European journal of internal medicine
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Eur. J. Intern. Med. · Oct 2008
ReviewObstructive sleep apnea syndrome is a systemic disease. Current evidence.
Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder, characterized by repeated disruptions of breathing during sleep. This disease has many potential consequences including excessive daytime sleepiness, neurocognitive deterioration, endocrinologic and metabolic effects, and decreased quality of life. Metabolic syndrome is another highly prevalence emerging public health problem that represents a constellation of cardiovascular risk factors. ⋯ A variety of phenomena are implicated in this disease such as modifications in the autonomic nervous system, hypoxemia-reoxygenation cycles, inflammation, and coagulation-fibrinolysis imbalance. OSAS patients also present increased levels of certain biomarkers linked to endocrine-metabolic and cardiovascular alterations among other systemic consequences. All of this indicates that, more than a local abnormality, OSAS should be considered a systemic disease.
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Eur. J. Intern. Med. · Oct 2008
Randomized Controlled TrialImpact of electronic monitoring of drug adherence on blood pressure control in primary care: a cluster 12-month randomised controlled study.
Poor long-term adherence is an important cause of uncontrolled hypertension. We examined whether monitoring drug adherence with an electronic system improves long-term blood pressure (BP) control in hypertensive patients followed by general practitioners (GPs). ⋯ GPs monitoring drug adherence in collaboration with pharmacists achieved a better BP control in hypertensive patients, although the impact of monitoring decreased with time.
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Eur. J. Intern. Med. · Oct 2008
Community acquired acute bacterial meningitis in children and adults: an 11-year survey in a community hospital in Israel.
We aimed to investigate the association between the presenting clinical manifestations of bacterial meningitis and the duration of time elapsed before lumbar puncture and start of antibiotic treatment. ⋯ The interval before diagnosis of community acquired ABM in both children and adults is longer for those patients who present to the emergency department with an atypical clinical picture, mostly, without fever and without nuchal rigidity. Until bacterial meningitis can be effectively prevented, we can expect this life-threatening infection to continue to cause diagnostic and medical difficulties.
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Eur. J. Intern. Med. · Jul 2008
Case ReportsWinging of the scapula: An unusual complication of needle thoracocentesis.
Needle thoracocentesis is a common interventional procedure and is generally considered to be safe. Major complications associated with this procedure are uncommon. Here we describe a rare instance of winging of the scapula following needle thoracocentesis.