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Annals of the American Thoracic Society

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https://www.readbyqxmd.com/read/28326798/indwelling-pleural-catheters-for-patients-with-hematologic-malignancies-a-14-year-single-center-experience
#1
Saadia A Faiz, Priyanka Pathania, Juhee Song, Liang Li, Diwakar D Balachandran, David E Ost, Rodolfo C Morice, Vickie R Shannon, Lara Bashoura, George A Eapen, Carlos A Jimenez
RATIONALE: Placement of an indwelling pleural catheter is an established modality for symptom relief and pleurodesis in the treatment of malignant pleural effusion. Concerns remain regarding possible infectious complications, risk of hemorrhage, and the rate of pleurodesis with the use of pleural catheters in the treatment of hematologic malignancies. OBJECTIVES: The goals of our study were: (1) to evaluate the safety and cumulative incidence of pleurodesis with indwelling pleural catheters for patients with hematologic malignancies; and (2) to evaluate overall survival of this cohort of patients with pleural effusions...
March 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28326793/changes-in-habitual-sleep-duration-after-continuous-positive-airway-pressure-for-obstructive-sleep-apnea
#2
Ryo Tachikawa, Takuma Minami, Takeshi Matsumoto, Kimihiko Murase, Kiminobu Tanizawa, Morito Inouchi, Toru Oga, Kazuo Chin
RATIONALE: Obstructive sleep apnea (OSA) can affect not only sleep quality but also sleep duration. Determining the therapeutic effects of continuous positive airway pressure (CPAP) on habitual sleep profiles may shed light on the impact of OSA on sleep duration. OBJECTIVES: To determine whether and how CPAP affects habitual sleep duration in patients with OSA. METHODS: Assessments of sleep duration and sleep quality were performed on 57 newly diagnosed study subjects with OSA (46 men, median 63 years, apnea-hypopnea index >20 h-1) at baseline and 3 months after initiation of CPAP therapy...
March 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28324671/dose-de-escalation-of-intrapleural-tissue-plasminogen-activator-therapy-for-pleural-infection-the-adapt-project
#3
Natalia Popowicz, Oliver Bintcliffe, Duneesha De Fonseka, Kevin G Blyth, Nicola A Smith, Francesco Piccolo, Geoffrey Martin, Donny Wong, Anthony Edey, Nick Maskell, Y C Gary Lee
RATIONALE: Intrapleural therapy with a combination of tissue plasminogen activator (tPA) 10mg and deoxyribonuclease (DNase) 5mg administered twice daily has been shown in randomized and open-label studies to enable adequate drainage of over 90% of infected pleural effusions without surgery. Potential bleeding risks associated with intrapleural tPA and the drug costs remain important concerns. The ongoing ADAPT (Alteplase Dose Assessment for Pleural infection Therapy) project aims to investigate the efficacy and safety of dose de-escalation for intrapleural tPA...
March 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28324670/relationship-of-antibiotic-treatment-to-recovery-after-acute-fev1-decline-in-children-with-cystic-fibrosis
#4
Wayne J Morgan, Jeffrey S Wagener, David J Pasta, Stefanie J Millar, Donald R VanDevanter, Michael W Konstan
RATIONALE: Children with cystic fibrosis often suffer acute declines in lung function. We previously showed that such declines are not always treated with antibiotics, but did not assess whether treatment improves the likelihood of recovery. OBJECTIVES: To determine whether new antibiotic treatment was associated with recovery from acute FEV1 decline. METHODS: We studied episodes of FEV1 decline (≥10% from baseline) from the Epidemiologic Study of Cystic Fibrosis...
March 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28306323/a-feasibility-assessment-of-behavioral-based-interviewing-to-improve-candidate-selection-for-a-pulmonary-and-critical-care-medicine-fellowship-program
#5
Geneva Tatem, Maria Kokas, Cathy L Smith, Bruno DiGiovine
Traditional interviews for residency and fellowship training programs are an important component in the selection process, but can be of variable value due to a non-standardized approach. We redesigned the candidate interview process for our large pulmonary and critical care medicine fellowship program in the United States using a behavioral-based interview structure. The primary goal of this approach was to standardize the assessment of candidates within non-cognitive domains with the goal of selecting those with the best fit for our institution's fellowship program...
