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https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#1
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049041/the-impact-of-lifestyle-intervention-on-atrial-fibrillation
#2
Kathryn L Hong, Benedict M Glover
PURPOSE OF REVIEW: Atrial fibrillation is the most common sustained cardiac arrhythmia, attributable to several factors that may be amenable through lifestyle modification. There is emerging evidence to suggest that the successful management of several cardiovascular risk factors [obesity, hypertension (HTN), diabetes mellitus, and obstructive sleep apnea (OSA)] can lead to fewer complications and atrial fibrillation prevention. However, the long-term sustainability and reproducibility of these effects have yet to be explored in larger studies...
October 18, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29042891/differential-effects-of-obesity-on-obstructive-sleep-apnea-syndrome-according-to-age
#3
Yu-Jin G Lee, Yu Jin Lee, Do-Un Jeong
OBJECTIVE: To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by age in relation to anthropometric measurements. METHODS: The medical records of 1,110 participants diagnosed with OSAS were analyzed according to age. All participants underwent nocturnal polysomnography and had their body mass index, waist circumference, neck circumference (NC), and waist-to-hip ratio measured. RESULTS: According to the multiple linear regression analysis model for the natural logarithm of the apnea-hypopnea index treating all four anthropometric measurements and gender as covariates, the final stepwise model accounted for an increasing percentage of the variability in the severity of OSAS as a function of age: 7...
September 2017: Psychiatry Investigation
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/29038199/does-the-treatment-of-obstructive-sleep-apnea-and-obesity-improve-pulsatile-hemodynamics
#5
EDITORIAL
Thomas Weber, Siegfried Wassertheurer
No abstract text is available yet for this article.
October 16, 2017: Hypertension
https://www.readbyqxmd.com/read/29035088/the-last-25-years-of-obstructive-sleep-apnea-epidemiology-and-the-next-25
#6
Paul E Peppard, Erika W Hagen
Considerable new knowledge regarding the epidemiology of obstructive sleep apnea (OSA) in adults arose from large-scale population-based epidemiologic investigations that initiated in the late 1980s to 1990s; these investigations have continued to produce relevant findings in recent years. In this Perspective, we briefly comment on the past 25 years of adult population-based OSA epidemiology and discuss selected ways in which the field can further progress over the coming decades. Population-based studies have shown that OSA is common in both men and women, and that prevalence is increasing...
October 16, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29031756/obstructive-sleep-apnea-in-pregnancy-is-associated-with-adverse-maternal-outcomes-a-national-cohort
#7
Ghada Bourjeily, Valery A Danilack, Margaret H Bublitz, Heather Lipkind, Janet Muri, Donna Caldwell, Iris Tong, Karen Rosene-Montella
OBJECTIVE: Pregnancy and the obesity epidemic impacting women of reproductive age appear to predispose women to obstructive sleep apnea (OSA) in pregnancy. The aim of this study is to examine the association between OSA and adverse maternal outcomes in a national cohort. METHODS: The National Perinatal Information Center in the US was used to identify women with a delivery discharge diagnosis of OSA from 2010 to 2014. We used the International Classification of Diseases, ninth Revision to classify OSA diagnosis and maternal outcomes...
October 2017: Sleep 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/29027646/prevalence-of-obstructive-sleep-apnea-among-obese-toddlers-and-preschool-children
#9
Saadoun Bin-Hasan, Sherri Katz, Zoe Nugent, Joy Nehme, Zihang Lu, Abdullah Khayat, Suhail Al-Saleh, Reshma Amin, Indra Narang
BACKGROUND: Obstructive sleep apnea (OSA) is a common disorder estimated at 1-5% in the school-aged children. With the obesity prevalence reaching staggering rates globally, OSA in obese adolescents is estimated to be 4-5-folds higher than their lean peers. There is a paucity of data regarding obesity-related OSA in children 6 years and less. This is particularly relevant as OSA is associated with neurocognitive deficits. The aim of this study is to evaluate the prevalence of OSA among obese toddlers and preschool children and further to determine what other factors may be associated with the presence of OSA...
October 13, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29024553/obesity-risk-factors-complications-and-strategies-for-sustainable-long-term-weight-management
#10
Sharon M Fruh
BACKGROUND AND PURPOSE: The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they can be ameliorated by weight loss, and consider weight-management strategies that may help patients achieve and maintain weight loss. METHODS: Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as "obesity," "overweight," "weight loss," "comorbidity," "diabetes," cardiovascular," "cancer," "depression," "management," and "intervention...
October 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29017230/-guidelines-in-practice-the-new-s3-guideline-sleeping-disorders-sleep-related-abnormal-breathing
#11
Martin Gerlach, Bernd Sanner
Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized...
October 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28988235/readmissions-and-emergency-department-visits-after-bariatric-surgery-at-saudi-arabian-hospital-the-rates-reasons-and-risk-factors
#12
Anwar Ahmed, Doaa AlBuraikan, Bashayr ALMuqbil, Wijdan AlJohi, Wala Alanazi, Budor AlRasheed
BACKGROUND: Saudi Arabian hospital readmissions and emergency department (ED) visits following bariatric surgery and discharge have never been investigated. This study aimed to evaluate the rates and reasons of hospital readmissions and ED visits related to surgical weight loss interventions at the King Abdulaziz Medical City - Riyadh. METHODS: We conducted a retrospective cohort study on 301 patients who underwent bariatric surgery between January 2011 and July 2016...
