Obstrüktif Uyku Apne Sendromlu Bir Hastada Polisomnografi Tetkiki Esnasında Solunum Arrestine Bağlı Exitus
Bibliographic record
Abstract
Obstrüktif Uyku Apne sendromu (OUAS) komplikasyonları arasında hayati önem taşıyan hipertansiyon, inme, iskemik kalp hastalığı ve kardiyak ritim bozukluğu gibi hastalıklar yer almaktadır.Kırk yaşında kadın hasta, şeker hastalığı, hipertansiyon, hipofiz mikroadenomu ve Cushing sendromu tanıları ile Endokrinoloji servisinde yatmakta iken, gece uykusunda nefes durmalarının gözlenmesi üzerine uyku bozuklukları birimimize yönlendirildi.Hastanın son 10 yıldır horlama, terleme, sabah yorgun uyanma ve gündüz aşırı uykululuk şikayetleri olduğu öğrenildi.Polisomnografi tetkikinde solunum kayıtlarında NREM uyku evresinde sürekli, saatte 60 sıklığında tekrarlayan obstrüktif tipte hipopneler kaydedildi.Hastanın REM uyku evresine girmesi ile birlikte 100 saniye süreli santral apne ve bunu takiben bradikardi ve kardiyak arrest gelişmiş, hasta tüm müdahalelere karşın kurtarılamamıştır.Burada, hayati riskleri olan ancak etkin tedavisi (invaziv olmayan mekanik ventilasyon) ile tüm komplikasyonları ortadan kaldırılabilen önemli bir nörolojik hastalık olan obstrüktif uyku apne sendromuna tüm branştaki hekimlerin dikkatinin çekilmesi hedeflemiştir.Özellikle hipertansiyon, obezite ve kalp hastalıkları gibi eşlik eden komorbiditelerin varlığında dikkatlice sorgulanmalı ve ivedilikle tedavi edilmelidir.Sunulan olguda olduğu gibi tanı ve tedavideki gecikmeler, ölümcül sonuçlar doğuracaktır.(JTSM 2014;1:33-5) Anah tar Ke li me ler: Obstrüktif uyku apne sendromu, santral apne, kardiyak ritim bozukluğu Obstructive sleep apnea syndrome (OSAS) has severe, life-threatening complications such as hypertension, stoke, ischemic heart disease or rhythm problems.A 40-year old woman was referred to our sleep laboratory due to witnessed apnea during her hospitalization in endocrinology yard because of hypertension, hipophyseal microadenoma and Cushing syndrome.Her past medical history revealed that she had snoring, sweating at night, tiredness in morning and excessive daytime sleepiness for the last 10 years.In polysomnography investigation, we observed continuous obstructive hypopneas during NREM sleep stage with an index of 60 (times per an hour).As she started to have REM sleep stage, she had a central apnea lasting for 100 seconds, followed by bradicardia and cardiac arrest; the patient was lost in spite of urgent intervention.Here we aimed to attract attention of physicians from all disciplines to OSAS, which is a neurological life-threatening condition but all complications could be removed by non-invasive mechanical ventilation therapy.Especially in the presence of hypertension, obesity and cardiac disorders, OSAS should be questioned in detailed and be treated immediately.Otherwise, delay in diagnosis and treatment would result in lethal consequences, as in the patient reported here.(JTSM 2014;1:33-5)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".