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Prevalência e correlação das dimensões oclusais transversais em pacientes com diferente diagnóstico de obstrução respiratória; Prevalence and correlation of transversal occlusal dimensions in patients with different diagnosis of airway obstruction

Costa, Fabricio Ricardo Ginez
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 22/01/2015 PT
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66.65%
Introdução: Dentre as alterações da má-oclusão dentária na primeira dentição, destaca-se a mordida cruzada posterior, a qual consiste numa relação de sobressaliência vestibular inversa dos dentes superiores com seus antagonistas inferiores. O crescimento das estruturas faciais é composto de múltiplas atividades funcionais inter-relacionadas por diferentes componentes da cabeça e pescoço. A respiração nasal é um dos elementos de atividade funcional. Se houver obstrução nas vias aéreas superiores, haverá adaptações funcionais na direção de crescimento das estruturas do esqueleto da face. A hiperplasia das tonsilas faríngeas e/ou palatinas associadas são uma das causas mais comuns de obstrução respiratória. Objetivos: investigar a prevalência da mordida cruzada posterior em crianças de 3 a 6 anos de idade e associá-la ao padrão respiratório; verificar se houve associação desta má-oclusão com o tipo da hiperplasia das tonsilas palatinas associadas ou não com tonsilas faríngeas; realizar uma análise comparativa em crianças respiradoras orais e respiradoras nasais na idade categorizada 3-4 anos e 5-6 anos nos seguintes aspectos: distâncias da largura dos arcos por meio das distâncias intercaninos e intermolares da maxila e mandíbula. Casuística e Métodos: Participaram deste estudo 53 crianças...

A comparison of nasopharyngeal endoscopy and lateral cephalometric radiography in the diagnosis of nasopharyngeal airway obstruction

Ianni Filho, Daniel; Raveli, Dirceu Barnabé; Raveli, Rosangela B.; De Castro Monteiro Loffredo, Leonor; Gandini Jr., Luiz G.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 348-352
ENG
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56.38%
Two auxiliary methods of diagnosing nasopharyngeal airway obstruction were compared. Cephalometric radiography and nasopharyngeal videoendoscopy were evaluated for efficacy in terms of reproducibility and validity. Thirty orthodontic patients (7 to 12 years of age) seeking otorhinolaryngologic treatment for mouth breathing, or mouth and nose breathing, had nasopharyngeal endoscopy and radiographic examinations performed on the same day. Two otorhinolaryngologists analyzed the results. Nasopharyngeal endoscopy was more reliable in identifying all the obstructive nasopharyngeal processes. Endoscopy obtained kappa index scores of almost perfect agreement for diagnosis of posterior nasal septum deviation, of substantial agreement for anterior nasal septum deviation and lower turbinate hypertrophy, and of moderate agreement for middle turbinate hypertrophy. Lateral cephalometric radiography obtained scores of perfect agreement for imaging hypertrophy of the middle turbinate, of almost perfect agreement for imaging hypertrophy of the posterior portion of the inferior turbinate, and of substantial agreement for imaging hypertrophy of the inferior turbinate. Radiographic diagnoses of hypertrophy of the middle and lower turbinates exhibited high sensitivity and low specificity when compared with diagnoses by nasopharyngeal endoscopy.

Contribution to the staging and immunological study of equine recurrent airway obstruction (RAO)

