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Quantitative Imaging and Bronchial Thermoplasty: Technically Impressive But Clinically Uncertain Chest (IF 9.6) Pub Date : 2024-04-08 Samuel Y. Ash MD
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Flow Limitation Frequency: A Metric to Assess Consequences of OSA? Chest (IF 9.6) Pub Date : 2024-04-08 Indu Ayappa PhD, Thomas M. Tolbert MD, David M. Rapoport MD
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Videofluoroscopy: A Promising Tool for Assessing Upper Airway Dysfunction During Mechanical Insufflation-Exsufflation Chest (IF 9.6) Pub Date : 2024-04-08 Max Sarmet SLP MSc, Vinicius Maldaner PT PhD, Jorge Luís Lopes Zeredo DDS PhD
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Living Donor Lung Transplantation After Hematopoietic Stem Cell Transplantation From the Same Donor: A Risk Worth Taking Chest (IF 9.6) Pub Date : 2024-04-08 Stefania Camagni MD, Lorenzo D’Antiga MD, Fabiano Di Marco MD, Lorenzo Grazioli MD, Ezio Bonanomi MD, Domenico Pinelli MD, Marta Beretta MD, Veronica Tintori MD, Alessandro Lucianetti MD, Michele Colledan MD
Living donor (LD) lung transplantation (LT) represents an exceptional procedure in Western countries. However, in selected situations, it could be a source of unique advantages, besides addressing organ shortage. We report a successful case of father-to-child single-lobe LT, because of the complications of hematopoietic stem cell transplantation from the same donor, with initial low-dose immunosuppressive
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Prediction Model Development and Evaluation: More Issues to Come Chest (IF 9.6) Pub Date : 2024-04-08 Shehabaldin Alqalyoobi MD
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A Biophilosophical Approach to the Determination of Brain Death Chest (IF 9.6) Pub Date : 2024-04-08 Daniel P. Sulmasy MD PhD MACP, Christopher A. DeCock MD, Carlo S. Tornatore MD, Allen H. Roberts II MD MDiv FCCP FACP, James Giordano PhD MPhil, G. Kevin Donovan MD
Technical and clinical developments have raised challenging questions about the concept and practice of brain death, culminating in recent calls for revision of the Uniform Determination of Death Act (UDDA), which established a whole brain standard for neurologic death. Proposed changes range from abandoning the concept of brain death altogether to suggesting that current clinical practice simply should
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A 38-Year-Old Woman With REM Predominant Central Sleep Apnea After Bulbar Infarction Chest (IF 9.6) Pub Date : 2024-04-08 Xin Ru Qu MD, Teng Han MD, Yi Ming Li MD, Xiao Lei Zhang MD
A 38-year-old previously healthy woman was referred to our sleep center for recurrent witnessed breathing arrest during sleep. She had been brought to the ED 3 months earlier because of sudden onset of dizziness with nausea and vomiting, numbness and weakness of the left limb, less clear speech, double vision, dysphagia, and choking cough while drinking water. Brain MRI showed an acute cerebral infarction
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An 88-Year-Old Woman With Pneumothorax and Black Pleural Effusion Chest (IF 9.6) Pub Date : 2024-04-08 Shota Takenaka MD, Masayo Yoshimura MD PhD, Yoshiaki Kinoshita MD PD, Takuhide Utsunomiya MD, Hisako Kushima MD PhD, Satoshi Nimura MD PhD, Hiroshi Ishii MD PhD
An 88-year-old woman was admitted to our hospital with the sudden onset of dyspnea after eating. The patient had undergone nephrectomy for a left renal tumor 24 years previously. The patient had been prescribed ferrous citrate for iron-deficiency anemia. She complained of appetite loss a few days before admission but had no abdominal pain. CT scan showed no abnormalities in the lungs but a mass in
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Candidacy Assessment for Extracorporeal CPR in Out-of-Hospital Cardiac Arrest: Still Much to Learn Chest (IF 9.6) Pub Date : 2024-04-08 Brian Grunau MD MHSc, Jan Bělohlávek MD PhD
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Mechanical Insufflation-Exsufflation: When the “Art of Coughing” Becomes Science Chest (IF 9.6) Pub Date : 2024-04-08 Isabelle Vivodtzev PhD, Mathieu Delorme PhD, François Lellouche MD PhD
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Artificial Intelligence in Medical Education: A Long Way to Go Chest (IF 9.6) Pub Date : 2024-04-08 David Furfaro MD, Leo Anthony Celi MD MPH, Richard M. Schwartzstein MD
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Left Heart Disease Phenotype in Pulmonary Arterial Hypertension: Considerations for Therapy Chest (IF 9.6) Pub Date : 2024-04-08 Nadine Al-Naamani MD MS, Thenappan Thenappan MD
