Chest
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Randomized Controlled Trial Comparative Study
Rapid vs Maintenance Vitamin D Supplementation in Deficient Asthmatic Children to Prevent Exacerbations.
Whether vitamin D reduces clinically important exacerbations of childhood asthma remains uncertain. We compared rapid to maintenance vitamin D repletion analyzed by baseline vitamin D level. ⋯ Rapid compared to maintenance vitamin D supplementation for children with the lowest levels resulted in short- but not long-term reduction in asthma exacerbations.
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There is increasing appreciation that mitochondria serve cellular functions beyond oxygen sensing and energy production. Accordingly, it has become important to explore noncanonical roles of mitochondria in normal and pathophysiological processes that influence airway structure and function in the context of diseases such as asthma and COPD. Mitochondria can sense upstream processes such as inflammation, infection, tobacco smoke, and environmental insults important in these diseases and in turn can respond to such stimuli through altered mitochondrial protein expression, structure, and resultant dysfunction. ⋯ Thus, understanding how mitochondrial structure and function play central roles in airway disease may be critical for the development of novel therapeutic avenues targeting dysfunctional mitochondria. In this case, it is likely that mitochondria of airway epithelium, smooth muscle, and fibroblasts play differential roles, consistent with their contributions to disease biology, underlining the challenge of targeting a ubiquitous cellular element of existential importance. This translational review summarizes the current state of understanding of mitochondrial processes that play a role in airway disease pathophysiology and identifying areas of unmet research need and opportunities for novel therapeutic strategies.
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Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by abnormal behaviors emerging during REM sleep that may cause injury or sleep disruption. The diagnosis requires polysomnography (PSG) demonstrating a loss of normal skeletal muscle atonia during REM sleep. RBD results from dysfunction of the brain stem circuits responsible for maintaining normal REM sleep atonia and suppressing behaviors during REM sleep. ⋯ RBD has been linked with narcolepsy and has been associated with a variety of other disorders. The management of RBD focuses on preventive/safety measures, counseling, monitoring for the development of a neurodegenerative disorder, and pharmacotherapy, which is typically effective but not well understood. The purpose of this article is to review and update our current understanding of the clinical features, epidemiology, demographics, pathophysiology, evaluation, diagnosis, differential diagnosis, causes, associations, and the clinical management of RBD.