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1.
Front Public Health ; 10: 976423, 2022.
Article in English | MEDLINE | ID: mdl-36033810

ABSTRACT

Background: Preventive public health has been suggested as methods for reducing the transmission of COVID-19. Safety and efficacy of one such public health measure: WASH intervention for COVID-19 has not been systematically reviewed. We undertook a rapid review to assess the effect of WASH intervention in reducing the incidence of COVID-19. Methods: We conducted searches in PubMed, MEDLINE, and EMBASE. We undertook screening of studies in two stages and extracted data and assessed the quality of evidence for the primary outcome using GRADE recommendations. Main results: We included a total of 13 studies with three studies on COVID-19 and 10 on SARS. The study found that hand washing, sterilization of hands, gargling, cleaning/shower after attending patients of COVID-19, or SARS was protective. Evidence also found that frequent washes can prevent SARS transmission among HCWs. However; one study reported that due to enhanced infection-prevention measures, front-line HCWs are more prone to hand-skin damage. The certainty of the evidence for our primary outcome as per GRADE was very low. We did not find any studies that assessed the effect of WASH on hospitalizations, and mortality due to COVID-19. Also; we did not find any study that compared WASH interventions with any other public health measures. Conclusions: Current evidence of WASH interventions for COVID-19 is limited as it is largely based on indirect evidence from SARS. Findings from the included studies consistently show that WASH is important in reducing the number of cases during a pandemic. Timely implementation of WASH along with other public health interventions can be vital to ensure the desired success. Further good-quality studies providing direct evidence of the efficacy of WASH on COVID-19 are needed.


Subject(s)
COVID-19 , Hand Disinfection , Humans , Incidence , Pandemics , Public Health
2.
JMIR Form Res ; 5(11): e24936, 2021 Nov 12.
Article in English | MEDLINE | ID: mdl-34508363

ABSTRACT

BACKGROUND: The role of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in indolent lymphoma has been minimally studied. OBJECTIVE: This study aims to assess the value of FDG-PET/CT in predicting the prognosis of indolent lymphoma. METHODS: We prospectively recruited 42 patients with indolent lymphoma. A total of 2 patients were excluded, and 40 underwent baseline PET/CT and follow-up at various time points. A total of 9 patients were observed only, 7 received 4 doses of rituximab alone, and 24 received chemoimmunotherapy. Metabolic response on follow-up PET/CT was assessed using the maximum standardized uptake value (SUVmax) and Deauville criteria (DC). We aimed to obtain the best SUVmax and DC to predict optimal survival rates, risk stratification, and optimize therapeutic strategies. The mean follow-up from the initial diagnosis was 33.83 months. RESULTS: SUVmax <4.35 at interim PET/CT provided the best discrimination, with a progression-free survival (PFS) of 100% and a median survival time of 106.67 months compared with SUVmax ≥4.35 (P=.04), which had a PFS of 43.8% and a median survival time of 50.17 months. This cutoff was also valuable in predicting overall survival at baseline, that is, 100% overall survival with baseline SUVmax <4.35, versus 58.4% for SUVmax ≥4.35 (P=.13). The overall survival of patients with a baseline DC score <3.0 was 100%, with a median overall survival of 106.67 months. CONCLUSIONS: We demonstrated the utility of PET/CT in indolent lymphomas. SUVmax (<4.35 vs ≥4.35) on interim PET/CT performed best in predicting PFS.

