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https://www.readbyqxmd.com/read/28333768/management-of-pediatric-non-alcoholic-fatty-liver-disease-by-academic-hepatologists-in-canada-a-nationwide-survey
#1
Marialena Mouzaki, Simon C Ling, Richard A Schreiber, Binita M Kamath
BACKGROUND: The literature on the optimal clinical management of pediatric patients with non-alcoholic fatty liver disease (NAFLD) is limited. The objective of this study was to identify discrepancies in the care provided to patients with NAFLD by hepatologists practicing in academic centers across Canada. METHODS: A nationwide survey was distributed electronically to all pediatric hepatologists practicing in university-affiliated hospitals using the infrastructure of the Canadian Pediatric Hepatology Research Group...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#2
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/28320866/adenotonsillotomy-versus-adenotonsillectomy-in-pediatric-obstructive-sleep-apnea-an-rct
#3
Anna Borgström, Pia Nerfeldt, Danielle Friberg
BACKGROUND: Adenotonsillectomy (ATE) is a well-established and effective treatment of pediatric obstructive sleep apnea (OSA). In recent years, a more conservative method, adenotonsillotomy (ATT), has gained popularity because it is associated with less postoperative morbidity. Yet no previous randomized study has compared these 2 methods regarding their effectiveness in treating pediatric OSA in terms of polysomnographic data, which was the primary aim of this study. The hypothesis was that ATT is noninferior to ATE after 1 year...
March 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28320844/the-effects-of-obstructive-sleep-apnea-syndrome-on-the-dentate-gyrus-and-learning-and-memory-in-children
#4
Jiook Cha, Johanna A Zea-Hernandez, Sanghun Sin, Katharina Graw-Panzer, Keivan Shifteh, Carmen R Isasi, Mark E Wagshul, Eileen E Moran, Jonathan Posner, Molly E Zimmerman, Raanan Arens
Obstructive sleep apnea syndrome (OSAS) is associated with intermittent hypoxia and sleep loss. In children, impairments of cognitive function are important manifestations, but underlying pathology is unknown. We hypothesized that OSAS would affect the dentate gyrus, a hippocampal subdivision essential to neurogenesis and cognition, and that this impact would further affect cognitive function in children. In children with OSAS (n=11) and control subjects (n=12; age and sex-matched), we performed diffusion tensor imaging and structural MRI, polysomnography, and neuropsychological assessments...
March 20, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28319673/the-effect-of-montelukast-on-mild-persistent-osa-after-adenotonsillectomy-in-children-a-preliminary-study
#5
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/28315149/can-myofunctional-therapy-increase-tongue-tone-and-reduce-symptoms-in-children-with-sleep-disordered-breathing
#6
Maria Pia Villa, Melania Evangelisti, Susy Martella, Mario Barreto, Marco Del Pozzo
PURPOSE: Data in the literature suggest that myofunctional therapy (MT) may be able to play a role in the treatment of children with sleep-disordered breathing (SDB). Our study investigated the effectiveness of MT in reducing respiratory symptoms in children with SDB by modifying tongue tone. METHODS: Polysomnographic recordings were performed at baseline to assess obstructive sleep apnea (OSA) severity in 54 children (mean age 7.1 ± 2.5 years, 29 male) with SDB...
March 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28303917/reduced-regional-grey-matter-volumes-in-pediatric-obstructive-sleep-apnea
#7
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/28281031/pulse-transit-time-as-a-tool-to-characterize-obstructive-and-central-apneas-in-children
#8
Lucie Griffon, Alessandro Amaddeo, Jorge Olmo Arroyo, Rossana Tenconi, Serena Caggiano, Sonia Khirani, Brigitte Fauroux
PURPOSE: The characterization of apneas during polysomnography (PSG) as obstructive or central is a key element of a sleep study. Pulse transit time (PTT) has demonstrated its potential as a noninvasive surrogate marker for inspiratory efforts. The aim of the study was to assess the ability of PTT to classify apneas as central or obstructive, as compared to respiratory inductance plethysmography (RIP) in children. METHODS: Overnight PSG with simultaneous PTT recording was performed on 11 consecutive children (mean age 8...
