American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Oct 2015
ReviewBone Metastases in Lung Cancer: Potential Novel Approaches to Therapy.
The skeleton is a common site of metastases in lung cancer, an event associated with significant morbidities and poor outcomes. Current antiresorptive therapies provide limited benefit, and novel strategies of prevention and treatment are urgently needed. ⋯ Progress propelled by preclinical models has led to a deeper understanding on the complex interplay of tumor cells in the osseous milieu, unveiling potential new targets for drug development. Improvements in early diagnosis through the use of sophisticated imaging techniques with bone serum biomarkers are also discussed in the context of identifying patients at risk and monitoring disease progression during the course of treatment.
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Am. J. Respir. Crit. Care Med. · Oct 2015
Randomized Controlled TrialFirst Human Challenge Testing of a Pneumococcal Vaccine - Double Blind Randomised Controlled Trial.
New vaccines are urgently needed to protect the vulnerable from bacterial pneumonia. Clinical trials of pneumonia vaccines are slow and costly, requiring tens of thousands of patients. Studies of pneumococcal vaccine efficacy against colonization have been proposed as a novel method to down-select between vaccine candidates. ⋯ 45340436.
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Am. J. Respir. Crit. Care Med. · Oct 2015
Observational StudyThe Utility of Preoperative Six-Minute Walk Distance in Lung Transplantation.
The use of 6-minute-walk distance (6MWD) as an indicator of exercise capacity to predict postoperative survival in lung transplantation has not previously been well studied. ⋯ 6MWD is significantly associated with post-transplant survival and is best incorporated into transplant evaluations on a continuous basis given limited ability of a single, dichotomous value to predict outcomes.
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Am. J. Respir. Crit. Care Med. · Oct 2015
Nocturnal Hypoxemia Severity Determines Renin-Angiotensin System Activity in Obstructive Sleep Apnea.
Obstructive sleep apnea (OSA) and nocturnal hypoxemia are associated with chronic kidney disease and up-regulation of the renin-angiotensin system (RAS), which is deleterious to renal function. The extent to which the magnitude of RAS activation is influenced by the severity of nocturnal hypoxemia and comorbid obesity has not been determined. ⋯ The severity of nocturnal hypoxemia influences the magnitude of renal, but not the systemic, RAS activation independently of obesity in patients with OSA.