Chest
-
Randomized Controlled Trial Multicenter Study
Interobserver variability in grading transbronchial lung biopsy specimens after lung transplantation.
Acute rejection remains a major source of morbidity after lung transplantation. Given the importance of this diagnosis, an international grading system was developed to standardize the diagnosis of acute lung-allograft rejection. The reliability of this grading system has not been adequately assessed by previous studies. ⋯ These results expand upon previous reports of interobserver variability in grading transbronchial biopsy specimens after lung transplantation. Given the variability in grading these specimens, we advocate further education of the histopathologic findings in lung transplant biopsy specimens, as well as revisiting the current criteria for grading transbronchial biopsy specimens to improve concordance among lung transplant pathologists.
-
Randomized Controlled Trial Multicenter Study
Sildenafil preserves exercise capacity in patients with idiopathic pulmonary fibrosis and right-sided ventricular dysfunction.
Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with pulmonary vasculopathy. ⋯ Sildenafil treatment in IPF with RVSD results in better preservation of exercise capacity as compared with placebo. Sildenafil also improves quality of life in subjects with RVH and RVSD.
-
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.
-
Multicenter Study
Independent association between nocturnal intermittent hypoxemia and metabolic dyslipidemia.
There is growing evidence from animal models that intermittent hypoxemia (IH) may induce dyslipidemia. Altered lipid metabolism may contribute to the increased cardiovascular risk observed in obstructive sleep apnea (OSA). In this multisite, cross-sectional study, we tested the hypothesis that there is an independent association between nocturnal IH and dyslipidemia in OSA. ⋯ Nocturnal IH is independently associated with metabolic dyslipidemia, which may predispose patients with OSA to a higher risk of cardiovascular disease.
-
Although COPD affects large sections of the population, its effects on postoperative outcomes have not been rigorously studied. The objectives of this study were to describe the prevalence of COPD in patients undergoing surgery and to analyze the associations between COPD and postoperative morbidity, mortality, and hospital length of stay. ⋯ COPD is common among patients undergoing surgery and is associated with increased morbidity, mortality, and length of stay.