Optimal Noninvasive Medicare Access Promotion: Patients with COPD Technical Expert Panel Report from the American College of Chest Physicians, the American Association for Respiratory Care, the American Academy of Sleep Medicine, and the American Thoracic Society
Chest. 2021 Jul 28:S0012-3692(21)01479-3. doi: 10.1016/j.chest.2021.06.082. Online ahead of print.ABSTRACTThis document summarizes the work of the Chronic Obstructive Pulmonary Disease (COPD) Technical Expert Panel working group. For patients with COPD, the most pressing current coverage barriers identified were onerous diagnostic requirements focused on oxygenation (rather than ventilation), and difficulty obtaining bilevel devices with backup rate capabilities. Because of these difficulties, many patients with COPD were instead sometimes prescribed home mechanical ventilators. Critical evidence supports changes to curren...
Source: Chest - August 2, 2021 Category: Respiratory Medicine Authors: Nicholas S Hill Gerard J Criner Richard D Branson Bartolome R Celli Neil R Macintyre Amen Sergew ONMAP Technical Expert Panel Source Type: research

Executive Summary: Optimal Noninvasive Ventilation Medicare Access Promotion (ONMAP)
Chest. 2021 Jul 28:S0012-3692(21)01481-1. doi: 10.1016/j.chest.2021.05.074. Online ahead of print.ABSTRACTThe current national coverage determinations (NCDs) for noninvasive ventilation for patients with thoracic restrictive disorders (TRD), chronic obstructive pulmonary disease (COPD) and hypoventilation syndromes (HS) were formulated in 1998. New original research, updated formal practice guidelines, and current consensus expert opinion have accrued that are in conflict with the existing NCDs. Some inconsistencies in the NCDs have been noted, and diagnostic and therapeutic technology has also advanced in the last quarter...
Source: Chest - August 2, 2021 Category: Respiratory Medicine Authors: Peter C Gay Robert L Owens ONMAP Technical Expert Panel Source Type: research

Optimal Noninvasive Medicare Access Promotion: Patients with Hypoventilation Syndromes A Technical Expert Panel Report from the American College of Chest Physicians, the American Association for Respiratory Care, the American Academy of Sleep Medicine, and the American Thoracic Society
Chest. 2021 Jul 29:S0012-3692(21)01484-7. doi: 10.1016/j.chest.2021.06.083. Online ahead of print.ABSTRACTThe existing coverage criteria for home noninvasive ventilation (NIV) do not recognize the diversity of hypoventilation syndromes and advances in technologies. This document summarizes the work of the Hypoventilation Syndromes Technical Expert Panel working group. The most pressing current coverage barriers identified were: 1) overreliance on arterial blood gases (particularly during sleep); 2) need to perform testing on prescribed oxygen; 3) requiring a sleep study to rule out obstructive sleep apnea as the cause of s...
Source: Chest - August 2, 2021 Category: Respiratory Medicine Authors: Babak Mokhlesi Christine H Won Barry J Make Bernardo J Selim Bernie Y Sunwoo ONMAP Technical Expert Panel Source Type: research

Optimal Noninvasive Medicare Access Promotion: Patients with Central Sleep Apnea A Technical Expert Panel Report from the American College of Chest Physicians, the American Association for Respiratory Care, the American Academy of Sleep Medicine, and the American Thoracic Society
Chest. 2021 Jul 28:S0012-3692(21)01482-3. doi: 10.1016/j.chest.2021.07.039. Online ahead of print.ABSTRACTThis document summarizes suggestions of the central sleep apnea (CSA) technical expert panel (TEP) working group. This paper shares our vision for bringing the right device to the right patient at the right time. For patients with CSA, current coverage criteria do not align with guideline treatment recommendations. For example, continuous positive airway pressure (CPAP) and oxygen therapy are recommended but not covered for CSA. On the other hand, BPAP without a backup rate may be a covered therapy for OSA, but it may ...
Source: Chest - August 2, 2021 Category: Respiratory Medicine Authors: Timothy I Morgenthaler Atul Malhotra Richard Berry Karin Johnson Marc Raphaelson ONMAP Technical Expert Panel Source Type: research

Optimal Noninvasive Medicare Access Promotion: Patients with Thoracic Restrictive Diseases A Technical Expert Panel Report from the American College of Chest Physicians, the American Association for Respiratory Care, the American Academy of Sleep Medicine, and the American Thoracic Society
Chest. 2021 Jul 28:S0012-3692(21)01488-4. doi: 10.1016/j.chest.2021.05.075. Online ahead of print.ABSTRACTThe existing coverage criteria for Non-Invasive Ventilation (NIV) do not recognize the benefits of early initiation of NIV for those with Thoracic Restrictive Disease (TRD) and do not address the unique needs for daytime support as the patient's progress to ventilator dependence. This document summarizes the work of the Thoracic Restrictive Disease Technical Expert Panel working group. The most pressing current coverage barriers identified were: 1) Delays in implementing NIV treatment 2) Lack of coverage for many non-p...
Source: Chest - August 2, 2021 Category: Respiratory Medicine Authors: Lisa F Wolfe Joshua O Benditt Loutfi Aboussouan Dean R Hess John M Coleman ONMAP Technical Expert Panel Source Type: research

