28. Short-term Effects of Supplemental Oxygen on 6-Min Walk Test Outcomes in Patients With COPD: A Randomized, Placebo-Controlled, Single-blind, Crossover Trial.
作者: Inga Jarosch.;Rainer Gloeckl.;Eva Damm.;Anna-Lena Schwedhelm.;David Buhrow.;Andreas Jerrentrup.;Martijn A Spruit.;Klaus Kenn.
来源: Chest. 2017年151卷4期795-803页
The acute effect of supplemental oxygen during exercise has been shown to differ largely among patients with COPD. It is unknown what factors influence oxygen response.
30. Maximal Inspiratory Pressure: Does the Choice of Reference Values Actually Matter?
作者: Antenor Rodrigues.;Marianne L Da Silva.;Danilo C Berton.;Gerson Cipriano.;Fabio Pitta.;Denis E O'Donnell.;J Alberto Neder.
来源: Chest. 2017年152卷1期32-39页
Single-point measurements of maximal inspiratory pressure (MIP) are frequently used to suggest muscle weakness in clinical practice. Although there is a large variability in "mean" predicted MIP depending on the chosen reference values, it remains unclear whether those discrepancies actually impact on the prevalence of weakness, that is, MIP below the lower limit of normal.
31. The Power of Flash Mob Research: Conducting a Nationwide Observational Clinical Study on Capillary Refill Time in a Single Day.
作者: Jelmer Alsma.;Jan L C M van Saase.;Prabath W B Nanayakkara.;W E M Ineke Schouten.;Anique Baten.;Martijn P Bauer.;Frits Holleman.;Jack J M Ligtenberg.;Patricia M Stassen.;Karin H A H Kaasjager.;Harm R Haak.;Frank H Bosch.;Stephanie C E Schuit.; .
来源: Chest. 2017年151卷5期1106-1113页
Capillary refill time (CRT) is a clinical test used to evaluate the circulatory status of patients; various methods are available to assess CRT. Conventional clinical research often demands large numbers of patients, making it costly, labor-intensive, and time-consuming. We studied the interobserver agreement on CRT in a nationwide study by using a novel method of research called flash mob research (FMR).
32. Percent Emphysema and Daily Motor Activity Levels in the General Population: Multi-Ethnic Study of Atherosclerosis.
作者: Christian M Lo Cascio.;Mirja Quante.;Eric A Hoffman.;Alain G Bertoni.;Carrie P Aaron.;Joseph E Schwartz.;Mark V Avdalovic.;Vincent S Fan.;Gina S Lovasi.;Steven M Kawut.;John H M Austin.;Susan Redline.;R Graham Barr.
来源: Chest. 2017年151卷5期1039-1050页
COPD is associated with reduced physical capacity. However, it is unclear whether pulmonary emphysema, which can occur without COPD, is associated with reduced physical activity in daily life, particularly among people without COPD and never smokers. We hypothesized that greater percentage of emphysema-like lung on CT scan is associated with reduced physical activity assessed by actigraphy and self-report.
33. Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study.
作者: Paul E Marik.;Vikramjit Khangoora.;Racquel Rivera.;Michael H Hooper.;John Catravas.
来源: Chest. 2017年151卷6期1229-1238页
The global burden of sepsis is estimated as 15 to 19 million cases annually, with a mortality rate approaching 60% in low-income countries.
34. A Man in His 20s With Diffuse Lung Opacities and Acute Respiratory Failure After Hookah Smoking.
A man in his 20s with no medical history presented with 2 days of progressively worsening shortness of breath accompanied by subjective fevers, chills, body aches, decreased appetite, night sweats, and cough producing nonbloody sputum. He denied childhood lung diseases, allergies, or a family history of lung disease. He did not smoke cigarettes but had smoked hookah in Saudi Arabia before moving to the United States 1 month before presentation and had restarted 2 days before the start of symptoms. He denied travel outside of the northeastern United States. He did not take medications, use illicit drugs, or engage in high-risk behavior.
35. A Woman in Her 60s With Fever and Altered Mental Status in a Psychiatric Hospital.
A woman in her 60s with a history of hepatitis C with cirrhosis and major depressive disorder with psychotic features was admitted to the inpatient psychiatric unit for suicidal ideation. She was initially treated with a combination of sertraline and paliperidone. The paliperidone was subsequently changed to risperidone and ultimately to olanzapine. She developed worsening mental status and was then treated for catatonia with benzodiazepines. Over 2 days, her mental status continued to worsen and she developed fever and tachycardia. She was transferred to the ICU and endotracheally intubated for inability to protect her airway. She was started on lactulose via orogastric tube but showed no improvement in her mental status after 2 days despite having two or three bowel movements per day.
