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https://www.readbyqxmd.com/read/29050058/-ambulant-anesthesia-limits-and-possibilities
#1
Harald Hofer, Frank Vescia
The number of operations carried out on an outpatient basis is increasing in Germany. This trend has been observed for years. The prerequisite is an infrastructure that is in line with guidelines. The competence of the anesthetist must not be restricted to that of a standard specialist anesthetist, but the physician should have experience in ambulatory anesthesia. Well-adjusted comorbidities of the patient are generally not a contraindication for an outpatient procedure. The heavily overweight patient can also be operated on an outpatient basis if he is compliant, comorbidities are well adjusted and intensive postoperative care is ensured...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29042870/update-of-minimally-invasive-surfactant-therapy
#2
REVIEW
Gyu-Hong Shim
To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death...
September 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29038950/firing-a-loaded-gun-during-sleep-in-an-elderly-man-with-a-perfect-storm-of-risk-factors-including-severe-obstructive-sleep-apnea
#3
Francesca Ingravallo, Carlos H Schenck, Ernesto D'Aloja, Monica Puligheddu
PURPOSE: We report a case of firing a loaded gun during sleep in a geriatric patient with undiagnosed major sleep disorders and multiple risk factors for sleep violence. Polysomnographic findings, diagnostic challenges, and forensic implications in this unprecedented geriatric case are discussed. METHODS: A 75-year-old employed man, married for 32 years, presented to a sleep center reporting to having fired a shot in his bedroom during sleep while his wife was away, without memory of hearing the gunshot...
October 16, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29038203/effect-of-continuous-positive-airway-pressure-weight-loss-or-continuous-positive-airway-pressure-plus-weight-loss-on-central-hemodynamics-and-arterial-stiffness
#4
Snigdha Jain, Indira Gurubhagavatula, Raymond Townsend, Samuel T Kuna, Karen Teff, Thomas A Wadden, Jesse Chittams, Alexandra L Hanlon, Greg Maislin, Hassam Saif, Preston Broderick, Zeshan Ahmad, Allan I Pack, Julio A Chirinos
Obesity and obstructive sleep apnea tend to coexist. Little is known about the effects of obstructive sleep apnea, obesity, or their treatment on central aortic pressures and large artery stiffness. We randomized 139 adults with obesity (body mass index >30 kg/m(2)) and moderate-to-severe obstructive sleep apnea to (1) continuous positive airway pressure (CPAP) therapy (n=45), (2) weight loss (WL) therapy (n=48), or (3) combined CPAP and WL (n=46) for 24 weeks. We assessed the effect of these interventions on central pressures and carotid-femoral pulse wave velocity (a measure of large artery stiffness), measured with arterial tonometry...
October 16, 2017: Hypertension
https://www.readbyqxmd.com/read/29036393/angiotensin-receptor-expression-and-vascular-endothelial-dysfunction-in-obstructive-sleep-apnea
#5
Rami N Khayat, Saradhadevi Varadharaj, Kyle Porter, Angela Sow, David Jarjoura, Mikhail A Gavrilin, Jay L Zweier
Background: Obstructive sleep apnea (OSA) is associated with vascular endothelial dysfunction (VED) in otherwise healthy patients. The role of renin-angiotensin system (RAS) in the OSA induced VED is not well understood. Methods: Recently diagnosed OSA patients with very low cardiovascular disease (CVD) risk (Framingham score <5%) were studied at diagnosis and after 12 weeks of verified continuous positive airway pressure (CPAP) therapy. Participants underwent biopsy of gluteal subcutaneous tissue at baseline and after CPAP...
September 27, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29035093/gastric-banding-surgery-versus-cpap-for-obstructive-sleep-apnea-a-randomized-controlled-trial
#6
Jessie P Bakker, Ali Tavakkoli, Michael Rueschman, Wei Wang, Robert Andrews, Atul Malhotra, Robert L Owens, Amit Anand, Katherine A Dudley, Sanjay R Patel
No abstract text is available yet for this article.
