scholarly journals Causative Factors for Complications in Transpalatal Advancement

2019 ◽  
Vol 129 (1) ◽  
pp. 18-22
Author(s):  
Lyndon Chan ◽  
Leon Kitpornchai ◽  
Stuart Mackay
Keyword(s):  
Retrospective Chart Review ◽  
P Value ◽  
Contributing Factors ◽  
Obstructive Sleep ◽  
Causative Factors ◽  
Sleep Parameters ◽  
Sleep Questionnaires ◽  
The University ◽  
Postoperative Level ◽  
Do So

Introduction: Transpalatal advancement (TPA) is a procedure that is used when modern variants of uvulopharyn-gopalatoplasty are unable to provide enough anterior traction. Although successful in reduction of obstructive sleep apnea (OSA) parameters, it also comes with procedure-specific risks. Formation of an oro-nasal fistula (ONF) is a complication that results in significant morbidity and a protracted treatment course. Methods: After approval from the University of Wollongong Health Research Ethics Committee, a retrospective chart review of all cases undergoing TPA performed by a single surgeon over a 10-year period from 2008 to 2018 was performed. Patients underwent pre- and postoperative level 1 or 2 polysomnography. Factors potentially contributing to palatal complications, as well as pre- and postoperative polysomnographic parameters, subjective sleep questionnaires, and body mass index (BMI) were statistically analyzed where a P value <.05 was considered a significant result. Results: A total of 59 patients were included. Overall palatal complication rate was 25.4% (15/59), with the most common being transient velo-palatal insufficiency (VPI) (8/59, 13.6%). ONF developed in 4/59 (6.8%) of patients. None of the analyzed contributing factors for palatal complications were statistically significant, except the presence of a high-arched palate and development of ONF. All analyzed sleep parameters, as well as BMI, were significantly different when comparing pre- to postoperative results. Conclusion: This study suggests that TPA has a role in current sleep surgery paradigms and can significantly improve both objective and subjective outcome measures of OSA. Surgeons contemplating TPA on patients with high-arched hard palates should do so with caution.

Outcome of adenotonsillectomy for obstructive sleep apnea in children under 3 years

2005 ◽  
Vol 132 (5) ◽  
pp. 681-684 ◽  
Author(s):  
Ron B. Mitchell ◽  
James Kelly
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
P Value ◽  
University Of New Mexico ◽  
Obstructive Sleep ◽  
Study Population ◽  
The Mean ◽  
The University ◽  
Head Neck ◽  
Respiratory Distress Index

OBJECTIVE: To study the outcome of adenotonsillectomy for obstructive sleep apnea (OSA) in children less than 3 years of age. DESIGN AND SETTING: Prospective study at the University of New Mexico Children's Hospital. Children with OSA underwent pre- and postoperative full-night polysomnography (PSG). Scores were compared using a paired t test. A P-value <0.05 was considered significant. RESULTS: The study population included 20 children. Fifteen (75%) were male. The mean age was 2.2 years (range, 1.1 to 3.0). Sixteen (80%) children had medical comorbidities. Over 25% of children had postoperative complications including laryngospasm and marked desaturations. The mean preoperative respiratory distress index (RDI) was 34.1 and the mean postoperative RDI was 12.2 ( P < 0.0001). After surgery, 7 (35%) children had an RDI < 5. Thirteen (65%) had a postoperative RDI ≥ 5 indicating persistent OSA. CONCLUSION AND SIGNIFICANCE: Children under 3 years show significant improvement in RDI after adenotonsillectomy for OSA, but they may develop complications after surgery. Postoperative PSG is recommended for children under 3 years of age to monitor the severity of persistent OSA. EBM rating: B-2. (Otolaryngol Head Neck Surg 2005;132:681-684.)

Decreased survival in cervical cancer patients with thromboembolic events

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16034-16034
Author(s):  
G. M. Jacobson ◽  
M. Goodheart ◽  
B. Smith ◽  
J. Lammli
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Proportional Hazards ◽  
Gynecologic Oncology ◽  
Retrospective Chart Review ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
P Value ◽  
Thromboembolic Events ◽  
The University

