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161. Effectiveness and Safety of Supervised Home-Based Physical Training in Patients With COPD on Long-term Home Oxygen Therapy: A Randomized Trial.
作者: Demetria Kovelis.;Anna R S Gomes.;Camila Mazzarin.;Samia K Biazim.;Fabio Pitta.;Silvia Valderramas.
来源: Chest. 2020年158卷3期965-972页
Patients with COPD in advanced stages who need long-term home oxygen therapy (LTHOT) have difficulty participating in outpatient pulmonary rehabilitation (PR) programs. This difficulty is due to the severity of their disease, limitations involving transportation and mobility, high costs, and issues related to patients' safety and individual needs. Unsupervised home-based physical training (PT) is frequently used.
162. Randomized Trial on the Effects of High-Dose Zopiclone on OSA Severity, Upper Airway Physiology, and Alertness.
作者: Sophie G Carter.;Jayne C Carberry.;Ronald R Grunstein.;Danny J Eckert.
来源: Chest. 2020年158卷1期374-385页
Studies indicate that standard doses of hypnotics reduce or do not change the apnea-hypopnea index (AHI) or pharyngeal muscle activity. A 1-month trial of nightly zopiclone (7.5 mg) modestly reduced the AHI vs baseline without changing other sleep parameters or next-day sleepiness.
163. Outcomes of Metabolic Resuscitation Using Ascorbic Acid, Thiamine, and Glucocorticoids in the Early Treatment of Sepsis: The ORANGES Trial.
作者: Jose Iglesias.;Andrew V Vassallo.;Vishal V Patel.;Jesse B Sullivan.;Joseph Cavanaugh.;Yasmine Elbaga.
来源: Chest. 2020年158卷1期164-173页
Sepsis is a major public health burden resulting in 25% to 30% in-hospital mortality and accounting for over 20 billion dollars of US hospital costs.
164. Ambulatory Oxygen in Fibrotic Interstitial Lung Disease: A Pilot, Randomized, Triple-Blinded, Sham-Controlled Trial.
作者: Yet H Khor.;Anne E Holland.;Nicole S L Goh.;Belinda R Miller.;Ross Vlahos.;Steven Bozinovski.;Aroub Lahham.;Ian Glaspole.;Christine F McDonald.
来源: Chest. 2020年158卷1期234-244页
Despite a lack of evidence, ambulatory oxygen therapy is frequently prescribed for patients with interstitial lung disease (ILD) and exertional desaturation. Patients often prefer portable oxygen concentrators to oxygen cylinders. This study aimed to examine the feasibility of conducting a clinical trial of ambulatory oxygen delivered via portable concentrators in patients with ILD.
165. A Randomized, Double-Blind, Placebo-Controlled Study of Pulsed, Inhaled Nitric Oxide in Subjects at Risk of Pulmonary Hypertension Associated With Pulmonary Fibrosis.
作者: Steven D Nathan.;Kevin R Flaherty.;Marilyn K Glassberg.;Ganesh Raghu.;Jeffrey Swigris.;Roger Alvarez.;Neil Ettinger.;Jim Loyd.;Peter Fernandes.;Hunter Gillies.;Bo Kim.;Parag Shah.;Lisa Lancaster.
来源: Chest. 2020年158卷2期637-645页
The interstitial lung diseases include a variety of disorders, many of which are characterized by fibrotic changes (fILD). Of the fILDs, Idiopathic pulmonary fibrosis is the most common. Pulmonary hypertension (PH) frequently complicates fILD and is associated with impaired functional capability, lower physical activity, and significantly reduced life expectancy. There is no proven treatment for patients with fILD-PH. We report results from the first cohort of a phase 2b/3 trial with pulsed inhaled nitric oxide (iNO) in patients with fILD-PH.
166. Effects of the Combination of Atomoxetine and Oxybutynin on OSA Endotypic Traits.
作者: Luigi Taranto-Montemurro.;Ludovico Messineo.;Ali Azarbarzin.;Daniel Vena.;Lauren B Hess.;Nicole A Calianese.;David P White.;Andrew Wellman.;Scott A Sands.
来源: Chest. 2020年157卷6期1626-1636页
We recently showed that administration of the combination of the noradrenergic drug atomoxetine plus the antimuscarinic oxybutynin (ato-oxy) prior to sleep greatly reduced OSA severity, likely by increasing upper airway dilator muscle activity during sleep. In patients with OSA who performed the ato-oxy trial with an esophageal pressure catheter to estimate ventilatory drive, the effect of the drug combination (n = 17) and of the single drugs (n = 6) was measured on the endotypic traits over a 1-night administration and compared vs placebo. This study also tested if specific traits were predictors of complete response to treatment (reduction in apnea-hypopnea index [AHI] > 50% and < 10 events/h).
