WikiJournalClub:List of landmark papers/Pulmonology

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Asthma

Chronic Obstructive Pulmonary Disease

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

treatment failure JAMA 2010;303:2035[[25]]

Obstructive Sleep Apnea

Pleural Effusion

Medical student

Venous Thromboembolism

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]

Interstitial Lung Disease

  • 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]]