Chest
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Nonventilated hospital-acquired pneumonia (NVHAP) is a serious nosocomial infection that is increasingly attributed to antibiotic-resistant bacteria. ⋯ The occurrence of NVHAP was associated with significant increases in mortality, the use of intensive care and mechanical ventilation, and hospital length of stay. We also found that respiratory viruses were an important cause of NVHAP. These findings suggest that efforts aimed at the successful prevention of NVHAP could improve patient outcomes and reduce health-care costs.
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Case Reports
Endobronchial Ultrasound: A New Technique of Pericardiocentesis in Posterior Loculated Pericardial Effusion.
Diagnostic and therapeutic pericardiocentesis is traditionally carried out via the transthoracic route under ultrasound or echocardiographic guidance. Posteriorly located loculated pericardial effusion cannot be safely drained using the standard subxiphoid or apical, intercostal approach. In the presence of clinically significant loculated effusion or effusion requiring diagnostic pericardiocentesis where an echocardiographic approach is not feasible, patients are usually referred for surgery. We here present a novel minimally invasive endobronchial ultrasound-guided approach for the aspiration of posteriorly loculated pericardial effusion that may obviate the need for surgery and its related complications.
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Lung cancer screening recommendations have been developed, but none are focused on veterans. We report the results of the lung cancer screening program at our Veterans Affairs medical center and compare them with historic results. ⋯ Implementation of lung cancer screening in the veteran population leads to detection of an increased number and proportion of early-stage lung cancers. Lung cancer screening in veterans may also increase the rate of lung cancer diagnoses in the immediate postimplementation period.
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OSA is associated with increased cancer incidence and mortality. Exosomes are vesicles secreted by most cells. They are released into the bloodstream and play a role in tumor progression and metastasis. We evaluated whether the chronic intermittent hypoxia (IH) that characterizes OSA leads to release of tumor-promoting exosomes in the circulation. ⋯ Circulating exosomes released under IH conditions in vivo selectively enhance specific properties of lung tumor cell cultures. Thus, plasma exosomes participate in the increased tumor aggressiveness observed in patients with OSA.
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Editorial Biography Historical Article
Giants in Chest Medicine: Bartolome Celli, MD, FCCP.