The effect of obstructive sleep apnea (OSA) on clinical outcomes after acute coronary syndrome (ACS) is incompletely defined. We sought to determine the prevalence of OSA in patients with ACS and ...evaluate prognostic impact of OSA and continuous positive airway pressure (CPAP) therapy in these patients. This was a prospective longitudinal cohort study of 73 patients admitted on cardiac intensive care unit for ACS. Cardiorespiratory sleep study and/or polysomnography were performed in all patients. CPAP was recommended if Apnea–Hypopnea Index ≥5. The main study outcome was a composite of death for any cause, myocardial infarction, and myocardial revascularization. OSA was diagnosed in 46 patients (63%). Age and cardiovascular risk factors were not significantly different between groups. OSA was classified as mild (m-OSA) in 14 patients (30%) and as moderate-to-severe (s-OSA) in 32 patients (70%). After a median follow-up of 75 months (interquartile range 71 to 79), patients with s-OSA had lower event-free survival rate. After adjustment for gender, patients with s-OSA showed a significantly higher incidence of the composite end point (hazard ratio 3.58, 95% CI 1.09 to 17.73, p = 0.035). Adherence to CPAP occurred in 19 patients (41%), but compliance to CPAP therapy did not reduce the risk of composite end point (hazard ratio 0.87, 95% CI 0.31 to 2.46, p = 0.798). In conclusion, OSA is an underdiagnosed disease with high prevalence in patients with ACS. It is urgent to establish screening protocols because those have high diagnostic yield and allow identifying a group of patients with manifestly unfavorable prognosis.
Syngamoniasis in tourist da Costa, Jose C; Delgado, M L; Vieira, Paulo ...
Emerging infectious diseases,
12/2005, Letnik:
11, Številka:
12
Journal Article
A aspiração de corpos estranhos é uma entidade frequente em crianças, mas rara em adultos. Os autores apresentam o caso de um adulto de 57 anos, sem comprometimento neurológico, que aspirou um ...caracol-das-vinhas (Helix pomatia) durante uma refeição.Foreign-body aspiration is a frequent occurrence in children, but much less common in adults. The authors present a case report of a 57 year old adult, without any neurological disease, who aspirated a snail (Helix pomatia) during a meal.
A aspiração de corpos estranhos é uma entidade frequente em crianças, mas rara em adultos. Os autores apresentam o caso de um adulto de 57 anos, sem comprometimento neurológico, que aspirou um ...caracoldas-vinhas (Helix pomatia) durante uma refeição.
Rev Port Pneumol 2008; XIV (3): 415-419
Foreign-body aspiration is a frequent occurrence in children, but much less common in adults. The authors present a case report of a 57 year old adult, without any neurological disease, who aspirated a snail (Helix pomatia) during a meal.
Rev Port Pneumol 2008; XIV (3): 415-419
Immunocytoma IgA. Case report Conde, Bebiana; Fernandes, Ana; Cunha, Manuel ...
Revista portuguesa de pneumologia,
2009 Jan-Feb, 20090101, Letnik:
15, Številka:
1
Journal Article
Immunocytoma is a non-Hodgkin's indolent evolution B cell lymphoma. It accounts for approximately 1-3% of non-Hodgkin's limphomas and usually onsets in adults aged over 50 years old. It manifests as ...lymphadenopathy, splenomegaly, hepatomegaly and lymphcytosis in 15 -30% of cases and is rarely seen with pulmonary involvement. Monocloncal peaks of serum immunoglobulin often occur. These are IgM and rarely IgA. We present as an example a male patient aged 52 years old, with recurrent respiratory infections. Clinical work -up identified an immunocytoma IgA stage IV. Diagnosing an indolent lymphoma, we prophylactic polyspecific human immunoglobulin to treat the respiratory infection. Evidence of lymphoma progression leads us to prescribe combined cyclo- phosphamide (C), vincristine (V), prednisone (P) e rituximab (R) (CVP-R), which has obtained a partial response over two years.
O imunocitoma é um linfoma não Hodgkin (LNH)de células B, com evolução habitualmente indolente. Representa aproximadamente 1 -3% dos LNH e atinge habitualmente adultos com mais de 50 anos, podendo ...manifestar-se por adenomegalias, hepatomegalia, esplenomegalia e linfocitose em 15 a 30% dos casos. Raramente tem envolvimento pulmonar. Com frequência ocorrendo picos monoclonais de imunoglobulinas, sericos, frequentemente IgM e raramente IgA. Como exemplo desta patologia apresentamos o caso clinico de um doente do sexo masculino, 52 anos, com clinica de infecções respiratórias bacterianas de repetição, com necessidade de internamentos sucessivos, cuja investigação identificou um imunocitoma IgA, estádio IV. Assumindo-se o diagnóstico de um linfoma indolente, decidiu-se iniciar terapêutica profiláctica com imunoglobulinas humanas poliespecÍficas, tendo havido diminuição das infecçoes respiratórias. Posteriormente, a evidência de progressão do linfoma condicionou o inicio de poliquimioterapia, com o esquema ciclofosfamida, vincristina, prednisolona (CVP) e rituximabR, tendo-se alcançado uma resposta parcial, que se manteve durante dois anos.Immunocytoma is a non-Hodgkin’s indolent evolution B cell lymphoma. It accounts for approximately 1-3% of non-Hodgkin's limphomas and usually onsets in adults aged over 50 years old. It manifests as lymphadenopathy, splenomegaly, hepatomegaly and lymphcytosis in 15 -30% of cases and is rarely seen with pulmonary involvement. Monocloncal peaks of serum immunoglobulin often occur. These are IgM and rarely IgA. We present as an example a male patient aged 52 years old, with recurrent respiratory infections. Clinical work -up identified an immunocytoma IgA stage IV. Diagnosing an indolent lymphoma, we prophylactic polyspecific human immunoglobulin to treat the respiratory infection. Evidence of lymphoma progression leads us to prescribe combined cyclophosphamide (C), vincristine (V), prednisone (P) e rituximab (R) (CVP-R), which has obtained a partial response over two years.
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