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Hemodynamic Insights From Simultaneous Common Carotid and Internal Jugular Doppler Ultrasonography in a Patient With Hypoxemia and Multiple Organ Dysfunction Chest (IF 9.6) Pub Date : 2024-04-08 Jon-Émile S. Kenny MD, Joseph K. Eibl PhD, Christine Horner MASc, Daniele Arcozzi MD, Federico Bonomi MD, Vito Fanelli MD, Antonio Visioli PhD, Alberto Goffi MD, Simone Piva MD
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The Importance of Identifying At-Risk Populations to Air Pollution Exposures and Quantifying Risks in Populations With Multiple Risk Factors Chest (IF 9.6) Pub Date : 2024-04-08 Kristen M. Rappazzo PhD, Thomas J. Luben PhD, Wayne E. Cascio MD FAHA
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A 24-Year-Old Woman With Refractory Hypoxemia Chest (IF 9.6) Pub Date : 2024-04-08 Christian Wong DO, Jae K. Chung DO, Kurt Hu MD, Amit Chopra MD
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Real World Data on Peripheral Vasopressors in Septic Shock Chest (IF 9.6) Pub Date : 2024-04-08 Ian J. Barbash MD
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Response Chest (IF 9.6) Pub Date : 2024-04-08 Joon Young Choi MD PhD, Ki Uk Kim MD PhD, Deog Kyeom Kim MD PhD, Yu-Il Kim MD PhD, Tae-Hyung Kim MD PhD, Won-Yeon Lee MD PhD, Seong Ju Park MD PhD, Yong Bum Park MD PhD, Jin Woo Song MD PhD, Kyeong-Cheol Shin MD PhD, Soo-Jung Um MD PhD, Kwang Ha Yoo MD PhD, Hyoung Kyu Yoon MD PhD, Chang Youl Lee MD PhD, Ho Sung Lee MD, Ah Young Leem MD PhD, Won-Il Choi MD PhD, Seong Yong Lim MD PhD, Chin Kook Rhee
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Real-World Clinical Studies to Understand the Current Status and Future Improvements of Pulmonary Rehabilitation in Chronic Lung Diseases Chest (IF 9.6) Pub Date : 2024-04-08 Hyun Lee MD PhD, Ji-Yong Moon MD PhD, Kyung Hoon Min MD PhD
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A 52-Year-Old Woman With Dysarthria, Ataxia, Xanthelasmas, and Miliary Pulmonary Nodules Chest (IF 9.6) Pub Date : 2024-04-08 Athena Huynh MD, Collin Pryma MD, Heather McPhaden MD, Karl-Christopher Yared MDCM, Yilin Zhang MD, Katie Beadon MD, Tony Ng MD PhD, Luke Y.C. Chen MD MMEd
A 52-year-old woman with no significant medical history was referred to our hospital for expedited workup of progressive dysarthria and ataxia over the past year. Prior CT angiography of the head and neck showed no relevant neurologic findings but did reveal miliary lesions in the lung apices, which was later confirmed via dedicated CT chest scan (Fig 1). Review of systems was negative for any respiratory
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Image-Assısted Pleural Needle Biopsy or Medical Thoracoscopy: Which Method for Which Patient? – A Randomızed Controlled Trial Chest (IF 9.6) Pub Date : 2024-03-28 Muzaffer Metintas MD, Guntulu Ak MD PhD, Huseyin Yildirim MD, Emine Dundar MD, Nevin Aydin MD, Sinan Erginel MD, Fusun Alatas MD, Senay Yilmaz MD, Selma Metintas MD PhD
Image-guided or assisted needle biopsies and the increasing use of medical thoracoscopy (MT) have increased the diagnostic accuracy of pleural diseases significantly. However, no consensus exists regarding which patients with pleural effusion should undergo MT and which patients should undergo image-guided or assisted needle biopsy as the first procedure to ensure greater diagnostic accuracy. Which
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Sarcoidosis Faculty Development: The Pipeline Is Running Dry Chest (IF 9.6) Pub Date : 2024-03-26 Nicholas Arger MD, Michelle Sharp MD MHS, Catherine Bonham MD, Divya Patel DO, Rohit Gupta MD, W. Ennis James MD
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Flow Cytometry as an Alternative to Microscopy for the Differentiation of BAL Fluid Leukocytes Chest (IF 9.6) Pub Date : 2024-03-26 Kai Bratke, Martin Weise, Paul Stoll, J. Christian Virchow, Marek Lommatzsch
Microscopy is currently the gold standard to differentiate BAL fluid (BALF) leukocytes. However, local expertise for microscopic BALF leukocyte differentiation is often unavailable in clinical practice. Can automated flow cytometry be used instead of microscopy to differentiate BALF leukocytes? A new automated flow cytometric method for BALF leukocyte differentiation, using four antibodies (anti-CD45
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Changes in Spirometry Interpretative Strategies: Implications for Classifying COPD and Predicting Exacerbations Chest (IF 9.6) Pub Date : 2024-03-26 J. Henry Brems MD MBE MHS, Aparna Balasubramanian MD MHS, Sarath Raju MD MPH, Nirupama Putcha MD MHS, Ashraf Fawzy MD MPH, Nadia N. Hansel MD MPH, Robert A. Wise MD, Meredith C. McCormack MD MHS
