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Sample records for levitys kasvustoon osa

  1. Endocrine and Metabolic Aspects of OSA

    Directory of Open Access Journals (Sweden)

    Ravinder Goswami

    2014-03-01

    Full Text Available Obstructive sleep apnea (OSA is characterized by repeated spells of apnea.Collapsibility of hypopharynx due to multiple factors involving pharyngeal dilatormuscles and deposition of fat or fluid in the surrounding soft tissues are importantcontributing factors in its pathogenesis. OSA commonly affects obese individuals.Males are more commonly affected than the females probably due to the disturbingeffect of testosterone on sleep.The impact of OSA on human health include disturbances in endocrine and metabolicsystem affecting hypothalamic-pituitary-gonadal axis, adrenocorticotrophic-cortisolaxis, growth hormone, antidiuretic hormones and insulin resistance. There is atendency for predisposition of the metabolic syndrome or its components includingglycemic dysregulation, hypertension, hyperlipidemia and physical parameters relatedto adiposity. On the other hand, several endocrine disorders such as hypothyroidism,growth hormone excess, polycystic ovarian disease and testosterone replacement areassociated with increased prevalence of OSA.There is limited information on the effect of treatment of OSA by continuous positiveairway pressure (CPAP on the endocrine and metabolic disturbances. There is a needto conduct randomized controlled trials using CPAP therapy in patients with OSA andto study its cause and effect relationship with endocrine and metabolic disturbances.

  2. Can you die from obstructive sleep apnoea syndrome (OSAS)?

    LENUS (Irish Health Repository)

    O'Carroll, G

    2015-02-01

    Studies suggest an independent association between Obstructive Sleep Apnoea Syndrome (OSAS) and cardiovascular death. The purpose of our study is to examine doctors\\' awareness of this association and to determine whether this correlates with recording of OSAS on death certificates. We contacted the Central Statistics Office (CSO) and obtained relevant mention of OSAS on death certificates. We surveyed doctors on their view of OSAS-related deaths, CSO data from 2008-2011 reveal two deaths with OSAS documented as a direct cause and 52 deaths with OSAS as a contributory cause. Seventy-five doctors\\' surveyed (41%) believe OSAS can be a direct cause of death and 177 (96%) believe OSAS can be an indirect cause of death. Only 22 (12%) had putdown OSAS as a cause of death. OSAS is seldom recorded on death certificates. This is at odds with epidemiological forecasts and contrary to an opinion poll from a selection of doctors.

  3. Brain metabolic impairment of OSAS: evidence from MRS

    International Nuclear Information System (INIS)

    Shen Jie; Long Miaomiao; Shen Wen; Qi Ji

    2011-01-01

    Objective: To evaluate the impact of obstructive sleep apnea syndrome (OSAS) on human cerebral metabolism by using magnetic resonance spectroscopy (MRS). Materials and methods: Twenty-one severe OSAS patients, 14 mild-moderate OSAS patients, and 15 healthy control subjects were included. All subjects underwent MRS using the point-resolved echo spin spectroscopy (PRESS). Proton volumes of interest were placed in the bilateral frontal lobes and left temporal -parietal-occipital cortex, and left hippocampus. Results: 1. Compared to the controls, the NAA/Cr ratio was significantly decreased in the left frontal lobe in the severe OSAS group (P=0.004), and in the right frontal lobe in the severe (P=0.002) and mild-moderate (P=0.007) OSAS patients. The NAA/Cr ratio trended to be decreased in the left hippocampus in the OSAS patients compared to controls. 2. A significant increase in the ml/Cr ratio was detected in the right frontal regions in the severe (P=0.008) and mild-moderate (P<0.001) OSAS groups. 3. Clx/Cr ratio values were significantly smaller than controls in the left (P=0.006) and right (P=0.027) frontal regions. Conclusion: Bilateral frontal lobes are the vulnerable location in patients with OSAS. MRS can be used to screen the brain metabolic impairment. (authors)

  4. Cognitive MAC designs for OSA networks

    CERN Document Server

    Derakhshani, Mahsa

    2014-01-01

    This SpringerBrief presents recent advances in the cognitive MAC designs for opportunistic spectrum access (OSA) networks. It covers the basic MAC functionalities and MAC enhancements of IEEE 802.11. Later chapters discuss the existing MAC protocols for OSA and classify them based on characteristic features. The authors provide new research in adaptive carrier sensing-based MAC designs tailored for OSA, which optimize spectrum utilization and ensure a peaceful coexistence of licensed and unlicensed systems. Analytically devised via optimization and game-theoretic approaches, these adaptive M

  5. Overlap syndrome of COPD and OSA in Koreans.

    Science.gov (United States)

    Choi, Kyung-Mee; Thomas, Robert J; Kim, Jinkwan; Lee, Seung Ku; Yoon, Dae Wui; Shin, Chol

    2017-07-01

    Overlap syndrome of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) leads to increased morbidity and mortality. There have been no reports available on the overlap syndrome for Koreans. Our primary aim was to identify prevalence and predictors of the overlap syndrome in Koreans.This is a cross-sectional study with a community-based sample of 1298 participants (mean age, 59.7 ± 6.7) from the cohort of Korean Genomic and Epidemiologic Study during 2013 to 2014. OSA and COPD were assessed by apnea-hypopnea index (AHI) and the ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC syndrome. The prevalence of COPD remained the same as 10.8% regardless of the presence of OSA. The mean ratio of FEV1/FVC for those with COPD was 0.77, regardless of OSA. The OR increased for age (OR, 1.1; 95% CI, 1.0-1.1) and smokers (OR, 3.6; 95% CI, 2.0-6.4), but decreased for body mass index (BMI) (OR, 0.84; 95% CI, 0.8-0.9) and overweight state (OR, 0.4; 95% CI, 0.2-0.7). Risk factors of the overlap syndrome differed by OSA severity, that is, BMI in those with moderate-to-severe OSA, whereas sex (OR, 4.7; 95% CI, 2.1-10.6) and age (OR, 1.1; 95% CI, 1.0-1.1) in those with mild OSA.In a population study from Korea, 10.8% of OSA patients had an overlap syndrome with COPD. Although BMI is a well-known risk factor of OSA, it is likely that being overweight may be protective for moderate-to-severe OSA patients from the risk of COPD (i.e., overlap syndrome).

  6. Security Analysis of Parlay/OSA Framework

    NARCIS (Netherlands)

    Corin, R.J.; Di Caprio, G.; Etalle, Sandro; Gnesi, S.; Lenzini, Gabriele; Moiso, C.; Villain, B.

    2004-01-01

    This paper analyzes the security of the Trust and Security Management (TSM) protocol, an authentication protocol which is part of the Parlay/OSA Application Program Interfaces (APIs). Architectures based on Parlay/OSA APIs allow third party service providers to develop new services that can access,

  7. Security Analysis of Parlay/OSA Framework

    NARCIS (Netherlands)

    Corin, R.J.; Di Caprio, G.; Etalle, Sandro; Gnesi, S.; Lenzini, Gabriele; Moiso, C.

    This paper analyzes the security of the Trust and Security Management (TSM) protocol, an authentication protocol which is part of the Parlay/OSA Application Program Interfaces (APIs). Architectures based on Parlay/OSA APIs allow third party service providers to develop new services that can access,

  8. Omal jalal maailma : 1.-5.osa / Paul Salopek ; fotografeerinud John Stanmeyer

    Index Scriptorium Estoniae

    Salopek, Paul

    2016-01-01

    Artikli 2. osa räägib autori rännakust läbi Saudi Araabias asuva Al-Hijāzi kõrbe, 3. osa rännakust piki Jordaania piiri ja Iisraelis, 4. osa rännakust Ida-Türgis ning kohtumistest Süüria sõjapõgenikega, 5. osa Armeeniast ja Türgist

  9. How do we recognize the child with OSAS?

    Science.gov (United States)

    Joosten, Koen F; Larramona, Helena; Miano, Silvia; Van Waardenburg, Dick; Kaditis, Athanasios G; Vandenbussche, Nele; Ersu, Refika

    2017-02-01

    Obstructive sleep-disordered breathing includes a spectrum of clinical entities with variable severity ranging from primary snoring to obstructive sleep apnea syndrome (OSAS). The clinical suspicion for OSAS is most often raised by parental report of specific symptoms and/or abnormalities identified by the physical examination which predispose to upper airway obstruction (e.g., adenotonsillar hypertrophy, obesity, craniofacial abnormalities, neuromuscular disorders). Symptoms and signs of OSAS are classified into those directly related to the intermittent pharyngeal airway obstruction (e.g., parental report of snoring, apneic events) and into morbidity resulting from the upper airway obstruction (e.g., increased daytime sleepiness, hyperactivity, poor school performance, inadequate somatic growth rate or enuresis). History of premature birth and a family history of OSAS as well as obesity and African American ethnicity are associated with increased risk of sleep-disordered breathing in childhood. Polysomnography is the gold standard method for the diagnosis of OSAS but may not be always feasible, especially in low-income countries or non-tertiary hospitals. Nocturnal oximetry and/or sleep questionnaires may be used to identify the child at high risk of OSAS when polysomnography is not an option. Endoscopy and MRI of the upper airway may help to identify the level(s) of upper airway obstruction and to evaluate the dynamic mechanics of the upper airway, especially in children with combined abnormalities. Pediatr Pulmonol. 2017;52:260-271. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Kuninglikus õukonnateatris. I-IV osa / Jaanus Rohumaa

    Index Scriptorium Estoniae

    Rohumaa, Jaanus, 1969-

    1999-01-01

    Jaanus Rohumaa Londonis Royal Court Theatre' poolt korraldatud residentuuris, mis on mõeldud tänapäeva näitekirjanikele ja lavastajatele. Muljeid kokkutulnud eri maade näitekirjanikest ja lavastajatest. Jaanus Rohumaa lavastab Londonis Royal Shakespeare Company teatris Jaan Tätte näidendit "Ristumine peateega"(II osa) Inglise näitekirjaniku Sarah Kane'i loomingust, Robert Lepage'i lavastusest "Imede geomeetria" (III osa)

  11. Obesity and Obstructive Sleep Apnea: Or is it OSA and Obesity?

    Science.gov (United States)

    2008-01-01

    32–44. 66] A.K. Al-Shukaili, A.A. Al-Jabri, Rheumatoid arthritis , cytokines and hypoxia. What is the link? Saudi Med. J. 27 (2006) 1642–1649. 67...OSA. OSA appears to increase secretion of and/or lter responsiveness to the adipocyte hormone leptin and the rexigenic hormone ghrelin , and these...diabetes, dementia, arthritis , nd OSA itself [65–69]. Sequelae of obesity and OSA cross all organ systems. or example, chronic excessive

  12. CPAP increases bronchial reactivity in OSAS patients

    Directory of Open Access Journals (Sweden)

    P. Korczyski

    2008-06-01

    Full Text Available Continuous positive airways pressure (CPAP is a well known and safe method of treatment patients with obstructive sleep apnoea syndrome (OSAS. The effects of CPAP administration on the upper respiratory tract are known. However its effects on the lower respiratory tract still needs to be determined. Studies on bronchial hyperreactivity in patients treated by CPAP are contradictory. The aim of the study was to assess the influence of a 3-week CPAP treatment in patients with OSAS and to evaluate associations between changes in bronchial reactivity and clinical features of OSAS and lung function tests (LFT. Patients with newly diagnosed OSAS and lack of infection or chronic illness of the respiratory tract or other conditions which could influence bronchial hyperreactivity (BHR were included. Investigations were performed in 101 patients. There were 88 males and 13 females, mean age 51.5±11.2 years and BMI 32.6±5.4 kg·m–2. Qualified patients were randomly divided into 2 groups: 76 patients to CPAP treatment group, 25 control group. Both groups did not differ in anthropometrics features, severity of OSAS and LFT. Metacholine challenge test (MchCT was performed at baseline and repeated after 3 weeks. Analysis of the individual results showed that in 11 patients the MchCT was positive (6 in the CPAP and 5 in the control groups. After 3 weeks in the group of CPAP treated patients an increase of BHR was noted. Log PC20M decreased from 1.38±0.3 to 1.26±0.5 (p<0.05. The number of patients with a positive result in the MchCT increased from 6 to 16 patients. There was no significant change in BHR in the control group. It was found that CPAP treated patients with BHR were older, had less severe OSAS and lower FEV1 (p<0.05. In none of the patients positive result of BHR did no affect compliance to CPAP treatment. Conclusions: CPAP therapy increases bronchial reactivity, but does not affect compliance to treatment.

  13. Network science meets respiratory medicine for OSAS phenotyping and severity prediction

    Directory of Open Access Journals (Sweden)

    Stefan Mihaicuta

    2017-05-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a common clinical condition. The way that OSAS risk factors associate and converge is not a random process. As such, defining OSAS phenotypes fosters personalized patient management and population screening. In this paper, we present a network-based observational, retrospective study on a cohort of 1,371 consecutive OSAS patients and 611 non-OSAS control patients in order to explore the risk factor associations and their correlation with OSAS comorbidities. To this end, we construct the Apnea Patients Network (APN using patient compatibility relationships according to six objective parameters: age, gender, body mass index (BMI, blood pressure (BP, neck circumference (NC and the Epworth sleepiness score (ESS. By running targeted network clustering algorithms, we identify eight patient phenotypes and corroborate them with the co-morbidity types. Also, by employing machine learning on the uncovered phenotypes, we derive a classification tree and introduce a computational framework which render the Sleep Apnea Syndrome Score (SASScore; our OSAS score is implemented as an easy-to-use, web-based computer program which requires less than one minute for processing one individual. Our evaluation, performed on a distinct validation database with 231 consecutive patients, reveals that OSAS prediction with SASScore has a significant specificity improvement (an increase of 234% for only 8.2% sensitivity decrease in comparison with the state-of-the-art score STOP-BANG. The fact that SASScore has bigger specificity makes it appropriate for OSAS screening and risk prediction in big, general populations.

  14. Digital Morphometrics: A New Upper Airway Phenotyping Paradigm in OSA.

    Science.gov (United States)

    Schwab, Richard J; Leinwand, Sarah E; Bearn, Cary B; Maislin, Greg; Rao, Ramya Bhat; Nagaraja, Adithya; Wang, Stephen; Keenan, Brendan T

    2017-08-01

    OSA is associated with changes in pharyngeal anatomy. The goal of this study was to objectively and reproducibly quantify pharyngeal anatomy by using digital morphometrics based on a laser ruler and to assess differences between subjects with OSA and control subjects and associations with the apnea-hypopnea index (AHI). To the best of our knowledge, this study is the first to use digital morphometrics to quantify intraoral risk factors for OSA. Digital photographs were obtained by using an intraoral laser ruler and digital camera in 318 control subjects (mean AHI, 4.2 events/hour) and 542 subjects with OSA (mean AHI, 39.2 events/hour). The digital morphometric paradigm was validated and reproducible over time and camera distances. A larger modified Mallampati score and having a nonvisible airway were associated with a higher AHI, both unadjusted (P digital morphometrics is an accurate, high-throughput, and noninvasive technique to identify anatomic OSA risk factors. Morphometrics may also provide a more reproducible and standardized measurement of the Mallampati score. Digital morphometrics represent an efficient and cost-effective method of examining intraoral crowding and tongue size when examining large populations, genetics, or screening for OSA. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  15. Uus äriseadustik lihtsustab osaühingu asutamist ja juhtimist / Karina Paatsi

    Index Scriptorium Estoniae

    Paatsi, Karina

    2010-01-01

    Osaühingut puudutavatest äriseadustiku muudatustest (sissemakseta osaühing, osa võõrandamise võimaluste laienemine, juhatuse liikme valimine tähtajatuks perioodiks, nõukogu nõude kaotamine, elukoha piirangu kaotamine, mitterahalise sissemakse hindamine, reservkapitali nõude kadumine)

  16. Preparation And Physicochemical Properties of Octenyl Succinic Anhydride (OSA) Modified Sago Starch

    International Nuclear Information System (INIS)

    Nur Farhana Zainal Abiddin; Anida Yusoff; Noorlaila Ahmad

    2016-01-01

    Starch from sago (Metroxylon sagu) was esterified with octenyl succinic anhydride (OSA) in order to regulate its shortcoming by adding amphiphilic properties. The objective of this work is to determine the physicochemical properties of native sago and OSA sago starches. The OSA sago starch was produced according to the optimum condition generated via response surface methodology (RSM) with 5.00 % OSA at pH 7.20 and a reaction time of 9.65 hours. The esterified sago starch gives a degree of substitution (DS) value of 0.012. The physicochemical properties of OSA sago starch was determined by measuring the amylose content, laser diffraction particle size analyzer, scanning electron microscopy (SEM) and Fourier transform infrared (FT-IR). The amylose content for OSA sago starch was found to be reduced after esterification reaction. The particle size of OSA sago starch was found to increase significantly (p<0.05) compared to their native starches. Scanning electron microscopy (SEM) revealed that OSA starch developed slightly rough surface and their edges lost some definition. FT-IR spectroscopy shows that there was appearance of new absorption correspond to ester carbonyl group (1717 cm -1 ) and carboxylate RCOO- (1569 cm -1 ). This study showed that the physicochemical properties of modified starches were influenced not only by DS but also on the botanical origin of the starches. (author)

  17. Age, gender, neck circumference, and Epworth sleepiness scale do not predict obstructive sleep apnea (OSA in moderate to severe chronic obstructive pulmonary disease (COPD: The challenge to predict OSA in advanced COPD.

    Directory of Open Access Journals (Sweden)

    Xavier Soler

    Full Text Available The combination of chronic obstructive pulmonary disease (COPD and obstructive sleep apnea (OSA is associated with substantial morbidity and mortality. We hypothesized that predictors of OSA among patients with COPD may be distinct from OSA in the general population. Therefore, we investigated associations between traditional OSA risk factors (e.g. age, and sleep questionnaires [e.g. Epworth Sleepiness Scale] in 44 patients with advanced COPD. As a second aim we proposed a pilot, simplified screening test for OSA in patients with COPD. In a prospective, observational study of patients enrolled in the UCSD Pulmonary Rehabilitation Program we collected baseline characteristics, cardiovascular events (e.g. atrial fibrillation, and sleep questionnaires [e.g. Pittsburgh Sleep Quality Index (PSQI]. For the pilot questionnaire, a BMI ≥25 kg/m2 and the presence of cardiovascular disease were used to construct the pilot screening test. Male: 59%; OSA 66%. FEV1 (mean ± SD = 41.0±18.2% pred., FEV1/FVC = 41.5±12.7%]. Male gender, older age, and large neck circumference were not associated with OSA. Also, Epworth Sleepiness Scale and the STOP-Bang questionnaire were not associated with OSA in univariate logistic regression. In contrast, BMI ≥25 kg/m2 (OR = 3.94, p = 0.04 and diagnosis of cardiovascular disease (OR = 5.06, p = 0.03 were significantly associated with OSA [area under curve (AUC = 0.74]. The pilot COPD-OSA test (OR = 5.28, p = 0.05 and STOP-Bang questionnaire (OR = 5.13, p = 0.03 were both associated with OSA in Receiver Operating Characteristics (ROC analysis. The COPD-OSA test had the best AUC (0.74, sensitivity (92%, and specificity (83%. A ten-fold cross-validation validated our results. We found that traditional OSA predictors (e.g. gender, Epworth score did not perform well in patients with more advanced COPD. Our pilot test may be an easy to implement instrument to screen for OSA. However, a larger validation study is necessary

  18. Age, gender, neck circumference, and Epworth sleepiness scale do not predict obstructive sleep apnea (OSA) in moderate to severe chronic obstructive pulmonary disease (COPD): The challenge to predict OSA in advanced COPD.

    Science.gov (United States)

    Soler, Xavier; Liao, Shu-Yi; Marin, Jose Maria; Lorenzi-Filho, Geraldo; Jen, Rachel; DeYoung, Pamela; Owens, Robert L; Ries, Andrew L; Malhotra, Atul

    2017-01-01

    The combination of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is associated with substantial morbidity and mortality. We hypothesized that predictors of OSA among patients with COPD may be distinct from OSA in the general population. Therefore, we investigated associations between traditional OSA risk factors (e.g. age), and sleep questionnaires [e.g. Epworth Sleepiness Scale] in 44 patients with advanced COPD. As a second aim we proposed a pilot, simplified screening test for OSA in patients with COPD. In a prospective, observational study of patients enrolled in the UCSD Pulmonary Rehabilitation Program we collected baseline characteristics, cardiovascular events (e.g. atrial fibrillation), and sleep questionnaires [e.g. Pittsburgh Sleep Quality Index (PSQI)]. For the pilot questionnaire, a BMI ≥25 kg/m2 and the presence of cardiovascular disease were used to construct the pilot screening test. Male: 59%; OSA 66%. FEV1 (mean ± SD) = 41.0±18.2% pred., FEV1/FVC = 41.5±12.7%]. Male gender, older age, and large neck circumference were not associated with OSA. Also, Epworth Sleepiness Scale and the STOP-Bang questionnaire were not associated with OSA in univariate logistic regression. In contrast, BMI ≥25 kg/m2 (OR = 3.94, p = 0.04) and diagnosis of cardiovascular disease (OR = 5.06, p = 0.03) were significantly associated with OSA [area under curve (AUC) = 0.74]. The pilot COPD-OSA test (OR = 5.28, p = 0.05) and STOP-Bang questionnaire (OR = 5.13, p = 0.03) were both associated with OSA in Receiver Operating Characteristics (ROC) analysis. The COPD-OSA test had the best AUC (0.74), sensitivity (92%), and specificity (83%). A ten-fold cross-validation validated our results. We found that traditional OSA predictors (e.g. gender, Epworth score) did not perform well in patients with more advanced COPD. Our pilot test may be an easy to implement instrument to screen for OSA. However, a larger validation study is necessary before

  19. Analysis of OSAS incidence and influential factors in middle-aged and elderly patients with hypertension.

    Science.gov (United States)

    Wang, Shuang; Niu, Xinqing; Zhang, Peipei; Su, Dexing; Zhang, Jing; Liu, Wei

    2018-04-24

    To investigate the detection rate and influencing factors of obstructive sleep apnea syndrome (OSAS) in middle-aged and elderly patients with hypertension. A total of 440 patients with hypertension were selected as the research objects, all of them participated in the Berlin questionnaire survey, and the polysomnography (PSG) was performed on the patients with a high risk of OSAS. The detection rate of OSAS was analyzed, the clinical data between non-OSAS group and OSAS group were compared and stepwise linear regression and Logistic regression were used to analyze the related influencing factors to apnea hyponea index (AHI) and OSAS in hypertensive patients. A total of 235 patients completed PSG and 196 patients were diagnosed as OSAS with the detection rate of 83.40%. The detection rate of OSAS in male patients was higher than that in females (89.04% vs.74.16%, x²=8.025, P=0.006). The detection rates of OSAS in normal BMI group, overweight group and obesity group were 56.52%, 92.37% and 100%, respectively (x²=36.438, P<0.001). The detection rates of OSAS in normal waistline group and central obesity group were 74.42% and 88.59% (x²=7.539, P=0.016). The detection rates of OSAS in grade1, grade 2 and grade 3 hypertension groups were 57.47%, 98.23% and 100%, respectively (x²=44.623, P<0.001). BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), low density lipoprotein (LDL) and waist circumference of OSAS group were all higher than those in non-OSAS group (P<0.05). BMI, SBP and DBP were positively correlated with AHI (p<0.05), which were independent risk factors of OSAS [OR value (95%CI) = 2.548 (1.449-4.327), 1.342 (1.214-1.965) and 1.169 (1.025-1.622), respectively, P<0.05]. The incidence of OSAS in middle-aged and elderly patients with hypertension is high. High BMI, SBP, and DBP are independent risk factors of OSAS.

  20. The effect of CPAP treatment on EEG of OSAS patients.

    Science.gov (United States)

    Zhang, Cheng; Lv, Jun; Zhou, Junhong; Su, Li; Feng, Liping; Ma, Jing; Wang, Guangfa; Zhang, Jue

    2015-12-01

    Continuous positive airway pressure (CPAP) is currently the most effective treatment method for obstructive sleep apnea syndrome (OSAS). The purpose of this study was to compare the sleep electroencephalogram (EEG) changes before and after the application of CPAP to OSAS patients. A retrospective study was conducted and 45 sequential patients who received both polysomnography (PSG) and CPAP titration were included. The raw data of sleep EEG were extracted and analyzed by engineers using two main factors: fractal dimension (FD) and the zero-crossing rate of detrended FD (zDFD). FD was an effective indicator reflecting the EEG complexity and zDFD was useful to reflect the variability of the EEG complexity. The FD and zDFD indexes of sleep EEG of 45 OSAS patients before and after CPAP titration were analyzed. The age of 45 OSAS patients was 52.7 ± 5.6 years old and the patients include 12 females and 33 males. After CPAP treatment, FD of EEG in non-rapid eye movement (NREM) sleep decreased significantly (P CPAP therapy (P CPAP therapy had a significant influence on sleep EEG in patients with OSAHS, which lead to a more stable EEG pattern. This may be one of the mechanisms that CPAP could improve sleep quality and brain function of OSAS patients.

  1. Low morning serum cortisol levels in children with tonsillar hypertrophy and moderate-to-severe OSA.

    Science.gov (United States)

    Malakasioti, Georgia; Alexopoulos, Emmanouel I; Varlami, Vasiliki; Chaidas, Konstantinos; Liakos, Nikolaos; Gourgoulianis, Konstantinos; Kaditis, Athanasios G

    2013-09-01

    Hypertrophic tonsillar tissue in children with obstructive sleep apnea (OSA) has enhanced expression of glucocorticoid receptors, which may reflect low endogenous cortisol levels. We have evaluated the effect of the interaction between tonsillar hypertrophy and OSA severity on morning serum cortisol levels. Children with and without snoring underwent polysomnography, tonsillar size grading, and measurement of morning serum cortisol. Seventy children (2-13 years old) were recruited: 30 with moderate-to-severe OSA (apnea-hypopnea index [AHI] > 5 episodes/h), 26 with mild OSA (AHI > 1 and ≤ 5), and 14 controls (no snoring; AHI ≤ 1). Tonsillar hypertrophy was present in 56.7%, 53.8%, and 42.9% of participants in each group, respectively. Application of a general linear model demonstrated a significant effect of the interaction between severity of OSA and tonsillar hypertrophy on cortisol levels (P = 0.04), after adjustment for obesity, gender, and age. Among children with tonsillar hypertrophy, subjects with moderate-to-severe OSA (n = 17; AHI 14.7 ± 10.6), mild OSA (n = 14; AHI 2.3 ± 1.2), and control participants (n = 6; AHI 0.7 ± 0.2) were significantly different regarding cortisol levels (P = 0.02). Subjects with moderate-to-severe OSA had lower cortisol (16.9 ± 8.7 mcg/dL) than those with mild OSA (23.3 ± 4.2; P = 0.01) and those without OSA (controls) (23.6 ± 5.3 mcg/dL; P = 0.04). In contrast, children with normal-size tonsils and moderate-to-severe OSA, mild OSA, and controls did not differ in cortisol levels. Children with moderate-to-severe obstructive sleep apnea and the phenotype of hypertrophic tonsils have reduced morning serum cortisol levels and potentially decreased glucocorticoid inhibitory effects on tonsillar growth.

  2. online-osa festivalil / Tiia Johannson

    Index Scriptorium Estoniae

    Johannson, Tiia, 1965-2002

    1998-01-01

    Prantsusmaa, Balti ja Põhjamaade video ja uue meedia festival "offline@online" Eesti Kunstiakadeemias. Ka eesti netikunstist, festivali korralduslikust küljest, tulevikuplaanidest. Erilist äramärkimist leidis sloveenia kunstniku Vuk Cosici töö "ascii history of moving images", online-presentatsioonide osas Lev Manovichi teoreetiline loeng "Uue meedia keel". Aadress festivali netikunsti vaatamiseks

  3. Evaluation of degree of lacunar infarction and carotid atherosclerosis in patients with different severity of OSAS

    Directory of Open Access Journals (Sweden)

    Ming Du

    2016-07-01

    Full Text Available Objective: To assess the degree of lacunar infarction and carotid atherosclerosis in patients with different severity of obstructive sleep apnea syndrome (OSAS. Methods: A total of 198 patients with OSAS were retrospectively studied from case information and test results, and were divided into mild group 84 cases, medium group 70 cases and severe group 44 cases according to apnea-hypopnea index (AHI, and 176 cases of non-OSAS people who received physical examination in our hospital during the same period were selected as healthy control group. Differences in the values of serum lacunar infarction-related indexes, blood viscosity and hemocyte-related indexes, carotid structure and function parameters, serum arteriosclerosis-related indexes and so on were compared among groups. Results: t-PA value of healthy control group was higher than those of OSAS group while vWF, PAI-1 and Fg values were lower than those of OSAS group (P<0.05, and with the increase of OSAS severity, t-PA value decreased while vWF, PAI-1 and Fg values increased (P<0.05; blood viscosity, Hct, PDW, RDW and EFR values of healthy control group were lower than those of OSAS group (P<0.05, and with the increase of OSAS severity, blood viscosity, Hct, PDW, RDW and EFR values increased (P<0.05; FMD, NID and DC values of healthy control group were higher than those of OSAS group while Dis, CC and PWV values were lower than those of OSAS group (P<0.05, and with the increase of OSAS severity, FMD, NID and DC values decreased while Dis, CC and PWV values increased (P<0.05; blood uric acid and EF-1 values of healthy control group were lower than those of OSAS group while CGRP and fetuin A levels were higher than those of OSAS group (P<0.05, and with the aggravation of OSAS, blood uric acid and EF-1 levels increased while CGRP and fetuin A levels decreased, and differences among groups were significant (P<0.05. Conclusions: With the aggravation of OSAS, patients’ microcirculation

  4. The USC-OSA-EPS section activities in optics

    Science.gov (United States)

    Aymerich, María.; Cambronero-López, Ferran; Aragón, Ángel L.; Delgado, Tamara; Blanco, Manuel; Gómez Varela, Ana I.; Gargallo, Ana; Williamson, Sandra; Amorín, Adán.; Sánchez-García, Ángel; Bao-Varela, Carmen; Flores-Arias, M. Teresa

    2017-08-01

    The USC-OSA Student Chapter and USC-EPS Young Minds Section is a group financed by The Optical Society (OSA) and the European Physical Society (EPS). It is formed by PhD and degree students from the Universidade de Santiago de Compostela (USC) and one supervisor of the Faculty of Physics. Its main goal is to promote and diffuse Optics in the society. For this purpose, the group carries out several activities in the academic and non-academic community. The group is also committed to the professional development of our members and motivates the exposition of our work into the scientific community.

  5. Assessment of the Depression, Anxiety, and Stress Scale (DASS-21) in untreated obstructive sleep apnea (OSA).

    Science.gov (United States)

    Nanthakumar, Shenooka; Bucks, Romola S; Skinner, Timothy C; Starkstein, Sergio; Hillman, David; James, Alan; Hunter, Michael

    2017-10-01

    The assessment of depression in obstructive sleep apnea (OSA) is confounded by symptom overlap. The Depression, Anxiety, and Stress Scale-short form (DASS-21) is a commonly used measure of negative affect, but it not known whether the DASS-21 is suitable for use in an OSA sample. This study compared the fit of Lovibond and Lovibond's (1995) correlated 3-factor structure of the DASS-21 and measurement invariance between a non-OSA and an OSA sample using confirmatory factor analysis. As measurement invariance was not found, to determine the source of non-invariance differential item functioning (DIF) was examined using dMACS. The correlated 3-factor structure (with correlated errors) of the DASS-21 was a better fit in the non-OSA sample. dMACS indicated that there was a degree of DIF for each of the subscales, especially for the Anxiety subscale, in which 2 symptoms (that are also physiological symptoms of OSA) produced lower severity scores in the OSA sample compared with the non-OSA sample. However, the degree of DIF for each of the subscales is not sufficient to cause concern when using the DASS-21; therefore, the total DASS-21 is suitable for use in an OSA sample. Interestingly, the impact of symptom overlap in anxiety symptoms may be reducing anxiety scores because of DIF, which contrasts with the proposed effect of symptom overlap in depression, where it leads to the inflation of depression scores in OSA. This deserves greater consideration in relation to OSA and other clinical disorders or chronic illness conditions with different patterns of overlapping symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Asthma Control and Its Relationship with Obstructive Sleep Apnea (OSA in Older Adults

    Directory of Open Access Journals (Sweden)

    Mihaela Teodorescu

    2013-01-01

    Full Text Available Background/Objectives. Asthma in older individuals is poorly understood. We aimed to characterize the older asthma phenotype and test its association with obstructive sleep apnea (OSA. Design. Cross-sectional. Setting. Pulmonary and Asthma/Allergy clinics. Participants. 659 asthma subjects aged 18–59 years (younger and 154 aged 60–75 (older. Measurements. Sleep Apnea scale of Sleep Disorders Questionnaire (SA-SDQ, asthma severity step (1–4, severe if step 3 or 4, established OSA diagnosis, continuous positive airway pressure (CPAP use, and comorbidities. Results. Older versus younger had worse control, as assessed by asthma step, lung function, and inhaled corticosteroid use. Among older subjects, after controlling for known asthma aggravators, OSA diagnosis was the only factor robustly associated with severe asthma: on average, OSA was associated with nearly 7 times greater likelihood of severe asthma in an older individual (OR=6.67. This relationship was of greater magnitude than in younger subjects (OR=2.16. CPAP use attenuated the likelihood of severe asthma in older subjects by 91% (P=0.005, much more than in the younger asthmatics. Conclusion. Diagnosed OSA increases the risk for worse asthma control in older patients, while CPAP therapy may have greater impact on asthma outcomes. Unrecognized OSA may be a reason for poor asthma control, particularly among older patients.

  7. The effect of allergic rhinitis on the degree of stress, fatigue and quality of life in OSA patients.

    Science.gov (United States)

    Park, Cheol Eon; Shin, Seung Youp; Lee, Kun Hee; Cho, Joong Saeng; Kim, Sung Wan

    2012-09-01

    Both allergic rhinitis (AR) and obstructive sleep apnea (OSA) are known to increase stress and fatigue, but the result of their coexistence has not been studied. The objective of this study was to evaluate the amount of stress and fatigue when AR is combined with OSA. One hundred and twelve patients diagnosed with OSA by polysomnography were enrolled. Among them, 37 patients were diagnosed with AR by a skin prick test and symptoms (OSA-AR group) and 75 patients were classified into the OSA group since they tested negative for allergies. We evaluated the Epworth sleepiness scale (ESS), stress score, fatigue score, ability to cope with stress, and rhinosinusitis quality of life questionnaire (RQLQ) with questionnaires and statistically compared the scores of both groups. There were no significant differences in BMI and sleep parameters such as LSAT, AHI, and RERA between the two groups. However, the OSA-AR group showed a significantly higher ESS score compared to the OSA group (13.7 ± 4.7 vs. 9.3 ± 4.8). Fatigue scores were also significantly higher in the OSA-AR group than in the OSA group (39.8 ± 11.0 vs. 30.6 ± 5.4). The OSA-AR group had a significantly higher stress score (60.4 ± 18.6 vs. 51.2 ± 10.4). The ability to cope with stress was higher in the OSA group, although this difference was not statistically significant. RQLQ scores were higher in the OSA-AR group (60.2 ± 16.7 compared to 25.1 ± 13.9). In conclusion, management of allergic rhinitis is very important in treating OSA patients in order to eliminate stress and fatigue and to minimize daytime sleepiness and quality of life.

  8. Autonomic and metabolic effects of OSA in childhood obesity.

    Science.gov (United States)

    Oliveira, F M; Tran, W H; Lesser, D; Bhatia, R; Ortega, R; Mittelman, S D; Keens, T G; Davidson Ward, S L; Khoo, M C

    2010-01-01

    This study investigates the effects of exposure to intermittent hypoxia on cardiovascular autonomic control and metabolic function in obese children with obstructive sleep apnea (OSA). Each subject underwent: (1) a polysomnography; (2) morning fasting blood samples and a subsequent FSIVGTT; (3) noninvasive measurement of respiration, arterial blood pressure, and heart rate during supine and standing postures. Assessment of adiposity was performed using a DEXA scan. From these measurements, we deduced the pertinent sleep parameters, Bergman minimal model parameters and the parameters characterizing a minimal model of cardiovascular variability. Results suggest that intermittent hypoxia in OSA contributes independently to insulin resistance and autonomic dysfunction in overweight children.

  9. Comparative Emulsifying Properties of Octenyl Succinic Anhydride (OSA-Modified Starch: Granular Form vs Dissolved State.

    Directory of Open Access Journals (Sweden)

    María Matos

    Full Text Available The emulsifying ability of OSA-modified and native starch in the granular form, in the dissolved state and a combination of both was compared. This study aims to understand mixed systems of particles and dissolved starch with respect to what species dominates at droplet interfaces and how stability is affected by addition of one of the species to already formed emulsions. It was possible to create emulsions with OSA-modified starch isolated from Quinoa as sole emulsifier. Similar droplet sizes were obtained with emulsions prepared at 7% (w/w oil content using OSA-modified starch in the granular form or molecularly dissolved but large differences were observed regarding stability. Pickering emulsions kept their droplet size constant after one month while emulsions formulated with OSA-modified starch dissolved exhibited coalescence. All emulsions stabilized combining OSA-modified starch in granular form and in solution showed larger mean droplet sizes with no significant differences with respect to the order of addition. These emulsions were unstable due to coalescence regarding presence of free oil. Similar results were obtained when emulsions were prepared by combining OSA-modified granules with native starch in solution. The degree of surface coverage of starch granules was much lower in presence of starch in solution which indicates that OSA-starch is more surface active in the dissolved state than in granular form, although it led to unstable systems compared to starch granule stabilized Pickering emulsions, which demonstrated to be extremely stable.

  10. Marcadores de estrés oxidativo en placentas de gestantes añosas

    Directory of Open Access Journals (Sweden)

    Silvia Suárez

    2007-12-01

    Full Text Available Introducción: Un factor de riesgo alto ginecoobstétrico que contribuye a la morbimortalidad materna perinatal es la edad materna mayor de 35 años. Es posible que el estado oxidativo en la placenta de la gestante añosa sea mayor a la de la gestante no añosa. Objetivo: Evaluar el estado oxidativo de la placenta en gestantes mayores de 35 años. Diseño: Estudio observacional y transversal. Lugar: Hospital Nacional Docente Materno Infantil San Bartolomé y Centro de Investigación de Bioquímica y Nutrición de la Universidad Nacional Mayor de San Marcos. Material biológico: 28 placentas de gestantes de 35 años o más y 28 placentas de gestantes de menos de 35 años, obtenidas de partos vaginales a término. Intervenciones: La muestra de placenta se homogenizó al 10% con buffer fosfato 10 mM, pH 7,4, se centrifugó a 2000 rpm por 5’. Parte del sobrenadante se usó para analizar lipoperoxidación y glutatión (GSH; el sobrenadante restante fue centrifugado a 42 000 rpm por 1 hora, para medir actividad de superóxido dismutasa (SOD. Principales medidas de resultados: Estado oxidativo de placentas obtenidas de mujeres añosas y no añosas. Resultados: La actividad de la SOD y el contenido de GSH placentarios en añosas fue 43,52 U/g de tejido y 4,67 µmol/mL x 10-²; para el grupo control fueron 54,13 U/g de tejido y 6,02 µmol/mL x 10-², respectivamente; en ambos hubo significancia estadística (p < 0,05. La medición de TBARS (lipoperoxidación no mostró diferencias significativas. Conclusiones: Las placentas obtenidas de mujeres añosas muestran menor capacidad de defensa antioxidante frente a las placentas obtenidas de mujeres no añosas.

  11. The USC-OSA Student Chapter: goals and benefits for the optics community

    Science.gov (United States)

    Gómez-Varela, A. I.; Gargallo, Ana; González Núñez, Héctor; Delgado-García, Tamara; Almaguer-Gómez, Citlalli; Cambronero-López, F.; Flores-Arias, M. T.

    2014-07-01

    The USC-OSA Student Chapter has been constituted in March 2013 by members of the University of Santiago de Compostela (USC) in Spain and sponsored by The Optical Society of America (OSA). It is formed by five graduate and one undergraduate students with the common interest in Optics and Photonics research and a professor of the USC is also involved as a faculty advisor. We decided to start this group with the aim of involving kids, precollege and undergraduate students in the world of Optics and Photonics. The activities that the USC-OSA Student Chapter members intend to realize are mainly educational tasks for the spreading of knowledge in Photonics by means of basic experiments, demonstrations and lectures by leading researchers and teachers. Most of the needed resources to accomplish these activities are provided by the OSA, such as educational posters and a portable kit for demonstrating Optics to students. At this moment the USC-OSA Student Chapter is carrying out several activities, as educational journeys at the Santiago de Compostela University Hospital Complex (CHUS), where hospitalized children can approach to Optics through some simple experiments and games. A teaching program is also being organized in collaboration with Galician secondary schools in order to show students the importance and uses of Optics and Photonics and to arouse their interest in this field, as well as encouraging them to develop their scientific thinking. Another activity will take place in November during the Science Week, which includes a program of lectures targeted to undergraduate students and an exposition of several demonstrations

  12. Effect of CPAP Therapy in Improving Daytime Sleepiness in Indian Patients with Moderate and Severe OSA.

    Science.gov (United States)

    Battan, Gulshan; Kumar, Sanjeev; Panwar, Ajay; Atam, Virendra; Kumar, Pradeep; Gangwar, Anil; Roy, Ujjawal

    2016-11-01

    Obstructive Sleep Apnoea (OSA) is a highly prevalent disease and a major public health issue in India. Excessive daytime sleepiness is an almost ubiquitous symptom of OSA. Epworth Sleepiness Scale (ESS) score is a validated objective score to measure the degree of daytime sleepiness. Continuous Positive Airway Pressure (CPAP) therapy has been established as the gold standard treatment modality for OSA patients. A few Indian studies have reported the effectiveness of CPAP therapy in improving ESS scores after 1 st month of CPAP use. To observe both, short-term (one month) and long-term (three month) effects of CPAP therapy on ESS scores in moderate to severe OSA patients. The patients complaining of excessive day-time sleepiness, snoring and choking episodes during sleep, consecutively presenting to medicine OPD over a period of 2 years, were subjected to Polysomnography (PSG). Seventy-three patients with apnoea-hypopnea index (AHI) ≥15 were categorised as having moderate to severe forms of OSA (moderate OSA with AHI=15-30 and severe OSA with AHI >30), and were scheduled for an initial trial of CPAP therapy. Forty-seven patients reported good tolerance to CPAP therapy after a trial period of 2 weeks and comprised the final study group. ESS scores in these patients were recorded at the baseline, and after 1 st and 3 rd month of CPAP therapy, and statistically analysed for significance. Mean ESS score at the baseline among moderate and severe OSA patients were 13.67±2.29 and 16.56 ±1.87, respectively. ESS score in both these subgroups improved significantly to 11.63±3.79, p=0.022, CI (0.3293-4.0106)} and 14.13 ±3.74, p CPAP therapy. Likewise, mean ESS scores among moderate and severe OSA patients improved significantly to 9.84 ±2.97, p = 0.022, CI (0.3293-4.0106) and 12.29 ±3.97, p CPAP therapy. The result of the present study shows that CPAP therapy is significantly effective in improving ESS scores in Indian patients having moderate to severe OSA. Benefits

  13. Remote sensing of methane with OSAS-lidar on the 2ν3 band Q-branch: Experimental proof

    Science.gov (United States)

    Galtier, Sandrine; Anselmo, Christophe; Welschinger, Jean-Yves; Sivignon, J. F.; Cariou, Jean-Pierre; Miffre, Alain; Rairoux, Patrick

    2018-06-01

    Optical sensors based on absorption spectroscopy play a central role in the detection and monitoring of atmospheric trace gases. We here present for the first time the experimental demonstration of OSAS-Lidar on the remote sensing of CH4 in the atmosphere. This new methodology, the OSAS-Lidar, couples the Optical Similitude Absorption Spectroscopy (OSAS) methodology with a light detection and ranging device. It is based on the differential absorption of spectrally integrated signals following Beer Lambert-Bouguer law, which are range-resolved. Its novelty originates from the use of broadband laser spectroscopy and from the mathematical approach used to retrieve the trace gas concentration. We previously applied the OSAS methodology in laboratory on the 2ν3 methane absorption band, centered at the 1665 nm wavelength and demonstrated that the OSAS-methodology is almost independent from atmospheric temperature and pressure. In this paper, we achieve an OSAS-Lidar device capable of observing large concentrations of CH4 released from a methane source directly into the atmosphere. Comparison with a standard in-situ measurement device shows that the path-integrated concentrations retrieved from OSAS-Lidar methodology exhibit sufficient sensitivity (2 000 ppm m) and observational time resolution (1 s) to remotely sense methane leaks in the atmosphere. The coupling of OSAS-lidar with a wind measurement device opens the way to monitor time-resolved methane flux emissions, which is important in regards to future climate mitigation involving regional reduction of CH4 flux emissions.

  14. Quality of Life in Youth With Obstructive Sleep Apnea Syndrome (OSAS) Treated With Continuous Positive Airway Pressure (CPAP) Therapy.

    Science.gov (United States)

    Lynch, Mary K; Elliott, Lindsey C; Avis, Kristin T; Schwebel, David C; Goodin, Burel R

    2017-05-30

    Improvement is sought for youth with obstructive sleep apnea syndrome (OSAS) who have poor quality of life (QoL), which resolves somewhat following treatment. One mitigating factor in improved QoL following treatment may be adherence to the CPAP protocol, which presents a barrier to most youth. This study explored relations between CPAP adherence and QoL in youth with OSAS. We recruited 42 youth-caregiver dyads in which youth between the ages of 8 and 16 years were diagnosed with OSAS and required CPAP use as part of their treatment plan. Following diagnosis of OSAS requiring treatment with CPAP therapy, caregivers completed baseline measures of OSAS-specific QoL. The OSAS-specific QoL domains assessed included sleep disturbance, physical symptoms, emotional distress, daytime function, and caregiver concern. Families received routine CPAP care for three months, after which caregivers again completed measures of OSAS-specific QoL. Adherence data were collected from smartcards within the CPAP machine after three months of treatment. Fifteen youth were adherent to CPAP therapy and 10 were not adherent. CPAP-adherent youth demonstrated significant changes in two domains of OSAS-specific QoL when compared to nonadherent youth: decreased sleep disturbance and decreased caregiver concern. CPAP adherence appears to be associated with positive changes in OSAS-specific QoL domains. It will be important for future research and clinical work to examine strategies for improving CPAP adherence in youth with OSAS.

  15. Nasal vs Oronasal CPAP for OSA Treatment: A Meta-Analysis.

    Science.gov (United States)

    Andrade, Rafaela G S; Viana, Fernanda M; Nascimento, Juliana A; Drager, Luciano F; Moffa, Adriano; Brunoni, André R; Genta, Pedro R; Lorenzi-Filho, Geraldo

    2018-03-01

    Nasal CPAP is the "gold standard" treatment for OSA. However, oronasal masks are frequently used in clinical practice. The aim of this study was to perform a meta-analysis of all randomized and nonrandomized trials that compared nasal vs oronasal masks on CPAP level, residual apnea-hypopnea index (AHI), and CPAP adherence to treat OSA. The Cochrane Central Register of Controlled Trials, Medline, and Web of Science were searched for relevant studies in any language with the following terms: "sleep apnea" and "CPAP" or "sleep apnea" and "oronasal mask" or "OSA" and "oronasal CPAP" or "oronasal mask" and "adherence." Studies on CPAP treatment for OSA were included, based on the following criteria: (1) original article; (2) randomized or nonrandomized trials; and (3) comparison between nasal and oronasal CPAP including pressure level, and/or residual AHI, and/or CPAP adherence. We identified five randomized and eight nonrandomized trials (4,563 patients) that reported CPAP level and/or residual AHI and/or CPAP adherence. Overall, the random-effects meta-analysis revealed that as compared with nasal, oronasal masks were associated with a significantly higher CPAP level (Hedges' g, -0.59; 95% CI, -0.82 to -0.37; P CPAP level, higher residual AHI, and poorer adherence than nasal masks. PROSPERO database; No.: CRD42017064584; URL: https://www.crd.york.ac.uk/prospero/. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  16. WBFSH aastakoosolek Varssavis. I-II osa / Raigo Kollom

    Index Scriptorium Estoniae

    Kollom, Raigo, 1936-

    2013-01-01

    Poolas 7.-9. oktoobrini Maailma Sporthobuste Kasvatajate Föderatsiooni peaassambleel toimunust ning loengutest ja aruteludest: Hobuste "genoomilisest aretusest", Jõudluskontrolli ja terviseandmete kasutamisest Rootsi aretuses, Hobuste lineaarse kirjeldamise meetodist, tõuraamatute tulevikust. Teises osas: Hobusekasvatuse seisust Poolas, Janow Podlaski hobusekasvatusest ja üldisest eluolust

  17. Increased MCP-1 gene expression in monocytes of severe OSA patients and under intermittent hypoxia.

    Science.gov (United States)

    Chuang, Li-Pang; Chen, Ning-Hung; Lin, Yuling; Ko, Wen-Shan; Pang, Jong-Hwei S

    2016-03-01

    Obstructive sleep apnea (OSA) is known to be a risk factor of coronary artery disease. Monocyte chemoattractant protein-1 (MCP-1), as a critical factor for monocyte infiltration, is known to play a role in the development of atherosclerosis. This study aimed to investigate the effect of intermittent hypoxia, the hallmark of OSA, on the MCP-1 expression of monocytes. Peripheral blood was sampled from 61 adults enrolled for suspected OSA. RNA was prepared from the isolated monocytes for the analysis of MCP-1. The effect of in vitro intermittent hypoxia on the regulation and function of MCP-1 was investigated on THP-1 monocytic cells and human monocytes. The mRNA and secreted protein levels were investigated by RT/real-time PCR and enzyme-linked immunosorbent assay, respectively. Monocytic MCP-1 gene expression was found to be increased significantly in severe OSA patients. In vitro intermittent hypoxia was demonstrated to increase the mRNA and protein expression levels of MCP-1 dose- and time-dependently in THP-1 monocytic cells. The MCP-1 mRNA expression in monocytes isolated from OSA patient was induced to a much higher level compared to that from normal control. Pre-treatment with inhibitor for p42/44 MAPK or p38 MAPK suppressed the activation of MCP-1 expression by intermittent hypoxia. This is the first study to demonstrate the increase of MCP-1 gene expression in monocytes of severe OSA patients. In addition, monocytic MCP-1 gene expression can be induced under intermittent hypoxia.

  18. OSA screening with the pediatric sleep questionnaire for adolescents undergoing bariatric surgery in teen-LABS.

    Science.gov (United States)

    Ishman, Stacey; Heubi, Christine; Jenkins, Todd; Michalsky, Marc; Simakajornboon, Narong; Inge, Thomas

    2016-11-01

    Obstructive sleep apnea (OSA) is reported in 70% of adolescents who present for bariatric surgery. The Pediatric Sleep Questionnaire (PSQ) was developed to identify children at risk for OSA but is not validated in adolescents with obesity. The aims of this study were: (1) to assess validity of the PSQ to detect OSA and (2) to determine the correlation between anthropometric and polysomnography measurements. A cross-sectional assessment of Teen-Longitudinal Assessment of Bariatric Surgery participants at high risk for OSA was performed. Participants completed an overnight polysomnography, and caregivers completed the PSQ. Forty-five participants (84% female, 78% Caucasian, mean age = 16.7 ± 1.5 years) were evaluated. Mean BMI was 51.3 ± 7.7 kg/m 2 and mean obstructive apnea-hypopnea index (oAHI) was 6.1 ± 5.9 events/h. For diagnosis of OSA (oAHI ≥5), the total PSQ score sensitivity, specificity, and positive predictive value (PPV) were 86%, 38%, and 55%, respectively. For snoring >50% of the time, PPV was 84%, sensitivity was 64%, and specificity was 43%. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir (ρ = 0.34, P = 0.027), whereas BMI, neck, and waist circumference correlated with neither. The PSQ demonstrated low specificity, and PPV and the question regarding snoring >50% of the time did not effectively identify OSA. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir. © 2016 The Obesity Society.

  19. Converting a manned LCU into an unmanned surface vehicle (USV): an open systems architecture (OSA) case study

    OpenAIRE

    Smith, Montrell F.

    2014-01-01

    Approved for public release; distribution is unlimited This thesis demonstrates the process by which the concepts of open systems architecture (OSA) might be applied within the context of an existing systems engineering methodology to result in a flexible system. This is accomplished by combining an existing systems engineering process model with OSA management and business principles to execute a successful asset-repurposing program. To demonstrate utility of this OSA approach to systems ...

  20. Association of Type D personality to perceived side effects and adherence in CPAP-treated patients with OSAS.

    Science.gov (United States)

    Broström, Anders; Strömberg, Anna; Mårtensson, Jan; Ulander, Martin; Harder, Lena; Svanborg, Eva

    2007-12-01

    Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side effects are common and long-term adherence low. The Type D (distressed) personality is defined as a combination of negative affectivity and social inhibition. The association of Type D personality with adherence has not been studied in CPAP-treated patients with OSAS. This study aimed to describe the prevalence of Type D personality in OSAS patients with CPAP treatment longer than 6 months and the association with self-reported side effects and adherence. A cross-sectional descriptive design was used. A total of 247 OSAS patients with a mean use of CPAP treatment for 55 months (6-182 months) were included. Data collection was achieved by two questionnaires; the Type D scale 14 (DS14) (Type D personality), SECI (side effects of CPAP), as well as from medical records (clinical variables and objective adherence to CPAP treatment). Type D personality occurred in 30% of the patients with OSAS and significantly (P < 0.05-0.001) increased the perceived frequency and severity of a broad range of side effects. The objective adherence was significantly lower (P < 0.001) for OSAS patients with Type D compared to OSAS patients without Type D, both with regard to a mean use of 4 h per night and 85% of the self-rated sleep time per night. The additional effect of a Type D personality on perceived side effects and adherence to CPAP treatment found in this study could be used by healthcare personnel when evaluating patients waiting for treatment.

  1. OSAS Surgery and Postoperative Discomfort: Phase I Surgery versus Phase II Surgery

    Directory of Open Access Journals (Sweden)

    Giulio Gasparini

    2015-01-01

    Full Text Available Introduction. This study aims to investigate the reasons that discourage the patients affected by OSAS to undergo orthognathic surgery and compares the postoperative discomfort of phase I (soft tissue surgery and phase II (orthognathic surgery procedures for treatment of OSAS. Material and Methods. A pool of 46 patients affected by OSAS was divided into two groups: “surgery patients” who accepted surgical treatments of their condition and “no surgery patients” who refused surgical procedures. The “surgery patients” group was further subdivided into two arms: patients who accepted phase I procedures (IP and those who accepted phase II (IIP. To better understand the motivations behind the refusal of II phase procedures, we asked the patients belonging to both the IP group and “no surgery” group to indicate the main reason that influenced their decision to avoid II phase procedures. We also monitored and compared five parameters of postoperative discomfort: pain, painkiller assumption, length of hospitalization, foreign body sensation, and diet assumption following IP and IIP procedures. Results. The main reason to avoid IIP procedures was the concern of a more severe postoperative discomfort. Comparison of the postoperative discomfort following IP versus IIP procedures showed that the former scored worse in 4 out of 5 parameters analyzed. Conclusion. IIP procedures produce less postoperative discomfort. IIP procedures, namely, orthognathic surgery, should be the first choice intervention in patients affected by OSAS and dentoskeletal malformation.

  2. Teadusseltside osa rahvuskultuuris ja Õpetatud Eesti Selts / Tiit Rosenberg

    Index Scriptorium Estoniae

    Rosenberg, Tiit, 1946-

    2005-01-01

    Seltsid said alguse 17. sajandil ja levisid Baltimaadesse 19. sajandiks. Ettekanne Eesti Teaduste Akadeemiaga assotsieerunud teadusseltside ühiskonverentsil (21.05.2003. a.) "Teadusseltside osa Eesti rahvusliku identiteedi kujunemisel ja säilimisel"

  3. Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects.

    Science.gov (United States)

    Park, Pona; Kim, Jinil; Song, Yoon Jae; Lim, Jae Hyun; Cho, Sung Woo; Won, Tae-Bin; Han, Doo Hee; Kim, Dong-Young; Rhee, Chae Seo; Kim, Hyun Jik

    2017-12-01

    Although continuous positive airway pressure (CPAP) is the most effective treatment modality, poor adherence still remains a problem for obstructive sleep apnea (OSA) treatment and there is little evidence regarding how this might be improved. This study aims to analyze the anatomic and clinical factors of OSA subjects who failed to comply with CPAP therapy.The medical records of 47 OSA subjects who received CPAP therapy as a first-line treatment modality were retrospectively reviewed. The medical records were reviewed for demographic and polysomnographic data and anatomic findings of the nasal cavity and oropharynx.24 patients who adhered to CPAP therapy and 23 patients who were nonadherent were enrolled in the study. There were no statistically significant differences in sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects. Mean body mass index of CPAP nonadherent group was significantly higher than CPAP adherent group. Higher grades of septal deviation and hypertrophic change of the inferior turbinate were observed more in the CPAP nonadherent group. In addition, CPAP nonadherent subjects showed considerably bigger tonsils and higher grade palatal position comparing with the CPAP adherent subjects. Subjective discomfort including inconvenience, mouth dryness, and chest discomfort were the main problems for OSA subjects who did not comply with CPAP therapy.Excessive upper airway blockage in the nasal cavity and oropharynx was predominant in CPAP nonadherent subjects, which might cause the reported subjective discomfort that reduces CPAP compliance. Therefore, resolution of these issues is needed to enhance CPAP compliance for control of OSA. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  4. Remote sensing of methane emissions by combining optical similitude absorption spectroscopy (OSAS) and lidar

    Science.gov (United States)

    Galtier, Sandrine; Anselmo, Christophe; Welschinger, Jean-Yves; Cariou, Jean-Pierre; Sivignon, Jean-François; Miffre, Alain; Rairoux, Patrick

    2018-04-01

    Monitoring the emission of gases is difficult to achieve in industrial sites and in environments presenting poor infrastructures. Hence, robust methodologies should be developed and coupled to Lidar technology to allow remote sensing of gas emission. OSAS is a new methodology to evaluate gas concentration emission from spectrally integrated differential absorption measurements. Proof of concept of OSAS-Lidar for CH4 emission monitoring is here presented.

  5. Driving simulator and neuropsychological [corrected] testing in OSAS before and under CPAP therapy.

    Science.gov (United States)

    Orth, M; Duchna, H-W; Leidag, M; Widdig, W; Rasche, K; Bauer, T T; Walther, J W; de Zeeuw, J; Malin, J-P; Schultze-Werninghaus, G; Kotterba, S

    2005-11-01

    Patients with obstructive sleep apnoea syndrome (OSAS) have an increased car accident rate. Investigations on accident frequency are based on case history, insurance reports and driving simulator studies. The present study combines neuropsychological testing of different attention aspects engaged in driving a car and driving simulation to evaluate a suitable instrument for assessing therapeutic effects of continuous positive airway pressure (CPAP). Driving simulator investigation and neuropsychological testing of alertness, vigilance and divided attention were performed in 31 patients with polysomnographically confirmed OSAS (apnoea-hypopnoea index 24.8+/-21.5.h(-1)) before, and 2 and 42 days after initiation of CPAP. Divided attention and alertness improved significantly during CPAP, whereas vigilance remained unchanged. However, accident frequency (OSAS before therapy: 2.7+/-2.0; 2 days after CPAP: 1.5+/-1.4; 42 days after CPAP: 0.9+/-1.3) and frequency of concentration faults (OSAS before therapy: 12.4+/-5.1; 2 days after CPAP: 6.5+/-3.9; 42 days after CPAP: 4.9+/-3.3) decreased in the simulated driving situation after 2 and 42 days of therapy. There was no relation between accident frequency, concentration faults and daytime sleepiness, as measured by the Epworth Sleepiness Scale, and polysomnographic or neuropsychological findings, respectively. In conclusion, the present results suggest that driving simulation is a possible benchmark parameter of driving performance in obstructive sleep apnoea syndrome patients.

  6. Assessment of the Depression, Anxiety, and Stress Scale (DASS-21) in untreated obstructive sleep apnea (OSA)

    DEFF Research Database (Denmark)

    Nanthakumar, Shenooka; Bucks, Romola S.; Skinner, Timothy C.

    2017-01-01

    compared the fit of Lovibond and Lovibond's (1995) correlated 3-factor structure of the DASS-21 and measurement invariance between a non-OSA and an OSA sample using confirmatory factor analysis. As measurement invariance was not found, to determine the source of non-invariance differential item functioning...... (DIF) was examined using dMACS. The correlated 3-factor structure (with correlated errors) of the DASS-21 was a better fit in the non-OSA sample. dMACS indicated that there was a degree of DIF for each of the subscales, especially for the Anxiety subscale, in which 2 symptoms (that are also...

  7. Remote sensing of methane emissions by combining optical similitude absorption spectroscopy (OSAS and lidar

    Directory of Open Access Journals (Sweden)

    Galtier Sandrine

    2018-01-01

    Full Text Available Monitoring the emission of gases is difficult to achieve in industrial sites and in environments presenting poor infrastructures. Hence, robust methodologies should be developed and coupled to Lidar technology to allow remote sensing of gas emission. OSAS is a new methodology to evaluate gas concentration emission from spectrally integrated differential absorption measurements. Proof of concept of OSAS-Lidar for CH4 emission monitoring is here presented.

  8. Does CPAP treatment lead to gastroesophageal reflux in patients with moderate and severe OSA?

    Science.gov (United States)

    Ozcelik, Hatice; Kayar, Yusuf; Danalioglu, Ahmet; Arabaci, Elif; Uysal, Omer; Yakar, Fatih; Kart, Levent

    2017-03-01

    Obstructive sleep apnea (OSA) leads to upper respiratory tract obstruction, causing increased abdominal-gastric pressure and decreased lower esophageal sphincter (LES) pressure and thus gastroesophageal reflux (GER). Continuous positive airway pressure (CPAP) is known to be an effective method for OSA treatment, but its effect on GER is still controversial. There are a very few studies investigating CPAP and GER relationship and performed based on pre- and post-treatment objective parameters of GER in patients with OSA. The study investigated the effect of CPAP treatment in patients with moderate and severe OSA without GER complaints on pre- and post-treatment objective GER parameters. The study included 25 patients with respiratory disturbance indices >15 without reflux symptoms who had undergone polysomnography at sleep laboratory. Age, sex, body mass index (BMI), waist, and neck circumference of the patients were documented. DeMeester score, LES pressure, and polysomnography parameters were evaluated pre- and post-CPAP. The results were statistically evaluated, and p value CPAP phase, mean sphincter pressure was 22.2 ± 1.2 (range 8-73), and mean DeMeester score was 18 ± 15.5 (range 0.2-57). At the post-CPAP, mean sphincter pressure was 22.9 ± 1.6 (range 9-95), and mean DeMeester score was 16.3 ± 14.8 (range 0.2-55). No significant difference (p > 0.05) was found comparing pre-CPAP and post-CPAP measurements. Objective criteria show that CPAP treatment does not cause reflux in patients with OSA. Unlike studies reported in the literature, this conclusion has been reached by pre- and post-CPAP assessments.

  9. Particle size and cholesterol content of a mayonnaise formulated by OSA-modified potato starch

    Directory of Open Access Journals (Sweden)

    Shiva Ghazaei

    2015-03-01

    Full Text Available Egg yolk was partially replaced (0, 25, 50, 75, and 100% with octenyl succinic anhydride (OSA-modified potato starch in a reduced-fat mayonnaise formulation to curtail the problems associated with high cholesterol and induced allergic reactions. The physicochemical properties included parameters such as: pH, fat content, and emulsion stability of the formulations analyzed. The samples with 75% and 100% egg yolk substitute showed the maximum emulsion stability (>95% after two of months storage, and they were selected according to cholesterol content, particle size distributions, dynamic rheological properties, microstructure, and sensory characteristic. A significant reduction (84-97% in the cholesterol content was observed in the selected samples. Particle size analysis showed that by increasing the amount of OSA starch, the oil droplets with the peak size of 70 µm engulfed by this compound became larger. The rheological tests elucidated that in the absence of egg yolk, OSA starch may not result in a final product with consistent texture and that the best ratio of the two emulsifiers (OSA starch/egg yolk to produce stable reduced-fat, low cholesterol mayonnaise is 75/25. The microscopic images confirmed the formation of a stable cohesive layer of starch surrounding the oil droplets emulsified in the samples selected.

  10. Nocturnal gastro-oesophageal reflux, asthma and symptoms of OSA: a longitudinal, general population study.

    Science.gov (United States)

    Emilsson, Össur I; Bengtsson, Anna; Franklin, Karl A; Torén, Kjell; Benediktsdóttir, Bryndís; Farkhooy, Amir; Weyler, Joost; Dom, Sandra; De Backer, Wilfried; Gislason, Thorarinn; Janson, Christer

    2013-06-01

    Nocturnal gastro-oesophageal reflux (nGOR) is associated with asthma and obstructive sleep apnoea (OSA). Our aim was to investigate whether nGOR is a risk factor for onset of asthma and onset of respiratory and OSA symptoms in a prospective population-based study. We invited 2640 subjects from Iceland, Sweden and Belgium for two evaluations over a 9-year interval. They participated in structured interviews, answered questionnaires, and underwent spirometries and methacholine challenge testing. nGOR was defined by reported symptoms. Subjects with persistent nGOR (n=123) had an independent increased risk of new asthma at follow-up (OR 2.3, 95% CI 1.1-4.9). Persistent nGOR was independently related to onset of respiratory symptoms (OR 3.0, 95% CI 1.6-5.6). The risk of developing symptoms of OSA was increased in subjects with new and persistent nGOR (OR 2.2, 95% CI 1.3-1.6, and OR 2.0, 95% CI 1.0-3.7, respectively). No significant association was found between nGOR and lung function or bronchial responsiveness. Persistent symptoms of nGOR contribute to the development of asthma and respiratory symptoms. New onset of OSA symptoms is higher among subjects with symptoms of nGOR. These findings provide evidence that nGOR may play a role in the genesis of respiratory symptoms and diseases.

  11. A Formal Security Analysis of an OSA/Parlay Authentication Interface

    NARCIS (Netherlands)

    Corin, R.J.; Di Caprio, G.; Etalle, Sandro; Gnesi, S.; Lenzini, Gabriele; Moiso, C.

    2005-01-01

    We report on an experience in analyzing the security of the Trust and Security Management (TSM) protocol, an authentication procedure within the OSA/Parlay Application Program Interfaces (APIs) of the Open Service Access and Parlay Group. The experience has been conducted jointly by research

  12. Osa Pärnu poliitikuid saab ärimeestelt igakuist tasu / Teet Roosaar

    Index Scriptorium Estoniae

    Roosaar, Teet, 1963-

    2005-01-01

    Kuigi Pärnu uus linnavalitsus kärpis volikogu liikmete äriühingute nõukogudest makstavat tasu poole väiksemaks, saab osa poliitikuid endiselt lisasissetulekut, teiste seas linnakassast doteeritavalt Pärnu ATP-lt

  13. Predicting uptake of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnoea (OSA)

    DEFF Research Database (Denmark)

    Skinner, Timothy; McNeil, Lindsay; Olaithe, Michelle

    2013-01-01

    diagnosed with OSA. Epworth sleepiness scale (ESS), Fatigue Severity Scale, Depression Anxiety Stress Scale and Illness Perception Questionnaire-Revised (IPQ-R) were administered at time of sleep study. These, patient demographics and sleep study variables were used to determine factors predicting patient......Purpose: Obstructive sleep apnoea (OSA) is a common disorder, for which continuous positive airway pressure (CPAP) therapy is a standard treatment. Despite its well-established efficacy, many patients choose not to initiate CPAP treatment. The present study investigated the degree to which...

  14. Obstructive Sleep Apnea Syndrome (OSAS, metabolic syndrome and mental health in small enterprise workers. feasibility of an Action for Health.

    Directory of Open Access Journals (Sweden)

    Sergio Garbarino

    Full Text Available OBJECTIVE: To determine the frequency of obstructive sleep apnea syndrome (OSAS, metabolic syndrome and common mental disorders in the working population of 11 small enterprises and the feasibility of a program of action for health. METHOD: The clinical risk of OSAS, the prevalence of metabolic syndrome, and the level of psychological disorders were assessed during routine medical examination at the workplace in 2012. The response to medical advice was assessed in 2013. RESULTS: 12.3% of the workers were suspected of being affected by OSAS. One or more components of metabolic syndrome were present in 24.5% of cases. OSAS in "healthy" workers was significantly associated with the presence of one or more components of metabolic syndrome (OR = 3.83; 95%CI 1.45-10.13 and with a psychological disorders score in the highest quartile (OR = 4.67; 95%CI = 1.72-12.64. Workers with suspected OSAS were reluctant to follow advice about undergoing further tests under the NHS. However, in some cases, confirmation of the OSAS diagnosis and subsequent treatment led to an improvement in metabolic condition. CONCLUSION: Although participation in treatment was limited, anecdotal cases support the idea that prevention of obstructive sleep apnea in the workplace might be useful for workers' health.

  15. Migrantide raha hoiab vee peal suurt osa endisest NL-ist / Ahto Lobjakas

    Index Scriptorium Estoniae

    Lobjakas, Ahto, 1970-

    2007-01-01

    Brüsselis tutvustatud Maailmapanga uuringust, mille kohaselt on suure osa endise NSVL-i vabariikide jaoks arvestatav sissetulekuallikas migrantide kojusaadetud raha. Lisa: Lääne-Euroopasse ja Venemaale

  16. Frequency of obstructive sleep apnea (OSA in patients with gastroesophageal reflux disease (GERD and the effect of nasal continuous positive airway pressure

    Directory of Open Access Journals (Sweden)

    Amany Shaker

    2016-10-01

    Conclusion: (1 A high risk for OSA development is more frequent in GERD patients especially NERD ones and who experience nighttime symptoms, (2 there is a mutual relationship between OSA and GERD reinforcing each other, and (3 CPAP therapy has a good role in the treatment of both OSA and GERD symptoms.

  17. The utility of the elbow sign in the diagnosis of OSA

    Directory of Open Access Journals (Sweden)

    Haytham Samy Diab

    2015-04-01

    Conclusion: The elbow sign questionnaire is a simple and quick screening tool for OSA with good sensitivity and specificity in comparison to other questionnaires, further studies are needed in other populations to determine its reliability and predictive utility.

  18. Treatment of OSA with CPAP Is Associated with Improvement in PTSD Symptoms among Veterans

    Science.gov (United States)

    Orr, Jeremy E.; Smales, Carolina; Alexander, Thomas H.; Stepnowsky, Carl; Pillar, Giora; Malhotra, Atul; Sarmiento, Kathleen F.

    2017-01-01

    Study Objectives: Posttraumatic stress disorder (PTSD) is common among veterans of the military, with sleep disturbance as a hallmark manifestation. A growing body of research has suggested a link between obstructive sleep apnea and PTSD, potentially due to obstructive sleep apnea (OSA) related sleep disruption, or via other mechanisms. We examined the hypothesis that treatment of OSA with positive airway pressure would reduce PTSD symptoms over 6 months. Methods: A prospective study of Veterans with confirmed PTSD and new diagnosis of OSA not yet using PAP therapy were recruited from a Veteran's Affairs sleep medicine clinic. All subjects were instructed to use PAP each night. Assessments were performed at 3 and 6 months. The primary outcome was a reduction in PTSD symptoms at 6 months. Results: Fifty-nine subjects were enrolled; 32 remained in the study at 6 months. A significant reduction in PTSD symptoms, measured by PCL-S score was observed over the course of the study (60.6 ± 2.7 versus 52.3 ± 3.2 points; p J Clin Sleep Med. 2017;13(1):57–63. PMID:27707436

  19. Obstructive sleep apnea (OSA): a complication of acute infectious mononucleosis infection in a child.

    Science.gov (United States)

    Cheng, Jeffrey

    2014-03-01

    Independently, obstructive sleep apnea (OSA) and infectious mononucleosis are not uncommon in the pediatric population, but acute onset of OSA, as a respiratory complication in the setting of acute EBV infection is extremely uncommon. Previous reports of this clinical entity are sparse and from nearly two decades ago. Urgent adenotonsillectomy was commonly advocated. This complication may be managed medically with systemic corticosteroids and non-invasive continuous positive airway pressure (CPAP), and a case is presented to highlight an updated management approach to this rarely encountered clinical problem in children. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. Olulist pärimisseadusest. [1.-3. osa] / Albert Paltser

    Index Scriptorium Estoniae

    Paltser, Albert, 1931-2007

    1998-01-01

    Pärandamise ja pärimise liikidest, esimese, teise ja kolmanda järjekorra seadusjärgsetest pärijatest ning abikaasa õigusest eelosale. Testamendi liikidest (notariaalne testament, notari hoiule antud testament, kodune testament), pärija pärandi osa määramisest testamendis, annakust, ase- ja järelpärijast, testamendi tühistamisest ja abikaasade vastastikusest testamendist. Pärimislepingust ja pärandi sundosast

  1. The comparison of nasal surgery and CPAP on daytime sleepiness in patients with OSAS.

    Science.gov (United States)

    Tagaya, M; Otake, H; Suzuki, K; Yasuma, F; Yamamoto, H; Noda, A; Nishimura, Y; Sone, M; Nakashima, T; Nakata, S

    2017-09-01

    Residual sleepiness after continuous positive airway pressure (CPAP) is a critical problem in some patients with obstructive sleep apnea syndrome (OSAS). However, nasal surgery is likely to reduce daytime sleepiness and feelings of unrefreshed sleep. The aim of this study is to clarify the effects of nasal surgery and CPAP on daytime sleepiness. This is a retrospective and matched-case control study. The participants were consecutive 40 patients with OSAS who underwent nasal surgery (Surgery group) and 40 matched patients who were treated with CPAP (CPAP group). In the Surgery group, although the nasal surgery did not decrease either apnea or hypopnea, it improved oxygenation, the quality of sleep. In the CPAP Group, the CPAP treatment reduced apnea and hypopnea, and improved oxygenation, quality of sleep. The degree of relief from daytime sleepiness was different between the two groups. The improvement of Epworth Sleepiness Scale was more significant in the Surgery Group than those in the CPAP Group (Surgery from 11.0 to 5.1, CPAP from 10.0 to 6.2). These findings suggest that the results of the nasal surgery is more satisfactory for some patients with OSAS than CPAP on daytime sleepiness.

  2. Lizards and Amphisbaenians, municipality of Viçosa, state of Minas Gerais, southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigues, A. C.

    2009-01-01

    Full Text Available We performed a survey of lizards and amphisbaenians from municipality of Viçosa, in Atlantic Forest from state ofMinas Gerais, southeastern Brazil, based on data of the herpetological collections of Museu de Zoologia João Moojen,Universidade Federal de Viçosa, and Museu de Zoologia, Universidade de São Paulo. One hundred and forty sixspecimens of 14 species were analyzed, belonging to the following families: Amphisbaenidae, Anguidae, Gekkonidae,Gymnophthalmidae, Leiosauridae, Polychrotidae, Scincidae, Teiidae and Tropiduridae. We hope to supply basicinformation that helps to understand species distribution of this group in the Atlantic Forest of Minas Gerais andsoutheastern Brazil.

  3. The use of endomarketing in credit unions: a case study of the UFVCredi and the Unicred-Viçosa O emprego do endomarketing em cooperativas de crédito: estudo de caso da UFV-Credi e da Unicred-Viçosa

    Directory of Open Access Journals (Sweden)

    Henrique Lopes Dornelas

    2002-11-01

    Full Text Available Endomarketing can be considered as a group of activities concerned with the internal aspects of the organization, whose purpose is to value the human being. In order to become competitive, the Credit Unions should adopt Endomarketing strategies that combine motivation, training and communication elements. The purpose of the present work was to verify how the Credit Union of the Workers of the Federal University of Viçosa Ltd. / UFV-CREDI and the Credit Union of the Doctors and Health-related Professionals of Viçosa Ltd. – UNICRED/VIÇOSA – MG are using the tools offered by Endomarketing. In the methodology, a study concerning the Endomarketing and the Credit Unions war carried out. After that, the employees and the members of the Credit Unions were asked to answer a questionnaire. After the analysis of the obtained data, it was concluded that UFV-CREDI and UNICRED/VIÇOSA-MG have effectively reached their objectives because their Endomarketing strategies have presented positive results, making it possible for them to get new members as well as to keep their members and employees motivated and satisfied with the products and services offered by the Credit Unions.O Endomarketing pode ser conceituado como um conjunto de atividades voltadas para o interior da organização, cuja finalidade é valorizar o ser humano. Para que as cooperativas de crédito sejam competitivas, elas devem adotar estratégias de Endomarketing, que combinem elementos de motivação, treinamento e comunicação. Procurou-se com o presente estudo, verificar como a Cooperativa de Economia e Crédito Mútuo dos Servidores da Universidade Federal de Viçosa – LTDA / UFV-CREDI e a Cooperativa de Economia e Crédito Mútuo dos Médicos e demais Profissionais da Saúde de Viçosa Ltda – UNICRED/VIÇOSA-MG estão utilizando as ferramentas oferecidas pelo Endomarketing. Na metodologia foi realizado um estudo acerca do Endomarketing e das cooperativas de crédito, para

  4. Effect of CPAP Withdrawal on BP in OSA: Data from Three Randomized Controlled Trials.

    Science.gov (United States)

    Schwarz, Esther I; Schlatzer, Christian; Rossi, Valentina A; Stradling, John R; Kohler, Malcolm

    2016-12-01

    Based on meta-analyses, the BP-lowering effect of CPAP therapy in patients with OSA is reported to be approximately 2 to 3 mm Hg. This figure is derived from heterogeneous trials, which are often limited by poor CPAP adherence, and thus the treatment effect may possibly be underestimated. We analyzed morning BP data from three randomized controlled CPAP withdrawal trials, which included only patients with optimal CPAP compliance. Within the three trials, 149 patients with OSA who were receiving CPAP were randomized to continue therapeutic CPAP (n = 65) or to withdraw CPAP (n = 84) for 2 weeks. Morning BP was measured at home before and after sleep studies in the hospital. CPAP withdrawal was associated with a return of OSA (apnea-hypopnea index [AHI] at a baseline of 2.8/h and at follow-up of 33.2/h). Office systolic BP (SBP) increased in the CPAP withdrawal group compared with the CPAP continuation group by +5.4 mm Hg (95% CI, 1.8-8.9 mm Hg; P = .003) and in the home SBP group by +9.0 mm Hg (95% CI, 5.7-12.3 mm Hg; P CPAP withdrawal results in a clinically relevant increase in BP, which is considerably higher than in conventional CPAP trials; it is also underestimated when office BP is used. Greater OSA severity is associated with a higher BP rise in response to CPAP withdrawal. ClinicalTrials.gov; No.: NCT01332175 and NCT01797653) URL: www.clinicaltrials.gov and ISRCTN registry (ISRCTN 93153804) URL: http://www.isrctn.com/. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  5. Lack of effect of sleep apnea on oxidative stress in obstructive sleep apnea syndrome (OSAS patients.

