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Chest
Journal Prestige (SJR): 2.524

Citation Impact (citeScore): 3
Number of Followers: 100

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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, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/S0012-3692(19)34300-4
  Issue No: Vol. 157, No. 1 (2020)
A 78-Year-Old Man With Repeated Dyspnea and Neutrophilia in
Peripheral Blood and BAL
- Authors: Erika Nakamatsu; Takayoshi Morita, Atsuyoshi Morishima, Hiroshi Tagawa, Mitsugi Furukawa, Masato Matsushita, Hiroyuki Yamane
  Abstract: A 78-year-old man with asthma and COPD presented with shortness of breath, cough, and severe malaise for 4 days. Upon arrival, the patient was conscious and body temperature was 37.5°C. Arterial oxygen saturation (Spo2) was 80% on room air. Laboratory data demonstrated a WBC count of 17,400/μL (89.5% neutrophils) and C-reactive protein of 5.00 mg/dL. CT scan of chest revealed scattered ground-glass in the upper right lobe and thickening of the bronchial wall. Based on these findings, acute bronchopneumonia was diagnosed and antibacterial therapy was started.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.07.034
  Issue No: Vol. 157, No. 1 (2020)
A 38-Year-Old Man With Well Treated OSA on CPAP With Persistent Nocturnal
Hypoxemia
- Authors: David J. Culpepper; Deborah Hong, Armand Ryden, Jesse Currier, Jonathan M. Tobis, Sharon De Cruz, Michelle R. Zeidler
  Abstract: A 38-year-old male with a prior diagnosis of severe OSA (apnea-hypopnea index [AHI] 99/h) presented for transfer of care. He was successfully titrated to CPAP of 10 cm H2O at an outside laboratory and was compliant with therapy with residual AHI 1.9/h. On presentation, he was polycythemic, with negative evaluation for primary polycythemia, and evaluation for hypoxemia was initiated.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.06.045
  Issue No: Vol. 157, No. 1 (2020)
A Woman With Dyspnea, Weight Loss, and Splenic Lesions
- Authors: Jennifer S. Hanberg; Dana Dunne
  Abstract: The patient is a 37-year-old hospital employee and current smoker with a 10 pack-year smoking history, who presented with dyspnea, chest pain, and weight loss. She was in her usual state of health until 4 months prior to admission when she developed intermittent left-sided chest pain, cough productive of scant yellow sputum, fevers, and anorexia. Initial chest radiograph was normal and her outpatient physician prescribed azithromycin, which she took without improvement. One month prior to admission, a follow-up chest radiograph revealed a left-sided upper lobe consolidation; she received a course of levofloxacin without improvement.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.08.2181
  Issue No: Vol. 157, No. 1 (2020)
A 59-Year-Old Man With Chronic Kidney Disease After Kidney Transplantation
Presents With Chronic Dyspnea
- Authors: Patrick Duncan; Stephanie Cull, Palmi Shah, Amie Gamino
  Abstract: A 59-year-old man presented to the ED with a chief complaint of shortness of breath. His past medical history was significant for end-stage renal disease secondary to lithium toxicity, immunosuppression subsequent to cadaveric renal transplantation, bipolar disorder, and hypertension. His shortness of breath had begun 6 months previously and was initially intermittent; it then progressed to constant shortness of breath over the few weeks before presentation. He had no fever, hemoptysis, or chest pain.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.08.1918
  Issue No: Vol. 157, No. 1 (2020)
A 64-Year-Old Man With Rapidly Progressive Respiratory Failure and
Pneumomediastinum
- Authors: Minkyung Kwon; Isabel Mira-Avendano, Andras Khoor, Jorge Mallea
  Abstract: A 64-year-old man presented for consideration for lung transplant. He had a history of previous tobacco use, OSA on CPAP therapy, and gastroesophageal reflux disease. He worked as a design engineer. The patient had a 4-year history of dyspnea on exertion, followed with periodic CT scan of the chest. Nine months prior to his evaluation for lung transplant, the patient developed worsening of dyspnea, dry cough, poor appetite, and weight loss. At times, the cough was violent and associated with chest pressure.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.07.026
  Issue No: Vol. 157, No. 1 (2020)
How the Right Heart Is Measuring Up in Pulmonary Hypertension
- Authors: Sean Gaine
  Pages: 1 - 2
  Abstract: Medicine is a science of uncertainty and an art of probability.Sir William Osler
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.09.038
  Issue No: Vol. 157, No. 1 (2020)
Lung Ultrasound for the Diagnosis of Acute Heart Failure in the ED
- Authors: Philippe Le Conte; François Javaudin
  Pages: 3 - 4
  Abstract: Despite advances, diagnosis of acute heart failure (AHF) in the ED remains challenging, especially in elderly patients presenting with symptoms of acute respiratory failure. However, initial diagnostic accuracy is pivotal to avoid inappropriate therapy that could worsen outcome. In a prospective observational survey including 514 elderly patients, Ray et al1 reported that misdiagnosis and subsequent inappropriate treatment resulted in a doubling of the OR for in-hospital mortality. Clinical findings are limited, as bilateral crackles have a positive likelihood ratio of only 4.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.09.032
  Issue No: Vol. 157, No. 1 (2020)
Taking the Air Out of Nebulized Lidocaine
- Authors: Emily DuComb; C. Matthew Kinsey
  Pages: 5 - 6
  Abstract: Flexible bronchoscopy is widely used for the diagnosis of various pulmonary conditions. Although it can be performed with topical analgesia alone, use of sedation improves patient tolerance of the procedure and working conditions for the bronchoscopist and is recommended unless contraindications exist.1 Adjunctive topical anesthesia with lidocaine is useful to improve cough and can reduce the amount of sedation required. This can be administered by various methods, including intranasally, inhaled via nebulization, sprayed into the oropharynx, injected transtracheally, and administered locally via the bronchoscope.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.09.006
  Issue No: Vol. 157, No. 1 (2020)
POINT: Can Screening for COPD Improve Outcomes' Yes
- Authors: Barbara P. Yawn; Fernando J. Martinez
  Pages: 7 - 9
  Abstract: COPD is a common but often underrecognized and underdiagnosed condition, especially in primary care settings in the United States.1 Despite being the fourth leading cause of death in the United States, both diagnosed and undiagnosed COPD are a major cause of morbidity, mortality, disability, hospitalizations, and health-care expenditures.2 The slow decline in lung function and compensatory activity limitation often results in failure of symptom reporting to clinicians, with patients attributing symptoms to aging, obesity, poor conditioning, or “smoker’s cough.” Primary care physicians also fail to query regarding chronic respiratory symptoms or note recurrent respiratory events as significant, leaving these patients to appear to be “asymptomatic.”
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.05.034
  Issue No: Vol. 157, No. 1 (2020)
COUNTERPOINT: Can Screening for COPD Improve Outcomes' No
- Authors: David M. Mannino; Byron Thomashow
  Pages: 9 - 12
  Abstract: In 2016, the US Preventive Services Task Force (USPSTF) “did not find evidence that screening for COPD in asymptomatic persons improves health-related quality of life, morbidity, or mortality.”1 The Task Force also concluded that early detection of COPD does not alter the course of disease or improve patient outcomes.1 The thought process underlying this decision could be summarized as follows: the only known intervention shown to change the natural history of COPD is smoking cessation; there is no evidence that knowledge of a COPD diagnosis increases the likelihood of smoking cessation; every smoker should stop smoking; thus there is no rationale to screen for COPD (particularly in a person who has no symptoms).
