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Biomedical subjects

J Roca

Publications and source records attributed to J Roca.

At least 163 records · Page 9Linked to original sources
PubMed1996

Genotype determination of hepatitis C virus from northern India: identification of a new subtype.

Hepatitis C virus (HCV) shows substantial nucleotide sequence diversity distributed throughout the viral genome, with many variants showing only 68-79% overall sequence homology. This has led to problems in diagnosis of HCV using commercial immunoassays. Based on clustering of homologous sequences, various genotypes and subtypes of HCV have been described from different geographical regions. In the present study, 11 isolates from India were genotyped using sequence comparison for part of the non-structural (NS5) and structural (core) regions. Parts of the genome covering 451 bp (nt 9-459) of the core gene and a 249 bp fragment (nt 7959-8207) of the NS5 gene were reverse transcribed and amplified using nested polymerase chain reaction (RT-PCR). The amplified fragments were cloned and sequenced. The classification into genotypes was done on the basis of phylogenetic analysis. Four isolates showed sequence homology to type 1b. Two of the isolates were classified as type 3a. One isolate was classified as type 3b and the remaining four isolates were found to be variants of type 3 but did not belong to any designated subtype. On the basis of phylogenetic analysis two of the unclassified isolates were put into a new subtype of 3 named as 3g. In one of these variants, parts of a 5'-noncoding (5' NCR; 204 bp), envelope-E1 (435 bp), and NS3 (502 bp) regions were also amplified, cloned, and sequenced. This study demonstrates the type 3 variants including a new subtype (3g) to be the major cause of HCV infection in India.

Amino Acid Sequence↗
PubMed1996

In vitro penetration assay of boar sperm fertility: effect of various factors on the penetrability of immature pig oocytes.

The present study was designed 1) to examine the influence of cumulus cells, ovary storage time and oocyte size on the penetrability of immature pig oocytes, and 2) to investigate the effect of 2 methods of treating the semen from different boars on the inter-assay variability of homologous in vitro penetration tests of boar sperm fertility. In Experiment 1, cumulus oocyte complexes, oocytes with spontaneous loss of the cumulus cells during collection, and oocytes mechanically stripped of cumulus cells were used. No differences were observed in oocyte penetrability among the 3 types of oocyte, although mechanical removal of the cumulus caused an increase (P < 0.005) in the degeneration rate compared with the other oocyte types. In Experiment 2, the oocytes were recovered from ovaries kept in PBS (30 degrees C) for 2, 4 or 6 h after slaughter of prepuberal gilts. Ovary storage did not modify the penetrability of oocytes but increased (P < 0.02) their degeneration rates. In Experiment 3, the diameters of fresh oocytes were determined after co-incubation with spermatozoa. They were classified into 4 groups according to diameter: A) < 105 microm, B) 105-115 microm, C) 116-120 microm and D) > 120 microm. Oocytes from Groups C and D exhibited higher (P < 0.05) penetrability than oocytes from the other groups. In Experiment 4, stored, diluted spermatozoa from 4 boars were pretreated by centrifugation at 50 x g for 3 min and subsequent concentration of the supernatants at 1,200 x g for 3 min. The pellets were treated (washed twice and preincubated for 40 minutes) before co-incubation with immature oocytes or used directly as untreated samples (unwashed and non-preincubated). A boar effect (P < 0.001) was evident for the parameters of in vitro penetration, independently of sperm treatment. When the oocytes were inseminated with untreated spermatozoa, the effects of the replicate and the boar-by-replicate interaction on the variability in oocyte penetrability were not significant. The results of this study indicate that the use of standardized immature pig oocytes and stored untreated, diluted spermatozoa can provide a useful method for optimizing the homologous in vitro penetration (hIVP) assay of boar fertility.

Journal Article↗
PubMed1996

Association of quantitative cytomegalovirus antigenemia with symptomatic infection in solid organ transplant patients.

