CHEST pulmonary最新文献

{"title":"Chest Wall Deformities in Adults With Fibrotic Interstitial Lung Disease Related to Surfactant-Related Gene Mutations","authors":"Margot Delin MD , Marie Pierre Debray MD , Marie Legendre MD, PhD , Lidwine Wemeau MD , Bruno Crestani MD, PhD , Emmanuel Brian MD , Justine Frija-Masson MD, PhD , Laurent Plantier MD, PhD , Spyros A. Papiris MD , Effrosyni D. Manali MD , Nadia Nathan MD, PhD , Raphael Borie MD, PhD","doi":"10.1016/j.chpulm.2024.100106","DOIUrl":"10.1016/j.chpulm.2024.100106","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140057","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":"Cost-Effectiveness of Rapid On-Site Evaluation During Navigational Bronchoscopy","authors":"Greta J. Dahlberg MD ,&nbsp;Caroline M. Godfrey MD, MPH ,&nbsp;Stephen A. Deppen PhD ,&nbsp;Jacob Richardson ,&nbsp;Brent E. Heideman MD ,&nbsp;Ankush P. Ratwani MD ,&nbsp;Rafael Paez MD ,&nbsp;Kaele M. Leonard MD ,&nbsp;Samira Shojaee MD, MPH ,&nbsp;Robert J. Lentz MD ,&nbsp;Eric L. Grogan MD, MPH ,&nbsp;Fabien Maldonado MD","doi":"10.1016/j.chpulm.2024.100066","DOIUrl":"10.1016/j.chpulm.2024.100066","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral pulmonary lesions (PPLs) are common, with &gt; 1.6 million PPLs incidentally identified in the United States annually. Navigational bronchoscopy (NB) is a cornerstone of the diagnostic evaluation of PPLs. Intraprocedural rapid on-site evaluation (ROSE) of biopsies obtained during NB is widely used, but the data for its utility are contradictory. The cost-effectiveness of ROSE has yet to be established; as such, ROSE currently has variable implementation between institutions and is not adequately reimbursed by payers.</div></div><div><h3>Research Question</h3><div>Is ROSE cost-effective during NB for PPLs from a third-party payer perspective?</div></div><div><h3>Study Design and Methods</h3><div>A cost-effectiveness model was constructed comparing NB for PPLs with vs without ROSE from a third-party payer perspective. The base case is a 60-year-old operative candidate with a 2-cm pulmonary nodule without radiographic mediastinal or hilar lymphadenopathy referred for NB. Cost per quality-adjusted life year gained was the primary outcome. Inputs for the model were estimated from published literature. One-way deterministic sensitivity analyses were conducted on all parameters. Probabilistic sensitivity analysis was performed.</div></div><div><h3>Results</h3><div>The use of ROSE resulted in a gain of 0.01 quality-adjusted life years and cost an additional $466. At a willingness-to-pay threshold of $100,000/life year, ROSE was cost-effective with an incremental cost-effectiveness ratio of $44,465.88. Sensitivity analyses on the sensitivity of NB with and without ROSE show that ROSE must increase the diagnostic sensitivity of the procedure by 3% to become cost-effective.</div></div><div><h3>Interpretation</h3><div>Our findings show that the use of ROSE during NB for PPLs is cost-effective for third-party payers at a willingness-to-pay threshold of $100,000/life year and should be reimbursed at a higher rate. The cost-effectiveness of ROSE hinges on the additional diagnostic sensitivity gained by using ROSE.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139933","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":"Sleep Hypoxemia as a Predictor of Mortality in Patients with Sleep Apnea","authors":"Mohammad Masoudian Khouzani DDS, MPH ,&nbsp;Jack Botros DDS ,&nbsp;Mariela Padilla DDS, MEd ,&nbsp;Richard J. Castriotta MD, FCCP","doi":"10.1016/j.chpulm.2024.100087","DOIUrl":"10.1016/j.chpulm.2024.100087","url":null,"abstract":"<div><h3>Background</h3><div>The Sleep Heart Health Study (SHHS) was a prospective cohort study formulated to explore the risk factors for development of cardiovascular disease in OSA, diagnosed via unaccompanied home sleep apnea test. We used these data to compare the association of the apnea-hypopnea index (AHI) and amount of sleep hypoxemia with the risk of all-cause mortality.</div></div><div><h3>Research Question</h3><div>What is the relationship among hypoxemia, AHI, and mortality in OSA?