Annals of the American Thoracic Society
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Respiratory diseases are a major cause of morbidity and mortality worldwide. The greatest impact of many of these diseases is felt in low- and middle-income countries, but their control and management is hampered by lack of accurate estimates of their prevalence, risk factors, and distribution, and knowledge of the social and cultural setting in which they occur. Providing enough information for cost-effective response to respiratory diseases requires research by trained investigators and public health personnel. ⋯ Post-MECOR, 64% of participants have published a medical paper, 79% have presented at a scientific or academic meeting, 51% have submitted a research protocol for funding, and 42% have had one funded. One-quarter have been awarded an academic or clinical fellowship, and 78% reported that MECOR had made a significant or extremely important contribution to their professional life and accomplishments. Future challenges include funding, recruitment of local faculty, helping to build the research infrastructure in MECOR countries, and providing ongoing mentoring for research.
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Observational Study
Pilot study of extracorporeal carbon dioxide removal to facilitate extubation and ambulation in exacerbations of chronic obstructive pulmonary disease.
Acute exacerbations of chronic obstructive pulmonary disease (COPD) requiring invasive mechanical ventilation (IMV) are associated with significant morbidity and mortality. Extracorporeal carbon dioxide removal (ECCO₂R) may facilitate extubation and ambulation in these patients and potentially improve outcomes. ⋯ ECCO₂R facilitates early extubation and ambulation in exacerbations of COPD requiring IMV and has the potential to serve as a new paradigm for the management of a select group of patients. Rigorous clinical trials are needed to corroborate these results and to investigate the effect on long-term outcomes and cost effectiveness over conventional management.
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Every year, hundreds of thousands of patients are diagnosed with incidentally detected pulmonary nodules, and if lung cancer screening is widely implemented, thousands more will be identified. The psychosocial outcomes associated with incidental nodule detection in general practice settings are virtually unknown. ⋯ Veterans from one hospital have little understanding of what nodules are, the likelihood of malignancy, and the follow-up plan. Their reaction to this knowledge deficit is variable and is likely related to preferred communication behaviors with their clinician. Evaluating communication in other settings is important to confirm these findings and to refine mechanisms to improve patient-centered care for those with incidentally detected pulmonary nodules.
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Letter Case Reports
Efficacy of sirolimus therapy for chylous effusions in lymphangioleiomyomatosis.