Background Trajectories of bedside vital signs have been used to identify sepsis subphenotypes with distinct outcomes and treatment responses. The objective of this study is to validate the vitals trajectory model in a multicenter cohort of hospitalized COVID-19 patients and to evaluate the clinical characteristics and outcomes of the resulting subphenotypes. Research Question Can the trajectory of

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Background Although racial and ethnic differences in continuous positive airway pressure (CPAP) adherence for obstructive sleep apnea (OSA) are widely established, no studies have examined the influence of perceived racial discrimination on CPAP usage, to our knowledge. Research Questions: 1) Do Black adults with OSA report experiencing greater amounts of discrimination than non-Hispanic White adults

Background Programmed death-ligand 1 (PD-L1) expression on tumor cells, evaluated by immunohistochemistry, guides the use of immunotherapy in advanced non-small cell lung cancer (NSCLC). Research Question What is the sensitivity and specificity of PD-L1 testing performed in cytological vs. paired histological specimens, in patients with non-small cell lung cancer? Study Design and Methods The MEDLINE

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Background A clinically applicable mortality-risk prediction system for pulmonary tuberculosis may improve treatment outcomes, but no easy-to-calculate and accurate score has yet been reported. We aimed to construct a simple and objective disease-severity score for patients with pulmonary tuberculosis. Research Question Does a clinical score consisting of simple objective factors predict the mortality

Background The effect of supplemental oxygen therapy in patients with intermediate-risk pulmonary embolism (PE) who do not have hypoxemia at baseline is uncertain. Research Question Does supplemental oxygen improve echocardiographic parameters in non-hypoxemic patients with intermediate-risk PE? Study Design and Methods This pilot trial randomly assigned non-hypoxemic patients with stable PE and echocardiographic

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Background The early-life origins of chronic pulmonary diseases are thought to arise in peripheral small airways. Predictors of ventilation inhomogeneity, a proxy of peripheral airway function, are understudied in schoolchildren. Research Question Is the double-tracer gas single-breath washout (DTG-SBW) measurement feasible in a pediatric field study setting? What are the predictors of the DTG-SBW

Chronic obstructive pulmonary disease patient care must include confirming a diagnosis with postbronchodilator spirometry. Because of the clinical heterogeneity and the reality that airflow obstruction assessed by spirometry only partially reflects disease severity, a thorough clinical evaluation of the patient should include assessment of symptom burden and risk of exacerbations that permits the implementation

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Venous bullet embolism is an exceedingly rare trauma diagnosis that presents diagnostic and therapeutic challenges. We present the case of a 32-year-old man who sustained multiple gunshot wounds with a venous bullet embolism to the right pulmonary artery. Imaging at first demonstrated a bullet lodged within the right lower lobe. The patient underwent multiple bronchoscopies and ultimately was found

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Case Presentation A 72-year-old woman with a history of adenocarcinoma of the lung, for which she was receiving tyrosine kinase inhibitor therapy with osimertinib, was admitted to the ED because of clinical deterioration with extreme fatigue and fever. She was already receiving antibiotic therapy initiated by her general practitioner because of symptoms of an upper respiratory tract infection. She

Case Presentation A 71-year-old woman sought treatment for a nonproductive cough. The patient had experienced no episodes of hemoptysis or shortness of breath. Her illness history included lumbago and dry mouth. The patient did not smoke and had no significant family medical history or medication use. She had no allergies to any food or drugs. Blood test results, including a CBC count, biochemical

Case Presentation A 74-year-old man presented to the ED with progressive dyspnea, orthopnea, and bilateral leg swelling for 2 months. He denied cough, hemoptysis, fever, night sweats, or weight loss. He had history of COPD and chronic atrial fibrillation. He had a 50 pack-year smoking history and had quit 7 years prior to presentation.

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Background Transient hyperglycemia is commonly seen during tuberculosis treatment, yet its association with unfavorable treatment outcomes is unclear. Research question Is there an association between glycated Haemoglobin (HbA1c) trajectories and tuberculosis treatment outcomes? Study design and methods Adults with pulmonary tuberculosis were prospectively evaluated for 18 months after their second

BACKGROUND No studies have reported therapies for the management of patients with refractory Mycobacterium abscessus pulmonary disease (MAB-PD). We implemented intermittent multi-drug intravenous therapy (IMIT) through repeated hospitalizations for MAB-PD patients who were refractory to antibiotics for over 12 months. RESEARCH QUESTION What are the effects of IMIT on patients with refractory MAB-PD

Background Associations between smoking and poor tuberculosis (TB) treatment outcomes are well documented. However, for important outcomes such as TB recurrence/relapse and mortality-during-treatment, as well as for associations with smokeless tobacco (ST), the evidence is not systematically summarised. Research Question Is tobacco use associated with risk of poor treatment outcomes among people with

Background Data are scarce regarding epidemiology and management of critically ill patients with lung abscesses. Research question What are the clinical and microbiological characteristics of critically ill patients with lung abscesses, how are they managed in the ICUs, and what are the risk factors of in-ICU mortality? Study Design and Methods Retrospective observational multicenter study, based on

