No description available.

Reproduction de : Thèse d'exercice : Médecine : Nancy 1 : 2006. / Titre provenant de l'écran-titre.

published_or_final_version / Medicine / Master / Doctor of Medicine

No description available.

Problem: The risk of serious postoperative cardiovascular and respiratory complications (SPCRCs) in patients with obstructive sleep apnea (OSA) is poorly defined. Methods: In this cohort study (n = 21221), patients with clinically diagnosed OSA were matched to controls without OSA to compare the risk of postoperative death and SPCRCs in an administrative database. Results: Compared to non-OSA controls, OSA patients were at increased risk of postoperative respiratory failure both before and after diagnosis with OSA. Prior to diagnosis, OSA patients, particularly those with severe OSA, were also at increased risk of cardiac arrest and SPCRCs . After diagnosis with OSA, except for postoperative respiratory failure, the risk of SPCRC’s was not different from controls. Also, the risk of postoperative death among OSA patients after diagnosis was not different from controls. Other important predictors of SPCRCs and death included admission in an intensive care unit at the time of surgery, a history of congestive heart failure, a higher Charlson comorbidity index score and the type of surgery. Conclusions: OSA was associated with an increased risk of SPCRCs, especially prior to diagnosis and in severe disease. This suggests that screening for and treating OSA in preoperative patients would reduce the risk of SPCRCs. However, the significant influences of the type of surgery and the presence of medical comorbidities on the risks of SPCRCs and death, regardless of the presence of OSA, must be considered in planning efficient and equitable interventions to reduce these risks.

No description available.

The relationship between perinatal complications and sensory-motor functions was examined. Information from the Maternal Perinatal Scale (MPS) was used to predict factor scores of the Dean Sensory-Motor Battery (DSMB). Participants were 187 normal nonreferred children who were administered the DSMB while their mothers completed the MPS. Using MPS items as predictors, separate stepwise regression analyses for each DSMB factor found that 11 - 16% of variance could be accounted for in sensory-motor performance. At least three MPS items significantly contributed to the prediction of each DSMB factor. Predictors of Sensory and Simple Motor functions (DSMB Factor I) included maternal bleeding during pregnancy, delay between membrane rupture (water break) and onset of labor, and evidence of hypoxia. Evidence of hypoxia, maternal bleeding during pregnancy, and delay between water break and labor onset were predictive of Motor and Complex Sensory functions (DSMB Factor II). In addition, gender of the child joined maternal bleeding during pregnancy, amount of swelling during pregnancy, and mother's height in predicting Subcortical Motor functions (DSMB Factor III). Additional analyses using a canonical correlation confirmed the results of the regression analyses. A linear composite of sensory and motor variables was primarily defined by DSMB factors I and II. The linear composite of perinatal information was defined primarily by the same items that emerged as significant predictors of sensorymotor functions in the regression analyses. Most notably, a redundancy analysis indicated that about 20% of variance in DSMB factor scores could be accounted for by a linear composite of perinatal information. In general, sensory-motor performance decreased as severity of perinatal complications increased. Results were discussed in terms of the implications of using a normal non-referred population. More importantly, the present data suggested the possibility that 1) the relationship between perinatal complications and sensory-motor functions may exist on a continuum rather than the dichotomous diagnosis/no diagnosis, and 2) the synergistic influence of multiple perinatal complications may contribute to the manifestation of clinically significant behaviors. The role of sensory-motor functions as a foundation for more complex behaviors is also discussed. / Department of Educational Psychology

Problem: The risk of serious postoperative cardiovascular and respiratory complications (SPCRCs) in patients with obstructive sleep apnea (OSA) is poorly defined. Methods: In this cohort study (n = 21221), patients with clinically diagnosed OSA were matched to controls without OSA to compare the risk of postoperative death and SPCRCs in an administrative database. Results: Compared to non-OSA controls, OSA patients were at increased risk of postoperative respiratory failure both before and after diagnosis with OSA. Prior to diagnosis, OSA patients, particularly those with severe OSA, were also at increased risk of cardiac arrest and SPCRCs . After diagnosis with OSA, except for postoperative respiratory failure, the risk of SPCRC’s was not different from controls. Also, the risk of postoperative death among OSA patients after diagnosis was not different from controls. Other important predictors of SPCRCs and death included admission in an intensive care unit at the time of surgery, a history of congestive heart failure, a higher Charlson comorbidity index score and the type of surgery. Conclusions: OSA was associated with an increased risk of SPCRCs, especially prior to diagnosis and in severe disease. This suggests that screening for and treating OSA in preoperative patients would reduce the risk of SPCRCs. However, the significant influences of the type of surgery and the presence of medical comorbidities on the risks of SPCRCs and death, regardless of the presence of OSA, must be considered in planning efficient and equitable interventions to reduce these risks.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2001. / Härtill 5 uppsatser.