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Journal Prestige (SJR): 2.524

Citation Impact (citeScore): 3
Number of Followers: 112

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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 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/S0012-3692(20)35214-4
  Issue No: Vol. 159, No. 1 (2021)
A 55-Year-Old Woman With Frequent Pulmonary Exacerbations and
Endobronchial Lesions
- Authors: Tiana R. Endicott-Yazdani; Robert W. Baird, Meghan S. Koch, Alastair J. Moore, Ariel M. Modrykamien
  Abstract: A 55-year-old woman with COPD, heart failure with preserved ejection fraction (congestive heart failure), diabetes mellitus, and hypertension presented with baseline dyspnea at rest that had worsened over the last week. She reported associated runny nose, congestion, and cough productive of green sputum. She smoked six cigarettes per day and denied alcohol, drugs, or occupational exposure. She was admitted and initiated on treatment for acute exacerbation of COPD; however, her condition did not improve with steroid, ceftriaxone, and nebulized albuterol and budesonide treatments.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2116
  Issue No: Vol. 159, No. 1 (2021)
A 2-Year-Old Boy With Hypoxemia, Pulmonary Hypertension, and Digital
Clubbing
- Authors: Fazılcan Zirek; Birsel Şen Akova, Gizem Özcan, Suat Fitoz, Nazan Çobanoğlu
  Abstract: A 2-year-old boy was referred to the Ankara University School of Medicine Children’s Hospital with a history of recurrent respiratory distress and cyanosis since birth. His medical history was significant for premature birth at 31 weeks via cesarean section, as an infant of a diabetic mother. There was no parental consanguinity. He was hospitalized in the neonatal ICU after birth because of respiratory distress. After receiving invasive mechanical ventilation for 4 days, noninvasive mechanical ventilation and oxygen therapy were given gradually.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2103
  Issue No: Vol. 159, No. 1 (2021)
A 33-Year-Old Man With Dyspnea, Chest Pain, and a Massive Pleural Effusion
- Authors: Padraig Hawkins; Aoife Doyle, Leo Gavin, Aurelie Fabre, David J. Murphy, Eleanor Dunican, Cormac McCarthy
  Abstract: A 33-year-old white man presented to the ED with 1-month history of worsening dyspnea. He experienced gradual onset of right-sided scapular pain and shortness of breath on exertion that progressively worsened over the course of 1 month. He had a mild nonproductive cough and intermittent subjective fevers and reported weight loss of approximately 2 kg over 1 month. He had a history of two episodes of acute pancreatitis that was thought to be autoimmune in origin. He was a never smoker; he denied illicit drug use or recent alcohol consumption.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2102
  Issue No: Vol. 159, No. 1 (2021)
A 28-Year-Old Man With Chest Pain, Shortness of Breath, and Hemoptysis
After Recovery From Coronavirus Disease 2019 Pneumonia
- Authors: John Odackal; Tijana Milinic, Tim Amass, Edward D. Chan, Jeremy Hua, Silpa Krefft
  Abstract: A 28-year-old man presented with shortness of breath, chest pain, and scant hemoptysis. Three weeks previously, he was admitted for coronavirus disease 2019 pneumonia that had been diagnosed by nasal swab polymerase chain reaction. Chest CT imaging demonstrated bilateral ground-glass opacities without evidence of VTE. He was treated with hydroxychloroquine, up to 7 L/min oxygen, and self-proning. After 8 days of hospitalization, he was discharged on 4 L/min oxygen. After discharge, his symptoms and hypoxia resolved.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.096
  Issue No: Vol. 159, No. 1 (2021)
A 65-Year-Old Woman With Dyspnea After Atrial Fibrillation Ablation
- Authors: Fahad Gul; Daniel Casey, Sumeet Mainigi, Glenn Eiger, Abesh Niroula
  Abstract: A 65-year-old woman with a history of chronic persistent atrial fibrillation, tobacco use, and COPD was admitted to the hospital 2 months after catheter ablation for persistent atrial fibrillation and dyspnea. Her dyspnea was present at rest and worsened by exertion with limitation to ambulating less than two blocks. She also endorsed a 1-month history of cough with minimally productive whitish sputum with frequent nocturnal exacerbations and orthopnea. She denied any fevers, chest pain, or hemoptysis.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.095
  Issue No: Vol. 159, No. 1 (2021)
A 49-Year-Old Man Presents With Fever of Unknown Origin and Cough
- Authors: Yongjin Ji; Peixia Yu, Changqing Zhao
  Abstract: A 49-year-old man presented with 3 months of persistent fever, cough, shortness of breath, and chest tightness. He had no response to treatment with antibiotics. He had been treated with an empiric 2-week course of steroids approximately 2 months before presentation, with mild and transient improvement. He did not use tobacco and had not experienced any weight loss, hemoptysis, arthralgia, or myalgia, and was otherwise in good health. He denied contact with anyone with pulmonary TB or other respiratory illnesses.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2094
  Issue No: Vol. 159, No. 1 (2021)
A 56-Year-Old Man With Chronic Cough, Hemoptysis, and a Left Lower Lobe
Infiltrate
- Authors: Alexandra Miller; Janelle Wenstrup, Sanja Antic, Chirayu Shah, Robert J. Lentz, Parker Panovec, Pierre P. Massion
  Abstract: A 56-year-old man presented to the lung nodule clinic with abnormal chest imaging prompted by a chronic cough and hemoptysis. Approximately 2.5 years earlier, while kneeling beside his car fixing a flat tire, he fell backwards while holding the tire cap in his mouth, causing him to inhale sharply and aspirate the cap. He immediately developed an intractable cough productive of flecks of blood. He presented to an emergency room but left before being seen because of a long wait time and his lack of health-care insurance.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.091
  Issue No: Vol. 159, No. 1 (2021)
Case of a 21-Year-Old Man With Hemoptysis, Recurrent Pneumothorax, and
Cavitary Lung Lesions
- Authors: Sang Yong Park; Ho Cheol Kim, Seongbong Wee, Yeon Joo Kim, Chae-Man Lim, Yong-Gil Kim, Geun Dong Lee, Seungjoo Lee, Hee Sang Hwang, Se Jin Jang, Beom Hee Lee, Won-Kyung Cho
  Abstract: A 21-year-old man was admitted to our hospital with recurrent bilateral pneumothorax and hemoptysis. Three years earlier, he underwent coil embolization due to a subarachnoid hemorrhage caused by an intracerebral aneurysm rupture. Two months after the coil embolization, he underwent an emergent total colectomy due to a massive infarction of the colon. One year after the colectomy, he started to have recurrent hemoptysis, and a few months later, multiple episodes of bilateral pneumothorax that required a chest tube placement began to occur.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2067
  Issue No: Vol. 159, No. 1 (2021)
Reversal of Acute Right Ventricular Failure Early Post Left Ventricular
Assist Device Placement by Intratracheal Milrinone Administration
- Authors: Ying Tung Sia; Caroline E. Gebhard, André Y. Denault
  Abstract: A 58-year-old man with medical history of hypertension and pulmonary sarcoidosis presented with palpitation and syncope. At arrival in the ED, multiple episodes of nonsustained ventricular tachycardia have been recorded. Transthoracic echocardiography (TTE) showed severe left ventricular dysfunction with suspected cardiac sarcoidosis. Shortly after admission, the patient went into cardiac arrest due to refractory ventricular tachycardia. CPR was performed, and venous-arterial extracorporeal membrane oxygenation was inserted through a femoral approach without complication.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.01.059
  Issue No: Vol. 159, No. 1 (2021)
A 58-Year-Old Man With Abdominal Ascites
- Authors: Zeina Almajthoub; Majdi AlNabulsi, Vibhu Sharma
  Abstract: A 58-year-old man with a history of active alcohol use presented to the ED with a 3-week history of nausea and abdominal discomfort. A CT scan of the abdomen with oral contrast showed mild distention of the stomach and first and second portions of the duodenum without definite obstructing mass. Bowel wall thickening “consistent with enteritis” was noted, as was ascites and a cirrhotic liver. He was discharged with advice to abstain from alcohol and advised to follow up with his primary care physician.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.01.058
  Issue No: Vol. 159, No. 1 (2021)
A 17-Year-Old With Becker Muscular Dystrophy and Unusual Polysomnography
Findings
- Authors: Grace R. Paul; Rami N. Khayat, Kavitha Kotha, Deipanjan Nandi, Linda Cripe, Richard Shell
  Abstract: A 17-year-old male patient who was diagnosed with Becker muscular dystrophy (nonsense mutation [c.3822C>A] within exon 28 of the DMD gene) at 6 years of age was evaluated in the multidisciplinary neuromuscular clinic for loss of ambulation for 1 year. From a pulmonary perspective, there were no acute or chronic respiratory symptoms, and no history of pneumonia or aspiration. Clinical examination revealed a nonambulant teenager, with normal oxygen saturation and end-tidal CO2 when awake, no respiratory distress, and symmetrically diminished aeration due to obesity (BMI 40 kg/m2).
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2057
  Issue No: Vol. 159, No. 1 (2021)
Sclerosing Pneumocytoma
- Authors: Nora Mayer; Giovanni Luca Carboni, Andrea Thielken, Dirk Wagnetz
  Abstract: Sclerosing pneumocytoma (SP) is a rare primary lung tumor. Typical carcinoids (TCs) count for 2% of lung malignancies. A description of a combined neoplasm of SP with a nodal and pleural metastasized TC has, to our knowledge, never been published. A 57-year-old actively smoking woman received a diagnosis of a lesion in the left lower lobe via a screening CT scan for rheumatoid arthritis. A fluorodeoxyglucose-PET scan confirmed a 21 × 26 × 16 mm (standardized uptake maximum value, 3.0), well-circumscribed round lesion with calcification, which was thought to be most probably benign.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.06.047
  Issue No: Vol. 159, No. 1 (2021)
More Movement for Better Control
- Authors: Anne E. Holland; Arwel W. Jones
  Pages: 1 - 2
  Abstract: The Global Initiative for Asthma recommends that adults with asthma should engage in regular physical activity for its general health benefits.1 The majority of trials to date have involved structured physical activity interventions in the form of exercise training. A recent systematic review indicated that aerobic exercise training improves asthma control and lung function in adults with asthma.2 Despite the clear potential of formal supervised exercise interventions in improving asthma outcomes,2 personal preferences and barriers to physical activity mean it is unlikely that a one-size-fits-all approach is suitable.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  Issue No: Vol. 159, No. 1 (2021)
Introducing the Adult Cystic Fibrosis Series
- Authors: Nicholas J. Simmonds
  Pages: 3 - 4
  Abstract: Cystic fibrosis (CF) has come a long way since its first description in 1938 by the pathologist Dorothy Andersen.1 What was then a fatal condition in childhood with a>90% mortality rate in the first year of life has now been transformed into a disease across the age spectrum for which survival well into adulthood is expected in most countries. Treatments have progressed dramatically from basic, but important, supportive and symptomatic interventions to state-of-the-art highly effective targeted therapies.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  Issue No: Vol. 159, No. 1 (2021)
Interstitial Lung Abnormality Incidentally Detected on CT
- Authors: David A. Lynch
  Pages: 5 - 6
  Abstract: With increasing use of chest CT scans for diagnosis and for lung cancer screening, the high prevalence of incidentally detected interstitial lung abnormality (ILA) in the lung parenchyma in older individuals has become apparent. In nine studies of CT scans that were performed for lung cancer screening or for epidemiologic purposes, including a total of 28,580 subjects, the prevalence of ILA ranged from 3% to 17%, with a mean of 8%. ILAs are present primarily in older subjects; the mean age of subjects with ILA in these studies ranged from 60 to 78 years old.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  Issue No: Vol. 159, No. 1 (2021)
Steady As She Goes
- Authors: Richard H. Savel; Yizhak Kupfer, Ariel L. Shiloh
  Pages: 7 - 8
  Abstract: In this issue of CHEST, Janz et al1 share the results of their study about integrating a clinical protocol when caring for critically ill patients with coronavirus disease 2019 (COVID-19). This particular retrospective, observational cohort study took place in four hospitals in New Orleans from early March to mid-April 2020. The authors focused their efforts in two major areas: (1) they wished to see if utilizing an evidence-based protocol would be associated with improved outcomes, and (2) they analyzed outcomes in their critically ill patients with COVID-19 who were admitted to so-called “safety-net” hospitals (SNH).
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.09.245
  Issue No: Vol. 159, No. 1 (2021)
The Promise (and Pitfalls) of Administrative Data for Idiopathic Pulmonary
Fibrosis
- Authors: Jolene H. Fisher
  Pages: 9 - 10
  Abstract: Reliable and current population-based estimates of idiopathic pulmonary fibrosis (IPF) mortality are needed to better understand the epidemiologic trends of IPF. This knowledge is key to informing IPF-related health policy, patient advocacy, and future research planning.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.09.241
  Issue No: Vol. 159, No. 1 (2021)
Hormones, Hemodynamics, and Hepatic Function
- Authors: Tim Lahm
  Pages: 11 - 13
  Abstract: Portopulmonary hypertension (PoPH) is characterized by the development of precapillary pulmonary hypertension (PH) in the setting of portal hypertension.1,2 Because of similarities with other forms of PAH, PoPH is classified as group 1 PH.2 PoPH occurs in approximately 5% of patients referred for orthotopic liver transplantation (OLT),1 and survival generally is poorer than in idiopathic PAH.3
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.09.240
  Issue No: Vol. 159, No. 1 (2021)
The Pursuit of Risk Assessment and Stratification Tools in Pulmonary
Arterial Hypertension
- Authors: H. James Ford; Barbara LeVarge
  Pages: 14 - 16
  Abstract: Initial and ongoing risk assessment in pulmonary arterial hypertension (PAH) is key in determining class and intensity of PAH-specific therapy, discussing prognosis, and optimizing timing for lung transplant referral. Treatment guidelines advocate for achievement and maintenance of low-risk status. In the last decade, tools to assess risk systematically have emerged, with the use of objective metrics beyond clinician gestalt. These instruments are derived from large clinical registries. Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL), a prospective study of>3,500 patients in the United States, led to the development of the first REVEAL Registry risk calculator (REVEAL 1.0).
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  Issue No: Vol. 159, No. 1 (2021)
Maternal Sleep-Disordered Breathing and Gestational Diabetes
- Authors: Laura Sanapo; Ghada Bourjeily
  Pages: 17 - 18
  Abstract: Sleep-disordered breathing (SDB) is common during pregnancy, it is associated with maternal obesity, and its incidence is likely to increase given the global rise in obesity among women. Objectively determined SDB occurs in 15% to 70% of metabolically complicated pregnancies, with multiple studies showing an association between SDB and gestational diabetes mellitus (GDM).1 GDM, defined as glucose intolerance diagnosed in pregnancy, is one of the most common obstetric complications, affecting 7% to 18% of pregnancies and is an important risk factor for maternal and neonatal morbidities.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.013
  Issue No: Vol. 159, No. 1 (2021)
A Good Night’s Sleep After the ICU
- Authors: Stuti J. Jaiswal; Robert L. Owens
  Pages: 19 - 20
  Abstract: Few things remain as elusive in medicine as understanding how to protect the human brain. Whereas there has been substantial clinical and scientific progress in other domains such as cardiovascular and cancer care, ways to concretely and systematically prevent cognitive decline remain undefined. Accordingly, as the medical care for critical illness becomes more advanced and more lives are saved, the short- and long-term neurocognitive consequences of an ICU stay are becoming increasingly apparent and important to address.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.09.006
  Issue No: Vol. 159, No. 1 (2021)
Comparing Outcomes of Segmentectomy and Lobectomy for Non-small Cell Lung
Cancer
- Authors: Marius A. Roman; Apostolos Nakas
  Pages: 21 - 22
  Abstract: Since the first lung resection for a tumor in 1861 by Pean,1 thoracic surgery has evolved considerably and now offers patients widely available, minimally invasive surgical options aimed at maintaining excellent oncologic outcomes. The pursuit of further improvement in disease-free survival with an ever-increasing multimorbidity population has led to the emergence of segmentectomy as the natural progression of parenchymal sparing operative techniques.2
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.063
  Issue No: Vol. 159, No. 1 (2021)
Health Organizations Have an Opportunity to Improve Shared Decision-Making
and Raise Lung Cancer Screening Rates
- Authors: Ronald E. Myers
  Pages: 23 - 24
  Abstract: The important article by Tabriz et al1 in this issue of CHEST points out that Centers for Medicare and Medicaid Services requires shared decision-making (SDM) (ie, patient screening eligibility assessment, education about lung cancer screening [LCS], use of a decision support intervention to clarify patient screening preference, and counseling about annual screening, follow up, and smoking cessation) for reimbursement of initial screening. In the United States, however, SDM occurs infrequently, and LCS rates are low.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  Issue No: Vol. 159, No. 1 (2021)
POINT: Should Corticosteroids Be Routine Treatment in Early ARDS' Yes
- Authors: Gianfranco Umberto Meduri; Bram Rochwerg
  Pages: 25 - 29
  Abstract: ARDS is a catastrophic illness of multifactorial etiology characterized by a stereotypical severe and diffuse inflammatory exudate of the pulmonary lobules that lead to acute hypoxemic respiratory failure that requires mechanical ventilation (MV) for life support. Clinically, ARDS progresses trough three temporal phases: acute (respiratory failure), subacute (postextubation), and chronic (after hospital discharge). ARDS is associated with a substantial public health impact. It is a relatively common disease (10% of all patients who are admitted to ICUs; 200,000 cases in United States each year), is associated with 35% to 45% hospital deaths,1 leads to significant long-term disability in survivors (correlating with the duration of MV),2 and portends a huge health care cost.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.057
  Issue No: Vol. 159, No. 1 (2021)
COUNTERPOINT: Should Corticosteroids Be Routine Treatment in Early
ARDS' No
- Authors: Matthew K. Hensley; Michael W. Sjoding, Hallie C. Prescott
  Pages: 29 - 33
  Abstract: To answer the question of whether to use steroid therapy routinely in early ARDS, we must first acknowledge that ARDS is a heterogeneous clinical syndrome that may result from a variety of underling diseases, which include pneumonia, aspiration, pancreatitis, shock, trauma, drugs, drowning, fat emboli, and blood transfusion. Despite its seemingly straightforward definition, there is poor agreement on ARDS diagnosis across clinicians.1 And, although the pathologic correlate of ARDS is diffuse alveolar damage, only 45% of patients whose condition meets the clinical criteria for ARDS have diffuse alveolar damage on autopsy.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.059
  Issue No: Vol. 159, No. 1 (2021)
Rebuttal From Dr Hensley et al
- Authors: Matthew K. Hensley; Michael W. Sjoding, Hallie C. Prescott
  Pages: 34 - 35
  Abstract: Drs Meduri and Rochwerg1 highlight important points regarding steroids use in early ARDS. We agree that ARDS is a severe, debilitating, and costly disease with a large public health impact. Similarly, we agree that a recent meta-analysis2 and randomized trial3 have found benefit with steroid use. However, we differ on how to apply this information to bedside clinical practice.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.060
  Issue No: Vol. 159, No. 1 (2021)
Rebuttal From Drs Meduri and Rochwerg
- Authors: Gianfranco Umberto Meduri; Bram Rochwerg
  Pages: 35 - 37
  Abstract: The points raised by Hensley et al1 regarding the heterogeneity of ARDS trigger, presentation, pathologic condition, and clinical course are well taken. Yet, despite different causes, the biologic and histologic characteristics of ARDS are quite similar and consistent with a corticosteroid-responsive disease. Across clinical phenotypes of ARDS, degree of severity in systemic and pulmonary inflammation (hypo- vs hyperinflammatory subphenotypes) is the primary determinant of outcome.2,3 And irrespective of cause, progression to fibroproliferation, with persistent elevation in markers of inflammation and coagulation, is shared by all clinical phenotypes and is corticosteroid-responsive.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.058
  Issue No: Vol. 159, No. 1 (2021)
Mechanical Ventilation Education for All
- Authors: Sebastián Rodríguez-Llamazares; Luis Joel Arroyo-Hernández, Carmen Margarita Hernández-Cárdenas
  Pages: 38 - 39
  Abstract: Unlike other pandemics, coronavirus disease 2019 (COVID-19) has required hospitals to increase their ICU capacity, specifically in their ability to provide mechanical ventilation (MV) for a great number of patients. Nearly 115,000 ventilators were projected to be needed at the peak of the US COVID-19 outbreak.1 Many centers have been able to increase not only their surge capacity but also fulfill the staffing deficit required for such growth. However, a previously documented underlying necessity2 has now resurfaced: personnel trained in MV are desperately needed.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.09.091
  Issue No: Vol. 159, No. 1 (2021)
The American College of Chest Physicians' Perspective on the American
Association of Bronchology and Interventional Pulmonology’s Certificate
of Added Qualification
- Authors: Stephanie M. Levine; Steven Q. Simpson, David A. Schulman, Clayton T. Cowl
  Pages: 40 - 41
  Abstract: In response to the American Association of Bronchology and Interventional Pulmonology’s (AABIP) Certificate of Added Qualification (CAQ) announcement published in CHEST,1,2 The American College of Chest Physician’s (CHEST) leadership has received several inquiries requesting clarification and seeking CHEST’s perspective. Over the last several weeks, leaders from CHEST, the American Thoracic Society, the Association of Pulmonary and Critical Care Medicine Program Directors, and the AABIP have met to attempt to clarify the intent of the AABIP CAQ program.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.09.265
  Issue No: Vol. 159, No. 1 (2021)
Criteria for Low-Dose CT Lung Cancer Screening in the Setting of Air
Pollution
- Authors: Vineet K. Khanna; Subha Ghosh, Heber MacMahon, Atul C. Mehta
  Pages: 42 - 45
  Abstract: The American College of Chest Physicians recommends that low-dose chest CT be offered to patients ages 55 to 77 years who have smoked 30 pack-years or more and either continue to smoke or have quit within the past 15 years.1 However, the bulk of medical literature leaves air pollution unaddressed, despite its rapid rise affecting nearly the entire global population. Pollution in many locations equals the carcinogenic risk of cigarettes. The scope of this exposure cannot be understated, with at least 95% of the world’s population breathing unhealthy air (Fig 1).
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2091
  Issue No: Vol. 159, No. 1 (2021)
An Evaluation of Bronchoscopy Diagnostic Yield
- Authors: Matthew Aboudara; Otis B. Rickman, Fabien Maldonado
  Pages: 437 - 438
  Abstract: In a previous issue of CHEST (June 2020), Silvestri and colleagues1 published a study that underscores key components in preparation for diagnostic bronchoscopy. Using a dataset from a genomic classifier validation study, the investigators incorporated clinician pretest probability into a multivariate logistic regression model and, not surprisingly, found a higher diagnostic yield with a higher pretest probability of cancer and a lower diagnostic yield with a lower pretest probability. In addition, the authors conclude that more careful patient selection for bronchoscopy needs to be considered, and perhaps bronchoscopy should not be the initial diagnostic test of choice for peripheral pulmonary nodules (PPN) unless there is lymphadenopathy or central tumors in which a needle can be visualized in the lesion under real-time ultrasound guidance.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.093
  Issue No: Vol. 159, No. 1 (2021)
Response
- Authors: Gerard A. Silvestri; Benjamin Bevill, Alex Chen, Nicholas J. Pastis, M. Patricia Rivera, Nichole T. Tanner, Lonny Yarmus, Anil Vachani
  Pages: 438 - 439
  Abstract: Thank you to Aboudara and colleagues for showing such keen interest in our study. We will respond to their individual concerns below, but first some general concepts are worth addressing. There exists a scientific graveyard strewn with quotes such as “not surprisingly” until one is surprised, and “it has been known for years” when “it” has only recently been proven in a randomized setting, or “we feel the findings are overly simplistic,” despite the fact that science has little to do with feelings and everything to do with proof.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2087
  Issue No: Vol. 159, No. 1 (2021)
The Importance of Patient-Centered Care
- Authors: Robert Chapman
  Pages: 439 - 440
  Abstract: I am writing in response to the thoughtful insights put forward by Dr Maldonado1 in the recent editorial introducing the section on Humanities in CHEST medicine. As the coronavirus disease 2019 outbreak sweeps across the globe, it is shining a spotlight on medical practices. The need to treat patients in a holistic manner has become more apparent than ever because we have all been forced to reassure concerned families, broach difficult conversations, and consider ceilings of treatment more frequently than we ever have before.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.076
  Issue No: Vol. 159, No. 1 (2021)
Response
- Authors: Fabien Maldonado
  First page: 440
  Abstract: We thank Dr Chapman for his insightful response to our editorial in which he highlights the necessity to appreciate the complexity of patient interactions that cannot be adequately grasped by the blind, mechanistic application of evidence-based guidelines, treatment algorithms, or allocation frameworks.1
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.008
  Issue No: Vol. 159, No. 1 (2021)
Clarkson’s Disease Episode or Secondary Systemic Capillary
Leak-Syndrome
- Authors: Marc Pineton de Chambrun; Jean-Michel Constantin, Alexis Mathian, Cyril Quemeneur, Victoria Lepere, Alain Combes, Charles-Edouard Luyt, Zahir Amoura
  First page: 441
  Abstract: We read with great interest the article by Case et al1 titled “Systemic Capillary Leak Syndrome secondary to COVID-19.” The authors described a fatal systemic capillary leak syndrome (SCLS) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. They suggest SCLS could be a varied presentation of the multisystemic inflammatory syndromes (MIS) associated with the coronavirus disease 2019 (COVID-19).
