The Advocate - June 8, 1961

Original title (1951-1987)--The Advocate: official publication of the Archdiocese of Newark (N.J.)

Elevated risk of motor vehicle accidents in patients with obstructive sleep apnea syndrome: A case-control study

WOS: 00020937040330

Gender differences in clinical and polysomnographic features of obstructive sleep apnea: a clinical study of 2827 patients

WOS: 000426724800038PubMed ID: 28197893Obstructive sleep apnea (OSA) is underdiagnosed in females due to different clinical presentation. We aimed to determine the effect of gender on clinical and polysomnographic features and identify predictors of OSA in women. Differences in demographic, clinical, and polysomnographic parameters between 2052 male and 775 female OSA patients were compared. In female OSA patients, age (56.1 +/- 9.7 vs. 50.4 +/- 11.6 years, p < 0.0001) and body mass index (36.3 +/- 8.6 vs. 31.8 +/- 5.9 kg/m(2), p < 0.0001) were increased, whereas men had higher waist-to-hip ratio and neck circumference (p < 0.0001). Hypertension, diabetes mellitus, thyroid disease, and asthma were more common in females (p < 0.0001). Men reported more witnessed apnea (p < 0.0001), but nocturnal choking, morning headache, fatigue, insomnia symptoms, impaired memory, mood disturbance, reflux, nocturia, and enuresis were more frequent in women (p < 0.0001). The indicators of OSA severity including apnea-hypopnea index (AHI) (p < 0.0001) and oxygen desaturation index (p = 0.007) were lower in women. REM AHI (p < 0.0001) was higher, and supine AHI (p < 0.0001) was lower in females. Besides, women had decreased total sleep time (p = 0.028) and sleep efficiency (p = 0.003) and increased sleep latency (p < 0.0001). In multivariate logistic regression analysis, increased REM AHI, N3 sleep, obesity, age, morning headache, and lower supine AHI were independently associated with female gender. These data suggest that frequency and severity of sleep apnea is lower in female OSA patients, and they are presenting with female-specific symptoms and increased medical comorbidities. Therefore, female-specific questionnaires should be developed and used for preventing underdiagnosis of OSA

Culture proven extra pulmonary tuberculosis: drug susceptibility and genetic profile analysis

WOS: 000448474100007PubMed ID: 30479231Introduction: Tuberculosis is seen generally in the lungs. Besides, all organs in the body can be affected by tuberculosis. Diagnosis of extra pulmonary tuberculosis (EPTB) is more difficult than pulmonary tuberculosis (PTB). Although, the isolation of Mycobacterium tuberculosis is gold standard of diagnosis of EPTB, the rate of bacteriologic isolation is low especially in EPTB. If M. tuberculosis is detected, it gives some information about the epidemiological features of the disease and drug susceptibility. Materials and Methods: In this study, extra pulmonary samples isolated M. tuberculosis in mycobacteriology laboratory were evaluated between 2009-2016. The identification of the genotype of isolated bacteria and drug sensitivity tests were conducted. Spoligotyping was accomplished using a standard technique as described previously. Results: During the study period, M. tuberculosis were cultured in 171 extra pulmonary samples of 165 patients (75 male, 90 female, mean age: 53.35 +/- 19.92). Initial direct microscopically examination was revealed M. tuberculosis in 44 patients. There were more than one extra pulmonary organ involvement in six patients. The most common EPTB forms were lymph node TB in 60 patients, pleural tuberculosis in 32 patients and bone tuberculosis in 25 patients. Immunosuppression was detected in 44 (%26.6) patients. Among these, seven patients were infected with HIV. In 21 of 175 samples, drug resistance was detected. Rifampicin resistance in 7 samples, high level isoniazid resistance in 11 samples and rifampicin plus isoniazid resistance (multiply drug resistance) in 6 samples were demonstrated. One hundred thirty-five clinical isolates were cultured from tuberculosis patient's different samples, of which the genetic profile was determined by using Spoligotyping. The major Spoligotypes were T (n= 62; 45.9%), LAM7-TUR (ST41) (n= 11; 8.1%) and H (n= 9; 6%) genotypes. Conclusion: The most common EPTB form was lymph node tuberculosis in culture proven patients. In these patients group, multiply drug resistance rate was low (3.6%). Spoligotypes T (45.9%) was detected as most common genetic profile

