Chest
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Multicenter Study
Changes in self-rated health after sepsis in older adults: A retrospective cohort study.
As more individuals survive sepsis, there is an urgent need to understand its effects on patient-reported outcomes. ⋯ Self-rated health worsened initially after sepsis but returned to the level of that of nonhospitalized control subjects by year 6. Mitigating sepsis-related functional disability may play a key role in improving self-rated health after sepsis.
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Thoracic transplantation is considered for patients with Eisenmenger syndrome (ES) who have refractory right ventricular failure despite optimal therapy for pulmonary arterial hypertension. This study compared the outcomes of bilateral lung transplantation (BLT) with cardiac defect repair vs combined heart-lung transplantation (HLT). ⋯ This study suggests that the best transplant option for patients with VSD remains HLT, which prevents subsequent development of ventricular failure. BLT with cardiac defect repair should be considered as the first-line treatment option in patients with ES due to an uncorrected atrial septal defect. These patients can be considered to have isolated and reversible right ventricular failure akin to patients with advanced pulmonary arterial hypertension.
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Observational Study
Risk factors for dysphagia in ICU patients following invasive mechanical ventilation.
Dysphagia is common and independently predicts death in ICU patients. Risk factors for dysphagia are largely unknown, with sparse data available from mostly small cohorts without systematic dysphagia screening. ⋯ In ICU patients, baseline neurologic disease, emergency admission, and duration of invasive mechanical ventilation appeared as prominent independent risk factors for dysphagia. Because all ICU patients after mechanical ventilation should be considered at risk for dysphagia, systematic screening for dysphagia is recommended in respective critically ill patients.
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Herpes simplex virus type 1 (HSV-1) is frequently detected in the BAL fluid of patients on mechanical ventilation. ⋯ These data suggest that detection of HSV-1 in the BAL of patients on mechanical ventilation may be of clinical significance and that specific antiviral treatment may improve clinical outcomes. However, this needs to be proven in multicenter randomized controlled trials before implementation into the clinical routine.
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Nasal (airway) epithelial methylation profiles have been associated with asthma, but the effects of such profiles on expression of distant cis-genes are largely unknown. ⋯ Previous epigenome-wide association studies of asthma have estimated the effects of DNA methylation markers on expression of nearby genes in airway epithelium. Our findings suggest that distant epigenetic regulation of gene expression in airway epithelium plays a role in atopic asthma.