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Showing posts with label Review. Show all posts
Showing posts with label Review. Show all posts

Monday, May 13, 2013

A.M. Best Places Medmarc's Rating Under Review With Positive Implications

Medmarc announced yesterday that it is to become part of ProAssurance, a $5-billion dollar organization with an A.M. Best rating of "A." Shortly thereafter, A.M. Best issued a Press Release on the likely effect of this merger on Medmarc's own rating, stating. "A.M. Best Co. has placed under review with positive implications the financial strength of A- (Excellent) and issuer credit rating of 'a-' of Medmarc Casualty Insurance Company and Noetic Specialty Insurance Company." The Release further states that "the positive implications reflect the potentially positive impact for Medmarc Group should it become a member of the ProAssurance organization in the future."

Click here to read the full Press Release from A.M. Best.


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Thursday, December 20, 2012

Opera Review: Opera of the Soul, Sparsely Staged

AppId is over the quota
AppId is over the quota
Operas written for the Opéra Comique are not necessarily comic, as works like Cherubini’s “Médée” attest, but we know from Mr. Pelly’s productions of Offenbach operettas and Donizetti’s “Fille du Régiment” that this director has a gift for comedy. For whatever reason he put that gift to work in the Royal Opera House at Covent Garden’s new staging of “Robert le Diable” (“Robert the Devil”), a chivalric tale of the supernatural in which the title character is saved from the powers of Hell by the redemptive love of a woman (shades of Wagner operas to come).

His production has audiences drawing comparisons — surely for the first time in history — between a French grand opera and Monty Python’s “Spamalot,” thanks to the way knights in heavy armorial suits (Mr. Pelly also designed the costumes) make jerky synchronized movements, and to sets by Chantal Thomas depicting the Sicilian princess Isabelle’s palace as a child’s paper cutout castle. There is room for humor in French grand opera — one of the numbers is labeled “duo bouffe” — but Mr. Pelly abuses the privilege, most damagingly in the stirring final trio.

Here, forces of good, represented by Robert’s foster-sister Alice, and of evil, represented by Robert’s father Bertram (an incarnation of the devil), vie for Robert’s soul. But Alice appears in a bed of clouds, like an emissary of heaven, and Bertram sings in front of a grizzly black-and-white cutout of a dragon’s head. No wonder the audience laughed when Robert agonized over his dilemma. Nor did the celebrated ballet for the ghosts of debauched nuns — naughty girls sent to convent to be straightened out — realize anything like its erotic potential.

A work that changed the course of opera history after a staggeringly successful premiere in 1831 deserves better. Chopin, an astute commentator on Parisian opera, proclaimed, “If ever magnificence was seen in the theater, I doubt that it reached the level of splendor shown in ‘Robert’ ... It is a masterpiece ... Meyerbeer has made himself immortal.”

Meyerbeer, a German Jew who thrived in Paris, was a first-rate musician with a genius for stagecraft and a self-prescribed mission to entertain by wowing an audience. His failure to cultivate what might be called “holy German art” (Wagner’s term in “Die Meistersinger”) of a more elevated nature won him the opprobrium of composers as diverse as Schumann and Wagner, even though the latter was quick to appropriate Meyerbeer’s techniques when they served him.

One opera enthusiast’s idea of entertainment may spell tedium for another, but Covent Garden’s director of opera, Kasper Holten, strikes a chord in a program comment by applying the words “shamelessly entertaining” to Meyerbeer. If the composer’s French grand operas are to work today, their splendor must be recreated convincingly for modern audiences as a virtue, the way Chopin viewed it, and not something to be viewed condescendingly.

This is a tall task requiring expenditures that opera houses may not want to lavish on works created primarily to entertain, although there is always the possibility of discovering more, as happened last year with “Les Huguenots” at La Monnaie in Brussels. The alternative is to skimp, as Covent Garden has done, or not do them at all.

Still, the new “Robert” is hardly a total loss, and Mr. Pelly at least allows the singers to credibly enact their roles in line with the story. Bryan Hymel, the dramatic tenor who starred at Covent Garden last season in another French grand opera, Berlioz’s “Les Troyens,” scores another major success with a Byronic portrayal of Robert that brings out similarities to Offenbach’s Hoffmann, whose passions are also deluded by magic. Hymel’s gleaming voice is securely produced, right up to high D.

Patrizia Ciofi’s soft-grained soprano is a lovely, but smallish match for Isabelle’s music, which includes the opera’s most memorable aria, “Robert, toi que j’aime” with its poignant phrase, “Grâce, grâce,” in which she begs Robert to repent for the sake of them both. Marina Poplavskaya (at the second performance) was announced as singing despite laryngitis, but this arresting if imperfect soprano sounded as good as I have heard her recently, especially in rich midrange. The bass John Relyea sings heartily as the devilish Bertram, but his unscripted final appearance during the wedding of Robert and Isabelle is another of Mr. Pelly’s miscalculations. Jean-François Borras’s flexible tenor served handsomely for Alice’s fiancé Raimbaut.

The conductor Daniel Oren sanctions cuts to the score said to number more than 60. It may seem quixotic to complain when the running time is four hours and twenty minutes, but last year’s “Troyens” lasted a good hour more. Will “Robert” ever be treated with comparable respect? It ought to be by any opera company that stages it, but I’m not holding my breath.

