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Lao M, Ou Q, Shan G, Zheng M, Pei G, Xu Y, Wang L, Tan J, Lu B. Pulse rate variability predicted cardiovascular disease in sleep disordered breathing: The Guangdong sleep health study. Respir Med 2023; 219:107408. [PMID: 37734671 DOI: 10.1016/j.rmed.2023.107408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES Pulse rate variability (PRV) predicts stroke in patients with sleep disordered breathing (SDB). However, the relationship between PRV and cardiovascular disease (CVD) was unknown in SDB. METHODS This was a cross-sectional study. Community residents in Guangdong were investigated. Sleep study were conducted with a type Ⅳ sleep monitoring. PRV parameters was assessed from the pulse waveforms derived from the sleep monitoring. RESULTS 3747 participants were enrolled. The mean age was 53.9 ± 12.7 years. 1149 (30.7%) were diagnosed as SDB. PRV parameters, except for the averages of pulse-to-pulse intervals (ANN), were higher in participants with SDB than those without. After adjusting for traditional CVD risk factors, deceleration capacity of rate (DC), ANN, and the percentage of pulse-to-pulse interval differences that were more than 50 ms (PNN50) were correlated with CVD risk in participants with SDB (OR were 0.826, 1.002, and 1.285; P were 0.003, 0.009, and 0.010), but not in participants without SDB. There was no interaction effect between DC, ANN, PNN50 and oxygen desaturation index. In hierarchical analysis, DC and ANN were predictors for CVD in SDB patients with age <60 years, male, overweight, diabetes, and normal lipid metabolism. PNN50 was predictor for CVD in the elderly SDB patients without overweight, diabetes or dyslipidemia. CONCLUSIONS PRV parameters may be specific predictors for CVD in SDB. PNN50 was a potent biomarker for CVD risk in the elderly with SDB, event without traditional CVD risk factors.
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Affiliation(s)
- Miaochan Lao
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Qiong Ou
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Murui Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Guo Pei
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yanxia Xu
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Longlong Wang
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Jiaoying Tan
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Bin Lu
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
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Pei G, Ou Q, Shan G, Hu Y, Lao M, Xu Y, Wang L, Tan J, Lu B. Screening practices for obstructive sleep apnea in healthy community people: a Chinese community-based study. J Thorac Dis 2023; 15:5134-5149. [PMID: 37868841 PMCID: PMC10586980 DOI: 10.21037/jtd-22-1538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 08/04/2023] [Indexed: 10/24/2023]
Abstract
Background Owing to the lack of clear guidelines, the significance of obstructive sleep apnea (OSA) screening in healthy community people is unclear. This study aimed to screen for OSA in a healthy community population and provide a basis for its screening. Methods Permanent residents from five communities in the coastal and mountainous areas of south China were selected. The screening process included demographic and sleep questionnaire surveys, and an OSA screening. To compare the prevalence and risk factors of OSA in different areas, a type IV wearable intelligent sleep monitor (WISM) was used for screening. Results A total of 3,650 participants completed all studies, with a mean age of 53.81±12.71 years. In addition, 4,318 participants completed the OSA screening within 30 days, and the objective screening speed was 200 people per day. The recovery rate of the screening equipment was 99.37% (4,291/4,318), the screening success rate was 89.63% (3,846/4,291), and the rejection rate was 2.7% (120/4,438). The prevalence of high-risk OSA screened using the Stop-Bang questionnaire was 42.8% (1,563/3,650) and that screened using the device was 30.7% (1,119/3,650). The prevalence of OSA screened using the Stop-Bang questionnaire was higher than that screened using the device (P<0.01). Further analysis of sleep quality and daytime sleepiness showed that 47.6% (1,736/3,650) of the community population had good sleep quality and 6.6% (240/3,650) had daytime sleepiness. Age, sex, body mass index (BMI), neck circumference, and hypertension were risk factors for OSA in the community population. Conclusions The use of objective type IV sleep detection equipment to screen a large sample population in the community in a short time is feasible. The prevalence of high-risk OSA screened using the Stop-Bang questionnaire was higher than that screened using the objective screening device.
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Affiliation(s)
- Guo Pei
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Qiong Ou
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Guangliang Shan
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yaoda Hu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Miaochan Lao
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yanxia Xu
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Longlong Wang
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Jiaoying Tan
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Bin Lu
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
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Deng H, Duan X, Huang J, Zheng M, Lao M, Weng F, Su QY, Zheng ZF, Mei Y, Huang L, Yang WH, Xing X, Ma X, Zhao W, Liu X. Association of adiposity with risk of obstructive sleep apnea: a population-based study. BMC Public Health 2023; 23:1835. [PMID: 37735660 PMCID: PMC10512644 DOI: 10.1186/s12889-023-16695-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Obesity is a crucial risk factor for obstructive sleep apnea (OSA), but the association between adiposity deposition and OSA risk has not reached a consistent conclusion. This study sought to reveal the association of multiple adiposity indicators with OSA risk. METHODS This cross-sectional study included 9,733 participants aged 35-74 years, recruited from an ongoing population-based cohort. OSA was assessed by the Berlin Questionnaire. Six adiposity indicators, including neck circumference (NC), body fat percentage (BF%), waist-to-hip ratio (WHR), visceral adiposity index (VAI), lipid accumulation product (LAP), and resting metabolic rate (RMR), were selected. Multivariate logistic regression models were used to examine the association of adiposity indicators with OSA risk. RESULTS One thousand six hundred twenty-six participants (16.71%) were classified into the OSA group. NC, BF%, WHR, VAI, LAP, and RMR were all positively associated with the risk of OSA after adjusting for confounders, regardless of age, sex, and history of dyslipidemia. Every 1-unit increment of NC, BF%, and VAI was associated with a 13%, 9%, and 14% increased risk of OSA, respectively; every 0.01-unit increment of WHR was associated with a 3% increased risk of OSA; every 10-unit increment of LAP and RMR was associated with 2% and 4% increased risk of OSA, respectively. CONCLUSIONS NC, BF%, WHR, VAI, LAP, and RMR were all independently and positively associated with OSA risk, regardless of age, sex, history of dyslipidemia, and menopausal status. Application of these new indicators could help to more comprehensively reflect and predict the risk of OSA in the general population.
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Affiliation(s)
- Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, 510080, China
| | - Xueru Duan
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Jun Huang
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, 510080, China
| | - Murui Zheng
- Faculty of Health Sciences, University of Macau, Macau SAR, 999078, China
| | - Miaochan Lao
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Fan Weng
- Guangzhou Yuexiu District Center for Disease Control and Prevention, Guangzhou, 510080, China
| | - Qi-Ying Su
- Dadong Street Community Health Service Center, Guangzhou, 510080, China
| | - Zhen-Feng Zheng
- Nancun Community Health Service Center, Guangzhou, 511442, China
| | - Yunting Mei
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Li Huang
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Wen-Han Yang
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Xiaohui Xing
- Guangdong Provincial Engineering Technology Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Xiaofeng Ma
- Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, 7 Zhuanchang Road, Xining, 810012, China.
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Nanshan District, 1088 Xueyuan Avenue, Shenzhen, 518055, China.
| | - Xudong Liu
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China.
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Pei G, Ou Q, Lao M, Wang L, Xu Y, Tan J, Zheng G. APAP Treatment Acceptance Rate and Cost-Effectiveness of Telemedicine in Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial. Nat Sci Sleep 2023; 15:607-622. [PMID: 37560381 PMCID: PMC10408676 DOI: 10.2147/nss.s416221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
PURPOSE This study evaluated the treatment acceptance rate and cost-effectiveness of the telemedicine model in clinical practice for adult patients with obstructive sleep apnea (OSA). PATIENTS AND METHODS Patients admitted to the sleep center for snoring were randomly divided into telemedicine and control groups. Patients diagnosed with moderate-to-severe OSA using the Home Sleep Apnea Test (HSAT) were voluntarily treated with auto-adjusted positive airway pressure (APAP) therapy. The acceptance rate of the APAP treatment, cost of patient visits, time cost, and labor cost of doctors in the two groups were observed. RESULTS A total of 57 subjects were included, with an average age of 40.12±11.73 years, including 47 males (82.5%); 26 patients were in the telemedicine group, and 31 were in the control group. Follow-up results showed that the acceptance rate of APAP treatment was 57.7% and 54.8% in the telemedicine and control groups, respectively, with no significant difference between the two groups (p=0.829). The cost-benefit analysis showed that the telemedicine group reduced the cost of patients' medical treatment [-457.84(-551.19,1466.87)] but increased the extra intervention frequency and time outside the doctor's office. Further analysis showed that male subjects of older age, higher education level, distant residence, no fatty liver, poor sleep quality, severe insomnia, and higher OSA severity were more likely to receive telemedicine diagnosis and treatment. CONCLUSION The APAP treatment acceptance rate and compliance of OSA patients in the telemedicine group were similar to those in the control group, and the cost of patients' medical treatment was reduced. However, telemedicine increases the frequency and duration of additional out-of-hospital interventions.
