Eduardo Dibur
Universidad de Buenos Aires, Facultad De Medicina, Graduate Student
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Research Interests: Psychology, Medicine, Humans, Obstructive sleep apnea, Female, and 13 moreMale, Clinical Sciences, Sleep breathing disorders, Polysomnography, Middle Aged, Observer Variation, Adult, Continuous Positive Airway Pressure, Surveys and Questionnaires, Guideline Adherence, Prescriptions, Epworth sleepiness scale, and Excessive Daytime Sleepiness
Research Interests: Psychology, Argentina, Medicine, Comorbidity, Prospective studies, and 15 moreHumans, Obstructive sleep apnea, Female, Male, Clinical Sciences, Polysomnography, Middle Aged, Adult, Oximetry, Apnea, Cross Sectional Studies, Receiver Operating Characteristic, Predictive value of tests, Continuous Positive Airway Pressure, and mass Screening
Research Interests:
Research Interests: Psychology, Medicine, Humans, Obstructive sleep apnea, Female, and 15 moreMale, ROC Curve, Clinical Sciences, Polysomnography, Aged, Middle Aged, Intraclass Correlation Coefficient, Observer Variation, Adult, Diagnostic Accuracy, Clinical Competence, Kappa, Receiver Operating Characteristic, Obstructive Sleep Apnea Syndrome, and Apnea hypopnea index
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The purpose of this study was to compare the performance of the automated detection versus the manual scoring from the ApneaLink™ device to diagnose obstructive sleep apnoea syndrome (OSAS).
Research Interests: Psychology, Medicine, Software, Humans, Female, and 15 moreMale, Sleep, Clinical Sciences, Sleep breathing disorders, Polysomnography, Aged, Middle Aged, Intraclass Correlation Coefficient, Concordance, Sleep-Disordered Breathing, Adult, Sensitivity and Specificity, roc analysis, Sleep Apnoea, and Respiratory disturbance index (RDI)
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Copyright © 2011 Carlos A. Nigro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is... more
Copyright © 2011 Carlos A. Nigro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To assess the diagnostic ability of WristOx 3100 using its three different recording settings in patients with suspected obstructive sleep apnea syndrome (OSAS).Methods. All participants (135) performed the oximetry (three oximetersWristOx 3100) and polysomnography (PSG) simultaneously in the sleep laboratory. Both recordings were interpreted blindly. Each oximeter was set to one of three different recording settings (memory capabilities 0.25, 0.5, and 1Hz). The software (nVision 5.1) calculated the adjusted O2 desaturation index-mean number of O2 desaturation per hour of analyzed recording ≥2, 3, and 4 % (ADI2, 3, and 4). The ADI2, 3, and 4 cutoff points that better discriminated between subjects with or without OSAS aro...
Background and Objective: The usefulness of pulse oximetry for the management of obstructive sleep apnea is controversial. The aim of this study was to assess the accuracy for indication of Continuous Positive Airway Pressure (CPAP)... more
Background and Objective: The usefulness of pulse oximetry for the management of obstructive sleep apnea is controversial. The aim of this study was to assess the accuracy for indication of Continuous Positive Airway Pressure (CPAP) treatment in patients with suspected obstructive sleep apnea (OSA) based on clinical and oximetry data as compared to polysomnography (PSG). Methods: This multicenter observational study involved seven sleep laboratories. Patients with suspicion of OSA who completed a standardized sleep questionnaire and a diagnostic PSG were enrolled. Eight observers logged on to a website independently and blindly. Seven observers only accessed the clinical data, curve and pulse oximetry results (Os-SO2-test method), while the eighth observer had full access to all indicators of PSG (O-PSG-reference method). Once observers assessed the information available on the website, they had to choose between three CPAP treatment options (yes/no/do not know) based on their knowl...
