5801. How Well Does CAPTURE Translate?: An Exploratory Analysis of a COPD Case-Finding Method for Spanish-Speaking Patients.
作者: Wilson A Quezada.;Beth A Whippo.;Patricia A Jellen.;Nancy K Leidy.;David M Mannino.;Katherine J Kim.;MeiLan K Han.;Julia F Houfek.;Barry Make.;Karen G Malley.;Catherine A Meldrum.;Stephen I Rennard.;Barbara P Yawn.;Fernando J Martinez.;Byron M Thomashow.; .
来源: Chest. 2017年152卷4期761-770页
This study tested the properties of a Spanish translation of CAPTURE (COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk) with selective use of peak expiratory flow (PEF).
5802. Circulating Biologically Active Adrenomedullin (bio-ADM) Predicts Hemodynamic Support Requirement and Mortality During Sepsis.
作者: Pietro Caironi.;Roberto Latini.;Joachim Struck.;Oliver Hartmann.;Andreas Bergmann.;Giuseppe Maggio.;Marco Cavana.;Gianni Tognoni.;Antonio Pesenti.;Luciano Gattinoni.;Serge Masson.; .
来源: Chest. 2017年152卷2期312-320页
The biological role of adrenomedullin (ADM), a hormone involved in hemodynamic homeostasis, is controversial in sepsis because administration of either the peptide or an antibody against it may be beneficial.
5803. Restrictive Spirometry Pattern Is Associated With Increased Arterial Stiffness in Men and Women.
作者: I-Hsuan Wu.;Zih-Jie Sun.;Feng-Hwa Lu.;Yi-Ching Yang.;Chieh-Ying Chou.;Chih-Jen Chang.;Jin-Shang Wu.
来源: Chest. 2017年152卷2期394-401页
There is growing evidence that pulmonary function impairment is related to cardiovascular events and death. Some studies have shown that the level of FVC is negatively related to arterial stiffness, but most studies were confined to men, and none of them examined the association of the presence of restrictive spirometry pattern with arterial stiffness. Therefore, this study aimed to investigate the association of restrictive spirometry pattern with arterial stiffness by sex.
5804. Morphine Use in the ED and Outcomes of Patients With Acute Heart Failure: A Propensity Score-Matching Analysis Based on the EAHFE Registry.
作者: Òscar Miró.;Víctor Gil.;Francisco J Martín-Sánchez.;Pablo Herrero-Puente.;Javier Jacob.;Alexandre Mebazaa.;Veli-Pekka Harjola.;José Ríos.;Judd E Hollander.;W Frank Peacock.;Pere Llorens.; .
来源: Chest. 2017年152卷4期821-832页
The objective was to determine the relationship between short-term mortality and intravenous morphine use in ED patients who received a diagnosis of acute heart failure (AHF).
5805. The Role of Infection in Interstitial Lung Diseases: A Review.
Interstitial lung disease (ILD) comprises an array of heterogeneous parenchymal lung diseases that are associated with a spectrum of pathologic, radiologic, and clinical manifestations. There are ILDs with known causes and those that are idiopathic, making treatment strategies challenging. Prognosis can vary according to the type of ILD, but many exhibit gradual progression with an unpredictable clinical course in individual patients, as seen in idiopathic pulmonary fibrosis and the phenomenon of "acute exacerbation"(AE). Given the often poor prognosis of these patients, the search for a reversible cause of respiratory worsening remains paramount. Infections have been theorized to play a role in ILDs, both in the pathogenesis of ILD and as potential triggers of AE. Research efforts thus far have shown the highest association with viral pathogens; however, fungal and bacterial organisms have also been implicated. This review aims to summarize the current knowledge on the role of infections in the setting of ILD.
5806. A 19-Year-Old College Student With Headache, Photophobia, and Flulike Illness.
A 19-year-old previously healthy man presented, minimally responsive, in respiratory distress to an ED after a 2-week history of headache, photophobia, and neck stiffness. Associated symptoms included low-grade fevers, malaise, and dark urine. He had no recent travel, ill contacts, consumption of undercooked meat, new sexual contacts, or illicit drug use. The patient resided in a campus dormitory and did not consume alcohol or tobacco.
5807. A 46-Year-Old Man With Dyspnea, Hypoxemia, and Radiographic Asymmetry After Redo Bilateral Lung Transplantation.
A 46-year-old man underwent redo bilateral sequential lung transplantation for rapidly progressive bronchiolitis obliterans syndrome that developed 3.5 years after initial transplantation. In the operating room, he was sedated and intubated with a dual lumen endotracheal tube with subsequent single right-lung ventilation and left allograft implantation. His pulmonary arterial pressure became elevated with reperfusion of the newly implanted left lung, which required initiation of cardiopulmonary bypass to facilitate implantation of the right lung. After implantation and reperfusion of the right lung, the patient was weaned from cardiopulmonary bypass. His chest was closed and he was transferred to the thoracic intensive care unit. On arrival to the intensive care unit, the patient was intubated, sedated, and had an oxygen saturation of 92% on a fraction of inspired oxygen of 100%, positive end-expiratory pressure of 10 cm H2O, and 20 parts per million of inhaled nitric oxide. He had a Swan-Ganz catheter in the right internal jugular vein that measured a mean pulmonary arterial pressure of 33 mm Hg and a pulmonary arterial systolic pressure of 63 mm Hg, which remained persistently elevated and prompted further diagnostic evaluation.
5808. A 28-Year-Old Woman With Branching Opacity and Chest Pain.
A 28-year-old female patient presented through her primary care physician with symptoms of atypical chest pain and chronic cough. Her pain was described as pleuritic and intermittently radiating to the right arm. Her medical history was significant for recurrent respiratory infections, gastritis, and a left ovarian cyst treated with ipsilateral salpingo-oophorectomy. She denied any history of smoking, known lung disease, or extrapulmonary infections.
5812. Treatment of Idiopathic Diaphragm Flutter: A Case Study.
作者: Michael Chiou.;María Victoria Herrero.;John R Bach.;Jeffrey L Cole.;Enrique Luis Gonzales.
来源: Chest. 2017年151卷4期e69-e71页
Diaphragm flutter is a rare disorder defined by dyspnea and often thoracoabdominal pain associated with rapid rhythmic involuntary contractions of the diaphragm with no effective treatment. A 35-year-old woman's flutter was triggered by increasing the depth of breathing and by (electrical) stimulation of the diaphragm. Medical therapy, phrenic nerve crush, and diaphragm pacer stimulation were ineffective. Since increasing diaphragm activity was a trigger, resting the diaphragm was tried. A manual resuscitator and, subsequently, mouthpiece and nasal noninvasive ventilatory support (NVS) instantaneously halted the flutter for 3 months and almost instantaneously for another 6 months. For 16 months, it has continued to halt flutter with rare episodes when getting out of bed that resolve with up to 40 minutes of NVS. To our knowledge, this is the first case of idiopathic diaphragmatic flutter for which diaphragm rest was used as successful treatment with no adverse effects. This should be tried for future cases.
5813. A Patient-Based Analysis of the Geographic Distribution of Mycobacterium avium complex, Mycobacterium abscessus, and Mycobacterium kansasii Infections in the United States.
作者: Mehdi Mirsaeidi.;Ann Vu.;Philip Leitman.;Arash Sharifi.;Susan Wisliceny.;Amy Leitman.;Andreas Schmid.;Michael Campos.;Joe Falkinham.;Matthias Salathe.
来源: Chest. 2017年151卷4期947-950页 |