A prospective virologic follow-up of solid organ transplant patients was designed to determine the usefulness of antigenemia and viremia as virologic markers for the diagnosis of cytomegalovirus (CMV) infections, and also for monitoring CMV disease and therapy control. A total of 629 blood samples from 127 patients (60 liver, 47 kidney, and 20 heart transplant recipients) were studied by tube and shell vial cultures, and by antigenemia assay. This later was carried out by an indirect immunofluorescent assay method for formalin-fixed cytospin slides containing 2 x 10(5) leukocytes, using a monoclonal antibody directed against the CMV pp65 antigen. CMV was detected by at least one of the three methods in 238 specimens (37.8%) from a total of 63 patients. The antigenemia assay was positive in 215 (90.3% of positive samples). A total of 94 samples were detected only by this marker, which occurred either in samples with low positive counts (70.2% with antigenemia counts < 10 positive cells/10(5) leukocytes) or in specimens from treated patients. There were 30 episodes of CMV disease in 23 patients. Antigenemia was positive in all these episodes, 27 of them with counts > 20 positive cells/10(5) leukocytes. With this cut-off, positive and negative predictive values for symptomatic CMV infection were 100% and 97.2%, respectively. The antigenemia assay is a rapid, sensitive, specific, and early marker of CMV infection in transplantees. Cultures became negative with antiviral therapy while remaining antigenemia detectable. There was an association between highest quantitative antigenemia test results and clinical symptoms in our patients. In its quantitative version, the assay is useful to detect symptomatic infection and appears to be a helpful tool in managing patients at risk and in guiding antiviral therapy.

Antigens, Viral↗
PubMed1996

Catalonia WHO Demonstration Project on Palliative Care Implementation 1990-1995: results in 1995.

A global, comprehensive, publicly planned and financed program to implement palliative care was designed by the Department of Health of Catalonia (6 million inhabitants. Planned in collaboration with the cancer unit of the WHO in 1989, the program was implemented in 1990-1995. It included specific services, measures general resources, education and training, organizational and educational standards, opioid availability, legislation and evaluation. The aims included coverage for cancer, AIDS, geriatric and other conditions, equity, quality, reference, and satisfaction for patients, families, and professionals. The results in 1995 include the implementation of 18 hospital support teams and 19 Units, with a total of 350 beds, 42 home-care teams. The coverage for cancer and AIDS is around 40%, and 44/55 (80%) districts have a specific team. Palliative care implementation has been completely publicly financed, with a total yearly investment of 2,200 million ptas. Eighty percent of this has been saved through radical changes in costs and the pattern of the use of resources. Palliative care implementation has demonstrated efficacy in the care of the patients and families, efficiency in the provision of care, and cost-benefit in the regional global approach. It adds qualitative and organizational values to the health-care system. Its implementation must be prioritized and planned by the health administration, not only to improve the quality of care for advanced and terminal patients, but also to improve the global efficiency and appropriate use of resources in the public health system.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Lectin histochemistry during in vitro capacitation and acrosome reaction in boar spermatozoa: new lectins for evaluating acrosomal status of boar spermatozoa.

Six peroxidase (HRP)-conjugated lectins have been used to analyze the distribution of carbohydrates in ejaculated boar spermatozoa during in vitro capacitation and acrosome reaction in air-dried preparations. The membranes of boar spermatozoa were positive to WGA and Con-A in the acrosome, middle piece and principal piece. PNA labelled the acrosomal region. DBA, UEA-I and LTA bound weakly or not to the spermatozoa. The lectin labelling pattern did not change during the in vitro capacitation. A diminution in the proportion of spermatozoa with acrosome positive to lectins PNA, WGA and Con-A was observed after coincubation with homologous immature oocytes. A positive correlation existed between the percentages of lectins bound to spermatozoa and the triple stain technique. The results show that peroxidase-conjugated lectins may be useful in determining acrosomal integrity of boar spermatozoa during in vitro capacitation and acrosome reaction.

