[Uvulopalatoplasty with a severe form of obstructive sleep apnea: long-term results]. / Uvulopalatoplastika pri tyazheloi forme obstruktivnogo apnoe sna: otdalennye rezul'taty.

OBJECTIVE: To assess the severity of daytime sleepiness and the level of sleep apnea/hypopnea index (AHI), as well as the possibility of their correction, in the long-term period after uvulopalatoplasty (UPP) in patients suffering from obesity and obstructive sleep apnea syndrome (OSAS). MATERIAL AND METHODS: We retrospectively analyzed the data of the patients, who requested a consultation due to nighttime snoring, witnessed sleep apneas and daytime drowsiness. We included men and women of ages 40 to 65 (24 male, 17 female) without cardiac or lung insufficiency. Group 1 consisted of 19 patients, who underwent UPP 3-5 years prior to current consultation. Group 2 consisted of 22 patients, who underwent UPP 6-12 earlier, despite prior diagnosis of severe OSAS. We performed cardiorespiratory sleep monitoring, additionally patients completed the Epworth scale and sleep quality scale. Patients were re-interviewed 2 months after initiation of CPAP therapy and or intraoral device treatment. RESULTS: Group 1 (n=19) displayed obesity (Body Mass Index 34.2±6.1 kg/m2), severe OSAS (AHI 55.2±18.5), high level of daytime drowsiness (Epworth score 18.7±6.3) and low sleep quality (13.0±6.8 sleep quality score). Group 2 (n=22) displayed reduction in AHI level - significant statistically, but not clinically without changes in daytime drowsiness and sleep quality, which were improved in 29 cases out of 41 with the help of CPAP-therapy (18 cases) or intraoral fixation devices (11 cases). CONCLUSION: UPP does not exert a clinically significant affect the severity of sleep disturbance in patients with obesity and severe OSAS. Night sleep study is essential before making a decision about UPP. Clinical state correction of patients in the long-term period of UPP is possible with the help of CPAP therapy or intraoral fixation devices.

[Doxylamine and melatonin in treatment of sleep disruption in gynecological practice]. / Doksilamin i melatonin v korrektsii narushenii sna v ginekologicheskoi praktike.

Symptoms of sleep disruption are widely prevalent in general population, but they are not necessarily form the full clinical presentation of insomnia. Diagnostic process should consider somatic diseases usually accompanied by sleep disruption. This review presents the data on insomnia symptoms in gynecological diseases: menstrual cycle related disorders, endometriosis, peri- and postmenopausal symptoms.

[Intermittent hypoxia due to sleep apnea syndrome in patients with type 2 diabetes mellitus]. / Periodicheskaia gipoksiia na fone sindroma apnoé vo sne u bol'nykh sakharnym diabetom 2-go tipa.

OBJECTIVES: To evaluate the possible association between intermittent hypoxia (IH) and HbA1c in patients with insufficient control type of 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: In this cross-sectional study 183 patients with HbAc1≥7% underwent three-channel overnight monitoring (ApneaLink) and completed Berlin Questionnaire, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Patients were divided in two groups, based on the cut-off value of oxygen desaturation index≥15. RESULTS AND CONCLUSION: There were 79 (43%) patients with intermittent hypoxia, which was associated with poorer glycaemic control, defined as HbA1c>8.7% (sample median) in the univariate analysis and after adjustment for body mass index OR 2,40 (CI 1.21-4.95, p=0.021). Neither of three questionnaires yielded satisfactory results as a screening method in patients with T2DM. There is a need to implement instrumental screening of sleep-disordered breathing in this population and to study the effects of CPAP-therapy on glycaemic control and carbohydrate metabolism.

[Antioxidant, anti-inflammatory and sedative effects of melatonin: results of clinical trials]. / Antioksidantnyi, protivovospalitel'nyi i sedativnyi éffekty melatonina: rezul'taty klinicheskikh issledovanii.

A literature review of clinical trials and systematic reviews on the antioxidant and anti-inflammatory effects of melatonin is presented. The results of animal studies and recent publications on the effects of melatonin in humans are summarized. Melatonin protects the cardiovascular system from destructive effects of ischemia/reperfusion, when the drug has been timely administered, has a neuroprotective effect in newborns with asphyxia. It is an effective drug in complex treatment of irritable bowel syndrome and inflammatory bowel diseases (Crohn's disease and ulcerative colitis). As an alternative to benzodiazepines, melatonin can be used for premedication and anxiety reduction in surgical interventions.

Treatment of climacteric symptoms with an ammonium succinate-based dietary supplement: a randomized, double-blind, placebo-controlled trial.

Peri- and postmenopausal women commonly suffer from climacteric symptoms. We evaluated the effectiveness and safety of dietary supplement Amberen to relieve vasomotor and psychosomatic symptoms during the course of a 3-month, randomized, double-blind, placebo-controlled study. General clinical assessment, evaluation using the Greene climacteric test and Spielberger-Hanin test, determination of plasma levels of gonadotropins, estradiol, leptin and apolipoproteins were used to evaluate 42-60-year-old women with vasomotor and psychosomatic menopausal symptoms. One hundred and twenty-five women were enrolled in the study and randomized between two groups. Based on the Greene test results, there was a statistically significant improvement (р < 0.05) in 13 out of 21 menopausal symptoms in women who took Amberen. During the course and by the end of the study, patients showed statistically significant changes in the levels of estradiol, gonadotropins and leptin, and decreases in body weight and waist circumference. Spielberger-Hanin test showed that Amberen stabilizes patients' psychological state with a statistically significant decrease in anxiety, increased stress resistance and improved adaptability. Comparative analysis of the vital signs measurements, blood tests and urinalysis did not show any negative effects of Amberen on the patients. Our findings indicate that Amberen can be considered a method of choice to relief mild/moderate climacteric symptoms.