Diagnosis and Evaluation of Hypersensitivity Pneumonitis: CHEST Guideline and Expert Panel Report
CONCLUSIONS: Diagnosis of HP should employ a patient-centered approach and include multidisciplinary assessment that incorporates the environmental and occupational exposure history and CT pattern to establish diagnostic confidence before considering bronchoalveolar lavage and/or lung biopsy. Criteria are presented to facilitate diagnosis of HP. Additional research is needed on the performance characteristics and generalizability of exposure assessment tools and traditional and new diagnostic tests in modifying clinical decision-making for HP, particularly among those with a provisional diagnosis.PMID:33861992 | DOI:10.101...
Source: Chest - April 16, 2021 Category: Respiratory Medicine Authors: Evans R Fern ández Pérez William D Travis David A Lynch Kevin K Brown Kerri A Johannson Mois és Selman Jay H Ryu Athol U Wells Yuh-Chin Tony Huang Carlos A C Pereira Mary-Beth Scholand Ana Villar Naohiko Inase Richard B Evans Stephen Mette Lindsy Fraze Source Type: research

The Utility of Chest CT imaging in suspected or diagnosed COVID-19 Patients - a review of literature
Chest. 2021 Apr 13:S0012-3692(21)00689-9. doi: 10.1016/j.chest.2021.04.004. Online ahead of print.ABSTRACTThe COVID-19 pandemic has had devastating medical and economic consequences globally. The severity of COVID-19 is related, in a large measure, to the extent of pulmonary involvement. The role of chest CT in the management of patients with COVID-19 has evolved since the onset of the pandemic. Specifically, the description of CT findings, use of CT chest in various acute and subacute settings and its usefulness in predicting chronic disease have been better defined. We performed a review of published data on CT scans in ...
Source: Chest - April 16, 2021 Category: Respiratory Medicine Authors: Stephen Machnicki Dhara Patel Anup Singh Arunabh Talwar Bushra Mina Margarita Oks Priyanka Makkar David Naidich Atul Mehta Nicholas Hill Kevin Brown Suhail Raoof Source Type: research

Hospital-acquired infections in critically-ill COVID-19 patients
Chest. 2021 Apr 12:S0012-3692(21)00679-6. doi: 10.1016/j.chest.2021.04.002. Online ahead of print.ABSTRACTBACKGROUND: Few small studies have described hospital-acquired infections (HAIs) during COVID-19.RESEARCH QUESTION: What patient characteristics in critically ill patients with COVID-19 are associated with HAIs and how do HAIs associate with outcomes in these patients?STUDY DESIGN AND METHODS: Multicenter retrospective analysis of prospectively collected data including adult patients with severe COVID-19, admitted to 8 Italian hub hospitals from February 20, 2020, to May 20, 2020. Descriptive statistics, univariable an...
Source: Chest - April 15, 2021 Category: Respiratory Medicine Authors: Giacomo Grasselli Vittorio Scaravilli Davide Mangioni Luigia Scudeller Laura Alagna Michele Bartoletti Giacomo Bellani Emanuela Biagioni Paolo Bonfanti Nicola Bottino Irene Coloretti Salvatore Lucio Cutuli Gennaro De Pascale Daniela Ferlicca Gabriele Fior Source Type: research

Hospital-acquired infections in critically-ill COVID-19 patients
Chest. 2021 Apr 12:S0012-3692(21)00679-6. doi: 10.1016/j.chest.2021.04.002. Online ahead of print.ABSTRACTBACKGROUND: Few small studies have described hospital-acquired infections (HAIs) during COVID-19.RESEARCH QUESTION: What patient characteristics in critically ill patients with COVID-19 are associated with HAIs and how do HAIs associate with outcomes in these patients?STUDY DESIGN AND METHODS: Multicenter retrospective analysis of prospectively collected data including adult patients with severe COVID-19, admitted to 8 Italian hub hospitals from February 20, 2020, to May 20, 2020. Descriptive statistics, univariable an...
Source: Chest - April 15, 2021 Category: Respiratory Medicine Authors: Giacomo Grasselli Vittorio Scaravilli Davide Mangioni Luigia Scudeller Laura Alagna Michele Bartoletti Giacomo Bellani Emanuela Biagioni Paolo Bonfanti Nicola Bottino Irene Coloretti Salvatore Lucio Cutuli Gennaro De Pascale Daniela Ferlicca Gabriele Fior Source Type: research

BLESS models: Improving Survival Prediction in Patients with Malignant Pleural Effusion and Metastasis
Chest. 2021 Apr 11:S0012-3692(21)00676-0. doi: 10.1016/j.chest.2021.03.059. Online ahead of print.ABSTRACTBACKGROUND: Evidence-based guidelines recommend management strategies for malignant pleural effusions (MPE) based on life expectancy. Existent risk-prediction rules do not provide precise individualized survival estimates.RESEARCH QUESTION: Can a newly developed continuous risk-prediction survival model for patients with MPE and known metastatic disease provide precise survival estimates?STUDY DESIGN AND METHODS: Single-center retrospective cohort study of patients with proven malignancy, pleural effusion, and known me...
Source: Chest - April 14, 2021 Category: Respiratory Medicine Authors: Sofia Molina Gabriela Martinez-Zayas Paula V Sainz Cheuk H Leung Liang Li Horiana B Grosu Roberto Adachi David E Ost Source Type: research

