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"CPAP" OR "Continuous Positive Airway Pressure"

Yaron Haviv, Lilach Kamer, Roee Sheinfeld, Galit Almoznino, Gideon Bachar
BACKGROUND: A dental appliance for obstructive sleep apnea (OSA) is recommended for patients who cannot adjust to continuous positive airway pressure (CPAP) treatments. OBJECTIVES: To describe patients with extremely severe OSA who were successfully treated with a dental appliance and to compare their characteristics with the relevant literature to identify clinical features associated with a good outcome. METHODS: The clinical, management, and outcome data of three patients with an apnea-hypopnea index (AHI) of > 80 who showed clinical improvement following treatment with a dental appliance were collected retrospectively from sleep laboratory reports in Israel over a period of 3 years...
July 2018: Israel Medical Association Journal: IMAJ
Emanuela di Palmo, Marcella Gallucci, Elena Tronconi, Rosalba Bergamaschi, Salvatore Cazzato, Claudio La Scola, Giampaolo Ricci, Andrea Pession
The term osteopetrosis describes a group of rare hereditary diseases of the skeleton, characterized by an increase in bone density, caused by a defect in the development or function of osteoclasts. It comprises a clinically and genetically heterogeneous conditions ranging from infantile onset life-threatening forms to mildest adult onset forms. "Malignant" osteopetrosis is characterized by bone fragility, short stature, compressive neuropathies, hypocalcaemia, pancytopaenia. The deficiency of carbonic anhydrase II causes a moderate form, presenting classically as a triad of osteopetrosis, renal tubular acidosis (RTA), and cerebral calcification...
2018: Frontiers in Pediatrics
Lucia De Martino, Nadya Yousef, Rafik Ben-Ammar, Francesco Raimondi, Shivani Shankar-Aguilera, Daniele De Luca
BACKGROUND AND OBJECTIVES: There are several lung ultrasound scores (LUS) for evaluating lung aeration in critically ill adults with restrictive lung disorders. A modified LUS adapted for neonates correlates well with oxygenation and is able to be used to predict the need for surfactant in preterm neonates with respiratory distress syndrome (RDS). However, no data are available for extremely preterm neonates for whom timely surfactant administration is especially important. We hypothesized that LUS might be reliable in extremely preterm neonates with RDS who are treated with continuous positive airway pressure...
August 14, 2018: Pediatrics
Chema Strik, Barend van den Beukel, Dagmar van Rijckevorsel, Martijn W J Stommel, Richard P G Ten Broek, Harry van Goor
The incidence of chronic postoperative abdominal pain (CPAP) after abdominal surgery is substantial and decreases overall quality of life. One in three patients report to have pain-related interference with mood, sleep and enjoyment of life and 12% visit the emergency department for pain related symptoms. Previous studies lack data on preoperative health and pain status, or are limited by small patient samples. The aim of this study is to assess risk factors for CPAP and gastrointestinal complaints six months after surgery...
August 11, 2018: Journal of Pain: Official Journal of the American Pain Society
Andreas Palm, Bengt Midgren, Jenny Theorell-Haglöw, Magnus Ekström, Mirjam Ljunggren, Christer Janson, Eva Lindberg
OBJECTIVES: Adherence to continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) is crucial. Our aim was to identify protective and risk factors against the discontinuation of CPAP treatment in patients with OSA and to estimate the mortality risk in those who were non-adherent to CPAP therapy. METHODS: This was a registry-based cohort study from 37 centers across Sweden with OSA patients on CPAP in the Swedevox Swedish national registry between July 2010 and March 2017...
July 17, 2018: Sleep Medicine
Mathieu Marillier, Mathieu Gruet, Sébastien Baillieul, Bernard Wuyam, Renaud Tamisier, Patrick Levy, Jean-Louis Pepin, Samuel Verges
OBJECTIVE AND BACKGROUND: Impaired cerebral blood flow and cerebrovascular reactivity to hypercapnia during wakefulness at rest as well as reduced exercise tolerance have been reported in severe obstructive sleep apnea (OSA) patients. Impaired cerebral oxygenation and hemodynamics can contribute to reduced exercise performance. We hypothesized that (i) OSA patients show impaired cerebrovascular response both during exercise and in response to hypercapnia together with reduced exercise tolerance and (ii) continuous positive airway pressure (CPAP) treatment improves these alterations in cerebral oxygenation...