March 17, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28304180/nanomedicine-for-the-treatment-of-acute-respiratory-distress-syndrome-the-2016-ats-bear-cage-award-winning-proposal
#6
Jacob S Brenner
After dozens of clinical trials, there are still no FDA-approved drugs which improve mortality in acute respiratory distress syndrome (ARDS). These poor results may in part be caused by three unique pharmacological challenges presented by ARDS: 1) ARDS patients are fragile due to concomitant multiple organ dysfunction, so do not tolerate off-target side effects of drugs; 2) inhaled drug delivery is impeded by the column of proteinaceous fluid covering the injured alveoli; 3) ARDS is heterogeneous in its underlying pathophysiology, so targeting one pathway is unlikely to improve most patients...
March 17, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28287827/intensive-care-unit-educators-a-multicenter-evaluation-of-behaviors-residents-value-in-attendings
#7
Lekshmi Santhosh, Snigdha Jain, Anna Brady, Michelle Sharp, W Graham Carlos
RATIONALE: It is important for attendings to know which behaviors influence learner perceptions. To date, two studies focusing on general medicine attendings have been published addressing internal medicine residents' perceptions of attendings; there are no data on intensive care unit (ICU) attendings. OBJECTIVES: We sought to expand the evidence regarding this topic through a multicenter study at four geographically diverse academic medical centers. Our study focused on identifying the teaching behaviors of ICU physicians that learners observe in attendings they value as effective educators...
March 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28282243/differences-in-right-ventricular-functional-changes-during-treatment-between-systemic-sclerosis-associated-pulmonary-arterial-hypertension-and-idiopathic-pulmonary-arterial-hypertension
#8
Rahul G Argula, Abhijit Karwa, Abigail Lauer, David Gregg, Richard M Silver, Carol Feghali-Bostwick, Lynn M Schnapp, Kim Egbert, Bruce W Usher, Viswanathan Ramakrishnan, Paul M Hassoun, Charlie Strange
RATIONALE: Patients with scleroderma associated pulmonary arterial hypertension (SSc-PAH) continue to have an unacceptably high mortality despite the progress achieved with pulmonary arterial vasodilator therapies. OBJECTIVES: We sought to determine whether SSc-PAH is a clinically distinct pulmonary vascular disease phenotype when compared to IPAH, based on the progression of echocardiographic right ventricular (RV) dysfunction. METHODS: Retrospective analysis of echocardiographic data in 13 SSc-PAH and 11 IPAH patients was used to delineate the progression of RV dysfunction during single or combination pulmonary arterial vasodilator therapy...
March 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28282227/an-integrated-framework-for-effective-and-efficient-communication-with-families-in-the-adult-intensive-care-unit
#9
Jennifer B Seaman, Robert M Arnold, Leslie P Scheunemann, Douglas B White
The increased focus on patient and family-centered care in adult intensive care units (ICUs) has generated multiple platforms for clinician-family communication beyond traditional interdisciplinary family meetings (family meetings)-including family-centered rounds, bedside or telephone updates, and electronic family portals. Some clinicians and administrators are now using these platforms instead of conducting family meetings. For example, some institutions are moving toward using family-centered rounds as the main platform for clinician-family communication, and some physicians rely on brief daily updates to the family at the bedside or by phone, in lieu of family meetings...
March 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28278389/clinical-equipoise-and-shared-decision-making-in-pulmonary-nodule-management-a-survey-of-american-thoracic-society-clinicians
#10
Jonathan M Iaccarino, James Simmons, Michael K Gould, Christopher G Slatore, Steven Woloshin, Lisa M Schwartz, Renda Soylemez Wiener
RATIONALE: Guidelines for pulmonary nodule evaluation suggest a variety of strategies, reflecting the lack of high-quality evidence demonstrating the superiority of any one approach. It is unclear whether clinicians agree that multiple management options are appropriate at different levels of risk and whether this impacts their decision-making approaches with patients. OBJECTIVES: To assess clinicians' perceptions of the appropriateness of various diagnostic strategies, approach to decision-making, and perceived clinical equipoise in pulmonary nodule evaluation...
