American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jan 2008
Autoantibodies in patients with chronic obstructive pulmonary disease.
Adaptive immune responses are present in patients with chronic obstructive pulmonary disease (COPD), and it has been postulated that these processes could be autoreactive. ⋯ IgG autoantibodies with avidity for pulmonary epithelium, and the potential to mediate cytotoxicity, are prevalent in patients with COPD. Autoreactive adaptive immune responses may be important in the etiology of this disease.
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Am. J. Respir. Crit. Care Med. · Jan 2008
ReviewEvolution of mechanical ventilation in response to clinical research.
Recent literature in mechanical ventilation includes strong evidence from randomized trials. Little information is available regarding the influence of these trials on usual clinical practice. ⋯ The strong concordance of predicted and observed practice changes suggests that randomized trial results have advanced mechanical ventilation practices internationally.
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Am. J. Respir. Crit. Care Med. · Jan 2008
Idiopathic pulmonary fibrosis: outcome in relation to smoking status.
The pathogenic importance of smoking status in idiopathic pulmonary fibrosis (IPF) is uncertain. In theory, increased oxidative stress in current and former smokers might promote disease progression. However, better survival has been reported for current smokers with IPF, although this might reflect less severe disease at presentation (a "healthy smoker effect"). ⋯ In IPF, survival and severity-adjusted survival are higher in nonsmokers than in former smokers or the combined group of former and current smokers. By contrast, a better outcome in current smokers, compared with former smokers, reflects less severe disease at presentation and may represent a healthy smoker effect.
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Am. J. Respir. Crit. Care Med. · Jan 2008
IFN-gamma production during initial infection determines the outcome of reinfection with respiratory syncytial virus.
Severe respiratory syncytial virus (RSV) bronchiolitis has been associated with deficient IFN-gamma production in humans, but the role of this cytokine in determining the outcome of reinfection is unknown. ⋯ IFN-gamma production during primary RSV infection is critical to the development of protection against AHR and lung histopathology on reinfection. Provision of IFN-gamma during primary infection in infancy may be a potential therapeutic approach to alter the course of RSV-mediated long-term sequelae.
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Am. J. Respir. Crit. Care Med. · Jan 2008
Acute hypercapnia improves indices of tissue oxygenation more than dobutamine in septic shock.
Hypercapnia has similar hemodynamic effects to those of a dobutamine infusion and may have relevance in the management of septic shock. ⋯ In this clinically relevant ovine model of septic shock, hypercapnia had similar effects to dobutamine on hemodynamic variables and lactic acidosis. Hypercapnia improved tissue oxygenation and reduced lung edema formation more than dobutamine administration.