Study Design: Prospective, cohort study.
Objectives: To evaluate the effectiveness of bi-level positive airway pressure (PAP) therapy and the patterns of use for sleep-disordered breathing (SDB) in individuals with spinal cord injury (SCI).
Setting: Academic tertiary care center, USA.
Methods: Overall, 91 adults with C1-T6 SCI for ≥3 months were recruited and 74 remained in the study to be evaluated for SDB and follow-up. Individuals with SDB but no nocturnal hypercapnia (NH) were prescribed auto-titrating PAP. Those with NH were prescribed PAP with volume-assured pressure support. Device downloads and overnight transcutaneous capnography were performed at 3, 6, and 12 months to quantify PAP use and effectiveness. Participants kept daily event logs, and quality of life (QOL) questionnaires were performed after 3, 6, and 12 months.
Results: Overall, 45% of 91 participants completed the study. There was great diversity among SCI patients in PAP utilization; after 3 months, 37.8% of participants used PAP for ≥70% nights and ≥240 min per night, whereas 42.2% seldom used PAP and 20% used PAP sporadically or for short periods. PAP therapy was effective in improving OSA in 89% and nocturnal hypercapnia in 77%. Higher PAP pressures predicted higher levels of device use. There were marked reductions in symptoms of autonomic dysreflexia (AD) and orthostatic hypotension as well as some improved indices of QOL.
Conclusions: Despite widely diverse patterns of use, PAP therapy may have short-term benefits with regard to QOL and reducing episodes of dizziness and autonomic dysreflexia.
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http://dx.doi.org/10.1038/s41393-018-0077-z | DOI Listing |
Taiwan J Obstet Gynecol
January 2025
Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:
Objective: Primary endometrial squamous cell carcinoma (PESCC) is an extremely rare type of endometrial cancer with limited research and understanding. This report presents a case of PESCC and reviews 37 cases from 1997.
Case Report: A 61-year-old menopausal woman presented with abnormal vaginal bleeding.
Sleep
December 2024
Midwest Cardiovascular Institute, Naperville, Illinois, USA.
Central sleep apnea (CSA), a rare polysomnographic finding in the general population, is prevalent in certain cardiovascular conditions including systolic and diastolic left ventricular dysfunction, atrial fibrillation, coronary artery disease, carotid artery stenosis, stroke and use of certain cardiac-related medications. Polysomnographic findings of CSA with adverse cardiovascular impacts include nocturnal hypoxemia and arousals, which can lead to increased sympathetic activity both at night and in the daytime. Among cardiovascular diseases, CSA is most prevalent in patients with left ventricular systolic dysfunction; a large study of more than 900 treated patients has shown a dose dependent relationship between nocturnal desaturation and mortality.
View Article and Find Full Text PDFSyst Rev
January 2025
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Background: Postoperative antibiotic prophylaxis (PAP) involves using antibiotics after surgery to prevent surgical site infections (SSIs). However, studies have shown that PAP offers no additional benefits compared to discontinuation after surgical incision closure, prompting its de-implementation to prevent unnecessary antibiotic use that may contribute to antibiotic resistance. We conducted this review to synthesize evidence for guiding the design and implementation of effective strategies for discontinuing PAP practice and optimizing antibiotic use in surgical settings.
View Article and Find Full Text PDFViruses
December 2024
Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada.
Hepatitis C virus (HCV) disproportionately affects certain sub-populations, including people with experience of incarceration (PWEI). Little is known about how perceptions of HCV and treatment have changed despite simplifications in testing and treatment in carceral settings. Nineteen semi-structured interviews were conducted with people living with or having a history of HCV infection released from Quebec provincial prison.
View Article and Find Full Text PDFBMC Psychol
January 2025
Department of Medical Psychology, Air Force Medical University, Xi'an, China.
Purpose: The purpose of this study was to use the advanced technique of Network Intervention Analysis (NIA) to investigate the trajectory of symptom change associated with the effects of self-control training on youth university students' chronic ego depletion aftereffects.
Methods: The nine nodes of chronic ego depletion aftereffects and integrated self-control training were taken as nodes in the network and analyzed using NIA. Networks were computed at the baseline, at the end of treatment, at 1-, 3-, 6-, 9- and 12-month follow up.
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