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https://www.readbyqxmd.com/read/28730908/electrical-stimulation-for-the-treatment-of-obstructive-sleep-apnoea-a-review-of-the-evidence
#1
Valeria Bisogni, Martino F Pengo, Andrea De Vito, Giuseppe Maiolino, Gian Paolo Rossi, John Moxham, Joerg Steier
Obstructi ve sleep apnoea is an increasingly prevalent clinical condition with significant impact on individuals and public health. Continuous positive airway pressure therapy is the standard treatment, but adherence is limited and alternative treatments are needed. In this context, non-invasive and invasive methods for the electrical stimulation of upper airway dilator muscles have been demonstrated to be effective in selected patients. Areas covered: This review will cover investigations on the clinical effects, safety, and tolerability of non-invasive and invasive electrical stimulation of the upper airway for the management of obstructive sleep apnoea...
July 21, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28728614/upper-airway-stimulation-for-treatment-of-obstructive-sleep-apnea-an-evaluation-and-comparison-of-outcomes-at-two-academic-centers
#2
Colin Huntley, Thomas Kaffenberger, Karl Doghramji, Ryan Soose, Maurits Boon
STUDY OBJECTIVES: Data from patients at Thomas Jefferson University Hospital (TJUH) and University of Pittsburgh Medical Center (UPMC) undergoing upper airway stimulation (UAS) were analyzed. We hypothesize that treatment with UAS will improve both subjective and objective outcome measures and results will be reproducible between institutions. METHODS: We reviewed patients undergoing UAS between May 2014 and August 2016. We recorded demographic data, Epworth Sleepiness Scale (ESS), and preoperative and postoperative polysomnographic information...
July 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28721156/obstructive-sleep-apnea-and-hormones-a-novel-insight
#3
Marek Ruchała, Barbara Bromińska, Ewa Cyrańska-Chyrek, Barbara Kuźnar-Kamińska, Magdalena Kostrzewska, Halina Batura-Gabryel
Obstructive sleep apnea (OSA), a disorder characterized by repetitive collapse of the upper respiratory tract during sleep, occurs in about 4% of middle-aged men and 2% of women. The incidence of the disorder is rising due to an increase in obesity and ageing of the population. Patients with obstructive sleep apnea are at elevated risk of some endocrinal and metabolic disorders, which may lead to serious consequences including shortening of life expectancy. The recognition and understanding of interactions between local upper airway dysfunction and its endocrinal consequences is therefore vital...
June 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28714612/weaning-from-long-term-continuous-positive-airway-pressure-or-noninvasive-ventilation-in-children
#4
Meriem Mastouri, Alessandro Amaddeo, Lucie Griffon, Annick Frapin, Samira Touil, Adriana Ramirez, Sonia Khirani, Brigitte Fauroux
OBJECTIVES: A significant number of children are able to discontinue long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) but the underlying disorders, weaning criteria, and outcome of these children have not been studied. STUDY DESIGN: Retrospective cohort follow up. SUBJECT SELECTION: Consecutive children who were weaned from long term CPAP/NIV between October 2013 and January 2016. METHODOLOGY: Underlying disorders, weaning criteria, and clinical outcome were analyzed...
July 17, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28714541/full-night-measurement-of-level-of-obstruction-in-sleep-apnea-utilizing-continuous-manometry
#5
Hahn Jin Jung, Jee Hye Wee, Chae-Seo Rhee, Jeong-Whun Kim
OBJECTIVES/HYPOTHESIS: To determine the average proportion of retropalatal or retroglossal obstruction occurring during a whole night in single patients with obstructive sleep apnea. STUDY DESIGN: Retrospective analysis. METHODS: Patients who underwent full-night polysomnography and upper airway pressure manometry at the same time were retrospectively enrolled. Airway obstruction levels were categorized into retropalatal or retroglossal obstruction according to the pressure change shown during pressure manometry...
July 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28714226/extranasopharyngeal-angiofibroma-revisited
#6
Jochen P Windfuhr, Julia Vent
BACKGROUND: Angiofibromas in the head and neck region usually arise in the nasopharynx, but may also occur elsewhere. This study aims at evaluating the incidence and clinical features of extranasopharyngeal angiofibroma (ENA). MATERIAL AND METHODS: Systematic review of the literature (Medline(®) and Google(™) ) up to December 31(st) , 2015. RESULTS: 174 cases of ENA were retrieved from a total of 170 publications. In contrast to former publications and previous understanding, the nasal septum was by far the most common site of the disease...