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.05.035
  Issue No: Vol. 157, No. 1 (2020)
Rebuttal From Drs Yawn and Martinez
- Authors: Barbara P. Yawn; Fernando J. Martinez
  Pages: 12 - 14
  Abstract: We read with great interest Drs Mannino and Thomashow’s discussion of COPD screening for asymptomatic individuals1 and agree it provides limited ability to identify, prevent, or treat COPD before symptoms appear. Indeed, smoking cessation and prevention remain key to disease prevention and progression.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.05.036
  Issue No: Vol. 157, No. 1 (2020)
Rebuttal From Drs Mannino and Thomashow
- Authors: David M. Mannino; Byron Thomashow
  Pages: 14 - 15
  Abstract: In their argument supporting the idea that screening for COPD can improve outcomes, Drs Yawn and Martinez1 argue that “COPD screening must develop better, more symptom-based tools and appropriate follow-up support.” We certainly agree with that conclusion and hope that CAPTURE (COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk) will lead to earlier diagnosis and earlier therapy.2 However, even if the ongoing study attempting to validate the utility of this tool in primary care confirms earlier results without disrupting practice patterns,3 the patients identified will be symptomatic but will not have received a diagnosis.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.05.037
  Issue No: Vol. 157, No. 1 (2020)
Can qSOFA Perform Better If Combined With Frailty Measures in Elderly
Patients'
- Authors: Kevin K.C. Hung; Ling Yan Leung, Joseph Walline, Colin A. Graham
  First page: 231
  Abstract: In the recently published study in CHEST (August 2019) by Anand et al,1 involving> 1 million adults admitted to 85 US hospitals, the major findings, that the Quick Sequential Organ Failure Assessment (qSOFA) has both low sensitivity for identifying suspected infection or sepsis and its prognostic significance is not specific to infection, are not surprising. We agree that the qSOFA has limited utility in the screening and diagnosis of sepsis. There remains a pressing need to develop new screening tools that are both sensitive and specific for sepsis.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.09.011
  Issue No: Vol. 157, No. 1 (2020)
Response
- Authors: Vijay Anand; Michael Klompas, Chanu Rhee
  Pages: 231 - 232
  Abstract: We thank Hung et al for their interest in our article1 and their ongoing contributions to understanding the strengths and limitations of the Quick Sequential Organ Failure Assessment (qSOFA). We agree that the performance of the qSOFA in elderly patients with frailty is an important topic of investigation. We would point out that the two studies cited by Hung et al on this issue had somewhat mixed findings. Although Fernando et al2 demonstrated particularly high mortality in patients who were critically ill with both the qSOFA and frailty, Bastoni et al3 found that the prognostic accuracy of the qSOFA was poor in a geriatric acute care setting and comparable with the Systemic Inflammatory Response Syndrome criteria.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.09.010
  Issue No: Vol. 157, No. 1 (2020)
Dear qSOFA, We Would Like to Get to Know You Better…
- Authors: Stephanie Parks Taylor; Marc Kowalkowski
  Pages: 232 - 233
  Abstract: In the August issue of CHEST, Anand et al1 use a large clinical and administrative dataset to evaluate the “appropriate role of qSOFA [quick Sequential Organ Failure Assessment] in sepsis screening, diagnosis, and triggering of empiric antibiotics.” Although the well-designed and executed study has many strengths, we wonder if the conclusions of the authors and the breakup letter penned by the accompanying editorial2 could be premature. The ultimate goal of predictive analytics is to improve decision-making, and the ultimate measure of a prognostic score’s usefulness is whether its use improves outcomes for patients.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.09.013
  Issue No: Vol. 157, No. 1 (2020)
Response
- Authors: Vijay Anand; Michael Klompas, Chanu Rhee
  Pages: 233 - 234
  Abstract: We thank Drs Taylor and Kowalkowski for their thoughtful letter and interest in our article.1 We agree that statistical performance should not be the sole criterion by which a sepsis screening or diagnostic strategy should be evaluated. We also agree that the ultimate measure of the relative value of a sepsis-screening system is whether real-world application leads to better outcomes for patients. Unfortunately, to our knowledge, a prospective comparative evaluation of various screening strategies, including quick Sequential Organ Failure Assessment (qSOFA) vs the systemic inflammatory response syndrome (SIRS) criteria, has not yet been published.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.09.014
  Issue No: Vol. 157, No. 1 (2020)
Quotes on Brain Death From Estol Incorrectly Attributed to Pope Benedict
XVI
- Authors: Doyen Nguyen
  Pages: 234 - 235
  Abstract: While researching an article on the social and legal complexities of “brain death,” I came across the literature review in CHEST (October 2014) by Miller et al.1 In that article (bottom of page 1094), Miller et al wrote “Pope Benedict XVI subsequently expanded on this by stating:” followed by two block quotes (page 1095). The authors also wrote, “Additionally, he stated:” between the two block quotes.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.08.2205
  Issue No: Vol. 157, No. 1 (2020)
Response
- Authors: Andrew C. Miller
  First page: 235
  Abstract: We thank Dr Nguyen for his thoughtful comments on our 2014 article on brain death and Islam.1 Although not the focus of the article, we address his comments regarding Catholicism. The loss of integration view has since predominated in Christianity since accepted as doctrine by the Council of Vienne (1312 ad). Pope Pius X stated that the specification of biological parameters indicating that death has occurred “does not fall within the competence of the Church.”2 Rather, it pertains to the responsibility and competence of the medical profession to judge and establish the signs that serve as reliable indicators that death has occurred with adequate moral certainty.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.09.012
  Issue No: Vol. 157, No. 1 (2020)
Lung Cancer Screening Uptake in the United States
- Authors: Patrick C. Yong; Keith Sigel, Sadiq Rehmani, Juan Wisnivesky, Minal S. Kale
  Pages: 236 - 238
  Abstract: The United States Preventive Services Task Force (USPSTF) guidelines recommend yearly low-dose CT (LDCT) screening for high-risk smokers. These guidelines are based on the National Lung Screening Trial (NLST), which showed that yearly LDCT screening for high-risk smokers decreased lung cancer-related mortality.1 Despite strong supporting evidence, national data indicate low screening uptake, with < 6% of USPSTF criteria-eligible smokers being screened in 2015.2 However, it is unclear if screening uptake is increasing, and very little is known about predictors of screening uptake.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.08.2176
  Issue No: Vol. 157, No. 1 (2020)
The Morphological Domain Does Not Affect the Rate of Progression to
Defined Autoimmune Diseases in Patients With Interstitial Pneumonia With
Autoimmune Features
- Authors: Gianluca Sambataro; Ada Vancheri, Sebastiano E. Torrisi, Michele Colaci, Mauro Pavone, Alessandro Libra, Emanuele Martorana, Roberta Rosso, Francesca Pignataro, Nicoletta Del Papa, Lorenzo Malatino, Stefano Palmucci, Domenico Sambataro, Carlo Vancheri
  Pages: 238 - 242
  Abstract: The term interstitial pneumonia with autoimmune features (IPAF) defines patients with interstitial lung disease (ILD) with some autoimmune characteristics that are insufficient to fulfill classification criteria for a specific connective tissue disease (CTD).1 IPAF classification comprises several items subdivided into clinical, serological, and morphological domains. Patients with a radiological or histological pattern of usual interstitial pneumonia (UIP) need at least one item from both the clinical and serological domains, whereas patients with other ILD patterns can be classified as IPAF even with only one item.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2020-01
  DOI: 10.1016/j.chest.2019.08.2175
  Issue No: Vol. 157, No. 1 (2020)
Disease Severity and Quality of Life in Patients with Idiopathic Pulmonary
Fibrosis: A Cross-Sectional Analysis of the IPF-PRO Registry
- 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). We 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. Fact or fiction
- Authors: Darryl A. Knight; Christopher L. Grainge, Stephen M. Stick, Anthony Kicic, Michael Schuliga
  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: a systematic review with meta-analysis
- 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, we tested the hypothesis that lower pulmonary function and respiratory illness are linked to an elevated risk of dementia.
