34,087 results match your criteria Chest[Journal]


Fluid management in acute kidney injury.

Chest 2019 Apr 16. Epub 2019 Apr 16.

Division of Nephrology & Hypertension, Division of Pulmonary & Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, US.

Correction of intravascular hypovolaemia is a key component of the prevention and management of acute kidney injury (AKI) but excessive fluid administration is associated with poor outcomes, including the development and progression of AKI. There is growing evidence that fluid administration should be individualised and take into account patient characteristics, nature of the acute illness and trajectories, and risks and benefits of fluids. Existing data support the preferential use of buffered solutions for fluid resuscitation of patients at risk of AKI who do not have hypochloraemia. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00123692193083
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http://dx.doi.org/10.1016/j.chest.2019.04.004DOI Listing
April 2019
1 Read

Chronic cough and gastroesophageal reflux in children - CHEST Guideline and Expert Panel Report.

Chest 2019 Apr 16. Epub 2019 Apr 16.

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, UMass Memorial Medical Center, Worcester, MA, USA.

Background: Whether gastroesophageal reflux (GER) or GER disease (GERD) causes chronic cough in children is controversial. Using the PICO format, we undertook 4 systematic reviews. For children with chronic cough (>4-weeks duration) and without underlying lung disease: (1) who do not have gastrointestinal GER symptoms, should empirical treatment for GERD be used? (2) with gastrointestinal GER symptoms, does treatment for GERD resolve the cough? (3) with or without gastrointestinal GER symptoms, what GER-based therapies should be used and for how long? (4) if GERD is suspected as the cause, what investigations and diagnostic criteria best determine GERD as the cause of the cough?

Methods: We used the CHEST Expert Cough Panel's protocol and American College of Chest Physicians (CHEST) methodological guidelines and GRADE framework. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00123692193083
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http://dx.doi.org/10.1016/j.chest.2019.03.035DOI Listing
April 2019
1 Read
7.483 Impact Factor

Radiation-Induced Lung Injury: Assessment and Management.

Chest 2019 Apr 15. Epub 2019 Apr 15.

Department of Radiation Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston TX, USA.

Radiation-induced lung injury (RILI) encompasses any lung toxicity induced by radiation therapy (RT) and manifests acutely as radiation pneumonitis (RP) and chronically as radiation pulmonary fibrosis (RPF). Since most patients with thoracic and breast malignancies are expected to undergo RT in their lifetime, many with curative intent, the population at risk is significant. Further, indications for thoracic RT are expanding given the advent of stereotactic body radiation therapy or stereotactic ablative radiotherapy (SBRT/SABR) for early stage lung cancer in non-surgical candidates as well as oligometastatic pulmonary disease from any solid tumor. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.033DOI Listing
April 2019
5 Reads

Imaging of pulmonary hypertension: Pictorial essay.

Chest 2019 Apr 11. Epub 2019 Apr 11.

Pulmonary hypertension (PH) is an end result of a diverse array of complex clinical conditions, which invoke hemodynamic and pathophysiological changes in the pulmonary vasculature. Many patients' symptoms begin with dyspnea on exertion for which screening tests like chest roentgenograms and more definitive non-invasive tests like CT scans are ordered initially. It is imperative that clinicians are cognizant of subtle clues on these imaging modalities that alert them to the possibility of PH. Read More

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http://dx.doi.org/10.1016/j.chest.2019.04.003DOI Listing
April 2019
7.483 Impact Factor

Accuracy of the Vancouver Lung Cancer Risk Prediction Model Compared with Radiologists.

Chest 2019 Apr 11. Epub 2019 Apr 11.

Department of Radiology, MC-2026, The University of Chicago, 5841 S. Maryland Avenue, Chicago, Illinois 60637.

Background: Risk models have been developed that include the subject's pretest risk profile and imaging findings to predict the risk of cancer in an objective way. We assessed the accuracy of the Vancouver Risk Prediction model compared with trainee and experienced radiologists using a subset of size-matched nodules from the National Lung Cancer Screening Trial (NLST).

