Margarida Aguiar - Academia.edu (original) (raw)
Papers by Margarida Aguiar
Revista Portuguesa de Pneumologia (English Edition), 2009
Resumo Vários estudos demonstram que os doentes com síndroma de apneia obstrutiva do sono (SAOS) ... more Resumo Vários estudos demonstram que os doentes com síndroma de apneia obstrutiva do sono (SAOS) têm um risco aumentado de acidentes de viação. O objectivo do presente trabalho consistiu em analisar, nestes doentes, se há diferenças nos que referem acidentes e/ /ou quase acidentes e aqueles que o não fazem. Material e métodos: Estudaram-se prospectivamente 163 doentes com SAOS (índice apneia/hipopneia (IAH)>10/h) diagnosticados por polissonografia nocturna (PSG), todos condutores de veículos, 18,4% do quais profissionais. Na altura da entrevista clínica foi inquirido se tinham tido, nos três anos antes acidentes e/ou quase acidentes devido a hipersonia diurna (Grupo II = 74) ou não (Grupo I = 89). Estes dois grupos foram comparados quanto a: idade, índice de massa corporal (IMC), escala de sonolência Abstract Several studies have demonstrated that obstructive sleep apnoea syndrome (OSAS) patients have a higher rate of road traffic accidents. Our study aimed to analyse any differences in OSAS patients between those who reported having had road traffic accidents and/or near misses and those who did not. Methods: We studied 163 patients with OSAS (apnoea-hypopnoea index (AHI)>10/h) diagnosed using nocturnal polysomnography (NPSG), all drivers, 18.4% of whom drove for a living. Patients were asked at their first clinical interview to self-report road traffic accidents and/or near misses over the past 3 years which had been caused by abnormal daytime drowsiness. This allowed patients to be divided into two groups, those who had had road traffic accidents and/or near misses and those who had not. Both were Síndroma de apneia obstrutiva do sono como causa de acidentes de viação Obstructive sleep apnoea syndrome as a cause of road traffic accidents Recebido para publicação/received for publication: 08.11.12 Aceite para publicação/accepted for publication: 08.12.23
![Research paper thumbnail of [Whole lung lavage - Report of four cases of alveolar proteinosis]](https://attachments.academia-assets.com/90210813/thumbnails/1.jpg)
](Revista portuguesa de pneumologia, 2009
Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lip... more Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lipoproteinaceous material that accumulates in the bronchi of patients with alveolar proteinosis, leading to clinical and functional improvement. There has been an evolution in the technique; initially it was performed under local anesthesia to each segment of the lung and currently it is performed under general anesthesia sequentially to both lungs. This review describes the whole lung lavage, its major indication, alveolar proteinosis and some data on the experience of our hospital.
Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lip... more Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lipoproteinaceous material that accumulates in the bronchi of patients with alveolar proteinosis, leading to clinical and functional improvement. There has been an evolution in the technique; initially it was performed under local anesthesia to each segment of the lung and currently it is performed under general anesthesia sequentially to both lungs.
Revista Portuguesa de Pneumologia, 2009
Resumo O tabagismo é uma importante causa de patologia pulmonar e a sua dependência poderá ser co... more Resumo O tabagismo é uma importante causa de patologia pulmonar e a sua dependência poderá ser considerada uma doença crónica e recorrente. Os benefícios da cessação tabágica são inquestionáveis e todos os médicos têm responsabilidade na sua recomendação. Objectivo: Caracterização da população que recorre à consulta de apoio ao fumador (CAF) do nosso hospital e procurar entender as razões do sucesso Materiais e métodos: Análise retrospectiva dos processos clínicos de todos os doentes que foram seguidos na CAF entre Janeiro de 2003 e Junho de 2006. Foram avaliados os seguintes parâmetros: idade, sexo, idade de início, carga tabágica (unidades maço ano-UMA), patologias associadas, grau de dependência (teste de Fargerström), tentativas prévias, motivações
Page 1. D47 INTERSTITIAL LUNG DISEASE: COLLAGEN-VASCULAR DISEASE, SARCOIDOSIS AND OTHER DIFFUSE L... more Page 1. D47 INTERSTITIAL LUNG DISEASE: COLLAGEN-VASCULAR DISEASE, SARCOIDOSIS AND OTHER DIFFUSE LUNG DISEASES / Thematic Poster Session / Wednesday, May 19/8:15 AM-4:00 PM / Area F, Hall G (First Level), Morial Convention Center ...
