No abstract available.
Pancreatitis*

No abstract available.
Adenocarcinoma* ; Cardia* ; Stomach*

No abstract available.
Wounds and Injuries*

Obstructive sleep apnea is a prevalent disease and contributes to consequences like hypertension, diabetes, stroke, cardiac disease, daytime sleepiness, decreased productivity, mood change, and quality of life. The mortality and morbidity due to consequences are related to severity of obstructive sleep apnea. The severity of obstructive sleep apnea is measured by apnea-hypopnea index or respiratory disturbance index. The diagnosis of obstructive sleep apnea is made by polysomnographic findings and/or one of its symptoms (daytime symptoms like unintentional sleep episode during wakefulness, daytime sleepiness, unrefreshing sleep, insomnia, or fatigue, nighttime symptoms like breath holding, gasping, or choking, or bed partner's report about loud snoring, breath stopping). Due to high cost, inconvenience, and availability of in-lab polysomnogrpahy, simple diagnostic tools are suggested. Portable polysomnography has advantages including low cost, home monitoring, and convenience. But portable polysomnography has limitations like safety issues, lead malfunction, sensitivity, and specificity. Moreover, in some patients, portable polysomnography cannot be applied. The standard suggested diagnostic methods and available alternative tools are reviewed.
Airway Obstruction ; Breath Holding ; Diagnosis* ; Efficiency ; Fatigue ; Heart Diseases ; Humans ; Hypertension ; Methods ; Mortality ; Polysomnography ; Quality of Life ; Sensitivity and Specificity ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep Initiation and Maintenance Disorders ; Snoring ; Stroke ; Wakefulness

Continuous positive airway pressure (CPAP) has proven very effective in the treatment of adult obstructive sleep apnea syndrome (OSAS). However, the CPAP device must be used every day and is associated with some discomfort. As a result, many patients do not comply with physician-recommended CPAP usage. Surgical intervention for OSAS eliminates issues with patient non-compliance. Although it is less effective than CPAP, surgery represents a feasible alternative for patients who are non-compliant with CPAP usage, have mild to moderate OSAS without significant comorbidities, or suffer from simple snoring. Nasal surgery can also reduce an individual's CPAP pressure requirement and thus increase compliance. Of the various surgical procedures available, uvulopalatopharyngoplasty, which removes excess tissue from the soft palate and pharynx, is successful only in selected patients, while multilevel surgery is more effective. For example, maxillomandibular advancement is promising, although it is associated with potential morphological change in the airway. Radiofrequency ablation and palatal implants are minimally invasive interventions for simple snoring and mild OSAS. In morbidly obese patients, bariatric surgery has proven particularly effective. Finally and most recently, surgically implanted devices that stimulate the hypoglossal nerve have been investigated.
Adult ; Bariatric Surgery ; Catheter Ablation ; Comorbidity ; Compliance ; Continuous Positive Airway Pressure ; Humans ; Hypoglossal Nerve ; Nasal Surgical Procedures ; Palate, Soft ; Patient Compliance ; Pharynx ; Sleep Apnea, Obstructive* ; Snoring ; Surgical Procedures, Operative

While errors in surgical site or patient identification should not occur, they are some of the most common sentinel events. These events affect not only the patient but also the surgeon and hospital. The exact incidence of surgical errors cannot be measured because measurement depends on voluntary reporting. There have been many efforts to reduce these surgical errors. For example, Universal protocol and time-out just before surgery begins have been introduced. It is also essential to mark the surgical site in a uniform manner. Despite these processes,surgical errors still happen for many reasons. One of most common root causes is communication error. It is essential to use precise communication and to speak up if something is wrong. Hospitals and surgeons should use leadership to involve their teams in a patient safety culture. Not only the system but also this patient safety culture can reduce the incidence of surgical error.
Humans ; Incidence ; Leadership ; Medical Errors ; Patient Safety ; Safety Management

No abstract available.

Nasal obstruction may cause or aggravate sleep disordered breathing but exact pathogenesis is not clear. The possible mechanism could be combination of alteration in upper airway aerodynaimcs, loss of nasal reflex or sensation, effect of mouth opening, and a genetic predisposition. Anatomical narrowing of nasal airway cause more rapid airflow and induce more negative inspiratory air pressure. So, it increases collapsibility of pharyngeal airway. Loss of nasal sensation to airflow block nasal reflex. Mouth opening decreases the activity of pharyngeal airway dilator muscles and narrowing the pharyngeal airway may occur. The treatment of nasal obstruction should be done according to the cause. The causes of nasal obstruction are various from problems of external nasal opening to nasopharynx. Relief of nasal obstruction may not cure sleep disordered breathing always. In some mild obstructive sleep apnea patients, treatment of nasal obstruction only may cure sleep disordered breathing. In some severe sleep apnea patients, treatment of nasal obstruction may increase compliance of continous nasal positive airway pressure.
Air Pressure ; Compliance ; Genetic Predisposition to Disease ; Humans ; Mouth ; Muscles ; Nasal Obstruction* ; Nasopharynx ; Reflex ; Sensation ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive

Obstructive sleep apnea has a close relationship with the anatomical characteristics of the upper airway. But we should consider that obstructive sleep apnea always occurs only when the patients are asleep. Diminishing of neural signal to pharyngeal dilator muscles during the sleep state has a great role in the pathogenesis of obstructive sleep apnea. Narrowing of the upper airway could be due to aging, abnormality of craniofacial skeleton, obesity, narrowing of nasal cavity, adhesive force of mucosa, gravity, sleep, vibratory trauma of upper airway when snoring, compliance of pharyngeal dilator muscle, and apnea threshold according to blood carbon dioxide concentration. Understanding of these possible causes may help to develop treatment modality for obstructive sleep apnea and to introduce individual treatment.
Adhesives ; Aging ; Apnea ; Carbon Dioxide ; Compliance ; Gravitation ; Humans ; Mucous Membrane ; Muscles ; Nasal Cavity ; Obesity ; Skeleton ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring

Sleep and public health has close relationship. Life in modern society makes human sleep deprived state. Sleep deprivation could induce cognitive deficits, heart diseases, glucose metabolic disorders, and decrease quality of life. Moreover, shift worker should work in mismatched circadian rhythm environment. Errors due to sleep deprivation, mismatched circadian rhythm, and various sleep disorders including sleep apnea could be tremendous hazard to public. By understanding sleep physiology, we can prevent sleep deprivation induced accidents and health problems. Sleep specialists have role of education and detection of patients with sleep disorders
Circadian Rhythm ; Glucose Metabolism Disorders ; Heart Diseases ; Humans ; Public Health ; Quality of Life ; Sleep Apnea Syndromes ; Sleep Deprivation ; Sleep Wake Disorders ; Specialization