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https://www.readbyqxmd.com/read/27732789/obstructive-sleep-apnea-update-and-future
#1
Diane C Lim, Allan I Pack
Obstructive sleep apnea (OSA) is a worldwide disease whose prevalence is increasing as obesity rates increase. The link between obesity and OSA is likely to be the deposition of fat in the tongue, compromising upper airway size. The role of obesity varies in different ethnic groups, with Chinese being particularly sensitive to increases in weight. OSA lends itself to a personalized approach to diagnosis and therapy. For example, different clinical OSA subtypes likely benefit from therapy in different ways. Hypoglossal nerve stimulation is a useful second-line therapy in patients who cannot tolerate continous positive airway pressure (CPAP) machines or intraoral devices...
October 5, 2016: Annual Review of Medicine
https://www.readbyqxmd.com/read/25683561/prevalence-of-central-sleep-apnea-during-continous-positive-airway-pressure-cpap-titration-in-subjects-with-obstructive-sleep-apnea-syndrome-at-an-altitude-of-2640%C3%A2-m
#2
Maria Angelica Bazurto Zapata, William Martinez-Guzman, Leslie Vargas-Ramirez, Karen Herrera, Mauricio Gonzalez-Garcia
BACKGROUND: The occurrence of central apneas when applying positive pressure (CPAP) to patients with obstructive sleep apnea syndrome (OSAS) is called complex sleep apnea (CompSA). This causes poor adherence to CPAP and persistence of symptoms. In Bogota, a city located at an altitude of 2640 m above sea level, chronic hypoxemia can generate certain instability of the respiratory system during sleep which could increase the presence of central apnea. The aim was to establish the prevalence of central apnea (central apnea index >5/h) in adults with moderate or severe OSAS during CPAP titration, and the factors associated with this...
March 2015: Sleep Medicine
https://www.readbyqxmd.com/read/24136286/-anesthesia-management-of-laparoscopic-radical-cystectomy-and-orthotopic-bladder-surgery-with-a-robotic-assisted-surgical-system
#3
Ling-Ling Ding, Hong Zhang, Wei-Dong Mi, Jing Liu, Chao-Hai Jin, Wei-Xiu Yuan, Yi Liu, Li-Ya Ni, Lu-Long Bo, Xiao-Ming Deng
OBJECTIVE: To summarize anesthesia management of laparoscopic radical cystectomy and orthotopic bladder surgery with a robotic surgical system. METHODS: In the study of 10 cases of bladder cancer, the robot-assisted radical cystectomy+expand lymphadenectomy+orthotopic bladder surgery with 60 degrees of Trendelenburg surgical position, was inserted into the manipulator under the video system monitor positioning, to complete the removal of the diseased tissue dissection and orthotopic ileal neobladder intra-abdominal...
October 18, 2013: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/23680299/clinical-review-helmet-and-non-invasive-mechanical-ventilation-in-critically-ill-patients
#4
REVIEW
Antonio M Esquinas Rodriguez, Peter J Papadakos, Michele Carron, Roberto Cosentini, Davide Chiumello
Non-invasive mechanical ventilation (NIV) has proved to be an excellent technique in selected critically ill patients with different forms of acute respiratory failure. However, NIV can fail on account of the severity of the disease and technical problems, particularly at the interface. The helmet could be an alternative interface compared to face mask to improve NIV success. We performed a clinical review to investigate the main physiological and clinical studies assessing the efficacy and related issues of NIV delivered with a helmet...
2013: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/23612264/efficacy-of-insure-during-nasal-cpap-in-preterm-infants-with-respiratory-distress-syndrome
#5
F Leone, D Trevisanuto, F Cavallin, M Parotto, V Zanardo
AIM: INSURE (INtubation, SURfactant, Extubation) is a proven complement of nasal CPAP (nCPAP) for respiratory distress syndrome (RDS) treatment of preterm infants. Early administration is characterized by greater success. We aimed to determine the efficacy and failure or other respiratory outcomes of INSURE administration during nasal continous positive airway pressure (nCPAP) treatment of RDS. METHODS: Among 824 premature infants neonatal intensive care unit (NICU) admitted at Padua University Hospital during 2007-2009, 209 (25...
