19 results on '"Harding, Susan M."'
Search Results
2. List of Contributors
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Alfano, Candice A., primary, Alonso, W. Jerome, additional, Amin, Raouf, additional, Brand, Sarah R., additional, Brimeyer, Chasity, additional, Boyd, Kevin L., additional, Carskadon, Mary A., additional, Carroll, John L., additional, Chervin, Ronald D., additional, Engler, Anat Cohen, additional, Cogen, Jonathan, additional, McLaughlin, Valerie, additional, Crowley, Stephanie J., additional, Cvengros, Jamie A., additional, Davidson, Sally L., additional, Donnelly, David F., additional, Durmer, Jeffrey S., additional, Dillon, James E., additional, Etzioni, Tamar, additional, Gozal, David, additional, Grigg-Damberger, Madeleine M., additional, Gringras, Paul, additional, Gut, Guy, additional, Harding, Susan M., additional, Haupt, Mark, additional, Herman, John H., additional, Horne, Rosemary S.C., additional, Ivanenko, Anna, additional, Johnson, Michaela C., additional, Katz, Eliot, additional, Kheirandish-Gozal, Leila, additional, Kohrman, Michael, additional, Kotagal, Suresh, additional, Kumar, Harsha, additional, Kushnir, Jonathan, additional, Krishna, Jyoti, additional, Loughmanee, Darius A., additional, Marcus, Carole L., additional, McColley, Susanna A., additional, Mindell, Jodi A., additional, Moore, Melisa, additional, O'Brien, Louise M., additional, Owens, Judith A., additional, Patwari, Pallavi P., additional, Pelayo, Rafael, additional, Perez, Iris A., additional, Pillar, Giora, additional, Poets, Christian F., additional, Rach, Amanda M., additional, Rand, Casey M., additional, Rosen, Gerald M., additional, Capdevila, Oscar Sans, additional, Shamsuzzaman, Abu, additional, Sheldon, Stephen H., additional, Sivan, Yakov, additional, Sulman, Cecille G., additional, Tal, Asher, additional, Tarokh, Leila, additional, Troxler, R. Bradley, additional, Vardhan, Sindhuja, additional, Wise, Merrill S., additional, Witmans, Manisha, additional, Wolfson, Amy R., additional, Woodson, B. Tucker, additional, Wyatt, James K., additional, and Young, Rochelle, additional
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- 2014
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3. Contributors
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Ahmed, Imran, primary, Arand, Donna L., additional, Arrigoni, Elda, additional, Attarian, Hrayr, additional, Barger, Laura K., additional, Barkoukis, Teri J., additional, Becker, Kendra, additional, Benson, Kathleen L., additional, Bianchi, Matt T., additional, M. Billiard, Michel, additional, Bista, Sabin R., additional, Blumer, Jeffrey, additional, Bonnet, Michael H., additional, Brainard, George, additional, Byrne, Brenda, additional, Cartwright, Rosalind D., additional, Chokroverty, Sudhansu, additional, Cohen, Daniel A., additional, Collop, Nancy A., additional, Correa, Leopoldo P., additional, Cortese, Bernadette M., additional, McLaughlin Crabtree, Valerie, additional, Cuellar, Norma G., additional, Cvengros, Jamie A., additional, DeMartinis, Nicholas A., additional, DeWolfe, Jennifer L., additional, Diederichs, Christina, additional, Dieffenbach, Paul, additional, Dodson, Ehren R., additional, Doghramji, Karl, additional, Eastman, Charmane I., additional, Espie, Colin A., additional, Ferber, Richard, additional, Friedman, Michael, additional, Ftouni, Suzanne, additional, Fuller, Patrick M., additional, Georgsson, Hlynur, additional, Gooneratne, Nalaka S., additional, Grigg-Damberger, Madeleine M., additional, Guille, Constance, additional, Hakim, Alex D., additional, Hanna, Philip A., additional, Harding, Susan M., additional, Harper, David G., additional, Hauri, Peter J., additional, Hirshkowitz, Max, additional, Howell, Michael J., additional, Hurwitz, Thomas D., additional, Ivanenko, Anna, additional, Johnson, Kyle P., additional, Juarascio, Adrienne, additional, Kanathur, Naveen, additional, Katz, Eliot S., additional, Kay, Abigail L., additional, Kotagal, Suresh, additional, Krueger, James M., additional, Krystal, Andrew D., additional, Kuhn, Brett R., additional, Kyle, Simon D., additional, Lammers, Gert Jan, additional, Lee-Chiong, Teofilo L., additional, Leesman, Christopher W., additional, Littner, Michael R., additional, Lockley, Steven W., additional, Lysenko, Liudmila, additional, Mahowald, Mark W., additional, Malow, Beth Ann, additional, Martin, Jennifer L., additional, Matheson, Jean K., additional, Mehta, Noshir R., additional, Mittleman, Murray A., additional, Mokhlesi, Babak, additional, Moldofsky, Harvey, additional, Murray, Brian J., additional, Neubauer, David N., additional, Nishino, Seiji, additional, Pamidi, Sushmita, additional, Pelayo, Rafael, additional, Phillips, Barbara A., additional, Pien, Grace W., additional, Poon, Charles, additional, Pulver, Tanya, additional, Quan, Stuart F., additional, Rajaratnam, Shantha M.W., additional, Randerath, Winfried J., additional, Revell, Victoria L., additional, Roane, Brandy M., additional, Roehrs, Timothy A., additional, Rosen, Carol L., additional, Rosen, Gerald, additional, Roth, Thomas, additional, Rye, David B., additional, Sakai, Noriaki, additional, Schenck, Carlos H., additional, Schweitzer, Paula K., additional, Scrivani, Steven J., additional, Serota, Ronald, additional, Singh, Rajinder, additional, Sletten, Tracey L., additional, Stober, Krystal R., additional, Sullivan, Shannon S., additional, Summers, Michael O., additional, Super, Elizabeth R., additional, Thirlwell, Celeste, additional, Thorpy, Michael J., additional, Trotti, Lynn Marie, additional, Uchiyama, Makoto, additional, Uhde, Thomas W., additional, Verrier, Richard L., additional, Wee, Alvin G., additional, Weinstein, Stephen P., additional, Winokur, Andrew, additional, Wyatt, James K., additional, Yaggi, H. Klar, additional, and Zielinski, Mark R., additional
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- 2012
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4. Sleep-Related Gastroesophageal Reflux Disease
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Harding, Susan M., primary
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- 2012
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5. Gastroesophageal Reflux
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Boedefeld, Robyn L., primary and Harding, Susan M., additional
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- 2008
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6. Contributors
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Apter, Andrea J., primary, Aysola, Ravi, additional, Bacharier, Leonard B., additional, Balkissoon, Ronald C., additional, Bel, Elisabeth H., additional, Bender, Bruce G., additional, Boedefeld, Robyn L., additional, Borish, Larry, additional, Bourdin, Arnaud, additional, Bousquet, Jean, additional, Boyd, Jessica H., additional, Bufford, Jeremy D., additional, Busse, William W., additional, Cairns, Charles B., additional, Calhoun, William J., additional, Casale, Thomas B., additional, Castro, Mario, additional, Cazzola, Mario, additional, Chanez, Pascal, additional, Cherniack, Reuben, additional, Chipps, Bradley, additional, Cockcroft, Don W., additional, Corbridge, Susan J., additional, Corbridge, Thomas C., additional, Corrigan, C.J., additional, Covar, Ronina A., additional, Czyzewski, Danita, additional, Deykin, Aaron, additional, Erwin, Elizabeth A., additional, Evans, David, additional, Fink, James B., additional, Fish, James E., additional, Frew, Anthony J., additional, Fuhlbrigge, Anne L., additional, George, Maureen, additional, Gerald, Lynn B., additional, Gibson, Peter G., additional, Guerra, Stefano, additional, Hanania, Nicola A., additional, Harding, Susan M., additional, Hussain, Iftikhar, additional, Janson, Susan L., additional, Jarjour, Nizar N., additional, Kakumanu, Sujani, additional, Kelsay, Kimberly, additional, Knowles, Sarah B., additional, Kraft, Monica, additional, Krawiec, Marzena, additional, Lemanske, Robert F., additional, Lima, John J., additional, Lugogo, Njira L., additional, Mangan, Joan M., additional, Mastronarde, John G., additional, McCartney, John G., additional, McQuaid, Elizabeth L., additional, Murugan, Anandhi T., additional, Altamura Namazy, Jennifer, additional, Parsons, Jonathan P., additional, Pascual, Rodolfo M., additional, Patel, Anand C., additional, Peters, Stephen P., additional, Platts-Mills, Thomas A.E., additional, Pleasants, Roy A., additional, Robinson, Jane, additional, Rubin, Bruce K., additional, Schatz, Michael, additional, Schend, Valerie A., additional, Silkoff, Phillip E., additional, Slade, David, additional, Slavin, Raymond G., additional, Sockrider, Marianna M., additional, Sorkness, Christine A., additional, Spahn, Joseph D., additional, Spahr, Jonathan E., additional, Steinke, John W., additional, Stewart, Lora, additional, Stokes, Jeffrey R., additional, Strunk, Robert C., additional, Szefler, Stanley J., additional, Talabere, Laurel R., additional, Tien, Karen J., additional, van Veen, Ilonka H., additional, Waldman Wagner, Christine, additional, Wamboldt, Frederick S., additional, Warner, John O., additional, Wechsler, Michael E., additional, Whelan, Glenn J., additional, Williams, Larry W., additional, Wilson, Sandra R., additional, Win, Patrick H., additional, and Wright, Anne L., additional
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- 2008
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7. Chronic Cough Due to Gastroesophageal Reflux in Adults: CHEST Guideline and Expert Panel Report.
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Kahrilas PJ, Altman KW, Chang AB, Field SK, Harding SM, Lane AP, Lim K, McGarvey L, Smith J, and Irwin RS
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- Adult, Chronic Disease, Cough prevention & control, Evidence-Based Medicine, Female, Gastroesophageal Reflux prevention & control, Humans, Cough etiology, Gastroesophageal Reflux complications
- Abstract
Background: We updated the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome., Methods: Two population, intervention, comparison, outcome (PICO) questions were addressed by systematic review: (1) Can therapy for gastroesophageal reflux improve or eliminate cough in adults with chronic and persistently troublesome cough? and (2) Are there minimal clinical criteria to guide practice in determining that chronic cough is likely to respond to therapy for gastroesophageal reflux?, Results: We found no high-quality studies pertinent to either question. From available randomized controlled trials (RCTs) addressing question #1, we concluded that (1) there was a strong placebo effect for cough improvement; (2) studies including diet modification and weight loss had better cough outcomes; (3) although lifestyle modifications and weight reduction may be beneficial in suspected reflux-cough syndrome, proton pump inhibitors (PPIs) demonstrated no benefit when used in isolation; and (4) because of potential carryover effect, crossover studies using PPIs should be avoided. For question #2, we concluded from the available observational trials that (1) an algorithmic approach to management resolved chronic cough in 82% to 100% of instances; (2) cough variant asthma and upper airway cough syndrome (UACS) (previously referred to as postnasal drip syndrome) from rhinosinus conditions were the most commonly reported causes; and (3) the reported prevalence of reflux-cough syndrome varied widely., Conclusions: The panelists (1) endorsed the use of a diagnostic/therapeutic algorithm addressing causes of common cough, including symptomatic reflux; (2) advised that although lifestyle modifications and weight reduction may be beneficial in suspected reflux-cough syndrome, PPIs demonstrated no benefit when used in isolation; and (3) suggested that physiological testing be reserved for refractory patients being considered for antireflux surgery or for those in whom there is strong clinical suspicion warranting diagnostic testing., (Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
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- 2016
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8. Assessment of Intervention Fidelity and Recommendations for Researchers Conducting Studies on the Diagnosis and Treatment of Chronic Cough in the Adult: CHEST Guideline and Expert Panel Report.
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French CT, Diekemper RL, Irwin RS, Adams TM, Altman KW, Barker AF, Birring SS, Blackhall F, Bolser DC, Boulet LP, Braman SS, Brightling C, Callahan-Lyon P, Canning BJ, Chang AB, Coeytaux R, Cowley T, Davenport P, Diekemper RL, Ebihara S, El Solh AA, Escalante P, Feinstein A, Field SK, Fisher D, French CT, Gibson P, Gold P, Gould MK, Grant C, Harding SM, Harnden A, Hill AT, Irwin RS, Kahrilas PJ, Keogh KA, Lane AP, Lim K, Malesker MA, Mazzone P, Mazzone S, McCrory DC, McGarvey L, Molasiotis A, Murad MH, Newcombe P, Nguyen HQ, Oppenheimer J, Prezant D, Pringsheim T, Restrepo MI, Rosen M, Rubin B, Ryu JH, Smith J, Tarlo SM, Vertigan AE, Wang G, Weinberger M, and Weir K
- Subjects
- Adult, Chronic Disease, Cough etiology, Humans, Outcome Assessment, Health Care, Practice Guidelines as Topic, Research Design, Cough diagnosis, Cough therapy
- Abstract
Background: Successful management of chronic cough has varied in the primary research studies in the reported literature. One of the potential reasons relates to a lack of intervention fidelity to the core elements of the diagnostic and/or therapeutic interventions that were meant to be used by the investigators., Methods: We conducted a systematic review to summarize the evidence supporting intervention fidelity as an important methodologic consideration in assessing the effectiveness of clinical practice guidelines used for the diagnosis and management of chronic cough. We developed and used a tool to assess for five areas of intervention fidelity. Medline (PubMed), Scopus, and the Cochrane Database of Systematic Reviews were searched from January 1998 to May 2014. Guideline recommendations and suggestions for those conducting research using guidelines or protocols to diagnose and manage chronic cough in the adult were developed and voted upon using CHEST Organization methodology., Results: A total of 23 studies (17 uncontrolled prospective observational, two randomized controlled, and four retrospective observational) met our inclusion criteria. These articles included 3,636 patients. Data could not be pooled for meta-analysis because of heterogeneity. Findings related to the five areas of intervention fidelity included three areas primarily related to the provider and two primarily related to the patients. In the area of study design, 11 of 23 studies appeared to be underpinned by a single guideline/protocol; for training of providers, two of 23 studies reported training, and zero of 23 reported the use of an intervention manual; and for the area of delivery of treatment, when assessing the treatment of gastroesophageal reflux disease, three of 23 studies appeared consistent with the most recent guideline/protocol referenced by the authors. For receipt of treatment, zero of 23 studies mentioned measuring concordance of patient-interventionist understanding of the treatment recommended, and zero of 23 mentioned measuring enactment of treatment, with three of 23 measuring side effects and two of 23 measuring adherence. The overall average intervention fidelity score for all 23 studies was poor (20.74 out of 48)., Conclusions: Only low-quality evidence supports that intervention fidelity strategies were used when conducting primary research in diagnosing and managing chronic cough in adults. This supports the contention that some of the variability in the reporting of patients with unexplained or unresolved chronic cough may be due to lack of intervention fidelity. By following the recommendations and suggestions in this article, researchers will likely be better able to incorporate strategies to address intervention fidelity, thereby strengthening the validity and generalizability of their results that provide the basis for the development of trustworthy guidelines.
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- 2015
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9. Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children: CHEST Guideline and Expert Panel Report.
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Vertigan AE, Murad MH, Pringsheim T, Feinstein A, Chang AB, Newcombe PA, Rubin BK, McGarvey LP, Weir K, Altman KW, Weinberger M, Irwin RS, Adams TM, Altman KW, Barker AF, Birring SS, Blackhall F, Bolser DC, Boulet LP, Braman SS, Brightling C, Callahan-Lyon P, Canning BJ, Chang AB, Coeytaux R, Cowley T, Davenport P, Diekemper RL, Ebihara S, El Solh AA, Escalante P, Feinstein A, Field SK, Fisher D, French CT, Gibson P, Gold P, Gould MK, Grant C, Harding SM, Harnden A, Hill AT, Irwin RS, Kahrilas PJ, Keogh KA, Lane AP, Lim K, Malesker MA, Mazzone P, Mazzone S, McCrory DC, McGarvey L, Molasiotis A, Murad MH, Newcombe P, Nguyen HQ, Oppenheimer J, Prezant D, Pringsheim T, Restrepo MI, Rosen M, Rubin B, Ryu JH, Smith J, Tarlo SM, Vertigan AE, Wang G, Weinberger M, Weir K, and Wiener RS
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- Adult, Child, Humans, Practice Guidelines as Topic, Somatoform Disorders psychology, Syndrome, Tics psychology, Cough etiology, Cough psychology, Habits, Somatoform Disorders diagnosis, Tics diagnosis
- Abstract
Background: We conducted a systematic review on the management of psychogenic cough, habit cough, and tic cough to update the recommendations and suggestions of the 2006 guideline on this topic., Methods: We followed the American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework. The Expert Cough Panel based their recommendations on data from the systematic review, patients' values and preferences, and the clinical context. Final grading was reached by consensus according to Delphi methodology., Results: The results of the systematic review revealed only low-quality evidence to support how to define or diagnose psychogenic or habit cough with no validated diagnostic criteria. With respect to treatment, low-quality evidence allowed the committee to only suggest therapy for children believed to have psychogenic cough. Such therapy might consist of nonpharmacologic trials of hypnosis or suggestion therapy, or combinations of reassurance, counseling, and referral to a psychologist, psychotherapy, and appropriate psychotropic medications. Based on multiple resources and contemporary psychologic, psychiatric, and neurologic criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition and tic disorder guidelines), the committee suggests that the terms psychogenic and habit cough are out of date and inaccurate., Conclusions: Compared with the 2006 CHEST Cough Guidelines, the major change in suggestions is that the terms psychogenic and habit cough be abandoned in favor of somatic cough syndrome and tic cough, respectively, even though the evidence to do so at this time is of low quality.
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- 2015
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10. Increased dietary sodium is related to severity of obstructive sleep apnea in patients with resistant hypertension and hyperaldosteronism.
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Pimenta E, Stowasser M, Gordon RD, Harding SM, Batlouni M, Zhang B, Oparil S, and Calhoun DA
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- Aldosterone urine, Blood Pressure physiology, Comorbidity, Cross-Sectional Studies, Female, Humans, Hyperaldosteronism urine, Hypertension urine, Male, Middle Aged, Polysomnography, Prevalence, Prospective Studies, Sleep Apnea, Obstructive urine, Sodium urine, Hyperaldosteronism epidemiology, Hypertension epidemiology, Severity of Illness Index, Sleep Apnea, Obstructive diagnosis, Sleep Apnea, Obstructive epidemiology, Sodium, Dietary adverse effects
- Abstract
Background: Obstructive sleep apnea (OSA) is a strong and independent risk factor for the development of hypertension, particularly resistant hypertension, and cardiovascular diseases. Patients with resistant hypertension have a high prevalence of OSA in association with elevated aldosterone levels, high salt intake, and salt-sensitive BP. The objective of this study was to determine whether dietary salt and aldosterone are associated with severity of OSA in patients with resistant hypertension., Methods: Ninety-seven patients with resistant hypertension were prospectively evaluated by overnight polysomnography and 24-h urinary sodium and aldosterone levels while maintaining their usual diet. Hyperaldosteronism was defined as a plasma renin activity of < 1 ng/mL/h and urinary aldosterone level of ≥ 12 μg/24 h., Results: Overall, patients' mean clinic BP was 156.3 ± 22.4/88.9 ± 13.3 mm Hg while taking an average of 4.3 ± 1.1 antihypertensive medications. Prevalence of OSA was 77.3%. Twenty-eight (28.9%) patients had hyperaldosteronism. Urinary sodium level was an independent predictor of severity of OSA only in patients with hyperaldosteronism., Conclusions: The findings suggest that dietary salt is related to the severity of OSA in patients with resistant hypertension and hyperaldosteronism. The results support dietary salt restriction as a treatment strategy for reduction of OSA severity in these patients.
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- 2013
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11. More pearls afoot.
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Heffner JE, Sahn SA, and Harding SM
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- Critical Care, Humans, Pulmonary Medicine, Radiography, Thoracic, Periodicals as Topic, Sleep Medicine Specialty, Sleep Wake Disorders
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- 2013
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12. Sleep and hypertension.
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Calhoun DA and Harding SM
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- Chronobiology Disorders physiopathology, Circadian Rhythm, Humans, Time Factors, Hypertension physiopathology, Sleep physiology, Sleep Wake Disorders physiopathology
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Ambulatory BP studies indicate that even small increases in BP, particularly nighttime BP levels, are associated with significant increases in cardiovascular morbidity and mortality. Accordingly, sleep-related diseases that induce increases in BP would be anticipated to substantially affect cardiovascular risk. Both sleep deprivation and insomnia have been linked to increases in incidence and prevalence of hypertension. Likewise, sleep disruption attributable to restless legs syndrome increases the likelihood of having hypertension. Observational studies demonstrate a strong correlation between the severity of obstructive sleep apnea (OSA) and the risk and severity of hypertension, whereas prospective studies of patients with OSA demonstrate a positive relationship between OSA and risk of incident hypertension. Intervention trials with continuous positive airway pressure (CPAP) indicate a modest, but inconsistent effect on BP in patients with severe OSA and a greater likelihood of benefit in patients with most CPAP adherence. Additional prospective studies are needed to reconcile observational studies suggesting that OSA is a strong risk factor for hypertension with the modest antihypertensive effects of CPAP observed in intervention studies.
