[Abbreviated diurnal polysomnographic records in the diagnosis of sleep obstructive apnea syndrome]. / Análisis de los registros polisomnográficos cortos diurnos en el diagnóstico del síndrome de apnea obstructiva del sueño.

OBJECTIVE: To demonstrate the validity of diurnal polysomnography for the diagnosis of obstructive sleep apnea syndrome (OSAS). METHODS: Twenty-five patients with suspect of OSAS were studied with two serial polysomnographic recordings: one during nighttime-nocturnal polysomnography (NPLS) and then a second polysomnographic study during the following morning (DPLS). In both recordings the Sensor Medic Polysomnograph 4250 was used. The certainty OSAS diagnosis was considered when an apnea-hypopnea index (AHI) > or = 10 in the nocturnal recording was obtained. The statistical study was performed with the R-Sigma Horus SA software and sensitivity and specificity values following formulas next indicated. RESULTS: The male/female ratio was 72%/28%. All patients were snorers and 64% had diurnal hypersomnia. Fourteen out of the 25 patients were true positive, five true negative, five false negative and one false positive patients. The specificity and sensitivity of DPLS were 83% and 73%, respectively, with a positive predictive value of 93% and a negative predictive value of 50%. CONCLUSIONS: Abbreviated diurnal polysomnographic recordings, performed with conventional polysomnography, have a good sensitivity and specificity for the diagnosis of OSAS. Given the possibility of false negative results in DPLS, a NPLS should be performed in the patient with presumed OSAS and negative diurnal polysomnographic study.

[Diagnostic and therapeutic thoracoscopy: apropos of 100 cases]. / Toracoscopia diagnóstica y terapéutica: a propósito de 100 casos.

Results and complications of 100 consecutive thoracoscopies performed with local anesthesia, in our department of pneumology are reviewed. The group is constituted by 60 men and 40 women with an average age of 56.1 +/- 16.7 years (13-81). Age difference between tumoral (n = 58) and tuberculous patients (n = 13) was statistically significant (59.6 +/- 12.8 vs 39.3 +/- 18.7; p < 0.001). The most frequent symptom on presentation was dyspnea, an significant association was detected between fever and tuberculosis (p < 0.001). Final diagnosis were: tumor (n = 58), non-specific inflammation (n = 16), tuberculosis (n = 13), pneumothorax (n = 11) and pneumonia (n = 2). In 14 patients some complication of the procedure appeared, all of these had little clinical significance and were resolved with minimal nursing care. To diagnose tumor, macroscopic aspect showed a sensitivity of 96.1%, specificity of 86% and 92% assurance.