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Background: The Tucson Children's Assessment of Sleep Apnea study (TuCASA) was designed to investigate the prevalence and correlates of objectively measured sleep-related breathing disorder (SBD) in preadolescent Hispanic and white children. Objective: To describe the associations of SBD and elevation in resting blood pressure in the first 239 children enrolled in TuCASA. Design: Children between the ages of 6 and 11 years (45% girls and 51% Hispanic) from elementary schools of the Tucson Unified School District were enrolled in this prospective cohort study. Resting systolic and diastolic blood pressure, sleep symptoms, and parental smoking status were obtained during evening home visits, followed by overnight unattended home polysomnography. Results: The mean (SD) systolic and diastolic blood pressures were 98.4 (10.6) mm Hg and 62.0 (8.9) mm Hg, respectively. Fifteen children had hypertension. The mean (SD) respiratory disturbance index (2%), defined as the number of apneas and hypopneas per hour of sleep associated with a 2% oxygen desaturation, was 2.3 (3.8) events per hour. Factors independently associated with systolic and diastolic blood pressure elevation were obesity, sleep efficiency, and respiratory disturbance index (2%). Conclusions: In preadolescent children, elevated blood pressure is associated with SBD and obesity, as previously noted in adults. The control of obesity in childhood may be important to reduce the daytime consequences of SBD and to reduce the risks of life-long hypertension. [ABSTRACT FROM AUTHOR]

Study objectives: The Tucson Children's Assessment of Sleep Apnea (TuCASA) study is designed to investigate the prevalence and correlates of objectively measured sleep-disordered breathing (SDB) in preadolescent children. This article describes the parental report of sleep symptoms associated with SDB in Hispanic and white children. Design: A 13-question sleep habits screening questionnaire designed to assess the severity of sleep-related symptoms associated with SDB in children 4 to 11 years of age. Setting: Questionnaires were completed by the parents of children attending elementary school in the Tucson Unified School District, Tucson, AZ. Participants: There were 1,494 questionnaires returned, which comprised a sample of whites (38%), Hispanics (45%), and other races (17%). Of these questionnaires, 1,214 were returned for the children of white (45.8%; 556 children) or Hispanic (54.2%; 658 children) ethnicity only. The primary analysis was completed on these 613 boys (50.5%) and 601 girls (49.5%). Results: In the total sample of 1,494 children, parents were more likely to report excessive daytime sleepiness (EDS) in female children than in male children (p < .01), however, this association did not achieve significance in the sample of only white and Hispanic children (p < .07). Composite variables for EDS and witnessed apnea (WITAP) show that parents of Hispanic children were more likely to report EDS (p < .01) and WITAP (p < .007). Hispanic children were also more likely to have learning problems (LPs) [p < .03] and to snore frequently (SN) [p < .02] than were white children. There were no significant differences between boys and girls for SN or WITAP. Hispanic boys were more likely to have reports of EDS (p < .02) and LPs (p < .04) than white boys, however, there were no other significant differences in gender or ethnicity in reports of EDS or LPs for white or Hispanic boys and girls. Those children with frequent LPs were significantly more likely to have... [ABSTRACT FROM AUTHOR]

The overall goal of the AANAC study is to improvedetection of astigmatism and prevention of amblyopia in populations with ahigh prevalence of astigmatism. To meet this goal, the study will evaluatefour methods of screening for astigmatism in preschool children and will assessboth the short-term and long-term benefits of early correction of astigmatismin improving acuity and preventing amblyopia. This paper presents an overviewof the design and methodology of the AANAC study. Subjects are members of the Tohono O'Odham Nation, a Native American tribewith a high prevalence of astigmatism. Preschool-age children who attend HeadStart are screened with four tools: the Marco Nidek KM-500 autokeratometer,the MTI photoscreener, the Nikon Retinomax K-Plus autorefractor, and the LeaSymbols acuity chart. Sensitivity and specificity for detection of significantastigmatism, as measured by a technique that uses both cycloplegic retinoscopyand cycloplegic autorefraction, is determined for each of the four screeningtools. Presence of amblyopia is evaluated by measurement of best-correctedrecognition acuity and acuity for orthogonal gratings. Spectacles are provided to all 3-year-old children with ≥2.00 diopters(D) of astigmatism and all 4- and 5-year-old children with ≥1.50 D of astigmatism.Persistence of amblyopia after glasses wearing is evaluated by follow-up measurementof best-corrected recognition acuity and acuity for orthogonal gratings, conducted2-5 months after glasses are prescribed. Long-term effectiveness of earlyscreening and glasses prescription is evaluated through measurement of recognitionacuity in two groups of first-grade children: one group who participated inthe Head Start program before the intensive vision screening program was initiated,and a second group who participated in the study's Head Start vision screeningprogram. [ABSTRACT FROM AUTHOR]