16034 Background: We have previously reported on the incidence of thromboembolic events (TE) in cervical cancer patients treated with definitive chemoradiation.Patients with TE seemed to have decreased survival compared to those without TE. We reviewed a larger cohort to compare the survival of cervical cancer patients with and without TE. Materials and Methods: We performed a retrospective chart review of cervical cancer patients diagnosed and treated at the University for Iowa from January 1997 until December 2003. Data sources included the University of Iowa Tumor Registry, the Gynecologic Oncology Tumor Data Base, and the relevant ICD-9 codes to identify cervical carcinoma and types of TE in both inpatients and outpatients. Statistical analysis included the Pearson chi-squared test for categorical variable, and the two-sample t-test for continuous factors. Log-rank tests were used for survival analysis along with the generation of Kaplan-Meier survival curves. Multivariate analysis was performed with Cox proportional hazards regression. All tests are two sided and carried out at the 5% level of significance. Results: Three hundred and fifty nine (359) patients were treated with surgery or chemoradiation; thirty-six patients (10%) developed TE. There were significant associations between thromboembolic status and pelvic irradiation (p=0.0493), chemotherapy (p=0.0118), and stage (p=0.0197). Survival could not be estimated for patients not experiencing a thromboembolism; survival did not drop below 50% by the end of follow-up. Median survival time for patients with thromboembolism was 4.5 years. According to log-rank test, this difference was significant (p-value<0.0001). Conclusion: The incidence of thromboembolic events in this cohort of cervical cancer patients was 10%. TE was associated with a significant decrease in survival. No significant financial relationships to disclose.

scholarly journals IS THERE AN ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA AND FRAILTY IN OLDER VETERANS WITH DIABETES?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S949-S949
Author(s):  
Jahan E Mahjabin ◽  
Dhanya Baskaran ◽  
Christopher Lewis ◽  
Valeria C Baldivieso ◽  
William Wohlgemuth ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Medical Center ◽  
Frailty Index ◽  
Retrospective Chart Review ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Frailty Status ◽  
Obstructive Sleep ◽  
The Mean

Abstract Obstructive Sleep Apnea is a highly prevalent disease, where incidence increases with age. Individuals with chronic diseases such as diabetes and obesity are at risk of OSA increasing the risk of frailty. A retrospective chart review was conducted to study the association between OSA and frailty in older diabetic Veterans. Baseline polysomnography data for 91 patients ≥ 65 years was obtained from the electronic health records at the Miami VA Medical Center. Patients were screened for frailty from January 2016 to August 2017, and followed until October 2018. Patients were then dichotomized into frail (Frailty Index (FI) ≥.21) and non-frail (robust FI =&lt;.10 and pre-frail FI ≥.10, &lt;.21) groups. The mean participant age is 70.9 years, with (SD) of 4.8. The mean age for the frail group is 71.1 years, with a SD of 5.2. Mean age for the non-frail group is 70.5 years, with a SD of 4.2. Linear regression demonstrated a significant positive linear relationship between BMI (t=2.096 p-value= .039) and the frailty index. In binomial logistic regression, adjusting for covariates, BMI was associated with increased apnea severity (OR=1.139, 95% CI= 1.044-1.241), p=.003. However, no significant association was found between FI and apnea severity. The severity of OSA based on the Apnea-Hypopnea Index had no significant association with frailty status. However, the study demonstrated a significant association between obesity and frailty, where higher BMI coincided with higher frailty. Increasing BMI coincided with increased severity of OSA, suggesting that BMI acts as a possible confounder between frailty and OSA.

Set up and management of a Data Science faculty at Shiga University

Impact ◽  
2019 ◽  
Vol 2019 (10) ◽  
pp. 18-20
Author(s):  
Akimichi Takemura
Keyword(s):  
Data Science ◽  
Science Faculty ◽  
Knowledge And Skills ◽  
International Trends ◽  
Leading Position ◽  
Global Understanding ◽  
Set Up ◽  
The University ◽  
Do So ◽  
Undergraduate Class

Shiga University opened the first data science faculty in Japan in April 2017. Beginning with an undergraduate class of 100 students, the Department has since established a Master's degree programme with 20 students in each annual intake. This is the first data science faculty in Japan and the University intends to retain this leading position, the Department is well-placed to do so. The faculty closely monitors international trends concerning data science and Artificial Intelligence (AI) and adapt its education and research accordingly. The genesis of this department marks a change in Japan's attitudes towards dealing with information and reflects a wider, global understanding of the need for further research in this area. Shiga University's Data Science department seeks to produce well-trained data scientists who demonstrate a good balance of knowledge and skills in each of the three key areas of data science.

