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Ding Q, Liu J, Wu J, Du J, Li X, Wang M, Sun Y, Yu Y, Wang J, Sun T, Zhang C, Lv C, Strohl KP, Han F, Dong X. Validation of a portable monitor compared with polysomnography for screening of obstructive sleep apnea in polio survivors. Front Neurol 2023; 14:1137535. [PMID: 37228407 PMCID: PMC10203206 DOI: 10.3389/fneur.2023.1137535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023] Open
Abstract
Subjective Sleep-disordered breathing (SDB) is highly prevalent in polio survivors. Obstructive sleep apnea (OSA) is the most frequent type. Full polysomnography (PSG) is recommended for OSA diagnosis in patients with comorbidities by current practice guidelines, but it is not always accessible. The purpose of this study was to evaluate whether type 3 portable monitor (PM) or type 4 PM might be a viable alternative to PSG for the diagnosis of OSA in postpolio subjects. Methods A total of 48 community-living polio survivors (39 men and 9 women) with an average age of 54.4 ± 5.3 years referred for the evaluation of OSA and who volunteered to participate were recruited. First, they completed the Epworth Sleepiness Scale (ESS) questionnaire and underwent pulmonary function testing and blood gas tests the day before PSG night. Then, they underwent an overnight in-laboratory PSG with a type 3 PM and type 4 PM recording simultaneously. Results The AHI from PSG, respiratory event index (REI) from type 3 PM, and ODI3 from type 4 PM was 30.27 ± 22.51/h vs. 25.18 ± 19.11/h vs. 18.28 ± 15.13/h, respectively (P < 0.001). For AHI ≥ 5/h, the sensitivity and specificity of REI were 95.45 and 50%, respectively. For AHI ≥ 15/h, the sensitivity and specificity of REI were 87.88% and 93.33%, respectively. The Bland-Altman analysis of REI on PM vs. AHI on PSG showed a mean difference of -5.09 (95% confidence interval [CI]: -7.10, -3.08; P < 0.001) with limits of agreement ranging from -18.67 to 8.49 events/h. ROC curve analysis for patients with REI ≥ 15/h showed an area under the curve (AUC) of 0.97. For AHI ≥ 5/h, the sensitivity and specificity of ODI3 from type 4 PM were 86.36 and 75%, respectively. For patients with AHI ≥ 15/h, the sensitivity was 66.67%, and the specificity was 100%. Conclusion Type 3 PM and Type 4 PM could be alternative ways to screen OSA for polio survivors, especially for moderate to severe OSA.
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Affiliation(s)
- Qidi Ding
- Department of Respiratory and Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Jianghua Liu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Jinxian Wu
- Department of Pediatric, Dongyang People's Hospital, Jinhua, Zhejiang, China
| | - Juan Du
- Department of Sleep Medicine, Dongyang Seventh People's Hospital, Jinhua, Zhejiang, China
| | - Xiao Li
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Meng Wang
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Yunliang Sun
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Yan Yu
- Department of the First School of Clinical Medicine, Binzhou Medical University, Binzhou, Shandong, China
| | - Jingyu Wang
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Ting Sun
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Chi Zhang
- Department of Respiratory and Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Changjun Lv
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Kingman P. Strohl
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, and Cleveland Louis Stokes VA Medical Center, Cleveland, OH, United States
| | - Fang Han
- Department of Respiratory and Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Xiaosong Dong
- Department of Respiratory and Sleep Medicine, Peking University People's Hospital, Beijing, China
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Genêt F, Salga M, De Brier G, Jouvion AX, Genêt G, Lofaso F, Prigent H, Obrecht M, Dziri S, Théfenne L. Accuracy of Resting Energy Expenditure Estimation Equations in Polio Survivors. Arch Phys Med Rehabil 2023; 104:418-424. [PMID: 36270514 DOI: 10.1016/j.apmr.2022.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/15/2022] [Accepted: 09/25/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To evaluate the accuracy of 4 equations validated for the general population to determine resting energy expenditure (REE) in polio survivors. DESIGN A descriptive, ambispective, single-center observational cohort study of minimal risk care. SETTING Tertiary university care hospital. PARTICIPANTS DATAPOL database of polio survivors followed up in a specialist department (N=298). INTERVENTIONS None. MAIN OUTCOMES MEASURES REE measurement by indirect calorimetry and estimated REE using 4 equations and comparing the values with indirect calorimetry. Analysis of correlations between measured REE and weight, height, and body mass index (BMI) and indicators of severity of polio sequelae. RESULTS Of the 298 polio cases in the database between January 2014 and May 2017, 41 were included (19 men and 22 women). Mean±SD BMI was 26.0±5.6 kg/m2 (56.1% below 25). Measured REE correlated significantly and positively with weight and weaker with BMI. Correlations between measured and estimated REE were strong (between 0.49 and 0.59); correlations were strongest for the simplified World Health Organization and the Harris and Benedict equations. However, the equations systematically overestimated REE by more than 20%, especially in men. We calculated a correction factor for the World Health Organization scale: -340.3 kcal/d for women and -618.8 kcal/d for men. CONCLUSION Analysis of REE is important for polio survivors; The use of estimation equations could lead to the prescription of a nonadapted diet. We determined a correction factor that should be validated in prospective studies.
