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  • 刊频： Twelve issues a year, 2015-
  • NLM标题： Ann Am Thorac Soc
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  • 1.

    【2hr】Risk Factors for and Prediction of Hypoxemia during Tracheal Intubation of Critically Ill Adults

    包量

    机译 重症成人气管插管中低氧血症的危险因素和预测
    摘要：Rationale: Hypoxemia is a common complication during tracheal intubation of critically ill adults and is a frequently used endpoint in airway management research. Identifying patients likely to experience low oxygen saturations during tracheal intubation may be useful for clinical practice and clinical trials.Objectives: To identify risk factors for lower oxygen saturations and severe hypoxemia during tracheal intubation of critically ill adults and develop prediction models for lowest oxygen saturation and hypoxemia.Methods: Using data on 433 intubations from two randomized trials, we developed linear and logistic regression models to identify preprocedural risk factors for lower arterial oxygen saturations and severe hypoxemia between induction and 2 minutes after intubation. Penalized regression was used to develop prediction models for lowest oxygen saturation after induction and severe hypoxemia. A simplified six-point score was derived to predict severe hypoxemia.Results: Among the 433 intubations, 426 had complete data and were included in the model. The mean (standard deviation) lowest oxygen saturation was 88% (14%); median (interquartile range) was 93% (83–98%). Independent predictors of severe hypoxemia included hypoxemic respiratory failure as the indication for intubation (odds ratio [OR], 2.70; 95% confidence interval [CI], 1.58–4.60), lower oxygen saturation at induction (OR, 0.92 per 1% increase; 95% CI, 0.89–0.96 per 1% increase), younger age (OR, 0.97 per 1-year increase; 95% CI, 0.95–0.99 per 1-year increase), higher body mass index (OR, 1.03 per 1 kg/m2; 95% CI, 1.00–1.06 per 1 kg/m2), race (OR, 4.58 for white vs. black; 95% CI, 1.97–10.67; OR, 4.47 for other vs. black; 95% CI, 1.19–16.84), and operator with fewer than 100 prior intubations (OR, 2.83; 95% CI, 1.37–5.85). A six-point score using the identified risk factors predicted severe hypoxemia with an area under the receiver operating curve of 0.714 (95% CI, 0.653 to 0.778).Conclusions: Lowest oxygen saturation and severe hypoxemia during tracheal intubation in the intensive care unit can be accurately predicted using routinely available preprocedure clinical data, with saturation at induction and hypoxemic respiratory failure being the strongest predictors. A simple bedside score may identify patients at risk for hypoxemia during intubation to help target preventative interventions and facilitate enrichment in clinical trials.
  • 2.

    【2hr】Prominent Bronchopulmonary Vascular Anastomoses in Fatal Childhood Asthma

    包量

    机译 致命性儿童哮喘中的明显支气管肺血管吻合
    摘要：
  • 3.

    【2hr】Incidence of Suicide and Association with Palliative Care among Patients with Advanced Lung Cancer

    包量

    机译 晚期肺癌患者的自杀发生率及与姑息治疗的关联
    摘要：
  • 4.

    【2hr】Intracellular Processing of Human Secreted Polymeric Airway Mucins

    包量

    机译 人类分泌的聚合性气道粘蛋白的细胞内加工
    摘要：Mucociliary clearance is a crucial component of innate defense of the lung. In respiratory diseases, such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis, mucus with abnormal properties contributes to obstruction of the airways. The failure in function of mucus in airway clearance and pathogen protection leads to chronic infection and risk of death. Polymeric mucins (MUC5AC and MUC5B) provide the structural framework of the airway mucus gel. The intracellular synthesis and assembly of these enormous, polymeric O-linked glycoproteins is a complex, multistage process involving intra- and intermolecular disulfide bond formation and extensive addition of O-glycan chains. The fully formed polymers are packaged in a highly organized and condensed form within secretory granules inside specialized secretory cells, and after the appropriate stimulus, mucins are released and expand to form mucus. This short article brings together the current knowledge on the different steps in the production of mucin polymers and the molecular mechanisms that condense them into a packaged form in secretory granules. It is by unraveling the molecular mechanisms that control intracellular mucin supramolecular structure that we might gain new insight into what determines mucus gel properties in health and disease.
  • 5.