167. Effect of Olfactory Stimulation by L-Menthol on Laboratory-Induced Dyspnea in COPD.
Inhalation of L-menthol as a transient receptor potential melastatin 8 agonist induces a cooling sensation in the airway. This cooling sensation induced through olfactory stimulation by L-menthol (OSM) alleviates dyspnea in healthy humans. Therefore, we investigated effects of OSM on the neural respiratory drive (NRD) and multidimensional aspects of dyspnea induced by inspiratory resistive loaded breathing in COPD.
168. Change in Clinical Practice Associated With a Large Randomized Controlled Trial Comparing RBC Transfusion Strategies.
作者: Kevin M Trentino.;Frank M Sanfilippo.;Michael F Leahy.;Shannon L Farmer.;Ian Gilfillan.;Kevin Murray.
来源: Chest. 2020年158卷2期719-721页 169. Aprepitant for Cough Suppression in Advanced Lung Cancer: A Randomized Trial.
作者: Vanita Noronha.;Atanu Bhattacharjee.;Vijay M Patil.;Amit Joshi.;Nandini Menon.;Srushti Shah.;Sadhana Kannan.;Sadaf A Mukadam.;Kamesh Maske.;Sandeep Ishi.;Kumar Prabhash.
来源: Chest. 2020年157卷6期1647-1655页
Although cough is a common and distressing symptom in patients with lung cancer, there is almost no evidence to guide treatment. Aprepitant, a centrally acting neurokinin-1 inhibitor, significantly decreased cough frequency in a pilot study.
170. Acute Ventilatory Support During Whole-Body Hybrid Rowing in Patients With High-Level Spinal Cord Injury: A Randomized Controlled Crossover Trial.
作者: Isabelle Vivodtzev.;Glen Picard.;Felipe X Cepeda.;J Andrew Taylor.
来源: Chest. 2020年157卷5期1230-1240页
High-level spinal cord injury (SCI) results in profound spinal and supraspinal deficits, leading to substantial ventilatory limitations during whole-body hybrid functional electrical stimulation (FES)-rowing, a form of exercise that markedly increases the active muscle mass via electrically induced leg contractions. This study tested the effect of noninvasive ventilation (NIV) on ventilatory and aerobic capacities in SCI.
171. Validation of the COPD Assessment Test (CAT) as an Outcome Measure in Bronchiectasis.
作者: Simon Finch.;Irena F Laska.;Hani Abo-Leyah.;Thomas C Fardon.;James D Chalmers.
来源: Chest. 2020年157卷4期815-823页
Objective assessment of symptoms in bronchiectasis is important for research and in clinical practice. The COPD Assessment Test (CAT) is a short, simple assessment tool widely used in COPD. The items included in the CAT are not specific to COPD and also reflect the dominant symptoms of bronchiectasis. We therefore performed a study to validate the CAT as an outcome measure in bronchiectasis.
172. The Impact of Gravity vs Suction-driven Therapeutic Thoracentesis on Pressure-related Complications: The GRAVITAS Multicenter Randomized Controlled Trial.
作者: Robert J Lentz.;Samira Shojaee.;Horiana B Grosu.;Otis B Rickman.;Lance Roller.;Jasleen K Pannu.;Zachary S DePew.;Labib G Debiane.;Joseph C Cicenia.;Jason Akulian.;Charla Walston.;Trinidad M Sanchez.;Kevin R Davidson.;Nikhil Jagan.;Sahar Ahmad.;Christopher Gilbert.;John T Huggins.;Heidi Chen.;Richard W Light.;Lonny Yarmus.;David Feller-Kopman.;Hans Lee.;Najib M Rahman.;Fabien Maldonado.; .
来源: Chest. 2020年157卷3期702-711页
Thoracentesis can be accomplished by active aspiration or drainage with gravity. This trial investigated whether gravity drainage could protect against negative pressure-related complications such as chest discomfort, re-expansion pulmonary edema, or pneumothorax compared with active aspiration.
173. A Prospective Randomized Comparative Study of Three Guided Bronchoscopic Approaches for Investigating Pulmonary Nodules: The PRECISION-1 Study.
作者: Lonny Yarmus.;Jason Akulian.;Momen Wahidi.;Alex Chen.;Jennifer P Steltz.;Sam L Solomon.;Diana Yu.;Fabien Maldonado.;Jose Cardenas-Garcia.;Daniela Molena.;Hans Lee.;Anil Vachani.; .
来源: Chest. 2020年157卷3期694-701页
The capability of bronchoscopy in the diagnosis of peripheral pulmonary nodules (PPNs) remains limited. Despite decades of effort, evidence suggests that the diagnostic accuracy for electromagnetic navigational bronchoscopy (EMN) and radial endobronchial ultrasound (EBUS) approach only 50%. New developments in robotic bronchoscopy (RB) may offer improvements in the assessment of PPNs.
174. The Neurokinin-1 Receptor Antagonist Orvepitant Is a Novel Antitussive Therapy for Chronic Refractory Cough: Results From a Phase 2 Pilot Study (VOLCANO-1).
作者: Jaclyn Smith.;David Allman.;Huda Badri.;Robert Miller.;Julie Morris.;Imran Satia.;Andrew Wood.;Michael K Trower.
