Chest
-
Black patients with lung cancer diagnosed at early stages-for which surgical resection offers a potential cure-experience worse overall survival than do their white counterparts. We undertook a population-based study to estimate the racial and ethnic disparity in death from competing causes and assessed its contribution to the gap in overall survival among patients with early-stage lung cancer. ⋯ Narrowing racial and ethnic disparities in survival among patients with early-stage lung cancer will rely on more than just equalizing access to surgical resection and will need to include better management and treatment of smoking-related comorbidities and diseases.
-
Endoscopic lung volume reduction has emerged over the past several years as a promising technique to improve the respiratory functional status of patients with advanced emphysema. Nevertheless, the procedure may be associated with various complications; among them, the development of bronchiectasis related to the coils has not yet been described. We report the case of a patient with emphysema who developed localized bronchiectasis at the site of coil insertion several months after lung volume reduction coil treatment.
-
The ability of specific histopathologic features to predict mortality or lung transplantation in patients with chronic hypersensitivity pneumonitis (HP) is unknown. ⋯ Histopathologic patterns of c-NSIP and PI-PFG had a better transplant-free survival than did patterns of UIP, f-NSIP, and BF. The presence of fibroblast foci or dense collagen fibrosis correlated with progression to death or lung transplantation. Identification of fibroblast foci on biopsy samples, regardless of the underlying histopathologic pattern, may be a clinically useful predictor of survival in patients with HP.
-
OSA results from the collapse of different pharyngeal structures (soft palate, tongue, lateral walls, and epiglottis). The structure involved in collapse has been shown to impact non-CPAP OSA treatment. Different inspiratory airflow shapes are also observed among patients with OSA. We hypothesized that inspiratory flow shape reflects the underlying pharyngeal structure involved in airway collapse. ⋯ Inspiratory flow shape is influenced by the pharyngeal structure causing collapse. Flow shape analysis may be used as a noninvasive tool to help determine the pharyngeal structure causing collapse.
-
Observational Study
Change in Psychologic, Physiologic, and Situational Factors in Adults After Treatment of Chronic Cough.
We hypothesized that addressing anxiety and depressive mood disorders will improve chronic cough severity and cough quality of life (CQOL). ⋯ Using the theory of unpleasant symptoms, we have come to appreciate that managing psychological, physiological, and situational factors in addition to focusing on identifying the cause of cough is important to maximize improvement in CQOL.