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The article discusses a study that described the safety and feasibility of percutaneous endoscopic gastrostomy (PEG) tube placement in interventional pulmonologists (IP) in a critically ill population. No procedural complications were reported during PEG tube placement. An excellent safety and efficiency profile was demonstrated in the performance of percutaneous dilatational tracheostomy (PDT) in critically ill patients.

The article discusses research which examined the reliability and validity of the Cough Quality-of-Life Questionnaire (CQLQ) in individuals with idiopathic pulmonary fibrosis (IPF). It cites the administration of a cough visual analog scale and the St. George's Respiratory Questionnaire to establish CQLQ's validity. Findings revealed high internal consistency for the CQLQ total. Concurrent validity was also observed in the CQLQ total score.

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure originally performed using a 22-gauge (22G) needle. A recently introduced 21-gauge (21G) needle may improve the diagnostic yield and sample adequacy of EBUS-TBNA, but prior smaller studies have shown conflicting results. To our knowledge, this is the largest study undertaken to date to determine whether the 21G needle adds diagnostic benefit.Methods: We retrospectively evaluated the results of 1,299 patients from the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation (AQuIRE) Diagnostic Registry who underwent EBUS-TBNA between February 2009 and September 2010 at six centers throughout the United States. Data collection included patient demographics, sample adequacy, and diagnostic yield. Analysis consisted of univariate and multivariate hierarchical logistic regression comparing diagnostic yield and sample adequacy of EBUS-TBNA specimens by needle gauge.Results: A total of 1,235 patients met inclusion criteria. Sample adequacy was obtained in 94.9% of the 22G needle group and in 94.6% of the 21G needle group (P = .81). A diagnosis was made in 51.4% of the 22G and 51.3% of the 21G groups (P = .98). Multivariate hierarchical logistic regression showed no statistical difference in sample adequacy or diagnostic yield between the two groups. The presence of rapid onsite cytologic evaluation was associated with significantly fewer needle passes per procedure when using the 21G needle (P < .001).Conclusions: There is no difference in specimen adequacy or diagnostic yield between the 21G and 22G needle groups. EBUS-TBNA in conjunction with rapid onsite cytologic evaluation and a 21G needle is associated with fewer needle passes compared with a 22G needle. [ABSTRACT FROM AUTHOR]

The article presents research on how clinical outcomes in adults with cystic fibrosis are commonly affected by pain. It explores how pain is directly associated with the symptoms of depression, anxiety and lower quality of life (QOL). It also concludes that pain is strongly linked to an increased risk of having both exacerbations and death.

The article discusses a study which examined the appropriate goal level for 25-hydroxyvitamin D in cystic fibrosis (CF). The study involved 216 patients with CF who were treated with vitamin D2. It was discovered that inadequate serum 25OHD levels are common in adults with CF and are associated with elevated parathyroid hormone (PTH) levels.

The article evaluates static expiratory lung compliance (CL) in patients with amyotrophic lateral sclerosis (ALS) and determines the effect of lung inflation with supramaximal inflation on CL. Patients conducted a battery of pulmonary function tests including for CL. The results show that ALS patients and diaphragmatic weakness have reduced CL and brief supramaximal inflation increases CL. The results also suggests that atelectasis or increased alveolar surface forces are present in ALS patients and the patients will have increased work of breathing.

Study objectives: To determine whether distraction therapy with nature sights and sounds during flexible bronchoscopy (FB) reduces pain and anxiety. Design: Randomized controlled trial. Setting: Teaching hospital in Baltimore, MD. Patients: Consecutive adult patients (n = 80) undergoing FB with conscious sedation. Intervention: Nature scene murals were placed at the bedside, and patients were provided a tape of nature sounds to listen to before, during, and after the procedure. Patients assigned to the control group were not offered either the nature scene or the sounds. Measurements and results: The primary outcomes were patient ratings of pain control (a 5-point scale ranging from poor to excellent) and anxiety. In a multivariate ordinal logistic regression model, the odds of better pain control were greater in the intervention patients than in the control patients (odds ratio [OR], 4.76; 95% confidence interval [CI], 1.35 to 16.7), after adjustment for age, gender, race, education, health status, and dose of narcotic medication. Older patients and patients with better health status reported significantly less pain. There was no difference in patient-reported anxiety between the two groups (OR, 0.87; 95% CI, 0.39 to 1.96). Conclusions: Distraction therapy with nature sights and sounds significantly reduces pain in patients undergoing FB. Although the precise mechanism of this beneficial effect requires further investigation, clinicians should consider this nonintrusive strategy in addition to standard analgesic medications in patients undergoing painful, invasive procedures. [ABSTRACT FROM AUTHOR]

Study Objectives: To determine which respiratory function tests best predicted diaphragmatic strength in patients with amyotrophic lateral sclerosis.Patients and Methods: Patients referred for pulmonary evaluation were included (n = 25) if they underwent measurement of transdiaphragmatic pressure (Pdi) and one or more of the following on the same day: upright FVC, supine FVC, upright FEV(1), supine FEV(1), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and PaCO(2). Abdominal paradox and use of accessory muscles were also assessed. Bivariate analyses were performed using simple linear regression. Sensitivity and specificity of the potential predictors to detect an abnormal Pdi (< 70 cm H(2)O) were calculated.Setting: Pulmonary function laboratory of an academic medical center.Results: Upright FVC, FEV(1), and MEP were all significantly correlated with Pdi, while MIP and PaCO(2) were not. Supine FVC was the most highly correlated predictor of Pdi (R(2) = 0.76). A cutoff of supine FVC that was < 75% predicted was 100% sensitive and specific for predicting an abnormally low Pdi. Accessory muscle use and abdominal paradox were both significantly associated with Pdi, and the presence of accessory muscle use had a sensitivity of 84% and a specificity of 100% for detecting a low Pdi.Conclusions: Our findings suggest that supine FVC is an excellent and simple test of diaphragmatic weakness. [ABSTRACT FROM AUTHOR]