Biomedical subjects

Mairav Cohen-Zion

Publications and source records attributed to Mairav Cohen-Zion.

10 recordsLinked to original sources

PubMed2006

Effects of alcohol and combined marijuana and alcohol use during adolescence on hippocampal volume and asymmetry.

BACKGROUND: Converging lines of evidence suggest that the hippocampus may be particularly vulnerable to deleterious effects of alcohol and marijuana use, especially during adolescence. The goal of this study was to examine hippocampal volume and asymmetry in adolescent users of alcohol and marijuana. METHODS: Participants were adolescent (aged 15-18) alcohol (ALC) users (n=16), marijuana and alcohol (MJ+ALC) users (n=26), and demographically similar controls (n=21). Extensive exclusionary criteria included prenatal toxic exposure, left handedness, and psychiatric and neurologic disorders. Substance use, cognitive, and anatomical measures were collected after at least 2 days of abstinence from all substances. RESULTS: Adolescent ALC users demonstrated a significantly different pattern of hippocampal asymmetry (p<.05) and reduced left hippocampal volume (p<.05) compared to MJ+ALC users and non-using controls. Increased alcohol abuse/dependence severity was associated with increased right>left (R>L) asymmetry and smaller left hippocampal volumes while marijuana abuse/dependence was associated with increased L>R asymmetry and larger left hippocampal volumes. Although MJ+ALC users did not differ from controls in asymmetry, functional relationships with verbal learning were found only among controls, among whom greater right than left hippocampal volume was associated with superior performance (p<.05). CONCLUSIONS: Aberrations in hippocampal asymmetry and left hippocampal volumes were found for adolescent heavy drinkers. Further, the functional relationship between hippocampal asymmetry and verbal learning was abnormal among adolescent substance users compared to healthy controls. These findings suggest differential effects of alcohol and combined marijuana and alcohol use on hippocampal morphometry and the relationship between hippocampal asymmetry and verbal learning performance among adolescents.

Adolescent↗

PubMed2005

Fatigue, sleep, and circadian rhythms prior to chemotherapy for breast cancer.

GOALS: Previous investigations have shown that women undergoing chemotherapy for breast cancer experience both disturbed sleep and fatigue. However, most of the previous research examined women either during or after chemotherapy. This study examined sleep, fatigue, and circadian rhythms in women with breast cancer before the start of chemotherapy. PATIENTS AND METHODS: Eighty five women with Stages I-IIIA breast cancer who were scheduled to begin adjuvant or neoadjuvant anthracycline-based chemotherapy participated. Each had sleep/wake activity recorded with actigraphy for 72 consecutive hours and filled out questionnaires on sleep, fatigue, depression, and functional outcome. MAIN RESULTS: On average, the women slept for about 6 h a night and napped for over an hour during the day. Sleep was reported to be disturbed and fatigue levels were high. Circadian rhythms were robust, but women who were more phase-delayed reported more daily dysfunction (p<0.01). CONCLUSIONS: The data from the current study suggest that the women with breast cancer likely experience both disturbed sleep and fatigue before the beginning of chemotherapy. Although their circadian rhythms are robust, breast cancer patients with more delayed rhythms experience more daily dysfunction secondary to fatigue. These data suggest that strategies to improve disturbed sleep and to phase-advance circadian rhythms prior to initiation of chemotherapy may be beneficial in improving daily function in breast cancer patients.

Adult↗

PubMed2005

The relationship between fatigue and light exposure during chemotherapy.

BACKGROUND: Fatigue is one of the most common and distressing complaints among cancer patients, not only during radiation and chemotherapy, but also for months to years after the completion of treatment. Fatigue interferes with patients' daily lives, reduces their quality of life, and is often a significant reason why patients discontinue treatment. We hypothesized that some of the fatigue may be related to disrupted circadian rhythms and low light exposure. The main objective of this study therefore was to investigate the association between fatigue and light exposure among patients with breast cancer. METHODS: As part of a larger, ongoing prospective study on fatigue, sleep, and circadian rhythms in patients with breast cancer, an analysis of 63 women newly diagnosed with stage I-IIIA breast cancer and scheduled to receive four cycles of adjuvant or neoadjuvant anthracycline-based chemotherapy was conducted. Data were collected before and during weeks 1, 2, and 3 of cycle 1 and cycle 4. Fatigue was assessed using the Short Form of Multidimensional Fatigue Symptom Inventory. Light exposure was recorded with a wrist actigraph. RESULTS: There were significant correlations between fatigue levels and light exposure (r=-0.28 to -0.45) within both cycle 1 and cycle 4, such that higher levels of fatigue were associated with less light exposure. There were also significant correlations between changes in light exposure and changes in fatigue within the first 2 weeks of each cycle (r=-0.28 to -0.52). CONCLUSIONS: Increased fatigue was significantly correlated with decreased light exposure among patients with breast cancer. Although the cause and effect of exacerbated fatigue and decreased light exposure cannot be confirmed by the current study, and lower light exposure may just in part be due to the fatigued patients spending less time outdoors in bright light, two hypotheses are proposed about the mechanisms by which light may alleviate the fatigue of patients with breast cancer. These results suggest the need for prospective intervention studies of light therapy for breast-cancer-related fatigue.