A randomized trial of Mycobacterium w in severe presumed Gram-negative sepsis (MIST)
Chest. 2021 Apr 11:S0012-3692(21)00680-2. doi: 10.1016/j.chest.2021.03.062. Online ahead of print.ABSTRACTBACKGROUND: Mycobacterium w (Mw), an immunomodulator, has been shown to resolve early organ failure in severe sepsis.RESEARCH QUESTION: Does Mw improve survival in subjects with severe presumed Gram-negative sepsis?STUDY DESIGN: and methods: This was a randomized, double-blind, placebo-controlled, parallel-group study conducted in intensive care units (ICUs) of five tertiary care centers in India. We included consecutive subjects (aged ≥18 years) with presumed Gram-negative sepsis in the study within 48 hours of the...
Source: Chest - April 14, 2021 Category: Respiratory Medicine Authors: Inderpaul Singh Sehgal Nita M Basumatary Sahajal Dhooria Kuruswamy Thurai Prasad Valliappan Muthu Ashutosh N Aggarwal Arnab Pal Maharshi Desai Dhruva Chaudhry Pravin Dinkar Supe Prakash Kurmi Rajat Choudhuri Chaitri Shah Ritesh Agarwal Source Type: research

BLESS models: Improving Survival Prediction in Patients with Malignant Pleural Effusion and Metastasis
Chest. 2021 Apr 11:S0012-3692(21)00676-0. doi: 10.1016/j.chest.2021.03.059. Online ahead of print.ABSTRACTBACKGROUND: Evidence-based guidelines recommend management strategies for malignant pleural effusions (MPE) based on life expectancy. Existent risk-prediction rules do not provide precise individualized survival estimates.RESEARCH QUESTION: Can a newly developed continuous risk-prediction survival model for patients with MPE and known metastatic disease provide precise survival estimates?STUDY DESIGN AND METHODS: Single-center retrospective cohort study of patients with proven malignancy, pleural effusion, and known me...
Source: Chest - April 14, 2021 Category: Respiratory Medicine Authors: Sofia Molina Gabriela Martinez-Zayas Paula V Sainz Cheuk H Leung Liang Li Horiana B Grosu Roberto Adachi David E Ost Source Type: research

A randomized trial of Mycobacterium w in severe presumed Gram-negative sepsis (MIST)
Chest. 2021 Apr 11:S0012-3692(21)00680-2. doi: 10.1016/j.chest.2021.03.062. Online ahead of print.ABSTRACTBACKGROUND: Mycobacterium w (Mw), an immunomodulator, has been shown to resolve early organ failure in severe sepsis.RESEARCH QUESTION: Does Mw improve survival in subjects with severe presumed Gram-negative sepsis?STUDY DESIGN: and methods: This was a randomized, double-blind, placebo-controlled, parallel-group study conducted in intensive care units (ICUs) of five tertiary care centers in India. We included consecutive subjects (aged ≥18 years) with presumed Gram-negative sepsis in the study within 48 hours of the...
Source: Chest - April 14, 2021 Category: Respiratory Medicine Authors: Inderpaul Singh Sehgal Nita M Basumatary Sahajal Dhooria Kuruswamy Thurai Prasad Valliappan Muthu Ashutosh N Aggarwal Arnab Pal Maharshi Desai Dhruva Chaudhry Pravin Dinkar Supe Prakash Kurmi Rajat Choudhuri Chaitri Shah Ritesh Agarwal Source Type: research

Fast development of high quality vaccines in a pandemic
Chest. 2021 Apr 10:S0012-3692(21)00681-4. doi: 10.1016/j.chest.2021.03.063. Online ahead of print.NO ABSTRACTPMID:33848535 | DOI:10.1016/j.chest.2021.03.063 (Source: Chest)
Source: Chest - April 13, 2021 Category: Respiratory Medicine Authors: Lauren Pischel Inci Yildirim Saad B Omer Source Type: research

Adiposity and interstitial lung abnormalities in community dwelling adults: the MESA cohort study
Chest. 2021 Apr 9:S0012-3692(21)00675-9. doi: 10.1016/j.chest.2021.03.058. Online ahead of print.ABSTRACTBACKGROUND: Obesity is associated with restrictive ventilatory defects and faster rate of decline in forced vital capacity (FVC). This association is not exclusively mediated by mechanical factors and may reflect direct pulmonary injury by adipose-derived mediators.RESEARCH QUESTION: Is adipose tissue involved in the pathogenesis of interstitial lung disease (ILD)?STUDY DESIGN AND METHODS: We evaluated the association of CT measures of pericardial, abdominal visceral, and abdominal subcutaneous adipose tissue, with high...
Source: Chest - April 12, 2021 Category: Respiratory Medicine Authors: Michaela R Anderson John S Kim Matthew Allison Jon T Giles Eric A Hoffman Jingzhong Ding R Graham Barr Anna Podolanczuk Source Type: research