March 9, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28272915/national-trends-in-admission-for-aspiration-pneumonia-in-the-united-states-in-2002-2012
#11
Chao-Ping Wu, Yu-Wei Chen, Min-Jung Wang, Evgeny Pinelis
RATIONALE: Aspiration pneumonia is a subset of pneumonias prevalent in elderly patients and patients with neurologic disorders. Previous studies mostly reported incidence and/or mortality rates from regional data or in specific subgroups of patients. There is paucity of nationwide data in contemporary United States population. OBJECTIVES: To describe United States national trends in acute care hospital admission for aspiration pneumonia from 2002 to 2012. METHODS: We used the US Nationwide Inpatient Sample (NIS) database to identify patients admitted with a primary diagnosis of aspiration pneumonia between 2002 and 2012...
March 8, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28267932/hemoglobin-is-a-vital-determinant-of-arterial-oxygen-content-in-hypoxemic-patients-with-pulmonary-arteriovenous-malformations
#12
Abeer Rizvi, Patricia Macedo, Lydia Babawale, Hannah C Tighe, J Michael B Hughes, James E Jackson, Claire L Shovlin
RATIONALE: Arterial partial pressure of oxygen (PaO2), and oxygen saturation (SaO2) are commonly measured in respiratory practice, but arterial oxygen content (CaO2) refers to the volume of oxygen delivered to the tissues per unit blood volume. CaO2 is calculated from SaO2 and the hemoglobin concentration in blood, recognizing that each gram of hemoglobin can transport approximately 1.34mls of oxygen when fully saturated. OBJECTIVES: To prospectively evaluate serial changes in CaO2 in man, incorporating and excluding dynamic changes to oxygenation and hemoglobin parameters that may occur during life...
March 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28267374/patients-with-copd-walk-with-altered-step-time-and-step-width-variability-as-compared-to-healthy-controls
#13
Jennifer M Yentes, Stephen I Rennard, Kendra K Schmid, Daniel Blanke, Nicholas Stergiou
RATIONALE: Compared to controls, patients chronic obstructive pulmonary disease (COPD) have an increased incidence of falls, demonstrate balance deficits, and alterations in medio-lateral trunk acceleration while walking. Measures of gait variability have been implicated as indicators of fall risk, fear of falling, and future falls. OBJECTIVES: To investigate whether alterations in gait variability are found in COPD patients as compared to healthy controls. METHODS: Twenty COPD patients (16 males; 63...
March 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28267357/forecasting-hospital-based-acute-health-services-utilization-rates-for-chronic-obstructive-pulmonary-disease-a-time-series-analysis
#14
Andrea Gershon, Deva Thiruchelvam, Rahim Moineddin, Xiu Yan Zhao, Jeremiah Hwee, Teresa To
RATIONALE: Knowing trends in and forecasting acute care hospital service utilization rates for COPD can enable health care providers, hospitals and health care decision makers to plan for the future. OBJECTIVES: We conducted a time-series analysis using health care administrative data from the province of Ontario, Canada to determine previous trends in acute care hospitalization and emergency department visit rates for COPD and then to forecast future utilization rates...
March 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28267349/oxygen-therapy-for-interstitial-lung-disease-a-mismatch-between-patient-expectations-and-experiences
#15
Yet H Khor, Nicole Sl Goh, Christine F McDonald, Anne E Holland
RATIONALE: Domiciliary oxygen therapy is commonly prescribed for patients with interstitial lung disease and hypoxemia, either at rest or during exertion, with the aim of improving symptoms and functional status. OBJECTIVES: This study aimed to explore perspectives of adults with interstitial lung disease about domiciliary oxygen therapy, comparing insights from patients using and not using oxygen therapy. METHODS: A qualitative study using semi-structured interviews was undertaken on 24 adults residing in and near Melbourne, Australia who had a diagnosis of interstitial lung disease and met the Thoracic Society of Australia and New Zealand Guidelines for domiciliary oxygen therapy...