36. A 48-Year-Old Man With Leukopenia, Jaundice, and Skin Rash After Lung Transplantation.
作者: Ali Ataya.;Abhishek Biswas.;Satish Chandrashekaran.;Juan C Salgado.;Steven S Goldstein.;Amir M Emtiazjoo.
来源: Chest. 2016年150卷6期e167-e170页
A 48-year-old African-American male subject presented with progressive fatigue, jaundice, and new-onset leukopenia 12 weeks after undergoing bilateral lung transplantation for advanced pulmonary sarcoidosis. His transplant surgery and immediate posttransplantation course were uneventful. Induction immunosuppression included methylprednisolone 500 mg intraoperatively and basiliximab (anti-IL-2 monoclonal antibody) on days 0 and 4 after transplantation. His maintenance immunosuppression posttransplantation was prednisone 20 mg daily, tacrolimus with target tacrolimus levels 10 to 15 ng/mL, and mycophenolate mofetil 750 mg twice daily. Both the donor and recipient were seropositive for cytomegalovirus and Epstein-Barr virus. Infectious disease prophylaxis consisted of valganciclovir, trimethoprim/sulfamethoxazole, and voriconazole. Results of the surveillance bronchoscopy conducted after the lung transplant were negative for acute cellular rejection or infection at 4 and 12 weeks' posttransplantation. Findings on spirometry had continuously improved since transplantation.
37. A 40-Year-Old Woman With Back Pain.
作者: Andreu Fernández-Codina.;Santiago Aranda-Rodríguez.;Cleofé Romagosa.;Maria Deu-Martin.;Carmen Parra-Fariñas.;Segundo Bujan-Rivas.
来源: Chest. 2016年150卷6期e159-e165页
A 40-year-old woman consulted our ED for a 7-month history of left dorsal back pain and dyspnea. The pain was initially dull and mechanical. Her general practitioner started nonsteroidal antiinflammatory drugs and physiotherapy, which provided partial relief. One week before consulting, the intensity of the pain increased, and she started to feel shortness of breath when performing her daily activities. She had lost 5 kg during the previous month. The patient was a healthy woman who lived in an urban area of Barcelona, Spain. She did not smoke or take drugs of abuse, and she worked as a butcher. During the initial evaluation, her blood pressure was 131/76 mm Hg, heart rate was 120 beats/min, temperature was 36.2°C, and ambient air pulse oximetry was 98%.
38. A 67-Year-Old Man With Severe Posttraumatic ARDS in Extracorporeal Membrane Oxygenation Presents Sudden Desaturation.
作者: Silvia Mongodi.;Marta Luperto.;Anita Orlando.;Aaron Venti.;Antonio Braschi.;Giorgio Antonio Iotti.;Francesco Mojoli.
来源: Chest. 2016年150卷6期e155-e157页 40. Successful Healing of Tracheal Radionecrosis: Role of Hyperbaric Oxygen Therapy.
作者: Miguel Ariza-Prota.;Arturo Morales.;Jose Grajeda.;Rosa López-Lisbona.;Noelia Cubero.;Jordi Dorca.;Antoni Rosell.
来源: Chest. 2016年150卷6期e147-e150页
Hyperbaric oxygen therapy, the administration of 100% oxygen at pressures > 1 atm, is believed to promote wound healing by increasing angiogenesis and collagen synthesis. To our knowledge, this treatment modality has never been described in patients with tracheal radionecrosis. Here, we report the case of a 55-year-old man diagnosed with stage IIIB lung adenocarcinoma who was treated with chemotherapy and concomitant external intensity-modulated radiotherapy involving the left lung and mediastinum. Nine months later, he presented with neck pain, cough with mucopurulent sputum, and fever. A PET-CT scan revealed a fissure in the posterior wall of the left upper trachea. Flexible bronchoscopy showed a tracheal ulceration with a small left posterior wall fissure that extended into the mediastinum. To our knowledge, this is the first report in the literature that suggests that treatment with hyperbaric oxygen therapy, local debridement, and antibiotics is a feasible and successful management option for patients with complicated tracheal radionecrosis.
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