Chest
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Observational Study
Mechanisms of exercise limitation and prevalence of pulmonary hypertension in pulmonary Langerhans cell histiocytosis.
Pulmonary Langerhans cell histiocytosis (PLCH) determines reduced exercise capacity. The speculated mechanisms of exercise impairment in PLCH are ventilatory and cardiocirculatory limitations, including pulmonary hypertension (PH). ⋯ ClinicalTrials.gov; No.: NCT02665546; URL: www.clinicaltrials.gov.
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Acute pericarditis is the most common presentation of pericardial diseases. Although generally benign, complications such as constrictive pericarditis, cardiac tamponade, and recurrence can occur. ⋯ Acute pericarditis is associated with at least one adverse outcome in 34% of patients. Subacute presentation and idiopathic etiology are associated with higher incidence of adverse outcomes, whereas elevated troponin I levels identify a group with reduced risk of recurrences.
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Lung ultrasonography (LUS), an imaging modality quickly performed, interpreted, and integrated by the treating physician at the bedside, is a particularly useful tool for acutely ill patients. In the evaluation of a patient with respiratory failure in the ICU or ED, LUS is superior to chest radiograph and generally comparable with CT imaging and reduces the need for patient transport and radiation exposure. This article will provide a concise review of LUS as it pertains to respiratory failure in general and will include examples of relevant ultrasound images and video clips from critically ill patients.
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Meta Analysis
Acetazolamide for Obstructive and Central Sleep Apnea: A Comprehensive Systematic Review and Meta-Analysis.
Therapy options for OSA and central sleep apnea (CSA) are limited, thus many patients remain untreated. Clinically, acetazolamide is sometimes used for CSA; however, given overlapping pathophysiologic properties of OSA and CSA, we hypothesized that acetazolamide is equally effective for both types. Prior reviews focused on specific subtypes of sleep apnea, study designs, and languages, thus including few studies (typically ≤3) limiting insights. ⋯ PROSPERO (CRD42019147504).
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Observational Study
"Incidence and Location of Atelectasis Developed During Bronchoscopy Under General Anesthesia" (I-LOCATE Trial).
Despite the many advances in peripheral bronchoscopy, its diagnostic yield remains suboptimal. With the use of cone-beam CT imaging we have found atelectasis mimicking lung tumors or obscuring them when using radial-probe endobronchial ultrasound (RP-EBUS), but its incidence remains unknown. ⋯ ClinicalTrials.gov; No.: NCT03523689; URL: www.clinicaltrials.gov.