Risk factors analysis and intervention of lung dysfunction in children with obstructive sleep apnea: A retrospective case series study

Aim: Our study was done to evaluate the role of Endoscopic posterior midline partial glossectomy as a surgical modality for the hypopharyngeal collapse in obstructive sleep apnea patients. Study design: Prospective case series study. Place and Duration of Study: Tanta university hospital, otolaryngology department, from October 2017 till March 2019. Methodology: This was a prospective case series study, conducted on 10 patients from 2017 -2019 with tongue base collapse and normal craniofacial angles, the patients were evaluated preoperative and 6 months postoperative subjectively by Epworth sleepiness scale (ESS) and objectively by polysomnography and lateral cephalometry. Results: Our study included 10 patients with age (mean ± SD48.70±4.08), BMI( mean ±SD24.45±1.56), 5 patients showed a significant reduction in AHI with a success rate of 50% with a significant change in ESS and the non-significant changes in cephalometric parameters. Conclusion: Transoral endoscopic posterior midline partial glossectomy can improve the surgical outcomes of obstructive sleep apnea patients.

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Integrated TCM care program combined with intranasal corticosteroids to treat pediatric obstructive sleep apnea: A case series study

Advances in Integrative Medicine ◽

10.1016/j.aimed.2019.03.257 ◽

2019 ◽

Vol 6 ◽

pp. S89

Author(s):

Lai Wan-Yu ◽

Yen Hung-Rong

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Case Series ◽

Care Program ◽

Intranasal Corticosteroids ◽

Obstructive Sleep ◽

Case Series Study ◽

Series Study

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Topical Triamcinolone on “Sweet Spots” to Block Dynamic Pain after Tonsillectomy and Uvulo-Palato-Pharyngo-Plasty

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420953602 ◽

2020 ◽

pp. 000348942095360

Author(s):

Joshua Kuang-Chao Chen ◽

David M. Niddam ◽

Tao-Hsin Tung ◽

Lieber Po-Hung Li

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Case Series ◽

Retrospective Case ◽

Average Improvement ◽

Obstructive Sleep ◽

Apnea Syndrome ◽

Sweet Spots

Objectives: Severe pain on swallowing (or dynamic pain) has long been a problem in patients receiving tonsillectomy and uvulopalatopharyngoplasty for the treatment of obstructive sleep apnea syndrome and/or snoring. We have previously verified that dynamic pain after laser-assisted uvulopalatoplasty could immediately be mitigated by local treatments with topical triamcinolone on the “sweet spots” of the wounds. This study aimed to assess the efficacy of applying triamcinolone on “sweet spot” in surgical incisions instead of whole surgical wounds to alleviate dynamic pain of some oropharyngeal surgeries such as tonsillectomy and uvulopalatopharyngoplasty. Methods: This study is a retrospective case series based on chart review of the participants. Forty-five subjects (31 males; 12~68 years, mean 34 years) with obstructive sleep apnea syndrome and/or snoring treated with tonsillectomy or uvulopalatopharyngoplasty were studied. Local treatments were done to sweet spots with triamcinolone on the 1st, 2nd, 3rd, and 7th days after the surgery. Evaluation of dynamic pain relief was performed by using a visual analogous scale. Results: Sweet spots treatment led to instantaneous reduction of dynamic pain. The average improvement level was ≥72% ( P ≤ .002). No gender effect was noted. Conclusion: Dynamic pain after tonsillectomy and uvulopalatopharyngoplasty could immediately be mitigated by local treatments upon sweet spots. Local treatments upon sweet spots were highly suggested to begin early post-operatively and be included in the take-home routines for patients receiving tonsillectomy and uvulopalatopharyngoplasty.

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Polysomnography in Pediatric Otolaryngology: If Not Obstructive Sleep Apnea, What Is It?

Otolaryngology ◽

10.1177/0194599817726977 ◽

2017 ◽

Vol 157 (6) ◽

pp. 1053-1059 ◽

Cited By ~ 4

Author(s):

