Obstructive sleep apnea (OSA) in children and adolescents is much more prevalent than most practitioners realize: it is found in 1% to 4% of children… Read More
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PLoS ONE: an inclusive, peer-reviewed, open-access resource from the PUBLIC LIBRARY OF SCIENCE. Reports of well-performed scientific studies from all disciplines freely available to the whole world.
PLoS ONE: an inclusive, peer-reviewed, open-access resource from the PUBLIC LIBRARY OF SCIENCE. Reports of well-performed scientific studies from all disciplines freely available to the whole world.
Cortical arousal caused by sleep disturbance can be recorded with electroencephalography ( EEG). ... Pulse transit time has been used in infant sleep studies as a marker for autonomic perturbations, including spontaneous and provoked arousal,.
Archives of Otolaryngology-Head & Neck Surgery, a monthly peer-reviewed medical journal published by American Medical Association, publishes original, peer-reviewed clinical and basic research articles
Sleep problems are associated with reduced physical and mental health. Altered function of the hypothalamic-pituitary-adrenocortical axis (HPAA) may be one underlying mechanism. We studied the associations between sleep problems and HPAA activity in children.|A cross-sectional epidemiological cohort study.|Salivary cortisol was sampled throughout one day at home and during the Trier Social Stress Test for Children (TSST-C) in clinic. Sleepdisorders were measured with a parent-rated Sleep Disturbance Scale for Children, and sleep duration measured by actigraphy for one week.|284 (51% girls) 8-year-old children.|Boys with sleep problems ( 85 th percentile in any of the sleep-wake transition, arousal, excessive daytime somnolence or sleep hyperhydrosis subscales) had lower diurnal salivary cortisol levels and salivary cortisol responses to TSST-C stress in comparison to boys without sleep problems. Girls with sleep problems ( 85 th percentile in disorders of initiating and
Electrocortical arousal (ECA) as an effect of visceral provocation or of its temporal relationships with aerodigestive reflexes in premature neonates is not known. We tested the hypothesis that esophageal provocation results in both esophageal reflex responses and ECAs during sleep and that ECAs are dependent on the frequency characteristics of esophageal neuromotor responses. We defined the spatiotemporal relationship of ECAs in relation to 1) spontaneous pharyngoesophageal swallow sequences and gastroesophageal reflux (GER) events and 2) sensory-motor characteristics of esophageal reflexes. Sixteen healthy premature neonates born at 27.9 3.4 wk were tested at 36.8 1.9 wk postmenstrual age. Ninety-five midesophageal and 31 sham stimuli were given in sleep during concurrent manometry and videopolysomnography. With stimulus onset as reference point, we scored the response latency, frequency occurrence and duration of arousals, peristaltic reflex, and upper esophageal sphincter
Functional significance of delta oscillations is not fully understood. One way to approach this question would be from an evolutionary perspective. Delta oscillations dominate the EEG of waking reptiles. In humans, they are prominent only in early developmental stages and during slow-wave sleep. Increase of delta power has been documented in a wide array of developmental disorders and pathological conditions. Considerable evidence on the association between delta waves and autonomic and metabolic processes hints that they may be involved in integration of cerebral activity with homeostatic processes. Much evidence suggests the involvement of delta oscillations in motivation. They increase during hunger, sexual arousal, and in substance users. They also increase during panic attacks and sustained pain. In cognitive domain, they are implicated in attention, salience detection, and subliminal perception. This evidence shows that delta oscillations are associated with evolutionary old
Excitability is probably the concept that fits better with the definition of the role of neurophysiology in the study of brainstem functions and circuits. Neurophysiological techniques are likely the best suited of all paraclinical tests for documenting the eventual excitability changes that may occur in certain physiological states and in many neurological disorders. The best known test of brainstem excitability is the blink reflex. While a single stimulus can already indicate the readiness of the interneuronal path and the facial motoneurons to fire, pairs of stimuli (conditioning and test) are suited to analyze the degree of excitability recovery after a single discharge. Another brainstem reflex circuit, which excitability testing can be of interest for physiological and clinical exams is the one involved in the startle reaction. The size of the responses and their habituation are the typical measures of excitability of the startle reflex circuit. Prepulse inhibition is a method
Insulin resistance (IR) and disorders of glucose metabolism (DGM) are risk factors for cardiovascular diseases. There are different reasons for development of DGM in patients with obstructive sleep apnoea syndrome (OSAS) and this association is controversial. We investigated the frequency of DGM and IR in patients with OSAS and determining factors for these disorders.|One hundred and twelve untreated patients with OSAS and 19 non-apnoeic snoring subjects upon polysomnography were included in this study. Oral glucose tolerance test (OGTT) was performed in all subjects who had fasting blood glucose < 125 mg/dl. IR method was analysed using homeostasis assessment model (HOMA-IR). Diabetes mellitus (DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were defined according to values of OGTT. DGM was defined as having one of the diagnoses of DM, IGT or IFG. Subjective sleepiness of all subjects was assessed with Epworth Sleepiness Scale (ESS). Excessive daytime
Making Public Health Policy and Economics a Priority Bryan R. Fine, MD, MPH, May 21, 2012 Public health as an important part of an allopathic, clinical program may be intuitive to some, but implementing it is still a challenge.
Using Pinterest to Market Your Medical Practice Jenny Conviser, PsyD, May 18, 2012 Pinterest is quickly becoming the next big social media outlet, so here's an easy guide on how your practice can get online and connect with patients.
How to Close Your Medical Practice the Right Way Sue Jacques, May 16, 2012 Whether you've decided to retire, relocate, or retreat from practice, you can reduce the pain for your patients and staff by following these five guidelines.