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https://www.readbyqxmd.com/read/28439962/balancing-task-focus-and-relationship-building-asking-sleepy-patients-about-traffic-risk-in-treatment-initiation-consultations
#1
Clara Iversen, Anders Broström, Martin Ulander
BACKGROUND: The use of traffic risk assessment questions is an understudied area in nursing research. Obstructive sleep apnoea is associated with an increased risk of traffic accidents. Therefore, traffic safety authorities demand adherent continuous positive airway pressure use. Nurses act as coaches to achieve treatment adherence, but they are also obliged to act as state agents by prohibiting obstructive sleep apnoea patients from drowsy driving. OBJECTIVE: To examine how nurses and obstructive sleep apnoea patients manage traffic risk assessment questions in the relation-building context of treatment initiation consultations...
April 24, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28439921/impact-of-obstructive-sleep-apnoea-and-intermittent-hypoxia-on-cardiovascular-and-cerebrovascular-regulation
#2
Andrew E Beaudin, Xavier Waltz, Patrick J Hanly, Marc J Poulin
Obstructive sleep apnoea (OSA) is associated with increased risk of cardiovascular and cerebrovascular disease, a consequence attributed in part to chronic intermittent hypoxia (IH) resulting from repetitive apnoeas during sleep. Although findings from experimental animal, and human, models have shown that IH is detrimental to vascular regulation, the severity of IH used in many of these animal studies (e.g. inspired fraction of oxygen (FI O2 ) = 2-3%; oxygen desaturation index (ODI) = 120 events h(-1) ) is considerably greater than that observed in the majority of patients with OSA...
April 24, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28438749/respiratory-difficulty-with-palatal-laryngeal-and-respiratory-muscle-tremor-in-adult-onset-alexander-s-disease
#3
John McAuley, Rowena Taylor, Anita Simonds, Sanjiv Chawda
Sleep apnoea and respiratory difficulties are reported in adult-onset Alexander's disease (AOAD), an autosomal-dominant leukodystrophy that presents mainly with progressive ataxia. We demonstrate for the first time that the respiratory symptoms can result from association of palatal tremor with a similar tremor of laryngeal and respiratory muscles that interrupts normal inspiration and expiration.A 60-year-old woman presented with progressive ataxia, palatal tremor and breathlessness. MRI revealed medullary atrophy, bilateral T2 hyperintensities in the dentate nuclei and hypertrophic olivary degeneration (HOD)...
April 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28433974/hypoactive-hypoalert-behaviour-and-thalamic-hypometabolism-due-to-intracranial-hypotension
#4
Seamus Kearney, Peter Flynn, Simon Hughes, Wendy Spence, Mark Owen McCarron
A 47-year-old man presented with a 9-year history of a hypoalert hypoactive behaviour syndrome, caused by the deep brain swelling variant of spontaneous intracranial hypotension. Along with apathy with retained cognition, he had stable ataxia, impaired upgaze and episodes of central apnoea. MRI brain showed a sagging brainstem, pointed ventricles and reduced angle between the vein of Galen and the straight sinus, but no meningeal enhancement or subdural collections. A dopamine transporter scan showed preganglionic dopamine receptor deficiency; a fluorodeoxy glucose positron emission tomography scan showed bilateral hypothalamic hypometabolism...
April 22, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28429032/obstructive-sleep-apnoea-and-type-2-diabetes-mellitus-are-they-connected
#5
Yingjuan Mok, Chee Wei Tan, Hang Siang Wong, Choon How How, Kah Leong Alvin Tan, Pon Poh Hsu
Obstructive sleep apnoea (OSA), a sleep-related breathing condition, is diagnosed based on a patient's apnoea-hypopnea index from a sleep study, and the presence or absence of symptoms. Diabetes mellitus (DM) and OSA share a significant common risk factor, obesity, with all three conditions contributing to the risk of developing cardiovascular diseases. The pathophysiological links between OSA and DM are still unclear, but intermittent hypoxia may be an important mechanism. More awareness of the possible link between OSA and DM is needed, given their increasing prevalence locally and worldwide...
April 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28427039/low-dose-growth-hormone-treatment-in-infants-and-toddlers-with-prader-willi-syndrome-is-comparable-to-higher-dosage-regimens
#6
Elly Scheermeyer, Mark Harris, Ian Hughes, Patricia A Crock, Geoffrey Ambler, Charles F Verge, Phil Bergman, George Werther, Maria E Craig, Catherine S Choong, Peter S W Davies
OBJECTIVE: Evaluate benefit and risk of low dose growth hormone treatment (GHT, 4.5mg/m(2)/week) in very young children with Prader-Willi Syndrome (PWS). DESIGN: Prospective longitudinal clinical intervention. METHODS: We evaluated 31 infants (aged 2-12months) and 42 toddlers (13-24months) from the PWS-OZGROW database for height, weight and BMI using the World Health Organization standard deviation scores (SDSWHO) and PWS specific BMI (SDSPWS), bone age, insulin-like growth factor 1 (IGF-I) levels and adverse events over 3years of GHT...
