1021. Recommendations for Clinicians to Combat Environmental Disparities in Pediatric Asthma: A Review.
作者: Marisa A Patti.;Noelle B Henderson.;Wanda Phipatanakul.;Medina Jackson-Browne.
来源: Chest. 2024年166卷6期1309-1318页
Asthma is a common and complex lung disease in children, with disproportionally higher prevalence and related adverse outcomes among children in racial and ethnic minority groups and of lower socioeconomic position. Environmental factors, including unhealthy housing and school-based exposures, can contribute to increased asthma morbidity and widening disparities. This underscores a significant environmental justice issue and suggests the need for clinical interventions to reduce sources of environmental exposures and ultimately diminish the observed disparities in childhood asthma.
1022. Role of Exercise Hemodynamics in the Prediction of Pulmonary Arterial Hypertension in BMPR2 Mutation Carriers.
作者: Christian Gerges.;Antoine Beurnier.;Xavier Jaïs.;Philippe Hervé.;Edmund M T Lau.;Barbara Girerd.;Sven Günther.;Amir Bouchachi.;Mitja Jevnikar.;Athénaïs Boucly.;Harm Jan Bogaard.;Gérald Simonneau.;Olivier Sitbon.;Laurent Savale.;Denis Chemla.;Marc Humbert.;David Montani.
来源: Chest. 2024年166卷5期1173-1183页
Exercise hemodynamics are recommended for early detection of pulmonary arterial hypertension (PAH) and have been suggested to be predictive of future development of PAH in high-risk populations such as BMPR2 mutation carriers. However, the optimal exercise hemodynamic screening parameter remains to be determined. Recent data suggest that pulmonary vascular distensibility (α) may serve as a useful parameter for early detection of PAH.
1023. Air Pollution Metabolomic Signatures and Chronic Respiratory Diseases Risk: A Longitudinal Study.
作者: Bingting Zhuo.;Shanshan Ran.;Aaron M Qian.;Junguo Zhang.;Maya Tabet.;Steven W Howard.;Zilong Zhang.;Fei Tian.;Hualiang Lin.
来源: Chest. 2024年166卷5期975-986页
Although evidence has documented the associations of ambient air pollution with chronic respiratory diseases (CRDs) and lung function, the underlying metabolic mechanisms remain largely unclear.
1024. Clinical Characteristics and Prognosis of Patients With Severe Pneumonia With Pneumocystis jirovecii Colonization: A Multicenter, Retrospective Study.
作者: Yongpo Jiang.;Xiaohan Huang.;Huili Zhou.;Mingqiang Wang.;Shengfeng Wang.;Xindie Ren.;Guojun He.;Jun Xu.;Qianqian Wang.;Muhua Dai.;Yonghui Xiong.;Lin Zhong.;Xuwei He.;Xuntao Deng.;Yujie Pan.;Yinghe Xu.;Hongliu Cai.;Shengwei Jin.;Hongyu Wang.;Lingtong Huang.
来源: Chest. 2025年167卷1期54-66页
For decades, the incidence and clinical characteristics of Pneumocystis jirovecii colonization in patients with severe pneumonia was unclear.
1025. Interstitial Lung Disease Mortality Disparities Along the US-Mexico Border, 1999-2020.
作者: Sabrina Soin.;Ramzi Ibrahim.;Vinita Kusupati.;Enkhtsogt Sainbayar.;Hoang Nhat Pham.;Bhupinder Natt.;João Paulo Ferreira.;Kamonpun Ussavarungsi.;See-Wei Low.
来源: Chest. 2024年166卷6期1455-1462页
Optimal diagnosis and management of interstitial lung diseases (ILDs) needs access to specialized centers, frequent monitoring, and complex therapeutic options. In underprivileged areas, these necessities can often lead to barriers in delivering care.
1026. Management of Central Airway Obstruction: An American College of Chest Physicians Clinical Practice Guideline.
作者: Kamran Mahmood.;Lindsy Frazer-Green.;Anne V Gonzalez.;Scott L Shofer.;Angela Christine Argento.;Ian Welsby.;Russell Hales.;Samira Shojaee.;Donna D Gardner.;Joe Y Chang.;Felix J F Herth.;Lonny Yarmus.
来源: Chest. 2025年167卷1期283-295页
Central airway obstruction (CAO), seen in a variety of malignant and nonmalignant airway disorders, is associated with a poor prognosis. The management of CAO is dependent on provider training and local resources, which may make the clinical approach and outcomes highly variable. We reviewed the current literature and provided evidence-based recommendations for the management of CAO.