March 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28253449/representative-chest-auscultation-findings-in-pulmonary-hypertension-phonocardiograms-and-sound-clips
#16
Takahiro Sato, Hiroshi Ohira, Ichizo Tsujino
NA.
March 2, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28253020/efficacy-of-treatment-for-latent-tuberculosis-in-patients-undergoing-treatment-with-a-tumor-necrosis-factor-antagonist
#17
Jungsil Lee, Eunyoung Kim, Eun Jin Jang, Chang-Hoon Lee, Eun Young Lee, Jong Pil Im, Sung Koo Han, Jae-Joon Yim
RATIONALE: Current guidelines recommend that all patients undergoing treatment with a tumor necrosis factor-α antagonists should receive screening for latent tuberculosis and appropriate treatment before initiating the inhibitor. However, no well-designed study has shown the efficacy of treating these patients for latent tuberculosis. OBJECTIVES: To compare the risk of active tuberculosis between tumor-necrosis-factorantagonists users who have received treatment for latent tuberculosis and those who have not...
March 2, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28248571/spontaneous-pneumothoraces-in-patients-with-birt-hogg-dub%C3%A3-syndrome
#18
Nishant Gupta, Elizabeth J Kopras, Elizabeth P Henske, Laura E James, Souheil El-Chemaly, Srihari Veeraraghavan, Matthew G Drake, Francis X McCormack
RATIONALE: Spontaneous pneumothorax is a common complication of Birt-Hogg-Dubé syndrome (BHD). The optimal approach to treatment and prevention of BHD-associated spontaneous pneumothorax, and to advising BHD patients regarding risk of pneumothorax associated with air travel is not well established. METHODS: Patients with BHD were recruited from the Rare Lung Diseases Clinic Network and the BHD Foundation, and surveyed about disease manifestations and air travel experiences...
March 1, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28248552/plasma-soluble-receptor-for-advanced-glycation-endproducts-in-idiopathic-pulmonary-fibrosis
#19
Ani Manichaikul, Li Sun, Alain C Borczuk, Suna Onengut-Gumuscu, Emily A Farber, Susan K Mathai, Weiming Zhang, Ganesh Raghu, Joel D Kaufman, Karen D Hinckley-Stukovsky, Steven M Kawut, Sanja Jelic, Wen Liu, Tasha E Fingerlin, David A Schwartz, Jessica L Sell, Stephen S Rich, R Graham Barr, David J Lederer
RATIONALE: The receptor for advanced glycation endproducts (RAGE) is underexpressed in IPF lung, yet the role of RAGE in human lung fibrosis remains uncertain. OBJECTIVES: To examine (1) the association between IPF risk and variation at rs2070600, a functional missense variant in AGER (the gene that codes for RAGE), and (2) the associations between plasma soluble RAGE (sRAGE) levels with disease severity and time to death or lung transplantation in IPF. METHODS: We genotyped the rs2070600 SNP in 108 adults with IPF and 324 race/ethnicity-matched controls...
March 1, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28248548/lung-function-in-south-african-adolescents-infected-perinatally-with-hiv-and-treated-long-term-with-antiretroviral-therapy
#20
Leah Nyawira Githinji, Diane M Gray, Sipho Hlengwa, Landon Myer, Heather J Zar
RATIONALE: Lung disease is a common cause of mortality and morbidity in HIV-infected adolescents, but there is limited information on the spectrum of lung function impairment in adolescents on antiretroviral therapy. OBJECTIVES: To investigate lung function in HIV-infected adolescents on antiretroviral therapy in the Cape Town Adolescent Antiretroviral Cohort. METHODS: A total of 515 South African adolescents aged 9 to 14 years, stable on antiretroviral therapy for at least 6 months, underwent baseline lung function testing...
March 1, 2017: Annals of the American Thoracic Society
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