Synergic Integration of the miRNome, Machine Learning and Bioinformatics for the Identification of Potential Disease-Modifying Agents in Obstructive Sleep Apnea.

Introduction: Understanding the diverse pathogenetic pathways in obstructive sleep apnea (OSA) is crucial for improving outcomes. microRNA (miRNA) profiling is a promising strategy for elucidating these mechanisms.

Objective: To characterize the pathogenetic pathways linked to OSA through the integration of miRNA profiles, machine learning (ML) and bioinformatics.

Congenital extraventricular neurocytoma with atypical features in a 3-day-old neonate.

Extraventricular neurocytoma (EVN) is a rare neuronal tumor with a marked tendency towards ganglionic or glial differentiation. Although EVN commonly occurs in young adults, congenital cases are extremely rare, and standardized therapeutic strategies remain undetermined. The presence of atypical features such as increased mitotic activity on histological analysis is correlated with a higher rate of recurrence and poor prognosis.

Generating synthetic CT images from unpaired head and neck CBCT images and validating the importance of detailed nasal cavity acquisition through simulations.

Background And Objective: Computed tomography (CT) of the head and neck is crucial for diagnosing internal structures. The demand for substituting traditional CT with cone beam CT (CBCT) exists because of its cost-effectiveness and reduced radiation exposure. However, CBCT cannot accurately depict airway shapes owing to image noise.

Symptoms, Quality of Life, and Executive Function in Children Who Snore.

Introduction: Mild sleep-disordered breathing (mSDB) in children is associated with both neurobehavioral morbidity and reduced quality of life (QOL). However, the association between symptom burden and QOL with executive function is not well understood, and it is not known whether QOL and symptom burden may help identify children with neurocognitive dysfunction.

Objective: To assess associations among executive function, QOL, and symptom burden in children with mSDB.

2024 Standardization of Polysomnography Reports - A Consensus of the Brazilian Sleep Association.

 The absence of standardized reporting for sleep medicine exams across different laboratories can lead to misinterpretation, diagnostic inconsistencies, and suboptimal treatment strategies. This document seeks to establish guidelines for the development of sleep study reports, covering recordings from studies of types 1 to 4, and represents the official position of Associação Brasileira do Sono (ABS; Brazilian Sleep Association) on the standardization of polysomnography (PSG) and cardiorespiratory polygraphies.  The recommendations for the items to be reported in PSG records were developed by means of a Delphi study, comprised of two voting rounds.

Treatment Approaches to Myasthenia Gravis and Obstructive Sleep Apnea: Case Report.

Myasthenia gravis (MG) is a chronic autoimmune disease characterized by progressive weakness and skeletal muscle fatigue due to the destruction of acetylcholine receptors, causing an abnormality in the synaptic junction between innervation and muscle fibers. The treatment of patients with MG and obstructive sleep apnea (OSA) is positive pressure in the airway; however, the lack of adherence to the protocol can lead to increased morbidity. A known alternative treatment for OSA is the mandibular advancement device (MAD).

Vomer-to-nasopharyngeal widths and post-adenoidectomy outcomes in children: A prospective blinded study.

Objectives: The vomer is an essential component of the nasopharynx. Although variations in vomer width(VW) and nasopharyngeal width(NW) can be observed, their clinical significance on post-adenoidectomy outcomes in children with sleep-disordered breathing and obstructive sleep apnea(SDB-OSA) remains uncertain. The primary outcome was to investigate the association between VW and post-adenoidectomy clinical improvement.

Mineralocorticoid receptor antagonism prevents coronary microvascular dysfunction in intermittent hypoxia independent of blood pressure.

Study Objectives: Obstructive sleep apnea (OSA), characterized by intermittent hypoxia (IH), and is associated with increased cardiovascular mortality that may not be reduced by standard therapies. Inappropriate activation of the renin-angiotensin-aldosterone system occurs in IH, and mineralocorticoid receptor (MR) blockade has been shown to improve vascular outcomes in cardiovascular disease. Thus, we hypothesized that MR inhibition prevents coronary and renal vascular dysfunction in mice exposed to chronic IH.

2024 Update of the RECOVER-Adult Long COVID Research Index.

Importance: Classification of persons with long COVID (LC) or post-COVID-19 condition must encompass the complexity and heterogeneity of the condition. Iterative refinement of the classification index for research is needed to incorporate newly available data as the field rapidly evolves.

Objective: To update the 2023 research index for adults with LC using additional participant data from the Researching COVID to Enhance Recovery (RECOVER-Adult) study and an expanded symptom list based on input from patient communities.

Association Between Chronotype and Chronic Neuropathic Pain Sensitivity: A Pilot Prospective, Observational, Single-Center, Cross-Sectional Study.

Background: Chronotype defines an organism's biological preference for timing of activity and sleep. Being a morning chronotype (i.e.

Pediatric Obstructive Sleep Apnea: Diagnostic Challenges and Management Strategies.

Pediatric obstructive sleep apnea (OSA) is a prevalent yet often underdiagnosed condition affecting 1-5% of children globally, with higher prevalence in populations such as those with Down syndrome and obesity. Characterized by recurrent upper airway obstruction during sleep, OSA can lead to serious health consequences, including neurocognitive deficits, behavioral issues, and cardiovascular complications. The diagnosis is complicated by symptom overlap with conditions like Attention-Deficit/Hyperactivity Disorder (ADHD) while polysomnography (PSG) remains the gold standard for diagnosis, access to this test is limited in many regions.

