American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 2018
Association of Height Growth in Puberty with Lung Function: A Longitudinal Study.
Rationale: Puberty may influence lung function, but the precise role of pubertal height growth in lung development is unclear. Objectives: To examine associations of timing of puberty and peak velocity of pubertal height growth with lung function in adolescence and early adulthood. Methods: Longitudinal analyses of repeat height measurements from age 5 to 20 years for a British birth cohort with 4,772 males and 4,849 females were conducted to characterize height growth trajectories and to derive pubertal age and peak height velocity using the validated SITAR (SuperImposition by Translation and Rotation) model. ⋯ A 1-cm/yr increase in peak velocity was associated with 145-ml (95% CI, 56-234 ml) and 50-ml (95% CI, 2-99 ml) increases in FVC for males and females, respectively. No associations were found with FEV1/FVC. Conclusions: Later onset and greater peak velocity of height growth in puberty are associated with increased FEV1 and FVC in young adults but there was no evidence of dysanapsis of pubertal lung growth.
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Am. J. Respir. Crit. Care Med. · Dec 2018
Multicenter StudyA Multivariable Prediction Model for Pneumocystis jirovecii Pneumonia in Hematology Patients with Acute Respiratory Failure.
The incidence of Pneumocystis jirovecii pneumonia (PjP) is rising. Longer time to treatment is associated with higher mortality. ⋯ The PjP score for hematology patients with acute respiratory failure can be computed at admission, based on readily available variables. Potential clinical benefits of using this score deserve assessment.
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Am. J. Respir. Crit. Care Med. · Dec 2018
Multicenter Study Comparative StudyRhinovirus Species-Specific Antibodies Differentially Reflect Clinical Outcomes in Health and Asthma.
Rationale: Rhinoviruses (RVs) are major triggers of common cold and acute asthma exacerbations. RV species A, B, and C may have distinct clinical impact; however, little is known regarding RV species-specific antibody responses in health and asthma. Objectives: To describe and compare total and RV species-specific antibody levels in healthy children and children with asthma, away from an acute event. ⋯ In asthma, RV-A and RV-C antibodies are much higher and further increase with disease severity and wheeze episodes. Higher antibody levels in asthma may be caused by a compromised innate immune response, leading to increased exposure of the adaptive immune response to the virus. Importantly, there is no apparent protection with increasing levels of antibodies.
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Am. J. Respir. Crit. Care Med. · Dec 2018
Early Pulmonary Vascular Disease in Young Adults Born Preterm.
Rationale: Premature birth affects 10% of live births in the United States and is associated with alveolar simplification and altered pulmonary microvascular development. However, little is known about the long-term impact prematurity has on the pulmonary vasculature. Objectives: Determine the long-term effects of prematurity on right ventricular and pulmonary vascular hemodynamics. ⋯ Preterm subjects were significantly less able to augment cardiac index or right ventricular stroke work during exercise. Among neonatal characteristics, total ventilatory support days was the strongest predictor of adult pulmonary pressure. Conclusions: Young adults born preterm demonstrate early pulmonary vascular disease, characterized by elevated pulmonary pressures, a stiffer pulmonary vascular bed, and right ventricular dysfunction, consistent with an increased risk of developing pulmonary hypertension.