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https://www.readbyqxmd.com/read/28629920/pulmonary-hypertension-in-parenchymal-lung-diseases-any-future-for-new-therapies
#1
REVIEW
Sergio Harari, Davide Elia, Marc Humbert
Pulmonary hypertension (PH) due to chronic lung diseases is associated with a poor prognosis, regardless of the underlying respiratory condition. Updated PH guidelines recommend optimal treatment of the underlying lung disease, including long-term oxygen therapy, in patients with chronic hypoxaemia despite the lack of randomized controlled clinical trials supporting this statement. So far, randomized controlled trials on drugs approved for pulmonary arterial hypertension (PAH) have yielded discouraging results in both interstitial lung diseases (ILD) and chronic obstructive pulmonary diseases (COPD) with PH...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28629919/comparing-pulmonary-nodule-location-during-electromagnetic-bronchoscopy-with-predicted-location-based-on-two-virtual-airway-maps-at-different-phases-of-respiration
#2
Brian S Furukawa, Nicholas J Pastis, Nichole T Tanner, Alexander Chen, Gerard A Silvestri
BACKGROUND: Electromagnetic navigational bronchoscopy (ENB) is guided-bronchoscopy to pulmonary nodules (PN) which relies on a pre-procedural chest CT to create a 3-dimensional (3-D) virtual airway map. The CT is traditionally done at a full inspiratory breath hold (INSP) but the procedure is performed while the patient tidal breaths, where lung volumes are closer to functional residual capacity. Movement of a PN from INSP to expiration (EXP) has been shown to average 17.6 mm. Therefore, the hypothesis of this study is that pre-procedural virtual maps built off a CT closer to physiological lung volumes during bronchoscopy may better represent the actual 3-D location of a PN...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28629918/trajectories-of-emergent-central-sleep-apnea-during-continuous-positive-airway-pressure-therapy
#3
Dongquan Liu, Jeff Armitstead, Adam Benjafield, Shiyun Shao, Atul Malhotra, Peter A Cistulli, Jean-Louis Pepin, Holger Woehrle
BACKGROUND: Emergence of central sleep apnea (CSA) during positive airway pressure (PAP) therapy has been observed clinically in ≈10% of OSA titration studies. This study assessed a PAP database to investigate trajectories of treatment-emergent CSA during continuous PAP (CPAP) therapy. METHODS: US telemonitoring device data were analyzed for the presence/absence of emergent CSA at baseline (Week 1) and Week 13. Defined groups were: obstructive sleep apnea (OSA; average central apnea index [CAI] <5/hour in Week 1, <5/hour in Week 13); transient CSA (CAI ≥5/hour in Week 1, <5/hour in Week 13); persistent CSA (CAI ≥5/hour in Week 1, ≥5/hour in Week 13); emergent CSA (CAI <5/hour in Week 1, ≥5/hour in Week 13)...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28629917/personalized-management-approach-for-obstructive-sleep-apnea
#4
REVIEW
Jayne C Carberry, Jason Amatoury, Danny J Eckert
Obstructive sleep apnea (OSA) is a heterogeneous disorder. If left untreated, OSA has major health, safety and economic consequences. In addition to varying levels of impairment in pharyngeal anatomy (narrow/collapsible airway), non-anatomical 'phenotypic traits' are also important contributors to OSA for most patients. However, the majority of existing therapies only target the anatomical cause (e.g. continuous positive airway pressure [CPAP], oral appliances, weight loss, positional therapy, and upper airway surgery)...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28629916/a-medical-student-perspective-on-physician-assisted-suicide
#5
John Y Rhee, Katharine A Callaghan, Philip Allen, Amanda Stahl, Martin T Brown, Alexandra Tsoi, Grace McInerney, Ana-Maria G Dumitru
Physician assisted suicide and euthanasia (PAS/E) has been increasingly discussed and debated in the public square, including in professional medical organizations. However, the medical student perspective on the debate has been essentially absent. We present a medical student perspective on the PAS/E debate as future doctors and those about to enter the profession. We argue that PAS/E is not in line with the core principles of medicine, and the focus should rather be on providing high-quality end-of-life and palliative care...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28629915/video-laryngoscopy-for-endotracheal-intubation-of-critically-ill-adults-a-systemic-review-and-meta-analysis
#6
Hui-Bin Huang, Jin-Min Peng, Biao Xu, Guang-Yun Liu, Bin Du