</div></div><div><h3>Study Design and Methods</h3><div>We compared the association of (1) the AHI, (2) the percentage of sleep time with oxygen saturation &lt; 85% (PERC85), and (3) the duration of sleep (in minutes) with oxygen saturation &lt; 85% (MIN85) with the risk of all-cause mortality in the SHHS. Multivariable logistic regression analyses were used and adjusted for age, sex, BMI, pack-years of smoking, cardiovascular score at baseline, and treatment status.</div></div><div><h3>Results</h3><div>PERC85 was associated with an increased risk of death (OR, 1.03; 95% CI, 1.01-1.05; <em>P</em> = .003). Patients with PERC85 of 1% to 5%, 5% to 20%, and &gt; 20% showed progressively higher risks compared with those with PERC85 of &lt; 1% (1%-5%: OR, 1.37 [95% CI, 1.02-1.83]; 5%-20%: OR, 1.76 [95% CI, 1.07-2.86]; &gt; 20%: OR, 2.93 [95% CI, 1.20-6.98]; <em>P &lt; .</em>05 for all). The MIN85 predicted all-cause mortality (OR, 1.01 [95% CI, 1.00-1.01]; <em>P = .</em>009). Participants with 2 to 30 min and &gt; 30 min of PERC85 showed higher likelihoods of death vs those with PERC85 of &lt; 2 min (2-30 mins: OR, 1.29 [95% CI, 1.01-1.63]; &gt; 30 min: OR, 2.15 [95% CI, 1.22-3.76]; <em>P</em> &lt; .05 for all). AHI was not associated with an increased risk of mortality.</div></div><div><h3>Interpretation</h3><div>Our findings indicate that sleep hypoxemia with MIN85 is a better predictor of mortality in OSA than AHI. Monitoring oxygen saturation levels and duration may be important for risk stratification and assessment of treatment adequacy in OSA, although this may be confounded by hypoxemia not related to OSA.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843509","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":"Safety, Efficacy, and Feasibility of Nebulized Long-Acting Bronchodilators vs Short-Acting Bronchodilators in Hospitalized Patients With Acute Exacerbations of COPD","authors":"Rajiv Dhand MD ,&nbsp;Samuel Treat MD ,&nbsp;Jennifer Ferris MSHS ,&nbsp;Paul D. Terry PhD ,&nbsp;Tracy Walker BA ,&nbsp;Scott Elder RRT ,&nbsp;Daniel Church RRT ,&nbsp;Danielle Dennis PharmD ,&nbsp;Barbara Faircloth PharmD ,&nbsp;Gulsah Onar MPH ,&nbsp;R. Eric Heidel PhD ,&nbsp;Isaac Biney MD ,&nbsp;Martin Valdes MD ,&nbsp;Milind Bhagat MBBS ,&nbsp;Nicholas Fuerst MD ,&nbsp;Shannon Cusick RN","doi":"10.1016/j.chpulm.2024.100105","DOIUrl":"10.1016/j.chpulm.2024.100105","url":null,"abstract":"<div><h3>Background</h3><div>Long-acting bronchodilators are preferred over short-acting bronchodilators in patients with stable COPD, but prospective studies are needed to determine the safety and efficacy of nebulized long-acting bronchodilators in hospitalized patients with exacerbations of COPD.</div></div><div><h3>Research Question</h3><div>In hospitalized patients with exacerbations of COPD, is a combination of nebulized long-acting formoterol/revefenacin as safe and effective as the short-acting nebulized albuterol/ipratropium combination?</div></div><div><h3>Study Design and Methods</h3><div>We conducted a prospective, randomized, parallel-group study comparing a nebulized formoterol/revefenacin combination with an albuterol/ipratropium combination among 60 hospitalized patients (30 in each group) with exacerbations of COPD who tested negative for COVID-19. Treatments were administered every 12 to 24 hours (formoterol/revefenacin) or every 6 hours (albuterol/ipratropium) by jet nebulizers for up to 7 days. Safety and efficacy assessments were recorded on days 1, 3, and 7, or at hospital discharge. Assessment of dyspnea by the Modified Borg dyspnea scale was the primary outcome. Data were analyzed with parametric or nonparametric statistical tests, and generalized estimating equations with an identity link function were used to analyze differences in the two groups. Statistical significance was assumed at an unadjusted two-sided alpha value of 0.05.</div></div><div><h3>Results</h3><div>Participants’ mean age was 63.2 (SD, 9.30) years, and 39 (65.0%) reported active tobacco use. Patients’ age, sex, race, smoking history, BMI, Charlson Comorbidity Index scores, supplemental oxygen requirements, and length of hospital stay were similar in the two groups (<em>P</em> &gt; .05 for all). Patients receiving formoterol/revefenacin had similar Modified Borg dyspnea scores (<em>P</em> = .95) and required fewer total drug doses (<em>P</em> &lt; .001), but there was a nonsignificant trend for more frequent rescue treatments (<em>P</em> = .08) compared with those receiving albuterol/ipratropium. There were no serious adverse events or treatment failures in either group.