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Sampol J, Ferrer J, Miravitlles M, Sáez M, Romero O, Sampol G. Poor sleep is associated with deficits of attention in COPD patients. Sleep Med 2023; 112:165-172. [PMID: 37866212 DOI: 10.1016/j.sleep.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/15/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Poor sleep and attention deficits are common in COPD. OBJECTIVES To assess the relationship between self-reported poor sleep and attention deficits in COPD. We also studied the association between self-reported sleep and the attention tests with the objective characteristics of sleep. METHODS Fifty-nine COPD patients were prospectively studied. Self-reported sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Objective characteristics of sleep were assessed by actigraphy and polysomnography. Attention was evaluated with the Oxford sleep resistance test (OSLER) and the Psychomotor vigilance test (PVT). RESULTS 28 (47 %) patients referred poor sleep (PSQI >5). In the OSLER test they showed earlier sleep onset than patients with good sleep, median (Interquartil range): 31.2 min (25.4-40) vs 40 min (28.5-40), p: 0.048. They also spent more time making errors: 4.5 % (0.6-7.6) of total test time vs 0.7 % (0.2-5.3), p: 0.048. In PVT, patients with poor sleep presented a greater dispersion of the reaction time values with a higher value in the slowest 10 % of the reactions, 828 (609-1667) msec. vs 708 (601-993) msec, p: 0.028. No association was found between self-reported poor sleep and objective sleep variables. We found no correlation between OSLER and PVT results and polysomnographic variables except between sleep efficiency and PVT response speed (β: 0.309, p: 0.018). CONCLUSION Self-reported poor sleep in COPD is associated with attention deficits. Sleep quality should be included in future studies of this facet of cognition in COPD, as well as to assess its potential usefulness as a therapeutic target.
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Affiliation(s)
- Júlia Sampol
- Respiratory Department, Vall d'Hebron University Hospital, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIIII), Barcelona, Spain; Multidisciplinary Sleep Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Jaume Ferrer
- Respiratory Department, Vall d'Hebron University Hospital, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIIII), Barcelona, Spain
| | - Marc Miravitlles
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIIII), Barcelona, Spain; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - María Sáez
- Respiratory Department, Vall d'Hebron University Hospital, Barcelona, Spain; Multidisciplinary Sleep Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Odile Romero
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIIII), Barcelona, Spain; Multidisciplinary Sleep Unit, Vall d'Hebron University Hospital, Barcelona, Spain; Neurophysiology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Gabriel Sampol
- Respiratory Department, Vall d'Hebron University Hospital, Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIIII), Barcelona, Spain; Multidisciplinary Sleep Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
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Jurado MJ, Sampol J, Quintana M, Romero O, Cambrodí R, Ferré A, Sampol G. End-tidal and transcutaneous CO 2 monitoring during sleep in children aged under three with suspected sleep apnea. Pediatr Pulmonol 2023; 58:963-966. [PMID: 36453512 DOI: 10.1002/ppul.26264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022]
Affiliation(s)
- María J Jurado
- Department of Clinical Neurophysiology, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Madrid, Spain
| | - Júlia Sampol
- Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Madrid, Spain.,Department of Respiratory Care, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manuel Quintana
- Department of Neurology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Odile Romero
- Department of Clinical Neurophysiology, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Madrid, Spain
| | - Roser Cambrodí
- Department of Clinical Neurophysiology, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Madrid, Spain
| | - Alex Ferré
- Department of Clinical Neurophysiology, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gabriel Sampol
- Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Madrid, Spain.,Department of Respiratory Care, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Cañellas Dols F, Entrambasaguas M, Wix R, Alvarez A, Romero O, Carvajal P, Pujol J, Puertas F. Insomnia Subtypes. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jurado MJ, Sampol G, Quintana M, Romero O, Cambrodí R, Ferré A, Sampol J. Nasal cannula use during polysomnography in children aged under three with suspected sleep apnea. Sleep Med 2022; 99:41-48. [PMID: 35947888 DOI: 10.1016/j.sleep.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Early diagnosis of obstructive sleep apnea (OSA) in children is important. The use of a nasal cannula as an airflow sensor during polysomnography has not been evaluated in younger children. The study aims to evaluate the use of nasal cannula in detecting respiratory events in children under three with suspected OSA during daytime nap studies. METHODS A total of 185 patients were prospectively included. Respiratory events were scored using nasal cannula alone, thermistor alone, and both methods simultaneously as the airflow sensor. Agreement and diagnostic accuracy were assessed. RESULTS One hundred and seventy-two children were finally analyzed and 110 (64.0%) presented OSA. Total sleep time with an uninterpretable signal was longer with the nasal cannula than with the thermistor (17.8% vs 1.9%; p < 0.001), and was associated with poor sensor tolerance and adenotonsillar hypertrophy. In the estimation of the apnea-hypopnea index, the nasal cannula showed lower agreement than the thermistor with the joint use of the two sensors (intraclass correlation coefficient: 0.79 vs 0.996 with thermistor). Compared with the thermistor, the nasal cannula presented lower sensitivity for detecting OSA (82.7% vs 95.5%) and a lower negative predictive value (76.5% vs 92.4%). Overall, fewer children were diagnosed with severe OSA with the nasal cannula (19.8% vs 30.8% with the thermistor, and 32.6% with both). CONCLUSIONS In children under the age of three, the ability of the nasal cannula to detect obstructive events was relatively low. Therefore, other non-invasive measurements for identifying respiratory events during sleep may be of additional value.
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Affiliation(s)
- María José Jurado
- Department of Clinical Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Avenida de Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Gabriel Sampol
- Department of Respiratory Care, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Avenida de Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Manuel Quintana
- Department of Neurology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | - Odile Romero
- Department of Clinical Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Avenida de Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Roser Cambrodí
- Department of Clinical Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Avenida de Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Alex Ferré
- Department of Clinical Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | - Júlia Sampol
- Department of Respiratory Care, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Multidisciplinary Sleep Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Avenida de Monforte de Lemos, 3-5, 28029, Madrid, Spain.
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Abstract
Melatonin is the main hormone involved in the control of the sleep-wake cycle. It is easily synthesisable and can be administered orally, which has led to interest in its use as a treatment for insomnia. Moreover, as production of the hormone decreases with age, in inverse correlation with the frequency of poor sleep quality, it has been suggested that melatonin deficit is at least partly responsible for sleep disorders. Treating this age-related deficit would therefore appear to be a natural way of restoring sleep quality, which is lost as patients age. However, despite the undeniable theoretical appeal of this approach to insomnia, little scientific evidence is available that supports any benefit of this substitutive therapy. Furthermore, the most suitable dose ranges and pharmaceutical preparations for melatonin administration are yet to be clearly defined. This review addresses the physiology of melatonin, the different pharmaceutical preparations, and data on its clinical usefulness.
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Affiliation(s)
- J J Poza
- Servicio de Neurología, Hospital Universitario Donostia, San Sebastián, España.
| | - M Pujol
- Unidad Multidisciplinar de Sueño, Hospital Universitario de Santa María, Lleida, España
| | - J J Ortega-Albás
- Unidad de Sueño, Hospital General Universitario de Castellón, Castellón, España
| | - O Romero
- Unidad Multidisciplinar de Sueño, Hospital Universitario Vall d́Hebron, Barcelona, España
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Alcazar M, Escribano J, Ferré N, Closa-Monasterolo R, Selma-Royo M, Feliu A, Castillejo G, Luque V, Closa-Monasterolo R, Escribano J, Luque V, Feliu-Rovira A, Ferré N, Muñoz-Hernando J, Gutiérrez-Marín D, Zaragoza-Jordana M, Gispert-Llauradó M, Rubio-Torrents M, Núñez-Roig M, Alcázar M, Sentís S, Esteve M, Monné-Gelonch R, Basora J, Flores G, Hsu P, Rey-Reñones C, Alegret C, Guillen N, Alegret-Basora C, Ferre R, Arasa F, Alejos A, Diéguez M, Serrano M, Mallafré M, González-Hidalgo R, Braviz L, Resa A, Palacios M, Sabaté A, Simón L, Losilla A, De La Torre S, Rosell L, Adell N, Pérez C, Tudela-Valls C, Caro-Garduño R, Salvadó O, Pedraza A, Conchillo J, Morillo S, Garcia S, Mur E, Paixà S, Tolós S, Martín R, Aguado F, Cabedo J, Quezada L, Domingo M, Ortega M, Garcia R, Romero O, Pérez M, Fernández M, Villalobos M, Ricomà G, Capell E, Bosch M, Donado A, Sanchis F, Boix A, Goñi X, Castilla E, Pinedo M, Supersaxco L, Ferré M, Contreras J, Sanz-Manrique N, Lara A, Rodríguez M, Pineda T, Segura S, Vidal S, Salvat M, Mimbrero G, Albareda A, Guardia J, Gil S, Lopez M, Ruiz-Escusol S, Gallardo S, Machado P, Bocanegra R, Espejo T, Vendrell M, Solé C, Urbano R, Vázquez M, Fernández-Antuña L, Barrio M, Baudoin A, González N, Olivé R, Lara R, Dinu C, Vidal C, González S, Ruiz-Morcillo E, Ainsa M, Vilalta P, Aranda B, Boada A, Balcells E. Gut microbiota is associated with metabolic health in children with obesity. Clin Nutr 2022; 41:1680-1688. [DOI: 10.1016/j.clnu.2022.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/16/2022] [Accepted: 06/04/2022] [Indexed: 11/03/2022]
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Martí S, Ferré A, Sampol G, Pallero M, Romero O, Ferrer J, Sampol J. Sleep increases leaks and asynchronies during home noninvasive ventilation: a polysomnographic study. J Clin Sleep Med 2022; 18:225-233. [PMID: 34314351 PMCID: PMC8807927 DOI: 10.5664/jcsm.9546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
STUDY OBJECTIVES In patients treated with noninvasive ventilation, sleep-related breathing changes can modify patient-ventilator interactions, which could reduce its effectiveness. The aim of this prospective observational study was to determine the impact of sleep/wake state on leaks, upper airway obstructive events, and asynchronies in patients treated by long-term noninvasive ventilation. METHODS Stable patients adapted to noninvasive ventilation were considered for nocturnal polysomnography. Unintentional leaks, upper airway obstructive events, and asynchronies were compared between sleep and awake periods. RESULTS Twenty-eight patients were enrolled. Underlying diagnoses were neuromuscular disease (n = 11), chest wall disease (n = 8), and obesity-hypoventilation (n = 9). Leaks were more frequent in sleep than in awake periods, with a median of 10% (interquartile range [IQR], 0%-75%) vs 1% (IQR, 0%-9%) of time (P < .001), respectively. During sleep, asynchronies with and without associated leak affected 27% of breaths (IQR, 16%-39%) compared with non-leak-related asynchronies that were recorded in 8% (IQR, 3%-25%) of breaths (P < .001). Asynchronies affecting more than 10% of total breaths were more frequent in sleep (25 patients, 89%) than in awake time (8 patients, 29%; P = .25). Eleven patients (39%) presented with 5 or more upper airway obstructive events without reduction in ventilatory drive per hour of sleep. CONCLUSIONS In patients adapted to home noninvasive ventilation, leaks, asynchronies, and upper airway obstructive events are frequent during the night and are concentrated in sleep periods. Asynchronies are often associated with leaks. These findings may have clinical implications considering that in patients with low sleep efficiency respiratory events could be underestimated if sleep is not evaluated. CITATION Martí S, Ferré A, Sampol G, et al. Sleep increases leaks and asynchronies during home noninvasive ventilation: a polysomnographic study. J Clin Sleep Med. 2022;18(1):225-233.
