Beclomethasone has lesser suppressive effects on inflammation and anti-bacterial immunity than Fluticasone or Budesonide in experimental infection models.
PMID: 32454043 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 23, 2020 Category: Respiratory Medicine Authors: Kamal F, Glanville N, Xia W, Bakhsoliani E, Aniscenko J, Bartlett NW, Edwards MR, Johnston SL, Singanayagam A Tags: Chest Source Type: research

Emotional experiences and coping strategies of family members of critically ill patients.
This study emphasizes similarities in emotions but diversity in coping strategies used by family members in the ICU. Understanding the relationship between ICU experiences, emotional responses, and long-term psychological outcomes may guide targeted interventions to improve mental health outcomes of ICU family members. PMID: 32454044 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 23, 2020 Category: Respiratory Medicine Authors: Harlan EA, Miller J, Costa DK, Fagerlin A, Iwashyna TJ, Chen EP, Lipman K, Valley TS Tags: Chest Source Type: research

Powerless in the ICU: Perspectives from Intensive Care Units in the Face of COVID-19.
PMID: 32454045 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 23, 2020 Category: Respiratory Medicine Authors: Ramachandran P, Swamy L, Kaul V, Agrawal A, Narasimhan M Tags: Chest Source Type: research

Negative Pressure Tent to Reduce Exposure of Health Care Workers to SARS CoV-2 During Aerosol Generating Respiratory Therapies.
PMID: 32454046 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 23, 2020 Category: Respiratory Medicine Authors: Fox TH, Silverblatt M, Lacour A, deBoisblanc BP Tags: Chest Source Type: research

CPAP Adherence, Mortality, and Progression-Free Survival in Interstitial Lung Disease and OSA.
Abstract BACKGROUND: Obstructive sleep apnea (OSA), a common co-morbidity in ILD, could contribute to a worsened course if untreated. It is unclear if adherence to CPAP therapy improves outcomes. METHODS: We conducted a ten-year retrospective observational multicenter cohort study, assessing adult patients with ILD who had undergone polysomnography. Subjects were categorized based on OSA severity into 'no/mild OSA' (AHI
Source: Chest - May 22, 2020 Category: Respiratory Medicine Authors: Adegunsoye A, Neborak JM, Zhu D, Cantrill B, Garcia N, Oldham JM, Noth I, Vij R, Kuzniar TJ, Bellam SK, Strek ME, Mokhlesi B Tags: Chest Source Type: research

Gastroesophageal Reflux Poses a Potential Risk for Late Complications of Bronchopulmonary Dysplasia: A Prospective Cohort Study.
Abstract BACKGROUND: Bronchopulmonary dysplasia (BPD) is the most common respiratory disorder in extremely low birth weight infants. Although most BPD symptoms improve, some late complications exist, even with regular treatment. Gastroesophageal reflux (GER), also common in extremely premature infants, may be related to many cardiorespiratory symptoms. However, the potential of GER as a risk factor for late complications associated with BPD is still unclear. RESEARCH QUESTION: Does GER increase the risk of late complications of BPD in infants? STUDY DESIGN: and Methods: A multi-center prospective cohort ...
Source: Chest - May 22, 2020 Category: Respiratory Medicine Authors: Wang LJ, Hu Y, Wang W, Zhang CY, Bai YZ, Zhang SC Tags: Chest Source Type: research

Differential effect of school-based pollution exposure in children with asthma born prematurely.
PMID: 32450239 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 22, 2020 Category: Respiratory Medicine Authors: Gaffin JM, Hauptman M, Petty CR, Haktanir-Abul M, Gunnlaugsson S, Lai PS, Baxi SN, Permaul P, Sheehan WJ, Wolfson JM, Coull BA, Gold DR, Koutrakis P, Phipatanakul W Tags: Chest Source Type: research

Sensitivity and Safety of Electromagnetic Navigation Bronchoscopy for Lung Cancer Diagnosis: Systematic Review and Meta-analysis.
CONCLUSION: ENB is very safe with good sensitivity for diagnosing malignancy in patients with PPL. The applicability of our findings is limited as the majority of studies were done with the superDimension navigation system and heterogeneity was high. PROSPERO CRD42019109449. PMID: 32450240 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 22, 2020 Category: Respiratory Medicine Authors: Folch EE, Labarca G, Ospina-Delgado D, Kheir F, Majid A, Khandhar SJ, Mehta HJ, Jantz MA, Fernandez-Bussy S Tags: Chest Source Type: research