Acrosome↗
PubMed1996

Mechanisms of gas exchange impairment in patients with liver cirrhosis.

This article reviews the basic pathophysiologic mechanisms underlying the abnormal pulmonary gas exchange often seen in patients with cirrhosis. To summarize, the following keypoints seem appropriate: (1) Patients with cirrhosis have a low pulmonary vascular tone characterized by a poor or absent hypoxic pressor response. This results in a marked dilation of the pulmonary vasculature. (2) This abnormal pulmonary vascular tone, independently of airway disease, causes VA/Q mismatch and mild to moderate hypoxemia. Yet, as liver disease progresses and hepatocellular function deteriorates, more severe degrees of intrapulmonary shunt emerge and, probably, O2 diffusion limitation ensues, causing severe respiratory failure (see Table 1). (3) At rest, the high cardiac output and minute ventilation of cirrhosis minimize the degree of arterial hypoxemia that otherwise would be expected from the observed degree of both VA/Q inequality and intrapulmonary shunt. During exercise, the relative "normalization' (with respect to metabolic demands) of the hemodynamic and ventilatory status of the patient explains the fall in PaO2. (4) A clear pathogenic mechanism of these pathophysiologic abnormalities is still lacking, although available evidence suggests that both the liver and the endothelial cells may play a pivotal role in the regulation of the pulmonary vascular tone in these patients. (5) To date, no pharmacologic intervention has been effective in treating hypoxemia in these patients. Yet liver transplantation helps in most of them. This observation reinforces the functional nature of the gas exchange abnormalities of cirrhosis.

Animals↗
PubMed1996

The probabilities of supercoil removal and decatenation by yeast DNA topoisomerase II.

BACKGROUND: In yeast a single type II DNA topoisomerase is involved in both the removal of DNA supercoils and the unlinking of intertwined pairs of newly replicated chromosomes or plasmids; in bacteria, two type II enzymes, DNA gyrase and DNA topoisomerase IV, function separately in the passage of DNA segments in cis and in trans. To deduce the molecular characteristics of these enzyme-mediated reactions, the efficiencies of supercoil removal and decatenation by the yeast enzyme upon the addition of a nonhydrolysable ATP analogue were determined. RESULTS: The probability that a bound enzyme transports a DNA segment in cis increases with positive or negative supercoiling of the DNA, and transport is nearly quantitative at high degrees of supercoiling. The relative probabilities of transporting a contiguous and noncontiguous DNA segment by a yeast enzyme bound to one member of a singly linked pair of 3.6-kb rings were calculated from the observed efficiency of decatenation. When the enzyme-bound ring is highly supercoiled, transport of a noncontiguous segment is more probable than a contiguous one. CONCLUSION: A DNA-bound yeast enzyme has no intrinsic bias in its selection of a contiguous or noncontiguous DNA segment for transport, and the selection is determined by DNA conformations. For the singly linked dimeric catenane studied, a high degree of supercoiling of the enzyme-bound DNA does not make supercoil removal more favourable than decatenation. In the case of bacterial gyrase, however, wrapping of a DNA segment around the enzyme is expected to strongly favour the transport of a contiguous segment.

Biological Transport, Active↗
PubMed1996

Physical exercise increases portal pressure in patients with cirrhosis and portal hypertension.

