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Diseases Involving the Lung Peribronchovascular Region: A CT Imaging Pathologic Classification Chest (IF 9.5) Pub Date : 2024-06-22 Linda Le MD, Navneet Narula MD, Fang Zhou MD, Paul Smereka MD, Jeffrey Ordner MD, Neil Theise MD, William H. Moore MD, Francis Girvin MD, Lea Azour MD, Andre L. Moreira MD PhD, David P. Naidich MD, Jane P. Ko MD
Chest CT imaging holds a major role in the diagnosis of lung diseases, many of which affect the peribronchovascular region. Identification and categorization of peribronchovascular abnormalities on CT imaging can assist in formulating a differential diagnosis and directing further diagnostic evaluation. The peribronchovascular region of the lung encompasses the pulmonary arteries, airways, and lung
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Associations Between Air Pollution and the Onset of Acute Exacerbations of COPD: A Time-Stratified Case-Crossover Study in China Chest (IF 9.5) Pub Date : 2024-06-19 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
Associations between air pollution and the acute exacerbations (AEs) of COPD 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. Are air pollutants associated with the onset of AEs of COPD in China? Who is more susceptible to the effects of air pollutants? Data regarding AEs of COPD
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Translating the Interplay of Cognition and Physical Performance in COPD and Interstitial Lung Disease: Meeting Report and Literature Review Chest (IF 9.5) Pub Date : 2024-06-18 Dmitry Rozenberg MD PhD, W. Darlene Reid PT PhD, Pat Camp PT PhD, Jennifer L. Campos PhD, Gail Dechman PT PhD, Paul W. Davenport PhD, Helga Egan, Jolene H. Fisher MD, Jordan A. Guenette PhD, David Gold PhD CPsych, Roger S. Goldstein MD, Donna Goodridge RN PhD, Tania Janaudis-Ferreira PT PhD, Alan G. Kaplan MD, Daniel Langer PT PhD, Darcy D. Marciniuk MD, Barbara Moore, Ani Orchanian-Cheff MISt, Jessica
Cognitive and physical limitations are common in individuals with chronic lung diseases, but their interactions with physical function and activities of daily living are not well characterized. Understanding these interactions and potential contributors may provide insights on disability and enable more tailored rehabilitation strategies. This review summarizes a 2-day meeting of patient partners,
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Physiological Consequences of Upper Airway Obstruction in Sleep Apnea Chest (IF 9.5) Pub Date : 2024-06-15 Ali Azarbarzin PhD, Gonzalo Labarca MD, Younghoon Kwon MD, Andrew Wellman MD PhD
OSA is diagnosed and managed by a metric called the apnea-hypopnea index (AHI). The AHI quantifies the number of respiratory events (apnea or hypopnea), disregarding important information on the characteristics and physiological consequences of respiratory events, including degrees of ventilatory deficit and associated hypoxemia, cardiac autonomic response, and cortical activity. The oversimplification
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The Proposed 9th Edition TNM Classification of Lung Cancer Chest (IF 9.5) Pub Date : 2024-06-15 Frank C. Detterbeck MD, Gavitt A. Woodard MD, Anna S. Bader MD, Sanja Dacic MD PhD, Michael J. Grant MD, Henry S. Park MD, Lynn T. Tanoue MD
A universal nomenclature of the anatomic extent of lung cancer has been critical for individual patient care as well as research advances. As progress occurs, new details emerge that need to be included in a refined system that aligns with contemporary clinical management issues. The 9th edition TNM classification of lung cancer, which is scheduled to take effect in January 2025, addresses this need
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Primary Ciliary Dyskinesia in Adult Bronchiectasis: Data from the German Bronchiectasis Registry PROGNOSIS Chest (IF 9.5) Pub Date : 2024-06-15 Raphael Ewen MD, Isabell Pink MD, Sivagurunathan Sutharsan MD, Sven P. Aries MD, Achim Grünewaldt MD, Amelia Shoemark PhD, Urte Sommerwerck MD, Ben O. Staar MD, Sabine Wege MD, Pontus Mertsch MD, Jessica Rademacher MD, Felix C. Ringshausen MD, PROGNOSIS Study Group, Borghild Grün, Bad Windsheim, Stefan Dargel, Katarina Ludwig, Andrés de Roux, Ralf Otto-Knapp, Hartmut Lode, Christian Gogoll, Meike Probst
