CHEST pulmonary最新文献

{"title":"Who Drives Pulmonology Evidence Synthesis?","authors":"Vivek Bhat , Abhishek Kumar , Sharanya Kaushik , Shreyas Bellur , Harsimran Singh Walia , Manmeet Singh Ahluwalia , Harneet Kaur Walia MD","doi":"10.1016/j.chpulm.2024.100041","DOIUrl":"10.1016/j.chpulm.2024.100041","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 2","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000072/pdfft?md5=bd2fb35978bf4c0d54252bf1df5bcf71&pid=1-s2.0-S2949789224000072-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Short-Term Increases in Ambient Fine Particulate Matter With Hospitalization for Asthma or COPD During Wildfire Season and Other Time Periods","authors":"Benjamin D. Horne PhD, MStat, MPH ,&nbsp;Mary M. Johnson MD, PhD ,&nbsp;Denitza P. Blagev MD ,&nbsp;Francois Haddad MD ,&nbsp;Kirk U. Knowlton MD ,&nbsp;Daniel Bride MS ,&nbsp;Tami L. Bair BS ,&nbsp;Elizabeth A. Joy MD, MPH ,&nbsp;Kari C. Nadeau MD, PhD","doi":"10.1016/j.chpulm.2024.100053","DOIUrl":"10.1016/j.chpulm.2024.100053","url":null,"abstract":"<div><h3>Background</h3><p>Short-term increases in air pollution are associated with poor asthma and COPD outcomes. Short-term elevations in fine particulate matter (PM_2.5) due to wildfire smoke are becoming more common.</p></div><div><h3>Research Question</h3><p>Are short-term increases in PM_2.5 and ozone in wildfire season and in winter inversion season associated with a composite of emergency or inpatient hospitalization for asthma and COPD?</p></div><div><h3>Study Design and Methods</h3><p>Case-crossover analyses evaluated 63,976 and 18,514 patients hospitalized for primary discharge diagnoses of asthma and COPD, respectively, between January 1999 and March 2022. Patients resided on Utah’s Wasatch Front where PM_2.5 and ozone were measured by Environmental Protection Agency-based monitors. ORs were calculated using Poisson regression adjusted for weather variables.</p></div><div><h3>Results</h3><p>Asthma risk increased on the same day that PM_2.5 increased during wildfire season (OR, 1.057 per +10 μg/m³; 95% CI, 1.019-1.097; <em>P</em> = .003) and winter inversions (OR, 1.023 per +10 μg/m³; 95% CI, 1.010-1.037; <em>P</em> = .0004). Risk decreased after 1 week, but during wildfire season risk rebounded at a 4-week lag (OR, 1.098 per +10 μg/m³; 95% CI, 1.033-1.167). Asthma risk for adults during wildfire season was highest in the first 3 days after PM_2.5 increases, but for children, the highest risk was delayed by 3 to 4 weeks. PM_2.5 exposure was weakly associated with COPD hospitalization. Ozone exposure was not associated with elevated risks.</p></div><div><h3>Interpretation</h3><p>In a large urban population, short-term increases in PM_2.5 during wildfire season were associated with asthma hospitalization, and the effect sizes were greater than for PM_2.5 during inversion season.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 2","pages":"Article 100053"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000199/pdfft?md5=74fed2bf98142ed2aeca7c9b2d31b20c&pid=1-s2.0-S2949789224000199-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise Capacity Following Pulmonary Embolism in Children and Adolescents","authors":"Mackenzie Parker, Joshua Greer, Surendranath Veeram Reddy, Maria Bano, Manal Al-Qahtani, Jeannie Dillenbeck, Sean Rinzler, Michael D. Nelson, Ang Gao, Song Zhang, Andrew R. Tomlinson, Tony G. Babb, A. Zia","doi":"10.1016/j.chpulm.2024.100073","DOIUrl":"https://doi.org/10.1016/j.chpulm.2024.100073","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398898","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":"Developing an Evidence-Based Interprofessional Algorithm to Apply Noninvasive Ventilation in Acute Exacerbation of COPD","authors":"Mary Jo S. Farmer MD, PhD ,&nbsp;Christine D. Callahan MS, RN ,&nbsp;Ashley M. Hughes PhD ,&nbsp;Karen L. Riska PhD ,&nbsp;Nicholas S. Hill MD","doi":"10.1016/j.chpulm.2024.100067","DOIUrl":"10.1016/j.chpulm.2024.100067","url":null,"abstract":"<div><h3>Background</h3><p>When