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It has been reported that the clinical expression of obstructive sleep apnea (OSA) may differ in women and men. The objective of this study was to evaluate the influence of gender on reported OSA-related symptoms in a large clinical... more
It has been reported that the clinical expression of obstructive sleep apnea (OSA) may differ in women and men. The objective of this study was to evaluate the influence of gender on reported OSA-related symptoms in a large clinical population of patients. The database from the sleep laboratory of a tertiary care center was examined. Adult patients who had undergone a diagnostic polysomnography and completed the Berlin questionnaire, a sleep questionnaire, and the Epworth sleepiness scale were selected. Multiple logistic regression analysis was performed to assess the relationship between OSA-associated symptoms and different potential explanatory variables. The study sample included 1084 patients, median age was 53 years, 46.5% (504) were women, 72.7% (788) had OSA (apnea/hypopnea index ≥ 5), and 31.2% were obese. After adjusting for age, body mass index, and apnea/hypopnea index, men were more likely to report snoring (OR 4.06, p < 0.001), habitual or loud snoring (OR 2.34, p &...
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A 66 year old patient turned up with a common variable immunodeficiency syndrome (IDCV) with frequent low tract respiratory infections and favorable evolution when using intravenous immunoglobulines. The possible physiopathologic... more
A 66 year old patient turned up with a common variable immunodeficiency syndrome (IDCV) with frequent low tract respiratory infections and favorable evolution when using intravenous immunoglobulines. The possible physiopathologic mechanisms in the development of this syndrome are analyzed. It is marked again the infrequent presentation of the IDCV in an old patient.
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... Laboratorio Pulmonar, Servicio de Neumonología , Hospital Alemán, Buenos Aires. Postal address : Dr. Carlos Nigro, Cachimayo 333, 1424 Buenos Aires, Argentina Fax: (54-11) 4827-7000 e-mail : cnigro@intramed.net. Abstract ...
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Resumen Se evalúan prospectivamente los factores predictores y nivel de cumplimiento del tratamiento con presión positiva continua nasal (CPAP) en un grupo de pacientes con síndrome de apnea del sueño. Valora efectos adversos y estado del... more
Resumen Se evalúan prospectivamente los factores predictores y nivel de cumplimiento del tratamiento con presión positiva continua nasal (CPAP) en un grupo de pacientes con síndrome de apnea del sueño. Valora efectos adversos y estado del equipamiento: ...
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Résumé/Abstract The exhaled markers of pulmonary disease are intra pulmonary air carried substances which can be measured by non-invasive ways with diverse devices. These markers are synthesized all around the human body and as being... more
Résumé/Abstract The exhaled markers of pulmonary disease are intra pulmonary air carried substances which can be measured by non-invasive ways with diverse devices. These markers are synthesized all around the human body and as being measured in the ...
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Sleep apnea syndrome (SAS) is a high prevalence condition in our population. Treatment results not only in improvement of symptoms (hypersomnolence, snoring) but also prevents cardiovascular and neurologic complications in severe disease.... more
Sleep apnea syndrome (SAS) is a high prevalence condition in our population. Treatment results not only in improvement of symptoms (hypersomnolence, snoring) but also prevents cardiovascular and neurologic complications in severe disease. The gold standard for assessment is polysomnography, but high cost and long waiting list prevent from making an early diagnosis of this syndrome. In our institution, patients with suspected SAS undergo nocturnal oximetry (NONIN 8600) or respiratory polygraphy (Autoset II Plus). Both methods show lower complexity and cost of implementation, proving effective for early diagnosis of this disorder, specially those moderate to severe. Studies comparing respiratory polygraphy with polysomnography showed a sensibility of 90-100% and specificity of 80-100%. We were able to reduce the indication of polysomnography to cases in which a diagnosis was not obtained with these methods, or another disease was suspected (narcolepsy, periodic limb movements, etc.). This resulted in a significant cost reduction for SAS evaluation.
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There are no data published about the agreement between the measurement of thoracic gas volume (TGV) during the airway resistance (TGV-Raw) and the conventional technique described by Dubois. The aim of this study was to establish the... more
There are no data published about the agreement between the measurement of thoracic gas volume (TGV) during the airway resistance (TGV-Raw) and the conventional technique described by Dubois. The aim of this study was to establish the agreement between both methods to measure TGV. We studied eighty consecutive subjects. Only sixty-six performed acceptable plethysmography maneuvers. The patients were measured with a constant volume plethysmograph (Medical Graphics 1085 DL). TGV was performed in the same patient with two techniques: 1) during the airway resistance (Raw) measurement (TGV-Raw) and 2) during quiet breathing at the end of expiration (TGV). The panting frequency was 1 to 2 Hz with both maneuvers. The differences between both techniques were expressed in percentage (deltaTGV %) and absolute values (deltaTGV). The TGV-Raw of the whole group was higher than TGV (3.69 +/- 1.08 l vs 3.28 +/- 1.05 l, p < 0.001). Similarly, the subgroups of patients had a greater TGV-Raw than ...
