جستجوی مقالات مرتبط با کلیدواژه « breath holding » در نشریات گروه « پزشکی »

We aimed to compare the effectiveness of Levetiracetam and Piracetam on the severity and frequency of spells in children with severe breath‑holding spells (BHS), i.e. bening, paroxysmal, and nonepileptic events that are common in early childhood.

This study is a randomized controlled clinical trial in 71 children from 6 months to 6 years of age with BHS. They were randomly assigned to the two study groups (Levetiracetam and Piracetam group). The frequency and severity of BHS and the response to treatment were recorded on monthly visits during our 3 months follow‑up.

There was a significant decline in the average number of frequency of spells before and after 3 months of treatment in each group in this study. Levetiracetam had significant effects on the average incidence of the loss of consciousness and seizure‑like movements in our study, while Piracetam had no significant effect on the loss of consciousness. Our result showed better response in the Levetiracetam group (88.9% partial or complete response after treatment) compared with the Piracetam group (77.1% partial or complete response after treatment); however, it was not significant. It seems that Levetiracetam had better effect than Piracetam in some aspects in the treatment of BHS.

Both Piracetam and Levetiracetam are safe and had significant effects on the frequency of BHS in our study, however, levetiracetam showed superior effects on the severity of BHS.

Background:

 Breath-holding spells (BHS) are brief periods when young children stop breathing for up to 1 minute and are widely recognized types of non-epileptic severe occasions in early stages of childhood. This study aimed to evaluate QTd and QTc changes in children with breath-holding spells compared with healthy children. 

Materials and Methods:

 This case-control study was conducted to evaluate ECG parameters' changes in 90 children with breath-holding spells compared to 90 healthy children, who were included as controls, without any breath - holding in pediatric neurology clinic of Ali Asghar Hospital of Medical Sciences, University of Zahedan (ZaUMS), Iran, in 2018. Electrocardiography measures were measured from 12-lead surface electrocardiograms of the patients and the control group. Data were analyzed using SPSS software version 18.0.

Results:
 In the study there were 46 (51.1%), and 35(38.9%) females in controls and Breath Holding patients, respectively. QT max (p=0.002), S in V1 (p <0.001), R in V5 (p <0.001), R in aVL (p <0.001), S in V3 (p=0.002), LV mass (p <0.001), QTd (p <0.001), QTc max (p <0.001), and QTcd (p <0.001) were different in patients compared to controls, significantly (p <0.05). QTd (p <0.001), QTc max (p=0.03), and QTcd (p <0.001) were higher in pallid attacks, significantly. QT max (p=0.039), and QT min (p=0.039) were different in boys and girls so that QT max and QT min were higher in girls. 

Conclusion:

 From the present study it can be concluded that QT, QTc, QTd and QTcd were higher in BHS. QTd, QTc max and QTcd were higher in pallid and QT max and QT min were higher in girls. However, in spite of what is reported in some studies, we suggest that obtaining ECG parameters is necessary to assess rhythm abnormality in children with BHS.

Breath holding spells (BHS) are paroxysmal events with apnea and postural tone with Electrocardiography (ECG) abnormality and epilepsy status reports. The study aimed to compare the ECG parameters’ in epilepsy and breath-holding children compared with healthy children. This case control study conducted on 270 participants consisted of 90 children in each group of epilepsy, breath-holding and control (healthy children) that were collected from pediatric clinics of Ali Asghar Hospital, Zahedan, Iran, for a period of one year starting in 2018. QT, QTd, QTc and QTcd were recorded after ECG for participants. Data were analyzed using SPSS 20.0 and the level of 0.05 was considered significant. From children, 45.6% were girls. Height and weight were the highest in controls and the lowest in breath-holding group, significantly (p <0.001). QT had the highest value in BHs, followed by epilepsy when dispersion QT, corrected QT had the highest values in epilepsy (448.62±56.14), and then BHS (433.00±32.76). QT abnormality in epilepsy, controls and BHs frequency of 16 (17.8%), 3(3.3%), and 7(7.8%), respectively (Chi-square=11.321, p=0.003). The abnormal individuals based on corrected QT frequency of 43(47.8%), 14(15.6%), and 26(28.9%) in epilepsy, controls and BHs groups and this trend was 44(48.9%), 9(10.00%), and 24 (26.70%) (Chi-square=33.611, p <0.001) for dispersion QTc, It was concluded that QTd, QTc and QTcd were higher in epilepticus children compared with breath-holding and controls. To maintain a good strategic treatment in patients with epilepsy, there is a need to assess alternations in ECG parameters, especially QT changes that lead to better comprehensive autonomic changes.

