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3001. Mediastinal Staging for Lung Cancer.
Mediastinal lymph node staging in the setting of known or suspected lung cancer is supported by multiple professional societies as standard for high-quality care, yet proper mediastinal staging often is lacking. Neglecting pathologic lymph node sampling can understage or overstage the patient and lead to inappropriate treatment. Although some cases of nodal disease are radiographically obvious, others are not as apparent, and both situations require pathologic proof to allow for appropriate treatment selection. This article discusses the nuances of mediastinal staging and emphasizes the usefulness of a multidisciplinary approach and dialog to address lung cancer staging and treatment. We summarize the relevant guidelines and literature and provide a case scenario to illustrate the approach to mediastinal staging from our viewpoints as a thoracic surgeon and pulmonologist.
3002. Emphysema Progression and Lung Function Decline Among Angiotensin Converting Enzyme Inhibitors and Angiotensin-Receptor Blockade Users in the COPDGene Cohort.
作者: Vickram Tejwani.;Ashraf Fawzy.;Nirupama Putcha.;Peter J Castaldi.;Michael H Cho.;Katherine A Pratte.;Surya P Bhatt.;David A Lynch.;Stephen M Humphries.;Gregory L Kinney.;Franco R D'Alessio.;Nadia N Hansel.; .
来源: Chest. 2021年160卷4期1245-1254页
Attenuation of transforming growth factor β by blocking angiotensin II has been shown to reduce emphysema in a murine model. General population studies have demonstrated that the use of angiotensin converting enzyme inhibitors (ACEis) and angiotensin-receptor blockers (ARBs) is associated with reduction of emphysema progression in former smokers and that the use of ACEis is associated with reduction of FEV1 progression in current smokers.
3003. A Pilot Randomized Trial of Transdermal Nicotine for Pulmonary Sarcoidosis.
作者: Elliott D Crouser.;Rachel M Smith.;Daniel A Culver.;Mark W Julian.;Karen Martin.;Joanne Baran.;Christopher Diaz.;Barbaros Selnur Erdal.;Erinn M Hade.
来源: Chest. 2021年160卷4期1340-1349页
Tobacco smoking is associated with a reduced risk of developing sarcoidosis, and we previously reported that nicotine normalizes immune responses to environmental antigens in patients with active pulmonary sarcoidosis. The effects of nicotine on the progression of pulmonary sarcoidosis are unknown.
3004. Delivering a Novel Medical Education "Escape Room" at a National Scientific Conference: First Live, Then Pivoting to Remote Learning Because of COVID-19.
作者: Viren Kaul.;Amy Morris.;June M Chae.;James A Town.;William F Kelly.
来源: Chest. 2021年160卷4期1424-1432页
Escape Rooms are gaining prominence as education modalities; the use of principles of game design have been shown to augment knowledge acquisition in a fun, team-based learning experience ("edutainment"). In this report, we outline some of the medical literature and then provide our step-by-step approach and lessons learned when building what was, to our knowledge, the first continuing medical education Escape Room at a national scientific meeting. We then comment on how this innovative educational offering was reimagined the following year for remote (virtual) learning because of the COVID-19 pandemic.
3005. Age-Specific Associations Between Habitual Snoring and Cardiovascular Diseases in China: A 10-Year Cohort Study.
作者: Yuxia Wei.;Jun Lv.;Yu Guo.;Zheng Bian.;Junning Fan.;Huaidong Du.;Ling Yang.;Yiping Chen.;Yulu Qin.;Ping Wang.;Junshi Chen.;Zhengming Chen.;Canqing Yu.;Liming Li.; .
来源: Chest. 2021年160卷3期1053-1063页
Limited convincing evidence is available of the relationship between habitual snoring and cardiovascular diseases (CVDs).
3006. Comparison of Two Proposed Changes to the Current Nodal Classification for Non--small Cell Lung Cancer Based on the Number and Ratio of Metastatic Lymph Nodes.
作者: Feng Li.;Ligong Yuan.;Yue Zhao.;Shuaibo Wang.;Zhuoheng Lv.;Yousheng Mao.
来源: Chest. 2021年160卷4期1520-1533页
The current nodal classification is unsatisfactory in distinguishing the prognostically heterogeneous N1 or N2 non-small cell lung cancer (NSCLC).
3007. Mucociliary Clearance Differs in Mild Asthma by Levels of Type 2 Inflammation.
作者: Timothy E Corcoran.;Alex S Huber.;Sherri L Hill.;Landon W Locke.;Lawrence Weber.;Ashok Muthukrishnan.;Elisa M Heidrich.;Sally Wenzel.;Mike M Myerburg.
来源: Chest. 2021年160卷5期1604-1613页
Although mucus plugging is a well-reported feature of asthma, whether asthma and type 2 inflammation affect mucociliary clearance (MCC) is unknown.
3008. Symptoms of Mental Health Disorders in Critical Care Physicians Facing the Second COVID-19 Wave: A Cross-Sectional Study.