Tilley, Paula Alexandra Botelho Garcia de Andrade Pimenta
Fonte: Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária Publicador: Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária
Tipo: Tese de Doutorado
Publicado em 06/12/2011 ENG
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66.42%
Tese de Doutoramento em Ciências Veterinárias especialidade de Clínica; Recurrent airway obstruction (RAO) is one of the most frequent lung diseases in horses and is similar to human asthma. We characterized equine RAO differential diagnosis (DD) in horses with long term cough and established a parallel between the DD in equine RAO and in human asthma. We correlated clinical, endoscopic, thoracic X-ray and bronchoalveolar lavage fluid scores in horses with RAO to establish relevance of each factor for the characterization of RAO stages in order to suggest a staging method. Cardiovascular effects of RAO were assessed. We also evaluated the response to skin prick tests (SPT) and in vitro allergy tests with common aeroallergens in horses with RAO and characterized RAO in Portugal by identifying relevant allergic factors. The importance of a thorough diagnosis is emphasized, including BAL and respiratory endoscopy, and a DD parallel is made with vocal cord dysfunction in man. A score model for the characterization of RAO stages is suggested. The first ECG and EcoCG values for Lusitano/Lusitano-cross horses are published with subtle changes in the RAO group. In this highly selected population immediate aeroallergen hypersensitivity was significant...

Efficacy of the FEV1/FEV6 ratio compared to the FEV1/FVC ratio for the diagnosis of airway obstruction in subjects aged 40 years or over

Rosa,F.W.; Perez-Padilla,R.; Camelier,A.; Nascimento,O.A.; Menezes,A.M.B.; Jardim,J.R
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2007 EN
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66.56%
The present cross-sectional, population-based study was designed to evaluate the performance of the FEV1/FEV6 ratio for the detection of airway-obstructed subjects compared to the FEV1/FVC <0.70 fixed ratio test, as well as the lower limit of normality (LLN) for 1000 subjects ³40 years of age in the metropolitan area of São Paulo, SP, Brazil. After the exclusion of 37 (3.7%) spirometries, a total of 963 pre-bronchodilator (BD) and 918 post-BD curves were constructed. The majority of the post-BD curves (93.1%) were of very good quality and achieved grade A (762 curves) or B (93 curves). The FEV1/FEV6 and FEV1/FVC ratios were highly correlated (r² = 0.92, P < 0.000). Two receiver operator characteristic curves were constructed in order to express the imbalance between the sensitivity and specificity of the FEV1/FEV6 ratio compared to two FEV1/FVC cut-off points for airway obstruction: equal to 70 (area under the curve = 0.98, P < 0.0001) and the LLN (area under the curve = 0.97, P < 0.0001), in the post-BD curves. According to an FEV1/FVC <0.70, the cut-off point for the FEV1/FEV6 ratio with the highest sum for sensitivity and specificity was 0.75. The FEV1/FEV6 ratio can be considered to be a good alternative to the FEV1/FVC ratio for the diagnosis of airway obstruction...

Importance of slow vital capacity in the detection of airway obstruction

Barros,Ana Raquel Goncalves de; Pires,Margarida Batista; Raposo,Nuno Miguel Ferreira
Fonte: Sociedade Brasileira de Pneumologia e Tisiologia Publicador: Sociedade Brasileira de Pneumologia e Tisiologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2013 EN
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66.73%
OBJECTIVE: To investigate the presence of airway obstruction by determining the FEV1/FVC and FEV1/slow vital capacity (SVC) ratios. METHODS: This was a quantitative, retrospective cross-sectional study. The sample comprised 1,084 individuals who underwent spirometry and plethysmography in a central hospital in Lisbon, Portugal. The study sample was stratified into six groups, by pulmonary function. RESULTS: The analysis of the FEV1/FVC ratio revealed the presence of airway obstruction in 476 individuals (43.9%), compared with 566 individuals (52.2%) for the analysis of the FEV1/SVC ratio. In the airway obstruction, airway obstruction plus lung hyperinflation, and mixed pattern groups, the difference between SVC and FVC (SVC − FVC) was statistically superior to that in the normal pulmonary function, reduced FEF, and restrictive lung disease groups. The SVC − FVC parameter showed a significant negative correlation with FEV1 (in % of the predicted value) only in the airway obstruction plus lung hyperinflation group. CONCLUSIONS: The FEV1/SVC ratio detected the presence of airway obstruction in more individuals than did the FEV1/FVC ratio; that is, the FEV1/SVC ratio is more reliable than is the FEV1/FVC ratio in the detection of obstructive pulmonary disease.