BACKGROUND & AIMS: In healthy subjects, exercise promotes marked hemodynamic and humoral changes characterized by an increase in cardiac output, a redistribution of blood flow to muscular territories under activity, and an increase in sympathoadrenergic activity. The aim of this study was to investigate the extent to which hemodynamic and humoral changes caused by exercise may influence portal and systemic hemodynamics in patients with cirrhosis. METHODS: In 8 patients with liver cirrhosis and portal hypertension, arterial pressure, cardiac output, portal pressure (as hepatic venous pressure gradient [HVPG]), and hepatic blood flow were measured before and at two steps of cycling exercise equivalent to 30% and 50% of their peak workload. RESULTS: Exercise (at 30% of peak work-load) significantly increased arterial pressure and cardiac output and decreased systemic vascular resistance. This was associated with a significant increase in HVPG (from 16.7 +/- 1.5 to 19.2 +/- 1.6 mm Hg; P < 0.01) and a significant reduction in hepatic blood flow (from 1291 +/- 216 to 1034 +/- 152 mL-min-1; P < 0.05). All of these changes were intensified at 50% of target workload. CONCLUSIONS: The present study shows that moderate exercise increases portal pressure and may therefore increase the risk of variceal bleeding in patients with esophageal varices. These findings suggest that cirrhotic patients with portal hypertension should be advised of potential risks during exercise.

Exercise↗
PubMed1996

Oocyte penetration by fresh or stored diluted boar spermatozoa before and after in vitro capacitation treatments.

This study examined whether washing and preincubation of boar spermatozoa was necessary to achieve high in vitro penetration rates of pig oocytes. In experiment 1, diluted, sperm-rich fractions, stored for 24 h at 16 degrees C (stored diluted sperm) were used. After centrifugation once at 50 g for 3 min, the supernatant was concentrated at 1200 g for 3 min. The pellets were washed (1200 g for 3 min) 0, 1, or 2 times in saline-BSA solution and preincubated for 0, 20, or 40 min in modified Medium 199 before insemination of immature oocytes. In experiment 2, immature and ovulated oocytes were inseminated with untreated (unwashed and nonpreincubated sperm from concentrated pellet resulting from centrifugation of supernatant fraction obtained by initial low-speed centrifugation) or treated (washed 2 times in saline-BSA solution and preincubated for 40 min), diluted spermatozoa that had been stored and processed as described above. In experiment 3, freshly undiluted or stored diluted spermatozoa were untreated or treated and used to penetrate immature oocytes. In experiment 4, immature oocytes were exposed to freshly undiluted or stored diluted spermatozoa from untreated or treated samples, and, at various times after insemination, oocytes were examined for evidence of penetration. High penetrability rates were obtained when untreated, stored diluted spermatozoa were used. Type of oocyte (immature vs. ovulated) did not affect penetrability regardless of whether untreated or treated, stored diluted spermatozoa were used. Penetration rates and number of spermatozoa per oocyte were lower (p < 0.05) using stored diluted spermatozoa that were washed twice and preincubated 40 min than when freshly undiluted or untreated, stored diluted spermatozoa were used. First evidence of penetration of oocytes by untreated or treated spermatozoa (freshly undiluted or stored diluted) was observed 3 h after insemination. Results indicate that, under the in vitro conditions studied, boar spermatozoa undergoes capacitation and a true acrosome reaction during coincubation with oocytes even when not washed or preincubated.

Animals↗
PubMed1996

Computed tomography-guided bronchoalveolar lavage in idiopathic pulmonary fibrosis.

