Perception of patients with retinal pathology on aspects of visual function and their management.

BACKGROUND AND OBJECTIVE: Age-related macular degeneration (AMD) and diabetic retinopathy (DR) are highly prevalent. OBJECTIVE: To explore perceptions of patients with AMD or DR about the impact of the disease and treatment on their daily living activities. MATERIALS AND METHODS: Semi-structured interviews with a questionnaire developed from validated patient reported outcomes questionnaires. The questionnaire consisted of 19 questions about the disease and 9 about the treatment. The questions (items) were answered on a scale from 1 to 9. In addition, the patient interviewed was invited to make free comments on each question. Nine patients with AMD and 9 with DR were interviewed by videoconference or telephone call. A quantitative analysis of the responses and a qualitative analysis of the comments were carried out. RESULTS: The most relevant item for patients with AMD or DR is "Recognize people when they are nearby", and "Read text in normal size font in a newspaper or book", followed, in patients with AMD, by "Do things what you would like" and, in patients with DR, "Feeling frustrated by the vision problems." Regarding the treatment, the most relevant aspects for both groups is that the treatment works and receiving appropriate information before and after the treatment. The qualitative comments were focused to the disease, the treatment, and to the role of doctors and the health system. CONCLUSION: Quantitative responses and free comments can be useful to improve the care of patients with AMD or DR by physicians and the health system.

Diagnostic accuracy of visual analysis versus dual time-point imaging with 18F-FDG PET/CT for the characterization of indeterminate pulmonary nodules with low uptake. / Precisión diagnóstica del análisis visual frente al protocolo de imagen tardía con 18F-FDG PET/TC para la caracterización de nódulos pulmonares indeterminados con baja captación.

OBJECTIVE: To determine the accuracy of visual analysis and the retention index (RI) with dual-time point 18F-FDG PET/CT for the characterization of indeterminate pulmonary nodules (IPN) with low FDG uptake. MATERIALS AND METHODS: A retrospective analysis was performed on 43 patients (28 men, 64 ± 11 years old, range 36-83 years) referred for IPN characterization with 18F-FDG-PET/CT and maximum standard uptake value ≤ 2.5 at 60 minutes post-injection (SUVmax1). Nodules were analyzed by size, visual score for FDG uptake on standard (OSEM 2,8) and high definition (HD) reconstructions, SUVmax1, SUVmax at 180 minutes post-injection (SUVmax2), and RI was calculated. The definitive diagnosis was based on histopathological confirmation (n = 28) or ≥ 2 years of follow-up. RESULTS: Twenty-four (56%) nodules were malignant. RI ≥ 10% on standard reconstruction detected 18 nodules that would have been considered negative using the standard SUVmax ≥ 2.5 criterion for malignancy. RI ≥ 10% had a sensitivity, specificity, PPV, NPV and accuracy of 75, 73.7, 78.3, 70, and 74.4%, respectively, while for FDG uptake > liver on HD these were 79.1, 63.2, 73.1, 70.6, and 72.1%, respectively. SUVmax1 ≥ 2, SUVmax2 > 2.5 and FDG uptake > liver on standard reconstruction had a PPV of 100%. FDG uptake > mediastinum on HD had a NPV of 100%. CONCLUSIONS: RI ≥ 10% was the most accurate criterion for malignancy, followed by FDG uptake > liver on HD reconstruction. On standard reconstruction, SUVmax1 ≥2 was highly predictive of malignancy, as well as SUVmax2 > 2.5 and FDG uptake > liver. FDG uptake < mediastinum on HD was highly predictive of benign nodules.

Surgical Outcomes in a Lung Cancer-Screening Program Using Low Dose Computed Tomography / Resultados quirúrgicos de un programa de cribado de cáncer de pulmón utilizando tomografía computarizada de baja dosis