Methods: One hundred cases from the NLST database were selected (size range: 4-20 mm), including 20 proven cancers and 80 size-matched benign nodules. Read More

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http://dx.doi.org/10.1016/j.chest.2019.04.002DOI Listing

Mobility identifies acutely ill patients at low risk of in-hospital mortality: a prospective multicenter study.

Chest 2019 Apr 11. Epub 2019 Apr 11.

Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark; Department of Emergency Medicine, Odense University Hospital, Denmark.

Introduction: a retrospective study has reported that impaired mobility on presentation (IMOP) enhanced the ability of vital signs to predict mortality in acutely ill patients. This study was designed to further examine the association between IMOP and in-hospital mortality.

Methods: prospective observational study of three different cohorts of acutely ill patients admitted to hospitals in Esbjerg, Denmark (998 patients), Basel, Switzerland (743 patients) and Kitovu, Uganda (1,622 patients). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00123692193082
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http://dx.doi.org/10.1016/j.chest.2019.04.001DOI Listing
April 2019
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On Being the Editor in Chief of the Journal CHEST: 14 Memorable Years.

Authors:
Richard S Irwin

Chest 2019 Apr 10. Epub 2019 Apr 10.

CHEST Editorial Office, Glenview, IL. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2019.01.040DOI Listing

Lung Transplant Outcomes in Pulmonary Fibrosis Patients with Telomere-Related Gene Variants.

Chest 2019 Apr 9. Epub 2019 Apr 9.

Duke University Medical Center.

Background: Pulmonary fibrosis (PF) is the most common disease indication for lung transplantation. Our recent work implicated an excess of rare genetic variants in the telomere-related genes TERT, RTEL1, and PARN in PF disease risk. The impact of such variants upon post-transplant outcomes is uncertain. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00123692193081
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http://dx.doi.org/10.1016/j.chest.2019.03.030DOI Listing
April 2019
8 Reads

Disparities in Geographic Access to Hospital Outpatient Pulmonary Rehabilitation Programs in the U.S.

Chest 2019 Apr 9. Epub 2019 Apr 9.

University of Minnesota Rural Health Research Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota.

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http://dx.doi.org/10.1016/j.chest.2019.03.031DOI Listing
April 2019
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Low and high blood eosinophil counts as biomarkers in hospitalised acute exacerbations of chronic obstructive pulmonary disease.

Chest 2019 Apr 9. Epub 2019 Apr 9.

Monash Lung and Sleep, Monash Health, Melbourne Australia; Monash University, Department of Medicine; Hudson Institute, Melbourne, Australia.

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http://dx.doi.org/10.1016/j.chest.2019.02.406DOI Listing
April 2019
1 Read
7.483 Impact Factor

Epidemiology of qSOFA Criteria in Undifferentiated Patients and Association with Suspected Infection and Sepsis.

Chest 2019 Apr 9. Epub 2019 Apr 9.

Department of Medicine, Brigham and Women's Hospital, Boston, MA; Department of Population Medicine, Harvard Medical School / Harvard Pilgrim Health Care Institute, Boston MA.

Background: The role of Quick Sequential Organ Failure Assessment (qSOFA) criteria in sepsis screening and management is controversial, particularly as they were derived only in patients with suspected infection. We examined the epidemiology and prognostic value of qSOFA in undifferentiated patients.

Methods: We identified patients with ≥2 qSOFA criteria within 1 day of admission among all adults admitted to 85 U. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.032DOI Listing

Comparison of All-Cause Mortality Following VTE Treatment Between Propensity Score-Adjusted Observational Studies and Matched Randomized Controlled Trials: Meta-Epidemiologic Study.

Chest 2019 Apr 25;155(4):689-698. Epub 2018 Oct 25.

Respiratory Department, Hospital Ramón y Cajal, Medicine Department, Universidad de Alcala (IRYCIS), Madrid, Spain.

Background: It is unknown whether propensity score-adjusted observational studies produce results comparable to those of randomized controlled trials (RCTs) that address similar VTE treatment issues.

