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https://www.readbyqxmd.com/read/28213776/the-importance-of-drug-induced-sedation-endoscopy-d-i-s-e-techniques-in-surgical-decision-making-conventional-versus-target-controlled-infusion-techniques-a-prospective-randomized-controlled-study-and-a-retrospective-surgical-outcomes-analysis
#1
Andrea De Vito, Vanni Agnoletti, Gianluca Zani, Ruggero Massimo Corso, Giovanni D'Agostino, Elisabetta Firinu, Chiara Marchi, Ying-Shuo Hsu, Stefano Maitan, Claudio Vicini
Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep...
February 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28210329/respiratory-illness-in-children-with-disability-a-serious-problem
#2
REVIEW
Marijke Proesmans
KEY POINTS: Children with neurocognitive impairment often present with chronic or recurrent respiratory problems.The respiratory problems have an important impact on quality of life and life expectancy.The underlying causes are multiple: risk of aspiration, insufficient cough, upper airway obstruction and progressive kyphoscoliosis.There is often a complex interplay between these known risk factors.The diagnostic and therapeutic approach should be multidisciplinary. EDUCATIONAL AIMS: To provide data on the prevalence of respiratory problems in children with disability and to increase awareness on this topic...
December 2016: Breathe
https://www.readbyqxmd.com/read/28207995/impact-of-continuous-positive-airway-pressure-in-patients-with-obstructive-sleep-apnea-during-drug-induced-sleep-endoscopy
#3
Carlos Torre, Stanley Yung-Chuan Liu, Clete A Kushida, Vladimir Nekhendzy, Leh-Kiong Huon, Robson Capasso
OBJECTIVES: The primary objective of the study was to understand the differential impact of Continuous Positive Airway Pressure (CPAP) on the location, degree, and pattern of airway collapse in Obstructive Sleep Apnea (OSA) patients utilizing Drug Induced Sleep Endoscopy (DISE). STUDY DESIGN: Non-randomized trial. SETTING: University Medical Center. PARTICIPANTS: 15 consecutive OSA patients undergoing DISE. MAIN OUTCOMES AND MEASURES: The patterns of airway collapse were videorecorded at baseline and under differential application of nasal CPAP (nCPAP) at 5,10, and 15 cm H2 O...
February 16, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28207796/post-extubation-stridor-in-respiratory-syncytial-virus-bronchiolitis-is-there-a-role-for-prophylactic-dexamethasone
#4
Esther S Veldhoen, Charlotte A Smulders, Teus H Kappen, Job C Calis, Job van Woensel, Paulien A M Raymakers-Janssen, Louis J Bont, Marije P Hennus
AIM: The purpose of this study was to determine the incidence of reintubation due to upper airway obstruction in a homogeneous group of ventilated infants with Respiratory Syncytial Virus bronchiolitis. Our secondary objective was to determine whether prophylactic administration of dexamethasone prior to extubation was associated with decreased risk of reintubation. METHODS: This retrospective observational study in two Pediatric Intensive Care Units in 2 university hospitals in The Netherlands included two hundred patients younger than 13 months admitted with respiratory insufficiency caused by Respiratory Syncytial Virus bronchiolitis, requiring invasive mechanical ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/28198643/the-role-of-curvilinear-distraction-system-in-pediatric-obstructive-sleep-apnea-a-case-report
#5
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/28197218/polysomnographic-findings-in-infants-with-pierre-robin-sequence
#6
Abdullah Khayat, Saadoun Bin-Hassan, Suhail Al-Saleh
INTRODUCTION: Pierre Robin sequence (PRS) is characterized by the triad of micrognathia, glossoptosis, and upper airway obstruction. It is commonly associated with the secondary cleft palate. Infants with PRS commonly have sleep-disordered breathing (SDB); including obstructive sleep apnea (OSA) as well as central sleep breathing abnormalities that are present from infancy. AIM OF THE STUDY: Evaluate the prevalence and severity of SDB in infants with PRS using polysomnography (PSG)...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28195345/in-vivo-measurements-of-human-neck-skin-elasticity-using-mri-and-finite-element-modeling
#7
Yunqiang An, Changjin Ji, Yong Li, Jianxia Wang, Xinyue Zhang, Yaqi Huang
PURPOSE: The assessment of mechanical properties of the human skin is very important in investigating the mechanism of obstructive sleep apnea, a common disorder characterized by repetitive collapse and obstruction of the upper airway during sleep. In this study, a unique method, combining magnetic resonance imaging (MRI) and finite element modeling (FEM), was developed to obtain the value of the in vivo elastic modulus of the neck skin. MEHTHOD: A total of 22 subjects, 16 males and 6 females, were recruited to participate in the MRI studies...
