The Effect of Sildenafil on Diffusion Capacity Measurements in Patients With Pulmonary Hypertension and Parenchymal Lung Disease View Homepage


Ontology type: schema:MedicalStudy     


Clinical Trial Info

YEARS

2009-2012

ABSTRACT

The purpose of this study was to investigate the acute effects of sildenafil on diffusion capacity, a commonly performed pulmonary function test, which is used to assess the lungs' gas exchange capability. This study does not assess safety or efficacy of the drug. The study does not have clinical end points. The variables studied are diffusion capacity and 6 minute walk after a single dose of sildenafil. This study has been completed. Detailed Description Sildenafil is a cyclic GMP selective phosphodiesterase type 5 inhibitor approved for use by the FDA in patients with pulmonary arterial hypertension. There has been recent interest in the use of the drug in patients with diffuse parenchymal lung diseases. This is largely based on sildenafil's salutary effects observed in small studies (Collard et al. 897-99;Ghofrani et al. 895-900;Collard et al. 897-99) and the frequent coexistence of pulmonary hypertension in these patients (Nathan et al. 657-63). In eight patients with pulmonary fibrosis and pulmonary hypertension, sildenafil reduced pulmonary artery pressure and improved shunt fraction as determined by multiple inert gas elimination technique (Ghofrani et al. 895-900;Nathan et al. 657-63). Collard et al demonstrated a 49 meter improvement in 6 minute walk distance in 11 patients with idiopathic pulmonary fibrosis and pulmonary hypertension after 3 months of therapy with sildenafil. Main theoretical concern with the use of pulmonary arterial vasodilator therapy has been worsening of ventilation perfusion matching due to release of hypoxic vasoconstriction. Such a phenomenon is well recognized during prostacyclin infusion(Ghofrani et al. 895-900;Walmrath et al. 1084-92). Inhaled route seems to circumvent this side effect by preferentially delivering the drug to the alveoli with high V/Q ratios and augmenting blood flow to these regions (Ghofrani et al. 895-900;Walmrath et al. 1084-92). In the only study to address possible effect of systemically administered sildenafil on gas exchange, Ghofrani et al observed improvement in V/Q matching in eight patients using the multiple inert gas elimination technique (MIGET). The authors postulated an enhancement of local defense mechanisms against hypoxia i.e. increased nitric oxide availability to hypoxic alveoli despite oral route of administration(Ghofrani et al. 895-900). In a recent study of 14 normal subjects, oral sildenafil did not effect DLCO measurements at rest, after exercise and under hypoxic conditions(Snyder et al. 421-30). Diffusion capacity of the lung for carbon monoxide (DLCO) is the clinically available method of assessing gas exchange for practitioners. It is frequently used as a tool for serial monitoring of diffuse parenchymal lung disease. American Thoracic Society has endorsed its use in the assessment of patients with idiopathic interstitial pneumonias(American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias . This Joint Statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS Board of Directors, June 2001 and by The ERS Executive Committee, June 2001 277-304). The aim of our study was to delineate the effects of orally administered sildenafil on diffusion capacity (absolute value). The significance of this information was twofold. First, it would be helpful clinically to determine the contribution of a pulmonary vasodilator to the change in DLCO to separate this effect from a true clinical change. Second, sildenafil's effect on gas exchange may lead to modifications in therapy such as changes in oxygen flow delivered to patients. This is not a study that measures clinical outcome or safety of sildenafil. A single dose was administered and effect on diffusion capacity and 6 minute walk were assessed compared to baseline. While we would caution clinicians for rare exceptions to these findings, we believe our data exclude a significant confounding effect in interpretation of diffusion capacity in patients with parenchymal lung disease who are treated for pulmonary hypertension with oral sildenafil. Whether this conclusion holds true at higher doses of sildenafil and in patients with vasodilator response may offer further venues for research. We were asked to retrospectively register the study at the request of BMC Pulmonary Medicine Journal Editorial Office prior to publication. More... »

