Top 5 Clinical Pulmonary Medicine Articles—March

Here are the top 5 picks for March 2017 from the Clinical Pulmonary Medicine NetWork.

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  1. 1. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data.
  2. This was a systematic review of 25 randomized control trials with a total of 10,933 participants included. Vitamin D was found to be associated with a reduced risk of at least one acute respiratory tract infection. This benefit was more profound with patients who were most deficient(levels <25nmol/L) and those receiving regular supplementation. These findings may help to clarify previously seen mixed results on the health benefits of vitamin D.
  3. 2. Exposure to low dose computed tomography for lung cancer screening and risk of cancer: secondary analysis of trial data and risk-benefit analysis.
  4. This study evaluated the effect of low dose computed tomography (CT) for lung cancer screening on the risk of future lung or major cancer. 5,203 high risk participants underwent a total of 42,228 low dose CT and 635 positron emission tomography (PET) scans over 10 years. The risk of induced cancer was 0.05%, or one per every 108 cancers detected. Low dose lung cancer screening for high risk patients is not without concerns but the benefits appear to outweigh possible negative outcomes.
  5. 3. A multicenter validation of the 1-min sit-to-stand test in patients with COPD
  6. This study compared physiologic parameters of the 1-min sit-to-stand (STS) to at 6-min walk test (6MWT) in 255 patients with COPD. They found similar physiologic responses in oxygen consumption (VO2), heart rate(HR), dyspnea, and leg fatigue in both testing modalities. The 1-min STS may be a reasonable alternative to assess exercise capacity in patients with COPD.
  7. 4. Intensive care unit educators: A multicenter evaluation of behaviors residents value in attendings.
  8. This multi-center, cross-sectional, survey study of four internal medicine (IM) residency programs evaluated 37-questions to assess the behaviors and skills learners find important in ICU attendings. 260 residents with mixed levels of training found the enthusiasm of attendings in teaching to be the most important followed by compassion to patients and families, ability to explain clinical reasoning, treated all staff members with respect, and enthusiasm on rounds. This may serve a guide to ICU attendings to better influence residents and resident education.
  9. 5. Natural history of Mycobacterium avium complex lung disease in untreated patients with stable course.
  10. This was a single center, retrospective study evaluating the natural course of 420 patients with Mycobacterium avium complex lung disease (MAC-LD). Over a 14-year period the investigators found 63% had progression of disease resulting in initiation of therapy within3 year of diagnosis, 24% had stable disease for median of 5.6 years, and, of untreated patients, 52% underwent spontaneous sputum conversion. Patients with higher BMI and less systemic symptoms at the time of diagnosis were more likely to have stable disease over the study period.
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