Chest最新文献

{"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}

{"title":"Rebuttal From Drs Oldham and Cottin.","authors":"Justin M Oldham,Vincent Cottin","doi":"10.1016/j.chest.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.chest.2024.12.007","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"50 1","pages":"1279-1281"},"PeriodicalIF":9.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932920","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":"APCCMPD and CHEST Medical Educator Scholar Fellowship: A Novel Mechanism to Build Diverse Medical Educators.","authors":"Mary Elizabeth Kreider,Kristin M Burkart,Joyce Reitzner,James A Frank,Jack Buckley,Doreen Addrizzo-Harris","doi":"10.1016/j.chest.2024.11.031","DOIUrl":"https://doi.org/10.1016/j.chest.2024.11.031","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"32 1","pages":"1285-1286"},"PeriodicalIF":9.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932924","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":"Differences in Expert Opinion on Selection of Initial Biologics and Biologic Switching in Severe Asthma.","authors":"İnsu Yılmaz,Murat Türk","doi":"10.1016/j.chest.2024.11.037","DOIUrl":"https://doi.org/10.1016/j.chest.2024.11.037","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"17 1","pages":"e167"},"PeriodicalIF":9.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143933008","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":"Association of Pulmonary Hypertension With Trastuzumab Emtansine: An Analysis of French Pulmonary Hypertension Registry and WHO Pharmacovigilance Database.","authors":"Camille Poisson, Alex Hlavaty, Nicolas Favrolt, Marie-Camille Chaumais, Julien Grynblat, Etienne-Marie Jutant, Benoît Lechartier, Arnaud Maurac, Pierre Mouillot, Sylvain Palat, Laurie Rambach, Fabrice Antigny, Vincent Cottin, Guillaume Beltramo, Marc Humbert, Charles Khouri, Philippe Bonniaud, David Montani","doi":"10.1016/j.chest.2024.11.006","DOIUrl":"10.1016/j.chest.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>Trastuzumab emtansine has been recently suspected to be associated with the development of pulmonary arterial hypertension (PAH).</p><p><strong>Research question: </strong>Is there an association between trastuzumab, trastuzumab emtansine, or trastuzumab deruxtecan and the development of PAH?</p><p><strong>Study design and methods: </strong>Characteristics of incident PAH cases treated with trastuzumab, trastuzumab emtansine, or trastuzumab deruxtecan were analyzed from the French Pulmonary Hypertension Registry, the VIGIAPATH program, concurrently with a pharmacovigilance disproportionality analysis using the World Health Organization pharmacovigilance database using a broad definition of pulmonary hypertension (PH) and a narrow definition of PAH. A signal of disproportionate reporting was deemed significant if the lower boundary of the 95% credibility interval of the information component (IC) was superior to 0. The variables were expressed as median (interquartile range [IQR]).</p><p><strong>Results: </strong>In the French PH Registry, we identified 8 incident cases of PAH after trastuzumab emtansine exposure and none with trastuzumab alone or trastuzumab deruxtecan. All cases occurred in female patients (age, 56; IQR, 49-61 years) with breast cancer. The delay between first exposure and PAH diagnosis was 43 months (IQR, 4.5-55). At diagnosis, 5 were in New York Heart Association functional class III/IV with severe hemodynamic impairment (mean pulmonary artery pressure, 42 mm Hg; cardiac index, 2.51 L/min/m²; pulmonary vascular resistance, 9.7 Wood units). Disproportionality analysis showed that only trastuzumab emtansine demonstrated a significant signal of disproportionate reporting using both a broad definition of PH (IC, 1.46; 0.86-1.95) and a narrow definition of PAH (IC, 1.76; 0.83-2.46). Trastuzumab displayed a significant signal using only the broad definition of PH, whereas trastuzumab deruxtecan was not associated with any significant signals of disproportionate reporting.</p><p><strong>Interpretation: </strong>Our results suggest that more patients exposed to trastuzumab emtansine developed PH compared with trastuzumab alone. Further assessment of this safety signal and exploration of pathophysiologic mechanisms is needed.