WikiJournalClub:List of landmark papers/Pulmonology

Lazarus et al Inhaled steroids compared with LABA [[1]]
Ratto et al IV not superior to PO [[2]]
LARGE LABA (salmeterol) improves PEF when addd to inhaled steroids [[3]]
SMART worst outcomes with LABA alone vs LABA in conjunction with inhaled steroids, may increase mortality [[4]]
if PEF decreased 15% x 2 days or decreased 30%, quadrupling inhaled steroid dose may decrease need for PO steroids AJRCCM 2009;180;598 AJRCCM 2009;180;598
Rodrigo et al increased bronchodilation when combined with albuterol Chest 2002;121:1977[[5]]
Hughes et al increases PEF and FEV1 Lancet 2003;361:2114[[6]]
TELICAST benefit of telithromycin in patients with acute exacerbations of asthma NEJM 2006;354:1589[[7]]
Beigelman et al evidence of improved sx and FEV1 may be related to anti-inflammatory effect Chest 2009;136:498[[8]]
High dose steroids Methylprednisolone in Status Asthmaticus Archives of IM 1983;143:1324
[Soroksky et al]] NIPPV may improve lung function, alleviate the attack faster, and significantly reduce the need for hospitalization Chest 2003;123:1018 [9]
2007 LOCSS: Salmeterol vs. fluticasone/salmeterol vs. monteleukast in asthma [10]
2010 TALC: Tiotropium in asthma [11]

Intern

Resident

POET-COPD Tiotropium vs. salmeterol in COPD [[14]]
INSPIRE Tiotropium vs. salmeterol/fluticasone propionate [[15]]
NIPPV Noninvasive Ventilation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease results in 58% decreased intubation, LOS by 3.2 d, 59% motality; initiate early if mod/severe dyspnea, decreased pH / increased PaCO2, RR > 25 NEJM 1995;333:817[[16]]
TRiStan Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. [[17]]
systemic corticosteroids Effect of Systemic Glucocorticoids on Exacerbations of Chronic Obstructive Pulmonary Disease decrease treatment failure, hospital stay, increase FEV1, but no motality benefit [[18]]
NOT Nocturnal oxygen therapy; hypoxemic COPD, continuous 02 associated with a lower

mortality than is nocturnal 0 2 therapy [[19]]

Fellow/Attending

[[20]]
Tiotropium+LABA+inh steroids increase FEV1, decrease COPD admits Annals 2007;146:545[[21]]
Corticosteroids for nonacidotic COPD, increase FEV1, shorter hospital stays, no mortality benefit Lancet 1999;354:456[[22]]
Outpt steroids Outpatient Oral Prednisone after Emergency Treatment of Chronic Obstructive Pulmonary Disease decreases relapses NEJM 1999;340:1941 [[23]]
Early Abx Antibiotics may improve outcome Annals 1987;106:196[[24]]
Early abx associated with improved outcomes among patients hospitalized for acute exacerbations of COPD regardless of the risk of

CPAP decreases blood pressure Lancet 2002;359:204[[26]]
[[]]decreases sleepiness and increases performance AJRCCM 2001;164:608[[27]]
[[]] in pts with HF, treatment of coexisting OSA by CPAP reduces systolic BP and improves LV systolic fx NEJM 2003;348:1233[[28]]

Medical student

Medical student

Intern

D-dimer high sensitivity, poor specificity, negative ELISA has 99% NPV and can be used to rule out PE in pts with "unlikely" pretest probability. JAMA 2006;295:172 [33]
PIOPED I VQ scan JAMA 1990;263:2753 [34]
PIOPED II CT angiography [NEJM 2006;354:2317 [35]

Resident

Fellow/Attending

Statin Rosuvastatin decreases risk of VTE NEJM 2009;360:1851 [38]
Air travel associated with PE NEJM 2001;345:779 [39]
D-dimer+CTA vs D-dimer+US: no change in outcomes Lancet 2008;371:1343 [40]
Matisse fondaparinux 5-10mg SC daily similar to UFH in HIT positive patients NEJM 2003;349:1695 [41]
Management Strategies and Prognosis of Pulmonary Embolism-3 heparin+alteplase can improve the clinical course of stable patients who have acute submassive pulmonary embolism and can prevent clinical deterioration requiring the escalation of treatment during the hospital stay vs heparin alone. risk of ICH ~3% and no proven mortality benefit.
IVC filters NEJM 1998;338:409 [42]
PREPIC IVC filters for VTE [43] (8-year follow-up)
2nd VTE event indefinite warfarin NEJM 1997;336:393 [44]
PREVENT Long-term, low-intensity warfarin therapy is a highly effective method of preventing recurrent venous thromboembolism. NEJM 2003;348:1425 [45]

IFIGENIA Tx for UIP/IPF. in addition to steroids + AZA, NAC 600 TID may slow decline in lung function NEJM 2005; 353:2229-2242[[46]]
Itraconazole - For patients with corticosteroid-dependent allergic bronchopulmonary aspergillosis, the addition of itraconazole can lead to improvement in the condition without added toxicity. NEJM 2000;342:756[[47]]

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