Robert le Diable. Royal Opera House, Covent Garden, London. Through Dec. 21.


View the original article here

Movie Review: ‘The Guilt Trip,’ With Barbra Streisand and Seth Rogen

AppId is over the quota
AppId is over the quota
The guilt that Ms. Streisand’s character, Joyce Brewster, lays on her grown son, Andy (Mr. Rogen), a struggling inventor, is larded with enough sweetness and awareness of appropriate boundaries that its humor caresses rather than stings. Joyce’s complaints mostly have to do with Andy’s decision to live 3,000 miles away from her in Los Angeles. When his mother becomes overbearing, Andy, sucking in his lower lip, politely silences her. Joyce, even at her most psychologically invasive, never whines or raises her voice.

Directed by Anne Fletcher (“The Proposal,” “27 Dresses”) from a pallid screenplay by Dan Fogelman (“Crazy, Stupid, Love”), “The Guilt Trip” is so comfy cozy that mothers and their grown children can watch it together without squirming. Even Joyce’s recollection of the time Andy’s penis turned purple is a zany throwaway remark delivered without a trace of Freudian insinuation.

What could have been a cutting satirical farce about domineering mothers and emasculated sons is a mildly funny, feel-good love story in which Mom’s sensible advice helps turn around her nerdy son’s foundering career. Although the main characters are softened Jewish stereotypes, there is no mention of religion.

Andy, who studied organic chemistry at U.C.L.A., is traveling around the country pitching an organic cleaning product he invented that consists of coconut and palm-kernel oils, and soy. You can even drink it. But his presentations are so stiff and jargony that potential backers nod off while he is talking.

When Andy makes a rare visit to see Joyce in New Jersey, he and his mother begin reminiscing. Joyce remembers her first boyfriend before she married Andy’s father, who died when Andy was 8. She has since had no love life.

Andy, sleuthing on the Internet, discovers an unmarried corporate executive living in San Francisco who has the same name as that boyfriend. He invites his mother to join him on his eight-day cross-country return trip without telling her of his plan to look up her first love at the end of the journey. Joyce, not knowing his agenda, jumps at the opportunity to be with her only child for several days.

One bland running joke is Joyce’s obsessive thrift. She insists that they rent a subcompact car instead of an S.U.V., a decision he regrets when they find themselves sandwiched between trucks in an Arkansas blizzard. Joyce also insists that they share the same room in motels and disturbs him with her habit of crunching handfuls of M&Ms while in bed. Since Ms. Streisand, now 70, looks 20 years younger, it is not implausible when one leering motel clerk mistakes them for lovers. But the movie makes little of the confusion.

Joyce is frisky and game for adventure, and in a Lubbock, Tex., steakhouse she agrees to play beat the clock while consuming a 50-ounce steak. This challenge, which could have been milked for farce, is another missed comic opportunity in a movie so timid it seems afraid of its own shadow. The chief pleasures of this mild-mannered dud lie in watching two resourceful comic actors go through their paces like the pros they are.

“The Guilt Trip” is rated PG-13 (Parents strongly cautioned). It has mild innuendo and some strong language.

The Guilt Trip

Opens on Wednesday nationwide.

Directed by Anne Fletcher; written by Dan Fogelman; director of photography, Oliver Stapleton; edited by Dana E. Glauberman and Priscilla Nedd-Friendly; music by Christophe Beck; production design by Nelson Coates; costumes by Danny Glicker; produced by Lorne Michaels, John Goldwyn and Evan Goldberg; released by Paramount Pictures. Running time: 1 hour 35 minutes.

WITH: Seth Rogen (Andy Brewster), Barbra Streisand (Joyce Brewster), Kathy Najimy (Gail), Yvonne Strahovski (Jessica) and Colin Hanks (Nick).


View the original article here

Wednesday, December 19, 2012

Movie Review: Michael Haneke’s ‘Amour,’ With Jean-Louis Trintignant

AppId is over the quota
AppId is over the quota
Did I mention this is a love story? It is, as well as a mystery of a type that, like some classic films noir and detective stories, reveals its secrets by rewinding to a past moment and then moving forward in time to return to the present. It opens with Georges and Anne, former music teachers, watching a concert by one of her prized students, the noted young pianist Alexandre Tharaud (as himself). Afterward they greet him backstage — Mr. Tharaud slices through a swarm of admirers to kiss her — and return home, an interlude set to his performance of Schubert’s Impromptu (Op. 90, No. 1), a type of music that’s called a character piece and is meant to convey a mood or idea.

The music helps set an air of soothing, restrained elegance as does Mr. Haneke’s meticulous compositions, his impeccable, steady framing and harmoniously arranged people and objects. Everything seems just so, just right, creating a sense of order that carries through until the couple reach their apartment and discover that the lock on their front door is broken. Someone apparently has tried to break in, a would-be intrusion that sends a shudder through the movie and down your spine. That’s because it echoes the first image of the firemen bursting into the apartment and because you never know what shocks, what brutality, Mr. Haneke — whose films include “The White Ribbon” and “Caché” as well as the Austrian version of “Funny Games” and its American redo — will let loose.

