The dentist's role in diagnosis and treatment of obstructive sleep apnea syndrome: a literature review.

The purpose of this work was to present a review of the literature concerning obstructive sleep apnea syndrome, and the role of the dentist in this pathology, both to identify elements useful for a good diagnosis and to apply the available therapeutic strategies. In literature there is no unanimous opinion on the treatment of OSAS. The multidisciplinary approach is necessary, creating teams made up of dentists, otolaryngologists and medical experts in sleep disorders, in order to develop a cooperation-based treatment plan for the disease. In this review, the importance of early diagnosis, orthodontic therapy in order to restore normal function is underlined, since OSAS is linked to a high risk of hypertension, cardiovascular diseases, daytime sleepiness, domestic and work accidents, with consequent deterioration of the quality of life.

Prediction of glucose oxidation rate during exercise.

Recently, the relationship between percentage maximal heart rate vs. glucose oxidation rate has been proposed as a tool for estimating glucose oxidation rate during exercise in insulin-dependent diabetic patients. The reliability of this relationship and its applicability to long-term exercise is evaluated. Eight healthy volunteers performed a graded cycloergometric exercise (10-min steps at 30, 50, 70, 90 % of ventilatory threshold). Heart rate and glucose oxidation rate (by indirect calorimetry) were measured during the last 5 min of each step. Volunteers underwent then three 1-hour constant intensity rides at 40, 60, 80 % of ventilatory threshold. Heart rate was recorded continuously; glucose oxidation rate was determined over 15-min periods. The percentage maximal heart rate vs. glucose oxidation rate relationship obtained from the graded exercise matched that previously reported. Independently of intensity, glucose oxidation rates observed during the 1-hr rides were linearly related to the estimated ones (R(2)>0.96, p<0.001), being, however, progressively over-estimated in subsequent exercise periods. The proposed correction yields values close to the identity line (y=1.001 x x; R2=0.974, p<0.001), the difference between observed and "corrected" values amounting to 0.23+/-2.17 mg x min (-1) x kg (-1). In conclusion, glucose oxidation rate can be estimated from heart rate, once proper correction factors are applied for long duration exercises.