Wadhwa H, Gradinaru C, Gates GJ, Badr MS, Mateika JH. Impact of intermittent hypoxia on long-term facilitation of minute ventilation and heart rate variability in men and women: do sex differences exist? J Appl Physiol 104: 1625-1633, 2008. First published April 10, 2008 doi:10.1152/japplphysiol.01273.2007.-Following exposure to intermittent hypoxia, respiratory motor activity and sympathetic nervous system activity may persist above baseline levels for over an hour. The present investigation was designed to determine whether sustained increases in minute ventilation and sympathovagal (S/V) balance, in addition to sustained depression of parasympathetic nervous system activity (PNSA), were greater in men compared with women following exposure to intermittent hypoxia. Fifteen healthy men and women matched for age, race, and body mass index were exposed to eight 4-min episodes of hypoxia during sustained hypercapnia followed by a 15-min end-recovery period. The magnitude of the increase in minute ventilation during the endrecovery period, compared with baseline, was similar in men and women (men, 1.52 Ϯ 0.03; women, 1.57 Ϯ 0.02 fraction of baseline; P Ͻ 0.0001). In contrast, depression of PNSA and increases in S/V balance were evident during the end-recovery period, compared with baseline, in men (PNSA, 0.66 Ϯ 0.06 fraction of baseline, P Ͻ 0.0001; S/V balance, 2.8 Ϯ 0.7 fraction of baseline, P Ͻ 0.03) but not in women (PNSA, 1.27 Ϯ 0.19 fraction of baseline, P ϭ 0.3; S/V balance, 1.8 Ϯ 0.6 fraction of baseline, P ϭ 0.2). We conclude that a sustained increase in minute ventilation, which is indicative of longterm facilitation, is evident in both men and women following exposure to intermittent hypoxia and that this response is independent of sex. In contrast, sustained alterations in autonomic nervous system activity were evident in men but not in women. carbon dioxide; parasympathetic nervous system; sympathovagal balance LONG-TERM FACILITATION (LTF) of minute ventilation and/or its components (i.e., tidal volume and breathing frequency) may be elicited during and following short-term exposure to intermittent hypoxia (i.e., 20 -30 min) (38,40,44). LTF is characterized by a gradual increase in respiratory motor activity during successive periods of normoxia that separate hypoxic episodes and by respiratory activity that remains elevated for up to 90 min following exposure to intermittent hypoxia (40). LTF of minute ventilation or phrenic nerve activity (3,10,22,48,49) and genioglossus muscle or hypoglossal nerve activity (2, 18, 34, 37) have been observed in goats (49), dogs (10), cats (34), ducks (41), rats (3, 18), and mice (48). Similarly, LTF of minute ventilation and genioglossus muscle activity have been observed in healthy humans (21) during wakefulness when carbon dioxide levels are sustained slightly above baseline values during and following exposure to intermittent hypoxia. However, LTF is absent in healthy individuals (14,24,35,36,43) and individuals with obstructive sleep apnea (26) when carbon dioxid...

This extensive review shows that various UBAs have different complication rates, with certain UBAs being more prone to serious complications. Based on available publications, most UBAs have a good safety profile, with low complication rates. However, although the majority of UBA complications are transient and require no or noninvasive treatment, serious complications may require invasive intervention and treatment.

In a large cohort of men undergoing RP, those with PSMs at the prostatic apex had lower BCR, metastases, or PCa death compared with those with PSMs at other locations. When adjusted for pathologic stage and grade, however, PSMs were associated with BCR but not long-term oncologic outcomes. These data confirm that men with apex-only PSMs may not be ideal candidates for adjuvant therapy after RP.

PC downward stage migration continues in black men but not in white men. Discontinuation of PSA-based screening for PC could disproportionately affect black men.

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