Chest
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Comparative Study Clinical Trial
Two-Year Follow-up in Patients Treated With Emphysematous Lung Sealant for Advanced Emphysema.
Endoscopic lung volume-reduction therapy for emphysema has been associated with therapeutic responses smaller in magnitude and less durable than surgical volume reduction (LVRS). Bronchoscopic emphysematous lung sealant (ELS) therapy has been shown to produce improvements in pulmonary function similar to surgery at 1 year. This case series summarizes safety and efficacy data of all patients from the initial ELS study out to 2 years. ⋯ An exponential model fit to FEV₁ data at 6, 12, 18, and 24 months predicted improvements from a baseline of > 5% out to 4.1 years, similar to what has been reported following surgery. This report confirms long-term safety and efficacy following ELS therapy in advanced emphysema. Studies in a larger cohort are needed to define the role of ELS therapy in the treatment algorithm of patients with this condition.
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Randomized Controlled Trial Comparative Study
Effects of Obstructive Sleep Apnea Treatment on Blood Pressure in Patients with Resistant Hypertension: A Randomized Trial.
OSA is extremely common among patients with resistant hypertension (HTN). However, the impact of the treatment of OSA with CPAP on BP in patients with resistant HTN is not well established. ⋯ The treatment of OSA with CPAP significantly reduces daytime BP in patients with resistant HTN. Therefore, our study reinforces the importance of recognizing and treating OSA in patients with resistant HTN.
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Comparative Study
LEFT VENTRICULAR EJECTION TIME IN ACUTE HEART FAILURE COMPLICATING PRE-CAPILLARY PULMONARY HYPERTENSION.
Novel noninvasive tools may improve the management of patients with pulmonary hypertension (PH) experiencing heart failure. Major right ventricle overload leads to decreased stroke volume, which shortens left ventricular ejection time (LVET). Our arterial tonometry study tested the hypothesis that LVET carries prognostic value in patients with precapillary PH with heart failure. ⋯ Shortened LVET at ICU admission was a prognostic factor in patients with precapillary PH with heart failure. Previously documented prognostic factors were also confirmed in this cohort.
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Comparative Study Clinical Trial
Objectively measured vs. self-reported compliance during oral appliance therapy for sleep-disordered breathing.
Assessment of the overall therapeutic effectiveness of oral appliance therapy can only be realized through objectively measured compliance. The aims of this study were to assess objectively measured compliance during oral appliance therapy at 1-year follow-up and to compare these data with self-reported use. ⋯ This study is the first to our knowledge to report the 1-year results of objectively measured compliance during oral appliance therapy. In addition, a high agreement between objective and subjective compliance data were reported, with a mean subjective overestimation of 30 min.
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Comparative Study
Correlation between Early Direct Communication of Positive CT Pulmonary Angiography Findings and Improved Clinical Outcomes.
Despite a general consensus that rapid communication of critical radiology findings from radiologists to referring physicians is imperative, a possible association with superior patient outcomes has not been confirmed. The objective of this study was to evaluate the correlation between early direct communication of CT image findings by radiologists to referring physicians and better clinical outcomes in patients with acute pulmonary embolism (PE). ⋯ Delay (> 1.5 h of CTPA acquisition) in direct communication of acute PE diagnosis from radiologists to referring physicians was significantly correlated with a higher risk of delayed treatment initiation and death within 30 days.