Sleep Apnea and Incident Unprovoked Venous Thromboembolism: Data from the Pays de la Loire Sleep Cohort.

Background:  Previous studies have reported inconsistent findings regarding the association between obstructive sleep apnea (OSA) and incident venous thromboembolism (VTE). More specifically, the association between OSA and unprovoked VTE was barely evaluated. We aimed to evaluate whether apnea hypopnea index (AHI) and nocturnal hypoxemia markers were associated with unprovoked VTE incidence in patients investigated for OSA.

Positive Airway Pressure Adherence, Mortality, and Cardiovascular Events in Patients with Sleep Apnea.

Randomized controlled trials showed no effect of positive airway pressure (PAP) therapy for obstructive sleep apnea (OSA) on cardiovascular (CV) risk. However, patient selection and low PAP adherence preclude the generalization of their data to clinical samples. To evaluate the association between hours of PAP use, mortality, and CV morbidity in real-life conditions.

Cancer risk in adherent users of polyurethane foam-containing CPAP devices for sleep apnoea.

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Sleep Apnea-Specific Hypoxic Burden, Symptom Subtypes, and Risk of Cardiovascular Events and All-Cause Mortality.

Data from population-based cohorts suggest that symptom subtypes and obstructive sleep apnea (OSA)-specific hypoxic burden (HB) could help to better identify patients with OSA at high cardiovascular (CV) risk. We aimed to evaluate whether those new markers are associated with the risk of major adverse CV events (MACE) in clinical setting. Data from the Pays de la Loire cohort were linked to health administrative data to identify the occurrence of MACE (a composite outcome including all-cause mortality, acute myocardial infarction, stroke, and unplanned coronary revascularization) in patients with newly diagnosed OSA and no overt CV disease.

Cancer risk in patients with sleep apnoea following adherent 5-year CPAP therapy.

Background: Increasing evidence suggests that obstructive sleep apnoea (OSA) contributes to cancer risk; however, limited data are available on the impact of continuous positive airway pressure (CPAP) therapy on cancer incidence. We aimed to determine whether adherence to CPAP therapy is associated with a reduction in all-cancer incidence compared with nonadherent patients with OSA.

Methods: The study relied on data collected by the multicentre Pays de la Loire Sleep Cohort study, linked to health administrative data, so as to identify new-onset cancer.

Association of Nocturnal Hypoxemia and Pulse Rate Variability with Incident Atrial Fibrillation in Patients Investigated for Obstructive Sleep Apnea.

Nocturnal hypoxemia and sympathetic/parasympathetic imbalance might contribute to the occurrence or atrial fibrillation (AF) in patients with obstructive sleep apnea (OSA). During sleep recordings, pulse rate variability (PRV) derived from oximetry might provide an accurate estimation of heart rate variability, which reflects the autonomic cardiovascular control. We aimed to evaluate whether indices of oxygen desaturation and PRV derived from nocturnal oximetry were associated with AF incidence in patients investigated for OSA.

Endothelial dysfunction and circulating microparticles from patients with obstructive sleep apnea.

Endothelial dysfunction is involved in vascular complications of obstructive sleep apnea (OSA). In this study, circulating microparticles (MPs) from patients with OSA-induced nocturnal desaturations were characterized and their effects on endothelial function were evaluated. Two age-matched groups of patients undergoing polysomnography for OSA were compared: 35 desaturators with a 3% oxyhemoglobin desaturation index (ODI) > or = 10 events per hour of sleep and 27 nondesaturators with ODI <10 events per hour.

Long-term outcome of noninvasive positive pressure ventilation for obesity hypoventilation syndrome.

Background: Few data are available on the long-term outcome of noninvasive positive pressure ventilation (NPPV) for obesity hypoventilation syndrome (OHS). This study was designed to determine long-term survival, treatment adherence, and prognostic factors in patients with OHS in whom NPPV was initiated in an acute setting vs under stable clinical conditions.

Methods: One hundred thirty consecutive patients with OHS (56 women) who started NPPV between January 1995 and December 2006 either under stable conditions (stable group, n = 92) or during ICU management of acute hypercapnic exacerbation (acute group, n = 38) were retrospectively analyzed.

High baseline insulin levels associated with 6-year incident observed sleep apnea.

Objective: Obstructive sleep apnea is common in patients with type 2 diabetes, and its association with insulin and insulin resistance has been examined in cross-sectional studies. We evaluate risk factors for incident observed sleep apnea in a general population not selected for sleep disturbances.

Research Design And Methods: A total of 1,780 men and 1,785 women, aged 33 to 68 years, from the cohort Data from an Epidemiologic Study on the Insulin Resistance Syndrome (D.

Lipid nanocapsules: ready-to-use nanovectors for the aerosol delivery of paclitaxel.