Primary ciliary dyskinesia (PCD) is a rare genetic disorder caused by the malfunction of motile cilia and a specific etiology of adult bronchiectasis of unknown prevalence. A better understanding of the clinical phenotype of adults with PCD is needed to identify individuals for referral to diagnostic testing. What is the frequency of PCD among adults with bronchiectasis; how do people with PCD differ
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Sex Differences Persist After Treatment With Ivacaftor in People With Cystic Fibrosis Chest (IF 9.5) Pub Date : 2024-06-11 Melanie Holtrop MD, Sophia Cosmich, MinJae Lee PhD, Ashley Keller MPH, Raksha Jain MD
Historically, studies show that female patients with cystic fibrosis (CF) have worse pulmonary outcomes than male patients, including decreased life expectancy. It is unknown whether this disparity persists in the new era of highly effective modulator therapies. Ivacaftor has been available in the United States for > 10 years, allowing for the opportunity to understand the impact this therapy may have
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A Nationwide Cohort Study of Delta and Omicron SARS-CoV-2 Outcomes in Vaccinated Individuals With Chronic Lung Disease Chest (IF 9.5) Pub Date : 2024-06-11 Liang En Wee MPH, Janice Yu Jin Tan BSS(Hons), Calvin J. Chiew MPH, John Arputhan Abisheganaden MRCP, Sanjay H. Chotirmall PhD, David Chien Boon Lye MBBS, Kelvin Bryan Tan PhD
Individuals with chronic lung disease (CLD) are more susceptible to respiratory viral infections; however, significant heterogeneity exists in the literature on CLD and COVID-19 outcomes. Data are lacking on outcomes with newer variants (eg, Omicron) and in vaccinated and boosted populations. What are the outcomes of SARS-CoV-2 infection in individuals with CLD during Delta and Omicron transmission
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Should We Reconsider Pneumocystis Pneumonia Presentation and Treatment According to Its Underlying Disease?: An Unsupervised Cluster Analysis of a Retrospective Multicenter Study Chest (IF 9.5) Pub Date : 2024-06-10 Benjamin Gaborit MD PhD, Romain Lécuyer MD PharmD, Nahéma Issa MD, Fabrice Camou MD, Rose-anne Lavergne PharmD PhD, Frederic Gabriel MD PhD, Florent Morio PharmD PhD, Emmanuel Canet MD PhD, François Raffi MD PhD, David Boutoille MD PhD, Anne Cady PharmD, Marie Gousseff MD, Yoann Crabol MD, Antoine Néel MD PhD, Benoît Tessoulin MD PhD, PRONOCYSTIS Study Group, Francois Raffi, David Boutoille, Charlotte
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Benefit-Risk Profile of P2X3 Receptor Antagonists for Treatment of Chronic Cough: Dose-Response Model-Based Network Meta-Analysis Chest (IF 9.5) Pub Date : 2024-06-08 Shota Yamamoto MD PhD, Nobuyuki Horita MD PhD, Johsuke Hara MD PhD, Mao Sasamoto MD, Yoshihiro Kanemitsu MD PhD, Yu Hara MD PhD, Yasushi Obase MD PhD, Takeshi Kaneko MD PhD, Akio Niimi MD PhD, Hiroshi Mukae MD PhD
Refractory or unexplained chronic cough disrupts quality of life and burdens health care systems around the world. The P2X3 receptor antagonist gefapixant is approved in many countries for its antitussive effects, but taste disturbances are a common adverse effect. Four newer, more selective P2X3 receptor antagonists have been developed to address this problem. How does the benefit-risk profile vary
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History and Familial Aggregation of Immune-Mediated Diseases in Sarcoidosis: A Register-Based Case-Control Family Study Chest (IF 9.5) Pub Date : 2024-06-08 Marios Rossides PhD, Susanna Kullberg PhD, Elizabeth V. Arkema ScD
An autoimmune component in the cause of sarcoidosis long has been debated, but population-based data on the clustering of immune-mediated diseases (IMDs) and sarcoidosis in individuals and families suggestive of shared cause is limited. Do patients with a history of IMDs have a higher risk of sarcoidosis and do IMDs cluster in families with sarcoidosis? We conducted a case-control family study (2001-2020)
