Chest最新文献

{"title":"Response.","authors":"Narelle S Cox, Christine F McDonald, Angela T Burge, Catherine J Hill, Janet Bondarenko, Anne E Holland","doi":"10.1016/j.chest.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.chest.2025.01.008","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 5","pages":"e170-e171"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy of Serum Antiglycopeptidolipid Core IgA Antibody Test for Screening Nontuberculous Mycobacterial Pulmonary Disease in Bronchiectasis: A European Multicenter Cohort Study.","authors":"Hayoung Choi, Chloe Hughes, Zsofia Eke, Morven Shuttleworth, Michal Shteinberg, Eva Polverino, Pieter C Goeminne, Tobias Welte, Francesco Blasi, Amelia Shoemark, Merete B Long, Stefano Aliberti, Charles S Haworth, Felix C Ringshausen, Michael R Loebinger, Natalie Lorent, James D Chalmers","doi":"10.1016/j.chest.2024.10.029","DOIUrl":"10.1016/j.chest.2024.10.029","url":null,"abstract":"<p><strong>Background: </strong>The serum antiglycopeptidolipid core IgA antibody test has been proposed as a diagnostic tool for Mycobacterium avium complex pulmonary diseases. Cross-reactivity with other nontuberculous mycobacteria (NTM), including Mycobacterium abscessus, indicates that it may have a role as a broader screening test for nontuberculous mycobacterial pulmonary disease (NTM-PD). NTM-PD is believed to be underdiagnosed in patients with bronchiectasis.</p><p><strong>Research question: </strong>Can the serum antiglycopeptidolipid core IgA antibody test be used to screen for NTM-PD in bronchiectasis?</p><p><strong>Study design and methods: </strong>Patients from the prospective European Bronchiectasis Registry (European Multicentre Bronchiectasis Audit and Research Collaboration-Bronchiectasis Research Involving Databases, Genomics and Endotyping; ClinicalTrails.gov Identifier: NCT03791086) were enrolled. Patients from the United Kingdom, Italy, Spain, Belgium, The Netherlands, and Germany were included. A control cohort of patients without any underlying lung disease also was recruited. The levels of serum IgA antibodies against the glycopeptidolipid core were measured using an enzyme immunoassay kit, and receiver operating characteristics curve analysis was conducted to evaluate the accuracy of the antibody level in screening for NTM-PD.</p><p><strong>Results: </strong>Two hundred eighty-two patients were enrolled (151 female patients [53.6%]; median age, 68 years). Median antiglycopeptidolipid core IgA antibody levels were 0.2 U/mL (interquartile range [IQR], 0.1-0.3 U/mL) in patients without NTM isolation and NTM-PD (n = 238), 0.3 U/mL (IQR, 0.2-0.4 U/mL) in patients with NTM isolation that was incompatible with the diagnosis of NTM-PD (n = 18), and 1.5 U/mL (IQR, 0.4-6.2 U/mL) in patients with NTM-PD (n = 26; P = .0001). Antibody levels showed excellent accuracy in identifying patients with NTM-PD (area under the receiver operating characteristic curve, 0.886; 95% CI, 0.800-0.973) in the bronchiectasis cohort and also showed excellent discrimination of patients with NTM-PD from those with NTM isolation who did not meet the diagnostic criteria for NTM-PD (0.816; 95% CI, 0.687-0.945).</p><p><strong>Interpretation: </strong>The antiglycopeptidolipid core IgA antibody demonstrated excellent efficacy in screening for NTM-PD in a large cohort of patients with bronchiectasis.</p><p><strong>Clinical trial registry: </strong>ClinicalTrials.gov; No.: NCT03791086; URL: www.</p><p><strong>Clinicaltrials: </strong>gov.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"1300-1310"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Socioeconomic Status and Phenotypic Frailty With Incident COPD: Findings From UK Biobank Participants.","authors":"Zhaolong Feng, Guoxian Li, Qida He, Na Sun, Tongxing Li, Qiang Han, Hanqing Zhao, Ze Ma, Mengtong Sun, Boyan Liu, Yu Wang, Zexin Lou, Siqian Ma, Yujie Shi, Jianing Li, Ziqing Sun, Miao Jiang, Yueping Shen","doi":"10.1016/j.chest.2024.11.004","DOIUrl":"10.1016/j.chest.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>The independent, mediation, interaction, and joint effects of socioeconomic status (SES) and phenotypic frailty on the incidence of COPD are unclear.</p><p><strong>Research question: </strong>Do SES and frailty increase the risk of COPD independently or jointly? Is there an interaction between the 2 factors in incident COPD? Does frailty play a mediating role between SES and COPD?</p><p><strong>Study design and methods: </strong>This study included 396,106 UK Biobank participants without COPD at baseline. Latent class analysis was used to define the SES of participants. Frailty was defined by the frailty phenotypes according to 5 factors. Cox regression models were used to examine the associations and calculate hazard ratios (HRs) and 95% CIs. Mediation and interaction analyses were used to explain the associations between SES and frailty on COPD risk.