There is a jolt of violence in “Amour,” never fear (or do!). Nothing, though, seems amiss the next morning while Georges and Anne eat breakfast in a corner of their kitchen, talking amid the clatter of dishes and cutlery. He notices that the salt shaker is empty and rises to refill it, and he continues to chatter unaware that Anne has frozen in her chair, as if turned to stone. Perplexed, he waves a hand in front of her seemingly unseeing eyes. After a few beats, he dresses, presumably to get a doctor, but, as abruptly, Anne seems to return to normal. She scolds him gently — she doesn’t remember what just happened — and then she pours the tea and misses her cup.

By the time you next see them together, Anne in a wheelchair. She has had an operation for a carotid artery obstruction and while the procedure has a high success rate, she has drawn a fatal short straw. “It’s all terribly exciting,” a visibly unexcited, deadpan Georges explains to their daughter, Eva (a fantastic Isabelle Huppert). Wildly self-centered, Eva asks about the operation only after she natters on about her work (she’s a musician), her husband and children. She may be embarrassed or unsettled by her mother’s illness, but when Eva asks what she can do, her words sound hollow. “We’ve always coped, your mother and I,” Georges says, maybe to reassure himself as much as a daughter who can feel like a stranger.

A grace note of the movie is that the distance between Eva and her parents, an alienation that adds an edge into her voice when she talks to Georges and he to her, is never explained. Mr. Haneke doesn’t put his characters on the couch, offering up personalities that can be easily scanned and compartmentalized. As a consequence, his characters can be difficult to get a handle on, opaque, which might be frustrating if there wasn’t so much meaning packed into their everyday conversations and gestures, including what they leave unsaid. Early on, for instance, Anne teases Georges — at least she seems to be teasing — by calling him a monster. She doesn’t explain herself and neither does Mr. Haneke, which allows her meaning to reverberate, to grow steadily louder until it booms.

After Anne returns home, she gradually goes from bad to worse. Georges tries to care for her by himself, but, in time, is forced to hire nurses. The inevitable is, well, inevitable. But in this movie it is also consistently surprising because of the clarity of Mr. Haneke’s vision. There is a great deal that is difficult to watch here, the indignities of a debilitating illness included, and the equally harsh pain of witnessing a great love, a longtime companion, slowly fade away. The moving, subtly brilliant performances of Ms. Riva (best known for “Hiroshima Mon Amour”) and Mr. Trintignant (“A Man and a Woman”) are a particular gift in this respect. The two are, after all, at once forever young, immortalized in their films, and as familiar to us as our grandparents.

The representation of pain can be rightly difficult to watch, yet all too often also meaningless. But “Amour,” despite its agonizing subject, holds you willingly throughout. A key to understanding why comes at the beginning, when you see Georges and Anne at the concert, tucked in the audience that’s facing forward as if it were looking at the camera or, disconcertingly, us. It’s hard to see them, but they’re there, somewhat center and to the left, waiting and then clapping. It’s curious, this impression that the characters you’re watching are in turn watching and even applauding you. The moment can be characterized as an instance of Brechtian estrangement, which is meant to break the effects of illusion and awaken an attitude of criticism in the audience. More simply, the theater audience directly mirrors the movie audience, eroding the nominal distance between them.

This erosion of distance actually strengthens the film’s emotional power. Viewers acquainted with Mr. Haneke’s work may find “Amour” too cold, cruel even, and its depiction of suffering a punishing, familiar gesture from a director who’s long been interested in transforming spectators from simple consumers into critical thinkers. There are certainly arguments to be made about whether movie-watching is ever simple or noncritical. Yet there’s another point to be made here, namely that all the violence in “Amour” is crucial to Mr. Haneke’s rigorous, liberatingly unsentimental worldview, one that gazes on death with the same benevolent equanimity as life. All of which is to say: bring hankies. This is a film that will make you weep not only because life ends but also because it blooms.

“Amour” is rated PG-13 (Parents strongly cautioned). Illness, suffering, death.

Amour

Opens on Wednesday in Manhattan.

Written and directed by Michael Haneke; director of photography, Darius Khondji; edited by Monika Willi and Nadine Muse; production design by Jean-Vincent Puzos; costumes by Catherine Leterrier; produced by Margaret Menegoz, Stefan Arndt, Veit Heiduschka and Michael Katz; released by Sony Pictures Classics. In French, with English subtitles. Running time: 2 hours 7 minutes.

WITH: Jean-Louis Trintignant (Georges), Emmanuelle Riva (Anne), Isabelle Huppert (Eva), Alexandre Tharaud (Alexandre), William Shimell (Geoff), Ram?n Agirre (Concierge’s Husband) and Rita Blanco (Concierge)


View the original article here

Monday, July 9, 2012

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.


View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.


View the original article here

Sunday, July 8, 2012

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.


View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.


View the original article here

Thursday, July 5, 2012

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.


View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.


