American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jun 2013
Randomized Controlled Trial Multicenter Study Comparative StudyWean earlier and automatically with new technology (the WEAN study). A multicenter, pilot randomized controlled trial.
Automated weaning has not been compared with a paper-based weaning protocol in North America. ⋯ Compared with a standardized protocol, automated weaning was associated with promising outcomes that warrant further investigation. Minor protocol modifications may increase compliance, facilitate recruitment, and enhance feasibility. Clinical trial registered with www.controlled-trials.com (ISRCTN43760151).
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Am. J. Respir. Crit. Care Med. · Jun 2013
Randomized Controlled Trial Multicenter StudyEfficacy and safety of ivacaftor in patients aged 6 to 11 years with cystic fibrosis with a G551D mutation.
Ivacaftor (VX-770), a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator, has been shown to improve lung function, pulmonary exacerbation rate, respiratory symptoms, and weight gain compared with placebo in patients with cystic fibrosis aged 12 years or older with a G551D-CFTR mutation. ⋯ In patients who are younger and healthier than those in previously studied populations, ivacaftor demonstrated a significant improvement in pulmonary function, weight, and CFTR activity compared with placebo. Clinical trial registered with www.clinicaltrials.gov (NCT00909727).
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Am. J. Respir. Crit. Care Med. · Jun 2013
Multicenter StudyDisrupted prenatal maternal cortisol, maternal obesity, and childhood wheeze. Insights into prenatal programming.
Exploring prenatal factors influencing childhood wheeze may inform programming mechanisms. ⋯ Maternal prenatal cortisol disruption and obesity were independently associated with children's wheeze. Obese women with adverse cortisol profiles were most likely to have children with repeated wheeze.
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Am. J. Respir. Crit. Care Med. · Jun 2013
Randomized Controlled Trial Comparative StudyModerately preterm children have more respiratory problems during their first 5 years of life than children born full term.
Pulmonary outcomes of moderate-preterm children (MP) are unknown. ⋯ MP have more respiratory symptoms than FT during early childhood. Factors associated with respiratory symptoms at school age are early respiratory problems, family history of asthma, higher social class, and passive smoking.
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Am. J. Respir. Crit. Care Med. · Jun 2013
ReviewAn official American Thoracic Society Clinical Practice Guideline: sleep apnea, sleepiness, and driving risk in noncommercial drivers. An update of a 1994 Statement.
Sleepiness may account for up to 20% of crashes on monotonous roads, especially highways. Obstructive sleep apnea (OSA) is the most common medical disorder that causes excessive daytime sleepiness, increasing the risk for drowsy driving two to three times. The purpose of these guidelines is to update the 1994 American Thoracic Society Statement that described the relationships among sleepiness, sleep apnea, and driving risk. ⋯ The recommendations presented in this guideline are based on the current evidence, and will require an update as new evidence and/or technologies becomes available.