  Citation: CHEST (2020)
  PubDate: 2020-01-14
  DOI: 10.1016/j.chest.2019.12.012
Arnold Nerve Reflex: Vagal Hypersensitivity in Chronic Cough with Various
Causes
- 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
County-Level Variations in Receipt of Surgery for Early-Stage Non-small
Cell Lung Cancer in the United States
- Authors: Helmneh M. Sineshaw; Liora Sahar, Raymond U. Osarogiagbon, W. Dana Flanders, K. Robin Yabroff, Ahmedin Jemal
  Pages: 212 - 222
  Abstract: Although counties are the smallest geographic level for comprehensive health-care delivery analysis, little is known about county-level variations in receipt of curative-intent surgery for early-stage non-small cell lung cancer (NSCLC) and factors contributing to such variations in the United States.
  Citation: CHEST 157, 1 (2020)
  PubDate: 2019-12-05
  DOI: 10.1016/j.chest.2019.09.016
  Issue No: Vol. 157, No. 1 (2019)
Machine Learning Characterization of COPD Subtypes: Insights from the
COPDGene Study
- 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 COPDGene study, which has generated ten-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 we 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 Corticosteroids and
Long-Acting β2 Agonist Combinations in Patients with Chronic Obstructive
Pulmonary Disease
- Authors: Ting-Yu Chang; Jung-Yien Chien, Chung-Hsuen Wu, Yaa-Hui Dong, Fang-Ju Lin
  Abstract: The differential risk of pneumonia among inhaled corticosteroids (ICSs) in patients with chronic obstructive pulmonary disease (COPD) requires more investigation, especially for beclomethasone-containing inhalers. This study aimed to compare the risk and benefit profile of different ICS/long-acting β2 agonist (LABA) combinations in COPD patients.
  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), we sought 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: A Perspective
from the National Lung Cancer Roundtable
- Authors: Joelle T. Fathi; Charles S. White, Grant M. Greenberg, Peter J. Mazzone, Robert A. Smith, Carey C. Thomson
  Citation: CHEST (2019)
  PubDate: 2019-12-23
  DOI: 10.1016/j.chest.2019.12.004
Sleep and Delirium in Critically Ill Adults: A Contemporary Review Chest
- 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, due to the nature of critical illness, sleep has not been considered a priority for patient care in the intensive care unit. More recently, research has demonstrated that sleep is markedly abnormal in critically ill patients. 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, drug or alcohol intoxication or withdrawal.
  Citation: CHEST (2019)
  PubDate: 2019-12-21
  DOI: 10.1016/j.chest.2019.12.003
CHEST Submission: Contemporary Reviews in Sleep Medicine The 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, healthy food stores), neighborhood deprivation (disadvantage, disorder), and the social environment (social cohesion, safety, 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 Following Veno-Arterial
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: Veno-arterial extra-corporeal membrane oxygenation therapy (VA-ECMO) following refractory cardiogenic shock (r-CS) or cardiac arrest (r-CA) has significant morbidity and mortality. Early outcome prediction is crucial in this setting, but data on neuro-prognostication are limited. We examined the prognostic value of clinical neurological 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: a promising strategy for imaging and treatment of respiratory
disease
- Authors: Hongbin Wang; Lina Wu, Xilin Sun
  Abstract: Accurate diagnosis is crucial for improving 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 to 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
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
  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
Neighborhood Disadvantage and Lung Cancer Incidence in Ever-Smokers at a
Safety-Net Healthcare System: A Retrospective Study
- 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. We sought 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, over 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. We sought to determine guideline-adherence rates in the setting of a multidisciplinary nodule clinic and describe reasons for non-adherence 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 Non-Vitamin K Antagonist Oral
Anticoagulants and Warfarin in the Elderly Asian Patients with Atrial
Fibrillation: A Nationwide Cohort Study
- 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 non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in the elderly, at different age strata (age 65-74, 75-89, ≥90) in the daily practice have not been well described, particularly in Asians. We aimed to assess the clinical outcomes of NOACs compared to warfarin for stroke prevention in elderly patients with AF.
  Citation: CHEST (2019)
  PubDate: 2019-12-03
  DOI: 10.1016/j.chest.2019.11.025
Post-embolotherapy pulmonary arteriovenous malformation follow-up: a role
for graded transthoracic contrast echocardiography prior to
high-resolution chest CT
- Authors: Daniel M. DePietro; Nicole R. Curnes, Jesse Chittams, Victor A. Ferrari, Reed E. Pyeritz, Scott O. Trerotola
  Abstract: High-resolution chest CT (HRCT) is recommended after PAVM embolotherapy to assess for PAVM persistence and untreated PAVM growth. Graded transthoracic contrast echocardiography (TTCE) predicts need for embolotherapy in PAVM screening. This study sought to determine whether post-embolotherapy graded TTCE can similarly predict 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: The Fitness Registry and the Importance
of Exercise National Database (FRIEND)
- 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 endpoint for critical care trials'
- Authors: Richard A. Veldhoen; Daniel Howes, David M. Maslove
  Abstract: Mortality has long been used as a primary endpoint for randomized controlled trials in critical care. Recently, a plurality of trials targeting mortality endpoints as their primary outcome have 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 towards a neutral result, as well as reasons to consider alternative endpoints 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: data from the International
Severe Asthma Registry (ISAR)
- Authors: Wang Eileen; 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, Mariana Alacqua, James Zangrilli, Lakmini Bulathsinhala, Victoria A. Carter, Isha Chaudhry, Neva Eleangovan, Naeimeh Hosseini, Ruth B. Murray, David B. Price
  Abstract: To date, clinical characteristics of the international severe asthma population are unknown. Inter-country comparisons are hindered by variable data collection within regional/national severe asthma registries. Our aim was to describe demographic and clinical characteristics of patients managed in severe asthma services in the USA, Europe, and 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 operators’ experience on reliability of lung ultrasound (LU) interpretation has not been investigated.We aim to study the effect of probes and operators’ 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
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.
  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
The role of house calls in the care of patients with pulmonary disease
- Authors: Elizabeth T. McCormick; Christian Escobar, Ania Wajnberg, Elizabeth T. McCormick
  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 non- homebound 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
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
  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
In-Hospital Mortality-Associated Factors of Thrombotic Antiphospholipid
Syndrome Patients Requiring Intensive Care Unit 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 thrombotic APS patients 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:
CHEST Guideline and Expert Panel Report
- 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 Rickman, Felix J.F. Herth, Venerino Poletti, Lonny 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 ER stress in Chronic Lung Disease: Will
Cell-Specific Targeting be the Key to the Cure'
- 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 healthcare 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 post-mortem computed
tomography 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. We used post-mortem computed tomography (PMCT) from a forensic database to determine the prevalence of pulmonary bullae/blebs in the normal Dutch adult population and its consequence for diving medicine, as they are often considered a contra-indication for diving.
