Read by QxMD icon Read


Dean E Schraufnagel, John Balmes, Clayton T Cowl, Sara De Matteis, Soon-Hee Jung, Kevin Mortimer, Rogelio Perez-Padilla, Mary B Rice, Horacio Riojas-Rodroguez, Akshay Sood, George D Thurston, Teresa To, Anessa Vanker, Donald J Wuebbles
Although air pollution is well-known to be harmful to the lung and airways, it can also damage most other organ systems of the body. It is estimated that about 500,000 lung cancer deaths and 1.6 million chronic obstructive pulmonary disease (COPD) deaths can be attributed to air pollution, but air pollution may also account for 19% of all cardiovascular deaths and 21% of all stroke deaths. Air pollution has been linked to other malignancies, such as bladder cancer and childhood leukemia. Lung development in childhood is stymied with exposure to air pollutants, and poor lung development in children predicts lung impairment in adults...
November 9, 2018: Chest
Minal S Kale, Juan Wisnivesky, Emanuela Taioli, Bian Liu
BACKGROUND: Low adoption of lung cancer screening is potentially due to inadequate access to a comprehensive lung cancer screening registry (LCSR), currently a requirement for reimbursement by the Centers for Medicare and Medicaid Services. However, variations in LCSR facilities have not been extensively studied. METHODS: We applied a hierarchical clustering method to a comprehensive database integrating state-level LCSR facility density, defined as the number of facilities per 100, 000 at-risk persons, lung cancer outcomes including mortality and stage specific incidence, as well as socio-economic and behavioral factors...
November 9, 2018: Chest
Dean E Schraufnagel, John Balmes, Clayton T Cowl, Sara De Matteis, Soon-Hee Jung, Kevin Mortimer, Rogelio Perez-Padilla, Mary B Rice, Horacio Riojas-Rodroguez, Akshay Sood, George D Thurston, Teresa To, Anessa Vanker, Donald J Wuebbles
Air pollution poses a great environmental risk to health. Outdoor fine particulate matter (PM2.5 ) exposure is the fifth leading risk factor for death in the world, accounting for 4.2 million deaths and more than a hundred million disability-adjusted-life-years lost according to the Global Burden of Disease Report. The World Health Organization attributes 3.8 million additional deaths to Indoor air pollution. Air pollution can harm acutely, usually manifested by respiratory or cardiac symptoms, as well as chronically, potentially affecting every organ in the body...
November 9, 2018: Chest
Wesley H Self, Dandan Liu, Nicholas Strayer, Stephan Russ, Michael J Ward, Nathan I Shapiro, Todd W Rice, Matthew W Semler
BACKGROUND: Septic shock therapies that shorten the time to physiologic and clinical recovery may result in financial savings. However, the financial implications of improving these non-mortal outcomes are not well characterized. Therefore, we quantified hospital charges associated with four outcomes: intensive care unit (ICU) length of stay, duration of invasive mechanical ventilation, duration of vasopressor use, and new renal replacement therapy. METHODS: This was an observational study using administrative data from a large academic hospital in the United States...
November 9, 2018: Chest
Zhu Zhang, Jieping Lei, Xiang Shao, Fen Dong, Jing Wang, Dingyi Wang, Sinan Wu, Wanmu Xie, Jun Wan, Hong Chen, Yingqun Ji, Qun Yi, Xiaomao Xu, Yuanhua Yang, Zhenguo Zhai, Chen Wang
BACKGROUND: Venous thromboembolism (VTE) has emerged as a major public health problem. However, data on VTE burden in China is seldom reported. METHODS: We collected data on patients with principal diagnose of VTE, pulmonary embolism (PE), or deep vein thrombosis (DVT) using the International Classification of Diseases, 10th Revision (ICD-10) from 90 hospitals across China. The trends in hospitalization rate, mortality, length of stay (LOS), and comorbidities from 2007 to 2016 were analyzed...
November 9, 2018: Chest
Klaudia A Kaczmarek, Rachel L Clifford, Alan J Knox
Epigenetic changes are heritable changes in gene expression, without changing the DNA sequence. Epigenetic processes provide a critical link between environmental insults to the airway and functional changes that determine how airway cells respond to future stimuli. There are three primary epigenetic processes: histone modifications, DNA modification, and non-coding RNAs. Airway smooth muscle (ASM) has several important roles in the development and maintenance of the pathological processes occurring in asthma, including inflammation, remodelling and contraction/hyperresponsiveness...
