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Annals of the American Thoracic Society

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https://www.readbyqxmd.com/read/28915069/facilitators-and-barriers-to-positive-airway-pressure-adherence-for-adolescents-a-qualitative-study
#1
Zahra Alebraheem, Alene Toulany, Adele Baker, Jennifer Christian, Indra Narang
RATIONALE: Low adherence to positive airway pressure (PAP) treatment for adolescents with obstructive sleep apnea (OSA) can have long-term cardio-metabolic and developmental impact. OBJECTIVES: To explore the facilitators and barriers to PAP use in adolescents with OSA. METHODS: We conducted a qualitative study using a descriptive thematic analysis approach. A total of 21 interviews were conducted in the clinical setting with adolescents prescribed PAP to treat OSA within the previous 12 months...
September 15, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28910146/management-of-ards-and-refractory-hypoxemia-a-multicenter-observational-study
#2
Erick H Duan, Neill Kj Adhikari, Frederick D'Aragon, Deborah J Cook, Sangeeta Mehta, Waleed Alhazzani, Ewan Goligher, Emmanuel Charbonney, Yaseen M Arabi, Tim Karachi, Alexis F Turgeon, Lori Hand, Qi Zhou, Peggy Austin, Jan Friedrich, Francois Lamontagne, François Lauzier, Rakesh Patel, John Muscedere, Richard Hall, Pierre Aslanian, Thomas Piraino, Martin Albert, Sean M Bagshaw, Mike Jacka, Gordon Wood, William Henderson, Delbert Dorscheid, Niall D Ferguson, Maureen O Meade
RATIONALE: Clinicians' current practice patterns in the management of acute respiratory distress syndrome (ARDS) and refractory hypoxemia are not well described. OBJECTIVES: To describe mechanical ventilation strategies and treatment adjuncts for adults with ARDS including refractory hypoxemia. METHODS: Prospective cohort study (March 2014-February 2015) of mechanically ventilated adults with moderate-to-severe ARDS requiring FiO2 ≥0.50 in 24 ICUs...
September 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28910142/distinct-phenotypes-of-smokers-with-fixed-airflow-limitation-identi%C3%AF-ed-by-cluster-analysis-of-severe-asthma
#3
Satoshi Konno, Natsuko Taniguchi, Hironi Makita, Yuji Nakamaru, Kaoruko Shimizu, Noriharu Shijubo, Satoshi Fuke, Kimihiro Takeyabu, Mitsuru Oguri, Hirokazu Kimura, Yukiko Maeda, Masaru Suzuki, Katsura Nagai, Yoichi M Ito, Sally E Wenzel, Masaharu Nishimura
RATIONALE: Smoking may have multifactorial effects on asthma phenotypes, particularly in severe asthma. Cluster analysis has been applied to explore novel phenotypes, which are not based on any priori hypotheses. OBJECTIVE: To explore novel severe asthma phenotypes by cluster analysis when including smoking asthmatics. METHODS: We recruited a total of 127 subjects with severe asthma, including 59 current or ex-smokers, from our university hospital and its 29 affiliated hospitals/pulmonary clinics...
September 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28846440/low-tidal-volume-versus-non-volume-limited-strategies-for-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#4
Allan J Walkey, Ewan Goligher, Lorenzo Del Sorbo, Carol Hodgson, Neill Kj Adhikari, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Dean Hess, Daniel S Talmor, B Taylor Thompson, Roy G Brower, Eddy Fan
RATIONALE: Trials investigating use of lower tidal volumes and inspiratory pressures for patients with acute respiratory distress syndrome (ARDS) have shown mixed results. OBJECTIVES: To compare clinical outcomes of mechanical ventilation strategies that limit tidal volumes and inspiratory pressures (LTV) to strategies with tidal volumes of 10-15 mL/kg among patients with ARDS. METHODS: Systematic review and meta-analysis of clinical trials investigating LTV mechanical ventilation strategies...
August 28, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28837781/reply-unilateral-pulmonary-edema-after-visiting-high-altitude
#5
Sujith V Cherian, Rosa M Estrada-Y-Martin
N/A.
