Chest
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Multicenter Study
Identification of distinct clinical subphenotypes in critically ill patients with COVID-19.
Subphenotypes have been identified in patients with sepsis and ARDS and are associated with different outcomes and responses to therapies. ⋯ We identified four subphenotypes of COVID-19 critical illness with distinct patterns of clinical and laboratory characteristics, comorbidity burden, and mortality.
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Multicenter Study Observational Study
Predicting Lymph Node Metastasis in Non-Small Cell Lung Cancer: Prospective External and Temporal Validation of the HAL and HOMER Models.
Two models, the Help with the Assessment of Adenopathy in Lung cancer (HAL) and Help with Oncologic Mediastinal Evaluation for Radiation (HOMER), were recently developed to estimate the probability of nodal disease in patients with non-small cell lung cancer (NSCLC) as determined by endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA). The objective of this study was to prospectively externally validate both models at multiple centers. ⋯ HAL and HOMER demonstrated good discrimination and calibration in multiple centers. Although calibration error was present, the magnitude of the error is small, such that the models are informative.
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Randomized Controlled Trial
A Mobile Health Intervention to Increase Physical Activity in Pulmonary Arterial Hypertension.
Supervised exercise training improves outcomes in patients with pulmonary arterial hypertension (PAH). The effect of an unsupervised activity intervention has not been tested. ⋯ ClinicalTrials.gov; No. NCT03069716; URL: www.clinicaltrials.gov.
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Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease of unknown origin. A limited number of small studies show an effect of tobacco smoking on risk of IPF, but second-hand smoking has not been examined. ⋯ Active and maternal tobacco smoking have an independent detrimental effect on risk of IPF and work synergistically. Also, intensity of smoking presents a dose-response association with IPF, strengthening the hypothesis for a potentially causal association.
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Smokers manifest varied phenotypes of pulmonary impairment. ⋯ Lung hyperinflation is associated strongly with clinical and subclinical CAD in smokers, including those with airflow obstruction. After lung hyperinflation was accounted for, FEV1 and emphysema no longer were associated with CAD. Subsequent studies should consider measuring lung hyperinflation and examining its mechanistic role in CAD in current and former smokers.