1027. Gravity- vs Wall Suction-Driven Large-Volume Thoracentesis: A Randomized Controlled Study.
作者: Samira Shojaee.;Jasleen Pannu.;Lonny Yarmus.;Alberto Fantin.;Christina MacRosty.;Roland Bassett.;Labib Debiane.;Zachary S DePew.;Saadia A Faiz.;Carlos A Jimenez.;Sameer K Avasarala.;Erik Vakil.;Andrew DeMaio.;Lara Bashoura.;Keerthana Keshava.;Travis Ferguson.;Roberto Adachi.;George A Eapen.;David E Ost.;Sami Bashour.;Asad Khan.;Vickie Shannon.;Ajay Sheshadri.;Roberto F Casal.;Scott E Evans.;Krystle Pew.;Nadia Castaldo.;Diwakar D Balachandran.;Vincenzo Patruno.;Robert Lentz.;Cheryl Pai.;Fabien Maldonado.;Lance Roller.;Junsheng Ma.;Jhankruti Zaveri.;Jenna Los.;Luis Vaquero.;Eva Ordonez.;Gulmira Yermakhanova.;Jason Akulian.;Cole Burks.;Roel-Rolando Almario.;Marie Sauve.;Jackson Pettee.;Laila Z Noor.;Muhammad H Arain.;Horiana B Grosu.
来源: Chest. 2024年166卷6期1573-1582页
Prior studies have found no differences in procedural chest discomfort for patients undergoing manual syringe aspiration or drainage with gravity after thoracentesis. However, whether gravity drainage could protect against chest pain due to the larger negative-pressure gradient generated by wall suction has not been investigated.
1028. Unsupervised Exercise in Interstitial Lung Disease: A Delphi Study to Develop a Consensus Preparticipation Screening Tool for Lymphangioleiomyomatosis.
作者: Claire E Child.;Lawrence A Ho.;Daniel Lachant.;Nishant Gupta.;Joel Moss.;Amanda Jones.;Rachana Krishna.;Anne E Holland.;MeiLan K Han.;Cormac McCarthy.;Ali Ataya.;Misbah Baqir.;Daniel F Dilling.;Jeff Swigris.;Erik R Swenson.;Mary Beth Brown.
来源: Chest. 2024年166卷5期1108-1123页
Little research is available to provide practical guidance to health care providers for exercise preparticipation screening and referral of patients with interstitial lung diseases (ILDs), including lymphangioleiomyomatosis (LAM), to participate in remote, unsupervised exercise programs.
1029. Novel Reference Equations for Pulmonary Artery Size and Pulsatility Using Echocardiography and Their Diagnostic Value in Pulmonary Hypertension.
作者: Shadi P Bagherzadeh.;Bettia E Celestin.;Everton J Santana.;Michael Salerno.;Kari C Nadeau.;Andrew J Sweatt.;Roham T Zamanian.;Francois Haddad.
来源: Chest. 2024年166卷5期1184-1196页
According to the most recent pulmonary hypertension (PH) guidelines, a main pulmonary artery (MPA) diameter > 25 mm on transthoracic echocardiography supports the diagnosis of PH. However, the size of the pulmonary artery (PA) may vary according to body size, age, and cardiac phases.
1030. Role of Pathologic Single-Nodal and Multiple-Nodal Descriptors in Resected Non-Small Cell Lung Cancer.
作者: Shinkichi Takamori.;Atsushi Osoegawa.;Asato Hashinokuchi.;Takashi Karashima.;Yohei Takumi.;Miyuki Abe.;Masafumi Yamaguchi.;Tomoyoshi Takenaka.;Tomoharu Yoshizumi.;Junjia Zhu.;Takefumi Komiya.
来源: Chest. 2024年166卷5期1218-1228页
The eighth edition of lung cancer nodal staging assignment includes the location of lymph node metastasis, but does not include single-nodal and multiple-nodal descriptors.
1031. Dexmedetomidine for Reducing Mortality in Patients With Septic Shock: A Randomized Controlled Trial (DecatSepsis).
作者: Ahmed Ragab Ezz Al-Regal.;Eyad Ahmed Ramzy.;Amer Abd Allah Atia.;Moataz Maher Emara.
