Chest
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Sleep-disordered breathing (SDB) occurring during rapid eye movement (REM) sleep occurs more frequently in women than men. We sought to characterize REM SDB prevalence by gender and age to identify factors that could account for this discrepancy. ⋯ REM SDB prevalence decreases with age in women as does REM AHI/NREM AHI, perhaps secondary to a disproportionate age-dependent rise in NREM vs REM AHI in women. Younger women may be protected from SDB during NREM sleep, even in the face of obesity. These patterns may reflect age-related decreases in female hormones.
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Childhood idiopathic bronchiectasis (IB) unrelated to cystic fibrosis (CF) or known immunodeficiency remains a common problem among indigenous populations in developed and developing countries. The physical and transport properties of sputum among children with IB have not been described, and these properties may suggest therapies that would be particularly effective for this group of children. ⋯ The physical and transport properties of sputum from children with IB who are stable in the outpatient setting are substantially different and lead to improved cough transportability compared to sputum from children with CF or adults with CB. Therapies that focus on cough may be sufficient to improve airway mucus clearance in children with IB. Sputum properties may explain in part the different clinical course of children with IB compared to children with CF.
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No score is available to assess severity and stratify mortality risk in ventilator-associated pneumonia (VAP). Our objective was to develop a severity assessment tool for VAP patients. ⋯ VAP PIRO score is a simple, practical clinical tool for predicting ICU mortality and health-care resources use that is likely to assist clinicians in determining VAP severity.