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Chest
Journal Prestige (SJR): 2.524

Citation Impact (citeScore): 3
Number of Followers: 102

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ISSN (Print) 0012-3692 - ISSN (Online) 1931-3543
Published by American College of Chest Physicians

[1 journal]

General Information
- Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/S0012-3692(20)30163-X
  Issue No: Vol. 157, No. 3 (2020)
Acute Respiratory Failure Associated With Vaping
- Authors: Craig Fryman; Becky Lou, Andrew G. Weber, Harry N. Steinberg, Sameer Khanijo, Annamaria Iakovou, Mina R. Makaryus
  Abstract: The use of e-cigarettes to deliver aerosolized nicotine has gained popularity in recent years. Numerous reports have cited the development of acute pulmonary disease linked to vaping nicotine as well as marijuana-based products. As cultural attitudes evolve and policies shift toward the legalization of marijuana, its use has become more prevalent. Given the increased prevalence of marijuana consumption and e-cigarette usage, better insight into its potential to cause lung toxicity is warranted. The clinical, radiographic, and histopathologic characteristics of lung injury associated with vaping, particularly with marijuana-based products, have yet to be well described in the literature.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
An 80-Year-Old Woman With a Solitary Pulmonary Nodule
- Authors: Jean-Baptiste Gibier; Magali Colombat, Nathalie Grardel, Marie de Charette, Ophélie Ouennoure, Rias Akkad, Marie-Christine Copin
  Abstract: An 80-year-old-woman was referred for evaluation of chest pain that appeared after providing care at home for her sick husband, which included helping him to get up and move about. The pain was initially triggered by lifting heavy objects but then became constant, without exacerbating or relieving factors. The pain was located in the left hemithorax and was not associated with shortness of breath or cough. Because the patient did not feel any better after a month, her general practitioner ordered a radiograph, which revealed a suspicious pulmonary nodule in the left upper lobe.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
A 54-Year-Old Woman With a History of Alcoholic Cirrhosis and Recurrent
Ascites Presenting With Abdominal Pain and Increasing Abdominal Girth
- Authors: Bruce F. Sabath; Samiha Khan
  Abstract: A 54-year-old woman with a history of alcoholic cirrhosis and recurrent ascites presented to the ED with 1 day of abdominal pain and increasing abdominal girth. She had undergone therapeutic paracentesis (5 L removed) the day prior but later noted that her fluid seemed to be reaccumulating. BP at presentation was 87/57 mm Hg, and her hemoglobin level was 6.5 g/dL; just prior to paracentesis the day before, these values had been 120/40 mm Hg and 8.6 g/dL, respectively. She also complained of lightheadedness.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.06.047
  Issue No: Vol. 157, No. 3 (2020)
A 78-Year-Old Man With Recurrent Hemoptysis and Persistent Pulmonary
Nodule
- Authors: Si Yuan Chew; Chien Sheng Tan, Youxin Puan, Jansen Meng Kwang Koh
  Abstract: A 78-year-old Chinese man presented in March 2019 with a 2-day history of small-volume hemoptysis. He did not report any associated chronic cough, sputum production, epistaxis, night sweats, unintentional weight loss, or fever. He was an ex-smoker of 10 pack years. His medical history was significant for ischemic heart disease on aspirin, as well as hospitalizations in 2016 and 2017 for hemoptysis. The patient’s evaluation for hemoptysis was only notable for a right middle lobe nodule on chest CT imaging and Klebsiella pneumoniae on sputum cultures, for which he was treated with antibiotics.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
A 62-Year-Old Woman With Diffuse Myalgias, Fatigue, and Shortness of
Breath
- Authors: Bryan D. Park; Kenneth Lyn-Kew, Ann Granchelli, Anuj Mehta
  Abstract: A 62-year-old woman with a history of partially treated Graves disease and hypertension presented with approximately 3 weeks of worsening fatigue, lower extremity myalgias, and shortness of breath. Her medical history included a thyroid radiofrequency ablation several years earlier. Following the ablation, she was found to have some residual thyroid activity, negating the need for therapy. She was lost to follow-up after months of normal thyroid-stimulating hormone values. On this presentation, the patient was noted to be in atrial fibrillation with a rapid ventricular rate, and although she presented alert and oriented initially, she developed progressive inattentiveness and confusion while in the ED.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.09.041
  Issue No: Vol. 157, No. 3 (2020)
A 46-Year-Old Woman With a Mediastinal Mass
- Authors: Uddalak Majumdar; Carol F. Farver, Atul C. Mehta
  Abstract: A 46-year-old otherwise healthy woman visited the ED twice over a period of 4 days for chest discomfort, midback pain, and dyspnea. The pain was localized, constant, nonpleuritic in nature, moderate in severity, and was not relieved by over-the-counter medications.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.09.034
  Issue No: Vol. 157, No. 3 (2020)
A Man in His 30s Presenting With Shortness of Breath and Productive Cough
After a Recent Pneumonia
- Authors: Haris Patail; Hassan Patail, Sahar Ahmad
  Abstract: A man in his 30s with a history of substance abuse, including opioids and tobacco, presented to the ED with cough productive of yellow sputum, shortness of breath, chills, and diaphoresis. Vital signs were significant for a BP of 106/65 mm Hg; other vital signs were normal. CBC analysis showed no leukocytosis, hemoglobin of 8.9 g/dL, and an elevated platelet count of 388 mL3. A month before presentation, the patient underwent right-sided thoracentesis at an outside hospital and was treated for pneumonia with antibiotics.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.06.046
  Issue No: Vol. 157, No. 3 (2020)
Bruxism Relieved Under CPAP Treatment in a Patient With OSA Syndrome
- Authors: Jean-Benoit Martinot; Jean-Christian Borel, Nhat-Nam Le-Dong, Philip E. Silkoff, Stephane Denison, David Gozal, Jean-Louis Pépin
  Abstract: Bruxism is a heterogeneous condition related to various underlying mechanisms, including the presence of OSA. This case report illustrates that sleep mandibular movement monitoring and analysis could provide a useful opportunity for detection of both sleep bruxism and respiratory effort. The current case suggests that tracking of respiratory effort could enable evaluation of bruxism and its potential interactions. Successful treatment of sleep-related respiratory effort may lead to improved or resolution of bruxism in cases where such a causal relationship does exist.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.07.032
  Issue No: Vol. 157, No. 3 (2020)
Bronchial Thermoplasty
- Authors: Geoffrey Lowell Chupp
  Pages: 479 - 480
  Abstract: In 2010, for the first time, the Federal Drug Agency approved bronchial thermoplasty (BT), a nonpharmacologic treatment for severe uncontrolled asthma. Indicated for disease that remains uncontrolled despite adherent use of high-dose inhaled corticosteroids and long-acting bronchodilators, BT is believed to work by applying radiofrequency energy via a catheter placed through a bronchoscope to airways between 3 and 10 mm in diameter. This action generates heat in the airway wall that preferentially injures smooth muscle cells, which fail to heal and regrow, reducing the muscle mass around the airway.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2020.01.003
  Issue No: Vol. 157, No. 3 (2020)
Predicting COPD and Lung Function Decline Among a General Population
- Authors: Valerie G. Press; Andrea Gershon, Denitza P. Blagev
  Pages: 481 - 483
  Abstract: Diagnosing COPD is an important public health priority. Currently, COPD is diagnosed through a combination of clinical symptoms and physiological measurements via pulmonary function tests (PFTs). However, “clinical” diagnoses of COPD are frequently made without the use of PFTs.1-3 Furthermore, because COPD is believed to be drastically underdiagnosed,1 effective tools to screen for risk of COPD among a general population are needed.4 However, screening for COPD using PFTs or questionnaires is not recommended by current guidelines due to a dearth of data regarding the efficacy of these tools for improving outcomes.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.11.028
  Issue No: Vol. 157, No. 3 (2020)
Screening Heroin Smokers’ Lung Function at Community Care Clinics
- Authors: Caroline Mitchell; Rod Lawson
  Pages: 484 - 486
  Abstract: The United Kingdom has the highest prevalence of opioid use disorder (OUD) in Europe with approximately 150,000 people currently receiving treatment for dependent opioid use.1 Since the 1980s, a unified harm minimization approach, which targets the high mortality and morbidity associated with injected opioids, has led to the promotion of the inhaled use of heroin as an alternative to injection.2
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2020.01.006
  Issue No: Vol. 157, No. 3 (2020)
Oxygen Targets for Patients Who Are Critically Ill
- Authors: Wesley H. Self; Matthew W. Semler, Todd W. Rice
  Pages: 487 - 488
  Abstract: With roots dating back to the 18th century, supplemental oxygen is one of medicine’s most common and fundamental therapies. However, despite generations of doctors using oxygen to treat hundreds of millions of patients, our understanding of how to use oxygen most effectively remains incomplete.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.12.010
  Issue No: Vol. 157, No. 3 (2020)
Lights, Camera, Action
- Authors: Alfin G. Vicencio; Joseph Piccione
  Pages: 489 - 490
  Abstract: “The Horse in Motion” is a series of photographs taken by Eadweard Muybridge in the 1870s depicting a horse in full gallop.1 Muybridge, a photographer hired by the former governor of California and horse racing enthusiast Leland Stanford, used an array of 12 cameras to capture sequential images of the animal to prove Stanford’s theory that all four of a horse’s feet were briefly off the ground during full gallop, a fact that was not discernible to the human eye alone. Subsequent improvements in both capturing and viewing “motion pictures” helped to launch the cultural phenomenon embodied by modern-day Hollywood but also had important implications in science and medicine.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.11.026
  Issue No: Vol. 157, No. 3 (2020)
Catheter-Directed Thrombolysis With Ultrasound Assistance for Acute
Pulmonary Embolism
- Authors: Srinath Adusumalli; Bram Geller, Jay Giri
  Pages: 491 - 492
  Abstract: Acute pulmonary embolism (PE) is the third leading cause of cardiovascular mortality in the United States after myocardial infarction and stroke.1-4 Accordingly, over the last decade, there has been an increasing focus on in-hospital and ambulatory treatment of PE. Specifically, novel multidisciplinary efforts such as Pulmonary Embolism Response Teams have proliferated throughout many tertiary and quaternary care institutions across the country and are focused on optimizing the care of patients presenting with intermediate and high-risk PE.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.11.027
  Issue No: Vol. 157, No. 3 (2020)
Utilization of Claims Data in Research
- Authors: Jed A. Gorden; Candice L. Wilshire, Christopher R. Gilbert
  Pages: 493 - 495
  Abstract: In this issue of CHEST, Verdial et al1 compare safety and cost between the two most commonly used mediastinal diagnostic and staging tools: endobronchial ultrasound (EBUS) and mediastinoscopy. They used MarketScan, a claims database that captures both inpatient and outpatient claims data for individuals with employer-provided commercial insurance. The sample size is large, with 30,570 patients undergoing mediastinal lymph node sampling for any reason. The overall findings of increased safety of EBUS and decreased procedural cost over mediastinoscopy are methodologically sound and consistent with prior published data.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.11.031
  Issue No: Vol. 157, No. 3 (2020)
POINT: Should the Use of Diagnostic Point-of-Care Ultrasound in Patient
Care Require Hospital Privileging/Credentialing' Yes
- Authors: James M. Walter; Lewis Satterwhite, Kenneth E. Lyn-Kew
  Pages: 496 - 498
  Abstract: Point-of-care ultrasound (POCUS) refers to the use of ultrasound by a bedside clinician to guide patient management in real time.1 There is growing consensus that POCUS is an essential tool for clinicians caring for acutely ill patients. Indeed, the integration of POCUS into routine care in the ICU is now widely viewed as standard of care.2
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
COUNTERPOINT: Should the Use of Diagnostic Point-of-Care Ultrasound in
Patient Care Require Hospital Privileging/Credentialing' No
- Authors: Jacqueline M. Kruser; Gregory A. Schmidt, Pierre D. Kory
  Pages: 498 - 500
  Abstract: We present the case against a requirement of specific hospital privileging/credentialing for critical care clinicians to apply diagnostic point-of-care ultrasound (POCUS).
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
Rebuttal from Drs Walter, Satterwhite, and Lyn-Kew
- Authors: James M. Walter; Lewis Satterwhite, Kenneth E. Lyn-Kew
  Pages: 500 - 502
  Abstract: We read with interest the Con argument presented by Dr Kruser and colleagues1 and appreciate the opportunity to respond. We would like to begin by emphasizing shared beliefs: (1) point-of-care ultrasound (POCUS) is a learnable skill. With the appropriate training infrastructure, pulmonary and critical care medicine (PCCM) providers can readily achieve competency. (2) POCUS can and should be incorporated into the care of acutely ill patients. (3) The goal of the critical care community should be to safely accelerate the dissemination of POCUS.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
Rebuttal From Drs Kruser, Schmidt, and Kory
- Authors: Jacqueline M. Kruser; Gregory A. Schmidt, Pierre D. Kory
  First page: 502
  Abstract: We thank our colleagues for presenting their case in support of hospital-regulated privileges to govern the use of point-of-care ultrasound (POCUS) by intensivists.1 Although we agree with several of their claims, their conclusion in favor of hospital privileging contains a misstep of logic along with a failure to fully anticipate the unfavorable consequences of POCUS regulation.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
Going Beyond “Bio-markers,” Think “Life-markers”
- Authors: Laren Tan; Geoff Chupp, Mario Castro, Monica Kraft
  Pages: 503 - 505
  Abstract: As the number of biologics for the treatment of moderate to severe asthma continues to grow, the dilemma of trying to choose the right biologic for the right patient is often heavily weighted on specific biomarkers. At present, biomarker cutoffs provide more options in biologic choice, and the need for shared decision-making (SDM) between patients and health-care providers is necessary to achieve a completely personalized treatment plan. In a survey of 300 patients who attended an allergy clinic, 53% indicated they had searched online for information on allergy prior to their consultation.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.08.2210
  Issue No: Vol. 157, No. 3 (2020)
Severe Acute Toxicity of Inhaled Nicotine and e-Cigarettes
- Authors: Xuesi M. Shao; Zhuang T. Fang
  Pages: 506 - 508
  Abstract: A recent statement from the US Food and Drug Administration (FDA)1 expresses concern regarding a potential safety issue related to seizures reported following e-cigarette use, particularly in youth and young adults. Since the publication of this statement in April 2019, the FDA announced an update on August 7, 2019, stating that the FDA continues to receive more reports of seizure cases (total 127) following e-cigarette use. This number is probably an underestimation due to the voluntary nature of the reports.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
Broncholithiasis and Primary Ciliary Dyskinesia
- Authors: Marcus P. Kennedy; Peadar G. Noone, Michael R. Knowles
  First page: 737
  Abstract: The publication by Alshabani et al1 in CHEST (September 2019) entitled “Broncholithiasis. A review” provides a concise and well-researched review of a clinical scenario that on occasion presents to most pulmonologists and bronchoscopists. It is notable that the authors list one of the chronic airway disorders, primary ciliary dyskinesia (PCD), as a cause of broncholithiasis, based on a single case report.2 However, this association was first highlighted in our previous publication of a large series of patients with PCD (N = 142) that included 28 patients aged ≥ 40 years, of whom 11 (40%) had calcification on CT imaging and five reported lithoptysis.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
Optimizing Prediction of the Lung Function Features of COPD
- Authors: Jennifer L. Perret; Koen Simons, Don Vicendese, Adrian Bickerstaffe, Tony Blakely, Shyamali C. Dharmage
  First page: 738
  Abstract: In 2008, the US National Heart, Lung, and Blood Institute task force highlighted the need to reduce, through population screening, the growing health burden attributable to COPD.1 Commendably, Chen et al,2 in this issue of CHEST, have responded to this clinical need by developing, validating, and implementing a personalized risk model to predict the risk of airflow obstruction and 20-year FEV1 trajectory for an individual from the general population. This model was developed using the Framingham offspring cohort (n = 4,167) and validated in almost 15,000 individuals from two other cardiovascular cohorts, although the larger had spirometry measured only over a 3-year period.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
Response
- Authors: Wenjia Chen; Don D. Sin, Mohsen Sadatsafavi
  Pages: 738 - 739
  Abstract: We agree with many points made by Perret et al and offer several additional analyses to enhance clarity.1 We agree on the need to provide 95% CIs for the area under the receiver operating characteristic curve (AUC-ROC, also known as the C-statistic). For the derivation cohort, the C-statistic was 0.762 (95% CI, 0.746-0.778), for validation cohort 1 it was 0.864 (95% CI, 0.850-0.882), and for validation cohort 2 it was 0.872 (95% CI, 0.856-0.887). In line with previous findings that the rate of lung function decline generally accelerates over time,2,3 our prediction models captured both the linear and quadratic decline in absolute FEV1.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  Issue No: Vol. 157, No. 3 (2020)
Should the Stethoscope Auscultation Be Routine Practice in the Evaluation
of the Acutely Breathless Patient' No
- Authors: Roberto Copetti; Luigi Vetrugno, Daniele Orso, Tiziana Bove
  Pages: 740 - 742
  Abstract: In a faraway hospital, a patient with strong dyspnea is brought to the ED. The patient is elderly, has suffered from an acute myocardial infarction in the past, is hypertensive, has recurrent heart failure episodes, is a heavy smoker, and has COPD. His performance is very poor, so he is very often bedridden. The physicians are uncertain about which diagnosis is most likely. Fortunately, one of the physicians has a newly invented tool. It allows him to hear the patient's chest, and on the basis of perceived different sounds, it is possible to establish, with reasonable probability, the diagnosis: he called it a “stethoscope.” The physician is about to approach the patient with this new instrument, but another physician stops him: “No! Does this instrument have strong evidence of its usefulness'”
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.09.043
  Issue No: Vol. 157, No. 3 (2020)
Point-of-Care Ultrasound in Respiratory Failure
- Authors: Nicholas Smallwood; Jennie Stephens, Martin Dachsel, Ashley Miller, Andrew Walden
  First page: 740
  Abstract: We were fascinated to read the yes-no debate in a recent issue of CHEST (September 2019) on the use of point-of-care ultrasound (POCUS) in the breathless patient,1,2 particularly as some of us were involved with a similar publication recently.3 We should declare we are clearly in favor of the “yes” camp and think it is important to highlight two important deficiencies in the “no” argument.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.09.042
  Issue No: Vol. 157, No. 3 (2020)
Response
- Authors: John P. Corcoran; Christian B. Laursen
  Pages: 742 - 743
  Abstract: We would like to thank our colleagues for their interest in and observations regarding the recent Point-Counterpoint debate1,2 around point-of-care ultrasound (POCUS) in the acutely breathless patient. We readily acknowledge the potential that POCUS has to improve clinical care in this often complex and vulnerable population; indeed, this belief is reflected in our own individual clinical and academic practice. However, just like our colleagues and many others who have published in and sought to advance this particular field, we practice from a privileged position in terms of our relative individual experience and expertise both as clinicians and sonographers.