Resumo Varios estudos demonstram que os doentes com sindroma de apneia obstrutiva do sono (SAOS) ... more Resumo Varios estudos demonstram que os doentes com sindroma de apneia obstrutiva do sono (SAOS) tem um risco aumentado de acidentes de viacao. O objectivo do presente trabalho consistiu em analisar, nestes doentes, se ha diferencas nos que referem acidentes e/ /ou quase acidentes e aqueles que o nao fazem. Material e metodos : Estudaram-se prospectivamen-te 163 doentes com SAOS (indice apneia/hipopneia (IAH) > 10/h) diagnosticados por polissonografia noc-turna (PSG), todos condutores de veiculos, 18,4% do quais profissionais. Na altura da entrevista clinica foi inquirido se tinham tido, nos tres anos antes acidentes e/ou quase acidentes devido a hipersonia diurna (Grupo II = 74) ou nao (Grupo I = 89). Estes dois grupos foram comparados quanto a: idade, indice de massa corporal (IMC), escala de sonolencia de Epworth (ESE), PaO 2 e PaCO 2 diurnas, avaliacao da qualidade de vida pelo inquerito Functional Outcomes of Sleep Questionnaire (FOSQ teste) e dados da polissonografia – temp...
Respiratory events related arousals (RERAs) are a possible reason for excessive daytime sleepines... more Respiratory events related arousals (RERAs) are a possible reason for excessive daytime sleepiness (EDS), fatigue and mood disturbances, a complex also known by the upper airway resistance syndrome. Our aim was to detect the importance of this pathology within the overall sleep studies performed at our sleep laboratory. Sleep and cardiorespiratory parameters were evaluated with standard polisonography (PSG) according to the recommendations of AASM. RERAs were identified by a flattening of the airflow registered by nasal cannula and/or a visible increase in thoraco-abdominal effort leading to an arousal. All PSGs recorded during a period of 6 month with an apnea/hypopnea index of less than 15/h were reanalyzed by a single sleep specialist. Patients (pts) demonstrating RERAs in more than 50% of all breathing events were included for further study. Within 303 sleep studies a total of 45 pts were included (14,8%), mean respiratory disturbance index 17,4±10,4/h. 71% were male, with a mea...
Nervous system infiltration occurs in approximately 5% of patients with sarcoidosis; it is associ... more Nervous system infiltration occurs in approximately 5% of patients with sarcoidosis; it is associated with a less favorable course and accounts for a disproportionate amount of disability. Our aim was to evaluate clinical manifestations of patients with neurosarcoidosis, their demographics, and form of presentation, extra-neurological involvement and therapy. We performed a retrospective analysis of 23 patients9 clinical records (5,1%) out of a total of 450 with biopsy proven or high clinical suspicion of sarcoidosis with neurological involvement. Five males, 20 caucasian, mean age of 47,8±9,9 years with mean follow-up of 10,4±8,2 years (min. 1 and max. 23 years). At presentation, in 10 patients, neurologic symptoms. Twenty-one patients had further involvement of at least a second organ and 18 also had pulmonary compromise. Most patients (n=15) had III, IV, VI or VII cranial nerve palsy conditioning dysarthria and diplopia. Three patients had peripheral neuropathy conditioning mainl...
In a time when sleep studies are progressively done out of sleep laboratories and the positive pr... more In a time when sleep studies are progressively done out of sleep laboratories and the positive pressure devices have many automatic features that allow easy home titration, our sleep clinic thought it would be important to review the cases of central sleep apnea and their titration in the sleep laboratory. Between 2009 and 2010 patients with central sleep apnea were selected and prospectively followed in our sleep clinic. Demographics, anatomic features, clinical symptoms, initial and therapeutic standard polissonography, associated pathologies and eventual improvements were described. A total of eleven patients were selected, one female, mean age 64,5±13,3, mean body mass index 30,3± 3,9 kg/m 2 , all snorers, nine referring hypertension, four with heart failure and five with a disease of the central nervous system. All but one referred daytime sleepiness and scored more than 10 in the Epworth scale. The polissonographies showed a mean apnea/hyponea index (AHI) of 44,1±14,7/H and a ...
