Implementing rehabilitation-led management of obstructive sleep apnoea in a spinal cord injury rehabilitation centre: a mixed-methods evaluation.

Purpose: The aim of this study was to evaluate the feasibility of an alternative, rehabilitation-led model for managing obstructive sleep apnoea (OSA) in an Australian spinal cord injury (SCI) inpatient rehabilitation centre.

Methods: The mixed-methods evaluation included quantitative analysis of clinical data and qualitative interviews with staff and patients to assess reach, effectiveness, adoption, acceptability, implementation, and sustainability (RE-AIM framework) of the OSA care model.

Results: During the 12-month pilot, 48 inpatients were screened, 24 were assessed for OSA, 12 were diagnosed and recommended treatment, 6 commenced continuous positive airway pressure (CPAP) therapy, and 4 were discharged on CPAP.

Long COVID clinical evaluation, research and impact on society: a global expert consensus.

Background: Long COVID is a complex, heterogeneous syndrome affecting over four hundred million people globally. There are few recommendations, and no formal training exists for medical professionals to assist with clinical evaluation and management of patients with Long COVID. More research into the pathology, cellular, and molecular mechanisms of Long COVID, and treatments is needed.

Review of organ damage from COVID and Long COVID: a disease with a spectrum of pathology.

Long COVID, as currently defined by the World Health Organization (WHO) and other authorities, is a symptomatic condition that has been shown to affect an estimated 10 %-30 % of non-hospitalized patients after one infection. However, COVID-19 can also cause organ damage in individuals without symptoms, who would not fall under the current definition of Long COVID. This organ damage, whether symptomatic or not, can lead to various health impacts such as heart attacks and strokes.

The P200 ERP Response in Mild Cognitive Impairment and the Aging Population.

Evoked potential metrics extracted from an EEG exam can provide novel sources of information regarding brain function. While the P300 occurring around 300 ms post-stimulus has been extensively investigated in relation to mild cognitive impairment (MCI), with decreased amplitude and increased latency, the P200 response has not, particularly in an oddball-stimulus paradigm. This study compares the auditory P200 amplitudes between MCI (28 patients aged 74(8)) and non-MCI, (35 aged 72(4)).

Prospective Evaluation of Autonomic Function and Intestinal Blood Flow in Health and Irritable Bowel Syndrome Shows Differences Limited to Patients With Constipation Predominance.

Background: Autonomic dysfunction may contribute to symptom generation in irritable bowel syndrome (IBS), possibly driven by psychological morbidity and activation of the hypothalamic-pituitary-adrenal axis. Previous data are conflicting, perhaps due to lack of accounting for differential bowel patterns in IBS (constipation vs. diarrhea) or by diverse methodologies used to measure autonomic function.

Vascular Pathogenesis in Acute and Long COVID: Current Insights and Therapeutic Outlook.

Long coronavirus disease 2019 (COVID-19)-a postacute consequence of severe acute respiratory syndrome coronavirus 2 infection-manifests with a broad spectrum of relapsing and remitting or persistent symptoms as well as varied levels of organ damage, which may be asymptomatic or present as acute events such as heart attacks or strokes and recurrent infections, hinting at complex underlying pathogenic mechanisms. Central to these symptoms is vascular dysfunction rooted in thrombotic endothelialitis. We review the scientific evidence that widespread endothelial dysfunction (ED) leads to chronic symptomatology.

Management of Sleep-Disordered Breathing in a Spinal Cord Injury Rehabilitation Center: Model of Care Adaptation and Implementation.

Background: Obstructive sleep apnea (OSA) is highly prevalent and poorly managed in spinal cord injury (SCI). Alternative management models are urgently needed to improve access to care. We previously described the unique models of three SCI rehabilitation centers that independently manage uncomplicated OSA.

Electrophysiological trajectories of concussion recovery: From acute to prolonged stages in late teenagers.

Purpose: Numerous studies have reported electrophysiological differences between concussed and non-concussed groups, but few studies have systematically explored recovery trajectories from acute concussion to symptom recovery and the transition from acute concussion to prolonged phases. Questions remain about recovery prognosis and the extent to which symptom resolution coincides with injury resolution. This study therefore investigated the electrophysiological differences in recoveries between simple and complex concussion.

Left Ventricular Support for Unprotected Left Main Coronary Artery Interventions (The Dayton Heart and Vascular Impella Registry).

Background: Coronary artery bypass grafting is the standard of care for patients with obstructive left main (LM) coronary disease. In poor surgical candidates, high-risk percutaneous coronary artery intervention (PCI) is an alternative.

Methods: We investigated a retrospective cohort of patients who underwent LM PCI from January 2010 to March 2014 ( = 89).

Effectiveness of a patient-centred sleep study report in the management of obstructive sleep apnoea.

Purpose: Obstructive sleep apnoea (OSA) is a common condition with a range of short- and long-term health implications. Providing patient-centred care is a key principle to ensure patients are well informed and empowered to participate in clinical decision making. This study aimed to develop a patient-centred sleep study report for patients with obstructive sleep apnoea and to determine whether or not its implementation led to improved patient understanding of their disease.

A transformational change in scintigraphic gastroesophageal reflux studies: A comparison with historic techniques.

