Overlap syndrome: Association of chronic obstructive pulmonary disease and obstructive sleep apnea syndrome

Abstract: COPD and the OSAHS are both common diseases affecting respectively 10% and 5% of the adult population over 40 years of age. Their coexistence, which is denominated as "overlap syndrome", can occur in about 0.5% of this population

Aim and materials: To assess the existence of a prevalence of OSAHS in patients with COPD through a prospective analysis: 70 had a confirmed isolated OSAHS [group A] and 11 had an OS [group B], all were compiled from January 2007 to June 2012

Results: The prevalence of OS in our study was 13.6%, OS patients were older than the isolated OSAHS patients [p < 0.05] with a male predominance in the Overlap arm [p < 0.05], and BMI was similar between the 2 groups [p = 0.22]. Tobacco is retained as a risk factor and 81.8% of patients with Overlap were smoking [p < 0.05]. Clinical signs most reported are nocturnal snoring and daytime sleepiness. The Epworth Sleepiness Scale was higher than 10 in the 2 groups [p < 0.05]. The Berlin questionnaire realized in 30 subjects in group A, was positive [40% of cases] and was positive in 63.6% of 7 subjects in group B. Spirometry showed that vital capacity, FEV1 and FEV1/CV were significantly decreased in the Overlap group [p < 0.001]. The recording shows a sleep apnea-hypopnea index [AHI] similar in the two groups [p < 0.05]

Conclusion: There was no correlation between COPD and OSAHS. The latter is a risk factor for the first

Association deep veinous thrombosis with pulmonary tuberculosis

Thromboembolic complications associated with infection by Mycobacte-rium tuberculosis have been reported in the literature that occurred in 1.5-3.4% of TB infection, which is a risk factor for deep vein thrombosis [DVT] related to the hypercoagulable state secondary to the inflammatory state. We report in this study the pathophysiological, therapeutic, epidemiological, and clinical aspects, of this association. This is a retrospective study done in our department between January 2010 and May 2013. It is about 30 cases of confirmed pulmonary tuberculosis associated with deep vein thrombosis. It is about 21 men and 9 women. Pulmonary tuberculosis was confirmed by the presence of acidoalcoolo-resistant bacillus on the sputum on a direct examination of 25 cases and bronchial aspiration in 5 cases. All patients had extensive radiological lesions. Phlebitis occurred within a mean of 17 days after the diagnosis of tuberculosis. It was confirmed by venous doppler deep ultrasound of inferior membres. All patients received anti-tuberculosis drugs in association with anticoagulant treatment. Etiologic investigations showed positive anti-phospholipid antibodies in one case, and decrease in C and S proteins in 2 patients in which phlebitis was complicated by arterial pulmonary embolism. We had difficulties in controlling prothrombin level in 9 cases and we prescribed low molecular weight heparin for 6 months in two cases. Thromboembolic disease is diagnosed systematically in the TB patients because of the risk of this complication particularly in extensive and severe forms. Prophylactic anticoagulation finds its indications in these forms