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Comparing respiratory polygraphy with pulse transit time analysis versus overnight polysomnography in the diagnosis of obstructive sleep apnoea in children.

Sleep Med 2021 May 1;81:457-462. Epub 2021 Mar 1.

FHKAM(Otolaryngology), Department of Otolaryngology, Tuen Mun Hospital, Hong Kong.

Objective: Obstructive sleep apnea syndrome in children is associated with significant morbidity. Polysomnography is the main diagnostic tool but is time consuming and requires skilled manpower to supervise the patient overnight and hence long referral to diagnosis time. However, there are limitations and underestimation of the apnoea hyponea index (AHI) with alternative home sleep apnoea testing (HSAT), such as type 3 respiratory polygraphy (RP). Read More

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Environmental Exposures in the Etiology of Abortion: Placental Toxic and Trace Element Levels.

Z Geburtshilfe Neonatol 2020 Dec 15;224(6):339-347. Epub 2020 Oct 15.

Yozgat Bozok University, Faculty of Medicine, Department of Obstetrics and Gynecology, Yozgat, Turkey.

Purpose: Intensive research has been conducted on the effects of toxic and trace elements on pregnancy. Previous studies indicated a possible relationship between placental levels of these elements and first-trimester abortion; however, their effects on the further gestational weeks are not clear. This study aimed to investigate the effect of changes in the levels of placental trace and toxic elements on second-trimester abortion. Read More

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December 2020

Machine learning for nocturnal mass diagnosis of atrial fibrillation in a population at risk of sleep-disordered breathing.

Physiol Meas 2020 11 6;41(10):104001. Epub 2020 Nov 6.

Faculty of Biomedical Engineering, Technion, Israel Institute of Technology, Haifa, Israel. Faculty of Electrical Engineering, Technion, Israel Institute of Technology, Haifa, Israel.

Objective: In this research, we introduce a new methodology for atrial fibrillation (AF) diagnosis during sleep in a large population sample at risk of sleep-disordered breathing.

Approach: The approach leverages digital biomarkers and recent advances in machine learning (ML) for mass AF diagnosis from overnight-hours of single-channel electrocardiogram (ECG) recording. Four databases, totaling n = 3088 patients and p = 26 913 h of continuous single-channel electrocardiogram raw data were used. Read More

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November 2020

Night-to-night variability of respiratory events in obstructive sleep apnoea: a systematic review and meta-analysis.

Thorax 2020 12 13;75(12):1095-1102. Epub 2020 Aug 13.

Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland

Background: It is current practice to use a single diagnostic sleep study in the diagnostic workup of obstructive sleep apnoea (OSA). However, a relevant night-to-night variability (NtNV) of respiratory events has been reported.

Methods: We evaluated the NtNV of respiratory events in adults with suspected or already diagnosed OSA who underwent more than one diagnostic sleep study. Read More

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December 2020

Night-to-night fluctuations in sleep apnea severity: diagnostic and treatment implications.

J Clin Sleep Med 2020 04;16(4):539-544

Department of Neurology, Virginia Commonwealth University, Richmond, Virginia.

Study Objectives: Sleep apnea is a common disorder with serious consequences; however, effective treatments are available. Successful implementation of treatment strategies relies on accurate diagnosis, which may be hampered by the presence of substantial nightly fluctuation in sleep apnea severity. We examined the amount of nightly fluctuation in the severity of sleep apnea around commonly used diagnostic and treatment cut points in individuals who underwent two nights of home sleep apnea testing (HSAT). Read More

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Multislice/multidetector-row computed tomography findings of a rare coronary anomaly: the first septal perforator branch originating from the left main coronary artery.

Folia Morphol (Warsz) 2018;77(3):597-600. Epub 2018 Jan 3.

Department of Radiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Centre, Trabzon, Turkey, Turkey.

