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Pediatric Obstructive Sleep Apnea

V Luzzi, G Di Carlo, M Saccucci, G Ierardo, E Guglielmo, M Fabbrizi, A M Zicari, M Duse, F Occasi, G Conti, E Leonardi, A Polimeni
OBJECTIVE: Sleep-disordered breathing (SDB) is among the most common diseases and includes a group of pathological conditions that form a severity continuum from primary snoring (PS) to obstructive sleep apnea (OSA). SDB presents a multifactorial etiology and in children, it is often linked to adenotonsillar hypertrophy, which may lead to an alteration of the breathing pattern. Therefore, several studies hinted at the existence of a correlation between SDB and the alteration of craniofacial growth...
October 2016: European Review for Medical and Pharmacological Sciences
Rui Wang, Yan Dong, Jia Weng, Emily Z Kontos, Ronald D Chervin, Carol L Rosen, Carole L Marcus, Susan Redline
RATIONALE: Prior research found that individual-level environmental and social indicators did not explain the racial disparity in obstructive sleep apnea syndrome. Neighborhood socioeconomic variables, risk factors for a range of adverse behavioral and health outcomes, may better explain this racial disparity and help identify modifiable intervention targets. OBJECTIVES: To evaluate the associations of neighborhood socioeconomic variables with obstructive sleep apnea severity and to assess whether the neighborhood variables explain the association between race and obstructive sleep apnea severity...
October 21, 2016: Annals of the American Thoracic Society
Yu-Shu Huang, Christian Guilleminault, Fang-Ming Hwang, Chuan Cheng, Cheng-Hui Lin, Hsueh-Yu Li, Li-Ang Lee
Pediatric obstructive sleep apnea (OSA) is associated with chronic systemic inflammation and with cognitive impairments. This study aimed to investigate the status of proinflammatory cytokines, particularly interleukin 17 (IL-17) and interleukin 23 (IL-23) and cognition in pediatric OSA.Controls and OSA children participated in the study. Exclusion criteria were adenotonsillectomy, heart, neurological and severe psychiatric diseases, craniofacial syndromes, and obesity. Polysomnogram was followed by serum testing for inflammatory markers and neurocognitive tests such as continuous performance task (CPT) and Wisconsin card sorting test, questionnaires, analyses of plasma high-sensitivity C-reactive protein (HS-CRP), tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), IL-17, and IL-23...
October 2016: Medicine (Baltimore)
Cláudia Maria de Felício, Franciele Voltarelli da Silva Dias, Gislaine Aparecida Folha, Leila Azevedo de Almeida, Jaqueline Freitas de Souza, Wilma Terezinha Anselmo-Lima, Luciana Vitaliano Voi Trawitzki, Fabiana Cardoso Pereira Valera
OBJECTIVES: The purposes of this study were (1) to identify possible differences in muscular and orofacial functions between children with obstructive sleep apnea (OSA) and with primary snoring (PS); (2) to examine the standardized difference between normal values of myofunctional scores and those of subjects with OSA or PS; and (3) to identify the features associated with OSA. METHODS: Participants were 39 children (mean age 8 ± 1.2 years) of which, 27 had a diagnosis of OSA and 12 had PS...
November 2016: International Journal of Pediatric Otorhinolaryngology
Nikita Kohli, Dana DeCarlo, Nira A Goldstein, Joshua Silverman
OUTCOME OBJECTIVE: For over fifty years, otolaryngologists, allergists, and immunologists have debated the effect of adenoidectomy or adenotonsillectomy on asthma outcomes in children. Although some have suggested that adenotonsillectomy may contribute to the subsequent development of asthma in children, others have argued that a common mechanism may cause both upper and lower airway disease, and that children who have symptoms severe enough to warrant adenotonsillectomy are also at increased risk of asthma and atopic disease...
