Clinical consequences of COVID-19 lockdown in patients with COPD: results of a pre-post study in Spain.
e; F, de Batlle J PMID: 33444614 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - January 11, 2021 Category: Respiratory Medicine Authors: González J, Moncusí-Moix A, Benitez ID, Santisteve S, Monge A, Fontiveros MA, Carmona P, Torres G, Barbé F, de Batlle J Tags: Chest Source Type: research

Psychological Symptoms Among Surrogates of Critically Ill Patients During and Before the COVID-19 Pandemic.
PMID: 33444615 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - January 11, 2021 Category: Respiratory Medicine Authors: Greenberg JA, Basapur S, Quinn TV, Bulger JL, Glover CM, Shah RC Tags: Chest Source Type: research

Allocation of Mechanical Ventilators During a Pandemic: A Mixed-Methods Study of Perceptions among Japanese Health Care Workers and the General Public.
Abstract 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. Questionnaires were distributed in person or online, and generalized linear models were u...
Source: Chest - January 11, 2021 Category: Respiratory Medicine Authors: Norisue Y, Deshpande GA, Kamada M, Nabeshima T, Tokuda Y, Goto T, Ishizuka N, Hara Y, Nakata R, Makino J, Matsumura M, Fujitani S, Hiraoka E Tags: Chest Source Type: research

Analysis of non-tuberculous mycobacterial lung disease in patients with primary Sj ögren's syndrome at a referral center.
Analysis of non-tuberculous mycobacterial lung disease in patients with primary Sjögren's syndrome at a referral center. Chest. 2021 Jan 10;: Authors: Weingart MF, Li Q, Choi S, Maleki-Fischbach M, Kwon YS, Koelsch T, Dow CT, Truong TQ, Chan ED PMID: 33440182 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - January 10, 2021 Category: Respiratory Medicine Authors: Weingart MF, Li Q, Choi S, Maleki-Fischbach M, Kwon YS, Koelsch T, Dow CT, Truong TQ, Chan ED Tags: Chest Source Type: research

Distinct airway involvement in subtypes of end-stage fibrotic pulmonary sarcoidosis.
Abstract 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 hist...
Source: Chest - January 10, 2021 Category: Respiratory Medicine Authors: Verleden SE, Vanstapel A, De Sadeleer L, Dubbeldam A, Goos T, Gyselinck I, Geudens V, Kaes J, Van Raemdonck DE, Ceulemans LJ, Yserbyt J, Vos R, Vanaudenaerde B, Weynand B, Verschakelen J, Wuyts WA Tags: Chest Source Type: research

Novel machine learning can predict acute asthma exacerbation.
CONCLUSIONS: Models built with ML algorithm from real-world outpatient EHR data accurately predict asthma exacerbation and can be incorporated into clinical decision tools to enhance outpatient care and prevent adverse outcomes. PMID: 33440184 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - January 10, 2021 Category: Respiratory Medicine Authors: Zein JG, Wu CP, Attaway AH, Zhang P, Nazha A Tags: Chest Source Type: research

Safety and efficacy of dexmedetomidine in acutely ill adults requiring non-invasive ventilation: a systematic review and meta-analysis of randomized trials.
ani W Abstract 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,...
Source: Chest - January 9, 2021 Category: Respiratory Medicine Authors: Lewis K, Piticaru J, Chaudhuri D, Basmaji J, Fan E, Møller MH, Devlin JW, Alhazzani W Tags: Chest Source Type: research

Effect of ultra-short-acting β-blockers on mortality in patients with persistent tachycardia despite initial resuscitation: a systematic review and meta-analysis of randomized controlled trials.
EFFECT OF ULTRA-SHORT-ACTING β-BLOCKERS ON MORTALITY IN PATIENTS WITH PERSISTENT TACHYCARDIA DESPITE INITIAL RESUSCITATION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. Chest. 2021 Jan 09;: Authors: Hasegawa D, Sato R, Prasitlumkum N, Nishida K, Takahashi K, Yatabe T, Nishida O Abstract 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 tachyc...
Source: Chest - January 9, 2021 Category: Respiratory Medicine Authors: Hasegawa D, Sato R, Prasitlumkum N, Nishida K, Takahashi K, Yatabe T, Nishida O Tags: Chest Source Type: research

