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sleep Surgery

Andreas Rohner, Jeannette D Widmer, Jennifer Klasen, Anita Scheiwiller, Dominik Muller, Markus K Muller
OBJECTIVE: The outcomes of patients undergoing band removal alone without an additional bariatric procedure after laparoscopic gastric banding are not well reported. We seek to close this gap in the literature. SETTING: Cantonal Hospital & University Teaching Hospital, Switzerland METHODS: In this retrospective study, we investigated 21 patients who underwent band removal with a mean follow-up of 63 months. Weight regain, co-morbidities, and quality of life were assessed...
September 14, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Rachid Chati, Emmanuel Huet, Lucie Grimberg, Lilian Schwarz, Jean-Jacques Tuech, Valérie Bridoux M D Ph D
BACKGROUND: Digestive surgery training is notoriously difficult and medical students choose this path less and less often leading to a veritable demographic crisis for this specialty in France. The aim of this study was to evaluate the working conditions to measure the prevalence of burnout syndrome (BOS) and to identify potential risk factors to implement preventive measures and appropriate support. METHODS: This was a multicenter, cross-sectional study. An anonymous questionnaire was sent by e-mail to 500 French digestive surgeons in training (residents and fellows)...
August 31, 2016: American Journal of Surgery
Paul Castellanos, Manjunath Mk, Ihab Atallah
The management of tracheobronchomalacia is a very challenging problem with few treatment options. This study aims to evaluate the outcomes of a novel surgical treatment for membranous tracheobronchomalacia. A consecutive series of patients with tracheobronchomalacia were treated with two to three holmium laser scarring surgeries of the hyperdynamic tracheal and bronchial walls for the purpose of stiffening them through fibrosis. Patients filled out a Dyspnea Index questionnaire before and after treatment. Ten patients were treated for their tracheobronchomalacia with a mean age of 54 years...
October 20, 2016: European Archives of Oto-rhino-laryngology
Hsueh-Yu Li, Yu-Lun Lo, Chao-Jan Wang, Li-Jen Hsin, Wan-Ni Lin, Tuan-Jen Fang, Li-Ang Lee
Surgical success for obstructive sleep apnea (OSA) depends on identifying sites of obstruction in the upper airway. In this study, we investigated sites of obstruction by evaluating dynamic changes in the upper airway using drug-induced sleep computed tomography (DI-SCT) in patients with OSA. Thirty-five adult patients with OSA were prospectively enrolled. Sleep was induced with propofol under light sedation (bispectral index 70-75), and low-dose 320-detector row CT was performed for 10 seconds over a span of 2-3 respiratory cycles with supporting a continuous positive airway pressure model...
October 20, 2016: Scientific Reports
Theodore Pincus
An MDHAQ/RAPID3 (multidimensional health assessment questionnaire/routine assessment of patient index data) was developed from the HAQ over 25 years, based on observations made from completion by every patient (with all diagnoses) at every routine rheumatology visit since 1980. Modification of the HAQ was viewed as similar to improving a laboratory test, with a primary focus on clinical value for diagnosis, prognosis, and/or management, as well as feasibility for minimal effect on clinical workflow. Rigorous attention, was also directed to validity, reliability, other methodologic and technological considerations, but after clinical value and feasibility were established...
September 2016: Clinical and Experimental Rheumatology
John Melissas, Konstantinos Stavroulakis, Vassilis Tzikoulis, Angeliki Peristeri, John A Papadakis, Abdolreza Pazouki, Alireza Khalaj, Ali Kabir
BACKGROUND: The purpose of this study is to compare sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) performed in Institutions participating in IFSO-European Chapter, Center of Excellence (COE) program. METHODS: Since the initiation of the program in January 2010, 6413 SGs and 10,622 RYGBPs performed as primary procedures by December 31, 2014, with at least 12-month follow-up, were retrospectively compared. RESULTS: There were steadily increasing numbers of patients underwent SG from 2010 to 2015...