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Framework for Research Gaps in Pediatric Ventilator Liberation Chest (IF 9.5) Pub Date : 2024-06-07 Samer Abu-Sultaneh MD, Narayan Prabhu Iyer MBBS MD, Analía Fernández MD, Lyvonne N. Tume RN PhD, Martin C.J. Kneyber MD PhD, Yolanda M. López-Fernández MD PhD, Guillaume Emeriaud MD PhD, Padmanabhan Ramnarayan MBBS MD, Robinder G. Khemani MD MsCI, Pediatric Ventilator Liberation Consensus Conference Expert Panel, Samer Abu-Sultaneh MD, Arun Kumar Baranwal MD, Bronagh Blackwood RN PhD, Hannah J. Craven
The 2023 International Pediatric Ventilator Liberation Clinical Practice Guidelines provided evidence-based recommendations to guide pediatric critical care providers on how to perform daily aspects of ventilator liberation. However, because of the lack of high-quality pediatric studies, most recommendations were conditional based on very low to low certainty of evidence. What are the research gaps
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Effective Behaviors of Leaders During Clinical Emergencies: A Qualitative Study of Followers’ Perspectives Chest (IF 9.5) Pub Date : 2024-06-03 Trevor C. Steinbach MD, Ann L. Jennerich MD, Başak Çoruh MD
To manage a clinical emergency effectively, physicians need well-developed leadership skills, yet limited structured leadership training is available for critical care trainees. To develop an effective curriculum, leadership competencies first must be defined. During clinical emergencies, what leadership behaviors do followers value? We conducted qualitative interviews with members of multidisciplinary
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The Clinical and Economic Implications of Different Treatment Pathways for Patients With Rapidly Recurrent Malignant Pleural Effusion Chest (IF 9.5) Pub Date : 2024-06-03 David E. Ost MD MPH, Claudia Goldblatt MPH, Molly Jung PhD MPH, Mia Weiss MPH, Shibei Xu MPH, Ashley Taneja PharmD, Erik Erdal PhD
Malignant pleural effusion (MPE) is a common cancer complication. Clinical and economic implications of different recurrent MPE treatment pathways have not been evaluated fully. What clinical outcomes, complications, health care resource use, and costs are associated with various rapidly recurrent MPE treatment pathways? This retrospective cohort study using Surveillance, Epidemiology and End Results
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Precision Medicine Approach in ARDS: A New Challenge Chest (IF 9.5) Pub Date : 2024-06-03 Luca Montini MD, Massimo Antonelli MD
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Management Strategies for Acute Pulmonary Embolism in the ICU Chest (IF 9.5) Pub Date : 2024-06-01 W. Cameron McGuire MD MPH, Lauren Sullivan MD, Mazen F. Odish MD, Brinda Desai MD, Timothy A. Morris MD, Timothy M. Fernandes MD MPH
Acute pulmonary embolism (PE) is a common disease encountered by pulmonologists, cardiologists, and critical care physicians throughout the world. For patients with high-risk acute PE (defined by systemic hypotension) and intermediate high-risk acute PE (defined by the absence of systemic hypotension, but the presence of numerous other concerning clinical and imaging features), intensive care often
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Chest CT Imaging Provides More Information Than Chest Radiography Alone in Determining Extent of Physiologic Impairment in Pulmonary Sarcoidosis Chest (IF 9.5) Pub Date : 2024-06-01 Bryan S. Benn MD PhD, William L. Lippitt PhD, Isabel Cortopassi MD, G.K. Balasubramani PhD, Eduardo Mortani Barbosa MD MBA, Wonder P. Drake MD, Erica Herzog MD, Kevin Gibson MD, Edward S. Chen MD, Laura L. Koth MD, Carl Fuhrman MD, David A. Lynch MBBCh, Naftali Kaminski MD, Stephen R. Wisniewski PhD, Nichole E. Carlson PhD, Lisa A. Maier MD MSPH
Sarcoidosis staging primarily has relied on the Scadding chest radiographic system, although chest CT imaging is finding increased clinical use. Whether standardized chest CT scan assessment provides additional understanding of lung function beyond Scadding stage and demographics is unknown and the focus of this study We used the National Heart, Lung, and Blood Institute study Genomics Research in