BACKGROUND: High resolution computed tomography (HRCT) is now recognised as a sensitive tool for predicting the histological characteristics of the lung parenchymal abnormalities in patients with idiopathic pulmonary fibrosis (IPF). A reticular pattern on HRCT scanning is indicative of fibrotic histology while a ground glass pattern has been associated with inflammatory disease. The purpose of the present study was to investigate whether the cell population in the bronchoalveolar lavage (BAL) fluid from different lobes differs according to HRCT characteristics in patients with IPF. METHODS: Twenty six patients with IPF (18 men) of mean (SE) age 67 (2) years were included in the study. A semiquantitative analysis of the extent of the abnormalities on the HRCT scan was applied by summing the proportion of both reticular and ground glass patterns in each lobe (expressed as percentage of total area evaluated) and 100 ml double BAL was then randomly performed in the lobe with the most extensive involvement (lobe A) and that with the least extensive involvement (lobe B). RESULTS: Twenty three of the 26 patients (88%) had an abnormal cell count in the BAL fluid from lobe A compared with 18 patients (69%) with abnormalities in the BAL fluid from lobe B. The median (range) percentage of 8.5% (0-34%) and the absolute numbers of neutrophils (1.3 x 10(4)/ml, 0-14.6 x 10(4)/ml) in lobe A were significantly higher than those in lobe B (5% (0-26%) and 1.2 x 10(4)/ml (0-5 x 10(4)/ml), respectively). The percentage (3%, 0-19%) and absolute numbers (0.65 x 10(4)/ml, 0-4 x 10(4)/ml (0-4.8 x 10(4)/ml), respectively). For the group as a whole a correlation was found between the percentage and absolute numbers of neutrophils in the BAL fluid and the total score of abnormalities on the HRCT scan in the most involved lobe (lobe A). Multiple regression analysis indicated that both the percentage and absolute numbers of neutrophils were significantly and independently related to the extent of ground glass pattern. CONCLUSIONS: In patients with IPF the cell population in the BAL fluid is not homogeneous and seems to be related to the characteristics of the abnormalities on the HRCT scan present in the lavaged lobe.

Aged↗
PubMed1996

Salbutamol reduces pulmonary neutrophil sequestration of platelet-activating factor in humans.

To investigate whether salbutamol inhibits platelet-activating factor (PAF)-induced neutrophil sequestration in the lungs, we studied eight nonatopic, nonsmoking, healthy subjects (six men; aged 27.0 +/- 1.5 (SE) yr) with PAF-induced bronchial response. Prior to PAF challenge (24 micrograms), they inhaled either salbutamol (300 micrograms) or placebo in a randomized, double-blind, crossover manner two weeks apart. Respiratory system resistance (Rrs), arterial blood gases, and neutrophil counts were measured 4, 8, 12 and 30 min after PAF. Neutrophil kinetics in the lungs were assessed by tracking autologous 99mTc-erythrocytes and 111in-neutrophils. Compared with salbutamol, arterial blood neutrophil counts fell (p < 0.04) maximally at 4 min after PAF, followed by a mild rebound neutrophilia, whereas Rrs increased (p < 0.01) and Pao2 decreased (p < 0.05) at 4 min only. The intrapulmonary activity of 111in-neutrophils after pretreatment with placebo was higher compared with salbutamol (1.98 +/- 0.15 versus 1.33 +/- 0.23 cps/mCi/pixel) (p < 0.01) although both their initial sequestration (first-pass) and subsequent washout were not significantly different. Inhaled salbutamol blocks pulmonary neutrophil sequestration and lung function abnormalities following PAF challenge in humans.

Administration, Inhalation↗
PubMed1996

Effect of nitric oxide inhalation on respiratory system resistance in chronic obstructive pulmonary disease.

Nitric oxide (NO) has been identified as a neurotransmitter of nonadrenergic noncholinergic bronchodilator nerves. To investigate whether inhaled NO exerts a bronchodilator effect in patients with chronic obstructive pulmonary disease (COPD), we measured the resistance of the respiratory system, using the forced oscillation technique, while breathing NO. Eight patients with COPD (7 men and 1 woman; aged 66 +/- 7 yrs (mean +/- SD); forced expiratory volume in one second (FEV1) 37 +/- 17% of predicted) and eight healthy subjects (7 men and 1 woman; 33 +/- 4 yrs; FEV1 108 +/- 14% pred) were studied. Nitric oxide, at a concentration of 40 parts per million (ppm) in air, was inhaled for 20 min. Total resistance (Rrs) and reactance (Xrs) of the respiratory system, arterial oxygen saturation, heart rate, tidal volume, and breathing frequency were continuously recorded at baseline, and during and after ceasing NO inhalation. Methaemoglobin levels were additionally measured in healthy subjects. At baseline, patients with COPD showed higher Rrs than healthy subjects (Rrs at 10 Hz (Rrs,10) 4.97 +/- 2.19 vs 2.29 +/- 0.65 hPa.L-1.s). During NO inhalation, no significant change in Rrs or in Xrs was observed. Mean variation in Rrs,10 while breathing NO was negligible and similar in the two groups (-0.10 +/- 0.13 hPa.L-1.s in COPD patients and -0.02 +/- 0.13 hPa.L-1.s in healthy subjects). Moreover, there were no differences in oxygen saturation, heart rate, tidal volume and breathing frequency during NO inhalation. Methaemoglobinaemia increased at the end of NO inhalation (from 0.48 +/- 0.18 to 0.81 +/- 0.16%), and this increment remained 10 min later (0.86 +/- 0.31%). From these results, we conclude that inhaled nitric oxide, at a concentration of 40 ppm, exerts no effect on respiratory system resistance in patients with chronic obstructive pulmonary disease or in healthy subjects.

