3561. The Value of Hemodynamic Measurements or Cardiac MRI in the Follow-up of Patients With Idiopathic Pulmonary Arterial Hypertension.
作者: Cathelijne Emma van der Bruggen.;Martin Louis Handoko.;Harm Jan Bogaard.;Johannes Timotheus Marcus.;Franciscus Petrus Theodorus Oosterveer.;Lilian Jacoba Meijboom.;Berend Eric Westerhof.;Anton Vonk Noordegraaf.;Frances S de Man.
来源: Chest. 2021年159卷4期1575-1585页
Treatment of patients with pulmonary arterial hypertension (PAH) is conventionally based on functional plus invasive measurements obtained during right heart catheterization (RHC). Whether risk assessment during repeated measurements could also be performed on the basis of imaging parameters is unclear, as a direct comparison of strategies is lacking.
3562. Institutional-Level Differences in Quality and Outcomes of Lung Cancer Resections in the United States.
作者: Raymond U Osarogiagbon.;Helmneh M Sineshaw.;Chun Chieh Lin.;Ahmedin Jemal.
来源: Chest. 2021年159卷4期1630-1641页
Institutional-level disparities in non-small cell lung cancer (NSCLC) survival may be driven by reversible differences in care-delivery processes. We quantified the impact of differences in readily identifiable quality metrics on long-term survival disparities in resected NSCLC.
3563. Assessing the Physiologic Endotypes Responsible for REM- and NREM-Based OSA.
作者: Simon A Joosten.;Shane A Landry.;Ai-Ming Wong.;Dwayne L Mann.;Philip I Terrill.;Scott A Sands.;Anthony Turton.;Caroline Beatty.;Luke Thomson.;Garun S Hamilton.;Bradley A Edwards.
来源: Chest. 2021年159卷5期1998-2007页
Patients with OSA can have the majority of their respiratory events in rapid eye movement (REM) sleep or in non-rapid eye movement (NREM) sleep. No previous studies have linked the different physiologic conditions in REM and NREM sleep to the common polysomnographic patterns seen in everyday clinical practice, namely REM predominant OSA (REMOSA) and NREM predominant OSA (NREMOSA).
3564. Plasma Insulin-like Growth Factor Binding Protein 7 Contributes Causally to ARDS 28-Day Mortality: Evidence From Multistage Mendelian Randomization.
作者: Xuesi Dong.;Zhaozhong Zhu.;Yongyue Wei.;Debby Ngo.;Ruyang Zhang.;Mulong Du.;Hui Huang.;Lijuan Lin.;Paula Tejera.;Li Su.;Feng Chen.;Amy M Ahasic.;B Taylor Thompson.;Nuala J Meyer.;David C Christiani.
来源: Chest. 2021年159卷3期1007-1018页
ARDS is a devastating syndrome with heterogeneous subtypes, but few causal biomarkers have been identified.
3566. The Potential Effects of Financial Conflicts of Interest of Speakers at the US Food and Drug Administration's Pulmonary-Allergy Drug Advisory Committee Meetings.
作者: Trevor Bickford.;Nicholas Kinder.;Wade Arthur.;Cole Wayant.;Matt Vassar.
来源: Chest. 2021年159卷6期2399-2401页 3567. Pilot Project to Assess the Potential Cost-Benefit of a Bronchoscopy Program for the Diagnosis of TB in Uganda.
作者: Peter Jackson.;Trishul Siddharthan.;A Christine Argento.;Ashutosh Sachdeva.;Lonny Yarmus.;Akshay Gupte.;Winceslaus Katagira.;Bruce Kirenga.;William Worodria.;Hans J Lee.
来源: Chest. 2021年159卷5期1970-1973页 3568. Assessment of Integrated Classifier's Ability to Distinguish Benign From Malignant Lung Nodules: Extended Analyses and 2-Year Follow-Up Results of the PANOPTIC (Pulmonary Nodule Plasma Proteomic Classifier) Trial.
作者: Nichole T Tanner.;Steven C Springmeyer.;Alex Porter.;James R Jett.;Peter Mazzone.;Anil Vachani.;Gerard A Silvestri.
来源: Chest. 2021年159卷3期1283-1287页 3571. Curious Case of Unexplained Dyspnea With Malignancy.
A 48-year-old female never smoker with hypothyroidism and no significant prior respiratory complaints presented with 1 month of gradually worsening dyspnea on exertion. She denied any associated fevers, chills, weight loss, chest pain, productive cough, hemoptysis, or sick contacts. She was recently diagnosed with stage IV triple negative adenocarcinoma of the breast and was yet to receive chemotherapy.
3572. A 48-Year-Old Woman With Chronic Cough, Dyspnea, and Bronchiectasis.
A 48-year-old woman sought a second opinion for dyspnea and chronic productive cough; she was a never smoker. Mild respiratory symptoms persisted since childhood and had progressively worsened over the previous decade. In addition, an unintentional 30-pound weight loss had occurred over several years. Six years previously, a diagnosis of hypersensitivity pneumonitis was made following right upper lobe wedge resection that revealed chronic bronchiolitis with interstitial pneumonia and non-necrotizing granulomatous inflammation. Subsequent use of prednisone elicited mild intermittent improvement. She had used feather pillows in the past without any other significant exposures. There were no reports of sinus or GI symptoms.
3573. A 52-Year-Old Man Presented With Cough, Chest Pain, and a Mass in the Right Lung.
作者: Serafeim Chrysikos.;Ourania Papaioannou.;Maria Anyfanti.;Theodoros Karampitsakos.;Ioannis Vamvakaris.;Argyrios Tzouvelekis.;Katerina Dimakou.
