Pneumonia in Immunocompromised Patients: Overview, Causes of Pneumonia, HIV/AIDS

Local Father Walking From Los Angeles To San Diego To Raise Awareness Of Rare Disease

Eric Borstein is known as "The Walking Man," and for good reason. He has Pulmonary Arterial Hypertension, a rare incurable disease that causes high blood pressure in the lungs. According to the American Lung Association, the cause of the progressive disorder is "usually unknown," and only 500 to 1,000 people are diagnosed each year in the U.S. After collapsing at his home from massive right heart failure, Borstein was taken to a hospital where he remained in the intensive care unit for 16 days, and as he put it bluntly, "[The doctors] didn't think I was going to leave." He was eventually discharged and subsequently put on what he called "very difficult" medications with side effects he found could be mitigated by walking. Thus, "The Walking Man" was born. Shot by KTLA photojournalist Phil Ige on Sept. 22, 2024.

View comments

Vets With Rare Lung Disease Could Get Benefits More Easily Under Proposed Changes, VA Says

Veterans with a rare lung disease could have an easier time collecting Department of Veterans Affairs disability benefits under proposed changes announced by the agency Wednesday.

The ailment, called constrictive bronchiolitis, or CB, is one of the burn pit-related illnesses covered under the PACT Act, the sweeping law passed two years ago that aimed to make it easier for veterans with certain diseases linked to toxic exposure to get VA care and benefits. But veterans with CB have reported still facing unique challenges to getting their benefits approved by the VA.

Now, the department is taking steps to remove the specific challenges veterans with CB face when applying for benefits.

Read Next: Marines Use Simulators for Mortar and Rocket Training that Could Protect Against Brain Injuries

"These steps are part of our comprehensive efforts to make sure that all those we serve -- including veterans who live with CB and their survivors -- get the benefits they deserve," VA Secretary Denis McDonough wrote in a letter to Senate Veterans Affairs Committee Chairman Jon Tester, D-Mont., released by the department Wednesday.

"Altogether, we are now delivering more care and more benefits to more veterans than ever before, but we will not rest until every veteran and survivor gets the care and benefits they deserve," McDonough added. "That is why today's proposed steps are so important, and that is why we will continue to do everything in our power to support veterans who live with CB and their survivors."

CB, also known as obliterative bronchiolitis or bronchiolitis obliterans, is the narrowing or obstruction of the lungs' smallest airways -- the bronchioles -- by scarring or fibrous tissue. The scarring prevents oxygen exchange between the lungs and the bloodstream, causing extreme fatigue.

Other symptoms include shortness of breath and unexplained wheezing or dry cough in the absence of a cold or allergies.

CB was one of the 23 ailments that the PACT Act classified as presumed to be linked to military service, meaning the burden is no longer on veterans to prove their illness was caused by military service in order to be approved for benefits.

But two specific issues have made it difficult for veterans with CB to collect benefits even after the PACT Act, veterans and experts recently told lawmakers in a roundtable to mark the anniversary of the bill.

First, CB is the only PACT Act respiratory illness that does not have its own diagnostic code in VA disability claims systems. That means the VA must enter a diagnostic code for a similar disease into the system, a practice it says allows the department to still award benefits but which veterans and advocates say fails to recognize the true effect of their condition. Second, it is difficult to diagnose CB, with the only current way to definitively diagnose it being a painful, invasive lung biopsy.

To address those hurdles, the VA is taking steps to add a diagnostic code specifically for CB. The department is also moving to allow two additional medical tests to evaluate those with CB that will "make it easier for veterans to obtain an accurate disability rating," according to McDonough's letter. The tests are maximum oxygen consumption and metabolic equivalents, which respectively measure oxygen and energy usage during exercise.

The changes announced Wednesday are not taking effect immediately. The department must first go through the federal rulemaking process, a sometimes lengthy undertaking that includes soliciting public comment. The proposed rule change will be published in the Federal Register on Thursday, according to a draft published on the agency's website Wednesday.

