Chest
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Little is known about the prevalence, predictors, and outcomes of late vasopressor administration which evolves after admission to the ICU. ⋯ Late vasopressor administration was modestly associated with comorbidities and admission illness severity. One-year mortality was higher among those who received late vasopressor administration compared with only early vasopressor administration. Research to understand optimization of late vasopressor therapy administration may improve long-term mortality.
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OSA is found commonly in the elderly population (≥65 years old), and CPAP improves sleepiness and health-related quality of life (HRQoL) in the middle-aged population; however, data about its efficacy in elderly patients are unclear. The purpose of this study was to evaluate the efficacy of CPAP for sleepiness, HRQoL, mood, and cognition in elderly patients with OSA. ⋯ Although CPAP therapy reportedly results in important clinical differences in sleepiness, HRQoL, and mood and a slight improvement in neurocognitive tests, concerns regarding the RoB and quality of the evidence do not support the benefit in all patients.
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Multicenter Study
Rurality, Stage-Stratified Use of Treatment Modalities and Survival of Non-small Cell Lung Cancer.
To eliminate them, non-small cell lung cancer (NSCLC) care and outcome disparities need to be better understood. ⋯ Rurality-associated treatment and survival disparities were present at the patient and institution levels, but the institution-level disparity was greater. Rural residents receiving care at urban institutions had similar outcomes to urban residents receiving care at urban hospitals. To overcome rurality-associated NSCLC survival disparity, interventions should preferentially target the institution level, including expanding access to higher-quality guideline-concordant care.
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DNA methylation and gene expression are promising biomarkers of various cancers, including non-small cell lung cancer (NSCLC). Besides the main effects of biomarkers, the progression of complex diseases is also influenced by gene-gene (G×G) interactions. ⋯ The integration of epigenetic and transcriptional biomarkers with main effects and G×G interactions significantly improves the accuracy of prognostic prediction of early-stage NSCLC survival.
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The interstitial lung diseases include a variety of disorders, many of which are characterized by fibrotic changes (fILD). Of the fILDs, Idiopathic pulmonary fibrosis is the most common. Pulmonary hypertension (PH) frequently complicates fILD and is associated with impaired functional capability, lower physical activity, and significantly reduced life expectancy. There is no proven treatment for patients with fILD-PH. We report results from the first cohort of a phase 2b/3 trial with pulsed inhaled nitric oxide (iNO) in patients with fILD-PH. ⋯ Treatment with iNO30 demonstrated clinically and statistically significant benefit in MVPA and clinically significant benefit in overall activity. In the OLE, higher doses of iNO were also safe and well tolerated while showing maintenance in activity parameters.