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- Mattress and pillow for prone positioning for treatment of obstructive sleep apnoeaPublication . Moniri, Armin; Nilsson, Michael; Attia, John; Ejnell, HasseConclusion: The new mattress and pillow for prone positioning (MPP) is efficient in reducing the apnoea-hypopnoea index (AHI) and oxygen desaturation index (ODI) in most patients with obstructive sleep apnoea (OSA), with satisfactory compliance. Objective: The aim of the present study was to evaluate the effect of the prone body and head sleep position on severity of disease in patients with OSA after 4 weeks of adaptation to a mattress and pillow facilitating prone positioning. Methods: Fourteen patients with mild to severe OSA, 11 men and 3 women with a mean AHI of 26 (min, 6; max, 53) and mean ODI of 21 (min, 6; max, 51) were evaluated. Two polysomnographic (PSG) studies were performed. The first PSG study was without any treatment and the second was after 4 weeks of adaptation to the MPP for prone positioning of the body and the head. Results: Mean AHI and ODI decreased from 26 and 21 to 8 and 7, respectively (p < 0.001) with treatment. The mean time spent in the supine position was reduced from 128 to 10 min (p = 0.02) and the prone time increased from 42 to 174 min (p = 0.02) with the MPP. The mean total sleep time was 390 min during the first PSG study night without treatment and 370 min during the second night with the MPP (p = 0.7). Ten patients (71%) reduced their AHI by at least 50% and reached a value < 10 during treatment. All patients managed to sleep on the MPP for > 4 h per night during the 4-week study.
- Autoinflation reduces middle ear effusion in children with otitis media with effusion.Publication . Bidarian Moniri, ArminOtitis media with effusion (OME) is defined as accumulation of fluid in the middle ear in absence of signs or symptoms of an acute ear infection.1 OME is usually associated with a conductive hearing loss that may affect the quality of life.1 Surgical treatment of OME with grommets is associated with substantial healthcare costs and is usually considered after a period of watchful waiting, leaving most children with OME untreated during this period.1 This raises the need for an efficient, non-invasive treatment option that can be offered to children with OME at an early stage. In 1968, Hunt-Williams presented a new method for autoinflation involving a plastic end-piece connected to a balloon, later developed into the Otovent device.2 The present study evaluates the effect of autoinflation with this method on children with OME.
- Fatigue and mental illness symptoms in long COVID: protocol for a prospective cohort multicenter observational studyPublication . Pires, Ligia; Reis, Cláudia; Mesquita Facão, Ana Rita; Moniri, Armin; Marreiros, Ana; Drummond, Marta; Berger-Estilita, JoanaBackground: The aftermath of the COVID-19 pandemic continues to affect millions worldwide, resulting in persisting postvirus complaints and impacting peoples' quality of life. Long COVID, characterized by lingering symptoms like fatigue and mental illness, can extend beyond a few months, necessitating further research to understand its implications. Objective: This study aims to quantify the degree of physical and psychological fatigue in patients following COVID-19 infection and examine its correlation with mental health disorders. Methods: Using a consecutive nonrandom sampling technique, we will conduct a prospective cohort multicenter observational study in 5 Portuguese hospitals. Symptomatic adult patients with previous COVID-19 attending follow-up consultations will be enrolled. We will include patients who had mild, moderate, and severe acute disease. We will assess clinical outcomes related to COVID-19, including the type of respiratory support such as high-flow nasal cannula, noninvasive ventilation, and invasive mechanical ventilation. The exclusion criteria will include previous severe psychiatric disorders confirmed by a psychiatrist; refusal or inability to respond to the questionnaire; concomitant neurological disorder; persistent fatigue symptoms during the 6 months before infection; and the need for invasive mechanical ventilation during COVID-19 infection due to a high prevalence of postintensive care syndrome. Our primary outcome is the prevalence of fatigue in patients with post-COVID-19 depression and/or anxiety, as measured by the Chalder Fatigue Scale (CFQ-11) and the Hospital Anxiety and Depression Scale (HADS). The secondary outcomes will include an assessment of health-related quality of life via the EQ-5D questionnaire and an exploration of the prevalence of symptoms of posttraumatic stress disorder (PTSD) using the 14-item Posttraumatic Stress Scale (PTSS-14). We will also examine the association between mental health symptoms and the severity of acute COVID-19. The post-COVID-19 data will be collected at least 6 months after the positive test and no longer than 9 months during the clinical appointment. Results: We expect our multicenter study on patients post COVID-19 to reveal a significant link between mental illness symptoms and both physical and psychological fatigue. Patients with heightened depression and anxiety may report increased levels of fatigue. Additionally, we expect to find persistent PTSD symptoms in a subset of participants, indicating the enduring psychological impact of the virus. Conclusions: This study may underscore the need for integrated care addressing physical and mental health in patients post COVID-19. The observed connections emphasize the importance of considering mental well-being for long-term health outcomes. Despite study limitations, our findings contribute valuable insights for future treatment strategies and highlight the necessity for comprehensive mental health support in post-COVID-19 care. This research provides valuable insights into the mental health implications of COVID-19 and its impact on post-COVID-19 fatigue and the overall well-being of affected individuals.
- New generation oral appliances for treatment of obstructive sleep apneaPublication . Silva, R.; Pires, L.; Belchior, I.; Moniri, ArminOral appliances (OA) have become one of the most important treatments for obstructive sleep apnea (OSA). Efficacy and compliance have been issues raised with this treatment modality. The new generation OAs, using precision technology, are generally smaller devices occupying less space in the mouth. They create less protrusion of the mandible compared to the classical devices. Previous studies on these devices report superior efficacy and compliance. In this study we evaluate the efficiency and compliance of a new generation OA, the Prosomnus EVO, in patients with mild-moderate OSA.
- Long COVID-19 fatigue and obstructive sleep apnea: is there a relation?Publication . Pires, L.; Ribeiro, R.; Belchior, I.; Saraiva, C.; Fatal, T.; Guimarães, M. J.; Moniri, Armin; Drummond, M.Fatigue has been reported as the most frequent long COVID-19 symptom. There is a physiological plausibility for relation be tween OSA and long-COVID-19 fatigue, by Intermittent nocturnal hypox emia, endothelial dysfunction, oxidative stress and low grade systemic inflammation. OSA activates the renin-angiotensin-aldosterone system (RAAS) and angiotensin-converting enzyme 2 (ACE2), which is the entry receptor for SARS-CoV-2. The aim of this study is to evaluate if untreated OSA is associated with COVID-19 long-term fatigue.