scholarly journals Cough Hypersensitivity in Patients With Metabolic Syndrome: A Clinical Finding and Its Possible Mechanisms

2021 ◽  
Author(s):  
Jiafen Cheng ◽  
Zhuangli Xie ◽  
Shengyuan Wang ◽  
Siwan Wen ◽  
Shanshan Niu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Gastroesophageal Reflux ◽  
Induced Sputum ◽  
Apnea Hypopnea Index ◽  
Minimum Concentration ◽  
Routine Physical Examination ◽  
Group 3 ◽  
Group 2 ◽  
Capsaicin Cough ◽  
Group 1

Abstract Purpose: To investigate the changes of cough sensitivity in patients with metabolic syndrome and its possible mechanisms. Method: A total of 29 metabolic syndrome (MetS) patients with OSAHS (group-1), 22 MetS patients without OSAHS (group-2), and 25 healthy controls (group-3) were included. All participants underwent a routine physical examination and completed the gastroesophageal reflux disease questionnaire (GerdQ), and the inflammatory mediator profile were determined. The cough threshold for capsaicin, induced sputum cell count and cell classification, and inflammatory mediators in induced sputum supernatants were compared. The correlation between capsaicin cough sensitivity and various indicators in the MetS population was analyzed. Results: The minimum concentration of inhaled capsaicin needed to induce ≥2 coughs (C2) was significantly different among three groups (H = 13.856, P < 0.001) and lower for group-1 and group-2 than it for group-3 (P = 0.001, P = 0.003), which was similar with the C5 concentrations (the minimum concentration of inhaled capsaicin needed to induce ≥5 coughs). The percentage of neutrophils in induced sputum and the concentrations of calcitonin gene-related peptide (CGRP), substance P (SP), and interleukin 8 (IL-8) in the sputum supernatant of group-1 and group-2 were significantly higher than those of group-3. Besides, the pepsin concentrations were significantly different among the 3 groups (F = 129.362, P < 0.001), which significantly was highest in group-1(P < 0.001) and lowest in group-3 (P < 0.001). In group-1, lgC2 and lgC5 were both negatively correlated with the apnea-hypopnea index (AHI, r = -0.577, P = 0.001; r = -0.394, P = 0.035). Conclusion: Increased capsaicin cough sensitivity in MetS patients is closely related to sleep apnea and gastroesophageal reflux. For patients in MetS patients without OSAHS, gastroesophageal reflux is an important factor for increased capsaicin cough sensitivity. Airway inflammation, especially airway neurogenic inflammation, may also play a role in the pathogenesis of increased capsaicin cough sensitivityTrial registration: The protocol was registered in the Chinese Clinical Trials Register (http://www. chictr. org. cn/) (ChiCTR1800014768). Written informed consent was obtained from all participants before enrollment.

scholarly journals Cough hypersensitivity in patients with metabolic syndrome: a clinical finding and its possible mechanisms

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiafen Cheng ◽  
Zhuangli Xie ◽  
Shengyuan Wang ◽  
Siwan Wen ◽  
Shanshan Niu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Gastroesophageal Reflux ◽  
Induced Sputum ◽  
Minimum Concentration ◽  
Calcitonin Gene ◽  
Routine Physical Examination ◽  
Group 3 ◽  
Group 2 ◽  
Capsaicin Cough ◽  
Group 1

