Chest
-
Meta Analysis
Perioperative Management of Vitamin K Antagonists and Direct Oral Anticoagulants: a Systematic Review and Meta-analysis.
The management of patients who are receiving chronic oral anticoagulation therapy and require an elective surgery or an invasive procedure is a common clinical scenario. ⋯ The certainty in the evidence supporting the perioperative management of anticoagulants remains limited. No high-quality evidence exists to support the practice of heparin bridging during the interruption of VKA or DOAC therapy for an elective surgery or procedure, or for the practice of interrupting VKA therapy for minor procedures, including cardiac device implantation, or continuation of a DOAC vs short-term interruption of a DOAC in the perioperative period.
-
Multicenter Study
Association between shared decision-making during family meetings and surrogates' trust in their ICU physician.
Although trust is central to successful physician-family relationships in ICUs, little is known about how to promote surrogates' trust of ICU physicians in this setting. ⋯ The conduct of family meetings and physicians' use of SDM behaviors during meetings were both associated with increases in surrogates' trust in the treating physician.
-
Observational Study
Motile ciliary disorders of the nasal epithelium in adults with bronchiectasis.
Motile ciliary disorder (MCD) has been implicated in chronic inflammatory airway diseases such as asthma and COPD. ⋯ Nasal ciliary markers profiling provides complimentary information to clinical endotyping of bronchiectasis.
-
Over recent years, positive airway pressure (PAP) remote monitoring has transformed the management of OSA and produced a large amount of data. Accumulated PAP data provide valuable and objective information regarding patient treatment adherence and efficiency. However, the majority of studies that have analyzed longitudinal PAP remote monitoring have summarized data trajectories in static and simplistic metrics for PAP adherence and the residual apnea-hypopnea index by the use of mean or median values. ⋯ To allow fair comparison among studies and to avoid biases in computation, PAP data processing and management should be conducted rigorously with these points in mind. PAP remote monitoring data contain a wealth of information that currently is underused in the field of sleep research. Improving the quality and standardizing data handling could facilitate data sharing among specialists worldwide and enable artificial intelligence strategies to be applied in the field of sleep apnea.
-
Observational Study
Racial Disparities in Lung Cancer Stage of Diagnosis among Adults Living in the Southeastern U.S.
Black Americans receive a diagnosis at later stage of lung cancer more often than White Americans. We undertook a population-based study to identify factors contributing to racial disparities in lung cancer stage of diagnosis among low-income adults. ⋯ Reducing racial disparities in lung cancer stage at presentation will require interventions on both structural and individual-level factors.