Chest
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Multicenter Study
Characterizing functional lung heterogeneity in COPD using reference equations for CT scan-measured lobar volumes.
CT scanning is increasingly used to characterize COPD. Although it is possible to obtain CT scan-measured lung lobe volumes, normal ranges remain unknown. Using COPDGene data, we developed reference equations for lobar volumes at maximal inflation (total lung capacity [TLC]) and relaxed exhalation (approximating functional residual capacity [FRC]). ⋯ Reference equations for lobar volumes may be useful in assessing regional lung dysfunction and how it changes in response to pharmacologic therapies and surgical or endoscopic lung volume reduction.
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Multicenter Study
Flash mob research: a single-day, multicenter, resident-directed study of respiratory rate.
Vital signs are critical data in the care of hospitalized patients, but the accuracy with which respiratory rates are recorded in this population remains uncertain. We used a novel flash mob research approach to evaluate the accuracy of recorded respiratory rates in inpatients. ⋯ Among hospitalized patients across the United States, recorded respiratory rates are higher than directly observed measurements and are significantly more likely to be 18 or 20 breaths/min.
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Lung cancer remains the leading cause of death worldwide. Because many patients with non-small cell lung cancer are elderly and have multiple comorbid conditions, many with potentially curable disease are unfit to undergo definitive surgical resection. Stereotactic body radiation therapy (SBRT) is increasingly being used to treat patients with medically inoperable stage I non-small cell lung cancer. ⋯ Services currently billed during planning and treatment of SBRT are detailed. This article introduces to consulting specialists and subspecialists a new Current Procedural Terminology code that has been proposed to more accurately reflect work performed during SBRT by these consulting providers. This code is described, and its implications for patient care are discussed.
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Randomized Controlled Trial
The Epworth Sleepiness Scale: conventional self vs physician administration.
The Epworth Sleepiness Scale (ESS) is a simple, self-administered questionnaire that provides a measurement of the subject's level of daytime sleepiness, and is widely used for patients with obstructive sleep apnea (OSA). Some works undermined its accuracy. The aim of this study was to compare self-administered ESS scores to physician-administered scores in a sample of patients with suspicion of OSA. ⋯ Our results lead us to consider the physician-administered ESS to be more accurate than the traditional ESS; thus, our suggestion is to validate this new method of administration.
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Data from long-term follow-up studies of patients with well-characterized asthma are limited. We studied all-cause and cause-specific mortality and risk factors in a large cohort of adults with asthma. ⋯ This 25-year prospective study of a large cohort of adults with well-characterized asthma showed an excess mortality compared with matched control subjects, to a large extent explained by death from obstructive lung disease.