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Affiliation(s)
- Guo Pei
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, 510006, People’s Republic of China
| | - Qiong Ou
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, 510006, People’s Republic of China
| | - Miaochan Lao
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, People’s Republic of China
| | - Longlong Wang
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, People’s Republic of China
| | - Yanxia Xu
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, People’s Republic of China
| | - Jiaoying Tan
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, People’s Republic of China
| | - Gaihong Zheng
- Department of Sleep Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, People’s Republic of China
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Liu Q, Pan L, Yang T, Ou Q, Sun Z, He H, Hu Y, Tu J, Lin B, Lao M, Liu C, Li B, Fan Y, Niu H, Wang L, Shan G. Association between long-term exposure to ambient particulate matter and pulmonary function among men and women in typical areas of South and North China. Front Public Health 2023; 11:1170584. [PMID: 37250094 PMCID: PMC10213661 DOI: 10.3389/fpubh.2023.1170584] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/07/2023] [Indexed: 05/31/2023] Open
Abstract
Background Studies comparing the effects of different sizes and concentrations of ambient particulate matter (PM) on pulmonary function in different regions and sexes remain sparse. Objectives To investigate the associations of different sizes and levels of long-term ambient PM exposure with pulmonary function among people of different sexes in typical areas of South and North China. Methods In 2021, a total of 1,592 participants aged 20-73 years were recruited to participate in the pulmonary function test from the baseline survey of the Diverse Life-Course Cohort (DLCC) in typical areas of Guangdong Province and Hebei Province. The three-year (2018-2020) average ambient PM concentrations were assessed from the ChinaHighPM1 dataset, ChinaHighPM2.5 dataset and ChinaHighPM10 dataset. Mean differences in pulmonary function were used in multilevel models for different regions and sexes. Results We discovered significant associations of ambient PM exposure with reduced forced vital capacity (FVC) and increased forced expiratory volume in 1 s/forced vital capacity ratio (FEV1/FVC) among men and lower levels of FEV1 and FVC among women, such that a 5-μg/m3 concentration increase in PM1, PM2.5, and PM10 was associated with decreases in FVC of 122.1 ml (95% confidence interval (CI): 30.8, 213.4), 54.6 ml (95% CI: 15.8, 93.3) and 42.9 ml (95% CI: 12.7, 73.1) and increases in FEV1/FVC of 2.2% (95% CI: 0.6, 3.9), 1.1% (95% CI: 0.4, 1.9) and 0.9% (95% CI: 0.3, 1.5) among men and decreases in FEV1 of 51.1 ml (95% CI: 9.7, 92.4), 21.6 ml (95% CI: 4.3, 38.9) and 16.7 ml (95% CI: 3.3, 30.1) and in FVC of 77.8 ml (95% CI: 10.0, 145.6), 38.7 ml (95% CI: 9.0, 68.5) and 31.1 ml (95% CI: 8.1, 54.1) among women in Hebei Province. There was no association between ambient PM and pulmonary function in Guangdong Province. Conclusion Long-term exposure to different sizes and concentrations of ambient PM were associated with FEV1 and FVC among men and women differently. The impact of ambient PM on FVC should be of greater concerned.
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Affiliation(s)
- Qihang Liu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ting Yang
- China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Qiong Ou
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Zhiwei Sun
- Department of Preventive Medicine, School of Public Health, Hebei University, Baoding, Hebei, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yaoda Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ji Tu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Binbin Lin
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Miaochan Lao
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Chang Liu
- Department of Preventive Medicine, School of Public Health, Hebei University, Baoding, Hebei, China
| | - Baicun Li
- China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Yajiao Fan
- Department of Preventive Medicine, School of Public Health, Hebei University, Baoding, Hebei, China
| | - Hongtao Niu
- China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Longlong Wang
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Deng H, Hu P, Li H, Zhou H, Wu X, Yuan M, Duan X, Lao M, Wu C, Zheng M, Lao XQ, Zhao W, Liu X. Correction: Novel lipid indicators and the risk of type 2 diabetes mellitus among Chinese hypertensive patients: findings from the Guangzhou Heart Study. Cardiovasc Diabetol 2023; 22:7. [PMID: 36631842 PMCID: PMC9835213 DOI: 10.1186/s12933-022-01731-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Hai Deng
- grid.413405.70000 0004 1808 0686Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Science, Guangzhou, 510080 China
| | - Peng Hu
- grid.411847.f0000 0004 1804 4300School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310 China ,grid.12981.330000 0001 2360 039XDepartment of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Huoxing Li
- grid.284723.80000 0000 8877 7471The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515 China
| | - Huanning Zhou
- Guangzhou Yuexiu District Center for Disease Control and Prevention, Guangzhou, China
| | - Xiuyi Wu
- Nancun Community Health Service Center, Guangzhou, 511442 China
| | - Maohua Yuan
- Dadong Street Community Health Service Center, Guangzhou, 510080 China
| | - Xueru Duan
- grid.12981.330000 0001 2360 039XDepartment of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Miaochan Lao
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, 510080 China
| | - Chuchu Wu
- grid.411847.f0000 0004 1804 4300School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310 China
| | - Murui Zheng
- grid.508371.80000 0004 1774 3337Department of Community Health, Guangzhou Center for Disease Control and Prevention, No. 1 Qide Road, Baiyun District, Guangzhou, 510440 China
| | - Xiang Qian Lao
- grid.10784.3a0000 0004 1937 0482JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, 999077 SAR China
| | - Wenjing Zhao
- grid.263817.90000 0004 1773 1790School of Public Health and Emergency Management, Southern University of Science and Technology, No. 1088 Xueyuan Avenue, Shenzhen, 518055 China
| | - Xudong Liu
- grid.411847.f0000 0004 1804 4300School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310 China
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Wang S, Xiong H, Wang L, Pei G, Lao M, Xu Y, Liu L, Luo S, Zhang Y, Ou Q. Association between residential greenness and obstructive sleep apnoea among adults in Southern China. Sci Total Environ 2022; 853:158414. [PMID: 36055505 DOI: 10.1016/j.scitotenv.2022.158414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/29/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND No previous study has explored the association of residential greenness with obstructive sleep apnoea (OSA) indexes. OBJECTIVE To investigate the association of exposure to residential greenness with OSA indexes in adults in Guangdong Province, Southern China. METHODS From January 1, 2005 to December 31, 2015, a total of 3925 participants were recruited from the Sleep Center of Guangdong Provincial People's Hospital. Apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) were measured by polysomnography or home sleep test (HST). Participants' daytime sleepiness scores were evaluated using The Epworth Sleeping Scale (ESS). The normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were used to assess residential greenness levels. Generalized linear regression models were used to assess the associations of residential greenness with OSA indexes after adjusting for multiple covariates. RESULTS The mean (standard deviation) age of the participants was 63.3 (14.4) years. In adjusted models, an interquartile range (IQR) increase in 3-year average NDVI was significantly associated with 9.8 % (95 % confidence interval [95 % CI]: 17.5 %, 2.1 %); 14.5 % (95 % CI: 24.5 %, 4.4 %) and 6.9 % (95 % CI: 13.7 %, 0.0 %) decreases in AHI, ODI and ESS scores, respectively. Furthermore, an IQR increase in 3-year average EVI was significantly associated with 7.8 % (95 % CI: 13.7 %, 1.9 %); 10.8 % (95 % CI: 18.3 %, 3.2 %) and 7.2 % (95 % CI: 12.5 %, 2.0 %) declines in AHI, ODI and ESS scores, respectively. Significant associations were only observed among males, adults aged ≥65 years old, and in the warm season. CONCLUSIONS Our study indicates that higher residential greenness was significantly associated with lower OSA indexes in adult population in South China, especially in males, in the elderly, and in the warm season.
