American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Feb 2022
Multicenter StudyNeighborhood-level Disadvantage Impacts on Patients with Fibrotic Interstitial Lung Disease.
Rationale: Fibrotic interstitial lung disease (fILD) is a group of pathologic entities characterized by scarring of the lungs and high morbidity and mortality. Research investigating how socioeconomic and residential factors impact outcomes in patients with fILD is lacking. Objectives: To determine the association between neighborhood-level disadvantage and presentation severity, disease progression, lung transplantation, and mortality in patients with fILD from the United States and Canada. ⋯ Greater disadvantage was associated with reduced baseline DLCO in both cohorts, but it was not associated with baseline FVC or FVC or DLCO decline in either cohort. Conclusions: Patients with fILD who live in areas with greater neighborhood-level disadvantage in the United States experience higher mortality, and patients with idiopathic pulmonary fibrosis experience lower odds of lung transplantation. These disparities are not seen in Canadian patients, which may indicate differences in access to care between the United States and Canada.
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Am. J. Respir. Crit. Care Med. · Feb 2022
Observational StudyHome Dust Allergen Exposure is Associated with Outcomes Among Sensitized Individuals with COPD.
Rationale: Environmental exposures have been associated with adverse outcomes in chronic obstructive pulmonary disease (COPD). Approximately one-third of individuals with COPD have allergic sensitization, but it is unknown whether exposure to allergens in the home is associated with outcomes. Objectives: To determine the prevalence and associations of allergen sensitization with exposure to common indoor allergens with symptoms and exacerbation risk in COPD. ⋯ Associations appeared to be more pronounced among individuals with lower lung function. Conclusions: Allergen exposures are common in COPD and associated with adverse outcomes among those with concomitant allergen sensitization. This study establishes allergens as an important home exposure that potentially could be addressed with comprehensive home environmental modification strategies to improve COPD outcomes.
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Am. J. Respir. Crit. Care Med. · Feb 2022
Letter Randomized Controlled TrialRapid Phospholipid Turnover After Surfactant Nebulization in Severe COVID-19 Infection: A Randomized Clinical Trial.