  Citation: CHEST 157, 3 (2020)
  PubDate: 2020-03
  DOI: 10.1016/j.chest.2019.11.020
  Issue No: Vol. 157, No. 3 (2020)
Effect of intermittent or continuous feed on muscle wasting in critical
illness: A phase II clinical trial
- Authors: Angela S. McNelly; Danielle E. Bear, Bronwen A. Connolly, Gill Arbane, Laura Allum, Azhar Tarbhai, Jackie A. Cooper, Philip A. Hopkins, Matthew P. Wise, David Brealey, Kieron Rooney, Jason Cupitt, Bryan Carr, Kiran Koelfat, Steven Olde Damink, Philip J. Atherton, Nicholas Hart, Hugh E. Montgomery, Zudin A. Puthucheary
  Abstract: Intermittent feeding in early critical illness is not shown to preserve muscle mass in this trial despite resulting in a greater achievement of nutritional targets than continuous feeding. However, it is feasible and safe.
  Citation: CHEST (2020)
  PubDate: 2020-04-02
  DOI: 10.1016/j.chest.2020.03.045
Preliminary Findings of Control of Dispersion of Aerosols and Droplets
during High Velocity Nasal Insufflation Therapy Using a Simple Surgical
Mask: Implications for High Flow Nasal Cannula
- Authors: Scott Leonard; Charles W. Atwood, Brian K. Walsh, Ronald J. DeBellis, George C. Dungan, Wayne Strasser, Jessica S. Whittle
  Citation: CHEST (2020)
  PubDate: 2020-04-02
  DOI: 10.1016/j.chest.2020.03.043
Undiagnosed Obstructive Sleep Apnea May Significantly Impact Outcomes in
Adults Admitted for COPD in an Inner-City Hospital
- Authors: Mario Naranjo; Leslee Willes, Barbara A. Prillaman, Stuart F. Quan, Sunil Sharma
  Abstract: Chronic Obstructive Pulmonary Disease (COPD) is the second most common cause of hospital admission in the United States. Obstructive sleep apnea (OSA) is a highly prevalent and underdiagnosed condition which may impact the outcome of COPD. We hypothesized that presence of unrecognized and untreated OSA will increase hospital readmissions in patients admitted for COPD exacerbation.
  Citation: CHEST (2020)
  PubDate: 2020-04-02
  DOI: 10.1016/j.chest.2020.03.036
Emerging Concepts of the Pathophysiology and Adverse Outcomes of Restless
Legs Syndrome
- Authors: Sofía Romero; Irene Cano-Pumarega, Diego García-Borreguero
  Abstract: Restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is a common neurological disorder affecting up to 5-10% of the population, but it still remains an underdiagnosed condition. RLS/WED is characterized by uncomfortable sensations, mainly in the legs, which appear during inactivity and worsen in the evening or at night. The prevalence of RLS/WED and periodic leg movements (PLMs) is increased in sleep-disordered-breathing patients, particularly in those with obstructive sleep apnoea (OSA), the most common sleep disorder encountered in sleep centres.
  Citation: CHEST (2020)
  PubDate: 2020-04-02
  DOI: 10.1016/j.chest.2020.03.035
Outcomes of a Peri and Post-operative management protocol for
Nontuberculous mycobacteria in lung transplant recipients
- Authors: Takashi Hirama; Lianne G. Singer, Sarah K. Brode, Theodore K. Marras, Shahid Husain
  Abstract: Owing to advanced respiratory disease among lung transplant (LTX) candidates, some could develop nontuberculous mycobacteria-pulmonary disease (NTM-PD). However, the appropriate management of NTM-PD found at the time of LTX is not clear. We, therefore, established a management protocol for peri-transplant NTM-PD, defined by the presence of granulomas and mycobacteriologic evidence of NTM in the explant. Between 2013 and 2014, 230 LTX recipients (LTRs) who survived>30 days post LTX were followed up to 2017.
  Citation: CHEST (2020)
  PubDate: 2020-04-02
  DOI: 10.1016/j.chest.2020.01.056
Safety of Ibuprofen in Patients with COVID-19; Causal or Confounded'
- Authors: Mohit Sodhi; Mahyar Etminan
  Citation: CHEST (2020)
  PubDate: 2020-03-31
  DOI: 10.1016/j.chest.2020.03.040
Treatment with convalescent plasma for critically ill patients with
SARS-CoV-2 infection
- Authors: Bin Zhang; Shuyi Liu, Tan Tan, Wenhui Huang, Yuhao Dong, Luyan Chen, Qiuying Chen, Lu Zhang, Qingyang Zhong, Xiaoping Zhang, Yujian Zou, Shuixing Zhang
  Abstract: As of March 24, 2020, novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been responsible for 379,661 infection cases with 16,428 deaths globally and the number is still increasing rapidly. Herein, we presented four critically ill patients with SARS-CoV-2 infection who received supportive care and convalescent plasma. Although all the four patients (including a pregnant woman) recovered from SARS-CoV-2 infection eventually, randomized trials are needed to eliminate the effect of other treatments and investigate the safety and efficacy of convalescent plasma therapy.
  Citation: CHEST (2020)
  PubDate: 2020-03-31
  DOI: 10.1016/j.chest.2020.03.039
Echocardiography-derived stroke volume index is associated with adverse
in-hospital outcomes in intermediate-risk acute pulmonary embolism: a
retrospective cohort study
- Authors: Graeme Prosperi-Porta; Kevin Solverson, Nowell Fine, Christopher J. Humphreys, André Ferland, Jason Weatherald
  Abstract: Low SVI was associated with in-hospital death or cardiopulmonary decompensation in acute PE. SVI had excellent performance compared to other clinical and echocardiographic variables.
  Citation: CHEST (2020)
  PubDate: 2020-03-31
  DOI: 10.1016/j.chest.2020.02.066
Combined treatment with hydrocortisone, vitamin C, and thiamine for sepsis
and septic shock (HYVCTTSSS): A randomized controlled clinical trial
- Authors: Ping Chang; Yuping Liao, Jianbin Guan, Yuexun Guo, Ming Zhao, Jianmin Hu, Jian Zhou, Hua Wang, Zhongran Cen, Ying Tang, Zhanguo Liu
  Abstract: Among patients with sepsis or septic shock, the combination of hydrocortisone, vitamin C, and thiamine did not reduce mortality compared with placebo.
  Citation: CHEST (2020)
  PubDate: 2020-03-31
  DOI: 10.1016/j.chest.2020.02.065
Long term noninvasive ventilation in the Geneva Lake area: indications,
prevalence and modalities
- Authors: C. Cantero; D. Adler, P. Pasquina, C. Uldry, B. Egger, M. Prella, A.B. Younossian, P. Gasche, J.L. Pépin, J.P. Janssens, investigators of the Geneva Lake Study
  Abstract: Use of NIV is increasing rapidly in this area, and the population treated is aging, comorbid, frequently obese. COPD is presently the leading indication followed by OHS.
  Citation: CHEST (2020)
  PubDate: 2020-03-31
  DOI: 10.1016/j.chest.2020.02.064
EFFECTIVENESS AND SAFETY OF SUPERVISED HOME-BASED PHYSICAL TRAINING IN
PATIENTS WITH COPD ON LONG-TERM HOME OXYGEN THERAPY: A RANDOMIZED TRIAL
- Authors: Demetria Kovelis; Anna R.S. Gomes, Camila Mazzarin, Samia k. Biazim, Fabio Pitta, Silvia Valderramas
  Abstract: Patients with chronic obstructive pulmonary disease (COPD) in advanced disease stage who need long-term home oxygen therapy (LTHOT) have difficulty participating in outpatient pulmonary rehabilitation (PR) programs due to the severity of their disease, limitations involving transportation and mobility, high costs and issues related to patients’ safety and individual needs. Unsupervised home-based physical training (PT) is frequently used. The main objective of this study was to investigate the effectiveness of a supervised home-based PT program on exercise capacity and other outcomes in patients with COPD on LTHOT
  Citation: CHEST (2020)
  PubDate: 2020-03-27
  DOI: 10.1016/j.chest.2020.02.063
Place of Death for Individuals with Chronic Lung Disease: Trends and
Associated Factors from 2003 to 2017 in the United States
- Authors: Sarah H. Cross; E. Wesley Ely, Dio Kavalieratos, James A. Tulsky, Haider J. Warraich
  Abstract: Home deaths are increasing among decedents from chronic lung disease increasing the need for quality end-of-life care in this setting. Further research should explore the end-of-life needs and preferences of these patients and their caregivers with particular attention paid to patients with ILD and CF who continue to have high rates of hospital death.
  Citation: CHEST (2020)
  PubDate: 2020-03-27
  DOI: 10.1016/j.chest.2020.02.062
The Association of ICU Acuity with Adherence to ICU Evidence-Based
Processes of Care
- Authors: Kelly C. Vranas; Jennifer Y. Scott, Omar Badawi, Michael O. Harhay, Christopher G. Slatore, Donald R. Sullivan, Meeta Prasad Kerlin
  Abstract: High ICU acuity is associated with better adherence to several evidence-based practices, which may be a marker of high-quality care. Future research should investigate how high-acuity ICUs approach ICU organization in order to identify targets to improve the quality of critical care across all ICU acuity levels.
  Citation: CHEST (2020)
  PubDate: 2020-03-27
  DOI: 10.1016/j.chest.2020.02.061
Comparison of Hospitalized Patients with Acute Respiratory Distress
Syndrome Caused by COVID-19 and H1N1
- Authors: Xiao Tang; Ronghui Du, Rui Wang, Tanze Cao, Lulu Guan, Chengqing Yang, Qi Zhu, Ming Hu, Xuyan Li, Ying Li, Lirong Liang, Zhaohui Tong, Bing Sun, Peng Peng, Huanzhong Shi
  Abstract: There were many differences between COVID-19 and H1N1-induced ARDS patients in clinical presentations. Compared with H1N1, patients with COVID-19 induced ARDS had lower severity of illness scores at presentation and lower SOFA-score adjusted mortality.
  Citation: CHEST (2020)
  PubDate: 2020-03-26
  DOI: 10.1016/j.chest.2020.03.032
Use of Intravenous Immunoglobulin G in HIT patients is not associated with
increased rates of thrombosis: A population-based study
- Authors: Binod Dhakal; Lisa Rein, Aniko Szabo, Anand Padmanabhan
  Citation: CHEST (2020)
  PubDate: 2020-03-26
  DOI: 10.1016/j.chest.2020.03.024
“Preparing for the COVID-19 Pandemic: Our Experience in New
York”
- Authors: Zubair Hasan; Mangala Narasimhan
  Citation: CHEST (2020)
  PubDate: 2020-03-25
  DOI: 10.1016/j.chest.2020.03.027
Obstructive sleep apnea and neurocognitive impairment in children with
congenital heart disease
- Authors: Daniel Combs; Jamie O. Edgin, Scott Klewer, Brent J. Barber, Wayne J. Morgan, Chiu-Hsieh Hsu, Ivo Abraham, Sairam Parthasarathy
  Abstract: Children with CHD and comorbid OSA have impaired neurocognition compared to children with CHD without comorbid OSA. OSA may be a reversible cause of neurocognitive impairment in children with CHD. Further research is needed to evaluate the effects of OSA treatment on neurocognitive impairment in children with CHD.
  Citation: CHEST (2020)
  PubDate: 2020-03-25
  DOI: 10.1016/j.chest.2020.03.021
Abnormal Pulmonary Lymphatic Flow in Patients with Lymphatic Anomalies and
Respiratory Compromise
- Authors: Maxim Itkin; Deborah Rabinowitz, Gregory Nadolski, Patrick Stafler, Leo Mascarenas, Denise Adams
  Abstract: Abnormal pulmonary lymphatic flow/ perfusion from the TD or retroperitoneum into lung parenchyma occurred in the majority of patients in this study. These findings can explain the interstitial lung disease and chylothorax resulting in deterioration of respiratory function in these patients. Future studies will determine, if mechanical cessation of this abnormal flow can improve pulmonary function and prolong survival in LA patients.
  Citation: CHEST (2020)
  PubDate: 2020-03-24
  DOI: 10.1016/j.chest.2020.02.058
Isolated pulmonary embolism is associated with a high risk of arterial
thrombotic disease – Results from the VTEval Study
- Authors: Vincent ten Cate; Lisa Eggebrecht, Andreas Schulz, Marina Panova-Noeva, Michael Lenz, Thomas Koeck, Steffen Rapp, Natalie Arnold, Karl J. Lackner, Stavros Konstantinides, Christine Espinola-Klein, Thomas Münzel, Jürgen H. Prochaska, Philipp S. Wild
  Abstract: Patients with isolated PE are at higher risk for arterial thrombosis, and may require screening for arterial disease and development of novel therapeutic strategies.
  Citation: CHEST (2020)
  PubDate: 2020-03-23
  DOI: 10.1016/j.chest.2020.01.055
Randomized trial on the effects of high-dose zopiclone on OSA severity,
upper airway physiology and alertness
- Authors: Sophie G. Carter; Jayne C. Carberry, Ronald R. Grunstein, Danny J. Eckert
  Abstract: A single night of treatment with high-dose zopiclone does not systematically reduce the AHI or increase the arousal threshold in selected people with OSA. The mechanisms for these unexpected findings require further investigation.
  Citation: CHEST (2020)
  PubDate: 2020-03-17
  DOI: 10.1016/j.chest.2020.02.057
Diagnostic accuracy of thoracic ultrasonography to differentiate
transudative from exudative pleural effusion
- Authors: Boris Shkolnik; Marc A. Judson, Adam Austin, Kurt Hu, Melissa D’souza, Alexis Zumbrunn, John T. Huggins, Recai Yucel, Amit Chopra
  Abstract: Thoracic ultrasonography is inadequate to reliably diagnose a transudative pleural effusion. Although the TUS findings of a complex effusion may suggest an exudative pleural effusion, specific pleural diagnoses cannot be confidently predicted.
  Citation: CHEST (2020)
  PubDate: 2020-03-17
  DOI: 10.1016/j.chest.2020.02.051
Association between participant contact attempts and reports of being
bothered in a national, longitudinal cohort study of ARDS survivors
- Authors: Michelle N. Eakin; Thomas Eckmann, Victor D. Dinglas, Ayodele A. Akinremi, Megan Hosey, Ramona O. Hopkins, Dale M. Needham
  Abstract: Comprehensive cohort retention efforts can achieve>95% retention rates in a national longitudinal study, with the vast majority of participants reporting little or no bother by contact attempts. Despite a high frequency of mental health symptoms in this population, such symptoms were not associated with participant feedback regarding contact attempts. Careful training of research staff may be important in achieving such results.
  Citation: CHEST (2020)
  PubDate: 2020-03-17
  DOI: 10.1016/j.chest.2020.02.050
Outcomes of Metabolic Resuscitation Using Ascorbic Acid, Thiamine, and
Glucocorticoids in the Early Treatment of Sepsis.
- Authors: Jose Iglesias; Andrew V. Vassallo, Vishal V. Patel, Jesse B. Sullivan, Joseph Cavanaugh, Yasmine Elbaga
  Abstract: Sepsis is a major public health burden resulting in 25-30% in-hospital mortality and accounting for over 20 billion dollars of United States hospital costs.
  Citation: CHEST (2020)
  PubDate: 2020-03-17
  DOI: 10.1016/j.chest.2020.02.049
INCREASED CHITOTRIOSIDASE IS ASSOCIATED WITH ASPERGILLUS AND FREQUENT
EXACERBATIONS IN SOUTH-EAST ASIANS WITH BRONCHIECTASIS
- Authors: Tuang Yeow Poh; Pei Yee Tiew, Albert Yick Hou Lim, Kai Xian Thng, Nur A'tikah Binte Mohamed Ali, Jayanth Kumar Narayana, Micheál Mac Aogáin, Zhijun Tien, Wui Mei Chew, Adrian Kwok Wai Chan, Holly R. Keir, Alison J. Dicker, Tidi Maharani Hassan, Huiying Xu, Augustine K.H. Tee, Thun How Ong, Mariko Siyue Koh, John Arputhan Abisheganaden, James D. Chalmers, Sanjay H. Chotirmall
  Abstract: Systemic CHIT1 activity may represent a useful clinical tool for the identification of fungal-driven ‘frequent exacerbators’ with bronchiectasis in South-East Asian populations.
  Citation: CHEST (2020)
  PubDate: 2020-03-14
  DOI: 10.1016/j.chest.2020.02.048
Diffusing Capacity is an Independent Predictor of Outcomes in Pulmonary
Hypertension Associated with Chronic Obstructive Pulmonary Disease
- Authors: Aparna Balasubramanian; Todd M. Kolb, Rachel L. Damico, Paul M. Hassoun, Meredith C. McCormack, Stephen C. Mathai
  Abstract: Among patients with COPD-PH, severe gas transfer impairment is associated with higher mortality, even when adjusting for airflow obstruction and hemodynamics, suggesting that DLCO may be a useful prognostic marker in this population. Future studies are needed to further investigate the association between DLCO and morbidity, and to determine the utility of DLCO as a biomarker for disease risk and severity in COPD-PH.
  Citation: CHEST (2020)
  PubDate: 2020-03-14
  DOI: 10.1016/j.chest.2020.02.047
Mortality of cardiovascular events in COPD patients with preceding
hospitalized acute exacerbation
- Authors: Mai Wang; Emily Pei-Ying Lin, Li-Ching Huang, Chung-Yi Li, Yu Shyr, Chao-Han Lai
  Abstract: Preceding hospitalized AE is associated with 90-day and overall mortality of cardiovascular events in COPD.