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Pulmonary abscess is still a condition with a high morbility and mortality, in spite of improvements in antimicrobial treatment, and is defined as a necrosis of pulmonary parenchyma produced by a microbial agent. The current mortality... more
Pulmonary abscess is still a condition with a high morbility and mortality, in spite of improvements in antimicrobial treatment, and is defined as a necrosis of pulmonary parenchyma produced by a microbial agent. The current mortality rate, according to different publications, is near 20%, and increases with comorbidity (diabetes, immunocompromised host, age). In the first decades of the xx century, treatment was limited to drainage, but the introduction of anesthetic techniques and better equipment allowed the incorporation of open thoracotomy and resection surgery (lobectomy or pneumonectomy according to the case). Since the beginning of the antibiotic era in the 1940s, the prognosis has improved and the use of surgical treatment decreased notoriously. Notwithstanding, at the present time around 10% of the cases are resolved surgically by percutaneous drainage or resection, because of abscess characteristics (size), general compromise of the patient (sepsis) or complications produ...
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Predictive factors and compliance level were evaluated in a group of patients with sleep apnea syndrome under CPAP treatment, assessing side effects and equipment condition: silicone interface (SI), mask-conectors (M-C), air tube (AT) and... more
Predictive factors and compliance level were evaluated in a group of patients with sleep apnea syndrome under CPAP treatment, assessing side effects and equipment condition: silicone interface (SI), mask-conectors (M-C), air tube (AT) and head strap (HS). Patients with >3mo treatment were included, clock counter reading was registered at the beginning, 2 and 4 mo. Patients were considered compliant (C+) when usage was >4h/day and >5day/week. Of 46 patients (male 34; age 62 +/- 9years; BMI 33 +/- 7kg/m2; AHI 38 +/- 18/h; time of therapy 2.1 +/- 1.7years; CPAP 9 +/- 1.4 cmH2O), 34 had a clock counter and 24 (71%) were C+. Initial symptoms included: somnolence (65%), snoring (39%), bed-partner witnessed apneas (28%). Comparing C+ and C- we didn't find significant difference in age, BMI, CPAP pressure, length of therapy, AHI and pre-treatment Epworth classification. Referred vs. measured time of use in C+ and C- were 6.6 +/- 1 vs. 6.1 +/- 1 h/d (p=0.02) and 5.6 +/- 1 vs. 2....
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Base de dados : LILACS. Pesquisa : 127521 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos... more
Base de dados : LILACS. Pesquisa : 127521 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 127521. ...
There are no data published about the agreement between the measurement of thoracic gas volume (TGV) during the airway resistance (TGV-Raw) and the conventional technique described by Dubois. The aim of this study was to establish the... more
There are no data published about the agreement between the measurement of thoracic gas volume (TGV) during the airway resistance (TGV-Raw) and the conventional technique described by Dubois. The aim of this study was to establish the agreement between both methods to measure TGV. We studied eighty consecutive subjects. Only sixty-six performed acceptable plethysmography maneuvers. The patients were measured with a constant volume plethysmograph (Medical Graphics 1085 DL). TGV was performed in the same patient with two techniques: 1) during the airway resistance (Raw) measurement (TGV-Raw) and 2) during quiet breathing at the end of expiration (TGV). The panting frequency was 1 to 2 Hz with both maneuvers. The differences between both techniques were expressed in percentage (deltaTGV %) and absolute values (deltaTGV). The TGV-Raw of the whole group was higher than TGV (3.69 +/- 1.08 l vs 3.28 +/- 1.05 l, p < 0.001). Similarly, the subgroups of patients had a greater TGV-Raw than ...