Hairy Polyp of the Supratonsillar Fossa Causing Intermittent Airway Obstruction

İsmi,Onur; Görür,Kemal; Arpacı,Rabia Bozdoğan; Vayisoglu,Yusuf; Özcan,Cengiz
Fonte: Fundação Otorrinolaringologia Publicador: Fundação Otorrinolaringologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2015 EN
Relevância na Pesquisa
66.42%
Introduction Dermoids frequently called "hairy polyps" and their nature have not been completely clarified. Objectives To discuss the unusual presentation, symptoms, incidence, histology, and perioperative management of hairy polyps in the light of a case and current literature. Resumed Report A 3-year-old boy presented with intermittent respiratory distress since birth. Oropharyngeal examination revealed a nasopharyngeal mass originating from the supratonsillar fossa. The mass was so mobile that it moved between the oropharynx and the nasopharynx during swallowing. The radiologic and pathologic examinations confirmed the mass as a hairy polyp. Conclusion In a pediatric age group with airway obstruction, hairy polyps of the oropharyngeal region must also be included in the differential diagnosis.

Effects of an external resistance on maximum flow in chronic obstructive lung disease: implications for recognition of coincident upper airway obstruction.

Robertson, D R; Swinburn, C R; Stone, T N; Gibson, G J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1989 EN
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46.77%
To determine how the presence of generalised airflow limitation due to chronic obstructive lung disease affects the recognition of simulated upper airway obstruction, a study was carried out in 12 patients (mean (SD) age 57 (7) years) with chronic obstructive lung disease (FEV1% predicted 53 (22), range 21-70) and 12 matched control subjects. Patients and control subjects performed maximal inspiratory and expiratory flow-volume curves in a variable volume plethysmograph with and without upper airway obstruction simulated at the mouth with a series of polythene washers of internal diameter 4, 6, 8, 10, and 12 mm. In patients, as in normal subjects, peak expiratory flow (PEF) and maximum inspiratory flow at 50% of vital capacity (Vmax50) were more sensitive to upper airway obstruction than were FEV1 or maximum expiratory flow at 50% VC (VEmax50); but the reductions in all indices caused by simulated upper airway obstruction were smaller in the patients than in the controls. The fall in PEF (whether expressed in absolute units or as a percentages) consequent on severe (4 mm) upper airway obstruction became smaller with increasing severity of chronic obstructive lung disease. The subjects also produced flow-volume curves with and without 6 mm upper airway obstruction while breathing helium and oxygen (heliox). In both groups the effects of heliox on PEF and Vmax50 were increased when upper airway obstruction was simulated. It was confirmed that the functional recognition of upper airway obstruction is more difficult in patients with chronic obstructive lung disease than in normal subjects and this difficulty increases with severity of disease; an unusually large increase in PEF or Vmax50 while the patient is breathing heliox should raise the suspicion of coexisting upper airway obstruction...

Late presentation of upper airway obstruction in Pierre Robin sequence

Wilson, A; Moore, D; Moore, M; Martin, A; Staugas, R; Kennedy, J
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /11/2000 EN
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46.74%
A retrospective review was carried out of 11 consecutive patients with the Pierre Robin sequence referred to a tertiary paediatric referral centre over a five year period from 1993 to 1998. Ten patients were diagnosed with significant upper airway obstruction; seven of these presented late at between 24 and 51 days of age. Failure to thrive occured in six of these seven infants at the time of presentation, and was a strong indicator of the severity of upper airway obstruction. Growth normalised on treatment of the upper airway obstruction with nasopharyngeal tube placement. All children had been reviewed by either an experienced general paediatrician or a neonatologist in the first week of life, suggesting that clinical signs alone are insufficent to alert the physician to the degree of upper airway obstruction or that obstruction developed gradually after discharge home. The use of polysomnography greatly improved the diagnostic accuracy in assesssing the severity of upper airway obstruction and monitoring the response to treatment. This report highlights the prevalence of late presentation of upper airway obstruction in the Pierre Robin sequence and emphasises the need for close prospective respiratory monitoring in this condition. Objective measures such as polysomnography should be used...

