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Autonomic cardiac modulation in obstructive sleep apnea: effect of an oral jaw-positioning appliance
No full textBackground: Patients with obstructive sleep apnea (OSA) are characterized by deranged
cardiovascular variability, a well-established marker of cardiovascular risk. While long-term
treatment with continuous positive airway pressure leads to a significant improvement of
cardiovascular variability, little is known of the possibility of achieving the same results with other
therapeutic approaches. The aim of our study was to investigate the responses of autonomic
indexes of neural cardiac control to another type of OSA treatment based on an oral jawpositioning
appliance.
Methods: In 10 otherwise healthy subjects with OSA (OSA) and in 10 subjects without OSA
(OSA) we measured heart rate, BP, and indices of autonomic cardiac regulation derived from
time-domain and spectral analysis of R-R interval (RRI), before and after 3 months of treatment
with the oral device. High-frequency (HF) power of RRI was taken as an index of parasympathetic
cardiac modulation, and the ratio between low-frequency (LF) and HF RRI powers as an indirect
marker of the balance between sympathetic and parasympathetic cardiac modulation.
Results: At baseline, in comparison with OSA subjects, OSA subjects displayed a significantly
lower RRI variance (p < 0.02) and reduced HF RRI powers (p < 0.001). After 3 months of
treatment with the oral device, the OSA group showed a marked reduction in apnea-hypopnea
index (p < 0.001), a lengthening in RRI and a significant increase in its variance (p < 0,02), an
increased HF RRI power (from 134 26 to 502 48 ms2, p < 0.001), and a reduction in LF/HF
RRI power ratio (from 3.11 0.8 to 1.5 0.5). As a result of these changes, after the 3-month
treatment there were no more significant differences between the two groups in these parameters.
In both OSA and OSA groups, body weight, heart rate, and BP did not change over time.
Conclusions: Three months of treatment with a specific oral jaw-positioning appliance improves
cardiac autonomic modulation in otherwise healthy patients with OSA of mild degree.
(CHEST 2006; 130:1362–1368
Randomized controlled study of an oral jaw-positioning appliance for the treatment of obstructive sleep apnea in children with malocclusion.
No full textItalian recommendations on dental support in the treatment of adult obstructive sleep apnea syndrome (OSAS)
No full textBACKGROUND:
The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring.
METHODS:
With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring.
RESULTS:
Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable.
CONCLUSIONS:
The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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