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.084
  Issue No: Vol. 159, No. 1 (2021)
What Is Tracheobronchomalacia in Obstructive Lung Disease'
- Authors: Takayuki Takimoto; Hiroko Kitaoka, Takashi Kijima
  Pages: 442 - 443
  Abstract: We read with great interest the article by Shah et al1 in CHEST (June 2020). They report a significant association between use of inhaled corticosteroids (ICS) in higher doses for a longer duration of time with tracheobronchomalacia in patients with COPD and asthma. The authors postulate that ICS could cause tracheobronchomalacia and be a risk for tracheobronchomalacia. That is an important and eye-opening message for clinicians because we occasionally overlook tracheobronchomalacia. Another interpretation for their findings is that they may incorrectly use ICS for tracheobronchomalacia as severe asthma or COPD.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.085
  Issue No: Vol. 159, No. 1 (2021)
Response
- Authors: Ali Ataya; Robert Case, Christopher Harden
  First page: 442
  Abstract: We thank Pineton de Chambrun et al for their interest in our reported case of systemic capillary leak syndrome (SCLS) associated with coronavirus disease 2019 (COVID-19), and we read with interest their report of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induced episode of Clarkson’s disease in a pediatric patient that they recently reported.1 They bring up multiple important points and questions that we will clarify and address.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2045
  Issue No: Vol. 159, No. 1 (2021)
Response
- Authors: Varun Shah; Bryan Husta, Suhail Raoof, Atul Mehta
  Pages: 443 - 444
  Abstract: We appreciate interest of Takimoto et al and their interpretations related to our recent article.1 A concern has been raised that an excessive dynamic airway collapse (EDAC) is being inferred as tracheobronchomalacia on the basis of a still picture from a CT scan as we stated in our methods. They have also indicated that a causal relationship cannot be inferred because pretreatment inhaled corticosteroids (ICS) data are not available. Although these observations are valid, we would like to bring to light the intent of our study and would want the readership to acknowledge the retrospective nature of our study.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2050
  Issue No: Vol. 159, No. 1 (2021)
How to Select Patients With Clinically Early-Stage Non-Small Cell Lung
Cancer for Segmentectomy'
- Authors: Han-Yu Deng; Xiaojun Tang, Qinghua Zhou
  Pages: 444 - 445
  Abstract: Anatomic lung resection has become the standard of care for early-stage non-small cell lung cancer (NSCLC) as recommended by current guidelines1 since the only completed randomized controlled trial comparing the effects of sublobar resection and lobectomy in treating cT1N0 NSCLC proved the superior outcomes of lobectomy over sublobar resection.2 However, sublobar resection, especially segmentectomy, has also been recently recommended for NSCLC < 2 cm with less malignant features,1 because of its advantages of lung tissue preservation and further resection for another lung cancer.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.083
  Issue No: Vol. 159, No. 1 (2021)
Response
- Authors: Vignesh Raman; Oliver K. Jawitz, Thomas A. D’Amico, Chi-Fu Jeffrey Yang, Betty C. Tong
  Pages: 445 - 446
  Abstract: We thank Dr Deng and colleagues for their interest in our recent publication1 examining the interplay between tumor size, histology, and comparative survival associated with lobectomy and segmentectomy in patients with early non-small cell lung cancer.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2044
  Issue No: Vol. 159, No. 1 (2021)
Should We Expand Invasive Mediastinal Staging to Peripheral T1 Lung
Tumors'
- Authors: Pascalin Roy; Marc Fortin
  Pages: 446 - 447
  Abstract: We read with great interest the DuComb et al1 article in CHEST (May 2020) on the impact of tumor location on radiologically occult mediastinal disease (OMD) in screening-detected cT1N0M0 non-small cell lung cancers (NSCLC) from the National Lung Screening Trial. They measured X, Y, and Z coordinates from the main carina to evaluate the centrality of tumors and found no association between tumor location and risk of N2/N3 disease. We congratulate them for their novel objective method but would like to discuss further their conclusions.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.092
  Issue No: Vol. 159, No. 1 (2021)
Response
- Authors: Emily A. DuComb; C. Matthew Kinsey
  Pages: 447 - 448
  Abstract: We greatly appreciate the thoughtful comments offered by Drs Roy and Fortin regarding our recently published manuscript,1 particularly given their work in this area.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2078
  Issue No: Vol. 159, No. 1 (2021)
Can a Test Being Evaluated in a Study Be Itself Used as a Reference
Standard'
- Authors: Kajal Arora; Valliappan Muthu, Ashutosh Nath Aggarwal, Ritesh Agarwal
  First page: 448
  Abstract: We read the article by Wang et al1 in CHEST (February 2020).1 We congratulate the authors for an interesting study. We do, however, have a specific question regarding the reference standard used in the study.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.090
  Issue No: Vol. 159, No. 1 (2021)
Response
- Authors: Guirong Wang; Hairong Huang
  Pages: 448 - 449
  Abstract: Comparing a new diagnostic with available methods to gain some idea about its performance at the early stage of usage is necessary. When the new diagnostic has evidently better sensitivity than the reference, poor specificity will surely be incurred. A latent class analysis has been introduced to overcome this disadvantage1; however, it had seldom been used for TB diagnostic evaluation. Complexity and the need for knowledge of mathematics or statistics might be the main reasons impeding its application.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2071
  Issue No: Vol. 159, No. 1 (2021)
Zinc and Coronavirus Disease 2019
- Authors: Alkesh Kumar Khurana; Sunaina Tejpal Karna, Aqeel Hussain
  Pages: 449 - 450
  Abstract: We read with interest the article by Yao et al1 this issue of CHEST whereby they have studied the effect of zinc supplementation in hospitalized patients of coronavirus disease 2019 (COVID-19) infection.1 In reference to the patient assessment parameters and results, one very important aspect needs attention. Although the authors have evaluated in detail the baseline clinical and treatment characteristics, they have no data pertaining to serum zinc levels before or after zinc supplementation. We do understand because this was a retrospective analysis with waiver of consent, but one should be cautious about the interpretation of results in this scenario.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2092
  Issue No: Vol. 159, No. 1 (2021)
Response
- Authors: Jasper Seth Yao; Joseph Alexander Paguio, Edward Christopher Dee, Hanna Clementine Tan, Achintya Moulick, Carmelo Milazzo, Jerry Jurado, Nicolás Della Penna, Leo Anthony Celi
  Pages: 450 - 451
  Abstract: We thank Dr Khurana et al for their thoughtful response to our letter1 and for pointing out the value of serum zinc levels. Our study assessed the association between zinc supplementation and survival among hospitalized patients with coronavirus disease 2019 (COVID-19), using a causal inference approach to retrospective data. Our institutions do not routinely measure serum zinc levels. Although our study population consisted of patients admitted to a single hospital, our study assessed the effect of zinc in the contexts in which it was routinely used in the inpatient setting at the peak of the COVID-19 pandemic in the United States.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.08.2093
  Issue No: Vol. 159, No. 1 (2021)
Personalized Medicine for OSA Syndrome in a Nutshell
- Authors: Christophe Gauld; Marie Darrason, Guillaume Dumas, Jean-Arthur Micoulaud-Franchi
  Pages: 451 - 452
  Abstract: In 2011, personalized medicine was defined as “the tailoring of medical treatment to the individual characteristics of each patient.”1 Since then, the term has been used widely in the field of Sleep Medicine, especially in the context of OSAS syndrome in CHEST.2,3 However, the term personalized medicine is related to a wider range of concepts that can overlap1 (Fig 1) for OSA syndrome. Despite a growing interest in this field, clarification is needed, especially concerning the conceptual structure of personalized medicine for OSA syndrome and how it may help in unifying the field.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.086
  Issue No: Vol. 159, No. 1 (2021)
Would You Withhold Fruit From the Critically Ill'
- Authors: Jose I. Iglesias; Outcomes of Metabolic Resuscitation Using Ascorbic Acid, Thiamine, Glucocorticoids in the Early Treatment of Sepsis (ORANGES) investigators∗
  Pages: 452 - 453
  Abstract: We read with great interest the editorial by Fujii and Udy1 in CHEST (July 2020) and appreciate their comments. In their editorial, Fujii and Udy1 fail to mention the issue of timing, however. Sepsis is a time-sensitive disease, and time to intervention is critical. Indeed, in our study, all patients were enrolled within 12 h of presenting to the ED.2 Although our study was underpowered for a mortality benefit, the early treatment may explain the reduction in vasopressor requirement. In the accompanying Combined Treatment With Hydrocortisone, Vitamin C and Thiamine for Sepsis and Septic Shock (HYVCTTSSS) study, Chang et al3 report a mortality reduction in those patients with a sepsis duration < 48 h.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.056
  Issue No: Vol. 159, No. 1 (2021)
Variability and Misclassification of Sleep Apnea Severity Based on
Multi-Night Testing
- Authors: Mahadevappa Hunasikatti
  Pages: 453 - 454
  Abstract: I read with interest the article by Punjabi et al1 in CHEST (July 2020). The authors state that “the reference AHI was obtained as the posterior mean.” However, this may not be the ideal AHI (apnea hypopnea index) value that should be compared. Despite limitations, polysomnogram is still the gold standard diagnostic test of choice, until we have a reliable alternate home sleep testing that has approximately the same sensitivity and specificity in ruling in and ruling out OSA. Their concern about polysomnogram (PSG) limitation, “It is well established that on the first night in a sleep laboratory, normal subjects and patients with sleep disorders exhibit alterations in sleep quality,” is justified.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.098
  Issue No: Vol. 159, No. 1 (2021)
Assessing Candidacy for Tracheostomy in Ventilated Patients With
Coronavirus Disease 2019
- Authors: Michael J. Brenner; Jose De Cardenas, Theodore J. Standiford, Brenden A. McGrath
  Pages: 454 - 455
  Abstract: With their recent consensus statement in CHEST (October 2020), Lamb et al1 bring much-needed clarity to the role of tracheostomy during the coronavirus disease 2019 (COVID-19) pandemic. Such guidance will be particularly impactful if implemented in a manner that engages multidisciplinary teams,2 diverse stakeholders,3 and delivers patient-centered care.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.07.100
  Issue No: Vol. 159, No. 1 (2021)
Response
- Authors: Carla R. Lamb; Neeraj R. Desai, Luis Angel, Septimiu Murgu
  Pages: 455 - 456
  Abstract: We thank Brenner et al for their interest in our consensus statement1 and for highlighting specific considerations relevant to performing tracheostomy during the coronavirus disease 2019 (COVID-19) pandemic. In their letter, Brenner et al cite the need to balance risk reduction of infection transmission among health-care workers during an aerosol-generating procedure, such as tracheostomy, while optimizing patient safety and readiness for the procedure. We agree that, for specific aerosol-generating procedures, the uncertainty and lack of definitive best practices regarding risk reduction early in the pandemic may have led to a preferential focus on health-care worker safety.
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.09.244
  Issue No: Vol. 159, No. 1 (2021)
Erratum to: CHEST 2019;155(3):565-586
- First page: 457
  Abstract: In the March 2019 issue, the article titled “Therapy for Pulmonary Arterial Hypertension in Adults: Update of the CHEST Guideline and Expert Panel Report” (CHEST 2019;155(3):565-586) by Klinger et al contained a typographical error in Table 3:
  Citation: CHEST 159, 1 (2021)
  PubDate: 2021-01
  DOI: 10.1016/j.chest.2020.11.021
  Issue No: Vol. 159, No. 1 (2021)
COPD comorbidity profiles and two-year trajectory of acute and post-acute
care utilization
- Authors: Ernest Shen; Janet S. Lee, Richard A. Mularski, Phillip Crawford, Alan S. Go, Sue H. Sung, Grace H. Tabada, Michael K. Gould, Huong Q. Nguyen
  Abstract: Multiple morbidity is the norm in advanced COPD and contributes to high symptom burden and worse outcomes.
  Citation: CHEST (2021)
  PubDate: 2021-01-18
  DOI: 10.1016/j.chest.2021.01.020
Impact of high dose prophylactic anticoagulation in critically ill
patients with COVID-19 pneumonia
- Authors: Charles Tacquard; Alexandre Mansour, Alexandre Godon, Julien Godet, Julien Poissy, Delphine Garrigue, Eric Kipnis, Sophie Rym Hamada, Paul Michel Mertes, Annick Steib, Mathilde Ulliel-Roche, Bélaïd Bouhemad, Maxime Nguyen, Florian Reizine, Isabelle Gouin-Thibault, Marie Charlotte Besse, Nived Collercandy, Stefan Mankikian, Jerrold H. Levy, Yves Gruel, Pierre Albaladejo, Sophie Susen, Anne Godier, GIHP group
  Abstract: High dose prophylactic anticoagulation is associated with a reduction in thrombotic complications in critically ill COVID-19 patients without an increased risk of hemorrhage. Randomized controlled trials comparing prophylaxis with higher doses of anticoagulants are needed to confirm these results.
  Citation: CHEST (2021)
  PubDate: 2021-01-15
  DOI: 10.1016/j.chest.2021.01.017
Multi-Organ Dysfunction following Severe Traumatic Brain Injury:
Epidemiology, Mechanisms, and Clinical Management
- Authors: Vijay Krishnamoorthy; Jordan M. Komisarow, Daniel T. Laskowitz, Monica S. Vavilala
  Citation: CHEST (2021)
  PubDate: 2021-01-15
  DOI: 10.1016/j.chest.2021.01.016
A Reserve System for the Equitable Allocation of a Severe Acute
Respiratory Syndrome Coronavirus 2 Vaccine
- Authors: Alan T. Makhoul; Brian C. Drolet
  Abstract: Arguably, no scientific discovery in recent memory has been as eagerly awaited as the development of a vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). With countless lives on standby until a vaccine is available, demand will almost certainly outstrip the initial supply. Furthermore, vaccination will have unprecedented social, economic, and political implications. During this pandemic, we have seen individuals, health-care systems, and governments hoard medical resources, including medications (eg, hydroxychloroquine, remdesivir), personal protective equipment, and life-sustaining equipment (eg, ventilators).
  Citation: CHEST (2021)
  PubDate: 2021-01-13
  DOI: 10.1016/j.chest.2020.08.2042
Chest CT Diagnosis and Clinical Management of Drug-related Pneumonitis in
Patients Receiving Molecular Targeting Agents and Immune Checkpoint
Inhibitors: A Position Paper from the Fleischner Society
- Authors: Takeshi Johkoh; Kyung Soo Lee, Mizuki Nishino, William D. Travis, Jay H. Ryu, Ho Yun Lee, Christopher J. Ryerson, Tomás Franquet, Alexander A. Bankier, Kevin K. Brown, Jin Mo Goo, Hans-Ulrich Kauczor, David A. Lynch, Andrew G. Nicholson, Luca Richeldi, Cornelia M. Schaefer-Prokop, Johny Verschakelen, Suhail Raoof, Geoffrey D. Rubin, Charles Powell, Yoshikazu Inoue, Hiroto Hatabu
  Abstract: Increasing use of molecular targeting agents and immune checkpoint inhibitors has increased the frequency and broadened the spectrum of lung toxicity, particularly in patients with cancer. In this position paper from the Fleischner Society, the authors provide diagnostic criteria and management recommendations of drug-related pneumonitis for radiologists, clinicians, clinical trialists, and trial sponsors.
  Citation: CHEST (2021)
  PubDate: 2021-01-12
  DOI: 10.1016/j.chest.2020.11.027
Psychological Symptoms Among Surrogates of Critically Ill Patients During
and Before the COVID-19 Pandemic
- Authors: Jared A. Greenberg; Santosh Basapur, Thomas V. Quinn, Jeffrey L. Bulger, Crystal M. Glover, Raj C. Shah
  Citation: CHEST (2021)
  PubDate: 2021-01-11
  DOI: 10.1016/j.chest.2020.12.056
Clinical consequences of COVID-19 lockdown in patients with COPD: results
of a pre-post study in Spain
- Authors: Jessica González; Anna Moncusí-Moix, Ivan D. Benitez, Sally Santisteve, Aida Monge, Maria Angeles Fontiveros, Paola Carmona, Gerard Torres, Ferran Barbé, Jordi de Batlle
  Citation: CHEST (2021)
  PubDate: 2021-01-10
  DOI: 10.1016/j.chest.2020.12.057
Allocation of Mechanical Ventilators During a Pandemic: A Mixed-Methods
Study of Perceptions among Japanese Health Care Workers and the General
Public
- Authors: Yasuhiro Norisue; Gautam A. Deshpande, Miku Kamada, Tadanori Nabeshima, Yasuharu Tokuda, Takao Goto, Noriyoshi Ishizuka, Yuki Hara, Rie Nakata, Jun Makino, Motoko Matsumura, Shigeki Fujitani, Eiji Hiraoka
  Abstract: Most respondents supported allocation principles developed internationally and disagreed with the idea of first-come, first-served allocation during resource shortages. The Japanese public seems to be largely prepared to discuss the ethical dilemmas and possible solutions regarding fair and transparent allocation of critical-care resources as a necessary step in confronting present and future pandemics and disasters.
  Citation: CHEST (2021)
  PubDate: 2021-01-10
  DOI: 10.1016/j.chest.2021.01.015
Novel machine learning can predict acute asthma exacerbation
- Authors: Joe G. Zein; Chao-Ping Wu, Amy H. Attaway, Peng Zhang, Aziz Nazha
  Abstract: Asthma exacerbations result in significant health and economic burden but is difficult to predict.
  Citation: CHEST (2021)
  PubDate: 2021-01-10
  DOI: 10.1016/j.chest.2020.12.051
Analysis of non-tuberculous mycobacterial lung disease in patients with
primary Sjögren’s syndrome at a referral center
- Authors: Melanie F. Weingart; Qing Li, Sangbong Choi, Mehrnaz Maleki-Fischbach, Yong Soo Kwon, Tilman Koelsch, Coad Thomas Dow, Tho Q. Truong, Edward D. Chan
  Citation: CHEST (2021)
  PubDate: 2021-01-10
  DOI: 10.1016/j.chest.2021.01.007
Palliative care needs and integration of palliative care support in
chronic obstructive pulmonary disease (COPD): a qualitative study
- Authors: Yu Fu; Anne Mason, Alison C. Boland, Gordon Linklater, Vania Dimitrova, Ascensión Doñate-Martínez, Michael I. Bennett
  Abstract: Palliative care is increasingly being implemented for non malignant diseases including COPD throughout the UK although models of working vary. A theoretical model is developed to illustrate the concept and pathway of the integration of palliative care support. A standardised screening and needs assessment tool is required to improve timely palliative care and address the significant needs of this population.
  Citation: CHEST (2021)
  PubDate: 2021-01-09
  DOI: 10.1016/j.chest.2020.12.055
EFFECT OF ULTRA-SHORT-ACTING β-BLOCKERS ON MORTALITY IN PATIENTS WITH
PERSISTENT TACHYCARDIA DESPITE INITIAL RESUSCITATION: A SYSTEMATIC REVIEW
AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
- Authors: Daisuke Hasegawa; Ryota Sato, Narut Prasitlumkum, Kazuki Nishida, Kunihiko Takahashi, Tomoaki Yatabe, Osamu Nishida
  Abstract: The use of ultra-short-acting β-blockers such as esmolol and landiolol in septic patients with persistent tachycardia despite initial resuscitation was associated with significantly lower 28-day mortality.
  Citation: CHEST (2021)
  PubDate: 2021-01-09
  DOI: 10.1016/j.chest.2021.01.009
Epidemiology, Risk Factors and Outcomes of Diffuse Alveolar Hemorrhage
after Hematopoietic Stem Cell Transplantation
- Authors: Zhenmei Zhang; Can Wang, Steve G. Peters, William J. Hogan, Shahrukh K. Hashmi, Mark R. Litzow, Mrinal S. Patnaik, Alexander S. Niven, Hemang Yadav
  Abstract: The mortality of DAH after HCT remains high, and patients can develop DAH long after transplantation. Later development of DAH (>30 days after HCT), need for invasive mechanical ventilation, thrombocytopenia and elevated INR are all associated with worse outcomes.
  Citation: CHEST (2021)
  PubDate: 2021-01-09
  DOI: 10.1016/j.chest.2021.01.008
Safety and efficacy of dexmedetomidine in acutely ill adults requiring
non-invasive ventilation: a systematic review and meta-analysis of
randomized trials
- Authors: Kimberley Lewis; Joshua Piticaru, Dipayan Chaudhuri, John Basmaji, Eddy Fan, Morten Hylander Møller, John W. Devlin, Waleed Alhazzani
  Abstract: Compared to any sedation strategy or placebo, dexmedetomidine reduced the risk of delirium and the need for mechanical ventilation, while increasing the risk of bradycardia and hypotension. The results are limited by imprecision and further large RCTs are needed.
  Citation: CHEST (2021)
  PubDate: 2021-01-09
  DOI: 10.1016/j.chest.2020.12.052
“Protein biomarkers for COPD outcomes”
- Authors: Karina A. Serban; Katherine A. Pratte, Russell P. Bowler
  Abstract: Chronic obstructive pulmonary disease (COPD) is a clinically heterogeneous syndrome characterized by injury to airways, airspaces and lung vasculature and usually caused by tobacco smoke and/or air pollution exposure. COPD is also independently associated with non-pulmonary comorbidities (e.g. cardiovascular disease) and malignancies (e.g. gastrointestinal and bladder), suggesting a role for systemic injury. Since not all those with exposure develop COPD, there has been a search for plasma and lung biomarkers that confer increased cross-sectional and longitudinal risk.
  Citation: CHEST (2021)
  PubDate: 2021-01-09
  DOI: 10.1016/j.chest.2021.01.004
Distinct airway involvement in subtypes of end-stage fibrotic pulmonary
sarcoidosis
- Authors: Stijn E. Verleden; Arno Vanstapel, Laurens De Sadeleer, Adriana Dubbeldam, Tinne Goos, Iwein Gyselinck, Vincent Geudens, Janne Kaes, Dirk E. Van Raemdonck, Laurens J. Ceulemans, Jonas Yserbyt, Robin Vos, Bart Vanaudenaerde, Birgit Weynand, Johny Verschakelen, Wim A. Wuyts
  Abstract: The large airways are differentially involved in subtypes of sarcoidosis, but the terminal bronchioles are universally lost. This suggests that small airway loss forms an important aspect in the pathophysiology of fibrotic pulmonary sarcoidosis.
  Citation: CHEST (2021)
  PubDate: 2021-01-09
  DOI: 10.1016/j.chest.2021.01.003
How I Do It: Creating an Incidental Pulmonary Nodule Safety-Net Program
- Authors: Ruth Van Gerpen
  Citation: CHEST (2021)
  PubDate: 2021-01-08
  DOI: 10.1016/j.chest.2020.12.053
Endobronchial Ultrasound Staging of Operable NSCLC: Do Triple Normal Lymph
Nodes Require Routine Biopsy'
- Authors: Danielle A. Hylton; Biniam Kidane, Jonathan Spicer, Simon Turner, Isabella Churchill, Kerrie Sullivan, Christian J. Finley, Yaron Shargall, John Agzarian, Andrew J.E. Seely, Kazuhiro Yasufuku, Waël C. Hanna, Canadian Association of Thoracic Surgery Research Group
  Abstract: At the time of staging for lung cancer, combining CT, PET and CLNS criteria can identify Triple Normal LNs which have a high NPV for malignancy. This raises the question of whether Triple Normal LNs require routine sampling during EBUS-TBNA. A prospective trial is required to confirm these findings.
