tag:blogger.com,1999:blog-105306862024-03-13T20:00:59.082+08:00Otolaryngology-Head & Neck SurgeryCASES AND UPDATES FOR OTOLARYNGOLOGISTS AND HEAD & NECK SURGEONSYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.comBlogger62125tag:blogger.com,1999:blog-10530686.post-79289560001402400622013-03-20T15:25:00.001+08:002013-03-20T15:25:36.079+08:00No life threatening complications from UPPP<div xmlns='http://www.w3.org/1999/xhtml'>The level of caution is usually high in anesthesising patients with OSA and even more so when these patients undergo airway surgery. <br/>
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Postop ICU care may even be routine in some centers. <br/>
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This retrospective review is good evidence to show that the risks aren't all that high and serious complications - the study cites reintubation and pulmonary edema as serious - do not occur post operatively after a UPPP. <br/>
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While caution is advised, an exaggerated fear is quite unnecessary. <br/>
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<a href='http://www.ncbi.nlm.nih.gov/PubMed/23504700?dopt=Abstract'>http://www.ncbi.nlm.nih.gov/PubMed/23504700?dopt=Abstract</a><br/><p style='font-size: xx-small' align='right'>posted from <a href='https://market.android.com/details?id=pl.przemelek.android.blogger'>Bloggeroid</a></p></div>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com7tag:blogger.com,1999:blog-10530686.post-36788330610254386252013-03-20T08:52:00.001+08:002013-03-20T08:52:41.685+08:00German NPC Results<div xmlns='http://www.w3.org/1999/xhtml'>Interesting to note that NPC in Europe has a very different profile and outcome from endemic Southeast Asia. <br/>
For one there is a much higher Type II WHO (33%) and Type I (19%). Survival is lower (75% 5ysr) and recurrence is high (34%)<br/>
<a href='http://www.ncbi.nlm.nih.gov/PubMed/23202863?dopt=Abstract'>http://www.ncbi.nlm.nih.gov/PubMed/23202863?dopt=Abstract</a><br/><p style='font-size: xx-small' align='right'>posted from <a href='https://market.android.com/details?id=pl.przemelek.android.blogger'>Bloggeroid</a></p></div>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com1tag:blogger.com,1999:blog-10530686.post-3297815760580469632013-03-08T12:56:00.001+08:002013-03-08T12:56:55.716+08:00Diet and NPC 2<p dir=ltr><a href="http://www.ncbi.nlm.nih.gov/PubMed/22848600?dopt=Abstract">Lowered risk of nasopharyngeal carcinoma and intake of plant vitamin, fresh fish, green tea and coffee: a case-control study in taiwan.</a></p>
<p dir=ltr>More NPC-specific cancer protective diet data available to us now. </p>
<p dir=ltr>In this study: phytocarotenoids, fresh fish (as opposed to salted fish) and coffee are significantly risk lowering. </p>
Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com1tag:blogger.com,1999:blog-10530686.post-84448907474065541902012-11-02T19:12:00.001+08:002012-11-02T19:12:55.356+08:00Drug therapy for OSA? <div xmlns='http://www.w3.org/1999/xhtml'>Generally drug therapy for OSA has had little evidence or pathophysiological leads for successful interventions. This study, albeit using the weight loss route with AHI end points, has shown good effect and warrants attention as far as treatment for overweight OSA goes. <br/>
<a href='http://www.ncbi.nlm.nih.gov/pubmed/23115402'>http://www.ncbi.nlm.nih.gov/pubmed/23115402</a></div>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com2tag:blogger.com,1999:blog-10530686.post-66552511437117189252012-11-02T19:00:00.001+08:002012-11-02T19:00:26.344+08:00Premies have more OSA<div xmlns='http://www.w3.org/1999/xhtml'>Who would've guessed someone would do such a study much less the fascinating results? It makes you think why Premies would be more at risk of OSA later on in childhood when they've caught up with their term counterparts. Does being prem predispose to adenoids? Is it retarded lower face craniofacial growth? Or some kind of local oropharyngeal neuropathy? <br/>
<a href='http://www.ncbi.nlm.nih.gov/pubmed/23115396'>http://www.ncbi.nlm.nih.gov/pubmed/23115396</a></div>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-35093449663173379522012-11-02T18:53:00.001+08:002012-11-02T18:53:21.701+08:00Portable monitoring for truckers - good or bad? <div xmlns='http://www.w3.org/1999/xhtml'>It's interesting that this article cites loss of data and loss to follow up as problems with portable monitoring vs full PSGs. My own instinct about this is to go with PM as a screening tool to increase detection and safety for public. But let's see how this debate plays out.. <br/>
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<a href='http://www.ncbi.nlm.nih.gov/pubmed/23115397'>http://www.ncbi.nlm.nih.gov/pubmed/23115397</a></div>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-48837232670186086552012-01-27T23:50:00.001+08:002012-01-27T23:50:38.432+08:00Continuous Positive Airway Pressure The - PubMed MobileMore encouraging data on the wavefront of studies on the CVS effects of CPAP therapy on OSA.
