Chest
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Asthma exacerbations result in significant health and economic burden, but are difficult to predict. ⋯ Models built with an ML algorithm from real-world outpatient EHR data accurately predicted asthma exacerbation and can be incorporated into clinical decision tools to enhance outpatient care and to prevent adverse outcomes.
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Niemann-Pick Disease type B (NPDB) is a rare autosomal recessive disease belonging to the family of lysosomal storage disorders. NPDB is caused by mutations of sphingomyelin phosphodiesterase 1 gene (SMPD1) and is characterized by hepatosplenomegaly, interstitial lung disease, recurrent pulmonary infections, and neurologic disorders. Bronchiectasis are atypical. ⋯ The singularity of this case lies in the presence of bronchiectasis, which is an unprecedently described phenotype of NPDB. This finding was accompanied by the detection of a novel SMPD1 mutation (p. Ala46=) of uncertain meaning.
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Respiratory complications such as swimming-induced pulmonary edema (SIPE) are a common feature of United States Navy Special Warfare (NSW) training. ⋯ The burden of SIPE in NSW training was greater than anticipated. Clinical symptoms and physical examination assisted by imaging were able to differentiate SIPE from pneumonia. ECG was not a useful diagnostic or screening tool, and height and weight did not affect risk of SIPE.
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American Thoracic Society/Infectious Diseases Society of America guidelines recommend against routine Legionella pneumophila testing, but recommend that hospitalized patients with community-acquired pneumonia receive empiric treatment covering Legionella. Testing, empiric treatment, and outcomes for patients with Legionella have not been well described. ⋯ Legionella is an uncommon cause of community-acquired pneumonia, occurring primarily from late spring through early autumn. Testing is uncommon, even among patients with risk factors, and many patients with positive test results failed to receive empiric coverage for LP.
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The primary curative treatment for thymic malignancies is surgery. For lung and esophageal cancer, substantive disparities in outcomes by race exist. Many of these disparities are attributed to the decreased use of surgery in non-White patients. Although thymic malignancies are treated by the same specialists as lung and esophageal cancer, it is unknown if there are racial disparities in the treatment of thymic malignancies. ⋯ A racial disparity exists in surgical therapy for thymic malignancies.