Recent guidelines for spirometry interpretation recommend both race-neutral reference equations and use of score thresholds to define severity of airflow obstruction. How does the transition from race-specific to race-neutral equations impact severity classifications for patients with COPD when using % predicted vs score thresholds, and do changes in severity correspond to clinical risk? This retrospective
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Relationship Between Lung Volumes and Heterogeneity in the Response to Elexacaftor/Tezacaftor/Ivacaftor in Patients With Cystic Fibrosis and Advanced Lung Disease Chest (IF 9.6) Pub Date : 2024-03-21 Andrea Gramegna MD, Gianfranco Alicandro PhD, Chiara Premuda MD, Francesca Lucca MD, Lucia Pinali MD, Mariangela Retucci PT, Valentina Vespro MD, Maria Carmela Andrisani MD, Gianpaolo Carraffiello MD, Francesco Amati MD, Sonia Volpi MD, Stefano Aliberti MD, Marco Cipolli MD, Francesco Blasi MD PhD
The effects of elexacaftor/tezacaftor/ivacaftor (ETI) on respiratory outcomes for people with cystic fibrosis (CF) were demonstrated by several clinical trials, mainly based on simple spirometry. However, gains in lung function may vary greatly between patients, and predictors of FEV change after treatment are still missing. Which ventilatory parameters are involved in the heterogeneity of FEV change
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The Association of Pregnancy With Outcomes Among Critically Ill Reproductive-Aged Women: A Propensity Score-Matched Retrospective Cohort Analysis Chest (IF 9.6) Pub Date : 2024-03-20 Rachel Kohn MD MSCE, Deepshikha C. Ashana MD MSCE MBA, Kelly C. Vranas MD MCR, Elizabeth M. Viglianti MD MPH, Katrina Hauschildt PhD, Catherine Chen MD, Emily A. Vail MD, Leslie Moroz MD, Hayley B. Gershengorn MD
The maternal mortality rate in the United States is unacceptably high. However, the relative contribution of pregnancy to these outcomes is unknown. Studies comparing outcomes among pregnant vs nonpregnant critically ill patients show mixed results and are limited by small sample sizes. What is the association of pregnancy with critical illness outcomes? We performed a retrospective cohort study of
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The Role of Pediatric Psychologists in Critical Care: Lessons Learned and Future Directions in Integrating Mental Health Care Into PICUs Chest (IF 9.6) Pub Date : 2024-03-19 Kristin Canavera PhD, Patricia Marik PsyD, Nicole M. Schneider PsyD, Jacquelyn Smith PhD
Pediatric psychologists are essential staff in the PICU. Their role in caring for critically ill children aligns with clinical practice guidelines for the mental health care needs of this population of patients. This article highlights the role of pediatric psychology in the PICU through illustrative case examples. We discuss lessons learned and future directions for the development and provision of
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Comparison of Contemporary Risk Scores in All Groups of Pulmonary Hypertension: A Pulmonary Vascular Research Institute GoDeep Meta-Registry Analysis Chest (IF 9.6) Pub Date : 2024-03-19 Athiththan Yogeswaran MD, Henning Gall MD PhD, Meike Fünderich MSc, Martin R. Wilkins MD, Luke Howard MD, David G. Kiely MD, Allan Lawrie MD, Paul M. Hassoun MD, Yuriy Sirenklo MD, Olena Torbas MD, Andrew J. Sweatt MD, Roham T. Zamanian MD, Paul G. Williams MD, Marlize Frauendorf MD, Alexandra Arvanitaki MD, George Giannakoulas MD, Khaled Saleh MD, Hani Sabbour MD, Hector R. Cajigas MD, Robert Frantz
Pulmonary hypertension (PH) is a heterogeneous disease with a poor prognosis. Accurate risk stratification is essential for guiding treatment decisions in pulmonary arterial hypertension (PAH). Although various risk models have been developed for PAH, their comparative prognostic potential requires further exploration. Additionally, the applicability of risk scores in PH groups beyond group 1 remains
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The Association Between Sputum Culture Conversion and Mortality in Cavitary Mycobacterium avium Complex Pulmonary Disease Chest (IF 9.6) Pub Date : 2024-03-18 Ju Kwang Lee MD, Seonok Kim MSc, Yong Pil Chong MD, Hyun Joo Lee MD, Tae Sun Shim MD, Kyung-Wook Jo MD
The association between treatment outcome and the mortality of complex pulmonary disease (MAC-PD) with cavitary lesions is unclear. This article assessed the impact of culture conversion on mortality in patients with cavitary MAC-PD. Is the achievement of sputum culture conversion in MAC-PD with cavitary lesions associated with the prognosis? From 2002 to 2020, a total of 351 patients with cavitary
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Laryngeal Dysfunction Manifesting as Chronic Refractory Cough and Dyspnea: Laryngeal Physiology in Respiratory Health and Disease Chest (IF 9.6) Pub Date : 2024-03-18 Krishna M. Sundar MD FCCP, Amanda Stark PhD, Michael J. Morris MD FCCP