Increases in plasma concentrations of a prostaglandin metabolite in acute airway obstruction.

Skoner, D P; Fireman, P; Davis, H W; Wall, R; Caliguiri, L A
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /08/1989 EN
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46.71%
Plasma concentrations of a stable prostaglandin F2 alpha metabolite were measured by radioimmunoassay during and after recovery from acute airway obstruction in 15 infants. Mean (SEM) metabolite concentrations (ng/l) in plasma obtained both before (1033 (418)) and after (1470 (413)) initial treatment for airway obstruction were significantly higher than those obtained from the same subjects after resolution of the obstruction--25.5 (6.6)--and those obtained from two comparison groups. Infants positive for respiratory syncytial virus (mean 1122 (227)) had significantly higher concentrations than those who were negative (207.6 (46)). Additionally, seven subjects with a history of recurrent wheezing after resolution of airway obstruction had a significantly higher mean level (3500 (1400)) during attacks of airway obstruction than those without (600 (100)). These data suggest that prostaglandin F2 alpha mediates respiratory inflammation in airway obstruction and that trials of specific anti-inflammatory agents for the treatment of airway obstruction may be warranted.

Late presentation of upper airway obstruction in Pierre Robin sequence

Wilson, A.; Moore, D.; Moore, M.; Martin, A.; Staugas, R.; Kennedy, J.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2000 EN
Relevância na Pesquisa
46.74%
A retrospective review was carried out of 11 consecutive patients with the Pierre Robin sequence referred to a tertiary paediatric referral centre over a five year period from 1993 to 1998. Ten patients were diagnosed with significant upper airway obstruction; seven of these presented late at between 24 and 51 days of age. Failure to thrive occured in six of these seven infants at the time of presentation, and was a strong indicator of the severity of upper airway obstruction. Growth normalised on treatment of the upper airway obstruction with nasopharyngeal tube placement. All children had been reviewed by either an experienced general paediatrician or a neonatologist in the first week of life, suggesting that clinical signs alone are insufficent to alert the physician to the degree of upper airway obstruction or that obstruction developed gradually after discharge home. The use of polysomnography greatly improved the diagnostic accuracy in assesssing the severity of upper airway obstruction and monitoring the response to treatment. This report highlights the prevalence of late presentation of upper airway obstruction in the Pierre Robin sequence and emphasises the need for close prospective respiratory monitoring in this condition. Objective measures such as polysomnography should be used...

Acute upper airway obstruction from acquired angioedema

Cheng, W.; Smith, W.; Russell, W.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
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56.38%
C1 esterase inhibitor deficiency is an unusual cause of acute upper airway angioedema. This case of angioedema is secondary to acquired C1 esterase inhibitor deficiency associated with neoplastic disease and triggered by the use of angiotensin converting enzyme inhibitors. It was sufficiently severe to require emergency airway management. A guide to the evaluation and management of angioedema is presented.; William YC Cheng, William B Smith and W John Russell

Case studies in the surgical management of nasal airway obstruction

Seiberling, K.; Wormald, P.J.
Fonte: W B Saunders Co Publicador: W B Saunders Co
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
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56.42%
This article focuses on the workup and treatment of two distinct cases of nasal obstruction. The first case has to do with a 24-year old male who presented with a brief seizure. Review of systems was positive only for longstanding right nasal obstruction. Imaging studies were consistent with a meningoencephalocele. The patient was taken to surgery for excision of the nasal mass and repair of the skull-base defect. Case two involves the treatment of a male with chronic nasal obstruction due to an S-shaped septal deviation and turbinate hypertrophy. The case illustrates the role of endoscopic septoplasty and shows how the endoscopic septoplasty technique is applied. The article also discusses the management of the enlarged turbinates.; Kristin A. Seiberling and Peter-John Wormald