October 16, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29032875/ventilator-use-by-emergency-medical-services-during-911-calls-in-the-united-states
#7
Mazen El Sayed, Hani Tamim, Aurelie Mailhac, Mann N Clay
BACKGROUND: Emergency and transport ventilators use in the prehospital field is not well described. This study examines trends of ventilator use by EMS agencies during 911 calls in the United States and identifies factors associated with this use. METHODS: This retrospective study used four consecutive releases of the US National Emergency Medical Services Information System (NEMSIS) public research dataset (2011-2014) to describe scene EMS activations (911 calls) with and without reported ventilator use...
October 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29031750/the-urge-to-move-and-breathe-the-impact-of-obstructive-sleep-apnea-syndrome-treatment-in-patients-with-previously-diagnosed-clinically-significant-restless-legs-syndrome
#8
Cristiana Silva, Ana Rita Peralta, Carla Bentes
OBJECTIVE: The association between restless legs syndrome (RLS) and obstructive sleep apnea syndrome (OSAS) has seldom been reported. There is one study reporting improvement of RLS symptoms severity in patients naive of treatment after initiation of continuous positive airway pressure (CPAP) for OSAS. The aim of this study was to evaluate the impact of the OSAS treatment in patients with previously diagnosed, clinically significant RLS in a usual clinical setting. METHODS: This was a retrospective study of RLS patients from a sleep clinic with a concomitant or subsequent diagnosis of OSAS...
October 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29029237/cpap-does-not-reduce-inflammatory-biomarkers-in-patients-with-coronary-artery-disease-and-nonsleepy-obstructive-sleep-apnea-a-randomized-controlled-trial
#9
Erik Thunström, Helena Glantz, Tülay Yucel-Lindberg, Kristin Lindberg, Mustafa Saygin, Yüksel Peker
Objectives: Obstructive sleep apnea (OSA) and enhanced vascular inflammation coexist in patients with coronary artery disease (CAD). Continuous positive airway pressure (CPAP) is first-line treatment for OSA with daytime sleepiness. This analysis of data from the RICCADSA trial investigated the effects of CPAP on inflammatory markers in patients with CAD and nonsleepy OSA. Methods: This single-center, randomized, controlled, open-label trial enrolled consecutive revascularized patients with nonsleepy OSA (apnea-hypopnea index >15/h; Epworth Sleepiness Scale score <10)...
October 5, 2017: Sleep
https://www.readbyqxmd.com/read/29027869/acceptance-of-telemonitoring-among-patients-with-obstructive-sleep-apnea-syndrome-how-is-the-perceived-interest-by-and-for-patients
#10
Julie S Bros, Caroline Poulet, Nathalie Arnol, Chrystèle Deschaux, Marc Gandit, Marie Charavel
BACKGROUND: Obstructive sleep apnea syndrome, a chronic respiratory disease, requires regular adherence to Continuous Positive Airway Pressure (CPAP) therapy. Telemonitoring may be relevant to support adherence, but nonetheless this raises ethical issues around the intrusive nature of the daily life of patients Objective: To explore the acceptance of telemonitoring by patients and the impact of this on adherence. MATERIALS AND METHODS: A prospective and observational study has been performed with 160 patients who initiated their CPAP therapy...
October 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29024308/does-remote-monitoring-change-osa-management-and-cpap-adherence
#11
REVIEW
Jean L Pépin, Renaud Tamisier, Dennis Hwang, Suresh Mereddy, Sairam Parthasarathy
It is increasingly recognized that the high prevalence of obstructive sleep apnoea (OSA), and its associated cardio-metabolic morbidities make OSA a burden for society. Continuous positive airway pressure (CPAP), the gold standard treatment, needs to be used for more than 4 h/night to be effective, but suffers from relatively poor adherence. Furthermore, CPAP is likely to be more effective if combined with lifestyle changes. Thus, the remote telemonitoring (TM) of OSA patients in terms of CPAP use, signalling of device problems, following disease progression, detection of acute events and monitoring of daily physical activity is an attractive option...
