Chest
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Although male sex is associated with poor prognosis in systemic sclerosis (SSc), it is unclear whether this association is independent of confounding factors such as occupational exposure to toxicants. ⋯ Occupational exposure to toxicants seems to predict decline of FVC in patients with SSc independently, regardless of sex. Assessment of occupational exposure may be useful for SSc prognostication.
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Pulse oximeters may produce less accurate results in non-White patients. ⋯ Compared with White patients, the prevalence of occult hypoxemia was higher in Black patients than in White patients about to undergo ECMO for respiratory failure, but it was comparable in Hispanic and Asian patients compared with White patients.
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Sleep disorders, including sleep apnea, have become a significant health issue in the United States. It is estimated that 22 million Americans have sleep apnea, with 80% of cases of moderate and severe OSA going undiagnosed. This number continues to increase with the obesity epidemic. ⋯ Unfortunately, sleep medicine currently remains an ambulatory practice. Hospital sleep medicine addresses this separation. Herein, we discuss our experience and the future potential of hospital sleep medicine programs.
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Body composition measures, specifically low weight or reduced muscle mass, are associated with mortality in COPD, but the effect of longitudinal body composition changes is undefined. ⋯ Longitudinal loss of PMA is associated with increased all-cause mortality, regardless of BMI or initial muscle mass. Consideration of novel screening tests and further research into mechanisms contributing to muscle decline may improve risk stratification and identify novel therapeutic targets in ever smokers.
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Previous studies suggesting that OSA may be an independent risk factor for VTE have been limited by reliance on administrative data and lack of adjustment for clinical variables, including obesity. ⋯ In this large cohort, we found that patients with more severe OSA as measured by the apnea-hypopnea index are more likely to have incident VTE. Adjusted analyses suggest that this association is explained on the basis of confounding by obesity. However, severe nocturnal hypoxemia may be a mechanism by which OSA heightens VTE risk.