Unusual causes of fatal upper aerodigestive tract obstruction in wild bottlenose dolphins (Tursiops aduncus)

Byard, R.; Tomo, I.; Kemper, C.; Gibbs, S.; Bossley, M.; Machado, A.; Hill, M.
Fonte: Humana Press, Inc. Publicador: Humana Press, Inc.
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
56.6%
Necropsy examination of dolphins living in Gulf St Vincent, Australia is routinely undertaken to enable the evaluation of disease processes and to provide rapid medicolegal assessment of any inflicted and/or accidental injuries. Two Indo-Pacific Bottlenose Dolphins (Tursiops aduncus) are reported to demonstrate conditions that may result in unexpected death involving upper airway compromise by quite unusual mechanisms. In the first case an adult male was found with extensive soft tissue trauma suggesting human interaction. At necropsy, death was due instead to upper airway obstruction from an impacted Slender-spined Porcupine Fish (Diodon nichthemerus) in the posterior pharynx and upper esophagus. In the second case, an adult male dolphin was found to have died, following several weeks’ illness, from upper airway obstruction due to extensive respiratory tract papillomatosis within the blowhole. Given the infectious etiology of this condition the local population will be monitored for similar lesions. These cases demonstrate rare causes of upper airway obstruction in wild dolphins that were identifiable only after detailed necropsy examination. The possibility of human involvement in the deaths could be excluded.; Roger W. Byard, Ikuko Tomo...

Awake upper airway obstruction in children with spastic quadriplegic cerebral palsy

Wilkinson, D.; Baikie, G.; Berkowitz, R.; Reddihough, D.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
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66.59%
Objective: Some children with severe cerebral palsy develop symptoms of upper airway obstruction (UAO) while awake. The aetiology, natural history and treatment of this complication have not previously been systematically described. This study documents a case series of children with severe cerebral palsy admitted to hospital because of severe awake UAO and reviews the relevant literature. Methods: The case records of children admitted to hospital with UAO while awake over an 8-month period were reviewed. Details of antecedent illness, comorbidities, acute management and follow up were collated. One case is presented in detail. Results: Eight children were admitted with UAO. Seven children required intensive care admission. One child died, and two underwent tracheostomy. Nasendoscopy showed pharyngeal collapse without anatomical obstruction in the majority. One child was discovered to have a brainstem malignancy. Conclusions: Upper airway obstruction is a potentially severe and life-threatening complication of cerebral palsy. In this series, a majority of children had obstruction related to pharyngeal hypotonia and collapse. This can lead to prolonged hospitalization and intensive care admission. It may raise difficult management issues.; Dominic J Wilkinson...

Postoperative cervical soft tissue hemorrhage with acute upper airway obstruction

Quick, E.; Byard, R.
Fonte: Amer Soc Testing Materials Publicador: Amer Soc Testing Materials
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
66.63%
Cervical surgery may be complicated by acute upper airway obstruction due to hematoma formation. Two cases are reported following cervical surgery where stridor, respiratory distress, and lethal airway occlusion resulted from hemorrhage that did not arise from large vessels. Case 1: A 50-year-old man who had an elective anterior fusion of C5-6 vertebrae developed marked neck swelling and stridor. At autopsy, there was significant cervical interstitial hemorrhage and edema. Major vessels were intact. Case 2: An 86-year-old man who underwent a carotid endarterectomy developed stridor and swelling of his neck. At autopsy, there was extensive interstitial hemorrhage and edema within the soft tissues of the neck. The endarterectomy site was intact. Both deaths were due to upper airway obstruction from postoperative cervical interstitial hemorrhage with no large vessel damage identified. Hemorrhage from small vessels may therefore lead to critical soft tissue hematoma formation and edema with airway obstruction and death.; Esther Quick and Roger W. Byard