Optimal Noninvasive Medicare Access Promotion: Patients with Obstructive Sleep Apnea A Technical Expert Panel Report from the American College of Chest Physicians, the American Association for Respiratory Care, the American Academy of Sleep Medicine, and the American Thoracic Society
Chest. 2021 Jul 28:S0012-3692(21)01486-0. doi: 10.1016/j.chest.2021.06.084. Online ahead of print.ABSTRACTThis document summarizes the work of the CPAP and Bilevel PAP Therapy for Obstructive Sleep Apnea (OSA) Technical Expert Panel working group. For PAP therapy, the most pressing current coverage barriers identified were: an insufficient symptom list describing all potential symptoms in patients with mild OSA; the 4 hours/night of PAP usage requirement to keep the device; the additional sleep studies requirement to re-qualify for PAP or supplemental oxygen; the inability to use telehealth visits for followup visits. Crit...
Source: Chest - August 2, 2021 Category: Respiratory Medicine Authors: Susheel P Patil Nancy A Collop Alex D Chediak Eric J Olson Kunwar Praveen Vohra ONMAP Technical Expert Panel Source Type: research

How I Review a Paper to Help Improve Citability and Impact
Chest. 2021 Jul 28:S0012-3692(21)01491-4. doi: 10.1016/j.chest.2021.07.042. Online ahead of print.NO ABSTRACTPMID:34331903 | DOI:10.1016/j.chest.2021.07.042 (Source: Chest)
Source: Chest - July 31, 2021 Category: Respiratory Medicine Authors: David M Mannino Source Type: research

The blood neutrophil count after 1 month of treatment predicts the radiological severity of lung disease at treatment end
Chest. 2021 Jul 28:S0012-3692(21)01490-2. doi: 10.1016/j.chest.2021.07.041. Online ahead of print.ABSTRACTBACKGROUND: Post-tuberculous lung disease confers significant morbidity. However, the determinants of persistent lung damage in tuberculosis are not well established. We investigated associations between tuberculosis-associated radiological changes and socio-demographic factors, surrogates of bacillary burden and blood inflammatory markers at initiation of therapy and after 1 month.RESEARCH QUESTION: What are the predictors of radiological severity at the end of tuberculosis treatment for tuberculosis?STUDY DESIGN AND ...
Source: Chest - July 31, 2021 Category: Respiratory Medicine Authors: Timothy Pw Jones Susannah Dabbaj Indrajeet Mandal Joanne Cleverley Charlotte Cash Marc Ci Lipman David M Lowe Source Type: research

Association between Obstructive Sleep Apnea and Quantitative Atherosclerotic Plaque Burden: A Coronary Computed Tomographic Angiography Study
Chest. 2021 Jul 28:S0012-3692(21)01489-6. doi: 10.1016/j.chest.2021.07.040. Online ahead of print.ABSTRACTBACKGROUND: Limited evidence is available regarding the association between obstructive sleep apnea (OSA) and coronary plaque assessed using quantitative coronary computed tomographic angiography (CCTA).RESEARCH QUESTION: Are there any associations of OSA severity-related indices with the presence and burden of coronary plaque?STUDY DESIGN AND METHODS: Cross-sectional data from 692 patients who underwent sleep monitoring and CCTA were used for this study. Of these patients, 120 (17.3%) underwent polysomnography, and 57...
Source: Chest - July 31, 2021 Category: Respiratory Medicine Authors: Mi Lu Fang Fang Zhenjia Wang Lei Xu John E Sanderson Xiaojun Zhan Lianping He Chan Wu Yongxiang Wei Source Type: research

How I Review a Paper to Help Improve Citability and Impact
Chest. 2021 Jul 28:S0012-3692(21)01491-4. doi: 10.1016/j.chest.2021.07.042. Online ahead of print.NO ABSTRACTPMID:34331903 | DOI:10.1016/j.chest.2021.07.042 (Source: Chest)
Source: Chest - July 31, 2021 Category: Respiratory Medicine Authors: David M Mannino Source Type: research

The blood neutrophil count after 1 month of treatment predicts the radiological severity of lung disease at treatment end
Chest. 2021 Jul 28:S0012-3692(21)01490-2. doi: 10.1016/j.chest.2021.07.041. Online ahead of print.ABSTRACTBACKGROUND: Post-tuberculous lung disease confers significant morbidity. However, the determinants of persistent lung damage in tuberculosis are not well established. We investigated associations between tuberculosis-associated radiological changes and socio-demographic factors, surrogates of bacillary burden and blood inflammatory markers at initiation of therapy and after 1 month.RESEARCH QUESTION: What are the predictors of radiological severity at the end of tuberculosis treatment for tuberculosis?STUDY DESIGN AND ...
Source: Chest - July 31, 2021 Category: Respiratory Medicine Authors: Timothy Pw Jones Susannah Dabbaj Indrajeet Mandal Joanne Cleverley Charlotte Cash Marc Ci Lipman David M Lowe Source Type: research

Association between Obstructive Sleep Apnea and Quantitative Atherosclerotic Plaque Burden: A Coronary Computed Tomographic Angiography Study
Chest. 2021 Jul 28:S0012-3692(21)01489-6. doi: 10.1016/j.chest.2021.07.040. Online ahead of print.ABSTRACTBACKGROUND: Limited evidence is available regarding the association between obstructive sleep apnea (OSA) and coronary plaque assessed using quantitative coronary computed tomographic angiography (CCTA).RESEARCH QUESTION: Are there any associations of OSA severity-related indices with the presence and burden of coronary plaque?STUDY DESIGN AND METHODS: Cross-sectional data from 692 patients who underwent sleep monitoring and CCTA were used for this study. Of these patients, 120 (17.3%) underwent polysomnography, and 57...
Source: Chest - July 31, 2021 Category: Respiratory Medicine Authors: Mi Lu Fang Fang Zhenjia Wang Lei Xu John E Sanderson Xiaojun Zhan Lianping He Chan Wu Yongxiang Wei Source Type: research