URL

https://clinicaltrials.gov/show/NCT01948518

Related SciGraph Publications

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/3048", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "type": "DefinedTerm"
      }
    ], 
    "description": "The purpose of this study was to investigate the acute effects of sildenafil on diffusion capacity, a commonly performed pulmonary function test, which is used to assess the lungs' gas exchange capability. This study does not assess safety or efficacy of the drug. The study does not have clinical end points. The variables studied are diffusion capacity and 6 minute walk after a single dose of sildenafil. This study has been completed.\n\nDetailed Description\nSildenafil is a cyclic GMP selective phosphodiesterase type 5 inhibitor approved for use by the FDA in patients with pulmonary arterial hypertension. There has been recent interest in the use of the drug in patients with diffuse parenchymal lung diseases. This is largely based on sildenafil's salutary effects observed in small studies (Collard et al. 897-99;Ghofrani et al. 895-900;Collard et al. 897-99) and the frequent coexistence of pulmonary hypertension in these patients (Nathan et al. 657-63). In eight patients with pulmonary fibrosis and pulmonary hypertension, sildenafil reduced pulmonary artery pressure and improved shunt fraction as determined by multiple inert gas elimination technique (Ghofrani et al. 895-900;Nathan et al. 657-63). Collard et al demonstrated a 49 meter improvement in 6 minute walk distance in 11 patients with idiopathic pulmonary fibrosis and pulmonary hypertension after 3 months of therapy with sildenafil. Main theoretical concern with the use of pulmonary arterial vasodilator therapy has been worsening of ventilation perfusion matching due to release of hypoxic vasoconstriction. Such a phenomenon is well recognized during prostacyclin infusion(Ghofrani et al. 895-900;Walmrath et al. 1084-92). Inhaled route seems to circumvent this side effect by preferentially delivering the drug to the alveoli with high V/Q ratios and augmenting blood flow to these regions (Ghofrani et al. 895-900;Walmrath et al. 1084-92). In the only study to address possible effect of systemically administered sildenafil on gas exchange, Ghofrani et al observed improvement in V/Q matching in eight patients using the multiple inert gas elimination technique (MIGET). The authors postulated an enhancement of local defense mechanisms against hypoxia i.e. increased nitric oxide availability to hypoxic alveoli despite oral route of administration(Ghofrani et al. 895-900). In a recent study of 14 normal subjects, oral sildenafil did not effect DLCO measurements at rest, after exercise and under hypoxic conditions(Snyder et al. 421-30). Diffusion capacity of the lung for carbon monoxide (DLCO) is the clinically available method of assessing gas exchange for practitioners. It is frequently used as a tool for serial monitoring of diffuse parenchymal lung disease. American Thoracic Society has endorsed its use in the assessment of patients with idiopathic interstitial pneumonias(American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias . This Joint Statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS Board of Directors, June 2001 and by The ERS Executive Committee, June 2001 277-304). The aim of our study was to delineate the effects of orally administered sildenafil on diffusion capacity (absolute value). The significance of this information was twofold. First, it would be helpful clinically to determine the contribution of a pulmonary vasodilator to the change in DLCO to separate this effect from a true clinical change. Second, sildenafil's effect on gas exchange may lead to modifications in therapy such as changes in oxygen flow delivered to patients. This is not a study that measures clinical outcome or safety of sildenafil. A single dose was administered and effect on diffusion capacity and 6 minute walk were assessed compared to baseline. While we would caution clinicians for rare exceptions to these findings, we believe our data exclude a significant confounding effect in interpretation of diffusion capacity in patients with parenchymal lung disease who are treated for pulmonary hypertension with oral sildenafil. Whether this conclusion holds true at higher doses of sildenafil and in patients with vasodilator response may offer further venues for research. We were asked to retrospectively register the study at the request of BMC Pulmonary Medicine Journal Editorial Office prior to publication.", 
    "endDate": "2012-06-01T00:00:00Z", 
    "id": "sg:clinicaltrial.NCT01948518", 
    "keywords": [
      "sildenafil", 
      "in-patient", 
      "pulmonary hypertension", 
      "lung disease", 
      "acute effect", 
      "diffusion", 
      "pulmonary function", 
      "capability", 
      "efficacy", 
      "drug", 