Abstract Purpose To investigate the changes of cough sensitivity in patients with metabolic syndrome and its possible mechanisms. Method A total of 29 metabolic syndrome (MetS) patients with OSAHS (group-1), 22 MetS patients without OSAHS (group-2), and 25 healthy controls (group-3) were included. All participants underwent a routine physical examination and completed the gastroesophageal reflux disease questionnaire (GerdQ), and the inflammatory mediator profile were determined. The cough threshold for capsaicin, induced sputum cell count and cell classification, and inflammatory mediators in induced sputum supernatants were compared. The correlation between capsaicin cough sensitivity and various indicators in the MetS population was analyzed. Results The minimum concentration of inhaled capsaicin needed to induce ≥ 5 coughs (C5) was significantly different among three groups (H = 14.393, P = 0.001) and lower for group-1 and group-2 than it for group-3 (P = 0.002, P = 0.005). The percentage of neutrophils in induced sputum and the concentrations of calcitonin gene-related peptide (CGRP), substance P (SP), and interleukin 8 (IL-8) in the sputum supernatant of group-1 and group-2 were significantly higher than those of group-3. Besides, the pepsin concentrations were significantly different among the 3 groups (F = 129.362, P < 0.001), which significantly was highest in group-1 (P < 0.001) and lowest in group-3 (P < 0.001). Triglycerides, AHI, pepsin concentration and BMI were risk factors of increased capsaicin cough sensitivity. Conclusion Increased capsaicin cough sensitivity in MetS patients is closely related to sleep apnea and gastroesophageal reflux. For patients in MetS patients without OSAHS, gastroesophageal reflux is an important factor for increased capsaicin cough sensitivity. Airway inflammation, especially airway neurogenic inflammation, may also play a role in the pathogenesis of increased capsaicin cough sensitivity. Trial registration The protocol was registered in the Chinese Clinical Trials Register (http://www.chictr.org.cn/) (ChiCTR1800014768). Written informed consent was obtained from all participants before enrollment.

scholarly journals M86. CAN WEIGHT GAIN CAUSE METABOLIC SYNDROME A DECADE LATER IN PATIENTS WITH SCHIZOPHRENIA SPECTRUM DISORDER?

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S167-S167
Author(s):  
Moradi Hawar ◽  
Lars Helldin ◽  
Anna-Karin Olsson ◽  
Pontén Anna
Keyword(s):  
Metabolic Syndrome ◽  
Weight Gain ◽  
Life Time ◽  
Spectrum Disorder ◽  
Schizophrenia Spectrum Disorder ◽  
Group 4 ◽  
Schizophrenia Spectrum ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Patients with schizophrenia spectrum disorder have a reduced life time expectancy with up to 20 years. Obesity and metabolic syndrome is highly prevalent and cardio vascular disease, CVD, remain the most common cause of the excess mortality. Despite studies showing the reduced life time expectancy and its causes the patients with schizophrenia spectrum disorder yet remain to benefit of the development of the healthcare. In this study we aim to focus on how the weight changes in different age groups and when do the cluster of conditions of metabolic syndrome start to occur. Methods In this naturalistic study we follow 71 patients, 47 man and 24 women diagnosed with schizophrenia spectrum disorder. We divided the patients into 5 different groups based on age. Group 1 aged 20–30 years, Group 2 aged 31–40 years, Group 3 aged 41–50 years, group 4 aged 51–60 years and Group 5 aged 61 years and elder. The longest time of observation was 18 years. Data on weight (kg) and disorders such as diabetes, hypertension and dyslipidemia were collected at baseline and then yearly thereafter. Data from baseline and the last yearly follow up were included in this study. Weight and the presence of the cluster of conditions that make up metabolic syndrome in the above-mentioned groups were analyzed. Results Patients in group 1 make the highest gain of weight with 0, 9 kg per year and group 2 with the least gain of weight only 0, 01 kg per year. Patients in group 3 have a weight loss of 0, 2 kg per year. At endpoint 9 out 19 patients in group 3 and 11 out of 21 patients in group 4 were treated for one, two or three conditions of the metabolic syndrome. Discussion In our study we show that weight gain appears at least 10 years before the development of metabolic syndrome. Despite the loss of weight that appear in group 3 the negative effects of the weight gained a decade earlier may be a factor that make patients aged 41 years and older to be at risk of developing metabolic syndrome.

scholarly journals THE COMPARISON OF THE EFFECT BETWEEN ALGINATE-BASED RAFT-FORMING LIQUID AND ALGINATE LIQUID ON GASTROESOPHAGEAL REFLUX DISEASE AND GASTRIC ULCER IN RATS