administered as first-line intervention to patients admitted with acute hypercapnic respiratory failure secondary to COPD exacerbation in conjunction with guideline-recommended therapies, noninvasive ventilation (NIV) has been shown to reduce mortality and endotracheal intubation. Opportunities to increase uptake of NIV continue to exist despite inclusion of this therapy in clinical guidelines. Prior studies suggest that efforts to increase NIV use in acute exacerbation of COPD (AECOPD) need to account for the complex and interprofessional nature of NIV delivery and the need for interprofessional team coordination.</p></div><div><h3>Research Question</h3><p>We sought to develop an evidence-based interprofessional algorithm to apply NIV in AECOPD to improve the appropriate utilization of NIV in AECOPD.</p></div><div><h3>Study Design and Methods</h3><p>In this prospective qualitative descriptive study, subject matter expert physicians, nurses, and respiratory therapists practicing in a variety of clinical settings caring for patients with AECOPD were recruited for semistructured interviews. The Consolidated Criteria for Reporting Qualitative Research checklist was followed for interview development. Interview themes applicable to interprofessional collaborative practice were identified using deductive thematic analysis. An NIV algorithm based on recent society guidelines was constructed. Interprofessional team tasks appropriate for each phase of the NIV process were integrated into the algorithm.</p></div><div><h3>Results</h3><p>We present an interprofessional team-based algorithm for delivery of NIV in AECOPD inclusive of patient selection and initiation, titration, monitoring, and weaning of NIV. The goal is to increase appropriate uptake of NIV in the AECOPD population.</p></div><div><h3>Interpretation</h3><p>The identified roles and responsibilities of an interprofessional team could be integrated into an interprofessional education program pertaining to use and management of NIV for patients with AECOPD emphasizing collaborative best practice, interprofessional team communication, and support of professional autonomy when appropriate.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100067"},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000333/pdfft?md5=4913f1fd3cf817387156239a84f5b692&pid=1-s2.0-S2949789224000333-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 28-Year-Old Woman With Chest Pain, Abdominal Pain, and Right Pleural Effusion","authors":"","doi":"10.1016/j.chpulm.2024.100064","DOIUrl":"10.1016/j.chpulm.2024.100064","url":null,"abstract":"<div><h3>Case Presentation</h3><p>A 28-year-old woman presented to the outpatient setting with right-sided intermittent chest pain for the past 8 months. For the past 3 months, she noticed breathlessness initially on exertion, which had progressed to dyspnea at rest. She also reported intermittent cramping abdominal pain, predominantly in the pelvis, that worsened during each menstrual cycle. She had regular menses and denied the use of any hormonal-based or barrier methods of contraception. She had never smoked. She was married and delivered a child 10 years ago. Two years before this presentation, she had undergone medical termination of pregnancy. A previous Pap smear of the cervix was normal. She denied any history of cough, hemoptysis, vomiting, diarrhea or hematemesis, dyspareunia, or post-coital bleeding. There was no relevant family history.