scholarly journals Features of lesion of ENT-organs in children with Down syndrome

2020 ◽  
pp. 15-18
Author(s):  
A.L. Kosakovskyi ◽  
◽  
Iu. Gavrylenko ◽  
M. Kyianytsia ◽  
◽  
...  
Keyword(s):  
Down Syndrome ◽  
Otitis Media ◽  
Primary Care Physicians ◽  
Significant Proportion ◽  
Acute Otitis Media ◽  
Educational Work ◽  
Children With Down Syndrome ◽  
Obstructive Sleep ◽  
Hearing Test ◽  
Families With Children

Objective: сlinical relevance and prevalence of ENT diseases in children with Down syndrome (DS) of Ukrainian, according to a survey of their parents. Analyze educational work among primary care physicians. Materials and methods. During 2019, 137 respondents, who were parents of children with Down syndrome, were surveyed. Аge varied from 3 months to 18 years. Results. Scheduled medical examinations in ENT doctors have the ability to conduct 81% of families with children with DS. 72.3% of the interviewed had their hearing assessed, of whom 19% had their hearing checked annually. 27.7% of children with DS do not have a hearing test. A significant proportion (81%) of parents of children with DS did not offer to assess the child's hearing. Acute otitis media is more commonly recorded at the age of 1 to 5 years. Surgical treatment for otitis media was performed in 7.2% of patients (tympano puncture/tympanocentesisin 5.1%; performed more than 2 times in 0.7%; middle ear bypass grafting in 1.5%). Acute bacterial rhinosinusitis was noted in 40.9% of children with DS, of which 82.1% had more than 3 episodes of acute rhinosinusitis during their lifetime. Allergies were reported in 34.3%. Obstructive sleep apnea is noted by 26.3%. 70.8% of parents observe their baby's shortness of breath, snoring. As for surgery: adenotomy was performed in 20.5%, of which 1.5% of children performed more than 1 time. Adenotomy is planned in 30% of the respondents. Tonsillectomy was performed in 1.5%, with 0.7% planned for the near future. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the parents and patients was obtained for conducting the studies. No conflict of interest was declared by the authors. Keywords: Down syndrome, ENT pathology, ENT organs, children, adolescents.

Sleep Positions in Children with Down Syndrome and Obstructive Sleep Apnea

2021 ◽  
Author(s):  
Jonathan D. Santoro ◽  
Justin Del Rosario ◽  
Beth Osterbauer ◽  
Emily S. Gillett ◽  
Debra M. Don
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Children With Down Syndrome ◽  
Obstructive Sleep

611 Sleep Disorders in a Longitudinal Community Cohort of Children with Down Syndrome

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A240-A240
Author(s):  
Nisha Patel ◽  
Timothy Morgenthaler ◽  
Julie Baughn
Keyword(s):  
Down Syndrome ◽  
Sleep Disorders ◽  
Screening Tools ◽  
Treatment Needs ◽  
Cross Sectional Survey ◽  
Periodic Limb Movement Disorder ◽  
Cross Sectional ◽  
Children With Down Syndrome ◽  
Obstructive Sleep ◽  
Respiratory Sleep Disorders

Abstract Introduction Obstructive sleep apnea (OSA) affects 50–79% of children with Down Syndrome (CDS) prompting the development of guidelines to increase early detection of OSA. Cross-sectional survey based data shows that CDS have higher rates of bedtime resistance, sleep anxiety, night waking and parasomnias, which are also under-recognized. However, due to increased survival of CDS it may be that OSA treated in childhood returns or worsens, or that CDS may develop other sleep disorders as their life experience and exposure to comorbidities expands. Little is known about sleep disorders across the life span of CDS and screening guidelines leave a gap beyond early childhood. We determined to enhance understanding of respiratory and non-respiratory sleep disorders in a community population of CDS. Methods A retrospective population based observational study of CDS born between 1995–2011 was performed using the Rochester Epidemiology Project database. Medical records from all encounters through July 2020 were reviewed to identify sleep disorders. Sleep diagnoses, sleep test results, and treatments aimed at sleep disorders were recorded. Results 94 CDS were identified with 85 providing consent for research. 54 out of 85 individuals were diagnosed with OSA with 26 diagnosed prior to age 4 and 25 undergoing polysomnography prior to treatment. 26 individuals underwent polysomnography following surgery of which 16 continued to have clinically significant OSA requiring further treatment with secondary surgery, CPAP or anti-inflammatory therapy. Other sleep disorders observed included insomnia (n=16), restless leg syndrome (n=7), periodic limb movement disorder (n=10), idiopathic hypersomnia (n=1), nightmares (n=1), nocturnal enuresis (n=1), bruxism (n=1) and delayed sleep phase disorder (n=1). Most non-OSA sleep disorders were diagnosed during OSA evaluation by sleep medicine providers. However, many children were on melatonin without a formal sleep disorder diagnosis. Conclusion Both OSA and other sleep disorders remain under-diagnosed in CDS. This may be due to lack of validated screening tools that can be administered at the primary care level. Screening recommendations should consider the longitudinal nature of OSA in CDS and the presence of non-respiratory sleep disorders. Adenotonsillectomy is not as effective in CDS and postsurgical polysomnography is warranted along with long term follow-up to assess for further treatment needs. Support (if any):