2017 ◽  
Vol 10 (12) ◽  
pp. 105
Author(s):  
Hakim Bangun ◽  
Anayanti Arianto ◽  
Ririn Astya ◽  
Gontar A Siregar
Keyword(s):  
Gastric Ulcer ◽  
Gastroesophageal Reflux Disease ◽  
Gastric Mucosa ◽  
Gastroesophageal Reflux ◽  
Negative Control ◽  
Gastric Lesions ◽  
Esophageal Erosion ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective: The objective of the study was to compare the effect between alginate (Alg)-based raft-forming and Alg liquid on healing gastroesophageal reflux disease (GERD) and gastric ulcer in rats.Methods: Each of the 18 fasted rats was given 1 ml acidified pepsin. Then, rats were divided into three groups. Each group consisted of six rats. Group 1 (negative control) was orally given 1 ml distilled water, Group 2 was given 1 ml Alg-based raft-forming liquid, and Group 3 was given 1 ml Alg liquid. Then, the abdomen of rats was incised under anesthesia with ketamine, and then both their pylorus and the forestomach were ligated to form gastric reflux. After 4 hrs, all rats were killed with chloroform and their esophagus and stomach were examined macroscopically and microscopically (histopathology).Results: On macroscopic observation, all of the Group 1 rats (negative control) showed esophageal lesions and gastric lesions. Four rats of Group 2 (given Alg-based raft-forming) showed no esophageal lesion and two more rats showed a slight lesion, but all of the tested rats showed gastric lesions. All of the rats of the Group 3 (given Alg liquid) showed esophageal lesions, but no gastric lesion on four rats and slight lesion on two rats. Microscopic observations showed that all of the Group 1 rats (negative control) showed esophageal erosion and gastric mucosa lesions. Rats of the Group 2 (given Alg-based raft-forming) showed almost no esophageal erosion, but all of them showed erosion of gastric mucosa. Rats of the Group 3 (given Alg liquid) showed esophageal erosion in all tested rats, but almost no gastric mucosa lesion.Conclusion: Alg-base raft-forming liquid is more effective in healing of GERD than Alg liquid. However, Alg-liquid is more effective in healing of gastric ulcer than Alg-based raft-forming liquid.

scholarly journals Steady-State Pharmacokinetics of Tenofovir-Based Regimens in HIV-Infected Pediatric Patients

2011 ◽  
Vol 55 (9) ◽  
pp. 4290-4294 ◽  
Author(s):  
Jennifer R. King ◽  
Ram Yogev ◽  
Patrick Jean-Philippe ◽  
Bobbie Graham ◽  
Andrew Wiznia ◽  
...  
Keyword(s):  
Fixed Dose ◽  
Target Range ◽  
Pharmacokinetic Parameters ◽  
Time Interval ◽  
Minimum Concentration ◽  
Once Daily ◽  
Daily Group ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACTHIV-infected children are treated with tenofovir in combination with other, potentially interacting, antiretroviral agents. We report the pharmacokinetic parameters of tenofovir in combination with efavirenz, darunavir-ritonavir, or atazanavir-ritonavir in HIV-infected children. HIV-infected patients 8 to 18 years of age receiving a tenofovir (300 mg)-based regimen containing efavirenz (300 or 600 mg) once daily (group 1), darunavir (300 or 600 mg)-ritonavir (100 mg) twice daily (group 2), or atazanavir (150 to 400 mg)-ritonavir (100 mg) once daily (group 3) were enrolled. Plasma samples were collected over a 24-h time interval. The 90% confidence intervals (90% CI) of the geometric means for the area under the plasma concentration-time curve (AUC) and the minimum concentration of drug in serum (Cmin) of each antiretroviral were computed and checked for overlap with intervals bracketing published values obtained in adult or pediatric studies demonstrating safety and/or efficacy. Group 1 efavirenz plasma concentrations were observed to be higher in patients receiving fixed-dose combination tablets compared with subjects receiving the individual formulation. In group 2, tenofovir and darunavir exposure was observed to be lower than expected. In group 3, tenofovir and atazanavir administered concomitantly produced exposures similar to those published for adult patients. The 90% CI of AUC andCminfor tenofovir overlapped the target range for all combinations. Informal comparisons of treatment groups did not indicate any advantage to any combination with respect to tenofovir exposure. Further study of exposures achieved with antiretrovirals administered in combination is warranted.

scholarly journals ROLE OF METFORMIN ON CLOZAPINE INDUCED DYSLIPIDAEMIA IN WISTAR RATS

