American journal of respiratory and critical care medicine最新文献

{"title":"Lung Function in the Second Decade of Life in Children after Early HIV Diagnosis and ART Initiation.","authors":"Andre G Gie, Marieke M van der Zalm, Eric D McCollum, Sara Browne, Mark F Cotton, Pierre Goussard, Steve Innes","doi":"10.1164/rccm.202409-1777RL","DOIUrl":"https://doi.org/10.1164/rccm.202409-1777RL","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Clinical Correlates of Radiologically Detected Coronary Artery Disease in COPD: A Cross-Sectional Observational Study.","authors":"Mairi A MacLeod, Kristopher D Knott, James P Allinson, Lydia J Finney, Dexter J Wiseman, Andrew I Ritchie, Aaron Braddy-Green, Sam Barlett-Pestell, Ralph Lopez, Logan Sun, Philippa Webb, Paras Dalal, Michael Rubens, Simon Davies, Dorian O Haskard, Anand Devaraj, Gavin C Donaldson, Ramzi Y Khamis, Edward D Nicol, Jadwiga A Wedzicha","doi":"10.1164/rccm.202404-0838OC","DOIUrl":"https://doi.org/10.1164/rccm.202404-0838OC","url":null,"abstract":"<p><strong>Rationale: </strong>Unrecognised coronary artery disease (CAD) may contribute to adverse outcomes in chronic obstructive pulmonary disease (COPD). Improved identification of at-risk groups could inform better preventative care. We aimed to evaluate the burden and relationships of radiologically detectable CAD in COPD, establish frequency of occult disease, and examine potential cardiovascular screening methods.</p><p><strong>Methods: </strong>Using CT coronary angiogram (CTCA), we prospectively evaluated CAD in 50 patients with COPD compared to age, sex-matched controls. In those with COPD, the relationship of CAD to cardiac symptoms (chest pain, dyspnoea), functional capacity (six-minute walk), exacerbations and inflammation was assessed. The performance of screening tests (cardiovascular risk scores, biomarkers and CT thorax-derived coronary artery calcium score (CACS-Tx)) were evaluated using receiver operator curves.</p><p><strong>Results: </strong>CAD was present in 88% of patients with COPD (42% had obstructive (≥50% stenosis of any vessel) and 28% severe obstructive (≥70%) disease). Rates of obstructive (OR 3·1 (95%CI 1·1-8·9) P=0·037) and severe obstructive CAD (OR 10·1(95%CI 1·9-52·7) P=0·006) were higher in COPD than controls. In the COPD group, those with CAD had greater functional impairments but not dyspnoea scores, and 75% reported no chest pain or prior IHD. CAD was more extensive in those with increased systemic inflammation (fibrinogen, c-reactive protein, leucocyte, and neutrophil count), bronchial wall thickening, and sputum bacterial growth but bore no relation to exacerbation frequency. CACS-Tx was an effective screening tool, with an area under the curve for CAD of 0·98 (95%CI 0·95-1·00) and obstructive CAD of 0·89 (95%CI 0·79-1·00).</p><p><strong>Conclusions: </strong>CTCA-detected CAD is common in patients with COPD, correlating poorly with symptoms and risk scores. Radiological screening, using CT thorax, might improve detection and outcomes in this patient group.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Disease Stability an Attainable COPD Treatment Goal?","authors":"Dave Singh, MeiLan K Han, Surya P Bhatt, Marc Miravitlles, Chris Compton, Stefanie Kolterer, Tharishini Mohan, Suneal K Sreedharan, Lee Tombs, David M G Halpin","doi":"10.1164/rccm.202406-1254CI","DOIUrl":"https://doi.org/10.1164/rccm.202406-1254CI","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a heterogenous lung condition characterized by progressive airflow obstruction. Despite advancements in diagnosis and treatment, the disease burden remains high; although clinical trials have shown improvements in outcomes such as exacerbations, quality of life, and lung function, improvement may not be attainable for many patients. For patients who do experience improvement, it is challenging to set management goals given the progressive nature of COPD. We therefore propose disease stability as an appropriate and attainable treatment goal. Other disease areas have developed definitions of no disease activity or remission, which provide relevant information for defining and achieving stability for patients with COPD. Disease stability builds on related concepts already defined in COPD such as clinical control and clinically important deterioration. Current components that could form part of a disease stability definition include exacerbations, health status (including quality of life and symptoms) and lung function. Considerations should be given to intervals over which stability is defined and assessed, appropriate thresholds, and defining a composite. Ensuring a holistic approach, objective measurements and harmonious, clear communication between patients and physicians can further support establishing disease stability. Here we propose a preliminary definition of disease stability, informed by existing research in COPD. Further research will be needed to validate the framework for use in clinical and research settings. Exploring disease stability as a goal, however, is an opportunity to develop and validate an attainable treatment target to advance the standard of care for patients with COPD.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inbuilt Errors: A Call for Standardized Definitions.","authors":"Aman Pande, Philppe Haouzi","doi":"10.1164/rccm.202411-2183LE","DOIUrl":"https://doi.org/10.1164/rccm.202411-2183LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Struggle Continues: Improving Outcomes for Surrogate Decision-Makers after the Intensive Care Unit.","authors":"Katherine R Courtright, James Downar","doi":"10.1164/rccm.202411-2233ED","DOIUrl":"https://doi.org/10.1164/rccm.202411-2233ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Position of the American Thoracic Society Journal Family on the Evolving Role of Artificial Intelligence in Scientific Research and Review.","authors":"Nitin Seam, Sanjay H Chotirmall, Fernando J Martinez, Andrew J Halayko, Michael O Harhay, Stephanie D Davis, Paul T Schumacker, Robert M Tighe, Kristin M Burkart, Colin Cooke","doi":"10.1164/rccm.202411-2208ED","DOIUrl":"https://doi.org/10.1164/rccm.202411-2208ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Cheng and Wei: Limitations in the Study of Vitamin D Supplementation and Severe Asthma Exacerbations.","authors":"Franziska J Rosser, Yueh-Ying Han, Juan C Celedón","doi":"10.1164/rccm.202411-2311LE","DOIUrl":"https://doi.org/10.1164/rccm.202411-2311LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limitations in the Study of Vitamin D Supplementation and Severe Asthma Exacerbations.","authors":"Kuan-Po Cheng, James Cheng-Chung Wei","doi":"10.1164/rccm.202411-2236LE","DOIUrl":"https://doi.org/10.1164/rccm.202411-2236LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling Dysanapsis: Genetic Insights into Airway Lung Mismatch and COPD.","authors":"Anne Yang, Jessica Bon","doi":"10.1164/rccm.202406-1256ED","DOIUrl":"10.1164/rccm.202406-1256ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1391-1392"},"PeriodicalIF":19.3,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Arousal Threshold: The \"Weakest Link\" in Obstructive Sleep Apnea Pathogenesis?","authors":"Simon A Joosten, Bradley A Edwards, Shane A Landry","doi":"10.1164/rccm.202408-1523ED","DOIUrl":"10.1164/rccm.202408-1523ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1396-1397"},"PeriodicalIF":19.3,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}