Abstract:
BACKGROUND:Periodic leg movements (PLMs) may appear during nasal CPAP titration, persisting despite the elimination of hypopneas. METHODS:Systematic recordings of expiratory abdominal muscles on the right and left sides with surface electromyographic (EMG) electrodes lateral to navel, and close from the lateral side of abdomen, were added during nasal CPAP titration for treatment of obstructive sleep apnea (OSA). Positive airway pressure was titrated during nocturnal polysomnography, based on analysis of the flow curve derived from the CPAP equipment and EEG analysis, including persistence of phases A2 and A3 of the cyclic alternating pattern (CAP). The requirement was to eliminate American Association of Sleep Medicine (AASM)-defined hypopnea and also flow limitation and abnormal EEG patterns. When CPAP reached valid results, it was lowered at the time of awakening by 2 or 3 cm H(2)O, and titration was performed again. Data collected during a 7-month period on adults with a prior diagnosis of OSA who had received treatment with nasal CPAP regardless of age and sex were rendered anonymous and were retrospectively rescored by a blinded investigator. RESULTS:Eighty-one successively seen patients with PLMs during CPAP titration were investigated. Elimination of AASM-defined hypopnea was not sufficient to eliminate the PLMs observed during the titration; higher CPAP eliminated flow limitation and CAP phases A2 and A3 and persisting PLMs. PLMs were associated with simultaneous EMG bursts in expiratory abdominal muscles. CONCLUSIONS:The presence of PLMs during CPAP titration indicates the persistence of sleep-disordered breathing. PLMs during CPAP titration are related to the presence of abdominal expiratory muscle activity.
journal_name
Chestjournal_title
Chestauthors
Seo WH,Guilleminault Cdoi
10.1378/chest.11-1563subject
Has Abstractpub_date
2012-07-01 00:00:00pages
111-118issue
1eissn
0012-3692issn
1931-3543pii
S0012-3692(12)60395-Xjournal_volume
142pub_type
杂志文章相关文献
CHEST文献大全abstract:BACKGROUND:While isolating the pulmonary arterial branches within the fissure is a crucial step in lobectomy, a largely fused fissure usually hinders its achievement, making lobectomy with video-assisted thoracoscopic surgery (VATS) difficult to achieve. For VATS lobectomy in lung cancer patients with a largely fused f...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.2.619
更新日期:2003-02-01 00:00:00
abstract::We wished to identify the physiologic abnormalities that distinguish severely breathless (SB) patients with chronic airflow limitation (CAL) from mildly breathless (MB) patients. Thirty-seven patients with stable, advanced CAL (FEV1 = 38 +/- 10 percent predicted, mean +/- SD) were separated into two distinct groups, S...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.3.824
更新日期:1992-09-01 00:00:00
abstract::Metastatic disease involving the heart may present in a variety of fashions. A patient with melanoma metastatic to the right ventricle which was diagnosed clinically by evidence of recent onset of right ventricular inflow and outflow tract obstruction is described. Important information regarding the extent of the met...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.92.2.362
更新日期:1987-08-01 00:00:00
abstract::Tracheal bronchus is a common anomaly that occurs in approximately 2% of people. Two children with multiple medical problems which led to endotracheal intubation are described. The hospital course for each child was complicated by persistent right upper lobe atelectasis. The presence of a tracheal bronchus was not rec...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.2.537
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Idiopathic pulmonary fibrosis (IPF) is a devastating disease, yet validated, reliable criteria for evaluating patient response to therapies in clinical trials are lacking. METHODS:To optimize selection of end point criteria for the study of interferon (IFN)-gamma1b in patients with IPF, we retrospectively a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.127.1.171
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To determine the sensitivity of bacteriologic studies in pediatric pulmonary tuberculosis. PATIENTS AND METHODS:Between January 1988 and December 1996, 104 consecutive patients aged 0 to 18 years received a diagnosis of primary pulmonary tuberculosis at our institution. Demographic, clinical, laboratory, and...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.119.5.1434
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Ultrasound enables the visualization of pleural-based lesions with a poor correlation to specific pathology. At this time, there are no data about the diagnostic value of contrast-enhanced sonography (CES) in pleural lesions. METHODS:From August 2004 to January 2005, 25 consecutive patients with clinical sy...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.6.3894
