Editorial
Type I diabetes: a new risk factor for obstructive sleep apnea
Read
1158
Timeswas read the article
514
Total PDF
644
Total HTML
Share statistics
array:24 [ "pii" => "S2173511515000573" "issn" => "21735115" "doi" => "10.1016/j.rppnen.2015.02.002" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "1045" "copyrightAnyo" => "2015" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "edi" "cita" => "Rev Port Pneumol. 2015;21:53-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1667 "formatos" => array:3 [ "EPUB" => 257 "HTML" => 777 "PDF" => 633 ] ] "itemSiguiente" => array:19 [ "pii" => "S217351151500024X" "issn" => "21735115" "doi" => "10.1016/j.rppnen.2014.07.005" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "1028" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2015;21:55-60" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2006 "formatos" => array:3 [ "EPUB" => 237 "HTML" => 1129 "PDF" => 640 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Obstructive sleep apnea and diabetes mellitus" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "55" "paginaFinal" => "60" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Graph 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 939 "Ancho" => 1621 "Tamanyo" => 66394 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Glycemic control in type 2 DM and apnea–hypopnea index.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jorge Vale, Paula Manuel, Eurico Oliveira, Ana Rita Oliveira, Eloisa Silva, Vitor Melo, Marta Sousa, João Carlos Alexandre, Isabel Gil, Amparo Sanchez, Edite Nascimento, António Simões Torres" "autores" => array:12 [ 0 => array:2 [ "nombre" => "Jorge" "apellidos" => "Vale" ] 1 => array:2 [ "nombre" => "Paula" "apellidos" => "Manuel" ] 2 => array:2 [ "nombre" => "Eurico" "apellidos" => "Oliveira" ] 3 => array:2 [ "nombre" => "Ana Rita" "apellidos" => "Oliveira" ] 4 => array:2 [ "nombre" => "Eloisa" "apellidos" => "Silva" ] 5 => array:2 [ "nombre" => "Vitor" "apellidos" => "Melo" ] 6 => array:2 [ "nombre" => "Marta" "apellidos" => "Sousa" ] 7 => array:2 [ "nombre" => "João Carlos" "apellidos" => "Alexandre" ] 8 => array:2 [ "nombre" => "Isabel" "apellidos" => "Gil" ] 9 => array:2 [ "nombre" => "Amparo" "apellidos" => "Sanchez" ] 10 => array:2 [ "nombre" => "Edite" "apellidos" => "Nascimento" ] 11 => array:2 [ "nombre" => "António Simões" "apellidos" => "Torres" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217351151500024X?idApp=UINPBA00004E" "url" => "/21735115/0000002100000002/v2_201503100122/S217351151500024X/v2_201503100122/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173511515000627" "issn" => "21735115" "doi" => "10.1016/j.rppnen.2015.02.005" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "1048" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "edi" "cita" => "Rev Port Pneumol. 2015;21:51-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1371 "formatos" => array:3 [ "EPUB" => 251 "HTML" => 653 "PDF" => 467 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "What we have done so far and what we can achieve (II)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "51" "paginaFinal" => "52" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1389 "Ancho" => 1489 "Tamanyo" => 81200 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evolution of visits and pages consulted in the PJP webpage over the past three years.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Morais" "autores" => array:1 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Morais" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511515000627?idApp=UINPBA00004E" "url" => "/21735115/0000002100000002/v2_201503100122/S2173511515000627/v2_201503100122/en/main.assets" ] "asociados" => array:2 [ 0 => array:19 [ "pii" => "S217351151500024X" "issn" => "21735115" "doi" => "10.1016/j.rppnen.2014.07.005" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "1028" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2015;21:55-60" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2006 "formatos" => array:3 [ "EPUB" => 237 "HTML" => 1129 "PDF" => 640 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Obstructive sleep apnea and diabetes mellitus" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "55" "paginaFinal" => "60" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Graph 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 939 "Ancho" => 1621 "Tamanyo" => 66394 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Glycemic control in type 2 DM and apnea–hypopnea index.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jorge Vale, Paula Manuel, Eurico Oliveira, Ana Rita Oliveira, Eloisa Silva, Vitor Melo, Marta Sousa, João Carlos Alexandre, Isabel Gil, Amparo Sanchez, Edite Nascimento, António Simões Torres" "autores" => array:12 [ 0 => array:2 [ "nombre" => "Jorge" "apellidos" => "Vale" ] 1 => array:2 [ "nombre" => "Paula" "apellidos" => "Manuel" ] 2 => array:2 [ "nombre" => "Eurico" "apellidos" => "Oliveira" ] 3 => array:2 [ "nombre" => "Ana Rita" "apellidos" => "Oliveira" ] 4 => array:2 [ "nombre" => "Eloisa" "apellidos" => "Silva" ] 5 => array:2 [ "nombre" => "Vitor" "apellidos" => "Melo" ] 6 => array:2 [ "nombre" => "Marta" "apellidos" => "Sousa" ] 7 => array:2 [ "nombre" => "João Carlos" "apellidos" => "Alexandre" ] 8 => array:2 [ "nombre" => "Isabel" "apellidos" => "Gil" ] 