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<br>Demonstrating an increase in nitric oxide and blood flow and a concommitant decrease in inflammatory mediators, the benefits are similar to and complents pharmacotherapy and exercise for the occlusive and thrombotic vascular diseases - ie. IHD, stroke, PVD.
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<br>It will be good to see sleep testing and CPAP become mainstay in the management and prevention of these vascular diseases
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<br><a href="http://www.ncbi.nlm.nih.gov/m/pubmed/22278815/">http://www.ncbi.nlm.nih.gov/m/pubmed/22278815/</a>
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<br>Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-12758041789877375692012-01-27T23:42:00.001+08:002012-01-27T23:42:07.378+08:00Polysomnographic findings and clinical presentation of adult men with OSA in China - PubMedWhat's useful about this simple descriptive study is that it represents a closer-to-home Asian profile, and a stratification into 3 equal groups of young/middle-aged/elderly men for comparison.
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<br>What the demonstrates is that OSA decreases in severity and CSA increases with age!
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<br>The questions this raises is:
<br>1- What physiologic mechanisms are at work to reduce upper airway obstruction and inhibit respiratory drive?
<br>2- What does this mean for long-term follow up? Should we retest and how often to see this reduction, potentially reversal of OSA?
<br>3- How does this change management strategies? Is there a role for weaning off CPAP (given the poor compliance rates, long term) and exploring surgical modalities as age advances? (I can see how this is important so that patients, given something to look forward to are not lost on follow up).
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<br><a href="http://www.ncbi.nlm.nih.gov/m/pubmed/22276350/">http://www.ncbi.nlm.nih.gov/m/pubmed/22276350/</a>
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<br>Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-41764116855502756382012-01-26T19:12:00.001+08:002012-01-26T19:12:08.363+08:00Children's Asthma Not Eased by Anti-Reflux DrugThis is one good example of how children aren't just small adults and extrapolating our experience treating 'acid asthma' successfully in adults isn't transferrable.
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<br>The findings in this study isn't surprising since we do know that asthma is an atopic disease which peaks in early childhood and abates after puberty, while the adult variety is a residual of that or a different entity altogether.
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<br>The premise for the success of PPIs in adults I believe is that reflux is responsible for prolonging asthma beyond childhood and also for new onset bronchospasm mimicking asthma.
