Posterior reversible encephalopathy syndrome (PRES) is a rare condition manifested by inflammation in certain areas of the brain. Rhabdomyolysis with acute kidney injury (AKI) complicated by PRES is rarely reported. A 26-year-old female presented with neurological symptoms, high blood pressure, and AKI. Her symptoms improved with blood pressure control, anticonvulsant drug medications, and renal replacement therapy. This case demonstrates that PRES should be considered in the differential diagnosis of patients who have rhabdomyolysis with AKI accompanied by neurological symptoms, including headaches and convulsions.

Nonconvulsive status epilepticus (NCSE) is an unusual complication in patients treated with cefepime. An 82-year-old woman on maintenance hemodialysis was given cefepime for pneumonia. Her level of consciousness decreased since the administration of cefepime, and she was diagnosed with NCSE based on electroencephalography (EEG) findings. After discontinuation of cefepime, improvement was seen both in the level of consciousness and EEG findings. Clinicians should be aware of cefepime-induced NCSE, particularly in patients with renal failure.

Background: The aim of this study was to investigate the predictive value of snoring frequency in the diagnosis and severity of obstructive sleep apnea. Methods: Patients who underwent polysomnography with one or more of the following characteristics were included: 1) sleepiness, non-restorative sleep, fatigue, or insomnia symptoms; 2) arousal due to cessation of breathing or the occurrence of gasping or choking when waking up; and 3) habitual snoring, breathing interruptions, or both, noted by a bed partner or other observer. We analyzed the differences in clinical and polysomnographic variables between patients with and without obstructive sleep apnea and investigated the associations of those variables with obstructive sleep apnea severity. Results: One hundred ninety-three patients met the inclusion criteria, and 145 of the 193 patients were diagnosed with obstructive sleep apnea. Multiple logistic regression analysis showed that large neck circumference (p = 0.0054) and high snoring index (p = 0.0119) were independent predictors for obstructive sleep apnea. Moreover, between the obstructive sleep apnea severity groups, there was a strong tendency of difference in body mass index (p = 0.0441) and neck circumference (p = 0.0846). However, there was no significant difference in snoring frequency according to obstructive sleep apnea severity (p = 0.4914). Conclusions: We confirmed that snoring frequency is a predictor of obstructive sleep apnea. In addition, we showed for the first time that snoring frequency is not associated with obstructive sleep apnea severity, thus it is not a valuable marker for predicting obstructive sleep apnea severity.

Citations

• Validity Analysis of Neck Circumference as a Screening Test for Hypoxia Occurrence in Patients Undergoing Sedative Endoscopy
  Hyun-Ji Song, Jiyun Kim
  Healthcare.2022; 10(4): 679.     CrossRef