Introduction: Obstructive sleep apnea is a clinical entity that is associated with an increase in morbidity and mortality and it is estimated that it is significantly undiagnosed. The objective of this study was to assess the risk of undiagnosed obstructive sleep apneain obese individuals.Material and Methods: A descriptive and analytical cross-sectional study; the risk of obstructive sleep apnea’s was assessed over a period of 11 months by applying the STOP-Bang questionnaire to all individuals who attended a family health unit who were aged ≥ 18 years and had body mass index of ≥ 30 kg/m2 and who had not yet been diagnosed with obstructive sleep apnea and agreed to participate; the risk of an undiagnosed moderate to severe obstructive sleep apnea was considered for any STOP-Bang score of ≥ 3. Results: The risk of undiagnosed obstructive sleep apnea was assessed in 888 individuals (59.3% females) with an average age of 59.6 ± 14.68 years and a mean body mass index 33.6 ± 3.43 kg/m2; the mean STOP-Bang score was 3.5 ± 1.74, 70.9% scored ≥ 3; the frequency of all STOP-Bang questionnaire parameters was higher (p < 0.004) within the group with score ≥ 3.Discussion: The studied population is one of the main strengths, since it is in obese people that the incidence of this disease is higher. There are some limitations related to this sample coming from a single family health unit, as well as the patients’ follow-up being carried out throughout routine appointments for diseases that are closely related with obstructive sleep apnea.Conclusion: The level of underdiagnosis of obstructive sleep apnea’s in obese individuals can be significantly high and a large proportion of them may have the disease at a moderate to severe stage; Family Physicians can have a very important role in screening and diagnosis.
The delivery of a highly available and robust service offering is one of the critical objectives of Service Providers. Reaching this objective depends on the level of control Service Providers have on underlying transport infrastructure. Despite current deployment of IMS-based architectures assumes a vertical integration, IMS-based services can be offered without having a control on the underlying IP network. This paper introduces a solution to enhance the robustness of IMS-based architectures without assuming a vertically integrated system. The paper focuses on failures experienced by core service nodes and describes an autonomic solution to allow customers to access to the service during failures. This paper introduces a novel entity called SBC_PROXY which relays messages from peer SBCs (Session Border Controller) to core service platform. An autonomous mode in which all SBCs are involved in the lookup and routing processes is also described. This paper does not make any assumption on the nature of the service which is offered through IMS. Nevertheless, a focus is put on session-based services such as Audio/Video Telephony.
Adult-onset autoimmune diabetes (AOAD) is clinical form of diabetes with a wide spectrum of genotypical and phenotypical manifestations, which has risen in prominence in recent decades, probably due to greater interest in its pathogenic mechanisms, and increased identification of autoimmune markers. The clinical presentation may vary from type 1 diabetes mellitus to latent autoimmune diabetes in adults, which although clearly distinct from a theoretical viewpoint, may pose various clinical pitfalls in practice. We present the case of a patient with AOAD which featured several diagnostic challenges during follow-up.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.