Biomedical subjects

Piotr Bielicki

Publications and source records attributed to Piotr Bielicki.

12 recordsLinked to original sources

PubMed2006

[Exhaled nitric oxide in patients with obstructive sleep apnea syndrome].

UNLABELLED: Exhaled nitric oxide has been extensively investigated as a non-invasive marker of airway inflammation. Some authors have suggested that morning FE(NO) in obstructive sleep apnea syndrome (OSAS) patients is elevated due to inflammation of upper airways, while others have not found any differences between patients and healthy subjects. The purpose of this study was to analyze concentration of exhaled nitric oxide (FE(NO)) in OSAS patients. METHODS: 119 (99 M, 20 F) consecutive patients of sleep laboratory participated in this study. Standard overnight sleep studies with polysomnography or portable screening device were carried out in the whole group: OSAS was diagnosed in 66 patients and 53 no-OSAS served as controls. FE(NO) was measured on-line with a flow rate kept at 0.045 - 0.055 l/s, according to the recommendations of ATS using a chemiluminescence analyzer twice: before the sleep study (8-10 p.m.) and after termination of data collection (6 - 8 a.m.). There were no differences in age between patients and controls. Respiratory disturbance index (RDI) was 40.3+/-24.9 in patients and 3.7+/-2.8 in controls (p<0.001). In OSAS patients both evening and morning FE(NO) was significantly higher compared to controls (23.1+/-14.8 ppb vs. 16.8+/-9.8 ppb and 22.4+/-13.2 ppb vs. 15.3+/-8.1 ppb respectively, p<0.05). Weak but statistically significant correlations for the whole group between morning FE(NO) and mean and minimum arterial oxygen saturation (SaO2) during sleep and number of study minutes with SaO2<90% were observed. Lower evening FE(NO) in OSAS patients with coexisting arterial hypertension when compared to normotensive OSAS patients was also noticed (19.1+/-10.8 ppb vs. 27.1+/-19.1 ppb; p<0.05). CONCLUSIONS: The increase in FE(NO) in OSAS patents may be caused by repetitive apneas and hypoxemia during sleep.

Adult↗

PubMed2006

[Influence of nasal continuous positive airway pressure on response to exercise in patients with obstructive sleep apnea syndrome].

UNLABELLED: Obstructive sleep apnea syndrome (OSAS) patients are at risk of cardiovascular complications. The aim of this study was to assess the effect of treatment with continuous positive airway pressure (CPAP) on the response to symptom limited exercise test. METHODS: twenty nine OSAS patients (1 F, 28 M), mean age 50.7+/-9.7 yrs with body mass index of 32.6+/-4.5 kg/m2 participated in the study. OSAS was diagnosed by overnight polysomnography. Incremental cardiopulmonary exercise test (CPET) on a treadmill was performed twice: before and after 2-3 weeks of regular treatment with CPAP. RESULTS: mean apnea + hypopnea index (AHI) before therapy was 57.6+/-12 h(-1). CPAP treatment did not change peak oxygen consumption (VO2max) (38.3+/-9.0 vs. 38.9+/-6.9 mlO2/kg/min, p=ns) or peak heart rate (153.4+/-21 min- vs. 155.5+/-22 min(-1), p=ns). There were no significant changes in ventilation or gas exchange variables. However, a decrease in peak systolic blood pressure from 194.5+/-24 mmHg to 186.7+/-27.9 mmHg (p<0.05) with CPAP treatment was found. During recovery a decrease in heart rate (at 1st minute and minutes 3 - 6) and mean arterial pressure (MAP) (minutes 4-7) with CPAP treatment was observed. Significant correlations between VO2max and AHI (r=-0,38, p<0,05); MAP at peak exercise and: AHI, mean oxygen saturation (SaO2) during sleep, minutes of sleep with SaO2<90% (T90); MAP at recovery (minutes 3-8) and T90 before CPAP treatment were also noted. CONCLUSIONS: OSAS patients are not limited on exercise. Treatment with nasal CPAP attenuates circulatory response to incremental exercise on a treadmill.

Blood Pressure↗

PubMed2006

[Obstructive sleep apnea in shift workers].

