Side effects and associated symptoms predict adherence to chronic noninvasive ventilation

Introduction: Patients on chronic noninvasive ventilation must adapt to NIV. Little is known how side effects and associated symptoms influence adherence to NIV.Methods: Consecutive patients at outpatient NIV clinic were included, with underlying diseases: obesity hypoventilation syndrome (OHS), kyphoscoliosis (KS) and COPD. Side effects and associated symptoms on NIV were recorded systematically with a questionnaire.Results: 231 patients (47% OHS, 9% KS, 44% COPD) were included, 66% men, age 64 ± 12 years. Of these, 85% were adherent to NIV, with no difference between disease groups. Patients reported nocturia (62%), insomnia (34%), mask leaks (27%), stomach distention (15%), skin issues (13%), deventilation dyspnea (11%), headache (8%), chest pain (4%). In multivariate analysis adjusted for sex, residual hypercapnia, insomnia, headaches, nocturia, mask leaks, deventilation dyspnea, chest pain, stomach distention, only deventilation dyspnea (OR 0.29, CI 0.088-0.94, p=0.039) was independently negatively associated with adherence. In the same model for each disease group, hypercapnia (OR 0.03, CI 0.002-0.41, p=0.009), insomnia (OR 0.014, CI 0.01-0.26, p
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Noninvasive ventilatory support Source Type: research

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Postoperative management of hallux valgus varies widely. Setting preoperative expectations is an important aspect of attaining a successful outcome, but this is not routinely reviewed in the literature. This chapter offers suggestions on successfully navigating this area of patient care. Current concepts focus on pain control, immobilization, and return to activities. This chapter also reviews the current literature in these areas and sets out the authors ’ preferred management in the postoperative setting.
Source: Foot and Ankle Clinics - Category: Orthopaedics Authors: Source Type: research
Publication date: Available online 23 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Prathiba M. De Silva, Ayesha Mahmud, Paul P. Smith, T. Justin ClarkAbstractObjectiveTo identify the most effective analgesia for women undergoing office hysteroscopy.Data sourcesMedline, Embase, CINAHL and the Cochrane library were searched from inception until August 2019 investigating the effect of different analgesics on pain control in office hysteroscopy.Methods of study selectionRandomised controlled trials were included that investigated the effect of analgesics on pain experienced by women undergoing diagnos...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
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Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
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Source: Metabolic Brain Disease - Category: Neurology Source Type: research
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Source: Metabolic Brain Disease - Category: Neurology Source Type: research
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Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
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Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
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Source: Pain - Category: Anesthesiology Tags: Systematic Review and Meta-Analysis Source Type: research
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Source: Pain - Category: Anesthesiology Tags: Systematic Review and Meta-Analysis Source Type: research
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Source: Pain - Category: Anesthesiology Tags: Topical Review Source Type: research
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