journal
https://read.qxmd.com/read/39004218/role-of-pathological-single-and-multiple-n-descriptors-in-resected-non-small-cell-lung-cancer
#1
JOURNAL ARTICLE
Shinkichi Takamori, Atsushi Osoegawa, Asato Hashinokuchi, Takashi Karashima, Yohei Takumi, Miyuki Abe, Masafumi Yamaguchi, Tomoyoshi Takenaka, Tomoharu Yoshizumi, Junjia Zhu, Takefumi Komiya
BACKGROUND: The 8th edition of lung cancer N staging assignment includes the location of lymph node metastasis, but does not include single- and multiple-N descriptors. RESEARCH QUESTION: Do the single- and multiple-N statuses stratify the prognosis of patients with non-small cell lung cancer (NSCLC)? STUDY DESIGN AND METHODS: Using the National Cancer Database, we analyzed patients with pathologically staged N1-2 NSCLC. N descriptors were classified into pathological single N1 (pSingle-N1), pathological multiple N1 (pMulti-N1), pSingle-N2, and pMulti-N2...
July 12, 2024: Chest
https://read.qxmd.com/read/39004217/dexmedetomidine-for-reducing-mortality-in-patients-with-septic-shock-a-randomized-controlled-trial-decatsepsis
#2
JOURNAL ARTICLE
Ahmed Ragab Ezz Al-Regal, Eyad Ahmed Ramzy, Amer Abd Allah Atia, Moataz Maher Emara
BACKGROUND: Sepsis, especially septic shock, and its complications have been linked to the hyperadrenergic stress response. RESEARCH QUESTION: Does decatecholaminization with dexmedetomidine (DEX) lower the in-hospital mortality in septic shock patients? STUDY DESIGN AND METHODS: This open-label randomized controlled trial assessed the effects of a heart rate (HR)-calibrated DEX infusion on in-hospital mortality in patients with septic shock and HR >90 beats per minute (bpm), whether they are mechanically ventilated or not...
July 12, 2024: Chest
https://read.qxmd.com/read/39004216/how-we-do-it-using-sotatercept-in-the-care-of-patients-with-pulmonary-arterial-hypertension
#3
REVIEW
Ioana R Preston, Denise Lewis, Mardi Gomberg-Maitland
Pulmonary arterial hypertension (PAH) is a rare disease of the pulmonary microvasculature leading to elevated pre-capillary pulmonary hypertension. Pulmonary vascular remodeling, a characteristic of PAH, is driven by dysfunctions in the signaling between the pulmonary smooth muscle and endothelial cells with abnormalities that affect cell proliferation and immune dysregulation. Sotatercept, an activin signaling inhibitor, has been recently approved by the Food and Drug Administration for the treatment of PAH, based on two pivotal clinical trials...
July 12, 2024: Chest
https://read.qxmd.com/read/39002815/determining-if-copd-self-management-televisit-based-interventions-are-evaluated-among-and-equitably-effective-across-diverse-patient-populations-to-reduce-acute-care-utilization-a-scoping-review
#4
REVIEW
Mahima Akula, May Nguyen, Joanna Abraham, Vineet M Arora, Folabomi Oladosu, Aashna Sunderrajan, Leah Traeger, Valerie G Press
TOPIC IMPORTANCE: With telemedicine's expansion during the COVID-19 pandemic, it became critical to evaluate whether patients have equitable access and capabilities to optimally use televisits for improved COPD outcomes such as reduced hospitalizations. This scoping review evaluated whether televisit-based interventions are evaluated and equitably effective in improving healthcare utilization outcomes among diverse patient populations with COPD. REVIEW FINDINGS: Using a systematic search for televisit-based COPD self-management interventions we found 20 studies for inclusion, all but one of which was published prior to the COVID-19 pandemic...
July 11, 2024: Chest
https://read.qxmd.com/read/38997086/two-birds-with-one-stone-cross-registry-analysis-of-women-undergoing-lung-cancer-and-breast-cancer-screening
#5
JOURNAL ARTICLE
John Michael Sweetnam, Lenka Goldman, Lars Grimm, Gerard A Silvestri, Nichole T Tanner
No abstract text is available yet for this article.
