Chest
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Randomized Controlled Trial
Solriamfetol for the treatment of excessive sleepiness in obstructive sleep apnea: A placebo-controlled randomized-withdrawal study.
Excessive sleepiness (ES) is a common symptom of OSA, which often persists despite primary OSA therapy. This phase III randomized withdrawal trial evaluated solriamfetol (JZP-110) for the treatment of ES in adults with OSA. ⋯ This study demonstrated maintenance of solriamfetol efficacy and safety over 6 weeks.
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Septic cardiomyopathy is a key feature of sepsis-associated cardiovascular failure. Despite the lack of consistent diagnostic criteria, patients typically exhibit ventricular dilatation, reduced ventricular contractility, and/or both right and left ventricular dysfunction with a reduced response to volume infusion. ⋯ Because there are no specific/causal therapeutics for the treatment of septic cardiomyopathy, the current guidelines for the treatment of septic shock represent the cornerstone of septic cardiomyopathy therapy. This review provides an up-to-date overview of the current understanding of the pathophysiology, summarizes the evidence of currently available diagnostic tools and treatment options, and highlights the importance of further urgently needed studies aimed at improving diagnosis and investigating novel therapeutic targets for septic cardiomyopathy.
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The prevalence of lung conditions, such as COPD and pulmonary fibrosis, and lung infections, such as pneumonia, increases sharply with age. The physiologic, cellular, and immunologic changes that occur during aging contribute to the development of lung disease. ⋯ Individuals with good lung function live longer, healthier lives, although the mechanisms by which this scenario occurs are not understood. The present article reviews changes in the aging lung that facilitate development of disease and the evidence supporting the idea that robust lung function reduces the risk of developing chronic inflammatory conditions that occur with age.
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The most important determinant of long-term survival in patients with idiopathic pulmonary fibrosis is the right ventricular (RV) adaptation to the increased pulmonary vascular resistance. Our aim was to explore RV contractile reserve during stress echocardiography in early-stage IPF. ⋯ RV myocardial dysfunction is already present at rest in early-stage IPF and worsens during exertion as detected by two-dimensional speckle-tracking echocardiography. The RV altered contractile reserve appears to be related to reduced exercise tolerability and impaired pulmonary hemodynamic.
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A 27-year-old Lebanese man was admitted to our department for multiple pulmonary lesions. The patient had reported persistent fever, cough, shortness of breath, and weight loss since his return from Lebanon 6 weeks earlier. He had been diagnosed with a severe form of Behçet disease 4 years ago, for which the ongoing treatment was a corticosteroid therapy associated with methotrexate and infliximab.