American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 2012
Biliary Sarcoidosis: Early Diagnosis Minimizes the Need for Surgery.
Biliary sarcoidosis is an unusual clinical entity which mimics autoimmune biliary disease and malignant distal obstruction. Three cases were managed in this series. ⋯ The third diagnosis was made using a Whipple resection specimen. Biliary sarcoidosis is an important consideration in those with an enigmatic presentation of jaundice as they may be managed non- operatively if expeditiously diagnosed.
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Am. J. Respir. Crit. Care Med. · Dec 2012
High levels of virus-specific CD4+ T cells predict severe pandemic influenza A virus infection.
T-cell responses have been implicated in control and exacerbation of lung injury during influenza A virus (IAV) infection. ⋯ High levels of circulating virus-specific CD4(+) T cells to two viral internal proteins (nucleoprotein and matrix) in the first phase of infection are associated with subsequent development of severe IAV infection. This finding could be an early and specific marker for ensuing clinical deterioration. Contrasting levels of antigen-specific CD8(+) T cells in lungs and blood have implications on design and analysis of clinical trials for T-cell vaccines because measurements of T cells in the periphery may not reflect events in the lungs.
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Am. J. Respir. Crit. Care Med. · Dec 2012
Systemic steroid exposure is associated with differential methylation in chronic obstructive pulmonary disease.
Systemic glucocorticoids are used therapeutically to treat a variety of medical conditions. Epigenetic processes such as DNA methylation may reflect exposure to glucocorticoids and may be involved in mediating the responses and side effects associated with these medications. ⋯ Our analyses suggest that systemic steroid use is associated with site-specific differential methylation throughout the genome. Differentially methylated CpG sites were found in biologically plausible and previously unsuspected pathways; these genes and pathways may be relevant in the development of novel targeted therapies.
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Am. J. Respir. Crit. Care Med. · Dec 2012
Comparative StudyNoninvasive ventilation in acute hypercapnic respiratory failure caused by obesity hypoventilation syndrome and chronic obstructive pulmonary disease.
Noninvasive ventilation (NIV) is widely used in episodes of acute hypercapnic respiratory failure (AHRF) in patients with chronic obstructive pulmonary disease (COPD). However, there is no evidence on the efficacy of NIV during similar episodes in obesity hypoventilation syndrome (OHS). Objectives: To compare the efficacy of NIV in episodes of AHRF caused by OHS and COPD. ⋯ Patients with OHS can be treated with NIV during an episode of AHRF with similar efficacy and better outcomes than patients with COPD.
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Am. J. Respir. Crit. Care Med. · Dec 2012
Traffic-related air pollution and lung function in children at 8 years of age: a birth cohort study.
Long-term exposure to air pollution has been related to lung function decrements in children, but the role of timing of exposure remains unknown. ⋯ Our results indicate that exposure to traffic-related air pollution during infancy affects lung function in children up to 8 years of age and particularly in those sensitized to common inhalant or food allergens.