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Stephen Greer, Ashley D Miller, Jeremiah S Smith, Jenny M Holcombe, James R Headrick
BACKGROUND: Utilizing our standardized approach to air leak reduction (STAR) protocol has led to a continual decrease in the need for inpatient recovery following lobectomy. Although next day discharges do occur, the current literature hasn't addressed their safety. We analyzed our STAR dataset to study this group and their outcomes. METHODS: A retrospective review of prospectively collected data from the STAR dataset was performed. Characteristics were compared between patients discharged on postoperative day (POD) 1 and those with longer admissions...
June 13, 2018: Annals of Thoracic Surgery
Rahel Kasteler, Linda M H Kam, Annette Weiss, Nicolas Waespe, Grit Sommer, Florian Singer, Nicolas X von der Weid, Marc Ansari, Claudia E Kuehni
BACKGROUND: Childhood cancer survivors are at increased risk for pulmonary morbidity and mortality. International guidelines recommend pulmonary function tests (PFT) during follow-up care. This nationwide study assessed how many children received PFT within 5 years after pulmotoxic treatment in Switzerland, types of tests, and predictors for testing. METHODS: We included all children from the Swiss Childhood Cancer Registry who were diagnosed with cancer from 1990 to 2013 at age 0-16 years, survived for ≥2 years from diagnosis, and had pulmotoxic chemotherapy with bleomycin, busulfan, nitrosoureas, and/or chest radiotherapy...
June 15, 2018: Pediatric Blood & Cancer
Thomas Radtke, Lukas Böni, Peter Bohnacker, Marion Maggi-Beba, Peter Fischer, Susi Kriemler, Christian Benden, Holger Dressel
BACKGROUND: Regular airway clearance by chest physiotherapy and/or exercise is critical to lung health in cystic fibrosis (CF). Combination of cycling exercise and chest physiotherapy using the Flutter® device on sputum properties has not yet been investigated. METHODS: This prospective, randomized crossover study compared a single bout of continuous cycling exercise at moderate intensity (experiment A, control condition) vs a combination of interval cycling exercise plus Flutter® (experiment B)...
June 14, 2018: BMC Pulmonary Medicine
Daniela Gompelmann, Pallav L Shah, Arschang Valipour, Felix J F Herth
Bronchoscopic thermal vapor ablation (BTVA) represents one of the endoscopic lung volume reduction (ELVR) techniques that aims at hyperinflation reduction in patients with advanced emphysema to improve respiratory mechanics. By targeted segmental vapor ablation, an inflammatory response leads to tissue and volume reduction of the most diseased emphysematous segments. So far, BTVA has been demonstrated in several single-arm trials and 1 multinational randomized controlled trial to improve lung function, exercise capacity, and quality of life in patients with upper lobe-predominant emphysema irrespective of the collateral ventilation...
June 12, 2018: Respiration; International Review of Thoracic Diseases
Sara Colella, Maik Haentschel, Pallav Shah, Venerino Poletti, Jürgen Hetzel
The lung biopsy in interstitial lung disease (ILD) represents an important diagnostic step when the clinical and radiological data are insufficient for a firm diagnosis. A growing body of evidence suggests the utility of transbronchial lung cryobiopsy (TBLC) in the diagnostic algorithm of ILD as it allows, compared to transbronchial lung biopsy with conventional forceps, a better identification of complex histological patterns - such as usual interstitial pneumonia - and can provide information which has a clinical impact on the multidisciplinary discussion similar to that provided by surgical lung biopsy...
June 12, 2018: Respiration; International Review of Thoracic Diseases
J M Figueira Gonçalves, L I Pérez Mendez, N Gurbani, I García-Talavera, J L Pérez Pinilla
INTRODUCTION: The COPD-LUCSS-DLCO score had been validated as a predictive tool capable of identifying patients with chronic obstructive pulmonary disease (COPD) and a high mortality risk associated with lung cancer (LC); however, studies have not been conducted yet on its use in standard clinical practice. The aim of this study was to estimate the COPD-LUCSS-DLCO scores for patients with COPD treated in Pulmonology consultations and to determine the incidence of LC in each of the subgroups...
June 7, 2018: Revista Clínica Española
Stylianos Panopoulos, Vassiliki-Kalliopi Bournia, George Konstantonis, Kalliopi Fragiadaki, Petros P Sfikakis, Maria G Tektonidou
OBJECTIVES: To determine predictors of morbidity and mortality in systemic sclerosis (SSc) in a long-term follow-up of an inception cohort of early SSc patients. METHODS: We evaluated clinical manifestations, laboratory and lung function tests at disease onset as predictors of morbidity and mortality in 3rd, 6th and 9th year in SSc patients recruited within 12 months of disease onset. RESULTS: A total of 115 SSc patients (97 women, mean age 48...
