Microscopic Small Airway Abnormalities Identified in Early Idiopathic Pulmonary Fibrosis Using Endobronchial Optical Coherence Tomography.

Idiopathic pulmonary fibrosis (IPF) affects the subpleural lung but is considered to spare small airways. Micro-computed tomography (micro-CT) studies demonstrated small airway reduction in end-stage IPF explanted lungs, raising questions about small airway involvement in early-stage disease. Endobronchial optical coherence tomography (EB-OCT) is a volumetric imaging modality that detects microscopic features from subpleural to proximal airways.

Rapid non-destructive volumetric tumor yield assessment in fresh lung core needle biopsies using polarization sensitive optical coherence tomography.

Adequate tumor yield in core-needle biopsy (CNB) specimens is essential in lung cancer for accurate histological diagnosis, molecular testing for therapeutic decision-making, and tumor biobanking for research. Insufficient tumor sampling in CNB is common, primarily due to inadvertent sampling of tumor-associated fibrosis or atelectatic lung, leading to repeat procedures and delayed diagnosis. Currently, there is no method for rapid, non-destructive intraprocedural assessment of CNBs.

Diagnostic Accuracy of Endobronchial Optical Coherence Tomography for the Microscopic Diagnosis of Usual Interstitial Pneumonia.

Early, accurate diagnosis of interstitial lung disease (ILD) informs prognosis and therapy, especially in idiopathic pulmonary fibrosis (IPF). Current diagnostic methods are imperfect. High-resolution computed tomography has limited resolution, and surgical lung biopsy (SLB) carries risks of morbidity and mortality.

Pain in Veterans with COPD: relationship with physical activity and exercise capacity.

Background: Pain is a common but underappreciated symptom experienced by people with Chronic Obstructive Pulmonary Disease (COPD). The relationships between pain and physical activity (PA) and exercise capacity are poorly understood.

Methods: This retrospective secondary analysis includes three cohorts of Veterans with COPD who participated in longitudinal studies evaluating PA and exercise capacity with objective measures of daily step counts and 6-min walk test (6MWT) distance, respectively.

Feasibility and Limitations of Proning Protocol for Nonintubated Patients With COVID-19.

Proning awake patients with COVID-19 is associated with lower mortality and intubation rates. However, these studies also demonstrate low participation rates and tolerance of awake proning. In this study, we attempt to understand barriers to proning.

An unusual case of button battery-induced traumatic tracheoesophageal fistula.

Background: Much of pediatric medicine is focused on prevention of disease and injury. Although accidental ingestions of various household chemicals and medicines are well described and the treatment is supported by local poison control hotlines, the ingestion of button batteries by children is less publicized, and the dangers are less understood by both parents and health care providers.

Methods: We describe a case report of a 17-month-old girl with no significant medical history who presented with respiratory distress, cough, and fever and subsequently was discovered to have ingested a button battery.

Beyond the professional fee: basic legal issues for physicians investing in the technical side of healthcare services, part 2.

As reimbursement for professional services shrinks compared with physicians' educational debt and practice expenses, physicians are looking for additional sources of revenue to supplement their practice income. A natural option to consider is investment in healthcare entities or equipment in order to share in the technical fees generated by such entities or equipment. Part 1 of this article reviewed relevant legal authorities and common investment opportunities.

Beyond the professional fee, Part 1: Basic legal issues for physicians investing in the technical side of healthcare services.

As reimbursement for professional services shrinks in comparison with physicians' educational debt and practice expenses, physicians are looking for additional sources of revenue to supplement their practice income. A natural option to consider is investment in healthcare entities or equipment in order to share in the technical fees generated by such entities or equipment.

Hospital costs of pediatric intensive care.

Objective: To characterize hospital costs of pediatric intensive care and to determine which demographic and disease characteristics are associated with cost.

Design: Prospective cohort study.

Setting: A 20-bed pediatric intensive care unit (PICU) in an urban university-affiliated teaching children's hospital.

Descriptive analysis of critical care units in the United States: patient characteristics and intensive care unit utilization.

Objective: To gather data about occupancy, admission characteristics, patients' ages, and types of therapy utilized in ICUs in the United States.

Design And Setting: Survey instruments were mailed to the administrators of 4,233 hospitals to gather information from the medical director of the institutions' respective ICUs for the purpose of developing a database on ICUs in the United States. The sampling frame for this study was based on all American Hospital Association (AHA) hospitals stating they had ICUs.

Undergraduate education in critical care medicine.

Objective: To review the current status and future needs of medical students with respect to education in critical care medicine.

Data Sources: Literature review and questionnaire administered at the 1990 Educational and Scientific Symposium of the Society of Critical Care Medicine.

Measurements And Main Results: Medical students are presently not required to master even the basic aspects of critical care medicine before licensing.

Descriptive analysis of critical care units in the United States.

Objective: To gather data about available technology, staffing, administrative policies, and bed capacities of ICUs in the United States.

Design And Setting: On January 15, 1991, survey instruments were mailed to the administrators of 4,233 hospitals to gather information from the medical director of the institutions' respective ICUs for the purpose of developing a database on ICUs in the United States. The sampling frame for this study was based on all American Hospital Association (AHA) hospitals that stated they have ICUs.

Pulmonary mechanics in infants after cardiac surgery.

Objective: To determine pulmonary mechanical characteristics in neonates after cardiac surgery.

Design: A prospective study.

Setting: A 23-bed, pediatric ICU in a 280-bed children's hospital.

Endotracheal tube leak pressure and tracheal lumen size in swine.

Endotracheal tube "leak" is often estimated in children to judge the fit of uncuffed endotracheal tubes within the trachea. Twenty-five swine were intubated with uncuffed tracheal tubes to determine whether a more sensitive measurement of leaks could be devised and whether leak pressure estimates fit between tracheal tube and trachea. We compared leak pressure measurement using a stethoscope and aneroid manometer with a technique using a microphone, pressure transducer, and recorder, and found no differences between the two methods.

Factors affecting leak around tracheal tubes in children.

This study determined which variables affected endotracheal tube "leak" pressures in 80 surgical patients, two weeks to 11 years of age, intubated with uncuffed tracheal tubes. We defined "leak" pressure as the inspiratory pressure needed to cause an audible escape of gas around the endotracheal tube. "Leak" pressure was measured after varying either head position, tracheal tube depth within the trachea, fresh gas flow rate, or degree of neuromuscular block.