Abstract：
:Sleep-related breathing disorders are strongly associated with increased risk of stroke independent of known risk factors. The direction of causation favors sleep-disordered breathing leading to stroke rather than the other way around, although definitive proof of this awaits the results of prospective cohort studies. If causal, even a moderately elevated risk of stroke coupled with the high prevalence of sleep-disordered breathing could have significant public health implications. The relationship between sleep-disordered breathing and stroke risk factors is complex, and likely part of the risk for cerebrovascular events is because of higher cardiovascular risk factors in patients with increased RDI. The mechanisms underlying this increased risk of stroke are multi-factorial and include reduction in cerebral blood flow, altered cerebral autoregulation, impaired endothelial function, accelerated atherogenesis, thrombosis, and paradoxic embolism. Because of the effects of sleep-disordered breathing on vascular tone, hypertension is believed to be a major mechanism by which sleep-disordered breathing might influence risk of stroke. Because sleep-related breathing disorders are treatable patients with stroke/TIA should undergo investigation, with a thorough sleep history interview, physical examination, and polysomnography. Treatment of sleep apnea has been shown to improve quality of life, lower blood pressure, improve sleep quality, improve neurocognitive functioning, and decrease symptoms of excessive daytime sleepiness [98]. Further treatment trials are needed to determine whether treatment improves outcome after stroke and whether treatment may serve as secondary prophylaxis and modify the risk of recurrent stroke or death.
journal_name
Clin Chest Medjournal_title
Clinics in chest medicineauthors
Yaggi H,Mohsenin Vdoi
10.1016/s0272-5231(03)00027-3subject
Has Abstractpub_date
2003-06-01 00:00:00pages
223-37issue
2eissn
0272-5231issn
1557-8216pii
S0272-5231(03)00027-3journal_volume
24pub_type
杂志文章,评审abstract：:Management of acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) is largely supportive, with the use of mechanical ventilation being a central feature. Recent advances in the understanding of ALI/ARDS and mechanical ventilation have revealed that lung-protective ventilation strategies may atten...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2006.06.008
更新日期：2006-12-01 00:00:00
abstract：:Lung diffusing capacity for carbon monoxide (Dlco) remains the only noninvasive pulmonary function test to provide an integrated picture of gas exchange efficiency in human lungs. Due to its critical dependence on the accessible "alveolar" volume (Va), there remains substantial misunderstanding on the interpretation o...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2019.02.005
更新日期：2019-06-01 00:00:00
abstract：:Traditional tuberculosis (TB) infection control focuses on the known patient with TB, usually on appropriate treatment. A refocused, intensified TB infection control approach is presented. Combined with active case finding and rapid molecular diagnostics, an approach called FAST is described as a convenient way to cal...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2019.07.010
更新日期：2019-12-01 00:00:00
abstract：:Lung cancer remains the most common fatal malignancy, so even modest therapeutic advances are potentially beneficial to large numbers of patients. For patients with regional nodal metastases identified at thoracotomy, adjuvant chemotherapy may be of benefit and additional clinical trials are in progress. Locally advan...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1993-03-01 00:00:00
abstract：:Non-small cell lung cancer with very limited extent of metastatic spread commonly is termed, oligometastatic disease (OMD), and typically described as no more than 3 to 5 lesions. Definitive local therapy potentially leads to significant improvement in progression-free survival and overall survival. OMD may occur de n...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2020.02.004
更新日期：2020-06-01 00:00:00
abstract：:Both chylothorax and pseudochylothorax are characterized by milky or turbid pleural effusions. The importance of distinguishing these two conditions cannot be overemphasized because the prognosis and management are different. ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章
doi：
更新日期：1985-03-01 00:00:00