Palliative care needs and integration of palliative care support in chronic obstructive pulmonary disease (COPD): a qualitative study.
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. STUDY DESIGN AND METHODS: A multicentre qualitative study was undertaken in COPD services and specialist palliative care in the UK, involving patients with severe COPD, their carers and health professionals. Data were collected using semi-structured interviews and analysed using framework analysis. Themes were integrated...
Source: Chest - January 9, 2021 Category: Respiratory Medicine Authors: Fu Y, Mason A, Boland AC, Linklater G, Dimitrova V, Doñate-Martínez A, Bennett MI Tags: Chest Source Type: research

"Protein biomarkers for COPD outcomes".
"Protein biomarkers for COPD outcomes". Chest. 2021 Jan 09;: Authors: Serban KA, Pratte KA, Bowler RP Abstract 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...
Source: Chest - January 9, 2021 Category: Respiratory Medicine Authors: Serban KA, Pratte KA, Bowler RP Tags: Chest Source Type: research

How I Do It: Creating an Incidental Pulmonary Nodule Safety-Net Program.
PMID: 33434500 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - January 9, 2021 Category: Respiratory Medicine Authors: Van Gerpen R Tags: Chest Source Type: research

Epidemiology, Risk Factors and Outcomes of Diffuse Alveolar Hemorrhage after Hematopoietic Stem Cell Transplantation.
Abstract 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. The incidence and outcomes of DAH development were evaluated. A multivariable logical regression model was...
Source: Chest - January 9, 2021 Category: Respiratory Medicine Authors: Zhang Z, Wang C, Peters SG, Hogan WJ, Hashmi SK, Litzow MR, Patnaik MS, Niven AS, Yadav H Tags: Chest Source Type: research

That "bulky Commodity, Tobacco".
That "bulky Commodity, Tobacco". Chest. 2021 Jan 09;: Authors: Dorner Z PMID: 33434502 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - January 9, 2021 Category: Respiratory Medicine Authors: Dorner Z Tags: Chest Source Type: research

Endobronchial Ultrasound Staging of Operable NSCLC: Do Triple Normal Lymph Nodes Require Routine Biopsy?
Abstract 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
Source: Chest - January 9, 2021 Category: Respiratory Medicine Authors: Hylton DA, Kidane B, Spicer J, Turner S, Churchill I, Sullivan K, Finley CJ, Shargall Y, Agzarian J, Seely AJE, Yasufuku K, Hanna WC, Canadian Association of Thoracic Surgery Research Group Tags: Chest Source Type: research

Risk factors of viral RNAaemia and its association with clinical prognosis among patients with severe COVID-19.
PMID: 33421381 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - January 6, 2021 Category: Respiratory Medicine Authors: Li H, Gu X, Li H, Gong F, Xu J, Wang Y, Li H, Ruan S, Yang Q, Cao B Tags: Chest Source Type: research

Impact of the COVID-19 pandemic on volumes and disparities in lung cancer screening.
PMID: 33417898 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - January 5, 2021 Category: Respiratory Medicine Authors: Henderson LM, Benefield T, Bosemani T, Long JM, Rivera MP Tags: Chest Source Type: research

Clinical impact of the new definition of pre-capillary pulmonary hypertension.
PMID: 33417899 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - January 5, 2021 Category: Respiratory Medicine Authors: Kovacs G, Zeder K, Rosenstock P, Avian A, Bachmaier G, Douschan P, Foris V, Sassmann T, Olschewski H Tags: Chest Source Type: research

Geographic Variation in Racial Disparities in Mortality from Influenza and Pneumonia in the US in the Pre-COVID-19 Era.
Abstract 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...
Source: Chest - January 2, 2021 Category: Respiratory Medicine Authors: Donaldson SV, Thomas AN, Gillum RF, Mehari A Tags: Chest Source Type: research