July 4, 2018: Sleep Medicine
Colin Huntley, Armin Steffen, Karl Doghramji, Benedikt Hofauer, Clemens Heiser, Maurits Boon
OBJECTIVES/HYPOTHESIS: An elevated body mass index (BMI) influences the severity of disease and treatment options utilized for obstructive sleep apnea (OSA). With this study, we aim to evaluate a cohort of patients undergoing upper airway stimulation (UAS) for treatment of OSA and assess the impact of BMI on surgical and quality of life outcomes. METHODS: We designed a case-control, retrospective review, of all patients undergoing UAS at two academic institutions between 2014 and 2017...
August 10, 2018: Laryngoscope
Mark J Peters, Rachel Agbeko, Peter Davis, Nigel Klein, Zohra Zenasi, Amy Jones, Christine Mackerness, Susan George, Paul Veys, Samiran Ray, Paul R Mouncey, David A Harrison, Kathy Rowan
OBJECTIVES: Previous trials in adults with impaired immunity and respiratory failure suggest that early noninvasive ventilation avoids endotracheal intubation and improves survival. No randomized clinical trials have addressed this question in children. DESIGN: We undertook an open, parallel-group randomized trial in three pediatric hospitals. SUBJECTS: Children with impaired immunity and acute respiratory failure defined as tachypnoea (> 90th centile); a new requirement for supplemental oxygen; and new chest radiograph infiltrates...
August 7, 2018: Pediatric Critical Care Medicine
Sushanth Bhat, Divya Gupta, Omar Akel, Peter G Polos, Vincent A DeBari, Shaista Akhtar, Anna McIntyre, Sue X Ming, Hinesh Upadhyay, Sudhansu Chokroverty
OBJECTIVE: The purpose of this study was to determine if the subjective improvements in daytime sleepiness, fatigue and depression experienced by patients with obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) therapy predict an objective improvement in vigilance, and whether patients with mild-to-moderate OSA differ from patients with severe OSA in this regard. METHODS: A total of 182 patients underwent psychomotor vigilance task (PVT) testing and measurements of subjective daytime sleepiness, fatigue and depression at baseline and after a minimum of one month of adherent CPAP use at an adequate pressure...
July 4, 2018: Sleep Medicine
Joanna E Wrede, Elizabeth C Parsons, Nathaniel F Watson
We present a patient who experienced insufflation of air under the left eyelid when using continuous positive airway pressure (CPAP) via an oronasal mask. The patient had a lacrimal stent in place for many years, which was a predisposing factor for this complication. Lacrimal stents are frequently used in the treatment of epiphora (excessive tearing) secondary to obstruction of the lacrimal drainage system. In this case, we review the pathophysiology of air regurgitation into the eye with CPAP use and methods previously described to address this rare complication...
August 6, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Donghee Kim, Aijaz Ahmed, Clete Kushida
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is associated with nonalcoholic fatty liver disease (NAFLD) and related advanced fibrosis. We studied the treatment of OSA with continuous positive airway pressure (CPAP) in a population with NAFLD. METHODS: Using an institutional database (2010-2014), we identified patients with NAFLD and OSA and studied changes in serum aminotransferases before and after CPAP use. We defined suspected NAFLD (sNAFLD) as serum alanine aminotransferase (ALT) > 30 U/L for men and > 19 U/L for women in the absence of known causes of chronic liver disease...
August 6, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Lília Andrade, Teresa Paiva
STUDY OBJECTIVES: This study has as its primary objective to evaluate the quality and effectiveness of type II ambulatory polysomnography (Amb-PSG) versus type I attended laboratory polysomnography (Lab-PSG) in diagnosing obstructive sleep apnea (OSA). Its secondary objective is to evaluate the clinical efficacy, quality of life (QoL), and treatment adherence after diagnosis. METHODS: An observational study of patients with OSA (n = 225) in whom diagnosis was made via Amb-PSG (n = 114) or Lab-PSG (n = 111)...
August 6, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Colin Huntley, Jeniece Cooper, Marlind Stiles, Ritu Grewal, Maurits Boon
STUDY OBJECTIVES: Oral appliance therapy (OAT) can be an effective treatment option for patients with obstructive sleep apnea unable to tolerate continuous positive airway pressure. We hypothesize that drug-induced sleep endoscopy (DISE) can be useful in identifying patients who will benefit from OAT. METHODS: A retrospective review of all patients who underwent DISE (DISE group) between January 2014 and June 2016 was carried out. We included patients if they received OAT based on recommendations made by DISE findings...
