STOP-BANG QUESTIONNAIRE - AN EASY TOOL FOR IDENTIFYING OBSTRUCTIVE SLEEP APNEA SYNDROME IN PATIENTS WITH TYPE 2 DIABETES MELLITUS.

Background: Patients with type 2 diabetes mellitus (T2DM) have a higher risk of developing obstructive sleep apnea (OSA) compared to the general population. Our study aims to analyze the usefulness of the STOP-BANG score, tool which was not yet validated in patients with diabetets, as a tool that estimates the severity of OSA, in patients with T2DM. Methods: 120 patients, who answered the STOP-BANG questionnaire and underwent polysomnography, were included in the study. The patients were divided into 3 groups, depending on the severity of OSA, defined by the apnea/hypopnea index (AHI). Results: A significant percentage of participants (42.1%) had a severe form of OSA (AHI ≥30) and a high percentage of subjects had a STOP-BANG score ≥5 (58.7%), equivalent to a severe form of the disease. The STOP-BANG score increased proportionally with AHI (p<0.001). The area under the ROC curve for the STOP-Bang score indicated an optimal cut-off value of 4.5, with a sensitivity of 88.2% and a specificity of 62.9% (p <0.001), STOP-BANG score ≥5 being an independent predictor for severe OSA in patients with T2DM. Conclusions: The STOP-BANG score can be used in patients with diabetes to detect severe OSA in order to establish appropriate therapeutic measures.

Study of Pulmonary Hypertension in Patients Suffering from Chronic Obstructive Pulmonary Disease.

Pulmonary hypertension (PAH) represents a frequent complication in patients suffering from chronic obstructive pulmonary disease (COPD), but the impact of accelerated inflammatory status on the pulmonary vascular bed is still insufficiently studied. OBJECTIVES: The study of the PAH's prevalence in patients suffering from COPD, its severity compared with lung function and the correlation with certain clinical, biological and functional parameters. MATERIAL AND METHOD: The study was performed on a group of 64 patients, average age 53 years, 42 of whom were men (65,62%), suffering from COPD who were admitted to the Emergency County Hospital Craiova, on the II-nd Medical Clinic, within a period of 18 months. When assessing the patients their clinical state was stable, without acute exacerbations items. The control group included 61 patients suffering from other diseases without inflammatory background, who were hospitalized in clinic in the same period. All the patients included in the study were evaluated by: physical examination, thoracic radiological examination, spirometry, inflammatory syndrome, echocardiography Doppler and oximetry. RESULTS: The results of the study show a prevalence of 54.6 % PAH and a statistically significant impact of age, duration of the disease, Sa O2, inflammatory status, which was quantified in the study by ESR, serum levels of CRP and serum level of TNF alpha over the risk of developing COPD in patients suffering from PAH. CONCLUSIONS: The occurrence and the severity of PAH in patients suffering from COPD seems to be correlated with their age, duration of the disease, Sa O2 and serum levels of inflammatory markers.

Study of the Etiological Spectrum of Spontaneous Bacterial Peritonitis in a Group of Patients Suffering from Liver Cirrhosis.

INTRODUCTION: Spontaneous bacterial peritonitis (SBP) represents the most severe and common infectious complication in patients suffering from liver cirrhosis. The objectives of the study were the evaluation of the risk factors responsible for the occurrence of the spontaneous bacterial peritonitis in a group of patients suffering from liver cirrhosis, the identification of the bacterial spectrum and assessing the response to antibiotic therapy. Material and method - The studied group included 64 patients suffering from liver cirrhosis, with an episode of SBP, who were admitted to the IInd Medical Clinic of the County Hospital of Craiova, within a period of 24 months. The control group included 61 patients with liver cirrhosis with an episode of decompensation of liver disease. The diagnosis of liver cirrhosis was established by using clinical, biological and imagistic criteria, and the SBP's diagnosis was based on cytological and bacteriological analysis of the ascites fluid. Patients suffering from hepatocellular carcinoma, portal vein thrombosis and other infectious conditions were excluded. The anamnesis, the duration of the disease, the alcohol intake, the complete clinical examination, the clinical, biological and imagistic evaluation were monitored. Results and conclusions - The most frequent etiology of SBP is represented in 67% of the cases by Gram negative germs, and thus, the antibiotic therapy will be orientated against this etiological segment. In what antibiotic sensitivity is concerned, most of the germs were sensitive to third generation cephalosporins, quinolones, carbapenems and vancomycin.