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Pediatric Obstructive Sleep Apnea

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https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#1
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28319673/the-effect-of-montelukast-on-mild-persistent-osa-after-adenotonsillectomy-in-children-a-preliminary-study
#2
Bing Wang, Jia Liang
This study sought to evaluate the treatment effect of montelukast in children with obstructive sleep apnea (OSA) after tonsillectomy and/or adenoidectomy (T&A). Fifty-eight children with persistent OSA after T&A were included and randomly divided into 2 groups: one group was administered montelukast for 12 weeks, and the other received no treatment. Clinical information, such as the apnea-hypopnea index (AHI) and nadir oxyhemoglobin saturation (nadir SpO2), was recorded. Symptoms of OSA were evaluated using the validated Pediatric Sleep Questionnaire (PSQ)...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28303917/reduced-regional-grey-matter-volumes-in-pediatric-obstructive-sleep-apnea
#3
Mona F Philby, Paul M Macey, Richard A Ma, Rajesh Kumar, David Gozal, Leila Kheirandish-Gozal
Pediatric OSA is associated with cognitive risk. Since adult OSA manifests MRI evidence of brain injury, and animal models lead to regional neuronal losses, pediatric OSA patients may also be affected. We assessed the presence of neuronal injury, measured as regional grey matter volume, in 16 OSA children (8 male, 8.1 ± 2.2 years, AHI:11.1 ± 5.9 events/hr), and 200 control subjects (84 male, 8.2 ± 2.0 years), 191 of whom were from the NIH-Pediatric MRI database. High resolution T1-weighted whole-brain images were assessed between groups with voxel-based morphometry, using ANCOVA (covariates, age and gender; family-wise error correction, P < 0...
March 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28293224/prevalence-of-m75-streptococcus-pyogenes-strains-harboring-slaa-gene-in-patients-affected-by-pediatric-obstructive-sleep-apnea-syndrome-in-central-italy
#4
Elisa Viciani, Francesca Montagnani, Giacinta Tordini, Antonio Romano, Lorenzo Salerni, Andrea De Luca, Paolo Ruggiero, Andrea G O Manetti
Recently we reported an association between pediatric obstructive sleep apnea syndrome (OSAS) and Group A streptococcus (GAS) sub-acute chronic tonsil colonization. We showed that GAS may contribute to tonsil hyperplasia via a streptolysin O (SLO)-dependent cysteinyl leukotrienes (CysLTs) production, which can trigger T and B cell proliferation. In the present study, we characterized the GAS strains isolated from pediatric OSAS patients in comparison with a panel of age and sex matched GAS strains unrelated to OSAS, but isolated in the same area and during the same period ranging from 2009 to 2013...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28292706/effect-of-airflow-and-material-models-on-tissue-displacement-for-surgical-planning-of-pharyngeal-airways-in-pediatric-down-syndrome-patients
#5
Dhananjay Radhakrishnan Subramaniam, Goutham Mylavarapu, Robert J Fleck, Raouf S Amin, Sally R Shott, Ephraim J Gutmark
Pharyngeal narrowing in obstructive sleep apnea (OSA) results from flow-induced displacement of soft tissue. The objective of this study is to evaluate the effect of airflow parameters and material model on soft tissue displacement for planning surgical treatment in pediatric patients with OSA and Down syndrome (DS). Anatomically accurate, three-dimensional geometries of the pharynx and supporting tissue were reconstructed for one pediatric OSA patient with DS using magnetic resonance images. Six millimeters of adenoid tissue was virtually removed based on recommendations from the surgeon, to replicate the actual adenoidectomy...
March 8, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28271512/scoping-review-of-pediatric-tonsillectomy-quality-of-life-assessment-instruments
#6
Stephen Shih-Teng Kao, Micah D J Peters, Nuwan Dharmawardana, Benjamin Stew, Eng Hooi Ooi
OBJECTIVES/HYPOTHESIS: Sleep-disordered breathing or recurrent tonsillitis have detrimental effects on the child's physical health and quality of life. Tonsillectomy is commonly performed to treat these common conditions and improve the child's quality of life. This scoping review aims to present a comprehensive and descriptive analysis of quality of life questionnaires as a resource for clinicians and researchers when deciding which tool to use when assessing the quality of life effects after tonsillectomy...
March 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28229031/characterization-of-sleep-architecture-in-down-syndrome-patients-pre-and-post-airway-surgery
#7
Mark Mims, Prasad John Thottam, Dennis Kitsko, Amber Shaffer, Sukgi Choi
OBJECTIVES: To define obstructive sleep architecture patterns in Down syndrome (DS) children as well as changes to sleep architecture patterns postoperatively. STUDY DESIGN: The study was a retrospective review. METHODS: Forty-five pediatric DS patients who underwent airway surgery between 2003 and 2014 at a tertiary children's hospital for obstructive sleep apnea (OSA) were investigated. Postoperative changes in respiratory parameters and sleep architecture (SA) were assessed and compared to general pediatric normative data using paired t-tests and Wilcoxon signed-rank test...
