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Persisting trend in the breach of medical neutrality: a wake-up call to the international community 28588964 2018 11 13 2059-7908 1 3 2016 BMJ global health BMJ Glob Health Persisting trend in the breach of medical neutrality: a wake-up call to the international community. e000109 10.1136/bmjgh-2016-000109 Bhuyan Soumitra S SS Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Memphis, Tennessee, USA. Ebuenyi Ikenna I King's College London
of obstructivesleepapnoeas/hypopnoeas and periodic leg movements, but sleep-disturbed, non-PTSD military had more EEG CAP sleep instability. Rank order determinants for the diagnosis of PTSD comprise paranoid thinking, onset to REM sleep, combat history and somatic symptoms. Decision-tree analysis showed that a specific military event (combat), delayed onset to REM sleep, paranoid thinking and medically unexplainable somatic pain and fatigue characterise chronic PTSD. More PTSD veterans reported domestic (...) Disturbed EEG sleep, paranoid cognition and somatic symptoms identify veterans with post-traumatic stress disorder Chronic post-traumatic stress disorder (PTSD) behavioural symptoms and medically unexplainable somatic symptoms are reported to occur following the stressful experience of military combatants in war zones.To determine the contribution of disordered EEG sleep physiology in those military combatants who have unexplainable physical symptoms and PTSD behavioural difficulties following
The Effect of Treatment of ObstructiveSleepApnea on Glycemic Control in Type 2 Diabetes There is uncertainty about the effects of treating obstructivesleepapnea on glycemic control in patients with type 2 diabetes.To determine whether treatment of obstructivesleepapnea in patients with type 2 diabetes improves glycemic control.In this trial, we randomized patients with type 2 diabetes and no previous diagnosis of obstructivesleepapnea, with a glycated hemoglobin level of 6.5-8.5 (...) improvements in vitality, mental health, and mental component summary scores in the positive airway pressure therapy group.This trial showed no effect of positive airway pressure therapy on glycemic control in patients with relatively well-controlled type 2 diabetes and obstructivesleepapnea. Clinical trial registered with www.clinicaltrials.gov (NCT00509223).
Lateral Cephalometric Measurements Aid in Diagnosing ObstructiveSleepApnea (OSA) UTCAT3104, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Lateral Cephalometric Measurements Aid in Diagnosing ObstructiveSleepApnea (OSA) Clinical Question In adult and adolescent patients, will lateral cephalometric measurements compared to polysomnography provide enough information for OSA diagnosis? Clinical Bottom Line Lateral
Remotely Controlled Mandibular Positioner (RCMP) Device Predicts Treatment Outcome and Effective Target Protrusive Position (ETPP) for ObstructiveSleepApnea (OSA) Treatment with an Oral Appliance UTCAT3106, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Remotely Controlled Mandibular Positioner (RCMP) Device Predicts Treatment Outcome and Effective Target Protrusive Position (ETPP) for ObstructiveSleepApnea (OSA (...) ) Treatment with an Oral Appliance Clinical Question Do remotely controlled mandibular advancement (RCMA) devices predict effective target protrusive position (ETPP) for oral appliances (OA) used to treat obstructivesleepapnea (OSA)? Clinical Bottom Line RCMP devices, such as the MATRx, can be a useful predictor in dental practice for prescribing the appropriate amount of mandibular advancement necessary for treatment of OSA with an OA. The device reduces chair time needed to titrate devices
Effect of Positive Airway Pressure on Cardiovascular Outcomes in Coronary Artery Disease Patients with Nonsleepy ObstructiveSleepApnea. The RICCADSA Randomized Controlled Trial Obstructivesleepapnea (OSA) is common in patients with coronary artery disease (CAD), many of whom do not report daytime sleepiness. First-line treatment for symptomatic OSA is continuous positive airway pressure (CPAP), but its value in patients without daytime sleepiness is uncertain.To determine the effects (...) of CPAP on long-term adverse cardiovascular outcome risk in patients with CAD with nonsleepy OSA.This single-center, prospective, randomized, controlled, open-label, blinded evaluation trial was conducted between December 2005 and November 2010. Consecutive patients with newly revascularized CAD and OSA (apnea-hypopnea index ≥15/h) without daytime sleepiness (Epworth Sleepiness Scale score <10) were randomized to auto-titrating CPAP (n = 122) or no positive airway pressure (n = 122).The primary