来源: Chest. 2024年166卷6期1394-1405页
Sepsis, especially septic shock, and its complications have been linked to the hyperadrenergic stress response.
1032. Using Sotatercept in the Care of Patients With Pulmonary Arterial Hypertension.
Pulmonary arterial hypertension (PAH) is a rare disease of the pulmonary microvasculature leading to elevated precapillary pulmonary hypertension. Pulmonary vascular remodeling, a characteristic of PAH, is driven by dysfunctions in the signaling between the pulmonary smooth muscle and endothelial cells with abnormalities that affect cell proliferation and immune dysregulation. Sotatercept, an activin signaling inhibitor, has recently been approved by the US Food and Drug Administration for the treatment of PAH based on two pivotal clinical trials. Evidence-based clinical trials have provided a framework to guide clinicians treating the disease; however, they are not tailored to the individual patient. Often, recommendations from these data are unclear or too general, due to remaining gaps in knowledge. In this edition of "How I Do It," we provide a case-based discussion of common clinical decisions regarding diagnostic testing, choice of first-line agents, escalation of therapy, potential timing of sotatercept, safety awareness, practical use, potential management changes, and the future use of sotatercept in other pulmonary hypertension cohorts.
1033. Determining If COPD Self-Management Televisit-Based Interventions Are Evaluated Among and Equitably Effective Across Diverse Patient Populations to Reduce Acute Care Use: A Scoping Review.
作者: Mahima Akula.;May Nguyen.;Joanna Abraham.;Vineet M Arora.;Folabomi Oladosu.;Aashna Sunderrajan.;Leah Traeger.;Valerie G Press.
来源: Chest. 2024年166卷6期1371-1393页
With telemedicine's expansion during the COVID-19 pandemic, it has become critical to evaluate whether patients have equitable access to and capabilities to use televisits optimally for improved COPD outcomes such as reduced hospitalizations. This scoping review evaluated whether televisit-based interventions are evaluated among and equitably effective in improving health care use outcomes among diverse patient populations with COPD.
1035. Rethinking Blood Eosinophils for Assessing Inhaled Corticosteroids Response in COPD: A Post Hoc Analysis From the FLAME Trial.
作者: Alexander G Mathioudakis.;Sebastian Bate.;Pradeesh Sivapalan.;Jens-Ulrik Stæhr Jensen.;Dave Singh.;Jørgen Vestbo.
来源: Chest. 2024年166卷5期987-997页
The varied treatment response to inhaled corticosteroids (ICS) in patients with COPD and the associated increased risk of pneumonia necessitate a personalized ICS therapeutic approach. This is informed by blood eosinophil count (BEC), which predicts ICS treatment response. However, BEC appears to change in response to ICS treatment.
1036. Association of RBC Transfusion Thresholds and Outcomes in Medical Patients With Acute Respiratory Failure Supported With Extracorporeal Membrane Oxygenation: A Single-Center Retrospective Cohort Study.
作者: Elias H Pratt.;Aaron M Pulsipher.;Nathaniel G Moulton.;Andrea MacDonald.;Emily Poehlein.;Cynthia L Green.;Craig R Rackley.
来源: Chest. 2024年166卷6期1406-1416页
The hemoglobin value to trigger RBC transfusion for patients receiving venovenous extracorporeal membrane oxygenation (ECMO) is controversial. Previous guidelines recommended transfusing to a normal hemoglobin level, but recent studies suggest that more RBC transfusions are associated with increased adverse outcomes.
1037. Interstitial Lung Disease in a 14-Year-Old Boy.
A 14-year-old Chinese boy presented with a 7-year history of exertional dyspnea and reduced exercise tolerance. His perinatal and family histories were unremarkable. He was short and underweight for his age since childhood but had normal intellectual development. At 3 years of age, he was admitted to the ICU for severe pneumonia and anemia, and he received blood transfusion. He developed exertional dyspnea and reduced exercise tolerance at 7 years of age and became reluctant to run or jump, with poor appetite, abdominal distension, and refusal of protein-rich foods. At 13 years of age, he experienced a coma during school military training, and he was hospitalized for hyperammonemia (blood ammonia levels between 98 and 148 μmol/L; normal range, 18-72 μmol/L). Brain MRI showed no abnormalities. He improved after symptomatic treatment and was discharged, without taking any oral medication afterwards. However, his dyspnea and exercise tolerance worsened gradually. This patient was referred to Children's Hospital affiliated with Zhengzhou University for further investigation and management.
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