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"1468-1480"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686040","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":"Dietary Pattern, Sputum DNA Methylation, and Lung Health: An Epidemiological Study in People Who Ever Smoked.","authors":"Yue Feng, Huining Kang, Akshay Sood, Dolores D Guest, Teresa T Fung, Cassie L Rowe, Maria A Picchi, Vernon Shane Pankratz, Steven A Belinsky, Shuguang Leng","doi":"10.1016/j.chest.2024.11.007","DOIUrl":"10.1016/j.chest.2024.11.007","url":null,"abstract":"<p><strong>Background: </strong>We previously identified a sputum 12-gene methylation panel that predicts lung aging and risk for lung cancer.</p><p><strong>Research question: </strong>Can the sputum methylation panel be used as a readout to derive a dietary pattern beneficial for lung health? Is this dietary pattern associated with various subjective and objective lung health phenotypes? Does this relationship vary among people who currently smoke vs previously smoked?</p><p><strong>Study design and methods: </strong>Using the Lovelace Smoker Cohort (LSC), we employed the least absolute shrinkage and selection operator regularized Poisson regression to define a dietary pattern for sputum. Associations of the dietary pattern with objective and subjective lung health measurements were examined using generalized linear and Cox models in the LSC and the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening trial.</p><p><strong>Results: </strong>The Dietary Pattern for Healthy Lung (DiPHeaL) includes low consumption of processed meat, and high consumption of dark green vegetables, tea, alcohol, and fruit juice. In the LSC, a higher DiPHeaL score (1 SD) was associated with better FEV₁ (by 96.1 mL/s), FEV₁/FVC ratio (by 1.83%), and respiratory quality of life (by 4.9 for activity score), and decreased cardiopulmonary mortality (by 47%) in participants who previously smoked (all P values < .05), but not in participants who currently smoke. Moreover, effect sizes of the DiPHeaL score on respiratory quality of life measures were greater among participants who previously smoked with airway obstruction compared with those without. Associations with cardiovascular and respiratory mortality were replicated in PLCO participants who previously smoked . A higher DiPHeaL score was also associated with lower lung cancer incidence in participants who previously smoked, as well as reduced COPD incidence and lung cancer mortality regardless of smoking status in the PLCO.</p><p><strong>Interpretation: </strong>We defined a novel dietary pattern for lung epigenetic aging, which linked to lung health measurements. Participants who previously smoked, especially those with airway obstruction, may benefit the most from nutritional modification.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"1333-1345"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response.","authors":"Simon Couillard, David J Jackson, Ian D Pavord, Michael E Wechsler","doi":"10.1016/j.chest.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.chest.2024.12.012","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 5","pages":"e168-e169"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975097","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":"Do Not Resuscitate the Direct Laryngoscope.","authors":"Michael F Aziz","doi":"10.1016/j.chest.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.chest.2025.01.019","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"2615 1","pages":"1259-1260"},"PeriodicalIF":9.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143933001","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":"Virtual Reality Anatomy Trainer Turns Teaching Endobronchial Ultrasound Inside-Out.","authors":"Melissa L New, Tristan J Huie, Dru Claar, Timothy Amass, Ryan A Peterson, Max McGrath, Nicholas Jacobson, Anna Neumeier, Darlene Nelson","doi":"10.1016/j.chest.2024.11.032","DOIUrl":"10.1016/j.chest.2024.11.032","url":null,"abstract":"<p><strong>Background: </strong>Traditional approaches for learning anatomy for curvilinear endobronchial ultrasound (EBUS) require learners to mentally visualize structures relative to the position of the bronchoscope. Virtual reality (VR) can show anatomy from the perspective of bronchoscopic tools.</p><p><strong>Research question: </strong>Does the use of a VR anatomy trainer for teaching EBUS-associated anatomy improve procedural performance compared with traditional methods?</p><p><strong>Study design and methods: </strong>In this randomized, crossover study design, participants studied EBUS-related anatomy during 2 sequential sessions using a VR trainer and a traditional modality (2-dimensional pictures or a 3-dimensional model). An EBUS simulator was used to test performance at baseline and following each training session. User experience and preferences were evaluated by using a mixed-methods approach of surveys and interviews. Spatial reasoning ability was measured by using the Mental Rotation Test.