published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Made available in DSpace on 2014-06-11T19:25:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-12-02Bitstream added on 2014-06-13T18:47:49Z : No. of bitstreams: 1 santos_vjb_me_botfm.pdf: 165407 bytes, checksum: 75e1e4eb834684addce37aa949b6f2b8 (MD5) / A síndrome da apnéia obstrutiva do sono (SAOS) está relacionada à lesão cardiovascular, causada por hipóxia intermitente e elevação de catecolaminas circulantes. A relação entre SAOS e doenças cardiovasculares não é completamente compreendida. Poucos estudos têm sido realizados em crianças. Uma série de relatos de casos de complicações cardiovasculares secundárias a distúrbios respiratórios obstrutivos graves relacionados ao sono têm sido descritos em pacientes pediátricos, como hipertensão pulmonar e cor pulmonale. Há divergências entre os estudos quanto à recuperação dos níveis de pressão arterial normal e descenso fisiológico noturno após a correção obstrutiva distúrbio respiratório. O objetivo deste estudo é studar as alterações da pressão arterial em crianças com distúrbios respiratórios obstrutivos, antes e após a correção dos distúrbios respiratórios através de adenotonsilectomia. Selecionamos crianças, de ambos os sexos, com idades entre 8-12 anos, com sintomas de distúrbios respiratórios do sono, com indicação de adenotonsilectomia. Submetidas à polissonografia basal, foram alocadas em dois grupos de acordo com diagnóstico de SAOS ou Ronco Primário. Realizou-se a monitorização de 24 horas da pressão arterial, repetido seis meses após a adenotonsilectomia. Um total de 26 crianças foram incluídas, dezoito eram do sexo masculino, idade média era de 11 anos. Crianças do grupo SAOS apresentaram níveis elevados de pressão arterial média e diastólica, quando comparadas a crianças do grupo Ronco Primário. A perda do descenso noturno fisiológico foi 6,66 vezes maior entre as crianças do grupo SAOS. Após adenotonsilectomia os grupos se mostraram homogêneos quanto aos níveis tensionais, sendo que a chance de perda do descenso noturno passou a ser insignificante... / Obstructive Sleep Apnea is related to cardiovascular injury, caused by intermittent hypoxia and elevation of circulating catecholamine. The mechanisms underlying the link between OSA and cardiovascular diseases are not completely understood. Only few studies have been performed in children. A number of case reports described cardiovascular complications of severe obstructive sleep-disordered breathing in pediatric patients, such as pulmonary hypertension and cor pulmonale. There are differences between studies regarding the recovery of normal blood pressure levels and nocturnal physiological decline after correcting obstructive respiratory disorder. The aim of this study is to study the 24 hours monitoring of blood pressure in children with OSA, before and after respiratory disorders correction through adenotonsillectomy. We selected children of both genders, aged 8-12 years with symptoms of sleep-disordered breathing, with indication of adenotonsillectomy. Underwent overnight polysomnography, were allocated into two groups according to diagnosis of OSA or primary snoring. We calculated the 24-hour monitoring of blood pressure, repeated six months after adenotonsillectomy. A total of 26 children were included, eighteen were male, median age was 11 years. Children of the OSA group showed elevated levels of diastolic and mean arterial pressure when compared to children in the Primary Snoring. The loss of physiological nocturnal dip was 6.66 times higher among children in the OSA. After adenotonsillectomy groups were homogeneous with regard to blood pressure levels, and the chance of loss of nocturnal became statistically insignificant. Our results clearly indicate that OSA children have an increased blood pressure 24 hours compared with those with primary snoring... (Complete abstract click electronic access below)

Orientador: Silke Anna Theresa Weber / Banca: José Roberto Fioretto / Banca: Inge Elly Kiemle Trindade / Resumo: A síndrome da apnéia obstrutiva do sono (SAOS) está relacionada à lesão cardiovascular, causada por hipóxia intermitente e elevação de catecolaminas circulantes. A relação entre SAOS e doenças cardiovasculares não é completamente compreendida. Poucos estudos têm sido realizados em crianças. Uma série de relatos de casos de complicações cardiovasculares secundárias a distúrbios respiratórios obstrutivos graves relacionados ao sono têm sido descritos em pacientes pediátricos, como hipertensão pulmonar e cor pulmonale. Há divergências entre os estudos quanto à recuperação dos níveis de pressão arterial normal e descenso fisiológico noturno após a correção obstrutiva distúrbio respiratório. O objetivo deste estudo é studar as alterações da pressão arterial