American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 2012
Clinical TrialGenome-wide association analysis of blood biomarkers in chronic obstructive pulmonary disease.
A genome-wide association study (GWAS) for circulating chronic obstructive pulmonary disease (COPD) biomarkers could identify genetic determinants of biomarker levels and COPD susceptibility. ⋯ Distant genetic loci and biomarker-coding genes affect circulating levels of COPD-related pneumoproteins. A subset of these protein quantitative trait loci may influence their gene expression in the lung and/or COPD susceptibility. Clinical trial registered with www.clinicaltrials.gov (NCT 00292552).
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Am. J. Respir. Crit. Care Med. · Dec 2012
ReviewImproving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity.
Critical illness and its treatment often result in long-term neuropsychiatric morbidities. Consequently, there is a need to focus on means to prevent or ameliorate these morbidities. Animal models provide important data regarding the neurobiological effects of physical activity, including angiogenesis, neurogenesis, and release of neurotrophic factors that enhance plasticity. ⋯ Barriers exist regarding implementing ICU rehabilitation in routine care, including use of sedatives and lack of awareness of post-ICU cognitive impairments. Further research is necessary to determine whether prior animal and human research, in conjunction with preliminary results from existing ICU studies, can translate into improvements for neuropsychiatric outcomes in critically ill patients. Studies are needed to evaluate biological mechanisms, risk factors, the role of pre-ICU functional level, and the timing, duration, and type of physical activity for optimal patient outcomes.
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Am. J. Respir. Crit. Care Med. · Dec 2012
Comparative StudyNoninvasive ventilation in acute hypercapnic respiratory failure caused by obesity hypoventilation syndrome and chronic obstructive pulmonary disease.
Noninvasive ventilation (NIV) is widely used in episodes of acute hypercapnic respiratory failure (AHRF) in patients with chronic obstructive pulmonary disease (COPD). However, there is no evidence on the efficacy of NIV during similar episodes in obesity hypoventilation syndrome (OHS). Objectives: To compare the efficacy of NIV in episodes of AHRF caused by OHS and COPD. ⋯ Patients with OHS can be treated with NIV during an episode of AHRF with similar efficacy and better outcomes than patients with COPD.
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Am. J. Respir. Crit. Care Med. · Dec 2012
High levels of virus-specific CD4+ T cells predict severe pandemic influenza A virus infection.
T-cell responses have been implicated in control and exacerbation of lung injury during influenza A virus (IAV) infection. ⋯ High levels of circulating virus-specific CD4(+) T cells to two viral internal proteins (nucleoprotein and matrix) in the first phase of infection are associated with subsequent development of severe IAV infection. This finding could be an early and specific marker for ensuing clinical deterioration. Contrasting levels of antigen-specific CD8(+) T cells in lungs and blood have implications on design and analysis of clinical trials for T-cell vaccines because measurements of T cells in the periphery may not reflect events in the lungs.
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Am. J. Respir. Crit. Care Med. · Dec 2012
Traffic-related air pollution and lung function in children at 8 years of age: a birth cohort study.
Long-term exposure to air pollution has been related to lung function decrements in children, but the role of timing of exposure remains unknown. ⋯ Our results indicate that exposure to traffic-related air pollution during infancy affects lung function in children up to 8 years of age and particularly in those sensitized to common inhalant or food allergens.