June 6, 2018: Autoimmunity Reviews
Caitlin C Jorgenson, Kirsten E Coffman, Bruce D Johnson
The single breath hold maneuver for measuring lung diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO) incorporates multiple sources of variability. This study examined how changes in intrathoracic pressure, inhalation time, and breath hold time affect DLCO, DLNO, alveolar-capillary membrane conductance (DmCO) and pulmonary capillary blood volume (Vc) at rest and during submaximal exercise. Thirteen healthy subjects (mean ± SD; age = 26 ± 3y) performed duplicate tests at rest and during submaximal exercise...
June 6, 2018: Respiratory Physiology & Neurobiology
Peter J Kneuertz, Desmond M D'Souza, Susan D Moffatt-Bruce, Robert E Merritt
BACKGROUND: Patients with limited pulmonary function have a high risk for pulmonary complications following lobectomy. Robotic approach is currently the least invasive approach. We hypothesized that robotic lobectomy may be of particular benefit in high-risk patients. METHODS: We reviewed our institutional Society of Thoracic Surgeons (STS) data on lobectomy patients from 2012 to 2017. Postoperative outcomes were compared between robotic and open lobectomy groups...
June 5, 2018: Journal of Cardiothoracic Surgery
Samuel Y Ash, Rola Harmouche, James C Ross, Alejandro A Diaz, Farbod N Rahaghi, Gonzalo Vegas Sanchez-Ferrero, Rachel K Putman, Gary M Hunninghake, Jorge Onieva Onieva, Fernando J Martinez, Augustine M Choi, Russell P Bowler, David A Lynch, Hiroto Hatabu, Surya P Bhatt, Mark T Dransfield, J Michael Wells, Ivan O Rosas, Raul San Jose Estepar, George R Washko
Purpose To determine if interstitial features at chest CT enhance the effect of emphysema on clinical disease severity in smokers without clinical pulmonary fibrosis. Materials and Methods In this retrospective cohort study, an objective CT analysis tool was used to measure interstitial features (reticular changes, honeycombing, centrilobular nodules, linear scar, nodular changes, subpleural lines, and ground-glass opacities) and emphysema in 8266 participants in a study of chronic obstructive pulmonary disease (COPD) called COPDGene (recruited between October 2006 and January 2011)...
June 5, 2018: Radiology
Robert P Baughman, Oksana A Shlobin, Athol U Wells, Esam H Alhamad, Daniel A Culver, Joseph Barney, Francis C Cordova, Eva M Carmona, Mary Beth Scholand, Marlies Wijsenbeek, Sivagini Ganesh, Surinder S Birring, Vasilis Kouranos, Lanier O'Hare, Joanne M Baran, Joseph G Cal, Elyse E Lower, Peter J Engel, Steven D Nathan
BACKGROUND: Pulmonary hypertension (PH) is a significant cause of morbidity and mortality in sarcoidosis. We established a multi-national registry of sarcoidosis associated PH (SAPH) patients. METHODS: Sarcoidosis patients with PH confirmed by right heart catheterization (RHC) were studied. Patients with pulmonary artery wedge pressure (PAWP) of 15 mmHg or less and a mean pulmonary artery pressure (mPAP) ≥ 25 Hg were subsequently analyzed. Data collected included hemodynamics, forced vital capacity (FVC), diffusion capacity of carbon monoxide (DLCO ), chest x-ray, and 6-min walk distance (6MWD)...
June 2018: Respiratory Medicine
Zhitao Gu, Huimin Wang, Teng Mao, Chunyu Ji, Yangwei Xiang, Yan Zhu, Ping Xu, Wentao Fang
Background: Limited resections for early stage lung cancer have been of increasing interests recently. However, it is still unclear to what extent a limited resection could preserve pulmonary function comparing to standard lobectomy, especially in the context of minimally invasive surgery. The purpose of this study was to evaluate postoperative changes of spirometry in patients undergoing video-assisted thoracic surgery (VATS) lobectomy or limited resections. Methods: Spirometry tests were obtained prospectively before and 6 months after 75 VATS lobectomy, 34 VATS segmentectomy, 15 VATS wedge resection...
April 2018: Journal of Thoracic Disease
Yoon Ki Cha, Jeung Sook Kim, Jae Hyun Kwon
Background: The aims of this study were to quantify pleural plaque volumes (PPVs) by computed tomography (CT) and investigate relations between PPV and pulmonary function after excluding other factors that might affect pulmonary function. Methods: Twenty-six subjects with pleural plaques and pulmonary function test (PFT) results among 1,544 subjects that registered with the Korea Environment Corporation for asbestos damage relief from January 2011 to December 2015 were included...