Circulating Plasma Biomarkers of Survival in Anti-fibrotic Treated Patients with Idiopathic Pulmonary Fibrosis.
Abstract BACKGROUND: A number of circulating plasma biomarkers have been shown to predict survival in patients with idiopathic pulmonary fibrosis (IPF), but most were identified prior to the use of anti-fibrotic therapy (AF) in this population. Because pirfenidone and nintedanib have been shown to slow IPF progression and may prolong survival, the role of such biomarkers in AF treated patients is unclear. RESEARCH QUESTION: To determine whether plasma concentration of CA-125, CXCL13, MMP7, SP-D, YKL-40, VCAM-1 and OPN is associated with differential transplant-free survival (TFS) in AF exposed and non-exposed...
Source: Chest - May 22, 2020 Category: Respiratory Medicine Authors: Adegunsoye A, Alqalyoobi S, Linderholm A, Bowman WS, Lee CT, Pugashetti JV, Sarma N, Ma SF, Haczku A, Sperling A, Strek ME, Noth I, Oldham JM Tags: Chest Source Type: research

Teaching Clinical Reasoning and Critical Thinking: From Cognitive Theory to Practical Application.
Abstract Teaching clinical reasoning is challenging, particularly in the time-pressured and complicated environment of the Intensive Care Unit. Clinical reasoning is a complex process in which one identifies and prioritizes pertinent clinical data to develop a hypothesis and a plan to confirm or refute that hypothesis. Clinical reasoning is related to and dependent on critical thinking skills, which are defined as one's capacity to engage in higher cognitive skills such as analysis, synthesis, and self-reflection. The authors review how an understanding of the cognitive psychological principles that contribute to ...
Source: Chest - May 22, 2020 Category: Respiratory Medicine Authors: Richards JB, Hayes MM, Schwartzstein RM Tags: Chest Source Type: research

Scarce resource allocation scores threaten to exacerbate racial disparities in healthcare.
PMID: 32450243 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 22, 2020 Category: Respiratory Medicine Authors: Miller WD, Peek ME, Parker WF Tags: Chest Source Type: research

Clinical phenotypes of atopy and asthma in COPD: a meta-analysis of SPIROMICS and COPDGene.
Wise RA, Diette GB, Hersh CP, Hansel NN Abstract BACKGROUND: Little is known about the concordance of atopy with asthma COPD overlap (ACO). Among individuals with COPD, a better understanding of the phenotypes characterized by asthma overlap and atopy is needed to better target therapies. RESEARCH QUESTION: What is the overlap between atopy and asthma status among individuals with COPD, and how are categories defined by the presence of atopy and asthma status associated with clinical and radiologic phenotypes and outcomes in the SPIROMICS and COPDGene studies? STUDY DESIGN AND METHODS: 403 individuals w...
Source: Chest - May 22, 2020 Category: Respiratory Medicine Authors: Putcha N, Fawzy A, Matsui EC, Liu M, Bowler RP, Woodruff P, O'Neal WK, Comellas AP, Han MK, Dransfield M, Wells JM, Lugogo N, Gao L, Talbot CC, Hoffman E, Cooper CB, Paulin LM, Kanner RE, Criner G, Ortega VE, Barr RG, Krishnan JA, Martinez FJ, Drummond MB Tags: Chest Source Type: research

A systematic review of the effect of delayed appropriate antibiotic treatment on the outcomes of patients with severe bacterial infections.
Abstract BACKGROUND: Patients with severe bacterial infections often experience delay in receiving appropriate treatment. Consolidated evidence of the impact of delayed appropriate treatment is needed to guide treatment and improve outcomes. RESEARCH QUESTION: What is the impact of delayed appropriate antibacterial therapy on clinical outcomes in patients with severe bacterial infections. STUDY DESIGN: and Methods.Literature searches of MEDLINE and Embase, conducted on 24 July 2018, identified studies published after 2007 reporting the impact of delayed appropriate therapy on clinical outcomes for hospit...
Source: Chest - May 21, 2020 Category: Respiratory Medicine Authors: Zasowski EJ, Bassetti M, Blasi F, Goossens H, Rello J, Sotgiu G, Tavoschi L, Arber MR, McCool R, Patterson JV, Longshaw CM, Lopes S, Manissero D, Nguyen ST, Tone K, Aliberti S Tags: Chest Source Type: research