    Directory of Open Access Journals (Sweden)

    M Simiakakis

    Full Text Available PURPOSE: The aim of this study was to evaluate markers of systemic oxidative stress and antioxidant capacity in subjects with and without OSAS in order to investigate the most important factors that determine the oxidant-antioxidant status. METHODS: A total of 66 subjects referred to our Sleep laboratory were examined by full polysomnography. Oxidative stress and antioxidant activity were assessed by measurement of the derivatives of reactive oxygen metabolites (d-ROMs and the biological antioxidant capacity (BAP in blood samples taken in the morning after the sleep study. Known risk factors for oxidative stress, such as age, sex, obesity, smoking, hypelipidemia, and hypertension, were investigated as possible confounding factors. RESULTS: 42 patients with OSAS (Apnea-Hypopnea index >15 events/hour were compared with 24 controls (AHI<5. The levels of d-ROMS were significantly higher (p = 0.005 in the control group but the levels of antioxidant capacity were significantly lower (p = 0.004 in OSAS patients. The most important factors predicting the variance of oxidative stress were obesity, smoking habit, and sex. Parameters of sleep apnea severity were not associated with oxidative stress. Minimal oxygen desaturation and smoking habit were the most important predicting factors of BAP levels. CONCLUSION: Obesity, smoking, and sex are the most important determinants of oxidative stress in OSAS subjects. Sleep apnea might enhance oxidative stress by the reduction of antioxidant capacity of blood due to nocturnal hypoxia.

  6. The rheological properties of blood and the risk of cardiovascular disease in patients with obstructive sleep apnea syndrome (OSAS

    Directory of Open Access Journals (Sweden)

    Władysław Pierzchała

    2011-07-01

    Full Text Available Obstructive sleep apnea (OSA is an important public health concern, which affects around 2–4% of the population. Left untreated, it causes a decrease not only in quality of life, but also of life expectancy. Despite the fact that knowledge about the mechanisms of development of cardiovascular disease in patients with OSA is still incomplete, observations confirm a relationship between sleep disordered breathing and the rheological properties of blood. One possible consequence of an increased incidence of cardiovascular disease may be a rise in mortality in OSA patients. Continuously improved research methods are allowing for an increasingly more accurate understanding of the significance of observed changes. (Folia Histochemica et Cytobiologica 2011, Vol. 49, No. 2, 206–210

  7. Cognition and nocturnal disturbance in OSA: the importance of accounting for age and premorbid intelligence

    DEFF Research Database (Denmark)

    Olaithe, Michelle; Skinner, Timothy C.; Hillman, David

    2015-01-01

    and a tertiary hospital sleep clinic. All underwent comprehensive, laboratory-based polysomnography (PSG) and completed assessments of cognition including attention, short- and long-term memory and executive function. Structural equation modelling (SEM) was used to construct a theoretically-driven model......© 2014, Springer-Verlag Berlin Heidelberg. Introduction: Obstructive sleep apnea (OSA) is a common disorder that is associated with impaired attention, memory and executive function. However, the mechanisms underlying such dysfunction are unclear. To determine the influence of sleep fragmentation...... these significant relationships. No significant predictors of memory function were found. Conclusions: The mechanisms underlying the effects of OSA on cognition remain to be defined. Implications are discussed in light of these findings....

  8. Piperaceae C. Agardh da Estação Experimental Mata do Paraíso, Viçosa, MG Piperaceae C. Agardh from the Experimental Station of "Mata do Paraíso", Viçosa, MG

    Directory of Open Access Journals (Sweden)

    Rita Maria de Carvalho-Okano

    1998-01-01

    Full Text Available Este trabalho consistiu no levantamento dos representantes de Piperaceae na Estação Experimental Mata do Paraíso, no município de Viçosa, MG (20º42'S e 42º55'W, coberta por Floresta Estacionai Semidecidual Montana. No período de março/97 a junho/98 foram realizadas 30 visitas quinzenais à Estação para coleta de material botânico que se encontra depositado no herbário VIC da Universidade Federal de Viçosa. Foram reconhecidos 18 táxons distribuídos nos gêneros Piper L. com 14 espécies, Ottonia Spreng. com três e Pothomorphe Miq. com uma espécie. As espécies mais abundantes foram Piper caldense C.DC., Piper gaudichaudianum Kunth e Piper vicosanum Yunck. São apresentadas chaves para identificação dos gêneros e espécies, descrições, ilustrações e comentários.An inventory of the Piperaceae species was made at the Experimental Station of "Mata do Paraíso" in Viçosa, Minas Gerais State (20º42'S and 42º55'W, an area covered by the Semideciduous Mesophytic Montana Forest. Thirty visits were made fortnightly to the station, from March/1997 to June/1998, in order to collect botanical material which was deposited in the VIC herbarium (Universidade Federal de Viçosa. Eighteen taxa, represented by the genera Piper L. (14 species, Ottonia Spreng (3 species, and Potliotnorplie Miq. (1 species were recognized. The most abundant species were Piper caldense CDC, Piper gaudichaudianum Kunth and Piper vicosanum Yunck. Identification keys for the genera and species as well as species descriptions, illustrations and comments are presented.

  9. Changes of plasma IL-6 and TNF-α levels after CPAP treatment in patients with obstructive sleep apnea syndrome (OSAS)

    International Nuclear Information System (INIS)

    Cao Zhuo; Wang Liangxing

    2009-01-01

    Objective: To investigate the changes of plasma IL-6 and TNF-α levels after continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea syndrome (OSAS). Methods: Plasma IL-6 and TNF-α levels were measured with RIA in 60 patients with OSAS both before and after CPAS therapy as well as in 30 controls. Results: Before CPAP therapy, the plasma IL-6 and TNF-α levels in patients with OSAS were significantly higher than those in controls (25.92 ± 4.48pg/ ml and 11.27 ± 2.60pg/ml vs 13.21 ± 1.97pg/ml and 5.83±0.99pg/mi, P 2 level (r=-0.495, 0.483, P<0.05). After treatment with CPAP for three months, the plasma IL-6 and TNF-α levels were significantly decreased (15.37±1.78pg/ml and 6.79±0.87pg/ml, vs pre-treatment levels, P<0.05, P<0.01). Conclusion: CPAP therapy could effectively decrease the plasma IL-6 and TNF-α levels in patients with OSAS. (authors)

  10. The efficacy of a brief motivational enhancement education program on CPAP adherence in OSA: a randomized controlled trial.

    Science.gov (United States)

    Lai, Agnes Y K; Fong, Daniel Y T; Lam, Jamie C M; Weaver, Terri E; Ip, Mary S M

    2014-09-01

    Poor adherence to CPAP treatment in OSA adversely affects the effectiveness of this therapy. This randomized controlled trial (RCT) examined the efficacy of a brief motivational enhancement education program in improving adherence to CPAP treatment in subjects with OSA. Subjects with newly diagnosed OSA were recruited into this RCT. The control group received usual advice on the importance of CPAP therapy and its care. The intervention group received usual care plus a brief motivational enhancement education program directed at enhancing the subjects' knowledge, motivation, and self-efficacy to use CPAP through the use of a 25-min video, a 20-min patient-centered interview, and a 10-min telephone follow-up. Self-reported daytime sleepiness adherence-related cognitions and quality of life were assessed at 1 month and 3 months. CPAP usage data were downloaded at the completion of this 3-month study. One hundred subjects with OSA (mean ± SD, age 52 ± 10 years; Epworth Sleepiness Scales [ESS], 9 ± 5; median [interquartile range] apnea-hypopnea index, 29 [20, 53] events/h) prescribed CPAP treatment were recruited. The intervention group had better CPAP use (higher daily CPAP usage by 2 h/d [Cohen d = 1.33, P motivational enhancement education in addition to usual care were more likely to show better adherence to CPAP treatment, with greater improvements in treatment self-efficacy and daytime sleepiness. ClinicalTrials.gov; No.: NCT01173406; URL: www.clinicaltrials.gov.

  11. Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension.

    Science.gov (United States)

    Wang, Lei; Li, Nanfang; Yao, Xiaoguang; Chang, Guijuan; Zhang, Delian; Heizhati, Mulalibieke; Wang, Menghui; Luo, Qin; Kong, Jianqiong

    2017-01-01

    Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA) was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA) (5.8%) and PA + OSA (4.9%). Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing's syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group. Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.

  12. Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension

    Directory of Open Access Journals (Sweden)

    Lei Wang

    2017-01-01

    Full Text Available Background. Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. Methods. Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. Results. Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA (5.8% and PA + OSA (4.9%. Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing’s syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group. Conclusion. Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.

  13. Topical nasal steroid treatment does not improve CPAP compliance in unselected patients with OSAS.

    Science.gov (United States)

    Strobel, Werner; Schlageter, Manuel; Andersson, Morgan; Miedinger, David; Chhajed, Prashant N; Tamm, Michael; Leuppi, Jörg D

    2011-02-01

    Continuous positive airways pressure (CPAP) for treatment of obstructive sleep apnea (OSA) can produce troublesome nasal symptoms (i.e. congestion, rhinorrhea) that may reduce the compliance of CPAP. Topical nasal steroids are often prescribed to reduce these side effects, although scientific data are scarce supporting any benefits of this treatment for CPAP-induced nasal side effects. To study whether a topical nasal steroid can reduce CPAP-induced nasal symptoms and improve CPAP adherence during the initial phase of OSA treatment. A randomized, double-blinded, placebo-controlled study with fluticasone propionate 100 μg/nasal cavity twice daily Treatment was started 10 days prior to and continued throughout the first 4 weeks of CPAP. 63 patients who were selected for CPAP treatment participated. Nasal symptoms were recorded, nasal patency was assessed and lung function was measured with a peak flow meter. The patients' adherence to CPAP was recorded by the CPAP device. Total nasal symptoms increased from baseline to 4 wks after CPAP use for both nasal treatments (p < 0.05). No differences in total nasal symptoms between treatments were seen (p = 1), and no differences in nasal peak flow values after treatment were seen (p = 0.11). Moreover, there were no differences in CPAP use between the treatments. Fluticasone propionate as a nasal topical steroid does not reduce CPAP-induced unwanted nasal side effects, and has no beneficial effect on CPAP compliance during the first four weeks of treatment in unselected patients with OSAS. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Oronasal mask may compromise the efficacy of continuous positive airway pressure on OSA treatment: is there evidence for avoiding the oronasal route?

    Science.gov (United States)

    Andrade, Rafaela Garcia Santos; Madeiro, Fernanda; Genta, Pedro Rodrigues; Lorenzi-Filho, Geraldo

    2016-11-01

    Continuous positive airway pressure (CPAP) delivered by nasal mask is the gold standard treatment for obstructive sleep apnea (OSA). However, oral and oronasal masks are also available. We considered experimental evidence and reviewed clinical trials that evaluated the impact of oral and oronasal mask on OSA treatment. One recent study in 18 OSA patients that slept with a customized oronasal mask with two sealed compartments showed that the change of CPAP flow from nasal to oronasal and oral caused upper airway obstruction because of posterior displacement of the tongue demonstrated by nasoendoscopy. Oral masks use a mouthpiece that may stabilize the jaw and the tongue and have shown to be effective. However, oral masks are not widely used in clinical practice. Four out of five observational studies and all five reviewed randomized studies showed a worse performance of oronasal when compared with nasal masks. Oronasal masks were associated with higher residual apnea-hypopnea index, lower adherence, more leaks, and less satisfaction than nasal mask in the majority of the studies. Nasal CPAP must be the first choice to treat OSA. Patients on oronasal mask should be carefully followed. VIDEO ABSTRACT.

  15. High Adherence to CPAP Treatment Does Not Prevent the Continuation of Weight Gain among Severely Obese OSAS Patients

    Science.gov (United States)

    Myllylä, Minna; Kurki, Samu; Anttalainen, Ulla; Saaresranta, Tarja; Laitinen, Tarja

    2016-01-01

    Study Objectives: Obstructive sleep apnea syndrome (OSAS) patients benefit from continuous positive airway pressure (CPAP) treatment in a dose-response manner. We determined adherence and weight control, as well as their predictors, among long-term CPAP users. Methods: Cohort of 1,023 OSAS patients had used CPAP on average of 6.6 ± 1.2 years. BMI was determined at baseline and at follow-up visits. There were 7.4 ± 1.7 BMI and 6.5 ± 1.8 CPAP usage measurements per patient on average. Using the Bayesian hierarchical model, we determined the patients' individual trends of BMI and adherence development. Patients with significantly increasing or decreasing trends were identified at the posterior probability level of > 90%. Results: The mean age in the cohort was 55.6 ± 9.8 years, BMI 33.5 ± 6.4 kg/m2, apnea-hypopnea index 33.7 ± 23.1, and CPAP usage 6.0 ± 1.8 h/day. The majority of patients had no significant change in BMI (mean annual weight gain 0.04 ± 0.29 kg/m2) or CPAP adherence (mean annual increase 11.4 ± 7.0 min/day). However, at the individual level, 10% of the patients showed significant annual weight gain (0.63 ± 0.35 kg/m2) during the 5-year follow-up period. At baseline these patients were already more severely obese (mean BMI 40.0 ± 5.9 kg/m2) despite being younger (mean 50.9 ± 9.5 years) than the rest of the cohort. Conclusions: In the majority of CPAP-treated OSAS patients, weight did not significantly change but gained slightly slower than in age-matched population in general. However, in 10% of patients, high adherence to CPAP treatment did not prevent the continuation of weight gain. These patients present a high-risk group for OSAS-related multimorbidity later in life. Citation: Myllylä M, Kurki S, Anttalainen U, Saaresranta T, Laitinen T. High adherence to CPAP treatment does not prevent the continuation of weight gain among severely obese OSAS patients. J Clin Sleep Med 2016;12(4):519–528. PMID:26888588

  16. SEA LEVEL RISE AND ITS POTENTIAL IMPACTS ON COASTAL URBAN AREA: A CASE OF ETI-OSA, NIGERIA

    Directory of Open Access Journals (Sweden)

    Ayodele Michael AGBOOLA

    2016-10-01

    Full Text Available This study examines the spatial extent of coastal urban development and its potential sensitivity to sea-level rise. The main aim of the study is to critically examine the extent of growth in Eti-Osa over time, and the potential impacts of sea leve rise. Landsat Enhanced Thematic Mapper Plus (ETM+ imageries of years 2000 and 2015 were used to evaluate the different land use type identified. Post-classification change detection method was used to evaluate the output of the maximum likelihood supervised classification analysis done. This was also used to estimate the changes induces through urban development on the environment which accounts for the biodiversity loss. ASTER GDEM 2 imagery of 2011 was used to generate the elevation data used for the inundation analysis. Thus, both Land use map of Eti-Osa in 2015 and the down scaled Sea-level rise scenarios (at 0.5 to 15 meters were used for the inundation mapping. Results obtained from this research affirms that indeed EtiOsa has been subjected to gross urban expansion giving room for diverse forms of environmental degradation among which are huge replacement of natural land cover with built-up, reclamation of wetlands and sand filling of water bodies. This basically illustrates growth but also the risk that accompanies the advent of excessive alteration of natural ecosystem as Sea-level rise projections imply in this research.

  17. CPAP treatment supported by telemedicine does not improve blood pressure in high cardiovascular risk OSA patients: a randomized, controlled trial.

    Science.gov (United States)

    Mendelson, Monique; Vivodtzev, Isabelle; Tamisier, Renaud; Laplaud, David; Dias-Domingos, Sonia; Baguet, Jean-Philippe; Moreau, Laurent; Koltes, Christian; Chavez, Léonidas; De Lamberterie, Gilles; Herengt, Frédéric; Levy, Patrick; Flore, Patrice; Pépin, Jean-Louis

    2014-11-01

    Obstructive sleep apnea (OSA) has been associated with hypertension, which is one of the intermediary mechanisms leading to increased cardiovascular morbidity. This study aimed at evaluating the effects of a combination of continuous positive airway pressure (CPAP) and telemedicine support on blood pressure (BP) reduction in high cardiovascular risk OSA patients. A multi-center randomized controlled trial that compared standard CPAP care and CPAP care and a telemedicine intervention. Sleep clinics in France. 107 adult (18-65 years old) OSA patients (AHI > 15 events/h) with a high cardiovascular risk (cardiovascular SCORE > 5% or secondary prevention). Patients were randomized to either standard care CPAP (n = 53) or CPAP and telemedicine (n = 54). Patients assigned to telemedicine were equipped with a smartphone for uploading BP measurements, CPAP adherence, sleepiness, and quality of life data; in return, they received pictograms containing health-related messages. The main outcome was home self-measured BP and secondary outcomes were cardiovascular risk evolution, objective physical activity, CPAP adherence, sleepiness and quality of life. Self-measured BP did not improve in either group (telemedicine or standard care). Patients in primary prevention showed greater BP reduction with CPAP treatment than those in secondary prevention. CPAP treatment supported by telemedicine alone did not improve blood pressure and cardiovascular risk in high cardiovascular risk OSA patients. This study emphasizes the need for diet and physical activity training programs in addition to CPAP when aiming at decreasing cardiometabolic risk factors in these patients. ClinicalTrials.gov identifier: NCT01226641.

  18. Perfil socioeconômico, nutricional e de antioxidantes de jovens fumantes, do município de Viçosa-MG

    OpenAIRE

    Batista, Ellencristina da Silva

    2006-01-01

    Com o objetivo de comparar o perfil socieconômico, nutricional e de antioxidantes de indivíduos jovens fumantes e não fumantes de Viçosa-MG, conduziu-se um estudo transversal controlado. Foram selecionados indivíduos fumantes e não fumantes de instituições de ensino da cidade de Viçosa-MG. Considerou-se como fumante o indivíduo que fumava pelo menos um cigarro diariamente, por pelo menos 30 dias antes do inicio do estudo, e não fumante o que nunca fumou e/ou não fumava esporadicamente. Os fum...

  19. Rice microRNA osa-miR1848 targets the obtusifoliol 14α-demethylase gene OsCYP51G3 and mediates the biosynthesis of phytosterols and brassinosteroids during development and in response to stress.

    Science.gov (United States)

    Xia, Kuaifei; Ou, Xiaojing; Tang, Huadan; Wang, Ren; Wu, Ping; Jia, Yongxia; Wei, Xiaoyi; Xu, Xinlan; Kang, Seung-Hye; Kim, Seong-Ki; Zhang, Mingyong

    2015-11-01

    Phytosterols are membrane components or precursors for brassinosteroid (BR) biosynthesis. As they cannot be transported long distances, their homeostasis is tightly controlled through their biosynthesis and metabolism. However, it is unknown whether microRNAs are involved in their homeostatic regulation. Rice (Oryza sativa) plants transformed with microRNA osa-miR1848 and its target, the obtusifoliol 14α-demethylase gene, OsCYP51G3, were used to investigate the role of osa-miR1848 in the regulation of phytosterol biosynthesis. osa-miR1848 directs OsCYP51G3 mRNA cleavage to regulate phytosterol and BR biosynthesis in rice. The role of OsCYP51G3 as one of the osa-miR1848 targets is supported by the opposite expression patterns of osa-miR1848 and OsCYP51G3 in transgenic rice plants, and by the identification of OsCYP51G3 mRNA cleavage sites. Increased osa-miR1848 and decreased OsCYP51G3 expression reduced phytosterol and BR concentrations, and caused typical phenotypic changes related to phytosterol and BR deficiency, including dwarf plants, erect leaves, semi-sterile pollen grains, and shorter cells. Circadian expression of osa-miR1848 regulated the diurnal abundance of OsCYP51G3 transcript in developing organs, and the response of OsCYP51G3 to salt stress. We propose that osa-miR1848 regulates OsCYP51G3 expression posttranscriptionally, and mediates phytosterol and BR biosynthesis. osa-miR1848 and OsCYP51G3 might have potential applications in rice breeding to modulate leaf angle, and the size and quality of seeds. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

  20. Control of OSA during automatic positive airway pressure titration in a clinical case series: predictors and accuracy of device download data.

    Science.gov (United States)

    Huang, Hsin-Chia Carol; Hillman, David R; McArdle, Nigel

    2012-09-01

    To investigate the factors associated with physiologic control of obstructive sleep apnea (OSA) during automatic positive airway pressure (APAP) titration in a clinical series. To also assess the usefulness of apnea-hypopnea index (AHI) data downloaded from the APAP device (Dev AHI). Retrospective review of a consecutive series of patients with OSA who underwent APAP titration (Autoset Spirit, ResMed, Bella Vista, New South Wales, Australia ) with simultaneous polysomnographic (PSG) monitoring in the sleep laboratory. Tertiary sleep clinic. There were 190 consecutive patients with OSA referred for APAP titration. There were 58% of patients who achieved optimal or good control of OSA (titration PSG AHI titration. The independent predictors of titration PSG AHI were a history of cardiac disease and elevated central apnea and arousal indices during the diagnostic study. Although the median and interquartile range (IQR) AHI from the device (7.0, 3.9-11.6 events/hr) was only slightly less than the PSG AHI (7.8, 3.9-14.4 events/hr, P = 0.04) during titration, case-by-case agreement between the two measures was poor (chi-square titration is often poor, and close clinical follow-up is particularly needed in patients with a history of cardiac disease or with high arousal or central apnea indices on the diagnostic study. Device AHI does not reliably assess control during APAP titration, and PSG assessment may be required if clinical response to treatment is poor. The findings relate to the ResMed AutoSet device and may not apply to other devices.

  1. O tratamento dos doentes insanos de Vila Viçosa no hospital de Rilhafoles (segunda metade do século XIX

    Directory of Open Access Journals (Sweden)

    Lobo de Araújo, Maria Marta

    2014-12-01

    Full Text Available In this work we examined the procedural requirements related to the sending of insane patients of Vila Viçosa to the hospital of Rilhafoles, in the second half of the 19th century, and the relationships established with the hospital of this Alentejo town relating to the payment of treatment. Faced with a severe financial crisis, the hospital of Vila Viçosa systematically refused the responsibility to send the insane patients to the Rilhafoles hospital in an attempt to pass this burden on the administration of the county, being very reluctant to pay the bills that came to him from the hospital of São José. The conflict between the two institutions came to the monarch with no other alternative than the payment, the hospital of village of the Alentejo region proceeded to sending parcels of money, albeit way too late. For the realization of this work we use the books of the Misericórdia and the documents of the Civil Governor found of the city of Évora under the custody of the Distrital Archive of the same city. This documents results, basically, from the correspondence between the Misericórdia of Vila Viçosa, the council administrator and the civil governor of Évora.[pt] Neste trabalho analisamos os trâmites processuais respeitantes ao envio de doentes insanos de Vila Viçosa para o hospital de Rilhafoles, na segunda metade do século XIX, e as relações estabelecidas com o hospital desta vila alentejana relativamente ao pagamento do tratamento. A braços com uma grave crise financeira, o hospital de Vila Viçosa recusava sistematicamente a responsabilidade de enviar os alienados para Rilhafoles, numa tentativa de passar esse ónus para a administração do concelho, mostrando-se muito renitente no pagamento das faturas que lhe chegavam do hospital de São José. O conflito entre as duas instituições chegou ao monarca e sem outra alternativa que a do pagamento, o hospital da vila alentejana procedeu ao envio de parcelas de dinheiro

  2. Recognition of upper airway and surrounding structures at MRI in pediatric PCOS and OSAS

    Science.gov (United States)

    Tong, Yubing; Udupa, J. K.; Odhner, D.; Sin, Sanghun; Arens, Raanan

    2013-03-01

    Obstructive Sleep Apnea Syndrome (OSAS) is common in obese children with risk being 4.5 fold compared to normal control subjects. Polycystic Ovary Syndrome (PCOS) has recently been shown to be associated with OSAS that may further lead to significant cardiovascular and neuro-cognitive deficits. We are investigating image-based biomarkers to understand the architectural and dynamic changes in the upper airway and the surrounding hard and soft tissue structures via MRI in obese teenage children to study OSAS. At the previous SPIE conferences, we presented methods underlying Fuzzy Object Models (FOMs) for Automatic Anatomy Recognition (AAR) based on CT images of the thorax and the abdomen. The purpose of this paper is to demonstrate that the AAR approach is applicable to a different body region and image modality combination, namely in the study of upper airway structures via MRI. FOMs were built hierarchically, the smaller sub-objects forming the offspring of larger parent objects. FOMs encode the uncertainty and variability present in the form and relationships among the objects over a study population. Totally 11 basic objects (17 including composite) were modeled. Automatic recognition for the best pose of FOMs in a given image was implemented by using four methods - a one-shot method that does not require search, another three searching methods that include Fisher Linear Discriminate (FLD), a b-scale energy optimization strategy, and optimum threshold recognition method. In all, 30 multi-fold cross validation experiments based on 15 patient MRI data sets were carried out to assess the accuracy of recognition. The results indicate that the objects can be recognized with an average location error of less than 5 mm or 2-3 voxels. Then the iterative relative fuzzy connectedness (IRFC) algorithm was adopted for delineation of the target organs based on the recognized results. The delineation results showed an overall FP and TP volume fraction of 0.02 and 0.93.

  3. Comparability of pulse oximeters used in sleep medicine for the screening of OSA

    International Nuclear Information System (INIS)

    Böhning, N; Schultheiß, B; Eilers, S; Schmittendorf, E; Penzel, T; Böhning, W

    2010-01-01

    Obstructive sleep apnea syndrome (OSA) is a frequent clinical picture. It is characterized by repetitive respiratory arrest with a consecutive decrease in arterial oxygen saturation (SaO 2 ). In clinical practice, the number of desaturations per hour, oxygen desaturation index (ODI), is used as an important diagnostic criterion. Medical literature, however, mentions different threshold values that are defined as pathological. By means of systematic comparative measurements, the study presented here will examine to what extent the diagnosis and the quantification of OSA severity are affected by the device-specific measurement technique, thus impacting the predictive value of nighttime pulse oximetry in outpatient OSA screening. Different pulse oximeters commonly used in clinical practice were analyzed comparatively regarding technical parameters, temporal dynamics and the reproducibility of measuring results. The measurements were executed simultaneously and time synchronized in a reference group of five test subjects (four males, one female, average age 33.0 ± 9.4 years), in a group of five patients (all males, average age 51.8 ± 18.4 years) and using a simulator (pulse oximeter simulator index 2). All devices underestimate the simulator's predetermined oxygen desaturation of 10%. The dispersion of values is high. The device-specific characteristics have a significant influence on the collected data. The fundamental weakness of the systems lies in the reproducibility of measuring results (this only seems adequate at a signal resolution in steps of 0.1%) as well as the differing temporal dynamics. In the synchronous use of different systems on patients for the purpose of a direct comparison of devices, the dispersion of values is serious, reaching a fluctuation range of up to factor 1.42. In measuring dynamic events (apneas), different pulse oximeters do not record identical values. This is due to the different internal signal processing of the devices

  4. Assessment and characterization of joineries in the city of Viçosa, MG/ Diagnóstico e caracterização das marcenarias na cidade de Viçosa, MG

    Directory of Open Access Journals (Sweden)

    José de Castro Silva

    2008-07-01

    Full Text Available The forestry sector is not only formed by large companies, such as pulp and paper or reconstituted panels, but also by small businesses, and often strictly family businesses, as joineries. This study aimed to identify, assess and characterize joineries in Viçosa, Minas Gerais. The object of study was limited to the city’s joinery businesses, mainly the ones belonging to the former Joiner’s Association. A questionnaire was drawn up to obtain information on the used wood, internal management and employee training, machinery, products, market, product advertising and prospects for the sector. It was found that both entrepreneurs and workers have low educational level and lack their own product design. They were producing only ordered products with intensive use of solid wood particularly from native forests. Products were heterogeneous, ranging from furniture to farm utilities. Competition, mainly the informal, represented the biggest obstacle to sector development, as well as serialized products from other locations sold in shops at lower prices. It was concluded that the joinery sector in Viçosa needs greater skill levels, both technical and managerial, to improve the activity. Moreover, the sector needs better organization through associations and support of agencies such as local Sebrae, and wider product advertising targeting consumers in the region.O setor florestal não é constituído apenas por grandes empresas, como as de celulose e papel ou de painéis reconstituídos, mas também por pequenas empresas, muitas das vezes estritamente familiares, como as marcenarias. O presente trabalho teve por objetivo a identificação, diagnóstico e caracterização das marcenarias de Viçosa, Estado de Minas Gerais. Delimitaram-se, como objeto de estudo, as empresas de marcenaria da cidade, principalmente, pertencentes ao antigo Núcleo de Marceneiros. Elaborou-se um questionário para buscar informações sobre a madeira utilizada

  5. AMINO ACID-BASED FERTILIZER AS AN ALTERNATIVE TO CALDA VIÇOSA IN ORGANIC AGRICULTURE

    Directory of Open Access Journals (Sweden)

    Diego Fontebasso Pelizari Pinto

    2017-10-01

    Full Text Available The aim of this study was to propose a mixture of micronutrients with amino acid-based foliar fertilizer as an alternative to calda viçosa for application in organic agriculture. The study was conducted in two simultaneous trials in an experimental field in Ipeúna, SP, Brazil. The test plant was carioca type dry edible bean cv. Pérola. The treatments in trial 1 were: Control 1 = water; FA = JK® amino acid-based foliar fertilizer; and FA+Mi = FA + CuSO4 + ZnSO4 + MnSO4 + H3BO3. In trial 2, the FA treatment was substituted by calda viçosa (CVi. The treatments were through spray application three times. Dry edible bean leaves were sampled for determination of macronutrient and micronutrient concentrations. Platings of the application rates used in the treatments were performed in the laboratory in a mixture with Bacillus thuringiensis and with Beauveria bassiana to compare the degree of compatibility by means of colony forming units (CFU. The FA+Mi and CVi treatments raised the concentrations of Zn, Cu, and Mn in the leaves. The FA+Mi was compatible, the FA was a stimulant, and the CVi was noxious to B. bassiana and to B. thuringiensis when integrated in the spray mixture.

  6. 5-years APAP adherence in OSA patients--do first impressions matter?

    Science.gov (United States)

    van Zeller, Mafalda; Severo, Milton; Santos, Ana Cristina; Drummond, Marta

    2013-12-01

    Although continuous positive airway pressure (CPAP) is effective in treating obstructive sleep apnoea (OSA), inadequate adherence remains a major cause of treatment failure. This study aimed to determine long term adherence to auto adjusting-CPAP (APAP) and its influencing factors including the role of initial compliance. Eighty-eight male patients with newly diagnosed moderate/severe OSA were included. After initiation of APAP treatment, patients had periodic follow-up appointments at 2 weeks, 6 months and then annually for at least 5 years. Patient's compliance to therapy was assessed in each appointment and predictors to treatment abandonment and poor compliance were evaluated. The studied population had a mean age of 53.8 years and mean apnoea-hypopnoea index of 52.71/h. The mean time of follow-up was 5.2 (± 1.6) years, during that time 22 (25%) patients abandoned APAP, those who maintained treatment had good compliance to it since 94% of them used it more than 4 h/day for at least 70% of days. A significant negative association was found between age, % of days and mean time of APAP use on 12th day and 6th month and the risk of abandoning. APAP use lower than 33% and 57% of days at 12th day and 6th month, respectively had high specificity (≈ 100%) to detect treatment abandonment. the majority of patients adheres to long term APAP treatment and has good compliance after 5-years of follow-up. Age and initial compliance (% days of use and mean hour/day) have the ability to predict future adherence, as soon as 12 days and 6 months after initiation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Improving PTSD Symptoms and Preventing Progression of Subclinical PTSD to an Overt Disorder by Treating Comorbid OSA With CPAP.

    Science.gov (United States)

    Ullah, M I; Campbell, Douglas G; Bhagat, Rajesh; Lyons, Judith A; Tamanna, Sadeka

    2017-10-15

    Obstructive sleep apnea (OSA) and posttraumatic stress disorder (PTSD) are common in United States veterans. These conditions often coexist and symptoms overlap. Previous studies reported improvement in PTSD symptoms with continuous positive airway pressure (CPAP) therapy for comorbid OSA but its effect has not been assessed in a non-PTSD cohort. We have prospectively assessed the effect of CPAP therapy on clinical symptom improvement as a function of CPAP compliance levels among PTSD and non-PTSD veterans. Veterans in whom OSA was newly diagnosed were enrolled in our study (n = 192). Assignment to PTSD and non-PTSD cohorts was determined by chart review. Each patient completed the military version of the PTSD Checklist (PCL), Epworth Sleepiness Scale (ESS), and reported nightmare frequency (NMF) at baseline and 6 months after CPAP therapy. CPAP adherence was objectively documented from machine compliance data. We had complete data for 177 veterans (PTSD n = 59, non-PTSD n = 118) for analysis. The mean ages were 51.24 years in the PTSD cohort and 52.36 years in the non-PTSD cohort ( P = .30). In the PTSD cohort, the mean total PCL score (baseline = 66.06, post-CPAP = 61.27, P = .004, d = -0.34) and NMF (baseline = 4.61, post-CPAP = 1.49, P = .0001, d = -0.51) decreased after 6 months of CPAP treatment. Linear regression analysis showed that the CPAP compliance was the only significant predictor for these changes among veterans with PTSD (PCL score: P = .033, R 2 = .65; NMF; P = .03, R 2 = .61). Further analysis by CPAP compliance quartiles in this cohort (Q1 = 0% to 25%, Q2 = 26% to 50%, Q3 = 51% to 75%, Q4 > 75%) revealed that mean total PCL score declined in Q2 (change = -3.91, P = .045, d = 0.43), Q3 (change = -6.6, P = .002, d = 0.59), and Q4 (change = -7.94, P = .037, d = 0.49). In the non-PTSD cohort, the PCL score increased despite CPAP therapy in lower CPAP compliance quartiles Q1 (change = 8.71, P = .0001, d = 0.46) and Q2 (change = 4.51, P = .046, d = 0

  8. 174 | P a g e

    African Journals Online (AJOL)

    Fr. Ikenga

    executive crime but no well-meaning government handles corruption with levity ..... institution by an employee or other person to appropriate authority26. ... families and relatives from actual or potential harassment, retaliation or intimidation.

  9. Specific insomnia symptoms and self-efficacy explain CPAP compliance in a sample of OSAS patients.

    Science.gov (United States)

    Philip, Pierre; Bioulac, Stéphanie; Altena, Elemarije; Morin, Charles M; Ghorayeb, Imad; Coste, Olivier; Monteyrol, Pierre-Jean; Micoulaud-Franchi, Jean-Arthur

    2018-01-01

    This study explores the association between specific insomnia symptoms (sleep onset, sleep maintenance and early morning awakenings symptoms) and self-efficacy (perceived self-confidence in the ability to use CPAP) with CPAP compliance in French patients with obstructive sleep apnea syndrome (OSAS). We performed a retrospective, cross-sectional analysis of CPAP compliance in a cohort of 404 patients diagnosed with OSAS. Patients completed mailed questionnaires on sleepiness (ESS), insomnia (ISI) and self-efficacy in sleep apnea (SEMSA). Linear regression modeling analyses were performed to explore the impact of measured variables on the number of hours of CPAP use. Of the initial pool of 404 patients, 288 returned the questionnaires (71% response rate). Their mean age was 63.16±12.73 yrs, 31% were females, mean BMI was 30.39±6.31 kg/m2, mean daily CPAP use was 6.19±2.03 h, mean number of years of use was 6.58±6.03 yrs, and mean initial AHI before CPAP use was 34.61±20.71 /h. Age (pCPAP use. We found that specific insomnia symptoms and self-efficacy were associated with CPAP compliance. Our findings underline the need to demonstrate that interventions that reduce insomnia symptoms and improve self-efficacy will increase CPAP compliance.

  10. Prevalência do complexo teníase-cisticercose na zona rural do município de Viçosa, Minas Gerais Prevalence of Taeniasis-cysticercosis complex in the rural area of Viçosa-MG, Brazil

    Directory of Open Access Journals (Sweden)

    Adriana Felix Iasbik

    2010-07-01

    Full Text Available A teníase é uma doença que se manifesta no ser humano em decorrência da presença da forma adulta da Taenia sp., enquanto a cisticercose decorre da infecção pelo estágio larvar da Taenia sp. ou Taenia solium, no caso dos suínos e humanos. Foi realizado um estudo transversal visando a determinar a prevalência de cisticercose em suínos e de teníase em 176 propriedades localizadas na zona rural de Viçosa, Minas Gerais (MG. Foram coletadas amostras de sangue de 226 suínos e fezes de 266 humanos, além da realização de um inquérito epidemiológico. Não foi identificada teníase humana, e a prevalência da cisticercose suína foi de 0,4%. As informações obtidas mostraram que a maioria das pessoas possuía o hábito de consumir carne suína não inspecionada; entretanto, todas as pessoas se alimentavam da carne bem aquecida. Em apenas 1,1% das propriedades, o esgoto era depositado diretamente no solo e em 99,4% destas a água era canalizada, enquanto 88,1% dos suínos eram criados presos. Concluiu-se que, na zona rural do município de Viçosa-MG, a prevalência do complexo teníase-cisticercose foi baixa, mostrando ainda um nível de contaminação inferior ao de outros municípios onde o complexo foi estudado.Taeniasis occurs due to the presence of the adult form of Taenia sp. in human beings, and cysticercosis is caused by the presence of the larval stage of T. solium in pigs and humans. A transversal study was conducted aiming to determine the prevalence of porcine cysticercosis and Taeniasis in 176 farms located in rural areas of Viçosa-MG. Blood samples of 226 pigs, and feces samples of 266 humans were collected. An epidemiological survey has also been done. We found a prevalence of 0.4% of porcine cysticercosis and Taeniasis has not been found. The epidemiological data has shown that although most people consumed non-inspected pork, it used to be prepared well-done. Data showed that 88.1% of the pigs are reared in confinement

  11. Sleep fragmentation: comparison of two definitions of short arousals during sleep in OSAS patients.

    Science.gov (United States)

    Smurra, M V; Dury, M; Aubert, G; Rodenstein, D O; Liistro, G

    2001-04-01

    The measurement of arousals during sleep is useful to quantify sleep fragmentation. The criteria for electroencephalography (EEG) arousals defined by the American Sleep Disorders Association (ASDA) have recently been criticized because of lack of interobserver agreement. The authors have adopted a scoring method that associates the increase in chin electromyography (EMG) with the occurrence of an alpha-rhythm in all sleep stages (Université Catholique de Louvain (UCL) definition of arousals). The aim of the present study was to compare the two scoring definitions in terms of agreement and repeatability and the time taken for scoring in patients with obstructive sleep apnoea syndrome (OSAS) of varying severity. Two readers using both ASDA and UCL definitions scored twenty polysomnographies (PSGs) each on two occasions. The PSGs were chosen retrospectively to represent a wide range of arousal index (from 6-82) in OSAS patients. There was no difference in the arousal indices between readers and between scoring methods. The mean+/-SD difference between the two definitions (the bias) was 1.1+/-3.76 (95% confidence interval: -0.66-2.86). There was a strong linear relationship between the arousal index scored with the two definitions (r=0.981, pASDA definitions (18.5+/-5.4 versus 25.3+/-6.6 min, p<0.001). In conclusion, it has been found that in obstructive sleep apnoea syndrome patients, the American Sleep Disorders Association and Université Catholique de Louvain definitions were comparable in terms of agreement and repeatability.

  12. Perfil cualitativo de metabolitos secundarios en la fracción comestible de especies leñosas seleccionadas por vacunos en un bosque semicaducifolio

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    Á Ojeda

    Full Text Available Con el fin de caracterizar cualitativamente el perfil de metabolitos secundarios de la fracción comestible de plantas leñosas seleccionadas por vacunos en silvopastoreo, las cuales se encuentran en un bosque tropófilo semicaducifolio de Venezuela, se utilizaron 14 vacunos machos Brahman x Holstein de 390,4 ± 18,0 kg de PV. Estos fueron manejados en pastoreo continuo en una superficie de 81 ha, de las cuales 50 ha correspondían a un bosque semicaducifolio y el resto, a vegetación herbácea natural (Cynodon nlemfuensis, Sporobolus indicus, Axonopus sp., Mimosa pudica e Hyptis suaveolens. La composición de la biomasa leñosa seleccionada por los animales se estudió mediante la evaluación de los fragmentos epidérmicos presentes en las heces colectadas por vía transrectal, cada 15 días. A partir de estos resultados, se tomaron muestras de cinco plantas por especie leñosa, en los periodos seco y lluvioso. Se determinaron 15 grupos de metabolitos: alcaloides, á-aminos, carbohidratos solubles, cardenólidos, cianógenos, esteroles, fenoles totales, flavonoides, lectinas, mucílagos, quinonas, saponinas, taninos extractables (totales y condensados y terpenoides. La mayoría de la biomasa correspondió a especies de la familia Fabaceae, las cuales presentaron todos los metabolitos evaluados. En ambos periodos se detectaron niveles de esteroles, terpenoides, fenoles totales y taninos extractables que variaron desde leves hasta cuantiosos. Con independencia del periodo, el 66,7 % de las especies presentó entre 10-11 metabolitos secundarios en su biomasa comestible. Se recomienda realizar estudios para la cuantificación de los metabolitos secundarios presentes en plantas leñosas de valor forrajero, para este sistema silvopastoril

  13. [Treatment compliance with continuous positive airway pressure device among adults with obstructive sleep apnea (OSA): how many adhere to treatment?].

    Science.gov (United States)

    Sarrell, E Michael; Chomsky, Ofer; Shechter, Dalia

    2013-03-01

    Obstructive sleep apnea syndrome (OSA) afflicts approximately 5% of the adult population and increases with age. The gold standard treatment is with the Continuous Positive Airways Pressure (CPAP) machine. Well-designed prospective trials to elucidate long term compliance with CPAP machine are rare. Assessing compliance and long-term use of CPAP machines among patients with OSA who were referred for treatment with this machine. A 4 years prospective cohort observational study was conducted using telephone interviews of 371 newly diagnosed patients with moderate to severe OSA, who received a specialist recommendation to use the CPAP machine which was bought and adjusted to their use. At the end of the first year, 126 (34%) of the OSA patients used the CPAP machine on a nightly basis (regular users), 120 (32.3%) had not used it at all, and 125 (33.7%) had used it only intermittently. The number of regular users increased between the 1st and 2nd year from 126 (34%), to 163 (44%) (p < 0.07) due to additions from the intermittent users group. The non-users group grew from 120 (32.3%) in the first year, and every year afterwards, up to 221 (59.6%) in the fourth year (p < 0.02). In contrast, there was a significant decrease in the intermittent users group, which declined from 125 (33.7%) in the first year to only 18 (4.8%) in the 4th year (p < 0.005). Most of the patients (92.9%) were males. The average age of the regular users was 59.6 years (+/- 11), which was higher in comparison to 55.9 years (+/- 10.3) for the non-users or 58.9 years (+/- 12.6) among the intermittent users (p = 0.064). There were no statistical differences in co-morbidities or demographics between the three groups. However, the regular users were found to have a higher score in the Epworth Sleepiness Scale (ESS) and a minimal arterial oxygen saturation (SaO2) level lower than the patients in the non-users and intermittent users groups (p = 0.019 and p = 0.03 respectively). Four years follow

  14. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

    Science.gov (United States)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Hügli, Gordana; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  15. Functional MRI of the pharynx in obstructive sleep apnea (OSA) with rapid 2-D flash sequences

    International Nuclear Information System (INIS)

    Jaeger, L.; Guenther, E.; Gauger, J.; Nitz, W.; Kastenbauer, E.; Reiser, M.

    1996-01-01

    Functional imaging of the pharynx used to be the domain of cineradiography, CT and ultrafast CT. The development of modern MRI techniques led to new access to functional disorders of the pharynx. The aim of this study was to implement a new MRI technique to examine oropharyngeal obstructive mechanisms in patients with obstructive sleep apnea (OSA). Sixteen patients suffering from OSA and 6 healthy volunteers were examined on a 1.5 T whole-body imager ('Vision', Siemens, Erlangen Medical Engineering, Germany) using a circular polarized head coil. Imaging was performed with 2D flash sequences in midsagittal and axial planes. Patients and volunteers were asked to breathe normally through the nose and to simulate snoring and the Mueller maneuver during magnetic resonance imaging (MRI). Prior to MRI, all patients underwent an ear, nose and throat (ENT) examination, functional fiberoptic nasopharyngoscopy and polysomnography. A temporal resolution of 6 images/s and an in-plane resolution of 2.67x1.8 mm were achieved. The mobility of the tongue, soft palate and pharyngeal surface could be clearly delineated. The MRI findings correlated well with the clinical examinations. We propose ultrafast MRI as a reliable and non-invasive method of evaluating pharyngeal obstruction and their levels. (orig.) [de

  16. CPAP Adherence is Associated With Attentional Improvements in a Group of Primarily Male Patients With Moderate to Severe OSA.

    Science.gov (United States)

    Deering, Sean; Liu, Lin; Zamora, Tania; Hamilton, Joanne; Stepnowsky, Carl

    2017-12-15

    Obstructive sleep apnea (OSA) is a widespread condition that adversely affects physical health and cognitive functioning. The prevailing treatment for OSA is continuous positive airway pressure (CPAP), but therapeutic benefits are dependent on consistent use. Our goal was to investigate the relationship between CPAP adherence and measures of sustained attention in patients with OSA. Our hypothesis was that the Psychomotor Vigilance Task (PVT) would be sensitive to attention-related improvements resulting from CPAP use. This study was a secondary analysis of a larger clinical trial. Treatment adherence was determined from CPAP use data. Validated sleep-related questionnaires and a sustained-attention and alertness test (PVT) were administered to participants at baseline and at the 6-month time point. Over a 6-month time period, the average CPAP adherence was 3.32 h/night (standard deviation [SD] = 2.53), average improvement in PVT minor lapses was -4.77 (SD = 13.2), and average improvement in PVT reaction time was -73.1 milliseconds (standard deviation = 211). Multiple linear regression analysis showed that higher CPAP adherence was significantly associated with a greater reduction in minor lapses in attention after 6 months of continuous treatment with CPAP therapy (β = -0.72, standard error = 0.34, P = .037). The results of this study showed that higher levels of CPAP adherence were associated with significant improvements in vigilance. Because the PVT is a performance-based measure that is not influenced by prior learning and is not subjective, it may be an important supplement to patient self-reported assessments. Name: Effect of Self-Management on Improving Sleep Apnea Outcomes, URL: https://clinicaltrials.gov/ct2/show/NCT00310310, Identifier: NCT00310310. © 2017 American Academy of Sleep Medicine

  17. Determinação de resíduos de organoclorados em águas fluviais do município de Viçosa - MG Determination of organochlorinated present in river from the region of Viçosa, MG

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    Cíntia Maria Chagas

    1999-07-01

    Full Text Available In this work the contamination, by organochlorinated, of a drinking water source located in the region of Viçosa, MG, was evaluated. The identification and quantification of the analytes was carried out using a gas-chromatograph equipped with an electron capture detector after liquid-liquid extraction and concentration. Four insecticides, Aldrin, Epoxy heptachloride, Endrin and op'- DDT were detected in concentrations that are higher than the safety limits established in the Brazilian legislation.

  18. The importance of neck circumference to thyromental distance ratio (NC/TM as a predictor of difficult intubation in obstructive sleep apnea (OSA patients

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    Hala Ezzat Abdel Naim

    2014-07-01

    Conclusion: Difficult intubation in OSA obese patients was independently associated with a Mallampati score of III or IV, and NC/TM ⩾5.15. Moreover, NC/TM yielded a high sensitivity, specificity and a negative predictive value.

  19. Sismos y lluvias, factores detonantes de deslizamientos de laderas en las regiones montañosas de Puebla, México

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    Oscar A. Cuanalo C.

    2006-01-01

    Full Text Available El estado de Puebla ubicado en el centro de la República Mexicana, se ve afectado por sismos producto de la actividad a lo largo del Cinturón Volcánico Mexicano que tienen impacto en el centro y sur del estado, además de lluvias intensas en las regiones montañosas ubicadas al Norte y Nororiente del mismo, originadas por los huracanes y tormentas tropicales procedentes del Golfo de México. El escenario anterior ofrece peculiaridades de tipo geomorfológico y meteorológico que han desencadenado deslizamientos de laderas, los cuales han causado considerables daños económicos y lamentables pérdidas humanas. En este artículo se describe brevemente las características geomorfológicas del estado de Puebla, considerando su clima, el cual tiene impacto en la meteorización de las rocas que conforman la región montañosa; además se incluye su historia sismológica en los últimos 100 años, para eventos mayores de 6° Richter, y las lluvias torrenciales de 1999 y 2005 que han desencadenado deslizamientos de laderas

  20. Sistemas de classificações geotécnicas de solos: estudo de caso aplicado à rodovia não pavimentada vcs 346, Viçosa, MG Geotechnical soil classification systems: case study applied to the vcs 346 unpaved road, Viçosa, MG

    Directory of Open Access Journals (Sweden)

    Taciano Oliveira da Silva

    2010-04-01

    Full Text Available Este artigo aborda uma contribuição às classificações geotécnicas tradicionais de solos Unified Soil Classification System (USC, Transportation Research Board System (TRB e a Metodologia Miniatura, Compactado, Tropical (MCT para um caso aplicado à rodovia municipal não pavimentada VCS 346, no Município de Viçosa, MG, considerando-se várias amostras deformadas de solos coletadas no subleito da referida via. Os principais objetivos deste estudo residem na contribuição de um banco de dados geotécnicos sobre classificações de solos tropicais, bem como na verificação de possíveis agrupamentos entre os sistemas geotécnicos tradicionais de classificação e a metodologia MCT. O programa de laboratório envolveu a realização dos seguintes ensaios: (i granulometria conjunta; (ii limites de Atterberg (LL e LP; (iii massa específica dos grãos do solo; (iv compactação Mini-MCV; e (v perda de massa do corpo-de-prova por imersão em água. Os resultados possibilitaram verificar que, após a classificação das amostras, vários agrupamentos entre os sistemas de classificações geotécnicas tradicionais coincidiram com aqueles já apresentados na metodologia MCT e, considerando a pedogênese da região de Viçosa, MG, para o grupo NG', houve a contribuição dos grupos SC, SM e CL do Sistema USC e do grupo A-4 do Sistema TRB.This paper addresses a contribution to the traditional geotechnical soil classifications systems USC (Unified Soil Classification and TRB (Transportation Research Board, and the MCT methodology (Miniature, Compacted, Tropical applied to a case study involving the laboratory geotechnical characterization of disturbed samples from the subgrade of the VCS 346 municipal unpaved road, located in Viçosa - MG. The main goals of this study are to contribute to the formation of a database directed to the geotechnical classification of tropical soils as well as to verify possible groupings among the traditional

  1. Indicadores de campo para solos hidromórficos na região de Viçosa (MG Field indicators for the identification of hydromorphic soils in the region of Viçosa, Minas Gerais - Brazil

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    C. E. B. Campos

    2003-12-01

    Full Text Available Indicadores locais são úteis para a identificação de ambientes. Na região de Viçosa, embora os solos encharcados ocorram sob vegetação de taboa (Thypha dominguensis, Gleissolos, de coloração típica acinzentada, são incomuns. A maioria dos solos com lençol freático alto é coberta pela taboa e as características gleizadas do solo são pouco pronunciadas, especialmente nos solos com mais altos teores de ferro. Não há clara conexão entre altura do lençol freático e deficiência de oxigênio. Como as relações entre altura do lençol freático, deficiência de oxigênio e cor do solo não são claras o bastante, hipotetizou-se que outros indicadores para as condições de redução poderiam ser encontrados nesses ambientes. Neste propósito, caracterizou-se o solo e trabalhou-se na sua relação com a vegetação. Estudaram-se os solos com várias intensidades de condições de drenagem em três áreas: Cajuri (Área 1, Viçosa (Área 2 e Coimbra (Área 3, todas pertencentes ao Planalto de Viçosa. Na avaliação das condições de redox dos solos (pH e pE a campo, utilizou-se um medidor digital adaptado a uma sonda de aço. Conquanto importante na identificação de indicadores de ambientes, a caracterização morfológica não se mostrou precisa o bastante para evidenciar o que os solos encharcados têm mais em comum: a deficiência de oxigênio por longos períodos. A cor, embora seja um bom e útil indicador para muitas das condições de drenagem do solo, não se mostrou também eficiente nessas áreas. De modo geral, os Gleissolos estudados apresentaram cromas maiores do que dois, o que supera o limite do critério para identificar horizonte glei no Sistema Brasileiro de Classificação de Solos, embora o teste indicador da presença de Fe2+ com alfa,alfa'-dipiridil tenha sido positivo. Por outro lado, a presença da taboa foi um bom indicador das condições de má drenagem. Nos locais dos povoamentos puros de taboa, os

  2. Effect of CPAP on Cardiac Function in Minimally Symptomatic Patients with OSA: Results from a Subset of the MOSAIC Randomized Trial.

    Science.gov (United States)

    Craig, Sonya; Kylintireas, Ilias; Kohler, Malcolm; Nicoll, Debby; Bratton, Daniel J; Nunn, Andrew J; Leeson, Paul; Neubauer, Stefan; Stradling, John R

    2015-09-15

    Minimally symptomatic obstructive sleep apnea (OSA) is highly prevalent, and the effects of continuous positive airway pressure (CPAP) on myocardial function in these patients are unknown. The MOSAIC randomized, controlled trial of CPAP for minimally symptomatic OSA assessed the effect of CPAP on myocardial function in a subset of patients. Two centers taking part in the MOSAIC trial randomized 238 patients in parallel to 6 months of CPAP (120) or standard care (118). Of these, 168 patients had echocardiograms, and 68 patients had a cardiac magnetic resonance scan (CMR). A larger group (314) from 4 centers had brain natriuretic peptide (BNP) measured. Mean (SD) baseline oxygen desaturation index (ODI) and Epworth sleepiness score (ESS) were 13.5 (13.2), and 8.4 (4.0), respectively. CPAP significantly reduced ESS and ODI. Baseline LV ejection fraction (LVEF) was well preserved (60.4%). CPAP had no significant effect on echo-derived left atrial (LA) area (-1.0 cm2, 95% CI -2.6 to +0.6, p = 0.23) or early to late left ventricular filling velocity (E/A) ratio (-0.01, 95% CI -0.07 to +0.05, p = 0.79). There was a small change in echo-derived LV end diastolic volume (EDV) with CPAP (-5.9 mL, 95% CI -10.6 to -1.2, p = 0.015). No significant changes were detected by CMR on LV mass index (+1.1 g/m(2), 95% CI -5.9 to +8.0, p = 0.76) or LVEF (+0.8%, 95% CI -1.2 to +2.8, p = 0.41). CPAP did not affect BNP levels (p = 0.16). Six months of CPAP therapy does not change cardiac functional or structural parameters measured by echocardiogram or CMR in patients with minimally symptomatic mild-to-moderate OSA. ISRCTN 34164388 (http://isrctn.org). © 2015 American Academy of Sleep Medicine.

  3. In patients with minimally symptomatic OSA can baseline characteristics and early patterns of CPAP usage predict those who are likely to be longer-term users of CPAP.

    Science.gov (United States)

    Turnbull, Christopher D; Bratton, Daniel J; Craig, Sonya E; Kohler, Malcolm; Stradling, John R

    2016-02-01

    Long-term continuous positive airway pressure (CPAP) usage varies between individuals. It would be of value to be able to identify those who are likely to benefit from CPAP (and use it long term), versus those who would not, and might therefore benefit from additional help early on. First, we explored whether baseline characteristics predicted CPAP usage in minimally symptomatic obstructive sleep apnoea (OSA) patients, a group who would be expected to have low usage. Second, we explored if early CPAP usage was predictive of longer-term usage, as has been shown in more symptomatic OSA patients. The MOSAIC trial was a multi-centre randomised controlled trial where minimally symptomatic OSA patients were randomised to CPAP, or standard care, for 6 months. Here we have studied only those patients randomised to CPAP treatment. Baseline characteristics including symptoms, questionnaires [including the Epworth sleepiness score (ESS)] and sleep study parameters were recorded. CPAP usage was recorded at 2-4 weeks after initiation and after 6 months. The correlation and association between baseline characteristics and 6 months CPAP usage was assessed, as was the correlation between 2 and 4 weeks CPAP usage and 6 months CPAP usage. One hundred and ninety-five patients randomised to CPAP therapy had median [interquartile range (IQR)] CPAP usage of 2:49 (0:44, 5:13) h:min/night (h/n) at the 2-4 weeks visit, and 2:17 (0:08, 4:54) h/n at the 6 months follow-up visit. Only male gender was associated with increased long-term CPAP use (male usage 2:56 h/n, female 1:57 h/n; P=0.02). There was a moderate correlation between the usage of CPAP at 2-4 weeks and 6 months, with about 50% of the variability in long-term use being predicted by the short-term use. In patients with minimally symptomatic OSA, our study has shown that male gender (and not OSA severity or symptom burden) is associated with increased long-term use of CPAP at 6 months. Although, in general, early patterns of CPAP

  4. Impact of CPAP on activity patterns and diet in patients with obstructive sleep apnea (OSA).

    Science.gov (United States)

    Batool-Anwar, Salma; Goodwin, James L; Drescher, Amy A; Baldwin, Carol M; Simon, Richard D; Smith, Terry W; Quan, Stuart F

    2014-05-15

    Patients with severe OSA consume greater amounts of cholesterol, protein, and fat as well as have greater caloric expenditure. However, it is not known whether their activity levels or diet change after treatment with CPAP. To investigate this issue, serial assessments of activity and dietary intake were performed in the Apnea Positive Pressure Long-term Efficacy Study (APPLES); a 6-month randomized controlled study of CPAP vs. sham CPAP on neurocognitive outcomes. Subjects were recruited into APPLES at 5 sites through clinic encounters or public advertisement. After undergoing a diagnostic polysomnogram, subjects were randomized to CPAP or sham if their AHI was ≥ 10. Adherence was assessed using data cards from the devices. At the Tucson and Walla Walla sites, subjects were asked to complete validated activity and food frequency questionnaires at baseline and their 4-month visit. Activity and diet data were available at baseline and after 4 months treatment with CPAP or sham in up to 231 subjects (117 CPAP, 114 Sham). Mean age, AHI, BMI, and Epworth Sleepiness Score (ESS) for this cohort were 55 ± 13 [SD] years, 44 ± 27 /h, 33 ± 7.8 kg/m(2), and 10 ± 4, respectively. The participants lacking activity and diet data were younger, had lower AHI and arousal index, and had better sleep efficiency (p Level of adherence defined as hours of device usage per night at 4 months was significantly higher among men in CPAP group (4.0 ± 2.9 vs. 2.6 ± 2.6). No changes in consumption of total calories, protein, carbohydrate or fat were noted after 4 months. Except for a modest increase in recreational activity in women (268 ± 85 vs. 170 ± 47 calories, p increase in recreational activity in women, OSA patients treated with CPAP do not substantially change their diet or physical activity habits after treatment. .

  5. Composición de especies leñosas en comunidades invadidas en montañas del centro de Argentina: su relación con factores ambientales locales

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    Sebastián R. Zeballos

    2014-12-01

    Full Text Available En todo el mundo, las invasiones de especies leñosas exóticas están amenazando las funciones ecosistémicas. La dispersión y el subsecuente reemplazo de bosques de especies nativas por comunidades dominadas por exóticas es evidente, particularmente, en proximidad a centros urbanos donde la presión de propágulos de especies exóticas es alta. Sin embargo, existe una falta de información sobre los factores ambientales que subyacen este reemplazo. En este estudio nos propusimos responder las siguientes preguntas: (1 ¿se observa una segregación espacial a escala local entre especies leñosas exóticas y/o nativas dominantes?, y (2 si existe esa segregación, ¿está asociada a variables ambientales? En el 2010 se establecieron 31 parcelas distribuidas en 16 laderas en los bosques Chaqueños de las Sierras de Córdoba, en Argentina central. En cada uno de los sitios de muestreo se relevó la composición y abundancia de todas las especies leñosas con un diámetro a la altura de la base superior a 5cm. Para caracterizar el ambiente en cada una de las parcelas medimos la posición topográfica (pendiente y orientación y algunas propiedades asociadas con la física (densidad aparente y compactación, estructura (profundidad y textura y con la química (pH y el contenido de nutrientes y agua del suelo. A través, de un análisis jerárquico de agrupamiento, se identificaron cinco comunidades de leñosas coexistiendo: (1 Bosques dominados por Ligustrum lucidum, (2 Bosques mixtos dominados por Lithraea molleoides y Celtis australis, (3 Matorrales de Condalia buxifolia, (4 Matorrales de Cotoneaster glaucophyllus, y (5 Pajonales con emergentes de Pyracantha angustifolia. Estas comunidades se asociaron diferencialmente a las variables topográficas y edáficas locales. La segregación ambiental observada sugiere que las especies invasoras tienen una capacidad potencial para colonizar casi todos los ambientes en el área de estudio (variando la

  6. Análise da atividade florestal no município de Viçosa-MG Analysis of forest activity in Viçosa-MG

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    Alessandro Albino Fontes

    2003-08-01

    Full Text Available Estudou-se a atividade florestal no município de Viçosa-MG, a partir de questionário aplicado aos agricultores cujas propriedades rurais possuíam florestas plantadas. Foi amostrado um total de 63 propriedades rurais, abrangendo uma área de 2.096,95 ha. As áreas de floresta nativa e plantada, na amostra, foram de 372,00 e 260,17 ha, o que corresponde, respectivamente, a 17,74 e 12,41% da área amostrada. O tipo de floresta nativa predominante foi a capoeira (67,55%, e a espécie preferida para o reflorestamento foi o eucalipto (92,68%. O uso médio da mão-de-obra nas fases de implantação, manutenção e colheita dos plantios florestais foi estimado em 30,21, 13,64 e 61,25 dias-homem/ha, respectivamente, totalizando 105,10 dias-homem/ha, sendo a participação da mão-de-obra familiar de 25,24%. Os custos inerentes à atividade florestal foram estimados em R$419,30/ha para implantação; R$146,49/ha e R$80,34/ha para manutenção no primeiro e segundo ano, respectivamente; e R$2,11/m³ para colheita da madeira. Os plantios florestais concentram-se nas áreas de encostas, e o número médio de empregos gerados pelo reflorestamento (eucalipto foi 0,042 emprego/ha. Concluiu-se, de modo geral, que o reflorestamento é considerado atividade pouco atrativa, não identificando propriedades tipicamente florestais, sendo recomendada a elaboração de políticas públicas de incentivo ao reflorestamento.Forest activity was studied in Viçosa-MG, through a questionnaire applied to farmers who planted forests. A total of 63 farms were sampled, comprising an area of 2,096.95 ha. The natural and planted forest areas sampled were of 372.00 ha and 260.17 ha, corresponding to 17.74% and 12.41%, respectively. The predominant natural forest was the secondary forest (capoeira (67.55%, and the species chosen for reforestation was eucalypt (92.68%. Average labor use in the phases of implementation, maintenance and harvest of the forest plantations was

  7. Adaptation and Validation of the Spanish Version of OSA-18, a Quality of Life Questionnaire for Evaluation of Children with Sleep Apnea-Hypopnea Syndrome.

    Science.gov (United States)

    Chiner, Eusebi; Landete, Pedro; Sancho-Chust, José Norberto; Martínez-García, Miguel Ángel; Pérez-Ferrer, Patricia; Pastor, Esther; Senent, Cristina; Arlandis, Mar; Navarro, Cristina; Selma, María José

    2016-11-01

    To analyze the reliability and validity of the Spanish version of the OSA-18 quality of life questionnaire in children with apnea-hypopnea syndrome (SAHS). Children with suspected SAHS were studied with polysomnography (PSG) before and after adenotonsillectomy (AA). Age, gender, clinical data, PSG, anthropometric data, and Mallampati and Brodsky scales were analyzed. OSA-18 was administered at baseline and 3-6months post AA. After translation and backtranslation by bilingual professionals, the internal consistency, reliability, construct validity, concurrent validity, predictive validity and sensitivity to change of the questionnaire was assessed. In total, 45 boys and 15 girls were evaluated, showing BMI 18±4, neck 28±5, Brodsky (0: 7%; 50 to 75%: 6%), AHI 12±7 pre AA. Global Cronbach alpha was 0.91. Correlations between domains were significant except for emotional aspects, although the total scores correlated with all domains (0.50 to 0.90). The factorial analysis was virtually identical to the original structure. The total scores showed good correlation for concurrent validity (0.2-0.45). With regard to predictive validity, the questionnaire adequately differentiated levels of severity according to Mallampati (ANOVA P=.002) and apnea-hypopnea index (ANOVA P=.006). Test-retest reliability was excellent, as was sensitivity to change, both in the total scores (P<.001) and in each domain (P<.001). The Spanish adaptation of the OSA-18 and its psychometric characteristics suggest that the Spanish version is equivalent to the original and can be used in Spanish-speaking countries. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Translation of Berlin Questionnaire to Portuguese language and its application in OSA identification in a sleep disordered breathing clinic

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    A.P. Vaz

    2011-03-01

    Full Text Available Background: Berlin Questionnaire (BQ, an English language screening tool for obstructive sleep apnea (OSA in primary care, has been applied in tertiary settings, with variable results. Aims: Development of BQ Portuguese version and evaluation of its utility in a sleep disordered breathing clinic (SDBC. Material and methods: BQ was translated using back translation methodology and prospectively applied, previously to cardiorespiratory sleep study, to 95 consecutive subjects, referred to a SDBC, with OSA suspicion. OSA risk assessment was based on responses in 10 items, organized in 3 categories: snoring and witnessed apneas (category 1, daytime sleepiness (category 2, high blood pressure (HBP/obesity (category 3. Results: In the studied sample, 67.4% were males, with a mean age of 51 ± 13 years. Categories 1, 2 and 3 were positive in 91.6, 24.2 and 66.3%, respectively. BQ identified 68.4% of the patients as being in the high risk group for OSA and the remaining 31.6% in the low risk. BQ sensitivity and specificity were 72.1 and 50%, respectively, for an apnea-hipopnea index (AHI > 5, 82.6 and 44.8% for AHI > 15, 88.4 and 39.1% for AHI > 30. Being in the high risk group for OSA did not infl uence significantly the probability of having the disease (positive likelihood ratio [LR] between 1.44-1.49. Only the items related to snoring loudness, witnessed apneas and HBP/obesity presented a statistically positive association with AHI, with the model constituted by their association presenting a greater discrimination capability, especially for an AHI > 5 (sensitivity 65.2%, specificity 80%, positive LR 3.26. Conclusions: The BQ is not an appropriate screening tool for OSA in a SDBC, although snoring loudness, witnessed apneas, HBP/obesity have demonstrated being significant questionnaire elements in this population. Resumo: Introdução: O Questionário de Berlim (QB, originalmente desenvolvido em língua inglesa como um instrumento de

  9. A mast fruiting episode of the tropical tree Peltogyne purpurea(Caesalpinaceaein the Osa Peninsula, Costa Rica

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    Oscar J Rocha

    2006-12-01

    Full Text Available Se describe un episodio de fructificación en masa en una población de Peltogyne purpurea de la Península de Osa, Costa Rica. En febrero y marzo de 2000, la mayor parte de los árboles de esta especie tuvo una gran cosecha de frutos. En los años anteriores, desde 1995, ninguno o muy pocos árboles produjeron frutos y la producción por árbol fue escasa. La cosecha del año 2000 fue masiva y todos los árboles examinados produjeron frutos abundantes. Este patrón reproductivo podría producir extinciones locales si la extracción maderera no lo toma en cuentaThe existence of mast fruiting has not been well documented in the Neotropics. The occurrence of a mast fruiting episode in the population of the tree Peltogyne purpurea in the Osa Peninsula of Costa Rica is described. In February and March of 2000 most of the trees of this species produced a large fruit crop, compared with 1995-1999, when the number of fruit producing trees was very low or zero and those that did bear fruit, did so at a low intensity. In contrast, the fruit crop of 2000 was massive, all trees examined produced fruits and the intensity of fruiting was maximal. There is not enough information on the event for a hypothesis to be formed because the climatic or biological cues that triggered this sporadic flowering are unknown and there is no meteorological data available for this area. Populations with this mode of reproduction may experience local extinction bacause of logging operations. Rev. Biol. Trop. 54 (4: 1151-1155. Epub 2006 Dec. 15

  10. A mast fruiting episode of the tropical tree Peltogyne purpurea(Caesalpinaceaein the Osa Peninsula, Costa Rica

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    Oscar J Rocha

    2006-12-01

    Full Text Available Se describe un episodio de fructificación en masa en una población de Peltogyne purpurea de la Península de Osa, Costa Rica. En febrero y marzo de 2000, la mayor parte de los árboles de esta especie tuvo una gran cosecha de frutos. En los años anteriores, desde 1995, ninguno o muy pocos árboles produjeron frutos y la producción por árbol fue escasa. La cosecha del año 2000 fue masiva y todos los árboles examinados produjeron frutos abundantes. Este patrón reproductivo podría producir extinciones locales si la extracción maderera no lo toma en cuenta

  11. 2005 CERN Relay Race

    CERN Multimedia

    Patrice Loiez

    2005-01-01

    The CERN Relay Race takes place each year in May and sees participants from all areas of the CERN staff. The winners in 2005 were The Shabbys with Los Latinos Volantes in second and Charmilles Technologies a close third. To add a touch of colour and levity, the CERN Jazz Club provided music at the finishing line.

  12. Inclusão digital de jovens na microrregião de Viçosa/Minas Gerais: dimensões políticas e subjetivas | Digital inclusion of youngsters in the Viçosa/Minas Gerais micro region: political and subjective dimensions

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    Daniela Alves de Alves

    2012-04-01

    Full Text Available Resumo O presente artigo apresenta resultados de um diagnóstico das implicações das políticas públicas de inclusão digital nas escolas de ensino médio da microrregião de Viçosa. Analisamos a amplitude e os efeitos destas políticas para os jovens da referida região, explorando qualitativamente a dimensão da inclusão, especialmente através da análise dos usos da tecnologia por parte dos jovens considerados incluídos. Constatamos que a inserção dos jovens em políticas de inclusão digital através da escola é limitada e a internet tem sido usada pelos jovens entrevistados predominantemente como espaço de sociabilidade e de pesquisas escolares. O acesso à internet apresenta inúmeras desigualdades. Palavras-chave inclusão digital, internet, rede sociotécnica, jovens, políticas públicas Abstract This article presents results from the diagnosis of the implications of public policies for digital inclusion in secondary schools of the micro-region of Viçosa, Minas Gerais, Brazil. The amplitude and effect of these policies for the youngsters of this region were analyzed, exploring qualitatively the dimensions of the inclusion, especially through the analysis of the uses of technology by the teenagers considered. It could be verified that the insertion of these youngsters in digital inclusion policies at school is limited, and that the Internet has been used by the juveniles interviewed predominantly as a space for sociability and school research. Access to the Internet represents innumerable inequalities. Keywords digital inclusion, internet, socio-technical web, youngsters, public policies

  13. Flora de importância polinífera para Apis mellifera (L. na região de Viçosa, MG

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    Anna Frida Hatsue Modro

    2011-10-01

    Full Text Available Procurou-se conhecer a flora de importância polinífera para Apis mellifera (L. na região de Viçosa, MG, em período de entressafra de mel, entre agosto e dezembro de 2005. O experimento foi realizado em dois apiários distintos, cada um com cinco colmeias. As cargas retidas nos coletores de pólen instalados nas colmeias foram analisadas quanto à origem botânica. As plantas em floração no entorno dos apiários foram coletadas e identificadas. A maioria das plantas de importância polinífera para abelhas na região de Viçosa era nativa, localizada em jardins e com hábito arbóreo. Pela análise palinológica, verificou-se que espécies como Anadenanthera colubrina, Arecaceae sp., Baccharis dracunculifolia, B. melastomaefolia, Coffea spp., Emilia sagittata, Eugenia uniflora, Mikania cordifolia, M. hirsutissima, Myrcia fallax, Psidium guajava, Vernonia condensata, V. diffusa, V. lanuginosa e V. mariana são potenciais recursos poliníferos a serem utilizados no período de entressafra do mel. Os resultados indicaram a importância de plantas localizadas em áreas abertas para o forrageamento de pólen por A. mellifera e confirmaram o potencial polinífero da região estudada, durante o período de entressafra do mel.

  14. Initiation of CPAP therapy for OSA: does prophylactic humidification during CPAP pressure titration improve initial patient acceptance and comfort?

    Science.gov (United States)

    Wiest, G H; Harsch, I A; Fuchs, F S; Kitzbichler, S; Bogner, K; Brueckl, W M; Hahn, E G; Ficker, J H

    2002-01-01

    Heated humidifiers (HH) enable effective treatment of upper airway dryness during nasal continuous positive airway pressure (nCPAP) therapy for obstructive sleep apnoea (OSA), but the role of prophylactic use of HH during the initiation of nCPAP treatment has not been studied so far. The aim of the present study was to investigate whether prophylactic HH during the initiation of CPAP would result in improved initial patient comfort and acceptance. In 44 consecutive, previously untreated OSA patients with no history of upper airway dryness, CPAP titration with and without HH was performed on two consecutive nights in a randomised order. The patients were interviewed after each treatment night in order to establish the comfort of the treatment, and, after the second treatment, they were asked which of the two nights they considered more pleasant, and which treatment they would prefer for long-term use. Following CPAP titration with HH, 32 patients (73%) claimed to have had a better night's sleep than usual (i.e. without CPAP treatment) compared with 33 patients (75%) saying the same following CPAP treatment without HH. For 21 patients (47.7%) treatment with HH was more pleasant, 23 (52.3%) saw no difference or said that treatment without HH was more pleasant. Nineteen patients (43.2%) gave preference to treatment with HH for long-term use, while 25 patients (56.8%) had no preference or said they would prefer treatment without HH. The use of HH during the initiation phase of CPAP treatment was associated neither with an initial improvement in comfort nor with greater initial treatment acceptance. Copyright 2002 S. Karger AG, Basel

  15. Adoção sequencial de tecnologia pós-colheita aplicada à cafeicultura em Viçosa (MG

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    Matheus Wemerson Gomes Pereira

    2010-06-01

    Full Text Available O processo de adoção tecnológica na agricultura é de fundamental importância para o aumento da produtividade e a melhoria da qualidade dos produtos agrícolas. O objetivo deste artigo é avaliar os determinantes da adoção da tecnologia pós-colheita na cafeicultura em Viçosa (MG, no ano de 2007. Os resultados sugerem que o modelo sequencial é o mais apropriado à análise e que as variáveis associativismo, rentabilidade, treinamento, crédito, capital próprio e escolaridade são os principais determinantes na adoção de estágios mais elevados de tecnologia pós-colheita aplicada à cafeicultura. Os efeitos marginais mais importantes para adoção de maiores níveis tecnológicos são associativismo, treinamento, crédito e rentabilidade.The process of tecnology adoption in agriculture is fundamentally important for increasing productivity and improving the quality of agricultural products. The objective of this study is to evaluate the factors that determine the technological adoption of post-harvest coffee employed in Viçosa (MG in the year of 2007. The results indicate that the sequential model is more appropriate for the analysis and the most important determinants for the adoption of higher levels of post-harvest technology are association, profitability, training, education, credit, stock of capital, and years at school. The most important marginal effects for the adoption of higher levels of post-harvest technology are association, training, credit and profitability.

  16. Determinants of Unintentional Leaks During CPAP Treatment in OSA.

    Science.gov (United States)

    Lebret, Marius; Arnol, Nathalie; Martinot, Jean-Benoît; Lambert, Loïc; Tamisier, Renaud; Pepin, Jean-Louis; Borel, Jean-Christian

    2018-04-01

    Unintentional leakage from the mouth or around the mask may lead to cessation of CPAP treatment; however, the causes of unintentional leaks are poorly understood. The objectives of this study were (1) to identify determining factors of unintentional leakage and (2) to determine the effect of the type of mask (nasal/oronasal) used on unintentional leakage. Seventy-four polysomnograms from patients with OSA syndrome treated with auto-CPAP were analyzed (23 women; 56 ± 13 years; BMI, 32.9 kg/m 2 (range, 29.0-38.0 kg/m 2 ). Polysomnographic recordings were obtained under auto-CPAP, and mandibular behavior was measured with a magnetic sensor. After sleep and respiratory scoring, polysomnographic signals were computed as mean values over nonoverlapping 10-s intervals. The presence/absence of unintentional leakage was dichotomized for each 10-s interval (yes/no). Univariate and multivariate conditional regression models estimated the risk of unintentional leaks during an interval "T" based on the explanatory variables from the previous interval "T-1." A sensitivity analysis for the type of mask was then conducted. The univariate analysis showed that mandibular lowering (mouth opening), a high level of CPAP, body position (other than supine), and rapid eye movement (REM) sleep increased the risk of unintentional leaks and microarousal decreased it. In the multivariate analysis, the same variables remained independently associated with an increased risk of unintentional leakage. The sensitivity analysis showed that oronasal masks reduced the risk of unintentional leaks in cases of mouth opening and REM sleep. Mouth opening, CPAP level, sleep position, and REM sleep independently contribute to unintentional leakage. These results provide a strong rationale for the definition of phenotypes and the individual management of leaks during CPAP treatment. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  17. Epidemiological analysis of structural alterations of the nasal cavity associated with obstructive sleep apnea syndrome (OSA).

    Science.gov (United States)

    Mekhitarian Neto, Levon; Fava, Antonio Sérgio; Lopes, Hugo Canhete; Stamm, Aldo

    2005-01-01

    The objective of this paper is to demonstrate that structural alterations of the nasal cavity, e.g. septal deviation and conchal hypertrophy have high incidence in patients with sleep apnea and hypopnea syndrome and must be addressed with associated specific procedures of the syndrome. Clinical retrospective. A retrospective study of 200 patients was performed, with 196 male and 4 female, attended at the otorhinolaryngology ambulatory of Hospital Prof. Edmundo Vasconcelos and Unidade Paulista de Otorrinolaringologia, all of them subjected to polysomnography, otorhinolaryngological physical exam, endoscopy exam, and surgical treatment with nasal and pharyngeal procedures. All of them were subjected to pharyngeal procedure: uvulopalatopharyngoplasty or uvulopalatoplasty and nose procedure: 176 septoplasty with partial turbinectomy (88%) and 24 isolated turbinectomy, with satisfactory results. We can see that structural alterations of the nasal cavity have high incidence in patients with OSA.

