Annals of the American Thoracic Society

RATIONALE: Cardiopulmonary exercise testing (CPET) is the gold standard to evaluate exertional breathlessness, a common and disabling symptom. However, interpretation of breathlessness responses to CPET is limited by a scarcity of normative data. OBJECTIVES: We aimed to develop normative reference equations for breathlessness intensity (Borg 0-10 category-ratio [CR10]) response in men and women aged ≥40 years during CPET, in relation to power output (W), rate of oxygen uptake (V'O2), and minute ventilation (V'E)...

BACKGROUND: Bronchopulmonary dysplasia (BPD) is the most common long-term complication of prematurity. While socioeconomic status is associated with BPD morbidities, the drivers of this association are poorly understood. In the United States, ambient air pollution (AAP) exposure is linked to both race/ethnicity and socioeconomic status. Furthermore, AAP exposure is known to have a detrimental effect on respiratory health in children. As such, we set out to assess if AAP exposure is linked to BPD morbidity in the outpatient setting...

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OBJECTIVE: Daily oral azithromycin therapy can reduce the risk of acute exacerbations of chronic obstructive pulmonary disease (COPD). However, given its adverse events and additional costs, it is not known whether adding long-term azithromycin as an adjunct therapy to inhaled pharmacotherapy is cost-effective. The objective of this study was to evaluate the cost-effectiveness add-on azithromycin therapy in COPD as recommended by contemporary COPD management guidelines. METHODS: We extended a previously validated Canadian COPD policy model to include azithromycin-related inputs and outcomes...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

RATIONALE: Radiologic pattern has been shown to predict survival in patients with fibrosing interstitial lung disease. The additional prognostic value of fibrosis extent by quantitative CT is unknown. OBJECTIVES: We hypothesized that fibrosis extent provides information beyond visually assessed CT pattern, that is useful for outcome prediction. METHODS: We performed a retrospective analysis of chest CT, demographics, longitudinal pulmonary function, and transplant-free survival on participants in the Pulmonary Fibrosis Foundation patient registry...

RATIONALE: Obstructive sleep apnea (OSA) is a prevalent sleep disorder that is frequently comorbid with insomnia, and often accompanied by metabolic diseases such as type 2 diabetes (T2DM). Although the apnea hypopnea index (AHI) is currently the diagnostic criteria for gauging OSA severity, the AHI has not consistently predicted incident diabetes. OBJECTIVES: To test whether a combined insomnia-OSA (COMISA) phenotype based on comorbid insomnia and sleep breathing impairment index (COMISA-SBII) predicts incident diabetes, and to compare the association with an AHI definition of COMISA (COMISA-AHI) in the Osteoporotic Fractures in Men (MrOS) study...

RATIONALE: Pulmonary arterial hypertension (PAH) is a heterogeneous disease with a complex diagnostic and treatment environment. Similarly complex heart and lung diseases have substantial regional variation; however, this has not been previously described in PAH. OBJECTIVES: To identify baseline differences in the characteristics and outcomes for participants in the Pulmonary Hypertension Association Registry (PHAR) between US Census Regions. METHODS: Adults with PAH were divided into regional groups (Northeast, South, Midwest, West) and baseline differences between census regions were presented...

RATIONALE: Despite the high prevalence and clear morbidity of cystic fibrosis (CF) pulmonary exacerbations (PEx), there have been no published clinical trials of outpatient exacerbation management. OBJECTIVE: To assess the feasibility of a pediatric clinical trial in which treatment of a mild PEx is assigned randomly to immediate oral antibiotics or "tailored therapy" (increased airway clearance alone with oral antibiotics added only for pre-specified criteria)...

RATIONALE: Interventions to promote adherence to long-term oxygen therapy (LTOT) in chronic obstructive pulmonary disease (COPD) are needed. OBJECTIVES: Examine the real-world effectiveness of phone-based peer coaching on LTOT adherence and other outcomes in a pragmatic trial of patients with COPD. METHODS: In a hybrid effectiveness-implementation pragmatic trial, patients were randomized to phone-based Proactive coaching (educational materials, five phone-based peer coaching sessions over 60 days), Reactive coaching (educational materials, peer coaching when requested), or usual care...

RATIONALE: Hypoxemia in fibrotic interstitial lung disease (ILD) indicates disease progression and is of prognostic significance. The onset of hypoxemia signifies disease progression and predicts mortality in fibrotic interstitial lung diseases (ILD). Accurately predicting new-onset exertional and resting hypoxemia prompts appropriate patient discussion and timely consideration of home oxygen. OBJECTIVE: We derived and externally validated a risk prediction tool for both new-onset exertional and resting hypoxemia...

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No abstract text is available yet for this article.

RATIONALE: Intimate partner violence (IPV) and child maltreatment have been separately associated with asthma in adults. No study has concurrently examined adulthood adverse events (including but not limited to IPV), child maltreatment, and asthma in adults. OBJECTIVE: To concurrently examine adulthood adverse events, child maltreatment and asthma in adults. METHODS: This was a cross-sectional study of adulthood adverse events, child maltreatment, and current asthma in 87,891 adults 40-69 years who participated in the UK Biobank...

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Patients with interstitial lung diseases (ILD) often have hypoxemia at rest and/or with exertion for which supplemental oxygen is commonly prescribed. The number of patients with ILD who require supplemental oxygen is unknown though estimates suggest it could be as much as 40%, many of whom may require high flow support (>4 L/min). Despite its frequent use, there is limited evidence for supplemental oxygen's impact on clinical outcomes in ILD with recommendations for its use primarily based on older studies in patients with chronic obstructive pulmonary disease (COPD)...

No abstract text is available yet for this article.

No abstract text is available yet for this article.