American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2017
Randomized Controlled TrialRandomized Trial of Liposomal Amikacin for Inhalation in Nontuberculous Mycobacterial Lung Disease.
Lengthy, multidrug, toxic, and low-efficacy regimens limit management of pulmonary nontuberculous mycobacterial disease. ⋯ Although the primary endpoint was not reached, LAI added to a multidrug regimen produced improvements in sputum conversion and 6-minute-walk distance versus placebo with limited systemic toxicity in patients with refractory MAC lung disease. Further research in this area is needed. Clinical trial registered with www.clinicaltrials.gov (NCT01315236).
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Am. J. Respir. Crit. Care Med. · Mar 2017
Multicenter Study Observational StudyEpidemiology of Weaning Outcome According to a New Definition. The WIND Study.
The weaning process concerns all patients receiving mechanical ventilation. A previous classification into simple, prolonged, and difficult weaning ignored weaning failure and presupposed the use of spontaneous breathing trials. ⋯ A new classification allows us to categorize all weaning situations. Every additional day without a weaning success after the first separation attempt increases the risk of dying.
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Am. J. Respir. Crit. Care Med. · Mar 2017
Genome-Wide Association Study of the Genetic Determinants of Emphysema Distribution.
Emphysema has considerable variability in the severity and distribution of parenchymal destruction throughout the lungs. Upper lobe-predominant emphysema has emerged as an important predictor of response to lung volume reduction surgery. Yet, aside from alpha-1 antitrypsin deficiency, the genetic determinants of emphysema distribution remain largely unknown. ⋯ This multicohort genome-wide association study identified new genomic loci associated with differential emphysematous destruction throughout the lungs. These findings may point to new biologic pathways on which to expand diagnostic and therapeutic approaches in chronic obstructive pulmonary disease. Clinical trial registered with www.clinicaltrials.gov (NCT 00608764).