The role of the microbiota-gut-brain axis and artificial intelligence in cognitive health of pediatric obstructive sleep apnea: A narrative review.

Pediatric obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder associated with significant neurocognitive and behavioral impairments. Recent studies have highlighted the role of gut microbiota and the microbiota-gut-brain axis (MGBA) in influencing cognitive health in children with OSA. This narrative review aims to summarize current knowledge on the relationship between gut microbiota, MGBA, and cognitive function in pediatric OSA.

Sleep-Disordered Breathing in Patients with Chronic Heart Failure and Its Implications on Real-Time Hemodynamic Regulation, Baroreceptor Reflex Sensitivity, and Survival.

Impairment in autonomic activity is a prognostic marker in patients with heart failure (HF), and its involvement has been suggested in cardiovascular complications of obstructive sleep apnea syndrome (OSAS) and Cheyne-Stokes respiration (CSR). This prospective observational study aims to investigate the implications of sleep-disordered breathing (SDB) on hemodynamic regulation and autonomic activity in chronic HF patients. Chronic HF patients, providing confirmation of reduced ejection fraction (≤35%), underwent polysomnography, real-time hemodynamic, heart rate variability (HRV), and baroreceptor reflex sensitivity (BRS) assessments using the Task Force Monitor.

Ambulatory pediatric adenotonsillectomy.

Purpose: This Continuing Professional Development module aims to help the general anesthesiologist recognize common pitfalls in ambulatory pediatric adenotonsillectomy and perform appropriate risk stratification, analgesic management, and disposition planning.

Principal Findings: Pediatric adenotonsillectomy is a widely performed procedure. An updated approach to preoperative risk assessment of commonly associated comorbidities allows the practitioner to anticipate and plan for adverse events.

Corrigendum: Association between obstructive sleep apnea risk and type 2 diabetes among Emirati adults: results from the UAE healthy future study.

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Comparison between three abbreviated methods for the diagnosis of obstructive sleep apnea syndrome in children and adolescents in a real-world setting - a prospective study using polysomnography.

Background: Oximetry was proposed as an abbreviated exam, easily accepted by the child, for the diagnosis of obstructive sleep apnea (OSA) for children located in regions where access to pediatric sleep labs is limited. The objective of this study was to determine the diagnostic value of the oxygen desaturation index (ODI), the number of ≥ 3% oxygen desaturations per hour of recording, obtained by portable oximetry performed in parallel with video-polysomnography (PSG), in a cohort of children, with and without comorbidities, referred for OSA.

Methods: Data from portable oximetry performed in parallel with PSG were prospectively collected.

The impact of gasping versus apnea on initial heart rate and response to positive pressure ventilation in the delivery room following interruption of placental blood flow.

Background: The impact and/or significance of gasping or apnea on cardio-respiratory status at birth remains unclear.

Objectives: The study objectives were to determine in infants presenting with gasping or apnea in the delivery room, initial heart rate (HR), responses to positive pressure ventilation (PPV), time to onset of spontaneous respirations, and the relationship of these responses to 24-hour outcome (death/survival) METHODS: Observation study undertaken in a rural setting involving late preterm and term newborns who gasped (n=126) or were apneic (n=105) at birth and received PPV had HR and respiratory parameters continuously measured and were video recorded.

Results: Apneic (12.

The Association Between Obesity and the Unified Airway in Children.

Chronic rhinosinusitis (CRS) and asthma frequently coexhist in children leading to the unified airway theory. Although obesity has been associated with CRS and asthma in adults, studies exploring that association in children are limited. The goal of this study was to evaluate the association between obesity and the unified airway in children.

Neonatal apnea and hypopnea prediction in infants with Robin sequence with neural additive models for time series.

Neonatal apneas and hypopneas present a serious risk for healthy infant development. Treating these adverse events requires frequent manual stimulation by skilled personnel, which can lead to alarm fatigue. This study aims to develop and validate an interpretable model that can predict apneas and hypopneas.

Cost-utility analysis of a tiered diagnostic approach combining a screening model and polysomnography in pediatric obstructive sleep apnea.

Study Objectives: Obstructive sleep apnea (OSA) is a common disorder in the pediatric population, primarily diagnosed through polysomnography (PSG). However, PSG can be expensive and is often limited in availability. This study aimed to develop a cost-effective diagnostic strategy by integrating a screening model with PSG.

Images: Combined positive air way pressure and atomoxetine-oxybutynin for the treatment of severe obstructive sleep apnea.

Obstructive sleep apnea (OSA) is one of the most common sleep disorders. Positive airway pressure therapy (PAP) is considered the gold standard for treating OSA. Yet, optimal therapy might not be achieved in some cases of severe OSA, despite using maximum settings.

Prevalence of depression in pediatric patients with diagnosed or at high risk for obstructive sleep apnea: A systematic review with meta-analysis.

Obstructive sleep apnea (OSA) may increase the risk of depression through various hypothesized mechanisms. Studies regarding this relationship with children are limited. This systematic review aims to assess the prevalence of depression in pediatric patients with OSA.