Administration, Inhalation↗
PubMed1996

Total serum IgE is associated with asthma independently of specific IgE levels. The Spanish Group of the European Study of Asthma.

In this study we aimed to assess whether the association between asthma (defined by symptoms and bronchial responsiveness) and total immunoglobulin E (IgE) levels was independent of specific IgE levels to common aeroallergens. A general population-based sample, supplemented with symptomatic individuals, comprising 1,916 young adults, aged 20-44 years, from five areas of Spain, performed a face-to-face respiratory questionnaire, and spirometry, and had total and specific serum IgE levels to mites, pets and moulds recorded. In 1,626 of the subjects, a dose-response methacholine challenge test was completed. Subjects reporting current attacks of asthma showed an association with total IgE (odds ratio (OR) for IgE > 100 kU.L-1 = 4.73, 95% confidence intervals (95% CI) = 2.01-11.12, adjusted for specific IgE, sex, age, smoking, forced expiratory volume in one second (FEV1), and area), which did not vary by bronchial responsiveness. The association between total IgE and asthma also occurred among those with negative specific IgE antibodies (OR 18.0; 95% CI 13.9-120). Individuals with current wheezing and bronchial responsiveness without attacks of asthma also showed an adjusted association with total IgE (OR 4.96; 95% CI 2.32-10.6), which remained for persons without specific IgE (OR 5.86; 95% CI 2.18-1.7). These findings reinforce previous evidence that asthma is associated with increased levels of total IgE, even in subjects negative for specific IgE to common aeroallergens.

Adult↗
PubMed1996

Bacterial colonization as a potential source of nosocomial respiratory infections in two types of spirometer.

The potential risk of spirometers in the transmission of respiratory infections has not been yet established. We performed a prospective cross-sectional study to determine the rate of colonization of a water-sealed spirometer and a pneumotachograph, and the potential risk of cross-transmission of microorganisms to patients using each of these devices. Fifty four patients (aged 51 +/- 18 (mean +/- SD) yrs) were included in the study. All of them had undergone forced spirometry with bronchodilator response by means of the water-sealed spirometer (n = 36) or the pneumotachograph (n = 18). None had a clinically apparent respiratory infection at the time of the study. Routine hygiene measures for respiratory equipment were performed before the study protocol. Samples for microbiological cultures of different parts both of the water-sealed spirometer (proximal and distal tubing, bell and water-bell) and pneumotachograph (proximal and distal tubing) were taken daily before and after the usual series of lung function tests during a 5 day period. Pharyngeal swab cultures were obtained before spirometry and 7 days later in each subject. Thirty six out of a total of 40 (90%) culture samples from the water-sealed spirometer showed microbial growth compared to 4 out of 30 (13%) samples obtained from the pneumotachograph (p < 0.0001). Significant colonization of the water-sealed spirometer was apparent after the third day of the study. The microorganisms most frequently isolated were penicillium sp. (62%), Pseudomonas fluorescens (32%), and Burkholderia cepacea (48%). Distal tubing, water and water-bell were the parts of the water-sealed spirometer that showed higher colonization counts (> or = 10(4) colony-forming units (cfu).mL-1). No transmission sequence of potentially pathogenic microorganisms from equipment to patients or vice versa could be demonstrated. In summary, the water-sealed spirometer frequently became colonized by microorganisms. The potential hazard of such equipment as reservoirs of microorganisms suggests a need for the implementation of new hygiene measures for their maintenance.