In April, Tester led 17 other senators in calling on the VA to make the changes similar to those announced Wednesday after a PBS NewsHour story highlighted the issue.

A Senate aide told Military.Com that, while not perfect, the VA's Wednesday announcement was a significant step forward and that Tester will monitor the implementation of the changes.

"Toxic-exposed veterans have waited decades to receive the benefits and health care the PACT Act provides, and it's critical VA is implementing the law the way veterans need and deserve," Tester said in an emailed statement Wednesday. "That means fixing outdated processes standing in the way of veterans and their newly expanded benefits. I'm glad to see the department answering my call to do this for veterans with constrictive bronchiolitis, and I'll keep holding VA accountable to roll out this law the way Congress intended."

Editor's note: This article has been updated to reflect that constrictive bronchiolitis is the only PACT Act respiratory illness without a diagnostic code in VA disability systems and to clarify the effects of not having its own diagnostic code.

Related: Burn Pit Victims with Rare Lung Disease Struggle to Get VA Care and Benefits

View comments

New Blood Test Aims To Gauge Odds Of Lung Issues Like COPD

An experimental blood test could one day help identify people most likely to develop severe lung problems like chronic obstructive pulmonary disease (COPD). Photo by Adobe Stock/HealthDay News

An experimental blood test could one day help identify people most likely to develop severe lung problems like COPD.

The test reviews a panel of 32 proteins in blood that best predict people most likely to suffer a rapid decline in lung function, according to a study published recently in the American Journal of Respiratory and Critical Care Medicine.

Adults with higher test scores have:

An 84% increased risk of COPD

An 81% increased chance of dying from a respiratory disease like COPD or pneumonia

A 17% increased risk of requiring hospital care for respiratory problems

A 10% increased risk of respiratory symptoms that need treatment, like a cough, mucus or shortness of breath

"Loss of lung function on a year-over-year basis is associated with poor respiratory health outcomes, but we do not have a good way to easily figure out if a patient is on a steep trajectory of lung function decline," said researcher Dr. Ravi Kalhan, a professor of pulmonary medicine at Northwestern University Feinberg School of Medicine in Chicago.

"If we had an easy-to-implement clinical tool, like a blood test, that captured someone's lung function trajectory at a single time point, it would enable earlier interventions which might, in the long run, improve lung health," Kalhan added.

Chronic obstructive pulmonary disease (COPD) is a group of lung diseases that include emphysema and chronic bronchitis.

COPD prevents airflow to the lungs, causing sufferers to struggle to breathe. There is no cure, and COPD gets worse over time. However, there are ways to manage and treat the lung illness

Researchers created the test using data collected from nearly 2,500 U.S. Adults during a 30-year study on heart and lung health.

Participants in the study took breathing tests to measure their lung function as many as six times over the three decades. During the study, 138 experienced a sharp decline in their lung function.

The research team screened thousands of proteins from blood samples provided by the participants at the 25-year mark. They found 32 proteins linked to lung function, and compiled them into a score that would predict a person's future likelihood of severe lung ailments.

Researchers then tested that score on data from more than 40,000 adults from two earlier studies, and found that the test did indeed successfully identify people with the greatest risk of lung problems.

"Similar to using cholesterol levels to gauge a patient's risk for having a heart attack, we're looking at biological pathways to predict a person's risk for having COPD or severe complications from COPD," explained lead researcher Dr. Gabrielle Liu, a pulmonologist and assistant professor of medicine at the University of California, Davis Medical Center.

The blood test still needs to be verified in clinical trials before it can receive approval from the U.S. Food and Drug Administration, researchers noted.

"We are still not ready for this test to be used in practice, but it's a promising advance," said James Kiley, director of lung diseases at the National Heart, Lung, and Blood Institute, which funded the study.

"It consolidates insights from decades of breathing tests and medical evaluations into a single tool that has the potential to identify patients at risk for severe disease and complications," he said in a National Institutes of Health news release.

More information

The American Lung Association has more about COPD.

Copyright © 2024 HealthDay. All rights reserved.

---