    【2hr】Restrictive Spirometry Pattern, Cardiac Structure and Function, and Incident Heart Failure in African Americans. The Jackson Heart Study

    包量

    机译 非裔美国人的限制性肺量计模式，心脏结构和功能以及突发性心力衰竭。杰克逊心脏研究
    摘要：Rationale: Although chronic obstructive pulmonary disease has been related to heart failure, the relationship between the restrictive spirometry pattern (forced vital capacity [FVC] < 80% predicted with preserved forced expiratory volume in 1 second [FEV1]/FVC ratio) and heart failure is poorly understood.Objectives: To determine whether having a restrictive spirometry pattern is associated with incident heart failure hospitalization.Methods: Community-dwelling African Americans from the Jackson Heart Study (total n = 5,306; analyzed n = 4,210 with spirometry and heart failure outcome data) were grouped by restrictive spirometry (FEV1/FVC ≥ 0.70, FVC < 80%; n = 840), airflow obstruction (FEV1/FVC < 0.70; n = 341), and normal spirometry (FEV1/FVC ≥ 0.70, FVC ≥ 80%; n = 3,029) at the time of baseline examination in 2000–2004. We assessed relationships of echocardiographic parameters and biomarkers with spirometry patterns using regression models. Incident heart failure was defined as an adjudicated hospitalization for heart failure after January 1, 2005 in subjects with no self-reported heart failure history. We used multivariable-adjusted Poisson regression models and Cox proportional hazards models, with death treated as a competing risk in the Cox models, to test associations between spirometry patterns and incident heart failure. We also modeled the association of FVC% predicted with heart failure hospitalization risk using a restricted cubic spline after excluding subjects with airflow obstruction.Results: At the time of baseline spirometry, participants with restrictive spirometry had a median age of 57.2 years (interquartile range, 47.8–64.1); 38.1% were male. Compared with normal spirometry, restrictive spirometry was associated with a higher transmitral early (E) wave velocity to atrial (A) wave velocity ratio, higher pulmonary artery systolic pressure, and higher endothelin levels. After a median follow-up time of 8.0 years, 8.0% of subjects with restrictive spirometry (n = 67) had developed incident heart failure, compared with 3.8% of those with normal spirometry (n = 115) and 10.6% of those with airflow obstruction (n = 36). After risk adjustment, both a restrictive pattern (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.1–2.0) and airflow obstruction (HR, 1.7; 95% CI, 1.1–2.5) were associated with increased rates of incident heart failure hospitalization compared with normal spirometry. Using flexible modeling, the lowest hazards of heart failure hospitalization were observed around FVC 90–100%, with lower FVC% values associated with an increased incidence of heart failure.Conclusions: Both a restrictive pattern on spirometry and airflow obstruction identify African Americans with impaired lung health at risk for heart failure.
  • 6.

    【2hr】Nicotine Dependence: Future Opportunities and Emerging Clinical Challenges

    包量

    机译 尼古丁依赖：未来的机会和新兴的临床挑战
    摘要：
  • 7.

    【2hr】Association between Inhaled Corticosteroid Use and Pulmonary Nontuberculous Mycobacterial Infection

    包量

    机译 吸入糖皮质激素的使用与肺非结核分枝杆菌感染之间的关联
    摘要：Rationale: Nontuberculous mycobacterial (NTM) pulmonary disease prevalence is increasing.Objectives: To determine the association between the use of inhaled corticosteroids and the likelihood of NTM pulmonary infection among individuals with treated airway disease.Methods: We conducted a case–control study of subjects with airway disease with and without NTM pulmonary infection (based on mycobacterial respiratory cultures) between 2000 and 2010 in northern California. We quantified the use of inhaled corticosteroids, other airway disease medications, and healthcare use within 6 months of NTM pulmonary infection identification. We used 1:10 case–control matching and conditional logistic regression to evaluate the association between the duration and cumulative dosage of inhaled corticosteroid use and NTM pulmonary infection.Results: We identified 248 cases with NTM pulmonary infection with an estimated rate of 16.4 cases per 10,000 subjects treated for airway disease. The median interval between treated airway disease cohort entry (defined as date of patient filling the third airway disease treatment prescription) and NTM case identification was 1,217 days. Compared with control subjects, subjects with NTM pulmonary infection were more likely to use airway disease medications including systemic steroids; they were also more likely to use health care. Any inhaled corticosteroids use between 120 days and 2 years before cohort entry was associated with substantially increased odds of NTM infection. For example, the adjusted odds ratio for NTM infection among inhaled corticosteroid users in a 2-year interval was 2.51 (95% confidence interval, 1.40–4.49; P < 0.01). Increasing cumulative inhaled corticosteroid dose was also associated with greater odds of NTM infection.Conclusions: Inhaled corticosteroid use, and particularly high-dose inhaled corticosteroid use, was associated with an increased risk of NTM pulmonary infection.
  • 8.

