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ATS Publishes Clinical Guideline On Obesity Hypoventilation Syndrome

The American Thoracic Society has published an official clinical guideline on the evaluation and management of obesity hypoventilation syndrome in the Society's Aug. 1 American Journal of Respiratory and Critical Care Medicine.

Obesity hypoventilation syndrome (OHS) is a breathing disorder that affects some people who are obese, causing them to have too much carbon dioxide and too little oxygen in their blood. Medically, OHS is defined by the combination of obesity (body mass index ?30 kg/m2), sleep-disordered breathing and awake daytime hypercapnia (awake resting partial pressure of arterial CO2 or PaCO2 ?45 mmHg at sea level), after excluding other causes for hypoventilation.

Studies have estimated that 8-20% of obese patients with sleep apnea have this potentially life-threatening condition. According to the authors of the guideline, most patients with OHS are undiagnosed or misdiag

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Goal-Oriented Rehab Improves Recovery In Older Adults

Goal-oriented, motivational physical and occupational therapy helps older patients recover more fully from broken hips, strokes and other ailments that land them in skilled nursing facilities for rehabilitation, according to new research at Washington University School of Medicine in St. Louis.

Enhanced Medical Rehabilitation -- an approach in which physical and occupational therapists work to engage patients more fully during therapy sessions -- helped patients recover function better than standard physical and occupational therapy that was provided to others in the same skilled nursing facilities, the researchers found.

Their findings are published July 31 in the journal JAMA Network Open.

"We found that when you engage and motivate people, they do better," said the study's first author, Eric J. Lenze, MD, a professor of psychiatry.

Patients receiving enhanced rehab did not get mor

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Rethinking Seizures Associated With Cardiac Disease

Most people with a medical condition called long QT syndrome have a mutation in a gene that causes bouts of fast, chaotic heartbeats. They also experience fainting spells and seizures. The clinical approach has largely assumed that when the heart beats erratically, the brain eventually does not get enough oxygen — which in turn causes the seizures.

Research from Washington University in St. Louis finds that mutations of a gene implicated in long QT syndrome in humans may trigger seizures because of their direct effects on certain classes of neurons in the brain — independent from what the genetic mutations do to heart function. The new work from Arts & Sciences was conducted with fruit flies and is published Aug. 8 in PLOS Genetics.

“This gene seems to be a key factor in the physiological process that protects neurons from starting to fire uncontrollably in response to a rapid increase

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The Medical Minute: AFib Common And Incurable, But Controllable

One of the most common problems cardiologists handle is atrial fibrillation, also called AFib or AF. AFib is an abnormal or irregular heartbeat that can lead to blood clots, stroke, heart failure and other heart-related complications.

As many as 6 million people in the United States and 33 million people worldwide have AFib, the exact cause of which is generally unknown. As people age, they are more likely to have AFib. The prevailing theory is that age-related changes in the heart – tissue changes called fibrosis – produce the arrhythmia. A genetic component is likely.

“I look at AFib as an iceberg,” said Dr. Christopher Rogers, a cardiologist at Penn State Health Medical Group ― Berks Cardiology. “We understand the small part above the water, but the part below is much larger, and we have yet to understand it. I hope in my career we will continue to see advancements in understanding

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