Nadia hansel

OBJECTIVE: Clinical implementation of remote monitoring of human function requires an understanding of its feasibility. We evaluated adherence and the resources required to monitor physical, cognitive, and psychosocial function in individuals with either chronic obstructive pulmonary disease or stroke during a three-month period. METHODS: Seventy-three individuals agreed to wear a Fitbit to monitor physical function and to complete monthly online assessments of cognitive and psychosocial function...

BACKGROUND: Limited data are available regarding marijuana smoking's impact on development or progression of chronic obstructive pulmonary disease (COPD) in middle-aged or older adults with a variable history of tobacco cigarette smoking. METHODS: We divided ever-tobacco smoking participants in the Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS) into three groups based on self-reported marijuana use: current, former or never marijuana smokers (CMS, FMS or NMS, respectively)...

RATIONALE: Bronchiectasis is common among those with heavy smoking histories, but risk factors for bronchiectasis, including alpha-1 antitrypsin deficiency, and its implications for COPD severity are uncharacterized in such individuals. OBJECTIVES: To characterize the impact of bronchiectasis on COPD and explore alpha-1antitrypsin as a risk factor for bronchiectasis. METHODS: SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) participants (N=914; ages 40-80 years; ≥20-pack-year smoking) had high-resolution computed tomography (CT) scans interpreted visually for bronchiectasis, based on airway dilation without fibrosis or cicatrization...

BACKGROUND: Abnormal lung volumes representing air trapping identify the subset of smokers with preserved spirometry who develop spirometric COPD and adverse outcomes. However, how lung volumes evolve in early COPD as airflow obstruction develops remains unclear. METHODS: To establish how lung volumes change with development of spirometric COPD, we examined lung volumes from the pulmonary function data (seated posture) available in the U.S. Department of Veterans Affairs electronic health records (n=71,356) and lung volumes measured by computed tomography (supine posture) available from COPDGene (n=7,969) and SPIROMICS (n=2,552) cohorts, and studied their cross-sectional distributions and longitudinal changes across airflow obstruction spectrum...

STUDY OBJECTIVES: To examine the association of self-identified race with sleep quality in heavy smokers. METHODS: We studied baseline data from 1965 Non-Hispanic White (NHW) and 462 African American (AA) participants from SPIROMICS with ≥20 pack-years smoking history. We first examined the PSQI's internal consistency and item-total correlation in a population with COPD. We then used staged multivariable regression to investigate the association of race and sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI)...

BACKGROUND: COPD diagnosis is tightly linked to the fixed-ratio spirometry criteria of FEV1 /FVC < 0.7. African-Americans are less often diagnosed with COPD. OBJECTIVE: Compare COPD diagnosis by fixed-ratio with findings and outcomes by race. DESIGN: Genetic Epidemiology of COPD (COPDGene) (2007-present), cross-sectional comparing non-Hispanic white (NHW) and African-American (AA) participants for COPD diagnosis, manifestations, and outcomes...

Organophosphate esters (OPEs) are an emerging class of chemicals used in a variety of consumer products as flame retardants, plasticizers, and additives. While prior epidemiologic studies suggest that OPEs may impact respiratory health, results remain inconclusive. We examined associations between urinary biomarkers of OPEs and symptoms of respiratory morbidity in a panel study of 147 predominantly Black school-aged children with asthma living in Baltimore City, Maryland. The study consisted of up to four seasonal, week-long, in-home visits where urine samples and self-reported asthma symptoms were collected on days 4 and 7 ( n samples = 438)...

While hypogammaglobulinemia is associated with COPD exacerbations, it is unknown whether frequent exacerbators have specific defects in antibody production/function. We hypothesized that reduced quantity/function of serum pneumococcal antibodies correlate with exacerbation risk in the SPIROMICS cohort. We measured total pneumococcal IgG in n = 764 previously vaccinated participants with COPD. In a propensity-matched subset of n = 200 with vaccination within five years (n = 50 without exacerbations in the previous year; n = 75 with one, n = 75 with ≥2), we measured pneumococcal IgG for 23 individual serotypes, and pneumococcal antibody function for 4 serotypes...

OBJECTIVE: To determine whether aggregate measures of occupational exposures are associated with COPD outcomes in the SubPopulations and InteRmediate Outcome Measures In COPD Study cohort. METHODS: Individuals were assigned to six predetermined exposure hazard categories based on self-reported employment history. Multivariable regression, adjusted for age, gender, race, current smoking status, and smoking pack-years determined the association of such exposures to odds of COPD and morbidity measures...