BACKGROUND: Endotracheal intubation (EI) in intensive care unit (ICU) patients is associated with an increased risk of life-threatening adverse events due to unstable conditions, rapid deterioration, limited preparation time, and variability in expertise of operators. We aimed to compare the effect of video laryngoscopy (VL) and direct laryngoscopy (DL) in ICU patients requiring EI. METHODS: We searched for relevant studies in PubMed, Embase, and the Cochrane database from inception up to Jan 30, 2017...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28629914/mortality-risk-prediction-in-scleroderma-related-interstitial-lung-disease-the-sadl-model
#7
Julie Morisset, Eric Vittinghoff, Brett M Elicker, Xiaowen Hu, Stephanie Le, Jay H Ryu, Kirk D Jones, Anna Haemel, Jeffrey A Golden, Francesco Boin, Brett Ley, Paul J Wolters, Talmadge E King, Harold R Collard, Joyce S Lee
RATIONALE: Interstitial lung disease (ILD) is an important cause of morbidity and mortality in scleroderma (Scl). Risk prediction and prognostication in Scl-ILD patients is challenging because of heterogeneity in the disease course. METHODS: We aimed to develop a clinical mortality risk prediction model for Scl-ILD. Patients with Scl-ILD were identified from two ongoing longitudinal cohorts: 135 patients at the University of California, San Francisco (UCSF, derivation cohort) and 90 patients at the Mayo Clinic (validation cohort)...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28625579/improved-early-detection-of-sepsis-in-the-emergency-department-with-a-novel-monocyte-distribution-width-biomarker
#8
Elliott D Crouser, Joseph E Parrillo, Christopher Seymour, Derek C Angus, Keri Bicking, Liliana Tejidor, Robert Magari, Diana Careaga, JoAnna Williams, Douglas R Closser, Michael Samoszuk, Luke Herren, Emily Robart, Fernando Chaves
BACKGROUND: Sepsis most often presents to the emergency department (ED), and delayed detection is harmful. The white blood count (WBC) is often used to detect sepsis, but changes in WBC size also correspond with sepsis. We sought to determine if volume increases of circulating immune cells adds value to the WBC for early sepsis detection in the ED. METHODS: A blinded, prospective cohort study was conducted in two different ED populations within a large academic hospital...
June 15, 2017: Chest
https://www.readbyqxmd.com/read/28625577/risk-factors-for-chronic-cough-among-14-669-individuals-from-the-general-population
#9
Yunus Çolak, Børge G Nordestgaard, Lars C Laursen, Shoaib Afzal, Peter Lange, Morten Dahl
BACKGROUND: Risk factors for chronic cough in the general population have not been described systematically. We identified and ranked chronic cough risk factors at the individual and community level using data from 14669 individuals from the Copenhagen General Population Study. METHODS: Severity of chronic cough was assessed using the Leicester Cough Questionnaire(LCQ). We ranked chronic cough risk factors based on magnitude of age-adjusted odds ratios(ORs) at the individual level and of the population attributable risks(PARs) at the community level...
June 15, 2017: Chest
https://www.readbyqxmd.com/read/28624182/oral-appliances-for-the-management-of-osa-an-updated-review-of-the-literature
#10
REVIEW
Mona M Hamoda, Yuuya Kohzuka, Fernanda R Almeida
Oral appliances (OAs) are becoming increasingly recognized not only as an alternative, but also possibly as an adjunct treatment modality for obstructive sleep apnea (OSA). Compared to Continuous Positive Airway Pressure (CPAP), the gold standard therapy, OAs are less efficacious but are more accepted and tolerated by the patients which may in turn lead to a comparable therapeutic effectiveness. Different oral appliance designs currently exist and even more are constantly emerging. Additionally, state of the art technologies are being utilized in the fabrication of many however, all the currently available OAs employ the same mechanism of action by targeting the anatomical component involved in the pathogenesis of the disease...
June 14, 2017: Chest
https://www.readbyqxmd.com/read/28625582/rebuttal-from-drs-lewis-and-greer
#11
EDITORIAL
Ariane Lewis, David Greer
No abstract text is available yet for this article.
June 12, 2017: Chest
https://www.readbyqxmd.com/read/28625581/point-should-informed-consent-be-required-for-apnea-testing-in-patients-with-suspected-brain-death-no
#12
EDITORIAL
Ariane Lewis, David Greer
No abstract text is available yet for this article.
June 12, 2017: Chest
https://www.readbyqxmd.com/read/28625580/counterpoint-should-informed-consent-be-required-for-apnea-testing-in-patients-with-suspected-brain-death-yes
#13
EDITORIAL
Robert D Truog, Robert C Tasker
No abstract text is available yet for this article.
June 12, 2017: Chest
https://www.readbyqxmd.com/read/28625578/rebuttal-from-drs-truog-and-tasker
#14
EDITORIAL
Robert D Truog, Robert C Tasker
No abstract text is available yet for this article.