  Citation: CHEST (2019)
  PubDate: 2019-11-21
  DOI: 10.1016/j.chest.2019.11.008
Comparative effects of LAMA-LABA-ICS versus LAMA-LABA for COPD: Cohort
study in real world clinical practice
- Authors: Samy Suissa; Sophie Dell’Aniello, Pierre Ernst
  Abstract: Triple therapy combinations of a long-acting muscarinic antagonist, a long-acting beta2-agonist and an inhaled corticosteroid (LAMA-LABA-ICS) for chronic obstructive pulmonary disease (COPD) were studied in randomized trials and observational studies, with variable results. We compared the effectiveness and safety of triple therapy to 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
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
  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
State-level variations in the utilization of lung cancer screening among
fee-for-service Medicare beneficiaries: an analysis of the 2015-2017
Physician and Other Supplier data
- Authors: Bian Liu; Kavita Dharmarajan, Claudia I. Henschke, Emanuela Taioli
  Abstract: Lung cancer screen (LCS) is an important secondary prevention measure to reduce lung cancer mortality. We aim to assess state-level variations in LCS among the US elderly during the first three 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: AN OPPORTUNITY FOR EARLY
INTERVENTION
- Authors: Juan José Soler-Cataluña; Bernardino Alcazar, 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: Deciphering the Contribution of Tobacco
Smoking
- 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 chronic obstructive pulmonary disease (COPD) is an independent risk factor for cardiovascular disease (CVD) 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 Post Pulmonary Embolism from VD/VT and Stroke Volume Defects
During Exercise
- Authors: Timothy M. Fernandes; Mona Alotaibi, Danielle Strozza, William Stringer, Janos Porszasz, Garner Faulkner, Cara Castro, Don Tran, Timothy A. Morris
  Abstract: Many pulmonary embolism (PE) patients report dyspnea on exertion after 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 systemic sclerosis associated pulmonary arterial
hypertension patients aged 70 years or less over the period 2006-2017 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 (SSc-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: a randomized controlled cross-over trial
- 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 limitation 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. We tested the effect of non-invasive ventilation (NIV) on ventilatory and aerobic capacities during 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: An Updated
Meta-Analysis
- Authors: Paula V. Sainz Zuñiga; Erik Vakil, S. Molina, Roland L. Bassett, David E. Ost
  Abstract: Registry trials have found 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 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
Caring for people with untreated pectus excavatum: An international online
survey
- Authors: Robert S. Eisinger; Saleem Islam
  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
Viral Infection Increases the Risk of Idiopathic Pulmonary Fibrosis: A
Meta-analysis
- 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 to possibly trigger or aggravate IPF, such as viral infection, the exact etiology of IPF remains unclear. Until now, there has been no systematic review to quantitatively assess the role of viral infection in IPF.
  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 chronic obstructive pulmonary disease (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: An Important Career Development
Exercise
- Authors: D. Clark Files; Patrick S. Hume, Jennifer Krall, Kristina Montemayor, Eric P. Schmidt, Landon S. King
  Citation: CHEST (2019)
  PubDate: 2019-11-12
Airway Management in Critical Illness: An Update
- 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 peri-procedural outcomes of elective intubation in the operating room when compared to emergency intubation in the intensive care unit (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 will provide an updated framework for airway assessment before direct laryngoscopy (DL) and video laryngoscopy (VL), utilization 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
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
  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
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 (AB)] and neutrophilic [cystic fibrosis (CF), primary ciliary dyskinesia (PCD)] chronic airway inflammation; however, lung function and airway remodelling relationship remains unclear. The aim of the study was to test whether ventilation inhomogeneity is related to RBM thickening.
  Citation: CHEST (2019)
  PubDate: 2019-11-08
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
  Citation: CHEST (2019)
  PubDate: 2019-11-08
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
  Citation: CHEST ()
  PubDate: 2019-11-05
Six-Minute Walk Test: Clinical Role, Technique, Coding and Reimbursement
- Authors: Priya Agarwala; Steve H. Salzman
  Citation: CHEST (2019)
  PubDate: 2019-11-02
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)
  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
mHealth Technologies in Cardiopulmonary Disease
- Authors: Grant E. MacKinnon; Evan L. Brittain
  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
State of the Art: Interventional Pulmonology
- Authors: Momen M. Wahidi; Felix JF. Herth, Alexander Chen, George Cheng, Lonny Yarmus
  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
Microbial Aerosols: New Diagnostic Specimens for Pulmonary Infections
- Authors: Kevin P. Fennelly; Carlos Acuna-Villaorduna, Edward Jones-Lopez, William G. Lindsley, Donald Milton
  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
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
  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
Recent Advances in Severe Asthma: from Phenotypes to Personalized Medicine
- Authors: Nathan Schoettler; Mary E. Strek
  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
  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
Association of contrast and acute kidney injury in the critically ill: A
propensity matched study
- 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
Early life exposure to oral antibiotics and lung function into early
adulthood
- Authors: Karoliny dos Santos; Caroline J. Lodge, Michael J. Abramson, Bircan Erbas, Catherine M. Bennett, Jennie Hui, Shyamali C. Dharmage, Adrian J. Lowe
  Abstract: While there is ongoing debate about the impact of early postnatal exposure to antibiotics on the development of asthma, the possibility that antibiotic exposure may impair lung function has not previously been examined. Furthermore, it is not clear if specific types of antibiotics may have a greater effect, or if children with genetic mutations in the oxidative stress response glutathione S-transferase (GST) superfamily may be at greater risk.
  Citation: CHEST (2019)
  PubDate: 2019-10-24
Lung involvement in Destombes-Rosai-Dorfman disease: clinical and
radiological features and response to the MEK inhibitor cobimetinib
- Authors: Quentin Moyon; Samia Boussouar, Philippe Maksud, Jean-François Emile, Frédéric Charlotte, Nathalie Aladjidi, Grégoire Prévot, Jean Donadieu, Zahir Amoura, Philippe Grenier, Julien Haroche, Fleur Cohen Aubart
  Abstract: Destombes-Rosai-Dorfman disease (RDD) is a rare multisystemic histiocytosis. Pulmonary involvement during RDD is poorly described. Here, we aimed to examine the clinical features, radiological features, and outcomes of 15 patients with RDD with lung involvement.
  Citation: CHEST (2019)
  PubDate: 2019-10-24
  DOI: 10.1016/j.chest.2019.09.036
Better with Ultrasound: Peripheral Intravenous Catheter Insertion
- Authors: Scott J. Millington; Ariel Hendin, Ariel L. Shiloh, Seth Koenig
  Abstract: Peripheral intravenous (PIV) catheter insertion is the most commonly performed procedure in hospitals. Multiple patient factors can make PIV insertion challenging, and ultrasound guidance has been demonstrated to improve the rate of success in these difficult patients. This article outlines the suggested techniques for the ultrasound-guided insertion of PIV catheters, midline catheters, and peripherally inserted central catheters. Illustrative figures and narrative videos demonstrating these techniques are included.
  Citation: CHEST (2019)
  PubDate: 2019-10-22
  DOI: 10.1016/j.chest.2019.04.139
Redesigning Care for Obstructive Sleep Apnea
- 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 obstructive sleep apnea (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 non-specialist 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
Better with Ultrasound: Arterial Line Placement
- Authors: Ann Wang; Ariel Hendin, Scott J. Millington, Seth Koenig, Lewis A. Eisen, Ariel L. Shiloh
  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
Adequacy of the Provider Workforce for Persons with Cardiopulmonary
Disease
- Authors: Robert L. Joyner; Shawna 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 to 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
Association Between Volume of Fluid Resuscitation and Intubation in High
Risk Septic Patients with Heart Failure, End Stage Renal Disease and
Cirrhosis
- Authors: Rizwan A. Khan; Nauman A. Khan, Seth R. Bauer, Manshi Li, Abhijit Duggal, Xiaofeng Wang, Anita J. Reddy
  Abstract: Initial fluid resuscitation volume for sepsis is controversial, particularly in patients at high baseline risk for complications. This study was designed to assess the association between 30mL/kg crystalloids and intubation in patients with sepsis or septic shock and heart failure, end stage renal disease or cirrhosis.
  Citation: CHEST (2019)
  PubDate: 2019-10-14
  DOI: 10.1016/j.chest.2019.09.029
Quality Gaps and Comparative Effectiveness in Lung Cancer Staging and
Diagnosis
- Authors: David E. Ost; Jiangong Niu, Hui Zhao, Horiana Grosu, Sharon H. Giordano
  Abstract: Guidelines recommend mediastinal sampling first for patients with mediastinal lymphadenopathy with suspected lung cancer. Our objective 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
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
  Citation: CHEST (2019)
  PubDate: 2019-10-11
  DOI: 10.1016/j.chest.2019.09.024
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.
  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
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
  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
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 10-70% 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 management pre-hospital and in the emergency department 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 given to computed tomographic scanning or rapid surgical intervention where appropriate.