Revista portuguesa de pneumologia
Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lip... more Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lipoproteinaceous material that accumulates in the bronchi of patients with alveolar proteinosis, leading to clinical and functional improvement. There has been an evolution in the technique; initially it was performed under local anesthesia to each segment of the lung and currently it is performed under general anesthesia sequentially to both lungs.This review describes the whole lung lavage, its major indication, alveolar proteinosis and some data on the experience of our hospital.
scielo.oces.mctes.pt
A pneumonia organizativa, anteriormente designada como BOOP, é uma entidade individualizada desde... more A pneumonia organizativa, anteriormente designada como BOOP, é uma entidade individualizada desde há duas décadas, que apresenta características clínicas, radiológicas e critérios histológicos de diagnóstico específicos. Caracterizámos os doentes com pneumonia organizativa seguidos em consulta de Pneumologia/Doenças do Interstício do nosso hospital, no período de Janeiro de 1997 a Dezembro de 2006, e comparámos os resultados com os da literatura. Materiais e métodos: Foram consultados retrospectivamente os processos dos doentes com o diagnóstico de pneumonia organizativa (OP) e avaliados os seguintes parâmetros: idade, sexo, clínica, características imagiológicas, tempo até ao diagnóstico, etiologia, alterações laboratoriais e histológicas, tratamento e recidivas. Re-Abstract Aim: to characterise outpatients of a Portuguese central hospital diagnosed with organising pneumonia (OP) and compare results with current literature. Methods: medical processes with diagnosis of OP were retrospectively studied as to demographics, aetiology, clinical and radiological features, average time until and date of diagnosis, laboratory and histological changes, treatment and relapse. Results-thirteen patients with a mean follow-up of 171.6 weeks (max 334 and min 28 weeks) were evaluated. Nine of these patients (70%) had cryptogenic OP (COP) while 30% had secondary OP (SOP), two with rheumatoid arthritis, one with dermatomyositis and another undergoing radiotherapy for breast cancer. Mean age was 55.6 Pneumonia organizativa-Experiência da consulta de um hospital central Organising pneumonia-the experience of an outpatient clinic of a central hospital Recebido para publicação/received for publication: 09.07.06 Aceite para publicação/accepted for publication
Revista Portuguesa De Pneumologia, 2011
Despite aggressive treatment, sarcoidosis may be debilitating and progressive. The role of tumor ... more Despite aggressive treatment, sarcoidosis may be debilitating and progressive. The role of tumor necrosis factor (TNF)-α in the genesis of granulomas is ambiguous. It has proven to be critical in the formation and maintenance of granulomatous inflammation and its antagonist, Infliximab, has therefore been used with success in the treatment of patients with sarcoidosis. There are, however, reports of onset
Sleep and control of breathing
Sleep and control of breathing
Sleep and Control of Breathing
Advances in Respiratory Medicine
Introduction: Noninvasive ventilation (NIV) is an increasingly used method of respiratory support... more Introduction: Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time and if properly applied, it can save patients' lives and improve long-term prognosis. However, both knowledge and skills of its proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training. Material and methods: Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews with the results analyzed by a team of experts across the world through e-mail based communications. Results: Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV education and training based on opinions from 58 experts across the twenty different countries of the world was formulated. 5 Conclusions: Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing countries.
Sleep & breathing = Schlaf & Atmung, Mar 15, 2017
Sleep related breathing disorders (SRBD) cause sleep fragmentation, intermittent hypoxia or a com... more Sleep related breathing disorders (SRBD) cause sleep fragmentation, intermittent hypoxia or a combination of both leading to homeostasis perturbations, including in the immune system. We investigated whether SRBD patients with or without intermittent hypoxia show substantial differences in perforin and granzyme-B positive peripheral blood lymphocytes. A total of 87 subjects were included and distributed as follows: 24 controls (C), 19 patients with respiratory effort related arousals due to increased upper airway resistance (UAR) without hypoxic events, 24 obese patients with obstructive sleep apnea (OSA) (oOSA), and 20 without obesity (noOSA). After polysomnographic recording, we analyzed in fasting blood samples routine hematologic and biochemical parameters and the percentage of lymphocytes containing the proteins perforin and granzyme-B (GrB). Kruskal-Wallis tests and a posteriori multiple comparisons were applied for statistical analysis of results. Perforin-positive γδ-cells r...