Post-Traumatic Stress Disorder is Associated with a Decrease in Anaerobic Threshold, O < sub > 2 < /sub > -Pulse, and Maximal Oxygen Uptake
Chest. 2021 Apr 9:S0012-3692(21)00674-7. doi: 10.1016/j.chest.2021.03.057. Online ahead of print.ABSTRACTBACKGROUND: Post-traumatic stress disorder (PTSD) has been linked to respiratory symptoms and functional limitations, but the mechanism(s) leading to this association are poorly defined.RESEARCH QUESTION: What is the relationship between PTSD, lung function, and the cardiopulmonary response to exercise in combat veterans presenting with chronic respiratory symptoms?STUDY DESIGN: and Methods: We prospectively enrolled military service members with respiratory symptoms following deployment to southwest Asia (SWA). All par...
Source: Chest - April 12, 2021 Category: Respiratory Medicine Authors: Michael J McMahon Aaron B Holley Whittney A Warren Jacob F Collen John H Sherner Joseph E Zeman Michael J Morris Source Type: research

Adiposity and interstitial lung abnormalities in community dwelling adults: the MESA cohort study
Chest. 2021 Apr 9:S0012-3692(21)00675-9. doi: 10.1016/j.chest.2021.03.058. Online ahead of print.ABSTRACTBACKGROUND: Obesity is associated with restrictive ventilatory defects and faster rate of decline in forced vital capacity (FVC). This association is not exclusively mediated by mechanical factors and may reflect direct pulmonary injury by adipose-derived mediators.RESEARCH QUESTION: Is adipose tissue involved in the pathogenesis of interstitial lung disease (ILD)?STUDY DESIGN AND METHODS: We evaluated the association of CT measures of pericardial, abdominal visceral, and abdominal subcutaneous adipose tissue, with high...
Source: Chest - April 12, 2021 Category: Respiratory Medicine Authors: Michaela R Anderson John S Kim Matthew Allison Jon T Giles Eric A Hoffman Jingzhong Ding R Graham Barr Anna Podolanczuk Source Type: research

Post-Traumatic Stress Disorder is Associated with a Decrease in Anaerobic Threshold, O < sub > 2 < /sub > -Pulse, and Maximal Oxygen Uptake
Chest. 2021 Apr 9:S0012-3692(21)00674-7. doi: 10.1016/j.chest.2021.03.057. Online ahead of print.ABSTRACTBACKGROUND: Post-traumatic stress disorder (PTSD) has been linked to respiratory symptoms and functional limitations, but the mechanism(s) leading to this association are poorly defined.RESEARCH QUESTION: What is the relationship between PTSD, lung function, and the cardiopulmonary response to exercise in combat veterans presenting with chronic respiratory symptoms?STUDY DESIGN: and Methods: We prospectively enrolled military service members with respiratory symptoms following deployment to southwest Asia (SWA). All par...
Source: Chest - April 12, 2021 Category: Respiratory Medicine Authors: Michael J McMahon Aaron B Holley Whittney A Warren Jacob F Collen John H Sherner Joseph E Zeman Michael J Morris Source Type: research

Association of triglyceride-glucose index and lung health: a population-based study
Chest. 2021 Apr 8:S0012-3692(21)00673-5. doi: 10.1016/j.chest.2021.03.056. Online ahead of print.ABSTRACTBACKGROUND: Metabolic syndrome and insulin resistance are associated with worsened outcomes of chronic lung disease. The triglyceride-glucose index (TyG), a measure of metabolic dysfunction, is associated with metabolic syndrome and insulin resistance, but its relationship to lung health is unknown.RESEARCH QUESTION: What is the relationship of TyG to respiratory symptoms, chronic lung disease, and lung function?STUDY DESIGN: and Methods: We analyzed the National Health and Nutrition Examination Survey from 1999-2012. P...
Source: Chest - April 11, 2021 Category: Respiratory Medicine Authors: Tianshi David Wu Ashraf Fawzy Emily Brigham Meredith C McCormack Ivan Rosas Dennis T Villareal Nicola A Hanania Source Type: research

Association of triglyceride-glucose index and lung health: a population-based study
Chest. 2021 Apr 8:S0012-3692(21)00673-5. doi: 10.1016/j.chest.2021.03.056. Online ahead of print.ABSTRACTBACKGROUND: Metabolic syndrome and insulin resistance are associated with worsened outcomes of chronic lung disease. The triglyceride-glucose index (TyG), a measure of metabolic dysfunction, is associated with metabolic syndrome and insulin resistance, but its relationship to lung health is unknown.RESEARCH QUESTION: What is the relationship of TyG to respiratory symptoms, chronic lung disease, and lung function?STUDY DESIGN: and Methods: We analyzed the National Health and Nutrition Examination Survey from 1999-2012. P...
Source: Chest - April 11, 2021 Category: Respiratory Medicine Authors: Tianshi David Wu Ashraf Fawzy Emily Brigham Meredith C McCormack Ivan Rosas Dennis T Villareal Nicola A Hanania Source Type: research

Introducing the Advanced Practice Respiratory Therapist (APRT)
Chest. 2021 Apr 2:S0012-3692(21)00666-8. doi: 10.1016/j.chest.2021.03.053. Online ahead of print.NO ABSTRACTPMID:33819470 | DOI:10.1016/j.chest.2021.03.053 (Source: Chest)
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Sarah M Varekojis Jessica Schweller Georgianna Sergakis Source Type: research