更新日期:2005-12-01 00:00:00
abstract:CASE PRESENTATION:A 34-year-old woman presented for evaluation of several months of a hoarse voice and dyspnea on exertion that progressed over the last 3 years. She had a clinical diagnosis of asthma that had been treated with bronchodilators and inhaled corticosteroids for a few years. She continued to use her inhale...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2019.01.021
更新日期:2019-06-01 00:00:00
abstract::Fluid infusion may be lifesaving in patients with severe sepsis, especially in the earliest phases of treatment. Following initial resuscitation, however, fluid boluses often fail to augment perfusion and may be harmful. In this review, we seek to compare and contrast the impact of fluids in early and later sepsis; sh...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.07-1496
更新日期:2008-01-01 00:00:00
abstract::The determination of effective dynamic and static relationships between pressure and volume aided in the diagnosis of pulmonary disease, its course, and the effects of therapy in 22 patients receiving continuous mechanical ventilation. These measurements were made on multiple occasions early in the course of mechanica...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.70.6.740
更新日期:1976-12-01 00:00:00
abstract::Theophylline is commonly prescribed for patients with nonasthmatic chronic airflow obstruction (CAO) even though clinical efficacy is not well established. We studied objective and subjective responses to theophylline in 14 men with CAO. Subjects randomly received week-long treatments of placebo or theophylline at two...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.82.5.538
更新日期:1982-11-01 00:00:00
abstract::We present an unusual case of a patient with chronic hepatitis C who experienced dyspnea, fever, and cough after 2 1/2 months' treatment with interferon. His radiograph demonstrated diffuse pulmonary infiltrates and bronchoalveolar lavage fluid showed an increase in lymphocytes, especially CD8-positive cells. The lung...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.2.612
更新日期:1994-08-01 00:00:00
abstract::Repeated aortic prosthetic valve endocarditis and aortic root abscesses were successfully treated by implantation of a valved conduit into the ascending aorta and by placement of saphenous vein grafts to the aorta distal to the conduit and to the right and left anterior descending coronary arteries. This procedure pro...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.85.6.832
更新日期:1984-06-01 00:00:00
abstract::The assessment of the structure and function of the subvalvular apparatus (SVA) in patients with rheumatic mitral stenosis (MS) is complex, yet is of major importance prior to therapeutic decision making. Currently available methods of assessment are neither sufficiently accurate nor feasible. We review anatomic and f...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.124.5.1929
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:It has been postulated that differences in provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) values between the dosimeter method and tidal breathing method might be due to differences in the dose of agonist delivered to the mouth. The aim of the present study was to determine the in...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.08-0093
更新日期:2008-10-01 00:00:00
abstract:INTRODUCTION:CD14 is a cell surface glycoprotein expressed mainly on mature monocytes and macrophages. Soluble CD14 (sCD14) is present in normal plasma and is found increased in serum of patients with septicemia, polytrauma, and sarcoidosis. In active sarcoidosis, increased levels of sCD14 in BAL supernatant have been ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.6.1614
更新日期:1995-12-01 00:00:00
abstract::The short-term effects of smoke inhalation have been little studied. This study evaluated whether firefighters experience a significant change in spirometric values following exposure to smoke from a fire. Sixty firefighters from the city of Pittsburgh completed a questionnaire (Medical Research Council) and underwent...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.4.806
更新日期:1990-04-01 00:00:00
abstract::We report a case of cardiac fibrosarcoma that was treated with cardiac tumor resection, chemotherapy, cardiac explantation, tumor repeat resection, and autotransplantation followed by external beam irradiation. The patient was able to achieve clinical remission and remained disease free > 2 years after the initial dia...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.5.1766
