Background Although the pathogenesis of central and obstructive events seems to be different, these two entities may somehow be related. We aimed to determine whether, as reported in previous research, the number of central sleep apnea (CSA) cases in a population of children with obstructive sleep apnea syndrome (OSAS) was greater than in patients without obstructive events, and if CSA worsens with increasing OSAS severity. As a second objective, we analyzed changes in central apnea index (CAI) after adenotonsillar surgery compared to changes when no surgery has been performed. Methods We retrospectively reviewed nocturnal polysomnography (PSG) data from children between 1 and 14 years of age with no neurological conditions or syndromes. Patients with CAI values greater than 5 per hour were diagnosed as having CSA. Improvements of greater than 50% in CAI on repeat PSG were considered to represent a real change. Results Data were available from 1279 PSG studies, resulting in 72 children with a CAI greater than 5 per hour (5.6%). Patients with OSAS showed a higher CAI (2.16) compared with those without OSAS (1.17), and this correlation increased with higher degrees of obstructive apnea severity. When adenotonsillectomy was performed due to OSAS, the CAI decreased by 1.37. The average decrease in PSG values was only 0.38 in cases where no surgery was performed. Conclusion The results of this study suggest that although CSA is perceived to be mostly associated with central nervous system ventilatory control, there may be a connection with airway obstruction and in children with CSA and OSA diagnosis adenotonsillectomy may improve both conditions.

Background: Diagnosis of immunoglobulin E (IgE)-mediated egg allergy is often based on both a compatible clinical history and either elevated IgE levels or a positive skin prick test. However, the gold standard is the oral food challenge (OFC). Previous studies have pointed to a correlation between IgE levels and OFC outcomes. Objective: This study aimed to determine the relationship between IgE levels and the outcome of OFC, seeking to establish cut-off OFC values that indicate a high likelihood of positive OFC results. Methods: A total of 198 patients who underwent OFC (and a serological IgE antibody assay within the three preceding months) were reviewed and divided by OFC type (i.e., baked, cooked, or raw egg). IgE-specific levels were assessed against the challenge outcome as well as cut-offs proposed by other authors. Results: Receiver-operating characteristic (ROC) curve analysis yielded a potentially useful ovomucoid IgE-specific cutoff used in OFC with cooked egg and several egg white and ovalbumin IgE-specific cut-offs for OFC with raw egg. We found no significant relationship between other specific IgE concentrations and the challenge threshold level with baked eggs. Conclusions: IgE-specific concentrations are useful as predictors of OFC outcome and should be considered when selecting patients challenge testing with boiled or raw egg. However, patients should undergo OFC with baked egg regardless of IgE levels.

No abstract

No abstract

No abstract