Sleep-Related Leg Movements in Patients with Transient Ischemic Attack and Controls

2018 ◽  
Vol 79 (3-4) ◽  
pp. 171-176 ◽  
Author(s):  
Mirjam H. Schipper ◽  
Korné Jellema ◽  
Diego Alvarez-Estevez ◽  
Johan Verbraecken ◽  
Roselyne M. Rijsman
Keyword(s):  
Cardiovascular Diseases ◽  
Transient Ischemic Attack ◽  
Sleep Apnea Syndrome ◽  
Control Group ◽  
Periodic Leg Movements ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Significant Difference ◽  
Ischemic Attack ◽  
Leg Movements

Background: Periodic leg movements during sleep (PLMS) have been associated with an increased risk for cardiovascular diseases and there is a high prevalence of PLMS found in patients with obstructive sleep apnea syndrome (OSAS). We evaluated patients with transient ischemic attack (TIA) for PLMS and respiratory related leg movements (RRLM), versus a control group without TIA. Methods: Twenty-five patients with TIA and 34 patients with no vascular diagnosis were referred for polysomnography. Diagnosis of PLMS was made if the periodic leg movement index (PLMI) was ≥5 and clinical significant as PLMI ≥15. Results: There was no significant difference in PLMI ≥5 and ≥15 between patients with and without TIA. In the absence of OSAS, 2 out of 5 TIA patients (40%) had a PLMI ≥15 compared to 1 of the 19 patients without TIA (5%; p = 0.037). There was no increase in RRLMs when OSAS was present. Conclusions: TIA patients did not have higher PLMI compared to controls, and in the presence of OSAS, there was no increase in RRLMs compared to patients without TIA. In selective patients, PLMS could be associated with cardiovascular diseases, since PLMS was clinically more often found in the TIA group without OSAS.

scholarly journals Systematic Review of Tongxinluo Capsule on the Therapeutic Effect and Hemorheology of Patients with Transient Ischemic Attack

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Peng Yang ◽  
Peng Liu ◽  
Ruijin Yang
Keyword(s):  
Clinical Efficacy ◽  
Shear Viscosity ◽  
Transient Ischemic Attack ◽  
Whole Blood ◽  
Clinical Decision Making ◽  
Cochrane Collaboration ◽  
Control Group ◽  
Specific Viscosity ◽  
Significant Difference ◽  
Ischemic Attack

Objectives. This study aims to systematically evaluate the clinical efficacy of Tongxinluo capsule in the treatment of transient ischemic attack (TIA) and its effect on hemorheology, thereby providing scientific basis for clinical decision making. Methods. A comprehensive and systematic literature retrieval was conducted in the CNKI, Wanfang database, SinoMed, EMbase, and PubMed to screen the randomized controlled trials (RCTs) of Tongxinluo capsule in the treatment of TIA. The retrieval time was from the inception of each database to September 10, 2020. Endnote X9 was used to screen the literature. Cochrane Collaboration tool for assessing risk of bias was used to evaluate the quality of the included studies. Stata16.0 statistical software was used for meta-analysis. Results. A total of 12 RCTs were included, involving 946 subjects. (1) The clinical efficacy of the Tongxinluo group was better than that of the control group (RR = 1.19, 95% CI (1.09, 1.30), P  ≤ 0.001). (2) The hemorheological characteristics of the Tongxinluo group were significantly improved compared with those of the control group (whole blood high shear viscosity: SMD = −1.61, 95% CI (−1.89, −1.34); P  ≤ 0.001, whole blood low shear viscosity: SMD = −1.06, 95% CI (−1.31, −0.80), P  ≤ 0.001, fibrinogen: SMD = −1.12, 95% CI (−1.94, −0.29), P  = 0.008, plasma specific viscosity: SMD = −1.00, 95% CI (−1.69, −0.31), P  = 0.004, and hematocrit: SMD = −1.47, 95% CI (−2.16, −0.77), P  ≤ 0.001). (3) There was no significant difference in the incidence of adverse reactions between the Tongxinluo group and control group (RR = 7.76, 95% CI (0.98, 61.28), P  = 0.052). Conclusion. Tongxinluo capsule is superior to conventional treatment in improving clinical overall response rate and hemorheological indexes and is relatively safe. Due to the deficiencies of the existing studies, more high-quality studies with rigorous design are required for further verification.

