American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jan 2012
Randomized Controlled TrialThe calcium sensitizer levosimendan improves human diaphragm function.
Acquired diaphragm muscle weakness is a key feature in several chronic conditions, including chronic obstructive pulmonary disease, congestive heart failure, and difficult weaning from mechanical ventilation. No drugs are available to improve respiratory muscle function in these patients. Recently, we have shown that the calcium sensitizer levosimendan enhances the force-generating capacity of isolated diaphragm fibers. ⋯ The calcium sensitizer levosimendan improves neuromechanical efficiency and contractile function of the human diaphragm. Our findings suggest a new therapeutic approach to improve respiratory muscle function in patients with respiratory failure.
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Am. J. Respir. Crit. Care Med. · Jan 2012
ReviewCorticosteroids in respiratory diseases in children.
We review recent advances in the use of corticosteroids (CS) in pediatric lung disease. CS are frequently used, systemically or by inhalation. Their mechanisms of action in pulmonary diseases are ill defined. ⋯ There is concern about adverse effects, especially growth and adrenal suppression, induced by systemic CS in children. These have been reduced, but not eliminated, with the use of the inhaled route. The benefits must be weighed against the potential detrimental effects.
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Am. J. Respir. Crit. Care Med. · Jan 2012
Doubling times and CT screen–detected lung cancers in the Pittsburgh Lung Screening Study.
As computed tomography (CT) screening for lung cancer becomes more widespread, volumetric analyses, including doubling times, of CT-screen detected lung nodules and lung cancers may provide useful information in the follow-up and management of CT-detected lung nodules and cancers. ⋯ Volumetric analysis of CT-detected lung cancers is particularly useful in AC/BAC. Prevalent cancers have a significantly slower DT than nonprevalent cancers and a higher percentage of adenocarcinoma/bronchioloalveolar carcinoma. These results should affect the management of indeterminant lung nodules detected on screening CT scans.
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Am. J. Respir. Crit. Care Med. · Jan 2012
Prostaglandin E2 as an inhibitory modulator of fibrogenesis in human lung allografts.
Donor mesenchymal stromal/stem cell (MSC) expansion and fibrotic differentiation is associated with development of bronchiolitis obliterans syndrome (BOS) in human lung allografts. However, the regulators of fibrotic differentiation of these resident mesenchymal cells are not well understood. ⋯ These data identify the PGE2 axis as an important autocrine-paracrine brake on fibrotic differentiation of LR-MSCs, a failure of which is associated with BOS.
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Am. J. Respir. Crit. Care Med. · Jan 2012
Assessing the site of maximal obstruction in the trachea using lateral pressure measurement during bronchoscopy.
Lateral airway pressure can provide valuable physiological information during bronchoscopy. ⋯ The direct measurement of pressure difference and the angle of the pressure-pressure curve represent a new assessment modality for the success of interventional bronchoscopy. Measuring lateral airway pressure could estimate the need for additional procedures better than bronchoscopy alone.