Respiratory medicine最新文献

{"title":"Obstructive sleep apnoea-associated factors in children and adolescents diagnosed by polysomnography: A scoping review","authors":"Júlia M. Saporiti DDS, MSc, PhD student,&nbsp;Thiago A. de Holanda DDS, MSc, PhD,&nbsp;Gabriela G. Torino DDS, MSc, PhD student,&nbsp;Noéli Boscato DDS, MSc, PhD","doi":"10.1016/j.rmed.2025.107942","DOIUrl":"10.1016/j.rmed.2025.107942","url":null,"abstract":"<div><h3>Purpose</h3><div>This scoping review aimed to map research on factors associated with obstructive sleep apnoea (OSA) in children and adolescents undergoing overnight polysomnography (PSG) and questionnaire-based diagnostic assessments.</div></div><div><h3>Methods</h3><div>Searches were conducted in three electronic databases up to May 2023, including nine observational studies, including 3482 individuals.</div></div><div><h3>Results</h3><div>Among the included studies, nine reported on sex, six on obesity, five on tonsillar hypertrophy, three on mouth breathing, two on allergic rhinitis, and three on smoking exposure. The sample comprised 3482 children, with subsets analyzed for sex (n = 3482), obesity (n = 2752), and tonsillar hypertrophy (n = 794). Meta-analysis demonstrated a significantly higher prevalence of OSA in males compared to females [P &lt; 0.0001; I² = 49 %], with a pooled relative risk (RR) of 1.15 (95 % confidence interval [CI]: 1.07–1.23). Associations were found between obesity and OSA [RR: 1.42; 95 % CI: 1.20–1.68; P = 0.02; I² = 61 %], and tonsillar size and OSA [RR: 1.61; 95 % CI: 1.35–1.92; P = 0.06; I² = 60 %].</div></div><div><h3>Conclusion</h3><div>Considering the study's limitations, these findings underscore the importance of considering sex, obesity, and tonsillar size when evaluating OSA in children and adolescents.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107942"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of mechanical ventilation and weaning in critically ill patients with neuromuscular disorders","authors":"Pinar Kucukdemirci Kaya,&nbsp;Remzi Iscimen","doi":"10.1016/j.rmed.2025.107951","DOIUrl":"10.1016/j.rmed.2025.107951","url":null,"abstract":"<div><h3>Purpose</h3><div>Myasthenia-gravis and Guillain-Barre-syndrome are two of the most common causes of acute and reversible neuromuscular-respiratory-failure(ARNRF), both may worsen respiratory-failure and need for invasive-mechanical-ventilation(IMV) for long-periods due to muscle-weakness. However, approitive IMV-mode for ARNRF patients that better gas-exchange and weaning in ARNRF remain unclear.</div></div><div><h3>Materials and methods</h3><div>Critically-ill-patiens with IMV due to ARNRF, who could meet the weaning-criterias (after intubation for more than 7-days; difficult-weaning), between 2013, and 2023 were included in the study. IMV-settings, simultaneous arterial-blood-gas (ABG) analyses, and prognosis were recorded for each patient on relevant days.</div></div><div><h3>Results</h3><div>Sixty-critically-ill-patients with ARNRF who defined as difficult-weaning were included in the study. When different IMV-modes were used in the same patient, simultaneous ABG results were compared for each ventilation-mode. It was determined that the partial-pressure-of-oxygen/fraction of inspired-oxygen-ratios were significantly higher and partial-carbon-dioxide-levels were significantly lower when critically-ill-patients were ventilated with the biphasic-positive-airway-pressure-ventilation(BIPAP) (95 % CI: [0.641–1.41]; <em>p</em> &lt; .001; 95 % CI: [-1.05-.351]; <em>p</em> &lt; .001, respectively). Length-of-time-until-weaning was significantly shorter in BIPAP-mode for each patient in the study group(95 % CI: [0.717–0.188]; <em>p</em> &lt; .001). Moreover, weaning-success was statistically higher in patients with ARNRF were ventilated with BIPAP one-week-before spontenous-breathing-trial (95 % CI [1.026–21.65]; <em>p</em> = .046) than with all other IMV-modes.</div></div><div><h3>Conclusion</h3><div>According to our findings, when BIPAP was selected as the IMV-settings, gas exchange was improved,and weaning-success was higher in critically-ill-patients with ARNRF.