July 17, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28711601/catecholaminergic-a1-c1-neurons-contribute-to-the-maintenance-of-upper-airway-muscle-tone-but-may-not-participate-in-nrem-sleep-related-depression-of-these-muscles
#7
Irma Rukhadze, Nancy J Carballo, Sathyajit S Bandaru, Atul Malhotra, Patrick M Fuller, Victor B Fenik
Neural mechanisms of obstructive sleep apnea, a common sleep-related breathing disorder, are incompletely understood. Hypoglossal motoneurons, which provide tonic and inspiratory activation of genioglossus (GG) muscle (a major upper airway dilator), receive catecholaminergic input from medullary A1/C1 neurons. We aimed to determine the contribution of A1/C1 neurons in control of GG muscle during sleep and wakefulness. To do so, we placed injections of a viral vector into DBH-cre mice to selectively express the hMD4i inhibitory chemoreceptors in A1/C1 neurons...
July 12, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28707161/a-weight-independent-association-between-atypical-antipsychotic-medications-and-obstructive-sleep-apnea
#8
Habibolah Khazaie, Amir Sharafkhaneh, Sepideh Khazaie, Mohammad Rasoul Ghadami
BACKGROUND: With increasing use of atypical antipsychotic (AAP) agents, the concern has been raised about the association between AAP agents and medical complications. Obstructive sleep apnea (OSA) is a common breathing disorder that adversely affects health and quality of life. Because the major risk factors for OSA are weight gain and obesity by altering the upper airway anatomy, an association between AAP and development of OSA is predictable. However, we hypothesized that AAP may promote OSA not only by weight gain but also because of its potential effects on upper airway muscle function...
July 13, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28702830/sleep-disordered-breathing-in-patients-with-neuromuscular-disease
#9
REVIEW
Mohamad Ammar Albdewi, Giuseppe Liistro, Riëm El Tahry
Sleep-disordered breathing (SDB) is relatively common in general population as well as in patients with neuromuscular disease. SDB comprises a wide spectrum of disorders varying from simple snoring to complete closure of the upper airway as seen in obstructive sleep apnoea (OSA). It includes also other disorders like prolonged hypoxemia, hypoventilation, and central sleep apnoea (CSA). Neuromuscular diseases (NMD) form a group of disorders that can cause significant reduction in the quality and span of life...
July 12, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28701601/an-antenatal-diagnosis-congenital-high-airway-obstruction
#10
S Miital, A Mittal, R Singal, S Singal, G Sekhon
Congenital high airway obstruction (CHAOS) is a rare lethal fetal malformation characterised by obstruction to the fetal upper airway, which can be partial or complete. Antenatal diagnosis of CHAOS is important due to recent management options. Diagnosis is made with secondary changes such as hyperechoic enlarged lungs resulting in mediastinal compression, ascites, hydrops, flattened or everted diaphragms and dilated distal airways. We reported a case of CHAOS, antenatally on ultrasonography (USG) at 20 weeks of gestation...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28698543/genistein-protects-genioglossus-myoblast-against-hypoxia-induced-injury-through-pi3k-akt-and-erk-mapk-pathways
#11
Wanghui Ding, Xiaoyan Chen, Wen Li, Zhen Fu, Jiejun Shi
Obstructive sleep apnea and hypopnea syndrome (OSAHS) is a clinical syndrome characterized by recurrent episodes of obstruction of the upper airway during sleep that leads to a hypoxic condition. Genioglossus, an important pharyngeal muscle, plays an important role in maintaining an open upper airway for effective breathing. Our previous study found that genistein (a kind of phytoestrogen) protects genioglossus muscle from hypoxia-induced oxidative injury. However, the underlying mechanism is still unknown...
July 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28697968/update-on-pathophysiology-and-treatment-of-childhood-obstructive-sleep-apnea-syndrome
#12
REVIEW
Justin C Brockbank
Obstructive sleep apnea syndrome (OSAS) is common in childhood and is characterized by recurrent upper airway obstructive events during sleep that produce significant neurocognitive and cardiovascular sequelae. The pathophysiology of childhood OSAS is complex and involves mechanical airway obstruction often secondary to adenotonsillar hypertrophy. However, neuromotor abnormalities and instability of central ventilatory control are also implicated. Several surgical and non-surgical treatment options for childhood OSAS are available, and will be discussed...
June 12, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28697196/fluorine-18-fluorodeoxyglucose-positron-emission-tomography-computed-tomography-findings-in-a-pediatric-mucoepidermoid-carcinoma-and-differential-diagnosis
#13
Jianhao Xie, Chao Ma, Jun Tang
An 11 years old boy was referred to our hospital. He complained for the last three months for intermittent cough and shortness of breath after exercise which worsened recently. Airways computed tomography (CT) showed an abnormal endobronchial tumor, obstructing the right main bronchus and also atelectasis in the upper lobe of the right lung. Bronchoscopy showed a wet on its surface mass obstructing the right main bronchus. Biopsy showed a mucoepidermoid carcinoma (MEC). The fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) scan showed in the same area a mass with slightly increased (18)F-FDG uptake (maximum standardized uptake value, SUVmax: 3...