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Clinical Features, Diagnostic, Etiology, and Outcome of Hospitalized Solid Organ Recipients With Community-Acquired Pneumonia: A Retrospective Cohort Analysis Chest (IF 9.5) Pub Date : 2024-05-30 Oana Joean MD, Laura Petra von Eynern, Tobias Welte MD, Gunilla Einecke MD PhD, Sabine Dettmer MD, Jan Fuge PhD, Richard Taubert MD, Heiner Wedemeyer MD, Jessica Rademacher MD
Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Limited evidence is available on the most effective diagnostic approaches, management strategies, and long-term outcomes for CAP in patients who have undergone solid organ transplantation. What is the acute and long-term morbidity and mortality after CAP in organ transplant recipients? We retrospectively analyzed
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Quantifying Diaphragm Blood Flow With Contrast-Enhanced Ultrasound in Humans Chest (IF 9.5) Pub Date : 2024-05-29 Jordan D. Bird MSc, Megan L. Lance BHSc, Ty R.W. Banser BHK, Scott F. Thrall MSc, Paul D. Cotton MSc, Jonathan R. Lindner MD, Neil D. Eves PhD, Paolo B. Dominelli PhD, Glen E. Foster PhD
Despite the known interplay between blood flow and function, there is currently no minimally invasive method to monitor diaphragm hemodynamics. We used contrast-enhanced ultrasound (CEUS) to quantify relative diaphragm blood flow () in humans and assessed the technique’s efficacy and reliability during graded inspiratory pressure threshold loading. We hypothesized that: (1) would linearly increase
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Pulmonary Hypertension in Interstitial Lung Disease: A Systematic Review and Meta-Analysis Chest (IF 9.5) Pub Date : 2024-05-29 Hui Li Ang MD, Max Schulte BHlthSc, Roseanne Kimberley Chan MD, Hann Hsiang Tan MD, Amelia Harrison MD, Christopher J. Ryerson MD, Yet Hong Khor MD PhD
Pulmonary hypertension (PH) is a key complication in interstitial lung disease (ILD), with recent therapeutic advances. What are the diagnostic evaluation, epidemiologic features, associated factors, prognostic significance, and outcome measures in interventional trials for PH in patients with ILD in the current literature? Ovid MEDLINE, Embase, and CENTRAL databases were searched for original research
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Sleep Apnea and Stroke: A Narrative Review Chest (IF 9.5) Pub Date : 2024-05-28 Laavanya Dharmakulaseelan MD/MEng, Mark I. Boulos MD
Stroke is the second-leading cause of death worldwide. OSA is an independent risk factor for stroke and is associated with multiple vascular risk factors. Poststroke OSA is prevalent and closely linked with various stroke subtypes, including cardioembolic stroke and cerebral small vessel disease. Observational studies have shown that untreated poststroke OSA is associated with an increased risk of
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The Cost-Effectiveness of Sleep Apnea Management: A Critical Evaluation of the Impact of Therapy on Health Care Costs Chest (IF 9.5) Pub Date : 2024-05-28 Sachin R. Pendharkar, Billingsley Kaambwa, Vishesh K. Kapur MD MPH
OSA is a widespread condition that significantly affects both health and health-related quality of life (HRQoL). If left untreated, OSA can lead to accidents, decreased productivity, and medical complications, resulting in significant economic burdens including the direct costs of managing the disorder. Given the constraints on health care resources, understanding the cost-effectiveness of OSA management
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CT Airway Mucus in Older People Without Chronic Respiratory Illness Chest (IF 9.5) Pub Date : 2024-05-28 Harkiran K. Kooner PhD, Hana Serajeddini MD, Rachel L. Eddy PhD, Cory Yamashita MD, Sarah Svenningsen PhD, Grace Parraga PhD
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Understanding Washington State’s Low Uptake of Lung Cancer Screening in Two Steps: A Geospatial Analysis of Patient Travel Time and Health Care Availability of Imaging Sites Chest (IF 9.5) Pub Date : 2024-05-28 Allison C. Welch MPH, Jed A. Gorden MD, Stephen J. Mooney PhD, Candice L. Wilshire MD MPH, Steven B. Zeliadt PhD
