American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 2014
Randomized Controlled Trial Multicenter StudyProcalcitonin Algorithm in Critically Ill Adults with Undifferentiated Infection or Suspected Sepsis: A Randomized Controlled Trial.
The role of procalcitonin (PCT), a widely used sepsis biomarker, in critically ill patients with sepsis is undetermined. ⋯ In critically ill adults with undifferentiated infections, a PCT algorithm including 0.1 ng/ml cut-off did not achieve 25% reduction in duration of antibiotic treatment. Clinical trial registered with http://www.anzctr.org.au (ACTRN12610000809033).
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Asthma is a major chronic disease ranging from mild to severe refractory disease and is classified into various clinical phenotypes. Severe asthma is difficult to treat and frequently requires high doses of systemic steroids. In some cases, severe asthma even responds poorly to steroids. ⋯ In addition, IL-17A has been described in multiple aspects of asthma pathogenesis, including structural alterations of epithelial cells and smooth muscle contraction. In this perspective article, we frame the topic of IL-17A effects in severe asthma by reviewing updated information from human studies. We summarize and discuss the implications of IL-17 in the induction of neutrophilic airway inflammation, steroid insensitivity, the epithelial cell profile, and airway remodeling.
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Am. J. Respir. Crit. Care Med. · Nov 2014
Obstructive Sleep Apnea During REM Sleep and Hypertension: Results of the Wisconsin Sleep Cohort.
Obstructive sleep apnea (OSA) is associated with hypertension. ⋯ Our findings indicate that REM OSA is cross-sectionally and longitudinally associated with hypertension. This is clinically relevant because treatment of OSA is often limited to the first half of the sleep period leaving most of REM sleep untreated.
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Am. J. Respir. Crit. Care Med. · Nov 2014
Early Respiratory Infection is Associated with Reduced Spirometry in Children with Cystic Fibrosis.
Pulmonary inflammation, infection, and structural lung disease occur early in life in children with cystic fibrosis. ⋯ The onset of lung disease in infancy, specifically the occurrence of lower respiratory tract infection, is associated with low lung function in young children with cystic fibrosis. Deficits in lung function measured in infancy persist into childhood, emphasizing the need for targeted therapeutic interventions in infancy to maximize functional outcomes later in life.