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Annals of the American Thoracic Society

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https://www.readbyqxmd.com/read/28421817/sequential-gm-csf-inhalation-after-whole-lung-lavage-for-pulmonary-alveolar-proteinosis-a-report-of-five-intractable-cases
#1
Shinya Ohkouchi, Keiichi Akasaka, Toshio Ichiwata, Shu Hisata, Hideya Iijima, Toshinori Takada, Hiroki Tsukada, Hideaki Nakayama, Jun-Ichi Machiya, Toshiya Irokawa, Hiromasa Ogawa, Yoko Shibata, Masakazu Ichinose, Masahito Ebina, Toshihiro Nukiwa, Hajime Kurosawa, Koh Nakata, Ryushi Tazawa
Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease characterized by the excessive accumulation of surfactant proteins within the alveolar spaces and by higher titers of autoantibodies to granulocyte/macrophage colony stimulating factor (GM-CSF) in the serum and bronchoalveolar lavage fluid (BALF). The antibodies inhibit the maturation and phagocytosis of alveolar macrophages (AMs). Although the standard therapy for aPAP has been whole-lung lavage (WLL), this procedure is invasive and needs to be repeated for several years...
April 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28421812/the-frequency-of-incidental-findings-and-subsequent-evaluation-in-low-dose-ct-scans-for-lung-cancer-screening
#2
Lillie Morgan, Humberto Choi, Michal Reid, Ali Khawaja, Peter J Mazzone
RATIONALE: The USPSTF recommends lung cancer screening with low-dose chest CT scans (LDCT) for a well-defined high-risk population. Data on the frequency and impact of incidental findings on LDCT scans performed within a centralized lung cancer screening program has not been reported. OBJECTIVES: Previous studies have reported IFs in the setting of clinical trials. We present our findings in a real clinical setting where the decision to manage these findings may depend on factors that are not captured in a research trial such as disclosing IFs, patient preferences, severity of comorbidities, and physician expertise...
April 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28418689/an-official-american-thoracic-society-workshop-report-chemical-inhalational-disasters-biology-of-lung-injury-development-of-novel-therapeutics-and-medical-preparedness
#3
Eleanor M Summerhill, Gary W Hoyle, Sven-Eric Jordt, Bronwen J Jugg, James G Martin, Sadis Matalon, Steven E Patterson, David J Prezant, Alfred M Sciuto, Erik R Svendsen, Carl W White, Livia Veress
This report is based upon the proceedings from the Inhalational Lung Injury Workshop jointly sponsored by the American Thoracic Society (ATS) and the National Institute of Health (NIH)/National Institute of Neurologic Disorders and Stroke (NINDS) Countermeasures Against Chemical Threats (CounterACT) program on May 21, 2013 in Philadelphia, PA. The CounterACT program facilitates research leading to the development of new and improved medical countermeasures for chemical threat agents. The workshop was initiated by the Terrorism and Inhalational Disasters (TID) Section of the Environmental, Occupational, and Population Health Assembly (EOPH) of the ATS...
April 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28410001/respiratory-pattern-and-tidal-volumes-differ-for-pressure-support-and-volume-assured-pressure-support-in-amyotrophic-lateral-sclerosis
#4
Trevor T Nicholson, Sean B Smith, Teepu Siddique, Robert Sufit, Senda Ajroud-Driss, John M Coleman, Lisa F Wolfe
RATIONALE: Amyotrophic Lateral Sclerosis is a progressive neuromuscular disease resulting in respiratory failure and death. Use of non-invasive ventilation (NIV) improves survival. However, use of Volume-Assured Pressure Support (VAPS) has not been extensively studied in ALS. OBJECTIVES: To explore the clinical utility of a detailed evaluation of device-recorded NIV data in the management of chronic respiratory failure in ALS. To determine if there are differences in efficacy between patients using VAPS or PS...