  Citation: CHEST (2020)
  PubDate: 2020-03-14
  DOI: 10.1016/j.chest.2020.02.046
Minimal clinically important differences for patient-reported outcome
- Authors: Patrícia Rebelo; Ana Oliveira, Lília Andrade, Carla Valente, Alda Marques
  Abstract: Fatigue is a burdensome and prevailing symptom in patients with chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) improves fatigue however, interpreting when such improvement is clinically relevant is challenging. Minimal clinically important differences (MCIDs) for instruments assessing fatigue are warranted to better tailor PR and guide clinical decisions. We estimated MCIDs for the functional assessment of chronic illness therapy-fatigue subscale (FACIT-FS), the modified-FACIT-FS and the checklist of individual strength-fatigue subscale (CIS-FS), in patients with COPD after PR.
  Citation: CHEST (2020)
  PubDate: 2020-03-14
  DOI: 10.1016/j.chest.2020.02.045
Derivation and Validation of a Diagnostic Prediction Tool for Interstitial
Lung Disease
- Authors: Janelle Vu Pugashetti; Aleksander Kitich, Shehabaldin Alqalyoobi, Anne-Catherine Maynard-Paquette, David Pritchard, Julia Graham, Noelle Boctor, Andrea Kulinich, Elyse Lafond, Elena Foster, Cesar Mendez, Saad Choudhry, Jean Chalaoui, Julie Morisset, Michael Kadoch, Justin M. Oldham
  Abstract: The ILD-Screen demonstrated good test performance in predicting ILD across diverse geographic settings and when applied prospectively. Systematic ILD-Screen application has the potential to reduce diagnostic delays and facilitate earlier intervention in patients with ILD.
  Citation: CHEST (2020)
  PubDate: 2020-03-14
  DOI: 10.1016/j.chest.2020.02.044
Managing Chronic Cough as a Symptom in Children and Management Algorithms:
CHEST Guideline and Expert Panel Report
- Authors: Anne B. Chang; John J. Oppenheimer, Richard S. Irwin, on behalf of the CHEST Expert Cough Panel
  Abstract: Cough is one of the most common presenting symptoms to general practitioners. The objective of this article is to collate the pediatric components of the CHEST chronic cough guidelines that have recently updated the 2006 guidelines to assist general and specialist medical practitioners in the evaluation and management of children who present with chronic cough.
  Citation: CHEST (2020)
  PubDate: 2020-03-13
  DOI: 10.1016/j.chest.2020.01.042
Change in V̇O2peak in response to aerobic exercise training and the
relationship with exercise prescription in people with COPD: A systematic
review and meta-analysis
- Authors: Thomas J.C. Ward; Charles D. Plumptre, Thomas E. Dolmage, Amy V. Jones, Ruth Trethewey, Pip Divall, Sally J. Singh, Martin R. Lindley, Michael C. Steiner, Rachael A. Evans
  Abstract: We investigated the effect of aerobic training and exercise prescription on peak oxygen uptake (V̇O2peak) in COPD.
  Citation: CHEST (2020)
  PubDate: 2020-03-12
  DOI: 10.1016/j.chest.2020.01.053
Pulmonary vascular and right ventricular burden during exercise in
interstitial lung disease
- Authors: Rudolf K.F. Oliveira; Aaron B. Waxman, Paul J. Hoover, Paul F. Dellaripa, David M. Systrom
  Abstract: Pulmonary hypertension (PH) adversely impact patient´s exercise capacity in interstitial lung disease (ILD). Pulmonary vascular and right ventricular (RV) dysfunction impact, however, have traditionally been thought to be mild, and clinically relevant principally in advanced lung disease states. We sought to evaluate the relative contributions of pulmonary mechanics, pulmonary vascular and RV function to the ILD exercise limit.
  Citation: CHEST (2020)
  PubDate: 2020-03-12
  DOI: 10.1016/j.chest.2020.02.043
Maternal distress during pregnancy and recurrence in early childhood
predicts atopic dermatitis and asthma in childhood
- Authors: Aaron P. van der Leek; Salma Bahreinian, Mariette Chartier, Matt Dahl, Meghan B. Azad, Marni D. Brownell, Anita L. Kozyrskyj
  Abstract: Using data from a provincial newborn screen and healthcare database for 12,587 children born in 2004, maternal distress was defined as: prenatal, and self-limiting, recurrent or late-onset postpartum. Atopic dermatitis (AD) and asthma at ages 5 and 7 were diagnosed from hospitalization, physician visit or prescription records. Associations between maternal distress, and childhood asthma and AD were determined with multiple logistic regression.
  Citation: CHEST (2020)
  PubDate: 2020-03-12
  DOI: 10.1016/j.chest.2020.01.052
Association Between Compliance with the Sepsis Quality Measure (SEP-1) and
Hospital Readmission
- Authors: Seth R. Bauer; Xiaozhen Han, Xiao-Feng Wang, Heather Blonsky, Anita J. Reddy
  Citation: CHEST (2020)
  PubDate: 2020-03-10
  DOI: 10.1016/j.chest.2020.02.042
Update on Persistent Excessive Daytime Sleepiness in Obstructive Sleep
Apnea
- Authors: Sogol Javaheri; Shahrokh Javaheri
  Abstract: Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder and subjective excessive daytime sleepiness (EDS) is the cardinal symptom for which many individuals seek medical advice. Positive airway pressure (PAP) devices, first line treatment for OSA, eliminates EDS in most patients. However, a subset of patients suffers from persistent EDS despite adherence to therapy. Multiple conditions, some reversible, could account for the residual sleepiness and need to be explored requiring detailed history, review of PAP data from the smart card and sometimes additional testing.
  Citation: CHEST (2020)
  PubDate: 2020-03-05
  DOI: 10.1016/j.chest.2020.02.036
Effect of Cefepime on Neurotoxicity Development in Critically Ill Adults
with Renal Dysfunction
- Authors: Attiya Khan; Joshua M. DeMott, Christy Varughese, Drayton A. Hammond
  Abstract: Pharmacodynamic and pathophysiologic changes in critically ill adults receiving cefepime may increase the risk of adverse events. This study evaluated the impact of cefepime exposure on neurotoxicity development in critically ill adults with renal dysfunction.
  Citation: CHEST (2020)
  PubDate: 2020-03-05
  DOI: 10.1016/j.chest.2020.01.051
Pulmonary Hypertension by the Method of Paul Wood
- Authors: John H. Newman
  Abstract: A physiological approach to the analysis of hemodynamic data in pulmonary hypertension (PH) has the advantage of reducing the large number (well over 100) of potential causal illnesses into four simple mechanisms. A fifth condition is composed of mixtures of the four basic mechanisms. This approach was beautifully described by Paul Wood, the great cardiologist whose name is given to the units of pulmonary vascular resistance (PVR), Wood units. This approach uses well understood physiological contributions to pulmonary vascular pressure.
  Citation: CHEST (2020)
  PubDate: 2020-03-05
  DOI: 10.1016/j.chest.2020.02.035
Treating Severe Obesity to Reduce Dyspnea in Patients with Chronic Lung
Disease: A Pilot Mixed Methods Study
- Authors: Kara Dupuy-McCauley; Paul Novotny, Roberto Benzo
  Citation: CHEST (2020)
  PubDate: 2020-03-04
  DOI: 10.1016/j.chest.2020.02.032
Financial Justification for Interventional Pulmonology Programs:
Terminology and Programmatic Models
- Authors: Amit K. Mahajan; Jennifer Bautista, Erin Hodson, Sandeep J Khandhar, Erik Folch, Susan Carroll, Steve Narang
  Abstract: Interventional pulmonology programs provide clinical benefit to patients and are financially sustainable. In order to appreciate and illustrate the economic value of interventional pulmonology programs to hospital systems, physicians must have an understanding of basic healthcare finance. Total revenue, adjusted gross revenue, contribution margin, variable direct costs, and indirect costs are terms that are essential for understanding the finances of bronchoscopy. Command of such vocabulary and its application is crucial for interventional pulmonologists to successfully establish financially sustainable bronchoscopy programs.
  Citation: CHEST (2020)
  PubDate: 2020-03-04
  DOI: 10.1016/j.chest.2020.02.026
Risk factors of infectious complications after endobronchial
ultrasound-guided transbronchial biopsy
- Authors: Tomohide Souma; Tomoyuki Minezawa, Hiroshi Yatsuya, Takuya Okamura, Kumiko Yamatsuta, Sayako Morikawa, Tomoya Horiguchi, Shingo Maeda, Yasuhiro Goto, Masamichi Hayashi, Sumito Isogai, Naoki Yamamoto, Masashi Kondo, Kazuyoshi Imaizumi
  Abstract: Infectious complications after endobronchial ultrasound-guided transbronchial biopsy with a guide sheath (EBUS-GS-TBB) are serious in that they may delay or change scheduled subsequent therapy. The aim of this study was to identify risk factors for infection after EBUS-GS-TBB.
  Citation: CHEST (2020)
  PubDate: 2020-03-04
  DOI: 10.1016/j.chest.2020.02.025
Who May Benefit from Diuretics in OSA' A Propensity Score-Match
Observational Study
- Authors: B. Revol; I. Jullian-Desayes, S. Bailly, R. Tamisier, Y. Grillet, M. Sapène, M. Joyeux-Faure, J.L. Pépin, OSFP national French registry scientific council
  Abstract: Diuretics have been reported as effective for reducing obstructive sleep apnea (OSA) severity by preventing fluid retention and reducing rostral fluid shift. The benefit of diuretics might vary depending upon the OSA clinical phenotype and comorbidities. To test this hypothesis, we conducted a propensity score-matched cohort analysis of data from the French national sleep apnea registry “Observatoire Sommeil de la Fédération de Pneumologie” (OSFP).
  Citation: CHEST (2020)
  PubDate: 2020-02-28
  DOI: 10.1016/j.chest.2020.01.050
Ambulatory oxygen in fibrotic ILD: a pilot, randomised, triple-blinded,
sham-controlled trial
- Authors: Yet H. Khor; Anne E. Holland, Nicole SL. Goh, Belinda R. Miller, Ross Vlahos, Steven Bozinovski, Aroub Lahham, Ian Glaspole, Christine F. McDonald
  Abstract: Despite a lack of evidence, ambulatory oxygen therapy is frequently prescribed for patients with interstitial lung disease (ILD) and exertional desaturation. Patients often prefer portable oxygen concentrators to oxygen cylinders. This study aimed to examine the feasibility of conducting a clinical trial of ambulatory oxygen delivered via portable concentrators in patients with ILD.
  Citation: CHEST (2020)
  PubDate: 2020-02-27
  DOI: 10.1016/j.chest.2020.01.049
Independent validation of early-stage NSCLC prognostic scores
incorporating epigenetic and transcriptional biomarkers with gene-gene
interactions and main effects
- Authors: Ruyang Zhang; Chao Chen, Xuesi Dong, Sipeng Shen, Linjing Lai, Jieyu He, Dongfang You, Lijuan Lin, Ying Zhu, Hui Huang, Jiajin Chen, Liangmin Wei, Xin Chen, Yi Li, Yichen Guo, Weiwei Duan, Liya Liu, Li Su, Andrea Shafer, Thomas Fleischer, Maria Moksnes Bjaanæs, Anna Karlsson, Maria Planck, Rui Wang, Johan Staaf, Åslaug Helland, Manel Esteller, Yongyue Wei, Feng Chen, David C. Christiani
  Abstract: DNA methylation and gene expression are promising biomarkers of various cancers, including non-small cell lung cancer (NSCLC). Besides main effects of biomarkers, the progression of complex diseases is also influenced by gene-gene (GxG) interactions. Screening the functional capacity of biomarkers based on main effects or interactions using multi-omics data may improve the accuracy of cancer prognosis.
  Citation: CHEST (2020)
  PubDate: 2020-02-27
  DOI: 10.1016/j.chest.2020.01.048
Simulation Training for Critical Care Airway Management: Assessing
Translation to Clinical Practice Using a Small Video Recording Device
- Authors: Ronak T. Shah; Mina R. Makaryus, Rohit Kumar, Effie Singas, Paul H. Mayo
  Abstract: Skill acquired through SBT of critical care fellows for CCAM transfers effectively to the real-life patient care arena. Second- and third-year fellows who had initially received SBT maintained skill at CCAM.
  Citation: CHEST (2020)
  PubDate: 2020-02-27
  DOI: 10.1016/j.chest.2020.01.047
Alternative Splicing of the Cardiac Sodium Channel in Pulmonary Arterial
Hypertension
- Authors: Debasree Banerjee; Tom N. Grammatopoulos, Amy Palmisciano, James R. Klinger, Ipsita Krishnan, Mary Whittenhall, Anyu Zhou, Samuel Dudley, Corey E. Ventetuolo
  Citation: CHEST (2020)
  PubDate: 2020-02-26
  DOI: 10.1016/j.chest.2019.12.052
Outcomes of Pulmonary Arterial Hypertension are Improved in a Specialty
Care Center
- Authors: Hongyang Pi; Chad M. Kosanovich, Adam Handen, Michael Tao, Jacqueline Visina, Gabrielle Vanspeybroeck, Marc A. Simon, Michael G. Risbano, Aken Desai, Michael A. Mathier, Belinda N. Rivera-Lebron, Quyen Nguyen, Jennifer Kliner, Mehdi Nouraie, Stephen Y. Chan
  Abstract: Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary arterial pressures managed by vasodilator therapies. Current guidelines encourage PAH management in specialty care centers (SCCs), but evidence is sparse regarding improvement in clinical outcomes and correlation to vasodilator use with referral. We hypothesize that PAH management at SCCs is associated with improved clinical outcomes.
  Citation: CHEST (2020)
  PubDate: 2020-02-25
  DOI: 10.1016/j.chest.2020.01.046
Use of combined do-not-resuscitate/do-not intubate orders without
documentation of intubation preferences: a retrospective observational
study at an academic Level 1 trauma center
- Authors: Jeffrey B. Rubins
  Abstract: Conflation of DNR and DNI into DNR/DNI does not reliably distinguish patients who refuse or accept intubation for indications other than cardiac arrest, and thus may inappropriately deny desired intubation for those who would accept it, and inappropriately impose intubation on patients who would not.
  Citation: CHEST (2020)
  PubDate: 2020-02-25
  DOI: 10.1016/j.chest.2020.02.020
Chronic Cough Due to Stable Chronic Bronchitis: CHEST Expert Panel Report
- Authors: Mark A. Malesker; Priscilla Callahan-Lyon, J. Mark Madison, Belinda Ireland, Richard S. Irwin, CHEST Expert Cough Panel
  Abstract: Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life and effective treatment strategies are needed. We conducted a systematic review on the management of chronic cough due to CB to update the recommendations and suggestions of the CHEST 2006 guideline on this topic.
  Citation: CHEST (2020)
  PubDate: 2020-02-24
  DOI: 10.1016/j.chest.2020.02.015
Diagnosis of EVALI: General Approach and the Role of Bronchoscopy
- Authors: Scott K. Aberegg; Sean D. Maddock, Denitza P. Blagev, Sean J. Callahan
  Abstract: A 23 year-old man arrives at the emergency department with a three week history of dyspnea, dry cough, fevers and night sweats. Two weeks previously, he was evaluated in an outpatient clinic and given a course of azithromycin for presumed infectious pneumonia. His symptoms did not improve and he was seen one week later in an urgent care center and given a prescription for doxycycline which he has been taking without improvement. He states that he feels miserable, has severe nausea and vomiting, and has not eaten in several days.
  Citation: CHEST (2020)
  PubDate: 2020-02-21
  DOI: 10.1016/j.chest.2020.02.018
Acute Cough Due to Acute Bronchitis in Immunocompetent Adult Outpatients
- Authors: Maeve P. Smith; Mark Lown, Sonal Singh, Belinda Ireland, Adam T. Hill, Jeffrey A. Linder, Richard S. Irwin, CHEST Expert Cough Panel
  Abstract: Evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 “Chronic Cough Due to Acute Bronchitis: ACCP Evidence-Based Clinical Practice Guidelines.”
  Citation: CHEST (2020)
  PubDate: 2020-02-21
  DOI: 10.1016/j.chest.2020.01.044
The Association between Air Pollution and Hospitalization of Patients with
Idiopathic Pulmonary Fibrosis in Chile: A daily time series analysis.
- Authors: Robert Dales; Claudia Blanco-Vidal, Sabit Cakmak
  Abstract: Idiopathic pulmonary fibrosis (IPF) causes progressive dyspnea, hypoxemia and death within a few years. Little is known about the effect of air pollution on disease exacerbations.
  Citation: CHEST (2020)
  PubDate: 2020-02-21
  DOI: 10.1016/j.chest.2020.02.017
A Randomized, double-blind, placebo-controlled study to assess the safety
and efficacy of pulsed, inhaled nitric oxide (iNO) at a dose of 30
mcg/kg-IBW/hr (iNO 30) in subjects at risk of Pulmonary Hypertension
associated with Pulmonary Fibrosis (PH-PF) receiving Oxygen Therapy
- Authors: Steve.D. Nathan; Kevin.R. Flaherty, Marilyn.K. Glassberg, Ganesh Raghu, Jeffrey Swigris, Roger Alvarez, Neil Ettinger, Jim Loyd, Peter Fernandes, Hunter Gillies, Bo Kim, Parag Shah, Lisa Lancaster
  Abstract: The interstitial lung diseases include a variety of disorders, many of which are characterized by fibrotic changes (fILD). Of the fILDs, Idiopathic Pulmonary Fibrosis (IPF) is the most common. Pulmonary hypertension (PH) frequently complicates fILD and is associated with impaired functional capability, lower physical activity and significantly reduced life expectancy. There is no proven treatment for patients with fILD-PH. We report results from the first Cohort of a Phase 2b/3 trial with pulsed iNO in patients with fILD-PH.
  Citation: CHEST (2020)
  PubDate: 2020-02-21
  DOI: 10.1016/j.chest.2020.02.016
‘HIGH RISK’ CLINICAL AND INFLAMMATORY CLUSTERS IN COPD OF
CHINESE DESCENT
- Authors: Pei Yee Tiew; Fanny Wai San Ko, Jayanth Kumar Narayana, Mau Ern Poh, Huiying Xu, Han Yee Neo, Li-Cher Loh, Choo-Khoo Ong, Micheál Mac Aogáin, Jessica Han Ying Tan, Nabilah Husna Kamaruddin, Gerald Jiong Hui Sim, Therese S. Lapperre, Mariko Siyue Koh, David Shu Cheong Hui, John Arputhan Abisheganaden, Augustine Tee, Krasimira Tsaneva-Atanasova, Sanjay H. Chotirmall
  Abstract: COPD is a heterogeneous disease demonstrating inter-individual variation. A high COPD prevalence in Chinese populations is described but little is known about disease clusters and prognostic outcomes in the Chinese population across South-East Asia. We aim to determine if clusters of Chinese patients with COPD exist and their association with systemic inflammation and clinical outcomes.