January 17, 2017: Curēus
https://www.readbyqxmd.com/read/28215263/sleep-disordered-breathing-systemic-adipokine-secretion-and-metabolic-dysregulation-in-overweight-and-obese-children-and-adolescents
#8
Annelies Van Eyck, Kim Van Hoorenbeeck, Benedicte Y De Winter, Luc Van Gaal, Wilfried De Backer, Stijn L Verhulst
OBJECTIVE: Obstructive sleep apnea (OSA) is common among overweight and obese children, and it is an independent risk factor for developing metabolic syndrome. However, the mechanisms linking OSA and metabolic syndrome are still unclear, but a role for adipose tissue dysfunction caused by intermittent hypoxia has been suggested. Therefore, the goal of this study was to investigate the relationship between OSA and systemic adipokine concentrations in overweight and obese children. METHODS: We included 164 overweight and obese children in a tertiary center and distributed them in groups based on their obstructive apnea-hypopnea index (111 controls, 28 mild OSA, 25 moderate-to-severe OSA)...
February 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28215262/bimaxillary-expansion-therapy-for-pediatric-sleep-disordered-breathing
#9
Stacey D Quo, Nelly Hyunh, Christian Guilleminault
INTRODUCTION: The aim of this retrospective study was to evaluate the results of bimaxillary expansion as a treatment option for pediatric sleep-disordered breathing. METHODS: Forty-five children, aged 3-14 years, with sleep-disordered breathing underwent bimaxillary expansion. They were subjected to baseline clinical evaluations, cephalometric X-rays, and polygraphic sleep studies. Three to six months after bimaxillary expansion, posttreatment sleep studies were performed...
February 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28212689/sleep-complaints-and-sleep-architecture-in-children-with-idiopathic-central-sleep-apnea
#10
Neepa Gurbani, Stijn L Verhulst, Chee Tan, Narong Simakajornboon
STUDY OBJECTIVES: Idiopathic central sleep apnea (ICSA) is categorized as a type of nonhypercapnic central sleep apnea (CSA). Recurrent cessation and resumption of respiration leads to sleep fragmentation, which causes excessive daytime sleepiness, frequent nocturnal awakenings, or both. ICSA has been described in the adult population but there is limited information in children. The purpose of this study was to describe clinical manifestations and polysomnographic findings in children with ICSA...
February 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28208178/lingual-tonsillectomy-for-treatment-of-pediatric-obstructive-sleep-apnea-a-meta-analysis
#11
Kun-Tai Kang, Peter J Koltai, Chia-Hsuan Lee, Ming-Tzer Lin, Wei-Chung Hsu
Importance: Evidence indicates correlations between lingual tonsil hypertrophy and pediatric obstructive sleep apnea (OSA). However, to our knowledge, a meta-analysis of surgical outcomes for lingual tonsillectomy in children with OSA has not been conducted. Objective: To evaluate the therapeutic outcomes of lingual tonsillectomy for treatment of pediatric OSA. Data Sources: The study protocol was registered on PROSPERO (CRD42015027053). PubMed, MEDLINE, EMBASE, and the Cochrane Reviews databases were searched independently by 2 authors for relevant articles published by September 2016...
February 16, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28206895/evaluation-of-current-screening-and-treatment-patterns-for-pediatric-obstructive-sleep-apnea-among-practicing-pediatric-dentists-in-the-united-states-a-pilot-study
#12
John Keating, Jae Hyun Park
PURPOSE: The purpose of this study was to provide an evaluation of educational experience, screening, referral, and treatment patterns by pediatric dentists in the United States with regards to obstructive sleep apnea (OSA) and sleep-disordered breathing (SDB). METHODS: A twenty-six question, multiple choice, electronic survey was developed using SurveyMonkey software. It was distributed to the 6,017 active American Academy of Pediatric Dentistry (AAPD) members, garnering a response rate of 7...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28198643/the-role-of-curvilinear-distraction-system-in-pediatric-obstructive-sleep-apnea-a-case-report
#13
David Serrano Faustino Ângelo, Bruno Rosa, Rogério Santos, Carlos Diogo Matos
OBJECTIVE: The authors present a case of obstructive sleep apnea associated with severe mandibular micrognathia treated by mandibular bone distraction with curvilinear system planned under computer assistance. CLINICAL PRESENTATION: A 15-year-old child with limited compliance to continuous positive airway therapy was referred to the authors' department. Observation revealed severe mandibular micrognathia as the major cause for obstructive sleep apnea syndrome. The first polysomnography study revealed 14 obstructive apneas, 16 obstructive hypopneas, and 4...
February 15, 2017: Cranio: the Journal of Craniomandibular Practice
https://www.readbyqxmd.com/read/28185814/obstructive-sleep-apnea-and-pulmonary-hypertension-in-children
#14
REVIEW
David G Ingram, Alvin V Singh, Zarmina Ehsan, Brian F Birnbaum
Obstructive sleep apnea (OSA) is a common pediatric breathing disorder, affecting 1-5% of all children. Pulmonary hypertension (PH), a severe complication of OSA, is associated with significant morbidity and mortality. Despite this important relationship between OSA and PH, there is sparse literature addressing this subject in children. This review will examine the putative relationship between OSA and PH, synthesize the available literature in children, and suggest a reasonable approach, despite limited data, for clinicians...
