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Safe sleep

Anna Serafini, Elizabeth Gerard, Pierre Genton, Arielle Crespel, Philippe Gelisse
Juvenile myoclonic epilepsy (JME) is both a frequent and a very characteristic epileptic syndrome with female preponderance. Treatment of JME in women of childbearing potential must consider multiple factors such as desire for pregnancy, use of contraception, seizure control and previously used antiepileptic drugs (AEDs). Approximately 85% of cases are well controlled with valproate, which remains the reference AED in JME but is nowadays considered unsafe for the expecting mother and her fetus. The prescription of valproate is now severely restricted in women of childbearing potential but may still be considered, at the lowest possible dose and when pregnancies can be reliably planned, with temporary alternatives to valproate prescribed before fertilization...
February 11, 2019: CNS Drugs
Fabiola Atzeni, Roberto Casale, Alessandra Alciati, Ignazio Francesco Masala, Alberto Batticciotto, Rossella Talotta, Maria Chiara Gerardi, Fausto Salaffi, Piercarlo Sarzi-Puttini
OBJECTIVES: Fibromyalgia (FM) is a syndrome of unknown aetiology that is characterised by widespread musculoskeletal pain, fatigue and disordered sleep, and often associated with neuropsychiatric and cognitive symptoms. Current treatment options are only partially effective, but hyperbaric oxygen therapy (HBOT) seems to be capable of relieving some of the symptoms. The aim of this study was to evaluate the efficacy and safety of HBOT after fewer sessions than generally used, chosen on the basis of pre-clinical and clinical data showing its rapid and sustained antinociceptive effect...
January 2019: Clinical and Experimental Rheumatology
Ramires Alsamir Tibana, Nuno Manuel Frade de Sousa, Jonato Prestes, Yuri Feito, Carlos Ernesto Ferreira, Fabrício Azevedo Voltarelli
The aim of this case study was to quantify the magnitude of internal load, acute/chronic workload ratio (ACWR), well-being perception, and heart rate variability (HRV) following 38 weeks of functional-fitness training in a female elite athlete. The internal load was obtained with session rating perceived exertion (session-RPE) while the ACWR was calculated by dividing the acute workload by the chronic workload (four-week average). Furthermore, HRV measurements were analyzed via a commercially available smartphone (HRV4training) each morning upon waking whilst in a supine position...
February 9, 2019: Sports
Raouf Madhkour, Andreas Wahl, Fabien Praz, Bernhard Meier
The patent foramen ovale (PFO) is a common anatomical variant in humans (prevalence 25%). Most often asymptomatic, it may engender paradoxically embolic strokes, myocardial infarctions, or visceral or peripheral ischemia. It is causatively related to migraine, positional or exertional hypoxemia with dyspnea, diving incidents, high altitude edema, and sleep apnea. Percutaneous closure of atrial septal defects was first performed in the seventies. A dedicated PFO occluder (Amplatzer PFO Occluder) was first used on September 10, 1997 by Kurt Amplatz and Bernhard Meier...
February 9, 2019: Expert Review of Medical Devices
David Veale
This paper argues that intermittent nursing observations of in-patients at night do not reduce the risk of suicide or severe self-harm. Suicides between 23.00 h and 07.00 h are rare, and these overwhelmingly occur under intermittent observations. Such observation is purely a defensive intervention to document that a patient is safe at a particular time, as there is no engagement. For the large majority of in-patients, it has the unintended consequence of causing sleep deprivation. The intervention may cause harm to in-patients by making their disorder worse and increase their risk during the day...
February 11, 2019: BJPsych Bulletin
Jun Shitara, Takatoshi Kasai, Sato Akihiro, Shoichiro Yatsu, Hiroki Matsumoto, Shoko Suda, Manabu Ogita, Naotake Yanagisawa, Kazutoshi Fujibayashi, Shuko Nojiri, Yuji Nishizaki, Naoko Ono, Satoru Suwa, Hiroyuki Daida
BACKGROUND: Suvorexant, an orexin receptor antagonist, is known as a safe and effective sleep medication. Many patients with heart failure (HF) have sleep-disordered breathing (SDB) and are short sleepers, and it is unknown whether suvorexant is effective in HF patients and can improve insomnia safely. The aim of this study is to examine the effect of suvorexant on SDB in patients with HF. METHODS: The Heart Failure with Insomnia and Suvorexant trial of Juntendo University Hospital and Juntendo Shizuoka Hospital (J-FLAVOR trial) is a multicenter trial with a randomized double crossover design...