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<br><a href="http://m.voanews.com/english/Childrens-Asthma-Not-Eased-by-Anti-Reflux-Drug-138085933.html">http://m.voanews.com/english/Childrens-Asthma-Not-Eased-by-Anti-Reflux-Drug-138085933.html</a>
<br>Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com1tag:blogger.com,1999:blog-10530686.post-20237675904761953772012-01-26T18:12:00.003+08:002012-01-26T18:15:32.090+08:00High rate of neck cancer<a href="http://2.bp.blogspot.com/--dQOiWRJqhE/TyEnaiiEFII/AAAAAAAAFEQ/CzkPQbE8TeM/s1600/NPC_THESTAR.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 176px; height: 320px;" src="http://2.bp.blogspot.com/--dQOiWRJqhE/TyEnaiiEFII/AAAAAAAAFEQ/CzkPQbE8TeM/s320/NPC_THESTAR.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5701881940127519874" /></a><br />The Star highlighted the importance of head & neck cancers in Malaysia, though that paragraph about isn't very clear, it is to say that...<br />1) NPC is the 5th most common cancer in Malaysia<br />2) NPC is the top head & neck cancer in Malaysia, and<br />3) As a group, head & neck cancer is the second most common, after female breast cancer, in Malaysia.<br /><br />http://thestar.com.my/news/story.asp?file=/2012/1/20/nation/10300494&sec=nationYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-1984632458309709652012-01-26T14:02:00.002+08:002012-01-26T18:05:53.662+08:00CPAP cures metabolic syndrome in obstructive sleep apnea (RCT, NEJM)This is a fascinating study not just because it demonstrates the benefit of CPAP in reducing sugar, blood pressure, cholesterol, and LDL, but more so for its use of a 'sham CPAP' for placebo!<br /><br />As the commentator notes, it's unclear if the benefits were the direct result of reducing hypoxic events or more indirectly because of increased activity and exercise in the less somnolent. It would be good to control for that. <br /><br /><a href="http://pulmccm.org/main/2012/randomized-controlled-trials/cpap-cures-metabolic-syndrome-in-obstructive-sleep-apnea-rct-nejm/">http://pulmccm.org/main/2012/randomized-controlled-trials/cpap-cures-metabolic-syndrome-in-obstructive-sleep-apnea-rct-nejm/</a><br /><br />Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com1tag:blogger.com,1999:blog-10530686.post-89688055316374611592012-01-26T12:44:00.002+08:002012-01-26T18:06:17.761+08:00Liow: Heavy snorers may have sleep disorderOur Minister of Health has taken cognizance of the serious health implications of OSA.<br /> <br /><a href="http://thestar.com.my/news/story.asp?file=/2012/1/8/nation/10225247&sec=nation">http://thestar.com.my/news/story.asp?file=/2012/1/8/nation/10225247&sec=nation</a><br /><br />Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-80694952478297116812012-01-26T12:10:00.001+08:002012-01-26T18:06:31.233+08:00Chemoradiotherapy for Early-stage Nasopharyngeal Disease - The ASCO PostGiven the better outcomes of Stage III and IV NPC on CCRT, one wonders if the same radiosensitising effect would benefit the earlier stages.<br /><br />Stage I and IIa NPC has up to now never been candidates for concurrent chemotherapy, since outcomes have been good on radiotherapy alone.<br /><br />This trial addresses that particular gap in our knowledge and the results suggest that the benefit is not only significant, it is a worthwhile endeavor given the minimal and controllable adverse effects.<br /><br /><a href="http://www.ascopost.com/articles/january-15-2012/chemoradiotherapy-for-early-stage-nasopharyngeal-disease/">http://www.ascopost.com/articles/january-15-2012/chemoradiotherapy-for-early-stage-nasopharyngeal-disease/</a><br /><br />Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-44758119963161766882011-10-24T11:00:00.002+08:002011-10-24T11:19:25.476+08:00OSA in Pediatric CNS tumor survivors<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://thehandiestone.typepad.com/.a/6a0120a6c5ca34970b01347fc545c3970c-800wi"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 226px; height: 170px;" src="http://thehandiestone.typepad.com/.a/6a0120a6c5ca34970b01347fc545c3970c-800wi" border="0" alt="" /></a><br /><br />An interesting study showing a high prevalence of OSA in children CNS tumor survivors. Rather remarkable is that while SDB is highly prevalent, it is the Obstructive apneas that are more prevalent than Central (14 out of 18). Another subgroup of patients to be on the alert for OSA in.