Multislice/multidetector-row computed tomography (MDCT) is now widely used for noninvasive assessment of coronary arteries, and it may sometimes reveal coronary anomalies. Detection of such anomalies may be relevant both during follow-up and for planning cardiac or coronary surgical/interventional procedures. These anomalies may be missed unless carefully sought. Read More

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Pharmacotherapy of Apnea by Cannabimimetic Enhancement, the PACE Clinical Trial: Effects of Dronabinol in Obstructive Sleep Apnea.

Sleep 2018 01;41(1)

Northwestern University Department of Neurology, Division of Sleep Medicine, Chicago, IL.

Study Objectives: There remains an important and unmet need for fully effective and acceptable treatments in obstructive sleep apnea (OSA). At present, there are no approved drug treatments. Dronabinol has shown promise for OSA pharmacotherapy in a small dose-escalation pilot study. Read More

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January 2018

Prevalence of sleep apnoea and capnographic detection of nocturnal hypoventilation in amyotrophic lateral sclerosis.

J Neurol Neurosurg Psychiatry 2018 04 20;89(4):418-424. Epub 2017 Oct 20.

Department of Sleep Medicine and Neuromuscular Disorders, University Hospital Münster, Münster, Germany.

Objective: This retrospective study aimed to investigate whether overnight oxymetry and early morning blood gas analysis predict nocturnal hypoventilation (NH) as reflected by night-time hypercapnia in patients with amyotrophic lateral sclerosis (ALS). In addition, prevalence and clinical determinants of sleep apnoea in ALS were evaluated.

Methods: In 250 patients with non-ventilated ALS, transcutaneous capnometry was performed along with polysomnography or polygraphy and early morning blood gases. Read More

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Polysomnographic phenotypes and their cardiovascular implications in obstructive sleep apnoea.

Thorax 2018 05 21;73(5):472-480. Epub 2017 Sep 21.

Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.

Background: Obstructive sleep apnoea (OSA) is a heterogeneous disorder, and improved understanding of physiologic phenotypes and their clinical implications is needed. We aimed to determine whether routine polysomnographic data can be used to identify OSA phenotypes (clusters) and to assess the associations between the phenotypes and cardiovascular outcomes.

Methods: Cross-sectional and longitudinal analyses of a multisite, observational US Veteran (n=1247) cohort were performed. Read More

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Detection of Acute and Early HIV-1 Infections in an HIV Hyper-Endemic Area with Limited Resources.

PLoS One 2016 20;11(10):e0164943. Epub 2016 Oct 20.

Department of Internal Medicine, University of Pretoria, City of Tshwane, South Africa.

Background: Two thirds of the world's new HIV infections are in sub-Saharan Africa. Acute HIV infection (AHI) is the time of virus acquisition until the appearance of HIV antibodies. Early HIV infection, which includes AHI, is the interval between virus acquisition and establishment of viral load set-point. Read More

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Missed retrosternal ectopic thyroid tissue in a patient operated for multinodular goiter.

Ulus Cerrahi Derg 2016 19;32(1):67-70. Epub 2015 Jun 19.

Clinic of Cardiovascular Surgery, Ahi Evren Thorasic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey.

Ectopic thyroid tissue has been found from the tongue to the diaphragm. The most common ectopic thyroid tissue has been found in the tongue, submandibular region, cervical lymph nodes, larynx, trachea, oesophagus, mediastinum, diaphragm and heart respectively. "Forgotten goiter" is an extremely rare disease which is defined as a mediastinal thyroid mass found after total thyroidectomy. Read More

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[Clinical research on micro-movement sensitive mattress sleep monitoring system in children with obstructive sleep apnea hypopnea syndrome].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015 Mar;50(3):215-20

Objective: To evaluate the diagnostic value of micro-movement sensitive mattress sleep monitoring system (MSMSMS) in children with obstructive sleep apnea hypopnea syndrome.

Methods: Sixty-five children with the complaint of sleep disorder were collected and detected by polysomnography and micro-sensitive mattress sleep monitoring system overnight at least seven hours. The date from two instruments were analyzed by computer automatically and then modified by two professional staff double-blind separately. Read More

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A new approach in the diagnosis of upper airway resistance syndrome (UARS): PAP method.

