scholarly journals New Challenges for Sleep Apnea Research: Simple Diagnostic Tools, Biomarkers, New Treatments and Precision Medicine

Sleep Science ◽  
2017 ◽  
Vol 10 (1) ◽  
Author(s):  
Luciano F. Drager
Keyword(s):  
Sleep Apnea ◽  
Precision Medicine ◽  
Diagnostic Tools ◽  
New Challenges ◽  
New Treatments

806 Barriers to screening and diagnosis of obstructive sleep apnea during inpatient traumatic brain injury rehabilitation

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A314-A315
Author(s):  
Bridget Cotner ◽  
Risa Nakase-Richardson ◽  
Becky Gius ◽  
Lauren Fournier ◽  
Alexa Watach ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Obstructive Sleep Apnea ◽  
Brain Injury ◽  
Sleep Apnea ◽  
Inpatient Rehabilitation ◽  
Screening Tools ◽  
Diagnostic Tools ◽  
Evidence Based ◽  
Implementation Barriers ◽  
Obstructive Sleep

Abstract Introduction Obstructive Sleep Apnea (OSA) is prevalent after moderate to severe traumatic brain injury (TBI) and may diminish recovery when left untreated. Despite the demonstrated importance of treating OSA following TBI, assessment for OSA during or soon after inpatient rehabilitation for TBI is limited. Little is known about barriers to implementing OSA screening and early diagnosis during inpatient rehabilitation thus hindering the translation of evidence-based OSA assessment procedures into clinical practice and potentially delaying necessary OSA treatment. The current analysis explored facilitators and barriers to implementing OSA screening tools in an inpatient rehabilitation setting from the perspectives of end user stakeholders. Methods Patients, families, industry, clinical providers and administrators participated in a two-day meeting following completion of a diagnostic clinical trial of OSA screening and diagnostic tools during inpatient rehabilitation. Stakeholders were provided with open ended questions generated by study investigators and given the opportunity to respond on paper or a “graffiti wall” (i.e., white board). Example questions include “What are the greatest needs of the healthcare system related to sleep apnea and TBI?” and “What are the key things we need to consider to move results into real-world practice?” Qualitative content analyses using a rapid matrix approach were conducted from stakeholder feedback obtained during the two-day meeting, which included a guided review of emerging OSA research and discussion of potential implementation barriers of OSA assessment during inpatient rehabilitation. Results Improved screening and treatment practices for OSA were the greatest needs identified. To meet these needs, stakeholders identified the importance of improving patient, family, and staff understanding of OSA (e.g., health literacy) and other sleep disorders through education; inpatient rehabilitation access to resources (technology; sleep providers); and reimbursement for additional inpatient procedures. Conclusion Although treatment of OSA is crucial for recovery during inpatient rehabilitation following TBI, barriers to earlier recognition, diagnosis, and treatment of OSA exists across several different domains, including education, resources, and funding policies. Findings support future implementation efforts to translate evidence-based care into practice to improve patient outcomes. Support (if any) PCORI-NCT03033901

The importance of mass communication in promoting positive health

2010 ◽  
pp. 108-111
Author(s):  
Thomas Lom
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Professionals ◽  
Public Health Policy ◽  
Mass Communication ◽  
Medical Science ◽  
Diagnostic Tools ◽  
Positive Health ◽  
For Profit ◽  
New Treatments

Medical science is enabling an explosion of discovery in diagnostic tools and in the development of new treatments and products. But how do we take advantage if we are not aware? That is where the power of mass communication comes into play. In a world with increasingly motivated and empowered patients, these go well beyond just the for-profit companies such as the pharmaceutical industry and include payers, governments, health care professionals, and institutions. The motivation for the dissemination of health information is a convergence of public health interest and public health policy with private sector commercial interests....

New treatments for obstructive sleep apnea in children

2020 ◽  
Vol 30 (3) ◽  
pp. 232-240
Author(s):  
Sheri Jones Oguh ◽  
Lisa Elden ◽  
Jordan Swanson ◽  
Ignacio Tapia ◽  
Rajeev Subramanyam
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep ◽  
New Treatments

scholarly journals Radiomics and Texture Analysis in Laryngeal Cancer. Looking for New Frontiers in Precision Medicine through Imaging Analysis

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1409 ◽  
Author(s):  
Chiesa-Estomba ◽  
Echaniz ◽  
Larruscain ◽  
Gonzalez-Garcia ◽  
Sistiaga-Suarez ◽  
...  
Keyword(s):  
Decision Making ◽  
Precision Medicine ◽  
Texture Analysis ◽  
Laryngeal Cancer ◽  
Clinical Decision Making ◽  
Functional Anatomy ◽  
Functional Results ◽  
Predictive Biomarker ◽  
Diagnostic Tools ◽  
Imaging Data

Radiomics and texture analysis represent a new option in our biomarkers arsenal. These techniques extract a large number of quantitative features, analyzing their properties to incorporate them in clinical decision-making. Laryngeal cancer represents one of the most frequent cancers in the head and neck area. We hypothesized that radiomics features can be included as a laryngeal cancer precision medicine tool, as it is able to non-invasively characterize the overall tumor accounting for heterogeneity, being a prognostic and/or predictive biomarker derived from routine, standard of care, imaging data, and providing support during the follow up of the patient, in some cases avoiding the need for biopsies. The larynx represents a unique diagnostic and therapeutic challenge for clinicians due to its complex tridimensional anatomical structure. Its complex regional and functional anatomy makes it necessary to enhance our diagnostic tools in order to improve decision-making protocols, aimed at better survival and functional results. For this reason, this technique can be an option for monitoring the evolution of the disease, especially in surgical and non-surgical organ preservation treatments. This concise review article will explain basic concepts about radiomics and discuss recent progress and results related to laryngeal cancer.