      "end point", 
      "variable", 
      "single dose", 
      "cyclic GMP", 
      "FDA", 
      "patient", 
      "pulmonary arterial hypertension", 
      "recent interest", 
      "salutary effect", 
      "small study", 
      "coexistence", 
      "Nathan", 
      "pulmonary fibrosis", 
      "pulmonary artery pressure", 
      "fraction", 
      "inert gas", 
      "improvement", 
      "distance", 
      "Idiopathic pulmonary fibrosis", 
      "therapy", 
      "Main", 
      "vasodilator", 
      "ventilation", 
      "release", 
      "vasoconstriction", 
      "phenomenon", 
      "infusion", 
      "route", 
      "side effect", 
      "alveolus", 
      "ratio", 
      "blood flow", 
      "possible effect", 
      "exchange", 
      "author", 
      "enhancement", 
      "defense mechanism", 
      "Anoxia", 
      "nitric oxide availability", 
      "oral route", 
      "Organization and Administration", 
      "Recent study", 
      "normal subject", 
      "measurement", 
      "rest", 
      "exercise", 
      "hypoxic condition", 
      "Snyder", 
      "carbon monoxide", 
      "DLCO", 
      "available method", 
      "practitioner", 
      "tool", 
      "American Thoracic Society", 
      "assessment", 
      "idiopathic interstitial pneumonia", 
      "american", 
      "International", 
      "classification", 
      "society", 
      "June", 
      "Executive Committee", 
      "absolute value", 
      "significance", 
      "contribution", 
      "clinical change", 
      "modification", 
      "oxygen", 
      "clinical outcome", 
      "safety", 
      "baseline", 
      "clinician", 
      "rare exception", 
      "confounding effect", 
      "interpretation", 
      "conclusion", 
      "high dose", 
      "vasodilator response", 
      "venue", 
      "request", 
      "BMC", 
      "Pulmonary Medicine", 
      "editorial", 
      "publication"
    ], 
    "name": "The Effect of Sildenafil on Diffusion Capacity Measurements in Patients With Pulmonary Hypertension and Parenchymal Lung Disease", 
    "sameAs": [
      "https://app.dimensions.ai/details/clinical_trial/NCT01948518"
    ], 
    "sdDataset": "clinical_trials", 
    "sdDatePublished": "2019-03-07T15:25", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "file:///pack/app/us_ct_data_00015.json", 
    "sponsor": [
      {
        "id": "https://www.grid.ac/institutes/grid.239578.2", 
        "type": "Organization"
      }
    ], 
    "startDate": "2009-06-01T00:00:00Z", 
    "subjectOf": [
      {
        "id": "https://doi.org/10.1016/s0140-6736(02)11024-5", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1000222068"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00421-008-0735-5", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1002442571", 
          "https://doi.org/10.1007/s00421-008-0735-5"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1183/09031936.05.00034905", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1013068950"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1378/chest.10-0969", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1015788101"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1378/chest.06-1466", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1021089890"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1164/ajrccm.166.1.at1102", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1027952403"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1378/chest.129.3.746", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1039202999"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1378/chest.06-2101", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1044637350"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1164/ajrccm.165.2.ats01", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1047187214"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1056/nejmoa1002110", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1049430244"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.vph.2006.01.013", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1052132202"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.2214/ajr.169.4.9308447", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1069321156"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://app.dimensions.ai/details/publication/pub.1077512801", 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://app.dimensions.ai/details/publication/pub.1081982457", 
        "type": "CreativeWork"
      }
    ], 
    "type": "MedicalStudy", 
    "url": "https://clinicaltrials.gov/show/NCT01948518"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/clinicaltrial.NCT01948518'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/clinicaltrial.NCT01948518'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/clinicaltrial.NCT01948518'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/clinicaltrial.NCT01948518'


