33,999 results match your criteria Chest[Journal]


Lung CT densitometry in idiopathic pulmonary fibrosis (IPF) for the prediction of natural course, severity and mortality.

Chest 2019 Feb 8. Epub 2019 Feb 8.

Department of Internal Medicine; Lung Clinic Waldhof-Elgershausen, 35753 Greifenstein, Germany; Member of the German Center for Lung Research; European IPF Registry and Biobank (eurIPFreg/bank). Electronic address:

Introduction: In this study, we retrospectively assessed the relation between physiological measurements, survival and quantitative computed tomographic (HRCT) indices in IPF patients.

Methods: 70 patients (48 male; mean age 66.3 years ± 9. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2019.01.019DOI Listing
February 2019

Chronic Rhinosinusitis Is an Independent Risk Factor for OSA in World Trade Center Responders.

Chest 2019 Feb 25;155(2):375-383. Epub 2018 Oct 25.

Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Background: Many respiratory conditions have been attributed to toxic dust and fume exposure in World Trade Center (WTC) rescue and recovery workers, who frequently report symptoms of OSA. We examined the prevalence of new-onset OSA and tested if the prevalence and severity of OSA are related to the presence of chronic rhinosinusitis (CRS).

Methods: A total of 601 subjects (83% men; age, 33-87 years; BMI, 29. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.10.015DOI Listing
February 2019

A 31-Year-Old Man With Airflow Obstruction, Intrathoracic Adenopathy, and Pulmonary Nodules.

Chest 2019 Feb;155(2):e55-e59

Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH.

Case Presentation: A 31-year-old white man presented for evaluation of productive cough and dyspnea on exertion of 2 months' duration. Associated symptoms included wheezing, chest tightness, and postnasal drip. He was recently treated for pneumonia with a 7-day course of levofloxacin because of an abnormal chest radiograph demonstrating bilateral infiltrates, but his symptoms failed to improve. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1038DOI Listing
February 2019

A 45-Year-Old Woman With Multiple Pulmonary Nodules and Sjögren Syndrome.

Chest 2019 Feb;155(2):e51-e54

Divisions of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Texas Health Science Center at Houston-McGovern Medical School, Houston, TX.

Case Presentation: A 45-year-old woman presented for evaluation for 3 months of coughing and dyspnea. A recent chest CT scan done for workup of her symptoms revealed a 2-cm right-sided pulmonary nodule. She had a medical history of Sjögren syndrome, hypertension, and obesity. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1077DOI Listing
February 2019
1 Read

A 51-Year-Old Man With Unresolved Pulmonary Infiltrates Following Streptococcus pneumoniae Pneumonia.

Chest 2019 Feb;155(2):e47-e50

Division of Pulmonary, Critical Care and Sleep Medicine, UC Davis Medical Center, Sacramento, CA. Electronic address:

Case Presentation: A 51-year-old man presented to the clinic 8 weeks after a 6-day hospital admission for severe multilobar pneumonia caused by Streptococcus pneumoniae. His productive cough resolved after antibiotics, but he reported persistent dyspnea. He recounted a lifelong history of recurrent sinusitis but no previous episodes of pneumonia. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1064DOI Listing
February 2019

A 58-Year-Old Woman With Back Pain and an Unusual Diagnosis.

Chest 2019 Feb;155(2):e37-e42

Department of Radiology, Lenox Hill Hospital, New York, NY.

Case Presentation: A 58-year-old postmenopausal woman presented to her primary care physician with lower back pain. She denied respiratory symptoms. Her medical history is significant for hypertension, hyperlipidemia, and prediabetes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.10.045DOI Listing
February 2019

Lung Ultrasound Diagnosis and Follow-up in a Case of Reexpansion Pulmonary Edema.

Chest 2019 Feb;155(2):e33-e36

Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1091DOI Listing
February 2019

A Woman With an Unusual Postprocedure Chest Radiograph.