Outcomes of Carotid Revascularization in the Treatment of Restenosis After Prior Carotid Endarterectomy

Stroke ◽  
2021 ◽  
Author(s):  
Nadin Elsayed ◽  
Ganesh Ramakrishnan ◽  
Isaac Naazie ◽  
Sharvil Sheth ◽  
Mahmoud B. Malas
Keyword(s):  
Carotid Endarterectomy ◽  
Transient Ischemic Attack ◽  
Multivariate Logistic Regression Analysis ◽  
Hospital Outcomes ◽  
Lower Odds ◽  
Carotid Revascularization ◽  
Increased Risk ◽  
Significant Difference ◽  
Ischemic Attack ◽  
Stroke Death

Background and Purpose: Restenosis after carotid endarterectomy (CEA) is associated with an increased risk of ipsilateral stroke. The optimal procedural modality for this indication has yet to be determined. Here, we evaluate the in-hospital outcomes of transcarotid artery revascularization (TCAR), redo-CEA, and transfemoral carotid artery stenting (TFCAS) in a large contemporary cohort of patients who underwent treatment for restenosis after CEA. Methods: We performed a retrospective analysis of all patients in the vascular quality initiative database who underwent TCAR, redo-CEA, or TFCAS after ipsilateral CEA between September 2016 and April 2020. Patients with prior ipsilateral CAS were excluded from this analysis. In-hospital outcomes following TCAR versus CEA and TCAR versus TFCAS were evaluated using multivariate logistic regression analysis. Results: A total of 4425 patients were available for this analysis. There were 963 (21.8%) redo-CEA, 1786 (40.4%) TFCAS, and 1676 (37.9%) TCAR. TCAR was associated with lower odds of in-hospital stroke/death (odds ratio [OR], 0.41 [95% CI, 0.24–0.70], P =0.021), stroke (OR, 0.46 [95% CI, 0.23–0.93], P =0.03), myocardial infarction (MI; OR, 0.32 [95% CI, 0.14–0.73], P =0.007), stroke/transient ischemic attack (OR, 0.42 [95% CI, 0.24–0.74], P =0.002), and stroke/death/MI (OR, 0.41 [95% CI, 0.24–0.70], P =0.001) when compared with redo-CEA. There was no significant difference in the odds of death between the 2 groups (OR, 0.99 [95% CI, 0.28–3.5], P =0.995). TCAR was also associated with lower odds of stroke/transient ischemic attack (OR, 0.37 [95% CI, 0.18–0.74], P =0.005) when compared with TFCAS. There was no significant difference in the odds of stroke, death, MI, stroke/death, or stroke/death/MI between TCAR and TFCAS. Conclusions: TCAR was associated with significantly lower odds of in-hospital stroke, MI, stroke/transient ischemic attack, stroke/death, and stroke/death/MI when compared with redo-CEA and lower odds of in-hospital stroke/transient ischemic attack when compared with TFCAS. Additional long-term studies are warranted to establish the role of TCAR for the treatment of restenosis after CEA.

scholarly journals Alterations in Serum Adropin, Adiponectin, and Proinflammatory Cytokine Levels in OSAS

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hakan Celikhisar ◽  
Gulay Dasdemir Ilkhan
Keyword(s):  
Proinflammatory Cytokine ◽  
Sleep Apnea Syndrome ◽  
Density Lipoprotein ◽  
Assay Method ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Cytokine Levels

Objective. The present study was planned to examine the relationships between obstructive sleep apnea syndrome (OSAS) and the newly revealed adipokines adropin and adiponectin concentrations that display significant metabolic and cardiovascular functions and the levels of proinflammatory cytokine levels. Method. A total of 166 overweight and obese male patients with a body mass index (BMI) >27 kg/m2 were included in the study. Among study participants, 84 were recently diagnosed with OSAS by polysomnography with an apnea-hypopnea index (AHI) ≥5, and 82 were nonapneic with normal polysomnography (AHI<5) findings. The serum adropin and adiponectin levels of all cases were analyzed via the enzyme-linked immunosorbent assay method. Serum interleukin-1 (IL-1) beta and tumor necrotizing factor-alpha (TNF-alpha) levels were determined using Luminex cytokine multiplex analyses. Results. The mean age of the OSAS patients was 50.9 ± 5.7 years and BMI was 32.4 ± 6.0 kg/m2, and there was no statistically significant difference determined with the control group (49.3 ± 5.8 years and 30.6 ± 5, 6 kg/m2) (p>0.05). There were no statistically significant differences between the OSAS and control groups concerning total cholesterol, triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and glucose levels. Adiponectin was lower in the OSAS group at a statistically significant level in comparison with the control group and was related at a statistically significant level to OSAS intensity. Adropin concentration was determined to be higher in the OSAS group at a statistically significant level in comparison with the control group. Conclusion. The results of our study suggest that increased adropin concentration may be an indicator of endothelium dysfunction in OSAS patients. Serum adropin and adiponectin levels may be new bioindicators used for diagnosis and risk assessment in OSAS patients.

