Uptake of lung cancer screening (LCS) in the United States has been limited, and some groups have argued that the unprecedented Centers for Medicare & Medicaid Services (CMS) coverage mandate for shared decision-making (SDM) contributed to the low screening rates. Late in 2021, the CMS initiated an update of its LCS coverage determination, which included 2 public comment periods.

Dyspnea increases mortality and remains unexplained in 15% of patients. Although OSA is linked to reduced exercise capacity during cardiopulmonary exercise testing, the association between dyspnea and OSA remains uncertain.

Chest medicine relies extensively on medical devices that comprise medical technology, artificial intelligence, software applications, and digital health; however, a comprehensive assessment of the evidence supporting US Food and Drug Administration (FDA) approval/clearance of these devices is lacking.

Circadian rhythms are often severely disrupted in critically ill patients in the ICU. The ICU environment, characterized by irregular light-dark signals, continuous nutrition, and round-the-clock interventions, contributes to this disruption by providing weak and conflicting timing cues to the circadian system. Extensive scientific research has demonstrated that circadian rhythms play a vital role in regulating physiology and maintaining overall health. Therefore, integrating circadian principles into critical care may represent a promising strategy to improve patient outcomes in the ICU.

Selexipag is an oral selective prostacyclin receptor agonist approved for treating pulmonary arterial hypertension (PAH) in adults.

Understanding the underlying cause of OSA in the individual patient, referred to as pathophysiologic endotyping, is essential for personalized care. The current classification of these traits from routine sleep recordings relies on manually scored arousals from sleep. Automating this process could widen the applicability of endotyping.

Home noninvasive ventilation (NIV) improves outcomes in patients with chronic respiratory failure; however, telemonitoring remains challenging due to undefined appropriate alert thresholds. Current leak thresholds lack clinical validation, potentially leading to inefficient care delivery and alert fatigue among health care providers.

Treatment selection in chronic hypersensitivity pneumonitis (HP) remains empiric because of a lack of randomized trial data. Although radiographic fibrosis extent often is used to inform treatment decisions, its usefulness as a theragnostic marker for immunomodulatory therapy is unknown.

Oral corticosteroids (OCSs) are recommended as first-line therapy for sarcoidosis, yet limited data describe the risk of steroid-associated adverse effects in this population.

Bronchopulmonary dysplasia (BPD) is the most common morbidity of very preterm (VPT) infants born < 32 weeks' gestation with lifelong consequences. Studies document wide variation between regions and units in BPD prevalence.

Fungal sensitization is an increasingly recognized endophenotype in chronic respiratory disease; however, its role in bronchiectasis remains poorly defined. This study aimed to provide the most comprehensive evaluation to date of fungal sensitization and its clinical relevance in bronchiectasis using an expanded panel of crude and recombinant fungal allergens.

An 18-year-old man with no prior medical history presented to the tertiary care center with a 6-month history of progressively worsening bone pain. The pain was localized to the right posterior ribs, mid-thoracic spine, and right iliac bone and was described as deep, throbbing, and exacerbated by physical activity, which significantly limited his mobility. Concurrently, he reported recurrent episodes of dyspnea and chest tightness, particularly in the supine position. Physical examination revealed reduced tactile fremitus and diminished breath sounds over the bilateral lower lung fields, with dullness to percussion. Bilateral pitting edema extended from the ankles to the knees (grade 1+), with no signs of joint swelling, skin rash, or lymphadenopathy. Vital signs were notable for low-grade fever (38.2 °C) and tachycardia (heart rate: 92 beats/min).

Flow-controlled ventilation (FCV) is characterized by a bidirectional linearized gas flow translating into a constant flow. We report the prolonged use of FCV in a 30-year-old patient with major trauma, including severe traumatic brain injury and posttraumatic ARDS, because the patient sustained other severe injuries such as those to the spine and pelvis. Conventional mechanical ventilation failed to attain normoxia and normocapnia, leading to hemodynamic compromise and refractory intracranial hypertension. FCV was used as an off-label rescue therapy because prone positioning and extracorporeal membrane oxygenation were contraindicated. Within a few hours, ventilation improved despite lower minute volumes. This was paralleled by a reduction in norepinephrine requirements and normalization of intracranial pressure. FCV was continued for 96 hours. This case report underlines the potential benefits of FCV as a novel ventilation mode in patients with ARDS and justifies future studies evaluating the outcome effects of FCV in this complex population.

Current evidence supports risk-based treatment for pulmonary arterial hypertension (PAH) with an endothelin receptor antagonist and phosphodiesterase type 5 inhibitor as initial therapy for patients with low- and intermediate-risk PAH, and triple therapy with the addition of a parenteral prostacyclin for patients with high-risk PAH.

Although quantitative CT imaging offers objective evaluation of radiologic progression in non-idiopathic pulmonary fibrosis (IPF) fibrosing interstitial lung disease (ILD), clinically meaningful thresholds for defining progressive pulmonary fibrosis (PPF) remain unclear.

IL-5 is a key mediator of severe eosinophilic asthma (SEA) and also may contribute to airway remodeling.

Pulmonary hypertension (PH) is characterized by a high mean pulmonary artery pressure and an impaired health-related quality of life. The Pulmonary Hypertension Functional Class Self-Report (PH-FC-SR), a patient-reported version of the World Health Organization Functional Classification (WHO-FC), was developed to assess PH functional class from the patient perspective.

In July 2021, the Veterans Health Administration (VHA) implemented a nationwide inhaler formulary change affecting approximately 260,000 veterans with COPD and asthma. Clinician perceptions regarding this formulary change are unknown.