Chest
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Recent evidence indicates that the rate of lung function decline is steepest in mild COPD and slower in moderate to severe COPD. The current study assessed whether lung function decline relates to baseline airflow obstruction severity in male heavy smokers. ⋯ Diagnosing COPD based on the presence of more severe airflow obstruction (as defined by FEV₁/FVC less than LLN) means that, at the time of such a diagnosis, subjects had passed the phase of strong lung-function decline.
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Poor fetal growth rate, as indicated by lower birth weight, is associated with lower respiratory function in childhood; however, findings in adult life remain inconsistent. A birth cohort provides the opportunity to study the association between birth weight and adult respiratory function. ⋯ Our longitudinal cohort study provides evidence of robust links between birth weight and adult lung function at the age of 21 years. Various estimates of the effect size in the literature may be related to the age at assessment.
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We undertook the current investigation to explore how the pressures of serving as a surrogate decision-maker (SDM) for an acutely ill family member influence attitudes regarding clinical investigation. ⋯ Despite significant emotional duress, SDMs expressed interest in investigation and described multiple factors motivating participation. Consent processes that minimize the effects of anxiety may be one strategy to enhance recruitment.
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This article is a review of the pertinent scientific data regarding obstructive sleep apnea (OSA) as presented in the medical literature. Attention regarding the diagnosis of OSA focused on the debate regarding home testing as compared with in-laboratory polysomnography (PSG), with a surprising result of possibly more cost benefit from PSG. ⋯ Multiple studies reviewed the comparative effects of oral appliances in conjunction with CPAP, with little difference between the two noted, especially for mild OSA. Finally, a number of studies evaluated both risks of OSA and outcomes from the use of CPAP, including functional outcomes, direct cardiac benefits, and overall cardiac mortality.
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Comparative Study
Clinical significance of the differentiation between Mycobacterium avium and Mycobacterium intracellulare in M avium complex lung disease.
Mycobacterium avium and Mycobacterium intracellulare are grouped together as the M avium complex; however, little is known about the clinical impact of this species differentiation. This study compared the clinical features and prognoses of patients with M avium and M intracellulare lung disease. ⋯ Patients with M intracellulare lung disease exhibited a more severe presentation and had a worse prognosis than patients with M avium lung disease in terms of disease progression and treatment response. Therefore, species differentiation between M avium and M intracellulare may have prognostic and therapeutic implications.