Laryngeal dysfunction as a cause of chronic refractory cough (CRC) and episodic dyspnea is often missed, which results in unnecessary testing and delays in diagnosis. Understanding laryngeal roles in breathing and airway protection can help to appreciate the propensity to laryngeal dysfunction with aging, chronic lung disease, and sleep apnea. The human larynx is a complex muscular structure that is
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Rates and Risk Factors of Progression in Patients With Nontuberculous Mycobacterial Pulmonary Disease: Secondary Analysis of a Prospective Cohort Study Chest (IF 9.6) Pub Date : 2024-03-16 Kwonhyung Hyung, Sung-A Kim, Joong-Yub Kim, Nakwon Kwak, Jae-Joon Yim MD PhD
The clinical course of nontuberculous mycobacterial pulmonary disease (NTM-PD) is varied, and a watchful waiting management strategy is appropriate for a subset of patients. Understanding disease progression and risk factors for progression is essential for deciding on an appropriate follow-up strategy. What is the rate of NTM-PD progression, and what are the predictors of progression? Patients with
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Nationwide Increasing Incidence of Nontuberculous Mycobacterial Diseases Among Adults in Denmark: Eighteen Years of Follow-Up Chest (IF 9.6) Pub Date : 2024-03-16 Andreas A. Pedersen MD, Anders Løkke DrMed, Andreas Fløe PhD, Rikke Ibsen MSc, Isik S. Johansen MD, Ole Hilberg MD
The epidemiology of nontuberculous mycobacteria (NTM) infections is not well described. In this study, we determine the incidence and prevalence of NTM infections and focus on social risk factors. In addition, we describe people with pulmonary and extrapulmonary NTM. What are the incidence and prevalence of NTM, and what are the characteristics of the affected patients? This is a nationwide retrospective
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Distribution of Acute and Chronic Kidney Disease Across Clinical Phenotypes for Sepsis Chest (IF 9.6) Pub Date : 2024-03-08 Luca Molinari MD, Gaspar Del Rio-Pertuz MD, Priyanka Priyanka BAMS MPH, Ali Smith BA, Joseph C. Maggiore BSE, Jason Kennedy MS, Hernando Gomez MD MPH, Christopher W. Seymour MD, John A. Kellum MD, ProCESS and ProGReSS-AKI Investigators
Sepsis is the most common cause of acute kidney injury (AKI) in critically ill patients. Four phenotypes (α, β, γ, δ) for sepsis, which have different outcomes and responses to treatment, were described using routine clinical data in the electronic health record. Do the frequencies of AKI, acute kidney disease (AKD), chronic kidney disease (CKD), and AKI on CKD differ by sepsis phenotype? This was
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Point-of-Care Lung Ultrasound in Emergency Medicine: A Scoping Review With an Interactive Database Chest (IF 9.6) Pub Date : 2024-03-07 Stig Holm Ovesen MD, Andreas Hvilshøj Clausen MD, Hans Kirkegaard MD PhD DMSc, Bo Løfgren MD PhD, Rasmus Aagaard MD PhD, Søren Helbo Skaarup MD PhD, Michael Dan Arvig MD PhD, Morten Hjarnø Lorentzen MD, Anne Heltborg Kristensen MD, Mariana Bichuette Cartuliares Cand.scient.san PhD, Casper Falster MD PhD, Liting Tong MD, Alessandra Rabajoli MD, Ronja Leth MD, Janeve Desy MD MEHP, Irene W.Y. Ma MD PhD
This scoping review was conducted to provide an overview of the evidence of point-of-care lung ultrasound (LUS) in emergency medicine. By emphasizing clinical topics, time trends, study designs, and the scope of the primary outcomes, a map is provided for physicians and researchers to guide their future initiatives. Which study designs and primary outcomes are reported in published studies of LUS in
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Antithrombotic Therapy for VTE Disease: Compendium and Review of CHEST Guidelines 2012-2021 Chest (IF 9.6) Pub Date : 2024-03-06 Scott M. Stevens MD, Scott C. Woller MD, Lisa Baumann Kreuziger MD, Kevin Doerschug MD, Geert-Jan Geersing MD PhD, Frederikus A. Klok MD PhD, Christopher S. King MD, Susan Murin MD, Janine R.E. Vintch MD, Philip S. Wells MD, Suman Wasan MD, Lisa K. Moores MD
The CHEST Antithrombotic Therapy for Venous Thromboembolism Disease evidence-based guidelines are now updated in a more frequent, focused manner. Guidance statements from the most recent full guidelines and two subsequent updates have not been gathered into a single source. An international panel of experts with experience in prior antithrombotic therapy guideline development reviewed the 2012 CHEST
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Preparing for Fellowship in Internal Medicine With a Focus on Pulmonary or Critical Care Medicine: Major Principles and New Realities Chest (IF 9.6) Pub Date : 2024-03-06 Matthew C. Miles MD MEd FCCP, Peter Lenz MD MEd FCCP, Jennifer McCallister MD FCCP, Kristin M. Burkart MD MSc FCCP, Candace Huebert MD FCCP, Jason Moore MD, Laura Hinkle MD, Briana Short MD, Brent Bagley MD, Gabriel Bosslet MD FCCP