August 24, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28825846/sleep-disturbance-in-smokers-with-preserved-pulmonary-function-and-chronic-obstructive-pulmonary-disease
#6
Lucas M Donovan, Peter J Rise, Shannon S Carson, Laura C Feemster, Matthew F Griffith, Vishesh K Kapur, Jerry A Krishnan, Peter K Lindenauer, Richard A Mularski, Edward T Naureckas, Brian N Palen, Elizabeth C Parsons, Laura J Spece, Michael V Vitiello, David H Au
RATIONALE: Sleep disturbance frequently affects patients with chronic obstructive pulmonary disease (COPD), and is associated with reduced quality of life and poorer outcomes. Recent data indicate that smokers with preserved pulmonary function have clinical symptoms similar to those meeting spirometric criteria for COPD, but little is known about the driving factors for sleep disturbance in this population of emerging interest. OBJECTIVES: To compare the magnitude and correlates of sleep disturbance between smokers with preserved pulmonary function and those with airflow obstruction...
August 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28820615/looking-back-and-then-forward-to-solve-our-environmental-health-problems
#7
Mary B Rice, Jonathan M Samet
N/A.
August 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28820609/cardio-pulmonary-interactions-physiologic-basis-and-clinical-applications
#8
Michael R Pinsky
The hemodynamic effects of ventilation can be grouped into three concepts: 1) spontaneous ventilation is exercise; 2) changes in lung volume alter autonomic tone, pulmonary vascular resistance, and can compress the heart in the cardiac fossa; 3) spontaneous inspiratory efforts decrease intrathoracic pressure (ITP) increasing venous return and impeding left ventricular (LV) ejection; whereas positive pressure ventilation decreases venous return and unloads LV ejection. Spontaneous inspiratory efforts may induce acute LV failure and cardiogenic pulmonary edema...
August 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28820608/skeletal-muscle-ultrasound-in-critical-care-a-tool-in-need-of-translation
#9
Marina Mourtzakis, Selina Parry, Bronwen Connolly, Zudin Puthucheary
With the emerging interest in documenting and understanding muscle atrophy and function in critically ill patients and survivors, ultrasonography has transformational potential in measuring muscle quantity and quality. Here, we discuss the importance of quantifying skeletal muscle in the ICU setting. We also identify the merits and limitations of various modalities that are capable of accurately and precisely measuring muscularity. Ultrasound is emerging as a potentially powerful tool for skeletal muscle quantification; however, there are key challenges that need to be addressed in future work to ensure useful interpretation and comparability of results across diverse observational and interventional studies...
August 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28817307/geographic-distribution-of-nontuberculous-mycobacterial-species-identified-among-clinical-isolates-in-the-united-states-2009-2013
#10
Alicen B Spaulding, Yi Ling Lai, Adrian M Zelazny, Kenneth N Olivier, Sameer S Kadri, D Rebecca Prevots, Jennifer Adjemian
RATIONALE: Nontuberculous mycobacteria are an important cause of morbidity in the United States, although patient outcomes vary greatly by species. Currently, nationally representative data on the distribution of mycobacterial species from clinical isolates are limited. OBJECTIVES: Using a national hospitalization database capturing microbiologic data for nearly six million patient encounters, we describe the geographic distribution of, and patient demographic features associated with, clinical mycobacterial isolates in the United States...
August 17, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28812906/recent-advances-in-ct-imaging-in-chronic-obstructive-pulmonary-disease
#11
Sandeep Bodduluri, Joseph M Reinhardt, Eric A Hoffman, John D Newell, Surya P Bhatt
Lung imaging is increasingly being used to diagnose, quantify and phenotype chronic obstructive pulmonary disease (COPD). Although spirometry is the gold standard for the diagnosis of COPD and for severity staging, the role of computed tomography (CT) imaging has expanded in both clinical practice and research. COPD is a heterogeneous disease with considerable variability in clinical features, radiographic disease, progression and outcomes. Recent studies have examined the utility of CT imaging in enhancing diagnostic certainty, improving phenotyping, predicting disease progression and prognostication, patient selection for intervention, and also in furthering our understanding of the complex pathophysiology of this disease...
August 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28806531/tidal-carbon-dioxide-as-a-prognostic-feature-in-inoperable-chronic-thromboembolic-pulmonary-hypertension
#12
Manuel J Richter, Khodr Tello, Katrin Milger, Hossein A Ghofrani, Henning Gall
No abstract text is available yet for this article.
August 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28806530/reply-tidal-carbon-dioxide-as-a-prognostic-feature-in-inoperable-chronic-thromboembolic-pulmonary-hypertension
#13
Caitlin E Welch, Anna R Hemnes
No abstract text is available yet for this article.
