American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 2018
Mortality Changes Associated with Mandated Public Reporting for Sepsis: The Results of the New York State Initiative.
In 2013, the New York State Department of Health (NYSDOH) began a mandatory state-wide initiative to improve early recognition and treatment of severe sepsis and septic shock. ⋯ New York's statewide initiative increased compliance with sepsis-performance measures. Risk-adjusted sepsis mortality decreased during the initiative and was associated with increased hospital-level compliance.
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Am. J. Respir. Crit. Care Med. · Dec 2018
Observational StudyLongitudinal Phenotypes and Mortality in Preserved Ratio Impaired Spirometry in the COPDGene Study.
Increasing awareness of the prevalence and significance of Preserved Ratio Impaired Spirometry (PRISm), alternatively known as restrictive or Global Initiative for Chronic Obstructive Lung Disease (GOLD)-unclassified spirometry, has expanded the body of knowledge on cross-sectional risk factors. However, longitudinal studies of PRISm remain limited. ⋯ PRISm is highly prevalent, is associated with increased mortality, and represents a transitional state for significant subgroups of subjects. Additional studies to characterize longitudinal progression in PRISm are warranted.
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Am. J. Respir. Crit. Care Med. · Dec 2018
End-of-Life Strategies among Patients with Advanced Chronic Obstructive Pulmonary Disease.
The burden of advanced chronic obstructive pulmonary disease (COPD) is high globally; however, little is known about how often end-of-life strategies are used by this population. ⋯ The proportion of people with advanced COPD using end-of-life strategies, although increasing, remains low. Efforts should focus on increasing access to such strategies and educating patients and providers of their benefits.
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Am. J. Respir. Crit. Care Med. · Dec 2018
Ambient Pollution-related Reprogramming of the Human Small Airway Epithelial Transcriptome.
Epidemiologic studies have demonstrated that exposure to particulate matter ambient pollution has adverse effects on lung health, exacerbated by cigarette smoking. Particulate matter less than or equal to 2.5 μm in aerodynamic diameter (PM2.5) is among the most harmful urban pollutants and is closely linked to respiratory disease. ⋯ PM2.5 exposure contributes to significant dysregulation of the SAE transcriptome of smokers, linking pollution and airway epithelial biology in the risk of development of respiratory disease in susceptible individuals.