Intense, short-term exposure to materials generated during the collapse of the World Trade Center was associated with bronchial responsiveness and the development of cough. Clinical and physiological severity was related to the intensity of exposure.
A t New York University Langone Health at the height of the coronavirus disease 2019 (COVID-19) pandemic, 22% of hospitalized patients diagnosed with COVID-19 infection required invasive mechanical ventilation (IMV) (1). We noted many patients with COVID-19 infection who developed pneumothorax, pneumomediastinum, and pneumopericardium, and in some cases, at multiple separate time points. Given this observation, we hypothesized that barotrauma related to IMV was elevated in patients with COVID-19 infection. The purpose of this study was to evaluate the rate of barotrauma in patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and who required IMV compared with other patients in the same institution during the same period who also required IMV, and to a temporally remote (pre-COVID-19) historical cohort of patients who required IMV support in the setting of acute respiratory distress syndrome (ARDS). Materials and Methods This retrospective study was performed with institutional review board waiver of authorization and consent (is20-00582) given the current urgent conditions created by the pandemic. Study Population The New York University Langone Health electronic medical record system (Epic Systems, Verona, Wis) was searched for patients age 18 years or older seen in our emergency department between March 1, 2020, and April 6, 2020, with chest imaging within 24 hours of nasopharyngeal or oropharyngeal swab testing for SARS-CoV-2. Test assay techniques are detailed in Appendix E1 (online). Patients with positive real-time reverse transcription polymerase chain reaction assays were deemed COVID-19 positive, and those with negative results were deemed COVID-19 negative. COVID-19 testing was performed in all patients who presented to the emergency
Purpose. The Early Lung Cancer Action Project (ELCAP) is designed to evaluate baseline and annual repeat screening by low radiation dose computed tomography (low-dose CT) in persons at high-risk for lung cancer.Methods. Since starting in 1993, the ELCAP has enrolled 1,000 asymptomatic persons, 60 years of age or older, with at least 10 pack-years (1 pack per day for 10 years, or 2 packs per day for 5 years) of cigarette smoking, no prior cancer, and medically fit to undergo thoracic surgery. After a structured interview and informed consent, baseline chest radiographs and low-dose CT were obtained on each subject. The diagnostic work-up of screen-detected noncalcified pulmonary nodules (NCN) was guided by ELCAP recommendations which included short-term highresolution CT follow-up for the smallest nodules.Baseline Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, 525 East 68th Street, New York, NY 10021, USA. Telephone: 212-746-2529; Fax: 212-746-2811 Received October 10, 2000 accepted for publication February 23, 2001. ©AlphaMed Press 1083-7159/2001 INTRODUCTIONIn the United States, the cure rate of lung cancer is a dismal 10%, and the 5-year survival rate is only slightly higher than the cure rate. In stage I lung cancer, by contrast, the 5-year survival rate upon resection is as high as 70%; but if left unresected, that rate is again of the order of a mere 10% [1,2]. While these rates imply that the cure rate of lung cancer can be substantially enhanced by screening and its associated earlier intervention, results of randomized trials have been interpreted as indicating that this is not the case [3].This paradox points to the possibility that the negative results of the randomized trials were a consequence of flaws in their design, execution and/or analysis. To quantify the
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