Sleep apnea episodes represent a problem both for the patients and for the patient�s bed partners. The objective of this study was to record the comparative effects of two types of polymeric appliances in the therapy of some mild apnea symptoms (bruxism and snoring). The effect of therapy with the used appliances was pursued on 42 patients, divided in two groups. In the first group of 21 patients, we used a custom made appliance achieved by Erkoflex disks, and in the second group of 21 patients, the preformed SomnoFit�-Oscimed polymeric appliance. The survey lasted for a 12 month period, 1 month before the insertion in mouth of the appliances and 11 months therapy with polymeric appliances. The authors� questionnaire was completed daily by the patients and their bed partners, which noted the night comfort with inserted appliances in the mouth, the existence/absence of morning pain in the area of the masseter muscle, existence/absence of the morning fatigue, respectively the maintaining, diminishing and the absence of snoring and of nocturnal bruxism. The results of the study were favorable and proved that the nocturnal therapy of bruxism and of snoring, by using these two polymeric appliances were efficient. SomnoFit� appliance performed better in reducing bruxism and snoring, but custom made Erkoflex appliances presented a greater resistance in time.

Respiratory dysfunctions have been associated with Parkinson’s disease since the first observations of the disease in 1817. Patients with Parkinson’s disease frequently present respiratory disorders with obstructive ventilatory patterns and restrictive modifications, as well as limitations in respiratory volumes. In addition, respiratory impairments are observed due to the rigidity and kyphosis that Parkinson’s disease patients experience. Subsidiary pulmonary complications can also appear as side effects of medication. Silent aspiration can be the cause of pneumonia in Parkinson’s disease. Pulmonary dysfunction is one of the main factors that leads to the morbidity and mortality of patients with Parkinson’s disease. Here, we performed a narrative review of the literature and reviewed studies on dyspnea, lung volumes, respiratory muscle function, sleep breathing disorders, and subsidiary speech and swallow impairments related to pulmonary dysfunction in patients with Parkinson’s disease.

Adiponectin is an adipokine associated with the healthy obese phenotype. Adiponectin increases insulin sensitivity and has cardio and vascular protection actions. Studies related to adiponectin, a modulator of the innate and acquired immunity response, have suggested a role of this molecule in asthma. Studies based on various asthma animal models and on the key cells involved in the allergic response have provided important insights about this relation. Some of them indicated protection and others reversed the balance towards negative effects. Many of them described the cellular pathways activated by adiponectin, which are potentially beneficial for asthma prevention or for reduction in the risk of exacerbations. However, conclusive proofs about their efficiency still need to be provided. In this article, we will, briefly, present the general actions of adiponectin and the epidemiological studies supporting the relation with asthma. The main focus of the current review is on the mechanisms of adiponectin and the impact on the pathobiology of asthma. From this perspective, we will provide arguments for and against the positive influence of this molecule in asthma, also indicating the controversies and sketching out the potential directions of research to complete the picture.

Objectives: to evaluate factors influencing breastfeeding duration in an integrative model, considering both the organization of medical care and the perinatal education. Methods: We conducted a cross sectional study with data collected in a face to face interview of 1,008 mothers with children aged between 9 and 14 months The questionnaire focused on the main characteristics of a Mother-Baby Friendly Hospital initiative and the type of perinatal education received by pregnant women. Correlation and partial correlation tests, non-parametric tests and classification tests were applied. Data were processed in SPSS 12.0 software. Results: The positive effects of Mother Baby Friendly Hospitals Organization initiative organization were confirmed. However, the main differentiator for breastfeeding duration was the level of formal education of pregnant mothers and the active seeking of perinatal education (r = 0.22, p< 0.001). The perinatal counseling was correlated with breastfeeding duration only for the subgroup participating to structured, dedicated time slot apart from the regular medical consultation (r = 0.079; p = 0.014), independently of mother’s age, education, residence, time to first breastfeeding contact, type of birth delivery and rooming in. Our results support a broader approach to perinatal education than medical counseling during pregnancy to increase the voluntary participation of future mothers to the perinatal educational programs. Conclusion: As mothers’ motivation to maintain the optimum duration of breastfeeding is a determinant factor, an earlier and sustained educational process, before pregnancy and after birth delivery, is necessary in order to create a general favorability for exclusive breastfeeding.

Association between chronic obstructive pulmonary disease (COPD) and sleep apnea SA (overlap syndrome - OS) includes serious clinical manifestations and high mortality due to early respiratory failure, cardiovascular and metabolic complications from both diseases. 90 COPD patients (85.5% males) were strongly suspected to have concomitant SA after clinical examination and sleep questionnaires. We performed a cardio-ventilatory poligraphy during sleep. 82 patients (91.1%) from our OS group had obstructive sleep apnea (OSA), 8 patients (8.9%) mixed apnea and 20% had also OHS. 17 (18.8%) of OS were overweight and 66 (73.3%) obese. A third of them were in a very active group of age: 49 patients (54.4%) under 60 year-old and 11 patients (12.2%) between 61-65 year/old. We noted severe complication/comorbidities in our OS group: 63.3% hypertension, 43.3% core pulmonale, 31.1% arrhythmia, 32.2% cardiac failure, 38.8% dyslipidemia, 31.1% diabetes. The second night investigation permitted titration for the targeted pressures for CPAP therapy (Continuous Positive Airways Pressure). Treatment of OS patients had an interdisciplinary approach: CPAP in OSA, BPAP (Bi-level Positive Airways Pressure) in OHS, inhaled bronchodilators, treatment of cardiovascular comorbities, pulmonary rehabilitation, weight loss, tobacco/alcohol cessation counseling, and oxygen therapy in remaining hypoxemic patients. 51.2% of patients had not accessibility for long time CPAP (lack of coverage by the public health system). OS included clinical aspects of severity due to both COPD and OSA. Clinical investigation, sleep questionnaires, assessment of the diurnal somnolence and sleep cardiorespiratory poligraphy are recommended in all COPD patients. Obesity was the main risk factor for OSA in COPD patients.