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Christopher E. Kline Lora E. Burke Susan M. Sereika Christopher C. Imes Bonny Rockette-Wagner Dara D. Mendez Patrick J. Strollo Yaguang Zheng Stephen L. Rathbun Eileen R. Chasens 《Mayo Clinic proceedings. Mayo Clinic》2018,93(9):1290-1298
Objective
To examine the bidirectional relationship between weight change and obstructive sleep apnea (OSA) in the context of a behavioral weight loss intervention.Patients and Methods
Adults who were overweight or obese (N=114) participated in a 12-month behavioral weight loss intervention from April 17, 2012, through February 9, 2015. The apnea-hypopnea index (AHI), a marker of the presence and severity of OSA, was assessed at baseline, 6 months, and 12 months. Linear mixed models evaluated the effect of weight change on the AHI and the effect of OSA (AHI ≥5) on subsequent weight loss. Secondary analyses evaluated the effect of OSA on intervention attendance, meeting daily calorie goals, and accelerometer-measured physical activity.Results
At baseline, 51.8% of the sample (n=59) had OSA. Adults who achieved at least 5% weight loss had an AHI reduction that was 2.1±0.9 (adjusted mean ± SE) events/h greater than those with less than 5% weight loss (P<.05). Adults with OSA lost a mean ± SE of 2.2%±0.9% less weight during the subsequent 6-month interval compared with those without OSA (P=.02). Those with OSA were less adherent to daily calorie goals (mean ± SE: 25.2%±3.3% vs 34.8%±3.4% of days; P=.006) and had a smaller increase in daily activity (mean ± SE: 378.3±353.7 vs 1060.1±377.8 steps/d; P<.05) over 12 months than those without OSA.Conclusion
Behaviorally induced weight loss in overweight/obese adults was associated with significant AHI reduction. However, the presence of OSA was associated with blunted weight loss, potentially via reduced adherence to behaviors supporting weight loss. These results suggest that OSA screening before attempting weight loss may be helpful to identify who may benefit from additional behavioral counseling. 相似文献3.
INAUGURAL ARTICLE by a Recently Elected Academy Member:Architectural DNA binding by a high-mobility-group/kinesin-like subunit in mammalian SWI/SNF-related complexes
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Poor oral hygiene is a problem for many people with mental retardation who live in state residential facilities. An integrated treatment approach to improve oral hygiene was designed and implemented. The program focused on increasing cooperation with daily oral care. We examined whether individualized oral care plans were more effective in improving the oral hygiene of people living in this facility than generalized staff training in oral care procedures. Oral hygiene ratings of 80 individuals were tracked over a one-year period and analyzed. A modest improvement was found for all people studied, with a greater improvement for those with individualized oral care plans. The need for follow-up data and procedures to ensure follow through of recommendations is emphasized. 相似文献
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Childhood chiasmal gliomas: update on the fate of patients in the 1969 San Francisco Study. 总被引:3,自引:1,他引:2
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We review the current status of 28 patients with chiasmal glioma who were originally reported on by Hoyt and Baghdassarian in 1969. The median period of follow-up was 20 years. Sixteen patients are now dead, five from chiasmal glioma and the rest from other causes. Four of the five deaths from chiasmal glioma occurred before 1969. The mortality rate in patients with neurofibromatosis and those without neurofibromatosis was essentially the same. Nine of 16 patients with neurofibromatosis are dead, two from chiasmal glioma, one from aspiration, and six from another tumour. Seven of 12 patients without neurofibromatosis are dead, three from chiasmal glioma, two from an operation on their tumour, and two from a medical illness. In general the quality of life of the surviving patients is good; none reported having a noticeable decrease in vision since 1969. 相似文献
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A prospective controlled 6-month study was undertaken to compare the effect of Ensure, a defined formula dietary supplement, and diet counselling in 122 outpatients with Crohn's disease. The compliance to Ensure was poor due to a high incidence of side effects. Taking any amount of Ensure reduced the need for surgery and the amount of hospitalization. There was a trend for patients receiving Ensure to experience a decline in the value of their Crohn's disease activity index (p less than 0.10). No consistent effects of Ensure were seen on the amount of work missed due to Crohn's disease, in laboratory measurements, in the need for prednisone or Salazopyrin. The vitamin B12 intake was improved, but otherwise nutrient intake declined due to a decreased food intake. Thus, certain beneficial clinical trends were associated with taking Ensure, but larger numbers of compliant patients will need to be studied to better assess the long-term role of defined formula diets in the management of outpatients with Crohn's disease. 相似文献
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Quantification of in vitro and in vivo angiogenesis stimulated by ovine forestomach matrix biomaterial 总被引:1,自引:0,他引:1
Irvine SM Cayzer J Todd EM Lun S Floden EW Negron L Fisher JN Dempsey SG Alexander A Hill MC O'Rouke A Gunningham SP Knight C Davis PF Ward BR May BC 《Biomaterials》2011,32(27):6351-6361
Ovine forestomach matrix (OFM) biomaterial acts as a biomimetic of native extracellular matrix (ECM) by providing structural and functional cues to orchestrate cell activity during tissue regeneration. The ordered collagen matrix of the biomaterial is supplemented with secondary ECM-associated macromolecules that function in cell adhesion, migration and communication. As angiogenesis and vasculogenesis are critical processes during tissue regeneration we sought to quantify the angiogenic properties of the OFM biomaterial. In vitro studies demonstrated that soluble OFM components stimulated human umbilical vein endothelial cell (HUVEC) migration and increased vascular sprouting from an aorta. Blood vessel density and branch points increased in response to OFM in an ex ovo chicken chorioallantoic membrane (CAM) assay. The OFM biomaterial was shown to undergo remodeling in a porcine full-thickness excisional model and gave rise to significantly more blood vessels than wounds treated with small intestinal submucosa decellularized ECM or untreated wounds. 相似文献