American journal of respiratory and critical care medicine
-
Am. J. Respir. Crit. Care Med. · Oct 2013
Challenges with QuantiFERON-TB Gold Assay for Large-Scale, Routine Screening of US Healthcare Workers.
North American occupational health programs that switched from the tuberculin skin test (TST) to IFN-γ release assays for latent tuberculosis screening are reporting challenges with interpretation of serial testing results in healthcare workers (HCWs). However, limited data exist on the reproducibility of serial IFN-γ release assay results in low-risk HCWs. ⋯ The manufacturer's definition of QFT conversion results in an inflated conversion rate that is incompatible with our low-risk setting. A significantly higher QFT cutoff value is needed to match the historical TST conversion rate. Nonreproducible conversions in most converters suggested false-positive results.
-
Am. J. Respir. Crit. Care Med. · Oct 2013
Risk Factors for Drug-Resistant Pathogens in Community-Acquired and Healthcare-Associated Pneumonia.
Identification of patients with drug-resistant pathogens at initial diagnosis is essential for treatment of pneumonia. ⋯ The clinical profile of HCAP was different from that of CAP. However, physicians can predict drug resistance in patients with either CAP or HCAP by taking account of the cumulative number of the risk factors. Clinical trial registered with https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000004001&language=E ; number UMIN000003306.
-
Am. J. Respir. Crit. Care Med. · Oct 2013
Lung Bone Marrow-Derived Hematopoietic Progenitor Cells Enhance Pulmonary Fibrosis.
Bone marrow (BM)-derived cells have been implicated in pulmonary fibrosis. However, their precise role in pathogenesis is incompletely understood. ⋯ BM-derived LHPCs with a novel phenotype could differentiate into GFP(hi) cells, which enhanced pulmonary fibrosis. Targeting this mobilized LHPCs might represent a novel therapeutic approach in chronic fibrotic lung diseases.
-
Am. J. Respir. Crit. Care Med. · Oct 2013
Endogenous Alpha-2-Antiplasmin is Protective during Severe Gram-Negative Sepsis (Melioidosis).
α2-Antiplasmin (A2AP) is a major inhibitor of fibrinolysis by virtue of its capacity to inhibit plasmin. Although the fibrinolytic system is strongly affected by infection, the functional role of A2AP in the host response to sepsis is unknown. ⋯ This study is the first to identify A2AP as a protective mediator during gram-negative (pneumo)sepsis by limiting bacterial growth, inflammation, tissue injury, and coagulation.