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Review Historical Article
The Science of Sleep in Medieval Arabic Medicine: Part 1: Ibn Sīnā's Pneumatic Paradigm.
Modern sleep specialists are taught that, before the twentieth century, sleep was universally classified as a passive phenomenon with minimal to no brain activity. However, these assertions are made on the basis of particular readings and reconstructions of the history of sleep, using Western European medical works and ignoring works composed in other parts of the world. ⋯ Avicenna, d. 1037) onward. Building on the earlier Greek medical tradition, Ibn Sīnā provided a new pneumatic understanding of sleep that allowed him to explain previously recorded phenomena associated with sleep, while providing a way to capture how certain parts of the brain (and body) can even increase their activities during sleep.
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Fractional exhaled nitric oxide (Feno), used as a biomarker, is influenced by several factors including ethnicity. Normative data are essential for interpretation, and currently single cutoff values are used in children and adults. ⋯ Because single pediatric, adult, or all-age Feno cutoff values used by current interpretive guidelines to define abnormality fail to account for factors that modify Feno values, we propose predicted and ULN values for First Nations Australians 4 to 76 years of age. Creating age- and height-adjusted predicted and ULN values could be considered for other ethnicities.
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Elevated mean pulmonary artery pressure (mPAP) is common in patients with hypertrophic cardiomyopathy (HCM) and heart failure symptoms. However, dynamic left ventricular (LV) outflow tract obstruction may confound interpretation of pulmonary hypertension (PH) pathophysiologic features in HCM when relying on resting invasive hemodynamic data alone. ⋯ To the best of our knowledge, these data demonstrate for the first time that in patients with obstructive HCM, heart failure is associated with pathogenic pulmonary vascular remodeling even when mPAP is elevated only mildly. These observations clarify PH pathophysiologic features in HCM, with future implications for clinical strategies that mitigate outflow tract obstruction.
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Pulmonary nodules are a common incidental finding on CT imaging. Few studies have described patient and nodule characteristics associated with a lung cancer diagnosis using a population-based cohort. ⋯ Lung cancer is uncommon among individuals with incidentally detected lung nodules. Some, but not all, previously identified factors associated with lung cancer also were associated with this outcome in this sample. These findings may have implications for clinical practice, future practice guidelines, and the development of novel lung cancer prediction models for individuals with incidentally detected lung nodules.
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The vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is a newly identified autoinflammatory disorder related to somatic UBA1 mutations. Up to 72% of patients may show lung involvement. ⋯ Pulmonary manifestations are frequent in VEXAS syndrome, but rarely are at the forefront. The initial outcome is favorable with prednisone and does not seem to lead to pulmonary fibrosis.