Christine H. Heubi ◽

Jareen Meinzen-Derr ◽

Sally R. Shott ◽

David F. Smith ◽

and Stacey L. Ishman

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Disturbances ◽

Case Series ◽

Central Sleep Apnea ◽

Categorical Variables ◽

Periodic Limb Movements ◽

Continuous Variables ◽

Retrospective Case ◽

Obstructive Sleep

Objective To determine common polysomnographic (PSG) diagnoses for children referred by otolaryngologists. Study Design Retrospective case series with chart review. Setting Single tertiary pediatric hospital (2010-2015). Subjects and Methods Review of the medical records of 1258 patients undergoing PSG by otolaryngology referral. Patients who underwent previous otolaryngologic surgery were excluded. Data distributions were evaluated using means with standard deviations for continuous variables and frequencies with percentages for categorical variables. Results A total of 1258 patients were included; 55.9% were male, 64.5% were Caucasian, 16.6% had Down syndrome, and 48% had public insurance. The median age at the time of PSG was 5.2 years (range = 0.2-18.94). Indications for PSG were sleep-disordered breathing (SDB; 69.4%), restless sleep (12.7%), airway anomalies (7.5%), and laryngomalacia (7.2%). SDB was seen in 73.4%, obstructive sleep apnea (OSA) in 53.2%, OSA + central sleep apnea (CSA) in 4.5%, CSA in 0.9%, and non-OSA snoring in 15%. Other diagnoses included periodic limb movements of sleep (PLMS; 7.4%), hypoventilation (6.8%), and nonapneic hypoxemia (2.6%). SDB was more common in younger children and seen in 91.4% of children <12 months and in 69.2% of children ≥24 months, while non-OSA snoring was more common with increasing age (3.7% in children <12 months, 17.7% of children ≥24 months). PLMS were seen in 8.9% of children ≥24 months and in no children <12 months. Conclusion While OSA and snoring were the most common diagnoses reported, PLMS, alveolar hypoventilation, and CSA occurred in 7.4%, 6.8%, and 5.4%, respectively. These findings indicate that additional diagnoses other than OSA should be considered for children seen in an otolaryngology clinic setting who undergo PSG for sleep disturbances.

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Childhood strokes in China describing clinical characteristics, risk factors and performance indicators: a case-series study

Stroke and Vascular Neurology ◽

10.1136/svn-2021-001062 ◽

2021 ◽

pp. svn-2021-001062

Author(s):

Yaxian Deng ◽

Gaifen Liu ◽

Guitao Zhang ◽

Juanyu Xu ◽

Chunmei Yao ◽

...

Keyword(s):

Risk Factors ◽

Clinical Characteristics ◽

Age At Onset ◽

Case Series ◽

Haemorrhagic Stroke ◽

Epidemiological Studies ◽

Neurological Deficits ◽

Retrospective Case ◽

Case Series Study ◽

Series Study

AimTo investigate clinical characteristics, risk factors (RFs), neurologic deficits and medical care provided in children who had a stroke in China.MethodsWe conducted a retrospective case-series study using the medical records of children aged 1 month to 18 years with arterial ischaemic stroke (AIS) or haemorrhagic stroke (HS) (with the entry codes I60, I61, I62, I63 (ICD-10)), who were admitted to different hospitals in Beijing, between January 2018 and December 2018. We obtained the following information from the charts: demographic characteristics, clinical presentations, RFs for paediatric stroke, laboratory examination, neuroimaging records and neurologic sequelae.ResultsWe identified 312 first admissions for stroke (172 AIS and 140 HS). The mean age at onset was 8.6±3.9 years for patients who had an AIS and 8 (5–13) years for patients who had an HS. There were more males than females in both groups (AIS: 59.88% vs 40.12%; HS: 52.14% vs 47.86%). A known aetiology was identified in 92.44% and 86.43% of patients who had an AIS and HS, respectively. The leading cause of AIS was cerebrovascular diseases including moyamoya (68.6%), while that for HS was arteriovenous malformation (51.43%). The most common initial clinical presentation was hemiplegia (86.05%) in patients who had an AIS and headache (67.86%) in patients who had an HS. The use of healthcare, including acute treatment (antithrombotic in 17.44%, anticoagulant in 5.23%) and secondary prevention (antithrombotic in 6.39%, anticoagulant in 1.16%), varied and was significantly lower among patients who had an AIS. The most common complications were epilepsy (22.09%) and pneumonia (4.65%) in patients who had an AIS and epilepsy (17.14%) and hydrocephalus (12.14%) in patients who had an HS. Neurological deficits occurred in 62.8% of patients who had an AIS and 72.86% of patients who had an HS.ConclusionCerebral arteriopathy was a major RF for both AIS and HS in children living in China. Large epidemiological studies are required to identify RFs to prevent stroke as well as appropriate interventions.

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Risk factors for in-hospital mortality after coronary artery bypass grafting in patients 80 years old or older: a retrospective case-series study

PeerJ ◽

10.7717/peerj.2667 ◽

2016 ◽

Vol 4 ◽

pp. e2667 ◽

Cited By ~ 1

Author(s):

Jacek Piątek ◽

Anna Kędziora ◽

Janusz Konstanty-Kalandyk ◽

Grzegorz Kiełbasa ◽

Marta Olszewska ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Hospital Mortality ◽