View the original article here

Saturday, June 16, 2012

Is obstructive sleep apnea associated with cortisol levels? A systematic review of the research evidence

a San Diego State University & University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, UCSD Mail Code 0804, La Jolla, CA, United Statesb Department of Psychiatry, University of California, San Diego, CA, United StatesReceived 8 March 2011. Revised 21 May 2011. Accepted 23 May 2011. Available online 30 July 2011.View full text The pathophysiology of obstructive sleep apnea (OSA) has been associated with dysregulation of the hypothalamic pituitary adrenal (HPA) axis; however a relationship between OSA and altered cortisol levels has not been conclusively established. We conducted a systematic review using the PRISMA Guidelines based on comprehensive database searches for 1) studies of OSA patients compared to controls in whom cortisol was measured and 2) studies of OSA patients treated with continuous positive airway pressure (CPAP) in whom cortisol was measured pre and post treatment. Five electronic databases were searched along with the reference lists of retrieved studies. The primary outcomes were 1) differences in cortisol between OSA and control subjects and 2) differences in cortisol pre-post CPAP treatment. Sampling methodology, sample timing and exclusion criteria were evaluated. Fifteen studies met the inclusion criteria. Heterogeneity of studies precluded statistical pooling. One study identified differences in cortisol between OSA patients and controls. Two studies showed statistically significant differences in cortisol levels pre-post CPAP. The majority of studies were limited by assessment of cortisol at a single time point. The available studies do not provide clear evidence that OSA is associated with alterations in cortisol levels or that treatment with CPAP changes cortisol levels. Methodological concerns such as infrequent sampling, failure to match comparison groups on demographic factors known to impact cortisol levels (age, body mass index; BMI), and inconsistent control of variables known to influence HPA function may have limited the results.

prs.rt("abs_end");Obstructive sleep apnea; Cortisol; Continuous positive airway pressure; Systematic review

Figures and tables from this article:

Fig. 1. PRISMA trial flow used to identify studies for detailed analysis of cortisol in 1) patients with obstructive sleep apnea and healthy controls and 2) patients with obstructive sleep apnea before and after treatment with continuous positive airway pressure. AHI = Apnea hypopnea index; CPAP = Continuous positive airway pressure.

View Within ArticleTable 1. The 7 included studies of cortisol in patients with OSA versus controls.

View table in articleNa = No information; OSA = Obstructive sleep apnea; BMI = Body mass index; AHI = Apnea hypopnea index; EDS = Excessive daytime sleepiness; w = with; wo = without.

View Within ArticleTable 2. The 8 included studies of cortisol in patients with OSA treated with CPAP.

View table in articleNa = No information; OSA = Obstructive sleep apnea; BMI = Body mass index; AHI = Apnea hypopnea index; EDS = Excessive daytime sleepiness; SE = Standard error of the mean; w = with; wo = without.

View Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

prs.rt('data_end');

View the original article here

Is obstructive sleep apnea associated with cortisol levels? A systematic review of the research evidence

a San Diego State University & University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, UCSD Mail Code 0804, La Jolla, CA, United Statesb Department of Psychiatry, University of California, San Diego, CA, United StatesReceived 8 March 2011. Revised 21 May 2011. Accepted 23 May 2011. Available online 30 July 2011.View full text The pathophysiology of obstructive sleep apnea (OSA) has been associated with dysregulation of the hypothalamic pituitary adrenal (HPA) axis; however a relationship between OSA and altered cortisol levels has not been conclusively established. We conducted a systematic review using the PRISMA Guidelines based on comprehensive database searches for 1) studies of OSA patients compared to controls in whom cortisol was measured and 2) studies of OSA patients treated with continuous positive airway pressure (CPAP) in whom cortisol was measured pre and post treatment. Five electronic databases were searched along with the reference lists of retrieved studies. The primary outcomes were 1) differences in cortisol between OSA and control subjects and 2) differences in cortisol pre-post CPAP treatment. Sampling methodology, sample timing and exclusion criteria were evaluated. Fifteen studies met the inclusion criteria. Heterogeneity of studies precluded statistical pooling. One study identified differences in cortisol between OSA patients and controls. Two studies showed statistically significant differences in cortisol levels pre-post CPAP. The majority of studies were limited by assessment of cortisol at a single time point. The available studies do not provide clear evidence that OSA is associated with alterations in cortisol levels or that treatment with CPAP changes cortisol levels. Methodological concerns such as infrequent sampling, failure to match comparison groups on demographic factors known to impact cortisol levels (age, body mass index; BMI), and inconsistent control of variables known to influence HPA function may have limited the results.

prs.rt("abs_end");Obstructive sleep apnea; Cortisol; Continuous positive airway pressure; Systematic review

Figures and tables from this article:

Fig. 1. PRISMA trial flow used to identify studies for detailed analysis of cortisol in 1) patients with obstructive sleep apnea and healthy controls and 2) patients with obstructive sleep apnea before and after treatment with continuous positive airway pressure. AHI = Apnea hypopnea index; CPAP = Continuous positive airway pressure.

View Within ArticleTable 1. The 7 included studies of cortisol in patients with OSA versus controls.

View table in articleNa = No information; OSA = Obstructive sleep apnea; BMI = Body mass index; AHI = Apnea hypopnea index; EDS = Excessive daytime sleepiness; w = with; wo = without.

View Within ArticleTable 2. The 8 included studies of cortisol in patients with OSA treated with CPAP.

View table in articleNa = No information; OSA = Obstructive sleep apnea; BMI = Body mass index; AHI = Apnea hypopnea index; EDS = Excessive daytime sleepiness; SE = Standard error of the mean; w = with; wo = without.

View Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

prs.rt('data_end');

View the original article here

Thursday, June 14, 2012

Secular trends in adult sleep duration: A systematic review

Little evidence exists to support the common assertion that adult sleep duration has declined. We investigated secular trends in sleep duration over the past 40 years through a systematic review.