<br /><br /><a href="http://www.ncbi.nlm.nih.gov/pubmed/22009579?dopt=Abstract">Excessive daytime sleepiness and sleep-... [Pediatr Blood Cancer. 2011] - PubMed - NCBI</a>: <br><br><a style="font-size:13px" href="https://chrome.google.com/webstore/detail/pengoopmcjnbflcjbmoeodbmoflcgjlk">'via Blog this'</a>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com1tag:blogger.com,1999:blog-10530686.post-50737388137531832072011-10-20T15:14:00.002+08:002011-10-20T15:20:19.297+08:00Oropharyngeal examination to predict sleep apnea severity<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.arabmedmag.com/issue-15-01-2005/images/herc177006.f1.gif"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 440px; height: 405px;" src="http://www.arabmedmag.com/issue-15-01-2005/images/herc177006.f1.gif" border="0" alt="" /></a><br />It's good to see a study that validates what is widely held belief among ENT surgeons. While assessing the oropharyngeal airway ALONE is hardly a holistic approach, a finding of a narrowed passage by Friedman Tongue Position in a patient with excessive daytime sleepiness or other comorbids of OSA (eg. refractory hypertension, ischemic heart disease) has been highly predictive of OSA in my own practice. <br /><br /><br /><a href="http://www.ncbi.nlm.nih.gov/pubmed/22006776?dopt=Abstract">Oropharyngeal examination to... [Arch Otolaryngol Head Neck Surg. 2011] - PubMed - NCBI</a>: <br><br><a style="font-size:13px" href="https://chrome.google.com/webstore/detail/pengoopmcjnbflcjbmoeodbmoflcgjlk">'via Blog this'</a>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com1tag:blogger.com,1999:blog-10530686.post-70101738331059487362011-01-02T14:57:00.000+08:002011-01-02T14:56:36.279+08:00Coronary CT Angiography Reveals Vessel Involvement in Obstructive Sleep Apnea : Internal Medicine NewsAn important step forward in delineating the relationship between OSA and IHD.
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<br>Already we know, hypoxia and sympathetic stimulation places the heart in a state of myocardial with reduced oxygenation.
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<br>The added insult of oxidative injury is the third and lethal blow it seems..
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<br><a href="http://www.internalmedicinenews.com/news/cardiovascular-disease/single-article/coronary-ct-angiography-reveals-vessel-involvement-in-obstructive-sleep-apnea/233e32a8fd.html">http://www.internalmedicinenews.com/news/cardiovascular-disease/single-article/coronary-ct-angiography-reveals-vessel-involvement-in-obstructive-sleep-apnea/233e32a8fd.html</a>
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<br>Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-36271310614436500292011-01-02T14:35:00.000+08:002011-01-02T14:34:02.562+08:00Experiments test if implant can block sleep apnea - Leesville, LA - Leesville Daily LeaderAn impanted synchronised nerve stimulator to increase muscle tone of the tongue, hence preventing retroglossal obstruction. How ingenious!
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<br><a href="http://www.leesvilledailyleader.com/news/x224240986/Experiments-test-if-implant-can-block-sleep-apnea">http://www.leesvilledailyleader.com/news/x224240986/Experiments-test-if-implant-can-block-sleep-apnea</a>
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<br>Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-65059218144467886222010-12-16T11:54:00.000+08:002010-12-16T11:53:53.065+08:00Prince Of Wales Hospital In Hong Kong First In Asia To Offer Cancer Patients Image-Guided RapidArc® RadiotherapySimilar to the high-speed 640 slice CTs, using Arc technology is the most logical thing to do. It really is quite amazing to watch these machines at work.
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<br><a href="http://www.medicalnewstoday.com/articles/211522.php">http://www.medicalnewstoday.com/articles/211522.php</a>
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<br>Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-74256603287164931742010-12-16T11:22:00.001+08:002010-12-16T11:22:02.994+08:00Guangdong Humen People Suspected Cancer Due To Fumes Emitted From Power Plants - Refractory IndustryThe nasopharynx being the airway brusher, fumes and pesticide-bearing wood dusts are always suspect causative agents.
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<br>The Humen people are among the most susceptible in the world to NPC and it doesn't help to be fogged in power plant fumes...