3.
J Clin Sleep Med ; 17(10): 2057-2065, 2021 10 01.
Article in English | MEDLINE | ID: mdl-33983111

ABSTRACT

STUDY OBJECTIVES: Home automatic positive airway pressure (APAP) therapy is becoming a mainstay treatment of obstructive sleep apnea. It is typically prescribed without any prior supervised titration. Initial experience of APAP treatment dictates subsequent use. Discomfort related to the APAP interface contributes to poor APAP adherence. METHODS: After obtaining institutional review board approval, 156 adult patients newly diagnosed with obstructive sleep apnea were prospectively randomized into 2 groups (group A and group B). Group A received a 30-minute personalized interface/mask fitting session supervised by a certified sleep technician, during which APAP therapy was simulated and patients were educated on proper use. Patients sampled different interfaces to address any issues with comfort. Group B received usual care where patients obtained an interface through durable medical equipment suppliers. Primary endpoints included percent APAP usage (number of days APAP was used for ≥ 4 hours divided by 30 days) and APAP usage (number of days APAP was used for any duration) during the initial 30 days of home APAP therapy. Interface-associated air leak served as the secondary endpoint. RESULTS: Mean percent APAP usage was higher in group A compared to group B (78.4% vs 67.8%; P = .04). On average, group A utilized the APAP machine on more days compared to group B (27 vs 24 days; P = .01). APAP interface associated air leak was lower in group A compared to group B (14.9 vs 21.1 l/min; P = .03). CONCLUSIONS: Our findings demonstrate that implementing a personalized interface fitting session supervised by a sleep technician improves APAP adherence. CITATION: Syed Z, Mehta I, Hella JR, Barber K, Khorfan F. Implementing a sleep technician-supervised and personalized APAP interface fitting session prior to initiation of home APAP therapy improves adherence in patients with obstructive sleep apnea. J Clin Sleep Med. 2021;17(10):2057-2065.


Subject(s)
Sleep Apnea, Obstructive , Adult , Continuous Positive Airway Pressure , Humans , Patient Compliance , Pressure , Sleep , Sleep Apnea, Obstructive/therapy
4.
J Infect Public Health ; 14(5): 647-650, 2021 May.
Article in English | MEDLINE | ID: mdl-33857723

ABSTRACT

We are reporting a 45-year-old woman with COVID-19 who presented to the Emergency Department with a transient loss of consciousness and was found to have a massive pulmonary embolism and an acute stroke. To our knowledge, this is the first reported case that calls for attention to the importance of vigilance for such a catastrophic presentation of COVID-19.


Subject(s)
COVID-19 , Pulmonary Embolism , Stroke , Female , Humans , Lung , Middle Aged , Pulmonary Embolism/diagnosis , SARS-CoV-2 , Stroke/diagnosis
5.
Saudi J Med Med Sci ; 9(1): 16-23, 2021.
Article in English | MEDLINE | ID: mdl-33519339

ABSTRACT

OBJECTIVE: To present the interim findings from a national study investigating the safety and efficacy of convalescent plasma (CP) containing detectable IgG antibodies as a treatment strategy for severe coronavirus disease 2019 (COVID-19). TRIAL DESIGN AND PARTICIPANTS: An open label, two-arm, phase-II clinical trial conducted across 22 hospitals from Saudi Arabia. The intervention group included 40 adults (aged ≥18 years) with confirmed severe COVID-19 and the control group included 124 patients matched using propensity score for age, gender, intubation status, and history of diabetes and/or hypertension. Intervention group included those (a) with severe symptoms (dyspnea; respiratory rate, ≥30/min; SpO2, ≤93%, PaO2/FiO2 ratio, <300; and/or lung infiltrates >50% within 24-48 h), (b) requiring intensive care unit (ICU) care or (c) experiencing life-threatening conditions. The control group included confirmed severe COVID-19 patients of similar characteristics who did not consent for CP infusion or were not able to receive CP due to its nonavailability. INTERVENTIONS: The intervention group participants were infused 300 ml (200-400 ml/treatment dose) CP at least once, and if required, daily for up to 5 sessions, along with receiving the best standard of care. The control group only received the best standard of care. OUTCOMES: The primary endpoints were safety and ICU length of stay (LOS). The secondary endpoints included 30-day mortality, days on mechanical ventilation and days to clinical recovery. RESULTS: CP transfusion did not result in any adverse effects. There was no difference in the ICU LOS (median 8 days in both groups). The mortality risk was lower in the CP group: 13% absolute risk reduction (P = 0.147), hazard ratio (95% confidence interval): 0.554 (0.299-1.027; P = 0.061) by log-rank test. There was no significant difference in the days on mechanical ventilation and days to clinical recovery. CONCLUSION: CP containing detectable antibodies is a safe strategy and may result in a decrease in mortality in patients with severe COVID-19. The results of the completed trial with a larger study sample would provide more clarity if this difference in mortality is significant. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04347681; Saudi Clinical Trials Registry No.: 20041102.