Presentation, Diagnosis and Management of Subglottic and Tracheal Stenosis During Systemic Inflammatory Diseases
Chest. 2021 Jul 26:S0012-3692(21)01391-X. doi: 10.1016/j.chest.2021.07.037. Online ahead of print.ABSTRACTBACKGROUND: Subglottic (SGS) and tracheal stenoses (TS) are characterized by a narrowing of the airways. We aimed to describe characteristics and prognosis of nontraumatic and nontumoral SGS or TS.RESEARCH QUESTION: What are the inflammatory etiologies of subglottic and tracheal stenosis and what are their characteristics and prognosis?STUDY DESIGN AND METHODS: We conducted a multicenter observational retrospective study of patients with neither traumatic nor tumoral SGS or TS.RESULTS: Eighty-one patients were included...
Source: Chest - July 29, 2021 Category: Respiratory Medicine Authors: Jennifer Catano Yurdagul Uzunhan Romain Paule J érémie Dion Alexis R égent Paul Legendre Fran çois Gonin Emmanuel Martinod Pascal Cohen Xavier Pu échal V éronique Le Guern Luc Mouthon Andr é Coste Christine Lorut Candice Lacroix Sophie P érié Ben Source Type: research

Presentation, Diagnosis and Management of Subglottic and Tracheal Stenosis During Systemic Inflammatory Diseases
Chest. 2021 Jul 26:S0012-3692(21)01391-X. doi: 10.1016/j.chest.2021.07.037. Online ahead of print.ABSTRACTBACKGROUND: Subglottic (SGS) and tracheal stenoses (TS) are characterized by a narrowing of the airways. We aimed to describe characteristics and prognosis of nontraumatic and nontumoral SGS or TS.RESEARCH QUESTION: What are the inflammatory etiologies of subglottic and tracheal stenosis and what are their characteristics and prognosis?STUDY DESIGN AND METHODS: We conducted a multicenter observational retrospective study of patients with neither traumatic nor tumoral SGS or TS.RESULTS: Eighty-one patients were included...
Source: Chest - July 29, 2021 Category: Respiratory Medicine Authors: Jennifer Catano Yurdagul Uzunhan Romain Paule J érémie Dion Alexis R égent Paul Legendre Fran çois Gonin Emmanuel Martinod Pascal Cohen Xavier Pu échal V éronique Le Guern Luc Mouthon Andr é Coste Christine Lorut Candice Lacroix Sophie P érié Ben Source Type: research

Hospitalization Risk for Medicare Beneficiaries With Nontuberculous Mycobacterial Pulmonary Disease
Chest. 2021 Jul 24:S0012-3692(21)01369-6. doi: 10.1016/j.chest.2021.07.034. Online ahead of print.ABSTRACTBACKGROUND: Nontuberculous mycobacterial pulmonary disease (NTM-PD) is an uncommon mycobacterial infection characterized by worsening lung function and increased healthcare resource utilization; however, overall risk for hospitalization among patients with NTM-PD remains unclear.STUDY DESIGN AND METHODS: A retrospective, nested, case-control study was conducted using the Medicare claims database. Cases were defined as patients with ≥2 NTM-PD claims ≥30 days apart between 1/1/07 and 12/31/15. We included individua...
Source: Chest - July 27, 2021 Category: Respiratory Medicine Authors: D Rebecca Prevots Theodore K Marras Ping Wang Kevin Mange Patrick A Flume Source Type: research

Treatment of Mycobacterium abscessus Pulmonary Disease
Chest. 2021 Jul 24:S0012-3692(21)01370-2. doi: 10.1016/j.chest.2021.07.035. Online ahead of print.ABSTRACTMycobacterium abscessus is the second most common nontuberculous mycobacterial lung disease pathogen and comprises three subspecies, abscessus, massiliense and bolletii. Subspecies identification is critical for disease management as subspecies abscessus and bolletii have an inducible macrolide resistance gene (erm(41)) that results in clinical macrolide resistance. In contrast subspecies massiliense does not have an active erm(41) gene and is therefore susceptible in vitro and clinically to macrolide-containing regime...
Source: Chest - July 27, 2021 Category: Respiratory Medicine Authors: David E Griffith Charles L Daley Source Type: research

Hospitalization Risk for Medicare Beneficiaries With Nontuberculous Mycobacterial Pulmonary Disease
Chest. 2021 Jul 24:S0012-3692(21)01369-6. doi: 10.1016/j.chest.2021.07.034. Online ahead of print.ABSTRACTBACKGROUND: Nontuberculous mycobacterial pulmonary disease (NTM-PD) is an uncommon mycobacterial infection characterized by worsening lung function and increased healthcare resource utilization; however, overall risk for hospitalization among patients with NTM-PD remains unclear.STUDY DESIGN AND METHODS: A retrospective, nested, case-control study was conducted using the Medicare claims database. Cases were defined as patients with ≥2 NTM-PD claims ≥30 days apart between 1/1/07 and 12/31/15. We included individua...
Source: Chest - July 27, 2021 Category: Respiratory Medicine Authors: D Rebecca Prevots Theodore K Marras Ping Wang Kevin Mange Patrick A Flume Source Type: research

Treatment of Mycobacterium abscessus Pulmonary Disease
Chest. 2021 Jul 24:S0012-3692(21)01370-2. doi: 10.1016/j.chest.2021.07.035. Online ahead of print.ABSTRACTMycobacterium abscessus is the second most common nontuberculous mycobacterial lung disease pathogen and comprises three subspecies, abscessus, massiliense and bolletii. Subspecies identification is critical for disease management as subspecies abscessus and bolletii have an inducible macrolide resistance gene (erm(41)) that results in clinical macrolide resistance. In contrast subspecies massiliense does not have an active erm(41) gene and is therefore susceptible in vitro and clinically to macrolide-containing regime...
Source: Chest - July 27, 2021 Category: Respiratory Medicine Authors: David E Griffith Charles L Daley Source Type: research

