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Age-related response of the genioglossus muscle EMG-activity to hypoxia in humans

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The prevalence of snoring and obstructive sleep apnea syndrome increases with age. Upper airway obstruction during sleep occurs when the dilator muscles are unable to overcome the negative pharyngeal pressure. The very important muscle dilator of the upper airway is the genioglossus muscle (GG). Our previous study showed an increase in GG-EMG activity during progressive hypoxia. In the present study a hypoxic increase in GG-EMG activity in response to hypoxia was investigated in two groups of 10 healthy subjects each: aged 29.1 ±1.8 and aged 53.2 ±2.3. The older humans showed reduced response of GG to hypoxia. We suggest that the biological aging process may be a risk factor for the obstructive sleep apnea syndrome.
Several studies showed that nasal airway is an active component of the respiratory system. Clinical data suggest that nasal obstruction causes episodes of obstructive apnea or hypopnea. In the present study, a possible influence of breathing through the nose on genioglossus muscle (GG, dilator of upper airway) reactivity to hypoxic activation was studied. Two groups of 20-30 years and 41-55 years old, 35 healthy subjects each, were investigated. The GG-EMG-activity was recorded and analyzed during progressive normocapnic hypoxia. The subjects breathed through the nose (N) or mouth (M) alone and through the nose and mouth (N&M). Significantly smaller increases in the GG-EMG-activity in response to hypoxia were observed during M breathing, as compared with N and M&N breathings, in both groups. The older subjects also showed a reduced response of GG-muscle to hypoxia, which was most pronounced during M breathing. We suggest that breathing through the nose activates the dilator muscle of upper airways, preventing apnea events.
Ventilatory responses to progressive hypercapnia were analyzed in the normocapnic and hypercapnic obstructive sleep apnea patients (OSA). The rebreathing hypercapnic and hypoxic tests were performed using the computerized equipment (Lungtest, MES), according to Read's method. The ventilatory response to hypoxia was impaired in all OSA patients. Concerning the hypercapnic ventilatory response, there were no differences between the OSA patients with normal end-tidal PCO2 and controls. Nine moderately hypercapnic OSA patients showed a right shift with a normal slope of the regression curve describing the relationship between the end-tidal PCO2 and minute ventilation. In contrast, three severely hypercapnic OSA patients showed a right shift with a decreased slope of this regression curve. We conclude that awake OSA patients who developed hypercapnic ventilatory insufficiency showed an impaired hypercapnic defense reaction.
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Occurrence of obstructive sleep apnea in a group of shift worked police officers

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Shift work is an important source of health disturbances. Night work has a negative influence on some spheres: biological, working, social, and medical. Disturbances of sleeping, one group of manifestations of medical problems, can be considered as a cause of health deterioration. This study focuses on the occurrence of breathing disturbances during sleep in shift workers. Twenty one shift worked police officers (40-60 years old) were compared with an age-matched control group operating in the some environment. All subjects underwent overnight polysomnography. The polysomnographic investigation by shift workers was conducted after a day shift and normal night sleep, after an adaptational night in the sleep laboratory. Obstructive sleep apnea was found in 8 shift workers (38%) with AHI of 5.72-45.45 and in 8 control volunteers (38% of the studied group) with AHI of 5.00-25.24. All breathing parameters, as measured by polysomnography, did not differ between the two groups. Our results do not confirm the hypothesis that chronic irregular work hours promote the occurrence of obstructive sleep apnea in subjects aged 40-60 years.
The presence of the flaA, cadF, cdtB and iam genes of Campylobacter spp. was determined with the PCR method. The materials to investigate were 56 C. jejuni and 23 C. coli strains isolated from clinical samples (children and domestic animals). It was found that all of the Campylobacter spp. isolates from children with diarrhoea and domestic animals had cadF gene, responsible for adherence. The flaA gene was present in all Campylobacter spp. isolates derived from children and cats. Occurrence of flaA gene was confirmed in 100% of C. jejuni strains obtained from dogs. The high prevalence of the cdtB gene associated with toxin production was observed in this study (100%-Campylobacter spp. isolates obtained from dogs and cats, 97.9%-Campylobacter spp. isolates from children). The isolates showed a wide variation for the presence of iam gene. The lowest prevalence (23.5%) was detected in Campylobacter spp. obtained from dogs. The highest rates of iam detection (91.6%) were revealed in C. coli isolates from children.
