No abstract

Obstructive sleep apnea (OSA) syndrome has emerged as a major public health problem because of its high prevalence amongst middle-aged, obese men as well as in lean individuals and women. It has been suggested that obesity's role in the genesis of sleep apnea is rather through its metabolic activity than a purely anatomic/mechanical impact. Recent studies demonstrate that circulating levels of adipokines, adipose tissue-derived secretory proteins, are altered in patients with OSA syndrome. For instance, leptin level is increased, whereas that of adiponectin decreased in OSA, and these changes can be reversed by treatment of apnea/hypopnea episodes. Adipokine pro le seems to change towards a proin ammatory pattern that may also contribute to OSA-related cardiometabolic diseases. The mechanisms of adipose dysfunction in OSA includes hypoxia, oxidative stress and increased sympathetic nervous activity, including alterations in the circulating levels of the neurotrophins nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF). In e ect, reversing hypoxia and attenuating oxidative stress and in ammation through adipokine-and NGF/BDNFtargeted pharmacology may provide novel therapeutic opportunities in patients with OSA syndrome.

BACKGROUND: Lateral epicondylitis (LE) can occur for many different reasons such as compelling repetitive movements in daily readings, incorrect posture use and work-related factors. Although several treatments are available for LE, the optimal evidence-based treatment remains uncertain. Joint protection techniques have been developed as a self-management intervention to reduce pain and disability and improve functionality by applying ergonomic approaches. OBJECTIVES: This study aimed to investigate the effects of telephone-based follow up on top of a home-based joint protection education programme on pain and functionality in individuals with LE. METHODS: Individuals were randomly assigned into 2 groups; 1) telephone-based group, receiving telephone-based follow-up on top of a home-based joint protection education programme, and 2) home-based group, receiving home-based joint protection education alone. Both groups were given training that increased awareness in LE and home-based exercise programme. In addition, telephone-based group was followed up by telephone three days a week for four weeks. RESULTS: Improvements from baseline to 4th week in Turkish version of the Patient-Rated Tennis Elbow Evaluation-pain (p = 0.001; effect size = 1.11) and function (p <  0.001; effect size = 1.77), Upper Extremity Functional Index (p = 0.001; effect size = 0.85) and The Turkish version of the Joint Protection Behavior Assessment-Short Form (p <  0.001; effect size = 1.54) in the telephone-based group were significantly higher than the improvements in the home-based group. CONCLUSIONS: Telephone-based follow-up in individuals with LE contributed to the awareness of pain, functionality and joint protection methods. Telephone-based joint protection education programmes can offer a health service within the scope of preventive and protective intervention programmes for LE.