The lower airways of asymptomatic chronic obstructive pulmonary disease (COPD) patients can be colonized by bacteria, mainly Haemophilus influenza, Streptococcus pneumoniae, and Moraxella catarrhalis. However, the role of lower airway bacteria in stable and exacerbated COPD has not been well defined. To determine the importance of lower airway bacterial infection in COPD we studied 40 outpatients with stable COPD (Group A: age 61.1 +/- 9.9 yr; [mean +/- SD]; FEV1/FVC 51.7 +/- 12.5) and 29 outpatients with exacerbated COPD (Group B: age 63.4, SD 9.0 yr; FEV1/FVC 52.0, SD 9.6), using the protected specimen brush (PSB) for microbiology sampling. Group A consisted of outpatients with stable COPD having normal or near-normal chest X-rays, with clinical indications for performing fiber-bronchoscopy (pulmonary nodule, remote hemoptysis); Group B consisted of patients with exacerbated COPD who voluntarily accepted lower airway microbiology sampling. To avoid contamination by upper airway flora the PSB was used for bacterial sampling in all the cases and concentrations > or = 1,000 colony-forming units/milliliter (CFU/ml) were considered positive. Results were as follows: Group A: Lung function data in outpatients with stable COPD were lower than the reference values for this population (FVC 2.97 +/- 1.02 L, FVC% 71.4 +/- 22.4, FEV1 1.59 +/- 0.79 L, FEV1% 51.2 +/- 23.0). Positive PSB cultures were obtained in 10 of 40 cases (25%), mainly of H. influenzae and S. pneumoniae. Two of 40 cases had positive cultures at concentrations > or = 10,000 CFU/ml (5.0%).(ABSTRACT TRUNCATED AT 250 WORDS)

A Ac co ou us st ti ic c a an na al ly ys si is s o of f s sn no or ri in ng g s so ou un nd d i in n p pa at ti ie en nt ts s w wi it th h s si im mp pl le e s sn no or r-Spectral analysis of snoring sound showed the existence of two different patterns. The first pattern was characterized by the presence of a fundamental frequency and several harmonics. The second pattern was characterized by a low frequency peak with the sound energy scattered on a narrower band of frequencies, but without clearly identified harmonics. The seven simple snorers and two of the 10 patients with OSA (AIH 13 and 14 events·h -1 , respectively) showed the first pattern. The rest of the OSA patients showed the second pattern. The peak frequency of snoring was significantly lower in OSA patients, with all but one OSA patient and only one simple snorer showing a peak frequency below 150 Hz A significant negative correlation was found between AHI and peak and mean frequencies of the snoring power spectrum (p<0.0016 and p<0.0089, respectively).In conclusion, this study demonstrates significant differences in the sound power spectrum of snoring sound between subjects with simple snoring and obstructive sleep apnoea patients.

background: Optimization of the indications for nocturnal polysomnography in the diagnosis of obstructive sleep apnea syndrome (OSAS) could lead to significant reductions in health expenditure. To this end, we assessed the usefulness of truncal obesity measurements in the diagnosis of OSAS. Methods and Procedures: One hundred ninety-two patients (152 men and 40 women) referred to our clinic with suspected OSAS underwent a complete polysomnography study and their BMI and truncal obesity measurements were obtained. Results:Comparison of patients defined as snorers with OSAS patients, by means of the Student's t-test revealed significant differences in the truncal obesity parameters such as waist-to-hip ratio (0.94 vs. 0.98) and waist circumference (100.7 cm vs. 106.3 cm). We found no significant differences between BMI values in the two groups. Indices of truncal obesity were analyzed as predictive factors for OSAS using a multivariate logistic regression model that included variable sex, and in which waist-to-hip ratio, BMI, neck circumference, and age were analyzed as binary variables. According to this model, our patients' risk of suffering from OSAS was 2.6 times greater if the waist-to-hip ratio was >1 in men and >0.85 in women. The risk of OSAS was also increased if the patients were men or over 52 years of age. Discussion: Obtaining simple measurements such as those for truncal obesity may help prioritize the use of polysomnography in patients with a greater risk of OSAS. Our results suggest that BMI is not a good predictor of OSAS in a group of patients with a high BMI.

A new system for automatic monitoring and analysis of snores during the night is presented. Sound intensity and several snore frequency parameters allow differentiation of snorers according to obstructive sleep apnea syndrome severity (OSAS). Automatic snore intensity and frequency monitoring and analysis could be a promising tool for screening OSAS patients, significantly improving the managing of this pathology.