Purpose: To assess longitudinal change in refractive, keratometric, and internal astigmatism in a sample of students from a population with a high prevalence of with-the-rule (WTR) astigmatism and to determine the optical origins of changes in refractive astigmatism., Methods: A retrospective analysis of longitudinal measurements of right eye refractive and keratometric astigmatism in Tohono O'odham Native American children was conducted. Changes in refractive and keratometric astigmatism per year were compared in a younger cohort (n = 1594, 3 to <11 years old) and an older cohort (n = 648, 11 to <19 years old). Data were analyzed in clinical notation (Cyl) and vector notation (J0, J45)., Results: On average, refractive astigmatism (means: 1.19 diopters [D] Cyl, +0.54 J0, +0.03 J45) resulted primarily from WTR corneal astigmatism (means: +0.85 J0, -0.02 J45) and against-the-rule (ATR) internal astigmatism (means: -0.31 J0, +0.05 J45). Mean longitudinal changes in astigmatism were statistically significant (younger cohort -0.02 D/y Cyl; older cohort +0.06 D/y Cyl). In the younger cohort, astigmatism decreased with age in low and moderate astigmats (<3.00 D) and increased with age in high astigmats (≥3.00 D). In the older cohort, astigmatism increased with age across all levels of astigmatism. Longitudinal changes in keratometric and internal astigmatism were negatively correlated in both cohorts., Conclusions: Cross-sectional data suggest the presence of a constant ATR contribution from internal astigmatism (0.60 D Cyl) that is close to the 0.50 D ATR constant reported by Javal and others. Highly astigmatic 3- to <11-year-old children and children older than age 11 years show a small (not clinically significant) increase in astigmatism with age. A negative correlation between changes in keratometric astigmatism and internal astigmatism suggests an active compensation that may contribute to the stability of astigmatism in Tohono O'odham children., (Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.)

Background: Cross-sectional reports have suggested that, among active smokers, previous exposure to parental smoking may increase susceptibility to development of chronic obstructive pulmonary disease. We assessed prospectively whether parental smoking enhances the effects of active smoking on early deficits of lung function in young adults., Methods: We used data from the prospective birth cohort, the Tucson Children's Respiratory Study. Maternal and paternal smoking was assessed via questionnaires completed by the parents at the time of the participant's birth. Active smoking by participants was assessed via personal questionnaires completed at ages 16 (YR16), 22 and 26 years. Four groups were generated based on the combination of parental and active smoking. Lung function parameters, including forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio, were assessed by spirometry before and after inhalation of 180 μg of albuterol at YR11, YR16, YR22 and YR26., Results: Complete data were available for 519 participants. Pre-bronchodilator FEV1/FVC values did not differ at YR11, YR16 or YR22 by parental or active smoking. However, at YR26 participants with exposure to parental and active smoking had pre-bronchodilator FEV1/FVC levels that were, on average, 2.8% (0.9% to 4.8%; p=0.003) lower than participants who were not exposed to parental or active smoking. In contrast, subjects who were only exposed to active smoking or only exposed to parental smoking did not differ from those who were not exposed to either. Between YR11 and YR26, participants with exposure to parental and active smoking had the steepest decline in sex, age and height adjusted residuals of FEV1/FVC, FEV1, forced expiratory flow between 25% and 75% of the FVC (FEF25-75) and FEF25-75/FVC (all p values between 0.03 and <0.001)., Conclusions: Parental and active smoking act synergistically to affect early lung function deficits in young adulthood.

Background: Recent studies have suggested that a restrictive pattern assessed with a single spirometric test is associated with increased morbidity and mortality. This study was undertaken to determine demographic, clinical and mortality profiles of subjects with either a recurrent or an inconsistent restrictive spirometric pattern assessed prospectively., Methods: Data from 2048 adult participants in the population-based TESAOD study were analysed. Normal (forced expiratory volume in 1 s/forced vital capacity (FEV(1)/FVC) ratio >or=70% and FVC >or=80% predicted), restrictive (FEV(1)/FVC >or=70% and FVC <80% predicted) and obstructive (FEV(1)/FVC <70%) patterns were assessed at the enrollment survey in 1972 and in 11 subsequent follow-up surveys up to 1996. Demographic and clinical characteristics were measured at enrollment and vital status and cause of death were assessed at January 2005., Results: Overall, 12% of participants had a restrictive spirometric pattern at enrollment. They were less likely to be male, to smoke and to have asthma, and had lower IgE levels than subjects in the obstructive group. Among subjects with a restrictive pattern at enrollment, 38% developed an obstructive pattern during follow-up. The remaining 62% had either a recurrent (restrictive pattern >or=50% of follow-up surveys) or inconsistent (restrictive pattern <50% of follow-up surveys) longitudinal restrictive pattern. The recurrent and inconsistent restrictive groups had increased mortality risk for all-cause (adjusted HR 1.7 (95% CI 1.3 to 2.3) and 1.9 (95% CI 1.4 to 2.6), respectively), heart disease (2.0 (95% CI 1.3 to 3.1) and 2.7 (95% CI 1.7 to 4.3)), stroke (2.4 (95% CI 0.9 to 6.3) and 3.5 (95% CI 1.2 to 9.8)) and diabetes (8.0 (95% CI 2.9 to 21.8) and 6.0 (95% CI 1.9 to 19.2))., Conclusions: The restrictive spirometric pattern identifies a pulmonary condition that is distinguishable from obstructive lung disease and is associated with an increased risk of life-threatening comorbidities.