Quality and rapidity of anticoagulation in patients with acute pulmonary embolism undergoing mechanical thrombectomy
Zhang RS, Ho AM, Elbaum L, Greco AA, Hall S, Postelnicu R, Mukherjee V, Maqsood MH, Keller N, Alviar CL and Bangalore S
Quality and rapidity of anticoagulation in patients with acute pulmonary embolism undergoing mechanical thrombectomy
Zhang RS, Ho AM, Elbaum L, Greco AA, Hall S, Postelnicu R, Mukherjee V, Maqsood MH, Keller N, Alviar CL and Bangalore S
The primary objective of our study was to determine the proportion of intermediate-risk PE patients undergoing mechanical thrombectomy (MT) who achieved therapeutic anticoagulation (AC) at the time of the procedure. The salient findings of our study showed that only a minority of patients (14.3%) were in the therapeutic range by ACT at the time of MT (primary outcome). Furthermore, in this higher-risk PE cohort selected for MT, 18.2% of patients were subtherapeutic after initially reaching therapeutic AC, 43% experienced supratherapeutic AC at some point before MT, and less than half (43%) attained therapeutic AC at 6 hours, highlighting the necessity for optimizing anticoagulation practices in acute PE.
Ambulatory diagnosis of sleep-disordered breathing: Pushing out the boundaries
McNicholas WT
Ambulatory diagnosis of sleep-disordered breathing: Pushing out the boundaries
McNicholas WT
Advances in signal technology facilitate the ambulatory diagnosis of obstructive sleep apnea and represent an important development in the management of this highly prevalent disorder. The recent report of Traverso and co-authors describes a novel diagnostic approach by an ingestible vital-monitoring pill that is capable of detecting sleep apnea.
A core outcome set for bronchiectasis in children and adolescents for use in clinical research: an international consensus study
Chang AB, Boyd J, Bush A, Hill AT, Powell Z, Zacharasiewicz A, Alexopoulou E, Collaro AJ, Chalmers JD, Constant C, Douros K, Fortescue R, Griese M, Grigg J, Hector A, Karadag B, Mazulov O, Midulla F, Moeller A, Proesmans M, Wilson C, Yerkovich ST, Kantar A and Grimwood K
A core outcome set for bronchiectasis in children and adolescents for use in clinical research: an international consensus study
Chang AB, Boyd J, Bush A, Hill AT, Powell Z, Zacharasiewicz A, Alexopoulou E, Collaro AJ, Chalmers JD, Constant C, Douros K, Fortescue R, Griese M, Grigg J, Hector A, Karadag B, Mazulov O, Midulla F, Moeller A, Proesmans M, Wilson C, Yerkovich ST, Kantar A and Grimwood K
Improving the treatment of non-cystic fibrosis bronchiectasis in children and adolescents requires high-quality research with outcomes that meet study objectives and are meaningful for patients and their parents and caregivers. In the absence of systematic reviews or agreement on the health outcomes that should be measured in paediatric bronchiectasis, we established an international, multidisciplinary panel of experts to develop a core outcome set (COS) that incorporates patient and parent perspectives. We undertook a systematic review from which a list of 21 outcomes was constructed; these outcomes were used to inform the development of separate surveys for ranking by parents and patients and by health-care professionals. 562 participants (201 parents and patients from 17 countries, 361 health-care professionals from 58 countries) completed the surveys. Following two consensus meetings, agreement was reached on a ten-item COS with five outcomes that were deemed to be essential: quality of life, symptoms, exacerbation frequency, non-scheduled health-care visits, and hospitalisations. Use of this international consensus-based COS will ensure that studies have consistent, patient-focused outcomes, facilitating research worldwide and, in turn, the development of evidence-based guidelines for improved clinical care and outcomes. Further research is needed to develop validated, accessible measurement instruments for several of the outcomes in this COS.
Relationship between mental health, sleep status and screen time among university students during the COVID-19 pandemic: a cross-sectional study
Wang W, Jiang J, Qi L, Zhao F, Wu J, Zhu X, Wang B and Hong X
Relationship between mental health, sleep status and screen time among university students during the COVID-19 pandemic: a cross-sectional study
Wang W, Jiang J, Qi L, Zhao F, Wu J, Zhu X, Wang B and Hong X
On 20 July 2021, after the outbreak of COVID-19 at Nanjing Lukou International Airport, several universities started closed management and online teaching. This had a large impact on students' daily life and study, which may lead to mental health problems. The purpose of this study is to study the effect of screen time on mental health status of university students and the possible mediating effect of sleep status.
Effect of prolonged sedation with dexmedetomidine, midazolam, propofol, and sevoflurane on sleep homeostasis in rats
Silverstein BH, Parkar A, Groenhout T, Fracz Z, Fryzel AM, Fields CW, Nelson A, Liu T, Vanini G, Mashour GA and Pal D
Effect of prolonged sedation with dexmedetomidine, midazolam, propofol, and sevoflurane on sleep homeostasis in rats
Silverstein BH, Parkar A, Groenhout T, Fracz Z, Fryzel AM, Fields CW, Nelson A, Liu T, Vanini G, Mashour GA and Pal D
Sleep disruption is a common occurrence during medical care and is detrimental to patient recovery. Long-term sedation in the critical care setting is a modifiable factor that affects sleep, but the impact of different sedative-hypnotics on sleep homeostasis is not clear.