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Affiliation(s)
- Sergi Martí
- Respiratory Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain,Address correspondence to: Sergi Martí, MD, PhD, Respiratory Department, Hospital Universitari Vall d’Hebron, Passeig Vall d’Hebron, 119-129, 08035 Barcelona, Spain;
| | - Alex Ferré
- Sleep Unit, Hospital Universitari Vall d’Hebron, Barcelona, Spain,Neurophysiology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Gabriel Sampol
- Respiratory Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain,Sleep Unit, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Mercedes Pallero
- Respiratory Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Odile Romero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain,Sleep Unit, Hospital Universitari Vall d’Hebron, Barcelona, Spain,Neurophysiology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Jaume Ferrer
- Respiratory Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Júlia Sampol
- Respiratory Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain,Sleep Unit, Hospital Universitari Vall d’Hebron, Barcelona, Spain
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Poza J, Pujol M, Ortega-Albás J, Romero O. Melatonin in sleep disorders. Neurología (English Edition) 2020; 37:575-585. [DOI: 10.1016/j.nrleng.2018.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 08/18/2018] [Indexed: 12/18/2022] Open
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Riba-Llena I, Álvarez-Sabin J, Romero O, Santamarina E, Sampol G, Maisterra O, Ferré Á, Montaner J, Quintana M, Delgado P. Nighttime hypoxia affects global cognition, memory, and executive function in community-dwelling individuals with hypertension. J Clin Sleep Med 2020; 16:243-250. [PMID: 31992414 DOI: 10.5664/jcsm.8174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The objective of this study was to determine which respiratory and architectural sleep parameters are related to cognitive function and cognitive status (mild cognitive impairment [MCI] versus normal cognitive aging [NCA]) in community-dwelling individuals with hypertension. Additionally, it aimed to determine whether the results changed in the presence or absence of vascular brain lesions (silent brain infarcts and extensive white matter hyperintensities [WMHs]). METHODS In a cohort of individuals with hypertension and without previous stroke or dementia, we conducted in-hospital polysomnography including electroencephalography, electro-oculography, electromyography, and magnetic resonance imaging to assess silent brain infarcts and WMHs. Cognitive testing was carried out with a screening test (Dementia Rating Scale version 2 [DRS-2]) and a complete cognitive visit. RESULTS This study included 158 participants with a median age of 65.0 years; 32.3% were females, and the median apnea-hypopnea index was 22.3 events/h. MCI was diagnosed in 24 study participants, and the rest had NCA. Regarding respiratory parameters, total DRS-2 scores (β; 95% CI) 0.121; 0.026, 0.215 were positively associated with mean O₂ saturation, whereas total (-0.022; -0.036, -0.009), executive function (-0.016; -0.026, -0.006) and memory (-0.017; -0.029, -0.004) DRS-2 scores were all negatively associated with the percent of time with oxygen saturation < 90% after correcting for education, vascular risk factors, and magnetic resonance imaging lesions. Regarding sleep architecture, Attention DRS-2 scores (0.0153; 0.001, 0.306) were independently associated with total sleep time. Similar results were obtained in the absence of silent brain infarcts or WMHs in the stratified analysis. None of the sleep parameters were associated with cognitive status. CONCLUSIONS Low oxygen saturation contributes to cognitive performance, and this effect appears even in the absence of vascular brain lesions in individuals with hypertension.
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Affiliation(s)
- Iolanda Riba-Llena
- Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Álvarez-Sabin
- Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Odile Romero
- Multidisciplinary Sleep Unit, Department of Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Estevo Santamarina
- Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gabriel Sampol
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Multidisciplinary Sleep Unit, Respiratory Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Olga Maisterra
- Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Álex Ferré
- Multidisciplinary Sleep Unit, Department of Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Montaner
- Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manuel Quintana
- Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Delgado
- Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Porta AV, Béjar JA, Trastulli D, Llabata P, Pros E, Villanueva A, Romero O, Sanchez-Cespedes M. EP1.14-39 BRG1 Deficient Cells Are Sensitive to the Inhibition of Specific Lysine Demethylases (KDMs) in Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ferré Á, Poca MA, de la Calzada MD, Moncho D, Urbizu A, Romero O, Sampol G, Sahuquillo J. A Conditional Inference Tree Model for Predicting Sleep-Related Breathing Disorders in Patients With Chiari Malformation Type 1: Description and External Validation. J Clin Sleep Med 2019; 15:89-99. [PMID: 30621833 DOI: 10.5664/jcsm.7578] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 09/13/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The aim of this study is to generate and validate supervised machine learning algorithms to detect patients with Chiari malformation (CM) 1 or 1.5 at high risk of the development of sleep-related breathing disorders (SRBD) using clinical and neuroradiological parameters. METHODS We prospectively included two independent datasets. A training dataset (n = 90) was used to obtain the best model, whereas a second dataset was used to validate it (n = 74). In both cohorts, the same clinical, neuroradiological, and sleep studies were carried out. We used two supervised machine learning approaches, multiple logistic regression (MLR) and the unbiased recursive partitioning technique conditional inference tree (URP-CTREE), to detect patients at high risk of SRBD. We then compared the accuracy, sensitivity, and specificity of the two prediction models. RESULTS Age (odds ratio [OR] 1.1 95% confidence interval [CI] 1.05-1.17), sex (OR 0.19 95% CI 0.05-0.67), CM type (OR 4.36 95% CI 1.14-18.5), and clivus length (OR 1.14 95% CI 1.01-1.31) were the significant predictor variables for a respiratory disturbance index (RDI) cutoff that was ≥ 10 events/h using MLR. The URP-CTREE model predicted that patients with CM-1 who were age 52 years or older and males with CM-1 who were older than 29 years had a high risk of SRBD. The accuracy of predicting patients with an RDI ≥ 10 events/h was similar in the two cohorts but in the URP-CTREE model, specificity was significantly greater when compared to MLR in both study groups. CONCLUSIONS Both MLR and URP-CTREE predictive models are useful for the diagnosis of SRBD in patients with CM. However, URP-CTREE is easier to apply and interpret in clinical practice.
