Chest
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Comparative Study
A Comparison of Health-Related Quality of Life in Idiopathic Pulmonary Fibrosis and Chronic Hypersensitivity Pneumonitis.
Patients with interstitial lung disease (ILD) have poor health-related quality of life (HRQL). However, whether HRQL differs among different subtypes of ILD is unclear. The aim of this study was to determine whether HRQL was different among patients with idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis (CHP). ⋯ HRQL is worse in CHP compared with IPF. HRQL differences between ILD subtypes are explained in part by differences in sex, dyspnea, and fatigue.
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Observational Study
Quality-adjusted Survival Following Treatment of Malignant Pleural Effusions with Indwelling Pleural Catheters.
Malignant pleural effusions (MPEs) are a frequent cause of dyspnea in patients with cancer. Although indwelling pleural catheters (IPCs) have been used since 1997, there are no studies of quality-adjusted survival following IPC placement. ⋯ IPC placement has significant beneficial effects in selected patient populations. The determinants of quality-adjusted survival in patients with MPE are complex. Although dyspnea is one of them, receiving treatment after IPC placement is also important. Future research should use patient-centered outcomes in addition to time-to-event analysis.
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Comparative Study
The right ventricle explains sex differences in survival in idiopathic pulmonary arterial hypertension.
Male sex is an independent predictor of worse survival in pulmonary arterial hypertension (PAH). This finding might be explained by more severe pulmonary vascular disease, worse right ventricular (RV) function, or different response to therapy. The aim of this study was to investigate the underlying cause of sex differences in survival in patients treated for PAH. ⋯ This study suggests that differences in RVEF response with initiation of medical therapy in idiopathic PAH explain a significant portion of the worse survival seen in men.
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Hyperinflation refers to a nonspecific increase in absolute lung volumes and has a poor prognosis in COPD. The relative contribution of increased airways resistance and increased parenchymal compliance to hyperinflation of each absolute lung volume is poorly understood. We hypothesized that increased residual volume (RV) and RV/total lung capacity (TLC) would be associated with reduced airway lumen dimensions, whereas increased functional residual capacity (FRC), TLC, and reduced inspiratory capacity (IC)/TLC would be associated with emphysema on CT scan. We examined whether clinical characteristics differed accordingly. ⋯ Gas trapping and hyperexpansion on plethysmography were associated with distinct differences in lung structure and clinical characteristics. Absolute lung volumes should not be considered equivalent in their estimation of hyperinflation and provide insight into the extent of airway and parenchymal abnormalities in COPD.
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Surfactant proteins play a key role in alveolar stability. We examined whether single nucleotide polymorphisms (SNPs) related to the surfactant protein genes are associated with severe influenza. ⋯ SFTPB polymorphism is associated with severe influenza. The role of SFTPB in influenza warrants further studies.