Respiratory sinus arrhythmia during sleep in children with upper airway obstruction

Kabir, M.; Kohler, M.; Pamula, Y.; Martin, A.; Kennedy, J.; Abbott, D.; Baumert, M.
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
46.79%
Upper airway obstruction during adulthood is associated with cardiovascular morbidity; cardiovascular consequences of childhood upper airway obstruction are less well established. This study aimed at investigating the effect of childhood upper airway obstruction on respiratory sinus arrhythmia as a measure of cardiac vagal modulation during night-time sleep. Overnight polysomnography was conducted in 40 healthy children (20 M; age: 7.5 ± 2.6 years; body mass index percentile: 60.7 ± 26.4%) and 40 children with upper airway obstruction (24 M; age: 7.5 ± 2.7 years; body mass index percentile: 65.8 ± 31.9%). We used the phase-averaging technique to compute respiratory sinus arrhythmia amplitude and phase delay. To study sleep stage effects and the effect of upper airway obstruction, respiratory sinus arrhythmia was measured during all artefact-free sleep episodes, and after exclusion of respiratory events. A significant increase in respiratory sinus arrhythmia amplitude and phase delay was observed during stage 4 sleep as compared with rapid eye movement sleep in both groups (amplitude: controls = 0.10 ± 0.03 versus 0.07 ± 0.02 s, P < 0.01, respectively, and upper airway obstruction = 0.07 ± 0.03 versus 0.05 ± 0.03 s, P < 0.05...

Paediatric sleep-disordered breathing due to upper airway obstruction in the orthodontic setting: a review

Katyal, V.; Kennedy, D.; Martin, A.; Dreyer, C.; Sampson, W.
Fonte: Australian Society of Orthodontists Publicador: Australian Society of Orthodontists
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
66.51%
The essential feature of paediatric sleep-disordered breathing (SDB) is increased upper airway resistance during sleep presenting clinically as snoring. Paediatric SDB is a continuum ranging from primary snoring (PS), which is not associated with gas exchange abnormalities or significant sleep fragmentation, to obstructive sleep apnoea (OSA) with complete upper airway obstruction, hypoxaemia, and obstructive hypoventilation. Adenotonsillar hypertrophy, obesity and craniofacial disharmonies are important predisposing factors in the development and progression of paediatric SDB. Clinical symptoms are significant and domains affected include behaviour, neurocognition, cardiovascular morbidity and quality of life. Overnight polysomnography is the current diagnostic gold standard method to assess SDB severity while adenotonsillectomy is the recommended first line of treatment. Other treatments for managing paediatric SDB include nasal continuous airway pressure, the administration of nasal steroids, dentofacial orthopaedic treatment and surgery. However, there are insufficient long-term efficacy data using dentofacial orthopaedics to treat paediatric SDB. Further studies are warranted to define the characteristics of patients who may benefit most from orthodontic treatment.; Vandana Katyal...

Increased thoracoabdominal asynchrony during breathing periods free of discretely scored obstructive events in children with upper airway obstruction

Immanuel, S.; Kohler, M.; Martin, A.; Kennedy, J.; Pamula, Y.; Kabir, M.; Saint, D.; Baumert, M.
Fonte: Springer Berlin Heidelberg Publicador: Springer Berlin Heidelberg
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
66.6%
Objective This study aims to investigate the impact of upper airway obstruction (UAO) in children by measuring thoracoabdominal asynchrony (TAA) during periods of sleep apnea/hypopnea and during scored-event-free (SEF) breathing periods. Methods Respiratory inductive plethysmographic signals were extracted from polysomnographic data, recorded before and after adenotonsillectomy in 40 children with UAO and 40 healthy, matched children at equivalent time points. Thoracoabdominal asynchrony was computed using a Hilbert transform-based phase difference estimation method in SEF periods during stage 2, stage 4 non-rapid eye movement (NREM), and rapid eye movement (REM) sleep and compared between the groups. Results At baseline, in the UAO group, TAA during obstructions were significantly higher than TAA during SEF periods in both stage 2 and REM sleep. Compared to controls, children with UAO had a significantly higher TAA during SEF periods in stage 2, stage 4 sleep, and REM sleep. This between-group difference was not significant post adenotonsillectomy. UAO group showed a significant decrease in TAA compared to their baseline during SEF stage 2 and 4 NREM, but not in REM. Conclusion Upper airway obstruction in children is associated with increased TAA during SEF periods...