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Affiliation(s)
- Álex Ferré
- Clinical Neurophysiology Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain.,Multidisciplinary Sleep Unit, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain.,Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital, Barcelona, Spain
| | - María A Poca
- Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital, Barcelona, Spain.,Neurosurgery Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - María Dolore de la Calzada
- Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital, Barcelona, Spain
| | - Dulce Moncho
- Clinical Neurophysiology Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain.,Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital, Barcelona, Spain
| | - Aintzane Urbizu
- Conquer Chiari Research Center, Department of Mechanical Engineering, The University of Akron, Ohio
| | - Odile Romero
- Clinical Neurophysiology Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain.,Multidisciplinary Sleep Unit, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Madrid, Spain
| | - Gabriel Sampol
- Multidisciplinary Sleep Unit, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de la Salud Carlos III (ISCIIII), Madrid, Spain.,Pneumology Department, Vall d'Hebron Research institute, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Juan Sahuquillo
- Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital, Barcelona, Spain.,Neurosurgery Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
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12
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Castro-Marrero J, Zaragozá MC, González-Garcia S, Aliste L, Sáez-Francàs N, Romero O, Ferré A, Fernández de Sevilla T, Alegre J. Poor self-reported sleep quality and health-related quality of life in patients with chronic fatigue syndrome/myalgic encephalomyelitis. J Sleep Res 2018; 27:e12703. [PMID: 29770505 DOI: 10.1111/jsr.12703] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 03/23/2018] [Indexed: 11/28/2022]
Abstract
Non-restorative sleep is a hallmark symptom of chronic fatigue syndrome/myalgic encephalomyelitis. However, little is known about self-reported sleep disturbances in these subjects. This study aimed to assess the self-reported sleep quality and its impact on quality of life in a Spanish community-based chronic fatigue syndrome/myalgic encephalomyelitis cohort. A prospective cross-sectional cohort study was conducted in 1,455 Spanish chronic fatigue syndrome/myalgic encephalomyelitis patients. Sleep quality, fatigue, pain, functional capacity impairment, psychopathological status, anxiety/depression and health-related quality of life were assessed using validated subjective measures. The frequencies of muscular, cognitive, neurological, autonomic and immunological symptom clusters were above 80%. High scores were recorded for pain, fatigue, psychopathological status, anxiety/depression, and low scores for functional capacity and quality of life, all of which correlated significantly (all p < 0.01) with quality of sleep as measured by the Pittsburgh Sleep Quality Index. Multivariate regression analysis showed that after adjusting for age and gender, the pain intensity (odds ratio, 1.11; p <0.05), psychopathological status (odds ratio, 1.85; p < 0.001), fibromyalgia (odds ratio, 1.39; p < 0.05), severe autonomic dysfunction (odds ratio, 1.72; p < 0.05), poor functional capacity (odds ratio, 0.98; p < 0.05) and quality of life (odds ratio, 0.96; both p < 0.001) were significantly associated with poor sleep quality. These findings suggest that this large chronic fatigue syndrome/myalgic encephalomyelitis sample presents poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index, and that this poor sleep quality is associated with many aspects of quality of life.
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Affiliation(s)
- Jesús Castro-Marrero
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria C Zaragozá
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Clinical Research Department, Laboratorios Viñas, Barcelona, Spain
| | - Sergio González-Garcia
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luisa Aliste
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Odile Romero
- Sleep Unit, Clinical Neurophysiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.,Instituto de Salud Carlos III, CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Alex Ferré
- Sleep Unit, Clinical Neurophysiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.,Instituto de Salud Carlos III, CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Tomás Fernández de Sevilla
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Alegre
- CFS/ME Unit, Internal Medicine Service, Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
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13
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Cobos M, Trunzo L, Vogt M, Romero O, Anessi C, Pachado J, Ciávaro M, Horak C, Bacqué M. Sterility and Safety Validation for Transport Packaging of Organs and Tissues. Transplant Proc 2018; 50:416-417. [DOI: 10.1016/j.transproceed.2017.12.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 12/05/2017] [Indexed: 11/25/2022]
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14
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Tió E, Gaig C, Giner-Soriano M, Romero O, Jurado MJ, Sansa G, Pujol M, Sans O, Álvarez-Guerrico I, Caballol N, Jimenez M, Becerra JL, Escartin A, Monasterio C, Molins A, Bove A, Viña J, Iranzo A, Cambrodi R, Calvo G, Morros R, Santamaria J. The prevalence of narcolepsy in Catalunya (Spain). J Sleep Res 2017; 27:e12640. [DOI: 10.1111/jsr.12640] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/02/2017] [Accepted: 10/18/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Ester Tió
- Neurology Department; Althaia; Xarxa Assistencial Universitària; Manresa Spain
| | - Carles Gaig
- Multidisciplinary Sleep Unit; Neurology Department; Hospital Clínic Barcelona; Barcelona Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Maria Giner-Soriano
- Institut Universitari d'Investigació en Atenció Primaria (IDIAP) Jordi Gol; Institut Català de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | - Odile Romero
- Multidiscilplinary Sleep Unit; Neurophisiology Department; Hospital Vall d'Hebrón; Barcelona Spain
| | - Maria-José Jurado
- Multidiscilplinary Sleep Unit; Neurophisiology Department; Hospital Vall d'Hebrón; Barcelona Spain
| | - Gemma Sansa
- Multidisciplinary Sleep Unit; Neurology Department; Hospital Parc Taulí; Sabadell Spain
| | - Montse Pujol
- Multidisciplinary Sleep Unit; Neurology Department; Hospital Universitari Santa Maria Lleida; Lleida Spain
| | - Oscar Sans
- Multidisciplinary Sleep Unit; Pediatrics Department; Hospital Sant Joan de Déu; Barcelona Spain
| | - Ion Álvarez-Guerrico
- Multidisciplinary Sleep Unit; Neurophisiology Department; Hospital del Mar; Barcelona Spain
| | - Nuria Caballol
- Neurology Department; Hospital Moisès Broggi; Sant Joan Despí Spain
| | - Marta Jimenez
- Neurology Department; Hospital Germans Trías i Pujol; Badalona Spain
| | - Juan-Luis Becerra
- Neurology Department; Hospital Germans Trías i Pujol; Badalona Spain
| | - Antonio Escartin
- Neurology Department; Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - Carmen Monasterio
- Multidisciplinary Sleep Unit; Respiratory Department; Hospital Universitari de Bellvitge; Catalunya Spain
| | - Albert Molins
- Neurology Department; Hospital Universitari Josep Trueta; Girona Spain
| | - Antoni Bove
- Sleep Unit; Hospital de Sant Pau i Santa Tecla; Tarragona Spain
| | - Jaume Viña
- Neurology Department; Hospital Joan XXIII; Tarragona Spain
| | - Alex Iranzo
- Multidisciplinary Sleep Unit; Neurology Department; Hospital Clínic Barcelona; Barcelona Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Roser Cambrodi
- Multidiscilplinary Sleep Unit; Neurophisiology Department; Hospital Vall d'Hebrón; Barcelona Spain
| | - Gonzalo Calvo
- Department of Clinical Pharmacology; Hospital Clínic Barcelona; Barcelona Spain
| | - Rosa Morros
- Institut Universitari d'Investigació en Atenció Primaria (IDIAP) Jordi Gol; Institut Català de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | - Joan Santamaria
- Multidisciplinary Sleep Unit; Neurology Department; Hospital Clínic Barcelona; Barcelona Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
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15
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Corral J, Mogollon MV, Sánchez-Quiroga MÁ, Gómez de Terreros J, Romero A, Caballero C, Teran-Santos J, Alonso-Álvarez ML, Gómez-García T, González M, López-Martínez S, de Lucas P, Marin JM, Romero O, Díaz-Cambriles T, Chiner E, Egea C, Lang RM, Mokhlesi B, Masa JF. Echocardiographic changes with non-invasive ventilation and CPAP in obesity hypoventilation syndrome. Thorax 2017; 73:361-368. [DOI: 10.1136/thoraxjnl-2017-210642] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/20/2017] [Accepted: 10/30/2017] [Indexed: 11/03/2022]
Abstract
RationaleDespite a significant association between obesity hypoventilation syndrome (OHS) and cardiac dysfunction, no randomised trials have assessed the impact of non-invasive ventilation (NIV) or CPAP on cardiac structure and function assessed by echocardiography.ObjectivesWe performed a secondary analysis of the data from the largest multicentre randomised controlled trial of OHS (Pickwick project, n=221) to determine the comparative efficacy of 2 months of NIV (n=71), CPAP (n=80) and lifestyle modification (control group, n=70) on structural and functional echocardiographic changes.MethodsConventional transthoracic two-dimensional and Doppler echocardiograms were obtained at baseline and after 2 months. Echocardiographers at each site were blinded to the treatment arms. Statistical analysis was performed using intention-to-treat analysis.ResultsAt baseline, 55% of patients had pulmonary hypertension and 51% had evidence of left ventricular hypertrophy. Treatment with NIV, but not CPAP, lowered systolic pulmonary artery pressure (−3.4 mm Hg, 95% CI −5.3 to –1.5; adjusted P=0.025 vs control and P=0.033 vs CPAP). The degree of improvement in systolic pulmonary artery pressure was greater in patients treated with NIV who had pulmonary hypertension at baseline (−6.4 mm Hg, 95% CI −9 to –3.8). Only NIV therapy decreased left ventricular hypertrophy with a significant reduction in left ventricular mass index (−5.7 g/m2; 95% CI −11.0 to –4.4). After adjusted analysis, NIV was superior to control group in improving left ventricular mass index (P=0.015). Only treatment with NIV led to a significant improvement in 6 min walk distance (32 m; 95% CI 19 to 46).ConclusionIn patients with OHS, medium-term treatment with NIV is more effective than CPAP and lifestyle modification in improving pulmonary hypertension, left ventricular hypertrophy and functional outcomes. Long-term studies are needed to confirm these results.Trial registration numberPre-results, NCT01405976 (https://clinicaltrials.gov/).