9 => array:2 [ "nombre" => "Amparo" "apellidos" => "Sanchez" ] 10 => array:2 [ "nombre" => "Edite" "apellidos" => "Nascimento" ] 11 => array:2 [ "nombre" => "António Simões" "apellidos" => "Torres" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217351151500024X?idApp=UINPBA00004E" "url" => "/21735115/0000002100000002/v2_201503100122/S217351151500024X/v2_201503100122/en/main.assets" ] 1 => array:16 [ "pii" => "X0873215915933033" "issn" => "08732159" "doi" => "10.1016/j.rppnen.2014.07.005" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2015;21:55-60" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5395 "formatos" => array:3 [ "EPUB" => 260 "HTML" => 3951 "PDF" => 1184 ] ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Obstructive sleep apnea and diabetes mellitus" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "55" "paginaFinal" => "60" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "320v21n02-90393303fig1.jpg" "Alto" => 939 "Ancho" => 1621 "Tamanyo" => 157359 ] ] "descripcion" => array:1 [ "en" => "Graph 1. Glycemic control in type 2 DM and apnea¿hypopnea index." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jorge Vale, Paula Manuel, Eurico Oliveira, Ana Rita Oliveira, Eloisa Silva, Vitor Melo, Marta Sousa, João Carlos Alexandre, Isabel Gil, Amparo Sanchez, Edite Nascimento, António Simões Torres" "autores" => array:12 [ 0 => array:2 [ "nombre" => "Jorge" "apellidos" => "Vale" ] 1 => array:2 [ "nombre" => "Paula" "apellidos" => "Manuel" ] 2 => array:2 [ "nombre" => "Eurico" "apellidos" => "Oliveira" ] 3 => array:2 [ "nombre" => "Ana Rita" "apellidos" => "Oliveira" ] 4 => array:2 [ "nombre" => "Eloisa" "apellidos" => "Silva" ] 5 => array:2 [ "nombre" => "Vitor" "apellidos" => "Melo" ] 6 => array:2 [ "nombre" => "Marta" "apellidos" => "Sousa" ] 7 => array:2 [ "nombre" => "João Carlos" "apellidos" => "Alexandre" ] 8 => array:2 [ "nombre" => "Isabel" "apellidos" => "Gil" ] 9 => array:2 [ "nombre" => "Amparo" "apellidos" => "Sanchez" ] 10 => array:2 [ "nombre" => "Edite" "apellidos" => "Nascimento" ] 11 => array:2 [ "nombre" => "António Simões" "apellidos" => "Torres" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0873215915933033?idApp=UINPBA00004E" "url" => "/08732159/0000002100000002/v0_201604141148/X0873215915933033/v0_201604141148/en/main.assets" ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Type I diabetes: a new risk factor for obstructive sleep apnea" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "53" "paginaFinal" => "54" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Geraldo Lorenzi-Filho, Luciano F. Drager" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Geraldo" "apellidos" => "Lorenzi-Filho" "email" => array:1 [ 0 => "geraldo.lorenzi@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Luciano F." "apellidos" => "Drager" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Pulmonary Division, Sleep Laboratory; Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hypertension Unit, Heart Institute (InCor), Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brasil" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Obstructive sleep apnea (OSA) is common in the general population but remains largely under recognized.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Risk factors for OSA include male gender, obesity and increasing age.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> There is growing evidence that OSA may cause several consequences including not only poor sleep quality and excessive daytime sleepiness but also contribute to detrimental cardiometabolic consequences.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> Therefore, recognizing populations that are at increased risk should help to detect OSA. In the present number of the Portuguese Journal of Pulmonology, Vale and colleagues provide novel evidence suggesting that type I diabetes is strongly associated with OSA.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The authors used portable monitoring to evaluate the presence of sleep disordered breathing among 46 adults with diabetes, divided in 23 with type I and 23 type II diabetes. Because OSA and type II diabetes share several common risk factors such as obesity, it is not surprising that OSA was extremely frequent in this population. This finding is therefore in line with several studies and point out to the low levels of OSA recognition among patients with type 2 diabetes.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Vale and colleagues took a step forward and showed a similar high frequency of OSA among adult patients with type I diabetes as compared with those with type II diabetes. Despite the fact that the patients with type I were not particularly obese (mean body mass index of 28<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>) and were in fact much younger than those with type II diabetes (mean age of 39 vs 62 years old, respectively) the frequency of OSA was similar among the two groups and ranged from 26 to 70% depending of the apnea hypopnea index criterion for OSA definition. The study is therefore in line with recent evidence pointing out that not only type II diabetes, but also type I diabetes is associated with a high prevalence of OSA.