July 12, 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28695449/obstructing-pathology-of-the-upper-airway-in-a-post-nap4-world-time-to-wake-up-to-its-optimal-management
#14
EDITORIAL
J Adam Law, Ian R Morris, Gemma Malpas
No abstract text is available yet for this article.
July 10, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28691984/stepwise-rostrocaudal-brainstem-anesthesia-as-a-complication-of-local-anesthesia-a-case-report
#15
Braden Waters, Ryan R Kroll, John Muscedere, Lysa Boissé Lomax, Jessica E Burjorjee
Iatrogenic cranial nerve palsies can rarely complicate neurosurgical, oral maxillofacial, and otolaryngological procedures. Among the most serious complications of cranial nerve palsy is upper airway obstruction, which is life threatening. We present a case of multiple cranial nerve palsies evolving rapidly in a rostrocaudal stepwise fashion after infiltration of lidocaine to repair a cerebrospinal fluid leak in a patient postoccipital craniectomy. This led to hypoxic respiratory failure requiring mechanical ventilation before resolving spontaneously...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28689530/congenital-vallecular-cyst-arare-and-potentially-lethal-condition
#16
Shabbir Ahmed Mallick, Tabinda Naz Qureshi, Ajoy Methew Varghese, Mona Mohammed Al Busaidi
Congenital vallecular cyst is a rare laryngeal lesion, accounting for 10-20% of all laryngeal cysts, with a potential to cause severe upper airway obstruction, which can be fatal. It can cause stridor, apnea, cyanosis, respiratory distress, and feeding difficulties. Diagnosis requires a high level of clinical suspicion and helps in timely intervention. Direct laryngoscopy is gold standard for definitive diagnosis. Treatment options include aspiration, marsupialization, and surgical excision. Here, we report a case of 7-week-old infant with complain of recurrent episodes of cyanosis when agitated, since the age of 3 weeks, admitted with impression of apparent life-threatening events (ALTEs)...
June 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28688869/ankylosis-of-temporomandibular-joints-after-mandibular-distraction-osteogenesis-in-patients-with-nager-syndrome-report-of-two-cases-and-literature-review
#17
REVIEW
Cheng Chun Wu, Daisuke Sakahara, Keisuke Imai
Nager syndrome, also known as Nager acrofacial dysostosis, was first described by Nager and de Reynier in 1948. The patients commonly present with micrognathia, and a preventive tracheostomy is necessary when there are symptoms of upper airway obstruction. Mandibular distraction osteogenesis is considered as an effective procedure, which not only improves micrognathia but also minimizes the chances of tracheostomy. However, mandibular distraction osteogenesis has some complications such as relapse, teeth injury, infection, and injury of the temporomandibular joints (TMJs)...
February 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28688570/congenital-nasal-obstruction-in-infants-a-retrospective-study-and-literature-review
#18
REVIEW
Vijay A Patel, Michele M Carr
OBJECTIVES: To identify etiologies of congenital nasal obstruction and describe clinical practice patterns in the evaluation, diagnosis, and treatment of symptomatic infants. METHODS: An electronic chart review from 1/1/2006-10/1/2016 for all patients with a diagnosis of nasal obstruction within the first six months of life using ICD-9 and 10 codes 478.19 and J34.89. RESULTS: A total of 34 patients were evaluated by the Division of Otolaryngology for this chief complaint...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28686377/-airways-access-in-cannot-intubate-situation-cricothyrotomy
#19
Frédéric Heymans, Pavel Dulguerov
In case of impossible intubation /oxygenation because of an upper airways obstruction, a cricothyrotomy is indicated. It is a relative simple and safe procedure that may be life saving. A blade, a tube and one's index finger are the only tools needed. The procedure can be done anywhere and every physician should be able to perform it. Several devices have been developed to try to improve it's success rate ; on the contrary, they render the task more complicated and lead to double failure rates with associated lesions, as described in our comparative study...
October 5, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28684586/exposure-to-intermittent-hypoxia-and-sustained-hypercapnia-reduces-therapeutic-cpap-in-participants-with-obstructive-sleep-apnea
#20
Mohamad El-Chami, Sukhesh Sudan, Ho-Sheng Lin, Jason H Mateika
PURPOSE: To determine if exposure to mild intermittent hypoxia leads to a reduction in the therapeutic continuous positive airway pressure required to eliminate breathing events. METHODS: Ten male participants were treated with twelve 2-minute episodes of hypoxia (PETO2 ≈ 50 mmHg) separated by 2-minute intervals of normoxia in the presence of PETCO2 that was sustained 3 mmHg above baseline. During recovery from the last episode the positive airway pressure was reduced in a step-wise fashion until flow limitation was evident...
July 6, 2017: Journal of Applied Physiology
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