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https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#1
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29137909/use-of-expired-air-carbon-monoxide-testing-in-clinical-tobacco-treatment-settings
#2
REVIEW
Adam O Goldstein, Stephanie P Gans, Carol Ripley-Moffitt, Chris Kotsen, Matthew Bars
Carbon Monoxide (CO) testing is considered an easy, non-invasive, and objective contribution to the assessment of smoking behavior, as CO is rapidly absorbed into the blood stream when lit cigarettes or cigars are inhaled. CO testing is a medically important, billable outpatient service that can contribute to sustainability of face-to-face tobacco use treatment services by clinicians. This article reviews research on the clinical use of CO testing to provide bio-medical feedback in assessing smoking behavior, on educating smokers on tobacco health effects, on assisting with treatment planning, and as a motivational tool to encourage people to become tobacco free...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29146405/point-should-segmentectomy-rather-than-lobectomy-be-the-operation-of-choice-for-early-stage-non-small-cell-lung-cancer-yes
#3
EDITORIAL
Antonio D'Andrilli, Erino Angelo Rendina
No abstract text is available yet for this article.
November 9, 2017: Chest
https://www.readbyqxmd.com/read/29146404/counterpoint-should-segmentectomy-rather-than-lobectomy-be-the-operation-of-choice-for-early-stage-non-small-cell-lung-cancer-no
#4
EDITORIAL
Luca Bertolaccini, Piergiorgio Solli
No abstract text is available yet for this article.
November 9, 2017: Chest
https://www.readbyqxmd.com/read/29146403/rebuttal-from-drs-d-andrilli-and-rendina
#5
EDITORIAL
Antonio D'Andrilli, Erino Angelo Rendina
No abstract text is available yet for this article.
November 9, 2017: Chest
https://www.readbyqxmd.com/read/29146402/rebuttal-from-drs-bertolaccini-and-solli
#6
EDITORIAL
Luca Bertolaccini, Piergiorgio Solli
No abstract text is available yet for this article.
November 9, 2017: Chest
https://www.readbyqxmd.com/read/29080708/classification-of-cough-as-a-symptom-in-adults-and-management-algorithms-chest-guideline-and-expert-panel-report
#7
Richard S Irwin, Cynthia L French, Anne B Chang, Kenneth W Altman
BACKGROUND: We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful? METHODS: We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework...
November 9, 2017: Chest
https://www.readbyqxmd.com/read/29126842/autoimmunity-and-copd-clinical-implications
#8
REVIEW
Gaetano Caramori, Paolo Ruggeri, Antonino Di Stefano, Sharon Mumby, Giuseppe Girbino, Ian M Adcock, Paul Kirkham
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Long term cigarette smoking is the cause of more than 90% of COPD in Westernized countries. However, only a fraction of chronic heavy smokers develop symptomatic COPD by the age of 80 years. COPD is characterized by an abnormal immune response in the lower airways and its progression is associated with infiltration of the lung by innate and adaptive inflammatory immune cells that form lymphoid follicles. There is growing evidence that both cellular- and antibody-mediated autoimmunity has a fundamental role in the pathogenesis of stable COPD...
November 7, 2017: Chest
https://www.readbyqxmd.com/read/29113816/hdac2-suppresses-il17a-mediated-airway-remodeling-in-human-and-experimental-modeling-of-copd
#9
Tianwen Lai, Baoping Tian, Chao Cao, Yue Hu, Jiesen Zhou, Yong Wang, Yanping Wu, Zhouyang Li, Xuchen Xu, Min Zhang, Feng Xu, Yuan Cao, Min Chen, Dong Wu, Bin Wu, Chen Dong, Wen Li, Songmin Ying, Zhihua Chen, Huahao Shen
BACKGROUND: Airway remodeling is a central feature of chronic obstructive pulmonary disease (COPD), but the mechanisms underlying its development have not been fully elucidated. OBJECTIVE: To determine whether histone deacetylase (HDAC) 2 protects against cigarette smoke (CS)-induced airway remodeling through IL17A-dependent mechanisms. METHODS: Sputum samples and lung tissues were obtained from control subjects and patients with COPD. The relationships between HDAC2, IL17A, and airway remodeling were investigated...
