Pediatric obstructive sleep apnea – Dental professionals can play a crucial role

2021 ◽  
Author(s):  
Nathalia Carolina Fernandes Fagundes ◽  
Carlos Flores‐Mir
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Crucial Role ◽  
Obstructive Sleep ◽  
Dental Professionals

scholarly journals GJA1 Expression and Left Atrial Remodeling in the Incidence of Atrial Fibrillation in Patients with Obstructive Sleep Apnea Syndrome

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1463
Author(s):  
Yung-Lung Chen ◽  
Yung-Che Chen ◽  
Ya-Ting Chang ◽  
Hui-Ting Wang ◽  
Wen-Hao Liu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Crucial Role ◽  
Left Atrial ◽  
Sleep Apnea Syndrome ◽  
Left Ventricular Ejection ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Obstructive sleep apnea syndrome (OSAS) is an important risk factor for atrial fibrillation (AF). GJA1 gene encoding connexin43, a major protein in cardiac gap junctions, plays a crucial role in the synchronized contraction of the heart and in cardiac arrhythmia. However, little is known regarding the role of GJA1 expression in the incidence of AF in patients with OSAS. All prospectively enrolled OSAS patients underwent polysomnography, electrocardiography, a 24-hour Holter test, and echocardiography. Moderate-to-severe OSAS was defined as an apnea-hypopnea index (AHI) ≥ 15. Exosomes were purified from the plasma of all OSAS patients and incubated in HL-1 cells to investigate the effect of exosomes from patients with and without AF on GJA1 expression. A total of 129 patients were recruited for this study; 26 were excluded due to an AHI < 15. Of the 103 enrolled patients, 21 had AF, and 82 did not. Multivariate analysis showed diabetes mellitus, lower sleep efficiency, lower left ventricular ejection fraction, and larger left atrial (LA) size were independent predictors of AF occurrence in OSAS patients. The area under the receiver operating characteristic curve for LA with a size ≥ 38.5 mm for predicting AF occurrence in OSAS patients was 0.795 (95% confidence interval [0.666, 0.925]); p < 0.001). GJA1 expression in HL-1 cells incubated with exosomes from OSAS patients with AF was lower than that with exosomes from patients without AF after controlling for age and sex and was negatively correlated with the AHI and oxygen desaturation index (ODI), especially during the non-rapid eye movement period (NREM) of OSAS patients with AF (all p < 0.05). LA size was an independent predictor of AF occurrence in OSAS patients. The AHI and ODI in the NREM period of OSAS patients with AF were negatively correlated with GJA1 expression in HL-1 cells, which offers a hint that GJA1 may play a crucial role in the development of AF in patients with OSAS.

scholarly journals Knowledge of Obstructive Sleep Apnea among Dental Fraternity in Riyadhof OSA (Ostructive Sleep Apnea ) among dental fraternity in Riyadh

2019 ◽  
Vol 7 (15) ◽  
pp. 2508-2512 ◽  
Author(s):  
Lingam Amara Swapna ◽  
Noora Fahad Alotaibi ◽  
Samah Abdulrahman Falatah ◽  
Meznah Saad Al Joaithen ◽  
Pradeep Koppolu
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Early Stage ◽  
Dental Students ◽  
Gender Comparison ◽  
Knowledge Based ◽  
Obstructive Sleep ◽  
Dental Practitioners ◽  
General Dentists ◽  
Dental Professionals

AIM: To assess and compare the knowledge of obstructive sleep apnea (OSA) among final years dental students, interns, dental practitioners and faculty working in and around Riyadh. METHODS: A questionnaire-based study comprising of 16 questions was conducted among final year dental clinical students, interns, dental practitioners and faculty working in and around Riyadh. Statistical Package for Social Sciences software (SPSS version 21) was used to analyse the statistical data. The p < 0.05 was considered statistically significant. RESULTS: A total of 450 respondents took part in the study. When gender comparison was done regarding the awareness of OSA, statistically significant differences were noted for the majority of questions. The response rate for the knowledge-based questions varied statistically concerning their speciality and educational qualifications. 65% of the participants admitted that they were unaware of the diagnostic tests performed for diagnosing these patients. It was noted that 85% of the participants wanted to attend a CDE program to know more about OSA. CONCLUSION: The study concludes that there is a significant lack of knowledge among final year students, interns and general dentists. This study emphasises the need for all dental professionals to regularly update their knowledge and equip themselves to identify and treat such patients at an early stage.

Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

2019 ◽  
Vol 4 (5) ◽  
pp. 878-892
Author(s):  
Joseph A. Napoli ◽  
Linda D. Vallino
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
A Priori ◽  
Sufficient Evidence ◽  
Obstructive Sleep ◽  
Before And After ◽  
Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

Sign in / Sign up

Export Citation Format

Share Document