</p><p><strong>Results: </strong>Sixty-eight fellows and residents at 3 institutions completed the study. All 3 learning methods improved EBUS performance significantly following the first, but not second, learning session. Learners spent more time (1.37 minutes) with VR, but no training method produced a greater improvement. Spatial reasoning ability was associated with improved EBUS performance. This impact was modified by training method: the VR approach leveled the impact of baseline spatial reasoning. The VR approach was preferred by 96% of learners. Qualitative data revealed a positive VR user experience with focused anatomy learning, ease of use, acceptable realism, and tolerance. This novel \"inside-looking-out\" perspective helped learners understand anatomy from the vantage of procedural tools and to create a mental map, but interpreting ultrasound remained challenging.</p><p><strong>Interpretation: </strong>A VR anatomy trainer was preferred by learners because it provided visualization that aligned best with the procedural perspective. This approach helped learners of all spatial reasoning ability improve their procedural performance.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"1440-1450"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812007","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":"Low-Dose Melatonin for Prevention of Delirium in Critically Ill Patients: A Multicenter, Randomized, Placebo-Controlled Feasibility Trial.","authors":"Lisa D Burry, David R Williamson, Michael E Detsky, Francis Bernard, Jennifer Foster, Sangeeta Mehta, Ruxandra Pinto, Damon C Scales, Louise Rose","doi":"10.1016/j.chest.2024.12.030","DOIUrl":"10.1016/j.chest.2024.12.030","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a common and serious syndrome of acute brain dysfunction associated with negative outcomes. Melatonin may have a role in delirium prevention for critically ill adults based on data from noncritically ill patient populations. Our objective was to assess the feasibility of a multicenter, randomized, placebo-controlled trial testing the hypothesis that low-dose melatonin prevents delirium in adults who are critically ill.</p><p><strong>Research question: </strong>Does low-dose melatonin prevent delirium in critically ill adults?</p><p><strong>Study design and methods: </strong>We conducted this 3-arm feasibility trial in 3 tertiary academic ICUs. Included participants were ≥ 18 years of age, confirmed free of delirium at enrollment, and anticipated to require a > 48-hour ICU stay. We randomized participants to nightly melatonin 0.5 mg, 2 mg, or placebo. Feasibility outcomes were protocol adherence and recruitment rates. Our primary feasibility target was ≥ 85% (± 5% margin of error) of drug doses administered as per protocol. Secondary objectives were to explore adverse drug effects, melatonin pharmacokinetics, and clinical outcomes.</p><p><strong>Results: </strong>We screened 2,259 patients and excluded 1,863 patients (82.5%), resulting in 396 eligible patients, of whom 71 provided consent, for a recruitment rate of 0.8 patients/mo/site. Median age was 60.5 years (interquartile range [IQR], 48-67 years), and median admission Sequential Organ Failure Assessment score was 7 (IQR, 3-10). Percentage drug administration protocol adherence per patient was a median of 100% (IQR, 92.3%-100%) or a mean of 88.7% (SD, 24.4%). Twenty-five protocol violations occurred, with no differences between groups. Fourteen patients (20%) experienced delirium during the study period and 25 patients (36%) experienced subsyndromal delirium, with no differences between study groups. No serious adverse effects were detected.</p><p><strong>Interpretation: </strong>Our trial protocol comparing 2 low doses of melatonin and placebo for delirium prevention in critically ill adults demonstrated feasibility for protocol adherence. However, trial eligibility rates were modest primarily because of delirium being present or the inability to screen. Consent rates also were low. This finding suggests that conducting delirium prevention trials that require delirium to be absent on enrollment is particularly challenging in the ICU.</p><p><strong>Clinical trial registry: </strong>ClinicalTrials.gov; No.: NCT02615340; URL: www.</p><p><strong>Clinicaltrials: </strong>gov.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"1397-1407"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}