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4981. Safety and Efficacy of Remimazolam Compared With Placebo and Midazolam for Moderate Sedation During Bronchoscopy.
作者: Nicholas J Pastis.;Lonny B Yarmus.;Frank Schippers.;Randall Ostroff.;Alexander Chen.;Jason Akulian.;Momen Wahidi.;Samira Shojaee.;Nichole T Tanner.;Sean P Callahan.;Gregory Feldman.;Daniel G Lorch.;Ikeadi Ndukwu.;Michael A Pritchett.;Gerard A Silvestri.; .
来源: Chest. 2019年155卷1期137-146页
While the complexity of flexible bronchoscopy has increased, standard options for moderate sedation medications have not changed in three decades. There is a need to improve moderate sedation while maintaining safety. Remimazolam was developed to address shortcomings of current sedation strategies.
4982. A Simple Clinical Risk Score (C2HEST) for Predicting Incident Atrial Fibrillation in Asian Subjects: Derivation in 471,446 Chinese Subjects, With Internal Validation and External Application in 451,199 Korean Subjects.
作者: Yan-Guang Li.;Daniele Pastori.;Alessio Farcomeni.;Pil-Sung Yang.;Eunsun Jang.;Boyoung Joung.;Yu-Tang Wang.;Yu-Tao Guo.;Gregory Y H Lip.
来源: Chest. 2019年155卷3期510-518页
The incidence of atrial fibrillation (AF) is increasing, conferring a major health-care issue in Asia. No risk score for predicting incident AF has been specifically developed in Asian subjects. Our aim was to investigate risk factors for incident AF in Asian subjects and to combine them into a simple clinical risk score.
4983. CT Imaging-Based Low-Attenuation Super Clusters in Three Dimensions and the Progression of Emphysema.
作者: Jarred R Mondoñedo.;Susumu Sato.;Tsuyoshi Oguma.;Shigeo Muro.;Adam H Sonnenberg.;Dean Zeldich.;Harikrishnan Parameswaran.;Toyohiro Hirai.;Béla Suki.
来源: Chest. 2019年155卷1期79-87页
Distributions of low-attenuation areas in two-dimensional (2-D) CT lung slices are used to quantify parenchymal destruction in patients with COPD. However, these segmental approaches are limited and may not reflect the true three-dimensional (3-D) tissue processes that drive emphysematous changes in the lung. The goal of this study was to instead evaluate distributions of 3-D low-attenuation volumes, which we hypothesized would follow a power law distribution and provide a more complete assessment of the mechanisms underlying disease progression.
4984. Building a Prediction Model for Radiographically Confirmed Pneumonia in Peruvian Children: From Symptoms to Imaging.
作者: Farhan Pervaiz.;Miguel A Chavez.;Laura E Ellington.;Matthew Grigsby.;Robert H Gilman.;Catherine H Miele.;Dante Figueroa-Quintanilla.;Patricia Compen-Chang.;Julio Marin-Concha.;Eric D McCollum.;William Checkley.
来源: Chest. 2018年154卷6期1385-1394页
Community-acquired pneumonia remains the leading cause of death in children worldwide, and current diagnostic guidelines in resource-poor settings are neither sensitive nor specific. We sought to determine the ability to correctly diagnose radiographically confirmed clinical pneumonia when diagnostics tools were added to clinical signs and symptoms in a cohort of children with acute respiratory illnesses in Peru.
4985. Chest CT Scan at Radiation Dose of a Posteroanterior and Lateral Chest Radiograph Series: A Proof of Principle in Lymphangioleiomyomatosis.
作者: Eileen Hu-Wang.;John L Schuzer.;Shirley Rollison.;Eric S Leifer.;Chloe Steveson.;Vissaagan Gopalakrishnan.;Jianhua Yao.;Tania Machado.;Amanda M Jones.;Patricia Julien-Williams.;Joel Moss.;Marcus Y Chen.
来源: Chest. 2019年155卷3期528-533页
Given the rising utilization of medical imaging and the risks of radiation, there is increased interest in reducing radiation exposure. The objective of this study was to evaluate, as a proof of principle, CT scans performed at radiation doses equivalent to that of a posteroanterior and lateral chest radiograph series in the cystic lung disease lymphangioleiomyomatosis (LAM).
