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BACKGROUND: In Japan, public dialog on allocation of life-saving medical resources remains taboo, and discussion has largely been avoided. RESEARCH QUESTION: Do Japanese health care workers and the general public agree with principles of ventilator allocation developed internationally? STUDY DESIGN AND METHODS: A 4-point Likert scale questionnaire was used to assess the extent of agreement or disagreement with internationally developed triage principles for rationing mechanical ventilators during pandemics...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

RATIONALE: Asthma exacerbations result in significant health and economic burden but is difficult to predict. OBJECTIVES: We aim to develop machine learning (ML) models with large-scale outpatient data to predict asthma exacerbations. METHODS: We analyzed data extracted from electronic health records (EHR) on asthmatics followed at the Cleveland Clinic from 2010 to 2018. Demographic information, comorbidities, lab values and asthma medications were included as covariates...

BACKGROUND: Sarcoidosis is a systemic granulomatous disease that in most cases affects the lung. Pulmonary fibrotic sarcoidosis is clinically, radiologically and pathologically a heterogeneous condition. Although there is substantial indirect evidence of small airway involvement, direct evidence is currently lacking. RESEARCH QUESTION: to investigate the role of the (small) airways in fibrotic sarcoidosis. STUDY DESIGN: and methods: Airway morphology was investigated in 7 explant lungs with end-stage fibrotic sarcoidosis using a combination of CT (large airways), microCT (small airways) and histology and compared to 7 unused donor lungs as controls with specific attention for different radiologically defined sarcoidosis subtypes...

No abstract text is available yet for this article.

Increasing use of molecular targeting agents and immune checkpoint inhibitors has increased the frequency and broadened the spectrum of lung toxicity, particularly in patients with cancer. In this position paper from the Fleischner Society, the authors provide diagnostic criteria and management recommendations of drug-related pneumonitis for radiologists, clinicians, clinical trialists, and trial sponsors.

BACKGROUND: Staging guidelines for lung cancer recommend endobronchial ultrasound (EBUS) and systematic biopsy of at least 3 mediastinal lymph node (LN) stations for accurate staging. A 4-point ultrasonographic score (Canada Lymph Node Score- CLNS) was developed to determine the probability of malignancy in each LN. A LN with a CLNS<2 is considered low probability for malignancy. We hypothesized that, in patients with cN0 non-small cell lung cancer, LNs with CLNS<2 may not require routine biopsy because they represent true node negative disease...

No abstract text is available yet for this article.

BACKGROUND: Diffuse alveolar hemorrhage (DAH) is an uncommon complication of hematopoietic stem cell transplant (HCT) that carries high morbidity and mortality. There are limited contemporary data regarding the incidence, outcomes and risk factors for DAH. RESEARCH QUESTION: What are the incidence, outcomes, and risk factors for developing DAH after HCT? METHODS: This is a single-center retrospective cohort study of patients who underwent HCT between January 1, 2005 and December 31st, 2016...

No abstract text is available yet for this article.

Chronic obstructive pulmonary disease (COPD) is a clinically heterogeneous syndrome characterized by injury to airways, airspaces and lung vasculature and usually caused by tobacco smoke and/or air pollution exposure. COPD is also independently associated with non-pulmonary comorbidities (e.g. cardiovascular disease) and malignancies (e.g. gastrointestinal and bladder), suggesting a role for systemic injury. Since not all those with exposure develop COPD, there has been a search for plasma and lung biomarkers that confer increased cross-sectional and longitudinal risk...

BACKGROUND: The provision of palliative care for severe chronic obstructive pulmonary disease (COPD) remains low resulting in unmet needs in patients and carers. RESEARCH QUESTION: This study aimed to 1) explore palliative care needs of patients living with severe COPD and their caregivers, 2) understand views of accessing and providing palliative care and factors influencing these experiences, and 3) explore to what extent palliative care and COPD services have been integrated...

BACKGROUND: Historically, β-blockers have been considered to be relatively contraindicated for septic shock because they may cause cardiac suppression. On the other hand, there is an increasing interest in the use of β-blockers for treating septic patients with persistent tachycardia despite initial resuscitation. RESEARCH QUESTION: Do ultra-short-acting β-blockers such as esmolol and landiolol improve mortality in septic patients with persistent tachycardia despite initial resuscitation? STUDY DESIGN AND METHODS: This was a systematic review and meta-analysis...

BACKGROUND: While clinical studies have evaluated dexmedetomidine as a strategy to improve non-invasive ventilation (NIV) comfort and tolerance in patients with acute respiratory failure (ARF), their results have not been summarized. RESEARCH QUESTION: We sought to determine if dexmedetomidine when compared to another sedative or placebo reduces the risk of delirium, mortality, need for intubation and mechanical ventilation, or intensive care unit (ICU) length of stay (LOS) in adults with ARF initiated on NIV in the ICU? STUDY DESIGN AND METHODS: We electronically searched MEDLINE, EMBASE, and the Cochrane Library from inception to July 31st, 2020 for randomized clinical trials (RCTs)...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: In 2018, influenza and pneumonia was the 8th leading cause of death in the United States (US). Since 1950, non-Hispanic blacks (NHB) have experienced higher rates of mortality than non-Hispanic whites (NHW). Previous studies revealed geographic variation in mortality rates by race. The identification of areas with the greatest disparity in influenza and pneumonia mortality may assist policy makers in the allocation of resources including for the COVID-19 pandemic. RESEARCH QUESTION: Does geographic variation in racial disparity in influenza and pneumonia mortality exist? STUDY DESIGN: and Methods: The Centers for Disease Control and Prevention (CDC) database for multiple cause of death between 1999-2018 for NHB and NHW decedents aged ≥ 25 years with an ICD-10 code for influenza (J09-J11) and pneumonia (J12-J18) was used...

BACKGROUND: Right ventricle (RV) dysfunction is associated with poorer outcomes in heart failure with preserved ejection fraction (HFpEF). Females are more likely to have HFpEF but males have worse prognosis and resting RV function. The contribution of dynamic RV-pulmonary artery (RV-PA) coupling between sex and its impact on peak exercise capacity (VO2) in HFpEF is not known. METHODS: We examined rest and exercise invasive pulmonary hemodynamics in 22 male HFpEF and 27 female HFpEF patients...