February 13, 2017: Medical Physics
https://www.readbyqxmd.com/read/28195009/the-combination-of-anatomy-and-genioglossus-activity-in-predicting-the-outcomes-of-velopharyngeal-surgery
#8
Di Zhao, YanRu Li, JunFang Xian, Yue Qu, Xin Cao, JingYing Ye
Objective This study aims to evaluate the combination of genioglossus (GG) activity and anatomical characteristics in predicting outcomes of velopharyngeal surgery in patients with obstructive sleep apnea (OSA). Study Design Case series with planned data collection. Setting Sleep medical center. Subjects and Methods Forty patients with OSA underwent overnight polysomnography with synchronous genioglossus electromyography (GGEMG) using intraoral electrodes. The upper airway anatomy was evaluated by 3-dimensional computed tomography in patients with OSA...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28194999/upper-airway-stimulation-for-obstructive-sleep-apnea
#9
M Boyd Gillespie, Ryan J Soose, B Tucker Woodson, Kingman P Strohl, Joachim T Maurer, Nico de Vries, David L Steward, Jonathan Z Baskin, M Safwan Badr, Ho-Sheng Lin, Tapan A Padhya, Sam Mickelson, W McDowell Anderson, Olivier M Vanderveken, Patrick J Strollo
Objective To assess patient-based outcomes of participants in a large cohort study-the STAR trial (Stimulation Therapy for Apnea Reduction)-48 months after implantation with an upper airway stimulation system for moderate to severe obstructive sleep apnea. Study Design A multicenter prospective cohort study. Setting Industry-supported multicenter academic and clinical setting. Subjects Participants (n = 91) at 48 months from a cohort of 126 implanted participants. Methods A total of 126 participants received an implanted upper airway stimulation system in a prospective phase III trial...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28190872/upper-airway-obstruction-requiring-emergent-tracheostomy-secondary-to-laryngeal-sarcoidosis-a-case-report
#10
Changwan Ryu, Erica L Herzog, Hongyi Pan, Robert Homer, Mridu Gulati
BACKGROUND Laryngeal sarcoidosis is a rare extrapulmonary manifestation of sarcoidosis, accounting for 0.33-2.1% of cases. A life-threatening complication of laryngeal sarcoidosis is upper airway obstruction. In this report we describe our experience in the acute and chronic care of a patient who required an emergent tracheostomy, with the aim to provide further insight into this difficult to manage disease. CASE REPORT A 37-year-old African American female with a 10-year history of stage 1 sarcoidosis presented with severe dyspnea...
February 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28187974/no-correlation-between-two-dimensional-measurements-and-three-dimensional-configuration-of-the-pharyngeal-upper-airway-space-in-cone-beam-computed-tomography
#11
Marie Dorothée Abé-Nickler, Samira Pörtner, Peter Sieg, Samer George Hakim
The aim of this study was to evaluate both the 2-dimensional (2D) and 3-dimensional (3D) configuration of the posterior airway space (PAS) in healthy 239 patients using cone-beam computed tomography (CBCT). In particular, we investigated the correlation between the 2D and 3D measurements in view of the potential impact on diagnosis of upper airway obstruction. The pharyngeal airway of each patient was studied at five levels: the level of the posterior nasal spine (PNS), the level of half-height of the PNS and the tip of the soft palate, the level of the tip of the soft palate, the level of the anterior-inferior point of the second vertebra, and at least the level of the top of the epiglottis...
