83 results on '"Apneas"'
Search Results
2. EEF1A2 pathogenic variant presenting in an infant with failure to thrive and frequent apneas requiring respiratory support.
- Author
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Vogt, Lindsey M., Lorenzo, Melissa, B. Prendergast, D'Arcy, Jobling, Rebekah, and Gill, Peter J.
- Abstract
EEF1A2 is a gene whose protein product, eukaryotic translation elongation factor 1 alpha 2 (eEF1A2), plays an important role in neurodevelopment. Reports of individuals with pathogenic variants in EEF1A2 are rare, with less than 40 individuals reported world‐wide, however a common feature is the association of the variant with developmental and epileptic encephalopathy. Thus far, there have been limited reports of other organ systems or body functions affected by variants in this gene. Here, we present a case of a child with EEF1A2‐related disorder who presented at 3 months of age with hypotonia, microcephaly, failure to thrive, and respiratory insufficiency with central apneas requiring respiratory support. Our case highlights the notion that the respiratory system may be highly implicated in EEF1A2‐related disorder, allowing for better phenotypic characterization of the disorder. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
3. Craniofacial reconstructions in children with craniosynostosis.
- Author
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Spazzapan, Peter, Kocar, Miha, Eberlinc, Andreja, Haber, Barbara, and Velnar, Tomaz
- Subjects
- *
CRANIOSYNOSTOSES , *CRANIOFACIAL abnormalities , *CHILDREN'S health , *INTRACRANIAL hypertension , *SURGICAL complications , *COGNITION - Abstract
Background: Craniosynostosis is a rare congenital disease of the skull. They arise when one or more cranial sutures ossify prematurely. This causes an obstruction to normal brain growth and leads to specific deformations of the skull, which may result in intracranial hypertension and cognitive delay. Materials and methods: We have retrospectively analysed all children treated at the Unit of paediatric neurosurgery of the University Medical Centre Ljubljana between June 2015 and September 2020. The following items have been recorded: affected suture, underlying syndromic condition, hydrocephalus, Chiari malformation, raised intracranial pressure, age at surgery, surgical technique, need for multiple operations and surgical complications. Results: During the study period, 71 children have been treated for craniosynostosis. The median postoperative follow-up was 31 months. There were: 54.9% sagittal, 25.3% metopic, 14.0% unicoronal, 1.4% bicoronal and 1.4% unilateral lambdoid craniosynostosis. Multiple sutures were affected in 2.8% cases. 7.0% of the cases were syndromic. Overall, 74 surgical procedures have been performed: frontoorbital advancement represented 40.5% of them; biparietal remodelling 32.4%: total cranial vault remodelling 22.9%; posterior distraction 2.7%; posterior expansion 1.3%. Median age at surgery was 12.8 months. Conclusions: The treatment of craniosynostosis is surgical and requires a multidisciplinary approach, with expertise in plastic and reconstructive surgery, maxillofacial surgery and neurosurgery. The aim of surgical treatment is to release the constrictive and deformative effect that the synostosis has on skull growth. This requires a remodelling of the neurocranium and, if necessary, of the viscerocranium. Beyond aesthetic purposes, the primary aim of surgical treatment is to permit a normal development of the brain. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
4. Clinical and Preclinical Evidence for M1 Muscarinic Acetylcholine Receptor Potentiation as a Therapeutic Approach for Rett Syndrome.
- Author
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Smith, Mackenzie, Arthur, Bright, Cikowski, Jakub, Holt, Calista, Gonzalez, Sonia, Fisher, Nicole M., Vermudez, Sheryl Anne D., Lindsley, Craig W., Niswender, Colleen M., and Gogliotti, Rocco G.
- Abstract
Summary: Rett syndrome (RTT) is a neurodevelopmental disorder that is characterized by developmental regression, loss of communicative ability, stereotyped hand wringing, cognitive impairment, and central apneas, among many other symptoms. RTT is caused by loss-of-function mutations in a methyl-reader known as methyl-CpG-binding protein 2 (MeCP2), a protein that links epigenetic changes on DNA to larger chromatin structure. Historically, target identification for RTT has relied heavily on Mecp2 knockout mice; however, we recently adopted the alternative approach of performing transcriptional profiling in autopsy samples from RTT patients. Through this mechanism, we identified muscarinic acetylcholine receptors (mAChRs) as potential therapeutic targets. Here, we characterized a cohort of 40 temporal cortex samples from individuals with RTT and quantified significantly decreased levels of the M
1 , M2 , M3 , and M5 mAChRs subtypes relative to neurotypical controls. Of these four subtypes, M1 expression demonstrated a linear relationship with MeCP2 expression, such that M1 levels were only diminished in contexts where MeCP2 was also significantly decreased. Further, we show that M1 potentiation with the positive allosteric modulator (PAM) VU0453595 (VU595) rescued social preference, spatial memory, and associative memory deficits, as well as decreased apneas in Mecp2+/- mice. VU595's efficacy on apneas in Mecp2+/- mice was mediated by the facilitation of the transition from inspiration to expiration. Molecular analysis correlated rescue with normalized global gene expression patterns in the brainstem and hippocampus, as well as increased Gsk3β inhibition and NMDA receptor trafficking. Together, these data suggest that M1 PAMs could represent a new class of RTT therapeutics. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
5. Predictive factors for CPAP failure in obstructive sleep apnea patients.
- Author
-
Goyal, Abhishek, Joshi, Ankur, Mitra, Arun, Khurana, Alkesh, and Chaudhary, Poonam
- Subjects
- *
SLEEP apnea syndromes , *CONTINUOUS positive airway pressure , *BODY mass index - Abstract
Objectives: Some patients with obstructive sleep apnea (OSA) do not respond to Continuous Positive Airway Pressure (CPAP) and for these patients, Bi-level PAP is the next level modality. This study by a theory driven hierarchical approach, tries to identify the predictors for CPAP failure among OSA patients. Methodology: The potential predictors for the model were identified from a theoretical framework rooted in clinical examination, laboratory parameters, and polysomnographic variables pertaining to OSA patients. All patients of OSA who underwent manual titration with CPAP or Bi-level PAP (in case of CPAP Failure) between June 2015 and October 2017 were included in model building. This study compared five competitive models blocks deliberated by increasing order of diagnostic complexity and availability of resources. The fitting of the model was determined by both internal and external validation. Results: Among the five competitive models, the selected model has the significant deviance reduction (−2LL = 121.99, X2 = 25.55, P < 0.0001) from the baseline model (−2LL = 217.356). This logistic regression model consists of the following binary predictors – Age >60 years (odds ratio [OR] = 3.23 [1.27–8.23]), body mass index >35 Kg/m2 (OR = 4.25 [1.78–10.13]), forced expiratory volume <60% (OR = 7.33 [2.83–18.72]), apnea-hypopnea index >75 (OR = 4.31 [1.61–11.56]) and T90 > 30% (OR = 6.67 [2.57–17.36]). Conclusion: These five factors (acronym as BIPAP) may aid to the clinical decision-making by predicting failure of CPAP and therefore may assist in more vigilant clinical care. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
6. Obstructive sleep apneas naturally occur in mice during REM sleep and are highly prevalent in a mouse model of Down syndrome
- Author
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Maria Lavinia Bartolucci, Chiara Berteotti, Sara Alvente, Stefano Bastianini, Sandra Guidi, Viviana Lo Martire, Gabriele Matteoli, Alessandro Silvani, Fiorenza Stagni, Marcello Bosi, Giulio Alessandri-Bonetti, Renata Bartesaghi, and Giovanna Zoccoli
- Subjects
Apneas ,Mice ,Down syndrome ,Breathing ,Respiratory disorder ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Study objectives: The use of mouse models in sleep apnea study is limited by the belief that central (CSA) but not obstructive sleep apneas (OSA) occur in rodents. We aimed to develop a protocol to investigate the presence of OSAs in wild-type mice and, then, to apply it to a validated model of Down syndrome (Ts65Dn), a human pathology characterized by a high incidence of OSAs. Methods: In a pilot study, nine C57BL/6J wild-type mice were implanted with electrodes for electroencephalography (EEG), neck electromyography (nEMG), and diaphragmatic activity (DIA), and then placed in a whole-body-plethysmographic (WBP) chamber for 8 h during the rest (light) phase to simultaneously record sleep and breathing activity. CSA and OSA were discriminated on the basis of WBP and DIA signals recorded simultaneously. The same protocol was then applied to 12 Ts65Dn mice and 14 euploid controls. Results: OSAs represented about half of the apneic events recorded during rapid-eye-movement-sleep (REMS) in each experimental group, while the majority of CSAs were found during non-rapid eye movement sleep. Compared with euploid controls, Ts65Dn mice had a similar total occurrence rate of apneic events during sleep, but a significantly higher occurrence rate of OSAs during REMS, and a significantly lower occurrence rate of CSAs during NREMS. Conclusions: Mice physiologically exhibit both CSAs and OSAs. The latter appear almost exclusively during REMS, and are highly prevalent in Ts65Dn. Mice may, thus, represent a useful model to accelerate the understanding of the pathophysiology and genetics of sleep-disordered breathing and to help the development of new therapies.
- Published
- 2021
- Full Text
- View/download PDF
7. Craniofacial reconstructions in children with craniosynostosis
- Author
-
Peter Spazzapan, Miha Kocar, Andreja Eberlinc, Barbara Haber, and Tomaz Velnar
- Subjects
craniosynostosis ,intracranial hypertension ,apneas ,hydrocephalus ,chiari malformation ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Background: Craniosynostosis is a rare congenital disease of the skull. They arise when one or more cranial sutures ossify prematurely. This causes an obstruction to normal brain growth and leads to specific deformations of the skull, which may result in intracranial hypertension and cognitive delay. Materials and methods: We have retrospectively analysed all children treated at the Unit of paediatric neurosurgery of the University Medical Centre Ljubljana between June 2015 and September 2020. The following items have been recorded: affected suture, underlying syndromic condition, hydrocephalus, Chiari malformation, raised intracranial pressure, age at surgery, surgical technique, need for multiple operations and surgical complications. Results: During the study period, 71 children have been treated for craniosynostosis. The median postoperative follow-up was 31 months. There were: 54.9% sagittal, 25.3% metopic, 14.0% unicoronal, 1.4% bicoronal and 1.4% unilateral lambdoid craniosynostosis. Multiple sutures were affected in 2.8% cases. 7.0% of the cases were syndromic. Overall, 74 surgical procedures have been performed: frontoorbital advancement represented 40.5% of them; biparietal remodelling 32.4%: total cranial vault remodelling 22.9%; posterior distraction 2.7%; posterior expansion 1.3%. Median age at surgery was 12.8 months. Conclusions: The treatment of craniosynostosis is surgical and requires a multidisciplinary approach, with expertise in plastic and reconstructive surgery, maxillofacial surgery and neurosurgery. The aim of surgical treatment is to release the constrictive and deformative effect that the synostosis has on skull growth. This requires a remodelling of the neurocranium and, if necessary, of the viscerocranium. Beyond aesthetic purposes, the primary aim of surgical treatment is to permit a normal development of the brain.