Early detection of lung cancer reduces cancer mortality; yet uptake for lung cancer screening (LCS) has been limited in Washington State. Geographic disparities contribute to low uptake, but do not wholly explain gaps in access for underserved populations. Other factors, such as an adequate workforce to meet population demand and the capacity of accredited screening facility sites, must also be considered
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Association of Age at Smoking Initiation, Age at Smoking Cessation, and Lower Respiratory Death Rage: Prospective Study of 500,000 Adults in the United States Chest (IF 9.5) Pub Date : 2024-05-25 Blake Thomson DPhil, Ahmedin Jemal DVM PhD, Farhad Islami MD PhD
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Review of Interventions That Improve Uptake of Lung Cancer Screening: A Cataloging of Strategies That Have Been Shown to Work (or Not) Chest (IF 9.5) Pub Date : 2024-05-24 Eduardo R. Núñez MD, Mayuko Ito Fukunaga MD, Gregg A. Stevens MSLS MST, James K. Yang MD, Sarah E. Reid MD, Jennifer L. Spiegel MD, Molly R. Ingemi MD, Renda Soylemez Wiener MD MPH
Lung cancer screening (LCS) has the potential to decrease mortality from lung cancer by 20%. Yet, more than a decade since LCS was established as an evidence-based practice, < 20% of the eligible population in the United States has been screened. This review focuses on critically appraising interventions that have been designed to increase the initial uptake of LCS, including how they address known
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Small Airways Obstruction and Mortality: Findings From the UK Biobank Chest (IF 9.5) Pub Date : 2024-05-24 Valentina Quintero Santofimio MSc, Ben Knox-Brown PhD, James Potts BSc, Samuel Bartlett-Pestell MD, Johanna Feary MD PhD, Andre F.S. Amaral PhD
Small airways obstruction (SAO) is common in general populations. It has been associated with respiratory symptoms, cardiometabolic diseases, and progression to COPD over time. Whether SAO predicts mortality is largely unknown. Is spirometry-defined SAO associated with increased mortality? Data were analyzed from 252,877 adult participants, aged 40 to 69 years at baseline, in the UK Biobank who had
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An Ethically Supported Framework for Determining Patient Notification and Informed Consent Practices When Using Artificial Intelligence in Health Care Chest (IF 9.5) Pub Date : 2024-05-22 Susannah L. Rose PhD, Devora Shapiro PhD
Artificial intelligence (AI) is being used increasingly in health care, and without an ethically supportable, standard approach to knowing when patients should be informed about AI, hospital systems and clinicians run the risk of fostering mistrust among their patients and the public. Therefore, hospital leaders need guidance on when to tell patients about the use of AI in their care. In this article
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ICU Staffing in the United States Chest (IF 9.5) Pub Date : 2024-05-22 Hayley B. Gershengorn MD, Allan Garland MD, Deena K. Costa PhD RN, Amy L. Dzierba PharmD, Robert Fowler MDCM, Andrew A. Kramer PhD, Vincent X. Liu MD, Danny Lizano MSHS PA-C, Damon C. Scales MD PhD, Hannah Wunsch MD
The last national estimates of US ICU physician staffing are 25 years old and lack information about interprofessional teams. How are US adult ICUs currently staffed? We conducted a cross-sectional survey (May 4, 2022-February 2, 2023) of adult ICU physicians (targeting nurse/physician leadership) contacted using 2020 American Hospital Association (AHA) database information and, secondarily, through
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Differential Effect of Positive End-Expiratory Pressure Strategies in Patients With ARDS: A Bayesian Analysis of Clinical Subphenotypes Chest (IF 9.5) Pub Date : 2024-05-18 Matthew T. Siuba DO, Lucas Bulgarelli BSc, Abhijit Duggal MD MPH, Alexandre B. Cavalcanti MD PhD, Fernando G. Zampieri MD PhD, Diego Ariel Rey PhD, Wellington dos Reis Lucena, Israel S. Maia MD, Denise M. Paisani PhD, Ligia N. Laranjeira, Ary Serpa Neto MD PhD, Rodrigo Octávio Deliberato MD PhD