April 2013: Minerva Pediatrica
https://www.readbyqxmd.com/read/23492064/-effectiveness-of-nasal-cpap-continous-positive-airway-pressure
#6
Gugger, Bassetti
Nasal continuous positive airway pressure (n-CPAP) is an effective treatment for the obstructive sleep apnea syndrome (OSAS). It is currently regarded as the first line therapy for OSAS. The principal indication for n-CPAP treatment is daytime sleepiness. Nasal-CPAP improves daytime sleepiness dramatically in severe cases and the effect is objectively measurable with the multiple sleep latency test (MSLT). It is noteworthy that n-CPAP also improves symptoms, subjective daytime sleepiness, cognitive function, IQ, mood, quality of life and driving ability already in patients with mild sleep apnea with an apnea/hypopneaindex (AHI) between 5 and 15 per hour of sleep during overnight polysomnography...
July 1, 2000: Therapeutische Umschau. Revue Thérapeutique
https://www.readbyqxmd.com/read/23312684/positioning-effects-on-lung-function-and-breathing-pattern-in-premature-newborns
#7
RANDOMIZED CONTROLLED TRIAL
Georgette Gouna, Thameur Rakza, Elaine Kuissi, Thomas Pennaforte, Sebastien Mur, Laurent Storme
OBJECTIVE: To compare breathing patterns and lung function in the supine, lateral, and prone positions in oxygen-dependent preterm infants. STUDY DESIGN: Respiratory function in preterm infants receiving nasal continous positive airway pressure therapy for mild respiratory failure was evaluated by respiratory inductive plethysmography. Infants were randomized to supine, left lateral, and prone positions for 3 hours. A nest provided a semiflexed posture for the infants placed in the left lateral position, similar to the in utero position...
June 2013: Journal of Pediatrics
https://www.readbyqxmd.com/read/19616133/continuous-positive-airway-pressure-reduces-loop-gain-and-resolves-periodic-central-apneas-in-the-lamb
#8
Bradley A Edwards, Scott A Sands, Clare Feeney, Elizabeth M Skuza, Vojta Brodecky, Malcolm H Wilkinson, Philip J Berger
Continous positive airway pressure (CPAP) is used to treat infant respiratory distress syndrome and apnea of prematurity, but its mode of action is not fully understood. We hypothesised that CPAP increases lung volume and stabilises respiratory control by decreasing loop gain (LG). Experimentally induced periodic breathing (PB) in the lamb was terminated early by CPAP in a dose-dependent manner, with a control epoch of 45.4+/-5.1s at zero CPAP falling to 32.9+/-5.4, 13.2+/-4.2 and 9.8+/-3.1s at 2.5, 5 and 10 cmH(2)O, respectively (p<0...
September 30, 2009: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/18669080/-analysis-of-some-of-the-possible-neonatal-risk-factors-of-development-of-retinopathy-of-prematurity
#9
Anna Niwald, Andrzej Piotrowski, Mirosława Grałek
PURPOSE: The aim of the study was to evaluate some of the possible risk factors for retinopathy of prematurity (ROP) treated with laser photocoagulation or cryocoagulation. MATERIAL AND METHODS: The study comprised 71 preterm infants with ROP needing treatment and 118 prematures without ROP or with ROP requiring no treatment, as a control group. All infants were born with gestational age < or = 32 weeks and birth weight < or = 1500g. The perinatal variables, including some of clinical data, the length of mechanical ventilation as well as continous positive airway pressure (CPAP), duration of total parenteral nutrition and some of laboratory data were analyzed, to evaluate their correlation with the development of ROP...
2008: Klinika Oczna
https://www.readbyqxmd.com/read/18651518/obstructive-sleep-apnea-as-a-risk-factor-for-cardiovascular-diseases
#10
Fahrettin Yilmaz, Serhan Ozyildirim, Fahrettin Talay, Kazim Karaaslan, Huseyin Gunduz
Obstructive sleep apnea (OSA) is a common medical condition that occurs in approximately 5% to 15% of the population. It is usually associated with an increased risk of cardiovascular disease. Diagnosis of OSA is based on polysomnography, and its severity is measured with an apnea-hypopnea index. Most of the adverse effects of OSA on the cardiovascular system are reversible with treatment. In addition to continous positive airway pressure therapy, precautions such as weight loss, avoidance of central nervous system depressants, treatment of nasal congestion and sleeping in the lateral position may help to treat OSA...