- Published
- 2022
- Full Text
- View/download PDF
8. Correlation of Salivary Resistin Levels with Obstructive Sleep Apnea Syndrome in Pediatric Subjects
- Author
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Jae Hyung Hwang, In Hye Kim, Hye Sook Lee, Dong Sun Park, and Chan-Soon Park
- Subjects
Apneas ,Obstructive sleep ,Saliva ,Resistin ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Background and Objective Obstructive sleep apnea syndrome (OSAS) is considered to be closely related to systemic inflammation. Resistin levels have been demonstrated to be a measure of systemic inflammation. For children, salivary resistin (SR) sampling is an easy and pain-free method for sample collection and is optimal for multiple sampling. Therefore, we aimed to evaluate correlations among SR levels, objective polysomnography (PSG) parameters, and subjective sleep symptoms. Methods Fifty-six children who attended our clinic over 1 year were enrolled prospectively; these children underwent clinical evaluation, questionnaire studies, and PSG. SR was measured at 2 points: at night before PSG and in the early morning after PSG. Results The subjects (n = 56) were divided into the control [n = 23, apnea hypopnea index (AHI) < 1] and OSAS (n = 33, AHI ≥ 1) groups. SR levels after PSG in the OSAS and control groups were similarly higher than that before PSG. There was no significant difference in SR levels between the two groups and among the control and OSAS subgroups. SR levels in the OSAS subgroups were not related to AHI, tonsil size, AN (adenoid-nasopharyngeal) ratio, questionnaire results, lowest oxygen saturation, and oxygen desaturation index (ODI). Conclusions SR levels had no significant correlation with AHI, scores of the Korean version of modified pediatric Epworth Sleepiness Scale, the lowest oxygen saturation, and ODI; SR levels exhibited diurnal variations regardless of the presence of OSAS. However, there is no consensus regarding the relationship between resistin levels and OSAS. Further studies should be pursued in the future.
- Published
- 2018
- Full Text
- View/download PDF
9. Neural crest-specific loss of Bmp7 leads to midfacial hypoplasia, nasal airway obstruction and disordered breathing, modeling obstructive sleep apnea
- Author
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Pranidhi Baddam, Vivian Biancardi, Daniela M. Roth, Farah Eaton, Claudine Thereza-Bussolaro, Rupasri Mandal, David S. Wishart, Amy Barr, Joanna MacLean, Carlos Flores-Mir, Silvia Pagliardini, and Daniel Graf
- Subjects
bone morphogenetic protein 7 ,midfacial hypoplasia ,airway obstruction ,nasal septum deviation ,turbinate hypertrophy ,apneas ,sleep-related breathing disorders ,Medicine ,Pathology ,RB1-214 - Abstract
Pediatric obstructive sleep apnea (OSA), a relatively common sleep-related breathing disorder affecting ∼1-5% of children, is often caused by anatomical obstruction and/or collapse of the nasal and/or pharyngeal airways. The resulting sleep disruption and intermittent hypoxia lead to various systemic morbidities. Predicting the development of OSA from craniofacial features alone is currently not possible, and controversy remains as to whether upper-airway obstruction facilitates reduced midfacial growth or vice versa. Currently, there is no rodent model that recapitulates both the development of craniofacial abnormalities and upper-airway obstruction to address these questions. Here, we describe that mice with a neural crest-specific deletion of Bmp7 (Bmp7ncko) present with a shorter, more acute-angled cranial base, midfacial hypoplasia, nasal septum deviation, turbinate swelling and branching defects, and nasal airway obstruction. Interestingly, several of these craniofacial features develop after birth during periods of rapid midfacial growth and precede the development of an upper-airway obstruction. We identified that, in this rodent model, no single feature appeared to predict upper-airway obstruction, but the sum of those features resulted in reduced breathing frequency, apneas and overall reduced oxygen consumption. Metabolomics analysis of serum from peripheral blood identified increased levels of hydroxyproline, a metabolite upregulated under hypoxic conditions. As this model recapitulates many features observed in OSA, it offers unique opportunities for studying how upper-airway obstruction affects breathing physiology and leads to systemic morbidities. This article has an associated First Person interview with the first author of the paper.
- Published
- 2021
- Full Text
- View/download PDF
10. Effects of Non-Nutritive Sucking on Gastroesophageal Reflux and Related Apneas in Symptomatic Preterm Infants (NNS-GER-SO)
- Author
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Luigi Corvaglia, Assistant Professor, University of Bologna (Italy); NICU Medical Director
- Published
- 2015
11. Clinical and Preclinical Evidence for M1 Muscarinic Acetylcholine Receptor Potentiation as a Therapeutic Approach for Rett Syndrome
- Author
-
Smith, Mackenzie, Arthur, Bright, Cikowski, Jakub, Holt, Calista, Gonzalez, Sonia, Fisher, Nicole M., Vermudez, Sheryl Anne D., Lindsley, Craig W., Niswender, Colleen M., and Gogliotti, Rocco G.
- Published
- 2022
- Full Text
- View/download PDF
12. Learning experiences comprising central ethanol exposure in rat neonates: Impact upon respiratory plasticity and the activity of brain catalase.
- Author
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Trujillo, Verónica, Macchione, Ana Fabiola, Albrecht, Paula Alejandra, Virgolini, Miriam Beatríz, and Molina, Juan Carlos
- Subjects
- *
SUDDEN infant death syndrome , *ALCOHOLISM relapse , *ETHANOL , *NEWBORN infants , *BRAIN , *ANIMAL populations , *RESEARCH , *ANIMAL experimentation , *RESEARCH methodology , *MEDICAL cooperation , *EVALUATION research , *LEARNING , *RATS , *COMPARATIVE studies , *OXIDOREDUCTASES , *RESPIRATION - Abstract
Fetal ethanol exposure represents a risk factor for sudden infant death syndrome, and the respiratory effects of fetal ethanol exposure promote hypoxic ischemic consequences. This study analyzes central ethanol's effects upon breathing plasticity during an ontogenetic stage equivalent to the human third gestational trimester. Ethanol's unconditioned breathing effects and their intervention in learning processes were examined. Since central ethanol is primarily metabolized via the catalase system, we also examined the effects of early history with the drug upon this system. During postnatal days 3, 5, and 7 (PDs 3-7), pups were intracisternally administered with vehicle or ethanol (300 mg%). They were tested in a plethysmograph scented or not scented with ethanol odor. The state of intoxication attenuated the onset of apneas, a phenomenon that is suggestive of ethanol's anxiolytic effects given the state of arousal caused by the novel environment and the stress of ethanol administration. At PD9, pups were evaluated when sober under sequential air conditions (initial-normoxia, hypoxia, and recovery-normoxia), with or without the presence of ethanol odor. Initial apneic episodes increased when ethanol intoxication was previously associated with the odor. Pups then ingested ethanol, and brain catalase activity was determined. Pre-exposure to ethanol intoxication paired with the odor of the drug resulted in heightened enzymatic activity. Central ethanol exposure appears to exert antianxiety effects that attenuate apneic disruptions. However, during withdrawal, the cues associated with such effects elicit an opposite reaction. The activity of the catalase system was also dependent upon learning processes that involved the association of environmental stimuli and ethanol intoxication. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
13. Opioid-Related Sleep-Disordered Breathing: An Update for Clinicians.
- Author
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Jehangir, Waqas, Karabachev, Alexander D., Mehta, Zankhana, and Davis, Mellar
- Abstract
Opioids are an effective treatment for patients with intractable pain. Long-term administration of opioids for pain relief is being delivered by an increasing number of medical providers in the United States including primary care physicians and nonspecialists. One common complication of chronic opioid use is sleep-disordered breathing which can result in various morbidities as well as an increase in all-cause mortality. It is important for providers to understand the relationship between opioids and sleep-disordered breathing as well as methods to improve diagnosis and strategies for treatment. This review aims to update clinicians on the mechanism, diagnosis, and treatment of opioid-related sleep-disordered breathing in order to improve the quality of care for patients with chronic pain. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
14. Co-existence of ethanol-related respiratory and motivational learning processes based on a tactile discrimination procedure in neonatal rats.
- Author
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D'aloisio, G., Acevedo, M.B., Macchione, A.F., Anunziata, F., and Molina, J.C.
- Subjects
- *
LEARNING , *CONDITIONED response , *PHARMACOLOGY , *ASSOCIATIVE learning , *NEURAL development , *MOTIVATIONAL interviewing , *SKELETAL maturity , *MOVEMENT sequences , *ANIMAL populations , *RESEARCH , *ANIMAL experimentation , *MOTIVATION (Psychology) , *RESEARCH methodology , *ALCOHOLIC intoxication , *MEDICAL cooperation , *EVALUATION research , *RATS , *COMPARATIVE studies , *RESPIRATION , *ETHANOL , *PROMPTS (Psychology) - Abstract
In rats, high ethanol doses during early postnatal life exert deleterious effects upon brain development that impact diverse social and cognitive abilities. This stage in development partially overlaps with the third human gestational trimester, commonly referred to as the brain growth spurt period. At this stage in development, human fetuses and rat neonates (postnatal days [PD] 3-9) exhibit relatively high respiratory rates that are affected by subteratogenic ethanol doses. Recent studies suggest conditioned breathing responses in the developing organism, given that there are explicit associations between exteroceptive stimuli and the state of ethanol intoxication. Furthermore, studies performed with near-term rat fetuses suggest heightened sensitivity to ethanol's motivational effects. The present study was meant to analyze the unconditioned effects of ethanol intoxication and the possible co-occurrence of learning mechanisms that can impact respiratory plasticity, and to analyze the preference for cues that signal the state of intoxication as well as the effects of the drug, related with motor stimulation. Neonatal rats were subjected to differential experiences with salient tactile cues explicitly paired or not paired with the effects of vehicle or ethanol (2.0 g/kg). A tactile discrimination procedure applied during PDs 3, 5, 7, and 9 allowed the identification of the emergence of ethanol-derived non-associative and associative learning processes that affect breathing plasticity, particularly when considering apneic disruptions. Ethanol was found to partially inhibit the disruptions that appeared to be intimately related with stressful circumstances defined by the experimental procedure. Tactile cues paired with the drug's effects were also observed to exert an inhibitory effect upon these breathing disruptions. The level of contingency between a given tactile cue and ethanol intoxication also resulted in significant changes in the probability of seeking this cue in a tactile preference test. In addition, the state of intoxication exerted motor-stimulating effects. When contrasting the data obtained via the analysis of the different dependent variables, it appears that most ethanol-derived changes are modulated by positive and/or negative (anti-anxiety) reinforcing effects of the drug. As a whole, the study indicates co-existence of ethanol-related functional changes in the developing organism that simultaneously affect respiratory plasticity and preference patterns elicited by stimuli that signal ethanol's motivational effects. These results emphasize the need to consider significant alterations due to minimal ethanol experiences that argue against "safe" levels of exposure in a critical stage in brain development. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
15. Predictive factors for CPAP failure in obstructive sleep apnea patients
- Author
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Abhishek Goyal, Poonam Chaudhary, Alkesh Kumar Khurana, Ankur Joshi, and Arun Mitra
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Apneas ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,External validation ,Physical examination ,Odds ratio ,Obstructive Sleep ,medicine.disease ,CPAP Ventilation ,respiratory tract diseases ,failure ,Obstructive sleep apnea ,Cpap ventilation ,CPAP ,Emergency medicine ,medicine ,Original Article ,Continuous positive airway pressure ,Clinical care ,business ,BiPAP Bilevel Positive Airway Pressure ,Body mass index - Abstract
Objectives: Some patients with obstructive sleep apnea (OSA) do not respond to Continuous Positive Airway Pressure (CPAP) and for these patients, Bi-level PAP is the next level modality. This study by a theory driven hierarchical approach, tries to identify the predictors for CPAP failure among OSA patients. Methodology: The potential predictors for the model were identified from a theoretical framework rooted in clinical examination, laboratory parameters, and polysomnographic variables pertaining to OSA patients. All patients of OSA who underwent manual titration with CPAP or Bi-level PAP (in case of CPAP Failure) between June 2015 and October 2017 were included in model building. This study compared five competitive models blocks deliberated by increasing order of diagnostic complexity and availability of resources. The fitting of the model was determined by both internal and external validation. Results: Among the five competitive models, the selected model has the significant deviance reduction (−2LL = 121.99, X2 = 25.55, P < 0.0001) from the baseline model (−2LL = 217.356). This logistic regression model consists of the following binary predictors – Age >60 years (odds ratio [OR] = 3.23 [1.27–8.23]), body mass index >35 Kg/m2 (OR = 4.25 [1.78–10.13]), forced expiratory volume 75 (OR = 4.31 [1.61–11.56]) and T90 > 30% (OR = 6.67 [2.57–17.36]). Conclusion: These five factors (acronym as BIPAP) may aid to the clinical decision-making by predicting failure of CPAP and therefore may assist in more vigilant clinical care.