ARDS is a heterogeneous condition with two subphenotypes identified by different methodologies. Our group similarly identified two ARDS subphenotypes using nine routinely available clinical variables. However, whether these are associated with differential response to treatment has yet to be explored. Are there differential responses to positive end-expiratory pressure (PEEP) strategies on 28-day mortality
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Static Immersion and Negative Static Lung Load-Induced Right Ventricle Systolic Function Adaptation: A Risk Factor for Immersion Pulmonary Edema Chest (IF 9.5) Pub Date : 2024-05-15 Arnaud Druelle, Basile Mouhat, Oumaima Zbitou, Olivier Castagna MD PhD
Immersion pulmonary edema (IPE) is a form of hemodynamic edema likely involving individual susceptibility. Can assessing right ventricle (RV) systolic adaptation during immersion be a marker for IPE susceptibility? Twenty-eight divers participated: 15 study participants with a history of IPE (IPE group; mean ± SD age, 40.2 ± 8.2 years; two women) and 13 control participants (no IPE group; mean ± SD
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Behind the Scenes: Facilitators and Barriers to Developing State Scarce Resource Allocation Plans for the COVID-19 Pandemic Chest (IF 9.5) Pub Date : 2024-05-06 Kirsten A. Riggan MA MS, Nicholas V. Nguyen BA, Jackson S. Ennis BA, Debra A. DeBruin PhD, Richard R. Sharp PhD, Jon C. Tilburt MD, Susan M. Wolf JD, Erin S. DeMartino MD
In response to COVID-19, many states revised, developed, or attempted to develop plans to allocate scarce critical care resources in the event that crisis standards of care were triggered. No prior analysis has assessed this plan development process, including whether plans were successfully adopted. How did states develop or revise scarce resource allocation plans during the COVID-19 pandemic, and
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Neutrophil-mediated Inflammatory Plasminogen Degradation, Rather Than High Plasminogen-Activator Inhibitor-1, May Underly Failures and Inefficiencies of Intrapleural Fibrinolysis Chest (IF 9.5) Pub Date : 2024-05-06 Christopher D. Barrett MD, Peter K. Moore MD, Ernest E. Moore MD, Hunter B. Moore MD PhD, James G. Chandler BS, Halima Siddiqui PhD, Elizabeth R. Maginot MD, Angela Sauaia MD PhD, Angel Augusto Pérez-Calatayud MD, Keely Buesing MD, Jiashan Wang MD, Cesar Davila-Chapa MD, Daniel Hershberger MD, Ivor Douglas MBBCh, Fredric M. Pieracci MD, Michael B. Yaffe MD PhD
Complex pleural space infections often require treatment with multiple doses of intrapleural tissue plasminogen activator (tPA) and deoxyribonuclease, with treatment failure frequently necessitating surgery. Pleural infections are rich in neutrophils, and neutrophil elastase degrades plasminogen, the target substrate of tPA, that is required to generate fibrinolysis. We hypothesized that pleural fluid
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Quantitative Imaging and Bronchial Thermoplasty: Technically Impressive But Clinically Uncertain Chest (IF 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) Pub Date : 2024-04-08 Shehabaldin Alqalyoobi MD
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A Biophilosophical Approach to the Determination of Brain Death Chest (IF 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) Pub Date : 2024-04-08 Ian J. Barbash MD
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Response Chest (IF 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) 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 9.5) Pub Date : 2024-03-26 Kai Bratke PhD, Martin Weise MD, Paul Stoll MD, J. Christian Virchow MD, Marek Lommatzsch MD
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 9.5) 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 9.5) 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 have yet to be defined. Which ventilatory parameters are involved in the heterogeneity of FEV
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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 9.5) 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 MSc, Katrina Hauschildt PhD, Catherine Chen MD, Emily A. Vail MD MSc, Leslie Moroz MD MS, 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