Nasal pathologies in patients with obstructive sleep apnoea

Nasal obstruction is a frequent condition in patients with obstructive sleep apnoea (OSA). Nasal obstruction leads to mouth breathing, which is thought to destabilise the upper airway to aggravate the condition. Three conditions could be considered as the cause of the nasal breathing obstruction: anatomical conditions of the nose (septum deviation, hypertrophy of the inferior turbinates), chronic rhinosinusitis (CRS) and chronic nasal inflammation caused by allergic rhinitis or non-allergic cellular rhinitis. In this prospective study, we present an evaluation of all these possible rhino-sinusal aspects in OSA patients to correlate different nasal pathologies with nasal obstruction. Fifty patients with a diagnosis of OSA were enrolled in the study. In 70% of OSA patients, nasal obstruction was confirmed by clinical evaluation and rhinomanometry testing. Normal rhino-sinus aspects were present in only 20% of OSAS patients, whereas one or more pathological rhino-sinus conditions were present in the remaining 80%. The percentage of OSA patients with a diagnosis of allergic rhinitis and non-allergic rhinitis was 18% and 26% respectively. Non-allergic rhinitis with neutrophils (NARNE) was the most frequent type of cellular rhinitis diagnosed in OSA patients (20% of cases). The results of the present study support and extend the observation that rhinitis is present in OSA patients. Mucosal inflammation caused by these conditions could be the cause of upper airway patency impairment inducing nasal mucosa swellin

The Multitude of Molecular Hydrogen Knots in the Helix Nebula

We present HST/NICMOS imaging of the H_2 2.12 \mu m emission in 5 fields in the Helix Nebula ranging in radial distance from 250-450" from the central star. The images reveal arcuate structures with their apexes pointing towards the central star. Comparison of these images with comparable resolution ground based images reveals that the molecular gas is more highly clumped than the ionized gas line tracers. From our images, we determine an average number density of knots in the molecular gas ranging from 162 knots/arcmin^2 in the denser regions to 18 knots/arcmin^2 in the lower density outer regions. Using this new number density, we estimate that the total number of knots in the Helix to be ~23,000 which is a factor of 6.5 larger than previous estimates. The total neutral gas mass in the Helix is 0.35 M_\odot assuming a mass of \~1.5x10^{-5} M_\odot for the individual knots. The H_2 intensity, 5-9x10^{-5} erg s^{-1} cm^{-2} sr^{-1}, remains relatively constant with projected distance from the central star suggesting a heating mechanism for the molecular gas that is distributed almost uniformly in the knots throughout the nebula. The temperature and H_2 2.12 \mu m intensity of the knots can be approximately explained by photodissociation regions (PDRs) in the individual knots; however, theoretical PDR models of PN under-predict the intensities of some knots by a factor of 10.Comment: 26 pages, 3 tables, 10 figures; AJ accepte

Testosterone insulin-like effects: an in vitro study on the short-term metabolic effects of testosterone in human skeletal muscle cells

Testosterone by promoting different metabolic pathways contributes to short-term homeostasis of skeletal muscle, the largest insulin-sensitive tissue and the primary site for insulin-stimulated glucose utilization. Despite evidences indicate a close relationship between testosterone and glucose metabolism, the molecular mechanisms responsible for a possible testosterone-mediated insulin-like effects on skeletal muscle are still unknown

A screening mechanism for extra W and Z gauge bosons

We generalize a previous construction of a fermiophobic model to the case of more than one extra $W$ and $Z$ gauge bosons. We focus in particular on the existence of screening configurations and their implication on the gauge boson mass spectrum. One of these configurations allows for the existence of a set of relatively light new gauge bosons, without violation of the quite restrictive bounds coming from the $\rho_{\rm NC}$ parameter. The links with Bess and degenerate Bess models are also discussed. Also the signal given here by this more traditional gauge extension of the SM could help to disentangle it from the towers of Kaluza-Klein states over $W$ and $Z$ gauge bosons in extra dimensions.Comment: 23 pages, 1 figure, extended discussion on precision tests. To appear in International Journal of Modern Physics

Efficacy of SSRIs on cognition of Alzheimer's disease patients treated with cholinesterase inhibitors.

Background: This study examines the joint effect on cognition of selective serotonin re-uptake inhibitors (SSRIs) and cholinesterase inhibitors (AChEIs) in depressed patients affected by Alzheimer’s disease (AD) living at home. Methods: The study was conducted in two different outpatient neurological clinics. 338 patients with probable ADwere treated with ChEis (donepezil, rivastigmine and galantamine) as per the clinician’s judgment and were observed for nine months. At study entry, participants underwent a multidimensional assessment evaluating cognitive, functional and psychobehavioral domains. All patients were evaluated at baseline, after one (T1), three (T2) and nine months (T3). Patients were grouped in three different categories (patients not depressed and not treated with SSRIs, patients depressed and treated with SSRIs, and patients depressed but not treated with SSRIs). Results: At baseline 182 were diagnosed as not depressed and not treated with SSRIs, 66 as depressed and treated with SSRIs, and 90 as depressed but not treated with SSRIs. The mean change in MMSE score from baseline to nine months showed that depressed patients not treated worsened in comparison with those not depressed and not treated with SSRIs (mean change −0.8±2.3 vs 0.04±2.9; p = 0.02) and patients depressed and treated with SSRI (mean change −0.8±2.3 vs 0.1±2.5; p = 0.03). Conclusions: In AD patients treated with AChEIs, SSRIs may exert some degree of protection against the negative effects of depression on cognition