  18. Estaquillas leñosas de fácil enraizamiento: Estudio del Esclerenquima Estaquillas leñosas de fácil enraizamiento: Estudio del Esclerénquima

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    González Elena

    1986-12-01

    Full Text Available An anatomy study was made of following wood easy-to-root species: Aucuba japonica Thunb., Buddleja  japonica Hemsley,  Buxus sempervirens L., Citrus aurantium.  L., Citrus limon (L. Burm. fil.,  Cvdonia oblonga Miller,  Erica arborea L., Escallonia rubra (Ruiz & Pavón Pers., Euonymus japonicus L. fil., Forsythia viridissima Lindl., Hydrangea macrophylla Ser., Morus alba L., Populus nigra L.,  Rhododendron ponticum L., Salix atrocinerea Brot., Salix  viminalis L., Sambucus nigra L. and Symphoricarpos albus (L. S. F. Blake.  It was observed the presence or absence of a discontinous sclerenchyma ring so the species studied had not a mechanical barrier to the emergence of adventitious roots. Se realizó un estudio histológico de las siguientes especies leñosas de fácil enraizamiento: Aucuba japonica Thumb, Buddleja japonica Hemsley, Buxus sempervirens L., Citrus aurantium L., Citrus limon (L. Burm, fil., Cydonia oblonga Miller, Erica arborea L., Escallonia rubra (Ruiz & Pavón Pers., Euonymus japonicus L. fil., Forsythia viridissima Lindl., Hydrangea macrophylla Ser., Morus alba L. Populus nigra L., Rhododendron ponticum L., Salix atrocinerea Brot., Salix viminalis L., Sambucus nigra L. y Syrnphoricarpos albus (L. S. F. Blake. Se observó la presencia o ausencia de un anillo discontinuo de esclerénquima, por lo tanto dichas especies no poseen ningún impedimento mecánico para la emergencia de las raíces adventicias.

  19. The importance of neck circumference to thyromental distance ratio (NC/TM) as a predictor of difficult intubation in obstructive sleep apnea (OSA) patients

    OpenAIRE

    Hala Ezzat Abdel Naim; Sabah Abdel Raouf Mohamed; Sherif Mohamed Soaida; Haitham Hassan Awad Eltrabily

    2014-01-01

    Background: The trial to find a bedside examination that is helpful for foreseeing difficult intubation is quite inspiring. It was reported that thyromental distance (TM), body mass index (BMI), neck circumference (NC) and a Mallampati score >3 were the only helpful bedside test predictors. By using magnetic resonance imaging, it was established that more fat was present in areas around the collapsible parts of the pharynx in OSA patients. So distribution of fat may provide a better suggestio...

  20. The predictive value of drug-induced sleep endoscopy for CPAP titration in OSA patients.

    Science.gov (United States)

    Lan, Ming-Chin; Hsu, Yen-Bin; Lan, Ming-Ying; Huang, Yun-Chen; Kao, Ming-Chang; Huang, Tung-Tsun; Chiu, Tsan-Jen; Yang, Mei-Chen

    2017-12-15

    The aim of this study was to identify possible upper airway obstructions causing a higher continuous positive airway pressure (CPAP) titration level, utilizing drug-induced sleep endoscopy (DISE). A total of 76 patients with obstructive sleep apnea (OSA) underwent CPAP titration and DISE. DISE findings were recorded using the VOTE classification system. Polysomnographic (PSG) data, anthropometric variables, and patterns of airway collapse during DISE were analyzed with CPAP titration levels. A significant association was found between the CPAP titration level and BMI, oxygen desaturation index (ODI), apnea-hypopnea index (AHI), and neck circumference (NC) (P CPAP titration level (P CPAP titration level and any other collapse at the tongue base or epiglottis. By analyzing PSG data, anthropometric variables, and DISE results with CPAP titration levels, we can better understand possible mechanisms resulting in a higher CPAP titration level. We believe that the role of DISE can be expanded as a tool to identify the possible anatomical structures that may be corrected by oral appliance therapy or surgical intervention to improve CPAP compliance.

  1. Estado nutricional e fatores associados em idosos do Município de Viçosa, Minas Gerais, Brasil Nutritional status and associated factors among the elderly in Viçosa, Minas Gerais State, Brazil

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    Clarissa de Matos Nascimento

    2011-12-01

    Full Text Available Investigaram-se as prevalências de baixo peso e excesso de peso, bem como os fatores associados em idosos. Trata-se de um estudo transversal, com 621 idosos residentes no Município de Viçosa, Minas Gerais, Brasil, realizado em 2009. As informações foram obtidas por meio de entrevistas domiciliares e se referiam à avaliação do estado nutricional, condições sociodemográficas e de saúde. Do total de pessoas estudadas, 53,3% eram do gênero feminino. A mediana do IMC foi de 26,40kg/m² (mínima 15,20 e máxima 46,82 e foi menor para os homens do que para as mulheres. A prevalência de excesso de peso foi elevada (45%; IC95%: 40%-49%, diminuiu com a idade, associou-se positivamente ao gênero feminino e história de artrite/artrose, e negativamente à faixa etária de 80 anos ou mais e ao tabagismo. A prevalência de baixo peso foi maior no gênero masculino (18,2%, aumentou com o avanço da idade e associou-se positivamente à pior percepção de saúde. O conjunto dos resultados salientam a importância de estratégias em saúde que favoreçam mudanças no estilo de vida e hábitos alimentares saudáveis.This cross-sectional study in 2009 focused on the prevalence of underweight and overweight and associated factors in a sample of 621 elderly individuals in Viçosa, Minas Gerais State, Brazil. Data were obtained through home interviews on nutritional status and socio-demographic and health conditions. Of the total sample, 53.3% were females. Median BMI was 26.40kg/m² (range = 15.20-46.82 and was lower for men than for women. Prevalence of overweight was high (45%; 95%CI: 40%-49%, decreased with age, was positively associated with female gender and history of arthritis/arthrosis, and was negatively associated with age 80 years or older and smoking. Prevalence of underweight was high in men (18.2%, increased with age, and was positively associated with worse self-rated health. The findings highlight the importance of health strategies

  2. Anemia ferropriva em crianças de 6 a 12 meses atendidas na rede pública de saúde do município de Viçosa, Minas Gerais Iron deficiency anemia in 6 to 12-month-old infants attended at the public health service of Viçosa, Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Danielle Góes da SILVA

    2002-09-01

    Full Text Available Este estudo teve como objetivos verificar a prevalência de anemia em lactentes de 6 a 12 meses atendidos na rede pública de saúde do município de Viçosa, MG e analisar alguns possíveis fatores de risco. As informações foram obtidas através de questionário aplicado aos responsáveis pela criança e através da verificação de medidas antropométricas e da dosagem de hemoglobina por hemoglobinômetro portátil. No diagnóstico de anemia, utilizou-se o ponto de corte de 11 g/dL. A prevalência de anemia ferropriva nas 204 crianças estudadas foi 60,8%, e 55,6% dos casos de anemia eram graves. A média da hemoglobina foi 9,28±1,07 nos anêmicos e 12,07±0,89 mg/dL nos não-anêmicos. A baixa escolaridade paterna e a idade materna mostraram associação estatística com a anemia (pThis study aimed at verifying the prevalence of anemia in 6 to 12-month-old infantsattended at the public health service of the city of Viçosa, state of Minas Gerais, and analyzing some possible risk factors. Information was obtained through questionnaire applied to those responsible for the infants and through the verification of the anthropometric measures and the hemoglobin dosage by portable hemoglobinometer. In diagnosing anemia, a 11g/dL cutoff point was used. The prevalence of iron deficiency anemia in a total of 204 infants reached 60.8%, and 55.6% of the cases of anemia were serious. The hemoglobin average was 9.28±1.07 mg/dL in anemic infants, and 12.07± 0.89 mg/dL in non-anemic ones. The father's low school level and the mother's age showed statistical association with anemia (p<0.05. A high prevalence and severity of the anemia was found, emphasizing the need for prevention and control of this disease in the city of Viçosa.

  3. Contaminación fecal en varios ríos de la Gran Área Metropolitana y la Península de Osa Fecal contamination in several rivers of the Greater Metropolitan Area and the Osa Peninsula

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    Guillermo Calvo Brenes

    2012-12-01

    Full Text Available La contaminación en los ríos de Costa Rica es un problema que merece especial atención. El concepto “contaminación del agua” implica la incorporación de materias extrañas a esta, tales como microorganis- mos (coliformes totales y fecales, productos quími- cos (jabones, fer tilizantes, pesticidas, metales pesados (cromo, plomo, mercurio, etc. o materia orgánica proveniente de los suelos a través de la escorrentía superficial y de las aguas residuales domésticas. Estas materias deterioran la calidad del agua y reducen los diferentes usos que podría tener un río. El recurso hídrico es importante tanto para la preservación de la vida humana como para la conservación de la flora y fauna. Costa Rica se ha caracterizado por ser un país poseedor de una rica biodiversidad. Sin embargo, muchos de los ríos de la Gran Área Metropolitana ya presentan una contaminación severa, según el Índice holandés de clasificación de la calidad del agua. En este estudio se analizó el contenido de colifor- mes fecales en 10 ríos de las provincias de San José, Alajuela, Heredia y Car tago, así como de la Península de Osa. Para correlacionar el contenido de colifor- mes fecales con la densidad poblacional, además, se muestrearon tres puntos en cada río: la zona alta cercana a la naciente, la zona media y la zona baja cercana a su desembocadura. Se encontró que los puntos de muestreo con densi- dades poblacionales medias o altas están altamente contaminados con coliformes fecales.Varios de ellos superan el límite máximo permisible en el contenido de coliformes fecales establecido por los reglamen- tos nacionales para el uso de los ríos en actividades de recreación de contacto primario. También se determinó que las zonas con menor pobla- ción, tales como los ríos Tigre y Rincón en la Península de Osa, el río Poás en Alajuela en todo su recorrido y los ríos Purires y Birrís en Cartago, en sus zonas medias y altas, están menos

  4. Effects of CPAP-therapy on brain electrical activity in obstructive sleep apneic patients: a combined EEG study using LORETA and Omega complexity : reversible alterations of brain activity in OSAS.

    Science.gov (United States)

    Toth, Marton; Faludi, Bela; Kondakor, Istvan

    2012-10-01

    Effects of initiation of continuous positive airway pressure (CPAP) therapy on EEG background activity were investigated in patients with obstructive sleep apnea syndrome (OSAS, N = 25) to test possible reversibility of alterations of brain electrical activity caused by chronic hypoxia. Normal control group (N = 14) was also examined. Two EEG examinations were done in each groups: at night and in the next morning. Global and regional (left vs. right, anterior vs. posterior) measures of spatial complexity (Omega complexity) were used to characterize the degree of spatial synchrony of EEG. Low resolution electromagnetic tomography (LORETA) was used to localize generators of EEG activity in separate frequency bands. Before CPAP-treatment, a significantly lower Omega complexity was found globally and over the right hemisphere. Due to CPAP-treatment, these significant differences vanished. Significantly decreased Omega complexity was found in the anterior region after treatment. LORETA showed a decreased activity in all of the beta bands after therapy in the right hippocampus, premotor and temporo-parietal cortex, and bilaterally in the precuneus, paracentral and posterior cingulate cortex. No significant changes were seen in control group. Comparing controls and patients before sleep, an increased alpha2 band activity was seen bilaterally in the precuneus, paracentral and posterior cingulate cortex, while in the morning an increased beta3 band activity in the left precentral and bilateral premotor cortex and a decreased delta band activity in the right temporo-parietal cortex and insula were observed. These findings indicate that effect of sleep on EEG background activity is different in OSAS patients and normal controls. In OSAS patients, significant changes lead to a more normal EEG after a night under CPAP-treatment. Compensatory alterations of brain electrical activity in regions associated with influencing sympathetic outflow, visuospatial abilities, long

  5. Estructura de una población del árbol Peltogyne purpurea (Cesalpinaceae en un bosque intervenido de la Península de Osa, Costa Rica

    Directory of Open Access Journals (Sweden)

    Braulio Vílchez

    2006-09-01

    Full Text Available Se estudió la regeneración de una población del árbol Peltogyne purpurea Pittier después de una corta selectiva de madera en el bosque lluvioso tropical de Mogos, Península de Osa, Costa Rica. La distribución de los árboles adultos de P. purpurea según el diámetro del tallo a la altura del pecho tiene forma de campana. La categoría con la mayor cantidad de individuos correspondió a los árboles con tallos con diámetros entre 70 y 80 cm. No hubo diferencia significativa en el número de brinzales encontrados en los transectos establecidos siguiendo los cuatro puntos cardinales alrededor de los árboles reproductivos (madre. En general, la mayoría de los brinzales se encontraban en los primeros metros alrededor del árbol madre. Se observó otro pico de abundancia de brinzales a la distancia correspondiente con el final de la copa del árbol. La extracción de madera puede tener un efecto negativo en la regeneración de P. purpurea.Population structure of the tree Peltogyne purpurea (Cesalpinaceae in an altered forest at Osa Peninsula, Costa Rica. The regeneration of the rain forest tree Peltogyne purpurea Pittier after selective logging was studied in Mogos, Osa Península, Costa Rica. The distribution of all adult trees of P. purpurea according to diameter at breath height (dbh categories revealed that the distribution of the adult trees followed a bell-shaped curve. The largest number of individuals was found in the 70 to 80 cm dbh category. We did not find any significant differences in the distribution of saplings around seed-producing trees. There were similar numbers of saplings in the four transects established around each reproductive tree following the four cardinal directions. Overall, the majority of the saplings were found in the first meters around each seed-producing tree. There was another peak in the number of saplings at the distance where the crown of the tree ended. Logging can negatively affect the regeneration

  6. Pre- and in-therapy predictive score models of adult OSAS patients with poor adherence pattern on nCPAP therapy

    Directory of Open Access Journals (Sweden)

    Wang Y

    2015-05-01

    Full Text Available Yeying Wang,1,2 Alan F Geater,3 Yanling Chai,1 Jiahong Luo,2 Xiaoqun Niu,1 Bing Hai,1 Jingting Qin,1 Yongxia Li1 1Department of Respiratory Medicine, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, People’s Republic of China; 2Department of Epidemiology and Biostatistics, School of Public Health, Kunming Medical University, Kunming, Yunnan Province, People’s Republic of China; 3Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand Objectives: To identify patterns of adherence to nasal continuous positive airway pressure (nCPAP use in the first 3 months of therapy among newly diagnosed adult patients with obstructive sleep apnea/hypopnea syndrome (OSAS and their predictors. To develop pretherapy and in-therapy scores to predict adherence pattern. Methods: Newly diagnosed adult OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures such as Epworth Sleepiness Scale (ESS, Fatigue Severity Scale (FSS, Zung’s Self-Rating Depression Scale (SDS, and The Pittsburgh Sleep Quality Index (PSQI at baseline and at the end of 3rd-week therapy were collected. Twelve weeks’ adherence data were collected from the nCPAP memory card, and K-means cluster analysis was used to explore adherence patterns. Predictive scores were developed from the coefficients of cumulative logit models of adherence patterns using variables available at baseline and after 3 weeks of therapy. Performance of the score was validated using 500 bootstrap resamples. Results: Seventy six patients completed a 12-week follow-up. Three patterns were revealed. Patients were identified as developing an adherence pattern that was poor (n=14, mean ± SD, 2.3±0.9 hours per night, moderate (n=19, 5.3±0.6 hours per night, or good (n=43, 6.8±0.3 hours per night. Cumulative logit regression models (good → moderate → poor revealed independent baseline

  7. Survey report. New energy vision formulation project for Osa Town, Okayama Prefecture; 2001 nendo Osa cho shin energy vision sakutei tou jigyo chosa hokokusho. Chiiki shin energy vision sakutei tou jigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-02-01

    A New Energy Vision was formulated for Osa Town after investigations about energy demand, new energy reserves, and their available amounts. The town consumes approximately 50.6-billion kcal in total, with automobiles consuming a half thereof as fuel. Studies were made about new energy reserves and recoverable amounts in the town, and then an estimation was made that 16.2 times 10{sup 5} kWh/year would be recoverable from photovoltaic energy, 1.58 times 10{sup 5} kWh from small-scale hydropower, 8.79 times 10{sup 6} kWh from ligneous biomass, and 1.96 times 10{sup 5} kWh from livestock biomass, and that 40 MW, for example, would come from wind power, subject to change depending on the wind power generator system to be built. Projects for new energy introduction were discussed, which involved the use of biodiesel fuel for official vehicles, installation of solar hot water showers in primary and junior high schools, application of photovoltaic/wind power to crime prevention lights and street lamps, snow melting systems for roads utilizing geothermal energy, use of heat from thinnings and ligneous waste, wind power facilities, small-scale hydropower facilities, introduction of new energy appliances into sightseeing facilities, and the introduction of photovoltaic power or the like into public facilities. (NEDO)

  8. Ocorrência da síndrome da apneia obstrutiva do sono (SAOS em crianças respiradoras orais Obstructive sleep apnea syndrome (OSAS in mouth breathing children

    Directory of Open Access Journals (Sweden)

    Suemy Cioffi Izu

    2010-10-01

    Full Text Available É bem estabelecido que a respiração oral em crianças está relacionada à hipertrofia adenoamigdaliana, que é a principal causa de apneia do sono nesta população. Apesar da importância deste tema, há poucos estudos que comprovam a relação entre SAOS e respiração oral. OBJETIVO: Determinar a prevalência de distúrbios respiratórios do sono em crianças respiradoras orais e sua correlação com achados otorrinolaringológicos. MATERIAL E MÉTODO: Foram avaliados retrospectivamente 248 prontuários de crianças respiradoras orais do serviço de Otorrinolaringologia Pediátrica de uma grande instituição entre 2000 e 2006, analisando os achados otorrinolaringológicos, polissonografia, nasofibroscopia e/ou radiografia em perfil do Cavum. O principal dado polissonográfico utilizado foi o índice de apneia (IA. Classificou-se como ronco primário aqueles com IA1. Desenho Científico: Coorte retrospectivo. RESULTADOS: Dos 248 pacientes incluídos, 144 (58% apresentavam ronco primário e 104 (42% apresentavam SAOS. Os achados otorrinolaringológicos mais frequentes foram Hipertrofia adenoamigdaliana (n=152; 61,2%, Hipertrofia de tonsila palatina (n=17; 6,8% Hipertrofia da tonsila faríngea (n=37; 14,9%, Rinite Alérgica (n=155; 62,5% e Otite Secretora (36; 14,5%. CONCLUSÕES: Ronco Primário e SAOS são frequentes em crianças respiradoras orais. A afecção otorrinolaringológica mais encontrada em crianças com SAOS é a hipertrofia adenoamigdaliana acompanhada ou não de rinite alérgica.It is well known that mouth breathing is associated with adenotonsillar hypertrophy - which is the main cause of obstructive sleep apnea among children. Despite the importance of this matter, there are only a handful of studies showing the relationship between OSAS and mouth breathing. AIM: to determine the prevalence of obstructive sleep disorders in mouth breathing children and study its correlation with otorhinolaryngological findings. STUDY

  9. La protección al consumidor por publicidad engañosa en el Ecuador y sus limitaciones legales de acuerdo a la legislación vigente

    OpenAIRE

    Guerra Naranjo, Marco Vinicio

    2006-01-01

    El ámbito comercial, inmensamente competitivo de proveedores de bienes y servicios y la masificación de sus ventas ha llevado a que se utilice con mayor frecuencia estrategias que implican el uso de publicidad agresiva y falsa, que tiende a perjudicar a los consumidores, quienes adquieren bienes y servicios, distintos a los que fueron publicitados o promocionados por cualquier medio, vulnerando con ello sus derechos con la ilícita publicidad engañosa. Por el contrario, el em...

  10. Genetics of Euglossini bees (Hymenoptera in fragments of the Atlantic Forest in the region of Viçosa, MG

    Directory of Open Access Journals (Sweden)

    A. M. Waldschmidt

    Full Text Available With uncontrolled deforestation, forest fragments remain, which in most cases are in different stages of regeneration and present isolated populations. In the present study we analyzed the genetic patterns of Eulaema nigrita populations in seven Atlantic Forest fragments of different sizes and successional stages in the region of Viçosa, MG. This was done by RAPD molecular markers. We observed that the area of the fragments had no effect on the genetic variability of E. nigrita in the direction predicted by meta-population models. Medium-sized well-preserved woods presented the lowest variability, whereas large and small woods were statistically identical. The evidence supports the notion that rural areas present greater dispersal among fragments, implying greater similarity between the populations of fragments located in rural areas when compared to fragments in urban areas.

  11. The "DOC" screen: Feasible and valid screening for depression, Obstructive Sleep Apnea (OSA) and cognitive impairment in stroke prevention clinics.

    Science.gov (United States)

    Swartz, Richard H; Cayley, Megan L; Lanctôt, Krista L; Murray, Brian J; Cohen, Ashley; Thorpe, Kevin E; Sicard, Michelle N; Lien, Karen; Sahlas, Demetrios J; Herrmann, Nathan

    2017-01-01

    Post-stroke Depression, Obstructive sleep apnea (OSA) and Cognitive impairment ("DOC") are associated with greater mortality, worse recovery and poorer quality of life. Best practice recommendations endorse routine screening for each condition; yet, all are under-assessed, diagnosed and treated. We seek to determine the feasibility and validity of an integrated tool ("DOC" screen) to identify stroke clinic patients at high-risk of depression, OSA, and cognitive impairment. All consecutive new referrals to a regional Stroke Prevention Clinic who were English-speaking and non-aphasic were eligible to be screened. Time for screen completion was logged. DOC screen results were compared to the neuropsychological battery and polysomnogram assessments using a modified receiver operator characteristic and area under the curve analysis. Data is reported to conform to STARD guidelines. 1503 people were screened over 2 years. 89% of eligible patients completed the screen in 5 minutes or less (mean 4.2 minutes), less than half the time it takes to complete the Montreal Cognitive Assessment (MoCA). 437 people consented to detailed testing. Of those, 421 completed the Structured Clinical Interview for Depression within 3 months of screening, 387 completed detailed neuropsychological testing within 3 months, and 88 had overnight polysomnograms. Screening scores combined with demographic variables (age, sex, education, body mass index), had excellent validity compared to gold standard diagnoses: DOC-Mood AUC 0.90; DOC-Apnea AUC 0.80; DOC-Cog AUC 0.81. DOC screen scores can reliably categorize patients in to low-, intermediate- or high-risk groups for further action and can do so with comparable accuracy to more time-consuming screens. Systematic screening of depression, obstructive sleep apnea, and cognitive impairment in 5 minutes or less is feasible and valid in a high volume stroke clinic using the DOC screen. The DOC screen may facilitate improved identification and treatment

  12. Flutuação populacional de espécies de cigarrinhas transmissoras da clorose variegada dos citros (CVC em Viçosa-MG Population dynamics of sharpshooters species transmitter of citrus variegated chlorosis (CVC in Viçosa-MG

    Directory of Open Access Journals (Sweden)

    Dierlei dos Santos

    2005-08-01

    Full Text Available Os objetivos deste trabalho foram avaliar a presença e a dinâmica populacional, ao longo do ano, de cigarrinhas transmissoras da CVC, no município de Viçosa - MG. As coletas foram realizadas no período de agosto de 2003 a julho de 2004, com auxílio de armadilhas adesivas amarelas e com rede entomológica (puçá. Das onze espécies comprovadamente capazes de transmitir a CVC, foram encontradas nove. O número total de cigarrinhas capturadas foi de 2.966, sendo 2.805 nas armadilhas e 161 no puçá. As três espécies da família Cicadellidae mais expressivas em número de insetos foram Bucephalogonia xanthophis (36,6% capturados na rede entomológica e 34,7% na armadilha, Dilobopterus costalimai (9,9% capturados na rede entomológica e 11,3% na armadilha e Acrogonia citrina (6,8% capturados na rede entomológica e 7,4% na armadilha. No mês de novembro, foram coletadas 378 cigarrinhas, correspondendo ao mês de maior incidência, sendo que 292 dessas foram coletadas na primeira quinzena, concorrendo para um pico populacional. Não houve diferença significativa entre o número médio de cigarrinhas coletadas no interior e na periferia da área.The objectives of this work were to evaluate the presence and the population dynamics of Citrus CVC transmitter sharpshooters along the year in the municipality of Viçosa- MG. The sharpshooter populations were monitored in the period of August 2003 to July 2004 using yellow adhesive traps and entomologic nets. During this period 2966 sharpshooters were captured and identified. Among eleven species known as CVC transmitters, nine were found in the region. The three most expressive species in number found were Bucephalogonia xanthophis (36,6% captured in entomological net and 34,7% in the trap, Dilobopterus costalimai (9,9% captured in entomological net and 11,3% in the trap and Acrogonia citrina (6,8% captured in entomological net and 7,4% in the trap. The largest incidence of sharpshooters occurred

  13. Reflexiones sobre la protección del consumidor de servicios turísticos frente a la publicidad engañosa de sociedades mercantiles turísticas

    OpenAIRE

    Barrero Rodríguez, Enrique; Viguera Revuelta, Rodrigo; Jiménez Caballero, José Luis (Coordinador)

    2016-01-01

    En la presente Comunicación, sus autores pretenden exponer la situación en la que los potenciales clientes de las empresas turísticas pueden sufrir engaños como consecuencia de la publicidad engañosa. En tales supuestos, el mercado se suele caracterizar por el uso de una determinada publicidad que pretende incidir en la voluntad del consumidor, de manera que la actividad publicitaria se muestra como realmente relevante y decisiva para la formación de la voluntad de los ref...

  14. Avaliação do perfil de trabalhadores e das condições de trabalho em marcenarias no município de Viçosa-MG Evalution of workers' profile and work conditions joineries in Viçosa, Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Kátia Regina Silva

    2002-11-01

    Full Text Available Esta pesquisa foi desenvolvida nos ambientes de trabalho de marcenarias localizadas no município de Viçosa, Minas Gerais, para realizar o levantamento do perfil dos trabalhadores e das condições de trabalho relacionadas às atividades exercidas em marcenarias, visando a melhoria da saúde, do bem-estar, da segurança, do conforto e da produtividade dos trabalhadores. O levantamento do perfil dos trabalhadores e das condições de trabalho foi realizado por intermédio da aplicação de questionários aos trabalhadores das marcenarias avaliadas e das observações e anotações realizadas durante a coleta dos dados. Pelos resultados obtidos, foram constatados diversos problemas relacionados aos marceneiros, como, por exemplo, cansaço, dores nas pernas e na coluna, alergia devido à utilização de produtos químicos e ao pó da madeira, falta de treinamento para exercer a profissão e praticamente nenhuma noção sobre segurança e higiene no trabalho. A incidência de acidentes relatados foi baixa; as mãos foram as partes mais afetadas por cortes leves, não tendo sido relatado nenhum tipo de acidente grave. Pôde-se constatar também que há necessidade de conscientizar os proprietários das marcenarias sobre a importância e os benefícios da segurança e higiene no trabalho para os seus funcionários.This work was carried out in joineries located in Viçosa, Minas Gerais, Brazil, to survey the profile of workers and work conditions related to the activities performed, aiming to promote health, welfare, safety, comfort and productivity of the workers. This survey was carried out by means of the application of questionnaires to the workers and from observations made during data collection. According to the obtained results, various problems related to the joiners were observed, such as fatigue, pain in legs and spine, allergies due to the use of chemicals and sawdust, lack of training for the work and almost none knowledge about work

  15. The Effect of the Transition to Home Monitoring for the Diagnosis of OSAS on Test Availability, Waiting Time, Patients’ Satisfaction, and Outcome in a Large Health Provider System

    Directory of Open Access Journals (Sweden)

    Ahmad Safadi

    2014-01-01

    Full Text Available During 2009, the Haifa district of Clalit Health Services (CHS has switched from in-lab polysomnography (PSG to home studies for the diagnosis of obstructive sleep apnea (OSA. We assessed the effects of this change on accessibility, waiting time, satisfaction, costs, and CPAP purchase by the patients. Data regarding sleep studies, CPAP purchase, and waiting times were collected retrospectively from the computerized database of CHS. Patients’ satisfaction was assessed utilizing a telephone questionnaire introduced to a randomized small sample of 70 patients. Comparisons were made between 2007 and 2008 (in-lab PSGs and 2010 and 2011 (when most studies were ambulatory. Of about 650000 insured individuals in the Haifa district of CHS, 1471 sleep studies were performed during 2007-2008 compared to 2794 tests during 2010-2011. The average waiting time was 9.9 weeks in 2007-2008 compared to 1.1 weeks in 2010-2011 (P<0.05. 597 CPAPs were purchased in 2007-2008 compared to 831 in 2010-2011. The overall patients’ satisfaction was similar, but discomfort tended to be higher in the in-laboratory group (4.1 vs 2.7 in a scale of 0–10; P=0.11. Switching to ambulatory diagnosis improved the test accessibility and reduced the waiting times. Patients’ satisfaction remained similarly high. The total direct cost of OSA management was reduced.

  16. Regeneração pós-fogo em um fragmento de floresta estacional semidecidual no município de Viçosa, MG

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    Sebastião Martins Venâncio

    2002-01-01

    Full Text Available Estudou-se a vegetação colonizadora seis meses após perturbação por fogo, em uma á rea do Campus da Universidade Federal de Viçosa, em Viçosa (20o 45’ S, 42o 51’ W , MG. A á rea total de floresta secundá ria atingida por incê ndio foi de 12 hectares, apresentando níveis diferenciados de destruição da vegetação. O estudo concentrou-se no trecho onde o efeito do fogo foi mais drá stico, com a destruição total da cobertura vegetal. Dentro da á rea de estudo, foram comparadas duas toposseqüê ncias de relevo: côncavo (ravina e convexo (crista. Em cada toposseqüê ncia, foram instaladas dezoito parcelas contíguas de 5x5 m, totalizando 36 parcelas, nas quais foram identificadas todas as plantas vasculares. No total, foram amostradas 75 espécies, pertencentes a 26 famílias. As famílias mais ricas em espécies foram: Asteraceae (14, Poaceae (10, Malvaceae (7 e Fabaceae (6. Na toposseq üê ncia crista as espécies com maior valor de cobertura foram: Sida carpinifolia seguida de Melinis minutiflora, Diodia alata e Eupatorium laevigatum, e na ravina: Melinis minutiflora, Eupatorium laevigatum, Sida carpinifolia e Sidastrum paniculatum. Todas as parcelas apresentaram mais de 90% da á rea coberta por vegetação herbá cea e subarbustiva, destacando a importâ ncia dessa vegetação inicial na proteção do solo contra processos erosivos em relevos acidentados.

  17. Algunas plantas leñosas del Trapecio Amazónico Colombiano

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    Dugand Armando

    1956-09-01

    Full Text Available La lista de plantas que compone este breve artículo fue confeccionada extrayendo los datos respectivos de la obra "Woods of Northeastern Peru" de Llewelyn Williams, publicada en FIELD MUSEUMOF NATURAL, HISTORY,BOTANICALSERIES, Vol. 15, pp. 1-509; 1936. En dicha obra el señor Williams cataloga -entre muchas otras de distintas regiones de la Amazonia peruana-- un buen numero de plantas leñosas coleccionadas por él en la hacienda "La Victoria", muy cerca de Leticia, haciéndolas figurar como del Perú. Esto se debe a que en la época que Williams visito aquella región hoy colombiana -a mediados de 1929- no se había perfeccionado todavía, o mejor dicho, no se había puesto en práctica (aunque ya estaba promulgado solemnemente el tratado de fronteras entre Colombia y el Perú que puso fin al litigio que estos dos países sostuvieron por más de un siglo sobre una gran parte del territorio selvoso que se extiende entre los ríos Caquetá y Amazonas. Digo que no se había puesto en practica dicho tratado porque, si bien se firmó el 24 de marzo de 1922 y se promulgo el 31 de marzo de 1938, sólo vino a ejecutarse in situ el 17 de agosto de 1930, después de localizada y amojonada la frontera, mediante la formalidad del acto de entrega y de recibo de los territorios que les tocó definitivamente a un país y al otro. Fue, pues, un año después de la visita de Williams a dicha región cuando la bandera y las autoridades colombianas reemplazaron efectivamente a las peruanas en el llamado "Trapecio Amazónico", cuya población principal es Leticia, sobre el rio Amazonas.

  18. Floristic composition of natural regeneration of tree species in a mountain seasonal semideciduous florest fragment over an eigth year period, in Viçosa, MG, Brazil

    OpenAIRE

    Higuchi, Pedro; Reis, Maria das Graças Ferreira; Reis, Geraldo Gonçalves dos; Pinheiro, Antonio Lelis; Silva, Crodoaldo Telmo da; Oliveira, Carlos Henrique Rodrigues de

    2006-01-01

    A florística da regeneração natural foi estudada em 10 locais, com seis sub-parcelas em cada local, em 1992, 1995 e 2000, em fragmento de Floresta Estacional Semidecidual Montana, em Viçosa, MG. A amostragem da classe 1 de tamanho de planta (até 1 m de altura), classe 2 (1-3 m de altura) e classe 3 (>3 m de altura e 3m and DBH < 5cm). A total of 4,149 individuals were sampled over the inventory period, comprising 42 families and 160 species, being 11.7 % pioneer, 62.1 % early secondary, and ...

  19. Projeto Sabão Ecológico: uma estratégia educacional para a reciclagem do óleo de cozinha no município de Viçosa

    OpenAIRE

    Yaankha Bharbara Allecxandria Bernardo da Silva Barbosa Cardoso; Sabrina Marcelino Amoglia; Julie Louise McClelland; Amanda Ferreira Teixeira; Laura Fernandes Melo

    2017-01-01

    O descarte inadequado de resíduos de óleo de cozinha usado pode causar danos ambientais no local onde é descartado, bem como no entorno, fato que desrespeita um dos direitos do ser humano: o acesso ao ambiente ecologicamente equilibrado. Neste contexto, o Projeto Sabão Ecológico foi criado pela ONG Engenheiros Sem Fronteiras – Núcleo Viçosa, devido à necessidade de conscientizar a população sobre os danos inerentes ao descarte incorreto desse óleo. Por meio de oficinas teórico-práticas, que e...

  20. Carotene and provitamin A content of vegetables sold in Viçosa, MG, Brazil, during spring and winter

    Directory of Open Access Journals (Sweden)

    Pollyanna Costa Cardoso

    2009-09-01

    Full Text Available This study investigated the α- and β-carotene content and provitamin A value of four leafy vegetables sold at local and street markets in Viçosa, MG, Brazil, in the spring and winter of 2002. Carotenoids were analyzed by high-performance liquid chromatography. α-Carotene was detected in all samples sold during spring, but was only present in a few samples of smooth and curly lettuce and kale in winter. β-Carotene was found in marked quantities in all leafy vegetables analyzed. Duncan's test (α = 5% showed significantly higher α-carotene content in curly lettuce and vitamin A value in large-leaved watercress in the spring. Mean β-carotene content and vitamin A value were 7544, 8751, 2584, 2792, 8193, and 5338 μg/100 g and 666, 760, 227, 238, 698, and 460 μg RAE/100 g in large-leaved and hydroponic watercress, smooth and curly lettuce, kale and spinach, respectively. All leafy vegetables analyzed represent important sources of provitamin A and supply an important part of the daily requirements of children and adults.Investigou-se o conteúdo de α e β-caroteno e avaliou-se o valor pro-vitamínico A de quatro hortaliças folhosas comercializadas em mercados locais e feira- livre de Viçosa, MG durante a primavera e o inverno de 2002. Os carotenóides foram analisados por Cromatografia Líquida de Alta Eficiência (CLAE. O α-caroteno foi detectado em todas as amostras analisadas na primavera, porém no inverno, somente algumas amostras de alface crespa e lisa, e couve apresentaram tal carotenóide. O β-caroteno foi encontrado, em quantidades apreciáveis, em todas as hortaliças folhosas analisadas. O teste de Duncan (α=5% detectou que o conteúdo de α-caroteno em alface crespa e o valor de vitamina A em agrião de folha larga foram estatisticamente superiores na primavera. Os teores médios de β-caroteno e de valor de vitamina A para agrião de folha larga e hidropônico, alface crespa e lisa, couve e espinafre foram: 7544; 8751

  1. The “DOC” screen: Feasible and valid screening for depression, Obstructive Sleep Apnea (OSA) and cognitive impairment in stroke prevention clinics

    Science.gov (United States)

    Swartz, Richard H.; Cayley, Megan L.; Lanctôt, Krista L.; Murray, Brian J.; Cohen, Ashley; Thorpe, Kevin E.; Sicard, Michelle N.; Lien, Karen; Sahlas, Demetrios J.; Herrmann, Nathan

    2017-01-01

    Background Post-stroke Depression, Obstructive sleep apnea (OSA) and Cognitive impairment (“DOC”) are associated with greater mortality, worse recovery and poorer quality of life. Best practice recommendations endorse routine screening for each condition; yet, all are under-assessed, diagnosed and treated. We seek to determine the feasibility and validity of an integrated tool (“DOC” screen) to identify stroke clinic patients at high-risk of depression, OSA, and cognitive impairment. Methods All consecutive new referrals to a regional Stroke Prevention Clinic who were English-speaking and non-aphasic were eligible to be screened. Time for screen completion was logged. DOC screen results were compared to the neuropsychological battery and polysomnogram assessments using a modified receiver operator characteristic and area under the curve analysis. Data is reported to conform to STARD guidelines. Findings 1503 people were screened over 2 years. 89% of eligible patients completed the screen in 5 minutes or less (mean 4.2 minutes), less than half the time it takes to complete the Montreal Cognitive Assessment (MoCA). 437 people consented to detailed testing. Of those, 421 completed the Structured Clinical Interview for Depression within 3 months of screening, 387 completed detailed neuropsychological testing within 3 months, and 88 had overnight polysomnograms. Screening scores combined with demographic variables (age, sex, education, body mass index), had excellent validity compared to gold standard diagnoses: DOC-Mood AUC 0.90; DOC-Apnea AUC 0.80; DOC-Cog AUC 0.81. DOC screen scores can reliably categorize patients in to low-, intermediate- or high-risk groups for further action and can do so with comparable accuracy to more time-consuming screens. Conclusions Systematic screening of depression, obstructive sleep apnea, and cognitive impairment in 5 minutes or less is feasible and valid in a high volume stroke clinic using the DOC screen. The DOC screen may

  2. Papilionoideae (Leguminosae arbóreas e lianas na estação de pesquisa, treinamento e educação ambiental (EPTEA, Mata do Paraíso, Viçosa, Zona da Mata Mineira Trees and lianes of the papilionoideae (Leguminosae in the research, training and environmental education station (EPTEA, Mata do Paraíso, Viçosa, Zona da Mata Mineira

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    Izabella Martins da Costa Rodrigues

    2007-01-01

    Full Text Available Este trabalho consiste em um levantamento florístico das árvores e lianas pertencentes à Papilionoideae da Mata do Paraíso, importante fragmento de Floresta Estacional Semidecidual Submontana, no Município de Viçosa, Zona da Mata mineira. A pesquisa de campo foi realizada por meio de visitas à área de estudo, no período de julho/2004 a agosto/2005. Foram reconhecidos 12 táxons infra-específicos pertencentes a oito gêneros, sendo Machaerium Pers. (4 spp. e Dalbergia L. f. (2 spp. os mais representativos. São apresentados chaves de identificação, descrições, ilustrações e comentários sobre os táxons analisados. Dalbergia nigra (Vell. Allemão ex Benth., espécie vulnerável, e Ormosia vicosana Rudd, endêmica da região, foram encontradas na EPTEA.This work is a floristic survey of trees and lianas of the Papilionoideae in the Mata do Paraíso, an important fragment of Submontane Semideciduous Seasonal Forest, in Viçosa, Zona da Mata Mineira. The fieldwork was carried out through visits to the studied area, from July/2004 to August/2005. Twelve taxa represented by eight genera were recorded. Machaerium Pers. (4spp. and Dalbergia L. f. (2 spp. were the most representatives. Identification keys, descriptions and illustrations are presented for the analyzed taxa. Dalbergia nigra (Vell. Allemão ex Benth., vulnerable species and, Ormosia vicosana Rudd, endemic for the region were found at EPTEA.

  3. Equações alométricas para estimativa de carbono em árvores de uma área urbana em Viçosa-MG

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    Daniel Brianezi

    2013-12-01

    Full Text Available Objetivou-se com este estudo gerar equações para estimar o carbono presente na arborização do campus-sede da Universidade Federal de Viçosa, contribuindo para o conhecimento sobre a capacidade das áreas verdes urbanas no sequestro e estocagem de carbono. Assim, inventariaram-se todas as árvores com DAP igual ou superior a 5 cm presentes na Universidade. Para as árvores não palmeiras, selecionaram-se 721 árvores-amostra, que foram cubadas rigorosamente em pé através da aplicação sucessiva da expressão de Smalian até o diâmetro-limite de 5 cm, tanto para o fuste quanto para os galhos. No caso das palmeiras, cubaram-se 100% dos indivíduos utilizando a expressão de Huber. A densidade básica da madeira com casca e o teor de carbono foram obtidos, nas palmeiras, com a retirada de um disco na porção do DAP, dada a dificuldade de tradagem. Já nas demais árvores, utilizou-se um trado mecânico. Com base no volume, na densidade básica e no teor de carbono, calcularam-se o carbono total e o carbono dos galhos. Ademais, avaliaram-se os modelos de Schumacher e Hall (1933 e Spurr (1952, modificado para estimar o carbono fixado nesses indivíduos. Nas árvores não palmeiras do campus-sede da Universidade Federal de Viçosa, o carbono total e o carbono dos galhos podem ser estimados, em kg, em razão do Diâmetro à Altura do Peito (DAP, em cm e da Altura Total (Ht, em m, por -0,906586+1,60421*LnDAP+0,37162*LnHt e por -2,052673+1,89903*LnDAP+0,24156*LnHt, respectivamente. Nas palmeiras, o carbono total pode ser estimado por -4,46988+199082*LnDAP+1,06420*LnHt.

  4. Evolución de la propiedad, la tecnología y la sostenibilidad en la región montañosa de Nariño.

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    Irma Baquero

    2010-05-01

    Full Text Available Se analiza el efecto de las instituciones en las decisiones de conservación de recursos naturales de los productores agropecuarios en la región montañosa de Nariño. El análisis se basa en las características del sistema de propiedad: derecho de exclusión, seguridad y capacidad de ser transado. A pesar de que la teoría considera a la propiedad privada como la que mayores incentivos genera para la conservación, los resultados del análisis demuestran que esto no siempre es cierto y que otros factores, como los demográficos y tecnológicos, fueron determinantes de las decisiones.

  5. Epidemiological survey of the taeniasis/cysticercosis complex in cattle farms in Viçosa County, Minas Gerais, Brazil Inquérito epidemiológico sobre o complexo teníase-cisticercose bovina no município de Viçosa, Minas Gerais

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    Tatiane O. Santos

    2013-04-01

    Full Text Available Despite the importance of human taeniasis/bovine cysticercosis for public and animal health and the economy, its actual epidemiological status in Brazil is not well-studied. We sought to assess the epidemiological profile of this zoonosis in the rural area of Viçosa County, Minas Gerais, Brazil. The prevalence of bovine cysticercosis was 0.42%, whereas no case of human taeniasis was diagnosed. Factors favoring the persistence of zoonosis were identified. These included the supply of untreated water to animals, animals raised for slaughter without sanitary supervision, poor mechanization of raising techniques, and the use of untreated water for human consumption. Bovine meat for human consumption acquired in the city or from the farm itself was characterized as a risk factor for bovine cysticercosis (Odds Ratio (OR =16.77; pApesar da importância do complexo teníase-cisticercose bovina para a saúde pública, animal e para a economia, a realidade epidemiológica da ocorrência dessas zoonoses no Brasil é pouco conhecida. Este estudo foi realizado com o objetivo de avaliar o perfil epidemiológico desta zoonose na zona rural do município de Viçosa, MG. A prevalência encontrada de cisticercose bovina foi de 0,42%, e nenhum caso de teníase humana foi diagnosticado. Foi verificada presença de fatores favoráveis a manutenção dessa zoonose, como fornecimento de água sem tratar aos animais, criação de animais destinados ao abate sem inspeção sanitária, criação de bovinos com baixa adoção de tecnologia, e utilização de água sem tratamento. O consumo de carne bovina oriunda da propriedade e da cidade foi caracterizado como variável de risco (OR=16,77; p<0,05 para a cisticercose bovina. Apesar disso, as famílias das propriedades pesquisadas possuíam hábitos favoráveis como medida de controle para o desenvolvimento desta parasitose, como a quase ausência de esgoto a céu aberto e a ingestão de carne bovina bem passada. A

  6. Epidemiological survey of the taeniasis/cysticercosis complex in cattle farms in Viçosa County, Minas Gerais, Brazil

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    Tatiane O. Santos

    2013-04-01

    Full Text Available Despite the importance of human taeniasis/bovine cysticercosis for public and animal health and the economy, its actual epidemiological status in Brazil is not well-studied. We sought to assess the epidemiological profile of this zoonosis in the rural area of Viçosa County, Minas Gerais, Brazil. The prevalence of bovine cysticercosis was 0.42%, whereas no case of human taeniasis was diagnosed. Factors favoring the persistence of zoonosis were identified. These included the supply of untreated water to animals, animals raised for slaughter without sanitary supervision, poor mechanization of raising techniques, and the use of untreated water for human consumption. Bovine meat for human consumption acquired in the city or from the farm itself was characterized as a risk factor for bovine cysticercosis (Odds Ratio (OR =16.77; p<0.05. Nevertheless, the families on the investigated farms did apply several appropriate measures to control this disease, such as the virtual lack of open sewers and the consumption of well-cooked meat. The presence of bovine cysticercosis cases, and the factors favoring its persistence, point to the need for constant epidemiological and sanitary surveillance in this county.

  7. Vulnerabilidad por aprovechamiento y distribución de especies leñosas desde la perspectiva comunitaria en la reserva cañón del Usumacinta, Tabasco, México

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    Samuel Cabrera-Pérez

    2015-08-01

    Full Text Available El objetivo de la investigación fue docu-mentar los usos y grado de vulnerabilidad de la flora leñosa multiuso, usando para ello la perspectiva de los pobladores, así como describir la distribución en los ambientes de estas especies sobre el territorio que ocupa la comunidad de Niños Héroes, Tenosique, Tabasco, México. Se emplearon métodos etnobotánicos tales como: recorridos de campo con conocedores de la flora del sitio, colecta botánica y aplicación de entrevistas en cada vivienda de la comunidad. Estas últimas, incluyeron preguntas generales y específicas para documentar los usos y pedir colaboración para la realización de un taller comunitario para fundamentar la construcción del índice vulnerabilidad por aprovechamiento de la flora leñosa. Se identificaron 168 especies de flora leñosa útil, de las cuales 97 son multiusos. Éstas se agruparon en 20 categorías de utilidad, entre las que destaca la leña con 71 especies, seguidas por materiales para instrumentos de trabajo de campo (65, materiales para la construcción de casas rurales (63, cerco muerto (53, comestible (53, y cerco vivo (50. La selva y el acahual son los hábitats con mayor número de especies de flora multiusos y proveen al colectivo 27 y 26% del total respectivamente. El 22% de las especies multiusos presentan alta vulnerabilidad de aprovechamiento, mientras que 50% están categorizadas con vulnerabilidad baja por aprovechamiento. El índice aquí evaluado, permite detectar el grado de vulnerabilidad al aprovechamiento de manera local o regional, pero no se corresponde a los índices de amenaza establecidos por la Norma Oficial Mexicana NOM-059-SEMARNAT de protección ambiental de especies nativas de México. Este índice permite poner alertas a nivel local o regional con relación a la fragilidad de las especies. La información generada, sienta bases para el manejo de los recursos y puede servir de guía para las agencias del gobierno, instituciones

  8. Análise hidrológica e socioambiental da bacia hidrográfica do córrego Romão dos Reis, Viçosa-MG The hydrographic watershed of Romão dos Reis stream, Viçosa-MG

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    Genice Vieira Santos

    2007-10-01

    Full Text Available O objetivo deste trabalho foi analisar os aspectos hidrológico e socioeconômico da bacia hidrográfica do córrego Romão dos Reis, que se localiza no Município de Viçosa, na região da Zona da Mata do Estado de Minas Gerais. O estudo enfatizou o uso e ocupação da terra como fatores determinantes na análise da qualidade da água, além dos fatores físicos da bacia. Esta foi dividida em sub-bacias, o que possibilitou a escolha de locais representativos para coleta e análise de dados. Coletaram-se os dados referentes a vazão, qualidade da água, elevações, precipitação, uso do solo, tipo de solo e aspectos sociais e econômicos. Para a elaboração dos mapas, utilizou-se o modelo digitalizado, construído a partir de mosaicos e fotos aéreas da região, na escala de 1:30.000. As informações sobre o número de moradores e proprietários, assim como os seus respectivos sistemas de cultivos e ocupação na bacia, foram obtidas por meio de entrevistas semi-estruturadas, visando melhor compreender a organização social e o manejo de uso da terra das propriedades. Foram apontados indicadores de degradação, assim como estratégias de manejo adequadas à melhoria ambiental, que venham contribuir e garantir a sustentabilidade da bacia.This study was carried out to analyze the hydrological and socioeconomic aspects in the hydrographic watershed of Romão dos Reis stream in Viçosa county, Zona da Mata region, Minas Gerais State. In this study, the land use and occupation are emphasized as determinant factors for analyzing water quality, besides physical factors. The watershed was divided into sub-watersheds enabling to choose the representative sites for data collection and analysis. Data on flow rate, water quality, relief, precipitation, landscape (top, hillside and terrace, soil type, social and economic aspects were collected. A digitalized model built from mosaics and aerial photos of the area at 1:30.000 scale was used to draw up

  9. Composição florística da vegetação arbórea de um trecho de floresta estacional semidecídua em Viçosa, Minas Gerais, e espécies de maior ocorrência na região Floristic composition of trees in a seasonal semidecious forest in Viçosa, Minas Gerais, and species of greater ocurrence in the region

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    Walnir Gomes Ferreira Júnior

    2007-12-01

    Full Text Available É grande a demanda por estudos ecológicos em florestas que possam embasar trabalhos de recuperação, conservação da biodiversidade e apoio à legislação ambiental. Entre esses estudos, primordialmente está o levantamento da flora. Nesse sentido, este trabalho teve como objetivo determinar a composição florística de um trecho da Reserva da Biologia, em Viçosa, MG, em regeneração natural há 80 anos, bem como realizar uma análise comparativa com outros trabalhos conduzidos na região, fornecendo, assim, informações que poderão embasar estudos sobre recuperação e conservação da biodiversidade dos fragmentos de Floresta Estacional Semidecidual. Os dados florísticos foram obtidos mediante a amostragem fitossociológica em 1 ha, pelo método de parcelas contíguas, em que todos os indivíduos arbóreos com circunferência de tronco >15 cm a 1,30 m do solo foram amostrados. Registraram-se 130 espécies, distribuídas em 94 gêneros, pertencentes a 38 famílias botânicas. A análise desses dados conjuntamente com de outros levantamentos realizados em trechos distintos da Reserva da Biologia, no campus da UFV, denota a marcante influência de variáveis ambientais locais (topografia, declividade, face de exposição solar e disponibilidade hídrica na distribuição da riqueza florística desse fragmento. Casearia decandra, Guapira opposita, Apuleia leiocarpa, Dalbergia nigra, Jacaranda macratha, Matayba elaeagnoides, Piptadenia gonoacantha, Bathysa nicholsonii, Carpotroche brasiliensis, Luehea grandiflora, Mabea fistulifera, Ocotea odorifera, Sorocea bonplandii e Zanthoxylum rhoifolium foram as espécies de maior ocorrência nos fragmentos estudados na região de Viçosa e adjacências, apresentando potencial para uso na recuperação florestal de áreas degradadas.There is a great demand for ecological studies on forests focusing on biodiversity conservation and establishment of environmental laws. The major need, however, is

  10. Tendências recentes nos elementos do clima e suas implicações na evapotranspiração da cultura do milho em Viçosa - MG Recent trends in the weather elements and its implications in the maize crop evapotranspiration in Viçosa-MG, Brazil

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    Leonidas P. de Alencar

    2011-01-01

    Full Text Available A mudança nas condições climáticas tem gerado grandes preocupações em nível mundial, sendo que uma das grandes questões, neste contexto, é o aquecimento global. As alterações ocorridas nas condições climáticas podem afetar a demanda de água das plantas, porque a evapotranspiração é afetada por mudanças nos elementos climáticos. O objetivo deste trabalho foi analisar os efeitos das possíveis mudanças dos elementos do clima na evapotranspiração de referência e na evapotranspiração da cultura do milho para a região de Viçosa - MG. Mediante análise de tendência pelo teste de Mann-Kendall e da estatística do teste t da regressão linear, verificou-se o comportamento dos seguintes elementos climáticos: temperaturas máxima e mínima, insolação, velocidade do vento e umidade relativa. Observou-se uma redução na evapotranspiração de referência e da cultura do milho ao longo dos últimos 41 anos, principalmente em razão da redução da insolação e da velocidade do vento. A evapotranspiração de referência apresentou redução da ordem de 4,2 mm por ano.The change in weather conditions has caused great concern in the world and the major issue, in this context, is the global warming. The changes in climate may affect the water demand of plants, because the evapotranspiration is affected by changes in climatic elements. The objective of this study was to examine the possible effects of climatological changes in evapotranspiration and reference evapotranspiration of corn in Viçosa - MG, Brazil. Trend analysis by the Mann-Kendall statistic and student t test of the linear regression were used to study the behavior of the following weather elements: maximum and minimum temperatures, sunshine duration, wind speed and relative humidity. It was observed a reduction in the reference evapotranspiration and maize crop evapotranspiration over the recent past 41 years, mainly because of reduced solar radiation and wind

  11. Estado actual de contaminación con coliformes fecales de los cuerpos de agua de la Península de Osa

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    Jesús Mora

    2010-12-01

    Full Text Available La contaminación de los cuerpos de aguaen Costa Rica y en todo el mundo es unode los principales problemas ambientales,debido a la importancia estratégicade este recurso. El recurso hídrico esun elemento esencial no solo para lapreservación de la vida, sino también parala conservación de la flora y fauna de laregión.Su conservación y su calidad estánestrechamente vinculadas, prácticamente,a todas las actividades económicas ysociales en forma ineludible, así como a lasalud de su población.La Península de Osa se ha caracterizadopor ser una zona con una exuberantebiodiversidad, tanto en su flora comoen su fauna, raramente encontrada enuna zona pequeña.En 1975, se creó elParque Nacional de Corcovado,el más importante parque de Costa Rica y queprotege a un tercio de la península. Esteexótico territorio que es la Península deOsa no está exento de amenazas, debido ala fragmentación y destrucción del hábitat,la deforestación por la explotación de lamadera y el mal planeamiento en el uso dela tierra, la extracción ilegal de recursos,entre ellos el oro, y el crecimiento de lapoblación en sus alrededores.El Reglamento para la evaluación y laclasificación de la calidad de cuerpos deagua superficiales establece como límiteen el contenido de coliformes fecalesen el agua para actividades recreativasde contacto primario, un valor de 1000(NMP/100mL. Este mismo valor máximose aplica para el riego de hortalizas yotros alimentos que se consumen crudos;mientras que para el uso en abrevaderosy actividades pecuarias el valor máximopermisible de coliformes fecales es de2000, por mencionar algunos casos.Se realizó un estudio sobre la contaminaciónmicrobiológica, utilizando como indicador                                                          el contenido de coliformes fecales

  12. Environmental service payments: evaluating biodiversity conservation trade-offs and cost-efficiency in the Osa Conservation Area, Costa Rica.

    Science.gov (United States)

    Barton, D N; Faith, D P; Rusch, G M; Acevedo, H; Paniagua, L; Castro, M

    2009-02-01

    The cost-efficiency of payments for environmental services (PES) to private landowners in the Osa Conservation Area, Costa Rica, is evaluated in terms of the trade-off between biodiversity representation and opportunity costs of conservation to agricultural and forestry land-use. Using available GIS data and an 'off-the-shelf' software application called TARGET, we find that the PES allocation criteria applied by authorities in 2002-2003 were more than twice as cost-efficient as criteria applied during 1999-2001. Results show that a policy relevant assessment of the cost-effectiveness of PES relative to other conservation policies can be carried out at regional level using available studies and GIS data. However, there are a number of data and conceptual limitations to using heuristic optimisation algorithms in the analysis of the cost-efficiency of PES. Site specific data on probabilities of land-use change, and a detailed specification of opportunity costs of farm land, labour and capital are required to use algorithms such as TARGET for ranking individual sites based on cost-efficiency. Despite its conceptual soundness for regional conservation analysis, biodiversity complementarity presents a practical challenge as a criterion for PES eligibility at farm level because it varies depending on the set of areas under PES contracts at any one time.

  13. Scarlet Macaw (Ara macao, Psittaciformes: Psittacidae Nest Characteristics in the Osa Peninsula Conservation Area (ACOSA, Costa Rica

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    John L Guittar

    2009-06-01

    Full Text Available The Scarlet Macaw (Ara macao is an endangered species. In Costa Rica, the Scarlet Macaw population of the Central Pacific Conservation Area (ACOPAC, n =432 individuals has undergone considerable study and has been used effectively as a flagship species for regional conservation. Costa Rica’s only other viable Scarlet Macaw population, located in the Osa Peninsula Conservation Area (ACOSA, n=800-1200 individuals, remains virtually unstudied. We studied ACOSA Scarlet Macaw nest cavities from February 19th to March 22nd 2006. Through informal interviews with park guards and residents, we found a total of 57 potential nests in 52 trees. Eleven nests were reported as frequently poached. Scarlet Macaws used 14 identified tree species, ten of which are unrecorded in Costa Rica. The most common nesting trees were Caryocar costaricense (n=12, 24%, Schizolobium parahyba (n=9, 18.0%, Ceiba pentandra (n=7, 14.0% and Ficus sp. (n=5, 10.0%. We compare nesting characteristics to those recorded in ACOPAC. A combination of bottom-up and top-down strategies are necessary to ensure the Scarlet Macaw’s long-term success, including environmental education in local schools, community stewardship of active nests, and the advertisement of stricter penalties for poaching. Rev. Biol. Trop. 57 (1-2: 387-393. Epub 2009 June 30.

  14. Resumen de tesis. El régimen jurídico de la publicidad engañosa por omisión: especial referencia a los derechos mexicano y español

    OpenAIRE

    Gómez Anel, María Isabel

    2015-01-01

    [ES] La investigación doctoral analiza el régimen legal de la publicidad engañosa por omisión llevando a cabo un análisis comparativo de los ordenamientos jurídicos español y mexicano. En primer término se aborda la publicidad en el marco de la tutela de los consumidores, los derechos fundamentales extensivos a la publicidad comercial y los principios básicos que las comunicaciones comerciales deben cubrir en torno a la protección jurídica de los consumidores. Es analizada la publicidad il...

  15. Condições de serventia de estradas não-pavimentadas: estudo de caso aplicado às vias do município de Viçosa, Estado de Minas Gerais, Brasil = Serviceability of unpaved roads: a case study applied to net road from Viçosa, Minas Gerais

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    Taciano Oliveira da Silva

    2011-04-01

    Full Text Available Este artigo apresenta a adaptação do método de classificação de estradas nãopavimentadas proposto por Eaton às condições encontradas em rodovias vicinais do município de Viçosa, Estado de Minas Gerais, considerando a sua potencialidade como ferramenta de suporte à gerência destas vias. Este estudo foi desenvolvido a partir deavaliações objetiva, realizada com o emprego de uma escala de notas, e subjetiva, em obediência à metodologia de Eaton, que foram conduzidas por uma equipe treinada previamente que executou inspeções de campo, atribuindo notas a 20 unidades amostrais, possuindo cada uma delas 50 m de comprimento e representativas de 10 trechos analisados de vias não-pavimentadas. A análise dos dados desta pesquisa possibilitou concluir que: (i não houve correlação entre os resultados das avaliações subjetiva e objetiva, e a aplicação dametodologia de Eaton à gerência de manutenção de vias não-pavimentadas pode não refletir as suas prioridades reais; (ii a avaliação subjetiva do trecho e a avaliação subjetiva do conjunto de suas unidades amostrais são correlatas, indicando ser coerente o emprego deste procedimento.This paper addresses the adaptation of the method of classification of unpaved roads developed by Eaton to the field conditions of local roads from the city of Viçosa, Minas Gerais State, Brazil, considering its potential as a support tool for the management of these roads. This study was developed encompassing objective evaluation, carried out with the application of a note scale, and subjective evaluation, according to the methodology of Eaton, which were performed by a team that accomplished the field inspections, attributing notes to the 20 sample units, each one 50 meters long andrepresenting 10 analyzed unpaved road segments. Conclusions are as follows: (i it was not observed any correlation between data from the objective and the subjective field evaluations, leading to the conclusion

  16. Carotenos e provitamina A em bertalha e ervas aromáticas comercializadas em Viçosa, Estado de Minas Gerais, durante as quatro estações do ano = Carotenes and provitamin A in basella and aromatic herbs marketed in Viçosa, Minas Gerais State, during the four seasons of the year

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    Marina Andrade Batista

    2006-01-01

    Full Text Available Este estudo teve como objetivos investigar o teor de a-caroteno, b-caroteno e calcular o valor de vitamina A em hortaliças comercializadas no mercado formal e informal de Viçosa, Estado de Minas Gerais, bem como avaliar a influência das quatro estações doano e do local de comercialização sobre o conteúdo desses nutrientes. As hortaliças (bertalha, cebolinha, coentro, manjericão e salsa foram analisadas utilizando-se a cromatografia líquida de alta eficiência (CLAE. Devido ao conteúdo inexpressivo de a-caroteno em todas as amostras, foi possível quantificar apenas o b-caroteno. Não se verificou diferença estatisticamente significativa (a = 0,05 no conteúdo de b-caroteno das hortaliças entre os diferentes estabelecimentos, nem entre as estações do ano. As hortaliçasmostraram-se excelentes fontes de provitamina A, e se consumidas regularmente, contribuem de forma importante na adequação diária de vitamina A para adultos e crianças. Além disso, esses alimentos são acessíveis à população por apresentarem baixo custo e serem facilmente encontrados.This study aimed to investigate the level of a-carotene, b-carotene and to calculate the value of vitamin A in vegetables sold at local markets and informal markets of Viçosa, Minas Gerais State, as wellas to evaluate the seasonal and commercial effects on the content of these pigments. The vegetables (basella, green onion, cilantro, sweet basil and parsley were analyzed through high-performance liquid chromatography (HPLC, being b-carotene the only pigment present in all the analyzed samples. No significant statistical differences (a = 0.05 were found in the contents of b-carotene of the vegetables either among the different stores, or among the different seasons. The vegetables analyzed are great provitamin A sources and, ifeaten on a regular basis, they can fit the daily requirements of vitamin A for adults and children. Besides, these foods are very accessible due to their

  17. Fatores socioeconômicos da produção de queijo minas frescal em agroindústrias familiares de Viçosa, MG Socioeconomic factors in the production of fresh cheese in family agribusiness of Viçosa, MG, Brazil

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    Mariana Barboza Vinha

    2010-09-01

    Full Text Available A produção de queijo minas frescal em agroindústrias familiares é amplamente difundida no Estado de Minas Gerais (MG associada à tradição cultural, à demanda do consumidor e ao rendimento do produto. Os objetivos deste estudo foram avaliar aspectos socioeconômicos da produção de queijos minas frescal fabricados em agroindústrias familiares no município de Viçosa-MG e caracterizar as principais dificuldades do setor. Os dados foram levantados pelo método de entrevista in loco em 12 agroindústrias, seis inspecionadas e seis não inspecionadas A renda do produtor familiar proveniente da produção do queijo minas frescal variou de 10 a 85% do total da renda familiar, com maiores percentuais para as agroindústrias inspecionadas. Em 83% das agroindústrias inspecionadas, a renda total era vinculada principalmente à produção do queijo. Os entraves na produção formal incluíram a competição com produtos informais, o baixo preço e a dificuldade de acesso a linhas de crédito e, para os produtores informais, incluíram escassez de matéria-prima e de mão de obra, variação sazonal da produção e ausência de infraestrutura adequada para produção. A produção de queijo minas frescal é uma atividade relevante na composição da renda familiar das agroindústrias, entretanto há necessidade de implementação de políticas públicas locais para melhor estruturação do setor, o que contribuirá para a sustentabilidade da produção familiar.The production of minas frescal cheese in familiar agribusiness is widely diffused in Minas Gerais State, associated to cultural tradition, consumer demand and product yield. The objectives of this study were to evaluate socioeconomic aspects on the production of minas frescal cheese produced in familiar agroindustries in the city of Viçosa-MG, Brazil and to characterize the main difficulties in this sector. Data were collected by the in loco interview method in 12 agribussiness, six of

  18. Análisis del éxito de incubación de la tortuga lora (Lepidochelys olivacea) en función del manejo de los nidos. Península de Osa, Costa Rica

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    Malmierca Pérez, Atenea

    2018-01-01

    En este trabajo de final de grado se expone un análisis del éxito de incubación (éxito de eclosión y éxito de emergencia) de la tortuga lora (Lepidochelys olivacea) en las playas Carate y La Leona (Península de Osa, Costa Rica), según los diferentes métodos de manejo de nidos realizados (nidos in situ, nidos reubicados en playa y nidos reubicados en el vivero). El objetivo principal de este trabajo es ver si tanto el manejo de los nidos, como la temperatura de la arena y el recubrimiento h...

  19. El Trabajo Comunitario en la Comunidad Montañosa de Jibacoa: Acciones de Recreación Física y Cultura Artística y Literaria

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    Javier Rodríguez Galindo

    2009-12-01

    Full Text Available En nuestro país, Cuba, se brinda gran atención al mejoramiento de la calidad de vida de los habitantes de las comunidades ubicadas en los cuatros macizos montañosos a través del Programa de montaña conocido como Plan Turquino; específicamente en nuestra provincia se ha logrado resultados significativos en los programas socio- culturales dirigidos a tales fines. Nuestra investigación se ha encaminado al estudio de la Recreación Física y la Cultura Artística y Literaria en la comunidad montañosa de Jibacoa. Las bases que nos antecedieron sobre esta temática nos muestra las insuficiencias en la integración entre los profesionales de la cultura física, promotores culturales y otros gestores del trabajo comunitario en la realización de las actividades recreativas y artísticas, la poca diversidad de las propuestas que se ofertan a la población, en especial a niñas y niños, insuficiente aprovechamiento del medio natural para la realización de las actividades, así como por las exigencias actuales de brindarles a las niñas y niños opciones recreativas en vistas del logro de una cultura general integral. Para llevar a cabo todo un proceso de recopilación de información se han aplicado diferentes métodos como: observación, encuestas, así como la aplicación de diferentes técnicas grupales, las cuales nos permitieron conocer el estado actual de la recreación en la comunidad montañosa de Jibacoa, enfatizando en la presencia de elementos físicos recreativos y artísticos y literarios. Dicha constatación nos colocan en la propuesta de un plan de acciones en correspondencias con los gustos y preferencias de las niñas y niños de la comunidad en estudio, la cual después de ser validada por parte del Grupo de Trabajo y otros Evaluadores Externos se llevo a la Práctica, logrando los criterio por parte de la comunidad, para estar en condiciones de una nueva planificación.

  20. Equação de biomassa e estoque de carbono do pinhão manso, no município de Viçosa, MG Biomass equation and carbon stock of jatropha crop, in Viçosa, Minas Gerais, Brazil

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    Diego de Paula Toledo

    2012-11-01

    Full Text Available O presente trabalho teve como objetivo estimar equações de biomassa e o estoque de carbono da cultura do Pinhão Manso (Jatrophacurcas L.. A área estudada localiza-se no município de Viçosa, MG. O plantio foi realizado em espaçamento 3,5x3,0m, em 4,64ha. Para quantificação da biomassa, foi utilizado o método direto e destrutivo, aplicado às árvores-amostra, que foram selecionadas de acordo com as medidas da altura, do diâmetro das copas e do número de ramos. A determinação da biomassa de cada árvore foi obtida pelo método da proporcionalidade. Os modelos testados foram adaptados de Spurr e de Schumacher & Hall, para biomassa aérea e biomassa total (biomassa aérea mais biomassa de raízes pivotantes. O estoque de carbono foi estimado através da multiplicação da biomassa seca pelo teor de carbono da matéria seca, que foi obtido pelo método da calcinação em mufla. A estimativa do CO2 equivalente estocado foi obtida pela multiplicação do estoque de carbono pelo fator 44/12. A equação que obteve melhor ajuste e que foi utilizada para determinação do estoque de carbono deste estudo foi a de Spurr, com os dados de biomassa total, B=0,7601*(DC2*H0,8949, em que B = biomassa (kg; DC = diâmetro de copa (m; e H = altura (m. O estoque de carbono encontrado da cultura, no quarto ano, foi de 6,79MgC ha-1, correspondendo a 24,89Mg CO2(eq ha-1. Os resultados mostram que o pinhão-manso é ambientalmente viável para elaboração de projetos MDL de florestamento/reflorestamento ou em projetos de carbono para mercados voluntários, agregando renda ao produtor rural e melhorando a atratividade financeira da cultura.This study had the objectives to estimate equations of biomass and carbon stock of Jatropha (Jatrophacurcas L.. The area of this study is located in Viçosa, Minas Gerais, planting carried out in 3.5x3.0m spacing at 4.64ha. To biomass quantification, we used the direct destructive method, applied to trees, which were

  1. Desenvolvimento dos frutos de lulo (Solanum quitoense LAM, em Viçosa-MG

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    Pedro Henrique Monteiro Matarazzo

    2013-03-01

    Full Text Available O lulo é um fruto tropical e exótico, originário dos Andes, tem cor laranja quando maduro, e é uma baga globosa, assemelha- se a um tomate, o epicarpo é grosso e coriáceo, sua polpa é verde-clara, pegajosa, ácida e suculenta, contendo muitas sementes. Objetivou-se acompanhar as características físicas, químicas e fisiológicas ocorridas durante o desenvolvimento do fruto de lulo, da antese ao amadurecimento completo, em Viçosa-MG. Os frutos apresentaram um padrão de crescimento sigmoidal simples em resposta à variação do tempo. O desenvolvimento do fruto foi dividido em três fases. A primeira foi até os 7,39 dias após a antese (DAA, sendo caracterizada pela alta taxa respiratória, provavelmente devido à intensa multiplicação celular, e o pericarpo apresentava coloração verde-clara. A segunda fase estendeu-se a partir dos 7,39 até os 57,63 DAA, sendo caracterizada pelas taxas máximas das características estudadas. A taxa respiratória cresceu até 45 DAA, mantendo-se estável até os 52 DAA. A última fase estendeu-se a partir dos 57,63 DAA até os 95,00 DAA. Essa fase foi caracterizada pela estabilização nas dimensões e no acúmulo de massa fresca. Nesse período, ocorreu a ascensão climatérica (dos 52 aos 59 DAA. O climatério respiratório ocorreu aos 66 DAA, com pico de produção de CO2 de 110,99 mg de CO2 kg-1h-1. O pós-climatério ocorreu dos 73 aos 95 DAA, quando houve aumento no teor de sólidos solúveis e queda da acidez titulável e vitamina C da polpa. Nessa fase, o pericarpo dos frutos apresentava-se com coloração alaranjada.

  2. Sensory analysis and volatile compounds of olive oil (cv. Cobrançosa from different irrigation regimes

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    Fernandes-Silva, A. A.

    2013-03-01

    Full Text Available The aim of this study was to assess the effect of different irrigation strategies on the sensory quality of virgin olive oil (VOO from the cv. “cobrançosa” integrated into a protected denomination of origin of “Azeite de Trás-os-Montes” in the Northeast of Portugal. Three irrigation treatments were applied: (T2-full irrigation, which received a seasonal water equivalent of 100% of the estimated crop evapotranspiration (ETc, (T1-continuous deficit irrigation (30% ETc and (T0- rainfed treatment. Data were collected from two consecutive crop years (2005-2006. Olive oil samples were analyzed for volatiles by GC-MS and the results compared with sensory evaluation data. Total volatile compounds tended to decrease with the amount of water applied. The characteristics pungent and bitter were more pronounced in olive oils from T0 and T1, which had higher polyphenolic concentrations, with a strong positive relationship with this variable and the bitter attribute. The Principal Components Analysis clearly separates the three olive oils from 2005, the driest year, and aggregates into a single group the three samples from 2006, suggesting no effect of irrigation on volatile compounds in years with a rainy spring and a marked effect in years with severe drought, suggesting that the effect of the trees’ water status on these variables occurs throughout the crop season and not just during the oil accumulation phase. In general, olive oil from the cv. Cobrançosa is more bitter than pungent and has a typical nutty sensory attribute shown by a strong positive relationship between benzaldehyde and the sensory notes of almonds and nuts.

    Este estudio tiene como objetivo evaluar el efecto de distintas estrategias de riego en la composición relativa de los compuestos volátiles y en la calidad sensorial. El experimento se realizó en el Noreste de Portugal, dentro de la denominación de origen protegida “Azeites de Tr

  3. Regeneración natural de plantas leñosas en una plantación costarricense de Vochysia guatemalensis (Vochysiaceae y el efecto de la fertilización con P y NPK

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    José Fco Di Stefano

    2009-11-01

    Full Text Available Las estrategias de manejo y las especies seleccionadas en plantaciones forestales pueden tener efectos positivos o negativos sobre la regeneración vegetal en los trópicos. Esta investigación estudió la abundancia y riqueza de plantas leñosas bajo el dosel de un monocultivo de Vochysia guatemalensis de diez años. Se evaluaron 19 parcelas de 80 m²en Tabarcia de Mora, con varios tratamientos de fertilización (0-0; 0-50; 50-0, 50-50 g/ planta de P, y NPK, respectivamente, este ultimó se aumentó de 150 a 200 g hasta que la plantación alcanzó los seis años, en un diseño factorial totalmente al azar. Se contaron e identificaron todas las especies leñosas con más de 0.5 m de altura, con un total de aproximadamente 10 000 ind/ha en 90 especies, siendo éstas principalmente nativas de la zona (varias maderables, otras importantes para la fauna, la mayoría con bajos índices de importancia (suma de la densidad y frecuencias relativas. Un 16% alcanzaron alturas superiores a 2.5 m. Se considera que varios factores pudieron favorecer dicha regeneración, como un dosel con una apertura inter-media, un manejo forestal de bajo impacto, la cercanía de un fragmento boscoso maduro, y el establecimiento de la plantación en sustitución de un cafetal donde se aplicaban estrategias de conservación de suelos y se fertilizaba anualmente. Finalmente, se determinó una mayor abundancia y riqueza en las parcelas con solo P (χ²=15.364, gl=3, p=0.002, probablemente porque los árboles de Vochysia tendieron a ser menos desarrollados en comparación con los otros tratamientos.

  4. Composição florística de uma floresta estacional semidecidual montana no município de Viçosa-MG Floristic composition of a montane seasonal semideciduous tropical forest in Viçosa, MG, Brasil

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    João Augusto Alves Meira-Neto

    2002-08-01

    Full Text Available O objetivo do presente estudo foi investigar a composição florística arbórea da Mata da Silvicultura (20º45'S e 42º55'W, município de Viçosa, Zona da Mata de Minas Gerais, com o intuito de avaliar sua similaridade com outras florestas. Para comparação florística foi utilizada a análise de agrupamentos pelo método de médias aritméticas não-ponderadas (UPGMA, a partir dos índices binários de similaridade de Sørensen entre as florestas comparadas. Foram relacionadas 154 espécies de 47 famílias botânicas para a Mata da Silvicultura. Esta mata mostrou-se mais similar às florestas semideciduais de altitude de Lavras (MG e de Atibaia (SP e menos similar às florestas submontanas e litorâneas. Estes resultados evidenciam uma importante influência das temperaturas na determinação do tipo florístico das florestas do Sudeste e Sul brasileiros.This study aims to investigate the floristic composition of the Silvicultura forest (20º45`S and 42º55´W by comparing it to other forest compositions. Thus, the cluster analysis method of unweighted pair-group using arithmetic averages (UPGMA was used, applying the Sørensen binary similarity index found among compared forests. A list of 154 species of 47 families was recorded. The Silvicultura forest is more similar to the montane semideciduous forests of Lavras and Atibaia, but less similar to submontane and coastal forests. These results show that temperature plays an important role in the floristic differentiation of the southern and southeastern Brazilian forest types.

