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Chest Medicine

Brief Review | Mechanical power: meaning, uses and limitations

13 Mar, 2023 | 14:44h | UTC

Mechanical power: meaning, uses and limitations – Intensive Care Medicine

 

Commentary on Twitter

 

Study shows potential for autonomous reporting of normal chest radiographs using artificial intelligence

13 Mar, 2023 | 14:41h | UTC

Autonomous Chest Radiograph Reporting Using AI: Estimation of Clinical Impact – Radiology

News Release: AI accurately identifies normal and abnormal chest x-rays – Radiological Society of North America

Commentary: AI Has High Sensitivity for Abnormal Chest Radiographs – HealthDay

 

Commentary on Twitter

 

RCT | Assessment of a text message–based smoking cessation intervention for adult smokers

9 Mar, 2023 | 14:09h | UTC

Assessment of a Text Message–Based Smoking Cessation Intervention for Adult Smokers in China: A Randomized Clinical Trial – JAMA Network Open

 

Commentary on Twitter

 

SR | There is insufficient evidence to recommend pharmacological treatments for central sleep apnea in adults

9 Mar, 2023 | 14:01h | UTC

Pharmacological treatment for central sleep apnoea in adults – Cochrane Library

Summary: Medicines for central sleep apnoea in adults – Cochrane Library

 

FDA panel endorses 2 RSV vaccines for older adults, but flag at potential increased risk of Guillain-Barre

8 Mar, 2023 | 14:27h | UTC

Pfizer vaccine:

In close vote, FDA advisers recommend Pfizer RSV vaccine for those 60 and older – CIDRAP

FDA advisors recommend first-ever RSV vaccine from Pfizer, despite possible Guillain-Barre risks – CNBC

GSK’s vaccine:

FDA panel recommends GSK’s RSV vaccine for ages 60 and up – CIDRAP

FDA advisors recommend GSK’s RSV vaccine for older adults, but flag potential safety risks – CNBC

See also: Rare neurological condition is ‘important potential risk’ of Pfizer’s RSV vaccine, FDA says – CNN

 

M-A | Comparison of a short vs. long-course antibiotic therapy for ventilator-associated pneumonia

7 Mar, 2023 | 13:18h | UTC

Summary:

This systematic review and meta-analysis of randomized controlled trials aimed to compare the rates of recurrence and relapse of ventilator-associated pneumonia (VAP) between short-course (≤8 days) and long-course (≥10-15 days) antibiotic therapy strategies. Five relevant studies involving 1069 patients were identified.

Compared to long-course therapy, short-course therapy increased the number of antibiotic-free days without any impact on recurrence and relapses of VAP, 28 days mortality, mechanical ventilation duration, number of extra-pulmonary infections, and length of ICU stay.

However, the study’s limitations, such as the small sample size and the lack of standardized definitions of the assessed outcomes, should be considered when interpreting the results.

Article: Comparison of a short versus long-course antibiotic therapy for ventilator-associated pneumonia: a systematic review and meta-analysis of randomized controlled trials – eClinicalMedicine

Commentary: Study finds benefits in short-course antibiotics for ventilator-associated pneumonia – CIDRAP

 

Position Statement | Chronic suppurative lung disease and bronchiectasis in children, adolescents and adults

7 Mar, 2023 | 13:04h | UTC

Thoracic Society of Australia and New Zealand (TSANZ) position statement on chronic suppurative lung disease and bronchiectasis in children, adolescents and adults in Australia and New Zealand – Respirology

 

SR | The effects of flow settings during high-flow nasal cannula support for adult subjects

7 Mar, 2023 | 12:40h | UTC

The effects of flow settings during high-flow nasal cannula support for adult subjects: a systematic review – Critical Care

 

BTS Clinical Guidance | Aspiration pneumonia

6 Mar, 2023 | 14:36h | UTC

BTS clinical statement on aspiration pneumonia – Thorax

 

