Altitude and Breathing during Sleep in Healthy Persons and Sleep Disordered Patients: A Systematic Review.

 The aim of this systematic review is to analyze the recent scientific evidence of the clinical effects of altitude on breathing during sleep in healthy persons and sleep disordered patients.  A search was carried out in PubMed and Scopus looking for articles published between January 1, 2010 and December 31, 2021, in English and Spanish, with the following search terms: "sleep disorders breathing and altitude". Investigations in adults and carried out at an altitude of 2000 meters above mean sea level (MAMSL) or higher were included.

An online survey detected knowledge gaps and cost-saving opportunities in asthma maintenance treatment among allergists, pulmonologists, ENTs and primary care.

Background: In April 2017 the Mexican Asthma Guidelines (GUIMA) were published. Before the launch, physicians' knowledge was explored related to key issues of the guideline.

Methods: A SurveyMonkey® survey was sent out to board-certified physicians of 5 medical specialties treating asthma.

[Lung-cancer screening program in Mexico].

La detección temprana de cáncer pulmonar (CP) en población de alto riesgo tiene el potencial de diagnosticar la enfermedad en estadios tempranos y facilitar el tratamiento oportuno con el fin de disminuir la tasa de mortalidad. En México, como en otros países en vías de desarrollo, además del tabaquismo, la exposición al humo de leña se posiciona como uno de los principales factores de riesgo para desarrollar CP, lo cual no se ha considerado en estudios de tamizaje previamente publicados. Distintas interrogantes surgen en relación con quiénes son las personas que presentan un alto riesgo de desarrollar CP en América Latina, cuál es el costo-beneficio de poner en marcha un programa de detección oportuna de CP en México y cuáles son los obstáculos que los países de la región enfrentan para su implementación.

Pediatric asthma treatment: What to do when international guideline recommendations do not agree.

Background: There was a need for a solid asthma guideline in Mexico to update and unify asthma management. Because high-quality asthma guidelines exist worldwide, in which the latest evidence on asthma management is summarized, the ADAPTE approach allows for the development of a national asthma guideline based on evidence from already existing guidelines, adapted to national needs.

Objective: To fuse evidence from the best asthma guidelines and adapt it to local needs with the ADAPTE approach.

[Mexican Asthma Guidelines: GUIMA 2017].

Background: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation.

Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted.

Long-Term Stability of a Portable Carbon Monoxide Single-Breath Diffusing Capacity Instrument.

Background: The 2005 American Thoracic Society/European Respiratory Society guidelines for single-breath diffusing capacity of the lung for carbon monoxide (D) recommend a weekly biological control test and/or D simulator to detect instrument error drift. Very little has been published regarding the results of such a quality assurance program. Our aim was to analyze the long-term stability of a portable D instrument.

Reference Values for the Diffusing Capacity Determined by the Single-Breath Technique at Different Altitudes: The Latin American Single-Breath Diffusing Capacity Reference Project.

Background: The lung diffusion capacity (DLCO) determined by the single-breath technique greatly helps in the differential diagnosis and classification of severity of common lung diseases. However, widespread use of single-breath DLCO tests in Latin America has been limited, in part, by the lack of appropriate reference values. Our objective was to derive robust reference equations for single-breath DLCO from healthy Hispanic adults, using the most recent guidelines and taking into account altitude above sea level and hemoglobin.

Diagnostic Value of the Morphometric Model and Adjusted Neck Circumference in Adults with Obstructive Sleep Apnea Syndrome.

Background: Obstructive sleep apnea syndrome is a major public health problem. The morphometric model and the Sleep Apnea Clinical Score are widely used to evaluate adults; however, neither of these tools has been validated in a Mexican population.

Objective: To determine the diagnostic value of the morphometric model and the Sleep Apnea Clinical Score and compare them with conventional clinical instruments.

Respiratory health in Latin America: number of specialists and human resources training.

Latin America is made up of a number of developing countries. Demographic changes are occurring in the close to 600 million inhabitants, in whom a significant growth in population is combined with the progressive ageing of the population. This part of the world poses great challenges for general and respiratory health.

Perceptions of short and long sleep duration and comorbid conditions: the PLATINO study.

Objectives: We aimed to describe the distribution of self-reported sleep duration in adults over the age of 40 years and to analyze the associated risk factors, comorbid conditions, and quality of life (QoL).

Methods: Our study was constructed as a cross-sectional population-based study and is part of the PLATINO (Spanish acronym for the Latin American Project for Research in Pulmonary Obstruction) study. It includes data from Mexico City (Mexico), Montevideo (Uruguay), Santiago (Chile), and Caracas (Venezuela).

[Burnout syndrome among medical residents during the influenza A H1N1 sanitary contigency in Mexico].

Objective: To measure the degree of stress among medical residents at a Third Level Hospital in Mexico City during the sanitary contingency caused by the AH1N1 influenza virus.

Methods: A transversal descriptive study with a non-probabilistic sample of 99 medical residents with different fields of specialization related to respiratory medicine. Researchers applied the Maslach Burnout Inventory questionnaire to evaluate three dimensions: emotional fatigue, depersonalization, and personal fulfillment.

Agreement between 95th percentile pressure based on a 7-night auto-adjusting positive airway pressure trial vs. equation-based predictions in sleep apnea.

Study Objectives: to analyze the agreement between effective CPAP-determined on the basis of a 7-night auto-adjusting positive airway pressure (APAP) trial at home with that obtained through 5 different predictive equations.

Methods: Data were collected from consecutive CPAP-naive patients with OSA who underwent a 7-night non-attended home-setting APAP trial. The 95th percentile APAP pressure was considered as the effective CPAP and also as the reference variable against which the equation-based predictions were compared.