Bacterial Infections↗
PubMed1996

Ventilation-perfusion response after fenoterol in hypoxemic patients with stable COPD.

BACKGROUND: The effects of vasoactive drugs, including bronchodilators, on vascular and pulmonary dynamics are interrelated, complex and difficult to measure, but important because of potential deleterious effects on gas exchange. METHODS: To assess the effects of fenoterol at both high and low dose on pulmonary gas exchange in 24 hypoxemic patients with stable COPD: fenoterol, 5 mg; fenoterol, 1 mg and ipratropium bromide, 0.5 mg; ipratropium bromide, 0.5 mg; or matched placebo were nebulized in a double-blind, placebo-controlled fashion. Spirometry, ventilation, systemic hemodynamics, and respiratory and inert gases were measured before and 15, 60, and 120 min after each treatment. RESULTS: Compared with placebo, heart rate (p < 0.002) and cardiac output (p = 0.05) increased after high-dose fenoterol therapy to return to baseline values by 120 min. Following fenoterol at high dose, mean maximum PaO2 change from baseline decreased by 6.3 +/- 1.1 mm Hg (SD) and both alveolararterial oxygen pressure difference (P[A-a]O2), by 8.3 +/- 4.0 mm Hg, and ventilation-perfusion (VA/Q) mismatching increased, as evidenced by increments of the dispersion of pulmonary blood flow, without reaching significance; likewise, low-dose fenoterol therapy increased VA/Q inequalities while both PaO2 and P(A-a)O2 remained unchanged. CONCLUSIONS: In this population of COPD patients, high-dose fenoterol therapy [corrected] significantly increased heart rate and cardiac output resulting in minor adverse consequences on arterial oxygenation and VA/Q relationships.

Adrenergic beta-Agonists↗
PubMed1996

[Anatomical alterations of the upper airway in the sleeping apnea syndrome. Diagnostical and therapeutic implications].

In this paper are assessed through ENT-exam, rhinomanometry and cephalometry both bipedal and in dorsal decubitus, the anatomical alterations occurring in the upper airways in 100 consecutive patients, polysomnographically diagnosed of SAOS. The patients were classified in 4 groups (after Fujita's modified classification): 2 having oropharyngeal obstruction (I and IIa) and other 2 with hypopharyngeal obstruction (IIb and III), which were subdivided in its time with nasal obstruction present (N+) or absent (N-). Group I and IIa (68 %) -theoretical candidates to an uvulopalatopharyngoplasty, UPPP-showed its predominance, followed by a high incidence of nasal obstruction (N+, 48 %) and a non negligeable number of hypopharyngeal alterations (32 %).

Adult↗
PubMed1996

[Evaluation of the cephalometric structure of the upper airway on the configuration of the obstructive sleep apnea syndrome].

Thirty aleatory patients polysomnographically diagnosed as sleep apnea syndrome (SAOS) with an apnea-hypoapnea index (AHI) accounting for 61.3 +/- 31.1 were, bipedal and in decubitus, cephalometrically explored, aiming at establish the correlation between the cephalometric quantum of the upper airway and the anthropomorphic and polysomnographic parameters clearly establishing the syndrome. The weak correlation confirmed among the AHI and the back passage in decubitus (PASDEC), even between the nocturnal oxymetric nadir and the length of the palate, advice against considering the gravity of the OSAS as sole function of the altered cephalometric degree checked in the test.

Adult↗