July 10, 2024: Chest
https://read.qxmd.com/read/38992490/rethinking-blood-eosinophils-for-assessing-ics-response-in-copd-a-post-hoc-analysis-from-flame
#6
JOURNAL ARTICLE
Alexander G Mathioudakis, Sebastian Bate, Pradeesh Sivapalan, Jens-Ulrik Stæhr Jensen, Dave Singh, Jørgen Vestbo
BACKGROUND: The varied treatment response to inhaled corticosteroids (ICS) in COPD, and the increased risk of pneumonia necessitate a personalised ICS therapeutic approach. This is informed by blood eosinophil count (BEC), which predicts ICS treatment response. However, BEC appears to change in response to ICS treatment. RESEARCH QUESTION: Does BEC measured on or off ICS treatment or the change in BEC during ICS treatment, best predict treatment response to ICS in COPD? STUDY DESIGN AND METHODS: FLAME, a 52-week, double-blind RCT compared LABA/LAMA versus LABA/ICS...
July 9, 2024: Chest
https://read.qxmd.com/read/38986867/association-of-red-blood-cell-transfusion-thresholds-and-outcomes-in-medical-patients-with-acute-respiratory-failure-supported-with-extra-corporeal-membrane-oxygenation-a-single-center-retrospective-cohort-study
#7
JOURNAL ARTICLE
Elias H Pratt, Aaron M Pulsipher, Nathaniel G Moulton, Andrea MacDonald, Emily Poehlein, Cynthia L Green, Craig R Rackley
BACKGROUND: The hemoglobin value to trigger red blood cell (RBC) transfusion for patients receiving venovenous extracorporeal membrane oxygenation (VV-ECMO) is controversial. Previous guidelines recommended transfusing to a normal hemoglobin, but recent studies suggest more RBC transfusions are associated with increased adverse outcomes. RESEARCH QUESTION: Is implementation of different institutional RBC transfusion thresholds for patients receiving VV-ECMO associated with changes in RBC utilization and patient outcomes? STUDY DESIGN AND METHODS: Single-center retrospective study of patients receiving VV-ECMO using segmented regression to test associations between implementation of institutional transfusion thresholds and trends in RBC utilization...
July 8, 2024: Chest
https://read.qxmd.com/read/38972349/eosinopenia-as-predictor-of-disease-severity-in-patients-with-community-acquired-pneumonia-an-observational-study
#8
JOURNAL ARTICLE
Barbara Christine Weckler, Hendrik Pott, Alan Race, Nattika Jugkaeo, Kapil Karki, Stephan Ringshandl, Christian Seidemann, Ines Schöndorf, Harald Renz, Sebastian Fähndrich, Anna Lena Jung, Wilhelm Bertrams, Adeline Makoudjou, Daniela Zöller, Susetta Finotto, Stefanie Schild, Susanne A Seuchter, Gernot Rohde, Frederik Trinkmann, Timm Greulich, Claus Franz Vogelmeier, Bernd Schmeck
No abstract text is available yet for this article.
July 5, 2024: Chest
https://read.qxmd.com/read/38972348/comparison-of-early-and-late-norepinephrine-administration-in-patients-with-septic-shock-a-systematic-review-and-meta-analysis
#9
JOURNAL ARTICLE
Chiwon Ahn, Gina Yu, Tae Gun Shin, Youngsuk Cho, Sunghoon Park, Gee Young Suh
BACKGROUND: Vasopressor administration at an appropriate time is crucial but the optimal timing remains controversial. RESEARCH QUESTION: Does early versus late norepinephrine (NE) administration impact the prognosis of septic shock? STUDY DESIGN AND METHODS: Searches were conducted on PubMed, EMBASE, the Cochrane Library, and KMBASE. We included studies of adults with sepsis and categorized patients into early and late NE group according to specific time points or differences in norepinephrine use protocols...
July 5, 2024: Chest
https://read.qxmd.com/read/38964674/association-between-spontaneous-breathing-trial-methods-and-reintubation-in-adult-critically-ill-patients-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#10
JOURNAL ARTICLE
Mariachiara Ippolito, Salvatore Sardo, Vincenzo Francesco Tripodi, Nicola Latronico, Elena Bignami, Antonino Giarratano, Andrea Cortegiani
BACKGROUND: Reintubation is associated with higher risk of mortality. There is no clear evidence on the best spontaneous breathing trial (SBT) method to reduce the risk of reintubation. RESEARCH QUESTION: Are different methods of conducting SBT in critically ill patients associated with different risk of reintubation compared to T-tube? STUDY DESIGN AND METHODS: We conducted a systematic review and Bayesian network meta-analysis of randomized controlled trials (RCTs) investigating the effects of different SBT methods on reintubation...
