Nocturnal parasympathetic modulation of heart rate in obesity-hypoventilation patients.

Heart rate variation (HRV) reflects the activity of the autonomic nervous system. The aim of the study was to analyze HRV in obstructive sleep apnea (OSA) and obesity hypoventilation (OH) patients to answer the question of whether chronic alveolar hypoventilation influences autonomic heart rate regulation. In 41 patients, diagnosed with either 'pure' OSA (n=23, apnea/hypopnea index--AHI: 43.8±18.0 PaCO2≤45 mmHg) or OH syndrome (n=18, AHI 58.7±38.0 PaCO2>46 mmHg), the HRV was analyzed, based on an 8 h ECG recording during sleep. In the OH patients, compared with the OSA patients, there was a globally decreased HRV, with a corresponding decrease in high frequency power in the spectral analysis of HRV and increased low frequency/high frequency ratio (p<0.05), indicating a reduced parasympathetic and increased sympathetic heart rate modulation. We conclude that hypoxemia and hypercapnia of the sleep disordered breathing have an impact on the autonomic heart rate regulation. HRV indices have a potential to become prognostic factors for the development of cardiovascular complications in patients with sleep disordered breathing.

Primary pulmonary MALT lymphoma - case report and literature overview.

OBJECTIVE: Primary pulmonary lymphomas (PPL) are rarely taken into consideration in the differential diagnosis of lung lesions. The aim of this report is to characterize the symptoms, diagnosis and treatment of primary MALT lymphoma of the lung. CASE REPORT: We present the case of a 48-year-old man who was admitted to hospital with a history of coughing, fever, fatigue and non-specific lesions on his chest X-ray. RESULTS: The patient was treated for pneumonia, but showed no improvement. A computer tomography revealed atypical lesions. After an initial examination and tests, no diagnosis could be established. A thoracotomy with an open lung biopsy was performed and MALT lymphoma was finally diagnosed. The patient underwent chemotherapy and showed a significant improvement. CONCLUSIONS: Primary MALT lymphoma is a rare disease and its diagnosis is difficult. There is no non-invasive test that is specific enough, so a proper diagnosis can only be established by a histopathological examination. The disease has a slow and mild course and the response to treatment is satisfactory.