Crossectional Study on the Performance of Screening Questionnaires for Prediction of Moderate to Severe Obstructive Sleep Apnea in Women.

Introduction The clinical manifestations of obstructive sleep apnea (OSA) are different between genders. Though there are several screening questionnaires for OSA, their performance in females is not fully understood, as women have been historically underrepresented in research studies. Objective To assess the performance of screening questionnaires and their capacity to identify a moderate to severe apnea-hypopnea index (AHI) in women. Materials and Methods The Epworth sleep scale (ESS), Berlin questionnaire, and STOP-BANG questionnaire (SBQ) were correlated with AHI. Also, the sensitivity (S), specificity (Sp), and area under the receiver operating characteristic (AUC-ROC) curve were calculated for each questionnaire and combinations thereof. Multiple regression models were used to identify ≥15 ev/h AHI. Results Our study included 5,344 patients: 1978 women (37.1%) aged 55.06 ± 14 years with body mass index (BMI): 32.6 ± 8.30 kg/m 2 , ESS: 7.69 ± 5.2 points, and high-risk Berlin score: 87.25%. An AHI ≥15 ev/h was found in 30.4% of women. In terms of the capacity to identify an ≥15 ev/h AHI in women, the AUC-ROC of ESS >10 and high-risk Berlin was 0.53 and 0.58, respectively. Three components of SBQ in any combination showed: a S of 65.1% (95% CI: 61.2-68.9), a Sp: 61.5% (95% CI: 58.9-64.1), with the AUC-ROC: 0.67. Conclusions Questionnaires perform differently in women. Therefore, it is necessary to take a gender-specific approach. The SBQ showed a higher discriminative power and more specificity than the ESS and the Berlin questionnaire. The best performance was obtained with any combination of 3 SBQ components. Age, BMI, neck circumference, and hypertension were the strongest predictors.

[Stiff person syndrome associated with thymoma]. / Síndrome de la persona rígida asociado a timoma.

Stiff-person syndrome is a rare neurological condition characterized by muscular rigidity of the trunk and extremities and muscle spasms triggered by sensory or emotional stimuli, which progresses towards prostration. It has a pathophysiogenic mechanism with an immunological basis, in which autoantibodies, such as antiGAD65, play a central role. Likewise, the detection of these antibodies corroborates the diagnosis in a patient with a suggestive clinical picture. Four to 6% of cases have underlying neoplasms. Treatment is based on symptomatic, immunomodulatory, and underlying disease management in paraneoplastic cases. We report a case of classic stiff person syndrome associated with thymoma and review the main characteristics of this entity.

El síndrome de persona rígida es un cuadro neurológico infrecuente caracterizado por rigidez muscular de tronco y extremidades y espasmos musculares gatillados por estímulos sensoriales o emocionales, que progresa hacia la postración. Cuenta con un mecanismo fisiopatogénico con base inmunológica, en el cual los autoanticuerpos, como el antiGAD65, cumplen un rol central. Asimismo, la detección de dichos anticuerpos corrobora el diagnóstico ante un paciente con cuadro clínico sugestivo. Un 4 a 6% de los casos tienen neoplasias subyacentes. El tratamiento se basa en el manejo sintomático, inmunomodulador y de la enfermedad de base en los casos paraneoplásicos. Reportamos un caso de síndrome de persona rígida clásico asociado a timoma y describimos las características principales de esta entidad.

Síndrome de la persona rígida asociado a timoma / Stiff person syndrome associated with thymoma

Resumen El síndrome de persona rígida es un cuadro neuro lógico infrecuente caracterizado por rigidez muscular de tronco y extremidades y espasmos musculares ga tillados por estímulos sensoriales o emocionales, que progresa hacia la postración. Cuenta con un mecanismo fisiopatogénico con base inmunológica, en el cual los autoanticuerpos, como el antiGAD65, cumplen un rol central. Asimismo, la detección de dichos anticuerpos corrobora el diagnóstico ante un paciente con cuadro clínico sugestivo. Un 4 a 6% de los casos tienen neoplasias subyacentes. El tratamiento se basa en el manejo sintomático, inmunomodulador y de la enfermedad de base en los casos paraneoplásicos. Reportamos un caso de síndrome de persona rígida clásico asociado a timoma y describimos las características principales de esta entidad.

Abstract Stiff-person syndrome is a rare neurological condi tion characterized by muscular rigidity of the trunk and extremities and muscle spasms triggered by sensory or emotional stimuli, which progresses towards prostra tion. It has a pathophysiogenic mechanism with an immunological basis, in which autoantibodies, such as antiGAD65, play a central role. Likewise, the detec tion of these antibodies corroborates the diagnosis in a patient with a suggestive clinical picture. Four to 6% of cases have underlying neoplasms. Treatment is based on symptomatic, immunomodulatory, and underlying disease management in paraneoplastic cases. We re port a case of classic stiff person syndrome associated with thymoma and review the main characteristics of this entity.