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<br><a href="http://business.ezinemark.com/guangdong-humen-people-suspected-cancer-due-to-fumes-emitted-from-power-plants-refractory-industry-31c8dac7a09.html">http://business.ezinemark.com/guangdong-humen-people-suspected-cancer-due-to-fumes-emitted-from-power-plants-refractory-industry-31c8dac7a09.html</a>
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<br>Sent by Maxis from my BlackBerry® smartphoneYoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-60973856385695348532010-05-04T00:24:00.000+08:002010-05-04T00:25:01.118+08:00Antioxidants for deafnessOxygen free radicals is now the scapegoat for everything from diabetes to cancer; so why not deafness? <p>We've always relegated presbycusis to just another one of the many unavoidable stigma of ageing, inexplicable and irreversible. Ageing is the next frontier of medicine and free radicals are the sands of time in the storm of decay.<br> <br>Sci Am reviews a fascinating recent animal study that demonstrated slowing of age-related deafness in rats by the administration of antioxidants. An elegant way of elucidating the mechanism of disease AND its treatment in a single experiment. <p>Unfortunately, the pharma industry will only seize this to sell us a plethora of antioxidants rather than have us relook at our toxic modern diets and lifestyles!<p><a href="http://www.scientificamerican.com/article.cfm?id=preventing-hearing-loss">www.scientificamerican.com/article.cfm?id=preventing-hearing-loss</a>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-19733630580507023582010-04-17T17:52:00.001+08:002010-04-30T09:30:58.805+08:00Things aren't always what they seem at firstNow that 4D IMRT is all the buzz, we are seeing more and more studies on the volume changes of tumors througout the course of chemoradiation. This is imaging science at its best, monitoring progress and titrating treatment according to burden of disease. Perhaps we can learn something in managing other pathologies; like infection for example.<p>Weekly volume and dosimetric changes during chemoradiotherapy with intensity-modulated radiation therapy for head and neck cancer: a prospective observational study. (<a href="http://www.ncbi.nlm.nih.gov/pubmed/20338474">http://www.ncbi.nlm.nih.gov/pubmed/20338474</a>) <br>Bhide SA, Davies M, Burke K, McNair HA, Hansen V, Barbachano Y, El-Hariry IA, Newbold K, Harrington KJ, Nutting CM. <br>Int J Radiat Oncol Biol Phys. 2010 Apr;76(5):1360-8.Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-7405945813290326102010-04-11T20:35:00.001+08:002010-04-30T09:33:21.831+08:00The Master speaksWhen it comes to surgical management of NPC, William Wei always has the last word. <p>So, it's good that he issues refreshers like this one to keep our management strategies abreast with latest developments.<p>This appears as the article 'Current management strategy of nasopharyngeal carcinoma' in Clin Exp Otorhinolaryngol. 2010 Mar;3(1):1-12<br> (<a href="http://www.ncbi.nlm.nih.gov/pubmed/20379395">http://www.ncbi.nlm.nih.gov/pubmed/20379395</a>)<p>Other review articles of relevance are linked as well.<br>(<a href="http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=20379395">http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=20379395</a>)Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-40987585335169044762010-04-11T14:54:00.001+08:002010-04-30T09:30:58.805+08:00New in OSAThis is music to my ears.<p>Authors Xu H, Huang W, Yu L, and Chen L. published in Acta Otolaryngolica this week an article entitled 'Sound spectral analysis of snoring sound and site of obstruction in obstructive sleep apnea syndrome.'<br /> (<a href="http://www.ncbi.nlm.nih.gov/pubmed/20377505">http://www.ncbi.nlm.nih.gov/pubmed/20377505</a>)<p>They showed objectively what we have known intuitively, that the higher the obstruction the lower the pitch of noise generated. In fact they found that lower obstructions had a greater proportion of >800Hz and >2000Hz first-snore sounds than higher obstructions.<p>This confirms the way we clinically differentiate stertor and stridor, and might even spawn a new wave of polysomnogram parameters.Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-84467850534934263442009-11-12T13:53:00.002+08:002009-11-12T14:23:52.780+08:00I can tell by the way you snore...<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.birdsasart.com/Hippo-Yawn.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 501px; height: 650px;" src="http://www.birdsasart.com/Hippo-Yawn.jpg" border="0" alt="" /></a><br />Wouldn't it be great if we didn't have to do expensive polysomnograms, read incomprehensible charts, and (in the public setting) wait for months for a sleep study? All just to diagnose OSA and say to a patient ok, now we are sure you need treatment. Especially when he's been falling asleep in your waiting room or just come in with head bandaged after his lorry overturned. You know he has OSA.