July 2, 2024: Chest
https://read.qxmd.com/read/38964673/development-and-validation-of-the-hms-sepsis-mortality-model
#11
JOURNAL ARTICLE
Hallie C Prescott, Megan Heath, Elizabeth S Munroe, John Blamoun, Paul Bozyk, Rachel K Hechtman, Jennifer K Horowitz, Namita Jayaprakash, Keith E Kocher, Mariam Younas, Stephanie P Taylor, Patricia J Posa, Elizabeth McLaughlin, Scott A Flanders
BACKGROUND: When comparing outcomes after sepsis, it is essential to account for patient case mix to make fair comparisons. We developed a model to assess risk-adjusted 30-day mortality in the Michigan Hospital Medicine Safety's sepsis initiative (HMS-Sepsis). QUESTION: Can HMS-Sepsis registry data adequately predict risk of 30-day mortality? Do performance assessments using adjusted vs unadjusted data differ? STUDY DESIGN AND METHODS: Retrospective cohort of community-onset sepsis hospitalizations in HMS-Sepsis registry (4/2022-9/2023), with split derivation (70%) and validation (30%) cohorts...
July 2, 2024: Chest
https://read.qxmd.com/read/38964672/severity-of-inhalation-injury-and-risk-of-nosocomial-pneumonia-a-retrospective-cohort-study
#12
JOURNAL ARTICLE
Taylor D Coston, Devin Gaskins, Austin Bailey, Emily Minus, Saman Arbabi, T Eoin West, Barclay T Stewart
BACKGROUND: The impact of inhalation injury on risk of nosocomial pneumonia, an important complication in burn patients, is not well established. RESEARCH QUESTION: Is more severe inhalation injury associated with increased risk of nosocomial pneumonia? STUDY DESIGN AND METHODS: We performed a retrospective cohort study of patients with suspected inhalation injury admitted to a regional burn center from 2011 to 2022 who underwent diagnostic bronchoscopy within 48 hours of admission...
July 2, 2024: Chest
https://read.qxmd.com/read/38964671/patient-and-provider-perspectives-driving-inhaler-choice-optimizing-sustainable-healthcare
#13
JOURNAL ARTICLE
Graham Lough, Sinthia Bosnic-Anticevich, Nicolas Roche, Omar S Usmani
No abstract text is available yet for this article.
July 2, 2024: Chest
https://read.qxmd.com/read/38950694/clinical-impact-of-telomere-length-testing-for-interstitial-lung-disease
#14
JOURNAL ARTICLE
David Zhang, Christina M Eckhardt, Claire McGroder, Shannon Benesh, Julie Porcelli, Christopher Depender, Kelsie Bogyo, Joseph Westrich, Amanda Thomas-Wilson, Vaidehi Jobanputra, Christine K Garcia
BACKGROUND: Shortened telomere length (TL) is a genomic risk factor for fibrotic interstitial lung disease (ILD), but its role in clinical management is unknown. RESEARCH QUESTION: What is the clinical impact of TL testing on the management of ILD? STUDY DESIGN AND METHODS: Patients were evaluated in the Columbia University ILD clinic and underwent CLIA-certified TL testing by flow cytometry and fluorescence in-situ hybridization (FlowFISH) as part of clinical management...
June 29, 2024: Chest
https://read.qxmd.com/read/38945358/characteristics-of-adults-with-severe-asthma-in-childhood-a-60-year-follow-up-study
#15
JOURNAL ARTICLE
Osman Savran, Klaus Bønnelykke, Charlotte Suppli Ulrik
BACKGROUND: Childhood asthma is a prevalent condition with potential impact on adult life. RESEARCH QUESTION: In a 60-year follow-up study of adults with a history of severe childhood asthma, what are the potential differences in characteristics between individuals with persistent asthma and asthma remission in adulthood? STUDY DESIGN AND METHODS: Danish adults with a history of childhood asthma and a 4-month stay in at an asthma care facility in Kongsberg, Norway (1950-1979) in childhood were included...