7.
Saudi Med J ; 41(10): 1063-1069, 2020 Oct.
Article in English | MEDLINE | ID: mdl-33026046

ABSTRACT

OBJECTIVES: To identify the epidemiologic profile of cerebral vein thrombosis (CVT) among fasting women using oral contraceptive pills  (OCPs) during the holy month of Ramadan. Methods: This retrospective study was conducted on all patients diagnosed with CVT and using OCPs from records at a tertiary care hospital in Riyadh, Saudi Arabia during 2016-2017. The study participants were categorized into 2 groups (an intermittently fasting group during the holy month of Ramadan and a non-fasting group).  Results: Out of 108 female patients with CVT, 36.1% were secondary to OCP, of whom 41% participants were fasting. The most affected site was the transverse sinus. Holocephalic headache was more common amongst fasting group (68.8%) compared to non-fasting group (30.4%) (p=0.025). Dehydration (p=0.003) amongst the fasting group and protein S deficiency (p=0.027) in the non-fasting group were identified as the 2 prominent risk factors. Unfractionated heparin was the most common anticoagulant therapies used during the initiation phase for non-fasting (36.4%) and fasting groups (50%). Conclusion: All women who are using OCP should undergo formal written risk assessments for factors of CVT. Our study suggests that the negative effects of OCPs use might outweigh its benefits; thus, it should be prescribed with caution, more so in fasting patients.


Subject(s)
Contraceptives, Oral/administration & dosage , Contraceptives, Oral/adverse effects , Fasting/adverse effects , Fasting/physiology , Intracranial Thrombosis/epidemiology , Intracranial Thrombosis/etiology , Islam , Venous Thromboembolism/epidemiology , Venous Thromboembolism/etiology , Adult , Dehydration/etiology , Female , Headache/etiology , Humans , Prevalence , Protein S Deficiency/etiology , Retrospective Studies , Risk Factors , Saudi Arabia/epidemiology
8.
Am J Case Rep ; 21: e922971, 2020 Sep 13.
Article in English | MEDLINE | ID: mdl-32920590

ABSTRACT

BACKGROUND Chronic myeloid leukemia (CML) is usually a tri-phasic myeloproliferative neoplasm, characterized by the presence of the BCR-ABL1 fusion gene, derived from a balanced translocation, t(9;22)(q34;q11). BCR-ABL tyrosine kinase inhibitors (TKI) are used to treat patients with CML. The addition of pegylated interferon-alpha2b to imatinib or dasatinib results in promising deep molecular responses. Because imatinib shows poor penetration into the central nervous system (CNS), the CNS may become a sanctuary site in patients on prolonged imatinib therapy for CML. It is extremely rare for the blast phase in patients with chronic phase CML to affect the CNS without concomitant bone marrow involvement. CASE REPORT This report describes a 57-year-old woman who was diagnosed with accelerated phase (AP) CML and failed high dose imatinib therapy. Despite achieving an excellent molecular response to dasatinib in 6 months, she developed recurrent isolated CNS blast crisis. Survival was prolonged after treatment with intrathecal chemotherapy and whole-brain radiation therapy combined with dasatinib. After achieving long and deep molecular remission with dasatinib and a few months of pegylated interferon-alpha2a, she lived for 18 months in treatment-free-remission (TFR). At age 65 years, she died of progressive rectal carcinoma with septic shock, cancer-related venous thromboembolism, and a possible autoimmune disorder. CONCLUSIONS This patient with accelerated phase CML and 2 isolated CNS blast crises died in TFR 8.5 years after her initial diagnosis and 7.5 years after her first isolated CNS blast crisis. Survival resulted from tailoring of therapies around her comorbidities.


