PubMed Journal Database | Chest 
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Showing PubMed Articles 1–25 of 103 from Chest
Accurate Measurement of Small Airways on Low Dose Thoracic CT Scans in Smokers.
ABSTRACT BACKGROUND: Partial volume averaging and tilt relative to the scan plane on transverse images limit the accuracy of CT airway wall thickness measurements, confounding assessment of the relationship between airway remodeling and clinical status in COPD. The purpose was to assess the effect of partial volume averaging and tilt corrections on airway wall thickness measurement accuracy and on relationships between airway wall thickening and clinical status in COPD. METHODS: Airway wall thickness measur...
The CF-ABLE Score: A Novel Clinical Prediction Rule for Prognosis in Cystic Fibrosis.
ABSTRACT BACKGROUND: Determining prognosis and predicting outcomes in cystic fibrosis (CF) is a complex issue and there have been very few clinically applicable models for this. Our aim was to create a simple practical outcome prediction tool for CF. METHODS: Forty-nine consecutive CF patients from a single centre were studied over an 84-month period (2004-2010). All baseline clinical parameters were gathered and Forced Expiratory Volume in 1 second (FEV1) measurements were analysed over the period. Using p...
ABSTRACT BACKGROUND Chronic obstructive pulmonary disease (COPD) is a devastating disease affecting millions worldwide. As disease pathogenesis includes both chronic pulmonary and systemic inflammation, anti-inflammatory effects of systemically administered mesenchymal stem cells (MSCs) may decrease inflammation resulting in improved lung function and quality of life. The goal of this study was to assess safety and to perform initial evaluation of potential efficacy of systemic MSC administration to patient...
ABSTRACT BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is often associated with elevation in pulmonary artery pressures. Although primary pulmonary arterial hypertension (PAH) has been associated with primary graft dysfunction (PGD), the role of secondary PAH in mediating PGD risk among IPF patients is incompletely understood. The purpose of this study was to evaluate the relationship between mean pulmonary artery pressure (mPAP) and PGD among patients with IPF. METHODS: We performed a multi-center prospe...
Abstract BACKGROUND: The radiological definition of airway dilatation and bronchiectasis in children has substantial limitations. Bronchoarterial ratio is a commonly used criterion to define airway dilatation despite the lack of normative pediatric data. The objective of our study was to determine the range of normal bronchial to accompanying arterial diameter ratio on high resolution CT scan of the chest in children and compare it with the available adult data. METHODS: Children undergoing Multi Detector C...
Abstract BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of nosocomial pneumonia. Societal guidelines suggest linezolid may be the preferred treatment of MRSA nosocomial pneumonia. We investigated the efficacy of linezolid compared with glycopeptide antibiotics (vancomycin or teicoplanin) for nosocomial pneumonia. METHODS: Systematic review and meta-analysis of English language randomized controlled trials comparing linezolid to glycopeptide antibiotics for suspected MRS...
ABSTRACT BACKGROUND: Although the physiologic range of pulmonary artery systolic pressure (PASP) has been reported, data on athletes are limited. Aim of the present study was to explore the full spectrum of PASP and the long term training impact in a large population of highly-trained athletes. METHODS: 615 consecutive athletes [370 endurance- (ATE) vs 245 strength-trained athletes (ATS); 28.4±10.1 years] and 230 healthy controls (27.5±11.3 years) underwent a transthoracic echocardiography. PASP was estim...
ABSTRACT BACKGROUND: Secondhand tobacco smoke exposure impedes control of pediatric asthma. Evidence of the efficacy of interventions to reduce children's exposure and improve disease outcomes has been inconclusive. METHODS: Caregivers of 519 children aged 3-12 years with asthma and reported smoke exposure attended two baseline assessment visits, which involved a parent interview, children's urine sample (for cotinine assay), and spirometry (children ≥5 years). Those (n=352) with significant documented ex...
Identification of Cells Expressing Interleukin-17A and F in the Lungs of COPD Patients.
