American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Sep 2015
Hospitalization Type Predicts Risk of Subsequent Severe Sepsis.
Hospitalization is associated with microbiome perturbation (dysbiosis), and this perturbation is more severe in patients treated with antimicrobials. ⋯ There is a strong dose-response relationship between events known to result in dysbiosis and subsequent severe sepsis hospitalization that is not present for rehospitalization for nonsepsis diagnoses.
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Am. J. Respir. Crit. Care Med. · Sep 2015
Ten Year Mortality Following Community Acquired Pneumonia: A Prospective Cohort.
Information on the long-term prognosis after community-acquired pneumonia (CAP) is limited. ⋯ Our results indicate that an episode of CAP confers a high risk of long-term adverse events compared with the general population who have not experienced CAP, and this is irrespective of age.
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Am. J. Respir. Crit. Care Med. · Sep 2015
Pulmonary Nontuberculous Mycobacterial Infection: A Multisystem Multigenic Disease.
The clinical features of patients infected with pulmonary nontuberculous mycobacteria (PNTM) are well described, but the genetic components of infection susceptibility are not. ⋯ Patients with PNTM have more low-frequency, protein-affecting variants in immune, CFTR, cilia, and connective tissue genes than their unaffected family members and control subjects. We propose that PNTM infection is a multigenic disease in which combinations of variants across gene categories, plus environmental exposures, increase susceptibility to the infection.
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Am. J. Respir. Crit. Care Med. · Sep 2015
Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study.
Smoking-related microvascular loss causes end-organ damage in the kidneys, heart, and brain. Basic research suggests a similar process in the lungs, but no large studies have assessed pulmonary microvascular blood flow (PMBF) in early chronic lung disease. ⋯ PMBF was reduced in mild COPD, including in regions of lung without frank emphysema, and may represent a distinct pathological process from small airways disease. PMBF may provide an imaging biomarker for therapeutic strategies targeting the pulmonary microvasculature.