OBJECTIVE: Lung cancer (LC) is the leading cause of death from cancer worldwide. More than 27,000 LCs are diagnosed annually in Spain, and most are unresectable. Early detection and treatment reduce LC mortality. This study describes surgical outcomes in a longstanding LC screening cohort in Spain. METHODS: We conducted a retrospective study of surgical outcomes in a LC screening (LCS) program using low dose computed tomography (LDCT) since the year 2000. A descriptive analysis of clinical and radiological parameters, presence or absence of a preoperative diagnosis, pathological staging, morbidity, mortality, and survival was performed. RESULTS: Ninety-seven (2.5%) LC were diagnosed in 3825 screened. Twenty individuals with LC had no surgery due to advanced stage or small cell histology. Eighty-seven surgical procedures were carried out for suspected or biopsy proven LC, detected by LDCT. Most operated patients were male (57[85%]) aged 64 ± 9.1 years. Nine patients underwent a second operation for a metachronous primary lung cancer. Mean tumor size was 15.2 ± 7.6 mm. Eight nodules were benign (9.2%). Lobectomy was performed in 56 cases (83.6%). Adenocarcinoma (n = 39; 58.2%) was the most frequent histological type followed by squamous cell carcinoma (n = 17; 25.4%). Fifty-nine (88%) tumors were in Stage I. Thirteen patients (15.4%) had 16 complications. The estimated survival rates at 5 and 10 years for stage I were 93% (95% CI: 79%-98%) and 83% (95% CI: 65%-92%), respectively. CONCLUSION: Lung cancer screening was associated with excellent surgical outcomes with 5 and 10-year survival rates exceeding 90 and 80%, respectively

OBJETIVO: El cáncer de pulmón (CP) es la principal causa de muerte por cáncer en todo el mundo. En España se diagnostican anualmente más de 27.000 CP y la mayoría son irresecables. La detección y el tratamiento tempranos reducen la mortalidad por CP. Este estudio describe los resultados quirúrgicos en una cohorte de cribado de CP de larga duración en España. MÉTODOS: Llevamos a cabo un estudio retrospectivo de los resultados quirúrgicos de un programa de cribado de CP (CCP) usando tomografía computarizada de baja dosis (LDCT, por sus siglas en inglés) en marcha desde el año 2000. Se realizó un análisis descriptivo de los parámetros clínicos y radiológicos, presencia o ausencia de un diagnóstico preoperatorio, estadificación patológica, morbilidad, mortalidad y supervivencia. RESULTADOS: Se diagnosticaron 97 (2,5%) CP entre 3.825 sujetos cribados. Veinte personas con CP no se sometieron a cirugía debido a un estado avanzado de la enfermedad o a una histología de células pequeñas. Se llevaron a cabo 87 procedimientos quirúrgicos por sospecha de CP o CP demostrado mediante biopsia, detectados en la LDCT. La mayoría de los pacientes operados fueron varones (57 [85%]) de 64 años ± 9,1 años. Nueve pacientes se sometieron a una segunda operación por un cáncer de pulmón primario metacrónico. El tamaño medio del tumor fue de 15,2 ± 7,6 mm. Ocho nódulos fueron benignos (9,2%). Se realizó lobectomía en 56 casos (83,6%). El adenocarcinoma (n = 39; 58,2%) fue el tipo histológico más frecuente seguido por el carcinoma de células escamosas (n = 17; 25,4%); 59 (88%) tumores se encontraban en estadio I. Trece pacientes (15,4%) tuvieron 16 complicaciones. Las tasas de supervivencia estimadas a los 5 y 10 años para el estadio I fueron del 93% (IC 95%: 79 al 98%) y del 83% (IC 95%: 65 al 92%), respectivamente. CONCLUSIÓN: El CCP se asoció con excelentes resultados quirúrgicos y con tasas de supervivencia a los 5 y 10 años superiores al 90 y al 80%, respectivamente

Chronic rhinosinusitis is associated with prolonged SARS-CoV-2 RNA shedding in upper respiratory tract samples: A case-control study.

BACKGROUND: SARS-CoV-2, the COVID-19 causative agent, has infected millions of people and killed over 1.6 million worldwide. A small percentage of cases persist with prolonged positive RT-PCR on nasopharyngeal swabs. The aim of this study was to determine risk factors for prolonged viral shedding amongst patient's basal clinical conditions. METHODS: We have evaluated all 513 patients attended in our hospital between 1 March and 1 July. We have selected all 18 patients with prolonged viral shedding and compared them with 36 sex-matched randomly selected controls. Demographic, treatment and clinical data were systematically collected. RESULTS: Global median duration of viral clearance was 25.5 days (n = 54; IQR, 22-39.3 days), 48.5 days in cases (IQR 38.7-54.9 days) and 23 days in controls (IQR 20.2-25.7), respectively. There were not observed differences in demographic, symptoms or treatment data between groups. Chronic rhinosinusitis and atopy were more common in patients with prolonged viral shedding (67%) compared with controls (11% and 25% respectively) (P < 0.001 and P = 0.003). The use of inhaled corticosteroids was also more frequent in case group (P = 0.007). Multivariate analysis indicated that CRS (odds ratio [OR], 18.78; 95% confidence interval [95%CI], 3.89-90.59; P < 0.001) was independently associated with prolonged SARS-CoV-2 RNA shedding in URT samples, after adjusting for initial PCR Ct values. CONCLUSION: We found that chronic rhinosinusitis and atopy might be associated with increased risk of prolonged viral shedding. If confirmed in prospective trials, this finding might have clinical implications for quarantine duration due to increased risk of pandemic spread.