作者: Elie Azoulay.;Frédéric Pochard.;Jean Reignier.;Laurent Argaud.;Fabrice Bruneel.;Pascale Courbon.;Alain Cariou.;Kada Klouche.;Vincent Labbé.;François Barbier.;Christophe Guitton.;Alexandre Demoule.;Achille Kouatchet.;Olivier Guisset.;Mercé Jourdain.;Laurent Papazian.;Guillaume Van Der Meersch.;Danielle Reuter.;Virginie Souppart.;Matthieu Resche-Rigon.;Michael Darmon.;Nancy Kentish-Barnes.; .
来源: Chest. 2021年160卷3期944-955页
Working in the ICU during the first COVID-19 wave was associated with high levels of mental health disorders.
3009. Epidemiology of Adult Pleural Disease in the United States.
作者: Srinivas R Mummadi.;James K Stoller.;Rocio Lopez.;Karthik Kailasam.;Colin T Gillespie.;Peter Y Hahn.
来源: Chest. 2021年160卷4期1534-1551页
Comprehensive US epidemiologic data for adult pleural disease are not available.
3010. Is Systemic Anticancer Therapy Associated With Higher Rates of Malignant Pleural Effusion Control in People With Pharmacologically Sensitive Tumors?: A Retrospective Analysis of Prospectively Collected Data.
作者: Nina Holling.;Sonia Patole.;Andrew R L Medford.;Nick A Maskell.;Anna C Bibby.
来源: Chest. 2021年160卷5期1915-1924页
Malignant pleural effusions (MPEs) often cause symptoms, and guidelines recommend early definitive intervention. However, observational data suggest that systemic anticancer treatment (SACT) may control MPE caused by certain pharmacologically sensitive tumors.
3011. Comparative Effectiveness and Safety of Different Types of Inhaled Long-Acting β2-Agonist Plus Inhaled Long-Acting Muscarinic Antagonist vs Inhaled Long-Acting β2-Agonist Plus Inhaled Corticosteroid Fixed-Dose Combinations in COPD A Propensity Score-Inverse Probability of Treatment Weighting Cohort Study.
作者: Meng-Ting Wang.;Jyun-Heng Lai.;Ya-Ling Huang.;Jun-Ting Liou.;Shih-Hsuan Cheng.;Chen Wei Lin.;Hsueh-Yi Pan.;Yu-Juei Hsu.;Chen-Liang Tsai.
来源: Chest. 2021年160卷4期1255-1270页
Despite multiple available fixed-dose combinations (FDCs) of inhaled long-acting β2-agonists (LABAs) plus long-acting muscarinic antagonists (LAMAs) and LABAs plus inhaled corticosteroids (ICS) for COPD, uncertainty remains regarding their comparative effects.
3013. Personalized Variable vs Fixed-Dose Systemic Corticosteroid Therapy in Hospitalized Patients With Acute Exacerbations of COPD: A Prospective, Multicenter, Randomized, Open-Label Clinical Trial.
作者: Li Li.;Nana Zhao.;Xiangyu Ma.;Fenfen Sun.;Binfeng He.;Zhen Qin.;Kui Wu.;Xingsheng Wang.;Qian Zhao.;Shisi Zhang.;Naifu Nie.;Dong Luo.;Bin Sun.;Ye Shen.;Yong He.;Fuqiang Wen.;Jinping Zheng.;Paul Jones.;Guoqiang Cao.
来源: Chest. 2021年160卷5期1660-1669页
Systemic corticosteroids for the treatment of COPD exacerbations decrease treatment failure and shorten the length of hospitalization. However, the optimal dose is unclear.
3014. Diagnostic Outcomes and Safety of Cryobiopsy Added to Conventional Sampling Methods: An Observational Study.
作者: Yuji Matsumoto.;Toshiyuki Nakai.;Midori Tanaka.;Tatsuya Imabayashi.;Takaaki Tsuchida.;Yuichiro Ohe.
来源: Chest. 2021年160卷5期1890-1901页
Cryobiopsy enables specialists to perform high-quality, large, entirely circumferential biopsies; therefore, it may improve the diagnostic yield of peripheral pulmonary lesions (PPLs), as has been previously observed regarding endobronchial tumors and interstitial lung diseases.
3020. A 26-Year-Old Woman With Dyspnea on Exertion.
A 26-year-old woman with no significant medical history was referred for 5 months of dry cough, dyspnea, presyncope and chest pressure, and nausea with exertion. The family history was notable for thromboembolic disease in the setting of malignancy and autoimmune disease. She was not on any medications. She is a never smoker and did not use recreational drugs. She had no work-related exposures. Her BP was 95/67 mm Hg; her heart rate was 93 beats per minute, and oxygen saturation was 98% on room air. Lung fields were clear to auscultation. She had a prominent P2 heart sound. There was no jugular venous distension or edema. There was no clubbing, rash, or synovitis.
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