Should hut lung be called domestically acquired particulate lung disease or domestically acquired pneumoconiosis?

Indoor air pollution appears to be a major environmental and public health hazard for large numbers of the underdeveloped world's population. A detailed environmental history is important for making diagnosis in most individuals from foreign rural settings with nonspecific respiratory symptoms. In this report, we describe an illustrative case of domestically acquired particulate lung disease (DAPLD) or "hut lung" in a 65-year-old Sudanese male who immigrated to the United States in 1986. He presented with symptoms of chronic productive cough and dyspnea. Imaging and pathology from transbronchial cryo biopsy revealed anthracosis consistent with DAPLD. This case demonstrates persistence of physiologic, radiographic, and histopathologic abnormalities years after removal from exposure. To the best of our knowledge, this is the first case of DAPLD reported from Sudan.

Effect of Gender on the Response to Hepatitis C Treatment in an Inner-City Population.

INTRODUCTION: Hepatitis C virus (HCV) is the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation in the United States. Response to treatment has improved with the addition of direct acting protease inhibitors. However, there are limited real-world data on the role of gender in achieving a sustained virologic response (SVR). METHODS: We conducted a cross-sectional study in 70 patients treated for HCV, genotype 1 infection with pegylated alpha interferon, ribavirin, and either telaprevir or boceprevir at our inner-city liver clinic. RESULTS: The SVR was significantly lower in women than in men (24% vs. 59%; p < .01). Statistical significance persisted after adjusting for age, race, genotype, prior treatment status, duration of therapy, and stage of fibrosis. The adjusted odds ratio for achieving SVR was significantly lower in women than in men (odds ratio [OR], 0.13; 95% CI, 0.03-0.58; p = .01). Relapse after completing treatment was more likely to occur in women (p = .02). Thirty-four patients (48%) did not complete therapy. Discontinuation because of loss to follow-up was more likely in women, whereas discontinuation owing to therapy limiting adverse drug events were more common in men. Discontinuation rates owing to failure of therapy were similar in men and women. CONCLUSIONS: There was a significant difference in SVR between men and women. Both biological and nonbiological factors, the latter including access to care, adherence to therapy, and attitudes of and toward health care providers all could play a role in contributing to the observed disparity between sexes in treatment response.