  Citation: CHEST (2021)
  PubDate: 2021-01-08
  DOI: 10.1016/j.chest.2020.12.050
That “bulky Commodity, Tobacco”
- Authors: Zachary Dorner
  Citation: CHEST (2021)
  PubDate: 2021-01-08
  DOI: 10.1016/j.chest.2020.12.024
Risk factors of viral RNAaemia and its association with clinical prognosis
among patients with severe COVID-19
- Authors: Hui Li; Xiaoying Gu, Huadong Li, Fengyun Gong, Jiuyang Xu, Yeming Wang, Haibo Li, Shunan Ruan, Qingyu Yang, Bin Cao
  Citation: CHEST (2021)
  PubDate: 2021-01-06
  DOI: 10.1016/j.chest.2020.11.071
Impact of the COVID-19 pandemic on volumes and disparities in lung cancer
screening
- Authors: Louise M. Henderson; Thad Benefield, Thangavijayan Bosemani, Jason M. Long, M. Patricia Rivera
  Citation: CHEST (2021)
  PubDate: 2021-01-05
  DOI: 10.1016/j.chest.2020.12.033
Clinical impact of the new definition of pre-capillary pulmonary
hypertension
- Authors: Gabor Kovacs; Katarina Zeder, Piet Rosenstock, Alexander Avian, Gerhard Bachmaier, Philipp Douschan, Vasile Foris, Teresa Sassmann, Horst Olschewski
  Citation: CHEST (2021)
  PubDate: 2021-01-04
  DOI: 10.1016/j.chest.2020.11.070
Geographic Variation in Racial Disparities in Mortality from Influenza and
Pneumonia in the US in the Pre-COVID-19 Era
- Authors: Sahai V. Donaldson; Alicia N. Thomas, Richard F. Gillum, Alem Mehari
  Abstract: In 1999-2018 the NHB-NHW disparity in AAMR from influenza and pneumonia was greatest in central metro areas of HHS regions 2 and 9.
  Citation: CHEST (2021)
  PubDate: 2021-01-01
  DOI: 10.1016/j.chest.2020.12.029
Sex-related differences in dynamic right ventricular-pulmonary vascular
coupling in heart failure with preserved ejection fraction
- Authors: Inderjit Singh; Rudolf K.F. Oliveira, Paul M. Heerdt, Rosa Pari, David M. Systrom, Aaron B. Waxman
  Abstract: Right ventricle (RV) dysfunction is associated with poorer outcomes in heart failure with preserved ejection fraction (HFpEF). Females are more likely to have HFpEF but males have worse prognosis and resting RV function. The contribution of dynamic RV-pulmonary artery (RV-PA) coupling between sex and its impact on peak exercise capacity (VO2) in HFpEF is not known.
  Citation: CHEST (2020)
  PubDate: 2020-12-31
  DOI: 10.1016/j.chest.2020.12.028
Phase II Investigation of the efficacy of Antimycobacterial therapy in
Chronic Pulmonary Sarcoidosis
- Authors: Wonder P. Drake; Daniel A. Culver, Robert P. Baughman, Marc A. Judson, Elliott D. Crouser, Ennis James, Gregory D. Ayers, Tan Ding, Kenny Abel, Abena Green, Amy Kerrigan, Ahmed Sesay, Gordon R. Bernard
  Abstract: A Phase I, single-center investigation demonstrated that 8 weeks of antimycobacterial therapy improved sarcoidosis forced vital capacity (FVC). Safety and efficacy assessments have not been performed in a multicenter cohort.
  Citation: CHEST (2020)
  PubDate: 2020-12-30
  DOI: 10.1016/j.chest.2020.12.027
Medical Education During the COVID-19 Pandemic
- Authors: Viren Kaul; Alice Gallo de Moraes, Dina Khateeb, Yonatan Greenstein, Gretchen Winter, JuneMee Chae, Nancy H. Stewart, Nida Qadir, Neha S. Dangayach
  Abstract: All aspects of medical education were affected by the Novel Coronavirus Infectious Disease-19 (COVID-19) pandemic. Several challenges were experienced by trainees and programs alike due to the economic repercussions of the pandemic, how social distancing affected the delivery of medical education, testing and interviewing, how the surge of patients affected redeployment of personnel, potential compromise in core training and the overall impact on the wellness and mental health of trainees and educators.
  Citation: CHEST (2020)
  PubDate: 2020-12-29
  DOI: 10.1016/j.chest.2020.12.026
Impact of Bronchiectasis on incident NTM pulmonary disease: A 10-Year
national cohort study
- Authors: Bumhee Yang; Jiin Ryu, Taehee Kim, Yong Suk Jo, Youlim Kim, Hye Yun Park, Young Ae Kang, Seung Jun Lee, Ok-Jun Lee, Ji-Yong Moon, Seung Won Ra, Sang-Heon Kim, Tae Hyung Kim, Yong-Soo Kwon, Yeon Mok Oh, Ki-Man Lee, Jang Won Sohn, Ho Joo Yoon, Hayoung Choi, Hyun Lee
  Citation: CHEST (2020)
  PubDate: 2020-12-26
  DOI: 10.1016/j.chest.2020.12.020
Categorized Priority Systems: A New Tool for Fairly Allocating Scarce
Medical Resources in the Face of Profound Social Inequities
- Authors: Tayfun Sönmez; Parag A. Pathak, M. Utku Ünver, Govind Persad, Robert D. Truog, Douglas B. White
  Citation: CHEST (2020)
  PubDate: 2020-12-25
  DOI: 10.1016/j.chest.2020.12.019
Impact of Right Ventricular Dysfunction on Short- and Long-Term Mortality
in Sepsis: A Meta-Analysis of 1,373 Patients
- Authors: Saraschandra Vallabhajosyula; Aditi Shankar, Rahul Vojjini, Wisit Cheungpasitporn, Pranathi R. Sundaragiri, Hilary M. DuBrock, Hiroshi Sekiguchi, Robert P. Frantz, Hector R. Cajigas, Garvan C. Kane, Jae K. Oh
  Abstract: In this meta-analysis of observational studies, RV dysfunction was associated with higher short-term and long-term mortality in sepsis and septic shock.
  Citation: CHEST (2020)
  PubDate: 2020-12-23
  DOI: 10.1016/j.chest.2020.12.016
RESEARCH LETTER: Pulmonary function and risk of Alzheimer dementia:
two-sample Mendelian randomization study
- Authors: Tom C. Russ; Sarah E. Harris, G. David Batty
  Citation: CHEST (2020)
  PubDate: 2020-12-21
  DOI: 10.1016/j.chest.2020.11.063
“We usually don’t vote on intubation.”
- Authors: Christopher E. Jensen; Katherine A. Despotes, Benjamin DeMarco
  Citation: CHEST (2020)
  PubDate: 2020-12-21
  DOI: 10.1016/j.chest.2020.11.062
Risk factors, management, and outcomes of legionella pneumonia in a large
nationally-representative sample
- Authors: Joshua Allgaier; Tara Lagu, Sarah Haessler, Peter B. Imrey, Abhishek Deshpande, Ning Guo, Michael B. Rothberg
  Abstract: Legionella is an uncommon cause of CAP, occurring primarily from late spring through early autumn. Testing is uncommon, even among patients with risk factors, and many positive patients failed to receive empiric coverage for LP.
  Citation: CHEST (2020)
  PubDate: 2020-12-19
  DOI: 10.1016/j.chest.2020.12.013
Which N descriptor is more predictive of prognosis in resected non-small
cell lung cancer: the number of involved nodal stations versus the
location-based pathological N stage'
- Authors: Long Xu; Hang Su, Yunlang She, Chenyang Dai, Mengmeng Zhao, Jiani Gao, Huikang Xie, Yijiu Ren, Dong Xie, Chang Chen
  Abstract: The nS classification could be used to provide a more accurate prognosis in patients with resected NSCLC. The nS is worth taking into consideration when defining nodal category in the forthcoming ninth edition of the staging system.
  Citation: CHEST (2020)
  PubDate: 2020-12-19
  DOI: 10.1016/j.chest.2020.12.012
Identifying and characterizing a chronic cough cohort through electronic
health records
- Authors: Michael Weiner; Paul R. Dexter, Kim Heithoff, Anna R. Roberts, Ziyue Liu, Ashley Griffith, Siu Hui, Jonathan Schelfhout, Peter Dicpinigaitis, Ishita Doshi, Jessica P. Weaver
  Abstract: NLP successfully identified a large cohort with CC. Most patients were identified through NLP alone, rather than diagnoses or medications. NLP improved detection of patients nearly seven-fold, addressing the gap in ability to identify and characterize CC disease burden. Nearly all cases appeared to be managed in primary care. Identifying these patients is important for characterizing treatment and unmet needs.
  Citation: CHEST (2020)
  PubDate: 2020-12-17
  DOI: 10.1016/j.chest.2020.12.011
Development and validation of algorithms to identify pulmonary arterial
hypertension in administrative data
- Authors: Kari R. Gillmeyer; Eduardo R. Nunez, Seppo T. Rinne, Shirley X. Qian, Elizabeth S. Klings, Renda Soylemez Wiener
  Abstract: Pulmonary arterial hypertension (PAH) is a rare disease and much of our understanding stems from single-center studies, which are limited by sample size and generalizability. Administrative data offer an appealing opportunity to inform clinical, research, and quality improvement efforts for PAH. Yet, there is currently no standardized, validated method to distinguish PAH from other subgroups of pulmonary hypertension (PH) within this data source.
  Citation: CHEST (2020)
  PubDate: 2020-12-17
  DOI: 10.1016/j.chest.2020.12.010
Development and Prospective Validation of a Deep Learning Algorithm for
Predicting Need for Mechanical Ventilation
- Authors: Supreeth P. Shashikumar; Gabriel Wardi, Paulina Paul, Morgan Carlile, Laura N. Brenner, Kathryn A. Hibbert, Crystal M. North, Shibani S. Mukerji, Gregory K. Robbins, Yu-Ping Shao, M. Brandon Westover, Shamim Nemati, Atul Malhotra
  Abstract: A transparent DL algorithm improves on traditional clinical criteria to predict the need for MV in hospitalized patients, including in those with COVID-19. Such an algorithm may help clinicians optimize timing of tracheal intubation, better allocate resources and staff, and improve patient care.
  Citation: CHEST (2020)
  PubDate: 2020-12-17
  DOI: 10.1016/j.chest.2020.12.009
The clinical use of lung MRI in cystic fibrosis: what, now, how'
- Authors: Gaël Dournes; Laura L. Walkup, Ilyes Benlala, Matthew M. Willmering, Julie Macey, Stephanie Bui, François Laurent, Jason C. Woods
  Abstract: To assess airway and lung parenchymal damage non-invasively in cystic fibrosis (CF), chest MRI has been historically out of the scope of routine clinical imaging due to technical difficulties such as the low proton density and respiratory and cardiac motion. However, technological breakthroughs have recently emerged to dramatically improve lung MRI quality (including signal-to-noise ratio, resolution, speed, contrast). At the same time, novel treatments have changed the landscape of CF clinical care.
  Citation: CHEST (2020)
  PubDate: 2020-12-17
  DOI: 10.1016/j.chest.2020.12.008
Endobronchial Valves for the Treatment of Advanced Emphysema
- Authors: Karin Klooster; Dirk-Jan Slebos
  Abstract: Bronchoscopic lung volume reduction with one-way endobronchial valves is a guideline treatment option for patients with advanced emphysema, supported by extensive scientific data. Patients limited by severe hyperinflation, with a suitable emphysema treatment target lobe and with absence of collateral ventilation are the responders to this treatment. Detailed patient selection, a professional treatment performance, and dedicated follow-up of the valve treatment, including management of complications, are key ingredients to success.
  Citation: CHEST (2020)
  PubDate: 2020-12-17
  DOI: 10.1016/j.chest.2020.12.007
“How I Do It: Nurse Coordinator Roles and Responsibilities for
Bronchoscopic Lung Volume Reduction with Endobronchial Valves”
- Authors: Hazelett Britney N; Paton Alichia, Majid Adnan, Schreefer Kimberly, Folch Erik, Johnson Margaret M, Patel Neal M, Abia-Trujillo David, Fernandez-Bussy Sebastian
  Abstract: Chronic Obstructive Pulmonary Disease (COPD) may cause profound dyspnea, functional impairment, and reduced quality of life. Available pharmacologic therapy provides suboptimal symptom improvement in many patients. Bronchoscopic lung volume reduction (BLVR), achieved with endobronchial valve (EBV) placement, can effectively improve dyspnea and functional status in appropriately selected patients. Operationalizing a safe and effective BLVR program requires appropriate oversight which can be achieved by a BLVR Nurse Coordinator (NC).
  Citation: CHEST (2020)
  PubDate: 2020-12-15
  DOI: 10.1016/j.chest.2020.11.041
Oncology Care Provider (OCP) Training in Empathic Communication Skills to
Reduce Lung Cancer Stigma
- Authors: Smita C. Banerjee; Noshin Haque, Elizabeth A. Schofield, Timothy J. Williamson, Chloé M. Martin, Carma L. Bylund, Megan J. Shen, Maureen Rigney, Heidi A. Hamann, Patricia A. Parker, Daniel C. McFarland, Bernard J. Park, Daniela Molena, Aimee Moreno, Jamie S. Ostroff
  Abstract: Empathy-based, stigma-reducing communication may lead to improved assessments of tobacco use and smoking cessation for patients with smoking-related cancers. These findings support the dissemination and further testing of a new ECS model for training OCPs in best practices for assessment of smoking history and engagement of patients who currently smoke in tobacco treatment delivery.
  Citation: CHEST (2020)
  PubDate: 2020-12-15
  DOI: 10.1016/j.chest.2020.11.024
Clinical outcomes and healthcare resource utilization associated with
reslizumab treatment in adults with severe eosinophilic asthma in
real-world practice
- Authors: Michael E. Wechsler; Stephen P. Peters, Tanisha D. Hill, Rinat Ariely, Michael R. DePietro, Maurice T. Driessen, Emi L. Terasawa, Darren R. Thomason, Reynold A. Panettieri
  Abstract: In clinical practice, reslizumab may have been initiated in response to heavy symptom burden and CAEs. Reslizumab was associated with improved clinical and patient-reported outcomes and significant reductions in asthma-related HRU.
  Citation: CHEST (2020)
  PubDate: 2020-12-14
  DOI: 10.1016/j.chest.2020.11.060
Decreasing case-fatality but not mortality rate following admission to
intensive care units in Australia, 2005-2018.
- Authors: Kevin B. Laupland; Alexis Tabah, Anthony D. Holley, Judith Bellapart, David V. Pilcher
  Citation: CHEST (2020)
  PubDate: 2020-12-14
  DOI: 10.1016/j.chest.2020.11.059
Quantitative Emphysema on Low-Dose Computed Tomography of the Chest and
Risk of Lung Cancer and Airflow Obstruction: An analysis of the National
Lung Screening Trial
- Authors: Wassim W. Labaki; Meng Xia, Susan Murray, Charles R. Hatt, Abdullah Al-Abcha, Michael C. Ferrera, Catherine A. Meldrum, Lauren A. Keith, Craig J. Galbán, Douglas A. Arenberg, Jeffrey L. Curtis, Fernando J. Martinez, Ella A. Kazerooni, MeiLan K. Han
  Abstract: Quantitative emphysema measured on LDCT of the chest can be leveraged to improve lung cancer risk prediction and help diagnose COPD in individuals who currently or formerly smoked undergoing lung cancer screening.
  Citation: CHEST (2020)
  PubDate: 2020-12-14
  DOI: 10.1016/j.chest.2020.12.004
Prolonged Hospitalization Following Acute Respiratory Failure
- Authors: Meghan Marmor; Sai Liu, Jin Long, Glenn M. Chertow, Angela J. Rogers
  Abstract: From 2004-2014, incidence and mortality decreased among patients with ARF and pLOS, and while per patient costs rose, percent of total cost of care remained stable. There is substantial variation in length-of-stay for patients with ARF by US region, hospital teaching status and patient insurance coverage.
  Citation: CHEST (2020)
  PubDate: 2020-12-14
  DOI: 10.1016/j.chest.2020.11.023
RESEARCH LETTER: Pulmonary function and risk of Alzheimer dementia:
two-sample Mendelian randomization study
- Authors: Tom C. Russ; Sarah E. Harris, G. David Batty
  Citation: CHEST (2020)
  PubDate: 2020-12-12
  DOI: 10.1016/j.chest.2020.11.056
Effects of low-load/high-repetition resistance training on exercise
capacity, health status and limb muscle adaptation in patients with severe
COPD: a randomized controlled trial
- Authors: Andre Nyberg; Mickael Martin, Didier Saey, Nadia Milad, Dany Patoine, Mathieu C. Morissette M, Dominique Auger, Per Stål, Francois Maltais
  Abstract: Single-limb LLHR-RT did not further increase mean 6MWD compared to two-limb LLHR-RT but it reduced exertional dyspnea and enabled more people reaching clinically relevant improvements in 6MWD. Independent of execution strategy, LLHR-RT improved exercise capacity, health status, muscle endurance and enabled several physiological muscle adaptations, reducing the negative consequences of limb muscle dysfunction in COPD.
  Citation: CHEST (2020)
  PubDate: 2020-12-11
  DOI: 10.1016/j.chest.2020.12.005
The Relationship Between Asthma and Cardiovascular Disease: An Examination
of the Framingham Offspring Study
- Authors: Matias E. Pollevick; Kevin Y. Xu, Grace Mhango, Emily G. Federmann, Rajesh Vedanthan, Paula Busse, Fernando Holguin, Alex D. Federman, Juan P. Wisnivesky
  Abstract: Our prospective analysis with>35 years of follow-up shows that asthma is a risk factor for CVD after adjusting for potential confounders. When assessing risk of cardiovascular disease, asthma should be evaluated and managed as a contributing risk factor to morbidity and mortality.
  Citation: CHEST (2020)
  PubDate: 2020-12-11
  DOI: 10.1016/j.chest.2020.11.053
Effect of CPAP therapy on kidney function in patients with chronic kidney
disease: a pilot randomized controlled trial
- Authors: Alex N. Rimke; Sofia B. Ahmed, Tanvir C. Turin, Sachin R. Pendharkar, Jill K. Raneri, Emma J. Lynch, Patrick J. Hanly
  Abstract: Although CPAP did not provide additional renal benefits over usual care in all CKD patients, there was some evidence that CPAP slowed the decline in eGFR in CKD patients with a lower risk of CKD progression. These preliminary data support the need and design of larger clinical trials exploring the effect of CPAP on kidney function.
  Citation: CHEST (2020)
  PubDate: 2020-12-11
  DOI: 10.1016/j.chest.2020.11.052
Effect of phenylephrine push prior to continuous infusion norepinephrine
in patients with septic shock
- Authors: Jaclyn M. Hawn; Seth R. Bauer, Jason Yerke, Manshi Li, Xiaofeng Wang, Anita J. Reddy, Eduardo Mireles-Cabodevila, Gretchen L. Sacha
  Abstract: Intravenous pushes of phenylephrine may be utilized for patients with septic shock with the intent of rapidly achieving mean arterial pressure (MAP) goals. However, the clinical effectiveness and safety of this approach is unclear. Therefore, we sought to answer the question, in patients with septic shock, is administration of a phenylephrine push prior to norepinephrine initiation associated with a higher incidence of hemodynamic stability'
  Citation: CHEST (2020)
  PubDate: 2020-12-11
  DOI: 10.1016/j.chest.2020.11.051
Corticosteroid therapy is associated with improved outcome in critically
ill COVID-19 patients with hyperinflammatory phenotype
- Authors: Hui Chen; Jianfeng Xie, Nan Su, Jun Wang, Qin Sun, Shusheng Li, Jun Jin, Jing Zhou, Min Mo, Yao Wei, Yali Chao, Weiwei Hu, Bin Du, Haibo Qiu
  Abstract: For critically ill patients with COVID-19, corticosteroid therapy was not associated with 28-day mortality, but the use of corticosteroids showed significant survival benefits in patients with the hyperinflammatory phenotype.
  Citation: CHEST (2020)
  PubDate: 2020-12-11
  DOI: 10.1016/j.chest.2020.11.050
Identification of distinct immunophenotypes in critically-ill COVID-19
patients
- Authors: Thibault Dupont; Sophie Caillat-Zucman, Véronique Fremeaux-Bacchi, Florence Morin, Etienne Lengliné, Michael Darmon, Régis Peffault de Latour, Lara Zafrani, Elie Azoulay, Guillaume Dumas
  Abstract: Severe COVID-19 patients exhibiting cytokine release marks, complement activation or B-lymphocyte defects are distinct from each other. Such immunologic variability argues in favor of targeting different mediators in different groups of patients and could serve as a basis for patient identification and clinical trial eligibility.
  Citation: CHEST (2020)
  PubDate: 2020-12-11
  DOI: 10.1016/j.chest.2020.11.049
“Diaphragm Ultrasound in Weaning from Mechanical Ventilation”
- Authors: Deepti Kilaru; Nova Panebianco, Cameron Baston
  Citation: CHEST (2020)
  PubDate: 2020-12-10
  DOI: 10.1016/j.chest.2020.12.003
Sleep Apnea and Insomnia: Emerging Evidence for Effective Clinical
Management
- Authors: Jason C. Ong; Megan R. Crawford, Douglas M. Wallace
  Abstract: Comorbid insomnia and sleep apnea (COMISA) are the most common co-occurring sleep disorders and presents many challenges to clinicians. This review provides an overview of the clinical challenges in the management of patients with COMISA with a focus on recent evidence regarding the evaluation and treatment of COMISA. Innovations in the assessment of COMISA have used profile analyses or dimensional approaches to examine symptom clusters or symptom severity that could be particularly useful in the assessment of COMISA.
  Citation: CHEST (2020)
  PubDate: 2020-12-09
  DOI: 10.1016/j.chest.2020.12.002
Long-Term Acute Care Hospitals Extend ICU Capacity for COVID-19 Response
and Recovery
- Authors: Antony M. Grigonis; Kusum S. Mathews, Wande O. Benka-Coker, Amanda M. Dawson, Samuel I. Hammerman
  Abstract: The COVID-19 pandemic has presented novel challenges for the entire healthcare continuum, requiring transformative changes to hospital and post-acute care, including clinical, administrative, and physical modifications to current standards of operations. Innovative use and adaptation of long-term acute care hospitals (LTACHs) can safely and effectively care for patients during the ongoing COVID-19 pandemic. A framework for the rapid changes, including increasing collaboration with external healthcare organizations, creating new methods for enhanced communication, and modifying processes focused on patient safety and clinical outcomes, is described for a network of 94 LTACHs.
  Citation: CHEST (2020)
  PubDate: 2020-12-09
  DOI: 10.1016/j.chest.2020.12.001
Temporal trends in tunneled pleural catheter utilization in patients with
malignancy: A multicenter review
- Authors: Candice L. Wilshire; Shu-Ching Chang, Christopher R. Gilbert, Jason A. Akulian, Mohammed K. AlSarraj, Rachelle Asciak, Benjamin T. Bevill, Kevin R. Davidson, Ashley Delgado, Horiana B. Grosu, Felix JF. Herth, Hans J. Lee, Justin E. Lewis, Fabien Maldonado, David E. Ost, Nicholas J. Pastis, Najib M. Rahman, Chakravarthy B. Reddy, Lance J. Roller, Trinidad M. Sanchez, Samira Shojaee, Henry Steer, Jeffrey Thiboutot, Momen M. Wahidi, Amber N. Wright, Lonny B. Yarmus, Jed A. Gorden
  Citation: CHEST (2020)
  PubDate: 2020-12-08
Racial Disparity in Surgical Therapy for Thymic Malignancies
- Authors: Deirdre Martinez-Meehan; Hussein Abdallah, Waseem Lutfi, Rajeev Dhupar, Neil Christie, James D. Luketich, Ibrahim Sultan, Olugbenga T. Okusanya
  Abstract: The primary curative treatment for thymic malignancies is surgery. For lung and esophageal cancer, there are substantive disparities in outcomes by race. Much of these disparities are attributed to the decreased utilization of surgery in African-American (AA) patients. Though thymic malignancies are treated by the same group of specialists as lung and esophageal cancer, it is not known if there are racial disparities in the treatment of thymic malignancies.