Quality of life in obstructive sleep apnea is related to female gender and comorbid insomnia

WOS: 000452078700016PubMed ID: 29352360Purpose Obstructive sleep apnea (OSA) is a common sleep disorder affecting health-related quality of life (QoL), and OSA severity is not a reliable indicator for QoL. The aim of this study was (1) to evaluate the impact of gender on QoL and (2) to identify the predictors of QoL in OSA patients. Methods World Health Organization Quality of Life Scale short form (WHOQOL-Bref) was used for evaluating QoL in OSA patients undergoing polysomnography in sleep laboratory of a university hospital. Results Out of 197 patients (age 50.4 +/- 12.1 years, AHI 38.5 +/- 28.4/h), 139 (70.6%) were men and 79.2% had moderate-to-severe OSA. Female gender, increased BMI, higher Epworth sleepiness score (ESS), and lower oxygen saturations were associated significantly with poor QoL in terms of all domains (physical, psychological, social relationship, and environmental) of WHOQOL-Bref questionnaire. The indicators of OSA severity (AHI and ODI) correlated negatively only with the physical domain. The subjects with comorbid insomnia and OSA had lower physical and social scores than subjects with no insomnia, and women with insomnia had significantly worse QoL scores in all domains than the others. In the multivariate linear regression analysis, female gender, comorbid insomnia, increased sleepiness, and higher BMI were significantly associated with poor QoL. Conclusions Female gender, comorbid insomnia, and daytime sleepiness were the outstanding factors affecting health-related QoL negatively in OSA. Besides, the impact of OSA on QoL may be explained by the presence of daytime sleepiness rather than OSA severity

EVALUATION OF 694 TUBERCULOUS LYMPHADENITIS CASES REPORTED FROM TURKEY BETWEEN 1997-2009 PERIOD BY POOLED ANALYSIS METHOD

WOS: 000281584800005PubMed ID: 21063988Tuberculosis which mainly involves the lungs, can also cause infection in almost all other organs and tissues in the body. One of the most common forms of extrapulmonary tuberculosis is tuberculous lymphadenitis. In this study, tuberculous lymphadenitis cases reported from Turkey in national and international journals in the last 12 years, were reviewed systematically with pooled-analysis method. Related articles were retrieved by search of three national (Ulakbim Turkish Medical literature databases, http://www.turkishmedline.com, http://medline.pleksus.com.tr) and two international databases [Pub-Med and Science Citation Index (SCI)]. Between the years 1997-2009, tuberculous lymphadenitis cases have been published in a total of 44 articles (13 international, 31 national data base). These articles included a total of 694 tuberculous lymphadenitis cases (62.4% women, 37.6% men; mean age 37.5 years). The distribution of the lymph nodes involved was determined in 528 cases and the most commonly involved areas were cervical (61.4%), mediastinal (20.5%) and axillary (6.4%) areas. The most common complaints of patients were fever (15.8%), weight loss (14.5%), malaise-fatigue (13.1%) and sweating (12.4%). Tuberculous lymphadenitis was identified in 10.6% (51/479) of the cases by direct microscopical examination, in 15.9% (65/408) by culture and in 648 cases from whom biopsies were taken, by histopathological examination. Tuberculin skin test positivity was detected in 78.9% (377/478) cases. History of contact with active tuberculosis patients was determined in 24.2% (88/364) of the patients. Coexisting lung tuberculosis was detected in 7.8% (54/694) of the cases. The total number of cases that had died was four; two cases due to malignancy, one due to sepsis and one due to central nervous system tuberculosis that have developed four years following the diagnosis of tuberculous lymphadenitis. Since microbiological diagnosis is difficult in tuberculous lymphadenitis and not available in all centers, evaluation of the patients' history and clinical findings are of great importance. This pooled analysis which enabled the evaluation of a large number of tuberculous lymphadenitis cases, indicated that in countries where tuberculosis is widespread, careful evaluation of clinical findings and a good microbiological and histopathological investigation will provide valuable support for diagnosis and treatment of tuberculous lymphadenitis