    【2hr】Actigraphy to Evaluate Sleep in the Intensive Care Unit. A Systematic Review

    包量

    机译 评估重症监护病房睡眠的书法。系统评价
    摘要：Rationale: Poor sleep quality is common in the intensive care unit (ICU) and may be associated with adverse outcomes. Hence, ICU-based efforts to promote sleep are gaining attention, motivating interest in methods to measure sleep in critically ill patients. Actigraphy evaluates rest and activity by algorithmically processing gross motor activity data, usually collected by a noninvasive wristwatch-like accelerometer device. In critically ill patients, actigraphy has been used as a surrogate measure of sleep; however, its use has not been systematically reviewed.Objectives: To conduct a systematic review of ICU-based studies that used actigraphy as a surrogate measure of sleep, including its feasibility, validity, and reliability as a measure of sleep in critically ill patients.Methods: We searched PubMed, EMBASE, CINAHL, Proquest, and Web of Science for studies that used actigraphy to evaluate sleep in five or more patients in an ICU setting.Results: Our search yielded 4,869 citations, with 13 studies meeting eligibility criteria. These 13 studies were conducted in 10 countries, and eight (62%) were published since 2008. Across the 13 studies, the mean total sleep time of patients in the ICU, as estimated using actigraphy, ranged from 4.4 to 7.8 hours at nighttime and from 7.1 to 12.1 hours over a 24-hour period, with 1.4 to 49.0 mean nocturnal awakenings and a sleep efficiency of 61 to 75%. When compared side-by-side with other measures of sleep (polysomnography, nurse assessments, and patient questionnaires), actigraphy consistently yielded higher total sleep time and sleep efficiency, fewer nighttime awakenings (vs. polysomnography), and more overall awakenings (vs. nurse assessment and patient questionnaires). None of the studies evaluated the association between actigraphy-based measures of sleep and outcomes of patients in the ICU.Conclusions: In critically ill patients, actigraphy is being used more frequently as a surrogate measure of sleep; however, because actigraphy only measures gross motor activity, its ability to estimate sleep is limited by the processing algorithm used. Prior ICU-based studies involving actigraphy were heterogeneous and lacked data regarding actigraphy-based measures of sleep and patient outcomes. Larger, more rigorous and standardized studies are needed to better understand the role of actigraphy in evaluating sleep and sleep-related outcomes in critically ill patients.
  • 9.

    【2hr】Defining the Value Proposition for Specialist Palliative Care Delivered in Intensive Care Units

    包量

    机译 定义重症监护病房提供的专科姑息治疗的价值主张
    • 作者：Christopher E. Cox
    • 刊名：Annals of the American Thoracic Society
    • 2018年第9期
    摘要：
  • 10.

    【2hr】Association between the Availability of Hospital-based Palliative Care and Treatment Intensity for Critically Ill Patients

    包量

    机译 重症患者的医院姑息治疗的可获得性与治疗强度之间的关联
    摘要：Rationale: In the intensive care unit (ICU), studies involving specialized palliative care services have shown decreases in the use of nonbeneficial life-sustaining therapies and ICU length of stay for patients. However, whether widespread availability of hospital-based palliative care is associated with less frequent use of high intensity care is unknown.Objectives: To determine whether availability of hospital-based palliative care is associated with decreased markers of treatment intensity for ICU patients.Methods: Retrospective cohort study of adult ICU patients in New York State hospitals, 2008–2014. Multilevel regression was used to assess the relationship between availability of hospital-based palliative care during the year of admission and hospital length of stay, use of mechanical ventilation, dialysis and artificial nutrition, placement of a tracheostomy or gastrostomy tube, days in ICU and discharge to hospice.Results: Of 1,025,503 ICU patients in 151 hospitals, 814,794 (79.5%) received care in a hospital with a palliative care program. Hospital length of stay was similar for patients in hospitals with and without palliative care programs (6 d [interquartile range, 3–12] vs. 6 d [interquartile range, 3–11]; adjusted rate ratio, 1.04 [95% confidence interval 1.03–1.05]; P < 0.001), as were other healthcare use outcomes. However, patients in hospitals with palliative care programs were 46% more likely to be discharged to hospice than those in hospitals without palliative care programs (1.7% vs. 1.4%; adjusted odds ratio, 1.46 [95% confidence interval 1.30–1.64]; P < 0.001).Conclusions: The availability of hospital-based palliative care was not associated with differences in in-hospital treatment intensity, but it was associated with significantly increased hospice use for ICU patients. Currently, the measurable benefit of palliative care programs for critically ill patients may be the increased use of hospice facilities, as opposed to decreased healthcare use during an ICU-associated hospitalization.
  • 11.