abstract：:Early detection and surgical resection are essential for the treatment of lung cancer. It would be ideal to be able to detect and treat preinvasive bronchial lesions, defined as dysplasia and carcinoma in situ before progressing to invasive cancer. Advanced airway-assessment techniques have opened an avenue for early ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2013.04.005
更新日期：2013-09-01 00:00:00
abstract：:In summary, the evaluation of the tired patient requires an awareness of the various meanings of tiredness. Furthermore, it is important to differentiate normal sleepiness that is a product of circadian rhythm variation in vigilance from pathologic sleepiness. Sleepiness that results from faulty habits, e.g., altered ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:Two recent major guidelines on diagnosis and treatment of ventilator-associated pneumonia (VAP) recommend consideration of local antibiotic resistance patterns and individual patient risks for resistant pathogens when formulating an initial empiric antibiotic regimen. One recommends against invasive diagnostic techniq...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2018.08.002
更新日期：2018-12-01 00:00:00
abstract：:Obstructive sleep-disordered breathing consists of a spectrum ranging from the upper airway resistance syndrome to complete apnea. Although this disorder is relatively common, it is still under-recognized, resulting in a significant increase in morbidity and mortality. In this article, we describe the rationale for tr...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70434-2
更新日期：1998-03-01 00:00:00
abstract：:Host defense mechanisms spaced along the respiratory tree and in the alveolar spaces effectively remove or contend with micro-organisms that enter the airways, so serious lung infections occur rarely in healthy people. Special circumstances, such as virgin exposure to a virulent microbe or a large innoculum of a patho...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1987-09-01 00:00:00
abstract：UNLABELLED:VAP is a complex nosocomial infection, the disease expression and resulting patient outcome of which is dependent on host factors, the causative organism, the timing and adequacy of treatment, and the presence of intrinsic or inducible antibiotic resistance. Significant improvements have been achieved in our...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70242-2
更新日期：1999-09-01 00:00:00
abstract：:Obesity hypoventilation syndrome has been noted for centuries, yet we still are trying to uncover the exact mechanisms behind the disease and best treatment modalities for patients afflicted by the condition. The syndrome, which results in symptoms based on a diverse spectrum of interactions between obesity, ventilato...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2018.01.006
更新日期：2018-06-01 00:00:00
abstract：:With the increasing threat of pandemic influenza and catastrophic bioterrorism, it is important for intensive care providers to be prepared to meet the challenge of large-scale airborne epidemics causing mass casualty respiratory failure. The severe acute respiratory syndrome outbreak exposed the vulnerability of heal...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2008.01.001
更新日期：2008-06-01 00:00:00
abstract：:This article focuses primarily on the recent literature on abdominal compartment syndrome (ACS) and the definitions and recommendations published by the World Society for the Abdominal Compartment Syndrome. The definitions regarding increased intra-abdominal pressure (IAP) are listed and are followed by an overview of...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2008.09.003
更新日期：2009-03-01 00:00:00
abstract：:Despite complete resection of what seems to be all evident tumor, one third to three quarters of patients with stages I and II NSCLC ultimately succumb to this neoplasm. Patients who are cured of an original NSCLC or small cell cancer remain at risk for a new primary lung cancer. Although the importance of lifelong su...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(03)00067-4
更新日期：2002-03-01 00:00:00
abstract：:The Early Goal-Directed Therapy versus Standard Care for Sepsis trial by Rivers and colleagues in 2001 suggested that a significant mortality reduction may be realized through goal-directed interventions early in the care of patients with septic shock. However, the recent publication of the Protocol-Based Care for Ear...
