501. 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.
502. 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.
503. 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.
504. 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.
505. 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.
506. 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.
507. 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.
508. 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.
509. 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.
510. Increased Burden of Pertussis Among Adolescents and Adults With Asthma or COPD in the United States, 2007 to 2019.
Individuals with chronic respiratory illnesses may be at higher risk of pertussis infection and severe pertussis than those without.
511. Role of Left Ventricular Dysfunction in Systemic Sclerosis-Related Pulmonary Hypertension.
作者: Justin K Lui.;Matthew Cozzolino.;Morgan Winburn.;Marcin A Trojanowski.;Renda Soylemez Wiener.;Michael P LaValley.;Andreea M Bujor.;Deepa M Gopal.;Elizabeth S Klings.
来源: Chest. 2024年165卷6期1505-1517页
In systemic sclerosis (SSc), pulmonary hypertension remains a significant cause of morbidity and mortality. Although conventionally classified as group 1 pulmonary arterial hypertension, systemic sclerosis-related pulmonary hypertension (SSc-PH) is a heterogeneous disease. The contribution of left-sided cardiac disease in SSc-PH remains poorly understood.
512. Use of Quantitative CT Imaging to Identify Bronchial Thermoplasty Responders.
作者: Maanasi Samant.;James G Krings.;Daphne Lew.;Charles W Goss.;Tammy Koch.;Mary Clare McGregor.;Jonathan Boomer.;Chase S Hall.;Ken B Schechtman.;Ajay Sheshadri.;Samuel Peterson.;Serpil Erzurum.;Zachary DePew.;Lee E Morrow.;D Kyle Hogarth.;Richard Tejedor.;Jennifer Trevor.;Michael E Wechsler.;Afshin Sam.;Xiaosong Shi.;Jiwoong Choi.;Mario Castro.
来源: Chest. 2024年165卷4期775-784页
Bronchial thermoplasty (BT) is a treatment for patients with poorly controlled, severe asthma. However, predictors of treatment response to BT are defined poorly.
513. Outcomes and Management After COVID-19 Critical Illness.
作者: Leigh Cagino.;Katharine Seagly.;Emily Noyes.;Hallie Prescott.;Thomas Valley.;Tammy Eaton.;Jakob I McSparron.
来源: Chest. 2024年165卷5期1149-1162页
COVID-19 has caused > 7 million deaths worldwide since its onset in 2019. Although the severity of illness has varied throughout the pandemic, critical illness related to COVID-19 persists. Survivors of COVID-19 critical illness can be left with sequelae of both the SARS-CoV-2 virus and long-term effects of critical illness included within post-intensive care syndrome. Given the complexity and heterogeneity of COVID-19 critical illness, the biopsychosocial-ecological model can aid in evaluation and treatment of survivors, integrating interactions among physical, cognitive, and psychological domains, as well as social systems and environments.
514. Sublobar Resection, Stereotactic Body Radiation Therapy, and Percutaneous Ablation Provide Comparable Outcomes for Lung Metastasis-Directed Therapy.
作者: Hunter C Gits.;Mitra A Khosravi Flanigan.;Jamie D Kapplinger.;Janani S Reisenauer.;Patrick W Eiken.;William G Breen.;Linh H Vu.;Brian T Welch.;William S Harmsen.;Courtney N Day.;Kenneth R Olivier.;Sean S Park.;Yolanda I Garces.;Christopher L Hallemeier.;Kenneth W Merrell.;Jonathan B Ashman.;Steven E Schild.;Michael P Grams.;J John Lucido.;K Robert Shen.;Stephen D Cassivi.;Dennis Wigle.;Francis C Nichols.;Shanda Blackmon.;Luis F Tapias.;Matthew R Callstrom.;Dawn Owen.
来源: Chest. 2024年165卷5期1247-1259页
Prolonged survival of patients with metastatic disease has furthered interest in metastasis-directed therapy (MDT).
515. Time-Limited Trials for Patients With Critical Illness: A Review of the Literature.
作者: Jacqueline M Kruser.;Nandita R Nadig.;Elizabeth M Viglianti.;Justin T Clapp.;Katharine E Secunda.;Scott D Halpern.
来源: Chest. 2024年165卷4期881-891页
Since the 1990s, time-limited trials have been described as an approach to navigate uncertain benefits and limits of life-sustaining therapies in patients with critical illness. In this review, we aim to synthesize the evidence on time-limited trials in critical care, establish what is known, and highlight important knowledge gaps.
