Airway Mucus Plugs on Chest Computed Tomography Are Associated with Exacerbations in COPD.

Unlabelled: Rationale/Objective: Acute exacerbations (AEs) of chronic obstructive pulmonary disease (COPD) are associated with significant morbidity and mortality. Whether mucus plugs are associated with prospective exacerbations has not been examined extensively.

Methods: Mucus plugs were visually-identified on baseline chest computed tomography (CT) scans from smokers with Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 2-4 COPD enrolled in two multicenter cohort studies: Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) and COPDGene.

Silent Airway Mucus Plugs in COPD and Clinical Implications.

Background: Airway mucus plugs are frequently identified on CT scans of patients with COPD with a smoking history without mucus-related symptoms (ie, cough, phlegm [silent mucus plugs]).

Research Question: In patients with COPD, what are the risk and protective factors associated with silent airway mucus plugs? Are silent mucus plugs associated with functional, structural, and clinical measures of disease?

Study Design And Methods: We identified mucus plugs on chest CT scans of participants with COPD from the COPDGene study. The mucus plug score was defined as the number of pulmonary segments with mucus plugs, ranging from 0 to 18, and categorized into three groups (0, 1-2, and ≥ 3).

Airway-Occluding Mucus Plugs and Mortality in Patients With Chronic Obstructive Pulmonary Disease.

Importance: Airway mucus plugs are common in patients with chronic obstructive pulmonary disease (COPD); however, the association of airway mucus plugging and mortality in patients with COPD is unknown.

Objective: To determine whether airway mucus plugs identified on chest computed tomography (CT) were associated with increased all-cause mortality.

Design, Setting, And Participants: Observational retrospective analysis of prospectively collected data of patients with a diagnosis of COPD in the Genetic Epidemiology of COPD cohort.

Smoldering myocarditis following immune checkpoint blockade.

Background: Severe myocarditis associated with electrical conduction abnormalities and occasionally heart failure has been well documented following treatment with immune checkpoint blockade with an estimated incidence of less than 1%. However, the incidence, early detection, and management of less severe immune-related myocarditis are unknown since most immunotherapy trials have not included routine cardiac monitoring. Herein, we provide the first description of subclinical or smoldering myocarditis with minimal signs and symptoms following immune checkpoint blockade with a single dose of ipilimumab and nivolumab.

Response of BRAF inhibitor-associated squamous cell lung carcinoma to drug withdrawal.

Vemurafenib and dabrafenib, two Food and Drug Administration-approved selective BRAF kinase inhibitors (BRAFi), have revolutionized the targeted therapy of cutaneous melanoma. Off-target effects of these drugs paradoxically activate the MAP kinase pathway in BRAF wild-type cells, leading to secondary malignancies. Although cutaneous squamous cell carcinomas are by far the most frequent, emergence of potentially life-threatening secondary tumors from other sites following prolonged therapy is a growing concern.

Improved identification of sternal injuries with multidetector computed tomography (MDCT): sagittal reconstructions.

Chest computed tomography is acquired in the axial plane, but sternal injuries may be missed on axial images. This study hypothesized that sagittal sternal reconstruction images improve detection of sternal injury and radiologist's confidence in diagnosis compared to axial images. Five radiologists independently reviewed first axial images and on a different day sagittal images of a retrospective set of trauma cases recording presence/absence of a sternal injury and/or adjacent hematoma.

Association Between Expiratory Central Airway Collapse and Respiratory Outcomes Among Smokers.

Importance: Central airway collapse greater than 50% of luminal area during exhalation (expiratory central airway collapse [ECAC]) is associated with cigarette smoking and chronic obstructive pulmonary disease (COPD). However, its prevalence and clinical significance are unknown.

Objective: To determine whether ECAC is associated with respiratory morbidity in smokers independent of underlying lung disease.

Pneumonia in hemodialysis patients: a challenging diagnosis in the emergency room.

Background: Diagnosing pneumonia in hemodialysis patients is challenging. We hypothesized that pulmonary edema, which occurs commonly in hemodialysis patients, may frequently be misdiagnosed as pneumonia.

Methods: We retrospectively reviewed the records of 105 hemodialysis patients admitted with the diagnosis of pneumonia.