Seven Pillars of Small Airways Disease in Asthma and COPD - Supporting Opportunities for Novel Therapies
Chest. 2021 Apr 2:S0012-3692(21)00660-7. doi: 10.1016/j.chest.2021.03.047. Online ahead of print.ABSTRACTIdentification of pathological changes in early and mild obstructive lung disease has revealed the importance of the small airways and their contribution to symptoms. Indeed, significant small airways dysfunction has been found before any overt airway obstruction is detectable by conventional spirometry techniques. However, most therapies for the treatment of obstructive lung disease target the physiological changes and associated symptoms that result from chronic lung disease, rather than directly targeting the specifi...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Omar S Usmani MeiLan K Han David A Kaminsky James Hogg Josephine Hjoberg Naimish Patel Megan Hardin Christina Keen Stephen Rennard Fran çois-Xavier Blé Mary N Brown Source Type: research

Effect of Early High-Dose Vitamin D3 Repletion on Cognitive Outcomes in Critically Ill Adults
This study evaluated long-term cognitive outcomes among patients enrolled in a multicenter, blinded, randomized clinical trial comparing vitamin D3 treatment versus placebo in critically-ill adults with vitamin D deficiency. Global cognition was measured by the Repeatable Battery for the Assessment of Neuropsychological Status. Executive function was measured with a composite score derived from three Delis-Kaplan Executive Function System subscales. Outcomes were assessed at a median (interquartile range) of 443 (390, 482) days after randomization and compared using multivariable proportional odds regression. Adjusted odds...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Jin H Han Adit A Ginde Samuel M Brown Adrienne Baughman Erin M Collar E Wesley Ely Michelle N Gong Aluko A Hope Peter C Hou Catherine L Hough Theodore J Iwashyna James C Jackson Akram Khan Onur M Orun Mayur B Patel Rameela Raman Todd W Rice Nancy Ringwood Source Type: research

Introducing the Advanced Practice Respiratory Therapist (APRT)
Chest. 2021 Apr 2:S0012-3692(21)00666-8. doi: 10.1016/j.chest.2021.03.053. Online ahead of print.NO ABSTRACTPMID:33819470 | DOI:10.1016/j.chest.2021.03.053 (Source: Chest)
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Sarah M Varekojis Jessica Schweller Georgianna Sergakis Source Type: research

Seven Pillars of Small Airways Disease in Asthma and COPD - Supporting Opportunities for Novel Therapies
Chest. 2021 Apr 2:S0012-3692(21)00660-7. doi: 10.1016/j.chest.2021.03.047. Online ahead of print.ABSTRACTIdentification of pathological changes in early and mild obstructive lung disease has revealed the importance of the small airways and their contribution to symptoms. Indeed, significant small airways dysfunction has been found before any overt airway obstruction is detectable by conventional spirometry techniques. However, most therapies for the treatment of obstructive lung disease target the physiological changes and associated symptoms that result from chronic lung disease, rather than directly targeting the specifi...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Omar S Usmani MeiLan K Han David A Kaminsky James Hogg Josephine Hjoberg Naimish Patel Megan Hardin Christina Keen Stephen Rennard Fran çois-Xavier Blé Mary N Brown Source Type: research

Effect of Early High-Dose Vitamin D3 Repletion on Cognitive Outcomes in Critically Ill Adults
This study evaluated long-term cognitive outcomes among patients enrolled in a multicenter, blinded, randomized clinical trial comparing vitamin D3 treatment versus placebo in critically-ill adults with vitamin D deficiency. Global cognition was measured by the Repeatable Battery for the Assessment of Neuropsychological Status. Executive function was measured with a composite score derived from three Delis-Kaplan Executive Function System subscales. Outcomes were assessed at a median (interquartile range) of 443 (390, 482) days after randomization and compared using multivariable proportional odds regression. Adjusted odds...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Jin H Han Adit A Ginde Samuel M Brown Adrienne Baughman Erin M Collar E Wesley Ely Michelle N Gong Aluko A Hope Peter C Hou Catherine L Hough Theodore J Iwashyna James C Jackson Akram Khan Onur M Orun Mayur B Patel Rameela Raman Todd W Rice Nancy Ringwood Source Type: research

Introducing the Advanced Practice Respiratory Therapist (APRT)
Chest. 2021 Apr 2:S0012-3692(21)00666-8. doi: 10.1016/j.chest.2021.03.053. Online ahead of print.NO ABSTRACTPMID:33819470 | DOI:10.1016/j.chest.2021.03.053 (Source: Chest)
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Sarah M Varekojis Jessica Schweller Georgianna Sergakis Source Type: research

Seven Pillars of Small Airways Disease in Asthma and COPD - Supporting Opportunities for Novel Therapies
Chest. 2021 Apr 2:S0012-3692(21)00660-7. doi: 10.1016/j.chest.2021.03.047. Online ahead of print.ABSTRACTIdentification of pathological changes in early and mild obstructive lung disease has revealed the importance of the small airways and their contribution to symptoms. Indeed, significant small airways dysfunction has been found before any overt airway obstruction is detectable by conventional spirometry techniques. However, most therapies for the treatment of obstructive lung disease target the physiological changes and associated symptoms that result from chronic lung disease, rather than directly targeting the specifi...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Omar S Usmani MeiLan K Han David A Kaminsky James Hogg Josephine Hjoberg Naimish Patel Megan Hardin Christina Keen Stephen Rennard Fran çois-Xavier Blé Mary N Brown Source Type: research