findings during follow-up, heart rate was reduced in children who had resolution of obstructivesleepapnoeasyndrome, while no differences in their respiratory rate or respiratory sinus arrhythmia were observed. Adenotonsillectomy for obstructivesleepapnoea increases baseline respiratory rate during sleep. Normalisation of apnoea-hypopnoea index, spontaneously or via surgery, lowers heart rate. Considering the small average effect size, the clinical significance is uncertain. (...) The effect of adenotonsillectomy for childhood sleepapnoea on cardiorespiratory control. The efficacy of adenotonsillectomy for relieving obstructivesleepapnoea symptoms in children has been firmly established, but its precise effects on cardiorespiratory control are poorly understood. In 375 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either adenotonsillectomy (n=194) or a strategy of watching waiting (n=181), respiratory rate, respiratory sinus
Oral appliances and functional orthopaedic appliances for obstructivesleepapnoea in children. Apnoea is a breathingdisorder marked by the absence of airflow at the nose or mouth. In children, risk factors include adenotonsillar hypertrophy, obesity, neuromuscular disorders and craniofacial anomalies. The most common treatment for obstructivesleepapnoeasyndrome (OSAS) in childhood is adeno-tonsillectomy. This approach is limited by its surgical risks, mostly in children with comorbidities (...) children and comparing an oral appliance to no treatment, was suitable for inclusion in the review. The trial assessed apnoea-hypopnoea, daytime symptoms (sleepiness, irritability, tiredness, school problems, morning headache, thirstiness in the morning, oral breathing and nasal stuffiness) and night-time symptoms (habitual snoring, restless sleep and nightmares measured by questionnaire). Results were inconsistent across outcomes measures and time points. The evidence was considered very low
sleepapnea. Vienna: Ludwig Boltzmann Institut fuer Health Technology Assessment (LBIHTA). Decision Support Document No. 100. 2016 Project page URL Final publication URL Additional data URL Indexing Status Subject indexing assigned by CRD MeSH Humans; Respiratory System; SleepApneaSyndromes Language Published English Country of organisation Austria English summary An English language summary is available. Address for correspondence Ludwig Boltzmann Institute fuer Health Technology Assessment (LBI (...) Upper airway stimulation for moderate-to-severe sleepapnea Upper airway stimulation for moderate-to-severe sleepapnea Upper airway stimulation for moderate-to-severe sleepapnea Schiller-Frühwirth I, Kisser A Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Schiller-Frühwirth I, Kisser A. Upper airway stimulation for moderate-to-severe
Is there an association between altered baroreceptor sensitivity and obstructivesleepapnoea in the healthy elderly? Obstructivesleepapnoea (OSA) is associated with a rise in cardiovascular risk in which increased sympathetic activity and depressed baroreceptor reflex sensitivity (BRS) have been proposed. We examined this association in a sample of healthy elderly subjects with unrecognised OSA. 801 healthy elderly (aged ≥65 years) subjects undergoing clinical, respiratory polygraphy (...) and vascular assessment were examined. According to the apnoea-hypopnoea index (AHI), the subjects were stratified into no OSA, mild-moderate OSA and severe OSA cases. OSA was present in 62% of the sample, 62% being mild-moderate and 38% severe. No differences were found for BRS value according to sex and OSA severity. 54% of the group had normal BRS value, 36% mild impairment and 10% severe dysfunction. BRS was negatively associated with body mass index (p=0.006), 24-h systolic (p=0.001) and diastolic