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16
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De Fabregues O, Dot J, Abu-Suboh M, Hernández-Vara J, Ferré A, Romero O, Ibarria M, Seoane JL, Raguer N, Puiggros C, Gómez MR, Quintana M, Armengol JR, Alvarez-Sabín J. Long-term safety and effectiveness of levodopa-carbidopa intestinal gel infusion. Brain Behav 2017; 7:e00758. [PMID: 28828219 PMCID: PMC5561319 DOI: 10.1002/brb3.758] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/26/2017] [Accepted: 06/04/2017] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Levodopa-carbidopa intestinal gel (LCIG) infusion has demonstrated to improve motor fluctuations. The aim of this study is to assess the long-term safety and effectiveness of LCIG infusion in advanced Parkinson's disease (PD) patients with motor fluctuations and its effect in nonmotor symptoms. METHODS Adverse events (AE) and their management, clinical motor, and nonmotor aspects were assessed up to 10 years. Thirty-seven patients were treated with LGIC; in three subsets of patients, specific batteries of tests were used to assess cognitive and behavior assessment for 6 months, quality of sleep for 6 months, and quality of life and caregiver burden for 1 year. RESULTS There was a high number of AE, but manageable, most of mild and moderate severity. All patients experienced significant improvement in motor fluctuations with a reduction in mean daily off time of 4.87 hr after 3 months (n = 37) to 6.25 hr after 9 years (n = 2). Diskynesias remained stables in 28 patients (75.7%) and improved in 5 patients (13.5%). There was no neuropsychological deterioration, but an improvement in attentional functions, voluntary motor control, and semantic fluency. Quality of sleep did not worsen, and there was an improvement in the subjective parameters, although overnight polysomnography did not change. There was a significant sustained improvement of 37% in PD-Q39 after 3 months and to 1 year, and a significant reduction in caregiver burden of 10% after 3 months. CONCLUSION LCIG infusion is a safe and efficacious treatment for the control of motor fluctuations, and for improvement or nonworsening of nonmotor aspects, long-term sustained, and feasible for use in routine care.
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Affiliation(s)
- Oriol De Fabregues
- Movement Disorders Unit Neurology Department Vall d'Hebron University Hospital Neurodegenerative Diseases Research Group-Vall d'Hebron Research Institute Autonomous University of Barcelona Barcelona Spain
| | - Joan Dot
- Digestive Endoscopy Department Vall d'Hebron University Hospital Barcelona Spain
| | - Monder Abu-Suboh
- Digestive Endoscopy Department Vall d'Hebron University Hospital Barcelona Spain
| | - Jorge Hernández-Vara
- Movement Disorders Unit Neurology Department Vall d'Hebron University Hospital Neurodegenerative Diseases Research Group-Vall d'Hebron Research Institute Autonomous University of Barcelona Barcelona Spain
| | - Alex Ferré
- Sleep Unit Neurophysiology Department Vall d'Hebron University Hospital Barcelona Spain
| | - Odile Romero
- Sleep Unit Neurophysiology Department Vall d'Hebron University Hospital Barcelona Spain
| | - Marta Ibarria
- Movement Disorders Unit Neurology Department Vall d'Hebron University Hospital Neurodegenerative Diseases Research Group-Vall d'Hebron Research Institute Autonomous University of Barcelona Barcelona Spain
| | - José Luis Seoane
- Electromyography Unit Neurophysiology Department Vall d'Hebron University Hospital Barcelona Spain
| | - Nuria Raguer
- Electromyography Unit Neurophysiology Department Vall d'Hebron University Hospital Barcelona Spain
| | - Carolina Puiggros
- Nutritional Support Department Vall d'Hebron University Hospital Barcelona Spain
| | - Maria Rosa Gómez
- Pharmacy Department Vall d'Hebron University Hospital Barcelona Spain
| | - Manuel Quintana
- Movement Disorders Unit Neurology Department Vall d'Hebron University Hospital Neurodegenerative Diseases Research Group-Vall d'Hebron Research Institute Autonomous University of Barcelona Barcelona Spain
| | - Josep Ramon Armengol
- Digestive Endoscopy Department Vall d'Hebron University Hospital Barcelona Spain
| | - José Alvarez-Sabín
- Movement Disorders Unit Neurology Department Vall d'Hebron University Hospital Neurodegenerative Diseases Research Group-Vall d'Hebron Research Institute Autonomous University of Barcelona Barcelona Spain
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17
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Alvarez-Sabín J, Romero O, Delgado P, Quintana M, Santamarina E, Ferré A, Maisterra O, Riba-Llena I, Montaner J, Sampol G. Obstructive sleep apnea and silent cerebral infarction in hypertensive individuals. J Sleep Res 2017. [PMID: 28631309 DOI: 10.1111/jsr.12571] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Obstructive sleep apnea syndrome is very prevalent in hypertensive subjects. Moreover, obstructive sleep apnea syndrome activates multiple processes that might be associated with silent cerebral infarct independently of established risk factors. Our aim is to estimate the frequency of obstructive sleep apnea syndrome in hypertensive patients with and without silent cerebral infarct, and to determine whether obstructive sleep apnea syndrome is an independent risk factor of silent cerebral infarct and/or lacunar silent cerebral infarct in patients with hypertension. In this matched cross-sectional study performed in hypertensive subjects, each patient with silent cerebral infarct detected by magnetic resonance imaging was matched with two patients without silent cerebral infarct. Polysomnographic studies were performed, and the apnea-hypopnea index was calculated. Severe obstructive sleep apnea syndrome was considered in those with apnea-hypopnea index >30. One-hundred and eighty-three patients, 61 with silent cerebral infarct and 122 without silent cerebral infarct, were evaluated. The mean age was 64.1 ± 4.5 years, and 72.1% were men. The frequency of severe obstructive sleep apnea syndrome was 44.3% in patients with silent cerebral infarct and 38.5% in the control group. An adjusted conditional logistic regression model did not show a significant increased risk of silent cerebral infarct in patients with severe obstructive sleep apnea syndrome (odds ratio 1.362; 95% confidence interval: 0.659-2.813; P = 0.404). Forty-three patients (70.5%) of the silent cerebral infarct were lacunar. The presence of severe obstructive sleep apnea syndrome was significantly higher in lacunar silent cerebral infarct when compared with patients without lacunar infarcts (55.8% versus 35.7%, P = 0.019), being independently associated on an adjusted logistic regression model (odds ratio 2.177; 95% confidence interval: 1.058-4.479; P = 0.035). In conclusion, severe obstructive sleep apnea syndrome is highly prevalent among hypertensive subjects, and is independently associated with lacunar silent cerebral infarct.
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Affiliation(s)
- José Alvarez-Sabín
- Department of Neurology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Odile Romero
- Multidisciplinary Sleep Unit, Department of Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Pilar Delgado
- Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manuel Quintana
- Department of Neurology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Estevo Santamarina
- Department of Neurology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alex Ferré
- Multidisciplinary Sleep Unit, Department of Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Olga Maisterra
- Department of Neurology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Iolanda Riba-Llena
- Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Montaner
- Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gabriel Sampol
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Multidisciplinary Sleep Unit, Respiratory Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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18
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Ferré Á, Poca MA, de la Calzada MD, Moncho D, Romero O, Sampol G, Sahuquillo J. Sleep-Related Breathing Disorders in Chiari Malformation Type 1: A Prospective Study of 90 Patients. Sleep 2017; 40:3766874. [DOI: 10.1093/sleep/zsx069] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Lecube A, Romero O, Sampol G, Mestre O, Ciudin A, Sánchez E, Hernández C, Caixàs A, Vigil L, Simó R. Sleep biosignature of Type 2 diabetes: a case-control study. Diabet Med 2017; 34:79-85. [PMID: 27278263 DOI: 10.1111/dme.13161] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 01/30/2023]
Abstract
AIM To determine whether or not the sleep disturbances associated with Type 2 diabetes affect the structure of sleep. METHODS We designed a case-control study in 76 patients with Type 2 diabetes and 76 control subjects without Type 2 diabetes, matched by age, gender, BMI and waist and neck circumferences. A subgroup of 32 patients with Type 2 diabetes was also matched with 64 control subjects without Type 2 diabetes according to apnoea-hypopnoea index score. Examination included an overnight full polysomnography. RESULTS No differences in the percentage of time spent in either rapid eye movement or non-rapid eye movement sleep were observed between groups; however, patients with Type 2 diabetes had more microarousal events during sleep than control subjects [41.4 (total range 4.0-104.4) vs 20.7 (total range 1.3-94.5) events/h; P < 0.001]. These differences were mainly observed during the non-rapid eye movement sleep [7.4 (total range 0-107.2) vs 0.2 (total range 0-65.2) events/h; P < 0.001]. In addition, sleep variables related to oxygen saturation measures, such as the percentage of time spent with oxygen saturation ≤90%, were significantly greater during the rapid eye movement sleep in patients with Type 2 diabetes [20.3 (total range 0-99.2) vs. 10.5 (total range 0-94.0)%; P = 0.047]. This pattern was maintained in the subgroup of patients matched by apnoea-hypopnaea index. Finally, stepwise regression analyses showed that apnoea-hypopnoea index, the presence of Type 2 diabetes and fasting plasma glucose value were independently associated with the number of microarousals (R2 =0.667). CONCLUSIONS Type 2 diabetes is associated with an altered sleep structure, with different effects according to rapid eye movement (increase in nocturnal hypoxia) or non-rapid eye movement (increase in sleep fragmentation) sleep.
