2892. IL-33 Depletion in COVID-19 Lungs.
作者: Rohit Gaurav.;Daniel R Anderson.;Stanley J Radio.;Kristina L Bailey.;Bryant R England.;Ted R Mikuls.;Geoffrey M Thiele.;Heather M Strah.;Debra J Romberger.;Todd A Wyatt.;John D Dickinson.;Michael J Duryee.;Dawn M Katafiasz.;Amy J Nelson.;Jill A Poole.
来源: Chest. 2021年160卷5期1656-1659页 2893. Risks and Benefits of Fluid Administration as Assessed by Ultrasound.
For patients in shock, decisions regarding administering or withholding IV fluids are both difficult and important. Although a strategy of relatively liberal fluid administration has traditionally been popular, recent trial results suggest that moving to a more fluid-restrictive approach may be prudent. The goal of this article was to outline how whole-body point-of-care ultrasound can help clarify both the possible benefits and the potential risks of fluid administration, aiding in the risk/benefit calculations that should always accompany fluid-related decisions.
2894. Presenting Features and Clinical Course of Chronic Nitrofurantoin-Induced Lung Toxicity.
作者: Vasilios Tzilas.;Antonios Charokopos.;Lykourgos Kolilekas.;Effrosyni Manali.;Spyridon Papiris.;Jay H Ryu.;Demosthenes Bouros.
来源: Chest. 2022年161卷3期748-752页 2895. Strategies to Improve Bedside Clinical Skills Teaching.
The bedside encounter between a patient and physician remains the cornerstone of the practice of medicine. However, physicians and trainees spend less time in direct contact with patients and families in the modern health care system. The current pandemic has further threatened time spent with patients. This lack of time has led to a decline in clinical skills and a decrease in the number of faculty members who are confident in teaching at the bedside. We offer several strategies to get physicians and trainees back to the bedside to engage in clinical skills teaching and assessment. We recommend that providers pause before bedside encounters to be present with patients and learners and to develop clear goals for a bedside teaching session. We suggest that clinical teachers practice an evidence-based approach, which includes an hypothesis-driven physical examination. We encourage the use of point-of-care technology to assist in diagnosis and to allow learners to calibrate traditional physical examination skills with real-time visualization of disease. Tools like point-of-care ultrasound can be powerful levers to get learners excited about bedside teaching and to engage patients in their clinical care. We value telemedicine visits as unique opportunities to engage with patients in their home environment and to participate in patient-directed physical examination maneuvers. Finally, we recommend that educators provide feedback to learners on specific clinical examination skills, whether in the clinic, the wards, or during dedicated clinical skills assessments.
2896. An Integrative Genomic Strategy Identifies sRAGE as a Causal and Protective Biomarker of Lung Function.
作者: Joshua Keefe.;Chen Yao.;Shih-Jen Hwang.;Paul Courchesne.;Gha Young Lee.;Josée Dupuis.;Joseph P Mizgerd.;George O'Connor.;George R Washko.;Michael H Cho.;Edwin K Silverman.;Daniel Levy.
来源: Chest. 2022年161卷1期76-84页
There are few clinically useful circulating biomarkers of lung function and lung disease. We hypothesized that genome-wide association studies (GWAS) of circulating proteins in conjunction with GWAS of pulmonary traits represents a clinically relevant approach to identifying causal proteins and therapeutically useful insights into mechanisms related to lung function and disease.
2897. Bilevel Noninvasive Ventilation During Exercise Reduces Dynamic Hyperinflation and Improves Cycle Endurance Time in Severe to Very Severe COPD.
作者: Clancy J Dennis.;Collette Menadue.;Tessa Schneeberger.;Daniela Leitl.;Ursula Schoenheit-Kenn.;Camilla M Hoyos.;Alison R Harmer.;David J Barnes.;Andreas R Koczulla.;Klaus Kenn.;Jennifer A Alison.
来源: Chest. 2021年160卷6期2066-2079页
During exercise, dynamic hyperinflation (DH), measured by a reduction in inspiratory capacity (IC), increases exertional dyspnea and reduces functional capacity in many patients with severe COPD. Although noninvasive ventilation (NIV) during exercise can improve exercise duration, the effect on DH is unclear.
2898. An Original Risk Score to Predict Early Major Bleeding in Acute Pulmonary Embolism: The Syncope, Anemia, Renal Dysfunction (PE-SARD) Bleeding Score.
作者: Romain Chopard.;Gregory Piazza.;Nicolas Falvo.;Fiona Ecarnot.;Mathieu Besutti.;Gilles Capellier.;François Schiele.;Marc Badoz.;Nicolas Meneveau.
来源: Chest. 2021年160卷5期1832-1843页
Improved prediction of the risk of early major bleeding in pulmonary embolism (PE) is needed to optimize acute management.
2899. A Validation Study of Four Different Cluster Analyses of OSA and the Incidence of Cardiovascular Mortality in a Hispanic Population.
作者: Gonzalo Labarca.;Jorge Dreyse.;Constanza Salas.;Francisca Letelier.;Jorge Jorquera.
来源: Chest. 2021年160卷6期2266-2274页
Previous studies reported a strong association between sleepiness-related symptoms and comorbidities with poor cardiovascular outcomes among patients with moderate to severe OSA (msOSA). However, the validation of these associations in the Hispanic population from South America and the ability to predict incident cardiovascular disease remain unclear.
2900. Impact of Antifibrotic Therapy on Mortality and Acute Exacerbation in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis.
作者: Tananchai Petnak.;Ploypin Lertjitbanjong.;Charat Thongprayoon.;Teng Moua.
来源: Chest. 2021年160卷5期1751-1763页
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease associated with significant morbidity and mortality. Nintedanib and pirfenidone are two antifibrotic medications currently approved for slowing the rate of lung function decline in IPF, but data on treatment effect on mortality and risk of acute exacerbation (AE) remains limited or unknown.
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