VO2MAX, 6-minute walk, and muscle strength each correlate with frailty in US veterans.

Introduction: Frailty often manifests as an increased vulnerability to adverse outcomes, and detecting frailty is useful for informed healthcare decisions. Veterans are at higher risk for developing frailty and at younger ages. The goal of this study was to investigate approaches in Veterans that can better inform the physiologic underpinnings of frailty, including maximal oxygen uptake (VO2max), 6-min walk, muscle strength, and inflammatory biomarkers.

Association between sleep health and rates of self-reported medical errors in intern physicians: an ancillary analysis of the Intern Health Study.

Study Objectives: Reduced sleep duration and work hour variability contribute to medical error and physician burnout. This study assesses the relationships between physician performance, burnout, and the dimensions of sleep beyond hours slept.

Methods: This was an ancillary analysis of 3 years of data from an international prospective cohort study: the Intern Health Study.

Post-Operative Outcomes of Pre-Thoracic Surgery Respiratory Muscle Training vs Aerobic Exercise Training: A Systematic Review and Network Meta-analysis.

Objective: To compare the postoperative outcomes of preoperative respiratory muscle training (RMT) with a device to preoperative aerobic exercise training (AET) in patients undergoing thoracic surgeries (cardiac and lung).

Data Sources: PubMed, EMBASE, Cochrane, and Web of Science were comprehensively searched upon inception to 9/2020.

Study Selection: All randomized control studies, including preoperative RMT and preoperative AET compared with a non-training control group, were included.

Racial disparity in sleep apnea-related mortality in the United States.

Background: Sleep apnea is one of the most common sleep disorders in the United States (US). Although the prevalence, risk factors, and clinical presentations of sleep apnea vary by racial groups, the racial disparity in sleep apnea-related mortality remains unclear.

Methods: Sleep apnea-related mortality for 1999-2019 was obtained from the National Center for Health Statistics provided by the Centers for Disease Control and Prevention.

Effects of Preoperative Breathing Exercise on Postoperative Outcomes for Patients With Lung Cancer Undergoing Curative Intent Lung Resection: A Meta-analysis.

Objective: To determine the benefits of preoperative breathing exercises on hospital length of stay (LOS), pneumonia, postoperative pulmonary complications (PPC), 6-minute walk distance (6MWD), forced expiratory volume in 1 second (FEV), and health-related quality of life (HRQOL) in patients undergoing surgical lung cancer resection.

Data Sources: PubMed, EMBASE, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials were comprehensively searched from inception to March 2021.

Study Selection: Only studies including preoperative inspiratory muscle training (IMT) and/or breathing exercises compared with a nontraining control group were included.

Case of haemophagocytic lymphohistiocytosis following Epstein-Barr virus infection.

Haemophagocytic lymphohistiocytosis (HLH) is a rare diagnosis that carries a high degree of mortality. We present this case of a previously healthy 22-year-old woman, who was admitted acutely ill to the hospital. One week prior, she had been seen by her primary care physician for fatigue and malaise.

Flip flop fungus sign: an FDG PET sign of benign pulmonary nodules.

A 71-year-old man was referred to pulmonary clinic for incidental findings of hypermetabolic lung nodule and mediastinal adenopathy on CT FDG PET performed for evaluation of cough. The patient underwent bronchoscopy with endobronchial ultrasound that was non-diagnostic. The patient was subsequently sent for video-assisted thoracoscopic lymph node biopsy notable for confluent caseating granulomas due to chronic infection by Review of previous PDG PET was notable for the flip flop fungus sign-a PDG PET finding that could have altered the patients' clinical course by potentially avoiding the need for invasive surgical tissue diagnosis.

Pancreaticopleural fistula: an uncommon cause of amylase-rich pleural effusion.

Pancreaticopleural fistula (PPF) causing pleural effusion as a complication of chronic pancreatitis is a rare finding. We present this finding in a 52-year-old man with a medical history significant for alcohol abuse, acute on chronic pancreatitis and severe chronic obstructive pulmonary disease, who presented with worsening dyspnoea for 3 days. CT scan of the chest showed a new large right-sided pleural effusion.

A Retrospective Observational Study of Domiciliary Oxygen Usage in a Subset of Veterans.

Background: Long-term oxygen therapy (LTOT) delivered continuously is known to decrease mortality in patients with COPD and who are hypoxemic; however, supportive data for LTOT use in patients without COPD is lacking. In addition, many patients may be prescribed LTOT without a definitive etiology for hypoxemia. First, we investigated the diagnoses for which oxygen was prescribed to a sample of veterans and whether each diagnosis was supported by confirmatory testing.

Positive Airway Pressure Adherence in Patients with Obstructive Sleep Apnea with Schizophrenia.

Introduction: To determine the 1-year and 3-year adherence rates with Positive Airway Pressure (PAP) therapy in patients with schizophrenia compared to matched controls.

