There is still a controversy regarding the relationship between sleep apnoea syndrome and headaches, especially morning headaches. Our objectives were: (i) to compare the prevalence and the clinical data of headaches in sleep apnoea syndrome (SAS) and control (snorers) groups defined by polysomnographic recording; (ii) to analyse the clinical improvement of headaches with appropriate treatment; and (iii) to correlate headaches with mood disorders, and nocturnal respiratory and architectural sleep parameters in order to understand the underlying pathophysiological mechanisms. This is a prospective study of 324 consecutive patients referred to our sleep centre for snoring. Of these, 312 patients who underwent sleep polysomnography were finally included. Patients and controls were interviewed about their medical past, headache history and clinical characteristics, their daytime sleepiness (Epworth's sleepiness scale) and their mood disorders (Zerssen's scale). Follow-up of patients with headaches (SAS and control groups), treated or not, was also assessed. According to our definition of SAS, patients were dissociated in SAS (n=164) and snorers (n=148). Fifty-three SAS patients had headaches, of whom 58.5% (n=30) suffered from morning headaches. However, there was no statistical difference between the two groups concerning the prevalence and the clinical characteristics of headaches. In addition, headaches and morning headaches were not correlated with nocturnal respiratory and architectural sleep parameters, nor with excessive daytime sleepiness, but were strongly correlated with mood disorders. In 36 SAS patients, headaches improved under treatment, but this was not statistically different from what was found among untreated snorers. Headaches and morning headaches are common in patients with SAS but may be considered as a non-specific symptom. The underlying mechanisms are not fully elucidated but depression could play an important role. Despite this absence of specificity, the treatment of SAS, especially nasal continuous positive airway pressure, leads to an improvement in headaches in several cases.

Population-based retrospective epidemiological study to estimate the burden o�� to estimate the burden o�� hospitalizations by cervical cancer in Spain.� �t �as conducted by using hospital �t �as conducted by using hospital discharge data ��rom the national surveillance system ��or hospital data, Conjunto Mínimo Básico de Datos (CMBD).� Records o�� all patients admitted to hospital �ith a diagnosis o�� malignant neoplasm o�� the cervix (�CD-9-MC codes 180.�0-180.�9) or carcinoma in situ o�� cervix (�CD-9-MC code 233.�1) during a ��our year period (1999)(2000)(2001)(2002), �ere selected.� �n annual average o�� �,1�1 hospitalizations �ith a primary or secondary �n annual average o�� �,1�1 hospitalizations �ith a primary or secondary annual average o�� �,1�1 hospitalizations �ith a primary or secondary diagnosis o�� cervical cancer and 2,761 hospitalizations due to carcinoma in situ �ere identi��ied.� �nnually there �ere 2�.�� and 17.�0 hospitalizations by cervical cancer and carcinoma in situ per 100,000 �omen ≥20 years o�� age, respectively.� Hospitalization rate by cervical cancer and carcinoma in situ peaks in �omen bet�een �� and �9 years o�� age (39.�� admissions per 100,000 �omen) and 30 to �� years o�� age (32.�2 per 100,000 �omen), respectively.� The mean cost o�� a hospitalization by cervical cancer and carcinoma in situ �as €3,098 and €2,192, respectively.� The estimated annual cost o�� hospitalizations ��or cervical cancer and carcinoma in situ in Spain �as 19 million €.�

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This epidemiological survey was undertaken to estimate the burden of hospital admissions for pneumonia and influenza in 50-64 years old persons in Spain during a four-year period (1999-2002). Data were obtained from the national surveillance system for hospital data maintained by the Ministry of Health and covering more than 95% of Spanish hospitals. There were 35,620 hospital admissions for pneumonia and influenza (ICD 9 CM 480-487; first listed diagnosis) during the study period. Annual incidence was 143 cases per 100,000 population. Rate of death and case-fatality rate were 8 per 100,000 population and 5.6%, respectively. The average length of hospitalization was 10.4 days. Men and older age groups showed a higher incidence, rate of death and case-fatality rate. These hospitalizations of 50-64 years old persons impose an annual direct cost of 12 to 24 millions euros. Preventive measures, such as vaccination will reduce pneumonia-related morbidity and could result in large cost savings to the Health Care System.

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