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Annals of the American Thoracic Society

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https://www.readbyqxmd.com/read/28208030/intensive-care-unit-admission-and-survival-among-older-patients-with-chronic-obstructive-pulmonary-disease-heart-failure-or-myocardial-infarction
#1
Thomas S Valley, Michael W Sjoding, Andrew M Ryan, Theodore J Iwashyna, Colin R Cooke
RATIONALE: Admission to an intensive care unit (ICU) may be beneficial to pneumonia patients with uncertain ICU needs; however, evidence regarding the association between ICU admission and mortality for other common conditions is largely unknown. OBJECTIVES: To estimate the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI)...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28207287/thiamine-as-a-renal-protective-agent-in-septic-shock-a-secondary-analysis-of-a-randomized-double-blind-placebo-controlled-trial
#2
Ari Moskowitz, Lars W Andersen, Michael N Cocchi, Mathias Karlsson, Parth V Patel, Michael W Donnino
RATIONALE: Acute kidney injury (AKI) is common in patients with sepsis and has been associated with high mortality rates. The provision of thiamine to septic patients may reduce the incidence and severity of sepsis-related AKI and thereby prevent renal failure requiring renal replacement therapy (RRT). OBJECTIVES: To test the hypothesis that thiamine supplementation mitigates kidney injury in septic shock. METHODS: This was a secondary analysis of a single-center, randomized, double-blind trial comparing thiamine to placebo in patients with septic shock...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28207279/angiotensin-converting-inhibitors-and-angiotensin-ii-receptor-blockers-and-longitudinal-change-in-percent-emphysema-on-computed-tomography-the-mesa-lung-study
#3
Megha A Parikh, Carrie P Aaron, Eric A Hoffman, Joseph E Schwartz, Jaime Madrigano, John H M Austin, Ravi Kalhan, Gina Lovasi, Karol Watson, Karen Hinckley Stukovsky, R Graham Barr
RATIONALE: Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death in the United States. Emphysema on computed tomography (CT) is associated with increased morbidity and mortality in patients with and without spirometrically defined COPD but no available medications target emphysema.  Transforming growth factor beta (TGF-β) and endothelial dysfunction are implicated in emphysema pathogenesis, and angiotensin II receptor blockers (ARB) inhibit TGF-β, improve endothelial function and restore airspace architecture in murine models...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28199137/patient-and-hospital-characteristics-associated-with-inter-hospital-transfer-for-adults-with-ventilator-dependent-respiratory-failure
#4
Nandita R Nadig, Andrew J Goodwin, Annie N Simpson, Kit N Simpson, Jeremy Richards, Dee W Ford
RATIONALE: Patients with ventilator-dependent respiratory failure have improved outcomes at centers with greater expertise, yet most patients are not treated in such facilities. Efforts to align care for respiratory failure and hospital capability would necessarily require inter-hospital transfer. OBJECTIVES: To characterize the prevalence and patient and hospital factors associated with inter-hospital transfer of adults residing in Florida with ventilator-dependent respiratory failure...
February 15, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28186843/risks-and-cough-aggravating-factors-in-prolonged-cough-epidemiological-observations-from-the-nagahama-cohort-study
#5
Hisako Matsumoto, Yumi Izuhara, Akio Niimi, Yasuharu Tabara, Tadao Nagasaki, Yoshihiro Kanemitsu, Kimihiko Murase, Tsuyoshi Oguma, Isao Ito, Shigeo Muro, Akihiro Sekine, Fumihiko Matsuda, Shinji Kosugi, Takeo Nakayama, Kazuo Chin, Michiaki Mishima
RATIONALE: Chronic cough hypersensitivity, a potentially important concept of chronic or prolonged cough, is featured by heightened cough response to low-intensity stimuli, which may be generated in the absence of airflow limitations or allergic conditions. However, there is little epidemiological evidence to support this. OBJECTIVES: In this large-scale community survey, we aimed to determine risks and cough-aggravating factors of prolonged cough, while focusing on serum IgE levels...
February 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28177656/sarcoidosis-increases-risk-of-hospitalized-infection-a-population-based-study-1976-2013
#6
Patompong Ungprasert, Cynthia S Crowson, Eric L Matteson
RATIONALE: Patients with sarcoidosis may have an increased risk of infection similar to other immune-mediated disorders. However, the data are still limited. OBJECTIVES: To investigate the risk of hospitalized infection among patients with sarcoidosis using a population-based cohort. METHODS: Using the Rochester Epidemiology Project record-linkage system, a cohort of incident cases of sarcoidosis in Olmsted County, Minnesota from 1976-2013 was identified...
