CHEST Guidelines-Response_chest

Response_chest_28 (1)

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The document consists of two separate letters to the editor discussing different studies published in the medical journal "CHEST."<br /><br />The first letter, authored by Gerard A. Silvestri and Nicholas James Pastis of the Medical University of South Carolina, addresses transbronchial cryobiopsies in the diagnosis of interstitial and other lung diseases. The authors agree with previous comments on the potential cost savings associated with this approach, in addition to its safety and effectiveness. They emphasize the need for well-designed, randomized controlled studies to better establish the procedure's role in diagnostic algorithms and advocate for evidence-based guidelines to enhance practice standards. They express anticipation for further research, suggesting that transbronchial cryobiopsies could significantly advance bronchoscopy techniques, similar to the impact of endobronchial ultrasound over the past decade.<br /><br />The second letter comments on an article by Alonso-Fernández et al. regarding the relationship between obstructive sleep apnea (OSA) and recurrent venous thromboembolism (VTE). The authors critique the study's methodology, questioning the rationale behind the inclusion criteria based on the apnea-hypopnea index (AHI) and the exclusion of patients with specific AHI scores. They note obesity as a significant risk factor for both OSA and pulmonary embolism, observing no significant differences in body mass index among patient groups in the study. The letter challenges the conclusions about continuous positive airway pressure (CPAP) treatment compliance and its effect on PE recurrence, suggesting statistical insignificance due to small sample sizes and advocating for larger studies. Additionally, they point out discrepancies in study parameters such as BMI, D-dimer levels, and other health metrics, indicating mild to moderate severity and nonsignificant differences between different patient groups.

Keywords

transbronchial cryobiopsies

interstitial lung diseases

bronchoscopy techniques

randomized controlled studies

obstructive sleep apnea

venous thromboembolism

apnea-hypopnea index

continuous positive airway pressure

pulmonary embolism

evidence-based guidelines