- Published
- 2021
16. Pulse transit time as a tool to characterize obstructive and central apneas in children.
- Author
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Griffon, Lucie, Amaddeo, Alessandro, Olmo Arroyo, Jorge, Tenconi, Rossana, Caggiano, Serena, Khirani, Sonia, and Fauroux, Brigitte
- Abstract
Purpose: The characterization of apneas during polysomnography (PSG) as obstructive or central is a key element of a sleep study. Pulse transit time (PTT) has demonstrated its potential as a noninvasive surrogate marker for inspiratory efforts
. The aim of the study was to assess the ability of PTT to classify apneas as central or obstructive, as compared to respiratory inductance plethysmography (RIP) in children.Methods: Overnight PSG with simultaneous PTT recording was performed on 11 consecutive children (mean age 8.9 years, range 1-18.2 years). The same observer scored the apneas using two blinded configurations: (1) theRIP scoring used the nasal pressure, thermistors, thoracic and abdominal movements, and pulse oximetry signals: (2) thePTT scoring used PTT in combination with all the other signalswithout the thoracic and abdominal movements.Results: One hundred fourteen apneas out of a total of 520 respiratory events were analyzed. With RIP, 58 (51%) apneas were scored as obstructive and 56 (49%) as central. Using PTT, 77 (68%) of the apneas were scored as obstructive and 37 (32%) as central. When using PTT, 30 apneas scored as central by RIP were scored as obstructive. PTT was highly sensitive (81%) but poorly specific (46%) in scoring 58 apneas as obstructive. PTT was less sensitive (46%) but highly specific (81%) to score 56 apneas as central.Conclusion: PTT may be used as an additional tool to RIP to improve the scoring of apneas as obstructive or central in children. The high percentage of artifact is a limitation of PTT. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
17. Effects of ion channel noise on neural circuits: an application to the respiratory pattern generator to investigate breathing variability.
- Author
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Haitao Yu, Dhingra, Rishi R., Dick, Thomas E., and Galán, Roberto F.
- Subjects
- *
NEURAL circuitry , *ION channel gating mechanisms , *PATTERN generators , *NEUROTRANSMITTERS , *NEURAL conduction - Abstract
Neural activity generally displays irregular firing patterns even in circuits with apparently regular outputs, such as motor pattern generators, in which the output frequency fluctuates randomly around a mean value. This "circuit noise" is inherited from the random firing of single neurons, which emerges from stochastic ion channel gating (channel noise), spontaneous neurotransmitter release, and its diffusion and binding to synaptic receptors. Here we demonstrate how to expand conductance-based network models that are originally deterministic to include realistic, physiological noise, focusing on stochastic ion channel gating. We illustrate this procedure with a well-established conductance- based model of the respiratory pattern generator, which allows us to investigate how channel noise affects neural dynamics at the circuit level and, in particular, to understand the relationship between the respiratory pattern and its breath-to-breath variability. We show that as the channel number increases, the duration of inspiration and expiration varies, and so does the coefficient of variation of the breath-to-breath interval, which attains a minimum when the mean duration of expiration slightly exceeds that of inspiration. For small channel numbers, the variability of the expiratory phase dominates over that of the inspiratory phase, and vice versa for large channel numbers. Among the four different cell types in the respiratory pattern generator, pacemaker cells exhibit the highest sensitivity to channel noise. The model shows that suppressing input from the pons leads to longer inspiratory phases, a reduction in breathing frequency, and larger breath-to-breath variability, whereas enhanced input from the raphe nucleus increases breathing frequency without changing its pattern. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
18. Schlafbezogene Atmungsstörungen im Kindes- und Jugendalter.
- Author
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Kerbl, R., Grigorow, I., and Sauseng, W.
- Abstract
Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2016
- Full Text
- View/download PDF
19. Neural crest-specific loss of Bmp7 leads to midfacial hypoplasia, nasal airway obstruction and disordered breathing, modeling obstructive sleep apnea
- Author
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Carlos Flores-Mir, Pranidhi Baddam, Joanna E. MacLean, Rupasri Mandal, Farah Eaton, Daniel Graf, Vivian Biancardi, Amy J. Barr, Daniela Marta Roth, David S. Wishart, Silvia Pagliardini, and Claudine Thereza-Bussolaro
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Craniofacial abnormality ,Bone morphogenetic protein 7 ,Neuroscience (miscellaneous) ,lcsh:Medicine ,Medicine (miscellaneous) ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Nasal septum deviation ,0302 clinical medicine ,Immunology and Microbiology (miscellaneous) ,Midfacial hypoplasia ,Internal medicine ,lcsh:Pathology ,medicine ,Nasal septum ,Craniofacial ,Apneas ,business.industry ,lcsh:R ,Intermittent hypoxia ,Airway obstruction ,medicine.disease ,Hypoplasia ,Turbinate hypertrophy ,respiratory tract diseases ,Sleep-related breathing disorders ,Obstructive sleep apnea ,030104 developmental biology ,medicine.anatomical_structure ,Cardiology ,Breathing ,business ,030217 neurology & neurosurgery ,lcsh:RB1-214 ,Research Article - Abstract
Pediatric obstructive sleep apnea (OSA), a relatively common sleep-related breathing disorder affecting ∼1-5% of children, is often caused by anatomical obstruction and/or collapse of the nasal and/or pharyngeal airways. The resulting sleep disruption and intermittent hypoxia lead to various systemic morbidities. Predicting the development of OSA from craniofacial features alone is currently not possible, and controversy remains as to whether upper-airway obstruction facilitates reduced midfacial growth or vice versa. Currently, there is no rodent model that recapitulates both the development of craniofacial abnormalities and upper-airway obstruction to address these questions. Here, we describe that mice with a neural crest-specific deletion of Bmp7 (Bmp7ncko) present with a shorter, more acute-angled cranial base, midfacial hypoplasia, nasal septum deviation, turbinate swelling and branching defects, and nasal airway obstruction. Interestingly, several of these craniofacial features develop after birth during periods of rapid midfacial growth and precede the development of an upper-airway obstruction. We identified that, in this rodent model, no single feature appeared to predict upper-airway obstruction, but the sum of those features resulted in reduced breathing frequency, apneas and overall reduced oxygen consumption. Metabolomics analysis of serum from peripheral blood identified increased levels of hydroxyproline, a metabolite upregulated under hypoxic conditions. As this model recapitulates many features observed in OSA, it offers unique opportunities for studying how upper-airway obstruction affects breathing physiology and leads to systemic morbidities. This article has an associated First Person interview with the first author of the paper., Summary: Using morphometric, respiratory function and metabolomics analyses, we demonstrate that the Bmp7 neural crest knockout mouse is a model for nasal airway obstruction with a craniofacial origin, allowing the study of disordered breathing.
- Published
- 2021
20. Sleep apneas and epilepsy comorbidity in childhood: a systematic review of the literature.
- Author
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Gogou, Maria, Haidopoulou, Katerina, Eboriadou, Maria, and Pavlou, Evaggelos
- Published
- 2015
- Full Text
- View/download PDF
21. Increased spleen volume provoked by temperate head-out-of-water immersion.
- Author
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Keeler JM, Hess HW, Tourula E, Baker TB, Kerr PM, Greenshields JT, Chapman RF, Johnson BD, and Schlader ZJ
- Subjects
- Humans, Adult, Female, Water, Blood Pressure physiology, Immersion, Apnea, Spleen
- Abstract
This study tested the hypotheses that 1 ) spleen volume increases during head-out-of-water immersion (HOWI) and returns to pre-HOWI values postdiuresis, and 2 ) the magnitude of apnea-induced spleen contraction increases when preapnea spleen volume is elevated. Spleen volume was measured before and after a set of five apneas in 12 healthy adults (28 ± 5 yr, 3 females) before, during (at 30 and 150 min), and 20 min after temperate temperature (36 ± 1°C) HOWI. At each time point, spleen length, width, and thickness were measured via ultrasound, and spleen volume was calculated using the Pilström equation. Compared with pre-HOWI (276 ± 88 mL), spleen volume was elevated at 30 (353 ± 94 mL, P < 0.01) and 150 (322 ± 87 mL, P < 0.01) min of HOWI but returned to pre-HOWI volume at post-HOWI (281 ± 90 mL, P = 0.58). Spleen volume decreased from pre- to postapnea bouts at each time point ( P < 0.01). The magnitude of reduction in spleen volume from pre- to postapneas was elevated at 30 min of HOWI (-69 ± 24 mL) compared with pre-HOWI (-52 ± 20 mL, P = 0.04) but did not differ from pre-HOWI at 150 min of HOWI (-54 ± 16 mL, P = 0.99) and post-HOWI (-50 ± 18 mL, P = 0.87). Thus, spleen volume is increased throughout 180 min of HOWI, and whereas apnea-induced spleen contraction is augmented after 30 min of HOWI, the magnitude of spleen contraction is unaffected by HOWI thereafter.