  Citation: CHEST (2020)
  PubDate: 2020-12-07
  DOI: 10.1016/j.chest.2020.11.048
Trends in the Prevalence of Non-tuberculous Mycobacterial Infection in
Patients with Non-Cystic Fibrosis Bronchiectasis in South Korea, 2012-2016
- Authors: Seung Jun Lee; Hayoung Choi, Hyun Lee, Seung Won Ra, Yeon Mok Oh, Sunmi Ju, Jung Wan You, Yi Yeong Jeong, Ho Cheol Kim, Jong Deog Lee
  Citation: CHEST (2020)
  PubDate: 2020-12-07
Antiplatelet drugs and risk of bleeding after bedside pleural procedures:
a national multicenter cohort study
- Authors: Laurence Dangers; Jonathan Giovannelli, Gilles Mangiapan, Mikael Alves, Naïke Bigé, Jonathan Messika, Elise Morawiec, Mathilde Neuville, Christophe Cracco, Gaëtan Béduneau, Nicolas Terzi, Isabelle Huet, Xavier Dhalluin, Nathalie Bautin, Jean-Jacques Quiot, Corinne Appere-de Vecchi, Thomas Similowski, Cécile Chenivesse
  Abstract: Antiplatelet therapy was associated with an increased risk of post-pleural procedure bleeding and serious bleeding. Future guidelines should take into account these results for patient safety.
  Citation: CHEST (2020)
  PubDate: 2020-12-05
Which adults presenting for SARS-CoV-2 testing are most likely to have a
positive swab' A population-based cohort of 15,132 adults from
Alberta, Canada
- Authors: Finlay A. McAlister; Tara A. Whitten, James A. King, Jeffrey A. Bakal
  Citation: CHEST (2020)
  PubDate: 2020-12-04
  DOI: 10.1016/j.chest.2020.11.043
How We Do It: Creating an Organizational Culture for the Chest Clinician
- Authors: James K. Stoller; Raed Dweik, Peter Rea
  Abstract: Organizational culture matters. Culture is a key driver of organizational performance and underpins the strategy that was discussed in a companion paper in this series. As previously discussed, if the strategy is the plants and the garden plan for a garden, the culture is the soil. Without a healthy culture, nothing will grow, irrespective of how well planned the garden or how beautiful the individual flowers.Using the case of establishing the culture in an institute at the Cleveland Clinic, the paper examines an approach to establishing and maintaining an organizational culture.
  Citation: CHEST (2020)
  PubDate: 2020-12-04
  DOI: 10.1016/j.chest.2020.11.040
Assessing Disparities in Lung Cancer Incidence for Gender Minority
Individuals Using California Cancer Registry Data
- Authors: Lihua Liu; Jean-Christophe N. Rwigema, Ziwei Song, Myles Cockburn, Albert J. Farias, Sue E. Kim, Elizabeth A. David
  Citation: CHEST (2020)
  PubDate: 2020-12-04
  DOI: 10.1016/j.chest.2020.11.039
Multisystem Inflammatory Syndrome in Adults
- Authors: Mark W. Tenforde; Sapna Bamrah Morris
  Abstract: Multisystem inflammatory syndrome in children (MIS-C) has become a recognized syndrome, whereas a parallel syndrome in adults has not been well defined. MIS-C was first reported in April 2020 as a hyperinflammatory syndrome with variable features of Kawasaki disease.1 Most cases occur several weeks following confirmed or suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children or young adults (≤ 21 years of age) who develop severe illness. The syndrome is typically characterized by fever, markedly elevated inflammatory biomarkers, and multiple organ system involvement, frequently with prominent GI symptoms.
  Citation: CHEST (2020)
  PubDate: 2020-12-04
  DOI: 10.1016/j.chest.2020.09.097
Performance of Risk factor-based Guidelines and Model-based Chest CT Lung
Cancer Screening in World Trade Center Exposed Fire Department
Rescue/Recovery Workers
- Authors: Krystal L. Cleven; Brandon Vaeth, Rachel Zeig-Owens, Hilary L. Colbeth, Nadia Jaber, Theresa Schwartz, Michael D. Weiden, Steven B. Markowitz, Gerard A. Silvestri, David J. Prezant
  Abstract: In this cohort, our findings support expanding eligibility for LDCT lung cancer screening by lowering smoking history from ≥30 to ≥20 pack-years and age from 55-years to 50-years old. Additional studies are needed to determine its generalizability to other occupational/environmental exposed cohorts.
  Citation: CHEST (2020)
  PubDate: 2020-12-02
  DOI: 10.1016/j.chest.2020.11.028
Chest CT in COVID-19 at the ED: Validation of the COVID-19 Reporting and
Data System (CO-RADS) and CT severity score
- Authors: Arthur W.E. Lieveld; Kaoutar Azijli, Bernd P. Teunissen, Rutger M. van Haaften, Ruud S. Kootte, Inge A.H. van den Berk, Sabine F.B. van der Horst, Carlijn de Gans, Peter M. van de Ven, Prabath W.B. Nanayakkara
  Abstract: Our findings support the use of CO-RADS and CTSS in triage, diagnosis and management decisions for patients presenting with possible COVID-19 at the ED.
  Citation: CHEST (2020)
  PubDate: 2020-11-30
  DOI: 10.1016/j.chest.2020.11.026
Tobacco Treatment Program Models in US Hospitals and Outpatient Centers
- Authors: Amanda M. Palmer; Alana M. Rojewski, Li-shiun Chen, Lisa M. Fucito, Panagis Galiatsatos, Hasmeena Kathuria, Stephanie R. Land, Glen D. Morgan, Alex T. Ramsey, Kimber P. Richter, Xiaozhong Wen, Benjamin A. Toll, SRNT Treatment Network
  Abstract: As tobacco use remains one of the leading causes of disease, disability, and mortality, tobacco treatment programs should be integrated into medical systems, such as hospitals and outpatient centers. Medical providers have a unique, high-impact opportunity to initiate smoking cessation treatment with patients. However, there are several barriers that may hinder the development and implementation of these programs. The purpose of this review is to address such barriers by illustrating several examples of successful tobacco treatment programs in US healthcare systems that were contributed by the authors.
  Citation: CHEST (2020)
  PubDate: 2020-11-28
  DOI: 10.1016/j.chest.2020.11.025
A minority of patients on mechanical ventilation consume disproportionate
resources: A retrospective cohort study
- Authors: Marya D. Zilberberg; Brian H. Nathanson, Judy Ways, Andrew F. Shorr
  Abstract: MV patients in the highest quintiles by MV duration utilize disproportionate amount of resources as evidenced by MV duration, hospital LOS, and costs, making them a potential target for streamlining MV care.
  Citation: CHEST (2020)
  PubDate: 2020-11-27
  DOI: 10.1016/j.chest.2020.11.022
Clinical outcomes according to ECG presentations in infarct-related
cardiogenic shock in CULPRIT-SHOCK
- Authors: Michel Zeitouni; Ibrahim Akin, Steffen Desch, Olivier Barthélémy, Delphine Brugier, Jean-Philippe Collet, Suzanne de Waha-Thiele, John P. Greenwood, Paul Guedeney, Georges Hage, Marie Hauguel-Moreau, Kurt Huber, Mathieu Kerneis, Marko Noc, Keith G. Oldroyd, Jan J. Piek, Stéphanie Rouanet, Stefano Savonitto, Pranas Serpytis, Johanne Silvain, Janina Stepinska, Eric Vicaut, Christiaan JM. Vrints, Stephan Windecker, Uwe Zeymer, Holger Thiele, Gilles Montalescot, CULPRIT-SHOCK trial investigators
  Abstract: In patients with cardiogenic shock, NSTE-MI and LBBB-MI presentations reflect higher risk profiles than STE-MI but are not independent risk factors of mortality. ECG presentations did not modify the treatment effect, supporting culprit-lesion-only PCI as the preferred strategy across the AMI spectrum.
  Citation: CHEST (2020)
  PubDate: 2020-11-25
Providing Outpatient Telehealth in the United States: Before and During
COVID-19
- Authors: Joshua J. Brotman; Robert M. Kotloff
  Abstract: Before COVID-19, telehealth evaluation and management services were not widely utilized in the United States and often restricted to rural areas or locations with poor access to care. Most Medicare beneficiaries could not receive telehealth services in their homes. In response to the COVID-19 pandemic, Medicare, Medicaid, and commercial insurers relaxed restrictions on both coverage and reimbursement of telehealth services. These changes, together with the need for social distancing, transformed the delivery of outpatient evaluation and management services through an increase in telehealth utilization.
  Citation: CHEST (2020)
  PubDate: 2020-11-24
  DOI: 10.1016/j.chest.2020.11.020
Incidence and Impact of Swimming Induced Pulmonary Edema (SIPE) on Navy
SEAL Candidates
- Authors: Charles Volk; Jeffrey Spiro, Gilbert Boswell, Peter Lindholm, Julia Schwartz, Zenus Wilson, Sara Burger, Michael Tripp
  Abstract: Respiratory complaints like swimming induced pulmonary edema (SIPE) are a common feature of United States Navy Special Warfare (NSW) training. We designed a study to evaluate the incidence and clinical features of SIPE seen in this population.
  Citation: CHEST (2020)
  PubDate: 2020-11-24
  DOI: 10.1016/j.chest.2020.11.019
Interrelationships between small airways dysfunction, neutrophilic
inflammation and exacerbation frequency in COPD
- Authors: Kerry Day; Kristoffer Ostridge, Joy Conway, Doriana Cellura, Alastair Watson, Cosma Mirella Spalluto, Karl J. Staples, Bruce Thompson, Tom Wilkinson, On behalf of the MICA II study group-Anna Freeman Hannah Burke
  Abstract: Increased acinar ventilation heterogeneity may be a consequence of previous exacerbations or highlight a group of patients prone to exacerbations. Measures of SAD were strongly associated with neutrophilic inflammation in the small airways of FE supporting the hypothesis that frequent exacerbations are associated with small airway disease related to increased cellular inflammation.
  Citation: CHEST (2020)
  PubDate: 2020-11-24
  DOI: 10.1016/j.chest.2020.11.018
Frequency, risk factors, clinical characteristics and outcomes of
spontaneous pneumothorax in patients with Covid-19: A case-control,
emergency medicine-based multicenter study
- Authors: Òscar Miró; Pere Llorens, Sònia Jiménez, Pascual Piñera, Guillermo Burillo-Putze, Alfonso Martín, Francisco Javier Martín-Sánchez, Eric Jorge García-Lamberetchs, Javier Jacob, Aitor Alquézar-Arbé, Josep Maria Mòdol, María Pilar López-Díez, Josep Maria Guardiola, Carlos Cardozo, Francisco Javier Lucas Imbernón, Alfons Aguirre Tejedo, Ángel García García, Martín Ruiz Grinspan, Ferran Llopis Roca, Juan González del Castillo, Spanish Investigators on Emergency Situations TeAm (SIESTA) network
  Abstract: SP as a form of COVID presentation at the ED is unusual (
  Citation: CHEST (2020)
  PubDate: 2020-11-20
  DOI: 10.1016/j.chest.2020.11.013
HOW CAN I SURVIVE THIS' Coping during COVID-19 pandemic
- Authors: Daniel Garros; Wendy Austin, Peter Dodek
  Abstract: Worldwide, healthcare professionals are experiencing unprecedented stress related to the COVID-19 pandemic. Responding to a new virus for which there is no effective treatment yet and no vaccine, is beyond challenging. Moral distress, experienced when clinicians are unable to act in the way that they believe they should, is often experience when dealing with end-of-life care issues, as well as insufficient resources. Both factors have been widespread during this pandemic, particularly when patients are dying alone, and lack of personal protection equipment plague many overburdened healthcare systems.
  Citation: CHEST (2020)
  PubDate: 2020-11-17
  DOI: 10.1016/j.chest.2020.11.012
Lower respiratory tract myeloid cells harbor SARS-CoV-2 and display an
inflammatory phenotype
- Authors: William G. Bain; Hernán F. Peñaloza, Mark S. Ladinsky, Rick van der Geest, Mara Sullivan, Mark Ross, Georgios D. Kitsios, Barbara Methe, Bryan J. McVerry, Alison Morris, Alan M. Watson, Simon C. Watkins, Claudette M. St Croix, Donna B. Stolz, Pamela J. Bjorkman, Janet S. Lee
  Citation: CHEST (2020)
  PubDate: 2020-11-17
A CLUSTER ANALYSIS OF BRONCHIECTASIS PATIENTS BASED ON THE AIRWAY IMMUNE
PROFILE
- Authors: Lídia Perea; Elisabet Cantó, Guillermo Suarez-Cuartin, Stefano Aliberti, James D. Chalmers, Oriol Sibila, Silvia Vidal
  Abstract: Bronchiectasis patients can be stratified in different clusters according to profiles of airway AMPs, inflammation, tissue remodeling and damage. The combination of these immunological variables shows a relationship with disease severity and future risk of exacerbations.
  Citation: CHEST (2020)
  PubDate: 2020-11-17
  DOI: 10.1016/j.chest.2020.11.011
Normative cardiopulmonary exercise test responses at the ventilatory
threshold in Canadian adults aged 40-80 years
- Authors: H. Lewthwaite; O. Elsewify, F. Niro, J. Bourbeau, J.A. Guenette, F. Maltais, D.D. Marciniuk, D.E. O’Donnell, B.M. Smith, M.K. Stickland, W.C. Tan, D. Jensen, The CanCOLD Collaborative Research Group, Canadian Respiratory Research Network
  Abstract: A contemporary reference set of CPET responses at Tvent from Canadian adults aged 40-80 years is presented, which differs from the previously recommended and often used reference set by Jones and coworkers.
  Citation: CHEST (2020)
  PubDate: 2020-11-17
  DOI: 10.1016/j.chest.2020.11.009
Added Diagnostic Utility Of Clinical Metagenomics For The Diagnosis Of
Pneumonia In Immunocompromised Adults
- Authors: Marwan M. Azar; Robert Schlaberg, Maricar F. Malinis, Santos Bermejo, Toni Schwarz, Heng Xie, Charles S. Dela Cruz
  Abstract: CMT+CM increased diagnostic yield in immunocompromised adults with pneumonia from 35% to 58%, mostly by detecting additional bacterial etiologies but was less useful for fungal pneumonia.
  Citation: CHEST (2020)
  PubDate: 2020-11-17
  DOI: 10.1016/j.chest.2020.11.008
Incidence of venous thromboembolism and bleeding among hospitalized
patients with COVID-19: a systematic review and meta-analysis
- Authors: David Jiménez; Aldara García-Sanchez, Parth Rali, Alfonso Muriel, Behnood Bikdeli, Pedro Ruiz-Artacho, Raphael Le Mao, Carmen Rodríguez, Beverley J. Hunt, Manuel Monreal
  Abstract: Among hospitalized patients with COVID-19, the overall estimated pooled incidence of VTE was 17.0%, with higher rates with routine screening, inclusion of distal DVT and subsegmental PE, in critically ill patients, and in prospective studies. Bleeding events were observed in 7.8% of patients and were sensitive to use of escalated doses of anticoagulants, and nature of data collection. Additional studies are required to ascertain the significance of various thrombotic events and to identify strategies to improve patient outcomes.
  Citation: CHEST (2020)
  PubDate: 2020-11-17
  DOI: 10.1016/j.chest.2020.11.005
Sex and survival after surgery for lung cancer: A Swedish nationwide
cohort
- Authors: Erik Sachs; Ulrik Sartipy, Veronica Jackson
  Abstract: Women who underwent pulmonary resections for lung cancer had significantly better prognosis than men. The survival advantage was evident regardless of age, common comorbidities, socioeconomic status, lifestyle factors, physical performance, type and extent of surgery, tumor characteristics and stage.
  Citation: CHEST (2020)
  PubDate: 2020-11-16
  DOI: 10.1016/j.chest.2020.11.010
Low-tidal volume mechanical ventilation against no ventilation during
cardiopulmonary bypass in heart surgery (MECANO): a randomized controlled
trial
- Authors: Lee S. Nguyen; Philippe Estagnasie, Messaouda Merzoug, Alain Brusset, Jean-Dominique Law Koune, Stephane Aubert, Thierry Waldmann, Cecile Naudin, Jean-Michel Grinda, Hadrien Gibert, Pierre Squara
  Abstract: Postoperative pulmonary complications are common after cardiac surgery and have been related to lung collapsus during cardiopulmonary bypass (CPB). There is no consensus on the effects of maintaining mechanical ventilation during CPB to decrease these complications.
  Citation: CHEST (2020)
  PubDate: 2020-11-16
Risk Factors for and Time to Recurrence of Symptomatic Malignant Pleural
Effusion in Patients with Metastatic Non-Small Cell Lung Cancer with EGFR
or ALK Mutations
- Authors: Audra J. Schwalk; David E. Ost, Sahara N. Saltijeral, Henriette De La Garza, Roberto F. Casal, Carlos A. Jimenez, Georgie A. Eapen, Jeff Lewis, Waree Rinsurongkawong, Vadeerat Rinsurongkawong, Jack Lee, Yasir Elamin, Jianjun Zhang, Jack A. Roth, Stephen Swisher, John Heymach, Horiana B. Grosu
  Abstract: Our findings indicate that patients with actionable mutations have a similar risk of MPE recurrence when compared to patients without mutations and would benefit from a similar definitive management approach to their MPE.
  Citation: CHEST (2020)
  PubDate: 2020-11-16
COVID-19 Test Correlation Between Nasopharyngeal Swab and Bronchoalveolar
Lavage in Asymptomatic Patients
- Authors: Jiwoon Chang; Kai E. Swenson, Arthur Sung, Harmeet Bedi
  Citation: CHEST (2020)
  PubDate: 2020-11-16
  DOI: 10.1016/j.chest.2020.11.006
“How I Do It: Assessing Patients for Air Travel”
- Authors: Amy L. Bellinghausen; Jess Mandel
  Abstract: Advising patients prior to air travel is a frequently overlooked, but important role of the physician, particularly primary care providers and pulmonary specialists. Although physiologic changes occur in all individuals during air travel, those with underlying pulmonary disease are at increased risk of serious complications, and require a specific approach to risk stratification. We discuss the available tools for assessing pre-flight risk, as well as strategies to minimize potential harm. We also present a case discussion to illustrate our approach to assessing patients for air travel, and discuss the specific conditions that should prompt a more thorough pre-flight workup.
  Citation: CHEST (2020)
  PubDate: 2020-11-16
  DOI: 10.1016/j.chest.2020.11.002
How I Do It: Restarting Respiratory Clinical Research in the Era of the
COVID19 Pandemic
- Authors: Jennifer L. Taylor-Cousar; Lisa Maier, Gregory P. Downey, Michael E. Wechsler
  Abstract: The clinical research we do to improve our understanding of disease and development of new therapies has temporarily been paused or delayed as the global healthcare enterprise has focused its attention on those impacted by COVID-19. While rates of SARS-CoV-2 infection are decreasing in many areas, many locations continue to have a high prevalence of infection. Nonetheless, research must continue and institutions are considering approaches to re-starting non-COVID related clinical investigation. Those restarting respiratory research must navigate the added planning challenges that take into account outcome measures that require aerosol generating procedures.
  Citation: CHEST (2020)
  PubDate: 2020-11-13
  DOI: 10.1016/j.chest.2020.11.001
Assessing the physiological endotypes responsible for REM and NREM based
obstructive sleep apnea.
- Authors: Simon A. Joosten; Shane A. Landry, Ai-Ming Wong, Dwayne L. Mann, Philip I. Terrill, Scott A. Sands, Anthony Turton, Caroline Beatty, Luke Thomson, Garun S. Hamilton, Bradley A. Edwards
  Abstract: This study is the first to link long recognized polysomnographic patterns of OSA to underlying physiological differences. NREMOSA patients have a higher loop gain in NREM sleep while REMOSA patients have a worsening of Vpassive in REM sleep.
  Citation: CHEST (2020)
  PubDate: 2020-11-13
Sigh in patients with acute hypoxemic respiratory failure and acute
respiratory distress syndrome: the PROTECTION pilot randomized clinical
trial.
- Authors: Tommaso Mauri; Giuseppe Foti, Carla Fornari, Giacomo Grasselli, Riccardo Pinciroli, Federica Lovisari, Daniela Tubiolo, Carlo Alberto Volta, Savino Spadaro, Roberto Rona, Egle Rondelli, Paolo Navalesi, Eugenio Garofalo, Rihard Knafelj, Vojka Gorjup, Riccardo Colombo, Andrea Cortegiani, Jian-Xin Zhou, Rocco D’Andrea, Italo Calamai, Ánxela Vidal González, Oriol Roca, Domenico Luca Grieco, Tomas Jovaisa, Dimitrios Bampalis, Tobias Becher, Denise Battaglini, Huiqing Ge, Mariana Luz, Jean-Michel Constantin, Marco Ranieri, Claude Guerin, Jordi Mancebo, Paolo Pelosi, Roberto Fumagalli, Laurent Brochard, Antonio Pesenti
  Abstract: Among hypoxemic intubated ICU patients, application of sigh was feasible and without increased risk.
  Citation: CHEST (2020)
  PubDate: 2020-11-13
Sepsis, the Administration of Intravenous Fluids and Respiratory failure:
A Retrospective analysis - SAIFR Study
- Authors: Nikhil Jagan; Lee E. Morrow, Ryan W. Walters, Robert W. Plambeck, Tej M. Patel, Karson F. Kalian, Jeffrey C. Macaraeg, Emily D. Dyer, Adam A. Bergh, Aaron J. Fried, Douglas R. Moore, Mark A. Malesker
  Abstract: In this single-center retrospective study we found by broadly defining respiratory failure as an increase in oxygen requirements, a conservative initial IVF resuscitation strategy did not correlate with decreased rates of hypoxemic respiratory failure.
  Citation: CHEST (2020)
  PubDate: 2020-11-13
The value of hemodynamic measurements or cardiac magnetic resonance
imaging in the follow-up of patients with idiopathic pulmonary arterial
hypertension.
- Authors: Cathelijne Emma van der Bruggen; Martin Louis Handoko, Harm Jan Bogaard, Johannes Timotheus Marcus, Franciscus Petrus Theodorus Oosterveer, Lilian Jacoba Meijboom, Berend Eric Westerhof, Anton Vonk Noordegraaf, Frances Sarah de Man
  Abstract: Risk-assessment at 1-year of follow-up based on CMR is at least equal to risk-assessment based on RHC. In this study, only changes in CMR- but not hemodynamic parameters are of prognostic predictive value during the first-year of follow-up.
  Citation: CHEST (2020)
  PubDate: 2020-11-13
Excellent Prognosis of Patients with Invasive Lung Adenocarcinomas
Intraoperatively Misdiagnosed as AAH/AIS/MIA by Frozen Section
- Authors: Yang Zhang; Chaoqiang Deng, Fangqiu Fu, Zelin Ma, Zhexu Wen, Xiangyi Ma, Shengping Wang, Yuan Li, Haiquan Chen
  Abstract: Patients undergoing limited resection of invasive LUAD misdiagnosed as AAH/AIS/MIA by FS had excellent prognosis. Sublobar resection guided by FS diagnosis would be adequate for these underestimated invasive LUAD.
  Citation: CHEST (2020)
  PubDate: 2020-11-13
Institution-level differences in quality and outcomes of lung cancer
resections in the United States.
- Authors: Raymond U. Osarogiagbon; Helmneh M. Sineshaw, Chun Chieh Lin, Ahmedin Jemal
  Abstract: Institution-level disparities in non-small cell lung cancer (NSCLC) survival may be driven by reversible differences in care-delivery processes. We quantified the impact of differences in readily identifiable quality metrics on long-term survival disparities in resected NSCLC.
  Citation: CHEST (2020)
  PubDate: 2020-11-13
Plasma insulin-like growth factor binding protein-7 (IGFBP-7) contributes
causally to ARDS 28-day mortality: evidence from multi-stage Mendelian
randomization
- Authors: Xuesi Dong; Zhaozhong Zhu, Yongyue Wei, Debby Ngo, Ruyang Zhang, Mulong Du, Hui Huang, Lijuan Lin, Paula Tejera, Li Su, Feng Chen, Amy M. Ahasic, B. Taylor Thompson, Nuala J. Meyer, David C. Christiani
  Abstract: We identified plasma IGFBP7 as a novel causal protein involved in the pathogenesis of ARDS 28-day mortality and platelet function in ARDS, a topic for further experimental and clinical investigation.