Methods: The PubMed and Web of Science databases were systematically searched for propensity score-adjusted observational studies, RCTs, and meta-analyses of RCTs that estimated all-cause mortality following VTE treatment. After identifying distinct clinical treatment issues evaluated in the eligible observational studies, a standardized algorithm was used to identify and match at least one RCT or RCT meta-analysis publication for paired study design analyses. Read More

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http://dx.doi.org/10.1016/j.chest.2018.10.016DOI Listing
April 2019
2 Reads

A 73-Year-Old Man With Progressive Whole Body Subcutaneous Gas After Pleural Catheter Removal.

Chest 2019 Apr;155(4):e97-e100

Division of Respiratory, Critical Care, & Occupational Pulmonary Medicine, University of Utah, Salt Lake City, UT; George E. Wahlen VA Medical Center, Salt Lake City, UT.

Case Presentation: A 73-year-old man presented to the ED of an outside hospital with asymptomatic chest wall swelling 10 h after discharge from our hospital. Four days earlier, he had presented to our hospital with increased dyspnea, cough, and sputum production. His history was notable for severe COPD with bullous emphysema. Read More

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http://dx.doi.org/10.1016/j.chest.2018.09.012DOI Listing
April 2019
2 Reads

A Nonsmoker Man in His 40s With a Diagnosis of Genetic-Related Idiopathic Pulmonary Fibrosis (Surfactant-Protein C Gene Mutation).

Chest 2019 Apr;155(4):e91-e96

Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy. Electronic address:

A nonsmoker man in his 40s underwent bilateral lung transplantation with a referral diagnosis of genetic-related idiopathic pulmonary fibrosis (IPF). The patient had no medical history in childhood and early adulthood, nor was there a family history of IPF. His nonsmoker father presented with lung cancer at 59 years of age. Read More

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http://dx.doi.org/10.1016/j.chest.2018.12.015DOI Listing
April 2019
2 Reads

A 75-Year-Old Woman With Cirrhosis and Shock.

Chest 2019 Apr;155(4):e87-e89

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ.

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http://dx.doi.org/10.1016/j.chest.2018.09.037DOI Listing
April 2019
7.483 Impact Factor

Rapid Diagnosis and Treatment of a Pleural Effusion in a 24-Year-Old Man.

Chest 2019 Apr;155(4):e83-e85

Department of Internal Medicine, Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Nebraska Medical Center, Omaha, NE.

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http://dx.doi.org/10.1016/j.chest.2018.09.036DOI Listing
April 2019
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Exacerbation of Previously Undiagnosed Bird Fancier's Lung by Pembrolizumab Therapy.

Chest 2019 Apr;155(4):e79-e82

Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.

Immune checkpoint inhibitors have revolutionized cancer therapy. As the use of checkpoint inhibitors becomes widespread, the early recognition and treatment of their unique spectrum of adverse effects, called immune-related adverse events, become critical. Perhaps the most significant of these is the pulmonary toxicity currently described as "pneumonitis. Read More

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http://dx.doi.org/10.1016/j.chest.2018.12.002DOI Listing
April 2019
2 Reads

A 49-Year-Old Woman With Chest Pain, Cough, and Hypoxemia After a Seizure.

Chest 2019 Apr;155(4):e113-e116

Pulmonary, Northwestern Medical Faculty Foundation, Chicago, IL. Electronic address:

Case Presentation: A 49-year-old woman with a medical history of epilepsy presented to the ED 1 h after a single, 15-min, witnessed, tonic-clonic seizure. Over the preceding 6 months, she had experienced five similar seizures of shorter duration. There were no recent changes to her phenytoin dose nor had she started any new medications. Read More

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http://dx.doi.org/10.1016/j.chest.2018.10.043DOI Listing
April 2019
1 Read

A 53-Year-Old Man Presenting With Diplopia and Cavitary Lung Nodules.

Chest 2019 Apr;155(4):e107-e112

Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.