- Published
- 2022
- Full Text
- View/download PDF
22. Reliability of SleepStrip as a screening test in obstructive sleep apnea patients.
- Author
-
Dinç, Aykut, Yılmaz, Metin, Tutar, Hakan, Aydil, Utku, Kızıl, Yusuf, Damar, Murat, and Kemaloğlu, Yusuf
- Subjects
- *
SLEEP apnea syndromes , *POLYSOMNOGRAPHY , *DROWSINESS , *MEDICAL screening equipment , *CARDIOVASCULAR diseases risk factors - Abstract
Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder and related to multiple conditions that cause mortality in adults. In the present study, reliability of SleepStrip, a disposable screening device for detection of OSAS, is tested. In this prospective, nonrandomized double-blinded single cohort study at an academic health center, the performance of the SleepStrip in detecting respiratory events and establishing an SleepStrip score (Sscore) in domestic use were compared to the apnea-hypopnea index (AHI) obtained by the standard polysomnography (PSG) recordings in the sleep laboratory. Forty-one patients who have the PSG results participated the study and wore the SleepStrips at home. Test efficiency rate was 75 % and there was a positive correlation between PSG-AHI scores and Sscores ( r = 0.71, p < 0.001). However, diagnostic accuracy analysis showed that the correlation between Sscores and PSG-AHI scores were significant only at AHI > 30 levels. The SleepStrip has 100 % specificity and positive predictive values, but it also has low negative predictive and sensitivity values. The SleepStrip is not a reliable screening test in differential diagnosis among simple snorers, mild, moderate and severe OSAS patients. However, high Sscores highly indicate the presence of moderate-severe OSAS. We can safely send these patients to split-night PSG and continuous, automatic, bi-level positive airway pressure (CPAP/BPAP/APAP) titration at the same night. The SleepStrip may increase the effective use of the sleep laboratories. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
23. Aplicación de una nueva terminología 'BRUE: Eventos breves, resueltos e inexplicados'. Definiciones y recomendaciones
- Author
-
Zenteno-Araos,Daniel, Díaz-Silva,Javiera, and Brockmann-Veloso,Pablo
- Subjects
ALTE ,BRUE ,apneas ,muerte súbita - Abstract
Resumen: Hace tres décadas se propuso el término Apparent Life-Threatening Events (ALTE), siendo incorpo rado paulatinamente en el enfrentamiento clínico de estos pacientes; permitiendo determinar riesgos, atribuir causas y realizar tratamientos específicos. Sin embargo, llevó a realizar estudios y hospitalizaciones en muchas instancias considerados innecesarios, generando un aumento de los costos sanitarios. Por estos motivos nace el concepto de Brief Resolved Unexplained Events (BRUE), que pretende disminuir la subjetividad del evento y focalizar una estrategia de manejo según determina ción del riesgo. En el siguiente artículo se analizan diferencias entre ALTE y BRUE según consensos internacionales y chilenos, profundizando en el enfrentamiento e incorporando consideraciones de relevancia para la práctica clínica cotidiana de lactantes que presentan un BRUE.
- Published
- 2020
24. Cardiorespiratory Events in Infants Born Preterm during the Transitional Period
- Author
-
Silvia Martini, Paola Rucci, Silvia Galletti, Giacomo Faldella, Marek Czosnyka, Topun Austin, Francesca Vitali, Giulia Frabboni, Peter Smielewski, Luigi Corvaglia, Smielewski, Peter [0000-0001-5096-3938], Apollo - University of Cambridge Repository, Martini S., Frabboni G., Rucci P., Czosnyka M., Smielewski P., Galletti S., Vitali F., Faldella G., Austin T., and Corvaglia L.
- Subjects
Bradycardia ,Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,very low birth weight ,hypoxic episodes ,bradycardia ,03 medical and health sciences ,patent ductus arteriosus ,0302 clinical medicine ,030225 pediatrics ,hypoxic episode ,cardiorespiratory monitoring ,medicine ,Humans ,030212 general & internal medicine ,apneas ,Prospective Studies ,gestational age ,Hypoxia ,medicine.diagnostic_test ,Event type ,business.industry ,Infant, Newborn ,Gestational age ,desaturation ,transition ,Cardiorespiratory fitness ,apnea ,pulse oximetry ,Pulse oximetry ,patent ductus arteriosu ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business ,Infant, Premature - Abstract
Objective: To investigate the features of cardiorespiratory events in infants born preterm during the transitional period, and to evaluate whether different neonatal characteristics may correlate with event type, duration, and severity. Study design: Infants with gestational age (GA)
- Published
- 2020
- Full Text
- View/download PDF
25. Aplicación de una nueva terminología 'BRUE: Eventos breves, resueltos e inexplicados'. Definiciones y recomendaciones
- Author
-
Zenteno-Araos, Daniel, Díaz-Silva, Javiera, and Brockmann-Veloso, Pablo
- Subjects
ALTE ,BRUE ,sudden death ,apneas ,muerte súbita ,apnea - Abstract
Resumen: Hace tres décadas se propuso el término Apparent Life-Threatening Events (ALTE), siendo incorpo rado paulatinamente en el enfrentamiento clínico de estos pacientes; permitiendo determinar riesgos, atribuir causas y realizar tratamientos específicos. Sin embargo, llevó a realizar estudios y hospitalizaciones en muchas instancias considerados innecesarios, generando un aumento de los costos sanitarios. Por estos motivos nace el concepto de Brief Resolved Unexplained Events (BRUE), que pretende disminuir la subjetividad del evento y focalizar una estrategia de manejo según determina ción del riesgo. En el siguiente artículo se analizan diferencias entre ALTE y BRUE según consensos internacionales y chilenos, profundizando en el enfrentamiento e incorporando consideraciones de relevancia para la práctica clínica cotidiana de lactantes que presentan un BRUE. Abstract: Three decades ago, the term Apparent Life-Threatening Events (ALTE) was proposed and was gra dually incorporated into the clinical approach of these patients, allowing to determine risks, attribute causes, and perform specific treatments. However, this led to studies and hospitalizations considered unnecessary in many cases, increasing health costs. For this reason, the concept of Brief Resolved Unexplained Events (BRUE) was created, in order to reduce the subjectivity of the event and focus a management strategy according to the risk determination. This article analyzes the differences bet ween ALTE and BRUE according to international and Chilean consensus, deepening the approach and incorporating relevant considerations for the daily clinical practice with infants who present a BRUE.
- Published
- 2020
26. Obstructive sleep apneas naturally occur in mice during REM sleep and are highly prevalent in a mouse model of Down syndrome
- Author
-
Gabriele Matteoli, Sara Alvente, Renata Bartesaghi, Stefano Bastianini, Sandra Guidi, Fiorenza Stagni, Marcello Bosi, Alessandro Silvani, Maria Lavinia Bartolucci, Viviana Lo Martire, Giovanna Zoccoli, Giulio Alessandri-Bonetti, Chiara Berteotti, Bartolucci M.L., Berteotti C., Alvente S., Bastianini S., Guidi S., Lo Martire V., Matteoli G., Silvani A., Stagni F., Bosi M., Alessandri-Bonetti G., Bartesaghi R., and Zoccoli G.
- Subjects
medicine.medical_specialty ,Down syndrome ,Apnea ,Sleep, REM ,Diaphragmatic breathing ,Pilot Projects ,Neurosciences. Biological psychiatry. Neuropsychiatry ,Electromyography ,Electroencephalography ,Mice ,Sleep and breathing ,Internal medicine ,medicine ,Animals ,Plethysmography, Whole Body ,Sleep Apnea, Obstructive ,Apneas ,medicine.diagnostic_test ,business.industry ,Sleep apnea ,medicine.disease ,Sleep Apnea, Central ,Sleep in non-human animals ,respiratory tract diseases ,Disease Models, Animal ,Neurology ,Breathing ,Respiratory disorder ,Cardiology ,business ,RC321-571 - Abstract
Study objectives: The use of mouse models in sleep apnea study is limited by the belief that central (CSA) but not obstructive sleep apneas (OSA) occur in rodents. We aimed to develop a protocol to investigate the presence of OSAs in wild-type mice and, then, to apply it to a validated model of Down syndrome (Ts65Dn), a human pathology characterized by a high incidence of OSAs. Methods: In a pilot study, nine C57BL/6J wild-type mice were implanted with electrodes for electroencephalography (EEG), neck electromyography (nEMG), and diaphragmatic activity (DIA), and then placed in a whole-body-plethysmographic (WBP) chamber for 8 h during the rest (light) phase to simultaneously record sleep and breathing activity. CSA and OSA were discriminated on the basis of WBP and DIA signals recorded simultaneously. The same protocol was then applied to 12 Ts65Dn mice and 14 euploid controls. Results: OSAs represented about half of the apneic events recorded during rapid-eye-movement-sleep (REMS) in each experimental group, while the majority of CSAs were found during non-rapid eye movement sleep. Compared with euploid controls, Ts65Dn mice had a similar total occurrence rate of apneic events during sleep, but a significantly higher occurrence rate of OSAs during REMS, and a significantly lower occurrence rate of CSAs during NREMS. Conclusions: Mice physiologically exhibit both CSAs and OSAs. The latter appear almost exclusively during REMS, and are highly prevalent in Ts65Dn. Mice may, thus, represent a useful model to accelerate the understanding of the pathophysiology and genetics of sleep-disordered breathing and to help the development of new therapies.
- Published
- 2021
27. GUÍAS PRÁCTICAS DE DIAGNÓSTICO Y TRATAMIENTO DEL SÍNDROME DE APNEAS E HIPOPNEAS OBSTRUCTIVAS DEL SUEÑO.
- Author
-
NOGUEIRA, FACUNDO, NIGRO, CARLOS, CAMBURSANO, HUGO, BORSINI, EDUARDO, SILIO, JULIO, and ÁVILA, JORGE
- Abstract
Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2013
28. Optimized Administration of the M 4 PAM VU0467154 Demonstrates Broad Efficacy, but Limited Effective Concentrations in Mecp2 +/ - Mice.
- Author
-
Cikowski J, Holt C, Arthur B, Smith M, Gonzalez S, Lindsley CW, Niswender CM, and Gogliotti RG
- Subjects
- Animals, Cholinergic Agents, Disease Models, Animal, Methyl-CpG-Binding Protein 2 genetics, Mice, Mice, Knockout, Thiophenes pharmacology, Pyridazines pharmacology, Rett Syndrome
- Abstract
Hypofunction of cholinergic circuits and diminished cholinergic tone have been associated with the neurodevelopmental disorder Rett syndrome (RTT). Specifically, deletion of Mecp2 in cholinergic neurons evokes the same social and cognitive phenotypes in mice seen with global Mecp2 knockout, and decreased choline acetyltransferase activity and vesamicol binding have been reported in RTT autopsy samples. Further, we recently identified significant decreases in muscarinic acetylcholine receptor subtype 4 (M
4 ) expression in both the motor cortex and cerebellum of RTT patient autopsies and established proof of concept that an acute dose of the positive allosteric modulator (PAM) VU0467154 (VU154) rescued phenotypes in Mecp2+/- mice. Here, we expand the assessment of M4 PAMs in RTT to address clinically relevant questions of tolerance, scope of benefit, dose response, chronic treatment, and mechanism. We show that VU154 has efficacy on anxiety, social preference, cognitive, and respiratory phenotypes in Mecp2+/- mice; however, the therapeutic range is narrow, with benefits seen at 3 mg/kg concentrations, but not 1 or 10 mg/kg. Further, sociability was diminished in VU154-treated Mecp2+/- mice, suggestive of a potential adverse effect. Compound efficacy on social, cognitive, and respiratory phenotypes was conserved with a 44-day treatment paradigm, with the caveat that breath rate was moderately decreased with chronic treatment in Mecp2+/+ and Mecp2+/- mice. VU154 effects on respiratory function correlated with an increase in Gsk3β inhibition in the brainstem. These results identify the core symptom domains where efficacy and adverse effects may present with M4 administration in RTT model mice and advocate for the continued evaluation as potential RTT therapeutics.- Published
- 2022
- Full Text
- View/download PDF
29. Tos Ferina y Síndrome Coqueluchoide en Niños Menores de 1 Año de Edad: Factores de Riesgo Asociada a Mortalidad. Estudio Transversal Descriptivo de 48 Casos.
