Chest
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COPD and OSA are both highly prevalent, which implies that both disorders occurring together (overlap syndrome) is likely to be common based on chance association alone. However, different clinical COPD phenotypes influence the likelihood of coexisting OSA in that the increased lung volumes and low BMI associated with the predominant emphysema phenotype protects against OSA, whereas the higher likelihood of peripheral edema and increased BMI associated with the predominant chronic bronchitis phenotype promotes OSA. ⋯ The diagnosis of OSA in patients with COPD requires awareness of relevant clinical features, and screening questionnaires may help identify suitable patients for further overnight study. The recognition of coexisting OSA in patients with COPD has important clinical relevance, as the management of patients with overlap syndrome is different from the management of COPD alone, and the survival of patients with overlap syndrome that is not treated with nocturnal positive airway pressure is significantly inferior to that of patients with overlap syndrome that is appropriately treated.
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Review
Surgical Treatment of Obstructive Sleep Apnea on Cardiovascular Outcomes: A Systematic Review.
OSA is an increasingly prevalent clinical problem with significant effects on quality of life and cardiovascular risk. Surgical therapy represents an important treatment for those unable to use positive airway pressure. This systematic review examines the available cardiovascular risk reduction data for the surgical treatment of OSA. ⋯ The published literature examining cardiovascular end points following surgical treatment of OSA is limited and generally of poor quality. However, available data from mainly small and observational studies suggest that surgical treatment of OSA may provide improvement in some cardiovascular end points. Larger, randomized, and prospective trials with more rigorous study designs are needed.
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Comparative Study Observational Study
Comparative clinical, physiological and inflammatory characteristics of elderly subjects with or without asthma and young asthmatics.
Asthma seems to present in the elderly as a specific phenotype that remains to be further described. In this prospective observational study, we aimed to assess the multidimensional aspects of asthma in the elderly. ⋯ Asthma in the elderly presents as a specific phenotype associated with increased airway obstruction and mixed airway inflammation in addition to signs of systemic inflammation.
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Case Reports
A 51-Year-Old Woman With an Increasing Chest Wall Mass Years After Resection of an Early Stage Lung Cancer.
A 51-year-old woman was found to have a new 14 × 6 mm soft tissue mass under the right serratus muscle on a CT scan of the chest performed for routine surveillance due to her history of stage I lung cancer. A follow-up CT scan performed 4 months later showed that the mass had increased in size to 22 × 8 mm. ⋯ She has no pain or swelling on the right lateral chest and no cough, fever, or shortness of breath. She is at her baseline health with good appetite and functional status.