Sex-related differences in dynamic right ventricular-pulmonary vascular coupling in heart failure with preserved ejection fraction.
We examined rest and exercise invasive pulmonary hemodynamics in 22 male HFpEF and 27 female HFpEF patients. In order to further investigate the discrepancy in RV-PA response between sex, we included 26 age matched control subjects (11 males and 15 females). Single beat analysis of RV pressure waveforms was used to determine the end-systolic elastance (Ees) and pulmonary arterial elastance (Ea). Right ventricular-pulmonary artery (RV-PA) coupling was determined as the ratio of Ees/Ea. RESULTS: Both HFpEF groups experienced decreased peak VO2 (%predicted). However, male HFpEF patients experienced greater decrement in p...
Source: Chest - December 31, 2020 Category: Respiratory Medicine Authors: Singh I, Oliveira RKF, Heerdt PM, Pari R, Systrom DM, Waxman AB Tags: Chest Source Type: research

Phase II Investigation of the efficacy of Antimycobacterial therapy in Chronic Pulmonary Sarcoidosis.
The objective of this study was to determine the safety and efficacy of anti-mycobacterial therapy on sarcoidosis physiologic and immunologic endpoints. STUDY DESIGN: and Methods: In a double-blind, placebo-controlled, multicenter investigation, pulmonary sarcoidosis patients were randomly assigned to receive 16-weeks of concomitant Levofloxacin, Ethambutol, Azithromycin and Rifabutin (CLEAR) or matching placebo to investigate the effect on FVC. The primary outcome was a comparison of change in percent of predicted FVC among patients randomized to CLEAR or placebo, in addition to their baseline immunosuppressive regim...
Source: Chest - December 30, 2020 Category: Respiratory Medicine Authors: Drake WP, Culver DA, Baughman RP, Judson MA, Crouser ED, James E, Ayers GD, Ding T, Abel K, Green A, Kerrigan A, Sesay A, Bernard GR Tags: Chest Source Type: research

Impact of Right Ventricular Dysfunction on Short- and Long-Term Mortality in Sepsis: A Meta-Analysis of 1,373 Patients.
Abstract BACKGROUND: Right ventricular (RV) dysfunction in sepsis and septic shock has been infrequently studied and has uncertain prognostic significance. RESEARCH QUESTION: Does RV function impact mortality in sepsis and septic shock? STUDY DESIGN AND METHODS: We reviewed the published literature from January 1999 to April 2020 for studies evaluating adult patients with sepsis and septic shock. Study definition of RV dysfunction was used to classify patients. The primary outcome was all-cause mortality divided into short-term mortality (intensive care unit stay, hospital stay or mortality ≤ 30 days)...
Source: Chest - December 23, 2020 Category: Respiratory Medicine Authors: Vallabhajosyula S, Shankar A, Vojjini R, Cheungpasitporn W, Sundaragiri PR, DuBrock HM, Sekiguchi H, Frantz RP, Cajigas HR, Kane GC, Oh JK Tags: Chest Source Type: research

"We usually don't vote on intubation."
"We usually don't vote on intubation." Chest. 2020 Dec 21;: Authors: Jensen CE, Despotes KA, DeMarco B PMID: 33359076 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - December 21, 2020 Category: Respiratory Medicine Authors: Jensen CE, Despotes KA, DeMarco B Tags: Chest Source Type: research

RESEARCH LETTER: Pulmonary function and risk of Alzheimer dementia: two-sample Mendelian randomization study.
PMID: 33359077 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - December 21, 2020 Category: Respiratory Medicine Authors: Russ TC, Harris SE, Batty GD Tags: Chest Source Type: research

Risk factors, management, and outcomes of legionella pneumonia in a large nationally-representative sample.
Abstract BACKGROUND: ATS/IDSA guidelines recommend against routine Legionella pneumophila testing but that hospitalized patients with community-acquired pneumonia (CAP) receive empiric treatment covering Legionella. Testing, empiric treatment, and outcomes for patients with Legionella have not been well described. RESEARCH QUESTION: Is testing for Legionella pneumophila appropriate and could it impact treatment? STUDY DESIGN AND METHODS: We conducted a large retrospective cohort analysis using 2010-2015 data from the Premier Healthcare Database. We included adults with a principal diagnosis code for pneu...
Source: Chest - December 19, 2020 Category: Respiratory Medicine Authors: Allgaier J, Lagu T, Haessler S, Imrey PB, Deshpande A, Guo N, Rothberg MB Tags: Chest Source Type: research