  Citation: CHEST (2020)
  PubDate: 2020-02-21
  DOI: 10.1016/j.chest.2020.01.043
Patterns of use of adjunctive therapies in patients with early moderate-
severe Acute Respiratory Distress syndrome: Insights from the LUNG SAFE
Study
- Authors: Abhijit Duggal; Emanuele Rezoagli, Tai Pham, Bairbre A. McNicholas, Eddy Fan, Giacomo Bellani, Gordon Rubenfeld, Antonio Pesenti, John G. Laffey, LUNG SAFE Investigators the ESICM Trials Group
  Abstract: Three in ten patients with moderate-severe ARDS, and only one third of non-survivors, received adjunctive strategies over the first 48 hours of ARDS. A more consistent and evidence driven approach to adjunct use may reduce costs and improve outcomes in patients with moderate-severe ARDS.
  Citation: CHEST (2020)
  PubDate: 2020-02-20
  DOI: 10.1016/j.chest.2020.01.041
Better With Ultrasound
- Authors: Ariel L. Shiloh; Christa McPhee, Lewis Eisen, Seth Koenig, Scott J. Millington
  Abstract: Ultrasound studies to detect DVT are traditionally performed and interpreted by sonographers and radiologists, respectively, but the growth of point-of-care ultrasound is putting this powerful tool in the hands of front-line physicians. Literature from ambulatory patients in the ED suggests this tool performs well in the hands of nonconventional users, and it is now being commonly deployed to aid in the management of critically ill patients. This article presents an approach for incorporating these tools into bedside practice, including illustrative figures and narrated video presentations to demonstrate the techniques described.
  Citation: CHEST (2020)
  PubDate: 2020-02-20
  DOI: 10.1016/j.chest.2020.01.038
A Novel Coronavirus (COVID-19) Outbreak
- Authors: Yi Zhang; Jiuyang Xu, Hui Li, Bin Cao
  Abstract: In December 2019, Wuhan, Hubei province, China, one of the six megalopolises with a population of 14 million, became the center of an outbreak of pneumonia of unknown cause. Because the early cases were linked to the Huanan Seafood Market, the market was shut down on January 1, 2020. One week later, on January 7, 2020, Chinese health authorities confirmed that they had identified a novel coronavirus (COVID-19). On January 30, 2020, the World Health Organization Director-General made the final decision on the determination of a Public Health Emergency of International Concern regarding the outbreak in China, with exportations to other countries.
  Citation: CHEST (2020)
  PubDate: 2020-02-19
  DOI: 10.1016/j.chest.2020.02.014
Incorporating Medical Student Documentation into the Billable Encounter: A
Pragmatic Approach to Implementation of the 2018 CMS Rule Revision
- Authors: Amy E. Blatt; Anne C. Nofziger, Paul C. Levy
  Abstract: In early 2018, CMS released the Medical Review of Evaluation and Management (E/M) Documentation, which allows supervising teaching physicians to rely on a medical student’s documentation to support billing for E/M services. This change has potential to enhance education, clinical documentation quality, and the satisfaction of students, post-graduate trainees, and teaching physicians. However, its practical adoption presents many challenges that must be navigated successfully to realize these important goals in compliance with federal and local requirements, while avoiding unintended downstream problems.
  Citation: CHEST (2020)
  PubDate: 2020-02-18
  DOI: 10.1016/j.chest.2020.02.010
Differences in clinical characteristics and outcomes between men and women
with idiopathic pulmonary fibrosis: a multicenter retrospective cohort
study
- Authors: Tanzira Zaman; Teng Moua, Eric Vittinghoff, Jay H. Ryu, Harold R. Collard, Joyce S. Lee
  Abstract: Male sex is associated with worse transplant-free survival in IPF. Cough may be a sex-specific predictor of survival in this population.
  Citation: CHEST (2020)
  PubDate: 2020-02-18
  DOI: 10.1016/j.chest.2020.02.009
Variability and Misclassification of Sleep Apnea Severity Based on
Multi-Night Testing
- Authors: Naresh M. Punjabi; Susheel Patil, Ciprian Crainiceanu, R. Nisha Aurora
  Abstract: Portable monitoring is a convenient means for diagnosing sleep apnea. However, data on whether 1 night of monitoring is sufficiently precise for the diagnosis of sleep apnea are limited. The current study sought to determine the variability and misclassification in disease severity over 3 consecutive nights in a large sample of patients referred for sleep apnea.
  Citation: CHEST (2020)
  PubDate: 2020-02-18
  DOI: 10.1016/j.chest.2020.01.039
Patient-Centered, Guideline-Concordant Discussion and Management of
Pulmonary Nodules
- Authors: Daniel C. Wiener; Renda Soylemez Wiener
  Abstract: Providing guideline-concordant management of pulmonary nodules can present challenges when a patient’s anxiety about cancer or fear of invasive procedures colors judgment. The way in which providers discuss and make decisions about how to evaluate a pulmonary nodule can affect patient satisfaction, distress, and adherence to evaluation. This article discusses the complexity of tailoring patient-provider communication, decision-making, and implementation of guidelines for pulmonary nodule evaluation to the individual patient, emphasizing the importance of how information is conveyed and the value of listening to and addressing patients’ concerns.
  Citation: CHEST (2020)
  PubDate: 2020-02-18
  DOI: 10.1016/j.chest.2020.02.007
Noninvasive Pulmonary Hemodynamic Evaluation in Athletes With
Exercise-Induced Hypoxemia
- Authors: Fabienne Durand; Anne-Fleur Gaston, Marco Vicenzi, Gael Deboeck, Enric Subirats, Vitalie Faoro
  Abstract: Pulmonary capillary stress failure is potentially involved in exercise-induced hypoxemia (ie, a significant fall in hemoglobin oxygen saturation [Spo2]) during sea level exercise in endurance-trained athletes. It is unknown whether there are specific properties of pulmonary vascular function in athletes exhibiting oxygen desaturation.
  Citation: CHEST (2020)
  PubDate: 2020-02-18
  DOI: 10.1016/j.chest.2020.01.037
Standardized Bleeding Definitions After Transbronchial Lung Biopsy
- Authors: Erik E. Folch; Amit K. Mahajan, Catherine L. Oberg, Fabien Maldonado, Eric Toloza, William S. Krimsky, Scott Oh, Mark R. Bowling, Sadia Benzaquen, Charles M. Kinsey, Atul C. Mehta, Sebastian Fernandez-Bussy, Javier Flandes, Kelvin Lau, Ganesh Krishna, Michael A. Nead, Felix Herth, Alejandro A. Aragaki-Nakahodo, Emanuela Barisione, Sandeep Bansal, Dragos Zanchi, Michael Zgoda, Peter O. Lutz, Robert J. Lentz, Christopher Parks, Mario Salio, Kenneth Perret, Colleen Keyes, Gregory P. LeMense, John D. Hinze, Adnan Majid, Merete Christensen, Jordan Kazakov, Gonzalo Labarca, Ernest Waller, Michael Studnicka, Catalina V. Teba, Sandeep J. Khandhar
  Abstract: Transbronchial lung biopsies are commonly performed for a variety of indications. Although generally well tolerated, complications such as bleeding do occur. Description of bleeding severity is crucial both clinically and in research trials; to date, there is no validated scale that is widely accepted for this purpose. Can a simple, reproducible tool for categorizing the severity of bleeding after transbronchial biopsy be created'
  Citation: CHEST (2020)
  PubDate: 2020-02-14
  DOI: 10.1016/j.chest.2020.01.036
Drowning Classification
- Authors: Thibaut Markarian; Anderson Loundou, Vera Heyer, Cyril Marimoutou, Laurie Borghese, Mathieu Coulange, Pierre Michelet
  Abstract: Drowning is still a major cause of accidental death worldwide. In 1997, Szpilman proposed a classification of drowning that has become the reference. As considerable efforts have been made to improve prevention and care, it seemed appropriate to reassess the prognosis and clinical presentation of drowning patients more than 20 years after this first publication. The aim of this study is to provide a reappraisal of patients who need advanced health care and a precise description of their respective neurologic, respiratory, and hemodynamic profiles.
  Citation: CHEST (2020)
  PubDate: 2020-02-14
  DOI: 10.1016/j.chest.2020.01.035
Lung Function Longitudinal Study by Phenotype and Genotype in Primary
Ciliary Dyskinesia
- Authors: Massimo Pifferi; Andrew Bush, Francesca Mariani, Martina Piras, Angela Michelucci, Angela Cangiotti, Maria Di Cicco, Maria Adelaide Caligo, Mario Miccoli, Attilio L. Boner, Diego Peroni
  Abstract: There is considerable variability in the severity and progression of lung disease in primary ciliary dyskinesia (PCD).1-3 Few studies have related progression of lung function to the underlying ultrastructural defect.4,5 We investigated the age-related evolution of spirometry to identify associations between ultrastructural defects, gene mutations, BMI,6 and bacterial airway infections in a longitudinal study of adult and pediatric patients with PCD.
  Citation: CHEST (2020)
  PubDate: 2020-02-12
  DOI: 10.1016/j.chest.2020.02.001
Recognition and Management of Myositis-associated Rapidly Progressive
Interstitial Lung Disease
- Authors: Renea Jablonski; Sangeeta Bhorade, Mary E. Strek, Jane Dematte
  Abstract: Idiopathic inflammatory myopathies are autoimmune processes that are characterized by skeletal muscle inflammation. The lung is the most commonly involved extramuscular organ, and, when present, pulmonary disease drives morbidity and mortality. A subset of patients can present with rapidly progressive hypoxemic respiratory failure due to myositis-related interstitial lung disease. Confirmatory autoantibody testing requires sending samples to a reference laboratory; thus, diagnosis of rapidly progressive myositis-associated interstitial lung disease relies on a high index of suspicion and careful history and physical examination.
  Citation: CHEST (2020)
  PubDate: 2020-02-11
  DOI: 10.1016/j.chest.2020.01.033
Palatal Sensory Function Worsens in Untreated Snorers but not in
CPAP-treated Patients With Sleep Apnea, Indicating Vibration-induced
Nervous Lesions
- Authors: Eva Svanborg; Martin Ulander, Anders Broström, Ola Sunnergren
  Abstract: Signs of both motor and sensory nervous lesions have previously been shown in the upper airway of patients with OSA and habitual snorers. Snoring per se may damage all upper airway neurons over time, thereby causing progression to manifest sleep apnea. To test this hypothesis, nonsnoring subjects, untreated snorers, and CPAP-treated patients underwent repeated sensory testing of the soft palate in a prospective long-term study.
  Citation: CHEST (2020)
  PubDate: 2020-02-11
  DOI: 10.1016/j.chest.2020.01.032
Somatostatin Analogs Improve Respiratory Symptoms in Patients With Diffuse
Idiopathic Neuroendocrine Cell Hyperplasia
- Authors: Taymeyah Al-Toubah; Jonathan Strosberg, Thor Halfdanarson, Kira Oleinikov, David J. Gross, Mintallah Haider, Mohamad Bassam Sonbol, Daniel Almquist, Simona Grozinsky-Glasberg
  Abstract: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare lung disease associated with proliferation of neuroendocrine cells in the lung and multifocal neuroendocrine tumorlets/tumors. Although usually considered an indolent condition, DIPNECH causes chronic, progressive cough and dyspnea which can adversely impact quality of life. There is very limited information on the treatment of this condition. The objective of this study was to assess changes in symptoms and pulmonary function tests (PFTs) in response to somatostatin analog (SSA) treatment.
  Citation: CHEST (2020)
  PubDate: 2020-02-11
  DOI: 10.1016/j.chest.2020.01.031
New Billing Rules for Outpatient Office Visit Codes
- Authors: Steve G. Peters
  Abstract: Guidelines for clinical documentation of evaluation and management face-to-face services were developed> 20 years ago. Recently, the Centers for Medicare & Medicaid Services (CMS) have addressed office and other outpatient services and the corresponding reimbursement, intending to reduce the amount of required documentation and to alleviate clerical burden. A CMS final rule for 2021 will eliminate the history and physical examination as criteria for level of service, allow time or medical decision-making to be used as coding criteria, and will recognize a code for prolonged service.
  Citation: CHEST (2020)
  PubDate: 2020-02-10
  DOI: 10.1016/j.chest.2020.01.028
Senotherapy
- Authors: Jonathan R. Baker; Louise E. Donnelly, Peter J. Barnes
  Abstract: There is increasing evidence that COPD is a disease of accelerated lung aging, with the accumulation of senescent cells that lose their ability to repair and secrete multiple inflammatory proteins known as the senescence-associated secretory phenotype (SASP), which mimic the profile of inflammatory mediators secreted in COPD. This review discusses novel drugs (senotherapies) that target cellular senescence and which may be a promising therapeutic approach to prevent currently unaddressed disease progression and mortality in COPD.
  Citation: CHEST (2020)
  PubDate: 2020-02-10
  DOI: 10.1016/j.chest.2020.01.027
Evaluating Knowledge, Attitudes, and Beliefs About Lung Cancer Screening
Using Crowdsourcing
- Authors: John Monu; Matthew Triplette, Douglas E. Wood, Erika M. Wolff, Danielle C. Lavallee, David R. Flum, Farhood Farjah
  Abstract: Lung cancer screening, despite its proven mortality benefit, remains vastly underutilized. Previous studies examined knowledge, attitudes, and beliefs to better understand the reasons underlying the low screening rates. These investigations may have limited generalizability because of traditional participant recruitment strategies and examining only subpopulations eligible for screening. The current study used crowdsourcing to recruit a broader population to assess these factors in a potentially more general population.
  Citation: CHEST (2020)
  PubDate: 2020-02-06
  DOI: 10.1016/j.chest.2019.12.048
Association of Medication Adherence and Clinical Outcomes in Sarcoidosis
- Authors: Michelle Sharp; Taylor Brown, Edward S. Chen, Cynthia S. Rand, David R. Moller, Michelle N. Eakin
  Abstract: Sarcoidosis, one of the most common interstitial lung diseases, has significant health disparities. Approximately 50% of individuals affected with sarcoidosis will undergo spontaneous remission, but those who do not undergo remission often require long-term or lifelong treatment to prevent disease progression. We sought to assess the association between medication adherence and clinical outcomes in sarcoidosis.
  Citation: CHEST (2020)
  PubDate: 2020-02-04
  DOI: 10.1016/j.chest.2020.01.026
Clinical Evaluation of Deployed Military Personnel With Chronic
Respiratory Symptoms
- Authors: Michael J. Morris; Robert J. Walter, Edward T. McCann, John H. Sherner, Christina G. Murillo, Brian S. Barber, John C. Hunninghake, Aaron B. Holley
  Abstract: Chronic respiratory symptoms are frequently reported after Southwest Asia deployment in support of combat operations. The full spectrum of clinical lung diseases related to these deployments is not well characterized.
  Citation: CHEST (2020)
  PubDate: 2020-02-01
  DOI: 10.1016/j.chest.2020.01.024
Luminal Plugging on Chest CT Scan
- Authors: Yuka Okajima; Carolyn E. Come, Pietro Nardelli, Sushil K. Sonavane, Andrew Yen, Hrudaya P. Nath, Nina Terry, Scott A. Grumley, Asmaa Ahmed, Seth Kligerman, Kathleen Jacobs, David A. Lynch, Barry J. Make, Edwin K. Silverman, George R. Washko, Raúl San José Estépar, Alejandro A. Diaz
  Abstract: Mucous exudates occluding the lumen of small airways are associated with reduced lung function and mortality in subjects with COPD; however, luminal plugs in large airways have not been widely studied. We aimed to examine the associations of chest CT scan-identified luminal plugging with lung function, health-related quality of life, and COPD phenotypes.
  Citation: CHEST (2020)
  PubDate: 2020-02-01
  DOI: 10.1016/j.chest.2019.12.046
Genetics and Other Omics in Pediatric Pulmonary Arterial Hypertension
- Authors: Carrie L. Welch; Wendy K. Chung
  Abstract: Pulmonary arterial hypertension (PAH) is a rare disease with high mortality despite therapeutic advances. Clinical management of children with PAH is particularly challenging because of increased complexity of disease etiology and clinical presentation, and the lack of data from pediatric-specific clinical trials. In children, PAH often develops in association with congenital heart disease and other developmental disorders. Emerging data from genetic studies of pediatric-onset PAH indicate that the genetic basis is different than that of adults.
  Citation: CHEST (2020)
  PubDate: 2020-01-29
  DOI: 10.1016/j.chest.2020.01.013
Effects of the Combination of Atomoxetine and Oxybutynin on OSA Endotypic
Traits
- Authors: Luigi Taranto-Montemurro; Ludovico Messineo, Ali Azarbarzin, Daniel Vena, Lauren B. Hess, Nicole A. Calianese, David P. White, Andrew Wellman, Scott A. Sands
  Abstract: We recently showed that administration of the combination of the noradrenergic drug atomoxetine plus the antimuscarinic oxybutynin (ato-oxy) prior to sleep greatly reduced OSA severity, likely by increasing upper airway dilator muscle activity during sleep. In patients with OSA who performed the ato-oxy trial with an esophageal pressure catheter to estimate ventilatory drive, the effect of the drug combination (n = 17) and of the single drugs (n = 6) was measured on the endotypic traits over a 1-night administration and compared vs placebo.
  Citation: CHEST (2020)
  PubDate: 2020-01-29
  DOI: 10.1016/j.chest.2020.01.012
The Evolving Landscape of Electronic Cigarettes
- Authors: Jack Bozier; Emily K. Chivers, David G. Chapman, Alexander N. Larcombe, Nicole Bastian, J.A. Masso-Silva, M.K. Byun, Christine F. McDonald, Laura E. Alexander Crotty, Miranda P. Ween
  Abstract: Smoking continues to be a burden to economies and health-care systems across the world. One proposed solution to the problem has been e-cigarettes; however, because they are a relatively new product in the market, little is known about their potential health impacts. Furthermore, e-cigarettes continue to evolve at a rapid rate, making it necessary to regularly review and synthesize available studies. Although e-cigarettes are marketed as a smoking cessation tool by some manufacturers, the reality is that many nonsmokers, including youth, are using them.