In this article, the authors provide guidance for applicants to any subspecialty in the medical specialties matching program, with a particular focus on those seeking a match into a pulmonary or critical care medicine training program, or both. The preparation, application, interview, ranking, and match steps are used to discuss available literature that informs this process. Preparing a fellowship
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Atrial Arrhythmias in Patients With Pulmonary Hypertension Chest (IF 9.6) Pub Date : 2024-03-05 Kyle O’Meara MD, Gregory Stone MD, Eric Buch MD, Adam Brownstein MD, Rajan Saggar MD, Richard Channick MD, Alexander E. Sherman MD, Aron Bender MD
Atrial arrhythmia (AA) are common in patients with pulmonary hypertension (PH) and contribute to morbidity and mortality. Given the growing PH population, understanding the pathophysiology, clinical impact, and management of AA in PH is important. AA occurs in PH with a 5-year incidence of 10% to 25%. AA confers a higher morbidity and mortality, and restoration of normal sinus rhythm improves survival
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Comparison Between REVEAL Lite 2 and COMPERA 2.0 for Risk Stratification in Pulmonary Arterial Hypertension Chest (IF 9.6) Pub Date : 2024-03-04 Sandeep Sahay MD, Nelson Villasmil Hernandez MD, Fredrick Wang MD, Matthew Wooten, Duc T. Nguyen MD PhD, Charles Fauvel MD, Raymond Benza, Edward A. Graviss PhD MPH
Risk stratification is the cornerstone of the management of pulmonary arterial hypertension (PAH). Current European Society of Cardiology/European Respiratory Society guidelines recommend using the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) three-strata risk model at baseline and the COMPERA 2.0 four-strata model at follow-up. However, the guidelines
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Use of Intravenous Albumin: A Guideline From the International Collaboration for Transfusion Medicine Guidelines Chest (IF 9.6) Pub Date : 2024-03-04 Jeannie Callum MD, Nikolaos J. Skubas MD, Aarti Bathla MPharm MPH, Homa Keshavarz PhD, Edward G. Clark MD, Bram Rochwerg MD, Dean Fergusson PhD, Sesmu Arbous MD, Seth R. Bauer PharmD, Louise China MD, Mark Fung MD, Rachel Jug MD, Michael Neill, Cary Paine MD, Katerina Pavenski MD, Prakesh S. Shah MD, Susan Robinson MD, Hua Shan MD, Zbigniew M. Szczepiorkowski MD PhD, Thierry Thevenot MD, Bovey Wu,
Albumin is used commonly across a wide range of clinical settings to improve hemodynamics, to facilitate fluid removal, and to manage complications of cirrhosis. The International Collaboration for Transfusion Medicine Guidelines developed guidelines for the use of albumin in patients requiring critical care, undergoing cardiovascular surgery, undergoing kidney replacement therapy, or experiencing
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How We Do It: Interdisciplinary Diagnosis and Management of Patients With Interstitial Lung Disease and Connective Tissue Disease Chest (IF 9.6) Pub Date : 2024-03-04 Sabina A. Guler MD PD, Tobias Scheschkowski MD, Anja Renner MSc, Lea Kämpf BSc, Matthias Gasser MD, Britta Maurer
A diagnosis of interstitial lung diseases (ILD) can be challenging, and the identification of an associated connective tissue disease (CTD) is crucial to estimate prognosis and TO establish the optimal treatment approach. Diagnostic delay, limited expertise, and fragmented care are barriers that impede the delivery of comprehensive health care for patients with rare, complex, and multiorgan diseases
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Effect of Corticosteroids on Long-term Humoral and Memory T-Cell Responses in Follow-up Visit of Hospitalized Patients With COVID-19 Chest (IF 9.6) Pub Date : 2024-03-01 Yeming Wang, Li Guo, Guohui Fan, Yang Han, Qiao Zhang, Weiyang Wang, Lili Ren, Hui Zhang, Geng Wang, Xueyang Zhang, Tingxuan Huang, Lan Chen, Lixue Huang, Xiaoying Gu, Dan Cui, Xinming Wang, Jingchuan Zhong, Ying Wang, Hui Li, Chaolin Huang, Jianwei Wang, Bin Cao MD
Corticosteroids have beneficial effects in improving outcomes in hospitalized patients with severe COVID-19 by suppressing excessive immune responses. However, the effect of corticosteroids on the humoral and T-cell responses of survivors of COVID-19 1 year after infection remains uncertain because it relates to the extent of immediate, antigen-specific defense provided by protective memory. What is
