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Biomedical subjects

R Peled

Publications and source records attributed to R Peled.

53 records · Page 3Linked to original sources
PubMed1986

Preliminary clinical experience with imipramine HCl in the treatment of sleep apnea syndrome.

In the last 2 years we have systematically treated 31 sleep apnea patients with 25-50 mg imipramine HCl given 30 min before bedtime. Imipramine treatment was attempted for nonoverweight patients with negative ear, nose and throat (ENT) findings and for patients who had not responded to weight reduction or ENT surgery (in all patients the apneas were not considered life threatening). Thirteen of the 31 (41.9%) patients, of whom 9 had central apnea, reported subjective improvement in diurnal and nocturnal symptoms within 10-15 days from the initiation of treatment. Sleep laboratory recordings conducted 1-5 months after the beginning of treatment revealed a significant decrease in the total number of apneas from 242 +/- 156 to 142.8 +/- 120.1 (p less than 0.01) in these patients. We concluded that treatment with imipramine may benefit selected sleep apnea patients particularly of the central type.

Adult↗
PubMed1986

Paroxysmal awakenings from sleep associated with excessive daytime somnolence: a form of nocturnal epilepsy.

We describe 14 hypersomniac patients whose polysomnographic recordings revealed abnormal EEG patterns consisting of paroxysmal epileptic discharges during stages 2 and 3 of NREM sleep, associated with arousals, fragmentation of sleep, and reduction in sleep efficiency, particularly REM sleep. Three patients who received anticonvulsants showed clinical and polysomnographic documented improvement in sleep patterns. These patients probably had a unique form of nocturnal epilepsy-related sleep disorder, manifested by paroxysmal wakenings from sleep.

Adolescent↗
PubMed1986

Time domain analysis of VEPs. Detection of waveform abnormalities in multiple sclerosis.

Visual evoked potentials (VEPs) are a useful tool in the diagnosis of multiple sclerosis. To improve their diagnostic power in the early stages of the disease, the VEP shape, as well as its latency, were considered. The Karhunen-Loeve expansion (KLE) was used because it affords an unique advantage in classifying the VEPs by their shape, and gives a well-defined criterion based on similarity to the normative prototype. Using this criterion, it was possible to quantitatively define normative limits of waveform. We were also able to detect early changes in VEPs recorded from suspected multiple sclerosis patients. KLE promises to enable classification of waveforms in early stages of the pathology, when peak-latency comparisons are the least effective.

Adult↗
PubMed1985

Periodic leg movements in sleep: effect of clonazepam treatment.

Periodic leg movements in sleep were diagnosed in 8 patients with insomnia and in 12 patients with hypersomnia. Polysomnography did not reveal any difference in the number of leg movements in these groups, the mean duration of a leg movement, or the number of activity epochs. Those with insomnia, however, had a shorter intermovement interval than those with hypersomnia, with more leg movements in each activity epoch. Treatment with 0.5 to 2 mg clonazepam improved subjective complaints and decreased the number of leg movements without affecting the intermovement interval or movement duration.

Adult↗
PubMed1985

A hypernychthemeral sleep-wake syndrome: a treatment attempt.

The wake and sleep-onset times of a patient with a sleep-wake cycle longer than 24 hr were recorded by the patient for 4 years. During this time, the patient found himself unable to maintain a 24-hr sleep-wake schedule. When treated with 1-2 mg clonazepam, taken nightly, he was able to become entrained to a 24-hr day. Despite entrainment of his sleep-wake cycle, the patient reported depression, lack of motivation and fatigue and chose not to continue taking the drug.

Adult↗
PubMed1984

Speech arrest and supplementary motor area seizures.

A right-handed man had recurrent episodes of speech arrest that were focal epileptic seizures. A metastatic adenocarcinoma was identified and removed from the left supplementary motor area. The similarity of these rare seizures to transient ischemic attacks may lead to an erroneous and hazardous misdiagnosis.

Adenocarcinoma↗
PubMed1984

Localized pontine lesion: nearly total absence of REM sleep.