Which N descriptor is more predictive of prognosis in resected non-small cell lung cancer: the number of involved nodal stations versus the location-based pathological N stage?
Abstract BACKGROUND: The eighth edition of nodal classification for non-small cell lung cancer (NSCLC) is defined only by the anatomical location of metastatic lymph nodes. RESEARCH QUESTION: We sought to evaluate the prognostic significance and discriminatory capability of the number of involved nodal stations (nS) in a large Chinese cohort. STUDY DESIGN AND METHODS: A total of 4,011 NSCLC patients undergoing surgical resection between 2009 and 2013 were identified. The optimal cut-off values for nS classification were determined using X-tile software. Kaplan-Meier and multivariate Cox analysis were use...
Source: Chest - December 19, 2020 Category: Respiratory Medicine Authors: Xu L, Su H, She Y, Dai C, Zhao M, Gao J, Xie H, Ren Y, Xie D, Chen C Tags: Chest Source Type: research

Endobronchial Valves for the Treatment of Advanced Emphysema.
Abstract Bronchoscopic lung volume reduction with one-way endobronchial valves is a guideline treatment option for patients with advanced emphysema, supported by extensive scientific data. Patients limited by severe hyperinflation, with a suitable emphysema treatment target lobe and with absence of collateral ventilation are the responders to this treatment. Detailed patient selection, a professional treatment performance, and dedicated follow-up of the valve treatment, including management of complications, are key ingredients to success. This treatment does not stand alone, it especially requires extensive knowl...
Source: Chest - December 17, 2020 Category: Respiratory Medicine Authors: Klooster K, Slebos DJ Tags: Chest Source Type: research

Development and Prospective Validation of a Deep Learning Algorithm for Predicting Need for Mechanical Ventilation.
Abstract BACKGROUND: Objective and early identification of hospitalized patients, and particularly those with novel coronavirus disease 2019 (COVID-19), who may require mechanical ventilation (MV) may aid in delivering timely treatment. RESEARCH QUESTION: Can a transparent deep learning (DL) model predict the need for MV in hospitalized patients and those with COVID-19 up to 24 hours in advance? STUDY DESIGN AND METHODS: We trained and externally validated a transparent DL algorithm to predict the future need for MV in hospitalized patients, including those with COVID-19, using commonly available data in...
Source: Chest - December 17, 2020 Category: Respiratory Medicine Authors: Shashikumar SP, Wardi G, Paul P, Carlile M, Brenner LN, Hibbert KA, North CM, Mukerji SS, Robbins GK, Shao YP, Westover MB, Nemati S, Malhotra A Tags: Chest Source Type: research

Development and validation of algorithms to identify pulmonary arterial hypertension in administrative data.
Abstract BACKGROUND: Pulmonary arterial hypertension (PAH) is a rare disease and much of our understanding stems from single-center studies, which are limited by sample size and generalizability. Administrative data offer an appealing opportunity to inform clinical, research, and quality improvement efforts for PAH. Yet, there is currently no standardized, validated method to distinguish PAH from other subgroups of pulmonary hypertension (PH) within this data source. RESEARCH QUESTION: We aimed to develop and validate a collection of algorithms to detect PAH in administrative data in two diverse settings: all...
Source: Chest - December 17, 2020 Category: Respiratory Medicine Authors: Gillmeyer KR, Nunez ER, Rinne ST, Qian SX, Klings ES, Wiener RS Tags: Chest Source Type: research

The clinical use of lung MRI in cystic fibrosis: what, now, how?
Abstract To assess airway and lung parenchymal damage non-invasively in cystic fibrosis (CF), chest MRI has been historically out of the scope of routine clinical imaging due to technical difficulties such as the low proton density and respiratory and cardiac motion. However, technological breakthroughs have recently emerged to dramatically improve lung MRI quality (including signal-to-noise ratio, resolution, speed, contrast). At the same time, novel treatments have changed the landscape of CF clinical care. In this contemporary context, there is a recent consensus that lung MRI can be used clinically to assess C...
Source: Chest - December 17, 2020 Category: Respiratory Medicine Authors: Dournes G, Walkup LL, Benlala I, Willmering MM, Macey J, Bui S, Laurent F, Woods JC Tags: Chest Source Type: research

