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BACKGROUND: Researchers have yet to obtain conclusive evidence differentiating among fixed-dose combinations (FDCs) of long-acting muscarinic antagonists (LAMAs) and long-acting beta-agonists (LABAs) for chronic obstructive pulmonary disease (COPD) in terms of real-world clinical outcomes. RESEARCH QUESTION: What are the differences between available LAMA/LABA FDCs on the risk of acute exacerbation and cardiovascular events? STUDY DESIGN AND METHODS: This retrospective cohort study based on a national insurance claims database included COPD patients aged 40 and older who were newly prescribed glycopyrronium/indacaterol (GLY/IND), umeclidinium/vilanterol (UMEC/VI), or tiotropium/olodaterol (TIO/OLO) FDC between January 1, 2015, and June 30, 2019...

BACKGROUND: Obstructive sleep apnea (OSA) has been linked to microaspiration, systemic inflammation and suboptimal immune function. RESEARCH QUESTION: Is OSA prospectively associated with risk of hospitalization with pneumonia, respiratory and total infections? STUDY DESIGN: Prospective cohort. METHODS: Participants of the Atherosclerosis Risk in Communities (ARIC) study (N=1,586) underwent polysomnography in 1996-1998 and were followed through 2018 for infection-related hospitalizations...

BACKGROUND: K+ channel inhibition has been identified in animal models as a potential target to increase pharyngeal dilator muscle activity and treat obstructive sleep apnea (OSA). However, these findings have not yet been translated to humans. RESEARCH QUESTION: Does a novel, potent, TASK 1/3 channel antagonist, BAY2586116, improve pharyngeal collapsibility in pigs and humans and secondarily, what is the optimal dose and mode of topical application? STUDY DESIGN AND METHODS: Pre-clinical study: Pharyngeal muscle activity and upper-airway collapsibility via transient negative pressure application was quantified in 13 anesthetized pigs during placebo, 0...

BACKGROUND: Black Americans are diagnosed at later stage of lung cancer more often than White Americans. We undertook a population-based study to identify factors contributing to racial disparities in lung cancer stage of diagnosis among low-income adults. RESEARCH QUESTION: Which multilevel factors contribute to racial disparities in stage of lung cancer at diagnosis? STUDY DESIGN AND METHODS: Incident lung cancers from the prospective observational Southern Community Cohort Study were identified by linkage with state cancer registries in 12 southeastern states...

BACKGROUND: Motile ciliary disorder (MCD) has been implicated in chronic inflammatory airway diseases such as asthma and chronic obstructive pulmonary disease. RESEARCH QUESTION: What is the characteristic of MCD of the nasal epithelium and the association with disease severity and inflammatory endotypes in adults with bronchiectasis? STUDY DESIGNS AND METHODS: In this observational study, we recruited 167 patients with bronchiectasis and 39 healthy controls who underwent brushing of nasal epithelium...

BACKGROUND: Swimming-Induced Pulmonary Edema (SIPE) is a respiratory condition frequently seen amongst Naval Special Warfare (NSW) trainees. The incidence of positive respiratory panels (RPs) in trainees diagnosed with SIPE is currently unknown. RESEARCH QUESTION: Is there a significant difference in the incidence of respiratory pathogens in nasopharyngeal samples of NSW candidates with SIPE and a control group? STUDY DESIGN AND METHODS: Retrospective analysis of clinical information from NSW Sea Air and Land (SEAL) candidates diagnosed with SIPE over a 12-month period...

BACKGROUND: Tranexamic acid (TA) is used to control bleeding in patients with hemoptysis. However, the effectiveness of the different routes of TA administration has not been studied. RESEARCH QUESTION: Does nebulized route of Tranexamic Acid (TA) administration reduce the amount of hemoptysis compared to intravenous route in patients presenting to emergency department (ED) with hemoptysis? METHODS: We conducted a pragmatic, open labelled, cluster randomized, parallel single centered pilot trial of nebulized TA (500mg tid) versus intravenous TA (500mg tid) in adult patients presenting to emergency department with active hemoptysis...

BACKGROUND: Hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) community-acquired pneumonia (CAP) and associated comorbidities are at increased risk of cardiovascular complications. The magnitude of effect of cardiovascular complications and the role of prior comorbidities on clinical outcomes are not well defined. RESEARCH QUESTION: What is the impact of cardiovascular complications on mortality in hospitalized patients with SARS-CoV-2 CAP? What is the impact of co-morbidities and other risk factors on the risk of developing cardiovascular complications and mortality in these patients? STUDY DESIGN AND METHODS: This cohort study included 1,645 hospitalized patients with SARS-CoV-2 CAP...

BACKGROUND: Pleural biopsies offer greater diagnostic sensitivity in malignant pleural effusions (MPE) compared to pleural fluid. The adequacy of pleural biopsies to achieve molecular marker status has not been studied and such information (termed 'actionable' histology) is critical in providing a rational, efficient and evidence-based approach to diagnostic investigation. RESEARCH QUESTION: What is the adequacy of various pleural biopsy techniques at providing adequate molecular diagnostic information to guide treatment in MPE? STUDY DESIGN AND METHODS: We analysed anonymised data on 183 patients from 4 sites across 3 countries in whom a pleural biopsy had confirmed a malignant diagnosis and molecular profiling was relevant for the diagnosed cancer type...

