Chest
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Changes in body composition, including loss of muscle mass and obesity, adversely affect lung function. ⋯ Lung function was associated significantly with visceral adiposity and skeletal muscle quality, which differed according to sex and BMI. Improving lung function may require tailored management, including reducing visceral fat, enhancing skeletal muscle quality based on CT scan-body composition analysis, or both.
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Patients with pulmonary subsolid nodules (SSNs) ≤ 2 cm in diameter and a consolidation-to-tumor ratio (CTR) ≤ 0.25 have good postoperative prognoses, but their management remains controversial. ⋯ Patients with SSNs ≤ 2 cm in diameter and CTR ≤ 0.25, watchful waiting could be more appropriate than upfront surgical intervention.
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Adaptation of the right ventricle is a key determinant of outcomes in pulmonary arterial hypertension (PAH). Despite a compelling rationale to develop targeted therapies for the right ventricle in PAH, no such treatments exist. H2-receptor antagonism is a potential myocardial-focused paradigm in heart failure. ⋯ The trial was registered at clinicaltrials.gov (NCT03554291).
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There are physician shortages in the United States including in the cardiopulmonary specialty. Nonphysician advanced practice providers, including nurse practitioners or physician assistants, have been proposed to meet some more routine patient care needs. A supplementary provider called an advanced practice respiratory therapist (APRT) has been proposed. ⋯ The study exposed a set of survey-derived metrics about potential content signaling whether there was endorsement among physicians, nonphysician advanced practice providers, and APRT graduates. Metrics are described from these and other subgroups plus the committee's decisions are explained about what content to assess and how. Most of the surveyed content was endorsed for being part of the APRT role; therefore, the committee proceeded to make design decisions about the outcome assessment.
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The latest meta-analysis indicated potential survival benefits from ultra-short-acting β-blockers in patients with sepsis with persistent tachycardia. However, subsequent multicenter randomized controlled trials (RCTs) have reported conflicting findings, prompting the need for an updated meta-analysis to incorporate these newly published RCTs. ⋯ In this updated meta-analysis, the use of esmolol or landiolol did not reduce mortality in patients with sepsis with persistent tachycardia. However, results were not robust and outcomes differed between single-center and multicenter RCTs. Moreover, sensitivity analyses showed the fragility of the primary outcome. Further studies regarding ultra-short-acting β-blockers with advanced cardiac monitoring or serial echocardiography are warranted.