Investigating insomnia in United States deployed military forces: A topic modeling approach
D'Souza EW, MacGregor AJ, Markwald RR, Elkins TA and Zouris JM
Investigating insomnia in United States deployed military forces: A topic modeling approach
D'Souza EW, MacGregor AJ, Markwald RR, Elkins TA and Zouris JM
This retrospective study analyzed free-text clinical notes from medical encounters for insomnia among a sample of deployed US military personnel. Topic modeling, a natural language processing technique, was used to identify thematic patterns in the clinical notes that were potentially related to insomnia diagnosis.
A French nationwide study compared various conditions and healthcare use of individuals < 65 years with a Down's syndrome to those without
Tuppin P, Barthelemy P, Debeugny G and Rachas A
A French nationwide study compared various conditions and healthcare use of individuals < 65 years with a Down's syndrome to those without
Tuppin P, Barthelemy P, Debeugny G and Rachas A
Few regular national clinical data are available for individuals with Down's syndrome (IDS) bearing in mind that they are subject to countries variations in medical termination of pregnancy and screening. Individuals < 65 in 2019 were selected in view of the low number of older IDS. Thus, 98% of 52.4 million people with correct data were included from the national health data system. IDS (35,342) were identified on the basis of the International Classification of Diseases 10th revision code (Q90). Risk ratios (RR) were calculated to compare the frequencies in 2019 between IDS and individual without Down's syndrome (IWDS) of use of health care. The prevalence of IDS was 0.07% (48% women), comorbidities were more frequent, especially in younger patients (24% < 1 year had another comorbidity, RR = 20), as was the percentage of deaths (4.6%, RR = 10). Overall, tumours were less frequent in IDS compared with IWDS (1.2%, RR = 0.7) except for certain leukaemias and testicular tumours (0.3%, RR = 4). Cardiac malformations (5.2%, RR = 52), dementia (1.2%, RR = 29), mental retardation (5%, RR = 21) and epilepsy (4%, RR = 9) were also more frequent in IDS. The most frequent hospital diagnoses for IDS were: aspiration pneumonia (0.7%, RR = 89), respiratory failure (0.4%, RR = 17), sleep apnoea (1.1%, RR = 8), cryptorchidism (0.3%, RR = 5.9), protein-energy malnutrition (0.1%, RR = 7), type 1 diabetes (0.2%, RR = 2.8) and hypothyroidism (0.1%, RR = 72). IDS were more likely to use emergency services (9%, RR = 2.4), short hospital stay (24%, RR = 1.6) or hospitalisation at home (0.6%, RR = 6). They consulted certain specialists two to three times more frequently than IWDS, for example cardiologists (17%, RR = 2.6). This study is the first detailed national study comparing IDS and non-IDS by age group. These results could help to optimize prenatal healthcare, medical and social support.
PERFORMANCE OF SIX SCREENING SCORES FOR OBSTRUCTIVE SLEEP APNOEA IN AN AFRICAN POPULATION
Wachinou AP, Fiogbe AA, Totah T, Salanon E, Solelhac G, Berger M, Haba-Rubio J, Amidou S, Agodokpessi G, Houinato D and Heinzer R
PERFORMANCE OF SIX SCREENING SCORES FOR OBSTRUCTIVE SLEEP APNOEA IN AN AFRICAN POPULATION
Wachinou AP, Fiogbe AA, Totah T, Salanon E, Solelhac G, Berger M, Haba-Rubio J, Amidou S, Agodokpessi G, Houinato D and Heinzer R
A screening tool for obstructive sleep apnoea (OSA) is useful in low-income countries where it may be difficult to access sleep recordings. The objective of this study was to assess the performance of six screening scores compared with objective sleep recording in an African population sample.
EVALUATION OF A MODIFIED EPWORTH SLEEPINESS SCALE TO RELIABLY ASSESS EXCESSIVE DAYTIME SLEEPINESS IN LOW-INCOME COUNTRIES: RESULTS FROM THE BENIN SOCIETY AND SLEEP (BESAS) STUDY
Wachinou AP, Fiogbe AA, Totah T, Salanon E, Solelhac GM, Berger M, Haba-Rubio J, Amidou S, Agodokpessi G, Houinato D and Heinzer R
EVALUATION OF A MODIFIED EPWORTH SLEEPINESS SCALE TO RELIABLY ASSESS EXCESSIVE DAYTIME SLEEPINESS IN LOW-INCOME COUNTRIES: RESULTS FROM THE BENIN SOCIETY AND SLEEP (BESAS) STUDY
Wachinou AP, Fiogbe AA, Totah T, Salanon E, Solelhac GM, Berger M, Haba-Rubio J, Amidou S, Agodokpessi G, Houinato D and Heinzer R
The Epworth Sleepiness Scale (ESS) is a tool widely used to assess excessive daytime sleepiness. Unfortunately, it is not reliable in low-income countries where situations such as reading a book, watching TV or driving a car are not common. The aim of this study was thus to assess the performance of a modified version of the Epworth scale in a low-income country.
Rebound pain after interscalene brachial plexus block for shoulder surgery: a randomized clinical trial of the effect of different multimodal analgesia regimens
Et T, Basaran B, Bilge A, Yarımoğlu R, Korkusuz M and Tülüce İ
Rebound pain after interscalene brachial plexus block for shoulder surgery: a randomized clinical trial of the effect of different multimodal analgesia regimens
Et T, Basaran B, Bilge A, Yarımoğlu R, Korkusuz M and Tülüce İ
Rebound pain is characterized by sudden, significant acute postoperative pain occurring after the resolution of inter-scalene block (ISB); it affects the quality of recovery postoperatively. Dexamethasone increases ISB resolution time and decreases opioid consumption and the incidence of rebound pain.
