CHEST pulmonary最新文献

{"title":"Canary in the Coalmine?","authors":"William J. Healy MD , Younghoon Kwon MD","doi":"10.1016/j.chpulm.2025.100155","DOIUrl":"10.1016/j.chpulm.2025.100155","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243255","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":"Dyspnea and Right-Sided Heart Failure in a Patient With a History of Pneumonectomy","authors":"Shelsey W. Johnson MD ,&nbsp;Melanie C. Kwan MD ,&nbsp;Sarah A.M. Cuddy MD ,&nbsp;Aaron B. Waxman MD, PhD ,&nbsp;Lida P. Hariri MD, PhD ,&nbsp;William M. Oldham MD, PhD","doi":"10.1016/j.chpulm.2025.100149","DOIUrl":"10.1016/j.chpulm.2025.100149","url":null,"abstract":"<div><h3>Case Presentation</h3><div>A 67-year-old man who never smoked was evaluated in the emergency department for 3 months of progressive dyspnea, lower extremity edema, and 20lb weight gain. Eighteen months before this, he had presented with hemoptysis and was ultimately found to have squamous cell lung cancer invading the left pulmonary artery without lymph node involvement, stage pT4N0M0, for which he underwent left pneumonectomy. His medical history was additionally notable for paroxysmal atrial fibrillation and factor V Leiden mutation (anticoagulated on apixaban). Social history was notable for work as a grocer in a supermarket; the patient denied history of asbestos exposure and had no known TB exposure or prior infection. The patient was admitted to general cardiology where he was afebrile, in atrial fibrillation with rapid ventricular response to 127 beats/min with associated hypotension (80/55 mm Hg); his oxygen saturation was 95% on room air. Physical examination was most notable for jugular venous distension and bilateral edema to the thigh. Electrocardiogram did not demonstrate ischemia. Laboratory evaluation demonstrated a creatinine level of 1.10 mg/dL, elevated from his recent baseline level of 0.52 mg/dL. Lactic acid was normal. His cardiac biomarkers were abnormal with an elevated N-terminal pro-B-type natriuretic peptide value (3,682 pg/mL) and high sensitivity troponin T (43 ng/L). Both WBC count and hemoglobin values were normal as were his thyroid hormone levels. IV diuretic and antiarrhythmic therapies were initiated with furosemide and amiodarone, respectively.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279504","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":"Connecting the Dots Between Asthma Control and Frailty in Older Adults With Moderate to Severe Asthma","authors":"Ricardo G. Figueiredo PhD ,&nbsp;Fernando Holguin MSc ,&nbsp;Márcia M.M. Pizzichini PhD ,&nbsp;Gabriela P. Pinheiro PhD ,&nbsp;Vanessa Arata MD ,&nbsp;Maisa F.M. Leal ,&nbsp;Cinthia V.N. Santana PhD ,&nbsp;José de Bessa Junior PhD ,&nbsp;Álvaro A. Cruz PhD","doi":"10.1016/j.chpulm.2025.100147","DOIUrl":"10.1016/j.chpulm.2025.100147","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261653","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 Multicenter Retrospective Study Evaluating IL-5-Targeted Biologic Therapies for the Treatment of Asthma and Allergic Bronchopulmonary Aspergillosis in Adults With Cystic Fibrosis","authors":"Sameer Desai PhD ,&nbsp;Sophia Shen MD ,&nbsp;Zosia Gryz BSc ,&nbsp;Elizabeth Tullis MD ,&nbsp;Anne L. Stephenson MD, PhD ,&nbsp;Bradley S. Quon MD, MSc","doi":"10.1016/j.chpulm.2025.100163","DOIUrl":"10.1016/j.chpulm.2025.100163","url":null,"abstract":"<div><h3>Background</h3><div>Biologic therapies targeting T-helper cell type 2 (Th2) eosinophilic inflammation have been used for difficult-to-treat asthma and allergic bronchopulmonary aspergillosis (ABPA), but safety and efficacy data are limited in the cystic fibrosis (CF) population.</div></div><div><h3>Research Question</h3><div>Are Th2 biologic therapies targeting eosinophilic inflammation effective and safe when used in adults with CF with asthma and/or ABPA overlap?</div></div><div><h3>Study Design and Methods</h3><div>This was a retrospective multicenter study. Individuals with CF receiving Th2 biologic therapies for asthma or ABPA at 2 large adult CF centers between 2016 and 2021 were included. Treatment safety and effectiveness up to 12 months after biologic initiation were evaluated. Outcomes of interest included percent predicted FEV₁ (ppFEV₁), rate of change in ppFEV₁, cumulative systemic corticosteroid (SCS) dose, and frequency of pulmonary exacerbations (PExs).</div></div><div><h3>Results</h3><div>Forty adults with CF received Th2 biologic therapies targeting eosinophilic inflammation during the study period. A total of 38 were eligible for study inclusion, and all received IL-5-directed therapies (mepolizumab: n = 27, benralizumab: n = 11): 17 (45%) for asthma only and 21 for ABPA (55%) with or without asthma. No significant biologic-related adverse effects were observed. There was no statistical difference in ppFEV₁ from baseline to 12-months postbiologic initiation, but the rate of change in ppFEV₁ improved in the 12 months postbiologic vs prebiologic with a pre-to-post difference of 3.7% (95% CI, 1.2%-6.3%). SCS dose and frequency of PExs requiring hospitalization did not differ significantly in the 12 months before biologic vs after biologic initiation.</div></div><div><h3>Interpretation</h3><div>Our results show that in adults with CF, anti-IL-5 biologic therapies were well tolerated and can improve rate of change in lung function, but there was no impact on SCS use or PEx frequency. Further study is needed to better define the role of Th2 biologics in the era of highly effective modulator therapy.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243263","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":"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":"Li X, Tang Y, Chen C, Wang P, Shen Y. CHEST Pulmonary. 2023;1(2):100011.","authors":"","doi":"10.1016/j.chpulm.2025.100172","DOIUrl":"10.1016/j.chpulm.2025.100172","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100172"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223454","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 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":"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":"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}