Continuous positive airway pressure and survival of very elderly persons with moderate to severe obstructive sleep apnea.

Objective: There is evidence of a beneficial effect of long-term continuous positive airway pressure (CPAP) on survival in elderly persons with obstructive sleep apnea (OSA), although the usual age cut off is between 60 and 70 years of age. Our objective was to determine this effect in very elderly patients (ie, those ≥80 years of age).

Methods: An observational study of a historic cohort of very elderly persons with moderate to severe OSA (apnea-hypopnea index ≥20) and the effect of long-term CPAP on their survival was performed.

Pulmonary vasculitis as the first manifestation of rheumatoid arthritis.

In this report, we describe a 61-year-old man that presented with isolated pulmonary vasculitis and a positive anti-cyclic citrullinated peptide (CCP) antibody. Within a few months, the patient developed the symmetric polyarthritis consistent with rheumatoid arthritis (RA). Because the anti-CCP antibody is highly specific for RA and vasculitis is a known association of RA, we suspect the pulmonary vasculitis in this patient was the first manifestation of underlying RA.