来源: Chest. 2020年157卷1期111-118页
Substance P and the neurokinin-1 (NK-1) receptor are implicated in chronic refractory cough pathophysiology. We assessed the efficacy and safety of orvepitant, a brain-penetrant NK-1 antagonist, in an open-label study in CRC patients with chronic refractory cough.
175. Pre-EDIT: A Randomized Feasibility Trial of Elastance-Directed Intrapleural Catheter or Talc Pleurodesis in Malignant Pleural Effusion.
作者: Geoffrey A Martin.;Selina Tsim.;Andrew C Kidd.;John E Foster.;Philip McLoone.;Anthony Chalmers.;Kevin G Blyth.
来源: Chest. 2019年156卷6期1204-1213页
Talc slurry pleurodesis (TSP) prevents recurrence of symptomatic malignant pleural effusion (MPE) in 71% to 78% patients. Nonexpansile lung (NEL) frequently accounts for TSP failure but is often occult predrainage, impairing selection of patients. NEL is associated with high pleural elastance (PEL), but technical limitations have hampered the development of PEL as a predictive NEL marker. We performed a single-center, randomized, controlled, open-label feasibility trial of EDIT (elastance-directed indwelling pleural catheter or TSP) management, using a novel digital manometer and a new definition of high PEL.
176. Use of an Ultrathin vs Thin Bronchoscope for Peripheral Pulmonary Lesions: A Randomized Trial.
作者: Masahide Oki.;Hideo Saka.;Fumihiro Asano.;Chiyoe Kitagawa.;Yoshihito Kogure.;Akifumi Tsuzuku.;Masahiko Ando.
来源: Chest. 2019年156卷5期954-964页
When evaluating peripheral pulmonary lesions, a 3.0-mm ultrathin bronchoscope (UTB) with a 1.7-mm working channel is advantageous regarding good access to the peripheral airway, whereas a 4.0-mm thin bronchoscope provides a larger 2.0-mm working channel, which allows the use of various instruments including a guide sheath (GS), larger forceps, and an aspiration needle. This study compared multimodal bronchoscopy using a UTB and a thin bronchoscope with multiple sampling methods for the diagnosis of peripheral pulmonary lesions.
177. A Randomized Trial of Nebulized Lignocaine, Lignocaine Spray, or Their Combination for Topical Anesthesia During Diagnostic Flexible Bronchoscopy.
作者: Sahajal Dhooria.;Shivani Chaudhary.;Babu Ram.;Inderpaul Singh Sehgal.;Valliappan Muthu.;Kuruswamy Thurai Prasad.;Ashutosh N Aggarwal.;Ritesh Agarwal.
来源: Chest. 2020年157卷1期198-204页
The optimal mode of delivering topical anesthesia during flexible bronchoscopy remains unknown. This article compares the efficacy and safety of nebulized lignocaine, lignocaine oropharyngeal spray, or their combination.
178. Alterations in Polyamine Metabolism in Patients With Lymphangioleiomyomatosis and Tuberous Sclerosis Complex 2-Deficient Cells.
作者: Yan Tang.;Souheil El-Chemaly.;Angelo Taveira-Dasilva.;Hilary J Goldberg.;Shefali Bagwe.;Ivan O Rosas.;Joel Moss.;Carmen Priolo.;Elizabeth P Henske.
来源: Chest. 2019年156卷6期1137-1148页
Lymphangioleiomyomatosis (LAM), a destructive lung disease that affects primarily women, is caused by loss-of-function mutations in TSC1 or TSC2, leading to hyperactivation of mechanistic/mammalian target of rapamycin complex 1 (mTORC1). Rapamycin (sirolimus) treatment suppresses mTORC1 but also induces autophagy, which promotes the survival of TSC2-deficient cells. Based on the hypothesis that simultaneous inhibition of mTORC1 and autophagy would limit the availability of critical nutrients and inhibit LAM cells, we conducted a phase 1 clinical trial of sirolimus and hydroxychloroquine for LAM. Here, we report the analyses of plasma metabolomic profiles from the clinical trial.
179. Patient-Level Trajectories and Outcomes After Low-Dose CT Screening in the National Lung Screening Trial.
Shared decision-making is an essential element of low-dose CT (LDCT) screening for lung cancer. Understanding patient-level outcomes from the National Lung Screening Trial (NLST) is critical to effectively communicate risks and benefits of screening to patients.
180. Proteomic Profiling to Identify Blood Biomarkers Predictive of Response to Azithromycin in Children and Adolescents With Cystic Fibrosis.
作者: Kang Dong.;Amrit Singh.;Raymond T Ng.;Don D Sin.;Scott J Tebbutt.;Felix Ratjen.;Bradley S Quon.
来源: Chest. 2019年156卷4期667-673页
Azithromycin reduces pulmonary exacerbation (PEx) risk in cystic fibrosis (CF), but not all individuals benefit. The goal of this study was to discover blood protein biomarkers predictive of clinical response to azithromycin treatment in children and adolescents with CF.
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