journal_title：Clinics in chest medicine
pub_type： 评论,杂志文章,评审
doi：10.1016/j.ccm.2016.01.016
更新日期：2016-06-01 00:00:00
abstract：:This article summarizes the health effects of indoor air pollutants and the modalities available to control them. The pollutants discussed include active and passive exposure to tobacco smoke; combustion products of carbon monoxide; nitrogen dioxide; products of biofuels, including wood and coal; biologic agents leadi...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:VAP is clearly associated with an increased mortality, principally because of virulent pathogens such as P. aeruginosa. Part of the increased mortality may be due to inadequacies of antibiotic therapy. Apparent failure of antibiotic therapy has many causes; some are related to deficiencies of the antibiotic therapy, b...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1995-03-01 00:00:00
abstract：:Complications of tracheotomy are largely preventable. Although some authors cite these complications as indications for prolonged endotracheal intubation to avoid tracheotomy, others believe that the laryngotracheal complications of prolonged endotracheal intubation warrant early tracheotomy. Obviously, unnecessary tr...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1991-09-01 00:00:00
abstract：:Infections due to the rapidly growing mycobacteria are being identified with increasing frequency, especially in the southern coastal United States. Cutaneous disease, including both community-acquired infections and nosocomial diseases such as augmentation mammaplasty wound infections and sternal wound infections, ar...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-09-01 00:00:00
abstract：:Pulmonary alveolar proteinosis (PAP) is a rare syndrome characterized by the accumulation of surfactant in alveoli and terminal airways resulting in respiratory failure. PAP comprises part of a spectrum of disorders of surfactant homeostasis (clearance and production). The surfactant production disorders are caused by...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2016.04.006
更新日期：2016-09-01 00:00:00
abstract：:The types of pulmonary arterial hypertension described here all focus attention on the changes produced in the lung's microcirculation, particularly the precapillary unit. Although one senses intuitively that obliteration of resistance arteries is an effective cause of hypertension, we emphasize that cell metaplasia a...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1983-05-01 00:00:00
abstract：:Massive hemoptysis accounts for a minority of all patients with hemoptysis but poses a major challenge for the acute and long-term treatment. Massive hemoptysis can lead to asphyxiation and airway obstruction, shock, and exsanguination. Bronchoscopy plays an integral part in managing massive hemoptysis in diagnosis an...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70129-5
更新日期：1999-03-01 00:00:00
abstract：:This review focuses on the top ten causes of ventilator-associated pneumonia (VAP), updating an earlier study. These pathogens have specific risk factors, different patterns of clinical resolution, and a wide range of attributable mortality. The discussion herein analyzes these aspects, placing particular emphasis on ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2004.10.017
更新日期：2005-03-01 00:00:00
abstract：:The use of nuclear magnetic resonance to produce diagnostic images of the human chest has just become possible. These images are computer-reconstructed maps of the distribution in tissue of protons and of some of their magnetic characteristics. The images are high resolution and anatomically accurate, are capable of d...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1984-06-01 00:00:00
abstract：:This article assesses the role of pharmacotherapy in the management of respiratory muscle dysfunction. It focuses on two classes of drugs, the methylxanthines and the sympathomimetic agents. A prospective section focuses also on the particularities of the diaphragm among the skeletal striated muscles. In addition, a n...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1988-06-01 00:00:00
abstract：:Endobronchial ablative therapies, such as mechanical debulking, laser therapy, electrocautery, argon plasma coagulation, cryotherapy, brachytherapy, photodynamic therapy, microdebrider bronchoscopy, resector balloon deobstruction, and intratumoral chemotherapy, are performed through a rigid or flexible bronchoscope in...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2017.11.008
更新日期：2018-03-01 00:00:00
abstract：:The basic science and clinical understanding of infection with Blastomyces dermatitidis has been a field of constant evolution and continued revision of hypotheses. This article highlights some areas in which recent progress has the potential for significant impact on the clinical care of patients. Specifically, this ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2009.02.003
更新日期：2009-06-01 00:00:00
abstract：:Biologic drugs have revolutionized the treatment of certain hematologic, autoimmune, and malignant diseases, but they may place patients at risk for reactivation or acquisition of tuberculosis. This risk is highest with the tumor necrosis factor-alpha (TNF-α) inhibitors. Amongst this class of drugs, the monoclonal ant...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2019.07.003
更新日期：2019-12-01 00:00:00