  5. STUDY OF THE SITUATION OF MASS MOVEMENTS IN THE URBAN AREA OF VIÇOSA (MG

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    Fernando Lucci Resende de Souza

    2005-05-01

    Full Text Available The understanding of the relief goes by something larger than the observation at the way, understanding several other factors as climate, soil types and vegetable covering. However, the forms of the relief interfere as one of the main components of the atmosphere,being necessary its knowledge for the understanding of the dynamics of the area research object.The agreement of the relief passes for something more important that the comment of its form, understanding several other factors as climate, soil types and vegetal covering. However, the forms of the relief are inserting as the one of the main components of theenvironment, being necessary its knowledge for the agreement of the dynamic of the area research object.This knowledge is indispensable, because it is impossible to repress the occupation expansion of the spaces and much less to restraint environmental impacts caused by the men and the nature is not capable to regenerate all of the damaged spaces in a short space of time.Many of the inhabited spaces are fruits of segregation, which would be consequence of the exclusion that the effective economical system imposes to the people and spaces. On the other hand, the environmental problems are not correlated only with outlying neighborhoods, but they come very visible in places where constructions of high purchasing power prevail. But, one thing we can do is to prevent, the areas that are not busy, because it is viable naturally,environmentally and less expensive economically speaking. It is in this context, which the study of the mass movements can be of vital importance. The present work seeks to characterize the mass movements that happen in the urban area of Viçosa, with the objective to relate and to compare the rising done in the urban area of the municipal district at the scale 1: 5000 for Vieira in the year of 2000, in order to verify the evolution of the areas studied by the referred author, being analyzed these progressed or some

  6. Implantação e impacto do Programa Nacional de Suplementação de Ferro no município de Viçosa - MG Implementation and impact of the National Iron Supplementation Program in the city of Viçosa, State of Minas Gerais

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    Catarina Machado Azeredo

    2011-10-01

    Full Text Available Objetivou-se avaliar a implantação do Programa Nacional de Suplementação de Ferro no município de Viçosa/MG e seu impacto em lactentes não anêmicos de 6 a 18 meses de idade, atendidos pelas Equipes de Saúde da Família. Realizou-se entrevistas aos profissionais de nível superior e às mães/responsáveis pelas crianças. As crianças não anêmicas e que não recebiam suplementação anteriormente (n=133 foram suplementadas com xarope de sulfato ferroso por seis meses. Realizou-se dosagem de hemoglobina, avaliação antropométrica e de condições socioeconômicas, antes e após os seis meses. Classificou-se como alta adesão as crianças que ingeriram 75% ou mais da dose prescrita e como baixa adesão as demais, de acordo com o referido pelas mães. Sobre a implantação do PNSF no município, observou-se que o sistema de distribuição nem sempre foi acessível ao grupo prioritário e houve ausência de capacitação e motivação da maioria dos Agentes Comunitários de Saúde; sobre o grupo prioritário observou-se ausência de divulgação para promoção do PNSF, além de sensibilização e educação somente de parte das mães; quanto ao suplemento as crianças tiveram baixa adesão e a dosagem não foi efetiva na prevenção da anemia. Portanto, a implantação do PNSF no município revelou entraves operacionais importantes.The scope of this work was to evaluate the implementation of the National Iron Supplementation Program (NISP in Viçosa in the State of Minas Gerais and its impact on 6- to 18-month-old non-anemic infants assisted by the Family Health Teams. Interviews were conducted with the professionals and with the children's mothers/guardians. The non-anemic children who didn't receive the earlier supplementation (n=133 were given ferrous sulphate syrup for six months. Hemoglobin dosage, anthropometric evaluation and a socioeconomic survey were conducted before and after the six-month period. Children who ingested 75

  7. Composição florística de dois trechos em diferentes etapas serais de uma floresta estacional semidecidual em Viçosa, Minas Gerais Floristic composition of two sites different seral stages of semideciduous seasonal montane forest in Viçosa, Minas Gerais

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    Rogério Ferreira Ribas

    2003-12-01

    Full Text Available O presente estudo foi desenvolvido em dois trechos de floresta semidecídua, com diferentes estádios de sucessão secundária, localizada no município de Viçosa-MG, objetivando verificar variações qualitativas na composição florística. Foram demarcadas, em cada trecho, dez parcelas de 10 x 20 m, nas quais foram inventariados todos os indivíduos lenhosos com circunferência à altura de 130 cm do solo maior ou igual a 5 cm. A similaridade florística entre as parcelas foi avaliada por meio de análise de agrupamentos, utilizando o índice de Sørensen. Foram amostradas 67 espécies no trecho com 15 anos e 69 no trecho com 30 anos. Dentre as espécies exclusivas, 38 foram para o trecho com 15 anos e 40 para o trecho com 30 anos. As famílias Annonaceae, Leguminosae Caesalpinioideae e Sapindaceae, com cinco, quatro e quatro espécies cada, respectivamente, e o gênero Nectandra, com duas espécies, foram os taxa mais bem representados no trecho com 15 anos. Por outro lado, as famílias Flacourtiaceae, Meliaceae e Myrtaceae, com quatro, três e quatro espécies, respectivamente, e o gênero Ocotea, com três espécies, foram mais bem representados no trecho com 30 anos. A similaridade florística entre parcelas de um mesmo trecho foi considerada alta, tendo sido relacionada à proximidade espacial, o que implica históricos de perturbação e regeneração semelhantes, resultando, conseqüentemente, em composições florísticas mais similares e mesmo estádio de sucessão secundária.This study was carried out in two sites of a semideciduous forest, under different stages of secondary succession in Viçosa, MG to verify qualitative variations in floristic composition. In each site, ten plots of 10 m x 20 m were delimited, with all woody individuals with circumference at 130 cm height from the soil larger than or equal to 5 cm being listed. Floristic similarity among parcels was evaluated through clustering analysis, using the S

  8. Diagnosis of health-related physical fitness in office workers of the Federal University of Viçosa

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    Cristiano Diniz da Silva

    2004-06-01

    Full Text Available The behavioral demands and the particularities of the activities performed by the employees from offices at the Federal University of Viçosa can offer a series of negative factors for health. The interface with the computer and task characteristics give a great body and also cognitive demands, that allied to several factors can represent the appearance or worsening repetitive lesions and/or work related problems in the skeletal muscle (Cumulative Trauma Disorders . This study aimed to diagnose the workers’ situation in relation to General Human Factors (GHF and level of Health-Related Fitness (HRFcomponents: cardiorrespiratory; flexibility; strength and percent of body fat. The sample was composed by 46 workers. For both sexes, the GHF variables of higher significance were: “posture perception”; “sensation of local pains and those from some movement or task” in the back, shoulders and arms areas. Referring to HRF, both sexes presented unsatisfactory levels for trunk-hip flexibility “ and great part of men were classified as” below average “ in the push-up test” which are risk factors for CTD. Significant portion of them presented high percent of body fat (25,0% or were “obese” (14,2%. In general terms of HFR, there should be interventions, such as physical activity and/or sports programs for this group of employees at this institution. It is suggested that actions should also be taken in the leisure activity offering, once it was shown that 39,2% of the men and 44,4% of the women have in TV their main leisure activity. RESUMO As exigências comportamentais e as particularidades das atividades desenvolvidas pelos funcionários de alguns setores caracterizados como escritórios da Universidade Federal de Viçosa podem estar potencializando uma série de fatores negativos para a saúde destes. A interface com o computador e a característica da tarefa levam a uma forte exigência física e também cognitiva, que aliadas a

  9. Obstructive Sleep Apnea

    Science.gov (United States)

    ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

  10. Influence of environmental variables on the shrub and tree species distribution in two Semideciduous Forest sites in Viçosa, Minas Gerais, Brazil.

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    Pinto, Sheila Isabel do C; Martins, Sebastião V; de Barros, Nairam F; Dias, Herly Carlos T; Kunz, Sustanis H

    2008-09-01

    The floristic variations of shrub and tree components were studied in two sites of Semideciduous Forest, initial forest and mature forest, located in the Mata do Paraíso Forest Reserve, in Viçosa, State of Minas Gerais, Southeastern Brazil, in order to analyze the floristic similarity and the correlations between environmental variables and the distribution of tree species in these forests. Individual trees with a diameter at breast height (DBH) > or = 4.8 cm were sampled in twenty 10 x 30 m plots (10 plots in each site). The plots were distributed systematically at 10 m intervals. The environmental variables analyzed were: the canopy openness and soil chemical and texture characteristics. The two forest sites showed clear differences in the levels of canopy openness and soil fertility, factors that reflect the floristic and successional differences of the shrub and tree component, revealed by the low similarity between these forests by cluster analysis. The canonical correspondence analysis (CCA) of environmental variables and species abundance indicated that the species in these forests studied are distributed under strong influence of canopy openness, moisture and soil fertility.

  11. Head, Neck, and Oral Cancer

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    Full Text Available ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

  12. Administration of Anesthesia

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    Full Text Available ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

  13. Corrective Jaw Surgery

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    Full Text Available ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

  14. Obstructive Sleep Apnea

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    Full Text Available ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

  15. Workplace worries: a preliminary look at online sexual activities at the office-emerging issues for clinicians and employers.

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    Cooper, Al; Safir, Marilyn P; Rosenmann, Amir

    2006-02-01

    Concerns about the impact of online sexual activities (OSA) on work-life are drastically increasing. This study examined 3,466 respondents who reported OSA, 18.5% of whom reported engaging in OSA at work. They were compared with the 81.5% who engaged in OSA at home, on average time spent in OSA, workplace policies regarding OSA, and relationship status. Two themes were identified and discussed: opportunity and sexual distress. Our findings indicate that participants are cognizant of issues of opportunity (e.g., the OSA from home group was more likely to indicate their workplace has established policies regarding OSA), and privacy, representing an important aspect of this theme (e.g., participants engaging in OSA at work were found to be twice as likely to have extra-marital affairs, compared with the OSA from home group). Secondly, our data suggests that many participants, especially from the OSA at work group, experience OSA-related distress. Engaging in OSA at the workplace may result in decreased productivity, issues of sexual harassment, and concerns about employee well-being. Clearly stated and consistently enforced policies regulating OSA are likely to mitigate workplace OSA. However, a significant minority of employees may have difficulties curbing OSA. Therefore, more sophisticated strategies to deal with workplace OSA should be established. Additional implications of importance for organizations and mental health professionals who support them are discussed.

  16. Mapping Tropical Forest Mosaics with C- and L-band SAR: First Results from Osa Peninsula, Costa Rica

    Science.gov (United States)

    Pinto, N.; Hensley, S.; Aguilar-Amuchastegui, N.; Broadbent, E. N.; Ahmed, R.

    2016-12-01

    In tropical countries, economic incentives and improved infrastructure are creating forest mosaics where small-scale farming and industrial plantations are embedded within and potentially replacing native ecosystems. Practices such as agroforestry, slash-and-burn cultivation, and oil palm monocultures bring widely different impacts on carbon stocks. Characterizing these production systems is not only critical to ascribe deforestation to particular drivers, but also essential to understand the impact of macroeconomic scenarios, national policies, and land tenure schemes on carbon fluxes. The last decade has experienced a dramatic improvement in the extent and consistency of tree cover and gross deforestation products from optical imagery. At the same time, recent work shows that Synthetic Aperture Radar (SAR) can complement optical data and reveal structural types that cannot be easily resolved with reflectance measurements alone. While these results demonstrate the validity of sensor fusion methodologies, they typically rely on local classifications or even manual delineation and as such they cannot support large-scale investigations. Furthermore, there have been few attempts to exploit PolInSAR or multiple wavelengths that can provide critical information to resolve natural and anthropogenic land cover types. We report results from our research at Costa Rica's Osa Peninsula. This site is ideal for algorithm development as it includes a highly diverse tropical forest within Corcovado National Park, as well as agroforestry zones, mangroves, and palm plantations. We first integrate SAR backscatter and coherence data from NASA's L-band UAVSAR, JAXA's ALOS/PALSAR, and ESA's Sentinel to produce a map of structural types. Second, we assess whether coherence measurements and PolInSAR retrievals can be used to resolve forest stand differences at 30m resolution and disitinguish between primary and secondary forest sites.

  17. Social Representations of the Artisan Work: Study of Case of an Association of Craftsmen in Viçosa, Minas Gerais – Brazil

    Directory of Open Access Journals (Sweden)

    Alair Ferreira de Freitas

    2010-07-01

    Full Text Available This article aims to analyze the social representations of small-scale artisans working for associated Association of Artisans and food producers Homemade of Viçosa, Minas Gerais State-Brazil (Adapac. To this end we have tried to identify and analyse the trajectory of the craftsmen and the reasons for becoming involved with crafts and renditions of the craft for craftsmen linked to this Association. The methodological strategy adopted for the research consisted in case study. As an instrument of data collection, were used to survey participant and application of semi-structured interviews. The method of "content analysis" was used in the Organization and analysis of data. For discussion of the results were defined two categories: (i motivations for the craft and (ii representations of the craft. The results show that this type of work associates itself as the premier opportunity to occupation and income generation found by some members and another as vocation and manual skills. For women the social representations of craft relate the condition of personal satisfaction and possibility of reconciliation with the domestic activities, while for men representations indicate the enhancement of the economic dimension of the craft, distinguishing it from domestic activities.

  18. Role of spousal involvement in continuous positive airway pressure (CPAP adherence in patients with obstructive sleep apnea (OSA

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    Batool-Anwar S

    2017-05-01

    Full Text Available Introduction: Little is known about the impact of spousal involvement on continuous positive airway pressure (CPAP adherence. The aim of this study was to determine whether spouse involvement affects adherence with CPAP therapy, and how this association varies with gender. Methods: 194 subjects recruited from Apnea Positive Pressure Long Term Efficacy Study (APPLES completed the Dyadic Adjustment Scale (DAS. The majority of participants were Caucasian (83%, and males (73%, with mean age of 56 years, mean BMI of 31 kg/m2. & 62% had severe OSA. The DAS is a validated 32-item self-report instrument measuring dyadic consensus, satisfaction, cohesion, and affectional expression. A high score in the DAS is indicative of a person’s adjustment to the marriage. Additionally, questions related to spouse involvement with general health and CPAP use were asked. CPAP use was downloaded from the device and self-report, and compliance was defined as usage > 4 h per night. Results: There were no significant differences in overall marital quality between the compliant and noncompliant subjects. However, level of spousal involvement was associated with increased CPAP adherence at 6 months (p=0.01. After stratifying for gender these results were significant only among males (p=0.03. Three years after completing APPLES, level of spousal involvement was not associated with CPAP compliance even after gender stratification. Conclusion: Spousal involvement is important in determining CPAP compliance in males in the 1st 6 months after initiation of therapy but is not predictive of longer-term adherence. Involvement of the spouse should be considered an integral part of CPAP initiation procedures.

  19. Patrones de riqueza altitudinal de Papilionidae, Pieridae y Nymphalidae (Lepidoptera: Rhopalocera en áreas montañosas de México

    Directory of Open Access Journals (Sweden)

    David

    2013-09-01

    Full Text Available Las mariposas diurnas integran uno de los grupos más utilizados para el reconocimiento y monitoreo de la diversidad de una biota. Se realizó un estudio comparativo de las faunas de mariposas de las familias Papilionidae, Pieridae y Nymphalidae de cinco áreas montañosas de México, situadas en las vertientes Atlántico y Pacífico: las sierras de Atoyac de Álvarez, Manantlán, Juárez, y las áreas de Teocelo-Xalapa y la región Loxicha, con un total de 34 localidades representativas de los cinco transectos altitudinales, que comprenden de los 300 a los 3 100m de altitud. Se observó una tendencia general a la disminución de la riqueza con la altitud. Se analizó la similitud entre el total de localidades mediante el índice de Sørensen, diferenciándose en primer lugar las dos estaciones de elevaciones superiores (sobre los 2 500msnm, caracterizadas por pobres lepidóptero-faunas. En el grupo principal (32 sitios las principales agrupaciones se dan de acuerdo, en primer lugar, a la pertenencia a la vertiente pacífica o atlántica, evento más histórico que ecológico y, después, las estaciones de una misma sierra o según tres diferentes pisos altitudinales, que se caracterizan de acuerdo con los táxones predominantes.

  20. Calidad nutricional y digestibilidad in situ de ensilajes de cuatro leñosas forrajeras

    Directory of Open Access Journals (Sweden)

    María Ligia Roa

    Full Text Available Se evaluó el efecto del tiempo de conservación en la calidad nutricional y la digestibilidad in situ de ensilajes de cuatro plantas leñosas forrajeras: Cratylia argentea (T1, Hibiscus rosa-sinensis (T2, Trichanthera gigantea (T3 y Tithonia diversifolia (T4. Las plantas fueron podadas a los seis meses de establecidas y a los tres meses de rebrote, y se utilizaron las hojas y ramas tiernas pequeñas para confeccionar 64 silos de 10 kg, en bolsas plásticas. Cada tiempo de conservación (0, 30, 60 y 90 días tuvo cuatro repeticiones. Para calcular la digestibilidad de la MS, el NT y la FDN y los parámetros de la digestibilidad efectiva (DE, se utilizaron cuatro bovinos fistulados en el rumen, distribuidos en un diseño cuadrado latino 4 x 4. Los ensilajes presentaron aspecto y olor agradables, con pH entre 4,2 y 4,6 y nitrógeno amoniacal menor que 1 %. El porcentaje de NT fue mayor para T1 (2,52 y T2 (2,43, y este nutriente se redujo hasta los 90 días. La DE de la MS, el NT y la FDN fue superior (p < 0,05 en T2, con tendencia a disminuir con el tiempo de conservación (90 días. Este mismo comportamiento presentaron las fracciones A, B y c. El mayor contenido de lignina se resentó en T3 (5,45 % y T4 (5,60 %, indicador que afectó de manera negativa la cinética ruminal. La disminución de la calidad nutricional y la digestibilidad por el tiempo de conservación fue menor para T2 y T3. Se concluye que las propiedades órganolepticas de los ensilajes fueron óptimas, el nitrógeno amoniacal no superó el 1% y el ácido láctico varió entre 1,0 y 3,6 %; mientras que el tiempo afectó en menor grado la composición nutricional del ensilaje de H. rosa-sinensis, con respecto a las otras forrajeras. Se recomienda ensilar para la época de seca y utilizar los ensilajes antes de los 60 días de conservación.

  1. Clinical, polysomnographic, and CPAP titration features of obstructive sleep apnea: Mixed versus purely obstructive type.

    Science.gov (United States)

    Lee, Sang-Ahm; Lee, Gha-Hyun; Chung, Yoo-Sam; Kim, Woo Sung

    2015-08-15

    To determine whether obstructive sleep apnea syndrome (OSAS) patients with mixed sleep apnea (MSA) have different clinical, polysomnographic, and continuous positive airway pressure (CPAP) titration findings compared to OSAS patients without MSA. We retrospectively reviewed the records of OSAS patients who had undergone CPAP titration and categorized them into pure-OSA and mixed-OSA groups. Demographic features, daytime sleepiness, and apnea severity were compared between the two groups using univariate and multivariate analyses. CPAP titration findings were also compared between the two groups. One hundred and ninety-five subjects (n=126 pure-OSA; n=69 mixed-OSA) were included in the analysis. Compared to the pure-OSA group, the mixed-OSA group had a higher percentage of males (p=0.003) and a higher body mass index (p=0.044), Epworth Sleepiness Scale score (p=0.028), and apnea-hypopnea index (AHI) (ptitration, and a higher titrated pressure than the pure-OSA group. Severe OSA, older age, male sex, obesity, and daytime sleepiness were related to mixed-OSA. Complex sleep apnea, less optimal titration, and a higher titrated CPAP were also associated with MSA in OSAS patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. O papel das franquias na reestruturação das cidades: a ascensão do setor em Viçosa – MG

    Directory of Open Access Journals (Sweden)

    Rodrigo Moraes Fritz

    2017-12-01

    Full Text Available No estágio atual do sistema capitalista no mundo, as estratégias dos agentes econômicos para sobreviverem no mercado se fazem cada vez mais notórias. Tida como uma modernização na forma de vender e comprar, o Franchising vem se destacando em todo mundo e sendo fator importante na economia dos países. As franquias são muito presentes em realidades urbanas complexas, como as metrópoles, porém, nos últimos anos, nota-se sua difusão para centros urbanos intermediários, particularmente em cidades consideradas como médias, que possuem certo grau de influência regional. A cidade de Viçosa, localizada na Zona da Mata mineira, faz parte desse conjunto de cidades que, pela centralidade que exercem, atraem capitais, pessoas e mercadorias. O crescente número de franquias na cidade em questão despertou o interesse em caracterizá-las e entendê-las do ponto de vista da sua espacialidade, bem como do potencial que apresentam para promover mudanças na estrutura urbana, já que elas são indutoras de investimentos, reestruturações e, principalmente, de centralidade.

  3. Obstructive sleep apnea combined dyslipidemia render additive effect on increasing atherosclerotic cardiovascular diseases prevalence.

    Science.gov (United States)

    Cao, Zhiyong; Zhang, Ping; He, Zhiqing; Yang, Jing; Liang, Chun; Ren, Yusheng; Wu, Zonggui

    2016-05-26

    Current study was designed to investigate the effects of obstructive sleep apnea (OSA) combined dyslipidemia on the prevalence of atherosclerotic cardiovascular diseases (ASCVD). This was a cross-sectional study and subjects with documented dyslipidemia and without previous diagnosis of OSA were enrolled. Polysomnography was applied to evaluate apnea-hypopnea index (AHI). Based on AHI value, subjects were classified into four groups: without OSA, mild, moderate and severe OSA groups. Clinical characteristics and laboratory examination data were recorded. Relationship between AHI event and lipid profiles was analyzed, and logistic regression analysis was used to evaluate the effects of OSA combined dyslipidemia on ASCVD prevalence. Totally 248 subjects with dyslipidemia were enrolled. Compared to the other 3 groups, subjects with severe OSA were older, male predominant and had higher smoking rate. In addition, subjects with severe OSA had higher body mass index, waist-hip ratio, blood pressure, and higher rates of overweight and obesity. Serum levels of fasting plasma glucose, glycated hemoglobin, LDL-C and CRP were all significantly higher. ASCVD prevalence was considerably higher in subjects with severe OSA. AHI event in the severe OSA group was up to 35.4 ± 5.1 events per hour which was significantly higher than the other groups (P dyslipidemia plus no-OSA group (reference group), OSA enhanced ASCVD risk in subjects with dyslipidemia, regardless of OSA severity. After extensively adjusted for confounding variables, the odds of dyslipidemia plus mild-OSA was reduced to insignificance. While the effects of moderate- and severe-OSA on promoting ASCVD risk in subjects with dyslipidemia remained significant, with severe-OSA most prominent (odds ratio: 1.52, 95% confidence interval: 1.13-2.02). OSA combined dyslipidemia conferred additive adverse effects on cardiovascular system, with severe-OSA most prominent.

  4. Evaluation studies on the combined effect of hydrothermal treatment and octenyl succinylation on the physic-chemical, structural and digestibility characteristics of sweet potato starch.

    Science.gov (United States)

    Lv, Qing-Qing; Li, Gao-Yang; Xie, Qiu-Tao; Zhang, Bao; Li, Xiao-Min; Pan, Yi; Chen, Han-Qing

    2018-08-01

    In order to increase the degree of substitution (DS), a combination of heat-moisture treatment (HMT) and octenyl succinylation (OSA) was used to modify sweet potato starch (SPS). The content of OSA had significant influence on the DS of starch, and DS of HMT OSA-modified SPS (HOSA-SPS) was higher than that of OSA-modified SPS (OSA-SPS), indicating that prior HMT could enhance the reaction. HOSA-SPS showed higher contents of SDS and RS in comparison with OSA-SPS as OSA concentration was beyond 6%. HMT decreased swelling power of starch while OSA modification had a contrary role (p < 0.05). Scanning electron microscopy (SEM) showed starch was destroyed by OSA modification while HMT had slight effect on the structure. X-ray diffraction (XRD) indicated that crystal type of starch was transformed from C- to A-type resulted from HMT, and remained unchanged by OSA modification. The onset, peak, and conclusion gelatinization temperatures of starch increased by HMT and decreased by OSA modification (p < 0.05). Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Rhythm disturbances in childhood obstructive sleep apnea during apnea-hypopnea episodes

    International Nuclear Information System (INIS)

    Khositseth, Anant; Chokechuleekorn, Jittamas; Kuptanon, Teeradej; Leejakpai, Anchalee

    2013-01-01

    Obstructive sleep apnoea (OSA) can result in cardiovascular complications. Nocturnal arrhythmias are reported up to 50% of adult OSA patients. Arrhythmias and heart rate variability in children with OSA have not been well studied. We sought to study rhythm disturbances in childhood OSA and also to analyze the relationship of heart rate variability to the severity of OSA in children. In a retrospective cross sectional study, records of children aged < 15 years with history of snoring and suspected OSA, who had undergone polysomnography (PSG) for first time were analyzed. The cardiac rhythm and heart rate variability were studied during PSG. A total of 124 patients diagnosed with OSA were grouped into mild (n = 52), moderate (n = 30), and severe (n = 42) OSA. During PSG, all had sinus arrhythmias and only three patients had premature atrial contractions (PACs). The standard deviation of heart rate (SD-HR) during rapid eye movement (REM) sleep in severe OSA (9.1 ± 2.4) was significantly higher than SD-HR in mild OSA (7.5 ± 1.3, P < 0.0001). The maximum heart rate (max-HR) during REM-sleep in severe OSA (132.1 ± 22.1) was significantly higher than the max-HR in mild OSA (121.3 ± 12.6 bpm, P = 0.016). There was no significant arrhythmia in children with OSA during their sleep. Heart rate variability correlated with the severity of OSA

  6. Obstructive sleep apnea and cortical thickness in females and males.

    Science.gov (United States)

    Macey, Paul M; Haris, Natasha; Kumar, Rajesh; Thomas, M Albert; Woo, Mary A; Harper, Ronald M

    2018-01-01

    Obstructive sleep apnea (OSA) affects approximately 10% of adults, and alters brain gray and white matter. Psychological and physiological symptoms of the disorder are sex-specific, perhaps related to greater injury occurs in female than male patients in white matter. Our objective was to identify influences of OSA separated by sex on cortical gray matter. We assessed cortical thickness in 48 mild-severe OSA patients (mean age±std[range] = 46.5±9.0[30.8-62.7] years; apnea-hypopnea index = 32.6±21.1[6-102] events/hour; 12 female, 36 male; OSA severity: 5 mild, 18 moderate, 25 severe) and 62 controls (mean age = 47.7±8.9[30.9-65.8] years; 22 female, 40 male). All OSA patients were recently-diagnosed via polysomnography, and control subjects screened and a subset assessed with sleep studies. We used high-resolution magnetic resonance imaging to identify OSA-related cortical thinning, based on a model with condition and sex as independent variables. OSA and OSA-by-sex interaction effects were assessed (Pfrontal lobe in female OSA vs. all other groups. Significant thinning within the pre- and post-central gyri and the superior temporal gyrus, extending into the insula, appeared between the general OSA populations vs. control subjects. No areas showed increased thickness in OSA vs. controls or positive female OSA interaction effects. Reduced cortical thickness likely represents tissue atrophy from long term injury, including death of neurons and supporting glia from repeated intermittent hypoxic exposure in OSA, although disease comordities may also contribute to thinning. Lack of polysomnography in all control subjects means results may be confounded by undiagnosed OSA. The greater cortical injury in cognitive areas of female OSA patients may underlie enhanced symptoms in that group. The thinning associated with OSA in male and females OSA patients may contribute to autonomic dysregulation and impaired upper airway sensori-motor function.

  7. Upper airway sensory function in children with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Tapia, Ignacio E; Bandla, Preetam; Traylor, Joel; Karamessinis, Laurie; Huang, Jingtao; Marcus, Carole L

    2010-07-01

    Children with the obstructive sleep apnea syndrome (OSAS) have impaired responses to hypercapnia, subatmospheric pressure, and inspiratory resistive loading during sleep. This may be due, in part, to an impairment in the afferent limb of the upper airway sensory pathway. Therefore, we hypothesized that children with OSAS had diminished upper airway sensation compared to controls. Case-control. Academic hospital. Subjects with OSAS aged 6-16 years, and age- and BMI-matched controls. Two-point discrimination (TPD) was measured during wakefulness with modified calipers in the anterior tongue, right interior cheek, and hard palate. Thirteen children with OSAS and 9 controls were tested. The age (mean +/- SD) for OSAS and controls was 11 +/- 4 vs. 13 +/- 2 years (NS); OSAS BMI Z score 2.4 +/- 0.5, controls 2.2 +/- 0.5 (NS); OSAS apnea hypopnea index 31 +/- 48, controls 0.4 +/- 0.5 events/hour (P Children with OSAS had impaired TPD in the anterior tongue (median [range]) = 9 [3-14] mm, controls 3 [1-7], P = 0.002) and hard palate (OSAS 6 [3-9] mm, controls 3 [1-4], P children with OSAS during wakefulness. We speculate that this impairment might be due to a primary sensory function abnormality or secondary to nerve damage and/or hypoxemia caused by OSAS. Further studies after treatment of OSAS are needed.

  8. Association of Canine Osteosarcoma and Monocyte Phenotype and Chemotactic Function.

    Science.gov (United States)

    Tuohy, J L; Lascelles, B D X; Griffith, E H; Fogle, J E

    2016-07-01

    Monocytes/macrophages are likely key cells in immune modulation in dogs with osteosarcoma (OSA). Increased peripheral monocyte counts are negatively correlated with shorter disease-free intervals in dogs with OSA. Understanding the monocyte/macrophage's modulatory role in dogs with OSA can direct further studies in immunotherapy development for OSA. That OSA evades the immune response by down-regulating monocyte chemokine receptor expression and migratory function, and suppresses host immune responses. Eighteen dogs with OSA that have not received definitive treatment and 14 healthy age-matched controls Clinical study-expression of peripheral blood monocyte cell surface receptors, monocyte mRNA expression and cytokine secretion, monocyte chemotaxis, and survival were compared between clinical dogs with OSA and healthy control dogs. Cell surface expression of multiple chemokine receptors is significantly down-regulated in peripheral blood monocytes of dogs with OSA. The percentage expression of CCR2 (median 58%, range 2-94%) and CXCR2 expression (median 54%, range 2-92%) was higher in control dogs compared to dogs with OSA (CCR2 median 29%, range 3-45%, P = 0.0006; CXCR2 median 23%, range 0.2-52%, P = 0.0007). Prostaglandin E2 (PGE2 ) (OSA, median 347.36 pg/mL, range 103.4-1268.5; control, 136.23 pg/mL, range 69.93-542.6, P = .04) and tumor necrosis factor-alpha (TNF-α) (P = .02) levels are increased in OSA monocyte culture supernatants compared to controls. Peripheral blood monocytes of dogs with OSA exhibit decreased chemotactic function when compared to control dogs (OSA, median 1.2 directed to random migration, range 0.8-1.25; control, 1.6, range of 0.9-1.8, P = .018). Dogs with OSA have decreased monocyte chemokine receptor expression and monocyte chemotaxis, potential mechanisms by which OSA might evade the immune response. Reversal of monocyte dysfunction using immunotherapy could improve survival in dogs with OSA. Copyright © 2016 The Authors. Journal of

  9. Obstructive Sleep Apnea and Retinopathy in Patients with Type 2 Diabetes. A Longitudinal Study

    Science.gov (United States)

    Altaf, Quratul A.; Dodson, Paul; Ali, Asad; Raymond, Neil T.; Wharton, Helen; Fellows, Hannah; Hampshire-Bancroft, Rachel; Shah, Mirriam; Shepherd, Emma; Miah, Jamili; Barnett, Anthony H.

    2017-01-01

    Rationale: Obstructive sleep apnea (OSA) is associated with several pathophysiological deficits found in diabetic retinopathy (DR). Hence, it’s plausible that OSA could play a role in the pathogenesis of sight-threatening DR (STDR). Objectives: To assess the relationship between OSA and DR in patients with type 2 diabetes and to assess whether OSA is associated with its progression. Methods: A longitudinal study was conducted in diabetes clinics within two U.K. hospitals. Patients known to have any respiratory disorder (including OSA) were excluded. DR was assessed using two-field 45-degree retinal images for each eye. OSA was assessed using a home-based multichannel cardiorespiratory device. Measurements and Main Results: A total of 230 patients were included. STDR and OSA prevalence rates were 36.1% and 63.9%, respectively. STDR prevalence was higher in patients with OSA than in those without OSA (42.9% vs. 24.1%; P = 0.004). After adjustment for confounders, OSA remained independently associated with STDR (odds ratio, 2.3; 95% confidence interval, 1.1–4.9; P = 0.04). After a median (interquartile range) follow-up of 43.0 (37.0–51.0) months, patients with OSA were more likely than patients without OSA to develop preproliferative/proliferative DR (18.4% vs. 6.1%; P = 0.02). After adjustment for confounders, OSA remained an independent predictor of progression to preproliferative/proliferative DR (odds ratio, 5.2; 95% CI confidence interval, 1.2–23.0; P = 0.03). Patients who received continuous positive airway pressure treatment were significantly less likely to develop preproliferative/proliferative DR. Conclusions: OSA is associated with STDR in patients with type 2 diabetes. OSA is an independent predictor for the progression to preproliferative/proliferative DR. Continuous positive airway pressure treatment was associated with reduction in preproliferative/proliferative DR. Interventional studies are needed to assess the impact of OSA

  10. Carotenos e provitamina A em bertalha e ervas aromáticas comercializadas em Viçosa, Estado de Minas Gerais, durante as quatro estações do ano - DOI: 10.4025/actascihealthsci.v28i1.1122 Carotenes and provitamin A in basella and aromatic herbs marketed in Viçosa, Minas Gerais State, during the four seasons of the year - DOI: 10.4025/actascihealthsci.v28i1.1122

    Directory of Open Access Journals (Sweden)

    José Benício Paes Chaves

    2006-03-01

    Full Text Available Este estudo teve como objetivos investigar o teor de α-caroteno, β-caroteno e calcular o valor de vitamina A em hortaliças comercializadas no mercado formal e informal de Viçosa, Estado de Minas Gerais, bem como avaliar a influência das quatro estações do ano e do local de comercialização sobre o conteúdo desses nutrientes. As hortaliças (bertalha, cebolinha, coentro, manjericão e salsa foram analisadas utilizando-se a cromatografia líquida de alta eficiência (CLAE. Devido ao conteúdo inexpressivo de α-caroteno em todas as amostras, foi possível quantificar apenas o β-caroteno. Não se verificou diferença estatisticamente significativa (α = 0,05 no conteúdo de β-caroteno das hortaliças entre os diferentes estabelecimentos, nem entre as estações do ano. As hortaliças mostraram-se excelentes fontes de provitamina A, e se consumidas regularmente, contribuem de forma importante na adequação diária de vitamina A para adultos e crianças. Além disso, esses alimentos são acessíveis à população por apresentarem baixo custo e serem facilmente encontrados.This study aimed to investigate the level of α-carotene, β-carotene and to calculate the value of vitamin A in vegetables sold at local markets and informal markets of Viçosa, Minas Gerais State, as well as to evaluate the seasonal and commercial effects on the content of these pigments. The vegetables (basella, green onion, cilantro, sweet basil and parsley were analyzed through high-performance liquid chromatography (HPLC, being β-carotene the only pigment present in all the analyzed samples. No significant statistical differences (α = 0.05 were found in the contents of β-carotene of the vegetables either among the different stores, or among the different seasons. The vegetables analyzed are great provitamin A sources and, if eaten on a regular basis, they can fit the daily requirements of vitamin A for adults and children. Besides, these foods are very

  11. Obstructive sleep apnoea is frequent in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Banghoej, Anne Margareta; Nerild, Henriette Holst; Kristensen, Peter Lommer

    2017-01-01

    mild OSA (60 patients (69%)). OSA was present in 32% of the patients with normal BMI, in 60% of overweight patients, and in 61% of obese patients. Patients with type 1 diabetes and OSA were largely asymptomatic and did not report more sleepiness than patients without OSA. At multivariate analysis, age......AIM: Obstructive Sleep Apnoea (OSA) is frequent in patients with type 2 diabetes. The aim of this study is to evaluate prevalence of OSA in patients with type 1 diabetes. METHODS: In a cross-sectional design, all patients with type 1 diabetes attending the outpatient clinic were offered screening...... of 200 of 518 eligible patients with type 1 diabetes (39%) participated (68% men; age 52±15years (mean±SD), diabetes duration 24±14years and BMI 25.3±3.3kg/m(2)). OSA was diagnosed in 92 patients (46% (95% CI: 40-53)). Five patients had known OSA, and OSA was newly diagnosed in 87 patients, predominantly...

  12. Association between Obstructive Sleep Apnea and Community-Acquired Pneumonia.

    Directory of Open Access Journals (Sweden)

    Eusebi Chiner

    Full Text Available We hypothesized that obstructive sleep apnea (OSA can predispose individuals to lower airway infections and community-acquired pneumonia (CAP due to upper airway microaspiration. This study evaluated the association between OSA and CAP.We performed a case-control study that included 82 patients with CAP and 41 patients with other infections (control group. The controls were matched according to age, sex and body mass index (BMI. A respiratory polygraph (RP was performed upon admission for patients in both groups. The severity of pneumonia was assessed according to the Pneumonia Severity Index (PSI. The associations between CAP and the Epworth Sleepiness Scale (ESS, OSA, OSA severity and other sleep-related variables were evaluated using logistic regression models. The associations between OSA, OSA severity with CAP severity were evaluated with linear regression models and non-parametric tests.No significant differences were found between CAP and control patients regarding anthropometric variables, toxic habits and risk factors for CAP. Patients with OSA, defined as individuals with an Apnea-Hypopnea Index (AHI ≥10, showed an increased risk of CAP (OR = 2·86, 95%CI 1·29-6·44, p = 0·01. Patients with severe OSA (AHI≥30 also had a higher risk of CAP (OR = 3·18, 95%CI 1·11-11·56, p = 0·047. In addition, OSA severity, defined according to the AHI quartile, was also significantly associated with CAP (p = 0·007. Furthermore, OSA was significantly associated with CAP severity (p = 0·0002, and OSA severity was also associated with CAP severity (p = 0·0006.OSA and OSA severity are associated with CAP when compared to patients admitted to the hospital for non-respiratory infections. In addition, OSA and OSA severity are associated with CAP severity. These results support the potential role of OSA in the pathogenesis of CAP and could have clinical implications. This link between OSA and infection risk should be explored to investigate the

  13. Head, Neck, and Oral Cancer

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    Full Text Available ... sleep apnea (OSA) is a serious and even life-threatening condition. The risks of undiagnosed OSA are ... sleep apnea (OSA) is a serious and even life-threatening condition. The risks of undiagnosed OSA are ...

  14. Administration of Anesthesia

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    Full Text Available ... sleep apnea (OSA) is a serious and even life-threatening condition. The risks of undiagnosed OSA are ... sleep apnea (OSA) is a serious and even life-threatening condition. The risks of undiagnosed OSA are ...

  15. Obstructive Sleep Apnea

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    Full Text Available ... sleep apnea (OSA) is a serious and even life-threatening condition. The risks of undiagnosed OSA are ... sleep apnea (OSA) is a serious and even life-threatening condition. The risks of undiagnosed OSA are ...

  16. Corrective Jaw Surgery

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    Full Text Available ... sleep apnea (OSA) is a serious and even life-threatening condition. The risks of undiagnosed OSA are ... sleep apnea (OSA) is a serious and even life-threatening condition. The risks of undiagnosed OSA are ...

  17. Investigation of the relationship between mean platelet volume and obstructive sleep apnea syndrome

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    Ersin Şükrü Erden

    2013-12-01

    Full Text Available Objective: Obstructive sleep apnea syndrome (OSAS is characterized by recurrent upper airway obstruction and intermittent hypoxia during sleep. Intermittent hypoxia and increased inflammatory activity plays a role in increased risk of cardiovascular disease in the OSAS. OSAS is an important cause of morbidity and mortality and cardiovascular disorders are the most important complications of OSAS. Mean platelet volume (MPV is a marker of platelet activation and function, and increased platelet volume is associated with increased platelet activity. Different diseases related with inflammation, hypoxia, vascular injury, thrombosis and atherosclerosis were found to be associated with MPV. In this study, we aimed to investigate the relationship between OSAS and MPV. Methods: In this retrospective study, data of sex and age matched 33 patients with moderate OSAS, 34 patients with severe OSAS and 30 healthy subjects were evaluated. Results: The mean MPV was found in control, moderate OSAS and severe OSAS groups as 7.83±1.00, 8.26±1.40 and 8.94±1.20 (fL respectively. The mean MPV value was significantly higher in severe OSAS group than control subjects (p=0.001. In correlation analysis, there were positive correlation between MPV with apnea-hypopnea index and total sleep time, and negative correlation between MPV with platelet count and minimum oxygen saturation (Respectively, p=0.003 / R=0.295, p=0.030 / R=0.221, p=0.011 / R= -0.257, p=0.019 / R= -0.238. Conclusion: In this study, the increased MPV was associated with severe OSAS and the results of this study suggest that the platelet activation is increased in OSAS. Hypoxia caused by OSAS, due to the activated platelets, may play a role in the development of cardiovascular diseases which is an important cause of morbidity and mortality in OSAS. J Clin Exp Invest 2013; 4 (4: 492-496

  18. The potential association between obstructive sleep apnea and diabetic retinopathy in severe obesity-the role of hypoxemia.

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    Dev Banerjee

    Full Text Available Obstructive sleep apnea (OSA is common in obese patients with type 2 diabetes mellitus (DM and may contribute to diabetic microvascular complications.To investigate the association between OSA, hypoxemia during sleep, and diabetic retinal complications in severe obesity. This was a prospective observational study of 93 obese patients mean (SD age: 52(10 years; mean (SD body mass index (BMI: 47.3(8.3 kg/m(2 with DM undergoing retinal screening and respiratory monitoring during sleep. OSA was defined as apnea-hypopnea index (AHI of ≥15 events/hour, resulting in two groups (OSA+ vs. OSA-.Forty-six patients were OSA+: median (95% CI AHI = 37(23-74/hour and 47 were OSA-ve (AHI = 7(4-11/hour. Both groups were similar for ethnicity, BMI, cardiovascular co-morbidities, diabetes duration, HbA1c, and insulin treatment (p>0.05. The OSA+ group was significantly more hypoxemic. There was no significant difference between OSA+ and OSA- groups for the presence of retinopathy (39% vs. 38%. More OSA+ subjects had maculopathy (22% vs. 13%, but this did not reach statistical significance. Logistic regression analyses showed that AHI was not significantly associated with the presence of retinopathy or maculopathy (p>0.05. Whilst minimum oxygen saturation was not significantly associated with retinopathy, it was an independent predictor for the presence of maculopathy OR = 0.79 (95% CI: 0.65-0.95; p<0.05, after adjustment.The presence of OSA, as determined by AHI, was not associated with diabetic retinal complications. In contrast, severity of hypoxemia during sleep (minimum oxygen saturations may be an important factor. The importance of hypoxia in the development of retinal complications in patients with OSA remains unclear and further studies assessing the pathogenesis of hypoxemia in patients with OSA and diabetic retinal disease are warranted.

  19. Evaluation of Ocular Surface Health in Patients with Obstructive Sleep Apnea Syndrome

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    Emine Esra Karaca

    2016-06-01

    Full Text Available Objectives: To evaluate ocular surface health in obstructive sleep apnea syndrome (OSAS and to investigate the tendency of these patients toward dry eyes. Materials and Methods: Fifty patients who underwent polysomnography and were diagnosed with OSAS and 50 normal control subjects were compared with respect to ocular surface disease index (OSDI, Schirmer I test and tear film break-up time (TBUT values. Results: Patients were grouped as mild (n=15, 30%, moderate (n=15, 30% and severe (n=20, 40% according to apnea-hypopnea index values. The right eyes of patients were included in both groups. OSDI values were as follows: control group, 18.7±8.5; mild OSAS group, 40.2±2.8; moderate OSAS group, 48.5±2.2 and severe OSAS group, 62.7±2.3 (p<0.001. TBUT values were as follows: control group, 12.3±4.9; mild OSAS group, 8.2±4.7; moderate OSAS group, 5.8±2.1 and severe OSAS group, 4.2±3.7 (p<0.001. Schirmer values were as follows: control group, 18±6.1 mm; mild OSAS group, 12.9±6.7 mm; moderate OSAS group, 8.5±5.2 mm and severe OSAS group, 7.9±4.7 mm (p<0.001. Conclusion: Patients with OSAS seem to have a tendency toward dry eyes. Clinicians should be aware of dry eye development in these patients

  20. Memory and Executive Screening for the Detection of Cognitive Impairment in Obstructive Sleep Apnea.

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    Mu, Li; Peng, Liping; Zhang, Zhengjiao; Jie, Jing; Jia, Siqi; Yuan, Haibo

    2017-10-01

    Obstructive sleep apnea (OSA) is commonly associated with cognitive dysfunction, which is more apparent in severe OSA and impairs quality of life. However, the clinical screening methods for these impairments in OSA are still limited. In this study, we evaluated the feasibility of using the Memory and Executive Screening (MES) for assessing cognitive performance in OSA. Twenty-four patients with nonsevere OSA and 36 patients with severe OSA participated in this study. All participants underwent comprehensive, laboratory-based polysomnography and completed assessments of cognitive function, which included both the MES and the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ). Both the total MES scores and 5 recall scores of the MES (MES-5R) were significantly lower in the severe OSA group than those in the nonsevere OSA group. The patients with severe OSA performed worse on the memory subtests of the MES-5R, especially on immediate recall. The sensitivity and specificity of the MES for identifying cognitive impairment in patients with OSA were 63.89% and 66.67%, respectively, for a cutoff value of cognitive dysfunction in patients with OSA. The sensitivity and specificity of the MES were similar to those of the MoCA-BJ. The MES-5R and total MES scores can assess the presence and severity of cognitive impairment in patients with severe OSA. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  1. The why, when and how to test for obstructive sleep apnea in patients with atrial fibrillation.

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    Desteghe, Lien; Hendriks, Jeroen M L; McEvoy, R Doug; Chai-Coetzer, Ching Li; Dendale, Paul; Sanders, Prashanthan; Heidbuchel, Hein; Linz, Dominik

    2018-04-12

    Sleep apnea is associated with increased cardiovascular risk and may be important in atrial fibrillation (AF) management. It is present in up to 62% of the AF population and is highly under-recognized and underdiagnosed. Obstructive sleep apnea (OSA) is strongly associated with AF and non-randomized trials have shown that its treatment can help to reduce AF recurrences and maintain sinus rhythm. The 2016 European Society of Cardiology guidelines for the management of AF recommend that AF patients should be questioned regarding the symptoms of OSA and that OSA-treatment should be optimized to improve AF treatment results. However, strategies on how to implement OSA testing in the standard work-up of AF patients are not provided in the guidelines. Additionally, overnight OSA monitoring rather than interrogation for OSA-related clinical signs alone may be necessary to reliably identify OSA in the majority of AF patients. This review summarizes the available clinical data on OSA in AF patients, and discusses the following key questions: Why and When is testing for OSA needed in AF patients? How and Where should it be performed and coordinated? and Who should test for OSA? To implement OSA testing in a cardiology or electrophysiology clinic, we propose a multidisciplinary integrated care approach based on a chronic care model. We describe the tools, infrastructure and coordination needed to test for OSA in the standard workup of patients with symptomatic AF prior to the initiation of directed invasive or pharmacological rhythm control management.

  2. Evaluation of P16 expression in canine appendicular osteosarcoma.

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    Murphy, B G; Mok, M Y; York, D; Rebhun, R; Woolard, K D; Hillman, C; Dickinson, P; Skorupski, K

    2017-06-20

    Osteosarcoma (OSA) is a common malignant bone tumor of large breed dogs that occurs at predictable anatomic sites. At the time of initial diagnosis, most affected dogs have occult pulmonary metastases. Even with aggressive surgical treatment combined with chemotherapy, the majority of dogs diagnosed with OSA live less than 1 year from the time of diagnosis. The ability to identify canine OSA cases most responsive to treatment is needed. In humans, OSA is also an aggressive tumor that is histologically and molecularly similar to canine OSA. The expression of the tumor suppressor gene product P16 by human OSA tissue has been linked to a favorable response to chemotherapy. We identified an antibody that binds canine P16 and developed a canine OSA tissue microarray in order to test the hypothesis that P16 expression by canine OSA tissue is predictive of clinical outcome following amputation and chemotherapy. Although statistical significance was not reached, a trend was identified between the lack of canine OSA P16 expression and a shorter disease free interval. The identification of a molecular marker for canine OSA is an important goal and the results reported here justify a larger study.

  3. Obstructive sleep apnea decreases central nervous system-derived proteins in the cerebrospinal fluid.

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    Ju, Yo-El S; Finn, Mary Beth; Sutphen, Courtney L; Herries, Elizabeth M; Jerome, Gina M; Ladenson, Jack H; Crimmins, Daniel L; Fagan, Anne M; Holtzman, David M

    2016-07-01

    We hypothesized that one mechanism underlying the association between obstructive sleep apnea (OSA) and Alzheimer's disease is OSA leading to decreased slow wave activity (SWA), increased synaptic activity, decreased glymphatic clearance, and increased amyloid-β. Polysomnography and lumbar puncture were performed in OSA and control groups. SWA negatively correlated with cerebrospinal fluid (CSF) amyloid-β-40 among controls and was decreased in the OSA group. Unexpectedly, amyloid-β-40 was decreased in the OSA group. Other neuronally derived proteins, but not total protein, were also decreased in the OSA group, suggesting that OSA may affect the interaction between interstitial and cerebrospinal fluid. Ann Neurol 2016;80:154-159. © 2016 American Neurological Association.

  4. Polymorphisms in nitric oxide synthase and endothelin genes among children with obstructive sleep apnea.

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    Chatsuriyawong, Siriporn; Gozal, David; Kheirandish-Gozal, Leila; Bhattacharjee, Rakesh; Khalyfa, Ahamed A; Wang, Yang; Sukhumsirichart, Wasana; Khalyfa, Abdelnaby

    2013-09-06

    Obstructive sleep apnea (OSA) is associated with adverse and interdependent cognitive and cardiovascular consequences. Increasing evidence suggests that nitric oxide synthase (NOS) and endothelin family (EDN) genes underlie mechanistic aspects of OSA-associated morbidities. We aimed to identify single nucleotide polymorphisms (SNPs) in the NOS family (3 isoforms), and EDN family (3 isoforms) to identify potential associations of these SNPs in children with OSA. A pediatric community cohort (ages 5-10 years) enriched for snoring underwent overnight polysomnographic (NPSG) and a fasting morning blood draw. The diagnostic criteria for OSA were an obstructive apnea-hypopnea Index (AHI) >2/h total sleep time (TST), snoring during the night, and a nadir oxyhemoglobin saturation DNA from peripheral blood was extracted and allelic frequencies were assessed for, NOS1 (209 SNPs), NOS2 (122 SNPs), NOS3 (50 SNPs), EDN1 (43 SNPs), EDN2 (48 SNPs), EDN3 (14 SNPs), endothelin receptor A, EDNRA, (27 SNPs), and endothelin receptor B, EDNRB (23 SNPs) using a custom SNPs array. The relative frequencies of NOS-1,-2, and -3, and EDN-1,-2,-3,-EDNRA, and-EDNRB genotypes were evaluated in 608 subjects [128 with OSA, and 480 without OSA (NOSA)]. Furthermore, subjects with OSA were divided into 2 subgroups: OSA with normal endothelial function (OSA-NEF), and OSA with endothelial dysfunction (OSA-ED). Linkage disequilibrium was analyzed using Haploview version 4.2 software. For NOSA vs. OSA groups, 15 differentially distributed SNPs for NOS1 gene, and 1 SNP for NOS3 emerged, while 4 SNPs for EDN1 and 1 SNP for both EDN2 and EDN3 were identified. However, in the smaller sub-group for whom endothelial function was available, none of the significant SNPs was retained due to lack of statistical power. Differences in the distribution of polymorphisms among NOS and EDN gene families suggest that these SNPs could play a contributory role in the pathophysiology and risk of OSA-induced cardiovascular

  5. Estructura, riqueza y composición de plantas leñosas en el golfo de Tribugá, Chocó, Colombia

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    Galicano Gloria

    2001-07-01

    Full Text Available Se estudió la estructura, riqueza y composición florística del componente leñoso de los bosques del Golfo de Tribugá, Costa Pacífica del Chocó, Colombia, con base en el muestreo de los individuos con DAP?: 5 cm en dos transectos de 0.4 ha cada uno y en la información previamente publicada para una ha en la misma zona. Los bosques son estructuralmente homogéneos y están caracterizados por la abundancia de palmas arborescentes, la escasez de lianas y la alta frecuencia de raíces zancos. Comparados con otros bosques de la región del Chocó biogeográfico con precipitación similar, los bosques del Golfo de Tribugá son más pobres en especies de plantas leñosas (en promedio 29 especies > 10 cm DAP en 0.1 ha, tienen menos individuos (en promedio 48 individuos z 10 cm DAP en 0.1 ha, árboles más gruesos (en promedio 9.8% de los individuos> 40 cm DAP en 0.1 ha y un área basal mayor (en promedio 3.16 m? por 0.1 ha incluyendo individuos > 10 cm DAP. Estas diferencias parecen ser consistentes con la existencia de una correlación negativa entre la fertilidad del suelo y, la densidad y la riqueza de árboles. A pesar de que la abundancia de especies y familias fue igual en todos los sitios, la similitud en composición florística fue muy baja. Sólo hubo 10 especies > 10 cm DAP comunes a los tres sitios. La importancia ecológica de las Moráceas parece estar entre las más altas registradas en el Neotrópico (VIF=48.2-53.9 para los individuos> 10 cm DAP. La estructura y los valores de riqueza de plantas leñosas de los bosques del Golfo de Tribugá se acercan más a los bosques de La Selva, Costa Rica, que a otros bosques igualmente lluviosos del Chocó biogeográfico.Structure, richness and floristic composition of the woody elements ofthe forests of the Golfo de Tribugá, Pacific Coast of Chocó, Colombia, were studied in two 0.4 ha plots sampled for all individuals ?: 5 cm dbh and using also previously published information for one l

  6. Pulse oximetry recorded from the Phone Oximeter for detection of obstructive sleep apnea events with and without oxygen desaturation in children.

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    Garde, Ainara; Dehkordi, Parastoo; Wensley, David; Ansermino, J Mark; Dumont, Guy A

    2015-01-01

    Obstructive sleep apnea (OSA) disrupts normal ventilation during sleep and can lead to serious health problems in children if left untreated. Polysomnography, the gold standard for OSA diagnosis, is resource intensive and requires a specialized laboratory. Thus, we proposed to use the Phone Oximeter™, a portable device integrating pulse oximetry with a smartphone, to detect OSA events. As a proportion of OSA events occur without oxygen desaturation (defined as SpO2 decreases ≥ 3%), we suggest combining SpO2 and pulse rate variability (PRV) analysis to identify all OSA events and provide a more detailed sleep analysis. We recruited 160 children and recorded pulse oximetry consisting of SpO2 and plethysmography (PPG) using the Phone Oximeter™, alongside standard polysomnography. A sleep technician visually scored all OSA events with and without oxygen desaturation from polysomnography. We divided pulse oximetry signals into 1-min signal segments and extracted several features from SpO2 and PPG analysis in the time and frequency domain. Segments with OSA, especially the ones with oxygen desaturation, presented greater SpO2 variability and modulation reflected in the spectral domain than segments without OSA. Segments with OSA also showed higher heart rate and sympathetic activity through the PRV analysis relative to segments without OSA. PRV analysis was more sensitive than SpO2 analysis for identification of OSA events without oxygen desaturation. Combining SpO2 and PRV analysis enhanced OSA event detection through a multiple logistic regression model. The area under the ROC curve increased from 81% to 87%. Thus, the Phone Oximeter™ might be useful to monitor sleep and identify OSA events with and without oxygen desaturation at home.

  7. Influence of Gender on Associations of Obstructive Sleep Apnea Symptoms with Chronic Conditions and Quality of Life

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    Sarah Appleton

    2018-05-01

    Full Text Available Women are less likely than men to be diagnosed with obstructive sleep apnea (OSA. We examined contemporary gender differences in symptoms, health status, and quality of life associated with diagnosed OSA and OSA symptoms in a population-based sample. A 2015 postal/on-line questionnaire of 2889 active participants of The North West Adelaide Health Study (response rate = 54%, male n = 704; female n = 856; age 30–100 years assessed previously diagnosed OSA, OSA symptoms, insomnia, doctor-diagnosed medical conditions, and the SF-36. In weighted analyses, self-reported diagnosed OSA (men: 12.6%, n = 95; women: 3.3%, n = 27 and OSA symptoms (men: 17.1%; women: 9.7% were more common in men. Diagnosed OSA showed stronger adjusted associations with typical OSA features in women, including obesity (women-odds ratio (OR, 95% CI: 5.7, 1.9–17.1, men: 2.2, 1.2–4.0, daytime sleepiness (women: 6.4, 2.7–15.6, men: 3.3, 2.1–5.4, and loud snoring (women: 25.4, 9.4–69.1, men: 8.7, 5.2–14.4. Diagnosed OSA was independently associated with cardiovascular disease (CVD in men, and in women with high cholesterol, respiratory disease, insomnia, and reduced SF-36 Physical Component Summary score. In both sexes, OSA symptoms were significantly associated with depression, insomnia, and moderate to severe impairments in SF-36 physical and mental component summary scores. Diagnosed women showed clinical characteristics overtly related to OSA. A higher index of clinical suspicion of OSA may be required in women for a condition regarded as male-predominant to increase equity in health outcomes.

  8. Self-control predicts attentional bias assessed by online shopping-related Stroop in high online shopping addiction tendency college students.

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    Jiang, Zhaocai; Zhao, Xiuxin; Li, Cancan

    2017-05-01

    The aim of this study was to examine the relationships of personality types (i.e., self-control, BAS/BIS) and online shopping addiction (OSA) behavior and to investigate whether high-OSA tendency individuals display attentional biases toward online shopping-related (OS-related) stimuli as well as the links between attentional bias and personality types. The study included 98 college students divided into three groups (i.e., high-, medium- and low-OSA) according to their OSA behavior. The personality types (i.e., self-control, BAS/BIS) and OSA behavior were investigated by questionnaires. The attentional bias was evaluated by the OS-related Stroop and dot-probe task (DPT) paradigms. OSA was positively predicted by time spent on online shopping per day and average consumption for online shopping monthly, and negatively by self-control. High-OSA individuals displayed significant attentional biases toward OS-related stimuli in the Stroop, but not DPT paradigm. Moreover, the attentional bias toward OSA-related stimuli in high-OSA individuals was negatively correlated with self-control. These findings demonstrated the critical role of self-control in OSA behavior and attentional bias to OS-related stimuli in high-OSA individuals, indicating that more importance should be attached to self-control for the clinical intervention of online shopping addiction in future studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. BMI1 is expressed in canine osteosarcoma and contributes to cell growth and chemotherapy resistance.

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    Shahi, Mehdi Hayat; York, Daniel; Gandour-Edwards, Regina; Withers, Sita S; Holt, Roseline; Rebhun, Robert B

    2015-01-01

    BMI1, a stem cell factor and member of the polycomb group of genes, has been shown to contribute to growth and chemoresistance of several human malignancies including primary osteosarcoma (OSA). Naturally occurring OSA in the dog represents a large animal model of human OSA, however the potential role of BMI1 in canine primary and metastatic OSA has not been examined. Immunohistochemical staining of canine primary and metastatic OSA tumors revealed strong nuclear expression of BMI1. An identical staining pattern was found in both primary and metastatic human OSA tissues. Canine OSA cell lines (Abrams, Moresco, and D17) expressed high levels of BMI1 compared with canine osteoblasts and knockdown or inhibition of BMI1 by siRNA or by small molecule BMI1-inhibitor PTC-209 demonstrated a role for BMI1 in canine OSA cell growth and resistance to carboplatin and doxorubicin chemotherapy. These findings suggest that inhibition of BMI1 in primary or metastatic OSA may improve response to chemotherapy and that the dog may serve as a large animal model to evaluate such therapy.

  10. Rhythm disturbances in childhood obstructive sleep apnea during apnea-hypopnea episodes

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    Anant Khositseth

    2013-01-01

    Methods: In a retrospective cross sectional study, records of children aged < 15 years with history of snoring and suspected OSA, who had undergone polysomnography (PSG for first time were analyzed. The cardiac rhythm and heart rate variability were studied during PSG. Results: A total of 124 patients diagnosed with OSA were grouped into mild ( n = 52, moderate ( n = 30, and severe ( n = 42 OSA. During PSG, all had sinus arrhythmias and only three patients had premature atrial contractions (PACs. The standard deviation of heart rate (SD-HR during rapid eye movement (REM sleep in severe OSA (9.1 ± 2.4 was significantly higher than SD-HR in mild OSA (7.5 ± 1.3, P < 0.0001. The maximum heart rate (max-HR during REM-sleep in severe OSA (132.1 ± 22.1 was significantly higher than the max-HR in mild OSA (121.3 ± 12.6 bpm, P = 0.016. Conclusions: There was no significant arrhythmia in children with OSA during their sleep. Heart rate variability correlated with the severity of OSA.

  11. Role of the Gut Microbiome in Obstructive Sleep Apnea-Induced Hypertension.

    Science.gov (United States)

    Durgan, David J; Ganesh, Bhanu P; Cope, Julia L; Ajami, Nadim J; Phillips, Sharon C; Petrosino, Joseph F; Hollister, Emily B; Bryan, Robert M

    2016-02-01

    Individuals suffering from obstructive sleep apnea (OSA) are at increased risk for systemic hypertension. The importance of a healthy gut microbiota, and detriment of a dysbiotic microbiota, on host physiology is becoming increasingly evident. We tested the hypothesis that gut dysbiosis contributes to hypertension observed with OSA. OSA was modeled in rats by inflating a tracheal balloon during the sleep cycle (10-s inflations, 60 per hour). On normal chow diet, OSA had no effect on blood pressure; however, in rats fed a high-fat diet, blood pressure increased 24 and 29 mm Hg after 7 and 14 days of OSA, respectively (Phypertensive OSA rats on high-fat diet into OSA recipient rats on normal chow diet (shown to be normotensive) resulted in hypertension similar to that of the donor (increased 14 and 32 mm Hg after 7 and 14 days of OSA, respectively; Phypertension, and suggest that manipulation of the microbiota may be a viable treatment for OSA-induced, and possibly other forms of, hypertension. © 2015 American Heart Association, Inc.

  12. Comportamento resiliente de um solo argiloso da região de Viçosa-MG no estado natural e estabilizado com cimento e alcatrão fracionado

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    Sant'Anna Giovanni Levi

    2003-01-01

    Full Text Available A importância do estudo das características resilientes dos solos e das misturas estabilizadas quimicamente justifica-se pela necessidade de conhecer o seu comportamento mecânico, sob a ação de cargas repetidas e transientes, quando constituintes do pavimento de estradas florestais. O método tradicional de determinação do módulo de resiliência, em laboratório, requer o emprego de um equipamento triaxial de cargas repetidas, que é relativamente complexo e caro, o que leva à necessidade de se desenvolver métodos mais simples para determinação do módulo de resiliência. Assim, buscou-se com este trabalho determinar o módulo de resiliência de um solo argiloso comum na região de Viçosa-MG em seu estado natural e quando estabilizado com cimento e alcatrão, como também propor correlações empíricas entre este e outros parâmetros geotécnicos de fácil obtenção em laboratório.

  13. Systematic review on noninvasive assessment of subclinical cardiovascular disease in obstructive sleep apnea: new kid on the block!

    Science.gov (United States)

    Ali, Shozab S; Oni, Ebenezer T; Warraich, Haider J; Blaha, Michael J; Blumenthal, Roger S; Karim, Adil; Shaharyar, Sameer; Jamal, Omar; Fialkow, Jonathan; Cury, Ricardo; Budoff, Matthew J; Agatston, Arthur S; Nasir, Khurram

    2014-10-01

    Patients with obstructive sleep apnea (OSA) have a high burden of cardiovascular disease (CVD) but a causal relationship between OSA and atherosclerotic CVD remains unclear. We systematically reviewed the literature analyzing the relationship. A review of the Medline database for studies noninvasively evaluating subclinical CVD in OSA was conducted. A total of fifty-two studies were included in this review. Across the studies the prevalence of atherosclerosis, as assessed by coronary artery calcification, carotid intima-media thickness, brachial artery flow-mediated dilation and pulse wave velocity was higher in patients with OSA and correlated with increasing severity and duration of OSA. This study shows OSA is an independent predictor of subclinical CVD as CVD is more likely to occur in patients with long standing and severe OSA. Further research is however necessary to identify specific OSA populations that would benefit from aggressive screening. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Biology, diagnosis and treatment of canine appendicular osteosarcoma: similarities and differences with human osteosarcoma.

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    Morello, Emanuela; Martano, Marina; Buracco, Paolo

    2011-09-01

    Osteosarcoma (OSA) is the most common primary bone tumour in dogs. The appendicular locations are most frequently involved and large to giant breed dogs are commonly affected, with a median age of 7-8 years. OSA is a locally invasive neoplasm with a high rate of metastasis, mostly to the lungs. Due to similarities in biology and treatment of OSA in dogs and humans, canine OSA represents a valid and important tumour model. Differences between canine and human OSAs include the age of occurrence (OSA is most commonly an adolescent disease in humans), localisation (the stifle is the most common site of localisation in humans) and limited use of neoadjuvant chemotherapy in canine OSA. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Osteocalcin and Osteonectin Expression in Canine Osteosarcoma.

    Science.gov (United States)

    Wehrle-Martinez, A S; Dittmer, K E; Aberdein, D; Thompson, K G

    2016-07-01

    Osteosarcoma (OSA) is a malignant heterogeneous primary bone tumor responsible for up to 90% of all primary bone tumors in dogs. In this study, osteocalcin (OC) and osteonectin (ON) immunoreactivity was evaluated in 23 canine OSAs, 4 chondrosarcomas, 4 fibrosarcomas, 2 hemangiosarcomas, and 4 histiocytic sarcomas. The effects of three different decalcification agents (ethylenediaminetetraetic acid [EDTA], formic acid and hydrochloric acid [HCl]) on the immunoreactivity for OC and ON was also assessed. Immunoreactivity to OC was present in 19/23 (83%) cases of OSA and all cases of chondrosarcoma. In three OSAs the extracellular matrix showed immunoreactivity to OC. None of the fibrosarcomas, histiocytic sarcomas or hemangiosarcomas showed immunoreactivity to OC. The sensitivity and specificity for OC in canine OSA in this study was 83% and 71% respectively. For ON, 100% of both OSAs (23/23) and non-OSAs (14/14) showed cytoplasmic immunoreactivity to this antibody, giving a sensitivity of 100% but a complete lack of specificity. There were no significant differences in immunoreactivity for OC and ON between the different decalcification agents used. In conclusion, OC showed high sensitivity for identifying OSA but it failed to distinguish between OSA and chondrosarcoma, and the osteoid produced by neoplastic cells in most cases did not show immunoreactivity to OC. These factors may limit the practical utility of OC in the diagnosis of OSA in dogs when chondrosarcoma is a differential diagnosis. ON showed no specificity in detecting OSA and has little practical application for the diagnosis of OSA in dogs. © The Author(s) 2016.

  16. Omega-3 Index and Obstructive Sleep Apnea: A Cross-Sectional Study.

    Science.gov (United States)

    Tittus, Janine; Huber, Marie Theres; Storck, Klaus; Köhler, Anton; Köhler, Jan M; von Arnim, Thomas; von Schacky, Clemens

    2017-10-15

    Erythrocyte levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Omega-3 Index) were previously found to be associated with obstructive sleep apnea (OSA) at very low levels (Omega-3 Index. These comorbidities can be improved by increasing intake of EPA and DHA, and thus the Omega-3 Index, preferably to its target range of 8% to 11%. Symptoms of OSA might improve by increasing the Omega-3 Index, but more research is needed. In our sleep laboratory, 357 participants with OSA were recruited, and data from 315 participants were evaluated. Three categories of OSA (none/ mild, moderate, severe) were defined based on apnea-hypopnea index. Anthropometrics and lifestyle characteristics (smoking, alcohol, fish intake, omega-3 supplementation) were recorded. Erythrocyte fatty acid compositions were assessed with the HS-Omega-3 Index methodology. The mean Omega-3 Index in all 3 categories of OSA was 5.7%, and no association with OSA was found. There were more male participants with severe OSA (79.7%, P = .042) than females, and participants with severe OSA had a significantly higher body mass index (32.11 ± 6.39 kg/m 2 , P = .009) than participants with mild or moderate OSA. Lifestyle characteristics were not significantly different. In contrast to our hypothesis, an Omega-3 Index of 5.7% was not associated with OSA severity. Previously, an Omega-3 Index Omega-3 Index > 5.7% in an intervention trial with EPA and DHA in OSA, comorbidities of OSA suggest a target range of 8% to 11%. © 2017 American Academy of Sleep Medicine

  17. Remission and incidence of obstructive sleep apnea from middle childhood to late adolescence.

    Science.gov (United States)

    Spilsbury, James C; Storfer-Isser, Amy; Rosen, Carol L; Redline, Susan

    2015-01-01

    To study the incidence, remission, and prediction of obstructive sleep apnea (OSA) from middle childhood to late adolescence. Longitudinal analysis. The Cleveland Children's Sleep and Health Study, an ethnically mixed, urban, community-based cohort, followed 8 y. There were 490 participants with overnight polysomnography data available at ages 8-11 and 16-19 y. Baseline participant characteristics and health history were ascertained from parent report and US census data. OSA was defined as an obstructive apnea- hypopnea index ≥ 5 or an obstructive apnea index ≥ 1. OSA prevalence was approximately 4% at each examination, but OSA largely did not persist from middle childhood to late adolescence. Habitual snoring and obesity predicted OSA in cross-sectional analyses at each time point. Residence in a disadvantaged neighborhood, African-American race, and premature birth also predicted OSA in middle childhood, whereas male sex, high body mass index, and history of tonsillectomy or adenoidectomy were risk factors among adolescents. Obesity, but not habitual snoring, in middle childhood predicted adolescent OSA. Because OSA in middle childhood usually remitted by adolescence and most adolescent cases were incident cases, criteria other than concern alone over OSA persistence or incidence should be used when making treatment decisions for pediatric OSA. Moreover, OSA's distinct risk factors at each time point underscore the need for alternative risk-factor assessments across pediatric ages. The greater importance of middle childhood obesity compared to snoring in predicting adolescent OSA provides support for screening, preventing, and treating obesity in childhood. © 2014 Associated Professional Sleep Societies, LLC.

  18. Impact of obstructive sleep apnea in transsphenoidal pituitary surgery: An analysis of inpatient data.

    Science.gov (United States)

    Chung, Sei Y; Sylvester, Michael J; Patel, Varesh R; Zaki, Michael; Baredes, Soly; Liu, James K; Eloy, Jean Anderson

    2018-05-01

    Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities. Retrospective analysis. The 2002 to 2013 National Inpatient Sample was queried for patients undergoing TSS for pituitary neoplasm. Patients with an additional diagnosis of OSA were identified, and compared to a non-OSA cohort. There were 17,777 patients identified; 5.0% (N = 889) had an additional diagnosis of OSA. The OSA cohort had more comorbidities including diabetes mellitus, congestive heart failure, chronic pulmonary disease, coagulopathy, hypertension, hypothyroidism, liver disease, obesity, peripheral vascular disease, renal failure, acromegaly, and Cushing's syndrome. Postoperatively, OSA was independently associated with increased risks of tracheostomy (P = .015) and hypoxemia (P transsphenoidal pituitary surgery, OSA was associated with higher rates of certain pulmonary and airway complications. OSA was not associated with increased non-pulmonary/airway complications or inpatient mortality, despite older average age and higher comorbidity rates. 2C. Laryngoscope, 128:1027-1032, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  19. Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Davidson, Karina W; Epling, John W; García, Francisco A R; Herzstein, Jessica; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Pignone, Michael P; Silverstein, Michael; Tseng, Chien-Wen

    2017-01-24

    Based on data from the 1990s, estimated prevalence of obstructive sleep apnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment, decreased quality of life, and motor vehicle crashes. To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for OSA in asymptomatic adults. The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of screening for OSA in asymptomatic adults seen in primary care, including those with unrecognized symptoms. The USPSTF also evaluated the evidence on the benefits and harms of treatment of OSA on intermediate and final health outcomes. The USPSTF found insufficient evidence on screening for or treatment of OSA in asymptomatic adults or adults with unrecognized symptoms. Therefore, the USPSTF was unable to determine the magnitude of the benefits or harms of screening for OSA or whether there is a net benefit or harm to screening. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults. (I statement).

  20. Association of obstructive sleep apnea with homocystein, nitric oxide and total antioxidant capacity levels in patients with or without coronary artery disease.

    Science.gov (United States)

    Ortaç Ersoy, Ebru; Fırat, Hikmet; Akaydın, Sevgi; Özkan, Yeşim; Durusu, Mine; Darılmaz Yüce, Gülbahar; Ergün, Recai; Topeli, Arzu; Ardıç, Sadık

    2014-01-01

    Obstructive sleep apnea (OSA) is associated with cardiovascular morbidity and mortality. Deficiency of nitric oxide (NO) and plasma levels of homocystein have been implicated in the pathogenesis of cardiovascular disease. OSA results in oxygen desaturation and arousal from sleep. Free oxygen radicals can be produced by hypoxia-reoxygenation. To test for the hypothesis that OSA is associated with cardiovascular morbidity, we investigated levels of homocystein, NO and total antioxidant capacity in OSA patients with and without coronary artery disease (CAD) in comparison with normal subjects and patients with CAD without OSA. Polysomnography was performed in 27 patients who had a myocardial infarction and in 25 patients without evidence of CAD. Patients were grouped according their polysomnography results as OSA with CAD (group 1), OSA without CAD (group 2), CAD (group 3), and normal (group 4) . Levels of homocystein, NO and total antioxidant capacity were determined after an overnight fasting. Data were analysed with parametric and non parametric statistical tests. According to apnea-hypopnea index (AHI) 44.4% of CAD patients were OSA. After polysomnographic evaluation, the patients were re-distributed as follows: OSA with CAD (n= 12), OSA without CAD (n= 14), CAD (n= 15), and normal (n= 11). Homocystein levels were higher in 3 groups compared to controls. AHI, MDI and desaturation time was higher in three -vessel disease compared to one and two- vessel diseases (p< 0.05). NO levels were correlated with the period of oxygen desaturation (r: -0.45, p= 0.031). The antioxidant capacity did not differ between OSA and healthy groups. OSA is frequent in CAD. AHI, MDI and desaturation time are higher in patients with severe CAD. It is important to evaluate OSA patients for CAD.

  1. Obstructive sleep apnoea is independently associated with the metabolic syndrome but not insulin resistance state

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    Sithole J

    2006-11-01

    Full Text Available Abstract Obstructive sleep apnoea (OSA is a cardio-metabolic disorder. Whether metabolic syndrome (MS, insulin resistance (IR and albuminuria are independently associated with OSA is unclear, but defining the interactions between OSA and various cardiovascular (CV risk factors independent of obesity facilitates the development of therapeutic strategies to mitigate their increased CV risks. We prospectively recruited 38 subjects with OSA and 41 controls. Anthropometric measurements, glucose, lipids, insulin and blood pressure (BP were measured after an overnight fast. IR state was defined as homeostasis model assessment (HOMA value >3.99 and MS diagnosed according to the International Diabetes Federation (IDF criteria. Subjects with OSA were more obese, more insulin resistant, more hyperglycaemic, had higher Epworth score (measure of day time somnolence and systolic blood pressure levels. The prevalence of MS was higher in OSA compared with non-OSA subjects (74% vs 24%, p 103 cm would predict MS in patients with OSA at 75–78% sensitivity and 61–64% specificity. The agreement between MS and IR state in this cohort is poor. Thus, OSA is associated with MS independent of obesity predominantly due to increased triglyceride, glucose and Epworth score values but not IR or microalbuminuria status. This observation suggests an alternative pathogenic factor mediating the increased cardiovascular risk in patients with OSA and MS, other than that due to IR. The independent link between Epworth score and MS in patients with OSA implicates the role of daytime sleepiness and chronic hypoxia as a potential mediator. Given the discordant between MS and IR state, measurement of waist is useful for predicting mainly MS but not insulin resistance status in patients with OSA. Appropriate pharmacological intervention targeting these independent factors is important in reducing the increased CV risks among patients with OSA.

  2. What is the most important factor affecting the cognitive function of obstructive sleep apnea syndrome patients: a single center study

    OpenAIRE

    LI Xiang; LI Yan-peng; WU Hui-juan; ZHANG Lin; ZHAO Zheng-qing; PENG Hua; ZHAO Zhong-xin

    2013-01-01

    Objective Patients with obstructive sleep apnea syndrome (OSAS) usually complain of daytime hypersomnia and decrease in cognitive function, which affects the quality of their work and life. The reason why the cognitive function of OSAS patients decreased remains controversial. The aim of this study is to evaluate the impairment and the main influencing factors of cognitive function in OSAS. Methods There were totally 50 OSAS patients (OSAS group) and 25 volunteers (control group) included i...

  3. Urinary Neurotransmitters Are Selectively Altered in Children With Obstructive Sleep Apnea and Predict Cognitive Morbidity

    Science.gov (United States)

    Kheirandish-Gozal, Leila; McManus, Corena J. T.; Kellermann, Gottfried H.; Samiei, Arash

    2013-01-01

    Background: Pediatric obstructive sleep apnea (OSA) is associated with cognitive dysfunction, suggesting altered neurotransmitter function. We explored overnight changes in neurotransmitters in the urine of children with and without OSA. Methods: Urine samples were collected from children with OSA and from control subjects before and after sleep studies. A neurocognitive battery assessing general cognitive ability (GCA) was administered to a subset of children with OSA. Samples were subjected to multiple enzyme-linked immunosorbent assays for 12 neurotransmitters, and adjusted for creatinine concentrations. Results: The study comprised 50 children with OSA and 20 control subjects. Of the children with OSA, 20 had normal GCA score (mean ± SD) (101.2 ± 14.5) and 16 had a reduced GCA score (87.3 ± 13.9; P neurotransmitters enabled prediction of OSA (area under the curve [AUC]: 0.923; P neurotransmitters in urine may not only predict OSA but also the presence of cognitive deficits. Larger cohort studies appear warranted to confirm these findings. PMID:23306904

  4. Childhood obstructive sleep apnea associates with neuropsychological deficits and neuronal brain injury.

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    Ann C Halbower

    2006-08-01

    Full Text Available Childhood obstructive sleep apnea (OSA is associated with neuropsychological deficits of memory, learning, and executive function. There is no evidence of neuronal brain injury in children with OSA. We hypothesized that childhood OSA is associated with neuropsychological performance dysfunction, and with neuronal metabolite alterations in the brain, indicative of neuronal injury in areas corresponding to neuropsychological function.We conducted a cross-sectional study of 31 children (19 with OSA and 12 healthy controls, aged 6-16 y group-matched by age, ethnicity, gender, and socioeconomic status. Participants underwent polysomnography and neuropsychological assessments. Proton magnetic resonance spectroscopic imaging was performed on a subset of children with OSA and on matched controls. Neuropsychological test scores and mean neuronal metabolite ratios of target brain areas were compared. Relative to controls, children with severe OSA had significant deficits in IQ and executive functions (verbal working memory and verbal fluency. Children with OSA demonstrated decreases of the mean neuronal metabolite ratio N-acetyl aspartate/choline in the left hippocampus (controls: 1.29, standard deviation [SD] 0.21; OSA: 0.91, SD 0.05; p = 0.001 and right frontal cortex (controls: 2.2, SD 0.4; OSA: 1.6, SD 0.4; p = 0.03.Childhood OSA is associated with deficits of IQ and executive function and also with possible neuronal injury in the hippocampus and frontal cortex. We speculate that untreated childhood OSA could permanently alter a developing child's cognitive potential.

  5. INFLUÊNCIA DOS FATORES EDÁFICOS NA VARIAÇÃO FLORÍSTICA DE FLORESTA ESTACIONAL SEMIDECIDUAL, EM VIÇOSA, MG

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    Antonio Jorge Tourinho Braga

    2015-08-01

    Full Text Available RESUMOO objetivo deste estudo foi verificar a possível correlação dos fatores edáficos na distribuição dos indivíduos de espécies arbóreas e a similaridade florística entre as populações, em dois trechos distintos de um fragmento de Floresta Estacional Semidecidual, em Viçosa, MG (20°46' S e 42°52' W. No trabalho, foram amostrados os indivíduos arbóreos superiores ou iguais a 15 cm (CAP, presentes em 20 parcelas de 25×10 m, estando metade dessas alocadas (10 em cada trecho de floresta. Na área das parcelas, foram coletadas amostras de solo (0-10 cm e submetidas às análises química e física. Os resultados dos atributos físicos e químicos do solo indicaram variações conforme as mudanças na topografia do terreno. A análise de correspondência canônica (CCA indicou correlação significativa entre a distribuição das espécies arbóreas avaliadas no perfil topográfico e a fertilidade do solo, enquanto a comparação entre as espécies pertencentes às florestas inicial e avançada apontou baixa similaridade florística. Verificou-se ainda que espécies como Casearia arborea, Ocotea laxa, Myrcia fallax, Siparuna guianensis, Apuleia leiocarpa, Matayba elaeagnoides e Sparattosperma leucanthum estão associadas a solos argilosos mais ácidos, de encostas e com maior teor de alumínio, permitindo o uso delas em programas de recuperação ambiental.

