journal
https://read.qxmd.com/read/38554817/image-assisted-pleural-needle-biopsy-or-medical-thoracoscopy-which-method-for-which-patient-a-randomized-controlled-trial
#1
JOURNAL ARTICLE
Muzaffer Metintas, Guntulu Ak, Huseyin Yildirim, Emine Dundar, Nevin Aydin, Sinan Erginel, Fusun Alatas, Senay Yilmaz, Selma Metintas
BACKGROUND: Image-guided or assisted needle biopsies and the increasing use of medical thoracoscopy (MT) have significantly increased the diagnostic accuracy of pleural diseases. However, there is no consensus on which patients should undergo medical thoracoscopy (MT) and which patient should undergo image-guided or assisted needle biopsy as the first procedure to ensure greater diagnostic accuracy in patients with pleural effusion. RESEARCH QUESTION: Which biopsy method is more appropriate for which patient to provide the highest diagnostic accuracy in the diagnosis of pleural effusion? METHODS: This prospective, randomized, parallel study included two hundred twenty-eight patients with undiagnosed exudative pleural effusion...
March 28, 2024: Chest
https://read.qxmd.com/read/38548100/sarcoidosis-faculty-development-the-pipeline-is-running-dry
#2
JOURNAL ARTICLE
Nicholas Arger, Michelle Sharp, Catherine Bonham, Divya Patel, Rohit Gupta, W Ennis James
No abstract text is available yet for this article.
March 26, 2024: Chest
https://read.qxmd.com/read/38548099/flow-cytometry-as-an-alternative-to-microscopy-for-the-differentiation-of-bronchoalveolar-lavage-fluid-leukocytes
#3
JOURNAL ARTICLE
Kai Bratke, Martin Weise, Paul Stoll, J Christian Virchow, Marek Lommatzsch
BACKGROUND: Microscopy is currently the gold standard to differentiate bronchoalveolar lavage fluid (BALF) leukocytes. However, local expertise for microscopic BALF leukocyte differentiation is often unavailable in clinical practice. RESEARCH QUESTION: Can automated flow cytometry be used instead of microscopy to differentiate BALF leukocytes? STUDY DESIGN AND METHODS: A new automated flow cytometric method for BALF leukocyte differentiation, using four antibodies (anti-CD45, anti-CD66b, anti-HLA-DR, anti-CD52) given to human BALF in one tube, was developed and prospectively validated in 745 unselected, subsequent BALF samples from patients with interstitial lung diseases (455 patients), infectious diseases (196 patients) and other diseases (94 patients)...
March 26, 2024: Chest
https://read.qxmd.com/read/38537688/changes-in-spirometry-interpretative-strategies-implications-for-classifying-copd-and-predicting-exacerbations
#4
JOURNAL ARTICLE
J Henry Brems, Aparna Balasubramanian, Sarath Raju, Nirupama Putcha, Ashraf Fawzy, Nadia N Hansel, Robert A Wise, Meredith C McCormack
BACKGROUND: Recent guidelines for spirometry interpretation recommend both race-neutral reference equations and use of z-score thresholds to define severity of airflow obstruction. RESEARCH QUESTION: How does the transition from race-specific to race-neutral equations impact severity classifications for patients with COPD when using percent-predicted versus z-score thresholds, and do changes in severity correspond to clinical risk? STUDY DESIGN AND METHODS: This retrospective cohort study included Black and White patients with COPD and available spirometry from the Johns Hopkins Health System...
March 25, 2024: Chest
https://read.qxmd.com/read/38521181/relationship-between-lung-volumes-and-heterogeneity-in-the-response-to-elexacaftor-tezacaftor-ivacaftor-in-patients-with-cystic-fibrosis-and-advanced-lung-disease
#5
JOURNAL ARTICLE
Andrea Gramegna, Gianfranco Alicandro, Chiara Premuda, Francesca Lucca, Lucia Pinali, Mariangela Retucci, Valentina Vespro, Maria Carmela Andrisani, Gianpaolo Carraffiello, Francesco Amati, Sonia Volpi, Stefano Aliberti, Marco Cipolli, Francesco Blasi
BACKGROUND: The effects of elexacaftor/tezacaftor/ivacaftor (ETI) on respiratory outcomes for people with CF (pwCF) were demonstrated by several clinical trials, mainly based on simple spirometry. However, gains in lung function may vary greatly between patients, but predictors of FEV1 change after treatment are still missing. RESEARCH QUESTION: Which ventilatory parameters are involved in the heterogeneity of FEV1 change after 12-month ETI treatment in pwCF with advanced lung disease? STUDY DESIGN: AND METHODS: This was a multicenter, observational, prospective cohort study at two major CF centers in Italy...