A single episode of breath holding (BH) is known to elevate the blood pressure and regular breathing exercise lowers the blood pressure. This prompted us to investigate how a series of BH epochs would affect the cardiovascular system.

To observe arterial blood pressure (ABP) and heart rate (HR) changes associated with a series of “BH epochs” following maximum inspiration and maximum expiration and find the underlying mechanisms for the change by auntonomic activity.

Thirty-five healthy young adults were instructed to hold their breath repetitively, for 5 minutes, in two patterns, one following maximum inspiration and other following maximum expiration. ABP and ECG (for Heart Rate Variability) were continuously recorded at rest and during both the maneuvers. Capillary blood gases (BG) were analysed at baseline and at the break point of the last epoch of BH.

ABP rose significantly at the breakpoint during both the maneuvers. No change in HR was observed.   There was significant fall in PO2 from 94.7(4.1) mmHg at baseline to 79.1(9.0) mmHg during inspiratory and 76.90(12.1) mmHg during expiratory BH. Similarly, SPO2 decreased from 96.3(1.9)% at baseline to 95.4(1.5)% and 94.5(2.7)% during inspiratory and expiratory BH respectively. Rise in PCO2 from 39.5(3.1)mmHg at baseline to 42.9(2.7)mmHg and 42.1(2.8)mmHg during inspiratory and expiratory BH respectively was observed. There was no significant correlation between blood gases and arterial blood pressure. Among HRV parameters, a significant decrease in SDNN, RMSSD, HFnu, total power and SD1/SD2 and significant increase in LFnu, LF/HF and SD2 was observed during both BH patterns.

Rhythmic BH patterns affect the cardiovascular system in similar way as a single episode of BH. Sympathetic over activity could be the postulated mechanism for the same.

The respiratory movements are one of the factors influencing standing balance. Although well-trained athletes have better postural performance compared to untrained men, it's not quite clear, if the former's upright posture would be more stable during different ventilation modes, maximal voluntary hyperventilation and inspiratory breath holding. There are no studies on this subject in the available literature. The aim of this study was to investigate an influence of maximal inspiratory breath-holding and maximal voluntary hyperventilation on the standing balance of athletes. Patients and We assessed the amplitude and the velocity of postural sway in the athletes (n = 38) and untrained subjects (n = 28) by the force platform. The frequency characteristics of the center of pressure (CP) oscillation's were also analyzed. The amplitude and the frequency of respiratory movements were estimated by the strain gauge. It was found that during quiet breath velocity and frequency of CP oscillations were lower in the athletes. Breath holding led to an increase of velocity and frequency of CP displacement in both groups, increase of these indices was more pronounced in the athletes. Maximal voluntary hyperventilation caused a significant increase of all stabilographic indices in both groups. Increase of frequency and amplitude of respiratory movements were mainly observed during hyperventilation in athletes and it caused an increase of the velocity of CP displacement. Changes of sway amplitude were the same in both groups. Breath holding led to activation of the postural control, which was more pronounced in the athletes. Hyperventilation caused an impairment of the postural stability. The athlete's postural system compensated the impact of hyperventilation more efficiently versus controls, but it was achieved at the expense of greater effort.