    【2hr】Myocardial Infarction and Ischemic Stroke after Exacerbations of Chronic Obstructive Pulmonary Disease

    包量

    机译 慢性阻塞性肺疾病加重后的心肌梗塞和缺血性卒中
    摘要：Rationale: Previous studies have suggested that acute exacerbations of chronic obstructive pulmonary disease (COPD) may be associated with increased risk of myocardial infarction and ischemic stroke.Objectives: We aimed to quantify the increased risks of myocardial infarction and ischemic stroke risk associated with both moderate and severe acute exacerbation, and to investigate factors that may modify these risks.Methods: We performed a self-controlled case series to investigate the rates of myocardial infarction and ischemic stroke after acute exacerbation compared with stable time, within individuals. The participants were 5,696 adults with COPD with a first myocardial infarction (n = 2,850) or ischemic stroke (n = 3,010) and at least one acute exacerbation from the UK Clinical Practice Research Datalink with linked Hospital Episodes Statistics data.Results: The risks of both myocardial infarction and ischemic stroke were increased in the 91 days after an acute exacerbation. The risks were greater after a severe exacerbation (incidence rate ratio [IRR], 2.58; 95% confidence interval [CI], 2.26–2.95 for myocardial infarction; and IRR, 1.97; 95% CI, 1.66–2.33 for ischemic stroke) than after a moderate exacerbation (IRR, 1.58; 95% CI, 1.46–1.71 for myocardial infarction; and IRR, 1.45; 95% CI, 1.33–1.57 for ischemic stroke). The relative risks of myocardial infarction and ischemic stroke associated with acute exacerbation were lower among those with more frequent exacerbations (IRR, 1.42; 95% CI, 1.24–1.62 vs. IRR, 1.69; 95% CI, 1.50–1.91 for myocardial infarction; and IRR, 1.30; 95% CI, 1.15–1.48 vs. IRR, 1.68; 95% CI, 1.50–1.89 for ischemic stroke). Higher GOLD stage was associated with a lower rate of myocardial infarction (IRR, 1.98; 95% CI, 1.61–2.05 vs. IRR, 1.69; 95% CI, 1.45–1.98) but not for ischemic stroke. Aspirin use at baseline was associated with a lower risk of ischemic stroke (IRR, 1.28; 95% CI, 1.10–1.50 vs. IRR, 1.63; 95% CI, 1.47–1.80) but not with myocardial infarction.Conclusions: Acute exacerbations of COPD are associated with an increased risk of myocardial infarction and ischemic stroke within 28 days of their onset. Several patient characteristics were identified that are associated with these events.
  • 12.

    【2hr】Health Services Utilization in Asthma Exacerbations and PM10 Levels in Rural Colorado

    包量

    机译 科罗拉多州农村地区哮喘急性发作和PM10水平的卫生服务利用
    摘要：Rationale: The San Luis Valley in rural Colorado often has elevated levels of ambient particulate matter. To date little is known about the impact of ambient particulate matter levels and medical care utilization due to asthma exacerbation in rural communities.Objectives: We investigated the impact of ambient particulate matter concentrations on emergency/urgent visits and hospitalizations for asthma in a rural community.Methods: Daily ambient particulate matter concentrations from an air quality monitor in the San Luis Valley (2003–2012) were obtained from the state health department. Deidentified data for emergency/urgent visits with a diagnosis code for asthma were collected from the local health care system organization. A generalized linear model using splines and employing generalized estimating equations for correlated measures over time was used to examine the association between daily counts of emergency/urgent visits for asthma and 3- to 5-day averaged ambient particulate matter concentrations.Results: For each 15-μg/m3 increase in 3-day averaged ambient particulate matter, there was an associated 3.1% increase in hospital counts for all patients with asthma (95% confidence interval, 0.3–5.9%; P = 0.03). When the 3-day average exceeded 50 μg/m3, asthma hospital visits increased by 16.8% (P = 0.03), and when it exceeded 100 μg/m3, visits increased by 65.8% (P = 0.002). In children, the odds of one asthma event requiring an emergency/urgent care visit increased 5.0% with each 15-μg/m3 increase in 3-day averaged ambient particulate matter (P = 0.22).Conclusions: We observed associations between ambient air levels of particulate matter with a diameter less than 10 μm and emergency/urgent care visits and hospitalization counts in a rural U.S. community prone to dust storms and Environmental Protection Agency exceedances.
  • 13.