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Clinical Correlates of a Nonplexiform Vasculopathy in Patients With a Diagnosis of Idiopathic Pulmonary Arterial Hypertension Chest (IF 9.6) Pub Date : 2024-03-01 Esther J. Nossent MD, Josien Smits MD, Celine Seegers MSc, Lilian J. Meijboom MD PhD, Anco Boonstra MD PhD, J. Aman MD PhD, F.S. De Man PhD, Harm Jan Bogaard MD PhD, Teodora Radonic MD PhD, Peter Dorfmüller MD PhD, Anton Vonk Noordegraaf MD PhD
The clinical phenotype of idiopathic pulmonary arterial hypertension (IPAH) patients has changed. Whether subgroups of patients with IPAH have different vascular phenotypes is a subject of debate. What are the histologic patterns and their clinical correlates in patients with a diagnosis of IPAH or hereditary pulmonary arterial hypertension (PAH)? In this this cross-sectional registry study, lung histologic
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Azithromycin Induced Asthma Remission in Adults With Persistent Uncontrolled Asthma: A Secondary Analysis of a Randomized, Double-Blind, Placebo-Controlled Trial Chest (IF 9.6) Pub Date : 2024-02-29 Dennis Thomas PhD, Vanessa M. McDonald PhD, Sean Stevens MBiostat, Melissa Baraket PhD, Sandra Hodge PhD, Alan James PhD, Christine Jenkins MD, Guy B. Marks PhD, Matthew Peters MD, Paul Reynolds MD PhD, John W. Upham PhD, Ian A. Yang PhD, Peter G. Gibson DMed
Asthma remission is a potential treatment goal. Does adding azithromycin to standard therapy in patients with persistent uncontrolled asthma induce remission compared with placebo? This secondary analysis used data from the AMAZES clinical trial—a double-blind placebo-controlled trial that evaluated the safety and efficacy of azithromycin on asthma exacerbations. The primary remission definition (referred
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Applying Noninvasive Ventilation in Treatment of Acute Exacerbation of COPD Using Evidence-Based Interprofessional Clinical Practice Chest (IF 9.6) Pub Date : 2024-02-28 Mary Jo S. Farmer MD PhD, Christine Callahan MS RN, Ashley M. Hughes PhD, Karen Riska PhD, Nicholas Hill MD
When administered as first-line intervention to patients admitted with acute hypercapnic respiratory failure secondary to COPD exacerbation in conjunction with guideline-recommended therapies, noninvasive ventilation (NIV) has been shown to reduce mortality and endotracheal intubation. Opportunities to increase uptake of NIV continue to exist despite inclusion of this therapy in clinical guidelines
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The Clinical Frailty Scale for Risk Stratification in Patients With Fibrotic Interstitial Lung Disease Chest (IF 9.6) Pub Date : 2024-02-27 Sabina A. Guler MD, Daniel-Costin Marinescu MD, Gerard Cox MD, Celine Durand MD, Jolene H. Fisher MD, Amanda Grant-Orser MD, Gillian C. Goobie MD PhD, Nathan Hambly MD, Kerri A. Johannson MD, Nasreen Khalil MD, Martin Kolb MD PhD, Stacey Lok MD, Sarah MacIsaac MD, Helene Manganas MD, Veronica Marcoux MD, Julie Morisset MD, Ciaran Scallan MD, Shane Shapera MD, Kelly Sun MD, Boyang Zheng MD, Christopher
Previous studies have shown the importance of frailty in patients with fibrotic interstitial lung disease (ILD). Is the Clinical Frailty Scale (CFS) a valid tool to improve risk stratification in patients with fibrotic ILD? Patients with fibrotic ILD were included from the prospective multicenter Canadian Registry for Pulmonary Fibrosis. The CFS was assessed using available information from initial
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Venovenous Extracorporeal Membrane Oxygenation Candidacy Decision-Making: Lessons and Hypotheses From a Single-Center Observational Analysis Chest (IF 9.6) Pub Date : 2024-02-27 Jonah Rubin MD, Alison S. Witkin MD, Jerome C. Crowley MD, Eriberto Michel MD, David M. Furfaro MD, Ricardo Teijeiro-Paradis MD, Annette Ilg MD, Raghu Seethala MD, Sophia Zhao, Eddy Fan MD PhD
Use of venovenous extracorporeal membrane oxygenation (ECMO) is increasing, but candidacy selection processes are variable and subject to bias. What are the reasons behind venovenous ECMO candidacy decisions, and are decisions made consistently across patients? Prospective observational study of all patients, admitted or outside hospital referrals, considered for venovenous ECMO at a tertiary referral
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Abnormal Exertional Breathlessness on Cardiopulmonary Cycle Exercise Testing in Relation to Self-Reported and Physiological Responses in Chronic Airflow Limitation Chest (IF 9.6) Pub Date : 2024-02-27 Magnus Ekström MD PhD, Pei Zhi Li MSc, Hayley Lewthwaite PhD, Jean Bourbeau MD, Wan C. Tan MD, Dennis Jensen PhD, CanCOLD Collaborative Research Group, Jean Bourbeau, Wan C. Tan, J. Mark FitzGerald, Don D. Sin, Darcy D. Marciniuk, Denis E. O’Donnell, Paul Hernandez, Kenneth R. Chapman, Brandie Walker, Shawn Aaron, François Maltais, Jonathon Samet, Milo Puhan, Qutayba Hamid, James C. Hogg, Jean Bourbeau