  Citation: CHEST (2020)
  PubDate: 2020-01-29
  DOI: 10.1016/j.chest.2019.12.042
Hospital-Based Resource Use and Costs Among Patients With Idiopathic
Pulmonary Fibrosis Enrolled in the Idiopathic Pulmonary Fibrosis
Prospective Outcomes (IPF-PRO) Registry
- Authors: Yanni Fan; Shaun D. Bender, Craig S. Conoscenti, Linda Davidson-Ray, Patricia A. Cowper, Scott M. Palmer, Joao A. de Andrade, IPF-PRO Registry Investigators
  Abstract: Idiopathic pulmonary fibrosis (IPF) is a rare and serious condition that is associated with high health-care resource use. The goal of this study was to estimate hospital-related resource use and costs by using a national, prospective registry of patients who were diagnosed with IPF or who had their diagnosis confirmed at the enrolling center in the past 6 months in the United States.
  Citation: CHEST (2020)
  PubDate: 2020-01-28
  DOI: 10.1016/j.chest.2019.12.041
Morbid Obesity and Mortality in Patients With VTE
- Authors: Matteo Giorgi-Pierfranceschi; Juan José López Núñez, Manuel Monreal, Chiara Cattabiani, Corrado Lodigiani, Pierpaolo Di Micco, Behnood Bikdeli, Andrei Braester, Silvia Soler, Francesco Dentali
  Abstract: The influence of morbid obesity on mortality in patients receiving anticoagulant therapy for VTE has not been consistently evaluated.
  Citation: CHEST (2020)
  PubDate: 2020-01-28
  DOI: 10.1016/j.chest.2019.12.040
Prognostic Value of 6-Min Walk Test to Predict Postoperative
- Authors: Hyun Lee; Hong Kwan Kim, Danbee Kang, Sunga Kong, Jae Kyung Lee, Genehee Lee, Sumin Shin, Juhee Cho, Jae Ill Zo, Young Mog Shim, Hye Yun Park
  Abstract: The risk stratification value of the 6-min walk test (6MWT) to decide the feasibility of surgical resection is not well elucidated in patients with non-small cell lung cancer (NSCLC) and moderately decreased lung function.
  Citation: CHEST (2020)
  PubDate: 2020-01-24
  DOI: 10.1016/j.chest.2019.12.039
Chronic Cough in Individuals With COPD
- Authors: Eskild Landt; Yunus Çolak, Peter Lange, Lars Christian Laursen, Børge G. Nordestgaard, Morten Dahl
  Abstract: The role and impact of chronic cough in individuals with COPD have not been described in the general population. This study hypothesized that comorbid chronic cough is a marker of disease severity in individuals with COPD.
  Citation: CHEST (2020)
  PubDate: 2020-01-24
  DOI: 10.1016/j.chest.2019.12.038
Noninvasive Prognostic Biomarkers for Left-Sided Heart Failure as
Predictors of Survival in Pulmonary Arterial Hypertension
- Authors: Catherine E. Simpson; Rachel L. Damico, Paul M. Hassoun, Lisa J. Martin, Jun Yang, Melanie K. Nies, R. Dhananjay Vaidya, Stephanie Brandal, Michael W. Pauciulo, Eric D. Austin, D. Dunbar Ivy, William C. Nichols, Allen D. Everett
  Abstract: Three biomarkers, soluble suppression of tumorigenicity 2 (ST2), galectin 3 (Gal3), and N-terminal brain natriuretic peptide prohormone (NT-proBNP), are approved for noninvasive risk assessment in left-sided heart failure, and small observational studies have shown their prognostic usefulness in heterogeneous pulmonary hypertension cohorts. We examined associations between these biomarkers and disease severity and survival in a large cohort of patients with pulmonary arterial hypertension (PAH) (ie, group 1 pulmonary hypertension).
  Citation: CHEST (2020)
  PubDate: 2020-01-24
  DOI: 10.1016/j.chest.2019.12.037
Lower vs Higher Fluid Volumes During Initial Management of Sepsis
- Authors: Tine Sylvest Meyhoff; Morten Hylander Møller, Peter Buhl Hjortrup, Maria Cronhjort, Anders Perner, Jørn Wetterslev
  Abstract: IV fluids are recommended during the initial management of sepsis, but the quality of evidence is low, and clinical equipoise exists. We aimed to assess patient-important benefits and harms of lower vs higher fluid volumes in adult patients with sepsis.
  Citation: CHEST (2020)
  PubDate: 2020-01-23
  DOI: 10.1016/j.chest.2019.11.050
Bronchodilator Response Assessed by the Forced Oscillation Technique
Identifies Poor Asthma Control With Greater Sensitivity Than Spirometry
- Authors: Alice M. Cottee; Leigh M. Seccombe, Cindy Thamrin, Gregory G. King, Matthew J. Peters, Claude S. Farah
  Abstract: Persistent bronchodilator response (BDR) following diagnosis of asthma is an underrecognized treatable trait, associated with worse lung function and asthma control. The forced oscillation technique (FOT) measures respiratory system impedance, and BDR cutoffs have been proposed for healthy adults; however, the relevance in asthma is unknown. We compared BDR cutoffs, using FOT and spirometry, in asthma and the relationship with asthma control.
  Citation: CHEST (2020)
  PubDate: 2020-01-23
  DOI: 10.1016/j.chest.2019.12.035
The Utility of Electronic Inhaler Monitoring in COPD Management
- Authors: Amy A. Attaway; Khaled Alshabani, Bruce Bender, Umur S. Hatipoğlu
  Abstract: COPD is a common respiratory disorder that poses a major health-care burden with societal and financial ramifications. Although effective inhaled therapies are available, nonadherence is common among patients with COPD and potentially contributes to the burden of this disease. Electronic inhaler monitoring (EIM) is a novel modality that enables real-time assessment of adherence to inhaled therapy and informs the assessment of treatment effectiveness. EIM can be combined with physician feedback, automated audiovisual reminders, and text messaging to bolster adherence.
  Citation: CHEST (2020)
  PubDate: 2020-01-22
  DOI: 10.1016/j.chest.2019.12.034
Effect of Olfactory Stimulation by L-Menthol on Laboratory-Induced Dyspnea
in COPD
- Authors: Masashi Kanezaki; Kunihiko Terada, Satoru Ebihara
  Abstract: Inhalation of L-menthol as a transient receptor potential melastatin 8 agonist induces a cooling sensation in the airway. This cooling sensation induced through olfactory stimulation by L-menthol (OSM) alleviates dyspnea in healthy humans. Therefore, we investigated effects of OSM on the neural respiratory drive (NRD) and multidimensional aspects of dyspnea induced by inspiratory resistive loaded breathing in COPD.
  Citation: CHEST (2020)
  PubDate: 2020-01-22
  DOI: 10.1016/j.chest.2019.12.028
Change in Clinical Practice Associated With a Large Randomized Controlled
Trial Comparing RBC Transfusion Strategies
- Authors: Kevin M. Trentino; Frank M. Sanfilippo, Michael F. Leahy, Shannon L. Farmer, Ian Gilfillan, Kevin Murray
  Abstract: In 2015, the Transfusion Indication Threshold Reduction (TITRe2) randomized controlled trial (RCT) reported significantly more deaths at 90 days in patients assigned to restrictive transfusion thresholds when compared with liberal thresholds after cardiac surgery.1 Although death was a secondary outcome and this finding was inconsistent with previous trials, it raised concerns about adopting restrictive thresholds.2 In 2008 in Western Australia, a Patient Blood Management Program3 was initiated, and between 2008 and 2014 this program resulted in significant reductions in pretransfusion hemoglobin thresholds.
  Citation: CHEST (2020)
  PubDate: 2020-01-22
  DOI: 10.1016/j.chest.2020.01.004
Pictorial Review of Thoracic Parasitic Diseases
- Authors: Luís F. Fiorentini; Pedro Bergo, Gustavo S.P. Meirelles, Julia Capobianco, Tan-Lucien Mohammed, Nupur Verma, Edson Marchiori, Klaus L. Irion, Bruno Hochhegger
  Abstract: Parasitoses are infectious diseases of global distribution, with predominance in areas of poor sanitation. Parasites cause damage through direct tissue injury and the inflammatory response generated by their migration and establishment in various organs. Thoracic involvement by parasitic disease can generate both specific and nonspecific clinical, laboratorial, and radiologic manifestations, which often makes their diagnosis challenging. The correct diagnosis is crucial for definition of treatment, which sometimes requires rapid intervention.
  Citation: CHEST (2020)
  PubDate: 2020-01-21
  DOI: 10.1016/j.chest.2019.12.025
An Evaluation of Diagnostic Yield From Bronchoscopy
- Authors: Gerard A. Silvestri; Benjamin T. Bevill, Jing Huang, Mary Brooks, Yoonha Choi, Giulia Kennedy, Lori Lofaro, Alex Chen, M. Patricia Rivera, Nichole T. Tanner, Anil Vachani, Lonny Yarmus, Nicholas J. Pastis
  Abstract: Bronchoscopy is commonly used to evaluate suspicious lung lesions. The yield is likely dependent on patient, radiographic, and bronchoscopic factors. Few studies have assessed these factors simultaneously while also including the preprocedure physician-assessed probability of cancer (pCA) when assessing yield.
  Citation: CHEST (2020)
  PubDate: 2020-01-21
  DOI: 10.1016/j.chest.2019.12.024
Association Between Inhaled Corticosteroids and Tracheobronchomalacia
- Authors: Varun Shah; Bryan Husta, Atul Mehta, Soumya Ashok, Oki Ishikawa, Guillaume Stoffels, Jennifer Hartzband, Richard Lazzaro, Byron Patton, Viera Lakticova, Suhail Raoof
  Abstract: The aim of this study was to assess any association between use of inhaled corticosteroids (ICS) and tracheobronchomalacia (TBM).
  Citation: CHEST (2020)
  PubDate: 2020-01-21
  DOI: 10.1016/j.chest.2019.12.023
Managing Chronic Cough due to Asthma and NAEB in Adults and Adolescents
- Authors: Andreanne Côté; Richard J. Russell, Louis-Philippe Boulet, Peter G. Gibson, Kefang Lai, Richard S. Irwin, Christopher E. Brightling, CHEST Expert Cough Panel
  Abstract: Asthma and non-asthmatic eosinophilic bronchitis (NAEB) are among the commonest causes of chronic cough in adults. We sought to determine the role of non-invasive measurements of airway inflammation, including induced sputum and fractional exhaled nitric oxide, in the evaluation of cough associated with asthma, and what the best treatment is for cough due to asthma or NAEB.
  Citation: CHEST (2020)
  PubDate: 2020-01-20
  DOI: 10.1016/j.chest.2019.12.021
Update on Apneas of Heart Failure With Reduced Ejection Fraction: Emphasis
on the Physiology of Treatment
- Authors: Shahrokh Javaheri; Lee K. Brown, Rami N. Khayat
  Abstract: Central sleep apnea/Hunter-Cheyne-Stokes breathing (CSA/HCSB) is prevalent in patients with heart failure with reduced ejection fraction (HFrEF). The acute pathobiologic consequences of CSA/HSCB eventually lead to sustained sympathetic overactivity, repeated hospitalization, and premature mortality. A few small randomized controlled trials (RCTs) have shown statistically significant and clinically important reduction in sympathetic activity when CSA/HCSB is attenuated by oxygen or PAP therapy, using both CPAP and adaptive servoventilation (ASV) devices.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.12.020
Aprepitant for Cough Suppression in Advanced Lung Cancer
- Authors: Vanita Noronha; Atanu Bhattacharjee, Vijay M. Patil, Amit Joshi, Nandini Menon, Srushti Shah, Sadhana Kannan, Sadaf A. Mukadam, Kamesh Maske, Sandeep Ishi, Kumar Prabhash
  Abstract: Although cough is a common and distressing symptom in patients with lung cancer, there is almost no evidence to guide treatment. Aprepitant, a centrally acting neurokinin-1 inhibitor, significantly decreased cough frequency in a pilot study.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.11.048
Genetic Risk Factors for Spontaneous Pneumothorax in Birt-Hogg-Dubé
Syndrome
- Authors: Elke C. Sattler; Zulfiya Syunyaeva, Ulrich Mansmann, Ortrud K. Steinlein
  Abstract: Birt-Hogg-Dubé syndrome (BHDS) is a genetic tumor syndrome characterized by lung cysts, spontaneous pneumothorax, fibrofolliculomas, and renal cell cancer. Because of its rarity and clinical heterogeneity, much is still unknown regarding the course of the disease and individual risk assessment. Therefore, we studied nonenvironmental risk factors for pneumothorax in a large sample of patients with BHDS.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.12.019
Associations Among 25-Hydroxyvitamin D Levels, Lung Function, and
Exacerbation Outcomes in COPD
- Authors: Robert M. Burkes; Agathe S. Ceppe, Claire M. Doerschuk, David Couper, Eric A. Hoffman, Alejandro P. Comellas, R. Graham Barr, Jerry A. Krishnan, Christopher Cooper, Wassim W. Labaki, Victor E. Ortega, J. Michael Wells, Gerard J. Criner, Prescott G. Woodruff, Russell P. Bowler, Cheryl S. Pirozzi, Nadia N. Hansel, Robert A. Wise, Todd T. Brown, M. Bradley Drummond, SPIROMICS Investigators
  Abstract: The relationship between 25-hydroxyvitamin D (25-OH-vitamin D) and COPD outcomes remains unclear. Using the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS), we determined associations among baseline 25-OH-vitamin D and cross-sectional and longitudinal lung function and COPD exacerbations.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.11.047
A Systematic Review of Digital vs Analog Drainage for Air Leak After
Surgical Resection or Spontaneous Pneumothorax
- Authors: Fadi Aldaghlawi; Jonathan S. Kurman, Jason A. Lilly, D. Kyle Hogarth, Jessica Donington, Mark K. Ferguson, Septimiu D. Murgu
  Abstract: The concerns regarding air leak after lung surgery or spontaneous pneumothorax include detection and duration. Prior studies have suggested that digital drainage systems permit shorter chest tube duration and hospital length of stay (LOS) by earlier detection of air leak cessation. We conducted a systematic review to assess the impact of digital drainage on chest tube duration and hospital LOS after pulmonary surgery and spontaneous pneumothorax.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.11.046
Eosinophilic Granulomatosis With Polyangiitis
- Authors: Alvise Berti; Divi Cornec, Marta Casal Moura, Robert J. Smyth, Lorenzo Dagna, Ulrich Specks, Karina A. Keogh
  Abstract: The long-term clinical course of asthma in patients with eosinophilic granulomatosis with polyangiitis (EGPA) remains unclear. We aimed to characterize long-term asthma in EGPA and to identify baseline predictors of long-term asthma severity.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.11.045
A Systematically Derived Exposure Assessment Instrument for Chronic
Hypersensitivity Pneumonitis
- Authors: Hayley Barnes; Julie Morisset, Philip Molyneaux, Glen Westall, Ian Glaspole, Harold R. Collard, CHP Exposure Assessment Collaborators
  Abstract: Chronic hypersensitivity pneumonitis (CHP) is an immune-mediated interstitial lung disease (ILD) caused by inhalational exposure to environmental antigens, resulting in parenchymal fibrosis. By definition, a diagnosis of CHP assumes a history of antigen exposure, but only half of all patients eventually diagnosed with CHP will have a causative antigen identified. Individual clinician variation in eliciting a history of antigen exposure may affect the frequency and confidence of CHP diagnosis.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.12.018
A Geographic Analysis of Racial Disparities in Use of Pulmonary
Rehabilitation After Hospitalization for COPD Exacerbation
- Authors: Kerry A. Spitzer; Mihaela S. Stefan, Aruna Priya, Quinn R. Pack, Penelope S. Pekow, Tara Lagu, Kathy M. Mazor, Victor M. Pinto-Plata, Richard L. ZuWallack, Peter K. Lindenauer
  Abstract: Guidelines recommend pulmonary rehabilitation (PR) after hospitalization for an exacerbation of COPD, but few patients enroll in PR. We explored whether density of PR programs explained regional variation and racial disparities in receipt of PR.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.11.044
Impact of Preoperative Measurement of Right Heart Chambers in the
Evaluation of Pulmonary Hypertension Following Aortic Valve Replacement
- Authors: Mercè Cladellas; Cora Garcia-Ribas, Mirea Ble, Miquel Gómez, Núria Farré, Aleksandra Mas-Stachurska, Consol Ivern, Joan Vila, Julio Martí-Almor
  Abstract: Severe pulmonary hypertension (PH) in patients with aortic stenosis is related to poor prognosis following aortic valve replacement (AVR). Current European PH guidelines recommend adding two different echocardiographic signs to tricuspid regurgitation velocity (TRV) in PH estimation, classifying its probability as low (TRV ≤ 2.8 m/s), intermediate (TRV 2.9-3.4 m/s), and high (TRV> 3.4 m/s). The right ventricle is an important determinant of prognosis in PH. The goal of this study was to analyze the value of right atrial area> 18 cm2 and right ventricular/left ventricular ratio> 1 in the long-term prognosis following AVR, mainly in the intermediate probability group.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.12.017
Underweight Patients With Cystic Fibrosis Have Acceptable Survival
Following Lung Transplantation
- Authors: Kathleen J. Ramos; Siddhartha G. Kapnadak, Miranda C. Bradford, Ranjani Somayaji, Eric D. Morrell, Joseph M. Pilewski, Erika D. Lease, Michael S. Mulligan, Moira L. Aitken, Cynthia J. Gries, Christopher H. Goss
  Abstract: Reduced BMI is an absolute contraindication for lung transplantation (LTx) at most centers in the United States. The objective of this study was to quantify post-LTx survival of moderate to severely underweight patients with cystic fibrosis (CF) (BMI < 17 kg/m2) in the United States relative to normal-weight recipients with CF and other frequently transplanted patient cohorts.
