Prevalence of primary open angle glaucoma in obstructive sleep apnea syndrome

Obstructive sleep apnea [OSA] is partial or complete recurrent upper airway obstructions during sleep. Reduction in blood flow of the optic nerve head is an important causative factor in glaucoma. The objective of this study is to determine the prevalence of primary open angle glaucoma [POAG] in OSA patients. From September 2009 to January 2010 in this descriptive-analytic cross sectional study, 90 cases of patients with OSA referred to Yazd Shahid Sadoughi hospital were collected and studied by polysomnography, blood gas analysis and ocular examination including measurement of intra ocular pressure, gonioscopy, fondoscopy and automated perimetry. Statistical analysis was performed by SPSS software. Thirty-one patients had mild OSA, 30 patients had moderate OSA and 29 patients had severe OSA. The prevalence of POAG in this group of patients was 10% [95% CI: 4-16]. It is higher than the general population in the same age group [p=0.017]. There was no significant correlation between the presence of glaucoma and apnea hypopnea index [AHI], mean saturation arterial O[2] [MSaO[2]], body mass index [BMI], sex and age. A significant correlation between AHI with IOP and cup/disc ratio was not documented. According to our founding, the prevalence of POAG in OSA patients was higher than the general population in the same age group. Thus we recommend screening of glaucoma in OSA patients. This Study suggests that AHI, MSaO[2], BMI, sex or age are not important risk factors for glaucoma in OSA patients

Lymphomatoid granulomatosis with splenomegaly and pancytopenia / 中国肺癌杂志

Lymphomatoid granulomatosis (LG) is an angiocentric lymphoproliferative disease. It usually involves lung, skin, and central nervous system, but splenomegaly and pancytopenia are the rare manifestations of the disease. We report a 15-year-old boy presented with fever, dry cough and dyspnea from two months ago, after admission patient had nodular lesions on the left leg and hepatosplenomegaly. Then he manifested neurologic signs such as seizure, aphasia and right-sided hemiplegia. Chest X-ray and CT scan revealed bilateral pulmonary nodules predominantly in lower lobes and peripheral lung fields. Laboratory exams showed pancytopenia. Skin biopsy was done, and histopathological examination and immunohistochemistry evaluation confirmed lymphomatoid granulomatosis. He was treated with steroid and cyclophosphamide but succumbed by neurologic involvement.

Antiphospholipid antibodies in venous thromboembolism patients younger than 50 years old

Antiphospholipid antibodies are among the most important risk factors of arterial and venous thrombosis. Various studies have demonstrated that these antibodies are seen in patients with deep vein thrombosis [DVT] and pulmonary embolism [PE] more than normal individuals but there are a few studies about prevalence of these antibodies in patients younger than 50 years old with venous thromboembolism [VTE]. This study aimed to evaluate these antibodies in this age group. This was a case-control study. Fifty patients younger than 50 years old with venous thromboembolism [DVT, PE or both] who were diagnosed according to the standard criteria were compared with 48 subjects in the control group. Subjects in the control group were age and sex matched with patients and had no history of venous thromboembolism. Both groups had no history of malignancy or other chronic diseases. Lupus anti-coagulant and serum anticardiolipin antibodies [IgG and IgM] were measured in both groups. Data were analyzed using SPSS version 11.5 software. Fifty VTE patients younger than 50 years of age enrolled in this study [28 males and 22 females; mean age: 38.14 +/- 6.5 yrs]. Forty-eight subjects were selected as healthy controls [27 males and 21 females; mean age: 38.35 +/- 5.06 yrs]. Mann-Whitney test showed a significant difference between serum IgM anticardiolipin antibody levels of VTE patients [8.04 MPL units/ml] and those of healthy subjects [1.85 MPL units/ml] [P=0.001]. Also, a significant difference was found between serum IgG anticardiolipin antibody levels of VTE patients [8.29 GPL units/ml] and those of healthy subjects [3.51 GPL units/ml] [P=0.001]. In VTE group, 7 patients [M/F=4/3] had an IgG level >10 GPL units/ml and 6 patients [M/F=2/4] had an IgM level >10 MPL units/ml while none of the healthy subjects had IgG or IgM levels higher than 10 [P[IgM] = 0.015 and P[IgG] = 0.007]. Lupus anti-coagulant was positive in four [8%] but negative in all healthy subjects [P=0.04]. This study demonstrated that antiphospholipid antibodies were more prevalent in VTE patients younger than 50 years old compared to healthy subjects. Considering the fact that these patients need stronger and longer treatment, it seems necessary to evaluate every VTE patient younger than 50 yrs for antiphospholipid syndrome