Tuberk Toraks 2015 ;63(1):31-6

Department of Chest Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey.

Introduction: Upper airway resistance syndrome (UARS) is characterized by repeated number of arousals at night, and excessive daytime sleepiness or somnolence (EDS). It is often missed in classical polysomnographic diagnostic approaches and misdiagnosed as simple snoring or idiopathic hypersomnia, thereby is often left untreated. We propose that positive airway pressure (PAP), which has shown to be effective against UARS, can be used as a diagnostic tool as well. Read More

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October 2015

Evaluating New Definitions of Acute and Early HIV Infection from HIV Surveillance Data.

Open AIDS J 2014 30;8:45-9. Epub 2014 Sep 30.

Public Health -- Seattle & King County, Prevention Division, Seattle, WA, USA ; University of Washington, Department of Epidemiology, Seattle, WA, USA ; University of Washington, Department of Medicine, Seattle, WA, USA.

Background: The U.S. HIV staging system is being revised to more comprehensively track early and acute HIV infection (AHI). Read More

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October 2014

Overnight polysomnography versus respiratory polygraphy in the diagnosis of pediatric obstructive sleep apnea.

Sleep 2014 Feb 1;37(2):255-60. Epub 2014 Feb 1.

Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL.

Background: Substantial discrepancies exist in the type of sleep studies performed to diagnose pediatric obstructive sleep apnea (OSA) in different countries. Respiratory polygraphic (RP) recordings are primarily performed in sleep laboratories in Europe, whereas polysomnography (PSG) constitutes the majority in the US and Australia. Home RP show consistent apnea-hypopnea index (AHI) underscoring, primarily because the total recording time is used as the denominator when calculating the AHI compared to total sleep time (TST). Read More

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February 2014

Sleep disordered breathing in chronic spinal cord injury.

J Clin Sleep Med 2014 Jan 15;10(1):65-72. Epub 2014 Jan 15.

Sleep Research Laboratory, John D. Dingell Veterans Affairs Medical Center, Wayne State University, Detroit, MI.

Study Objectives: Spinal cord injury (SCI) is associated with 2-5 times greater prevalence of sleep disordered breathing (SDB) than the general population. The contribution of SCI on sleep and breathing at different levels of injury using two scoring methods has not been assessed. The objectives of this study were to characterize the sleep disturbances in the SCI population and the associated physiological abnormalities using quantitative polysomnography and to determine the contribution of SCI level on the SDB mechanism. Read More

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January 2014

A case of obstructive sleep apnea syndrome caused by malignant melanoma in the nasal cavity and paranasal sinus.

J Cancer Res Ther 2013 Apr-Jun;9(2):276-7

Department of Pulmonology, Kameda Medical Center, Chiba, Japan.

A 71 year-old obese woman complained of obstructive sleep apnea syndrome (OSAS) related symptoms. The apnea-hypopnea index (AHI) was 73.5/hour. Read More

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February 2014

Impaired vigilance and increased accident rate in public transport operators is associated with sleep disorders.

Accid Anal Prev 2013 Mar 20;51:208-14. Epub 2012 Dec 20.

Center for Sleep and Vigilance Disorders, Institution of Medicine, Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Objectives: Sleep disturbances can impair alertness and neurocognitive performance and increase the risk of falling asleep at the wheel. We investigated the prevalence of sleep disorders among public transport operators (PTOs) and assessed the interventional effects on hypersomnolence and neurocognitive function in those diagnosed with obstructive sleep apnea (OSA).

Methods: Overnight polygraphy and questionnaire data from 101 volunteers (72 males, median age 48 range [22-64] years, 87 PTOs) employed at the Gothenburg Public Transportation Company were assessed. Read More

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[Evaluation of a portable device based on peripheral arterial tone in the detection of obstructive sleep apnea].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012 Feb;47(2):112-6

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University; Capital University of Medical Sciences School of Otorhinolaryngology, Beijing 100020, China.