November 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29019472/microbiological-monitoring-of-continuous-positive-airway-pressure-and-resuscitation-equipment-in-very-low-birth-weight-infants
#12
Torben Christian Winking, Jörg Wüllenweber, Frank Kipp, Esther Rieger-Fackeldey
BackgroundTo investigate the colonization of respiratory equipment and the rate of respiratory infections of very-low birth weight (VLBW) infants.MethodsThe prospective study includes 26 VLBW infants on continuous airway pressure (CPAP) from September until December 2012. Swabs from respiratory equipment and colonization/infections were evaluated.ResultsA total of 603 swabs was cultured with 298 isolates; 59% of cultures from CPAP equipment (n=337; 95% confidence interval (CI; 54;64)) and 19% from ambu bags (n=51; 95% CI (14;24)) were positive...
October 11, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29016785/obstructive-sleep-apnea-is-associated-with-increased-rotor-burden-in-patients-undergoing-focal-impulse-and-rotor-modification-guided-atrial-fibrillation-ablation
#13
Daniel J Friedman, Peter Liu, Adam S Barnett, Kristen Bova Campbell, Kevin P Jackson, Tristram D Bahnson, James P Daubert, Jonathan P Piccini
Aims: To assess whether obstructive sleep apnea (OSA) was associated with increased rotor burden among atrial fibrillation (AF) patients. Methods and results: We studied 33 consecutive patients who were scheduled for focal impulse and rotor modulation (FIRM) ablation at our institution to describe the mapping, ablation, and outcomes, among patients with and without OSA. Patients underwent biatrial FIRM mapping in AF with ablation of stable rotors in addition to conventional ablation lesion sets...
August 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28993211/global-cognitive-profile-and-different-components-of-reaction-times-in-obstructive-sleep-apnea-syndrome-effects-of-continuous-positive-airway-pressure-over-time
#14
Maria Devita, Andrea Zangrossi, Maurizio Marvisi, Paola Merlo, Maria Luisa Rusconi, Sara Mondini
Obstructive sleep apnea syndrome (OSAS) has been recurrently associated with cognitive and psychomotor impairments. However, the occurrence and possible reversibility of these deficits are still extremely controversial, also as a result of different methodologies adopted used by scholars. The aim of the present study was to compare over time the global cognitive profile of patients with OSAS undergoing the continuous positive airway pressure treatment (CPAP; N=23) with that of patients with OSAS who were not (N=10)...
October 6, 2017: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/28987230/controversies-in-obstructive-sleep-apnea-surgery
#15
REVIEW
Carolyn C Dicus Brookes, Scott B Boyd
Obstructive sleep apnea (OSA) is a common chronic disease characterized by repetitive pharyngeal collapse during sleep. OSA is associated with cardiovascular disease and increased mortality, among other issues. Continuous positive airway pressure (CPAP) is considered first line therapy for OSA, but is not always tolerated. Both non-surgical and surgical alternative management strategies are available for the CPAP intolerant patient. This article explores controversies surrounding airway evaluation, definition of successful treatment, and surgical management of the CPAP intolerant patient with moderate to severe OSA...
November 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28983863/therapeutic-efficacy-of-mandibular-advancement-devices-in-patients-with-severe-sleep-apnea-a-preliminary-report
#16
M Wojda, Jolanta Kostrzewa-Janicka, P Bieleń, P Jurkowski, E Mierzwińska-Nastalska
Obstructive sleep apnea (OSA) is defined as episodes of upper airway obstructions during sleep. The method of choice in conservative treatment of OSA is the use of devices that produce positive airway pressure (CPAP). In patients with mild-moderate form of OSA, intraoral mandibular advancement devices (MAD) are applied. The aim of the study was to evaluate the therapeutic efficacy of MAD in patients with severe OSA who were unable to use CPAP. In this preliminary study three patients from a group of 25 severe OSA sufferers who failed to use CPAP, were included...
