Chest wall reconstruction with acellular dermal matrix (AlloDerm) and a latissimus muscle flap.
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Biomedical subjects
Publications and source records attributed to Douglas Schmidt.
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PURPOSE: Chronic fatigue syndrome (CFS) is characterized by profound fatigue accompanied by disturbances of sleep, cognition, mood, and other symptoms. Our objective was to describe sleep architecture in CFS-discordant twin pairs. METHODS: We conducted a co-twin control study of 22 pairs of monozygotic twins where one twin met criteria for CFS and the co-twin was healthy. Twins underwent two nights of polysomnography. RESULTS: The percentage of Stage 3 and REM sleep was greater among the CFS twins than their healthy co-twins (P< or = .05 for both), but no other differences in sleep architecture including sleep latency, REM latency, and total sleep time were observed. Compared to their co-twins, CFS twins had higher values for the apnea-hypopnea index and apnea-hypopnea arousal index (P< or =.05 for both). CONCLUSION: These results do not provide strong evidence for a major role for abnormalities in sleep architecture in CFS. Respiration appears impaired in CFS, but these clinical abnormalities cannot alone account for the prominence of sleep complaints in this illness. The co-twin control methodology highlights the importance of selecting well-matched control subjects.
Demographic, injury-related, and symptom variables at intake, 3 months, and 12 months postinjury were compared between 50 treated adults with mild traumatic brain injury (MTBI) who were not seeking or receiving financial compensation at any time and 18 who were at each time. Compensation seekers/receivers reported symptom incidence and severity as approximately 1 SD higher at each time. The level of difference between the groups did not significantly differ across time. No demographic variables distinguished the groups. No injury-related variable other than more immediate postinjury prescription medication use was predictive of the greater symptom complaints for the patients seeking or receiving compensation. However, this medication effect did not explain away the compensation effect when medication use was co-varied in an analysis. Our study appears to be the first to examine the relationship between financial compensation and symptom report in an MTBI sample specifically treated for their condition. Our results indicate that even highly patient-rated treatment is not adequate to wash out the strong relationship between financial compensation status and symptom report after MTBI.
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