American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 2015
Biomarker Development for COPD: From Discovery to Clinical Implementation.
Chronic obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality in the world. Regrettably, there are no biomarkers to objectively diagnose COPD exacerbations, which are the major drivers of hospitalization and deaths from COPD. ⋯ Although there has been a tremendous investment in COPD biomarker discovery over the past 2 decades, clinical translation and implementation have not matched these efforts. In this article, we outline the challenges of biomarker development in COPD and provide an overview of a developmental pipeline that may be able to surmount these challenges and bring novel biomarker solutions to accelerate therapeutic discoveries and to improve the care and outcomes of the millions of individuals worldwide with COPD.
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Am. J. Respir. Crit. Care Med. · Nov 2015
Clinical and Immunological Factors in Emphysema Progression: 5-year Prospective LES-COPD Study.
Cross-sectional studies of T-cell responses to self-antigens correlate with baseline emphysema severity. ⋯ The rate of emphysema progression quantified by CT scans among ever-smokers was highly variable; clinical factors and biomarkers explained only some of the variability. Aggressive clinical care that targets active smokers with autoreactive T cells and low BMI may temporize progression of emphysema.
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Am. J. Respir. Crit. Care Med. · Nov 2015
Quantitative Magnetic Resonance Imaging of Bronchopulmonary Dysplasia in the NICU Environment.
Bronchopulmonary dysplasia (BPD) is a prevalent yet poorly characterized pulmonary complication of premature birth; the current definition is based solely on oxygen dependence at 36 weeks postmenstrual age without objective measurements of structural abnormalities across disease severity. ⋯ Pulmonary MRI reveals quantifiable, significant differences between patients with BPD, premature patients without BPD, and full-term control subjects. These methods could be implemented to individually phenotype disease, which may impact clinical care and predict future outcomes.
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Am. J. Respir. Crit. Care Med. · Nov 2015
Clinical TrialEffects of Aged Stored Autologous Red Blood Cells on Human Endothelial Function.
A major abnormality that characterizes the red cell "storage lesion" is increased hemolysis and reduced red cell lifespan after infusion. Low levels of intravascular hemolysis after transfusion of aged stored red cells disrupt nitric oxide (NO) bioavailabity, via accelerated NO scavenging reaction with cell-free plasma hemoglobin. The degree of intravascular hemolysis post-transfusion and effects on endothelial-dependent vasodilation responses to acetylcholine have not been fully characterized in humans. ⋯ We demonstrate that the transfusion of blood at the limits of Food and Drug Administration-approved storage has a significant effect on the forearm circulation and impairs endothelial function. Clinical trial registered with www.clinicaltrials.gov (NCT 01137656).
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Am. J. Respir. Crit. Care Med. · Nov 2015
Recent Trends in the Identification of Incidental Pulmonary Nodules.
Pulmonary nodules are common incidental findings, but information about their incidence in the era of computed tomography (CT) is lacking. ⋯ Incidental pulmonary nodules are an increasingly common consequence of routine medical care, with an incidence that is much greater than recognized previously. More frequent nodule identification has not been accompanied by increases in the diagnosis of cancerous nodules.