Sleep apnea I and II

            NAVARRA , SPAIN - Reuters Health reported severe sleep apnea (SSA) appears to be an independent risk for ischemic stroke in elderly patients, stated a report in the journal Stroke. Sleep apnea occurs when breathing is briefly but frequently blocked while sleeping. Ischemic stroke, the most common type, occurs when oxygen to the brain is blocked, usually by a blood clot, causing "ischemia" or tissue death. Reports have supported a causal relationship between sleep apnea and stroke, Dr. Roberto Munoz, of Hospital de Navarra, and colleagues note. However, these studies focused primarily on middle-aged subjects. Scientists studied 394 patients 70-100. At the start of the six-year study, subjects were stroke-free and weren’t institutionalized. In follow-up, 20 ischemic strokes occurred, the report shows. After accounting for gender, age, smoking status, and other confounding variables, SSA raised the risk of ischemic stroke by 2.52-fold. A randomized trial to study the effect of relieving sleep apnea with CPAP therapy on stroke in this patient population is warranted to further establish a causal relationship, researchers conclude.

            BIRMINGHAM , AL - New guidelines for healthcare professionals could lead to significantly fewer foot complications and amputations by changing the way doctors treat the feet of diabetes patients, Newswise stated. The guidelines from the American College of Foot and Ankle Surgeons (ACFAS) introduce two substantial changes: a focus on prevention, and the use of multidisciplinary teams of specialists. These reflect global medical evidence that a multidisciplinary approach gets dramatic reductions in complications and amputations in diabetic feet. They mirror an increasing emphasis on management of chronic diseases like diabetes. ACFAS had a supplement in the Journal of Foot & Ankle Surgery. “These state-of-the-art guidelines give foot and ankle surgeons and other medical professionals a powerful new tool to help improve and maintain the quality of life for millions of people with diabetes,” says Dr. James L. Thomas, foot and ankle surgeon and ACFAS president. “They don’t erase patients’ responsibility to manage their disease, inspect their feet daily, and get regular checkups.”

            WASHINGTON - Newswise noted ideas from the American College of Chest Physicians (ACCP), American College of Occupational and Environmental Medicine (ACOEM), and the National Sleep Foundation (NSF) offer an updated consistent approach to screening and management of obstructive sleep apnea (OSA) among commercial motor vehicle (CMV) operators. Published as a supplement to the Journal of Occupational and Environmental Medicine, the recommendations include a more thorough screening and evaluation process, modified criteria for returning to work after treatment, and follow-up and recertification. “Sleepiness and inattention contribute to a significant number of CMV crashes each year and OSA has been shown to increase significantly a risk of driving drowsy. Yet, current CMV screening and treatment procedures are ambiguous and not reflective of the latest advancements in the diagnosis and management of OSA,” said Dr. Nancy Collop, of the ACCP Sleep Institute. “Conflicting approaches to screening and management of OSA have left drivers undiagnosed, which puts the driver and general public at risk.”

            BETHESDA , MD - A clinical trial is testing whether injection of a long-lasting antipsychotic medication every two weeks has better adherence to treatment and better outcomes among schizophrenics than do oral drugs taken daily. The $10 million trial is funded by the National Institute of Mental Health (NIMH) and is called Preventing Relapse in Schizophrenia: Oral Antipsychotics Compared to Injectables - Evaluating Efficacy (PROACTIVE). Patients can participate for any 2.5-year period during the -five-year study conducted at seven U.S. sites and will include only newer, second-generation antipsychotic medications. About 1% of U.S. adults, or 2.4 million, have schizophrenia, among the most serious mental illnesses. Its symptoms, such as loss of contact with reality, disordered thinking, flat emotions, and social withdrawal, can lead to long-term disability. The study is addressing a major challenge in the treatment of schizophrenia: how best to encourage long-term treatment and medication adherence. Research shows schizophrenics who take antipsychotic drugs consistently fare better than those who don’t. These medications help prevent symptoms and relapse and reduce hospitalizations. However, many patients stop taking medications or take them sporadically.

PHILADELPHIA - Newswise noted RT Image chose the Hospital of the University of Pennsylvania (HUP) as one of “25 Most Influential” movers and shakers in the radiology field in 2006. Every year, RT Image magazine lists its roster of radiology’s most powerful people, institutions, and organizations based on who has influenced the radiology profession in a positive way in the last year. RT Image named HUP for its recent installation of three new, state-of-the-art, high-powered MRI (Magnetic Resonance Imaging) systems. The combination is a “Radiology First” for any U.S. hospital, especially fitting since HUP was the first hospital to get and use an MRI back in 1984. The new machines include a 1.5 Tesla (T) wide-bore scanner designed for larger and claustrophobic patients, a cardiac system allowing physicians to capture a rapidly beating heart, and a 3T scanner permitting sharper brain imaging. The publication also noted HUP as an innovator in PET/CT technology.