of the flight trajectories of migrating nocturnal insects. PMID:19889697

  10. Time esophageal pH < 4 overestimates the prevalence of pathologic esophageal reflux in subjects with gastroesophageal reflux disease treated with proton pump inhibitors

    PubMed Central

    Gerson, Lauren B; Triadafilopoulos, George; Sahbaie, Peyman; Young, Winston; Sloan, Sheldon; Robinson, Malcolm; Miner, Philip B; Gardner, Jerry D

    2008-01-01

    Background A Stanford University study reported that in asymptomatic GERD patients who were being treated with a proton pump inhibitor (PPI), 50% had pathologic esophageal acid exposure. Aim We considered the possibility that the high prevalence of pathologic esophageal reflux might simply have resulted from calculating acidity as time pH < 4. Methods We calculated integrated acidity and time pH < 4 from the 49 recordings of 24-hour gastric and esophageal pH from the Stanford study as well as from another study of 57 GERD subjects, 26 of whom were treated for 8 days with 20 mg omeprazole or 20 mg rabeprazole in a 2-way crossover fashion. Results The prevalence of pathologic 24-hour esophageal reflux in both studies was significantly higher when measured as time pH < 4 than when measured as integrated acidity. This difference was entirely attributable to a difference between the two measures during the nocturnal period. Nocturnal gastric acid breakthrough was not a useful predictor of pathologic nocturnal esophageal reflux. Conclusion In GERD subjects treated with a PPI, measuring time esophageal pH < 4 will significantly overestimate the prevalence of pathologic esophageal acid exposure over 24 hours and during the nocturnal period. PMID:18498663

  11. Effect of partial agonist activity in beta blockers in severe angina pectoris: a double blind comparison of pindolol and atenolol.

    PubMed Central

    Quyyumi, A A; Wright, C; Mockus, L; Fox, K M

    1984-01-01

    The use of beta adrenoceptor blockade in the treatment of rest angina is controversial, and the effects on severe angina of partial agonist activity in beta blockers are unknown. Eight patients with effort angina and seven with effort and nocturnal angina and severe coronary artery disease were studied initially when they were not taking any antianginal drugs. Pindolol 5 mg thrice daily (with partial agonist activity) and atenolol 100 mg daily (without partial agonist activity) were given for five days each in a double blind randomised manner. Diaries of angina were kept and treadmill exercise testing and ambulatory ST monitoring performed during the last 48 hours of each period of treatment. Daytime and nocturnal resting heart rates and the frequency of angina were significantly reduced by atenolol compared with pindolol (p less than 0.01). The duration of exercise was significantly increased and the frequency, duration, and magnitude of daytime and nocturnal episodes of ST segment depression on ambulatory monitoring were reduced by atenolol. Reduction in resting heart rate is important in the treatment of both effort and nocturnal angina. Partial agonist activity in beta adrenoceptor antagonists may be deleterious in patients with severe angina pectoris. PMID:6148991

  12. [Parasomnias].

    PubMed

    Bassetti, C; Hess, C W

    1993-10-01

    Parasomnias are frequent. They usually represent either the exaggeration of a physiological phenomenon (e.g. sleep starts) or a non-disturbing, idiopathic and usually benign sleep disorder (e.g. sleep talking and bruxism), which need only counseling and improvement of sleep hygiene. However, occasionally parasomnias are of clinical relevance. They can cause insomnia or hypersomnia (e.g. 'myoclonus nocturnus'), psychosocial stress (e.g. sleep-related enuresis and sleep walking) and injuries to oneself and others (e.g. REM-parasomnia). Finally, they can be symptomatic of neurological and medical disorders (e.g. sleep paralysis and 'myoclonus nocturnus'). In these cases special investigations including video-polysomnography can establish a correct diagnosis and allow a specific treatment.

  13. Geomagnetic disturbance and the orientation of nocturnally migrating birds.

    PubMed

    Moore, F R

    1977-05-06

    Free-flying passerine migrants respond to natural fluctuations in the earth's magnetic field. The variability in flight directions of nocturnal migrants is significantly correlated with increasing geomagnetic disturbance as measured by both the K index and various components of the earth's magnetic field. The results indicate that such disturbances influence the orientation of free-flying migrants, but the evidence is not sufficient to show that geomagnetism is a cue in their orientation system.