516. Tolerability Outcomes of American Thoracic Society/Infectious Diseases Society of America Guideline-Recommended Multidrug Antibiotic Treatment for Mycobacterium avium Complex Pulmonary Disease in US Medicare Beneficiaries With Bronchiectasis.
作者: Jennifer H Ku.;Emily Henkle.;Kathleen F Carlson.;Miguel Marino.;Sarah K Brode.;Theodore K Marras.;Kevin L Winthrop.
来源: Chest. 2024年165卷5期1058-1069页
Nontuberculous mycobacteria are environmental organisms that are increasingly causing chronic and debilitating pulmonary infections, of which Mycobacterium avium complex (MAC) is the most common pathogen. MAC pulmonary disease (MAC-PD) is often difficult to treat, often requiring long-term multidrug antibiotic therapy.
517. Epidemiology of Intensive Care Patients Classified as a Third Sex in Australia and New Zealand.
作者: Lucy J Modra.;Alisa M Higgins.;David V Pilcher.;Ada S Cheung.;Morgan N Carpenter.;Michael Bailey.;Sav Zwickl.;Rinaldo Bellomo.
来源: Chest. 2024年165卷5期1120-1128页
Patient sex affects treatment and outcomes in critical illness. Previous studies of sex differences in critical illness compared female and male patients. In this study, we describe the group of patients classified as a third sex admitted to ICUs in Australia and New Zealand.
518. Situs Ambiguus Is Associated With Adverse Clinical Outcomes in Children With Primary Ciliary Dyskinesia.
作者: Kimberley R Kaspy.;Sharon D Dell.;Stephanie D Davis.;Thomas W Ferkol.;Margaret Rosenfeld.;Scott D Sagel.;Carlos Milla.;Kenneth N Olivier.;Andrew T Barber.;Wallace Wee.;Feng-Chang Lin.;Lang Li.;Emmanouil Rampakakis.;Maimoona A Zariwala.;Michael R Knowles.;Margaret W Leigh.;Adam J Shapiro.
来源: Chest. 2024年165卷5期1070-1081页
Primary ciliary dyskinesia (PCD) is a rare disorder of motile cilia associated with situs abnormalities. At least 12% of patients with PCD have situs ambiguus (SA), including organ laterality defects falling outside normal arrangement (situs solitus [SS]) or mirror image inversion (situs inversus totalis [SIT]).
519. A 65-Year-Old Man With Concerns of Hemoptysis After Recent Motor Vehicle Accident and Blunt Trauma to Chest.
作者: Shaheryar Usman.;Shahan Haseeb.;Muhammad Jahanzaib Khan.;Andrew Weber.
来源: Chest. 2023年164卷6期e173-e176页
A 65-year-old man with a medical history of anxiety and depression came to the ED with concerns of coughing blood-tinged phlegm for the past 3 days. Four days before the presentation, the patient had a motor vehicle accident as a restrained driver with airbag deployment. The patient struck his chest against the steering wheel. He was evaluated at a level 1 trauma center and underwent a whole-body scan, including a CT scan of the chest, which showed no acute abnormalities. Apart from mild-to-moderate bruising and tenderness on the right side of his face, nose, and anterior chest, the patient was stable and was discharged the next day. After returning home, the patient started coughing blood-tinged phlegm, which became progressively bloodier for the next 3 days, achieving individual posttussive volumes of 1 T of frank blood. In the ED, the patient denied any similar symptoms in the past. He denied any recent or distant known history of malignancy, infections, or travel outside the United States. He lives by himself and previously worked various jobs. He endorsed active tobacco use and smoking 3 to 6 cigarettes per day for the past 20 years with 5 pack-year history. Patient reported consuming one to two alcohol drinks per month.
520. A 56-Year-Old Man With Progressive Subacute Hypoxemia.
作者: Alexander W Steinberg.;Fatima Zeba.;Athos J Rassias.;Prerna Mota.
来源: Chest. 2023年164卷6期e169-e172页
A 56-year-old man with a medical history of diabetes, no prior lung disease, and no tobacco exposure presented with exhaustion and a nonproductive cough 7 days after working in an old farmhouse in Vermont. His friend who worked with him exhibited similar symptoms. He was treated as an outpatient with doxycycline; however, his clinical condition deteriorated and necessitated hospitalization and subsequent intubation.
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