Chest
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No previous study has evaluated the association between admission to ICUs during round time and patient outcome. The objective of this study was to determine the association between round-time ICU admission and patient outcome. ⋯ Patients admitted to the ICU during morning rounds have higher severity of illness and mortality rates.
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Cystic fibrosis (CF) lung disease is characterized by structural changes in the airways and parenchyma. No sputum biomarker exists to measure the degree of active structural destruction during pulmonary exacerbation in patients with CF. The noninvasive measurement of desmosine, a breakdown product of elastin, may reflect ongoing lung injury and serve as a biomarker of short-term damage. Our objectives were to measure desmosine in the sputum of patients with CF hospitalized for treatment of a pulmonary exacerbation and to explore the correlation between desmosine levels and other markers of clinical improvement, including lung function and inflammatory mediators, following hospitalization. ⋯ Sputum desmosine, a novel measure of acute structural lung injury, may serve as a marker of structural lung damage occurring during exacerbations of lung disease in CF.
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The authors of previous reports have suggested that women are more susceptible to cigarette smoke and to an airway-predominant COPD phenotype rather than an emphysema-predominant COPD phenotype. The purpose of this study was to test for sex differences in COPD phenotypes by using high-resolution CT (HRCT) scanning in male and female smokers with and without COPD. ⋯ Male smokers have more emphysema than female smokers, but female smokers do not show increased wall thickness compared with men.
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Pleural effusion is a common complication of cardiac surgery, but its characteristics and predisposing factors should be documented further. Our objective was to determine the prevalence, characteristics, and determinants of clinically significant pleural effusions, defined as those requiring therapeutic pleural drainage according to clinical assessment. ⋯ Pleural effusion is a common complication of heart surgery, is associated with other postoperative complications, and is more frequent in women and in patients with associated cardiac or vascular comorbidities and medications used to treat those conditions.
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We previously reported that approximately one-fourth of patients with lymphangioleiomyomatosis (LAM) may respond to therapy with bronchodilators. However, the validity of those observations has been questioned. The aims of the present study were to determine the prevalence of reversible airflow obstruction in patients with LAM and to identify associated clinical and physiologic parameters. ⋯ Patients with LAM may have partially reversible airflow obstruction. A positive response to bronchodilators is associated with an accelerated rate of decline in pulmonary function.