Hospitalization Risk for Medicare Beneficiaries With Nontuberculous Mycobacterial Pulmonary Disease
Chest. 2021 Jul 24:S0012-3692(21)01369-6. doi: 10.1016/j.chest.2021.07.034. Online ahead of print.ABSTRACTBACKGROUND: Nontuberculous mycobacterial pulmonary disease (NTM-PD) is an uncommon mycobacterial infection characterized by worsening lung function and increased healthcare resource utilization; however, overall risk for hospitalization among patients with NTM-PD remains unclear.STUDY DESIGN AND METHODS: A retrospective, nested, case-control study was conducted using the Medicare claims database. Cases were defined as patients with ≥2 NTM-PD claims ≥30 days apart between 1/1/07 and 12/31/15. We included individua...
Source: Chest - July 27, 2021 Category: Respiratory Medicine Authors: D Rebecca Prevots Theodore K Marras Ping Wang Kevin Mange Patrick A Flume Source Type: research

Treatment of Mycobacterium abscessus Pulmonary Disease
Chest. 2021 Jul 24:S0012-3692(21)01370-2. doi: 10.1016/j.chest.2021.07.035. Online ahead of print.ABSTRACTMycobacterium abscessus is the second most common nontuberculous mycobacterial lung disease pathogen and comprises three subspecies, abscessus, massiliense and bolletii. Subspecies identification is critical for disease management as subspecies abscessus and bolletii have an inducible macrolide resistance gene (erm(41)) that results in clinical macrolide resistance. In contrast subspecies massiliense does not have an active erm(41) gene and is therefore susceptible in vitro and clinically to macrolide-containing regime...
Source: Chest - July 27, 2021 Category: Respiratory Medicine Authors: David E Griffith Charles L Daley Source Type: research

Tyrosine kinase inhibitors for acute respiratory failure due to non-small-cell lung cancer involvement in intensive care unit
Chest. 2021 Jul 21:S0012-3692(21)01358-1. doi: 10.1016/j.chest.2021.06.079. Online ahead of print.NO ABSTRACTPMID:34302842 | DOI:10.1016/j.chest.2021.06.079 (Source: Chest)
Source: Chest - July 24, 2021 Category: Respiratory Medicine Authors: Y Tandjaoui-Lambiotte Y Akrour A Gibelin F Gonzalez A Stoclin A S Moreau P Jaubert A Oppenheimer B Duchemann S Gaudry GRRROH study group: F El Kouari E De Montmollin M Pineton de Chambrun F Wallet A Lautrette N Dufour D Contou J D Ricard R Persichini J Ma Source Type: research

Tyrosine kinase inhibitors for acute respiratory failure due to non-small-cell lung cancer involvement in intensive care unit
Chest. 2021 Jul 21:S0012-3692(21)01358-1. doi: 10.1016/j.chest.2021.06.079. Online ahead of print.NO ABSTRACTPMID:34302842 | DOI:10.1016/j.chest.2021.06.079 (Source: Chest)
Source: Chest - July 24, 2021 Category: Respiratory Medicine Authors: Y Tandjaoui-Lambiotte Y Akrour A Gibelin F Gonzalez A Stoclin A S Moreau P Jaubert A Oppenheimer B Duchemann S Gaudry GRRROH study group: F El Kouari E De Montmollin M Pineton de Chambrun F Wallet A Lautrette N Dufour D Contou J D Ricard R Persichini J Ma Source Type: research

Tyrosine kinase inhibitors for acute respiratory failure due to non-small-cell lung cancer involvement in intensive care unit
Chest. 2021 Jul 21:S0012-3692(21)01358-1. doi: 10.1016/j.chest.2021.06.079. Online ahead of print.NO ABSTRACTPMID:34302842 | DOI:10.1016/j.chest.2021.06.079 (Source: Chest)
Source: Chest - July 24, 2021 Category: Respiratory Medicine Authors: Y Tandjaoui-Lambiotte Y Akrour A Gibelin F Gonzalez A Stoclin A S Moreau P Jaubert A Oppenheimer B Duchemann S Gaudry GRRROH study group: F El Kouari E De Montmollin M Pineton de Chambrun F Wallet A Lautrette N Dufour D Contou J D Ricard R Persichini J Ma Source Type: research

Pre- and postnatal household air pollution exposures and pneumonia risk: Evidence from GRAPHS
Chest. 2021 Jul 20:S0012-3692(21)01363-5. doi: 10.1016/j.chest.2021.06.080. Online ahead of print.ABSTRACTBACKGROUND: Nearly 40% of the world's population is exposed daily to household air pollution. The relative impact of prenatal and postnatal household air pollution exposure on early childhood pneumonia, a leading cause of mortality, is unknown.RESEARCH QUESTION: Are prenatal and/or postnatal household air pollution associated with pneumonia risk in the first year of life?STUDY DESIGN AND METHODS: The Ghana Randomized Air Pollution and Health Study (GRAPHS) enrolled 1,414 non-smoking, pregnant women prior to 24 weeks ge...
Source: Chest - July 23, 2021 Category: Respiratory Medicine Authors: Patrick L Kinney Kwaku-Poku Asante Alison G Lee Kenneth A Ae-Ngibise Katrin Burkart Ellen Boamah-Kaali Mieks Twumasi Stephaney Gyaase Ashlinn Quinn Felix B Oppong Blair J Wylie Seyram Kaali Steven Chillrud Abena Yawson Darby Jack Seth Owusu-Agyei Source Type: research