October 20, 2016: Obesity Surgery
Madhuri S Kurdi, Sindhu Priya Muthukalai
BACKGROUND AND AIMS: Melatonin (MT), a naturally occurring pituitary hormone has a sleep promoting effect. There are very few studies on pre-operative oral MT (0.2-0.5 mg/kg) in children. We planned a study to assess the efficacy of oral MT in two doses and compare it with oral midazolam and placebo for pre-operative anxiolysis, sedation, maintenance of cognition and psychomotor skills, parental separation behaviour and venepuncture compliance. METHODS: This prospective double-blind randomised study was conducted after ethical committee approval on 100 children aged 5-15 years, American Society of Anaesthesiologists physical status I and II undergoing elective surgery at our hospital from January 1, 2014, to December 31, 2014...
October 2016: Indian Journal of Anaesthesia
Susana Vacas, Vincent Degos, Mervyn Maze
BACKGROUND: Sleep is integral to biologic function, and sleep disruption can result in both physiological and psychologic dysfunction including cognitive decline. Surgery activates the innate immune system, inducing neuroinflammatory changes that interfere with cognition. Because surgical patients with sleep disorders have an increased likelihood of exhibiting postoperative delirium, an acute form of cognitive decline, we investigated the contribution of perioperative sleep fragmentation (SF) to the neuroinflammatory and cognitive responses of surgery...
October 11, 2016: Anesthesia and Analgesia
Seong Hwan Kim
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the concurrent use of three antihypertensive agents of different classes at optimal dosing, of which one should be a diuretic. Accordingly, it is not synonymous with uncontrolled hypertension. Among a variety of risk factors, obstructive sleep apnea (OSA), which is a common type of sleep-disordered breathing, has been recognized a well-established risk factor for resistant hypertension. Indeed, both European and American guidelines for the management of arterial hypertension stated that OSA is a modifiable cause of resistant hypertension...
September 2016: Journal of Hypertension
Wei-Jei Lee
Obesity is a pan-endemic health problem in both developed and developing countries, in both western and eastern countries. It increases risk for many common diseases, including type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, osteoarthritis, cancers and depression etc.. Although the incidence of obesity in Asia is relatively low, Asian patients tend to have similar incidence of obesity related metabolic syndrome at lower BMI level comparing to Caucasians because of central obesity...
September 2016: Journal of Hypertension
Ottavio Piccin, Giovanni Sorrenti, Francesca Milano
Sleep apnea has been shown to be more prevalent in patients who underwent radiotherapy and or surgery for head and neck cancer. Here we describe two cases of severe OSAS induced by surgery and radiotherapy, treated by Mandibular Advancing Devices as an alternative option to continuous positive airway pressure.
September 2016: Journal of Maxillofacial and Oral Surgery
Roisin Bartlam, Rajiv Mohanraj
BACKGROUND: Seizures can lead to cardiac arrhythmias by a number of mechanisms including activation/inhibition of cortical autonomic centers, increase in vagal tone through activation of brainstem reflex centers, and respiratory failure. Ictal asystole (IA) is a potential mechanism underlying sudden unexpected death in epilepsy (SUDEP). We analyzed the clinical features of 5 patients who developed IA requiring pacemaker implantation. METHODS: Patients with ictal arrhythmias were identified from the video-telemetry and ambulatory EEG database at Greater Manchester Neurosciences Centre, as well as an independent epilepsy residential care facility...
October 13, 2016: Epilepsy & Behavior: E&B
Christophe Colas-Ribas, Isabelle Signolet, Samir Henni, Mathieu Feuillloy, Frédéric Gagnadoux, Pierre Abraham
The prevalence of pulmonary disease in patients with peripheral artery disease (PAD) has not been extensively studied. Recent evidence has shown that ∼20% of the patients have an atypical chest transcutaneous oxygen pressure (TcpO2) pattern during exercise, which suggests walking-induced hypoxemia. The main objectives of this study were to: (1) describe in a retrospective way the characteristics of the patients suffering from claudication, who attended a treadmill testing in our laboratory, (2) assess the prevalence of known or unknown pulmonary disease...
