American journal of respiratory and critical care medicine
-
Am. J. Respir. Crit. Care Med. · Oct 2016
Randomized Controlled TrialEfficacy and Safety of Outpatient Treatment Based on the Hestia Clinical Decision Rule With or Without NT-proBNP Testing in Patients With Acute Pulmonary Embolism: A Randomized Clinical Trial.
Outpatient treatment of pulmonary embolism (PE) may lead to improved patient satisfaction and reduced healthcare costs. However, trials to assess its safety and the optimal method for patient selection are scarce. ⋯ Outpatient treatment of patients with PE selected on the basis of the Hestia criteria alone was associated with a low risk of adverse events. Given the low number of patients with elevated NT-proBNP levels, this trial was unable to draw definite conclusions regarding the incremental value of NT-proBNP testing in patients who fulfill the Hestia criteria. Clinical trial registered with www.trialregister.nl/trialreg/admin/rctview.asp?TC=2603 (NTR2603).
-
Am. J. Respir. Crit. Care Med. · Oct 2016
Randomized Controlled TrialHeterogeneity in the Effects of Reward- and Deposit-based Financial Incentives on Smoking Cessation.
Targeting different smoking cessation programs to smokers most likely to quit when using them could reduce the burden of lung disease. ⋯ Heterogeneity among smokers in their acceptance and response to different forms of incentives suggests potential benefits of targeting behavior-change interventions based on patient characteristics. Clinical trial registered with www.clinicaltrials.gov (NCT 01526265).
-
Am. J. Respir. Crit. Care Med. · Oct 2016
Randomized Controlled TrialDesipramine Increases Genioglossus Activity and Reduces Upper Airway Collapsibility During Non-REM Sleep in Healthy Subjects.
Obstructive sleep apnea is a state-dependent disease. One of the key factors that triggers upper airway collapse is decreased pharyngeal dilator muscle activity during sleep. To date, there have not been effective methods to reverse pharyngeal hypotonia pharmacologically in sleeping humans. ⋯ Desipramine reduces the state-related drop in tonic genioglossus muscle activity that occurs from wakefulness to non-REM sleep and reduces airway collapsibility. These data provide a rationale for a new pharmacologic therapy for obstructive sleep apnea. Clinical trial registered with www.clinicaltrials.gov (NCT02428478).