Abstract:
OBJECTIVES:Obstructive sleep apnea (OSA) is a prevalent disorder that is associated with multiple medical consequences. Although in-laboratory polysomnography is the gold standard for the diagnosis of OSA, portable monitors have been developed and studied to help increase efficiency and ease of diagnosis. We aimed to assess the adequacy of a midlevel provider specializing in sleep medicine to risk-stratify patients for OSA based on a chart review versus a comprehensive clinic evaluation before scheduling an unattended sleep study. METHODS:This study was an observational, nonrandomized, retrospective data collection by chart review of patients accrued prospectively who underwent an unattended sleep study at the Sleep Health Center at the Memphis Veterans Affairs Medical Center during the first 13 months of the program (May 1, 2011-May 31, 2012). A total of 205 patients were included in the data analysis. RESULTS:Analysis showed no statistically significant differences between chart review and clinic visit groups (P = 0.54) in terms of OSA diagnosis. Although not statistically significant, the analysis shows a trend toward higher mean age (50.3 vs 47.4 years; P = 0.10) and lower mean body mass index (34.4 vs 36.0; P = 0.08) in individuals who were evaluated during a comprehensive clinic visit. A statistically significant difference is seen in terms of the pretest clinical probability of OSA being moderate or high in 62.2% of patients in the clinic visit group and 95.7% in the chart review group, with a χ2P ≤ 0.0001. CONCLUSIONS:In the Veterans Health Administration's system, the assessment of pretest probability may be determined by a midlevel provider using chart review with equal efficacy to a comprehensive face-to-face evaluation in terms of OSA diagnosis via unattended sleep studies.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Alsharif AM,Potts M,Laws R,Freire AX,Sultan-Ali Idoi
10.14423/SMJ.0000000000000543subject
Has Abstractpub_date
2016-10-01 00:00:00pages
677-681issue
10eissn
0038-4348issn
1541-8243pii
SMJ50271journal_volume
109pub_type
杂志文章abstract::Lyme disease, now the most common tick-borne illness in the United States, has recently received much media attention, due in part to its potentially serious sequelae in untreated patients. Because a rare patient with late illness may lack antibodies to the etiologic agent, Borrelia burgdorferi, physicians may be temp...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199110000-00024
更新日期:1991-10-01 00:00:00
abstract::We have used the island gluteus maximus musculocutaneous flap to cover sacral pressure sores. In this report, we describe the surgical anatomy, cadaveric dissections (n = 25), and postoperative follow-up (one to 40 months) in 13 clinical cases. Our results compare favorably with those of other previously reported seri...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::Children with sickle cell anemia who were less than 5 years old were observed over a three-year period. Those born to recent Haitian immigrants accounted for 108.4 patient-years. They had seven episodes of Streptococcus pneumoniae bacteremia and five due to Haemophilus influenzae for rates of 6.5 and 4.6 episodes per ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198907000-00009
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVES:To characterize pain and exposure after Prolift placement and identify risk factors. METHODS:A case series of women who underwent Prolift vaginal mesh were surveyed. Pain was assessed using a visual analog scale. Exposure was evaluated clinically. RESULTS:Of 183 eligible patients, 160 completed the survey,...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000377
更新日期:2015-12-01 00:00:00
abstract::A retrospective study of 45 patients hospitalized with blastomycosis of bones or joints revealed 41 cases of osteomyelitis and 12 cases of septic arthritis. The majority were men (35 [78%] patients) and non-Aboriginal (32 [71%] patients). Median time from the onset of symptoms to hospitalization was shorter in women t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3180487a92
更新日期:2007-06-01 00:00:00
abstract::Lymphoid interstitial pneumonitis (LIP) is a rare complication of AIDS in adults. Patients with AIDS and LIP are at high risk for bacterial pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. We have described an HIV-positive patient with LIP complicated by recurrent pneumo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199210000-00022
更新日期:1992-10-01 00:00:00
abstract::For over a decade there has been concern about hepatitis related to halothane anesthesia. No dose relationship or other direct cause has ever been established, and jaundice has been found to occur after other anesthetics for surgical operations. Enflurane is a newer halogenated compound with a remarkable record of saf...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197807000-00012