UNLABELLED: The aim of the study was to compare intensity of sleep disordered breathing in standard nocturnal polisomnography (PSG) and diurnal PSG after night shift in shift workers with obstructive sleep apnea syndrome. METHODS: 25 shift workers (24 M, 1 F), aged 45,4 +/- 9,1 yrs, of mean BMI 31,9 +/- 4,02 kg/m2 were studied. Nocturnal PSG and diurnal PSG after night shift were performed in all participants. RESULTS: The mean apnea/hypopnea index (AHI) in diurnal PSG was higher than AHI in nocturnal PSG, 47,8+/- 27,4/h vs 38,0 +/-24,1/h respectively, (p<0,05). Not significant tendency towards higher oxygen desaturation index (ODI) in diurnal PSG was observed, 40,4 +/-25,5/h vs 31,9 +/-25,8/h respectively. CONCLUSION: The study demonstrated that there is a significant increase in AHI in diurnal PSG after night shift compared to standard night PSG in shift workers with OSAS. This may negatively influence diagnosis and treatment.

Adult↗

PubMed2006

[Obstructive sleep apnoea syndrome in younger and older age groups--differences and similarities].

UNLABELLED: The prevalence of OSA rises with age, however it is also diagnosed in patients below the age of 35 years. Aim of the paper was the camparison of the severity and clinical features of OSA in young and elderly subjects. The study was a retrospective analysis of 561 subjects aged > 65 yrs and 319 subjects aged < 35 yrs who were investigated in our Sleep Laboratory between 1992-2005 due to snoring or daytime sleepiness. They all underwent full polisomnography or a limited recording. In patients with diagnosed OSA (AHI > 10) we initiated CPAP therapy. RESULTS: OSA was diagnosed in 383 (63,3%) older patients and in 144 (45,1%) younger patients. BMI was significantly higher in younger subjects than in older (32,2+/-6,9 vs 28,9+/-5,1 kg/m2). The prevalence of OSA among women was significantly higher in older patients than in younger (26,4 vs 5,8%). Younger patients with OSA had a significantly higher AHI (42,7+/-32,1 vs 32,2+/-18,4) and a longer duration of apneas expressed as percentage of total sleep time spent in apnea (31,6+/-23,2 vs 26,5+/-17,7%). CPAP therapy was initiated in 185 older patients and 41% of them continue therapy. In younger group patients CPAP therapy was started in 51 patients and 47% of them continue therapy. The mean therapeutic pressure was significantly higher in younger patients with OSA (9,2+/-2,2 vs 8,2+/-2,2 cmH2O). CONCLUSIONS: 1/ OSA is more frequent in elderly patients ; 2/ in young patients OSA is more severe and requires higher pressures in CPAP therapy; 3/ OSA among women is four time more frequent in older patients than in younger.

Adult↗

PubMed2006

[Familial clustering of symptoms typical for OSAS].

The aim of the study was to compare the incidence of obstructive sleep apnoea syndrome (OSAS) symptoms in relatives of subjects with OSAS and in relatives without OSAS but with clinical symptoms of this disease. The study group consisted of 186 relatives of patients with OSAS and 117 relatives of patients with symptoms of OSAS in whom the disease was not confirmed by polysomnography. They were all mailed a questionnaire with questions concerning anthropometric data, the presence of symptoms typical for OSAS and the presence of concomitant diseases. Analysis of the obtained data revealed an increased frequency of snoring, sleep apnea and nycturia in the relatives of patients with OSAS when compared to relatives of patients without OSAS, but the difference was not statistically significant. The incidence of daytime OSAS symptoms was significantly higher in the group of relatives of patients with OSAS. No differences in the incidence of arterial hypertension, ischaemic heart disease and diabetes mellitus were found.

Body Mass Index↗

PubMed2006

[Serum concentration of homocysteine and the risk of atherosclerosis in patients with obstructive sleep apnea syndrome].