Subject(s)
Antineoplastic Agents , Brain Neoplasms , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Aged , Antineoplastic Agents/therapeutic use , Blast Crisis , Central Nervous System , Cranial Irradiation , Female , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Middle Aged , Protein Kinase Inhibitors/therapeutic use
9.
JMIR Res Protoc ; 9(10): e23543, 2020 Oct 02.
Article in English | MEDLINE | ID: mdl-32903199

ABSTRACT

BACKGROUND: The COVID-19 pandemic is expected to cause significant morbidity and mortality. The development of an effective vaccine will take several months to become available, and its affordability is unpredictable. Transfusion of convalescent plasma (CP) may provide passive immunity. Based on initial data from China, a group of hematologists, infectious disease specialists, and intensivists drafted this protocol in March 2020. OBJECTIVE: The aim of this study is to test the feasibility, safety, and efficacy of CP in treating patients with COVID-19 across Saudi Arabia. METHODS: Eligible patients with COVID-19 will be recruited for CP infusion according to the inclusion criteria. As COVID-19 has proven to be a moving target as far as its management is concerned, we will use current definitions according to the Ministry of Health (MOH) guidelines for diagnosis, treatment, and recovery. All CP recipients will receive supportive management including all available recommended therapies according to the available MOH guidelines. Eligible CP donors will be patients with COVID-19 who have fully recovered from their disease according to MOH recovery criteria as detailed in the inclusion criteria. CP donors have to qualify as blood donors according to MOH regulations except for the history of COVID-19 in the recent past. We will also test the CP donors for the presence of SARS-CoV-2 antibodies by a rapid test, and aliquots will be archived for future antibody titration. Due to the perceived benefit of CP, randomization was not considered. However, we will compare the outcome of the cohort treated with CP with those who did not receive CP due to a lack of consent or lack of availability. In this national collaborative study, there is a likelihood of not finding exactly matched control group patients. Hence, we plan to perform a propensity score matching of the CP recipients with the comparator group patients for the major characteristics. We plan to collect demographic, clinical, and laboratory characteristics of both groups and compare the outcomes. A total sample size of 575 patients, 115 CP recipients and 460 matched controls (1:4 ratio), will be sufficient to detect a clinically important hospital stay and 30-day mortality difference between the two groups with 80% power and a 5% level of significance. RESULTS: At present, patient recruitment is still ongoing, and the interim analysis of the first 40 patients will be shared soon. CONCLUSIONS: In this paper, we present a protocol for a national collaborative multicenter phase II study in Saudi Arabia for assessing the feasibility, safety, and potential efficacy of CP in treating patients with severe COVID-19. We plan to publish an interim report of the first 40 CP recipients and their matched comparators soon. TRIAL REGISTRATION: ClinicalTrials.gov NCT04347681; https://clinicaltrials.gov/ct2/show/NCT04347681. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/23543.

10.
J King Saud Univ Sci ; 32(7): 3159-3166, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32921965

ABSTRACT

OBJECTIVES: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, also known as COVID-19 pandemic has caused an alarming situation worldwide. Since the first detection, in December 2019, there have been no effective drug therapy options for treating the SARS-CoV-2 pandemic. However, healthcare professionals are using chloroquine, hydroxychloroquine, remdesivir, convalescent plasma and some other options of treatments. This study aims to compare the biological, molecular, pharmacological, and clinical characteristics of these three treatment modalities for SARS-COV-2 infections, Chloroquine and Hydroxychloroquine, Convalescent Plasma, and Remdesivir. METHODS: A search was conducted in the "Institute of Science Information (ISI)-Web of Science, PubMed, EMBASE, ClinicalTrials.gov, Cochrane Library databases, Scopus, and Google Scholar" for peer reviewed, published studies and clinical trials through July 30, 2020. The search was based on keywords "COVID-19" SARS-COV-2, chloroquine, hydroxychloroquine, convalescent plasma, remdesivir and treatment modalities. RESULTS: As of July 30, 2020, a total of 36,640 relevant documents were published. From them 672 peer reviewed, published articles, and clinical trials were screened. We selected 17 relevant published original articles and clinical trials: 05 for chloroquine and/or hydroxychloroquine with total sample size (n = 220), 05 for Remdesivir (n = 1,781), and 07 for Convalescent Plasma therapy (n = 398), with a combined total sample size (n = 2,399). Based on the available data, convalescent plasma therapy showed clinical advantages in SARS-COV-2 patients. CONCLUSIONS: All three treatment modalities have both favorable and unfavorable characteristics, but none showed clear evidence of benefit for early outpatient disease or prophylaxis. Based on the current available data, convalescent plasma therapy appears to show clinical advantages for inpatient use. In the future, ongoing large sample size randomized controlled clinical trials may further clarify the comparative efficacy and safety of these three treatment classes, to conclusively determine whom to treat with which drug and when to treat them.