Background Navigating through the bronchial tree and visualizing all bronchial segments is the initial step toward learning flexible bronchoscopy. A novel bronchial segment identification system based on artificial intelligence (AI) has been developed to help guide trainees toward more effective training. Research Question Does feedback from an AI-based automatic bronchial segment identification system

Topic importance Thoracic imaging with computed tomography (CT) has become an essential component in the evaluation of respiratory and thoracic diseases. Providers have historically utilized conventional single energy CT; however, prevalence of dual energy CT (DECT) is increasing and as such it is important for thoracic physicians to recognize the utility and limitations of this technology. Review

Background Historically, norepinephrine has been administered through a central venous catheter (CVC) due to concerns about the risk of ischemic tissue injury if extravasation from a peripheral intravenous catheter (PIV) occurs. Recently, several reports have suggested that peripheral administration of norepinephrine may be safe. Research question Can a protocol for peripheral norepinephrine administration

Background COVID-19 led to unprecedented inpatient capacity challenges particularly in Intensive Care Units (ICUs), which spurred development of statewide or regional placement centers for coordinating transfer (load balancing) of adult patients needing intensive care to hospitals with remaining capacity. Research Question Do Medical Operations Coordination Centers (MOCC) augment patient placement

Background Pulmonary involvement is the leading cause of death in systemic sclerosis (SSc) and may manifest as interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), or in combination of both (ILD-pulmonary hypertension (PH)). Aim of this analysis was to determine prevalence, clinical characteristics, and survival of these different forms within the registry of the German Network for

Background Related to ongoing demographic changes, the spectrum of patients with cardiogenic shock (CS) has significantly changed and more patients develop CS in the absence of acute myocardial infarction (AMI). However, these patients were typically excluded from prior studies. Very limited data regarding the prognostic role of CS onset and hospital admission is available. Research Question Does the

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Background Trimethoprim-sulfamethoxazole (TMP-SMX) is an effective treatment for Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients with and without human immunodeficiency virus (HIV) infection; however, a high incidence of adverse events has been observed. Low-dose TMP-SMX is a potentially effective treatment with fewer adverse events; however, evidence is limited. Research question

Background There are several antibiotic regimens to treat community-acquired pneumonia (CAP). Research question In patients hospitalized to a non-ICU ward setting with CAP, is there a difference between first-line and alternative antibiotic regimens (β-lactam plus macrolide (BL+M), β-lactam alone (BL), respiratory fluoroquinolone (FQ) or β-lactam plus doxycycline (BL+D)) in terms of in-hospital mortality

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Background Both the incidence of lung cancer and the prevalence of metabolic syndrome (MetS) have been increasing worldwide. The relationship between MetS and lung cancer remains controversial. Research Question Is the risk of lung cancer associated with MetS and its components? Study Design and Methods Multivariable Cox regression models were used to estimate the hazard ratio (HR) of MetS-related

Background In immunocompromised patients with acute respiratory failure (ARF), the clinical significance of respiratory virus detection in the nasopharynx remains uncertain. Research Question Is viral detection in nasopharyngeal swabs associated with causes and outcomes of ARF in immunocompromised patients? Study Design and Methods Preplanned post hoc analysis of a randomized controlled trial enrolling

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Background Idiopathic subglottic stenosis (iSGS) is a recurrent, chronic disease defined by fibro-inflammatory narrowing of the subglottic airway. A key challenge in treatment is monitoring disease progression, which may be debilitating and unpredictable in timing. Research Question Can the SGS-6 Questionnaire be validated as a novel QOL instrument to proactively monitor breathing, disease progression

BACKGROUND Acute chest syndrome (ACS) is a life-threatening complication of sickle-cell disease (SCD). Although respiratory pathogens are frequently detected in children with ACS, their respective role in triggering the disease is still unclear. We hypothesized that ACS incidence followed the unprecedented population-level changes in respiratory pathogens dynamics following the COVID-19-related non-pharmaceutical

Background The American Joint Committee on Cancer (AJCC) 8th Edition TNM staging manual for non-small-cell lung cancer (NSCLC) M1a descriptors include tumors presenting with malignant pleural or pericardial effusion (“M1a-Effusion”), pleural or pericardial nodule(s) (“M1a-Pleural”), or separate tumor nodule(s) in a contralateral lobe (“M1a-Contralateral”). Research Question Is M1a NSCLC presenting

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Background Waterpipe tobacco smoking (WPS) is popular among young adults globally and exposes users to toxicants. Research Question Is WPS associated with impaired measures of arterial function and does WPS acutely impair these measures in young adults? Study Design and Methods We assessed heart rate (HR), brachial and aortic blood pressure (BP), HR-adjusted augmentation index (AI), and carotid-femoral

Background Clinical practice guidelines separately describe radiologic patterns of usual interstitial pneumonia (UIP) and fibrotic hypersensitivity pneumonitis (fHP), without direction on whether or how to apply these approaches concurrently within a single patient. Research Question How can we integrate guideline-defined radiologic patterns to diagnose interstitial lung disease (ILD) and what are

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