Surgical Outcomes in a Lung Cancer-Screening Program Using Low Dose Computed Tomography.

OBJECTIVE: Lung cancer (LC) is the leading cause of death from cancer worldwide. More than 27,000 LCs are diagnosed annually in Spain, and most are unresectable. Early detection and treatment reduce LC mortality. This study describes surgical outcomes in a longstanding LC screening cohort in Spain. METHODS: We conducted a retrospective study of surgical outcomes in a LC screening (LCS) program using low dose computed tomography (LDCT) since the year 2000. A descriptive analysis of clinical and radiological parameters, presence or absence of a preoperative diagnosis, pathological staging, morbidity, mortality, and survival was performed. RESULTS: Ninety-seven (2.5%) LC were diagnosed in 3825 screened. Twenty individuals with LC had no surgery due to advanced stage or small cell histology. Eighty-seven surgical procedures were carried out for suspected or biopsy proven LC, detected by LDCT. Most operated patients were male (57[85%]) aged 64±9.1 years. Nine patients underwent a second operation for a metachronous primary lung cancer. Mean tumor size was 15.2±7.6mm. Eight nodules were benign (9.2%). Lobectomy was performed in 56 cases (83.6%). Adenocarcinoma (n=39; 58.2%) was the most frequent histological type followed by squamous cell carcinoma (n=17; 25.4%). Fifty-nine (88%) tumors were in Stage I. Thirteen patients (15.4%) had 16 complications. The estimated survival rates at 5 and 10 years for stage I were 93% (95% CI: 79%-98%) and 83% (95% CI: 65%-92%), respectively. CONCLUSION: Lung cancer screening was associated with excellent surgical outcomes with 5 and 10-year survival rates exceeding 90 and 80%, respectively.

Coagulación de plexo coroideo como procedimiento aislado en el tratamiento de la hidrocefalia / Choroid plexus coagulation as an isolated procedure in the treatment of hydrocephalus

La coagulación de plexo coroideo (CPC) es un procedimiento que nace del intento histórico de tratar la hidrocefalia. Desarrollado en la primera mitad del siglo XX, pero posteriormente abandonado por su baja tasa de éxito y alta tasa de complicaciones. Con el advenimiento de la neuroendoscopía moderna se adapta la idea de la CPC en un intento de dar cabida a alternativas a la derivación de líquido cefalorraquídeo (LCR) como procedimiento estándar para tratar la hidrocefalia. Actualmente su uso se ha difundido mayormente en conjunto con la tercer ventriculostomía endoscópica como una opción eficaz, más barata y exenta de los riesgos inherentes de una derivación de LCR. No obstante, se ha reportado su éxito como procedimiento aislado en casos seleccionados como en hidrocefalia comunicante lentamente progresiva, hidranencefalia y un posible rol en el tratamiento de la hiperplasia de plexo coroideo. El objetivo de esta revisión es determinar la efectividad de la CPC aislada como tratamiento para la hidrocefalia en diversos escenarios clínicos e identificar las variables asociadas a su éxito.

Choroid plexus coagulation (CPC) is a procedure born of historic attempts to treat hydrocephalus. Developed in the first half of the 20th century, it was later abandoned because of its low success rate and high rate of complications. With the advent of modern neuro-endoscopy the CPC was adapted in an attempt to open the way for alternatives to CSF shunt as the standard procedure for treating hydrocephalus. Its use has spread mainly in conjunction with endoscopic third ventriculostomy as an option which is effective, cheaper and without the risks inherent in a CSF shunt. However, there have been reports of its success as an isolated procedure in selected cases such as chronic progressive communicating hydrocephalus, hydranencephaly and it has a possible role in the treatment of choroid plexus hyperplasia. The objective of this review is to determine the effectiveness of isolated CPC as treatment for hydrocephalus in various clinical setti ngs and identify the variables associated with its success.