No abstract text is available yet for this article.

BACKGROUND: Bronchodilator responsiveness (BDR), in obstructive lung disease varies over time and may be associated with distinct clinical features. RESEARCH QUESTION: Is consistent BDR over time (always present) differentially associated with obstructive lung disease features relative to inconsistent (sometimes present) or never (never present) BDR in tobacco-exposed people with or without COPD. STUDY DESIGN AND METHODS: We retrospectively analyzed data of 2,269 tobacco-exposed participants in SPIROMICS with or without COPD...

BACKGROUND: Preserved ratio impaired spirometry (PRISm) is a heterogeneous condition characterized by a normal forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio with underlying impairment of pulmonary function. Data relating to the association of baseline and trajectories of PRISm with diverse cardiovascular outcomes is sparse. RESEARCH QUESTION: How do baseline and trajectories of PRISm impact subsequent cardiovascular events? STUDY DESIGN AND METHODS: In the UK Biobank cohort study, we included cardiovascular disease (CVD) free participants with spirometry (FEV1 and FVC values) at baseline (2006-2010)...

Prior to the COVID-19 pandemic, the incidence of self-harm was already on the rise. Hanging/suffocation accounted for 50% of the increase in suicide attempts and remains the second leading cause of death from self-harm in the United States. Studies on the management of near hanging patients are lacking and most published literature is retrospective. Following airway and circulation assessment, clinical examination and imaging, namely CT angiography, remain the standard to identify the injuries associated with near hanging - cervical spine fracture, blunt cerebrovascular injury, laryngeal injury, injury to the trachea and oropharynx...

BACKGROUND: Home hospital (HH) is hospital-level substitutive care delivered at home for acutely ill patients who would traditionally be cared for in the hospital. Despite HH programs operating successfully for years, and scientific evidence of similar or better outcomes compared to bricks and mortar care, HH outcomes in the US for respiratory disease have not been evaluated. RESEARCH QUESTION: Do outcomes differ between patients admitted to HH with acute respiratory illness vs other acute general medical conditions? STUDY DESIGN AND METHODS: Retrospective evaluation of prospectively collected data of patients admitted to HH (2017-21)...

BACKGROUND: In some patients with progressive fibrosing interstitial lung disease (ILD), disease is caused by carriage of a mutation in a surfactant related gene (SRG) such as, SFTPC, SFTPA2 (SFTP) or ABCA3. However, no aggregated data on disease evolution and treatment outcome has ever been presented for these patients. RESEARCH QUESTION: In adult ILD patients with an SRG mutation, what is the course of lung function after diagnosis and under treatment and the survival in comparison with sporadic idiopathic pulmonary fibrosis (sIPF) and familial pulmonary fibrosis (FPF)? STUDY DESIGN AND METHODS: We retrospectively examined the clinical course of a cohort of adults SRG patients by screening 48 subjects from 20 families with an SRG mutation for availability of clinical follow-up data...

BACKGROUND: Deficiencies in risk assessment for patients with pulmonary nodules (PNs) contribute to unnecessary invasive testing and delays in diagnosis. RESEARCH QUESTION: What is the accuracy of a novel PN risk model that includes plasma proteins and clinical factors? How does the accuracy compare to an established risk model? STUDY DESIGN AND METHODS: Based on technology utilizing magnetic nanosensors, assays were developed with seven plasma proteins...

BACKGROUND: Pulmonary arteriovenous malformations (PAVMs) are direct connections between the pulmonary artery and the pulmonary vein, mostly associated with hereditary haemorrhagic telangiectasia (HHT). PAVMs can lead to severe neurological complications - such as stroke and brain abscess. The risk of complications decreases after embolisation. Therefore, screening for PAVMs using transthoracic contrast echocardiography (TTCE) is recommended, including a rescreening interval of 5 years...

No abstract text is available yet for this article.

BACKGROUND: Pulmonary sarcoidosis is characterized by the accumulation of immune cells that form granulomas affecting the lungs. Efzofitimod (ATYR1923), a novel immunomodulator, selectively binds neuropilin-2, which is upregulated on immune cells in response to lung inflammation. RESEARCH QUESTION: What is the tolerability, safety, and effect on outcomes from efzofitimod in pulmonary sarcoidosis? STUDY DESIGN AND METHODS: A randomized, double-blind, placebo-controlled study evaluating multiple ascending doses of efzofitimod administered intravenously every four weeks for 24 weeks...

BACKGROUND: The coronavirus 2019 (COVID-19) pandemic affected stroke care worldwide. Data from low- and middle-income countries is limited. RESEARCH QUESTION: What was the impact of the pandemic in intensive care admissions and outcomes of patients with stroke, in comparison to trends over the last ten years? STUDY DESIGN AND METHODS: Retrospective cohort study including prospectively collected data from 165 ICUs in Brazil between 2011 and 2020...