 

This table displays all metadata directly associated to this object as RDF triples.

154 TRIPLES      16 PREDICATES      123 URIs      103 LITERALS      1 BLANK NODES

Subject Predicate Object
1 sg:clinicaltrial.NCT01948518 schema:about anzsrc-for:3048
2 schema:description The purpose of this study was to investigate the acute effects of sildenafil on diffusion capacity, a commonly performed pulmonary function test, which is used to assess the lungs' gas exchange capability. This study does not assess safety or efficacy of the drug. The study does not have clinical end points. The variables studied are diffusion capacity and 6 minute walk after a single dose of sildenafil. This study has been completed. Detailed Description Sildenafil is a cyclic GMP selective phosphodiesterase type 5 inhibitor approved for use by the FDA in patients with pulmonary arterial hypertension. There has been recent interest in the use of the drug in patients with diffuse parenchymal lung diseases. This is largely based on sildenafil's salutary effects observed in small studies (Collard et al. 897-99;Ghofrani et al. 895-900;Collard et al. 897-99) and the frequent coexistence of pulmonary hypertension in these patients (Nathan et al. 657-63). In eight patients with pulmonary fibrosis and pulmonary hypertension, sildenafil reduced pulmonary artery pressure and improved shunt fraction as determined by multiple inert gas elimination technique (Ghofrani et al. 895-900;Nathan et al. 657-63). Collard et al demonstrated a 49 meter improvement in 6 minute walk distance in 11 patients with idiopathic pulmonary fibrosis and pulmonary hypertension after 3 months of therapy with sildenafil. Main theoretical concern with the use of pulmonary arterial vasodilator therapy has been worsening of ventilation perfusion matching due to release of hypoxic vasoconstriction. Such a phenomenon is well recognized during prostacyclin infusion(Ghofrani et al. 895-900;Walmrath et al. 1084-92). Inhaled route seems to circumvent this side effect by preferentially delivering the drug to the alveoli with high V/Q ratios and augmenting blood flow to these regions (Ghofrani et al. 895-900;Walmrath et al. 1084-92). In the only study to address possible effect of systemically administered sildenafil on gas exchange, Ghofrani et al observed improvement in V/Q matching in eight patients using the multiple inert gas elimination technique (MIGET). The authors postulated an enhancement of local defense mechanisms against hypoxia i.e. increased nitric oxide availability to hypoxic alveoli despite oral route of administration(Ghofrani et al. 895-900). In a recent study of 14 normal subjects, oral sildenafil did not effect DLCO measurements at rest, after exercise and under hypoxic conditions(Snyder et al. 421-30). Diffusion capacity of the lung for carbon monoxide (DLCO) is the clinically available method of assessing gas exchange for practitioners. It is frequently used as a tool for serial monitoring of diffuse parenchymal lung disease. American Thoracic Society has endorsed its use in the assessment of patients with idiopathic interstitial pneumonias(American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias . This Joint Statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS Board of Directors, June 2001 and by The ERS Executive Committee, June 2001 277-304). The aim of our study was to delineate the effects of orally administered sildenafil on diffusion capacity (absolute value). The significance of this information was twofold. First, it would be helpful clinically to determine the contribution of a pulmonary vasodilator to the change in DLCO to separate this effect from a true clinical change. Second, sildenafil's effect on gas exchange may lead to modifications in therapy such as changes in oxygen flow delivered to patients. This is not a study that measures clinical outcome or safety of sildenafil. A single dose was administered and effect on diffusion capacity and 6 minute walk were assessed compared to baseline. While we would caution clinicians for rare exceptions to these findings, we believe our data exclude a significant confounding effect in interpretation of diffusion capacity in patients with parenchymal lung disease who are treated for pulmonary hypertension with oral sildenafil. Whether this conclusion holds true at higher doses of sildenafil and in patients with vasodilator response may offer further venues for research. We were asked to retrospectively register the study at the request of BMC Pulmonary Medicine Journal Editorial Office prior to publication.
3 schema:endDate 2012-06-01T00:00:00Z
4 schema:keywords American Thoracic Society
5 Anoxia
6 BMC
7 DLCO
8 Executive Committee
9 FDA
10 Idiopathic pulmonary fibrosis
11 International
12 June
13 Main
14 Nathan
15 Organization and Administration
16 Pulmonary Medicine
17 Recent study
18 Snyder
19 absolute value
20 acute effect
