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  1. Article ; Online: Pulmonary Hypertension in Interstitial Lung Disease: Updates in Disease, Diagnosis, and Therapeutics.

    Haynes, Zachary A / Chandel, Abhimanyu / King, Christopher S

    Cells

    2023  Volume 12, Issue 19

    Abstract: Pulmonary hypertension is a debilitating condition that frequently develops in the setting of interstitial lung disease, likely related to chronic alveolar hypoxemia and pulmonary vascular remodeling. This disease process is likely to be identified more ... ...

    Abstract Pulmonary hypertension is a debilitating condition that frequently develops in the setting of interstitial lung disease, likely related to chronic alveolar hypoxemia and pulmonary vascular remodeling. This disease process is likely to be identified more frequently by providers given recent advancements in definitions and diagnostic modalities, and provides practitioners with emerging opportunities to improve patient outcomes and quality of life. Despite years of data suggesting against the efficacy of pulmonary vasodilator therapy in patients with pulmonary hypertension due to interstitial lung disease, new data have emerged identifying promising advancements in therapeutics. The authors present to you a comprehensive review of pulmonary hypertension in interstitial lung disease, reviewing our current understanding of pathophysiology, updates in diagnostic approaches, and highlights of recent clinical trials which provide an effective approach for medical management.
    MeSH term(s) Humans ; Hypertension, Pulmonary/complications ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/therapy ; Quality of Life ; Lung Diseases, Interstitial/complications ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/therapy ; Lung
    Language English
    Publishing date 2023-10-01
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2661518-6
    ISSN 2073-4409 ; 2073-4409
    ISSN (online) 2073-4409
    ISSN 2073-4409
    DOI 10.3390/cells12192394
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Cardiopulmonary exercise testing in younger patients with persistent dyspnea following acute, outpatient COVID-19 infection.

    Holley, Aaron B / Fabyan, Kimberly D / Haynes, Zachary A / Holtzclaw, Arthur W / Huprikar, Nikhil A / Shumar, John N / Sheth, Phorum S / Hightower, Stephanie L

    Physiological reports

    2024  Volume 12, Issue 3, Page(s) e15934

    Abstract: Studies using cardiopulmonary exercise testing (CPET) to evaluate persistent dyspnea following infection with COVID-19 have focused on older patients with co-morbid diseases who are post-hospitalization. Less attention has been given to younger patients ... ...

    Abstract Studies using cardiopulmonary exercise testing (CPET) to evaluate persistent dyspnea following infection with COVID-19 have focused on older patients with co-morbid diseases who are post-hospitalization. Less attention has been given to younger patients with post-COVID-19 dyspnea treated as outpatients for their acute infection. We sought to determine causes of persistent dyspnea in younger patients recovering from acute COVID-19 infection that did not require hospitalization. We collected data on all post-COVID-19 patients who underwent CPET in our clinic in the calendar year 2021. Data on cardiac function and respiratory response were abstracted, and diagnoses were assigned using established criteria. CPET data on 45 patients (238.3 ± 124 days post-test positivity) with a median age of 27.0 (22.0-40.0) were available for analysis. All but two (95.6%) were active-duty service members. The group showed substantial loss of aerobic capacity-average VO
    MeSH term(s) Humans ; Exercise Test/methods ; Outpatients ; COVID-19/complications ; Dyspnea/diagnosis ; Dyspnea/etiology ; Respiration ; Exercise Tolerance/physiology
    Language English
    Publishing date 2024-02-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2724325-4
    ISSN 2051-817X ; 2051-817X
    ISSN (online) 2051-817X
    ISSN 2051-817X
    DOI 10.14814/phy2.15934
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Challenges in mitigating context specificity in clinical reasoning: a report and reflection.

    Konopasky, Abigail / Durning, Steven J / Battista, Alexis / Artino, Anthony R / Ramani, Divya / Haynes, Zachary A / Woodard, Catherine / Torre, Dario

    Diagnosis (Berlin, Germany)

    2020  Volume 7, Issue 3, Page(s) 291–297

    Abstract: Objectives Diagnostic error is a growing concern in U.S. healthcare. There is mounting evidence that errors may not always be due to knowledge gaps, but also to context specificity: a physician seeing two identical patient presentations from a content ... ...

