Obstructive sleep apnoea syndrome: underestimated and undertreated.

The obstructive sleep apnoea syndrome (OSAS) was first identified only 40 years ago and its clinical importance is increasingly recognized. Although now acknowledged as a worldwide problem, which in Western countries affects 2-4% of middle-aged men and 1-2% of middle-aged women, the majority of affected individuals remain undiagnosed. OSAS is strongly associated with obesity but is also increasingly identified in the less obese, in whom a particular craniofacial structure is an important contributory factor.

White matter disease and sleep-disordered breathing after acute stroke.

Objective: To assess sleep-disordered breathing (SDB) in patients with acute stroke and its relationship to prestroke cerebrovascular disease, particularly leukoariosis.

Methods: The authors studied SDB and CT evidence of prestroke cerebrovascular disease, nonacute brain infarction, and white matter disease (WMD) in 78 previously independent patients with acute stroke. Subjects underwent respiratory sleep studies to determine the Apnea-Hypopnea Index (AHI) and Desaturation Index (DI) 7 to 14 days following stroke.

Body composition of preterm infants during infancy.

Aims: To examine body composition in preterm infants.

Methods: Body composition was measured by dual energy x-ray absorptiometry (DEXA) at hospital discharge, term, 12 weeks, and at 6 and 12 months corrected age in 125 infants (birthweight < or = 1750 g, gestational age < or = 34 weeks).

Results: Body weight derived by DEXA accurately predicted that determined by conventional scales.

Oral glutamine challenge in cirrhotics pre- and post-liver transplantation: a psychometric and analyzed EEG study.

Latent or sub-clinical hepatic encephalopathy is a recognized complication of cirrhosis and is thought to represent one end of the spectrum of neuropsychiatric impairment, which occurrs as a result of portal-systemic shunting. We studied the psychometric, analyzed electroencephalography (EEG), and venous blood ammonia responses to an oral glutamine challenge in 17 patients with cirrhosis and in 4 normal controls. The cirrhotics were attending for liver transplant assessment and had no clinical evidence of hepatic encephalopathy.

The accuracy of recording of occupational history in patients with bladder cancer.

Objective: To determine how accurately information on the occupations of patients with transitional cell carcinoma of the bladder (TCC) was recorded.

Patients And Methods: Using a semi-structured interview and a standard proforma, 108 patients with TCC of the urinary tract were studied and the results compared with records in their case notes.

Results: Case notes were substantially correct in only 39% of patients.

Oesophageal epiphrenic diverticulum: an unusual presentation and review.

Epiphrenic pulsion diverticula are rare and often asymptomatic. We describe a case presenting in an unusual fashion, and review the controversy over the management of this condition with regard to the requirement for myotomy and antireflux surgery. We believe that both procedures are necessary, but believe that both procedures are necessary, but optimal management strategies are unlikely to be resolved as the rarity of the condition precludes largescale prospective studies.

P53 expression, ploidy and progression in pT1 transitional cell carcinoma of the bladder.

Objective: To investigate a potential role for overexpression of the p53 protein in the identification of pT1 bladder tumours destined to progress.

Patients And Methods: The protein expression of the tumour suppressor gene p53, nuclear ploidy and tumour grade were studied in 25 patients with pT1 bladder tumours. Follow-up data was available for 21 tumours over a 10 year period.

Long-term pacing in heart transplant recipients is usually unnecessary.

The indications for and timing of permanent pacing were reviewed in all 17 of 154 adult heart transplant recipients at this center who have had permanent pacemakers implanted. Resting 12-lead ECGs recorded during routine follow-up were examined. A prospective study of pacing requirement was then undertaken.