Revista Portuguesa de Pneumologia (English Edition), 2009
Resumo Vários estudos demonstram que os doentes com síndroma de apneia obstrutiva do sono (SAOS) ... more Resumo Vários estudos demonstram que os doentes com síndroma de apneia obstrutiva do sono (SAOS) têm um risco aumentado de acidentes de viação. O objectivo do presente trabalho consistiu em analisar, nestes doentes, se há diferenças nos que referem acidentes e/ /ou quase acidentes e aqueles que o não fazem. Material e métodos: Estudaram-se prospectivamente 163 doentes com SAOS (índice apneia/hipopneia (IAH)>10/h) diagnosticados por polissonografia nocturna (PSG), todos condutores de veículos, 18,4% do quais profissionais. Na altura da entrevista clínica foi inquirido se tinham tido, nos três anos antes acidentes e/ou quase acidentes devido a hipersonia diurna (Grupo II = 74) ou não (Grupo I = 89). Estes dois grupos foram comparados quanto a: idade, índice de massa corporal (IMC), escala de sonolência Abstract Several studies have demonstrated that obstructive sleep apnoea syndrome (OSAS) patients have a higher rate of road traffic accidents. Our study aimed to analyse any differences in OSAS patients between those who reported having had road traffic accidents and/or near misses and those who did not. Methods: We studied 163 patients with OSAS (apnoea-hypopnoea index (AHI)>10/h) diagnosed using nocturnal polysomnography (NPSG), all drivers, 18.4% of whom drove for a living. Patients were asked at their first clinical interview to self-report road traffic accidents and/or near misses over the past 3 years which had been caused by abnormal daytime drowsiness. This allowed patients to be divided into two groups, those who had had road traffic accidents and/or near misses and those who had not. Both were Síndroma de apneia obstrutiva do sono como causa de acidentes de viação Obstructive sleep apnoea syndrome as a cause of road traffic accidents Recebido para publicação/received for publication: 08.11.12 Aceite para publicação/accepted for publication: 08.12.23
Revista portuguesa de pneumologia, 2009
Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lip... more Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lipoproteinaceous material that accumulates in the bronchi of patients with alveolar proteinosis, leading to clinical and functional improvement. There has been an evolution in the technique; initially it was performed under local anesthesia to each segment of the lung and currently it is performed under general anesthesia sequentially to both lungs. This review describes the whole lung lavage, its major indication, alveolar proteinosis and some data on the experience of our hospital.
Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lip... more Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lipoproteinaceous material that accumulates in the bronchi of patients with alveolar proteinosis, leading to clinical and functional improvement. There has been an evolution in the technique; initially it was performed under local anesthesia to each segment of the lung and currently it is performed under general anesthesia sequentially to both lungs.
Revista Portuguesa de Pneumologia, 2009
Resumo O tabagismo é uma importante causa de patologia pulmonar e a sua dependência poderá ser co... more Resumo O tabagismo é uma importante causa de patologia pulmonar e a sua dependência poderá ser considerada uma doença crónica e recorrente. Os benefícios da cessação tabágica são inquestionáveis e todos os médicos têm responsabilidade na sua recomendação. Objectivo: Caracterização da população que recorre à consulta de apoio ao fumador (CAF) do nosso hospital e procurar entender as razões do sucesso Materiais e métodos: Análise retrospectiva dos processos clínicos de todos os doentes que foram seguidos na CAF entre Janeiro de 2003 e Junho de 2006. Foram avaliados os seguintes parâmetros: idade, sexo, idade de início, carga tabágica (unidades maço ano-UMA), patologias associadas, grau de dependência (teste de Fargerström), tentativas prévias, motivações
Page 1. D47 INTERSTITIAL LUNG DISEASE: COLLAGEN-VASCULAR DISEASE, SARCOIDOSIS AND OTHER DIFFUSE L... more Page 1. D47 INTERSTITIAL LUNG DISEASE: COLLAGEN-VASCULAR DISEASE, SARCOIDOSIS AND OTHER DIFFUSE LUNG DISEASES / Thematic Poster Session / Wednesday, May 19/8:15 AM-4:00 PM / Area F, Hall G (First Level), Morial Convention Center ...