Effect of Early High-Dose Vitamin D3 Repletion on Cognitive Outcomes in Critically Ill Adults
This study evaluated long-term cognitive outcomes among patients enrolled in a multicenter, blinded, randomized clinical trial comparing vitamin D3 treatment versus placebo in critically-ill adults with vitamin D deficiency. Global cognition was measured by the Repeatable Battery for the Assessment of Neuropsychological Status. Executive function was measured with a composite score derived from three Delis-Kaplan Executive Function System subscales. Outcomes were assessed at a median (interquartile range) of 443 (390, 482) days after randomization and compared using multivariable proportional odds regression. Adjusted odds...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Jin H Han Adit A Ginde Samuel M Brown Adrienne Baughman Erin M Collar E Wesley Ely Michelle N Gong Aluko A Hope Peter C Hou Catherine L Hough Theodore J Iwashyna James C Jackson Akram Khan Onur M Orun Mayur B Patel Rameela Raman Todd W Rice Nancy Ringwood Source Type: research

Introducing the Advanced Practice Respiratory Therapist (APRT)
Chest. 2021 Apr 2:S0012-3692(21)00666-8. doi: 10.1016/j.chest.2021.03.053. Online ahead of print.NO ABSTRACTPMID:33819470 | DOI:10.1016/j.chest.2021.03.053 (Source: Chest)
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Sarah M Varekojis Jessica Schweller Georgianna Sergakis Source Type: research

Seven Pillars of Small Airways Disease in Asthma and COPD - Supporting Opportunities for Novel Therapies
Chest. 2021 Apr 2:S0012-3692(21)00660-7. doi: 10.1016/j.chest.2021.03.047. Online ahead of print.ABSTRACTIdentification of pathological changes in early and mild obstructive lung disease has revealed the importance of the small airways and their contribution to symptoms. Indeed, significant small airways dysfunction has been found before any overt airway obstruction is detectable by conventional spirometry techniques. However, most therapies for the treatment of obstructive lung disease target the physiological changes and associated symptoms that result from chronic lung disease, rather than directly targeting the specifi...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Omar S Usmani MeiLan K Han David A Kaminsky James Hogg Josephine Hjoberg Naimish Patel Megan Hardin Christina Keen Stephen Rennard Fran çois-Xavier Blé Mary N Brown Source Type: research

Effect of Early High-Dose Vitamin D3 Repletion on Cognitive Outcomes in Critically Ill Adults
This study evaluated long-term cognitive outcomes among patients enrolled in a multicenter, blinded, randomized clinical trial comparing vitamin D3 treatment versus placebo in critically-ill adults with vitamin D deficiency. Global cognition was measured by the Repeatable Battery for the Assessment of Neuropsychological Status. Executive function was measured with a composite score derived from three Delis-Kaplan Executive Function System subscales. Outcomes were assessed at a median (interquartile range) of 443 (390, 482) days after randomization and compared using multivariable proportional odds regression. Adjusted odds...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Jin H Han Adit A Ginde Samuel M Brown Adrienne Baughman Erin M Collar E Wesley Ely Michelle N Gong Aluko A Hope Peter C Hou Catherine L Hough Theodore J Iwashyna James C Jackson Akram Khan Onur M Orun Mayur B Patel Rameela Raman Todd W Rice Nancy Ringwood Source Type: research

Introducing the Advanced Practice Respiratory Therapist (APRT)
Chest. 2021 Apr 2:S0012-3692(21)00666-8. doi: 10.1016/j.chest.2021.03.053. Online ahead of print.NO ABSTRACTPMID:33819470 | DOI:10.1016/j.chest.2021.03.053 (Source: Chest)
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Sarah M Varekojis Jessica Schweller Georgianna Sergakis Source Type: research

Seven Pillars of Small Airways Disease in Asthma and COPD - Supporting Opportunities for Novel Therapies
Chest. 2021 Apr 2:S0012-3692(21)00660-7. doi: 10.1016/j.chest.2021.03.047. Online ahead of print.ABSTRACTIdentification of pathological changes in early and mild obstructive lung disease has revealed the importance of the small airways and their contribution to symptoms. Indeed, significant small airways dysfunction has been found before any overt airway obstruction is detectable by conventional spirometry techniques. However, most therapies for the treatment of obstructive lung disease target the physiological changes and associated symptoms that result from chronic lung disease, rather than directly targeting the specifi...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Omar S Usmani MeiLan K Han David A Kaminsky James Hogg Josephine Hjoberg Naimish Patel Megan Hardin Christina Keen Stephen Rennard Fran çois-Xavier Blé Mary N Brown Source Type: research

Effect of Early High-Dose Vitamin D3 Repletion on Cognitive Outcomes in Critically Ill Adults
This study evaluated long-term cognitive outcomes among patients enrolled in a multicenter, blinded, randomized clinical trial comparing vitamin D3 treatment versus placebo in critically-ill adults with vitamin D deficiency. Global cognition was measured by the Repeatable Battery for the Assessment of Neuropsychological Status. Executive function was measured with a composite score derived from three Delis-Kaplan Executive Function System subscales. Outcomes were assessed at a median (interquartile range) of 443 (390, 482) days after randomization and compared using multivariable proportional odds regression. Adjusted odds...
Source: Chest - April 5, 2021 Category: Respiratory Medicine Authors: Jin H Han Adit A Ginde Samuel M Brown Adrienne Baughman Erin M Collar E Wesley Ely Michelle N Gong Aluko A Hope Peter C Hou Catherine L Hough Theodore J Iwashyna James C Jackson Akram Khan Onur M Orun Mayur B Patel Rameela Raman Todd W Rice Nancy Ringwood Source Type: research

