Chest
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In healthy individuals, billions of cells die by apoptosis each day. Clearance of these apoptotic cells, termed "efferocytosis," must be efficient to prevent secondary necrosis and the release of proinflammatory cell contents that disrupt tissue homeostasis and potentially foster autoimmunity. During inflammation, most apoptotic cells are cleared by macrophages; the efferocytic process actively induces a macrophage phenotype that favors tissue repair and suppression of inflammation. ⋯ This review of the English-language scientific literature (2006 to mid-2012) explains how such existing therapies as corticosteroids, statins, and macrolides may act in part by augmenting apoptotic cell clearance. However, efferocytosis can also impede host defenses against lung infection. Thus, determining whether novel therapies to augment efferocytosis should be developed and in whom they should be used lies at the heart of efforts to differentiate specific phenotypes within complex chronic lung diseases to provide appropriately personalized therapies.
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Patients with sleep disorders are most concerned with the impact of these diseases on their quality of life. Patient-reported outcome (PRO) measurement tools, which assess aspects of a patient's health status that come directly from the patient, are well suited to evaluate quality of life related to sleep disorders. ⋯ This article reviews various PRO measure tools used for sleep disorders in clinical and research settings. These instruments may play a role in screening, diagnosis, and monitoring of various sleep disorders.
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The past century witnessed a rapid development of respiratory medicine in China. The major burden of respiratory disease has shifted from infectious diseases to chronic noninfectious diseases. ⋯ Nevertheless, respiratory diseases remain a major public health problem, with new challenges such as air pollution and nosocomial infections. This review describes the history, accomplishments, new challenges, and opportunities in respiratory medicine in China.
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Review Case Reports
Evaluation and management of pill aspiration: case discussion and review of the literature.
Pill aspiration represents a unique type of foreign body aspiration requiring a distinct diagnostic and therapeutic approach. In many cases, the "foreign body" itself may no longer be present, whereas the airway manifestations may persist for months to years. ⋯ Endobronchial surveillance may be important to identify impending airway obstruction via secretions, edema, granulation tissue, or fibrotic stricture. In many cases, the airway sequelae of pill aspiration can be effectively managed with bronchoscopy.
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Randomized Controlled Trial
The Epworth Sleepiness Scale: conventional self vs physician administration.
The Epworth Sleepiness Scale (ESS) is a simple, self-administered questionnaire that provides a measurement of the subject's level of daytime sleepiness, and is widely used for patients with obstructive sleep apnea (OSA). Some works undermined its accuracy. The aim of this study was to compare self-administered ESS scores to physician-administered scores in a sample of patients with suspicion of OSA. ⋯ Our results lead us to consider the physician-administered ESS to be more accurate than the traditional ESS; thus, our suggestion is to validate this new method of administration.