Chest
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Sarcoidosis is a multisystem inflammatory disease where management and outcomes can vary widely. The renin-angiotensin-aldosterone system (RAAS) has been implicated in its pathogenesis, yet the impact of RAAS modulators on health outcomes in sarcoidosis remains poorly understood. ⋯ Our findings suggest that ACE inhibitors and ARB's have divergent effects on outcomes in sarcoidosis patients. These findings highlight the potential pathogenic role of RAAS signaling in this disease and underscore the importance of carefully selecting RAAS modulators for individuals with sarcoidosis.
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In the Handling Oxygenation Targets in COVID-19 (HOT-COVID) trial, a partial pressure of arterial oxygen (PaO2) target of 60 mmHg compared to 90 mmHg resulted in more days alive without life support at 90 days in adult ICU patients with coronavirus disease 2019 (COVID-19) and hypoxemia. The trial was stopped after enrolling 726 of 780 planned patients due to slow recruitment. Here, we present the preplanned Bayesian analysis of the HOT-COVID trial. ⋯ In ICU patients with COVID-19 and hypoxemia, we found high probability for a clinically relevant benefit of targeting a PaO2 of 60 mmHg vs. 90 mmHg on number of days alive without life support.
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Sarcoidosis is a granulomatous disease with varying courses of disease progression. Environmental exposures are thought to be contributors to disease onset. Exposure to air pollutants such as fine particulate matter (PM2.5) and nitrogen dioxide (NO2) have been identified as contributors to health disparities in lung diseases; little is known about these environmental exposures' associations with disease outcomes in sarcoidosis. ⋯ Higher exposure to PM2.5 and NO2 was associated with worse DLCO% predicted. Black individuals with sarcoidosis were exposed to higher PM2.5 and NO2 than non-Hispanic White individuals. Air pollution exposure may be a contributor to reported health disparities in sarcoidosis.
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The physiological effects of different ventilation strategies on patients with acute respiratory distress syndrome (ARDS) need to be better understood. ⋯ APRV, as compared to LTV, could recruit dorsal region, reduce dorsal shunt, increase dorsal ventilation-perfusion matching, and improve ventilation homogeneity of the lungs, leading to better gas exchange and Crs in patients with moderate-to-severe ARDS.
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Osteogenesis Imperfecta (OI) is a rare hereditary disease mainly resulting in reduced or altered collagen type I. Collagen type I is a major constituent of the respiratory system, and normal collagen type I is vital for the pulmonary tissue function. ⋯ Overall, the admission rates for respiratory diseases were low in the OI cohort, but a higher relative risk of hospitalizations due to respiratory disease than in the general population. Timely diagnosis and treatment of respiratory complications in individuals with OI is warranted.