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Femenino , Adulto , Humanos , Warfarina/efectos adversos , Metrorragia/inducido químicamente , Anticoagulantes/efectos adversos , Factores de Coagulación Sanguínea/efectos adversos , Vitamina K/antagonistas & inhibidoresAsunto(s)
Anticoagulantes/efectos adversos , Factores de Coagulación Sanguínea/uso terapéutico , Metrorragia/tratamiento farmacológico , Warfarina/efectos adversos , Acetazolamida/administración & dosificación , Acetazolamida/uso terapéutico , Adulto , Anticoagulantes/administración & dosificación , Anticoagulantes/uso terapéutico , Síndrome de Behçet/sangre , Síndrome de Behçet/complicaciones , Trastornos de la Conciencia/etiología , Sinergismo Farmacológico , Femenino , Glaucoma de Ángulo Cerrado/complicaciones , Glaucoma de Ángulo Cerrado/tratamiento farmacológico , Humanos , Ibuprofeno/administración & dosificación , Ibuprofeno/efectos adversos , Relación Normalizada Internacional , Inhibidor de Coagulación del Lupus/análisis , Metrorragia/inducido químicamente , Metrorragia/complicaciones , Trombofilia/sangre , Trombofilia/tratamiento farmacológico , Trombofilia/etiología , Trombofilia/fisiopatología , Warfarina/administración & dosificación , Warfarina/uso terapéuticoRESUMEN
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Asunto(s)
Femenino , Adulto , Humanos , Obesidad Mórbida/complicaciones , Respiración con Presión Positiva , Trastornos Puerperales/terapia , Edema Pulmonar/terapia , Trastornos Puerperales/complicaciones , Edema Pulmonar/complicacionesAsunto(s)
Adenocarcinoma/patología , Neoplasias Pulmonares/patología , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/terapia , Adulto , Broncoscopía , Resultado Fatal , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/terapia , Masculino , Tomografía Computarizada por Rayos XRESUMEN
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Asunto(s)
Adulto , Humanos , Masculino , Femenino , Broncoscopía , Quimioterapia Combinada , Terapia Antirretroviral Altamente Activa , Adenocarcinoma , Fármacos Anti-VIH , Resultado Fatal , Infecciones por VIH , Tomografía Computarizada por Rayos X , Lipodistrofia , Terapia Antirretroviral Altamente Activa , Neoplasias PulmonaresRESUMEN
This study was conducted to determine the influence of puberty on features of sleep-disordered breathing (SDB) in adolescents. The study was performed in a general population sample of 226 adolescents of both sexes (aged 11-19 yrs) recruited from the secondary school population of the city of Seville, Spain. Subjects were divided into two groups: 1) postpubertal, i.e. females who had undergone menarche and males in whom axillary hair development or peak height velocity had occurred > 1 yr before the study; and 2) peripubertal, i.e. females who had not undergone menarche and males who had not developed axillary hair nor reached peak height velocity, or subjects in whom these pubertal changes had appeared < 1 yr before the study. All subjects answered a questionnaire on SDB and underwent overnight cardiorespiratory polygraphy. There were 50 males and 40 females (mean +/- SD age 13.5 +/- 1.2 yrs) in the peripubertal group, and 54 males and 82 females (age 16.3 +/- 1.7 yrs) in the postpubertal group. Males exhibited significantly higher neck circumference/height index and waist/hip index than females in both the peripubertal and postpubertal groups. In the postpubertal group, snoring and polygraphic alterations (respiratory events and oximetric parameters) were significantly more frequent in males than in females. Postpubertal adolescents showed sex differences in clinical and polygraphic parameters that were not observed at earlier pubertal stages. These findings support the influence of sex hormones on sex differences in sleep-disordered breathing.
Asunto(s)
Síndromes de la Apnea del Sueño/epidemiología , Población Urbana/estadística & datos numéricos , Adolescente , Factores de Edad , Niño , Estudios Transversales , Trastornos de Somnolencia Excesiva/epidemiología , Trastornos de Somnolencia Excesiva/etiología , Femenino , Humanos , Incidencia , Masculino , Polisomnografía , Pubertad/fisiología , Factores Sexuales , Síndromes de la Apnea del Sueño/etiología , Ronquido/epidemiología , Ronquido/etiología , España/epidemiologíaRESUMEN
STUDY OBJECTIVES: To determine the frequency, symptoms, and polygraphic features of sleep-related breathing disorders (SRBD) in adolescents aged 12 to 16 years. DESIGN: Cross-sectional study. SETTING: Randomly selected secondary schools in the city of Seville, SPAIN: PARTICIPANTS: A general population sample of adolescents (n = 101; mean [+/- SD] age, 13.2 +/- 0.8 years). INTERVENTIONS: An 82-item questionnaire regarding anthropometric data and nocturnal and daytime symptoms suggestive of SRBD was administered. Symptoms were evaluated according to a 4-point frequency scale. Snorers answered "sometimes" or "often" in the question about snoring, and nonsnorers answered "never" or "rarely." All subjects underwent an overnight cardiorespiratory polygraphy at home. RESULTS: Twenty-nine percent of the subjects were snorers. Excessive daytime sleepiness was present in 14% of subjects, and sleep apnea was present in 3%. Polygraphy showed a respiratory disturbance index > or = 10 in 18 subjects (17.8%), but concurrent symptoms highly suggestive of SRBD were found in only 2 subjects (1.9%). Snorers had higher waist-to-hip ratios and a higher frequency of witnessed apnea or labored breathing as well as higher values of respiratory events as compared with nonsnorers. However, oximetry data were similar in both groups. CONCLUSIONS: In a nonselected group of adolescents aged 12 to 16 years, the frequency of symptoms potentially associated with SRBD was similar to that reported for younger children. Snoring was associated with a higher occurrence of other nocturnal symptoms, a more central pattern of body fat distribution, and a higher respiratory disturbance index as compared with nonsnorers. Although polygraphic abnormalities were mild, two cases of probable SRBD were found with a prevalence rate of 1.9%.
