American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jan 2016
Randomized Controlled Trial Multicenter StudyEfficacy of Nintedanib in Idiopathic Pulmonary Fibrosis Across Pre-specified Subgroups in INPULSIS®.
In the two replicate, placebo-controlled, 52-week, phase III INPULSIS trials, nintedanib 150 mg twice daily significantly reduced the annual rate of decline in FVC, the primary endpoint, in subjects with idiopathic pulmonary fibrosis (IPF). It is unknown if this effect was uniform across all subjects treated with nintedanib. ⋯ Pooled data from the INPULSIS trials support a consistent effect of nintedanib across a range of IPF phenotypes by slowing disease progression across a number of prespecified subgroups.
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Am. J. Respir. Crit. Care Med. · Jan 2016
The Chitinase Proteins YKL-40 and Chitotriosidase are Increased in Both Asthma and COPD.
Serum chitinases may be novel biomarkers of airway inflammation and remodeling, but less is known about factors regulating their levels. ⋯ YKL-40 and chitotriosidase are increased in asthma and more so in COPD. The data in the present study support these substances as being relatively steroid-insensitive, non-T-helper cell type 2-type biomarkers distinctly related to chronic inflammatory disease processes.
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Am. J. Respir. Crit. Care Med. · Jan 2016
Randomized Controlled Trial Multicenter StudyRandomized Trial of Communication Facilitators to Reduce Family Distress and Intensity of End-of-life Care.
Communication with family of critically ill patients is often poor and associated with family distress. ⋯ Communication facilitators may be associated with decreased family depressive symptoms at 6 months, but we found no significant difference at 3 months or in anxiety or PTSD. The intervention reduced costs and length of stay, especially among decedents. This is the first study to find a reduction in intensity of end-of-life care with similar or improved family distress. Clinical trial registered with www.clinicaltrials.gov (NCT 00720200).
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Am. J. Respir. Crit. Care Med. · Jan 2016
Comparative StudyRising Billing for Intermediate Intensive Care Among Hospitalized Medicare Beneficiaries Between 1996 and 2010.
Intermediate care (i.e., step-down or progressive care) is an alternative to the intensive care unit (ICU) for patients with moderate severity of illness. The adoption and current use of intermediate care is unknown. ⋯ Intermediate care billing increased markedly between 1996 and 2010. These findings highlight the need to better define the value, specific practices, and effective use of intermediate care for patients and hospitals.