  Citation: CHEST (2019)
  PubDate: 2019-10-09
  DOI: 10.1016/j.chest.2019.09.020
Basic primer for finances in academic adult and pediatric pulmonary
divisions
- Authors: Lynn M. Schnapp; Michael J. Steiner, Stephanie D. Davis
  Abstract: The finances of academic medical centers (AMCs) are complex and rapidly evolving. This financial environment can have important effects on faculty expectations, compensation and the work environment. This article describes the commonly used concepts and models related to financial decision-making in Pulmonology and Critical Care divisions across AMCs in the country. Faculty clinical productivity is often measured by work relative value units (wRVUs) which are set nationally for a discrete piece of physician work and attempt to equilibrate aspects of care across specialties.
  Citation: CHEST (2019)
  PubDate: 2019-10-05
  DOI: 10.1016/j.chest.2019.09.019
Allergic Rhinitis and Obstructive Sleep Apnea in Children Residing at
High-Altitude
- Authors: Luis Fernando Giraldo-Cadavid; Karen Perdomo-Sanchez, Jorge Luis Córdoba-Gravini, Maria Isabel Escamilla, Miguel Suarez, Natalia Gelvez, David Gozal, Elida Dueñas-Meza
  Abstract: Obstructive sleep apnea (OSA) affects 2–4 % of the pediatric population; allergic rhinitis (AR) has been identified as a risk factor in sleep-disordered-breathing, but no studies evaluating such association have been conducted in high altitude environments. We aimed to assess whether the severity of AR is associated with the severity of OSA in children undergoing polysomnography (PSG) in the high-altitude city of Bogota, Colombia.
  Citation: CHEST (2019)
  PubDate: 2019-10-04
  DOI: 10.1016/j.chest.2019.09.018
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 thoracic surgery (VATS) for NSCLC is limited.
  Citation: CHEST (2019)
  PubDate: 2019-10-04
  DOI: 10.1016/j.chest.2019.09.017
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
  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
Risk reduction and right heart reverse remodeling by upfront triple
combination therapy in pulmonary arterial hypertension
- Authors: Michele D’Alto; Roberto Badagliacca, Paola Argiento, Emanuele Romeo, Andrea Farro, Silvia Papa, Berardo Sarubbi, Maria Giovanna Russo, Carmine Dario Vizza, Paolo Golino, Robert Naeije
  Abstract: Combinations of therapies are currently recommended for the most severely ill patients with pulmonary arterial hypertension (PAH), and excellent results have been reported with triple upfront combination of these drugs. We evaluated the effects of this approach on right ventricular (RV) function and outcome in patients with severe PAH.
  Citation: CHEST (2019)
  PubDate: 2019-09-26
  DOI: 10.1016/j.chest.2019.09.009
Circulating Endometrial Cells in Women with Spontaneous Pneumothorax
- Authors: Imrich Kiss; Eliska Pospisilova, Katarina Kolostova, Vilem Maly, Ivan Stanek, Robert Lischke, Jan Schutzner, Ireneusz Pawlak, Vladimir Bobek
  Abstract: The occurrence of catamenial pneumothorax (CP) is rare and the awareness of this diagnosis among clinicians is insufficient. CP is highly correlated with pelvic endometriosis and remains the most common form of thoracic endometriosis syndrome. Circulating Endometrial Cells (CECs) were previously detected in patients with pelvic endometriosis. Could CECs bring new insights into pneumothorax management'
  Citation: CHEST (2019)
  PubDate: 2019-09-19
  DOI: 10.1016/j.chest.2019.09.008
Early Readmission to Hospital in Cancer Patients with Malignant Pleural
Effusions: Analysis of the Nationwide Readmissions Database
- Authors: Michael A. Mitchell; Inderdeep Dhaliwal, Sunita Mulpuru, Kayvan Amjadi, Alex Chee
  Abstract: Hospital readmissions are costly to healthcare systems and represent a measure of quality care. Cancer patients with malignant pleural effusions (MPE) are at high risk for rehospitalization, yet risk factors for readmissions in this population are not well described. Understanding the incidence and risk factors for readmission could facilitate the development of a readmission reduction strategy in this patient population.
  Citation: CHEST (2019)
  PubDate: 2019-09-19
  DOI: 10.1016/j.chest.2019.09.007
Respiratory duty cycles in individuals with and without airway
hyperresponsiveness
- Authors: Christianne M. Blais; Beth E. Davis, Brian L. Graham, Donald W. Cockcroft
  Abstract: The respiratory duty cycle (Ti/Ttot) can influence bronchoprovocation test results and nebulized drug delivery. The Ti/Ttot has not yet been examined in individuals with airway hyperresponsiveness (AHR) in typical bronchoprovocation test conditions. This study investigated the mean Ti/Ttot in participants with and without AHR and whether the Ti/Ttot changes with increasing bronchoconstriction.
  Citation: CHEST (2019)
  PubDate: 2019-09-19
  DOI: 10.1016/j.chest.2019.09.005
Sleep Apnea and Chronic Kidney Disease - A State of the Art Review
- Authors: Chou-Han Lin; Renee C. Lurie, Owen D. Lyons
  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
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
  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
Phenotypic sub-types of obstructive sleep apnea: a challenge and
opportunity for precision medicine
- Authors: Andrey Zinchuk; Henry K. Yaggi
  Abstract: Current strategies for management of obstructive sleep apnea (OSA) reflect a one-size-fits-all approach. Diagnosis and severity of OSA are based on the apnea hypopnea index and treatment initiated with continuous positive airway pressure (CPAP), followed by trials of alternatives, such as oral appliances, if CPAP “fails.” This approach does not consider heterogeneity of individuals with OSA, reflected by varying risk factors, pathophysiological causes, clinical manifestations and consequences. Recently, studies using analytic approaches such as cluster analysis have taken advantage of this heterogeneity to identify OSA phenotypes, or sub-types of patients with unique characteristics, that may enable more personalized approaches to prognostication and treatment.
  Citation: CHEST (2019)
  PubDate: 2019-09-17
  DOI: 10.1016/j.chest.2019.09.002
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
  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
Use of imaging and diagnostic procedures after low dose computed
tomography screening for lung cancer
- Authors: Shawn P.E. Nishi; Jie Zhou, Ikenna Okereke, Yong-Fang Kuo, James Goodwin
  Abstract: Clinical trials have demonstrated a mortality benefit from lung cancer screening (LCS) by low dose computed tomography (LDCT) in current or past tobacco smokers who meet criteria. Potential harms of screening mostly relate to downstream evaluation of abnormal screens. Little data exist on the rates outside of clinical trials of imaging and diagnostic procedures following screening LDCT. We describe rates in the community setting of follow up imaging and diagnostic procedures after screening LDCT.
  Citation: CHEST (2019)
  PubDate: 2019-09-12
  DOI: 10.1016/j.chest.2019.08.2187
Estimated Ventricular Size, Asthma Severity and Exacerbations: The SARP
III Cohort
- Authors: Samuel Y. Ash; Gonzalo Vegas Sanchez-Ferrero, Mark L. Schiebler, Farbod N. Rahaghi, Ashish Rai, Carolyn E. Come, James C. Ross, Alysha G. Colon, Juan Carlos Cardet, Eugene R. Bleecker, Mario Castro, John V. Fahy, Sean B. Fain, Benjamin M. Gaston, Eric A. Hoffman, Nizar N. Jarjour, Jason K. Lempel, David T. Mauger, Matthew C. Tattersall, Sally E. Wenzel, Bruce D. Levy, George R. Washko, Elliot Israel, Raul San Jose Estepar, SARP Investigators
  Abstract: Relative enlargement of the pulmonary artery (PA) on chest computed tomography (CT) is associated with respiratory exacerbations in patients with chronic obstructive pulmonary disease or cystic fibrosis. We sought to determine if similar findings were present in patients with asthma and if they were explained by differences in ventricular size.