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Does night work favor sleep-related accidents in police officers?

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Several studies of sleep-breathing physiology have suggested that sleep deprivation may worsen obstructive sleep apnea. The aim of the study was to determine the direct effect of night work on breathing variables during sleep in fast-rotating shift workers. Twenty one men - police officers, fast-rotating shift workers, underwent polysomnography on 2 occasions: under a normal sleeping condition after day work and after sleep deprivations after night work. Both sleep studies were conducted within 2 to 3 weeks of each other. Approximately half of the group was tested under control conditions (day work) first, with the remaining subjects tested under sleep deprivation conditions (night work) first. After a night shift the subjects did not show a significantly different apnea-hypopnea-index (AHI). However, night work significantly increased several breathing variables recorded during sleep after it: total duration of obstructive apneas (OA) during REM sleep, mean duration of OA during arousal, total duration of OA during NREM sleep, apnea index during arousal, mean length of OA during sleep period time, total duration of OA during sleep period time, mean length of OA during total sleep time, mean length of hypopnea during REM sleep, total duration of hypopnea during sleep period time and during total sleep time, maximal length of central apnea and OA, and total sleep time. Night work does not favor obstructive sleep apnea episodes during sleep, but worsens many an obstructive sleep apnea variable, as measured by polysomnography.
Our previous studies indicated the presence of a respiratory effector of carotid baroreceptor activation: the respiratory resistance. A brief decrease in respiratory resistance was observed in response to carotid baroreceptor activation. In the course of aging we found a decrease in the heart response to carotid baroreceptor activation and disappearance of the respiratory response. The aim of the present study was to determine whether the circadian variations of baroreflex sensitivity, as related to aging, are attributable to changes in cardiovascular and respiratory control in the elderly. We evaluated the cardiac responses and the reflex changes of the respiratory resistance to carotid baroreceptor activation every two hours in: 12 healthy male subjects aged 20-38 years, 6 male subjects aged 20-38 years and 6 male subjects aged 70-80 years. Two neck-chambers were used to produce a brief suction, applied to carotid sinus regions, activating the carotid baroreceptor. We found that the circadian courses of the cardiac and respiratory responses to baroreceptor activation were shifted down in the older groups of subjects, as compared with the younger ones. In the 50-80-year old subjects no respiratory response to carotid baroreceptor stimulation was observed. We further found that the impaired carotid baroreflex control of heart function and of respiratory resistance, observed in older subjects, reached a minimum between 3.00 and 7.00 hours in the morning. We conclude that this period is a risk time for the occurrence of cardiac disorders, especially for cardiac arrhythmias, and it is also the time of impaired reflex control of respiratory resistance.
The aim of this study was to evaluate the cardiovascular response to the activation of arterial chemoreceptors during voluntary apnea in snoring subjects. Fifty five men were enrolled in the study: 33 snorers and 22 non-snorers (control group). The majority of snorers were overweight and hypertensive. The experimental session consisted of 20 voluntary inspiratory apneas interspersed with 1 min free breathing periods, and 20 min recovery. The following parameters were recorded noninvasively: blood pressure, ECG, and arterial oxygen saturation. Data analysis was based on the Smietanowski procedure, written in the 4-th generation script language of MATLAB environment, which allows assessing the relative contribution of cardiac and vascular components to blood pressure variability. The results indicate that repetitive apneas led to significantly greater increases in blood pressure in the snorers. In this group, the domination of vascular influences during apnea periods reached 67 ±2.0%, which was greater than the 56 ±1.8% in the non-snorers (P<0.01). In contrast, the contribution of the cardiac component in the blood pressure response to apnea was greater in the non-snorers: 33 ±3% vs. 20 ±2% in the snorers (P<0.01). We conclude that activation of carotid chemoreceptors during voluntary apnea evokes a greater cardiovascular response in snorers, related to the reflex increase in total peripheral vascular resistance, and, consequently, a greater increase in blood pressure.