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> Another important message of the study of Vale and colleagues was that there was no association between OSA and complaints of excessive daytime sleepiness among patients with diabetes. In contrast to patients referred to sleep laboratories, among consecutive patients with cardiovascular diseases such as hypertension as well among those with metabolic syndrome and diabetes, the association between OSA and excessive daytime sleepiness is very poor or non- existent.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,8</span></a> This raises one important question: What is the real significance of an altered sleep study among patients with no overt symptoms? The current working hypothesis is that OSA is more than a common condition but when present contributes to poor cardiovascular and metabolic outcome.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The primary mechanisms that are deleterious to the cardiovascular and metabolic system includes increased negative intrathoracic pressure during the efforts for breath against an occluded airway, arousals from sleep and intermittent hypoxia. There is growing evidence that these primary events that occur during sleep trigger a cascade of detrimental effects, including increased sympathetic activity, oxidative stress, metabolic deregulation such as insulin resistance and lipid dysfunction, endothelial dysfunction and accelerated atherosclerosis.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Consistent with the hypothesis that OSA may contribute to poor glicemic control, Vale and colleagues found that the AHI was significantly lower and in the normal range among patients with type II diabetes and normal glycosylated hemoglobin (HbA1c) as compared to patients with type II diabetes and elevated HbA1C. The serum level of HbA1C is known to reflect average glycemia over the preceding 2–3 months and therefore one possible conclusion is that OSA contributed to poor glicemic control. The interpretation of such cross sectional data is, however, limited and the authors acknowledged that due to the relatively small sample they were under powered to correct for confounding variables. There is some evidence that OSA treatment promotes better glucose control in type 2 diabetes.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Future randomized studies are necessary in order to evaluate whether treatment of OSA contributes to a better control of type I diabetes. Another important aspect that the study of Vale and colleagues raises is the relationship between type I diabetes and sleep. It must be stressed that type I diabetes and glicemic control may affect circadian rhythms, sleep duration and quality of sleep.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Therefore the interaction of such factors may go far beyond OSA. One attractive hypothesis is that diabetes may cause subtle alterations in the upper airway function. Consistent with this hypothesis, diabetes was recently associated with decreased nasal mucociliary function.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Although not directly related to OSA pathogenesis, it raises the hypothesis that other functions such as upper airway neuro reflexes that are important to stabilize the upper airway during sleep are impaired among patients with long lasting type I diabetes. Recent studies showed that OSA was independently associated with macrovascular complications, retinopathy as well as cardiovascular autonomic neuropathy among patients with type I diabetes.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,12</span></a> Therefore, OSA could also be seen as a complication of diabetes. Independent of the exact mechanism linking type I diabetes to OSA, the study of Vale and colleagues contribute to the hypothesis that OSA should be actively searched not only among patients with type II diabetes but also among those with type I diabetes.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Tufik" 1 => "R. Santos-Silva" 2 => "J.A. Taddei" 3 => "L.R. Bittencourt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.sleep.2009.10.005" "Revista" => array:7 [ "tituloSerie" => "Sleep Med." "fecha" => "2010" "volumen" => "11" "numero" => "5" "paginaInicial" => "441" "paginaFinal" => "446" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20362502" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.R. Genta" 1 => "F. Schorr" 2 => "D.J. Eckert" 3 => "E. Gebrim" 4 => "F. Kayamori" 5 => "H.T. Moriya" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Upper airway collapsibility is associated with obesity and hyoid position Sleep." "fecha" => "2014" "volumen" => "37" "numero" => "10" "paginaInicial" => "1673" "paginaFinal" => "1678" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.F. Drager" 1 => "S.M. Togeiro" 2 => "V.Y. Polotsky" 3 => "G. Lorenzi-Filho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2013.05.045" "Revista" => array:7 [ "tituloSerie" => "J Am Coll Cardiol." "fecha" => "2013" "volumen" => "62" "numero" => "7" "paginaInicial" => "569" "paginaFinal" => "576" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23770180" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atherosclerosis. The incremental role of obstructive sleep apnoea on markers of atherosclerosis in patients with metabolic syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.F. Drager" 1 => "L.A. Bortolotto" 2 => "C. Maki-Nunes" 3 => "I.C. Trombetta" 4 => "M.J. Alves" 5 => "R.F. Fraga" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.atherosclerosis.2009.08.016" "Revista" => array:7 [ "tituloSerie" => "Atherosclerosis" "fecha" => "2010" "volumen" => "208" "numero" => "2" "paginaInicial" => "490" "paginaFinal" => "495" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19762024" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Vale J, Manuel P, Oliveira E, Oliveira AR, Silva E, Melo V, et al. Obstructive sleep apnea and diabetes mellitus. Rev Port Pneumol. <a href="http://dx.doi.org/10.1016/j.rppnen.2014.07.005">http://dx.doi.org/10.1016/j.rppnen.2014.07.005</a>" ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High prevalence of obstructive sleep apnoea syndrome in a Type 1 diabetic adult population: a pilot study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.L. Borel" 1 => "P.Y. Benhamou" 2 => "J.P. Baguet" 3 => "S. Halimi" 4 => "P. Levy" 5 => "J.M. Mallion" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1464-5491.2010.03096.x" "Revista" => array:7 [ "tituloSerie" => "Diabet Med" "fecha" => "2010" "volumen" => "27" "numero" => "11" "paginaInicial" => "1328" "paginaFinal" => "1329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20950392" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obstructive sleep apnoea in people with Type 1 diabetes: prevalence and association with micro- and macrovascular complications" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Manin" 1 => "A. Pons" 2 => "P. Baltzinger" 3 => "F. Moreau" 4 => "C. Iamandi" 5 => "J.M. Wilhelm" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/dme.12582" "Revista" => array:7 [ "tituloSerie" => "Diabet Med." "fecha" => "2015" "volumen" => "32" "numero" => "1" "paginaInicial" => "90" "paginaFinal" => "96" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25186832" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.F. Drager" 1 => "P.R. Genta" 2 => "R.P. Pedrosa" 3 => "F.B. Nerbass" 4 => "C.C. Gonzaga" 5 => "E.M. Krieger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjcard.2009.12.017" "Revista" => array:7 [ "tituloSerie" => "Am J Cardiol." "fecha" => "2010" "volumen" => "105" "numero" => "8" "paginaInicial" => "1135" "paginaFinal" => "1139" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20381666" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.R. Babu" 1 => "J. Herdegen" 2 => "L. Fogelfeld" 3 => "S. Shott" 4 => "T. Mazzone" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archinte.165.4.447" "Revista" => array:7 [ "tituloSerie" => "Arch Intern Med." "fecha" => "2005" "volumen" => "165" "numero" => "4" "paginaInicial" => "447" "paginaFinal" => "452" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15738376" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Type 1 Diabetes associated with sleep disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.T.U. Barone" 1 => "L. Menna-Barreto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Sleep Science" "fecha" => "2009" "volumen" => "2" "numero" => "2" "paginaInicial" => "96" "paginaFinal" => "98" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aging, diabetes, and hypertension are associated with decreased nasal mucociliary clearance" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. de Oliveira-Maul" 1 => "H.B. de Carvalho" 2 => "D. Miyuki Goto" 3 => "R. Mendonça Maia" 4 => "C. Fló" 5 => "V. Barnabé" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.12-1183" "Revista" => array:7 [ "tituloSerie" => "Chest." "fecha" => "2013" "volumen" => "143" "numero" => "4" "paginaInicial" => "1091" "paginaFinal" => "1097" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23100111" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Front Endocrinol (Lausanne). Cardiovascular autonomic neuropathy contributes to sleep apnea in young and lean type 1 diabetes mellituspatients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.C. Janovsky" 1 => "L.C. Rolim" 2 => "J.R. de Sá" 3 => "D. Poyares" 4 => "S. Tufik" 5 => "A.B. Silva" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fendo.2014.00119" "Revista" => array:5 [ "tituloSerie" => "Front Endocrinol (Lausanne)." "fecha" => "2014" "volumen" => "5" "paginaInicial" => "119" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25157241" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735115/0000002100000002/v2_201503100122/S2173511515000573/v2_201503100122/en/main.assets" "Apartado" => array:4 [ "identificador" => "9716" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorials" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735115/0000002100000002/v2_201503100122/S2173511515000573/v2_201503100122/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511515000573?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 6 | 16 |
| 2024 October | 38 | 31 | 69 |
| 2024 September | 46 | 21 | 67 |
| 2024 August | 49 | 32 | 81 |
| 2024 July | 68 | 27 | 95 |
| 2024 June | 51 | 30 | 81 |
| 2024 May | 31 | 33 | 64 |
| 2024 April | 33 | 29 | 62 |
| 2024 March | 26 | 26 | 52 |
| 2024 February | 36 | 23 | 59 |
| 2024 January | 26 | 25 | 51 |
| 2023 December | 18 | 25 | 43 |
| 2023 November | 44 | 27 | 71 |
| 2023 October | 45 | 53 | 98 |
| 2023 September | 15 | 34 | 49 |
| 2023 August | 20 | 16 | 36 |
| 2023 July | 18 | 26 | 44 |
| 2023 June | 19 | 16 | 35 |
| 2023 May | 32 | 25 | 57 |
| 2023 April | 19 | 9 | 28 |
Show all