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Affiliation(s)
- A Lecube
- Department of Endocrinology and Nutrition, Hospital Universitari Arnau de Vilanova, IRBLLEIDA, Universitat de Lleida, Lleida, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Department of Endocrinology, Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - O Romero
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Sleep Unit, Department of Neurophysiology, Institut de Recerca i Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Sampol
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Sleep Unit, Department of Pneumology, Institut de Recerca i Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - O Mestre
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Department of Endocrinology, Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Ciudin
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Department of Endocrinology, Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Sánchez
- Department of Endocrinology and Nutrition, Hospital Universitari Arnau de Vilanova, IRBLLEIDA, Universitat de Lleida, Lleida, Spain
| | - C Hernández
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Department of Endocrinology, Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Caixàs
- Department of Endocrinology and Nutrition, Corporació Sanitària Parc Taulí, Parc Taulí, Spain
| | - L Vigil
- Sleep Unit, Department of Pneumology, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - R Simó
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Department of Endocrinology, Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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20
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González-Cuevas M, Romero O, Toledo M, Quintana M, Cambrodí R, Santamarina E, Jurado MJ, Ferrer A, Salas-Puig X. Effect of adjunctive perampanel on the quality of sleep and daytime somnolence in patients with epilepsy. Epilepsy Behav Case Rep 2016; 7:13-15. [PMID: 28066710 PMCID: PMC5200874 DOI: 10.1016/j.ebcr.2016.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/05/2016] [Accepted: 10/13/2016] [Indexed: 11/29/2022]
Abstract
This prospective uncontrolled study evaluated the effect of low-dose adjunctive perampanel therapy (4 mg/day for 3 months) on the sleep-wake cycle and daytime somnolence in adult patients (n = 10) with focal seizures. A > 50% reduction in the number of seizures was reported in 80% of the study patients; treatment had no significant effect on any sleep parameters as evident by the Maintenance of Wakefulness Test, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale scores. Two patients reported dizziness with treatment. In conclusion, low-dose perampanel may improve seizure control without affecting the sleep characteristics or daytime somnolence in patients with epilepsy.
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Affiliation(s)
| | - Odile Romero
- Sleep Unit, Neurophysiology Department, Hospital Vall Hebron, Barcelona, Spain
| | - Manuel Toledo
- Epilepsy Unit, Neurology Department, Hospital Vall Hebron, Barcelona, Spain
| | - Manuel Quintana
- Epilepsy Unit, Neurology Department, Hospital Vall Hebron, Barcelona, Spain
| | - Roser Cambrodí
- Sleep Unit, Neurophysiology Department, Hospital Vall Hebron, Barcelona, Spain
| | - Estevo Santamarina
- Epilepsy Unit, Neurology Department, Hospital Vall Hebron, Barcelona, Spain
| | - Maria José Jurado
- Sleep Unit, Neurophysiology Department, Hospital Vall Hebron, Barcelona, Spain
| | - Alex Ferrer
- Sleep Unit, Neurophysiology Department, Hospital Vall Hebron, Barcelona, Spain
| | - Xavier Salas-Puig
- Epilepsy Unit, Neurology Department, Hospital Vall Hebron, Barcelona, Spain
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Lecube A, Sánchez E, Gómez-Peralta F, Abreu C, Valls J, Mestre O, Romero O, Martínez MD, Sampol G, Ciudin A, Hernández C, Simó R. Global Assessment of the Impact of Type 2 Diabetes on Sleep through Specific Questionnaires. A Case-Control Study. PLoS One 2016; 11:e0157579. [PMID: 27315083 PMCID: PMC4912108 DOI: 10.1371/journal.pone.0157579] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 06/01/2016] [Indexed: 12/12/2022] Open
Abstract
Abstract Type 2 diabetes (T2D) is an independent risk factor for sleep breathing disorders. However, it is unknown whether T2D affects daily somnolence and quality of sleep independently of the impairment of polysomnographic parameters. Material and Methods A case-control study including 413 patients with T2D and 413 non-diabetic subjects, matched by age, gender, BMI, and waist and neck circumferences. A polysomnography was performed and daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). In addition, 135 subjects with T2D and 45 controls matched by the same previous parameters were also evaluated through the Pittsburgh Sleep Quality Index (PSQI) to calculate sleep quality. Results Daytime sleepiness was higher in T2D than in control subjects (p = 0.003), with 23.9% of subjects presenting an excessive daytime sleepiness (ESS>10). Patients with fasting plasma glucose (FPG ≥13.1 mmol/l) were identified as the group with a higher risk associated with an ESS>10 (OR 3.9, 95% CI 1.8–7.9, p = 0.0003). A stepwise regression analyses showed that the presence of T2D, baseline glucose levels and gender but not polysomnographic parameters (i.e apnea-hyoapnea index or sleeping time spent with oxigen saturation lower than 90%) independently predicted the ESS score. In addition, subjects with T2D showed higher sleep disturbances [PSQI: 7.0 (1.0–18.0) vs. 4 (0.0–12.0), p<0.001]. Conclusion The presence of T2D and high levels of FPG are independent risk factors for daytime sleepiness and adversely affect sleep quality. Prospective studies addressed to demonstrate whether glycemia optimization could improve the sleep quality in T2D patients seem warranted.
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Affiliation(s)
- Albert Lecube
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Biomedical Research Institute of Lleida (IRBLLEIDA), Universitat de Lleida, Av Rovira Roure 80, 25198, Lleida, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
- * E-mail:
| | - Enric Sánchez
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Biomedical Research Institute of Lleida (IRBLLEIDA), Universitat de Lleida, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Fernando Gómez-Peralta
- Endocrinology and Nutrition Unit, Segovia General Hospital, C/Miguel Servet s/n, 40002, Segovia, Spain
| | - Cristina Abreu
- Endocrinology and Nutrition Unit, Segovia General Hospital, C/Miguel Servet s/n, 40002, Segovia, Spain
| | - Joan Valls
- Biostatistics and Epidemiology Unit, Biomedical Research Institute of Lleida (IRBLLEIDA), Av Rovira Roure 80, 25198, Lleida, Spain
| | - Olga Mestre
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - Odile Romero
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Sleep Unit, Neurophysiology Department, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - María Dolores Martínez
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Biomedical Research Institute of Lleida (IRBLLEIDA), Universitat de Lleida, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Gabriel Sampol
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Sleep Unit, Pneumology Department, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - Andreea Ciudin
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - Cristina Hernández
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
| | - Rafael Simó
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Pg Vall d’Hebron 119-129, 08035, Barcelona, Spain
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Moreno-Pérez S, Fernández-Lorente G, Romero O, Guisán JM, López-Gallego F. Fabrication of heterogeneous biocatalyst tethering artificial prosthetic groups to obtain omega-3-fatty acids by selective hydrolysis of fish oils. RSC Adv 2016. [DOI: 10.1039/c6ra21121f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Immobilized enzymes tethering artificial prosthetic groups improve both the hydrolysis rate and the selectivity towards the eicosapentaenoic acid acyl chains.
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Affiliation(s)
- S. Moreno-Pérez
- Enzymatic Engineering Group
- Instituto de Catálisis y Petroleoquímica
- CSIC
- Madrid
- Spain
| | - G. Fernández-Lorente
- Food Microbiology and Biocatalysis Group
- Institute of Food Science Research
- CSIC
- Madrid
- Spain
| | - O. Romero
- Enzymatic Engineering Group
- Instituto de Catálisis y Petroleoquímica
- CSIC
- Madrid
- Spain
| | - J. M. Guisán
- Enzymatic Engineering Group
- Instituto de Catálisis y Petroleoquímica
- CSIC
- Madrid
- Spain
| | - F. López-Gallego
- Heterogeneus Biocatalysis Group
- CIC BiomaGUNE
- San Sebastian-Donostia
- Spain
- Ikerbasque, Basque Foundation for Science
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Lecube A, Sampol G, Hernández C, Romero O, Ciudin A, Simó R. Characterization of sleep breathing pattern in patients with type 2 diabetes: sweet sleep study. PLoS One 2015; 10:e0119073. [PMID: 25760760 PMCID: PMC4356580 DOI: 10.1371/journal.pone.0119073] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 01/10/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although sleep apnea-hypopnea syndrome (SAHS) is highly prevalent in patients with type 2 diabetes (T2D), it is unknown whether or not subjects with and without T2D share the same sleep breathing pattern. METHODOLOGY/PRINCIPAL FINDINGS A cross-sectional study in patients with SAHS according to the presence (n = 132) or not (n = 264) of T2D. Both groups were matched by age, gender, BMI, and waist and neck circumferences. A subgroup of 125 subjects was also matched by AHI. The exclusion criteria included chronic respiratory disease, alcohol abuse, use of sedatives, and heart failure. A higher apnea hypopnea index (AHI) was observed in T2D patients [32.2 (10.2-114.0) vs. 25.6 (10.2-123.4) events/hours; p = 0.002). When sleep events were evaluated separately, patients with T2D showed a significant increase in apnea events [8.4 (0.1-87.7) vs. 6.3 (0.0-105.6) e/h; p = 0.044), as well as a two-fold increase in the percentage of time spent with oxygen saturation <90% [15.7 (0.0-97.0) vs. 7.9 (0.0-95.6) %; <0.001)], higher rates of oxygen desaturation events, and also higher daily sleepiness [7.0 (0.0-21.0) vs. 5.0 (0.0-21.0); p = 0.006)] than subjects without T2D. Significant positive correlations between fasting plasma glucose and AHI, the apnea events, and CT90 were observed. Finally, multiple linear regression analyses showed that T2D was independently associated with AHI (R2 = 0.217), the apnea index (R2 = 0.194), CT90 (R2 = 0.222), and desaturation events. CONCLUSIONS/SIGNIFICANCE T2D patients present a different pattern of sleep breathing than subject without diabetes. The most important differences are the severity of hypoxemia and the number of apneas whereas the incidence of hypopnea episodes is similar.
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Affiliation(s)
- Albert Lecube
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Endocrinology Department, Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, IRB-Lleida, Universitat de Lleida, Lleida, Spain
- * E-mail:
| | - Gabriel Sampol
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Sleep Unit, Neurophysiology Department, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Hernández
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Endocrinology Department, Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Odile Romero
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Sleep Unit, Neurophysiology Department, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andreea Ciudin
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Endocrinology Department, Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rafael Simó
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Endocrinology Department, Diabetes and Metabolism Research Unit, Institut de Recerca i Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
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Filice M, Romero O, Gutiérrez-Fernández J, de las Rivas B, Hermoso JA, Palomo JM. Synthesis of a heterogeneous artificial metallolipase with chimeric catalytic activity. Chem Commun (Camb) 2015; 51:9324-7. [DOI: 10.1039/c5cc02450a] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The practical synthesis in high overall yields of a heterogeneous artificial copper-lipase with chimeric catalytic activity (native plus artificial) is presented here. This novel hybrid catalyst showed excellent catalytic properties in Diels–Alder and cascade reactions.