2007: Cardiology Journal
https://www.readbyqxmd.com/read/17953247/improvement-of-associated-respiratory-problems-in-morbidly-obese-patients-after-open-roux-en-y-gastric-bypass
#11
C Martí-Valeri, A Sabaté, C Masdevall, A Dalmau
BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is present in 44% of patients scheduled for bariatric surgery. Respiratory dysfunction associated with this syndrome is attributable to chronic obstructive pulmonary disease (COPD) and/or obesity hypoventilation syndrome (OHS). We studied the long-term effect of bariatric surgery on weight loss, on the respiratory comorbidities associated with obesity, and on the need for non-invasive positive pressure ventilation. METHODS: We followed a sample of patients with respiratory co-morbidity scheduled for open Capella Roux-en-Y gastric bypass (RYGBP) over 5-years...
August 2007: Obesity Surgery
https://www.readbyqxmd.com/read/17716282/daytime-sympathetic-hyperactivity-in-osas-is-related-to-excessive-daytime-sleepiness
#12
Vincenzo Donadio, Rocco Liguori, Roberto Vetrugno, Manuela Contin, Mikael Elam, B Gunnar Wallin, Tomas Karlsson, Enrico Bugiardini, Agostino Baruzzi, Pasquale Montagna
The aim of this study was to investigate the relationships among sympathetic hyperactivity, excessive daytime sleepiness (EDS) and hypertension in obstructive sleep apnoea syndrome (OSAS). Ten newly diagnosed OSAS patients with untreated EDS and daytime hypertension underwent polysomnography (PSG) and daytime measurements of plasma noradrenaline (NA), ambulatory blood pressure (BP), muscle sympathetic nerve activity (MSNA) by microneurography and objective assessment of EDS before and during 6 months of compliance-monitored continuous positive airway pressure (CPAP) treatment...
September 2007: Journal of Sleep Research
https://www.readbyqxmd.com/read/17338008/long-term-compliance-with-continous-positive-airway-pressure-in-patients-with-obstructive-sleep-apnea-syndrome
#13
S O Wali
A ten-year retrospective analysis of the clinical features and survival of 60 Saudi children with systemic lupus erythematosus (SLE) was made. All the patients fulfilled the 1982 American College of Rheumatologyâs revised criteria for SLE and had had the disease at or before the age of 16 years. The female to male ratio was 5:1, the mean age of onset was 12.1 years (range 1.6-16 years), and the mean duration of follow-up was 4.7 years (range 2.2-11). Thirty-eight patients (63%) were diagnosed correctly before referral to KFSH&RC or KKUH...
November 1997: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/16157997/effects-of-long-term-nasal-continuous-positive-airway-pressure-on-c-reactive-protein-in-patients-with-obstructive-sleep-apnea-syndrome
#14
Tsuneto Akashiba, Toshiki Akahoshi, Seiji Kawahara, Toru Majima, Takashi Horie
Serum levels of C-reactive protein (CRP) were measured in 96 consecutive patients with obstructive sleep apnea syndrome (OSAS) before and after nasal continous positive airway pressure treatment. CRP levels only displayed significant correlations with body mass index (BMI) before treatment. No significant changes were observed in BMI and CRP levels after 9 months of treatment. These data suggest that CRP levels in patients with OSAS may be associated with obesity rather than OSAS itself.
August 2005: Internal Medicine
https://www.readbyqxmd.com/read/15490710/morbidity-and-mortality-of-low-birth-weight-infants-in-the-new-born-unit-of-kenyatta-national-hospital-nairobi
#15
D E Simiyu
BACKGROUND: Morbidity and mortality of low birth weight (LBW) infants at Kenyatta National Hospital (KNH) has previously been found to be high. Other centres have shown that even with lack of neonatal intensive care facilities, selective interventions can be implemented that improve neonatal survival rates. It is important to identify those factors at KNH that when selectively modified, will improve the quality of care hence survival rates. OBJECTIVE: To quantify the morbidity and mortality of LBW infants in KNH...