scholarly journals 0771 Severe Obstructive Sleep Apnea In Children With Down Syndrome

SLEEP ◽  
2018 ◽  
Vol 41 (suppl_1) ◽  
pp. A287-A287
Author(s):  
J N Mian ◽  
B Gunaratnam ◽  
E Senthilvel
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Severe Obstructive Sleep Apnea ◽  
Children With Down Syndrome ◽  
Obstructive Sleep

scholarly journals Possibilities of tropical treatment of bacterial ENT infections

2021 ◽  
pp. 44-54
Author(s):  
P. A. Shamkina ◽  
A. A. Krivopalov ◽  
P. I. Panchenko ◽  
S. V. Ryazantsev
Keyword(s):  
Antibiotic Resistance ◽  
Otitis Media ◽  
Primary Care Physicians ◽  
Bacterial Infections ◽  
Acute Otitis Media ◽  
Medical Community ◽  
Antibacterial Drug ◽  
Upper Respiratory Tract ◽  
Inappropriate Use ◽  
Acute Rhinosinusitis

The overuse and inappropriate use of systemic antibiotics is the most serious cause of problems associated with the increasing resistance of bacterial pathogens. What served as the basis for WHO to call the XXI century “The era of antibiotic resistance”. The wide spread of resistant strains of microorganisms, the growth of severe and complicated forms of diseases leads to an increase in the frequency of unfavorable treatment outcomes. In the Russian Federation, an increase in the incidence of acute rhinosinusitis from 4.6 to 12.7 cases per 1000 population has been noted in the last decade. The incidence of acute rhinosinusitis in Europe is recorded in 6.4 ± 3.6 of all cases of visits to primary care physicians. Up to 38% of outpatients in the ENT profile suffer from various forms of otitis media, including up to 30% of acute otitis media. The most important way to overcome the global problem of antibiotic resistance, along with the delayed use of systemic antibacterial drugs initiated by the world medical community, is to switch to the active use of topical drugs with antimicrobial activity. The article provides an overview of the data of domestic and foreign literature on the properties of a topical antibacterial drug with the active ingredient hydroxymethylquinoxaline dioxide. The results of experimental work and clinical studies, proving the high efficacy and safety of the drug in the complex treatment of bacterial infections of the upper respiratory tract, have been analyzed.

Effect of a 1-week intense myofunctional training on obstructive sleep apnoea in children with Down syndrome

2018 ◽  
Vol 104 (3) ◽  
pp. 275-279 ◽  
Author(s):  
Magnus von Lukowicz ◽  
Nina Herzog ◽  
Sebastian Ruthardt ◽  
Mirja Quante ◽  
Gabriele Iven ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Marginal Effect ◽  
Sleep Study ◽  
Desaturation Index ◽  
Intensive Training ◽  
Children With Down Syndrome ◽  
Training Camp ◽  
Obstructive Sleep

BackgroundObstructive sleep apnoea (OSA) is common in children with Down syndrome (DS), yet difficult to treat. As muscular hypotonia of the upper airway may cause OSA and is also common in DS, we tested whether intense myofunctional therapy improves OSA in children with DS.Patients and methodsForty-two children underwent cardiorespiratory sleep studies immediately before and after a 1-week intensive training camp consisting of three daily 45 min sessions of myofunctional exercises according to Padovan. Primary outcome was the mixed-obstructive-apnoea/hypopnoea index (MOAHI), secondary outcomes the ≤3% oxygen desaturation index (DI3), the ≤90% desaturation index (DI90) and the lowest pulse oximeter saturation (SpO2nadir).ResultsEighteen recordings had ≥3 hours of artefact-free recording in both the pretreatment and post-treatment sleep study and were therefore included in the analysis. Mean age was 6.3 years (SD 2.5); 83% had OSA prior to intervention. Mean MOAHI was 6.4 (SD 8.6) before and 6.4 (SD 10.8) after the intervention (p>0.05); the DI3 and SpO2nadir also did not change. Only the DI90 decreased significantly from 2.7 (SD 4.5) to 2.1 (SD 3.7) (p<0.05).ConclusionThe 1-week intense myofunctional training camp evaluated here in children with DS had only a marginal effect on OSA. Whether a longer follow-up period or duration of intervention would yield stronger effects remains to be determined.