em crianças com distúrbios respiratórios obstrutivos, antes e após a correção dos distúrbios respiratórios através de adenotonsilectomia. Selecionamos crianças, de ambos os sexos, com idades entre 8-12 anos, com sintomas de distúrbios respiratórios do sono, com indicação de adenotonsilectomia. Submetidas à polissonografia basal, foram alocadas em dois grupos de acordo com diagnóstico de SAOS ou Ronco Primário. Realizou-se a monitorização de 24 horas da pressão arterial, repetido seis meses após a adenotonsilectomia. Um total de 26 crianças foram incluídas, dezoito eram do sexo masculino, idade média era de 11 anos. Crianças do grupo SAOS apresentaram níveis elevados de pressão arterial média e diastólica, quando comparadas a crianças do grupo Ronco Primário. A perda do descenso noturno fisiológico foi 6,66 vezes maior entre as crianças do grupo SAOS. Após adenotonsilectomia os grupos se mostraram homogêneos quanto aos níveis tensionais, sendo que a chance de perda do descenso noturno passou a ser insignificante... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Obstructive Sleep Apnea is related to cardiovascular injury, caused by intermittent hypoxia and elevation of circulating catecholamine. The mechanisms underlying the link between OSA and cardiovascular diseases are not completely understood. Only few studies have been performed in children. A number of case reports described cardiovascular complications of severe obstructive sleep-disordered breathing in pediatric patients, such as pulmonary hypertension and cor pulmonale. There are differences between studies regarding the recovery of normal blood pressure levels and nocturnal physiological decline after correcting obstructive respiratory disorder. The aim of this study is to study the 24 hours monitoring of blood pressure in children with OSA, before and after respiratory disorders correction through adenotonsillectomy. We selected children of both genders, aged 8-12 years with symptoms of sleep-disordered breathing, with indication of adenotonsillectomy. Underwent overnight polysomnography, were allocated into two groups according to diagnosis of OSA or primary snoring. We calculated the 24-hour monitoring of blood pressure, repeated six months after adenotonsillectomy. A total of 26 children were included, eighteen were male, median age was 11 years. Children of the OSA group showed elevated levels of diastolic and mean arterial pressure when compared to children in the Primary Snoring. The loss of physiological nocturnal dip was 6.66 times higher among children in the OSA. After adenotonsillectomy groups were homogeneous with regard to blood pressure levels, and the chance of loss of nocturnal became statistically insignificant. Our results clearly indicate that OSA children have an increased blood pressure 24 hours compared with those with primary snoring... (Complete abstract click electronic access below) / Mestre

One in three American older adults fall every year, making falls the leading cause of nonfatal injury treated in the emergency department (Centers for Disease Control and Prevention [CDC], 2013). Fall-related injuries cost the United States healthcare system nearly $30 billion a year and result in 27,000 deaths per year (Burns, Stevens, & Lee, 2016). The risk of falls increases with age, occurring more often in women than man. Age-related muscle weakness and functional decline contribute to fall risk. Age-related changes in neuroendocrine hormone production and shifts in circadian rhythms promote sleep disorders, affecting nearly two-thirds of older adults. Poor sleep quality over time leads to drowsiness and impaired attention span and judgment. The purpose of this secondary analysis of a previously collected data set was to describe the relationships among frailty, subjective sleep quality, and falls in community-dwelling older adults. This secondary analysis also sought to determine the extent to which frailty and subjective sleep quality predict risk of future falls among community-dwelling older adults. Correlational analyses were performed to determine the nature and significance of the relationship between sleep quality and falls, frailty and falls, and sleep quality and frailty. A multiple regression analysis was performed to determine if sleep quality and frailty combined could predict falls. Frailty was found to account for a small variance in fall risk. However, sleep quality was not significantly related to falls nor was sleep quality predictive of falls. Risk for falls should be assessed at every clinical encounter and efforts to promote restful sleep should be addressed at least annually to reduce the risks of falls, functional decline, and sleep disorders among older adults in the community. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection