Showing papers by "Michael H. Silber published in 2016"

Autoimmune sleep disorders.

Abstract: A number of autoantibodies, some paraneoplastic, are associated with sleep disorders. Morvan syndrome and limbic encephalitis, associated with voltage-gated potassium channel-complex antibodies, principally against CASPR2 and LGI1, can result in profound insomnia and rapid eye movement sleep behavior disorder (RBD). Patients with aquaporin-4 antibodies and neuromyelitis optica may develop narcolepsy in association with other evidence of hypothalamic dysfunction, sometimes as the initial presentation. Central sleep apnea and central neurogenic hypoventilation are found in patients with anti-N-methyl-d-aspartate receptor antibody encephalitis, and obstructive sleep apnea, stridor, and hypoventilation are prominent features of a novel tauopathy associated with IgLON5 antibodies. In addition, paraneoplastic diseases may involve the hypothalamus and cause sleep disorders, particularly narcolepsy and RBD in those with Ma1 and Ma2 antibodies. Patients with antineuronal nuclear autoantibodies type 2 may develop stridor. Several lines of evidence suggest that narcolepsy is an autoimmune disorder. There is a strong relationship with the human leukocyte antigen (HLA) DQB1*06:02 haplotype and polymorphisms in the T-cell receptor alpha locus and purinergic receptor P2Y11 genes. Patients with recent-onset narcolepsy may have high titers of antistreptococcal or other antibodies, although none has yet been shown to be disease-specific but, supporting an immune basis, recent evidence indicates that narcolepsy in children can be precipitated by one type of vaccination against the 2009-2010 H1N1 influenza pandemic.

Examining the Frequency of Stimulant Misuse among Patients with Primary Disorders of Hypersomnolence: A Retrospective Cohort Study.

Abstract: Study Objectives:Narcolepsy and idiopathic hypersomnia are commonly treated by sleep specialists and encountered by other medical providers Although pharmacotherapy with modafinil and traditional

Blended Learning: Transformation of Phlebotomy Education at Mayo Clinic

Abstract: Blended learning, a combination of online and face-to-face classroom experiences, is of particular interest in health sciences education. Mayo School of Health Sciences, one of the five schools within the Mayo Clinic College of Medicine, assessed the use of blended learning across three allied health education programs: clinical neurophysiology, histology, and phlebotomy. The process involved analysis of the individual programs and the establishment of a philosophy to underpin the use of blended learning within the school. To evaluate the results of the redesigned blended phlebotomy program that was implemented in September 2012, we collected data on resource use, program accessibility, student performance, and student satisfaction. The results showed that the blended learning environment enhanced the overall course framework, by providing greater accessibility (geographically and temporally), and improved efficiency in the use of faculty, classroom and laboratory space; while maintaining strong student performance. Although student satisfaction decreased initially, program adjustments resulted in subsequent student cohorts reporting high satisfaction. We showed the utility of blended learning being adopted in health sciences programs traditionally delivered face-to-face and the value of technology used effectively in teaching and learning. ABBREVIATIONS:MSHS - Mayo School of Health Sciences, NAACLS - National Accrediting Agency for Clinical Laboratory Sciences