Systematic search of 5 electronic databases was conducted to identify repeat cross-sectional studies of sleep duration in community-dwelling adults using comparable sampling frames and measures over time. We also attempted to access unpublished or semi-published data sources in the form of government reports, theses and conference proceedings. No studies were excluded based on language or publication date. The search identified 278 potential reports, from which twelve relevant studies were identified for review.

The 12 studies described data from 15 countries from the 1960s until the 2000s. Self-reported average sleep duration of adults had increased in 7 countries: Bulgaria, Poland, Canada, France, Britain, Korea and the Netherlands (range: 0.1–1.7 min per night each year) and had decreased in 6 countries: Japan, Russia, Finland, Germany, Belgium and Austria (range: 0.1–0.6 min per night each year). Inconsistent results were found for the United States and Sweden.

There has not been a consistent decrease in the self-reported sleep duration of adults from the 1960s to 2000s. However, it is unclear whether the proportions of very short and very long sleepers have increased over the same period, which may be of greater relevance for public health.

Table 1. Literature search strategy and number of results for each database.

View table in articleView Within ArticleTable 2. Summary of included results by country (some studies have multiple results).

View table in articleView Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.


View the original article here

Secular trends in adult sleep duration: A systematic review

Little evidence exists to support the common assertion that adult sleep duration has declined. We investigated secular trends in sleep duration over the past 40 years through a systematic review.

Systematic search of 5 electronic databases was conducted to identify repeat cross-sectional studies of sleep duration in community-dwelling adults using comparable sampling frames and measures over time. We also attempted to access unpublished or semi-published data sources in the form of government reports, theses and conference proceedings. No studies were excluded based on language or publication date. The search identified 278 potential reports, from which twelve relevant studies were identified for review.

The 12 studies described data from 15 countries from the 1960s until the 2000s. Self-reported average sleep duration of adults had increased in 7 countries: Bulgaria, Poland, Canada, France, Britain, Korea and the Netherlands (range: 0.1–1.7 min per night each year) and had decreased in 6 countries: Japan, Russia, Finland, Germany, Belgium and Austria (range: 0.1–0.6 min per night each year). Inconsistent results were found for the United States and Sweden.

There has not been a consistent decrease in the self-reported sleep duration of adults from the 1960s to 2000s. However, it is unclear whether the proportions of very short and very long sleepers have increased over the same period, which may be of greater relevance for public health.

Table 1. Literature search strategy and number of results for each database.

View table in articleView Within ArticleTable 2. Summary of included results by country (some studies have multiple results).

View table in articleView Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.


View the original article here

Wednesday, June 13, 2012

Longitudinal associations between sleep duration and subsequent weight gain: A systematic review

a Doctoral Program in Population Health and Clinical Outcomes Research, Department of Preventive Medicine, HSC Level 3, Stony Brook University, Stony Brook, NY 11794-8338, USAb Department of Preventive Medicine, Graduate Program in Public Health, HSC Level 3, room 071, Stony Brook University, Stony Brook, NY 11794-8338, USAReceived 31 December 2010. Revised 19 May 2011. Accepted 23 May 2011. Available online 23 July 2011.View full text To systematically examine the relationship between sleep duration and subsequent weight gain in observational longitudinal human studies.

Systematic review of twenty longitudinal studies published from 2004–October 31, 2010.

While adult studies (n = 13) reported inconsistent results on the relationship between sleep duration and subsequent weight gain, studies with children (n = 7) more consistently reported a positive relationship between short sleep duration and weight gain.

While shorter sleep duration consistently predicts subsequent weight gain in children, the relationship is not clear in adults. We discuss possible limitations of the current studies: 1) the diminishing association between short sleep duration on weight gain over time after transition to short sleep, 2) lack of inclusion of appropriate confounding, mediating, and moderating variables (i.e., sleep complaints and sedentary behavior), and 3) measurement issues.

prs.rt("abs_end");Sleep; Obesity; Weight gain; Longitudinal studiesBMI, Body mass index; CDC, Centers for Disease Control and Prevention

Figures and tables from this article:

Fig. 1. Illustration of literature search.

View Within ArticleFig. 2. Patel & Hu Model2 with media use added.

View Within ArticleTable 1. Adult studies.

View table in articleView Within ArticleTable 2. Adult Study Independent Variables.

View table in articleView Within ArticleTable 3. Children Studies.

View table in articleView Within ArticleTable 4. Children Study Independent Variables.

View table in articleView Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

prs.rt('data_end');

View the original article here

Longitudinal associations between sleep duration and subsequent weight gain: A systematic review

a Doctoral Program in Population Health and Clinical Outcomes Research, Department of Preventive Medicine, HSC Level 3, Stony Brook University, Stony Brook, NY 11794-8338, USAb Department of Preventive Medicine, Graduate Program in Public Health, HSC Level 3, room 071, Stony Brook University, Stony Brook, NY 11794-8338, USAReceived 31 December 2010. Revised 19 May 2011. Accepted 23 May 2011. Available online 23 July 2011.View full text To systematically examine the relationship between sleep duration and subsequent weight gain in observational longitudinal human studies.

Systematic review of twenty longitudinal studies published from 2004–October 31, 2010.

While adult studies (n = 13) reported inconsistent results on the relationship between sleep duration and subsequent weight gain, studies with children (n = 7) more consistently reported a positive relationship between short sleep duration and weight gain.