Asunto(s)
Síndromes de la Apnea del Sueño/diagnóstico , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Síndromes de la Apnea del Sueño/epidemiología , Síndromes de la Apnea del Sueño/fisiopatología , Encuestas y CuestionariosRESUMEN
UNLABELLED: Daytime sleepiness is an important symptom in obstructive sleep apnea syndrome. The Epworth sleepiness scale gives a subjective estimate of the level of sleepiness by asking the patient to estimate the probability of falling asleep during each of eight activities of daily living. OBJECTIVE: We aimed to see whether patients suspected of sleep apnea and their partners or other living companions assessed daytime sleepiness differently. MATERIAL AND METHOD: One hundred fifty-nine consecutive patients referred for suspicion of sleep respiratory disorder were studied. Patients and their partners assessed sleepiness separately using the Epworth scale. RESULTS: One hundred forty subjects were men and 19 were women. The mean global Epworth score provided by the patients was significantly lower than that of their companions (10 +/- 0.37 versus 11 +/- 0.42; p < 0.001). However, the two were closely correlated (rho = 0.79). CONCLUSION: Our results indicate that living companions' subjective Epworth scale assessment of sleepiness is greater than is that of patients themselves.
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Trastornos de Somnolencia Excesiva/diagnóstico , Trastornos de Somnolencia Excesiva/etiología , Apnea Obstructiva del Sueño/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , EspososRESUMEN
Pulmonary arteriovenous fistula in a 63-year-old woman with no relevant medical history presented with neurological symptoms secondary to multiple polymicrobial abscesses. As a result of this finding, relatives were examined under suspicion of the presence of systemic angiomatosis (hemorrhagic hereditary telangiectasia or Rendu-Osler-Weber disease), which is asymptomatic in many victims. Follow-up and early diagnosis is crucial to preventing severe neurological complications by treatment of arteriovenous malformations and antibiotic prophylaxis during dental or other invasive procedures.
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Fístula Arteriovenosa/complicaciones , Absceso Encefálico/etiología , Fístula Arteriovenosa/genética , Absceso Encefálico/microbiología , Salud de la Familia , Femenino , Humanos , Persona de Mediana Edad , Telangiectasia Hemorrágica Hereditaria/diagnósticoAsunto(s)
Corticoesteroides/efectos adversos , Agonistas Adrenérgicos beta/efectos adversos , Asma/complicaciones , Complicaciones del Embarazo/tratamiento farmacológico , Edema Pulmonar/inducido químicamente , Ritodrina/efectos adversos , Enfermedad Aguda , Adulto , Asma/tratamiento farmacológico , Quimioterapia Combinada , Femenino , Muerte Fetal/inducido químicamente , Humanos , Embarazo , Tercer Trimestre del Embarazo , GemelosRESUMEN
We aimed to study whether the presence of obstructive sleep apnea syndrome (OSAS) in patients with chronic obstructive pulmonary disease (COPD) led to differences in clinical picture, gas exchange during awake and sleep states and mechanical ventilation, in comparison with patients with COPD alone. We enrolled 48 COPD patients. In 26 (54.1%), OSAS was ruled out (non-OSAS COPD group) by polysomnography, and in 22 (45.8%) associated OSAS was diagnosed (OSAS COPD group). Patients in the OSAS COPD group experienced greater daytime sleepiness and less dyspnea. Body mass index was not significantly difference. The OSAS COPD group had significantly lower daytime PaO2 (66.4 +/- 10.4 mmHg in the OSAS COPD group and 75.5 +/- 11.2 mmHg in the non-OSAS COPD group; p = 0.01); there were no differences in PaCO2.Pimax in the OSAS-COPD group was 70.6 +/- 23.8 cmH2O, a level that was significantly lower than in the non-OSAS COPD group (Pimax 90.5 +/- 26.1 cmH2O; p = 0.04). Patients in the non-OSAS COPD group experienced longer periods of REM sleep. Nighttime saturation parameters were significantly different in the group with OSAS. We conclude that patients with both OSAS and COPD experience greater oximetric changes than those without OSAS, during both sleep and awake states. The deterioration of respiratory muscle pressures in such patients may play an important role in the changes. The groups also present differences in the intensity of some symptoms, such as degree of daytime sleepiness and dyspnea.