Publications by authors named "Stacey Lok"
Background: BAL cellular analysis is often recommended during the initial diagnostic evaluation of fibrotic interstitial lung disease (ILD). Despite recommendation for its use, between-center heterogeneity exists and supportive data concerning the clinical utility and correlation of BAL findings with radiologic features or patterns remain sparse.
Research Question: In patients with fibrotic ILD, are BAL findings associated with radiologic features, patterns, and clinical diagnoses?
Study Design And Methods: Patients with fibrotic ILD who underwent BAL for diagnostic evaluation and who were enrolled in the prospective Canadian Registry for Pulmonary Fibrosis were re-reviewed in a standardized multidisciplinary discussion (MDD).
Background: Fibrotic interstitial lung disease (ILD) is frequently associated with abnormal oxygenation; however, little is known about the accuracy of oxygen saturation by pulse oximetry (SpO) compared with arterial blood gas (ABG) saturation (SaO), the factors that influence the partial pressure of carbon dioxide (PaCO) and the impact of PaCO on outcomes in patients with fibrotic ILD.
Study Design And Methods: Patients with fibrotic ILD enrolled in a large prospective registry with a room air ABG were included. Prespecified analyses included testing the correlation between SaO and SpO, the difference between SaO and SpO, the association of baseline characteristics with both the difference between SaO and SpO and the PaCO, the association of baseline characteristics with acid-base category, and the association of PaCO and acid-base category with time to death or transplant.
Background And Objective: Establishing an accurate and timely diagnosis of idiopathic pulmonary fibrosis (IPF) is essential for appropriate management and prognostication. In some cases, surgical lung biopsy (SLB) is performed but carries non-negligible risk. The objective of this retrospective study was to determine if SLB is associated with accelerated lung function decline in patients with IPF using the Canadian Registry for Pulmonary Fibrosis.
View Article and Find Full Text PDFBackground: Previous studies have shown the importance of frailty in patients with fibrotic interstitial lung disease (ILD).
Research Question: Is the Clinical Frailty Scale (CFS) a valid tool to improve risk stratification in patients with fibrotic ILD?
Study Design And Methods: Patients with fibrotic ILD were included from the prospective multicenter Canadian Registry for Pulmonary Fibrosis. The CFS was assessed using available information from initial ILD clinic visits.
Objectives: Interstitial lung disease (ILD) in CTDs has highly variable morphology. We aimed to identify imaging features and their impact on ILD progression, mortality, and immunosuppression response.
Methods: Patients with CTD-ILD had high-resolution chest CT (HRCT) reviewed by expert radiologists blinded to clinical data for overall imaging pattern [usual interstitial pneumonia (UIP); non-specific interstitial pneumonia (NSIP); organizing pneumonia (OP); fibrotic hypersensitivity pneumonitis (fHP); and other].
Article Synopsis
- Interstitial pneumonia with autoimmune features (IPAF) shares similarities with connective tissue disease-associated interstitial lung disease (CTD-ILD) but does not fully meet the criteria for a specific connective tissue disease.
- A study compared the characteristics and survival of IPAF with CTD-ILD and unclassifiable ILD, revealing that IPAF patients are older and have a greater smoking history compared to CTD-ILD, while having worse lung function than unclassifiable ILD.
- The findings suggest that while patients with IPAF experience worse survival rates compared to CTD-ILD, they have similar mortality to those with unclassifiable ILD, raising questions about whether IPAF should be viewed as a separate category of interstitial lung disease
Article Synopsis
- Hypoxemia in fibrotic interstitial lung disease (ILD) signals disease progression and can predict patient mortality.
- A risk prediction tool was created to identify new-onset exertional and resting hypoxemia using data from ILD registries in Canada, Australia, and the U.S.
- The model's effectiveness was assessed, showing good performance based on factors like age, body mass index, and specific lung function measures, although the validation cohort showed some issues with calibration for resting hypoxemia.
Article Synopsis
- Clinical practice guidelines currently distinguish between different radiologic patterns for usual interstitial pneumonia (UIP) and fibrotic hypersensitivity pneumonitis (fHP), but do not clarify how to use these approaches together for diagnosis in individual patients.
- A study involving 1,593 patients aimed to integrate these radiologic patterns for diagnosing interstitial lung disease (ILD), revealing that typical UIP patterns strongly correlated with idiopathic pulmonary fibrosis (IPF) diagnoses, while the typical fHP pattern was linked to fHP diagnoses in a significant portion of cases.
- The findings suggest that an integrated approach is feasible, highlighting that over 5% gas trapping on expiratory imaging is a key diagnostic feature that helps differentiate compatible fHP from other patterns, thus calling
Background: Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is challenging to manage, with a paucity of robust data to guide treatment. Our aim was to characterize the pharmacologic treatment of RA-ILD utilizing a retrospective design in a national multi-center prospective cohort, and to identify associations between treatment and change in lung function and survival.
Methods: Patients with RA-ILD and a radiological pattern of non-specific interstitial pneumonia (NSIP) or usual interstitial pneumonia (UIP) were included.
Introduction: Interstitial lung disease (ILD) is a frequent manifestation of connective tissue disease (CTD) with substantial variability in prevalence and outcomes reported across CTD subtypes. This systematic review summarises the prevalence, risk factors and ILD patterns on chest computed tomography of CTD-ILD.
Methods: A comprehensive search was performed in Medline and Embase to identify eligible studies.
Background: Little is known about generalisability of randomised controlled trials (RCTs) for idiopathic pulmonary fibrosis (IPF). We evaluated eligibility criteria for phase III IPF RCTs to determine their representativeness in clinical registries, and calculated forced vital capacity (FVC) changes according to eligibility criteria.
Methods: Common eligibility criteria used in >60% of IPF RCTs were identified from a literature search and applied to patients with IPF from prospective Australian and Canadian registries.
Background And Objective: Inhalational exposures are a known cause of interstitial lung disease (ILD), but little is understood about their prevalence across ILD subtypes and their relationship with pulmonary function and survival.
Methods: Patients with fibrotic ILD were identified from the multicentre Canadian Registry for Pulmonary Fibrosis. Patients completed questionnaires regarding ILD-related occupational and environmental exposures.
Background: Pulmonary fibrosis (PF) is associated with reduction in vital capacity (VC) and increase in expiratory flow rates, including peak expiratory flow (PEF). Full pulmonary function testing and computed tomography chest scans are limited resources in some geographic areas and a simple and sensitive screening test would be of value. We hypothesized that increase in the ratio of % predicted PEF over % predicted VC (%PEF/%VC), from spirometry alone might be sensitive to screen for pulmonary fibrosis.
View Article and Find Full Text PDFPrevalence of allergen sensitization in 1000 adults in Saskatchewan.
Allergy Asthma Clin Immunol
February 2017
Background: The prevalence of sensitization varies geographically based on multiple environmental factors including humidity. The aim of this study was to determine the prevalence of atopy in symptomatic adults. More importantly we aimed to obtain a regional statistic of sensitization to common allergens given Saskatchewan's dry climate.
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