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Clinical and epidemiological characteristics associated with dengue fever in 2011-2016 in Bang Phi District, Ratchaburi Province, Thailand.

Data often focus on dengue endemic areas. METHODS: To better understand the epidemiology and clinical features of dengue fever in Thailand, a fever monitoring study was conducted among patients aged 1 to 55 years who developed non-local febrile illness at Bang Phae Community Hospital in Thailand. Until September. 2016.
Results: Of the 951 febrile episodes, 130 cases of dengue were confirmed. People aged 10 to 14 were most affected, followed by people aged 15 to 19, with about 15% of confirmed dengue cases in adults aged 25 and over. There were annual peaks of dengue incidence between June and November. The most prevalent serotype was DENV-2 in 2012, DENV-3 in 2014, and DENV-4 and -3 in 2015. Of the dengue cases, 65% were accurately detected by NS1 Dengue RDT. The detection rate was similar between primary and secondary dengue cases, with 66% of secondary dengue cases versus 60% of primary cases having positive RDT NS1 results. Of the dengue cases, 66% were clinically diagnosed as suspected dengue, or DHF, prior to laboratory confirmation. Dengue was positively associated with rash, headache, bloody vomiting and altered consciousness, compared to non-dengue fever. Patients with dengue were 10.6 times more likely to be hospitalized, compared to patients without dengue. Of the dengue cases, 95 were secondary and 35 were primary. There were 8 suspected dengue cases and all were identified as secondary dengue. Secondary dengue cases were 3.5 times more likely to be hospitalized than primary dengue cases. Although most of our dengue positive patients were secondary cases of dengue, with a few patients showing manifestations of dengue hemorrhagic fever, our cases of dengue were mostly mild disease. Even among children younger than 10 years old, 61% developed a secondary infection, and the rate of secondary infection increased with age.
While the majority of confirmed dengue cases were children, approximately three-quarters of confirmed dengue cases in this study were secondary dengue. The results of our study, consistent with previous data from the country, confirm the excessive transmission of DENV in Thailand, even in non-epidemic years. With many interventions to prevent and control dengue fever available, including dengue vaccines, decisions regarding future implementation strategies must be based on disease burden data.

STOP-BANG as a preoperative risk assessment tool for predicting procedural airway maneuvers and adverse events in the GI laboratory

There is a significant prevalence of undiagnosed obstructive sleep apnea (OSA) in patients receiving anesthesia for gastrointestinal (GI) laboratory procedures, with potentially serious adverse events associated with untreated obstructive sleep apnea. This quality improvement project aims to identify patients at high risk for obstructive sleep apnea and to assess the risks of procedural airway maneuvers and adverse events in the gastroenterology laboratory. In the gastroenterology laboratory, nurses administered and documented the STOP-BANG questionnaire as part of the pre-procedure evaluation of 80 patients undergoing elective procedures. The incidence of airway maneuvers and adverse events during the procedures was measured using a checklist given to the anesthesiology nurses when they brought patients to the postoperative area. Patients with STOP-BANG scores less than 5 and scores of 5 and above were compared. Descriptive and inferential statistics were used to analyze differences in patient outcomes. Patients with high STOP-BANG scores had a greater need for airway maneuvers and a higher incidence of adverse events (P = 0.05). These results support the use of STOP-BANG as a pre-procedural risk assessment tool. Anesthesiologists can anticipate airway interventions during the procedure, consider preventive interventions in a gastroenterology laboratory, and be more vigilant when caring for patients with high STOP-BANG scores who are at high risk for undiagnosed obstructive sleep apnea.

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Bangs Lab Bead Storage Buffer, pH 7.4

BUFF5-1000 Bangs Laboratories 1000 ML 186.07 EUR

Bangs Lab Bead Storage Buffer, pH 7.4

BUFF5-2000 Bangs Laboratories 2000 ML 255.24 EUR

Bangs Lab Bead Storage Buffer, pH 7.4

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Bangs Lab Bead Storage Buffer, pH 7.4

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Bangs Lab Bead Storage Buffer, pH 8.5

BUFF6-2000 Bangs Laboratories 2000 ML 255.24 EUR

Bangs Lab Bead Storage Buffer, pH 8.5

BUFF6-250 Bangs Laboratories 250 ML 105.17 EUR

 

What is the best screening questionnaire for predicting obstructive sleep apnea in a community of sleep clinics considering age, gender and comorbidities?