Identifying and characterizing a chronic cough cohort through electronic health records.
Abstract BACKGROUND: Chronic cough (CC) of eight or more weeks affects about 10% of adults and may lead to expensive treatments and reduced quality of life. Incomplete diagnostic coding complicates identifying CC in electronic health records (EHRs). Natural language processing (NLP) of EHR text could improve detection. RESEARCH QUESTION: We assessed NLP in identifying cough in EHRs, and characterized adults and encounters with CC. STUDY DESIGN AND METHODS: A Midwestern EHR system identified patients aged 18-85 during 2005-2015. NLP evaluated text notes except prescriptions and instructions, for mentions ...
Source: Chest - December 17, 2020 Category: Respiratory Medicine Authors: Weiner M, Dexter PR, Heithoff K, Roberts AR, Liu Z, Griffith A, Hui S, Schelfhout J, Dicpinigaitis P, Doshi I, Weaver JP Tags: Chest Source Type: research

Oncology Care Provider (OCP) Training in Empathic Communication Skills to Reduce Lung Cancer Stigma.
Abstract BACKGROUND: Despite the clinical importance of assessing smoking history and advising patients who smoke to quit, lung cancer patients often experience feelings of blame and stigma during clinical encounters with their oncology care providers (OCPs). Promoting empathic communication during these encounters may help reduce patients' experience of stigma and improve related clinical outcomes. This paper presents the first-reported OCP- and patient-reported data on the usefulness of an OCP-targeted empathic communication skills (ECS) training to reduce lung cancer stigma and improve communication. RESEA...
Source: Chest - December 15, 2020 Category: Respiratory Medicine Authors: Banerjee SC, Haque N, Schofield EA, Williamson TJ, Martin CM, Bylund CL, Shen MJ, Rigney M, Hamann HA, Parker PA, McFarland DC, Park BJ, Molena D, Moreno A, Ostroff JS Tags: Chest Source Type: research

"How I Do It: Nurse Coordinator Roles and Responsibilities for Bronchoscopic Lung Volume Reduction with Endobronchial Valves".
"How I Do It: Nurse Coordinator Roles and Responsibilities for Bronchoscopic Lung Volume Reduction with Endobronchial Valves". Chest. 2020 Dec 15;: Authors: Britney N H, Alichia P, Adnan M, Kimberly S, Erik F, Margaret M J, Neal M P, David AT, Sebastian FB Abstract Chronic Obstructive Pulmonary Disease (COPD) may cause profound dyspnea, functional impairment, and reduced quality of life. Available pharmacologic therapy provides suboptimal symptom improvement in many patients. Bronchoscopic lung volume reduction (BLVR), achieved with endobronchial valve (EBV) placement, can effectively improv...
Source: Chest - December 15, 2020 Category: Respiratory Medicine Authors: Britney N H, Alichia P, Adnan M, Kimberly S, Erik F, Margaret M J, Neal M P, David AT, Sebastian FB Tags: Chest Source Type: research

Decreasing case-fatality but not mortality rate following admission to intensive care units in Australia, 2005-2018.
PMID: 33333056 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - December 14, 2020 Category: Respiratory Medicine Authors: Laupland KB, Tabah A, Holley AD, Bellapart J, Pilcher DV Tags: Chest Source Type: research

Prolonged Hospitalization Following Acute Respiratory Failure.
Abstract BACKGROUND: A better understanding of the clinical features associated with prolonged hospitalization in acute respiratory failure may allow for better informed care planning. RESEARCH QUESTION: To assess the incidence, mortality, cost and clinical determinants of prolonged hospitalization among patients with acute respiratory failure (ARF). STUDY DESIGN AND METHODS: Using the National Inpatient Sample (NIS) data from 2004 to 2014, we identified adults 18 years and older with International Classification of Disease, 9th Edition (ICD-9), codes for ARF requiring mechanical ventilation for at least...
Source: Chest - December 14, 2020 Category: Respiratory Medicine Authors: Marmor M, Liu S, Long J, Chertow GM, Rogers AJ Tags: Chest Source Type: research