Lung Cancer Screening Rates During the COVID-19 Pandemic
Chest. 2021 Jul 20:S0012-3692(21)01364-7. doi: 10.1016/j.chest.2021.07.030. Online ahead of print.NO ABSTRACTPMID:34298006 | DOI:10.1016/j.chest.2021.07.030 (Source: Chest)
Source: Chest - July 23, 2021 Category: Respiratory Medicine Authors: Stacey A Fedewa Priti Bandi Robert A Smith Gerard A Silvestri Ahmedin Jemal Source Type: research

Differential Effects of Electronic Hookah Vaping and Traditional Combustible Hookah Smoking on Oxidation, Inflammation and Arterial Stiffness
Chest. 2021 Jul 20:S0012-3692(21)01360-X. doi: 10.1016/j.chest.2021.07.027. Online ahead of print.ABSTRACTBACKGROUND: Traditional hookah smoking has quickly grown to become a global tobacco epidemic. More recently, electronic (e-) hookahs-vaped through traditional waterpipes-were introduced as healthier alternatives to combustible hookah. With combustible tobacco smoking, oxidative stress, inflammation and vascular stiffness are key components in the development and progression of atherosclerosis. The comparable effects of hookah are unknown.RESEARCH QUESTION: What is the differential acute effect of e-hookah vaping vs com...
Source: Chest - July 23, 2021 Category: Respiratory Medicine Authors: Mary Rezk-Hanna Rajat Gupta Charlie O Nettle Daniel Dobrin Chiao-Wei Cheng Angelica Means Mary Lynn-Brecht Donald P Tashkin Jesus A Araujo Source Type: research

Pre- and postnatal household air pollution exposures and pneumonia risk: Evidence from GRAPHS
Chest. 2021 Jul 20:S0012-3692(21)01363-5. doi: 10.1016/j.chest.2021.06.080. Online ahead of print.ABSTRACTBACKGROUND: Nearly 40% of the world's population is exposed daily to household air pollution. The relative impact of prenatal and postnatal household air pollution exposure on early childhood pneumonia, a leading cause of mortality, is unknown.RESEARCH QUESTION: Are prenatal and/or postnatal household air pollution associated with pneumonia risk in the first year of life?STUDY DESIGN AND METHODS: The Ghana Randomized Air Pollution and Health Study (GRAPHS) enrolled 1,414 non-smoking, pregnant women prior to 24 weeks ge...
Source: Chest - July 23, 2021 Category: Respiratory Medicine Authors: Patrick L Kinney Kwaku-Poku Asante Alison G Lee Kenneth A Ae-Ngibise Katrin Burkart Ellen Boamah-Kaali Mieks Twumasi Stephaney Gyaase Ashlinn Quinn Felix B Oppong Blair J Wylie Seyram Kaali Steven Chillrud Abena Yawson Darby Jack Seth Owusu-Agyei Source Type: research

Lung Cancer Screening Rates During the COVID-19 Pandemic
Chest. 2021 Jul 20:S0012-3692(21)01364-7. doi: 10.1016/j.chest.2021.07.030. Online ahead of print.NO ABSTRACTPMID:34298006 | DOI:10.1016/j.chest.2021.07.030 (Source: Chest)
Source: Chest - July 23, 2021 Category: Respiratory Medicine Authors: Stacey A Fedewa Priti Bandi Robert A Smith Gerard A Silvestri Ahmedin Jemal Source Type: research

Differential Effects of Electronic Hookah Vaping and Traditional Combustible Hookah Smoking on Oxidation, Inflammation and Arterial Stiffness
Chest. 2021 Jul 20:S0012-3692(21)01360-X. doi: 10.1016/j.chest.2021.07.027. Online ahead of print.ABSTRACTBACKGROUND: Traditional hookah smoking has quickly grown to become a global tobacco epidemic. More recently, electronic (e-) hookahs-vaped through traditional waterpipes-were introduced as healthier alternatives to combustible hookah. With combustible tobacco smoking, oxidative stress, inflammation and vascular stiffness are key components in the development and progression of atherosclerosis. The comparable effects of hookah are unknown.RESEARCH QUESTION: What is the differential acute effect of e-hookah vaping vs com...
Source: Chest - July 23, 2021 Category: Respiratory Medicine Authors: Mary Rezk-Hanna Rajat Gupta Charlie O Nettle Daniel Dobrin Chiao-Wei Cheng Angelica Means Mary Lynn-Brecht Donald P Tashkin Jesus A Araujo Source Type: research

Covid-19 and Risk of Venous Thromboembolism in Ethnically Diverse Populations
Chest. 2021 Jul 19:S0012-3692(21)01353-2. doi: 10.1016/j.chest.2021.07.025. Online ahead of print.ABSTRACTBACKGROUND: Limited existing data suggest the novel coronavirus disease 2019 (Covid-19) may increase risk for venous thromboembolism (VTE) but information from large, ethnically diverse populations with appropriate controls are lacking.RESEARCH QUESTION: Does the rate of VTE among adults hospitalized with Covid-19 differ from matched hospitalized controls without Covid-19?STUDY DESIGN AND METHODS: We conducted a retrospective study among hospitalized adults with laboratory-confirmed Covid-19 and hospitalized adults wit...
Source: Chest - July 22, 2021 Category: Respiratory Medicine Authors: Alan S Go Kristi Reynolds Grace H Tabada Priya A Prasad Sue Hee Sung Elisha Garcia Cecilia Portugal Dongjie Fan Ashok P Pai Margaret C Fang Source Type: research

