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Personality profiles in patients with obstructive sleep apnea

ObjectiveThe Minnesota Multiphasic Personality Inventory (MMPI) responses between snorers and obstructive sleep apnea (OSA) may be different. Thus, we compared the MMPI responses between snorers and OSA.DesignA clinical-based cross-sectional survey.ParticipantsThis is a survey of 94 treatment-naive sleep-disordered breathing (SDB) subjects.MethodClinical information, body mass index (BMI), 36-item Short Form Health Survey, the Turkish version of the MMPI, Epworth sleepiness scale (ESS), fatigue scale, attention-deficit scale, and polysomnography were collected. All patients with OSA and snorers was accepted as individuals with SDB (AHI > 0 events/h). The threshold of five apnea and hypopnea per hour of sleep was chosen to define both OSA and snorers. Disability profile is consisting of four or more MMPI clinical scale elevations.ResultsOSA patients compared to snorers have significantly higher absolute scores on hypochondriasis (Hs) (65.0 ± 12.0 vs 58.4 ± 7.9, p = 0.01, respectively). OSA patients compared to snorers have significantly higher rate of clinical elevation on both psychopathic deviance (13.0 vs 0 %, p = 0.03, respectively) and Hs (26.1 vs 3.3 %, p = 0.01, respectively).People with disability profile has lower the quality of life, a higher score for inattention, a higher fatigue scores, and higher sleepiness scores. The quality of life and attention deficit and daytime sleepiness scores were associated with total MMPI absolute score in individuals with SDB in bivariate analyses.ConclusionPresent study indicated that patients with OSAS compared to snorers displayed significantly more hyopchondriasis and psychopathic deviance personality characteristics. The daytime functions in individuals with sleep-disordered breathing may be influenced by the severity of psychopathology.

Low Cognitive Ability in Subjects with Bronchiectasis

BACKGROUND: Bronchiectasis may change cognitive function. The mechanism responsible for cognitive dysfunction in COPD may be neuronal damage caused by hypoxia. Cognitive function in patients with bronchiectasis is also likely to be affected by similar mechanisms. The goal of this study was to determine the frequency and determinants of low cognitive ability in subjects with stable bronchiectasis. METHODS: Thirty subjects with stable bronchiectasis and 25 healthy volunteers underwent a cognitive ability assessment using the Wechsler Adult Intelligence Scale. Bronchiectasis was diagnosed by high-resolution computed tomography of the chest. Age, body mass index, the Hospital Anxiety and Depression Scale, and pulmonary function were assessed. Perceived intensity of dyspnea after exercise (after climbing 3 flights of stairs) was estimated using a modified Borg scale. RESULTS: Mean scores on the verbal and performance tests and full-scale IQ scores were significantly lower in subjects with bronchiectasis than in healthy volunteers. Low cognitive ability in subjects with bronchiectasis was associated with higher depression scores, lower oxygen saturation, and poor lung function after adjusting for potential confounders in multivariate analysis. Borg scores after exercise in subjects with bronchiectasis and low cognitive ability were higher than those in subjects with bronchiectasis and high cognitive ability, despite similar PaO2 and FEV1 in both groups. CONCLUSIONS: Low cognitive ability in subjects with bronchiectasis may be associated with reduced lung function, more serious hypoxemia, and higher depressive symptoms. Subjects with bronchiectasis and low cognitive ability feel more intense dyspnea than do those with high cognitive ability.

Metabolic syndrome in interstitial lung diseases

Introduction: Inflammation and physical inactivity are common potential mechanisms for metabolic syndrome (MS) and interstitial lung diseases (ILD). Therefore, we investigated factors determining MS and its frequency in ILDs in the present study. Method: A total of 64 patients diagnosed with ILD were enrolled in the study. Patients had fibrosis classification (FC) according to Muller method by performing HRCT examinations and total fibrosis score (TFS) was obtained according to fibrosis degree in the whole lung. MS diagnosis was made according to National Cholesterol Education Program (NAEP). Total MS component number was also calculated as MS score. Patients had respiratory function, carbonmonoxide diffusion, and lung volume tests, and arterial blood gaseous analyses were performed. Results: Of patients, 27 (42%) were diagnosed with MS. In Pearson9s correlation test, negative correlations were determined between DLCO% and MS presence (p= 0.005) and MS score (p= 0.04); between TLC% and MS presence (p= 0.02) and MS score (p= 0.01); between physical health score and MS score (p= 0.03). Negative correlations were also determined between physical health score and TFS (p= 0.004), and FC (p= 0.006). Conclusion: Metabolic disorders in ILD are increased in relationship with parameters showing the disease severity. Further studies are required to determine correlations between these two diseases.

Case of round pneumonia: pulmonary infarct and a rare situation that is similar with the lung cancer

Round pneumonia (RP) is a rare radiological presentation of a subtype of lobar pneumonia that arises because of a developmental defect in connective tissues (pores of Köhn and channels of Lambert). The round appearance on chest X‐ray (CXR) is thought to occur from an infectious process that spreads from small peripheral alveoli centrifugally through interalveolar channels via the pores of Kohn and the canals of Lambert. This explains the nonsegmental distribution and shape of RP. The pathogenesis of RP is unknown. An alternative theory holds that RP in children occurs because of underdeveloped pores of Kohn and the absence of canals of Lambert, limiting the spread of the organism and resulting in a focal, round mass seen on radiographs. As a result of this developmental defect, dissemination of infection remains in a limited area. While this is a well‐known entity in childhood, it has been described infrequently in adults. Lesions of RP are not necessarily round; oval lesions can also be seen. It is a radiological subtype of the pneumonia subtype and presents as a solitary nodule or a mass lesion in CXR.