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Affiliation(s)
- Suhan Wang
- Medical Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hailin Xiong
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China; Departments of Medical Oncology, Huizhou Municipal Central Hospital of Guangdong Province, Huizhou, China
| | - Longlong Wang
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Guo Pei
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Miaochan Lao
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Yanxia Xu
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Linjiong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Siqi Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Qiong Ou
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China.
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Lao M, Gao P, Liu Y, Yan L, Gao X. Venous malformation presenting as Mauritia arabica-like bronchial wall thickness: a case report. J Int Med Res 2022; 50:3000605221138453. [PMID: 36446778 PMCID: PMC9716616 DOI: 10.1177/03000605221138453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Primary pulmonary venous malformation is rare and usually presents as single or multiple round masses or nodules. Here, we present the first report of a case of venous malformation presenting as Mauritia arabica-like bronchial wall thickness that was initially misdiagnosed as bronchiectasis. A Chinese man in his late 20s presented complaining of hemoptysis for 10 days. Computed tomography demonstrated bronchiectasis and M. arabica-like bronchial wall thickening in the left lower lobe. He was unresponsive to medical treatment for bronchiectasis and underwent thoracoscopic left lower lobectomy. Histopathological examination revealed venous malformation around the bronchial walls with no bronchiectasis. Venous malformation should be considered in the differential diagnosis of bronchiectasis, especially in patients with the following triad of signs: no response to antibiotics, M. arabica-like bronchial wall thickness, and normal accompanying arteries.
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Affiliation(s)
- Miaochan Lao
- Department of Geriatric Respiratory Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Ping Gao
- Department of Geriatric Respiratory Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China,Ping Gao, Department of Geriatric Respiratory Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, No. 106 Zhongshan Er Rd, Guangzhou 510080, China.
| | - Yanhui Liu
- Department of Pathology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lixu Yan
- Department of Pathology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xinglin Gao
- Department of Geriatric Respiratory Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
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Wang L, Ou Q, Shan G, Lao M, Xu Y, Pei G. Distinct phenotypic clusters of sleep‐disordered breathing and their association with medical care‐seeking behaviour and sleep habits: the Guangdong Sleep Health Study. J Sleep Res 2022; 32:e13762. [PMID: 36325765 DOI: 10.1111/jsr.13762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/13/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
Sleep-disordered breathing (SDB) is highly prevalent, but its rates of diagnosis and treatment are low. As a heterogeneous condition, it is associated with delayed diagnosis and/or suboptimal treatment. We aimed to determine distinct SDB clusters and examine their association with medical care-seeking behaviour and sleep habits in a community-dwelling population in South China. Participants were enrolled in the 'Guangdong Sleep Health Study'. Five distinct community sites were investigated. Participant information was collected, and overnight sleep monitoring was performed. Latent class analysis was performed to classify patients with SDB based on patterns of SDB-related symptoms and signs. Overall, 1,524 patients with SDB were evaluated. Four distinct clusters were identified: 'minimally symptomatic' (Cluster 2), which was the most dominant subtype (41.6%), followed by 'pure insomnia/fewer daytime symptoms' (Cluster 4; 24.7%), 'insomnia/multiple daytime symptoms' (Cluster 3; 17.8%), and 'upper airway symptoms with sleepiness' (Cluster 1; 15.9%). The overall medical care-seeking rate attributable to sleep and breathing disorders was only 3.3%: 10.3% in Cluster 3, 2.5% in Cluster 1, 2.1% in Cluster 4, and 1.3% in Cluster 2, in which Cluster 3 was the highest and Cluster 2 was the lowest (adjusted p < 0.05). Regarding the sleep habit of going to bed and waking up at a consistent time, Cluster 3 exhibited the worst performance and Cluster 2 the best. In conclusion, distinct phenotypic subtypes were identified in community-dwelling patients with SDB. Tailored strategies to encourage medical care-seeking, early identification, and optimisation of treatment are necessary considering the different subtypes.
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Affiliation(s)
- Longlong Wang
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangdong Provincial Geriatrics Institute Guangzhou China
- The Second School of Clinical Medicine Southern Medical University Guangzhou China
| | - Qiong Ou
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangdong Provincial Geriatrics Institute Guangzhou China
- The Second School of Clinical Medicine Southern Medical University Guangzhou China
| | - Guangliang Shan
- Department of Epidemiology & Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College Beijing China
| | - Miaochan Lao
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangdong Provincial Geriatrics Institute Guangzhou China
| | - Yanxia Xu
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangdong Provincial Geriatrics Institute Guangzhou China
| | - Guo Pei
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences Guangdong Provincial Geriatrics Institute Guangzhou China
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Cheng Y, Ou Q, Chen B, Loffler KA, Doug McEvoy R, Xu Y, Wang Q, Lao M. The changes of AHI after long-term CPAP in patients with comorbid OSA and cardiovascular disease. Sleep Breath 2022; 27:511-518. [DOI: 10.1007/s11325-022-02633-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022]
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Xiong H, Lao M, Zhang S, Chen J, Shi Q, Xu Y, Ou Q. A cross-sectional study of obstructive sleep apnea in patients with colorectal cancer. J Gastrointest Oncol 2022; 13:683-694. [PMID: 35557570 PMCID: PMC9086062 DOI: 10.21037/jgo-22-175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/02/2022] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The association between colorectal cancer (CRC) and obstructive sleep apnoea (OSA) has been attracting increasing attention. several studies had confirmed that OSA increases the risk of CRC onset. However, the findings of studies on the morbidity of OSA in patients with CRC were unclear. Therefore, this study aimed to investigate the morbidity of OSA in patients with CRC as well as the association between the clinicopathological characteristics of OSA and CRC. METHODS A total of 414 patients with a pathological diagnosis of CRC from 1 January, 2020 to 30 December, 2020 were included in this study. Demographic characteristics, clinical information, and tumor characteristics of participants were collected; sleep was monitored using a wearable oximeter and via sleep quality questionnaire. The oxygen desaturation index (ODI) was used to classify OSA severity so that the diagnostic criteria for OSA were set based on the ODI as 0-5 (normal) and ≥5 (abnormal). After correcting for confounding factors, a logistic regression analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the factors affecting the tumor lymph node stage (N stage). RESULTS A total of 402 patients with CRC were included in this study, including 225 (55.97%) men and 177 (44.03%) women. The mean ODI value of participants was 3.40±8.17. The morbidity of OSA among the patients with CRC having ODI ≥5 was 16.17%. A comparison between the normal and abnormal ODI value groups revealed that the high proportion of abnormal ODI was related to higher N stage (P<0.05). Logistic regression analysis revealed a correlation of ODI values and age to the N stage. Specifically, CRC patients with an abnormal ODI had a higher risk of lymph node metastasis compared to those with normal ODI (OR =1.915, 95% CI: 1.025 to 3.579). Moreover, patients with CRC aged ≥65 years had a higher risk of lymph node metastasis compared to those aged <65 years (OR =2.190, 95% CI: 1.163 to 4.125). CONCLUSIONS CRC patients with abnormal ODI are susceptible to OSA. Additionally, abnormal ODI and age ≥65 years are relevant factors for the N2 stage.