Long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome treatment

Background: The purpose of this study was to evaluate long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome (OSAS) treatment using a specific questionnaire, the Palate Postoperative Problem Score (PPOPS). Methods: 140 patients who underwent barbed reposition pharyngoplasty (BRP) surgery in the Morgagni Pierantoni Hospital of Forlì, Italy were enrolled in the study. Postoperative outcomes were evaluated in a short- and long-term follow-up using the PPOPS questionnaire. The average period of follow-up was 26 months. All patients received the PPOPS questionnaire by telephone in a period between April and August 2019. Results: 51% of patients complained of swallowing problems after surgery. In 91% of cases, the problem cleared up spontaneously. At the time of the interview, only 9% of patients had a residual swallowing difficult. At the time of PPOPS evaluation, rhinolalia was observed in 8% of patients, whereas nose regurgitation was present in 2% of patients. In 20% of patients, the foreign body sensation was present during follow-up. The value of apnea-hypopnea index (AHI) reduced from the preoperative value of 31.5 to the postoperative value of 11.4. Conclusions: BRP surgery proved to be an effective technique, appreciated by the majority of patients. Use of the PPOPS questionnaire has demonstrated that the BRP technique seems to ensure efficacy and lower morbidity, with few complications after surgery

Long-Term Results of Conservative Surgery and Radiotherapy for Ductal Carcinoma In Situ Using Lung Density Correction: The University of Michigan Experience

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72520/1/j.1524-4741.2007.00447.x.pd

Molecular Hydrogen in the Ring Nebula: Clumpy Photodissociation Regions

Article DOI: 10.1086/345911 Article Stable URL: http://www.jstor.org/stable/10.1086/345911We present a 0 .65 resolution H2 1-0 S(1) 2.122 mm image of the Ring Nebula (NGC 6720), which was taken with the Near Infrared Imager at the WIYN 3.5 m telescope on Kitt Peak. The high resolution of the H2 observation is sufficient to reveal the finer structure of the molecular material in this nebula. The morphology of the molecular emission is compared to that of the ionized emission from the Ring Nebula as seen by the Hubble Space Telescope (HST; He ii, [O iii], and [N ii]), and it is clear that the dark clumps seen by HST match the locations of clumpy H2 emission, suggesting that these clumps are similar to the cometary knots seen in the Helix Nebula. As with the Helix, the clumpy H2 emission from the main ring of the Ring Nebula is contained within the optically bright ionized nebula, implying that the molecular gas is shielded inside dense condensations. Comparison of the observed H2 average surface brightnesses for the Ring Nebula [(1.5 ergs cm 2 s 1 sr 1] with time-dependent models of the expected H2 0.5)#10 4 emission from planetary nebulae (PNe) shows that it is consistent with H2 excitation in photodissociation regions (PDRs), confirming previous suggestions. Comparison of the Ring Nebula H2 emission with a younger PN, NGC 2346, and an older PN, the Helix Nebula, suggests an evolution in H2 surface brightness consistent with the time-dependent PDR models. Moreover, the knots of molecular gas appear to become more isolated as the PN evolves, consistent with optical studies of knots in PNe.A. K. S. was supported by NASA JPL 961504 and NASA STI 7898.02-96A. A. K. S. and M. M. were supported by NSF CAREER award AST 97-33697

Doses to internal organs for various breast radiation techniques - implications on the risk of secondary cancers and cardiomyopathy

<p>Abstract</p> <p>Background</p> <p>Breast cancers are more frequently diagnosed at an early stage and currently have improved long term outcomes. Late normal tissue complications induced by adjuvant radiotherapy like secondary cancers or cardiomyopathy must now be avoided at all cost. Several new breast radiotherapy techniques have been developed and this work aims at comparing the scatter doses of internal organs for those techniques.</p> <p>Methods</p> <p>A CT-scan of a typical early stage left breast cancer patient was used to describe a realistic anthropomorphic phantom in the MCNP Monte Carlo code. Dose tally detectors were placed in breasts, the heart, the ipsilateral lung, and the spleen. Five irradiation techniques were simulated: whole breast radiotherapy 50 Gy in 25 fractions using physical wedge or breast IMRT, 3D-CRT partial breast radiotherapy 38.5 Gy in 10 fractions, HDR brachytherapy delivering 34 Gy in 10 treatments, or Permanent Breast ¹⁰³Pd Seed Implant delivering 90 Gy.</p> <p>Results</p> <p>For external beam radiotherapy the wedge compensation technique yielded the largest doses to internal organs like the spleen or the heart, respectively 2,300 mSv and 2.7 Gy. Smaller scatter dose are induced using breast IMRT, respectively 810 mSv and 1.1 Gy, or 3D-CRT partial breast irradiation, respectively 130 mSv and 0.7 Gy. Dose to the lung is also smaller for IMRT and 3D-CRT compared to the wedge technique. For multicatheter HDR brachytherapy a large dose is delivered to the heart, 3.6 Gy, the spleen receives 1,171 mSv and the lung receives 2,471 mSv. These values are 44% higher in case of a balloon catheter. In contrast, breast seeds implant is associated with low dose to most internal organs.</p> <p>Conclusions</p> <p>The present data support the use of breast IMRT or virtual wedge technique instead of physical wedges for whole breast radiotherapy. Regarding partial breast irradiation techniques, low energy source brachytherapy and external beam 3D-CRT appear safer than ¹⁹²Ir HDR techniques.</p