Vaping-related Acute Parenchymal Lung Injury: A Systematic Review.
Abstract The ongoing U.S. outbreak of vaping-related acute lung injury, recently named EVALI (E-cigarette or vaping product use associated acute lung injury), has reignited concerns about the health effects of vaping. Initial case reports of vaping-related lung injury date back to 2012, but the ongoing outbreak of EVALI began in the summer of 2019 and has been implicated in 2,807 cases and 68 deaths as of this writing. Review of the scientific literature reveals 216 patient cases spanning 41 reports of parenchymal lung injury attributed to vaping. In this review, we detail the clinical, radiographic, pathologic pa...
Source: Chest - May 19, 2020 Category: Respiratory Medicine Authors: Jonas AM, Raj R Tags: Chest Source Type: research

Pressure-support ventilation versus T-piece during spontaneous breathing trials before extubation among patients at high-risk of extubation failure: a post-hoc analysis of a clinical trial.
P, Terzi N, Dellamonica J, Lacave G, Robert R, Ragot S, Frat JP, HIGH-WEAN Study Group and for the REVA Research Network Abstract BACKGROUND: Spontaneous breathing trial (SBT) using T-piece remains the most frequently performed trial before extubation in ICUs. RESEARCH QUESTION: We aimed at determining whether initial SBT using pressure-support ventilation (PSV) could increase successful extubation rates among patients at high-risk of extubation failure. STUDY DESIGN: and Methods: Post-hoc analysis of a multicenter trial focusing on reintubation in patients at high-risk of extubation failure. The initial...
Source: Chest - May 18, 2020 Category: Respiratory Medicine Authors: Thille AW, Coudroy R, Nay MA, Gacouin A, Demoule A, Sonneville R, Beloncle F, Girault C, Dangers L, Lautrette A, Levrat Q, Rouzé A, Vivier E, Lascarrou JB, Ricard JD, Razazi K, Barberet G, Lebert C, Ehrmann S, Massri A, Bourenne J, Pradel G, Bailly P, Te Tags: Chest Source Type: research

Serum IgG Levels and Risk of COPD Hospitalization: A Pooled Meta-Analysis.
Yusen RD, Au DH, Pike KC, Fan VS, Leung JM, Man SP, Aaron SD, Reed RM, Sin DD Abstract BACKGROUND: Hypogammaglobulinemia (serum immunoglobulin G (IgG) levels
Source: Chest - May 18, 2020 Category: Respiratory Medicine Authors: Leitao Filho FS, Mattman A, Schellenberg R, Criner GJ, Woodruff P, Lazarus SC, Albert RK, Connett J, Han MK, Gay SE, Martinez FJ, Fuhlbrigge AL, Stoller JK, MacIntyre NR, Casaburi R, Diaz P, Panos RJ, Cooper JA, Bailey WC, LaFon DC, Sciurba FC, Kanner RE, Tags: Chest Source Type: research

Screening Adherence in the Veterans Administration Lung Cancer Screening Demonstration Project.
Abstract BACKGROUND: Adherence to annual low-dose computed tomography was 95% in the National Lung Screening Trial and must be replicated in order to achieve mortality benefit from screening. RESEARCH QUESTION: Determine adherence rates within the Veterans Affairs Lung Cancer Screening Demonstration Project (LCSDP) and identify factors predictive of adherence. STUDY DESIGN: and Methods: A secondary data analysis of the LCSDP conducted at 8 VA medical centers was performed to determine adherence to follow-up imaging and determine factors predictive of adherence. RESULTS: A total of 2103 patients were...
Source: Chest - May 18, 2020 Category: Respiratory Medicine Authors: Tanner NT, Brasher PB, Wojciechowski B, Ward R, Slatore C, Gebregziabher M, Silvestri GA Tags: Chest Source Type: research

