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61 (95% confidence interval 1.12 to 2.32; p = 0.011). No other prescreening symptoms evaluated were associated with an increased likelihood of SCAF detection although patients without detected SCAF had an even higher frequency of symptoms than those with detected SCAF. Thus, REVEAL AF demonstrated that the presence of palpitations is associated with an increased likelihood of SCAF whereas other common symptoms are not; and, symptoms, per se, may more likely be consequent to associated disorders than they are a direct consequence of SCAF.
Pregnant women and their neonates represent 2 vulnerable populations with an interdependent immune system that are highly susceptible to viral infections. The immune response of pregnant women to severe acute respiratory syndrome coronavirus 2 and the interplay of how the maternal immune response affects the neonatal passive immunity have not been studied systematically.
We characterized the serologic response in pregnant women and studied how this serologic response correlates with the maternal clinical presentation and with the rate and level of passive immunity that the neonate received from the mother.
Women who gave birth and who tested positive for immunoglobulin M or immunoglobulin G against severe acute respiratory syndrome coronavirus 2 using semiquantitative detection in a New York City hospital between March 22, 2020, and May 31, 2020, were included in this study. A retrospective chart review of the cases that met the inclusion criteria was conducted to determine the presence of coronavirus dgies.One of the central questions in visual neuroscience is how the sparse retinal signals leaving our eyes are transformed into a rich subjective visual experience of the world. Invasive physiology studies, which offers the highest spatial resolution, have revealed many facts about the processing of simple visual features like contrast, color, and orientation, focusing on the early visual areas. At the same time, standard human fMRI studies with comparably coarser spatial resolution have revealed more complex, functionally specialized, and category-selective responses in higher visual areas. Although the visual system is the best understood among the sensory modalities, these two areas of research remain largely segregated. High-resolution fMRI opens up a possibility for linking them. On the one hand, it allows studying how the higher-level visual functions affect the fine-scale activity in early visual areas. On the other hand, it allows discovering the fine-scale functional organization of higher visual areas and exploring their functional connectivity with visual areas lower in the hierarchy. In this review, I will discuss examples of successful work undertaken in these directions using high-resolution fMRI and discuss where this method could be applied in the future to advance our understanding of the complexity of higher-level visual processing.
Racial and ethnic as well as economic disparities in access to care among persons with asthma and COPD have been described, but long-term access trends are unclear.
Has health coverage and access to care and medications among adults with airways disease improved, and have disparities narrowed?
Using the 1997 through 2018 National Health Interview Survey, we examined time trends in health coverage and the affordability of medical care and prescription drugs for adults with asthma and COPD, overall and by income and by race and ethnicity. We performed multivariate linear probability regressions comparing coverage and access in 2018 with that in1997.
Our sample included 76,843 adults with asthma and 30,548 adults with COPD. Among adults with asthma, lack of insurance rose in the first decade of the twenty-first century, peaking with the Great Recession, but fell after implementation of the Affordable Care Act (ACA). From 1997 through 2018, the uninsured rate among adults with asthma decreased from 19.4%to 9.6%(adjusted 9.27 percentage points; 95%CI, 7.1%-11.5%). However, the proportions delaying or foregoing medical care because of cost or going without medications did not improve. Racial and ethnic as well as economic disparities present in 1997 persisted over the study period. Trends and disparities among those with COPD were similar, although the proportion going without needed medications worsened, rising by an adjusted 7.8 percentage points.
Coverage losses among persons with airways disease in the first decade of the twenty-first century were more than reversed by the ACA, but neither care affordability nor disparities improved. Further reform is needed to close these gaps.
Coverage losses among persons with airways disease in the first decade of the twenty-first century were more than reversed by the ACA, but neither care affordability nor disparities improved. Further reform is needed to close these gaps.The purpose of this review was to describe our management approach to patients with treatment-emergent central sleep apnea (TECSA). The emergence of central sleep apnea during positive airway pressure therapy occurs in approximately 8% of titration studies for OSA, and it has been associated with several demographic, clinical, and polysomnographic factors, as well as factors related to the titration study itself. TECSA shares similar pathophysiology with central sleep apnea. In fact, central and OSA pathophysiologic mechanisms are inextricably intertwined, with ventilatory instability and upper airway narrowing occurring in both entities. TECSA is a "dynamic" process, with spontaneous resolution with ongoing positive airway pressure therapy in most patients, persistence in some, or appearing de novo in a minority of patients. Management strategy for TECSA aims to eliminate abnormal respiratory events, stabilize sleep architecture, and improve the underlying contributing medical comorbidities. PT2385 CPAP therapy remains a standard therapy for TECSA. Expectant management is appropriate given its transient nature in most cases, whereas select patients would benefit from an early switch to an alternative positive airway pressure modality. Other treatment options include supplemental oxygen and pharmacologic therapy.