February 8, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28165295/trainee-wellness-why-it-matters-and-how-to-promote-it
#7
Michelle Sharp, Kristin M Burkart
Wellness is critical to physicians in training and the general physician workforce. Currently physicians in general and especially intensive care unit physicians are experiencing high rates of depression and burnout. The prevalence of burnout is greatest in resident and fellow trainees. The Accreditation Council for Graduate Medical Education has recognized the importance of physician wellness by proposing Common Program Requirements that pertain to trainee and faculty well-being. Several individual-focused, organizational, and structural strategies have been described in the literature as helpful in decreasing burnout...
February 6, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28157394/how-well-prepared-are-medical-and-nursing-students-to-identify-common-hazards-in-the-icu
#8
Alison S Clay, Saumil M Chudgar, Kathleen M Turner, Jacqueline Vaughn, Nancy W Knudsen, Jeanne M Farnan, Vineet M Arora, Margory A Molloy
RATIONALE: Care in the hospital is hazardous. Harm in the hospital may prolong hospitalization, increase suffering, result in death, and increase costs of care. While the interprofessional team is critical to eliminating hazards that may result in adverse events to patients, professional students' formal education may not prepare students adequately for this role. OBJECTIVES: To determine if medical and nursing students can identify hazards of hospitalization that could result in harm to patients and to detect differences between professions in the types of hazards identified...
February 3, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28157389/critical-thinking-in-critical-care-five-strategies-to-improve-teaching-and-learning-in-the-intensive-care-unit
#9
Margaret M Hayes, Souvik Chatterjee, Richard M Schwartzstein
Critical thinking, the capacity to be deliberate about thinking, is increasingly the focus of undergraduate medical education, but is not commonly addressed in graduate medical education. Without critical thinking, physicians, particularly residents, are prone to cognitive errors, which can lead to diagnostic errors, especially in a high stakes environment such as the intensive care unit. Although challenging, critical thinking skills can be taught. Currently there is a paucity of data to support an educational gold standard for teaching critical thinking, but we believe that five strategies, routed in cognitive theory and our personal teaching experiences, provide an effective framework to teach critical thinking in the intensive care unit...
February 3, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28145770/objective-and-structured-assessment-of-lung-ultrasound-competence-a-multispecialty-delphi-consensus-and-construct-validity-study
#10
Søren Helbo Skaarup, Christian B Laursen, Anne Sofie Bjerrum, Ole Hilberg
RATIONALE: Point-of-care lung ultrasound imaging has substantial diagnostic value and is widely used in respiratory, emergency and critical care medicine. Like other ultrasound examinations, lung ultrasound is operator-dependent. The current recommendations for competence in lung ultrasound sets a fixed number of ultrasound procedures to be performed without considering different learning rates. Recommendations do not consider different uses of lung ultrasound across specialties. OBJECTIVE: To create a reliable, valid and feasible instrument to assess lung ultrasound competence that includes the diverse use of lung ultrasound among medical specialties...
February 1, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28145736/central-line-proficiency-test-outcomes-after-simulation-training-vs-traditional-training-to-competence
#11
Ali A Alsaad, Vandana Y Bhide, Jimmy L Moss, Scott M Silvers, Margaret M Johnson, Michael J Maniaci
RATIONALE: Studies have shown the importance of simulation-based training on the outcomes of central venous catheter (CVC) insertion by trainees. OBJECTIVES: To compare the performance of internal medicine trainees who underwent standardized simulation training of CVC insertion to that of internal medicine trainees who had traditional CVC training and were already deemed competent to perform the procedure during a proficiency evaluation using a training mannequin...
February 1, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28145734/-fellow-of-the-day-a-novel-trainee-role-to-improve-fellows-outpatient-continuity-clinics
#12
Diana J Kelm, Joseph Skalski, Kannan Ramar
RATIONALE: The implementation of team-based care models in residency programs is one method to improve patient and provider outpatient satisfaction. However, to our knowledge, this has not yet been studied in fellowship programs. OBJECTIVES: We instituted a pilot project to test a team-based model of care in our Pulmonary and Critical Care Medicine (PCCM) fellows' clinic by creating a new outpatient role called the "Fellow of the Day" with the goal of reducing clinical disruption for the fellows, provide more educational value for medical students, and improve patient care...
February 1, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28128966/assessing-patient-and-provider-perceptions-of-factors-associated-with-patient-engagement-in-asthma-care
#13
Tamar Sapir, Kathleen F Moreo, Laurence S Greene, Laura C Simone, Jeffrey D Carter, James J L Mateka, Nicola A Hanania
RATIONALE: National quality improvement initiatives emphasize building partnerships between patients and providers by promoting patient engagement through communication, shared decision-making, and self-care skills. Efforts to promote patient engagement are especially important for people with asthma. To cultivate effective partnerships in asthma care, patients and providers may benefit from understanding each other's values and perceptions regarding treatment goals, shared decision-making, and barriers to optimal care and outcomes...