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- 2010
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13. Plasma aldosterone is related to severity of obstructive sleep apnea in subjects with resistant hypertension.
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Pratt-Ubunama MN, Nishizaka MK, Boedefeld RL, Cofield SS, Harding SM, and Calhoun DA
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- Adult, Aged, Case-Control Studies, Female, Humans, Male, Middle Aged, Polysomnography, Prospective Studies, Respiratory Function Tests, Severity of Illness Index, Aldosterone blood, Hypertension blood, Hypertension complications, Sleep Apnea, Obstructive blood, Sleep Apnea, Obstructive complications
- Abstract
Objective: Obstructive sleep apnea (OSA) and primary aldosteronism are common in subjects with resistant hypertension; it is unknown, however, if the two disorders are causally related. This study relates plasma aldosterone and renin levels to OSA severity in subjects with resistant hypertension, and in those with equally severe OSA but without resistant hypertension serving as control subjects., Methods: Seventy-one consecutive subjects referred to the University of Alabama at Birmingham (UAB) for resistant hypertension (BP uncontrolled on three medications) and 29 control subjects referred to UAB Sleep Disorders Center for suspected OSA were prospectively evaluated by an early morning plasma aldosterone concentration (PAC) and renin level, and by overnight, attended polysomnography., Results: OSA (apnea-hypopnea index [AHI] > or = 5/h) was present in 85% of subjects with resistant hypertension. In these subjects, PAC correlated with AHI (rho = 0.44, p = 0.0002) but not renin concentration. Median PAC was significantly lower in control subjects compared to subjects with resistant hypertension (5.5 ng/dL vs 11.0 ng/dL, p < 0.05) and not related to AHI. In male subjects compared to female subjects with resistant hypertension, OSA was more common (90% vs 77%) and more severe (median AHI, 20.8/h vs 10.8/h; p = 0.01), and median PAC was significantly higher (12.0 ng/dL vs 8.8 ng/dL, p = 0.006)., Conclusion: OSA is extremely common in subjects with resistant hypertension. A significant correlation between PAC and OSA severity is observed in subjects with resistant hypertension but not in control subjects. While cause and effect cannot be inferred, the data suggest that aldosterone excess may contribute to OSA severity.
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- 2007
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14. Gastroesophageal reflux as an asthma trigger: acid stress.
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Harding SM
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- Gastroesophageal Reflux drug therapy, Gastroesophageal Reflux epidemiology, Humans, Prevalence, Asthma etiology, Gastroesophageal Reflux complications
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- 2004
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15. Aldosterone excretion among subjects with resistant hypertension and symptoms of sleep apnea.
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Calhoun DA, Nishizaka MK, Zaman MA, and Harding SM
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- Aldosterone blood, Female, Humans, Hyperaldosteronism complications, Hypertension complications, Hypertension drug therapy, Male, Middle Aged, Renin, Sleep Apnea, Obstructive blood, Sleep Apnea, Obstructive complications, Aldosterone urine, Hypertension urine, Sleep Apnea, Obstructive urine
- Abstract
Objective: The severity of obstructive sleep apnea (OSA) correlates with the difficulty of controlling BP. The mechanism, however, by which sleep apnea contributes to the development of resistant hypertension remains obscure. Having observed a high prevalence of OSA among hypertensive subjects with primary hyperaldosteronism, we hypothesized a possible association between sleep apnea and aldosterone excretion., Design: In consecutive subjects referred to a university clinic for resistant hypertension, we prospectively determined plasma renin activity (PRA), plasma aldosterone concentration (PAC), and 24-h urinary aldosterone excretion during high dietary salt ingestion. In addition, all subjects completed the Berlin Questionnaire, a survey designed to identify subjects at risk of having sleep apnea. Primary hyperaldosteronism (PA) was defined as a PRA < 1.0 ng/mL/h and 24-h urinary aldosterone excretion > 12 micro g during high urinary sodium excretion (> 200 mEq/24 h)., Results: Of the 114 subjects evaluated, 72 subjects had a high probability and 42 subjects had a low probability of having sleep apnea based on their responses to the Berlin Questionnaire. Subjects at high risk for sleep apnea were almost two times more likely to have PA diagnosed (36 vs 19%, p < 0.05), tended to have lower PRA (1.2 +/- 1.8 ng/mL/h vs 1.9 +/- 4.1 ng/mL/h), and had significantly greater 24-h urinary aldosterone excretion (13.6 +/- 9.6 micro g vs 9.8 +/- 7.6 micro g, p < 0.05) compared to subjects at low risk of sleep apnea., Conclusion: These data provide evidence of increased aldosterone excretion in subjects with resistant hypertension and symptoms of sleep apnea. While the causality of this association is unknown, it is hypothesized that sleep apnea contributes to the development of resistant hypertension by stimulating aldosterone excretion.
