RESUMO
Snoring and obstructive sleep apnea (OSA) are related to narrowing of the upper airway. A mandibular advancement splint (MAS) could improve both conditions by increasing oropharyngeal and hypopharyngeal dimensions. The effects of a MAS on snoring and OSA was evaluated 3.5 +/- 2.1 (mean +/- SD) mo after issue in 57 subjects with habitual loud snoring, 39 of whom had an apnea-hypopnea index (AHI) > or = 10. Assessment was by questionnaire (all subjects) and polysomnography (51 subjects, 47 male) including measurement of sound intensity. Use of the MAS was randomized to first or second half of study. Snores were scored where inspiratory noise was greater than 5 dB above background. Total sleep time, sleep efficiency, % REM sleep, and % sleep spent supine were similar (p > 0.05) with and without the MAS. Snores per sleep minute, corrected for time in apnea, and sound intensity of snores (% snores > or = 50 dB) decreased with the MAS from 11.0 +/- 5.8 and 42.0 +/- 25.0% to 9.0 +/- 6.0 (p < 0.01) and 26.2 +/- 25.2% (p < 0.01), respectively. Using the MAS significantly improved OSA: AHI decreased from 32.2 +/- 28.5 to 17.5 +/- 22.7 (p < 0.01) and arousal index decreased from 31.4 +/- 20.6 to 19.0 +/- 14.6 (p < 0.01). AHI decreased to < 20 with the MAS in 12 of 17 subjects where untreated AHI was between 20 and 60, and in 2 of 9 subjects where untreated AHI was > 60. Forty-five patients continued to use the MAS regularly.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Mandíbula , Placas Oclusais , Desenho de Aparelho Ortodôntico , Síndromes da Apneia do Sono/terapia , Ronco/terapia , Adulto , Idoso , Análise de Variância , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Placas Oclusais/estatística & dados numéricos , Polissonografia/estatística & dados numéricos , Indução de Remissão , Síndromes da Apneia do Sono/diagnóstico , Ronco/diagnóstico , Inquéritos e QuestionáriosAssuntos
Mandíbula , Contenções Periodontais/estatística & dados numéricos , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/terapia , Ronco/etiologia , Ronco/terapia , Resultado do Tratamento , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Polissonografia , Sono REMRESUMO
A case of pulmonary actinomycosis presenting with a right calf abscess and complicated by effusive constrictive pericarditis is discussed. Clinical improvement occurred with antibiotic therapy and pericardiectomy. There was no evidence of recurrence after 18 months.
Assuntos
Actinomicose/complicações , Pneumopatias Fúngicas/complicações , Derrame Pericárdico/etiologia , Pericardite Constritiva/etiologia , Actinomyces/isolamento & purificação , Actinomicose/diagnóstico por imagem , Actinomicose/microbiologia , Humanos , Pneumopatias Fúngicas/diagnóstico por imagem , Pneumopatias Fúngicas/microbiologia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
This case concerns a patient with intracranial extramedullary hematopoiesis (EH) suspected on a CT scan and subsequently confirmed with In-111 chloride and Tc-99m SC bone marrow scans. The bone marrow scans also provided additional information by demonstrating other sites of EH in the paravertebral tissues and bone marrow expansion into the distal extremities.
Assuntos
Encéfalo/patologia , Hematopoese Extramedular , Mielofibrose Primária/diagnóstico , Adulto , Medula Óssea/diagnóstico por imagem , Humanos , Radioisótopos de Índio , Masculino , Mielofibrose Primária/fisiopatologia , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios XRESUMO
Experiments are described which show that the torsional oscillations arising in a strand of the slime mould, Physarum polycephalum, under certain conditions remain closely correlated to oscillations in cytoplasmic streaming. When this is the case, the direction of rotation is related to the direction of streaming by a left-hand rule.