Obstructive Sleep Apnea in Children With Down Syndrome

PEDIATRICS ◽  
1991 ◽  
Vol 88 (1) ◽  
pp. 132-139
Author(s):  
Carole L. Marcus ◽  
Thomas G. Keens ◽  
Daisy B. Bautista ◽  
Walter S. von Pechmann ◽  
Sally L. Davidson Ward
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Arterial Oxygen Saturation ◽  
Sleep Apnea Syndrome ◽  
Arterial Oxygen ◽  
Children With Down Syndrome ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
End Tidal

Children with Down syndrome have many predisposing factors for the obstructive sleep apnea syndrome (OSAS), yet the type and severity of OSAS in this population has not been characterized. Fifty-three subjects with Down syndrome (mean age 7.4 ± 1.2 [SE] years; range 2 weeks to 51 years) were studied. Chest wall movement, heart rate, electrooculogram, end-tidal Po2 and Pco2, transcutaneous Po2 and Pco2, and arterial oxygen saturation were measured during a daytime nap polysomnogram. Sixteen of these children also underwent overnight polysomnography. Nap polysomnograms were abnormal in 77% of children; 45% had obstructive sleep apnea (OSA), 4% had central apnea, and 6% had mixed apneas; 66% had hypoventilation (end-tidal Pco2, &gt;45 mm Hg) and 32% desaturation (arterial oxygen saturation &lt;90%). Overnight studies were abnormal in 100% of children, with OSA in 63%, hypoventilation in 81%, and desaturation in 56%. Nap studies significantly underestimated the presence of abnormalities when compared to overnight polysomnograms. Seventeen (32%) of the children were referred for testing because OSAS was clinically suspected, but there was no clinical suspicion of OSAS in 36 (68%) children. Neither age, obesity, nor the presence of congenital heart disease affected the incidence of OSA, desaturation, or hypoventilation. Polysomnograms improved in all 8 children who underwent tonsilletomy and adenoidectomy, but they normalized in only 3. It is concluded that children with Down syndrome frequently have OSAS, with OSA, hypoxemia, and hypoventilation. Obstructive sleep apnea syndrome is seen frequently in those children in whom it is not clinically suspected. It is speculated that OSAS may contribute to the unexplained pulmonary hypertension seen in children with Down syndrome.

Demographic and Clinical Characteristics Associated With Adherence to Guideline-Based Polysomnography in Children With Down Syndrome

2020 ◽  
pp. 019459982095483
Author(s):  
Philip D. Knollman ◽  
Christine H. Heubi ◽  
Susan Wiley ◽  
David F. Smith ◽  
Sally R. Shott ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Down Syndrome ◽  
Clinical Characteristics ◽  
Medical Center ◽  
Demographic Data ◽  
Children With Down Syndrome ◽  
Medical Need ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
History Of

Objectives To compare the demographic and clinical characteristics of children with Down syndrome who did and did not receive polysomnography to evaluate for obstructive sleep apnea after publication of the American Academy of Pediatrics’ guidelines recommending universal screening by age 4 years. Study Design Retrospective cohort study. Setting Single tertiary pediatric hospital. Methods Review was conducted of children with Down syndrome born between 2007 and 2012. Children who obtained polysomnography were compared with children who did not, regarding demographic data, socioeconomic status, and comorbidities. Results We included 460 children with Down syndrome; 273 (59.3%) received at least 1 polysomnogram, with a median age of 3.6 years (range, 0.1-8.9 years). There was no difference in the distribution of sex, insurance status, or socioeconomic status between children who received polysomnography and those who did not. There was a significant difference in race distribution ( P = .0004) and distance from home to the medical center ( P < .0001) between groups. Among multiple medical comorbidities, only children with a history of hypothyroidism ( P = .003) or pulmonary aspiration ( P = .01) were significantly more likely to have obtained polysomnography. Conclusions Overall, 60% of children with Down syndrome obtained a polysomnogram. There was no difference between groups by payer status or socioeconomic status. A significant difference in race distribution was noted. Proximity to the medical center and increased medical need appear to be associated with increased likelihood of obtaining a polysomnogram. This study illustrates the need for improvement initiatives to increase the proportion of patients receiving guideline-based screening.

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