CHEST pulmonary最新文献

{"title":"Safety and Feasibility of a Two-Way Audiovisual Teleconferenced Pulmonary Rehabilitation Program","authors":"Emily S. Wan MD, MPH ,&nbsp;Josephine Decherd MPH ,&nbsp;Christine Stella NP ,&nbsp;Jonathan R. Venne PT ,&nbsp;Brenda McKeon NP ,&nbsp;Stephanie A. Robinson PhD ,&nbsp;Patricia Bamonti PhD ,&nbsp;Marilyn L. Moy MD, MSc","doi":"10.1016/j.chpulm.2024.100089","DOIUrl":"10.1016/j.chpulm.2024.100089","url":null,"abstract":"<div><h3>Background</h3><div>Given limited access to center-based, in-person pulmonary rehabilitation (PR), alternative delivery strategies are needed.</div></div><div><h3>Research Question</h3><div>We compared a virtual PR program with a conventional center-based one with respect to safety, feasibility/acceptability, and geographic catchment (primary outcomes). We explored efficacy by examining changes in functional outcomes (secondary outcomes).</div></div><div><h3>Study Design and Methods</h3><div>This single-center observational real-world report included patients enrolled from July 30, 2020, through June 30, 2023, who attended one or more PR class. Patients undergoing virtual PR exercised in their homes under direct supervision via two-way audiovisual teleconferencing. Baseline demographic information and adverse events were extracted from electronic medical records. Google Maps estimated distance and drive time from residential addresses to the PR center. Intake and exit evaluations for secondary (functional) outcomes and feedback questionnaires were completed in a subset.</div></div><div><h3>Results</h3><div>A total of 120 (52 in-person and 68 virtual) patient enrollments were examined; 84% of patients had COPD. Mean age, FEV₁ and FVC % predicted, and baseline 6-min walk test distance were similar between groups. For safety, the overall rate of PR-related adverse events was 1.2 per 1,000 person-days of observation, with no between-group differences. For feasibility, the average number of exercise classes completed (12.4 ± 6.2 vs 13.0 ± 6.1) and proportion of patients completing ≥ 70% of classes (61.5% vs 67.6%) was comparable between the in-person and virtual groups, respectively. For acceptability, among those who completed the virtual PR feedback questionnaire (n = 30), 100% felt safe exercising at home, 97% endorsed clear internet connection, and 90% agreed education sessions were easy to understand. For geographic catchment, patients in virtual PR lived farther (median, 34.1 miles; interquartile range, 16.6-45.1 vs median, 10.3 miles; interquartile range, 5.6-20.6 miles; <em>P</em> &lt; .001) and had longer drive times (mean 86.0 ± 31.6 vs 51.4 ± 31.9 min; <em>P</em> &lt; 0.001) than patients in in-person PR. In the subset with both intake and exit evaluations, similar improvements were observed in functional outcomes and dyspnea in both groups.</div></div><div><h3>Interpretation</h3><div>This study suggests that two-way audiovisual teleconferenced PR is safe, feasible/acceptable, and significantly expands geographic catchment.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100089"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effectiveness of ChatGPT and Google Gemini in Providing Lung Cancer Screening Recommendations for Vulnerable Communities","authors":"Caretia J. Washington BS ,&nbsp;Joel Divaker MPH ,&nbsp;Michael K. Gould MD, MS ,&nbsp;Gerard A. Silvestri MD, MS ,&nbsp;Tracy E. Crane PhD, RDN ,&nbsp;Bruno Hochhegger MD, PhD ,&nbsp;Shama D. Karanth PhD ,&nbsp;Dejana Braithwaite PhD, MSc","doi":"10.1016/j.chpulm.2025.100167","DOIUrl":"10.1016/j.chpulm.2025.100167","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100167"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Same Day Discharge Program After Pulmonary Wedge Resection","authors":"David Sahai BSc ,&nbsp;Richard C. Chaulk MD ,&nbsp;Richard Malthaner MD ,&nbsp;Mehdi Qiabi MD ,&nbsp;Dalilah Fortin MD ,&nbsp;Richard Inculet MD ,&nbsp;Rahul Nayak MD","doi":"10.1016/j.chpulm.2025.100148","DOIUrl":"10.1016/j.chpulm.2025.100148","url":null,"abstract":"<div><h3>Background</h3><div>The current practice for patients undergoing minimally invasive pulmonary wedge resection (MIS-PWR) is to remain in hospital with a chest tube (CT) in situ for at least 24 hours. There exists emerging evidence that patients typically do not encounter significant complications during this period. However, this has not been studied prospectively.