Chest
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Smoking is one of the major lifestyle factors influencing the health of human beings. Life-long cigarette smokers have a higher prevalence of common diseases such as atherosclerosis and COPD with significant systemic impact. The present review evaluates current knowledge concerning possible pathways through which cigarette smoking can affect human health, with special focus on extrapulmonary effects. ⋯ Furthermore, rheologic, coagulation and endothelial function markers like hematocrit, blood and/or plasma viscosity, fibrin d-dimer, circulating adhesion molecules (intracellular adhesion molecule-1, selectins), tissue plasminogen activator antigen, and plasminogen activator inhibitor type I are altered in chronic cigarette smokers. Although most of smoking-induced changes are reversible after quitting, some inflammatory mediators like CRP are still significantly raised in ex-smokers up to 10 to 20 years after quitting, suggesting ongoing low-grade inflammatory response persisting in former smokers. New longitudinal epidemiologic and genetic studies are required to evaluate the role of smoking itself and possible gene/environment interplay in initiation and development of smoking-induced common diseases affecting humans.
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Transfusion practice has been under great scrutiny over the last 2 decades. The examination of transfusion risks and benefits have been particularly important in the critically ill patient population. This review will examine some of the important controversies still surrounding the use of RBC transfusion in the critically ill patient.
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Randomized Controlled Trial Comparative Study
Fixed and autoadjusting continuous positive airway pressure treatments are not similar in reducing cardiovascular risk factors in patients with obstructive sleep apnea.
A strong association between obstructive sleep apnea (OSA) and the risk for cardiovascular and cerebrovascular diseases has been reported. Continuous positive airway pressure (CPAP) is the first-line therapy for OSA, able not only to reduce daytime sleepiness but also to improve cardiovascular and metabolic outcomes. Autoadjusting CPAP (APAP), an alternative treatment to CPAP, can reduce OSA symptoms while increasing long-term CPAP compliance without the high costs of CPAP titration. However, no data are available on the effects of APAP on cardiovascular risk factors ⋯ Our results suggest that CPAP and APAP, despite significant effects on OSA indexes and symptoms, do not improve cardiovascular risk factors in the same fashion.
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Comparative Study Clinical Trial
Differential flow analysis of exhaled nitric oxide in patients with asthma of differing severity.
The majority of asthmatic patients achieve control of their illness; others do not. It is therefore crucial to validate/develop strategies that help the clinician monitor the disease, improving the response to treatment. ⋯ Differential flow analysis of exhaled NO provides additional information about the site of inflammation in asthma and may be useful in assessing the response of peripheral inflammation to therapy.
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On average, patients receiving therapy with oral anticoagulants (OACs) in the community are in the therapeutic range only 55% of the time. Anticoagulation control strongly influences the risk of hemorrhagic and thromboembolic events in such patients. However, not all anticoagulation-associated events are attributable to poor anticoagulation control, nor do all hemorrhagic or thromboembolic events occur in anticoagulated patients. ⋯ Our study showed that extreme anticoagulation intensity significantly impacted the health of the population. Improving anticoagulation control will have significant effects on the incidence of serious hemorrhagic and thromboembolic events in the both the anticoagulated and entire populations.