Background: The inclusion of scintigraphy in the diagnostic algorithm for gastroesophageal reflux is controversial due to variability in methodology and reporting. A novel scintigraphic reflux study has been developed and validated against the current standards for the diagnosis of gastroesophageal reflux disease (GORD).

Objective: To compare a new scintigraphic reflux test against historic techniques and standardised diagnostic reference tests for gastroesophageal reflux disease.

Fungal Pneumonia in The Immunocompetent Host: A Possible Statistical Connection Between Allergic Fungal Sinusitis with Polyposis and Recurrent Pulmonary Infection Detected by Gastroesophageal Reflux Disease Scintigraphy.

Objectives: Fungal pneumonia in the immune competent host is a rarity with few reported cases in the literature. We present a series of 7 cases of recurrent fungal pneumonia in association with allergic fungal rhinosinusitis and gastroesophageal reflux disease (GERD). We hypothesised that recurrent infection may have been transported from the infected paranasal sinuses into the lung by GERD as the process was terminated by surgical fundoplication in 2 of these patients.

In-clinic event related potentials after sports concussion: A 4-year study.

Purpose: Electrophysiological event-related potentials (ERP's) have been reported to change after concussion. The objective of this study is to use a simple 2-tone auditory P300 ERP in routine clinical settings to measure changes from baseline after concussion and to determine if these changes persist at return to play when other standard measures have normalized.

Methods: Three-hundred sixty-four (364) student athletes, aged 17-23 years, participating in contact sports were tracked over consecutive years.

Simultaneous tonsillectomy and nasal surgery in adult obstructive sleep apnea: a pilot study.

Objective: Although adenotonsillectomy is the accepted treatment for obstructive sleep apnea (OSA) in the pediatric population, tonsillectomy has not been widely adopted in adults, and its success in this group has not been well reported. Despite the lack of current evidence, there may be an important role for tonsillectomy in selected adult cases, and further study is required. This is a pilot study from a larger group of subjects currently enrolled and awaiting surgery and repeat polysomnography.

Sniff nasal inspiratory pressure and sleep disordered breathing in childhood neuromuscular disorders.

The ease of sniff nasal inspiratory pressure testing may extend application of respiratory muscle assessment to younger and cognitively-impaired children. We sought to quantify sniff nasal inspiratory pressure in childhood neuromuscular disorders, and to correlate this measure with conventional pulmonary function tests and overnight polysomnography. Thirty children (mean 9.

Liraglutide: a once-daily human glucagon-like peptide-1 analogue for type 2 diabetes mellitus.

Purpose: The pharmacology, pharmacokinetics, efficacy, safety, dosage and administration, adverse effects, and place in therapy of liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, are reviewed.

Summary: Liraglutide, the first once-daily human GLP-1 analogue, retains 97% homology with the endogenous hormone and shares its glucose-dependent glucose-lowering action but has a considerably longer half-life that supports once-daily dosing. After promising Phase II study results, the Liraglutide Effect and Action in Diabetes (LEAD) Phase III clinical development program, involving more than 4000 patients worldwide, investigated the efficacy and tolerability of liraglutide 1.

The utility of the AusEd driving simulator in the clinical assessment of driver fatigue.

Several driving simulators have been developed which range in complexity from PC based driving tasks to advanced "real world" simulators. The AusEd driving simulator is a PC based task, which was designed to be conducive to and test for driver fatigue. This paper describes the AusEd driving simulator in detail, including the technical requirements, hardware, screen and file outputs, and analysis software.

Low-resolution electromagnetic tomography neurofeedback.

Through continuous feedback of the electroencephalogram (EEG) humans can learn how to shape their brain electrical activity in a desired direction. The technique is known as EEG biofeedback, or neurofeedback, and has been used since the late 1960s in research and clinical applications. A major limitation of neurofeedback relates to the limited information provided by a single or small number of electrodes placed on the scalp.

Hippocampal area metabolites relate to severity and cognitive function in obstructive sleep apnea.

Background And Purpose: Obstructive sleep apnea (OSA) is associated with intermittent hypoxia and cognitive decrements. As the hippocampus is particularly susceptible to hypoxia, we hypothesized that it may show biochemical abnormalities, and they may relate to apnea severity.

Patients And Methods: Eight males with OSA and five age-matched controls underwent neurocognitive testing before and after polysomnography and proton magnetic resonance spectra were obtained from the left hippocampal area of all subjects.

Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers.

Sleep-disordered breathing and excessive sleepiness may be more common in commercial vehicle drivers than in the general population. The relative importance of factors causing excessive sleepiness and accidents in this population remains unclear. We measured the prevalence of excessive sleepiness and sleep-disordered breathing and assessed accident risk factors in 2,342 respondents to a questionnaire distributed to a random sample of 3,268 Australian commercial vehicle drivers and another 161 drivers among 244 invited to undergo polysomnography.

Treadmill ambulation with partial body weight support for the treatment of low back and leg pain.

Study Design: A single-subject experimental design using an A-B-A treatment protocol.

Objective: To determine whether walking on a treadmill with partial body weight support (PBWS) would be an effective adjunct treatment method to standard care for decreasing pain and increasing function in patients suffering from low back and leg pain.

Background: Mechanical low back pain (LBP) is commonly aggravated by activities that increase axial loading in the spine, such as sitting, standing, and walking.