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Affiliation(s)
- M. Filice
- Departamento de Biocatálisis, Instituto de Catálisis
- CSIC
- Marie Curie 2
- Campus UAM
- Madrid
| | - O. Romero
- Departamento de Biocatálisis, Instituto de Catálisis
- CSIC
- Marie Curie 2
- Campus UAM
- Madrid
| | - J. Gutiérrez-Fernández
- Departamento de Cristalografía y Biología Estructural
- Instituto de Química-Física Rocasolano (CSIC)
- Serrano 119
- Madrid
- Spain
| | - B. de las Rivas
- Departamento de Biotecnología Microbiana
- Instituto de Ciencia y Tecnología de alimentos y Nutrición
- (CSIC)
- Madrid
- Spain
| | - J. A. Hermoso
- Departamento de Cristalografía y Biología Estructural
- Instituto de Química-Física Rocasolano (CSIC)
- Serrano 119
- Madrid
- Spain
| | - J. M. Palomo
- Departamento de Biocatálisis, Instituto de Catálisis
- CSIC
- Marie Curie 2
- Campus UAM
- Madrid
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Sotelo M, Pesce H, Romero O. Un nuevo caso de Blastomicoma Blastomicoide Sudamericano. An Fac med 2014. [DOI: 10.15381/anales.v43i3.6327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Desde 1937, año en que P. WEISS y T. ZAVALETA publicaron el primer caso peruano de la micosis profunda denominado Blastomicosis Sudamericana, esta afección ha sido objeto de estudio entre nosotros habiéndose referido hasta ahora 20 casos publicados y 10 en curso de estudio y motivo de Tesis (O.R.), todos procedentes de nuestra amazonía.
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Jurado M, Sampol G, Romero O. Assessment of noninvasive PACO2 and nasal-cannula pressure transducer during polysomnography in children younger than 3years with osas. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Banea O, Cambrodí R, Espadaler J, Romero O. Neurophysiologic analysis of spontaneous nocturnal neck myoclonus in an 18-year-old patient. Neurophysiol Clin 2013. [DOI: 10.1016/j.neucli.2013.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Ferre A, Rahnama K, Vila J, Cambrodi R, Jurado M, Romero O. Cardiorespiratory polygraphy diagnostic accuracy in mild to moderate obstructive sleep apnea hypopnea syndrome (OSAHS). Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ferre A, Poca M, La Calzada MD, Moncho D, Romero O, Sahuquillo J. Sleep related breathing disorders (SRBD) in patients with chiari type I malformation before and after posterior fossa decompression. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ferre A, Ribó M, Rodríguez-Luna D, Romero O, Sampol G, Molina C, Álvarez-Sabin J. Strokes and their relationship with sleep and sleep disorders. Neurología (English Edition) 2013. [DOI: 10.1016/j.nrleng.2010.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Méndez E, Pérez M, Romero O, Beltrán E, Castro S, Corona J, Corona A, Cuevas M, Bustos E. Effects of electrode material on the efficiency of hydrocarbon removal by an electrokinetic remediation process. Electrochim Acta 2012. [DOI: 10.1016/j.electacta.2012.04.042] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ferré A, Vila J, Jurado MJ, Arcalis N, Camps J, Cambrodi R, Romero O. Sleep-related painful erections associated with obstructive sleep apnea syndrome. Arch Sex Behav 2012; 41:1059-1063. [PMID: 22350120 DOI: 10.1007/s10508-011-9894-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 07/14/2011] [Accepted: 11/05/2011] [Indexed: 05/31/2023]
Abstract
Sleep-related painful erection is a rare syndrome recognized by reports of painful nocturnal erection, an association between REM sleep and pain, and the absence of pain during wakeful sexual activity. Approximately 30 cases have been reported in the literature. We add two more cases, each of which seemed to be associated with severe sleep apnea. Treatment of the apnea with Continuous Positive Airway Pressure device lessened the symptom in both men. Implications of this association are discussed.
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Affiliation(s)
- Alex Ferré
- Sleep Unit and Clinical Neurophysiology Department, Vall d'Hebrón University Hospital, Barcelona, Spain.
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Ferré A, Sampol G, Jurado MJ, Cambrodi R, Lloberes P, Romero O. Neurophysiological two-channel polysomnographic device in the diagnosis of sleep apnea. J Clin Sleep Med 2012; 8:163-8. [PMID: 22505861 DOI: 10.5664/jcsm.1770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVE Our objective was to evaluate a portable device (Somté, Compumedics, Australia), which incorporates 2 neurophysiological channels (electroencephalography and electrooculography) with cardiorespiratory monitoring for the diagnosis of obstructive sleep apnea (OSA). METHOD Full polysomnography (PSG) and Somté recordings were simultaneously performed in 68 patients with suspected OSA. Data were analyzed blindly by 2 scorers. RESULTS A good agreement between methods in sleep efficiency was observed (68.8% [18.4] with PSG vs 68% [19.1] with Somté [p: n.s.] for scorer 1, and 67.5% [19.1] vs 68.4% [18.5; p: n.s.] for scorer 2). The apnea-hypopnea index (AHI) obtained with Somté was lower than with PSG: 19 (17.8) vs 21.7 (19) (p < 0.001) for scorer 1, and 16.6 (16.7) vs 20 (18.8) (p < 0.001) for scorer 2. The sensitivity of Somté for a PSG-AHI > 5 was 91% for scorer 1 and 90% for scorer 2, while specificity was 77% and 90%, respectively. The areas under the receiver operating curve for different PSG-AHI cutoff points (≥ 5, ≥ 15, and ≥ 30) were 0.81, 0.90, and 0.86, respectively, for scorer 1, and 0.90, 0.88, and 0.83 for scorer 2. CONCLUSIONS These data suggest that Somté is an effective device to identify sleep and respiratory variables in patients with suspected OSA.
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Affiliation(s)
- Alex Ferré
- Unidad Multidisciplinar de Sueño, Hospital Universitario Vall d'Hebrón, Paseo Vall d'Hebrón 119-12908035, Barcelona.
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Esteve N, Ribera H, Mora C, Romero O, Garrido P, Verd M. [Treating acute postoperative pain: evaluation of results on the surgical ward]. Rev Esp Anestesiol Reanim 2011; 58:353-361. [PMID: 21797085 DOI: 10.1016/s0034-9356(11)70084-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To describe management of acute postoperative pain on the surgical ward. To study the relationship between pain and a variety of surgical procedures and approaches. To determine the level of information patients received, their expectations, and their satisfaction with treatment of postoperative pain. PATIENTS AND METHODS Cross-sectional observational study by survey and review of patient records. We studied 234 patients, including all who were hospitalized for more than 24 hours after scheduled or emergency operations. The main variables recorded were pain intensity at rest and during movement, including on the day after surgery, and the surgical procedure and approach. RESULTS The prevalence of pain (>3 on a numerical scale) on the surgical ward was 33% at rest and 66% during movement. The prevalence of intense pain (>6 on the numerical scale) was 1.7% at rest and 7.3% during movement. Factors related to greater pain intensity were timing, that is, the first day after surgery, when 74.4% of patients experienced their most intense pain; type of surgery and approach (P<.004); and expecting to experience moderate or intense pain (P<.001). CONCLUSIONS Recording the prevalence of postoperative pain on a surgical ward provides information about the real situation of acute postoperative pain control. Pain on movement is a principal indicator for detecting groups of patients for whom analgesic protocols could be improved. Type of surgery and approach is a fundamental factor to consider when comparing the results of analgesic protocols.
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Affiliation(s)
- N Esteve
- Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitari Son Espases, Palma de Mallorca.
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Lloberes P, Lozano L, Sampol G, Romero O, Jurado MJ, Ríos J, Untoria MD, Tovar JL. Obstructive sleep apnoea and 24-h blood pressure in patients with resistant hypertension. J Sleep Res 2011; 19:597-602. [PMID: 20545837 DOI: 10.1111/j.1365-2869.2010.00839.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Obstructive sleep apnoea (OSA) is common in patients with resistant hypertension, but understanding of the pathogenic mechanisms linking both conditions is limited. This study assessed the prevalence of OSA and the relationships between OSA and 24-h blood pressure (BP) in 62 consecutive patients with resistant hypertension, defined as clinic BP values ≥ 140/90 despite the prescription of at least three drugs at adequate doses, including a diuretic. In order to exclude a 'white coat effect', only patients with ambulatory 24-h BP values ≥ 125/80 were recruited. Patients underwent polysomnography, 24-h ambulatory BP monitoring and completed the Epworth sleepiness scale (ESS). OSA was defined as an apnoea-hypopnoea index (AHI) ≥ 5 and excessive daytime sleepiness (EDS) by an ESS ≥ 10. A multiple linear regression analysis was used to assess the association of anthropometric data, OSA severity measures and ESS with 24-h systolic and diastolic BP. Mean 24-h BP values were 139.14/80.98 mmHg. Ninety per cent of patients had an AHI ≥ 5 and 70% had an AHI ≥ 30. Only the ESS was associated with 24-h diastolic BP [slope 0.775, 95% confidence interval (CI) 0.120-1.390, P < 0.02); age was associated negatively with 24-h diastolic BP (slope -0.64, 95% CI -0.874 to -0.411, P < 0.001). Compared with those without EDS, patients with EDS showed a significantly higher frequency of diastolic non-dipping pattern (69.2% versus 34.7%, P < 0.032). Our results demonstrate a high prevalence of severe OSA in patients with resistant hypertension and suggest that EDS could be a marker of a pathogenetic mechanism linking OSA and hypertension.
