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3. Efficacy of Home Single-Channel Nasal Pressure for Recommending Continuous Positive Airway Pressure Treatment in Sleep Apnea

Author

Masa, Juan F., Duran-Cantolla, Joaquin, Capote, Francisco, Cabello, Marta, Abad, Jorge, Garcia-Rio, Francisco, Ferrer, Antoni, Fortuna, Ana M., Gonzalez-Mangado, Nicolas, de la Peña, Monica, Aizpuru, Felipe, Barbe, Ferran, Montserrat, Jose M., Larrateguy, Luis D., de Castro, Jorge Rey, Garcia-Ledesma, Estefania, Corral, Jaime, Martin-Vicente, Maria J., Martinez-Null, Cristina, Egea, Carlos, Cancelo, Laura, García-Díaz, Emilio, Carmona-Bernal, Carmen, Sánchez-Armengol, Ángeles, Mayos, Merche, Miralda, Rosa M, Troncoso, Maria F., Gonzalez, Monica, Martinez-Martinez, Marian, Cantalejo, Olga, Piérola, Javier, Vigil, Laura, Embid, Cristina, del Mar Centelles, Mireia, Prieto, Teresa Ramírez, Rojo, Blas, and Lores, Vanesa

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, portable monitor, medicine.medical_treatment, Polysomnography, Apnealink, Nose, Young Adult, CPAP, Physiology (medical), Internal medicine, medicine, Pressure, Humans, Continuous positive airway pressure, Aged, Aged, 80 and over, Sleep Apnea, Obstructive, Receiver operating characteristic, medicine.diagnostic_test, Continuous Positive Airway Pressure, business.industry, Home Single-Channel Nasal Pressure for Recommending CPAP Treatment, Area under the curve, Sleep apnea, Middle Aged, sleep apnea, medicine.disease, nervous system diseases, respiratory tract diseases, Clinical trial, Obstructive sleep apnea, medicine.anatomical_structure, Editorial, ROC Curve, Anesthesia, Area Under Curve, Female, Neurology (clinical), business
Abstract

Introduction Unlike other prevalent diseases, obstructive sleep apnea (OSA) has no simple tool for diagnosis and therapeutic decision-making in primary healthcare. Home single-channel nasal pressure (HNP) may be an alternative to polysomnography for diagnosis but its use in therapeutic decisions has yet to be explored. Objectives To ascertain whether an automatically scored HNP apnea-hypopnea index (AHI), used alone to recommend continuous positive airway pressure (CPAP) treatment, agrees with decisions made by a specialist using polysomnography and several clinical variables. Methods Patients referred by primary care physicians for OSA suspicion underwent randomized polysomnography and HNP. We analyzed the total sample and both more and less symptomatic subgroups for Bland and Altman plots to explore AHI agreement; receiver operating characteristic curves to establish area under the curve (AUC) measurements for CPAP recommendation; and therapeutic decision efficacy for several HNP AHI cutoff points. Results Of the 787 randomized patients, 35 (4%) were lost, 378 (48%) formed the more symptomatic and 374 (48%) the less symptomatic subgroups. AHI bias and agreement limits were 5.8 ± 39.6 for the total sample, 5.3 ± 38.7 for the more symptomatic, and 6 ± 40.2 for the less symptomatic subgroups. The AUC were 0.826 for the total sample, 0.903 for the more symptomatic, and 0.772 for the less symptomatic subgroups. In the more symptomatic subgroup, 70% of patients could be correctly treated with CPAP. Conclusion Automatic HNP scoring can correctly recommend CPAP treatment in most of more symptomatic patients with OSA suspicion. Our results suggest that this device may be an interesting tool in initial OSA management for primary care physicians, although future studies in a primary care setting are necessary. Clinical trials information Clinicaltrial.gov identifier: NCT01347398.

Published
2015

4. Effectiveness of Three Sleep Apnea Management Alternatives

Author

Masa, Juan F., primary, Corral, Jaime, additional, de Cos, Julio Sanchez, additional, Duran-Cantolla, Joaquin, additional, Cabello, Marta, additional, Hernández-Blasco, Luis, additional, Monasterio, Carmen, additional, Alonso, Alberto, additional, Chiner, Eusebi, additional, Aizpuru, Felipe, additional, Vázquez-Polo, Francisco-José, additional, Zamorano, Jose, additional, Montserrat, Jose M., additional, Garcia-Ledesma, Estefania, additional, Pereira, Ricardo, additional, Cancelo, Laura, additional, Martinez, Angeles, additional, Sacristan, Lirios, additional, Salord, Neus, additional, Carrera, Miguel, additional, Sancho-Chust, José N., additional, Negrín, Miguel A., additional, and Embid, Cristina, additional

Published
2013
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5. Diagnosis Supersimplified of Patients With Suspected Obstructive Sleep Apnoea-hypopnoea (OSAH)

Author

Durán Cantolla, Joaquín, primary, Aizpuru, Felipe, additional, Egea, Carlos, additional, Miranda, Erika, additional, Rubio, Ramón, additional, Martínez-Null, Cristina, additional, Cancelo, Laura, additional, Álvarez, Ainhoa, additional, Leuza, Elena, additional, Larrañaga, Marian, additional, Ajuria, Isabel, additional, Capote, Francisco, additional, García, Emilio, additional, Sanchez-Armegol, Maria Angeles, additional, Mayos, Mercedes, additional, Fortuna, Ana, additional, Masa, Juan Fernando, additional, Rubio, Manola, additional, Abad, Jorge, additional, García-Río, Francisco, additional, Montserrat, Jose María, additional, Ballester, Eugeni, additional, Centelles, María del Mar, additional, Gonzalez, Mónica, additional, Cabello, Marta, additional, Queipo, Carlos, additional, Ferrer, Antoni, additional, De La Peña, Monica, additional, Gonzalez-Mangado, Nicolas, additional, Troncoso, María, additional, Rey, Jorge, additional, Larrateguii, Luis, additional, and Barbe, Ferran, additional

Published
2010
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9. Effectiveness of home single-channel nasal pressure for sleep apnea diagnosis.