Objective: To assess the accuracy of a wrist-worn device (Watch-PAT 200) in the diagnosis of obstructive sleep apnea syndrome (OSAHS).

Methods: Forty-three adult subjects with suspected OSAHS simultaneously had a standard in-laboratory polysomnogram (PSG) and wore the Watch-PAT 200 during a full-night recording. PSG sleep and respiratory events were scored according to standard criteria. Read More

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February 2012

Rapid HIV screening: missed opportunities for HIV diagnosis and prevention.

J Clin Virol 2012 May 29;54(1):42-7. Epub 2012 Feb 29.

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

Background: Although rapid HIV tests increase the number of persons who are aware of their HIV status, they may fail to detect early HIV infection.

Objectives: To evaluate the sensitivity for early HIV infection of several rapid tests and third- and fourth-generation assays compared with nucleic acid amplification testing (NAAT).

Study Design: Sensitivity for early HIV infection was evaluated using 62 NAAT-positive/WB-negative or indeterminate specimens from the CDC Acute HIV Infection study. Read More

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Characterization of acute HIV-1 infection in high-risk Nigerian populations.

J Infect Dis 2012 Apr 21;205(8):1239-47. Epub 2012 Feb 21.

Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.

Background: Acute phase of human immunodeficiency virus (HIV) infection (AHI) may account for a significant proportion of HIV-1 transmission. We identified and characterized individuals in Nigeria with AHI.

Methods: Individuals were tested using a combination of rapid HIV testing in mobile units and laboratory-based specimen pooling for nucleic acid amplification testing. Read More

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The detection of acute HIV infection.

J Infect Dis 2010 Oct;202 Suppl 2:S270-7

Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7030, USA.

Acute human immunodeficiency virus (HIV) infection (AHI) can be defined as the time from HIV acquisition until seroconversion. Incident HIV infection is less well defined but comprises the time from the acquisition of HIV (acute infection) through seroconversion (early or primary HIV infection) and the following months until infection has been well established, as characterized by a stable HIV viral load (viral load set point) and evolution of antibodies with increased concentration and affinity for HIV antigens. During AHI, a viral latent pool reservoir develops, the immune system suffers irreparable damage, and the infected (often unsuspecting) host may be most contagious. Read More

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October 2010

First-night-effect on polysomnographic respiratory sleep parameters in patients with sleep-disordered breathing and upper airway pathology.

Eur Arch Otorhinolaryngol 2010 Sep 2;267(9):1449-53. Epub 2010 Feb 2.

Department of Otorhinolaryngology, The University Hospitals of Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.

The objective of this study is to test whether there is a difference between the polysomnographic (PSG) values of Apnea-hypopnea index (AHI), minimal oxygen saturation (SpO(2)), oxygen desaturation index (ODI) and arousal index recorded on two consecutive nights (so-called "first night effect") in patients with sleep-disordered breathing (SDB) and concomitant upper airway pathology. Retrospective case-control study of polysomnographical recordings of 130 patients (112 males, 18 females, age range 23-80 years) with SDB and upper airway pathology who were tested on two consecutive nights in a hospital sleep laboratory was conducted. Only patients with upper airway pathology without other medical conditions causing SDB were included. Read More

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September 2010

Evaluation of documentation in potential abusive head injury of infants in a Paediatric Emergency Department.

Acta Paediatr 2009 May;98(5):777-81

Astrid Lindgren Children's Hospital, Karolinska Institutet, Department of Woman and Child Health, Stockholm, Sweden.

Aim: The aim is to evaluate medical record documentation regarding potential abusive head injury (AHI) in infants presenting to a Paediatric Emergency Department (ED) with certain primary complaints known to be associated with AHI.

Methods: A database search was performed to find all medical records over a period of one year relating to those children who had one AHI-related primary complaint and who had had a CT head-scan performed in conjunction with admission. Each medical record was reviewed, in order to assess whether potential abuse had been investigated and documented. Read More

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Identifying people with acute HIV infection: demographic features, risk factors, and use of health care among individuals with AHI in North Carolina.