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Affiliation(s)
- Patricia Lloberes
- Department of Pulmonology (Sleep Unit), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Ferre A, Ribó M, Rodríguez-Luna D, Romero O, Sampol G, Molina CA, Álvarez-Sabin J. Strokes and their relationship with sleep and sleep disorders. Neurologia 2010; 28:103-18. [PMID: 21163212 DOI: 10.1016/j.nrl.2010.09.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 08/26/2010] [Accepted: 09/18/2010] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION In the current population, strokes are one of the most important causes of morbidity and mortality, to which new risk factors are increasingly being attributed. Of late, there is increased interest in the relationship between sleep disorders and strokes as regards risk and prognosis. DEVELOPMENT This article presents the changes in sleep architecture and brain activity in stroke patients, as well as the interaction between stroke and sleep disorders, including those which may also influence the outcome and recovery from strokes. The different treatments discussed in the literature are also reviewed, as correct treatment of such sleep disorders may not only improve quality of life and reduce after-effects, but can also increase life expectancy. CONCLUSIONS Sleep disorders are becoming increasingly associated with stroke. In addition to being a risk factor, they can also interfere in the outcome and recovery of stroke patients. This article aims to present an exhaustive and current review on strokes and their relationship with sleep alterations and sleep disorders.
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Affiliation(s)
- A Ferre
- Servicio de Neurofisiología Clínica, Unidad de Sueño, Hospital Universitario de la Vall d'Hebron, Barcelona, España.
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Sampol G, Rodés G, Ríos J, Romero O, Lloberes P, Morell F. [Acute hypercapnic respiratory failure in patients with sleep apneas]. Arch Bronconeumol 2010; 46:466-72. [PMID: 20655644 DOI: 10.1016/j.arbres.2010.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 05/10/2010] [Accepted: 05/16/2010] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Acute hypercapnic respiratory failure (AHRF) is a serious condition observed in some patients with sleep apnea-hypopnea syndrome (SAHS). The objective of the present study was to study the clinical characteristics of SAHS patients who develop AHRF and their prognosis. PATIENTS AND METHOD A total of 70 consecutive SAHS patients who survived an AHRF episode and 70 SAHS patients paired by age with no previous history of AHRF were prospectively studied and followed up for 3 years. RESULTS The deterioration of lung function due to obesity or concomitant chronic obstructive pulmonary diseases (COPD) was common in SAHS patients with AHRF. In the multivariate analysis, the risk factors associated with AHRF were baseline PaO(2,) the theoretical percentage value of the forced vital capacity, alcohol consumption, and benzodiazepines. The mortality during follow up was higher among patients who had AHRF than in the control group. The main cause of death was respiratory, and the coexistence of COPD was identified as a mortality risk factor. CONCLUSIONS The development of AHRF in SAHS patients is associated with a deterioration in lung function and with alcohol and benzodiazepine consumption. The patients had a higher mortality after the AHRF episode, mainly a respiratory cause. New studies are required that evaluate the different available therapeutic options in these patients.
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Affiliation(s)
- Gabriel Sampol
- Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, España.
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Sampol G, Rodés G, Ríos J, Romero O, Lloberes P, Morell F. Acute Hypercapnic Respiratory Failure in Patients with Sleep Apneas. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1579-2129(10)70114-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lecube A, Sampol G, Lloberes P, Romero O, Mesa J, Hernández C, Simó R. Diabetes is an independent risk factor for severe nocturnal hypoxemia in obese patients. A case-control study. PLoS One 2009; 4:e4692. [PMID: 19262746 PMCID: PMC2650786 DOI: 10.1371/journal.pone.0004692] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 01/18/2009] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and obesity have become two of the main threats to public health in the Western world. In addition, obesity is the most important determinant of the sleep apnea-hypopnea syndrome (SAHS), a condition that adversely affects glucose metabolism. However, it is unknown whether patients with diabetes have more severe SAHS than non-diabetic subjects. The aim of this cross-sectional case-control study was to evaluate whether obese patients with T2DM are more prone to severe SAHS than obese non-diabetic subjects. METHODOLOGY/PRINCIPAL FINDINGS Thirty obese T2DM and 60 non-diabetic women closely matched by age, body mass index, waist circumference, and smoking status were recruited from the outpatient Obesity Unit of a university hospital. The exclusion criteria included chronic respiratory disease, smoking habit, neuromuscular and cerebrovascular disease, alcohol abuse, use of sedatives, and pregnancy. Examinations included a non-attended respiratory polygraphy, pulmonary function testing, and an awake arterial gasometry. Oxygen saturation measures included the percentage of time spent at saturations below 90% (CT90). A high prevalence of SAHS was found in both groups (T2DM:80%, nondiabetic:78.3%). No differences in the number of sleep apnea-hypopnea events between diabetic and non-diabetic patients were observed. However, in diabetic patients, a significantly increase in the CT90 was detected (20.2+/-30.2% vs. 6.8+/-13,5%; p = 0.027). In addition, residual volume (RV) was significantly higher in T2DM (percentage of predicted: 79.7+/-18.1 vs. 100.1+/-22.8; p<0.001). Multiple linear regression analyses showed that T2DM but not RV was independently associated with CT90. CONCLUSIONS/SIGNIFICANCE T2DM adversely affects breathing during sleep, becoming an independent risk factor for severe nocturnal hypoxemia in obese patients. Given that SAHS is a risk factor of cardiovascular disease, the screening for SAHS in T2DM patients seems mandatory.
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Affiliation(s)
- Albert Lecube
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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Selva-O'Callaghan A, Sampol G, Romero O, Lloberes P, Trallero-Araguás E, Vilardell-Tarrés M. Obstructive sleep apnea in patients with inflammatory myopathies. Muscle Nerve 2009; 39:144-9. [DOI: 10.1002/mus.21204] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Roldán N, Sampol G, Sagalés T, Romero O, José Jurado M, Ríos J, Lloberes P. Análisis de coste-eficacia de la graduación automática de la presión positiva continua de la vía aérea en el domicilio: ¿una o 2 noches? Arch Bronconeumol 2008. [DOI: 10.1016/s0300-2896(08)75775-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Roldán N, Sampol G, Sagalés T, Romero O, Jurado MJ, Ríos J, Lloberes P. [Cost-effectiveness analysis of automatic titration of continuous positive airway pressure at home in 1 night versus 2 nights]. Arch Bronconeumol 2008; 44:664-670. [PMID: 19091235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To assess the cost-effectiveness of automatic continuous positive airway pressure (CPAP) titration at home on 1 night or 2 consecutive nights in patients with the sleep apnea-hypopnea syndrome (SAHS). PATIENTS AND METHODS A home titration study was performed using automatic CPAP for 2 consecutive nights on 100 patients with SAHS and an indication for CPAP. The number of successful studies and the costs of the first night and both nights were analyzed. The pressure requirements on each night and the agreement between the pressures selected visually by 2 different observers were compared. RESULTS CPAP titration was successful in 85% and 80% of patients on the first night and second night, respectively, and in 88% of patients after both nights. No significant differences between the 2 nights were found for the following parameters: 95th percentile pressure (mean [SD], 10.2 [1.8] cm H(2)O and 10.2 [1.6] cm H(2)O on the first and second nights, respectively), mean pressure (7.8 [1.7] cm H(2)O and 7.7 [1.7] cm H(2)O), or the pressure selected visually (9.4 [1.5] cm H(2)O and 9.4 [1.4] cm H(2)O). Interobserver agreement on the pressure selected was good: the k statistics were 0.956 for the first night and 0.91 for the second night. The 1-night study cost euro232.63 and the 2-night study cost euro227.93. CONCLUSIONS Automatic CPAP titration at home for 1 night enables a substantially greater number of patients to be studied at a similar cost than is possible when titration is accomplished in 2 consecutive nights.
