Minal Patel

Waist circumference and sleep disordered breathing.

Objectives/Hypothesis: To explore how the different metrics of obesity, specifically body mass index (BMI), Mallampati, neck circumference, waist circumference, and waist‐hip ratio, correlate with metrics of sleep disordered breathing (SDB), specifically the apnea/hypopnea index (AHI), and which is/are the most likely to predict and correlate with SDB.

Computed tomography imaging of patients with obstructive sleep apnea

Objectives/Hypothesis: This study used computed tomography (CT) to identify anatomic features of the awake upper respiratory tract (URT) that correlate with severity of obstructive sleep apnea (OSA).

Proenkephalin predicts acute kidney injury in cardiac surgery patients.

AIMS Acute kidney injury (AKI) occurs in up to 40% of patients undergoing cardiac surgery. Proenkephalin A 119-159 (pro-ENK) is a novel, stable surrogate biomarker for enkephalins, endogenous opioids involved in various physiological processes, including neurohormonal stress. MATERIAL AND METHODS 92 patients undergoing cardiac surgery at the Veterans Affairs San Diego Healthcare System had a post-hoc analysis performed to determine the ability of pro-ENK to predict AKI as well as to compare it against other risk factors for development of AKI. RESULTS Of 92 patients, 20 patients developed AKI post-operatively. Pro-ENK levels were significantly elevated in patients who develop AKI. Log pro-ENK value pre-operatively has an odds ratio of 23.8 (p = 0.011, 95% CI = 2 - 270) in its association with AKI. Pro-ENK performs similarly to baseline creatinine in its ability to predict post-operative AKI. Importantly, pro-ENK has a strong positive correlation with creatinine (r = 0.806). Additionally, changes in pro-ENK level, from pre-operatively to 12 hours post-operatively have greatest area under curve by ROC analysis for AKI after post-operative day 1. CONCLUSION Pro-ENK is associated with prediction of AKI in patients undergoing cardiac surgery. Pro-ENK likely has decreased clearance in the setting of AKI. However, future studies analyzing this novel biomarker should be considered to further elucidate its clinical utility and to better understand mechanisms of renal injury.

Prevalence of Snoring in College Students

Snoring in college students may be the earliest presentation of adult sleep-disordered breathing, yet the literature contains few studies that demonstrate its effects on learning or whether early diagnosis leads to interruption of disease progression or prevention of comorbidities. Objective and Participants: The authors conducted this study in January-April 2004 to assess the prevalence of snoring in college students (N = 2,200). Methods: They developed a questionnaire on sleep behaviors and distributed it to 18- to 25-year-old undergraduates at a California university. Results: Almost one-third (30%) of participants reported snoring. The prevalence of snoring was higher among men than women (42% and 25%, respectively). The prevalence of self-reported snoring was highest in Asian students (37%). Conclusions: Snoring is highly prevalent in college students; prevalence is higher in men than women, correlates with body mass index, and varies by ethnicity.