November 8, 2018: Chest
Pamela J McShane, Gregory Tino
Bronchiectasis is an important clinical syndrome due to its increasing prevalence, significant economic burden on healthcare, and associated morbidity. Until recently, the disease was considered an "orphan" and essentially neglected from a therapeutic standpoint. Fortunately, many recent advances have been made in the field. Several national registries have formed to provide databases from which to study bronchiectasis patients. Experts published a consensus definition of a bronchiectasis-specific exacerbation which will serve as a unified definition for future clinical trials...
November 4, 2018: Chest
Jean-Benoit Martinot, Nam N Le-Dong, Etienne Crespeigne, Philip E Silkoff, Valérie Cuthbert, Stéphane Denison, Jean-Christian Borel, Jean-Louis Pépin
RATIONALE: The respiratory effort index derived from vertical mandibular movements (MM-REI) is a potential marker of increased respiratory effort during sleep. We evaluated the effectiveness of mandibular advancement splint therapy using MM-REI, in comparison with the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). METHODS: Fifty-six subjects (median age, 47 years) with OSA treated with a custom mandibular advancement splint (Herbst appliance) were evaluated at the end of the titration procedure when snoring was reported absent by the sleep partner...
October 31, 2018: Chest
Amber J Oberle, Sunita Kumar, Michael Nelson, Monica Kraft, Peter H Lenz
No abstract text is available yet for this article.
October 30, 2018: Chest
David A Schulman, Craig A Piquette, Mir M Alikhan, Neil Freedman, Sunita Kumar, Jennifer McCallister, Babak Mokhlesi, Jean Santamauro, Effie Singas, Eric Stern, Kingman P Strohl, Kenneth R Casey
This manuscript provides a detailed list of the sleep-related curricular competencies for fellows in pulmonary or combined pulmonary and critical care programs. The list was developed through a formal Delphi process, incorporating representatives from the American College of Chest Physicians, the Association of Pulmonary and Critical Care Program Directors, and the American Thoracic Society. The consensus process was also informed by data collected regarding the current scope of practice from both program directors and recent fellowship graduates...
October 27, 2018: Chest
Jesús Villar, Haibo Zhang, Arthur S Slutsky
The acute respiratory distress syndrome (ARDS) is an acute inflammatory pulmonary process triggered by severe pulmonary and systemic insults to the alveolar-capillary membrane. This leads to increased vascular permeability, development of interstitial and alveolar protein-rich edema, leading to acute hypoxemic respiratory failure. Supportive treatment includes the use of lung protective ventilatory strategies which decrease the work of breathing, can improve oxygenation, and minimize ventilator-induced lung injury...
October 27, 2018: Chest
Ariel Jaitovich, Malik M H S Khan, Ria Itty, Hau Chieng, Camille Dumas, Pallavi Nadendla, John Fantauzzi, Recai Yucel, Paul J Feustel, Marc A Judson
BACKGROUND: Skeletal muscle dysfunction occurring as a result of intensive care unit (ICU) admission associates with higher mortality. While preadmission higher body mass index (BMI) correlates with better outcomes, the impact of baseline muscle and fat mass have not been defined. Therefore, we investigated the association of ICU admission's skeletal muscle and fat mass with survival and disability at hospital discharge. METHODS: Single center, prospective, observational cohort study of medical intensive care unit (MICU) patients from an academic institution in the Unites States...
October 27, 2018: Chest
Neal Navani, David Fisher, Jayne F Tierney, Richard J Stephens, Sarah Burdett
BACKGROUND: Clinical staging of NSCLC helps determine prognosis and management of patients; few data exist on accuracy of clinical staging and the impact on treatment and survival of patients. We assessed whether participant or trial characteristics were associated with clinical staging accuracy as well as impact on survival. METHODS: We used individual participant data from RCTs, supplied for a meta-analysis of pre-operative chemotherapy (+/- radiotherapy) versus surgery alone (+/- radiotherapy) in NSCLC...