Clinical outcomes and healthcare resource utilization associated with reslizumab treatment in adults with severe eosinophilic asthma in real-world practice.
Abstract BACKGROUND: Reslizumab, an anti-interleukin-5 (anti-IL-5) monoclonal antibody, is indicated as add-on maintenance treatment for adults with severe eosinophilic asthma. RESEARCH QUESTION: This retrospective study examined real-world outcomes associated with reslizumab use in patients with severe eosinophilic asthma in US clinical practice. STUDY DESIGN AND METHODS: Patient-level data from adults treated with reslizumab were obtained from center- and panel-based medical chart reviews. Eligible patients had available medical records and treatment history for ≥ 6 months pre-reslizumab treatment i...
Source: Chest - December 14, 2020 Category: Respiratory Medicine Authors: Wechsler ME, Peters SP, Hill TD, Ariely R, DePietro MR, Driessen MT, Terasawa EL, Thomason DR, Panettieri RA Tags: Chest Source Type: research

Quantitative Emphysema on Low-Dose Computed Tomography of the Chest and Risk of Lung Cancer and Airflow Obstruction: An analysis of the National Lung Screening Trial.
an MK Abstract BACKGROUND: Lung cancer risk prediction models do not routinely incorporate imaging metrics available on low-dose computed tomography (LDCT) of the chest ordered for lung cancer screening. RESEARCH QUESTION: What is the association between quantitative emphysema measured on LDCT and lung cancer incidence and mortality, all-cause mortality, and airflow obstruction in individuals who currently or formerly smoked undergoing lung cancer screening? STUDY DESIGN AND METHODS: In 7,262 participants in the CT arm of the National Lung Screening Trial, % low attenuation area (%LAA) was defined as the...
Source: Chest - December 13, 2020 Category: Respiratory Medicine Authors: Labaki WW, Xia M, Murray S, Hatt CR, Al-Abcha A, Ferrera MC, Meldrum CA, Keith LA, Galbán CJ, Arenberg DA, Curtis JL, Martinez FJ, Kazerooni EA, Han MK Tags: Chest Source Type: research

RESEARCH LETTER: Pulmonary function and risk of Alzheimer dementia: two-sample Mendelian randomization study.
PMID: 33321123 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - December 12, 2020 Category: Respiratory Medicine Authors: Russ TC, Harris SE, Batty GD Tags: Chest Source Type: research

Identification of distinct immunophenotypes in critically-ill COVID-19 patients.
mas G Abstract BSACKGROUND: Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection causes direct lung damage, overwhelming endothelial activation and inflammatory reaction leading to acute respiratory failure and multi-organ dysfunction. Ongoing clinical trials are evaluating targeted therapies to hinder this exaggerated inflammatory response. Critically-ill COVID-19 patients have shown heterogeneous severity trajectories, suggesting that response to therapies is likely to vary across patients. RESEARCH QUESTION: Are critically-ill COVID-19 patients biologically and immunologically dissociable...
Source: Chest - December 11, 2020 Category: Respiratory Medicine Authors: Dupont T, Caillat-Zucman S, Fremeaux-Bacchi V, Morin F, Lengliné E, Darmon M, Peffault de Latour R, Zafrani L, Azoulay E, Dumas G Tags: Chest Source Type: research

Corticosteroid therapy is associated with improved outcome in critically ill COVID-19 patients with hyperinflammatory phenotype.
Abstract BACKGROUND: Corticosteroid therapy is commonly used in patients with coronavirus disease 2019 (COVID-19), while its impact on outcomes and which patients could benefit from corticosteroid therapy are uncertain. RESEARCH QUESTION: Whether clinical phenotypes of COVID-19 were associated with differential response to corticosteroid therapy. STUDY DESIGN AND METHODS: Critically ill patients with COVID-19 from Tongji hospital between Jan 2020 and Feb 2020 were included, and the main exposure of interest was the administration of intravenous corticosteroids. The primary outcome was 28-day mortality. M...
Source: Chest - December 11, 2020 Category: Respiratory Medicine Authors: Chen H, Xie J, Su N, Wang J, Sun Q, Li S, Jin J, Zhou J, Mo M, Wei Y, Chao Y, Hu W, Du B, Qiu H Tags: Chest Source Type: research