Artery Bypass ◽

Nyha Class ◽

Case Series ◽

Bypass Grafting ◽

Retrospective Case ◽

Case Series Study ◽

Series Study

Background Age remains a significant and unmodifiable risk factor for cardiovascular diseases, and an increasing number of patients older than 80 years of age undergo Coronary Artery Bypass Grafting (CABG). Old age is also an independent risk factor for postoperative complications. The aim of this study is to describe the population of patients 80 years of age or older who underwent CABG procedure and to assess the mortality rate and risk factors for in-hospital mortality. Methods A retrospective case-series study analyzing 388 consecutive patients aged 80 years of age or older who underwent isolated CABG procedure between 2010 and 2014 in the Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow. Results In-hospital mortality stood at 7%, compared to 3.4% for all isolated CABG procedures at our Institution. In an univariate logistic regression analysis, risk factors for in-hospital mortality were as follows: NYHA class (p = 0.005, OR 1.95, 95% CI [1.23–3.1]), prolonged mechanical ventilation (p < 0.001, OR 7.08, 95% CI [2.47–20.3]), rethoracotomy (p = 0.04, OR 3.31, 95% CI [1.04–10.6]), duration of the procedure and ECC (for every 10 min p = 0.01, OR 1.01, 95% CI [1.0–1.01]; p = 0.03, OR 1.01, 95% CI [1.0–1.02], respectively), PRBC, FFP, and PLT transfusion (for every unit transfused p = 0.004, OR 1.42, 95% CI [1.12–1.8]; p = 0.002, OR 1.55, 95% CI [1.18–2.04]; p = 0.009, OR 1.93, 95% CI [1.18–3.14], respectively). Higher LVEF (p = 0.02, OR 0.97, 95% CI [0.94–0.99]) and LIMA graft implantation (p = 0.04, OR 0.36, 95% CI [0.13–0.98) decreased the in-hospital mortality. Death before discharge was more often observed in patients with multiple risk factors for cardiovascular diseases (0–2 –5.7%; 3–7.4%, 4–26.6%; p = 0.03). Conclusions Older age is associated with higher in-hospital mortality after isolated CABG at our Institution. Risk stratification scores and individualized risk evaluation, centered on comorbidities, NYHA class and left ventricular function, should be assessed in all cases. Whenever suitable, LIMA grafts should be used. Prolonged procedure and ECC time worsen the short-term outcome. Elderly individuals should be closely monitored postoperatively and the care should be focused on excessive blood loss and respiratory failure.

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Risk factors for adhesive capsulitis requiring shoulder arthroscopy: A clinical retrospective case series study

Journal of Orthopaedics ◽

10.1016/j.jor.2019.11.024 ◽

2020 ◽

Vol 19 ◽

pp. 14-16

Author(s):

Ryan S. Selley ◽

Daniel J. Johnson ◽

Richard W. Nicolay ◽

Ksheeraja Ravi ◽

Cort D. Lawton ◽

...

Keyword(s):

Risk Factors ◽

Shoulder Arthroscopy ◽

Adhesive Capsulitis ◽

Case Series ◽

Retrospective Case ◽

Retrospective Case Series ◽

Case Series Study ◽

Series Study

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Electrophysiological effects and clinical utility of propafenone in children

Cardiology in the Young ◽

10.1017/s1047951121002857 ◽

2021 ◽

pp. 1-5

Author(s):

Manavotam Singh ◽

Keore McKenzie ◽

Mark L. Hudak ◽

Anil K. Gehi ◽

Sunita J. Ferns

Keyword(s):

Case Series ◽

Clinical Effectiveness ◽

Retrospective Case ◽

Cardiac Side Effects ◽

Cardiac Depression ◽

Case Series Study ◽

Baseline Characteristics ◽

Antiarrhythmic Medication ◽

Electrophysiological Effects ◽

Series Study

Abstract Aim: This retrospective case series study sought to describe the safety and clinical effectiveness of propafenone for the control of arrhythmias in children with and without CHD or cardiomyopathy. Methods: We reviewed baseline characteristics and subsequent outcomes in a group of 63 children treated with propafenone at 2 sites over a 15-year period Therapy was considered effective if no clinically apparent breakthrough episodes of arrhythmias were noted on the medication. Results: Sixty-three patients (29 males) were initiated on propafenone at a median age of 2.3 years. CHD or cardiomyopathy was noted in 21/63 (33%). There were no significant differences between demographics, clinical backgrounds, antiarrhythmic details, side effect profiles, and outcomes between children with normal hearts and children with CHD or cardiomyopathy. Cardiac depression at the initiation of propafenone was more common amongst children with CHD or cardiomyopathy compared to children with normal hearts. Systemic ventricular function was diminished in 15/63 patients (24%) prior to starting propafenone and improved in 8/15 (53%) of patients once better rhythm control was achieved. Other than one child in whom medication was stopped due to gastroesophageal reflux, no other child experienced significant systemic or cardiac side effects during treatment with propafenone. Propafenone achieved nearly equal success in controlling arrhythmias in both children with normal hearts and children with congenital heart disease or cardiomyopathy (90% versus 86%, p = 0.88). Conclusion: Propafenone is a safe and effective antiarrhythmic medication in children.

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