Adult↗

PubMed2005

Comparing night-to-night variability of sleep measures in elderly African Americans and Whites.

There has been great interest in the night-to-night variability of sleep-disordered breathing because of the implications for the accuracy and costs associated with diagnostic testing. Night-to-night variability of sleep and respiratory parameters were examined in 66 older Whites and 56 older African Americans. Each participant had his or her sleep recorded for 2 nights with portable recording equipment. The correlations between the 2 nights were all large. Analyses of variance showed that men had a greater change in apnea index and in number of apneas than women. There were no differences in the parameters for African Americans versus Whites. One night of sleep recording may be sufficient for studying sleep disorders in elderly persons.

Aged↗

PubMed2004

The effects of standard anthracycline-based chemotherapy on soluble ICAM-1 and vascular endothelial growth factor levels in breast cancer.

PURPOSE: The circulating soluble form of intercellular adhesion molecule-1 (sICAM-1) and vascular endothelial growth factor (VEGF) are elevated in women with breast cancer and associated with tumor progression and poor prognosis. This study examined the effects of anthracycline-based chemotherapy on plasma sICAM-1 and VEGF, as well as soluble P-selectin, von Willebrand factor, and interleukin-6 levels. EXPERIMENTAL DESIGN: Twenty-six women diagnosed with stage I-IIIA breast cancer (mean age, 48.4 +/- 10.4 years; range, 34-79 years) were studied before (week 1) and at weeks 2 and 3 of cycles 1 and 4 of chemotherapy. RESULTS: The initial effect of chemotherapy was to reduce sICAM-1 levels; compared with pretreatment, sICAM-1 levels were decreased at week 2 of both cycles (P values < 0.01). sICAM-1 levels were elevated, however, at the start of cycle 4 as compared with pretreatment (P < 0.01). Chemotherapy led to an increase in sICAM-1 levels in node-positive but not node-negative patients (P < 0.01). VEGF levels were decreased at week 2 of cycle 4 (P = 0.001) and remained so at week 3. Similar to sICAM-1, VEGF levels were elevated at the start of cycle 4 as compared with pretreatment (P < 0.006). Soluble P-selectin levels decreased during week 2 of cycle 4 (P = 0.026). Neither interleukin-6 or von Willebrand factor were significantly changed in response to chemotherapy. CONCLUSIONS: The findings support prior studies suggesting that sICAM-1 levels derive from sources other than endothelial cells. In addition, whereas the more immediate effect of chemotherapy is to reduce sICAM-1 and VEGF, continued treatment may lead to significant elevations.

Adult↗

PubMed2004

Cognitive changes and sleep disordered breathing in elderly: differences in race.

OBJECTIVES: Sleep disordered breathing (SDB) is a highly prevalent sleep disorder in older persons. It is known to be associated with reductions in cognitive function. As part of a larger study examining SDB in African-Americans and Caucasians, it became possible to examine whether racial background may differentially affect the relationship between SDB and cognitive performance. METHODS: Community-dwelling African-American and Caucasian elderly (ages 65+) at high risk for SDB were tested at two time points. During each visit, subjects were interviewed in their homes about their sleep and medical condition. The Mini-Mental Status Examination (MMSE) was used to assess cognitive function. Objective sleep studies were recorded in the subjects' homes and scored for sleep, apneic events, and oxygen saturation levels. RESULTS: Increases in respiratory disturbance index (RDI) were associated with decreases in cognitive performance over time, after controlling for gender and education level. There were no differential effects of race on this relationship. There was no relationship between declining cognitive function and hypoxemia. CONCLUSIONS: Analyses of the data confirm that declining cognitive function in older persons with mild to moderate SDB is related to the amount of respiratory disturbances occurring at night, and suggest that the effect of SDB on cognitive decline is unrelated to race and measured hypoxemia. The large number of community-dwelling elderly with mild to moderate SDB may accrue considerable benefits (both cognitively and medically) from the treatment of SDB, even if they are not markedly hypoxemic.

Black or African American↗

PubMed2004

Sleep in children with attention-deficit hyperactivity disorder (ADHD): a review of naturalistic and stimulant intervention studies.

