Chest最新文献

{"title":"Infections and Lung Cancer: An Opportunity to Identify High-Risk Individuals Beyond Smoking?","authors":"Dominique S Michaud","doi":"10.1016/j.chest.2024.08.032","DOIUrl":"https://doi.org/10.1016/j.chest.2024.08.032","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 1","pages":"21-23"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964091","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":"The DecatSepsis Randomized Controlled Trial: Dexmedetomidine's Potential and Persisting Puzzles in Septic Shock.","authors":"Wei-Zhen Tang, Wei-Ze Xu, Tai-Hang Liu","doi":"10.1016/j.chest.2024.07.169","DOIUrl":"https://doi.org/10.1016/j.chest.2024.07.169","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 1","pages":"e30"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964035","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":"Beta Blockers and Septic Shock: More Work to Do.","authors":"Tony Whitehouse, Mervyn Singer","doi":"10.1016/j.chest.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.chest.2024.09.007","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 1","pages":"9-10"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964078","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":"Difficulties in the Concurrent Diagnoses of Sarcoidosis and Autoimmune Disorders.","authors":"Johnny F Jaber, Lauran Zeineddine, Divya C Patel, Diana Gomez-Manjarres","doi":"10.1016/j.chest.2024.09.023","DOIUrl":"https://doi.org/10.1016/j.chest.2024.09.023","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 1","pages":"e31-e32"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964089","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":"Moataz Maher Emara","doi":"10.1016/j.chest.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.chest.2024.09.001","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 1","pages":"e29"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964100","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":"Are Statistical Tests Really Needed to Compare Training and Validation Sets for Prediction Model Development and Evaluation?","authors":"Yuxuan Jin, Mithat Gönen, Michael W Kattan","doi":"10.1016/j.chest.2024.07.164","DOIUrl":"https://doi.org/10.1016/j.chest.2024.07.164","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 1","pages":"40-41"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964074","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":"Hospital-Treated Infectious Diseases, Infection Burden, and Risk of Lung Cancer: An Observational and Mendelian Randomization Study.","authors":"Jiazhen Zheng, Jinghan Huang, Quan Yang, Rui Zhou, Yining Huang, Xianbo Wu, Shaojun Tang","doi":"10.1016/j.chest.2024.06.3811","DOIUrl":"10.1016/j.chest.2024.06.3811","url":null,"abstract":"<p><strong>Background: </strong>Although infections play a role in the development of lung cancer, the longitudinal association between infection and the risk of lung cancer is disputed, and data relating to pathogen types and infection sites are sparse.</p><p><strong>Research question: </strong>How do infections affect subsequent lung cancer risk, and is the impact limited to specific microbes rather than infection burden?</p><p><strong>Study design and methods: </strong>Data on > 900 infectious diseases were gathered from the UK Biobank study. Short- and long-term effects of infections were assessed by using time-varying Cox proportional hazards models. The analysis was repeated, excluding patients with concurrent multi-pathogen infections or outcomes within the 10 years following the initial hospitalization for the index infection. A life table approach was used to estimate years of life lost from lung cancer. Infection burden was defined as the sum of the number of infection episodes over time and co-occurring infections. The genome-wide association studies used in two-sample Mendelian randomization were obtained from mostly European ancestry.</p><p><strong>Results: </strong>Hospital-treated infectious disease was associated with a greater risk of lung cancer (adjusted hazard ratio [aHR], 1.79; 95% CI, 1.74-1.83). aHRs for lung cancer ranged from 1.39 to 2.82 across pathogen types. The impact of lower respiratory tract infections (LRTIs) on lung cancer was the strongest, with an aHR of 3.22 (95% CI, 2.64-3.92); the aHR for extra-LRTIs was 1.29 (95% CI, 1.16-1.44). A dose-response association was observed between infection burden and lung cancer risk across different FEV₁ percent predicted (P_trend < .001). Multiple infections led to significant life lost from lung cancer at the age of 50 years. Mendelian randomization analysis reaffirmed the causal association.</p><p><strong>Interpretation: </strong>Both observational and genetic analyses suggest that infectious diseases could increase the risk of lung cancer. The dual perspective on the LRTIs and extra-LRTIs impacts may inform lung cancer prevention strategies.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"270-282"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859178","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":"Gender Differences in Outcomes of Ambulatory and Hospitalized Patients With Obesity Hypoventilation Syndrome.","authors":"Nathan C Nowalk, Babak Mokhlesi, Julie M Neborak, Juan Fernando Masa Jimenez, Ivan Benitez, Francisco J Gomez de Terreros, Auxiliadora Romero, Candela Caballero-Eraso, Maria F Troncoso, Mónica González, Soledad López-Martín, José M Marin, Sergi Martí, Trinidad Díaz-Cambriles, Eusebi Chiner, Carlos Egea, Isabel Utrabo, Ferran Barbe, Maria Ángeles Sánchez-Quiroga","doi":"10.1016/j.chest.2024.10.002","DOIUrl":"10.1016/j.chest.2024.10.002","url":null,"abstract":"<p><strong>Background: </strong>Obesity hypoventilation syndrome (OHS) is associated with high morbidity and mortality. There are few data on whether there are gender differences in outcomes.