- Author
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Gómez-Rivera, Norberto, García-Zarate, María Guadalupe, Álvarez-Hernández, Gerardo, Villalobos-García, Luis, Fonseca-Chon, Ignacio, Cano-Rangel, Manuel Alberto, Vázquez-Pizaña, Elba, and López-Miranda, Adela
- Subjects
- *
WHOOPING cough , *LEUCOCYTOSIS , *JUVENILE diseases , *RISK assessment , *ANTI-infective agents , *CHILD mortality , *VACCINATION of children - Abstract
Objective: To describe the clinical presentation of 48 cases and the risk factors associated with mortality. Study Design: Transversal, descriptive, between January 2009 and March 2010. Materials y Methods: Two groups were compared for the descriptive analysis: group 1; patients who passed away, group 2, patients who survived. The selected variables were: Age, sex, cough characteristics, vaccination history, leukocytosis, X-ray, antimicrobial treatment and mortality. The statistic significance was evaluated by Student T test, Pearson Χ² test and Fisher's Exact Test. Results of p <.05 were considered significant. Results: Positive samples to patients in 18 cases (38%), positive samples to relatives in 5 cases (10%). Positive samples group 1; 7 cases (100%), positive samples group 2, 11 cases (61%). Apneas: group 1; 7 cases, group 2: 5 cases; 42% when p = 0.001 (significant). Pneumonias: group 1; 7 cases, group 2; 25 cases, when p= 0.0001 (significant). Starting leucocytes (average) group1; 74,457 mm3. Group 2 51,667 mm3, p = 0.0177. Leukocytosis on day 4; group 1 80,014. Group 2 20,428 mm3, when p = 0.0001. Mortality 15%. Conclusions: Presence of apnea, leukocytosis and pneumonia can be considered as a risk factor considering they were significantly higher in G1 in comparison to G2. [ABSTRACT FROM AUTHOR]
- Published
- 2011
30. Mechanisms of sympathetic activation and blood pressure elevation by intermittent hypoxia
- Author
-
Prabhakar, Nanduri R. and Kumar, Ganesh K.
- Subjects
- *
REGULATION of blood pressure , *HYPOXEMIA , *SLEEP apnea syndromes , *VASOCONSTRICTORS , *BARORECEPTORS , *CAROTID body , *BLOOD vessels - Abstract
Abstract: Sleep disordered breathing with recurrent apneas is one of the most frequently encountered breathing disorder in adult humans and preterm infants. Recurrent apnea patients exhibit several co-morbidities including hypertension and persistent sympathetic activation. Intermittent hypoxia (IH) resulting from apneas appears to be the primary stimulus for evoking autonomic changes. The purpose of this article is to briefly review the effects of IH on chemo- and baro-reflexes and circulating vasoactive hormones and their contribution to sympathetic activation and blood pressures. Sleep apnea patients and IH-treated rodents exhibit exaggerated arterial chemo-reflex. Studies on rodent models demonstrated that IH leads to hyperactive carotid body response to hypoxia. On the other hand, baro-reflex function is attenuated in patients with sleep apnea and in IH-treated rodents. Circulating vasoactive hormone levels are elevated in sleep apnea patients and in rodent models of IH. Thus, persistent sympathetic activation and hypertension associated with sleep apneas seems to be due to a combination of altered chemo- and baro-reflexes resulting in sympathetic activation and action of elevated circulating levels of vasoactive hormones on vasculature. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
31. Contrasting effects of estradiol and progesterone on respiratory pattern and hypoxic ventilatory response in newborn male rats
- Author
-
Lefter, Raluca, Doan, Van Diep, and Joseph, Vincent
- Subjects
- *
REGULATION of respiration , *ESTRADIOL , *PROGESTERONE , *NEWBORN infants , *PLETHYSMOGRAPHY , *APNEA , *LABORATORY rats - Abstract
Abstract: We tested the hypothesis that postnatal exposure to progesterone or estradiol exerts distinct effects on respiratory control, apnea frequency, and on hypoxic ventilatory response (HVR). To this aim, we assessed breathing pattern using whole body plethysmography in normoxia and during a sustained hypoxic exposure (10% O2—30min) in 10-day-old male rats raised by dams implanted with osmotic minipumps delivering either estradiol (E2, 7.0μgday−1), estradiol+progesterone (E2 +P, 7.0+70μgday−1) or vehicle (propylene glycol) at a regular flow rate throughout postnatal days 1–14. Compared to vehicle, E2 and E2 +P pups had a reduced ventilation, metabolic rate and rectal temperature. HVR was specifically increased in E2 +P pups compared to controls and E2 pups. On the contrary, both E2 and E2 +P pups did not reduced metabolism as much as controls during hypoxic exposure, and the decrease in rectal temperature was abolished. Surprisingly, E2 +P pups showed a dramatic elevation of sigh frequency, while progesterone (in E2 +P compared to E2 and Veh pups) reduced apnea frequency. These findings are relevant to better understand the role of placental steroids on respiratory and metabolic control during early development in rats, and could ultimately contribute to a better understanding of specific respiratory control disorders in preterm neonates, which are chronically deprived from placental steroids exposure. [Copyright &y& Elsevier]
- Published
- 2008
- Full Text
- View/download PDF
32. Obstructive sleep apneas naturally occur in mice during REM sleep and are highly prevalent in a mouse model of Down syndrome.
- Author
-
Bartolucci, Maria Lavinia, Berteotti, Chiara, Alvente, Sara, Bastianini, Stefano, Guidi, Sandra, Lo Martire, Viviana, Matteoli, Gabriele, Silvani, Alessandro, Stagni, Fiorenza, Bosi, Marcello, Alessandri-Bonetti, Giulio, Bartesaghi, Renata, and Zoccoli, Giovanna
- Subjects
- *
LABORATORY mice , *NON-REM sleep , *RAPID eye movement sleep , *DOWN syndrome , *ANIMAL disease models - Abstract
The use of mouse models in sleep apnea study is limited by the belief that central (CSA) but not obstructive sleep apneas (OSA) occur in rodents. We aimed to develop a protocol to investigate the presence of OSAs in wild-type mice and, then, to apply it to a validated model of Down syndrome (Ts65Dn), a human pathology characterized by a high incidence of OSAs. In a pilot study, nine C57BL/6J wild-type mice were implanted with electrodes for electroencephalography (EEG), neck electromyography (nEMG), and diaphragmatic activity (DIA), and then placed in a whole-body-plethysmographic (WBP) chamber for 8 h during the rest (light) phase to simultaneously record sleep and breathing activity. CSA and OSA were discriminated on the basis of WBP and DIA signals recorded simultaneously. The same protocol was then applied to 12 Ts65Dn mice and 14 euploid controls. OSAs represented about half of the apneic events recorded during rapid-eye-movement-sleep (REMS) in each experimental group, while the majority of CSAs were found during non-rapid eye movement sleep. Compared with euploid controls, Ts65Dn mice had a similar total occurrence rate of apneic events during sleep, but a significantly higher occurrence rate of OSAs during REMS, and a significantly lower occurrence rate of CSAs during NREMS. Mice physiologically exhibit both CSAs and OSAs. The latter appear almost exclusively during REMS, and are highly prevalent in Ts65Dn. Mice may, thus, represent a useful model to accelerate the understanding of the pathophysiology and genetics of sleep-disordered breathing and to help the development of new therapies. • Mice physiologically exhibit both central sleep apneas and obstructive sleep apneas. • Obstructive sleep apneas appear almost exclusively during rapid-eye-movement-sleep. • Obstructive sleep apneas are prevalent in Ts65Dn, a mouse model of Down syndrome. • Mice models help to understand the pathophysiology of sleep-disordered breathing. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
33. Effects of hypoxia and hypercapnia on nonnutritive swallowing in newborn lambs.
- Author
-
Duvareille, Charles, Lafrance, Mylène, Samson, Nathalie, St-Hilaire, Marie, Pladys, Patrick, Micheau, Philippe, Bournival, Véronique, Langlois, Carole, and Praud, Jean-Paul
- Subjects
HYPOXEMIA ,HYPERCAPNIA ,RESPIRATION ,EYE movements ,DIAPHRAGM (Anatomy) ,ANIMAL models in research - Abstract
The aim of the present study was to investigate the effect of hypercapnia and hypoxia on apnea and nonnutritive swallowing (NNS) frequency, as well as on the coordination between NNS and phases of the respiratory cycle in newborn lambs, while taking into account the potential effects of states of alertness. Six lambs were chronically instrumented for recording electroencephalogram, eye movements, diaphragm and thyroarytenoid muscle (a glottal adductor) activity, nasal airflow, and electro-cardiogram. Polysomnographic recordings were performed in nonsedated lambs exposed to air (control), 10% 02, and 5% CO
2 in a random order at 3, 4, and 5 days of age. Although hypercapnia decreased apnea frequency in wakefulness and active sleep (P = 0.002 vs. air and hypoxia), hypoxia had no significant effect on apnea. In addition, although hypercapnia increased NNS frequency during wakefulness and quiet sleep (P < 0.005 vs. air and hypoxia), hypoxia tended to decrease NNS frequency. Finally, only hypercapnia altered NNS-breathing coordination by increasing NNS at the transition from inspiration to expiration (ie-type NNS; P < 0.001 vs. air and hypoxia). In conclusion, whereas hypercapnia increases overall NNS frequency by specifically increasing ie-type NNS, hypoxia has the inverse tendency. Results were identical in all three states of alertness. [ABSTRACT FROM AUTHOR]- Published