NHLBI NIH HHS United States R01 HL114024 HL NHLBI NIH HHS United States R01 HL114676 HL NHLBI NIH HHS United States Editorial Research Support, N.I.H., Extramural Comment 2016 09 12 United States Hypertension 7906255 0194-911X IM Hypertension. 2016 Nov;68(5):1264-1270 27620392 Disorders of Excessive Somnolence Humans Hypertension SleepApneaSyndromesSleepApnea, Obstructive 2016 9 14 6 0 2018 1 18 6 0 2016 9 14 6 0 ppublish 27620397 PMC5063701 HYPERTENSIONAHA.116.07073 10.1161/HYPERTENSIONAHA (...) Somnolence â€“ The Silent Partner in the SleepApnea-Hypertension Relationship 27620397 2018 01 16 2018 12 02 1524-4563 68 5 2016 11 Hypertension (Dallas, Tex. : 1979) Hypertension Somnolence: The Silent Partner in the SleepApnea-Hypertension Relationship. 1100-1102 Covassin Naima N From the Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN. Somers Virend K VK From the Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN. email@example.com. eng R01 HL065176 HL
Transvenous neurostimulation for central sleepapnoea: a randomised controlled trial. Central sleepapnoea is a serious breathingdisorder associated with poor outcomes. The remedé system (Respicardia Inc, Minnetonka, MN, USA) is an implantable device which transvenously stimulates a nerve causing diaphragmatic contraction similar to normal breathing. We evaluated the safety and effectiveness of unilateral neurostimulation in patients with central sleep apnoea.We recruited patients from 31 (...) hospital-based centres in Germany, Poland, and the USA in this prospective, multicentre, randomised trial. Participants had to have been medically stable for at least 30 days and have received appropriate guideline recommended therapy, be aged at least 18 years, be expected to tolerate study procedures, and willing and able to comply with study requirements. Eligible patients with an apnoea-hypopnoea index (AHI) of at least 20 events per h, tested by a polysomnography, underwent device implantation
2016LancetControlled trial quality: predicted high
Cognitive Behavioral Therapy for Insomnia in Older Veterans Using Nonclinician Sleep Coaches: Randomized Controlled Trial To test a new cognitive behavioral therapy for insomnia (CBT-I) program designed for use by nonclinicians.Randomized controlled trial.Department of Veterans Affairs healthcare system.Community-dwelling veterans aged 60 and older who met diagnostic criteria for insomnia of 3 months duration or longer (N = 159).Nonclinician "sleep coaches" delivered a five-session manual-based (...) CBT-I program including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy (individually or in small groups), with weekly telephone behavioral sleep medicine supervision. Controls received five sessions of general sleep education.Primary outcomes, including self-reported (7-day sleep diary) sleep onset latency (SOL-D), wake after sleep onset (WASO-D), total wake time (TWT-D), and sleep efficiency (SE-D); Pittsburgh Sleep Quality Index (PSQI); and objective sleep efficiency
obstructivesleepapnea and minimal sleepiness. In the CPAP group, the mean duration of adherence to CPAP therapy was 3.3 hours per night, and the mean apnea-hypopnea index (the number of apnea or hypopnea events per hour of recording) decreased from 29.0 events per hour at baseline to 3.7 events per hour during follow-up. After a mean follow-up of 3.7 years, a primary end-point event had occurred in 229 participants in the CPAP group (17.0%) and in 207 participants in the usual-care group (15.4%) (hazard (...) CPAP for Prevention of Cardiovascular Events in ObstructiveSleepApnea. Obstructivesleepapnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain.After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructivesleepapnea and coronary
A mobile diabetes management and educational system for type-2 diabetics in Saudi Arabia (SAED) Diabetes is a chronic disease, with high prevalence across many nations, which is characterized by elevated level of blood glucose and risk of acute and chronic complication. The Kingdom of Saudi Arabia (KSA) has one of the highest levels of diabetes prevalence globally. It is well-known that the treatment of diabetes is complex process and requires both lifestyle change and clear pharmacologic (...) the effectiveness of this approach in the in Saudi patients. This study investigates the impact of using mobile health technologies for the self-management of diabetes in Saudi Arabia.In this study, an intelligent mobile diabetes management system (SAED), tailored for T2D patients in KSA was developed. A pilot study of the SAED system was conducted in Saudi Arabia with 20 diabetic patients for 6 months duration. The patients were randomly categorized into a control group who did not use the SAED system