</p><p><strong>Research question: </strong>Do women with OHS experience worse outcomes in ambulatory and hospitalized settings compared to men?</p><p><strong>Study design and methods: </strong>Post hoc analyses were performed on two separate OHS cohorts: (1) stable ambulatory patients from the two Pickwick randomized controlled trials; and (2) hospitalized patients with acute-on-chronic hypercapnic respiratory failure from a retrospective international cohort. We first conducted bivariate analyses of baseline characteristics and therapeutics between genders. Variables of interest from these analyses were then grouped into linear mixed effects models, Cox proportional hazards models, or logistic regression models to assess the association of gender on various clinical outcomes.</p><p><strong>Results: </strong>The ambulatory prospective cohort included 300 patients (64% self-identified as women), and the hospitalized retrospective cohort included 1,162 patients (58% self-identified as women). For both cohorts, women were significantly older and more obese than men. Compared with men, baseline Paco₂ was similar in ambulatory patients but higher in hospitalized women. In the ambulatory cohort, in unadjusted analysis, women had increased risk of emergency department visits. However, gender was not associated with the composite outcome of emergency department visit, hospitalization, or all-cause mortality in the fully adjusted model. In the hospitalized cohort, prescription of positive airway pressure was less prevalent in women at discharge. In unadjusted analysis, hospitalized women had a higher mortality at 3, 6, and 12 months following hospital discharge compared with men. However, after adjusting for age, gender was not associated with mortality.</p><p><strong>Interpretation: </strong>Our findings indicate that although the diagnosis of OHS is established at a more advanced age in women, gender is not independently associated with worse clinical outcomes after adjusting for age. Future studies are needed to examine gender-related health disparities in diagnosis and treatment of OHS.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"245-258"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399457","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":"Mortality in Patients With Sepsis Treated With Esmolol or Landiolol: A Systematic Review and Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis.","authors":"Ryota Sato, Simone Messina, Daisuke Hasegawa, Cristina Santonocito, Giulia Scimonello, Giulia Sanfilippo, Andrea Morelli, Siddharth Dugar, Filippo Sanfilippo","doi":"10.1016/j.chest.2024.08.020","DOIUrl":"10.1016/j.chest.2024.08.020","url":null,"abstract":"<p><strong>Background: </strong>The latest meta-analysis indicated potential survival benefits from ultra-short-acting β-blockers in patients with sepsis with persistent tachycardia. However, subsequent multicenter randomized controlled trials (RCTs) have reported conflicting findings, prompting the need for an updated meta-analysis to incorporate these newly published RCTs.</p><p><strong>Research question: </strong>Does the use of ultra-short-acting β-blockers (esmolol or landiolol) in patients with sepsis with persistent tachycardia improve mortality?</p><p><strong>Study design and methods: </strong>We conducted an updated systematic search through April 2, 2024, exploring the MEDLINE, Cochrane Central Register of Controlled Trials, and Embase databases for RCTs reporting mortality in adult patients with sepsis treated with esmolol or landiolol as compared with those treated with neither of these or receiving placebo and published in English. Meta-analyses were conducted with the random effects model. The primary outcome was mortality at the longest follow-up, with subgroup analysis separating single-center RCTS from large multicenter RCTs.</p><p><strong>Results: </strong>Eight RCTs (885 patients) were included in the primary analysis. Ultra-short-acting β-blockers did not improve mortality significantly at the longest follow-up (risk ratio, 0.84; 95% CI, 0.68-1.02; P = .08; I² = 51%; very low certainty of the evidence) and 28-day mortality (risk ratio, 0.77; 95% CI, 0.59-1.00; P = .05; I² = 62%). Subgroup analyses of mortality outcomes pointed toward different results between single-center and multicenter RCTs. Trial sequence analyses showed that both mortality outcomes were not robust. The sensitivity analyses suggested a significant reduction in mortality by adding RCTs published in non-English languages.</p><p><strong>Interpretation: </strong>In this updated meta-analysis, the use of esmolol or landiolol did not reduce mortality in patients with sepsis with persistent tachycardia. However, results were not robust and outcomes differed between single-center and multicenter RCTs. Moreover, sensitivity analyses showed the fragility of the primary outcome. Further studies regarding ultra-short-acting β-blockers with advanced cardiac monitoring or serial echocardiography are warranted.</p><p><strong>Trial registry: </strong>International Prospective Register of Systematic Reviews; No.: CRD42024503570; URL: https://www.crd.york.ac.uk/prospero/.</p>","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":"121-138"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092460","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 Dr Jones.","authors":"Barbara E Jones","doi":"10.1016/j.chest.2024.08.053","DOIUrl":"https://doi.org/10.1016/j.chest.2024.08.053","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"167 1","pages":"32-33"},"PeriodicalIF":9.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964097","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}