</div></div><div><h3>Interpretation</h3><div>Our findings indicate that in nonventilated hospitalized patients with exacerbations of COPD, the institution of nebulized formoterol/revefenacin in combination within 24 to 36 hours of hospital admission provided convenient dosing and required fewer drug doses to achieve comparable efficacy and safety with the standard short-acting nebulized albuterol/ipratropium combination.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140055","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":"Evolution of Home Mechanical Ventilation in Sweden Over 27 Years","authors":"Andreas Palm MD, PhD ,&nbsp;Ludger Grote MD, PhD ,&nbsp;Jonas Einarsson MD ,&nbsp;Daniel Hansson MD ,&nbsp;Mirjam Ljunggren MD, PhD ,&nbsp;Josefin Sundh MD, PhD ,&nbsp;Magnus Ekström MD, PhD","doi":"10.1016/j.chpulm.2024.100108","DOIUrl":"10.1016/j.chpulm.2024.100108","url":null,"abstract":"<div><h3>Background</h3><div>Home mechanical ventilation (HMV), noninvasive ventilation and invasive ventilation outside a hospital setting, is a key treatment to improve outcomes in chronic hypoventilation.</div></div><div><h3>Research Question</h3><div>What are the temporal trends observed over 27 years in Sweden regarding the incidence, prevalence, diagnostic spectrum, and patient characteristics associated with HMV?</div></div><div><h3>Study Design and Methods</h3><div>This was a national population-based longitudinal analysis of the Course of Disease in Patients Reported to the Swedish CPAP Oxygen and Ventilator Registry (DISCOVERY) study of patients initiating HMV between 1996 and 2022. Time trends stratified by the underlying diagnosis group (lung disease, predominantly COPD, restrictive thoracal diseases, obesity hypoventilation syndrome [OHS], neuromuscular diseases, amyotrophic lateral sclerosis, and other neurologic disorders) were analyzed using linear regression models.</div></div><div><h3>Results</h3><div>We included 10,555 patients aged ≥ 16 years (mean age 63 [SD, 15] years; 50% women). Between 1996 and 1998 and 2020 and 2022, the HMV incidence increased threefold to 7 per 100,000 people, and the prevalence increased sixfold to 33 per 100,000 people. The most common indication for incident HMV shifted from restrictive thoracal diseases (35% in 1996-1998 to 3% in 2020-2022) to lung disease (14% to 31%), OHS (23% to 33%), and amyotrophic lateral sclerosis (4% to 14%) by 2020 to 2022 (<em>P</em> &lt; .001). The proportion of women increased from 47% to 54% (<em>P</em> &lt; .013) and the age at initiation of HMV increased from 58 [SD, 15] to 66 [SD, 14] years (<em>P</em> &lt; .001). Lung function measured as vital capacity at treatment start increased significantly in all diagnosis groups except for OHS, where both vital capacity and FEV₁ decreased. In the registry’s first and last 3-year periods, the proportion of patients ventilated invasively decreased from 10% to 2% (<em>P</em> &lt; .001).</div></div><div><h3>Interpretation</h3><div>In the 27 years until 2022, the incidence and prevalence of HMV in Sweden have increased markedly, patient demographics have changed, and use of invasive ventilation has decreased. The average age of patients initiated on HMV has increased, but treatment is started earlier in the disease trajectory.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140062","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":"Machines Are Learning Chest Auscultation. Will They Also Become Our Teachers?","authors":"Hans Pasterkamp MD ,&nbsp;Hasse Melbye MD, PhD","doi":"10.1016/j.chpulm.2024.100079","DOIUrl":"10.1016/j.chpulm.2024.100079","url":null,"abstract":"<div><div>Great strides in the development of machine learning techniques are bringing applications of artificial intelligence to ever more areas of clinical medicine. Their potential in the evaluation of visual images and in speech recognition is well established. Recently, the capabilities of machine hearing have been also applied to chest auscultation (ie, the automated analysis, characterization, and classification of heart and lung sounds). Comparing strengths and limitations of human vs machine hearing can help to put these developments in perspective. Humans have multisensory perception (ie, they receive