Effect of Continuous Positive Airway Pressure Therapy in Patient with Obstructive Sleep Apnea and Pulmonary Hypertension: A literature review.

Patients with obstructive sleep apnea (OSA) and pulmonary hypertension (PH) have a reduced functional capacity and potential survival. Continuous positive airway pressure (CPAP) is the primary treatment for OSA, and this improves sleep parameters, functional activity, and possibly pulmonary artery pressures (PAPs). This literature review summarizes the available studies that have measured changes in PAPs in patients with sleep apnea following the institution of CPAP. The PubMed.gov database was searched with a combination of keywords including: "Pulmonary Hypertension," "Obstructive Sleep Apnea," and "Continuous Positive Airway Pressure." Specific inclusion and exclusion criteria were applied to select prospective studies, and data were carefully extracted from each study. Seven unique studies were identified from a list of 272 search results. The studies included a range of CPAP treatments; all showed significant improvement in PAP. The average improvement in PAP across all studies when weighted for a number of participants was 9.33 ± 7.71 mm Hg. This systematic literature review demonstrates that CPAP treatment reduces PAPs in patients with OSA. The study intervals ranged from 48 hours to 6 months to determine the effects of CPAP on PH in these patients. The literature review undertaken during the analysis of these original studies on OSA and PH provides information about vascular remodeling during OSA and the effect of apnea on O2 saturation, intrathoracic pressure swings, and sympathetic surges post apnea. Patients with OSA frequently have significant comorbidity, including hypertension, obesity, and overlap syndromes with other pulmonary disorders and/or cardiac disorders. This comorbidity increases the complexity of management and likely contributes to poor outcomes. The gold standard for making a diagnosis of PH requires right heart catheterization, but practical issues dictate the need for frequent echocardiograms to evaluate right ventricular systolic pressures and right atrial and ventricle chamber sizes. A better understanding of the association between OSA and PH and its treatment with CPAP will require long-term perspective studies.

Improving personal growth and sustaining mental and physical health of radiologists: essential quotients to embrace.

This special report provides a viewpoint on attaining knowledge of essential traits also known as quotients (Q) that can improve the mental, physical, and spiritual satisfaction and health of radiologists. While intelligence Q is generally above-average for most doctors and radiologists, other Qs needed for wholesome personal growth include emotional Q, spiritual Q, cultural Q, and more importantly, the meaning Q. Self-reflection and embracing such elements can aid in personal development, enhanced mental peace, and improved systems-based practice in the context of integrated healthcare organizations. KEY POINT: • Emotional, spiritual, cultural, and meaning quotients can be embraced by radiologists for better self-development and improved systems-based practice in the context of integrated healthcare organizations.

Efficacy of organo-selenium-incorporated urinary catheter tubing for in vitro growth inhibition of E. coli, K. pneumoniae, P. aeruginosa, and H. influenzae.

PURPOSE: Catheter-associated urinary tract infections are of significant medical burden in cost, morbidity, and mortality. Experimental selenium-coated medical devices have demonstrated non-toxic in vitro and in vivo antimicrobial activity. While antimicrobial-coated catheters have shown efficacy in preventing CAUTIs, selenium has not been tested in this context. The purpose of this in vitro study is to evaluate selenium-incorporated urinary catheters for inhibition of uropathogenic bacterial growth and biofilm formation. METHODS: Urinary catheters incorporated with 1% organo-selenium and standard (uncoated) catheters were incubated in vitro with E. coli, K. pneumoniae, P. aeruginosa, H. influenzae, and combinations of these bacteria. Growth was evaluated by colony-forming unit count and visualized with confocal laser and scanning electron microscopy. Organo-selenium catheter material integrity was also tested by soaking the tubing in phosphate-buffered saline for 12 weeks at 37 °C. RESULTS: Organo-selenium-incorporated catheters demonstrated total reduction (100%) of in vitro bacterial growth and biofilm formation for E. coli, K. pneumoniae, H. influenzae, and a combination of these species when compared to control. P. aeruginosa growth was inhibited by approximately 4 logs (99.99%). Complete inhibition of E. coli growth was maintained after long-term phosphate-buffered saline soaking. CONCLUSION: The results demonstrate that organo-selenium was stably incorporated into catheter tubing and inhibited bacterial attachment, growth, and biofilm formation for multiple uropathogenic organisms. Furthermore, long-term soaking of organo-selenium tubing in phosphate-buffered saline did not show any decline in bacterial growth inhibition or biofilm formation. These findings suggest that organo-selenium-incorporated catheters may be advantageous in preventing catheter-associated urinary tract infections and warrant further in vivo and clinical evaluation.

The efficacy of organo-selenium conjugated cellulose polymer dressing to inhibit Candida albicans biofilm formation.

Selenium covalently bonded to cellulose can catalyze the formation of superoxide radicals. Candida albicans, colonizes epithelial surfaces and can be a fatal infection in immunocompromised people. In this study, we demonstrated the ability of organo-selenium, covalently attached to cotton textile dressings to kill C. albicans biofilms.