Movement distribution: a new measure of sleep fragmentation in children with upper airway obstruction

Coussens, S.; Baumert, M.; Kohler, M.; Martin, J.; Kennedy, D.; Lushington, K.; Saint, D.; Pamula, Y.
Fonte: American Academy of Sleep Medicine Publicador: American Academy of Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
66.6%
STUDY OBJECTIVES: To develop a measure of sleep fragmentation in children with upper airway obstruction based on survival curve analysis of sleep continuity. DESIGN: Prospective repeated measures. SETTING: Hospital sleep laboratory. PARTICIPANTS: 92 children aged 3.0 to 12.9 years undergoing 2 overnight polysomnographic (PSG) sleep studies, 6 months apart. Subjects were divided into 3 groups based on their obstructive apnea and hypopnea index (OAHI) and other upper airway obstruction (UAO) symptoms: primary snorers (PS; n = 24, OAHI <1), those with obstructive sleep apnea syndrome (OSAS; n = 20, OAHI ≥1) and non-snoring controls (C; n = 48, OAHI <1). INTERVENTIONS: Subjects in the PS and OSAS groups underwent tonsillectomy and adenoidectomy between PSG assessments. MEASUREMENTS AND RESULTS: Post hoc measures of movement and contiguous sleep epochs were exported and analyzed using Kaplan-Meier estimates of survival to generate survival curves for the 3 groups. Statistically significant differences were found between these group curves for sleep continuity (P < 0.05) when using movement events as the sleep fragmenting event, but not if stage 1 NREM sleep or awakenings were used. CONCLUSION: Using conventional indices of sleep fragmentation in survival curve analysis of sleep continuity does not provide a useful measure of sleep fragmentation in children with upper airway obstruction. However...

Obesity and risk of sleep related upper airway obstruction in Caucasian children

Kohler, M.; Lushington, K.; Couper, R.; Martin, A.; van den Heuvel, C.; Pamula, Y.; Kennedy, D.
Fonte: The American Academy of Sleep Medicine Publicador: The American Academy of Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
66.73%
Obesity is thought to be a significant risk factor for upper airway obstruction during sleep in children. However, the moderating influences of age and ethnicity have not been well explored and the relative contribution of obesity per se to upper airway obstruction has yet to be quantified. Given the markedly increasing prevalence of childhood obesity, an objective understanding of the impact of obesity on upper airway obstruction is important. The purpose of the present study was to examine the interaction between obesity, age and upper airway obstruction in Australian Caucasian children referred for evaluation of snoring. METHODS: This was a retrospective case study involving 190 children (4-12 y) who were referred for evaluation of upper airway obstruction and underwent one night of polysomnography at the Adelaide Women's and Children's Hospital Sleep Disorders Unit. Children were classified as Infrequent Snorers (n = 80), Habitual Snorers (n = 68) or Obstructive Sleep Apnea Syndrome (OSAS) (n = 42) (i.e., obstructive apnea hypopnea index (OAHI) > or = 1). RESULTS: Thirty-five percent (66/190) of children were overweight or obese. Body mass index but not age was a significant but weak predictor of OAHI (< 5% of the variance). CONCLUSION: In Australian Caucasian children aged 4-12 years who snore...