June 12, 2017: Chest
https://www.readbyqxmd.com/read/28610911/airway-glucose-homeostasis-a-new-target-in-the-prevention-and-treatment-of-pulmonary-infection
#15
REVIEW
Emma H Baker, Deborah L Baines
In health, the glucose concentration of airway surface liquid (ASL) is 0.4mM, around 12 times lower than blood glucose concentration. Airway glucose homeostasis is a set of processes that actively maintain low ASL glucose concentration against the transepithelial gradient. Tight junctions between airway epithelial cells restrict paracellular glucose movement. Epithelial cellular glucose transport and metabolism removes glucose from ASL. Low ASL glucose concentrations make an important contribution to airways defence against infection, limiting bacterial growth by restricting nutrient availability...
June 10, 2017: Chest
https://www.readbyqxmd.com/read/28583618/new-anti-eosinophil-drugs-for-asthma-and-copd-targeting-the-trait
#16
REVIEW
Elisabeth H Bel, Anneke Ten Brinke
Asthma and chronic obstructive airways disease (COPD) are prevalent chronic inflammatory airway diseases that are responsible for a large global disease burden. Both diseases are complex and heterogeneous, and are increasingly recognized as overlapping syndromes that may share similar pathophysiologic mechanisms and treatable traits. Eosinophilic airway inflammation is considered the most influential treatable trait of chronic airway disease, and over the last decade several monoclonal antibodies and small molecule therapies have been developed to target this trait...
June 2, 2017: Chest
https://www.readbyqxmd.com/read/28583617/totally-implantable-intravenous-treprostinil-therapy-in-pulmonary-hypertension-assessment-of-the-implantation-procedure
#17
Aaron B Waxman, Hugh T McElderry, Mardi Gomberg-Maitland, Martin C Burke, Edgar L Ross, Malcolm M Bersohn, Sanjog S Pangarkar, James H Tarver, Diane L Zwicke, Jeremy P Feldman, Murali M Chakinala, Robert P Frantz, Geoffrey B Thompson, Fernando Torres, Richard L Rauck, Kathy Clagg, Louise Durst, Pei Li, Marty Morris, Kara L Southall, Leigh Peterson, Robert C Bourge
BACKGROUND: Prostacyclins improve symptoms and survival in pulmonary arterial hypertension (PAH). In response to risks associated with external delivery systems, an implantable intravenous infusion system was developed. A multicenter, prospective, single-arm, clinical trial (DelIVery for PAH) was conducted to evaluate this system for treprostinil in PAH. This analysis describes the findings related to the implant procedure. METHODS: Patients (n=64) with PAH (WHO Group 1) receiving stable intravenous treprostinil were enrolled...
June 2, 2017: Chest
https://www.readbyqxmd.com/read/28576630/ca-125-in-disease-progression-and-treatment-of-lymphangioleiomyomatosis
#18
Connie G Glasgow, Gustavo Pacheco-Rodriguez, Wendy K Steagall, Mary E Haughey, Patricia A Julien-Williams, Mario P Stylianou, Bernadette R Gochuico, Joel Moss
BACKGROUND: Lymphangioleiomyomatosis (LAM) is a destructive lung disease of women caused by proliferation of neoplastic-like LAM cells, with mutations in the TSC1/2 tumor suppressor genes. Based on case reports, CA-125 (an ovarian cancer biomarker) can be elevated in LAM patients. We hypothesized that elevated serum CA-125 levels seen in some LAM patients were due to LAM, not other malignancies, and might respond to sirolimus treatment. METHODS: Serum CA-125 levels were measured for 241 patients at each visit...
May 30, 2017: Chest
https://www.readbyqxmd.com/read/28554732/a-randomised-control-trial-of-atorvastatin-in-bronchiectasis-patients-infected-with-pseudomonas-aeruginosa-a-proof-of-concept-study
#19
Pallavi Bedi, James D Chalmers, Catriona Graham, Andrea Clarke, Samantha Donaldson, Catherine Doherty, John Rw Govan, Donald J Davidson, Adriano G Rossi, Adam T Hill
INTRODUCTION: There are no randomised control trials of statin therapy in patients with severe bronchiectasis, chronically infected with Pseudomonas aeruginosa. METHODS: 32 patients chronically infected with P. aeruginosa were recruited in this double blind cross over RCT. 16 patients were recruited in each arm, given atorvastatin 80mg or placebo for 3months, followed by a washout period for 6weeks, crossed over and administered the alternative therapy for 3months...
May 26, 2017: Chest
https://www.readbyqxmd.com/read/28552544/pulmonary-manifestations-in-the-rheumatic-diseases
#20
REVIEW
Tracy J Doyle, Paul F Dellaripa
Lung disease in the rheumatic diseases presents unique challenges for diagnosis and management and is a source of significant morbidity and mortality for patients. Unlike the idiopathic interstitial pneumonias, patients with rheumatic diseases experience lung disease in the context of a systemic disease that may make it more difficult to recognize and that may present greater risks with treatment. Despite recent advances in our awareness of these diseases, there is still a significant lack of understanding of natural history to elucidate which patients will develop disease that is progressive and thus warrants treatment...
May 25, 2017: Chest
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