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respiratory. sleep medicine

Joseph D Tobias, Thomas P Green, Charles J Coté
Codeine has been prescribed to pediatric patients for many decades as both an analgesic and an antitussive agent. Codeine is a prodrug with little inherent pharmacologic activity and must be metabolized in the liver into morphine, which is responsible for codeine's analgesic effects. However, there is substantial genetic variability in the activity of the responsible hepatic enzyme, CYP2D6, and, as a consequence, individual patient response to codeine varies from no effect to high sensitivity. Drug surveillance has documented the occurrence of unanticipated respiratory depression and death after receiving codeine in children, many of whom have been shown to be ultrarapid metabolizers...
September 19, 2016: Pediatrics
Catherine Mary Hill, Annette Carroll, Dagmara Dimitriou, Johanna Gavlak, Kate Heathcote, Veline L'Esperance, Ana Baya, Rebecca Webster, Maria Pushpanathan, Romola Starr Bucks
STUDY OBJECTIVES: To compare polysomnographic parameters in high altitude (HA) native Andean children with low altitude (LA) native peers in order to explain the nocturnal oxyhemoglobin saturation (SpO2) instability reported in HA native children and to study the effect on sleep quality. METHODS: Ninety-eight healthy children aged 7-10 y and 13-16 y were recruited at LA (500 m) or HA (3650 m) above sea level. Physical examination was undertaken and genetic ancestry determined from salivary DNA to determine proportion of European ancestry, a risk factor for poor HA adaptation...
September 9, 2016: Sleep
David T Mage, Maria Luisa Latorre, Alejandro G Jenik, E Maria Donner
INTRODUCTION: The cause of the sudden infant death syndrome (SIDS) is perhaps the oldest of unsolved mysteries of medicine, possibly dating back to Exodus in Biblical times when Egyptian children died in their sleep as if from a plague. It occurs when infants die unexpectedly with no sufficient cause of death found in a forensic autopsy, including death scene investigation and review of medical history. That SIDS is an X-linked recessive death from infectious respiratory disease of a physiologically anemic infant and not a simple anomalous cardiac or neurological condition is an extraordinary claim that requires extraordinary evidence...
2016: Frontiers in Neurology
Lan Wang, Bigyan Pudasaini, Xue-Fen Wang
BACKGROUND: Occult bronchial foreign body can be very difficult to diagnose early in an adult patient without acute symptoms. This report describes a rare case of undetected Chinese medicine "Coptis chinensis" aspiration for 10 long years. METHODS: A case was reported that a female patient complained of a 10-year history of productive cough. A battery of tests were given to confirm the diagnosis. RESULTS: Chest computed tomography (CT) showed extensive bronchiectasis and multiple nodules, along with stenosis of left lower lobar bronchus...
August 2016: Medicine (Baltimore)
Reynolds Gaw, Carissa Yap, Sarah M Newhouse, Vinod Aiyappan
No abstract text is available yet for this article.
September 1, 2016: American Journal of Respiratory and Critical Care Medicine
Lu-jiao Gao, Xing-hua Bai
OBJECTIVE: To observe the curative effect of needling stimulation of the dorsal segment (7 spots below the spinous processes from T3 to T9) of the Governor Vessel for gastro-esophageal reflux disease (GERD). METHODS: A total of 60 cases of GERD patients were randomly divided into acupuncture group and medication group (n = 30 in each group). For patients of the acupuncture group, the depression spots below the spinous processes from T3 to T9, including both acupoints [Shenzhu (GV 12), Shendao (GV 11), Lingtai (GV 10), Zhiyang (GV 9), Jinsuo (GV 8)] and non-acupoints (T4, T8) were punctured with filiform needles, once every other day for 8 weeks...
April 2016: Zhen Ci Yan Jiu, Acupuncture Research
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Hartmut Schulz, Piero Salzarulo
For centuries the scope of sleep disorders in medical writings was limited to those disturbances which were either perceived by the sleeper him- or herself as troublesome, such as insomnia, or which were recognized by an observer as strange behavioral acts during sleep, such as sleepwalking or sleep terrors. Awareness of other sleep disorders, which are caused by malfunction of a physiological system during sleep, such as sleep-related respiratory disorders, were widely unknown or ignored before sleep monitoring techniques became available, mainly in the second half of the 20(th) century...