June 28, 2024: Chest
https://read.qxmd.com/read/38945357/percutaneous-lung-biopsy-prevalence-and-use-of-lung-rads-in-the-veterans-health-administration-lung-cancer-screening-program
#16
JOURNAL ARTICLE
Andrew R Hwang, Nathan Mesfin, Matthew Kogut, Marva V Foster, Marlena H Shin, Daniel J Sturgeon, Hillary J Mull
No abstract text is available yet for this article.
June 28, 2024: Chest
https://read.qxmd.com/read/38909953/diseases-involving-the-lung-peribronchovascular-region-a-ct-pathologic-classification
#17
REVIEW
Linda Le, Navneet Narula, Fang Zhou, Paul Smereka, Jeffrey Ordner, Neil Theise, William H Moore, Francis Girvin, Lea Azour, Andre L Moreira, David P Naidich, Jane P Ko
TOPIC IMPORTANCE: Chest computed tomography (CT) holds a major role in the diagnosis of lung disease, many of which affect the peri-bronchovascular (PBV) region. Identification and categorization of PBV abnormalities on CT can assist in formulating a differential diagnosis and directing further diagnostic evaluation. REVIEW FINDINGS: The PBV region of the lung encompasses the pulmonary arteries, airways, and lung interstitium. Understanding disease processes associated with structures of the PBV region and their appearances on CT aids in prompt diagnosis...
June 21, 2024: Chest
https://read.qxmd.com/read/38906463/sepsis-order-set-use-associated-with-increased-care-value
#18
JOURNAL ARTICLE
Christopher R Dale, Shih-Ting Chiu, Shelley Schoepflin Sanders, Caleb J Stowell, Tessa L Steel, Joshua M Liao, James I Barnes
BACKGROUND: Sepsis is common and expensive and there is evidence that sepsis order sets may help improve care. There is very incomplete evidence of the effects of sepsis order sets on the value of care produced by hospitals or the societal costs of sepsis care. RESEARCH QUESTION: In patients hospitalized for sepsis, is the receipt a of a sepsis order set vs. no order set associated with improved value of care, defined as decreased hospital mortality, decreased hospital direct variable costs and decreased societal spending on hospitalizations? STUDY DESIGN AND METHODS: Retrospective cohort study of patients discharged with sepsis ICD-10 codes over two years from a large integrated delivery system...
June 19, 2024: Chest
https://read.qxmd.com/read/38906462/associations-between-air-pollution-and-the-onset-of-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-a-time-stratified-case-crossover-study-in-china
#19
JOURNAL ARTICLE
Yue Niu, Hongtao Niu, Xia Meng, Yixiang Zhu, Xiaoxia Ren, Ruoxi He, Hanna Wu, Tao Yu, Yushi Zhang, Haidong Kan, Renjie Chen, Ting Yang, Chen Wang
BACKGROUND: Associations between air pollution and the acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have been established primarily in time-series studies in which exposure and case data were at the aggregate level, limiting the identification of susceptible populations. RESEARCH QUESTION: Are air pollutants associated with the onset of AECOPD in China? Who is more susceptible to the effects of air pollutants? STUDY DESIGN AND METHODS: AECOPD data were obtained from the Acute Exacerbation of Chronic Obstructive Pulmonary Disease Registry study and air pollution data were assigned to individuals based on their residential address...
June 19, 2024: Chest
https://read.qxmd.com/read/38906461/-against-medical-advice-discharges-after-respiratory-related-hospitalizations-strategies-for-respectful-care
#20
REVIEW
J Henry Brems, Judith Vick, Deepshikha Ashana, Mary Catherine Beach
Against medical advice (AMA) discharges are practically and emotionally challenging for both patients and clinicians. Moreover, they are common after admissions for respiratory conditions, such as COPD and asthma, and are associated with poor outcomes. Despite the challenges presented by AMA discharges, clinicians rarely receive formal education and have limited guidance on how to approach these discharges. Often, the approach to AMA discharges prioritizes designating the discharge as 'AMA,' while effective coordination of discharge care receives less attention...
June 19, 2024: Chest
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