Home CHEST Thought Leaders Hot in CHEST August 2018

Hot in Journal CHEST® August 2018

By: Dr. Chris Carroll

Dr. Chris Carroll

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 August, so let's hear from Dr. Carroll as he outlines his highlights. After reviewing the issue, be sure to share your hot list on our Facebook wall, tweet with the hashtag #journalCHEST, or discuss in the CHEST LinkedIn group.



Happy summer, fellow CHEST® readers! Hopefully you’re enjoying a vacation at some point this month. If so, remember to bring a copy of August’s CHEST. There are some great articles this month, and here are some of the highlights from my top picks.

Investigation of Public Perception of Brain Death Using the Internet

AKA apparently everything you read on the Internet isn’t true? ¯\_(ツ)_/¯

Brain death (or death by neurologic criteria) is a hard concept for families to understand and especially difficult to come to terms with suddenly in an emotional setting such as an intensive care unit. And as providers, we are tasked with compassionately shepherding families through this difficult time. But we’re not the only educational sources available to these families, who frequently also turn to the internet for education.

In a study in this month’s CHEST, Dr. Amy Jones and colleagues investigated the top 10 Google searches and top 10 YouTube hits for “brain death.” Perhaps unsurprisingly, they found significant inaccuracies in 4 of 10 Google links and 6 of 10 YouTube videos. The most popular links were Wikipedia and a satirical video by the humor website The Onion. The Google links were difficult to read and, on average, needed a 12th-grade reading level. The YouTube videos were frequently emotional (78%); 80% of YouTube comments were inaccurate, and one-third contained negative comments toward physicians.

This study highlights the importance of clinicians to be aware of this information that the patients are receiving, as well as for clinicians and medical societies to be present on the internet to participate in these discussions. An excellent paper! And don’t miss the accompanying editorial by Drs. Sochet and Nakagawa.

Chronic Cough Related to Acute Viral Bronchiolitis in Children: CHEST Expert Panel Report

Viral infections are common in children and not uncommonly children develop a chronic cough after these infections. In this month’s CHEST, Dr. Anne Chang and colleagues used the CHEST Expert Cough Panel’s protocol and CHEST’s methodological guidelines and GRADE framework to develop several consensus-based suggestions and directions for future studies.

Specifically, this group suggests that asthma medications and osmotic agents should NOT be used in children with chronic cough. Additionally, there should be an evaluation of cough pointers (such as coughing with feeding and digital clubbing). In children without cough pointers with wet or productive cough, 2 weeks of antibiotics for common respiratory infections should be used. Check out this article in the August issue for more information about recommended treatments and for more information regarding CHEST pediatric chronic cough guidelines!

Sleep Disorders in Patients With Posttraumatic Stress Disorder

In this month’s CHEST, Dr. Ali El-Solh and colleagues published a contemporary review on the interrelation between sleep disturbances and posttraumatic stress disorder (PTSD). A growing body of evidence shows that each can worsen the other, and that treatment of sleep disturbances in this population has not been optimal. In this excellent review, Dr. El-Solh and colleagues review the issues underlying these complex conditions and treatment and outline an approach for management of sleep and for CPAP nonadherence complicated by insomnia and nightmares.

El-Sohl sleep ptsd

El-Sohl AA, Riaz U, Roberts J. Sleep disorders in patients with posttraumatic stress disorder. CHEST. 2018;1542(2):427-439.

On Doctors and Their Operas: A Critical (and Lyrical) Analysis of Medicine in Opera

Finally, in this month’s CHEST, Dr. Joan Soriano conducted a comprehensive analysis of physician roles in classical opera repertoire. Dr. Soriano reviewed 493 operas over 239 years, of which 11% had a patient and/or doctor as characters. Of the 34 operas with physician roles, there was a significant gender bias with all roles represented by male characters and lower vocal registers. Guiseppe Verdi was the composer with the highest interest in doctors and medicine, with nine operas that included medical doctors. A fascinating review. And really, how often do you see figures like this in a medical journal?

Soriano- operaSoriano - opera voice

Soriano JB. On doctors and their operas: a critical (and lyrical) analysis of medicine in opera. CHEST. 2018;154(2):409-415.