Cathepsin B promotes collagen biosynthesis driving Bronchiolitis Obliterans Syndrome.

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Bronchiolitis obliterans syndrome (BOS) is a major complication after lung transplantation (LTx). BOS is characterised by massive peribronchial fibrosis, leading to air trapping induced pulmonary dysfunction. Cathepsin B, a lysosomal […]

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TNF-mediated alveolar macrophage necroptosis drives disease pathogenesis during Respiratory Syncytial Virus infection.

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Respiratory Syncytial Virus (RSV) is the major cause of acute bronchiolitis in infants under 2 years old. Necroptosis has been implicated in the outcomes of respiratory virus infections. Here we report […]

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TMEM16A/ANO1 calcium-activated chloride channel as a novel target for the treatment of human respiratory syncytial virus infection.

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Human respiratory syncytial virus (HRSV) is a common cause of respiratory tract infections (RTIs) globally and is one of the most fatal infectious diseases for infants in developing countries. Of […]

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The mononuclear phagocyte system contributes to fibrosis in post-transplant Obliterans Bronchiolitis.

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Bronchiolitis Obliterans Syndrome (BOS) is a fibrotic disease heavily responsible for high mortality rates after lung transplantation. Myofibroblasts are primary effectors of this fibrotic process, but their origin is still […]

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Can acute cough characteristics from sound recordings differentiate common respiratory illnesses in children? A comparative prospective study.

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Acute respiratory illnesses cause substantial morbidity worldwide. Cough is a common symptom in these childhood respiratory illnesses but there is currently no large cohort data on whether various cough characteristics […]

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Machine learning algorithms to differentiate among pulmonary complications after hematopoietic cell transplant.

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Pulmonary complications, including infections, are highly prevalent in patients after hematopoietic cell transplant with chronic graft-versus-host disease. These comorbid diseases can make the diagnosis of early lung graft-versus-host disease (bronchiolitis […]

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Prevalence of Continuous Pulse Oximetry Monitoring in Hospitalized Children With Bronchiolitis Not Requiring Supplemental Oxygen.

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US national guidelines discourage the use of continuous pulse oximetry monitoring in hospitalized children with bronchiolitis who do not require supplemental oxygen.Measure continuous pulse oximetry use in children with bronchiolitis.A […]

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Prospective community programme versus parent-drive care to prevent respiratory morbidity in children following hospitalisation with severe bronchiolitis or pneumonia.

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Hospitalisation with severe lower respiratory tract infection (LRTI) in early childhood is associated with ongoing respiratory symptoms and possible later development of bronchiectasis. We aimed to reduce this intermediate respiratory […]

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Geospatial and seasonal variation of bronchiolitis in England: a cohort study using hospital episode statistics.

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Rates of hospital admissions for bronchiolitis vary seasonally and geographically across England; however, seasonal differences by area remain unexplored. We sought to describe spatial variation in the seasonality of hospital […]

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Intragraft donor-specific anti-HLA antibodies in phenotypes of chronic lung allograft dysfunction.

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Abstract: Circulating anti-HLA donor-specific serum antibodies (sDSA) increase the risk of chronic lung allograft dysfunction (CLAD) and mortality. Discrepancies between serological and pathological/clinical findings are common. Therefore, we aimed to […]

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Clinico-radiologic Features of Lung Disease Associated with Aspiration Identified on Lung Biopsy.

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Abstract: Aspiration-related lung diseases are commonly diagnosed presumptively based on the clinical context and radiologic findings. Limited data exist on the spectrum of clinico-radiologic presentations associated with aspiration.We reviewed all […]

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Pneumonia versus Graft Dysfunction as the cause of acute respiratory failure after Lung Transplant: A 4-year multicenter prospective study in 153 adults requiring intensive care (ICU) admission.

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We aimed to assess the main causes of intensive care readmissions (ICUr) in lung transplant (LT) adults and to identify independent predictors of ICU mortality (primary end-point).This Spanish 5-centre prospective cohort study enrolled all LT adults with ICUr after post-LT ICU discharge, between 2012 and 2016. Patients were followed until hospital discharge or death.One hundred and fifty-three LT recipients presented 174 ICUr a median of 6?months [IQR 2-25] post-LT. Chronic lung allograft dysfunction (CLAD) was reported in 39 (25.5%) recipients, 13 of whom (all exitus) had restrictive allograft syndrome (RAS). Acute respiratory failure (ARF) (110, 71.9%) was the main condition requiring ICUr. Graft rejection (six, 5% acute) caused only 12 (11%) admissions whereas pneumonia (56, 36.6%) was the main cause (50 admitted for ARF and six for shock), with P. aeruginosa (50% multidrug-resistant) being the predominant pathogen. Fifty-five (35.9%) and 69 (45.1%) recipients died in the ICU and the hospital respectively. Bronchiolitis obliterans syndrome (BOS) stage-2 (adjusted-OR: 7.2 (1-65.7)), BOS stage-3 (aOR: 13.7 (2.5-95.3)), RAS (aOR: >50) and pneumonia at ICUr (aOR: 2.5 (1-7.1)) were identified in multivariate analyses as independent predictors of ICU mortality. Only eight (5%) patients had positive donor-specific antibodies prior to ICUr, and this variable did not affect the model.In conclusion, ARF was the main condition requiring ICUr in LT recipients, and was associated with high mortality. Pneumonia was the main cause of death, and was also an independent predictor. RAS should receive palliative care rather than ICU admission.

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