April 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28406727/the-experience-of-patients-with-alcohol-misuse-after-surviving-a-critical-illness-a-qualitative-study
#5
Brendan J Clark, Jacqueline Jones, K Diandra Reed, Rachel Marie Hodapp, Ivor S Douglas, David Van Pelt, Ellen L Burnham, Marc Moss
RATIONALE: Alcohol misuse is common in patients admitted to the intensive care unit (ICU) but there is currently no evidence-based approach to address drinking in ICU survivors. OBJECTIVES: We sought to describe the experience of ICU survivors with alcohol misuse during their hospitalization and the 3 months following hospital discharge in order to inform an alcohol specific intervention for this unique population. METHODS: We conducted a descriptive qualitative study of ICU survivors from medical ICUs in three separate hospitals with a positive screening result on the Alcohol Use Disorders Identification Test...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28406718/pleural-touch-preparations-and-direct-visualization-of-the-pleura-during-medical-thoracoscopy-for-the-diagnosis-of-malignancy
#6
Horiana B Grosu, Macarena R Vial, Erik Vakil, Roberto F Casal, George A Eapen, Rodolfo Morice, John Stewart, Mona G Sarkiss, David E Ost
RATIONALE: During diagnostic thoracoscopy, talc pleurodesis following biopsy is appropriate if the probability of malignancy is sufficiently high. Findings on direct visual assessment of the pleura during thoracoscopy, rapid onsite evaluation (ROSE) of touch preparations (touch preps) of thoracoscopic biopsy specimens and preoperative imaging, may help predict the likelihood of malignancy; however, data on the performance of these methods are limited. OBJECTIVE: To assess the performance of ROSE of touch preps, direct visual assessment of the pleura during thoracoscopy and preoperative imaging in diagnosing malignancy...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28406714/clinical-outcomes-associated-with-achromobacter-species-infection-in-patients-with-cystic-fibrosis
#7
Ranjani Somayaji, Sanja Stanojevic, D Elizabeth Tullis, Anne L Stephenson, Felix Ratjen, Valerie Waters
RATIONALE: Achromobacter species are increasingly identified in individuals with cystic fibrosis (CF), but the clinical outcomes in these patients remain poorly understood. OBJECTIVES: We aimed to determine the association of Achromobacter infection on clinical outcomes in pediatric and adult patients with CF. METHODS: A cohort study of pediatric and adult CF patients was conducted from 1997 - 2014 in Toronto, Canada. Achromobacter spp infection was categorized as no history of infection, intermittent, and chronic infection (≥ 2 positive cultures in preceding 12 months)...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28406713/an-observational-study-of-outcomes-and-tolerances-in-patients-with-cystic-fibrosis-initiated-on-lumacaftor-ivacaftor
#8
Mark T Jennings, Rebecca Dezube, Shruti Paranjape, Natalie E West, Gina Hong, Andrew Braun, Jonathan Grant, Christian A Merlo, Noah Lechtzin
RATIONALE: In July 2015, the FDA approved lumacaftor/ivacaftor for use in patients with CF. This drug targets the primary defect in the CFTR protein that is conferred by the F508del CFTR mutation. OBJECTIVE: As there is limited experience with this therapy outside of clinical trials, this study aims to examine the clinical experience of this new drug in a CF population. METHODS: Retrospective cohort study of individuals followed at the Johns Hopkins CF Center, who initiated treatment with lumacaftor/ivacaftor...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28406710/suboptimal-inspiratory-flow-rates-are-associated-with-chronic-obstructive-pulmonary-disease-and-all-cause-readmissions
#9
Chee H Loh, Stephen P Peters, Tina M Lovings, Jill A Ohar
RATIONALE: Dry powdered inhalers (DPIs) are prescribed after hospitalization for acute exacerbation of COPD (AECOPD). Peak inspiratory flow (PIF) affects DPI delivery. OBJECTIVES: To study the impact of PIF on readmission after hospitalization for AECOPD. METHODS: A retrospective analysis of hospitalized patients, enrolled in an AECOPD care plan, was performed. Data analyzed included PIF, age, gender, length of stay, Charlson Comorbidity Index, COPD Assessment Test (CAT) and Modified Medical Research Council score, % predicted FEV1, FVC and inspiratory capacity (IC)...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28406709/long-term-outcomes-in-a-population-based-cohort-with-respiratory-nontuberculous-mycobacteria-isolation
#10