While shorter sleep duration consistently predicts subsequent weight gain in children, the relationship is not clear in adults. We discuss possible limitations of the current studies: 1) the diminishing association between short sleep duration on weight gain over time after transition to short sleep, 2) lack of inclusion of appropriate confounding, mediating, and moderating variables (i.e., sleep complaints and sedentary behavior), and 3) measurement issues.

prs.rt("abs_end");Sleep; Obesity; Weight gain; Longitudinal studiesBMI, Body mass index; CDC, Centers for Disease Control and Prevention

Figures and tables from this article:

Fig. 1. Illustration of literature search.

View Within ArticleFig. 2. Patel & Hu Model2 with media use added.

View Within ArticleTable 1. Adult studies.

View table in articleView Within ArticleTable 2. Adult Study Independent Variables.

View table in articleView Within ArticleTable 3. Children Studies.

View table in articleView Within ArticleTable 4. Children Study Independent Variables.

View table in articleView Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

prs.rt('data_end');

View the original article here

Sunday, June 3, 2012

Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: A systematic review

Kim E. Innesa, b, Corresponding author contact information, E-mail the corresponding author, Terry Kit Selfea, b, c, E-mail the corresponding author, Parul Agarwala, d, E-mail the corresponding authora Department of Community Medicine, West Virginia University School of Medicine, PO Box 9190, Morgantown, WV 26506-9190, USAb Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, PO Box 800782, McLeod Hall, Charlottesville, VA 22908-0782, USAReceived 1 February 2011. Revised 7 April 2011. Accepted 11 April 2011. Available online 5 July 2011.View full text Restless legs syndrome (RLS) is a distressing sleep and sensorimotor disorder that affects a large percentage of adults in the western industrialized world and is associated with profound reductions in quality of life. However, the etiology of RLS remains incompletely understood. Enhanced understanding regarding both the antecedents and sequelae of RLS could shed new light on the pathogenesis of RLS. Evidence from an emerging body of literature suggests associations between RLS and diabetes, hypertension, obesity, and related conditions linked to sympathetic activation and metabolic dysregulation, raising the possibility that these factors may likewise play a significant role in the development and progression of RLS, and could help explain the recently documented associations between RLS and subsequent cardiovascular disease. However, the relation between RLS and these chronic conditions has received relatively little attention to date, although potential implications for the pathogenesis and treatment of RLS could be considerable. In this paper, we systematically review the recently published literature regarding the association of RLS to cardiovascular disease and related risk factors characterized by sympathoadrenal and metabolic dysregulation, discuss potential underlying mechanisms, and outline some possible directions for future research.

prs.rt("abs_end");Restless legs syndrome; RLS; Ekbom disease; Cardiovascular disease; Hypertension; Diabetes; Impaired glucose tolerance; Obesity; Weight gain; Dyslipidemia; Autonomic dysfunction; HPA axis dysfunction

Figures and tables from this article:

Table 1. Summary table of study characteristics. N = 30 studies (1995-2010).

View table in articleAbbreviations: CVD = cardiovascular disease; DM = diabetes; DM2 = type 2 diabetes; dx = diagnosis; IGT = impaired glucose tolerance: IRLSSG = international restless legs syndrome study group; Min freq/sev = minimum frequency and/or severity; pts = patients; pts = patients; VA = veterans administration; w/ = with.

View Within ArticleTable 2. Relation of RLS to cardiovascular disease. Summary of study characteristics and findings (N = 15 studies published between 1995 and 2010).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CAD = Coronary artery disease; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD = International Classification of Diseases; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infraction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); pt = patient; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleTable 3. Relation of RLS to hypertension: Summary of study characteristics and findings (N = 17 studies published between 1995 and 2010).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DBP = diastolic blood pressure; DM = diabetes mellitus; DM2 = type 2 diabetes; DM1 = type 1 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); Pt = patient; RLS = restless legs syndrome; SBP = systolic blood pressure; SDB = Sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.* Calculated from data provided in paper.

View Within ArticleTable 4. Relation of RLS to diabetes and impaired glucose tolerance: Summary of study characteristics and findings (N=26 studies (1995-2010)).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BG = blood glucose; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HOMA = homeostasis model assessment; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; IGT = impaired glucose tolerance; ICSD = international classification of sleep disorders; IGR = impaired glucose regulation; IGT = impaired glucose tolerance; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MONICA = monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% Confidence Interval); pts = patients; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = Strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.*Calculated from data provided in table.

View Within ArticleTable 5. Relation of RLS to obesity, weight gain, and dyslipidemia: Summary of study characteristics and findings (N=18 studies with data on the association of RLS to obesity/weight gain, 7 studies with data on the association of RLS to lipid profiles).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICSD = international classification of sleep disorders; IRLS = intl RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = Monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% confidence interval); RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

prs.rt('data_end');

