Chest
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American Heart Association Advanced Cardiac Life Support (ACLS) guidelines support the use of either amiodarone or lidocaine for cardiac arrest caused by ventricular tachycardia or ventricular fibrillation (VT/VF) based on studies of out-of-hospital cardiac arrest. Studies comparing amiodarone and lidocaine in adult populations with in-hospital VT/VF arrest are lacking. ⋯ Compared with amiodarone, lidocaine therapy among adult patients with in-hospital cardiac arrest from VT/VF was associated with statistically significantly higher rates of ROSC, 24 h survival, survival to hospital discharge, and favorable neurologic outcome.
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Observational Study
Sex- And Race-Based Differences In The Treatment Of Interstitial Lung Diseases in North America And Australasia.
Biological sex, gender, and race are important considerations in patients with interstitial lung diseases (ILDs). ⋯ Sex- and race-based differences exist in the initiation of ILD treatment, with variability across different cohorts in different countries. Reasons for these differences need to be further explored in future studies.
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Randomized Controlled Trial
A total diet replacement weight management programme for difficult-to-treat asthma associated with obesity: a randomised controlled feasibility trial.
Obesity is often associated with uncontrolled, difficult-to-treat asthma and increased morbidity and mortality. Previous studies suggest that weight loss may improve asthma outcomes, but with heterogenous asthma populations studied and unclear consensus on the optimal method of weight management. The Counterweight-Plus Programme (CWP) for weight management is an evidence-based, dietitian-led total diet replacement (TDR) program. ⋯ Using a structured weight management program results in clinically important improvements in asthma control and quality of life over 16 weeks compared with UC in adults with difficult-to-treat asthma and obesity. This generalizable program is easy to deliver for this challenging phenotype. Longer-term outcomes continue to be studied.
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Emerging data suggest that determination of physiologic endotypic traits (eg, loop gain) may enable precision medicine in OSA. ⋯ Endotypic trait analysis using a single standard polysomnography shows acceptable reliability and reproducibility in patients with moderate to severe OSA. The reported MDDs of endotypic traits may facilitate the quantification of relevant changes and may guide future evaluation of interventions in OSA.
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Early detection of lung cancer through management of pulmonary nodules (PNs) may reduce lung cancer mortality. We assessed the relationship between PNs and lung cancer. ⋯ Patients with lung cancer who received a diagnosis after identification of PNs tended to have localized disease. Of all patients with localized disease, almost one-third had PNs that were diagnosed previously, compared with 5% of patients who had undergone LDCT scan screening. PNs represent a relatively common presentation of potentially curable lung cancer.