American journal of respiratory and critical care medicine
-
Am. J. Respir. Crit. Care Med. · Mar 2017
Randomized Controlled Trial Multicenter StudyBenefits of Long-Term Pulmonary Rehabilitation Maintenance Program in Severe COPD Patients: 3 Year Follow-Up.
In chronic obstructive pulmonary disease (COPD), the benefits of pulmonary rehabilitation (PR) tend to wane over time. Whether maintenance techniques may help sustain the benefits achieved after completion of the initial PR program remains controversial. ⋯ This study shows a 2-year beneficial effect of a program of rehabilitation maintenance on the BODE index and 6MWD when compared with a standard strategy. This effect vanishes after the second year of follow-up. Clinical trial registered with www.clinicaltrials.gov (NCT 01090999).
-
Am. J. Respir. Crit. Care Med. · Mar 2017
ReviewCarbon Monoxide Poisoning: Pathogenesis, Management and Future Directions of Therapy.
Carbon monoxide (CO) poisoning affects 50,000 people a year in the United States. The clinical presentation runs a spectrum, ranging from headache and dizziness to coma and death, with a mortality rate ranging from 1 to 3%. A significant number of patients who survive CO poisoning suffer from long-term neurological and affective sequelae. ⋯ Although hyperbaric oxygen significantly reduces the permanent neurological and affective effects of CO poisoning, a portion of survivors still have substantial morbidity. There has been some early success in therapies targeting the downstream inflammatory and oxidative effects of CO poisoning. New methods to directly target the toxic effect of CO, such as CO scavenging agents, are currently under development.
-
Am. J. Respir. Crit. Care Med. · Mar 2017
Multicenter StudyPermissive Underfeeding or Standard Enteral Feeding in High and Low Nutritional Risk Critically Ill Adults: Post-hoc Analysis of the PermiT trial.
The optimal nutritional strategy for critically ill adults at high nutritional risk is unclear. ⋯ Among patients with high and low nutritional risk, permissive underfeeding with full protein intake was associated with similar outcomes as standard feeding.
-
Am. J. Respir. Crit. Care Med. · Mar 2017
Asthma Trajectories in a Population-based Birth Cohort: Impacts of Air Pollution and Greenness.
The heterogeneity of asthma phenotypes may explain inconsistencies in observed associations with environmental exposures. ⋯ Traffic-related air pollution increased the probability of a chronic asthma trajectory.
-
Am. J. Respir. Crit. Care Med. · Mar 2017
Genetic Modifiers of Progression-free Survival in Never-smoking Lung Adenocarcinoma Patients Treated with First-line TKIs.
Patients with non-small cell lung cancer (NSCLC) with mutated epidermal growth factor receptor (EGFR) are relatively sensitive to EGFR-tyrosine kinase inhibitor (TKI) treatment and have longer progression-free survival (PFS) when treated with EGFR-TKI compared with platinum-based chemotherapy. However, many patients with advanced NSCLC who have mutated EGFR do not respond to first-line EGFR-TKI treatment and still have shorter PFS. ⋯ Genetic variants in 4q12 merit further investigation to assess their potential as pharmacogenomic predictors for and to understand the biology underlying its influence on PFS in patients treated with TKI therapy.