Chest
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The independent, mediation, interaction, and joint effects of socioeconomic status (SES) and phenotypic frailty on the incidence of chronic obstructive pulmonary disease (COPD) are unclear. ⋯ Low SES and frailty are independent risk factors for COPD, and these two factors also have synergistic interaction in COPD. Frailty partially mediated the association between SES and COPD. Thus, the early identification and reversal of frailty may minimize the risk of COPD, especially in individuals with low SES.
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Quantitative Computed Tomography Analysis in Rheumatoid Arthritis-Related Interstitial Lung Disease.
Quantitative chest computed tomography (CT) may be a useful predictor of outcome in rheumatoid arthritis-related interstitial lung disease (RA-ILD). ⋯ In two cohorts of patients with RA-ILD, quantitative assessment of lung fibrosis on CT was associated with worse lung function at baseline and risk of mortality. Increase in DTA-derived lung fibrosis score on sequential scans was associated with subsequent risk of mortality. Quantitative CT should be considered for use as a clinical and research outcome assessment tool in RA-ILD.
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The current guidelines do not recommend β-blockers in pulmonary arterial hypertension (PAH) unless indicated by comorbidities. However, the evidence regarding the role of β-blockers in PAH is contradictory. ⋯ Out of the 806 patients, 469 (58.2%) received β-blockers at the time of PAH diagnosis. In PSM, β-blocker treatment showed a higher incidence of the composite endpoint (HR:1.44; 95% CI: 1.04-1.99; P = .03) and had neutral impact on mortality (HR, 1.22; 95% CI, 0.87-1.72; P = .25). When stratified by the presence of comorbidities, β-blockers showed adverse effects on composite endpoint in patients without comorbidities and a neutral effect in patients with at least one comorbidity INTERPRETATION: β-blockers pose significant risks in patients with PAH, especially in patients without coexisting systemic hypertension, CAD and arrhythmia.
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Obstructive sleep apnea (OSA) causes episodes of fragmented sleep and intermittent hypoxia and leads to excessive daytime sleepiness (EDS). Deficits in cognitive function are a troublesome symptom in patients with OSA and EDS. ⋯ NCT04789174; EudraCT: 2020-004243-92.