[Continuous positive pressure through the nose can reverse chronic hypercapnia]. / La presión positiva continua por vía nasal puede revertir la hipercapnia crónica.

Sleep apnea syndrome is a clinical entity characterized by respiratory pauses during spontaneous sleep during which desaturation exists. A reduced group of patients suffering this pathology present chronic alveolar hypoventilation. The application of continuous positive pressure through the nose (CPAPn) is an effective therapeutic measure in the treatment of sleep apnea syndrome in its obstructive form. Its long term application normalizes, in some patients with chronic alveolar hypoventilation, daytime hypercapnia. We describe two patients presenting sleep apnea syndrome in whom the application of CPAPn reverted chronic hypercapnia after three and five months of treatment respectively. We agree with other authors that such normalization can be conditioned by a better performance of inspiratory musculature after the continuous application of CPAPn, which decreases the pressure which has to be generated by respiratory muscles in order to maintain inspiratory flux.

[The effect of continuous positive-pressure via the nose (CPAPn) on the ventilatory pattern]. / Efectos de la presión positiva continua a través de la nariz (CPAPn) sobre el patrón ventilatorio.

The modifications in the ventilation pattern when a continuous positive pressure is applied through the nose (CPAPn) in an acute form or by increasing pressures is evaluated in 13 normal subjects and 8 individuals presenting obstructive sleep apnea syndrome (OSAS). No significant modifications are observed in breathing frequency or breathing time when 5 and 10 cm of H2 are applied. It is concluded that this mechanism does not seem to be involved in the disappearance of hypercapnia which occurs in some patients with OSAS.

[Diagnostic usefulness of 2-dimensional echocardiography in eosinophilic endomyocardial disease (Loeffler disease)]. / Utilidad diagnóstica de la ecocardiografía bidimensional en la enfermedad endomiocárdica eosinofílica (enfermedad de Löffler).

We present an uncommon case of idiopathic hypereosinophilic syndrome with cardiac involvement (fibroplastic parietal endocarditis --Löffler's disease--) in a 48-year-old female with congestive heart failure and hypereosinophilia. The 2-D echo findings (biventricular apical obliteration by echogenic endomyocardial proliferations with normal systolic inward motion) were the clue for the diagnosis that was hemodynamically and pathologically confirmed subsequently. We emphasize the diagnostic value of two-dimensional echocardiography in this condition and review the literature on it.