View the original article here

Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: A systematic review

Kim E. Innesa, b, Corresponding author contact information, E-mail the corresponding author, Terry Kit Selfea, b, c, E-mail the corresponding author, Parul Agarwala, d, E-mail the corresponding authora Department of Community Medicine, West Virginia University School of Medicine, PO Box 9190, Morgantown, WV 26506-9190, USAb Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, PO Box 800782, McLeod Hall, Charlottesville, VA 22908-0782, USAReceived 1 February 2011. Revised 7 April 2011. Accepted 11 April 2011. Available online 5 July 2011.View full text Restless legs syndrome (RLS) is a distressing sleep and sensorimotor disorder that affects a large percentage of adults in the western industrialized world and is associated with profound reductions in quality of life. However, the etiology of RLS remains incompletely understood. Enhanced understanding regarding both the antecedents and sequelae of RLS could shed new light on the pathogenesis of RLS. Evidence from an emerging body of literature suggests associations between RLS and diabetes, hypertension, obesity, and related conditions linked to sympathetic activation and metabolic dysregulation, raising the possibility that these factors may likewise play a significant role in the development and progression of RLS, and could help explain the recently documented associations between RLS and subsequent cardiovascular disease. However, the relation between RLS and these chronic conditions has received relatively little attention to date, although potential implications for the pathogenesis and treatment of RLS could be considerable. In this paper, we systematically review the recently published literature regarding the association of RLS to cardiovascular disease and related risk factors characterized by sympathoadrenal and metabolic dysregulation, discuss potential underlying mechanisms, and outline some possible directions for future research.

prs.rt("abs_end");Restless legs syndrome; RLS; Ekbom disease; Cardiovascular disease; Hypertension; Diabetes; Impaired glucose tolerance; Obesity; Weight gain; Dyslipidemia; Autonomic dysfunction; HPA axis dysfunction

Figures and tables from this article:

Table 1. Summary table of study characteristics. N = 30 studies (1995-2010).

View table in articleAbbreviations: CVD = cardiovascular disease; DM = diabetes; DM2 = type 2 diabetes; dx = diagnosis; IGT = impaired glucose tolerance: IRLSSG = international restless legs syndrome study group; Min freq/sev = minimum frequency and/or severity; pts = patients; pts = patients; VA = veterans administration; w/ = with.

View Within ArticleTable 2. Relation of RLS to cardiovascular disease. Summary of study characteristics and findings (N = 15 studies published between 1995 and 2010).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CAD = Coronary artery disease; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD = International Classification of Diseases; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infraction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); pt = patient; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleTable 3. Relation of RLS to hypertension: Summary of study characteristics and findings (N = 17 studies published between 1995 and 2010).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DBP = diastolic blood pressure; DM = diabetes mellitus; DM2 = type 2 diabetes; DM1 = type 1 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); Pt = patient; RLS = restless legs syndrome; SBP = systolic blood pressure; SDB = Sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.* Calculated from data provided in paper.

View Within ArticleTable 4. Relation of RLS to diabetes and impaired glucose tolerance: Summary of study characteristics and findings (N=26 studies (1995-2010)).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BG = blood glucose; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HOMA = homeostasis model assessment; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; IGT = impaired glucose tolerance; ICSD = international classification of sleep disorders; IGR = impaired glucose regulation; IGT = impaired glucose tolerance; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MONICA = monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% Confidence Interval); pts = patients; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = Strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.*Calculated from data provided in table.

View Within ArticleTable 5. Relation of RLS to obesity, weight gain, and dyslipidemia: Summary of study characteristics and findings (N=18 studies with data on the association of RLS to obesity/weight gain, 7 studies with data on the association of RLS to lipid profiles).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICSD = international classification of sleep disorders; IRLS = intl RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = Monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% confidence interval); RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

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Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: A systematic review

Kim E. Innesa, b, Corresponding author contact information, E-mail the corresponding author, Terry Kit Selfea, b, c, E-mail the corresponding author, Parul Agarwala, d, E-mail the corresponding authora Department of Community Medicine, West Virginia University School of Medicine, PO Box 9190, Morgantown, WV 26506-9190, USAb Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, PO Box 800782, McLeod Hall, Charlottesville, VA 22908-0782, USAReceived 1 February 2011. Revised 7 April 2011. Accepted 11 April 2011. Available online 5 July 2011.View full text Restless legs syndrome (RLS) is a distressing sleep and sensorimotor disorder that affects a large percentage of adults in the western industrialized world and is associated with profound reductions in quality of life. However, the etiology of RLS remains incompletely understood. Enhanced understanding regarding both the antecedents and sequelae of RLS could shed new light on the pathogenesis of RLS. Evidence from an emerging body of literature suggests associations between RLS and diabetes, hypertension, obesity, and related conditions linked to sympathetic activation and metabolic dysregulation, raising the possibility that these factors may likewise play a significant role in the development and progression of RLS, and could help explain the recently documented associations between RLS and subsequent cardiovascular disease. However, the relation between RLS and these chronic conditions has received relatively little attention to date, although potential implications for the pathogenesis and treatment of RLS could be considerable. In this paper, we systematically review the recently published literature regarding the association of RLS to cardiovascular disease and related risk factors characterized by sympathoadrenal and metabolic dysregulation, discuss potential underlying mechanisms, and outline some possible directions for future research.

prs.rt("abs_end");Restless legs syndrome; RLS; Ekbom disease; Cardiovascular disease; Hypertension; Diabetes; Impaired glucose tolerance; Obesity; Weight gain; Dyslipidemia; Autonomic dysfunction; HPA axis dysfunction

Figures and tables from this article:

Table 1. Summary table of study characteristics. N = 30 studies (1995-2010).