  14. Surface Layer Processes And Nocturnal Low Level Jet Development--An Observational Study During Pecan

    DTIC Science & Technology

    2016-12-01

    PROCESSES AND NOCTURNAL LOW-LEVEL JET DEVELOPMENT—AN OBSERVATIONAL STUDY DURING PECAN by Michael K. Beall December 2016 Thesis Advisor... OBSERVATIONAL STUDY DURING PECAN 5. FUNDING NUMBERS 6. AUTHOR(S) Michael K. Beall 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate... research project and collected high-resolution stable boundary layer data as it evolved through the night. The objective of this study was to use this

  15. Orchestration of carbohydrate processing for crassulacean acid metabolism

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Borland, Anne M.; Guo, Hao-Bo; Yang, Xiaohan

    The production of phosphoenolpyruvate as a substrate for nocturnal CO 2 uptake represents a significant sink for carbohydrate in CAM plants which has to be balanced with the provisioning of carbohydrate for growth and maintenance. In starch-storing CAM species, diversification in chloroplast metabolite transporters, and the deployment of both phosphorolytic and hydrolytic routes of starch degradation accommodate a division of labour in directing C-skeletons towards nocturnal carboxylation or production of sucrose for growth. In soluble-sugar storing CAM plants, the vacuole plays a central role in managing carbon homeostasis. The molecular identities of various types of vacuolar sugar transporters have onlymore » been identified for C 3 species within the last 10 years. In conclusion, the recent availability of CAM genomes enables the identification of putative orthologues of vacuolar sugar transporters which represent strategic targets for orchestrating the diel provisioning of substrate for nocturnal carboxylation and growth.« less

  16. Correlates Among Nocturnal Agitation, Sleep, and Urinary Incontinence in Dementia

    PubMed Central

    Rose, Karen; Specht, Janet; Forch, Windy

    2016-01-01

    Family caregivers of elders with dementia often face the challenging behaviors of nighttime agitation, sleep disturbances, and urinary incontinence. To date, no study has examined the interrelationships of these behaviors in community-dwelling persons. This single group, descriptive study employs wireless body sensors to objectively collect data on nighttime agitation, sleep, and urinary incontinence in patients with dementia in their homes over a 5- to 7-day period. The aims are to (1) examine the feasibility and acceptability of the use of body sensors in community-dwelling persons with dementia; (2) describe patterns of nocturnal agitation, sleep continuity and duration, and nighttime urinary incontinence; and (3) examine the relationships among nocturnal agitation, sleep continuity and duration, and nighttime urinary incontinence. Data collection is in early stages and is still in progress. Challenges and advantages from preliminary data collection are reported. PMID:24670931

  17. A comparison of idiopathic hypersomnia and narcolepsy-cataplexy using self report measures and sleep diary data.

    PubMed Central

    Bruck, D; Parkes, J D

    1996-01-01

    Eighteen patients with idiopathic hypersomnia (IH) were compared with 50 patients with the narcoleptic syndrome of cataplexy and daytime sleepiness (NLS) using self report questionnaires and a diary of sleep/wake patterns. The IH group reported more consolidated nocturnal sleep, a lower propensity to nap, greater refreshment after naps, and a greater improvement in excessive daytime sleepiness since onset than the NLS group. In IH, the onset of excessive daytime sleepiness was predominantly associated with familial inheritance or a viral illness. Two variable--number of reported awakenings during nocturnal sleep and the reported change in sleepiness since onset--provided maximum discrimination between the IH and NLS groups. Confusional arousals, extended naps or nocturnal sleep, autonomic nervous system dysfunction, low ratings of medication effectiveness, or side effects of medication were not associated differentially with either IH or NLS. PMID:8778267

  18. Orchestration of carbohydrate processing for crassulacean acid metabolism

    DOE PAGES

    Borland, Anne M.; Guo, Hao-Bo; Yang, Xiaohan; ...

