American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Oct 2011
Multicenter StudyEffect of five genetic variants associated with lung function on the risk of chronic obstructive lung disease, and their joint effects on lung function.
Genomic loci are associated with FEV1 or the ratio of FEV1 to FVC in population samples, but their association with chronic obstructive pulmonary disease (COPD) has not yet been proven, nor have their combined effects on lung function and COPD been studied. ⋯ Variants in TNS1, GSTCD, and HTR4 are associated with COPD. Our highest risk score category was associated with a 1.6-fold higher COPD risk than the population average score.
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Am. J. Respir. Crit. Care Med. · Oct 2011
Randomized Controlled Trial Multicenter StudyContinuity of care in intensive care units: a cluster-randomized trial of intensivist staffing.
Little is known about the consequences of intensivists’ work schedules, or intensivist continuity of care. ⋯ Work schedules where intensivists received weekend breaks were better for the physicians and, despite lower continuity of intensivist care, did not worsen outcomes for medical ICU patients.
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Am. J. Respir. Crit. Care Med. · Oct 2011
Multicenter StudyParental stress increases the detrimental effect of traffic exposure on children's lung function.
Emerging evidence indicates that psychosocial stress enhances the effect of traffic exposure on the development of asthma. ⋯ A high-stress home environment is associated with increased susceptibility to lung function effects of air pollution both at home and at school.
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Am. J. Respir. Crit. Care Med. · Oct 2011
Multicenter StudyChest computed tomography scores of severity are associated with future lung disease progression in children with cystic fibrosis.
Most children with cystic fibrosis (CF) experience a slow decline in spirometry, although some children continue to be at risk for more significant lung disease progression. Chest computed tomography (CT) scans have been shown to be more sensitive to changes in lung disease than spirometry and may provide a means for predicting future lung disease progression. ⋯ Chest CT scan scores are associated with future lung disease severity, and quantitative chest imaging(chest CT scan and chest radiograph scores) is more strongly associated with future lung disease severity than measures of spirometry. These findings may help clinicians identify patients at risk of future lung disease progression.
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Am. J. Respir. Crit. Care Med. · Oct 2011
Multicenter StudyThe effect of insurance status on mortality and procedural use in critically ill patients.
Lack of health insurance maybe an independent risk factor for mortality and differential treatment in critical illness. ⋯ Lack of health insurance is associated with increased 30-day mortality and decreased use of common procedures for the critically ill in Pennsylvania. Differences were not attributable to hospital-level effects, suggesting that the uninsured have a higher mortality and receive fewer procedures when compared with privately insured patients treated at the same hospitals.