Carlos Alberto Nigro

Hospital Alemán

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Eduardo Borsini

Hospital Británico de Buenos Aires

Edgardo Rhodius

Hospital Alemán

Eduardo Dibur

Hospital Alemán

Glenda Ernst

Hospital Británico de Buenos Aires

Magalí Blanco

Hospital Británico de Buenos Aires

Alejandro Salvado

Hospital Británico de Buenos Aires

Facundo Nogueira

Hospital de Clínicas "José de San Martín"

Ignacio Bledel

Hospital Alemán

M Gallinella Muzi

University of Rome Tor Vergata

F Andréoli

University of Modena and Reggio Emilia

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Hospital Alemán

University of Rome Tor Vergata

Hospital Británico de Buenos Aires

University of Buenos Aires

Università Cattolica del Sacro Cuore

Policlinico Tor Vergata

Hospital Británico

Agostino Gemelli University Polyclinic

Instituto Argentino de Diagnóstico y Tratamiento

Hospital Privado

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Effect of the definition of hypopnea on apnea/hypopnea index.

PubMed (2003)

Carlos Alberto Nigro Edgardo Rhodius

The objective of this study was to determine whether different decreases in oxygen saturation (SaO2) or the presence of electroencephalographic arousals (EEGA) in the definition of hypopnea modify hypopnea index and apnea/hypopnea index and the prevalence of obstructive sleep apnea/hypopnea syndrome (OSAHS). A total of 20 polysomnographies performed in patients with OSAHS were analyzed. There are four different definitions of hypopnea: > or = 30% reduction in airflow or 50% decrease in abdominal movement associated with decreases SaO2 > or = 3% (type 1); decreases SaO2 > or = 3% or EEGA (type 2); decreases SaO2 > or = 4% (type 3); decreases SaO2 > or = 4% or EEGA (type 4). The prevalence of OSAHS was calculated for an apnea/hypopnea index (AHI) > or = 10 and > or = 15. Hypopnea index (HI) and AHI types 2 and 4 were higher than type 3 (HI: type 2: 20 +/- 10.6, type 4: 18.6 +/- 10, type 3: 11.4 +/- 10, p < 0.001; AHI: type 2: 23.3 +/- 11.6, type 4: 21.4 +/- 11.2, type 3: 14.7 +/- 11.6, p < 0.001). No differences were observed between HI and AHI types 1 and 2 (HI: type 1: 17.4 +/- 10, type 2: 20 +/- 10.6; AHI: type 1: 20.6 +/- 11.8, type 2: 23 +/- 11.6, p > 0.05). The prevalence of OSAHS was 30-55% in type 3, 70-85% in type 4 (p < 0.05), and 70-85% in types 1 and 2 (p > 0.05). In our patient's population, the presence of EEGA in the definition of hypopnea significantly increased the HI, the AHI and the prevalence of OSAHS when associated with a > or = 4% decrease in SaO2.

Hypopnea

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A case of recurrent ileal perforation treated with permacol TT biological implant

Hernia (2012)

M Gallinella Muzi Giorgio Attinà Maurizio Grande Carlos Alberto Nigro Federica Cadeddu

Perforation

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IL TRATTAMENTO CHIRURGICO DELLE EMORROIDI IN DAY-SURGERY CON LA RADIOFREQUENZA

M Gallinella Muzi Cristina Ridolfi M Grande Carlos Alberto Nigro F Andréoli

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Comparison of the automatic analysis versus the manual scoring from ApneaLink™ device for the diagnosis of obstructive sleep apnoea syndrome

Sleep And Breathing (2010)

Carlos Alberto Nigro Eduardo Dibur Silvia Aimaretti Sergio González Edgardo Rhodius

Concordance

Respiratory disturbance index

Neuroradiology

10.1007/s11325-010-0421-9

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Citations (42)

Lavado broncoalveolar en el diagnóstico de la tuberculosis miliar

Medicina-buenos Aires (1986)

Carlos Alberto Nigro Rodolfo Lima Araújo D O Kniznik Guillermo B. Semeniuk

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Simulated intention-to-treat analysis based on clinical parameters of patients at high risk for sleep apnea derivated to respiratory polygraphy

Sleep Science (2018)

