American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Apr 2013
Randomized Controlled Trial Multicenter StudyExploring the effects of omalizumab in allergic asthma: an analysis of biomarkers in the EXTRA study.
For many patients with asthma, allergic airway inflammation is primarily a Th2-weighted process; however, heterogeneity in patterns of inflammation suggests phenotypic distinctions exist that influence disease presentation and treatment effects. ⋯ The difference in exacerbation frequency between omalizumab and placebo was greatest in the three high-biomarker subgroups, probably associated with the greater risk for exacerbations in high subgroups. Additional studies are required to explore the value of these biomarkers in clinical practice. Clinical trial registered with www.clinicaltrials.gov (NCT00314574).
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Am. J. Respir. Crit. Care Med. · Apr 2013
Randomized Controlled TrialCharacteristics of lung cancers detected by computer tomography screening in the randomized NELSON trial.
The NELSON (Nederlands Leuvens Longkanker Screenings Onderzoek) trial is, with 15,822 participants, the largest European lung cancer computer tomography screening trial. A volumetry-based screening strategy, stringent criteria for a positive screening, and an increasing length of screening interval are particular features of the NELSON trial. ⋯ Despite stringent criteria for a positive screening, an increasing length of screening interval, and few female participants, the screening strategy of the NELSON trial resulted in a favorable cancer stage distribution at diagnosis, which is essential for the effectiveness of our screening strategy. Clinical trial registered with www.trialregister.nl (ISRCTN63545820).
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Am. J. Respir. Crit. Care Med. · Apr 2013
Randomized Controlled Trial Multicenter StudyHealth outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial.
Continuous positive airway pressure (CPAP) and mandibular advancement device (MAD) therapy are commonly used to treat obstructive sleep apnea (OSA). Differences in efficacy and compliance of these treatments are likely to influence improvements in health outcomes. ⋯ Important health outcomes were similar after 1 month of optimal MAD and CPAP treatment in patients with moderate-severe OSA. The results may be explained by greater efficacy of CPAP being offset by inferior compliance relative to MAD, resulting in similar effectiveness. Clinical trial registered with https://www.anzctr.org.au (ACTRN 12607000289415).
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Am. J. Respir. Crit. Care Med. · Apr 2013
Randomized Controlled Trial Multicenter StudyA multicenter randomized trial of atorvastatin therapy in intensive care patients with severe sepsis.
Observational studies link statin therapy with improved outcomes in patients with severe sepsis. ⋯ Atorvastatin therapy in severe sepsis did not affect IL-6 levels. Prior statin use was associated with a lower baseline IL-6 concentration and continuation of atorvastatin in this cohort was associated with improved survival. Clinical trial registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12607000028404).