  6. A case-control study of Drug-Induced Sleep Endoscopy (DISE) in pediatric population: A proposal for indications.

    Science.gov (United States)

    Collu, Maria Antonietta; Esteller, Eduard; Lipari, Fiorella; Haspert, Raul; Mulas, Demetrio; Diaz, Miguel Angel; Dwivedi, Raghav C

    2018-05-01

    To evaluate whether and when Drug-Induced Sleep Endoscopy (DISE) changes diagnosis and treatment plan in pediatric Obstructive Sleep Apnoea Syndrome (OSAS) with the aim to identify specific subgroups of patients for whom DISE should be especially considered. A case-control study of DISE in 150 children with OSAS. Pre-operative OSA were assessed through detailed history, Chervin questionnaire, physical examination and overnight polysomnography. The group of study was divided into three subgroups according to clinical and polysomnographyc criteria: conventional OSAS, disproportional OSAS and persistent OSAS. Endoscopic evaluation of the upper airway during DISE was scored using Chan classification. Surgical treatment was tailored individually upon the basis of sleep endoscopy findings: performance of any surgery other than tonsillectomy and adenoidectomy (T&A) was considered as a change of the treatment plan. Cases and controls were compared considering presence and absence of DISE-directed extra surgery, respectively. 150 patients with mean age (SD) 56.09 (23.94) months and mean apnoea-hypopnea index (AHI) of 5.79 (6.52) underwent DISE. The conventional subgroup represented the 58.67% of the sample (n = 88), while the disproportional one counted for the 26.67% (n = 40), and the persistent one for 14.66% (n = 22) of the population. Sleep endoscopy changed the surgical plan in 4.5% of conventional OSAS, 17.5% of disproportional OSAS and 72.7% of persistent OSAS (p < 0.005). Overall, a change of the treatment plan operated by DISE was associated with a non-conventional OSAS status (OR = 6; 95% CI = 1.6-26.4). DISE is a safe procedure in children suffering from OSAS, and, despite being unnecessary in conventional cases of OSA, DISE should be considered not only in syndromic children, as previously demonstrated, but also in the general non-syndromic pediatric population, in the case of non-conventional OSA patients, and in children with persistent

  7. Was That Levity or Livor Mortis? Crime Scene Investigators' Perspectives on Humor and Work

    Science.gov (United States)

    Vivona, Brian D.

    2012-01-01

    Humor is common and purposeful in most work settings. Although researchers have examined humor and joking behavior in various work settings, minimal research has been done on humor applications in the field of crime scene investigation. The crime scene investigator encounters death, trauma, and tragedy in a more intimate manner than any other…

  8. Risky consumption habits and safety of fluid milk available in retail sales outlets in Viçosa, Minas Gerais State, Brazil.

    Science.gov (United States)

    Pieri, Fabio Alessandro; Colombo, Monique; Merhi, Carolina Milner; Juliati, Vinícius Augusto; Ferreira, Marcello Sebe; Nero, Marcelo Antônio; Nero, Luis Augusto

    2014-06-01

    This study aimed to assess raw milk consumption habits in the urban population of Viçosa, Minas Gerais, Brazil, and the microbiological safety and quality of the fluid milk available in retail sales outlets in the same region. A simplified questionnaire regarding raw milk consumption was applied to the persons responsible for food acquisition in 411 residences. The regular consumption of raw milk was observed by 18.5% of the interviewers, and lack of knowledge of possible risks related to this food product. Microbiological safety and quality were assessed for raw (n=69), pasteurized (n=80), and ultra-high-temperature (UHT)-treated milk (n=80) by analyzing the counts of mesophilic aerobes, coliforms, and Escherichia coli, and detection of Listeria monocytogenes and Salmonella spp.; raw milk samples were also subjected to enumeration of coagulase-positive Staphylococcus. Concerning raw milk, 59.4% of the samples were considered as produced in inadequate hygienic conditions, 5.8% of the samples presented counts of coagulase-positive Staphylococcus lower than 100 colony-forming units (CFU)/mL, and no samples presented with positive results for L. monocytogenes or Salmonella spp. All pasteurized and UHT milk samples presented with low counts of mesophilic aerobes and coliforms, while L. monocytogenes and Salmonella spp. were absent. The data demonstrated that raw milk was consumed by the population studied. Despite the absence of potential hazards, raw milk was of poor hygienic quality, in contrast with the processed fluid milk available in retail sales outlets that was safe and of good hygienic quality, highlighting the suitability of pasteurized and UHT milk for human consumption.

  9. Diversidade e equitabilidade de Plantas Alimentícias Não Convencionais na zona rural de Viçosa, Minas Gerais, Brasil

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    T.F. BARREIRA

    2015-01-01

    Full Text Available RESUMO O presente estudo analisou a diversidade e equitabilidade de plantas alimentícias não convencionais (PANCs na zona rural de Viçosa, Minas Gerais, Brasil. A pesquisa foi conduzida utilizando a amostragem Bola de Neve com entrevistas semiestruturadas aplicadas à 20 moradores de nove comunidades rurais. Avaliou-se a frequência relativa de citação das espécies (Fr; a diversidade e equitabilidade das mesmas, utilizando os índices de Shannon-Wiener (H’ e de Pielou (J’, respectivamente. As espécies foram listadas pela família, nome científico, nomes populares, ambiente de propagação, hábito de crescimento, formas de consumo, estado de domesticação, ciclo de produção e registro por meio de consultas em herbários do bioma Mata Atlântica. Foram encontradas 59 espécies de PANCs, distribuídas em 30 famílias botânicas e 48 gêneros. As famílias asteraceae e myrtaceae se destacaram pela riqueza florística, contribuindo com 11 e 7 espécies, respectivamente. Espécies da família asteraceae obtiveram as maiores frequências relativas (32,2. Obteve-se índice de diversidade Shannon-Wiener de 1,65 (Base 10, e de equitabilidade de Pielou de 0,93. Os resultados encontrados estão similares à de outros estudos desenvolvidos no bioma Mata Atlântica, observou-se ampla diversidade de PANCs na área de estudo, e o conhecimento sobre estas encontra-se distribuído uniformemente entre os moradores.

  10. Recent advances in the management of obstructive sleep apnea: The dental perspective.

    Science.gov (United States)

    Prabhat, K C; Goyal, Lata; Bey, Afshan; Maheshwari, Sandhya

    2012-07-01

    Obstructive sleep apnea (OSA) is common in adult population. OSA shows detrimental effects on health, neuropsychological development, quality-of-life, and economic potential and now it is recognized as a public health problem. Despite the availability of expanded therapeutic options, polysomnography and nasal continuous positive airway pressure (CPAP) are the gold standards for the diagnosis and treatment for OSA. Recently, American Academy of Sleep Medicine has recommended oral appliances for OSA. Hence the therapeutic interventions that are directed at the site of airway obstruction in the maxillofacial region are within the scope of dentistry. Treatment of OSA can improve vitality, social and daytime functioning, family life and mental health of a person and hence the quality-of-life. Obesity is the main predisposing factor for OSA. Other than obesity, craniofacial abnormalities such as micrognathia and retrognathia, age, ethnic background and genetic predisposition, consumption of alcohol, smoking, and sedatives may also predispose to OSA. Treatment modalities for OSA are behavior modification, diet and medication, CPAP devices, surgical (maxillo-mandibular advancement surgery), and oral appliances. Treatment of a patient with OSA not only improves the physical health of the patients but also the mental and social well-being.

  11. BMI1 is expressed in canine osteosarcoma and contributes to cell growth and chemotherapy resistance.

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    Mehdi Hayat Shahi

    Full Text Available BMI1, a stem cell factor and member of the polycomb group of genes, has been shown to contribute to growth and chemoresistance of several human malignancies including primary osteosarcoma (OSA. Naturally occurring OSA in the dog represents a large animal model of human OSA, however the potential role of BMI1 in canine primary and metastatic OSA has not been examined. Immunohistochemical staining of canine primary and metastatic OSA tumors revealed strong nuclear expression of BMI1. An identical staining pattern was found in both primary and metastatic human OSA tissues. Canine OSA cell lines (Abrams, Moresco, and D17 expressed high levels of BMI1 compared with canine osteoblasts and knockdown or inhibition of BMI1 by siRNA or by small molecule BMI1-inhibitor PTC-209 demonstrated a role for BMI1 in canine OSA cell growth and resistance to carboplatin and doxorubicin chemotherapy. These findings suggest that inhibition of BMI1 in primary or metastatic OSA may improve response to chemotherapy and that the dog may serve as a large animal model to evaluate such therapy.

  12. Obstructive Sleep Apnea Screening Using a Piezo-Electric Sensor.

    Science.gov (United States)

    Erdenebayar, Urtnasan; Park, Jong Uk; Jeong, Pilsoo; Lee, Kyoung Joung

    2017-06-01

    In this study, we propose a novel method for obstructive sleep apnea (OSA) detection using a piezo-electric sensor. OSA is a relatively common sleep disorder. However, more than 80% of OSA patients remain undiagnosed. We investigated the feasibility of OSA assessment using a single-channel physiological signal to simplify the OSA screening. We detected both snoring and heartbeat information by using a piezo-electric sensor, and snoring index (SI) and features based on pulse rate variability (PRV) analysis were extracted from the filtered piezo-electric sensor signal. A support vector machine (SVM) was used as a classifier to detect OSA events. The performance of the proposed method was evaluated on 45 patients from mild, moderate, and severe OSA groups. The method achieved a mean sensitivity, specificity, and accuracy of 72.5%, 74.2%, and 71.5%; 85.8%, 80.5%, and 80.0%; and 70.3%, 77.1%, and 71.9% for the mild, moderate, and severe groups, respectively. Finally, these results not only show the feasibility of OSA detection using a piezo-electric sensor, but also illustrate its usefulness for monitoring sleep and diagnosing OSA. © 2017 The Korean Academy of Medical Sciences.

  13. "Silent" Sleep Apnea in Dentofacial Deformities and Prevalence of Daytime Sleepiness After Orthognathic and Intranasal Surgery.

    Science.gov (United States)

    Posnick, Jeffrey C; Adachie, Anayo; Singh, Neeru; Choi, Elbert

    2018-04-01

    The purposes of this study were to determine the occurrence of undiagnosed "silent" obstructive sleep apnea (OSA) in dentofacial deformity (DFD) patients at initial surgical presentation and to report on the level of daytime sleepiness in DFD patients with OSA and chronic obstructive nasal breathing (CONB) after undergoing bimaxillary, chin, and intranasal surgery. A retrospective cohort study of patients with a bimaxillary DFD and CONB was implemented. Patients were divided into those with no OSA (group I) and those with OSA (group II). Group II was further subdivided into patients referred with polysomnogram (PSG)-confirmed OSA (group IIa) and those with a diagnosis of OSA only after surgical consultation, airway evaluation, and a positive PSG (group IIb). Group II patients were analyzed at a minimum of 1 year after surgery (range, 1 to 10 years) for daytime sleepiness with the Epworth Sleepiness Scale. Patients with postoperative excessive daytime sleepiness were assessed for risk factors and continued need for OSA treatment. Patients in group II were studied to determine which DFD patterns were most associated with OSA. We compared the prevalence of OSA between our study population and the general population. Two hundred sixty-two patients met the inclusion criteria. Of these, 23% (60 of 262) had PSG-confirmed OSA (group II). This rate was much higher than that found in the general population. Of the patients, 7% (19 of 262) were known to have OSA at initial surgical consultation (group IIa). An additional 16% (41 of 262) were later confirmed by PSG to have OSA (group IIb). Patients with primary mandibular deficiency and short face DFDs were most likely to have OSA (P surgery. A significant association was found between group II patients with postoperative excessive daytime sleepiness ("sleepy" or "very sleepy") and a preoperative body mass index category of overweight (P = .026). Our study found silent OSA to be frequent in the DFD population. The

  14. Impact of obstructive sleep apnea on lung volumes and mechanical properties of the respiratory system in overweight and obese individuals.

    Science.gov (United States)

    Abdeyrim, Arikin; Zhang, Yongping; Li, Nanfang; Zhao, Minghua; Wang, Yinchun; Yao, Xiaoguang; Keyoumu, Youledusi; Yin, Ting

    2015-07-25

    Even through narrowing of the upper-airway plays an important role in the generation of obstructive sleep apnea (OSA), the peripheral airways is implicated in pre-obese and obese OSA patients, as a result of decreased lung volume and increased lung elastic recoil pressure, which, in turn, may aggravate upper-airway collapsibility. A total of 263 male (n = 193) and female (n = 70) subjects who were obese to various degrees without a history of lung diseases and an expiratory flow limitation, but troubled with snoring or suspicion of OSA were included in this cross-sectional study. According to nocturnal-polysomnography the subjects were distributed into OSA and non-OSA groups, and were further sub-grouped by gender because of differences between males and females, in term of, lung volume size, airway resistance, and the prevalence of OSA among genders. Lung volume and respiratory mechanical properties at different-frequencies were evaluated by plethysmograph and an impulse oscillation system, respectively. Functional residual capacity (FRC) and expiratory reserve volume were significantly decreased in the OSA group compared to the non-OSA group among males and females. As weight and BMI in males in the OSA group were greater than in the non-OSA group (90 ± 14.8 kg vs. 82 ± 10.4 kg, p volumes decreases were independent from BMI and associated with the severity of OSA. This result was further confirmed by the female cohort. Significant increases in total respiratory resistance and decreases in respiratory conductance (Grs) were observed with increasing severity of OSA, as defined by the apnea-hypopnea index (AHI) in both genders. The specific Grs (sGrs) stayed relatively constant between the two groups in woman, and there was only a weak association between AHI and sGrs among man. Multiple-stepwise-regression showed that reactance at 5 Hz was highly correlated with AHI in males and females or hypopnea index in females, independently

  15. Perioperative management of children with obstructive sleep apnea.

    Science.gov (United States)

    Schwengel, Deborah A; Sterni, Laura M; Tunkel, David E; Heitmiller, Eugenie S

    2009-07-01

    Obstructive sleep apnea syndrome (OSA) affects 1%-3% of children. Children with OSA can present for all types of surgical and diagnostic procedures requiring anesthesia, with adenotonsillectomy being the most common surgical treatment for OSA in the pediatric age group. Thus, it is imperative that the anesthesiologist be familiar with the potential anesthetic complications and immediate postoperative problems associated with OSA. The significant implications that the presence of OSA imposes on perioperative care have been recognized by national medical professional societies. The American Academy of Pediatrics published a clinical practice guideline for pediatric OSA in 2002, and cited an increased risk of anesthetic complications, though specific anesthetic issues were not addressed. In 2006, the American Society of Anesthesiologists published a practice guideline for perioperative management of patients with OSA that noted the pediatric-related risk factor of obesity, and the increased perioperative risk associated with adenotonsillectomy in children younger than 3 yr. However, management of OSA in children younger than 1 yr-of-age was excluded from the guideline, as were other issues related specifically to the pediatric patient. Hence, many questions remain regarding the perioperative care of the child with OSA. In this review, we examine the literature on pediatric OSA, discuss its pathophysiology, current treatment options, and recognized approaches to perioperative management of these young and potentially high-risk patients.

  16. Effects of positive airway pressure therapy on cardiovascular and metabolic markers in males with obstructive sleep apnea.

    Science.gov (United States)

    Feliciano, A; Oliveira, M J; Cysneiros, A; Martinho, C; Reis, R P; Penque, D; Pinto, P; Bárbara, C

    Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular/metabolic complications. Some analytical parameters (homocysteine, glycemic and lipidic profiles) are recognized markers of these consequences. Limited data is available on the association of these markers and OSAS's severity/response to positive airway pressure therapy (PAP). In this prospective study we analyzed polysomnographic and analytical data of male patients admitted to sleep laboratory. The aim was to evaluate metabolic/cardiovascular markers in snorers and OSAS patients, to relate with sleep parameters and PAP response. One-hundred and three patients were included, and 73 (71%) were OSAS patients. OSAS patients were similar to snorers except for higher body mass index (BMI) and dyslipidemia. Severe OSAS patients showed higher glycemia, HbA1c, insulin, and insulin resistance, and lower HDL cholesterol in comparison to mild-moderate (pprofile and triglycerides were slightly correlated with OSAS severity. 46 OSAS patients were submitted to 6 months of PAP, with a statistical decrease in mean values of homocysteine, glycemia, total and LDL cholesterol (pprofiles changed significantly after 6 months of PAP therapy in OSAS, supporting its cardiovascular and metabolic protective effect. Our study has reinforced the importance of analytical cardiovascular/metabolic evaluation as complementary tool of diagnosis/treatment response in OSAS. Copyright © 2017 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

  17. Assessment of obstructive sleep apnoea treatment success or failure after maxillomandibular advancement.

    Science.gov (United States)

    de Ruiter, M H T; Apperloo, R C; Milstein, D M J; de Lange, J

    2017-11-01

    Maxillomandibular advancement (MMA) is an alternative therapeutic option that is highly effective for treating obstructive sleep apnoea (OSA). MMA provides a solution for OSA patients that have difficulty accepting lifelong treatments with continuous positive airway pressure or mandibular advancement devices. The goal of this study was to investigate the different characteristics that determine OSA treatment success/failure after MMA. The apnoea-hypopnoea index (AHI) was used to determine the success or failure of OSA treatment after MMA. Sixty-two patients underwent MMA for moderate and severe OSA. A 71% success rate was observed with a mean AHI reduction of 69%. A statistically significant larger neck circumference was measured in patients with failed OSA treatments following MMA (P=0.008), and older patients had failed OSA treatments with MMA: 58 vs. 53 years respectively (P=0.037). Cephalometric analysis revealed no differences between successful and failed OSA treatment outcomes. There was no difference in maxillary and mandibular advancements between success and failed MMA-treated OSA patients. The complications most frequently reported following MMA were sensory disturbances in the inferior alveolar nerve (60%) and malocclusion (24%). The results suggest that age and neck girth may be important factors that could predict susceptibility to OSA treatment failures by MMA. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Prevalence of obstructive sleep apnea in patients with chronic wounds.

    Science.gov (United States)

    Patt, Brian T; Jarjoura, David; Lambert, Lynn; Roy, Sashwati; Gordillo, Gayle; Schlanger, Richard; Sen, Chandan K; Khayat, Rami N

    2010-12-15

    Chronic non-healing wounds are a major human and economic burden. Obstructive sleep apnea (OSA) is prevalent in patients with obesity, diabetes, aging, and cardiovascular disease, all of which are risk factors for chronic wounds. We hypothesized that OSA would have more prevalence in patients of a wound center than the general middle-aged population. Consecutive patients of the Ohio State University Comprehensive Wound Center (CWC) were surveyed with the Berlin and Epworth questionnaires. In the second stage of the protocol, 50 consecutive unselected CWC patients with lower extremity wounds underwent home sleep studies. In 249 patients of the CWC who underwent the survey study, OSA had been previously diagnosed in only 22%. The prevalence of high-risk status based on questionnaires for OSA was 46% (95% CI 40%, 52%). In the 50 patients who underwent home sleep studies, and using an apnea hypopnea index of 15 events per hour, the prevalence of OSA was 57% (95% CI 42%, 71%). There was no difference between the Berlin questionnaire score and weight between patients with OSA and those without. The prevalence of OSA in patients with chronic wounds exceeds the estimated prevalence of OSA in the general middle aged population. This study identifies a previously unrecognized population with high risk for OSA. Commonly used questionnaires were not sufficiently sensitive for the detection of high risk status for OSA in this patient population.

  19. Inflammatory markers and obstructive sleep apnea in obese children: the NANOS study.

    Science.gov (United States)

    Gileles-Hillel, Alex; Alonso-Álvarez, María Luz; Kheirandish-Gozal, Leila; Peris, Eduard; Cordero-Guevara, José Aurelio; Terán-Santos, Joaquin; Martinez, Mónica Gonzalez; Jurado-Luque, María José; Corral-Peñafiel, Jaime; Duran-Cantolla, Joaquin; Gozal, David

    2014-01-01

    Obesity and obstructive sleep apnea syndrome (OSA) are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities. To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG) variables. Methods. In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4-15 years) were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw. Plasma samples were assayed for multiple inflammatory markers. 204 children were enrolled in the study; 75 had OSA, defined by an obstructive respiratory disturbance index (RDI) of 3 events/hour total sleep time (TST). BMI, gender, and age were similar in OSA and no-OSA children. Monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in OSA children, with interleukin-6 concentrations being higher in moderate-severe OSA (i.e., AHI > 5/hrTST; P < 0.01), while MCP-1 levels were associated with more prolonged nocturnal hypercapnia (P < 0.001). IL-6, MCP-1, and PAI-1 are altered in the context of OSA among community-based obese children further reinforcing the proinflammatory effects of sleep disorders such as OSA. This trial is registered with ClinicalTrials.gov NCT01322763.

  20. Projeto Sabão Ecológico: uma estratégia educacional para a reciclagem do óleo de cozinha no município de Viçosa

    Directory of Open Access Journals (Sweden)

    Yaankha Bharbara Allecxandria Bernardo da Silva Barbosa Cardoso

    2017-12-01

    Full Text Available O descarte inadequado de resíduos de óleo de cozinha usado pode causar danos ambientais no local onde é descartado, bem como no entorno, fato que desrespeita um dos direitos do ser humano: o acesso ao ambiente ecologicamente equilibrado. Neste contexto, o Projeto Sabão Ecológico foi criado pela ONG Engenheiros Sem Fronteiras – Núcleo Viçosa, devido à necessidade de conscientizar a população sobre os danos inerentes ao descarte incorreto desse óleo. Por meio de oficinas teórico-práticas, que ensinam a produção de sabão artesanal a partir do óleo usado, o projeto apresenta um destino sustentável para o mesmo, gerando um produto capaz de auxiliar no orçamento doméstico ou mesmo gerar renda para a comunidade, já tendo alcançado avaliação positiva pelos participantes. Dessa forma, o projeto tem impactado diversas esferas, promovendo benefícios ambientais, sociais e financeiros aos envolvidos, por meio da educação ambiental, utilizada como ferramenta de transformação da sociedade.

  1. Sleep Misperception in Chronic Insomnia Patients with Obstructive Sleep Apnea Syndrome: Implications for Clinical Assessment.

    Science.gov (United States)

    Choi, Su Jung; Suh, Sooyeon; Ong, Jason; Joo, Eun Yeon

    2016-11-15

    To investigate whether sleep perception (SP), defined by the ratio of subjective and objective total sleep time, and habitual sleep time in various sleep disorders may be based on comorbid insomnia status. We enrolled 420 patients (age 20-79 y) who underwent polysomnography (PSG). They were divided into three groups based on chief complaints: chronic insomnia (CI, n = 69), patients with both obstructive sleep apnea and insomnia (OSA-I, n = 49) or OSA only (OSA, n = 149). Healthy volunteers were also recruited (normal controls [NC], n = 80). We compared differences in PSG parameters and habitual sleep duration and investigated the discrepancy between objective and subjective total sleep time (TST) and sleep latency among four groups. Subjective TST was defined as sleep time perceived by participants the next morning of PSG. SP for TST was highest in the OSA group (median 92.9%), and lowest in the CI group (80.3%). SP of the NC group (91.4%) was higher than the CI, but there was no difference between OSA-I and OSA groups. OSA-I had higher depressive mood compared to the OSA group (p insomnia and arousal index of PSG. Insomnia patients with (OSA-I) or without OSA (CI) reported the smallest discrepancy between habitual sleep duration and objective TST. Patients with OSA with or without insomnia have different PSG profiles, which suggests that objective measures of sleep are an important consideration for differentiating subtypes of insomnia and tailoring proper treatment. A commentary on this articles appears in this issue on page 1437. © 2016 American Academy of Sleep Medicine

  2. Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder.

    Science.gov (United States)

    Murata, Emi; Mohri, Ikuko; Kato-Nishimura, Kumi; Iimura, Jiro; Ogawa, Makoto; Tachibana, Masaya; Ohno, Yuko; Taniike, Masako

    2017-06-01

    Obstructive sleep apnea (OSA) may affect daily cognitive functioning in children. The aims of our study were two-fold. The first aim was to detect, using the Child Behavior Checklist (CBCL), whether adenotonsillectomy (AT) for the treatment of OSA improved the behavior of children with autism spectrum disorder (ASD). The second aim was to identify characteristics for behavioral improvement following the treatment of OSA in these children with ASD. The behaviors of ASD children aged 5-14 years diagnosed as having OSA (n=30) were evaluated using CBCL before and after AT. CBCL evaluation of ASD children without OSA at two time points with the same interval served as a control (n=24). We statistically examined the two groups. In addition, we conducted a paired t-test to assess changes in CBCL Tscores between the improved group and unchanged/deteriorated group to identify characteristics that may affect behavioral changes following OSA treatment. After AT, T-scores of the CBCL scales were significantly improved in the OSA group, but no change was observed in the control. A paired t-test revealed that the improved group had significantly higher scores on the CBCL pre-AT than the unchanged/deteriorated group in ASD children with OSA after OSA treatment. Behavioral problems were significantly improved following AT in ASD children with OSA. Early detection and treatment of children with OSA is essential to prevent behavioral problems and to support mental development. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Association between absolute tumor burden and serum bone-specific alkaline phosphatase in canine appendicular osteosarcoma.

    Science.gov (United States)

    Sternberg, R A; Pondenis, H C; Yang, X; Mitchell, M A; O'Brien, R T; Garrett, L D; Helferich, W G; Hoffmann, W E; Fan, T M

    2013-01-01

    In dogs with appendicular osteosarcoma (OSA), increased pretreatment serum bone-specific alkaline phosphatase (BALP) activity is a negative prognostic factor, associated with shorter disease-free intervals and survival times, but a biologic basis for observed differential serum BALP activities in canine OSA patients remains incompletely defined. Serum BALP activity will correlate with absolute tumor burden in dogs with OSA. This study included 96 client-owned dogs with appendicular OSA. In canine OSA cell lines, the expression and membranous release of BALP was evaluated in vitro. The correlation between serum BALP activity and radiographic primary tumor size was evaluated in OSA-bearing dogs. In dogs developing visceral OSA metastases, serial changes in serum BALP activities were evaluated in relation to progression of macroscopic metastases, and visceral metastatic OSA cells were evaluated for BALP expression. In vitro, BALP expression was not associated with either tumorigenic or metastatic phenotype, rather the quantity of membranous BALP released was proportional with cell density. In dogs devoid of macroscopic metastases, there was a positive correlation between serum BALP activity and absolute primary tumor size. In dogs with progressive OSA metastases, serum BALP activity increased and coincided with the development of macroscopic metastases. OSA cells derived from visceral metastatic lesions retained BALP expression. Tumor burden is a determinant of serum BALP activity in dogs with appendicular OSA. The association between increased pretreatment BALP activity and negative clinical prognosis may simply be attributed to greater initial tumor burden, and consequently more advanced tumor stage. Copyright © 2013 by the American College of Veterinary Internal Medicine.

  4. Prevalence of metabolic syndrome in a north Indian hospital-based population with obstructive sleep apnoea

    Science.gov (United States)

    Agrawal, Swastik; Sharma, Surendra K.; Sreenivas, Vishnubhatla; Lakshmy, Ramakrishnan

    2011-01-01

    Background & objectives: Obstructive sleep apnoea (OSA) is known to be associated with cardiovascular risk factors and metabolic syndrome (MS). The burden of MS in patients with OSA in India is unknown. We investigated the prevalence of MS and its components in a cross-sectional study in patients with and without OSA in a hospital-based population of a tertiary health care centre in New Delhi, India. Methods: Consecutive patients undergoing overnight polysomnography in the Sleep Laboratory of the Department of Internal Medicine of All India Institute of Medical Sciences (AIIMS) hospital, New Delhi, were studied. Anthropometry and body composition analysis, blood pressure (BP), fasting blood glucose, insulin resistance by homeostasis model assessment (HOMA-IR) and fasting blood lipid profile were measured. MS was defined using the National Cholesterol Education Program Adult treatment panel III criteria, with Asian cut-off values for abdominal obesity. Results: Of the 272 subjects recruited, 187 (82%) had OSA [apnoea-hypopnoea index (AHI)>5 events/h] while 40 (18%) had a normal sleep study. Prevalence of MS in OSA patients was 79 per cent compared to 48 per cent in non-OSA individuals [OR 4.15, (2.05-8.56), P<0.001]. Prevalence of OSA in mild, moderate and severe OSA was 66, 72 and 86 per cent, respectively (P<0.001). Patients with OSA were more likely to have higher BP [OR: 1.06 (1.02-1.11)], fasting insulin [OR: 1.18 (1.05-1.32)], HOMA-IR [OR: 1.61 (1.11-2.33)] and waist circumference [OR: 1.20 (1.13-1.27)]. Interpretation & conclusions: Our findings suggest that OSA is associated with a 4-fold higher occurrence of MS than patients without OSA. The prevalence of MS increases with increasing severity of OSA, therefore, early detection will be beneficial. PMID:22199102

  5. Thiol/disulfide homeostasis in pregnant women with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Üstündağ, Yasemin; Demirci, Hakan; Balık, Rifat; Erel, Ozcan; Özaydın, Fahri; Kücük, Bilgen; Ertaş, Dilber; Ustunyurt, Emin

    2017-11-27

    Repetitive episodes of hypoxia and reoxygenation during sleep in patients with obstructive sleep apnea syndrome (OSAS) resemble an ischemia-reperfusion injury. We aimed to test the hypothesis that oxidative stress occurs in pregnant women with OSAS. We also aimed to compare thiol/disulfide homeostasis with ischemia-modified albumin (IMA) and total antioxidant capacity (TAC) as markers of ischemia-reperfusion injury in pregnant women with and without OSAS and healthy control. This study included 29 pregnant women with OSAS, 30 women without OSAS in the third trimester applying for periodic examinations, and 30 healthy women. Serum IMA and TAC (using the ferric reducing power of plasma method) were measured. Serum thiol/disulfide homeostasis was determined by a novel automated method. The mean age of the pregnant women with OSAS was 31.0 ± 4.7 years with a mean gestational age of 36.5 ± 3.0 weeks. The mean age of pregnant women without OSAS was 29.8 ± 4.9 years with a mean gestational age of 36.9 ± 2.7 weeks. The mean age of the nonpregnant control group was 29.7 ± 6.4 years. Both native thiol (291 ± 29 μmol/L versus 314 ± 30 μmol/L; p = .018) and total thiol (325 ± 32 versus 350 ± 32, p = .025) levels were lower in pregnant women with OSAS compared to pregnant women without OSAS, respectively (p total thiol levels were lower in pregnant women with OSAS compared to those without OSAS. However, dynamic thiol/disulfide homeostasis parameters cannot provide valuable information to discriminate OSAS in pregnant women.

  6. The correlation between growth hormone receptor (GHR) polymorphism and obstructive sleep apnea syndrome among the Han and Hani population in China.

    Science.gov (United States)

    Ji, Juanjuan; Yang, Yunwei; Lin, Yan; Li, Xudong; Wu, Xiaoguang; Yang, Xi; Zhong, Ling; Tang, Ying; Huang, Zhiyong; He, Xiaoguang

    2018-04-13

    Obstructive sleep apnea syndrome (OSAS) is a common health problem that is associated with abnormality in craniofacial morphology. The growth hormone receptor (GHR) belongs to the cytokine receptor superfamily and mediates the majority of growth hormone signaling, which, among other functions, determines mandibular growth and development. The aim of this study was to determine if correlations exist between single nucleotide polymorphisms (SNPs) in the GHR gene and OSAS in the Han or Hani ethnic groups in China. A total of 274 Han subjects (106 with OSAS and 168 without OSAS) and a total of 270 Hani subjects (64 with OSAS and 206 without OSAS) were enrolled in our study. Genomic DNA was extracted from peripheral blood obtained from all subjects. Genotyping was undertaken for eight SNPs in the GHR gene (rs3756416, rs7727047, rs2910875, rs12153009, rs2972781, rs12518414, rs4410646, and rs6451620) using PCR amplification and Sanger sequencing. The genotype frequency of rs12518414 was associated with OSAS in both the Han and Hani groups, and the A allele frequency was remarkably lower in Hani OSAS patients compared with Hani controls (16.7 vs 29.9%). In addition, the G allele frequency of the rs3756416 SNP was significantly lower in OSAS patients compared with normal controls in the Hani ethnic group (12.5 vs 24.6%). In a comparison between ethnic groups, genotype frequencies of four SNPs (rs2972781, rs6451620, rs12518414, and rs7727047) differed between Han and Hani OSAS patients, with the A allele frequency of the rs12518414 and G allele frequency of the rs7727047 were significantly higher in the Han OSAS patients. In conclusion, significant associations were detected between some SNPs in the GHR gene and OSAS occurrence while others appeared to be ethnicity-dependent.

  7. Obstructive sleep apnea and the risk of atopic dermatitis: a population-based case control study.

    Directory of Open Access Journals (Sweden)

    Kai-Jen Tien

    Full Text Available BACKGROUND: Obstructive sleep apnea (OSA is associated with systemic inflammation and induces various comorbid medical diseases. To date, no study has explored the relationship between OSA and atopic dermatitis (AD, an inflammatory and autoimmune skin disorder. This study investigated the longitudinal risk for AD in patients with OSA. METHODS: A random sample of 1,000,000 individuals from Taiwan's National Health Insurance database was collected. From this sample, 1222 patients with newly-diagnosed OSA between 2000 and 2005 were identified and compared with a matched cohort of 18330 patients without OSA. All patients were tracked for 5.5 years from the index date in order to identify which patients subsequently developed AD. RESULTS: During the 5.5-year follow-up period, the incidence rates of AD in the OSA cohort and comparison groups were 9.81 and 6.21 per 1000 person-years, respectively. After adjustment for age, gender, diabetes, hypertension, coronary heart disease, obesity, allergy, allergic rhinitis, asthma, monthly income, and geographic location, patients with OSA were 1.5-times more likely to develop AD than patients without OSA (95% CI = 1.15-1.95, p = 0.0025. The hazard risk for AD was greater in male OSA patients and young OSA patients (0-18 and 19-34 years, adjusted HRs being 1.53 (95% CI = 1.14-2.06, p = 0.005, 4.01(95% CI = 1.57-10.26, p = 0.0038 and 1.75(95% CI = 1.00-3.04, p = 0.0483, respectively. The log-rank test indicated that OSA patients <35-years-old had significantly higher cumulative incidence rates of AD than those patient of the same age in the comparison group (p = 0.0001. CONCLUSION: Patients with OSA, especially male patients and younger patients, are at an increased risk for AD later in life.

  8. Keha ja häälega kirjutatud lood I-III / Heili Einasto

    Index Scriptorium Estoniae

    Einasto, Heili

    2006-01-01

    Mõtteid Soome Rahvusooperi etendustelt 2006. aasta kevadel. Põhjamaade koreograafia õhtust. I. osa: Põhjamaade koreograafia õhtu; II. osa: John Neumeieri "Kajakas"; III. osa: W. A. Mozarti ooperid

  9. Fate of oil-SPM aggregates in the St-Lawrence estuary

    International Nuclear Information System (INIS)

    Khelifa, A.; Brown, C.

    2009-01-01

    The formation of aggregates of oil-suspended particulate matter (SPM) has been studied extensively over the last 4 decades. This paper presented the results of a full scale numerical study that examined the fate of oil-SPM aggregates (OSAs) formed in the St-Lawrence estuary in both shallow and deep water. OSAs form from the natural heteroaggregation between suspended oil droplets and SPM following an oil spill in the aquatic environment. Until recently, it was believed that this natural process helps clean oiled shorelines by dispersing spilled oil in coastal waters rich in SPM. However, new studies have shown that the density of OSAs may exceed the density of the seawater and their formation may result in the transfer of considerable amounts of oil from the water column to the seafloor. This study was conducted using real hydrodynamic data, recent laboratory data related to the size, density and oil content of OSAs and the commercial CHEMMAP software. Simulations were run for 5 days for each scenario. The concentrations of OSAs in the water column and on the seafloor were tracked in space and time. According to the results, the size and density of OSAs have a strong influence on the fate of OSAs, as do water depth and current density. OSAs of 200 μm in size and higher settled within half a day in shallow water zones, and within 5 days in deep water zones. The resulting oil concentration in bottom sediment showed strong increase with the size of OSA in shallow water, but small increase in deep water. Sedimentation of OSAs with an average size of 200 μm is affected by the effective density. In general, horizontal mixing had a much smaller effect on the sedimentation of OSAs than those obtained with their size and effective density. It was concluded that ideally, the fate of OSAs should be addressed using a dynamic model that relates the size of OSAs to local intensity of turbulence. 20 refs., 1 tab., 10 figs.

  10. Effects of continuous positive airway pressure on anxiety, depression, and major cardiac and cerebro-vascular events in obstructive sleep apnea patients with and without coronary artery disease.

    Science.gov (United States)

    Lee, Ming-Chung; Shen, Yu-Chih; Wang, Ji-Hung; Li, Yu-Ying; Li, Tzu-Hsien; Chang, En-Ting; Wang, Hsiu-Mei

    2017-01-01

    Obstructive sleep apnea (OSA) is associated with bad cardiovascular outcomes and a high prevalence of anxiety and depression. This study investigated the effects of continuous positive airway pressure (CPAP) on the severity of anxiety and depression in OSA patients with or without coronary artery disease (CAD) and on the rate of cardio- and cerebro-vascular events in those with OSA and CAD. This prospective study included patients with moderate-to-severe OSA, with or without a recent diagnosis of CAD; all were started on CPAP therapy. Patients completed the Chinese versions of the Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) at baseline and after 6-month follow-up. The occurrence of major adverse cardiac and cerebrovascular events (MACCE) was assessed every 3 months up to 1 year. BAI scores decreased from 8.5 ± 8.4 at baseline to 5.4 ± 6.9 at 6 months in CPAP-compliant OSA patients without CAD ( P < 0.05). BAI scores also decreased from 20.7 ± 14.9 to 16.1 ± 14.5 in CPAP-compliant OSA patients with CAD. BDI-II scores decreased in CPAP-compliant OSA patients without CAD (from 11.1 ± 10.7 at baseline to 6.6 ± 9.5 at 6 months) and in CPAP-compliant OSA patients with CAD (from 20.4 ± 14.3 to 15.9 ± 7.3). In addition, there was a large effect size (ES) of BAI and BDI in 6-month CPAP treatment of OSA patients with CAD and a large ES in those with OSA under CPAP treatment. In OSA patients with CAD, the occurrence of MACCE was significantly lower in CPAP-compliant patients than that in CPAP noncompliant patients (11% in CPAP compliant and 50% in noncompliant; P < 0.05). CPAP improved anxiety and depression in OSA patients regardless of CAD. In OSA patients with CAD, CPAP-compliant patients had a lower 1-year rate of MACCE than CPAP-noncompliant patients.

  11. Plasma natriuretic peptides in children and adolescents with obstructive sleep apnoea and their changes following intervention

    Directory of Open Access Journals (Sweden)

    Albert Martin Li

    2014-03-01

    Full Text Available Objective: This study aimed to evaluate circulating natriuretic peptides (NP concentration in obese and non-obese children and adolescents with and without OSA, and their levels following OSA treatment.Methods: Subjects with habitual snoring and symptoms suggestive of OSA were recruited. They underwent physical examination and overnight polysomnography (PSG. OSA was diagnosed if obstructive apnea hypopnea index (OAHI ≥1/h. Fasting serum atrial natriuretic peptide (ANP and brain natriuretic peptide (BNP were taken after overnight PSG. The subjects were divided into obese, non-obese, with and without OSA groups for comparisons.Results: 114 children (77 were boys with a median (IQR age of 10.8 (8.3-12.7 years (range: 2.4-11.8 years were recruited. Sixty-eight subjects were found to have OSA. Natriuretic peptide levels did not differ between subjects with and without OSA in both obese and non-obese groups. . Stepwise multiple linear regressions revealed that body mass index (BMI z-score was the only independent factor associated with NP concentrations. Fifteen children with moderate-to-severe OSA (OAHI >5/h underwent treatment and there were no significant changes in both ANP and BNP levels after intervention.Conclusion: BMI rather than OSA was the main determinant of natriuretic peptide levels in school-aged children and adolescents.

  12. Cytotoxic action of Brazilian propolis in vitro on canine osteosarcoma cells.

    Science.gov (United States)

    Cinegaglia, N C; Bersano, P R O; Búfalo, M C; Sforcin, J M

    2013-09-01

    Osteosarcoma (OSA) is a primary bone neoplasm frequently diagnosed in dogs. The biology of OSA in pet dogs is identical to that of pediatric patients, and it has been considered an excellent model in vivo to study human OSA. Since the individual response to chemotherapy is unpredictable and considering that propolis is a natural product with several biological properties, this work evaluated the cytotoxic action of propolis on canine OSA cells. The primary cell culture of canine OSA was obtained from the tumor of a dog with OSA. Cell viability was assessed after incubation with propolis, 70% ethanol (propolis solvent), and carboplatin after 6, 24, 48, and 72 h. Cell viability was analyzed by the crystal violet method. Data showed that canine OSA cells were sensitive to propolis in a dose- and time-dependent manner and had a distinct morphology compared to control. Its solvent (70% ethanol) had no effect on cell viability, suggesting that the cytotoxic action was exclusively due to propolis. Our propolis sample exerted a cytotoxic effect on canine OSA cells, and its introduction as a possible therapeutic agent in vivo could be investigated, providing a new contribution to OSA treatment. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Metabolic aspects of obstructive sleep apnoea syndrome

    Directory of Open Access Journals (Sweden)

    M. R. Bonsignore

    2009-06-01

    Full Text Available Insulin resistance is often associated with obstructive sleep apnoea syndrome (OSAS and could contribute to cardiovascular risk in OSAS. Sleep loss and intermittent hypoxia could contribute to the pathogenesis of the metabolic alterations associated with obesity, a common feature of OSAS. The biology of the adipocyte is being increasingly studied, and it has been found that hypoxia negatively affects adipocyte function. In November 2007, the European Respiratory Society and two EU COST Actions (Cardiovascular risk in OSAS (B26 and Adipose tissue and the metabolic syndrome (BM0602, held a Research Seminar in Düsseldorf, Germany, to discuss the following: 1 the effects of hypoxia on glucose metabolism and adipocyte function; 2 the role of inflammatory activation in OSAS and obesity; 3 the alarming rates of obesity and OSAS in children; 4 the harmful effects of the metabolic syndrome in OSAS; 5 the effects of OSAS treatment on metabolic variables; and 6 the relationship between daytime sleepiness and hormonal and inflammatory responses. Insulin resistance in skeletal muscle, the role of the endocannabinoid system and novel pharmacological approaches to treat insulin resistance were also discussed. As obesity and hypoxia could be the basic links between OSAS and adipocyte dysfunction, further research is needed to translate these new data into clinical practice.

  14. Effects of obstructive sleep apnea and its treatment over the erectile function: a systematic review

    Directory of Open Access Journals (Sweden)

    Felix Campos-Juanatey

    2017-01-01

    Full Text Available Erectile dysfunction (ED is considered a condition with a broad range of etiologies. Obstructive sleep apnea (OSA syndrome is one of the lesser studied risk factors for ED. We intend to summarize the current evidence on the relationship between OSA and sexual impairment, focusing on the results in terms of erectile function of the different therapies offered to OSA patients. A systematic review was conducted, selecting articles related to the physiology of OSA and ED, and to the treatments of OSA syndrome and their reported outcomes in erectile and sexual function. Higher prevalences of ED in the OSA groups have been published. However, whether this effect on the erectile function occurs in the entire range of OSA severities remains unclear. Several hypotheses were proposed to explain the physiology of this association. Continuous Positive Airway Pressure as a treatment for OSA patients with ED has achieved a significative improvement in the sexual parameters in most of the studies. Phosphodiesterase type 5 inhibitors (iPDE5 on demand are useful as a treatment for ED in this subgroup of patients, with high satisfaction rates. The surgical treatment for the OSA evidenced benefits over the erectile function, and the effect on the sexual satisfaction of the therapy using Mandibular Advancement Devices is still undefined.

  15. [Quality of life in patients with obstructive sleep apnea].

    Science.gov (United States)

    Kasibowska-Kuźniar, Kamilla; Jankowska, Renata; Kuźniar, Tomasz

    2004-11-01

    Obstructive sleep apnea syndrome (OSA) is a condition affecting up to 5% of the population, in which episodes of upper airway obstruction lead to temporary cessation of airflow, disturbed sleep architecture and daily somnolence. The health consequences of OSA also include psychological and cognitive deficits, an increased risk of systemic and pulmonary hypertension, coronary disease, bradyarrhythmias and motor vehicle accidents. Symptoms and complications of OSA lead to a significant decrease of health-related quality of life (HRQOL) of affected patients. We review the current literature on HRQOL effects of OSA and its treatment. There is good evidence of beneficial effect of the continuous positive airway pressure (CPAP) therapy on the quality of life of patients with OSA. Improvements in HRQOL are most appreciable in patients with moderate to severe OSA, although they also seem to be present in selected patients with mild OSA. The effects of dental devices and surgical procedures on HRQOL of patients with OSA have not been studied in randomized, placebo-controlled trials. Health-related quality of life has become one of the major outcome measures in patients with sleep apnea. Assessment of HRQOL has become a crucial part of any clinical study involving patients with OSA.

  16. Oncostatin M promotes STAT3 activation, VEGF production, and invasion in osteosarcoma cell lines

    International Nuclear Information System (INIS)

    Fossey, Stacey L; Bear, Misty D; Kisseberth, William C; Pennell, Michael; London, Cheryl A

    2011-01-01

    We have previously demonstrated that both canine and human OSA cell lines, as well as 8 fresh canine OSA tumor samples, exhibit constitutive phosphorylation of STAT3, and that this correlates with enhanced expression of matrix metalloproteinase-2 (MMP2). While multiple signal transduction pathways can result in phosphorylation of STAT3, stimulation of the cytokine receptor gp130 through either IL-6 or Oncostatin M (OSM) is the most common mechanism through which STAT3 is activated. The purpose of this study was to evaluate the role of IL-6 and OSM stimulation on both canine and human OSA cell lines to begin to determine the role of these cytokines in the biology of OSA. RT-PCR and Western blotting were used to interrogate the consequences of OSM and IL-6 stimulation of OSA cell lines. OSA cells were stimulated with OSM and/or hepatocyte growth factor (HGF) and the effects on MMP2 activity (gel zymography), proliferation (CyQUANT), invasion (Matrigel transwell assay), and VEGF production (Western blotting, ELISA) were assessed. The small molecule STAT3 inhibitor LLL3 was used to investigate the impact of STAT3 inhibition following OSM stimulation of OSA cells. Our data demonstrate that the OSM receptor (OSMR), but not IL-6 or its receptor, is expressed by all human and canine OSA cell lines and canine OSA tumor samples; additionally, OSM expression was noted in all tumor samples. Treatment of OSA cell lines with OSM induced phosphorylation of STAT3, Src, and JAK2. OSM stimulation also resulted in a dose dependent increase in MMP2 activity and VEGF expression that was markedly reduced following treatment with the small molecule STAT3 inhibitor LLL3. Lastly, OSM stimulation of OSA cell lines enhanced invasion through Matrigel, particularly in the presence of rhHGF. In contrast, both OSM and HGF stimulation of OSA cell lines did not alter their proliferative capacity. These data indicate OSM stimulation of human and canine OSA cells induces STAT3 activation, thereby

  17. Oncostatin M promotes STAT3 activation, VEGF production, and invasion in osteosarcoma cell lines

    Directory of Open Access Journals (Sweden)

    Kisseberth William C

    2011-04-01

    Full Text Available Abstract Background We have previously demonstrated that both canine and human OSA cell lines, as well as 8 fresh canine OSA tumor samples, exhibit constitutive phosphorylation of STAT3, and that this correlates with enhanced expression of matrix metalloproteinase-2 (MMP2. While multiple signal transduction pathways can result in phosphorylation of STAT3, stimulation of the cytokine receptor gp130 through either IL-6 or Oncostatin M (OSM is the most common mechanism through which STAT3 is activated. The purpose of this study was to evaluate the role of IL-6 and OSM stimulation on both canine and human OSA cell lines to begin to determine the role of these cytokines in the biology of OSA. Methods RT-PCR and Western blotting were used to interrogate the consequences of OSM and IL-6 stimulation of OSA cell lines. OSA cells were stimulated with OSM and/or hepatocyte growth factor (HGF and the effects on MMP2 activity (gel zymography, proliferation (CyQUANT, invasion (Matrigel transwell assay, and VEGF production (Western blotting, ELISA were assessed. The small molecule STAT3 inhibitor LLL3 was used to investigate the impact of STAT3 inhibition following OSM stimulation of OSA cells. Results Our data demonstrate that the OSM receptor (OSMR, but not IL-6 or its receptor, is expressed by all human and canine OSA cell lines and canine OSA tumor samples; additionally, OSM expression was noted in all tumor samples. Treatment of OSA cell lines with OSM induced phosphorylation of STAT3, Src, and JAK2. OSM stimulation also resulted in a dose dependent increase in MMP2 activity and VEGF expression that was markedly reduced following treatment with the small molecule STAT3 inhibitor LLL3. Lastly, OSM stimulation of OSA cell lines enhanced invasion through Matrigel, particularly in the presence of rhHGF. In contrast, both OSM and HGF stimulation of OSA cell lines did not alter their proliferative capacity. Conclusions These data indicate OSM stimulation of

  18. Heart rate responses to autonomic challenges in obstructive sleep apnea.

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    Paul M Macey

    Full Text Available Obstructive sleep apnea (OSA is accompanied by structural alterations and dysfunction in central autonomic regulatory regions, which may impair dynamic and static cardiovascular regulation, and contribute to other syndrome pathologies. Characterizing cardiovascular responses to autonomic challenges may provide insights into central nervous system impairments, including contributions by sex, since structural alterations are enhanced in OSA females over males. The objective was to assess heart rate responses in OSA versus healthy control subjects to autonomic challenges, and, separately, characterize female and male patterns. We studied 94 subjects, including 37 newly-diagnosed, untreated OSA patients (6 female, age mean ± std: 52.1 ± 8.1 years; 31 male aged 54.3 ± 8.4 years, and 57 healthy control subjects (20 female, 50.5 ± 8.1 years; 37 male, 45.6 ± 9.2 years. We measured instantaneous heart rate with pulse oximetry during cold pressor, hand grip, and Valsalva maneuver challenges. All challenges elicited significant heart rate differences between OSA and control groups during and after challenges (repeated measures ANOVA, p<0.05. In post-hoc analyses, OSA females showed greater impairments than OSA males, which included: for cold pressor, lower initial increase (OSA vs. control: 9.5 vs. 7.3 bpm in females, 7.6 vs. 3.7 bpm in males, OSA delay to initial peak (2.5 s females/0.9 s males, slower mid-challenge rate-of-increase (OSA vs. control: -0.11 vs. 0.09 bpm/s in females, 0.03 vs. 0.06 bpm/s in males; for hand grip, lower initial peak (OSA vs. control: 2.6 vs. 4.6 bpm in females, 5.3 vs. 6.0 bpm in males; for Valsalva maneuver, lower Valsalva ratio (OSA vs. control: 1.14 vs. 1.30 in females, 1.29 vs. 1.34 in males, and OSA delay during phase II (0.68 s females/1.31 s males. Heart rate responses showed lower amplitude, delayed onset, and slower rate changes in OSA patients over healthy controls, and impairments may be more pronounced in

  19. Obstructive sleep apnea is associated with altered midbrain chemical concentrations.

    Science.gov (United States)

    Macey, Paul M; Sarma, Manoj K; Prasad, Janani P; Ogren, Jennifer A; Aysola, Ravi; Harper, Ronald M; Thomas, M Albert

    2017-11-05

    Obstructive sleep apnea (OSA) is accompanied by altered structure and function in cortical, limbic, brainstem, and cerebellar regions. The midbrain is relatively unexamined, but contains many integrative nuclei which mediate physiological functions that are disrupted in OSA. We therefore assessed the chemistry of the midbrain in OSA in this exploratory study. We used a recently developed accelerated 2D magnetic resonance spectroscopy (2D-MRS) technique, compressed sensing-based 4D echo-planar J-resolved spectroscopic imaging (4D-EP-JRESI), to measure metabolites in the midbrain of 14 OSA (mean age±SD:54.6±10.6years; AHI:35.0±19.4; SAO 2 min:83±7%) and 26 healthy control (50.7±8.5years) subjects. High-resolution T1-weighted scans allowed voxel localization. MRS data were processed with custom MATLAB-based software, and metabolite ratios calculated with respect to the creatine peak using a prior knowledge fitting (ProFit) algorithm. The midbrain in OSA showed decreased N-acetylaspartate (NAA; OSA:1.24±0.43, Control:1.47±0.41; p=0.03; independent samples t-test), a marker of neuronal viability. Increased levels in OSA over control subjects appeared in glutamate (Glu; OSA:1.23±0.57, Control:0.98±0.33; p=0.03), ascorbate (Asc; OSA:0.56±0.28, Control:0.42±0.20; (50.7±8.5years; p=0.03), and myo-inositol (mI; OSA:0.96±0.48, Control:0.72±0.35; p=0.03). No differences between groups appeared in γ-aminobutyric acid (GABA) or taurine. The midbrain in OSA patients shows decreased NAA, indicating neuronal injury or dysfunction. Higher Glu levels may reflect excitotoxic processes and astrocyte activation, and higher mI is also consistent with glial activation. Higher Asc levels may result from oxidative stress induced by intermittent hypoxia in OSA. Additionally, Asc and Glu are involved with glutamatergic processes, which are likely upregulated in the midbrain nuclei of OSA patients. The altered metabolite levels help explain dysfunction and structural deficits in

  20. Integração na criação de frangos de corte na microrregião de Viçosa - MG: viabilidade econômica e análise de risco

    Directory of Open Access Journals (Sweden)

    Adelson Martins Figueiredo

    2006-12-01

    Full Text Available Na microrregião de Viçosa - MG, a criação de frango de corte via contratos de integração com a PIF-PAF S/A Indústria e Comércio tornou-se fonte adicional de renda para as propriedades rurais de pequeno e médio porte. Assim, este trabalho visou verificar a viabilidade de contratos de integração nessa região; especificamente, pretendeu-se elaborar e analisar um projeto de implantação de um aviário, determinar a rentabilidade do investimento, mensurar os riscos da atividade sob o ponto de vista do integrado e auxiliar a tomada de decisão. Para isso, calcularam-se indicadores de viabilidade econômica do projeto, como Valor Presente Líquido, Taxa Interna de Retorno e Razão Benefício/Custo; além disso, foi feita uma análise de sensibilidade para posterior análise de risco. Os resultados apontaram para a viabilidade econômica do projeto; ademais constatou-se que a sua lucratividade é mais sensível aos componentes da receita do que dos custos, sendo o preço recebido por ave a variável de maior sensibilidade. Percebeu-se também que os contratos de integração não eliminam totalmente o risco da atividade e que a integradora transfere parte do risco de preços ao produtor.The chicken production in Viçosa area is done by integration agreement with Pif Paf Company and it is an important option for increasing the income of small farmers. The objective of this paper is to check the viability of integration agreements. A project of a plant for chicken production was drawn and observed in order to determine its profitability and risks, with the purpose of helping the decision making. The Net Present Value, Internal Rate of Return, Cost/Benefit Ratio, Risk Sensitivity and Risk Analysis were calculated. The results show that the project is feasible and the profitability is more sensitive to changes in production price than changes in production costs. This study also points out that the integration agreement does not eliminate the

  1. Manifestations of Insomnia in Sleep Apnea: Implications for Screening and Treatment.

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    Bailes, Sally; Rizzo, Dorrie; Baltzan, Marc; Grad, Roland; Pavilanis, Alan; Creti, Laura; Fichten, Catherine S; Libman, Eva

    2016-01-01

    The aims of this study were to examine the presence, type, and severity of insomnia complaints in obstructive sleep apnea (OSA) patients and to assess the utility of the Sleep Symptom Checklist (SSC) for case identification in primary care. Participants were 88 OSA patients, 57 cognitive-behavioral therapy for insomnia (CBT-I) patients, and 14 healthy controls (Ctrl). Each completed a sleep questionnaire as well as the SSC, which includes insomnia, daytime functioning, psychological, and sleep disorder subscales. Results showed that OSA patients could be grouped according to 3 insomnia patterns: no insomnia (OSA), n = 21; insomnia (OSA-I), n = 30, with a subjective complaint and disrupted sleep; and noncomplaining poor sleepers (OSA-I-NC), n = 37. Comparisons among the OSA, CBT-I, and Ctrl groups demonstrate distinct profiles on the SSC subscales, indicating its potential utility for both case identification and treatment planning.

  2. Impact of gender on snore-based obstructive sleep apnea screening

    International Nuclear Information System (INIS)

    De Silva, S; Abeyratne, U R; Hukins, C

    2012-01-01

    Obstructive sleep apnea syndrome (OSA) is a serious widespread disease in which upper airways (UA) are collapsed during sleep. OSA has marked male predominance in prevalence. Although women are less vulnerable to OSA, under-diagnosed OSA in women may associate with serious consequences. Snoring is commonly associated with OSA and one of the earliest symptoms. Snore sounds (SS) are generated due to vibration of the collapsing soft tissues of the UA. Structural and functional properties of the UA are gender dependent. SS capture these time varying gender attributed UA properties and those could be embedded in the acoustic properties of SS. In this paper, we investigate the gender-specific acoustic property differences of SS and try to exploit these differences to enhance the snore-based OSA detection performance. We developed a snore-based multi-feature vector for OSA screening and one time-measured neck circumference was augmented. Snore features were estimated from SS recorded in a sleep laboratory from 35 females and 51 males and multi-layer neural network-based pattern recognition algorithms were used for OSA/non-OSA classification. The results were K-fold cross-validated. Gender-dependent modeling resulted in an increase of around 7% in sensitivity and 6% in specificity at the decision threshold AHI = 15 against a gender-neutral model. These results established the importance of adopting gender-specific models for the snore-based OSA screening technique. (paper)

  3. Leptin and ghrelin levels in patients with obstructive sleep apnea syndrome.

    Science.gov (United States)

    Ulukavak Ciftci, Tansu; Kokturk, Oguz; Bukan, Neslihan; Bilgihan, Ayse

    2005-01-01

    Leptin is a hormone with well-investigated functions concerning body composition, energy homeostasis and feeding behavior in humans. The obstructive sleep apnea syndrome (OSAS) is strongly associated with obesity, which is known to be closely associated with hyperleptinemia. More recently, ghrelin, a hormone that also influences appetite and energy homeostasis, has been discovered. The aim of this study was to investigate serum leptin and ghrelin levels in obese patients with OSAS in comparison with equally obese controls without OSAS. Thirty untreated obese patients with moderate-severe OSAS (apnea-hypopnea index: AHI > or =15) and 22 obese controls (AHI <5) were studied. To confirm the diagnosis, all patients underwent standard polysomnography in our sleep disorders center. Serum samples were taken at 08:00 h in the morning after overnight fasting. Significantly higher serum leptin levels were found in OSAS patients compared to controls (p = 0.012), but there was no significant difference in serum ghrelin levels between OSAS patients and controls. Serum leptin levels were significantly correlated with body mass index in both OSAS patients (r = 0.55, p = 0.002) and controls (r = 0.46, p = 0.028), but only in OSAS patients was the leptin level significantly correlated with AHI (r = 0.38, p = 0.036). These data support findings suggesting that leptin is a hormonal factor affected by OSAS and not determined by obesity alone. Further studies are needed to investigate the relationship between serum ghrelin and OSAS. (c) 2005 S. Karger AG, Basel

  4. Obstructive sleep apnea: management considerations in psychiatric patients

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    Heck T

    2015-10-01

    Full Text Available Taryn Heck,1 Monica Zolezzi21Pharmacy Department, University of Alberta Hospital, Alberta Health Services, Edmonton, AB, Canada; 2Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, QatarAbstract: Psychiatric disorders and obstructive sleep apnea (OSA are often comorbid. However, there is limited information on the impact of psychotropic medications on OSA symptoms, on how to manage psychiatric pharmacotherapy in patients presenting with OSA, or on the effectiveness and challenges of OSA treatments in patients with comorbid mental illness. As such, the objective of this article is to provide an overview of some epidemiological aspects of OSA and treatment considerations in the management of OSA in individuals with comorbid psychiatric disorders. Predefined keywords were used to search for relevant literature in electronic databases. Data show that OSA is particularly prevalent in patients with psychiatric disorders. The medical care that patients with these comorbidities require can be challenging, as some of the psychiatric medications used by these patients may exacerbate OSA symptoms. As such, continuous positive airway pressure continues to be the first-line treatment, even in patients with psychiatric comorbidity. However, more controlled studies are required, particularly to determine continuous positive airway pressure compliance in patients with mental illness, the impact of treating OSA on psychiatric symptoms, and the impact of the use of psychotropic medications on OSA symptoms.Keywords: obstructive sleep apnea, psychiatric disorders, comorbidity, psychotropic medications

  5. Pulmonary hypertension and echocardiogram parameters in obstructive sleep apnea.

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    Wong, H T; Chee, K H; Chong, A W

    2017-06-01

    Obstructive sleep apnea (OSA) is a growing health hazard in the United States and worldwide. OSA is now recognized as a disorder with systemic manifestations and its association with obesity and adverse cardiovascular consequences. There is increasing evidence that OSA may be associated with systemic hypertension and an increased incidence of stroke, heart failure, myocardial infarction, and arrhythmias. Less information is available about the association between OSA and pulmonary hypertension (PH). We therefore conduct this study to look at the prevalence of the pulmonary hypertension in obstructive sleep apnea patient and to identify risk factors leading to pulmonary hypertension among OSA patient. We studied and analyzed all OSA patient confirmed by polysomnograph in the year 2015. Twenty-five patients with OSA were included in this study with prevalence of pulmonary hypertension of 16%. Univariate analysis of various factors revealed a statistically significant association between having the lowest SpO 2 of pulmonary hypertension (p = 0.016). There were no statistically significant associations between age, gender, smoking status, hypertension, body mass index (BMI), or apnea-hypopnea index (AHI) with occurrence of pulmonary hypertension. AHI is not a good predictor for pulmonary hypertension. The real value of using AHI to predict the health risk of OSA is doubtful. We recommend routine echocardiogram among OSA patient. The objective information in the echocardiogram provides evidence for counseling of patient with disease of OSA and hence hopefully can improve compliance of patient to treatment especially usage of CPAP.

  6. Inflammatory Markers and Obstructive Sleep Apnea in Obese Children: The NANOS Study

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    Alex Gileles-Hillel

    2014-01-01

    Full Text Available Introduction. Obesity and obstructive sleep apnea syndrome (OSA are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities. Aim. To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG variables. Methods. In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4–15 years were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw. Plasma samples were assayed for multiple inflammatory markers. Results. 204 children were enrolled in the study; 75 had OSA, defined by an obstructive respiratory disturbance index (RDI of 3 events/hour total sleep time (TST. BMI, gender, and age were similar in OSA and no-OSA children. Monocyte chemoattractant protein-1 (MCP-1 and plasminogen activator inhibitor-1 (PAI-1 levels were significantly higher in OSA children, with interleukin-6 concentrations being higher in moderate-severe OSA (i.e., AHI > 5/hrTST; P<0.01, while MCP-1 levels were associated with more prolonged nocturnal hypercapnia (P<0.001. Conclusion. IL-6, MCP-1, and PAI-1 are altered in the context of OSA among community-based obese children further reinforcing the proinflammatory effects of sleep disorders such as OSA. This trial is registered with ClinicalTrials.gov NCT01322763.

  7. Impaired Neurobehavioural Performance in Untreated Obstructive Sleep Apnea Patients Using a Novel Standardised Test Battery

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    Angela L. D'Rozario

    2018-05-01

    Full Text Available Objective/BackgroundAlthough polysomnography (PSG is the gold-standard measure for assessing disease severity in obstructive sleep apnea (OSA, it has limited value in identifying individuals experiencing significant neurobehavioural dysfunction. This study used a brief and novel computerised test battery to examine neurobehavioural function in adults with and without OSA.Patients/Methods204 patients with untreated OSA [age 49.3 (12.5 years; body mass index, [BMI] 33.6 (8.0 kg/m2; Epworth sleepiness scale 12 (4.9/24; apnea hypopnea index 33.6 (25.8/h] and 50 non-OSA participants [age 39.2 (14.0 years; BMI 25.8 (4.2 kg/m2, ESS 3.6 (2.3/24]. All participants completed a computerised neurobehavioural battery during the daytime in the sleep clinic. The OSA group subsequently underwent an overnight PSG. The 30 min test battery assessed cognitive domains of visual spatial scanning and selective attention (Letter Cancellation Test, executive function (Stroop task and working memory (2- and 3-Back tasks, and a validated sustained attention task (psychomotor vigilance task, PVT. Group differences in performance were compared. Associations between disease severity and performance were examined in the OSA group.ResultsAfter controlling for age, gender and education, OSA patients demonstrated impaired performance on the Stroop-Text, 2 and 3-Back tasks, and the PVT compared with the non-OSA group. OSA patients had worse performance on the LCT with fewer average hits albeit with better accuracy. Some OSA polysomnographic disease severity measures were weakly correlated with performance.ConclusionsThis brief test battery may provide a sensitive, standardised method of assessing daytime dysfunction in OSA.

  8. Prevalence of obstructive sleep apnea among obese toddlers and preschool children.

    Science.gov (United States)

    Bin-Hasan, Saadoun; Katz, Sherri; Nugent, Zoe; Nehme, Joy; Lu, Zihang; Khayat, Abdullah; Al-Saleh, Suhail; Amin, Reshma; Narang, Indra

    2018-05-01

    Obstructive sleep apnea (OSA) is a common disorder estimated at 1-5% in the school-aged children. With the obesity prevalence reaching staggering rates globally, OSA in obese adolescents is estimated to be 4-5-folds higher than their lean peers. There is a paucity of data regarding obesity-related OSA in children 6 years and less. This is particularly relevant as OSA is associated with neurocognitive deficits. The aim of this study is to evaluate the prevalence of OSA among obese toddlers and preschool children and further to determine what other factors may be associated with the presence of OSA. A retrospective study involving children ≤6 years, identified from two Canadian pediatric tertiary care centers who had an in-lab polysomnography (PSG). Obesity was defined by a BMI of > 95th percentile for age and gender or a z-score of > 2. OSA was diagnosed if the obstructive apnea-hypopnea index (OAHI) was greater than 2 events per hour. There were 60 participants included; the mean age was 4.4 years (standard deviation [SD] ± 1.7), mean BMI z-score was 3.0 (SD ± 1.2). Of these, 22/60 (36.6%) had OSA. Compared with the non-OSA group, the OSA group had a higher Epworth sleepiness score (p = 0.03) and were more likely to snore (p = 0.01). Young obese children should be assessed for OSA. A history of snoring and daytime sleepiness may be useful indicators to facilitate triage for a PSG, especially in resource-limited settings.

  9. Review of and Updates on Hypertension in Obstructive Sleep Apnea

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    Masood Ahmad

    2017-01-01

    Full Text Available Obstructive sleep apnea (OSA is a prevalent sleep disorder as is hypertension (HTN in the 21st century with the rising incidence of obesity. Numerous studies have shown a strong association of OSA with cardiovascular morbidity and mortality. There is overwhelming evidence supporting the relationship between OSA and hypertension (HTN. The pathophysiology of HTN in OSA is complex and dependent on various factors such as sympathetic tone, renin-angiotensin-aldosterone system, endothelial dysfunction, and altered baroreceptor reflexes. The treatment of OSA is multifactorial ranging from CPAP to oral appliances to lifestyle modifications to antihypertensive drugs. OSA and HTN both need prompt diagnosis and treatment to help address the growing cardiovascular morbidity and mortality due to these two entities.

  10. Obstructive sleep apnea and cancer: effects of intermittent hypoxia?

    Science.gov (United States)

    Kukwa, Wojciech; Migacz, Ewa; Druc, Karolina; Grzesiuk, Elzbieta; Czarnecka, Anna M

    2015-01-01

    Obstructive sleep apnea (OSA) is a common disorder characterized by pauses in regular breathing. Apneic episodes lead to recurrent hypoxemia-reoxygenation cycles with concomitant cellular intermittent hypoxia. Studies suggest that intermittent hypoxia in OSA may influence tumorigenesis. This review presents recent articles on the potential role of OSA in cancer development. Relevant research has focused on: molecular pathways mediating the influence of intermittent hypoxia on tumor physiology, animal and epidemiological human studies linking OSA and cancer. Current data relating OSA to risk of neoplastic disease remain scarce, but recent studies reveal the potential for a strong relation. More work is, therefore, needed on the impact of OSA on many cancer-related aspects. Results may offer enlightenment for improved cancer diagnosis and treatment.

  11. Hippocampal hypertrophy and sleep apnea: a role for the ischemic preconditioning?

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    Ivana Rosenzweig

    Full Text Available The full impact of multisystem disease such as obstructive sleep apnoea (OSA on regions of the central nervous system is debated, as the subsequent neurocognitive sequelae are unclear. Several preclinical studies suggest that its purported major culprits, intermittent hypoxia and sleep fragmentation, can differentially affect adult hippocampal neurogenesis. Although the prospective biphasic nature of chronic intermittent hypoxia in animal models of OSA has been acknowledged, so far the evidence for increased 'compensatory' neurogenesis in humans is uncertain. In a cross-sectional study of 32 patients with mixed severity OSA and 32 non-apnoeic matched controls inferential analysis showed bilateral enlargement of hippocampi in the OSA group. Conversely, a trend for smaller thalami in the OSA group was noted. Furthermore, aberrant connectivity between the hippocampus and the cerebellum in the OSA group was also suggested by the correlation analysis. The role for the ischemia/hypoxia preconditioning in the neuropathology of OSA is herein indicated, with possible further reaching clinical implications.

  12. Rheological, pasting, thermal and retrogradation properties of octenyl succinic anhydride modified potato starch

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    Chuin WON

    Full Text Available Abstract The objective of the present study was to investigate the rheological, pasting, and thermal properties of octenyl succinic anhydrate (OSA-modified potato starch. Potato starch was modified using different concentrations of OSA (0, 1, 3, and 5%, v/v. The degree of substitution (DS for the OSA-modified starch ranged from 0.0012 to 0.0055. The amylose leaching values of native and OSA-modified potato starch with different DS levels were in the range of 47.09-87.32%. The gel strength values of the OSA-modified starch were lower than those of native potato starch. Rapid Visco Analyzer data showed that peak, hot pasting, final and setback viscosities of the native starch decreased after OSA modification. Dynamic shear rheological tests, conducted at 4 °C, indicated that OSA-modified potato starch had weak gel-like behavior with the storage moduli (G' higher than the loss moduli (G” over most of the frequency ranges (0.63-63.8 rad·s-1.

  13. Evaluation of obstructive sleep apnea symptoms in pregnant women with chronic disease.

    Science.gov (United States)

    Karaduman, Mevlüt; Sarı, Oktay; Aydoğan, Umit; Akpak, Yaşam Kemal; Semiz, Altuğ; Yılanlıoğlu, Necip Cihangir; Keskin, Uğur

    2016-10-01

    Obstructive sleep apnea syndrome (OSAS) is a disease which is estimated to be undiagnosed to a large extent. Hence, the prevalence of OSAS in pregnant women is unknown. We aimed to evaluate the symptoms of obstructive sleep apnea in pregnant women with chronic diseases. In the study, 97 pregnant women with chronic diseases and 160 healthy pregnant women were included. A form questioning socio-demographic characteristics and pregnancy characteristics, Epworth scale and the Berlin questionnaire to evaluate the risk of OSAS were applied to participants. It has been determined that 10-12.5% of healthy pregnant women, 34-45.4% of pregnants with chronic diseases and 20.6-23.3% of all pregnant women had a high risk of OSAS, the pregnants with chronic disease compared to healthy pregnant women had statistically significant higher risk of OSAS. The risk of OSAS was found to be significantly higher especially in pregnant women with hypertension and diabetes. OSAS can lead to the adverse consequences in pregnancy, should be questioned for all pregnants especially those with chronic diseases. Pregnant women with OSAS should be monitored more carefully in terms of diabetes and hypertension in antenatal care.

  14. Supra-Epiglottic Upper Airway Volume in Elderly Patients with Obstructive Sleep Apnea Hypopnea Syndrome.

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    Boutet, Claire; Abdirahman Mohamed Moussa, Syad; Celle, Sébastien; Laurent, Bernard; Barthélémy, Jean-Claude; Barral, Fabrice-Guy; Roche, Frédéric

    2016-01-01

    Small upper airway measurements areas and high body mass index are recognized risk factors for obstructive sleep apnea syndrome (OSAS) in non-elderly populations; however, there is limited information regarding elderly patients. We evaluated whether upper airway volume is associated with OSAS and OSAS treated with continuous positive airway pressure (CPAP) treatment and whether BMI is correlated with upper airway volume and measurements in elderly subjects. In 60 volunteers aged 75.58±0.9 years: 20 OSAS, 20 OSAS chronically treated with CPAP, and 20 controls, semi-automatic segmentation, retropalatal distance and transverse diameter of the supra-epiglottic upper airway were evaluated using 3DT1-weighted magnetic resonance imaging. Anteroposterior to transverse diameter ratio was defined as retropalatar diameter/transverse diameter. There were no significant differences in supra-epiglottic upper airway volume between OSAS, CPAP treated patients, and controls. There were significant differences in retropalatal distance and anteroposterior to transverse diameter ratio between OSAS, CPAP treated patients, and controls (P = 0.008 and Psupra-epiglottic upper airway volume. In elderly subjects, OSAS and body mass index are not associated with changes in supra-epiglottic upper airway volume but are associated with modification of pharynx shape.

  15. Association between QRS duration and obstructive sleep apnea.

    Science.gov (United States)

    Gupta, Shuchita; Cepeda-Valery, Beatriz; Romero-Corral, Abel; Shamsuzzaman, Abu; Somers, Virend K; Pressman, Gregg S

    2012-12-15

    Both obstructive sleep apnea (OSA) and prolonged QRS duration are associated with hypertension, heart failure, and sudden cardiac death. However, possible links between QRS duration and OSA have not been explored. Cross-sectional study of 221 patients who underwent polysomnography at our center. Demographics, cardiovascular risk factors and ECG were collected to explore a relationship between OSA and QRS duration. The apnea-hypopnea index (AHI) was positively correlated with QRS duration (r = 0.141, p = 0.03). Patients were divided into 3 groups: AHI 30 (55). The mean QRS duration prolonged significantly as OSA worsened (AHI 30, 95 ± 19.9 ms, p = 0.001). QRS ≥ 100 ms was present in 12.7% of patients with severe OSA compared with 0% in the rest of the sample (p < 0.0001). After adjustment for age, race, and cardiovascular risk factors, this association remained significant in women but not in men. QRS duration and OSA were significantly associated. Severity of OSA independently predicted prolonged QRS in women but not men. Nevertheless, prolongation of QRS duration in either sex may potentiate arrhythmic risks associated with OSA.

  16. Cellular and Phenotypic Characterization of Canine Osteosarcoma Cell Lines

    Directory of Open Access Journals (Sweden)

    Marie E. Legare, Jamie Bush, Amanda K. Ashley, Taka Kato, William H. Hanneman

    2011-01-01

    Full Text Available Canine and human osteosarcoma (OSA have many similarities, with the majority of reported cases occurring in the appendicular skeleton, gender predominance noted, high rate of metastasis at the time of presentation, and a lack of known etiology for this devastating disease. Due to poor understanding of the molecular mechanisms underlying OSA, we have characterized seven different OSA canine cell lines: Abrams, D17, Grey, Hughes, Ingles, Jarques, and Marisco and compared them to U2, a human OSA cell line, for the following parameters: morphology, growth, contact inhibition, migrational tendencies, alkaline phosphatase staining, heterologous tumor growth, double-strand DNA breaks, and oxidative damage. All results demonstrated the positive characteristics of the Abrams cell line for use in future studies of OSA. Of particular interest, the robust growth of a subcutaneous tumor and rapid pulmonary metastasis of the Abrams cell line in an immunocompromised mouse shows incredible potential for the future use of Abrams as a canine OSA model. Further investigations utilizing a canine cell model of OSA, such as Abrams, will be invaluable to understanding the molecular events underlying OSA, pharmaceutical inhibition of metastasis, and eventual prevention of this devastating disease.

  17. Gastric bypass is an effective treatment for obstructive sleep apnea in patients with clinically significant obesity.

    Science.gov (United States)

    Rasheid, Sowsan; Banasiak, Magdalena; Gallagher, Scott F; Lipska, Anna; Kaba, Shadi; Ventimiglia, Daniel; Anderson, W McDowell; Murr, Michel M

    2003-02-01

    We have demonstrated that obstructive sleep apnea (OSA) is prevalent in 60% of patients undergoing bariatric surgery. A study was conducted to determine whether weight loss following bariatric surgery ameliorates OSA. All 100 consecutive patients with symptoms of OSA were prospectively evaluated by polysomnography before gastric bypass. Preoperative and postoperative scores of Epworth Sleepiness Scale (ESS), Respiratory Disturbance Index (RDI), and other parameters of sleep quality were compared using t-test. Preoperative RDI was 40 +/- 4 (normal 5 events/hour, n = 100). 13 patients had no OSA, 29 had mild OSA, while the remaining 58 patients were treated preoperatively for moderate-severe OSA. At a median of 6 months follow-up, BMI and ESS scores improved (38 +/- 1 vs 54 +/- 1 kg/m2, 6 +/- 1 vs 12 +/- 0.1, P losing weight (BMI 40 +/- 2 vs 62 +/- 3 kg/m2, P sleep efficiency (85 +/- 2% vs 65 +/- 5%), all P < 0.001, postop vs preop; and RDI (56 +/- 13 vs 23 +/- 7, P = 0.041). Regression analysis demonstrated no correlation between preoperative BMI, ESS score and the severity of OSA; and no correlation between % excess body weight loss and postoperative RDI. Weight loss following gastric bypass results in profound improvement in OSA. The severity of apnea cannot be reliably predicted by preoperative BMI and ESS; therefore, patients with symptoms of OSA should undergo polysomnography.

  18. Effect of CPAP on arterial stiffness in severely obese patients with obstructive sleep apnoea.

    Science.gov (United States)

    Seetho, Ian W; Asher, Rebecca; Parker, Robert J; Craig, Sonya; Duffy, Nick; Hardy, Kevin J; Wilding, John P H

    2015-12-01

    Obstructive sleep apnoea (OSA) may independently increase cardiovascular risk in obesity. Although there is evidence that arterial stiffness is altered in OSA, knowledge of these effects with continuous positive airway pressure (CPAP) in severe obesity (body mass index (BMI) ≥ 35 kg/m(2)) is limited. This study aimed to explore how arterial stiffness, as measured by the augmentation index (Aix), changed in severely obese patients with OSA who were treated with CPAP and in patients without OSA. Forty-two patients with severe obesity-22 with OSA, 20 without OSA-were recruited at baseline and followed-up after a median of 13.5 months. Pulse wave analysis (PWA) was performed using applanation tonometry at the radial artery to measure augmentation index (Aix), augmentation pressure (AP) and subendocardial viability ratio (SEVR). Cardiovascular parameters and body composition were also measured. There were significant improvements in Aix, AP (both P CPAP compared with subjects without OSA. Epworth scores (P CPAP. Regression showed that CPAP was significantly associated with change in arterial stiffness from baseline. However, patients with OSA on CPAP continued to have increased arterial stiffness (Aix) (P CPAP in severe obesity, CPAP alone is not sufficient to modify PWA measures to levels comparable with non-OSA patients. This supports a need for a multifaceted approach when managing cardiovascular risk in patients with severe obesity and obstructive sleep apnoea receiving CPAP therapy.