- 2007
- Full Text
- View/download PDF
34. Treatment with desipramine improves breathing and survival in a mouse model for Rett syndrome.
- Author
-
Roux, Jean‐Christophe, Dura, Emmanuelle, Moncla, Anne, Mancini, Josette, and Villard, Laurent
- Subjects
- *
RETT syndrome , *ANIMAL models in research , *NEUROLOGY , *CARRIER proteins , *NORADRENALINE , *MICE , *THERAPEUTICS - Abstract
Rett syndrome (RS) is a severe X-linked neurological disorder in which most patients have mutations in the methyl-CpG binding protein2 ( MECP2) gene. No effective treatment exists. We previously showed that the Mecp2-deficient mice, a mouse model of RS, have highly variable respiratory rhythm and frequent apneas due to reduced norepinephrine (NE) content, and a drastic decrease of tyrosine hydroxylase (TH)-expressing neurons in the medulla. We showed here that treating these mice with desipramine (DMI), which specifically inhibits NE reuptake, significantly improved their respiratory rhythm during several weeks. In addition, the treatment significantly extended their lifespan. At the cellular level, we showed that the reduced number of TH-expressing neurons before treatment in the mutant animals was not due to apoptosis. Conversely, we found that DMI treatment increased the number of TH-expressing neurons in the mutant brainstem to reach wild-type levels. We showed that this increase was not due to cellular proliferation. We propose that the Mecp2-deficient TH-expressing neurons lose their ability to synthesize TH at some point during their postnatal development. Our results suggest that a pharmacological stimulation of the noradrenergic system could be a promising approach for the treatment of the respiratory dysfunction which causes a significant proportion of death in RS patients. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
35. Cardiovascular Disorders and Obstructive Sleep Apnea Syndrome.
- Author
-
Coccagna, Giorgio, Pollini, Antonella, and Provini, Federica
- Subjects
- *
CARDIOVASCULAR diseases , *SLEEP apnea syndromes , *HEART diseases , *RESPIRATION , *HYPERTENSION , *CORONARY disease - Abstract
The first polysomnographic recordings with concomitant monitoring of cardiocirculatory parameters demonstrated that obstructive apneas arising during sleep are accompanied by a marked increase in pulmonary and systemic arterial pressure and severe alveolar hypoventilation. Apneas also may give rise to cardiac arrhythmias, namely potentially life-threatening bradyarrhythmias. The long-term repercussions of these nocturnal cardiocirculatory changes on subsequent cardiovascular diseases and the patient's life expectancy are more controversial. There is little doubt that patients with obstructive sleep apnea syndrome (OSAS) have systemic arterial hypertension, ischemic heart disease, transient ischemic attacks, or stroke more often than control populations and have a shorter life expectancy. However, these clinical manifestations may be at least partly due to myriad other risk factors almost always present in OSAS patients (in particular obesity, diabetes, alcoholism, and cigarette smoking). Few multivariate epidemiological surveys have addressed all these confounding factors. The effectiveness of continuous positive airway pressure treatment in reducing the incidence of cardiovascular comorbidity in OSAS patients is not disputed, even though controlled epidemiological surveys on large populations are scant. This overview of cardiovascular disorders and OSAS examines the latest literature findings aimed at establishing the true impact of nocturnal apneas on cardiocirculatory disease (systemic arterial hypertension, ischemic heart disease, stroke, pulmonary hypertension and right heart failure and mortality). [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
36. Intermittent hypoxia augments carotid body and ventilatory response to hypoxia in neonatal rat pups.
- Author
-
Ying-Jie Peng, Rennison, Julie, and Prabhakar, Nanduri R.
- Subjects
NEWBORN infants ,HYPOXEMIA ,CAROTID body ,CHEMORECEPTORS ,REGULATION of respiration - Abstract
Carotid bodies are functionally immature at birth and exhibit poor sensitivity to hypoxia. Previous studies have shown that continuous hypoxia at birth impairs hypoxic sensing at the carotid body. Intermittent hypoxia (IH) is more frequently experienced in neonatal life. Previous studies on adult animals have shown that IH facilitates hypoxic sensing at the carotid bodies. On the basis of these studies, in the present study we tested the hypothesis that neonatal IH facilitates hypoxic sensing of the carotid body and augments ventilatory response to hypoxia. Experiments were performed on 2-day-old rat pups that were exposed to 16 h of IH soon after the birth. The IH paradigm consisted of 15 s of 5% O
2 (nadir) followed by 5 min of 21% O2 (9 episodes/h). In one group of experiments (IH and control, n = 6 pups each), sensory activity was recorded from ex vivo carotid bodies, and in the other (IH and control, n = 7 pups each) ventilation was monitored in unanesthetized pups by plethysmography. In control pups, sensory response of the carotid body was weak and was slow in onset (∼100 s). In contrast, carotid body sensory response to hypoxia was greater and the time course of the response was faster (-30 s) in IH compared with control pups. The magnitude of the hypoxic ventilatory response was greater in IH compared with control pups, whereas changes in O2 consumption and CO2 production during hypoxia were comparable between both groups. The magnitude of ventilatory stimulation by hyperoxic hypercapnia (7% CO2 -balance O2 ), however, was the same between both groups of pups. These results demonstrate that neonatal IH facilitates carotid body sensory response to hypoxia and augments hypoxic ventilatory chemoreflex. [ABSTRACT FROM AUTHOR]- Published
- 2004
- Full Text
- View/download PDF
37. Detection of delay time between the alterations of cardiac rhythm and periodic breathing
- Author
-
Figliola, A., Rosso, O.A., and Serrano, E.
- Subjects
- *
PHYSIOLOGY , *WAVELETS (Mathematics) , *FOURIER analysis , *WAVE packets - Abstract
Analysis of time-series multichannel physiological data were performed using wavelets. Wavelet provides a time-scale description and lead us to decompose any signal into frequency bands. A better precision in the frequency domain is often necessary to detect stationary phenomena or characterize time–frequency structures. A natural idea is to combine wavelet analysis with local Fourier analysis using an appropriate strategy: the wave packets. In this paper, we apply trigonometric wave packets to determine the time lag between the start of the apneas in the breathing and the consistent disorder in the cardiac rhythm. We show that breathing dynamic drives the evolution of the cardiac rhythm. [Copyright &y& Elsevier]
- Published
- 2003
- Full Text
- View/download PDF
38. Beyond resistant hypertension
- Author
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Martínez-García, Miguel Ángel, Navarro-Soriano, Cristina, Torres, Gerard, Barbé, Ferrán, Caballero-Eraso, Candela, Lloberes, Patricia, Diaz-Cambriles, Teresa, Somoza, María, Masa, Juan F., González, Mónica, Mañas, Eva, Peña, Mónica de la, García-Río, Francisco, Montserrat, Josep M., Muriel, Alfonso, Selma-Ferrer, Maria Jose, García-Ortega, Alberto, Campos-Rodríguez, Francisco, Martínez-García, Miguel Ángel, Navarro-Soriano, Cristina, Torres, Gerard, Barbé, Ferrán, Caballero-Eraso, Candela, Lloberes, Patricia, Diaz-Cambriles, Teresa, Somoza, María, Masa, Juan F., González, Mónica, Mañas, Eva, Peña, Mónica de la, García-Río, Francisco, Montserrat, Josep M., Muriel, Alfonso, Selma-Ferrer, Maria Jose, García-Ortega, Alberto, and Campos-Rodríguez, Francisco
- Abstract
Obstructive sleep apnea (OSA) is an independent cause of resistant hypertension (RH) but its association with refractory hypertension (RfH), a recently described form of severe hypertension, has not yet been investigated. This study seeks to analyze the association between the presence and severity of OSA/OSA syndrome with RfH and to compare it with a group of patients with OSA/OSA syndrome and RH. We conducted a multicenter, cross-sectional study of consecutive patients diagnosed with RH by means of 24-hour ambulatory blood pressure monitoring. Those patients with blood pressure levels ≥130/80 mm Hg, despite taking at least 5 antihypertensive drugs, were considered to have true RfH. All patients underwent a sleep study and completed a detailed clinical history related to OSA, current medication, and cardiovascular diseases. Overall, 229 patients were included (mean age, 58.3 years; 63% male), of whom 42 (18.3%) satisfied the criteria for RfH. Compared with those with RH, patients with RfH had a higher cardiovascular risk profile, higher blood pressure measurements, and a 2-fold greater risk of having both severe OSA (odds ratio, 2.1, with a prevalence of apnea-hypopnea index ≥15, 95.2% and apnea-hypopnea index ≥30, 64.3%) and OSA syndrome (apnea-hypopnea index ≥5+Epworth Sleepiness Scale >10; odds ratio, 1.9; 52.4% versus 37.3%; P=0.023), as well as higher OSA severity (apnea-hypopnea index, 41.8 versus 33.8 events/h; P=0.026). Patients with RfH had an even greater prevalence and severity of OSA and OSA syndrome than RH patients, highlighting the need to identify these patients to refer them to sleep units on a preferential basis.
- Published
- 2018
39. Relationship between refractory hypertension and obstructive sleep apnea
- Author
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Martínez-García, Miguel Ángel, Navarro-Soriano, Cristina, Torres, Gerard, Barbé, Ferrán, Caballero-Eraso, Candela, Lloberes, Patricia, Diaz-Cambriles, Teresa, Somoza, María, Masa, Juan F., González, Mónica, Mañas, Eva, Peña, Mónica de la, García-Río, Francisco, Montserrat, Josep M., Muriel, Alfonso, Selma-Ferrer, Maria Jose, García-Ortega, Alberto, and Campos-Rodríguez, Francisco
- Subjects
Apneas ,Cardiovascular diseases ,hypertension ,stomatognathic system ,prevalence ,Blood pressure ,nervous system diseases ,respiratory tract diseases - Abstract
Obstructive sleep apnea (OSA) is an independent cause of resistant hypertension (RH) but its association with refractory hypertension (RfH), a recently described form of severe hypertension, has not yet been investigated. This study seeks to analyze the association between the presence and severity of OSA/OSA syndrome with RfH and to compare it with a group of patients with OSA/OSA syndrome and RH. We conducted a multicenter, cross-sectional study of consecutive patients diagnosed with RH by means of 24-hour ambulatory blood pressure monitoring. Those patients with blood pressure levels ≥130/80 mm Hg, despite taking at least 5 antihypertensive drugs, were considered to have true RfH. All patients underwent a sleep study and completed a detailed clinical history related to OSA, current medication, and cardiovascular diseases. Overall, 229 patients were included (mean age, 58.3 years; 63% male), of whom 42 (18.3%) satisfied the criteria for RfH. Compared with those with RH, patients with RfH had a higher cardiovascular risk profile, higher blood pressure measurements, and a 2-fold greater risk of having both severe OSA (odds ratio, 2.1, with a prevalence of apnea-hypopnea index ≥15, 95.2% and apnea-hypopnea index ≥30, 64.3%) and OSA syndrome (apnea-hypopnea index ≥5+Epworth Sleepiness Scale >10; odds ratio, 1.9; 52.4% versus 37.3%; P=0.023), as well as higher OSA severity (apnea-hypopnea index, 41.8 versus 33.8 events/h; P=0.026). Patients with RfH had an even greater prevalence and severity of OSA and OSA syndrome than RH patients, highlighting the need to identify these patients to refer them to sleep units on a preferential basis.
