Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive #Sleep #Apnea

Many adults with obstructive sleep apnea (OSA) use device treatments inadequately and remain untreated.. ..Among 102 participants who were randomized (mean [SD] age, 44.6 [12.8] years; 18 [18%] women), 91 (89%) completed the trial. The mean AHI was 47.9 at baseline and 20.8 at 6 months for the surgery group and 45.3 at baseline and 34.5 at 6 months for the medical management group (mean … Continue reading Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive #Sleep #Apnea

Association of New-Onset Atrial #Fibrillation After Noncardiac #Surgery With Subsequent #Stroke and Transient Ischemic Attack

Outcomes of postoperative atrial fibrillation (AF) after noncardiac surgery are not well defined.. ..The median age of the 452 matched patients was 75 years (IQR, 67-82 years) and 51.8% of patients were men. Patients with postoperative AF had significantly higher CHA2DS2-VASc scores than those in the no AF group (median, 4 [IQR, 2-5] vs 3 [IQR, 2-5]; P < .001). Over a median follow-up of 5.4 years … Continue reading Association of New-Onset Atrial #Fibrillation After Noncardiac #Surgery With Subsequent #Stroke and Transient Ischemic Attack

American Academy of #Pediatrics – Section on #Surgery Five Things Physicians and Patients Should Question

. Avoid the routine use of whole-body computed #tomography (CT) scanning (pan-scanning) in pediatric trauma patients. . Avoid using computed tomography (CT scan) as the first-line imaging modality in the evaluation of suspected appendicitis in children. Ultrasound should be done first with a CT scan or magnetic resonance imaging (MRI) considered in equivocal cases. . Avoid performing antireflux operations (fundoplications) during gastrostomy insertion in most … Continue reading American Academy of #Pediatrics – Section on #Surgery Five Things Physicians and Patients Should Question

Randomized Trial of Medical versus Surgical Treatment for Refractory #Heartburn

..Heartburn that persists despite proton-pump inhibitor ( #PPI ) treatment is a frequent clinical problem with multiple potential causes. Treatments for PPI-refractory heartburn are of unproven efficacy and focus on controlling gastroesophageal reflux with reflux-reducing medication (e.g., baclofen) or antireflux surgery or on dampening visceral hypersensitivity with neuromodulators (e.g., desipramine). Prerandomization procedures excluded 288 patients: 42 had relief of their heartburn during the 2-week omeprazole … Continue reading Randomized Trial of Medical versus Surgical Treatment for Refractory #Heartburn