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Obesity hypoventilation

Serap Argun Baris, Dilek Tuncel, Cigdem Ozerdem, Huseyin Kutlu, Tugba Onyilmaz, Ilknur Basyigit, Hasim Boyaci, Fusun Yildiz
BACKGROUND: The aim of this study is to evaluate the presence of neurocognitive dysfunctions, depression and anxiety and the effect of positive airway pressure (PAP) therapy on these alterations in Obesity Hypoventilation Syndrome (OHS) patients. METHODS: Ten healthy normal and obese controls, 10 OHS and 10 OSAS patients were included in the study. Short form-36, Beck Depression Scale and State-Trade Anxiety Inventory (STAI 1-2) were performed. Wisconsin Card Sorting Test (WCST), Montreal Cognitive Assessment Scale (MOCA), Enhanced Cued Recall (ECR) and Mini Mental Test (MMT) were used for neurocognitive evaluation...
2016: Multidisciplinary Respiratory Medicine
Paul L Schneider, Zhaoping Li
OBJECTIVE: To provide a thorough analysis of the range of ethical concerns that may present in relation to the care of the morbidly obese inpatient over the course of several years of care. METHODS: A narrative of the patient's complex medical care is given, with particular attention to the recommendations of three separate ethics committee consultations that were sought by his health care providers. An ethical analysis of the relevant issues is given within the Principles of Biomedical Ethics framework, highlighting the principles of autonomy, beneficence, non-maleficence, and justice...
2016: Narrative Inquiry in Bioethics
Adel S Al-Harbi, Abdullah Al-Shamrani, Baha A Al-Shawwa
Rapid-onset obesity, hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) is a rare disease, but could be fatal if not diagnosed early. It mimics many other diseases and it may take few years after the onset of rapid obesity to have the other clinical features. Therefore, any patient with rapid-onset obesity after the age of 2 years should have high index of suspicion and long term follow up. We report a case of ROHHAD in Saudi Arabia and we highlight the clinical features and the importance of early diagnosis and management...
November 2016: Saudi Medical Journal
P Gouda, J Chua, D Langan, T Hannon, A Scott, A O'Regan
BACKGROUND: While domiciliary non-invasive ventilation (NIV) was initially used in the treatment of respiratory failure resulting from chest wall deformity, the main indication is now chronic obstructive pulmonary disease (COPD) with recurrent exacerbations associated with type 2 respiratory failure. A longitudinal study of domiciliary NIV provides insights into the evolution of this treatment in the west of Ireland. METHODS: The cohort of patients receiving new prescriptions for domiciliary NIV from Galway University Hospital from 2000 to 2012 was reviewed using study coordinator chart reviews and telephone follow-ups...
October 15, 2016: Irish Journal of Medical Science
H Coleman Robinson
Restrictive lung diseases are a heterogeneous group of conditions characterized by a restrictive pattern on spirometry and confirmed by a reduction in total lung volume. Patients with more severe symptoms may have a reduced diffusing capacity of the lung for carbon monoxide. Etiologies can be intrinsic with lung parenchymal involvement, as in interstitial lung diseases, or extrinsic to the lung, as in obesity and neuromuscular disorders. Idiopathic pulmonary fibrosis is a chronic progressive interstitial pneumonia with fibrosis for which treatment is primarily supportive with oxygen therapy, pulmonary rehabilitation, and management of comorbid conditions...
September 2016: FP Essentials
Juan F Masa, Jaime Corral, Auxiliadora Romero, Candela Caballero, Joaquin Terán-Santos, Maria L Alonso-Álvarez, Teresa Gomez-Garcia, Mónica González, Soledad López-Martínez, Pilar De Lucas, José M Marin, Sergi Marti, Trinidad Díaz-Cambriles, Eusebi Chiner, Miguel Merchan, Carlos Egea, Ana Obeso, Babak Mokhlesi
RATIONALE: Low flow supplemental oxygen is commonly prescribed to patients with obesity hypoventilation syndrome (OHS). However, there is a paucity of data regarding its efficacy and safety. OBJECTIVES: To assess the medium-term treatment efficacy of adding supplemental oxygen therapy to commonly prescribed treatment modalities in OHS. METHODS: In this post hoc analysis of a previous randomized controlled trial, we studied 302 sequentially screened OHS patients who were randomly assigned to noninvasive ventilation, continuous positive airway pressure, or lifestyle modification...
August 22, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Telma C A Sequeira, Ahmed S BaHammam, Antonio M Esquinas
Obesity is a global epidemic that adversely affects respiratory physiology. Sleep-disordered breathing and obesity hypoventilation syndrome (OHS) are among the most common pulmonary complications related to obesity class III. Patients with OHS may present with acute hypercapnic respiratory failure (AHRF) that necessitates immediate noninvasive ventilation (NIV) or invasive ventilation and intensive care unit (ICU) monitoring. The OHS is underrecognized as a cause of AHRF. The management of mechanical ventilation in obese ICU patients is one of the most challenging problems facing respirologists, intensivists, and anesthesiologists...