Emily Henkle, Shannon A Novosad, Sean Shafer, Katrina Hedberg, Sarah A R Siegel, Jennifer Ku, Cara Varley, D Rebecca Prevots, Theodore K Marras, Kevin L Winthrop
RATIONALE: The natural history of nontuberculous mycobacterial (NTM) respiratory infection within the general population is poorly understood. OBJECTIVES: To describe the long-term clinical, microbiologic, and radiographic outcomes of patients with respiratory NTM isolates. METHODS: We previously identified a population-based cohort of patients with respiratory NTM isolation during 2005-6, and categorized patients as cases or non-cases using the ATS/IDSA pulmonary NTM disease criteria at that time...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28406708/pack-year-cigarette-smoking-history-for-determination-of-lung-cancer-screening-eligibility-comparison-of-the-electronic-medical-record-versus-a-shared-decision-making-conversation
#11
Hannah E Modin, Joelle T Fathi, Christopher R Gilbert, Candice L Wilshire, Andrew K Wilson, Ralph W Aye, Alexander S Farivar, Brian E Louie, Eric Vallières, Jed A Gorden
RATIONALE: Implementation of lung cancer screening programs is occurring across the United States. Programs vary in approaches to patient identification and shared decision making. The eligibility of persons referred to screening programs, the outcomes of eligibility determination during shared decision making, and the potential for the electronic medical record to identify eligible individuals have not been well described. OBJECTIVES: Our objectives were to assess the eligibility of individuals referred for lung cancer screening, and compare information extracted from the electronic medical record to information derived from a shared decision making conversation for the determination of eligibility for lung cancer screening...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28399377/transbronchial-lung-cryobiopsy-and-video-assisted-thoracoscopic-lung-biopsy-in-the-diagnosis-of-diffuse-parenchymal-lung-disease-a-meta-analysis-of-diagnostic-test-accuracy
#12
Imran H Iftikhar, Lana Alghothani, Alejandro Sardi, David Berkowitz, Ali I Musani
BACKGROUND: Transbronchial lung cryobiopsy (TBLC) is increasingly being used for the assessment of diffuse pulmonary lung diseases (DPLD). Several studies have shown larger biopsy samples and higher yields compared to conventional transbronchial biopsies. However, the higher risk of bleeding and other complications has raised concerns for widespread use of this modality. OBJECTIVE: To study the diagnostic accuracy and safety profile of TBLC and compare with video assisted thoracoscopic (VATS), by reviewing available evidence from the literature...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28399376/evaluation-of-appropriate-mediastinal-staging-among-ebus-bronchoscopists
#13
Russell J Miller, Lakshmi Mudambi, Macarena R Vial, Mike Hernandez, George A Eapen
RATIONALE: Endobronchial ultrasound (EBUS) has transformed mediastinal staging in lung cancer. A systematic approach, beginning with lymph nodes contralateral to the primary tumor (N3), is considered superior to selective sampling of radiographically abnormal nodes. However, the extent to which this recommendation is followed in practice remains unknown. OBJECTIVES: To assess the frequency in which pulmonologists, pulmonary fellows, and interventional pulmonologists endoscopically stage lung cancer appropriately...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28398090/cardiopulmonary-exercise-testing-in-pediatrics
#14
Tim Takken, Bart C Bongers, Marco van Brussel, Eero A Haapala, Erik Hj Hulzebos
Aerobic fitness is an important determinant of overall health. Higher aerobic fitness has been associated with many health benefits. Because myocardial ischemia is rare in children, indications for exercise testing differ in children compared to adults. Pediatric exercise testing is imperative to unravel the physiological mechanisms of a reduced aerobic fitness and to evaluate intervention effects in children and adolescents with a chronic disease or disability. Cardiopulmonary exercise testing includes the measurement of respiratory gas exchange and is the gold standard for determining aerobic fitness, as well as for examining the integrated physiological responses to exercise in pediatric medicine...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28398079/near-fatal-lung-injury-with-rapid-onset-bronchiectasis-caused-by-traditional-fumigation-therapy-on-the-french-island-of-mayotte
#15
Romain Persichini, Nicolas Allou, Jérôme Allyn, Dominique Grenet, Charles Cerf, Elisabeth Longchampt, Nathalie Coolen-Allou
No abstract text is available yet for this article.
