Chest
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Guidelines advise minimizing asthma exacerbation risk, which is achieved partially through good clinical practice activities, including scheduled asthma reviews, inhaler technique checks, and asthma management plans. We assessed how frequently these activities are provided and how effective they are in clinical practice. ⋯ Most children in the United Kingdom do not receive the guideline-recommended activities to monitor their asthma. This study suggests that these activities, if implemented, are effective in clinical practice and maximally effective when combined in the same visit.
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Hypnotics and Mortality in Idiopathic Pulmonary Fibrosis: Hospital and National Data-Based Analysis.
Patients with idiopathic pulmonary fibrosis (IPF) may experience insomnia and use hypnotics. However, the effect of the use of hypnotics on their clinical course remains unclear. ⋯ This study found that continuous use of hypnotics was associated with an increased risk of mortality in patients with IPF. Given the relatively high cumulative incidence of hypnotics use in this population, there is an urgent need to reassess the appropriate use of hypnotics for patients with IPF.
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Refractory or unexplained chronic cough disrupts quality of life and burdens health care systems around the world. The P2X3 receptor antagonist gefapixant is approved in many countries for its antitussive effects, but taste disturbances are a common adverse effect. Four newer, more selective P2X3 receptor antagonists have been developed to address this problem. ⋯ University Hospital Medical Information Network Center (UMIN-CTR); No. UMIN000050622; URL: https://center6.umin.ac.jp.
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Sarcoidosis staging primarily has relied on the Scadding chest radiographic system, although chest CT imaging is finding increased clinical use. ⋯ In this study, CT scan features explained additional variability in lung function beyond Scadding stage, with some CT scan features obviating the associations between lung function and Scadding stage. Whether CT scan features, phenotypes, or endotypes could be useful for treating patients with sarcoidosis needs more study.
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Reintubation is associated with higher risk of mortality. There is no clear evidence on the best spontaneous breathing trial (SBT) method to reduce the risk of reintubation. ⋯ In this study, HFO SBT was associated with a lower risk of reintubation compared with other SBT methods. The results of our analysis should be considered with caution due to the low number of studies that investigated HFO SBTs and potential clinical heterogeneity related to cointerventions. Further trials should be performed to confirm the results on larger cohorts of patients and to assess specific subgroups.