August 15, 2016: Journal of Intensive Care Medicine
J M Luo, Y Xiao
No abstract text is available yet for this article.
August 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
Victoria Connor, Sizheng Zhao, Robert Angus
Smith-Magenis syndrome (SMS) is a rare genetic neurodevelopmental disorder characterised by behavioural disturbances, intellectual disability and early onset obesity. The physical features of this syndrome are well characterised; however, behavioural features, such as sleep disturbance, are less well understood and difficult to manage. Sleep issues in SMS are likely due to a combination of disturbed melatonin cycle, facial anatomy and obesity-related ventilatory problems. Sleep disorders can be very distressing to patients and their families, as exemplified by our patient's experience, and can worsen behavioural issues as well as general health...
2016: BMJ Case Reports
Diana Reppucci, Jill Hamilton, E Ann Yeh, Sherri Katz, Suhail Al-Saleh, Indra Narang
BACKGROUND: Rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD) is a rare disease with a high mortality rate. Although nocturnal hypoventilation (NH) is central to ROHHAD, the evolution of sleep disordered breathing (SDB) is not well studied. The aim of the study was to assess early manifestations of SDB and their evolution in ROHHAD syndrome. METHODS: Retrospective study of children with ROHHAD at two Canadian centers...
2016: Orphanet Journal of Rare Diseases
Erika J MacIntyre, Leyla Asadi, Doug A Mckim, Sean M Bagshaw
Background. The prevalence of patients supported with home mechanical ventilation (HMV) for chronic respiratory failure has increased. However, the clinical outcomes associated with HMV are largely unknown. Methods. We performed a systematic review of studies evaluating patients receiving HMV for indications other than obstructive lung disease, reporting at least one clinically relevant outcome including health-related quality of life (HRQL) measured by validated tools; hospitalization requirements; caregiver burden; and health service utilization...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Juan F Masa, Jaime Corral, Candela Caballero, Emilia Barrot, Joaquin Terán-Santos, Maria L Alonso-Álvarez, Teresa Gomez-Garcia, Mónica González, Soledad López-Martín, Pilar De Lucas, José M Marin, Sergi Marti, Trinidad Díaz-Cambriles, Eusebi Chiner, Carlos Egea, Erika Miranda, Babak Mokhlesi, Estefanía García-Ledesma, M-Ángeles Sánchez-Quiroga, Estrella Ordax, Nicolás González-Mangado, Maria F Troncoso, Maria-Ángeles Martinez-Martinez, Olga Cantalejo, Elena Ojeda, Santiago J Carrizo, Begoña Gallego, Mercedes Pallero, M Antonia Ramón, Josefa Díaz-de-Atauri, Jesús Muñoz-Méndez, Cristina Senent, Jose N Sancho-Chust, Francisco J Ribas-Solís, Auxiliadora Romero, José M Benítez, Jesús Sanchez-Gómez, Rafael Golpe, Ana Santiago-Recuerda, Silvia Gomez, Mónica Bengoa
BACKGROUND: Non-invasive ventilation (NIV) is an effective form of treatment in patients with obesity hypoventilation syndrome (OHS) who have concomitant severe obstructive sleep apnoea (OSA). However, there is a paucity of evidence on the efficacy of NIV in patients with OHS without severe OSA. We performed a multicentre randomised clinical trial to determine the comparative efficacy of NIV versus lifestyle modification (control group) using daytime arterial carbon dioxide tension (PaCO2) as the main outcome measure...
October 2016: Thorax
Lena Lavie, Peretz Lavie
No abstract text is available yet for this article.
July 2016: Chest
Juan F Masa, Isabel Utrabo, Javier Gomez de Terreros, Myriam Aburto, Cristóbal Esteban, Enric Prats, Belén Núñez, Ángel Ortega-González, Luis Jara-Palomares, M Jesus Martin-Vicente, Eva Farrero, Alicia Binimelis, Ernest Sala, José C Serrano-Rebollo, Emilia Barrot, Raquel Sánchez-Oro-Gomez, Ramón Fernández-Álvarez, Francisco Rodríguez-Jerez, Javier Sayas, Pedro Benavides, Raquel Català, Francisco J Rivas, Carlos J Egea, Antonio Antón, Patricia Peñacoba, Ana Santiago-Recuerda, M A Gómez-Mendieta, Lidia Méndez, José J Cebrian, Juan A Piña, Enrique Zamora, Gonzalo Segrelles
BACKGROUND: Severe acidosis can cause noninvasive ventilation (NIV) failure in chronic obstructive pulmonary disease (COPD) patients with acute hypercapnic respiratory failure (AHRF). NIV is therefore contraindicated outside of intensive care units (ICUs) in these patients. Less is known about NIV failure in patients with acute cardiogenic pulmonary edema (ACPE) and obesity hypoventilation syndrome (OHS). Therefore, the objective of the present study was to compare NIV failure rates between patients with severe and non-severe acidosis admitted to a respiratory intermediate care unit (RICU) with AHRF resulting from ACPE, COPD or OHS...