  Citation: CHEST (2019)
  PubDate: 2019-09-12
  DOI: 10.1016/j.chest.2019.08.2185
Contemporary Review in Critical Care Medicine:Mitochondria and Critical
Illness
- Authors: Gerald S. Supinski; Elizabeth A. Schroder, Leigh Ann Callahan
  Abstract: Classically, mitochondria have largely been thought to influence the development of illness by modulating cell metabolism and determining the rate of production of high energy phosphate compounds (e.g. ATP). It is now recognized that this is a simplistic view and that mitochondria play key roles in many other processes, including cell signaling, regulating gene expression, modulating cellular calcium levels and influencing the activation of cell death pathways (e.g. caspase activation). Moreover, these multiple mitochondrial functional characteristics are now known to influence the evolution of cellular and organ function in many disease states, including sepsis, ICU acquired skeletal muscle dysfunction, acute lung injury, acute renal failure, and critical illness related immune function dysregulation.
  Citation: CHEST (2019)
  PubDate: 2019-09-05
  DOI: 10.1016/j.chest.2019.08.2182
The Relationship of Pleural Manometry with Post-Thoracentesis Chest
Radiographic Findings in Malignant Pleural Effusion
- Authors: Amit Chopra; Marc A. Judson, Peter Doelken, Fabien Maldonado, Najib Rahman, John T. Huggins
  Abstract: Both elevated pleural elastance (E-PEL) and radiographic evidence of incomplete lung expansion following thoracentesis have been used to exclude patients with a malignant pleural effusion (MPE) from undergoing pleurodesis. We report a cohort of MPE patients in which complete drainage was attempted with pleural manometry to determine the frequency of E-PEL and its relationship with the post-thoracentesis radiographic findings.
  Citation: CHEST (2019)
  PubDate: 2019-08-28
  DOI: 10.1016/j.chest.2019.08.1920
Electrosurgical and Laser Therapy Tools for the Management of Malignant
Central Airway Obstructions
- Authors: Amit K. Mahajan; Omar Ibrahim, Ricardo Perez, Catherine L. Oberg, Adnan Majid, Erik Folch
  Abstract: Central airway obstruction (CAO) is associated with significant morbidity and increased mortality. Bronchoscopic electrosurgical and laser ablative tools have proven to be safe and effective instruments for the treatment of malignant CAO. While therapeutic modalities such as electrocautery, argon plasma coagulation (APC), and laser have been utilized for decades, additional tools including radiofrequency ablation (RFA) catheters continue to be developed for the treatment of CAO. These modalities are considered safe in the hands of experienced operators, though serious complications can occur.
  Citation: CHEST (2019)
  PubDate: 2019-08-28
  DOI: 10.1016/j.chest.2019.08.1919
CAT (COPD ASSESSMENT TEST) In Bronchiectasis: Minimum Clinically Important
Difference and Psychometric Validation. A Prospective Study
- Authors: David De la Rosa Carrillo; Casilda Olveira Fuster, Marta García-Clemente, Rosa M 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 endpoints in bronchiectasis (BE). However, the majority of HRQoL questionnaires are time-consuming or not validated in BE. The COPD Assessment Test (CAT) in an easy-to-use questionnaire. The objective of this study was to perform a complete validation of CAT in BE.
  Citation: CHEST (2019)
  PubDate: 2019-08-22
  DOI: 10.1016/j.chest.2019.08.1916
Accuracy of Xpert MTB/RIF Ultra for the diagnosis of pleural tuberculosis
in a multicentre cohort study
- Authors: Guirong Wang; Shuqi Wang, Xinting Yang, Qing Sun, Guanglu Jiang, Mailing Huang, Fengmin Huo, Yifeng Ma, Xiaoyou Chen, Hairong Huang
  Abstract: The Xpert MTB/RIF (Xpert) assay has greatly improved the diagnosis of tuberculosis (TB) and identification of resistance to rifampicin (RIF). However, sensitivity of Xpert remains poor for pleural fluid detection. This study evaluated the performance of the novel next-generation Xpert MTB/RIF Ultra (Xpert Ultra) in comparison to Xpert for pleural TB diagnosis.
  Citation: CHEST (2019)
  PubDate: 2019-08-19
  DOI: 10.1016/j.chest.2019.07.027
Bronchoscope-Related “Superbug” Infections
- Authors: Atul C. Mehta; Lawrence F. Muscarella
  Abstract: Several recent cases associating cleaned and high-level disinfected duodenoscopes with outbreaks of carbapenem-resistant Enterobacteriaceae (CRE) and related multidrug-resistant organisms (MDROs) may cause bronchoscopists, pulmonologists and other stakeholders to inquire about the adequacy of today’s practices for reprocessing flexible bronchoscopes. The primary objectives of this study were to address these questions and investigate the risk of reprocessed bronchoscopes transmitting infections of CRE and related MDROs.
  Citation: CHEST (2019)
  PubDate: 2019-08-14
  DOI: 10.1016/j.chest.2019.08.003
Critically Ill Patients with the HIV: 40 Years Later
- Authors: Élie Azoulay; Nathalie de Castro, François Barbier
  Abstract: The development of combination antiretroviral therapies (cART) in the mid-nineties has dramatically modified the clinical presentation of critically ill HIV-infected patients. Most of cART-treated patients ageing with controlled HIV replication are nowadays admitted to the intensive care unit (ICU) for non-AIDS-related events, mostly bacterial pneumonia and exacerbation of comorbidities, variably impacted by chronic HIV infection – e.g., chronic obstructive pulmonary disease, cardiovascular diseases, or solid neoplasms.
  Citation: CHEST (2019)
  PubDate: 2019-08-14
  DOI: 10.1016/j.chest.2019.08.002
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
Eligibility for Lung Volume Reduction Surgery in Chronic Obstructive
Pulmonary Disease patients identified in a UK primary care setting
- Authors: H. Whittaker; O. Connell, J. Campbell, A.F. Elbehairy, N.S. Hopkinson, J.K. Quint
  Abstract: Although lung volume reduction surgery (LVRS) improves survival in appropriately selected patients with Chronic Obstructive Pulmonary Disease (COPD), few procedures are performed. The National Institute for Clinical and Healthcare Excellence recently recommended a more systematic approach to identifying potential candidates. We investigated LVRS referrals from a UK primary care population and aimed to establish an accurate estimate of eligible patients and determine a strategy for identifying potential candidates systematically.
  Citation: CHEST (2019)
  PubDate: 2019-08-02
  DOI: 10.1016/j.chest.2019.07.016
Apneas of Heart Failure and Phenotype-Guided Treatments Part One:
Obstructive Sleep Apnea
- Authors: Shahrokh Javaheri; Lee K. Brown, William T. Abraham, Rami Khayat
  Abstract: Sleep-disordered breathing (SDB), including obstructive and central sleep apnea (OSA and CSA), is highly prevalent in patients with heart failure (HF). Multiple studies have shown this high prevalence in asymptomatic as well as symptomatic patients with reduced left ventricular ejection fraction (HFrEF), as well as those with preserved ejection fraction (HFpEF).The acute pathobiological consequences of OSA including exaggerated sympathetic activity, oxidative stress, and inflammation, eventually could lead to progressive left ventricular dysfunction, repeated hospitalization, and excessive mortality.
  Citation: CHEST (2019)
  PubDate: 2019-04-29
  DOI: 10.1016/j.chest.2019.02.407
Corticosteroid withdrawal-induced loss of control in mild to moderate
asthma is independent of classic granulocyte activation
- Authors: Linsey E.S. de Groot; Marianne A. van de Pol, Niki Fens, Barbara S. Dierdorp, Tamara Dekker, Wim Kulik, Christof J. Majoor, Jörg Hamann, Peter J. Sterk, René Lutter
  First page: 16
  Abstract: Loss of asthma control and asthma exacerbations are associated with increased sputum eosinophil counts. Yet, whether eosinophils, or indeed the also present neutrophils, actively contribute to the accompanying inflammation has not been investigated extensively.