October 2016: Medicine (Baltimore)
Khaled Elbahrawy, Alaa El-Deeb
BACKGROUND: Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis, immediate anticoagulation, and intervention to restore mesenteric blood flow adequately. AIMS: To investigate the effect of rectus sheath block (RSB) for postoperative analgesia in patients with mesenteric vascular occlusion. SETTINGS AND DESIGN: Forty patients with mesenteric vascular occlusion, American Society of Anesthesiologists physical status I or II or III, scheduled for laparotomy were enrolled in this study...
September 2016: Anesthesia, Essays and Researches
Mark A D'Agostino
The standard treatment for patients with obstructive sleep apnea syndrome is positive airway pressure (PAP) therapy. However when PAP therapy fails, surgery maybe an option to alleviate the obstruction. The base of tongue plays an important role in this obstruction, and addressing the tongue base surgically can be a challenge for the head and neck surgeon. Transoral robotic surgery (TORS) using the da Vinci Surgical System provides a safe and effective way to approach and manage the base of tongue and supraglottis...
October 11, 2016: Otolaryngologic Clinics of North America
A L Ambrosoli, L Guzzetti, M Chiaranda, S Cuffari, M Gemma, G Cappelleri
We compared the effect of two different positions of a sciatic nerve catheter within the popliteal fossa on local anaesthetic consumption and postoperative analgesia in patients undergoing day-case hallux valgus repair. Eighty-four patients were randomly allocated to receive a sciatic nerve catheter either between the tibial and peroneal components (sciatic group) or medial to the tibial nerve (tibial group). The primary endpoint was postoperative local anaesthetic consumption, while secondary endpoints were pain scores, number of occasions where sleep was disturbed by pain and incidence of insensate limb and foot drop at 24 h and 48 h postoperatively...
November 2016: Anaesthesia
Michal R Janik, Maciej Walędziak, Jakub Brągoszewski, Andrzej Kwiatkowski, Krzysztof Paśnik
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is one of the most frequently performed bariatric procedures. Hemorrhagic complications (HC) after surgery are common and require surgical revision. Accurate estimation of the risk of postoperative HC can improve surgical decision-making process and minimize the risk of reoperation. The aim of the present study was to develop a predictive model for HC after LSG. MATERIAL AND METHODS: The retrospective analysis of 522 patients after primary LSG was performed...
October 11, 2016: Obesity Surgery
Mathias Baumert, Yvonne Pamula, James Martin, Declan Kennedy, Anand Ganesan, Muammar Kabir, Mark Kohler, Sarah A Immanuel
The efficacy of adenotonsillectomy for relieving obstructive sleep apnoea 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 arrhythmia and heart rate were analysed during quiet, non-apnoeic and non-hypopnoeic breathing throughout sleep at baseline and at 7 months using overnight polysomnography...
April 2016: ERJ Open Research
J S Park, D K Chan, S R Parikh, A K Meyer, K W Rosbe
OBJECTIVE: To study the efficacy of surgical management for obstructive sleep apnea (OSA) syndrome in children with hypotonia, and to identify common anatomic sites of airway obstruction. METHODS: Retrospective chart review of polysomnographic parameters and quality of life instrument scores for seventy eight children with hypotonia who underwent surgical intervention for sleep-disordered breathing at two tertiary children's hospitals, and analysis of drug-induced sleep endoscopy data using a previously validated scoring system...
November 2016: International Journal of Pediatric Otorhinolaryngology
Nikita Kohli, Dana DeCarlo, Nira A Goldstein, Joshua Silverman
OUTCOME OBJECTIVE: For over fifty years, otolaryngologists, allergists, and immunologists have debated the effect of adenoidectomy or adenotonsillectomy on asthma outcomes in children. Although some have suggested that adenotonsillectomy may contribute to the subsequent development of asthma in children, others have argued that a common mechanism may cause both upper and lower airway disease, and that children who have symptoms severe enough to warrant adenotonsillectomy are also at increased risk of asthma and atopic disease...
November 2016: International Journal of Pediatric Otorhinolaryngology
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