The Relationship Between Asthma and Cardiovascular Disease: An Examination of the Framingham Offspring Study.
Abstract BACKGROUND: Although asthma has been suggested as a risk factor for cardiovascular disease (CVD), robust longitudinal evidence of this relationship is limited. RESEARCH QUESTION: Using Framingham Offspring Cohort data, we sought to longitudinally examine the association between asthma and lifetime risk of CVD while controlling for cardiovascular risk factors included in the Framingham Risk Score. STUDY DESIGN AND METHODS: We analyzed data from a prospective population-based cohort of 3,612 individuals, ages 17 to 77 years, who participated in Framingham Offspring Study examinations from 1979 to ...
Source: Chest - December 11, 2020 Category: Respiratory Medicine Authors: Pollevick ME, Xu KY, Mhango G, Federmann EG, Vedanthan R, Busse P, Holguin F, Federman AD, Wisnivesky JP Tags: Chest Source Type: research

Effects of low-load/high-repetition resistance training on exercise capacity, health status and limb muscle adaptation in patients with severe COPD: a randomized controlled trial.
is F Abstract BACKGROUND: Training volume is paramount in the magnitude of physiological adaptations following resistance training. However, patients with severe COPD are limited by dyspnea during traditional two-limb low-load/high-repetition resistance training (LLHR-RT), resulting in sub-optimal training volumes. During a single exercise session, single-limb LLHR-RT decreases the ventilatory load and enables higher localized training volumes compared to two-limb LLHR-RT. RESEARCH QUESTION: Does single-limb LLHR-RT lead to more profound effects when compared to two-limb LLHR-RT on exercise capacity (6-minute...
Source: Chest - December 11, 2020 Category: Respiratory Medicine Authors: Nyberg A, Martin M, Saey D, Milad N, Patoine D, Morissette M MC, Auger D, Stål P, Maltais F Tags: Chest Source Type: research

Effect of CPAP therapy on kidney function in patients with chronic kidney disease: a pilot randomized controlled trial.
Abstract BACKGROUND: Obstructive sleep apnea (OSA) is common in chronic kidney disease (CKD) and may accelerate a decline in kidney function. It is not clear whether treatment of OSA with continuous positive airway pressure (CPAP) improves kidney function. RESEARCH QUESTION: Does treatment with CPAP improve kidney function in patients with CKD and co-existing OSA? STUDY DESIGN AND METHODS: A randomized, controlled, non-blinded, parallel clinical trial was performed on patients with stages 3 and 4 CKD and co-existing OSA comparing the effect of CPAP versus usual care on the estimated glomerular filtration...
Source: Chest - December 11, 2020 Category: Respiratory Medicine Authors: Rimke AN, Ahmed SB, Turin TC, Pendharkar SR, Raneri JK, Lynch EJ, Hanly PJ Tags: Chest Source Type: research

Effect of phenylephrine push prior to continuous infusion norepinephrine in patients with septic shock.
CONCLUSION: Phenylephrine pushes were associated with a higher incidence of early but not sustained hemodynamic stability, and were independently associated with higher ICU mortality. Caution is warranted when clinicians are considering the use of phenylephrine pushes in patients with septic shock. PMID: 33316239 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - December 11, 2020 Category: Respiratory Medicine Authors: Hawn JM, Bauer SR, Yerke J, Li M, Wang X, Reddy AJ, Mireles-Cabodevila E, Sacha GL Tags: Chest Source Type: research

"Diaphragm Ultrasound in Weaning from Mechanical Ventilation".
"Diaphragm Ultrasound in Weaning from Mechanical Ventilation". Chest. 2020 Dec 10;: Authors: Kilaru D, Panebianco N, Baston C PMID: 33309837 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - December 10, 2020 Category: Respiratory Medicine Authors: Kilaru D, Panebianco N, Baston C Tags: Chest Source Type: research

