Chest
-
The diagnostic workup of individuals suspected of having lung cancer can be complex and protracted because conventional symptoms of lung cancer have low specificity and sensitivity. ⋯ The DELFI score distinguishes individuals with lung cancer from those without cancer better than suspicious symptoms do. These results represent proof-of-concept support that fragmentation-based biomarker approaches may facilitate diagnostic resolution for patients with concerning symptoms of lung cancer.
-
Randomized Controlled Trial
Effects of Positive Airway Pressure Therapy on Glycemic Variability in Patients with Type 2 Diabetes and Obstructive Sleep Apnea: A Randomized Controlled Trial.
Glycemic variability is associated with increased risk for cardiovascular disease in patients with type 2 diabetes independent of glycosylated hemoglobin A1c (HbA1c) levels. Given the conflicting evidence on the effect of positive airway pressure (PAP) therapy for OSA on HbA1c, elucidating its effect on glycemic variability has value. ⋯ PAP therapy did not improve glycemic control or variability in patients with moderate-to-severe OSA and type 2 diabetes. Exploratory analyses suggested that PAP therapy may improve glucose variability in female participants. Post-dinner and bedtime glucose levels were higher in those who did not receive PAP therapy.
-
Open-Label Trial of Amikacin Liposome Inhalation Suspension in Mycobacterium abscessus Lung Disease.
Mycobacterium abscessus is the second most common nontuberculous mycobacterium respiratory pathogen and shows in vitro resistance to nearly all oral antimicrobials. M abscessus treatment success is low in the presence of macrolide resistance. ⋯ In a cohort of patients primarily with macrolide-resistant M abscessus, one-half of the patients using ALIS showed sputum culture conversion to negative findings. The emergence of mutational amikacin resistance was not uncommon and occurred with the use of clofazimine monotherapy.
-
Does obstructive sleep apnea increase risk for cancer? A large historical sleep clinic cohort study.
The relationship between OSA and cancer is unclear. ⋯ Nocturnal hypoxemia is independently associated with prevalent cancer. OSA severity is associated with incident cancer, although this association seems secondary to other risk factors for cancer development. OSA is not an independent risk factor for cancer incidence.
-
Introduction of novel therapies for cystic fibrosis (CF) raises the question of whether traditional treatments can be withdrawn. Nebulized hypertonic saline (HS) potentially could be discontinued in patients receiving dornase alfa (DA). ⋯ In the era before modulators, CFF508del showed no significant difference in lung function when nebulized HS was added to DA for 1 to 5 years.