Albert Lim Rafanan, MD Pulmonary, Critical Care and Sleep Medicine Chong Hua Hospital, Cebu City, Visayas, Philippines WHAT IS OBSTRUCTIVE SLEEP APNEA(OSA)? Loud snoring which is interrupted by respiratory arrest (apnea) of more than 10 secs in duration is obstructive sleep apnea. This is usually accompanied by a reduction in blood oxygen saturation followed by a microawakening to breath. In severe cases, hundreds of breathing pauses can occur every night. In obstructive apnea, the throat closes during inhalation due to excessive relaxation of the pharynx muscles and the floor of the mouth, accompanied by increased tissue pressure from outside. This prevents air from entering the lungs, and the patient is threatened with suffocation. IS OSA DANGEROUS? WHAT ARE THE EFFECTS? OSA has been associated with an increased mortality ratio of 3.33. Sleep apnea has been associated with … Read entire article »

Maria Arleen G. Atilano-Obsioma, MD Infectious Disease Consultant Capitol University Medical City, Cagayan de Oro City Severe sepsis and septic shock are major healthcare problems affecting millions of individuals around the world each year. In 2004, an international group of experts in the diagnosis and management of infection and sepsis published the first internationally accepted guidelines that the clinicians could use to improve outcomes in severe sepsis and septic shock. The 2008 guideline is an update to the previous guideline. The key recommendations include: early goal-directed resuscitation of the septic patient during the first 6 hours after recognition; blood cultures prior to antibiotic therapy; imaging studies performed promply; administration of broad-spectrum antibiotic therapy within 1 hour of diagnosis; reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate; a usual … Read entire article »