Neonatal lung ultrasound and surfactant administration: a pragmatic, multicenter study
Chest. 2021 Jul 19:S0012-3692(21)01354-4. doi: 10.1016/j.chest.2021.06.076. Online ahead of print.ABSTRACTBACKGROUND: Previous research shows that a lung ultrasound score (LUS) can anticipate CPAP failure in neonatal respiratory distress syndrome.RESEARCH QUESTION: Can LUS also predict the need for surfactant replacement?STUDY DESIGN AND METHODS: Multicenter, pragmatic study on preterm neonates who underwent lung ultrasound at birth and those given surfactant by masked physicians were also scanned within 24 hours from administration. Clinical data and respiratory support variables were recorded. Accuracy of LUS, SatO2/FiO2...
Source: Chest - July 22, 2021 Category: Respiratory Medicine Authors: Francesco Raimondi Fiorella Migliaro Iuri Corsini Fabio Meneghin Luca Pierri Serena Salom è Alessandro Perri Salvatore Aversa Stefano Nobile Silvia Lama Silvia Varano Marilena Savoia Sara Gatto Valentina Leonardi Letizia Capasso Virgilio Paolo Carnielli Source Type: research

Parapneumonic Effusions are characterized by elevated levels of Neutrophil Extracellular Traps (NETs)
Chest. 2021 Jul 19:S0012-3692(21)01357-X. doi: 10.1016/j.chest.2021.07.026. Online ahead of print.ABSTRACTBACKGROUND: Neutrophil Extracellular Traps (NETs) are increasingly implicated in acute and chronic conditions involving multiple organ systems.RESEARCH QUESTION: Are NETs concentrations higher in parapneumonic effusions compared to effusions of other etiologies and does this reflect the inflammatory nature of these effusions?STUDY DESIGN AND METHODS: Patients (N=101) presenting to hospital with undifferentiated pleural effusion for investigation had pleural fluid classified based on cytology, biochemical, microbiologic...
Source: Chest - July 22, 2021 Category: Respiratory Medicine Authors: Scott H Twaddell Peter G Gibson Christopher Grainge Katherine J Baines Source Type: research

Pulmonary arterial hypertension and intraductal papillary mucinous neoplasms of the pancreas: A novel association?
Chest. 2021 Jul 17:S0012-3692(21)01356-8. doi: 10.1016/j.chest.2021.06.078. Online ahead of print.NO ABSTRACTPMID:34284002 | DOI:10.1016/j.chest.2021.06.078 (Source: Chest)
Source: Chest - July 20, 2021 Category: Respiratory Medicine Authors: Michael H Lee Jennifer Doran Tami J Bang Robin Hohsfield Peter Hountras Genevieve Boddie Mihir S Wagh David Badesch Todd M Bull Source Type: research

Veno-Venous Extracorporeal Membrane Oxygenation (ECMO) for Myositis-Associated Rapidly Progressive Interstitial Lung Disease (RP-ILD)
Chest. 2021 Jul 17:S0012-3692(21)01348-9. doi: 10.1016/j.chest.2021.06.075. Online ahead of print.NO ABSTRACTPMID:34284003 | DOI:10.1016/j.chest.2021.06.075 (Source: Chest)
Source: Chest - July 20, 2021 Category: Respiratory Medicine Authors: Jonah Rubin Katharine E Black Robert W Hallowell Alison S Witkin Melissa Lydston Kenneth Shelton Jerome Crowley Yehuda Vogel Yuval Raz Source Type: research

"Fertility and Pregnancy in Cystic fibrosis"
Chest. 2021 Jul 17:S0012-3692(21)01352-0. doi: 10.1016/j.chest.2021.07.024. Online ahead of print.ABSTRACTPeople with Cystic fibrosis (pwCF) have experienced increased survival and wellbeing in recent decades, such that more than half of those living with CF are adults. Consequently, sexual and reproductive health is increasingly important for pwCF as many are considering parenthood. Most men and some women with CF (wwCF) will have reduced fertility, which in both sexes is multifactorial. However, unplanned pregnancies in women are not rare, and contraception and its interaction with CF complications need to be addressed b...
Source: Chest - July 20, 2021 Category: Respiratory Medicine Authors: Michal Shteinberg Jennifer L Taylor-Cousar Isabelle Durieu Malena Cohen-Cymberknoh Source Type: research

Pulmonary arterial hypertension and intraductal papillary mucinous neoplasms of the pancreas: A novel association?
Chest. 2021 Jul 17:S0012-3692(21)01356-8. doi: 10.1016/j.chest.2021.06.078. Online ahead of print.NO ABSTRACTPMID:34284002 | DOI:10.1016/j.chest.2021.06.078 (Source: Chest)
Source: Chest - July 20, 2021 Category: Respiratory Medicine Authors: Michael H Lee Jennifer Doran Tami J Bang Robin Hohsfield Peter Hountras Genevieve Boddie Mihir S Wagh David Badesch Todd M Bull Source Type: research

Veno-Venous Extracorporeal Membrane Oxygenation (ECMO) for Myositis-Associated Rapidly Progressive Interstitial Lung Disease (RP-ILD)
Chest. 2021 Jul 17:S0012-3692(21)01348-9. doi: 10.1016/j.chest.2021.06.075. Online ahead of print.NO ABSTRACTPMID:34284003 | DOI:10.1016/j.chest.2021.06.075 (Source: Chest)
Source: Chest - July 20, 2021 Category: Respiratory Medicine Authors: Jonah Rubin Katharine E Black Robert W Hallowell Alison S Witkin Melissa Lydston Kenneth Shelton Jerome Crowley Yehuda Vogel Yuval Raz Source Type: research