Prevalence of sleep related symptoms in four Latin American cities.

Study Objectives: to estimate the prevalence of the most common sleep related symptoms (SRS) in the metropolitan areas of Mexico City, Montevideo (Uruguay), Santiago (Chile), and Caracas (Venezuela).

Methods: The study consisted of a multistage cluster sampling of adults aged > or = 40 years living in metropolitan areas. All participants completed a questionnaire on sleep related symptoms.

Spirometry quality-control strategies in a multinational study of the prevalence of chronic obstructive pulmonary disease.

Unlabelled: We report the characteristics of a centralized spirometry quality-control program developed for a population-based survey of the prevalence of chronic obstructive pulmonary disease in 5 cities: São Paulo, Brazil; México City, México; Montevideo, Uruguay; Santiago, Chile; and Caracas, Venezuela (the Latin American Project for the Investigation of Obstructive Lung Diseases [PLATINO]).

Methods: We developed and used a 3-level quality-control system. Level 1: The spirometer used in the survey (EasyOne), gives quality-control messages to the user/clinician.

[Agreement between oxygen desaturation index and apnea-hypopnea index in adults with suspected obstructive sleep apnea at an altitude of 2240 m].

Objective: Altitude can affect the diagnostic accuracy of portable monitors used to diagnose suspected obstructive sleep apnea syndrome on the basis of oxygen desaturation measurements. The aim of this study was to determine agreement between the desaturation index measured by oximetry and the apnea-hypopnea index measured by polysomnography in Mexico City (2240 m above sea level). We also wished to determine agreement between the desaturation index and the respiratory disturbance index measured by monitoring airflow with a single-channel recording device.

[Spirometry reference values after inhalation of 200 microg of salbutamol].

Objective: The criteria for disease severity established by the Global Initiative for Chronic Obstructive Lung Disease are based on forced expiratory volume in 1 second (FEV1) expressed as a percentage of the predicted value after application of a bronchodilator. This study aims to determine postbronchodilator spirometry reference values.

Subjects And Methods: A cluster sample of subjects aged 40 years or over was chosen to be representative of the metropolitan areas of 5 Latin American cities (São Paulo, Mexico City, Montevideo, Santiago, and Caracas).

Impact of bronchodilator use on the prevalence of COPD in population-based samples.

The aim of this study was to describe the impact of using bronchodilators on the prevalence of Chronic Obstructive Pulmonary Disease in a population-based survey (Platino study). A cluster sampling of subjects 40 years of age or older, representative of the metropolitan areas of 5 Latin American cities (Sao Paulo, Mexico, Montevideo, Santiago and Caracas) was chosen. Spirometry according to ATS standards was done before and after inhalation of 200 micrograms of salbutamol in 5183 subjects.

[Continuous positive airway pressure used by adults with obstructive sleep apneas after prescription in a public referral hospital in Mexico City].

Objective: The aim of this study was to analyze the frequency of initiation of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea syndrome (OSAS) in a referral hospital in Mexico City serving mainly patients without public health insurance coverage and to assess their level of adherence.

Patients And Methods: Patients with OSAS diagnosed by polysomnography or by simplified respiratory polygraphy for whom nasal CPAP was prescribed were enrolled in the study. Titration of CPAP was performed during polysomnography or with an automatic CPAP device.

The long-term stability of portable spirometers used in a multinational study of the prevalence of chronic obstructive pulmonary disease.

Background: We report the performance of an ultrasound-based portable spirometer (EasyOne) used in a population-based survey of the prevalence of chronic obstructive pulmonary disease, conducted in 5 Latin American cities: São Paulo, Brazil; México City, México; Montevideo, Uruguay; Santiago, Chile; and Caracas, Venezuela (the Latin American COPD Prevalence Study [PLATINO]).

Methods: During the survey period (which ranged from 3 months to 6 months in the various locations) we collected daily calibration data from the 70 EasyOne spirometers used in the 5 survey cities. The calibrations were conducted with a 3-L syringe, and the calibration data were stored in the spirometer's database.

[Precision and accuracy of "a pocket" pulse oximeter in Mexico City].

Background: Pulse oximeters are frequently used in the clinical practice and we must known their precision and accuracy. The objective was to evaluate the precision and accuracy of a "pocket" pulse oximeter at an altitude of 2,240 m above sea level.

Methods: We tested miniature pulse oximeters (Onyx 9,500, Nonin Finger Pulse Oximeter) in 96 patients sent to the pulmonary laboratory for an arterial blood sample.

[Effect of tobacco smoking, respiratory symptoms and asthma on spirometry among adults attending a check-up clinic in Mexico City].

Objective: To evaluate the effect of tobacco smoking, respiratory symptoms, and asthma on lung function among Mexican adults who were evaluated during a medical exam in a private health clinic.

Material And Methods: Reference prediction equations were generated for spirometry parameters [forced vital capacity (FVC), forced expired volume in one second (FEV1) and FEV1/FVC] based on multiple linear regression models. The effect of tobacco smoking, respiratory symptoms and asthma on these equations were explored.

[Breathing during sleep in patients with chronic obstructive pulmonary disease at an altitude of 2,240 meters].

Introduction: Patients with chronic obstructive pulmonary disease (COPD) dwellers of Mexico City may present a significant hypoxemia as a consequence of the lung disease and the altitude (2,240 m). These patients usually show a poorer hypoxemia during sleep.

Objective: To describe breathing during sleep in COPD patients residing at the altitude of Mexico City and the effect of supplementary oxygen.

[Obesity and asthma].

Obesity and asthma are two disorders of high and increasing worldwide prevalence. A consistent association between obesity and asthma has been recently found in case-control, cross-sectional and longitudinal studies. This association is more consistent in women after the puberty.