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Affiliation(s)
- Hailin Xiong
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Miaochan Lao
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Shuyi Zhang
- Departments of Medical Oncology, Huizhou Municipal Central Hospital of Guangdong Province, Huizhou, China
| | - Jialian Chen
- Quality Control Department, Huizhou Municipal Central Hospital of Guangdong Province, Huizhou, China
| | - Qianping Shi
- Department of Education and Science, Huizhou Municipal Central Hospital of Guangdong Province, Huizhou, China
| | - Yanxia Xu
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Qiong Ou
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Xiong H, Lao M, Wang L, Xu Y, Pei G, Lu B, Shi Q, Chen J, Zhang S, Ou Q. The Incidence of Cancer Is Increased in Hospitalized Adult Patients With Obstructive Sleep Apnea in China: A Retrospective Cohort Study. Front Oncol 2022; 12:856121. [PMID: 35433429 PMCID: PMC9008763 DOI: 10.3389/fonc.2022.856121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background The association between obstructive sleep apnea (OSA) and the incidence and mortality of cancer remain unclear, especially in Asian populations. Thus, this study was conducted to explore the relationship between OSA and the incidence and mortality of cancer in hospitalized patients. Methods This retrospective cohort study evaluated inpatients from Guangdong Provincial People’s Hospital for suspected OSA between January 2005 and December 2015. Cancer incidence, all-cause mortality, and cancer mortality and were determined using data from the hospital information system and Centers for Disease Control. Between-group comparisons were carried out by performing a chi-square test and analysis of variance. Kaplan–Meier analysis and the Cox proportional risk model were applied to investigate the association between OSA and cancer incidence and mortality. Results Of the 4,623 hospitalized patients included, 3,786 (81.9%) patients were diagnosed with OSA. After a median follow-up of 9.1 years (interquartile range, 9.79–11.44), the incidence of cancer was 6.6% (251/3,786), with lung cancer having the highest incidence at 1.6% (60/3,786). The mortality rate of OSA patients was higher than that of non-OSA patients (16.83% vs.12.78%, p=0.008), but the relationship between apnea-hypopnea index (AHI), oxygen saturation less than 90% (TSat90), and cancer mortality was not statistically significant (p>0.05).The mortality rate for all types of cancer was 2.8% (105/3,786), with lung cancer having the highest mortality rate at 0.8% (32/3,786). The cumulative incidence of cancer in the severe OSA group was 8.2%, which was higher than that in the normal, mild, and moderate OSA groups (P=0.010). Further, the Cox proportional risk regression model showed a progressive enhancement in the risk of cancer incidence as the AHI increased (adjusted hazard ratio [HR]: 1.009 [95% confidence interval (CI): 1.003–1.016], P=0.005). Based on subgroup analysis, the risk of cancer increased as the AHI increased in patients aged <65 years (adjusted HR: 1.019 [95% CI: 1.007–1.031], P=0.002). In addition, the cancer incidence was significantly higher in the severe OSA group than in the normal, mild, and moderate OSA groups (adjusted HR: 2.825 [95% CI: 1.358–5.878], P=0.019). Conclusion The incidence of cancer is higher in patients with OSA than in non-OSA patients and is significantly positively associated with the severity of OSA. Particularly, for OSA patients aged <65 years, lung cancer is the main cause of death in those with new-onset cancer. Mortality was higher in OSA patients than in non-OSA patients.
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Affiliation(s)
- Hailin Xiong
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Miaochan Lao
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Longlong Wang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Yanxia Xu
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Guo Pei
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Bin Lu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Qianping Shi
- Huizhou Municipal Central Hospital of Guangdong Province, Huizhou, China
| | - Jialian Chen
- Huizhou Municipal Central Hospital of Guangdong Province, Huizhou, China
| | - Shuyi Zhang
- Huizhou Municipal Central Hospital of Guangdong Province, Huizhou, China
| | - Qiong Ou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
- *Correspondence: Qiong Ou,
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13
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Lao M, Cheng Y, Gao X, Ou Q. The interaction among OSA, CPAP, and medications in patients with comorbid OSA and cardiovascular/cerebrovascular disease: a randomized controlled trial. BMC Pulm Med 2022; 22:99. [PMID: 35313858 PMCID: PMC8939073 DOI: 10.1186/s12890-022-01879-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/07/2022] [Indexed: 01/08/2023] Open
Abstract
Background Most patients with comorbid sleep apnea (OSA), cardiovascular (CV) disease, and/or cerebrovascular (CeV) disease simultaneously take medications. Whether OSA and continuous positive airway pressure (CPAP) interact with CV/CeV medications remains unknown. This study aimed to determine the interaction among OSA, CPAP, and CV/CeV medications; the effects of medications on major adverse cardiac and cerebrovascular events, and survival in patients with comorbid OSA and CV/CeV. Methods This was a post hoc analysis of the data from one center of the Sleep Apnea Cardiovascular Endpoints Study. Participants (aged 45–75 years) with comorbid OSA and CV/CeV were randomized to receive usual care with or without CPAP from December 2008 to November 2013. The primary endpoint was death and the secondary endpoint was a composite of death, myocardial infarction, stroke, hospitalization for unstable angina, heart failure, and transient ischemic attack. Results In total, 131 patients were analyzed. Sixty-three were in the CPAP group and 68 were in the usual care group, 41 had good adherence to CPAP (65.1%), and the median follow-up time was 43.0 (35.0, 54.0) months. In Cox regression analysis, ACE inhibitors and nitrates were independent factors for decreased survival in patients with comorbid OSA and CV/CeV (chi-square = 22.932, P = 0.003; ACE inhibitors: OR 7.241, P = 0.048, 95% CI 1.016–51.628; nitrates: OR 18.012, P = 0.011, 95% CI 1.923–168.750). ACE inhibitors increased mortality and secondary endpoints in the CPAP group (chi-square = 4.134, P = 0.042) but not in patients with good CPAP adherence. Clopidogrel and nitrates decreased survival in usual care group (clopidogrel: chi-square = 5.312, P = 0.021; nitrates: chi-square = 6.417, P = 0.011), but not in CPAP group. Conclusions OSA may predispose patients with CV/CeV and CV/CeV medications to a negative effect. CPAP treatment may neutralize the negative effects of OSA by relieving chronic intermittent hypoxia. Trial registration ClinicalTrials.gov (NCT00738179, first registration date: 20/08/2008).
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Affiliation(s)
- Miaochan Lao
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, No. 106 Zhongshan Er Rd, Guangzhou, 510080, China
| | - Yilu Cheng
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, No. 106 Zhongshan Er Rd, Guangzhou, 510080, China
| | - Xinglin Gao
- Geriatric Respiratory Department I, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Qiong Ou
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, No. 106 Zhongshan Er Rd, Guangzhou, 510080, China.
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Wang L, Ou Q, Shan G, Lao M, Pei G, Xu Y, Huang J, Tan J, Chen W, Lu B. Independent Association Between Oxygen Desaturation Index and Cardiovascular Disease in Non-Sleepy Sleep-Disordered Breathing Subtype: A Chinese Community-Based Study. Nat Sci Sleep 2022; 14:1397-1406. [PMID: 35979084 PMCID: PMC9377398 DOI: 10.2147/nss.s370471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Non-sleepy sleep-disordered breathing (SDB) is increasingly recognized as an important clinical subtype. The association between non-sleepy SDB and cardiovascular disease (CVD) is not well understood. Our objectives were to investigate the relationship between non-sleepy SDB and CVD and determine which nocturnal hypoxia parameter most strongly reflects this association in a large community population. PATIENTS AND METHODS Cross-sectional data from 3626 randomly-selected Chinese community-dwelling participants who underwent overnight type IV sleep monitoring were analyzed. Parameters of nocturnal hypoxemia were extracted from sleep monitoring devices, including mean nocturnal oxygen saturation, lowest oxygen saturation, oxygen desaturation index (ODI), and time with oxygen saturation <90%. An ODI ≥7.0 events/h was considered to signify SDB. An Epworth Sleepiness Scale score of 10 or less indicated no sleepiness. RESULTS The SDB rate was 30.7% (1114/3626), of which 96.5% (1075/1114) were considered the non-sleepy SDB subtype. ODI, typical nocturnal intermittent hypoxia indicator for SDB, was independently related to CVD, regardless of whether excessive daytime sleepiness was present. After adjusting for confounders, ODI most strongly reflected the association between non-sleepy SDB and CVD (OR:1.023; 95% CI:1.003-1.043). We observed a nonlinear association between ODI and the prevalence of CVD, where the likelihood of CVD increased with ODI≥10 events/h and a markedly increasing trend was observed with ODI ≥20 events/h (reference ODI = 7.0 events/h). Metabolic parameters, Pittsburgh Sleep Quality Index, and inflammatory marker did not mediate the association between ODI and CVD in the non-sleepy SDB subtype. CONCLUSION In the Chinese community-dwelling population, non-sleepy SDB was highly prevalent. ODI, an easily extracted indicator from a type IV sleep monitor, most strongly reflected the association between non-sleepy SDB and CVD.