November 4, 2017: Chest
https://www.readbyqxmd.com/read/29113815/evaluation-of-left-ventricular-diastolic-function-by-the-intensivist
#10
REVIEW
Yonatan Y Greenstein, Paul H Mayo
The assessment of left ventricular diastolic function is an important element of advanced critical care echocardiography. Standard methods of evaluating diastolic function that are routinely performed on an elective basis in the cardiology echocardiography laboratory may be difficult to apply in the critical care unit. In this article, we review methods of measuring diastolic function with echocardiography that are of relevance to the intensivist and present two options for measurement: the standard cardiology method and a simplified approach...
November 4, 2017: Chest
https://www.readbyqxmd.com/read/29108815/non-invasive-blood-pressure-monitoring-in-the-critically-ill-time-to-abandon-the-intra-arterial-catheter
#11
REVIEW
Karim Lakhal, Stephan Ehrmann, Thierry Boulain
Although its reliability is often questioned, non-invasive blood pressure (NIBP) monitoring with an oscillometric arm cuff is widely used, even in shocked critically ill patients. When correctly implemented, modern arm NIBP devices actually can provide accurate and precise measurements of mean blood pressure as well as clinically meaningful information such as identification of hypo- and hypertensive patients and monitoring of response to therapy. Even in specific circumstances such as arrhythmia, hypotension, vasopressor infusion and possibly in obese patients, arm NIBP could be useful, contrary to widespread belief...
November 3, 2017: Chest
https://www.readbyqxmd.com/read/29103942/chest-home-of-the-clinician-educator
#12
William F Kelly, Alexander S Niven
No abstract text is available yet for this article.
November 2, 2017: Chest
https://www.readbyqxmd.com/read/29100885/a-phase-ii-clinical-trial-of-low-dose-inhaled-carbon-monoxide-in-idiopathic-pulmonary-fibrosis
#13
Ivan O Rosas, Hilary J Goldberg, Harold R Collard, Souheil El-Chemaly, Kevin Flaherty, Gary M Hunninghake, Joseph A Lasky, David J Lederer, Roberto Machado, Fernando J Martinez, Rie Maurer, Danielle Teller, Imre Noth, Elizabeth Peters, Ganesh Raghu, Joe G N Garcia, Augustine M K Choi
BACKGROUND: Preclinical studies have demonstrated that low-dose carbon monoxide (CO) can abrogate experimental lung fibrosis. To test the therapeutic role of inhaled CO, we designed a clinical study in patients with idiopathic pulmonary fibrosis (IPF). METHODS: We conducted a multicenter, phase IIa, double-blinded, sham-controlled, clinical trial. Patients with IPF were randomized to treatment with inhaled CO at 100 to 200 parts per million or to inhaled 21% oxygen for 2 h daily, twice weekly, for 12 weeks...
October 31, 2017: Chest
https://www.readbyqxmd.com/read/29106902/the-use-of-m-mode-ultrasonography-to-differentiate-the-etiology-of-b-lines
#14
Anup K Singh, Paul H Mayo, Seth Koenig, Aranabh Talwar, Mangala Narasimhan
BACKGROUND: The presence of B lines on lung ultrasonography is a characteristic feature of both cardiogenic pulmonary edema (CPE) and non cardiogenic alveolar interstitial syndrome (NCAIS), so their presence does not allow the clinician to differentiate between the two entities. Our study uses M mode ultrasonography of the pleura to differentiate cardiogenic pulmonary edema vs. non cardiogenic alveolar interstitial syndrome. METHODS: A total of 43 subjects were enrolled in the study and based upon history, physical examination, and chart review the patients were divided into three groups...
October 26, 2017: Chest
https://www.readbyqxmd.com/read/29080709/internet-based-monitoring-in-the-severe-asthma-research-program-identifies-a-subgroup-of-patients-with-labile-asthma-control
#15
Kelly Wong-McGrath, Loren C Denlinger, Eugene R Bleecker, Mario Castro, Ben Gaston, Elliot Israel, Nizar N Jarjour, David T Mauger, Stephen Peters, Brenda R Phillips, Sally E Wenzel, John V Fahy, Michael C Peters
BACKGROUND: We designed an Internet-Based Monitoring Systems (IBS) survey to facilitate monitoring of asthma symptoms and asthma exacerbations in the Severe Asthma Research Program (SARP). Our objective was to evaluate compliance with the IBS survey tool and to explore how data from an IBS tool can inform understanding of asthma phenotypes. METHODS: We invited adult subjects in the SARP III cohort (N = 528) to complete a monthly IBS asthma control survey. We compared the characteristics of subjects who did and those who did not participate in the IBS survey tool...