visual and tactile information while auscultating). Humans also surpass machines in the ability to focus attention on listening for specific sounds in noisy environments. Together with information on a patient’s history and presumed medical diagnosis, and with frequent repetition, chest auscultation remains a trainable and valuable human skill. Advantages of machine hearing of chest sounds with digital stethoscopes include not only objective acoustic analysis but also storage of data that allows comparisons over time, presentation in audiovisual format, and wireless communication. Machines can support patient management by relating acoustic analyses to clinical diagnoses, serving as decision support for further investigations, and by monitoring of patients over time. The potential of machines to become teachers of chest auscultation is only now coming into focus. In the near future, assessment of chest sounds will largely remain in the domain of traditional acoustic stethoscopes. However, machines may well be used for training students in different health care professions and nonmedical caregivers, provided that humans remain part of the process.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140056","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":"Use of Ketamine for Conscious Sedation in Flexible Bronchoscopy","authors":"Joshua M. Boster MD ,&nbsp;Steven T. Stoffel DO ,&nbsp;S. Michael Goertzen DO ,&nbsp;Melissa M. Rosas MD ,&nbsp;Jerome C. Edelson MD ,&nbsp;Michael J. Morris MD ,&nbsp;Robert J. Walter MD ,&nbsp;John C. Hunninghake MD ,&nbsp;Edward T. McCann MD ,&nbsp;Andrew M. Hersh MD ,&nbsp;Jess T. Anderson DO","doi":"10.1016/j.chpulm.2024.100109","DOIUrl":"10.1016/j.chpulm.2024.100109","url":null,"abstract":"<div><h3>Background</h3><div>Ketamine has both analgesic and sedative properties, combined with favorable hemodynamic effects, which makes it a theoretically ideal agent for bronchoscopic sedation. Studies in the adult population that demonstrate safety, efficacy, and patient/physician satisfaction are lacking. We hypothesized that ketamine is an effective alternative to standard moderate sedation (SMS) regimens used for bronchoscopic sedation and may be preferred by patients and physicians.</div></div><div><h3>Research Question</h3><div>Is ketamine an effective alternative to SMS for flexible fiberoptic bronchoscopy?</div></div><div><h3>Study Design and Methods</h3><div>A randomized controlled trial was conducted comparing ketamine to SMS using midazolam and fentanyl for outpatient flexible fiberoptic bronchoscopy from July 2019 to March 2022. Patients who met inclusion criteria were randomized to receive either ketamine or SMS for bronchoscopic sedation. This was a single-anonymized study and the primary outcome was patient satisfaction based on the Patient Satisfaction with Sedation Instrument.</div></div><div><h3>Results</h3><div>A total of 56 patients were enrolled with 28 randomized to each cohort. There was a significant increase in reported sedation side effects based on the Patient Satisfaction with Sedation Instrument (21.8 [SD 9.1] vs 17.0 [SD 5.6], <em>P</em> = .02) in the ketamine vs SMS cohorts respectively; however, global satisfaction was similar (5.4 [SD 4.6] vs 4.6 [SD 1.5], <em>P</em> = .38). Physician global satisfaction based on the Clinician Satisfaction with Sedation Instrument was significantly worse in the ketamine cohort (50.9 [SD 23.2] vs 35.0 [SD 10.8], <em>P</em> = .002), with significantly worse satisfaction scores in the sedation administration subset (26.7 [SD 12.5] vs 17.2 [SD 5.0], <em>P</em> ≤ .001) and secretions produced category (2.97 [SD 1.8] vs 1.93 [SD 1.6], <em>P</em> = .02). There were no significant differences in adverse events, and all procedures were completed successfully.</div></div><div><h3>Interpretation</h3><div>Our results indicate that ketamine is safe in adult patients undergoing flexible fiberoptic bronchoscopy. However, the use of ketamine was associated with increased patient-reported side effects and decreased physician satisfaction.