March 24, 2017: Growth Hormone & IGF Research
https://www.readbyqxmd.com/read/28424459/development-and-outcomes-of-a-primary-care-based-sleep-assessment-service-in-canterbury-new-zealand
#7
Michael J Epton, Paul T Kelly, Brett I Shand, Sallyanne V Powell, Judith N Jones, Graham R B McGeoch, Michael C Hlavac
Prior to 2007, increasing demand for sleep services, plus inability to adequately triage severity, led to long delays in sleep assessment and accessing continuous positive airway pressure. We established a community sleep assessment service carried out by trained general practices using a standardised tool and overnight oximetry. All cases were discussed at a multi-disciplinary meeting, with four outcomes: severe obstructive sleep apnoea treated with continuous positive airway pressure; investigation with more complex studies; sleep physician appointment; no or non-severe sleep disorder for general practitioner management...
April 19, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28424366/sleep-apnoea-insulin-resistance-and-diabetes-the-first-step-is-in-the-fat
#8
EDITORIAL
Isaac Almendros, Francisco García-Río
No abstract text is available yet for this article.
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28424360/intermittent-hypoxia-in-obstructive-sleep-apnoea-mediates-insulin-resistance-through-adipose-tissue-inflammation
#9
Aoife M Murphy, Amandine Thomas, Sophie J Crinion, Brian D Kent, Murtaza M Tambuwala, Aurelie Fabre, Jean-Louis Pepin, Helen M Roche, Claire Arnaud, Silke Ryan
Obstructive sleep apnoea (OSA) is increasingly associated with insulin resistance. The underlying pathophysiology remains unclear but intermittent hypoxia (IH)-mediated inflammation and subsequent dysfunction of the adipose tissue has been hypothesised to play a key role.We tested this hypothesis employing a comprehensive translational approach using a murine IH model of lean and diet-induced obese mice, an innovative IH system for cell cultures and a tightly controlled patient cohort.IH led to the development of insulin resistance in mice, corrected for the degree of obesity, and reduced insulin-mediated glucose uptake in 3T3-L1 adipocytes, associated with inhibition of the insulin-signalling pathway and downregulation of insulin-receptor substrate-1 mRNA...
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28419406/routine-oro-nasopharyngeal-suction-versus-no-suction-at-birth
#10
REVIEW
Jann P Foster, Jennifer A Dawson, Peter G Davis, Hannah G Dahlen
BACKGROUND: Oro/nasopharyngeal suction is a method used to clear secretions from the oropharynx and nasopharynx through the application of negative pressure via a suction catheter or bulb syringe. Traditionally, airway oro/nasopharyngeal suction at birth has been used routinely to remove fluid rapidly from the oropharynx and nasopharynx in vigorous and non-vigorous infants at birth. Concerns relating to the reported adverse effects of oro/nasopharyngeal suctioning led to a practice review and routine oro/nasopharyngeal suctioning is no longer recommended for vigorous infants...
April 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28419356/arousal-induced-hypocapnia-does-not-reduce-genioglossus-activity-in-obstructive-sleep-apnea-arousal-induced-hypocapnia-in-osa-muscle-effects
#11
Jennifer M Cori, Therese Thornton, Fergal J O'Donoghue, Peter D Rochford, David P White, John Trinder, Amy S Jordan
Study Objectives: To determine whether arousals that terminate obstructive events in obstructive sleep apnea (OSA): 1. Induce hypocapnia and 2. Subsequently reduce genioglossus muscle activity following the return to sleep. Methods: 31 untreated OSA patients slept instrumented with: sleep staging electrodes, nasal mask and pneumotachograph, end-tidal CO2 monitoring and intramuscular genioglossus electrodes. End-tidal CO2 was monitored and respiratory arousals were assigned an end-arousal CO2 change value (PETCO2 on the last arousal breath minus each individual's wakefulness PETCO2)...
April 13, 2017: Sleep
https://www.readbyqxmd.com/read/28417583/ethnic-differences-in-the-pathogenesis-of-obstructive-sleep-apnoea-exploring-non-anatomical-factors
#12
EDITORIAL
Abd A Tahrani
No abstract text is available yet for this article.
April 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28413970/optimizing-the-management-of-uncontrolled-resistant-hypertension-the-importance-of-sleep-apnoea-syndrome
#13
Jacek Wolf, Krzysztof Narkiewicz
Obstructive sleep apnoea (OSA) constitutes the most prevalent form of abnormal respiratory control during sleep in adults. Evidence linked OSA to cardiovascular disease, and the role of OSA in abnormal blood pressure (BP) control has been extensively studied. Although longitudinal trials suggest a causative role of OSA in the development of hypertension, the evidence is not fully consistent. Nasal continuous positive airway pressure (nCPAP) applied during sleep is well documented and a highly efficient therapeutic aid to eliminate OSA...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28412180/computational-fluid-dynamics-study-of-the-pharyngeal-airway-space-before-and-after-mandibular-setback-surgery-in-patients-with-mandibular-prognathism
#14
Y Yajima, M Oshima, T Iwai, H Kitajima, S Omura, I Tohnai
The purpose of this study was to investigate the relationship between the pressure drop in the pharyngeal airway space (ΔPPAS) and the minimum cross-sectional area (minCSA) of the pharyngeal airway before and after mandibular setback surgery using computational fluid dynamics, in order to prevent iatrogenic obstructive sleep apnoea. Eleven patients with mandibular prognathism underwent bilateral sagittal split osteotomy for mandibular setback. Three-dimensional models of the upper airway were reconstructed from preoperative and postoperative computed tomography images, and simulations were performed using computational fluid dynamics...