  Citation: CHEST (2020)
  PubDate: 2020-01-17
  DOI: 10.1016/j.chest.2019.11.043
Treatment Duration and Disease Recurrence Following the Successful
Treatment of Patients With Mycobacterium avium Complex Lung Disease
- Authors: Koji Furuuchi; Kozo Morimoto, Atsuyuki Kurashima, Keiji Fujiwara, Keitaro Nakamoto, Yoshiaki Tanaka, Hiromasa Tachibana, Kozo Yoshimori, Yuka Sasaki, Ken Ohta
  Abstract: Treatment of Mycobacterium avium complex lung disease (MAC-LD) is challenging because it requires long-term therapy with multiple antibiotics, and the treatment outcomes are relatively poor.1,2 Moreover, there is a high rate of recurrence, either by relapse or reinfection.3 Although MAC-LD treatment guidelines in the United States recommended 12 months of treatment following culture conversion,4 there is limited evidence for this approach. In addition, although reinfection is common, several studies showed that 25% to 50% of the recurrence was due to true relapse.
  Citation: CHEST (2020)
  PubDate: 2020-01-16
  DOI: 10.1016/j.chest.2019.12.016
Disease Severity and Quality of Life in Patients With Idiopathic Pulmonary
Fibrosis
- Authors: Emily C. O’Brien; Anne S. Hellkamp, Megan L. Neely, Aparna Swaminathan, Shaun Bender, Laurie D. Snyder, Daniel A. Culver, Craig S. Conoscenti, Jamie L. Todd, Scott M. Palmer, Thomas B. Leonard, IPF-PRO Registry investigators
  Abstract: Limited data are available on the association between clinically measured disease severity markers and quality of life (QOL) in idiopathic pulmonary fibrosis (IPF). The study examined the associations between objective disease severity metrics and QOL in a contemporary IPF population.
  Citation: CHEST (2020)
  PubDate: 2020-01-15
  DOI: 10.1016/j.chest.2019.11.042
Epithelial Mesenchymal Transition in Respiratory Disease
- Authors: Darryl A. Knight; Christopher L. Grainge, Stephen M. Stick, Anthony Kicic, Michael Schuliga
  Abstract: Aberrant wound repair and fibrosis play a fundamental role in many major diseases concerning pulmonologists, including all forms of pulmonary fibrosis as well as COPD, asthma, cystic fibrosis (CF), bronchiolitis obliterans syndrome (BOS), and bronchiectasis. Accordingly, understanding normal and abnormal wound repair in the lung is a major objective of many academic groups and industry programs; one aspect of wound repair requiring urgent attention focuses on what drives the increased number of extracellular matrix (ECM)-secreting mesenchymal cells.
  Citation: CHEST (2020)
  PubDate: 2020-01-14
  DOI: 10.1016/j.chest.2019.12.014
Respiratory Disease and Lower Pulmonary Function as Risk Factors for
Dementia
- Authors: Tom C. Russ; Mika Kivimäki, G. David Batty
  Abstract: In addition to affecting the oxygen supply to the brain, pulmonary function is a marker of multiple insults throughout life (including smoking, illness, and socioeconomic deprivation). In this meta-analysis of existing longitudinal studies, the hypothesis that lower pulmonary function and respiratory illness are linked to an elevated risk of dementia was tested.
  Citation: CHEST (2020)
  PubDate: 2020-01-14
  DOI: 10.1016/j.chest.2019.12.012
Arnold Nerve Reflex
- Authors: Yonglin Mai; Chen Zhan, Shengfang Zhang, Jiaxing Liu, Wanqin Liang, Jiawei Cai, Kefang Lai, Nanshan Zhong, Ruchong Chen
  Abstract: A higher incidence of Arnold nerve reflex (ANR) has been observed in patients with chronic cough. However, the different ANR response in various causes of chronic cough remains unclear. Furthermore, it is unknown whether ANR will change after effective treatment.
  Citation: CHEST (2020)
  PubDate: 2020-01-13
  DOI: 10.1016/j.chest.2019.11.041
Machine Learning Characterization of COPD Subtypes
- Authors: Peter J. Castaldi; Adel Boueiz, Jeong Yun, Raul San Jose Estepar, James C. Ross, George Washko, Michael H. Cho, Craig P. Hersh, Gregory L. Kinney, Kendra A. Young, Elizabeth A. Regan, David A. Lynch, Gerald J. Criner, Jennifer G. Dy, Stephen I. Rennard, Richard Casaburi, Barry J. Make, James Crapo, Edwin K. Silverman, John E. Hokanson, COPDGene Investigators
  Abstract: COPD is a heterogeneous syndrome. Many COPD subtypes have been proposed, but there is not yet consensus on how many COPD subtypes there are and how they should be defined. The COPD Genetic Epidemiology Study (COPDGene), which has generated 10-year longitudinal chest imaging, spirometry, and molecular data, is a rich resource for relating COPD phenotypes to underlying genetic and molecular mechanisms. In this article, we place COPDGene clustering studies in context with other highly cited COPD clustering studies, and summarize the main COPD subtype findings from COPDGene.
  Citation: CHEST (2019)
  PubDate: 2019-12-27
  DOI: 10.1016/j.chest.2019.11.039
Comparative Safety and Effectiveness of Inhaled Corticosteroid and
Long-Acting β2-Agonist Combinations in Patients With COPD
- Authors: Ting-Yu Chang; Jung-Yien Chien, Chung-Hsuen Wu, Yaa-Hui Dong, Fang-Ju Lin
  Abstract: The differential risk of pneumonia among inhaled corticosteroid (ICS) use in patients with COPD requires more investigation, especially regarding beclomethasone-containing inhalers. The goal of this study was to compare the risk and benefit profile of different ICS/long-acting β2-agonist (LABA) combinations in patients with COPD.
  Citation: CHEST (2019)
  PubDate: 2019-12-27
  DOI: 10.1016/j.chest.2019.12.006
IgA Antibodies Directed Against Citrullinated Protein Antigens Are
Elevated in Patients With Idiopathic Pulmonary Fibrosis
- Authors: Joshua J. Solomon; Scott Matson, Lindsay B. Kelmenson, Jonathan H. Chung, Stephen B. Hobbs, Ivan O. Rosas, Paul F. Dellaripa, Tracy J. Doyle, Sergio Poli, Anthony J. Esposito, Ashley Visser, A. Itzam Marin, Isabelle Amigues, Evans R. Fernández Pérez, Kevin K. Brown, Michael Mahler, David Heinz, Carlyne Cool, Kevin D. Deane, Jeffrey J. Swigris, M. Kristen Demoruelle
  Abstract: The etiology of idiopathic pulmonary fibrosis (IPF) is unknown. Because it shares genetic, histopathologic, and radiographic features with the fibrosing interstitial lung disease seen in rheumatoid arthritis (RA), the goal of this study was to investigate RA-related autoantibodies in IPF.
  Citation: CHEST (2019)
  PubDate: 2019-12-23
  DOI: 10.1016/j.chest.2019.12.005
Appraising the Integral Role of the Electronic Health Record and Tracking
Software in the Implementation of Lung Cancer Screening
- Authors: Joelle T. Fathi; Charles S. White, Grant M. Greenberg, Peter J. Mazzone, Robert A. Smith, Carey C. Thomson
  Abstract: The development of a high-quality lung cancer screening (LCS) program poses many operational challenges. Compared with criteria for other cancer screening target populations, the criteria for LCS eligibility are more complex, including age, smoking history, and general health status. Furthermore, among Medicare-eligible adults who qualify for LCS, which is a substantial proportion of the target population, the Centers for Medicare & Medicaid Services (CMS) has regulatory mandates that apply to the screening process and must be met for reimbursement.
  Citation: CHEST (2019)
  PubDate: 2019-12-23
  DOI: 10.1016/j.chest.2019.12.004
Sleep and Delirium in Adults Who Are Critically Ill
- Authors: Margaret A. Pisani; Carolyn D’Ambrosio
  Abstract: Sleep is important to health and well-being, and studies in healthy adults have demonstrated that sleep deprivation impacts respiratory, immune, and cognitive function. Historically, because of the nature of critical illness, sleep has not been considered a priority for patient care in the ICU. More recently, research has demonstrated that sleep is markedly abnormal in patients who are critically ill. In addition, there is often disruption of circadian rhythms. Delirium is a syndrome of acute alteration in mental status that occurs in the setting of contributing factors such as serious illness, medication, and drug or alcohol intoxication or withdrawal.
  Citation: CHEST (2019)
  PubDate: 2019-12-21
  DOI: 10.1016/j.chest.2019.12.003
Physical and Social Environment Relationship With Sleep Health and
Disorders
- Authors: Martha E. Billings; Lauren Hale, Dayna A. Johnson
  Abstract: Sleep health is a multidimensional construct that includes adequate duration, quality, and appropriately timed sleep that may be influenced by environmental factors. In this review, we focus on how an individual’s living and sleeping environment, both the surrounding neighborhood physical and social features and the atmosphere around them, may impact their sleep health. We explore the associations of the physical environment (urban density, recreational facilities, green space, mixed land use, and healthy food stores), neighborhood deprivation (disadvantage and disorder), and the social environment (social cohesion, safety, and stigma) with sleep in both adult and pediatric populations.
  Citation: CHEST (2019)
  PubDate: 2019-12-20
  DOI: 10.1016/j.chest.2019.12.002
Neurological Pupil index for Early Prognostication After Venoarterial
Extracorporeal Membrane Oxygenation
- Authors: John-Paul Miroz; Nawfel Ben-Hamouda, Adriano Bernini, Federico Romagnosi, Filippo Bongiovanni, Aurélien Roumy, Matthias Kirsch, Lucas Liaudet, Philippe Eckert, Mauro Oddo
  Abstract: Venoarterial extracorporeal membrane oxygenation therapy (VA-ECMO) after refractory cardiogenic shock or cardiac arrest has significant morbidity and mortality. Early outcome prediction is crucial in this setting, but data on neuroprognostication are limited. We examined the prognostic value of clinical neurologic examination, using an automated device for the quantitative measurement of pupillary light reactivity.
  Citation: CHEST (2019)
  PubDate: 2019-12-20
  DOI: 10.1016/j.chest.2019.11.037
Intratracheal Delivery of Nano- and Microparticles and Hyperpolarized
Gases
- Authors: Hongbin Wang; Lina Wu, Xilin Sun
  Abstract: Accurate diagnosis is crucial to improve the treatment and prognosis of respiratory disease, especially lung cancer. Tumors and lesions located deep in the lung are directly accessible via dendritic tracheal bronchus, thereby opening a new way to tackle respiratory disease. Intratracheal delivery is an innovative, noninvasive approach for imaging and treating respiratory disease efficiently, when compared with other delivery methods. Intratracheal delivery of nano- and microparticles and hyperpolarized gases offers valuable clinical advantages, such as assessing lung function, monitoring ventilation and perfusion, controlling disease progression, and inhibiting tumor growth.
  Citation: CHEST (2019)
  PubDate: 2019-12-20
  DOI: 10.1016/j.chest.2019.11.036
Neighborhood Disadvantage and Lung Cancer Incidence in Ever-Smokers at a
Safety Net Health-Care System
- Authors: Yosra Adie; Daniel J. Kats, Abdulhakim Tlimat, Adam Perzynski, Jarrod Dalton, Douglas Gunzler, Yasir Tarabichi
  Abstract: Neighborhood circumstances have an influence on multiple health outcomes, but the association between neighborhood conditions and lung cancer incidence has not been studied in sufficient detail. The goal of this study was to understand whether neighborhood conditions are independently associated with lung cancer incidence in ever-smokers after adjusting for individual smoking exposure and other risk factors.
  Citation: CHEST (2019)
  PubDate: 2019-12-17
  DOI: 10.1016/j.chest.2019.11.033
Multidisciplinary Team-Based Management of Incidentally Detected Lung
Nodules
- Authors: Francys C. Verdial; David K. Madtes, Guang-Shing Cheng, Sudhakar Pipavath, Richard Kim, Jesse J. Hubbard, Megan Zadworny, Douglas E. Wood, Farhood Farjah
  Abstract: Each year,> 1.5 million Americans are diagnosed with an incidentally detected lung nodule. Practice guidelines attempt to balance the benefit of early detection of lung cancer with the risks of diagnostic testing, but adherence to guidelines is low. The goal of this study was to determine guideline adherence rates in the setting of a multidisciplinary nodule clinic and describe reasons for nonadherence as well as associated outcomes.
  Citation: CHEST (2019)
  PubDate: 2019-12-17
  DOI: 10.1016/j.chest.2019.11.032
International Severe Asthma Registry
- Authors: The ISAR Study Group
  Abstract: Regional and/or national severe asthma registries provide valuable country-specific information. However, they are often limited in scope within the broader definitions of severe asthma, have insufficient statistical power to answer many research questions, lack intraoperability to share lessons learned, and have fundamental differences in data collected, making cross comparisons difficult. What is missing is a worldwide registry which brings all severe asthma data together in a cohesive way, under a single umbrella, based on standardized data collection protocols, permitting data to be shared seamlessly.
  Citation: CHEST (2019)
  PubDate: 2019-12-12
Comparing the Effectiveness and Safety of Nonvitamin K Antagonist Oral
Anticoagulants and Warfarin in Elderly Asian Patients With Atrial
Fibrillation
- Authors: Tze-Fan Chao; Chern-En Chiang, Jo-Nan Liao, Tzeng-Ji Chen, Gregory Y.H. Lip, Shih-Ann Chen
  Abstract: Stroke prevention in elderly patients with atrial fibrillation (AF) can be challenging, requiring a balance between thromboembolism prevention and serious bleeding. Comparisons of nonvitamin K antagonist oral anticoagulants (NOACs) and warfarin in older adults at different age strata (65-74, 75-89, and ≥ 90 years of age) in the daily practice have not been well described, particularly in Asians. We aimed to assess the clinical outcomes of NOACs compared with warfarin for stroke prevention in elderly patients with AF.
  Citation: CHEST (2019)
  PubDate: 2019-12-03
  DOI: 10.1016/j.chest.2019.11.025
Postembolotherapy Pulmonary Arteriovenous Malformation Follow-Up
- Authors: Daniel M. DePietro; Nicole R. Curnes, Jesse Chittams, Victor A. Ferrari, Reed E. Pyeritz, Scott O. Trerotola
  Abstract: High-resolution chest CT (HRCT) scan is recommended after pulmonary arteriovenous malformation (PAVM) embolotherapy to assess for PAVM persistence and untreated PAVM growth. Graded transthoracic contrast echocardiography (TTCE) predicts the need for embolotherapy in PAVM screening. This study sought to determine whether postembolotherapy graded TTCE can similarly predict the need for repeat embolotherapy.
  Citation: CHEST (2019)
  PubDate: 2019-11-30
  DOI: 10.1016/j.chest.2019.11.023
Reference Standards for Ventilatory Threshold Measured With
Cardiopulmonary Exercise Testing
- Authors: Baruch Vainshelboim; Ross Arena, Leonard A. Kaminsky, Jonathan Myers
  Abstract: Established reference standards for the ventilatory threshold (Vt) are lacking. The aim of this study was to develop reference standards for the Vt derived from cardiopulmonary exercise testing (CPX) using treadmill and cycle ergometry.
  Citation: CHEST (2019)
  PubDate: 2019-11-30
  DOI: 10.1016/j.chest.2019.11.022
Is Mortality a Useful Primary End Point for Critical Care Trials'
- Authors: Richard A. Veldhoen; Daniel Howes, David M. Maslove
  Abstract: Mortality has long been used as a primary end point for randomized controlled trials in critical care. Recently, a plurality of trials targeting mortality end points as their primary outcome has failed to detect a difference between study arms. While there are a number of reasons for the preponderance of such neutral trials, the use of mortality as an outcome is one important consideration. We explore some of the reasons why such trials may be biased toward a neutral result, as well as reasons to consider alternative end points that are better coupled to the expected therapeutic effect.
  Citation: CHEST (2019)
  PubDate: 2019-11-29
  DOI: 10.1016/j.chest.2019.11.019
The Association of Nicotine Replacement Therapy With Outcomes Among
Smokers Hospitalized for a Major Surgical Procedure
- Authors: Mihaela S. Stefan; Quinn Pack, Meng-Shiou Shieh, Penelope S. Pekow, Steven L. Bernstein, Karthik Raghunathan, Katie S. Nason, Peter K. Lindenauer
  Abstract: There are concerns that starting nicotine replacement therapy (NRT) in the immediate perioperative period may negatively impact wound healing. We investigated the association of NRT with postoperative outcomes among smokers hospitalized for a surgical procedure.
  Citation: CHEST (2019)
  PubDate: 2019-11-29
Characterization of Severe Asthma Worldwide
- Authors: Eileen Wang; Michael E. Wechsler, Trung N. Tran, Liam G. Heaney, Rupert C. Jones, Andrew N. Menzies-Gow, John Busby, David J. Jackson, Paul E. Pfeffer, Chin Kook Rhee, You Sook Cho, G. Walter Canonica, Enrico Heffler, Peter G. Gibson, Mark Hew, Matthew Peters, Erin S. Harvey, Marianna Alacqua, James Zangrilli, Lakmini Bulathsinhala, Victoria A. Carter, Isha Chaudhry, Neva Eleangovan, Naeimeh Hosseini, Ruth B. Murray, David B. Price
  Abstract: Clinical characteristics of the international population with severe asthma are unknown. Intercountry comparisons are hindered by variable data collection within regional and national severe asthma registries. We aimed to describe demographic and clinical characteristics of patients treated in severe asthma services in the United States, Europe, and the Asia-Pacific region.
  Citation: CHEST (2019)
  PubDate: 2019-11-27
Effect of Different Probes and Expertise on the Interpretation Reliability
of Point-of-Care Lung Ultrasound
- Authors: Clotilde Gomond-Le Goff; Laura Vivalda, Silvia Foligno, Barbara Loi, Nadya Yousef, Daniele De Luca
  Abstract: The effect of different probes and operator experience on the reliability of lung ultrasound (LU) interpretation has not been investigated. We studied the effect of probes and operator experience on the interpretation reliability of LU in critically ill neonates.
  Citation: CHEST (2019)
  PubDate: 2019-11-27
  DOI: 10.1016/j.chest.2019.11.013
Role of House Calls in the Care of Patients With Pulmonary Disease
- Authors: Elizabeth T. McCormick; Christian Escobar, Ania Wajnberg
  Abstract: As the population ages, and more patients with chronic pulmonary diseases become frail and functionally impaired, the prevalence of homebound patients grows. Homebound patients have higher disease burden, inpatient utilization rates, and mortality than nonhomebound patients. Vulnerable homebound patients with pulmonary disease benefit from pulmonary expertise to evaluate and optimize their complex medication regimens; evaluate equipment such as nebulizers, home oxygen, ventilators, and suction machines; and coordinate services.