  Citation: CHEST (2019)
  PubDate: 2019-10-14
  DOI: 10.1016/j.chest.2019.09.027
Meeting the Challenge of Identifying New Treatments for Type 2-low
Neutrophilic Asthma
- Authors: Or Kalchiem-Dekel; Xianglan Yao, Stewart J. Levine
  First page: 26
  Abstract: Asthma pathobiology can be broadly classified by endotypes of type 2-high and type 2-low disease, with a significant percentage of asthmatics having a type 2-low endotype that is poorly responsive to the anti-inflammatory actions of corticosteroids. Therapeutic approaches that target mediators of type 2-low asthma with neutrophilic airway inflammation have yet to enter clinical practice. Therefore, an unmet need exists for the development of new treatments for patients with a neutrophilic asthma, especially those with severe disease.
  Citation: CHEST (2019)
  PubDate: 2019-09-13
  DOI: 10.1016/j.chest.2019.08.2192
Incidence and Mortality of Adults Hospitalized with Community-Acquired
Pneumonia According to Clinical Course
- Authors: Paula Peyrani; Forest W. Arnold, Jose Bordon, Stephen Furmanek, Carlos M. Luna, Rodrigo Cavallazzi, Julio Ramirez
  First page: 34
  Abstract: After hospitalization for community-acquired pneumonia (CAP), patients’ clinical course may progress to clinical improvement, clinical failure, or non-resolving pneumonia. The epidemiology and outcomes of patients with CAP according to clinical course has not been well-studied. The objective of this study was to characterize the incidence and outcomes for each clinical course of hospitalized patients with CAP.
  Citation: CHEST (2019)
  PubDate: 2019-10-11
  DOI: 10.1016/j.chest.2019.09.022
Ebola Virus in the Democratic Republic of the Congo: Advances and
Remaining Obstacles in Epidemic Control, Clinical Care, and Biomedical
Research
- Authors: Julie Erb-Alvarez; Aaron M. Wendelboe, Daniel S. Chertow
  First page: 42
  Citation: CHEST (2019)
  PubDate: 2019-09-10
  DOI: 10.1016/j.chest.2019.08.2183
Subtyping COPD using visual and quantitative CT features
- Authors: Jinkyeong Park; Brian D. Hobbs, James D. Crapo, Barry J. Make, Elizabeth A. Regan, Stephen Humphries, Vincent J. Carey, David A. Lynch, Edwin K. Silverman, COPDGene Investigators
  First page: 47
  Abstract: Multiple studies have identified COPD subtypes using visual or quantitative evaluation of CT images. However, there has been no systematic assessment of a combined visual and quantitative CT classification. We integrated visually defined patterns of emphysema with quantitative imaging features and spirometry data to produce a set of ten non-overlapping CT subtypes, and we assessed differences between subtypes in demographic features, physiology, longitudinal disease progression, and mortality.
  Citation: CHEST (2019)
  PubDate: 2019-07-05
  DOI: 10.1016/j.chest.2019.06.015
The Burden of Substance Abuse Related Admissions to the Medical Intensive
Care Unit
- Authors: Donald Westerhausen; Anthony J. Perkins, Joshua Conley, Babar A. Khan, Mark Farber
  First page: 61
  Abstract: Admissions to intensive care unit (ICU) related to alcohol, prescription and illicit drugs shown to be widespread and costly. In 1993, study by Baldwin et al. revealed 28% of ICU admissions at Johns Hopkins Hospital related to substance abuse and accrued 39% costs. Since then, healthcare expenditures have increased, and substance abuse treatment admissions have risen. We conducted a study to provide updated data on ICU utilization and costs related to licit and illicit abuse at a large county hospital in Indianapolis, Indiana.
  Citation: CHEST (2019)
  PubDate: 2019-09-05
  DOI: 10.1016/j.chest.2019.08.2180
Plasma Mitochondrial DNA Levels are Associated with Acute Respiratory
Distress Syndrome in Trauma and Sepsis Patients
- Authors: Hilary E. Faust; John P. Reilly, Brian J. Anderson, Caroline A.G. Ittner, Caitlyn M. Forker, Peggy Zhang, Benjamin A. Weaver, Daniel N. Holena, Paul N. Lanken, Jason D. Christie, Nuala J. Meyer, Nilam S. Mangalmurti, Michael G.S. Shashaty
  First page: 67
  Abstract: Critically ill patients who develop the acute respiratory distress syndrome (ARDS) have substantial associated morbidity and mortality. Circulating mitochondrial DNA (mtDNA) released during critical illness causes endothelial dysfunction and lung injury in experimental models. We hypothesized that elevated plasma mtDNA is associated with ARDS in critically ill trauma and sepsis patients.
  Citation: CHEST (2019)
  PubDate: 2019-10-14
  DOI: 10.1016/j.chest.2019.09.028
Managing Massive Hemoptysis
- Authors: Kevin Davidson; Samira Shojaee
  First page: 77
  Abstract: Massive hemoptysis is a medical emergency with high mortality presenting several difficult diagnostic and therapeutic challenges. The origin of bleeding and underlying etiology often is not immediately apparent and techniques for management of this dangerous condition necessitate an expedient response. Unlike hemorrhage in other circumstances, a small amount of blood can rapidly flood the airways thereby impairing oxygenation and ventilation leading to asphyxia and consequent cardiovascular collapse.
  Citation: CHEST (2019)
  PubDate: 2019-07-30
  DOI: 10.1016/j.chest.2019.07.012
Right Ventricle to Left Ventricle ratio at CTPA predicts mortality in
Interstitial Lung Disease
- Authors: Simon Bax; Joseph Jacob, Riaz Ahmed, Charlene Bredy, Konstantinos Dimopoulos, Aleksander Kempny, Maria Kokosi, Gregory Kier, Elisabetta Renzoni, Philip L. Molyneaux, Felix Chua, Vasilis Kouranos, Peter George, Colm McCabe, Michael Wilde, Anand Devaraj, Athol Wells, S John Wort, Laura C. Price
  First page: 89
  Abstract: Patients with interstitial lung disease (ILD) may develop pulmonary hypertension (PH), often disproportionate to ILD severity. Right ventricle to left ventricle diameter ratio (RV:LV) measured at CT pulmonary angiography (CTPA), has been shown to provide valuable information in pulmonary arterial hypertension patients and to predict death or deterioration in acute pulmonary embolism.
  Citation: CHEST (2019)
  PubDate: 2019-07-24
  DOI: 10.1016/j.chest.2019.06.033
Accuracy of several lung ultrasound methods for the diagnosis of acute
heart failure in the emergency department: A multicenter prospective study
- Authors: Aurélien Buessler; Tahar Chouihed, Kévin Duarte, Adrien Bassand, Matthieu Huot-Marchand, Yannick Gottwalles, Alice Pénine, Elies André, Lionel Nace, Déborah Jaeger, Masatake Kobayashi, Stéfano Coiro, Patrick Rossignol, Nicolas Girerd
  First page: 99
  Abstract: Early appropriate diagnosis of acute heart failure (AHF) is recommended by international guidelines. This study assessed the value of several lung ultrasound (LUS) strategies for identifying AHF in the emergency department (ED).
  Citation: CHEST (2019)
  PubDate: 2019-08-02
  DOI: 10.1016/j.chest.2019.07.017
The Neurokinin-1 Receptor Antagonist Orvepitant is a Novel Antitussive
Therapy for Chronic Refractory Cough: Results from a Phase 2 Pilot Study
(VOLCANO-1)
- Authors: Jaclyn Smith; David Allman, Huda Badri, Robert Miller, Julie Morris, Imran Satia, Andrew Wood, Michael Trower
  First page: 111
  Abstract: Substance P and the neurokinin-1 (NK-1) receptor are implicated in chronic refractory cough (CRC) pathophysiology. We assessed the efficacy and safety of orvepitant, a brain-penetrant NK-1 antagonist, in an open-label study in CRC patients.