  Citation: CHEST (2020)
  PubDate: 2020-11-12
The Potential effects of financial conflicts of interest of speakers at
the U.S Food and Drug Administration’s Pulmonary-Allergy Drug Advisory
Committee meetings
- Authors: Bickford Trevor; Kinder Nicholas, Arthur Wade, Wayant Cole, Vassar Matt
  Citation: CHEST (2020)
  PubDate: 2020-11-07
Pilot project to assess the potential cost benefit of a bronchoscopy
program for the diagnosis of tuberculosis in Uganda
- Authors: Peter Jackson; Trishul Siddharthan, A. Christine Argento, Ashutosh Sachdeva, Lonny Yarmus, Akshay Gupte, Winceslaus Katagira, Bruce Kirenga, William Worodria, Hans J. Lee
  Citation: CHEST (2020)
  PubDate: 2020-11-07
Incorporating baseline lung function in lung cancer screening: Does a
“lung health check” help predict outcomes'
- Authors: Robert P. Young; Raewyn J. Hopkins, Greg D. Gamble, Gerard A. Silvestri
  Citation: CHEST (2020)
  PubDate: 2020-11-07
Assessment of Integrated Classifier’s Ability to Distinguish Benign From
Malignant Lung Nodules: Extended Analyses and 2 Year Follow-Up Results of
the PANOPTIC (Pulmonary Nodule Plasma Proteomic Classifier) Trial
- Authors: Nichole T. Tanner; Steven C. Springmeyer, Alex Porter, James R. Jett, Peter Mazzone, Anil Vachani, Gerard A. Silvestri
  Citation: CHEST (2020)
  PubDate: 2020-11-07
A clinic blueprint for post-COVID-19 RECOVERY: Learning from the past,
looking to the future
- Authors: Denyse D. Lutchmansingh; Melissa P. Knauert, Danielle E. Antin-Ozerkis, Geoffrey Chupp, Lauren Cohn, Charles S. Dela Cruz, Lauren E. Ferrante, Erica L. Herzog, Jonathan Koff, Carolyn L. Rochester, Changwan Ryu, Inderjit Singh, Mayanka Tickoo, Vikki Winks, Mridu Gulati, Jennifer D. Possick
  Abstract: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic poses extraordinary challenges. The tremendous number of coronavirus disease 2019 (COVID-19) cases in the United States has resulted in a large population of survivors with prolonged post-infectious symptoms. The creation of multidisciplinary post-COVID-19 clinics to address both persistent symptoms and potential long-term complications requires an understanding of the acute disease and the emerging data regarding COVID-19 outcomes.
  Citation: CHEST (2020)
  PubDate: 2020-11-04
Key Highlights from the AABIP Evidence-Informed Guidelines and Expert
Panel Report for the Management of Indwelling Pleural Catheters
- Authors: CDR. Russell J. Miller; Ara A. Chrissian, Y. C. Gary Lee, Najib M. Rahman, Momen M. Wahidi, Alain Tremblay, David W. Hsia, Francisco A. Almeida, Samira Shojaee, Lakshmi Mudambi, Adam R. Belanger, Harmeet Bedi, Yaron B. Gesthalter, Margaret Gaynor, Karen L. MacKenney, Sandra Zelman Lewis, Roberto F. Casal
  Citation: CHEST (2020)
  PubDate: 2020-11-01
  DOI: 10.1016/j.chest.2020.09.282
Airborne Particulate Concentrations During and After Pulmonary Function
Testing
- Authors: Jie Li; Guoqiang Jing, James B. Fink, Janos Porszasz, Ellen M. Moran, Renee D. Kiourkas, Roisin McLaughlin, David L. Vines, Rajiv Dhand
  Citation: CHEST (2020)
  PubDate: 2020-10-31
What does SARS-CoV-2 mean for global pneumonia prevention, diagnosis and
treatment'
- Authors: Shally Awasthi; Harry Campbell, Charles S. Dela Cruz, Hamish R. Graham, Leith Greenslade, Fyezah Jehan, Heather J. Zar
  Citation: CHEST (2020)
  PubDate: 2020-10-30
Potential for state restrictions to impact critical care of pregnant
patients with COVID-19
- Authors: Erin Sullivan DeMartino; Julie Chor
  Citation: CHEST (2020)
  PubDate: 2020-10-30
“Impact of Corticosteroids in COVID-19 Outcomes: Systematic Review
and Meta-Analysis”
- Authors: Edison J. Cano; Xavier Fonseca Fuentes, Cristina Corsini Campioli, John C. O’Horo, Omar Abu Saleh, Yewande Odeyemi, Hemang Yadav, Zelalem Temesgen
  Abstract: Our results show evidence of mortality benefit in severely-ill COVID-19 treated with CS. CS are widely used in COVID-19 cases worldwide and a rapidly developing global pandemic warrants further high-quality clinical trials to define the most beneficial timing and dosing for CS.
  Citation: CHEST (2020)
  PubDate: 2020-10-28
Respiratory function testing after a recent myocardial infarction is safe
- Authors: Esther Sim; Warren R. Ruehland, Celia J. Lanteri, Danny J. Brazzale
  Citation: CHEST (2020)
  PubDate: 2020-10-27
Prevalence and Disparities in Influenza Vaccination among Patients with
Chronic Obstructive Pulmonary Disease in the United States
- Authors: Gul Jana Saeed; Javier Valero-Elizondo, Reed Mszar, Gowtham R. Grandhi, Miguel Cainzos-Achirica, Saad B. Omer, Khurram Nasir
  Citation: CHEST (2020)
  PubDate: 2020-10-27
Characteristics of cardiac injury in critically ill patients with COVID-19
- Authors: Denis DOYEN; Pierre DUPLAND, Lucas MORAND, Etienne FOURRIER, Clément SACCHERI, Matthieu BUSCOT, Hervé HYVERNAT, Emile FERRARI, Gilles BERNARDIN, Alain CARIOU, M.I.R.A. Jean-Paul, Matthieu JAMME, Jean DELLAMONICA, Mathieu JOZWIAK
  Abstract: Cardiac injury is common and early in critically ill COVID-19 patients. Electrocardiographic and/or echocardiographic signs of LV abnormalities were the most frequent abnormalities and patients with cardiac injury experienced more RV than LV systolic dysfunction.
  Citation: CHEST (2020)
  PubDate: 2020-10-27
Tele-ICU Implementation and Risk-Adjusted Mortality Differences Between
Daytime and Nighttime Coverage
- Authors: Mario V. Fusaro; Christian Becker, Daniel Miller, Ibrahim F. Hassan, Corey Scurlock
  Abstract: We found a reduction in risk-adjusted ICU mortality with implementation of Tele-ICU driven predominantly within the PM admission group. The PM admission SMR was 1.30 which may suggest an association with pre Tele-ICU implementation SMR>1 and mortality reduction. Future studies should seek to confirm this finding and explore other important Tele-ICU outcomes in the context of observed to expected ratios.
  Citation: CHEST (2020)
  PubDate: 2020-10-27
Obstructive Sleep Apnea patients adhering to Continuous positive Airway
Pressure: A randomized trial
- Authors: Jean-Louis Pépin; Ognian Georgiev, Rumen Tiholov, Valérie Attali, Johan Verbraecken, Bertien Buyse, Markku Partinen, Ingo Fietze, Georgi Belev, Dejan Dokic, Renaud Tamisier, Patrick Lévy, Isabelle Lecomte, Jeanne-Marie Lecomte, Jean-Charles Schwartz, Yves Dauvilliers, HAROSA I study group
  Abstract: Pitolisant used as adjunct to CPAP therapy for OSA with residual sleepiness despite good CPAP adherence significantly reduces subjective and objective sleepiness and improves participant-reported outcomes and physician-reported disease severity.
  Citation: CHEST (2020)
  PubDate: 2020-10-26
  DOI: 10.1016/j.chest.2020.09.281
Operational challenges of a low-dose CT lung cancer screening program
during the COVID-19 pandemic
- Authors: Min Lang; Tristan Yeung, Joanne O. Shepard, Amita Sharma, Milena Petranovic, Efren J. Flores, Theresa C. McLoud, Avik Som, Sanjay Saini, Anand M. Prabhakar, Marc Succi, Brent P. Little
  Citation: CHEST (2020)
  PubDate: 2020-10-26
Air Pollution and Asthma – Mechanisms of Harm and Considerations for
Clinical Interventions
- Authors: Paul E. Pfeffer; Ian S. Mudway, Jonathan Grigg
  Abstract: There is global concern regarding the harmful impact of polluted air on the respiratory health of asthmatic patients. Multiple epidemiological studies have shown ongoing associations between high levels of air pollution and poor early-life lung growth, development of allergic sensitisation, development of asthma, airway inflammation, acutely impaired lung function, respiratory tract infections and asthma exacerbations. However, studies have often yielded inconsistent findings and not all studies have found significant associations – this may relate to both variations in statistical, measurement and modelling methodologies between studies, as well as differences in the concentrations and composition of air pollution globally.
  Citation: CHEST (2020)
  PubDate: 2020-10-24
Adherence to Asthma Biologics: Implications for Patient Selection, Step
Therapy and Outcomes
- Authors: Jacob T. Maddux; Jonathan W. Inselman, Molly M. Jeffery, Regina W. Lam, Nilay D. Shah, Matthew A. Rank
  Abstract: Adherence to asthma biologic is higher than to ICS, and is associated with different factors.
  Citation: CHEST (2020)
  PubDate: 2020-10-24
Comparative effectiveness of heart rate control medications for the
treatment of sepsis-associated atrial fibrillation
- Authors: Nicholas A. Bosch; Justin M. Rucci, Joseph M. Massaro, Michael R. Winter, Emily K. Quinn, Ki H. Chon, David D. McManus, Allan J. Walkey
  Abstract: In a large cohort of patients with sepsis and atrial fibrillation with rapid ventricular response, a beta-blocker treatment strategy was associated with improved heart rate control at 1 hour, but generally similar heart rate control at 6 hours compared to amiodarone, calcium channel blocker, or digoxin.
  Citation: CHEST (2020)
  PubDate: 2020-10-24
Race Correction and Spirometry: Why History Matters
- Authors: Lundy Braun
  Abstract: In recent months, medical institutions across the U.S. redoubled their efforts to examine the history of race and racism in medicine, in classrooms, in research, and in clinical practice. In this essay, I explore the history of racialization of the spirometer, a widely used instrument in pulmonary medicine to diagnose respiratory diseases and to assess eligibility for compensation. Beginning with Thomas Jefferson, who first noted racial difference in what he referred to as “pulmonary dysfunction,” to the current moment in clinical medicine, I interrogate the history of the idea of “correcting” for race and how researchers explained difference.
  Citation: CHEST (2020)
  PubDate: 2020-10-24
Trends and Geographic Variation in Acute Respiratory Failure and Acute
Respiratory Distress Syndrome Mortality in the United States
- Authors: Vibhu Parcha; Rajat Kalra, Surya P. Bhatt, Lorenzo Berra, Garima Arora, Pankaj Arora
  Abstract: The ARF-related mortality increased at ∼3.4% annually, and ARDS-related mortality showed a lack of decline in the last five years. These data contextualize important health information to guide priorities for research, clinical care, and policy, especially during the coronavirus disease-19 pandemic in the US.
  Citation: CHEST (2020)
  PubDate: 2020-10-22
Is Biopsy of Contralateral Hilar N3 Lymph Nodes that Are PET-CT Negative
Necessary When Performing EBUS Staging'
- Authors: Paula V. Sainz Zúñiga; Gabriela Martinez-Zayas, Sofia Molina, Horiana B. Grosu, Muhammad H. Arain, David E. Ost
  Abstract: When using moderate sedation, because time is limited, it is reasonable to start with the mediastinal N3 nodes if the hilar and mediastinal N3 nodes are PET-negative. Patients with PET-positive mediastinal N3 involvement probably should have their hilar N3 nodes sampled.
  Citation: CHEST (2020)
  PubDate: 2020-10-22
A comparison of the PanCan model and Lung-RADS to assess cancer
probability among persons with screening-detected, solid lung nodules
- Authors: Vandana Sundaram; Michael K. Gould, Viswam S. Nair
  Abstract: PanCan and Lung-RADS had similar overall accuracy for assessing cancer in screening-detected, solid lung nodules with evidence of discordance by subgroup. The existence of Lung-RADS category 4 nodules with a>3-5% PanCan risk may result in unnecessary procedures.
  Citation: CHEST (2020)
  PubDate: 2020-10-22
Carbapenem Antibiotics for the Empiric Treatment of Nosocomial Pneumonia:
A Systematic Review and Meta-Analysis
- Authors: Mackenzie Howatt; Michael Klompas, Andre C. Kalil, Mark Metersky, John Muscedere
  Abstract: Carbapenem based empiric regimens were associated with lower mortality rates compared to non-carbapenems, largely driven by trials of VAP. The mortality effect was not observed in trials with high-disease severity and was not associated with Pseudomonas. The mortality difference was observed mainly in studies that utilized ceftazidime as control. There was a trend towards increasing resistance associated with carbapenems.
  Citation: CHEST (2020)
  PubDate: 2020-10-22
Long-term benefits of pulmonary rehabilitation in COPD patients: a 2-year
follow-up study
- Authors: A.M. Yohannes; S. Dryden, R. Casaburi, N.A. Hanania
  Abstract: Pulmonary rehabilitation (PR) improves exercise capacity in chronic obstructive pulmonary disease (COPD) patients in the short-term. In patients with COPD, we explored the long-term benefits on symptoms of dyspnea, anxiety, depression and quality of life two years after completion of eight weeks of PR.
  Citation: CHEST (2020)
  PubDate: 2020-10-21
System-wide strategies were associated with improved outcome in critically
ill COVID-19 patients – experience from a large Healthcare Network
- Authors: Peng Zhang; Abhijit Duggal, Gretchen L. Sacha, Joseph Keller, Lori Griffiths, Hassan Khouli
  Citation: CHEST (2020)
  PubDate: 2020-10-20
How I Do It: Managing M. avium complex lung disease with a little help
from my friend
- Authors: David E. Griffith; Timothy R. Aksamit
  Abstract: Management of Mycobacterium avium complex (MAC) lung disease is complicated, frequently unsuccessful and frustrating to patients and clinicians. The initial treatment effort may not be solely directed at MAC infection, rather it is often initiating airway clearance measures for bronchiectasis. The next important steps are deciding who to treat and when to initiate therapy. Definitive or unambiguous guidance for these decisions is often elusive. The evidence supporting the current macrolide-based regimen for treating MAC lung disease is compelling.
  Citation: CHEST (2020)
  PubDate: 2020-10-17
Association Between Anticoagulation and Survival in Interstitial Lung
Disease: An Analysis of the Pulmonary Fibrosis Foundation (PFF) Registry
- Authors: Christopher King; Elizabeth Freiheit, A. Whitney Brown, Oksana A. Shlobin, Shambhu Aryal, Kareem Ahmad, Vikramjit Khangoora, Kevin R. Flaherty, Drew Venuto, Steven D. Nathan
  Abstract: The need for anticoagulation is associated with an increased risk for death or transplant in patients with ILD, in both the IPF and non-IPF population. Further research is required to determine if warfarin and DOACs present varying safety profiles in ILD patients. (292 words)
  Citation: CHEST (2020)
  PubDate: 2020-10-16
Comparative Survival Analysis of Immunomodulatory Therapy for COVID-19
'Cytokine Storm'
- Authors: Sonali Narain; Dimitre G. Stefanov, Alice S. Chau, Andrew G. Weber, Galina Marder, Blanka Kaplan, Prashant Malhotra, Ona Bloom, Audrey Liu, Martin L. Lesser, Negin Hajizadeh, Northwell COVID-19 Research Consortium
  Abstract: The combination of corticosteroids with tocilizumab had superior survival outcome when compared to standard of care and corticosteroids alone or in combination with anakinra. Furthermore, corticosteroid use either alone or in combination with tocilizumab or anakinra was associated with reduced hospital mortality for patients with COVID-19 cytokine storm compared to standard of care.
  Citation: CHEST (2020)
  PubDate: 2020-10-16
  DOI: 10.1016/j.chest.2020.09.275
Prolonged Circulation Time is Associated with Mortality Among Older Men
with Sleep Disordered Breathing
- Authors: Younghoon Kwon; Scott A. Sands, Katie L. Stone, Luigi Taranto-Montemurro, Raichel M. Alex, David P. White, Andrew Wellman, Susan Redline, Ali Azarbarzin
  Abstract: LFCT is associated with both CV and all-cause mortality in older men, independent of baseline CV burden and SDB metrics. LFCT may be a novel physiologic marker for CV vulnerability and adverse outcomes in patients with SDB.
  Citation: CHEST (2020)
  PubDate: 2020-10-15
Humanizing ICU COVID care
- Authors: J. Marin-Corral; À. Garcia-Sanz, J.R. Masclans
  Citation: CHEST (2020)
  PubDate: 2020-10-15
Consensus Guidelines for Evaluation and Management of Pulmonary Disease in
Sjögren’s
- Authors: Augustine S. Lee; R. Hal Scofield, Katherine Morland Hammitt, Nishant Gupta, Donald E. Thomas, Teng Moua, Kamonpun Ussavarungsi, E. William St. Clair, Richard Meehan, Kieron Dunleavy, Matt Makara, Steven E. Carsons, Nancy L. Carteron
  Abstract: Pulmonary disease is a potentially serious yet underdiagnosed complication of Sjögren’s syndrome, the second most common autoimmune rheumatic disease. Approximately 16% of patients with Sjögren’s demonstrate pulmonary involvement with higher mortality and lower quality of life. Clinical practice guidelines for pulmonary manifestations of Sjögren’s were developed by the Sjögren’s Foundation after identifying a critical need for early diagnosis and improved quality and consistency of care.
  Citation: CHEST (2020)
  PubDate: 2020-10-15
Paired nasopharyngeal and deep lung testing for SARS-CoV2 reveals a viral
gradient in critically ill patients: a multi-centre study
- Authors: Islam Hamed; Nesreen Shaban, Marwan Nassar, Dilek Cayir, Sam Love, Martin D. Curran, Stephen Webb, Huina Yang, Katherine Watson, Anthony Rostron, Vilas Navapurkar, Razeen Mahroof, Andrew Conway Morris
  Citation: CHEST (2020)
  PubDate: 2020-10-14
Global impact of COVID-19 infection requiring admission to the intensive
care unit: a systematic review and meta-analysis
- Authors: Elinor Tan; Jialu Song, Adam M. Deane, Mark P. Plummer
  Abstract: Critically ill patients with COVID-19 who are admitted to ICU require substantial organ support and prolonged ICU and hospital level care. The pooled estimate of global mortality for severe COVID-19 is
  Citation: CHEST (2020)
  PubDate: 2020-10-14
Right Ventricular Dysfunction in Early Sepsis and Septic Shock
- Authors: Michael J. Lanspa; Meghan M. Cirulis, Brandon M. Wiley, Troy D. Olsen, Emily L. Wilson, Sarah M. Beesley, Samuel M. Brown, Eliotte L. Hirshberg, Colin K. Grissom
  Abstract: Right ventricular dysfunction is present in nearly half of studied septic patients and is associated with over threefold higher 28-day mortality.
  Citation: CHEST (2020)
  PubDate: 2020-10-14
  DOI: 10.1016/j.chest.2020.09.274
Ansa Cervicalis Stimulation: A New Direction in Neurostimulation for
Obstructive Sleep Apnea
- Authors: David T. Kent; David Zealear, Alan R. Schwartz
  Abstract: ACS independently increased VImax during propofol sedation and drove further increases in VImax when combined with HNS. The branch of the ansa cervicalis innervating the sternothyroid muscle is easily accessed. Confirmation of the ansa cervicalis as a viable neurostimulation target may enable caudal pharyngeal traction as a novel respiratory neurostimulation strategy for treating OSA.
  Citation: CHEST (2020)
  PubDate: 2020-10-13
Preventing COPD readmissions under the Hospital Readmissions Reduction
Program: How far have we come'
- Authors: Valerie G. Press; Laura C. Myers, Laura C. Feemster
  Abstract: The Hospital Readmissions Reduction Program (HRRP) was developed and implemented by the Centers for Medicare and Medicaid Services to curb the rate of 30-day hospital readmissions for certain common and high impact conditions. In October 2014, chronic obstructive pulmonary disease (COPD) became a target condition for which hospitals were penalized for excess readmissions. The appropriateness, utility and potential unintended consequences of the metric have been a topic of debate since it was first enacted.
  Citation: CHEST (2020)
  PubDate: 2020-10-13
Management for the drowning patient
- Authors: David Szpilman; Paddy Morgan
  Abstract: Drowning is “the process of experiencing respiratory impairment from submersion or immersion in liquid”. According to WHO, drowning claim the lives of more than 40 people every hour of every day. Drowning involves some physiological principles and medical interventions that are unique. It occurs in a deceptively hostile environment that involves an underestimation of the dangers or an overestimation of water competency. It has been estimated that more than 90% are preventable. When water is aspirated into the airways, coughing is the initial reflex response.
  Citation: CHEST (2020)
  PubDate: 2020-10-13
How I Do It: Dosing Fluids in Early Septic Shock
- Authors: Dipayan Chaudhuri; Brent Herritt, Kimberley Lewis, Jose L. Diaz-Gomez, Alison Fox-Robichaud, Ian Ball, John Granton, Bram Rochwerg
  Abstract: Early intravenous fluid administration remains one of the modern pillars of sepsis treatment, however, questions regarding amount, type, rate, mechanism of action and even the benefits of fluid remain unanswered. Administering the optimal fluid volume is important as overzealous fluid resuscitation can precipitate multiorgan failure, prolong mechanical ventilation and worsen patient outcomes. After the initial resuscitation, further fluid administration should be determined by individual patient factors and measures of fluid responsiveness.
  Citation: CHEST (2020)
  PubDate: 2020-10-12
  DOI: 10.1016/j.chest.2020.09.269
Risk factors of fat embolism syndrome after trauma: a nested case-control
study using a nationwide trauma registry in Japan
- Authors: Takako Kainoh; Hiroki Iriyama, Akira Komori, Daizoh Saitoh, Toshio Naito, Toshikazu Abe
  Abstract: Long bone and open fractures in injuries to the extremities were associated with FES. Although bone reduction and fixation was not associated with FES, delay time to the operation was associated with FES.
  Citation: CHEST (2020)
  PubDate: 2020-10-12
  DOI: 10.1016/j.chest.2020.09.268
Safety and Efficacy of Bronchoscopy in Critically Ill Patients with
COVID-19
- Authors: Stephanie H. Chang; Jeffrey Jiang, Zachary N. Kon, David M. Williams, Travis Geraci, Deane E. Smith, Robert J. Cerfolio, Michael Zervos, Costas Bizekis
  Citation: CHEST (2020)
  PubDate: 2020-10-08
  DOI: 10.1016/j.chest.2020.09.263
Gaps in COPD guidelines of low- and middle-income countries: a systematic
scoping review
- Authors: Aizhamal Tabyshova; John R. Hurst, Joan B. Soriano, William Checkley, Erick Wan-Chun Huang, Antigona C. Trofor, Oscar Flores-Flores, Patricia Alupo, Gonzalo Gianella, Tarana Ferdous, David Meharg, Jennifer Alison, Jaime Correia de Sousa, Maarten J. Postma, Niels H. Chavannes, Job FM. van Boven, Collaborators
  Abstract: Several development, content, context and quality gaps exist in COPD guidelines from LMICs that may hamper effective implementation. Overall, COPD guidelines in LMICs should be more widely available and should be transparently developed and updated. Guidelines may be further enhanced by better inclusion of local risk-factors, case finding and co-morbidity management, preferably tailored to available financial and staff resources.
  Citation: CHEST (2020)
  PubDate: 2020-10-07
  DOI: 10.1016/j.chest.2020.09.260
Essential Components of an Interstitial Lung Disease Clinic: Results from
a Delphi Survey and Patient Focus Group Analysis
- Authors: Bridget A. Graney; Christophe He, Michael Marll, Scott Matson, Pauline Bianchi, Gregory P. Cosgrove, Joyce S. Lee, The PFF CCN Delphi Collaborators
  Abstract: The essential components of an ILD clinic are well-aligned between physician experts and patients. Future research can use these findings to evaluate the impact of these components on patient outcomes and inform best-practices for ILD clinics throughout the world.