Case Presentation: A 53-year-old Chinese man presented with 1 week of worsening diplopia and left-sided facial droop. His symptoms developed during a readmission for elective drainage and curettage of a perianal abscess that recurred despite drainage 2 weeks before. He denied having other neurologic symptoms, and did not report any cough, sputum production, night sweats, or fever. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00123692183260
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http://dx.doi.org/10.1016/j.chest.2018.10.021DOI Listing
April 2019
4 Reads
7.483 Impact Factor

A 32-Year-Old Woman With Miscarriage, Headache, Hepatitis, and Pulmonary Disease.

Chest 2019 Apr;155(4):e101-e105

Department of Medicine, Division of Pulmonary and Critical Care Medicine, Tufts University School of Medicine, Boston, MA; Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA.

Case Presentation: A 32-year-old Nigerian woman, who became pregnant after undergoing in vitro fertilization, was admitted with nausea and abdominal pain. She had a history of two miscarriages and infertility because of tubal blockage treated by salpingectomy. One week prior, she presented to an outside hospital with premature rupture of membranes resulting in stillborn delivery of twins. Read More

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http://dx.doi.org/10.1016/j.chest.2018.10.001DOI Listing
April 2019
2 Reads

Fourteenth Century Iconography of Digital Clubbing in Prince William II of Aragon (1312-1338).

Chest 2019 Apr;155(4):880-882

Warwick Medical School, Microbiology and Infection Unit, The University of Warwick; Legal Medicine Section, Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy; UMR 7268, Laboratoire d'Anthropologie bio-culturelle, Droit, Etique & Santé (Adés), Faculté de Médecine de Marseille, Montigny-Le-Bretonneux, France. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2019.01.022DOI Listing

Open Tension Pneumothorax in "The Dying Niobid" (Uffizi Gallery).

Chest 2019 Apr;155(4):878-880

Warwick Medical School, Microbiology and Infection Unit, The University of Warwick, Coventry, England; Legal Medicine Section, Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy; UMR 7268, Laboratoire d'Anthropologie bio-culturelle, Droit, Etique & Santé (Adés), Faculté de Médecine de Marseille, Montigny-Le-Bretonneux, France. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2018.12.028DOI Listing
April 2019
1 Read

Response.

Chest 2019 Apr;155(4):876-877

Pulmonary Department, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Kfar Saba, Israel. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2019.01.020DOI Listing

Tranexamic Acid Inhalations in Nonmassive Hemoptysis: A Word of Caution.

Chest 2019 Apr;155(4):876

AP-HP, Réanimation polyvalente et surveillance continue, Hôpital Antoine Béclère, Clamart, France; INSERM U999, Centre Chirurgical Marie Lannelongue, Université Paris Sud, Le Plessis Robinson, France. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2018.12.027DOI Listing

The Clinical Examination.

Authors:
David Mathew

Chest 2019 Apr;155(4):875

Singapore.

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http://dx.doi.org/10.1016/j.chest.2018.09.009DOI Listing

Ode to Dementia.

Authors:
David Mathew

Chest 2019 Apr;155(4):874

Singapore.

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http://dx.doi.org/10.1016/j.chest.2018.09.010DOI Listing

Nasal High-Frequency Oscillatory Ventilation in Preterm Infants With Respiratory Distress Syndrome and ARDS After Extubation: A Randomized Controlled Trial.

Chest 2019 Apr;155(4):740-748

Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China; Chongqing Key Laboratory of Pediatrics, Chongqing, China; Department of Pediatrics, Daping Hospital of the Army Medical University, Chongqing, China. Electronic address:

Background: Nasal high-frequency oscillatory ventilation (NHFOV) has been described as supplying the combined advantages of nasal CPAP (NCPAP) and HFOV. However, its effect on preterm infants needs to be further elucidated. Our objective was to assess whether NHFOV could reduce intubation and Pco levels as compared with NCPAP during the postextubation phase in preterm infants. Read More

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http://dx.doi.org/10.1016/j.chest.2019.01.014DOI Listing
April 2019
2 Reads
7.483 Impact Factor

Rebuttal From Drs Viau-Lapointe and Fan.

Chest 2019 Apr;155(4):669-670

Interdepartmental Division of Critical Care Medicine, University of Toronto; and Department of Medicine, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2018.11.021DOI Listing

Rebuttal From Drs Aguilar and Kollef.