View table in articleAbbreviations: CVD = cardiovascular disease; DM = diabetes; DM2 = type 2 diabetes; dx = diagnosis; IGT = impaired glucose tolerance: IRLSSG = international restless legs syndrome study group; Min freq/sev = minimum frequency and/or severity; pts = patients; pts = patients; VA = veterans administration; w/ = with.

View Within ArticleTable 2. Relation of RLS to cardiovascular disease. Summary of study characteristics and findings (N = 15 studies published between 1995 and 2010).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CAD = Coronary artery disease; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD = International Classification of Diseases; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infraction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); pt = patient; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleTable 3. Relation of RLS to hypertension: Summary of study characteristics and findings (N = 17 studies published between 1995 and 2010).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DBP = diastolic blood pressure; DM = diabetes mellitus; DM2 = type 2 diabetes; DM1 = type 1 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; ICSD = international classification of sleep disorders; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = monitoring trends and determinants in CVD survey-Augsburg; n’s = numbers; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OR = odds ratio (95% Confidence Interval); Pt = patient; RLS = restless legs syndrome; SBP = systolic blood pressure; SDB = Sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.* Calculated from data provided in paper.

View Within ArticleTable 4. Relation of RLS to diabetes and impaired glucose tolerance: Summary of study characteristics and findings (N=26 studies (1995-2010)).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BG = blood glucose; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HOMA = homeostasis model assessment; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICD9CM = international classification of diseases, 9th revision, clinical modification; IGT = impaired glucose tolerance; ICSD = international classification of sleep disorders; IGR = impaired glucose regulation; IGT = impaired glucose tolerance; IRLS = international RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MONICA = monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% Confidence Interval); pts = patients; RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = Strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/in = within; w/o = without.*Calculated from data provided in table.

View Within ArticleTable 5. Relation of RLS to obesity, weight gain, and dyslipidemia: Summary of study characteristics and findings (N=18 studies with data on the association of RLS to obesity/weight gain, 7 studies with data on the association of RLS to lipid profiles).

View table in articleAbbreviations: appt = appointment; ARIC = atherosclerosis risk in communities; BMI = body mass index; BOLD = the burden of obstructive lung diseases study; BP = blood pressure; btwn = between; CHF = congestive heart failure; CHS = cardiovascular health study; condn = condition; CVD = cardiovascular disease; DM = diabetes mellitus; DM1 = type 1 diabetes; DM2 = type 2 diabetes; dx = diagnosis; ECA = epidemiologic catchment area; F=female; FBG = fasting blood glucose; FHS = framingham heart study; Freq = frequency; Hgb = hemoglobin; HPFS = health professionals follow-up study; HTN = hypertension; hx = history; ICSD = international classification of sleep disorders; IRLS = intl RLS study group rating scale; IRLSSG = international restless legs syndrome study group; M = male; MEMO = the memory and morbidity in augsburg elderly study; MI = myocardial infarction; MONICA = Monitoring trends and determinants in CVD survey-Augsburg; NC-FP-RN = north carolina family practice research network; NHS II = nurses health study II; NSF = national sleep foundation poll; NY cohorts = new york hypertension cohorts; OGTT = oral glucose tolerance test; OR = odds ratio (95% confidence interval); RLS = restless legs syndrome; SDB = sleep disordered breathing; SHHS = sleep heart health study; SHS = strong heart study; SPAR = the official database covering the total population of Sweden; Sx = symptoms; TG = triglycerides; Tucson cohorts = tucson epidemiologic study of airways obstructive diseases and the health and environment study; tx = treatment; VA = veterans administration; w/ = with; w/o = without.*Calculated from data provided in paper.

View Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

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Friday, May 18, 2012

Month in Review: February in Design

AppId is over the quota
AppId is over the quota
Remodelista - Feb in Design.jpg

Blame it on the final stretch of winter, but February had us yearning for warmer places and outdoor settings at Remodelista. Some stories took us around the world: we obsessed over an eco-friendly retreat in the high desert of California and longed to visit the summer in a quiet fishing village in Brazil. With the new season approaching, we also had our eye on clean spaces and spring colors. We found inspiration from a minimal and open box house featured on Design Boom, as well as from a light-filled New York loft documented on An Afternoon With by Michael Mundy. In terms of what's new and next, Yatzer took us to the world of color, giving readers a look inside the studio of designer Phil Cuttance and his FACETURE project, while Gwyneth Paltrow blogged about her day at the biannual home décor and furniture trade show Maison & Objet in Paris.

Like it or not, February marks the celebration of romance, and we enjoyed Valentine's Day stories across the blogging world; from the SF Girl By Bay's post on bold uses of the color pink to Design Sponge's tips on creating a romantic tablescape using vintage glass. Remodelista visited a retro workshop in Los Angeles that brought us back to our school days of creating our own handmade valentines.

Lastly, February brought the kickoff to the world calendar of fall fashion shows with New York Fashion Week. Designers, models, bloggers, editors, and the rest of the sartorially inspired gathered to show and take in all the new innovations in style. The week delivered a range of stories; from the "thrill ride" of Proenza Schouler as described by the LA Times blog, to the bronzed cheeks of the Rodarte models. And with the launch of Remodelista's Style Counsel earlier this year, our editors are also engaging in the dialogue of fashion, and will be divulging the "sartorial secrets of our friends in the design world" all throughout the year.

Guest post from the editors at Remodelista, the sourcebook for the considered home.

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