21 alveolus
22 american
23 assessment
24 author
25 available method
26 baseline
27 blood flow
28 capability
29 carbon monoxide
30 classification
31 clinical change
32 clinical outcome
33 clinician
34 coexistence
35 conclusion
36 confounding effect
37 contribution
38 cyclic GMP
39 defense mechanism
40 diffusion
41 distance
42 drug
43 editorial
44 efficacy
45 end point
46 enhancement
47 exchange
48 exercise
49 fraction
50 high dose
51 hypoxic condition
52 idiopathic interstitial pneumonia
53 improvement
54 in-patient
55 inert gas
56 infusion
57 interpretation
58 lung disease
59 measurement
60 modification
61 nitric oxide availability
62 normal subject
63 oral route
64 oxygen
65 patient
66 phenomenon
67 possible effect
68 practitioner
69 publication
70 pulmonary arterial hypertension
71 pulmonary artery pressure
72 pulmonary fibrosis
73 pulmonary function
74 pulmonary hypertension
75 rare exception
76 ratio
77 recent interest
78 release
79 request
80 rest
81 route
82 safety
83 salutary effect
84 side effect
85 significance
86 sildenafil
87 single dose
88 small study
89 society
90 therapy
91 tool
92 variable
93 vasoconstriction
94 vasodilator
95 vasodilator response
96 ventilation
97 venue
98 schema:name The Effect of Sildenafil on Diffusion Capacity Measurements in Patients With Pulmonary Hypertension and Parenchymal Lung Disease
99 schema:sameAs https://app.dimensions.ai/details/clinical_trial/NCT01948518
100 schema:sdDatePublished 2019-03-07T15:25
101 schema:sdLicense https://scigraph.springernature.com/explorer/license/
102 schema:sdPublisher N48da01438d124d158e1a8f52ce8291a8
103 schema:sponsor https://www.grid.ac/institutes/grid.239578.2
104 schema:startDate 2009-06-01T00:00:00Z
105 schema:subjectOf sg:pub.10.1007/s00421-008-0735-5
106 https://app.dimensions.ai/details/publication/pub.1077512801
107 https://app.dimensions.ai/details/publication/pub.1081982457
108 https://doi.org/10.1016/j.vph.2006.01.013
109 https://doi.org/10.1016/s0140-6736(02)11024-5
110 https://doi.org/10.1056/nejmoa1002110
111 https://doi.org/10.1164/ajrccm.165.2.ats01
112 https://doi.org/10.1164/ajrccm.166.1.at1102
113 https://doi.org/10.1183/09031936.05.00034905
114 https://doi.org/10.1378/chest.06-1466
115 https://doi.org/10.1378/chest.06-2101
116 https://doi.org/10.1378/chest.10-0969
117 https://doi.org/10.1378/chest.129.3.746
118 https://doi.org/10.2214/ajr.169.4.9308447
119 schema:url https://clinicaltrials.gov/show/NCT01948518
120 sgo:license sg:explorer/license/
121 sgo:sdDataset clinical_trials
122 rdf:type schema:MedicalStudy
123 N48da01438d124d158e1a8f52ce8291a8 schema:name Springer Nature - SN SciGraph project
124 rdf:type schema:Organization
125 anzsrc-for:3048 schema:inDefinedTermSet anzsrc-for:
126 rdf:type schema:DefinedTerm
127 sg:pub.10.1007/s00421-008-0735-5 schema:sameAs https://app.dimensions.ai/details/publication/pub.1002442571
128 https://doi.org/10.1007/s00421-008-0735-5
129 rdf:type schema:CreativeWork
130 https://app.dimensions.ai/details/publication/pub.1077512801 schema:CreativeWork
131 https://app.dimensions.ai/details/publication/pub.1081982457 schema:CreativeWork
132 https://doi.org/10.1016/j.vph.2006.01.013 schema:sameAs https://app.dimensions.ai/details/publication/pub.1052132202
133 rdf:type schema:CreativeWork
134 https://doi.org/10.1016/s0140-6736(02)11024-5 schema:sameAs https://app.dimensions.ai/details/publication/pub.1000222068
135 rdf:type schema:CreativeWork
136 https://doi.org/10.1056/nejmoa1002110 schema:sameAs https://app.dimensions.ai/details/publication/pub.1049430244
137 rdf:type schema:CreativeWork
138 https://doi.org/10.1164/ajrccm.165.2.ats01 schema:sameAs https://app.dimensions.ai/details/publication/pub.1047187214
139 rdf:type schema:CreativeWork
140 https://doi.org/10.1164/ajrccm.166.1.at1102 schema:sameAs https://app.dimensions.ai/details/publication/pub.1027952403
141 rdf:type schema:CreativeWork
142 https://doi.org/10.1183/09031936.05.00034905 schema:sameAs https://app.dimensions.ai/details/publication/pub.1013068950
143 rdf:type schema:CreativeWork
144 https://doi.org/10.1378/chest.06-1466 schema:sameAs https://app.dimensions.ai/details/publication/pub.1021089890
145 rdf:type schema:CreativeWork
146 https://doi.org/10.1378/chest.06-2101 schema:sameAs https://app.dimensions.ai/details/publication/pub.1044637350
147 rdf:type schema:CreativeWork
148 https://doi.org/10.1378/chest.10-0969 schema:sameAs https://app.dimensions.ai/details/publication/pub.1015788101
149 rdf:type schema:CreativeWork
150 https://doi.org/10.1378/chest.129.3.746 schema:sameAs https://app.dimensions.ai/details/publication/pub.1039202999
151 rdf:type schema:CreativeWork
152 https://doi.org/10.2214/ajr.169.4.9308447 schema:sameAs https://app.dimensions.ai/details/publication/pub.1069321156
153 rdf:type schema:CreativeWork
154 https://www.grid.ac/institutes/grid.239578.2 schema:Organization
 




Preview window. Press ESC to close (or click here)


...