"Fertility and Pregnancy in Cystic fibrosis"
Chest. 2021 Jul 17:S0012-3692(21)01352-0. doi: 10.1016/j.chest.2021.07.024. Online ahead of print.ABSTRACTPeople with Cystic fibrosis (pwCF) have experienced increased survival and wellbeing in recent decades, such that more than half of those living with CF are adults. Consequently, sexual and reproductive health is increasingly important for pwCF as many are considering parenthood. Most men and some women with CF (wwCF) will have reduced fertility, which in both sexes is multifactorial. However, unplanned pregnancies in women are not rare, and contraception and its interaction with CF complications need to be addressed b...
Source: Chest - July 20, 2021 Category: Respiratory Medicine Authors: Michal Shteinberg Jennifer L Taylor-Cousar Isabelle Durieu Malena Cohen-Cymberknoh Source Type: research

Interhospital Transfer of Patients with Acute Pulmonary Embolism (PE): Challenges and Opportunities
Chest. 2021 Jul 14:S0012-3692(21)01336-2. doi: 10.1016/j.chest.2021.07.013. Online ahead of print.ABSTRACTAcute pulmonary embolism (PE) is associated with significant morbidity and mortality. The management paradigm for acute PE has evolved in recent years with wider availability of advanced treatment modalities ranging from catheter-directed reperfusion therapies to mechanical circulatory support. This evolution has coincided with the development and implementation of institutional pulmonary embolism response teams (PERT) nationwide and internationally. Because most institutions are not equipped or staffed for advanced PE...
Source: Chest - July 17, 2021 Category: Respiratory Medicine Authors: Parth Rali Daniel Sacher Belinda Rivera-Lebron Rachel Rosovsky Jean M Elwing Jonathan Berkowitz Bushra Mina Bhavinkumar Dalal George A Davis David M Dudzinski Alicia Duval Eugene Ichinose Christopher Kabrhel Aniruddh Kapoor Ka U Lio Robert Lookstein Micha Source Type: research

Interhospital Transfer of Patients with Acute Pulmonary Embolism (PE): Challenges and Opportunities
Chest. 2021 Jul 14:S0012-3692(21)01336-2. doi: 10.1016/j.chest.2021.07.013. Online ahead of print.ABSTRACTAcute pulmonary embolism (PE) is associated with significant morbidity and mortality. The management paradigm for acute PE has evolved in recent years with wider availability of advanced treatment modalities ranging from catheter-directed reperfusion therapies to mechanical circulatory support. This evolution has coincided with the development and implementation of institutional pulmonary embolism response teams (PERT) nationwide and internationally. Because most institutions are not equipped or staffed for advanced PE...
Source: Chest - July 17, 2021 Category: Respiratory Medicine Authors: Parth Rali Daniel Sacher Belinda Rivera-Lebron Rachel Rosovsky Jean M Elwing Jonathan Berkowitz Bushra Mina Bhavinkumar Dalal George A Davis David M Dudzinski Alicia Duval Eugene Ichinose Christopher Kabrhel Aniruddh Kapoor Ka U Lio Robert Lookstein Micha Source Type: research

Interhospital Transfer of Patients with Acute Pulmonary Embolism (PE): Challenges and Opportunities
Chest. 2021 Jul 14:S0012-3692(21)01336-2. doi: 10.1016/j.chest.2021.07.013. Online ahead of print.ABSTRACTAcute pulmonary embolism (PE) is associated with significant morbidity and mortality. The management paradigm for acute PE has evolved in recent years with wider availability of advanced treatment modalities ranging from catheter-directed reperfusion therapies to mechanical circulatory support. This evolution has coincided with the development and implementation of institutional pulmonary embolism response teams (PERT) nationwide and internationally. Because most institutions are not equipped or staffed for advanced PE...
Source: Chest - July 17, 2021 Category: Respiratory Medicine Authors: Parth Rali Daniel Sacher Belinda Rivera-Lebron Rachel Rosovsky Jean M Elwing Jonathan Berkowitz Bushra Mina Bhavinkumar Dalal George A Davis David M Dudzinski Alicia Duval Eugene Ichinose Christopher Kabrhel Aniruddh Kapoor Ka U Lio Robert Lookstein Micha Source Type: research

How I Do It: Point-of-Care Ultrasound for Bedside Diagnosis of Lower Extremity Deep Venous Thrombosis
This article outlines accepted techniques for the POCUS DVT exam, discusses the historical context from which the current recommendations have evolved, and provides illustrations alongside ultrasound images of relevant venous anatomy to orient the clinician. Finally, common pitfalls and methods to avoid them are described.PMID:34270964 | DOI:10.1016/j.chest.2021.07.010 (Source: Chest)
Source: Chest - July 16, 2021 Category: Respiratory Medicine Authors: Mary E Barrosse-Antle Kamin H Patel Jeffrey A Kramer Cameron M Baston Source Type: research

Screening for Lung Cancer: CHEST Guideline and Expert Panel Report - Executive Summary
CONCLUSIONS: Evidence suggests that low-dose CT screening for lung cancer can result in a favorable balance of benefit and harms. The selection of screen-eligible individuals, the quality of imaging and image interpretation, the management of screen detected findings, and the effectiveness of smoking cessation interventions, can impact this balance.PMID:34270965 | DOI:10.1016/j.chest.2021.07.003 (Source: Chest)
Source: Chest - July 16, 2021 Category: Respiratory Medicine Authors: Peter J Mazzone Gerard A Silvestri Lesley H Souter Tanner J Caverly Jeffrey P Kanne Hormuzd A Katki Renda Soylemez Wiener Frank C Detterbeck Source Type: research