January 27, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28125277/the-african-pediatric-fellowship-training-program-in-pediatric-pulmonology-a-model-for-growing-african-capacity-in-child-lung-health
#14
Heather J Zar, Aneesa Vanker, Diane Gray, Marco Zampoli
Childhood respiratory diseases are the major cause of mortality and morbidity in African children. However, there is limited expertise in pediatric pulmonology in Africa. The African Pediatric Fellowship Program (APFP) was developed in the Department of Pediatrics and Child Health at the University of Cape Town in partnership with African academic institutions beyond South Africa to promote training of African child health professionals and build capacity. From 2008 to 2016, 11 fellows have completed APFP training in pediatric pulmonology...
January 26, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28118039/residence-in-rural-areas-of-the-united-states-and-lung-cancer-mortality-disease-incidence-treatment-disparities-and-stage-specific-survival
#15
Graham T Atkins, Taeha Kim, Jeffrey Munson
RATIONALE: There is increased lung cancer mortality in rural areas of the United States. However, it remains unclear to what extent rural-urban differences in disease incidence, stage at diagnosis or treatment explain this finding. OBJECTIVES: To explore the relationship between smoking rates, lung cancer incidence, and lung cancer mortality in populations across the rural-urban continuum. To determine whether survival is decreased in rural patients diagnosed with lung cancer and whether this is associated with rural-urban differences in stage at diagnosis or the treatment received...
January 24, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28118021/notification-of-nontuberculous-mycobacteria-an-australian-perspective
#16
Rachel Thomson, Ellen Donnan, Anastasios Konstantinos
In Queensland, Australia, all cases of mycobacterial infection (TB and NTM) are notifiable under the Queensland Public Health Act (2005). This process originally emerged to avoid NTM confounding with notification of cases of Tuberculosis, but has facilitated awareness of the increasing incidence and changing epidemiology of NTM.(1) While initially not a public health priority, the notification process has facilitated research that has led to an appreciation of both public health and environmental health issues associated with these pathogens...
January 24, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28099054/association-between-do-not-resuscitate-do-not-intubate-status-and-resident-physician-decision-making-a-national-survey
#17
Elizabeth K Stevenson, Hashim M Mehter, Allan J Walkey, Renda Soylemez Wiener
RATIONALE: Compared to their Full Code counterparts, patients with Do Not Resuscitate/Do Not Intubate (DNR/DNI) status receive fewer interventions and have higher mortality than predicted by clinical characteristics. OBJECTIVES: To assess whether internal medicine residents, the front-line providers for many hospitalized patients, would manage hypothetical patients differently based on code status. We hypothesized respondents would be less likely to provide a variety of interventions to DNR/DNI patients than Full Code patients...
January 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28086029/implementation-of-a-professional-society-core-curriculum-and-integrated-maintenance-of-certification-program
#18
W Graham Carlos, Jason T Poston, Gaetane C Michaud, Charles S Dela Cruz, Andrew M Luks, Debra Boyer, Paul E Moore, Jakob I McSparron, Margaret M Hayes, Jay S Balachandran, Tisha S Wang, Eileen Larsson, Jennifer Siegel-Gasiewski, Alan Kantz, James M Beck, Carey C Thomson
Medical professional societies exist to foster collaboration, guide career development, and provide continuing medical education opportunities. Maintenance of certification is a process by which physicians complete formal educational activities approved by certifying organizations. The American Thoracic Society (ATS) established an innovative maintenance of certification program in 2012 as a means to formalize and expand continuing medical education offerings. This program is unique as it includes explicit opportunities for collaboration and career development in addition to providing continuing medical education and maintenance of certification credit to society members...
January 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28086028/-busy-being-born-my-path-in-medical-education
#19
Robert M Kotloff
None required.
January 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28079399/safety-and-efficacy-of-tissue-plasminogen-activator-tpa-and-deoxyribonuclease-dnase-for-complicated-pleural-effusions-secondary-to-abdominal-pathology
#20
Adnan Majid, Sebastian Ochoa, Sumit Chatterji, Sebastian Fernandez-Bussy, Fayez Kheir, Estefania Rivera, George Cheng, Erik Folch
RATIONALE: Exudative pleural effusions may arise secondary to inflammation of intra-abdominal structures. Pleural space loculations can complicate these effusions, preventing adequate chest tube drainage and leading to consideration of surgical intervention. Previous studies have demonstrated that intrapleural administration of tissue plasminogen activator (tPA) combined with human recombinant deoxyribonuclease (DNase) can improve fluid drainage and reduce surgery for patients with loculated parapneumonic effusions; however, the efficacy of this treatment has not been evaluated for complicated pleural effusions attributed to intraabdominal inflammation...
January 12, 2017: Annals of the American Thoracic Society
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