Chest
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Single lung transplantation (SLT) is associated with worse long-term outcomes than bilateral lung transplantation (BLT), but often is performed in older adults at risk of not tolerating BLT. ⋯ In older adults, SLT is associated with less morbidity and comparable early survival relative to BLT, but lower 5-year survival. SLT is reasonable to perform in older adults at high risk of not tolerating BLT.
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We investigated dyspnea; its associated risk factors; and its impact on health care utilization, quality of life, and work productivity in adults with undiagnosed respiratory symptoms. ⋯ Our findings showed that in community-based adults with undiagnosed respiratory symptoms, those identified with PRISm experienced the greatest impact of dyspnea. Dyspnea imposes burdens on the health care system and is associated with impaired quality of life and work productivity.
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Post-pulmonary embolism (PE) dyspnea is common. Existing noninvasive studies have demonstrated that post-PE dyspnea is associated with elevations in right ventricular (RV) afterload, dead space ventilation, and deconditioning. We aimed to use invasive cardiopulmonary exercise testing (iCPET) parameters in patients with post-PE dyspnea to identify unique physiologic phenotypes. ⋯ iCPET revealed significant heterogeneity in post-PE dyspnea. Three phenotypes are characterized by differences in RV afterload: ventilatory efficiency, respiratory mechanics, and peripheral oxygen use.
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The diagnostic performance of the available risk assessment models for VTE in patients who are critically ill receiving pharmacologic thromboprophylaxis is unclear. ⋯ gov. ISRCTN44653506.