Chest
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Recent policy initiatives aim to improve the value of care for patients hospitalized with pneumonia. It is unclear whether higher 30-day episode spending at the hospital level is associated with any difference in patient mortality among fee-for-service Medicare beneficiaries. ⋯ Higher hospital-level spending for a 30-day episode of care for pneumonia was not associated with any difference in patient mortality.
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A 75-year-old man was referred to our institution for worsening dyspnea, decreased activity tolerance, myalgias, and an increase in oxygen requirement. Nine months before the initial referral, the patient presented to an outside hospital for acute hypoxemic respiratory failure requiring a right-sided video-assisted thoracoscopic surgery (VATS) lung biopsy that disclosed organizing pneumonia (OP). ⋯ Prior attempts to further reduce prednisone resulted in worsening dyspnea, fevers, and myalgias. Despite optimal medical treatment for 3 months, he presented to our institution with progressive dyspnea, an increased oxygen requirement to 6 L/min, fatigue, and muscle weakness.
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A 54-year-old woman was admitted to the general medical floor after undergoing percutaneous nephrolithotomy via the supracostal approach. On postprocedure day 1, she developed low-grade fever, dry cough, shortness of breath, and palpitations.
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Editorial Comment
COUNTERPOINT: Are Eosinophils Useful for the Management of COPD? No.