American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Apr 2015
Optimizing the Detection of Recent Tuberculosis Infection in Children in a High TB-HIV Burden Setting.
Children who are young, malnourished, and infected with HIV have significant risk of tuberculosis (TB) morbidity and mortality following TB infection. Treatment of TB infection is hindered by poor detection and limited pediatric data. ⋯ Where resources allow, use of IFN-γ release assays should be considered in children who are young, recently exposed, and infected with HIV because they may offer advantages compared with the tuberculin skin test for identifying TB infection, and improve targeted, cost-effective delivery of preventive therapy. Affordable tests of infection could dramatically impact global TB control.
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Am. J. Respir. Crit. Care Med. · Apr 2015
Validation and Important Differences for The Sarcoidosis Assessment Tool: A New Patient Reported Outcome Measure.
Patient-reported outcome (PRO) measures have been developed to measure symptoms and other aspects of health-related quality of life. ⋯ We demonstrated that the SAT is a reliable and consistent sarcoidosis-specific PRO. It has excellent internal consistency and reliability. A range of clinically important differences has been established for the SAT modules. Clinical trial registered with www.clinicaltrials.gov (NCT 00955279).
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Am. J. Respir. Crit. Care Med. · Apr 2015
An official american thoracic society/european respiratory society statement: research questions in chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and resource use worldwide. The goal of this Official American Thoracic Society (ATS)/European Respiratory Society (ERS) Research Statement is to describe evidence related to diagnosis, assessment, and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. ⋯ Great strides have been made in the diagnosis, assessment, and management of COPD as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS Research Statement highlights the types of research that leading clinicians, researchers, and patient advocates believe will have the greatest impact on patient-centered outcomes.
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Am. J. Respir. Crit. Care Med. · Apr 2015
Divergent, Coexisting, Pseudomonas aeruginosa Lineages in Chronic Cystic Fibrosis Lung Infections.
Pseudomonas aeruginosa, the predominant cause of chronic airway infections of patients with cystic fibrosis, exhibits extensive phenotypic diversity among isolates within and between sputum samples, but little is known about the underlying genetic diversity. ⋯ Our population-level analysis demonstrates that coexistence of distinct lineages of P. aeruginosa Liverpool Epidemic Strain within individuals is common. In several cases, coexisting lineages may have been present in the infecting inoculum or assembled through multiple transmissions. Divergent lineages can share mutations via homologous recombination, potentially aiding adaptation to the airway during chronic infection. The genetic diversity of this transmissible strain within infections, revealed by high-resolution genomics, has implications for patient segregation and therapeutic strategies.
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Am. J. Respir. Crit. Care Med. · Apr 2015
Platelet Activation and Aggregation Promote Lung Inflammation and Influenza Virus Pathogenesis.
The hallmark of severe influenza virus infection is excessive inflammation of the lungs. Platelets are activated during influenza, but their role in influenza virus pathogenesis and inflammatory responses is unknown. ⋯ The intricate relationship between hemostasis and inflammation has major consequences in influenza virus pathogenesis, and antiplatelet drugs might be explored to develop new antiinflammatory treatment against influenza virus infections.