BTS Clinical Guidance | Prevention and management of community-acquired pneumonia in people with learning disability

6 Mar, 2023 | 14:34h | UTC

BTS Clinical Statement on the prevention and management of community-acquired pneumonia in people with learning disability – Thorax

 

Editorial | Helmet trials: resolving the puzzle

6 Mar, 2023 | 14:05h | UTC

Helmet trials: resolving the puzzle – Intensive Care Medicine (if the link is paywalled, try this one in PMC)

 

RCT | Effects of a respiratory distress symptom intervention for lung cancer breathlessness–cough–fatigue symptom cluster

2 Mar, 2023 | 12:51h | UTC

Respiratory distress symptom intervention for non-pharmacological management of the lung cancer breathlessness–cough–fatigue symptom cluster: randomised controlled trial – BMJ Supportive & Palliative Care

 

RCT | Single chest tube superior to double chest tube post decortication in trauma/TB patients

27 Feb, 2023 | 12:53h | UTC

Effectiveness of Single Chest Tube vs Double Chest Tube Application Post Decortication: Prospective Randomized Controlled Study – Journal of the American College of Surgeons

 

M-A | COVID-19 convalescent plasma outpatient therapy may prevent hospitalizations

23 Feb, 2023 | 13:37h | UTC

Convalescent Plasma Outpatient Therapy to Prevent Outpatient Hospitalization: A Meta-analysis of Individual Participant Data From Five Randomized Trials – Clinical Infectious Diseases

Commentary: New analysis shows how convalescent plasma can be used as effective, low-cost COVID-19 treatment – News Medical

 

Diagnosis and management of myositis-associated lung disease

23 Feb, 2023 | 13:25h | UTC

Diagnosis and Management of Myositis-associated Lung Disease – CHEST

 

M-A | Past SARS-CoV-2 infection provides long-lasting protection against severe disease caused by all variants

22 Feb, 2023 | 12:48h | UTC

Summary: The article describes a systematic review and meta-analysis of studies assessing protection from past SARS-CoV-2 infection against subsequent re-infection, symptomatic COVID-19 disease, and severe disease. The researchers identified 65 studies from 19 different countries and found that protection from past infection against re-infection from pre-omicron variants was high and remained so even after 40 weeks. However, protection was substantially lower for the omicron BA.1 variant and declined more rapidly over time than protection against previous variants. Protection from severe disease was high for all variants, estimated at 90·2% for ancestral, alpha, and delta variants, and 88·9% for omicron BA.1 at 40 weeks. The study highlights the importance of considering past infection in assessing future disease burden from COVID-19, providing guidance on when individuals should be vaccinated, and designing policies that mandate vaccination for workers or restrict access. The findings also suggest that individuals with a documented infection should be treated similarly to those who have been fully vaccinated with high-quality vaccines.

Article: Past SARS-CoV-2 infection protection against re-infection: a systematic review and meta-analysis – The Lancet

News Release: The Lancet: Most comprehensive study to date provides evidence on natural immunity protection by COVID-19 variant and how protection fades over time – Institute for Health Metrics and Evaluation

Commentaries:

Previous COVID-19 may slash severe illness at reinfection by 89% – CIDRAP

Natural Immunity Against COVID-19 ‘At Least’ On Par With Vaccination in Preventing Death – Health Policy Watch

 

RCT | Another study shows Ivermectin does not benefit patients with Covid-19

22 Feb, 2023 | 12:45h | UTC

Summary: The study aimed to evaluate whether Ivermectin, at a maximum dose of 600 μg/kg daily for 6 days, shortened symptom duration or prevented hospitalization among outpatients with mild to moderate COVID-19. A total of 1206 US adults were enrolled in the double-blind, randomized, placebo-controlled platform trial, with follow-up data through November 10, 2022. The study found that the median time to sustained recovery was 11 days in both the ivermectin and placebo groups. Among those receiving Ivermectin, 5.7% were hospitalized, died, or had urgent or emergency care visits compared with 6.0% receiving placebo. These findings, along with all the previous studies to date, do not support using Ivermectin in patients with mild to moderate COVID-19.