Author

Masa, Juan F, Duran-Cantolla, Joaquin, Capote, Francisco, Cabello, Marta, Abad, Jorge, Garcia-Rio, Francisco, Ferrer, Antoni, Mayos, Merche, Gonzalez-Mangado, Nicolas, de la Peña, Monica, Aizpuru, Felipe, Barbe, Ferran, Montserrat, Jose M, Larrateguy, Luis D, de Castro, Jorge Rey, Garcia-Ledesma, Estefania, Utrabo, Isabel, Corral, Jaime, Martinez-Null, Cristina, Egea, Carlos, Cancelo, Laura, García-Díaz, Emilio, Carmona-Bernal, Carmen, Sánchez-Armengol, Angeles, Fortuna, Ana M, Miralda, Rosa M, Troncoso, Maria F, Monica, Gonzalez, Martinez-Martinez, Marian, Cantalejo, Olga, Piérola, Javier, Vigil, Laura, Embid, Cristina, Del Mar Centelles, Mireia, Prieto, Teresa Ramírez, Rojo, Blas, and Vanesa, Lores

Abstract

Home single-channel nasal pressure (HNP) may be an alternative to polysomnography (PSG) for obstructive sleep apnea (OSA) diagnosis, but no cost studies have yet been carried out. Automatic scoring is simpler but generally less effective than manual scoring.

Published
2014
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10. Significance of including a surrogate arousal for sleep apnea-hypopnea syndrome diagnosis by respiratory polygraphy.

Author

Masa, Juan F, Corral, Jaime, Gomez de Terreros, Javier, Duran-Cantolla, Joaquin, Cabello, Marta, Hernández-Blasco, Luis, Monasterio, Carmen, Alonso, Alberto, Chiner, Eusebi, Aizpuru, Felipe, Zamorano, Jose, Cano, Ricardo, Montserrat, Jose M, Garcia-Ledesma, Estefania, Pereira, Ricardo, Cancelo, Laura, Martinez, Angeles, Sacristan, Lirios, Salord, Neus, and Carrera, Miguel

Published
2013
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11. [Community-acquired pneumonia due to Legionella pneumophila serogroup 1. Study of 97 cases].

Author

Benito JR, Montejo JM, Cancelo L, Zalacaín R, López L, Fernández Gil de Pareja J, Alonso E, and Oñate J

Subjects
Acute Kidney Injury blood, Acute Kidney Injury etiology, Adult, Aged, Anti-Bacterial Agents, Antigens, Bacterial blood, Antigens, Bacterial urine, Community-Acquired Infections drug therapy, Community-Acquired Infections epidemiology, Community-Acquired Infections microbiology, Comorbidity, Creatine Kinase blood, Drug Therapy, Combination therapeutic use, Female, Humans, Incidence, Legionella pneumophila classification, Legionella pneumophila immunology, Legionella pneumophila pathogenicity, Legionnaires' Disease diagnosis, Legionnaires' Disease drug therapy, Legionnaires' Disease microbiology, Male, Middle Aged, Pneumonia, Bacterial drug therapy, Pneumonia, Bacterial epidemiology, Pneumonia, Bacterial microbiology, Prognosis, Retrospective Studies, Risk Factors, Smoking epidemiology, Spain epidemiology, Legionella pneumophila isolation & purification, Legionnaires' Disease epidemiology
Abstract

Introduction: Legionella pneumophila is the causal agent of 5% to 12% of sporadic community-acquired pneumonia cases, though rates are changing with the use of new diagnostic methods., Methods: This is a retrospective study of all patients admitted to our hospital with community-acquired pneumonia due to Legionella pneumophila between 1997 and 2001. Diagnostic criteria included either a positive Legionella serogroup 1 urinary antigen test or seroconversion and a chest radiograph consistent with pneumonia., Results: A total of 97 patients were studied. Ninety cases (92.8%) were community-acquired and 7 (7.2%) were associated with travelling. In 82 cases (84.5%) the presentation was sporadic. Seventy-five patients were smokers (77.3%). The most common symptoms were fever in 91 patients (93.8%) and cough in 67 (68.1%). In five patients (5.2%) creatine phosphokinase concentrations were over 5 times their baseline values (in two over 100 times); four of these patients presented acute renal failure. Seroconversion was observed in 23/42 patients (54.8%). There were no statistically significant differences between the administration of erythromycin or clarithromycin in monotherapy, or in combination with rifampin. Nineteen patients (19.6%) presented acute renal failure and mechanical ventilation was necessary in 22 (22.7%). Twelve patients died (12.5%). Independent prognostic factors associated with death included respiratory rate > 30 breaths/min, urea > 60 mg/dL and PaO2 < 60 mmHg. A significant linear association was found between severity scale scores and the presence of complications or mortality., Conclusion: The Legionella urinary antigen test permits early diagnosis and treatment of this disease. The severity scale is an indicator of complications or death.

Published
2003

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