    【2hr】Association between Obstructive Sleep Apnea and Cardiovascular Risk Factors: Variation by Age, Sex, and Race. The Multi-Ethnic Study of Atherosclerosis

    包量

    机译 阻塞性睡眠呼吸暂停与心血管危险因素之间的关联：年龄，性别和种族的差异。动脉粥样硬化的多民族研究
    摘要：Rationale: The association between obstructive sleep apnea (OSA) and cardiovascular disease (CVD) is complex, bidirectional, and may vary across groups. Understanding which cardiovascular risk factors vary in their relationship to OSA across population groups may improve knowledge of OSA-related CVD susceptibility.Objectives: To better understand the heterogeneity of associations, we assessed whether associations of OSA with cardiovascular risk factors vary by age, sex, and race/ethnicity.Methods: We performed cross-sectional analyses of 1,344 Multi-Ethnic Study of Atherosclerosis participants who underwent overnight full polysomnography, assays of fasting blood, and assessments of cardiovascular risk factors. Risk factors considered were blood pressure, glucose/lipid concentrations, white blood cell (WBC) total and subset counts, and cystatin C. The outcome was the apnea–hypopnea index (AHI). Linear regression analyses with tests for interactions were conducted.Results: The sample had a mean age of 68 ± 9 years. Forty-seven percent of the sample was male, and 32% had moderate or severe OSA (AHI, ≥15). Multivariable adjusted analysis showed significant associations between higher AHI with lower high-density lipoprotein cholesterol and higher diastolic blood pressure and neutrophil counts. Significant interactions with demographic factors were observed. Stronger associations were shown between AHI and higher total WBC count (Pint = 0.006) and glucose concentrations (Pint = 0.006) in younger (<65 yr) than in older individuals, higher triglyceride concentrations in men than in women (Pint = 0.006), and higher total WBC (Pint = 0.07) and monocyte counts (Pint = 0.03) in African American individuals than in other racial groups.Conclusions: In a multiethnic cohort, we found increased levels of cardiovascular risk factors in association with OSA, including elevated neutrophil counts, a marker of inflammation. Furthermore, several associations were stronger in men, younger individuals, and African American individuals, highlighting pathways for CVD risk that may explain heterogeneity in the associations between CVD and OSA across population groups.
  • 14.

    【2hr】Early Hospital Readmissions after an Acute Exacerbation of Chronic Obstructive Pulmonary Disease in the Nationwide Readmissions Database

    包量

    机译 全国再入院数据库中慢性阻塞性肺疾病急性加重后的早期医院入院
    摘要：Rationale: Understanding the causes and factors related to readmission for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) within a nationwide database including all payers and ages can provide valuable input for the development of generalizable readmission reduction strategies.Objectives: To determine the rates, causes, and predictors for early (3-, 7-, and 30-d) readmission in patients hospitalized with AECOPD in the United States using the Nationwide Readmission Database after the initiation of the Hospital Readmissions Reduction Program, but before its expansion to COPD.Methods: We conducted an analysis of the Nationwide Readmission Database from 2013 to 2014. Index admissions and readmissions for an AECOPD were defined consistent with Hospital Readmissions Reduction Program guidelines. We investigated the percentage of 30-day readmissions occurring each day after discharge and the most common readmission diagnoses at different time periods after hospitalization. The relationship between predictors (categorized as patient, clinical, and hospital factors) and early readmission were evaluated using a hierarchical two-level logistic model. To examine covariate effects on early-day readmission, predictors for 3-, 7-, and 30-day readmissions were modeled separately.Results: There were 202,300 30-day readmissions after 1,055,830 index AECOPD admissions, a rate of 19.2%. The highest readmission rates (4.2–5.5%) were within the first 72 hours of discharge, and 58% of readmissions were within the first 15 days. Respiratory-based diseases were the most common reasons for readmission (52.4%), and COPD was the most common diagnosis (28.4%). Readmission diagnoses were similar at different time periods after discharge. Early readmission was associated with patient (Medicaid payer status, lower household income, and higher comorbidity burden) and clinical factors (longer length of stay and discharge to a skilled nursing facility). Predictors did not vary substantially by time of readmission after discharge within the 30-day window.Conclusions: Thirty-day readmissions after an AECOPD remain a major healthcare burden, and are characterized by a similar spectrum of readmission diagnoses. Predictors associated with readmission include both patient and clinical factors. Development of a COPD-specific risk stratification algorithm based on these factors may be necessary to better predict patients with AECOPD at high risk of early readmission.
  • 15.