March 21, 2024: Chest
https://read.qxmd.com/read/38513965/the-association-of-pregnancy-with-outcomes-among-critically-ill-reproductive-aged-women-a-propensity-score-matched-retrospective-cohort-analysis
#6
JOURNAL ARTICLE
Rachel Kohn, Deepshikha C Ashana, Kelly C Vranas, Elizabeth M Viglianti, Katrina Hauschildt, Catherine Chen, Emily A Vail, Leslie Moroz, Hayley B Gershengorn
BACKGROUND: The maternal mortality rate in the US is unacceptably high. However, the relative contribution of pregnancy to these outcomes is unknown. Studies comparing outcomes among pregnant versus non-pregnant critically ill patients show mixed results and are limited by small sample sizes. RESEARCH QUESTION: What is the association of pregnancy with critical illness outcomes? STUDY DESIGN AND METHODS: We performed a retrospective cohort study of 18-55-year-old women who received invasive mechanical ventilation (MV) on hospital day 0 or 1, or had sepsis present on admission (infection with organ failure) discharged from Premier Healthcare Database hospitals in 2008-2021...
March 19, 2024: Chest
https://read.qxmd.com/read/38513964/the-role-of-pediatric-psychologists-in-critical-care-lessons-learned-and-future-directions-in-integrating-mental-health-care-into-pediatric-intensive-care-units
#7
REVIEW
Kristin Canavera, Patricia Marik, Nicole M Schneider, Jacquelyn Smith
Pediatric psychologist are essential staff in the pediatric intensive care unit (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 paper 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 mental health services in PICUs. We address relevant ways for critical care providers to understand the importance of evidence-based psychological care and advocate for the inclusion of psychologists on multidisciplinary PICU teams...
March 19, 2024: Chest
https://read.qxmd.com/read/38508335/the-association-between-sputum-culture-conversion-and-mortality-in-cavitary-mycobacterium-avium-complex-pulmonary-disease
#8
JOURNAL ARTICLE
Ju Kwang Lee, Seonok Kim, Yong Pil Chong, Hyun Joo Lee, Tae Sun Shim, Kyung-Wook Jo
BACKGROUND: The association between treatment outcome and the mortality of Mycobacterium avium complex (MAC) pulmonary disease (PD) with cavitary lesions is unclear. Here, we assessed the impact of culture conversion on mortality in patients with cavitary Mycobacterium avium complex pulmonary disease. RESEARCH QUESTION: Is the achievement of sputum culture conversion in MAC-PD with cavitary lesions associated with the prognosis? STUDY DESIGN AND METHODS: From 2002 to 2020, 351 patients with cavitary MAC-PD (105 with the fibrocavitary type and 246 with the cavitary nodular bronchiectatic type), who had been treated with a ≥6-month macrolide-containing regimen at a tertiary referral center in South Korea, were retrospectively enrolled in this study...
March 18, 2024: Chest
https://read.qxmd.com/read/38508334/comparison-of-contemporary-risk-scores-in-all-groups-of-pulmonary-hypertension-a-pvri-godeep-meta-registry-analysis
#9
JOURNAL ARTICLE
Athiththan Yogeswaran, Henning Gall, Meike Fünderich, Martin R Wilkins, Luke Howard, David G Kiely, Allan Lawrie, Paul M Hassoun, Yuriy Sirenklo, Olena Torbas, Andrew J Sweatt, Roham T Zamanian, Paul G Williams, Marlize Frauendorf, Alexandra Arvanitaki, George Giannakoulas, Khaled Saleh, Hani Sabbour, Hector R Cajigas, Robert Frantz, Imad Al Ghouleh, Stephen Y Chan, Evan Brittain, Jeffrey S Annis, Antonella Pepe, Stefano Ghio, Stylianos Orfanos, Anastasia Anthi, Raphael W Majeed, Jochen Wilhelm, Hossein Ardeschir Ghofrani, Manuel J Richter, Friedrich Grimminger, Sandeep Sahay, Khodr Tello, Werner Seeger
BACKGROUND: Pulmonary hypertension (PH) is a heterogeneous disease with poor prognosis. Accurate risk stratification is essential for guiding treatment decisions in pulmonary arterial hypertension (PAH). While various risk models were developed for PAH, their comparative prognostic potential requires further exploration. Additionally, the applicability of risk scores in PH groups beyond group 1 remains to be investigated. RESEARCH QUESTION: Are risk scores originally developed for PAH predictive in PH group 1-4? STUDY DESIGN AND METHODS: We conducted a comprehensive analysis of outcomes among incident PH patients enrolled in the multicenter worldwide PVRI-GoDeep meta-registry...
