Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of upper airway collapse associated with oxygen desaturation and sleep disruption. It is proposed that these periodic changes lead to molecular variations that can be detected by assessing serum biomarkers. Studies have identified inflammatory, oxidative, and metabolic perturbations attributable to sleep-disordered breathing. Given that OSAS is associated with increased cardiovascular and cerebrovascular morbidity, the ideal biomarker should enable timely recognition with the possibility of intervention. There is accumulating data on the utility of serum biomarkers for the evaluation of disease severity, prognosis, and response to treatment. However, current knowledge is limited by data collection techniques, disease complexity, and potential confounding factors. The current paper reviews the literature on the use of serum biomarkers in OSAS. It is concluded that the ideal serum biomarker still needs to be discovered, while caution is needed in the interpretation of hitherto available results.

Vit D levels were lower in OSAS patients compared with non-apnoeic controls. Several indices of OSAS severity also correlated with Vit D levels.

Background: Sleep disturbances, such as difficulty in falling asleep, maintaining sleep, poor sleep efficiency, early awakening, and excessive daytime sleepiness, are common in patients with cancer. The aim of this study was to evaluate sleep characteristics in newly diagnosed lung cancer patients before and after three months of chemotherapy treatment. Methods: Forty-nine patients with lung cancer, without brain metastasis, were included. Anthropometric and disease characteristics were collected. Upon diagnosis and after three months, a polysomnographic examination was conducted and the patients completed the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Severity Scale (FSS) and the Medical Research Council (MRC) dyspnoea scale. Results: Before chemotherapy, the mean PSQI score was 7.1 Ϯ 4, the FSS score was 3.92 Ϯ 2, and the ESS score was 6.8 Ϯ 4. The MRC score was low at 1.6 Ϯ 1.1. A significant correlation between FSS and global PSQI was revealed (r = 0.424, P < 0.01), as well as with several of the PSQI components. After chemotherapy, no statistically significant change was observed in the PSQI (mean: 6.6 Ϯ 4.5, t-score: 0.784, P = 0.438), or the FSS score (4.4 Ϯ 2.2, t-score: -1.375, P = 0.177). Sleep efficiency was significantly reduced (P = 0.008), without any change in the distribution of sleep stages. Conclusion: The perception of sleep quality is poor among newly diagnosed lung cancer patients and is correlated with fatigue. After chemotherapy, self-reported sleep impairment is present and sleep efficiency is reduced, without significant change in sleep architecture.

We evaluated early atherosclerotic lesions in 20 non-smokers with newly diagnosed Obstructive Sleep Apnoea (OSA) and without known comorbidities by measuring common carotid artery intima media thickness (CCA-IMT), transcranial Doppler ultrasound (TCD), and ankle brachial index (ABI). These were compared with 20 healthy age- and BMI-matched controls. In OSA patients, CCA-IMT was not significantly higher vs. controls (0.74±0.17 vs. 0.66±0.12 mm, p=0.201) and it was positively correlated with neck circumference (r=0.466, p=0.039), arousal index (r=0.663, p=0.001), gamma-glutamyl transpeptidase activity (r=0.474, p=0.035) while it was negatively correlated with Forced Expiratory Volume in 1 sec (r=-0.055, p=0.012). No difference was noted between patients and controls in terms of vascular stenosis on TCD examination, while asymptomatic peripheral artery disease was found in one patient with OSA. In conclusion, OSA patients without known comorbidities exhibit a non-significant increase in CCA-IMT without further evidence of vascular disease, but additional experience in a larger patient series is needed.

IntroductionSerratia marcescens is a Gram-negative bacillus which belongs to the family Enterobacteriaceae. It is a facultative anaerobe and produces red pigment at room temperature. It naturally occurs in soil and water as well as the intestines, and it is responsible for nosocomial infections. There have been few reports about community acquired pneumonia of Serratia.Case presentationThis report presents a 37-year-old man with hemoptysis, fever, and shortness of breath. The clinical and laboratory examinations revealed that the patient had pseudohemoptysis due to S. marcescens pneumonia, on an immunocompromised pattern, because of the coexistence of sarcoidosis (stage 1).ConclusionAppropriate antibiotic therapy for Serratia was administered, and the patient’s symptoms regressed. The patient is healthy and asymptomatic after 1-year follow-up. To the best of the authors’ knowledge, this is the first reported case of a pseudohemoptysis in a patient with pulmonary sarcoidosis.