  Citation: CHEST (2020)
  PubDate: 2020-10-05
  DOI: 10.1016/j.chest.2020.09.256
Renin-Angiotensin-Aldosterone System Inhibitor Use and Mortality in
Pulmonary Hypertension: Insights from the Veterans Affairs CART Database
- Authors: Tim Lahm; Edward Hess, Anna E. Barón, Thomas M. Maddox, Mary E. Plomondon, Gaurav Choudhary, Bradley A. Maron, Roham T. Zamanian, Peter J. Leary
  Abstract: ACEI/ARB use is associated with lower mortality in veterans with PH. AA use is a marker of disease severity in PH. ACEIs/ARBs may represent a novel treatment strategy for diverse PH phenotypes.
  Citation: CHEST (2020)
  PubDate: 2020-10-04
  DOI: 10.1016/j.chest.2020.09.258
Acute Kidney Injury During Hospitalization Increases the Risk for Venous
Thromboembolism
- Authors: Michael J. McMahon; Jacob F. Collen, Kevin K. Chung, Ian J. Stewart, Haydar Al-Eid, Lisa K. Moores, Aaron B. Holley
  Abstract: We found AKI increases the risk for HR-VTE in a large, heterogeneous population that includes medical and surgical patients. However, this relationship was not seen in patients with traumatic injuries.
  Citation: CHEST (2020)
  PubDate: 2020-10-04
  DOI: 10.1016/j.chest.2020.09.257
Effect of Age on the Efficacy and Safety of Once-Daily Single-Inhaler
Triple Therapy Fluticasone Furoate/Umeclidinium/Vilanterol in Patients
With Chronic Obstructive Pulmonary Disease: A Post Hoc Analysis of the
IMPACT Trial
- Authors: Nicola A. Hanania; David M. Mannino, Gerard J. Criner, Mark T. Dransfield, MeiLan K. Han, C. Elaine Jones, Sally Kilbride, David A. Lomas, Neil Martin, Fernando J. Martinez, Dave Singh, Robert A. Wise, David M.G. Halpin, Robson Lima, David A. Lipson
  Abstract: FF/UMEC/VI reduced the rate of moderate/severe exacerbations and improved lung function and health status versus FF/VI and UMEC/VI irrespective of age for most endpoints, with a similar safety profile.
  Citation: CHEST (2020)
  PubDate: 2020-10-04
  DOI: 10.1016/j.chest.2020.09.253
Shades of Gray: Subsolid Nodule Considerations and Management
- Authors: Lea Azour; Jane P. Ko, David P. Naidich, William H. Moore
  Abstract: Subsolid nodules are common on chest CT and may be either benign or malignant. Their varied features, and broad differential diagnoses present management challenges. While subsolid nodules often represent lung adenocarcinomas, other possibilities are common, and influence management. Practice guidelines exist for subsolid nodule management for both incidentally and screening-detected nodules, incorporating patient and nodule characteristics. This review will highlight similarities and differences amongst these algorithms, with the intent of providing a resource for comparison, and aid in choosing management options.
  Citation: CHEST (2020)
  PubDate: 2020-10-04
  DOI: 10.1016/j.chest.2020.09.252
Projecting long-term health and economic burden of chronic obstructive
pulmonary disease in the United States
- Authors: Zafar Zafari; Shukai Li, Michelle N. Eakin, Martine Bellanger, Robert M. Reed
  Abstract: This study projects the substantial burden of COPD that the American society is expected to incur with current patterns for treatments and smoking rates. Mitigating such burden requires targeted budget appropriations and cost-effective interventions.
  Citation: CHEST (2020)
  PubDate: 2020-10-01
  DOI: 10.1016/j.chest.2020.09.255
Medication Discontinuation in Adults with Chronic Obstructive Pulmonary
Disease Discharged from Hospital: A Population-Based Cohort Study
- Authors: Andrea S. Gershon; Rachel E. McGihon, Deva Thiruchelvam, Teresa To, Robert Wu, Chaim M. Bell, Shawn D. Aaron, Canadian Respiratory Research Network
  Abstract: In an observational study of highly adherent COPD patients, hospitalization was associated with an increased risk of long-acting inhaler discontinuation. These results suggest a likely larger discontinuation problem among less adherent patients and should be confirmed in a prospective cohort of average COPD patients. Quality improvement efforts should focus on safe transitions and patient medication reconciliation after discharge.
  Citation: CHEST (2020)
  PubDate: 2020-10-01
  DOI: 10.1016/j.chest.2020.09.254
Dyspnea, Acute Respiratory Failure, Psychological Trauma, and Post-ICU
Mental Health: A caution and a call for research.
- Authors: Christopher M. Worsham; Robert B. Banzett, Richard Schwartzstein
  Abstract: Dyspnea is an uncomfortable sensation with the potential to cause psychological trauma. Patients presenting with acute respiratory failure, particularly when tidal volume is restricted during mechanical ventilation, may experience the most distressing form of dyspnea known as air hunger. Air hunger activates brain pathways known to be involved in post-traumatic stress disorder (PTSD), anxiety, and depression. These conditions are considered part of the post-intensive care syndrome. These sequelae may be even more prevalent among patients with acute respiratory distress syndrome (ARDS).
  Citation: CHEST (2020)
  PubDate: 2020-10-01
  DOI: 10.1016/j.chest.2020.09.251
Randomized Controlled Trial of a Novel Communication Device Assessed
during Noninvasive Ventilation Therapy
- Authors: An-Kwok Ian Wong; Patricia C. Cheung, James Zhang, George Cotsonis, Michael Kutner, Peter C. Gay, Nancy A. Collop
  Abstract: Use of this PAP communication device significantly improves both intelligibility and comfort. This is one of the first studies quantifying communication impairment during PAP delivery.
  Citation: CHEST (2020)
  PubDate: 2020-10-01
  DOI: 10.1016/j.chest.2020.09.250
Disparities in Sleep Health and Potential Intervention Models: A Focused
Review
- Authors: Martha E. Billings; Robyn T. Cohen, Carol M. Baldwin, Dayna A. Johnson, Brian N. Palen, Sairam Parthasarathy, Sanjay R. Patel, Maureen Russell, Ignacio E. Tapia, Ariel A. Williamson, Sunil Sharma
  Abstract: Disparities in sleep health are important but under-recognized contributors to health disparities. Understanding the factors contributing to sleep heath disparities and developing effective interventions are critical to improving all aspects of heath. Sleep heath disparities are impacted by socio-economic status, racism, discrimination, neighborhood segregation, geography, social patterns and access to healthcare as well as by cultural beliefs necessitating a cultural appropriateness component in any intervention devised for reducing sleep health disparities.
  Citation: CHEST (2020)
  PubDate: 2020-09-29
  DOI: 10.1016/j.chest.2020.09.249
How I Do It: Approach to Eosinophilia Presenting with Pulmonary Symptoms
- Authors: Chen E. Rosenberg; Paneez Khoury
  Abstract: Eosinophilia with pulmonary involvement is characterized by the presence of peripheral blood eosinophilia, typically ≥500 cells/mm3; pulmonary symptoms and physical exam findings, which are nonspecific; radiographic evidence of pulmonary disease; and is further supported by histopathologic evidence of tissue eosinophilia in a lung or pleura biopsy specimen and/or increased eosinophils in bronchoalveolar lavage fluid, usually > 10 percent. Considering that there are a variety of underlying etiologies of eosinophilia with pulmonary manifestations and overlapping clinical, laboratory and radiologic features, it is essential to systematically approach the evaluation of eosinophilia with pulmonary findings.
  Citation: CHEST (2020)
  PubDate: 2020-09-28
  DOI: 10.1016/j.chest.2020.09.247
Operational recommendations for scarce resource allocation in a public
health crisis
- Authors: Michael R. Ehmann; Elizabeth K. Zink, Amanda B. Levin, Jose I. Suarez, Harolyn ME. Belcher, Elizabeth L. Daugherty Biddison, Danielle J. Doberman, Karen D’Souza, Derek M. Fine, Brian T. Garibaldi, Eric A. Gehrie, Sherita H. Golden, Ayse P. Gurses, Peter M. Hill, Mark T. Hughes, Jeffrey Kahn, Colleen G. Koch, Jason J. Marx, Barry R. Meisenberg, Jeffrey Natterman, Cynda H. Rushton, Adam Sapirstein, Stephen R. Selinger, R Scott Stephens, Eric S. Toner, Yoram Unguru, Maureen van Stone, Allen Kachalia
  Abstract: The COVID-19 pandemic may require rationing of various medical resources if demand exceeds supply. Theoretical frameworks for resource allocation have provided much needed ethical guidance but hospitals still need to address objective practicalities and legal vetting to operationalize scarce resource allocation schemata.To develop operational scarce resource allocation processes for public health catastrophes, including the COVID-19 pandemic, five health systems in Maryland formed a consortium – with diverse expertise and representation – representing more than half of all hospitals in the state.
  Citation: CHEST (2020)
  PubDate: 2020-09-25
  DOI: 10.1016/j.chest.2020.09.246
The accuracy of repeated sleep studies in obstructive sleep apnoea: a
longitudinal observational study with 14 nights of oxygen saturation
monitoring
- Authors: Maurice Roeder; Noriane A. Sievi, Matteo Bradicich, Fabian Grewe, Sandra Siegfried, Thomas Gaisl, Malcolm Kohler
  Abstract: One single night of in-hospital RP may miss relevant OSA. Multiple study nights, e.g. using ambulatory oxygen saturation monitoring, increase accuracy for diagnosing moderate OSA.
  Citation: CHEST (2020)
  PubDate: 2020-09-24
  DOI: 10.1016/j.chest.2020.09.098
Characteristics and long-term outcomes of pulmonary veno-occlusive disease
induced by Mitomycin-C
- Authors: Marie-Caroline Certain; Marie-Camille Chaumais, Xavier Jaïs, Laurent Savale, Andrei Seferian, Florence Parent, Marjolaine Georges, Nicolas Favrolt, Arnaud Bourdin, Clément Boissin, Vincent Cottin, Julie Traclet, Sébastien Renard, Violaine Noel, François Picard, Barbara Girerd, Ghigna Marie-Rosa, Frédéric Perros, Olivier Sitbon, Philippe Bonniaud, Marc Humbert, David Montani
  Abstract: PVOD after MMC is a rare but life-threatening complication associated with a poor prognosis despite MMC withdrawal and PAH-specific therapy.
  Citation: CHEST (2020)
  PubDate: 2020-09-23
  DOI: 10.1016/j.chest.2020.09.238
Leadership Essentials for the Chest Physician: Change
- Authors: James K. Stoller
  Abstract: Change is a fact of life; the absence of change creates stagnation. This is perhaps especially true in healthcare, where progress in treating disease depends on innovation and progress.At the same time, change is often uncomfortable. Thus, it is helpful to model the change process in order to optimize the chances of successfully effecting change. Furthermore, how to lead change is a critical leadership competency.Three models for leading change are reviewed – the first by Kotter, which was not designed for healthcare, the second by Heath and Heath called “switch”, and the third by Silversin and Kornacki, which was uniquely designed for healthcare.
  Citation: CHEST (2020)
  PubDate: 2020-09-20
  DOI: 10.1016/j.chest.2020.09.094
“How I Do It”: Building Teams in Healthcare
- Authors: James K. Stoller
  Abstract: Because teams can accomplish goals that individuals cannot, teams matter. Indeed, teams especially matter in settings like healthcare, where favorable outcomes depend critically on the contributions of many different people with diverse skills. As important as effective teambuilding is for healthcare, how to build teams is often not included in medical curricula and doctors learn to build teams by hidden curricula. In the context that we can do better, this “How I do it” presents an approach to building a team in a common scenario for the chest physician – picking up the inpatient Pulmonary Consult Service.
  Citation: CHEST (2020)
  PubDate: 2020-09-20
  DOI: 10.1016/j.chest.2020.09.092
The US Strategic National Stockpile (SNS) Ventilators in COVID-19: A
Comparison of Functionality and Analysis regarding the Emergency Purchase
of 200,000 devices.
- Authors: Rich Branson; Jeffrey R. Dichter, Henry Feldman, Asha Devereaux, David Dries, John F. Perry, Joshua Benditt, Tanzib Hossain, Marya Ghazipura, Mary King, Marie Baldisseri, Michael D. Christian, Guillermo Domingiuez-Cherit, Kiersten Henry, Anne Marie O. Martland, Meredith Huffines, Doug Ornoff, Jason Persoff, Dario Rodriquez, Ryan C. Maves, Niranjan "Tex" Kissoon, Lewis Rubinson
  Abstract: Current SNS ventilators and those on order are capable of supporting most but not all COVID-19 patients. Technologic, logistic, and educational challenges encountered from current SNS ventilators are summarized, with potential next generation SNS ventilator updates offered.
  Citation: CHEST (2020)
  PubDate: 2020-09-20
  DOI: 10.1016/j.chest.2020.09.085
Use of Handheld Point-of-Care Ultrasound in Emergency Airway Management
- Authors: Daniel R. Austin; Marvin G. Chang, Edward A. Bittner
  Abstract: Emergency airway management (EAM) is associated with a high rate of complications, morbidity and mortality. Handheld point-of-care ultrasound (POCUS) shows promise as an emerging technology to facilitate rapid screening for difficult laryngoscopy, identify the cricothyroid membrane (CTM) for potential cricothyroidotomy, assess for increased aspiration risk, as well as provide confirmation of proper endotracheal tube (ETT) positioning. This review summarizes the available evidence for the use of POCUS in EAM, provides an algorithm to facilitate its incorporation into existing EAM practice to improve patient safety and serve as a framework for future validation studies.
  Citation: CHEST (2020)
  PubDate: 2020-09-20
  DOI: 10.1016/j.chest.2020.09.083
Lung-Protective Ventilation and Associated Outcomes and Costs Among
Patients Receiving Invasive Mechanical Ventilation in the Emergency
Department
- Authors: Shannon M. Fernando; Eddy Fan, Bram Rochwerg, Karen E.A. Burns, Laurent J. Brochard, Deborah J. Cook, Allan J. Walkey, Niall D. Ferguson, Catherine L. Hough, Daniel Brodie, Andrew J.E. Seely, Venkatesh Thiruganasambandamoorthy, Jeffrey J. Perry, Alexandre Tran, Peter Tanuseputro, Kwadwo Kyeremanteng
  Abstract: Use of lung-protective ventilation in the ED was associated with important patient- and system-centered outcomes, including lower hospital mortality, decreased incidence of ARDS, lower hospital length of stay, and decreased total costs. Protocol development promoting the regular use of lung-protective ventilation in the ED may be of value.
  Citation: CHEST (2020)
  PubDate: 2020-09-19
  DOI: 10.1016/j.chest.2020.09.100
The spectrum of sleep disorders in Parkinson’s disease: a review
- Authors: Lajoie AC; Lafontaine AL, Kaminska M
  Abstract: There is increasing interest in the effects of sleep and sleep disturbances on the brain, particularly in relation to aging and neurodegenerative processes. Parkinson’s disease (PD) is the second most common neurodegenerative disorder, with growing prevalence worldwide. Sleep disorders, including sleep-disordered breathing (SDB), are amongst the most frequent non-motor manifestations of PD. They can substantially impair quality of life, and possibly affect the course of the disease. This article reviews the etiology, implications and management of sleep disturbances in PD, such as excessive daytime sleepiness, insomnia, restless legs syndrome, rapid eye movement sleep behavior disorder and SDB.
  Citation: CHEST (2020)
  PubDate: 2020-09-18
  DOI: 10.1016/j.chest.2020.09.099
Leadership Essentials for the Chest Physician: Models, Attributes, and
Styles
- Authors: James K. Stoller
  Abstract: In the context that leadership matters and that leadership competencies differ from those needed to practice medicine or conduct research, developing leadership competencies for physicians is important. Indeed, effective leadership is needed ubiquitously in healthcare, both at the executive level and at the bedside, e.g., leading clinical teams and problem-solving on the ward.Various leadership models have been proposed, most converging on common attributes – as described by Kouzes and Posner – of envisioning a new and better future state, inspiring others around this shared vision, empowering others to effect the vision, modeling the expected behaviors, and engaging others by appealing to shared values.
  Citation: CHEST (2020)
  PubDate: 2020-09-18
  DOI: 10.1016/j.chest.2020.09.095
Leadership Essentials for the Chest Physician: Emotional Intelligence
- Authors: James K. Stoller
  Abstract: Emotional intelligence (EI) has become widely appreciated as an important leadership attribute, in business, education and, increasingly, in healthcare. Defined as “the capacity to understand your own and others’ emotions and to motivate and develop yourself and others in service of improved work performance and enhanced organizational effectiveness,” EI is correlated with a number of success attributes in several sectors, e.g., in business, enhanced business performance and enhanced personal career success; and in healthcare, with enhanced patient satisfaction, lower burnout, lower litigation risk, and enhanced leadership success.
  Citation: CHEST (2020)
  PubDate: 2020-09-18
  DOI: 10.1016/j.chest.2020.09.093
“A National Survey of Burnout and Depression Among Fellows Training in
Pulmonary and Critical Care Medicine: A Special Report by the APCCMPD
- Authors: Michelle Sharp; Kristin M. Burkart, Mark H. Adelman, Rendell W. Ashton, Lee Daugherty Biddison, Gabriel T. Bosslet, Stephen T. Doyle, Thomas Eckmann, Malik M. Khurram S. Khan, Peter H. Lenz, Jennifer W. McCallister, Jacqueline O’Toole, Cynthia S. Rand, Kristin A. Riekert, Morgan I. Soffler, Gretchen R. Winter, Sandra Zaeh, Michelle N. Eakin
  Abstract: Given the high prevalence of burnout and depressive symptoms among fellows training in PCCM, there is an urgent need to identify solutions that address this public health crisis. Strategies such as providing an easily accessible coverage system; access to mental health resources; reducing EHR burden; addressing work hours; and addressing financial concerns among trainees may help reduce burnout or depressive symptoms and should be further studied by the graduate medical education community.
  Citation: CHEST (2020)
  PubDate: 2020-09-18
  DOI: 10.1016/j.chest.2020.08.2117
Cardiopulmonary exercise and the risk of aerosol generation while wearing
a surgical mask
- Authors: Scott A. Helgeson; Bryan J. Taylor, Kaiser G. Lim, Augustine S. Lee, Alexander S. Niven, Neal M. Patel
  Citation: CHEST (2020)
  PubDate: 2020-09-18
  DOI: 10.1016/j.chest.2020.09.088
A Perspective on the Educational “SWOTh” of the Coronavirus
Pandemic
- Authors: James K. Stoller
  Abstract: The coronavirus pandemic has disrupted clinical practice, healthcare organizations, and life. In the context that “a crisis is a terrible thing to waste,” as disruptive as the pandemic has been to traditional practices – both clinically and educationally – opportunities have also presented. Clinical benefits have included the propulsion of clinical innovation, including development of novel vaccines; accelerated understanding of multiplex ventilation, etc. Approaches to educating students and other learners have also changed radically, with suspension of live teaching in most instances and a precipitous transition to virtual instruction.
  Citation: CHEST (2020)
  PubDate: 2020-09-18
  DOI: 10.1016/j.chest.2020.09.087
Analysis of Pneumothorax in Non-invasive Ventilator Users with Duchenne
Muscular Dystrophy
- Authors: Han Eol Cho; Justin Byun, Won Ah Choi, Myungsang Kim, Kyeong Yeol Kim, Seong-Woong Kang
  Abstract: Upon pneumothorax occurrence in patients with Duchenne muscular dystrophy, recurrences and severe lung damage are common; moreover, they have higher mortality rates than patients without pneumothorax. Chest CT scans should be performed to identify risk factors and treatment should be initiated accordingly. In addition, physicians should consider chest CT even if there is no x-ray abnormality in case of suspected pneumothorax.
  Citation: CHEST (2020)
  PubDate: 2020-09-18
  DOI: 10.1016/j.chest.2020.09.086
Distinguishing smoking related lung disease phenotypes via imaging and
molecular features
- Authors: Ehab Billatos; Samuel Y. Ash, Fenghai Duan, Ke Xu, Justin Romanoff, Helga Marques, Elizabeth Moses, MeiLan K. Han, Elizabeth A. Regan, Russell P. Bowler, Stefanie E. Mason, Tracy J. Doyle, Rubén San José Estépar, Ivan O. Rosas, James C. Ross, Xiaohui Xiao, Hanqiao Liu, Gang Liu, Gauthaman Sukumar, Matthew Wilkerson, Clifton Dalgard, Chris Stevenson, Duncan Whitney, Denise Aberle, Avrum Spira, Raúl San José Estépar, Marc E. Lenburg, George R. Washko, of the DECAMP COPDGene Investigators
  Abstract: Using quantitative CT imaging, we identified three groups of individuals in older ever-smokers that replicate in two cohorts. Airway gene expression differences between the three groups suggests increased levels of inflammation in the most severe clinical phenotype, possibly mediated by the TNF-α and interferon-β pathways.
  Citation: CHEST (2020)
  PubDate: 2020-09-15
  DOI: 10.1016/j.chest.2020.08.2115
Expanding Applications of Pulmonary MRI in the Clinical Evaluation of Lung
Disorders: Fleischner Society Position Paper
- Authors: Mark L. Schiebler; Grace Parraga, Warren B. Gefter, Bruno Madore, Kyung Soo Lee, Yoshiharu Ohno, Hans-Ulrich Kauczor, Hiroto Hatabu
  Citation: CHEST (2020)
  PubDate: 2020-09-14
  DOI: 10.1016/j.chest.2020.09.075
Hypercoaguability in CoVID-19 ICU Patients with Respiratory Failure
Results in an Increased Prevalence of Venous Thromboembolic Disease
- Authors: Sarah A. Long; Mohammad Y. Tahboub, Jaime Palomino, Ala L. Alkhatib, Thomas Kennedy, James Caridi, Joseph A. Lasky
  Citation: CHEST (2020)
  PubDate: 2020-09-13
  DOI: 10.1016/j.chest.2020.09.081
Flow identified site of collapse during drug-induced sleep endoscopy:
feasibility and preliminary results
- Authors: Sara Op de Beeck; Eli Van de Perck, Daniel Vena, Elahe Kazemeini, Marijke Dieltjens, Marc Willemen, Andrew Wellman, Johan Verbraecken, Scott A. Sands, Olivier M. Vanderveken
  Citation: CHEST (2020)
  PubDate: 2020-09-13
  DOI: 10.1016/j.chest.2020.09.079
Effects of Random Measurement Error on Lung Cancer Screening Decisions:
- Authors: Tanner J. Caverly; Xuefei Zhang, Rodney A. Hayward, Ji Zhu, Akbar K. Waljee
  Abstract: Random error in real-world pack-year assessments leads to a substantial rate of misclassifying who should be offered CT screening if a > 30 pack-year criterion is used. However, using a lung cancer risk threshold mitigates the impact of unreliable pack-year information. Decision-makers concerned about the impact of unreliable pack year information should consider using risk-based approaches to CT screening.
  Citation: CHEST (2020)
  PubDate: 2020-09-13
  DOI: 10.1016/j.chest.2020.08.2112
Etoposide as Salvage Therapy for Cytokine Storm due to COVID-19
- Authors: Maulin Patel; Eduardo Dominguez, Daniel Sacher, Parag Desai, Ashwin Chandar, Michael Bromberg, Roberto Caricchio, Gerard J. Criner, Temple University COVID-19 Research Group
  Abstract: COVID-19 has resulted in significant morbidity and mortality due to lack of effective therapies. Therapeutic strategies under investigation target the overactive cytokine response with anti-cytokine or immunomodulators therapies. We present a unique case of severe cytokine storm resistant to multiple anti-cytokine therapies, but eventually responsive to Etoposide. Thus, Etoposide may have a role as salvage therapy in treatment of cytokine storm in COVID-19. To our knowledge, this is the first reported case of use of Etoposide in COVID-19.
  Citation: CHEST (2020)
  PubDate: 2020-09-12
  DOI: 10.1016/j.chest.2020.09.077
Exercise Pulmonary Resistances Predict Long-Term Survival in Systemic
Sclerosis
- Authors: Katarina Zeder; Alexander Avian, Gerhard Bachmaier, Philipp Douschan, Vasile Foris, Teresa Sassmann, Florentine C. Moazedi-Fuerst, Winfried B. Graninger, Franz Hafner, Marianne Brodmann, Wolfgang Salmhofer, Horst Olschewski, Gabor Kovacs
  Abstract: PVR and TPR at peak exercise, mPAP/CO slope and TPG/CO slope are predictors of age-adjusted long-term mortality in SSc patients with no or mildly increased pulmonary arterial pressure.