Quantification of Arterial and Venous Morphological Markers in Pulmonary Arterial Hypertension Using Computed Tomography
Chest. 2021 Jul 13:S0012-3692(21)01326-X. doi: 10.1016/j.chest.2021.06.069. Online ahead of print.ABSTRACTBACKGROUND: Pulmonary hypertension is a heterogeneous disease and a significant portion of patients at risk for it have available computed tomography (CT) imaging. Advanced automated processing techniques could be leveraged to for early detection, screening and development of quantitative phenotypes. Pruning and vascular tortuosity have been previously described in pulmonary arterial hypertension (PAH) but the extent of these phenomena in arterial versus venous pulmonary vasculature and in exercise pulmonary hypertensi...
Source: Chest - July 16, 2021 Category: Respiratory Medicine Authors: Farbod N Rahaghi Pietro Nardelli Eileen Harder Inderjit Singh Gonzalo Vegas Sanchez-Ferrero James C Ross Rub én San José Estépar Samuel Y Ash Andetta R Hunsaker Bradley A Maron Jane A Leopold Aaron B Waxman Ra úl San José Estépar George R Washko Source Type: research

Precision Medicine and Heterogeneity of Treatment Effect in Therapies for Acute Respiratory Distress Syndrome
Chest. 2021 Jul 13:S0012-3692(21)01327-1. doi: 10.1016/j.chest.2021.07.009. Online ahead of print.ABSTRACTAcute respiratory distress syndrome (ARDS) is a clinically heterogenous syndrome, rather than a distinct disease. This heterogeneity at least partially explains the difficulty in studying treatments for these patients and contributes to the numerous trials of therapies for the syndrome that have not shown benefit. Recent studies have identified different subphenotypes within the heterogenous patient population. These different subphenotypes likely have variable clinical responses to specific therapies, a concept known ...
Source: Chest - July 16, 2021 Category: Respiratory Medicine Authors: Yasin A Khan Eddy Fan Niall D Ferguson Source Type: research

Screening for Lung Cancer: CHEST Guideline and Expert Panel Report
CONCLUSIONS: Evidence suggests that low-dose CT screening for lung cancer can result in a favorable balance of benefit and harms. The selection of screen-eligible individuals, the quality of imaging and image interpretation, the management of screen detected findings, and the effectiveness of smoking cessation interventions, can impact this balance.PMID:34270968 | DOI:10.1016/j.chest.2021.06.063 (Source: Chest)
Source: Chest - July 16, 2021 Category: Respiratory Medicine Authors: Peter J Mazzone Gerard A Silvestri Lesley H Souter Tanner J Caverly Jeffrey P Kanne Hormuzd A Katki Renda Soylemez Wiener Frank C Detterbeck Source Type: research

How I do it. Work-up of severe asthma
CONCLUSION: After assessment of treatment adherence and exclusion of relevant comorbidities, the patient was found to have severe asthma with ICS-resistant type-2 airway inflammation. We will consider additional treatment options at our next appointment (Part 2/2 of this How I Do It series).PMID:34265308 | DOI:10.1016/j.chest.2021.07.008 (Source: Chest)
Source: Chest - July 15, 2021 Category: Respiratory Medicine Authors: Simon Couillard David J Jackson Michael E Wechsler Ian D Pavord Source Type: research

How I do it. Work-up of severe asthma
CONCLUSION: After assessment of treatment adherence and exclusion of relevant comorbidities, the patient was found to have severe asthma with ICS-resistant type-2 airway inflammation. We will consider additional treatment options at our next appointment (Part 2/2 of this How I Do It series).PMID:34265308 | DOI:10.1016/j.chest.2021.07.008 (Source: Chest)
Source: Chest - July 15, 2021 Category: Respiratory Medicine Authors: Simon Couillard David J Jackson Michael E Wechsler Ian D Pavord Source Type: research

Optimizing diagnostic and staging pathways for suspected lung cancer: a decision analysis
Chest. 2021 Jul 10:S0012-3692(21)01314-3. doi: 10.1016/j.chest.2021.06.065. Online ahead of print.ABSTRACTBACKGROUND: The optimal diagnostic and staging strategy for patients with suspected lung cancer is not known.RESEARCH QUESTION: What diagnostic and staging strategies are most cost-effective for lung cancer?STUDY DESIGN AND METHODS: A decision model was developed using a hypothetical patient with a high probability of lung cancer. Sixteen unique permutations of bronchoscopy with fluoroscopy, radial endobronchial ultrasound (rEBUS), electromagnetic navigation, convex EBUS (cEBUS) with or without rapid-onsite evaluation ...
Source: Chest - July 13, 2021 Category: Respiratory Medicine Authors: Erik Vakil Nsikak Jackson Paula V Sainz-Zu ñega Sofia Molina Gabriella Martinez-Zayas Scott B Cantor Horiana B Grosu Roberto F Casal David E Ost Source Type: research

Optimizing diagnostic and staging pathways for suspected lung cancer: a decision analysis
Chest. 2021 Jul 10:S0012-3692(21)01314-3. doi: 10.1016/j.chest.2021.06.065. Online ahead of print.ABSTRACTBACKGROUND: The optimal diagnostic and staging strategy for patients with suspected lung cancer is not known.RESEARCH QUESTION: What diagnostic and staging strategies are most cost-effective for lung cancer?STUDY DESIGN AND METHODS: A decision model was developed using a hypothetical patient with a high probability of lung cancer. Sixteen unique permutations of bronchoscopy with fluoroscopy, radial endobronchial ultrasound (rEBUS), electromagnetic navigation, convex EBUS (cEBUS) with or without rapid-onsite evaluation ...
Source: Chest - July 13, 2021 Category: Respiratory Medicine Authors: Erik Vakil Nsikak Jackson Paula V Sainz-Zu ñega Sofia Molina Gabriella Martinez-Zayas Scott B Cantor Horiana B Grosu Roberto F Casal David E Ost Source Type: research