Chest
-
Observational Study
Long term noninvasive ventilation in the Geneva Lake area: indications, prevalence and modalities.
Noninvasive ventilation (NIV) is standard of care for chronic hypercapnic respiratory failure, but indications, devices, and ventilatory modes are in constant evolution. ⋯ Use of NIV is increasing rapidly in this area, and the population treated is aging, comorbid, and frequently obese. COPD is presently the leading indication followed by OHS.
-
Comparative Study
Comparison of Hospitalized Patients with Acute Respiratory Distress Syndrome Caused by COVID-19 and H1N1.
Since the outbreak of coronavirus disease 2019 (COVID-19) in China in December 2019, considerable attention has been focused on its elucidation. However, it is also important for clinicians and epidemiologists to differentiate COVID-19 from other respiratory infectious diseases such as influenza viruses. ⋯ There were many differences in clinical presentations between patients with ARDS infected with either COVID-19 or H1N1. Compared with H1N1 patients, patients with COVID-19-induced ARDS had lower severity of illness scores at presentation and lower SOFA score-adjusted mortality.
-
Observational Study
Who May Benefit from Diuretics in OSA? A Propensity Score-Match Observational Study.
Diuretics have been reported as effective for reducing OSA severity by preventing fluid retention and reducing rostral fluid shift. The benefit of diuretics might vary depending on the OSA clinical phenotype and comorbidities. To test this hypothesis, we conducted a propensity score-matched cohort analysis of data from the French national sleep apnea registry "Observatoire Sommeil de la Fédération de Pneumologie." ⋯ Diuretics appear to have a positive impact on OSA severity in overweight or moderately obese patients with hypertension. A prospective study is needed to confirm that diuretics are of interest in combined therapies for hypertensive patients with OSA.
-
The novel coronavirus disease 2019 (COVID-19) has become a global health emergency. The cumulative number of new confirmed cases and deaths are still increasing out of China. Independent predicted factors associated with fatal outcomes remain uncertain. ⋯ The proposed nomogram accurately predicted clinical outcomes of patients with COVID-19 based on individual characteristics. Earlier identification, more intensive surveillance, and appropriate therapy should be considered in patients at high risk.
-
Causal directed acyclic graphs (cDAGs) have become popular tools for researchers to better examine biases related to causal questions. DAGs comprise a series of arrows connecting nodes that represent variables and in doing so can demonstrate the causal relation between different variables. cDAGs can provide researchers with a blueprint of the exposure and outcome relation and the other variables that play a role in that causal question. cDAGs can be helpful in the design and interpretation of observational studies in pulmonary, critical care, sleep, and cardiovascular medicine. They can also help clinicians and researchers to better identify the structure of different biases that can affect the validity of observational studies. ⋯ We use cDAGs and clinical examples that are mostly focused in the area of pulmonary medicine to describe the structure of confounding, selection bias, overadjustment bias, and detection bias. These principles are then applied to a more complex published case study on the use of statins and COPD mortality. We also introduce readers to other resources for a more in-depth discussion of causal inference principles.