Chest 2019 Apr;155(4):668-669

Division of Pulmonary/Critical Care Medicine, Washington University School of Medicine, St. Louis, MO. Electronic address:

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https://linkinghub.elsevier.com/retrieve/pii/S00123692183278
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http://dx.doi.org/10.1016/j.chest.2018.11.017DOI Listing
April 2019
5 Reads

COUNTERPOINT: Does Persistent or Worsening ARDS Refractory to Optimized Ventilation and Proning Deserve a Trial of Prostacyclin? No.

Chest 2019 Apr;155(4):665-668

Interdepartmental Division of Critical Care Medicine, University of Toronto; and Department of Medicine, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2018.11.020DOI Listing

POINT: Does Persistent or Worsening ARDS Refractory to Optimized Ventilation and Proning Deserve a Trial of Prostacyclin? Yes.

Chest 2019 Apr;155(4):662-665

Division of Pulmonary/Critical Care Medicine, Washington University School of Medicine, St. Louis, MO. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2018.11.018DOI Listing
April 2019
1 Read

Giants in Chest Medicine: Donald C. Zavala, MD, FCCP.

Chest 2019 Apr;155(4):659-661

Pulmonary, Occupational Medicine and Critical Care Division at the University of Iowa Hospitals and Clinics, Iowa City, IA. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2018.12.025DOI Listing

Weighing the Impact of CPAP Therapy on Body Mass in Persons With OSA.

Chest 2019 Apr;155(4):657-658

Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, and the Division of Sleep Medicine, Harvard Medical School, Boston, MA. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2018.10.029DOI Listing
April 2019
1 Read

CT Phenotypes in Hypersensitivity Pneumonitis.

Authors:
David A Lynch

Chest 2019 Apr;155(4):655-656

Department of Radiology, National Jewish Health, Denver, CO. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2018.10.048DOI Listing
April 2019
2 Reads

Real-World Data for Pulmonary Arterial Hypertension.

Chest 2019 Apr;155(4):653-654

Intermountain Medical Center, Murray, UT. Electronic address:

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http://dx.doi.org/10.1016/j.chest.2019.01.031DOI Listing

OSA, Short Sleep Duration, and Their Interactions With Sleepiness and Cardiometabolic Risk Factors in Adults: The ELSA-Brasil Study.

Chest 2019 Mar 25. Epub 2019 Mar 25.

Center of Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil.

Background: OSA and short sleep duration (SSD) are frequently associated with daytime symptoms and cardiometabolic deregulation. However, the vast majority of studies addressing OSA have not evaluated SSD, and vice versa. Our aim was to evaluate the association of OSA, SSD, and their interactions with sleepiness and cardiometabolic risk factors in a large cohort of adults. Read More

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http://dx.doi.org/10.1016/j.chest.2018.12.003DOI Listing
March 2019
1 Read

Development of a Risk Prediction Model to Estimate the Probability of Malignancy in Pulmonary Nodules Being Considered for Biopsy.

Chest 2019 Mar 30. Epub 2019 Mar 30.

Respiratory Institute, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH.

Background: The main goal in the evaluation of a pulmonary nodule (PN) is to expedite treatment of malignant nodules and minimize procedures for benign nodules. Available validated risk prediction models are most accurate when used within populations similar to those in which they were developed. The goal of this study was to develop a malignancy risk prediction model that estimates the probability of malignancy for PNs considered high enough risk to recommend biopsy. Read More

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http://dx.doi.org/10.1016/j.chest.2019.01.038DOI Listing
March 2019
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RECONSIDERING VASOPRESSORS FOR CARDIOGENIC SHOCK Everything should be made as simple as possible, but not simpler.

Chest 2019 Mar 29. Epub 2019 Mar 29.

(a)Emeritus Université Paris 7, Denis Diderot; (b)UMR INSERM 1160, France.

