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Kiss B, Neagos CM, Jimborean G, Sárközi HK, Szathmary M, Neagos A. Comorbidities and Laryngeal Cancer in Patients with Obstructive Sleep Apnea: A Review. Medicina (Kaunas) 2023; 59:1959. [PMID: 38004008 PMCID: PMC10672902 DOI: 10.3390/medicina59111959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/24/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023]
Abstract
Introductions: The global prevalence of obstructive sleep apnea shows that this disease appears in 1 billion people, with the prevalence exceeding 50% in some countries. Treatment is necessary to minimize negative health impacts. Obstructive sleep apnea (OSA) is defined as a cause of daytime sleepiness, as well as a clinical manifestation of sleep-disordered breathing. In the literature, there are numerous controversial studies regarding the etiology of this condition, but it is universally accepted that reduced activity in the upper airway muscles plays a significant role in its onset. Additionally, OSA has been associated with a series of comorbidities, such as type II diabetes, metabolic syndrome, and cardiovascular and pulmonary conditions, as well as head and neck tumors, especially oropharyngeal and laryngeal tumors. This is a review of the subject of OSA that considers several aspects: an analysis of the comorbidities associated with OSA, the involvement of tumor pathology in the onset of OSA, and the association of OSA with various types of laryngeal cancers. Additionally, it includes an evaluation of postoperative and medical outcomes for patients with OSA and laryngeal tumors treated surgically and medically, including chemotherapy. Relevant Sections: By taking into consideration the stated objective, a systematic analysis of the available literature was conducted, encompassing the PubMed, Medline, and Scopus databases. The evaluation was based on several keywords, including head and neck cancer, diabetes, diabetic, overlap syndrome, cardiovascular conditions, laryngeal neoplasm, radiotherapy, and chemotherapy, as well as the concept of quality of life in laryngectomized patients and patients with OSA. Discussions: The review evaluates the involvement of OSA in the presence of comorbidities, as well as the increased incidence of OSA in patients with laryngeal cancer. It is important to note that surgical and post-surgical treatment can play a significant role in triggering OSA in these patients. Conclusions: The studies regarding the correlations between OSA, comorbidities, and head and neck tumors indicate a significantly increased risk of OSA in association with conditions such as diabetes, metabolic syndrome, cardiovascular diseases, and head and neck tumors, particularly laryngeal tumors. This association has a physio-pathological basis. The various surgical methods followed by radiation and chemotherapy for tumor treatment do not exclude an increased risk of developing OSA after treatment. This significantly influences the quality of life of patients who survive these types of tumors. Future directions: Due to the multiple comorbidities associated with OSA, the extension of polysomnography associated with investigations during sleep, such as drug-induced sleep endoscopy, represents a tendency for the early diagnosis of this pathology, which affects the quality of life of these patients. Patients with head and neck cancer are at high risk of developing obstructive sleep apnea; this is why it is necessary to expand the polysomnographic investigation of these patients after surgical procedures or after radiotherapy and chemotherapy.
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Affiliation(s)
- Beata Kiss
- Department of Otorinolaryngology, Emergency County Hospital Targu Mures, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania (C.M.N.)
| | - Cristian Mircea Neagos
- Department of Otorinolaryngology, Emergency County Hospital Targu Mures, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania (C.M.N.)
| | - Gabriela Jimborean
- Pneumologic Department, George Emil Palade University of Medicine Science and Technology, 540136 Târgu Mures, Romania; (G.J.); (H.K.S.); (M.S.)
| | - Hédi Katalin Sárközi
- Pneumologic Department, George Emil Palade University of Medicine Science and Technology, 540136 Târgu Mures, Romania; (G.J.); (H.K.S.); (M.S.)
| | - Mioara Szathmary
- Pneumologic Department, George Emil Palade University of Medicine Science and Technology, 540136 Târgu Mures, Romania; (G.J.); (H.K.S.); (M.S.)
| | - Adriana Neagos
- Department of Otorinolaryngology, Emergency County Hospital Targu Mures, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania (C.M.N.)
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Pătrîntașu DE, Sárközi HK, Lupușor E, Vlangăr IE, Rotariu GM, Rența IA, Nan AN, Budin CE. A Multidisciplinary Approach as a Goal for the Management of Complications in Systemic Scleroderma: A Literature Review and Case Scenario. Diagnostics (Basel) 2023; 13:3332. [PMID: 37958228 PMCID: PMC10648338 DOI: 10.3390/diagnostics13213332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Systemic sclerosis (also known as scleroderma) is a chronic fibrosing autoimmune disease with both skin and multisystem organ involvement. Scleroderma has the highest mortality among all rheumatic diseases. The pathophysiology mechanism of systemic sclerosis is a progressive self-amplifying process, which involves widespread microvascular damage, followed by a dysregulation of innate and adaptive immunity and inflammation and diffuse fibrosis of the skin and visceral organs. Fibrosis of internal organs is a hint for systemic sclerosis, moreover associated with interstitial lung disease (SSc-ILD) is a complex process. In order to correlate scientific data from the literature with clinical experience, we present the case of a 56-year-old woman who was diagnosed with systemic sclerosis 16 years ago. The association of numerous comorbidities characterized by a considerable level of seriousness characterizes this case: the highly extensive systemic damage, the cardiovascular impact of the illness, and the existence of severe pulmonary arterial hypertension. The systemic and clinical manifestations, respiratory functional tests, radiological features, and specific therapy are discussed.