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28398078/fetal-growth-and-childhood-lung-function-in-the-stoppa-twin-study
#16
Anne K Örtqvist, Vilhelmina Ullemar, Cecilia Lundholm, Ralf Kuja-Halkola, Patrik K E Magnusson, Paul Lichtenstein, Jenny Hallberg, Catarina Almqvist
Rationale Associations between fetal growth restriction and lung function impairment could be due to gestational age, shared (familial) genetic and environmental factors. Objectives To study the association between fetal growth and lung function in childhood, while taking gestational age and familial factors into account. Methods Firstly, full cohort analyses of twins were performed to study the association between birth weight, gestational age and fetal growth and lung function (forced expiratory volume in first second (FEV1), forced vital capacity (FVC) and FEV1/FVC) in z-scores before (n=520) and after (n=539) bronchodilator treatment...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28398076/refining-low-physical-activity-measurement-improves-frailty-assessment-in-advanced-lung-disease-and-survivors-of-critical-illness
#17
Matthew R Baldwin, Jonathan P Singer, Debbie Huang, Jessica Sell, Wendy C Gonzalez, Lauren Pollack, Mathew S Maurer, Frank F D'Ovidio, Matthew Bacchetta, Joshua R Sonett, Selim M Arcasoy, Lori Shah, Hilary Robbins, Steven R Hays, Jasleen Kukreja, John R Greenland, Rupal J Shah, Lorriana Leard, Matthew Morrell, Cynthia Gries, Patricia P Katz, Jason D Christie, Joshua M Diamond, David J Lederer
RATIONALE: The frail phenotype has gained popularity as a clinically relevant measure in adults with advanced lung disease and critical illness survivors. Since respiratory disease and chronic illness can greatly limit physical activity, the measurement of participation in traditional leisure-time activities as a frailty component may lead to substantial misclassification of frailty in pulmonary and critical care patients. OBJECTIVES: To test and validate replacing the Duke Activities Scale Index (DASI), a simple 12-item questionnaire, for the Minnesota Leisure Time Activities (MLTA), a detailed questionnaire covering 18 leisure time activities, as the measure of low activity in the Fried frailty phenotype instrument (FFP)...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28398073/the-link-between-reduced-inspiratory-capacity-and-exercise-intolerance-in-chronic-obstructive-pulmonary-disease
#18
Denis E O'Donnell, Amany F Elbehairy, Katherine A Webb, J Alberto Neder
Low inspiratory capacity (IC), chronic dyspnea and reduced exercise capacity are inextricably linked and are independent predictors of increased mortality in chronic obstructive pulmonary disease (COPD). It is no surprise, therefore, that a major goal of management is to improve IC by reducing lung hyperinflation in order to improve respiratory symptoms and health-related quality of life. The negative effects of lung hyperinflation on respiratory muscle and cardio-circulatory function during exercise are now well established...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28388260/acute-exacerbation-and-decline-in-forced-vital-capacity-are-associated-with-increased-mortality-in-idiopathic-pulmonary-fibrosis
#19
Miya O Paterniti, Youwei Bi, Dinko Rekić, Yaning Wang, Banu A Karimi-Shah, Badrul A Chowdhury
RATIONALE: Exploration of forced vital capacity (FVC) as it relates to mortality in idiopathic pulmonary fibrosis (IPF), a chronic, progressive, and ultimately fatal parenchymal lung disease, is important both clinically and to the current drug development paradigm. We evaluated the association between FVC decline and mortality in the largest, well-characterized placebo cohort to date. Additionally, we sought to explore the risk of death from acute exacerbations and further validate previously identified baseline predictors of mortality...
April 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28387543/effect-of-4-aminopyridine-on-genioglossus-muscle-activity-during-sleep-in-healthy-adults
#20
Luigi Taranto-Montemurro, Scott A Sands, Ali Azarbarzin, Melania Marques, Camila M de Melo, Bradley A Edwards, Danny J Eckert, Ludovico Messineo, David P White, Andrew Wellman
RATIONALE: The reduction in upper airway muscle activity from wakefulness to sleep plays a key role in the development of obstructive sleep apnea. Potassium (K+) channels have been recently identified as the downstream mechanisms through which hypoglossal motoneuron membrane excitability is reduced both in non-REM (NREM) and REM sleep. In animal models, the administration of 4-aminopyridine (4-AP), a voltage-gated K+ channel blocker, increased genioglossus activity during wakefulness and across all sleep stages...
April 7, 2017: Annals of the American Thoracic Society
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