1668. Update on Biomarkers for the Stratification of Indeterminate Pulmonary Nodules.
作者: Rafael Paez.;Michael N Kammer.;Nicole T Tanner.;Samira Shojaee.;Brent E Heideman.;Tobias Peikert.;Meridith L Balbach.;Wade T Iams.;Boting Ning.;Marc E Lenburg.;Christopher Mallow.;Lonny Yarmus.;Kwun M Fong.;Stephen Deppen.;Eric L Grogan.;Fabien Maldonado.
来源: Chest. 2023年164卷4期1028-1041页
Lung cancer is the leading cause of cancer-related deaths. Early detection and diagnosis are critical, as survival decreases with advanced stages. Approximately 1.6 million nodules are incidentally detected every year on chest CT scan images in the United States. This number of nodules identified is likely much larger after accounting for screening-detected nodules. Most of these nodules, whether incidentally or screening detected, are benign. Despite this, many patients undergo unnecessary invasive procedures to rule out cancer because our current stratification approaches are suboptimal, particularly for intermediate probability nodules. Thus, noninvasive strategies are urgently needed. Biomarkers have been developed to assist through the continuum of lung cancer care and include blood protein-based biomarkers, liquid biopsies, quantitative imaging analysis (radiomics), exhaled volatile organic compounds, and bronchial or nasal epithelium genomic classifiers, among others. Although many biomarkers have been developed, few have been integrated into clinical practice as they lack clinical utility studies showing improved patient-centered outcomes. Rapid technologic advances and large network collaborative efforts will continue to drive the discovery and validation of many novel biomarkers. Ultimately, however, randomized clinical utility studies showing improved patient outcomes will be required to bring biomarkers into clinical practice.
1669. Effect of Hypertonic Saline on Lung Function as Add-on Treatment in People With Cystic Fibrosis Receiving Dornase Alfa: A Cystic Fibrosis Foundation Patient Registry Analysis.
作者: Athanasios G Kaditis.;James Acton.;Connie Fenton.;Leila Kheirandish-Gozal.;Zarah Ner.;Rebekah Nevel.;David Gozal.;Adrienne Ohler.
来源: Chest. 2023年164卷4期860-871页
Introduction of novel therapies for cystic fibrosis (CF) raises the question of whether traditional treatments can be withdrawn. Nebulized hypertonic saline (HS) potentially could be discontinued in patients receiving dornase alfa (DA).
1670. Observation, Aspiration, or Tube Thoracostomy for Primary Spontaneous Pneumothorax: A Systematic Review, Meta-Analysis, and Cost-Utility Analysis.
作者: Gilgamesh Eamer.;Christopher A Povolo.;Jo-Anne Petropoulos.;Arto Ohinmaa.;Lisa Vanhouwelingen.
来源: Chest. 2023年164卷4期1007-1018页
Primary spontaneous pneumothorax (PSP) has several commonly used management strategies: observation, aspiration, and chest tube placement. Economic modelling of pooled data comparing techniques has not been performed.
1671. Prospective Detection of Early Lung Cancer in Patients With COPD in Regular Care by Electronic Nose Analysis of Exhaled Breath.
作者: Rianne de Vries.;Niloufar Farzan.;Timon Fabius.;Frans H C De Jongh.;Patrick M C Jak.;Eric G Haarman.;Erik Snoey.;Johannes C C M In 't Veen.;Yennece W F Dagelet.;Anke-Hilse Maitland-Van Der Zee.;Annelies Lucas.;Michel M Van Den Heuvel.;Marguerite Wolf-Lansdorf.;Mirte Muller.;Paul Baas.;Peter J Sterk.
来源: Chest. 2023年164卷5期1315-1324页
Patients with COPD are at high risk of lung cancer developing, but no validated predictive biomarkers have been reported to identify these patients. Molecular profiling of exhaled breath by electronic nose (eNose) technology may qualify for early detection of lung cancer in patients with COPD.
1672. Pressure-Dependent Pneumothorax and Air Leak: Physiology and Clinical Implications.
作者: Amit Chopra.;Peter Doelken.;Kurt Hu.;John T Huggins.;Marc A Judson.
来源: Chest. 2023年164卷3期796-805页
Pressure-dependent pneumothorax is a common clinical event, often occurring after pleural drainage in patients with visceral pleural restriction, partial lung resection, or lobar atelectasis from bronchoscopic lung volume reduction or an endobronchial obstruction. This type of pneumothorax and air leak is clinically inconsequential. Failure to appreciate the benign nature of such air leaks may result in unnecessary pleural procedures or prolonged hospital stay. This review suggests that identification of pressure-dependent pneumothorax is clinically important because the air leak that results is not related to a lung injury that requires repair but rather to a physiological consequence of a pressure gradient. A pressure-dependent pneumothorax occurs during pleural drainage in patients with lung-thoracic cavity shape/size mismatch. It is caused by an air leak related to a pressure gradient between the subpleural lung parenchyma and the pleural space. Pressure-dependent pneumothorax and air leak do not need any further pleural interventions.
1673. Nocturnal Hypoxemia Associates With Symptom Progression and Mortality in Patients With Progressive Fibrotic Interstitial Lung Disease.
作者: Katherine J Myall.;Alex G West.;Jennifer L Martinovic.;Jodie L Lam.;Diana Roque.;Zhe Wu.;Toby M Maher.;Philip L Molyneaux.;Eui-Sik Suh.;Brian D Kent.
来源: Chest. 2023年164卷5期1232-1242页
OSA and nocturnal hypoxemia (NH) are common in patients with fibrotic interstitial lung disease (F-ILD), but their relationship with disease outcomes remains unclear.
1674. Effectiveness of Flexible Bronchoscopy Simulation-Based Training: A Systematic Review.
作者: Eveline C F Gerretsen.;Aoben Chen.;Jouke T Annema.;Marleen Groenier.;Erik H F M van der Heijden.;Walther N K A van Mook.;Frank W J M Smeenk.
来源: Chest. 2023年164卷4期952-962页
The implementation of simulation-based training (SBT) to teach flexible bronchoscopy (FB) skills to novice trainees has increased during the last decade. However, it is unknown whether SBT is effective to teach FB to novices and which instructional features contribute to training effectiveness.
1675. Arterial Pressure Response to an Increase in Norepinephrine Varies Depending on the Baseline Norepinephrine Dose in Patients With Septic Shock.
作者: Nicholas A Bosch.;Bijan Teja.;Anica C Law.;Hannah Wunsch.;Allan J Walkey.
来源: Chest. 2023年164卷5期1228-1231页 |