Mortality risk prediction in amyopathic dermatomyositis associated with interstitial lung disease: the FLAIR model.
Abstract BACKGROUND: The prognosis of amyopathic dermatomyositis (ADM)-associated interstitial lung disease (ILD) is poor. A mortality risk score model is needed to predict survival in patients with ADM-ILD and guide clinical treatment. RESEARCH QUESTION: How to identify ADM-ILD patients at high risk and to predict patients' outcome based on a risk stratification model? STUDY DESIGN: and Methods: We evaluated 207 patients with ADM-ILD in this prospective inception study. We used a multivariable Cox proportional hazards model to identify the independent prognostic risk factors and created a risk score mod...
Source: Chest - May 16, 2020 Category: Respiratory Medicine Authors: Lian X, Zou J, Guo Q, Chen S, Lu L, Wang R, Zhou M, Fu Q, Ye Y, Bao C Tags: Chest Source Type: research

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for PD-L1 Testing In Non-Small Cell Lung Cancer.
This study investigates sampling adequacy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for PD-L1 testing when compared to other methods. Furthermore, the relationship between clinico-pathological characteristics and PD-L1 expression in the study population have been examined. METHODS: Five hundred seventy-seven NSCLC specimens were analysed from consecutive patients with NSCLC across six centres in United Kingdom and one in the United States between January 2015 and December 2016. MAIN RESULTS: In the EBUS-TBNA group (189 specimens), the overall percentage of patients with succe...
Source: Chest - May 16, 2020 Category: Respiratory Medicine Authors: Perrotta F, Nankivell M, Adizie B, Maqsood U, Elshafi M, Jafri S, Lerner AD, Woolhouse I, Munavvar M, Evison M, Booton R, Baldwin DR, Janes SM, Kerr KM, Bianco A, Yarmus L, Navani N Tags: Chest Source Type: research

Effectiveness of an Opt-Out Electronic-Heath Record-based Tobacco Treatment Consult Service at an Urban Safety-Net Hospital.
Abstract BACKGROUND: To address the burden of tobacco use in underserved populations, our safety-net hospital developed a tobacco treatment intervention consisting of an "opt-out" Electronic Health Record (EHR)-based Best Practice Alert (BPA)+order-set, which triggers consultation to an inpatient Tobacco Treatment Consult (TTC) service for all hospitalized smokers. RESEARCH QUESTION: We sought to understand if the intervention would increase patient-level outcomes (receipt of tobacco treatment during hospitalization and at discharge; 6-month smoking abstinence), and improve hospital-wide performance...
Source: Chest - May 16, 2020 Category: Respiratory Medicine Authors: Herbst N, Wiener RS, Helm ED, O'Donnell C, Fitzgerald C, Wong C, Bulekova K, Waite M, Mishuris RG, Kathuria H Tags: Chest Source Type: research

Effects of anti-T2 biologic treatment on lung ventilation evaluated by MRI in adults with prednisone-dependent asthma.
Abstract BACKGROUND: The functional consequence of airway obstruction in asthma can be regionally measured using inhaled gas magnetic resonance imaging (MRI). Ventilation defects visualized by MRI persist post-bronchodilator in severe asthmatics with uncontrolled sputum eosinophilia and may be due to eosinophil driven airway pathology that is responsive to "anti-T2" therapy. RESEARCH QUESTION: Do anti-T2 therapies that clear eosinophils from the airway lumen decrease ventilation defects, measured by inhaled gas MRI, in adults with prednisone-dependent asthma? STUDY DESIGN: and Methods: Inhaled ...
Source: Chest - May 16, 2020 Category: Respiratory Medicine Authors: Svenningsen S, Eddy RL, Kjarsgaard M, Parraga G, Nair P Tags: Chest Source Type: research