November 2016: International Journal of Pediatric Otorhinolaryngology
Leila Kheirandish-Gozal, David Gozal
Since the initial report 40 years ago on pediatric obstructive sleep apnea syndrome (OSAS) as a distinct and prevalent clinical entity, substantial advances have occurred in the delineation of diagnostic and treatment approaches. However, despite emerging and compelling evidence that OSAS increases the risk for cognitive, cardiovascular and metabolic end-organ morbidities, routine assessment of such morbidities is seldom conducted in clinical practice. One of the major reasons for such discrepancies resides in the relatively labor-intensive and onerous steps that would be required to detect the presence of any of such morbidities, further adding to the already elevated cost of diagnosing the disorder...
October 6, 2016: Chest
Gamze Ozgurhan, Aysel Vehapoglu, Oznur Vermezoglu, Rabia Nur Temiz, Asuman Guney, Bulent Hacihamdioglu
The aim of the following study is to evaluate the risk of obstructive sleep apnea syndrome (OSAS) in subjects with vitamin D deficiency.Prospective and comparative study.We enrolled 240 subjects into the study. The participants were divided into 2 groups based on 25-hydroxyvitamin D (25[OH]D) levels: low level of 25(OH)D (<20 ng/mL) group (n = 120) and control (>20 ng/mL) group (n = 120). Subjects were classified as being at a high or low risk of developing OSAS by using the Berlin Questionnaire. Risk of developing OSAS, gender, age, and body mass index (BMI) z-score were assessed by comparing the low level of 25(OH)D group and control group...
September 2016: Medicine (Baltimore)
Gregory W Jackson
A case report is presented which demonstrates the effectiveness of comprehensive orthodontic treatment combined with orthognathic surgery in the correction of malocclusion and reduction in the sequelae of Obstructive Sleep Apnea (OSA). The patient's severe OSA was improved to very mild as evaluated by full overnight polysomnogram. The orthodontic treatment included the expansion of both dental arches and mandibular advancement surgery. There was significant improvement in the patient's sleep continuity and architecture with the elimination of obstructive apneas...
2016: Case Reports in Dentistry
Esengul Keleş, Arzu Gebeşçe, Filiz Turan, Fatma Fidan, Hamza Yazgan, Bülent Baştürk, Mehmet Demirdöven, Alparslan Tonbul, Mahmut Kaya
No abstract text is available yet for this article.
June 2016: Iranian Journal of Public Health
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
David F Smith, Ting Sa, Matthew Fenchel, Aliza P Cohen, Christine Heubi, Sally R Shott, Christine G Gourin, Stacey L Ishman
OBJECTIVES/HYPOTHESIS: We sought to characterize changes in the patterns of inpatient surgical sleep care over time and ascertain if these changes were consistent with previously reported trends in adult surgical sleep care. STUDY DESIGN: Repeated cross-sectional study. METHODS: Discharge data from the U.S. Nationwide Inpatient Sample for 125,691 nasal, palatal, or hypopharyngeal procedures in children for sleep-disordered breathing or obstructive sleep apnea (OSA) from 1993 to 2010 were analyzed using cross-tabulations and multivariate regression modeling...
September 19, 2016: Laryngoscope
Sharon H Gnagi, David R White
PURPOSE OF REVIEW: To discuss current modalities of endoscopic airway management beyond balloon dilation therapy. RECENT FINDINGS: Advances continue to be made through technology and bioengineering with exciting potential in the pediatric airway. Smaller robots and instrumentation allow increased endoscopic surgical success. Biodegradable stents and bioengineered grafts are on the horizon for use in airway surgery. Dysphonia following airway reconstruction is of increasing recognition with new endoscopic treatments being performed...
September 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Stacey Ishman, Christine Heubi, Todd Jenkins, Marc Michalsky, Narong Simakajornboon, Thomas Inge
OBJECTIVE: Obstructive sleep apnea (OSA) is reported in 70% of adolescents who present for bariatric surgery. The Pediatric Sleep Questionnaire (PSQ) was developed to identify children at risk for OSA but is not validated in adolescents with obesity. The aims of this study were: (1) to assess validity of the PSQ to detect OSA and (2) to determine the correlation between anthropometric and polysomnography measurements. METHODS: A cross-sectional assessment of Teen-Longitudinal Assessment of Bariatric Surgery participants at high risk for OSA was performed...