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:To investigate the associations of maternal and grandmaternal smoking before, during, and after pregnancy with childhood asthma. DESIGN, SETTING, AND PARTICIPANTS:We conducted a case-control study nested within the Children's Health Study in southern California. The case patients consisted of 338 children wi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.127.4.1232
更新日期:2005-04-01 00:00:00
abstract::Colonization of the lower respiratory tract by enteric Gram-negative bacilli (EGNB) has been a frequent finding in patients with long-term tracheostomies; however, the association of hospitalization and certain features of serious illness with this phenomenon has not been clearly established. Because such factors can ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.85.1.39
更新日期:1984-01-01 00:00:00
abstract::Each of four examiners performed standardized physical examinations on a group of patients who had just undergone tests of ventilatory function. The intensity of breath sounds heard with deep inspiration was graded on a rating scale of 0 to 4; the grades in six areas of the chest were added to give a total score, with...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.70.3.341
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:Previous studies have shown a high prevalence of bronchiectasis in patients with moderate to severe COPD. However, the factors associated with bronchiectasis remain unknown in these patients. The objective of this study is to identify the factors associated with bronchiectasis in patients with moderate to se...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.10-1758
更新日期:2011-11-01 00:00:00
abstract::Most patients with severe, acute pulmonary embolism (PE) have arterial hypoxemia. To further define the respective roles of ventilation to perfusion (VA/Q) mismatch and intrapulmonary shunt in the mechanism of hypoxemia, we used both right heart catheterization and the six inert gas elimination technique in seven pati...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.88.6.829
更新日期:1985-12-01 00:00:00
abstract::We present a case of adult acute epiglottitis that was successfully managed by endotracheal intubation without the need for subsequent tracheostomy. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.1.93
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Characterizing acute exacerbations of COPD (AECOPD) and individualizing therapy is challenging. Key exacerbation therapies include antibiotics and systemic corticosteroids. Blood eosinophils, when either low or high, may offer a simple, inexpensive distinction to predict beneficial responses to these therapi...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1016/j.chest.2019.02.406
更新日期:2019-07-01 00:00:00
abstract::Malignant pleural effusions cause significant morbidity, but there is no gold standard minimally invasive treatment. A new therapeutic approach combines talc pleurodesis and indwelling pleural catheters (IPCs) to enable outpatient management. This case series summarizes the safety and efficacy data of all patients (24...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.14-0394
更新日期:2014-12-01 00:00:00
abstract:PURPOSES:To determine the diagnostic capabilities of dynamic high-resolution electron-beam (HREB) CT scanning for diagnosing bronchiolitis obliterans syndrome (BOS) in lung transplant recipients. MATERIALS AND METHODS:At the time of follow-up examinations after lung transplantation, 52 patients were examined by dynami...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.126.2.447
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Pulmonary edema may alter alveolar bacterial clearance and infectivity. Manipulation of fluid balance aimed at reducing fluid overload may, therefore, influence ventilator-associated pneumonia (VAP) occurrence in intubated patients. The objective of the present study was to assess the impact of a depletive f...
journal_title:Chest
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.13-2564
更新日期:2014-07-01 00:00:00
abstract::The pulmonary status of 178 asymptomatic asthmatic children with normal time-volume spirograms was further evaluated using flow-volume loops, body plethysmographic studies, and blood gas tensions in arterialized capillary blood. Residual volume (RV) was abnormal in 26%, total lung capacity (TLC) in 33%, RV/TLC% in 41%...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.3.361
更新日期:1977-03-01 00:00:00
abstract::Recent extensive development of thoracic surgery meets the need to treat elderly patients with a wide variety of pathophysiologic alterations, even if they require continuous medical assistance and high technologic support. Methods in providing such care are still limited by imprecision in evaluation of results; in th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.3.627
更新日期:1990-09-01 00:00:00