"Endobronchial Optical Coherence Tomography as a Novel Method for In Vivo Microscopic Assessment of Interstitial Lung Abnormalities ." American Journal of Respiratory and Critical Care Medicine, 0(ja), pp.

The ability to monitor disease progression over time is critical to inform patient care and prognosis, especially in usual interstitial pneumonia (UIP), the histopathological pattern seen in idiopathic pulmonary fibrosis (IPF). HRCT is limited in resolution to detect disease changes on a microscopic level, and surgical lung biopsy (SLB) has high risk of morbidity and mortality precluding its use to assess progression. Endobronchial optical coherence tomography (EB-OCT) is a bronchoscopic, minimally-invasive, high-resolution imaging method that accurately detects microscopic ILD features and is repeatable. Here, we evaluate the utility of repeat EB-OCT for monitoring microscopic disease progression in UIP/IPF.

BACKGROUND:Vaping, including the use of electronic cigarettes (e-cigarettes), has become increasingly prevalent, yet the associated long-term health risks are largely unknown. Given the prevalence of use, particularly among adolescents early in their lifespan, it is vital to understand the potential chronic pathologic sequelae of vaping.METHODS:We present the cases of four patients with chronic lung disease associated with e-cigarette use characterized by clinical evaluation, with pulmonary function tests (PFTs), chest high-resolution computed tomography (HRCT), endobronchial optical coherence tomography (EB-OCT) imaging, and histopathologic assessment.RESULTS:Each patient presented with shortness of breath and chest pain in association with a 3- to 8-year history of e-cigarette use, with mild progressive airway obstruction on PFTs and/or chest HRCT findings demonstrating evidence of air trapping and bronchial wall thickening. EB-OCT imaging performed in two patients showed small airway-centered fibrosis with bronchiolar narrowing and lumen irregularities. The predominant histopathologic feature on surgical lung biopsy was small airway-centered fibrosis, including constrictive bronchiolitis and MUC5AC overexpression in all patients. Patients who ceased vaping had a partial, but not complete, reversal of disease over 1 to 4 years.CONCLUSIONS:After thorough evaluation for other potential etiologies, vaping was considered to be the most likely common causal etiology for all patients due to the temporal association of symptomatic chronic lung disease with e-cigarette use and partial improvement in symptoms after e-cigarette cessation. In this series, we associate the histopathologic pattern of small airway-centered fibrosis, including constrictive bronchiolitis, with vaping, potentially defining a clinical and pathologic entity associated with e-cigarette use. (Funded in part by the National Institutes of Health.).

BACKGROUND:We aimed to determine if antibody type is an indicator of pulmonary histopathology, using antisynthetase antibody positive interstitial lung disease (ILD) cases with lung biopsy or autopsy findings.METHODS:We conducted a comprehensive review of the English language literature in PubMed to identify ILD histopathology results for cases with antibodies against anti-aminoacyl-transfer RNA (tRNA) synthetases (anti-ARS antibodies), including Jo1, PL-12, PL-7, KS, ES, and OJ. We additionally identified patients who had ILD, anti-ARS antibodies, and a lung biopsy between 2015 and 2020 at Beth Israel Deaconess Medical Center. For each case, we documented the specific anti-ARS antibody and major histopathologic patterns identified on biopsy or autopsy, including usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), organizing pneumonia (OP), and acute lung injury (ALI). To determine if histopathology varied by antibody type, we compared the proportion of each of four major patterns by antibody type using the Fisher's Exact test.RESULTS:We identified 310 cases with pathology findings and anti-ARS antibody positivity, including 12 cases from our institution. The proportion of NSIP differed significantly across antibody type, found in 31% of Jo1 (p < 0.01), 67% of EJ (p < 0.01), and 63% of KS (p < 0.01) cases. OP was common in Jo1 (23%, p = 0.07), but rare in EJ (4%, p = 0.04) and KS (4%, p = 0.04). UIP was common in PL-12 alone (36%, p = 0.03).CONCLUSION:The frequency of histopathologic findings in ILD with anti-ARS positivity varies significantly by antibody type, and NSIP occurs in less than half of all cases.

Exhaled nitric oxide fraction (FeNO) is an indicator of allergic airway inflammation. However, it is unknown how asthma, allergic rhinitis (AR) and allergic sensitisation relate to FeNO, particularly among adolescents and in overlapping conditions. We sought to determine the associations between asthma, AR, and aeroallergen immunoglobulin (Ig)E and FeNO in adolescents. We measured FeNO among 929 adolescents (aged 11–16 years) in Project Viva, an unselected prebirth cohort in Massachusetts, USA. We defined asthma as ever asthma physician diagnosis plus wheezing in the past year or taking asthma medications in the past month, AR as a physician diagnosis of hay fever or AR, and aeroallergen IgE as any IgE >0.35 IU·mL−1 among 592 participants who provided blood samples. We examined associations of asthma, AR and IgE with percent difference in FeNO in linear regression models adjusted for sex, race/ethnicity, age and height, maternal education and smoking during pregnancy, and household/neighbourhood demographics. Asthma (14%) was associated with 97% higher FeNO (95% CI 70–128%), AR (21%) with 45% higher FeNO (95% CI 28–65%), and aeroallergen IgE (58%) with 102% higher FeNO (95% CI 80–126%) compared to those without each condition, respectively. In the absence of asthma or AR, aeroallergen IgE was associated with 75% higher FeNO (95% CI 52–101), while asthma and AR were not associated with FeNO in the absence of IgE. The link between asthma and AR with FeNO is limited to those with IgE-mediated phenotypes. FeNO may be elevated in those with allergic sensitisation alone, even in the absence of asthma or AR.