  Citation: CHEST (2020)
  PubDate: 2020-09-12
  DOI: 10.1016/j.chest.2020.08.2110
A Cluster of Beryllium Sensitization Traced to the Presence of Beryllium
in Concrete Dust
- Authors: Björn C. Frye; Caroline Quartucci, Stefan Rakete, Aleksandar Grubanovic, Kerstin Höhne, Felix Mangold, Reto Gieré, Joachim Müller-Quernheim, Gernot Zissel
  Abstract: We describe a cluster of beryllium-sensitized workers from a non-beryllium-related industry caused by environmental exposure to beryllium-containing concrete dust, which exhibited markedly elevated beryllium content. Importantly, analyses of dusts from different localities contain markedly different amounts of beryllium. Thus, besides workplace-related exposure, environmental factors are also capable to elicit a beryllium sensitization.
  Citation: CHEST (2020)
  PubDate: 2020-09-11
  DOI: 10.1016/j.chest.2020.09.073
THE HEALTHY AIRWAY MYCOBIOME IN INDIVIDUALS OF ASIAN DESCENT
- Authors: Nur A'tikah Binte Mohamed Ali; Fransiskus Xaverius Ivan, Micheál Mac Aogáin, Jayanth Kumar Narayana, Shuen Yee Lee, Chin Leong Lim, Sanjay H. Chotirmall
  Citation: CHEST (2020)
  PubDate: 2020-09-10
  DOI: 10.1016/j.chest.2020.09.072
The COVID-19 Pandemic’s Impact on Critical Care Resources and
Providers: A Global Survey
- Authors: Sarah Wahlster; Monisha Sharma, Ariane K. Lewis, Pratik V. Patel, Christiane Hartog, Gemi Jannotta, Patricia Blissitt, Erin K. Kross, Nicholas J. Kassebaum, David M. Greer, J. Randall Curtis, Claire J. Creutzfeldt
  Abstract: Our findings demonstrate variability in ICU resource availability and utilization worldwide. The high prevalence of provider burnout, and its association with reported insufficient resources and poor communication from supervisors suggest a need for targeted interventions to support HCPs on the front lines.
  Citation: CHEST (2020)
  PubDate: 2020-09-10
  DOI: 10.1016/j.chest.2020.09.070
Behavioral and regional brain responses to inhalation of capsaicin
modified by painful conditioning in humans
- Authors: Abubakar B. Abubakar; Tara G. Bautista, Matthew R. Dimmock, Stuart B. Mazzone, Michael J. Farrell
  Abstract: Pain-related decreases of cough and UTC are accompanied by widespread changes in brain activity during capsaicin inhalation, suggesting that pain can modify the central processing of inputs arising from the airways. A mechanistic understanding of how cough and pain processing interact within the brain may help develop more effective therapies to reduce unwanted coughing.
  Citation: CHEST (2020)
  PubDate: 2020-09-10
  DOI: 10.1016/j.chest.2020.08.2105
Maxim Integrated Smartphone Sensor with App Meets FDA/ISO Standards for
Clinical Pulse Oximetry and can be Reliably Utilized by a Wide Range of
Patients.
- Authors: Sara H. Browne; Mike Bernstein, Samuel C. Pan, Jonathan Gonzalez Garcia, Craig A. Easson, Chung-Che Huang, Florin Vaida
  Abstract: Our findings support the application for full FDA/ISO approval of the smartphone sensor with App tested for use in clinical pulse oximetry. Given the immense and immediate practical medical importance of remote intermittent clinical pulse oximetry to both chronic disease management and the global ability to respond to respiratory viral pandemics, the smartphone sensor with APP should be prioritized and fast tracked for FDA/ ISO approval to allow clinical use.
  Citation: CHEST (2020)
  PubDate: 2020-09-10
  DOI: 10.1016/j.chest.2020.08.2104
Effect of normobaric hypoxia on exercise performance in pulmonary
hypertension – randomized trial
- Authors: Schneider Simon R; Mayer Laura C, Lichtblau Mona, Berlier Charlotte, Schwarz Esther I, Saxer Stéphanie, Furian Michael, Bloch Konrad E, Ulrich Silvia
  Abstract: In PH-patients, short-time exposure to hypoxia was well tolerated but reduced CWRET-time compared to normoxia in association with hypoxemia, lactacidemia and hypocapnia. Since pulmonary hemodynamics and dyspnea at end-exercise remained unaltered, the hypoxia-induced exercise limitation may be due to a reduced oxygen delivery causing peripheral tissue hypoxia, augmented lactic acid loading and hyperventilation.
  Citation: CHEST (2020)
  PubDate: 2020-09-08
  DOI: 10.1016/j.chest.2020.09.004
COVID-19 acute myocarditis and Multisystem Inflammatory Syndrome in adult
intensive and cardiac care units
- Authors: Guillaume Hékimian; Mathieu Kerneis, Michel Zeitouni, Fleur Cohen-Aubart, Juliette Chommeloux, Nicolas Bréchot, Alexis Mathian, Guillaume Lebreton, Matthieu Schmidt, Miguel Hié, Johanne Silvain, Marc Pineton de Chambrun, Julien Haroche, Sonia Burrel, Stéphane Marot, Charles-Edouard Luyt, Pascal Leprince, Zahir Amoura, Gilles Montalescot, Alban Redheuil, Alain Combes
  Citation: CHEST (2020)
  PubDate: 2020-09-07
  DOI: 10.1016/j.chest.2020.08.2099
Real World Effectiveness of Benralizumab in Severe Eosinophilic Asthma
- Authors: Joanne E. Kavanagh; Andrew P. Hearn, Jaideep Dhariwal, Gráinne d’Ancona, Abdel Douiri, Cris Roxas, Mariana Fernandes, Linda Green, Louise Thomson, Alexandra M. Nanzer, Brian D. Kent, David J. Jackson
  Abstract: In a large real-world SEA cohort, benralizumab led to significant improvements in all clinical outcome measures. A lack of response was seen in a minority and should be a focus for future investigation.
  Citation: CHEST (2020)
  PubDate: 2020-08-31
  DOI: 10.1016/j.chest.2020.08.2083
Submaximal eccentric cycling in people with COPD: acute whole-body
cardiopulmonary and muscle metabolic responses
- Authors: Thomas J.C. Ward; Martin R. Lindley, Richard A. Ferguson, Despina Constantin, Sally J. Singh, Charlotte E. Bolton, Rachael A. Evans, Paul L. Greenhaff, Michael C. Steiner
  Abstract: Cardiopulmonary and blood lactate responses during submaximal ECC were less compared to CON at equivalent mechanical workloads in health and COPD, and this was confirmed at a muscle level in COPD. Submaximal ECC was well tolerated and allowed greater mechanical work at lower ventilatory cost. However, in people with COPD, a training intervention based on ECC is unlikely to stimulate cardiovascular and metabolic adaptation to the same extent as CON.
  Citation: CHEST (2020)
  PubDate: 2020-08-31
  DOI: 10.1016/j.chest.2020.08.2082
Using Geospatial Analysis to Evaluate Access to Lung Cancer Screening in
the United States
- Authors: Liora Sahar; Vanhvilai L. Douangchai Wills, Ka Kit Liu, Ella A. Kazerooni, Debra S. Dyer, Robert A. Smith
  Abstract: Screening current and former heavy smokers aged 55-80 years for lung cancer with low dose chest CT has been recommended by the USPSTF since 2013. Although the number of screening facilities in the US has increased, screening uptake has been slow. To better understand the slow screening uptake, we evaluated geographic access to screening facilities nationwide.
  Citation: CHEST (2020)
  PubDate: 2020-08-31
  DOI: 10.1016/j.chest.2020.08.2081
Effectiveness of proton pump inhibitors in idiopathic pulmonary fibrosis:
a population-based cohort study
- Authors: Tanja Tran; Deborah Assayag, Pierre Ernst, Samy Suissa
  Abstract: PPI use was not associated with lower mortality or hospitalization incidence in this large study conducted among patients with IPF within a real world setting of clinical practice and designed to avoid biases affecting previous studies. PPIs may not be as beneficial in treating IPF as suggested by some studies and conditionally recommended in treatment guidelines.
  Citation: CHEST (2020)
  PubDate: 2020-08-31
  DOI: 10.1016/j.chest.2020.08.2080
Angiotensin II Infusion for Shock: A Multicenter Study of Post-Marketing
Use
- Authors: Patrick M. Wieruszewski; Erica D. Wittwer, Kianoush B. Kashani, Daniel R. Brown, Simona O. Butler, Angela M. Clark, Craig J. Cooper, Danielle L. Davison, Ognjen Gajic, Kyle J. Gunnerson, Rachel Tendler, Kristin C. Mara, Erin F. Barreto
  Abstract: In post-marketing use for vasopressor-refractory shock, 67% of angiotensin II recipients experienced a favorable hemodynamic response. Patients with lower lactate concentrations and those receiving vasopressin were more likely to respond to angiotensin II. Angiotensin II responders experienced a reduced mortality.
  Citation: CHEST (2020)
  PubDate: 2020-08-31
  DOI: 10.1016/j.chest.2020.08.2074
Effect of Early Balanced Crystalloids before ICU Admission on Sepsis
Outcomes
- Authors: Karen E. Jackson; Li Wang, Jonathan D. Casey, Gordon R. Bernard, Wesley H. Self, Todd W. Rice, Matthew W. Semler, SMART Investigators the Pragmatic Critical Care Research Group
  Abstract: Among patients with sepsis, the effect of balanced crystalloids versus saline on mortality was greater for patients for whom fluid choice was controlled starting in the ED compared to starting in the ICU.
  Citation: CHEST (2020)
  PubDate: 2020-08-31
  DOI: 10.1016/j.chest.2020.08.2068
Ventilatory Mechanics in Early vs Late Intubation in a Cohort of COVID-19
Patients with Acute Respiratory Distress Syndrome: A Single Center’s
Experience
- Authors: Aloknath Pandya; Navjot Ariyana Kaur, Daniel Sacher, Oisin O’Corragain, Daniel Salerno, Parag Desai, Sameep Sehgal, Matthew Gordon, Rohit Gupta, Nathaniel Marchetti, Huaqing Zhao, Nicole Patlakh, Gerard J. Criner, Temple University COVID-19 Research Group
  Citation: CHEST (2020)
  PubDate: 2020-08-30
  DOI: 10.1016/j.chest.2020.08.2084
Development of Drugs for Nontuberculous Mycobacterial Disease:
Clinicians’ Interpretation of a US FDA Workshop
- Authors: Patrick A. Flume; David E. Griffith, James D. Chalmers, Charles L. Daley, Kenneth Olivier, Anne O’Donnell, Timothy Aksamit, Shannon Kasperbauer, Amy Leitman, Kevin L. Winthrop
  Abstract: The Food & Drug Administration (FDA) convened a workshop to discuss clinical trial design challenges and considerations related to the treatment of non-tuberculous mycobacterial pulmonary disease (NTM-PD), to include topics such as clinical trial endpoints, duration, and populations. Here the clinicians participating in the meeting provide their interpretation of the discussion, which included FDA and industry representatives. The treatment of NTM-PD typically includes multiple antibiotics for a prolonged period, can be difficult to tolerate, and there is great need for new treatment options.
  Citation: CHEST (2020)
  PubDate: 2020-08-23
  DOI: 10.1016/j.chest.2020.08.2055
Survival After Detection of Stage I Lung Cancer by Screening in the
National Lung Screening Trial
- Authors: David S. Gierada; Paul F. Pinsky
  Abstract: Long-term lung cancer-specific survival of Stage I lung cancer was greater with CT than with CXR screening or in the general population, for smaller primary tumor size, and with surgical treatment.
  Citation: CHEST (2020)
  PubDate: 2020-08-18
  DOI: 10.1016/j.chest.2020.08.2048
Robotic Bronchoscopy for Peripheral Pulmonary Lesions: A Multicenter Pilot
and Feasibility Study (BENEFIT)
- Authors: Alexander C. Chen; Nicholas J. Pastis, Amit K. Mahajan, Sandeep J. Khandhar, Michael J. Simoff, Michael S. Machuzak, Joseph Cicenia, Thomas R. Gildea, Gerard A. Silvestri
  Abstract: This is the first, prospective, multicenter study of robotic bronchoscopy in patients with peripheral pulmonary lesions. Successful lesion localization was achieved in 96.2% of cases with an adverse event rate comparable to conventional bronchoscopic procedures. Additional large prospective studies are warranted to evaluate procedure characteristics such as diagnostic yield.
  Citation: CHEST (2020)
  PubDate: 2020-08-18
  DOI: 10.1016/j.chest.2020.08.2047
Clinical Molecular Imaging of Pulmonary CXCR4 Expression to Predict
Outcome of Pirfenidone Treatment in IPF
- Authors: Thorsten Derlin; Benedikt Jaeger, Danny Jonigk, Rosa Apel, Julia Freise, Hoen-oh Shin, Desiree Weiberg, Gregor Warnecke, Tobias L. Ross, Hans-Jürgen Wester, Benjamin Seeliger, Tobias Welte, Frank M. Bengel, Antje Prasse
  Abstract: CXCR4-targeted PET imaging identified disease activity and predicted outcome of IPF patients treated with pirfenidone. It may serve as a future biomarker for personalized guidance of antifibrotic treatment.
  Citation: CHEST (2020)
  PubDate: 2020-08-18
  DOI: 10.1016/j.chest.2020.08.2043
Positive airway pressure for the treatment of obstructive sleep apnea
syndrome in infants
- Authors: Christopher M. Cielo; Patricia Hernandez, Alyssa M. Ciampaglia, Melissa S. Xanthopoulos, Suzanne E. Beck, Ignacio E. Tapia
  Abstract: Objective data demonstrates that PAP is both highly effective at treating OSAS and well-tolerated in infants. Like older patients, PAP should be considered along with other therapies for the treatment of OSAS in even the youngest children.
  Citation: CHEST (2020)
  PubDate: 2020-08-14
  DOI: 10.1016/j.chest.2020.08.020
A fluid challenge test for the diagnosis of occult heart failure
- Authors: Michele D'Alto; David Badesch, Eduardo Bossone, Barry A. Borlaug, Evan Brittain, Marc Humbert, Robert Naeije
  Abstract: A right heart catheterization with measurements of pulmonary artery wedge pressure (PAWP) may be necessary for the diagnosis of left heart failure as a cause of pulmonary hypertension or unexplained dyspnea. Diagnostic cut-off values are a PAWP of ≥ 15 mmHg at rest a PAWP of ≥ 25 mmHg during exercise. However, accurate measurement of PAWP can be challenging and heart failure may be occult. A left heart catheterization, with measurement of left ventricular end-diastolic pressure, may also be indecisive.
  Citation: CHEST (2020)
  PubDate: 2020-08-13
  DOI: 10.1016/j.chest.2020.08.019
Vascular Pruning on Computed Tomography and Interstitial Lung
Abnormalities in the Framingham Heart Study
- Authors: Andrew J. Synn; Wenyuan Li, Gary M. Hunninghake, George R. Washko, Raúl San José Estépar, George T. O’Connor, Cyrus A. Kholdani, Robert W. Hallowell, Alexander A. Bankier, Murray A. Mittleman, Mary B. Rice
  Abstract: In this cohort of community-dwelling adults not selected on the basis of lung disease, more severe vascular pruning on CT was associated with greater odds of ILA, ILA progression, and restrictive pattern on spirometry. Pruning on CT may be an indicator of early pulmonary vasculopathy associated with interstitial lung disease.
  Citation: CHEST (2020)
  PubDate: 2020-08-13
  DOI: 10.1016/j.chest.2020.07.082
Central sleep apnea predicts pulmonary complications after cardiac surgery
- Authors: Maria Tafelmeier; Lili Luft, Elisabeth Zistler, Bernhard Floerchinger, Daniele Camboni, Marcus Creutzenberg, Florian Zeman, Christof Schmid, Lars Siegfried Maier, Stefan Wagner, Michael Arzt
  Abstract: Amongst established risk factors for postoperative MPCs, CSA, heart failure, and history of transient ischemic attack or stroke were significantly associated with postoperative MPCs. Our findings contribute to identify patients at high-risk for postoperative MPCs.
  Citation: CHEST (2020)
  PubDate: 2020-08-12
  DOI: 10.1016/j.chest.2020.07.080
Thoracic quantitative dynamic MRI to understand developmental changes in
normal ventilatory dynamics
- Authors: Yubing Tong; Jayaram K. Udupa, Joseph M. McDonough, Caiyun Wu, Changjian Sun, Catherine Qiu, Carina Lott, Nirupa Galagedera, Jason B. Anari, Oscar H. Mayer, Drew A. Torigian, Patrick J. Cahill
  Abstract: Normal right and left ventilatory volume components have considerable asymmetry in morphology and dynamics and change with age. Chest wall and diaphragm contributions vary in a likewise manner. Thoracic QdMRI can provide quantitative data to characterize the regional function and growth of the thorax as it relates to ventilation.
  Citation: CHEST (2020)
  PubDate: 2020-08-05
  DOI: 10.1016/j.chest.2020.07.066
Minimal Inhibitory Concentration of Clofazimine among Clinical Isolates of
Nontuberculous Mycobacteria and Its Impact on Treatment Outcome
- Authors: Nakwon Kwak; Jake Whang, Jeong Seong Yang, Taek Soo Kim, Sung A. Kim, Jae-Joon Yim
  Abstract: The MICs of clofazimine varied widely in clinical isolates from patients with NTM-PD. Negative conversion of sputum culture with clofazimine use was associated with a lower MIC value. Clofazimine use could be considered in patients with NTM-PD when the MIC value is ≤ 0.25 mg/L.
  Citation: CHEST (2020)
  PubDate: 2020-07-23
  DOI: 10.1016/j.chest.2020.07.040
Long-term disabilities of survivors of out-of-hospital cardiac arrest: the
Hanox study
- Authors: Anne Peskine; Alain Cariou, David Hajage, Nicolas Deye, Emmanuel Guérot, Martin Dres, Romain Sonneville, Alexandre Lafourcade, Vincent Navarro, Hélène Robert, Philippe Azouvi, Tarek Sharshar, Eleonore Bayen, Charles-Edouard Luyt, Hanox Study Group
  Abstract: Among patients who awoke (GCS≥12) in the 14 days following OHCA, 35% had moderate-to-severe disabilities or had died at M18. Interestingly, patients improved until M18 post-OHCA. Risk factors associated with poor functional outcome were low-flow time, clinical severity at ICU admission, prolonged coma duration and mechanical ventilation.
  Citation: CHEST (2020)
  PubDate: 2020-07-20
  DOI: 10.1016/j.chest.2020.07.022
Clinical and Genetic Spectrum of Children with Primary Ciliary Dyskinesia
in China
- Authors: Yuhong Guan; Haiming Yang, Xingfeng Yao, Hui Xu, Hui Liu, Xiaolei Tang, Chanjuan Hao, Xiang zhang, Shunying Zhao, Wentong Ge, Xin Ni
  Abstract: Primary ciliary dyskinesia (PCD) is a heterogeneous disease with a diverse clinical and genetic spectrum among populations worldwide. Few cases of pediatric PCD have been reported from China. Methods: Clinical characteristics, laboratory findings, and genetic results obtained for 81 patients with PCD were retrospectively reviewed at a single center in China. Genetic sequencing was conducted using whole-exome screening.
  Citation: CHEST (2020)
  PubDate: 2020-07-02
  DOI: 10.1016/j.chest.2020.06.045
A behaviour change intervention aimed at increasing physical activity
improves clinical control in adults with asthma: a randomised controlled
trial
- Authors: Patricia D. Freitas; Natalia FP. Passos, Regina M. Carvalho-Pinto, Milton A. Martins, Vinicius Cavalheri, Kylie Hill, Rafael Stelmach, Celso RF. Carvalho
  First page: 46
  Abstract: In adults with moderate to severe asthma, a comprehensive behaviour change intervention that increased physical activity also produced improvements in asthma clinical control, sedentary time, sleep quality and anxiety symptoms.
  Citation: CHEST (2020)
  PubDate: 2020-09-12
  DOI: 10.1016/j.chest.2020.08.2113
Aspiration risk factors, microbiology and empiric antibiotics for patients
hospitalized with community-acquired pneumonia
- Authors: Judith Marin-Corral; Sergi Pascual-Guardia, Amati Francesco, Stefano Aliberti, Joan R. Masclans, Nilam Soni, Alejandro Rodriguez, Oriol Sibila, Francisco Sanz, Giovanni Sotgiu, Antonio Anzueto, Katerina Dimakou, Roberta Petrino, Ewoudt van de Garde, Marcos I. Restrepo, GLIMP investigators
  First page: 58
  Abstract: Hospitalized patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared to patients without aspiration risk factors. Gram-negative bacteria were more prevalent in patients with severe ACAP. Despite having similar microbiological flora between groups, a large proportion of CAP patients received anti-anaerobic antibiotic coverage.
  Citation: CHEST (2020)
  PubDate: 2020-07-17
  DOI: 10.1016/j.chest.2020.06.079
Lung Histopathology in COVID-19 as Compared to SARS and H1N1 Influenza: A
Systematic Review
- Authors: Lida P. Hariri; Crystal M. North, Angela R. Shih, Rebecca A. Israel, Jason H. Maley, Jullian A. Villalba, Vladimir Vinarsky, Jonah Rubin, Daniel A. Okin, Alyssa Sclafani, Jehan W. Alladina, Jason W. Griffith, Michael A. Gillette, Yuval Raz, Christopher J. Richards, Alexandra K. Wong, Amy Ly, Yin P. Hung, Raghu R. Chivukula, Camille R. Petri, Tiara F. Calhoun, Laura N. Brenner, Kathryn A. Hibbert, Benjamin D. Medoff, C. Corey Hardin, James R. Stone, Mari Mino-Kenudson
  First page: 73
  Abstract: DAD, the histologic correlate of ARDS, is the predominant histopathologic pattern identified in lung pathology from patients with COVID-19, H1N1 influenza and SARS. Microthrombi were reported more frequently in both patients with COVID-19 and SARS as compared to H1N1 influenza. Future work is needed to validate this histopathologic finding and, if confirmed, elucidate the mechanistic underpinnings and characterize any associations with clinically important outcomes.
  Citation: CHEST (2020)
  PubDate: 2020-10-06
  DOI: 10.1016/j.chest.2020.09.259
Use of Ivermectin is Associated with Lower Mortality in Hospitalized
Patients with COVID-19 (ICON study)
- Authors: Juliana Cepelowicz Rajter; Michael S. Sherman, Naaz Fatteh, Fabio Vogel, Jamie Sacks, Jean-Jacques Rajter
  First page: 85
  Abstract: Ivermectin treatment was associated with lower mortality during treatment of COVID-19, especially in patients with severe pulmonary involvement. Randomized controlled trials are needed to confirm these findings.
  Citation: CHEST (2020)
  PubDate: 2020-10-12
Pulmonary exacerbations in adults with cystic fibrosis - a grown-up issue
in a changing CF landscape
- Authors: Gemma E. Stanford; Kavita Dave, Nicholas J. Simmonds
  First page: 93
  Abstract: Pulmonary exacerbations (PEx) are significant life events in people with cystic fibrosis (CF), associated with declining lung function, reduced quality of life (QoL), hospitalisations and decreased survival. The adult CF population is increasing worldwide, with many patients surviving prolonged periods with severe multi-morbid disease. In many countries the number of adults with CF exceeds the number of children, and PEx are particularly burdensome for adults as they tend to require longer courses and more intravenous treatment than children.