[Overdiagnosis in cancer screening]. / Sobrediagnóstico en cribado de cáncer.

In screening programs, overdiagnosis is defined as the detection of a disease that would have gone undetected without screening when that disease would not have resulted in morbimortality and was treated unnecessarily. Overdiagnosis is a bias inherent in screening and an undesired effect of secondary prevention and improved sensitivity of diagnostic techniques. It is difficult to discriminate a priori between clinically relevant diagnoses and those in which treatment is unnecessary. To minimize the effects of overdiagnosis, screening should be done in patients at risk.

Antitumoral efficacy of DNA nanoparticles in murine models of lung cancer and pulmonary metastasis.

Polyethylenimine (PEI)-DNA complexes are nanoparticles that are able to efficiently transfer plasmids to the lungs. Interleukin-12 (IL12) gene transfer using PEI may represent an important strategy for lung cancer treatment. In this study, we evaluated the antitumoral efficacy of the administration of PEI-DNA nanoparticles carrying IL12 gene (PEI-IL12) for the treatment of lung cancer and pulmonary metastases in animal models. After inoculation of tumor cells, mice were treated intravenously with a single dose of PEI-IL12, PEI nanoparticles carrying the reporter gene beta-galactosidase (PEI-LacZ) or vehicle. Transgene expression, survival rates and immune response were analyzed in both models. Administration of PEI-LacZ and PEI-IL12 nanoparticles controlled tumor growth and prolonged survival times in both animal models. Although PEI-IL12 and PEI-LacZ administration showed similar antitumoral effects in the lung cancer model, the efficacy of PEI-IL12 was significantly superior in the inhibition of the development of pulmonary metastases. Furthermore, the administration of PEI-DNA nanoparticles results in the production of high levels of proinflammatory cytokines. Our results showed that PEI-DNA nanoparticles are an efficient vector for mediating gene transfer to the lungs, are a potent inducer of the innate immune response and represents an interesting strategy for the treatment of bronchogenic carcinoma and metastatic lung carcinoma.

Molecular characterization of small peripheral lung tumors based on the analysis of fine needle aspirates.

The computed tomography (CT)-based early lung cancer diagnostic technologies allow the detection of very small stage I lung tumors. As part of these screening protocols any suspicious nodule has to be diagnosed morphologically, which requires CT-guided Fine Needle Aspiration, open biopsy or surgery. Fine Needle Aspiration (FNA) cytology is a well-recognised method for a rapid and accurate diagnosis of small lung tumors. Molecular analysis of the FNA specimens could complement cytology diagnosis by the characterization of the biological traits at the preoperative stage. In this study, we aimed to characterize the biological profile of 33 paraffin-embedded transthoracic FNA samples obtained from three groups of lung cancer patients: two groups of small early-detected lung adenocarcinomas (radiologically subsolid and solid nodules) and a third group of small metastatic adenocarcinomas. Genetic analysis was performed by fluorescence in situ hybridization using the four-color LAVysion probe. p53 and Ki-67 protein expression was also evaluated by immunocytochemistry. The samples showed gains for all targets analyzed; two cases had EGFR gene amplification and two cases had MYC amplification. There were no significant differences in the percentage of genetically malignant cells and the expression of Ki-67 among the three groups. However, p53 accumulation was significantly higher in the metastatic group compared to the subsolid early-detected group (P = 0.001). In conclusion, molecular analysis of FNA specimens may provide useful information at preoperative stages. In our series, a good prognostic profile in subsolid early detected adenocarcinomas is suggested.

Detección y caracterización del nódulo pulmonar por tomografía computarizada / Detection and characterization of pulmonary nodules using multislice computed tomography

El nódulo pulmonar es un hallazgo frecuente en los estudios torácicos realizados durante la práctica clínica diaria. Aunque no existen datos clínicos o radiológicos patognomónicos que indiquen su naturaleza exacta, el contexto clínico y la caracterización adecuada del nódulo pulmonar permiten realizar el diagnóstico correcto en la mayoría de los casos. En este artículo se exponen los aspectos más relevantes de lautilidad de la tomografía computarizada multicorte (TCMC) para detectar y caracterizar los nódulos pulmonares de forma no invasiva

Pulmonary nodules are a common finding in routine chest studies. Although there are no pathognomic clinical or radiological signs that enable the exact nature of a pulmonary nodule to be determined, the clinical context and the appropriate characterization of the pulmonarynodule make it possible to reach the correct diagnosis in most cases. This article discusses the most important aspects involved in the use of multislice computed tomography in the noninvasive detection and characterization of pulmonary nodules (AU)

[Detection and characterization of pulmonary nodules using multislice computed tomography]. / Detección y caracterización del nódulo pulmonar por tomografía computarizada multicorte.