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000308/pdfft?md5=195cfa1ee7f63b1ac87cc4e2748d6f80&pid=1-s2.0-S2949789224000308-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occurrence of Emphysema in Individuals with the Williams-Beuren Syndrome: A Narrative Review","authors":"Uddalak Majumdar, Theresa M. Kline, James K. Stoller","doi":"10.1016/j.chpulm.2024.100063","DOIUrl":"https://doi.org/10.1016/j.chpulm.2024.100063","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139258","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":"Significance of normal lung volume on quantitative computed tomography analysis in Group 1 and Group 3 pulmonary hypertension","authors":"T. Okaya, A. Shigeta, N. Tanabe, K. Tatsumi, H. Yokota, A. Nishiyama, A. Naito, A. Sekine, T. Sugiura, S. Sakao, T. Suzuki","doi":"10.1016/j.chpulm.2024.100062","DOIUrl":"https://doi.org/10.1016/j.chpulm.2024.100062","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"9 s2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141023579","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 69-Year-Old Man With Rheumatoid Arthritis and Pleural Effusion","authors":"Ishan A. Patel MD,&nbsp;Neel Vahil MD,&nbsp;Keith Albrektson MD,&nbsp;Lucie Griffin DO","doi":"10.1016/j.chpulm.2024.100057","DOIUrl":"10.1016/j.chpulm.2024.100057","url":null,"abstract":"<div><h3>Case Presentation</h3><p>A 69-year-old male with a history of ongoing tobacco use and long-standing history of seropositive rheumatoid arthritis on chronic immunosuppressive therapy (daily hydroxychloroquine, weekly methotrexate with etanercept) presented to the outpatient clinic with 6 weeks of weight loss, cough, and malaise. There was no history of recent infections, hospitalizations, or other significant changes to his health other than having a 3-month lapse in his rheumatoid arthritis medications due to prescription filling issues.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 2","pages":"Article 100057"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000230/pdfft?md5=4ee336948716e03b1d7ad0a4bbeae803&pid=1-s2.0-S2949789224000230-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Eccentric Cycling on Oxygen Uptake and Hemodynamics in Patients With Pulmonary Vascular Disease","authors":"Julian Müller MSc ,&nbsp;Simon R. Schneider PhD ,&nbsp;Anna Titz MD ,&nbsp;Claudia Thalmann RN ,&nbsp;Esther I. Schwarz MD ,&nbsp;Christoph Bauer PhD ,&nbsp;Ekkehard Grünig MD ,&nbsp;Malcolm Kohler MD ,&nbsp;Mona Lichtblau MD ,&nbsp;Silvia Ulrich MD","doi":"10.1016/j.chpulm.2024.100054","DOIUrl":"10.1016/j.chpulm.2024.100054","url":null,"abstract":"<div><h3>Background</h3><p>Eccentric cycling exercise (ECC) allows training at low metabolic costs and may therefore be valuable for patients with precapillary pulmonary hypertension (PH) due to pulmonary vascular disease (PVD).</p></div><div><h3>Research Question</h3><p>What are the ventilatory and circulatory responses of ECC vs concentric cycling exercise (CON) in patients with PVD?</p></div><div><h3>Study Design and Methods</h3><p>This was a randomized controlled crossover trial in which patients diagnosed with PVD, defined as either pulmonary arterial or chronic thromboembolic PH, performed CON and ECC cycling tests at identical submaximal work rates, following stepwise incremental protocols. Oxygen uptake and additional cardiorespiratory responses were measured breath-by-breath by ergospirometry. Hemodynamic parameters (eg, systolic pulmonary arterial pressure [sPAP], tricuspid annular plain systolic excursion) were measured by echocardiography.</p></div><div><h3>Results</h3><p>Thirty-three patients (19 with pulmonary arterial hypertension and 14 with chronic thromboembolic PH; 13 female; mean age, 50 ± 15 years) were included. At identical work rates during ECC compared with CON, oxygen uptake was significantly lower by −200 mL/min (−40%; 95% CI, −272 to −129; <em>P</em> &lt; .01), minute ventilation was significantly lower by −5.5 L/min (−30%; 95% CI, −9.2 to −3.1; <em>P</em> &lt; .01), and sPAP was significantly lower by −12 mm Hg (−20%; 95% CI, −20 to −4; <em>P</em> &lt; .01). Right ventricular-arterial coupling, as measured by tricuspid annular plain systolic excursion/sPAP, was 0.11 mm/mm Hg higher (31%; 95% CI, 0.04-0.18; <em>P</em> &lt; .01). No adverse events occurred.</p></div><div><h3>Interpretation</h3><p>This study supports the hypothesis that ECC is a feasible and well-tolerated exercise modality for patients with PVD, with lower oxygen demand and a reduced load on the right ventricle. Future studies should investigate whether ECC improves exercise capacity, muscle force, and possibly hemodynamics during prolonged rehabilitation programs in patients with PVD.