</div></div><div><h3>Research Question</h3><div>Is it feasible and safe for patients to undergo early CT removal and same day discharge (SDD) after elective MIS-PWR?</div></div><div><h3>Study Design and Methods</h3><div>We conducted a nonrandomized prospective clinical trial in 2 phases to assess early CT removal and SDD after elective MIS-PWR. Phase 1 focused on the safety of early CT removal with patients undergoing removal at 4 hours postoperatively. Phase 2 evaluated both early CT removal and SDD. The primary outcomes were rate of successful early CT removal and the rate of successful SDD.</div></div><div><h3>Results</h3><div>In phase 1, a total of 51 patients were enrolled (intervention group: n = 31, control group: n = 20). In the intervention group, 22 (71%) had early removal of CT. Patients who underwent early CT removal in this phase had a significantly shorter median length of hospital stay in days (2.0 in control group vs 1.0 in intervention group; <em>P</em> = .0185) without significant differences in postoperative day 1 and 30 complications or return to the hospital. In phase 2, a total of 43 patients were enrolled (intervention group: n = 23, control group: n = 20). In the intervention group, 17 (74%) had early CT removal and 14 (61%) successfully underwent SDD. There were no significant differences noted in postoperative day 1 and 30 complications or early return to hospital. No patients required pleural reintervention after early CT removal.</div></div><div><h3>Interpretation</h3><div>Our results indicate that select patients undergoing MIS-PWR can safely undergo early CT removal and can be safely discharged on the day of surgery.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: NCT05067738; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 53-Year-Old Female With Dyspnea and Hemoptysis","authors":"Arsh Chowdhary MD ,&nbsp;Hemali Rochlani MD ,&nbsp;Daniel G. Fein MD ,&nbsp;Berrin Ustun MD ,&nbsp;Ali Sadoughi MD ,&nbsp;Marc Vimolratana MD ,&nbsp;Gerardo Eman MD","doi":"10.1016/j.chpulm.2025.100168","DOIUrl":"10.1016/j.chpulm.2025.100168","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"60-Year-Old Man With Recurrent Hemoptysis, Pulmonary Nodules, and Mediastinal Lymphadenopathy","authors":"Srikant Kashinath Malegaonkar MD, DM","doi":"10.1016/j.chpulm.2025.100141","DOIUrl":"10.1016/j.chpulm.2025.100141","url":null,"abstract":"<div><h3>Case Presentation</h3><div>A 60-year-old man with type 2 diabetes mellitus sought treatment at our clinic with episodes of recurrent streaky hemoptysis (about 2 episodes per year for the last 3 years). These episodes resolved with oral antibiotics and empiric oral tranexamic acid given over a short duration of 2 to 3 days. The patient did not smoke and had no other notable medical history, except that one of his coworkers was receiving treatment for pulmonary TB.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice Patterns and Outcomes of Initial Anticoagulation Among Hospitalized Patients With Low- and Low-Intermediate-Risk Pulmonary Embolism","authors":"Grace M. Ferri MD ,&nbsp;Om A. Kothari MD ,&nbsp;Sarika D. Gurnani MD ,&nbsp;Anica C. Law MD, MS ,&nbsp;Nicholas A. Bosch MD, MSc ,&nbsp;Burton H. Shen MD","doi":"10.1016/j.chpulm.2025.100151","DOIUrl":"10.1016/j.chpulm.2025.100151","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines recommend treatment with direct oral anticoagulants (DOACs) over unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) among ambulatory patients, including patients in the emergency department, with pulmonary embolism (PE) at low risk for mortality; however, recent evidence suggests that patients with low-risk PE are usually admitted to the hospital from the emergency department rather than discharged on DOACs.