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107951"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung clearance index: A sensitive measure of airway function improvement in adolescents after weight loss from bariatric surgery","authors":"Patrick Stafler ,&nbsp;Benjamin Rothschild ,&nbsp;Yulia Gendler ,&nbsp;Emmanuelle Seguier-Lipszyc ,&nbsp;Simona Tyroler ,&nbsp;Orith Waisbourd-Zinman ,&nbsp;Meir Mei-Zahav ,&nbsp;Dario Prais ,&nbsp;Vered Shkalim Zemer","doi":"10.1016/j.rmed.2025.107950","DOIUrl":"10.1016/j.rmed.2025.107950","url":null,"abstract":"<div><h3>Background</h3><div>Morbid obesity in adolescents impacts respiratory function, often leading to reduced lung volume and obstructive ventilatory defects. However, standard spirometric values frequently remain within normal ranges.</div></div><div><h3>Objectives</h3><div>We hypothesized that Lung Clearance Index (LCI) is a more sensitive marker for detecting airway dysfunction in adolescents with morbid obesity than conventional lung function tests.</div></div><div><h3>Methods</h3><div>A prospective single-center cohort study evaluated adolescents with morbid obesity undergoing laparoscopic sleeve gastrectomy (LSG). Assessments included fractional exhaled nitric oxide, multiple breath washout, spirometry, plethysmography, diffusion capacity, and a 6-min walk test, conducted pre- and post-surgery.</div></div><div><h3>Results</h3><div>Seventeen adolescents (mean age 17.1 years, BMI 45.5 kg/m²) were studied. Pre-surgery, LCI was slightly elevated (mean 7, SD ± 0.7), other lung function measures were normal. LCI correlated with BMI (r = 0.637, p = 0.014), no correlation was found between FEV₁ and BMI (r = −0.083, p = 0.752). Post-surgery, mean LCI fell from 7 (±0.7) to 6.5 (±0.7), p = 0.009. The pre-operatively observed correlation between LCI and BMI was no longer present post-operatively (r = 0.362, p = 0.225). LCI changes (r = 0.676, p = 0.011) correlated with BMI changes, whilst FEV₁ did not (r = 0.160, p = 0.540).</div></div><div><h3>Conclusions</h3><div>LCI appeared to be a more sensitive marker than conventional spirometry for detecting airway dysfunction in adolescents with morbid obesity. Significant post-surgery improvements suggested enhanced ventilation homogeneity. LCI may detect subtle airway changes in this population, and be potentially valuable for both clinical assessment and research.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107950"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke volume augmentation improves with PH-targeted therapy in patients with exercise-induced pulmonary hypertension","authors":"Kabadi Alisha A,&nbsp;Yang Jenny Z,&nbsp;Fernandes Timothy M","doi":"10.1016/j.rmed.2024.107921","DOIUrl":"10.1016/j.rmed.2024.107921","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Exercise-induced pulmonary arterial hypertension (EiPH) is often treated with off-label use of pulmonary arterial hypertension-targeted therapy (PH-targeted therapy). Most measures of PAH severity are normal in patients with EiPH, posing challenges in evaluating for physiological improvement in patients treated for EiPH. In this study, we used non-invasive cardiopulmonary exercise testing (CPET) to assess for objective improvement in patients treated for EiPH. Fourteen patients were included in the study, diagnosed with EiPH by invasive CPET with simultaneous right heart catheterization and subsequently treated with PH-targeted therapy. Follow-up non-invasive CPET was performed to evaluate oxygen consumption (VO&lt;sub&gt;2&lt;/sub&gt;, L/min) and oxygen pulse (O&lt;sub&gt;2&lt;/sub&gt; pulse, ml/beat), which was defined by the ratio of VO&lt;sub&gt;2&lt;/sub&gt; to heart rate (beats/min).). Adequate stroke volume augmentation was a ratio of O&lt;sub&gt;2&lt;/sub&gt; pulse at anaerobic threshold (O&lt;sub&gt;2&lt;/sub&gt; pulse&lt;sub&gt;AT&lt;/sub&gt;) to O&lt;sub&gt;2&lt;/sub&gt; pulse at rest (O&lt;sub&gt;2&lt;/sub&gt; pulse&lt;sub&gt;R&lt;/sub&gt;) of &gt;2.6. The results showed a significant improvement in O&lt;sub&gt;2&lt;/sub&gt; pulse and VO&lt;sub&gt;2&lt;/sub&gt; at anaerobic threshold after treatment with PH-targeted therapy. In addition, O&lt;sub&gt;2&lt;/sub&gt; Pulse&lt;sub&gt;AT&lt;/sub&gt;:O2 Pulse&lt;sub&gt;R&lt;/sub&gt; significantly improved. Patients treated for EiPH demonstrated improvement in both stroke volume augmentation and VO&lt;sub&gt;2&lt;/sub&gt; measured on non-invasive CPET, supporting the use of this test to assess for objective improvement in exercise capacity for patients treated for EiPH.