American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jun 2014
Randomized Controlled TrialEffectiveness of Motivational Interviewing to Reduce Head Start Children's Secondhand Smoke Exposure: A Randomized Clinical Trial.
Secondhand smoke exposure (SHSe) is a significant modifiable risk for respiratory health in children. Although SHSe is declining overall, it has increased for low-income and minority populations. Implementation of effective SHSe interventions within community organizations has the potential for significant public health impact. ⋯ MI may be effective in community settings to reduce child SHSe. More research is needed to identify ways to tailor interventions to directly impact child SHSe and to engage more families to make behavioral change. Clinical trial registered with www.clinicaltrials.gov (NCT 00927264).
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Am. J. Respir. Crit. Care Med. · Jun 2014
Multicenter Study Observational StudyRole of Sleep Apnea and CPAP therapy in the incidence of stroke or coronary heart disease in women.
It is unknown whether obstructive sleep apnea (OSA) may be a risk factor for incident cardiovascular events in women. ⋯ In women, untreated OSA is associated with increased incidence of serious cardiovascular outcomes, particularly incident stroke. Adequate CPAP treatment seems to reduce this risk.
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Am. J. Respir. Crit. Care Med. · Jun 2014
Randomized Controlled TrialKeratinocyte Growth-Factor Promotes Epithelial Survival and Resolution in a Human Model of Lung Injury.
Increasing epithelial repair and regeneration may hasten resolution of lung injury in patients with the acute respiratory distress syndrome (ARDS). In animal models of ARDS, keratinocyte growth factor (KGF) reduces injury and increases epithelial proliferation and repair. The effect of KGF in the human alveolus is unknown. ⋯ KGF treatment increases BAL surfactant protein D, a marker of type II alveolar epithelial cell proliferation in a human model of acute lung injury. Additionally, KGF increases alveolar concentrations of the antiinflammatory cytokine IL-1Ra, and mediators that drive epithelial repair (MMP-9) and enhance macrophage clearance of dead cells and bacteria (GM-CSF). Clinical trial registered with ISRCTN 98813895.
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Am. J. Respir. Crit. Care Med. · Jun 2014
ReviewInvestigating the role of NOD-Like Receptors in Bacterial Lung Infection.
Lower respiratory tract infections (LRTIs) are a persistent and pervasive public health problem worldwide. Pneumonia and other LRTIs will be among the leading causes of death in adults, and pneumonia is the single largest cause of death in children. LRTIs are also an important cause of acute lung injury and acute exacerbations of chronic obstructive pulmonary disease. ⋯ The lung contains NLR-expressing immune cells such as leukocytes and nonimmune cells such as epithelial cells that are in constant and close contact with invading microbes. This pulmonary perspective addresses our current understanding of the structure and function of NLR family members, highlighting advances and gaps in knowledge, with a specific focus on immune responses in the respiratory tract during bacterial infection. Further advances in exploring cellular and molecular responses to bacterial pathogens are critical to develop improved strategies to treat and prevent devastating infectious diseases of the lung.
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Am. J. Respir. Crit. Care Med. · Jun 2014
Observational StudyTHE NON-ALLERGIC ASTHMA OF OBESITY: A MATTER OF DISTAL LUNG COMPLIANCE.
The pathogenesis of asthma in obesity is poorly understood, but may be related to breathing at low lung volumes. ⋯ Weight loss decompresses the lung in both obese control subjects and patients with asthma, but the more pronounced effects of weight loss on lung elastance suggest that the distal lung is inherently more collapsible in people with asthma.