Chest
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Randomized Controlled Trial Multicenter Study
The association between a Darc gene polymorphism and clinical outcomes in African American patients with acute lung injury.
Acute lung injury (ALI) mortality is increased among African Americans compared with Americans of European descent, and genetic factors may be involved. A functional T-46C polymorphism (rs2814778) in the promoter region of Duffy antigen/receptor for chemokines (Darc) gene, present almost exclusively in people of African descent, results in isolated erythrocyte DARC deficiency and has been implicated in ALI pathogenesis in preclinical and murine models, possibly because of an increase in circulating Duffy-binding, proinflammatory chemokines like IL-8. We sought to determine the effect of the functional rs2814778 polymorphism, C/C genotype (Duffy null state), on clinical outcomes in African Americans with acute lung injury. ⋯ Our results provide evidence that the functional rs2814778 polymorphism in the gene encoding DARC is associated with worse clinical outcomes among African Americans with ALI, possibly via an increase in circulating IL-8.
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Acute eosinophilic pneumonia (AEP) is an idiopathic disease characterized by pulmonary eosinophilia. Because the fraction of exhaled nitric oxide (Feno) is a surrogate of eosinophilic inflammation, we evaluated the levels, changed treatments, and the diagnostic role of Feno in patients with AEP. ⋯ The Feno level was significantly higher in patients with AEP than in those without AEP. Feno measurement can be used as a diagnostic tool to differentiate patients with AEP from those without AEP.
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Randomized Controlled Trial Multicenter Study Comparative Study
Macrolide antibiotics and survival in patients with acute lung injury.
Animal models suggest that immunomodulatory properties of macrolide antibiotics have therapeutic value for patients with acute lung injury (ALI). We investigated the association between receipt of macrolide antibiotics and clinical outcomes in patients with ALI. ⋯ Receipt of macrolide antibiotics was associated with improved outcomes in patients with ALI.
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Randomized Controlled Trial Comparative Study
The effects of a "new" walking aid on exercise performance in patients with COPD: a randomized crossover trial.
Generally, the use of a rollator improves mobility in patients with COPD. Nevertheless, not all patients benefit from its use, and many patients feel embarrassed about using it. Therefore, other walking aids are worthwhile to consider. We compared the direct effects of a "new" ambulation aid (a modern draisine) with the effects of a rollator on 6-min walk distance (6MWD) in patients with COPD. ⋯ The mean difference in 6MWD between a modern draisine and a rollator seems clinically relevant, with the same metabolic requirements and symptom Borg scores. Therefore, this "new" ambulation aid could be a good alternative to the rollator to improve functional exercise performance in patients with COPD.
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Lung cancer is the leading cause of cancer-related mortality in the United States and around the world. There are > 90 million current and ex-smokers in the United States who are at increased risk of lung cancer. ⋯ However, to implement this program nationwide using the NLST inclusion and exclusion criteria would be extremely expensive, with CT scan costs alone > $2 billion per annum. In this article, we offer a possible low-cost strategy to risk-stratify smokers on the basis of spirometry measurements and emphysema scoring by radiologists on CT scans.