Patient case (clinical description): A 47-year-old man comes to the office for routine checkup. He is complaining of chronic cough and occasional but progressive dyspnea.  Other medical conditions include hypertension and osteoarthritis.  The patient smokes a pack of cigarettes daily and does not use alcohol or illicit drugs.  He used to be a construction worker. On examination, there are decreased breath sounds and percussive dullness at the base of both lungs.  Chest CT scan reveals a mild bilateral pleural effusion and diffuse thickening of the pleura. The patient's documents show chronic exposure to asbestosis. The specimen of the lungs reveled  pulmonary fibrosis that is most predominant in the lower lobes, characterized  by the presence of asbestos bodies (golden-brown beaded rods with translucent centers).

Patient's own account: I'm a 47-year-old former construction worker. I'm a man and I smoke a pack of cigs a day but I don't drink or do drugs. I went to my routine checkup because I've been coughing so much lately. I also had shortness of breath and it got worse over time. I already suffer from hypertension and osteoarthritis. My doctor found that I have decreased breath sounds. I did a chest scan and it seems that I have fluid around my lungs, and the lining of my lungs has become thicker in many areas. I have been exposed a lot to asbestos fibers. The other lung exam showed that I have pulmonary fibrosis, especially in the lower part of my lungs and they found some asbestos there.

Clinical trial: Breath Training Exercise for the Reduction of Chronic Dyspnea

Eligibility criteria:
Inclusion Criteria:

          -  >18 years of age

          -  Diagnosis of a chronic pulmonary disorder (a diagnosis of lung cancer is not required
             as the symptom of dyspnea, not cancer itself, is targeted)

          -  If diagnosed with lung cancer, must have completed definitive treatment more than 6
             months prior

          -  At least moderate dyspnea defined by a BDI score of 6 or less in the Self-
             Administered Computerized Versions of the Baseline and Transition Dyspnea
             Indexes(SAC-BDI/TDI)13,14 (This cutoff score is close to the score of 5.7 used to
             define "moderate dyspnea" in the publication that validated the instrument and is
             selected by attending physicians in the Pulmonary Service as a good indication of
             "moderate dyspnea" in clinical practice. A typical person with BDI of 6, for example,
             would be a 52 year old woman who has to pause when walking because of dyspnea and/or
             has eliminated doing an activity because of dyspnea).

          -  Able to safely complete the Six Minute Walk Test (6MWT)15 as per attending physician's
             clinical judgment.

          -  Respiratory functions clinically stable for the preceding 3 months and expected to be
             stable for the next 3 months as determined by project PIs and other Pulmonary Medicine
             faculty.

        Exclusion Criteria:

          -  Life expectancy less than 6 months

          -  Any cause of dyspnea that is determined by the investigators as readily reversible by
             other means (e.g. pleural effusion, pulmonary embolism, acute infection, anemia
             Hb<9.0, etc.)

          -  Non-English speaking
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 19 Years old.


Eligibility (NLI label): Entailment