- Published
- 2018
40. Diagnóstico de los trastornos respiratorios del sueño en recién nacidos con sospecha de apneas: comparación entre la saturometría nocturna y la poligrafía
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Valentina Díaz, Aldo Bancalari, Daniel Zenteno, Pablo E. Brockmann, Ximena Navarro, and Iván Rodríguez-Núñez
- Subjects
medicine.medical_specialty ,poligrafía ,02 engineering and technology ,Hypoxemia ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Screening method ,Neonatology ,apneas ,Saturometría nocturna continua ,business.industry ,Apnea ,020206 networking & telecommunications ,Predictive value ,Confidence interval ,recién nacidos ,Recien nacido ,Pediatrics, Perinatology and Child Health ,Cardiology ,medicine.symptom ,business ,Pneumonology - Abstract
Resumen Introducción: La Saturometría Nocturna Continua (SpChC), es utilizada en Unidades de Neonato logia para detección de eventos de hipoxemia en Recién Nacidos (RN) con episodios de apneas. La Poligrafía (PG) presenta un número mayor de canales de medición. El objetivo fue evaluar el rendi miento diagnóstico de la SpOhC respecto a la Poligrafía en RN con sospecha de apneas. Pacientes y Método: Se analizaron retrospectivamente resultados de SpOhC y PG realizadas en forma simultáneas en RN con sospecha de apneas, en un periodo de tres años. Se utilizó un saturómetro Masimo Radi-cal-7® con 2 canales y un polígrafo Apnea Link Plus® con 5 canales de registro simultáneos. Se con sideró PG alterada: índice de desaturaciones bajo 80% por hora > a 1 y/o número de desaturaciones bajo 80% > 20 segundos mayor a uno en todo el registro validado y/o índice de apnea hipoapnea > a 1 evento por hora. Paralelamente, se definió SpOhC alterada cuando uno o ambos de los criterios de saturometria bajo 80%, estaban alterados. Se calcularon valores de sensibilidad, especificidad, valores predictivos y Likelihood Ratio (LLR) para la SpÜ2C. Los resultados se expresaron en valor absoluto, con 95% de intervalo de confianza. Resultados: Se realizaron 40 SpÜ2C y PG simultáneos; un 80% (32/40) de ellos fueron RN prematuros, 60% (24/40) varones. Un 38% (15/40) de las SpOhC y un 15% (6/40) de las PG resultaron alteradas (p < 0,05). La SpÜ2C presenta una Sensibilidad 100%, Especificidad 74%, El VPP 40%, VPN 100%, LLR + 3,78 y LLR-0. Conclusión: En los RN estudiados, la SpC2C posee un alto valor diagnóstico, sin embargo, puede presentar falsos positivos; por lo cual se sugiere utilizar como método de tamizaje y realizar confirmación diagnóstica con otro examen de sueño, como la PG.
- Published
- 2017
41. Diagnóstico de los trastornos respiratorios del sueño en recién nacidos con sospecha de apneas: comparación entre la saturometría nocturna y la poligrafía
- Author
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Zenteno, Daniel, Bancalari, Aldo, Navarro, Ximena, Díaz, Valentina, Rodríguez-Núñez, Iván, and Brockmann, Pablo
- Subjects
polygraphy ,recién nacidos ,newborns ,poligrafía ,Continuous nocturnal saturometry ,apneas ,Saturometría nocturna continua - Abstract
Resumen Introducción: La Saturometría Nocturna Continua (SpChC), es utilizada en Unidades de Neonato logia para detección de eventos de hipoxemia en Recién Nacidos (RN) con episodios de apneas. La Poligrafía (PG) presenta un número mayor de canales de medición. El objetivo fue evaluar el rendi miento diagnóstico de la SpOhC respecto a la Poligrafía en RN con sospecha de apneas. Pacientes y Método: Se analizaron retrospectivamente resultados de SpOhC y PG realizadas en forma simultáneas en RN con sospecha de apneas, en un periodo de tres años. Se utilizó un saturómetro Masimo Radi-cal-7® con 2 canales y un polígrafo Apnea Link Plus® con 5 canales de registro simultáneos. Se con sideró PG alterada: índice de desaturaciones bajo 80% por hora > a 1 y/o número de desaturaciones bajo 80% > 20 segundos mayor a uno en todo el registro validado y/o índice de apnea hipoapnea > a 1 evento por hora. Paralelamente, se definió SpOhC alterada cuando uno o ambos de los criterios de saturometria bajo 80%, estaban alterados. Se calcularon valores de sensibilidad, especificidad, valores predictivos y Likelihood Ratio (LLR) para la SpÜ2C. Los resultados se expresaron en valor absoluto, con 95% de intervalo de confianza. Resultados: Se realizaron 40 SpÜ2C y PG simultáneos; un 80% (32/40) de ellos fueron RN prematuros, 60% (24/40) varones. Un 38% (15/40) de las SpOhC y un 15% (6/40) de las PG resultaron alteradas (p < 0,05). La SpÜ2C presenta una Sensibilidad 100%, Especificidad 74%, El VPP 40%, VPN 100%, LLR + 3,78 y LLR-0. Conclusión: En los RN estudiados, la SpC2C posee un alto valor diagnóstico, sin embargo, puede presentar falsos positivos; por lo cual se sugiere utilizar como método de tamizaje y realizar confirmación diagnóstica con otro examen de sueño, como la PG. Abstract Introduction: Night Continuous Saturometry (CSO2) is used in Neonatal Units to detect events of hypoxemia in Newborns (NB) with apnea episodes. Polygraphy (PG) has a larger number of measuring channels. Our goal was to evaluate the diagnostic performance of CSO2 compared to Polygra phy in NB with suspected sleep apneas. Patients and Method: Results of CSO2 and PG performed simultaneously in RN with suspected apneas were retrospectively analyzed over a three-year period. A 2-channel Masimo Radical-7® pulse oximeter and an Apnea Link Plus® polygraph with 5 simulta neous recording channels were used. Altered PG was defined as: desaturation index under 80% per hour > 1 and/or number of desaturations under 80% > 20 seconds greater than one in the whole va lidated registry and/or hypoapnea apnea index > 1 event per hour. In parallel, altered SpO2C was de fined when one or both of the 80% saturation criteria were altered. Sensitivity, specificity, predictive values and Likelihood Ratio (LLR) for CSO2 were calculated. Results were expressed in absolute value, with 95% confidence interval. Results: Simultaneous 40 CSO2 and PG were performed; 80% (32/40) of them were preterm infants, 60% (24/40) males. 38% (15/40) of the CSO2 and 15% (6/40) of the PGs were altered (p < 0.05). CSO2 has a 100% Sensitivity, 74% Specificity, 40% VPP, 100% VPN, LLR + 3.78 and LLR-0. Conclusion: In the studied NB, CSO2 has a high diagnostic value, however, it may present false positives; It is suggested to use as a screening method and to perform diagnostic confirmation with another sleep test, such as PG.
- Published
- 2017
42. Herzrhythmusstörungen bei unreifen und reifen Neugeborenen.
- Author
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Diekmann, L.
- Abstract
Copyright of Zeitschrift für Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 1970
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43. Cardiorespiratory Events in Infants Born Preterm during the Transitional Period.
- Author
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Martini, Silvia, Frabboni, Giulia, Rucci, Paola, Czosnyka, Marek, Smielewski, Peter, Galletti, Silvia, Vitali, Francesca, Faldella, Giacomo, Austin, Topun, and Corvaglia, Luigi
- Abstract
Objective: To investigate the features of cardiorespiratory events in infants born preterm during the transitional period, and to evaluate whether different neonatal characteristics may correlate with event type, duration, and severity.Study Design: Infants with gestational age (GA) <32 weeks and/or birth weight <1500 g were enrolled in this observational prospective study. Heart rate (HR) and peripheral oxygen saturation (SpO2) were recorded continuously over the first 72 hours. Cardiorespiratory events of ≥10 seconds were clustered into isolated desaturation (SpO2 <85%), isolated bradycardia (HR <100 bpm or <70% of baseline), or combined desaturation/bradycardia and classified as mild, moderate, or severe. The daily incidences of isolated desaturation, isolated bradycardia, and combined desaturation and bradycardia were analyzed. The effects of relevant clinical variables on cardiorespiratory event type and severity were assessed using generalized estimating equations.Results: Among the 1050 events analyzed, isolated desaturations were the most frequent (n = 625) and isolated bradycardias the least common (n = 171). The number of cardiorespiratory events increased significantly from day 1 to day 2 (P = .028). One in 5 events had severe characteristics; event severity was highest for combined desaturation and bradycardia (P < .001). Compared with other event types, the incidence of combined desaturation and bradycardia was inversely correlated with GA (P = .029) and was higher with the use of continuous positive airway pressure (P = .002). The presence of a hemodynamically significant patent ductus arteriosus was associated with the occurrence of isolated desaturations (P = .001) and with a longer duration of cardiorespiratory events (P = .003).Conclusions: Cardiorespiratory events during transition exhibit distinct types, duration, and severity. Neonatal characteristics are associated with the clinical features of these events, indicating that a tailored clinical approach may reduce the hypoxic burden in preterm infants aged 0-72 hours. [ABSTRACT FROM AUTHOR]- Published
- 2020
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44. Neural crest-specific deletion of Bmp7 leads to midfacial hypoplasia, nasal airway obstruction, and disordered breathing modelling Obstructive Sleep Apnea.
- Author
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Baddam P, Biancardi V, Roth DM, Eaton F, Thereza-Bussolaro C, Mandal R, Wishart DS, Barr A, MacLean J, Flores-Mir C, Pagliardini S, and Graf D
- Abstract
Pediatric obstructive sleep apnea (OSA), a relatively common sleep-related breathing disorder (SRBD) affecting approximately 1-5% of children, is often caused by anatomical obstruction and/or collapse of the nasal and/or pharyngeal airways. The resulting sleep disruption and intermittent hypoxia lead to various systemic morbidities. Predicting the development of OSA from craniofacial features alone is currently not possible and a controversy remains if upper airway obstruction facilitates reduced midfacial growth or vice-versa. Currently, there is no rodent model that recapitulates both the development of craniofacial abnormalities and upper airway obstruction to address these questions. Here, we describe that mice with a neural crest-specific deletion of Bmp7 (Bmp7
ncko ) present with shorter, more acute angled cranial base, midfacial hypoplasia, nasal septum deviation, turbinate swelling and branching defects, and nasal airway obstruction. Interestingly, several of these craniofacial features develop after birth during periods of rapid midfacial growth and precede the development of an upper airway obstruction. We identified that in this rodent model, no single feature appeared to predict upper airway obstruction, but the sum of those features resulted in a reduced breathing frequency, apneas and overall reduced oxygen consumption. Metabolomics analysis of serum from peripheral blood identified increased levels of hydroxyproline, a metabolite upregulated under hypoxic conditions. As this model recapitulates many features observed in OSA, it offers unique opportunities for studying how upper airway obstruction affects breathing physiology and leads to systemic morbidities., (© 2021. Published by The Company of Biologists Ltd.)- Published
- 2021
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45. Guías prácticas de diagnóstico y tratamiento del síndrome de apneas e hipopneas obstructivas del sueño
- Author
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Facundo Nogueira, Carlos Nigro, Hugo Cambursano, Eduardo Borsini, Julio Silio, and Jorge Ávila
- Subjects
lcsh:Immunologic diseases. Allergy ,Apneas ,Polisomnografía ,lcsh:R ,Guías ,lcsh:Medicine ,lcsh:RC109-216 ,lcsh:RC581-607 ,Hipersomnolencia ,lcsh:Infectious and parasitic diseases - Abstract
El síndrome de apneas e hipopneas obstructivas del sueño (SAHOS) constituye una de las afecciones respiratorias crónicas de mayor relevancia, dada su elevada prevalencia en la población general y sus consecuencias clínicas. En 2001 la Asociación Argentina de Medicina Respiratoria (AAMR) publicó el Primer Consenso Argentino de Trastornos Respiratorios Vinculados al Sueño. Desde entonces se ha generado una gran cantidad de evidencia científica sobre esta enfermedad. Por tal motivo, la Sección Sueño, Oxigenoterapia y otros Cuidados Respiratorios Domiciliarios de la AAMR, se propuso actualizar su Consenso confeccionando estas Guías Prácticas de tratamiento de pacientes con SAHOS. Un grupo de trabajo de la Sección, expertos y especialistas en el tema, revisó la bibliografía y confeccionó estas guías orientadas a la resolución práctica de problemas clínicos que pueden surgir de la atención de pacientes con este síndrome. En su desarrollo se define el cuadro, los criterios diagnósticos y de gravedad; a su vez se describen sus factores de riesgo, las formas de presentación, epidemiología y consecuencias, fundamentalmente los efectos sobre la capacidad cognitiva, el aparato cardio-vascular y el metabolismo. Se detalla la metodología diagnóstica, sus distintas variables e indicaciones y los requisitos técnicos para su validación e interpretación. Por último se desarrollan las alternativas terapéuticas, así como también aspectos prácticos de su implementación. La intención de los autores ha sido la de generar una herramienta accesible de formación y difusión de estos trastornos que afectan la salud de la población.