Characteristics of Effective Teachers of Invasive Bedside Procedures: A Multi-Institutional Qualitative Study.
Abstract BACKGROUND: Faculty supervision of invasive bedside procedures (IBPs) in the intensive care unit (ICU) may enhance procedural education and ensure patient safety. However, there is limited research on teaching effectiveness in the ICU and there are no best teaching practices regarding the supervision of IBPs. RESEARCH QUESTION: We conducted a multi-institutional qualitative study of pulmonary and critical care medicine (PCCM) faculty and fellows to better understand characteristics of effective IBP teachers. STUDY DESIGN: and Methods: Separate focus groups (FGs) were conducted with fellows and f...
Source: Chest - May 16, 2020 Category: Respiratory Medicine Authors: Kelm DJ, Ridgeway JL, Ratelle JT, Sawatsky AP, Halvorsen AJ, Niven AS, Brady A, Hayes MM, McSparron JI, Ramar K, Beckman TJ Tags: Chest Source Type: research

Baseline Characteristics and Progression of a Spectrum of Interstitial Lung Abnormalities and Disease in Rheumatoid Arthritis.
Abstract BACKGROUND: Interstitial lung abnormalities (ILA) and interstitial lung disease (ILD) are seen in up to 60% of individuals with rheumatoid arthritis (RA), some of which will progress to have a significant impact on morbidity and mortality. Better characterization of progressive interstitial changes and identification of risk factors associated with progression may enable earlier intervention and improved outcomes. RESEARCH QUESTION: what are baseline characteristics associated with RA-ILD progression? STUDY DESIGN: and Methods: Retrospective study where all clinically-indicated computed tomograp...
Source: Chest - May 16, 2020 Category: Respiratory Medicine Authors: Kawano-Dourado L, Doyle TJ, Bonfiglioli K, Sawamura MVY, Nakagawa RH, Arimura FE, Lee HJ, Arrais de Souza Rangel D, Bueno C, Carvalho CRR, Sabbag ML, Molina C, Rosas IO, Kairalla RA Tags: Chest Source Type: research

The Lung Function Laboratory to Assist Clinical-Decision Making in Pulmonology: Evolving Challenges to an Old Issue.
Abstract The lung function laboratory frequently provides relevant information to the practice of Pulmonology. Clinical interpretation of pulmonary function and exercise tests, however, has more recently been complicated by temporal changes in demographics (higher life expectancy) and anthropometric attributes (increased obesity prevalence) and the surge of polypharmacy in a sedentary population suffering from multiple chronic-degenerative diseases. In this narrative review, we concisely discuss some key challenges to testing interpretation which have been impacted from these epidemiological shifts: a) the confoun...
Source: Chest - May 16, 2020 Category: Respiratory Medicine Authors: Neder JA, Berton DC, O'Donnell DE Tags: Chest Source Type: research

KEY HIGHLIGHTS of the Canadian Thoracic Society's Position Statement on the Optimization of Chronic Obstructive Pulmonary Disease Management during the COVID-19 Pandemic.
PMID: 32422130 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 15, 2020 Category: Respiratory Medicine Authors: Bhutani M, Hernandez P, Bourbeau J, Dechman G, Penz E, Aceron R, Beauchamp M, Wald J, Stickland M, Olsen SR, Goodridge D Tags: Chest Source Type: research

Better with Ultrasound: Thoracic Ultrasound.
This article outlines the basic building blocks that make up a thoracic ultrasound exam, regardless of which specific scanning protocol is performed. Narrative videos and illustrative figures demonstrating these techniques are included. PMID: 32422131 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 15, 2020 Category: Respiratory Medicine Authors: Hendin A, Koenig S, Millington SJ Tags: Chest Source Type: research

Prevalence of anti-neutrophil cytoplasmic antibodies and associated vasculitis in chronic obstructive pulmonary disease associated with alpha-1-antitrypsin deficiency: an ancillary study to a prospective study on 180 French patients.
PMID: 32417149 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 14, 2020 Category: Respiratory Medicine Authors: Deshayes S, Silva NM, Khoy K, Mariotte D, Le Mauff B, Mornex JF, Pison C, Cuvelier A, Balduyck M, Pujazon MC, Fournier M, Ilalne BA, Thabut G, Mal H, Aouba A Tags: Chest Source Type: research

Fatigue Symptoms during the First Year after ARDS.
PMID: 32416159 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 13, 2020 Category: Respiratory Medicine Authors: Savino S, Maurizia C, Alberto VC Tags: Chest Source Type: research

