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Study Objectives: We tested a telemedicine model of care to initiate continuous positive airway pressure (CPAP) for patients with obstructive sleep apnea (OSA) living in remote Western Australia.
Methods: A prospective study comparing telemedicine for CPAP initiation in a remote population versus standard face-to-face CPAP initiation in a metropolitan population. The primary outcome was average nightly CPAP use in the final week of a CPAP trial.
Results: A total of 186 participants were allocated to either telemedicine (n = 56) or standard care (n = 130). The average distance from the study center for the telemedicine group was 979 km (±792 km) compared to 19 km (±14 km) for the standard care group. The CPAP trial duration in the standard care group was less than the telemedicine group (37.6 vs 69.9 days, p < .001). CPAP adherence in the telemedicine group was not inferior to standard care (Standard 4.7 ± 0.2 h, Telemedicine 4.7 ± 0.3 h, p = 0.86). No differences were found between groups in residual apnea-hypopnea index, symptom response, sleep specific quality of life at the end of the trial, and continued CPAP use (3-6 months). Participant satisfaction was high in both groups. Total health care costs of the telemedicine model were less than the standard model of care. An estimated A$4538 per participant in travel costs was saved within the telemedicine group by reducing the need to travel to the sleep center for in-person management.
Conclusions: In remote dwelling adults starting CPAP for the treatment of OSA, outcomes using telemedicine were comparable to in-person management in a metropolitan setting.
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http://dx.doi.org/10.1093/sleep/zsac157 | DOI Listing |
Reprod Health
December 2024
Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
Introduction: Although the Government of Nepal has developed strategies to integrate contraceptive services with abortion care to better meet the contraceptive needs of women, data indicate that significant gaps in services remain. This paper assessed post-abortion contraceptive use, trends over 36 -months, and factors influencing usage.
Methods: Data from this paper came from an ongoing cohort study of 1831 women who sought an abortion from one of the sampled 22 government-approved health facilities across Nepal.
J Headache Pain
December 2024
Pfizer SAS, Bogota, Colombia.
Background: To describe the epidemiology and clinical characteristics of migraine and the status of treatment in Colombia. Additionally, the use of health resources by patients was measured.
Methods: This was a non-interventional, retrospective, descriptive study conducted in one Colombian Health Management Organization (HMO) from 2018 to 2022 with a follow-up period of 5 years.
BMC Med Inform Decis Mak
December 2024
Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Background: Psychological disorders, such as anxiety and depression, are considered to be one of the causes of noncardiac chest pain (NCCP). And these patients can be challenging to differentiate from coronary artery disease (CAD), leading to a considerable number of patients still undergoing angiography. We aim to develop a practical prediction model and nomogram using cardiopulmonary exercise testing (CPET), to help identify these patients.
View Article and Find Full Text PDFBMC Surg
December 2024
Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, No.25, Taiping Street, Jiangyang District, Luzhou, 646000, China.
Objective: To evaluate the efficacy of pedicled supraclavicular flaps in hypopharyngectomy reconstruction, with a focus on preserving laryngeal function.
Methods: From August 2019 to June 2022, 14 patients with primary hypopharyngeal carcinoma who met the inclusion and exclusion criteria and underwent the repair of hypopharyngeal defects using pedicled supraclavicular flaps were included retrospectively. Relevant clinical evaluation indicators include patient characteristics, defect sizes, flap sizes, flap harvesting time, postoperative hospital stay, postoperative complications, recurrence, and survival outcomes.
Eye (Lond)
December 2024
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Objectives: To determine the association between telomere length (TL) and age-related macular degeneration (AMD) and examine the potential variations with sex and ethnicity.
Methods: Population-based, cross-sectional study. A total of 52,083 participants from the UK Biobank were included.
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