January 10, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28185010/evaluation-of-effects-of-anterior-palatoplasty-operation-on-upper-airway-parameters-in-computed-tomography-in-patients-with-pure-snoring-and-obstructive-sleep-apnea-syndrome
#12
Adin Selcuk, Tulay Ozer, Erkan Esen, Fatih Ozdogan, Halil Erdem Ozel, Turgut Yuce, Sebla Caliskan, Sinem Dasli, Nagihan Bilal, Gulden Genc, Selahattin Genc
AIM: To investigate changes in upper airway volume parameters measured by computerized tomography scans in patients with surgically treated by anterior palatoplasty of whom having pure snoring and mild-moderate obstructive sleep apnea. METHOD: A prospective study on consecutively anterior palatoplasty performed pure snoring and obstructive sleep apnea patients. Computerized tomography scans were obtained preoperatively and following anterior palatoplasty procedure to measure changes in upper airway volume...
February 9, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28184275/postoperative-negative-pressure-pulmonary-edema-following-repetitive-laryngospasm-even-after-reversal-of-neuromuscular-blockade-by-sugammadex-a-case-report
#13
Ji Hyeon Lee, Jae Ho Lee, Min Hyun Lee, Hyun Oh Cho, Soon Eun Park
Laryngospasm, an occlusion of the glottis, can occur at any time during anesthesia, and is associated with serious perioperative complications such as hypoxia, hypercabia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death. Importantly, postoperative negative pressure pulmonary edema (NPPE) is a rare, but well described life-threatening complication related to acute and chronic upper airway obstruction. Sugammadex well known for affirmatively reducing the postoperative pulmonary complications associated with residual neuromuscular blockade may have an indirect role in triggering the negative intrathoracic pressure by raising a rapid and efficacious respiratory muscle strength in acute upper airway obstruction...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28181680/early-term-deliveries-and-the-risk-of-pediatric-obstructive-sleep-apnoea-in-the-offspring
#14
Asnat Walfisch, Tamar Wainstock, Ofer Beharier, Daniella Landau, Eyal Sheiner
BACKGROUND: Preterm delivery may affect the development of the upper airways resulting in a higher risk of obstructive sleep apnoea (OSA). We investigated whether children born at early term (37-38 6/7 weeks' gestation) are at an increased risk for childhood OSA as compared with those born later. METHODS: In this population-based cohort analysis all singleton deliveries occurring between 1991-2013 at a single regional tertiary medical centre were included. Gestational age upon delivery was sub-divided into: early preterm (<33 6/7 weeks' gestation), late preterm (34-36 6/7), early term, full term (39-40 6/7), late term (41-41 6/7), and post term (>42 0/7)...
February 9, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28181359/general-anesthesia-with-a-native-airway-for-patients-with-mucopolysaccharidosis-type-iii
#15
Mineto Kamata, Christopher McKee, Kristen V Truxal, Kevin M Flanigan, Kim L McBride, Shawn C Aylward, Joseph D Tobias, Marco Corridore
BACKGROUND: Mucopolysaccharidosis type III is a progressive disease with worsening airway, pulmonary, and cardiac involvement that may complicate anesthetic care. AIM: To prospectively evaluate the incidence of airway issues and complications during magnetic resonance imaging (MRI) and lumbar puncture (LP) during general anesthesia with a native airway for patients with mucopolysaccharidosis type III. METHOD: The study was a part of the natural history study...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28179132/gefitinib-gefitinib-microspheres-loaded-polyurethane-constructs-as-drug-eluting-stent-coating
#16
Weiluan Chen, Johanna Clauser, Anja Lena Thiebes, Donnacha J McGrath, Nicola Kelly, Mies J van Steenbergen, Stefan Jockenhoevel, Ulrich Steinseifer, Peter E McHugh, Wim E Hennink, Robbert J Kok
One of the complications of bronchotracheal cancer is obstruction of the upper airways. Local tumor resection in combination with an airway stent can suppress intraluminal tumor (re)growth. We have investigated a novel drug-eluting stent coating for local release of the anticancer drug gefitinib. A polyurethane (PU) sandwich construct was prepared by a spray coating method in which gefitinib was embedded between a PU support layer of 200μm and a PU top layer of 50-200μm. Gefitinib was either embedded in the construct as small crystals or as gefitinib-loaded poly(lactic-co-glycolic acid) (PLGA) microspheres (MSP)...