Pulmonary nodules are a common finding in routine chest studies. Although there are no pathognomic clinical or radiological signs that enable the exact nature of a pulmonary nodule to be determined, the clinical context and the appropriate characterization of the pulmonary nodule make it possible to reach the correct diagnosis in most cases. This article discusses the most important aspects involved in the use of multislice computed tomography in the noninvasive detection and characterization of pulmonary nodules.

Factors determining early adherence to a lung cancer screening protocol.

Lung cancer screening using computed tomography (CT) is effective in detecting early stage disease. However, concerns regarding adherence have been raised. The current authors conducted a retrospective observational study of 641 asymptomatic smokers enrolled in a lung cancer screening programme between 2000 and 2003. Adherent subjects were compared with nonadherent subjects with regard to lung function, sex, age, motivation for enrollment, smoking status, distance to the referral centre, family history of lung cancer, asbestos exposure, education, the presence and type of nodule(s) seen on initial CT, and exposure to a nursing intervention designed to improve adherence. Overall, early adherence to the study protocol was 65%. Multivariate analysis confirmed the importance of sex, proximity to the referral centre, the presence of noncalcified nodules, and the nursing intervention as factors conditioning adherence to the study protocol. Patients encouraged to participate in the study were more adherent, as were former smokers. Sex interactions were observed in multivariate analysis. The nursing intervention was significant for females, while abnormal lung function improved male adherence. Adherence to lung cancer screening is particularly good among females and subjects living near the referral centre. The present study suggests the need to develop new strategies, especially those targeting males and subjects with low risk perception, in order to improve adherence.

Hyperleptinaemia, respiratory drive and hypercapnic response in obese patients.

Leptin is a powerful stimulant of ventilation in rodents. In humans, resistance to leptin has been consistently associated with obesity. Raised leptin levels have been reported in subjects with sleep apnoea or obesity-hypoventilation syndrome. The aim of the present study was to assess, by multivariate analysis, the possible association between respiratory centre impairment and levels of serum leptin. In total, 364 obese subjects (body mass index >or=30 kg.m(-2)) underwent the following tests: sleep studies, respiratory function tests, baseline and hypercapnic response (mouth occlusion pressure (P(0.1)), minute ventilation), fasting leptin levels, body composition and anthropometric measures. Subjects with airways obstruction on spirometry were excluded. Out of the 346 subjects undergoing testing, 245 were included in the current analysis. Lung volumes, age, log leptin levels, end-tidal carbon dioxide tension, percentage body fat and minimal nocturnal saturation were predictors for baseline P(0.1). The hypercapnic response test was performed by 186 subjects; log leptin levels were predictors for hypercapnic response in males, but not in females. Hyperleptinaemia is associated with a reduction in respiratory drive and hypercapnic response, irrespective of the amount of body fat. These data suggest the extension of leptin resistance to the respiratory centre.

Consentimiento informado en Implantología Oral. Propuesta de documentos / Informed consent in Oral Implantology. Proposal of documents

La Implantología es una de las áreas de la Odontoestomatología más afectadas por los problemas legales derivados de la Ley Básica Reguladora de la Autonomía del Paciente y ello por varias razones: por ser una actividad claramente quirúrgica, por haber sido encuadrada dentro de la llamada “medicina satisfactiva” y por pertenecer casi exclusivamente a la práctica privada de la odontoestomatología. Tiene además la peculiaridad de que los procedimientos quirúrgicos y prostodóncicos están íntimamente relacionados, y es, en ocasiones, muy complejo deslindar la responsabilidad que corresponde a cada uno de estos actos. En el presente artículo nos centraremos en las repercusiones que sobre esta área de la odontoestomatología tiene la reciente Ley Básica Reguladora de la Autonomía del Paciente en lo que a la información y al consentimiento se refiere. También haremos una propuesta de documentos que, a nuestro juicio, cumplen con los requisitos señalados por la legislación actual (AU)