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Sanjana Pampati, Laxmaiah Manchikanti
BACKGROUND: In modern medicine, obstructive sleep apnea syndrome (OSAS) is a commonly described sleep disorder with airway obstruction, disrupted sleep, and excessive daytime sleepiness. Since its description in 1976 by Guilleminault et al, numerous epidemiologic studies and systematic reviews, with multiple comorbidities related to cardiovascular sequelae, altered cognitive function, and multiple other potential complications have been described. Multiple risk factors have been identified included obesity, smoking, alcohol consumption, and other factors...
May 2016: Pain Physician
Oana-Claudia Deleanu, Diana Pocora, Stefan Mihălcuţă, Ruxandra Ulmeanu, Ana-Maria Zaharie, Florin Dumitru Mihălţan
The various ill effects that tobacco smoking has on health have been largely studied, particularly on vascular, neoplastic, and respiratory diseases. Lately, the discussion about the negative impact of cigarette smoking moved towards sleep medicine. Tobacco consumption has been associated with sleep disordered architecture, both during regular intake and after withdrawal. Its effects on sleep disordered breathing (SDB) and especially obstructive sleep apnea syndrome (OSAS) still remain a matter of debate. It is unclear whether smoking represents a risk factor for OSAS or whether smoking cessation has any beneficial effects on OSAS and its therapy...
January 2016: Pneumologia: Revista Societății Române de Pneumologie
Sebastian Zaremba, Christina H Shin, Matthew M Hutter, Sanjana A Malviya, Stephanie D Grabitz, Teresa MacDonald, Daniel Diaz-Gil, Satya Krishna Ramachandran, Dean Hess, Atul Malhotra, Matthias Eikermann
BACKGROUND: Bariatric surgery patients are vulnerable to sleep-disordered breathing (SDB) early after recovery from surgery and anesthesia. The authors hypothesized that continuous positive airway pressure (CPAP) improves postoperative oxygenation and SDB and mitigates opioid-induced respiratory depression. METHODS: In a randomized crossover trial, patients after bariatric surgery received 30% oxygen in the postanesthesia care unit (PACU) under two conditions: atmospheric pressure and CPAP (8 to 10 cm H2O)...
July 2016: Anesthesiology
Jason H Mateika, Dragana Komnenov
Over the past three decades exposure to intermittent hypoxia (IH) has generally been considered a stimulus associated with a number of detrimental outcomes. However, there is sufficient evidence to link IH to many beneficial outcomes but they have largely been ignored, particularly in the field of sleep medicine in the United States. Recent reviews have postulated that this apparent contradiction is related to the severity and duration of exposure to IH; mild forms of IH initiate beneficial outcomes while severe forms of IH are coupled to detrimental consequences...
May 8, 2016: Experimental Neurology
Joel Reiter, Bashar Zleik, Mihaela Bazalakova, Pankaj Mehta, Robert Joseph Thomas
STUDY OBJECTIVES: To assess the frequency, severity, and determinants of residual respiratory events during continuous positive airway therapy (CPAP) for obstructive sleep apnea (OSA) as determined by device output. METHODS: Subjects were consecutive OSA patients at an American Academy of Sleep Medicine accredited multidisciplinary sleep center. Inclusion criteria included CPAP use for a minimum of 3 months, and a minimum nightly use of 4 hours. Compliance metrics and waveform data from 217 subjects were analyzed retrospectively...
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Amanda Lau, Chris Ewing, Juanita Gnanapragasam, Carina Majaesic, Joanna MacLean, Piush J Mandhane
BACKGROUND: Recognition of the impact of sleep disordered breathing (SDB) on health has increased referrals in pediatric respiratory medicine with a concomitant increase in wait-times. METHODS: To reduce wait-time (primary outcome), we developed a rapid SDB clinic (RSC) to identify, diagnose, and treat patients with few to no comorbidities (uncomplicated) and presumed SDB based on the referral letter. The RSC uses 1) parent-report questionnaires to capture the patients' medical history and 2) sleep testing (e...