2018 ◽  
pp. 1-5
Author(s):  
Syed Shoib Md Hussaini ◽  
Akram A Naikwadi ◽  
Narsapur VU
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Type Ii Diabetes ◽  
Wistar Rats ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Metabolic Derangement ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: The clinical research in past decade has reported that most second-generation antipsychotics (SGAs) can cause serious metabolic derangement, which substantially increases the risk for type II diabetes mellitus. Several retrospective studies have shown increased in serum triglyceride in patients treated with Clozapine. SGAs induced metabolic syndrome is characterized by weight gain, hyperglycaemia, hypertension, hyperlipidaemia, glucose intolerance and insulin resistance. Metformin is currently used to treat metabolic syndrome and type II diabetes mellitus. It is therefore important to determine whether Metformin is efficacious in treating Clozapine-induced metabolic derangement like dyslipidaemia. Objectives: To evaluate the effect of Metformin in minimizing Clozapine induced metabolic derangement like dyslipidaemia. Methodology: Wistar rats weighing 180-240g either sex were divided into 3 groups of 6 rats each. Group 1 served as control, Group 2 Treated with Clozapine 25mg/kg body weight and Group 3 Treated with Clozapine 25mg + Metformin 100mg/kg body weight for 28 days P.O. Group 2 and group 3 were treated for 28 days. Biochemical investigations: Retro-orbital blood was collected for Lipid profile. Result: Lipid profile of group 2 rats treated with Clozapine showed dyslipidaemia (TG 103.3 ±1.7mg/dl, Tc 113.7 ±1.6mg/dl). Whereas group 3 rats treated with Clozapine 25mg + Metformin showed normal lipid levels (TG 94.7±1.7mg/dl, TC 102.8 ±0.8 mg/dl) comparable to group 1(TG 93.0 ±2.6mg/dl, TC 103.7 ±1.5mg/dl). Conclusion: This study exploring the use of Metformin to prevent metabolic derangement like dyslipidaemias in patients of schizophrenia treated with Clozapine. KEYWORDS: Clozapine; Metformin; Dyslipidaemia.

Follow-up of Congenital Diaphragmatic Hernia: Need for Routinary Assessment of Acid Gastroesophageal Reflux with pH-metry

2017 ◽  
Vol 28 (06) ◽  
pp. 502-507 ◽  
Author(s):  
Andrea Zanini ◽  
Giorgio Farris ◽  
Anna Morandi ◽  
Irene Festa ◽  
Giulia Brisighelli ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Group Analysis ◽  
Level Of Evidence ◽  
Group 3 ◽  
Group 2 ◽  
Ph Metry ◽  
Group 1

Introduction We aim to assess gastroesophageal reflux (GER) in patients treated for congenital diaphragmatic hernia (CDH) and to determine whether a pH-metry investigation should be routinely performed in follow-up. Materials and Methods Twenty-four-hour pH-metry at 1 year was performed in all patients treated for CDH between January 2014 and April 2015 (Group 1). We compared pH-metry results to those of two other groups: children treated for esophageal atresia (EA) (Group 2) and normal babies presenting with typical symptoms (Group 3). All the pH-metric findings were analyzed and compared. Intra-group analysis was performed in Group 1. Results Group 1 consisted of 21, Group 2 of 24, and Group 3 of 21 patients. Mean pH-metry values for Groups 1, 2, and 3 were, respectively: reflux index (RI) 4.3, 5.1, and 3.9; total number of refluxes (NR) 79.5, 88.8, and 88.7; refluxes longer than 5′ (R > 5) 1.7, 2.3, and 1.47; and longest reflux episode (LR) 11.4, 13.3, and 8.6. No significant differences were found between Group 1 and the others. Only two CDH patients presented with GER-related symptoms. Patch was associated with significantly higher RI (8.5 vs. 2.98, p = 0.03). The worse was the defect, the worse were the pH-metric results (RI: A3.09, B3.15, and C9.1). Conclusion We believe that a routine GER assessment should be performed in all CDH patients regardless the presence of symptoms. Level of Evidence This is a Level II study.

scholarly journals EFFECT OF SIZE OF INTESTINAL DIVERSIONS IN OBESE PATIENTS WITH METABOLIC SYNDROME SUBMITTED TO GASTRIC BYPASS