AIM: to evaluate usefulness of serum homocysteine concentration in assessing the risk of atherosclerosis in patients with OSAS. MATERIALS AND METHODS: 47 patients (mean age 50.6+/-10.3 years, mean BMI 31.52+/-6.04 kg/m2), with OSAS confirmed by polisomnography and 12 healthy snoring subjects (mean age 42.8 +/-16.8 years, mean BMI 26.9+/-2.95 kg/m2) were enrolled to the study. OSAS patients were divided into two groups - subjects with normal blood pressure (group A, n=32, mean age 51.3+/-10.3 years, mean BMI 30.6+/-4.4 kg/m2) and subjects with arterial hypertension (group B, n=15, mean age 52.7+/-9.8 years, mean BMI 31.4+/-5.0 kg/m2). None of the study subjects was treated with statins or fibrates. Serum concentration ofhomocysteine, uric acid, glucose level and lipid profile was evaluated in all subjects. RESULTS: We found significant abnormalities in the lipid profile in all the study groups. The mean concentrations of cholesterol (mg/dL), triglycerides (mg/dL) and homocysteine (micromol/L) were as follows: 215.0+/-34.2, 200.0+/-173.0, 8.2+/-2.9 in group A, 216.5+/-43.1, 189.3+/-138.8, 8.40+/-1.67 in group B. 195.0+/-32.9, 154.3+/-133.0, 9.3+/-2.1 in the control group. No significant correlation between the homocysteine concentration and level of cholesterol or triglycerides was found. CONCLUSIONS: the serum concentration of homocysteine seems not to be a good marker in the evaluation of the risk of atherosclerosis in patients with OSAS.

Adult↗

PubMed2005

[Effect of nasal obstruction on subjective assessment of sleep quality by the patients with obstructive sleep apnea].

In 52 patients with Obstructive Sleep Apnea Syndrome (OSAS) and nasal obstruction due to nasal septum deformation, hypertrophy of inferior nasal concha or posttraumatic external nose deformity the evaluation of the day somnolence using the Epworth Scale was carried out. The patients were randomly divided in to two groups. The first group consisted of 40 patients who were subjected to appropriate corrective surgery of the nasal obstruction. The remaining 12 patients constituted the control group. After 3 month each of the patients was asked to fill in the same questionnaire. Among the patients who underwent the surgical procedure day somnolence intensity was decreased approximately 2 times whereas in the control group no significant changes were observed. Results of this study could be crucial for the discussion concerning the complex influence of the nasal obstruction on the pathomechanism and symptomatology of obstructive breathing disorders during sleep.

Adult↗

PubMed2005

[Serum leptin concentration and sympathetic activation estimated on the adrenaline and noradrenaline serum concentration in patients with obstructive sleep apnea].

UNLABELLED: Hypertension, coronary heart diseases, obesity, diabetes mellitus are often present in patients with obstructive sleep apnea (OSA). The aim of the study was to estimate the serum leptin concentration and sympathetic activity in patients with obstructive sleep apnea and in control group. INVESTIGATED GROUP: 51 persons (F6, M45) were included into the study. The control group (GK) consisted of 15 snoring person (15 M) in the age x = 44.19 +/- 14.60, study group (GB) consisted of 36 patients with OSA (6F, 30M) in the age 5 1.47 +/- 8.95 years. METHODS: Leptin was measured by RIA methods using the HUMAN LEPTIN RIA KIT (LINCO Research, Inc).: adrenaline and noradrenaline were measured in the serum by HPLC methods (BIO-RAD). RESULTS: The serum concentrations of leptin (ng/mL), adrenaline and noradrenaline (pg/mL) in patients with OSA compared with control group were respectively 15.55 +/- 11.26 : 61.2 +/- 27.4: 523.2 +/- 165.1 vs 10.34+/- 6.86 : 47.7 +/- 27.3: 447.9 +/- 102.6. There was positive significant correlation between leptin concentration and BMI (r = 0,34) and serum leptin and adrenalin concentration (r = 0,34). The serum leptin concentration was significantly higher in the female group. In the male group there was tendency to increase leptin concentration together with degree of OSA grade estimated by AHI and AHI <50 leptin concentration 12.23+/- 6.96 ng/mL vs AHI>50 and leptin concentration 13.35 +/- 3.54ng/ml. CONCLUSIONS: 1. In the group of patients with OSA the serum concentrations of leptin, adrenaline and noradrenaline were higher then in control group. 2. There are positive statistical significant correlation between serum leptin levels and BMI and serum adrenaline concentration in the study group. 3. The serum leptin concentration was higher in the female group. 4. There was tendency to increased leptin concentration in the study group together with degree of OSA grade estimated by AHI. 5. Our results confirm correlation between leptin and sympathetic activity and their influences on obesity and degree of OSA grade in studied group.

Adult↗

PubMed2004

[Functional nasal surgery in the treatment of obstructive sleep apnea].