Eight whole-night polysomnographic recordings were conducted in a 33-year-old man with a localized pontine lesion inflicted by a shrapnel fragment. Sleep recordings revealed no rapid eye movement (REM) sleep in 3 nights, and markedly reduced REM sleep in 5 nights; non-rapid eye movement (NREM) sleep was normal. In spite of marked reduction of REM sleep, the patient conducted a normal life and had none of the typical symptoms of REM-sleep deprivation.

Adult↗
PubMed1984

Auditory middle latency-evoked potentials during sleep apnea.

Auditory middle-latency evoked potentials (AMEP) were recorded in 10 subjects with predominantly central sleep apnea. AMEP were recorded during: waking; non-rapid eye movement (non-REM) sleep between apneic episodes; first half of apneas; and second half of apneas. Latencies of vertex positive peaks Po and Pa were determined, and the effect of the apnea phase on these latencies was evaluated. The latencies measured did not reveal chronic or acute functional abnormality of central auditory structures, which may result from or cause apneic episodes during non-REM sleep. The normalcy and stability of AMEP during apneic sleep may indicate effective compensatory mechanisms in central auditory structures. Alternatively, the lack of changes may result from the variability of AMEP, which may obscure small functional changes.

Adult↗
PubMed1983

Auditory brainstem evoked potentials during sleep apnea.

Auditory brainstem evoked potentials (ABEPs) were recorded from seven subjects with predominantly central sleep apnea. ABEPs were recorded during: (1) waking, (2) non-REM sleep between apneic episodes, (3) first half of apneas, and (4) second half of apneas. Latencies of vertex positive peaks III, V, and VI as well as the V-III interpeak latency difference were determined, and the effect of apnea phase on these measures were evaluated. The measures studied did not reveal chronic or acute functional abnormality of auditory brainstem, which may result from or cause apneic episodes during non-REM sleep. The normality and stability of ABEPs during apneic sleep indicate effective compensatory mechanisms in auditory brainstem. Brainstem functional changes associated with central apneas may not be reflected in the ABEP measures studied, unless they are part of a more extensive dysfunction.

Adult↗
PubMed1981

Auditory brain stem evoked potentials: clinical promise of increasing stimulus rate.

Auditory brain stem evoked potentials (ABEPs) were recorded from 10 adults and 10 children who where neurologically and audiometrically normal. ABEPs were recorded in response to 75 dB HL clicks presented at rates of 10/sec and 50/sec. Normative values were calculated for amplitude and latency, as well as for inter-peak amplitude ratio and a variety of inter-peak latency differences and interaural differences at the two stimulus presentation rates. Normative values of the effect of increasing stimulus rate were calculated as well. Measures of changes in ABEPs between stimulus rates of 50/sec and 10/sec were the only derived measures that were significantly different between our adult and child normal populations. In addition, 50 patients with various conditions affecting the brain stem were examined. Increasing stimulus presentation rate had a significant effect on detection of abnormality in ABEPs from the patients examined. Measures of changes in ABEPs between stimulus rates of 50/sec and 10/sec seemed to be sensitive to a subset of abnormalities in our patient population. The case histories of the patients indicate that the subset may be impaired synaptic function. Measures of the effect of rate on ABEPs may complement the traditional measures that are primarily sensitive to white matter lesions.

Acoustic Stimulation↗
PubMedDate not supplied

Differences in lung function among school children in communities in Israel.

Differences in lung functions of school-age children who lived near two electrical power plants in the Ashkelon district of Israel were studied. Lung-function tests were performed, and the American Thoracic Society questionnaire was administered in three study periods during the following years: (1) 1990, (2) 1994, and (3) 1997. Measurements of air pollutants (i.e., sulfur dioxide, nitric oxides, ozone) were also taken during the aforementioned study periods. Statistical analysis included an estimation of a series of fixed-effects regression models. A total of 2,455, 1,613, and 4,346 observations were included in the analyses for study years 1990, 1994, and 1997, respectively. The authors controlled for age, sex, height, weight, parents' education and smoking status, and being born out of Israel, and, consequently, substantial differences in lung function across the different communities and study periods were demonstrated in the study area. No robust association with air pollution was demonstrated. The cause of these differences in the respiratory health of children remains unknown.

Air Pollutants↗