Not Just Little ARDS? Pediatric Critical Care and Biomarkers for Pediatric Acute Respiratory Distress Syndrome.
PMID: 32416160 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 13, 2020 Category: Respiratory Medicine Authors: Carroll CL Tags: Chest Source Type: research

Intermittent enteral nutrition as a sole intervention has no impact on muscle wasting in critical illness.
INTERMITTENT ENTERAL NUTRITION AS A SOLE INTERVENTION HAS NO IMPACT ON MUSCLE WASTING IN CRITICAL ILLNESS. Chest. 2020 May 13;: Authors: Ridley EJ, Peake SL PMID: 32416161 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 13, 2020 Category: Respiratory Medicine Authors: Ridley EJ, Peake SL Tags: Chest Source Type: research

A National Strategy for Ventilator and ICU Resource Allocation During the COVID-19 Pandemic.
PMID: 32413343 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 12, 2020 Category: Respiratory Medicine Authors: Ramachandran P, Swamy L, Kaul V, Agrawal A Tags: Chest Source Type: research

Ventilators-by-Lottery: The Least Unjust Form of Allocation in the COVID-19 Pandemic.
PMID: 32413344 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 12, 2020 Category: Respiratory Medicine Authors: Silva DS Tags: Chest Source Type: research

Building the Pyramids.
PMID: 32413345 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 12, 2020 Category: Respiratory Medicine Authors: Bhatt A, Nair S, Postelnicu R, Basavaraj A, Uppal A, Mukherjee V Tags: Chest Source Type: research

Paediatric patients of outreach specialist Queensland clinics have lung function improvement comparable to that of tertiary paediatric patients.
Abstract BACKGROUND: Inequitable access to quality healthcare contributes to the known poorer outcomes of people living in regional/remote areas (c.f. urban-based), especially for First Nations people. Integration of specialist outreach services within primary care is one strategy that can reduce the inequity when modelled to the needs and available resources of target communities. RESEARCH QUESTION: To evaluate whether respiratory outreach clinics in regional and remote Queensland are as effective as tertiary respiratory services at improving the lung function of children. STUDY DESIGN AND METHODS: From...
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: Collaro AJ, Chang AB, Marchant JM, Rodwell LT, Masters IB, Chatfield MD, McElrea MS Tags: Chest Source Type: research

Chicken soup in the time of COVID.
PMID: 32387517 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: Rennard SI, Kalil AC, Casaburi R Tags: Chest Source Type: research

Managing fatigue in patients with interstitial lung disease.
Abstract Fatigue is one of the most burdensome symptoms in interstitial lung disease (ILD), and can have a major impact on quality of life of patients, social interactions and work capacity. The etiology of fatigue is complex, and it is caused or aggravated by a combination of different predisposing, precipitating and perpetuating factors. There is no uniform definition of fatigue, but it is often divided in a physical and mental component. Several validated questionnaires can be used for structural assessment of fatigue in daily care. Although the high burden of fatigue in ILD is increasingly recognized, studies ...
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: Kahlmann V, Moor CC, Wijsenbeek MS Tags: Chest Source Type: research

Cardiorespiratory progression over 5 years and role of corticosteroids in DMD: a single site retrospective longitudinal study.
Abstract BACKGROUND: Duchenne muscular dystrophy (DMD) boys treated with corticosteroids (CS) have prolonged survival and respiratory function when compared to CS-naïve. RESEARCH QUESTION: The differential impact of frequently used corticosteroids and their regimens on long-term (>5 years) cardiorespiratory progression in DMD children is unknown STUDY DESIGN: and Methods. Retrospective longitudinal study including DMD children followed at Dubowitz Neuromuscular Centre (Great Ormond Street Hospital London), May 2000-June 2017. Patients enrolled in any interventional clinical trials were excluded. We co...
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: Trucco F, Domingos J, Tay CG, Ridout D, Maresh K, Munot P, Sarkozy A, Robb S, Quinlivan R, Riley M, Burch M, Fenton M, Wallis C, Chan E, Abel F, Manzur A, Muntoni F Tags: Chest Source Type: research