April 12, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28409851/response-to-a-combination-of-oxygen-and-a-hypnotic-as-treatment-for-obstructive-sleep-apnoea-is-predicted-by-a-patient-s-therapeutic-cpap-requirement
#15
Shane A Landry, Simon A Joosten, Scott A Sands, David P White, Atul Malhotra, Andrew Wellman, Garun S Hamilton, Bradley A Edwards
BACKGROUND AND OBJECTIVE: Upper airway collapsibility predicts the response to several non-continuous positive airway pressure (CPAP) interventions for obstructive sleep apnoea (OSA). Measures of upper airway collapsibility cannot be easily performed in a clinical context; however, a patient's therapeutic CPAP requirement may serve as a surrogate measure of collapsibility. The present work aimed to compare the predictive use of CPAP level with detailed physiological measures of collapsibility...
April 13, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28409007/subclinical-sleep-apnoea-and-plasma-levels-of-endothelin-1-among-young-and-healthy-adults
#16
Tobias Schoen, Stefanie Aeschbacher, Joerg D Leuppi, David Miedinger, Ursina Werthmüller, Joel Estis, John Todd, Martin Risch, Lorenz Risch, David Conen
OBJECTIVE: Obstructive sleep apnoea (OSA) is a risk factor for vascular disease and other adverse outcomes. These associations may be at least partly due to early endothelin-1 (ET-1)-mediated endothelial dysfunction (ED). Therefore, we assessed the relationships between subclinical sleep apnoea and plasma levels of ET-1. METHODS: We performed a population-based study among 1255 young and healthy adults aged 25-41 years. Cardiovascular disease, diabetes or a body mass index >35 kg/m(2) were exclusion criteria...
2017: Open Heart
https://www.readbyqxmd.com/read/28407220/patient-controlled-analgesia-with-remifentanil-versus-alternative-parenteral-methods-for-pain-management-in-labour
#17
REVIEW
Stephanie Weibel, Yvonne Jelting, Arash Afshari, Nathan Leon Pace, Leopold Hj Eberhart, Johanna Jokinen, Thorsten Artmann, Peter Kranke
BACKGROUND: Multiple analgesic strategies for pain relief during labour are available. Recently remifentanil, a short-acting opioid, has recently been used as an alternative analgesic due to its unique pharmacological properties. OBJECTIVES: To systematically assess the effectiveness of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28406975/positional-therapy-in-sleep-apnoea-one-fits-all-what-determines-success-in-positional-therapy-in-sleep-apnoea-syndrome
#18
Natascha Troester, Michael Palfner, Markus Dominco, Christoph Wohlkoenig, Erich Schmidberger, Martin Trinker, Alexander Avian
INTRODUCTION: Positional therapy is a simple means of therapy in sleep apnoea syndrome, but due to controversial or lacking evidence, it is not widely accepted as appropriate treatment. In this study, we analysed data to positional therapy with regard to successful reduction of AHI and predictors of success. METHODS: All consecutive patients undergoing polysomnography between 2007 and 2011 were analysed. We used a strict definition of positional sleep apnoea syndrome (supine-exclusive sleep apnoea syndrome) and of therapy used...
2017: PloS One
https://www.readbyqxmd.com/read/28403704/nursing-management-of-reflex-anoxic-seizures-in-children
#19
Neal Patel, Rowan Kerr-Liddell, Louise Challis, Siba Prosad Paul
Children who present with transient loss of consciousness (T-LOC) are often first seen in emergency departments (EDs). Reflex anoxic seizure (RAS), vasovagal syncope and prolonged respiratory apnoea are benign, syncopal events that can be generally managed by explanation and reassurance. RAS is a short, paroxysmal, self-reverting episode of asystole that is triggered by pain, fear or anxiety and is caused by increased vagal response. It is an important differential diagnosis in pre-school age children who present with T-LOC, but is often underdiagnosed and can sometimes be misdiagnosed as epilepsy...
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28403407/apnoeic-oxygenation-in-adults-under-general-anaesthesia-using-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-a-physiological-study
#20
I-M Gustafsson, Å Lodenius, J Tunelli, J Ullman, M Jonsson Fagerlund
Background.: Apnoeic oxygenation during anaesthesia has traditionally been limited by the rapid increase in carbon dioxide and subsequent decrease in pH. Using a Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) technique a slower increase in carbon dioxide than earlier studies was seen. Notably, apnoeic oxygenation using THRIVE has not been systematically evaluated with arterial blood gases or in patients undergoing laryngeal surgery. The primary aim of this study was to characterize changes in arterial P O 2 , P CO 2 and pH during apnoeic oxygenation using THRIVE under general anaesthesia...
April 1, 2017: British Journal of Anaesthesia
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