Chest 2019 Feb;155(2):e29-e31

Division of Pulmonary, Critical Care, and Sleep Medicine, Medical College of Wisconsin, Milwaukee, WI.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.09.034DOI Listing
February 2019

A 46-Year-Old Woman With an Uncommon Case of Massive Pneumothorax.

Chest 2019 Feb;155(2):e25-e28

Thoracic Surgery Unit, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.

A 46-year-old woman arrived at our ED for the worsening of a thoracic pain localized in the left interscapulo-vertebral region that she had been commenting on for the past few days. Anamnestic data were collected; vital parameters, blood tests, and ECG were normal. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.10.051DOI Listing
February 2019

Acute Hypoxemia and Coma in a Patient With Hemoglobin SC Disease.

Chest 2019 Feb;155(2):e21-e23

Division of Pulmonary and Critical Care, Department of Medicine, Hennepin County Medical Center, Minneapolis, MN. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.10.050DOI Listing
February 2019

Blood Testing for Differential Diagnosis of Pulmonary Alveolar Proteinosis Syndrome.

Chest 2019 Feb;155(2):450-452

Translational Pulmonary Science Center, Cincinnati, OH; Division of Pulmonary Biology, Children's Hospital Medical Center, Cincinnati, OH; Division of Pulmonary Medicine, Children's Hospital Medical Center, Cincinnati, OH; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.11.002DOI Listing
February 2019

Response.

Chest 2019 Feb;155(2):450

Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, England.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.10.031DOI Listing
February 2019

Symptoms Associated With Pertussis Are Insufficient to Rule In or Rule Out the Diagnosis.

Chest 2019 Feb;155(2):449-450

Department of Medicine, University of Washington School of Medicine, Seattle, WA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.10.028DOI Listing
February 2019

Stethoscope: An Introspection.

Chest 2019 Feb;155(2):448

Nashville, TN.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1050DOI Listing
February 2019

And Then.

Authors:
Paul Rousseau

Chest 2019 Feb;155(2):446-447

Charleston, SC.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1041DOI Listing
February 2019

Chronic Thromboembolic Pulmonary Hypertension Cases Cluster in Families.

Chest 2019 Feb;155(2):384-390

Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT; George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT.

Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a serious sequela of pulmonary embolism (PE) and occurs in about 3% of acute PE survivors. Common inherited thrombophilias, including the Factor V Leiden mutation, are not associated with increased risk of CTEPH, even though they increase the risk for VTE. Whether other inherited genetic factors contribute to the risk of developing CTEPH remains unknown. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.10.004DOI Listing
February 2019
1 Read

Rebuttal From Drs Oldham and Danoff.

Chest 2019 Feb;155(2):264-265

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1071DOI Listing
February 2019

Rebuttal From Drs Lee and Fischer.

Chest 2019 Feb;155(2):263-264

Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1072DOI Listing
February 2019

COUNTERPOINT: Does Interstitial Pneumonia With Autoimmune Features Represent a Distinct Class of Patients With Idiopathic Interstitial Pneumonia? No.

Chest 2019 Feb;155(2):260-263

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1073DOI Listing
February 2019

POINT: Does Interstitial Pneumonia With Autoimmune Features Represent a Distinct Class of Patients With Idiopathic Interstitial Pneumonia? Yes.

Chest 2019 Feb;155(2):258-260

Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1074DOI Listing
February 2019

Giants in Chest Medicine: Professor Atul C. Mehta, MBBS, FCCP.

Authors:
James K Stoller

Chest 2019 Feb;155(2):254-257

Cleveland Clinic, Cleveland, OH. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.10.047DOI Listing
February 2019

Indwelling Pleural Catheter for Refractory Hepatic Hydrothorax: The Evidence Is Still Fluid.