May 1, 2016: Pediatric Pulmonology
Jiewen Zheng, Weidong Wang, Zhengbo Zhang, Dalei Wu, Hao Wu, Chung-Kang Peng
Deriving respiratory signal from a surface electrocardiogram (ECG) measurement has advantage of simultaneously monitoring of cardiac and respiratory activities. ECG-based cardiopulmonary coupling (CPC) analysis estimated by heart period variability and ECG-derived respiration (EDR) shows promising applications in medical field. The aim of this paper is to provide a quantitative analysis of the ECG-based CPC, and further improve its performance. Two conventional strategies were tested to obtain EDR signal: R-S wave amplitude and area of the QRS complex...
July 2016: Medical Engineering & Physics
Dmitriy Kogan, Arad Jain, Shawn Kimbro, Guillermo Gutierrez, Vivek Jain
BACKGROUND: Respiratory inductance plethysmography (RIP) is a tool used during a polysomnogram (PSG), which serves as a surrogate of respiratory effort and can help detect inspiratory air-flow limitation. We hypothesize that RIP can improve the sensitivity and specificity of scoring hypopneas when compared with both the recommended and acceptable criteria of the American Academy of Sleep Medicine. METHODS: We retrospectively analyzed a cohort of 12 subjects who had no obstructive sleep apnea (OSA) or mild OSA on PSG when scored by the American Academy of Sleep Medicine acceptable criteria for hypopneas but had high clinical suspicion for a diagnosis of OSA...
August 2016: Respiratory Care
Fernanda Fatureto-Borges, Geraldo Lorenzi-Filho, Luciano F Drager
Obstructive sleep apnea (OSA) is an extremely common comorbid condition in patients with hypertension, with a prevalence of ~50%. There is growing evidence suggesting that OSA is a secondary cause of hypertension, associated with both poor blood pressure (BP) control and target organ damage in patients with hypertension. The application of continuous positive airway pressure (CPAP) during sleep is the gold standard treatment of moderate- to-severe OSA and very effective in abolishing obstructive respiratory events...
2016: Integrated Blood Pressure Control
F S Magnet, W Windisch, J H Storre
Respiratory insufficiency type 2 (ventilatory failure) is characterized by hypercapnia due to alveolar hypoventilation. Therefore, the monitoring of pCO2 is essential for diagnostic and surveillance purposes. Various techniques which differ in the way of measurement (e.g., invasive/noninvasive, continuous/noncontinuous) and their indication are available. Arterial blood gas analysis (ABG) as an invasive procedure is the gold standard procedure and is mostly used in emergency medicine or intensive care units (ICUs)...
April 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Anil Kumar, Priyanka Chanana, Supriti Choudhary
The pharmacological management of insomnia has lately become a challenge for researchers worldwide. As per the third International Classification of Sleep disorders (ICSD-3) insomnia can be defined as a state with repeated difficulty in sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for sleep, and results in some form of daytime impairment. The conventional treatments approved for management of insomnia were benzodiazepines (BZDs) (estazolam, quazepam, triazolam, flurazepam and temazepam) and non-BZDs, also known as z-drugs (zaleplon, zolpidem, and eszopiclone), tricyclic antidepressant (TCA) doxepin as well as melatonin agonists, e...
April 2016: Pharmacological Reports: PR
A Waris, M Macharia, E K Njeru, F Essajee
BACKGROUND: Acute upper respiratory infection is the most common childhood illness and presents with cough, coryza and fever. Available evidence suggests that cough medicines may be no more effective than honey-based cough remedies. OBJECTIVE: To compare effectiveness of honey, salbutamol and placebo in the treatment of cough in children with acute onset cough. DESIGN: Randomised control trial. SETTING: Aga Khan University Hospital Paediatric Casualty...
February 2014: East African Medical Journal
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