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J Chee, B W S R Robinson, R A Holt, J Creaney
Harnessing the immune system to fight cancer is an exciting advancement in lung cancer therapy. Anti-tumor immunity can be augmented by checkpoint blockade therapy, which removes the inhibition/brakes imposed on the immune system by the tumor. Checkpoint blockade therapy with anti-PD1/anti-PDL1 antibodies causes tumor regression in around 25% of lung cancer patients. In another approach, the immune system is forced or accelerated to attack the tumour, via augmentation of the anti-tumour response against mutations carried by each lung tumour...
October 18, 2016: Chest
Eric L Scholten, Roy Semaan, Peter Illei, Christopher Mallow, Sixto Arias, David Feller-Kopman, Karen Oakjones-Burgess, Bernice Frimpong, Ricardo Ortiz, Hans Lee, Lonny Yarmus
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of thoracic structures is a commonly performed tissue sampling technique. The usage of an inner-stylet in the EBUS needle has never been rigorously evaluated, and may be unnecessary. METHODS: In a prospective randomized single blinded controlled clinical trial, patients with a clinical indication for EBUS-TBNA underwent lymph node sampling using both with-stylet and without-stylet techniques...
October 18, 2016: Chest
Deisy Barrios, Vladimir Rosa-Salazar, Raquel Morillo, Rosa Nieto, Sara Fernández, José Luis Zamorano, Manuel Monreal, Adam Torbicki, Roger D Yusen, David Jiménez
BACKGROUND: For patients diagnosed with acute pulmonary embolism (PE), the prognostic significance of concomitant right heart thrombi (RHT) lacks clarity. METHODS: We performed a meta-analysis of studies that enrolled patients with acute PE to assess the prognostic value of echocardiography-detectable RHT for the primary outcome of short-term all-cause mortality, and the secondary outcome of short-term PE-related mortality. We conducted unrestricted searches of Pubmed and Embase from 1980 through January 31, 2016 and used the terms "right heart thrombi", "pulmonary embolism", and "prognos*"...
October 13, 2016: Chest
Simon Couillard, Pierre Larivée, Josiane Courteau, Alain Vanasse
RATIONALE: A subset of patients with chronic obstructive pulmonary disease (COPD) demonstrates eosinophilic inflammation either in their sputum or blood. Previous studies regarding the association between increased blood eosinophils and poor readmission outcomes are conflicting. OBJECTIVE: Investigate outcomes following severe COPD exacerbations in patients with higher blood eosinophils. METHODS: With an observational study design, hospitalizations for severe COPD exacerbation were retrospectively gathered...
October 13, 2016: Chest
Mina Akizuki, Naoki Serizawa, Atsuko Ueno, Taku Adachi, Nobuhisa Hagiwara
RATIONALE: Balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) improves hemodynamics and exercise capacity. However, its effect on respiratory function is unclear. OBJECTIVES: To investigate the effect of BPA on respiratory function. METHODS: We enrolled inoperable CTEPH who underwent BPA primarily in lower lobe arteries (first series) and upper and middle lobe arteries (second series). We compared changes in hemodynamics and respiratory function between different BPA fields...
October 13, 2016: Chest
Zach Rozenbaum, Shafik Khoury, Galit Aviram, Yaniv Gura, Jack Sherez, Avi Man, Jason Shimiaie, Thierry Le Tourneau, Amir Halkin, Simon Biner, Gad Keren, Yan Topilsky
BACKGROUND: Discriminating circulatory problems with reduced stroke volume from de-conditioning in which the muscles cannot consume O2 normally by gas exchange parameters is difficult. METHODS: We performed combined stress echo and cardio-pulmonary (CPET) tests in 110 patients (20 normal effort capacity, 54 attenuated stroke volume response, 36 de-conditioning) to evaluate multiple hemodynamic parameters and oxygen content difference (A-VO2 Difference) in four predefined activity levels to assess which of the gas measures may help in the discrimination...
October 11, 2016: Chest
Steven Maltby, Peter G Gibson, Heather Powell, Vanessa M McDonald
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are common airway diseases. Individuals with overlapping asthma and COPD experience increased health impairment and severe disease exacerbations. Efficacious treatment options are required for this population. Omalizumab (anti-IgE) therapy is effective in patients with severe, persistent asthma, but limited data are available on efficacy in populations with overlapping asthma and COPD. METHODS: Data from the Australian Xolair Registry (AXR) was used to compare treatment responses in individuals with asthma-COPD overlap to severe asthma alone...
October 11, 2016: Chest
William T Kuo, Justin I Odegaard, Jarrett K Rosenberg, Lawrence V Hofmann
BACKGROUND: Many patients are subjected to the potential risks and morbidity associated with an indwelling IVC filter when standard methods fail to remove the filter. We evaluated the safety and effectiveness of the excimer laser-sheath technique for removing embedded IVC filters. METHODS: Over a 5-year period, 251 consecutive patients undergoing laser-assisted filter retrieval were prospectively enrolled. There were 103 men and 148 women (mean:46 years, range:15-82)...
October 8, 2016: Chest
Bing-Cheng Zhao, Tong-Yi Huang, Qi-Wen Deng, Wei-Feng Liu, Jian Liu, Wen-Tao Deng, Ke-Xuan Liu, Cai Li
BACKGROUND: Postoperative atrial fibrillation/flutter (POAF) is associated with significant morbidity and mortality after general thoracic surgery, but the need and the best agent for prophylaxis remains obscure. METHODS: A systematic literature search was performed to identify randomized controlled trials that compared regimens for POAF prophylaxis after general thoracic surgery. Random-effects meta-analyses with trial sequential analyses were performed to compare the effects of medical prophylaxis versus placebo/usual care...
