Increased overnight hypoxia as a surrogate of OSA severity was associated with increased cancer incidence. This association seems to be limited to men and patients younger than 65 years of age.

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Context-Systemic hypertension is prevalent among patients with obstructive sleep apnea (OSA). Short-term studies indicate that continuous positive airway pressure (CPAP) therapy reduces blood pressure in patients with hypertension and OSA.Objective-To determine whether CPAP therapy is associated with a lower risk of incident hypertension.Design, Setting, and Participants-A prospective cohort study of 1889 participants without hypertension who were referred to a sleep center in Zaragoza, Spain, for nocturnal polysomnography between January 1, 1994, and December 31, 2000. Incident hypertension was documented at annual follow-up visits up to January 1, 2011. Multivariable models adjusted for Corresponding Author: José M. Marin, MD, Respiratory Department, Hospital Universitario Miguel Servet, Avda Isabel la Católica, 1-3, 50006 Zaragoza, Spain (jmmarint@unizar.es).. Author Contribution: Dr Marin had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Conclusion-Compared with participants without OSA, the presence of OSA was associated with increased adjusted risk of incident hypertension; however, treatment with CPAP therapy was associated with a lower risk of hypertension. HHS Public AccessOBSTRUCTIVE SLEEP APNEA (OSA), a prevalent condition that is estimated to affect 17% of US adults, is associated with an increased risk for cardiovascular diseases and overall mortality. [1][2][3][4][5] Although treatment of OSA with continuous positive airway pressure (CPAP) therapy is associated with decreased overall cardiovascular risk, its efficacy in preventing new-onset hypertension is unknown. 2Several cross-sectional studies link OSA to arterial hypertension, a major risk factor for fatal and nonfatal cardiovascular events. [6][7][8][9][10] However, the association between OSA and increased rate of incident hypertension has not been observed consistently in prospective studies. 11,12 A relatively short follow-up period (<5 years) and a limited inclusion of patients with severe OSA hinder conclusions regarding the association of OSA with incident hypertension. 11,12 Further more, the contribution of change in body weight over time, a well-established risk factor for both hypertension and OSA, to the development of newonset hyper-tension has not been investigated in patients with OSA. 13 Treatment of OSA eliminates repetitive episodes of hypoxia associated with transient cessation of breathing and stabilizes cardiovascular function. 14 Short-term studies indicate that CPAP use is associated with a reduction in blood pressure in patients with hypertension and OSA. 15 Whether long-term CPAP therapy prevents or reduces the rate of new-onset hypertension in patients with OSA has not been investigated. We hypothesized that OSA is an independent risk factor for the development of new-onset hypertension and that longterm CPAP therapy reduces this risk regardless of change in body weight over time. Clinical DataDemographic, anthropomet...

Exosomes are nano-vesicles present in the circulation that are involved in cell-to-cell communication and regulation of different biological processes. MicroRNAs (miRNAs) are part of their cargo and are potential biomarkers. Methods of exosome isolation and the inter-individual and intra-individual variations in circulating miRNA exosomal cargo have been poorly investigated. This study aims for comparing two exosome isolation methods and to assess the stability of eleven plasma exosomal miRNAs over time. In addition to evaluate miRNA variability of both kits, the effect of freezing plasma before exosome isolation or freezing isolated exosomes on miRNA stability was also evaluated. MiRNA levels were tested in 7 healthy subjects who underwent four different blood extractions obtained in 4 consecutive weeks. One of the isolation kits displayed generally better amplification signals, and miRNAs from exosomes isolated after freezing the plasma had the highest levels. Intra-subject and inter-subject coefficients of variance were lower for the same isolation kit after freezing plasma. Finally, miRNAs that showed an acceptable expression level were stable across the consecutive extractions. This study shows for the first time the stability over time of miRNAs isolated from circulating plasma exosomes, establishing a key step in the use of exosomal miRNAs as biomarkers.

Study design: A systematic review was undertaken, based upon methods recommended for effectiveness questions but adapted to identify observational risk factor (RF) studies. Objectives: The literature identifies many RFs for pressure ulcer (PU) recurrence and development; however, RFs independently predictive of PU development in adults with spinal cord injury (SCI) have not been determined. A systematic review was undertaken to identify RFs for PUs for people with SCI. Setting: Acute hospital, community and rehabilitation settings. Methods: Electronic searches of MEDLINE, EMbase and Cochrane databases from 1980 to 2011 were completed. Retrieved studies were assessed for eligibility and quality criteria applied by two independent reviewers. Identified RFs were categorised into themes and compared and contrasted with RFs identified for the general PU population. Results: The five studies included 18 RFs. These were classified into six themes: sociodemographic, neurological, functional, clinical, biological and medical care management. RFs for both the general and SCI-specific populations were similar, however, clinical, functional and hospital management emerged as specific RF domains for the SCI population. Conclusion: We identified SCI-specific RFs for the development and recurrence of PUs. However, these findings are based on a small number of studies; highlighting the need for further confirmatory work to reduce PU development and recurrence, and provide a foundation for SCI risk assessment development.