Resumo Varios estudos demonstram que os doentes com sindroma de apneia obstrutiva do sono (SAOS) ... more Resumo Varios estudos demonstram que os doentes com sindroma de apneia obstrutiva do sono (SAOS) tem um risco aumentado de acidentes de viacao. O objectivo do presente trabalho consistiu em analisar, nestes doentes, se ha diferencas nos que referem acidentes e/ /ou quase acidentes e aqueles que o nao fazem. Material e metodos : Estudaram-se prospectivamen-te 163 doentes com SAOS (indice apneia/hipopneia (IAH) > 10/h) diagnosticados por polissonografia noc-turna (PSG), todos condutores de veiculos, 18,4% do quais profissionais. Na altura da entrevista clinica foi inquirido se tinham tido, nos tres anos antes acidentes e/ou quase acidentes devido a hipersonia diurna (Grupo II = 74) ou nao (Grupo I = 89). Estes dois grupos foram comparados quanto a: idade, indice de massa corporal (IMC), escala de sonolencia de Epworth (ESE), PaO 2 e PaCO 2 diurnas, avaliacao da qualidade de vida pelo inquerito Functional Outcomes of Sleep Questionnaire (FOSQ teste) e dados da polissonografia – temp...
Respiratory events related arousals (RERAs) are a possible reason for excessive daytime sleepines... more Respiratory events related arousals (RERAs) are a possible reason for excessive daytime sleepiness (EDS), fatigue and mood disturbances, a complex also known by the upper airway resistance syndrome. Our aim was to detect the importance of this pathology within the overall sleep studies performed at our sleep laboratory. Sleep and cardiorespiratory parameters were evaluated with standard polisonography (PSG) according to the recommendations of AASM. RERAs were identified by a flattening of the airflow registered by nasal cannula and/or a visible increase in thoraco-abdominal effort leading to an arousal. All PSGs recorded during a period of 6 month with an apnea/hypopnea index of less than 15/h were reanalyzed by a single sleep specialist. Patients (pts) demonstrating RERAs in more than 50% of all breathing events were included for further study. Within 303 sleep studies a total of 45 pts were included (14,8%), mean respiratory disturbance index 17,4±10,4/h. 71% were male, with a mea...
Nervous system infiltration occurs in approximately 5% of patients with sarcoidosis; it is associ... more Nervous system infiltration occurs in approximately 5% of patients with sarcoidosis; it is associated with a less favorable course and accounts for a disproportionate amount of disability. Our aim was to evaluate clinical manifestations of patients with neurosarcoidosis, their demographics, and form of presentation, extra-neurological involvement and therapy. We performed a retrospective analysis of 23 patients9 clinical records (5,1%) out of a total of 450 with biopsy proven or high clinical suspicion of sarcoidosis with neurological involvement. Five males, 20 caucasian, mean age of 47,8±9,9 years with mean follow-up of 10,4±8,2 years (min. 1 and max. 23 years). At presentation, in 10 patients, neurologic symptoms. Twenty-one patients had further involvement of at least a second organ and 18 also had pulmonary compromise. Most patients (n=15) had III, IV, VI or VII cranial nerve palsy conditioning dysarthria and diplopia. Three patients had peripheral neuropathy conditioning mainl...
In a time when sleep studies are progressively done out of sleep laboratories and the positive pr... more In a time when sleep studies are progressively done out of sleep laboratories and the positive pressure devices have many automatic features that allow easy home titration, our sleep clinic thought it would be important to review the cases of central sleep apnea and their titration in the sleep laboratory. Between 2009 and 2010 patients with central sleep apnea were selected and prospectively followed in our sleep clinic. Demographics, anatomic features, clinical symptoms, initial and therapeutic standard polissonography, associated pathologies and eventual improvements were described. A total of eleven patients were selected, one female, mean age 64,5±13,3, mean body mass index 30,3± 3,9 kg/m 2 , all snorers, nine referring hypertension, four with heart failure and five with a disease of the central nervous system. All but one referred daytime sleepiness and scored more than 10 in the Epworth scale. The polissonographies showed a mean apnea/hyponea index (AHI) of 44,1±14,7/H and a ...