October 6, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28983236/development-of-a-clinical-pathway-and-technical-aspects-of-upper-airway-stimulation-therapy-for-obstructive-sleep-apnea
#17
REVIEW
Olivier M Vanderveken, Jolien Beyers, Sara Op de Beeck, Marijke Dieltjens, Marc Willemen, Johan A Verbraecken, Wilfried A De Backer, Paul H Van de Heyning
Obstructive sleep apnea (OSA) is a common disease with high morbidity and related mortality. Narrowing and collapse of the pharyngeal airway during sleep characterize the disease, resulting in a decrease (hypopnea) or a complete cessation (apnea) of oronasal airflow. Upper airway stimulation (UAS), using electrical neurostimulation of the hypoglossal nerve (n. XII) synchronized with ventilation, is a novel, evolving treatment option. UAS was found to be an effective treatment in CPAP-intolerant patients. The treatment success is partly due to the strict selection of the patients, based on previous findings...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28982804/autoadjusted-versus-fixed-cpap-for-obstructive-sleep-apnoea-a-multicentre-randomised-equivalence-trial
#18
Konrad E Bloch, Fabienne Huber, Michael Furian, Tsogyal D Latshang, Christian M Lo Cascio, Yvonne Nussbaumer-Ochsner, Oliver Senn, Erich W Russi, Malcolm Kohler, Otto D Schoch, Alexander Turk, Edelbert Imhof, Irène Laube, Felix Matthews, Robert Thurnheer
BACKGROUND: The obstructive sleep apnoea syndrome (OSAS) is conventionally treated by continuous positive airway pressure set at a fixed level (fCPAP). Automatic mask pressure adjustment (autoCPAP) is increasingly used during home therapy. We investigated whether autoCPAP is equivalent to fCPAP in improving sleepiness in patients with OSAS in the long-term. METHODS: In this multicentre equivalence trial, 208 patients with OSAS, with median Epworth sleepiness score (ESS) 13, apnoea/hypopnoea index 48...
October 5, 2017: Thorax
https://www.readbyqxmd.com/read/28982776/blood-pressure-response-to-cpap-treatment-in-subjects-with-obstructive-sleep-apnoea-the-predictive-value-of-24-h-ambulatory-blood-pressure-monitoring
#19
Anabel L Castro-Grattoni, Gerard Torres, Montserrat Martínez-Alonso, Ferran Barbé, Cecilia Turino, Alicia Sánchez-de-la-Torre, Anunciacion Cortijo, Joaquin Duran-Cantolla, Carlos Egea, Gonzalo Cao, Manuel Sánchez-de-la-Torre
The reduction in blood pressure (BP) with continuous positive airway pressure (CPAP) is modest and highly variable. In this study, we identified the variables that predict BP response to CPAP.24-h ambulatory BP monitoring (ABPM), C-reactive protein (CRP), leptin, adiponectin and 24-h urinary catecholamine were measured before and after 6 months of CPAP in obstructive sleep apnoea (OSA) patients.Overall, 88 middle-aged, obese male patients with severe OSA (median apnoea-hypopnoea index 42 events·h(-1)) were included; 28...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28977669/stable-breathing-in-patients-with-obstructive-sleep-apnea-is-associated-with-increased-effort-but-not-lowered-metabolic-rate
#20
Camila M de Melo, Luigi Taranto-Montemurro, James P Butler, David P White, Stephen H Loring, Ali Azarbarzin, Melania Marques, Philip J Berger, Andrew Wellman, Scott A Sands
Study objectives: In principle, if metabolic rate were to fall during sleep in a patient with obstructive sleep apnea (OSA), ventilatory requirements could be met without increased respiratory effort thereby favoring stable breathing. Indeed, most patients achieve periods of stable flow-limited breathing without respiratory events for periods during the night for reasons that are unclear. Thus, we tested the hypothesis that in patients with OSA, periods of stable breathing occur when metabolic rate (VO2) declines...
July 23, 2017: Sleep
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