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IDENTIFYING PATIENTS AT RISK FOR OBSTRUCTIVE SLEEP APNEA IN PRIMARY HEALTH CARE: CAN OBESITY IN COMBINATION WITH OTHER HIGH-RISK DIAGNOSES BE USED FOR SCREENING PURPOSES?
Title
IDENTIFYING PATIENTS AT RISK FOR OBSTRUCTIVE SLEEP APNEA IN PRIMARY HEALTH CARE: CAN OBESITY IN COMBINATION WITH OTHER HIGH-RISK DIAGNOSES BE USED FOR SCREENING PURPOSES?.
Creator
Lima, Clelia, Norris, Anne, University of Central Florida
Abstract / Description
Obstructive sleep apnea (OSA) affects about 15 million adults in the United States, and is an independent risk factor for all-cause mortality. The under-diagnosing of OSA has been linked to the inadequate screening by primary care practitioners (PCPs). Existing screening tools are not widely used by PCPs possibly due to time constraints they experience as providers. This study demonstrates how common high-risk diagnoses (obesity, hypertension, diabetes mellitus type 2, dyslipidemia,...
Show moreObstructive sleep apnea (OSA) affects about 15 million adults in the United States, and is an independent risk factor for all-cause mortality. The under-diagnosing of OSA has been linked to the inadequate screening by primary care practitioners (PCPs). Existing screening tools are not widely used by PCPs possibly due to time constraints they experience as providers. This study demonstrates how common high-risk diagnoses (obesity, hypertension, diabetes mellitus type 2, dyslipidemia, arrhythmia, and coronary artery disease) can be used to help PCPs identify adult patients at risk for OSA. Unlike other screening tools, these diagnoses are easy to identify in a routine visit. This study was a retrospective chart review that used a random sample of 220 electronic health records. Seventy percent of the sample was positive for OSA, 69% had obesity, and 33% had two or more high-risk diagnoses. The setting of this study was six sleep centers located in five cities in Central Florida. Logistic regression was used to analyze the data to determine interaction among variables and odds ratios. The variables "obesity" and "two or more high-risk diagnoses" had significant effects on the likelihood of being diagnosed with OSA independently of each other (odds ratio of 4.2 and 4.3 respectively; p<.001). However, there was no significant interaction between these two variables (p=.56). The predictive value for an OSA diagnosis using "obesity" was 83%, and it was 88% using "two or more high-risk diagnoses." These findings argue for the use of high-risk diagnoses to identify patients at risk for OSA. PCPs are in an ideal position to increase the number of patients screened and treated for OSA because they routinely see patients with these diagnoses in their practices. Proper diagnosis and treatment of OSA has the potential to improve patients' outcomes and their quality of life.
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Date Issued
2011
Identifier
CFE0003620, ucf:48863
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003620
Biomechanical Models of Human Upper and Tracheal Airway Functionality
Title
Biomechanical Models of Human Upper and Tracheal Airway Functionality.
Creator
Kuruppumullage, Don Nadun, Ilegbusi, Olusegun, Kassab, Alain, Moslehy, Faissal, Santhanam, Anand, Mansy, Hansen, Hoffman Ruddy, Bari, University of Central Florida
Abstract / Description
The respiratory tract, in other words, the airway, is the primary airflow path for several physiological activities such as coughing, breathing, and sneezing. Diseases can impact airway functionality through various means including cancer of the head and neck, Neurological disorders such as Parkinson's disease, and sleep disorders and all of which are considered in this study. In this dissertation, numerical modeling techniques were used to simulate three distinct airway diseases: a weak...
Show moreThe respiratory tract, in other words, the airway, is the primary airflow path for several physiological activities such as coughing, breathing, and sneezing. Diseases can impact airway functionality through various means including cancer of the head and neck, Neurological disorders such as Parkinson's disease, and sleep disorders and all of which are considered in this study. In this dissertation, numerical modeling techniques were used to simulate three distinct airway diseases: a weak cough leading to aspiration, upper airway patency in obstructive sleep apnea, and tongue cancer in swallow disorders. The work described in this dissertation, therefore, divided into three biomechanical models, of which fluid and particulate dynamics model of cough is the first. Cough is an airway protective mechanism, which results from a coordinated series of respiratory, laryngeal, and pharyngeal muscle activity. Patients with diminished upper airway protection often exhibit cough impairment resulting in aspiration pneumonia. Computational Fluid Dynamics (CFD) technique was used to simulate airflow and penetrant behavior in the airway geometry reconstructed from Computed Tomography (CT) images acquired from participants. The second study describes Obstructive Sleep Apnea (OSA) and the effects of dilator muscular activation on the human retro-lingual airway in OSA. Computations were performed for the inspiration stage of the breathing cycle, utilizing a fluid-structure interaction (FSI) method to couple structural deformation with airflow dynamics. The spatiotemporal deformation of the structures surrounding the airway wall was predicted and found to be in general agreement with observed changes in luminal opening and the distribution of airflow from upright to supine posture. The third study describes the effects of cancer of the tongue base on tongue motion during swallow. A three-dimensional biomechanical model was developed and used to calculate the spatiotemporal deformation of the tongue under a sequence of movements which simulate the oral stage of swallow.
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Date Issued
2018
Identifier
CFE0007034, ucf:51986
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007034