The clinical respiratory journal
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To review the airway microbiome in chronic obstructive pulmonary disease (COPD), bronchiectasis and bronchiectasis-COPD overlap (BCO). ⋯ Use of next-generation sequencing has revolutionised our detection and understanding of the airway microbiome in chronic respiratory diseases such as COPD and bronchiectasis. Targeted amplicon sequencing reveals important associations between the respiratory microbiome and disease outcome while metagenomics may elucidate functional pathways. How best to apply this information into patient care, monitoring and treatment, however, remains challenging and necessitates further study.
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Risk stratification for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) may help clinicians choose appropriate treatments and improve the quality of care. ⋯ The new scale may help to stratify the risk of in-hospital mortality of AECOPD. The DECAF performed as well as the new instrument, and it appears to be valid in Chinese patients.
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We investigated the randomized controlled trials (RCTs) related to acute respiratory distress syndrome (ARDS) to assess the presentation and frequency of misrepresented research findings, also known as spin. ⋯ RCTs of ARDS interventions with nonsignificant primary endpoints often included spin in the abstract. Spin in the abstract may influence clinician appraisal and interpretation of diagnostic or treatment modalities.
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Patients with pulmonary embolism (PE) have a higher red cell distribution width (RDW), which may complicate the interpretation of the prognosis of PE. We aim to evaluate the diagnostic utility of the RDW in patients with PE. ⋯ An elevated RDW has the potential to be a biomarker for prognosis in PE patients.
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To characterize the clinical course and outcome of children with status asthmaticus (SA) admitted to a pediatric intensive care unit (PICU) METHODS: All patients with SA who were admitted to a PICU from January 2003 to December 2018 were reviewed. Polymerase chain reaction (PCR) studies on nasopharyngeal aspirate for respiratory pathogens were performed from 2014 to 2018. ⋯ SA accounts for a small proportion of PICU admissions. LOS was short and prognosis generally good. Nonadherence to prior asthma therapy was common. The most common trigger is enterovirus/rhinovirus for children with severe asthma requiring PICU admission. A trend of increase in usage of ipratropium, magnesium sulfate and NIV was observed. Primary prevention and early treatment of exacerbation are the most important step in managing children with asthma. Regular follow-up to ensure compliance together with annual vaccination could possibly avoid PICU admissions.