Jude the Obscure

2008 ◽  
Author(s):  
Thomas Hardy
Keyword(s):  
Working Class ◽  
Critical Edition ◽  
The World ◽  
The University ◽  
Jude The Obscure ◽  
Do So

Wherefore is light given to him that is in misery, and life unto the bitter in soul?' Jude Fawley, poor and working-class, longs to study at the University of Christminster, but he is rebuffed, and trapped in a loveless marriage. He falls in love with his unconventional cousin Sue Bridehead, and their refusal to marry when free to do so confirms their rejection of and by the world around them. The shocking fate that overtakes them is an indictment of a rigid and uncaring society. Hardy's last and most controversial novel, Jude the Obscure caused outrage when it was published in 1895. This is the first truly critical edition, taking account of the changes that Hardy made over twenty-five years. It includes a new chronology and bibliography and substantially revised notes.

scholarly journals Prelacteal Feeding Practices and Its Associated Factors among Mother of Children Less Than 2 Years of Age in Kersa District, Eastern Ethiopia

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110183
Author(s):  
Ahmedzekuwan Adem ◽  
Nega Assefa ◽  
Merga Deresa ◽  
Mohammed Yuya ◽  
Galana Mamo Ayana ◽  
...  
Keyword(s):  
Associated Factors ◽  
Feeding Practices ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Contributing Factors ◽  
Prelacteal Feeding ◽  
Cross Sectional ◽  
Timely Initiation ◽  
Eastern Ethiopia ◽  
Initiation Of Breastfeeding

Background. Prelacteal feeding is defined as administration of any substances other than breast milk to newborn babies during the first 3 days after birth. Despite its negative health outcomes, it is commonly practiced in developing countries. Therefore, this study aimed at assessing the prevalence of pre-lacteal feeding practices and associated factors among mothers of children aged less than 2 years of age in Kersa district, Eastern Ethiopia. Method. A community-based cross-sectional study design was conducted among 465 mothers having children aged less than 2 years in Kersa district. A multistage sampling technique was used to select study participants. Binary logistic regression analysis was fitted to identify factors associated with prelacteal feeding practices. Variables with a P-value <.05 were identified as statistically significant factors. Results. The prevalence of pre-lacteal feeding in Kersa district was 46.4% (95% CI; 42.0%, 51.5%). Initiating breastfeeding after 1 hour of delivery (AOR = 10.80, 95% CI: (5.79, 20.17)), giving birth at home (AOR = 2.77, 95% CI: (1.41, 5.46)), not knowing risks associated with pre-lacteal feeding (AOR = 3.25, 95% CI: (1.72, 6.15)) and perceiving pre-lacteal feeding as beneficial (AOR = 9.56, 95% CI: (4.45, 20.52)) were factors significantly associated with practice pre-lacteal feeding practices. Conclusion. Significant proportions of mothers were practicing pre-lacteal feeding in the study area. Late initiation of breastfeeding, home delivery, not knowing risks of prelacteal feeding, and perceiving pre-lacteal feeding as beneficial were contributing factors for practicing of pre-lacteal feeding. Therefore, promoting institutional delivery and timely initiation of breastfeeding would reduce prelacteal feeding in Kersa district.

scholarly journals Modified STOP-Bang for predicting perioperative adverse events in the Thai population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Sangkum ◽  
Chama Wathanavaha ◽  
Visasiri Tantrakul ◽  
Munthana Pothong ◽  
Cherdkiat Karnjanarachata
Keyword(s):  
High Risk ◽  
Adverse Events ◽  
Oxygen Therapy ◽  
Elective Surgery ◽  
Low Risk ◽  
Perioperative Outcomes ◽  
P Value ◽  
Icu Admission ◽  
Obstructive Sleep ◽  
Postanesthetic Care Unit

