American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jul 2015
Letter Case Reports Randomized Controlled TrialLow-Dose FK506 (Tacrolimus) in End-Stage Pulmonary Arterial Hypertension.
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Am. J. Respir. Crit. Care Med. · Jul 2015
Randomized Controlled TrialRacial Differences in Outcomes within the National Lung Screening Trial: Implications for Widespread Implementation.
Black individuals with lung cancer (LC) experience higher mortality because they present with more advanced disease and are less likely to undergo curative resection for early-stage disease. The National Lung Screening Trial (NLST) demonstrated improved LC mortality by screening high-risk patients with low-dose computed tomography (LDCT). The benefit of LDCT screening in black individuals is unknown. ⋯ Black individuals screened with LDCT had decreased mortality from lung cancer. However, the demographics associated with improved LC survival were less commonly found in black individuals. The overall mortality in the NLST was higher for black individuals than white individuals, but improved in black individuals screened, suggesting that this subgroup may have had improved access to care. To realize the reductions in mortality from LC screening, dissemination efforts need to be tailored to meet the needs of this community.
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Am. J. Respir. Crit. Care Med. · Jul 2015
Randomized Controlled TrialEight Hours of Nightly CPAP Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Prediabetes: A Randomized Controlled Trial.
Although obstructive sleep apnea (OSA) is associated with impaired glucose tolerance and diabetes, it remains unclear whether OSA treatment with continuous positive airway pressure (CPAP) has metabolic benefits. ⋯ In patients with prediabetes, 8-hour nightly CPAP treatment for 2 weeks improves glucose metabolism compared with placebo. Thus, CPAP treatment may be beneficial for metabolic risk reduction. Clinical trial registered with www.clinicaltrials.gov (NCT 01156116).
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Am. J. Respir. Crit. Care Med. · Jul 2015
Randomized Controlled Trial Multicenter StudyEfficacy of Different Treatment Alternatives for Obesity Hypoventilation Syndrome: Pickwick Study.
The incidence of obesity hypoventilation syndrome (OHS) may be increasing in parallel with the present obesity epidemic. Despite extensive noninvasive ventilation (NIV) and continuous positive airway pressure (CPAP) use in patients with OHS, information regarding efficacy is limited. ⋯ NIV and CPAP were more effective than lifestyle modification in improving clinical symptoms and polysomnographic parameters, although NIV yielded better respiratory functional improvements than did CPAP. Long-term studies must demonstrate whether this functional improvement has relevant implications. Clinical trial registered with www.clinicaltrials.gov (NCT01405976).