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 15-19 ◽  
Author(s):  
Rafael Jacques RAMOS ◽  
Cláudio Corá MOTTIN ◽  
Letícia Biscaino ALVES ◽  
Daniela BENZANO ◽  
Alexandre Vontobel PADOIN
Keyword(s):  
Metabolic Syndrome ◽  
Gastric Bypass ◽  
Loop Group ◽  
Intestinal Loop ◽  
Obese Patients ◽  
Alimentary Limb ◽  
Biliopancreatic Limb ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACT Background: There is no consensus on the ideal size of intestinal loops in gastric bypass of bariatric surgeries. Aim: To evaluate the metabolic outcome of patients submitted to gastric bypass with alimentary and biliopancreatic loops of different sizes. Methods: Was conducted a retrospective cohort study in diabetic obese patients (BMI≥35 kg/m2) with metabolic syndrome submitted to gastric bypass. The patients were divided into three groups according to the size of the intestinal loop: group 1, biliopancreatic limb 50 cm length and alimentary limb 100 cm length; group 2 , biliopancreatic limb 50 cm length and alimentary limb 150 cm length; and group 3, biliopancreatic limb 100 cm length and alimentary limb 150 cm length. The effect of gastric bypass with different sizes of intestinal loops in relation to the parameters that define metabolic syndrome was determined. Results: Sixty-three patients were evaluated, and they had a mean age of 44.7±9.4 years. All were diabetics, with 62 (98.4%) being hypertensive and 51 (82.2%) dyslipidemic. The three groups were homogeneous in relation to the variables. In 24 months, there was a remission of systemic arterial hypertension in 65% of patients in group 1, 62.5% in group 2 and 68.4% in group 3. Remission of diabetes occurred in 85% of patients in group 1, 83% in group 2 and 84% in group 3. There was no statistical difference in %LEW between the groups, and waist measurements decreased in a homogeneous way in all groups. The size of loops also had no influence on the improvement in dyslipidemia. Conclusion: Variation in size of intestinal loops does not appear to influence improvement in metabolic syndrome in this group of patients.

scholarly journals Examination of Gastroesophageal Reflux by Transabdominal Ultrasound: Can a Slow, Trickling form of Reflux be Responsible for Reflux Esophagitis?

2000 ◽  
Vol 14 (7) ◽  
pp. 588-592 ◽  
Author(s):  
László Madi-Szabo ◽  
György Kocsis
Keyword(s):  
Gastroesophageal Reflux ◽  
Test Meal ◽  
Special Kind ◽  
Control Group ◽  
Lower Esophagus ◽  
Transabdominal Ultrasonography ◽  
Group 3 ◽  
Group 2 ◽  
Control Group Group ◽  
Group 1

BACKGROUND: Ultrasound can visualize significant portions of the upper and lower esophagus; it is without any instrumental interference in real conditions and displays events in motion.PURPOSE: To study the events that occur during swallowing and gastroesophageal reflux.PATIENTS AND METHODS: Group 1 comprised 25 patients with retrosternal complaints, selected for esophageal surface ultrasonography for endoscopic signs of esophagitis. Group 2 comprised 25 patients who underwent initial transabdominal ultrasonography. For 3 to 6 h before ultrasonography, nothing was given by mouth to the 50 patients labelled as having gastroesophageal reflux disease (GERD). Ultrasonography was then performed for 15 to 20 mins after drinking one mouthful of water or tea, or swallowing some saliva to provoke reflux. The events were recorded on videotape rolls. Endoscopy was carried out in all 50 cases; in 46 cases (21 and 25 from groups 1 and 2, respectively), gastric acidity and bacteriology were subsequently examined (test meal). Manometry and pH were not measured to avoid provocation of reflux by the instruments. Thirty patients without any esophageal complaints or signs of esophagitis (though suffering from gastric and duodenal diseases) were designated as the control group (group 3). The available results were compared.RESULTS: In 32 of 46 patients diagnosed with GERD (69.5% in groups 1 and 2), a special kind of reflux was observed by ultrasonography: a slow, trickling reflux of the gastric content was seen, mostly after swallowing. A fast clearance followed four to six episodes of the trickling reflux, only after an interval of 0.5 to 2 mins. Only fast refluxes and immediate clearance were observed in the control group.CONCLUSIONS: The observations above may indicate a special form of gastroesophageal reflux, namely, a slow, trickling form of it. It can be responsible for the development of GERD. Fast reflux and immediate clearance are common; however, this special trickling form was observed only in GERD patients. This may explain a number of often contradictory measurements and can make the effect of cisapride more understandable. A test meal is always necessary to distinguish a bilious reflux from an acidic one, because only the latter may require aggresive antacidic treatment.