Peak Inspiratory Flow as A Predictive Therapeutic Biomarker in COPD
Chest. 2021 Apr 1:S0012-3692(21)00662-0. doi: 10.1016/j.chest.2021.03.049. Online ahead of print.ABSTRACTBiomarkers in chronic obstructive pulmonary disease may be clinical (prior exacerbation history), physiological (forced expiratory volume in one second), or blood based (eosinophil count or fibrinogen level). There has been recent interest in using biomarkers to predict response to therapy in clinical practice. The benefits of inhaled therapy depend on correct use of the inhaler including an appropriate inspiratory flow. Of the available delivery systems, dry powder inhalers are unique as they have an internal resistanc...
Source: Chest - April 4, 2021 Category: Respiratory Medicine Authors: Donald A Mahler David M G Halpin Source Type: research

Peak Inspiratory Flow as A Predictive Therapeutic Biomarker in COPD
Chest. 2021 Apr 1:S0012-3692(21)00662-0. doi: 10.1016/j.chest.2021.03.049. Online ahead of print.ABSTRACTBiomarkers in chronic obstructive pulmonary disease may be clinical (prior exacerbation history), physiological (forced expiratory volume in one second), or blood based (eosinophil count or fibrinogen level). There has been recent interest in using biomarkers to predict response to therapy in clinical practice. The benefits of inhaled therapy depend on correct use of the inhaler including an appropriate inspiratory flow. Of the available delivery systems, dry powder inhalers are unique as they have an internal resistanc...
Source: Chest - April 4, 2021 Category: Respiratory Medicine Authors: Donald A Mahler David M G Halpin Source Type: research

"How I Do It: Rapid Design & amp; Implementation of Post-COVID Clinics"
We describe the design and implementation of multidisciplinary post-COVID-19 clinics at two academic health systems, Johns Hopkins and the University of California-San Francisco. We highlight components of the model which should be replicated across sites, while acknowledging opportunities to tailor offerings to the local institutional context. Our goal is to provide a replicable framework for others to create these much-needed care delivery models for survivors of COVID-19.PMID:33811910 | DOI:10.1016/j.chest.2021.03.044 (Source: Chest)
Source: Chest - April 3, 2021 Category: Respiratory Medicine Authors: Lekshmi Santhosh Brian Block Soo Yeon Kim Sarath Raju Rupal J Shah Neeta Thakur Emily Pfeil Brigham Ann Marie Parker Source Type: research

Polarization sensitive optical coherence tomography (PS-OCT) for bronchoscopic airway smooth muscle detection in bronchial thermoplasty treated asthma patients
Chest. 2021 Mar 27:S0012-3692(21)00653-X. doi: 10.1016/j.chest.2021.03.042. Online ahead of print.NO ABSTRACTPMID:33785301 | DOI:10.1016/j.chest.2021.03.042 (Source: Chest)
Source: Chest - March 31, 2021 Category: Respiratory Medicine Authors: M Vaselli P C Wijsman J Willemse A W M Goorsenberg F Feroldi J N S d'Hooghe J T Annema J F de Boer P I Bonta Source Type: research

Polarization sensitive optical coherence tomography (PS-OCT) for bronchoscopic airway smooth muscle detection in bronchial thermoplasty treated asthma patients
Chest. 2021 Mar 27:S0012-3692(21)00653-X. doi: 10.1016/j.chest.2021.03.042. Online ahead of print.NO ABSTRACTPMID:33785301 | DOI:10.1016/j.chest.2021.03.042 (Source: Chest)
Source: Chest - March 31, 2021 Category: Respiratory Medicine Authors: M Vaselli P C Wijsman J Willemse A W M Goorsenberg F Feroldi J N S d'Hooghe J T Annema J F de Boer P I Bonta Source Type: research

Polarization sensitive optical coherence tomography (PS-OCT) for bronchoscopic airway smooth muscle detection in bronchial thermoplasty treated asthma patients
Chest. 2021 Mar 27:S0012-3692(21)00653-X. doi: 10.1016/j.chest.2021.03.042. Online ahead of print.NO ABSTRACTPMID:33785301 | DOI:10.1016/j.chest.2021.03.042 (Source: Chest)
Source: Chest - March 31, 2021 Category: Respiratory Medicine Authors: M Vaselli P C Wijsman J Willemse A W M Goorsenberg F Feroldi J N S d'Hooghe J T Annema J F de Boer P I Bonta Source Type: research

Polarization sensitive optical coherence tomography (PS-OCT) for bronchoscopic airway smooth muscle detection in bronchial thermoplasty treated asthma patients
Chest. 2021 Mar 27:S0012-3692(21)00653-X. doi: 10.1016/j.chest.2021.03.042. Online ahead of print.NO ABSTRACTPMID:33785301 | DOI:10.1016/j.chest.2021.03.042 (Source: Chest)
Source: Chest - March 31, 2021 Category: Respiratory Medicine Authors: M Vaselli P C Wijsman J Willemse A W M Goorsenberg F Feroldi J N S d'Hooghe J T Annema J F de Boer P I Bonta Source Type: research

"Effect of a Basic Training Nicotine-Free Policy on Soldiers in the United States Army"
Chest. 2021 Mar 26:S0012-3692(21)00564-X. doi: 10.1016/j.chest.2021.03.039. Online ahead of print.NO ABSTRACTPMID:33781753 | DOI:10.1016/j.chest.2021.03.039 (Source: Chest)
Source: Chest - March 30, 2021 Category: Respiratory Medicine Authors: Adam Edward Lang Aleksandra Yakhkind Robert W Lamb Kathleen M Stack Source Type: research

