Most patients with multidrug-resistant tuberculosis can be cured with the use of appropriate, intensive treatment regimens.
From the present study, we propose that after accurate classification, interventional bronchoscopic management may have an important role in the treatment of benign tracheal stenosis. Bronchoscopic treatment should be considered as first-line therapy for simple stenoses, whereas complex stenoses need a multidisciplinary approach and often require surgical intervention. However, bronchoscopic treatment may be a valid conservative approach in the management of patients with complex tracheal stenosis who are not eligible for operative treatment.
Study Objectives: The cardiovascular complications caused by obstructive sleep apnea (OSA) decrease after continuous positive airway pressure treatment (CPAP). Mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) are newly recognized tools for assessing cardiovascular risk. Methods: From a selection of patients with symptoms of nocturnal snoring and/or excessive daytime sleepiness, 36 males with an apnea-hypopnea index (AHI) > 30/h and 22 age-matched normal male controls with AHI < 5/h were included. Patients with OSA underwent another night of CPAP titration, and 11 patients were excluded at the 6-month evaluation due to poor compliance with the home CPAP therapy. Complete blood count parameters of compliant patients and the control group were evaluated. S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea (OSA) is characterized by collapse of the upper airway during sleep, recurring apnea, intermittent hypoxemia, and daytime sleepiness. The severity of OSA is evaluated in terms of the number of apnea/hypopnea episodes per hour of sleep and is expressed as the apnea-hypopnea index (AHI). 1Red blood cell distribution width (RDW) is a numerical measure of the size variability of circulating erythrocytes and is routinely reported as a component of the complete blood count in the differential diagnosis of anemia. Disorders related to ineffective erythropoiesis or increased red blood cell destruction cause greater size heterogeneity and thus a higher RDW. 2,3Several studies have reported increased platelet activation and aggregation in patients with OSA. 4,5 It has been shown that platelet size, as measured by mean platelet volume (MPV), correlates with platelet reactivity, and is regarded as an easy and useful tool for indirect monitoring of platelet activity. As larger platelets have greater thrombotic potential, the RDW, MPV, and platelet distribution width (PDW) have been shown to be related to cardiovascular morbidity and mortality in patients with cardiac diseases. In OSA patients, RDW, MPV, and PDW are newly recognized indicators of the severity of the condition that are associated with no additional cost compared to a routinely performed complete blood count. 11-14Continuous positive airway pressure (CPAP) therapy is the gold standard in patients with severe OSA. MPV is reduced after CPAP therapy in severe OSA patients, indicating that CPAP therapy has cardioprotective effects. 15 To our knowledge, the effect of CPAP therapy on RDW and PDW in OSA patients has not been reported; thus, we decided to investigate this possibility. BRIEF SUMMARYCurrent Knowledge/Study Rationale: Mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) are newly recognized tools for assessing cardiovascular risk. These markers increase in patients with OSA. The effect of CPAP treatment on these parameters was evaluated. Study Impact: Our data suggest that complete blood count parameters such as MPV, PDW, and RDW changed ...
In patients referred with a clinical diagnosis of OSAS, RDW may be a marker for the severity of the condition. As RDW is usually included in a complete blood count, it could provide an inexpensive tool for triaging OSAS patients for polysomnography evaluation.
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