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Affiliation(s)
- François Genêt
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Département Parasport Santé, Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France; UPOH (Unité Péri Opératoire du Handicap, Perioperative Disability Unit), Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France.
| | - Marjorie Salga
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Département Parasport Santé, Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France; UPOH (Unité Péri Opératoire du Handicap, Perioperative Disability Unit), Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Gratiane De Brier
- Service de médecine physique et de réadaptation, Hôpital d'Instruction des Armées Laveran, Marseille, France
| | - Arnaud-Xavier Jouvion
- Service de médecine physique et de réadaptation, Hôpital d'Instruction des Armées Laveran, Marseille, France
| | - Guillaume Genêt
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Département Parasport Santé, Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Frédéric Lofaso
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Service de médecine physique et de réadaptation, Hôpital d'Instruction des Armées Laveran, Marseille, France; Service d'explorations fonctionnelles, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Hélène Prigent
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Service d'explorations fonctionnelles, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Maxime Obrecht
- Service de médecine physique et de réadaptation, Hôpital d'Instruction des Armées Laveran, Marseille, France
| | - Sophie Dziri
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; UPOH (Unité Péri Opératoire du Handicap, Perioperative Disability Unit), Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Laurent Théfenne
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Military Educational Establishment of the Army Health Service, Ecole du Val de Grâce, 1 Pl. Alphonse Laveran, 75005 Paris, France
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Cavallieri F, Sellner J, Zedde M, Moro E. Neurologic complications of coronavirus and other respiratory viral infections. HANDBOOK OF CLINICAL NEUROLOGY 2022; 189:331-358. [PMID: 36031313 PMCID: PMC9418023 DOI: 10.1016/b978-0-323-91532-8.00004-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In humans, several respiratory viruses can have neurologic implications affecting both central and peripheral nervous system. Neurologic manifestations can be linked to viral neurotropism and/or indirect effects of the infection due to endothelitis with vascular damage and ischemia, hypercoagulation state with thrombosis and hemorrhages, systemic inflammatory response, autoimmune reactions, and other damages. Among these respiratory viruses, recent and huge attention has been given to the coronaviruses, especially the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic started in 2020. Besides the common respiratory symptoms and the lung tropism of SARS-CoV-2 (COVID-19), neurologic manifestations are not rare and often present in the severe forms of the infection. The most common acute and subacute symptoms and signs include headache, fatigue, myalgia, anosmia, ageusia, sleep disturbances, whereas clinical syndromes include mainly encephalopathy, ischemic stroke, seizures, and autoimmune peripheral neuropathies. Although the pathogenetic mechanisms of COVID-19 in the various acute neurologic manifestations are partially understood, little is known about long-term consequences of the infection. These consequences concern both the so-called long-COVID (characterized by the persistence of neurological manifestations after the resolution of the acute viral phase), and the onset of new neurological symptoms that may be linked to the previous infection.
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Affiliation(s)
- Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Johann Sellner
- Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria,Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - Marialuisa Zedde
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elena Moro
- Division of Neurology, CHU of Grenoble, Grenoble Alpes University, Grenoble Institute of Neurosciences, Grenoble, France,Correspondence to: Elena Moro, Service de neurologie, CHU de Grenoble (Hôpital Nord), Boulevard de la Chantourne, 38043 La Tronche, France. Tel: + 33-4-76-76-94-52, Fax: +33-4-76-76-56-31
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Grill B, Cole M. Approach to Fatigue and Energy Conservation. Phys Med Rehabil Clin N Am 2021; 32:493-507. [PMID: 34175009 DOI: 10.1016/j.pmr.2021.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fatigue, a common complaint in individuals with postpolio syndrome (PPS), is defined as an overwhelming sustained feeling of exhaustion and diminished capacity for physical and mental work. A comprehensive medical work-up is needed to rule out all other causes of fatigue. A sleep study should be considered for individuals with PPS who complain of fatigue. Self-reported outcome measures, such as the Fatigue Severity Scale, are reliable and valid tools to measure fatigue in this population. Fatigue management consists of individualized treatment of underlying medical conditions, energy conservation, pacing techniques, and lifestyle modifications.
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Affiliation(s)
- Beth Grill
- Spaulding Outpatient Center Framingham, 570 Worcester Road, Framingham, MA 01702, USA.
| | - Maria Cole
- Spaulding Outpatient Center Framingham, 570 Worcester Road, Framingham, MA 01702, USA
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