Chest
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Randomized Controlled Trial Multicenter Study
A Double-blind Randomized Placebo-controlled Phase-3 Trial of Tobramycin Inhalation Solution in Adults with Bronchiectasis with Pseudomonas aeruginosa Infection.
Few large-scale studies have demonstrated the efficacy of tobramycin nebulization in bronchiectasis. We evaluated the efficacy and safety of nebulized tobramycin inhalation solution (TIS) in adults with bronchiectasis with Pseudomonas aeruginosa infection. ⋯ TIS is an effective treatment option and has an acceptable safety profile in patients with bronchiectasis with P aeruginosa infection.
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Randomized Controlled Trial
Long-term azithromycin in children with bronchiectasis unrelated to cystic fibrosis: treatment effects over time.
Following evidence from randomized controlled trials, patients with bronchiectasis unrelated to cystic fibrosis receive long-term azithromycin to reduce acute respiratory exacerbations. However, the period when azithromycin is effective and which patients are likely to most benefit remain unknown. ⋯ Australian New Zealand Clinical Trials Registry; ACTRN12610000383066.
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The prognosis and therapeutic responses are worse for pulmonary arterial hypertension associated with systemic sclerosis (SSc-PAH) compared with idiopathic pulmonary arterial hypertension (IPAH). This discrepancy could be driven by divergence in underlying metabolic determinants of disease. ⋯ Patients with SSc-PAH are characterized by an unfavorable bioactive metabolic profile that may explain the poor and limited response to therapy. These data provide important metabolic insights into the molecular heterogeneity underlying differences between subgroups of PAH.
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As broader geographic sharing is implemented in lung transplant allocation through the Composite Allocation Score (CAS) system, models predicting waitlist and posttransplant (PT) survival will become more important in determining access to organs. ⋯ Use of alternative modeling strategies and contemporary cohorts did not improve performance of models determining access to lung transplant.
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Observational Study
Temporal trends and variation in bronchoscopy use for acute respiratory failure in the US.
National data on bronchoscopy for the evaluation of acute respiratory failure are lacking, and the limited available data suggest wide variation in use. ⋯ Bronchoscopy use among hospitalizations treated with IMV has increased over time. The large variation in use of bronchoscopy across hospitals suggests potentially unwarranted practice variation and need for further studies to clarify which patients benefit from bronchoscopy.