Exertional breathlessness is a cardinal symptom of cardiorespiratory disease. How does breathlessness abnormality, graded using normative reference equations during cardiopulmonary exercise testing (CPET), relate to self-reported and physiological responses in people with chronic airflow limitation (CAL)? An analysis was done of people aged ≥ 40 years with CAL undergoing CPET in the Canadian Cohort
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Noninvasive Electromagnetic Phrenic Nerve Stimulation in Critically Ill Patients: A Feasibility Study Chest (IF 9.6) Pub Date : 2024-02-24 Alessandro Panelli MD, Aline M. Grimm, Sven Krause MSc, Michael A. Verfuß, Bernhard Ulm, Julius J. Grunow MD, Hermann G. Bartels, Niklas M. Carbon MD, Thomas Niederhauser PhD, Steffen Weber-Carstens MD, Laurent Brochard MD, Stefan J. Schaller MD
Electromagnetic stimulation of the phrenic nerve induces diaphragm contractions, but no coils for clinical use have been available. We recently demonstrated the feasibility of ventilation using bilateral transcutaneous noninvasive electromagnetic phrenic nerve stimulation (NEPNS) before surgery in lung-healthy, normal-weight patients in a dose-dependent manner. Is NEPNS feasible in critically ill patients
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International Variation in Severe Exacerbation Rates in Patients With Severe Asthma Chest (IF 9.6) Pub Date : 2024-02-21 Tae Yoon Lee MSc, David Price FRCGP, Chandra Prakash Yadav PhD, Rupsa Roy MSc, Laura Lim Huey Mien MSc, Eileen Wang MD PhD, Michael E. Wechsler MD, David J. Jackson MBBS MRCP(UK) PhD, John Busby PhD, Liam G. Heaney MD, Paul E. Pfeffer MRCP(UK) PhD, Bassam Mahboub MD, Diahn-Warng Perng (Steve) MD PhD, Borja G. Cosio MD PhD, Luis Perez-de-Llano MD PhD, Riyad Al-Lehebi MD, Désirée Larenas-Linnemann MD
Exacerbation frequency strongly influences treatment choices in patients with severe asthma. What is the extent of the variability of exacerbations rate across countries and its implications in disease management? We retrieved data from the International Severe Asthma Registry, an international observational cohort of patients with a clinical diagnosis of severe asthma. We identified patients ≥ 18
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CT Imaging Assessment of Response to Treatment in Allergic Bronchopulmonary Aspergillosis in Adults With Bronchial Asthma Chest (IF 9.6) Pub Date : 2024-02-20 Cendrine Godet MD, Anne-Laure Brun MD, Francis Couturaud MD PhD, François Laurent MD PhD, Jean-Pierre Frat MD PhD, Sylvain Marchand-Adam MD PhD, Frédéric Gagnadoux MD PhD, Elodie Blanchard MD, Camille Taillé MD PhD, Bruno Philippe MD, Sandrine Hirschi MD, Claire Andréjak MD PhD, Arnaud Bourdin MD PhD, Cécile Chenivesse MD PhD, Stéphane Dominique MD PhD, Gilles Mangiapan MD PhD, Marlène Murris-Espin
One of the major challenges in managing allergic bronchopulmonary aspergillosis remains consistent and reproducible assessment of response to treatment. What are the most relevant changes in CT scan parameters over time for assessing response to treatment? In this ancillary study of a randomized clinical trial (NebuLamB), patients with asthma with available CT scan and without exacerbation during a
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Barriers and Facilitators of Surrogates Providing Consent for Critically Ill Patients in Clinical Trials: A Qualitative Study Chest (IF 9.6) Pub Date : 2024-02-20 Dustin C. Krutsinger MD, Shannon I. Maloney PhD, Katherine R. Courtright MD, Karsten Bartels MD PhD
Enrollment into critical care clinical trials is often hampered by the need to rely on surrogate decision-makers. To identify potential interventions facilitating enrollment into critical care clinical trials, a better understanding of surrogate decision-making for critical care clinical trial enrollment is needed. What are the barriers and facilitators of critical care trial enrollment? What are surrogate
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Anaerobic Antibiotic Coverage in Aspiration Pneumonia and the Associated Benefits and Harms: A Retrospective Cohort Study Chest (IF 9.6) Pub Date : 2024-02-20 Anthony D. Bai MD, Siddhartha Srivastava MD, Geneviève C. Digby MD, Vincent Girard MD, Fahad Razak MD, Amol A. Verma MD
Antibiotics with extended anaerobic coverage are used commonly to treat aspiration pneumonia, which is not recommended by current guidelines. In patients admitted to hospital for community-acquired aspiration pneumonia, does a difference exist between antibiotic therapy with limited anaerobic coverage (LAC) vs antibiotic therapy with extended anaerobic coverage (EAC) in terms of in-hospital mortality
