American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · May 2015
Historical ArticleHistory of Mechanical Ventilation: From Vesalius to Ventilator-Induced Lung Injury.
Mechanical ventilation is a life-saving therapy that catalyzed the development of modern intensive care units. The origins of modern mechanical ventilation can be traced back about five centuries to the seminal work of Andreas Vesalius. ⋯ One of the great advances in ventilatory support over the past few decades has been the development of lung-protective ventilatory strategies, based on our understanding of the iatrogenic consequences of mechanical ventilation such as ventilator-induced lung injury. These strategies have markedly improved clinical outcomes in patients with respiratory failure.
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Am. J. Respir. Crit. Care Med. · May 2015
Randomized Controlled TrialLong-term Follow-up Results of the DANTE Trial, a Randomized Study of Lung Cancer Screening with Spiral Computed Tomography.
Screening for lung cancer with low-dose spiral computed tomography (LDCT) has been shown to reduce lung cancer mortality by 20% compared with screening with chest X-ray (CXR) in the National Lung Screening Trial, but uncertainty remains concerning the efficacy of LDCT screening in a community setting. ⋯ Because of its limited statistical power, the results of the DANTE (Detection And screening of early lung cancer with Novel imaging TEchnology) trial do not allow us to make a definitive statement about the efficacy of LDCT screening. However, they underline the importance of obtaining additional data from randomized trials with intervention-free reference arms before the implementation of population screening.
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Am. J. Respir. Crit. Care Med. · May 2015
Non-invasive Analysis of the Sputum Transcriptome Discriminates Clinical Phenotypes of Asthma.
The airway transcriptome includes genes that contribute to the pathophysiologic heterogeneity seen in individuals with asthma. ⋯ There are common patterns of gene expression in the sputum and blood of children and adults that are associated with near-fatal, severe, and milder asthma.
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Am. J. Respir. Crit. Care Med. · May 2015
PRAGMA-CF: a Quantitative Structural Lung Disease CT Outcome in Young Children with Cystic Fibrosis.
Chest computed tomography (CT) is the gold standard for demonstrating cystic fibrosis (CF) airway disease. However, there are no standardized outcome measures appropriate for children younger than 6 years. ⋯ PRAGMA-CF is a sensitive and reproducible outcome measure for assessing the extent of lung disease in very young children with CF.
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Am. J. Respir. Crit. Care Med. · May 2015
Risk Assessment of Tuberculosis in Contacts by Interferon-γ Release Assays (IGRAs). A TBNET Study.
Latent infection with Mycobacterium tuberculosis is defined by a positive IFN-γ release assay (IGRA) result in the absence of active tuberculosis. Only few, mostly monocentric studies have evaluated the role of IGRAs to predict the development of tuberculosis in recent contacts in low-incidence countries of tuberculosis. ⋯ Tuberculosis rarely developed among contacts, and preventive chemotherapy effectively reduced the tuberculosis risk among IGRA-positive contacts. Although the negative predictive value of IGRAs is high, the risk for the development of tuberculosis is poorly predicted by these assays.