Recent scientific statements and publications have recommended the use of vasoconstrictors as the first line pharmacological choice for most cases of cardiogenic shock (CS), without abundance of strong clinical evidence. One challenge of guidelines is that the way recommendations are stated can potentially lead to oversimplification of complex situations. Except for acute coronary syndrome with CS, in which maintenance of coronary perfusion pressure seems logical prior to revascularization, physiologic consequences of increasing afterload by use of vasoconstrictors should be analyzed. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.020DOI Listing
March 2019
1 Read

Mycobacterium bolletii lung disease in cystic fibrosis.

Chest 2019 Mar 29. Epub 2019 Mar 29.

Centre de Ressources et de Compétences pour la Mucoviscidose, Pneumologie et Allergologie Pédiatriques, Hôpital Necker Enfants Malades, Paris, France. Electronic address:

Background: The cystic fibrosis (CF) pathogen, Mycobacterium abscessus complex, covers three "subspecies": "M. abscessus", "M. massiliense", and "M. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.019DOI Listing
March 2019
3 Reads

Legal Objections to Use of Neurologic Criteria to Declare Death in the United States: 1968 to 2017.

Chest 2019 Mar 29. Epub 2019 Mar 29.

Population Health, NYU Langone Medical Center, New York, NY.

Background: There have been a number of prominent lawsuits challenging the use of neurologic criteria to declare death in the United States.

Methods: To put these lawsuits into perspective, we conducted a search of Nexis Uni to identify cases from the past 50 years that involved objections to the use of neurologic criteria to declare death in the United States.

Results: We identified lawsuits about 67 decedents (59 state and 8 federal) from 34 different regions which were filed for crime-related issues (n = 42), hospital-related issues (n = 20), insurance-related issues (n = 2), and other issues related to time of death (n = 3). Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.018DOI Listing

Anaerobic threshold and respiratory compensation point identification during CPET in chronic heart failure.

Chest 2019 Mar 26. Epub 2019 Mar 26.

Centro Cardiologico Monzino, IRCCS, Milano, Italy; Dept. of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milano, Italy. Electronic address:

Background: We evaluated the prognostic significance of the simple presence or absence of identifiable anaerobic threshold (AT) and respiratory compensation point (RCP) at cardiopulmonary exercise test (CPET) performed with a maximal incremental exercise protocol.

Methods: In the present multicenter study, we retrospectively analyzed data of 1995 reduced-ejection-fraction heart failure (HFrEF) patients. All underwent clinical and laboratory evaluation, echocardiography, and maximal CPET at baseline. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.013DOI Listing
March 2019
1 Read

Patients With OSA Are Perceived as Younger Following Treatment With CPAP.

Chest 2019 Mar 27. Epub 2019 Mar 27.

Faculdade de Medicina FMUSP, Universidade de São Paulo, Heart Institute (InCor), Pulmonary Division, Sleep Laboratory, São Paulo/SP, Brazil; Núcleo Interdisciplinar da Ciência do Sono (NICS), São Paulo/SP, Brazil. Electronic address:

Background: The aim of this study was to compare the effects of CPAP treatment and placebo intervention on the facial appearance of patients with OSA.

Methods: Patients with severe OSA were randomized to receive either CPAP treatment or nasal dilator (placebo) intervention for 1 month. The sequence was interposed by 15 days of washout with no treatment. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.015DOI Listing
March 2019
1 Read

Impact of Long-Term Exposures to Ambient PM and Ozone on ARDS Risk for Older Adults in the United States.

Chest 2019 Mar 26. Epub 2019 Mar 26.

Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA. Electronic address:

Background: Chronic exposures to particulate matter with an aerodynamic diameter < 2.5 μm (PM) and ozone pollution can affect respiratory function. ARDS, an often lethal respiratory failure, is most common among older adults. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.017DOI Listing
March 2019
1 Read

Comparative Effectiveness and Safety of Long-Acting β-Agonist-Long-Acting Muscarinic Antagonists vs Long-Acting β-Agonist-Inhaled Corticosteroid Treatment of COPD in Real-World Clinical Practice.

Chest 2019 Mar 26. Epub 2019 Mar 26.

Centre for Clinical Epidemiology, Lady Davis Institute-Jewish General Hospital, and the Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.