October 26, 2017: Chest
https://www.readbyqxmd.com/read/29080710/conservative-management-in-traumatic-pneumothoraces-an-observational-study
#16
Steven P Walker, Shaney L Barratt, Julian Thompson, Nick A Maskell
BACKGROUND: Traumatic pneumothoraces are a common consequence of major trauma. Despite this, there is a paucity of literature regarding their optimal management, including the role of conservative treatment. The aim of this study was to assess the treatment, complications and outcomes of traumatic pneumothoraces in patients presenting to a Major Trauma Centre. METHODS: The prospectively collected Trauma Audit and Research Network (TARN) database was used to identify all patients presenting with traumatic pneumothoraces to a UK Major Trauma Centre from April 2012 to December 2016...
October 25, 2017: Chest
https://www.readbyqxmd.com/read/29066390/pulmonary-nodules-a-small-problem-for-many-severe-distress-for-some-and-how-to-communicate-about-it
#17
REVIEW
Christopher G Slatore, Renda Soylemez Wiener
Every year, millions of patients are diagnosed with pulmonary nodules, and as increasing numbers of people undergo lung cancer screening, even more patients will be found to have a nodule. The vast majority of patients cannot benefit from the detection of a pulmonary nodule because most are benign. Accordingly, it is important to develop strategies to minimize harm, in particular the distress of a "near-cancer" diagnosis. In other settings, communication strategies are critical mediators of patient-centered outcomes for those with cancer and those at-risk of cancer...
October 21, 2017: Chest
https://www.readbyqxmd.com/read/29066389/disease-severity-dependence-of-the-longitudinal-association-between-ct-lung-density-and-lung-function-in-smokers
#18
Alejandro A Diaz, Matthew Strand, Harvey O Coxson, James C Ross, Raul San Jose Estepar, David Lynch, Eva M van Rikxoort, Ivan O Rosas, Gary M Hunninghake, Rachel K Putman, Hiroto Hatabu, Andrew Yen, Gregory L Kinney, John E Hokanson, Edwin K Silverman, James Crapo, George R Washko
BACKGROUND: In smokers, the lung parenchyma is characterized by inflammation and emphysema, processes that can result in local gain and loss of lung tissue. CT measures of lung density might reflect lung tissue changes; however, longitudinal data regarding the effects of CT lung tissue on FEV1 in smokers with and without COPD are scarce. METHODS: The 15th percentile of CT lung density was obtained from the scans of 3,390 smokers who completed baseline and 5-year follow-up of the Genetic Epidemiology of COPD (COPDGene) study visits...
October 21, 2017: Chest
https://www.readbyqxmd.com/read/29066388/sleep-disordered-breathing-in-pregnancy
#19
REVIEW
Sushmita Pamidi, R John Kimoff
Emerging literature suggests that sleep-disordered breathing (SDB) worsens over the course of pregnancy and is associated with adverse maternal and fetal outcomes. Earlier studies, using mainly snoring as a surrogate marker for SDB, have shown an increase in the prevalence of SDB during pregnancy compared to the pregravid state. More recently, prospective observational studies using ascertainment of SDB with complete polysomnography have shown a prevalence ranging from ∼17-45% in the third trimester. Pregnancy itself can be associated with daytime hypersomnolence and as such, complaints of increasing fatigue and sleepiness during pregnancy are not specific for the presence of SDB...
October 21, 2017: Chest
https://www.readbyqxmd.com/read/29066387/clinical-course-of-sarcoidosis-in-world-trade-center-exposed-firefighters
#20
Kerry M Hena, Jennifer Yip, Nadia Jaber, David Goldfarb, Kelly Fullam, Krystal Cleven, William Moir, Rachel Zeig-Owens, Mayris P Webber, Daniel M Spevack, Marc A Judson, Lisa Maier, Andrew Krumerman, Anthony Aizer, Simon D Spivack, Jessica Berman, Thomas K Aldrich, David J Prezant
BACKGROUND: Sarcoidosis is believed to represent a genetically primed, abnormal immune response to an antigen exposure or inflammatory trigger, with both genetic and environmental factors playing a role in disease onset and phenotypic expression. In a population of firefighters with post-World Trade Center (WTC) 9/11/2001 (9/11) sarcoidosis, we have a unique opportunity to describe the clinical course of incident sarcoidosis during the 15 years' postexposure and, on average, 8 years following diagnosis...
October 21, 2017: Chest
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