Background and aimsObstructive sleep apnea syndrome (OSA) affects the quality of life (QOL) due to the effects on the patient’s physical and mental function. QOL in sleep apnea may improve under continuous airway positive pressure (CPAP) therapy. The purpose of this study was to assess the OSA patients QOL before and after 3 months of CPAP therapy using Calgary Sleep Apnea Quality of Life Index (SAQLI).MethodsWe conducted a study in 79 sleep apnea subjects diagnosed using cardiorespiratory portable monitoring, under CPAP therapy, monitored in our Sleep Laboratory from January 2011 to December 2014. This is a cross-sectional study, achieved through quantitative research (SAQLI questionnaire application) about the perception of quality of life in patients with sleep apnea in the moment of diagnosis and 3 months after CPAP therapy.ResultsOf the 79 subjects, 59 (74.7%) were men and 20 (26.3%) women; mean age was 54.13 years (SD±10.87), the mean apnea-hypopnea index (AHI) was 52.46±20.83 events/h. In all 4 domains of SAQLI: daily functioning with mean pretreatment score 4.13±0.58 versus mean post treatment score 5.43±0.52; social interactions with mean pretreatment score 3.68±0.55 versus post treatment mean score 5.36±0.57; emotional functioning with mean pretreatment score 3.83±0.53 versus mean post treatment mean 5.38±0.56 and symptoms with mean pretreatment score 0.81±0.12 versus mean post treatment score 1.15±0.14, quality of life was improved after 3 months of therapy, with significantly statistical correlation (p=0.00). Also, an improvement was seen in mean total score of SAQLI after therapy as compared to baseline 3.11±0.32 versus 4.24±0.39 (p<0.01).ConclusionThe quality of life in sleep apnea was better after CPAP therapy than from baseline, according Calgary Sleep Apnea Quality of Life Index. The SAQLI is a useful toll to evaluate quality of life in sleep apnea, especially to highlight the benefits of CPAP therapy, even with short time monitoring.

Climate change is associated with atmospheric warming due to continuous increase in anthropogenic greenhouse gas concentration following the industrial revolution. The urban areas are more responsible for these changes. Europe for example has experienced a progressive warming +0.9 °C for . Climate change is unequivocal and represents a possible threat for patients affected by allergic conditions because it is related with an increased distribution and concentration of pollen. Higher temperature, wet condition (especially thunderstorms), wind speed, transition of cold fronts, environmental changes (allergenic pollens arrived in new areas), are mechanisms which involve changes of production, dispersion and allergen content of pollen. Prolonged and more severe pollen seasons are leading to worsened asthma and allergies. The interaction of pollen with urban air pollutants could also lead to an increased effect of aeroallergens on allergic patients, with a greater likelihood of the development of an allergic respiratory disease in sensitized subjects and exacerbation of symptomatic patients. Air pollution could induce damage to airways mucosa, thus promoting sensitization of the airways; also it could increase the expression of allergenic proteins (allergen contents of pollen produce by plants is increased by higher temperature and CO 2 enriched atmosphere). By increasing pollen concentration or making the airways susceptible to allergens, the climate change and air pollution have a negative impact on human health.Keywords: air pollutants, allergic diseases, asthma, climate change, pollen Climate change is unequivocal and represents a possible threat for patients affected by allergic conditions (Cecchi et al., 2010). Climate change, if present, is associated with atmospheric warming, so-called "global warming", as well as volatile weather patterns, leading to more severe winters at a given latitude (since cold air typically further north in latitude is pushed south) and hotter summer months, when the earth is closer to the sun (Petoukhov et al., 2010). Global average temperature has increased by more than 0.7 °C over the past 100 years. The Intergovernmental Panel on Climate Change (IPCC) projects that the average global surface air temperatures in the years 2090-2099 are likely to be between 1.8 and 4.0 °C warmer than those in 1980-1999, depending on which climate scenarios are input into the models. Europe for example has experienced a progressive warming +0.9 ° C for 1901-2005 (IPCC Climate change, 2007. In addition to global warming, some regions, including northern Europe, are projected to experience increased rainfall while others, including the Mediterranean, are expected to experience substantial droughts. Extreme weather events, such as heat waves, heavy precipitation and thunderstorms, are also predicted to increase over the next few decades (Cecchi et al., 2010).Because of the climate changes the temporal distribution and concentration of ambient pollen could be increased. The mechanism which is le...

Obstructive sleep apnea syndrome (OSAS) in children is characterized by recurrent events of partial or complete upper airway obstruction during sleep. Functional orthopedics has been used for patients who have OSAS and craniofacial anomalies because they change the mandible posture forwards, improving the respiratory function. In present, much attention is accorded to the relationship between respiratory function and facial morphology. This study combines the cephalometric measurements and cardio-respiratory polygraphy, in order to analyze the effects of a modified functional Twin Block polymeric appliance on respiratory variables in OSAS patients. The chief complaints of the included in study patients was the crooked teeth and the teasing about their smile. Pretreatment facial photographs show labial position of anterior teeth, gummy smile, a large overjet, incompetent lips and retrognathic mandible. The patients underwent overnight cardio-respiratory polygraphic tests in the same Sleep Laboratory, before and after mandibular advancement device treatment. At the end of the orthopedic treatment phase, the beneficial result of this study was the mandible correction, the maxilla restrained, over jet decreased, improving the facial profile and reintegration of the patient in the school social environment. The education of the parents and of the small patients to recognize the symptoms of sleep apnea and to apply the available effective treatments with a positive social impact on self-esteem and which recovers the facial aesthetics and functionality is a stringent necessity.

Background/Aims: The antiatherosclerotic enzyme paraoxonase (PON1) is affected by disease and lifestyle. We investigated the impact of diet in diabetic foot patients from 2 European countries. Methods: Dietary intake and serum PON1 activity, using as substrate paraoxon (paraoxonase) or phenylacetate (arylesterase), were assessed in patients from Bucharest (n = 40) and Antwerp (n = 30) and in 34 healthy controls. Results: The diabetic patients had lower paraoxonase and arylesterase activities than the controls. Arylesterase was lowest in the Bucharest patients, 116 ± 42 U/ml, versus 141 ± 43 and 184 ± 49 U/ml in the Antwerp patients and controls, respectively (p < 0.0005). The Bucharest patients had worse glycemic control, higher blood pressure, lower HDL cholesterol and a diet richer in cholesterol and poorer in monounsaturated fats and fish. In contrast, their median intake of vitamins E and C, folic acid and flavonoids was higher, 82 mg (range: 4–259 mg), versus 28 mg (range: 5–169 mg) aglycone units in Antwerp (p = 0.005). Flavonoid intake predicted arylesterase independently of HDL cholesterol, region and sex (β = 0.27; p = 0.03), and patients with high intake achieved normal levels of arylesterase (30.1 ± 10.0 U/µmol in the highest versus 21.0 ± 8.2 U/µmol total cholesterol in the lowest tertile; p = 0.02). Conclusion: A flavonoid-rich diet is positively associated with PON1 arylesterase activity in diabetic foot patients.

The main determinant of visfatin in T2D patients with DKD is inflammation; in normoalbuminuric patients, a positive link to adiposity and altered glycemic control and a trend towards a negative correlation to uOC was observable; the latter relationship was evident in patients without DKD.