The aim of this study was to investigate the role of cats and dogs as a potential reservoir of Campylobacter spp. Rectal swabs from 83 dogs and 71 cats were examined. Samples were obtained from the animals aged between 2 weeks and 24 months living in shelters, private households, farms and from veterinary clinics located in Bydgoszcz region during routine check-up. Campylobacter spp. were isolated from 4.81% dogs and 9.86% cats, respectively. C. jejuni was predominant in this study. All strains were isolated in autumn and winter from the animals living in farms and private houses. All the animals positive for Campylobacter prevalence had access to small water basins, accidental source of food and had contact with wild birds, poultry or their feaces. Isolates characterization revealed high prevalence of Campylobacter virulence genes-flaA, cadF and cdtB. 91% of isolated strains were susceptible to erythromycin. 81% among isolated strains were susceptible to azithromycin, 64% to tetracycline and 36% to ciprofloxacin. For 2 C. jejuni strains isolated from cats Random Amplified Polymorphic DNA (RAPD) profiling indicated 80% homology between them.
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Effects of training on the ventilatory response to hypoxia

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The purpose of the present study was to examine the influence of systematical training on the ventilatory response to hypoxia. A rebreathing technique - progressive isocapnic hypoxia - was used to measure hypoxic chemoreflex reactivity. The ventilatory response was measured in a group of 22 world class adult kayakers (22.6 ±1.9 yr), 16 young kayakers (17.8 ±1.1 yr), and 38 control subjects (21.9 ±1.9 yr). The ventilatory response to hypoxia - analyzed as the relationship (slope) MV/SaO2 (minute ventilation/oxygen arterial blood saturation) - in the adult kayakers was significantly lower (-1.03 ±0.28 L/min/%, P<0.01) compared with those in the control group (-1.81 ±0.54 L/min/%) and the young kayakers (-1.54 ±0.6 L/min/%; the difference between the latter two was insignificant). The following values of P0.1/SaO2 (mouth occlusion pressure/oxygen arterial blood saturation) relationship were found for the investigated groups: adult kayakers (-0.20 ±0.1 cmH2O/%, P<0.05), young kayakers (-0.47 ±0.1 cmH2O/%, N.S.), control group (-0.48 ±0.18 cm H2O/%). Correlation between the hypoxic ventilatory response and VO2max was significant in both groups of kayakers. These findings indicate that tolerance for hypoxia was elevated in the group of athletes compared with the control group. Hypoxic tolerance correlates with the duration of training.
Several lines of evidence suggest that physical exercise not only influences the development of muscles, cardiovascular and respiratory systems, but also exerts a significant influence on the central nervous system. We examined the influence of strength and endurance training on cognitive performance in 33 healthy elderly volunteers (women, mean age 63.5 ±4.5 yr) over a 3-month period of supervised training program. A control group consisted of 8 age-matched (mean age 66.3 ±4.6) healthy volunteers who did not participate in any exercise training program. To evaluate the cognitive performance in our subjects we used two tests: face/name association test and Stroop test. The tests were applied shortly before and immediately after the training program. In the experimental group, a significant improvement in the association test performance, on average, from 71.6 ±7.3% to 79.7 ±7.2% (P<0.0001) was observed over the 3-month training period. There were no changes in the Stroop test results over the same time. Likewise, there were no changes in the control groups. Our data demonstrate that the training regime that is strictly followed over a relatively short period of time may improve the performance in associative memory tasks in elderly subjects. The study supports the notion that physical exercise influences cognitive performance and extend this notion to be valid for healthy elderly subjects.
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The majority of hemodialyzed patients suffer from sleep disturbances. In the present study the prelevence of sleep apnea syndrome in hemodialyzed patients with end-stage renal disease (ESRD-patients) was investigated by the survey, Epworth Sleepiness Scale (ESS), and polysomnography (PSG). Sixty-one patients: 24 women and 37 men were involved in the study. All subjects participated in the first part of the study consisting of the survey and ESS. The second and third parts consisted of nighttime PSG, performed the night after hemodialysis (17 patients) and between hemodialyses (11 patients). Eleven out of the 61 patients had the symptoms of sleep apnea and heavy daily sleepiness. Eleven subjects were involved in the double PSG study: after and between hemodialyses. Obstrucive sleep apnea was found in 7 of those patients during both nights analyzed. Our results confirm the occurrence of sleep disorders in ESRD-patients. Hemodialysis does not change the prevalence of obstructive sleep apnea in chronic renal disease.
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