October 8, 2016: Chest
Jamie S Sheth, John A Belperio, Michael C Fishbein, Ella A Kazerooni, Amir Lagstein, Susan Murray, Jeff L Myers, Richard H Simon, Thomas H Sisson, Baskaran Sundaram, Eric S White, Meng Xia, David Zisman, Kevin R Flaherty
BACKGROUND: Surgical lung biopsy (SLB) is invasive and not possible in all patients with undiagnosed interstitial lung diseases (ILD). We hypothesized that transbronchial biopsy (TBB) findings combined with clinical and high resolution computed tomography (HRCT) data leads to a confident diagnosis congruent to SLB, and therefore avoids the need for SLB in some patients. METHODS: We evaluated 33 patients being evaluated for suspected ILD who underwent HRCT, TBB and SLB...
October 8, 2016: Chest
Ayodeji Adegunsoye, Mary E Strek, Edward Garrity, Robert Guzy, Remzi Bag
Lung transplantation has evolved into a life-saving treatment with improved quality of life for patients with end-stage respiratory failure unresponsive to other medical or surgical interventions. With improving survival rates, the number of lung transplant recipients with pre-existing and post-transplant comorbidities that require attention continues to increase. A partnership between transplant and non-transplant care providers is necessary to deliver comprehensive and optimal care for transplant candidates and recipients...
October 8, 2016: Chest
John W Upham, Yang Xi
Dendritic cells (DC) are potent antigen presenting cells. Because of their particular ability to initiate and regulate cell mediated and humoral immune responses, there is considerable interest in the role that DC play in the pathogenesis of various lung diseases, especially those in which there is an excessive immune response to specific antigens (as in asthma) or a deficient immune response (as in lung cancer). A number of DC subpopulations have been defined in the lungs including myeloid or conventional DC that initiate T-cell immunity and antibody production, and plasmacytoid DC that have an important role in anti-viral immunity and immune tolerance...
October 8, 2016: Chest
Paul M O'Byrne
No abstract text is available yet for this article.
October 6, 2016: Chest
Peter J Barnes
No abstract text is available yet for this article.
October 6, 2016: Chest
Peter J Barnes
No abstract text is available yet for this article.
October 6, 2016: Chest
Paul M O'Byrne
No abstract text is available yet for this article.
October 6, 2016: Chest
Leila Kheirandish-Gozal, David Gozal
Since the initial report 40 years ago on pediatric obstructive sleep apnea syndrome (OSAS) as a distinct and prevalent clinical entity, substantial advances have occurred in the delineation of diagnostic and treatment approaches. However, despite emerging and compelling evidence that OSAS increases the risk for cognitive, cardiovascular and metabolic end-organ morbidities, routine assessment of such morbidities is seldom conducted in clinical practice. One of the major reasons for such discrepancies resides in the relatively labor-intensive and onerous steps that would be required to detect the presence of any of such morbidities, further adding to the already elevated cost of diagnosing the disorder...
October 6, 2016: Chest
Faith S Luyster, Patrick J Strollo, Fernando Holguin, Mario Castro, Eleanor M Dunican, John Fahy, Benjamin Gaston, Elliot Israel, Nizar N Jarjour, David T Mauger, Wendy C Moore, Sally E Wenzel
BACKGROUND: Sleep difficulties are commonly reported by patients with asthma. However, the prevalence of insomnia and its association with disease burden and well-being is unknown. OBJECTIVE: We aimed to determine the prevalance of insomnia, defined as combined sleep-specific complaints with associated daytime symptoms, among a large sample of adults with asthma, and to compare well-being, asthma control, and asthma-related healthcare utilization in individuals with asthma and insomnia and those without insomnia...
October 6, 2016: Chest
Ieuan Edward Shepherd Evans, Pallavi Bedi, Tom M Quinn, Adam T Hill
BACKGROUND: There is increased interest in the association of vascular disease with COPD and pneumonia, but there is a lack of research in this area with patients with bronchiectasis. METHODS: A retrospective study of 400 patients attending a specialist bronchiectasis clinic in NHS Lothian, Edinburgh, UK between May 2013 and September 2014 was conducted. The study assessed the prevalence of vascular disease (ischemic heart disease, cerebrovascular disease, peripheral vascular disease and atrial fibrillation)...
October 6, 2016: Chest
Chul Hwan Park, Kyunghwa Han, Jin Hur, Sang Min Lee, Ji Won Lee, Sung Ho Hwang, Jae Seung Seo, Kye Ho Lee, Woocheol Kwon, Tae Hoon Kim, Byoung Wook Choi
BACKGROUND: An optimal method of pre-operative localization for pulmonary nodules has yet to be established. This systematic review and meta-analysis aimed to compare the success and complication rates associated with three pulmonary nodule localization methods for video-assisted thoracoscopic surgery (VATS): hook-wire localization, microcoil localization, and lipiodol localization. MATERIALS AND METHODS: We searched the PubMed, MEDLINE, and EMBASE databases for prospective or retrospective English language studies of VATS localization in adult patients...
October 4, 2016: Chest
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