April 2018: Journal of Thoracic Disease
D Zhang, Y Guan, L Fan, Y Xia, S Y Liu
Objective: To quantify emphysema and air trapping at inspiratory and expiratory phase multi-slice spiral CT(MSCT) scanning in smokers without respiratory symptoms, and analyze the correlation between the CT quantifiable parameters and lung function parameters. Methods: A total of 72 smokers, who underwent medical examinations from September 2013 to September 2016 in Changzheng Hospital were enrolled in this research and were divided into two groups: 24 smokers with COPD and 48 smokers without COPD.Besides, thirty-nine non-smokers with normal pulmonary function were enrolled as the controls...
May 22, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Christopher A Mecoli, Ami A Shah, Francesco Boin, Fredrick M Wigley, Laura K Hummers
Two major complications in scleroderma patients that cause substantial morbidity and mortality are ischemic digital lesions (DL) and pulmonary hypertension (PH). The clinician's ability to predict which patients will develop these complications is imperfect. We conducted a prospective observational cohort study of 300 patients with scleroderma who were followed for at least a 5-year period. At baseline, patients lacked evidence of PH and were without a current DL. At each 6-month visit, the patient was examined for signs/symptoms of PH and/or a DL...
May 26, 2018: Clinical Rheumatology
Boglárka Lilla Szentes, Michael Kreuter, Thomas Bahmer, Surinder S Birring, Martin Claussen, Julia Waelscher, Reiner Leidl, Larissa Schwarzkopf
BACKGROUND: Patients with interstitial lung diseases (ILD) have impaired health-related quality of life (HRQL). Little is known about the applicability of the disease-specific King's Brief Interstitial Lung Disease questionnaire (K-BILD) and the generic EQ-5D-5L in a German setting. METHODS: We assessed disease-specific (K-BILD) and generic HRQL (EQ-5D experience based value set (EBVS) and Visual Analog Scale (VAS)) in 229 patients with different ILD subtypes in a longitudinal observational study (HILDA)...
May 25, 2018: Respiratory Research
Ganesh Raghu, Bernt van den Blink, Mark J Hamblin, A Whitney Brown, Jeffrey A Golden, Lawrence A Ho, Marlies S Wijsenbeek, Martina Vasakova, Alberto Pesci, Danielle E Antin-Ozerkis, Keith C Meyer, Michael Kreuter, Hugues Santin-Janin, Geert-Jan Mulder, Brian Bartholmai, Renu Gupta, Luca Richeldi
Importance: Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with poor prognosis. Approved therapies do not halt disease progression. Objective: To determine the effect of recombinant human pentraxin 2 vs placebo on change from baseline to week 28 in mean forced vital capacity (FVC) percentage of predicted value. Design, Setting, and Participants: Phase 2, randomized, double-blind, placebo-controlled trial conducted at 18 sites in 7 countries of eligible patients with IPF (N = 117; aged 40-80 years; FVC ≥50% and ≤90% predicted; ratio of forced expiratory volume in the first second/FVC >0...
May 20, 2018: JAMA: the Journal of the American Medical Association
Ida Pesonen, Lisa Carlson, Nicola Murgia, Riitta Kaarteenaho, Carl Magnus Sköld, Marjukka Myllärniemi, Giovanni Ferrara
Background: Idiopathic pulmonary fibrosis (IPF) is characterized by progressive loss of lung function with high mortality within the first 5 years from diagnosis. In 2011-2014, two drugs, pirfenidone and nintedanib, have been approved worldwide for prevention of IPF progression. National IPF-registries have been established in both Finland and Sweden. Our study explored potential differences in the care of IPF in these two countries. Methods: Patients included consecutively in the Finnish and Swedish IPF-registries from January 1, 2014 through December 31, 2016 were included in the study...
2018: Multidisciplinary Respiratory Medicine
Joana Caetano, Filipe S Paula, Marta Amaral, Susana Oliveira, José D Alves
OBJECTIVE: The aim of this study was to evaluate the association of nailfold videocapillaroscopy (NVC) changes with the presence and severity of interstitial lung disease (ILD) in systemic sclerosis. METHODS: This was a cross-sectional analysis of 48 systemic sclerosis patients (21 patients with ILD). The NVC characteristics considered were capillary organization, capillary loss (CL), avascular areas, enlarged and giant capillaries, hemorrhages, abnormally shaped capillaries, edema, and intermittent flux...
May 19, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Kohei Aoki, Yotaro Izumi, Wataru Watanabe, Yuji Shimizu, Hisato Osada, Norinari Honda, Toshihide Itoh, Mitsuo Nakayama
BACKGROUND: While many studies have evaluated the change in lung volume before and after lung resection and correlated this with pulmonary function test results, there is very little evidence on the changes in ventilation perfusion ratio (V/Q) before versus after lung resection. In the present pilot study, we evaluated if V/Q mapping can be constructed using dual energy CT images. METHODS: Thirty-one lung cancer patients planned for pulmonary resection were included in this study...
May 18, 2018: Journal of Cardiothoracic Surgery
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