February 5, 2019: Journal of Cardiology
Guohua Zheng, Bai Chen, Qianying Fang, Qiu Lin, Jing Tao, Lidian Chen
The aim of current study was to assess the effects of Baduanjin exercise on cerebrovascular function, cardiac structure and cardiac function, static pulmonary function, traditional risk factors of CVD and the related psychological outcomes in older community adults at risk for ischaemic stroke. A randomized controlled trial was conducted in three community between November 2013 and October 2015. Older community-dwelling adults (N = 170) were randomly allocated into either a Baduanjin training (5 × 60 min/weekly) or control group who kept their unaltered lifestyle during a 12-week intervention period...
February 4, 2019: Scientific Reports
X Zhang, Y H Liu, J Wu, C B Gao, Y Zhao, Y Wang, D Wang
Objective: To explore the clinical value of modified cricothyrotomy in the multiplane surgery under general anesthesia for patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS). Method: A retrospective review was made among 20 cases with severe OSAHS treated a concurrent multiplane surgery under the condition of modified cricothyrotomy with general anesthesia, performed during recent 3 years, with their clinical data reviewed carefully. General anesthesia was carried out by inserting trachea cannula through mouth at first, and then, modified cricothyrotomy was performed via a transverse incision, followed by pulling out trachea cannula and inserting endotracheal tube through thyrocricoid incision...
November 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Khai Beng Chong, Andrea De Vito, Claudio Vicini
Drug-induced sleep endoscopy is a safe and practical technique to evaluate the dynamic upper airway collapse during sleep. We review drug-induced sleep endoscopy in adults, including its indications, technique, evaluation of upper airway collapse, and clinical application. Drug-induced sleep endoscopy is useful to improve treatment options selection for patients with obstructive sleep apnea, especially for those who are unable to accept or tolerate continuous positive airway pressure therapy. Owing to a lack of standardization for drug-induced sleep endoscopy, it is difficult to compare the published literature from different sleep centers across the world...
March 2019: Sleep Medicine Clinics
Hailey W Bulls, Aasha I Hoogland, David Craig, Judith Paice, Young Doo Chang, Ritika Oberoi-Jassal, Sahana Rajasekhara, Meghan Haas, Margarita Bobonis, Brian D Gonzalez, Diane Portman, Heather S L Jim
CONTEXT: Cancer-related pain is a common symptom that is often treated with opioids. However, legislation aimed at containing the opioid crisis, coupled with public fears about opioid risks, may contribute to opioid stigma in cancer patients. To our knowledge, no prior research has examined opioid stigma and stigma-related behavior in this population. OBJECTIVE: To describe opioid use, including reasons for use and over- and under-use behavior; characterize opioid stigma; and identify potentially maladaptive associated behaviors...
January 28, 2019: Journal of Pain and Symptom Management
İsmail Güler, İhsan Kuzucu, Deniz Baklacı, Rauf Oğuzhan Kum, Nurcan Yurtsever Kum, Müge Özcan
Objective: Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of upper respiratory-tract obstruction during sleep and decrease in arterial oxygen saturation. Expansion sphincter pharyngoplasty (ESP) is a simple, safe, and effective method for the surgical treatment of OSAS. The aim of our study was to evaluate the efficacy of ESP with polysomnography (PSG) in OSAS patients. Methods: This study was conducted on patients referred to our center for the treatment of snoring, apnea, witnessed apnea, and daytime sleepiness during 2010-2018...
December 2018: Turkish Archives of Otorhinolaryngology
Jordan Anderson, Sevilay Dalabih, Esma Birisi, Abdallah Dalabih
OBJECTIVES: Chloral hydrate had been extensively used for children undergoing sedation for imaging studies, but after the manufacturer discontinued production, pediatric sedation providers explored alternative sedation medications. Those medications needed to be at least as safe and as effective as chloral hydrate. In this study, we examined if pentobarbital is a suitable replacement for chloral hydrate. METHODS: Subjects who received pentobarbital were recruited from a prospectively collected database, whereas we used a retrospective chart review to study subjects who received chloral hydrate...
November 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Ghazal Ayoub, Young Eun Kim, Tong In Oh, Sang-Wook Kim, Eung Je Woo
Noninvasive continuous imaging of the upper airway during natural sleep was conducted for patients with obstructive sleep apnea (OSA) using the electrical impedance tomography (EIT) technique. A safe amount of alternating current (AC) was injected into the lower head through multiple surface electrodes. Since the air is an electrical insulator, upper airway narrowing during OSA altered internal current pathways and changed the induced voltage distribution. Since the measured voltage data from the surface of the lower head were influenced not only by upper airway narrowing but respiratory motions, head motions, and blood flows, we developed a pre-processing algorithm to extract the voltage component originated from upper airway closing and opening...