October 26, 2018: Chest
Colin Suen, Clodagh M Ryan, Talha Mubashir, Najib Ayas, Lusine Abrahamyan, Jean Wong, Babak Mokhlesi, Frances Chung
BACKGROUND: In the surgical setting, obstructive sleep apnea (OSA) is associated with an increased risk of postoperative complications. At present, risk stratification using OSA-associated parameters derived from polysomnography (PSG) or overnight oximetry to predict postoperative complications has not been established. The objective of this narrative review is to evaluate the literature to determine the association between parameters extracted from in-laboratory PSG, portable PSG, or overnight oximetry and postoperative adverse events...
October 22, 2018: Chest
Nichole T Tanner, Gerard A Silvestri
No abstract text is available yet for this article.
October 22, 2018: Chest
Edward J Schenck, Clara Oromendia, Lisa K Torres, David A Berlin, Augustine M K Choi, Ilias I Siempos
BACKGROUND: Observational studies suggest that some patients meeting criteria for acute respiratory distress syndrome (ARDS) no longer fulfill the oxygenation criterion early in the course of their illness. This subphenotype of rapidly improving ARDS has not been well characterized. We attempted to assess the prevalence, characteristics and outcomes of rapidly improving ARDS and to identify which variables are useful to predict it. METHODS: We performed a secondary analysis of patient-level data from six ARDS Network randomized controlled trials...
October 22, 2018: Chest
Michael D Davis, Isao Suzaki, Shuichi Kawano, Kosaku Komiya, Qing Cai, Youngman Oh, Bruce K Rubin
BACKGROUND: Tissue factor (TF) canonically functions as the initiator of the coagulation cascade. TF levels are increased in inflamed airways and appear to be important for tumor growth and metastasis. We hypothesized that airway epithelia release TF as part of a wound repair program. OBJECTIVES: To evaluate whether airway epithelia release TF in response to pro-inflammatory stimuli and investigate roles of TF in cell growth and repair. METHODS: Airway epithelial cells were exposed to 10 μg/mL lipopolysaccharide or 1 ng/mL Transforming Growth Factor beta (TGF-beta)...
October 22, 2018: Chest
Theodore G Liou
Normal cystic fibrosis (CF) transmembrane regulator (CFTR) protein has multiple functions in health and disease. Many mutations in the CFTR gene produce abnormal or absent protein. CFTR protein dysfunction underlies the classic CF phenotype of progressive pulmonary and gastrointestinal pathology but may underlie diseases not usually associated with CF. This review highlights selected extra-pulmonary disease that may be associated with abnormal CFTR. Increasing survival in CF is associated with increasing incidence of diseases associated with aging...
October 22, 2018: Chest
Shona Fielding, Marielle Pijnenburg, Johan C de Jongste, Katharine C Pike, Graham Roberts, Helen Petsky, Anne B Chang, Maria Fritsch, Thomas Frischer, Stanley Szefler, Peter Gergen, Francoise Vermeulen, Robin Vael, Steve Turner
BACKGROUND: Repeated measurements of spirometry and fractional exhaled nitric oxide (FeNO) are recommended as part of the management of childhood asthma, but the evidence base for such recommendations is small. We tested the hypothesis that reducing spirometric indices or increasing FeNO will predict poor future asthma outcomes. METHODS: A one-stage individual patient data meta-analysis used data from seven randomised controlled trials where FeNO was used to guide asthma treatment, and where spirometric indices were also measured...
October 22, 2018: Chest
Jennifer E Bayly, Debra Bernat, Lauren Porter, Kelvin Choi
BACKGROUND: Current research suggests an association of electronic nicotine delivery systems (ENDS) use with asthma symptoms in youth, but little is known about the association of secondhand ENDS aerosol exposure and asthma control. The present study examines the relationship of secondhand ENDS aerosol exposure and asthma exacerbations among youth with asthma. METHODS: Youth who participated in the 2016 Florida Youth Tobacco survey (aged 11-17 years) with a self-reported diagnosis of asthma (n= 11,830) reported asthma attacks in the past 12 months, demographics, cigarette use, cigar use, hookah use, ENDS use, past-30-day secondhand smoke exposure, and past-30-day secondhand ENDS aerosol exposure...
October 22, 2018: Chest
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"