- Published
- 2013
46. Framing multiple sclerosis under a polysomnographic perspective.
- Author
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Tanioka K, Castelnovo A, Tachibana N, Miano S, Zecca C, Gobbi C, and Manconi M
- Subjects
- Humans, Polysomnography, Sleep, Multiple Sclerosis complications, Multiple Sclerosis epidemiology, Restless Legs Syndrome, Sleep Wake Disorders diagnosis, Sleep Wake Disorders epidemiology
- Abstract
Multiple sclerosis (MS) is a mainly demyelinating, autoimmune, and disabling neurological disease. In addition to well-known clinically evident symptoms such as coordination or motor problems, increasing attention has been posed to a constellation of less evident symptoms significantly contributing to the clinical impact of MS. Among others, sleep symptoms have been only recently explored. This systematic review summarizes objective sleep findings detected by using polysomnography and their relationship with clinical variables in MS patients. While it is well known that sleep disorders are frequent in MS, objective clinical data are still scarce. Literature based on subjective reports indicate sleep disorders as highly frequent in MS patients; however, objective data are still scarce. New large case-control instrumental investigations are warranted to establish the real objective entity and impact of sleep comorbidities., (© Sleep Research Society 2019. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.)
- Published
- 2020
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- View/download PDF
47. Evaluation of adaptation to noninvasive ventilation in patients with chronic respiratory failure
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Naeck, Roomila, Naeck, Roomila, Unité de Recherche Clinique du CHITS, Laboratoire des Sciences de l'Information et des Systèmes (LSIS), Aix Marseille Université (AMU)-Université de Toulon (UTLN)-Arts et Métiers Paristech ENSAM Aix-en-Provence-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Université de Toulon (UTLN)-Arts et Métiers Paristech ENSAM Aix-en-Provence-Centre National de la Recherche Scientifique (CNRS), Université de Rouen, Christophe Letellier, Antoine Cuvelier, and Centre National de la Recherche Scientifique (CNRS)-Arts et Métiers Paristech ENSAM Aix-en-Provence-Université de Toulon (UTLN)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Arts et Métiers Paristech ENSAM Aix-en-Provence-Université de Toulon (UTLN)-Aix Marseille Université (AMU)
- Subjects
[PHYS]Physics [physics] ,covariance croisée ,[SPI] Engineering Sciences [physics] ,noninvasive ventilation ,polysomnographie ,[PHYS] Physics [physics] ,cross covariance ,[SPI]Engineering Sciences [physics] ,polysomnography ,insuffisance respiratoire ,sommeil ,[NLIN] Nonlinear Sciences [physics] ,[NLIN]Nonlinear Sciences [physics] ,apneas ,sleep ,chronic respiratory failure ,apnées ,ventilation non-invasive - Abstract
A decrease in the efficiency of the ventilatory mecanic leads to chronic respiratory failure. So far, the treatment that has been priviledged consists in a noninvasive ventilation, used mostly at night during sleep time. The aim of this work is to study the impact that the noninvasive ventilation has on the organism, which means studying its impact on the quality of breath as well as the quality of sleep. The mechanisms underlying patient-ventilator interactions and the influences of these mechanisms are considered and quantified. To do so, two studies based on polysomnography were carried out. During a preliminary retrospective study, synoptics were made which allowed us to have a global visualization of the events occuring during the night, by the simultaneous representation of the recording variables during the polysomnography. We were then able to quantify the connections between the various patient-ventilator asynchronisms and the non-intentional leaks. Four different patient-ventilator types of interactions could thus be highlighted. A second study, prospective this time, was carried out on how patients who suffer from chronic ventilatory failure can adapt themselves to non-invasive ventilation during the initiation period. This study was based on the analysis of three polysomnographies : one was made during the first night at the hospital under spontaneous breathing, the second one was made during the second night under noninvasive ventilation and the third one was made15 days later. An individual analysis could then be carried out, based on the interpretation of the synoptics of each patient, and a global analysis was performed as well through a statistic approach. A Shannon entropy calculated on recurrence plot, was also used to estimate the quality of sleep. During the initiation of long-term noninvasive ventilation, ventilatory parameters (oxymetry and capnography) were improved, patients showed a progressive increase of the time spent in REM sleep and the sleep fragmentation was reduced thanks to a correction of obstructive sleep apneas. Under noninvasive ventilation, cardiac variability, estimated with a Shannon entropy based on a symbolic dynamic, was significantly reduced. Only a few effects of the asynchronisms on ventilation quality were noticed in this study., Résumé.La diminution de l’efficacité de la mécanique ventilatoire entraîne une insuffisance respiratoire chronique. A ce jour, le traitement privilégié consiste en une assistance ventilatoire non invasive, essentiellement utilisée la nuit. L’objectif de ce travail est d’étudier les influences de la ventilation non invasive sur l’organisme non seulement du point de vue de la qualité de la respiration, mais aussi sur la qualité du sommeil. Les mécanismes sous-jacents aux interactions patient-ventilateur et leurs influences sont pris en compte et quantifiés. Pour cela, deux études basées sur des polysomnographies ont été effectuées. Lors d’une première étude rétrospective, des synoptiques permettant une visualisation globale des événements au cours de la nuit par la représentation simultanée des variables enregistrées lors de la polysomnographie ont été construits. Ensuite, nous avons quantifié les relations entre les différents asynchronismes patient-ventilateur et les fuites non intentionnelles. Quatre types d’interactions patient-ventilateur ont ainsi pu être mis en évidence. Une seconde, prospective, a été conduite sur l’adaptation des patients à la ventilation non invasive lors de sa mise en place chez des patients atteints d’insuffisance respiratoire chronique. Reposant sur trois polysomnographies respectivement réalisées lors de la première nuit à l’hôpital en ventilation spontanée, lors de la deuxième à l’hôpital sous assistance ventilatoire non invasive et lors d’une troisième nuit à l ?hôpital, 15 jours après l’appareillage. Une analyse individuelle a été effectuée par l’interprétation des synoptiques de chacun des patients, et une analyse globale a été effectuée par une approche statistique. Une entropie de Shannon, calculée à partir de diagrammes de proche-retour, a également été utilisée pour estimer la qualité du sommeil. La mise en place de la ventilation se traduit par une amélioration des paramètres ventilatoires (oxymétrie et capnographie), une amélioration voire une restauration du temps passé en sommeil paradoxal, et une diminution de la fragmentation du sommeil par la correction des apnées obstructives. Sous ventilation, la variabilité cardiaque, estimée à partir d’une entropie de Shannon calculée sur la base d’une dynamique symbolique, diminue significativement. Peu d’effets des asynchronismes sur la qualité de la ventilation ont été notés au cours de cette étude.
- Published
- 2011
48. Use of computerized visual performance test in assessing day-time vigilance in patients with sleep apneas and restless sleep
- Author
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Jokinen, Tapio, Salmi, Tapani, Ylikoski, Anne, and Partinen, Markku
- Published
- 1995
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49. Polysomnographic reference curves for the first and second year of life
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Schlüter, Bernhard, Buschatz, Dirk, and Trowitzsch, Eckardt
- Published
- 2001
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50. Effects of ion channel noise on neural circuits: an application to the respiratory pattern generator to investigate breathing variability.
- Author
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Yu H, Dhingra RR, Dick TE, and Galán RF
- Subjects
- Action Potentials physiology, Animals, Humans, Respiratory Physiological Phenomena, Central Pattern Generators cytology, Ion Channels physiology, Models, Neurological, Neurons physiology, Respiration
- Abstract
Neural activity generally displays irregular firing patterns even in circuits with apparently regular outputs, such as motor pattern generators, in which the output frequency fluctuates randomly around a mean value. This "circuit noise" is inherited from the random firing of single neurons, which emerges from stochastic ion channel gating (channel noise), spontaneous neurotransmitter release, and its diffusion and binding to synaptic receptors. Here we demonstrate how to expand conductance-based network models that are originally deterministic to include realistic, physiological noise, focusing on stochastic ion channel gating. We illustrate this procedure with a well-established conductance-based model of the respiratory pattern generator, which allows us to investigate how channel noise affects neural dynamics at the circuit level and, in particular, to understand the relationship between the respiratory pattern and its breath-to-breath variability. We show that as the channel number increases, the duration of inspiration and expiration varies, and so does the coefficient of variation of the breath-to-breath interval, which attains a minimum when the mean duration of expiration slightly exceeds that of inspiration. For small channel numbers, the variability of the expiratory phase dominates over that of the inspiratory phase, and vice versa for large channel numbers. Among the four different cell types in the respiratory pattern generator, pacemaker cells exhibit the highest sensitivity to channel noise. The model shows that suppressing input from the pons leads to longer inspiratory phases, a reduction in breathing frequency, and larger breath-to-breath variability, whereas enhanced input from the raphe nucleus increases breathing frequency without changing its pattern., New & Noteworthy: A major source of noise in neuronal circuits is the "flickering" of ion currents passing through the neurons' membranes (channel noise), which cannot be suppressed experimentally. Computational simulations are therefore the best way to investigate the effects of this physiological noise by manipulating its level at will. We investigate the role of noise in the respiratory pattern generator and show that endogenous, breath-to-breath variability is tightly linked to the respiratory pattern., (Copyright © 2017 the American Physiological Society.)
- Published
- 2017
- Full Text
- View/download PDF
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