Abstract BACKGROUND: Lymphocytes secrete IL-17A and IL-17F which enhance innate immune responses. IL-17 expression has not been studied in COPD small airways. The aim was to quantify IL-17A and IL-17F expression in the peripheral lung tissue of COPD patients compared to controls and to identify inflammatory cells that express IL-17. METHODS: IL-17 expression was assessed using immunohistochemistry in peripheral lung tissue (18 COPD patients, 10 smokers and 10 non-smokers with normal lung function) and induc...
Effects of Varenicline on Smoking Cessation in Mild-to-Moderate COPD: A Randomized Controlled Trial.
ABSTRACT BACKGROUND: Smoking is the most important risk factor for COPD and accelerates its progression. Despite the health implications, a large proportion of patients with COPD continue to smoke, so finding effective smoking cessation interventions for this population is paramount. This is the first randomized clinical trial to compare the efficacy and safety of varenicline versus placebo in smokers with mild-to-moderate COPD. METHODS: In a 27 center, double-blind, multinational study, 504 patients with m...
Clinical significant change of stroke volume in pulmonary hypertension.
Abstract BACKGROUND: Stroke volume is probably the best hemodynamic parameter, which reflects therapeutic changes and contains prognostic information in pulmonary hypertension (PH). Stroke volume directly reflects right ventricular (RV) function in response to its load, without the correction of compensatory increased heart rate as is the case for cardiac output. For this reason, stroke volume is an important hemodynamic parameter to monitor during treatment, which can be measured noninvasively. However, th...
Clinical Features of Pneumonia Caused by Influenza A (H1N1) Virus in Beijing, China.
Abstract BACKGROUND: Data on symptoms and radiographic changes in patients with 2009 pandemic influenza A (H1N1) pneumonia during convalescence have not been reported. METHODS: During October 26, 2009 and January 23, 2010, adult pneumonia patients with laboratory-confirmed or clinically suspected 2009 pandemic influenza A (H1N1) infections were observed for clinical characteristics, high-resolution chest CT and lung function tests changes during acute and 3-month convalescent phases. RESULTS: Of the 65 case...
Abstract BACKGROUND: There are various schemas designed to stratify risk of thromboembolism (TE) in patients with atrial fibrillation (AF) of which the CHADS(2) (Cardiac Failure, Congestive heart failure, Hypertension, Age, Diabetes, Stroke [Doubled]) score is the most widely studied. We evaluated whether the CHADS(2) score was adequate for TE risk stratification whilst assessing cardiac risk in patients with AF revascularized with coronary artery stents. METHODS: We reviewed 604 consecutive patients with A...
BACKGROUND: Recent studies suggest that Doppler echocardiographic (DE) estimates of pulmonary artery systolic pressure (PASP) may not be as accurate as previously believed. We sought to determine the accuracy of PASP measurements using DE compared to right heart catheterization (RHC) in patients with pulmonary hypertension (PH). METHODS: We compared DE estimates of PASP to invasively measured PASP during RHC in 160 consecutive patients with PH (Part 1). To account for possible changes in hemodynamics betwee...
Rapid Response Team in an Academic Institution -- Does it Make a Difference?
Abstract BACKGROUND: Although data remains contradictory, rapid response systems are implemented across US hospitals. We aimed to determine whether implementation of a rapid response team (RRT) in a tertiary academic hospital improved outcomes. METHODS: Our hospital is a tertiary academic medical center with 24-hour in-house resident coverage. We conducted a retrospective cohort study comparing twenty-seven months after implementation of the rapid response team (April 1, 2006 to June 31, 2008) and nine mont...
A NOVEL APPROACH TO STUDYING THE RELATIONSHIP BETWEEN SUBJECTIVE AND OBJECTIVE MEASURES OF COUGH.
ABSTRACT BACKGROUND: Currently no data is available on the relationship between changes in objective and subjective measures of cough, the magnitude of change in cough frequency perceived by patients as clinically meaningful, or sample sizes required to show significant changes in cough therapeutic trials. As patients anecdotally report reductions in cough severity whilst undergoing oesophageal testing, we aimed to address these issues by assessing objective and subjective measures of cough with and without...
