American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · May 2017
Lung Pathologies in a Chronic Inflammation Mouse Model are Independent of Eosinophil Degranulation.
The release of eosinophil granule proteins in the lungs of patients with asthma has been dogmatically linked with lung remodeling and airway hyperresponsiveness. However, the demonstrated inability of established mouse models to display the eosinophil degranulation occurring in human subjects has prevented a definitive in vivo test of this hypothesis. ⋯ These data suggest that improvements observed in patients with asthma responding to therapeutic strategies ablating eosinophils may occur as a consequence of targeting immunoregulatory mechanisms and not by simply eliminating the destructive activities of these purportedly end-stage effector cells.
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Am. J. Respir. Crit. Care Med. · May 2017
Randomized Controlled Trial Comparative StudyBalanced Crystalloids versus Saline in the Intensive Care Unit: The SALT Randomized Trial.
Saline is the intravenous fluid most commonly administered to critically ill adults, but it may be associated with acute kidney injury and death. Whether use of balanced crystalloids rather than saline affects patient outcomes remains unknown. ⋯ An electronic health record-embedded, cluster-randomized, multiple-crossover trial comparing saline with balanced crystalloids can produce well-balanced study groups and separation in crystalloid receipt. Clinical trial registered with www.clinicaltrials.gov (NCT 02345486).
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Am. J. Respir. Crit. Care Med. · May 2017
Randomized Controlled TrialPedometer Step Count Targets During Pulmonary Rehabilitation in COPD: A Randomized Controlled Trial.
Increasing physical activity is a key therapeutic aim in chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) improves exercise capacity, but there is conflicting evidence regarding its ability to improve physical activity levels. ⋯ Pedometer-directed step-count targets during an outpatient PR program did not enhance moderate-intensity physical activity levels in people with COPD. Clinical trial registered with www.clinicaltrials.gov (NCT01719822).
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Am. J. Respir. Crit. Care Med. · May 2017
Neutrophil Elastase Activity is Associated with Exacerbations and Lung Function Decline in Bronchiectasis.
Sputum neutrophil elastase and serum desmosine, which is a linked marker of endogenous elastin degradation, are possible biomarkers of disease severity and progression in bronchiectasis. This study aimed to determine the association of elastase activity and desmosine with exacerbations and lung function decline in bronchiectasis. ⋯ Sputum neutrophil elastase activity is a biomarker of disease severity and future risk in adults with bronchiectasis.