July 2004: East African Medical Journal
https://www.readbyqxmd.com/read/15143450/-conservative-treatment-in-mild-obstructive-sleep-apnea-comparison-of-theophylline-and-nasal-continous-positive-airway-pressure-ventilation
#16
COMPARATIVE STUDY
M Rieger, E Di Martino, M Westhofen
BACKGROUND: Comparison of theophylline and nasal continous positive airway pressure-ventilation (nCPAP) in patients non eligible for surgical treatment with obstructive sleep apnea. PATIENTS AND MATERIALS: In a prospective non-randomized study 60 patients with mild obstructive sleep apnea were investigated. All individuals were not eligible for surgery under general anaesthesia or refused surgical treatment. The efficacy of a daily single dose oral theophylline (5 - 7 mg/kg body weight, n = 30) and nCPAP ventilation (n = 30) was evaluated by apnea-hypopnea index (AHI) and Epworth Sleepiness Scale (ESS)...
May 2004: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/11894203/improvement-of-cpap-therapy-by-a-self-adjusting-system
#17
Katrin Pilz, Stefan Thalhofer, Philipp Meissner, Peter Dorow
The first generation of Auto CPAP devices caused respiratory arousal by apnoes, hypopnoeas, incomplete obstructions and pressurechanges. The new, second generation of CPAP devices which is based on forced oscillation technique will change the pressure with slower velocity and before the respiratory arousal reaction will occur (1, 9, 10). Fifty patients with severe sleep apnoea (AHI 66+/-26 /h) were treated with both, constant- CPAP (continous positive airway pressure) or Auto CPAP under polysomnographic control in a randomised order...
2000: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/11868127/sleep-breathing-disorders-and-heart-failure
#18
Stefan Thalhofer, Peter Dorow
Cheyne-Stokes respiration is known to be associated with severe left heart failure. Because of severe desaturation, sleep fragmentation, arousals, and an increase in sympathetic activity, Cheyne-Stokes respiration may lead to a further impairment of cardiac function and to a worsening of quality of life. Although the pathology of Cheyne-Stokes respiration is not fully understood, enhanced chemoreceptor sensitivity, prolonged circulation time, as well as decreased pulmonary gas stores and increased ventilatory drive may be contributing factors...
2000: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/8008564/sleep-apnoea-laser-therapy-for-osas
#19
I Macdougald
The standard treatments for obstructive sleep apnoea syndrome (OSAS) to date have been postural treatment, which involves the patient sleeping on the stomach; continuous positive airway pressure, using a nasal mask during the night to maintain a positive pressure to prevent collapse of the airway; and surgical uvolopalatopharyngoplasty (UPPP). This is a radical surgical procedure where the soft palate and uvula are excised. There are drawbacks to all of these procedures, either because patients may regard as unacceptable the position they must maintain in bed or the equipment required to be worn or because of surgical complications...
May 11, 1994: Nursing Times
https://www.readbyqxmd.com/read/1090210/lung-volumes-and-closing-capacity-with-continuous-positive-airway-pressure
#20
N Abboud, K Rehder, J R Rodarte, R E Hyatt
Total lung capacity, vital capacity, residual volume, and functional residual capacity were determined by body plethysmography and the single-breath oxygen (SBO2) test was performed at 0, 5, and 11 cm H20 continuous positive airway pressure in healthy, awake, seated, spontaneously breathing subjects. Mean values for the absolute lung volume at which phase IV of the SBO2 test begins (closing capacity) did not change significantly with continous positive airway pressure at 5 or 11 cm H2O. Mean total lung capacity, functional residual capacity, and residual volume increased significantly, and the mean closing volume, the lung volume above residual volume at which phase IV begins, decreased significantly with 11 cm H20 continuous positive airway pressure; differences at 5 cm H20 were not significant...
February 1975: Anesthesiology
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