Contributing Factors of Excessive Daytime Sleepiness in Morbid Obese Patients with Obstructive Sleep Apnea

Background@#Obesity, obstructive sleep apnea (OSA), and excessive daytime sleepiness (EDS) are common conditions and are interrelated. Obesity is a risk factor for OSA and independently associated with EDS. We aimed to evaluate frequency of EDS in morbid obese patients with OSA and to identify contribution factor for EDS. @*Methods@#This was a retrospective cross-sectional study in single sleep center. Consecutive patients with OSA (with apnea-hypopnea index 5/h or more) with morbid obesity (body mass index over 35 kg/m2) was enrolled. EDS were defined as Epworth Sleepiness Scale of 10 points or more. Clinical and polysomnographic variables were compared between those with and without EDS. @*Results@#Total 110 morbid obese patients with OSA were enrolled, and 34 (31%) of them had EDS. Those with EDS had higher subjective symptom of insomnia and depression. Rapid eye movement sleep latency was shorter and minimum saturation was lower for those with EDS. Multivariate logistic regression analysis identified insomnia severity (odds ratio, 1.117) and minimum saturation (odds ratio, 0.952) as independent contribution factor for EDS. @*Conclusions@#Result of this study suggest that 31.4% of morbid obese patients with OSA have EDS, and it can be affected by insomnia severity and desaturation during sleep.

Analysis Quality and Content of CPR Information in One Korean Portal Site

PURPOSE: To evaluate the types of questions and the quality of Internet information regarding basic life support (BLS) in the general public. METHODS: We identified the questions and answers by entering the following keywords into the famous Korean search engine, Naver, in the year 2015: ‘ Basic life support’, ‘ chest compression’, ‘ rescue breath’, ‘ defibrillation’, ‘ cardiac arrest’, and ‘ airway obstruction’. A total of 269 cases were identified. We classified the questions into one of 17 subgroups. The accuracy of answers was analyzed based on the contents of the 2010 American Heart Association Cardiopulmonary Resuscitation Guidelines. The reliability of the answers was analyzed by the health on the net foundation code of conduct (authoritative, attribution, transparency). RESULTS: The most frequently asked question was about ‘ when do I perform BLS?’. The second is ‘ chest compression technique’, and third is ‘ how to do BLS’. In assessing the accuracy of answers, 196 answers (72.9%) were determined to be correct. However, the reliability of answers was relatively low, except author's transparency (80.7%); authoritative is 49.4% and attribution is only 16.4%. CONCLUSION: The most common question for the general public was when to perform BLS. Other questions were ‘ how to perform BLS’ or questions regarding chest compression techniques as well as issues regarding female patient and legal problem. This result can be used to educate the public on BLS. According to our results, the accuracy of the information regarding BLS is moderate, but reliability is not acceptable. The quality of BLS information on the Internet should be managed at an expert level.

An Deletion/Insertion Polymorphism of the Angiotensin Converting Enzyme Gene in Ischemic Stroke Patients

BACKGROUND: A deletion (D)/insertion (I) polymorphism of the angiotensin-converting enzyme (ACE) gene is known to be associated with hypertension, left ventricular hypertrophy, myocardial infarction. Cardiac diseases, such as atrial fibrillation, valvular heart disease, myocardiac infarction and coronary artery disease have been clearly associated with increasing the risk of ischemic stroke. We investigated the relationship between ACE gene deletion/insertion (D/I) polymorphism and the pattern of ischemic stroke. METHODS: The pattern of ACE genotypes in 59 stroke patients including symptomatic carotid artery territory cerebral ischemia were compared with 101 age-matched control subjects. In the stroke patients, the degrees of stenosis of bilateral cervical carotid arteries and their major intracranial tributaries were recorded according to duplex neck sonography and magnetic resonance angiography. DNA was extracted from peripheral blood and ACE I/D polymorphism is confirmed by PCR method. RESULTS: In the stroke patients, 25.4% showed the I I genotypes, 8.5% the ID genotypes and 66.1% the DD genotypes. In the control group, the frequencies of each genotype were 20.8%, 55.4% and 23.8%, respectively. The DD genotypes were more common in patients with ischemic stroke compared with the controls, but there was no significant association between ACE genotypes and sub-types of cerebrovascular disease. CONCLUSIONS: The deletion polymorphism in the angiotensin-converting enzyme gene may play a role in development of ischemic stroke.