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Objective: To evaluate the usefulness of a portable recording device (Oxyflow, EdenTec) to measure oronasal airflow, oxygen saturation and arterial pulse for diagnosing sleep apnea syndrome (SAS) using conventional polysomnography as the gold standard., Methods: Sixty-two subjects suspected of having SAS were studied prospectively by simultaneously recording conventional polysomnography and Oxyflow data in the sleep laboratory. Two different investigators, blinded to each other's findings, interpreted the data from each method. The apnea-hypopnea index (AHI) cut-off points used were?? 10, 15 and 30. The sensitivity, specificity, positive predictive value and negative predictive value of the Oxyflow indices for each AHI cut-off point were calculated. Both computer-generated and manually collected data from the Oxyflow device were analyzed. Manual readings were recorded by two independent investigators and interobserver agreement was calculated. The usefulness of both automatic and manual analyses for SAS diagnosis was assessed using receiver operating characteristic curves (ROC)., Results: Fifty-eight (93.5%) men and 4 (6.5%) women with a mean age (+/- SD) of 53 +/- 11 years (29-73) were enrolled. An AHI > or = 10 was observed in 58% of the patients and mean AHI was 25 +/- 28 (0-125). The index of respiratory disturbance per hour of analysis with desaturation events > or = 4% (RDI4%) was the parameter with the largest area under the ROC curve (0.90 for AHI > or = 10; 0.94 for AHI > or = 15 and 0.96 for AHI > or 30). Manual reading was practical and reproducible (agreement 0.93, kappa coefficient 0.82) but its efficiency was no greater than that of automatic analysis., Conclusions: The Oxyflow device may be a useful diagnostic tool for SAS. Its portability and simplicity makes it potentially useful for in-home studies.

Spontaneous pneumothorax is a relatively frequent complication of human immunodeficiency virus (HIV) infection. Seven hundred sixty-five HIV-infected inpatients were treated at Marques de Valdecilla University Hospital between 1990 and 1996. Spontaneous pneumothorax developed in 9 patients. Pneumocystis carinii pneumonia was diagnosed in 6 patients (66%), either before or simultaneous to the appearance of pneumothorax. Pneumothorax was related to active or old tuberculosis infection in 3 patients (33%). Prophylactic therapy with nebulized pentamidine was used in 55% of the patients. Successful initial control of pneumothorax was achieved with simple drains in 58% of the episodes, although the recurrence rate was 71%. Pleurodesis with talcum with a chest tube was used successfully in 3 patients, in 2 because of sings of persistent air leakage uncorrected by simple drainage. Pleurodesis initially failed but later controlled pneumothorax the second time it was used. The mortality rate in this series was 66%, with a mean survival time of 55.6 days. We conclude that spontaneous pneumothorax is associated with poor prognosis in HIV infected patients. Prior or concurrent P. carinni pneumonia or tuberculosis were the etiologic factors identified in our patients. A simple pleural drain was associated with a high rate of recurrence, such that pleurodesis seems warranted in all patients.

Small cell carcinoma of the lung occasionally presents as a single pulmonary nodule, but its expression in the form of multiple pulmonary nodules has not been reported in the literature. We describe a single case of small cell carcinoma of the lung presenting as multiple pulmonary nodules that seems to have been cured by chemotherapy.