American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Sep 2011
Multicenter StudyDetection of pulmonary emboli with 99mTc-labeled anti-D-dimer (DI-80B3)Fab' fragments (ThromboView).
We report a new method to diagnose acute pulmonary embolism (PE) by single photon emission computerized tomography (SPECT) after administration of (99m)Tc-labeled anti-D-dimer (DI-80B3) monoclonal antibody Fab' fragments. This novel technique provides an additional approach to diagnosing PE in patients for whom other methods are nondiagnostic or contraindicated. Objectives: We performed a prospective, multicenter study to investigate the sensitivity and specificity of (99m)Tc-DI-80B3/SPECT in patients with suspected acute PE. ⋯ (99m)Tc-DI-80B3/SPECT was sensitive and specific for acute PE in subjects with moderate to high clinical probability of PE or a positive D-dimer test. (99m)Tc-DI-80B3/SPECT demonstrated an acceptable safety profile and avoids exposure to contrast.
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Am. J. Respir. Crit. Care Med. · Sep 2011
Has my patient responded? Interpreting clinical measurements such as the 6-minute-walk test.
To correctly interpret clinical measurements it is necessary to understand the standard deviation and the standard error; the former reflects the range or variability of individuals within a sample and the latter reflects the precision for which the group parameters have been estimated. When evaluating an individual patient, test measurement properties such as repeatability will assist in concluding whether a repeated test, measured to monitor the response to an intervention, has changed beyond its natural variability. Using the “best” test has an inherent bias and ignores the natural test variation, whereas the average of repeated tests is more representative of the true value, making it more discriminative to change. Serial measurements to follow progress will increase a clinician's confidence in the observed effects of treatment.
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Am. J. Respir. Crit. Care Med. · Sep 2011
Acute exacerbations of chronic obstructive pulmonary disease: identification of biologic clusters and their biomarkers.
Exacerbations of chronic obstructive pulmonary disease (COPD) are heterogeneous with respect to inflammation and etiology. ⋯ The heterogeneity of the biologic response of COPD exacerbations can be defined. Sputum IL-1β, serum CXCL10, and peripheral eosinophils are biomarkers of bacteria-, virus-, or eosinophil-associated exacerbations of COPD. Whether phenotype-specific biomarkers can be applied to direct therapy warrants further investigation.
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Am. J. Respir. Crit. Care Med. · Sep 2011
Elevated eosinophil protein X in urine from healthy neonates precedes development of atopy in the first 6 years of life.
Biomarkers predicting development of atopic disease are needed for targeted preventive measures and to study if disease pathology may be active before onset of symptoms. ⋯ Eosinophil protein X in urine from asymptomatic neonates is a biomarker significantly associated with later development of allergic sensitization, nasal eosinophilia, and eczema during the first 6 years of life. These findings suggest activation of eosinophil granulocytes early in life before development of atopy-related symptoms.
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Idiopathic pulmonary fibrosis (IPF) is a deadly progressive disease with few treatment options. Transglutaminase 2 (TG2) is a multifunctional protein, but its function in pulmonary fibrosis is unknown. ⋯ TG2 is involved in pulmonary fibrosis in a mouse model and in human disease and is important in normal fibroblast function. With continued research on TG2, it may offer a new therapeutic target.