BACKGROUND: Polymorphisms and products of the cyclooxygenase (COX) pathway have been associated with development of COPD and adverse outcomes. COX-produced prostaglandin E2 (PGE-2) may play a role in the inflammation observed in COPD, potentially through deleterious airway macrophage polarization. Better understanding the role of PGE-2 in COPD morbidity may inform trials for therapeutics targeting the COX pathway or PGE-2. METHODS: Urine and induced sputum were collected from former smokers with moderate-severe COPD...

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) affects ∼16 million U.S. adults. Phthalates, synthetic chemicals in consumer products, may adversely impact pulmonary function and airway inflammation; however, their role on COPD morbidity remains unknown. OBJECTIVE: We examined associations between phthalate exposures and respiratory morbidity among 40 COPD patients who were former smokers. METHODS: We quantified 11 phthalate biomarkers in urine samples collected at baseline in a 9-month prospective cohort study in Baltimore, Maryland...

No abstract text is available yet for this article.

RATIONALE: Obstructive sleep apnea is highly prevalent in children with asthma, particularly in obese children. The sleep-related breathing disorder screening questionnaire has low screening accuracy for obstructive sleep apnea in children with asthma. Our goal was to identify the questions on the sleep-related breathing disorder survey associated with obstructive sleep apnea in children with asthma. METHODS: Participants completed the survey, underwent polysomnography and their body mass index z-score was measured...

BACKGROUND: Indoor air quality represents a modifiable exposure to Chronic Obstructive Pulmonary Disease (COPD) health. In a randomized controlled trial (CLEAN AIR study), air cleaner assignment had causal effect in improving COPD outcomes. It is unclear, however, what is the treatment effect among those for whom intervention reduced air pollution and whether it was reduction in fine particulate matter (PM2.5 ) or nitrogen dioxide (NO2 ) that contributed to such improvement. Because pollution is a posttreatment variable, treatment effect cannot be assessed while controlling for pollution using intention-to-treat (ITT) analysis...

No abstract text is available yet for this article.

RATIONALE: Ambient air pollution exposure is associated with respiratory morbidity among individuals with chronic obstructive pulmonary disease (COPD), particularly among those with concomitant obesity. Although people with COPD report high incidence of poor sleep quality, no studies have evaluated the association between air pollution exposure, obesity, and sleep disturbances in COPD. METHODS: We analyzed data collected from current and former smokers with COPD enrolled in the Subpopulations and Intermediate Outcome Measures in COPD pollution ancillary study (SPIROMICS-AIR)...

BACKGROUND: Bronchodilator responsiveness (BDR) in obstructive lung disease varies over time and may be associated with distinct clinical features. RESEARCH QUESTION: Is consistent BDR over time (always present) differentially associated with obstructive lung disease features relative to inconsistent (sometimes present) or never (never present) BDR in tobacco-exposed people with or without COPD? STUDY DESIGN AND METHODS: We retrospectively analyzed data from 2,269 tobacco-exposed participants in the Subpopulations and Intermediate Outcome Measures in COPD Study with or without COPD...

BACKGROUND: Airway macrophages (AM), crucial for the immune response in chronic obstructive pulmonary disease (COPD), are exposed to environmental particulate matter (PM), which they retain in their cytoplasm as black carbon (BC). However, whether AM BC accurately reflects environmental PM2.5 exposure, and can serve as a biomarker of COPD outcomes, is unknown. METHODS: We analyzed induced sputum from participants at 7 of 12 sites SPIROMICS sites for AM BC content, which we related to exposures and to lung function and respiratory outcomes...

Introduction: Antiplatelet therapy has been associated with fewer exacerbations and reduced respiratory symptoms in COPD. Whether platelet activation is associated with respiratory symptoms in COPD is unknown. Methods: Former smokers with spirometry-confirmed COPD had urine 11-dehydro-thromboxane B2 (11dTxB2), plasma soluble CD40L (sCD40L) and soluble P-selectin (sP-selectin) repeatedly measured during a 6-9-month study period. Multivariate mixed-effects models adjusted for demographics, clinical characteristics, and medication use evaluated the association of each biomarker with respiratory symptoms, health status, and quality of life...

RATIONALE: Indoor air pollution represents a modifiable risk factor for respiratory morbidity in COPD. The effects of indoor air pollution, as well as the impact of interventions to improve indoor air quality, on cardiovascular morbidity in COPD remain unknown. OBJECTIVE: To determine the association between indoor particulate matter(PM) and heart rate variability(HRV), a measure of cardiac autonomic function tied to cardiovascular morbidity and mortality, as well as the impact of household air purifiers on HRV...