  19. Effects of obstructive sleep apnea on hemodynamic parameters in patients entering cardiac rehabilitation.

    Science.gov (United States)

    Hargens, Trent A; Aron, Adrian; Newsome, Laura J; Austin, Joseph L; Shafer, Brooke M

    2015-01-01

    Obstructive sleep apnea (OSA) is a prevalent form of sleep-disordered breathing. Evidence suggests that OSA may lead to cardiac remodeling, although the literature is equivocal. Previous literature suggests a high percentage of individuals entering a cardiac rehabilitation (CR) program also have OSA. The objective of this study was to determine whether resting hemodynamic variables were altered in OSA subjects entering CR compared with those without OSA, as determined by impedance cardiography. Subjects entering an early outpatient CR program were screened for OSA using an at-home screening device and verified by a sleep physician. Subjects were divided into an OSA group (n = 48) or a control group (n = 25) on the basis of the screening results. Hemodynamic variables were measured during supine rest using impedance cardiography. A 6-minute walk test was performed to assess functional capacity. The proportion of cardiac diagnoses was similar between groups. Overall, 66% of the subjects were positive for OSA. Subject groups did not differ by age, body mass index, heart rate, diastolic blood pressure, or functional capacity. Cardiac output, cardiac index, stroke volume, contractility index, and left cardiac work index were all significantly decreased in the OSA group compared with the control group (P disadvantage in recovering from their cardiac event, and place them at increased risk for secondary complications.

  20. An interactive ocean surface albedo scheme (OSAv1.0): formulation and evaluation in ARPEGE-Climat (V6.1) and LMDZ (V5A)

    Science.gov (United States)

    Séférian, Roland; Baek, Sunghye; Boucher, Olivier; Dufresne, Jean-Louis; Decharme, Bertrand; Saint-Martin, David; Roehrig, Romain

    2018-01-01

    Ocean surface represents roughly 70 % of the Earth's surface, playing a large role in the partitioning of the energy flow within the climate system. The ocean surface albedo (OSA) is an important parameter in this partitioning because it governs the amount of energy penetrating into the ocean or reflected towards space. The old OSA schemes in the ARPEGE-Climat and LMDZ models only resolve the latitudinal dependence in an ad hoc way without an accurate representation of the solar zenith angle dependence. Here, we propose a new interactive OSA scheme suited for Earth system models, which enables coupling between Earth system model components like surface ocean waves and marine biogeochemistry. This scheme resolves spectrally the various contributions of the surface for direct and diffuse solar radiation. The implementation of this scheme in two Earth system models leads to substantial improvements in simulated OSA. At the local scale, models using the interactive OSA scheme better replicate the day-to-day distribution of OSA derived from ground-based observations in contrast to old schemes. At global scale, the improved representation of OSA for diffuse radiation reduces model biases by up to 80 % over the tropical oceans, reducing annual-mean model-data error in surface upwelling shortwave radiation by up to 7 W m-2 over this domain. The spatial correlation coefficient between modeled and observed OSA at monthly resolution has been increased from 0.1 to 0.8. Despite its complexity, this interactive OSA scheme is computationally efficient for enabling precise OSA calculation without penalizing the elapsed model time.

  1. Sleep apnoea and driving risk: the need for regulation

    Directory of Open Access Journals (Sweden)

    Walter T. McNicholas

    2015-12-01

    Full Text Available Obstructive sleep apnoea syndrome (OSAS is a highly prevalent chronic respiratory disorder with prevalence among adult males of ≥10%. The most common daytime symptom associated with OSAS is excessive sleepiness, which in more severe manifestations can result in sleepiness at the wheel while driving and probably contributes to the substantial increase in accident risk among patients with OSAS. Fortunately, current evidence indicates that successful therapy of OSAS, particularly with continuous positive airway pressure, can bring the accident risk down to levels similar to an equivalent general population. The recognition of the increased driving accident risk in OSAS prompted the Transport and Mobility Directorate of the European Commission to establish a working group on this topic in 2012, which ultimately led to a revision of Annex III of the EU Driving Licence Directive, which is subject to mandatory implementation by European Union member states by December 2015. This directive specifies that patients with moderate or severe OSAS associated with significant daytime sleepiness should be prohibited from driving until effective therapy is established. These new regulations are designed to balance the legitimate objective of public safety with not penalising OSAS patients who are complying with effective therapy. Successful implementation of regulations on driving in OSAS patients must also include measures to educate relevant stakeholders including patients, medical personnel, traffic police and employers in the transport industry. The key objective is to encourage patients with possible OSAS to seek diagnosis and treatment and not to inhibit OSAS patients from coming forward.

  2. Sleep apnoea and driving risk: the need for regulation.

    Science.gov (United States)

    McNicholas, Walter T; Rodenstein, Daniel

    2015-12-01

    Obstructive sleep apnoea syndrome (OSAS) is a highly prevalent chronic respiratory disorder with prevalence among adult males of ≥10%. The most common daytime symptom associated with OSAS is excessive sleepiness, which in more severe manifestations can result in sleepiness at the wheel while driving and probably contributes to the substantial increase in accident risk among patients with OSAS. Fortunately, current evidence indicates that successful therapy of OSAS, particularly with continuous positive airway pressure, can bring the accident risk down to levels similar to an equivalent general population. The recognition of the increased driving accident risk in OSAS prompted the Transport and Mobility Directorate of the European Commission to establish a working group on this topic in 2012, which ultimately led to a revision of Annex III of the EU Driving Licence Directive, which is subject to mandatory implementation by European Union member states by December 2015. This directive specifies that patients with moderate or severe OSAS associated with significant daytime sleepiness should be prohibited from driving until effective therapy is established. These new regulations are designed to balance the legitimate objective of public safety with not penalising OSAS patients who are complying with effective therapy. Successful implementation of regulations on driving in OSAS patients must also include measures to educate relevant stakeholders including patients, medical personnel, traffic police and employers in the transport industry. The key objective is to encourage patients with possible OSAS to seek diagnosis and treatment and not to inhibit OSAS patients from coming forward. Copyright ©ERS 2015.

  3. Perioperative management of obstructive sleep apnea: a survey of Veterans Affairs health care providers.

    Science.gov (United States)

    Dhanda Patil, Reena; Patil, Yash J

    2012-01-01

    (1) To determine the presence of Veterans Affairs (VA) institutional guidelines for the perioperative management of obstructive sleep apnea (OSA); (2) to examine current use of preoperative screening tools for OSA in the VA; and (3) to understand current VA practice patterns regarding postoperative disposition of patients with OSA. Survey study. Veterans Affairs hospitals with surgical services; sample size 102 facilities. Veterans Affairs health care providers. The authors surveyed health care providers at VA hospitals using a survey tool developed by the authors. The response rate was 80%. A variety of preoperative screening tools for OSA were used by respondents, most commonly American Society of Anesthesiologists guidelines (53%). A policy for postoperative disposition of known and presumed OSA was present in 26% and 19% of responses, respectively. Of those respondents reporting a formal postoperative care policy, 48% and 30% admitted patients to a monitored ward bed and surgical intensive care unit, respectively. Of the 74% of respondents unaware of an institutional policy, Anesthesia and Surgery worked together to dictate postoperative disposition of patients with known OSA 73% of the time. The degree of OSA was ranked as the most important factor (58%) influencing postoperative disposition. Ten percent of respondents reported a major perioperative complication attributable to OSA in the past year. This survey study elucidates the heterogeneity of preoperative screening for and postoperative care of veterans with OSA. Future investigators may use these data to formalize institutional policies with regard to patients with OSA, with potentially significant impacts on patient care and usage of financial resources.

  4. Does comorbid obstructive sleep apnea impair the effectiveness of cognitive and behavioral therapy for insomnia?

    Science.gov (United States)

    Sweetman, Alexander; Lack, Leon; Lambert, Sky; Gradisar, Michael; Harris, Jodie

    2017-11-01

    Comorbid insomnia and obstructive sleep apnea (OSA) represents a highly prevalent and debilitating condition; however, physicians and researchers are still uncertain about the most effective treatment approach. Several research groups have suggested that these patients should initially receive treatment for their insomnia before the sleep apnea is targeted. The current study aims to determine whether Cognitive and Behavioral Therapy for Insomnia (CBT-i) can effectively treat insomnia in patients with comorbid OSA and whether its effectiveness is impaired by the presence of OSA. A retrospective chart review was conducted to examine 455 insomnia patients entering a CBT-i treatment program in a hospital out-patient setting. Three hundred and fourteen patients were diagnosed with insomnia alone and 141 with insomnia and comorbid OSA. Improvements in average sleep diary parameters, global insomnia severity, and several daytime functioning questionnaires from baseline, to post-treatment, to 3-month follow-up were compared between insomnia patients with and without comorbid OSA. Insomnia patients with comorbid OSA experienced significant improvements in insomnia symptoms, global insomnia severity, and other daytime functioning measures during and following treatment. Furthermore, improvements were no different between patients with or without comorbid OSA. Sleep apnea presence and severity were not related to rates of insomnia-remission or treatment-resistance following treatment. CBT-i is an effective treatment in the presence of comorbid OSA. This information offers support for the suggestion that patients with comorbid insomnia and OSA should be treated with CBT-i prior to the treatment of the OSA. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Pharyngeal chemosensitivity in patients with obstructive sleep apnea and healthy subjects.

    Science.gov (United States)

    Heiser, Clemens; Zimmermann, Ingo; Sommer, J Ulrich; Hörmann, Karl; Herr, Raphael M; Stuck, Boris A

    2013-09-01

    Signs of pharyngeal neurodegeneration have been detected in patients with obstructive sleep apnea (OSA). Along with this neurodegeneration, a decreased pharyngeal sensitivity to mechanical stimulation has been described. The decreased sensitivity may play a role in the pathophysiology of this disease. The aim of the study was to investigate the chemosensitivity of the pharyngeal mucosa in patients with OSA compared with controls. Healthy controls and patients with OSA (age: 30-60 years) were included. Testing of oropharyngeal chemosensitivity was performed with subjective intensity ratings of capsaicin (SIR, visual analogue scale 0-10), air puffs (presented with an olfactometer), and stimulation with CO2 at the posterior pharyngeal wall. A 2-point discrimination test at the soft palate, an intensity rating of capsaicin at the tongue, and a nasal lateralization test were performed. Twenty-six patients with OSA and 18 healthy controls were included. No differences were detected in the SIR of capsaicin at the tongue or in the nasal lateralization test. At the pharynx, a decreased sensitivity to capsaicin (OSA: 6.8 ± 2.3; healthy control: 8.6 ± 1.3), air puffs (OSA: 2.8 ± 1.9; healthy control: 4.2 ± 1.6), and stimulation with CO2 (OSA: 1.5 ± 1.7; healthy control: 2.8 ± 1.8) were demonstrated in patients with OSA (all P < 0.05). Two-point discrimination at the soft palate was reduced with statistical significance in the OSA group (OSA: 11.5 ± 5.4 mm; healthy control: 5.0 ± 2.4 mm). The results suggest reduced pharyngeal chemosensitivity in OSA patients in addition to the reduced mechanical pharyngeal sensitivity shown with 2-point discrimination. This demonstrates peripheral neurodegeneration in the context of this disease.

  6. Utility of Acoustic Pharyngometry for the Diagnosis of Obstructive Sleep Apnea.

    Science.gov (United States)

    Kendzerska, Tetyana; Grewal, Monica; Ryan, Clodagh M

    2016-11-01

    Owing to resource limitations, the testing of patients for obstructive sleep apnea (OSA) is often delayed. There is a need to accurately triage and expedite testing in those with a high pretest probability of OSA. Acoustic pharyngometry is a simple, noninvasive technique used to assess the upper airway cross-sectional area (UA-XSA), which is known to be reduced in those with OSA. To determine the discriminative ability and predictive value of UA-XSA measurements by acoustic pharyngometry for OSA. We conducted a cross-sectional study with a clinical cohort of consecutive adults with suspected OSA who had undergone both polysomnography and acoustic pharyngometry. OSA was defined as an apnea-hypopnea index greater than or equal to 5. Multivariable logistic regression analyses and receiver operating characteristic curves were used. The cohort included 576 subjects, 87% of whom had OSA and 64% of whom were men. The subjects' median body mass index (BMI) was 30.3 kg/m 2 , and their median age was 57 years. The median UA-XSA at FRC when sitting was significantly smaller in those with OSA compared with those without OSA (3.3 cm 2 [interquartile range, 2.7-3.8] vs. 3.7 cm 2 [interquartile range, of 2.9-4.2]). When the analysis was controlled for age, sex, BMI, and comorbidities, the odds of OSA increased for every 1-cm 2 decrease in the mean UA-XSA FRC when sitting (odds ratio, 1.62; 95% confidence interval, 1.23-2.13). The mean UA-XSA provided fair discrimination for OSA (area under the curve, 0.60). A cutoff value of 3.75 cm 2 , the point with the best sum of sensitivity and specificity, had sensitivity of 73% and specificity of 46%. The magnitude of the incremental discriminative value of UA-XSA over clinical variables (age, sex, BMI, and comorbidities) was small and nonsignificant (P = 0.5). The mean UA-XSA at FRC when sitting or supine provided no further significant advantage over clinical variables for the discernment of OSA.

  7. Evaluation of the risk factors of depressive disorders comorbid with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Cai LQ

    2017-01-01

    Full Text Available Liqiang Cai,1 Luoyi Xu,1 Lili Wei,1 Yi Sun,2 Wei Chen1,3 1Department of Psychiatry, Sir Run Run Shaw Hospital, Collaborative Innovation Center for Brain Science, Zhejiang University School of Medicine, 2Department of Electroencephalogram, Sir Run Run Shaw Hospital, 3Key Laboratory of Medical Neurobiology, Chinese Ministry of Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China Objective: Overlap of obstructive sleep apnea (OSA complicates diagnosis of depressive disorder and renders antidepressant treatment challenging. Previous studies have reported that the incidence of OSA is higher in patients with depression than in the general population. The purpose of this article was to investigate clinical risk factors to predict OSA in depression disorders.Methods: A total of 115 patients diagnosed with major depressive disorder (MDD and bipolar disorder (in a major depressive episode, who underwent overnight polysomnography, were studied retrospectively. They were divided into two groups: non-OSA and OSA. The patients who had apnea–hypopnea index (AHI <5 were defined as the non-OSA group, whereas the OSA group was defined as those with an AHI ≥5. Logistic regression was used to analyze the association among AHI and clinical factors, including sex, age, body mass index (BMI, Hamilton Depression Rating Scale (HAMD, Hamilton Anxiety Rating Scale, Pittsburgh Sleep Quality Index (PSQI, and diagnosis (MDD or bipolar disorder [in a major depressive episode].Results: In 115 patients, 51.3% had OSA. Logistic regression analysis showed significant associations between AHI and diagnosis (MDD or bipolar disorder [in a major depressive episode], BMI, HAMD, and PSQI (P<0.05.Conclusion: The findings of our study suggested that the rate of depression being comorbid with OSA is remarkably high and revealed that there is a high rate of undetected OSA among depressive disorder patients and untreated OSA among mood

  8. CERN Relay Race: the Shabbys win again, this time with music

    CERN Multimedia

    2005-01-01

    The Shabbys definitely seem unbeatable. They won the CERN Relay Race for the fifth consecutive year by a comfortable margin (picture below). It was a more neck-and-neck finish for second and third place but in the end Los Latinos Volantes came in second by a hair's breadth in front of Charmilles Technologies in third place, a reversal of last year's positions. For the less competitive participants, the Relay Race retains its traditional charm as a moment of relaxation and as an event in which taking part is more important than winning. In addition, even if the sun was noticeable by its absence, CERN's excellent Jazz Club band added a novel touch of colour and levity. Participants and spectators alike greatly appreciated their musical accompaniment on the finishing line! All the results are published in this issue on page 5 of the Staff Association section.

  9. Neurocognitive function in obstructive sleep apnoea: a meta-review.

    Science.gov (United States)

    Bucks, Romola S; Olaithe, Michelle; Eastwood, Peter

    2013-01-01

    Adult obstructive sleep apnoea (OSA) is associated with cognitive dysfunction. While many review articles have attempted to summarize the evidence for this association, it remains difficult to determine which domains of cognition are affected by OSA. This is because of marked differences in the nature of these reviews (e.g. many are unsystematic) and the many different tasks and domains assessed. This paper addresses this issue by comparing the results of only systematic reviews or meta-analyses assessing the effects of OSA on cognition, the relationship between OSA severity and cognition, and/or the effects of treatment on cognition in OSA. Electronic databases and hand-searching were undertaken to select reviews that reported on these areas. We found 33 reviews; five reviews met predetermined, stringent selection criteria. The majority of reviews supported deficits in attention/vigilance, delayed long-term visual and verbal memory, visuospatial/constructional abilities, and executive function in individuals with OSA. There is also general agreement that language ability and psychomotor function are unaffected by OSA. Data are equivocal for the effects of OSA on working memory, short-term memory and global cognitive functioning. Attention/vigilance dysfunction appears to be associated with sleep fragmentation and global cognitive function with hypoxaemia. Continuous positive airway pressure treatment of OSA appears to improve executive dysfunction, delayed long-term verbal and visual memory, attention/vigilance and global cognitive functioning. In order to improve our understanding of cognitive dysfunction in OSA, future research should pay particular attention to participant characteristics, measures of disease severity and choice of neuropsychological tests. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

  10. Sleep apnea in patients reporting insomnia or restless legs symptoms.

    Science.gov (United States)

    Bianchi, M T; Goparaju, B; Moro, M

    2016-01-01

    Insomnia and restless legs syndrome (RLS) are defined by self-reported symptoms, and polysomnography (PSG) is not routinely indicated. Occult obstructive sleep apnea (OSA), common even in asymptomatic adults, may complicate management of patients presenting with insomnia or restless legs. To this end, we investigated objective sleep apnea metrics in a large retrospective cohort according to self-reported symptom profiles. We compared sleep apnea findings in patients referred to our center according to self-reported symptoms associated with insomnia, sleep apnea, and restless legs. The cohort included over 1900 adults who underwent diagnostic (n = 1418) or split-night (n = 504) PSGs and completed a symptom and medical history questionnaire. More than 30% of patients who did not endorse any OSA symptoms, but did endorse insomnia or restless legs symptoms, were found to have OSA based on apnea-hypopnea index (AHI) >5 during overnight laboratory testing. Regression models of the full cohort showed that the risk of OSA was related, as expected, to older age, male sex, elevated body mass index, and presence of OSA symptoms. The presence of insomnia symptoms did not alter the risk of OSA. The presence of restless legs symptoms showed a small odds ratio for lowered OSA risk. Objective evidence of OSA occurs similarly in those with insomnia or restless legs symptoms, even among those without self-reported OSA symptoms. Providers should be aware of the potential for occult OSA in populations with insomnia and restless legs, which may complicate their management in addition to presenting an independent medical risk itself. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement.

    Science.gov (United States)

    Ramar, Kannan; Rosen, Ilene M; Kirsch, Douglas B; Chervin, Ronald D; Carden, Kelly A; Aurora, R Nisha; Kristo, David A; Malhotra, Raman K; Martin, Jennifer L; Olson, Eric J; Rosen, Carol L; Rowley, James A

    2018-03-30

    The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.

  12. Nonlinear Dynamics Forecasting of Obstructive Sleep Apnea Onsets.

    Directory of Open Access Journals (Sweden)

    Trung Q Le

    Full Text Available Recent advances in sensor technologies and predictive analytics are fueling the growth in point-of-care (POC therapies for obstructive sleep apnea (OSA and other sleep disorders. The effectiveness of POC therapies can be enhanced by providing personalized and real-time prediction of OSA episode onsets. Previous attempts at OSA prediction are limited to capturing the nonlinear, nonstationary dynamics of the underlying physiological processes. This paper reports an investigation into heart rate dynamics aiming to predict in real time the onsets of OSA episode before the clinical symptoms appear. A prognosis method based on a nonparametric statistical Dirichlet-Process Mixture-Gaussian-Process (DPMG model to estimate the transition from normal states to an anomalous (apnea state is utilized to estimate the remaining time until the onset of an impending OSA episode. The approach was tested using three datasets including (1 20 records from 14 OSA subjects in benchmark ECG apnea databases (Physionet.org, (2 records of 10 OSA patients from the University of Dublin OSA database and (3 records of eight subjects from previous work. Validation tests suggest that the model can be used to track the time until the onset of an OSA episode with the likelihood of correctly predicting apnea onset in 1 min to 5 mins ahead is 83.6 ± 9.3%, 80 ± 8.1%, 76.2 ± 13.3%, 66.9 ± 15.4%, and 61.1 ± 16.7%, respectively. The present prognosis approach can be integrated with wearable devices, enhancing proactive treatment of OSA and real-time wearable sensor-based of sleep disorders.

  13. PREVALENCE OF SLEEP DISORDERED BREATHING IN PATIENTS WITH NEWLY DIAGNOSED ACROMEGALY

    Directory of Open Access Journals (Sweden)

    U. A. Tsoy

    2014-01-01

    Full Text Available Background: Obstructive sleep disordered breathing or obstructive sleep apnea (OSA is the most common respiratory impairment in acromegaly. OSA is bound up with heightened cardiovascular mortality. Aim: Тo study frequency, features, and structure of sleep disordered breathing in patients with newly diagnosed acromegaly and to elucidate the factors influencing their development. Materials and methods: 38 patients (10 men, 28 women, median age 53 (28-76 years, median body mass index (BMI 29 (19.9-44.3 kg/m² with newly diagnosed acromegaly were recruited into the study. All subjects underwent full polysomnography (Embla N7000, Natus, USA and Remlogica software (USA. Results: Sleep disordered breathing was found in 28 (73.7% patients. OSA was revealed in all cases, in 11 (39.3% subjects it was mixed. In 10 (35.7% patients OSA was mild, in 8 (28.6% moderate, and in 10 (35.7% severe. BMI (р<0.01, disease duration (р=0.003, and insulin-like growth factor-1 (IGF-1 level (р=0.04 were different in patients without OSA and patients with moderate-to-severe OSA. No difference was found in sex (р=0.4, age (р=0.064, and growth hormone level (р=0.6. Frequency of arterial hypertension, diabetes mellitus, and other glucose metabolism impairments was the same in subjects without OSA and with severe-to-moderate OSA. Conclusion: All patients with newly diagnosed acromegaly should undergo polysomnography. BMI, disease duration, and IGF-1 level are significant risk factors for OSA development. Correlation OSA with arterial hypertension and glucose metabolism impairments needs to be further investigated.

  14. Topological Reorganization of the Default Mode Network in Severe Male Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Liting Chen

    2018-06-01

    Full Text Available Impaired spontaneous regional activity and altered topology of the brain network have been observed in obstructive sleep apnea (OSA. However, the mechanisms of disrupted functional connectivity (FC and topological reorganization of the default mode network (DMN in patients with OSA remain largely unknown. We explored whether the FC is altered within the DMN and examined topological changes occur in the DMN in patients with OSA using a graph theory analysis of resting-state functional magnetic resonance imaging data and evaluated the relationship between neuroimaging measures and clinical variables. Resting-state data were obtained from 46 male patients with untreated severe OSA and 46 male good sleepers (GSs. We specifically selected 20 DMN subregions to construct the DMN architecture. The disrupted FC and topological properties of the DMN in patients with OSA were characterized using graph theory. The OSA group showed significantly decreased FC of the anterior–posterior DMN and within the posterior DMN, and also showed increased FC within the DMN. The DMN exhibited small-world topology in both OSA and GS groups. Compared to GSs, patients with OSA showed a decreased clustering coefficient (Cp and local efficiency, and decreased nodal centralities in the left posterior cingulate cortex and dorsal medial prefrontal cortex, and increased nodal centralities in the ventral medial prefrontal cortex and the right parahippocampal cortex. Finally, the abnormal DMN FC was significantly related to Cp, path length, global efficiency, and Montreal cognitive assessment score. OSA showed disrupted FC within the DMN, which may have contributed to the observed topological reorganization. These findings may provide further evidence of cognitive deficits in patients with OSA.

  15. Electrocatalytic activity of self-doped polyaniline

    International Nuclear Information System (INIS)

    Shieh, Yeong-Tarng; Jung, Jeng-Ji; Lin, Rong-Hsien; Yang, Chien-Hsin; Wang, Tzong-Liu

    2012-01-01

    Self-doped conducting polyaniline-modified indium tin oxide (ITO) electrodes were prepared by cyclic voltammetry on ITO substrates in aniline (AN) and o-aminobenzene sulfonic acid (OSA) mixed monomer solutions with AN/OSA mole ratios of 25/75, 50/50, and 75/25, followed by investigations on electrocatalytic activities of the copolymers to redox reactions of Fe(CN) 6 3−/4− as a probe in aqueous solutions of different pH using cyclic voltammetry. For a given pH, the P(25AN-co-75OSA)-modified ITO electrode demonstrated the highest current density, followed by the P(50AN-co-50OSA)- and by the P(75AN-co-25OSA)-modified ITO electrodes. It can be concluded that a higher content of OSA (sulfonate) in the copolymer exhibited a higher extent of self-doping in the copolymer, leading to a higher electrocatalytic activity to redox reactions of the probe. The electrocatalytic activities of the copolymers decreased with increasing pH. The P(25AN-co-75OSA)-modified ITO electrode was electroactive for sensing the redox reactions of the probe in aqueous solutions of up to pH 7, the P(50AN-co-50OSA)-modified ITO electrode was electroactive for up to only pH 5, but the P(75AN-co-25OSA)-modified ITO electrode was not electroactive in aqueous solution of pH even as low as 2.

  16. [Obesity and obstructive sleep apnea in children].

    Science.gov (United States)

    Amaddeo, A; de Sanctis, L; Olmo Arroyo, J; Giordanella, J-P; Monteyrol, P-J; Fauroux, B

    2017-02-01

    Obesity, along with hypertrophy of the adenoids and the tonsils, represents one of the major risk factors for obstructive sleep apnea (OSA) in children. Obesity is associated with an increase in the prevalence and the severity of OSA and is a major factor in the persistence and aggravation of OSA over time. Neurocognitive dysfunction and abnormal behavior are the most important and frequent end-organ morbidities associated with OSA in children. Other deleterious consequences such as cardiovascular stress and metabolic syndrome are less common in children than in adults with OSA. Defining the exact role of obesity in OSA-associated end-organ morbidity in children is difficult because of the complex and multidimensional interactions between sleep in general, OSA, obesity, and metabolic dysregulation. This may explain why obesity itself has not been shown to be associated with a significant increase in OSA-associated end-organ morbidity. Obesity is linked to a decreased treatment efficacy and, in particular, of adenotonsillectomy. Peri- and postoperative complications are more common and more severe in obese children as compared with normal-weight controls. Continuous positive airway pressure (CPAP) is frequently needed, but compliance with CPAP is less optimal in obese children than in non-obese children. In conclusion, obesity represents a major public health problem worldwide; its prevention is one of the most efficient tools for decreasing the incidence and the morbidity associated with OSA in children. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Intermittent hypoxia simulating obstructive sleep apnea causes pulmonary inflammation and activates the Nrf2/HO-1 pathway.

    Science.gov (United States)

    Wang, Yeying; Chai, Yanling; He, Xiaojie; Ai, Li; Sun, Xia; Huang, Yiling; Li, Yongxia

    2017-10-01

    Obstructive sleep apnea (OSA) is a disorder with high morbidity in adults. OSA damages multiple organs and tissues, including the cardiovascular and cerebrovascular systems, the metabolism system, the lungs, liver and heart. OSA-induced damage is earliest and greatest to the pulmonary tissue. The present study established a rat OSA model of differing severity by inducing intermittent hypoxia with different concentrations of O 2 and it was determined that OSA caused a severe oxidative stress response and pulmonary inflammation in a dose-dependent manner. OSA increased serum levels of C-reactive protein and 8-isoprostane and elevated the expression of malondialdehyde, tumor necrosis factor α, interleukin (IL)-1β and IL-6 in the pulmonary tissue. Furthermore, the expression of two important antioxidants, superoxide dismutase and glutathione, was downregulated following intermittent hypoxia. By contrast, levels of cylooxygenase 2 and inducible nitric oxide synthase, which are crucial in the antioxidative response, increased. In addition, OSA activates the nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase (OH)-1 antioxidative signaling pathway. Finally, all increases and decreases in levels of inflammatory and antioxidative substances were dependent on oxygen concentrations. Therefore, the present study demonstrated that OSA, simulated by intermittent hypoxia, caused an oxidative stress response and pulmonary inflammation, and activated the canonical antioxidative Nrf2/HO-1 signaling pathway in a dose-dependent manner. These results may facilitate the development of clinical therapies to treat pulmonary diseases caused by OSA.

  18. Análisis de la calidad de varios cuerpos de agua superficiales en el GAM y la Península de Osa utilizando el Índice Holandés Quality analysis of various surface water bodies in the GAM and the osa peninsula using the Dutch Index

    Directory of Open Access Journals (Sweden)

    Guillermo Calvo Brenes

    2012-11-01

    Full Text Available A pesar de la cantidad de ríos que tiene Costa Rica, la mayoría muestra algún grado de contaminación. Por lo tanto, resultan de particular interés aquellos que forman parte de la Gran Área Metropolitana, en donde se concentra el 70% de la población del país. Si bien la calidad del agua se puede determinar por medio del análisis de distintos indicadores, es ventajosa su simplificación por medio del uso de índices de calidad del agua. Uno de los índices adoptados en Costa Rica es el “Índice holandés de valoración de la calidad del agua” (ICA holandés, el cual se basa en el uso de tres indicadores: la demanda bioquímica de oxígeno, el nitrógeno amoniacal y el oxígeno disuelto, este último expresado como porcentaje de saturación de oxígeno. En el presente estudio se analizaron estos indicadores en diez ríos localizados en las provincias de San José, Alajuela, Heredia y Cartago, así como en la Península de Osa. Además, para correlacionar el ICA holandés con la densidad poblacional, se muestrearon tres puntos en cada río: la zona alta cercana a la naciente del río, la zona media y la zona baja, ubicada cerca de la desembocadura del río. Se encontró que los ríos que atraviesan las ciudades altamente densas, las cuales poseen densidades poblacionales superiores a los 8000 habitantes por kilómetro cuadrado (hab/km2, muestran niveles de contaminación en los ríos de “severa” a “muy severa”; por otra parte, lugares con densidades poblacionales entre los 3000-8000 hab/km2, en general, muestran niveles de contaminación de “moderada” a “severa”; mientras que los poblados con menos de 1000 hab/ km2 causan que la calidad de las aguas presente un nivel de contaminación de “incipiente” a “no contaminada”. Estos resultados pueden variar dependiendo del caudal de los ríos, su recorrido total y el uso que se le dé a la tierra. El análisis de Regresión Lineal Univariable mostró una correlaci

  19. Childhood Obesity and Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Indra Narang

    2012-01-01

    Full Text Available The global epidemic of childhood and adolescent obesity and its immediate as well as long-term consequences for obese individuals and society as a whole cannot be overemphasized. Obesity in childhood and adolescence is associated with an increased risk of adult obesity and clinically significant consequences affecting the cardiovascular and metabolic systems. Importantly, obesity is additionally complicated by obstructive sleep apnea (OSA, occurring in up to 60% of obese children. OSA, which is diagnosed using the gold standard polysomnogram (PSG, is characterised by snoring, recurrent partial (hypopneas or complete (apneas obstruction of the upper airway. OSA is frequently associated with intermittent oxyhemoglobin desaturations, sleep disruption, and sleep fragmentation. There is emerging data that OSA is associated with cardiovascular burden including systemic hypertension, changes in ventricular structure and function, arterial stiffness, and metabolic syndromes. Thus, OSA in the context of obesity may independently or synergistically magnify the underlying cardiovascular and metabolic burden. This is of importance as early recognition and treatment of OSA in obese children are likely to result in the reduction of cardiometabolic burden in obese children. This paper summarizes the current state of understanding of obesity-related OSA. Specifically, this paper will discuss epidemiology, pathophysiology, cardiometabolic burden, and management of obese children and adolescents with OSA.

  20. Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk.

    Science.gov (United States)

    Dobrosielski, Devon A; Papandreou, Christopher; Patil, Susheel P; Salas-Salvadó, Jordi

    2017-06-30

    Obstructive sleep apnoea (OSA) is associated with increased cardiovascular disease (CVD) morbidity and mortality. It is accepted that OSA and obesity commonly coexist. The American Academy of Sleep Medicine recommends dietary-induced weight loss and exercise as lifestyle treatment options for OSA. However, most clinical trials upon which this recommendation is based have focused on establishing the effectiveness of calorie-restricted, often low-fat diets for improving OSA severity, whereas less attention has been given to the means through which weight loss is achieved ( e.g. altered dietary quality) or whether diet or exercise mediates the associations between reduced weight, improved OSA severity and the CVD substrate. The current evidence suggests that the benefits of a low-carbohydrate or Mediterranean diet in overweight and obese individuals go beyond the recognised benefits of weight reduction. In addition, exercise has an independent protective effect on vascular health, which may counter the increased oxidative stress, inflammation and sympathetic activation that occur in OSA patients. This review aims to expand our understanding of the effects of diet and exercise on OSA and associated CVD complications, and sets the stage for continued research designed to explore optimal lifestyle strategies for reducing the CVD burden in OSA patients. Copyright ©ERS 2017.

  1. Alveolar-derived exhaled nitric oxide is reduced in obstructive sleep apnea syndrome.

    Science.gov (United States)

    Foresi, Antonio; Leone, Clementina; Olivieri, Dario; Cremona, George

    2007-09-01

    Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular diseases, in particular systemic arterial hypertension. We postulated that intermittent nocturnal hypoxia in OSAS may be associated to decreased fractional exhaled nitric oxide (FENO) levels from distal airspaces. Multiple flow rate measurements have been used to fractionate nitric oxide (NO) from alveolar and bronchial sources in 34 patients with OSAS, in 29 healthy control subjects, and in 8 hypertensive non-OSAS patients. The effect of 2 days of treatment with nasal continuous positive airway pressure (nCPAP) on FENO was examined in 18 patients with severe OSAS. We found that the mean [+/- SE] concentrations of exhaled NO at a rate of 50 mL/s was 21.8 +/- 1.9 parts per billion (ppb) in patients with OSAS, 25.1 +/- 3.3 ppb in healthy control subjects, and 15.4 +/- 1.7 ppb in hypertensive control patients. The mean fractional alveolar NO concentration (CANO) in OSAS patients was significantly lower than that in control subjects (2.96 +/- 0.48 vs 5.35 +/- 0.83 ppb, respectively; p bronchial FENO, is impaired in patients with OSAS and that this impairment is associated with an increased risk of hypertension. NO production within the alveolar space is modified by treatment with nCPAP.

  2. Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk

    Directory of Open Access Journals (Sweden)

    Devon A. Dobrosielski

    2017-06-01

    Full Text Available Obstructive sleep apnoea (OSA is associated with increased cardiovascular disease (CVD morbidity and mortality. It is accepted that OSA and obesity commonly coexist. The American Academy of Sleep Medicine recommends dietary-induced weight loss and exercise as lifestyle treatment options for OSA. However, most clinical trials upon which this recommendation is based have focused on establishing the effectiveness of calorie-restricted, often low-fat diets for improving OSA severity, whereas less attention has been given to the means through which weight loss is achieved (e.g. altered dietary quality or whether diet or exercise mediates the associations between reduced weight, improved OSA severity and the CVD substrate. The current evidence suggests that the benefits of a low-carbohydrate or Mediterranean diet in overweight and obese individuals go beyond the recognised benefits of weight reduction. In addition, exercise has an independent protective effect on vascular health, which may counter the increased oxidative stress, inflammation and sympathetic activation that occur in OSA patients. This review aims to expand our understanding of the effects of diet and exercise on OSA and associated CVD complications, and sets the stage for continued research designed to explore optimal lifestyle strategies for reducing the CVD burden in OSA patients.

  3. Genioglossus fatigue in obstructive sleep apnea.

    LENUS (Irish Health Repository)

    McSharry, David

    2012-08-15

    Obstructive sleep apnea (OSA) is a prevalent disorder that may cause cardiovascular disease and fatal traffic accidents but the pathophysiology remains incompletely understood. Increased fatigability of the genioglossus (the principal upper airway dilator muscle) might be important in OSA pathophysiology but the existing literature is uncertain. We hypothesized that the genioglossus in OSA subjects would fatigue more than in controls. In 9 OSA subjects and 9 controls during wakefulness we measured maximum voluntary tongue protrusion force (Tpmax). Using surface electromyography arrays we measured the rate of decline in muscle fiber conduction velocity (MFCV) during an isometric fatiguing contraction at 30% Tpmax. The rate of decline in MFCV provides an objective means of quantifying localized muscle fatigue. Linear regression analysis of individual subject data demonstrated a significantly greater decrease in MFCV in OSA subjects compared to control subjects (29.2 ± 20.8% [mean ± SD] versus 11.2 ± 20.8%; p=0.04). These data support increased fatigability of the genioglossus muscle in OSA subjects which may be important in the pathophysiology of OSA.

  4. Ambulatory monitoring in the diagnosis and management of obstructive sleep apnoea syndrome

    Directory of Open Access Journals (Sweden)

    Jaime Corral-Peñafiel

    2013-09-01

    Full Text Available Obstructive sleep apnoea (OSA is a highly prevalent disorder associated with complications such as arterial hypertension, cardiovascular diseases and traffic accidents. The resources allocated for OSA are insufficient and OSA is a significant public health problem. Portable recording devices have been developed for the detection of OSA syndrome and have proved capable of providing an equivalent diagnosis to in-laboratory polysomnography (PSG, at least in patients with a high pre-test probability of OSA syndrome. PSG becomes important in patients who have symptoms and certain comorbidities such as chronic obstructive pulmonary disease or stroke, as well as in patients with a clinical history suggesting a different sleep disorder. Continuous positive airway pressure is the most effective treatment in OSA. Ambulatory monitoring of the therapeutic modalities has been evaluated to enhance the care process and reduce costs compared to the conventional approach, without sacrificing efficiency. This review evaluates the role of portable monitoring devices in the diagnostic process of OSA and the search for alternative strategies based on ambulatory management protocols.

  5. Ambulatory positional obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Fernando Di-Tullio

    Full Text Available Objective: To establish the prevalence of positional (PP OSA patients using self-administered home-based respiratory polygraphy (RP. Materials and Methods: 52 month retrospective study based on RP records. Results: 200 PR records: 70.5% men 29.5% women. 76% were diagnosed with OSA and 54.6% with PP OSA. There were no significant differences in Epworth Sleepiness Scale, apnea hypopnea index and oxygen desaturation index. PP OSA patients were younger, had a lower BMI (30.3±0.9 vs. 35.3±1.2 (p<0.0001, and the time they spent with oxygen saturation <90% (T<90 was lower (8.8 vs. 28.7±6.7, p=0.0038. The PP OSA group spent 43% of total recording time in the supine position. Conclusions: The prevalence of PP OSA patients studied with RP is similar to the one described by sleep laboratories. They have lower BMI, present mostly mild OSA with less desaturation, and are less likely to receive CPAP therapy.

  6. General physicians' perspective of sleep apnea from a developing country.

    Science.gov (United States)

    Hussain, Syed Fayyaz; Zahid, Sumaiya; Haqqee, Raana; Khan, Javaid Ahmed

    2003-06-01

    To assess the knowledge of general physicians about the diagnosis and management of obstructive sleep apnea (OSA), a self-administered questionnaire, containing 15 questions, was distributed to 160 doctors attending a pulmonary CME program in March 2002. After 15 minutes of response time, the questionnaires were collected. The data were entered and analyzed using SPSS (Version 10.0) software. One hundred and twenty (75%) questionnaires were returned. Only 41% of responders had ever read an article about OSA and 36% had suspected it at least once in their practice. The majority (61-77%) of responders were aware of the common symptoms of OSA, but 55% did not recognize its association with hypertension. A significant number of doctors were not aware that OSA could occur in non-obese individuals (33%), women (42%) and children (39%). Only 25% of responders recognized that a history and blood tests were insufficient to make a reliable diagnosis of OSA. Half of the responders were aware of CPAP therapy for OSA, whereas 18% would have prescribed sedatives to treat sleep disturbances in OSA.

  7. Continuous positive airway pressure for the treatment of obstructive sleep apnea.

    Science.gov (United States)

    Nurwidya, Fariz; Susanto, Agus Dwi; Juzar, Dafsah A; Kobayashi, Isao; Yunus, Faisal

    2016-01-01

    Obstructive sleep apnea (OSA) is a recurrent episode of partial or complete upper airway obstruction during sleep despite ongoing respiratory efforts and is implicated as the risk factor of cardiovascular disease. The OSA syndrome is typified by recurring partial or total occlusion of the pharynx, sleep fragmentation, episodes of gasping, and, eventually, daytime sleepiness. If it is left untreated, OSA syndrome can cause hypertension, coronary artery disease congestive heart disease, insulin resistance and death. In this review, we describe the pathogenesis and diagnosis of OSA. We also focused on the continuous positive airway pressure (CPAP) as the main therapy for OSA. CPAP has been shown to provide benefit for not only respiratory system, but also for cardiovascular system and metabolic system. Finally, we discussed briefly about the issue of adherence of using CPAP that could contribute to lower compliant in patient with OSA.

  8. Frequency of distribution of inflammatory cytokines IL-1, IL-6 and TNF-alpha gene polymorphism in patients with obstructive sleep apnea.

    Science.gov (United States)

    Popko, K; Gorska, E; Potapinska, O; Wasik, M; Stoklosa, A; Plywaczewski, R; Winiarska, M; Gorecka, D; Sliwinski, P; Popko, M; Szwed, T; Demkow, U

    2008-12-01

    Obesity is one of the most commonly identified factors for the obstructive sleep apnea syndrome (OSAS). Adipose tissue is the source of many cytokines, among them there are IL-6, IL-1, and TNF-alpha. The level of inflammatory cytokines increases in people with OSAS and obesity. The aim of this study was to evaluate the distribution of genotypes in inflammatory cytokine genes in people with obesity-related OSAS. The examined group consisted of 102 person with obesity related-OSAS and 77 normal weight person without OSAS. Genotyping of DNA sequence variation was carried out by restriction enzyme (IL-1: Taq I, IL-6: Lwe I, TNF-alpha: Nco I) analysis of PCR amplified DNA. The study revealed a significant correlation between polymorphism located in the promoter region of inflammatory cytokine genes and obesity-related OSAS.

  9. [Mandibular advancement devices in the treatment of obstructive sleep apnea].

    Science.gov (United States)

    Korczyński, Piotr; Górska, Katarzyna; Wilk, Krzysztof; Bielicki, Piotr; Byśkiniewicz, Krzysztof; Baczkowski, Tadeusz

    2004-12-01

    Obstructive sleep apnea (OSA) affects approximately 450,000 people in Poland. Use of nasal continuous positive airway pressure (nCPAP) devices and laryngeal surgery are widely accepted OSA treatment methods. In 1995 ASDA approved oral devices for treatment of OSA patients. The aim of the study was to determine efficiency of mandibular advancement devices (MAD) in OSA therapy. The study group included 20 patients with OSA, all of whom did not tolerate nCPAP and did not have indications or did not agree for surgical treatment. Control polysomnography was carried out in 11 patients using MAD. In 64% of patients AHI was lower then 10. No correlation between MAD use and AHI values was found. 45% of patients declared improvement of sleep quality and life comfort. Use of mandibular advancement devices is an important alternative therapy of OSA.

  10. Continuous Positive Airway Pressure Prevents Hypoxia in Dental Patient with Obstructive Sleep Apnea Syndrome under Intravenous Sedation.

    Science.gov (United States)

    Kasatkin, Anton A; Reshetnikov, Aleksei P; Urakov, Aleksandr L; Baimurzin, Dmitrii Y

    2017-01-01

    Use of sedation in patients with obstructive sleep apnea (OSA) in dentistry is limited. Hypoxia may develop during medication sleep in dental patients with OSA because of repetitive partial or complete obstruction of the upper airway. In this regard, anesthesiologists prefer not to give any sedative to surgical patients with OSA or support the use of general anesthesia due to good airway control. We report a case where we could successfully sedate a dental patient with OSA using intraoperative continuous positive airway pressure (CPAP) without hypoxia. Use of sedation and intraoperative CPAP in patients with OSA may be considered only if the effectiveness at home CPAP therapy is proven.

  11. The correlation of anxiety and depression with obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Fariborz Rezaeitalab

    2014-01-01

    Full Text Available Background: Obstructive sleep apnea syndrome (OSAS is a common sleep disorder characterized by repeated upper airway obstruction during sleep. While respiratory pauses followed by loud snoring and daytime sleepiness are the main symptoms of OSAS, the patients may complain from sleep disruption, headache, mood disturbance, irritability, and memory impairment. However, the association of sleep apnea with anxiety and depression is not completely understood. Adherence to continuous positive airway pressure (CPAP, the treatment of choice for OSAS, may be influenced by psychological conditions, especially claustrophobia. The aim of this study was to evaluate the association of OSAS with anxiety and depression symptoms. This study also investigated the association of anxiety with body mass index (BMI and the severity of OSAS. Materials and Methods: We conducted a cross-sectional study on 178 adult individuals diagnosed with OSAS at the sleep laboratory between September 2008 and May 2012. The participants were interviewed according to a checklist regarding both their chief complaints and other associated symptoms. The psychological status was assessed according to Beck anxiety inventory (BAI and Beck depression inventory (BDI scoring. The severity of breathing disorder was classified as mild, moderate, and severe based on apnea-hypopnea index (AHI which was ascertained by overnight polysomnography. Daytime sleepiness was assessed by Epworth sleepiness scale (ESS. Results: The mean (SD age of participants was 50.33 years. In terms of sex, 85.5% of the study population were males and14.4% were females. We found no relation between sex and the symptoms of OSAS. Regarding the frequency of anxiety and depression symptoms, 53.9% of the individuals had some degree of anxiety, while 46.1% demonstrated depressive symptoms. In terms of OSAS severity, this study showed that OSAS severity was associated with the frequency of anxiety, chocking, and sleepiness (P

  12. A novel derivative of doxorubicin, AD198, inhibits canine transitional cell carcinoma and osteosarcoma cells in vitro.

    Science.gov (United States)

    Rathore, Kusum; Cekanova, Maria

    2015-01-01

    Doxorubicin (DOX) is one of the most commonly used chemotherapeutic treatments for a wide range of cancers. N-benzyladriamycin-14-valerate (AD198) is a lipophilic anthracycline that has been shown to target conventional and novel isoforms of protein kinase C (PKC) in cytoplasm of cells. Because of the adverse effects of DOX, including hair loss, nausea, vomiting, liver dysfunction, and cardiotoxicity, novel derivatives of DOX have been synthesized and validated. In this study, we evaluated the effects of DOX and its derivative, AD198, on cell viability of three canine transitional cell carcinoma (K9TCC) (K9TCC#1-Lillie, K9TCC#2-Dakota, K9TCC#4-Molly) and three canine osteosarcoma (K9OSA) (K9OSA#1-Zoe, K9OSA#2-Nashville, K9OSA#3-JJ) primary cancer cell lines. DOX and AD198 significantly inhibited cell proliferation in all tested K9TCC and K9OSA cell lines in a dose-dependent manner. AD198 inhibited cell viability of tested K9TCC and K9OSA cell lines more efficiently as compared to DOX at the same concentration using MTS (3-(4,5-dimethyl-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2h-tetrazolium) assay. AD198 had lower IC50 values as compared to DOX for all tested K9TCC and K9OSA cell lines. In addition, AD198 increased apoptosis in all tested K9TCC and K9OSA cell lines. AD198 increased the caspase activity in tested K9TCC and K9OSA cell lines, which was confirmed by caspase-3/7 assay, and cleavage of poly (ADP-ribose) polymerase (PARP) was confirmed by Western blotting analysis. In addition, AD198 cleaved PKC-δ, which subsequently activated the p38 signaling pathway, resulting in the apoptosis of tested K9TCC and K9OSA cell lines. Inhibition of the p38 signaling pathway by SB203580 rescued DOX- and AD198-induced apoptosis in tested K9TCC and K9OSA cell lines. Our in vitro results suggest that AD198 might be considered as a new treatment option for K9TCC and K9OSA cell lines cancers in vivo.

  13. Biomarkers of Alzheimer Disease in Children with Obstructive Sleep Apnea: Effect of Adenotonsillectomy.

    Science.gov (United States)

    Kheirandish-Gozal, Leila; Philby, Mona F; Alonso-Álvarez, María Luz; Terán-Santos, Joaquin; Gozal, David

    2016-06-01

    Obese children are at increased risk for developing obstructive sleep apnea (OSA), and both of these conditions are associated with an increased risk for end-organ morbidities. Both OSA and obesity (OB) have been associated with increased risk for Alzheimer disease (AD). This study aimed to assess whether OSA and OB lead to increased plasma levels of 2 AD markers amyloid β protein 42 (Aβ42) and pre-senilin 1 (PS1). Fasting morning plasma samples from otherwise healthy children with a diagnosis of OB, OSA, or both (OSA+OB), and controls, and in a subset of children with OSA after adenotonsillectomy (T&A) were assayed for Aβ42 and PS1 levels using commercial enzyme-linked immunosorbent assay kits. 286 children (mean age of 7.2 ± 2.7 y) were evaluated. Compared to control subjects, OB children had similar Aβ42 (108.3 ± 31.7 pg/mL versus 83.6 ± 14.6 pg/mL) and PS1 levels (0.89 ± 0.44 ng/mL versus 0.80 ± 0.29 pg/mL). However, OSA children (Aβ42: 186.2 ± 66.7 pg/mL; P < 0.001; PS1: 3.42 ± 1.46 ng/mL; P < 0.001), and particularly OSA+OB children had significant elevations in both Aβ42 (349.4 ± 112.9 pg/mL; P < 0.001) and PS1 (PS1: 4.54 ± 1.16 ng/mL; P < 0.001) circulating concentrations. In a subset of 24 children, T&A resulted in significant reductions of Aβ42 (352.0 ± 145.2 versus 151.9 ± 81.4 pg/mL; P < 0.0001) and PS1 (4.82 ± 1.09 versus 2.02 ± 1.18 ng/mL; P < 0.0001). Thus, OSA, and particularly OSA+OB, are associated with increased plasma levels of AD biomarkers, which decline upon treatment of OSA in a representative, yet not all- encompassing subset of patients, suggesting that OSA may accelerate AD-related processes even in early childhood. However, the cognitive and overall health-related implications of these findings remain to be defined. © 2016 Associated Professional Sleep Societies, LLC.

  14. Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Mirrakhimov Aibek E

    2013-02-01

    Full Text Available Abstract Background Obstructive sleep apnea (OSA is a common disease, affecting approximately 2% of women and 4% of men residing in Western communities. No systematically reviewed data are available about the prevalence of this disease in Asia, the most heavily populated continent. Methods PubMed/Medline, Scopus and Google Scholar were searched for articles published from 1993 to May 2012 that reported the prevalence of OSA diagnosed via sleep monitoring and the prevalence of patients at risk for OSA as assessed by symptomatology and/or sleep questionnaires. We have also searched abstract database of major pulmonary and sleep scientific societies for relevant abstracts presented from 2010 to 2012. The following inclusion criteria were used: articles published in English, age ≥ 18 years, ≥ 100 participants in studies using sleep monitoring for the diagnosis of OSA, ≥ 300 participants in studies using questionnaires to detect patients at high risk for OSA. Exclusion criteria: duplicate publications, studies reporting the prevalence of central sleep apnea only, hospital based studies as well as studies assessing OSA prevalence among patients with resistant arterial hypertension, chronic kidney disease, heart failure and in patients with concomitant neurological disease. Results Twenty four articles were found to meet the inclusion criteria, covering 47,957 subjects (26,042 men and 21,915 women and four relevant abstracts were noted. OSA prevalence ranged from 3.7% to 97.3%. Male gender, older age, a higher BMI and waist to hip ratio, greater neck circumference, arterial hypertension, smoking, snoring and daytime sleepiness were associated with OSA. Sample size, difference between the populations studied and the fact that some works included patients with a high pre-test probability of OSA explain the difference in prevalence rates. Conclusion This systematic review highlights the lack of data regarding the prevalence of OSA in Asians

  15. Metabolic biomarkers in community obese children: effect of obstructive sleep apnea and its treatment.

    Science.gov (United States)

    Alonso-Álvarez, María Luz; Terán-Santos, Joaquin; Gonzalez Martinez, Mónica; Cordero-Guevara, José Aurelio; Jurado-Luque, María José; Corral-Peñafiel, Jaime; Duran-Cantolla, Joaquin; Ordax Carbajo, Estrella; MasaJimenez, Fernando; Kheirandish-Gozal, Leila; Gozal, David

    2017-09-01

    Obesity and obstructive sleep apnea in children have been associated with metabolic morbidities. The present study aimed to evaluate the presence of metabolic alterations among obese children recruited from the community, with and without obstructive sleep apnea syndrome (OSAS), and the impact of treatment of OSAS on metabolic profiles. A cross-sectional, prospective, multicenter study of Spanish children aged 3-14 years with a body mass index (BMI) ≥95th percentile for age and sex were randomly selected in the first phase. Four groups emerged for follow-up: (1) no treatment; (2) dietary intervention; (3) surgical treatment of OSA; and (4) continuous positive airway pressure (CPAP) treatment of OSA. Fasting blood tests were performed at baseline (T0) and approximately one year after the intervention (T1). A total of 113 obese children with a mean age of 11.3 ± 2.9 years completed T0 and T1 assessments. Their mean BMI z-score at T1 was 1.34 ± 0.59, and mean Respiratory Disturbance Index was 8.6 ± 13.0 at T0 and 3.3 ± 4.0/hour total sleep time at T1. Only glucose fasting levels differed among metabolic parameters in obese children with OSAS and without OSAS at baseline (T0) (p = 0.018). There were statistically significant differences between surgically treated OSAS (p = 0.002), and CPAP-treated OSAS (p = 0.024) versus the non-OSAS group in the glucose levels between baseline (T0) and follow-up (T1) after controlling for age and change in BMI. Significant univariate associations between BMI and C-reactive protein, insulin, and homeostasis model assessment of insulin resistance emerged at both T0 and T1. Concurrent obesity and OSAS could promote metabolic and inflammatory alterations, and the latter appeared to be sensitive to OSAS treatment outcomes. ClinicalTrials.gov Identifier: NCT01322763. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Physiological consequences of CPAP therapy withdrawal in patients with obstructive sleep apnoea—an opportunity for an efficient experimental model

    OpenAIRE

    Schwarz, Esther I.; Stradling, John R.; Kohler, Malcolm

    2018-01-01

    Randomised controlled trials (RCTs) of continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA) are time consuming, and their findings often inconclusive or limited due to suboptimal CPAP adherence in CPAP-naïve patients with OSA. Short-term CPAP withdrawal in patients with prior optimal CPAP adherence results in recurrence of OSA and its consequences. Thus, this experimental model serves as an efficient tool to investigate both the consequences of untreated OSA, and poten...

  17. Comparative review of human and canine osteosarcoma: morphology, epidemiology, prognosis, treatment and genetics.

    Science.gov (United States)

    Simpson, Siobhan; Dunning, Mark David; de Brot, Simone; Grau-Roma, Llorenç; Mongan, Nigel Patrick; Rutland, Catrin Sian

    2017-10-24

    Osteosarcoma (OSA) is a rare cancer in people. However OSA incidence rates in dogs are 27 times higher than in people. Prognosis in both species is relatively poor, with 5 year OSA survival rates in people not having improved in decades. For dogs, 1 year survival rates are only around ~ 45%. Improved and novel treatment regimens are urgently required to improve survival in both humans and dogs with OSA. Utilising information from genetic studies could assist in this in both species, with the higher incidence rates in dogs contributing to the dog population being a good model of human disease. This review compares the clinical characteristics, gross morphology and histopathology, aetiology, epidemiology, and genetics of canine and human OSA. Finally, the current position of canine OSA genetic research is discussed and areas for additional work within the canine population are identified.

  18. Correlation of obstructive sleep apnoea and laryngopharyngeal reflux: phmetry study.

    Science.gov (United States)

    Elhennawi, D M; Ahmed, M R; Abou-Halawa, A S

    2016-12-01

    To study the correlation of obstructive sleep apnoea (OSA) and laryngopharyngeal reflux (LPR). A descriptive study. Suez Canal University Hospital, Ismailia, Egypt. 62 patients with polysomnography confirmed OSA. Patients were evaluated with ambulatory 24-h double channel pH monitoring. Mean reflux symptom index in the study group was 9 ± 5.5, and it was > 13 in all patients with severe OSA. Signs of LPR reflux were present in 34 (55%) patients. Abnormal reflux was detected in the distal oesophagus in 41 patients (66%) and in the proximal oesophagus in 21 patients (34%). Patients with severe OSA had significantly higher nocturnal LPR reflux episodes compared to patients with mild disease (P .05). LPR is common in patients with OSA. Patients with severe OSA have significantly higher nocturnal LPR. This should be considered when treating this group of patients. © 2016 John Wiley & Sons Ltd.

  19. Office management of obstructive sleep apnoea: appliances.

    Science.gov (United States)

    Johnson, Matthew D

    2015-08-01

    Oral appliances are becoming increasingly common in the treatment of obstructive sleep apnoea (OSA). They work by advancing the mandible and opening the pharynx. There are several types of devices available for use. Many patients intolerant to continuous positive airway pressure (CPAP) are using oral appliances for OSA. Oral appliances have been shown to improve polysomnography, quality of life and health measures associated with OSA. There is current work to better identify patients who are ideal candidates. Development of titratable devices and monitoring are optimizing usage. They have been compared with CPAP, with both showing improvement in OSA; however, CPAP remains superior overall. Oral appliances are becoming first-line therapy for mild and moderate OSA. They provide a meaningful alternative in severe OSA for patients unable to use CPAP. Device titration and usage monitoring are beginning to hone oral appliances as a therapeutic option.

  20. Banco de sementes do solo de uma Floresta Estacional Semidecidual, em Viçosa, Minas Gerais.

    Directory of Open Access Journals (Sweden)

    Juvenal Pinheiro Batista Neto

    2010-08-01

    Full Text Available Avaliou-se quantitativa e qualitativamente a florística do banco de sementes do solo de um fragmento de Floresta Estacional Semidecidual Montana, no município de Viçosa, MG. No final da estação chuvosa (março/2004, foram coletadas duas amostras de solo de 20 x 15 cm, com 5 cm de profundidade, no centro de seis subparcelas contíguas de 10 x 20 m, em dez parcelas permanentes de 20 x 60 m, em dez locais, totalizando 120 amostras (3,6 m2. As amostras de solo foram colocadas em estruturas de sombreamento de 11,5 % e 60 %, e as sementes germinadas foram identificadas em graminóides, herbáceo-cipós, arbustivas e arbóreas. Foram registradas 3.416 sementes germinadas, sendo 30,2 % graminóides, 29,2 % herbáceo-cipós, 17,5 % arbustivas e 23,1 % arbóreas, estas duas últimas distribuídas em 17 famílias, 25 gêneros e 31 espécies. Melastomataceae, Cecropiaceae e Piperaceae contribuíram com 31,8 %, 10,0 % e 8,8 % do total de espécies, respectivamente, sendo que Miconia cinnamomifolia e Leandra purpurascens foram responsáveis por 59,3 % das sementes arbustivo-arbóreas germinadas. As pioneiras se destacaram com 61,3 % das espécies e 88,5 % das sementes germinadas. Não foram registradas espécies secundárias tardias. A densidade média de sementes germinadas para todos os hábitos e locais foi de 949 sementes/m2. O número de espécies e de sementes germinadas do grupo arbustivo-arbóreo diferiu significativamente pelo teste Kruskal-Wallis (P ≤ 0,05 entre os locais estudados. Esses resultados indicam que, no banco de sementes do solo, há predomínio de espécies pioneiras que são importantes para a sucessão em clareiras ou após o corte da floresta. Porém, esse estoque de sementes não é suficiente para a continuidade do processo de sucessão, que inclui o estabelecimento de maior proporção de espécies secundárias iniciais e tardias. Isso indica que há necessidade de um manejo adequado do banco de pl

  1. Detecting obstructive sleep apnea in children by self-affine visualization of oximetry.

    Science.gov (United States)

    Garde, Ainara; Dekhordi, Parastoo; Petersen, Christian L; Ansermino, J Mark; Dumont, Guy A

    2017-07-01

    Obstructive sleep apnea (OSA), characterized by cessations of breathing during sleep due to upper airway collapse, can affect the healthy growth and development of children. The gold standard for OSA diagnosis, polysomnography(PSG), is expensive and resource intensive, resulting in long waiting lists to perform a PSG. Previously, we investigated the time-frequency analysis of blood oxygen saturation (SpO 2 ) to screen for OSA. We used overnight pulse oximetry from 146 children, collected using a smartphone-based pulse oximeter (Phone Oximeter), simultaneously with standard PSG. Sleep technicians manually scored PSG and provided the average of apnea/hypoapnea events per hour (AHI). In this study, we proposed an alternative method for analyzing SpO 2 , in which a set of contracting transformations form a self-affine set with a 2D attractor, previously developed for qualitative visualization of the photoplethysmogram and electroencephalogram. We applied this technique to the overnight SpO 2 signal from individual patients and extracted features based on the distribution of points (radius and angle) in the visualization. The cloud of points in children without OSA (NonOSA) was more confined than in children with OSA, which was reflected by more empty pixels (radius and angles). The maximum value, skewness and standard deviation of the distribution of points located at different radius and angles were significantly (Bonferroni corrected) higher in NonOSA compared to OSA children. To detect OSA defined at different levels (AHI≥5, AHI≥10 and AHI≥15), three multivariate logistic regression models were implemented using a stepwise feature selection and internally validated through bootstrapping. The models (AHI≥5, AHI≥10, AHI≥15), consisting of 3, 4 and 1 features respectively, provided a bootstrap-corrected AUC of 73%, 81%, 73%. Thus, applying this visualization to nocturnal SpO 2 could yield both visual and quantitative information that might be useful for

  2. A 5-Year Follow-up Study on the Relationship between Obstructive Sleep Apnea and Parkinson Disease.

    Science.gov (United States)

    Sheu, Jau-Jiuan; Lee, Hsin-Chien; Lin, Herng-Ching; Kao, Li-Ting; Chung, Shiu-Dong

    2015-12-15

    Sleep disturbances are among the most common nonmotor symptoms of Parkinson disease. However, no large epidemiological data regarding the association between obstructive sleep apnea (OSA) and Parkinson disease have been reported. The goal of this study was to investigate the risk for Parkinson disease during a 5-y follow-up period after a diagnosis of OSA using a population-based dataset. The data for this retrospective longitudinal cohort study were retrieved from the Taiwan Longitudinal Health Insurance Database 2000. We identified 1,532 patients with OSA as the study cohort and randomly selected 7,660 patients as the comparison cohort. Each subject was individually followed up for a 5-y period to identify those in whom Parkinson disease subsequently developed. Stratified Cox proportional hazard regressions were performed as a means of comparing the 5-y risk of subsequent Parkinson disease between the study cohort and comparison cohort. Of the 9,192 total patients, Parkinson disease developed in 0.73% during the 5-y follow-up period: 1.24% and 0.63% in the OSA and control cohorts, respectively. After censoring patients who died during the follow-up period and adjusting for socio-demographic characteristics, the hazard ratio (HR) of Parkinson disease during the 5-y follow-up period for patients with OSA was 2.26 (95% confidence interval [CI] = 1.32-3.88) compared with comparison patients. In addition, among females, the adjusted HR of Parkinson disease was 3.54 (95% CI = 1.50-8.34) for patients with OSA compared to patients without OSA. However, among males, there was no significantly increased hazard of Parkinson disease for patients with OSA compared to those without OSA. Female patients with OSA were found to be at a significant risk of subsequent Parkinson disease during a 5-y follow-up period. © 2015 American Academy of Sleep Medicine.

  3. Fatigued on Venus, sleepy on Mars-gender and racial differences in symptoms of sleep apnea.

    Science.gov (United States)

    Eliasson, Arn H; Kashani, Mariam D; Howard, Robin S; Vernalis, Marina N; Modlin, Randolph E

    2015-03-01

    Clinical guidelines for the care of obstructive sleep apnea (OSA) recommend evaluation of daytime sleepiness but do not specify evaluation of fatigue. We studied how subjects with and without OSA experience fatigue and sleepiness, examining the role of gender and race. Consecutive subjects entering our heart health registry completed validated questionnaires including Berlin Questionnaire for OSA, Fatigue Scale, and Epworth Sleepiness Scale. Data analysis was performed only with Whites and Blacks as there were too few subjects of other races for comparison. Of 384 consecutive subjects, including 218 women (57 %), there were 230 Whites (60 %) and 154 Blacks (40 %), with average age of 55.9 ± 12.8 years. Berlin Questionnaires identified 221 subjects (58 %) as having high likelihood for OSA. Fatigue was much more common in women (75 %) than in men (46 %) with OSA (p men (29 %) without OSA (p = 0.86). In multivariate analysis, men with OSA were sleepier than women; Black men with OSA had higher Epworth scores (mean ± SD, 12.8 ± 5.2) compared to White men (10.6 ± 5.3), White women (10.0 ± 4.5), and Black women (10.5 ± 5.2), p = 0.05. These gender differences were not related to the effects of age, body mass index, perceived stress, sleep duration, or thyroid function. Women report fatigue more commonly with OSA than men. Men experience sleepiness more commonly with OSA than women. The findings suggest that evaluation of sleep disorders must include an assessment of fatigue in addition to sleepiness to capture the experience of women.

  4. Effect of obstructive sleep apnea on the sleep architecture in cirrhosis.

    Science.gov (United States)

    Kappus, Matthew R; Leszczyszyn, David J; Moses, Leonard; Raman, Shekar; Heuman, Douglas M; Bajaj, Jasmohan S

    2013-03-15

    Sleep disturbances in cirrhosis are assumed to be due to hepatic encephalopathy (HE). The interaction between cirrhosis, prior HE, and obstructive sleep apnea (OSA) has not been evaluated. We aimed to evaluate the additional effect of cirrhosis with and without prior HE on the sleep architecture and perceived sleep disturbances of OSA patients. A case-control review of OSA patients who underwent polysomnography (PSG) in a liver-transplant center was performed. OSA patients with cirrhosis (with/without prior HE) were age-matched 1:1 with OSA patients without cirrhosis. Sleep quality, daytime sleepiness, sleep quality, and sleep architecture was compared between groups. Forty-nine OSA cirrhotic patients (age 57.4 ± 8.3 years, model for end-stage liver disease (MELD) 8.3 ± 5.4, 51% HCV, 20% prior HE) were age-matched 1:1 to OSA patients without cirrhosis. Apnea-hypopnea index, arousal index, sleep efficiency, daytime sleepiness, and effect of sleepiness on daily activities were similar between OSA patients with/ without cirrhosis. Sleep architecture, including %slow wave sleep (SWS), was also not different between the groups. MELD was positively correlated with time in early (N1) stage (r = 0.4, p = 0.03). All prior HE patients (n = 10) had a shift of the architecture towards early, non-restorative sleep (higher % [N2] stage [66 vs 52%, p = 0.005], lower % SWS [0 vs 29%, p = 0.02], lower REM latency [95 vs 151 minutes, p = 0.04]) compared to the rest. Alcoholic etiology was associated with higher latency to N1/N2 sleep, but no other effect on sleep architecture was seen. OSA can contribute to sleep disturbance in cirrhosis and should be considered in the differential of sleep disturbances in cirrhosis. Prior HE may synergize with OSA in worsening the sleep architecture.

  5. Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls

    Energy Technology Data Exchange (ETDEWEB)

    Fricke, Bradley L. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Emory University School of Medicine, Department of Radiology, Atlanta, GA (United States); Donnelly, Lane F. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Shott, Sally R. [Cincinnati Children' s Hospital Medical Center, Division of Otolaryngology, Cincinnati, OH (United States); Kalra, Maninder; Poe, Stacy A.; Chini, Barbara A.; Amin, Raouf S. [Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Cincinnati, OH (United States)

    2006-06-15

    Cine MRI has become a useful tool in the evaluation of patients with persistent obstructive sleep apnea (OSA) despite previous surgical intervention and in patients with underlying conditions that render them susceptible to multilevel airway obstruction. Findings on cine MRI studies have also increased our understanding of the mechanisms and anatomic causes of OSA in children. To compare lingual tonsil size between children with OSA and a group of normal controls. In addition, a subanalysis was made of the group of children with OSA comparing lingual tonsils between children with and without underlying Down syndrome. Children with persistent OSA despite previous palatine tonsillectomy and adenoidectomy and controls without OSA underwent MR imaging with sagittal fast spin echo inversion-recovery images, and lingual tonsils were categorized as nonperceptible at imaging or present and measurable. When present, lingual tonsils were measured in the maximum anterior-posterior diameter. If lingual tonsils were greater than 10 mm in diameter and abutting both the posterior border of the tongue and the posterior pharyngeal wall, they were considered markedly enlarged. There were statistically significant differences between the OSA and control groups for the presence vs. nonvisualization of lingual tonsils (OSA 33% vs. control 0%, P=0.0001) and mean diameter of the lingual tonsils (OSA 9.50 mm vs. control 0.0 mm, P=0.00001). Within the OSA group, there were statistically significant differences between children with and without Down syndrome for the three lingual tonsil width categories (P=0.0070) and occurrence of markedly enlarged lingual tonsils (with Down syndrome 35% vs. without Down syndrome 3%, P=0.0035). Enlargement of the lingual tonsils is relatively common in children with persistent obstructive sleep apnea after palatine tonsillectomy and adenoidectomy. This is particularly true in patients with Down syndrome. (orig.)

  6. Neurobehavioural correlates in older children and adolescents with obesity and obstructive sleep apnoea.

    Science.gov (United States)

    Tan, Evan; Healey, Dione; Schaughency, Elizabeth; Dawes, Patrick; Galland, Barbara

    2014-01-01

    The relationship between obstructive sleep apnoea (OSA) and poorer neurobehavioural outcomes in school-age children is well established, but the relationship in obese children and adolescents, in whom OSA is more common, is not so well established. We aimed to investigate this relationship in 10-18-year-olds. Thirty-one participants with a mean body mass index (BMI) of 32.3 ± 4.9 enrolled. BMI-for-age cut-offs were used to define obesity. Participants underwent polysomnography and were classified into OSA (apnoea-hypopnoea index (AHI) > 2 per hour) and non-OSA (AHI ≤ 2) groups. Intelligence, memory and learning, academic achievement, behaviour and executive functioning were assessed using the Wechsler Abbreviated Scale of Intelligence, Wide Range Assessment of Memory and Learning 2, Wechsler Individual Achievement Test II (WIAT-II), Behavioural Assessment System for Children 2 and Behaviour Rating Inventory of Executive Function, respectively. Forty-eight per cent (15/31) were classified as having OSA, and 52% (16/31) as non-OSA. The obese cohort performed below the average of normative data on several neurobehavioural measures. WIAT-II maths scores were significantly lower (P = 0.034) in the OSA group than in the non-OSA group (means 84.5 vs. 94.6, respectively), losing significance after adjustment for IQ, age and gender. Self-reported school problems were significantly worse in the OSA group before and after multivariate adjustment (P = 0.010, Cohen's d = 1.02). No other significant differences were found. Results suggest that OSA may increase risk for some poorer educational and behavioural outcomes. The findings are reasonably consistent with and add to the evidence base of the few studies that have explored this relationship. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  7. Genome-wide gene expression array identifies novel genes related to disease severity and excessive daytime sleepiness in patients with obstructive sleep apnea.

    Directory of Open Access Journals (Sweden)

    Yung-Che Chen

    Full Text Available We aimed to identify novel molecular associations between chronic intermittent hypoxia with re-oxygenation and adverse consequences in obstructive sleep apnea (OSA. We analyzed gene expression profiles of peripheral blood mononuclear cells from 48 patients with sleep-disordered breathing stratified into four groups: primary snoring (PS, moderate to severe OSA (MSO, very severe OSA (VSO, and very severe OSA patients on long-term continuous positive airway pressure treatment (VSOC. Comparisons of the microarray gene expression data identified eight genes up-regulated with OSA and down-regulated with CPAP treatment, and five genes down-regulated with OSA and up-regulated with CPAP treatment. Protein expression levels of two genes related to endothelial tight junction (AMOT P130, and PLEKHH3, and three genes related to anti-or pro-apoptosis (BIRC3, ADAR1 P150, and LGALS3 were all increased in the VSO group, while AMOT P130 was further increased, and PLEKHH3, BIRC3, and ADAR1 P150 were all decreased in the VSOC group. Subgroup analyses revealed that AMOT P130 protein expression was increased in OSA patients with excessive daytime sleepiness, BIRC3 protein expression was decreased in OSA patients with hypertension, and LGALS3 protein expression was increased in OSA patients with chronic kidney disease. In vitro short-term intermittent hypoxia with re-oxygenation experiment showed immediate over-expression of ADAR1 P150. In conclusion, we identified a novel association between AMOT/PLEKHH3/BIRC3/ADAR1/LGALS3 over-expressions and high severity index in OSA patients. AMOT and GALIG may constitute an important determinant for the development of hypersomnia and kidney injury, respectively, while BIRC3 may play a protective role in the development of hypertension.

  8. Aberrant brain functional connectome in patients with obstructive sleep apnea.

    Science.gov (United States)

    Chen, Li-Ting; Fan, Xiao-Le; Li, Hai-Jun; Ye, Cheng-Long; Yu, Hong-Hui; Xin, Hui-Zhen; Gong, Hong-Han; Peng, De-Chang; Yan, Li-Ping

    2018-01-01

    Obstructive sleep apnea (OSA) is accompanied by widespread abnormal spontaneous regional activity related to cognitive deficits. However, little is known about the topological properties of the functional brain connectome of patients with OSA. This study aimed to use the graph theory approaches to investigate the topological properties and functional connectivity (FC) of the functional connectome in patients with OSA, based on resting-state functional magnetic resonance imaging (rs-fMRI). Forty-five male patients with newly diagnosed untreated severe OSA and 45 male good sleepers (GSs) underwent a polysomnography (PSG), clinical evaluations, and rs-fMRI scans. The automated anatomical labeling (AAL) atlas was used to construct the functional brain connectome. The topological organization and FC of brain functional networks in patients with OSA were characterized using graph theory methods and investigated the relationship between functional network topology and clinical variables. Both the patients with OSA and the GSs exhibited high-efficiency "small-world" network attributes. However, the patients with OSA exhibited decreased σ, γ, E glob ; increased Lp, λ; and abnormal nodal centralities in several default-mode network (DMN), salience network (SN), and central executive network (CEN) regions. However, the patients with OSA exhibited abnormal functional connections between the DMN, SN, and CEN. The disrupted FC was significantly positive correlations with the global network metrics γ and σ. The global network metrics were significantly correlated with the Epworth Sleepiness Scale (ESS) score, Montreal Cognitive Assessment (MoCA) score, and oxygen desaturation index. The findings suggest that the functional connectome of patients with OSA exhibited disrupted functional integration and segregation, and functional disconnections of the DMN, SN, and CEN. The aberrant topological attributes may be associated with disrupted FC and cognitive functions. These

  9. Association between plasma neutrophil gelatinase associated lipocalin level and obstructive sleep apnea or nocturnal intermittent hypoxia.

    Directory of Open Access Journals (Sweden)

    Kimihiko Murase

    Full Text Available Both obstructive sleep apnea (OSA and a novel lipocalin, neutrophil gelatinase associated lipocalin (Ngal, have been reported to be closely linked with cardiovascular disease and loss of kidney function through chronic inflammation. However, the relationship between OSA and Ngal has never been investigated.To evaluate the relationship between Ngal and OSA in clinical practice.In 102 patients, polysomnography was performed to diagnose OSA and plasma Ngal levels were measured. The correlations between Ngal levels and OSA severity and other clinical variables were evaluated. Of the 46 patients who began treatment with continuous positive airway pressure (CPAP, Ngal levels were reevaluated after three months of treatment in 25 patients.The Ngal level correlated significantly with OSA severity as determined by the apnea hypopnea index (r = 0.24, p = 0.01 and 4% oxygen desaturation index (ODI (r = 0.26, p = 0.01. Multiple regression analysis showed that the Ngal level was associated with 4%ODI independently of other clinical variables. Compliance was good in 13 of the 25 patients who used CPAP. Although the OSA (4%ODI: 33.1±16.7 to 1.1±1.9/h, p<0.01 had significantly improved in those with good compliance, the Ngal levels were not significantly changed (60.5±18.1 before CPAP vs 64.2±13.9 ng/ml after CPAP, p = 0.27.Plasma Ngal levels were positively associated with the severity of OSA. However, the contribution rate of OSA to systemic Ngal secretion was small and changes in Ngal levels appeared to be influenced largely by other confounding factors. Therefore, it does not seem reasonable to use the Ngal level as a specific biomarker of OSA in clinical practice.

  10. Association of Interleukin-10 gene promoter polymorphisms with obstructive sleep apnea.

    Science.gov (United States)

    Özdaş, Sibel; Özdaş, Talih; Acar, Mustafa; Erbek, Selim S; Köseoğlu, Sabri; Göktürk, Gökhan; Izbirak, Afife

    2016-05-01

    Interleukin-10 (IL) is an anti-inflammatory cytokine that regulates normal sleep patterns, and recent studies have reported that it is a potential useful biomarker to identify presence and severity of sleep apnea syndrome (OSAS). Promoter polymorphisms of IL-10 gene have been associated with altered expression levels, which contributes to OSAS. The aim of this study was to determine the prevalence of -1082 G/A, -819 C/T, and -592 C/A promoter polymorphisms of IL-10 gene in individuals with OSAS and controls. An open-label study was performed in the Otorhinolaryngology and Sleep Disorders Outpatient Clinics. One hundred four cases with OSAS were included as the study group, and 78 individuals without OSAS were included as the controls. DNAs were extracted from peripheral blood leukocytes, and the sites that encompassed those polymorphisms were identified by DNA sequencing analyses. Data were analyzed with SNPStats and multifactor dimensionality reduction (MDR) software. The prevalence of OSAS was higher in males in the study group when compared to controls (P = 0.0003). The IL-10-1082 G/A, -819 C/T, and -592 C/A SNPs, and their minor alleles were associated with a significantly increased risk for OSAS compared to the controls (P ˂ 0.05 for all). Furthermore, ATA haplotype frequency was significantly higher in the study group compared to the control group, but the GCC haplotype frequency was lower (P = 0.0001 and P = 0.0001). As indicated in MDR analysis, combinations of IL-10 gene were associated with OSAS in single-, double-, and triple-locus analyses. The prevalences of the IL-10 gene promoter polymorphisms were different in OSAS patients and the controls in Turkish population. IL-10 gene polymorphisms may lead to altered inflammatory cascade, which might contribute to OSAS. Further studies on larger cohorts are needed to validate our findings.