更新日期:1978-07-01 00:00:00
abstract::A 45-year-old Costa Rican woman was seen for a jejunostomy tube malfunction. There was no evidence of tube malposition or intestinal obstruction. During endoscopy, a long worm was retrieved from the distal duodenum; it was later confirmed to be Ascaris lumbricoides. After treatment with mebendazole, no further episode...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318172f678
更新日期:2008-06-01 00:00:00
abstract::This paper briefly reviews the available evidence for the influence of environmental and occupational factors in the development of cancer of the larynx. Although several occupational exposures have been suggested to play a role in the etiology of this disease, few have been convincingly confirmed. The strong associat...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198307000-00020
更新日期:1983-07-01 00:00:00
abstract::A clinical diagnosis of meningitis in neonates is difficult because of paucity of physical findings. In older infants and children, nuchal rigidity, Kernig's or Brudzinski's sign, or bulging fontanelles are sought. A review of 1,064 cases of bacterial meningitis beyond the neonatal period revealed that 16 (1.5%) patie...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198204000-00018
更新日期:1982-04-01 00:00:00
abstract::To our knowledge, this is the first known case of a patient with leptospirosis and very elevated CSF, which caused hydrocephalus. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181a0ae80
更新日期:2009-05-01 00:00:00
abstract::Appendicovesical fistula is an uncommon condition usually occurring in boys and young men and associated with chronic urinary tract infection. Diagnosis is based on cystoscopic findings that may be confirmed by a retrograde study. Treatment by appendectomy is usually successful. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198004000-00037
更新日期:1980-04-01 00:00:00
abstract::We have described a patient with long-standing chronic granulocytic leukemia. Although most patients with this disorder eventually have a picture of acute leukemia (blast crisis), this patient had massive thrombocytosis (platelet count greater than 5.000 x 10(9)/L) without major symptoms, but he died after transfusion...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198804000-00029
更新日期:1988-04-01 00:00:00
abstract::With the advent and increased use of chemotherapeutic agents and radiation therapy, cancer survival rates have increased. With increased survival, both acute and chronic cardiotoxic adverse effects have emerged. The growing need for managing the treatment of individuals with chemotherapy-induced cardiotoxicity has led...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.14423/SMJ.0000000000000232
更新日期:2015-02-01 00:00:00
abstract::Sarcoidosis rarely involves the genitourinary system or the spinal cord. This report describes a case of sarcoidosis with a scrotal mass, a mass compressing the spinal cord, and lesions in the liver and spleen. This case illustrates an uncommon manifestation of sarcoidosis, which may mimic disseminated testicular canc...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000163306.54629.35
更新日期:2005-09-01 00:00:00
abstract::A case of multifocal systemic sporotrichosis presenting with lobar pneumonia caused by Sporothrix schenkii is described. While five cases of pulmonary involvement in multifocal sporotrichosis have been previously reported, all had nodular or cavitary apical lesions. Similarly, unifocal pulmonary sporotrichosis usually...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198106000-00030
更新日期:1981-06-01 00:00:00
abstract::Angioedema has not been associated with losartan therapy in hemodialysis patients, as it has been with angiotensin converting enzyme (ACE) inhibitors. We report the case of a hemodialysis patient who previously had angioedema after therapy with ACE inhibitors and again had angioedema while taking losartan. We suggest ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199705000-00020
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:This study was done to determine survival rates in subpopulations of severely neurologically disabled children who reside in pediatric skilled nursing facilities and to compare these survival rates with those in previously published studies. METHODS:Data were collected at three pediatric skilled nursing fac...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199802000-00009
更新日期:1998-02-01 00:00:00