Chest 2019 Feb;155(2):251-253

Division of Allergy, Pulmonary and Critical Care Medicin, Vanderbilt University School of Medicine, Nashville, TN. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.07.037DOI Listing
February 2019

The National Heart, Lung, and Blood Institute Lymphangioleiomyomatosis Registry: Making LAMonade out of LAMons.

Authors:
Daniel Dilling

Chest 2019 Feb;155(2):249-250

Division of Pulmonary and Critical Care Medicine, Loyola University Chicago Stritch School of Medicine Ringgold Standard Institution, Maywood, IL. Electronic address:

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692183249
Publisher Site
http://dx.doi.org/10.1016/j.chest.2018.09.013DOI Listing
February 2019
1 Read

Heroin Smoking and COPD: A Case for Targeted Screening Spirometry.

Authors:
Donald P Tashkin

Chest 2019 Feb;155(2):247-248

Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA. Electronic address:

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1039DOI Listing
February 2019

Epilepsy and Sleep Related Breathing Disturbances.

Chest 2019 Jan 31. Epub 2019 Jan 31.

Director, Cleveland Clinic Sleep Disorders Center, Cleveland, OH, US. Electronic address:

Epilepsy is the fourth most common neurological disorder in the US, affecting over 2.2 million people. Epilepsy is associated with a number of medical and psychiatric comorbidities, higher health care utilization, cost and substantial economic burden. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692193006
Publisher Site
http://dx.doi.org/10.1016/j.chest.2019.01.016DOI Listing
January 2019
3 Reads

Overdiagnosis of COPD in subjects with unobstructed spirometry - a BOLD analysis.

Chest 2019 Jan 31. Epub 2019 Jan 31.

Respiratory Epidemiology and Public Health, Imperial College, London, United Kingdom.

Background: There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003-2012.

Methods: A false positive diagnosis of COPD was considered when participants reported a doctor's diagnosis of COPD, but post-bronchodilator spirometry was unobstructed (FEV/FVC>LLN). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2019.01.015DOI Listing
January 2019
1 Read

Principles and Practice of Antibiotic Stewardship in the ICU.

Chest 2019 Jan 25. Epub 2019 Jan 25.

Pulmonary and Critical Care, Northwestern University Feinberg School of Medicine, 240 E. Huron Street, McGaw M-300, Chicago, IL 60611.

In the face of emerging drug resistant pathogens and a decrease in the development of new antimicrobial agents, antibiotic stewardship should be practiced in all critical care units. Antibiotic stewardship should be a core competency of all critical care practitioners in conjunction with a formal Antibiotic Stewardship Program (ASP). Prospective audit and feedback, and antibiotic time outs are effective components of an ASP in the ICU. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692193006
Publisher Site
http://dx.doi.org/10.1016/j.chest.2019.01.013DOI Listing
January 2019
2 Reads

Real-time breath analysis reveals specific metabolic signatures of COPD exacerbations.

Chest 2019 Jan 24. Epub 2019 Jan 24.

Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland. Electronic address:

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) are defined by acute worsening of respiratory symptoms leading to a change in therapy. Identifying altered metabolic processes in patients at risk for future exacerbations is desirable for treatment optimization, the development of new therapeutic strategies, and might also be of diagnostic value. We aimed to identify affected pathways using the profiles of volatile organic compounds in exhaled breath from COPD patients with and without frequent exacerbations (>2 exacerbations within the last 12 months). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.12.023DOI Listing
January 2019
3 Reads

A novel algorithm to analyze epidemiology and outcomes of carbapenem resistance among patients with hospital-acquired and ventilator-associated pneumonia: A retrospective cohort study.

Chest 2019 Jan 24. Epub 2019 Jan 24.

Washington Hospital Center, Washington, DC.

Background: Carbapenem resistance (CR) is a growing concern. Applying a novel algorithm, we examined epidemiology and outcomes of CR among gram-negative (GN) pathogens in hospital-acquired (HAP) and ventilator-associated pneumonia (VAP).

