CPAP treatment supported by telemedicine does not improve blood pressure in high cardiovascular risk OSA patients: a randomized, controlled trial.

Study Objectives: Obstructive sleep apnea (OSA) has been associated with hypertension, which is one of the intermediary mechanisms leading to increased cardiovascular morbidity. This study aimed at evaluating the effects of a combination of continuous positive airway pressure (CPAP) and telemedicine support on blood pressure (BP) reduction in high cardiovascular risk OSA patients.

Design: A multi-center randomized controlled trial that compared standard CPAP care and CPAP care and a telemedicine intervention.

Low physical activity is a determinant for elevated blood pressure in high cardiovascular risk obstructive sleep apnea.

Introduction: Obstructive sleep apnea (OSA) is associated with cardiovascular morbidity, including hypertension. Beyond the severity of nocturnal hypoxia, other factors such as metabolic abnormalities but also sedentary behaviors and insufficient physical activity may contribute to elevated blood pressure (BP). To clarify the respective role of these factors as determinants of BP in OSA patients, we examined the relationship between BP and anthropometrics, severity of sleep apnea, and objectively measured physical activity and sedentary behaviors.

[How do we reduce the under-reporting of occupational primary lung cancer].

Unlabelled: The under-reporting of occupational lung cancer is due to insufficient recognition of occupational exposure and inadequate medico-legal action.

Materials And Methods: All cases of primary bronchial carcinoma seen at the University Hospital of Grenoble between October 1996 and December 1998 completed a standardised questionnaire set by a physician in occupational medicine. When evidence of exposure to occupational carcinogens was established a claim for occupational disease was made and the outcomes of these claims were obtained from the Department of Social Security at the end of 2000.

[Cushing syndrome and small cell carcinoma. Three case reports].

Paraneoplastic Cushing's syndrome associated with small cell carcinoma is a poor prognosis factor. Opportunistic infections are an important factor of morbidity and mortality. Therefore antiadrenal medications are necessary before initiating cytotoxic chemotherapy.

[An unusual case of cardiac insufficiency].

A 70 year old patient with a past history of a left ventricular cardiomyopathy with concentric hypertrophy presented with an exacerbation of cardiac failure; radiology revealed bilateral lung infiltrations, predominantly on the right and a restrictive ventilatory disorder. The broncho-alveolar lavage revealed a lymphocytosis with CD4 prominence. Microbiological examination was negative.