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1061. Pulmonary Nocardiosis With Endobronchial Involvement Caused by Nocardiaaraoensis.
作者: Yuka Tajima.;Takahiro Tashiro.;Tsuguhiro Furukawa.;Katsumi Murata.;Akira Takaki.;Kazuaki Sugahara.;Akiko Sakagami.;Megumi Inaba.;Takashi Marutsuka.;Naomi Hirata.
来源: Chest. 2024年165卷1期e1-e4页
We report a rare case of pulmonary nocardiosis with endobronchial involvement caused by Nocardia araoensis. A 79-year-old man with a history of asthma and a previous right upper lobectomy for lung cancer and organizing pneumonia presented with cough and dyspnea. He presented with right bronchial stenosis associated with various mucosal lesions, including ulcerative and exophytic lesions. N araoensis was detected in sputum samples collected via bronchoscopy. The mucosal lesions improved after a 2-week course of meropenem. After a further 6 months of oral sulfamethoxazole-trimethoprim treatment, the mucosal lesions completely disappeared. Based on bronchoscopic and pathophysiologic findings, the patient was diagnosed with pulmonary nocardiosis with endobronchial involvement. Nocardiosis should be considered in the differential diagnosis of endobronchial mucosal lesions.
1067. Implementing a Pediatric Pulmonary Embolism Response Team Model: An Institutional Experience.
作者: Dalia A Bashir.;Jamie C Cargill.;Srinath Gowda.;Matthew Musick.;Ryan Coleman.;Corey A Chartan.;Lisa Hensch.;Amir Pezeshkmehr.;Athar M Qureshi.;Sarah E Sartain.
来源: Chest. 2024年165卷1期192-201页
Pulmonary embolism is increasing in prevalence among pediatric patients; although still rare, it can create a significant risk for morbidity and death within the pediatric patient population. Pulmonary embolism presents in various ways depending on the patient, the size of the embolism, and the comorbidities. Treatment decisions are often driven by the severity of the presentation and hemodynamic effects; severe presentations require more invasive and aggressive treatment. We describe the development and implementation of a pediatric pulmonary embolism response team designed to facilitate rapid, multidisciplinary, data-driven treatment decisions and management.
1073. Measuring Implicit Bias in ICU Notes Using Word-Embedding Neural Network Models.
作者: Julien Cobert.;Hunter Mills.;Albert Lee.;Oksana Gologorskaya.;Edie Espejo.;Sun Young Jeon.;W John Boscardin.;Timothy A Heintz.;Christopher J Kennedy.;Deepshikha C Ashana.;Allyson Cook Chapman.;Karthik Raghunathan.;Alex K Smith.;Sei J Lee.
来源: Chest. 2024年165卷6期1481-1490页
Language in nonmedical data sets is known to transmit human-like biases when used in natural language processing (NLP) algorithms that can reinforce disparities. It is unclear if NLP algorithms of medical notes could lead to similar transmissions of biases.
1074. Long-Term Effects of COVID-19 on the Cardiopulmonary System in Adults and Children: Current Status and Questions to be Resolved by the National Institutes of Health Researching COVID to Enhance Recovery Initiative.
作者: Franz Rischard.;Natasha Altman.;Jacqueline Szmuszkovicz.;Frank Sciurba.;Erika Berman-Rosenzweig.;Simon Lee.;Sankaran Krishnan.;Ngan Truong.;John Wood.;Aloke V Finn.; .
来源: Chest. 2024年165卷4期978-989页
Long COVID may occur in at least 10% of patients recovering from SARS-CoV-2 infection and often is associated with debilitating symptoms. Among the organ systems that might be involved in its pathogenesis, the respiratory and cardiovascular systems may be central to common symptoms seen in survivors of COVID-19, including fatigue, dyspnea, chest pain, cough, and exercise intolerance. Understand the exact symptomatology, causes, and effects of long COVID on the heart and lungs may help us to discover new therapies. To that end, the National Institutes of Health is sponsoring a national study population of diverse volunteers to support large-scale studies on the long-term effects of COVID-19.