  Citation: CHEST (2019)
  PubDate: 2019-11-27
In-Hospital Mortality-Associated Factors in Patients With Thrombotic
Antiphospholipid Syndrome Requiring ICU Admission
- Authors: Marc Pineton de Chambrun; Romaric Larcher, Frédéric Pène, Laurent Argaud, Julien Mayaux, Matthieu Jamme, Remi Coudroy, Alexis Mathian, Aude Gibelin, Elie Azoulay, Yacine Tandjaoui-Lambiotte, Auguste Dargent, François-Michel Beloncle, Jean-Herlé Raphalen, Amélie Couteau-Chardon, Nicolas de Prost, Jérôme Devaquet, Damien Contou, Samuel Gaugain, Pierre Trouiller, Steven Grangé, Stanislas Ledochowski, Jérémie Lemarie, Stanislas Faguer, Vincent Degos, Charles-Edouard Luyt, Alain Combes, Zahir Amoura
  Abstract: The antiphospholipid syndrome (APS) is a systemic autoimmune disease defined by thrombotic events that can require ICU admission because of organ dysfunction related to macrovascular and/or microvascular thrombosis. Critically ill patients with thrombosis and APS were studied to gain insight into their prognoses and in-hospital mortality-associated factors.
  Citation: CHEST (2019)
  PubDate: 2019-11-26
  DOI: 10.1016/j.chest.2019.11.010
Transbronchial Cryobiopsy for the Diagnosis of Interstitial Lung Diseases
- Authors: Fabien Maldonado; Sonye K. Danoff, Athol U. Wells, Thomas V. Colby, Jay H. Ryu, Moishe Liberman, Momen M. Wahidi, Lindsy Frazer, Juergen Hetzel, Otis B. Rickman, Felix J.F. Herth, Venerino Poletti, Lonny B. Yarmus
  Abstract: Transbronchial cryobiopsy (TBC) is increasingly recognized as a potential alternative to surgical lung biopsy (SLB) for the diagnosis of interstitial lung disease (ILD). The goal of this analysis was to examine the literature on TBC as it relates to diagnostic utility and safety to provide evidence-based and expert guidance to clinicians.
  Citation: CHEST (2019)
  PubDate: 2019-11-26
Protein Misfolding and Endoplasmic Reticulum Stress in Chronic Lung
Disease
- Authors: Safaa Naiel; Victor Tat, Manreet Padwal, Megan Vierhout, Olivia Mekhael, Tamana Yousof, Anmar Ayoub, Soumeya Abed, Anna Dvorkin-Gheva, Kjetil Ask
  Abstract: Chronic lung disease accounts for a significant global burden with respect to death, disability, and health-care costs. Due to the heterogeneous nature and limited treatment options for these diseases, it is imperative that the cellular and molecular mechanisms underlying the disease pathophysiology are further understood. The lung is a complex organ with a diverse cell population, and each cell type will likely have different roles in disease initiation, progression, and resolution. The effectiveness of a given therapeutic agent may depend on the net effect on each of these cell types.
  Citation: CHEST (2019)
  PubDate: 2019-11-25
  DOI: 10.1016/j.chest.2019.11.009
Prevalence of Pulmonary Bullae and Blebs in Postmortem CT Imaging With
Potential Implications for Diving Medicine
- Authors: Henri M. de Bakker; Melanie Tijsterman, Olga J.G. de Bakker-Teunissen, Vidija Soerdjbalie-Maikoe, Rob A. van Hulst, Bernadette S. de Bakker
  Abstract: Pulmonary bullae and blebs can result in a pneumothorax. Their prevalence in the normal population is currently unknown. Postmortem CT (PMCT) images from a forensic database were used to determine the prevalence of pulmonary bullae/blebs in the normal Dutch adult population and its consequence for diving medicine, as bullae and blebs are often considered a contraindication for diving.
  Citation: CHEST (2019)
  PubDate: 2019-11-21
  DOI: 10.1016/j.chest.2019.11.008
Comparative Effects of LAMA-LABA-ICS vs LAMA-LABA for COPD
- Authors: Samy Suissa; Sophie Dell’Aniello, Pierre Ernst
  Abstract: Triple therapy combinations of a long-acting muscarinic antagonist (LAMA), a long-acting beta2-agonist (LABA), and an inhaled corticosteroid (ICS) for COPD were studied in randomized trials and observational studies, with variable results. We compared the effectiveness and safety of triple therapy with a LAMA-LABA combination in a real-world clinical practice setting.
  Citation: CHEST (2019)
  PubDate: 2019-11-21
  DOI: 10.1016/j.chest.2019.11.007
State-Level Variations in the Utilization of Lung Cancer Screening Among
Medicare Fee-for-Service Beneficiaries
- Authors: Bian Liu; Kavita Dharmarajan, Claudia I. Henschke, Emanuela Taioli
  Abstract: Lung cancer screening (LCS) is an important secondary prevention measure to reduce lung cancer mortality. The goal of this study was to assess state-level variations in LCS among the US elderly during the first 3 years since Medicare began its LCS reimbursement policy in 2015.
  Citation: CHEST (2019)
  PubDate: 2019-11-21
  DOI: 10.1016/j.chest.2019.11.005
Evaluation of Changes in Control Status in COPD
- Authors: Juan José Soler-Cataluña; Bernardino Alcázar, Maribel Marzo, Joselín Pérez, Marc Miravitlles
  Abstract: Control has been proposed as a dynamic tool that can capture changes in the clinical status of patients with COPD.
  Citation: CHEST (2019)
  PubDate: 2019-11-21
  DOI: 10.1016/j.chest.2019.11.004
Thirty-Day Spending and Outcomes for an Episode of Pneumonia Care Among
Medicare Beneficiaries
- Authors: Jordan D. Anderson; Rishi K. Wadhera, Karen E. Joynt Maddox, Yun Wang, Changyu Shen, Jennifer P. Stevens, Robert W. Yeh
  Abstract: Recent policy initiatives aim to improve the value of care for patients hospitalized with pneumonia. It is unclear whether higher 30-day episode spending at the hospital level is associated with any difference in patient mortality among fee-for-service Medicare beneficiaries.
  Citation: CHEST (2019)
  PubDate: 2019-11-21
  DOI: 10.1016/j.chest.2019.11.003
Cardiovascular Risk in COPD
- Authors: Thibaud Soumagne; Nicolas Roche, Alicia Guillien, Malika Bouhaddi, Steffi Rocchi, Sophie Hue, Frédéric Claudé, Lucie Bizard, Pascal Andujar, Jean-Charles Dalphin, Bruno Degano
  Abstract: The observation that COPD is an independent risk factor for cardiovascular disease (CVDs) comes from comparisons between smokers with COPD and smokers without COPD. The mechanisms that explain increased risk of CVD in patients with COPD are still unclear.
  Citation: CHEST (2019)
  PubDate: 2019-11-21
  DOI: 10.1016/j.chest.2019.11.002
Dyspnea Postpulmonary Embolism From Physiological Dead Space Proportion
and Stroke Volume Defects During Exercise
- Authors: Timothy M. Fernandes; Mona Alotaibi, Danielle M. Strozza, William W. Stringer, Janos Porszasz, Garner G. Faulkner, Cara F. Castro, Don A. Tran, Timothy A. Morris
  Abstract: Many patients with pulmonary embolism (PE) report dyspnea on exertion following long-term treatment. Increased physiological dead space proportion (VD/VT) and decreased cardiac stroke volume reserve may distinguish persistent effects of PE itself from symptoms reflecting comorbid conditions or deconditioning.
  Citation: CHEST (2019)
  PubDate: 2019-11-21
Survival Improved in Patients Aged ≤ 70 Years With Systemic
Sclerosis-Associated Pulmonary Arterial Hypertension During the Period
2006 to 2017 in France
- Authors: Eric Hachulla; David Launay, Athénaïs Boucly, Luc Mouthon, Pascal de Groote, Vincent Cottin, Grégory Pugnet, Grégoire Prévôt, Delphine Bourlier, Claire Dauphin, Ari Chaouat, Jason Weatherald, Gérald Simonneau, David Montani, Marc Humbert, Olivier Sitbon, Jonathan Giovannelli
  Abstract: To date, nothing is known about the evolution of survival in systemic sclerosis-associated pulmonary arterial hypertension (PAH) over the last decade.
  Citation: CHEST (2019)
  PubDate: 2019-11-19
Acute Ventilatory Support During Whole-Body Hybrid Rowing in Patients With
High-Level Spinal Cord Injury
- Authors: Isabelle Vivodtzev; Glen Picard, Felipe X. Cepeda, J. Andrew Taylor
  Abstract: High-level spinal cord injury (SCI) results in profound spinal and supraspinal deficits, leading to substantial ventilatory limitations during whole-body hybrid functional electrical stimulation (FES)-rowing, a form of exercise that markedly increases the active muscle mass via electrically induced leg contractions. This study tested the effect of noninvasive ventilation (NIV) on ventilatory and aerobic capacities in SCI.
  Citation: CHEST (2019)
  PubDate: 2019-11-15
Results of an Expert Consensus Survey on the Treatment of Pulmonary
Arterial Hypertension With Oral Prostacyclin Pathway Agents
- Authors: Vallerie V. McLaughlin; Richard Channick, Teresa De Marco, Harrison W. Farber, Sean Gaine, Nazzareno Galié, Richard A. Krasuski, Ioana Preston, Rogerio Souza, J. Gerry Coghlan, Robert P. Frantz, Anna Hemnes, Nick H. Kim, Irene M. Lang, David Langleben, Mengtao Li, Olivier Sitbon, Victor Tapson, Adaani Frost
  Abstract: Treatment of pulmonary arterial hypertension (PAH) has evolved substantially over the past two decades and varies according to etiology, functional class (FC), hemodynamic parameters, and other clinical factors. Current guidelines do not provide definitive recommendations regarding the use of oral prostacyclin pathway agents (PPAs) in PAH. To provide guidance on the use of these agents, an expert panel was convened to develop consensus statements for the initiation of oral PPAs in adults with PAH.
  Citation: CHEST (2019)
  PubDate: 2019-11-15
Sensitivity of Radial Endobronchial Ultrasound-Guided Bronchoscopy for
Lung Cancer in Patients With Peripheral Pulmonary Lesions
- Authors: Paula V. Sainz Zuñiga; Erik Vakil, Sofia Molina, Roland L. Bassett, David E. Ost
  Abstract: Registry trials have found radial endobronchial ultrasound (r-EBUS) sensitivity to vary between institutions, suggesting that in clinical practice, r-EBUS sensitivity may be lower than reported in clinical trials. We performed a meta-analysis to update the estimates of r-EBUS sensitivity and to explore factors contributing to heterogeneity of results.
  Citation: CHEST (2019)
  PubDate: 2019-11-15
Viral Infection Increases the Risk of Idiopathic Pulmonary Fibrosis
- Authors: Gaohong Sheng; Peng Chen, Yanqiu Wei, Huihui Yue, Jiaojiao Chu, Jianping Zhao, Yihua Wang, Wanguang Zhang, Hui-Lan Zhang
  Abstract: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic lung disease with a poor prognosis. Although many factors have been identified that possibly trigger or aggravate IPF, such as viral infection, the exact cause of IPF remains unclear. Until now, there has been no systematic review to assess the role of viral infection in IPF quantitatively.
  Citation: CHEST (2019)
  PubDate: 2019-11-12
Validation of the COPD Assessment Test (CAT) as an Outcome Measure in
Bronchiectasis
- Authors: Simon Finch; Irena F. Laska, Hani Abo-Leyah, Thomas C. Fardon, James D. Chalmers
  Abstract: Objective assessment of symptoms in bronchiectasis is important for research and in clinical practice. The COPD Assessment Test (CAT) is a short, simple assessment tool widely used in COPD. The items included in the CAT are not specific to COPD and also reflect the dominant symptoms of bronchiectasis. We therefore performed a study to validate the CAT as an outcome measure in bronchiectasis.
  Citation: CHEST (2019)
  PubDate: 2019-11-12
Grant Writing for Clinicians in Training
- Authors: D. Clark Files; Patrick S. Hume, Jennifer Krall, Kristina Montemayor, Eric P. Schmidt, Landon S. King
  Abstract: One of the best experiences of subspecialty fellowship training is the development of an original research project. Although the time, scope, and opportunities of research training and clinical training programs differ, each program has some exposure to research. For fellows interested in a career in academic medicine, this research training period is essential to developing the academic skill set necessary to establish an academic niche as junior faculty. Surprisingly, research training can be equally important for fellows geared toward careers in clinical medicine, as this experience can positively influence one’s professional skill set in multiple dimensions.
  Citation: CHEST (2019)
  PubDate: 2019-11-12
Airway Management in Critical Illness
- Authors: J. Aaron Scott; Stephen O. Heard, Maksim Zayaruzny, J. Matthias Walz
  Abstract: Expertise in airway management is a vital skill for any provider caring for critically ill patients. A growing body of literature has identified the stark difference in periprocedural outcomes of elective intubation in the operating room when compared with emergency intubation in the ICU. A number of strategies to reduce the morbidity and mortality associated with airway management in the critically ill have been described. In this review, we provide an updated framework for airway assessment before direct laryngoscopy and video laryngoscopy, and use of newer pharmacologic agents; comment on current concepts in tracheal intubation in the ICU; and address human factors around critical decision-making during ICU airway management.
  Citation: CHEST (2019)
  PubDate: 2019-11-08
Ventilation Inhomogeneity and Bronchial Basement Membrane Changes in
Chronic Neutrophilic Airway Inflammation
- Authors: Václav Koucký; Jiří Uhlík, Lenka Hoňková, Miroslav Koucký, Tereza Doušová, Petr Pohunek
  Abstract: Bronchial epithelial reticular basement membrane (RBM) thickening occurs in diseases with both eosinophilic (allergic bronchial asthma [BA]) and neutrophilic (cystic fibrosis [CF] and primary ciliary dyskinesia [PCD]) chronic airway inflammation; however, the lung function and airway remodeling relation remains unclear. The aim of this study was to test whether ventilation inhomogeneity is related to RBM thickening.
  Citation: CHEST (2019)
  PubDate: 2019-11-08
Association of Contrast and Acute Kidney Injury in the Critically Ill
- Authors: Lisa-Mae S. Williams; Gail R. Walker, James W. Loewenherz, Louis T. Gidel
  Abstract: Despite evidence that low osmolar radiocontrast media is not associated with acute kidney injury, it is important to evaluate this association in critically ill patients with normal kidney function.
  Citation: CHEST (2019)
  PubDate: 2019-10-25
Redesigning Care for OSA
- Authors: Lucas M. Donovan; Aditi Shah, Ching Li Chai-Coetzer, Ferran Barbé, Najib T. Ayas, Vishesh K. Kapur
  Abstract: Constrained by a limited supply of specialized personnel, health systems face a challenge in caring for the large number of patients with OSA. The complexity of this challenge is heightened by the varied clinical presentations of OSA and the diversity of treatment approaches. Innovations such as simplified home-based care models and the incorporation of nonspecialist providers have shown promise in the management of uncomplicated patients, producing comparable outcomes to the resource-intensive traditional approach.
  Citation: CHEST (2019)
  PubDate: 2019-10-19
Adequacy of the Provider Workforce for Persons With Cardiopulmonary
Disease
- Authors: Robert L. Joyner; Shawna L. Strickland, Ellen A. Becker, Emily Ginier, Shane Keene, Kathy Rye, Carl F. Haas
  Abstract: Access and quality of health care for cardiopulmonary disease in the United States ranks poorly compared with economically similar nations. No recent comprehensive assessment of the cardiopulmonary workforce is available. This systematic review was conducted to evaluate current published evidence about the workforce caring for persons with cardiopulmonary disease.
  Citation: CHEST (2019)
  PubDate: 2019-10-14
  DOI: 10.1016/j.chest.2019.09.030
Quality Gaps and Comparative Effectiveness in Lung Cancer Staging and
Diagnosis
- Authors: David E. Ost; Jiangong Niu, Hui Zhao, Horiana B. Grosu, Sharon H. Giordano
  Abstract: Guidelines recommend mediastinal sampling first for patients with mediastinal lymphadenopathy with suspected lung cancer. The objective of this study was to describe practice patterns and outcomes of diagnostic strategies in patients with lung cancer.
  Citation: CHEST (2019)
  PubDate: 2019-10-12
  DOI: 10.1016/j.chest.2019.09.025
Thoracic Injury in Patients Injured by Explosions on the Battlefield and
in Terrorist Incidents
- Authors: Andrew McDonald Johnston; Joseph Edward Alderman
  Abstract: Thoracic injury is common on the battlefield and in terrorist attacks, occurring in 10% to 70% of patients depending on the type of weapons used. Typical injuries seen include bullet, blast, and fragment injuries to the thorax, which are often associated with injuries to other parts of the body. Initial treatment prehospital and in the ED is carried out according to the principles of Tactical Combat Casualty Care or other standard trauma management systems. Immediately life-threatening problems including catastrophic hemorrhage are dealt with rapidly, and early consideration is given to CT scanning or rapid surgical intervention where appropriate.
  Citation: CHEST (2019)
  PubDate: 2019-10-09
  DOI: 10.1016/j.chest.2019.09.020
Comparative Effectiveness of Robotic-Assisted Surgery for Resectable Lung
Cancer in Older Patients
- Authors: Rajwanth R. Veluswamy; Stacey-Ann Whittaker Brown, Grace Mhango, Keith Sigel, Daniel G. Nicastri, Cardinale B. Smith, Marcelo Bonomi, Matthew D. Galsky, Emanuela Taioli, Alfred I. Neugut, Juan P. Wisnivesky
  Abstract: Robotic-assisted surgery (RAS) is a novel surgical approach increasingly used for patients with non-small cell lung cancer (NSCLC). However, data comparing the effectiveness and costs of RAS vs open thoracotomy and video-assisted thoracoscopic surgery (VATS) for NSCLC are limited.
