Discriminating between positional and non-positional obstructive sleep apnea using some clinical characteristics.

PURPOSE: The primary objective of this paper was to identify significant factors associated with positional Obstructive Sleep Apnea (POSA) and to provide a clinical tool for discriminating non positional from POSA. Secondary objectives were about estimating the prevalence of POSA, comparing the polysomnographic variables across POSA and non-POSA patients. METHODS: This was a cross sectional study on 278 patients who completed an overnight sleep study for OSA assessment. Patients were aged over 18 years, without central sleep apnea or narcolepsy and slept no less than 20 min in a non-supine position. POSA was defined as a total apnea/hypopnea index (AHI) ≥5 and a ratio supine AHI/non-supine AHI ≥2. The binary logistic regression was used for modeling the likelihood for OSA patient to be positional, and the LASSO method was used for selecting the optimal set of clinical characteristics associated with POSA. RESULTS: Overall, 53% of patients had POSA. These patients were younger (p = 0.005), had lower BMI (p < 0.0001), lower prevalence of hypertension (p = 0.006), lower Berlin (p = 0.01), and lower STOP (p = 0.001) scores compared to non-POSA patients. Neck and waist circumference were higher in non-POSA (p = 0.005, p = 0.009, respectively) patients. Age, BMI, DBP, Mallampati, and Berlin scores were found to be the best clinical characteristics associated with POSA with an area under the ROC curve (AUC) of 0.71 (95% CI [0.63, 0.78]). CONCLUSIONS: Half of patients referred for the sleep study had POSA. Age, BMI, DBP, Mallampati, and Berlin scores, put together, were shown to act as good clinical characteristics to discriminate between POSA and non-POSA patients.

Effects of a rapid peer-based HIV/AIDS educational intervention on knowledge and attitudes of high school students in a high-income Arab country.

INTRODUCTION: In response to low knowledge about HIV and intolerant attitudes toward persons living with HIV among Arab university students, a peer-based educational intervention was developed and impact evaluated on knowledge and attitudes of high school students in 2 of 4 main cities of United Arab Emirates. METHODS: Four small teams of final year medical students, 3 female and 1 male, were trained. Multistage random sampling selected 14 female and 5 male Arab schools, then 56 female and 14 male grade 12 classes in Al Ain and Abu Dhabi. The 90-minute intervention included a factual presentation and 3 attitude workshops. Baseline and postintervention knowledge and attitudes were assessed. Significance was tested by McNemar, Wilcoxon signed rank, and multilevel regression tests. RESULTS: Response was 99.6%, 1398 females and 505 males. Misconceptions about modes of transmission and intolerant attitudes were evident. Mean knowledge score improved from 65% to 82% and attitude 51% to 64%, that is, relative increase 26% (P < 0.0005). Females had slightly lower baseline knowledge than males but showed greater improvement in knowledge and attitudes (P < 0.0005) CONCLUSIONS: Grade 12 students' knowledge about HIV/AIDS was inadequate and attitudes stigmatizing. Peer-based knowledge workshops were effective, especially among females. Concise integrated teaching and workshops designed to address key knowledge and attitudinal deficiencies can be highly effective.