September 15, 2016: Obesity
Valerie G Kirk, Warren K Yunker
No abstract text is available yet for this article.
September 15, 2016: American Journal of Respiratory and Critical Care Medicine
Ghassan Idris, Barbara Galland, Christopher J Robertson, Mauro Farella
BACKGROUND: Sleep-Disordered Breathing (SDB) varies from habitual snoring to partial or complete obstruction of the upper airway and can be found in up to 10% of children. SDB can significantly affect children's wellbeing, as it can cause growth disorders, educational and behavioral problems, and even life-threatening conditions, such as cardiorespiratory failure. Adenotonsillectomy represents the primary treatment for pediatric SDB where adeno-tonsillar hypertrophy is indicated. For those with craniofacial anomalies, or for whom adenotonsillectomy or other treatment modalities have failed, or surgery is contra-indicated, mandibular advancement splints (MAS) may represent a viable treatment option...
2016: Frontiers in Physiology
Shelagh A Cofer, Becky Baas, Edythe Strand, Cara C Cockerill
OBJECTIVES/HYPOTHESIS: To evaluate the effectiveness, durability, and safety of a tissue filler (dextranomer and hyaluronic acid copolymer) when injected submucosally in the nasopharynx to treat velopharyngeal insufficiency (VPI) in pediatric patients. STUDY DESIGN: Retrospective case series. METHODS: Charts were reviewed for all patients treated with injectable filler at a tertiary children's center for VPI from April 2010 through September 2013...
September 1, 2016: Laryngoscope
Shalini Paruthi, Paula Buchanan, Jia Weng, Ronald D Chervin, Ronald B Mitchell, Dawn Dore-Stites, Anjali Sadhwani, Eliot S Katz, John Bent, Carol L Rosen, Susan Redline, Carole L Marcus
STUDY OBJECTIVES: To describe parental reports of sleepiness and sleep duration in children with polysomnography (PSG)-confirmed obstructive sleep apnea (OSA) randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC) in the ChildHood Adenotonsillectomy Trial (CHAT). We hypothesized children with OSA would have a larger improvement in sleepiness 6 mo following eAT compared to WWSC. METHODS: Parents of children aged 5.0-9.9 y completed the Epworth Sleepiness Scale modified for children (mESS) and the Pediatric Sleep Questionnaire-Sleepiness Subscale (PSQ-SS)...
August 19, 2016: Sleep
Filippo Montevecchi, Chiara Bellini, Giuseppe Meccariello, Paul T Hoff, Elisa Dinelli, Iacopo Dallan, Ruggero M Corso, Claudio Vicini
Pediatric obstructive sleep apnea syndrome (OSAS) is primarily caused by adenotonsillar hypertrophy. However, tongue base hypertrophy is increasingly being recognized as a cause, even after adenotonsillectomy. We report three cases of pediatric OSAS successfully treated by transoral robotic reduction of the tongue base. In all children, we were able to achieve improved retrolingual patency while avoiding significant procedure-related morbidity. In conclusion, tongue base reduction by transoral robotic surgery appears to be a feasible solution for the base of tongue obstruction due to lingual tonsil hypertrophy in pediatric patients...
August 27, 2016: European Archives of Oto-rhino-laryngology
Shikha S Sundaram, Ann Halbower, Zhaoxing Pan, Kristen Robbins, Kelley E Capocelli, Jelena Klawitter, Colin T Shearn, Ronald J Sokol
BACKGROUND & AIMS: Oxidative stress is proposed as a central mediator in NAFLD pathogenesis, but the specific trigger for reactive oxygen species generation has not been clearly delineated. In addition, emerging evidence shows that obesity related obstructive sleep apnea (OSA) and nocturnal hypoxia are associated with NAFLD progression in adults. The aim of this study was to determine if OSA/nocturnal hypoxia-induced oxidative stress promotes the progression of pediatric NAFLD. METHODS: Subjects with biopsy proven NAFLD and lean controls were studied...
September 2016: Journal of Hepatology
Maurizio Parola, Pietro Vajro
No abstract text is available yet for this article.
September 2016: Journal of Hepatology
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