Sex differences of continuous positive airway pressure treatment on flow-mediated dilation in patients with obstructive sleep apnea syndrome

Introduction: There is growing research evidence suggesting the presence of endothelial dysfunction and systemic inflammation in patients with obstructive sleep apnea syndrome (OSAS). Continuous positive airway pressure (CPAP) is the most effective method for treating OSAS; nonetheless, the effects of CPAP on the aforementioned pathophysiologic pathways as well as on the systemic disease that result or coexist with the OSAS remain elusive. Aim: To assess the effect of 3-month CPAP therapy on endothelial-dependent dilation, plasma levels of inflammatory markers, blood pressure (BP), and glucose control on male and female patients with OSAS. Methods: Our study group consisted of 40 (24 males and 16 females) patients with no prior history of cardiovascular disease, with an apnea-hypopnea index >= 15, who were assigned to receive CPAP treatment. Measurements of flow-mediated dilation (FMD), 24-hour ambulatory BP, and blood analysis were performed at baseline and 3 months after CPAP therapy. Results: Baseline FMD values were negatively correlated with the apnea-hypopnea index (r=-0.55, P=0.001). After 3 months of CPAP, there was an increase in the FMD values (5.40%+/- 2.91% vs 3.13%+/- 3.15%, P<0.05) and a significant reduction in the patients’ 24-hour systolic BP (122.82 +/- 11.88 mmHg vs 130.24 +/- 16.75 mmHg, P<0.05), diastolic BP (75.44 +/- 9.14 mmHg vs 79.68 +/- 11.09 mmHg, P<0.05), and pulse pressure (47.38 +/- 9.77 mmHg vs 52.72 +/- 11.38 mmHg, P<0.05); daytime systolic BP (125.76 +/- 12.69 mmHg vs 132.55 +/- 17.00 mmHg, P<0.05) and diastolic BP (77.88 +/- 10.39 mmHg vs 82.25 +/- 11.01 mmHg, P<0.05); nighttime systolic BP (118.17 +/- 13.16 mmHg vs 126.22 +/- 17.42 mmHg, P<0.05) and pulse pressure (46.61 +/- 10.76 mmHg vs 52.66 +/- 11.86 mmHg, P<0.05); and C-reactive protein and HbA1c levels (0.40 [0.40-0.70] mg/L vs 0.60 [0.40-0.84] mg/L and 5.45%+/- 0.70% vs 5.95%+/- 1.08%, respectively; P<0.05). When divided by sex, only male patients produced similar statistically significant results, while female patients failed to show such associations. Conclusion: Our results suggest that CPAP therapy improves the endothelial function, the BP, and the glucose control in male patients with OSAS. Further research is warranted in order to verify these results and to further elucidate the impact of CPAP on the cardiovascular risk of male and female patients with OSAS

Enhancement of intratumoral chemotherapy with cisplatin with or without microwave ablation and lipiodol : future concept for local treatment in lung cancer

Novel therapies for lung cancer are being explored nowadays with local therapies being the tip of the arrow. Intratumoral chemotherapy administration and local microwave ablation have been investigated in several studies. It has been previously proposed that lipiodol has the ability to modify the microenvironment matrix. In our current study we investigated this theory in BALBC mice. In total 160 BALBC mice were divided in eight groups: a) control, b) cisplatin, c) microwave, d) microwave and lipiodol, e) cisplatin and lipiodol, f) microwave and cisplatin, g) lipiodol and h) lipiodol, cisplatin and microwave. Lewis lung carcinoma cell lines (106) were injected into the right back leg of each mouse. After the 8th day, when the tumor volume was about 100mm3 the therapy application was initiated, once per week for four weeks. Magnetic resonance imaging was performed for each tumor when a mouse died or when sacrificed if they were still alive by the end of the experiment (8-Canal multifunctional spool; NORAS MRI products, Gmbh, Germany). Imaging and survival revealed efficient tumor apoptosis for the groups b,c,d,e and f. However; severe toxicity was observed in group h and no follow up was available for this group after the second week of therapy administration. Lipiodol in its current form does assist in a more efficient way the distribution of cisplatin, as the microwave apoptotic effect. Future modification of lipiodol might provide a more efficient method of therapy enhancement. Combination of drug and microwave ablation is possible and has an efficient apoptotic effect