March 9, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28268987/identifying-individual-sleep-apnea-hypoapnea-epochs-using-smartphone-based-pulse-oximetry
#9
Ainara Garde, Parastoo Dekhordi, J Mark Ansermino, Guy A Dumont
Sleep apnea, characterized by frequent pauses in breathing during sleep, poses a serious threat to the healthy growth and development of children. Polysomnography (PSG), the gold standard for sleep apnea diagnosis, is resource intensive and confined to sleep laboratories, thus reducing its accessibility. Pulse oximetry alone, providing blood oxygen saturation (SpO2) and blood volume changes in tissue (PPG), has the potential to identify children with sleep apnea. Thus, we aim to develop a tool for at-home sleep apnea screening that provides a detailed and automated 30 sec epoch-by-epoch sleep apnea analysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267299/predicting-the-effect-of-treatment-in-paediatric-osa-by-clinical-examination-and-functional-respiratory-imaging
#10
Monique Slaats, Wim Vos, Cedric Van Holsbeke, Jan De Backer, Dieter Loterman, Wilfried De Backer, An Boudewyns, Stijn Verhulst
OBJECTIVE: The aim of this study was to investigate whether functional respiratory imaging (FRI) or clinical examination could predict treatment outcome for obstructive sleep apnea (OSA) in normal-weight, non-syndromic children. METHODS: Normal weight children diagnosed with OSA by polysomnography were prospectively included. All children got a thorough evaluation and an ultra-low dose computed tomography scan of the upper airway (UA). A 3-D reconstruction was built combined with computational fluid dynamics for FRI...
March 7, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28241176/predictors-of-obstructive-sleep-apnea-severity-in-adolescents
#11
Mark Baker, Brian Scott, Romaine F Johnson, Ron B Mitchell
Importance: Untreated obstructive sleep apnea has severe health consequences, yet little is known about predictors of sleep apnea severity in the adolescent population. Objective: To evaluate clinical and demographic factors associated with obstructive sleep apnea severity in adolescents. Design, Setting, and Participants: A retrospective case series of 224 children (53% male), ages 12 to 17 years who underwent polysomnography from January 1, 2013, to June 4, 2015...
February 23, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28239978/sleep-disordered-breathing-and-its-management-in-children-with-achondroplasia
#12
Rossana Tenconi, Sonia Khirani, Alessandro Amaddeo, Caroline Michot, Geneviève Baujat, Vincent Couloigner, Livio De Sanctis, Syril James, Michel Zerah, Valérie Cormier-Daire, Brigitte Fauroux
Sleep-disordered breathing is a common feature in children with achondroplasia. The aim of our study was to review the poly(somno)graphic (P(S)G) findings and consequent treatments in children with achondroplasia followed in the national reference center for skeletal dysplasia. A retrospective review of the clinical charts and P(S)G of 43 consecutive children (mean age 3.9 ± 3.5 years) with achondroplasia seen over a period of 2 years was performed. Twenty four (59%) children had obstructive sleep apnea (OSA)...
February 27, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28230307/cdkl5-deficiency-entails-sleep-apneas-in-mice
#13
Viviana Lo Martire, Sara Alvente, Stefano Bastianini, Chiara Berteotti, Alessandro Silvani, Alice Valli, Rocchina Viggiano, Elisabetta Ciani, Giovanna Zoccoli
A recently discovered neurodevelopmental disorder caused by the mutation of the cyclin-dependent kinase-like 5 gene (CDKL5) entails complex autistic-like behaviours similar to Rett syndrome, but its impact upon physiological functions remains largely unexplored. Sleep-disordered breathing is common and potentially life-threatening in patients with Rett syndrome; however, evidence is limited in children with CDKL5 disorder, and is lacking altogether in adults. The aim of this study was to test whether the breathing pattern during sleep differs between adult Cdkl5 knockout (Cdkl5-KO) and wild-type (WT) mice...
February 23, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28229031/characterization-of-sleep-architecture-in-down-syndrome-patients-pre-and-post-airway-surgery
#14
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/28227197/identifying-individual-sleep-apnea-hypoapnea-epochs-using-smartphone-based-pulse-oximetry
#15
Ainara Garde, Parastoo Dekhordi, J Mark Ansermino, Guy A Dumont, Ainara Garde, Parastoo Dekhordi, J Mark Ansermino, Guy A Dumont, J Mark Ansermino, Parastoo Dekhordi, Guy A Dumont, Ainara Garde
Sleep apnea, characterized by frequent pauses in breathing during sleep, poses a serious threat to the healthy growth and development of children. Polysomnography (PSG), the gold standard for sleep apnea diagnosis, is resource intensive and confined to sleep laboratories, thus reducing its accessibility. Pulse oximetry alone, providing blood oxygen saturation (SpO2) and blood volume changes in tissue (PPG), has the potential to identify children with sleep apnea. Thus, we aim to develop a tool for at-home sleep apnea screening that provides a detailed and automated 30 sec epoch-by-epoch sleep apnea analysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224648/impacts-of-disease-severity-on-postoperative-complications-in-children-with-sleep-disordered-breathing
#16
Kun-Tai Kang, I-Sheng Chang, Chia-Chen Tseng, Wen-Chin Weng, Tzu-Yu Hsiao, Pei-Lin Lee, Wei-Chung Hsu
OBJECTIVES/HYPOTHESIS: To investigate the effects of diseases severity on postoperative complications following adenotonsillectomy (T&A) in children with sleep-disordered breathing (SDB). STUDY DESIGN: Retrospective study. METHODS: Children aged <18 years were enrolled and underwent T&A for treating SDB. Polysomnography was used to classify the disease severity: primary snoring (apnea-hypopnea index [AHI] <1), mild (AHI = 1-5), moderate (AHI = 5-10), and severe obstructive sleep apnea [OSA] (AHI ≥10)...
February 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28220307/drug-induced-sedation-endoscopy-in-children-2%C3%A2-years-with-obstructive-sleep-apnea-syndrome-upper-airway-findings-and-treatment-outcomes
#17
A Boudewyns, P Van de Heyning, S Verhulst
Few data are available about the pattern of upper airway (UA) obstruction in children <2 years with obstructive sleep apnea syndrome (OSAS). Also, the role of adenoidectomy versus adenotonsillectomy (AT) is poorly defined in this age group. We performed drug-induced sedation endoscopy (DISE) in young OSAS children to investigate the pattern of UA obstruction and the value of DISE in therapeutic decision making. Retrospective analysis of ≤2-year-old children undergoing DISE-directed UA surgery. OSAS severity and the treatment outcomes were documented by polysomnography...
February 20, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28215268/periodic-limb-movements-and-restless-legs-syndrome-in-children-with-a-history-of-prematurity
#18
Christopher M Cielo, Lourdes M DelRosso, Ignacio E Tapia, Sarah N Biggs, Gillian M Nixon, Lisa J Meltzer, Joel Traylor, Ji Young Kim, Carole L Marcus
INTRODUCTION: Little is known about the pediatric population at an increased risk of restless legs syndrome (RLS) and periodic limb movement disorder (PLMD). Polysomnographic data from the Caffeine for Apnea of Prematurity-Sleep (CAPS) study showed a high prevalence of elevated periodic limb movement index (PLMI) in a cohort of ex-preterm children, but the clinical importance of this finding, such as association with RLS, is unknown. We hypothesized that ex-preterm children would have a high prevalence of RLS and PLMD...
February 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28215263/sleep-disordered-breathing-systemic-adipokine-secretion-and-metabolic-dysregulation-in-overweight-and-obese-children-and-adolescents
#19
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
#20
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
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