来源: Chest. 2020年158卷5期e241-e244页
A 52-year-old man, current smoker with a 50 pack-year history, presented to our department with cough, yellow sputum, and localized right chest pain. Chest radiograph revealed a large mass in the right upper lobe. He denied the presence of fever, night sweats, or weight loss. He has a medical history of COPD and anxiety disorder. He was receiving long-acting beta agonists/long-acting muscarinic antagonists as a treatment for COPD and quetiapine 100 mg for anxiety disorder.
3574. A 44-Year-Old Woman With Chest Pain and Dyspnea.
A 44-year-old woman with a medical history of anti-phospholipid antibody syndrome complicated by recurrent pulmonary emboli with subsequent chronic hypoxic respiratory failure (3 L/min oxygen baseline) presented to the ED with 2 to 3 weeks of shortness of breath and pleuritic chest pain that radiated to the center of her back. These symptoms were accompanied by an increase in her oxygen requirement from 3 L/min to 6 L/min. She also reported nausea, vomiting, lightheadedness, and dizziness for the same period. The patient had two prior pulmonary emboli in the same year, which prompted a hypercoagulable workup, ultimately revealing a diagnosis of antiphospholipid antibody syndrome. The second pulmonary embolus occurred while the patient was on coumadin, though achieving a therapeutic international normalized ratio was challenging. At the recommendation of the Hematology Department, she was transitioned to systemic anticoagulation with low-molecular-weight heparin (LMWH) at a dose of 1.5 mg/kg twice daily, which was her regimen at the time of admission. The patient confirmed total compliance with her anticoagulation therapy, and she denied any recent travel or long periods of being sedentary. She was up to date on her age-appropriate cancer screening, without any evidence of active malignancy.
3575. A 28-Year-Old Pregnant Woman With a Lung Abscess and Complicated Pleural Effusion.
A 28-year-old woman G1P0 at 22 weeks of gestation and with no significant medical history presented to the ED complaining of worsening dyspnea and right-sided pleuritic chest pain. Symptoms started 2 weeks before presentation, with minimal productive cough and dyspnea on exertion. One week after the initial symptoms, the patient started noticing right-sided chest and shoulder pain along with subjective fevers and night sweats. She denied hemoptysis, weight loss, abdominal pain, diarrhea, nausea, vomiting, arthralgia, or rash. Her pregnancy had so far been uncomplicated. The patient did not use tobacco, alcohol, or recreational drugs. She worked at a daycare center but denied any particular sick contacts. She moved to the United States 7 years ago from Sudan and denied any recent travel.
3576. A 35-Year-Old Man With Recurrent Pneumonia and Whitish Sputum.
作者: Sophia Keddache.;Frédéric Claudé.;Inès Saïzonou.;Jean Charles Dalphin.;Thibaud Soumagne.
来源: Chest. 2020年158卷5期e229-e232页
A 35-year-old man was admitted for recurrent episodes of pneumonia. He complained of a 2-month history of exertional dyspnea and productive cough with whitish and viscous sputum which was poorly responsive to antibiotic therapy. He also reported a weight loss of 5 kg since the first symptoms appeared. There was no dysphagia, fever, or chest pain. He currently did not use medication and did not have a relevant medical history except a current 10 pack-year smoking history. He did not report any history of trauma or respiratory exposure to fats.
3577. Successful Induction Treatment With Rituximab of Isolated Pauci-Immune Pulmonary Capillaritis Presenting as Diffuse Alveolar Hemorrhage in a Pediatric Patient.
作者: Katherine E Lewinter.;Michal Cidon.;Mikako Warren.;Manvi Bansal.
来源: Chest. 2020年158卷5期e225-e227页
Diffuse alveolar hemorrhage often presents as dyspnea, cough, or hemoptysis, and it is mediated by both immune and nonimmune processes. Isolated pauci-immune capillaritis (IPPC) is a rare diagnosis in which capillaritis, small-vessel vasculitis of the lung, is found on biopsy in the absence of an underlying systemic disorder. Traditionally, IPPC has been treated similarly to anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis with cyclophosphamide and glucocorticoids. However, few cases describing management options are available in the literature, especially among pediatric patients. Our report of successful induction of remission in an adolescent girl suggests that the combination of IV rituximab and pulse methylprednisolone may be a viable option for disease control in pediatric patients with IPPC.
3578. A Case of Lymphangiomatosis With Infected Lymphangiomas Effectively Treated by Thoracoscopic Debridement and Drainage.
作者: Takao Minakata.;Takashi Suzuki.;Yoshito Kamio.;Mitsutaka Kadokura.;Naoya Himuro.;Hidefumi Takei.
来源: Chest. 2020年158卷5期e221-e224页
A 40-year-old woman with lymphangiomatosis also had an intrathoracic lymphangioma infection. Since the age of 8 years, the patient had undergone repeated abdominal and mediastinal cyst surgeries and had received a diagnosis of lymphangiomatosis. At this time, she showed a high fever of 38.5°C. Cultures of both blood and fluid aspirated from the cyst were positive for Staphylococcus aureus. Chest CT imaging revealed an enlarged right-sided mediastinal cystic lymphangioma with new septa in it. A chest tube was inserted into the cyst to remove effusion. The patient was then started with the antibacterial drug cefazolin at 3 g/d. But effective drainage was difficult because of the high viscosity of the effusion and septa working as barriers. We removed these components with endoscopic surgical instruments and via a pulsed-lavage system under general anesthesia. Postoperative CT images showed reexpanded lung structure and reduced cyst size. The patient has taken a favorable course for 2 years.
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