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Validation of a Multi-Protein Plasma Classifier to Identify Benign Lung Nodules.

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Validation of a Multi-Protein Plasma Classifier to Identify Benign Lung Nodules.

J Thorac Oncol. 2015 Jan 14;

Authors: Vachani A, Pass HI, Rom WN, Midthun DE, Edell ES, Laviolette M, Li XJ, Fong PY, Hunsucker SW, Hayward C, Mazzone PJ, Madtes DK, Miller YE, Walker MG, Shi J, Kearney P, Fang KC, Massion PP

Abstract
PURPOSE:: Indeterminate pulmonary nodules (IPNs) lack clinical or radiographic features of benign etiologies and often undergo invasive procedures unnecessarily, suggesting potential roles for diagnostic adjuncts using molecular biomarkers. The primary objective was to validate a multivariate classifier that identifies likely benign lung nodules by assaying plasma protein expression levels, yielding a range of probability estimates based on high negative predictive values (NPVs) for patients with 8 to 30 mm IPNs.
METHODS:: A retrospective, multi-center, case-control study was performed using multiple reaction monitoring mass spectrometry, a classifier comprising 5 diagnostic and 6 normalization proteins, and blinded analysis of an independent validation set of plasma samples.
RESULTS:: The classifier achieved validation on 141 lung nodule-associated plasma samples based on predefined statistical goals to optimize sensitivity. Using a population based NSCLC prevalence estimate of 23% for 8 to 30 mm IPNs, the classifier identified likely benign lung nodules with 90% NPV and 26% PPV, as shown in our prior work, at 92% sensitivity and 20% specificity, with the lower bound of the classifier's performance at 70% sensitivity and 48% specificity. Classifier scores for the overall cohort were statistically independent of patient age, tobacco use, nodule size and COPD diagnosis. The classifier also demonstrated incremental diagnostic performance in combination with a four-parameter clinical model.
CONCLUSIONS:: This proteomic classifier provides a range of probability estimates for the likelihood of a benign etiology that may serve as a non-invasive, diagnostic adjunct for clinical assessments of patients with IPNs.

PMID: 25590604 [PubMed - as supplied by publisher]

Chronic obstructive pulmonary disease in nonsmokers by occupation and exposure: a brief review.

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Chronic obstructive pulmonary disease in nonsmokers by occupation and exposure: a brief review.

Curr Opin Pulm Med. 2015 Jan 14;

Authors: Bang KM

Abstract
PURPOSE OF REVIEW: This review gives an overview on recent reports of various occupations associated with chronic obstructive pulmonary disease (COPD) and exposures to associate with COPD among nonsmokers.
RECENT FINDINGS: Recent research has focused on identifying occupations with increased risk of COPD and exposures associated with COPD among nonsmokers based on national health survey data in the United States and studies in other countries. Recently reported prevalence of COPD among nonsmokers was 2.8% in the United States and the prevalence in other countries varied from 2% to 4.2%. The newly identified occupations with high COPD prevalence include machine operators, construction trades, financial record processing, cotton workers, farm machinery workers, construction workers, and bus drivers.
SUMMARY: The results of various studies among nonsmokers show that some occupations are associated with an increased risk of developing COPD, but no exact causes are reported. More research is needed to confirm the newly identified occupations associated with an increased risk of COPD and to identify causal risk factors. To reduce the prevalence of COPD in the workplace, etiologic research and preventive interventions should focus on occupations at risk for occupational exposures.

PMID: 25590955 [PubMed - as supplied by publisher]

The Lancet Respiratory Medicine: Study reveals rate at which smokers metabolize nicotine could predict the best way to quit smoking

(The Lancet) The success of different smoking cessation treatments could be predicted by how quickly smokers break down (metabolize) nicotine in their bodies, according to new research published in The Lancet Respiratory Medicine journal. (Source: EurekAlert! - Medicine and Health)

Oxygen Saturation Index and Severity of Hypoxic Respiratory Failure

Conclusion: OSI correlates significantly with OI in infants with HRF. This noninvasive measure may be used to assess the severity of HRF and PPHN in neonates without arterial access.Neonatology 2015;107:161-166 (Source: Neonatology)

Intubation after noninvasive ventilation failure in chronic obstructive pulmonary disease: associated factors at emergency department presentation

Objective: Noninvasive ventilation (NIV) is a common practice in acute hypercapnic respiratory failure (AHRF) because of exacerbation of chronic obstructive pulmonary disease (COPD). However, a recent study has shown that patients who require invasive mechanical ventilation (IMV) after failure of NIV experience high mortality rates (up to 30%). Therefore, the aim of this study is to determine the parameters, specifically for emergency department (ED) presentation, associated with the transition from NIV to IMV because of NIV failure. Patients and methods: This is a 4-year retrospective cohort study in the EDs of two Dutch hospitals. International Classification of Disease codes were used to identify 139 COPD patients treated with NIV. Those with AHRF (pH limits: 7.25–7.35), a full resusc...

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