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- Franklin, Karl A., et al.
(författare)
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Obstructive sleep apnea is a common disorder in the population : a review on the epidemiology of sleep apnea
- 2015
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Ingår i: Journal of Thoracic Disease. - 2072-1439 .- 2077-6624. ; 7:8, s. 1311-1322
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Forskningsöversikt (refereegranskat)abstract
- The prevalence of obstructive sleep apnea (OSA) defined at an apnea-hypopnea index (AHI) >= 5 was a mean of 22% (range, 9-37%) in men and 17% (range, 4-50%) in women in eleven published epidemiological studies published between 1993 and 2013. OSA with excessive daytime sleepiness occurred in 6% (range, 3-18%) of men and in 4% (range, 1-17%) of women. The prevalence increased with time and OSA was reported in 37% of men and in 50% of women in studies from 2008 and 2013 respectively. OSA is more prevalent in men than in women and increases with age and obesity. Smoking and alcohol consumption are also suggested as risk factors, but the results are conflicting. Excessive daytime sleepiness is suggested as the most important symptom of OSA, but only a fraction of subjects with AHI >5 report daytime sleepiness and one study did not find any relationship between daytime sleepiness and sleep apnea in women. Stroke and hypertension and coronary artery disease are associated with sleep apnea. Cross-sectional studies indicate an association between OSA and diabetes mellitus. Patients younger than 70 years run an increased risk of early death if they suffer from OSA. It is concluded that OSA is highly prevalent in the population. It is related to age and obesity. Only a part of subjects with OSA in the population have symptoms of daytime sleepiness. The prevalence of OSA has increased in epidemiological studies over time. Differences and the increase in prevalence of sleep apnea are probably due to different diagnostic equipment, definitions, study design and characteristics of included subjects including effects of the obesity epidemic. Cardiovascular disease, especially stroke is related to OSA, and subjects under the age of 70 run an increased risk of early death if they suffer from OSA.
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| 2. |
- Koyi, Hirsh, et al.
(författare)
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Biopsy testing in an inoperable, non-small cell lung cancer population : a retrospective, real-life study in Sweden
- 2015
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Ingår i: Journal of Thoracic Disease. - 2072-1439 .- 2077-6624. ; 7:12, s. 2226-2233
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Tidskriftsartikel (refereegranskat)abstract
- Background: Correct diagnosis and staging are required for optimal treatment choice in lung cancer patients. This retrospective, patient medical records study investigated the clinical practice of lung cancer biopsy procedures and testing in Sweden. Methods: Consecutive patients with a recorded inoperable, malignant tumour of bronchus and lung were retrospectively identified at geographically widespread pulmonology clinics (NCT01139619). Data, including diagnostic sampling methodology [bronchoscopy, biopsy by pulmonologist and computed tomography (CT)-guided biopsy], were collected for patients diagnosed between 1 June 2009-31 May 2010, and analysed using descriptive statistics. A study-predefined algorithm, including six criteria on tumour localization and size, forced expiratory volume in one second (FEV1), blood saturation and risk of bleeding theoretically categorizing patient suitability for CT-guided biopsy, was used. Results: In total, 132 patients (mean age 68 years, 48% women, 61% adenocarcinoma, 86% current/former smokers, 96% performance status <= 2, mean FEV1 volume >= 2 L) were included. The majority were examined by > 1 diagnostic procedure (29% by CT-guided biopsy). Median overall time from first hospital contact to established diagnosis was 12.0 days (10.0 and 28.0 days for bronchoscopy and CT-guided biopsy, respectively). No major differences in lung function, age, performance status or predefined algorithm criteria were noted for patients examined by CT-guided biopsy versus bronchoscopy or biopsy. Complications were reported for 11 patients, including pneumothorax in six patients. Histopathology was used most frequently to diagnose and subtype (70%), although 66% of patients examined solely by bronchoscopy were diagnosed by cytology. For 26.5% of patients, epidermal growth factor receptor (EGFR) mutation testing was recorded. Conclusions: No limitations regarding patient suitability or methodological complications were noted in this real-life, observational study. The CT-guided biopsy is a relatively safe and well-established method, and may need to be utilized further to fulfil current and future demands for faster diagnosis and high quality tissue as new tumour markers and targeted therapies become available.
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| 3. |
- Lavdas, Eleftherios, et al.
(författare)
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A method for limiting pitfalls in the production of enhancement kinetic curves in 3T dynamic magnetic resonance mammography
- 2012
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Ingår i: Journal of Thoracic Disease. - 2072-1439 .- 2077-6624. ; 4:4, s. 358-367
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of the present study is to investigate means for the reduction or even elimination of enhancement kinetic curve errors due to breast motion in order to avoid pitfalls and to increase the sensitivity and specificity of the method. Methods: 115 women underwent breast Magnetic Resonance Imaging (MRI). All patients were properly immobilized in a dedicated bilateral phased array coil. A magnetic resonance unit 3-Tesla (Signa, GE Healthcare) was used. The following sequences were applied: (I) axial T2-TSE, (II) axial STIR and (III) Vibrant axial T1-weighted fat saturation (six phases). Kinetic curves were derived semi-automatically using the software of the system and manually by positioning the regions of interest (ROI) from stable reference points in all the phases. Results: 376 abnormalities in 115 patients were investigated. In 81 (21.5%) cases, a change of the enhancement kinetic curve type was found when the two different methods were used. In cases of large fatty breasts, a change of the enhancement kinetic curve type in 13 lesions was found. In cases of small and dense breasts, only in 4 lesions the kinetic curve type changed, whereas in cases of small and fatty breasts, the kinetic curve type changed in 64 lesions (50 were observed in left breasts and 14 in right breasts). Conclusions: The derivation of enhancement kinetic curves should be performed by controlling and verifying that the ROIs lay at the same location of the lesion in all the phases of the dynamic study.
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| 4. |
- Agewall, S
(författare)
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Morphine in acute heart failure
- 2017
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Ingår i: Journal of thoracic disease. - : AME Publishing Company. - 2072-1439 .- 2077-6624. ; 9:7, s. 1851-1854
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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