Attention-Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder of childhood. Multiple clinical and research reports suggest extensive sleep disturbances in children with ADHD, however, current data is contradictory. This paper reviewed 47 research studies (13 stimulant intervention and 34 naturalistic) on ADHD that were published since 1980. The main objectives of this review were to provide pediatric clinicians and researchers a clear and concise summary of published sleep data in children with ADHD, to provide a more accurate description of the current knowledge of the relationship between sleep and ADHD, and to provide current information on the effect of stimulant medication on sleep. Twenty-five of the reviewed studies used subjective reports of sleep, six were actigraphic studies, and 16 were overnight polysomnographic sleep studies (two of which also included Multiple Sleep Latency Tests). All participants were between the age of 3 and 19, and 60% were male. The results indicate high rates of parental reports of sleep disturbances in medicated and unmedicated children with ADHD, however, the majority of these findings have not been confirmed by objective sleep data. Although, agreement among objective studies is not absolute, the data suggest increased nighttime activity, reduced rapid eye movement sleep, and significant daytime somnolence in unmedicated children with ADHD when compared to controls. Data also suggest a possible increased prevalence of periodic limb movements in sleep in children with ADHD, however, little differences in sleep-disordered breathing. The limited number of studies, small and heterogeneous samples, and other methodological limitations make definite results difficult to determine. Future research will need to further clarify the relationship between sleep and ADHD and the effects of stimulants on sleep of children with ADHD.

Adolescent↗

PubMed2003

The relationship between congestive heart failure, sleep apnea, and mortality in older men.

STUDY OBJECTIVES: To examine the association of sleep apnea with heart disease. DESIGN: Prospective study. SETTING: Medical wards at the Veterans Affairs San Diego Healthcare System. PATIENTS: Three hundred fifty-three randomly selected inpatient men. MEASUREMENTS AND RESULTS: Sleep was recorded for 2 nights in the hospital. Medical conditions were obtained from hospital medical records. Cox proportional hazards analyses indicated that patients with congestive heart failure (CHF) plus central sleep apnea (CSA) had shorter survival than those with just CHF, just sleep apnea (obstructive or central), or neither. Survival for those with obstructive sleep apnea (OSA) or CSA and no CHF was no different than for those with neither disorder. Follow-up analysis showed that for those with no CHF, neither CSA nor OSA shortened survival (p > 0.80). For those with CHF, having CSA shortened the life span with a hazard ratio of 1.66 (p = 0.012), but having OSA had no effect. Patients with CHF had more severe sleep apnea than those with no heart disease. CONCLUSIONS: This study does not clarify the issues of cause and effect, but does reinforce the strong associations between sleep apnea and heart disease in elderly men. These data suggest that people with coronary disease should be regarded as a risk group for sleep apnea.

Age Factors↗

PubMed2002

Long-term follow-up of periodic limb movements in sleep in older adults.

STUDY OBJECTIVES: The goal of this study was to examine the natural history of periodic limb movements in sleep (PLMS) in older adults. DESIGN: Prospective, longitudinal design. SETTING: San Diego area. PARTICIPANTS: Community-dwelling older adults. INTERVENTIONS: NA MEASUREMENTS AND RESULTS: Subjects participated in follow-up visits every few years. Sleep disorders were assessed at each visit using sleep questionnaires and overnight sleep recordings. Changes in PLMS over time were examined as well as variables that were associated with change. Average PLMS did not change over time, although there was considerable variability within the sample. In women, changes in PLMS were associated with changes in sleep-disordered breathing. This relationship was not found in men. CONCLUSIONS: Although the prevalence of PLMS is high for older adults, the severity of the disorder does not progressively worsen with increasing age.

Adult↗

PubMed2002

The effect of race and sleep-disordered breathing on nocturnal BP "dipping": analysis in an older population.

STUDY OBJECTIVES: BP normally drops (or "dips") by approximately 10% at nighttime; however, in a number of illnesses there is an increased amount of "nondipping" of nocturnal BP. This study examined whether nondipping in older African Americans and older white subjects is related to the presence of sleep-disordered breathing (SDB) and hypertension. DESIGN: Prospective study with a convenience sample. SETTING: All data were collected in the subjects' homes. PARTICIPANTS: Seventy self-defined African Americans with complaints of snoring or excessive daytime sleepiness, and 70 age-matched and gender-matched white subjects. MEASUREMENTS AND RESULTS: Sleep was recorded for 2 nights, with 1 night of oximetry. BP was recorded on a separate 24-h period. African Americans had higher dipping ratios than white subjects even after accounting for covariates such as respiratory disturbance index (RDI), oxygen desaturation index (ODI), body mass index, and average 24-h mean arterial pressure (p = 0.025). Higher values of RDI (R(2) = 0.0686, p = 0.021) and ODI (R(2) = 0.042, p < 0.03) were correlated with higher dipping ratios in both African Americans and white subjects. However, there was a three-way interaction such that higher RDIs were correlated primarily with nondipping in African Americans receiving antihypertensive medication (R(2) = 0.0373, p = 0.022). CONCLUSIONS: These results demonstrated that African Americans tend to be "nondippers," while white subjects tended to be "dippers." This nondipping was not a result of weight, gender, or of having SDB. The analyses also confirmed that, in both races, the dipping ratio was greatest in those with SDB and hypertension. The third hypothesis, that RDI would be greatest in the nondipping hypertensive subjects, was true only for the African Americans.

Age Distribution↗