    2016-04-19

    The production of phosphoenolpyruvate as a substrate for nocturnal CO 2 uptake represents a significant sink for carbohydrate in CAM plants which has to be balanced with the provisioning of carbohydrate for growth and maintenance. In starch-storing CAM species, diversification in chloroplast metabolite transporters, and the deployment of both phosphorolytic and hydrolytic routes of starch degradation accommodate a division of labour in directing C-skeletons towards nocturnal carboxylation or production of sucrose for growth. In soluble-sugar storing CAM plants, the vacuole plays a central role in managing carbon homeostasis. The molecular identities of various types of vacuolar sugar transporters have onlymore » been identified for C 3 species within the last 10 years. In conclusion, the recent availability of CAM genomes enables the identification of putative orthologues of vacuolar sugar transporters which represent strategic targets for orchestrating the diel provisioning of substrate for nocturnal carboxylation and growth.« less

  19. Evaluating the Efficacy of Nocturnal Continuous Subcutaneous Apomorphine Infusion in Sleep Disorders in Advanced Parkinson's Disease: The APO-NIGHT Study.

    PubMed

    Fernández-Pajarín, Gustavo; Sesar, Ángel; Ares, Begoña; Castro, Alfonso

    2016-10-19

    There are not many data about the beneficial effect of nocturnal continuous subcutaneous apomorphine infusion (NCSAI) over sleep disturbances in advanced Parkinson's disease (PD). Evaluate the effect of the NCSAI in sleeping problems and insomnia due to nocturnal hypokinesia inadvanced PD. We assessed 17 advanced PD patients with several sleep disturbances measured by SCOPA-SLEEP and PDSS scales. All the patients were on apomorphine infusion during daytime. This therapy was extended to nighttime. We evaluated the patients before the onset and after six weeks with NCSAI. NCSAI allowed highly significant improvements in SCOPA-SLEEP and PDSS scales (p<0.0001), and daytime somnolence. NCSAI was well tolerated with no major adverse effects were noticed. This study shows and confirms the efficacy of NCSAI on the sleep disturbances related to advanced PD. We provide an easy protocol to start this therapy.

  20. An assessment of spatio-temporal relationships between nocturnal bird migration traffic rates and diurnal bird stopover density.

    PubMed

    Horton, Kyle G; Shriver, W Gregory; Buler, Jeffrey J

    2016-01-01

    Daily magnitudes and fluxes of landbird migration are often measured via nocturnal traffic rates aloft or diurnal densities within terrestrial habitats during stopover. However, these measures are not consistently correlated and at times reveal opposing trends. For this reason we sought to determine how comparison methods (daily magnitude or daily flux), nocturnal monitoring tools (weather surveillance radar, WSR; thermal imaging, TI), and temporal scale (preceding or following diurnal sampling) influenced correlation strength from stopover densities estimated by daily transect counts. We quantified nocturnal traffic rates at two temporal scales; averaged across the entire night and within individual decile periods of the night, and at two spatial scales; within 1 km of airspace surrounding the site via WSR and directly overhead within the narrow beam of a TI. Overall, the magnitude of daily bird density during stopover was positively related to the magnitude of broad-scale radar traffic rates of migrants on preceding and following nights during both the spring and fall. These relationships were strongest on the following night, and particularly from measures early in the night. Only during the spring on the following nights did we find positive correlations between the daily flux of transect counts and migration traffic rates (both WSR and TI). This indicates that our site likely had a more consistent daily turnover of migrants compared to the fall. The lack of general correlations between seasonal trends or daily flux in fine-scale TI traffic rates and stopover densities across or within nights was unexpected and likely due to poor sampling of traffic rates due to the camera's narrow beam. The order (preceding or following day) and metric of comparisons (magnitude or flux), as well as the tool (WSR or TI) used for monitoring nocturnal migration traffic can have dramatic impacts when compared with ground-based estimates of migrant density. WSR provided measures of the magnitude and daily flux in nocturnal migration traffic rates that related to daily stopover counts of migrants during spring and fall. Relationships among migrating bird flux measures are more complex than simple measures of magnitude of migration. Care should be given to address these complexities when comparing data among methods.

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