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Introduction: The Spanish Society of Pulmonology and Thoracic Surgery created a registry for hospitalised patients with COVID-19 and the different types of respiratory support used (RECOVID). Objectives. To describe the profile of hospitalised patients with COVID-19, comorbidities, respiratory support treatments and setting. In addition, we aimed to identify varying profiles of patients according to outcomes and the complexity of respiratory support needed.

Methods: Multicentre, observational study in 49 Spanish hospitals. A protocol collected demographic data, comorbidities, respiratory support, treatment setting and 1-year follow-up. Patients were described using either frequency and percentages or median and interquartile range, as appropriate. A cluster analysis made it possible to identify different types of profile among the patients.

Results: In total, 2148 of 2454 hospitalised patients (87.5%) received care in the conventional ward, whilst 126 in IRCU and 180 in ICU. In IRCU, 30% required high-flow nasal oxygen whilst 25%, non-invasive mechanical ventilation and 17%, mechanical ventilation. Four clusters of patients were identified. Two clusters were more likely to require IRCU/ICU admission, although primarily Cluster 2: Cluster (C) 1 consisted of patients without comorbidities and C2, those with comorbidities. Both presented higher inflammatory levels and lower lymphocyte count and SpO2/FiO2; however, C2 showed worse values. Two different clusters identified patients requiring less complex respiratory support. C3 presented higher comorbidities and elevated lymphocyte count, SpO2/FiO2 and low C-reactive protein (CRP). C4 included those without comorbidities except for arterial hypertension, lymphopenia and an intermediate CRP. In-hospital mortality and subsequent 1-year mortality were greater for C2 (28.6% and 7.1%) and C1 (11.1%, 8.3%) than for C4 (3.3%, 1.8%) and C3 (0%, 0%).

Conclusions: The cluster analysis identified four clinical phenotypes requiring distinct types of respiratory support, with great differences present per characteristics and outcomes.

The associations between anxiety, depression, and the prognosis of COPD remain uncertain. The present study aims to investigate the associations of anxiety and depression with 30-day readmission rates and acute exacerbations of COPD (AECOPD). Four databases were searched to identify relevant studies published before 13 March 2024. Studies that report on the impact of anxiety and depression on the prognosis of AECOPD were included. The pooled effect size and its 95% confidence interval (CI) were calculated using a random effects model. The primary outcomes were 30-day readmission and AECOPD within the first year after discharge in COPD patients. Of the 5,955 studies screened, 14 studies were included in the analysis. Patients with anxiety had a higher risk of AECOPD within the first year after discharge compared to those without anxiety (HR: 2.10, 95% CI: 1.28-3.45, p = 0.003). Patients with depression also had a higher risk of AECOPD within the first year after discharge (HR: 1.36, 95% CI: 1.10-1.69, p = 0.004). Similar results were observed in the associations of anxiety and depression with 30-day readmission. Our results suggested that anxiety and depression were associated with an increased risk of 30-day readmission and AECOPD in patients with COPD.

Background: Cardiac tumors are rare, and a nonsurgical diagnosis is preferred for determining appropriate treatment strategies.

Research question: Can Endobronchial ultrasound-guided cryobiopsy (EBUS-cryo) be useful for diagnosing cardiac tumors?

Study design and methods: This paper presents a case report on the successful diagnosis of a rare cardiac tumor using EBUS-cryo. A 60-year-old woman was referred to our hospital after echocardiography revealed an epicardial tumor compressing the bilateral atria. Computed tomography revealed a 90-mm cardiac tumor adjacent to the tracheal bifurcation compressing the surrounding large vessels. Endobronchial ultrasound-guided cryobiopsy (EBUS-cryo) was performed, and a histological diagnosis of schwannoma, a type of peripheral nerve sheath tumor (PNST), was made without severe complications. Surgical resection was performed, and the tumor was found to originate from the pericardium on the left atrial wall.

Results: The surgical specimens contained small areas of perineurioma in addition to schwannoma, leading to the final diagnosis of extremely rare hybrid PNST.

Conclusion: EBUS-cryo can be one of useful biopsy techniques for diagnosing cardiac tumors.

Purpose: Although previous studies have compared strength-training adaptations between free weights (FW) and machine-guided exercises, those studies did not use a Smith machine (SM), which most closely replicates the exercises performed with FW. Thus, the aim of the present study was to investigate the chronic effects of strength-focused, velocity-based training regimens using FW versus SM.

Methods: Thirty-seven sport-science students (14 female) were assigned, balanced by sex and relative strength, to either an FW or SM training group. The training program lasted 8 weeks (2 sessions/wk), and participants performed 4 sets per exercise (back squat and bench press) at 70% of their 1-repetition maximum with moderate effort levels (20%-25% velocity loss). Load-velocity profile parameters (load-axis intercept, velocity-axis intercept, and area under the load-velocity relationship line), cross-sectional areas of the vastus lateralis and pectoralis major muscles, and the number of repetitions to failure in the bench-press exercise were assessed before and after the training program. Mechanical variables were assessed using both FW and SM.

Results: All variables, with the exception of back-squat velocity-axis intercept (P = .124), improved in both training groups. The changes in load-axis intercept and area under the load-velocity relationship line were more pronounced when the training and testing conditions matched. Failure in the bench-press exercise and cross-sectional areas of the vastus lateralis and pectoralis major showed comparable improvements for both training groups, while velocity-axis intercept tended to improve more in the SM group.

Conclusions: The general population, unconcerned with the specificity of strength adaptations, can choose a training modality (FW or SM) based on personal preferences.

Objective: This study aimed to assess the safety and potential efficacy of high-dose inhaled nitric oxide therapy for the prevention of postoperative pneumonia in cardiac surgery patients.

Methods: A prospective randomised controlled pilot study included 74 patients with moderate risk of postoperative pneumonia after elective cardiac surgery under cardiopulmonary bypass. Patients were randomised into two groups. The main group (NO-group) (n = 37) received inhaled nitric oxide at a dose of 200 ppm for 30 minutes 2 times a day for 5 days or until pneumonia developed. The control group received conventional postoperative care (n = 37). The primary endpoint was the incidence of postoperative pneumonia during in-hospital stay.

Results: Preventive nitric oxide inhalations were associated with a reduced incidence of postoperative nosocomial pneumonia (2 (5.4%) cases in the main group (NO-group) vs. 9 (24.3%) cases in the control group, p = 0.046; OR = 0.178, 95% CI = 0.036-0.89)). There was no decrease in either peak expiratory flow, or peak inspiratory flow in comparison with the preoperative values in the NO-group. Inhaled nitric oxide therapy is safe. It did not lead to an increase in the incidence of acute kidney injury.

Conclusions: High-dose inhaled nitric oxide therapy is safe and effective for the prevention of postoperative nosocomial pneumonia in cardiac surgery.