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BACKGROUND Recent studies indicate that standard doses of hypnotics reduce or do not change the apnea-hypopnea index (AHI) or pharyngeal muscle activity. A 1-month trial of nightly zopiclone (7.5mg) modestly reduced the AHI versus baseline without changing other sleep parameters or next-day sleepiness. RESEARCH QUESTION This study aimed to determine the effects of high-dose zopiclone (15mg) on AHI, arousal threshold, genioglossus muscle responsiveness and next-day alertness in selected people with obstructive sleep apnea (OSA) (low-moderate arousal thresholds without major overnight hypoxemia). We hypothesised that high-dose zopiclone would yield greater increases in arousal threshold and therefore larger reductions in AHI but may come at the expense of increased hypoxemia and next-day impairment. STUDY DESIGN and methods 28 participants (AHI=29±20events/h) suspected to have low-moderate arousal thresholds were studied during two in-laboratory polysomnographies, separated by 1-week, with an epiglottic pressure catheter and genioglossus intramuscular electrodes. Participants received 15mg of zopiclone or placebo at each visit according to a double-blind, randomized, cross-over design. find more Each morning subjective sleepiness and alertness via a driving simulator task were assessed. RESULTS The AHI did not change from placebo to zopiclone (-1.5events/h, 95% CI -6.6, 3.5events/h; p=0.54). Arousal threshold, genioglossus muscle responsiveness and most other sleep parameters and measures of next-day sleepiness and alertness also did not change with zopiclone. INTERPRETATION A single night of treatment with high-dose zopiclone does not systematically reduce the AHI or increase the arousal threshold in selected people with OSA. The mechanisms for these unexpected findings require further investigation. The current work coupled simultaneous sulfide and nitrate removal in a Microbial Fuel Cell (MFC). The substrate removal and electricity generation were coupled at influent Sulfide to Nitrate molar ratios (S/N ratios) of 50, 51, 52 and 53. The sulfide concentrations used included 60 mg S/L, 300 mg S/L, 540 mg S/L, 780 mg S/L and 1020 mg S/L. The effect of S/N ratio on the performance of substrate removal was greater at higher influent sulfide concentration. The electricity generation also varied at different influent sulfide concentrations and S/N ratios. The number of electrons generated at S/N ratio of 52 was the largest at any fixed influent sulfide concentration. The Pearson correlation showed that effluent sulfate concentration and nitrogen gas had significant positive correlations with steady state voltage (or electronic quantity). Moreover, the simulation models were developed to establish the relation between substrate removal and electricity generation at various S/N ratios. To achieve in the reconstruction of the anterior cruciate ligament a graft with strength, tension and low comorbidity is fundamental. An emerging concept is that a graft diameter of less than 7mm carries a greater risk of re-rupture and instability. Consequently, different methods are being sought to predict intra-surgical size. The objective is to predict the size of the hamstring graft by measuring the area of the semitendinous and gracilis tendon with magnetic resonance imaging (MRI). METHODOLOGY We carried out an observational retrospective study of 56 patients. They underwent anterior cruciate ligament reconstruction with 4-GST hamstring graft. The parameters evaluated were anthropometric data, hamstring graft diameter, area of gracilis and semitendinosus tendon in MRI. The measurements were made by three independent evaluators. RESULTS The mean diameter of the intrasurgical graft was 8.46mm, in the MRI the area of the gracilis was 8,875mm and the semitendinosus area was 13,068mm. Their mean was 22.12 for the automatic measurement and 21.53 for the manual measurement. The interobserver correlation was regular for the automatic measurement (ICC = 0.595) and low for the manual measurement (ICC = 0.446). The result of the intraobserver correlation was excellent (ICC = 0.917). We did not obtain a statistical correlation between the measurement of areas and the increase of the graft diameter (R = 0.069, P = .63). CONCLUSION We determined with our results that the intrasurgical graft size is not predictable with the measurement of the area of the gracilis and semitendinosus tendon on the MRI. BACKGROUND AND OBJECTIVE Periacetabular osteotomy (PAO) is an accepted and worldwide technique recognized for residual dysplasia treatment and even in unstable hips with limited acetabular coverage. The aim of this study is to analyse the functional, radiological and complication results in patients treated with mini-invasive PAO. MATERIAL AND METHODS We performed a retrospective study in which we analysed 131 cases undergoing mini-invasive PAO at our centre. The degree of joint degeneration was evaluated with Tönnis scale, Wiberg angle, acetabular index (AI), anterior coverage angle (AC), joint space, complications and functional outcome with the Non-Arthritic Hip Score (NAHS) were analysed preoperatively and at the end of follow-up. RESULTS The average age was 32.3±9.5 (SD) years, 102 (77.9%) were female and 29 (22.1%) were male. 7.7±2.8 (SD) years follow up. The radiological parameters improved between the pre-surgical phase and the end of follow-up, Wiberg angle+18.5° (18.3° versus 36.8°, 95% CI 17.3 to 19.7), AC angle+13.5° (26.2° versus 39.7°, 95%CI 11.6 to 15.4) and the AI -11.1° (19.5° versus 8.4°; 95%CI -12.1 to -10,1). In addition, the functional results, with the NAHS scale, improved+31.3 points (60.7 pre-surgical versus 92 at the end of follow-up, 95% CI 28.7 to 33.8). The most common complication was transient lateral femoral cutaneous nerve hypoaesthesia in 10 cases (7%). CONCLUSION The mini-invasive PAO approach is a reproducible technique, it allows restoration of acetabular coverage and provides an improvement in functional scales as confirmed by our series. OBJECTIVE To investigate power of computed tomography venography (CTV) to identify and characterize iliac vein obstruction (IVO) compared with intravascular ultrasound (IVUS) examination in highly symptomatic patients with chronic venous disease (CVD). METHODS CVD CEAP C3-6 limbs with visual analog scale for pain score of greater than 3 and/or Venous Clinical Severity Scale of greater than 8 were prospectively investigated with CTV and IVUS examination. The segment of maximum IVO was verified and categorically classified group I, 0% to 49%; group II, 50% to 79%; and group III, 80% or greater. The CTV's screening power to detect the point and degree of maximum IVO was compared with IVUS. RESULTS The CTV point of maximum IVO was 80% in the left limb, 10% in the right limb, 10% bilaterally; 2% in the inferior vena cava; 91% in the common iliac vein (CIV) confluence (41.6% below the CIV confluence, 34.5 at the CIV confluence, and 23.9% above the CIV confluence); 7% at the external iliac vein (kappa index 0.841; P less then .
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