UNLABELLED: The study included 22 males with significant decrease in nasal patency, at age of 44+/-7 yrs with body mass index 28.9+/-3.8 kg/m2, diagnosed with obstructive sleep apnea syndrome (OSAS) by polysomnography. All patients underwent functional, corrective nasal surgery. In one patient an infection in the wound occurred. Postoperatively 19 (86%) patients reported significant subjective improvement. With regard to polysomnography, one patient was cured and in another one a decrease of AHI to more than 50% of baseline was found. In 6 (27.3%) patients AHI rose from 33.2+/-13 to 53.6+/-21.2. CONCLUSION: Nasal surgery in OSAS shows limited effectiveness. Because of multilevel decrease in airway patency, some of the patients may need a step-wise approach to surgical treatment.

Adult↗

PubMed2004

[Mandibular advancement devices in the treatment of obstructive sleep apnea].

UNLABELLED: Obstructive sleep apnea (OSA) affects approximately 450,000 people in Poland. Use of nasal continuous positive airway pressure (nCPAP) devices and laryngeal surgery are widely accepted OSA treatment methods. In 1995 ASDA approved oral devices for treatment of OSA patients. The aim of the study was to determine efficiency of mandibular advancement devices (MAD) in OSA therapy. MATERIAL AND METHODS: The study group included 20 patients with OSA, all of whom did not tolerate nCPAP and did not have indications or did not agree for surgical treatment. RESULTS: Control polysomnography was carried out in 11 patients using MAD. In 64% of patients AHI was lower then 10. No correlation between MAD use and AHI values was found. 45% of patients declared improvement of sleep quality and life comfort. CONCLUSIONS: Use of mandibular advancement devices is an important alternative therapy of OSA.

Adult↗

PubMed2004

[Reproducibility of exhaled nitric oxide (FENO) measurements in healthy subjects].

UNLABELLED: The aim of the study was to evaluate the short-term variability of FENO in healthy subjects. METHODS: 33 healthy volunteers (26 F, 7 M) aged 32.6 +/- 9.5 yrs with body mass index (BMI) of 23.3 +/- 3 kg/m2 participated in the study. Exhaled nitric oxide was analyzed on 5 consecutive days with a chemiluminescence analyzer (NIOX, Aerocrine, Sweden) according to the ATS recommendations. The exhalation flow was between 0.045 and 0.055 l/s. The measurements were performed at the same time of the day and the subjects were asked to refrain from eating and drinking for at least one hour before the analysis. RESULTS: The mean value of FENO for the whole group was 13.9 +/- 5.4 ppb, there were no correlations between FENO and age, BMI, sex or the concentration of ambient nitric oxide. Day-to-day coefficient of variation was 13.3 +/- 5.3% (range 4.6 - 23.9%), the value of pooled SD - 2.1 ppb and ICC (intraclass correlation coefficient) was 0.84. No relationship was observed between variability of FENO and intervals between measurement of exhaled nitric oxide and intake of food or beverages. CONCLUSION: Chemiluminescence analysis of FENO with NIOX is a highly reproducible method, however one has to take into account the possibility of about 13% variability of FENO within 5 days.

Adult↗

PubMed2002

[Clinical effects of surgical treatment of obstructive sleep apnea syndrome].

Aim of this study was to estimate the efficiency of surgical interventions in the treatment of obstructive sleep apnea (OSAS). Inclusion criteria for treatment were: presence of anatomical abnormalities within upper airways, a will to undergo surgical procedure and no medical contraindication for this treatment. Study group consisted of 43 men at age 42.8 +/- 6.8 year with mean pretreatment value of AHI: 49.5 +/- 21.5. Nasal surgery was performed in 26 cases interventions improving patency of nose were performed, uvulopalatopharyngoplasty in 17 and in two the tonsillectomy. Diagnosis of OSAS was made on the basis of typical complains and symptoms and results of nocturnal polysomnography. During follow-up, subjective improvement was reported by 35 (81%) of patients. Polysomnography revealed a significant decrease of AHI to below 15 in 10 (23%) cases; a lowering over 50% of AHI was obtained in 6 (14%) cases: in another 7 (16%) an increase in post-surgery AHI value was noticed. Efficiency of each intervention is presented as follows: tonsillectomy: 100%, uvulopalatopharyngoplasty: 41% and nasal surgery: 4.2%. Deterioration of OSAS in 7 cases was most probably due to more sleep on back during the follow-up.

Adult↗