August 6, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Soontharee Congrete, Maythawee Bintvihok, Charat Thongprayoon, Tarun Bathini, Boonphiphop Boonpheng, Konika Sharma, Ronpichai Chokesuwattanaskul, Narat Srivali, Tanyanan Tanawuttiwat, Wisit Cheungpasitporn
BACKGROUND/OBJECTIVES: Patients with obstructive sleep apnea (OSA) have an increased the risk of developing atrial fibrillation (AF). However, it remains unclear if patients with OSA carry a higher risk of recurrent AF after successful catheter ablation. This meta-analysis was conducted (1) to evaluate the association between OSA and recurrent AF after catheter ablation, and (2) to assess the effect of continuous positive airway pressure (CPAP) on the risk of recurrent AF in patients with OSA...
August 8, 2018: Journal of Evidence-based Medicine
Mercè Pascual, Jordi de Batlle, Ferran Barbé, Anabel L Castro-Grattoni, Josep M Auguet, Lydia Pascual, Manel Vilà, Anunciación Cortijo, Manuel Sánchez-de-la-Torre
OBJECTIVES: Obstructive sleep apnea (OSA) is among the least studied risk factors for erectile dysfunction (ED). We aimed to determine ED prevalence in newly-diagnosed OSA patients, describe their main characteristics and assess continuous positive airway pressure (CPAP) effects on ED. METHODS: Cross-sectional study assessing ED prevalence in OSA patients and open-label, parallel, prospective randomized controlled trial evaluating 3-month CPAP treatment effects on sexual function, satisfaction, and psychological, hormonal and biochemical profiles...
2018: PloS One
Amir Kugelman, Liron Borenstein-Levin, Huda Jubran, Gil Dinur, Shlomit Ben-David, Elena Segal, Julie Haddad, Fanny Timstut, Iris Stein, Imad R Makhoul, Ori Hochwald
Iatrogenesis is more common in neonatal intensive care units (NICUs) because the infants are vulnerable and exposed to prolonged intensive care. Sixty percent of extremely low-birth-weight infants are exposed to iatrogenesis. The risk factors for iatrogenesis in NICUs include prematurity, mechanical or non-invasive ventilation, central lines, and prolonged length of stay. This led to the notion that "less is more." In the delivery room delayed cord clamping is recommended for term and preterm infants, and suction for the airways in newborns with meconium-stained fluid is not performed anymore...
July 30, 2018: Rambam Maimonides Medical Journal
Madalina Macrea, Sabrina Campbell, Thomas Martin, Kris Ann Oursler
BACKGROUND: Overlap syndrome (OS) describes the association of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) in a single individual. Subjects with OS have increased cardiovascular mortality which is presumed to be inflammation-mediated. As a clinical biomarker, an increased neutrophil count correlates with the severity of coronary artery stenosis. OBJECTIVES: As little is known about the role of neutrophils in the underlying inflammatory mechanisms in OS, we aimed to assess the percentage of peripheral neutrophils (PPN) in OS vs in COPD alone...
August 7, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Marius Lebret, Bernard Wuyam, Dominique Bertrand, Christiane Chaudot, Jean-Louis Pépin, Jean-Christian Borel
Sleep-related breathing disturbances are exacerbated at altitude in patients with Obstructive Sleep Apnea (OSA). The objective of this case report was to determine if a portable auto-CPAP device effectively treated sleep apnea across different altitudes. We report the severity of sleep apnea from 60 to 12,000 feet high in a man with severe OSA (Apnea Hypopnea Index at diagnosis = 60 events/hour) during the 2017 Dakar rally over the Andes mountains. The man was equipped with a lightweight portable auto-CPAP device with a narrow window [6-8 cmH2 O]...
March 2018: Sleep Science
Maria de Lourdes Rabelo Guimarães, Ana Paula Hermont, Thais Moura Guimarães, Cibele Dal-Fabbro, Lia Bittencourt, Cauby Maia Chaves Junior
Mandibular advancement device (MAD) has been described as an alternative treatment to the severe obstructive sleep apnea (OSA), once it is not as effective as the continuous positive airway pressure therapy (CPAP) in reducing the apnea and hypopnea index (AHI). The objective of this study is to report a case using a MAD in a CPAP-intolerant patient suffering from severe OSA. Polysomnography exams were performed before and after treatment. Five months after fitting and titrating the MAD, the AHI was reduced from 80...
March 2018: Sleep Science
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