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- 2004
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16. Chronic cough: practical considerations.
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Harding SM
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- Chronic Disease, Cough etiology, Diagnostic Techniques, Digestive System, Gastroesophageal Reflux complications, Humans, Hydrogen-Ion Concentration, Cough diagnosis, Cough drug therapy, Gastroesophageal Reflux diagnosis, Gastroesophageal Reflux drug therapy, Gastrointestinal Agents therapeutic use, Proton Pump Inhibitors
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- 2003
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17. Woman with dry cough and dyspnea on exertion has clubbing, conjunctival injection, and diffuse crackles.
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Harding SM
- Subjects
- Adult, Bronchial Neoplasms diagnosis, Diagnosis, Differential, Female, Humans, Lung Diseases, Interstitial diagnosis, Occupational Diseases etiology, Pneumoconiosis etiology, Sjogren's Syndrome diagnosis, Alloys adverse effects, Cobalt adverse effects, Giant Cells pathology, Occupational Diseases pathology, Pneumoconiosis pathology, Tungsten adverse effects
- Published
- 2003
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18. Oropharyngeal dysfunction in COPD patients: the need for clinical research.
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Harding SM
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- Humans, Oropharynx physiopathology, Pulmonary Disease, Chronic Obstructive physiopathology
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- 2002
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19. Oral corticosteroids increase esophageal acid contact times in patients with stable asthma.
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Lazenby JP, Guzzo MR, Harding SM, Patterson PE, Johnson LF, and Bradley LA
- Subjects
- Adult, Cross-Over Studies, Female, Gastric Acid metabolism, Gastroesophageal Reflux chemically induced, Humans, Hydrogen-Ion Concentration, Male, Manometry, Middle Aged, Prospective Studies, Asthma drug therapy, Esophagus drug effects, Prednisone adverse effects
- Abstract
Study Objectives: The prevalence of gastroesophageal reflux disease (GERD) is higher in people with asthma than in control populations. Predisposing factors for GERD development may include asthma medications such as prednisone. The objective of this study was to determine whether prednisone alters GERD parameters in people with asthma., Design: Prospective, single-blinded, placebo-controlled, crossover study., Setting: University medical center clinic., Participants: Twenty adults with stable, moderate persistent asthma with minimal esophageal reflux symptoms (less than three times a week) who were not receiving antireflux therapy., Intervention: Prednisone, 60 mg/d, for 7 days., Measurements and Results: Asthma, esophageal reflux symptoms, and spirometry were measured during baseline, placebo, and prednisone phases, each 7 days in duration. Dual-probe esophageal pH monitoring, esophageal and respiratory manometrics (20 subjects), and basal and stimulated gastric acid secretion (4 subjects) were measured after placebo and prednisone phases. There were significant increases in esophageal acid contact times at the distal and proximal pH probes during the prednisone phase. Total percentage of time that pH was < 4.0 at the distal probe was 2.5 +/- 0.4% for placebo compared with 5.9 +/- 0.9% for prednisone (p < 0.002). Total percentage of time that pH was < 4.0 at the proximal probe was 0.3 +/- 0.1% for placebo and 0.8 +/- 0.2% for prednisone (p < 0.0007). There were no significant changes in subject weight, spirometry, asthma or esophageal reflux symptoms, manometrics, or basal or stimulated gastric acid secretion., Conclusion: Prednisone, 60 mg/d for 7 days, increased esophageal acid contact times in this small population of people with stable asthma; however, the mechanism for this finding is unclear.
- Published
- 2002
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