RESUMEN
INTRODUCTION: Investigation for obstructive sleep apnea syndrome (OSAS) is mandatory before bariatric surgery. Data regarding chronic insomnia and chronic sleep deprivation are scarce in this population. METHODS: A cross-sectional study assessing the prevalence of chronic insomnia, OSAS and chronic sleep privation in an obese population referred for bariatric surgery. RESULTS: In all, 88 patients (74% women, median age 41 [33.5-50] years and median body mass index 42 [39.2-45.7] kg/m2) were included. The prevalence of chronic insomnia was 31% in the 87% suffering from OSAS that required continuous positive airway pressure therapy. Comorbid insomnia and sleep apnoea (COMISA) were found in 27% of our population. Chronic insomnia was associated with a lower quality of life (median EQ5D analogue visual scale: 60 [50-70] P=0.04) and a poor sleep quality (median Pittsburgh sleep quality index (PSQI): 8 (6-11 P<0.01) The deleterious combination of sleep privation and insomnia had a higher impact in terms of impairment of quality of life and sleep quality (median EQ5D analogue visual scale: 50 [40-65] P=0.02 et median PSQI: 11 [9-14, P<0.01) CONCLUSION: Chronic insomnia and sleep privation have synergistic deleterious effects in candidates for bariatric surgery. Further studies need to be conducted to evaluate the evolution after surgery.
Asunto(s)
Cirugía Bariátrica , Calidad de Vida , Adulto , Presión de las Vías Aéreas Positiva Contínua , Estudios Transversales , Femenino , Humanos , Masculino , SueñoAsunto(s)
Granuloma de Cuerpo Extraño/diagnóstico , Granuloma del Sistema Respiratorio/diagnóstico , Nódulos Pulmonares Múltiples/diagnóstico , Adulto , Carbón Orgánico/administración & dosificación , Diagnóstico Diferencial , Reacciones Falso Positivas , Femenino , Granuloma de Cuerpo Extraño/complicaciones , Granuloma de Cuerpo Extraño/patología , Granuloma del Sistema Respiratorio/complicaciones , Granuloma del Sistema Respiratorio/patología , Humanos , Inhalación , Nódulos Pulmonares Múltiples/etiología , Nódulos Pulmonares Múltiples/metabolismo , Nódulos Pulmonares Múltiples/patología , Tomografía de Emisión de Positrones , Radiografía TorácicaRESUMEN
Spontaneous haemothorax is a rare event in the general population. However some diseases, including hereditary multiple exostosis, have an increased incidence of this complication. We report the case of a 22 year old patient with hereditary multiple exostosis who presented with a right sided haemothorax due to an exostosis of the seventh rib. The pathophysiology of spontaneous haemothorax in the setting of hereditary multiple exostosis is discussed together with surgical treatment and long term follow up.
