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U.S. Officials Abandon Sleep Apnea Screening Requirements for Truck Drivers, Train Engineers

U.S. officials are abandoning plans to require sleep apnea screening for truck drivers and train engineers, a decision that safety experts say puts millions of lives at risk. The Federal Railroad Administration and Federal Motor Carrier Safety Administration said late last week that they are no longer pursuing the regulation that would require testing for the fatigue-inducing disorder that's been blamed for deadly rail crashes in New York City and New Jersey and several highway crashes. The agencies argue that it should be up to railroads and trucking companies to decide whether to test employees. One railroad that does test, Metro-North in the New York City suburbs, found that 11.6 percent of its engineers have sleep apnea. The decision to kill the sleep apnea regulation is the latest step in President Donald Trump's campaign to drastically slash federal regulations. The Trump administration has withdrawn or delayed hundreds of proposed regulations since he took office in January — moves the president has said will help bolster economic growth. Late last year, the FRA issued a safety advisory that was meant as a stopgap measure urging railroads to begin sleep apnea testing while the rules made their way through the legislative process. Without a regulation mandating testing, which would have needed approval from Congress, regulators couldn't cite trucking companies or railroads if a truck or train crashed because the operator fell asleep at the helm. Sleep apnea is esp...
Source: JEMS: Journal of Emergency Medical Services News - Category: Emergency Medicine Authors: Tags: News Operations Source Type: news

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The metabolic syndrome —otherwise called syndrome X, insulin resistance syndrome, Reaven syndrome, and “the deadly quartet”—is the name given to the aggregate of clinical conditions comprising central and abdominal obesity, systemic hypertension, insulin resistance (or type 2 diabetes mellitus), and atherogenic dy slipidemia. It is a prothrombotic and proinflammatory state characterized by increased inflammatory cytokine activity. In addition to inflammatory dermatoses such as psoriasis, lichen planus, and hidradenitis suppurativa, metabolic syndrome is also commonly associated with accelerated athe...
Source: Clinics in Dermatology - Category: Dermatology Authors: Source Type: research
Conclusions This technique is successful in congenital and acquired VPI, and in patients with complex craniofacial syndromes. Customization of lateral ports based on preoperative nasopharyngoscopy, and avoidance of a midline palate splitting incision, make this an attractive option for superior-based flap surgery.
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
ABSTRACT Recently, the orofacial myofunctional therapy (OMT) has appeared as a possible alternative treatment for obstructive sleep apnea (OSA). Systematic reviews are required to achieve scientific evidence, seeking to direct the decision on therapeutic issues. The aim of this study was to systematically review the literature about the OMT proposals in adults with OSA related to symptoms and physiological parameters. Data sources were Lilacs, MEDLINE, Pubmed, Cochrane and Scielo using the descriptors: obstructive sleep apnea; myofunctional therapy; oropharyngeal exercises; breathing exercises; upper airway exercises; spee...
Source: Revista CEFAC - Category: Speech-Language Pathology Source Type: research
Erika Marulanda-Londo ño, Seemant Chaturvedi
Source: Frontiers in Neurology - Category: Neurology Source Type: research
AbstractBackgroundIn Canada, severe obesity (BMI  ≥ 35 kg/m2) affects 5% or 1.2 million adults. Bariatric surgery is the only effective treatment for severe obesity, but the demand for publicly funded procedures is high and capacity limited. Little is known in Canada about the types of patients undergoing these procedures, especially laparoscopic sleeve gastrectomy (LSG). The study objective is to examine the socio-demographic profile, morbidity and HRQoL of patients accessing LSG in one Canadian province.MethodsHealth status and HRQoL were examined in patients (n = 195) undergoing LSG. ...
Source: BMC Obesity - Category: Eating Disorders & Weight Management Source Type: research
Conclusions: The presence and the association of comorbidities seems to be higher in patients suffering from OSA, OS, OHS. Subjects suffering of OHS present a high prevalence of main diseases despite their younger age compared with others patients with SDB. Sleepiness may have a role, at least in a subset of these patients, into the development of comorbidities. This article is protected by copyright. All rights reserved.
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Article Source Type: research
Authors: Vichinsky E Abstract Sickle cell disease is now a chronic adult illness characterized by progressive multiorgan failure, particularly involving the brain and kidney. The etiology is multifactorial; it includes hemolysis and nitric oxide deficiency. As patients age, most experience neurologic insult. Twenty-five percent of older adults have had a clinical stroke and at least half of the population have had a silent infarct, cortical atrophy, and neurocognitive impairment. Periodic screening with neuroimaging and neurocognitive testing is recommended. Identification and correction of modifiable risk factors ...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
Conclusions Patients with renal dysfunction, sleep apnea, or postoperative infection were particularly likely to be readmitted; optimizing the management of these factors may reduce early readmission after TAAA repair.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Publication date: Available online 9 December 2017 Source:Respiratory Physiology & Neurobiology Author(s): Adrianne G. Huxtable, Elizabeth Kopp, Brendan J. Doughtery, Jyoti J. Watters, Gordon S. Mitchell Although inflammation is prevalent in many clinical disorders challenging breathing, we are only beginning to understand the impact of inflammation on neural mechanisms of respiratory control. We recently demonstrated one form of respiratory motor plasticity is extremely sensitive to even mild inflammation induced by a single night (8hours) of intermittent hypoxia (IH-1), mimicking aspects of obstructive sleep apnea. ...
Source: Respiratory Physiology and Neurobiology - Category: Respiratory Medicine Source Type: research
Authors: Aboussouan LS, Golish JA, Wood BG Abstract Preview Repeated occlusion of the upper airway during sleep results in the obstructive sleep apnea syndrome. Affected individuals may experience excessive daytime sleepiness, intellectual impairment, and personality changes, and their risk of cerebrovascular accidents, ischemic heart disease, and severe respiratory failure is increased. The authors of this article examine methods of recognizing the disorder, indications for treatment, and various medical and surgical approaches to management. PMID: 29211558 [PubMed]
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
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