abstract::We reviewed 76 cases of small cell bronchogenic carcinoma seen at the University of South Florida Medical Center. One third of the 55 patients who have subsequently died did so within one month of diagnosis. Thirty-five patients were treated with cyclophosphamide, adriamycin, vincristine, and radiation therapy includi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197805000-00013
更新日期:1978-05-01 00:00:00
abstract::Acquired immunodeficiency syndrome (AIDS) has engendered a crisis of fear among the public and health professionals alike. In addition to the myriad anxieties that generally accompany dying and death, AIDS patients must deal with numerous additional fears. In rushing to treat the physiologic aspects of AIDS, health pr...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198702000-00022
更新日期:1987-02-01 00:00:00
abstract::Tobacco use is associated with numerous illnesses and contributes to as many as 400,000 deaths in the United States each year. Most tobacco use in the United States is in the form of cigarette smoking, but smokeless tobacco use is particularly high in certain areas and within certain subpopulations. Among US adults, s...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Human immunodeficiency virus (HIV) seroprevalence surveys help determine the extent of HIV and the need for routine HIV counseling and testing. We sought to describe trends in five south Georgia hospitals and compare two protocols for conducting anonymous HIV surveys. METHODS:From 1993 to 1997, each hospita...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::A bulging fissure sign was noticed on chest roentgenogram in a patient with H influenzae pneumonia. This sign is usually associated with Klebsiella pneumonia and has also been seen in pneumococcal and plague pneumonia, tuberculosis, mass lesions of the lung, and large lung abscesses. This is thought to be the first re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197811000-00048
更新日期:1978-11-01 00:00:00
abstract::We present a case believed to be the first reported North American presentation of Ascaris lumbricoides within the urogenital tract. A young man came to the emergency department because of painless hematuria and having observed a 6-inch worm exit his urethra while urinating. The most common site for A lumbricoides inf...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::Esophagogastric variceal hemorrhage is a common cause of upper gastrointestinal bleeding in patients with portal hypertension. In addition, it is now recognized that patients with alcohol-induced chronic liver disease and portal hypertension frequently bleed from acute mucosal lesions. Since alcohol can cause these le...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198304000-00015
更新日期:1983-04-01 00:00:00
abstract::We have described the radiographic features of a case of solitary giant hepatocellular carcinoma in a noncirrhotic liver. It was angiographically avascular and resembled a massive metastatic tumor. Most hepatocellular carcinomas appear highly vascular on angiography. Hypovascularity may sometimes be encountered in the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198310000-00027
更新日期:1983-10-01 00:00:00
abstract::One hundred fifty patients underwent surgery for mitral valve disease between January 1974 and May 1981. There were 98 female and 52 male patients with a mean age of 57 years (+/- 18.6). One hundred forty-six patients were in New York Heart Association functional class III or IV. Pathologic diagnoses included 67% rheu...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198306000-00005
更新日期:1983-06-01 00:00:00
abstract::Obstructive biliary disease in childhood is not common, but should be considered in the differential diagnosis of a child with jaundice, abdominal pain, or an abdominal mass. We have reviewed the experience at Vanderbilt Children's Hospital from 1970 to 1985, during which 87 children 18 years of age or younger with bi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198611000-00007
更新日期:1986-11-01 00:00:00
abstract::Three foreign bodies were successfully removed from the upper gastrointestinal tract with a fiberoptic endoscope. They included a food bolus lodged above an esophageal stricture, a metallic nebulizer tip impacted in the mid-esophagus, and a spoon lodged in the stomach. A razor blade could not be removed from the duode...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197706000-00019
更新日期:1977-06-01 00:00:00
abstract::The temporary tissue expander can generate an excess of full-thickness skin that can be recruited into an adjacent area of tissue deficiency caused by scar contracture. The creation of a pseudobursa enhances the functional improvement gained by this technique. Now in its developmental stage, tissue expansion carries a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198604000-00011
更新日期:1986-04-01 00:00:00