Chest
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Comorbid ischemic heart disease (IHD) is a common and important cause of morbidity and mortality in patients with COPD. The impact of IHD on COPD in terms of a patient's health status, exercise capacity, and symptoms is not well understood. ⋯ Comorbid IHD is associated with worse health status, lower exercise capacity, and more dyspnea in stable patients with COPD as well as with longer exacerbations but not with an increased exacerbation frequency.
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Comparative Study
Direct comparison of three natriuretic peptides for prediction of short- and long-term mortality in patients with community-acquired pneumonia.
Early and accurate risk stratification for patients with community-acquired pneumonia (CAP) is an unmet clinical need. ⋯ Natriuretic peptides are simple and powerful predictors of short- and long-term mortality for patients with CAP. Their prognostic accuracy is comparable to PSI.
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Myeloid-derived suppressor cells (MDSCs) are increased in inflammatory and autoimmune disorders and orchestrate immune cell responses therein. Pulmonary hypertension (PH) is associated with inflammation, autoimmunity, and lung vascular remodeling. Immature myeloid cells are found in the lungs of humans and animals with PH, and we hypothesized that they would be increased in the blood of patients with PH compared with control subjects. ⋯ Circulating activated MDSCs are significantly increased in children with PH compared with control subjects. Further investigation of these cells is warranted, and we speculate that they might play significant immunomodulatory roles in the disease pathogenesis of PH.
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Interferon-γ release assays (IGRAs) have been incorporated into several national guidelines for latent TB infection (LTBI) diagnosis. However, their optimal application is still controversial and evolving. The aim of this study is to evaluate the performance of confirmatory IGRAs in addition to tuberculin skin tests (TSTs) in high school students with TST-positive (TST+) results who have had contact with another student who had TB (referred to in this article as "contacts") in TB outbreaks in a high BCG-vaccinated population. ⋯ The addition of a confirmatory IGRA for TST+ contacts could effectively focus the targeting of LTBI treatment to fewer contacts in an intermediate-incidence setting in a high BCG-vaccinated population.
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Small vessel disease is a major determinant of poor outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension (CTEPH). Out-of-proportion pulmonary vascular resistance (PVR) may indicate the presence of small vessel disease, but it is a very subjective evaluation. We investigated poor subpleural perfusion as a marker for small vessel disease and assessed its association with disease severity and surgical outcome of CTEPH. ⋯ Poor subpleural perfusion in the capillary phase of pulmonary angiography might be related to small vessel disease and a poor surgical outcome of CTEPH.