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Affiliation(s)
- Dariana-Elena Pătrîntașu
- Pneumology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania; (D.-E.P.); (H.K.S.); (E.L.); (I.-A.R.); (C.E.B.)
| | - Hédi Katalin Sárközi
- Pneumology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania; (D.-E.P.); (H.K.S.); (E.L.); (I.-A.R.); (C.E.B.)
- Pneumology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 540139 Targu Mures, Romania
| | - Eugeniu Lupușor
- Pneumology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania; (D.-E.P.); (H.K.S.); (E.L.); (I.-A.R.); (C.E.B.)
| | - Irina Elena Vlangăr
- Cardiology Department, Elias University Emergency Hospital, 011461 Bucharest, Romania;
| | - Gheorghe-Marian Rotariu
- Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 540139 Targu Mures, Romania;
| | - Ionuț-Alexandru Rența
- Pneumology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania; (D.-E.P.); (H.K.S.); (E.L.); (I.-A.R.); (C.E.B.)
| | - Anda-Nicoleta Nan
- Pneumology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania; (D.-E.P.); (H.K.S.); (E.L.); (I.-A.R.); (C.E.B.)
| | - Corina Eugenia Budin
- Pneumology Department, Mures Clinical County Hospital, 540142 Targu Mures, Romania; (D.-E.P.); (H.K.S.); (E.L.); (I.-A.R.); (C.E.B.)
- Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, 540139 Targu Mures, Romania
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Ciurba BE, Sárközi HK, Szabó IA, Ianoși ES, Grigorescu BL, Csipor-Fodor A, Tudor TP, Jimborean G. Applicability of lung ultrasound in the assessment of COVID-19 pneumonia: Diagnostic accuracy and clinical correlations. Respir Investig 2022; 60:762-771. [PMID: 35995704 PMCID: PMC9359491 DOI: 10.1016/j.resinv.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/19/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The purpose of this study was to assess the diagnostic accuracy of lung ultrasound (LUS) in determining the severity of coronavirus disease 2019 (COVID-19) pneumonia compared with thoracic computed tomography (CT) and establish the correlations between LUS score, inflammatory markers, and percutaneous oxygen saturation (SpO2). METHODS This prospective observational study, conducted at Târgu-Mureș Pulmonology Clinic included 78 patients with confirmed severe acute respiratory syndrome coronavirus-2 infection via nasopharyngeal real-time-polymerase chain reaction (RT-PCR) (30 were excluded). Enrolled patients underwent CT, LUS, and blood tests on admission. Lung involvement was evaluated in 16 thoracic areas, using AB1 B2 C (letters represent LUS pattern) scores ranging 0-48. RESULTS LUS revealed bilateral B-lines (97.8%), pleural irregularities with thickening/discontinuity (75%), and subpleural consolidations (70.8%). Uncommon sonographic patterns were alveolar consolidations with bronchogram (33%) and pleural effusion (2%). LUS score cutoff values of ≤14 and > 22 predicted mild COVID-19 (sensitivity [Se] = 84.6%; area under the curve [AUC] = 0.72; P = 0.002) and severe COVID-19 (Se = 50%, specificity (Sp) = 91.2%, AUC = 0.69; P = 0.02), respectively, and values > 29 predicted the patients' transfer to the intensive care unit (Se = 80%, Sp = 97.7%). LUS score positively correlated with CT score (r = 0.41; P = 0.003) and increased with the decrease of SpO2 (r = -0.49; P = 0.003), with lymphocytes decline (r = -0.52; P = 0.0001). Patients with consolidation patterns had higher ferritin and C-reactive protein than those with B-line patterns (P = 0.01; P = 0.03). CONCLUSIONS LUS is a useful, non-invasive and effective tool for diagnosis, monitoring evolution, and prognostic stratification of COVID-19 patients.
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Affiliation(s)
- Bianca Emilia Ciurba
- Pneumology Department from Mureș; County Clinical Hospital, Gheorghe Marinescu Street Number 5, Târgu Mureș, Postal code 540098, Romania; 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, Gheorghe Marinescu Street Number 38, Postal code 540139, Romania
| | - Hédi Katalin Sárközi
- Pneumology Department from Mureș; County Clinical Hospital, Gheorghe Marinescu Street Number 5, Târgu Mureș, Postal code 540098, Romania; 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, Gheorghe Marinescu Street Number 38, Postal code 540139, Romania
| | - István Adorjan Szabó
- 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, Gheorghe Marinescu Street Number 38, Postal code 540139, Romania.
| | - Edith Simona Ianoși
- Pneumology Department from Mureș; County Clinical Hospital, Gheorghe Marinescu Street Number 5, Târgu Mureș, Postal code 540098, Romania; 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, Gheorghe Marinescu Street Number 38, Postal code 540139, Romania
| | - Bianca Liana Grigorescu
- 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, Gheorghe Marinescu Street Number 38, Postal code 540139, Romania; Anesthesiology and Intensive Therapy Department from Emergency Mureș; County Clinical Hospital, Gheorghe Marinescu Street Number 50, Târgu Mureș, Postal code 540136, Romania
| | - Alpar Csipor-Fodor
- Pneumology Department from Mureș; County Clinical Hospital, Gheorghe Marinescu Street Number 5, Târgu Mureș, Postal code 540098, Romania
| | - Toma P Tudor
- University Hospital Lewisham & Greenwich, Owen Centre Lewisham Hospital Lewisham High Street, London SE13 6LH, UK
| | - Gabriela Jimborean
- Pneumology Department from Mureș; County Clinical Hospital, Gheorghe Marinescu Street Number 5, Târgu Mureș, Postal code 540098, Romania; 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology from Târgu Mureș, Gheorghe Marinescu Street Number 38, Postal code 540139, Romania
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