American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jan 2014
Multicenter StudyDeterminants of Procedural Pain Intensity in the Intensive Care Unit: The Europain Study.
Intensive care unit (ICU) patients undergo several diagnostic and therapeutic procedures every day. The prevalence, intensity, and risk factors of pain related to these procedures are not well known. ⋯ Knowledge of risk factors for greater procedural pain intensity identified in this study may help clinicians select interventions that are needed to minimize procedural pain. Clinical trial registered with www.clinicaltrials.gov (NCT 01070082).
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Am. J. Respir. Crit. Care Med. · Jan 2014
Multicenter Study Comparative StudyInterferon-γ Release Assays and Tuberculin Skin Testing for Diagnosis of Latent Tuberculosis Infection in Healthcare Workers in the United States.
IFN-γ release assays (IGRAs) are alternatives to tuberculin skin testing (TST) for diagnosis of latent tuberculosis infection. Limited data suggest IGRAs may not perform well for serial testing of healthcare workers (HCWs). ⋯ Most conversions among HCWs in low TB incidence settings appear to be false positives, and these occurred six to nine times more frequently with IGRAs than TST; repeat testing of apparent converters is warranted.
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Am. J. Respir. Crit. Care Med. · Jan 2014
Risk Factors and Comorbidities in the Pre-Clinical Stages of Chronic Obstructive Pulmonary Disease.
There is little information about comorbidities and their risk factors in the preclinical stages of chronic obstructive pulmonary disease (COPD). ⋯ Premorbid risk factors and comorbid diseases were more prevalent in the preclinical stages of COPD and smokers without COPD. Physical inactivity and smoking were more strongly associated with the presence of comorbidities compared with airflow obstruction. Clinical trial registered with www.clinicaltrials.gov (NCT 01314807).
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Am. J. Respir. Crit. Care Med. · Jan 2014
Persistent Latent Tuberculosis Reactivation Risk in US Immigrants.
Current guidelines limit latent tuberculosis infection (LTBI) evaluation to persons in the United States less than or equal to 5 years based on the assumption that high TB rates among recent entrants are attributable to high LTBI reactivation risk, which declines over time. We hypothesized that high postarrival TB rates may instead be caused by imported active TB. ⋯ High postarrival TB rates were caused by detection of imported TB through active postarrival surveillance. Among immigrants without active TB at baseline, reported TB did not decline over 9 years, indicating sustained high risk of LTBI reactivation. Revised guidelines should support LTBI screening and treatment more than 5 years after U.S. arrival.
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Am. J. Respir. Crit. Care Med. · Jan 2014
Letter Case ReportsDiffuse panbronchiolitis and IgA nephropathy.