    Abstract Objectives Diagnostic error is a growing concern in U.S. healthcare. There is mounting evidence that errors may not always be due to knowledge gaps, but also to context specificity: a physician seeing two identical patient presentations from a content perspective (e.g., history, labs) yet arriving at two distinct diagnoses. This study used the lens of situated cognition theory - which views clinical reasoning as interconnected with surrounding contextual factors - to design and test an instructional module to mitigate the negative effects of context specificity. We hypothesized that experimental participants would perform better on the outcome measure than those in the control group. Methods This study divided 39 resident and attending physicians into an experimental group receiving an interactive computer training and "think-aloud" exercise and a control group, comparing their clinical reasoning. Clinical reasoning performance in a simulated unstable angina case with contextual factors (i.e., diagnostic suggestion) was determined using performance on a post-encounter form (PEF) as the outcome measure. The participants who received the training and did the reflection were compared to those who did not using descriptive statistics and a multivariate analysis of covariance (MANCOVA). Results Descriptive statistics suggested slightly better performance for the experimental group, but MANCOVA results revealed no statistically significant differences (Pillai's Trace=0.20, F=1.9, df=[4, 29], p=0.15). Conclusions While differences were not statistically significant, this study suggests the potential utility of strategies that provide education and awareness of contextual factors and space for reflective practice.
    Language English
    Publishing date 2020-07-10
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2194-802X
    ISSN (online) 2194-802X
    DOI 10.1515/dx-2020-0018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Risk factors of persistent insomnia among survivors of traumatic injury: a retrospective cohort study.

    Haynes, Zachary A / Collen, Jacob F / Poltavskiy, Eduard A / Walker, Lauren E / Janak, Jud / Howard, Jeffrey T / Werner, J Kent / Wickwire, Emerson M / Holley, Aaron B / Zarzabal, Lee Ann / Sim, Alan / Gundlapalli, Adi / Stewart, Ian J

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

    2021  Volume 17, Issue 9, Page(s) 1831–1840

    Abstract: Study objectives: Insomnia is a diagnosis with broad health and economic implications that has been increasingly recognized in military service members. This trend was concurrent with an increase in traumatic wartime injuries. Accordingly, we sought to ... ...

    Abstract Study objectives: Insomnia is a diagnosis with broad health and economic implications that has been increasingly recognized in military service members. This trend was concurrent with an increase in traumatic wartime injuries. Accordingly, we sought to determine longitudinal predictors of persistent insomnia in combat veterans who sustained traumatic injuries.
    Methods: Retrospective cohort study of service members deployed to conflict zones from 2002 to 2016, with longitudinal follow-up in the Veterans Affairs and Military Health Systems. Two cohorts were derived: (1) service members who sustained traumatic injuries and (2) an age-, sex-, and service component-matched cohort of uninjured service members who deployed to a combat zone. Insomnia was defined using
    Results: The final population of 17,374 service members was followed from date of injury (or date of matched participant's injury) for a median of 8.4 (interquartile range, 5.3-10.7) years. Service members with traumatic injury were at significantly greater risk of developing insomnia than uninjured service members (hazard ratio = 1.43; 95% confidence interval, 1.30-1.58) after adjustment. Traumatic brain injury was associated with insomnia compared with patients without traumatic brain injury in the multivariable model: mild/unclassified traumatic brain injury (hazard ratio = 2.07; 95% confidence interval, 1.82-2.35) and moderate/severe/ penetrating traumatic brain injury (hazard ratio = 2.43; 95% confidence interval, 2.06-2.86). Additionally, burn injury (hazard ratio = 1.95; 95% confidence interval, 1.47-2.59) and amputation (hazard ratio = 1.61; 95% confidence interval, 1.26-2.06) significantly increased the risk of a diagnosis.
    Conclusions: Traumatic injuries significantly predicted a diagnosis of insomnia after controlling for mental health disorders. Our findings strongly suggest the need for long-term surveillance of sleep disorders in trauma survivors.
    Citation: Haynes ZA, Collen JF, Poltavskiy EA, et al. Risk factors of persistent insomnia among survivors of traumatic injury: a retrospective cohort study.
    MeSH term(s) Cohort Studies ; Humans ; Military Personnel ; Retrospective Studies ; Risk Factors ; Sleep Initiation and Maintenance Disorders/complications ; Sleep Initiation and Maintenance Disorders/epidemiology ; Stress Disorders, Post-Traumatic/complications ; Stress Disorders, Post-Traumatic/epidemiology ; Survivors ; Veterans
    Language English
    Publishing date 2021-04-29
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2397213-0
    ISSN 1550-9397 ; 1550-9389
    ISSN (online) 1550-9397
    ISSN 1550-9389
    DOI 10.5664/jcsm.9276
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6590: Show issues Location:
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  5. Article ; Online: Obstructive sleep apnea among survivors of combat-related traumatic injury: a retrospective cohort study.