1075. Extraneous Load, Patient Census, and Patient Acuity Correlate With Cognitive Load During ICU Rounds.
作者: Natalie Held.;Anna Neumeier.;Timothy Amass.;Elizabeth Harry.;Raymond Pomponio.;Ryan A Peterson.;Tristan J Huie.;Marc Moss.
来源: Chest. 2024年165卷6期1448-1457页
Cognitive load theory asserts that learning and performance degrade when cognitive load exceeds working memory capacity. This is particularly relevant in the learning environment of ICU rounds, when multidisciplinary providers integrate complex decision-making and teaching in a noisy, high-stress environment prone to cognitive distractions.
1076. Impact of Rheumatoid Arthritis and Seropositivity on the Risk of Non-Cystic Fibrosis Bronchiectasis.
作者: Hayoung Choi.;Kyungdo Han.;Jin Hyung Jung.;Junhee Park.;Bo-Guen Kim.;Bumhee Yang.;Yeonghee Eun.;Hyungjin Kim.;Dong Wook Shin.;Hyun Lee.
来源: Chest. 2024年165卷6期1330-1340页
Despite the coexistence of bronchiectasis and rheumatoid arthritis (RA) and the poor prognosis associated with the combination of conditions, to our knowledge, no longitudinal studies that comprehensively evaluated whether patients with RA have a higher risk of bronchiectasis compared with those without RA have been published. Whether seropositivity is associated with an increased risk of bronchiectasis in RA is the subject of ongoing controversy.
1077. Hospital Policy Variation in Addressing Decisions to Withhold and Withdraw Life-Sustaining Treatment.
作者: Gina M Piscitello.;Patrick G Lyons.;Valerie Gutmann Koch.;William F Parker.;Michael T Huber.
来源: Chest. 2024年165卷4期950-958页
Sociodemographic disparities in physician decisions to withhold and withdraw life-sustaining treatment exist. Little is known about the content of hospital policies that guide physicians involved in these decisions.
1078. Impact of SARS-CoV-2 Vaccine Rollout on Hispanic and Non-Hispanic Admission and Mortality Trends: An Interrupted Time Series Analysis.
作者: Amelia Barwise.;Aysun Tekin.;Juan Pablo Domecq Garces.;Ognjen Gajic.;Brian W Pickering.;Michael Malinchoc.
来源: Chest. 2024年165卷6期1341-1351页
Challenges with SARS-CoV-2 vaccine prioritization, access, and hesitancy have influenced vaccination uptake.
1079. Diagnostic Yield vs Diagnostic Accuracy for Peripheral Lung Biopsy Evaluation: Evidence Supporting a Future Pragmatic End Point.
作者: Kaele M Leonard.;See-Wei Low.;Cristina Salmon Echanique.;Briana A Swanner.;Joyce Johnson.;Greta Dahlberg.;Rafael Paez.;Ankush P Ratwani.;Samira Shojaee.;Otis B Rickman.;Fabien Maldonado.;Robert J Lentz.
来源: Chest. 2024年165卷6期1555-1562页
Diagnostic yield and accuracy endpoints have been used inconsistently in the evaluation of advanced diagnostic bronchoscopy devices and techniques, limiting between-study comparisons. In addition, diagnostic accuracy can be adjudicated only after prolonged clinical follow-up, which delays reporting on the performance of novel devices.
1080. Impact of Antigen Exposure on Outcomes and Treatment Response in Fibrotic Hypersensitivity Pneumonitis.
作者: Monica L Mullin.;Gustavo Fernandez.;Daniel-Costin Marinescu.;Boyang Zheng.;Alyson W Wong.;Deborah Assayag.;Jolene H Fisher.;Kerri A Johannson.;Nasreen Khalil.;Martin Kolb.;Helene Manganas.;Veronica Marcoux.;Julie Morisset.;Bohyung Min.;Erica Farrand.;Christopher J Ryerson.
来源: Chest. 2024年165卷6期1435-1443页
Patients with fibrotic hypersensitivity pneumonitis (fHP) are frequently treated with immunosuppression to slow lung function decline; however, the impact of this treatment has not been studied across different types of antigen exposure.
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