scholarly journals The Effect of Vitamin C Therapy Towards Malondialdehyde Plasma Content on Chronic Tonsillitis Patients With Risk of Obstructive Sleep Apnea Syndrome

2018 ◽  
Vol 10 (9) ◽  
pp. 97
Author(s):  
Sutji Pratiwi Rahardjo Hiro ◽  
Hiro Salomo Mangape ◽  
Abdul Qadar Punagi ◽  
Andi Nilawati Usman
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Vitamin C ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Chronic Tonsillitis ◽  
Control Group ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Apnea Syndrome

INTRODUCTION: Sleep Apnea Syndrome is a syndrome with an episode of apnea or hypopnea during sleep. The objective of this study was to investigate the effect of the vitamin C therapy to plasma Malondialdehyde (MDA) level in patients with chronic tonsillitis who have a risk factor of Obstructive Sleep Apnea Syndrome (OSAS), measured pre and post-therapy.METHODS: The design of this study was a clinical trial with pre-test and post-test control group. This study was conducted in Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Teaching Hospital in Makassar and 30 subjects was enrolled (20 subjects were patients with chronic tonsillitis and OSAS, and 10 subjects were control). The measurement of plasma MDA level was obtained using ELISA method. The data were analyzed using the Mann-Whitney test and Chi-square test.RESULTS: The results of this study showed a decreasing level of plasma MDA in patients with chronic tonsillitis and OSAS after the vitamin C therapy. However, there was no significant difference between patients who had not received vitamin C therapy.CONCLUSION: The intervention of vitamin C in chronic tonsillitis patients and can reduce levels of plasma MDA.

Effects of Sleep-Related Disorders on the Prognosis of Amyotrophic Lateral Sclerosis

2019 ◽  
Vol 19 (3-4) ◽  
pp. 148-154 ◽  
Author(s):  
Aylin Reyhani ◽  
Gulcin Benbir Senel ◽  
Derya Karadeniz
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Central Sleep Apnea ◽  
Periodic Leg Movements ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome ◽  
Lateral Sclerosis ◽  
Leg Movements

Background/Objective: In this study, we demonstrated the effects of obstructive sleep apnea syndrome (OSAS) on the prognosis of amyotrophic lateral sclerosis (ALS). However, the effects of sleep-related disorders other than breathing problems are still waiting to be delineated. Methods: In this longitudinal retrospective and prospective study, we investigated 73 patients with ALS compared to 20 healthy subjects, to determine sleep-related disorders and their impact on disease prognosis. Results: In patients with ALS, the mean respiratory disturbance index (RDI) was 28.0/h, which was significantly higher than that in the controls (p < 0.001). OSAS was present in 67% of the patients, sleep-related hypoxemia was observed in 13.7% of the patients, and 5.4% had central sleep apnea syndrome. In patients with bulbar-onset disease, higher RDI was almost significantly associated with lower survival (p = 0.056). The mean index of periodic leg movements in sleep was significantly higher in patients with ALS (34.0 ± 19.9/h) than that in the controls (12.5 ± 15.5/h; p < 0.001). Periodic leg movements disorder (PLMD) was diagnosed in 23 patients with ALS (31.5%); fragmentary myoclonus was present in 13.7% of patients, and REM-sleep behavior disorder was diagnosed in 4 patients (5.4%). The presence of PLMD in addition to OSAS was significantly associated with worse prognosis and poorer survival (p = 0.040). Conclusions: These findings emphasize that sleep-related disorders other than OSAS deserve attention in ALS. ALS is a catastrophic and frustrating disease for both patients and physicians; thus, the diagnosis and treatment of comorbid sleep disorders could improve the survival of patients with ALS.

Postoperative monitoring of children with obstructive sleep apnea syndrome

2014 ◽  
Vol 155 (18) ◽  
pp. 703-707 ◽  
Author(s):  
Pálma Benedek ◽  
Gabriella Kiss ◽  
Eszter Csábi ◽  
Gábor Katona
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Preoperative Evaluation ◽  
Sleep Apnea Syndrome ◽  
Study Patient ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Apnea Syndrome

Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.

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