scholarly journals The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites

Toxins ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 363 ◽  
Author(s):  
Williams ◽  
Layfield ◽  
Vallance ◽  
Patel ◽  
Bicknell ◽  
...  
Keyword(s):  
Paradigm Shift ◽  
Adverse Reactions ◽  
Treatment Strategies ◽  
Diagnostic Tools ◽  
Neglected Tropical Disease ◽  
Symptom Presentation ◽  
Molecular Therapeutics ◽  
Metalloprotease Inhibitors ◽  
New Treatments

Snakebite envenoming (SBE) is a priority neglected tropical disease, which kills in excess of 100,000 people per year. Additionally, many millions of survivors also suffer through disabilities and long-term health consequences. The only treatment for SBE, antivenom, has a number of major associated problems, not least, adverse reactions and limited availability. This emphasises the necessity for urgent improvements to the management of this disease. Administration of antivenom is too frequently based on symptomatology, which results in wasting crucial time. The majority of SBE-affected regions rely on broad-spectrum polyvalent antivenoms that have a low content of case-specific efficacious immunoglobulins. Research into small molecular therapeutics such as varespladib/methyl-varespladib (PLA2 inhibitors) and batimastat/marimastat (metalloprotease inhibitors) suggest that such adjunctive treatments could be hugely beneficial to victims. Progress into toxin-specific monoclonal antibodies as well as alternative binding scaffolds such as aptamers hold much promise for future treatment strategies. SBE is not implicit during snakebite, due to venom metering. Thus, the delay between bite and symptom presentation is critical and when symptoms appear it may often already be too late to effectively treat SBE. The development of reliable diagnostical tools could therefore initiate a paradigm shift in the treatment of SBE. While the complete eradication of SBE is an impossibility, mitigation is in the pipeline, with new treatments and diagnostics rapidly emerging. Here we critically review the urgent necessity for the development of diagnostic tools and improved therapeutics to mitigate the deaths and disabilities caused by SBE.

scholarly journals How to Be Savvy About Gender Disparities in Academic Stroke Medicine

Stroke ◽  
2020 ◽  
Vol 51 (9) ◽  
Author(s):  
Aleksandra Pikula ◽  
Luciana Catanese ◽  
Cheryl D. Bushnell ◽  
Valeria Caso ◽  
Julie K. Silver
Keyword(s):  
Clinical Care ◽  
Critical Role ◽  
Women's Leadership ◽  
Gender Disparities ◽  
Early Career ◽  
Diagnostic Tools ◽  
Career Stage ◽  
Clinical Practices ◽  
New Treatments

In the past decade, stroke medicine has evolved from discovery of innovative diagnostic tools to implementation of new treatments. These advances are projected to increase the demand for stroke neurologists in academic and clinical practices, but hopefully with equitable opportunities for everyone across the gender spectrum. Academic medicine provides opportunities to participate in clinical care, teaching, research, and administration. The early career stage is short-focused on finding an academic niche and developing new skills that will help you navigate the academic environment. A recent InterSECT article emphasized the critical role of women’s leadership in stroke medicine. In this article, we reflect on workforce gender disparities and provide 5 practical strategies that may help women overcome barriers and advance their work mission.

scholarly journals N-terminal pro-brain natriuretic peptide: a potential follow-up biomarker of mandibular advancement device efficacy on cardiac function in obstructive sleep apnea

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1818
Author(s):  
Denis Monneret
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Controlled Trial ◽  
Blood Pressure Reduction ◽  
Cardiac Biomarkers ◽  
Mandibular Advancement ◽  
Diagnostic Tools ◽  
Obstructive Sleep

Interrelationships between obstructive sleep apnea (OSA) and cardiovascular diseases are now recognized, but some underlying pathophysiological mechanisms remain controversial. Circulating cardiac biomarkers are diagnostic tools that can help understand them, in particular the N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker of myocardial stretch, and a potential indicator of subclinical cardiac stress in OSA. Continuous positive airway pressure (CPAP), the first-line treatment of moderate to severe OSA, may be considered as uncomfortable, resulting in poor adherence, and reduced effectiveness. In this case, mandibular advancement devices (MAD) are an effective alternative therapy, more comfortable, and generally well accepted, with higher compliance. To date, few studies have compared the cardiovascular effects of CPAP and MAD. From recent literature reviews, it emerges that both therapies are effective in blood pressure reduction. However, the effects of MAD on other cardiovascular outcomes are conflicting, in particular as regards to its impact on circulating cardiac biomarkers. In a recent ancillary study from a randomized controlled trial, Recoquillon et al concluded that two months of MAD treatment had no effect on NT-proBNP plasma levels in patients with severe OSA. The present discussion analyses this result from a biological, statistical, and analytical standpoint, in light of results from other studies evaluating natriuretic peptides in MAD-treated OSA, with the aim to support further longitudinal studies designed with a high methodological quality.

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