Chest Medicine

Long term risk of symptomatic recurrent venous thromboembolism after discontinuation of anticoagulant treatment for first unprovoked venous thromboembolism event: systematic review and meta-analysis – The BMJ (free)

Commentary: Long-Term Risk for Recurrent VTE Significant After Stopping Anticoagulation – NEJM Journal Watch (free)

“the risk of recurrent VTE was 10% in the first year after treatment, 16% at two years, 25% at five years, and 36% at 10 years, with 4% of recurrent VTE events resulting in death.”


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Review: Diaphragmatic Dysfunction

14 Jul, 2019 | 19:45h | UTC

GINA 2019: a fundamental change in asthma management – European Respiratory Journal (free)

Original Guideline: 2019 GINA Report, Global Strategy for Asthma Management and Prevention (free PDF)

Related Studies: #ATS2019 – Controlled Trial of Budesonide–Formoterol as Needed for Mild Asthma (link to abstract and commentaries) AND Randomized Controlled Trials: Treatments for Mild Asthma Compared (link to abstract and commentaries)

“GINA no longer recommends treating adults/adolescents with asthma with short-acting bronchodilators alone. Instead, they should receive symptom-driven (in mild asthma) or a daily corticosteroid-containing inhaler, to reduce risk of severe exacerbations.”


Miracle medical machine ECMO makes heroic rescues, but leaves patients in limbo – Kaiser Health News / USA Today (free)

“ECMO is not designed to be a destination, but a bridge to somewhere – recovery, transplantation or an implanted heart device. But when patients are too sick to reach those goals, ECMO can become a “bridge to nowhere,” leaving the patient in limbo…”


Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Setting Positive End-Expiratory Pressure in Mechanically Ventilated Patients Undergoing Surgery (free)


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Eosinophil-guided corticosteroid therapy in patients admitted to hospital with COPD exacerbation (CORTICO-COP): a multicentre, randomised, controlled, open-label, non-inferiority trial – The Lancet Respiratory Medicine (link to abstract – $ for full-text)

Commentary: 2 Minute Medicine Rewind May 20, 2019 (4th Summary)

See also: Video Summary – Medwire News (free audio)


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Controlled Trial of Budesonide–Formoterol as Needed for Mild Asthma – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Treatment Changes for Mild Asthma? – NEJM Journal Watch (free)

Just Presented at the 2019 Meeting of the American Thoracic Society.


Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries: Sedation and controlled paralysis do not improve survival of ICU patients with ARDS – University of Pittsburgh (free)

Just Presented at the 2019 Meeting of the American Thoracic Society.


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Indian Guidelines for Spirometry

9 May, 2019 | 18:23h | UTC

Positional therapy for obstructive sleep apnoea – Cochrane Library (free)

Summary: Are interventions to keep people sleeping on their side the best way to treat obstructive sleep apnoea? – Cochrane Library (free)


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Review: Tumoral Pulmonary Hypertension

20 Apr, 2019 | 14:43h | UTC

Effect of an Incentive Spirometer Patient Reminder After Coronary Artery Bypass Grafting: A Randomized Clinical Trial – JAMA Surgery (free for a limited period)

Invited Commentary: Benefits of Incentive Spirometry: Still More Work to Do – JAMA Surgery (free)

Simple intervention leading to improved outcomes, but confirmatory studies are required (see invited commentary).


NICE Guideline: Lung Cancer

29 Mar, 2019 | 07:54h | UTC

Diagnostic Accuracy of Point-of-Care Lung Ultrasonography and Chest Radiography in Adults With Symptoms Suggestive of Acute Decompensated Heart Failure: A Systematic Review and Meta-analysis – JAMA Network Open (free)

“The findings suggest that Lung Ultrasonography is more sensitive than Chest Radiography in detecting pulmonary edema in ADHF”.


Acute Respiratory Distress Syndrome – Nature Reviews Disease Primer (free PDF)


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Signs and Symptoms That Rule out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis – Journal of the American Board of Family Medicine (free)

Adults with an acute respiratory infection who have normal vital signs (temperature < 37,8 / respiratory rate < 20 / heart rate < 100) and a normal pulmonary examination are very unlikely to have CAP.


A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy – New England Journal of Medicine (link to abstract – $ for full-text)

Editorial: The Dangerous Flavors of E-Cigarettes (free)

Commentaries: E-cigarettes more effective than nicotine replacement therapies, finds major trial – Queen Mary University of London (free) AND UK study shows e-cigarettes help adult smokers quit, but US experts urge caution – CNN (free) AND E-Cigarettes Are Effective at Helping Smokers Quit, a Study Says – The New York times (10 articles per month are free) AND E-cigarettes ‘much better for quitting smoking’ – BBC (free) AND Study Found Vaping Beat Traditional Smoking-Cessation Options – NPR (free)


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Automated Triaging of Adult Chest Radiographs with Deep Artificial Neural Networks – Radiology (free for a limited period)

Commentary: AI interprets chest x-rays, prioritizes critical findings – Radiology Business (free)


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Temporarily quadrupling the dose of inhaled steroid to prevent asthma exacerbations: FAST – Health Technology Assessment (free)


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Comparison of Nicotine and Toxicant Exposure in Users of Electronic Cigarettes and Combustible Cigarettes – JAMA Network Open (free)

Commentaries: Will the Debate Over e-Cigarettes Start Cooling Down? – JAMA Network Open (free) AND E-cigarettes less toxic to users than cigarettes, study says – CNN (free)


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Review: Diaphragmatic Dysfunction

7 Dec, 2018 | 02:12h | UTC

Review: Confounders of Severe Asthma

5 Dec, 2018 | 00:01h | UTC