"Effect of a Basic Training Nicotine-Free Policy on Soldiers in the United States Army"
Chest. 2021 Mar 26:S0012-3692(21)00564-X. doi: 10.1016/j.chest.2021.03.039. Online ahead of print.NO ABSTRACTPMID:33781753 | DOI:10.1016/j.chest.2021.03.039 (Source: Chest)
Source: Chest - March 30, 2021 Category: Respiratory Medicine Authors: Adam Edward Lang Aleksandra Yakhkind Robert W Lamb Kathleen M Stack Source Type: research

Hormone replacement therapy and development of new asthma
Chest. 2021 Jan 28:S0012-3692(21)00210-5. doi: 10.1016/j.chest.2021.01.054. Online ahead of print.ABSTRACTBACKGROUND: Hormone replacement therapy is prescribed to millions of women worldwide. Previous studies have suggested that hormone replacement therapy has both protective and harmful effects in asthma.RESEARCH QUESTION: Is hormone replacement therapy in menopause associated with new development of asthma?STUDY DESIGN AND METHODS: We undertook a nested case-control study based on the Danish registers from June 1, 1995 to December 31, 2018. A diagnosis of asthma was defined as two redeemed prescriptions of inhaled cortic...
Source: Chest - March 29, 2021 Category: Respiratory Medicine Authors: Erik Soeren Halvard Hansen Kristian Aasbjerg Amalie Lykkemark Moeller Elisabeth Juul Gade Christian Torp-Pedersen Vibeke Backer Source Type: research

The effect of a quality improvement intervention on sleep and delirium in critically ill patients in a surgical intensive care unit
Chest. 2021 Mar 24:S0012-3692(21)00548-1. doi: 10.1016/j.chest.2021.03.030. Online ahead of print.ABSTRACTBACKGROUND: Delirium is a deleterious condition affecting up to 60% of patients in the surgical intensive care unit (SICU). Few SICU-focused delirium interventions have been implemented, including those addressing sleep-wake disruption, a modifiable delirium risk factor common in critically ill patients.RESEARCH QUESTION: What is the effect on delirium and sleep quality of a multicomponent non-pharmacological intervention aimed at improving sleep-wake disruption in patients in the SICU setting?STUDY DESIGN AND METHODS:...
Source: Chest - March 28, 2021 Category: Respiratory Medicine Authors: Joseph E Tonna Anna Dalton Angela P Presson Chong Zhang Elizabeth Colantuoni Kirsten Lander Sullivan Howard Julia Beynon Biren B Kamdar Source Type: research

The effect of a quality improvement intervention on sleep and delirium in critically ill patients in a surgical intensive care unit
Chest. 2021 Mar 24:S0012-3692(21)00548-1. doi: 10.1016/j.chest.2021.03.030. Online ahead of print.ABSTRACTBACKGROUND: Delirium is a deleterious condition affecting up to 60% of patients in the surgical intensive care unit (SICU). Few SICU-focused delirium interventions have been implemented, including those addressing sleep-wake disruption, a modifiable delirium risk factor common in critically ill patients.RESEARCH QUESTION: What is the effect on delirium and sleep quality of a multicomponent non-pharmacological intervention aimed at improving sleep-wake disruption in patients in the SICU setting?STUDY DESIGN AND METHODS:...
Source: Chest - March 28, 2021 Category: Respiratory Medicine Authors: Joseph E Tonna Anna Dalton Angela P Presson Chong Zhang Elizabeth Colantuoni Kirsten Lander Sullivan Howard Julia Beynon Biren B Kamdar Source Type: research

Psychological Outcomes in Family Members of Acute Respiratory Failure Patients: Does Inter-ICU Transfer Play a Role?
Chest. 2021 Mar 19:S0012-3692(21)00511-0. doi: 10.1016/j.chest.2021.03.025. Online ahead of print.ABSTRACTBACKGROUND: Family members of ICU patients experience a constellation of sequelae described as post-intensive care syndrome-family. The influence that an inter-ICU transfer has on psychological outcomes is unknown.RESEARCH QUESTION: Is inter-ICU transfer associated with poor psychological outcomes in families of Acute Respiratory Failure (ARF) patients?STUDY DESIGN: and Methods- Cross-sectional observational study of 82 families of patients admitted to adult ICUs (tertiary hospital). Data included demographics, admissi...
Source: Chest - March 23, 2021 Category: Respiratory Medicine Authors: Nandita R Nadig Katherine R Sterba Annie N Simpson Kenneth J Ruggiero Catherine T Hough Andrew J Goodwin Kyle White Dee W Ford Source Type: research

Psychological Outcomes in Family Members of Acute Respiratory Failure Patients: Does Inter-ICU Transfer Play a Role?
Chest. 2021 Mar 19:S0012-3692(21)00511-0. doi: 10.1016/j.chest.2021.03.025. Online ahead of print.ABSTRACTBACKGROUND: Family members of ICU patients experience a constellation of sequelae described as post-intensive care syndrome-family. The influence that an inter-ICU transfer has on psychological outcomes is unknown.RESEARCH QUESTION: Is inter-ICU transfer associated with poor psychological outcomes in families of Acute Respiratory Failure (ARF) patients?STUDY DESIGN: and Methods- Cross-sectional observational study of 82 families of patients admitted to adult ICUs (tertiary hospital). Data included demographics, admissi...
Source: Chest - March 23, 2021 Category: Respiratory Medicine Authors: Nandita R Nadig Katherine R Sterba Annie N Simpson Kenneth J Ruggiero Catherine T Hough Andrew J Goodwin Kyle White Dee W Ford Source Type: research