Research Interests:
Objective. To assess the diagnostic ability of WristOx 3100 using its three different recording settings in patients with suspected obstructive sleep apnea syndrome (OSAS). Methods. All participants (135) performed the oximetry (three... more
Objective. To assess the diagnostic ability of WristOx 3100 using its three different recording settings in patients with suspected obstructive sleep apnea syndrome (OSAS). Methods. All participants (135) performed the oximetry (three oximeters WristOx 3100) and polysomnography (PSG) simultaneously in the sleep laboratory. Both recordings were interpreted blindly. Each oximeter was set to one of three different recording settings (memory capabilities 0.25, 0.5, and 1 Hz). The software (nVision 5.1) calculated the adjusted O2 desaturation index-mean number of O2 desaturation per hour of analyzed recording ≥2, 3, and 4% (ADI2, 3, and 4). The ADI2, 3, and 4 cutoff points that better discriminated between subjects with or without OSAS arose from the receiver-operator characteristics (ROCs) curve analysis. OSAS was defined as a respiratory disturbance index (RDI) ≥ 5. Results. 101 patients were included (77 men, mean age 52, median RDI 22.6, median BMI 27.4 kg/m(2)). The area under the R...
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Objective. To evaluate the accuracy and reliability of the medical decision based on the results of the hand scoring from a two-channel recording device (ApneaLink) plus clinical data for the prescription of a CPAP assay in patients with... more
Objective. To evaluate the accuracy and reliability of the medical decision based on the results of the hand scoring from a two-channel recording device (ApneaLink) plus clinical data for the prescription of a CPAP assay in patients with suspected OSA. Methods. 39 subjects were assessed in the sleep laboratory with polysomnography and ApneaLink. The patients completed the Epworth sleepiness scale and a clinical history. Two blinded independent observers decided to prescribe CPAP according to the results of the PSG (gold standard, observer A), ApneaLink (alternative method, observer B), and the clinical parameters. Sensitivity and specificity of observer B on the indication of CPAP were calculated. The interobserver agreement for the indication of CPAP was assessed using kappa statistics. Results. 38 subjects were included (26 men, mean age 47.5, mean RDI 28.7, mean BMI 31.4 kg/m(2)). The prevalence of OSA was 84%. The sensitivity and specificity of observer B to initiate a CPAP trial were 90.6% and 100%, respectively. The interrater agreement for the prescription of CPAP was good (kappa: 0.75). Conclusion. This study has shown that the use of ApneaLink plus clinical data has made it possible to indicate CPAP reliably in most patients with high-clinical pretest for OSA.
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The purpose of this study was to compare the performance of the automated detection versus the manual scoring from the ApneaLink™ device to diagnose obstructive sleep apnoea syndrome (OSAS).
Research Interests:
OBJECTIVE: The aim of this study was to assess the accuracy of oximetry and the clinical parameters for the prescription of continuous positive airway pressure (CPAP) in patients with suspected obstructive sleep apnea syndrome (OSAS).... more
OBJECTIVE: The aim of this study was to assess the accuracy of oximetry and the clinical parameters for the prescription of continuous positive airway pressure (CPAP) in patients with suspected obstructive sleep apnea syndrome (OSAS). METHODS: All participants (135) performed oximetry (WristOx 3100™) and polysomnography (PSG) simultaneously in the sleep laboratory. The patients completed the Epworth sleepiness scale, the Berlin questionnaire, and a clinical history. Two blind independent observers decided to prescribe CPAP according to the results of the PSG (gold standard, observer A), oximetry (alternative method, observer B), and the clinical parameters. The accuracy of observer B on the indication of CPAP, using different cutoff points of the adjusted desaturation index (ADI3 and ADI4), was evaluated by the area under the receiver operating characteristics curve (AUC-ROC). The interobserver agreement for the indication of CPAP was assessed using kappa statistics. RESULTS: One hu...
Research Interests: Psychology, Psychometrics, Argentina, Cross-Cultural Comparison, Humans, and 15 moreObstructive sleep apnea, Female, Male, ROC Curve, Clinical Sciences, Sleep breathing disorders, Polysomnography, Middle Aged, Questionnaires, Observer Variation, Cost Benefit Analysis, Reproducibility of Results, Oximetry, Predictive value of tests, and Continuous Positive Airway Pressure
... Laboratorio Pulmonar, Servicio de Neumonología , Hospital Alemán, Buenos Aires. Postal address : Dr. Carlos Nigro, Cachimayo 333, 1424 Buenos Aires, Argentina Fax: (54-11) 4827-7000 e-mail : cnigro@intramed.net. Abstract ...