BackgroundBoth obstructive sleep apnea syndrome (OSAS) and coronary artery calcification (CAC) are considered to be related with the presence of coronary artery disease (CAD). In this study we evaluate the association between OSAS and presence of subclinical atherosclerosis assessed by tomographic coronary calcium score in patients who had OSAS but no history of known CAD.MethodsSeventy-three patients who were asymptomatic for CAD and had suspected OSAS were referred to overnight attended polysomnography. Patients were classified into 4 groups according to the Apnea-Hypopnea Index (AHI). All patients underwent computed tomographic examination for tomographic coronary calcification scoring. Physical examination, sleep study recordings, complete blood count and serum biochemistry were obtained from all patients.ResultsIn the whole group, AHI levels were weakly correlated with coronary calcium score (r = 0.342, p = 0.003) and body mass index (r = 0.337, p = 0.004), moderately correlated with basal oxygen saturation (r = −0.734, p < 0.001), and strongly correlated with oxygen desaturation index (r = 0.844, p < 0.001). In an univariate analysis, age, AHI, basal oxygen saturation, and oxygen desaturation index were associated with CAC in patients with OSAS. In a multiple logistic regression model, age (OR 1.108,%95 CI 1.031-1.191, p = 0.005) and AHI (OR 1.036,% 95 CI 1.003-1.070, p = 0.033) were only independent predictors of CAC in patients with OSAS with a sensitivity of 88.9% and 77.8% and a specificity of 54.3% and 56.5% respectively.ConclusionsOur findings suggest that in patients with moderate or severe OSAS and advanced age, physicians should be alert for the presence of subclinical atherosclerosis.
Background: Both obstructive sleep apnea syndrome (OSAS) and coronary artery calcification (CAC) are considered to be related with the presence of coronary artery disease (CAD). In this study we evaluate the association between OSAS and presence of subclinical atherosclerosis assessed by tomographic coronary calcium score in patients who had OSAS but no history of known CAD. Methods: Seventy-three patients who were asymptomatic for CAD and had suspected OSAS were referred to overnight attended polysomnography. Patients were classified into 4 groups according to the Apnea-Hypopnea Index (AHI). All patients underwent computed tomographic examination for tomographic coronary calcification scoring. Physical examination, sleep study recordings, complete blood count and serum biochemistry were obtained from all patients. Results: In the whole group, AHI levels were weakly correlated with coronary calcium score (r = 0.342, p = 0.003) and body mass index (r = 0.337, p = 0.004), moderately correlated with basal oxygen saturation (r = −0.734, p < 0.001), and strongly correlated with oxygen desaturation index (r = 0.844, p < 0.001). In an univariate analysis, age, AHI, basal oxygen saturation, and oxygen desaturation index were associated with CAC in patients with OSAS. In a multiple logistic regression model, age (OR 1.108,%95 CI 1.031-1.191, p = 0.005) and AHI (OR 1.036,% 95 CI 1.003-1.070, p = 0.033) were only independent predictors of CAC in patients with OSAS with a sensitivity of 88.9% and 77.8% and a specificity of 54.3% and 56.5% respectively. Conclusions: Our findings suggest that in patients with moderate or severe OSAS and advanced age, physicians should be alert for the presence of subclinical atherosclerosis.
Varisella enfeksiyonu (suçiçeği), döküntülü, genellikle kendini sınırlayabilen, bulaşıcı bir çocukluk hastalığıdır. Sekonder bakteriyel enfeksiyonlar, nörolojik sorunlar, pnömoni ve hematolojik tutulum ise iyi bilinen komplikasyonlarıdır. Epididimoorşit, epididim ve testislerin iltihabı, nadir ve bilinmeyen bir suçiçeği komplikasyonudur. Burada, epididimoorşit ile komplike suçiçeği enfeksiyonu geçiren beş yaşında bir erkek hasta sunulmaktadır. Hastanemize vezikülopüstüler suçiçeği döküntüsünün yedinci gününde skrotumda şişlik nedeniyle başvuran hastaya skrotal Doppler ultrasonografi ile epididimoorşit tanısı konulmuştur. Antimikrobiyal ve destekleyici tedavi için hastaneye yatırılıp, altıncı günde genel durumu iyi olarak oral tedaviye devam etmek üzere taburcu edilmiştir. Bu olgu sunumu ile sık görülen hastalıkların nadir komplikasyonları olabileceğine dikkat çekmek istenmiştir. Epididimoorşit ile varisella enfeksiyonu nadir; fakat önlenebilir bir problemdir.
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