</p></div><div><h3>Clinical Trial Registration</h3><p>ClinicalTrials.gov; No.: NCT05186987; URL: <span>www.clinicaltrials.gov</span><svg><path></path></svg></p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 2","pages":"Article 100054"},"PeriodicalIF":0.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000205/pdfft?md5=95087b9f10d5de9715ecfa15b2b03d99&pid=1-s2.0-S2949789224000205-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140408441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Capsaicin as Treatment for Unexplained Chronic Cough and Airway Symptoms","authors":"Ewa Ternesten-Hasséus PhD ,&nbsp;Ewa-Lena Johansson PhD ,&nbsp;Eva Millqvist MD, PhD","doi":"10.1016/j.chpulm.2024.100049","DOIUrl":"10.1016/j.chpulm.2024.100049","url":null,"abstract":"<div><h3>Background</h3><p>Unexplained chronic cough (UCC) is characterized by persistent coughing without evident medical explanation.</p></div><div><h3>Research Question</h3><p>Does daily oral administration of natural capsaicin (chili) improve refractory coughing in patients with UCC?</p></div><div><h3>Study Design and Methods</h3><p>Forty-six patients (mean age, 60.5 years) with UCC participated in this crossover, randomized double-anonymized study. For 4 weeks, the participants took capsules containing pure capsaicin orally, and after a washout of 2 weeks, took placebo capsules for 4 weeks. A capsaicin inhalation cough test was used to assess the capsaicin inhalation concentration required to reach two coughs and the capsaicin inhalation concentration required to reach five coughs. The number of coughs in a 24-h period and the number of coughs per hour were recorded on four occasions using the Leicester Cough Monitor. Participants completed questionnaires with items on cough, cough-related symptoms, and quality of life.</p></div><div><h3>Results</h3><p>The mean values for capsaicin inhalation concentration required to reach two coughs and the capsaicin inhalation concentration required to reach five coughs increased after the capsaicin treatment period as compared with the first visit (baseline; <em>P</em> &lt; .05 and <em>P</em> &lt; .03, respectively), although they did not differ from the placebo recordings. Neither the capsaicin nor the placebo treatment significantly reduced the cough frequency, nor did they differ between the two treatment periods. When dividing the participants into low-cougher (≤ 400 coughs within 24 h) and high-cougher (&gt; 400 coughs within 24 h) groups, the low coughers experienced a significantly better outcome from capsaicin, but not from placebo. The visual analog scale symptom scores improved after capsaicin treatment compared with baseline and placebo treatment in terms of the frequencies of coughing (<em>P &lt; .</em>001), rhinitis (<em>P &lt; .</em>03), and throat irritation (<em>P &lt; .</em>01). The Leicester Cough Questionnaire scores improved after capsaicin treatment compared with baseline and compared with the placebo treatment group for all the domains (<em>P &lt; .</em>01 for the total score).</p></div><div><h3>Interpretation</h3><p>In this study, capsaicin powder taken orally was found to be clinically effective and well tolerated by patients with UCC. The results suggest a future treatment for UCC.</p></div><div><h3>Trial Registry</h3><p>European Union Drug Regulating Authorities Clinical Trials Database; No.: EudraCT 2016-004463-39; URL: <span>https://www.clinicaltrialsregister.eu</span><svg><path></path></svg></p><p>ClinicalTrials.gov; No.: <span>NCT04125563</span><svg><path></path></svg>; URL: <span>www.clinicaltrials.gov</span><svg><path></path></svg></p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100049"},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000151/pdfft?md5=38d3d9b768ac0c1e7fe04c5fc22f885b&pid=1-s2.0-S2949789224000151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}