American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 2017
Randomized Controlled Trial Comparative StudyPulmonary Infections in the Elderly Lead to Impaired Neutrophil Targeting, Improved by Simvastatin.
Dysregulated neutrophil functions with age and sepsis are described. Statins are associated with improved infection survival in some observational studies, but trials in critically ill patients have not shown benefit. Statins also alter neutrophil responses in vitro. ⋯ Infections in older adults are associated with prolonged, impaired neutrophil migration, potentially contributing to poor outcomes. Statins improve neutrophil migration in vivo in health and in vitro in milder infective events, but not in severe sepsis, supporting their potential utility as an early intervention during pulmonary infections. Clinical trial registered with www.clinicaltrialsregister.eu (2011-002082-38).
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Am. J. Respir. Crit. Care Med. · Nov 2017
Randomized Controlled Trial Multicenter StudyHome Monitoring in CF to Identify and Treat Acute Pulmonary Exacerbations: eICE Study Results.
Individuals with cystic fibrosis (CF) experience frequent acute pulmonary exacerbations, which lead to decreased lung function and reduced quality of life. ⋯ An intervention of home monitoring among patients with CF was able to detect more exacerbations than usual care, but this did not result in slower decline in lung function. Clinical trial registered with www.clinicaltrials.gov (NCT01104402).
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Am. J. Respir. Crit. Care Med. · Nov 2017
Randomized Controlled TrialEffect of Emphysema Extent on Serial Lung Function in Patients with Idiopathic Pulmonary Fibrosis.
Patients with idiopathic pulmonary fibrosis and emphysema may have artificially preserved lung volumes. ⋯ FVC measurements may not be appropriate for monitoring disease progression in patients with idiopathic pulmonary fibrosis and emphysema extent greater than or equal to 15%.
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Am. J. Respir. Crit. Care Med. · Nov 2017
Randomized Controlled TrialConventional Polysomnography is Not Necessary for the Management of Most Patients with Suspected Obstructive Sleep Apnea.
Home respiratory polygraphy may be a simpler alternative to in-laboratory polysomnography for the management of more symptomatic patients with obstructive sleep apnea, but its effectiveness has not been evaluated across a broad clinical spectrum. ⋯ Home respiratory polygraphy management is similarly effective to polysomnography, with a substantially lower cost. Therefore, polysomnography is not necessary for most patients with suspected sleep apnea. This finding could change established clinical practice, with a clear economic benefit. Clinical trial registered with www.clinicaltrials.gov (NCT 01752556).