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Affiliation(s)
- Longlong Wang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, People's Republic of China
| | - Qiong Ou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, People's Republic of China
| | - Guangliang Shan
- Department of Epidemiology & Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, People's Republic of China
| | - Miaochan Lao
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, People's Republic of China
| | - Guo Pei
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, People's Republic of China
| | - Yanxia Xu
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, People's Republic of China
| | - Jinhuan Huang
- Department of Pulmonary and Critical Care Medicine, People's Hospital of Chenghai, Shantou, People's Republic of China
| | - Jiaoying Tan
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, People's Republic of China
| | - Weiping Chen
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, People's Republic of China
| | - Bing Lu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, People's Republic of China
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Abstract
Background Patients with obstructive sleep apnea (OSA) often present with cardiovascular symptoms. Holter monitors were reported to predict sleep apnea, though were rarely used in everyday clinical practice. In this study, by comparing Holter monitoring to polysomnography (PSG), we try to find out an operable way for clinicians to use Holter to predict OSA risk. Methods Patients (n=63) suspected of OSA underwent Holter monitoring with concurrent PSG at a sleep center. Respiration and heart rate variability (HRV) indices were calculated from the Holter and compared with PSG indices. Results The sensitivity of the Holter-derived respiratory waveform for OSA was 90.0%, and the specificity was 82.6%. The time domain indices including standard deviation of all NN intervals during 24 hours, mean of standard deviation of the averages of NN intervals in all 5-minute segments, square root of the mean squared differences of successive NN intervals, percentage of beat-to-beat NN interval differences that were more than 50 milliseconds, and the frequency domain index of high frequency decreased in participants with OSA and correlated with the PSG derived indices including apnea-hypopnea index (AHI), oxygen reduction index (ODI) and nadir SaO2. Logistic regression showed that standard deviation of all NN intervals during 24 hours and gender could predict the risk of OSA (P<0.001), with a sensitivity for diagnosing moderate to severe OSA of 87.5% and could accurately distinguish the risk of OSA in 77.8% of patients. Males with standard deviation of all NN intervals during 24 hours ≤177 ms or females with standard deviation of all NN intervals during 24 hours ≤80.9 ms were considered to be at high risk for OSA. Conclusions Commercial and common parameters from Holter monitoring could predict the risk of OSA with high sensitivity. Therefore, the risk of OSA may be assessed using the Holter examination to improve the diagnosis and treatment rate of OSA.
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Affiliation(s)
- Miaochan Lao
- Department of Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Qiong Ou
- Department of Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Cui'e Li
- Electrocardiographic Room, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Cardiovascular Institute, Guangzhou, China
| | - Qian Wang
- Department of Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Ping Yuan
- Department of Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yilu Cheng
- Department of Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute/Medical College, South China University of Technology, Guangzhou, China
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Chen D, Yuan S, Lao M, Zhan Y, Xu H, Liang L, Cai X, Wang X, Zhan Z. Umbilical arterial Doppler ultrasonography predicts late pregnancy outcomes in patients with lupus nephritis: a multicenter study from southern China. Lupus 2019; 28:1312-1319. [PMID: 31495267 DOI: 10.1177/0961203319873702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To investigate the fetal adverse pregnancy outcomes (APOs) and the predictive value of umbilical arterial Doppler ultrasonography in the third trimester in pregnant women with lupus nephritis (LN). METHODS A retrospective cohort study enrolling 203 LN patients from 2007 to 2017 was performed. Ultrasonic parameters were recorded. RESULTS Fetal APOs occurred in 103 patients (103/203, 50.7%). Sixty-six pregnancies (66/203, 32.5%) ended with preterm births. The incidence rate of intrauterine growth restriction (IUGR) was 18.2% (37/203). Fetal distress was noted in 23 pregnancies (23/203, 11.3%). All the Doppler parameters elevated in patients with IUGR, fetal distress, and composite conditions. Resistance index (RI) indicated the highest risk of IUGR and composite APOs. The cutoff values were 0.66 and 0.67, respectively. Sensitivities were 51.4% and 33.7%, and specificities were 87.4% and 92.1%. Peak velocity of the umbilical arteries at end-systole (Vmax, abbreviated as S) to that at end-diastole (Vmin, abbreviated as D) (S/D) ratio was also a best predictor for IUGR, with the optimal cutoff value of 2.88. Sensitivity and specificity were comparable with RI. Pulsatility index (PI) over 0.84 was an ideal indicator for fetal distress with an optimal combination of sensitivity (89.5%) and specificity (51.6%). CONCLUSIONS Fetal complications were frequent in patients with LN. Umbilical arterial Doppler ultrasonography was a useful measure to predict late IUGR, fetal distress, and the composite APOs.
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Affiliation(s)
- D Chen
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - S Yuan
- Department of Rheumatology, South China University of Technology, Guangzhou, China
| | - M Lao
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Department of Geriatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Y Zhan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - H Xu
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - L Liang
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - X Cai
- Department of Rheumatology, South China University of Technology, Guangzhou, China
| | - X Wang
- Department of Ultrasound, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Z Zhan
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Lao M, Hänisch J, Kauffmann-Weiss S, Gehring R, Fillinger H, Drechsler A, Holzapfel B. High current variable temperature electrical characterization system for superconducting wires and tapes with continuous sample rotation in a split coil magnet. Rev Sci Instrum 2019; 90:015106. [PMID: 30709201 DOI: 10.1063/1.5078447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 12/14/2018] [Indexed: 06/09/2023]
Abstract
A new state-of-the-art electrical transport measurement system was developed for the characterization of industrially produced coated conductors (CCs). The current leads are rated to a conduct current of up to 1000 A, which opens up the possibility of measuring the critical current Ic of tapes at a wide range of temperatures. The setup operates in a He-gas flow cryostat that provides stable temperatures between 1.8 and 200 K. The setup is equipped with a split-coil magnet that can apply fields of up to 6 T. A continuous rotation of the sample with respect to the magnetic field with an angular resolution of 0.5° enables characterization of anisotropic Ic of different tapes. In the measured voltage-current curves, weak sample heating mostly occurs from the dissipation in the tape during the Ic transition. It is demonstrated that the system can provide reliable data on the properties of CCs at temperatures lower than 77 K for a magnet design and other applications. The results allow the study of vortex pinning for further prospects of engineering the microstructure of the superconducting layer as well as to assess the performance of various tapes with different architectures to achieve optimum performance at different operating temperatures and magnetic fields.
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Affiliation(s)
- M Lao
- Institute of Technical Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - J Hänisch
- Institute of Technical Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Kauffmann-Weiss
- Institute of Technical Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - R Gehring
- Institute of Technical Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - H Fillinger
- Institute of Technical Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Drechsler
- Institute of Technical Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Holzapfel
- Institute of Technical Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
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Lao M, Wang X, Ding M, Yang Z, Chen H, Liang L, Zhan Z, Chen D. Invasive fungal disease in patients with systemic lupus erythematosus from Southern China: a retrospective study. Lupus 2018; 28:77-85. [PMID: 30526329 DOI: 10.1177/0961203318817118] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective To investigate the characteristics and associated factors of invasive fungal disease in patients with systemic lupus erythematosus from Southern China. Methods A retrospective study was performed. Demographic and clinical characteristics, laboratory data, and radiographic manifestations were recorded. Results A total of 45 lupus patients with invasive fungal disease (incidence 1.1%) were included. Twenty-three cases (51.1%) were infected with mold and 22 cases (48.9%) with yeast. Aspergillus spp. (44.4%) and Cryptococcus spp. (33.3%) were common. Aspergillosis mainly occurred in the lung. Cryptococcosis developed in the lung (40.0%), meninges (46.7%) and bloodstream (13.3%). Compared with yeast infection, mold infection tended to develop in patients with active lupus nephritis (65.2% vs. 31.8%, P = 0.03) and the mortality rate was higher (20.0% vs. 0%, P = 0.001). Co-infection with bacteria, virus or superficial fungi occurred in 12 patients (26.7%). Multivariate logistic regression analysis indicated that lymphopenia (odds ratio 2.65, 95% confidential interval 1.14–6.20, P = 0.02) and an accumulated dose of glucocorticoid (odds ratio 1.58, 95% confidence interval 1.10–2.25, P = 0.01) was associated with invasive fungal disease in lupus patients. Conclusion Mold infection tended to develop in patients with active lupus disease with high mortality. Co-infection is not rare. Lymphopenia and an accumulated dose of glucocorticoid are associated with invasive fungal disease in lupus patients.