  Citation: CHEST (2019)
  PubDate: 2019-10-04
  DOI: 10.1016/j.chest.2019.09.017
COPD Assessment Test in Bronchiectasis: Minimum Clinically Important
Difference and Psychometric Validation
- Authors: David De la Rosa Carrillo; Casilda Olveira, Marta García-Clemente, Rosa‐María Girón‐Moreno, Rosa Nieto‐Royo, Annie Navarro‐Rolon, Concepción Prados‐Sánchez, Oriol Sibila, Miguel-Ángel Martínez-García
  Abstract: Health-related quality of life (QoL) is one of the most important end points in bronchiectasis (BE). However, the majority of health-related QoL questionnaires are time-consuming or not validated in BE. The COPD Assessment Test (CAT) is an easy-to-use questionnaire. The objective of this study was to perform a complete validation of the CAT in BE.
  Citation: CHEST (2019)
  PubDate: 2019-08-22
  DOI: 10.1016/j.chest.2019.08.1916
Extremes of Age Decrease Survival in Adults After Lung Transplant
- Authors: Carli J. Lehr; Eugene H. Blackstone, Kenneth R. McCurry, Lucy Thuita, Wayne M. Tsuang, Maryam Valapour
  Abstract: Age has been implicated as a factor in the plateau of long-term survival after lung transplant.
  Citation: CHEST (2019)
  PubDate: 2019-08-13
  DOI: 10.1016/j.chest.2019.06.042
Safety and effectiveness of bronchial thermoplasty when FEV1 less than 50%
- Authors: David Langton; Alvin Ing, David Fielding, Nicole Hersch, Joy Sha, Virginia Plummer, Francis Thien
  First page: 509
  Abstract: The randomized clinical trials of bronchial thermoplasty (BT) were conducted in patients with a baseline FEV1 greater than 50%. There is a paucity of data regarding BT in patients with more severe obstruction, and consequently these patients are often excluded from receiving BT. The purpose of this study was to compare safety and efficacy outcomes in a large cohort of patients with an FEV1 less than 50% with a cohort of less obstructed patients.
  Citation: CHEST (2019)
  PubDate: 2019-09-13
  DOI: 10.1016/j.chest.2019.08.2193
Recent Advances in Severe Asthma: from Phenotypes to Personalized Medicine
- Authors: Nathan Schoettler; Mary E. Strek
  First page: 516
  Abstract: This review focuses on recent clinical and translational discoveries in severe and uncontrolled asthma that now enable phenotyping and personalized therapies in these patients. While asthma is common in both children and adults and typically responds to standard therapies, a subset of individuals with asthma experience severe and/or persistent symptoms despite appropriate therapies. Airflow obstruction leading to frequent symptoms requiring higher levels of controller therapy is the cardinal feature of severe asthma, but the underlying molecular mechanisms, or endotypes, are diverse and variable between individuals.
  Citation: CHEST ()
  PubDate: 2019-10-30
Rate and predictors of bacteremia in afebrile community-acquired pneumonia
- Authors: Christina Forstner; Vladimir Patchev, Gernot Rohde, Jan Rupp, Martin Witzenrath, Tobias Welte, Heinz Burgmann, Mathias W. Pletz, CAPNETZ study group
  First page: 529
  Abstract: Although blood cultures (BCs) are the gold standard for detecting bacteremia, the utility of BCs in patients with community-acquired pneumonia (CAP) is controversial. This study describes the proportion of patients with CAP and afebrile bacteremia and identifies the clinical characteristics predicting the necessity for BCs in afebrile patients.
  Citation: CHEST (2019)
  PubDate: 2019-10-26
Microbial Aerosols: New Diagnostic Specimens for Pulmonary Infections
- Authors: Kevin P. Fennelly; Carlos Acuna-Villaorduna, Edward Jones-Lopez, William G. Lindsley, Donald Milton
  First page: 540
  Abstract: Pulmonary infections are important causes of global morbidity and mortality, but diagnostics are often limited by the ability to collect specimens easily, safely and in a cost-effective manner. We review recent advances in the collection of infectious aerosols from patients with tuberculosis and with influenza. Although this research has been focused on assessing the infectious potential of such patients, we propose that these methods have the potential to lead to the use of patient-generated microbial aerosols as non-invasive diagnostic tests of disease as well as tests of infectiousness.
  Citation: CHEST (2019)
  PubDate: 2019-10-31
An individualized prediction model for long-term lung function trajectory
and risk of COPD in the general population
- Authors: Wenjia Chen; Don D. Sin, J Mark FitzGerald, Abdollah Safari, Amin Adibi, Mohsen Sadatsafavi
  First page: 547
  Abstract: Prediction of future lung function will enable the identification of individuals at high risk of developing chronic obstructive pulmonary disease (COPD), but the trajectory of lung function decline greatly varies among individuals. We developed and validated an individualized prediction model of lung function trajectory and risk of airflow limitation in the general population.
  Citation: CHEST (2019)
  PubDate: 2019-09-19
  DOI: 10.1016/j.chest.2019.09.003
Screening heroin smokers attending community drug clinics for change in
lung function: A cohort study
- Authors: Rebecca Nightingale; Kevin Mortimer, Emanuele Giorgi, Paul P. Walker, Marie Stolbrink, Tara Byrne, Kerry Marwood, Sally Morrison-Griffiths, Susan Renwick, Jamie Rylance, Hassan Burhan
  First page: 558
  Abstract: Heroin smokers have high rates of chronic obstructive pulmonary disease (COPD), respiratory morbidity, hospital admission and mortality. We assessed the natural history of symptoms and lung function in this population over time.
  Citation: CHEST (2019)
  PubDate: 2019-11-21
  DOI: 10.1016/j.chest.2019.11.006
The Search for Optimal Oxygen Saturation Targets in Critically Ill
Patients: Observational Data from Large ICU Databases
- Authors: Willem van den Boom; Michael Hoy, Jagadish Sankaran, Mengru Liu, Haroun Chahed, Mengling Feng, Kay Choong See
  First page: 566
  Abstract: While low oxygen saturations are generally regarded as deleterious, recent studies in intensive care unit (ICU) patients have shown that a liberal oxygen strategy increases mortality. However, the optimal oxygen saturation target remains unclear. We therefore aimed to elucidate this optimal range with real world data.
  Citation: CHEST (2019)
  PubDate: 2019-10-04
  DOI: 10.1016/j.chest.2019.09.015
Better with Ultrasound: Arterial Line Placement
- Authors: Ann Wang; Ariel Hendin, Scott J. Millington, Seth Koenig, Lewis A. Eisen, Ariel L. Shiloh
  First page: 574
  Abstract: Arterial catheterization is frequently performed in intensive care units to facilitate hemodynamic monitoring and frequent blood sampling. Overall, arterial catheterization has high success and low complication rates, but in critically ill patients the incidence of failure is higher due to hypotension, peripheral edema, and obesity. Ultrasound guidance significantly increases the likelihood of successful cannulation and decreases complications compared to traditional landmark-based techniques. Multiple ultrasound techniques for radial and femoral arterial catheter insertion have been described; this article presents an approach for incorporating these tools into bedside practice, including illustrative figures and narrated video presentations to demonstrate the techniques described.
  Citation: CHEST (2019)
  PubDate: 2019-10-18
  DOI: 10.1016/j.chest.2019.08.2209
Associations of Serum Adipokines with Subclinical Interstitial Lung
Disease Among Community-Dwelling Adults: the MESA study
- Authors: John S. Kim; Michaela R. Anderson, Anna J. Podolanczuk, Steven M. Kawut, Matthew A. Allison, Ganesh Raghu, Karen Hinckley-Stuckovsky, Eric A. Hoffman, Russell P. Tracy, R. Graham Barr, David J. Lederer, Jon T. Giles
  First page: 580
  Abstract: Adipokines have inflammatory and fibrotic properties that may be critical in interstitial lung disease (ILD). We examined associations of serum adipokine levels with computed tomography (CT)-based measures of subclinical ILD and lung function among community-dwelling adults.
  Citation: CHEST (2019)
  PubDate: 2019-10-31
Caring for people with untreated pectus excavatum: An international online
survey
- Authors: Robert S. Eisinger; Saleem Islam
  First page: 590
  Abstract: Pectus excavatum is a chest-wall deformity with no known cause and no standardized guidelines for evaluation or management. There is a pressing need to characterize the symptoms that these individuals experience, and to evaluate a potential mismatch between their expected and observed experiences with healthcare. We hypothesized that these individuals would feel that their healthcare needs are not adequately met.
  Citation: CHEST (2019)
  PubDate: 2019-11-12
Ultrashort Echo-time MRI for the Assessment of Tracheomalacia in Neonates
- Authors: Erik B. Hysinger; Alister J. Bates, Nara S. Higano, Dan Benscoter, Robert J. Fleck, Catherine Hart, Gregory Burg, Alessandro De Alarcon, Paul S. Kingma, Jason C. Woods
  First page: 595
  Abstract: Bronchoscopy is the gold standard for evaluating tracheomalacia; however, reliance on an invasive procedure limits understanding of normal airway dynamics. Self-gated ultrashort echo-time magnetic resonance imaging (UTE MRI) can assess tracheal dynamics; but has not been rigorously evaluated.
  Citation: CHEST (2019)
  PubDate: 2019-12-17
  DOI: 10.1016/j.chest.2019.11.034
Six-Minute Walk Test: Clinical Role, Technique, Coding and Reimbursement
- Authors: Priya Agarwala; Steve H. Salzman
  First page: 603
  Citation: CHEST (2019)
  PubDate: 2019-11-02
How I Do It: An Algorithmic Approach to the Interpretation of Diffuse Lung
Disease on Chest CT Imaging
- Authors: James F. Gruden; David P. Naidich, Stephen C. Machnicki, Stuart L. Cohen, Francis Girvin, Suhail Raoof
  First page: 612
  Citation: CHEST ()
  PubDate: 2019-11-05
Utility of simplified PESI score for identification of low-risk pulmonary
embolism patients with active cancer: From the COMMAND VTE Registry
- Authors: Yugo Yamashita; Takeshi Morimoto, Hidewo Amano, Toru Takase, Seiichi Hiramori, Kitae Kim, Maki Oi, Masaharu Akao, Yohei Kobayashi, Mamoru Toyofuku, Toshiaki Izumi, Tomohisa Tada, Po-Min Chen, Koichiro Murata, Yoshiaki Tsuyuki, Yuji Nishimoto, Syunsuke Saga, Tomoki Sasa, Jiro Sakamoto, Minako Kinoshita, Kiyonori Togi, Hiroshi Mabuchi, Kensuke Takabayashi, Yusuke Yoshikawa, Hiroki Shiomi, Takao Kato, Takeru Makiyama, Koh Ono, Takeshi Kimura, COMMAND VTE Registry Investigators.
  First page: 636
  Abstract: The simplified pulmonary embolism severity index (sPESI) score is a practical score for identification of low-risk pulmonary embolism (PE) patients, although it has not been applied in active cancer patients. The current study aimed to evaluate the utility of sPESI score for PE patients with active cancer.
  Citation: CHEST (2019)
  PubDate: 2019-10-09
  DOI: 10.1016/j.chest.2019.08.2206
Utilization and Outcomes of Thrombolytic Therapy for Acute Pulmonary
Embolism: A Nationwide Cohort Study
- Authors: Sebastian E. Beyer; Colby Shanafelt, Duane S. Pinto, Jeffrey L. Weinstein, Herbert D. Aronow, Ido Weinberg, Robert W. Yeh, Eric A. Secemsky, Brett J. Carroll
  First page: 645
  Abstract: There are increased options to deliver thrombolytic treatment for acute, high-risk pulmonary embolism (PE). The goals of this study were to examine practice patterns of systemic thrombolysis and catheter-directed thrombolysis (CDT) and to compare outcomes after CDT with ultrasound facilitation (CDT-US) and CDT alone.
  Citation: CHEST (2019)
  PubDate: 2019-11-26
mHealth Technologies in Cardiopulmonary Disease
- Authors: Grant E. MacKinnon; Evan L. Brittain
  First page: 654
  Abstract: Mobile health (mHealth) technologies are modernizing medicine by affording greater patient engagement, monitoring, outreach, and healthcare delivery. The cardiopulmonary fields have led the integration of mHealth into clinical practice and research. mHealth technologies in these areas include smartphone applications, wearable devices, and hand-held devices, among others, and provide real-time monitoring of numerous important physiologic measurements and other key parameters. Use of mHealth-compatible devices has increased in recent years, and age and socioeconomic gaps of ownership are narrowing.
  Citation: CHEST (2019)
  PubDate: 2019-10-31
Responsiveness of Patient Reported Outcomes to Treatment among Patients
with Type 2 Diabetes Mellitus and Obstructive Sleep Apnea
- Authors: Lucas M. Donovan; Lan Yu, Suzanne M. Bertisch, Daniel J. Buysse, Michael Rueschman, Sanjay R. Patel.
  First page: 665
  Abstract: The Patient Reported Outcomes Information System (PROMIS) includes two instruments to quantify sleep symptoms (sleep disturbance, SDA; sleep-related impairment, SRI) in diverse populations across a wide symptom spectrum. However, the responsiveness of PROMIS measures to treatment of sleep disorders is unknown. We examined the responsiveness of the PROMIS sleep scales to the treatment of obstructive sleep apnea (OSA).
  Citation: CHEST (2019)
  PubDate: 2019-11-27
  DOI: 10.1016/j.chest.2019.11.011
Sleep Apnea and Chronic Kidney Disease - A State of the Art Review
- Authors: Chou-Han Lin; Renee C. Lurie, Owen D. Lyons
  First page: 673
  Abstract: Patients with chronic kidney disease have increased morbidity and mortality, mainly due to cardiovascular disease. Compared to the general population, patients with chronic kidney disease have an increased prevalence of both obstructive and central sleep apnea, and the presence of sleep apnea in this population has been associated with an increased risk of cardiovascular events and mortality. While obstructive sleep apnea can lead to an increase in the rate of kidney function decline, there is also evidence that the presence of end stage renal disease can lead to worsening of sleep apnea, indicating a bidirectional relationship between sleep apnea and chronic kidney disease.
  Citation: CHEST (2019)
  PubDate: 2019-09-19
  DOI: 10.1016/j.chest.2019.09.004
Safety and Costs of Endobronchial Ultrasound-Guided Nodal Aspiration and
Mediastinoscopy
- Authors: Francys C. Verdial; Kathleen Berfield, Douglas E. Wood, Michael Mulligan, Joshua Roth, David O. Francis, Farhood Farjah
  First page: 686
  Abstract: There remains debate over the best invasive diagnostic modality for mediastinal nodal evaluation. Prior studies have limited generalizability and insufficient power to detect differences in rare adverse events. We compared the risks and costs of endobronchial ultrasound-guided nodal aspiration (EBUS) and mediastinoscopy performed for any indication in a large national cohort.
  Citation: CHEST (2019)
  PubDate: 2019-10-09
  DOI: 10.1016/j.chest.2019.09.021
A Prospective Randomized Comparative Study of Three Guided Bronchoscopic
Approaches for Investigating Pulmonary Nodules (The PRECISION-1 Study)
- Authors: Lonny Yarmus; Jason Akulian, Momen Wahidi, Alex Chen, Jennifer P. Steltz, Sam L. Solomon, Diana Yu, Fabien Maldonado, Jose Cardenas-Garcia, Daniela Molena, Hans Lee, Anil Vachani, Interventional Pulmonary Outcomes Group (IPOG)
  First page: 694
  Abstract: In a cadaver model, utilization of RB significantly increased the ability to localize and successfully puncture small PPN when compared with existing technologies. This study demonstrates the potential of RB to precisely reach, localize and puncture small nodules in the periphery of the lung.
  Citation: CHEST (2019)
  PubDate: 2019-11-01
The Impact of Gravity versus Suction-driven Therapeutic Thoracentesis on
Pressure-related Complications: the GRAVITAS Multicenter Randomized
Controlled Trial
- Authors: Robert J. Lentz; Samira Shojaee, Horiana B. Grosu, Otis B. Rickman, Lance Roller, Jasleen K. Pannu, Zachary S. DePew, Labib G. Debiane, Joseph C. Cicenia, Jason Akulian, Charla Walston, Trinidad M. Sanchez, Kevin R. Davidson, Nikhil Jagan, Sahar Ahmad, Christopher Gilbert, John T. Huggins, Heidi Chen, Richard W. Light, Lonny Yarmus, David Feller-Kopman, Hans Lee, Najib M. Rahman, Fabien Maldonado, Interventional Pulmonary Outcomes Group
  First page: 702
  Abstract: Thoracentesis can be accomplished by active aspiration or drainage with gravity. We investigated whether gravity drainage could protect against negative-pressure related complications, such as chest discomfort, re-expansion pulmonary edema or pneumothorax, compared to active aspiration.
  Citation: CHEST (2019)
  PubDate: 2019-11-08
A Blueprint for Success: Design and Implementation of an Ideal
Bronchoscopy Suite
- Authors: Atul C. Mehta; Sameer K. Avasarala, Prasoon Jain, Himanshu Deshwal, Thomas R. Gildea
  First page: 712
  Citation: CHEST (2019)
  PubDate: 2019-10-11
  DOI: 10.1016/j.chest.2019.09.024
State of the Art: Interventional Pulmonology
- Authors: Momen M. Wahidi; Felix JF. Herth, Alexander Chen, George Cheng, Lonny Yarmus
  First page: 724
  Abstract: Interventional Pulmonology (IP) has evolved over the last decade from an obscure subspecialty in pulmonary medicine to a recognized discipline offering advanced consultative and procedural services to patients with thoracic malignancy, anatomical airway diseases and pleural pathology. Innovative Interventions are now also available for diseases not traditionally treated procedurally such as asthma and emphysema. The IP field has established certification examinations and training standards for IP training programs in an effort to enhance training quality and ensure competency.
  Citation: CHEST (2019)
  PubDate: 2019-10-31
Extracorporeal membrane oxygenation for severe ARDS due to immune diffuse
alveolar hemorrhage: a retrospective observational study
- Authors: Benjamin Seeliger; Klaus Stahl, Heiko Schenk, Julius J. Schmidt, Olaf Wiesner, Tobias Welte, Christian Kuehn, Johann Bauersachs, Marius M. Hoeper, Sascha David
  First page: 744
  Citation: CHEST (2019)
  PubDate: 2019-11-08