Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sleep apnea syndrome is a constellation of symptoms resulting from recurrent episodes of apnea during sleep. Often the upper airway becomes obstructed during slumber in this disorder. Symptoms relate to sleep deprivation and include morning headaches, daytime somnolence, personality changes with deteriorating intellectual capacity, nocturnal enuresis, and sexual dysfunction. Diagnosis is assisted by polysomnographic recordings. Therapy is directed at the cause of obstruction when one can be found, weight loss in massively obese patients, tracheostomy in the symptomatic patient. Four patients with documented sleep apnea syndrome are discussed. One patient, a thin adolescent female underwent adenoidectomy without improvement. Two massively obese adult males required tracheostomy with marked amelioration of symptoms. One additional adult male was found to have sleep apnea due to severe, acquired micrognathia; he was significantly improved by tracheostomy. All three adult patients were found by endoscopic visualization to have marked pharyngeal soft tissue collapse with inspiration during apneic episodes. Possible causes of pharyngeal collapse are discussed.
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PMID:Endoscopic findings in sleep apnea syndrome. 23 Nov 20

An unusual case is described in which partial upper airway obstruction led to a sequence of events characterized by sleep disturbance, enuresis, somnolence and cardio-respiratory collapse. The upper airway obstruction was not immediately apparent as the cause of subsequent clinical events. Attention is drawn to the general medical problems which may be produced by upper airway obstruction, with particular reference to those accompanying obesity and abnormal stature.
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PMID:Partial upper airway obstruction and sleep apnoea. 62 56

Obstructive sleep apnea syndrome (OSAS) is a complex disorder characterized by a sleep-related collapse of the upper airway. The most likely candidate for the common pathway linking various abnormalities casually associated with OSAS (such as adenotonsillar hypertrophy, obesity, retro- or micrognathia, acromegaly, or more subtle structural anomalies) is an abnormally small upper airway lumen. Symptoms of OSAS that appear during sleep include snoring, abnormal motor activity, disturbed nocturnal sleep, a sensation of choking, heartburn, nocturia, nocturnal enuresis, and heavy sweating. Daytime waking symptoms are dominated by often profound sleepiness, which may secondarily be associated with automatic behavior, retrograde amnesia, hypnagogic hallucinations, personality changes, sexual difficulties, and headaches. Careful evaluation, both sleeping and waking, are essential to select appropriate treatment. Treatments include nasal continuous positive airway pressure, tracheostomy, weight loss, uvulopalatopharyngoplasty, mandibular advancement, and so forth.
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PMID:Obstructive sleep apnea syndrome. A review. 333 20

Improved case identification of children with upper airway obstruction during sleep should result if physicians are aware of such signs and symptoms as excessive daytime sleepiness, loud snoring, restless sleep, recurrent nocturnal enuresis, systemic and pulmonary hypertension, undergrowth or obesity, and cor pulmonale. Furthermore, partial airway obstruction during wakefulness may be a risk factor for the development of sleep apneas or hypopneas. In suspected cases, polysomnography is a useful method for confirming and quantitating the type (central, obstructive, or mixed) and extent of ventilatory disturbance during sleep and its functional significance (such as arterial oxyhemoglobin desaturation or cardiac arrhythmia). Other methods may be employed to yield similar data. There seem to be at least two groups of children reported in the literature, those in whom there is a specific surgically correctable lesion (such as adenotonsillar hypertrophy) versus those who eventually need tracheotomy because of collapse of upper airway musculature during sleep. In the latter group of children, it is necessary to hypothesize an additional defect in the CNS regulation of respiration during sleep. Further research is necessary to define the boundary between normal and abnormal breathing during sleep, and to understand more thoroughly the effects of intermittent hypoventilation on daytime functioning.
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PMID:Sleep disorders associated with upper airway obstruction in children. 731 58

The vasoconstrictive and antidiuretic physiologic properties of vasopressin (antidiuretic hormone) have long been known. Until recently however, vasopressin was mostly used for diabetes insipidus and noctournal enuresis. This review summarizes the growing body of evidence regarding the perioperative use of vasopressin and its analogues in the management of certain forms of cardiovascular collapse. Physiologically, vasopressin is involved in regulating osmotic, volemic, and cardiovascular homeostasis. It acts via several specific vasopressin receptors that are variably distributed in the heart, kidneys and vasculature etc. Under normal conditions, its antidiuretic effect predominates and vasopressin only induces vasoconstriction at high concentrations. Regarding catecholamine-resistant vasodilatory shock, current evidence suggests that with adequate volume resuscitation, exogenous vasopressin in low "physiologic" doses (0.01-0.04 units/min) safely supports mean arterial pressure without adversely affecting myocardial function and splanchnic circulation. One possible explanation is that metabolic acidosis impairs the function of alpha-adrenergic (but not vasopressin) receptors, thus diminishing the response to catecholamines. Although there is yet no clear cut mortality benefit, vasopressin is now recommended as a second-line agent in septic shock for its catecholamine-sparing effect and as an alternative to epinephrine in cardiopulmonary resuscitation. It has also demonstrated efficacy in ameliorating vasoplegia after cardiopulmonary bypass as well as perioperative hypotension in patients on renin-angiotensin system antagionists preoperatively. In summary, accumulating clinical experience and formal studies indicate that vasopressin has a role in restoring vascular tone in refractory vasodilatory shock states with minimal adverse effects provided that euvolemia is assured.
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PMID:Recent advances in perioperative anesthetic management update on the role of vasopressin and its effects on outcomes. 2276 70