Annals of the American Thoracic Society
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Randomized Controlled Trial
Montelukast for Children with Obstructive Sleep Apnea: Results of a Double-Blind, Randomized, Placebo-Controlled Trial.
Obstructive sleep apnea (OSA) is highly prevalent in children and is usually treated by adenotonsillectomy. Nonsurgical therapies for OSA consist primarily of antiinflammatory approaches and have gained popularity, but their efficacy remains to be critically examined. ⋯ When compared with placebo, montelukast for 16 weeks effectively reduced the severity of obstructive sleep apnea in children 2-10 years of age. These results support a therapeutic role for leukotriene modifiers in pediatric OSA provided that long-term trials confirm current findings. Clinical trial registered with www.clinicaltrials.gov (NCT 00599534).
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Multicenter Study
Epidemiology of Vasopressin Use for Adults with Septic Shock.
Vasopressin may be used to treat vasodilatory hypotension in septic shock, but it is not recommended by guidelines as a first- or second-line agent. Little is known about how often the drug is used currently in septic shock. ⋯ Approximately one-fifth of patients with septic shock received vasopressin, but rarely as a single vasopressor. The use of vasopressin has increased over time. The likelihood of receiving vasopressin was strongly associated with the specific hospital to which each patient was admitted.
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Radiologist reports of pulmonary nodules discovered incidentally on computed tomographic (CT) images of the chest may influence subsequent evaluation and management. ⋯ Within one multifacility urban health system in the United States, the terms used by radiologists to describe incidental pulmonary nodules were associated with documentation of the nodule by the ordering physician and subsequent follow-up. Standard terminology should be used to describe pulmonary nodules to improve patient outcomes.
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The American Thoracic Society (ATS), in collaboration with George Mason University, surveyed international members of the society to assess perceptions, clinical experiences, and preferred policy responses related to global climate change. A recruitment email was sent by the ATS President in October 2015 to 5,013 international members. Subsequently, four reminder emails were sent to nonrespondents. ⋯ Respondents further indicated that physicians and physician organizations should play an active role in educating patients, the public, and policy makers on the human health effects of climate change. International ATS respondents, like their counterparts in the U. S., observed that human health is already adversely affected by climate change, and support responses to address this situation.