</div></div><div><h3>Research Question</h3><div>Among hospitalized patients with low- and low-intermediate-risk PE, how do patterns in anticoagulation and outcomes vary between institutions?</div></div><div><h3>Study Design and Methods</h3><div>This multicenter retrospective cohort study used the PINC AI enhanced administrative database (2016-2022). Eligible adult patients were admitted to a general ward, had an International Classification of Diseases, 10th Revision, diagnosis code for PE present on admission, were initiated on anticoagulation (UFH, LMWH/fondaparinux, or a DOAC) on but not before day 1, and had troponin and brain natriuretic peptide below the upper limit of normal. Initial anticoagulation practices were summarized overall and by hospital. Regression modeling was used to determine associations between initial anticoagulation and median length of stay.</div></div><div><h3>Results</h3><div>Among 2,369 eligible patients, the percentage of patients initiated on UFH was 54%, initiated on LMWH/fondaparinux was 41%, and initiated on DOACs was 4%. Anticoagulation with DOACs decreased median length of stay by 0.62 days (95% CI, −1.04 to −0.20) compared with those who initially received UFH.</div></div><div><h3>Interpretation</h3><div>Our results showed that hospitalized patients with low- and low-intermediate-risk PE generally do not receive initial DOACs. However, use of initial DOAC therapy was associated with shorter hospital length of stay compared with other initial anticoagulation strategies.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100151"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 65-Year-Old Woman With Massive Hemoptysis After COVID-19 Infection","authors":"Lissette Orozco MD ,&nbsp;Bruno DiGiovine MD","doi":"10.1016/j.chpulm.2025.100152","DOIUrl":"10.1016/j.chpulm.2025.100152","url":null,"abstract":"<div><h3>Case Presentation</h3><div>A 65-year-old woman presented with a 7-day history of generalized weakness, cough, and hemoptysis described as streaks of blood during the first 2 days, and as half a cup to a cup of bright red blood with clots thereafter. Seven weeks earlier she was hospitalized with COVID-19 pneumonia for which she received supplemental oxygen with high flow nasal cannula, remdesivir, dexamethasone, and tocilizumab.</div><div>Her medical history included stage 3a chronic kidney disease, multinodular goiter, hypertension, and type II diabetes mellitus. She denied recent use of anticoagulants or nonsteroidal antiinflammatory drugs. She denied any recent trauma including pulmonary contusion. The patient did not have any history of rash, hematuria, or known autoimmune disease preceding this episode of hemoptysis.</div><div>The patient had previous tobacco use with a 20 pack-year history and quit 7 years ago. She did not use alcohol or other recreational drugs. Family history was notable for breast cancer in her mother. She had no history of recent travel or exposure to sick contacts.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mind the Gap","authors":"Nitish Behary Paray MBChB MRCP ,&nbsp;Vasilis Kouranos PhD ,&nbsp;Raheel Ahmed MBBS MRCP","doi":"10.1016/j.chpulm.2025.100135","DOIUrl":"10.1016/j.chpulm.2025.100135","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100135"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth Rehabilitation Using Videoconferencing","authors":"Abebaw Mengistu Yohannes PhD ,&nbsp;George Marty Solomon","doi":"10.1016/j.chpulm.2024.100111","DOIUrl":"10.1016/j.chpulm.2024.100111","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing the Obesity Paradox in Alpha-1 Antitrypsin Deficiency-Related COPD","authors":"Daniel Yee MD ,&nbsp;Monica P. Goldklang MD","doi":"10.1016/j.chpulm.2025.100153","DOIUrl":"10.1016/j.chpulm.2025.100153","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100153"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}