Hot in CHEST December 2016
December 8, 2016
By Dr. Deep Ramachandran
Each month, we ask Drs. Chris Carroll and Deep Ramachandran, Social Media Co-Editors of CHEST, to weigh in on the hot topics in CHEST. It's December, so let's hear from Dr. Ramachandran as he outlines his highlights. After reviewing the issue, be sure to share your hot list our Facebook wall, tweet with the hashtag #DecCHEST, or discuss in the CHEST LinkedIn group.
Point/counterpoint: Are IVC filters worth the risk?
IVC filter use has become increasingly controversial, particularly with publicity regarding complications experienced with some IVC filters. The case for IVC filters is that they have proven efficacy in catching blood clots that are known to cause death. Thus they can be beneficial in the correct patient groups. However, filters have known risks. Has the fact that they can be retrieved made us throw caution to the wind? This, so the argument goes, has perhaps been the reason that the use of these filters in the United States is fivefold greater than in European countries. Check out the debate.
CPAP via oronasal route
CPAP for treatment of obstructive sleep apnea has traditionally been delivered through the nasal route. In this study, researchers sought to determine the effectiveness of nasal vs oral and oronasal CPAP masks at maintaining airway patency. Is the wisdom that led to the recommendation that nasal CPAP be the preferred mode of therapy over oral interfaces borne out of this study? You be the judge!
Insomnia associated with worse asthma control
Insomnia is a common occurrence in those with asthma. In this study, insomnia was associated with greater levels of anxiety and depression. In addition, researchers found that the presence of asthma significantly increased the risk of having asthma that was not well-controlled. Could this lead to insomnia as a positive target of asthma control therapy? Take a look at the study for yourself and see what you think!
Is culture-negative sepsis a separate clinical entity?
The diagnosis of sepsis is denoted by the presence of systemic inflammatory response in the presence of infection. Often the presence of infection is suspected and not borne out by positive cultures. In this study, investigators attempted to discern the significance of culture-negative severe sepsis. Their findings suggest that culture-negative sepsis has its own unique set of comorbidities and may portend a poorer prognosis.
COPD-related death in China accounts for one-third of global COPD related mortality
Chinese investigators sought to determine a nationwide, province-by-province estimate of COPD prevalence and mortality in China. These findings not only show that COPD-related deaths account for a large percentage of worldwide COPD deaths, but they also demonstrated a dramatic rise in the nationwide prevalence of COPD over a 23-year period.