  Citation: CHEST (2020)
  PubDate: 2020-09-20
  DOI: 10.1016/j.chest.2020.09.084
Performance of the Xpert MTB/RIF Ultra assay for determining cause of
death by tuberculosis in tissue samples obtained by minimally invasive
autopsies
- Authors: Alberto L. Garcia-Basteiro; Juan Carlos Hurtado, Paola Castillo, Fabiola Fernandes, Mireia Navarro, Lucilia Lovane, Isaac Casas, Llorenç Quintó, Dercio Jordao, Mamudo R. Ismail, Cesaltina Lorenzoni, Carla Carrilho, Ariadna Sanz, Natalia Rakislova, Aurea Mira, Miriam J. Alvarez-Martínez, Anelsio Cossa, Frank Cobelens, Inácio Mandomando, Jordi Vila, Quique Bassat, Clara Menendez, Jaume Ordi, Miguel J. Martínez
  First page: 103
  Citation: CHEST (2020)
  PubDate: 2020-07-11
  DOI: 10.1016/j.chest.2020.06.071
The minimal effect of zinc on the survival of hospitalized patients with
Covid-19: an observational study
- Authors: Jasper Seth Yao; Joseph Alexander Paguio, Edward Christopher Dee, Hanna Clementine Tan, Achintya Moulick, Carmelo Milazzo, Jerry Jurado, Nicolás Della Penna, Leo Anthony Celi
  First page: 108
  Citation: CHEST (2020)
  PubDate: 2020-07-22
  DOI: 10.1016/j.chest.2020.06.082
Male sex, severe obesity, older age, and chronic kidney disease are
associated with COVID-19 severity and mortality in New York City
- Authors: Joseph Rapp; Wil Lieberman-Cribbin, Stephanie Tuminello, Emanuela Taioli
  First page: 112
  Citation: CHEST (2020)
  PubDate: 2020-08-28
  DOI: 10.1016/j.chest.2020.08.2065
Deterioration of Nighttime Respiratory Mechanics in Chronic Obstructive
Pulmonary Disease: Impact of Bronchodilator Therapy
- Authors: Nicolle J. Domnik; Matthew D. James, Robin E. Scheeren, Grace A. Ayoo, Sarah M. Taylor, Amanda T. Di Luch, Kathryn M. Milne, Sandra G. Vincent, Devin B. Phillips, Amany F. Elbehairy, Sophie J. Crinion, Helen S. Driver, J Alberto Neder, Denis E. O’Donnell
  First page: 116
  Abstract: Respiratory mechanics significantly deteriorated at night during PL. While morning trough IC was unchanged, evening bronchodilator treatment was consistently associated with sustained overnight improvements in dynamic respiratory mechanics and inspiratory neural drive compared with placebo.
  Citation: CHEST (2020)
  PubDate: 2020-06-26
  DOI: 10.1016/j.chest.2020.06.033
Interstitial lung abnormalities and the clinical course in patients with
COPD
- Authors: Tae Seung Lee; Kwang Nam Jin, Hyun Woo Lee, Seo-Young Yoon, Tae Yun Park, Eun Young Heo, Deog Kyeom Kim, Hee Soon Chung, Jung-Kyu Lee
  First page: 128
  Abstract: ILA was significantly associated with moderate-to-severe acute exacerbation in patients with COPD, and the progression of ILA was associated with an accelerated decline in lung function.
  Citation: CHEST (2020)
  PubDate: 2020-08-13
  DOI: 10.1016/j.chest.2020.08.017
A Tool to Assess Participation in People with COPD: Validation of the Late
Life Disability Instrument
- Authors: Sachi O’Hoski; Ayse Kuspinar, Julie Richardson, Joshua Wald, Dina Brooks, Roger Goldstein, Marla K. Beauchamp
  First page: 138
  Abstract: The LLDI shows test-retest reliability, internal consistency and construct and face validity in people with COPD. The LLDI can be used to assess participation in this population.
  Citation: CHEST (2020)
  PubDate: 2020-08-31
  DOI: 10.1016/j.chest.2020.08.2079
Computed Tomography Imaging and Comorbidities in Chronic Obstructive
Pulmonary Disease: Beyond Lung Cancer Screening
- Authors: Deepti Singhvi; Jessica Bon
  First page: 147
  Abstract: Comorbidities significantly contribute to morbidity, mortality, and health care costs in individuals with chronic obstructive pulmonary disease (COPD). Comorbidity prevalence does not always correlate with lung disease severity and the elevated risk of certain comorbidities is often independent of shared risk factors such as tobacco burden. While COPD management guidelines recognize the importance of identifying and treating comorbidities as part of the comprehensive management of COPD patients, little guidance is provided regarding best screening practices.
  Citation: CHEST (2020)
  PubDate: 2020-08-21
  DOI: 10.1016/j.chest.2020.08.2053
Higher versus lower oxygenation strategies in acutely ill adults. A
systematic review with meta-analysis and Trial Sequential Analysis
- Authors: Marija Barbateskovic; Olav L. Schjørring, Sara Russo Krauss, Christian S. Meyhoff, Janus J. Jakobsen, Bodil S. Rasmussen, Anders Perner, Jørn Wetterslev
  First page: 154
  Abstract: conflict of interest statements: MB, SRK, JCJ: None known. OLS is a member of the Management Committee of the HOT-ICU (Handling Oxygenation Targets in the Intensive Care Unit) trial, investigating higher versus lower oxygenation targets in patients admitted to the ICU (NCT03174002). CSM reports direct and indirect departmental research funding from Ferring Pharmaceuticals, Radiometer, Merck, Sharp & Dohme Corp., and Boehringer Ingelheim as well as lecture fee from Radiometer outside the submitted work. CSM was the principal investigator of the PROXI trial (PeRioperative OXygen fraction – effect on surgical site Infection and pulmonary complications after abdominal surgery) investigating higher versus lower levels of perioperative inspiratory oxygen. Furthermore, he is a principle site investigator of the HOT-ICU trial and sponsor for the VIXIE trial investigating perioperative inspiratory oxygen (NCT03494387). BSR is the sponsor and primary investigator of the HOT-ICU trial. AP is a member of the Management Committee of the HOT-ICU trial. JW is a member of the task at Copenhagen Trial Unit (CTU) to develop theory and software for doing Trial Sequential Analysis (TSA) available as freeware including a comprehensive manual at www.ctu/tsa and a member of the Management committee of the HOT-ICU trial.
  Citation: CHEST (2020)
  PubDate: 2020-07-17
  DOI: 10.1016/j.chest.2020.07.015
Survivors of intensive care with type 2 diabetes and the effect of shared
care follow-up clinics: the SWEET-AS randomized controlled pilot study
- Authors: Yasmine Ali Abdelhamid; Liza K. Phillips, Mary G. White, Jeffrey Presneill, Michael Horowitz, Adam M. Deane
  First page: 174
  Abstract: Outcomes for ICU survivors with type 2 diabetes are poor. Due to low participation and high mortality, a larger trial of a shared-care follow-up clinic in this cohort using the present design does not appear feasible.
  Citation: CHEST (2020)
  PubDate: 2020-08-11
  DOI: 10.1016/j.chest.2020.08.011
Prevalence of Reverse Triggering in Early ARDS: Results from a Multicenter
Observational Study
- Authors: Pablo O. Rodriguez; Norberto Tiribelli, Sebastian Fredes, Emiliano Gogniat, Gustavo Plotnikow, Ignacio Fernandez Ceballos, Romina Pratto, Alejandro Raimondi, María Guaymas, Santiago Ilutovich, Eduardo San Roman, Matías Madorno, Patricio Maskin, Laurent Brochard, Mariano Setten, GRAAVEplus (Grupo Argentino de estudio de Asincronías en la VEntilación mecánica) study group
  First page: 186
  Abstract: Fifty percent of patients under assist-control ventilation for mild or moderate ARDS, sedated and non-paralyzed, present RT without breath-stacking on the first day of mechanical ventilation. RT may be associated with low tidal volumes.
  Citation: CHEST (2020)
  PubDate: 2020-08-13
  DOI: 10.1016/j.chest.2020.08.018
Critically Ill Adults with COVID-19 in New Orleans and Care with an
Evidence-based Protocol
- Authors: David R. Janz; Scott Mackey, Nirav Patel, Beau P. Saccoccia, Michelle St. Romain, Bethany Busack, Hayoung Lee, Lana Phan, Jordan Vaughn, David Feinswog, Ryan Chan, Lauren Auerbach, Nicholas Sausen, Joseph Grace, Marian Sackey, Anushka Das, Angellica O. Gordon, Jennifer Schwehm, Robin McGoey, Kyle I. Happel, Stephen P. Kantrow
  First page: 196
  Abstract: Care of critically ill COVID-19 patients with an evidence-based protocol is associated with increased time alive and free of invasive mechanical ventilation. In-hospital survival occurred in the majority of critically ill adults with COVID-19 admitted to an academic safety net hospital’s ICUs despite a high rate of co-morbidities.
  Citation: CHEST (2020)
  PubDate: 2020-09-13
  DOI: 10.1016/j.chest.2020.08.2114
How I do it – Lung Ultrasound for Patients with COVID-19 Pulmonary
Disease
- Authors: Scott J. Millington; Seth Koenig, Paul Mayo, Giovanni Volipcelli
  First page: 205
  Abstract: Given the general utility of lung ultrasound (LUS) for the evaluation of respiratory failure in acutely ill patients, it is logical to consider its specific advantages in COVID-19 related pulmonary disease. The authors, representing the extensive experience of the North American and European COVID-19 epicenters, present an ultrasound scanning protocol and report on the common associated ultrasound findings.
  Citation: CHEST (2020)
  PubDate: 2020-08-21
  DOI: 10.1016/j.chest.2020.08.2054
Prevalence and perceptions of bundled informed consent in United States
academic medical intensive care units: a national survey
- Authors: Asha M. Anandaiah; Nicholas S. Ward
  First page: 212
  Citation: CHEST (2020)
  PubDate: 2020-08-18
  DOI: 10.1016/j.chest.2020.08.2051
Post-Intensive Care Unit COVID-19 Outcomes-a Case Series
- Authors: Chintan Ramani; Eric M. Davis, John S. Kim, J Javier Provencio, Kyle B. Enfield, Alex Kadl
  First page: 215
  Citation: CHEST (2020)
  PubDate: 2020-08-21
  DOI: 10.1016/j.chest.2020.08.2056
Impact of idiopathic pulmonary fibrosis on longitudinal healthcare
utilization in a community-based cohort of patients
- Authors: Erica Farrand; Carlos Iribarren, Eric Vittinghoff, Tory Levine-Hall, Brett Ley, George Minowada, Harold R. Collard
  First page: 219
  Abstract: This study defines a marked increase in HRU in IPF patients compared to controls, with accelerated use beginning at least 1-year pre-diagnosis and elevated use sustained over the following 5-years. It is the first study to evaluate longitudinal medication trends in IPF. Collectively this information is foundational to advancing IPF care delivery models and supporting clinical decision-making.
  Citation: CHEST (2020)
  PubDate: 2020-07-24
  DOI: 10.1016/j.chest.2020.07.035
Mortality Trends of Idiopathic Pulmonary Fibrosis in the United States
from 2004 to 2017
- Authors: Niranjan Jeganathan; Rory A. Smith, Matheni Sathananthan
  First page: 228
  Abstract: From 2004 to 2017, the IPF age-adjusted mortality rates decreased. This may partly be explained by a decline in smoking in the U.S., but further research is needed to evaluate other environmental and genetic contributors.
  Citation: CHEST (2020)
  PubDate: 2020-08-13
  DOI: 10.1016/j.chest.2020.08.016
The Thousand Faces of Leptin in the Lung
- Authors: Etienne-Marie Jutant; Ly Tu, Marc Humbert, Christophe guignabert, Alice Huertas
  First page: 239
  Abstract: Leptin is a pleotropic hormone known to regulate a wide range of systemic functions, from satiety to inflammation. Increasing evidence has shown that leptin and its receptor, ObR, are not only expressed in adipose tissue but also in several organs, including the lungs. Leptin levels were first believed to only be elevated in the lungs of obese patients and it was suspected to be responsible for obesity-related lung complications. Aside from obesity, leptin displays many faces in the respiratory system, independently of body weight, as this cytokine-like hormone plays important physiological roles, from the embryogenic state to maturation of the lungs and the control of ventilation.
  Citation: CHEST (2020)
  PubDate: 2020-08-10
  DOI: 10.1016/j.chest.2020.07.075
Recognition and management of protracted bacterial bronchitis in
Australian Aboriginal children: a knowledge translation approach
- Authors: Pamela Laird; Roz Walker, Mary Lane B.Nur, James Totterdell, Anne Chang, André Schultz
  First page: 249
  Abstract: Health seeking for children with chronic wet cough can be facilitated through provision of culturally secure health information. Clinician proficiency in the management of PBB can be improved with KT strategies which include training in culturally informed management, leading to better health outcomes. Comprehensive strategies that include both families and health systems are required to ensure that chronic wet cough in children is detected and optimally managed.
  Citation: CHEST (2020)
  PubDate: 2020-07-13
  DOI: 10.1016/j.chest.2020.06.073
Can acute cough characteristics from sound recordings differentiate common
respiratory illnesses in children' A comparative prospective study
- Authors: Nina Bisballe-Müller; Anne B. Chang, Erin J. Plumb, Victor M. Oguoma, Susanne Halken, Gabrielle B. McCallum
  First page: 259
  Abstract: Cough characteristics alone are not distinct enough to accurately differentiate between common acute respiratory illnesses in children.
  Citation: CHEST (2020)
  PubDate: 2020-07-08
  DOI: 10.1016/j.chest.2020.06.067
Feasibility of a 5G-based robot-assisted remote ultrasound system for
cardiopulmonary assessment of COVID-19 patients
- Authors: Ruizhong Ye; Xianlong Zhou, Fei Shao, Linfei Xiong, Jun Hong, Haijun Huang, Weiwei Tong, Jing Wang, Shuangxi Chen, Ailin Cui, Chengzhong Peng, Yan Zhao, Legao Chen
  First page: 270
  Abstract: 5G-based robot-assisted remote ultrasound system is feasible, and effectively obtains ultrasound characteristics for cardiopulmonary assessment of COVID-19 patients. By following established protocols and considering medical history, clinical manifestations, and laboratory markers, it might help to evaluate the severity of COVID-19 remotely.
  Citation: CHEST (2020)
  PubDate: 2020-07-09
  DOI: 10.1016/j.chest.2020.06.068
Global physiology and pathophysiology of cough: Part 1. Cough
phenomenology: CHEST Guideline and Expert Panel report
- Authors: Kai K. Lee; Paul W. Davenport, Jaclyn A. Smith, Richard S. Irwin, Lorcan McGarvey, Stuart B. Mazzone, Surinder S. Birring, CHEST Expert Cough Panel
  First page: 282
  Abstract: The purpose of this state-of-the-art review is to update the American College of Chest Physicians (CHEST) 2006 guideline on global physiology and pathophysiology of cough.
  Citation: CHEST (2020)
  PubDate: 2020-09-01
  DOI: 10.1016/j.chest.2020.08.2086
“How to Review Post-lobectomy Posteroanterior Chest
Radiographs”
- Authors: Jeong Min Ko; Min Kyung Jung, Hyun Jin Park
  First page: 294
  Abstract: Lung cancer is currently the most common malignancy in the world. A lobectomy is the gold standard of care for most patients with an operable lung cancer and accounts for 60-70% of lung resection. The chest radiograph may appear normal after a lobectomy, particularly in uncomplicated cases. However, lobectomy usually leaves the surgical staples at the bronchial stump and causes various changes in the intra- and extrapulmonary thoracic structures on plain radiographs. These changes may differ according to the resected lobe.
  Citation: CHEST (2020)
  PubDate: 2020-08-31
  DOI: 10.1016/j.chest.2020.08.2072
BMI is causally associated with pulmonary artery pressure but not
hemodynamic evidence of pulmonary vascular remodeling
- Authors: Timothy E. Thayer; Rebecca T. Levinson, Shi Huang, Tufik Assad, Eric Farber-Eger, Quinn S. Wells, Jonathan D. Mosley, Evan L. Brittain
  First page: 302
  Abstract: BMI is a modifier of pulmonary hypertension severity in both PAH and PVH but is only involved in the pathogenesis of PVH.
  Citation: CHEST (2020)
  PubDate: 2020-07-23
  DOI: 10.1016/j.chest.2020.07.038
United States Pulmonary Hypertension Scientific Registry (USPHSR):
Baseline Characteristics
- Authors: Jessica B. Badlam; David B. Badesch, Eric D. Austin, Raymond L. Benza, Wendy K. Chung, Harrison W. Farber, Kathy Feldkircher, Adaani E. Frost, Abby D. Poms, Katie A. Lutz, Michael W. Pauciulo, Chang Yu, William C. Nichols, C. Gregory Elliott, Robert Simms, Terry Fortin, Zeenat Safdar, Charles D. Burger, Robert P. Frantz, Nicholas S. Hill, Sophia Airhart, Jean Elwing, Simon R. Marc, James White, Ivan M. Robbins, Murali M. Chakinala
  First page: 311
  Abstract: Group 1 PAH patients remain predominately middle-aged women diagnosed with IPAH or APAH. Delays in diagnosis of PAH persist. Treatment with combinations of PAH targeted medications are more common than in the past. Women often report pregnancy complications, as well as exposure to anorexigens, oral contraceptives, and/or recreational drugs. Genetic tests frequently identify unsuspected HPAH.
  Citation: CHEST (2020)
  PubDate: 2020-08-25
  DOI: 10.1016/j.chest.2020.07.088
Gender Differences in Portopulmonary Hypertension
- Authors: Hilary M. DuBrock; Rodrigo Cartin-Ceba, Richard N. Channick, Steven M. Kawut, Michael J. Krowka
  First page: 328
  Abstract: Compared to males, female LT candidates with POPH had a higher PVR, lower MELD score and were more likely to have autoimmune liver disease. Females and males had similar overall survival, but female gender was associated with worse survival in younger patients.
  Citation: CHEST (2020)
  PubDate: 2020-08-12
  DOI: 10.1016/j.chest.2020.07.081
Development and Validation of an Abridged Version of the REVEAL 2.0 Risk
Score Calculator, REVEAL Lite 2, for use in Patients with Pulmonary
Arterial Hypertension
- Authors: Raymond L. Benza; Manreet K. Kanwar, Amresh Raina, Jacqueline V. Scott, Carol L. Zhao, Mona Selej, C. Greg Elliott, Harrison W. Farber
  First page: 337
  Abstract: REVEAL Lite 2, an abridged version of REVEAL 2.0, provides a simplified method of risk assessment that can be implemented routinely in daily clinical practice. REVEAL Lite 2 is a robust tool that provides discrimination between patients at low, intermediate, and high risk of 1-year mortality.
  Citation: CHEST (2020)
  PubDate: 2020-08-31
  DOI: 10.1016/j.chest.2020.08.2069
How I Do It: The PERT Concept: A Step-by-Step Approach to Managing PE
- Authors: Belinda N. Rivera-Lebron; Parth M. Rali, Victor F. Tapson
  First page: 347
  Abstract: Pulmonary embolism (PE) is a major source of morbidity and mortality. The presentation of acute PE varies, ranging from few or no symptoms to sudden death. Patient outcome depends upon how well the right ventricle can sustain the increased afterload caused by the embolic burden. Careful risk stratification is critical and the pulmonary embolism response team (PERT) concept offers a rapid and multidisciplinary approach. Anticoagulation is essential unless contraindicated; thrombolysis, surgical embolectomy, and catheter-directed approaches are also available.
  Citation: CHEST (2020)
  PubDate: 2020-08-03
  DOI: 10.1016/j.chest.2020.07.065
Maternal Sleep-Disordered Breathing in Pregnancy and Increased Nocturnal
Glucose Levels in Women with Gestational Diabetes
- Authors: Raphieal Newbold; Andrea Benedetti, R John Kimoff, Sara Meltzer, Natasha Garfield, Kaberi Dasgupta, Robert Gagnon, Lorraine Lavigne, Allen Olha, Evelyne Rey, Sushmita Pamidi
  First page: 356
  Abstract: Greater severity of SDB was associated with higher nocturnal and morning glucose levels in women with GDM.
  Citation: CHEST (2020)
  PubDate: 2020-07-17
  DOI: 10.1016/j.chest.2020.07.014
Sleep Fragmentation and Cognitive Trajectories after Critical Illness
- Authors: M. Elizabeth Wilcox; Mary Pat McAndrews, Julie Van, James C. Jackson, Ruxandra Pinto, Sandra E. Black, Andrew S. Lim, Jan O. Friedrich, Gordon D. Rubenfeld
  First page: 366
  Abstract: Sleep fragmentation estimated by actigraphy was associated with worse cognitive performance in hospital, but not at later time intervals. Further research is needed to better delineate the relationship between persistent sleep disturbances and cognition in larger numbers of ICU survivors.
  Citation: CHEST (2020)
  PubDate: 2020-07-24
  DOI: 10.1016/j.chest.2020.07.036
Age and gender disparities in adherence to continuous positive airway
pressure
- Authors: Sanjay R. Patel; Jessie P. Bakker, Christy J. Stitt, Mark S. Aloia, S. Mehdi Nouraie
  First page: 382
  Abstract: CPAP adherence rates vary substantially by demographics, with 18-30 year old women having the lowest adherence. The pattern of use over the first 90 days also varies substantially by age and gender. Further research to understand and address the etiology of disparities will be crucial to maximizing the benefits of CPAP therapy.
  Citation: CHEST (2020)
  PubDate: 2020-07-17
  DOI: 10.1016/j.chest.2020.07.017
The Effect of Tumor Size and Histology on Outcomes Following Segmentectomy
vs. Lobectomy for Clinically Node-negative Non-small Cell Lung Cancer
- Authors: Vignesh Raman; Oliver K. Jawitz, Soraya L. Voigt, Kristen E. Rhodin, Thomas A. D’Amico, David H. Harpole, Chi-Fu Jeffrey Yang, Betty C. Tong
  First page: 390
  Abstract: In this NCDB study of patients with node-negative NSCLC, we found different tumor size thresholds, based on histology, that identified populations of patients who least and most benefit from lobectomy compared to segmentectomy.
  Citation: CHEST (2020)
  PubDate: 2020-07-08
  DOI: 10.1016/j.chest.2020.06.066
Impact of the Percepta Genomic Classifier on Clinical Management Decisions
in a Multicenter Prospective Study
- Authors: Hans J. Lee; Peter Mazzone, David Feller-Kopman, Lonny Yarmus, Kyle Hogarth, Lori R. Lofaro, Bailey Griscom, Marla Johnson, Yoonha Choi, Jing Huang, Sangeeta Bhorade, Avrum Spira, Giulia C. Kennedy, Momen M. Wahidi, Percepta Registry Investigators
  First page: 401
  Abstract: The Percepta genomic classifier has been clinically validated as a complement to bronchoscopy for lung nodule evaluation. This study examines the impact on clinical management decisions of the Percepta result in patients with low/ intermediate risk lung nodules.
  Citation: CHEST (2020)
  PubDate: 2020-08-03
  DOI: 10.1016/j.chest.2020.07.067
How Health Care Organizations Implement Shared Decision Making When It Is
Required for Reimbursement: The Case of Lung Cancer Screening
- Authors: Amir Alishahi Tabriz; Christine Neslund-Dudas, Kea Turner, M Patricia Rivera, Daniel S. Reuland, Jennifer Elston Lafata
  First page: 413
  Abstract: Those responsible for developing and managing SDM-LCS programs voiced concerns regarding both patient access and SDM quality, regardless of organizational context, or LCS-SDM model implemented. The challenge facing these organizations, and those wanting to help patients and clinicians balance the tradeoffs inherent with LCS, is how to move beyond a “check box” documentation requirement to a process that enables LCS to be offered to all high risk patients, but used only by those who are informed and for whom screening represents a value concordant service.
  Citation: CHEST (2020)
  PubDate: 2020-08-12
  DOI: 10.1016/j.chest.2020.07.078
A brief overview of the national outbreak of e-cigarette, or vaping,
product use ─associated lung injury (EVALI) and the primary causes
- Authors: Emily Kiernan; Eleanor S. Click, Paul Melstrom, Mary E. Evans, Mark R. Layer, David N. Weissman, Sarah Reagan-Steiner, Jennifer L. Wiltz, Susan Hocevar, Alyson B. Goodman, Evelyn Twentyman
  First page: 426
  Citation: CHEST (2020)
  PubDate: 2020-08-03
  DOI: 10.1016/j.chest.2020.07.068
Clinical Characteristics of DIPNECH: A Retrospective Analysis
- Authors: Daniel R. Almquist; Mohamad Bassam Sonbol, Heidi Kosiorek, Thorvardur Halfdanarson, Helen J. Ross, Dawn Jaroszewski
  First page: 432
  Citation: CHEST (2020)
  PubDate: 2020-08-13
  DOI: 10.1016/j.chest.2020.08.012
The Subway
- Authors: Rana Awdish
  First page: 435
  Citation: CHEST (2020)
  PubDate: 2020-10-22