October 7, 2017: Obesity Facts
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
#13
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/28981946/-association-of-kcne1-and-kcne4-gene-polymorphisms-with-atrial-fibrillation-among-uygur-and-han-chinese-populations-in-xinjiang
#14
Haijun Miao, Xiaohui Zhou, Keyimu Kabinur, Ting Zou, Abulizi Palida, Baopeng Tang
OBJECTIVE: To assess the association of KCNE1 (rs1805127) and KCNE4 (rs12621643) polymorphisms with atrial fibrillation (AF) among ethnic Uygur and Han Chinese in Xinjiang. METHODS: A case-control study was carried out. The patients and controls were selected based on ethnicity, gender and age with an 1:1 ratio. DNA was extracted from peripheral blood samples. Genotypes of KCNE1 (rs1805127) and KCNE4 (rs12621643) were determined with a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay...
October 10, 2017: Zhonghua Yi Xue Yi Chuan Xue za Zhi, Zhonghua Yixue Yichuanxue Zazhi, Chinese Journal of Medical Genetics
https://www.readbyqxmd.com/read/28966731/clinicals-and-upper-airway-characteristics-in-obese-children-with-obstructive-sleep-apnea
#15
Eli O Martinelli, Fernanda Louise M Haddad, Renato Stefanini, Gustavo A Moreira, Priscila B Rapoport, Luis Carlos Gregório, Sérgio Tufik, Lia Rita A Bittencourt
INTRODUCTION: Obesity is a factor that is strongly related to the occurrence of obstructive sleep apnea (OSA) in adults, although this association remains controversial for children. OBJECTIVE: The aim of this study was to compare the clinical and upper airway charactheristics, obtained by questionnaires, physical examination and laboratory tests, among obese children with and without OSA. METHOD: This was aprospective cohort study. 44 obese children (body mass index above the 95th percentile) were included in the study...
January 2017: Sleep Science
https://www.readbyqxmd.com/read/28966594/the-role-of-the-autonomic-nervous-system-in-the-pathophysiology-of-obesity
#16
REVIEW
Daniela Guarino, Monica Nannipieri, Giorgio Iervasi, Stefano Taddei, Rosa Maria Bruno
Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS) dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28958052/treating-chronic-hypoventilation-with-automatic-adjustable-versus-fixed-epap-intelligent-volume-assured-positive-airway-pressure-support-ivaps-a-randomized-controlled-trial
#17
Nigel McArdle, Clare Rea, Stuart King, Kathleen Maddison, Dinesh Ramanan, Sahisha Ketheeswaran, Lisa Erikli, Vanessa Baker, Jeff Armitstead, Glenn Richards, Bhajan Singh, David Hillman, Peter Eastwood
Objectives: New non-invasive ventilation (NIV) modes can automatically adjust pressure support settings to deliver effective ventilation in response to varying ventilation demands. It is recommended that fixed expiratory positive airway pressure (FixedEPAP) is determined by attended laboratory polysomnographic (PSG) titration. This study investigated whether automatically-determined EPAP (AutoEPAP) was non-inferior to FixedEPAP for the control of obstructive sleep apnea (OSA) during intelligent volume-assured pressure support (iVAPS) treatment of chronic hypoventilation...
August 14, 2017: Sleep
https://www.readbyqxmd.com/read/28947309/wilson-s-disease-and-cardiac-myopathy
#18
Donald J Grandis, Gregory Nah, Isaac R Whitman, Eric Vittinghoff, Thomas A Dewland, Jeffrey E Olgin, Gregory M Marcus
Wilson's disease is a well-characterized disorder known to cause liver and brain disease due to abnormal copper deposition. Data regarding copper infiltration of the heart is conflicting, and the risk of heart disease has not been well described. We aimed to determine whether Wilson's disease is associated with cardiac myopathy, clinically evident in the atria as atrial fibrillation (AF) and in the ventricles as heart failure (HF). We longitudinally assessed 14.3 million patients in the California Healthcare Cost and Utilization Project database from 2005 through 2009 for diagnoses of Wilson's disease, AF, HF, and covariates using International Classification of Diseases-9th Edition codes...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28943894/prevalence-and-severity-of-syndrome-z-in-women-with-metabolic-syndrome-on-waiting-list-for-bariatric-surgery-a-cross-sectional-study
#19
Eduardo Araujo Perez, Luis Vicente Franco Oliveira, Wilson Rodrigues Freitas, Carlos Alberto Malheiros, Elias Jirjoss Ilias, Anderson Soares Silva, Jessica Julioti Urbano, Patricia Clemente Oliveira, Felipe X Cepeda, Luciana M M Sampaio, Ivani C Trombetta, Humberto Delle, Daniel Gianella Neto, Sergio Roberto Nacif, Roberto Stirbulov
BACKGROUND: In recent years, obesity has become one of the most important public health problems in the world, with a growing prevalence in both developed and developing countries. Recent studies show that sleep disturbances, especially obstructive sleep apnoea (OSA) may be a manifestation of metabolic syndrome (MetS). Although the association of OSA with the MetS is largely attributed to obesity, the exact pathophysiological mechanisms and their individual characteristics still need to be identified...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28935145/determinants-of-obstructive-sleep-apnea-syndrome-pro-inflammatory-state-and-dysfunction-of-high-density-lipoprotein
#20
Yusuf Karadeniz, Altan Onat, Tuğba Akbaş, Barış Şimşek, Hüsniye Yüksel, Günay Can
OBJECTIVE: The goal of this study was to determine variables preceding and predicting incident obstructive sleep apnea syndrome (OSAS) in the population at large. METHODS: Anthropometric, lipid, and non-lipid variables in participants with newly developing OSAS (n = 131) were compared with those of a cohort sample (n = 2615) of the Turkish Adult Risk Factor study. Available values preceding (by a median of 32 mo) the development of OSAS were used in multivariable Cox regression models...
November 2017: Nutrition
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