The purpose of this study was to assess the predictive power of screening questionnaires, including the Epworth Polysomnography Scale (ESS), the Berlin Questionnaire (BQ), and the STOP-Bang Questionnaire (SBQ) in identifying patients with high OSA risk in the clinic. . sleeping position Taking into account age, gender and comorbidities.
MATERIALS AND METHODS: We included 1003 patients admitted to our sleep center with a primary diagnosis of obstructive sleep apnea between June 2016 and May 2018. All patients underwent in vitro polysomnography and completed ESS questionnaires. and BERLIN and STOP-LIVE. Predictive parameters were calculated for each screening questionnaire. For the apnea index (AHI) 5/hour, the sensitivity and specificity of EES, BQ, and SBQ were 50.6%, 89.8%, 97.9%, 56.6%, 27.3%, and 16.2%, respectively. The STOP-Bang questionnaire had the highest sensitivity in both men and women (99.1%, 94.8%, respectively) and in different age groups (97.3% for the -45 age group, 99.2% for the -65 age group). In the groups of patients with arterial hypertension, diabetes, coronary artery disease, COPD and asthma, the sensitivity of the STOP-Bang questionnaire was 99.5%, 100%, 99.5%, 100%, 97, 4%, respectively. . The STOP-Bang questionnaire had the highest sensitivity for detecting patients at risk for OSA in the clinical sleep setting. The STOP-Bang questionnaire was superior to the Berlin and ESS questionnaire in different age groups, gender and comorbidities. Because of the close relationship between OSA and comorbidities, it is imperative that patients with OSA be evaluated on an outpatient basis in the departments of internal medicine, cardiology, and chest diseases. The STOP-Bang Questionnaire, with its high sensitivity, may be useful in screening for obstructive sleep apnea. However, the low specificity of the questionnaire should be improved.

STOP-Bang and NoSAS questionnaires as a screening tool for OSA: Which is the best option?

There is currently a significant growth in the number of patients with suspected obstructive sleep apnea (OSA) referred to sleep clinics. In this sense, methods of screening and stratification of the severity of this disease are becoming increasingly relevant.
OBJECTIVE: To evaluate the performance of the NoSAS and STOP-Bang scores on a sleep apnea screening in a sleep clinic. Prospectively, over a 12-month period, all patients referred by primary care physicians to our sleep unit for clinical evaluation who underwent in vitro polysomnography (PSG) also completed NoSAS (neck circumference, obesity, snoring, age, gender) and STOP- Bang (snoring, fatigue, marked apnea, (high) blood pressure, BMI, age, neck circumference, gender). Receiver operating characteristics (ROC) analysis was used to find scores that simultaneously increase sensitivity and specificity for each diagnosis.
Of the 294 individuals, 84% had obstructive sleep apnea, 28.8% had mild symptoms, 34.8% had moderate, and 36.4% had severe.
Using a nosas score to predict osa, moderate to severe, and severe osa, the roc area was: 0.770 (95% CI: 0.703–0.837), p < 0.001, sensitivity 57.5%, and 83.0% specificity for an outcome. out of 12 0.746 (95% CI: 0.691–0.802), p < 0.001, sensitivity 68.2% and specificity of 75.4% for mark 13; 0.686 (95% CI: 0.622-0.749), p < 0.001, sensitivity 71.1% and specificity 58.3% for score 13, respectively.
Using the cut-off score to predict OSA, moderate to severe OSA, and severe OSA, the rocker zone was: 0.862 (95% CI: 0.808–0.916), p < 0.001, sensitivity 68.4% and specificity 85, 1% for a score of 5 0.813 (95% CI: 0.756-0.861), p < 0.001, sensitivity 77.3% and specificity 66.1% for a score of 5; 0.787 (95% CI: 0.732-0.841), p < 0.001, sensitivity 70.0% and specificity 79.9% for a score of 6, respectively. The ROC area was consistently high for both scores, confirming the diagnostic ability of the NoSAS and STOP-Bang questionnaires for all OSA scores. Therefore, our results suggest that these questionnaires can be a powerful tool for patient discovery and stratification in the diagnosis of OSA. In general, the diagnostic ability of STOP-Bang was higher than that of NoSAS.