The Evaluation of Adenotonsillectomy on TNF-α and IL-6 Levels in Obese Children With Obstructive Sleep Apnea

March 1, 2014 Chu L, Li Q

T&A therapy can improve clinical symptoms and signs but is not a cure for the treatment of obese children with OSA. The inflammation levels of TNF-α and IL-6 changed little. To reduce the risk for excessive daytime sleepiness, supplementary therapies should be introduced for OSA.

Clinical Pediatric, Literature Updates

Meta-Analysis Demonstrates Lack of Association Between the ACE Gene I/D Polymorphism and Obstructive Sleep Apnea-Hypopnea Syndrome Occurrence and Severity

March 1, 2014 Feng Y, Ri J, Wan HY, Shi GC, Li QY, Fan L

Overall, the ACE I/D polymorphism was not significantly associated with an increase in OSAHS risk [odds ratio (OR) = 1.21; 95% confidence interval (95%CI) = 0.88–1.65; P = 0.24].

Clinical Pediatric, Literature Updates

Nocturnal Autonomic Function in Preschool Children With Sleep-Disordered Breathing

March 1, 2014 Nisbet LC, Yiallourou SR, Nixon GM, Biggs SN, Davey MJ, Trinder J, Walter LM, Horne RS.

In preschool children, OSA is associated with altered HRV, largely due to the HF fluctuations in heart rate (HR) which occur during respiratory events and are still evident during stable sleep. The preschool age may represent a window of opportunity for treatment of OSA before the onset of the severe autonomic dysfunction associated with OSA in adults and older children.

Clinical Pediatric, Literature Updates

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

March 1, 2014 Kheirandish-Gozal L, McManus CJ, Kellermann GH, Samiei A, Gozal D.

Combinatorial approaches using defined cutoffs in overnight changes in concentrations of selected neurotransmitters in urine may not only predict OSA but also the presence of cognitive deficits. Larger cohort studies appear warranted to confirm these findings.

Clinical Pediatric, Literature Updates

Circulating Adropin Concentrations in Pediatric Obstructive Sleep Apnea: Potential Relevance to Endothelial Function

March 1, 2014 Gozal D, Kheirandish-Gozal L, Bhattacharjee R, Molero-Ramirez H, Tan HL, Bandla HP.

Plasma adropin concentrations are reduced in pediatric OSA when endothelial dysfunction is present, and return to within normal values after adenotonsillectomy. Assessment of circulating adropin concentrations may provide a reliable indicator of vascular injury in the context of OSA in children.

Clinical Pediatric, Literature Updates

Endothelial Dysfunction in Children With Obstructive Sleep Apnea is Associated With Epigenetic Changes in the eNOS Gene

March 1, 2014 Kheirandish-Gozal L, Khalyfa A, Gozal D, Bhattacharjee R, Wang Y

The presence of abnormal eNOS-dependent vascular responses in children with OSA is associated with epigenetic modifications in the eNOS gene.

Clinical Adult, Literature Updates

Sleep Apnea and Risk of Pneumonia: A Nationwide Population-Based Study

March 1, 2014 Su VY, Liu CJ, Wang HK, Wu LA, Chang SC, Perng DW, Su WJ, Chen YM, Lin EY, Chen TJ, Chou KT.

In this large population based study, over 34,000 patients were followed to explore the risk of incident pneumonia among adults with sleep apnea, either with or without the need of CPAP therapy. Using administrative databases, patients with sleep apnea were compared to controls matched for age, sex, and comorbidities. Kaplan-Meier analysis showed that patients with sleep apnea had a higher incidence of pneumonia. After multivariate adjustment, a 1.20-fold increase in incident pneumonia was noted in patients with sleep apnea. It was interesting to note that the risk was even higher among patients who received CPAP therapy, however data on compliance to therapy was not available. The limitations of the study include reliability of the administrative database codes for the diagnosis of sleep apnea possibly resulting in a misclassification bias.

Clinical Adult, Literature Updates

Inpatient Falls After Total Knee Arthroplasty: The Role of Anesthesia Type and Peripheral Nerve Blocks

March 1, 2014 Memtsoudis SG, Danninger T, Rasul R, Poeran J, Gerner P, Stundner O, Mariano ER, Mazumdar M

The aim of the study is to characterize cases of in-patient falls, identify risk factors.” Amongst anesthesia related risk factors, the authors identified the presence of sleep apnea as a significant risk factor for this event.

Clinical Adult, Literature Updates

Sleep Apnoea Adversely Affects the Outcome in Patients Who Undergo Posterior Lumbar Fusion: A Population-Based Study

March 1, 2014 Stundner O, Chiu YL, Sun X, Ramachandran SK, Gerner P, Vougioukas V, Mazumdar M, Memtsoudis SG.

Using a national database, patients who underwent lumbar fusion between 2006 and 2010 were identified, and sub-grouped by diagnosis of sleep apnoea and compared. Sleep apnoea emerged as an independent risk factor for the development of peri-operative complications (odds ratio (OR) 1.50, confidence interval (CI) 1.38;1.62), blood product transfusions (OR 1.12, CI 1.03;1.23), mechanical ventilation (OR 6.97, CI 5.90;8.23), critical care services (OR 1.86, CI 1.71;2.03), prolonged hospitalisation and increased cost (OR 1.28, CI 1.19;1.37; OR 1.10, CI 1.03;1.18).