Article: Effect of Higher-Dose Ivermectin for 6 Days vs Placebo on Time to Sustained Recovery in Outpatients With COVID-19: A Randomized Clinical Trial – JAMA

Editorials:

At a Higher Dose and Longer Duration, Ivermectin Still Not Effective Against COVID-19 – JAMA

The Ethics of Clinical Research: Managing Persistent Uncertainty – JAMA

Related:

RCT | Ivermectin does not improve time to recovery in outpatients with mild to moderate COVID-19.

RCT | Metformin, Ivermectin, and Fluvoxamine are not beneficial for obese outpatients with Covid-19.

Ivermectin for COVID-19 Cochrane review update: 11 trials and no evidence of benefit shown.

RCT: Early treatment with ivermectin does not improve outcomes in patients with Covid-19.

RCT: In patients with mild to moderate Covid-19 and comorbidities, treatment with Ivermectin did not reduce the risk of disease progression.

Case Series: Toxic effects from ivermectin use associated with prevention and treatment of Covid-19.

Long-term consequences of the misuse of ivermectin data.

Ivermectin: How false science created a Covid ‘miracle’ drug.

Fraudulent ivermectin studies open up new battleground between science and misinformation.

The lesson of ivermectin: meta-analyses based on summary data alone are inherently unreliable.

Ivermectin: Cochrane’s most talked about review so far, ever. Why?

Flawed ivermectin preprint highlights challenges of COVID drug studies.

Systematic review: no evidence to support the use of Ivermectin for treating or preventing COVID-19.

Why was a major study on ivermectin for covid-19 just retracted?

RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.

Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials – “IVM did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease”.

Ivermectin is the new hydroxychloroquine, take 2 – “Ivermectin shouldn’t be used to treat COVID-19 outside of the context of a well-designed clinical trial”.

Therapeutics and COVID-19 | WHO guideline update advises Ivermectin should only be used to treat COVID-19 within clinical trials

RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19

 

Review | Comorbidities, multimorbidity and COVID-19

22 Feb, 2023 | 12:39h | UTC

Comorbidities, multimorbidity and COVID-19 – Nature Medicine

 

Sleep irregularity linked to subclinical markers of cardiovascular disease

21 Feb, 2023 | 11:51h | UTC

Summary: The study examined the association between sleep irregularity and subclinical markers of cardiovascular disease in a population of over 2000 participants with a mean age of 68. The participants completed 7-day wrist actigraphy that detected when they were asleep and awake. The results showed that sleep irregularity, particularly sleep duration irregularity, was associated with subclinical atherosclerosis, including high coronary artery calcium burden and abnormal ankle-brachial index. These associations persisted even after adjusting for cardiovascular disease risk factors and other sleep characteristics such as obstructive sleep apnea, sleep duration, and sleep fragmentation. While it is important to note that observational studies like this one cannot establish causation and may be subject to residual confounding, the findings suggest that promoting regular sleep schedules could be an essential aspect of lifestyle recommendations for preventing cardiovascular disease.

Article: Sleep Irregularity and Subclinical Markers of Cardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis – Journal of the American Heart Association

News Release: Irregular sleeping habits may increase risk of atherosclerosis in older adults – American Heart Association

Commentaries:

Study finds chronically disrupted sleep may increase the risk for heart disease – Vanderbilt University Medical Center

Sleep Irregularity Linked to Measures of Subclinical Atherosclerosis – HealthDay

Irregular sleep may be harmful to your heart, study finds – CNN

 

Cohort Study | One third of patients hospitalized with Covid-19 persist with lung abnormalities after 2 years

21 Feb, 2023 | 11:47h | UTC

Summary: The study aimed to assess changes in chest CT abnormalities and pulmonary function in patients two years after recovery from SARS-CoV-2 infection. The prospective study followed 144 participants discharged from the hospital after SARS-CoV-2 infection between January 15 and March 10, 2020. The participants underwent serial chest CT scans and pulmonary function tests at 6 months, 12 months, and 2 years after symptom onset. The study found that 39% of participants had persistent interstitial lung abnormalities at 2 years, and this was associated with respiratory symptoms and decreased diffusion pulmonary function.