Aerosol drug delivery permits the development of dose-intensification strategies in severe, malignant lung diseases. The aim of the study was to demonstrate that the encapsulation of paclitaxel in lipid nanocapsules (LNCs), a novel drug nanocarrier for lipophilic components, allows one to provide pulmonary drug delivery of paclitaxel by nebulisation, thereby allowing preclinical and clinical studies. LNC dispersions are made into aerosols with commercial nebulisers.

Microvascular endothelial function in obstructive sleep apnea: Impact of continuous positive airway pressure and mandibular advancement.

Objectives: Endothelial dysfunction has been proposed as a potential mechanism implicated in the pathogenesis of cardiovascular complications of obstructive sleep apnea syndrome (OSAS). This study aimed to evaluate the microvascular endothelial function (MVEV) in OSAS and the impact on MVEF of 2 months of treatment with continuous positive airway pressure (CPAP) and mandibular advancement device (MAD).

Methods: Microvascular reactivity was assessed using laser Doppler flowmetry combined with acetylcholine (Ach) and sodium nitroprusside (SNP) iontophoresis in 24 OSAS patients and 9 control patients.

Mandibular advancement for obstructive sleep apnea: dose effect on apnea, long-term use and tolerance.

Background: Previous studies have documented an effect of mandibular advancement (MA) on pharyngeal airway size and collapsibility.

Objectives: We aimed to describe the course of the apnea-hypopnea index (AHI) and the snoring index (SI) during progressive MA and to evaluate the long-term efficacy, tolerance and usage of MA therapy after progressive MA titration in sleep apnea patients.

Methods: Sixty-six patients with obstructive sleep apnea syndrome underwent sequential sleep recordings during progressive MA titration.

Sleep disturbances and impaired daytime functioning in outpatients with newly diagnosed lung cancer.

Background: Clinical experience suggests that lung cancer (LC) is associated with sleep disturbances that may contribute to impaired daytime functioning and quality of life. Using questionnaires and home actigraphic recordings, we tried to determine whether sleep quality and daytime alertness are impaired in patients with newly diagnosed LC.

Patients And Methods: Twenty-nine outpatients with newly diagnosed LC and an Eastern Cooperative Oncology Group performance status View Article and Find Full Text PDF

Gemcitabine aerosol: in vitro antitumor activity and deposition imaging for preclinical safety assessment in baboons.

Aim: To characterize gemcitabine aerosol, its in vitro activity against lung cancer cells, its deposition, and tolerance in a non-human primate model.

Methods: In vitro cytotoxicity of nebulized gemcitabine against NCI-H460 and A549 lung cancer cells was tested using a growth inhibition assay and compared with non-nebulized gemcitabine. The (99m)Tc-DTPA-radiolabeled gemcitabine aerosol was characterized by cascade impaction and the gemcitabine mass/(99m)Tc activity relationship was established for further quantitative nuclear imaging.

Safety of pulmonary administration of gemcitabine in rats.

The purpose of this research was to evaluate the safety of pulmonary administration of gemcitabine and to determine the maximum tolerated dose by weekly pulmonary administrations in an animal model. Five groups of eight Wistar rats received gemcitabine at doses of 2, 4, 6, or 8 mg/kg or the vehicle solution by endotracheal spray with scintigraphic imaging of lung deposition. In order to document the safety of digestive exposure, five groups of eight rats received gemcitabine at the same dosages or the vehicle solution by gavage.

[Management of stable COPD].

The term chronic obstructive pulmonary disease (COPD) is mainly characterised by an irreversible obstructive airway obstruction, that in most cases, is secondary to tobacco exposure. Management of the disease includes an assessment of severity, and measures to decrease FEV decline, to treat bronchial obstruction, to improve exercise tolerance and to correct abnormal gas exchange. Treatment not only requires drug therapy, but also respiratory rehabilitation, surgery of emphysema, and psychosocial support.

Influence of predicted FEV1 on bronchodilator response in asthmatic patients.

Background: There is currently disagreement on the way of expressing the reversibility of airflow obstruction, with some evaluations based on the initial FEV(1) while others use predicted FEV(1) (according to age, gender and height).

Objectives: To test the relevance of expressing bronchodilator response as a percentage of predicted FEV(1), we evaluated the influence of morphological data on the response to bronchodilators in a population with a large range of predicted values.

Methods: We measured the change in FEV(1) after inhalation of 200 microg of salbutamol in 30 asthmatic subjects (15 adults and 15 children) in whom predicted FEV(1) ranged between 1.

Validation of a suprasternal pressure transducer for apnea classification during sleep.

Study Objectives: To validate a new method of evaluation of respiratory efforts during polysomnographic recordings.

Setting: NA PARTICIPANTS: 26 patients with sleep apnea syndrome, either during diagnostic assessment (n=16) or under nasal continuous positive airway pressure (n=10).

Methods: This method consists of measuring suprastemal pressure by a pressure transducer placed over the trachea above the sternal notch (Pst).