Eduardo Borsini Magalí Blanco Glenda Ernst Paulina Montenegro Alejandro Salvado

Obstructive Sleep Apnea-Hypopnea Syndrome (OSAS) is a public health problem. We designed a pilot study to validate empiric indication of CPAP therapy in a population with moderate-to-high pre-test probabilities who underwent self-administered home-based respiratory polygraphy (RP).A cross-sectional simulation study was performed. CPAP therapy could be indicated by two independent blind observers. Observer 1´s decision was based on the results of STOP-BANG (SBQ) and Epworth Sleepiness Scale (ESS) and Observer 2 used all objective data provided by RP + SBQ + ESS.We evaluated 1763 patients; 1060 men and 703 women (39.2%) with a mean age of 53.6±13.8 and a body mass index (BMI) of 32.8±7.5 kg/m2. We found evidence of mild (34.1%), moderate (26.6%), and severe (18.3%) There were Apnea-Hypopnea Index (AHI) relationship between > 5 or < 5 SBQ and RP AHI (p<0.05). BMI > 25 kg/m2 + snoring (S) + observed apnea (O) + 1 of the following: ESS > 11, hypertension (HT) or > 5 SBQ components showed sensitivity of 40% (CI95%: 37.3-43) and specificity of 95.1% (CI93.4-96.4). The performance of 5 SBQ components with regard to gender and empirical CPAP therapy was; (women vs. men): AUC-ROC 0.625 (CI95%: 0.599-0.651) vs. 0.70 (CI95%: 0.68-0.72), p<0.01, respectively.STOP-BANG and ESS made it possible to indicate CPAP reliably (low rate of false-positive results) in 20-40% of patients who needed such therapy according to clinical history and RP results. These clinical criteria performed better in male.

Epworth Sleepiness Scale

10.5935/1984-0063.20180030

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Hipoxemia y el riesgo de hipertensión arterial en apnea obstructiva del sueño

Respirar (2023)

Eduardo Borsini Magalí Blanco Miguel Schiavone Alejandro Salvado Ignacio Bledel

Introduction: there is limited information about the role of hypoxemia degree as a risk factor for hypertension (HTN) in patients with obstructive sleep apnea (OSA). The objective of this study is to assess hypoxemia as an independent risk factor for HTN in a work model based on real-life patients examined at sleep unit. Methods: this retrospective study consisted of a predictive model using multiple logistic regression to establish the relationship between HTN and age, sex, body mass index (BMI), apnea/hypopnea index (AHI) and time below SO2 ≤ 90% (T90 ≥ 3%). Results: we included 3.854 patients (median age: 55 years), mostly men (61.5%). According to the model, the variables that were significantly associated with HTN were: age (OR: 3.27 – 3.29, CI95% 2.83 – 3.80, p < 0.0001), male sex (OR 1.35, CI95% 1.17 – 1.56, p < 0.001), Obesity (OR 1.83, CI95% 1.59 – 2.11, p < 0.0001), AHI > 15 events per hour (OR 1.22, CI95% 1.05 – 1.43, p < 0.01) and T90 ≥ 3% (OR 1.56 – 1.57, CI95% 1.32 – 1.84, p < 0.0001). Conclusion: in a clinical population of subjects suspected of OSA, nocturnal hypoxemia measure as T90 ≥ 3% was associated with HTN.

10.55720/respirar.15.1.2

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Contribution of pulse oximetry in relation to respiratory ﬂow events in a home-based approach aimed at diagnosing obstructive sleep apnea.

DOAJ (DOAJ: Directory of Open Access Journals) (2021)

Eduardo Borsini Magalí Blanco Glenda Ernst Alejandro Salvado Ignacio Bledel

To compare pulse oximetry with manual analysis against all signals of respiratory polygraphy. This retrospective study estimated sensitivity (S), specificity (Sp) and positive/negative likelihood ratio (LR+/-) of the oxygen desaturation index (ODI-test) and apnea-hypopnea index (AHI-reference). 3854 patients (61.5% men) were included. Age, BMI, Epworth sleepiness scale and AHI were: 55 years (44-65), 30.9kg/m2 (27-36), 7 points (4-11), and 14 events/hour (6-25), respectively. 18% showed an AHI <5 events/hour, 34% = 5 and <15, 27% = or > 15 and < 30, and 31% > 30. The S, Sp, and LR+/- of ODI for AHI = 5 events/hour was 93%, 92%, 12 and 0.08 with an accuracy of 93%. For AHI = 15 events/hour, the values were: S 94%, Sp 94%, LR+ 15 and LR- 0.06 and 94% accuracy (r(2) Spearman: 0.92). In a population at a high risk for OSA, home-based pulse oximetry had a diagnostic accuracy > 90% when is compared against all respiratory signals obtained from simpliﬁed home sleep testing.

