Asunto(s)
Presión de las Vías Aéreas Positiva Contínua/métodos , Laringe/fisiopatología , Paladar Blando/fisiopatología , Faringe/fisiopatología , Trastornos de la Sensación/epidemiología , Trastornos de la Sensación/fisiopatología , Apnea Obstructiva del Sueño/fisiopatología , Apnea Obstructiva del Sueño/terapia , Humanos , Apnea Obstructiva del Sueño/epidemiologíaRESUMEN
The medical and dental aspects of management for patients diagnosed with snoring and obstructive sleep apnoea are well documented. However, guidance for treatment by the general dental practitioner is lacking. This article reviews aspects of appliance provision and presents the use of a silicone material in an attempt to improve the longevity of a recognized prosthesis.
Asunto(s)
Avance Mandibular/instrumentación , Ferulas Oclusales , Diseño de Aparato Ortodóncico , Apnea Obstructiva del Sueño/terapia , Ronquido/terapia , Resinas Acrílicas , Odontología General , Humanos , Cobertura del Seguro , Maloclusión/etiología , Ferulas Oclusales/efectos adversos , Ferulas Oclusales/economía , Paladar Blando/fisiopatología , Satisfacción del Paciente , Siliconas , Apnea Obstructiva del Sueño/fisiopatología , Ronquido/fisiopatología , Trastornos de la Articulación Temporomandibular/etiología , Lengua/fisiopatologíaRESUMEN
BACKGROUND: Postoperative cognitive dysfunction (POCD) after noncardiac surgery is strongly associated with increasing age in elderly patients; middle-aged patients (aged 40-60 yr) may be expected to have a lower incidence, although subjective complaints are frequent. METHODS: The authors compared the changes in neuropsychological test results at 1 week and 3 months in patients aged 40-60 yr, using a battery of neuropsychological tests, with those of age-matched control subjects using Z-score analysis. They assessed risk factors and associations of POCD with measures of subjective cognitive function, depression, and activities of daily living. RESULTS: At 7 days, cognitive dysfunction as defined was present in 19.2% (confidence interval [CI], 15.7-23.1) of the patients and in 4.0% (CI, 1.6-8.0) of control subjects (P < 0.001). After 3 months, the incidence was 6.2% (CI, 4.1-8.9) in patients and 4.1% (CI, 1.7-8.4) in control subjects (not significant). POCD at 7 days was associated with supplementary epidural analgesia and reported avoidance of alcohol consumption. At 3 months, 29% of patients had subjective symptoms of POCD, and this finding was associated with depression. Early POCD was associated with reports of lower activity scores at 3 months. CONCLUSIONS: Postoperative cognitive dysfunction occurs frequently but resolves by 3 months after surgery. It may be associated with decreased activity during this period. Subjective report overestimates the incidence of POCD. Patients may be helped by recognition that the problem is genuine and reassured that it is likely to be transient.