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: <span><span>NCT06181188</span><svg><path></path></svg></span>; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140058","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":"Using Real-World Research to Study the Impact of Chronic Daily Therapy Discontinuation in Cystic Fibrosis","authors":"Bradley H. Rosen ,&nbsp;Kevin J. Psoter ,&nbsp;Kathryn A. Sabadosa ,&nbsp;Georgene E. Hergenroeder ,&nbsp;Lisa L. Bendy ,&nbsp;Nell Meosky Luo ,&nbsp;Connie Zhang ,&nbsp;Clement L. Ren ,&nbsp;Cynthia D. Brown MD","doi":"10.1016/j.chpulm.2024.100080","DOIUrl":"10.1016/j.chpulm.2024.100080","url":null,"abstract":"<div><h3>Background</h3><div>Chronic daily therapies (CDTs) are the foundation of clinical care for people with cystic fibrosis (CF), but these therapies impose considerable burden. In the era of elexacaftor/tezacaftor/ivacaftor (ETI) therapy, it is not clear if CDT discontinuation would lead to a greater decrease in lung function.</div></div><div><h3>Research Question</h3><div>In people with CF who are taking or about to start ETI, does CDT discontinuation lead to lower lung function at 12 months?</div></div><div><h3>Study Design and Methods</h3><div>People with CF who are aged 12 years or older and receiving or about to start ETI therapy were included in the Home-Reported Outcomes in Cystic Fibrosis 2 (HERO-2) study, an observational cohort study that used real-world research principles. Recruitment for HERO-2 used a multimodal approach consisting of recruitment sites, referral sites, and community-based strategies. The sole method of study engagement for participants was through the Folia Health application, which participants used to track CDT and symptoms, while completing monthly validated patient-reported assessments. Demographic and clinical data, including spirometry findings, were collected through linkage with the Cystic Fibrosis Foundation Patient Registry (CFFPR). The study was designed to detect a difference of 3% in FEV₁ % predicted between individuals who did and did not discontinue any CDT.</div></div><div><h3>Results</h3><div>The multimodal approach to recruitment and broad inclusion criteria allowed HERO-2 to recruit rapidly from &gt; 70 sites, including smaller affiliate centers and community-based outreach sites. The protocol is still being executed, with anticipated results to be published when the complete CFFPR data are available.</div></div><div><h3>Interpretation</h3><div>To our knowledge, HERO-2 is the first study in the population with CF that was designed using real-world research principles.</div></div><div><h3>Trial Registry</h3><div>ClinicalTrials.gov; No.: <span><span>NCT04798014</span><svg><path></path></svg></span>; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140064","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 59-Year-Old Man With a Pulmonary Cavity Containing Fungus Balls","authors":"Takafumi Kato MD, PhD ,&nbsp;Hiroshi Igei MD ,&nbsp;Mizuki Morota MD, PhD ,&nbsp;Takuma Yotsumoto MD, PhD ,&nbsp;Takeshi Fukami MD, PhD ,&nbsp;Masashi Kitani MD ,&nbsp;Akira Hebisawa MD, PhD ,&nbsp;Junko Suzuki MD ,&nbsp;Akira Watanabe MD, PhD ,&nbsp;Nobuharu Ohshima MD, PhD ,&nbsp;Yoshiteru Morio MD, PhD ,&nbsp;Hirotoshi Matsui MD, PhD","doi":"10.1016/j.chpulm.2024.100100","DOIUrl":"10.1016/j.chpulm.2024.100100","url":null,"abstract":"<div><h3>Case Presentation</h3><div>A 59-year-old man living in the suburban area of Greater Tokyo presented to his local hospital with chronic productive cough persisting for 1 year and hemoptysis for the past 3 months. A chest CT scan revealed an uneven cavity containing multiple masses in his right upper lobe (<span><span>Fig 1</span></span>). Sputum culture turned positive twice for filamentous fungi, but species could not be identified. The patient had active tobacco use with a 25 pack-year smoking history. Additionally, he had a history of hypertension and untreated diabetes mellitus, with a hemoglobin A1C level of 12.2%. Consequently, he was referred to our hospital for further investigation and treatment.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140065","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":"Pleural Procedure Education in Fellowship","authors":"Ilana Roberts Krumm MD, MAEd ,&nbsp;Van Holden MD ,&nbsp;Lekshmi Santhosh MD, MAEd","doi":"10.1016/j.chpulm.2024.100091","DOIUrl":"10.1016/j.chpulm.2024.100091","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100091"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140059","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}