Article: Longitudinal Assessment of Chest CT Findings and Pulmonary Function in Patients after COVID-19 – Radiology

Editorial: Radiologic Findings after COVID-19 and the Correlation with Lung Function – Radiology

Commentaries:

Post-COVID-19 CT scans show lung abnormalities persist two years later – News Medical

COVID’s aftermath: Persistent organ damage at 1 year, lung abnormalities at 2 – CIDRAP

 

Phase 2b RCT | Ad26.RSV.preF–Respiratory Syncytial Virus preF protein vaccine is immunogenic in older adults

17 Feb, 2023 | 13:30h | UTC

Summary: A phase 2b clinical trial evaluated the Ad26.RSV.preF–RSV preF protein vaccine’s efficacy, immunogenicity, and safety in preventing RSV-mediated lower respiratory tract disease in adults aged 65 years and older. The vaccine was effective in preventing the disease and immunogenic, as demonstrated by the increase in RSV A2 neutralizing antibody titers after vaccination. The vaccine was associated with higher rates of adverse events than the placebo, but most were of mild to moderate severity. The trial concluded that Ad26.RSV.preF–RSV preF protein vaccine was effective in preventing RSV-mediated lower respiratory tract disease in older adults.*

Article: Efficacy and Safety of an Ad26.RSV.preF–RSV preF Protein Vaccine in Older Adults – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Ad26.RSV.preF-RSV preF Protein Vaccine Immunogenic in Seniors – HealthDay

 

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

 

RCT | Respiratory Syncytial Virus prefusion F protein vaccine provides protection for older adults

17 Feb, 2023 | 13:32h | UTC

Summary: A phase 2b clinical trial evaluated the Ad26.RSV.preF–RSV preF protein vaccine in adults aged 65 years and older. The vaccine was effective and immunogenic, as demonstrated by the increase in RSV A2 neutralizing antibody titers after vaccination. The vaccine was associated with higher rates of adverse events than the placebo, but most were of mild to moderate severity.*

Article: Respiratory Syncytial Virus Prefusion F Protein Vaccine in Older Adults – New England Journal of Medicine (link to abstract – $ for full-text)

 

Commentary on Twitter

 

*Note: This summary was created through the collaboration of a medical editor and ChatGPT.

 

RCT | Effect of non-invasive ventilation after extubation in critically ill patients with obesity

17 Feb, 2023 | 13:10h | UTC

Effect of non-invasive ventilation after extubation in critically ill patients with obesity in France: a multicentre, unblinded, pragmatic randomised clinical trial – The Lancet Respiratory Medicine (link to abstract – $ for full-text)

 

Commentary on Twitter

 

Case Reports | Seventeen cases of daptomycin-induced eosinophilic pneumonia in bone and joint infections

17 Feb, 2023 | 12:54h | UTC

Seventeen Cases of Daptomycin-Induced Eosinophilic Pneumonia in a Cohort of Patients Treated for Bone and Joint Infections: Proposal for a New Algorithm – Open Forum Infectious Diseases

 

RCT | Home high-flow nasal cannula oxygen therapy for stable hypercapnic COPD

17 Feb, 2023 | 12:53h | UTC

Home High-Flow Nasal Cannula Oxygen Therapy for Stable Hypercapnic COPD: A Randomized Clinical Trial – American Journal of Respiratory and Critical Care Medicine

 

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