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Affiliation(s)
- Nicolás Roldán
- Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Barcelona, España
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Mita AC, Yee LK, Papadopoulos KP, Heath EI, Romero O, Lloyd GK, Cropp G, Spear MA, Mita MM, LoRusso PM. Phase I study of NPI-2358 (a novel vascular disrupting agent) in patients with solid tumors and lymphomas. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.3525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sarantopoulos J, Mita AC, Mulay M, Romero O, Lu J, Capilla F, Chen L, Hwang Y, Friberg G, Rosen LS. A phase IB study of AMG 479, a type 1 insulin-like growth factor receptor (IGF1R) antibody, in combination with panitumumab (P) or gemcitabine (G). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.3583] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Roldán N, Sampol G, Sagalés T, Romero O, Jurado MJ, Ríos J, Lloberes P. Cost-Effectiveness Analysis of Automatic Titration of Continuous Positive Airway Pressure at Home in 1 Night Versus 2 Nights. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1579-2129(09)60004-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zojwalla NJ, Takimoto CH, Lucarelli AG, Clark R, Mita AC, Mita MM, Romero O, Schuck EL, Krivelevich I, Sweeney CJ. A phase I trial of E7974 administered on days 1, 8, and 15 of a 28-day cycle in patients with solid malignancies. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.2543] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2543 Background: E7974 is a synthetic hemiasterlin analogue exhibiting binding to a and β tubulin. It induces disruption of spindle formation and mitotic arrest characteristic of anti-tubulin cancer drugs. Unlike taxanes and vincas, E7974 is a poor substrate for the PgP drug efflux pump, potentially overcoming this common mechanism of drug resistance. E7974 demonstrates broad anti-tumor activity against a number of human tumor xenografts. Methods: We conducted the initial Phase I trial using an accelerated dose escalation design to determine the maximum tolerated dose (MTD) and pharmacokinetic (PK) profile of E7974 administered IV over 2–5 minutes on Days 1, 8, and 15 of a 28-day cycle. Results: Sixteen patients (7 male, 9 female) with a variety of tumor types and a median age of 54 yrs.(range: 33–78 yrs) were treated at doses of 0.15 mg/m2, 0.21 mg/m2, and 0.29 mg/m2. In the accelerated phase, 0.15 mg/m2 and 0.21 mg/m2 were tolerated. At the 0.29 mg/m2 dose level, one patient experienced grade 4 neutropenia after Day 8. Expansion of the 0.21 mg/m2 dose level resulted in one patient experiencing grade 4 neutropenic fever. Two other patients experienced grades 2 and 3 neutropenia, resulting in delayed dosing beyond Cycle 1. Five additional patients were treated at 0.15 mg/m2; none experienced a DLT or dose delay, thus confirming 0.15 mg/m2 as the MTD. Other observed drug- related toxicities included mild to moderate fatigue, nausea, vomiting, constipation, neuropathy, and myalgias. The PK profile of E7974 can be characterized by moderate to large distribution (Vss = 50 - 133 L), slow clearance (CL = 1.4 - 9 L/hr) and moderate to slow elimination (t1/2 = 6.3 - 31 hr). Approximately 34 - 84% of the administered dose was recovered unchanged in the urine 48 hours post-dose. Stable disease was seen in one patient with colorectal cancer (6 cycles). The MTD cohort has been expanded to a total of 16 evaluable patients for confirmation of tolerability and PK. Conclusions: The recommended Phase 2 dose on Days 1, 8, and 15 of a 28-day schedule is 0.15 mg/m2. Observed toxicities were manageable and reversible. Enrollment is ongoing. [Table: see text]
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Affiliation(s)
- N. J. Zojwalla
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
| | - C. H. Takimoto
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
| | - A. G. Lucarelli
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
| | - R. Clark
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
| | - A. C. Mita
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
| | - M. M. Mita
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
| | - O. Romero
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
| | - E. L. Schuck
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
| | - I. Krivelevich
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
| | - C. J. Sweeney
- Eisai Medical Research, Ridgefield Park, NJ; Cancer Therapy and Research Center, San Antonio, TX; Indiana University, Indianapolis, IN; Eisai Research Institute, Andover, MA
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Sampol G, Rodés G, Romero O, Jurado MJ, Lloberes P. Adherence to nCPAP in patients with coronary disease and sleep apnea without sleepiness. Respir Med 2006; 101:461-6. [PMID: 16919928 DOI: 10.1016/j.rmed.2006.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Revised: 06/14/2006] [Accepted: 07/08/2006] [Indexed: 10/24/2022]
Abstract
Many patients with obstructive sleep apnea (OSA) do not have sleepiness and adherence to nasal continuous positive airway pressure (nCPAP) is unknown when this treatment is primarily recommended for a cardiovascular concern. The aim of this study was to determine the adherence to nCPAP in patients with coronary artery disease (CAD) and OSA without sleepiness. nCPAP was recommended in 75 patients with CAD and OSA, 29 without and 46 with sleepiness. The daily use of nCPAP and changes in sleepiness (Epworth Sleepiness Scale), in other OSA symptoms and in SF-36 quality-of-life questionnaires were evaluated at 1 yr of follow-up. Sixty-seven patients (89%) were still using nCPAP at the end of follow-up. The absence of sleepiness at diagnosis did not imply a greater number of nCPAP refusals and nCPAP adherence was similar in both groups, 5.1 (1.5) h in patients without versus 5.4 (1.6) h in patients with sleepiness. In patients with sleepiness at diagnosis, the use of nCPAP was associated with reduced sleepiness and improvement in the OSA symptoms and quality-of-life questionnaires; in contrast, only the symptoms questionnaire improved in patients without sleepiness. In conclusion, in our experience adherence to nCPAP treatment in patients with CAD and OSA is not influenced by the absence of sleepiness.
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Affiliation(s)
- Gabriel Sampol
- Respiratory Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Lorente J, Jurado MJ, Romero O, Quesada P, Quesada JL, Sagalés T. [Effects of functional septoplasty in obstructive sleep apnea syndrome]. Med Clin (Barc) 2005; 125:290-2. [PMID: 16159552 DOI: 10.1157/13078422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate the efficacy of functional septoplasty in a group of patients with septal dysmorphy and obstructive sleep apnea syndrome (OSAS). PATIENTS AND METHOD 34 patients with nasal respiratory insufficiency and chronic snore were included from 1997 to 2003. All of them were diagnosed of OSAS by nocturnal polysomnography (PSG) and of septal dysmorphy by ORL physical examination. Patients were clinically followed-up at 1, 3 and 6 months after surgery. PSG was also evaluated at 6 months postsurgery. RESULTS A significant objective reduction of the apnea-hypopnea index (AHI) (45.8 vs 31.9), severity of OSAS, and minimal mean oxygen saturation (76.4 to 83.1) was found. Moreover, we observed a significant improvement of subjective scales of sleepiness (13 vs 6) and the patients' satisfaction degree (72% of patients improved). CONCLUSIONS Functional septoplasty is an effective treatment in patients with OSAS and septal dysmorphy.
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Affiliation(s)
- Juan Lorente
- Servicio de Otorrinolaringología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Takimoto CH, Schwartz G, Romero O, Patnaik A, Tolcher A, Garrison M, Oldham FB, Bernareggi A, Rowinsky E. Phase I evaluation of paclitaxel poliglumex (PPX) administered weekly for patients with advanced cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C. H. Takimoto
- Cancer Therapy & Research Ctr, San Antonio, TX; Cell Therapeutics, Inc, Seattle, WA
| | - G. Schwartz
- Cancer Therapy & Research Ctr, San Antonio, TX; Cell Therapeutics, Inc, Seattle, WA
| | - O. Romero
- Cancer Therapy & Research Ctr, San Antonio, TX; Cell Therapeutics, Inc, Seattle, WA
| | - A. Patnaik
- Cancer Therapy & Research Ctr, San Antonio, TX; Cell Therapeutics, Inc, Seattle, WA
| | - A. Tolcher
- Cancer Therapy & Research Ctr, San Antonio, TX; Cell Therapeutics, Inc, Seattle, WA
| | - M. Garrison
- Cancer Therapy & Research Ctr, San Antonio, TX; Cell Therapeutics, Inc, Seattle, WA
| | - F. B. Oldham
- Cancer Therapy & Research Ctr, San Antonio, TX; Cell Therapeutics, Inc, Seattle, WA
| | - A. Bernareggi
- Cancer Therapy & Research Ctr, San Antonio, TX; Cell Therapeutics, Inc, Seattle, WA
| | - E. Rowinsky
- Cancer Therapy & Research Ctr, San Antonio, TX; Cell Therapeutics, Inc, Seattle, WA
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Lloberes P, Rodríguez B, Roca A, Sagales MT, de la Calzada MD, Giménez S, Romero O, Sampol G. Comparison of conventional nighttime with automatic or manual daytime CPAP titration in unselected sleep apnea patients: study of the usefulness of daytime titration studies. Respir Med 2004; 98:619-25. [PMID: 15250227 DOI: 10.1016/j.rmed.2003.12.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Daytime CPAP titration studies with full polysomnography have been successfully performed in patients with severe sleep apnea-hypopnea syndrome (SAHS). The implementation of daytime studies in unselected SAHS patients could help to reduce the waiting lists for CPAP titrations. The main purpose of this study was to compare the effectiveness of conventional versus manual or automatic daytime CPAP titration in unselected patients with SAHS. Ninety-three consecutive patients with SAHS in whom CPAP was indicated were assigned to conventional titration or to manual or automatic (AutoSet) daytime CPAP titration, after sleep deprivation. The number of valid studies, sleep architecture, final pressure selected and mean pressure in the different sleep stages were compared. Changes in sleepiness (Epworth sleepiness score) and hours of CPAP use were assessed after 3 months of treatment. Four patients did not sleep (3 AutoSet, 1 conventional daytime groups). Sleep latency was shorter during automatic daytime titration whereas REM latency was shorter in daytime studies; the percentage of sleep stages was similar during all types of titration. CPAP requirements were significantly higher during REM sleep in conventional and manual daytime titrations while mean pressure was unchanged throughout sleep stages during AutoSet titration. CPAP pressure selected with conventional or daytime manual titration (7.5(2.2) cm H2O and 7.4(1.5) cm H2O, ns) were significantly lower (P< 0.001) than with AutoSet (9.4(1.6) cm H20. All groups showed similar decrease of sleepiness and hours of use of CPAP at 3 months of follow-up. Automatic and manual daytime PSG studies after sleep deprivation are useful for CPAP titration in unselected patients with SAHS. Pressure selected with AutoSet is significantly higher than with conventional daytime or nighttime titration, although not significant in terms of treatment compliance and symptom improvement.
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Affiliation(s)
- Patricia Lloberes
- Servei de Pneumologia, Hospital General Universitari Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain.
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