Search

Seda Tural Onur,1 Samim Emet,2 Sinem Nedime Sokucu,1 Imran Onur2 1Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Chest Disease, Zeytinburnu, Istanbul, Turkey; 2Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey Introduction: The interval from the peak to the end of the electrocardiographic (ECG) T wave (Tp–Te) can estimate cardiovascular mortality and ventricular tachyarrhythmias.Objectives: In this study, we aimed to define a new ECG parameter in patients with COPD.Methods: This was a cross-sectional observational study that included COPD patients who were diagnosed previously and followed up in the outpatient clinic. All data of the patients’ demographic features, history, spirometry, and electrocardiographs were analyzed.Results: We enrolled 134 patients with COPD and 40 healthy volunteers as controls in our study. Patients already known to be having COPD who were under follow-up for their COPD and diagnosed as having COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria were included. Men comprised 82.8% of the COPD group and 73.2% of controls. The mean age in the COPD and control group was 60.2±9.4 and 58.2±6.7 years, respectively. There was no significant difference between the groups for age or sex (p=0.207, p=0.267, respectively). There were 46 (34.3%) patients in group A, 23 (17.2%) patients in group B, 26 (19.4%) patients in group C, and 46 (29.1%) patients in group D as COPD group. There was a significant increase in Tp–Te results in all precordial leads in the COPD group compared with the control group (p

IntroductionObstructive sleep apnea (OSA) is a multisystem physiological disorder of breathing during sleep that may contribute to systemic physiological imbalances and can also be exacerbated by the use of some commonly prescribed medications.MethodsIn a randomized parallel design trial, we included phenotypic mild to severe OSA mouth-breathing subjects (n = 36) confirmed by home polygraphy, to evaluate the efficacy of oral appliance plus mouth shield and oral appliance only during sleep on night 1 (T1) after 4 weeks (T2), and after 8 weeks (T3) of oral appliance therapy. Respiratory dynamics data were collected. Primary outcomes were respiratory event index and mouth breathing. Anamnesis on medication intake was collected at enrollment.ResultsThe respiratory event index and the hypopnea index did not statistically differ between groups at T3. Oral appliance plus mouth shield and oral appliance only significantly reduced mouth breathing at T2 (p = 0.012) and T3 (p ≤ 0.001) compared with baseline. Exploratory analyses showed oral appliance plus mouth shield supine respiratory rate at T3 (p = 0.039) was marginally decreased compared with oral appliance only. The snore percentage did not differ statistically between groups at T3. Oral appliance only showed a marginal oxygen saturation increase (p = 0.019) at T3 compared with oral appliance plus mouth shield. At T3, medication users had persistent respiratory events, mouth breathing, and snoring compared with non-medication users. Logistic regression showed medication use may increase the odds of mouth breathing (OR = 1.148; p = 0.015) and snoring (OR = 1.036; p = 0.049).DiscussionIn our OSA-mouth breathing cohort, oral appliance only was similar to oral appliance plus mouth shield in attenuating the respiratory event index, hypopnea index, and mouth breathing after 8 weeks. Oral appliance only increased oxygen saturation at T3, while oral appliance plus mouth shield maintained a relatively narrow oxygen saturation range from T1–3. Oral appliance plus mouth shield marginally lowered the supine respiratory rate at T3 compared with oral appliance only. Persistent respiratory events, mouth breathing, and snoring were observed in medication users at T3.

ABSTRACT Introduction: Shorter miniscrew implants (MSIs) are needed to make orthodontics more effective and efficient. Objective: To evaluate the stability, insertion torque, removal torque and pain associated with 3 mm long MSIs placed in humans by a novice clinician. Methods: 82 MSIs were placed in the buccal maxillae of 26 adults. Pairs of adjacent implants were immediately loaded with 100g. Subjects were recalled after 1, 3, 5, and 8 weeks to verify stability and complete questionnaires pertaining to MSI-related pain and discomfort. Results: The overall failure rate was 32.9%. The anterior and posterior MSIs failed 35.7% and 30.0% of the time, respectively. Excluding the 10 MSIs (12.2%) that were traumatically dislodged, the failure rates in the anterior and posterior sites were 30.1% and 15.2%, respectively; the overall primary failure rate was 23.6%. Failures were significantly (p= 0.010) greater (46.3% vs 19.5%) among the first 41 MSIs than the last 41 MSIs that were placed. Excluding the traumatically lost MSIs, the failures occurred on or before day 42. Subjects experienced very low pain (2.2% of maximum) and discomfort (5.5% of maximum) during the first week only. Conclusions: Shorter 3 mm MSIs placed by a novice operator are highly likely to fail. However, failure rates can be substantially decreased over time with the placement of more MSIs. Pain and discomfort experienced after placing 3 mm MSIs is minimal and temporary.

Respiration rate (RR) dynamics entrains brain neural networks. RR differences between mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in response to oral appliance therapy (OAT) are unknown. This pilot study investigated if RR during stable sleep shows a relationship to pathological severity in subjects with MCI and AD who snore and if RR is influenced following stabilization of the upper airway using OAT. The study cohort was as follows: cognitively normal (CN; n = 14), MCI (n = 14) and AD (n = 9); and a sub-population receiving intervention, CN (n = 5), MCI (n = 7), AD (n = 6) subjects. The intervention used was an oral appliance plus a mouth shield (Tx). RR maximum (max) rate (breaths/minute) and RR fluctuation during 2116 stable sleep periods were measured. The Montreal cognitive assessment (MoCA) was administered before and after 4 weeks with Tx. Baseline data showed significantly higher RR fluctuation in CN vs. AD (p < 0.001) but not between CN vs. MCI (p = 0.668). Linear mixed model analysis indicated Tx effect (p = 0.008) for RR max. Tx after 4 weeks lowered the RR-max in MCI (p = 0.022) and AD (p < 0.001). Compared with AD RR max, CN (p < 0.001) and MCI (p < 0.001) were higher with Tx after 4 weeks. Some MCI and AD subjects improved executive and memory function after 4 weeks of Tx.