ABSTRACT
INTRODUCTION: The evolution of patients with obstructive sleep apnea (OSA) non-eligible for PAP-therapy at diagnosis is unknown. Currently, the severity of OSA is based on the apnea-hypopnea index (AHI), but its prognostic relevance has raised concerns. The Baveno classification may allow a better stratification of severity and therapeutic guidance in OSA. METHODS: Patients with AHI≥5/h in 2015, classified into Baveno groups A and B and non-eligible for PAP therapy at diagnosis and over 5 years, were analyzed. Patients were reclassified into Baveno groups (A-D) and changes in groups over 5 years were explored. Patients in Baveno groups C and D, who developed major cardiovascular comorbidities (CVC) or end-organ damage (EOD group), were compared with patients in Baveno groups A and B (non-EOD group). To identify predictors of the development of major CVC or EOD, a logistic regression analysis was performed. RESULTS: There were 76 patients, 58% male, mean age 51.9 ± 10.1 years, mean body mass index (BMI) of 30.3 ± 5.0 kg/m2 and median AHI of 8.9 (5.9-12.0) events/h. At diagnosis, 46% and 54% of patients were classified into Baveno group A and group B, respectively. In total, 21% of patients developed major CVC or EOD (Baveno group C or D); higher age (p = 0.011) and BMI (p = 0.004) and a higher percentage of central apneas (p = 0.012) at diagnosis significantly predicted it, while sex, sleepiness, insomnia, AHI, ODI and T90 were not. CONCLUSIONS: A significant percentage of patients non-eligible for PAP-therapy at diagnosis of OSA developed CVC or EOD; higher age and BMI and a higher percentage of central apneas were significant predictors.
Subject(s)
Esophageal and Gastric Varices , Sleep Apnea, Obstructive , Adult , Body Mass Index , Female , Humans , Male , Middle Aged , Polysomnography , Severity of Illness Index , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/therapyABSTRACT
Sao apresentados 24 casos de silicose em cavadores de pocos cuja idade media era de 44 anos (29 a 58). Todos eram sintomaticos sendo os sintomas mais comuns a dispneia e a tosse. Todos apresentaram lesoes radiologicas, predominando a fibrose pulmonar nos lobos superiores. O eletrocardiograma mostrou sobrecarga de camara direita em tres casos, bloqueio de ramo direito em dois, sendo normal em 19 casos.A espirometria revelou um disturbio funcional misto em 12 casos, restricao pura em cinco, obstrucao pura em tres e foi normal em quatro casos