    【2hr】The Cost of Caring: Emotion, Burnout, and Psychological Distress in Critical Care Clinicians

    包量

    机译 关爱的代价：重症监护医生的情绪，倦怠和心理困扰
    摘要：
  • 16.

    【2hr】Otolaryngology in Critical Care

    包量

    机译 重症监护中的耳鼻喉科
    摘要：Diseases affecting the ear, nose, and throat are prevalent in intensive care settings and often require combined medical and surgical management. Upper airway occlusion can occur as a result of malignant tumor growth, allergic reactions, and bleeding events and may require close monitoring and interventions by intensivists, sometimes necessitating surgical management. With the increased prevalence of immunocompromised patients, aggressive infections of the head and neck likewise require prompt recognition and treatment. In addition, procedure-specific complications of major otolaryngologic procedures can be highly morbid, necessitating vigilant postoperative monitoring. For optimal outcomes, intensivists need a broad understanding of the pathophysiology and management of life-threatening otolaryngologic disease.
  • 17.

    【2hr】Underreporting of Interstitial Lung Abnormalities on Lung Cancer Screening Computed Tomography

    包量

    机译 肺癌筛查计算机断层扫描对间质性肺异常的报道不足
    摘要：
  • 18.

    【2hr】Diet Pattern and Respiratory Morbidity in the Atherosclerosis Risk in Communities Study

    包量

    机译 社区研究中动脉粥样硬化风险中的饮食模式和呼吸道疾病
    摘要：Rationale: Dietary intake is a potential risk factor for respiratory morbidity in adult populations. Few studies capture the effect of dietary patterns, representative of the combination of nutrients consumed, on self-reported respiratory morbidity in combination with objective measures of lung function.Objectives: To evaluate patterns of dietary intake in relation to respiratory morbidity and objective measures of lung function in a U.S. population.Methods: The ARIC (Atherosclerosis Risk in Communities) study investigators enrolled 15,792 participants from four U.S. communities between 1987 and 1989 and collected data using a validated food frequency questionnaire to assess diet. Principal component analysis was applied, and patterns representative of “Western” and “Prudent” diets emerged. We investigated cross-sectional associations between dietary patterns and pulmonary assessments that included asthma and chronic obstructive pulmonary disease (COPD) diagnosis, respiratory symptoms, and lung function. Multivariable Poisson regression models included quintiles of dietary patterns and potential confounders. Interaction of dietary patterns with obesity, sex, and smoking status was assessed in relation to all outcomes.Results: Higher scores in the “Western” dietary pattern (quintile 5 vs. quintile 1) were associated with higher prevalence of COPD (prevalence ratio [PR], 1.62; 95% confidence ratio [CI], 1.33–1.97), wheeze (PR, 1.37; 95% CI, 1.11–1.69), cough (PR, 1.32; 95% CI, 1.32–1.59), and phlegm (PR, 1.27; 95% CI, 1.05–1.54) and lower percent predicted forced expiratory volume in 1 second (FEV1), percent predicted forced vital capacity (FVC), and FEV1/FVC ratio. Higher scores in the “Prudent” dietary pattern (quintile 5 vs. quintile 1) were associated with lower prevalence of COPD (PR, 0.82; 95% CI, 0.70–0.95) and cough (PR, 0.77; 95% CI, 0.67–0.89) and higher percent predicted FEV1 and FEV1/FVC ratio. The prevalence of asthma was not related to dietary intake.Conclusions: A “Western” dietary pattern was associated with respiratory symptoms, lower lung function, and COPD in ARIC participants.
  • 19.

    【2hr】Intrapleural Fibrinolytic Therapy for Empyema and Pleural Loculation: Knowns and Unknowns

    包量

    机译 脓胸和胸膜定位的胸膜内纤溶治疗：已知和未知
    摘要：
  • 20.

    【2hr】Integrating Geriatric Principles into Critical Care Medicine: The Time Is Now

    包量

    机译 将老年医学原理纳入重症监护医学：时机已到
    摘要：
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