  11. SOS score: an optimized score to screen acute stroke patients for obstructive sleep apnea.

    Science.gov (United States)

    Camilo, Millene R; Sander, Heidi H; Eckeli, Alan L; Fernandes, Regina M F; Dos Santos-Pontelli, Taiza E G; Leite, Joao P; Pontes-Neto, Octavio M

    2014-09-01

    Obstructive sleep apnea (OSA) is frequent in acute stroke patients, and has been associated with higher mortality and worse prognosis. Polysomnography (PSG) is the gold standard diagnostic method for OSA, but it is impracticable as a routine for all acute stroke patients. We evaluated the accuracy of two OSA screening tools, the Berlin Questionnaire (BQ), and the Epworth Sleepiness Scale (ESS) when administered to relatives of acute stroke patients; we also compared these tools against a combined screening score (SOS score). Ischemic stroke patients were submitted to a full PSG at the first night after onset of symptoms. OSA severity was measured by apnea-hypopnea index (AHI). BQ and ESS were administered to relatives of stroke patients before the PSG and compared to SOS score for accuracy and C-statistics. We prospectively studied 39 patients. OSA (AHI ≥10/h) was present in 76.9%. The SOS score [area under the curve (AUC): 0.812; P = 0.005] and ESS (AUC: 0.789; P = 0.009) had good predictive value for OSA. The SOS score was the only tool with significant predictive value (AUC: 0.686; P = 0.048) for severe OSA (AHI ≥30/h), when compared to ESS (P = 0.119) and BQ (P = 0.191). The threshold of SOS ≤10 showed high sensitivity (90%) and negative predictive value (96.2%) for OSA; SOS ≥20 showed high specificity (100%) and positive predictive value (92.5%) for severe OSA. The SOS score administered to relatives of stroke patients is a useful tool to screen for OSA and may decrease the need for PSG in acute stroke setting. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls

    International Nuclear Information System (INIS)

    Fricke, Bradley L.; Donnelly, Lane F.; Shott, Sally R.; Kalra, Maninder; Poe, Stacy A.; Chini, Barbara A.; Amin, Raouf S.

    2006-01-01

    Cine MRI has become a useful tool in the evaluation of patients with persistent obstructive sleep apnea (OSA) despite previous surgical intervention and in patients with underlying conditions that render them susceptible to multilevel airway obstruction. Findings on cine MRI studies have also increased our understanding of the mechanisms and anatomic causes of OSA in children. To compare lingual tonsil size between children with OSA and a group of normal controls. In addition, a subanalysis was made of the group of children with OSA comparing lingual tonsils between children with and without underlying Down syndrome. Children with persistent OSA despite previous palatine tonsillectomy and adenoidectomy and controls without OSA underwent MR imaging with sagittal fast spin echo inversion-recovery images, and lingual tonsils were categorized as nonperceptible at imaging or present and measurable. When present, lingual tonsils were measured in the maximum anterior-posterior diameter. If lingual tonsils were greater than 10 mm in diameter and abutting both the posterior border of the tongue and the posterior pharyngeal wall, they were considered markedly enlarged. There were statistically significant differences between the OSA and control groups for the presence vs. nonvisualization of lingual tonsils (OSA 33% vs. control 0%, P=0.0001) and mean diameter of the lingual tonsils (OSA 9.50 mm vs. control 0.0 mm, P=0.00001). Within the OSA group, there were statistically significant differences between children with and without Down syndrome for the three lingual tonsil width categories (P=0.0070) and occurrence of markedly enlarged lingual tonsils (with Down syndrome 35% vs. without Down syndrome 3%, P=0.0035). Enlargement of the lingual tonsils is relatively common in children with persistent obstructive sleep apnea after palatine tonsillectomy and adenoidectomy. This is particularly true in patients with Down syndrome. (orig.)

  13. Obstructive Sleep Apnea and Aldosterone

    Science.gov (United States)

    Svatikova, Anna; Olson, Lyle J.; Wolk, Robert; Phillips, Bradley G.; Adachi, Taro; Schwartz, Gary L.; Somers, Virend K.

    2009-01-01

    Background: Obstructive sleep apnea (OSA) is a major risk factor for hypertension and has been associated with increased risk for cardiovascular morbidity. A dysregulated renin-angiotensin-aldosterone system may contribute to excess sodium retention and hypertension and may be activated in OSA. We tested the hypothesis that serum levels of aldosterone and plasma renin activity (PRA) are increased by apneic sleep in subjects without cardiovascular disease, compared to healthy control subjects. Methods and Results: Plasma aldosterone level was measured in 21 subjects with moderate to severe OSA and was compared to 19 closely matched healthy subjects. Plasma renin activity (PRA) was measured in 19 OSA patients and in 20 healthy controls. Aldosterone and PRA were measured before sleep (9pm), after 5 hrs of untreated OSA (2am) and in the morning after awakening (6am). There were no baseline (9pm) differences in serum aldosterone levels and PRA between the healthy controls and OSA patients (aldosterone: 55.2 ± 9 vs 56.0 ± 9 pg/mL; PRA: 0.99 ± 0.15 vs 1.15 ± 0.15 ng/mL/hr). Neither several hours of untreated severe OSA nor CPAP treatment affected aldosterone levels and PRA in OSA patients. Diurnal variation of both aldosterone and PRA was observed in both groups, in that morning renin and aldosterone levels were higher than those measured at night before sleep. Conclusions: Our study shows that patients with moderate to severe OSA without co-existing cardiovascular disease have plasma aldosterone and renin levels similar to healthy subjects. Neither untreated OSA nor CPAP treatment acutely affect plasma aldosterone or renin levels. Citation: Svatikova A; Olson LJ; Wolk R; Phillips BG; Adachi T; Schwartz GL; Somers VK. Obstructive sleep apnea and aldosterone. SLEEP 2009;32(12):1589-1592. PMID:20041594

  14. Prevalence, sleep characteristics, and comorbidities in a population at high risk for obstructive sleep apnea: A nationwide questionnaire study in South Korea.

    Directory of Open Access Journals (Sweden)

    Jun-Sang Sunwoo

    Full Text Available To determine the prevalence, sleep characteristics, and comorbidities associated with a high risk for obstructive sleep apnea (OSA in the Korean adult population.We analyzed data from 2,740 subjects who responded to a nationwide questionnaire survey of sleep characteristics. Those who qualified under two or more symptom categories of the Berlin questionnaire were defined as "at high risk for OSA". We investigated their socio-demographic information, sleep habits, and medical and psychiatric comorbidities. Logistic regression analyses were performed to identify factors and consequences significantly associated with a high risk for OSA.The prevalence of a high risk for OSA was 15.8% (95% confidence interval [CI] 14.5-17.2%. Multiple logistic regression analysis showed that old age (≥ 70 years, odds ratio [OR] 2.68 and body mass index ≥ 25 kg/m2 (OR 10.75 were significantly related with a high risk for OSA, whereas regular physical activity (OR 0.70 had a protective effect. Subjective sleep characteristics associated with a high risk for OSA were perceived insufficient sleep (OR 1.49, excessive daytime sleepiness (OR 1.88, and insomnia (OR 3.70. In addition, hypertension (OR 5.83, diabetes mellitus (OR 2.54, hyperlipidemia (OR 2.85, and anxiety (OR 1.63 were comorbid conditions independently associated with a high risk for OSA.This is the first study to demonstrate the prevalence of a high risk for OSA in a nationwide representative sample of the Korean adult population. These findings elucidate the epidemiology and clinical characteristics of those at high risk for OSA.

  15. Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening.

    Science.gov (United States)

    Yusoff, M Fadhli Mohd; Baki, Marina Mat; Mohamed, Norlen; Mohamed, A Sani; Yunus, M Razif Mohamad; Ami, Mazita; Othman, Ilhamah; Ishak, Azlan I

    2010-12-01

    Obstructive sleep apnea (OSA) has been identified as one of the significant risk factors for motor vehicle crashes (MVCs). In the interest of public safety, this study was conducted to determine the prevalence of OSA and its associated factors among express bus drivers in Malaysia. Identifying factors or conditions related with OSA is very important because they can be used as indicators to subject a person to a confirmatory diagnosis using polysomnography testing. Two hundred eighty-nine randomly selected express bus drivers from 5 express bus companies participated in the study. Information on demography, medical history, clinical symptoms, and signs of OSA were collected by a designated medical officer and the diagnosis of OSA was done based on the Apnea Hypopnoea Index (AHI) from polysomnography testing. Based on AHI, 128 (44.3%) subjects were diagnosed as having OSA with 83 (28.7%), 26 (9.0%), and 26 (6.6%) classified as mild, moderate, and severe OSA, respectively. Multiple logistic regression analysis results showed that age (odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.01-1.09), snoring (OR = 3.54, 95% CI 1.91-6.57), body mass index (BMI; OR = 1.17, 95% CI 1.09-1.25), hypertension (OR = 1.87, 95% CI 1.02-3.40), and neck circumference (OR = 1.31, 95% CI 1.18-1.46) were significantly associated with OSA status. The results supported the need for identifying the risk group for OSA among express bus drivers and the need to diagnose them early for an early intervention.

  16. A method to screen obstructive sleep apnea using multi-variable non-intrusive measurements

    International Nuclear Information System (INIS)

    De Silva, S; Abeyratne, U R; Hukins, C

    2011-01-01

    Obstructive sleep apnea (OSA) is a serious sleep disorder. The current standard OSA diagnosis method is polysomnography (PSG) testing. PSG requires an overnight hospital stay while physically connected to 10–15 channels of measurement. PSG is expensive, inconvenient and requires the extensive involvement of a sleep technologist. As such, it is not suitable for community screening. OSA is a widespread disease and more than 80% of sufferers remain undiagnosed. Simplified, unattended and cheap OSA screening methods are urgently needed. Snoring is commonly associated with OSA but is not fully utilized in clinical diagnosis. Snoring contains pseudo-periodic packets of energy that produce characteristic vibrating sounds familiar to humans. In this paper, we propose a multi-feature vector that represents pitch information, formant information, a measure of periodic structure existence in snore episodes and the neck circumference of the subject to characterize OSA condition. Snore features were estimated from snore signals recorded in a sleep laboratory. The multi-feature vector was applied to a neural network for OSA/non-OSA classification and K-fold cross-validated using a random sub-sampling technique. We also propose a simple method to remove a specific class of background interference. Our method resulted in a sensitivity of 91 ± 6% and a specificity of 89 ± 5% for test data for AHI THRESHOLD = 15 for a database consisting of 51 subjects. This method has the potential as a non-intrusive, unattended technique to screen OSA using snore sound as the primary signal

  17. Impaired behavioral and neurocognitive function in preschool children with obstructive sleep apnea.

    Science.gov (United States)

    Landau, Yael E; Bar-Yishay, Orit; Greenberg-Dotan, Sari; Goldbart, Aviv D; Tarasiuk, Ariel; Tal, Asher

    2012-02-01

    We aimed to examine the hypothesis that behavioral and neurocognitive functions of preschool children with Obstructive Sleep Apnea Syndrome (OSAS) are impaired compared to healthy children, and improve after adenotonsillectomy (TA). A comprehensive assessment battery was used to assess cognitive and behavioral functions, and quality of life in children with OSAS compared to matched controls. 45 children (mean age 45.5 ± 9 months, 73% boys, BMI 15.7 ± 2) with OSAS were compared to 26 healthy children (mean age 48.6 ± 8 months, 46% boys, BMI 16.4 ± 2). Mean AHI in the OSAS group was 13.2 ± 10.7 (ranging from 1.2 to 57). Significantly impaired planning and fluency (executive function) were found in children with OSAS, as well as impaired attention and receptive vocabulary. Parents and teachers described the OSAS group as having significantly more behavior problems. Quality of life questionnaire in children with OSAS (mean 2.3, range 0.7-4.3) was significantly worse compared to controls (mean 0, range: 0-4), P improvement was documented in verbal and motor fluency, sustained attention, and vocabulary. After TA, fewer behavioral problems were seen. Preschool children with OSAS present significantly impaired executive functions, impaired attention and receptive vocabulary, and more behavior problems. One year after TA, the prominent improvements were in behavior and quality of life. These findings suggest that the impact of OSAS on behavioral and cognitive functions begins in early childhood. Copyright © 2011 Wiley Periodicals, Inc.

  18. Leaching of PAHs from agricultural soils treated with oil shale combustion ash: an experimental study.

    Science.gov (United States)

    Jefimova, Jekaterina; Adamson, Jasper; Reinik, Janek; Irha, Natalya

    2016-10-01

    The present study focuses on the fate of polycyclic aromatic hydrocarbons (PAHs) in soils amended with oil shale ash (OSA). Leachability studies to assess the release of PAHs to the environment are essential before the application of OSA in agriculture. A quantitative estimation of the leaching of PAHs from two types of soil and two types of OSA was undertaken in this study. Two leaching approaches were chosen: (1) a traditional one step leaching scheme and (2) a leaching scheme with pretreatment, i.e.., incubation of the material in wet conditions imitating the field conditions, followed by a traditional leaching procedure keeping the total amount of water constant. The total amount of PAHs leached from soil/OSA mixtures was in the range of 15 to 48 μg/kg. The amount of total PAHs leached was higher for the incubation method, compared to the traditional leaching method, particularly for Podzolic Gleysols soil. This suggests that for the incubation method, the content of organic matter and clay minerals of the soil influence the fate of PAHs more strongly compared to the traditional leaching scheme. The amount of PAHs leached from OSA samples is higher than from soil/OSA mixtures, which suggests soils to inhibit the release of PAHs. Calculated amount of PAHs from experimental soil and OSA leaching experiments differed considerably from real values. Thus, it is not possible to estimate the amount of PAHs leached from soil/OSA mixtures based on the knowledge of the amount of PAHs leached from soil and OSA samples separately.

  19. Endothelial Dysfunction in Children With Obstructive Sleep Apnea Is Associated With Elevated Lipoprotein-Associated Phospholipase A2 Plasma Activity Levels.

    Science.gov (United States)

    Kheirandish-Gozal, Leila; Philby, Mona F; Qiao, Zhuanghong; Khalyfa, Abdelnaby; Gozal, David

    2017-02-09

    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. One hundred sixty children (mean age 7.1±2.3 years), either nonobese with (n=40) and without OSA (n=40) or obese with (n=40) and without OSA (n=40) underwent overnight polysomnographic and postocclusive reperfusion evaluation and a fasting blood draw the morning after the sleep study. In addition to lipid profile, Lp-PLA2 plasma activity was assessed using a commercial kit. Obese children and OSA children had significantly elevated plasma Lp-PLA2 activity levels compared to controls. Furthermore, when both obesity and OSA were concurrently present or when endothelial function was present, Lp-PLA2 activity was higher. Treatment of OSA by adenotonsillectomy resulted in reductions of Lp-PLA2 activity (n=37; P <0.001). Lp-PLA2 plasma activity is increased in pediatric OSA and obesity, particularly when endothelial dysfunction is present, and exhibits decreases on OSA treatment. The short-term and long-term significance of these findings in relation to cardiovascular risk remain undefined. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  20. Physiological consequences of CPAP therapy withdrawal in patients with obstructive sleep apnoea-an opportunity for an efficient experimental model.

    Science.gov (United States)

    Schwarz, Esther I; Stradling, John R; Kohler, Malcolm

    2018-01-01

    Randomised controlled trials (RCTs) of continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA) are time consuming, and their findings often inconclusive or limited due to suboptimal CPAP adherence in CPAP-naïve patients with OSA. Short-term CPAP withdrawal in patients with prior optimal CPAP adherence results in recurrence of OSA and its consequences. Thus, this experimental model serves as an efficient tool to investigate both the consequences of untreated OSA, and potential treatment alternatives to CPAP. The CPAP withdrawal protocol has been thoroughly validated, and applied in several RCTs focusing on cardiovascular and metabolic consequences of untreated OSA, as well as the assessment of treatment alternatives to CPAP.

  1. Physiological consequences of CPAP therapy withdrawal in patients with obstructive sleep apnoea—an opportunity for an efficient experimental model

    Science.gov (United States)

    Stradling, John R.; Kohler, Malcolm

    2018-01-01

    Randomised controlled trials (RCTs) of continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA) are time consuming, and their findings often inconclusive or limited due to suboptimal CPAP adherence in CPAP-naïve patients with OSA. Short-term CPAP withdrawal in patients with prior optimal CPAP adherence results in recurrence of OSA and its consequences. Thus, this experimental model serves as an efficient tool to investigate both the consequences of untreated OSA, and potential treatment alternatives to CPAP. The CPAP withdrawal protocol has been thoroughly validated, and applied in several RCTs focusing on cardiovascular and metabolic consequences of untreated OSA, as well as the assessment of treatment alternatives to CPAP. PMID:29445525

  2. Outcomes in coronary artery disease patients with sleepy obstructive sleep apnoea on CPAP

    NARCIS (Netherlands)

    Peker, Yuksel; Thunstrom, Erik; Glantz, Helena; Wegscheider, Karl; Eulenburg, Christine

    2017-01-01

    Coronary artery disease (CAD) patients with obstructive sleep apnoea (OSA) have increased risk for major adverse cardiovascular and cerebrovascular events (MACCEs) compared with CAD patients without OSA. We aimed to address if the risk is similar in both groups when OSA patients are treated. This

  3. Increased cell-free DNA concentrations in patients with obstructive sleep apnea.

    Science.gov (United States)

    Shin, Chol; Kim, Jin K; Kim, Je H; Jung, Ki H; Cho, Kyung J; Lee, Chang K; Lee, Seung G

    2008-12-01

    Blood concentrations of cell-free DNA, which is considered to be released during apoptosis, are elevated under some pathological conditions such as cardiovascular disease and cancer. The association between obstructive sleep apnea (OSA) and cell-free DNA concentrations has not been reported so far. The purpose of the present study was to examine the association between OSA and plasma DNA concentrations. A case-control study was conducted using a total of 164 men aged 39-67 years, who were free of coronary heart disease and cancer. Laboratory-based overnight polysomnography was performed for all participants. On the basis of polysomnography, patients with an apnea-hypopnea index (AHI) = 5-30 events/h were defined as having mild-moderate OSA (n = 33) and those with >30 events/h were defined as having severe OSA (n = 49). All 82 controls had AHI DNA concentrations from all participants were analyzed for the beta-globin gene using fluorescence-based real-time polymerase chain reaction. Patients with severe OSA had significantly higher plasma DNA concentrations than persons with mild-moderate OSA and those without OSA (P DNA concentration (P DNA concentrations (>8 microg/L) had approximately fourfold higher odds of OSA than those with low DNA levels. Further data are warranted to confirm the association for men and to evaluate the association for women.

  4. Memory and Obstructive Sleep Apnea: A Meta-Analysis

    Science.gov (United States)

    Wallace, Anna; Bucks, Romola S.

    2013-01-01

    Study Objectives: To examine episodic memory performance in individuals with obstructive sleep apnea (OSA). Design Meta-analysis was used to synthesize results from individual studies examining the impact of OSA on episodic memory performance. The performance of individuals with OSA was compared to healthy controls or normative data. Participants Forty-two studies were included, comprising 2,294 adults with untreated OSA and 1,364 healthy controls. Studies that recorded information about participants at baseline prior to treatment interventions were included in the analysis. Measurements Participants were assessed with tasks that included a measure of episodic memory: immediate recall, delayed recall, learning, and/or recognition memory. Results: The results of the meta-analyses provide evidence that individuals with OSA are significantly impaired when compared to healthy controls on verbal episodic memory (immediate recall, delayed recall, learning, and recognition) and visuo-spatial episodic memory (immediate and delayed recall), but not visual immediate recall or visuo-spatial learning. When patients were compared to norms, negative effects of OSA were found only in verbal immediate and delayed recall. Conclusions: This meta-analysis contributes to understanding of the nature of episodic memory deficits in individuals with OSA. Impairments to episodic memory are likely to affect the daily functioning of individuals with OSA. Citation Wallace A; Bucks RS. Memory and obstructive sleep apnea: a meta-analysis. SLEEP 2013;36(2):203-220. PMID:23372268

  5. Obstructive sleep apnea and energy balance regulation: A systematic review.

    Science.gov (United States)

    Shechter, Ari

    2017-08-01

    Obesity and obstructive sleep apnea (OSA) have a reciprocal relationship. Sleep disruptions characteristic of OSA may promote behavioral, metabolic, and/or hormonal changes favoring weight gain and/or difficulty losing weight. The regulation of energy balance (EB), i.e., the relationship between energy intake (EI) and energy expenditure (EE), is complex and multi-factorial, involving food intake, hormonal regulation of hunger/satiety/appetite, and EE via metabolism and physical activity (PA). The current systematic review describes the literature on how OSA affects EB-related parameters. OSA is associated with a hormonal profile characterized by abnormally high leptin and ghrelin levels, which may encourage excess EI. Data on actual measures of food intake are lacking, and not sufficient to make conclusions. Resting metabolic rate appears elevated in OSA vs. Findings on PA are inconsistent, but may indicate a negative relationship with OSA severity that is modulated by daytime sleepiness and body weight. A speculative explanation for the positive EB in OSA is that the increased EE via metabolism induces an overcompensation in the drive for hunger/food intake, which is larger in magnitude than the rise in EI required to re-establish EB. Understanding how OSA affects EB-related parameters can help improve weight loss efforts in these patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. The genetics of obstructive sleep apnoea.

    LENUS (Irish Health Repository)

    Kent, Brian D

    2012-02-01

    PURPOSE OF REVIEW: Obstructive sleep apnoea syndrome (OSAS) is a highly prevalent disorder associated with reduced quality of life and adverse cardiovascular and metabolic sequelae. Recent years have seen an intensification of the research effort to establish the genetic contribution to the development of OSAS and its sequelae. This review explores emerging evidence in this field. RECENT FINDINGS: A genetic basis for sleep-disordered breathing has been demonstrated for discrete disorders such as Treacher-Collins and Down syndromes, but the picture is less clear in so-called idiopathic OSAS. A degree of heritability appears likely in some of the intermediate phenotypes that lead to OSAS, particularly craniofacial morphology. However, only sparse and often contradictory evidence exists regarding the role of specific polymorphisms in causing OSAS in the general population. Similarly, investigations of the cardiovascular sequelae of OSAS have in general failed to consistently find single causative genetic mutations. Nonetheless, evidence suggests a role for tumour necrosis factor-alpha polymorphisms in particular, and large-scale family studies have suggested shared pathogenetic pathways for the development of obesity and OSAS. SUMMARY: As with other common disorders, OSAS is likely to result from multiple gene-gene interactions occurring in a suitable environment. The application of modern genetic investigative techniques, such as genome-wide association studies, may facilitate new discoveries in this field.

  7. Effect of CPAP-therapy on bronchial and nasal inflammation in patients affected by obstructive sleep apnea syndrome.

    Science.gov (United States)

    Lacedonia, D; Salerno, F G; Carpagnano, G E; Sabato, R; Depalo, A; Foschino-Barbaro, M P

    2011-06-01

    Obstructive sleep apnea syndrome (OSAS) has been shown to be associated to upper and lower airways inflammation. Continuous positive airway pressure (CPAP) is the elective treatment of OSAS. The aim of the present study was to assess the effect of CPAP-therapy on airway and nasal inflammation. In 13 non-smoking subjects affected by untreated OSAS and in 11 non-smoking normal volunteers, airway inflammation was detected by analyses of the induced sputum. In the OSAS group measurements were repeated after 1, 10 and 60 days of the appropriate CPAP treatment. In addition, in 12 subjects of the OSAS group, nasal inflammation was detected by the analysis of induced nasal secretions at baseline, and after 1, 10 and 60 days of CPAP treatment. OSAS patients, compared to normal controls, showed at baseline a higher percentage of neutrophils and a lower percentage of macrophages in the induced sputum. One, 10 and 60 days of appropriate CPAP-therapy did not change the cellular profile of the induced sputum. In addition, in the OSAS patients, the high neutrophilic nasal inflammation present under baseline conditions was not significantly modified by CPAP-therapy. Finally, no patients developed airway hyper-responsiveness after CPAP therapy. In OSAS subjects, the appropriate CPAP-therapy, while correcting the oxygen desaturation, does not modify the bronchial and nasal inflammatory profile.

  8. Brain Structure Network Analysis in Patients with Obstructive Sleep Apnea.

    Directory of Open Access Journals (Sweden)

    Yun-Gang Luo

    Full Text Available Childhood obstructive sleep apnea (OSA is a sleeping disorder commonly affecting school-aged children and is characterized by repeated episodes of blockage of the upper airway during sleep. In this study, we performed a graph theoretical analysis on the brain morphometric correlation network in 25 OSA patients (OSA group; 5 female; mean age, 10.1 ± 1.8 years and investigated the topological alterations in global and regional properties compared with 20 healthy control individuals (CON group; 6 females; mean age, 10.4 ± 1.8 years. A structural correlation network based on regional gray matter volume was constructed respectively for each group. Our results revealed a significantly decreased mean local efficiency in the OSA group over the density range of 0.32-0.44 (p < 0.05. Regionally, the OSAs showed a tendency of decreased betweenness centrality in the left angular gyrus, and a tendency of decreased degree in the right lingual and inferior frontal (orbital part gyrus (p < 0.005, uncorrected. We also found that the network hubs in OSA and controls were distributed differently. To the best of our knowledge, this is the first study that characterizes the brain structure network in OSA patients and invests the alteration of topological properties of gray matter volume structural network. This study may help to provide new evidence for understanding the neuropathophysiology of OSA from a topological perspective.

  9. Recognized Obstructive Sleep Apnea is Associated With Improved In-Hospital Outcomes After ST Elevation Myocardial Infarction.

    Science.gov (United States)

    Mohananey, Divyanshu; Villablanca, Pedro A; Gupta, Tanush; Agrawal, Sahil; Faulx, Michael; Menon, Venugopal; Kapadia, Samir R; Griffin, Brian P; Ellis, Stephen G; Desai, Milind Y

    2017-07-20

    Obstructive sleep apnea (OSA) is an independent risk factor for many cardiovascular conditions such as coronary artery disease, myocardial infarction, systemic hypertension, pulmonary hypertension, and stroke. However, the association of OSA with outcomes in patients hospitalized for ST-elevation myocardial infarction remains controversial. We used the nation-wide inpatient sample between 2003 and 2011 to identify patients with a primary discharge diagnosis of ST-elevation myocardial infarction and then used the International Classification of Diseases, Clinical Modification code 327.23 to identify a group of patients with OSA. The primary outcome of interest was in-hospital mortality, and secondary outcomes were in-hospital cardiac arrest, length of stay and hospital charges. Our cohort included 1 850 625 patients with ST-elevation myocardial infarction, of which 1.3% (24 623) had documented OSA. OSA patients were younger and more likely to be male, smokers, and have chronic pulmonary disease, depression, hypertension, known history of coronary artery disease, dyslipidemia, obesity, and renal failure ( P ST-elevation myocardial infarction patients with recognized OSA had significantly decreased mortality compared with patients without OSA. Although patients with OSA had longer hospital stays and incurred greater hospital charges, there was no difference in incidence of in-hospital cardiac arrest. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  10. Obstructive sleep apnea syndrome as a novel cause for Ménière's disease.

    Science.gov (United States)

    Nakayama, Meiho; Kabaya, Kayoko

    2013-10-01

    Several recent reports have described the relation between sleep disorders and inner ear function. There are also many reports that insomnia is observed in Ménière's patients. However, the possibility that obstructive sleep apnea syndrome (OSAS) might affect Ménière's disease or other neurotological consequences was not noticed, until studies using polysomnography for these patients. OSAS may cause not only vestibular but also auditory dysfunction. Several reports suggest that insufficient supply of blood via the vertebral basilar artery, which supplies the inner ear, may cause hydropic distension of the endolymphatic system and lead to Ménière's disease. However, few people noticed that in OSAS this insufficient supply might be exacerbated in the night while patients are sleeping. Even more, we should note that Ménière's patients may not only suffer from insomnia, but also that the impaired sleep might be caused by OSAS. Physicians routinely prescribe benzodiazepines or other drugs that have hypnotic, muscle relaxing, antianxiety, and anticonvulsant properties for insomnia, but these properties may have the effect of aggravating OSAS symptoms. Continuous positive airway pressure (CPAP) is an effective therapy used worldwide for the treatment of OSAS. CPAP or surgeries for OSAS may also be useful as one aspect of treatment for Ménière's disease patients with OSAS.

  11. Impact of Obstructive Sleep Apnea Syndrome on Endothelial Function, Arterial Stiffening, and Serum Inflammatory Markers: An Updated Meta-analysis and Metaregression of 18 Studies.

    Science.gov (United States)

    Wang, Jiayang; Yu, Wenyuan; Gao, Mingxin; Zhang, Fan; Gu, Chengxiong; Yu, Yang; Wei, Yongxiang

    2015-11-13

    Obstructive sleep apnea syndrome (OSAS) has been indicated to contribute to the development of cardiovascular disease; however, the underlying mechanism remains unclear. This study aimed to test the hypothesis that OSAS may be associated with cardiovascular disease by elevating serum levels of inflammatory markers and causing arterial stiffening and endothelial dysfunction. Related scientific reports published from January 1, 2006, to June 30, 2015, were searched in the following electronic literature databases: PubMed, Excerpta Medica Database, ISI Web of Science, Directory of Open Access Journals, and the Cochrane Library. The association of OSAS with serum levels of inflammatory markers, endothelial dysfunction, and arterial stiffening were investigated. Overall, 18 eligible articles containing 736 patients with OSAS and 424 healthy persons were included in this meta-analysis. Flow-mediated dilation in patients with moderate-severe OSAS was significantly lower than that in controls (standardized mean difference -1.02, 95% CI -1.31 to -0.73, Preactive protein and C-reactive protein (standardized mean difference 0.58, 95% CI 0.42-0.73, P<0.0001) were significantly higher in patients with OSAS than in controls. OSAS, particularly moderate-severe OSAS, appeared to reduce endothelial function, increase arterial stiffness, and cause chronic inflammation, leading to the development of cardiovascular disease. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  12. Wireless Wearable Multisensory Suite and Real-Time Prediction of Obstructive Sleep Apnea Episodes.

    Science.gov (United States)

    Le, Trung Q; Cheng, Changqing; Sangasoongsong, Akkarapol; Wongdhamma, Woranat; Bukkapatnam, Satish T S

    2013-01-01

    Obstructive sleep apnea (OSA) is a common sleep disorder found in 24% of adult men and 9% of adult women. Although continuous positive airway pressure (CPAP) has emerged as a standard therapy for OSA, a majority of patients are not tolerant to this treatment, largely because of the uncomfortable nasal air delivery during their sleep. Recent advances in wireless communication and advanced ("bigdata") preditive analytics technologies offer radically new point-of-care treatment approaches for OSA episodes with unprecedented comfort and afforadability. We introduce a Dirichlet process-based mixture Gaussian process (DPMG) model to predict the onset of sleep apnea episodes based on analyzing complex cardiorespiratory signals gathered from a custom-designed wireless wearable multisensory suite. Extensive testing with signals from the multisensory suite as well as PhysioNet's OSA database suggests that the accuracy of offline OSA classification is 88%, and accuracy for predicting an OSA episode 1-min ahead is 83% and 3-min ahead is 77%. Such accurate prediction of an impending OSA episode can be used to adaptively adjust CPAP airflow (toward improving the patient's adherence) or the torso posture (e.g., minor chin adjustments to maintain steady levels of the airflow).

  13. Changes of plasma ADM and ANP of pulmonary artery hypertension in patients with obstructive sleep apnea syndrome

    International Nuclear Information System (INIS)

    Gao Zhi; Zhong Jian; Sheng Chunyong; Xu Shouhong

    2005-01-01

    Objective: To explore the incidence of pulmonary artery hypertension (PAH) and changes of plasma adrenomedullin (ADM) and atrial natriuretic polypeptide (ANP) in patients with obstructive sleep apnea syndrome (OSAS). Methods: 32 healthy middle- and elder-aged cases were randomly selected as control group, 61 cases were confirmed clinically with OSAS. The pressure of pulmonary artery was measured with real time gray scale two-dimensional ultrasonic tomography, the blood plasma levels of ADM and ANP were determined with radioimmunoassay method. Results: Among 61 OSAS patients, 26 of them presented with PAH, its incidence in OSAS was 42.6%. The plasma level of ADM in OSAS with non-PAH group had statistical difference compared with control group ( P < 0.05 ) , also there were significant differences between PAH, non-PAH and control group (P<0.001). Concurrently, the plasma level of ANP in OSAS with PAH, non-PAH also had significant differences compared with control group (P<0.001). Conclusions: There was high incidence of PAH in OSAS patients. The plasma levels of ADM and ANP positively correlated with PAH. ANP played a role in the pathophysiologic genesis of PAH. (authors)

  14. Sleep apnea syndrome and cognition

    Directory of Open Access Journals (Sweden)

    Emilia eSforza

    2012-05-01

    Full Text Available Obstructive sleep apnea (OSA is a sleep-related breathing disorder characterized by repetitive episodes of airflow cessation resulting in brief arousals and intermittent hypoxemia. Several studies have documented significant daytime cognitive and behavioral dysfunction that seems to extend beyond that associated with simple sleepiness and that persists in some patients after therapeutic intervention. A still unanswered question is whether cognitive symptoms in OSA are primarily a consequence of sleep fragmentation and hypoxemia, or whether they coexist independently from OSA. Moreover, very little is known about OSA effects on cognitive performances in the elderly in whom an increased prevalence of OSA is present.In this review we will consider recent reports in the association between sleep apnea and cognition, with specific interest in elderly subjects, in whom sleep disturbances and age-related cognitive decline naturally occur. This will allow us to elucidate the behavioral and cognitive functions in OSA patients and to gain insight into age differences in the cognitive impairment.Clinically, these outcomes will aid clinicians in the evaluation of diurnal consequences of OSA and the need to propose early treatment.

  15. Chronic intermittent hypoxia and obstructive sleep apnea: an experimental and clinical approach

    Science.gov (United States)

    Sforza, Emilia; Roche, Fréderic

    2016-01-01

    Obstructive sleep apnea (OSA) is a prevalent sleep disorder considered as an independent risk factor for cardiovascular consequences, such as systemic arterial hypertension, ischemic heart disease, cardiac arrhythmias, metabolic disorders, and cognitive dysfunction. The pathogenesis of OSA-related consequence is assumed to be chronic intermittent hypoxia (IH) inducing alterations at the molecular level, oxidative stress, persistent systemic inflammation, oxygen sensor activation, and increase of sympathetic activity. Overall, these mechanisms have an effect on vessel permeability and are considered to be important factors for explaining vascular, metabolic, and cognitive OSA-related consequences. The present review attempts to examine together the research paradigms and clinical studies on the effect of acute and chronic IH and the potential link with OSA. We firstly describe the literature data on the mechanisms activated by acute and chronic IH at the experimental level, which are very helpful and beneficial to explaining OSA consequences. Then, we describe in detail the effect of IH in patients with OSA that we can consider “the human model” of chronic IH. In this way, we can better understand the specific pathophysiological mechanisms proposed to explain the consequences of IH in OSA. PMID:27800512

  16. The effect of obstructive sleep apnea syndrome on growth and development in nonobese children: a parallel study of twins.

    Science.gov (United States)

    Zhang, Xiao Man; Shi, Jun; Meng, Guo Zhen; Chen, Hong Sai; Zhang, Li Na; Wang, Zhao Yan; Wu, Hao

    2015-03-01

    To explore the effects of obstructive sleep apnea syndrome (OSAS) on children's growth by the study of identical twins. Seventeen cases of nonobese children with OSAS were included in this study. The control group was their identical twin sibling, who had no signs of OSAS. Data including height, weight, and serum insulin-like growth factor 1 levels were analyzed before tonsillectomy and adenoidectomy (T&A) and at 3, 6, and 12 months after surgery. The mean apnea hyponea index was 3.9 times/hour in patients with OSAS and became normal after surgery. Minimum oxygen saturation gradually increased after T&A. The height and weight of the OSAS group before T&A was lower than the control group. During the follow-up period, height and weight increased but were lower than the control group. Serum insulin-like growth factor 1 levels in the OSAS group before T&A were lower than the control group. The level was significantly increased 3 months after T&A. OSAS impairs growth and development. Significant growth recovery occurs after T&A, and early surgical intervention is an important factor for improvement in growth. Copyright © 2015. Published by Elsevier Inc.

  17. Elevated Plasma Levels of Soluble (Pro)Renin Receptor in Patients with Obstructive Sleep Apnea Syndrome in Parallel with the Disease Severity.

    Science.gov (United States)

    Nishijima, Tsuguo; Tajima, Kazuki; Yamashiro, Yoshihiro; Hosokawa, Keisuke; Suwabe, Akira; Takahashi, Kazuhiro; Sakurai, Shigeru

    2016-04-01

    (Pro)renin receptor ((P)RR), a receptor for renin and prorenin, is implicated in the pathophysiology of diabetes mellitus, hypertension and their complications. Soluble (P)RR (s(P)RR) is composed of extracellular domain of (P)RR and thus exists in blood. We have reported that plasma concentrations of s(P)RR were elevated in male patients with obstructive sleep apnea syndrome (OSAS). The aim of the present study was to clarify the difference in plasma s(P)RR concentrations between male and female OSAS patients. Plasma s(P)RR concentrations were studied in 289 subjects (206 males and 83 females) consisting of 259 OSAS patients and 30 non-OSAS control subjects. The 259 OSAS patients were classified into mild (5 ≤ apnea hypopnea index (AHI) value found in male subjects (male r = 0.413, p < 0.0001; female r = 0.263, p < 0.05). Importantly, when OSAS patients (26 males and 15 females) with AHI ≥ 20 underwent continuous positive airway pressure treatment, plasma s(P)RR levels were significantly decreased. In conclusion, plasma s(P)RR levels are elevated in both male and female OSAS patients in parallel with the disease severity.

  18. Management of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2014-03-01

    Full Text Available Obstructive Sleep Apnea (OSA is an important public health problem and is associatedwith considerable morbidity and mortality. Therefore, treatment of this condition is ofparamount importance. The treatment of OSA includes general and behaviouralmeasures, mechanical measures including continuous positive airway pressure(CPAP, Bilevel positive airway pressure (BiPAP and Oral Appliances (OA,pharmacological treatment and surgical procedures. Continuous positive airwaypressure (CPAP treatment reverses the repetitive upper airway obstruction of sleepapnea and associated daytime sleepiness and is the most effective treatment for OSA.However maintaining patient adherence to CPAP therapy is a challenge. Weight lossshould be recommended to overweight patients with OSA, as it has been shown thatweight reduction has additional health benefits. Treatment of underlying medicalconditions such as hypothyroidism or acromegaly has profound effect onapnea/hypopnea index. A subset of patients with OSA may benefit from supplementaloxygen and positional therapy. Presently, there are no effective pharmacotherapeuticagents for treatment of patients with OSA and the role of surgical treatment in OSA iscontroversial. However, pharmacological treatment of persisting residual sleepiness,despite adequate positive airway pressure therapy delivery and adherence, is indicatedand may improve daytime sleepiness.Key words : CPAP, Oral appliances, Modafinil, CPAP complianceUvulopalatopharyngoplasty, positional therapy

  19. Sleeping too close together: obesity and obstructive sleep apnea in childhood and adolescence.

    Science.gov (United States)

    Mathew, Joseph L; Narang, Indra

    2014-09-01

    To review the current available literature exploring the prevalence, severity, consequences and treatments for obesity related OSA in children and adolescents. The published literature was searched through EMBASE and Pubmed using a pre-defined search strategy. There is evidence showing that OSA occurs more frequently and may be more severe in children and adolescents who are overweight or obese compared with lean children. Obesity and OSA are independently associated with adverse cardiovascular, metabolic, and neuropsychological consequences. The magnitude of these abnormalities when obesity and OSA co-exist is not well established. Treatment options for obesity related OSA includes adenotonsillectomy, but it does not cure OSA in over 50% of obese children. Positive airway pressure (PAP) therapy delivered through continuous or bi-level modes is successful, but limited by generally poor compliance. There is increasing experience with bariatric surgical techniques which are effective for the treatment of obesity and its related complications. As obesity related OSA is highly prevalent, more research is needed to understand the interaction of these two conditions with regards to pathophysiology, adverse consequences and optimal management strategies. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Estrutura do componente arbustivo-arbóreo de dois estádios sucessionais de floresta estacional semidecidual na Reserva Florestal Mata do Paraíso, Viçosa, MG, Brasil Structure of the tree-shrub component in two successional stages of semideciduous forest in the Mata do Paraíso Forest Reserve, Viçosa, MG, Brazil

    Directory of Open Access Journals (Sweden)

    Sheila Isabel do Carmo Pinto

    2007-10-01

    Full Text Available Realizou-se o estudo das variações estruturais do componente arbustivo- arbóreo em dois estádios sucessionais - inicial e madura - de Floresta Estacional Semidecidual, na Reserva Florestal Mata do Paraíso, em Viçosa, MG, Brasil. A Reserva Florestal está situada nas coordenadas 20º45'S e 42º55'W e a uma altitude média de 689 m. O clima da região é classificado como Cwb pelo sistema de Köppen. As espécies arbustivo-arbóreas foram amostradas dentro de 20 parcelas de 10 x 30 m, sendo 10 parcelas em cada estádio sucessional, sendo considerados apenas os indivíduos com diâmetro a 1,30 m do solo (DAP > 4,8 cm. Na floresta inicial foram amostrados 399 indivíduos, distribuídos em 27 famílias e 55 espécies. As espécies com maior valor de importância (VI foram Piptadenia gonoacantha, Vernonanthura diffusa, Miconia cinnamomifolia, Piptocarpha macropoda e Luehea grandiflora. O índice de diversidade de Shannon (H' foi de 3,31 nat.ind.-1 e a equabilidade de Pielou (J', igual a 0,83. No estádio floresta madura foram amostrados 623 indivíduos, distribuídos em 31 famílias e 78 espécies. As espécies com maior valor de importância (VI foram Euterpe edulis, Piptadenia gonoacantha, Nectandra lanceolata, Myrcia sphaerocarpa e Guapira opposita. O índice de diversidade de Shannon (H' foi de 3,46 nat.ind.-1 e a equabilidade de Pielou (J', igual a 0,79. As distribuições diamétricas das quatro espécies mais abundantes em cada estádio sucessional apresentaram padrões distintos, aparentemente relacionados ao estádio sucessional.The study of the floristic and structural variations of the tree-shrub component was carried out in two successional stages of Semideciduous Forest, initial and mature, located in the Mata do Paraíso Forest Reserve, in Viçosa, Minas Gerais State, Brazil. The Forest Reserve is located at 20º45'S and 42º55'W, with average altitude of 689 m. The regional climate is classified as Cwb by the Köppen system

  1. Portable Prescreening System for Sleep Apnea

    DEFF Research Database (Denmark)

    Guul, Martin Kjær; Jennum, Poul; Sørensen, Helge Bjarup Dissing

    2016-01-01

    for sleep apnea is at high risk or low risk of having OSA. A new test setup was developed containing an Android based smartphone, the built in accelerometer, and a microphone. To ease the clinical analysis of the data a MATLAB based graphical user interface has been developed visualizing the data allowing......Obstructive sleep apnea (OSA) occurs in more than 4 % of the adult population. Diagnoses for OSA in sleep clinics are costly and more than half of those submitted to a sleep clinic do not have OSA. A simple, easy, and portable homebased monitoring system to evaluate who are in high- or low risk...... of suffering from OSA would be beneficial. The system must be able to identify individuals with a high pre-test reliability regarding OSA with the aim of referral and further investigation. We aimed to develop a portable, smartphone, and homebased monitoring system to classify whether a patient screened...

  2. Improvement in Obstructive Sleep Apnea With Weight Loss is Dependent on Body Position During Sleep.

    Science.gov (United States)

    Joosten, Simon A; Khoo, Jun K; Edwards, Bradley A; Landry, Shane A; Naughton, Matthew T; Dixon, John B; Hamilton, Garun S

    2017-05-01

    Weight loss fails to resolve obstructive sleep apnea (OSA) in most patients; however, it is unknown as to whether weight loss differentially affects OSA in the supine compared with nonsupine sleeping positions. We aimed to determine if weight loss in obese patients with OSA results in a greater reduction in the nonsupine apnea/hypopnea index (AHI) compared with the supine AHI, thus converting participants into supine-predominant OSA. Post hoc analysis of data from a randomized controlled trial assessing the effect of weight loss (bariatric surgery vs. medical weight loss) on OSA in 60 participants with obesity (body mass index: >35 and sleep study at 2 years. Eight of 37 (22%) patients demonstrated a normal nonsupine AHI (sleep avoidance may cure their OSA. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  3. Surgery for adult patients with obstructive sleep apnoea: A review for general practitioners.

    Science.gov (United States)

    Phan, Nga T; Wallwork, Benjamin; Panizza, Benedict

    2016-08-01

    Obstructive sleep apnoea (OSA) is a complex disease process that involves collapse of the upper airway during sleep and subsequent reduction or cessation of airflow. Continuous positive airway pressure (CPAP) is the primary treatment for OSA and is the recommended first-line treatment for patients with moderate-to-severe forms of the disease. However, some patients are unable to tolerate CPAP or are unwilling to accept it as a form of permanent management. In these cases, surgical management aimed at addressing anatomical obstruction may be useful and warranted. This article presents an overview of the surgical options available for OSA. The review also describes a useful approach for selecting appropriate patients for surgery. On the basis of an OSA model that accounts for observed increased risk of stroke, cardiovascular disease and motor vehicle accidents, there is evidence to support that surgery is beneficial and cost-effective for patients with severe OSA who are intolerant of CPAP. There are many surgical options available for OSA.

  4. Vargamäelt leigust ei leitud / Jan Kaus

    Index Scriptorium Estoniae

    Kaus, Jan, 1971-

    2008-01-01

    Vargamäel 21. juunil 22 tundi kestnud maratonetendusest Tammsaare "Tõe ja õiguse" põhjal - Elmo Nüganeni lavastused "Tõde ja õigus. Teine osa", "Karin. Indrek. Tõde ja õigus. 4" ja "Wargamäe Wabariik" (III osa) ning Jaanus Rohumaa lavastus "Vargamäe kuningriik" (I ja V osa)

  5. Airway inflammation in patients affected by obstructive sleep apnea syndrome.

    Science.gov (United States)

    Salerno, F G; Carpagnano, E; Guido, P; Bonsignore, M R; Roberti, A; Aliani, M; Vignola, A M; Spanevello, A

    2004-01-01

    Obstructive sleep apnea syndrome (OSAS) has been shown to be associated to upper airway inflammation. The object of the present study was to establish the presence of bronchial inflammation in OSAS subjects. In 16 subjects affected by OSAS, and in 14 healthy volunteers, airway inflammation was detected by the cellular analysis of the induced sputum. OSAS patients, as compared to control subjects, showed a higher percentage of neutrophils (66.7+/-18.9 vs. 25.8+/-15.6) (Pbronchial inflammation characterized by a significant increase in neutrophils.

  6. Sexual function in male patients with obstructive sleep apnoea

    DEFF Research Database (Denmark)

    Petersen, Marian; Kristensen, Ellids; Berg, Søren

    2010-01-01

    OBJECTIVE: Our objective was to investigate general and functional aspects of sexuality in male patients with a confirmed diagnosis of obstructive sleep apnoea (OSA) and compare the results with normative data. MATERIALS AND METHODS: We investigated 308 male patients (age 30-69) admitted to a sleep...... of sexuality were worse in patients with (untreated) OSA when compared with normative data. Both aspects were dependent on age, obesity, social factors and concomitant medication but not on the severity of OSA as reflected by the apnoea-hypopnoea index or subjective sleepiness. CONCLUSION: We conclude...... that although sexual dysfunction is more prevalent in OSA patients than in the general population, it is a complex problem relating more to age, obesity, social factors and comorbidity than to the severity of OSA....

  7. A laboratory study on formation of oil-SPM aggregates using the NIST standard reference material 1941b. Volume 1

    International Nuclear Information System (INIS)

    Khelifa, A.; Fieldhouse, B.; Wang, Z.; Yang, C.; Landriault, M.; Fingas, M.; Brown, C.E.; Gamble, L.; Pjontek, D.

    2007-01-01

    The dispersion of spilled oil in water can be enhanced by a natural process in which suspended particulate matter (SPM) combines with oil droplets to form Oil-SPM aggregates (OSA). A laboratory setup and procedure were developed in this study to examine the formation of OSAs in which the sediment (Standard Reference Material 1941b) was mixed with Arabian Medium, Alaska North Slope and South Louisiana crudes at concentrations varying from 25 to 300 mg/L. The OSAs were separated from the bulk water using a newly developed procedure. Gas chromatography combined with flame ionization analysis was used to measure the oil trapped in the OSAs. The sediment trapped in the sinking OSAs was then isolated for gravimetric quantification. This procedure has the potential to isolate sinking OSAs with minimum alteration with dispersed oil. Oil mass of less than 2 mg trapped in OSAs was measured with 0.8 mg uncertainty at a 95 per cent confidence level. This setup was capable of imaging droplets of 0.1 μg and up in size. The study showed that formation of sinking OSAs reaches maximum efficiency at an optimum oil to sediment ratio that decreases from 0.5 to approximately 0.1 when the ratio between oil density and the water density increases from 0.84 to 0.97. The percentage of oil trapped in sinking OSAs increases quickly from approximately 0.5 per cent to 30 per cent of the initial oil mass when sediment concentration increases from 25 to 100 mg/l. The highest trapping efficiency was found to decrease exponentially with oil density. 33 refs., 2 tabs., 12 figs

  8. Experimental study on kinetics oil oil-suspended particulate matter aggregation

    International Nuclear Information System (INIS)

    Sun, J.; Environment Canada, Ottawa, ON; Khelifa, A.; Wang, Z.; Brown, C.; Fieldhouse, B.; Yang, C.; Zheng, X.; Wong, S.; So, L.C.

    2009-01-01

    Past studies of oil spills have shown that oil suspended particulate matter aggregates (OSAs) play a role in enhancing the natural cleansing of oiled shorelines. OSAs result from aggregation between suspended oil droplets and suspended particulate matter (SPM) in aquatic environments. During this process, oil dispersion into the water column is significantly increased since the surface of the oil droplet is surrounded by sediment particles. In addition, the accelerated biodegradation of the oil can be attributed to the greater oil-water contact area. This study focused on the kinetic aspects of OSA formation, with particular reference to the time scale of this process and its significance to oil dispersion following oil spills in water. A laboratory study was conducted to measure the time scale of OSA formation and its variations with mixing conditions. A reciprocating shaker and various oil/sediment mixtures were used to prepare the OSAs. Standard reference material 1941b was used as the natural sediment mixed with Arabian medium crude and artificial seawater under various mixing energies. The sediment-to-oil ratio remained constant for all experiments. Gas chromatography-flame ionization detection (GC-FID) analysis was used to measure the total petroleum hydrocarbons (TPH) trapped in negatively buoyant OSAs. Results showed that the TPH in OSAs increased exponentially with shaking time and reached an equilibrium value within 3 hours. The equilibrium decreased from 3 hours to 1.3 hours when the shaking rate increased from 2.0 to 2.3 Hz. It was concluded that high mixing energy enhances OSA formation and shortens the time for OSA formation. 42 refs., 6 tabs., 5 figs

  9. DNA methylation in inflammatory genes among children with obstructive sleep apnea.

    Science.gov (United States)

    Kim, Jinkwan; Bhattacharjee, Rakesh; Khalyfa, Abdelnaby; Kheirandish-Gozal, Leila; Capdevila, Oscar Sans; Wang, Yang; Gozal, David

    2012-02-01

    Pediatric obstructive sleep apnea (OSA) leads to multiple end-organ morbidities that are mediated by the cumulative burden of oxidative stress and inflammation. Because not all children with OSA exhibit increased systemic inflammation, genetic and environmental factors may be affecting patterns of DNA methylation in genes subserving inflammatory functions. DNA from matched children with OSA with and without high levels of high-sensitivity C-reactive protein (hsCRP) were assessed for DNA methylation levels of 24 inflammatory-related genes. Primer-based polymerase chain reaction assays in a case-control setting involving 47 OSA cases and 31 control subjects were conducted to confirm the findings; hsCRP and myeloid-related protein (MRP) 8/14 levels were also assayed. Forkhead box P3 (FOXP3) and interferon regulatory factor 1 (IRF1) showed higher methylation in six children with OSA and high hsCRP levels compared with matched children with OSA and low hsCRP levels (P DNA methylation levels compared with children with OSA and low CRP levels and control subjects. IRF1 did not exhibit significant differences. FOXP3 DNA methylation levels correlated with hsCRP and MRP 8/14 levels and with apnea-hypopnea index (AHI), BMI z score, and apolipoprotein B levels. A stepwise multiple regression model showed that AHI was independently associated with FOXP3 DNA methylation levels (P gene, which regulates expression of T regulatory lymphocytes, is more likely to display increased methylation among children with OSA who exhibit increased systemic inflammatory responses. Thus, epigenetic modifications may constitute an important determinant of inflammatory phenotype in OSA, and FOXP3 DNA methylation levels may provide a potential biomarker for end-organ vulnerability.

  10. Association of pediatric obstructive sleep apnea with poor academic performance: A school-based study from India.

    Science.gov (United States)

    Goyal, Abhishek; Pakhare, Abhijit P; Bhatt, Girish C; Choudhary, Bharat; Patil, Rajesh

    2018-01-01

    Pediatric obstructive sleep apnea (OSA) is a highly prevalent but often neglected disorder. There is paucity of reports on the prevalence of pediatric OSA from India. This study was done to estimate the prevalence of OSA in school children aged 5-10 years and its association with academic performance. This school-based cross-sectional epidemiological study was conducted from July 2015 to November 2015. A questionnaire seeking information on sociodemographic variables, school performance, sleeping pattern, and a validated 22-item pediatrics sleep-related breathing disorder (SRBD) scale was distributed to 1820 pupils in three primary schools. The prevalence of OSA (defined as SRBD score >33%) was reported as proportion and its 95% confidence interval (CI). We received 1520 questionnaires out of 1820 distributed and of which 1346 were complete and were analyzed. The prevalence of OSA among children in our study was 9.6% (95% CI: 8.1%-11.7%). On multivariate analysis, working mother (adjusted odds ratio [OR]: 1.8; 95% CI: 1.2-2.7), sleep bruxism (adjusted OR: 1.7; 95% CI: 1.1-2.6), and sleep talking (adjusted OR: 3.0; 95% CI: 1.9-4.7) were found to be independently associated with OSA. Students with positive SRBD were more prone to nocturnal enuresis (NE) (OR 3.48; 95% CI 2.27-5.26) and poor academic performance in all subjects. OSA is highly prevalent (9.6%) in Indian children. OSA is associated with NE and poor academic performance in all subjects. This study found association of maternal occupation and OSA which needs to be confirmed in larger studies.

  11. The Differential Effects of Regular Shift Work and Obstructive Sleep Apnea on Sleepiness, Mood and Neurocognitive Function.

    Science.gov (United States)

    Cori, Jennifer M; Jackson, Melinda L; Barnes, Maree; Westlake, Justine; Emerson, Paul; Lee, Jacen; Galante, Rosa; Hayley, Amie; Wilsmore, Nicholas; Kennedy, Gerard A; Howard, Mark

    2018-05-29

    To assess whether poor sleep quality experienced by regular shift workers and individuals with obstructive sleep apnea (OSA) affects neurobehavioral function similarly, or whether the different aetiologies have distinct patterns of impairment. 37 shift workers (> 24 hours after their last shift), 36 untreated patients with OSA and 39 healthy controls underwent assessment of sleepiness (Epworth Sleepiness Scale [ESS], Oxford Sleep Resistance Test), mood (Beck Depression Index, State Trait Anxiety Inventory [STAI], Profile of Mood States), vigilance (Psychomotor Vigilance Task [PVT], AusEd driving simulation), neurocognitive function (Logical Memory, Trails Making Task, Digit Span and Victoria Stroop Test) and polysomnography. There were no significant differences between the groups in respect to sleepiness (ESS score [median, IQR] = 10.5, 6.3-14 versus 7, 5-11.5 for OSA group and shift work group, respectively) or mood, with the exception of state anxiety which was elevated in the OSA group (STAI score [median, IQR] = 35, 29-43 versus 30, 24-33.5 for OSA group and shift work group, respectively). However, the OSA group performed significantly worse than the shift work group on the driving task (crash proportion = 46.9% versus 18.9% for OSA group and shift work group, respectively) and the PVT (lapses [median, IQR] = 3, 2-6 versus 2, 0-3.5 for OSA group and shift work group, respectively), as well as most of the neurocognitive measures. Participants with OSA had similar sleepiness and mood to the shift work group, but worse vigilance and neurocognitive function. These findings suggest that distinct causes of sleep disturbance likely result in different patterns of neurobehavioral dysfunction. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.

  12. Prevalence of Primary Open Angle Glaucoma in Obstructive Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammad Raza Besharati

    2014-01-01

    Full Text Available Background: Obstructive sleep apnea (OSA is partial or complete recurrent upper airway obstructions during sleep. Reduction in blood flow of the optic nerve head is an important causative factor in glaucoma. The objective of this study is to determine the prevalence of primary open angle glaucoma (POAG in OSA patients. Materials and Methods: From September 2009 to January 2010 in this descriptive-analytic cross sectional study, 90 cases of patients with OSA referred to Yazd Shahid Sadoughi hospital were collected and studied by polysomnography, blood gas analysis and ocular examination including measurement of intra ocular pressure, gonioscopy, fondoscopy and automated perimetry. Statistical analysis was performed by SPSS software6T. Results: Thirty-one patients had mild OSA, 30 patients had moderate OSA and 29 patients had severe OSA. The prevalence of POAG in this group of patients was 10% (95% CI: 4-16. It is higher than the general population in the same age group (p=0.017. There was no significant correlation between the presence of glaucoma and apnea hypopnea index (AHI, mean saturation arterial OR2R (MSaOR2R, body mass index (BMI, sex and age. A significant correlation between AHI with IOP and cup/disc ratio was not documented6T. Conclusion: According to our founding, the prevalence of POAG in OSA patients was higher than the general population in the same age group. Thus we recommend screening of glaucoma in OSA patients. This Study suggests that AHI, MSaOR2R, BMI, sex or age are not important risk factors for glaucoma in OSA patients6T

  13. Obstructive sleep apnea, diagnosed by the Berlin questionnaire and association with coronary artery disease severity

    Directory of Open Access Journals (Sweden)

    Abdullatef Ghazal

    2015-09-01

    Full Text Available BACKGROUND: Obstructive sleep apnea syndrome (OSAS is a highly prevalent sleep-related disorder that is associated with increased risk of hypertension (HTN and coronary heart disease. This study aimed to evaluate the correlation between the OSAS and coronary artery disease (CAD severity. METHODS: The cross-sectional study was conducted from September 2012 to December 2013. We enrolled 127 patients with chronic stable angina who were referred for coronary angiographic studies in Shahid Chamran and Nour Hospitals in Isfahan, Iran. The Berlin questionnaire (BQ was used for estimate the probability of OSAS in patients as a low or high probability. Demographic characteristics and metabolic risk factors including diabetes mellitus, HTN, obesity, and smoking also were recorded. The severity of CAD was assessed and compared based on the Gensini score with Mann–Whitney U statistical test. Independent t-test for continuous variables and chi-square test for categorical variables were used. RESULTS: Totally, 65.4% of subjects were considered as high and 34.6% as low probability for OSAS, which 81.1% of them had CAD. There was a significant difference between body mass index, systolic blood pressure, diastolic blood pressure, and ischemic heart disease drug consumption with OSAS probability (P < 0.0500. CAD was accompanied by OSAS significantly (P = 0.0260. The Gensini score was significantly higher in patients with high OSAS probability (100.4 ± 69.1 vs. 65.3 ± 68.9; P = 0.0030. OSAS also increase odds of CAD based on regression analysis (odds ratio, 95% confidence interval = 2.7. CONCLUSION: This study indicates that more severe CAD is associated with high OSAS probability identified by BQ.   

  14. Experimental study on kinetics oil oil-suspended particulate matter aggregation

    Energy Technology Data Exchange (ETDEWEB)

    Sun, J. [Ocean Univ. of China, Qingdoa (China). Environmental Science and Engineering Inst.; Environment Canada, Ottawa, ON (Canada). Emergencies Science and Technology Section, Emergencies, Operational Analytical Laboratories and Research Support Division; Khelifa, A.; Wang, Z.; Brown, C.; Fieldhouse, B.; Yang, C. [Environment Canada, Ottawa, ON (Canada). Emergencies Science and Technology Section, Emergencies, Operational Analytical Laboratories and Research Support Division; Zheng, X. [Ocean Univ. of China, Qingdoa (China). Environmental Science and Engineering Inst.; Wong, S. [Ottawa Univ., ON (Canada). Dept. of Chemistry; So, L.C. [Waterloo Univ., ON (Canada). Faculty of Engineering

    2009-07-01

    Past studies of oil spills have shown that oil suspended particulate matter aggregates (OSAs) play a role in enhancing the natural cleansing of oiled shorelines. OSAs result from aggregation between suspended oil droplets and suspended particulate matter (SPM) in aquatic environments. During this process, oil dispersion into the water column is significantly increased since the surface of the oil droplet is surrounded by sediment particles. In addition, the accelerated biodegradation of the oil can be attributed to the greater oil-water contact area. This study focused on the kinetic aspects of OSA formation, with particular reference to the time scale of this process and its significance to oil dispersion following oil spills in water. A laboratory study was conducted to measure the time scale of OSA formation and its variations with mixing conditions. A reciprocating shaker and various oil/sediment mixtures were used to prepare the OSAs. Standard reference material 1941b was used as the natural sediment mixed with Arabian medium crude and artificial seawater under various mixing energies. The sediment-to-oil ratio remained constant for all experiments. Gas chromatography-flame ionization detection (GC-FID) analysis was used to measure the total petroleum hydrocarbons (TPH) trapped in negatively buoyant OSAs. Results showed that the TPH in OSAs increased exponentially with shaking time and reached an equilibrium value within 3 hours. The equilibrium decreased from 3 hours to 1.3 hours when the shaking rate increased from 2.0 to 2.3 Hz. It was concluded that high mixing energy enhances OSA formation and shortens the time for OSA formation. 42 refs., 6 tabs., 5 figs.

  15. Association of pediatric obstructive sleep apnea with poor academic performance: A school-based study from India

    Directory of Open Access Journals (Sweden)

    Abhishek Goyal

    2018-01-01

    Full Text Available Background: Pediatric obstructive sleep apnea (OSA is a highly prevalent but often neglected disorder. There is paucity of reports on the prevalence of pediatric OSA from India. This study was done to estimate the prevalence of OSA in school children aged 5–10 years and its association with academic performance. Methodology: This school-based cross-sectional epidemiological study was conducted from July 2015 to November 2015. A questionnaire seeking information on sociodemographic variables, school performance, sleeping pattern, and a validated 22-item pediatrics sleep-related breathing disorder (SRBD scale was distributed to 1820 pupils in three primary schools. The prevalence of OSA (defined as SRBD score >33% was reported as proportion and its 95% confidence interval (CI. Results: We received 1520 questionnaires out of 1820 distributed and of which 1346 were complete and were analyzed. The prevalence of OSA among children in our study was 9.6% (95% CI: 8.1%–11.7%. On multivariate analysis, working mother (adjusted odds ratio [OR]: 1.8; 95% CI: 1.2–2.7, sleep bruxism (adjusted OR: 1.7; 95% CI: 1.1–2.6, and sleep talking (adjusted OR: 3.0; 95% CI: 1.9–4.7 were found to be independently associated with OSA. Students with positive SRBD were more prone to nocturnal enuresis (NE (OR 3.48; 95% CI 2.27–5.26 and poor academic performance in all subjects. Conclusion: OSA is highly prevalent (9.6% in Indian children. OSA is associated with NE and poor academic performance in all subjects. This study found association of maternal occupation and OSA which needs to be confirmed in larger studies.

  16. EEG arousal prediction via hypoxemia indicator in patients with ...

    African Journals Online (AJOL)

    Obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder characterized by recurrent airflow obstruction caused by a total or partial collapse of the upper airway. OSAS is a common affliction suffered by millions. The arousal index (ArI) is the best predictor of daytime somnolence for patients with OSAS, ...

  17. Impact of Obstructive Sleep Apnea on the Levels of Placental Growth Factor (PlGF and Their Value for Predicting Short-Term Adverse Outcomes in Patients with Acute Coronary Syndrome.

    Directory of Open Access Journals (Sweden)

    Antonia Barcelo

    Full Text Available Placental growth factor (PlGF induces angiogenesis and promotes tissue repair, and plasma PlGF levels change markedly during acute myocardial infarction (AMI. Currently, the impact of obstructive sleep apnea (OSA in patients with AMI is a subject of debate. Our objective was to evaluate the relationships between PlGF levels and both the severity of acute coronary syndrome (ACS and short-term outcomes after ACS in patients with and without OSA.A total of 538 consecutive patients (312 OSA patients and 226 controls admitted for ACS were included in this study. All patients underwent polygraphy in the first 72 hours after hospital admission. The severity of disease and short-term prognoses were evaluated during the hospitalization period. Plasma PlGF levels were measured using an electrochemiluminescence immunoassay.Patients with OSA were significantly older and more frequently hypertensive and had higher BMIs than those without OSA. After adjusting for age, smoking status, BMI and hypertension, PlGF levels were significantly elevated in patients with OSA compared with patients without OSA (19.9 pg/mL, interquartile range: 16.6-24.5 pg/mL; 18.5 pg/mL, interquartile range: 14.7-22.7 pg/mL; p1, even after adjustment.The results of this study show that in patients with ACS, elevated plasma levels of PlGF are associated with the presence of OSA and with adverse outcomes during short-term follow-up.ClinicalTrials.gov NCT01335087.

  18. Excessive daytime sleepiness and metabolic syndrome in men with obstructive sleep apnea: a large cross-sectional study.

    Science.gov (United States)

    Fu, Yiqun; Xu, Huajun; Xia, Yunyan; Qian, Yingjun; Li, Xinyi; Zou, Jianyin; Wang, Yuyu; Meng, Lili; Tang, Xulan; Zhu, Huaming; Zhou, Huiqun; Su, Kaiming; Yu, Dongzhen; Yi, Hongliang; Guan, Jian; Yin, Shankai

    2017-10-03

    Excessive daytime sleepiness is a common symptom in obstructive sleep apnea (OSA). Previous studies have showed that excessive daytime sleepiness is associated with some individual components of metabolic syndrome. We performed a large cross-sectional study to explore the relationship between excessive daytime sleepiness and metabolic syndrome in male OSA patients. A total of 2241 suspected male OSA patients were consecutively recruited from 2007 to 2013. Subjective daytime sleepiness was assessed using the Epworth sleepiness scale. Anthropometric, metabolic, and polysomnographic parameters were measured. Metabolic score was used to evaluate the severity of metabolic syndrome. Among the male OSA patients, most metabolic parameters varied by excessive daytime sleepiness. In the severe group, male OSA patients with excessive daytime sleepiness were more obese, with higher blood pressure, more severe insulin resistance and dyslipidemia than non-sleepy patients. Patients with metabolic syndrome also had a higher prevalence of excessive daytime sleepiness and scored higher on the Epworth sleepiness scale. Excessive daytime sleepiness was independently associated with an increased risk of metabolic syndrome (odds ratio =1.242, 95% confidence interval: 1.019-1.512). No substantial interaction was observed between excessive daytime sleepiness and OSA/ obesity. Excessive daytime sleepiness was related to metabolic disorders and independently associated with an increased risk of metabolic syndrome in men with OSA. Excessive daytime sleepiness should be taken into consideration for OSA patients, as it may be a simple and useful clinical indicator for evaluating the risk of metabolic syndrome.

  19. Risk of post-operative pneumocephalus in patients with obstructive sleep apnea undergoing transsphenoidal surgery.

    Science.gov (United States)

    White-Dzuro, Gabrielle A; Maynard, Ken; Zuckerman, Scott L; Weaver, Kyle D; Russell, Paul T; Clavenna, Matthew J; Chambless, Lola B

    2016-07-01

    Patients undergoing transsphenoidal surgery (TSS) have an anterior skull base defect that limits the use of positive pressure ventilation post-operatively. Obstructive sleep apnea (OSA) can be seen in these patients and is treated with continuous positive airway pressure (CPAP). In our study we documented the incidence of pre-existing OSA and reported the incidence of diagnosed pneumocephalus and its relationship to OSA. A retrospective review was conducted from a surgical outcomes database. Electronic medical records were reviewed, with an emphasis on diagnosis of OSA and documented symptomatic pneumocephalus. A total of 324 patients underwent 349 TSS for sellar mass resection. The average body mass index of the study cohort was 32.5kg/m(2). Sixty-nine patients (21%) had documented OSA. Only 25 out of 69 (36%) had a documented post-operative CPAP plan. Out of all 349 procedures, there were two incidents of pneumocephalus diagnosed. Neither of the patients had pre-existing OSA. One in five patients in our study had pre-existing OSA. Most patients returned to CPAP use within several weeks of TSS for resection of a sellar mass. Neither of the patients with pneumocephalus had pre-existing OSA and none of the patients with early re-initiation of CPAP developed this complication. This study provides preliminary evidence that resuming CPAP early in the post-operative period might be less dangerous than previously assumed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. The association of snoring and risk of obstructive sleep apnea with poor academic performance among university students.

    Science.gov (United States)

    Khassawneh, Basheer Y; Alkhatib, Loiy L; Ibnian, Ali M; Khader, Yousef S

    2018-04-20

    Subjects with obstructive sleep apnea (OSA) have neurocognitive dysfunction. The aim of this study was to estimate the prevalence of symptoms and risk of OSA among university students and the association with academic performance. A cross-sectional study was conducted at Jordan University of Science and Technology. Students from faculties of engineering, medicine, nursing, pharmacy, and dentistry were asked to participate in this study. The Berlin Sleep Questionnaire was used to report symptoms and risk of OSA. Below average cumulative scores were considered poor academic performance. A total of 777 students (51% female; mean age, 20 years) completed the study questionnaire. According to the study definition, 42 students (5.4%) had high risk for OSA. Snoring was reported by 11% and daytime sleepiness and fatigue by 30%. Compared to female students, male students had more snoring (14.6 vs. 7.6%, p = 0.002) and higher risk for OSA (6.5 vs. 1.6%, p = 0.001). Both self-reported snoring and being at high risk for OSA were associated with poor academic performance (27.9 vs. 11.6% and 23.1 vs. 9.2%, respectively; p academic performance in students at high risk for OSA was 2.4 (CI 1.11-5.2, p = 0.027). Snoring and OSA were uncommon among university students. However, both were more common among male students and were associated with poor academic performance.

  1. Sexual Issues in Treating Trauma Survivors.

    Science.gov (United States)

    Zoldbrod, Aline P

    The effect of interpersonal trauma on sexuality can be profound. The field of sexual trauma is complex empirically and clinically, with contradictory theories and conflicting data. Research definitions and treatment protocols for child sexual abuse are very imprecise. There are no firm, empirically proven guidelines for treating men and women who have been sexually abused as children or adolescents. Overt sexual abuse (OSA) in children and adolescents is defined here as molestation, rape, or incest. Research has shown that OSA may, but does not necessarily, lead to sexual dysfunction in adulthood. The effects of OSA are worsened by concurrent types of family of origin abuse, such as emotional abuse or physical abuse. One factor that seems related to the varying impact of OSA on adult sexuality is the patients' family of origin experience with nonsexual Milestones of Sexual Development. Without positive experiences with touch, trust and empathy, the ability to relax and be soothed, and power, the effects of OSA are potentiated and complicated. Sexuality is embodied, so experiences with touch are particularly important when working with OSA. A three-color Body Map technique which assesses stored associations to touch is provided. The concept of developmental sexual trauma (DST) is introduced as a way to label traumagenic family events which potentiate OSA or negatively effect sex but which are not explicitly sexual in origin. Strategies to assess and treat OSA are reviewed. Body Maps are recommended to assess and treat sexual trauma.

  2. What is the most important factor affecting the cognitive function of obstructive sleep apnea syndrome patients: a single center study

    Directory of Open Access Journals (Sweden)

    LI Xiang

    2013-05-01

    Full Text Available Objective Patients with obstructive sleep apnea syndrome (OSAS usually complain of daytime hypersomnia and decrease in cognitive function, which affects the quality of their work and life. The reason why the cognitive function of OSAS patients decreased remains controversial. The aim of this study is to evaluate the impairment and the main influencing factors of cognitive function in OSAS. Methods There were totally 50 OSAS patients (OSAS group and 25 volunteers (control group included in our study. All of them were monitored by polysomnography (PSG and tested by Continuous Performance Test (CPT, n-back test and Stroop Color?Word Test (CWT to evaluate their sleep condition and cognitive function. Results No significant difference was found between the two groups in total sleep time and sleep efficiency (P > 0.05, for all. Compared with control group, OSAS group had significant increased time of non-rapid eye movement (NREM sleep stage Ⅰ and stage Ⅱ, significant decreased time of stage Ⅲ (P 0.05, for all, while had significant connection with AI and NREM Ⅲ (P < 0.05, for all. The rate of OSAS patients who underwent nasal continuous positive airway pressure (nCPAP treatment was very low, only 8% (4/50. Conclusion The abnormality of OSAS patients' sleep structure is characterized with sleep fragmentation and decrease of NREM Ⅲ, which may be the main factors of cognitive impairment. Exploration of treatment methods targeted on regulating the effected hormones and receptors is meaningful.

  3. Gender differences in respiratory disturbance, sleep and daytime sleepiness in hypertensive patients with different degrees of obesity.

    Science.gov (United States)

    Broström, Anders; Sunnergren, Ola; Nilsen, Per; Fridlund, Bengt; Ulander, Martin; Svanborg, Eva

    2013-04-01

    Hypertension (HT) and obesity have both been linked to obstructive sleep apnoea (OSA). Difficulties have been described in identifying patients with OSA in primary care, causing low referral rates to sleep clinics. Increased knowledge about gender-specific characteristics and symptoms may help to identify patients. The aim was to describe gender differences regarding undiagnosed OSA, self-rated sleep, insomnia and daytime sleepiness in middle-aged primary care patients with HT and different degrees of obesity. A cross-sectional design was used and 394 patients (52.5% women), mean age 57.8 years (SD 6.7 years), with HT (BP >140/90 mmHg) were included. Clinical examinations, respiratory recordings and self-rated scales regarding OSA symptoms, sleep, insomnia and daytime sleepiness were used. Body mass index (BMI) was classified according to the criteria from the National Institutes of Health. Pre-obesity and obesity classes I and II were seen among 53%, 26% and 8% of the men and 37%, 19% and 14% of the women, respectively. Occurrence of mild, moderate and severe OSA increased significantly across the BMI classes for both genders (pobesity class II had OSA. Insomnia was prevalent in obese patients. Other clinical variables did not differ between BMI classes or genders. The occurrence of overweight/obesity and OSA was high among both genders. A high BMI might be a convenient clinical marker for healthcare personnel to identify hypertensive patients with possible OSA in need of further evaluation and treatment.

  4. Prostitution in Galicia: Clients and Feminine Imaginary

    Directory of Open Access Journals (Sweden)

    Agueda Gómes Suárez

    2010-01-01

    Full Text Available Today, the prostitution in our society turns out to be an indicator of the dominant “sexual culture” in the patriarchal and capitalist societies. This article tries to contribute with another approach to the analysis of the sexual industry in our country, adjusting, principally, to the experiences of the men involved in the phenomenon of the prostitution in Galicia. The dramatic quality in which the women in prostitution live their reality and the levity and idleness, in which the clients enjoy themselves, show the controversial and worrying face of this reality. The analysis of the clients’ speech across the “Frame Analysis”, and the study of the feminine dominant imaginary among them are portrayed in this text, together with the speech of the women in prostitution and of the men who occupy masculinized spaces. This article tries to be a contribution to the complex study of the phenomenon of the prostitution in our country.

  5. Cine Club

    CERN Multimedia

    Cine Club

    2014-01-01

    On the occasion of CERN’s 60th anniversary the CERN CinéClub will be showing films from all CERN member states. Thursday 18 September 2014 at 20:00 CERN Council Chamber Avé   Directed by Konstantin Bojanov Bulgaria, 2011, 86 minutes   Inspired by haunting real-life events and encounters, Konstantin Bojanov’s debut feature is as spontaneous and freewheeling as the characters’ adventures. Portraying the unfolding of two personal dramas with levity and humour, this remarkable, triple-award winning film explores exceptional moments when time feels suspended, and one’s responsibility is only to the beat of one’s own heart.  

While hitchhiking from Sofia to Ruse, Kamen, an alienated art student, meets Avé, a 17-year-old runaway. With each ride they hitch, Avé invents new identities for both of them, her compulsive lies dragging Kamen deeper and deeper into trouble, drawin...