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Affiliation(s)
- M. Lao
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Geriatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - X. Wang
- Department of Ultrasound, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - M. Ding
- Department of Geriatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Z. Yang
- Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - H. Chen
- Department of Respirology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - L. Liang
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Z. Zhan
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - D. Chen
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Chen W, Ma T, Bai X, Zhang X, Li G, Lao M, Liang T. Acute Graft-vs-Host Disease After Liver Transplantation in a Patient Presenting With Neurogenic Symptoms as the Single Primary Manifestation: A Case Report. Transplant Proc 2018; 50:4028-4032. [DOI: 10.1016/j.transproceed.2018.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 05/23/2018] [Indexed: 12/24/2022]
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Lao M, Gao X, Li J. [Interventional treatment of acquired respiratory fistulas]. Zhonghua Jie He He Hu Xi Za Zhi 2016; 39:221-223. [PMID: 26980539 DOI: 10.3760/cma.j.issn.1001-0939.2016.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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22
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Szaflik J, Major J, Izdebska J, Lao M, Szaflik J. Systemic immunosuppression with mycophenolate mofetil to prevent corneal graft rejection after high risk penetrating keratoplasty: a 2-year follow-up study. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.1493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- J.P. Szaflik
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
| | - J. Major
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
| | - J. Izdebska
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
| | - M. Lao
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
| | - J. Szaflik
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
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Szaflik J, Major J, Izdebska J, Lao M, Szaflik J. Systemic immunosuppression with mycophenolate mofetil to prevent corneal graft rejection after high risk penetrating keratoplasty: a 2-year follow-up study. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J.P. Szaflik
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
| | - J. Major
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
| | - J. Izdebska
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
| | - M. Lao
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
| | - J. Szaflik
- Department of Ophthalmology; Medical University of Warsaw; Warszawa Poland
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Li J, Gao X, Chen J, Lao M, Wang S, Zeng G. Endoscopic closure of acquired oesophagorespiratory fistulas with cardiac septal defect occluders or vascular plugs. Respir Med 2015; 109:1069-78. [DOI: 10.1016/j.rmed.2015.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/04/2015] [Accepted: 04/24/2015] [Indexed: 11/25/2022]
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Chan N, Lao M, Yam K, Poon C, Yiu B, Wong L, Poon Y. Any differences on the rehabilitation outcomes for children with cerebral palsy undergone selective dorsal rhizotomy: single level vs multi-level laminectomy? Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Huang H, Wang J, Lao M, Zhang S, Gao X, Li J. [A review for voltage-gated potassium channels in the pathogenesis of pulmonary hypertension]. Zhonghua Jie He He Hu Xi Za Zhi 2015; 38:125-127. [PMID: 25908424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Galceran J, Lao M, David C, Companys E, Rey-Castro C, Salvador J, Puy J. The impact of electrodic adsorption on Zn, Cd and Pb speciation measurements with AGNES. J Electroanal Chem (Lausanne) 2014. [DOI: 10.1016/j.jelechem.2014.03.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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28
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Grochowiecki T, Gała̢zka Z, Frunze S, Nazarewski S, Jakimowicz T, Pa̢czek L, Durlik M, Lao M, Szmidt J. Influence of Simultaneous Pancreas and Preemptive Kidney Transplantation on Severity of Postoperative Complications. Transplant Proc 2011; 43:3102-4. [DOI: 10.1016/j.transproceed.2011.08.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Nowacka-Cieciura E, Kamiñska B, Cieciura T, Gradowska L, Pazik J, Lao M, Rowiñski W, Paczek L. Randomised open clinical trial of conversion from mycophenolate mofetil to azathioprine in cadaveric renal transplantation. Transpl Int 2011. [DOI: 10.1111/j.1432-2277.2000.tb02119.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Baczewska-Mazurkiewicz D, Rydzewska G, Milewski J, Durlik M, Lao M, Rydzewski A. Magnification chromoendoscopy in comparison to standard chromoendoscopy for detection of intestinal metaplasia in renal transplant recipients. Adv Med Sci 2006; 51:115-8. [PMID: 17357289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE Renal transplantation is associated with frequent gastrointestinal complications. Intestinal metaplasia is a feature of atrophic gastritis whereas the diagnosis of Barrett's esophagus is based on histological demonstration of specialized metaplasia. Both conditions are associated with increased risk of adenocarcinoma. The aim of the present study was to assess whether magnification endoscopy improves the diagnostic accuracy of intestinal metaplasia in stomach and in esophagus. MATERIAL AND METHODS In this non-randomized, feasibility study thirty one (12 women and 19 men) renal transplant recipients, with a mean age of 44.0 years were evaluated for the presence of intestinal metaplasia. Standard esophagogastroscopy with methylene blue staining was followed by magnification endoscopy. The presence of gastritis and intestinal metaplasia was classified according to modified updated Sydney classification. RESULTS Of 31 patients, 16 patients had endoscopic and histopathological evidence of gastric intestinal metaplasia, and standard endoscopy with methylene blue staining was sufficient for diagnosis (15 from 16). Magnification endoscopy allowed identification of 6 patients with specialized intestinal metaplasia in Barrett's esophagus, which would be otherwise missed. CONCLUSIONS In this study diagnostic accuracy of standard endoscopy for identification of intestinal metaplasia in the stomach was not improved by the use of magnification endoscopy, but the latter was an accurate method of predicting specialized intestinal metaplasia in Barrett's esophagus. The use of magnification endoscopy in the clinical setting of renal transplantation needs further studies.
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Affiliation(s)
- D Baczewska-Mazurkiewicz
- Department of Internal Medicine and Gastroenterology, Central Clinical Hospital of Ministry of Home Affairs and Administration, Warsaw, Poland
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Matłosz B, Mróz A, Durlik M, Wesołowska A, Sadowska A, Cieciura T, Perkowska A, Deborska-Materkowska D, Szmidt J, Michalak G, Paczek L, Lao M. Polyomavirus BK infection. Transplant Proc 2004; 35:2196-8. [PMID: 14529886 DOI: 10.1016/s0041-1345(03)00818-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Because it is an important factor affecting renal transplant function, BK infections are significant problem in posttransplant. BK nephropathy develops in 5% of renal allograft recipients, in most cases within the first year after the procedure. The gold standard for BK nephropathy diagnosis is still immunohistochemical staining for large T antigen in graft biopsy specimens. The aim of the present study was to evaluate the incidence of and factors influencing BK nephropathy in our renal allograft population. Among 89 renal or pancreas/kidney allograft recipients, BKV DNA was detected in 1 or more serum samples in 17 patients but BK nephropathy was diagnosed in only 1 case. Plasmacytic tubulitis was an exclusive feature in PCR-positive patients with 2 (20%) cases but no such findings in the PCR-negative group. In 40% of patients in the PCR-positive group at least 1 rejection episode was diagnosed versus 22% in the PCR-negative group. There were no significant differences in both groups according to total ischemia time, immunosuppressive treatments, or mean serum creatinine at 1 year after transplantation.
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Affiliation(s)
- B Matłosz
- Department of Transplantation Medicine and Nephrology, Transplantation Institute, Warsaw, Poland
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32
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Baczkowska T, Perkowska-Francka A, Durlik M, Cieciura T, Nowacka-Cieciura E, Pazik J, Lewandowska D, Mroz A, Matlosz B, Chmura A, Galazka Z, Lao M. The role of the protocol biopsies in renal allograft recipients. Transplant Proc 2004; 35:2179-81. [PMID: 14529881 DOI: 10.1016/s0041-1345(03)00807-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Subclinical rejection and long-term cyclosporine nephrotoxicity are well-known risk factors of chronic allograft nephropathy. In a prospective study 32 low-risk patients were randomized to either a reduced CsA dose (5 mg/kg/d) and daclizumab (group A, n = 16) for 7 months posttransplant with subsequent CsA tapering/withdrawal, or to a normal CsA dose (10 mg/kg/day) without daclizumab (group B, n = 16). Both groups received MMF and prednisone. Protocol biopsies were obtained at engraftment and 3 and 12 months after Tx. The number of rejection episodes was the primary endpoint. The secondary endpoints were: renal function, histological parameters related to CsA, and serum levels of TGF-beta and PDGF-BB. A low incidence of clinically suspected rejection episodes was observed (19% in group A and 12.4% in group B; P = NS). Although protocol biopsies showed 12 subclinical rejection episodes (six in group A, six in group B), serum creatinine levels were not different between the examined groups at 3 months. However, at 12 months, there was a statistically improved mean creatinine level in group A patients (1.2 mg/dL +/- 0.5 in group A vs 1.54 mg/dL in group B; P <.05). Chronic histopathologic changes were significant for biopsies at 3 and 12 months in both groups compared to the baseline findings for protocol biopsies (with no differences between groups, or between 3 and 12 months in both groups). Serum TGF-beta and PDGF-BB did not differ between the groups. Protocol biopsies may be useful to monitor safety and efficiency of new immunosuppressive protocols. Immunosuppressive regimens with low CsA doses followed by the drug's complete withdrawal seem to be efficient and safe in low-risk kidney allograft recipients.