Intermittent hypoxia and respiratory patterns during sleep of preterm infants aged 3 to 18 months residing at high altitude

SLEEP ◽  
2021 ◽  
Author(s):  
Elida Duenas-Meza ◽  
María Isabel Escamilla-Gil ◽  
María Angelica Bazurto-Zapata ◽  
Elizabeth Caparo ◽  
Miguel Suarez Cuartas ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
High Altitude ◽  
Preterm Infants ◽  
Intermittent Hypoxia ◽  
Age Groups ◽  
Apnea Hypopnea Index ◽  
Group 3 ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Abstract Study Objectives The aim of this study was to determine the impact of apneas on oxygen saturation and the presence of intermittent hypoxia, during sleep of preterm infants (PTIs) born at high altitudes and compare with full-term infants (FTIs) at the same altitude. Methods PTIs and FTIs from 3 to 18 months were included. They were divided into three age groups: 3–4 months (Group 1); 6–7 months (Group 2), and 10–18 months (Group 3). Polysomnography parameters and oxygenation indices were evaluated. Intermittent hypoxia was defined as brief, repetitive cycles of decreased oxygen saturation. Kruskal-Wallis test for multiple comparisons, t-test or Mann–Whitney U-test were used. Results 127 PTI and 175 FTI were included. Total apnea-hypopnea index (AHI) was higher in PTI that FTI in all age groups (Group 1: 33.5/h vs. 12.8/h, p = 0.042; Group 2: 27.0/h vs. 7.4/h, p &lt; 0.001; and Group 3: 11.6/h vs. 3.1/h, p &lt; 0.001). In Group 3, central-AHI (8.0/h vs. 2.3/h, p &lt; 0.001) and obstructive-AHI (1.8/h vs. 0.6/h, p &lt; 0.008) were higher in PTI than FTI. T90 (7.0% vs. 0.5, p &lt; 0.001), oxygen desaturation index (39.8/h vs. 11.3, p &lt; 0.001) were higher in PTI than FTI, nadir SpO2 (70.0% vs. 80.0, p&lt;0.001) was lower in PTI. Conclusion At high altitude, compared to FTI, PTI have a higher rate of respiratory events, greater desaturation, and a delayed resolution of these conditions, suggesting the persistence of intermittent hypoxia during the first 18 months of life. This indicates the need for follow-up of these infants for timely diagnosis and treatment of respiratory disturbances during sleep.

scholarly journals Continuous Positive Airway Pressure Device Time to Procurement in a Disadvantaged Population

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Lourdes M. DelRosso ◽  
Romy Hoque ◽  
Andrew L. Chesson
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Apnea Hypopnea Index ◽  
Disadvantaged Population ◽  
Obstructive Sleep ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Introduction.The management of obstructive sleep apnea (OSA) in patients who cannot afford a continuous positive airway pressure (CPAP) device is challenging. In this study we compare time to CPAP procurement in three groups of patients diagnosed with OSA: uninsured subsidized by a humanitarian grant (Group 1), uninsured unsubsidized (Group 2), and those with Medicare or Medicaid (Group 3). We evaluate follow-up and adherence in Group 1. We hypothesize that additional factors, rather than just the ability to obtain CPAP, may uniquely affect follow-up and adherence in uninsured patients.Methods.30 patients were in Groups 1 and 2, respectively. 12 patients were in Group 3. Time of CPAP procurement from OSA diagnosis to CPAP initiation was assessed in all groups. CPAP adherence data was collected for Group 1 patients at 1, 3, 6, and 9 months.Results.There were no significant differences between groups in gender, age, body mass index, or apnea hypopnea index. The mean time to procurement in Group 1 was shorter compared to Group 2 but not significant. Compared to both Group 1 and Group 2, Group 3 patients had significantly shorter times to device procurement.Conclusion.Time to procurement of CPAP was significantly shorter in those with Medicaid/Medicare insurance compared to the uninsured.

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