Pulse Oximetry

Sleep

10.5935/1984-0063.20200042

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Citations (3)

Síndrome de obesidad e hipoventilación. Abordaje diagnóstico y tratamiento

Fronteras en Medicina (2021)

Eduardo Borsini Pablo Young Carlos Alberto Nigro

La obesidad es un problema de salud pública que produce cambios en la función respiratoria y el sueño.El síndrome de obesidad e hipoventilación (SOH) se de ne por: hipoventilación en vigilia (PaCO2>45 mmHg), IMC≥30 kg/m2 en adultos o > percentilo 95 en niños y cuando la causa no es una enfermedad del parénquima pulmonar, pared torácica o vías aéreas, uso de medicación, trastornos neurológicos ni síndromes de hipoventilación alveolar centrales.Su prevalencia es ≈0.4% en la población general.La mayoría de los pacientes permanecen sin tratar hasta que un evento banal desenmascara la hipercapnia o desencadena falla respiratoria.El 90% tiene apnea obstructiva del sueño (AOS) coexistente, correspondiendo a AOS severa (índice de apneas-hipopneas [IAH]>30 ev/h) en el 70%.El tratamiento depende de la situación clínica (aguda o crónica).En la insuciencia respiratoria aguda el tratamiento es la ventilación no invasiva (VNI).Después de la estabilización de la hipercapnia, se puede considerar una prueba terapéutica con CPAP si existe AOS severa.En el SOH estable con AOS severa se sugiere CPAP como primera línea, aunque la VNI es la alternativa si los síntomas no mejoran, la hipercapnia persiste, el IAH no se reduce o la CPAP se tolera mal.En pacientes sin AOS severa la recomendación es el VNI.Las intervenciones que reducen el 25-30% el peso corporal (cirugía bariátrica derivativa) son necesarias para mejorar la hipoventilación.El manejo multidisciplinario con una mirada holística multidimensional es necesario a todos los niveles; individual, familiar, social y sanitario.

10.31954/rfem/202104/0277-0288

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Citations (1)

[Practical guidelines for the diagnosis and treatment of obstructive sleep apnea syndrome].

PubMed (2013)

Facundo Nogueira Carlos Alberto Nigro Hugo Cambursano Eduardo Borsini Julio Silio

Obstructive sleep apnoea syndrome (OSAS) is one of the most relevant chronic respiratory pathologies due to its high prevalence and impact in morbidity and mortality. In 2001, the Asociación Argentina de Medicina Respiratoria (AAMR) published the first Argentinean Consensus on Sleep-Related breathing Disorders. Since then, wide new scientific evidence has emerged, increasing significantly the knowledge about this pathology. According to this, the Sleep-Related breathing Disorders and Oxygen Therapy Section of the AAMR, decided to update its Consensus, developing this Practical Guidelines on Management of patients with OSAS. A working group was created with members belonging to the section, experts in OSAS. They extensively reviewed the literature and wrote these guidelines, orientated to practical resolution of clinical problems and giving answers to questions emerged from dealing with patients who suffer from this syndrome. The document defines OSAS and describes the diagnosis and severity criteria, as well as the risk factors, ways of presentation and epidemiology. Clinical consequences, mainly on cognition, cardiovascular system and metabolism are pointed out. Different diagnostic methods, with their indications and technical aspects for validation and interpretation are detailed. Finally, we describe therapeutic alternatives, as well as practical aspects of their implementation. The authors' aim was to generate an accessible tool for teaching and spreading the knowledge on these disorders, which have a great impact in public health.

Presentation (obstetrics)

Sleep medicine

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Citations (49)