August 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28800256/the-critical-care-crisis-of-opioid-overdoses-in-the-united-states
#14
Jennifer P Stevens, Michael J Wall, Lena Novack, John Marshall, Douglas J Hsu, Michael D Howell
RATIONALE: Opioid abuse is increasing, but its impact on critical care resources in the United States is unknown. OBJECTIVE: We hypothesized that there would be a rising need for critical care among opioid-associated overdoses in the United States. METHODS: We analyzed all adult admissions using a retrospective cohort study from 162 hospitals in 44 states discharged between January 1, 2009 - September 31, 2015 to describe the incidence of intensive care unit (ICU) admissions for opioid overdose over this time...
August 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28799774/real-time-surveillance-of-influenza-morbidity-tracking-intensive-care-unit-resource-utilization
#15
Arthur W Baker, Michael B Edmond, Loreen A Herwaldt, Luke F Chen, Sudha Srikantaswamy, Daniel J Sexton
RATIONALE: Existing real-time surveillance of influenza morbidity, based primarily upon time-trended U.S. hospitalization and death data, is inadequate. These surveillance methods do not accurately predict hospital resource requirements or sufficiently capture the public health impact of the current influenza season. OBJECTIVES: To determine the feasibility and potential usefulness of tracking surrogate markers of influenza morbidity among patients hospitalized with influenza...
August 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28796538/oxygen-therapy-for-interstitial-lung-disease-physicians-perceptions-and-experiences
#16
Yet H Khor, Nicole Sl Goh, Christine F McDonald, Anne E Holland
RATIONALE: Domiciliary oxygen therapy (DOT) is commonly prescribed for patients with interstitial lung disease (ILD) and hypoxaemia, although evidence supporting benefit is limited. OBJECTIVES: The aim of this study was to explore perspectives of respiratory physicians about DOT in patients with ILD. METHODS: A qualitative study was undertaken with 26 respiratory physicians from Australia. Interviews were transcribed verbatim and coded independently by two investigators...
August 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28796532/hospital-variation-in-do-not-resuscitate-orders-and-end-of-life-healthcare-use-in-the-united-states
#17
Allan J Walkey, Amber E Barnato, Seppo T Rinne, Colin R Cooke, Meng-Shiou Shieh, Penelope S Pekow, Peter K Lindenauer
N/A.
August 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28796527/role-of-leptin-in-obstructive-sleep-apnea
#18
Ikuyo Imayama, Bharati Prasad
Leptin is a peptide hormone mainly produced in white adipose tissue. It is known to regulate energy homeostasis, inflammation, metabolism, and sympathetic nerve activity. Increasing evidence suggests it has a role in ventilatory function and upper airway obstruction. Leptin levels correlate positively with measurements of adiposity and can potentially provide important insights into the pathophysiology of diseases associated with obesity. Obesity is a strong risk factor for obstructive sleep apnea, a disease characterized by periodic upper airway occlusion during sleep...
August 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28795838/hospital-procalcitonin-testing-and-antibiotic-treatment-of-patients-admitted-for-copd-exacerbation
#19
Peter K Lindenauer, Meng-Shiou Shieh, Mihaela S Stefan, Kimberly A Fisher, Sarah D Haessler, Penelope S Pekow, Michael B Rothberg, Jerry A Krishnan, Allan J Walkey
RATIONALE: Randomized trials suggest that assessment of serum procalcitonin (PCT) levels can be used to safely limit antibiotic use among patients hospitalized for exacerbations of COPD. OBJECTIVES: To determine the impact of PCT testing on antibiotic treatment of patients hospitalized for exacerbations of COPD in routine practice. METHODS: We conducted a series of cross-sectional and longitudinal multivariable analyses using data from 2009-2011 and 2013-2014 from a sample of 505 US hospitals Results: Of 203,177 patients hospitalized for COPD exacerbation in 2013-14, nearly 9 out of 10 were treated with antibiotics...
August 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28787174/an-association-of-air-pollution-exposure-and-severe-bronchiolitis-hospitalizations-a-population-based-study
#20
Maayan Yitshak-Sade, Dror Yudovitch, Victor Novack, Asher Tal, Itai Kloog, Aviv Goldbart
Background Several studies have found higher risks for childhood respiratory illness, associated with exposure to Particulate Matter<10µm[PM10] and <2.5µm in diameter[PM2.5] and gaseous pollution. We analyzed the association between air pollution and hospitalizations due to bronchiolitis, an obstructive pulmonary disorder, commonly caused by RSV infant infection. Methods Data were obtained from a local tertiary medical center providing services for a population of 700,000 comprising two ethnic groups: predominantly urban Jews and rural Bedouin-Arabs...
August 8, 2017: Annals of the American Thoracic Society
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