Methods: A case-control retrospective analysis was performed in a Veterans Affairs hospital. All symptomatic patients with schizophrenia ever started on PAP therapy between 2007 and 2015 were compared with controls matched for severity of sleep apnea based on AHI, BMI, and age at the time of diagnosis.

Longer Duration of Palliative Care in Patients With COPD Is Associated With Death Outside the Hospital.

Patients with advanced chronic obstructive pulmonary disease (COPD) have a significant symptom burden despite maximal medical therapy, yet few are referred for concomitant palliative care. To evaluate the utilization and impact of palliative care on the location of death and to identify clinical variables associated with palliative care contact. Retrospective chart review from 2010 to 2016 at the VA Western New York Healthcare System using ICD-9/10 diagnosis of COPD.

Anti-interleukin (IL)-5 as a steroid-sparing agent in chronic eosinophilic pneumonia.

: Anti-interleukin (IL)-5 therapy is a novel drug class clinically effective in patients with diverse eosinophil-related disorders such as allergic eosinophilic asthma, eosinophilic granulomatosis with polyangiitis (EGPA), nasal polyposis, eosinophilic COPD, and other non-pulmonary disorders such as eosinophilic esophagitis. Chronic eosinophilic pneumonia (CEP) is a steroid responsive disorder, however, relapses are common following corticosteroid tapering. : We present the case of a 42-year-old woman with steroid-dependent relapsing CEP successfully treated with anti-IL-5 antibody.

Incidental Finding of Bronchopulmonary Sequestration in a 64-Year-Old Female.

Background: Bronchopulmonary sequestration is a congenital abnormality of the primitive foregut. In adults, the typical age at presentation is 20-25 years.

Case Report: A 64-year-old female was referred for evaluation of an 8 × 6-cm right lower lobe cystic lesion.

The Influence of Body Composition on Pulmonary Rehabilitation Outcomes in Chronic Obstructive Pulmonary Disease Patients.

Introduction: Alterations in body composition are commonly present in chronic obstructive pulmonary disease (COPD). The hypothesis of this study is that COPD patients would achieve clinical benefits after pulmonary rehabilitation (PR) independent of muscle mass depletion or body weight.

Methods: We conducted a retrospective cohort study using single-frequency bioelectrical impedance analysis (BIA) for assessment of fat-free mass (FFM) depletion (muscle depletion).

Endobronchial hamartoma; a rare structural cause of chronic cough.

Pulmonary hamartomas are rare benign tumors consisting of multiple mesenchymal cell lines like cartilage, bone and fat. We discuss an interesting case of a 53-year-old male patient, who was referred to our clinic for persistent cough. Chest X-ray revealed a left suprahilar density associated with plate like atelectasis, which on chest CT was found to be a densely calcified nodule, causing narrowing of the left upper lobe (LUL) bronchus with calcified bilateral hilar lymph nodes.

Endobronchial lipoma causing progressive dyspnea.

We describe a 63-year-old male who presented with progressive exertional dyspnea, post-obstructive pneumonia and chest CT findings of an endobronchial lesion. Bronchoscopy revealed an endobronchial lipoma, which was resected using snare electrocautery. Complete resolution of the patient's symptoms was noted following bronchoscopic resection.

Omalizumab versus Mepolizumab as add-on therapy in asthma patients not well controlled on at least an inhaled corticosteroid: A network meta-analysis.

Objective: The purpose of this study is to examine the comparative efficacy of Omalizumab (OMA) and Mepolizumab (Mepo) in the treatment of severe asthma by performing a network meta-analysis.

Method: Data Sources: A systematic review of the literature was performed through four databases from their inception to February 2016.

Study Selections: Randomized control trials and cohort studies were considered if they addressed the individual efficacy of OMA and Mepo in the treatment of asthma that was not well controlled on inhaled corticosteroids (ICSs) with or without other agents.

Comorbidities in Patients With Chronic Obstructive Pulmonary Disease and Pulmonary Rehabilitation Outcomes.

Purpose: The objective of this study was to evaluate the impact of comorbidities as potential predictors of the response to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD).

Methods: The study included 165 patients with COPD with exercise limitations. Comorbidity was classified as cardiac, metabolic, orthopedic, behavioral health problems, or other diseases.

Continuous Positive Airway Pressure Adherence In Patients with Obstructive Sleep Apnea & Symptomatic BPH.

Purpose To determine the short-term and long-term adherence rates with continuous positive airway pressure (CPAP) therapy in sleep apnea patients with benign prostatic hyperplasia (BPH) compared to matched controls. Methods A case-control retrospective analysis was performed in a veterans affairs hospital. All symptomatic patients with BPH (n = 107) ever started on CPAP therapy between 2006 and 2012 were compared with controls matched for severity of sleep apnea (AHI).