Key Points Question How does the accuracy of lung ultrasound compare with chest radiography for diagnosing cardiogenic pulmonary edema in patients presenting to any clinical setting with dyspnea? Findings In this systematic review with meta-analysis of 6 prospective cohort studies representing 1827 patients, lung ultrasonography was found to be more sensitive than chest radiography for the detection of cardiogenic pulmonary edema and had comparable specificity. Meaning Lung ultrasonography appeared to be useful as an adjunct imaging study in patients presenting with dyspnea at risk for heart failure.

Objective The cyclin‐dependent kinase like 5 (CDKL5) gene is a known cause of early onset developmental and epileptic encephalopathy, also known as CDKL5 deficiency disorder (CDD). We sought to (1) provide a description of seizure types in patients with CDD, (2) provide an assessment of the frequency of seizure‐free periods and cortical visual impairment (CVI), (3) correlate these features with genotype and gender, and (4) correlate these features with developmental milestones. Methods This is a cohort study of patients with CDD. Phenotypic features were explored and correlated with gene variant grouping and gender. A developmental score was created based on achieving seven primary milestones. Phenotypic variables were correlated with the developmental score to explore markers of better developmental outcomes. Multivariate linear regression was used to account for age at last visit. Results Ninety‐two patients with CDD were seen during the enrollment period. Eighteen were male (19%); median age at last visit was 5 years (interquartile range = 2.0‐11.0). Eighty‐one percent of patients developed epileptic spasms, but only 47% of those also had hypsarrhythmia. Previously described hypermotor‐tonic‐spasms sequence was seen in only 24% of patients, but 56% of patients had seizures with multiple phases (often tonic and spasms). Forty‐three percent of patients experienced a seizure‐free period ranging from 1 to >12 months, but only 6% were still seizure‐free at the last visit. CVI was present in 75% of all CDD patients. None of these features was associated with genotype group or gender. CVI was correlated with reduced milestone achievement after adjusting for age at last visit and a history of hypsarrhythmia. Significance The most common seizure types in CDD are epileptic spasms (often without hypsarrhythmia) and tonic seizures that may cluster together. CVI is a common feature in CDD and is correlated with achieving fewer milestones.

Medicare's payment reforms in the 1990s significantly affected hospital length of stay and post-acute care (PAC) (eg, skilled nursing or rehabilitation) facility use. 1 , 2 H o w e v e r , f e w s t u d i e s d e s c r i b e c o nt e m p o r a r y length of stay and postdisc h a rge c a r e t r e n d s i n a nationally representative sample of Medicare and non-Medicare patients. We sought to understand these trends using the National Hospital Discharge Survey (NHDS) from 1996 to 2010.Methods | The NHDS is a nationally representative annual probability sample of discharges from hospitals in all 50 states. 3 We included all hospital discharges of patients 18 years or older, excluding patients transferred to other hospitals, discharges against medical advice, discharges without a destination coded, or hospital lengths of stay more than 31 days (together, <7% of all discharges). We used NHDS definitions for discharge to home or a care facility.We evaluated trends in discharges to PAC facilities as well as length of stay over the 15-year period, then calculated relative percentage changes for each year, using 1996 rates as a baseline. To account for the aging of the population, all trends were age-adjusted by the US Census population in 2003 (www.census.gov). The derived age-specific estimates for each individual year were weighted to reflect the age distribution in 2003, the midpoint of our analysis. Analyses were conducted using SAS statistical software (version 9.