Predicting weaning failure from invasive mechanical ventilation: The promise and pitfalls of clinical prediction scores.

Prediction of weaning success from invasive mechanical ventilation remains a challenge in everyday clinical practice. Several prediction scores have been developed to guide success during spontaneous breathing trials to help with weaning decisions. These scores aim to provide a structured framework to support clinical judgment.

Established and Emerging Asthma Biomarkers with a Focus on Biologic Trials: A Narrative Review.

Chronic airway inflammation with variable airflow obstruction is clinical asthma, and it arises from distinct molecular and pathological mechanisms called endotypes. Biomarkers allow for precise endotype characterization and have been used in clinical trials to design, monitor, and evaluate outcomes for asthma biologic therapies. This review will highlight the central and evolving role of biomarkers for past, present, and future asthma, with a focus on regulatory-approved biologic therapies and emerging biomarkers.

The Emerging Biomarkers in Chronic Obstructive Pulmonary Disease: A Narrative Review.

The burden of chronic obstructive pulmonary disease (COPD) is increasing, especially for women in low-to-middle income countries. Biomarkers provide ever-increasing diagnostic precision for COPD and show promise for primary, secondary, and tertiary disease prevention. This review describes emerging applications for biomarkers in COPD, especially as they align with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) emphasis on prevention, early diagnosis, and response to therapy.

Racial Disparities in Septic Shock Outcomes: A Nationwide Analysis (2016-2020).

Background: The mortality rate and outcomes of septic shock can vary, depending on the patient's race. The most comprehensive national study on these racial disparities is dated, and recent studies have reported mixed findings.

Objective: To gain insight into racial variation in outcomes of septic shock and understand underlying factors.

Asthma outcomes in a safety net hospital system: A comparative study to a national cohort.

Background: Asthma disproportionately affects vulnerable populations. Safety net hospitals (SNHs) manage a significant proportion of these patients. Despite the assumption that patients in SNHs have more severe asthma, little is known about how their outcomes compare to the general population.

Personalized COPD Care: The Future of Precision-Based Therapies.

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory illness characterized by long-standing respiratory symptoms and airflow limitation. It is a major contributor to respiratory disease-related deaths and currently ranked as the sixth leading cause of mortality in the United States. Approved pharmacological therapies for the stable disease primarily consist of inhaled short and long-acting bronchodilators, inhaled corticosteroids, azithromycin, and roflumilast.

Biologics in Asthma: Emerging Biologics.

Advances in our understanding of asthma pathophysiology have led to the advent of multiple targeted asthma therapies such as biologics. However, partial response to biologics occurs, indicating residual disease activity in some patients. Hence, there exists a need for new therapies that focus on novel pathways, alongside perhaps evaluation of combination biologic therapies and modulators of downstream cytokine activation.

Reimagining critical care: Trends and shifts in 21 century medicine.

Critical care medicine has undergone significant evaluation in the 21 century, primarily driven by advancements in technology, changes in healthcare delivery, and a deeper understanding of disease processes. Advancements in technology have revolutionized patient monitoring, diagnosis, and treatment in the critical care setting. From minimally invasive procedures to advances imaging techniques, clinicians now have access to a wide array of tools to assess and manage critically ill patients more effectively.

Traumatic brain injury and variants of shock index.

Traumatic Brain Injury is a major cause of death and long-term disability. The early identification of patients at high risk of mortality is important for both management and prognosis. Although many modified scoring systems have been developed for improving the prediction accuracy in patients with trauma, few studies have focused on prediction accuracy and application in patients with traumatic brain injury.

Inhalational Drug Devices: Revisiting the Linchpin of Asthma Management.

Asthma remains a prevalent condition among all age groups globally. First-line treatment requires the delivery of medications into the distal respiratory tract via inhalers. Using appropriate inhaler techniques is a significant challenge in achieving disease control.

Community-acquired pneumonia: The importance of the early detection of drug-resistant organisms.

Pneumonia is a disease associated with significant healthcare burden with over 1.5 million hospitalizations annually and is the eighth leading cause of death in the United States. While community-acquired pneumonia (CAP) is generally considered an acute time-limited illness, it is associated with high long-term mortality, with nearly one-third of patients requiring hospitalization dying within one year.

Driving pressure decoded: Precision strategies in adult respiratory distress syndrome management.

Mechanical ventilation (MV) is an important strategy for improving the survival of patients with respiratory failure. However, MV is associated with aggravation of lung injury, with ventilator-induced lung injury (VILI) becoming a major concern. Thus, ventilation protection strategies have been developed to minimize complications from MV, with the goal of relieving excessive breathing workload, improving gas exchange, and minimizing VILI.

Revisiting Asthma Obstructive Sleep Apnea Overlap: Current Knowledge and Future Needs.

Asthma and obstructive sleep apnea are highly prevalent conditions with a high cost burden. In addition to shared risk factors, existing data suggest a bidirectional relationship between asthma and OSA, where each condition can impact the other. Patients with asthma often complain of sleep fragmentation, nocturnal asthma symptoms, daytime sleepiness, and snoring.

Update on the Role of FeNO in Asthma Management.

Asthma is a heterogenous disorder characterized by presence of different phenotypes and endotypes. Up to 10% of the individuals suffer from severe asthma and are at increased risk of morbidity and mortality. Fractional exhaled nitric oxide (FeNO) is a cost-effective, point of care biomarker that is used to detect type 2 airway inflammation.

A rare case of isolated thoracic AL-amyloidoma causing complete atelectasis of the right lung.

Tumoral amyloidosis, or amyloidoma, is a benign, but rare form of amyloidosis that has been reported with a favorable prognosis following surgical resection in some case reports. We present a case of acute on chronic respiratory failure secondary to extensive growth of a thoracic amyloidoma causing atelectasis of the right lung. Our case patient had greater morbidity due to late presentation and extensive disease at diagnosis, precluding any surgical intervention.

Phenotypes of Asthma-Chronic Obstructive Pulmonary Disease Overlap.

Asthma and chronic obstructive pulmonary disease are considered unique diseases with distinct characteristics. Asthma-chronic obstructive pulmonary disease overlap is a disorder in which the clinical characteristics of asthma and chronic obstructive pulmonary disease coexist. Asthma-chronic obstructive pulmonary disease overlap is a heterogenous condition; patients can have varied clinical presentations.

May-Thurner Syndrome: A Rare Case of Unilateral Deep Vein Thrombosis in an Elderly Woman.

BACKGROUND Deep vein thrombosis (DVT) is a critical disorder with a high incidence and a high disease burden. Multiple acquired and genetic factors leading to hypercoagulation, venous injury, and venous stasis account for its basic pathophysiology. One of the rarely considered underlying etiologies of DVT is May-Thurner Syndrome (MTS), also known as iliac vein compression syndrome.

Potential predictors of outcomes among hospitalized COVID-19 patients treated with convalescent plasma: a single-center study.

The coronavirus disease 2019 pandemic is a major international public health crisis, which has led to over 3 million deaths as of April 2021. Several therapeutics have been tried for this deadly illness including antivirals, immunosuppressive agents and convalescent plasma (CP). In this study, we present our inner-city safety net hospital experience with CP therapy.

A Rare Case of Mycobacterium Monacense Osteomyelitis: A Case Report.

is a yellow-pigmented, rapidly growing non-tuberculous mycobacterium (RGM). It is a rare pathogen in humans, and only a very few cases of skin and lung infection related to it have been reported. In this report, we present the case of a 70-year-old Hispanic male who was brought to the hospital with back pain for 11 months.