12.
Cureus ; 11(5): e4786, 2019 May 30.
Article in English | MEDLINE | ID: mdl-31367504

ABSTRACT

Acquired hemophilia is a rare autoimmune disorder that is a result of antibodies against clotting factor VIII and it presents with excessive or prolonged bleeding, often into the muscles. Thrombotic phenomena with lupus anticoagulant are common in patients with systemic lupus erythematosus (SLE). We report a rare case of a young female with no significant past medical history presenting with hematoma of the hand who was later on found to have acquired hemophilia, SLE with antiphospholipid antibodies (APLA). She was successfully treated with upfront rituximab and prednisolone leading to early and prolonged remission. No increased incidence of infections was noted. Upfront rituximab appears to be a safe and effective option in the management of such patients when compared to use of cytotoxic agents such as cyclophosphamide; however, further data from randomized studies is needed. Neutropenia and acquired hemophilia should also be considered to be listed under hematological manifestations of SLE diagnostic criteria, as they are not uncommon in such patients.

13.
J Appl Physiol (1985) ; 119(6): 617-26, 2015 Sep 15.
Article in English | MEDLINE | ID: mdl-26183479

ABSTRACT

We investigated if the number and duration of breathing events coupled to upper airway collapsibility were affected by the time of day. Male participants with obstructive sleep apnea completed a constant routine protocol that consisted of sleep sessions in the evening (10 PM to 1 AM), morning (6 AM to 9 AM), and afternoon (2 PM to 5 PM). On one occasion the number and duration of breathing events was ascertained for each sleep session. On a second occasion the critical closing pressure that demarcated upper airway collapsibility was determined. The duration of breathing events was consistently greater in the morning compared with the evening and afternoon during N1 and N2, while an increase in event frequency was evident during N1. The critical closing pressure was increased in the morning (2.68 ± 0.98 cmH2O) compared with the evening (1.29 ± 0.91 cmH2O; P ≤ 0.02) and afternoon (1.25 ± 0.79; P ≤ 0.01). The increase in the critical closing pressure was correlated to the decrease in the baseline partial pressure of carbon dioxide in the morning compared with the afternoon and evening (r = -0.73, P ≤ 0.005). Our findings indicate that time of day affects the duration and frequency of events, coupled with alterations in upper airway collapsibility. We propose that increases in airway collapsibility in the morning may be linked to an endogenous modulation of baseline carbon dioxide levels and chemoreflex sensitivity (12), which are independent of the consequences of sleep apnea.


Subject(s)
Respiratory System/physiopathology , Sleep Apnea, Obstructive/physiopathology , Sleep/physiology , Adult , Carbon Dioxide/metabolism , Humans , Male , Pressure , Respiration , Respiratory System/metabolism , Sleep Apnea, Obstructive/metabolism , Time Factors
14.
J Appl Physiol (1985) ; 117(10): 1149-56, 2014 Nov 15.
Article in English | MEDLINE | ID: mdl-25213638

ABSTRACT

Our investigation was designed to determine whether the time of day affects the carbon dioxide reserve and chemoreflex sensitivity during non-rapid eye movement (NREM) sleep. Ten healthy men with obstructive sleep apnea completed a constant routine protocol that consisted of sleep sessions in the evening (10 PM to 1 AM), morning (6 AM to 9 AM), and afternoon (2 PM to 5 PM). Between sleep sessions, the participants were awake. During each sleep session, core body temperature, baseline levels of carbon dioxide (PET(CO2)) and minute ventilation, as well as the PET(CO2) that demarcated the apneic threshold and hypocapnic ventilatory response, were measured. The nadir of core body temperature during sleep occurred in the morning and was accompanied by reductions in minute ventilation and PetCO2 compared with the evening and afternoon (minute ventilation: 5.3 ± 0.3 vs. 6.2 ± 0.2 vs. 6.1 ± 0.2 l/min, P < 0.02; PET(CO2): 39.7 ± 0.4 vs. 41.4 ± 0.6 vs. 40.4 ± 0.6 Torr, P < 0.02). The carbon dioxide reserve was reduced, and the hypocapnic ventilatory response increased in the morning compared with the evening and afternoon (carbon dioxide reserve: 2.1 ± 0.3 vs. 3.6 ± 0.5 vs. 3.5 ± 0.3 Torr, P < 0.002; hypocapnic ventilatory response: 2.3 ± 0.3 vs. 1.6 ± 0.2 vs. 1.8 ± 0.2 l·min(-1)·mmHg(-1), P < 0.001). We conclude that time of day affects chemoreflex properties during sleep, which may contribute to increases in breathing instability in the morning compared with other periods throughout the day/night cycle in individuals with sleep apnea.