AIDS Behav 2009 Dec 6;13(6):1075-83. Epub 2009 Jan 6.

Department of Infectious Disease, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.

Identifying and counseling individuals with Acute HIV Infection (AHI) offers a critical opportunity to avert preventable HIV transmission, however, opportunities to recognize these individuals may be missed. We surveyed 32 adults diagnosed with AHI during voluntary HIV testing from 1/1/03 to 2/28/05 in publicly funded testing sites in NC to describe their clinical, social, and behavioral characteristics. Eighty-one percent of participants were men; 59% were African American. Read More

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December 2009

Clinical diagnosis of sleep apnea based on single night of polysomnography vs. two nights of polysomnography.

Sleep Breath 2009 Aug 9;13(3):221-6. Epub 2008 Dec 9.

Sleep Research Unit, Toronto Western Research Institute, University Health Network, ON, Canada.

Purpose: The purpose of this study was to investigate apnea-hypopnea index (AHI) across two polysomnographies (PSGs) to examine AHI variability and impact on clinical diagnosis.

Materials And Methods: Two-night PSGs of 193 sleep clinic patients were reviewed, and the AHI variability was analyzed. Anonymized records from five patients with significant night-to-night AHI variability were used in this study: the two-night PSGs from two patients were represented as four individual PSGs; the two-night PSG for two others were represented as being obtained from two different sleep clinics; the last patient's PSG was shown as a two-night study. Read More

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[Evaluation on the accuracy of obese indexes in predicting obstructive sleep apnea-hypopnea syndrome in male adults].

Zhonghua Liu Xing Bing Xue Za Zhi 2007 Oct;28(10):1021-5

Department of Geriatrics, 2nd Xiangya Hospital of Central-south University, Changsha, China.

Objective: To determine the best cutoff value and reference standard of obese indexes and to compare their diagnostic value in screening, predicting and diagnosing obstructive sleep apnea-hypopnea syndrome (OSAHS) in male adults by receiver operating characteristic curve (ROC).

Methods: A total of 1110 male adults were included and cross-sectional study was adopted. Four parameters including: body mass index (BMI), neck circumference (NC), waist circumference (WC) and waist-to-hip ratio (WHR) were studied. Read More

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October 2007

Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study.

Arch Intern Med 2002 Apr;162(8):893-900

Department of Population Health Sciences, University of Wisconsin, Madison, WI, USA.

Background: Sleep-disordered breathing (SDB) is common, but largely undiagnosed in the general population. Information on demographic patterns of SDB occurrence and its predictive factors in the general population is needed to target high-risk groups that may benefit from diagnosis.

Methods: The sample comprised 5615 community-dwelling men and women aged between 40 and 98 years who were enrolled in the Sleep Heart Health Study. Read More

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Diagnosing respiratory events and tracing air flow by internal thermistors.

Acta Otolaryngol 2000 Mar;120(3):414-9

SRBD Unit, Department of Otorhinolaryngology, Ullevaal University Hospital, Oslo, Norway.

We have developed a new method to measure flow in patients with sleep-related breathing disorders (SRBD). These flow sensors are modified thermistors located in the same sensors we use for pressure measurement in the upper airways to find the obstructive segments during apnoeas. The aim of this study was to test if using internal thermistors as indicator of air flow has advantages compared with the external thermistor method in detecting respiratory events. Read More

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Utility of home oximetry as a screening test for patients with moderate to severe symptoms of obstructive sleep apnea.

Sleep 1999 Nov;22(7):932-7

Respiratory Section, University Hospital Marqués de Valdecilla, University of Cantabria, Santander, Spain.

Objective: To determine the value of home oximetry as a screening test in patients with moderate to severe symptoms of obstructive sleep apnea (OSA).

Design: Retrospective, observational study.

Setting: The Sleep Unit of a tertiary referral, university hospital. Read More

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November 1999