Abstract BACKGROUND: The mechanism of the gender difference in cough reflex threshold has not been clearly elucidated. In the present study, we evaluated gender differences of cough reflex threshold along with the perceptions of respiratory sensations, urge-to-cough and dyspnea. METHODS: Nineteen male and 20 female healthy never-smokers were recruited via public postings. The cough reflex threshold and the urge-to-cough were evaluated by inhalation of citric acid. The perception of dyspnea was evaluated by...
Carbocisteine protects against emphysema induced by cigarette smoke extract in rats.
Abstract BACKGROUND: Chronic inflammation, imbalance of proteolytic and anti-proteolytic activities, oxidative stress and apoptosis of lung structural cells contribute to the pathogenesis of chronic obstructive pulmonary disease (COPD). There is increasing evidence that carboxymethylcysteine (carbocisteine or CMC) commonly used for its mucoactive property has diverse pharmacological actions including significant antioxidant activity. We hypothesize that carbocisteine protects against cigarette smoke extract...
BACKGROUND: Training on a cardiopulmonary simulator improves subsequent diagnostic performance on the same simulator. But data are lacking on transfer of learning. Here our objective was to determine if training on a cardiorespiratory simulator improves diagnostic performance on a real patient. METHODS: We randomly allocated first year medical students at the University of Calgary to simulator training in one of three clinical scenarios of acute-onset chest pain: pulmonary embolism with right ventricular st...
Abstract BACKGROUND: Growth differentiation factor (GDF)-15 is a secreted member of the transforming growth factor-β (TGFβ) cytokine superfamily. GDF-15 levels are elevated in the serum of patients with cardiovascular diseases. We hypothesized that GDF-15 levels would also be increased in the plasma and lung tissue of patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). METHODS: GDF-15 levels were measured in plasma in subjects with SSc-PAH (n=30) compared with SSc subjec...
Prognostic Significance of Nestin Expression in Resected Non-Small Cell Lung Cancer.
Abstract BACKGROUND: Nestin is a class VI intermediate filament protein expressed in stem/progenitor cells during central nervous system development. Nestin expression has been detected in many kinds of tumors and reported in a recent small-scale study in non-small cell lung cancer (NSCLC). We investigated the relationships between nestin expression and clinicopathological parameters and determined its prognostic significance concerning survival in patients with resected NSCLCs. METHODS: Nestin expression i...
ABSTRACT INTRODUCTION: Psychological symptoms of post-traumatic stress disorder (PTSD) and depression are relatively common among family members of patients dying in the ICU. The patient-level risk factors for these family symptoms are not well understood, but may help target future interventions. METHODS: We performed a cohort study of family members of patients who died in the ICU or within 30 hours of ICU transfer. Outcomes included self-reported symptoms of PTSD and depression. Predictors included patie...
Abstract BACKGROUND: Infection in humans has been linked with altered cytokine gene transcription. It is unclear whether this phenomenon is a consequence of an established disease process or precedes the infective process. The primary endpoint of this study was to determine whether hospital acquired pneumonia was associated with differential gene expression of IFN-γ, TNF α and IL-23-p-19. The secondary endpoint was to identify whether alteration in gene expression preceded the clinical onset of infection....
Abstract BACKGROUND: Patients with severe Chronic Obstructive Pulmonary Disease (COPD) or Chronic Heart Failure (CHF) are often confronted with decisions concerning life-sustaining treatments. Aim of this prospective observational study was to assess life-sustaining treatment preferences, advance care planning and quality of end-of-life care communication in Dutch outpatients with clinically stable, but severe COPD or CHF. METHODS: The following outcomes were assessed in outpatients with severe COPD (n=105)...
Abstract BACKGROUND: Symptomatic disease due to nontuberculous mycobacteria (NTM) is known to occur commonly in the presence of structural lung disease, but is not described in association with asthma. METHODS: Case-control nested in a cohort. We identified 22 patients with difficult asthma referred to a tertiary academic referral centre and subsequently found to have infection with NTM. We matched each case with 2 controls (next 2 consecutive patients referred for asthma management). RESULTS: It took on av...