January 11, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28183716/endothelial-dysfunction-in-children-with-obstructive-sleep-apnea-is-associated-with-elevated-lipoprotein-associated-phospholipase-a2-plasma-activity-levels
#15
Leila Kheirandish-Gozal, Mona F Philby, Zhuanghong Qiao, Abdelnaby Khalyfa, David Gozal
BACKGROUND: Obstructive sleep apnea (OSA) is a highly prevalent condition, especially in obese children, and has been associated with increased risk for endothelial dysfunction and dislipidemia, which are precursors of atherosclerosis. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is recognized as an independent risk factor for cardiovascular risk and atheromatous plaque activity. We hypothesized that Lp-PLA2 levels would be elevated in children with OSA, particularly among obese children who also manifest evidence of endothelial dysfunction...
February 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28162008/clinical-implications-of-understanding-the-association-between-oxidative-stress-and-pediatric-nafld
#16
Jake P Mann, Massimiliano Raponi, Valerio Nobili
Oxidative stress is central to the pathogenesis of non-alcoholic steatohepatitis. The reactive oxygen species (ROS) that characterise oxidative stress are generated in several cellular sites and their production is influence by multi-organ interactions. Areas covered: Mitochondrial dysfunction is the main source of ROS in fatty liver and is closely related to endoplasmic reticulum stress. Both are caused by lipotoxicity and together these three factors form a cycle of progressive organelle damage, resulting in sterile inflammation and apoptosis...
April 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28159487/the-use-of-pulse-transit-time-in-pediatric-sleep-studies-a-systematic-review
#17
REVIEW
Laurelle A Smith, Patrick J Dawes, Barbara C Galland
As a surrogate measure of blood pressure, pulse transit time (PTT) is commonly used in studies investigating arterial function and respiratory sleep disturbance. A systematic search of the literature was conducted with the aim of reviewing the usefulness of the technique within pediatric sleep studies. All studies that used PTT as a diagnostic tool during sleep in infants, children or adolescents were considered. The search yielded 425 articles, of which 21 full-text articles met inclusion criteria, the majority reporting on obstructive sleep apnea (OSA)...
November 30, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28141652/tracheal-cartilaginous-sleeve-in-syndromic-craniosynostosis-an-underrecognized-source-of-significant-morbidity-and-mortality
#18
Brent B Pickrell, Jesse D Meaike, Karina T Cañadas, Binoy M Chandy, Edward P Buchanan
Tracheal cartilaginous sleeve (TCS) is a rare and previously unrecognized source of morbidity and mortality in patients with certain craniosynostosis syndromes. There is a paucity of reporting on this airway anomaly, and the true incidence of TCS is largely unknown. The purpose of this study was to investigate the incidence of TCS among patients with syndromic craniosynostosis at our institution. Patients with syndromic craniosynostosis who underwent direct bronchoscopy and laryngoscopy were evaluated retrospectively by pediatric otolaryngologists for the presence of TCS and associated anomalies...
January 30, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28124477/a-predictive-model-for-obstructive-sleep-apnea-and-down-syndrome
#19
Brian G Skotko, Eric A Macklin, Marco Muselli, Lauren Voelz, Mary Ellen McDonough, Emily Davidson, Veerasathpurush Allareddy, Yasas S N Jayaratne, Richard Bruun, Nicholas Ching, Gil Weintraub, David Gozal, Dennis Rosen
Obstructive sleep apnea (OSA) occurs frequently in people with Down syndrome (DS) with reported prevalences ranging between 55% and 97%, compared to 1-4% in the neurotypical pediatric population. Sleep studies are often uncomfortable, costly, and poorly tolerated by individuals with DS. The objective of this study was to construct a tool to identify individuals with DS unlikely to have moderate or severe sleep OSA and in whom sleep studies might offer little benefit. An observational, prospective cohort study was performed in an outpatient clinic and overnight sleep study center with 130 DS patients, ages 3-24 years...
January 26, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28109487/utility-of-polysomnography-in-determination-of-laryngomalacia-severity
#20
Jacqueline E Weinstein, Claire M Lawlor, Eric L Wu, Kimsey H Rodriguez
OBJECTIVE: To examine the efficacy of polysomnography in determining the severity of laryngomalacia in pediatric patients. METHODS: Prospective cohort study. Pediatric patients referred to our pediatric otolaryngology department with a polysomnogram already performed for a presumptive diagnosis of laryngomalacia were enrolled in the study. Patients with concurrent airway lesions or neuromuscular disorders were excluded. Patients underwent history, physical exam, and flexible fiberoptic laryngoscopy...
February 2017: International Journal of Pediatric Otorhinolaryngology
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