Chest
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Randomized Controlled Trial Multicenter Study
Use of an Ultrathin Versus Thin Bronchoscope for Peripheral Pulmonary Lesions: A Randomized Trial.
When evaluating peripheral pulmonary lesions, a 3.0-mm ultrathin bronchoscope (UTB) with a 1.7-mm working channel is advantageous regarding good access to the peripheral airway, whereas a 4.0-mm thin bronchoscope provides a larger 2.0-mm working channel, which allows the use of various instruments including a guide sheath (GS), larger forceps, and an aspiration needle. This study compared multimodal bronchoscopy using a UTB and a thin bronchoscope with multiple sampling methods for the diagnosis of peripheral pulmonary lesions. ⋯ Multimodal bronchoscopy using a UTB afforded a higher diagnostic yield than that using a thin bronchoscope in the diagnosis of small peripheral pulmonary lesions.
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Randomized Controlled Trial Multicenter Study
Patient-level trajectories and outcomes after low-dose CT screening in the National Lung Screening Trial.
Shared decision-making is an essential element of low-dose CT (LDCT) screening for lung cancer. Understanding patient-level outcomes from the National Lung Screening Trial (NLST) is critical to effectively communicate risks and benefits of screening to patients. ⋯ We provide important patient-level data from the NLST that can be used to guide shared decision-making. The risk-to-benefit ratio of screening may vary significantly in some patients, such as those with COPD, in whom both risks and benefits of screening may be increased.
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This study aimed to identify changing spatial and temporal trends of lung cancer mortality rates (LCMRs) among subpopulations in China (according to region, age, and sex). ⋯ Disparities in the spatial and temporal trends of LCMRs among subpopulations highlight the need for investigation into potential drivers, especially for the east, south, and southwest of China. These findings may help health authorities target interventions to those most in need to reduce the lung cancer burden in China.
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Multicenter Study
Percent of time in range 70-139mg/dL is associated with reduced mortality among critically ill patients receiving intravenous insulin infusion.
In addition to hyperglycemia, hypoglycemia, and glycemic variability, reduced time in targeted blood glucose range (TIR) is associated with increased risk of death in critically ill patients. This relation between TIR and mortality may be confounded by diabetic status and antecedent glycemic control. ⋯ TIR was independently associated with mortality in critically ill patients, particularly those with good antecedent glucose control.