2016: BMC Pulmonary Medicine
S Ibáñez-Micó, A M Marcos Oltra, S de Murcia Lemauviel, R Ruiz Pruneda, C Martínez Ferrández, R Domingo Jiménez
INTRODUCTION: ROHHAD syndrome (rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation) is a rare and complex disease, presenting in previously healthy children at the age of 2-4 years. Up to 40% of cases are associated with neural crest tumours. DEVELOPMENT: We present the case of a 2-year-old girl with symptoms of rapidly progressing obesity, who a few months later developed hypothalamic dysfunction with severe electrolyte imbalance, behaviour disorder, hypoventilation, and severe autonomic dysregulation, among other symptoms...
June 20, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
W Kinnear, J Colt, L Watson, P Smith, L Johnson, S Burrows, M Sovani, A Khanna, P Maddison, A Wills
Long-term non-invasive ventilation (NIV) was introduced in the 1980s, initially mainly for patients with poliomyelitis, muscular dystrophy (MD) or scoliosis. The obesity-hypoventilation syndrome has since become the commonest reason for referral to most centres providing home-NIV. Patients with MD are numerically a much smaller part of the workload, but as their disease progresses the need for ventilatory support changes and they require regular comprehensive assessment of their condition. We have examined the trend in MD use of home-NIVin our unit over the last 25 years...
June 21, 2016: Chronic Respiratory Disease
Lisa A Jacobson, Shruti Rane, Lisa J McReynolds, Diana A Steppan, Allen R Chen, Ido Paz-Priel
Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) is a rare, generally progressive, and potentially fatal syndrome of unclear etiology. The syndrome is characterized by normal development followed by a sudden, rapid hyperphagic weight gain beginning during the preschool period, hypothalamic dysfunction, and central hypoventilation, and is often accompanied by personality changes and developmental regression, leading to substantial morbidity and mortality...
July 2016: Pediatrics
Liam M Hannan, Hamna Sahi, Jeremy D Road, Christine F McDonald, David J Berlowitz, Mark E Howard
RATIONALE: Comparisons of home mechanical ventilation services have demonstrated considerable regional variation in patient populations managed with this therapy. The respiratory care practices used to support individuals receiving assisted ventilation also appear to vary, but they are not well described. It is uncertain whether differences in the approach to care could influence health outcomes for individuals receiving assisted ventilation. OBJECTIVES: We sought to identify and describe the respiratory care practices of home ventilation providers in two different regions and determine whether care practice differences influence health-related quality of life...
June 2016: Annals of the American Thoracic Society
Aylin Özsancak Uğurlu, Huriye Berk Takır, Begüm Ergan, Erdal İn, Ezgi Özyilmaz, Özlem Ertan Edipoğlu, Eylem Acartürk, Ege Güleç Balbay, Aslı Görek Dilektaşlı, Tülay Kıvanç, Pervin Korkmaz Ekren, Sevinç Sarınç Ulaşlı, Ilgaz Doğrul, Elif Yılmazel Uçar, Şehnaz Olgun, Özkan Devran, Recai Ergun, Zuhal Karakurt
INTRODUCTION: To define approach of pulmonologists in Turkey to noninvasive mechanical ventilation (NIV) use for chronic respiratory failure (CRF), the most currently applied technique for home mechanical ventilation. PATIENTS AND METHODS: A 38-question survey, developed and tested by the authors, was distributed throughout Turkey to 2205 pulmonologists by e-mail. RESULT: Twenty-seven percent of the pulmonologists responded (n=596). Domiciliary NIV was reported to be prescribed by 340 physicians [57...
March 2016: Tüberküloz Ve Toraks
Mukesh Sanklecha, Suba Sundaresan, Vrajesh Udani
BACKGROUND: ROHHAD syndrome is an exceedingly rare cause of central hypoventilation. CASE CHARACTERISTICS: A 7-year-old girl with ROHHAD syndrome who had central hypoventilation, rapid weight gain, multiple cardiac arrests and hyperprolactinemia. OUTCOME: She required prolonged and repeated ventilation, and finally died due to complications of ventilation. MESSAGE: ROHHAD Syndrome should be suspected in any child who presents with obesity, behavioral changes or autonomic instability following a neural crest tumor...
April 2016: Indian Pediatrics
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