CONTEXT: Renal artery pseudoaneurysm is a rare complication after renal injury but should be suspected whenever there is recurrent hematuria after renal trauma. CASE REPORTS: We present three cases of pseudoaneurysm after blunt renal trauma and a review of the literature. All patients underwent renal angiography. Two cases were diagnosed during the initial hospital stay due to hematuria, or in the follow-up period during recovery. One patient was hemodynamically unstable. Two patients successfully underwent coil embolization in a single session. In the other case, selective embolization was attempted, but was unsuccessful because artery catheterization was impossible. Procedural and medical success and complications were retrospectively assessed from the patients' records. The clinical presentation, treatment options and clinical decisions are discussed. CONCLUSIONS: Renal artery pseudoaneurysm may develop acutely or even years after the initial injury. Signs and symptoms may have a wide spectrum of presentation. Selective angiographic embolization is an effective treatment that reduces the extent of parenchymal infarction.RESUMO CONTEXTO: Pseudoaneurisma de artéria renal é uma complicação rara após lesão renal, mas deve ser suspeitada quando houver hematúria recorrente após trauma renal. RELATO DE CASOS: Três casos de pseudoaneurisma após trauma renal fechado são apresentados, além de revisão da literatura. Todos os pacientes foram submetidos a angiografia renal. Dois dos casos foram diagnosticados durante a estadia hospitalar inicial, por hematúria ou no período de acompanhamento durante a recuperação. Um paciente estava hemodinamicamente instável. Dois pacientes foram submetidos a embolização com coil com sucesso em uma única sessão. No outro caso, a embolização seletiva foi tentada sem sucesso, devido à impossibilidade de cateterização da artéria. O sucesso médico e do procedimento e as complicações foram retrospectivamente avaliados a partir dos registros dos pacientes. A apresentação clínica, opções de tratamento e decisões clínicas são discutidas. CONCLUSÕES: Pseudoaneurisma de artéria renal pode se desenvolver agudamente ou até mesmo anos após o trauma inicial. Sinais e sintomas podem ter um amplo espectro de apresentação. Embolização angiográfica seletiva é um tratamento efetivo, reduzindo a extensão de infarto parenquimatoso.
Sleep apnea–hypopnea syndrome (SAHS) is a serious sleep disorder, and snoring is one of its earliest and most consistent symptoms. We propose a new methodology for identifying two distinct types of snores: the so-called non-regular and regular snores. Respiratory sound signals from 34 subjects with different ranges of Apnea-Hypopnea Index (AHI = 3.7–109.9 h−1) were acquired. A total number of 74,439 snores were examined. The time interval between regular snores in short segments of the all night recordings was analyzed. Severe SAHS subjects show a shorter time interval between regular snores (p = 0.0036, AHI cp: 30 h−1) and less dispersion on the time interval features during all sleep. Conversely, lower intra-segment variability (p = 0.006, AHI cp: 30 h−1) is seen for less severe SAHS subjects. Features derived from the analysis of time interval between regular snores achieved classification accuracies of 88.2 % (with 90 % sensitivity, 75 % specificity) and 94.1 % (with 94.4 % sensitivity, 93.8 % specificity) for AHI cut-points of severity of 5 and 30 h−1, respectively. The features proved to be reliable predictors of the subjects’ SAHS severity. Our proposed method, the analysis of time interval between snores, provides promising results and puts forward a valuable aid for the early screening of subjects suspected of having SAHS.
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