The Trouble with Group 3 Pulmonary Hypertension in Interstitial Lung Disease: Dilemmas in Diagnosis and the Conundrum of Treatment.
Abstract Pulmonary hypertension due to interstitial lung disease (PH-ILD) can complicate a multitude of interstitial lung diseases including idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonitis, and non-specific interstitial pneumonitis. Development of PH-ILD is associated with increased need for supplemental oxygen, reduced mobility, and decreased survival. A high index of suspicion is required to make the diagnosis given the substantial overlap in symptoms with those of interstitial lung disease without PH. Severely reduced diffusing capacity or six-minute walk test distance, prominent exertional ...
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: King CS, Shlobin OA Tags: Chest Source Type: research

Patient versus Clinician Perspectives on Communication about Results of Lung Cancer Screening: A Qualitative Study.
Abstract BACKGROUND: In the incidental pulmonary nodule and breast cancer screening settings, high-quality patient-centered communication can improve adherence to evaluation and mitigate patient distress. While guidelines emphasize shared decision-making prior to lung cancer screening, little is known about patient-clinician communication following lung cancer screening. RESEARCH QUESTION: How do patients and clinicians perceive communication and results notification following lung cancer screening, and are there approaches that may mitigate or exacerbate distress? STUDY DESIGN: and Methods: We conducted...
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: Wiener RS, Clark JA, Koppelman E, Bolton R, Fix GM, Slatore CG, Kathuria H Tags: Chest Source Type: research

Comparison of diagnostic sleep studies in hospitalized neurorehabilitation patients with moderate to severe traumatic brain injury.
This study aimed to evaluate the non-inferiority and diagnostic accuracy of a portable Level 3 sleep study relative to Level 1 polysomnography in hospitalized neurorehabilitation patients with traumatic brain injury. STUDY DESIGN: and Methods: This is a prospective clinical trial conducted at six TBI Model System study sites between 05/2017 and 02/2019. Of 896 admissions, 449 were screened and eligible for the trial with 345 consented. Additional screening left 263 eligible for and completing simultaneous administration of both Level 1 and 3 sleep studies with final analyses completed on n=214 (median age=42; ED Glasg...
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: Nakase-Richardson R, Schwartz DJ, Ketchum JM, Drasher-Phillips L, Dahdah MN, Monden KR, Bell K, Hoffman J, Whyte J, Bogner J, Calero K, Magalang U Tags: Chest Source Type: research

Typology of Published Randomized Controlled Trials investigating initial ventilation strategy in Critically Ill Patients with Acute Respiratory Failure-A methodological review.
CONCLUSIONS: The typology of published RCTs in ARF patients could be used to frame future trial designs in this field, and guide clinicians and researchers towards optimal research transfer to the bedside. PMID: 32387523 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: Dumas G, Chevret S, Le Corre M, Lemiale V, Jaber S, Azoulay E Tags: Chest Source Type: research

Loyola University Chicago Stritch School of Medicine - Division of Pulmonary and Critical Care Medicine.
PMID: 32387524 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: Dilling D Tags: Chest Source Type: research

Rurality, Stage-Stratified Use of Treatment Modalities and Survival of Non-small Cell Lung Cancer.
We examined guideline-concordant use of active treatment for NSCLC across 5 institutions in one community-based healthcare system spanning 44% of the Delta Regional Authority catchment area from 2011-2017. Institution- and patient-level rurality were based on Rural-Urban Commuting Area codes. Chi-squared, F-tests, and logistic regressions were used to analyze differences across institutions and rurality; survival was examined using log-rank tests and Cox regression. RESULTS: Of 6,259 patients, 47% resided in rural areas; 2 of 5 institutions were rurally located and provided care for 20% of patients. Compared to rural ...
Source: Chest - May 6, 2020 Category: Respiratory Medicine Authors: Ray MA, Faris NR, Derrick A, Smeltzer MP, Osarogiagbon RU Tags: Chest Source Type: research

Critical Conversations: Say This, Not That.
PMID: 32376149 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - May 3, 2020 Category: Respiratory Medicine Authors: Malek J, Bibler TM, Childress A, Crist J, Fedson S, Horner C, Moore B, Nelson R Tags: Chest Source Type: research