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Affiliation(s)
- T Baczkowska
- Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Warsaw, Poland
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Paczek L, Lao M, Durlik M, Szmidt J, Rowinski W. Immunosuppression in kidney transplantation in Poland. Transplant Proc 2004; 36:173S-176S. [PMID: 15041331 DOI: 10.1016/j.transproceed.2004.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper presents experience with cyclosporine A in kidney allograft recipients at the Transplantation Institute, the Medical University of Warsaw. Comparative studies on pharmacokinetics and bioavailability of CsA and Neoral as well as monitoring of the drug immunosuppressive activity are presented. The implementation of CsA to immunosuppressive therapy in renal allograft recipients have greatly improved the grafts and patients survival. CsA has been used in a great percentage of patients after renal allograft in Poland (72%) and seems to be in some patients the gold standard of immunosuppression.
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Affiliation(s)
- L Paczek
- Transplantation Institute, Medical University of Warsaw, Warsaw, Poland
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Abstract
Infectious complications, including pneumonia, remain one of the leading causes of morbidity and mortality in kidney allograft recipients. The aim of the study was to evaluate the relationship between pneumonia occurrence and treatment duration and recipient age, cause of native kidney insufficiency, dialysis duration, time between transplantation and onset, HLA matching, PRA immunosuppressive protocol, acute rejection incidence and treatment, kidney function at the pneumonia onset, as well as presence of comorbid conditions. One hundred and twenty pneumonia cases occurred in kidney allograft recipients transplanted between 1991 and 2000 with 12 to 120 months follow-up. Twenty five percentage of pneumonia episodes were diagnosed during the first posttransplant month, 25% between 2 and 6 months, and 25% at 0.5 to 3 years. Treatment duration measured from pneumonia onset to the study endpoint of recovery, which was defined as antibiotic withdrawal, show 50% of patient we cured after 15 days and 75% after 24 days of treatment. The risk of prolonged pneumonia treatment was associated with: second versus first kidney transplantation with RR = 2.3 (P <.02) and medians of treated time 28 versus 15 days; as well as serum creatinine level above 2 mg/dL (RR = 1.4; P <.098). Exposure to enhanced-potency immunosuppressive protocols including induction therapy with mono- or polyclonal antibodies increased the RR = 1.65 (P <.02), and lengthened the time to 18 versus 14 days. Maintenance immunosuppression with agents other than cyclosporine also enhanced the risk. (RR = 2.18; P <.068).
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Affiliation(s)
- J Pazik
- Department of Transplantation Medicine and Nephrology, Transplantation Institute, Warsaw, Poland
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35
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Mróz A, Durlik M, Cieciura T, Pazik J, Baczkowska T, Chmura A, Nazarewski S, Lao M. C4d complement split product expression in chronic rejection of renal allograft. Transplant Proc 2003; 35:2190-2. [PMID: 14529884 DOI: 10.1016/s0041-1345(03)00799-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Chronic allograft rejection remains the major cause of late renal graft loss. Its pathogenesis is complex, depending on both immunological and nonimmunological factors. An important role in development of chronic rejection is ascribed to an ongoing immunological reaction mainly of the humoral type. C4d complement split product, as a stable fragment of complement degradation activated by antigen-antibody complexes, is considered to be an indicator of humoral activity in allografts. The aim of the present study was to establish a correlation between C4d expression and morphological findings specific for chronic rejection among biopsy specimens from patients with deteriorating graft function versus protocol biopsy specimens versus biopsy specimens of native kidneys with glomerular diseases. C4d deposits in peritubular capillaries and glomeruli were observed in 83% of patients with morphological changes of chronic rejection. No C4d expression was found in the protocol biopsy group. C4d deposits in glomeruli localizations were found in kidneys from patients with glomerulopathies; the pattern of distribution was similar to that for antibodies characteristic for glomerulonephritis. There was a positive correlation between C4d expression and morphological features of chronic rejection. In our opinion, only peritubular capillary localization is specific for a rejection process; glomerular localization is nonspecific and probably secondary to antigen-antibody complex deposition in course of some types of glomerulopathies.
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Affiliation(s)
- A Mróz
- Department of Transplantation Medicine and Nephrology, Transplantation Institute Warsaw, Warsaw, Poland
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36
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Deborska D, Durlik M, Sadowska A, Nowacka-Cieciura E, Pazik J, Lewandowski Z, Chmura A, Galazka Z, Paczek L, Lao M. Human herpesvirus-6 in renal transplant recipients: potential risk factors for the development of human herpesvirus-6 seroconversion. Transplant Proc 2003; 35:2199-201. [PMID: 14529887 DOI: 10.1016/s0041-1345(03)00792-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Herpesviruses, including human herpesvirus-6 (HHV-6), reactivate and have the potential to be pathogenic in immunocompromised patients. Little information is available regarding the correlation between immunosuppressive therapy and HHV-6 seroconversion after organ transplantation. Serum samples obtained from 120 kidney and kidney/pancreas transplant recipients were tested to explore the potential risk factors for developing HHV-6 infection including types of immunosuppression and induction/rejection therapy. Stored serum samples obtained prior to and at the 2nd, 4th, 12th and 48th weeks after transplantation were tested for anti-HHV-6 immunoglobulin (Ig)M antibodies using indirect immunofluorescence assay. Prior to transplantation and 48 weeks after transplantation the sera were additionally tested for anti-HHV-6 IgG using enzyme-linked immunoassay. Ninety-one percent of 120 recipients were HHV-6 IgG-positive before transplantation. One hundred seven of 120 patients were anti-HHV-6 IgM-negative before transplantation. Primary/secondary HHV-6 seroconversion occurred in sera of 46.6% of these 107 patients. HHV-6 seroconversion most frequently occurred 2 to 4 weeks after transplantation. There was no significant relationship between HHV-6 seroconversion and the treatment with methylprednisolone (MP). The incidence of HHV-6 seroconversion was significantly higher in subjects who were treated with the regimens including Daclizumab or Sirolimus as compared with those who were on other protocols. HHV-6 seropositivity in the Polish population of organ transplant recipients is very high. We demonstrated a trend toward association of HHV-6 seroconversion with type of immunosuppressive therapy.