March 18, 2024: Chest
https://read.qxmd.com/read/38508333/laryngeal-dysfunction-manifesting-as-chronic-refractory-cough-and-dyspnea-laryngeal-physiology-in-respiratory-health-and-disease
#10
REVIEW
Krishna M Sundar, Amanda Stark, Michael J Morris
TOPIC IMPORTANCE: 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. REVIEW FINDINGS: The human larynx is a complex muscular structure that undertakes multiple roles of breathing, vocalization, coughing and swallowing...
March 18, 2024: Chest
https://read.qxmd.com/read/38499239/nationwide-increasing-incidence-of-nontuberculous-mycobacterial-diseases-among-adults-in-denmark-eighteen-years-of-follow-up
#11
JOURNAL ARTICLE
Andreas A Pedersen, Anders Løkke, Andreas Fløe, Rikke Ibsen, Isik S Johansen, Ole Hilberg
BACKGROUND: The epidemiology of nontuberculous mycobacteria (NTM) infections is not well described. In this study, we determined the incidence and prevalence of NTM infections and focused on social risk factors. Additionally, we described persons suffering from pulmonary and extrapulmonary NTM. RESEARCH QUESTION: What is the incidence and prevalence of NTM and what are the characteristics of the affected patients? METHODS: This is a nationwide retrospective register-based cohort study in Denmark...
March 16, 2024: Chest
https://read.qxmd.com/read/38499238/rates-and-risk-factors-of-progression-in-patients-with-nontuberculous-mycobacterial-pulmonary-disease-secondary-analysis-of-a-prospective-cohort-study
#12
JOURNAL ARTICLE
Kwonhyung Hyung, Sung-A Kim, Joong-Yub Kim, Nakwon Kwak, Jae-Joon Yim
BACKGROUND: 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. RESEARCH QUESTION: What is the rate of NTM-PD progression, and what are the predictors of progression? STUDY DESIGN AND METHODS: Patients with NTM-PD who were enrolled in a prospective observational cohort study between July 1, 2011, and December 31, 2022 were included in this analysis...
March 16, 2024: Chest
https://read.qxmd.com/read/38462074/distribution-of-acute-and-chronic-kidney-disease-across-clinical-phenotypes-for-sepsis
#13
JOURNAL ARTICLE
Luca Molinari, Gaspar Del Rio-Pertuz, Priyanka Priyanka, Ali Smith, Joseph C Maggiore, Jason Kennedy, Hernando Gomez, Christopher W Seymour, John A Kellum
BACKGROUND: 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 response to treatment, were described using routine clinical data in the electronic health record. RESEARCH QUESTIONS: Do the frequencies of AKI, acute kidney disease (AKD), chronic kidney disease (CKD), and AKI-on-CKD differ by sepsis phenotype? STUDY DESIGN AND METHODS: Secondary analysis of a randomized clinical trial of early resuscitation, including patients with septic shock at 31 sites...
March 8, 2024: Chest
https://read.qxmd.com/read/38458432/preparing-for-fellowship-in-internal-medicine-with-a-focus-on-pulmonary-and-or-critical-care-medicine-major-principles-and-new-realities
#14
REVIEW
Matthew C Miles, Peter Lenz, Jennifer McCallister, Kristin M Burkart, Candace Huebert, Jason Moore, Laura Hinkle, Briana Short, Brent Bagley, Gabriel Bosslet
In this manuscript, 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 and/or Critical Care Medicine training program. The PAIR-Match steps (preparation, application, interview, ranking, match) are used to discuss available literature that informs this process. Preparing a fellowship application is discussed in terms of personal career goals, and specific strategies are suggested that can help a candidate assess a program's fit with those goals...
March 6, 2024: Chest
https://read.qxmd.com/read/38458431/point-of-care-lung-ultrasound-in-emergency-medicine-a-scoping-review-with-an-interactive-database
#15
JOURNAL ARTICLE
Stig Holm Ovesen, Andreas Hvilshøj Clausen, Hans Kirkegaard, Bo Løfgren, Rasmus Aagaard, Søren Helbo Skaarup, Michael Dan Arvig, Morten Hjarnø Lorentzen, Anne Heltborg Kristensen, Mariana Bichuette Cartuliares, Casper Falster, Liting Tong, Alessandra Rabajoli, Ronja Leth, Janeve Desy, Irene W Y Ma, Jesper Weile
BACKGROUND: We conducted a scoping review 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, we provide a map for physicians and researchers to guide their future initiatives. RESEARCH QUESTION: Which study designs and primary outcomes are reported in published studies of LUS in emergency medicine? STUDY DESIGN AND METHODS: We performed a systematic search in the PubMed/MEDLINE, EMBASE, Web of Science, Scopus, and Cochrane Library databases for LUS studies published before May 13, 2023...