A Retrospective Evaluation of the Frequency of Impulsive Compulsive Behaviors in Parkinson's Disease Patients Treated with Continuous Waking Day Apomorphine Pumps Impulsive compulsive behaviors (ICBs) can have a deleterious impact on the lives of patients with PD with orally active dopamine agonist treatment recognized as the greatest risk factor. However, the relationship between subcutaneous administration of the dopamine agonist, apomorphine, and impulsive compulsive behaviors is unknown.We (...) conducted a retrospective analysis of 28 advanced PD patients treated with subcutaneous waking day apomorphine ambulatory minipumps at the National Hospital for Neurology and Neurosurgery (London, UK).Twelve of the patients had experienced impulsive compulsive behaviors before starting apomorphine. Reduction of oral dopamine agonist dose before apomorphine had led to complete resolution in 6 cases with no recurrence on long-term apomorphine maintenance therapy. Six patients still had active impulsive
oxygen or positive airway pressure devices after diagnosis and treatment initiation. Tags OSA, OSAH, OSAHS, Apnea, Apneas, Apnoea, Apnoeas, Sleep, sleepdisorder, sleepdisorderedbreathing, sleepdisorders, CPAP, BIPAP, BPAP, home oxygen, retest, reassessment, Continuous Positive Airway Pressure, Diagnosis, Intermittent Positive-Pressure Ventilation, Oxygen Inhalation Therapy, Positive-Pressure Respiration, Sleep, SleepApneaSyndromes, SleepDisorders, SleepDisorders, Intrinsic, Diagnostic Tests (...) Retesting of Patients with SleepDisorders: Cost-Effectiveness and Guidelines Retesting of Patients with SleepDisorders: Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Retesting of Patients with SleepDisorders: Cost-Effectiveness and Guidelines Retesting of Patients with SleepDisorders: Cost-Effectiveness and Guidelines Published on: August 10, 2016 Project Number: RB1013-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result
of children suspected of having sleepdisorderedbreathing (SDB) based on complaints, symptoms and signs. Systematic polysomnographic evaluation followed the clinical examination. A retrospective analysis of 150 successively seen children suspected of having SDB was performed, in addition to a comparison of the findings between children with and without short lingual frenula. Among the children, two groups of obstructivesleepapnoeasyndrome (OSAS) were found: 1) absence of adenotonsils enlargement (...) A frequent phenotype for paediatric sleepapnoea: short lingual frenulum A short lingual frenulum has been associated with difficulties in sucking, swallowing and speech. The oral dysfunction induced by a short lingual frenulum can lead to oral-facial dysmorphosis, which decreases the size of upper airway support. Such progressive change increases the risk of upper airway collapsibility during sleep. Clinical investigation of the oral cavity was conducted as a part of a clinical evaluation
have been investigated. Drugs also play an important role in the treatment of insomnia and new drugs have been introduced as options for treating patients with sleep initiation and sleep maintenance insomnia. In this review, we will discuss advances in the past six years in both non-pharmacologic and pharmacologic treatments for patients with chronic insomnia. We will also review the controversies surrounding some of the current drug treatments, as well as the role that technology and personal (...) Advances in the management of chronic insomnia. Chronic insomnia is a common condition that affects people worldwide and has negative effects on patients' health and wellbeing. The treatment of insomnia can be complex and time consuming for patients and providers. Although behavioral interventions are the first line therapy, there are barriers to access for these treatments. However, in recent years, alternative ways of providing these behavioral therapies that make them more widely available