Psychological Outcomes in Family Members of Acute Respiratory Failure Patients: Does Inter-ICU Transfer Play a Role?
Chest. 2021 Mar 19:S0012-3692(21)00511-0. doi: 10.1016/j.chest.2021.03.025. Online ahead of print.ABSTRACTBACKGROUND: Family members of ICU patients experience a constellation of sequelae described as post-intensive care syndrome-family. The influence that an inter-ICU transfer has on psychological outcomes is unknown.RESEARCH QUESTION: Is inter-ICU transfer associated with poor psychological outcomes in families of Acute Respiratory Failure (ARF) patients?STUDY DESIGN: and Methods- Cross-sectional observational study of 82 families of patients admitted to adult ICUs (tertiary hospital). Data included demographics, admissi...
Source: Chest - March 23, 2021 Category: Respiratory Medicine Authors: Nandita R Nadig Katherine R Sterba Annie N Simpson Kenneth J Ruggiero Catherine T Hough Andrew J Goodwin Kyle White Dee W Ford Source Type: research

Psychological Outcomes in Family Members of Acute Respiratory Failure Patients: Does Inter-ICU Transfer Play a Role?
Chest. 2021 Mar 19:S0012-3692(21)00511-0. doi: 10.1016/j.chest.2021.03.025. Online ahead of print.ABSTRACTBACKGROUND: Family members of ICU patients experience a constellation of sequelae described as post-intensive care syndrome-family. The influence that an inter-ICU transfer has on psychological outcomes is unknown.RESEARCH QUESTION: Is inter-ICU transfer associated with poor psychological outcomes in families of Acute Respiratory Failure (ARF) patients?STUDY DESIGN: and Methods- Cross-sectional observational study of 82 families of patients admitted to adult ICUs (tertiary hospital). Data included demographics, admissi...
Source: Chest - March 23, 2021 Category: Respiratory Medicine Authors: Nandita R Nadig Katherine R Sterba Annie N Simpson Kenneth J Ruggiero Catherine T Hough Andrew J Goodwin Kyle White Dee W Ford Source Type: research

Severe intra-abdominal hypertension in critically-ill COVID-19 patients with acute kidney injury
Chest. 2021 Mar 18:S0012-3692(21)00496-7. doi: 10.1016/j.chest.2021.03.019. Online ahead of print.NO ABSTRACTPMID:33745987 | PMC:PMC7970792 | DOI:10.1016/j.chest.2021.03.019 (Source: Chest)
Source: Chest - March 22, 2021 Category: Respiratory Medicine Authors: Vincent Dupont Claire Gamblin Mathieu Bard Gautier Julien Michel Bonnivard Vanessa Champenois Antoine Goury Bruno Mourvillier Source Type: research

Sex and Gender Omic biomarkers in men and women with COPD: Considerations for precision medicine
Chest. 2021 Mar 18:S0012-3692(21)00507-9. doi: 10.1016/j.chest.2021.03.024. Online ahead of print.ABSTRACTSex and gender differences in lung health and disease are imperative to consider and study if precision pulmonary medicine is to be achieved. The development of reliable COPD biomarkers has been elusive and the translation of biomarkers to clinical care has been limited. Useful and effective biomarkers must be developed with attention to clinical heterogeneity of COPD-there is inherent heterogeneity related to grouping women and men together in the studies of COPD. Considering sex and gender differences and influences ...
Source: Chest - March 22, 2021 Category: Respiratory Medicine Authors: Dawn L DeMeo Source Type: research

Media Portrayals of the Acute Respiratory Distress Syndrome
Chest. 2021 Mar 18:S0012-3692(21)00494-3. doi: 10.1016/j.chest.2021.03.017. Online ahead of print.NO ABSTRACTPMID:33745989 | DOI:10.1016/j.chest.2021.03.017 (Source: Chest)
Source: Chest - March 22, 2021 Category: Respiratory Medicine Authors: Shannon M Fernando Rebecca Mathew Carol L Hodgson Eddy Fan Daniel Brodie Source Type: research

Provision of Smoking Cessation Resources in the Context of in-person Shared Decision Making for Lung Cancer Screening
Chest. 2021 Mar 18:S0012-3692(21)00493-1. doi: 10.1016/j.chest.2021.03.016. Online ahead of print.ABSTRACTBACKGROUND: Lung cancer screening (LCS) is effective at reducing mortality for high-risk smokers. Mortality benefits go beyond early cancer detection, as shared-decision making (SDM) may present a "teachable moment" to reinforce cessation and provide resources.RESEARCH QUESTION: How well is smoking cessation performed during LCS SDM encounters and what patient and provider characteristics associated with smoking cessation assistance?STUDY DESIGN AND METHODS: This is a retrospective cohort study of current smo...
Source: Chest - March 22, 2021 Category: Respiratory Medicine Authors: Jolie Shen Kristina Crothers Erin K Kross Kaylee Petersen Anne C Melzer Matthew Triplette Source Type: research