</p><p><strong>Results: </strong>During a median follow-up period of 13.5 years, 12,626 individuals were diagnosed with COPD. Compared with high SES or robust individuals, low SES (HR, 2.69; 95% CI, 2.48-2.92) or frailty (HR, 2.75; 95% CI, 2.58-2.93) increased the risk of COPD, respectively; 11.80% of the association between SES and COPD was mediated by frailty. In addition, there was a statistically significant additive interaction of low SES and frailty with COPD incidence (relative risk due to interaction, 3.591; 95% CI, 2.189-4.992; attributable proportion due to the interaction, 0.433; 95% CI, 0.276-0.589). Compared with robust individuals with high SES, frail individuals with low SES have the highest risk of COPD (HR, 7.85; 95% CI, 6.96-8.86).</p><p><strong>Interpretation: </strong>Our findings indicate that low SES and frailty are independent risk factors for COPD, and these 2 factors also have synergistic interaction in COPD. Frailty partially mediated the association between SES and COPD. Thus, the early identification and reversal of frailty may minimize the risk of COPD, especially in individuals with low SES.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"1321-1332"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is a \"Fine Tuning\" of the Flow Rate During High Flow Oxygen Therapy Clinically Relevant?: The Optimal Setting of High Flow Nasal Cannula Should Be Explored Further.","authors":"Alessandro Galazzi,Giacomo Grasselli","doi":"10.1016/j.chest.2025.01.028","DOIUrl":"https://doi.org/10.1016/j.chest.2025.01.028","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"26 1","pages":"1257-1258"},"PeriodicalIF":9.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extra-ICU Unsurvivability: Impermissible to Unilaterally Withdraw Extracorporeal Membrane Oxygenation.","authors":"Thaddeus Mason Pope","doi":"10.1016/j.chest.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.chest.2025.01.003","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"25 1","pages":"e171-e172"},"PeriodicalIF":9.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease Beyond the Lungs: Optimal Care of Multi-Organ Disease After Lung Transplantation.","authors":"A Whitney Brown,Erin E Tallarico,Virginia Steen","doi":"10.1016/j.chest.2024.09.036","DOIUrl":"https://doi.org/10.1016/j.chest.2024.09.036","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"13 1","pages":"1282-1284"},"PeriodicalIF":9.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143933002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Sarcoidosis Mortality Rates in United States Veterans: Who Are More Affected and Why?","authors":"Marios Rossides","doi":"10.1016/j.chest.2024.11.018","DOIUrl":"https://doi.org/10.1016/j.chest.2024.11.018","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"26 1","pages":"1263-1264"},"PeriodicalIF":9.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143933003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Decision-Making in the ICU: Communicating With Patients Who Speak a Language of Lesser Diffusion.","authors":"Ibrahim Serhat Karakus, Sumera R Ahmad, Amelia K Barwise","doi":"10.1016/j.chest.2025.02.001","DOIUrl":"10.1016/j.chest.2025.02.001","url":null,"abstract":"<p><p>Effective bidirectional communication is crucial during end-of-life decision-making, which requires clear understanding between clinicians and patients and their family members about treatment options, preferences, and goals of care. For those who have a non-English language preference or who have difficulty speaking, reading, writing, and understanding English, interpreters are essential. However, patients who speak rarer languages, known as languages of lesser diffusion (LLDs), such as Karen, spoken in Thailand and Myanmar, face unique challenges because of limited interpretation resources. In this work, we discuss the case of a Karen-speaking patient admitted to the ICU who lacked decision-making capacity, requiring the involvement of family members who also spoke Karen for a code status discussion. Despite efforts to find an interpreter, no Karen interpreter was available initially, complicating the communication and decision-making about changing the code status to do not resuscitate/do not intubate. A remote Karen interpreter was identified later, allowing for effective communication and clinician assurance that the family did understand the implications of their decision and had made it voluntarily. End-of-life decision-making is complex and challenging, requiring culturally sensitive communication. Patients who speak LLDs face unique difficulties in these discussions compared with those who speak more common languages because of the lack of interpretation resources. The purpose of this case report is to draw attention to these specific challenges and explore ethical concerns when engaging in decision-making conversations with patients and families who speak an LLD.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"1462-1467"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response.","authors":"Laavanya Dharmakulaseelan, Mark I Boulos","doi":"10.1016/j.chest.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.chest.2024.12.010","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 5","pages":"e174-e175"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to: Moores LK, Tritschler T, Brosnahan S, et al. Chest. 2022;162(1):213-225.","authors":"","doi":"10.1016/j.chest.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.chest.2025.04.001","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"166 1","pages":"1514"},"PeriodicalIF":9.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}