<br /><br />Well, it seems the <a href="http://www.healthjockey.com/2009/11/11/snoring-sounds-could-possibly-hold-the-answer-to-a-good-night-sleep/">people in Brisbane</a> have found a way.<br /><br />I have been thinking along the lines of a biochemical marker or something that might be detected in the breath. Imagine bus drivers having to check in for a urine test or breathalyser test before they board and you get the idea.<br /><br />The <a href="http://www.healthjockey.com/2009/11/11/snoring-sounds-could-possibly-hold-the-answer-to-a-good-night-sleep/">sleep team in University of Queensland</a> have reported they can HEAR that you have OSA.<br /><br />I guess I have always had this hunch. Haven't you? There's a rhythmic hiss in the meeting room and you thought it was the air-condition vent until the guy next to you starts nodding. You think the ventilator is leaking when you realise your assistant in OR is stertoring. You know. Nothing scientific. No data to base this on. Just that visceral hunch that there's no way you can be breathing right during sleep if you are hissing with every breath through the day.<br /><br />But these guys down under have made a science of it and claim over 90% sensitivity and specificity by simply analysing the audio recording of your snore!<br /><br /><a target="blank" href="http://www.healthjockey.com/2009/11/11/snoring-sounds-could-possibly-hold-the-answer-to-a-good-night-sleep/">Read the Article at HealthJockey.com<br /><br /><a target="blank" href="http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=DetailsSearch&term=udantha+abeyratne,+snore&log$=activity">Review the scientific papers</a> related to snoring by their lead researcher <a target="blank" href="http://www.uq.edu.au/uqresearchers/researcher/abeyratneur.html">Dr. Udantha Abeyratne</a>.<br /></a>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com0tag:blogger.com,1999:blog-10530686.post-30292912862913156252009-11-10T20:35:00.004+08:002009-11-10T23:26:00.428+08:00Post exposure prophylaxis for Varicella?<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.pharmaceutical-technology.com/projects/merck2/images/MERCK4.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 269px;" src="http://www.pharmaceutical-technology.com/projects/merck2/images/MERCK4.jpg" border="0" alt="" /></a><br />The author of this blog is currently in day 7 of illness, suffering from a moderate form of varicella. In spite of starting acyclovir (thanks to vigilant and quick-acting wife) on the day of eruptions, the disease process was not halted and vesicles are florid. While we are taking precautions against pneumonia, encephalitis, and other adult-onset associated complications, it is my 2yr old that I agonise about.<br /><br />He is an 'exposed' individual. Varicella infections in children are mild and rarely complicated. Being an otolaryngologist, however, we know that Ramsay-Hunt (herpes zoster oticus; i.e. reactivation of virus in facial nerve) syndrome causes debilitating facial palsy - sometimes irreversible. Shingles is painful, too. My question is, should I bother vaccinating him now? He was planned for his jab next week, but now that he is exposed, shouldn't I just wait and see if he develops the infection which would obviate vaccination altogether?<br /><br />Well, this is where the evidence is really useful:<br /><br />According to the <a href="http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001833/frame.html">Cochrane review</a> of randomized trials evaluating varicella vaccine in children and adults; from 3 trials with 110 healthy siblings of household contacts where they received post-exposure prophylaxis (PEP) within 3 days of exposure or not at all:<br /> - varicella developed in 18% (PEP) vs. 78% (no PEP) (p < 0.05)<br /> - moderate to severe varicella developed in 2% (PEP) vs. 76% (no PEP) (p < 0.05)<br /> - PEP group who developed varicella had mild disease (< 50 skin lesions)<br /> - no trials reported on adverse events following immunization<br /><br />Also, for all my healthcare worker friends out there, don't be a hero (or a chicken, depending why you're delaying.) Get yourself jabbed now! Varicella vaccine is recommended for those who have never had chickenpox and are seronegative for varicella antibodies. The caveat (or bonus) is 1-5% adult develop varicella-like rashes that shed the virus and should be removed from patient contact (perfect excuse for holiday, no?) <a href="http://www.ncbi.nlm.nih.gov/pubmed/9402814?dopt=Abstract">[Am Fam Physician 1997 Dec;56(9):2291]<span style="font-style:italic;"></span></a>Yoke-Yeow Yaphttp://www.blogger.com/profile/05894275779933392361noreply@blogger.com1