    Haynes, Zachary A / Stewart, Ian J / Poltavskiy, Eduard A / Holley, Aaron B / Janak, Jud C / Howard, Jeffrey T / Watrous, Jessica / Walker, Lauren E / Wickwire, Emerson M / Werner, Kent / Zarzabal, Lee Ann / Sim, Alan / Gundlapalli, Adi / Collen, Jacob F

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

    2021  Volume 18, Issue 1, Page(s) 171–179

    Abstract: Study objectives: Obstructive sleep apnea is prevalent among military members despite fewer traditional risk factors. We sought to determine the incidence and longitudinal predictors of obstructive sleep apnea in a large population of survivors of ... ...

    Abstract Study objectives: Obstructive sleep apnea is prevalent among military members despite fewer traditional risk factors. We sought to determine the incidence and longitudinal predictors of obstructive sleep apnea in a large population of survivors of combat-related traumatic injury and a matched control group.
    Methods: Retrospective cohort study of military service members deployed to conflict zones from 2002-2016 with longitudinal follow-up in the Veterans Affairs and Military Health Systems. Two cohorts of service members were developed: (1) those who sustained combat injuries and (2) matched, uninjured participants.
    Results: 17,570 service members were retrospectively analyzed for a median of 8.4 years. After adjustment, traumatic brain injury (hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.20-1.60), posttraumatic stress disorder (HR 1.24, 95% CI 1.05-1.46), depression (HR 1.52, 95% CI 1.30-1.79), anxiety (HR 1.40, 95% CI 1.21-1.62), insomnia (HR 1.71, 95% CI 1.44-2.02), and obesity (HR 2.40, 95% CI 2.09-2.74) were associated with development of obstructive sleep apnea. While combat injury was associated with obstructive sleep apnea in the univariate analysis (HR 1.25, 95% CI 1.17-1.33), the direction of this association was reversed in the multivariable model (HR 0.74, 95% CI 0.65-0.84). In a nested analysis, this was determined to be due to the effect of mental health diagnoses.
    Conclusions: The incidence of obstructive sleep apnea is higher among injured service members (29.1 per 1,000 person-years) compared to uninjured service members (23.9 per 1,000 person-years). This association appears to be driven by traumatic brain injury and the long-term mental health sequelae of injury.
    Citation: Haynes ZA, Stewart IJ, Poltavskiy EA, et al. Obstructive sleep apnea among survivors of combat-related traumatic injury: a retrospective cohort study.
    MeSH term(s) Humans ; Military Personnel ; Retrospective Studies ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/epidemiology ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/etiology ; Survivors
    Language English
    Publishing date 2021-07-16
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2397213-0
    ISSN 1550-9397 ; 1550-9389
    ISSN (online) 1550-9397
    ISSN 1550-9389
    DOI 10.5664/jcsm.9530
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6590: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
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