Alex George Stanciu, Alexandra Cirticioiu and Adriana Neagos
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Mihaela Trenchea, Agripina Rașcu and Oana-Cristina Arghir
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Nicoleta Dumitrescu, Raluca Enache and Codrut Sarafoleanu
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Irén Csiszér, Simona Mocanu, Vlad Budu and Adriana Neagos
BACKGROUND. Even if it is a rare variant growth pattern of squamous cell carcinoma, sarcomatoid carcinoma seems to have almost the same clinical manifestations and risk factors as conventional squamous cell carcinoma.
CASE REPORT. This paper presents a complex case of a 59-year-old female patient known with laryngeal papillomatosis, who presented in our Department for moderate to severe inspiratory dyspnea associated with dysphonia and difficulty in swallowing. We mention that the patient had been previously evaluated by a pneumologist for apnea, snoring and daytime sleepiness and diagnosed and treated for sleep apnea syndrome. Clinical, laboratory, imaging and pathologic examinations revealed the association of upper airway obstruction with laryngeal cancer. Surgical intervention consisted in total laryngectomy and selective neck dissection associated with permanent tracheotomy. The microscopic appearance was that of a bilateral transglottic sarcomatoid squamous cell carcinoma without metastasis in the right lymph node.
CONCLUSION. It is important to evaluate the clinical and imagistic status of patients with laryngeal tumors in order to make a correct decision concerning their treatment policy. We emphasize that cooperation between multiple departments is absolutely necessary in order to adequately resolve, explore, diagnose and treat patients with laryngeal pathology.
Manuela Arbune, Irina-Magdalena Dumitru and Mariana Cretu-Stuparu
Sleep disorders commonly occur in chronic diseases and are a great impairment on the quality of life. The current study aims to characterize the sleep problems of a group of Romanian HIV positive patients. A cross sectional study assessed sleep disorders by a series of self-report questionnaires: STOP-BANG, Epworth Sleep Questionnaire and Pittsburgh Sleep Quality Index. Demographic data, antiretroviral therapy, Lymphocytes CD4 levels were collected from medical records. Exclusion criteria were illiteracy, severe neurocognitive dysfunction and depression. We included 102 patients infected with human immunodeficiency virus, age between 22 and 50, sex ratio M/F=1.17. Reported conditions related to sleep disorders were: smoking (50%), hypertension (18%), obesity (6%) and snoring (7%). The STOP-BANG scale indicated 19% intermediate risk and 2% high risk of sleep apnea. According to Epworth score, daytime sleepiness was found in 18% of patients, 2% of them were dangerously sleepy. The average global score of Pittsburg Sleep Questionnaire is indicative of poor sleep quality in 42% cases. No correlation of sleep scores with antiretroviral regimens was found. Sleep problems with negative impact on daily functioning are frequent under age 50, in patients with human immunodeficiency virus. The management of chronic co-morbidities and psychological support should improve sleep disorders related to human immunodeficiency virus.
Magdalena Dobrowolska-Zarzycka, Izabella Dunin-Wilczynska, Iwona Mitura and Jolanta Szymanska
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4. Kuźmińska M., Marcinkowska-Suchowierska E.: Otyłość a obturacyjny bezdech senny. Post. Nauk Med., 9, 26, 2013.
5. Mayer P., Pepin G., Bettega D., et al.: Relationship between body mass index, age and upper airway measurements in snorers and sleep apnoea patients. Eur. Respire J., 1801, 9, 1996.
6. Ono T., Lowe A.A., Ferguson K.A., et al.: Associations between upper airway structure, body position and obesity in skeletal Class I male patients with obstructive sleep apnea. Am. J. Orthod. Dentofac. Orthop