Subject(s)
Carbon Dioxide/metabolism , Chemoreceptor Cells/metabolism , Circadian Rhythm , Lung/innervation , Reflex , Sleep Apnea, Obstructive/metabolism , Sleep Stages , Actigraphy , Activity Cycles , Adult , Body Temperature Regulation , Humans , Male , Polysomnography , Pulmonary Ventilation , Respiratory Mechanics , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/physiopathology , Time Factors
15.
PLoS One ; 8(6): e66449, 2013.
Article in English | MEDLINE | ID: mdl-23840471

ABSTRACT

OBJECTIVES: This study aimed to compare the impact of Gross Domestic Product (GDP) per capita, spending on Research and Development (R&D), number of universities, and Indexed Scientific Journals on total number of research documents (papers), citations per document and Hirsch index (H-index) in various science and social science subjects among Asian countries. MATERIALS AND METHODS: In this study, 40 Asian countries were included. The information regarding Asian countries, their GDP per capita, spending on R&D, total number of universities and indexed scientific journals were collected. We recorded the bibliometric indicators, including total number of research documents, citations per document and H-index in various science and social sciences subjects during the period 1996-2011. The main sources for information were World Bank, SCI-mago/Scopus and Web of Science; Thomson Reuters. RESULTS: The mean per capita GDP for all the Asian countries is 14448.31±2854.40 US$, yearly per capita spending on R&D 0.64±0.16 US$, number of universities 72.37±18.32 and mean number of ISI indexed journal per country is 17.97±7.35. The mean of research documents published in various science and social science subjects among all the Asian countries during the period 1996-2011 is 158086.92±69204.09; citations per document 8.67±0.48; and H-index 122.8±19.21. Spending on R&D, number of universities and indexed journals have a positive correlation with number of published documents, citations per document and H-index in various science and social science subjects. However, there was no association between the per capita GDP and research outcomes. CONCLUSION: The Asian countries who spend more on R&D have a large number of universities and scientific indexed journals produced more in research outcomes including total number of research publication, citations per documents and H-index in various science and social science subjects.


Subject(s)
Biomedical Research/economics , Gross Domestic Product , Periodicals as Topic/statistics & numerical data , Research Support as Topic/statistics & numerical data , Universities/statistics & numerical data , Asia , Humans
16.
Respir Physiol Neurobiol ; 188(3): 289-300, 2013 Sep 15.
Article in English | MEDLINE | ID: mdl-23587570

ABSTRACT

This review examines the role that respiratory plasticity has in the maintenance of breathing stability during sleep in individuals with sleep apnea. The initial portion of the review considers the manner in which repetitive breathing events may be initiated in individuals with sleep apnea. Thereafter, the role that two forms of respiratory plasticity, progressive augmentation of the hypoxic ventilatory response and long-term facilitation of upper airway and respiratory muscle activity, might have in modifying breathing events in humans is examined. In this context, present knowledge regarding the initiation of respiratory plasticity in humans during wakefulness and sleep is addressed. Also, published findings which reveal that exposure to intermittent hypoxia promotes breathing instability, at least in part, because of progressive augmentation of the hypoxic ventilatory response and the absence of long-term facilitation, are considered. Next, future directions are presented and are focused on the manner in which forms of plasticity that stabilize breathing might be promoted while diminishing destabilizing forms, concurrently. These future directions will consider the potential role of circadian rhythms in the promotion of respiratory plasticity and the role of respiratory plasticity in enhancing established treatments for sleep apnea.