March 6, 2024: Chest
https://read.qxmd.com/read/38458430/antithrombotic-therapy-for-vte-disease-compendium-and-review-of-chest-guidelines-2012-2021
#16
REVIEW
Scott M Stevens, Scott C Woller, Lisa Baumann Kreuziger, Kevin Doerschug, Geert-Jan Geersing, Frederikus A Klok, Christopher S King, Susan Murin, Janine R E Vintch, Philip S Wells, Suman Wasan, Lisa K Moores
The CHEST Antithrombotic Therapy for Venous Thromboembolism Disease evidencebased guidelines are now updated in a more frequent, focused manner. Guidance statements from the most recent full guideline and two subsequent updates have not been gathered into a single source. METHODS An international panel of experts with experience in prior Antithrombotic Therapy guideline development reviewed the 2012 CHEST Antithrombotic Therapy guideline and its two subsequent updates. All guideline statements, and their associated Patient, Intervention, Comparator, Outcome questions were assembled...
March 6, 2024: Chest
https://read.qxmd.com/read/38453002/atrial-arrhythmias-in-patients-with-pulmonary-hypertension
#17
REVIEW
Kyle O'Meara, Gregory Stone, Eric Buch, Adam Brownstein, Rajan Saggar, Richard Channick, Alexander E Sherman, Aron Bender
TOPIC IMPORTANCE: Atrial arrhythmia (AA) are common in patients with pulmonary hypertension (PH) and contribute to morbidity and mortality. Given the growing PH population, it is important to understand the pathophysiology, clinical impact, and management of AA in PH. REVIEW FINDINGS: AA occurs in PH with a five-year incidence of 10-25%. AA confers a higher morbidity and mortality, and restoration of normal sinus rhythm improves survival and functionality. AA is thought to develop due to structural alterations of the right atrium caused by changes to the right ventricle (RV) due to elevated pulmonary artery pressures...
March 5, 2024: Chest
https://read.qxmd.com/read/38447641/interdisciplinary-diagnosis-and-management-of-patients-with-interstitial-lung-disease-and-connective-tissue-disease
#18
REVIEW
Sabina A Guler, Tobias Scheschkowski, Anja Renner, Lea Kämpf, Matthias Gasser, Britta Maurer
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 establish the optimal treatment approach. Diagnostic delay, limited expertise and fragmented care are barriers that impede the delivery of comprehensive healthcare for patients with rare, complex and multiorgan diseases such as CTD and ILD. In this article we present our perspective on the interdisciplinary diagnosis and interprofessional treatment of patients with ILD and suspected CTD or CTD at risk for ILD...
March 4, 2024: Chest
https://read.qxmd.com/read/38447640/comparison-between-reveal-lite-2-and-compera-2-0-for-risk-stratification-in-pulmonary-arterial-hypertension
#19
JOURNAL ARTICLE
Sandeep Sahay, Nelson Villasmil Hernandez, Fredrick Wang, Matthew Wooten, Duc T Nguyen, Charles Fauvel, Raymond Benza, Edward A Graviss
BACKGROUND: Risk stratification is the cornerstone of the management of pulmonary arterial hypertension (PAH). Current ESC/ERS guidelines recommend using the COMPERA 3-strata risk model at baseline, and the COMPERA 2.0 4-strata model at follow-up. However, the guidelines did not take into consideration other available risk scores such as REVEAL Lite 2. RESEARCH QUESTION: Is REVEAL Lite 2 better at discriminating risk than the COMPERA risk assessment models at baseline or follow up evaluations? STUDY DESIGN AND METHODS: We analyzed data from the consecutively enrolled PAH patients between the period of June 2011 to February 2022 in the PAH registry at our expert Pulmonary Hypertension Center...
March 4, 2024: Chest
https://read.qxmd.com/read/38447639/use-of-intravenous-albumin-a-guideline-from-the-international-collaboration-for-transfusion-medicine-guidelines
#20
Jeannie Callum, Nikolaos J Skubas, Aarti Bathla, Homa Keshavarz, Edward G Clark, Bram Rochwerg, Dean Fergusson, Sesmu Arbous, Seth R Bauer, Louise China, Mark Fung, Rachel Jug, Michael Neill, Cary Paine, Katerina Pavenski, Prakesh S Shah, Susan Robinson, Hua Shan, Zbigniew M Szczepiorkowski, Thierry Thevenot, Bovey Wu, Simon Stanworth, Nadine Shehata
BACKGROUND: Albumin is commonly employed across a wide range of clinical settings to improve hemodynamics, facilitate fluid removal, and 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, kidney replacement therapy, or experiencing complications of cirrhosis. METHODS: Co-chairs oversaw the guideline development process and the panel included researchers, clinicians, methodologists, and a patient representative...
March 4, 2024: Chest
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