Abstract Background Undiagnosed obstructive sleep apnea (OSA) is associated with adverse perioperative outcomes. The STOP-Bang questionnaire is a validated screening tool for OSA. However, its precision may vary among different populations. This study determined the association between high-risk OSA based on the modified STOP-Bang questionnaire and perioperative adverse events. Methods This cross-sectional study included patients undergoing elective surgery from December 2018 to February 2019. The modified STOP-Bang questionnaire includes a history of Snoring, daytime Tiredness, Observed apnea, high blood Pressure, Body mass index > 30 kg/m2, Age > 50, Neck circumference > 40 cm, and male Gender. High risk for OSA was considered as a score ≥ 3. Results Overall, 400 patients were included, and 18.3% of patients experienced perioperative adverse events. On the basis of modified STOP-Bang, the incidence of perioperative adverse events was 23.2 and 13.8% in patients with high risk and low risk (P-value 0.016) (Original STOP-Bang: high risk 22.5% vs. low risk 14.7%, P-value 0.043). Neither modified nor original STOP-Bang was associated with perioperative adverse events (adjusted OR 1.91 (95% CI 0.99–3.66), P-value 0.055) vs. 1.69 (95%CI, 0.89–3.21), P-value 0.106). Modified STOP-Bang ≥3 could predict the incidence of difficult ventilation, laryngoscopic view ≥3, need for oxygen therapy during discharge from postanesthetic care unit and ICU admission. Conclusions Neither modified nor original STOP-Bang was significantly associated with perioperative adverse events. However, a modified STOP-Bang ≥3 can help identify patients at risk of difficult airway, need for oxygen therapy, and ICU admission. Trial registrations This study was registered on Thai Clinical Trials Registry, identifier TCTR20181129001, registered 23 November 2018 (Prospectively registered).

scholarly journals Paediatric Sleep Questionnaire for Obstructive Sleep Apnoea Syndrome Screening: Is Sleep Quality Worthy of Note?

2021 ◽  
Vol 11 (4) ◽  
pp. 1440 ◽  
Author(s):  
Vera Panzarella ◽  
Giovanna Giuliana ◽  
Paola Spinuzza ◽  
Gaetano La Mantia ◽  
Laura Maniscalco ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Screening Tools ◽  
Obstructive Sleep Apnoea Syndrome ◽  
P Value ◽  
Predictive Values ◽  
Sleep Questionnaire ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep

Obstructive sleep apnoea syndrome (OSAS) is the most severe condition on the spectrum of sleep-related breathing disorders (SRBDs). The Paediatric Sleep Questionnaire (PSQ) is one of the most used and validated screening tools, but it lacks the comprehensive assessment of some determinants of OSAS, specifically anamnestic assessment and sleep quality. This study aims to assess the accuracy of some specific items added to the original PSQ, particularly related to the patient’s anamnestic history and to the quality of sleep, for the screening of OSAS in a paediatric population living in Sicily (Italy). Fifteen specific items, divided into “anamnestic” and “related to sleep quality” were added to the original PSQ. The whole questionnaire was administered via a digital form to the parents of children at 4 schools (age range: 3–13 years). For each item, sensitivity and specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. The highest sensitivity (80.0, 95% CI: 28.4; 99.5), in combination with the highest specificity (61.1, 95% CI: 35.7; 82.7), was found for the Item 32 (“assumption of bizarre or abnormal positions during sleep”). This item was found statistically significant for predicting the occurrence of OSAS in children (p-value ≤0.003). The study demonstrates the accuracy of specific items related to sleep quality disturbance for the preliminary assessment of the disease. Although these results should be validated on a larger sample of subjects, they suggest that including the factors discriminating sleep quality could further increase the efficiency and accuracy of PSQ.

Effect of position therapy and oral devices on sleep parameters in patients with obstructive sleep apnea

2021 ◽  
Author(s):  
Masaaki Suzuki ◽  
Yoshihiro Funayama ◽  
Mika Homma ◽  
Kana Shibasaki ◽  
Taiji Furukawa ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep ◽  
Sleep Parameters

Otologic Complications of Radiation Therapy

1979 ◽  
Vol 87 (3) ◽  
pp. 359-363 ◽  
Author(s):  
John V. O'Neill ◽  
Arthur H. Katz ◽  
Emanuel M. Skolnik
Keyword(s):  
Radiation Therapy ◽  
External Auditory Canal ◽  
Radiation Dosage ◽  
Preventive Measures ◽  
Contributing Factors ◽  
University Of Illinois ◽  
Nasopharyngeal Tumors ◽  
The University ◽  
Serous Otitis Media

Radiation therapy has proved to be a valuable modality in the management of patients with nasopharyngeal tumors. Routine follow-up of patients in the tumor clinic of the University of Illinois Eye and Ear Infirmary appeared to indicate an increasing incidence of otologic pathology. For this reason, a retrospective study focusing on the otologic findings in patients whose radiation therapy for nasopharyngeal tumors included the external auditory canal, middle ear space, or eustachian tube was performed. The results of this study are discussed in relationship to total radiation dosage, time of survival after therapy, and pretreatment otologic status. The complications covered a spectrum from intermittent serous otitis media to osteoradionecrosis of the external auditory canal. Possible contributing factors are discussed, and preventive measures are suggested.

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