Equipoise exists regarding the optimal method to drain pleural fluid during thoracentesis. While several institutions use wall-based automated suction, others point to the risk of excessively high suction pressures and therefore elevated barotrauma risk as a reason to avoid it. We first performed in vitro experiments involving drainage of a 1-liter saline bag using standard thoracentesis apparatus, a digital manometer, and either manual drainage (using a 60 mL syringe) or automated drainage (using wall suction at the maximum setting).
View Article and Find Full Text PDFCurr Opin Pulm Med
September 2025
Purpose Of Review: Interstitial lung disease (ILD) and consequent pulmonary fibrosis are associated with significant morbidity and mortality with limited treatment options. There are more than 200 different etiologies that can lead to ILD. As a result, diagnostic accuracy and delay, prognostication, and treatment responses are still rife with challenges.
View Article and Find Full Text PDFMelanoma differentiation-associated gene 5 (MDA-5) autoimmunity has been increasingly recognized in association with interstitial lung disease (ILD), particularly in the context of viral infections. While MDA-5 ILD is typically rapidly progressive with high mortality, emerging evidence suggests that COVID-19 may induce a distinct, more indolent phenotype. We report two cases of MDA-5 ILD following COVID-19 infection with a slowly progressive course.
View Article and Find Full Text PDFBackground: Few cohorts have study populations large enough to conduct molecular analysis of ex vivo lung tissue for genomic analyses. Transcriptome imputation is a non-invasive alternative with many potential applications. We present a novel transcriptome-imputation method called the Lung Gene Expression and Network Imputation Engine (LungGENIE) that uses principal components from blood gene-expression levels in a linear regression model to predict lung tissue-specific gene-expression.
View Article and Find Full Text PDFBackground: Preserved ratio impaired spirometry (PRISm) findings are heterogeneous and include restrictive lung disease. Interstitial lung abnormalities (ILAs) may represent early interstitial lung disease. The relationship between PRISm and ILAs is not well understood.
View Article and Find Full Text PDFBupropion is a norepinephrine-dopamine reuptake inhibitor that is commonly used as an antidepressant and for smoking cessation. Bupropion overdose can lead to serious side effects which include seizures, status epilepticus, and fatal arrhythmias. Managing bupropion toxicity is challenging as there is no effective antidote and treatment is largely supportive.
View Article and Find Full Text PDFAm J Respir Crit Care Med
September 2024
Introduction: Interstitial lung abnormalities (ILA) often represent early fibrotic changes that can portend a progressive fibrotic phenotype. In particular, the fibrotic subtype of ILA is associated with increased mortality and rapid decline in lung function. Understanding the differential gene expression that occurs in the lungs of participants with fibrotic ILA may provide insight into development of a useful biomarker for early detection and therapeutic targets for progressive pulmonary fibrosis.
View Article and Find Full Text PDFAm J Respir Crit Care Med
October 2023
In addition to rare genetic variants and the locus, common genetic variants contribute to idiopathic pulmonary fibrosis (IPF) risk. The predictive power of common variants outside the locus for IPF and interstitial lung abnormalities (ILAs) is unknown. We tested the predictive value of IPF polygenic risk scores (PRSs) with and without the region on IPF, ILA, and ILA progression.
View Article and Find Full Text PDFPatients who undergo heart valve replacements with mechanical valves need to take Vitamin K Antagonists (VKA) drugs (Warfarin, Nicoumalone) which has got a very narrow therapeutic range and needs very close monitoring using PT-INR. Accessibility to physicians to titrate drugs doses is a major problem in low-middle income countries (LMIC) like India. Our work was aimed at predicting the maintenance dosage of these drugs, using the de-identified medical data collected from patients attending an INR Clinic in South India.
View Article and Find Full Text PDFBackground: Interstitial lung abnormalities (ILAs) are associated with increased mortality. It is unclear whether multimorbidity accounts for the mortality association or how strongly ILA is associated with mortality relative to other common age-associated diseases. We determined the association of ILA with all-cause mortality adjusted for multimorbidity, compared mortality associated with ILA and prevalent cardiovascular disease (CVD), diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease and cancer and also determined the association between ILA and these diseases.
View Article and Find Full Text PDFBackground: Interstitial lung abnormalities (ILA) are radiologic findings that may progress to idiopathic pulmonary fibrosis (IPF). Blood gene expression profiles can predict IPF mortality, but whether these same genes associate with ILA and ILA outcomes is unknown. This study evaluated if a previously described blood gene expression profile associated with IPF mortality is associated with ILA and all-cause mortality.
View Article and Find Full Text PDFBackground The clinical impact of interstitial lung abnormalities (ILAs) on poor prognosis has been reported in many studies, but risk stratification in ILA will contribute to clinical practice. Purpose To investigate the association of traction bronchiectasis/bronchiolectasis index (TBI) with mortality and clinical outcomes in individuals with ILA by using the COPDGene cohort. Materials and Methods This study was a secondary analysis of prospectively collected data.
View Article and Find Full Text PDFBackground: Interstitial lung abnormalities (ILA) share many features with idiopathic pulmonary fibrosis; however, it is not known if ILA are associated with decreased mean telomere length (MTL).
Methods: Telomere length was measured with quantitative PCR in the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) and Age Gene/Environment Susceptibility Reykjavik (AGES-Reykjavik) cohorts and Southern blot analysis was used in the Framingham Heart Study (FHS). Logistic and linear regression were used to assess the association between ILA and MTL; Cox proportional hazards models were used to assess the association between MTL and mortality.
Background: Most pulmonary conditions reduce FVC, but studies of patients with combined pulmonary fibrosis and emphysema demonstrate that reductions in FVC are less than expected when these two conditions coexist clinically.
Research Question: Do interstitial lung abnormalities (ILAs), chest CT imaging findings that may suggest an early stage of pulmonary fibrosis in individuals with undiagnosed disease, affect the association between emphysema and FVC?
Study Design And Methods: Measures of ILA and emphysema were available for 9,579 and 5,277 participants from phases 1 (2007-2011) and 2 (2012-2016) of the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease Study (COPDGene), respectively. ILA were defined by Fleischner Society guidelines.
Am J Respir Crit Care Med
February 2022
Intractable Rare Dis Res
November 2019
Coronary artery disease (CAD) patients might have concomitant mesenteric artery stenosis (MAS). Identification of risk factors predicting mesenteric artery involvement might guide screening high risk individuals. A dilemma of intervention in radiologically severe MAS exists.
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