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If NHLBI set research priorities for pediatric cardiomyopathy and heart failure, it would help investigators better align their application with institute goals.
Many pharma companies are developing inhaled antibiotics for patients with bronchiectasis, recognizing the increasing market (over 110,000 patients in the US). These drugs cost thousands of dollars per year and will be heavily marketed and heavily used, as there are limited options for these patients. It is unknown if rotating oral antibiotics (cost is a fraction of the inhaled ABx) would yield similar results. A Cochrane ...more »
The true prevalence of Nontuberculous mycobacterial (NTM) lung infections remains incompletely understood, however several aspects of NTM lung disease prevalence are becoming more clear. NTM lung disease is currently more common in the U.S. than TB (by a factor of 3) and has consistently been shown to be increasing in prevalence. When viewed in the context of likely universal environmental NTM exposure this increasing ...more »
Community-acquired pneumonia (CAP) is responsible for over 1 million hospital admissions and about 100,000 deaths per year. We still do not know the best antibiotic regimen to treat CAP. Retrospective studies and cohort studies support giving macrolides, while randomized controlled studies (essentially all done by pharma) have not shown benefit of macrolides. Guidelines allow either a macrolide or a quinolone.
1) Phase III efficacy trials of new tuberculosis drugs (e.g., bedaquiline, delamanid, PA-824) that have shown promise in early phase studies for multidrug-resistant tuberculosis. 2) Phase III efficacy trials of new and existing tuberculosis drugs to development very short course regimens (3-4 months). 3) Phase III efficacy trials of new and existing drugs for treatment of latent tuberculosis infection in contacts of ...more »
1. Monotherapy with a quinolone vs combination therapy with a 3rd generation cephalosporin. The issue of the best antibiotic treatment for severe CAP has been a major area of contention now for a decade and it is the most common cause of infectious death in the United States. 2. Combination therapy vs monotherapy for pneumonia due to Pseudomonas. This is another major area of contention – for nearly 2 decades, and generates ...more »
Would an NIH trans-IC office of critical care research improve coordination and strategic planning across?
How can we insure that there are sufficient numbers of clinical scientists over the next 20 years?
Will adaptive trial design improve clinical research for acute lung injury?
Can novel extracorporeal devices that remove carbon dioxide be tested to limit or avoid positive pressure ventilation in patients with acute respiratory failure from COPD?
Can novel therapeutics including cell-based therapy be tested in patients with severe acute lung injury (P/F <200) and shock (need for vasopressors) since these are the patients with the highest mortality (> 30%) based on NHLBI ARDS Network data?
Ventilating patients in the operating room constitutes the largest number of patients exposed to mechanical ventilation in this country and world wide [many millions of patients]. Postoperative pulmonary problems may, in part, due to the mechanical ventilation received in the OR. Yet, this cohort has never been systematically studied in terms of the effect of specific ventilatory patterns on postoperative outcomes. Data ...more »