4986. A 67-Year-Old Man With Palpitations During Sleep.
作者: Sharon De Cruz.;Anna Selvaggio.;Ravi Aysola.;Sanjay Bindra.;Alex Padilla.;Michelle Zeidler.
来源: Chest. 2018年154卷4期e97-e100页
A 67-year-old man with a history of atrial fibrillation (AF) presented to his physician with symptoms of episodic, nighttime palpitations and excessive daytime sleepiness. Four years prior he underwent radiofrequency ablation after a confirmed diagnosis of AF with subsequent resolution of his palpitations. His palpitations returned approximately 1 year following the ablation. These events would occur only at night and awake him from sleep. Holter monitoring showed baseline sinus rhythm with multiple episodes of AF with rates of 75 to 169 beats/min. These events were all nocturnal and correlated with the symptom diary; episodes ranged from 45 min to 2 h. An echocardiogram showed normal left ventricular size and ejection fraction with a mildly enlarged right atrium (4.38 cm) and no evidence of pulmonary hypertension.
4988. Pirfenidone-Induced Sarcoid-Like Reaction: A Novel Complication.
作者: Nicholas A Kolaitis.;Jasleen Kukreja.;Kirk D Jones.;Steven R Hays.;Lorriana E Leard.
来源: Chest. 2018年154卷4期e89-e92页
Idiopathic pulmonary fibrosis is the most common idiopathic interstitial pneumonia. Prognosis is poor with a median survival <3 years. Pirfenidone is one of two US Food and Drug Administration-approved medications that slow disease progression. We describe the development of lymphadenopathy or a sarcoid-like reaction following initiation of pirfenidone, a complication not previously reported.
4989. A 26-Year-Old Man With a Pleural Effusion and Headache.
A 26-year-old man presented to the ED with dizziness and gait imbalance. He noted dizziness for 3 months, but symptoms progressed more rapidly over the last 3 weeks when he began experiencing nausea, vomiting, and "wobbly legs." These symptoms would worsen with physical exertion, especially when lifting heavy objects. On review of systems, he also reported subjective fevers and chills. He had no appreciable dyspnea, cough, chest pain, or increased sputum production. The patient recalled a history of "brain surgery" approximately 4 years prior to his presentation, but no further details could be provided at the time.
4990. A 62-Year-Old Woman With Acute Respiratory Failure and a Painful Right Lower Limb.
作者: David Lagier.;Marine Gaudry.;Hubert Lepidi.;Cindy Perron.;Catherine Guidon.
来源: Chest. 2018年154卷4期e107-e111页
A 62-year-old woman with no medical history was admitted to the ED for fever, acute respiratory failure, and pain in the right lower limb. Three months prior to presentation, she had spent 45 days travelling through India and Thailand. She presented with no signs of traveler's disease such as fever or diarrhea during that trip. Two weeks following her return to France, the patient presented with an episode of bronchitis and received 5 days of treatment with cefixime (a third-generation cephalosporin). Despite this antibiotic treatment, her symptoms worsened and she developed, over the following 3 weeks, general weakness and arthralgia/myalgia. Due to the severity of hypoxemia, the patient was immediately transferred to the ICU.
4991. A 38-Year-Old Man With a 2-Month History of Fever, Cough, Palpitations, and Weight Loss.
作者: Dimitrios Papadopoulos.;Alexandra Nakou.;Konstantinos Lymperopoulos.;Vasiliki Filaditaki.
来源: Chest. 2018年154卷4期e101-e105页
A 38-year-old man of Indian origin, who migrated to Greece 13 years prior to presentation, was admitted to our hospital with a 2-month history of nonprogressive, intermittent (mostly evening), low-grade (up to 38.5°C) fever, accompanied by night sweats, dry cough, mild dyspnea on exertion (modified Medical Research Council Dyspnea Scale grade 1), anorexia, fatigue, and weight loss of 10 kg. He also experienced continuous palpitations, which were regular, not associated with chest pain or dizziness, and aggravated on exertion. He had not taken any medication for his condition, except for antipyretic agents, nor had he sought medical advice. He was a nonsmoker, had a history of past alcohol dependence, and had been hospitalized twice for acute pancreatitis due to hypertriglyceridemia. He had also been diagnosed with diabetes mellitus, presumably poorly controlled because he mentioned not taking any medication or having regular follow-up.
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