The Use of Bronchoscopy during the COVID-19 Pandemic: CHEST/AABIP Guideline and Expert Panel Report.
CONCLUSIONS: The evidence on the role of bronchoscopy during the COVID-19 pandemic is sparse. To maximize protection of patients and HCW, bronchoscopy should be used sparingly in the evaluation and management of patients with suspected or confirmed COVID-19 infections. In an area where community transmission of COVID-19 infection is present, bronchoscopy should be deferred for non-urgent indications and, if necessary to perform, HCW should wear personal protective equipment while performing the procedure even on asymptomatic patients. PMID: 32361152 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - April 30, 2020 Category: Respiratory Medicine Authors: Wahidi MM, Shojaee S, Lamb CR, Ost D, Maldonado F, Eapen G, Caroff DA, Stevens MP, Ouellette DR, Lilly C, Gardner DD, Glisinski K, Pennington K, Alalawi R Tags: Chest Source Type: research

When the game changes: Guidance to adjust sarcoidosis management during the COVID-19 pandemic.
PMID: 32360495 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - April 29, 2020 Category: Respiratory Medicine Authors: Sweiss NJ, Korsten P, Syed H, Syed A, Baughman RP, Yee AMF, Culver DA, Sosenko T, Azuma A, Bonella F, Costabel U, Drake WP, Drent M, Lower EE, Israel-Biet D, Mostard RL, Nunes H, Rottoli P, Spagnolo P, Wells AU, Wuyts WA, Judson MA Tags: Chest Source Type: research

Histopathological comparison of endobronchial biopsies from different pulmonary lobes of severe asthmatic patients.
PMID: 32360725 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - April 28, 2020 Category: Respiratory Medicine Authors: Karakioulaki M, Koletsa T, Papakonstantinou E, Savic S, Grize L, Jahn K, Tamm M, Stolz D Tags: Chest Source Type: research

Swimming-Induced Pulmonary Edema - diagnostic criteria validated by lung ultrasound.
n AB Abstract BACKGROUND: Despite increasing popularity of open water swimming worldwide, swimming induced pulmonary edema (SIPE) is a poorly recognized condition lacking established diagnostic criteria. RESEARCH QUESTION: To determine diagnostic criteria of SIPE during a large open water swimming event. STUDY DESIGN: Cross-sectional study METHODS: In total 17,904 individuals swam 1000, 1500 or 3000 m in cold open water during Sweden's largest open water swimming event in 2018 and 2019. Out of 166 swimmers seeking medical attention for acute respiratory symptoms, 160 were included in the study. Medical h...
Source: Chest - April 28, 2020 Category: Respiratory Medicine Authors: Hårdstedt M, Seiler C, Kristiansson L, Lundeqvist D, Klingberg C, Eriksson AB Tags: Chest Source Type: research

Prognostic value of lung ultrasound B-lines in systemic sclerosis.
Abstract BACKGROUND: A high percentage of systemic sclerosis (SSc) patients develop interstitial lung disease (ILD) during the disease course. Recent data have shown that lung ultrasound (LUS) can assess ILD by the evaluation of B-lines, the sonographic sign of pulmonary interstitial involvement. Our aim was to establish the prognostic value of B-lines in a large number of SSc patients. METHODS: A total of 396 consecutive SSc patients, enrolled at three Rheumatology Departments, underwent a comprehensive LUS examination on the antero-lateral and posterior chest for a total of 58 scanning sites. All available ...
Source: Chest - April 28, 2020 Category: Respiratory Medicine Authors: Gargani L, Bruni C, Romei C, Frumento P, Moreo A, Agoston G, Guiducci S, Bellando-Randone S, Lepri G, Belloli L, Della Rossa A, Delle Sedie A, Stagnaro C, De Nes M, Salvadori S, Mosca M, Falaschi F, Epis O, Picano E, Matucci-Cerinic M Tags: Chest Source Type: research

Incidence and risk model development for severe tachypnea following terminal extubation.
CONCLUSIONS: Up to one-third of ICU patients undergoing PVW experience severe tachypnea. Administration of pre-extubation opiates (anticipatory dosing) represents a key modifiable factor that may reduce poor symptom control. PMID: 32360728 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - April 28, 2020 Category: Respiratory Medicine Authors: Fehnel CR, Armengol de la Hoz M, Celi LA, Campbell ML, Hanafy K, Nozari A, White DB, Mitchell SL Tags: Chest Source Type: research