NIV for OHS without severe OSAS: is it worth it?

Home non-invasive ventilation (NIV) has been used to manage chronic respiratory failure since the polio epidemics of the 1940s; however, the support for many of the indications remains based on small non-randomised or uncontrolled studies. Obesity hypoventilation syndrome (OHS) is an increasingly common cause of chronic respiratory failure and indication for home mechanical ventilation; unsurprisingly as the diagnosis remains frequently missed, significant variation exists across Europe.1 2 The majority of patients with OHS have significant obstructive sleep apnoea (OSA) and recent data have demonstrated the benefits of NIV in a randomised controlled trial.3 4 However, it has been increasingly clear that the clinical description which was first reported over 60 years ago5 is in fact made up of distinct clinical phenotypes, most frequently divided by the nature of the sleep-disordered breathing, which is driving respiratory failure.6 In fact,...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Editorial Source Type: research

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Source: Journal of Child and Adolescent Psychopharmacology - Category: Pediatrics Authors: Source Type: research
Publication date: Available online 4 December 2019Source: Joint Bone SpineAuthor(s): Alice Courties, Francis BerenbaumAbstractOne quarter of 45-year-old adults will develop symptomatic hip osteoarthritis (OA). Therefore, hip OA affects a very significant number of patients and, together with knee OA, is associated with increased cardiovascular mortality. Primary prevention involves the identification and management of its modifiable risk factors. Those that we know of today include anatomical abnormalities, joint trauma, certain occupations and, to a lesser extent, obesity. Screening for hip dysplasia as early as possible,...
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
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