The COVID-19 pandemic has drastically affected the traditional methods residency programs use to train their residents. Chief residents serve a unique role as part of the residency leadership to foster the education and development of the residents. Given the rapid shift in demands on physicians in the face of the pandemic, the responsibilities of the chief residents have also shifted to help prepare the residents to meet these demands as frontline providers. There is not a precedent for how residency programs respond to this crisis while maintaining their primary role to develop and train physicians. The authors have identified 5 questions chief residents can ask to guide their program's response to the demands of COVID-19 during this uncertain time in health care.

Fractional exhaled nitric oxide (FeNO) is a marker of airway inflammation that is well-characterized in allergic disease states. However, FeNO is also involved in nonallergic inflammatory and pulmonary vascular mechanisms or responses to environmental stimuli. We sought to determine the extent to which obesity or sedentary lifestyle is associated with FeNO in adolescents not selected on the basis of allergic disease. In Project Viva, a prebirth cohort study, we measured body mass index (BMI), skinfold thicknesses, waist circumference, body fat, hours watching television, hours of physical activity, and heart rate after exercise among 929 adolescents (median age, 12.9). We measured FeNO twice and averaged these as a continuous, log-transformed outcome. We performed linear regression models, adjusted for child age, sex, height, and race/ethnicity, maternal education and smoking during pregnancy, household income and smoking, and neighbourhood characteristics. In secondary analysis, we additionally adjusted for asthma. More than 2 hours spent watching TV was associated with 10% lower FeNO (95% confidence interval [CI]: -20, 0%). Higher body fat percentage was also associated with lower FeNO. After additional adjustment for asthma, teens who are underweight (BMI <5th %tile, 3%) had 22% lower FeNO (95%CI: -40, 2%) and teens who are overweight (BMI >= 85th %ile, 28%) had 13% lower FeNO (95%CI: -23, -2%). Each of these associations of lifestyle and body weight with lower FeNO were greater in magnitude after adjusting for asthma. In summary, sedentary lifestyle, high and low BMI were all associated with lower FeNO in this adolescent cohort.

MethodsWe measured eNO among teenagers (age 11-16) in the Project Viva cohort. We defined current asthma as having an asthma diagnosis and taking medications or wheezing in the past 12 months, and AR as having a diagnosis of hayfever or AR. IgE was having any environmental inhalant IgE (against plant or animal allergen)> 0.35 IU/mL. We used the average of two eNO measurements as a continuous, log-transformed outcome in linear regression models, adjusted for age, sex, ethnicity, height; maternal education and smoking during pregnancy; median household income and education in residential census tract; household income; and any smokers at home. We examined associations of current asthma, ever AR, and environmental IgE with eNO in separate models. Then, selecting two of these (asthma, AR and/or IgE) at a time, we categorized participants as having one, both, or neither to investigate …

Psycho-OncologyVolume 26, Issue 10 p. 1700-1703 CLINICAL CORRESPONDENCE “The song inside”: “La canción por dentro”—Individual and dyadic impact of breast cancer for caregivers of Latina survivors Juliana Munoz, Juliana Munoz Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorChristina Rush, Christina Rush Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorBess Flashner, Bess Flashner Harvard Medical School, Boston, MA, USASearch for more papers by this authorGhipsel Cibrian, Ghipsel Cibrian Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorSandra Martinez, Sandra Martinez Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorClaudia Campos, Claudia Campos Nueva Vida, Washington, DC, USASearch for more papers by this authorMigdalia Torres, Migdalia Torres Gilda's Club, New York, NY, USASearch for more papers by this authorOlympia Cepeda, Olympia Cepeda Latina SHARE, NY, USASearch for more papers by this authorCharlene Kuo, Charlene Kuo Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorStacey Kaltman, Stacey Kaltman Department of Psychiatry, Georgetown University, Washington, DC, USASearch for more papers by this authorLina Jandorf, Lina Jandorf Icahn School of Medicine, Mount Sinai, New York, NY, USASearch for more papers by this authorKristi D. Graves, Corresponding Author Kristi D. Graves kdg9@georgetown.edu Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA Correspondence Kristi D. Graves, Cancer Control Program, Lombardi Comprehensive Cancer Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007, USA. Email: kdg9@georgetown.eduSearch for more papers by this author Juliana Munoz, Juliana Munoz Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorChristina Rush, Christina Rush Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorBess Flashner, Bess Flashner Harvard Medical School, Boston, MA, USASearch for more papers by this authorGhipsel Cibrian, Ghipsel Cibrian Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorSandra Martinez, Sandra Martinez Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorClaudia Campos, Claudia Campos Nueva Vida, Washington, DC, USASearch for more papers by this authorMigdalia Torres, Migdalia Torres Gilda's Club, New York, NY, USASearch for more papers by this authorOlympia Cepeda, Olympia Cepeda Latina SHARE, NY, USASearch for more papers by this authorCharlene Kuo, Charlene Kuo Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USASearch for more papers by this authorStacey Kaltman, Stacey Kaltman Department of Psychiatry, Georgetown University, Washington, DC, USASearch for more papers by this authorLina Jandorf, Lina Jandorf Icahn School of Medicine, Mount Sinai, New York, NY, USASearch for more papers by this authorKristi D. Graves, Corresponding Author Kristi D. Graves kdg9@georgetown.edu Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA Correspondence Kristi D. Graves, Cancer Control Program, Lombardi Comprehensive Cancer Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007, USA. Email: kdg9@georgetown.eduSearch for more papers by this author First published: 27 November 2016 https://doi.org/10.1002/pon.4326Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume26, Issue10October 2017Pages 1700-1703 RelatedInformation