Subject(s)
Hypoxia/physiopathology , Respiratory Mechanics/physiology , Sleep Apnea Syndromes/physiopathology , Animals , Circadian Rhythm/physiology , Humans , Respiratory Muscles/innervation , Respiratory Muscles/physiology
17.
J Appl Physiol (1985) ; 114(1): 52-65, 2013 Jan 01.
Article in English | MEDLINE | ID: mdl-23139361

ABSTRACT

We examined the impact of arousal state, sex, and obstructive sleep apnea (OSA) on the magnitude of progressive augmentation of the hypoxic ventilatory response and ventilatory long-term facilitation (vLTF). We also examined whether exposure to intermittent hypoxia during sleep has an impact on the apnea-hypopnea index (AHI) in individuals with OSA. Ten men and seven women with OSA, along with ten healthy men and ten healthy women, were exposed to twelve 2-min episodes of hypoxia (end-tidal PO(2): 50 Torr) in the presence of sustained hypercapnia (end-tidal PCO(2): 3 Torr above baseline), followed by a 30-min recovery period during wakefulness and sleep. The OSA participants completed an additional sham study during sleep. The AHI during the first hour of sleep following the intermittent hypoxia and sham protocols were compared. Progressive augmentation was only evident during wakefulness and was enhanced in the OSA participants. vLTF was evident during wakefulness and sleep. When standardized to baseline, vLTF was greater during wakefulness and was enhanced in the OSA group (men: wakefulness 1.39 ± 0.08 vs. sleep 1.14 ± 0.03; women: wakefulness 1.35 ± 0.03 vs. sleep 1.16 ± 0.05 fraction of baseline; P ≤ 0.001) compared with control (men: wakefulness 1.19 ± 0.03 vs. sleep 1.09 ± 0.03; women: wakefulness 1.26 ± 0.05 vs. sleep 1.08 ± 0.04 fraction of baseline; P ≤ 0.001). The AHI following exposure to intermittent hypoxia was increased (intermittent hypoxia 72.8 ± 7.3 vs. sham 56.5 ± 7.0 events/h; P ≤ 0.01). Sex-related differences were not observed for the primary measures. We conclude that progressive augmentation is not evident, and the magnitude of vLTF is diminished during sleep compared with wakefulness in men and women. However, when present, the phenomena are enhanced in individuals with OSA. The AHI data indicate that, under the prevailing experimental conditions, vLTF did not serve to mitigate apnea severity.


Subject(s)
Arousal/physiology , Hypoxia/physiopathology , Pulmonary Ventilation/physiology , Sleep Apnea Syndromes/physiopathology , Sleep Apnea, Obstructive/physiopathology , Sleep/physiology , Adult , Female , Humans , Male , Respiratory Mechanics/physiology , Sex Factors , Tidal Volume/physiology , Wakefulness/physiology , Young Adult
18.
Meat Sci ; 37(1): 103-13, 1994.
Article in English | MEDLINE | ID: mdl-22059416

ABSTRACT

Proximate composition, sarcoplasmic and myofibrillar protein fractions of buffalo meat were similar to those of beef. Buffalo meat was also rich in lysine. Meat from young animals had a lower collagen content than that from old ones. As the temperature of holding the carcasses was increased, the rate of pH fall was faster. Meat from stressed animals showed a higher ultimate pH. Percentage of cooking loss and thermal shrinkage was higher in muscles of old animals than in young ones, which probably reflected the poor condition of the older animals. Meat cooked by pressure cooking showed lower Warner-Bratzler shear values as compared with meat cooked in boiling water.

19.
Meat Sci ; 35(3): 331-40, 1993.
Article in English | MEDLINE | ID: mdl-22061227

ABSTRACT

A study was conducted on some physico-chemical and sensory characteristics of buffalo meat frozen by plate and blast freezing and stored at -15 ± 3°C for a period of 3 months. A marginal increase in pH values and drip losses were observed during the storage period. Drip losses were less in blast frozen samples. WHC, cooking losses thermal shrinkage and WB Shear values indicated inconsistent results, during storage. Similar observations were recorded with regard to tyrosine and TBA values. No significant differences in the physico-chemical characteristics were observed between meat cuts and minced meat. Plate frozen meat samples scored higher for texture, juiciness and aroma. Both the plate and blast frozen meat samples, however, were similar in overall quality according to taste panel results.

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