February 4, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28178173/screening-for-hereditary-angioedema-hae-at-13-emergency-centers-in-osaka-japan-a-prospective-observational-study
#17
Tomoya Hirose, Futoshi Kimbara, Masahiro Shinozaki, Yasuaki Mizushima, Hidehiko Yamamoto, Masashi Kishi, Takeyuki Kiguchi, Shigeru Shiono, Mitsuhiro Noborio, Akihiro Fuke, Hiroshi Akimoto, Takaaki Kimura, Shinichiro Kaga, Takahiko Horiuchi, Takeshi Shimazu
Hereditary angioedema (HAE) with deficiency of C1 inhibitor (C1-INH) is an autosomal-dominant disease characterized by recurrent episodes of potentially life-threatening angioedema. The objective is to study the incidence of HAE among patients who visit the emergency department.This was a 3-year prospective observational screening study involving 13 urban tertiary emergency centers in Osaka prefecture, Japan. Patients were included if they met the following criteria: unexplained edema of the body, upper airway obstruction accompanied by edema, anaphylaxis, acute abdomen with intestinal edema (including ileus and acute pancreatitis), or asthma attack...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28161892/osa-and-cardiometabolic-risk-what-s-the-bottom-line
#18
REVIEW
Camilla M Hoyos, Luciano F Drager, Sanjay R Patel
Obstructive sleep apnoea (OSA) is a common condition characterized by repetitive upper airway obstruction during sleep. OSA promotes wide intrathoracic pressure swings, intermittent hypoxia and sleep fragmentation. Growing evidence derived from animal models mimicking the oxygen profile observed in patients with OSA as well as clinical studies support that this important sleep-disordered breathing is associated with increased cardiovascular risk. Although the precise mechanisms are not fully established, it is conceivable that the metabolic deregulation promoted by the components of OSA may have an important causal role in the poor cardiovascular prognosis...
February 5, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28146288/outcomes-and-prognostic-factors-of-surgical-treatments-for-brachycephalic-obstructive-airway-syndrome-in-3-breeds
#19
Nai-Chieh Liu, Gerhard U Oechtering, Vicki J Adams, Lajos Kalmar, David R Sargan, Jane F Ladlow
OBJECTIVE: To determine prognostic indicators for the surgical treatment of brachycephalic obstructive airway syndrome (BOAS) and to compare the prognosis of 2 multilevel surgical procedures. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Client-owned pugs, French bulldogs, and bulldogs (n = 50). METHODS: Noninvasive whole-body barometric plethysmography (WBBP) was used to assess respiratory function before, 1 month and 6 months after upper airway corrective surgery...
February 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28143688/sleep-apnea-state-of-the-art
#20
REVIEW
Martin R Cowie
Many patient with, or at risk of, cardiovascular disease have sleep disordered breathing (SDB), which can be either obstructive (with intermittent collapse of the upper airway) or central (episodic loss of respiratory drive). SDB is associated with sleep disturbance, hypoxemia, hemodynamic changes, and sympathetic activation. Such patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and partially normalize the sleep and respiratory physiology, but recent randomized trials of cardiovascular outcomes in SDB have either been neutral (obstructive sleep apnea) or suggested the possibility of harm, likely from increased sudden death, in central sleep apnea...
December 20, 2016: Trends in Cardiovascular Medicine
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