Long-Term Acute Care Hospitals Extend ICU Capacity for COVID-19 Response and Recovery.
Abstract The COVID-19 pandemic has presented novel challenges for the entire healthcare continuum, requiring transformative changes to hospital and post-acute care, including clinical, administrative, and physical modifications to current standards of operations. Innovative use and adaptation of long-term acute care hospitals (LTACHs) can safely and effectively care for patients during the ongoing COVID-19 pandemic. A framework for the rapid changes, including increasing collaboration with external healthcare organizations, creating new methods for enhanced communication, and modifying processes focused on patient...
Source: Chest - December 9, 2020 Category: Respiratory Medicine Authors: Grigonis AM, Mathews KS, Benka-Coker WO, Dawson AM, Hammerman SI Tags: Chest Source Type: research

Sleep Apnea and Insomnia: Emerging Evidence for Effective Clinical Management.
Abstract Comorbid insomnia and sleep apnea (COMISA) are the most common co-occurring sleep disorders and presents many challenges to clinicians. This review provides an overview of the clinical challenges in the management of patients with COMISA with a focus on recent evidence regarding the evaluation and treatment of COMISA. Innovations in the assessment of COMISA have used profile analyses or dimensional approaches to examine symptom clusters or symptom severity that could be particularly useful in the assessment of COMISA. Recent randomized controlled trials have provided important evidence about the safety an...
Source: Chest - December 9, 2020 Category: Respiratory Medicine Authors: Ong JC, Crawford MR, Wallace DM Tags: Chest Source Type: research

Temporal trends in tunneled pleural catheter utilization in patients with malignancy: A multicenter review.
di MM, Wright AN, Yarmus LB, Gorden JA PMID: 33307064 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - December 7, 2020 Category: Respiratory Medicine Authors: Wilshire CL, Chang SC, Gilbert CR, Akulian JA, AlSarraj MK, Asciak R, Bevill BT, Davidson KR, Delgado A, Grosu HB, Herth FJ, Lee HJ, Lewis JE, Maldonado F, Ost DE, Pastis NJ, Rahman NM, Reddy CB, Roller LJ, Sanchez TM, Shojaee S, Steer H, Thiboutot J, Wah Tags: Chest Source Type: research

Racial Disparity in Surgical Therapy for Thymic Malignancies.
Abstract OBJECTIVE: The primary curative treatment for thymic malignancies is surgery. For lung and esophageal cancer, there are substantive disparities in outcomes by race. Much of these disparities are attributed to the decreased utilization of surgery in African-American (AA) patients. Though thymic malignancies are treated by the same group of specialists as lung and esophageal cancer, it is not known if there are racial disparities in the treatment of thymic malignancies. METHODS: A retrospective cohort analysis was performed using the National Cancer Data Base (NCDB) of patients who were diagnosed with ...
Source: Chest - December 7, 2020 Category: Respiratory Medicine Authors: Martinez-Meehan D, Abdallah H, Lutfi W, Dhupar R, Christie N, Luketich JD, Sultan I, Okusanya OT Tags: Chest Source Type: research

Trends in the Prevalence of Non-tuberculous Mycobacterial Infection in Patients with Non-Cystic Fibrosis Bronchiectasis in South Korea, 2012-2016.
PMID: 33301746 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - December 7, 2020 Category: Respiratory Medicine Authors: Lee SJ, Choi H, Lee H, Ra SW, Oh YM, Ju S, You JW, Jeong YY, Kim HC, Lee JD Tags: Chest Source Type: research

Antiplatelet drugs and risk of bleeding after bedside pleural procedures: a national multicenter cohort study.
henivesse C Abstract BACKGROUND: The decision making on antiplatelet drug withdrawal or continuation before performing a pleural procedure is based on the balance between the risk of bleeding associated with the antiplatelet therapy and the risk of arterial thrombosis due to its interruption. Knowledge on antiplatelet therapy-associated risk of bleeding after pleural procedure is lacking. RESEARCH QUESTION: Is the risk of bleeding associated with antiplatelet drugs increased in patients undergoing pleural procedures? STUDY DESIGN AND METHODS: We conducted a French multicenter cohort study in 19 centers. ...
Source: Chest - December 5, 2020 Category: Respiratory Medicine Authors: Dangers L, Giovannelli J, Mangiapan G, Alves M, Bigé N, Messika J, Morawiec E, Neuville M, Cracco C, Béduneau G, Terzi N, Huet I, Dhalluin X, Bautin N, Quiot JJ, Vecchi CA, Similowski T, Chenivesse C Tags: Chest Source Type: research