Search results for " Positive"
showing 10 items of 397 documents
Development and Validation of the OSA-CPAP Perceived Competence Evaluation Interview
2021
Continuous positive airway pressure (CPAP) is one of the most common therapies for Obstructive Sleep Apnea (OSA). We present a brief, patient-reported outcome measure used to assess patients' levels of adherence with CPAP treatment.A questionnaire was developed based on academic literature. We qualitatively tested a pool of 18 items. It was tested in a sample of 174 patients from the Hospital La Princesa. Next, 1021 patients from Catalonia were evaluated.5 items were removed. Nominal groups referred to three areas: general knowledge about OSA and its risks; CPAP treatment information and expectations; CPAP use, monitoring, and confidence with its use. The 13 retained items maintained the sa…
Personalised medicine in sleep respiratory disorders: focus on obstructive sleep apnoea diagnosis and treatment
2017
In all fields of medicine, major efforts are currently dedicated to improve the clinical, physiological and therapeutic understanding of disease, and obstructive sleep apnoea (OSA) is no exception. The personalised medicine approach is relevant for OSA, given its complex pathophysiology and variable clinical presentation, the interactions with comorbid conditions and its possible contribution to poor outcomes. Treatment with continuous positive airway pressure (CPAP) is effective, but CPAP is poorly tolerated or not accepted in a considerable proportion of OSA patients. This review summarises the available studies on the physiological phenotypes of upper airway response to obstruction durin…
The puzzle of metabolic effects of obstructive sleep apnoea in children.
2016
In adults, obstructive sleep apnoea (OSA) is often associated with metabolic alterations. Although obesity is a major culprit [1], large epidemiological studies have reported a metabolic risk associated with OSA that is independent of obesity. In particular, meta-analyses have shown that effective treatment of OSA by continuous positive airway pressure (CPAP) improves glycaemic control in both diabetic [2] and nondiabetic patients [3]. In obese children with obstructive sleep apnoea insulin resistance is common while lipids do not show a clear pattern
Chronic kidney disease in patients with obstructive sleep apnea. A narrative review.
2018
Prevalence of both chronic kidney disease (CKD) and obstructive sleep apnea (OSA) is continuously increasing. Moreover, the prevalence of OSA increases as kidney function declines and is higher among patients with end-stage renal disease (ESRD). In addition, OSA is recognized as a potential nontraditional risk factor for development and progression of CKD. Continuous positive airway pressure (CPAP) plays a pivotal role in the management of OSA, eliminating patients' symptoms and improving their quality of life. Recent studies suggested that CPAP treatment may have beneficial effects on kidney function among patients with OSA. This narrative review summarizes the existing knowledge on the as…
Sleep apnoea and metabolic dysfunction.
2013
Obstructive sleep apnoea (OSA) is a highly prevalent condition often associated with central obesity. In the past few years, several studies have analysed the potential independent contribution of OSA to the pathogenesis of metabolic abnormalities, including type 2 diabetes, the metabolic syndrome and non-alcoholic fatty liver disease. New perspectives in OSA patient care have been opened by the promotion of lifestyle interventions, such as diet and exercise programmes that could improve both OSA and the metabolic profile. The rich clinical literature on this subject, together with the growing amount of data on pathophysiological mechanisms provided by animal studies using the chronic inter…
Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre…
2021
BackgroundRespiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.MethodsPRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of…
The right interface for the right patient in noninvasive ventilation: a systematic review
2022
Introduction Research in the field of noninvasive ventilation (NIV) has contributed to the development of new NIV interfaces. However, interface tolerance plays a crucial role in determining the beneficial effects of NIV therapy. Areas covered This systematic review explores the most significant scientific research on NIV interfaces, with a focus on the potential impact that their design might have on treatment adherence and clinical outcomes. The rationale on the choice of the right interface among the wide variety of devices that are currently available is discussed here. Expert opinion The paradigm 'The right mask for the right patient' seems to be difficult to achieve in real life. Rang…
Completely positive invariant conjugate-bilinear maps on partial *-algebras
2007
The notion of completely positive invariant conjugate-bilinear map in a partial *-algebra is introduced and a generalized Stinespring theorem is proven. Applications to the existence of integrable extensions of *-representations of commutative, locally convex quasi*-algebras are also discussed.
Perturbed eigenvalue problems for the Robin p-Laplacian plus an indefinite potential
2020
AbstractWe consider a parametric nonlinear Robin problem driven by the negativep-Laplacian plus an indefinite potential. The equation can be thought as a perturbation of the usual eigenvalue problem. We consider the case where the perturbation$$f(z,\cdot )$$f(z,·)is$$(p-1)$$(p-1)-sublinear and then the case where it is$$(p-1)$$(p-1)-superlinear but without satisfying the Ambrosetti–Rabinowitz condition. We establish existence and uniqueness or multiplicity of positive solutions for certain admissible range for the parameter$$\lambda \in {\mathbb {R}}$$λ∈Rwhich we specify exactly in terms of principal eigenvalue of the differential operator.