The Implantology is one of the areas of the Odontoestomatology more affected by the legal problems derived from the Regulating Basic Law of the Autonomy of the Patient, and it for several reasons: for being a clearly surgical activity, for being fitted within the call ‘satisfactive medicine’ and to belong almost exclusively to the private practice of the Odontoestomatology. It has in addition the peculiarity of which the surgical and prosthodontics procedures intimately are related, and is sometimes, very complex to define the responsibility of corresponds to each one of these acts. In the present article we will be centred in the repercussions that on this area of the Odontoestomatology the recent Regulating Basic Law of the Autonomy of the Patient has in which to the information and the consent it talks about. Also we will make a proposal of documents that, in our opinion, fulfill the requirements indicated by the present legislation (AU)

The cause of death of Emperor Charles V.

Abstract. Plasmodium falciparum malaria was the cause of death of Emperor Charles V. This confirmation was achieved by microscopy analysis of the Emperor's remnants.

[Lung transplant]. / Trasplante pulmonar.

A lung transplant is usually the final therapeutic option for patients with respiratory insufficiency. In spite of the many advances in immunology and the management of complications, mortality and morbidity associated with this transplant are far higher than with others. Acute rejection is an almost universal problem in the first year, while obliterative bronchitis reduces long term survival. Respiratory infections also play a significant role in the complications associated with lung transplants due to the constant exposure of the graft to the outside. However, the success of this therapeutic option, which basically depends on a suitable selection of donor and recipient, are evident, above all with respect to quality of life.

Trasplante pulmonar / Lung transplant

El tranplante pulmonar suele ser la última opción terapéutica para pacientes con insuficiencia respiratoria. A pesar de los muchos avances en inmunología y el manejo de las complicaciones, la mortalidad y morbilidad asociadas a este trasplante son muy superiores a los demás. El rechazo agudo es casi un problema universal en el primer año, mientras que la bronquiolitis obliterante limita la supervivencia a largo plazo. Las infecciones respiratorias también cumplen un papel importante en las complicaciones asociadas al trasplante pulmonar por la constante exposición del injerto al medio exterior. No obstante, los éxitos de esta opción terapéutica que depende fundamentalmente de una correcta selección de donante y receptor, son evidentes, sobre todo en cuanto a calidad de vida se refiere

A lung transplant is usually the final therapeutic option for patients with respiratory insufficiency. In spite of the many advances in immunology and the management of complications, mortality and morbidity associated with this transplant are far higher than with others. Acute rejection is an almost universal problem in the first year, while obliterative bronchitis reduces long term survival. Respiratory infections also play a significant role in the complications associated with lung transplants due to the constant exposure of the graft to the outside. However, the success of this therapeutic option, which basically depends on a suitable selection of donor and recipient,are evident, above all with respect to quality of life

Síndrome de apneas-hipopneas del sueño: un problema sanitario / No disponible

El síndrome de apneas-hipopneas del sueño (SAHS) es una entidad muy frecuente en las sociedades desarrolladas, asociado a factores como obesidad, sexo masculino, edad, alteraciones endocrinometabólicas, anormalidades craneofaciales e historia familiar previa. Aunque las consecuencias del SAHS son todavía motivo de controversia,parece asociarse a diversas complicaciones neurocognitivasy cardiovasculares derivadas de la fragmentación del sueño y de la hipoxemia e hipercapnia durante los episodios de apnea-hipopnea. De hecho, son la severidad de los síntomas diurnos y el impacto de la enfermedad sobre la calidad de vida del paciente, y no la mera consideración de los índices de apnea-hipopnea durante el sueño, los que deben guiar la atención del paciente con sospecha de apneas del sueño. Se revisan las complicaciones clínicas derivadas de las apneas del sueño

Obstructive sleep apnea-hypopnea syndrome is very prevalent among developed societies, associated with a series of risk factors like obesity, male gender, age, endocrine illnesses, cranio-facial abnormalitiesand family history. Although there is still controversy about the clinical consequences of sleep apnea, they appear to be related to several neurocognitive and cardiovascular disturbances caused by sleep fragmentation, and hypoxia and hypercapnia during episodes of apnea - hypopnea. In fact, it is the severity of diurnal symptoms and the impact on quality of life, and not only the apnea-hypopnea index, which should guide the approach to patients in whom sleep apnea issuspected. This brief article intends to review the clinical consequences of sleep apneas, without a comprehensive description of the diagnosis and treatment of this entity (AU)