  6. Effects of positive airway pressure therapy on cardiovascular and metabolic markers in males with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    A. Feliciano

    2017-07-01

    Full Text Available Introduction: Obstructive sleep apnea syndrome (OSAS is associated with cardiovascular/metabolic complications. Some analytical parameters (homocysteine, glycemic and lipidic profiles are recognized markers of these consequences. Limited data is available on the association of these markers and OSAS's severity/response to positive airway pressure therapy (PAP. Material and methods: In this prospective study we analyzed polysomnographic and analytical data of male patients admitted to sleep laboratory. The aim was to evaluate metabolic/cardiovascular markers in snorers and OSAS patients, to relate with sleep parameters and PAP response. One-hundred and three patients were included, and 73 (71% were OSAS patients. OSAS patients were similar to snorers except for higher body mass index (BMI and dyslipidemia. Severe OSAS patients showed higher glycemia, HbA1c, insulin, and insulin resistance, and lower HDL cholesterol in comparison to mild–moderate (p < 0.05, p < 0.05, p < 0.001, p < 0.001, p < 0.05, respectively. Glycemic profile and triglycerides were slightly correlated with OSAS severity. 46 OSAS patients were submitted to 6 months of PAP, with a statistical decrease in mean values of homocysteine, glycemia, total and LDL cholesterol (p < 0.05, p < 0.05, p < 0.05, respectively, and in glycemia and LDL cholesterol in severe group only (p < 0.05, p < 0.05, respectively. Results: This study demonstrated an association between glucose metabolism parameters and triglycerides with OSAS severity underlying the complexity of the process leading to cardiovascular/metabolic complications in this disorder. Moreover, homocysteine, glycemic and lipidic profiles changed significantly after 6 months of PAP therapy in OSAS, supporting its cardiovascular and metabolic protective effect. Conclusion: Our study has reinforced the importance of analytical cardiovascular/metabolic evaluation as

  7. Association of Incident Obstructive Sleep Apnea with Outcomes in a Large Cohort of US Veterans

    Science.gov (United States)

    Molnar, Miklos Z; Mucsi, Istvan; Novak, Marta; Szabo, Zoltan; Freire, Amado X; Huch, Kim M; Arah, Onyebuchi A; Ma, Jennie Z; Lu, Jun L; Sim, John J; Streja, Elani; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P

    2015-01-01

    Rationale There is a paucity of large cohort studies examining the association of obstructive sleep apnea(OSA) with clinical outcomes including all-cause mortality, coronary heart disease(CHD), strokes and chronic kidney disease(CKD). Objectives We hypothesized that a diagnosis of incident OSA is associated with higher risks of these adverse clinical outcomes. Methods, Measurements In a nationally representative cohort of over 3 million(n=3,079,514) US veterans(93% male) with baseline estimated glomerular filtration rate (eGFR)≥60 ml/min/1.73m2, we examined the association between the diagnosis of incident OSA, treated and untreated with continuous positive airway pressure(CPAP), and: 1) all-cause mortality, 2) incident CHD, 3) incident strokes, 4)incident CKD defined as eGFR<60 ml/min/1.73m2, and 5)slopes of eGFR. Main Results Compared to OSA negative patients, untreated and treated OSA was associated with 86% higher mortality risk,(adjusted hazard ratio and 95% confidence interval: 1.86(1.81-1.91)) and 35% (1.35(1.21-1.51)), respectively. Similarly, untreated and treated OSA was associated with 3.5 times(3.54(3.40-3.69)) and 3 times(3.06(2.62-3.56)) higher risk of incident CHD; 3.5 times higher risk of incident strokes(3.48(3.28-3.64) and 3.50(2.92-4.19)) for untreated and treated OSA, respectively. The risk of incident CKD was also significantly higher in untreated(2.27(2.19-2.36)) and treated(2.79(2.48-3.13)) OSA patients. The median (interquartile range) of the eGFR slope was −0.41(−2.01 - 0.99), −0.61(−2.69 - 0.93) and −0.87(−3.00 - 0.70)ml/min/1.73m2 in OSA negative, untreated and treated OSA positive patients, respectively. Conclusions In this large and contemporary cohort of more than 3 million US veterans, a diagnosis of incident OSA was associated with higher mortality, incident CHD, stroke and CKD and with faster kidney function decline. PMID:26038534

  8. The effect of the severity of obstructive sleep apnea syndrome on telomere length.

    Science.gov (United States)

    Tempaku, Priscila Farias; Mazzotti, Diego Robles; Hirotsu, Camila; Andersen, Monica Levy; Xavier, Gabriela; Maurya, Pawan Kumar; Rizzo, Lucas Bortolotto; Brietzke, Elisa; Belangero, Sintia Iole; Bittencourt, Lia; Tufik, Sergio

    2016-10-25

    Aging is associated with an increase in the prevalence of obstructive sleep apnea syndrome (OSAS) as well as the shortening of telomeres. It is known that OSAS-related factors are stimuli that can contribute to the acceleration of cellular senescence. Thus, the present study aimed to compare the leukocyte telomere length (LTL) between OSAS patients and controls, as well as to verify the correlation between LTL and sleep parameters. We used DNA extracted of 928 individuals from EPISONO to measure the LTL by the quantitative real-time polymerase chain reaction. All individuals were subjected to one full-night polysomnography. LTL was significantly shorter in OSAS patients compared to controls. The results showed negative correlations between LTL and the following variables: apnea-hypopnea index, respiratory disturbance index, desaturation index and wake after sleep onset. LTL was positively correlated with sleep efficiency, total sleep time, basal, minimum and maximum oxygen saturation. Lastly, it was observed that OSAS severity was associated with shorter LTL even after adjusting for sex, age, years of schooling, body mass index, diabetes, stroke and heart attack. In conclusion, our study indicates the presence of an association between LTL and OSAS and a significant impact of severity of OSAS in telomeres shortening.

  9. Risk of developing obstructive sleep apnea among women with polycystic ovarian syndrome: a nationwide longitudinal follow-up study.

    Science.gov (United States)

    Lin, Ting-Yang; Lin, Pei-Yin; Su, Tung-Ping; Li, Cheng-Ta; Lin, Wei-Chen; Chang, Wen-Hang; Chen, Tzeng-Ji; Bai, Ya-Mei; Chen, Mu-Hong

    2017-08-01

    Previous cross-sectional studies have suggested a comorbid relationship between polycystic ovarian syndrome (PCOS) and obstructive sleep apnea (OSA). However, the temporal association between these two distinct diseases has not yet been investigated. Using the Taiwan National Health Insurance Research Database, 4595 women with PCOS and 4595 (1:1) age-/sex-matched controls were enrolled into the present study between 1998 and 2009, and followed to the end of 2011. Those who developed OSA during the follow-up were identified. Women with PCOS had a greater incidence of developing OSA (1.71 vs 0.63 1000 person-years, p < 0.001) than those without PCOS. The Cox regression analysis after adjusting for demographic data and medical comorbidities showed that women with PCOS had an elevated likelihood of subsequent OSA (hazard ratio: 2.63, 95% CI 1.57-4.04) during the follow-up compared to the controls. Women with PCOS were associated with an increased risk of developing OSA in later life. Further studies would be required to investigate the underlying pathophysiology between PCOS and OSA, and to clarify whether prompt intervention for PCOS would reduce the risk of OSA. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Association between waking electroencephalography and cognitive event-related potentials in patients with obstructive sleep apnea.

    Science.gov (United States)

    Baril, Andrée-Ann; Gagnon, Katia; Gagnon, Jean-François; Montplaisir, Jacques; Gosselin, Nadia

    2013-07-01

    Sleepiness, cognitive deficits, abnormal event-related potentials (ERP), and slowing of the waking electroencephalography (EEG) activity have been reported in patients with obstructive sleep apnea (OSA). Our study aimed at evaluating if an association exists between the severity of ERP abnormalities and EEG slowing to better understand cerebral dysfunctions in OSA. Twelve OSA patients and 12 age-matched controls underwent an overnight polysomnographic recording, an EEG recording of 10 min of wakefulness, and an auditory ERP protocol known to specifically recruit attention. P300 and P3a ERP components were measured as well as the spectral power in each frequency band of the waking EEG. Pearson product moment correlations were used to measure associations between ERP characteristics and EEG spectral power in OSA patients and control subjects. A positive correlation between the late P300 amplitude and θ power in the occipital region was observed in OSA subjects (P<.01). A positive correlation was also found between P3a amplitude and β1 power in central region in OSA subjects (P<.01). No correlation was observed for control subjects. ERP abnormalities observed in an attention task are associated with a slowing of the waking EEG recorded at rest in OSA. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Reduced Systemic Levels of IL-10 Are Associated with the Severity of Obstructive Sleep Apnea and Insulin Resistance in Morbidly Obese Humans

    Directory of Open Access Journals (Sweden)

    Sonia Leon-Cabrera

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA has been related to elevation of inflammatory cytokines and development of insulin resistance in morbidly obese (MO subjects. However, it is still unclear whether the systemic concentration of anti-inflammatory mediators is also affected in MO subjects directly related to the severity of OSA and level of insulin resistance. Normal weight and MO subjects were subjected to overnight polysomnography in order to establish the severity of OSA, according to the apnea-hypopnea index (AHI. Blood samples were obtained for estimation of total cholesterol and triglycerides, insulin, glucose, insulin resistance, tumor necrosis factor alpha (TNF-α, interleukin 12 (IL12, and interleukin 10 (IL-10. Serum levels of IL-10 were significantly lower in MO subjects with OSA than in MO and control individuals without OSA. Besides being inversely associated with serum TNF-α and IL-12, decreased IL-10 levels were significantly related to increased AHI, hyperinsulinemia, and insulin resistance. Serum IL-10 is significantly reduced in morbidly obese subjects with severe OSA while also showing a clear relationship with a state of hyperinsulinemia and insulin resistance probably regardless of obesity in the present sample. It may be of potential clinical interest to identify the stimulatory mechanisms of IL-10 in obese individuals with OSA.

  12. Brain Structure Network Analysis in Patients with Obstructive Sleep Apnea.

    Science.gov (United States)

    Luo, Yun-Gang; Wang, Defeng; Liu, Kai; Weng, Jian; Guan, Yuefeng; Chan, Kate C C; Chu, Winnie C W; Shi, Lin

    2015-01-01

    Childhood obstructive sleep apnea (OSA) is a sleeping disorder commonly affecting school-aged children and is characterized by repeated episodes of blockage of the upper airway during sleep. In this study, we performed a graph theoretical analysis on the brain morphometric correlation network in 25 OSA patients (OSA group; 5 female; mean age, 10.1 ± 1.8 years) and investigated the topological alterations in global and regional properties compared with 20 healthy control individuals (CON group; 6 females; mean age, 10.4 ± 1.8 years). A structural correlation network based on regional gray matter volume was constructed respectively for each group. Our results revealed a significantly decreased mean local efficiency in the OSA group over the density range of 0.32-0.44 (p gyrus, and a tendency of decreased degree in the right lingual and inferior frontal (orbital part) gyrus (p < 0.005, uncorrected). We also found that the network hubs in OSA and controls were distributed differently. To the best of our knowledge, this is the first study that characterizes the brain structure network in OSA patients and invests the alteration of topological properties of gray matter volume structural network. This study may help to provide new evidence for understanding the neuropathophysiology of OSA from a topological perspective.

  13. Among Metabolic Factors, Significance of Fasting and Postprandial Increases in Acyl and Desacyl Ghrelin and the Acyl/Desacyl Ratio in Obstructive Sleep Apnea before and after Treatment.

    Science.gov (United States)

    Chihara, Yuichi; Akamizu, Takashi; Azuma, Masanori; Murase, Kimihiko; Harada, Yuka; Tanizawa, Kiminobu; Handa, Tomohiro; Oga, Toru; Mishima, Michiaki; Chin, Kazuo

    2015-08-15

    There are reports suggesting that obstructive sleep apnea (OSA) may itself cause weight gain. However, recent reports showed increases in body mass index (BMI) following continuous positive airway pressure (CPAP) treatments. When considering weight changes, changes in humoral factors that have significant effects on appetite such as acyl (AG) and desacyl ghrelin (DAG), leptin, insulin, and glucose and their interactions, examples of which are AG/DAG and AG/insulin, are important. The aim of this study was to test the hypothesis that some appetite-related factors had a specific profile before and after CPAP treatment. Metabolic parameters were measured cross-sectionally while fasting and 30, 60, 90, and 120 min following breakfast in no or mild OSA (apnea-hypopnea index fasting and postprandial glucose, insulin, and leptin levels did not differ between no or mild OSA and moderate-to-severe OSA participants, AG and DAG, including AG/DAG and AG/insulin, under fasting and postprandial conditions were significantly increased in the moderate-to-severe OSA patients (p continuous changes in ghrelin secretion in OSA patients existed at least within 3 months of CPAP treatment. Methods to prevent OSA as well as treatment in its early stage may be recommended. © 2015 American Academy of Sleep Medicine.

  14. Obstructive sleep apnea in children with cerebral palsy and epilepsy.

    Science.gov (United States)

    Garcia, John; Wical, Beverly; Wical, William; Schaffer, Leah; Wical, Thomas; Wendorf, Heather; Roiko, Samuel

    2016-10-01

    To examine the risk of obstructive sleep apnea (OSA) in children with cerebral palsy (CP) and/or epilepsy. This cross-sectional study employs the Pediatric Sleep Questionnaire (PSQ), the Gross Motor Function Classification System (GMFCS), and chart review to identify symptoms of OSA in children presenting to a multi-specialty pediatric healthcare institution. Two-hundred and fifteen patients were grouped into those with epilepsy (n=54), CP (n=18), both (n=55), and neither (comparison group, n=88). The comparison group comprised children with developmental disabilities but not children with typical development. Significantly increased PSQ scores (indicating increased risk of OSA) were found among children with CP (58%) and CP with epilepsy (67%) than among the comparison group (27%; pChildren with both CP and epilepsy had a greater number of increased PSQ scores compared with CP alone (pchildren at risk of OSA (46%) than did the medical record review for symptoms of OSA (8.2%, pChildren with CP of greater severity or comorbid epilepsy are at increased risk of OSA. This study supports the routine questionnaire-based assessment for OSA as a regular part of the care of all children with CP, especially in those with more severe CP and those with epilepsy. © 2016 Mac Keith Press.

  15. Raznõje litsa Indreka Paasa / Eteri Kekelidze

    Index Scriptorium Estoniae

    Kekelidze, Eteri, 1944-

    2008-01-01

    Vargamäel 22 tundi kestnud maratonetendusest Tammsaare "Tõe ja õiguse" põhjal - Elmo Nüganeni lavastused "Tõde ja õigus. Teine osa", "Karin. Indrek. Tõde ja õigus. 4" ja "Wargamäe Wabariik" (III osa) ning Jaanus Rohumaa lavastus "Vargamäe kuningriik" (I ja V osa). Pikemalt "Wargamäe Wabariigi" lavastusest

  16. MiR-34a regulates the invasive capacity of canine osteosarcoma cell lines.

    Science.gov (United States)

    Lopez, Cecilia M; Yu, Peter Y; Zhang, Xiaoli; Yilmaz, Ayse Selen; London, Cheryl A; Fenger, Joelle M

    2018-01-01

    Osteosarcoma (OSA) is the most common bone tumor in children and dogs; however, no substantial improvement in clinical outcome has occurred in either species over the past 30 years. MicroRNAs (miRNAs) are small non-coding RNAs that regulate gene expression and play a fundamental role in cancer. The purpose of this study was to investigate the potential contribution of miR-34a loss to the biology of canine OSA, a well-established spontaneous model of the human disease. RT-qPCR demonstrated that miR-34a expression levels were significantly reduced in primary canine OSA tumors and canine OSA cell lines as compared to normal canine osteoblasts. In canine OSA cell lines stably transduced with empty vector or pre-miR-34a lentiviral constructs, overexpression of miR-34a inhibited cellular invasion and migration but had no effect on cell proliferation or cell cycle distribution. Transcriptional profiling of canine OSA8 cells possessing enforced miR-34a expression demonstrated dysregulation of numerous genes, including significant down-regulation of multiple putative targets of miR-34a. Moreover, gene ontology analysis of down-regulated miR-34a target genes showed enrichment of several biological processes related to cell invasion and motility. Lastly, we validated changes in miR-34a putative target gene expression, including decreased expression of KLF4, SEM3A, and VEGFA transcripts in canine OSA cells overexpressing miR-34a and identified KLF4 and VEGFA as direct target genes of miR-34a. Concordant with these data, primary canine OSA tumor tissues demonstrated increased expression levels of putative miR-34a target genes. These data demonstrate that miR-34a contributes to invasion and migration in canine OSA cells and suggest that loss of miR-34a may promote a pattern of gene expression contributing to the metastatic phenotype in canine OSA.

  17. Cerebral vasoreactivity in response to a head-of-bed position change is altered in patients with moderate and severe obstructive sleep apnea.

    Science.gov (United States)

    Gregori-Pla, Clara; Cotta, Gianluca; Blanco, Igor; Zirak, Peyman; Giovannella, Martina; Mola, Anna; Fortuna, Ana; Durduran, Turgut; Mayos, Mercedes

    2018-01-01

    Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA. Furthermore, we have monitored the effect of two years of continuous positive airway pressure (CPAP) treatment on the cerebral vasoreactivity. CBF was measured at different head-of-bed position changes (supine to 30° to supine) in sixty-eight patients with OSA grouped according to severity (forty moderate to severe, twenty-eight mild) and in fourteen control subjects without OSA. A subgroup (n = 13) with severe OSA was measured again after two years of CPAP treatment. All patients and controls showed a similar CBF response after changing position from supine to 30° (p = 0.819), with a median (confidence interval) change of -17.5 (-10.3, -22.9)%. However, when being tilted back to the supine position, while the control group (p = 0.091) and the mild patients with OSA (p = 0.227) recovered to the initial baseline, patients with moderate and severe OSA did not recover to the baseline (9.8 (0.8, 12.9)%, p < 0.001) suggesting altered cerebral vasoreactivity. This alteration was correlated with OSA severity defined by the apnea-hypopnea index, and with mean nocturnal arterial oxygen saturation. The CBF response was normalized after two years of CPAP treatment upon follow-up measurements. In conclusion, microvascular CBF response to a head-of-bed challenge measured by diffuse correlation spectroscopy suggests that moderate and severe patients with OSA have altered cerebral vasoreactivity related to OSA severity. This may normalize after two years of CPAP

  18. MiR-34a regulates the invasive capacity of canine osteosarcoma cell lines.

    Directory of Open Access Journals (Sweden)

    Cecilia M Lopez

    Full Text Available Osteosarcoma (OSA is the most common bone tumor in children and dogs; however, no substantial improvement in clinical outcome has occurred in either species over the past 30 years. MicroRNAs (miRNAs are small non-coding RNAs that regulate gene expression and play a fundamental role in cancer. The purpose of this study was to investigate the potential contribution of miR-34a loss to the biology of canine OSA, a well-established spontaneous model of the human disease.RT-qPCR demonstrated that miR-34a expression levels were significantly reduced in primary canine OSA tumors and canine OSA cell lines as compared to normal canine osteoblasts. In canine OSA cell lines stably transduced with empty vector or pre-miR-34a lentiviral constructs, overexpression of miR-34a inhibited cellular invasion and migration but had no effect on cell proliferation or cell cycle distribution. Transcriptional profiling of canine OSA8 cells possessing enforced miR-34a expression demonstrated dysregulation of numerous genes, including significant down-regulation of multiple putative targets of miR-34a. Moreover, gene ontology analysis of down-regulated miR-34a target genes showed enrichment of several biological processes related to cell invasion and motility. Lastly, we validated changes in miR-34a putative target gene expression, including decreased expression of KLF4, SEM3A, and VEGFA transcripts in canine OSA cells overexpressing miR-34a and identified KLF4 and VEGFA as direct target genes of miR-34a. Concordant with these data, primary canine OSA tumor tissues demonstrated increased expression levels of putative miR-34a target genes.These data demonstrate that miR-34a contributes to invasion and migration in canine OSA cells and suggest that loss of miR-34a may promote a pattern of gene expression contributing to the metastatic phenotype in canine OSA.

  19. Sleeping over a sleep disorder - Awareness of obstructive sleep apnoea as a modifiable risk factor for hypertension and stroke: A survey among health care professionals and medical students.

    Science.gov (United States)

    Sharma, Sushma; Srijithesh, P R

    2013-04-01

    Obstructive sleep apnoea (OSA) syndrome is an established and modifiable but under recognized risk factor for common disorders like stroke and hypertension. To assess awareness level of health care practitioners and medical students about OSA as a risk factor for stroke and hypertension. Questionnaire based survey with multiple response type and fill in the blanks type questions. The data was compiled and analyzed using SPSS version 19. 180 participants completed the survey questionnaire. Only 24 (13.3%) identified OSA as a reversible risk factor for ischemic stroke. 11 (6%) participants only could answer OSA as an identified risk factor for hypertension as per Seventh Joint National Committee report. This study reveals dismal level of awareness, among health professionals and medical students, about OSA being an established and modifiable risk factor for hypertension and ischemic stroke.

  20. Predictive factors warrant screening for obstructive sleep apnea in COPD: a Taiwan National Survey

    Directory of Open Access Journals (Sweden)

    Hang LW

    2016-03-01

    Full Text Available Liang-Wen Hang,1,2 Jeng-Yuan Hsu,3 Chee-Jen Chang,4 Hao-Chien Wang,5,6 Shih-Lung Cheng,7,8 Ching-Hsiung Lin,9 Ming-Cheng Chan,3 Chin-Chou Wang,10 Diahn-Warng Perng,11 Chong-Jen Yu5,6 On behalf of the Taiwan COPD Consortium 1Department of Respiratory Therapy, College of Health Care, China Medical University, 2Sleep Medicine Center, Department of Pulmonary and Critical Care Medicine, China Medical University Hospital, 3Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 4Biostatistical Center for Clinical Research, Chang Gung Memorial Hospital, Linkou Branch, Guishan Township, Taoyuan County, 5Department of Internal Medicine, National Taiwan University Hospital, 6Department of Internal Medicine, National Taiwan University, College of Medicine, Taipei, 7Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, 8Department of Chemical Engineering and Materials Science, Yuan Ze University, Chung-Li City, Taoyuan County, 9Division of Chest Medicine, Changhua Christian Hospital, Changhua City, Changhua County, 10Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 11Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China Background and objectives: COPD and obstructive sleep apnea (OSA share similar pathological processes and cardiovascular sequelae. Coexisting OSA in COPD – “overlap syndrome” – has worse prognosis than either condition alone, and appropriate treatment improves survival. Our objectives were to ascertain the frequency at which COPD coexists with the risk of OSA in Taiwan and to compare the risk factors, COPD symptoms, and life quality metrics between COPD subgroups with versus without risk of OSA. Methods: We conducted a random cross-sectional national telephone survey of adults >40 years old in Taiwan. Participants fulfilling an epidemiological case definition of COPD completed a

  1. Obstructive sleep apnea and intermittent hypoxia increase expression of dual specificity phosphatase 1.

    Science.gov (United States)

    Hoffmann, Michal S; Singh, Prachi; Wolk, Robert; Narkiewicz, Krzysztof; Somers, Virend K

    2013-12-01

    Dual specificity phosphatase 1 (DUSP1) inhibits mitogen activated protein kinase activity, and is activated by several stimuli such as sustained hypoxia, oxidative stress, and hormones. However, the effect of intermittent hypoxia is not known. The aim of this study was to evaluate the role of intermittent hypoxia on DUSP1 expression, and to validate its role in a human model of intermittent hypoxia, as seen in obstructive sleep apnea (OSA). OSA is characterized by recurrent episodes of hypoxemia/reoxygenation and is a known risk factor for cardiovascular morbidity. In-vitro studies using human coronary artery endothelial cells (HCAEC) and ex-vivo studies using white blood cells isolated from healthy and OSA subjects. Intermittent hypoxia induced DUSP1 expression in human coronary artery endothelial cells (HCAEC), and in granulocytes isolated from healthy human subjects. Functionally, DUSP1 increased the expression and activity of manganese superoxide dismutase (MnSOD) in HCAEC. Further, significant increases in DUSP1 mRNA from total blood, and in DUSP1 protein in mononuclear cells and granulocytes isolated from OSA subjects, were observed in the early morning hours after one night of intermittent hypoxemia due to untreated OSA. This early-morning OSA-induced augmentation of DUSP1 gene expression was attenuated by continuous positive airway pressure (CPAP) treatment of OSA. Intermittent hypoxia increases MnSOD activity via increased DUSP1 expression in HCAEC. Similarly, overnight intermittent hypoxemia in patients with OSA induces expression of DUSP1, which may mediate increases of MnSOD expression and activity. This may contribute significantly to neutralizing the effects of reactive oxygen species, a consequence of the intermittent hypoxemia/reperfusion elicited by OSA. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Polymorphism of the ACE gene and the risk of obstructive sleep apnoea.

    Science.gov (United States)

    Chmielewska, Izabela; Mlak, Radosław; Krawczyk, Paweł; Czukiewska, Ewa; Milanowski, Janusz

    2013-01-01

    Obstructive sleep apnoea/hypopnea syndrome (OSA) is characterized by obstruction of the upper airway during sleep, resulting in repetitive breathing pauses accompanied by oxygen desaturation and arousal from sleep. Among the candidate genes affecting the risk of OSA, genes whose polymorphisms influence the development of diseases with similar pathogenesis such as OSA could be listed: APOE, genes for leptin and leptin receptor, TNFA1, ADRB2 and ACE (gene for angiotensin-converting enzyme). Until now there has been a confirmed relationship between ACE gene polymorphism and cardiovascular diseases, but its effect on the incidence of OSA is debatable. The aim of this study was to investigate the effect of ACE gene insertion/deletion (I/D) polymorphism on the risk of OSA. Fifty-five patients with confirmed diagnose of OSA and qualified to CPAP therapy entered the study. The control group included 50 subjects who did not complain of any sleep related symptoms. Diagnose of OSA was set on the basis of full overnight polysomnography together with Epworth Sleepiness Scale according to American Academy of Sleep Medicine guidelines. DNA was isolated from peripheral blood leukocytes with Qiagen DNA mini Kit. ACE gene polymorphism was determined in genomic DNA using allele specific polymerase chain reaction. Different sizes of PCR products were observed on agarose gel electrophoresis. There were non-significant differences in the frequency of ACE genotypes. However, allele D had significantly lower prevalence in the study group than in the control group. (χ(2) = 4.25 p = 0.04). Moreover, I allele carriers had a threefold greater risk of developing OSA (HR = 2.748, 95% CI = 1.029-7.340, p gene polymorphism might be useful to determine the risk of developing OSA in clinically predisposed patients.

  3. Volumetric Brain Morphometry Changes in patients with Obstructive Sleep Apnea Syndrome : effects of CPAP treatment and literature review.

    Directory of Open Access Journals (Sweden)

    Nelly T Huynh

    2014-04-01

    Full Text Available Introduction: Obstructive sleep apnea syndrome (OSAS is a frequent breathing disorder occurring during sleep that is characterized by recurrent hypoxic episodes and sleep fragmentation. It remains unclear whether OSAS leads to structural brain changes, and if so, in which brain regions. Brain region-specific gray and white matter volume (GMV and WMV changes can be measured with voxel-based morphometry (VBM. The aims of this study were to use VBM to analyze GMV and WMV in untreated OSAS patients compared to healthy controls (HC; examine the impact of OSAS-related variables (nocturnal hypoxemia duration and sleep fragmentation index on GMV and WMV; and assess the effects of therapeutic versus sham continuous positive airway pressure (CPAP. We discuss our results in light of previous findings and provide a comprehensive literature review. Methods: Twenty-seven treatment-naïve male patients with moderate to severe OSAS and seven healthy age- and education-matched control subjects (HC were recruited. After a baseline fMRI scan, patients randomly received either active (therapeutic, n=14 or sham (subtherapeutic, n=13 nasal CPAP treatment for 2 months. Results: Significant negative correlations were observed between nocturnal hypoxemia duration and GMV in bilateral lateral temporal regions. No differences in GMV or WMV were found between OSAS patients and HC, and no differences between CPAP versus sham CPAP treatment effects in OSAS patients. Conclusion: It appears that considering VBM GMV changes there is little difference between OSAS patients and HC. The largest VBM study to date indicates structural changes in the lateral aspect of the temporal lobe, which also showed a significant negative correlation with nocturnal hypoxemia duration in our study. This finding suggests an association between the effect of nocturnal hypoxemia and decreased GMV in OSAS patients.

  4. Formation of oil-SPM aggregates under various mixing intensities

    International Nuclear Information System (INIS)

    Sun, J.; Zheng, X.

    2009-01-01

    A considerable amount of petroleum products spill into aquatic ecosystems as a result of increased marine transportation of crude oil products. The oil spill response community is therefore seeking an economical and environmentally sound technology to remove oil from shorelines. The formation of oil-suspended particulate matter (SPM) aggregates (OSAs) occurs when oil and SPM are present in a turbulent system. This process is known to enhance natural cleaning of oiled shorelines by increasing oil dispersion into the water column and accelerating the biodegradation of the oil. This paper reported on a laboratory study that was conducted to investigate OSA formation under different mixing energy levels. It presented the results of experiments conducted with Arabian heavy crude oil, standard reference material 1941b, artificial seawater, and 3 shaking rates of the reciprocating shaker. The results are intended to offer insight into the rate and extent of oil sediment interaction following an oil spill in the marine environment under different mixing conditions. Mixing energy is expected to have a considerable control on OSA formation because it controls the splitting of an oil slick into small droplets, the aggregation between the droplets and SPM, and the breakage rate of natural flocs. The concentration of the OSA was measured using the gas chromatography-flame ionization detection (GC-FID) method. Ultraviolet epi-fluorescence image analysis was used to measure the structure of OSAs and the concentration of oil droplets forming OSAs. The results showed that the formation of OSAs increased as the mixing energy increased. A consistent increase in droplet concentration in OSAs was also noted as the mixing energy increased. Both oil droplet size and OSA size decreased as the mixing intensity increased. 38 refs., 4 tabs., 3 figs.

  5. Patients with a high risk for obstructive sleep apnea syndrome: postoperative respiratory complications.

    Science.gov (United States)

    Pereira, H; Xará, D; Mendonça, J; Santos, A; Abelha, F J

    2013-01-01

    STOP-BANG score (snore; tired; observed apnea; arterial pressure; body mass index; age; neck circumference and gender) can predict the risk of a patient having Obstructive Syndrome Apnea (OSA). The aim of this study was to evaluate the incidence STOP-BANG score≥3, in surgical patients admitted to the Post-Anesthesia Care Unit (PACU). Observational, prospective study conducted in a post-anesthesia care unit (PACU) during three weeks (2011). The study population consisted of adult patients after noncardiac and non-neurological surgery. Patients were classified as high risk of OSA (HR-OSA) if STOP-BANG score≥3 and Low-risk of OSA (LR-OSA) if STOP-BANG score<3 (LR-OSA). Patient demographics, intraoperative and postoperative data were collected. Patient characteristics were compared using Mann-Whitney U-test, t-test for independent groups, and chi-square or Fisher's exact test. A total of 357 patients were admitted to PACU; 340 met the inclusion criteria. 179 (52%) were considered HR-OSA. These patients were older, more likely to be masculine, had higher BMI, higher ASA physical status, higher incidence of ischemic heart disease, heart failure, hypertension, dyslipidemia and underwent more frequently insulin treatment for diabetes. These patients had more frequently mild/moderated hypoxia in the PACU (9% vs. 3%, p=0.012) and had a higher incidence of residual neuromuscular blockade (NMB) (20% vs. 16%, p=0.035). Patients with HR-OSA had a longer hospital stay. Patients with HR-OSA had an important incidence among patients scheduled for surgery in our hospital. These patients had more co-morbidities and were more prone to post-operative complications. Copyright © 2012 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  6. Reduced Inspiratory Muscle Strength in Patients with Type 2 Diabetes Mellitus and Obstructive Sleep Apnoea

    DEFF Research Database (Denmark)

    Rehling, Thomas; Banghoj, Anne Margareta; Kristiansen, Marie Hvelplund

    2017-01-01

    Background: Obstructive sleep apnoea (OSA) is related to type 2 diabetes (T2DM), and it may be associated with reduced inspiratory muscle strength (IMS). The aim of this study was to investigate the IMS in patients with T2DM, with or without OSA. Methods: Patients with T2DM with OSA (n = 33...

  7. Anticancer effects of geopropolis produced by stingless bees on canine osteosarcoma cells in vitro.

    Science.gov (United States)

    Cinegaglia, Naiara Costa; Bersano, Paulo Ricardo Oliveira; Araújo, Maria José Abigail Mendes; Búfalo, Michelle Cristiane; Sforcin, José Maurício

    2013-01-01

    Geopropolis is produced by indigenous stingless bees from the resinous material of plants, adding soil or clay. Its biological properties have not been investigated, such as propolis, and herein its cytotoxic action on canine osteosarcoma (OSA) cells was evaluated. OSA is a primary bone neoplasm diagnosed in dogs being an excellent model in vivo to study human OSA. spOS-2 primary cultures were isolated from the tumor of a dog with osteosarcoma and incubated with geopropolis, 70% ethanol (geopropolis solvent), and carboplatin after 6, 24, 48, and 72 hours. Cell viability was analyzed by the crystal violet method. Geopropolis was efficient against canine OSA cells in a dose- and time-dependent way, leading to a distinct morphology compared to control. Geopropolis cytotoxic action was exclusively due to its constituents since 70% ethanol (its solvent) had no effect on cell viability. Carboplatin had no effect on OSA cells. Geopropolis exerted a cytotoxic effect on canine osteosarcoma, and its introduction as a possible therapeutic agent in vivo could be investigated, providing a new contribution to OSA treatment.

  8. Flexible surface acoustic wave respiration sensor for monitoring obstructive sleep apnea syndrome

    Science.gov (United States)

    Jin, Hao; Tao, Xiang; Dong, Shurong; Qin, Yiheng; Yu, Liyang; Luo, Jikui; Deen, M. Jamal

    2017-11-01

    Obstructive sleep apnea syndrome (OSAS) has received much attention in recent years due to its significant harm to human health and high morbidity rate. A respiration monitoring system is needed to detect OSAS, so that the patient can receive treatment in a timely manner. Wired and wireless OSAS monitoring systems have been developed, but they require a wire connection and batteries to operate, and they are bulky, heavy and not user-friendly. In this paper, we propose the use of a flexible surface acoustic wave (SAW) microsensor to detect and monitor OSAS by measuring the humidity change associated with the respiration of a person. SAW sensors on rigid 128° YX LiNbO3 substrate are also characterized for this application. Results show both types of SAW sensors are suitable for OSAS monitoring with good sensitivity, repeatability and reliability, and the response time and recovery time for the flexible SAW sensors are 1.125 and 0.75 s, respectively. Our work demonstrates the potential for an innovative flexible microsensor for the detection and monitoring of OSAS.

  9. Oxidative stress mediated arterial dysfunction in patients with obstructive sleep apnoea and the effect of continuous positive airway pressure treatment

    Directory of Open Access Journals (Sweden)

    Del Ben Maria

    2012-07-01

    Full Text Available Abstract Background Several studies suggest an increase of oxidative stress and a reduction of endothelial function in obstructive sleep apnoea syndrome (OSAS. We assessed the association between OSAS, endothelial dysfunction and oxidative stress. Further aim was to evaluate the effect of nasal continuous positive airway pressure (nCPAP on oxidative stress and arterial dysfunction. Methods We studied 138 consecutive patients with heavy snoring and possible OSAS. Patients underwent unattended overnight home polysomnography. Ten patients with severe OSAS were revaluated after 6 months of nCPAP therapy. To assess oxidative stress in vivo, we measured urinary 8-iso-PGF2α and serum levels of soluble NOX2-derived peptide (sNOX2-dp. Serum levels of nitrite/nitrate (NOx were also determined. Flow-mediated brachial artery dilation (FMD was measured to asses endothelial function. Results Patients with severe OSAS had higher urinary 8-iso-PGF2α (p Conclusions The results of our study indicate that patients with OSAS and cardiometabolic comorbidities have increased oxidative stress and arterial dysfunction that are partially reversed by nCPAP treatment.

  10. Anticancer Effects of Geopropolis Produced by Stingless Bees on Canine Osteosarcoma Cells In Vitro

    Directory of Open Access Journals (Sweden)

    Naiara Costa Cinegaglia

    2013-01-01

    Full Text Available Geopropolis is produced by indigenous stingless bees from the resinous material of plants, adding soil or clay. Its biological properties have not been investigated, such as propolis, and herein its cytotoxic action on canine osteosarcoma (OSA cells was evaluated. OSA is a primary bone neoplasm diagnosed in dogs being an excellent model in vivo to study human OSA. spOS-2 primary cultures were isolated from the tumor of a dog with osteosarcoma and incubated with geopropolis, 70% ethanol (geopropolis solvent, and carboplatin after 6, 24, 48, and 72 hours. Cell viability was analyzed by the crystal violet method. Geopropolis was efficient against canine OSA cells in a dose- and time-dependent way, leading to a distinct morphology compared to control. Geopropolis cytotoxic action was exclusively due to its constituents since 70% ethanol (its solvent had no effect on cell viability. Carboplatin had no effect on OSA cells. Geopropolis exerted a cytotoxic effect on canine osteosarcoma, and its introduction as a possible therapeutic agent in vivo could be investigated, providing a new contribution to OSA treatment.

  11. Emotionally laden impulsivity interacts with affect in predicting addictive use of online sexual activity in men.

    Science.gov (United States)

    Wéry, Aline; Deleuze, Jory; Canale, Natale; Billieux, Joël

    2018-01-01

    The interest in studying addictive use of online sexual activities (OSA) has grown sharply over the last decade. Despite the burgeoning number of studies conceptualizing the excessive use of OSA as an addictive disorder, few have tested its relations to impulsivity, which is known to constitute a hallmark of addictive behaviors. To address this missing gap in the literature, we tested the relationships between addictive OSA use, impulsivity traits, and affect among a convenience sample of men (N=182; age, M=29.17, SD = 9.34), building upon a theoretically driven model that distinguishes the various facets of impulsivity. Results showed that negative urgency (an impulsivity trait reflecting the tendency to act rashly in negative emotional states) and negative affect interact in predicting addictive OSA use. These results highlight the pivotal role played by negative urgency and negative affect in addictive OSA use, supporting the relevance of psychological interventions that focus on improving emotional regulation (e.g., to reduce negative affect and learn healthier coping strategies) to mitigate excessive use of OSA. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Mapping Global Ocean Surface Albedo from Satellite Observations: Models, Algorithms, and Datasets

    Science.gov (United States)

    Li, X.; Fan, X.; Yan, H.; Li, A.; Wang, M.; Qu, Y.

    2018-04-01

    Ocean surface albedo (OSA) is one of the important parameters in surface radiation budget (SRB). It is usually considered as a controlling factor of the heat exchange among the atmosphere and ocean. The temporal and spatial dynamics of OSA determine the energy absorption of upper level ocean water, and have influences on the oceanic currents, atmospheric circulations, and transportation of material and energy of hydrosphere. Therefore, various parameterizations and models have been developed for describing the dynamics of OSA. However, it has been demonstrated that the currently available OSA datasets cannot full fill the requirement of global climate change studies. In this study, we present a literature review on mapping global OSA from satellite observations. The models (parameterizations, the coupled ocean-atmosphere radiative transfer (COART), and the three component ocean water albedo (TCOWA)), algorithms (the estimation method based on reanalysis data, and the direct-estimation algorithm), and datasets (the cloud, albedo and radiation (CLARA) surface albedo product, dataset derived by the TCOWA model, and the global land surface satellite (GLASS) phase-2 surface broadband albedo product) of OSA have been discussed, separately.

  13. The More the Merrier? Working Towards Multidisciplinary Management of Obstructive Sleep Apnea and Comorbid Insomnia

    Science.gov (United States)

    Ong, Jason C.; Crisostomo, M. Isabel

    2013-01-01

    Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is associated with negative cardiovascular consequences and adverse events from excessive daytime sleepiness. Insomnia is the inability to initiate or maintain sleep accompanied by daytime dysfunction. OSA and insomnia co-occur at a high rate, and such patients appear to have distinct clinical features of both disorders. Although empirically supported treatments are now available for OSA and insomnia independently, there are currently no standards or guidelines for how to combine or initiate these treatments for patients who suffer from both sleep disorders. Our goal was to review the literature on current diagnostic considerations, clinical features, pathophysiology, and treatment approaches for patients with OSA and comorbid insomnia. In particular, the potential benefits and challenges of using a multidisciplinary treatment model are discussed, including a research strategy that could inform implementation of pulmonary and behavioral sleep medicine treatments. The research, clinical, and policy implications of treating both OSA and insomnia are discussed with the hope that further activity will establish standards or guidelines for patients with OSA and insomnia. PMID:23382086

  14. Cephalometric risk factors associated with myocardial infarction in patients suffering from obstructive sleep apnea: A pilot case-control study.

    Science.gov (United States)

    Davoudmanesh, Zeinab; Bayat, Mohamad; Abbasi, Mohsen; Rakhshan, Vahid; Shariati, Mahsa

    2017-01-01

    Obstructive sleep apnea (OSA) and its craniofacial anatomic risk factors might play a role in several cardiovascular diseases, including myocardial infarction (MI). However, there are no data about cephalometric findings among OSA patients with MI. In this pilot case-control study, about 2000 individuals referred to the sleep center were evaluated according to apnea - hypopnea index (AHI) and other inclusion criteria. Included were 62 OSA male patients (AHI > 10), of whom 6 had an MI history. In both control (n = 56) and MI groups (n = 6), 18 cephalometric parameters were traced. Data were analyzed using independent samples t-test. Compared with control OSA patients, OSA patients with MI showed a significantly larger tongue length (p = 0.015). The other cephalometric variables were not significantly different between the two groups. An elongated tongue might be considered a risk factor for MI in OSA patients. The role of other variables remains inconclusive and open to investigation with larger samples (determined based on pilot studies such as this report) collected in longitudinal fashion.

  15. Obstructive Sleep Apnea in MPS

    Directory of Open Access Journals (Sweden)

    Abhijit Ricky Pal MBBChir, MA, MD, FRCS(ORL-HNS

    2015-11-01

    Full Text Available The mucopolysaccharidoses (MPSs are a group of inherited, metabolic disorders characterized by progressive multisystem accumulation of partially degraded glycosaminoglycans. This manifests with multilevel airway obstruction, presenting with obstructive sleep apnea (OSA. We systematically reviewed the literature to determine the severity and prevalence of OSA in MPS based on polysomnography analysis. Fifteen studies with 294 participants met the inclusion criteria for review. The pretreatment prevalence of OSA in MPS was 81% with a mean apnea–hypopnea index (AHI of 10.4. Patients with MPS I are most significantly affected, with 75% suffering with moderate to severe OSA (mean AHI, 16.6. Enzyme replacement therapy (ERT results in an almost significant reduction in OSA in MPS I ( P = .06, while adenotonsillar surgery significantly improves AHI ( P = .002. Obstructive sleep apnea least affects MPS III. There is a lack of long-term post-ERT and hematopoietic stem cell transplant data relating to OSA outcomes in this population, with further prospective studies required to determine the ongoing response to treatment.

  16. Obstructive sleep apnea syndrome among obese individuals: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Débora Aparecida Oliveira Modena

    Full Text Available Summary Introduction: The obstructive sleep apnea syndrome (OSAS is a respiratory illness, characterized by recurrent episodes of apnea and hypopnea, leading to reduction or cessation of the airflow. Obesity is one of the major risk factors for the development of OSAS. To help in the diagnosis of this disease, easily applicable and low-cost questionnaries were developed, such as the Berlin Questionnaire (BQ. Objective: To evaluate the efficacy of the BQ for the screening of OSAS among candidates to bariatric surgery in a multidisciplinary preoperative program. Method: This is an observational, descriptive and cross-sectional study which evaluated obese individuals that were being prepared for bariatric surgery by means of the BQ. Results: BQ was able to detect that minimal variations in the body mass index, neck circumference and hip-to-waist ratio lead to changes in the risk to develop OSAS; the higher the values of these variables, the higher the risk for OSAS development. Conclusion: BQ was an efficient and reliable tool to demonstrate the high risk for OSAS development in individual with obesity.

  17. Continuing the Original Stanford Sleep Surgery Protocol From Upper Airway Reconstruction to Upper Airway Stimulation: Our First Successful Case.

    Science.gov (United States)

    Liu, Stanley Yung; Riley, Robert Wayne

    2017-07-01

    In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness. This report describes a patient who was successfully treated with phase 1 and 2 operations more than a decade previously. He returned at 65 years of age with relapse of moderate OSA, and after workup with polysomnography and drug-induced sleep endoscopy, he underwent upper airway stimulation of the hypoglossal nerve that resulted in a cure of OSA. This case shows why upper airway stimulation is an appropriate option for patients with OSA relapse, after previously successful maxillomandibular advancement. Copyright © 2017. Published by Elsevier Inc.

  18. PAHs in leachates from thermal power plant wastes and ash-based construction materials.

    Science.gov (United States)

    Irha, Natalya; Reinik, Janek; Jefimova, Jekaterina; Koroljova, Arina; Raado, Lembi-Merike; Hain, Tiina; Uibu, Mai; Kuusik, Rein

    2015-08-01

    The focus of the current study is to characterise the leaching behaviour of polycyclic aromatic hydrocarbons (PAHs) from oil shale ashes (OSAs) of pulverised firing (PF) and circulating fluidised-bed (CFB) boilers from Estonian Thermal Power Plant (Estonia) as well as from mortars and concrete based on OSAs. The target substances were 16 PAHs from the EPA priority pollutant list. OSA samples and OSA-based mortars were tested for leaching, according to European standard EN 12457-2 (2002). European standard CEN/TC 15862(2012) for monolithic matter was used for OSA-based concrete. Water extracts were analysed by GC-MS for the concentration of PAHs. Naphthalene, acenaphthene, fluorene, phenanthrene, anthracene, fluoranthene and pyrene were detected. Still, the release of PAHs was below the threshold limit value for inert waste. The amount of the finest fraction (particle size materials did not lead to the immobilisation of soluble PAHs. Release of PAHs from the monolith samples did not exceed 0.5 μg/m(2). In terms of leaching of PAHs, OSA is safe to be used for construction purposes.

  19. Epigenetics modifications and Subclinical Atherosclerosis in Obstructive Sleep Apnea: The EPIOSA study.

    Science.gov (United States)

    Marin, Jose M; Artal, Jorge; Martin, Teresa; Carrizo, Santiago J; Andres, Marta; Martin-Burriel, Inmaculada; Bolea, Rosa; Sanz, Arianne; Varona, Luis; Godino, Javier; Gallego, Begoña; Garcia-Erce, Jose A; Villar, Isabel; Gil, Victoria; Forner, Marta; Cubero, Jose P; Ros, Luis

    2014-07-12

    Obstructive sleep apnea (OSA) is associated with increased risk for cardiovascular morbidity and mortality. Epidemiological and animal models studies generate hypotheses for innovative strategies in OSA management by interfering intermediates mechanisms associated with cardiovascular complications. We have thus initiated the Epigenetics modification in Obstructive Sleep Apnea (EPIOSA) study (ClinicalTrials.gov identifier: NCT02131610). EPIOSA is a prospective cohort study aiming to recruit 350 participants of caucasian ethnicity and free of other chronic or inflammatory diseases: 300 patients with prevalent OSA and 50 non-OSA subjects. All of them will be follow-up for at least 5 years. Recruitment and study visits are performed in single University-based sleep clinic using standard operating procedures. At baseline and at each one year follow-up examination, patients are subjected to a core phenotyping protocol. This includes a standardized questionnaire and physical examination to determine incident comorbidities and health resources utilization, with a primary focus on cardiovascular events. Confirmatory outcomes information is requested from patient records and the regional Department of Health Services. Every year, OSA status will be assessed by full sleep study and blood samples will be obtained for immediate standard biochemistry, hematology, inflammatory cytokines and cytometry analysis. For biobanking, aliquots of serum, plasma, urine, mRNA and DNA are also obtained. Bilateral carotid echography will be performed to assess subclinical atherosclerosis and atherosclerosis progression. OSA patients are treated according with national guidelines. EPIOSA will enable the prospective evaluation of inflammatory and epigenetics mechanism involved in cardiovascular complication of treated and non-treated patients with OSA compared with non OSA subjects.

  20. ΔNp63 mediates cellular survival and metastasis in canine osteosarcoma.

    Science.gov (United States)

    Cam, Maren; Gardner, Heather L; Roberts, Ryan D; Fenger, Joelle M; Guttridge, Denis C; London, Cheryl A; Cam, Hakan

    2016-07-26

    p63 is a structural homolog within the 53 family encoding two isoforms, ΔNp63 and TAp63. The oncogenic activity of ΔNp63 has been demonstrated in multiple cancers, however the underlying mechanisms that contribute to tumorigenesis are poorly characterized. Osteosarcoma (OSA) is the most common primary bone tumor in dogs, exhibiting clinical behavior and molecular biology essentially identical to its human counterpart. The purpose of this study was to evaluate the potential contribution of ΔNp63 to the biology of canine OSA. As demonstrated by qRT-PCR, nearly all canine OSA cell lines and tissues overexpressed ΔNp63 relative to normal control osteoblasts. Inhibition of ΔNp63 by RNAi selectively induced apoptosis in the OSA cell lines overexpressing ΔNp63. Knockdown of ΔNp63 upregulated expression of the proapoptotic Bcl-2 family members Puma and Noxa independent of p53. However the effects of ΔNp63 required transactivating isoforms of p73, suggesting that ΔNp63 promotes survival in OSA by repressing p73-dependent apoptosis. In addition, ΔNp63 modulated angiogenesis and invasion through its effects on VEGF-A and IL-8 expression, and STAT3 phosphorylation. Lastly, the capacity of canine OSA cell lines to form pulmonary metastasis was directly related to expression levels of ΔNp63 in a murine model of metastatic OSA. Together, these data demonstrate that ΔNp63 inhibits apoptosis and promotes metastasis, supporting continued evaluation of this oncogene as a therapeutic target in both human and canine OSA.

  1. Evaluation of Anthropometric and Metabolic Parameters in Obstructive Sleep Apnea

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    Yaşar Yildirim

    2015-01-01

    Full Text Available Aims. Sleep disorders have recently become a significant public health problem worldwide and have deleterious health consequences. Obstructive sleep apnea (OSA is the most common type of sleep-related breathing disorders. We aimed to evaluate anthropometric measurements, glucose metabolism, and cortisol levels in patients with obstructive sleep apnea (OSA. Materials and Methods. A total of 50 patients with a body mass index ≥30 and major OSA symptoms were included in this study. Anthropometric measurements of the patients were recorded and blood samples were drawn for laboratory analysis. A 24-hour urine sample was also collected from each subject for measurement of 24-hour cortisol excretion. Patients were divided equally into 2 groups according to polysomnography results: control group with an apnea-hypopnea index (AHI <5 (n=25 and OSA group with an AHI ≥5 (n=25. Results. Neck and waist circumference, fasting plasma glucose, HbA1c, late-night serum cortisol, morning serum cortisol after 1 mg dexamethasone suppression test, and 24-hour urinary cortisol levels were significantly higher in OSA patients compared to control subjects. Newly diagnosed DM was more frequent in patients with OSA than control subjects (32% versus 8%, p=0.034. There was a significant positive correlation between AHI and neck circumference, glucose, and late-night serum cortisol. Conclusions. Our study indicates that increased waist and neck circumferences constitute a risk for OSA regardless of obesity status. In addition, OSA has adverse effects on endocrine function and glucose metabolism.

  2. Sleep disordered breathing and autonomic function in overweight and obese children and adolescents

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    Annelies Van Eyck

    2016-12-01

    Full Text Available Obstructive sleep apnoea (OSA, common in children with obesity, is associated with cardiovascular morbidity. Autonomic dysfunction has been suggested to be a key player in the development of these complications. We investigated the relationship between obesity, OSA and sympathetic activity in children. 191 children with obesity were included and distributed into two groups: 131 controls and 60 with OSA. Beat-to-beat RR interval data were extracted from polysomnography for heart rate variability analysis. Urinary free cortisol levels were determined. Urinary free cortisol did not differ between groups and was not associated with OSA, independent of the level of obesity. Differences in heart rate variability measures were found: mean RR interval decreased with OSA, while low/high-frequency band ratio and mean heart rate increased with OSA. Heart rate variability measures correlated with OSA, independent of obesity parameters and age: oxygen desaturation index correlated with mean heart rate (r=0.19, p=0.009 and mean RR interval (r= −0.18, p=0.02, while high-frequency bands and low/high-frequency band ratio correlated with arterial oxygen saturation measured by pulse oximetry (SpO2 (r= −0.20, p=0.008 and r= −0.16, p=0.04 and SpO2 nadir (r=0.23, p=0.003 and r= −0.19, p=0.02. These results suggest that sympathetic heart activity is increased in children with obesity and OSA. Measures of hypoxia were related to increased sympathetic tone, suggesting that intermittent hypoxia is involved in autonomic dysfunction.

  3. Depression and obstructive sleep apnea.

    Science.gov (United States)

    Hobzova, Milada; Prasko, Jan; Vanek, Jakub; Ociskova, Marie; Genzor, Samuel; Holubova, Michaela; Grambal, Ales; Latalova, Klara

    2017-10-01

    Obstructive sleep apnea (OSA), is described as intermittent interruptions or reductions in airflow which are initiated by an incomplete or complete collapse of the upper airways despite respiratory effort. When left untreated, OSA is connected with comorbid conditions, such as cardiovascular and metabolic illnesses. The PubMed database was used to examine papers published until April 2017 using the subsequent terms: "obstructive sleep apnea" or "obstructive sleep apnoea" and "depression" in successive combination with "CPAP (continuous positive airway pressure)", "therapy", "pharmacotherapy", "psychotherapy", "cognitive behavioral therapy" or "quality of life". After assessment for the suitability, 126 articles were chosen. The numerous evidence of a connection between OSA and depressive symptoms, as well as depressive disorder, were found. This connection may be directly or indirectly linked due to the participation of some OSA mediators consequences such as obesity, hypertension, and the decreased quality of life. Patients with the comorbid major depression and OSA reported more severe and longer episodes of depression. Nevertheless, the information on the effect of the treatment of OSA using CPAP on the depressive symptoms was limited. Still, the current state of the art suggests that this treatment decreases the severity of the comorbid depressive symptoms. It is important to evaluate the symptoms of depression in the patients with OSA. On the other side, a psychiatrist should not just treat the depression, as it is also important to screen individuals at high risk of OSA when assessing patients for depressive disorder, especially those with depression resistant to treatment.

  4. Effects of obstructive sleep apnea and obesity on exercise function in children.

    Science.gov (United States)

    Evans, Carla A; Selvadurai, Hiran; Baur, Louise A; Waters, Karen A

    2014-06-01

    Evaluate the relative contributions of weight status and obstructive sleep apnea (OSA) to cardiopulmonary exercise responses in children. Prospective, cross-sectional study. Participants underwent anthropometric measurements, overnight polysomnography, spirometry, cardiopulmonary exercise function testing on a cycle ergometer, and cardiac doppler imaging. OSA was defined as ≥ 1 obstructive apnea or hypopnea per hour of sleep (OAHI). The effect of OSA on exercise function was evaluated after the parameters were corrected for body mass index (BMI) z-scores. Similarly, the effect of obesity on exercise function was examined when the variables were adjusted for OAHI. Tertiary pediatric hospital. Healthy weight and obese children, aged 7-12 y. N/A. Seventy-one children were studied. In comparison with weight-matched children without OSA, children with OSA had a lower cardiac output, stroke volume index, heart rate, and oxygen consumption (VO2 peak) at peak exercise capacity. After adjusting for BMI z-score, children with OSA had 1.5 L/min (95% confidence interval -2.3 to -0.6 L/min; P = 0.001) lower cardiac output at peak exercise capacity, but minute ventilation and ventilatory responses to exercise were not affected. Obesity was only associated with physical deconditioning. Cardiac dysfunction was associated with the frequency of respiratory-related arousals, the severity of hypoxia, and heart rate during sleep. Children with OSA are exercise limited due to a reduced cardiac output and VO2 peak at peak exercise capacity, independent of their weight status. Comorbid OSA can further decrease exercise performance in obese children.

  5. A Preliminary Efficacy and Feasibility of an Obstructive Sleep Apnea Educational Intervention in Oman

    Science.gov (United States)

    Al Mezeini, Khamis Abdallah

    Background: Obstructive sleep apnea (OSA) is chronic disorder that contributes to multiple physiological and psychological conditions. Obstructive sleep apnea contributes to high rates of morbidity and mortality and has substantial impacts on both health care costs and the quality of life for affected individuals and their families. Healthcare providers - particularly primary health care nurses - are ideally situated to interrupt the cascading consequences of OSA if they are equipped with evidence-based knowledge about the disease process and appropriate methods for screening, education, and preventive interventions. Purpose: The purpose of the study was to test the preliminary efficacy and feasibility of an online health educational intervention on the knowledge and attitudes of OSA among primary health care nurses in Oman. Methods: This study was designed to assess the preliminary efficacy and feasibility of an online educational program on OSA by randomly assigning subjects to either a treatment (OSA content) or attention control (diabetes content) group. At baseline, the OSA knowledge and attitudes of both groups were assessed by the Obstructive Sleep Apnea Knowledge and Attitudes (OSAKA) questionnaire; both groups also completed the Diabetes Basic Knowledge Test (DBKT) to use for control comparisons. Following randomization, the intervention group viewed a 15-minute narrated video on "Brief Introduction to OSA for Omani Nurses" and the control group viewed a similarly formatted 15-minute narrated video on diabetes. The intent was for the subjects in both groups to complete a posttest that included both the OSAKA and DBKT instruments; however, due to a programming error, the software did not present the DBKT to the intervention subjects and did not present the OSAKA instrument to the control subjects as intended. Therefore, the results describe the findings from a one-group, pretest-posttest intervention study to assess the preliminary efficacy and feasibility

  6. A novel derivative of doxorubicin, AD198, inhibits canine transitional cell carcinoma and osteosarcoma cells in vitro

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    Rathore K

    2015-09-01

    Full Text Available Kusum Rathore, Maria Cekanova Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, USA Abstract: Doxorubicin (DOX is one of the most commonly used chemotherapeutic treatments for a wide range of cancers. N-benzyladriamycin-14-valerate (AD198 is a lipophilic anthracycline that has been shown to target conventional and novel isoforms of protein kinase C (PKC in cytoplasm of cells. Because of the adverse effects of DOX, including hair loss, nausea, vomiting, liver dysfunction, and cardiotoxicity, novel derivatives of DOX have been synthesized and validated. In this study, we evaluated the effects of DOX and its derivative, AD198, on cell viability of three canine transitional cell carcinoma (K9TCC (K9TCC#1-Lillie, K9TCC#2-Dakota, K9TCC#4-Molly and three canine osteosarcoma (K9OSA (K9OSA#1-Zoe, K9OSA#2-Nashville, K9OSA#3-JJ primary cancer cell lines. DOX and AD198 significantly inhibited cell proliferation in all tested K9TCC and K9OSA cell lines in a dose-dependent manner. AD198 inhibited cell viability of tested K9TCC and K9OSA cell lines more efficiently as compared to DOX at the same concentration using MTS (3-(4,5-dimethyl-2-yl-5-(3-carboxymethoxyphenyl-2-(4-sulfophenyl-2h-tetrazolium assay. AD198 had lower IC50 values as compared to DOX for all tested K9TCC and K9OSA cell lines. In addition, AD198 increased apoptosis in all tested K9TCC and K9OSA cell lines. AD198 increased the caspase activity in tested K9TCC and K9OSA cell lines, which was confirmed by caspase-3/7 assay, and cleavage of poly (ADP-ribose polymerase (PARP was confirmed by Western blotting analysis. In addition, AD198 cleaved PKC-δ, which subsequently activated the p38 signaling pathway, resulting in the apoptosis of tested K9TCC and K9OSA cell lines. Inhibition of the p38 signaling pathway by SB203580 rescued DOX- and AD198-induced apoptosis in tested K9TCC and K9OSA cell lines. Our in vitro results suggest

  7. Diagnostic Accuracy of Obstructive Airway Adult Test for Diagnosis of Obstructive Sleep Apnea.

    Science.gov (United States)

    Gasparini, Giulio; Vicini, Claudio; De Benedetto, Michele; Salamanca, Fabrizio; Sorrenti, Giovanni; Romandini, Mario; Bosi, Marcello; Saponaro, Gianmarco; Foresta, Enrico; Laforì, Andreina; Meccariello, Giuseppe; Bianchi, Alessandro; Toraldo, Domenico Maurizio; Campanini, Aldo; Montevecchi, Filippo; Rizzotto, Grazia; Cervelli, Daniele; Moro, Alessandro; Arigliani, Michele; Gobbi, Riccardo; Pelo, Sandro

    2015-01-01

    The gold standard for the diagnosis of Obstructive Sleep Apnea (OSA) is polysomnography, whose access is however reduced by costs and limited availability, so that additional diagnostic tests are needed. To analyze the diagnostic accuracy of the Obstructive Airway Adult Test (OAAT) compared to polysomnography for the diagnosis of OSA in adult patients. Ninety patients affected by OSA verified with polysomnography (AHI ≥ 5) and ten healthy patients, randomly selected, were included and all were interviewed by one blind examiner with OAAT questions. The Spearman rho, evaluated to measure the correlation between OAAT and polysomnography, was 0.72 (p diagnostic accuracy for the diagnosis of OSA. It has also been shown to be able to discriminate among the different degrees of severity of OSA. Additional large studies aiming to validate this questionnaire as a screening or diagnostic test are needed.

  8. Obstructive Sleep Apnea: An Unusual Cause of Hemorrhagic Stroke.

    Science.gov (United States)

    Pawar, Nilesh H; O'Riordan, Jennifer A; Malik, Preeti; Vasanwala, Farhad F

    2017-09-27

    Stroke is one of the most common causes of mortality and morbidity worldwide. Hemorrhagic stroke comprises 10-20% of strokes. Here, we present a case report of hemorrhagic stroke that may have been secondary to untreated Obstructive Sleep Apnea (OSA) in a young man with no other cardiovascular risk factors or features of metabolic syndrome. A 32-year-old man was admitted for hemorrhagic stroke. An initial thorough workup for the etiology of stroke was inconclusive. Eventually, a polysomnography was done, which demonstrated OSA suggesting that untreated OSA may have contributed to his stroke. OSA may cause hemorrhagic stroke by nocturnal blood pressure surge. So, all physicians should consider doing polysomnography for unexplained hemorrhagic stroke or in patients at risk. Diagnosing and treating OSA would be critical in preventing hemorrhagic stroke and its recurrences.

  9. Evaluation of Inflammatory Markers in a Large Sample of Obstructive Sleep Apnea Patients without Comorbidities

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    Izolde Bouloukaki

    2017-01-01

    Full Text Available Systemic inflammation is important in obstructive sleep apnea (OSA pathophysiology and its comorbidity. We aimed to assess the levels of inflammatory biomarkers in a large sample of OSA patients and to investigate any correlation between these biomarkers with clinical and polysomnographic (PSG parameters. This was a cross-sectional study in which 2983 patients who had undergone a polysomnography for OSA diagnosis were recruited. Patients with known comorbidities were excluded. Included patients (n=1053 were grouped according to apnea-hypopnea index (AHI as mild, moderate, and severe. Patients with AHI < 5 served as controls. Demographics, PSG data, and levels of high-sensitivity C-reactive protein (hs-CRP, fibrinogen, erythrocyte sedimentation rate (ESR, and uric acid (UA were measured and compared between groups. A significant difference was found between groups in hs-CRP, fibrinogen, and UA. All biomarkers were independently associated with OSA severity and gender (p<0.05. Females had increased levels of hs-CRP, fibrinogen, and ESR (p<0.001 compared to men. In contrast, UA levels were higher in men (p<0.001. Our results suggest that inflammatory markers significantly increase in patients with OSA without known comorbidities and correlate with OSA severity. These findings may have important implications regarding OSA diagnosis, monitoring, treatment, and prognosis. This trial is registered with ClinicalTrials.gov number NCT03070769.

  10. Screening Questionnaires for Obstructive Sleep Apnea: An Updated Systematic Review.

    Science.gov (United States)

    Amra, Babak; Rahmati, Behzad; Soltaninejad, Forogh; Feizi, Awat

    2018-05-01

    Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is associated with significant morbidity. We sought to present an updated systematic review of the literature on the accuracy of screening questionnaires for OSA against polysomnography (PSG) as the reference test. Using the main databases (including Medline, Cochrane Database of Systematic Reviews and Scopus) we used a combination of relevant keywords to filter studies published between January 2010 and April 2017. Population-based studies evaluating the accuracy of screening questionnaires for OSA against PSG were included in the review. Thirty-nine studies comprising 18 068 subjects were included. Four screening questionnaires for OSA had been validated in selected studies including the Berlin questionnaire (BQ), STOP-Bang Questionnaire (SBQ), STOP Questionnaire (SQ), and Epworth Sleepiness Scale (ESS). The sensitivity of SBQ in detecting mild (apnea-hypopnea index (AHI) ≥ 5 events/hour) and severe (AHI ≥ 30 events/hour) OSA was higher compared to other screening questionnaires (range from 81.08% to 97.55% and 69.2% to 98.7%, respectively). However, SQ had the highest sensitivity in predicting moderate OSA (AHI ≥ 15 events/hour; range = 41.3% to 100%). SQ and SBQ are reliable tools for screening OSA among sleep clinic patients. Although further validation studies on the screening abilities of these questionnaires on general populations are required.

  11. Three-dimensional photography for the evaluation of facial profiles in obstructive sleep apnoea.

    Science.gov (United States)

    Lin, Shih-Wei; Sutherland, Kate; Liao, Yu-Fang; Cistulli, Peter A; Chuang, Li-Pang; Chou, Yu-Ting; Chang, Chih-Hao; Lee, Chung-Shu; Li, Li-Fu; Chen, Ning-Hung

    2018-06-01

    Craniofacial structure is an important determinant of obstructive sleep apnoea (OSA) syndrome risk. Three-dimensional stereo-photogrammetry (3dMD) is a novel technique which allows quantification of the craniofacial profile. This study compares the facial images of OSA patients captured by 3dMD to three-dimensional computed tomography (3-D CT) and two-dimensional (2-D) digital photogrammetry. Measurements were correlated with indices of OSA severity. Thirty-eight patients diagnosed with OSA were included, and digital photogrammetry, 3dMD and 3-D CT were performed. Distances, areas, angles and volumes from the images captured by three methods were analysed. Almost all measurements captured by 3dMD showed strong agreement with 3-D CT measurements. Results from 2-D digital photogrammetry showed poor agreement with 3-D CT. Mandibular width, neck perimeter size and maxillary volume measurements correlated well with the severity of OSA using all three imaging methods. Mandibular length, facial width, binocular width, neck width, cranial base triangle area, cranial base area 1 and middle cranial fossa volume correlated well with OSA severity using 3dMD and 3-D CT, but not with 2-D digital photogrammetry. 3dMD provided accurate craniofacial measurements of OSA patients, which were highly concordant with those obtained by CT, while avoiding the radiation associated with CT. © 2018 Asian Pacific Society of Respirology.

  12. Perioperative management and complications in patients with obstructive sleep apnea undergoing transsphenoidal surgery: Our institutional experience.

    Science.gov (United States)

    Rahimi, Eiman; Mariappan, Ramamani; Tharmaradinam, Suresh; Manninen, Pirjo; Venkatraghavan, Lashmi

    2014-07-01

    Patients with endocrine diseases such as acromegaly and Cushing's disease have a high prevalence of obstructive sleep apnea (OSA). There is controversy regarding the use of continuous positive airway pressure (CPAP) following transsphenoidal surgery. The aim of this study was to compare the perioperative management and complications, in patients with or without OSA undergoing transsphenoidal surgery. After Research Ethics Board approval, we retrospectively reviewed the charts of all patients who underwent transsphenoidal surgery in our institution from 2006 to 2011. Information collected included patients' demographics, pathology of lesion, history of OSA, anesthetic and perioperative management and incidence of perioperative complications. Patients with sleep study proven OSA were compared with a control group, matched for age, sex and pathology of patients without OSA. Statistical analysis was performed using t-test and Chi-square test and the P transsphenoidal surgery, 105 patients were found to be at risk for OSA by a positive STOP-BANG scoring assessment. Preoperative sleep study testing was positive for OSA in 38 patients. Post-operative hypoxemia (SpO2 transsphenoidal surgery can be treated in most but not all patients with high flow oxygen using the face mask. We were able to safely use CPAP in a very small number of patients but caution is needed to prevent complications. Further prospective studies are needed to determine the safe use of CPAP in patients after transsphenoidal surgery.

  13. Markers of Myocardial Ischemia in Patients with Obstructive Sleep Apnea and Coronary Artery Disease

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    Misa Valo

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA is characterized by intermittent hypoxia during sleep. We tested the hypothesis that nocturnal myocardial ischemia is detectable by ST segment depression and elevation of high sensitive troponin T (hsTrop T and B-type natriuretic peptide (NT-proBNP in patients with OSA and coexisting coronary artery disease (CAD. Twenty-one patients with OSA and CAD and 20 patients with OSA alone underwent in-hospital polysomnography. Blood samples for hsTrop T and NT-proBNP measurements were drawn before and after sleep. ST segment depression was measured at the time of maximum oxygen desaturation during sleep. The apnea-hypopnea-index (AHI, oxygen saturation nadir, and time in bed with oxygen saturation of ≤80% were similar in both groups. Levels of hsTrop T and NT-proBNP did not differ significantly before and after sleep but NT-proBNP levels were significantly higher in patients suffering from OSA and CAD compared to patients with OSA alone. No significant ST depression was found at the time of oxygen saturation nadir in either group. Despite the fact that patients with untreated OSA and coexisting CAD experienced severe nocturnal hypoxemia, we were unable to detect myocardial ischemia or myocyte necrosis based on significant ST segment depression or elevation of hsTrop T and NT-proBNP, respectively.

  14. The measurements of multiple slices CT on the narrow pharyngeal cavity in obstructive sleep apnea-hypopnea syndrome

    International Nuclear Information System (INIS)

    Shen Jie; Qi Ji; Yin Jianzhong

    2007-01-01

    Objective: To define the characteristic values of the pharyngeal cavity by comparing the values of measures and ratios between the patients with obstructive sleep apnea-hypopnea syndrome (OSAS) and controls. Methods: Sixty-eight OSAS patients who were diagnosed using polysomnography, and 56 healthy people were scanned by MSCT (multiple slices computed tomography) in the awake state. Then, the values were measured on the reformatted images and were compared between two groups. Results: Of the 63 values, 49 values were different between the two groups, and among those, 4 values were entered into the Discriminant Functions. These were the left-right diameter (LR) [OSAS: LR=(9.4±3.7) mm, controls: LR=(20.1±5.0) mm, t=-13.820, P=0.000] and the cross-sectional area (XSA) [OSAS: XSA=(54±27) mm 2 , controls: XSA=(164±77) mm 2 , t=-10.944, P=0.000] of RP, the heights of tongue [OSAS: (75.4±8.3) mm, controls: (58.4±9.8) mm, t=10.476, P=0.000], the lengths of uvula/the lengths of airway (OSAS: 0.139±0.039, controls: 0.154±0.048, t=-1.983, P=0.050). Conclusions: Many measures and ratios were different between the two groups, but there were overlaps between them. Measures using the Discriminant Functions can help the diagnosis of OSAS. (authors)

  15. Tae-Eum Type as an Independent Risk Factor for Obstructive Sleep Apnea

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    Seung Ku Lee

    2013-01-01

    Full Text Available Obstructive sleep apnea (OSA is prevalent and associated with several kinds of chronic diseases. There has been evidence that a specific type of Sasang constitution is a risk factor for metabolic and cardiovascular diseases that can be found in patients with OSA, but there are no studies that address the association between the Sasang constitution type (SCT and OSA. The purpose of this study was to investigate the association between the SCT and OSA. A total of 652 participants were included. All participants were examined for demographic information, medical history, and completed an interviewer-administered questionnaire on life style and sleep-related variables. Biochemical analyses were performed to determine the glucose and lipid profiles. An objective recording of OSA was done with an unattended home PSG using an Embla portable device. The apnea-hypopnea index (AHI and oxygen desaturation index (ODI were significantly higher in the Tae-eum (TE type as compared to the So-eum (SE and the So-yang (SY types. Even after adjusting for confounding variables, the TE type still had a 2.34-fold (95% CI, 1.11–4.94; P=0.0262 increased risk for OSA. This population-based cohort study found that the TE constitutional type is an independent risk factor for the development of OSA.

  16. The effect of sleep onset on upper airway muscle activity in patients with sleep apnoea versus controls

    Science.gov (United States)

    Fogel, Robert B; Trinder, John; White, David P; Malhotra, Atul; Raneri, Jill; Schory, Karen; Kleverlaan, Darci; Pierce, Robert J

    2005-01-01

    Pharyngeal dilator muscles are important in the pathophysiology of obstructive sleep apnoea syndrome (OSA). We have previously shown that during wakefulness, the activity of both the genioglossus (GGEMG) and tensor palatini (TPEMG) is greater in patients with OSA compared with controls. Further, EMG activity decreases at sleep onset, and the decrement is greater in apnoea patients than in healthy controls. In addition, it is known that the prevalence of OSA is greater in middle-aged compared with younger men. Thus, we had two goals in this study. First we compared upper airway muscle activity between young and middle-aged healthy men compared with men with OSA. We also explored the mechanisms responsible for the decrement in muscle activity at sleep onset in these groups. We investigated muscle activity, ventilation , and upper airway resistance (UAR) during wakefulness and sleep onset (transition from α to θ EEG activity) in all three groups. Measurements were obtained during basal breathing (BB) and nasal continuous positive airway pressure (CPAP) was applied to reduce negative pressure-mediated muscle activation). We found that during wakefulness there was a gradation of GGEMG and UAR (younger < older < OSA) and that muscle activity was reduced by the application of nasal CPAP (to a greater degree in the OSA patients). Although CPAP eliminated differences in UAR during wakefulness and sleep, GGEMG remained greater in the OSA patients. During sleep onset, a greater initial fall in GGEMG was seen in the OSA patients followed by subsequent muscle recruitment in the third to fifth breaths following the α to θ transition. On the CPAP night, and GGEMG still fell further in the OSA patients compared with control subjects. CPAP prevented the rise in UAR at sleep onset along with the associated recruitment in GGEMG. Differences in TPEMG among the groups were not significant. These data suggest that the middle-aged men had upper airway function midway between that of

  17. Koguteos Soome põllumajanduse ajaloost / Ülle Tarkiainen

    Index Scriptorium Estoniae

    Tarkiainen, Ülle

    2007-01-01

    Rerts. rmt.: Suomen maatalouden historia, osa 1. Perinteisen maatalouden aika. Esihistoriasta 1870-luvulle. Toim. Viljo Rasila, Eino Jutikkala, Anneli Mäkelä-Alitalo. Helsinki, 2003. 646 lk. ; osa 2. Kasvun ja kriisien aika. 1870-luvulta 1950-luvulle. Toim. Matti Peltonen. Helsinki, 2004. 534 lk.; osa 3. Suurten muutosten aika. Jälleenrakennuskaudesta EU-Suomeen. Toim. Pirjo Markkola. Helsinki, 2004. 518 lk.

  18. Folkloor muutuvas maailmas / Annika Markson ; juhendaja Mari Raidmets

    Index Scriptorium Estoniae

    Markson, Annika

    2008-01-01

    Artikli esimene osa kirjeldab rahvaluulet ja selle arengut tänapäeval, teine osa rahvatantsu ja line-tantsu arengut Eestis ning kolmandas osa räägitakse grafiti ajaloost ja selle rollist tänapäeva ühiskonnas. Töö lisades on välja toodud intervjuud, küsitluste vastused ning diagrammilised ülevaated küsitlustest

  19. Correlation between Inflammatory Markers of Atherosclerosis and Carotid Intima-Media Thickness in Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Marco Matteo Ciccone

    2014-01-01

    Full Text Available Obstructive Sleep Apnea (OSA is a sleep-related breathing disorder associated with the development of cardiovascular diseases and atherosclerosis. Systemic inflammation plays an important role in the development of cardiovascular complications in OSA patients. The aim of the study was to evaluate the relationship between carotid intima-media thickness (cIMT and inflammatory markers plasma levels in OSA patients. We enrolled 80 OSA patients and 40 controls matched for age and body mass index (BMI. The presence and severity of sleep apnea was determined by in-laboratory portable monitoring (PM. Demographic data, blood pressure, heart rate, and cIMT were measured. High-sensitive C-Reactive Protein (hsCRP, interleukin (IL-6, tumor necrosis factor (TNF-α and pentraxin (PTX-3 serum concentrations were detected. cIMT was higher in OSA patients than controls (0.89 ± 0.13 mm vs. 0.65 ± 0.1 mm, p < 0.01. Moderate-severe OSA patients (0.95 ± 0.09 mm had significantly increased cIMT than mild OSA (0.76 ± 0.1 mm; p < 0.01 and control (0.65 ± 0.1 mm; p < 0.01. hsCRP, IL-6, TNF-α, and PTX-3 in patients with OSA (1.67 ± 0.66 mg/L, 2.86 ± 1.39 pg/mL, 20.09 ± 5.39 pg/mL, 2.1 ± 0.59 ng/mL, respectively were significantly higher than in controls (1.08 ± 0.53 mg/L, p < 0.01; 1.5 ± 0.67 pg/mL, p < 0.01; 12.53 ± 3.48 pg/mL, p < 0.01; 1.45 ± 0.41 ng/mL, p < 0.01, respectively. Carotid IMT was significantly correlated to CRP (r = 0.44; p < 0.01, IL-6 (r = 0.42; p < 0.01, TNF-α (r = 0.53; p < 0.01, and PTX-3 (r = 0.49; p < 0.01. OSA patients showed increased cIMT, CRP, IL-6, TNF-α, and PTX-3 levels. Inflammatory markers levels are correlated to cIMT in OSA patients.

  20. Quality of sleep and risk for obstructive sleep apnoea in ambulant individuals with type 2 diabetes mellitus at a tertiary referral hospital in Kenya: a cross-sectional, comparative study.

    Science.gov (United States)

    Sokwalla, Sairabanu Mohammed Rashid; Joshi, Mark David; Amayo, Erastus Olonde; Acharya, Kirtida; Mecha, Jared Ongechi; Mutai, Kenneth Kipyegon

    2017-02-06

    Sleep disorders are common and associated with multiple metabolic and psychological derangements. Obstructive sleep apnoea (OSA) is among the most common sleep disorders and an inter-relationship between OSA, insulin resistance, obesity, type 2 diabetes (T2DM) and cardiovascular diseases has been established. Prevalence of sleep disorders in Kenyans, particularly in individuals with T2DM is unknown. We thus aimed to determine prevalence of poor quality of sleep (QOS) and high risk for OSA, among persons with T2DM and determine their associations with socio-demographic and anthropometric variables. Utilising a Cross- Sectional Descriptive design, QOS and risk for OSA were determined in a randomly selected sample of patients with T2DM (cases) and an age and sex matched comparison group. The validated Pittsburgh Sleep Quality Index (PSQI) and Berlin Questionnaire (BQ) were used to measure QOS and risk for OSA respectively. Associations between poor QOS, high risk for OSA, and socio-demographic and anthropometric variables in cases were evaluated. From 245 randomly selected persons with T2DM attending outpatient clinics, aged over 18 years, 22 were excluded due to ineligibility thus 223 were included in the analysis; 53.8% were females, mean age was 56.8 (SD 12.2) years and mean BMI was 28.8 kg/m 2 (SD 4.4). Among them, 119 (53%, CI 95% 46.5-60.2) had poor QOS and 99 (44% CI 95% 37.8-50.9) were at high risk for OSA. Among 112 individuals in comparison group, 33 (29.5%, CI 95% 20.9-38.3) had poor QOS and 9 (8%, CI 95% 3.3-13.4) had high risk for OSA. Cases had a significantly higher probability for poor QOS [OR 2.76 (95% CI 1.7-4.4))] and high risk for OSA [OR 9.1 (95% CI 4.4-19.0)]. Higher waist circumference was independently associated with a high risk for OSA in cases. We demonstrate a high burden of sleep disturbances in patients with T2DM. Our findings may have implications for clinicians to screen for sleep disorders when assessing patients with T2DM and