Annals of the American Thoracic Society
-
Randomized Controlled Trial Multicenter Study
Effect of Continuous Positive Airway Pressure on Airway Reactivity in Asthma. A Randomized, Sham-controlled Clinical Trial.
Studies have demonstrated that application of stress suppresses airway smooth muscle contractility. In animal models of asthma, continuous positive airway pressure (CPAP) reduced airway reactivity. Short-term studies of CPAP in patients with asthma showed reductions in airway reactivity. ⋯ Adherence to nocturnal CPAP was low. There was no evidence to support positive pressure as being effective for reducing airway reactivity in people with well-controlled asthma. Regardless, airway reactivity was improved in all groups, which may represent an effect of participating in a study and/or an effect of warm, humid, filtered air on airway reactivity. Clinical trial registered with www.clinicaltrials.gov (NCT01629823).
-
Little is known about vulnerable patients' perceptions and understanding of, and preferences for, lung cancer screening decision aids. ⋯ Vulnerable patients find lung cancer screening decision aids helpful and generally show increased knowledge after reviewing decision aids, particularly of harms. Our results can inform future implementation efforts.
-
Unlike tuberculosis, nontuberculous mycobacterial disease is not reportable to public health authorities in the United States, and the total burden of disease is uncertain. ⋯ The mortality rate of nontuberculous mycobacterial disease among HIV-uninfected individuals has increased in the United States between 1999 and 2014. These deaths occurred disproportionately in older white women. Considering the concurrent decline in tuberculosis-related deaths, these findings demonstrate a shift in the epidemiology of fatal mycobacterial infections in the United States.
-
The U.S. Preventive Services Task Force recommends annual low-dose computed tomography (LDCT) for lung cancer screening in high-risk individuals. Preventive healthcare is provided predominantly by primary care providers (PCPs). Successful implementation of a screening program requires acceptance and participation by both providers and patients, with available collaboration with pulmonologists. ⋯ While patients and providers are receptive to LDCT screening, efforts are needed to improve guideline knowledge and adherence among providers. System-level interventions are necessary to facilitate time and resources for shared decision making and smoking cessation counseling and treatment. Further research is needed to identify optimal strategies for effective lung cancer screening in the community.
-
Multicenter Study
Lung Function Trajectory in Bronchiolitis Obliterans Syndrome after Allogeneic Hematopoietic Cell Transplant.
The natural history of lung function in patients with bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic cell transplant is poorly characterized. Understanding the trajectory of lung function is necessary for prompt clinical recognition and treatment and also for the rational design of prospective studies. ⋯ The FEV1 trajectory in patients with BOS after hematopoietic cell transplant in a contemporary era of management follows a predominant pattern of rapid FEV1 decline in the 6 months prior to diagnosis, followed by FEV1 stabilization after diagnosis.