Revista portuguesa de pneumologia
Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lip... more Whole lung lavage is a technique that was developed in the 1960s with the purpose of removing lipoproteinaceous material that accumulates in the bronchi of patients with alveolar proteinosis, leading to clinical and functional improvement. There has been an evolution in the technique; initially it was performed under local anesthesia to each segment of the lung and currently it is performed under general anesthesia sequentially to both lungs.This review describes the whole lung lavage, its major indication, alveolar proteinosis and some data on the experience of our hospital.
scielo.oces.mctes.pt
A pneumonia organizativa, anteriormente designada como BOOP, é uma entidade individualizada desde... more A pneumonia organizativa, anteriormente designada como BOOP, é uma entidade individualizada desde há duas décadas, que apresenta características clínicas, radiológicas e critérios histológicos de diagnóstico específicos. Caracterizámos os doentes com pneumonia organizativa seguidos em consulta de Pneumologia/Doenças do Interstício do nosso hospital, no período de Janeiro de 1997 a Dezembro de 2006, e comparámos os resultados com os da literatura. Materiais e métodos: Foram consultados retrospectivamente os processos dos doentes com o diagnóstico de pneumonia organizativa (OP) e avaliados os seguintes parâmetros: idade, sexo, clínica, características imagiológicas, tempo até ao diagnóstico, etiologia, alterações laboratoriais e histológicas, tratamento e recidivas. Re-Abstract Aim: to characterise outpatients of a Portuguese central hospital diagnosed with organising pneumonia (OP) and compare results with current literature. Methods: medical processes with diagnosis of OP were retrospectively studied as to demographics, aetiology, clinical and radiological features, average time until and date of diagnosis, laboratory and histological changes, treatment and relapse. Results-thirteen patients with a mean follow-up of 171.6 weeks (max 334 and min 28 weeks) were evaluated. Nine of these patients (70%) had cryptogenic OP (COP) while 30% had secondary OP (SOP), two with rheumatoid arthritis, one with dermatomyositis and another undergoing radiotherapy for breast cancer. Mean age was 55.6 Pneumonia organizativa-Experiência da consulta de um hospital central Organising pneumonia-the experience of an outpatient clinic of a central hospital Recebido para publicação/received for publication: 09.07.06 Aceite para publicação/accepted for publication
Revista Portuguesa De Pneumologia, 2011
Despite aggressive treatment, sarcoidosis may be debilitating and progressive. The role of tumor ... more Despite aggressive treatment, sarcoidosis may be debilitating and progressive. The role of tumor necrosis factor (TNF)-α in the genesis of granulomas is ambiguous. It has proven to be critical in the formation and maintenance of granulomatous inflammation and its antagonist, Infliximab, has therefore been used with success in the treatment of patients with sarcoidosis. There are, however, reports of onset
Sleep and control of breathing
Sleep and control of breathing
Sleep and Control of Breathing
Advances in Respiratory Medicine
Introduction: Noninvasive ventilation (NIV) is an increasingly used method of respiratory support... more Introduction: Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time and if properly applied, it can save patients' lives and improve long-term prognosis. However, both knowledge and skills of its proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training. Material and methods: Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews with the results analyzed by a team of experts across the world through e-mail based communications. Results: Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV education and training based on opinions from 58 experts across the twenty different countries of the world was formulated. 5 Conclusions: Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing countries.
Sleep & breathing = Schlaf & Atmung, Mar 15, 2017
Sleep related breathing disorders (SRBD) cause sleep fragmentation, intermittent hypoxia or a com... more Sleep related breathing disorders (SRBD) cause sleep fragmentation, intermittent hypoxia or a combination of both leading to homeostasis perturbations, including in the immune system. We investigated whether SRBD patients with or without intermittent hypoxia show substantial differences in perforin and granzyme-B positive peripheral blood lymphocytes. A total of 87 subjects were included and distributed as follows: 24 controls (C), 19 patients with respiratory effort related arousals due to increased upper airway resistance (UAR) without hypoxic events, 24 obese patients with obstructive sleep apnea (OSA) (oOSA), and 20 without obesity (noOSA). After polysomnographic recording, we analyzed in fasting blood samples routine hematologic and biochemical parameters and the percentage of lymphocytes containing the proteins perforin and granzyme-B (GrB). Kruskal-Wallis tests and a posteriori multiple comparisons were applied for statistical analysis of results. Perforin-positive γδ-cells r...