Materials And Methods: In a retrospective cohort design within the Premier Research database (2009-2016), we included all hospitalized adult patients with a gram-negative organism in a respiratory or blood culture who fit criteria for HAP/VAP based on ICD-9-CM codes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.12.024DOI Listing
January 2019
2 Reads

The Association of Waterpipe Smoking and Coronary Artery Calcium in a Community-Based Sample.

Chest 2019 Jan 23. Epub 2019 Jan 23.

Hamad Medical Corporation, Doha Qatar.

Background: Waterpipe smoking is increasing in popularity, driven partly by a perception of reduced harm compared to cigarette smoking. This study evaluates the association of waterpipe smoking with coronary artery calcium (CAC), a marker of coronary heart disease (CHD) risk, in a community-based sample.

Methods: 175 exclusive waterpipe smokers and 170 non-smokers, 35 years and older were recruited from the community in Lebanon and Qatar. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2019.01.010DOI Listing
January 2019

Systemic markers of inflammation in smokers with symptoms despite preserved spirometry in SPIROMICS.

Chest 2019 Jan 23. Epub 2019 Jan 23.

University of California, San Francisco - San Francisco (USA).

Background: Chronic respiratory symptoms and exacerbation-like events are common among ever smokers without airflow limitation on spirometry. The pathobiology of respiratory disease in this subgroup remains poorly defined, but may be due to underlying inflammation that overlaps with COPD or asthma. We hypothesized that symptoms, exacerbations, and functional measures of disease severity among smokers with preserved spirometry would be associated with markers of systemic inflammation, similar to what is reported in bone fide COPD, rather than elevated type 2 inflammation which is often present in asthma. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692193003
Publisher Site
http://dx.doi.org/10.1016/j.chest.2018.12.022DOI Listing
January 2019
2 Reads

Prevalence of atrial fibrillation in hospital encounters with end-stage chronic obstructive pulmonary disease on home oxygen: National trends in the United States.

Chest 2019 Jan 23. Epub 2019 Jan 23.

Department of Health Statistics, Second Military Medical University, Shanghai 200433, China; Tongji University School of Medicine, Shanghai 200092, China. Electronic address:

Background: This study aimed to evaluate the prevalence of atrial fibrillation (AF) in hospital encounters with end-stage chronic obstructive pulmonary disease (COPD) on home oxygen admitted for COPD exacerbation.

Methods: We used the 2003-2014 Nationwide Inpatient Sample to conduct a retrospective analysis. The present study included all patients aged ≥18 years with a primary diagnosis of COPD on home oxygen who were hospitalized for COPD exacerbation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.12.021DOI Listing
January 2019
2 Reads

Adherence to CPAP: What should we be aiming for, and how can we get there?

Chest 2019 Jan 23. Epub 2019 Jan 23.

National Jewish Health, Denver Colorado.

The purpose of this review is to summarize what is currently known regarding two important questions facing the field of sleep medicine today: 1) How many hours of continuous positive airway pressure (CPAP) use per night are necessary to improve daytime symptoms and reduce cardiovascular risk associated with obstructive sleep apnea (OSA)?; and 2) What strategies could be implemented to optimize adherence in clinical settings? Despite the widespread adoption of a threshold approach to CPAP management, the literature to date suggests a dose-response relationship between CPAP usage and a range of outcomes including sleepiness, functional status, and blood pressure, and that the optimal adherence level differs depending on the outcome in question. Over the years, psychological measures of behavior change constructs have been increasingly recognized as the most consistent predictors of CPAP adherence, and as such, the most successful interventions for optimizing adherence have been behavioral in nature. Unfortunately, behavioral therapies have not been translated from highly-controlled research settings to comparative-effectiveness studies and finally into routine care, mainly due to feasibility and cost issues. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2019.01.012DOI Listing
January 2019
2 Reads

Lung Allocation Score Thresholds Prioritize Survival After Lung Transplantation.

Chest 2019 Jan 18. Epub 2019 Jan 18.

Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH; Department of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH. Electronic address:

Background: The lung allocation score (LAS) prioritizes lung transplant (LTx) candidates with poor transplant-free survival and expected survival benefit from LTx. Although patients with the highest LAS have the shortest waiting time, mortality benefit is unclear in this group, raising criticism that the LAS inappropriately prioritizes critically ill candidates. We aim to identify a threshold above which increasing LAS values do not predict increasing survival benefit. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692193002
Publisher Site
http://dx.doi.org/10.1016/j.chest.2019.01.008DOI Listing
January 2019
5 Reads

Which Physicians Are Taking Care of People With COPD?

Chest 2019 Jan 18. Epub 2019 Jan 18.

Department of Medicine, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada. Electronic address:

Background: There is limited knowledge on what proportions of patients with COPD receive ambulatory care from primary care physicians, pulmonologists, or other specialists. We evaluated the types and combinations of physicians who provide ambulatory care to patients with COPD.

Methods: We conducted a population-based cross-sectional study using health administrative datasets from Ontario, Canada between April 1, 2014 and March 31, 2015. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.12.018DOI Listing
January 2019
1 Read

The Impact on Monetized Health Economic Outcomes of Treatments for OSA: A Systematic Review.

Chest 2019 Jan 18. Epub 2019 Jan 18.

Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland, Baltimore, MD.

Objective: To review systematically the published literature regarding the impact of treatment for OSA on monetized health economic outcomes.

Methods: Customized structured searches were performed in PubMed, Embase (Embase.com), and the Cochrane Central Register of Controlled Trials (Wiley) databases. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692193002
Publisher Site
http://dx.doi.org/10.1016/j.chest.2019.01.009DOI Listing
January 2019
6 Reads

Lytic Therapy for Retained Traumatic Hemothorax: A Systematic Review and Meta-analysis.

Chest 2019 Jan 18. Epub 2019 Jan 18.

Department of Surgery, Pennsylvania State University College of Medicine, Hershey, PA; Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, University Park, PA; Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA.

Background: Intrapleural lytic therapy has been established as an important modality of treatment for many pleural disorders, including hemothorax and empyema. Retained traumatic hemothorax is a common and understudied subset of pleural disease. The current standard of care for retained traumatic hemothorax is operative management. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2019.01.007DOI Listing
January 2019
1 Read

Integrating Genomics Into Management of Fibrotic Interstitial Lung Disease.

Chest 2019 Jan 17. Epub 2019 Jan 17.

Division of Pulmonary & Critical Care & Sleep Medicine (Dr Noth), Department of Medicine, University of Virginia, VA.

Fibrotic interstitial lung diseases (ILDs) have a high mortality rate with an unpredictable disease course and clinical features that frequently overlap. Recent data indicate important roles for genomics in the mechanisms underlying susceptibility and progression of pulmonary fibrosis. The impact of these genomic markers on pharmacotherapy and their contribution to outcomes is increasingly recognized. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692193000
Publisher Site
http://dx.doi.org/10.1016/j.chest.2018.12.011DOI Listing
January 2019
5 Reads

Multiple Respiratory Microbiota Profiles Are Associated With Lower Airway Inflammation in Children With Protracted Bacterial Bronchitis.

Chest 2019 Jan 17. Epub 2019 Jan 17.

Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital and the Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia.

Background: Effective management of protracted bacterial bronchitis (PBB) is needed to prevent chronic disease (eg, bronchiectasis). Understanding the contributions of ongoing airway infection and inflammation is important to achieving optimal PBB treatments. The aim of this study was to compare BAL microbiota, bacterial biomass, and inflammatory markers in children with PBB and age-matched control patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2019.01.002DOI Listing
January 2019
3 Reads

Use of CT Scanning to Quantify Progression and Response to Treatment in LAM.

Chest 2019 Jan 17. Epub 2019 Jan 17.

Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Electronic address:

Background: In lymphangioleiomyomatosis (LAM), infiltration of the lungs with smooth muscle-like LAM cells results in cystic destruction and decline in lung function, effects stabilized by sirolimus therapy. LAM lung disease is followed, in part, by high-resolution CT scans. To obtain further information from these scans, we quantified changes in lung parenchyma by analyzing image "texture. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2019.01.004DOI Listing
January 2019
2 Reads

Therapy for Pulmonary Arterial Hypertension in Adults 2018: Update of the CHEST Guideline and Expert Panel Report.

Chest 2019 Jan 17. Epub 2019 Jan 17.

University of Colorado School of Medicine, Aurora, CO. Electronic address:

Background: Pulmonary arterial hypertension (PAH) carries a poor prognosis if not promptly diagnosed and appropriately treated. The development and approval of 14 medications over the last several decades have led to a rapidly evolving approach to therapy, and have necessitated periodic updating of evidence-based treatment guidelines. This guideline statement, which now includes a visual algorithm to enhance its clinical utility, represents the fourth iteration of the American College of Chest Physicians Guideline and Expert Panel Report on Pharmacotherapy for PAH. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.11.030DOI Listing
January 2019
1 Read
7.483 Impact Factor

Genetic polymorphisms in sepsis and cardiovascular disease Do similar risk genes suggest similar drug targets?

Chest 2019 Jan 17. Epub 2019 Jan 17.

University of British Columbia, Critical Care Research Laboratories, Centre for Heart Lung Innovation, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6.

Genetic variants are associated with altered clinical outcome of patients with sepsis and cardiovascular diseases. Common gene signaling pathways may be involved in the pathophysiology of these diseases. A better understanding of genetic commonality among these diseases may enable the discovery of important genes, signaling pathways and therapeutic targets for these diseases. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2019.01.003DOI Listing
January 2019
1 Read

Adding a LAMA to ICS/LABA Therapy: A Meta-analysis of Triple Therapy in COPD.

Chest 2019 Jan 17. Epub 2019 Jan 17.

Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome "Tor Vergata," Rome, Italy.

Background: Inhaled corticosteroid (ICS)/long-acting β-agonist (LABA) combination commonly prescribed to treat COPD; therefore, we performed a meta-analysis on the effect of adding a long-acting muscarinic receptor antagonist (LAMA) to ICS/LABA combination in COPD.

Methods: Studies were identified by searching in different databases the randomized controlled trials that investigated the effect of ICS/LABA/LAMA combination in COPD. The primary end points were the effect of triple therapy on trough FEV, risk of acute exacerbation of COPD (AECOPD), and risk of cardiovascular serious adverse events (SAEs), compared with ICS/LABA combination. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692193001
Publisher Site
http://dx.doi.org/10.1016/j.chest.2018.12.016DOI Listing
January 2019
12 Reads

Hierarchical Condition Categories for Pulmonary Diseases: Population Health Management and Policy Opportunities.

Authors:
Gary E Weissman

Chest 2019 Jan 16. Epub 2019 Jan 16.

Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine, Palliative and Advanced Illness Research Center, Department of Medicine, Perelman School of Medicine, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA. Electronic address:

Hierarchical condition categories (HCCs) are groups of diagnostic codes that are used to adjust federal payments to insurers and health systems based on differences in expected spending. Risk models built on HCCs improve on previous adjustment strategies that used demographic characteristics but did not include clinical diagnoses. Thus, accurate coding by clinicians of inpatient and outpatient encounters ensures capitated payments and reimbursements that are commensurate with predicted expenditures. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692193000
Publisher Site
http://dx.doi.org/10.1016/j.chest.2018.12.013DOI Listing
January 2019
3 Reads

Raw Bioelectrical Impedance Analysis Variables Are Independent Predictors of Early All-cause Mortality in Patients With COPD.

Chest 2019 Jan 17. Epub 2019 Jan 17.

Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center, Private Hospital, Naples, Italy; Department of Medicine and Health Sciences, "V Tiberio" University of Molise, Campobasso, Italy.

Background: Bioelectrical impedance analysis (BIA) is a valuable method for estimating fat-free mass and fat mass in patients with COPD by using specific predictive equations. In addition, raw BIA variables such as high- to low-frequency impedance ratios (IRs) and phase angle, most likely as a result of providing information on muscle quality, have been related to disease severity and mortality in patients with several diseases but never in COPD. The aim of this study was to investigate the predictive role of raw BIA variables on 2-year survival in COPD. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2019.01.001DOI Listing
January 2019

Rhinoviruses and Their Receptors.

Chest 2019 Jan 17. Epub 2019 Jan 17.

Department of Pediatrics, University of Wisconsin-Madison, Madison, WI.

Human rhinoviruses (RVs) are picornaviruses that can cause a variety of upper and lower respiratory tract illnesses, including the common cold, bronchitis, pneumonia, and exacerbations of chronic respiratory diseases such as asthma. There are currently > 160 known types of RVs classified into three species (A, B, and C) that use three different cellular membrane glycoproteins expressed in the respiratory epithelium to enter the host cell. These viral receptors are intercellular adhesion molecule 1 (used by the majority of RV-A and all RV-B types), low-density lipoprotein receptor family members (used by 12 RV-A types), and cadherin-related family member 3 (CDHR3; used by RV-C). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.12.012DOI Listing
January 2019
8 Reads

Outcomes Associated With De-escalating Therapy for Methicillin-Resistant Staphylococcus aureus in Culture-Negative Nosocomial Pneumonia.

Chest 2019 Jan 25;155(1):53-59. Epub 2018 Oct 25.

Barnes-Jewish Hospital, Saint Louis, MO; Saint Louis College of Pharmacy, Saint Louis, MO. Electronic address:

Background: In culture-positive nosocomial pneumonia, de-escalation (DE) from broad-spectrum empirical antimicrobials to narrower-spectrum agents has shown to decrease broad-spectrum antibiotic use without compromising patient outcomes. However, uncertainty exists regarding the safety of anti-methicillin-resistant Staphylococcus aureus (MRSA) agent DE in culture-negative nosocomial pneumonia. This study aimed to determine if anti-MRSA agent DE in culture-negative nosocomial pneumonia affects 28-day and hospital mortality, ICU and hospital length of stay (LOS), treatment failure, and safety. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00123692183259
Publisher Site
http://dx.doi.org/10.1016/j.chest.2018.10.014DOI Listing
January 2019
3 Reads

Ultrasound Diagnosis of Cardiac Arrest in a Patient With Hematologic Disease.

Chest 2019 Jan;155(1):e9-e12

Anesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo Hospital, Pavia, Italy; Department of Clinical-Surgical, Pediatric and Diagnostic Sciences-Anesthesia, Intensive Care and Pain Therapy, University of Pavia, Pavia, Italy.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1089DOI Listing
January 2019
1 Read

A 30-Year-Old Woman With Tricuspid Valvectomy Presents With Shock.

Chest 2019 Jan;155(1):e5-e7

University of Louisville, Louisville, KY.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.08.1090DOI Listing
January 2019
1 Read

A 35-Year-Old Woman With Acute Pleuritic Chest Pain and an Unusual Mediastinal Opacity.

Chest 2019 Jan;155(1):e17-e20

Université Claude Bernard Lyon 1, Pierre Bénite, France; Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, centre hospitalier Lyon Sud, Hospices civils de Lyon, Pierre Bénite, France. Electronic address:

Case Presentation: A 35-year-old woman came to the ED following 2 days of chest pain. She was a nonsmoker, taking no medications, and not using a contraceptive pill. The patient had no history of recent travel but had given birth (full-term pregnancy) 4 months earlier. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2018.07.036DOI Listing
January 2019
1 Read