  Citation: CHEST (2019)
  PubDate: 2019-08-14
  DOI: 10.1016/j.chest.2019.08.001
Lung Hyperlucency - A Clinical-Radiologic Algorithmic Approach to
Diagnosis
- Authors: Sujith V. Cherian; Francis Girvin, David P. Naidich, Stephen Machnicki, Kevin K. Brown, Jay H. Ryu, Nishant Gupta, Vishisht Mehta, Rosa M. Estrada -Y- Martin, Mangala Narasimhan, Margarita Oks, Suhail Raoof
  First page: 119
  Abstract: Areas of diminished lung density are frequently identified both on routine chest radiographs and chest CT examinations. Colloquially referred to as “hyperlucent” foci of lung, a broad range of underlying pathophysiologic mechanisms and differential diagnoses account for these changes. Despite this, the spectrum of etiologies can be categorized into underlying parenchymal, airway and vascular related entities, respectively. The purpose of this review is to provide a practical diagnostic algorithmic approach to pulmonary hyperlucencies incorporating clinical history and characteristic imaging patterns to narrow the differential.
  Citation: CHEST (2019)
  PubDate: 2019-07-26
  DOI: 10.1016/j.chest.2019.06.037
Better with Ultrasound: Transcranial Doppler
- Authors: Vincent I. Lau; Atul Jaidka, Katie Wiskar, Nicholas Packer, J. Elaine Tang, Seth Koenig, Scott J. Millington, Robert T. Arntfield
  First page: 142
  Abstract: Transcranial Doppler (TCD) ultrasound is a non-invasive method of obtaining bedside neurologic information that can supplement the physical examination. In critical care, this can be of particular value in the unconscious patient with an equivocal neurologic exam, as TCD findings can help the clinician in decisions related to more definitive imaging studies as well as potential clinical interventions. Though TCD is traditionally the domain of sonographers and radiologists, there is increasing adoption of goal-directed TCD at the bedside in the critical care environment.
  Citation: CHEST (2019)
  PubDate: 2019-09-30
  DOI: 10.1016/j.chest.2019.08.2204
Impact of the New Pulmonary Hypertension Definition on Heart Transplant
Outcomes: Expanding the Hemodynamic Risk Profile
- Authors: Todd C. Crawford; Peter J. Leary, Charles Fraser, Alejandro Suarez-Pierre, J. Trent Magruder, William A. Baumgartner, Kenton J. Zehr, Glenn J. Whitman, S. Carolina Masri, Farooq Sheikh, Teresa De Marco, Bradley A. Maron, Kavita Sharma, Nisha A. Gilotra, Stuart D. Russell, Brian A. Houston, Bhavadharini Ramu, Ryan J. Tedford
  First page: 151
  Abstract: At the recent 6th World Symposium on Pulmonary Hypertension (PH), the definition of PH was redefined to include lower pulmonary artery pressures in the setting of an elevated pulmonary vascular resistance (PVR). However, the relevance of this change to subjects with PH due to left heart disease as well as the pre-operative assessment of heart transplant (HT) recipients is unknown.
  Citation: CHEST (2019)
  PubDate: 2019-08-22
  DOI: 10.1016/j.chest.2019.07.028
Retrospective validation of the REVEAL 2.0 Risk Score with the Australian
and New Zealand Pulmonary Hypertension Registry Cohort
- Authors: James J. Anderson; Edmund M. Lau, Melanie Lavender, Raymond Benza, David S. Celermajer, Nicholas Collins, Carolyn Corrigan, Nathan Dwyer, John Feenstra, Mark Horrigan, Dominic Keating, Fiona Kermeen, Eugene Kotlyar, Tanya McWilliams, Bronwen Rhodes, Peter Steele, Vivek Thakkar, Trevor Williams, Helen Whitford, Kenneth Whyte, Robert Weintraub, Jeremy P. Wrobel, Anne Keogh, Geoff Strange
  First page: 162
  Abstract: Pulmonary arterial hypertension (PAH) prognosis has improved with targeted therapies although the long-term outlook remains poor. Objective multi-parametric risk assessment is recommended to identify patients at risk of early morbidity and mortality, and for optimization of treatment. The REVEAL 2.0 Risk Score is a new model proposed for the follow-up of PAH patients but has not been externally validated.
  Citation: CHEST (2019)
  PubDate: 2019-09-26
  DOI: 10.1016/j.chest.2019.08.2203
Upper Airway Stimulation versus Positive Airway Pressure Impact on Blood
Pressure and Sleepiness Symptoms in Obstructive Sleep Apnea
- Authors: Harneet K. Walia; Nicolas R. Thompson, Kingman P. Strohl, Michael D. Faulx, Tina Waters, Alan Kominsky, Nancy Foldvary-Schaefer, Reena Mehra
  First page: 173
  Abstract: Positive airway pressure (PAP) and upper airway stimulation (UAS) are approved obstructive sleep apnea (OSA) treatment options.. Although the effect of PAP on improvement in blood pressure (BP) and daytime sleepiness (defined by Epworth Sleepiness Scale, ESS) has been established, the impact of UAS on BP remains unclear. We hypothesize that PAP and UAS will confer improvements in BP and daytime sleepiness.
  Citation: CHEST (2019)
  PubDate: 2019-07-09
  DOI: 10.1016/j.chest.2019.06.020
Sleep pharmacotherapy for common sleep disorders in pregnancy and
lactation
- Authors: Margaret A. Miller; Niharika Mehta, Courtney Clark-Bilodeau, Ghada Bourjeily
  First page: 184
  Citation: CHEST (2019)
  PubDate: 2019-10-14
  DOI: 10.1016/j.chest.2019.09.026
A randomized trial of nebulized lignocaine, lignocaine spray or their
combination for topical anesthesia during diagnostic flexible bronchoscopy
- Authors: Sahajal Dhooria; Shivani Chaudhary, Babu Ram, Inderpaul Singh Sehgal, Valliappan Muthu, Kuruswamy Thurai Prasad, Ashutosh N. Aggarwal, Ritesh Agarwal
  First page: 198
  Abstract: The optimal mode of delivering topical anesthesia during flexible bronchoscopy remains unknown. Herein, we compare the efficacy and safety of nebulized lignocaine, lignocaine oropharyngeal spray, or their combination.
  Citation: CHEST (2019)
  PubDate: 2019-07-09
  DOI: 10.1016/j.chest.2019.06.018
Assessment of Diaphragm Function and Pleural Pressures during
Thoracentesis
- Authors: Yunuen Aguilera Garcia; Atul Palkar, Seth Koenig, Mangala Narasimhan, Paul H. Mayo
  First page: 205
  Abstract: This prospective observational study reports on diaphragm excursion, velocity of diaphragm contraction, and changes in pleural pressure that occur with thoracentesis.
  Citation: CHEST (2019)
  PubDate: 2019-08-06
  DOI: 10.1016/j.chest.2019.07.019
Pleural Cryobiopsy - A Systematic Review and Meta-Analysis
- Authors: Majid Shafiq; Jaskaran Sethi, Muhammad S. Ali, Uzair K. Ghori, Tajalli Saghaie, Erik Folch
  First page: 223
  Abstract: Pleural biopsy using either video-assisted thoracoscopic surgery or medical pleuroscopy is the current diagnostic gold standard for pleural pathology with a high, yet imperfect, diagnostic yield. Cryobiopsy may provide greater tissue, increase depth of sampled tissue, and/or reduce crush artifact. However, its impact on diagnostic yield remains uncertain and there are potential concerns regarding its safety too. We performed a systematic review and meta-analysis in order to investigate the same.
  Citation: CHEST (2019)
  PubDate: 2019-10-11
  DOI: 10.1016/j.chest.2019.09.023