Background: Long-acting β-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) are recommended as initial maintenance treatments for COPD, with their combination (LABA-LAMA) advocated as the disease progresses. Randomized trials comparing the effectiveness of this combination with the alternative combination of LABA with inhaled corticosteroid (LABA-ICS) have reported conflicting data, while there are no real-world comparative effectiveness and safety studies of these regimens in clinical practice settings.

Methods: We identified a cohort of patients with COPD during 2002-2015, age 55 years or older, from the United Kingdom's Clinical Practice Research Datalink. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.005DOI Listing

Prevalence of Disagreement About Appropriateness of Treatment Between ICU Patients/Surrogates and Clinicians.

Chest 2019 Mar 26. Epub 2019 Mar 26.

Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.

Background: ICU patients/surrogates may experience adverse outcomes related to perceived inappropriate treatment. The objective was to determine the prevalence of patient/surrogate-reported perceived inappropriate treatment, its impact on adverse outcomes, and discordance with clinicians.

Methods: We conducted a multicenter, prospective, observational study of adult ICU patients. Read More

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http://dx.doi.org/10.1016/j.chest.2019.02.404DOI Listing
March 2019
1 Read

How OSA Evolves From Childhood to Young Adulthood: Natural History From a 10-Year Follow-up Study.

Chest 2019 Mar 26. Epub 2019 Mar 26.

Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. Electronic address:

Background: Understanding the natural history of childhood OSA can help to determine disease prognosis and to guide risk stratification and management strategies.

Methods: To evaluate the natural history of childhood OSA and factors associated with spontaneous remission and persistent and incident OSA from childhood to late adolescence/early adulthood, a longitudinal analysis of a prospective community-based cohort was designed. Subjects from a cohort established for an OSA prevalence study were invited to participate in this 10-year follow-up study. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.007DOI Listing
March 2019
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Use of Balloon Atrial Septostomy in Patients With Advanced Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis.

Chest 2019 Mar 23. Epub 2019 Mar 23.

Department of Cardiovascular Medicine, Duke University Health System, Durham, NC.

Background: Despite the use and purported benefits of balloon atrial septostomy (BAS), its safety, efficacy, and therapeutic role in the setting of advanced pulmonary arterial hypertension (PAH) are not well defined.

Objective: The goal of this study was to conduct a systematic review and meta-analysis to better determine the evidence supporting the use of BAS in PAH.

Methods: MEDLINE, Scopus, Cochrane Library, and Clinicaltrials. Read More

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http://dx.doi.org/10.1016/j.chest.2019.03.003DOI Listing
March 2019
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Fractional Exhaled Nitric Oxide Values in Indigenous Australians 3 to 16 Years of Age.

Chest 2019 Mar 23. Epub 2019 Mar 23.

Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD; Indigenous Respiratory Outreach Care Program, The Prince Charles Hospital, Brisbane, QLD; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD.

Background: Fractional exhaled nitric oxide (Feno) levels can identify eosinophilic asthma phenotypes. We aimed to determine Feno values of healthy Aboriginal and/or Torres Strait Islander (Indigenous) Australians, differences between these Indigenous ethnic groups, and appropriateness of published cutoff values.

Methods: We measured Feno levels in 1,036 Indigenous Australians (3-16 years of age). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00123692193068
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http://dx.doi.org/10.1016/j.chest.2019.02.401DOI Listing
March 2019
10 Reads

CT Scan and Functional MRI to Evaluate Airway Mucus in Severe Asthma.

Chest 2019 Mar 23. Epub 2019 Mar 23.

Department of Medicine, McMaster University, Hamilton, ON, Canada; Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada.

Background: Intraluminal contributor(s) to airflow obstruction in severe asthma are patient-specific and must be evaluated to personalize treatment. The occurrence and functional consequence of airway mucus in the presence or absence of airway eosinophils remain undetermined.

Objective: The objective of this study was to understand the functional consequence of airway mucus in the presence or absence of eosinophils and to identify biomarkers of mucus-related airflow obstruction. Read More

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http://dx.doi.org/10.1016/j.chest.2019.02.403DOI Listing
March 2019
1 Read