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Disproportionate Use of the ED by Patients 3-Years After e-Cigarette–Associated or Vaping-Associated Lung Injury Chest (IF 9.6) Pub Date : 2024-02-20 Michael S. Zhang MD PhD, Taylor Nee MBMS, Michael Lynch MD, Jason Rose MD, Alison Morris MD, Divay Chandra MD
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Clinician- and Patient-Identified Solutions to Reduce the Fragmentation of Post-ICU Care in Australia Chest (IF 9.6) Pub Date : 2024-02-19 Nina Leggett DPT BBiomed, Kate Emery BExSci DPT, Thomas C. Rollinson BPhysio(Hons), Adam M. Deane MBBS PhD, Craig French MBBS, Jo-Anne Manski-Nankervis MBBS(Hons) CHIA PhD, Glenn Eastwood PhD GDipNurs(CritCare), Briannah Miles BBiomed(Hons), Sophie Witherspoon MD, Jonathan Stewart MRes MPhil, Mark Merolli PhD CHIA, Yasmine Ali Abdelhamid MBBS PhD, Kimberley J. Haines PhD
Critical care survivors experience multiple care transitions, with no formal follow-up care pathway. What are the potential solutions to improve the communication between treating teams and integration of care following an ICU admission, from the perspective of patients, their caregivers, intensivists, and general practitioners (GPs) from diverse socioeconomic areas? This study included a qualitative
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Automatic Mechanical Ventilation vs Manual Bag Ventilation During CPR: A Pilot Randomized Controlled Trial Chest (IF 9.6) Pub Date : 2024-02-18 Jonghwan Shin MD PhD, Hui Jai Lee MD PhD, Kwang Nam Jin MD PhD, Jung Ho Shin MD PhD, Kyoung Min You MD PhD, Stephen Gyung Won Lee MD, Jin Hee Jung MD PhD, Kyoung Jun Song MD PhD, Jieun Pak MD MD, Tae Yun Park MD, Chang Je Park, Gi Tak Bae RN
There is insufficient evidence supporting the theory that mechanical ventilation can replace the manual ventilation method during CPR. Is using automatic mechanical ventilation feasible and comparable to the manual ventilation method during CPR? This pilot randomized controlled trial compared automatic mechanical ventilation (MV) and manual bag ventilation (BV) during CPR of out-of-hospital cardiac
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Lung Consolidation Depth and Gas Exchange in Different Types of Neonatal Respiratory Failure: The UNION Multicenter Study Chest (IF 9.6) Pub Date : 2024-02-16 Daniele De Luca MD PhD, Anna Foti MD, Almudena Alonso-Ojembarrena MD PhD, Valentina Condò MD, Letizia Capasso MD, Roberto Raschetti MD, Luca Bonadies MD PhD, Eugenio Baraldi MD, Fabio Mosca MD, Francesco Raimondi MD PhD, UNION (Lung Ultrasound Features and Inflammation in NICU-admitted Neonates) study group
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Partnering With Patients With Sarcoidosis to Implement a Community Advisory Board Chest (IF 9.6) Pub Date : 2024-02-16 Leila Bushweller, Sandra Hodges, Linda Meyer, Johnie Reed, Karen Saunders, Rhonda Jenkins MPH, Kristen A. Berg PhD CRC, J. Daryl Thornton MD, Manuel L. Ribeiro Neto MD, Daniel A. Culver DO, Logan J. Harper MD
Community advisory boards (CABs) are increasingly recognized as a means of incorporating patient experience into clinical practice and research. The power of CABs is derived from engaging with community members as equals throughout the research process. Despite this, little is known of community member experience and views on best practices for running a CAB in a rare pulmonary disease. What are CAB
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Does Rheumatoid Arthritis Increase the Risk of COPD?: A Nationwide Retrospective Cohort Study Chest (IF 9.6) Pub Date : 2024-02-15 Chiwook Chung MD, Hyungjin Kim MD PhD, Kyungdo Han PhD, Jinhyoung Jung PhD, Yeonghee Eun MD PhD, Hyun Lee MD, Junhee Park MD, Dong Wook Shin MD PhD DrPH, Sei Won Lee MD PhD
Most reports of pulmonary manifestations in rheumatoid arthritis (RA) have been related to interstitial lung diseases. RA and COPD are both chronic inflammatory systemic diseases. Does RA increase the risk of developing COPD? Is there a difference between seropositive and seronegative RA in the risk of COPD? Using the Korean National Health Insurance Database, we screened individuals diagnosed with
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An Update on Patient-Reported Outcomes in Asthma Chest (IF 9.6) Pub Date : 2024-02-15 Tianshi David Wu MD MHS, Zuzana Diamant MD PhD, Nicola A. Hanania MD
Patient-reported outcomes (PROs) are information provided by patients on their condition, function, well-being, or experience. Instruments to quantify PROs, called patient-reported outcome measures (PROMs), allow standardized assessment of a unique dimension of health that cannot be measured physically. Herein, we discuss how to appraise PROMs critically and provide an update on their use in asthma