January 28, 2019: Annals of Biomedical Engineering
Jaime A Newberry
Despite the release of guidelines by the American Academy of Pediatrics (AAP) on safe infant sleep and public service campaigns aimed at reducing risk factors over the past 25 years, deaths due to Sudden Infant Death Syndrome (SIDS) and Sudden Unexplained Infant Death (SUID) are still the 4th leading causes of infant death in the United States. Findings from several studies demonstrate that nurses do not consistently model safe sleep practices with infants due to a lack of education on evidence-based practice and misconceptions regarding safe infant sleep...
January 2019: Journal of Pediatric Nursing
Kira Vibe Jespersen, Marit Otto, Morten Kringelbach, Eus Van Someren, Peter Vuust
Music is often used as a self-help tool to alleviate insomnia. To evaluate the effect of bedtime music listening as a strategy for improving insomnia, we conducted an assessor-blinded randomized controlled trial. Fifty-seven persons with insomnia disorder were included and randomized to music intervention (n = 19), audiobook control (n = 19) or a waitlist control group (n = 19). The primary outcome measure was the Insomnia Severity Index. In addition, we used polysomnography and actigraphy to evaluate objective measures of sleep, and assessed sleep quality and quality of life...
January 24, 2019: Journal of Sleep Research
Qing Feng, Lu-Lu Bin, Yan-Bing Zhai, Min Xu, Zhi-Shun Liu, Wei-Na Peng
OBJECTIVE: To observe the efficacy and safety of electroacupuncture (EA) on improving mini-mental state examination (MMSE) in patients with Alzheimer's disease (AD), and to evaluate the efficacy during follow-up visit. METHODS: Forty patients were randomly divided into a treatment group and a control group, 20 patients in each one (3 patients dropped off in the treatment group and 4 patients in the control group). The patients in the treatment group were treated with acupuncture at Baihui (GV 20), Fengfu (GV 16), Shenting (GV 24), Taiyang (EX-HN 5), Shangyintang (Extra 3) and Dazhong (KI 14); besides, EA was applied at Taiyang (EX-HN 5), Baihui (GV 20) and Shenting (GV 24) with dilatational wave, 10 Hz/50 Hz in frequency, 0...
January 12, 2019: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Zhitao Hou, Zhongren Sun, Shentian Sun
OBJECTIVE: To compare the effect on post-stroke insomnia between the repetitive transcranial acupuncture stimulation (rTAS) and the conventional western medication in the patients and to explore the mechanism. METHODS: Ninety patients of post-stroke insomnia were randomized into a rTAS group, a medication group and a placebo group, 30 cases in each one. In the rTAS group, patients were intervened by rTAS. The acupoints were Baihui (GV 20), Ningshen (Extra), emotion area, Wangu (GB 12), Taiyang (EX-HN 5), Neiguan (PC 6), Shenmen (HT 7), Sanyinjiao (SP 6), Zhaohai (KI 6), Zusanli (ST 36) and Taichong (LR 3)...
October 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Sriram Prasath, Kavitha Palaniappan
Human exposure to engineered nanoparticles has become inevitable in today's extensive commercial use and large-scale production of engineered nanoparticles. Even though several studies have characterised the exposure to nanomaterials during wakeful state (related to occupational exposures and exposures from commercially available particles), very few studies on human exposure during sleep exist. As the study of exposure to all possible nanomaterials during sleep is extensive, this study focuses on exposure to specifically silver nanoparticles which are present in beddings and mattresses...
January 22, 2019: Environmental Geochemistry and Health
Sun Shin Yi, Soo-Ho Chung, Pan Soo Kim
Lack of adequate sleep has become increasingly common in our 24/7 modern society. Reduced sleep has significant health consequences including metabolic and cardiovascular disorders, and mental problems including depression. In addition, although the increase in life expectancy has provided a dream of longevity to humans, the occurrence of osteoporosis is a big obstacle to this dream for both male and female. It is known that insomnia and bone health problems, which are very critical conditions in human life, interestingly, share a lot of pathogenesis in recent decades...
December 2018: Journal of Menopausal Medicine
Sanghee Moon, Caio V M Sarmento, Irina V Smirnova, Yvonne Colgrove, Kelly E Lyons, Sue M Lai, Wen Liu
Background: Non-motor symptoms such as sleep disturbance, cognitive decline, fatigue, anxiety, and depression in Parkinson's disease (PD) impact quality of life. Increased levels of pro-inflammatory cytokines in individuals with PD have been reported, which may contribute to non-motor symptoms. A mind-body exercise, Qigong, has demonstrated benefits across different medical conditions. However, a lack of evidence causes clinicians and patients to be uncertain about the effects of Qigong in individuals with PD...
January 18, 2019: Medicines (Basel, Switzerland)
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