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Affiliation(s)
- D Deborska
- Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Warsaw, Poland
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Perkowska A, Elhasade A, Durlik M, Placha G, Gałazka Z, Lao M, Gaciong Z. The effect of chronic allograft rejection on plasma regulators of fibrinolysis. Ann Transplant 2003; 7:44-51. [PMID: 12221903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
Chronic renal allograft rejection is often associated with the presence of fibrin thrombi in the microcirculation. Our purpose was to evaluate the influence of chronic rejection on fibrinolytic regulators in plasma of renal allograft recipients. We evaluated the concentration and activities of tPA, uPA and PAI-I in plasma from kidney allograft recipients. We studied 64 patients who underwent kidney transplantation from cadaveric allograft donors. At the time of the study 38 patients had stable graft function for at least 6 months proceeding the study, and 26 recipients had biopsy-proven chronic rejection of the kidney transplant. Control group included 30 healthy blood donors. In kidney transplant recipients we found significantly higher plasma tPA activity (median: 0.99 IU/ml; range: 0-3.8 IU/ml) in comparison to healthy controls (median: 0.15 IU/ml; range: 0-2.8 IU/ml) (p = 0.002) as well as significantly lower plasma PAI-I activity (median: 7.06 U/ml; range: 0-33.2 U/ml) in comparison to healthy controls (median: 21.8 U/ml; range: 0-36.7 U/ml), (p = 0.0001). Among transplant recipients, PAI-I plasma activity in recipients with chronic graft rejection (median: 10.16 U/ml; range: 0-33.2 U/ml) was significantly higher than in patients with stable graft function (median: 4.83 U/ml; range: 0-22.9 U/ml), (p = 0.01). In transplant recipients with stable graft function and poorly controlled hypertension we found significantly higher PAI-I plasma activity in comparison to recipients with normal blood pressure (p = 0.006). In kidney transplant recipients there was a positive correlation between the dose of prednisone and PAI-I activity in plasma (p = 0.01) and an association between BMI value and plasma PAI-I activity (p = 0.008), as well as an association between BMI value and plasma tPA-Ant concentration (p = 0.006). Among transplant recipients, patients treated with ACE inhibitors had significantly lower uPA plasma activity than the rest of the group (p = 0.003). In recipients with stable graft function we found a correlation between CsA concentration and tPA activity (p = 0.04), as well as an association between the dose of CsA and uPA-Ant concentration in plasma (p = 0.049). In patients with chronic graft rejection we found a negative correlation between the dose of prednisone and uPA-Ant plasma level (p = 0.004). Renal allograft recipients have higher tPA and lower PAI-I activities in plasma in comparison to healthy individuals. Chronic allograft rejection, is as well as poorly controlled hypertension, seem to be associated with an increase PAI-I plasma activity. In kidney graft recipients there is a relation between the value of BMI and the activity and concentration of tPA-Ant as well as the value of BMI and the PAI-I activity in plasma. Poorly controlled hypertension is associated with an increase in PAI-I plasma activity. The results of our study suggest a stimulatory effect of CsA on tPA and PAI-I plasma activities as well as on uPA-Ant concentration, while prednisone in turn seems to enhance PAI-I activity in plasma and decrease uPA expression. In renal allograft recipients ACE inhibitors seem to reduce uPA plasma activity.
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Affiliation(s)
- A Perkowska
- Transplantation Institute, Warsaw Medical University, Warsaw, Poland.
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38
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Nowaczyk M, Kasprzycka M, Górski A, Wierzbicki P, Wyzgal J, Durlik M, Gradowska L, Perkowska A, Lao M, Paczek L, Korczak-Kowalska G. Intracellular cytokine production in chronic renal allograft rejection. Transplant Proc 2002; 34:3132-3. [PMID: 12493398 DOI: 10.1016/s0041-1345(02)03617-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- M Nowaczyk
- Transplantation Institute, The Medical University of Warsaw, Warsaw, Poland
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39
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Rowiński W, Korczak-Kowalska G, Samsel R, Zderska M, Chmura A, Włodarczyk Z, Pliszczynski J, Wyzgał J, Cieciura T, Łagiewska B, Wałaszewski J, Paczek L, Lao M, Górski A. Can the immunosuppressive [correction of immunosupressive] effect of perioperative single high-dose antithymocyte globulin administration in kidney allograft recipients be due to apoptosis of activated lymphocytes? Transplant Proc 2002; 34:1622-4. [PMID: 12176510 DOI: 10.1016/s0041-1345(02)03047-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- W Rowiński
- General and Transplanataion Surgery, Transplantation Institute, the Medical University of Warsaw, U1 Nowogrodzka 59, 02-006 Warsaw, Poland
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40
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Nowacka-Cieciura E, Durlik M, Cieciura T, Kukuła K, Lewandowska D, Baçzkowska T, Deborska D, Lao M, Szmidt J, Rowiński W. Elevated serum immunoglobulins after steroid withdrawal in renal allograft recipients. Transplant Proc 2002; 34:564-6. [PMID: 12009625 DOI: 10.1016/s0041-1345(01)02847-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ewa Nowacka-Cieciura
- Transplantation Institute, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, Poland
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41
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Szmidt J, Durlik M, Gałazka Z, Nazarewski S, Górnicka B, Ziarkiewicz-Wróblewska B, Bojakowski K, Nowacka-Cieciura E, Lao M. Low-stage renal carcinoma of the native kidneys in renal transplant recipients. Transplant Proc 2002; 34:583-4. [PMID: 12009631 DOI: 10.1016/s0041-1345(01)02852-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Jacek Szmidt
- Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
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42
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Nowacka-Cieciura E, Durlik M, Cieciura T, Lewandowska D, Baczkowska T, Kukuła K, Lao M, Szmidt J, Rowinski W. Steroid withdrawal after renal transplantation--risks and benefits. Transplant Proc 2002; 34:560-3. [PMID: 12009624 DOI: 10.1016/s0041-1345(01)02846-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ewa Nowacka-Cieciura
- Transplantation Institute, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, Poland
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43
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Michalak G, Czerwiński J, Kwiatkowski A, Danielewicz R, Kosieradzki M, Lisik W, Chmura A, Lao M, Durlik M, Wałaszewski J, Rowiński W. Surgical complications observed in simultaneous pancreas-kidney transplantation: thirteen years of experience of one center. Transplant Proc 2002; 34:661-2. [PMID: 12009657 DOI: 10.1016/s0041-1345(01)02880-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Grzegorz Michalak
- Department of General and Transplantation Surgery, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, Poland
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44
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Gałazka Z, Szmidt J, Nazarewski S, Grochowiecki T, Swiercz P, Bojakowska M, Bojakowski K, Lao M. Long-term results of kidney transplantation in recipients with atherosclerotic iliac arteries. Transplant Proc 2002; 34:604-5. [PMID: 12009639 DOI: 10.1016/s0041-1345(01)02860-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Z Gałazka
- Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland
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45
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Baczkowska T, Kukula K, Nowacka-Cieciura E, Cieciura T, Lewandowska D, Ciecierski R, Grochowiecki T, Rowinski W, Szmidt J, Durlik M, Lao M. Use of daclizumab in the immunosuppression of high-risk kidney and kidney/pancreas recipients: Warsaw Transplantation Center experience. Transplant Proc 2002; 34:551-2. [PMID: 12009620 DOI: 10.1016/s0041-1345(01)02842-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- T Baczkowska
- Transplantation Institute, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, Poland
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46
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Baczkowska T, Serafinowicz A, Kukuła K, Nowacka-Cieciura E, Cieciura T, Deborska D, Gałazka Z, Rowiński W, Szmidt J, Durlik M, Lao M. Cyclosporine blood concentration at 2 hours (C(2)) from drug ingestion as the best single indicator of adequate cyclosporine immunosuppression in renal allograft recipients--a four-year follow-up. Transplant Proc 2002; 34:556-7. [PMID: 12009622 DOI: 10.1016/s0041-1345(01)02844-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Teresa Baczkowska
- Transplantation Institute, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, Poland
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47
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Perkowska A, Elhasade A, Gaciong Z, Durlik M, Placha G, Galazka Z, Lao M. Regulators of fibrynolysis in plasma of kidney transplant recipients. Transplant Proc 2002; 34:585-8. [PMID: 12009632 DOI: 10.1016/s0041-1345(01)02853-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Agnieszka Perkowska
- Transplantation Institute, Medical University, Nowogrodzka 59, 02-006 Warsaw, Poland
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48
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Deborska D, Durlik M, Sadowska A, Matłosz B, Baczkowska T, Paczek L, Szmidt J, Rowiński W, Lao M. Human herpesvirus-6 and human herpesvirus-8 seroprevalence in kidney transplant recipients. Transplant Proc 2002; 34:673-4. [PMID: 12009660 DOI: 10.1016/s0041-1345(01)02883-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Dominika Deborska
- Department of Transplantation Medicine and Nephrology, Transplantation Institute, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, Poland.
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49
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Wierzbicki P, Korczak-Kowalska G, Durlik M, Kłosowska D, Wyzgał J, Paczek L, Lao M, Górski A. The T-cell apoptosis in the early period after renal allograft transplantation. Transplant Proc 2002; 34:685-6. [PMID: 12009664 DOI: 10.1016/s0041-1345(01)02887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Piotr Wierzbicki
- Transplantation Institute, Medical University of Warsaw, 59 Nowogrodzka Street, 02-006 Warsaw, Poland
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50
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Matl I, Bachleda P, Michalsky R, Navratil P, Lao M, Treska V, Prestele H, Matthisson M, Korn A. Basiliximab can be administered safely and effectively in a single dose on day 1 postrenal transplantation in patients receiving triple therapy with azathioprine. Transplant Proc 2001; 33:3205-6. [PMID: 11750375 DOI: 10.1016/s0041-1345(01)02364-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- I Matl
- Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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