&lt;/div&gt;&lt;div&gt;Structured Abstract.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Rationale&lt;/h3&gt;&lt;div&gt;Exercise-induced pulmonary arterial hypertension (EiPH) is a clinical entity characterized by exertional dyspnea. Cardiopulmonary exercise testing (CPET) can evaluate exertional limitations in EiPH patients and assess response to therapy. We describe a series of patients treated for EiPH and monitored with non-invasive CPET.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;case series of 14 patients with EiPH treated with PH-targeted therapy. EiPH was defined by a slope of the mean pulmonary artery pressure (mPAP) vs cardiac output of &gt;3 mmHg/L/min with a resting mPAP of &lt;20 mmHg and pulmonary vascular resistance &lt;3 Woods units. Oxygen pulse (O&lt;sub&gt;2&lt;/sub&gt; pulse, ml/beat), a surrogate of stroke volume (SV), was measured by the ratio of oxygen consumption (VO&lt;sub&gt;2&lt;/sub&gt;, L/min) to heart rate (beats/min). Adequate SV augmentation was a ratio of O&lt;sub&gt;2&lt;/sub&gt; pulse at anaerobic threshold (O&lt;sub&gt;2&lt;/sub&gt; pulse&lt;sub&gt;AT&lt;/sub&gt;) to O&lt;sub&gt;2&lt;/sub&gt; pulse at rest (O&lt;sub&gt;2&lt;/sub&gt; pulse&lt;sub&gt;R&lt;/sub&gt;) of &gt;2.6.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Patients were majority female (86 %) with a mean age of 59.1.±12.2 years, and 57 % had connective tissue diseases. Patients took PH-targeted therapy (endothelin receptor antagonist (n = 7), phosphodiesterase-5 inhibitor (n = 5) or both (n = 2)) for a median exposure of 150 days. There was no change i","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107921"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between calcium channel blocker use and the risk of interstitial lung disease and idiopathic pulmonary fibrosis: A longitudinal cohort study","authors":"Hye Jin Jang ,&nbsp;Yu Min Seong ,&nbsp;Jihyeon Jeong ,&nbsp;Jin-Young Huh ,&nbsp;Jin-Ho Kim ,&nbsp;Kyung Hoon Kim ,&nbsp;Joo Hun Park ,&nbsp;Won-Il Choi","doi":"10.1016/j.rmed.2025.107939","DOIUrl":"10.1016/j.rmed.2025.107939","url":null,"abstract":"<div><h3>Introduction</h3><div>Ca2+ signaling in fibroblasts would be one of the important mediators of lung fibrosis.</div><div>This study investigated the relationship between calcium channel blocker usage and the risk of developing interstitial lung disease and idiopathic pulmonary fibrosis.</div></div><div><h3>Material and methods</h3><div>This cohort study used data from the Korean National Health Screening Cohort spanned from January 1, 2004, to December 31, 2015. The study included 394,142 participants. CCB usage, as a time-dependent variable assessed every two years, was categorized by medication status (ever-users and never-users) and further divided into five groups based on cumulative defined daily dose: &lt;182.5, 182.5–365.0, 365.0–547.5, and ≥547.5. Incidence rates of ILD and IPF among CCB users compared to never-users, analyzed using time-dependent Cox regression models.</div></div><div><h3>Results</h3><div>The incidence rates were 27.7 per 100,000 person-years for ILD and 15.0 per 100,000 person-years for IPF among never-users, compared to 19.5 per 100,000 person-years for ILD and 13.9 per 100,000 person-years for IPF among ever-users. The adjusted hazard ratios (aHRs) were 0.68 [95 % confidence interval (CI), 0.55–0.83] for ILD and 0.69 (95 % CI, 0.54–0.88) for IPF. Increasing categories of CCB usage were significantly associated with a lower risk of ILD [aHRs: 1.23 (95 % CI, 0.97–1.56), 1.20 (0.85–1.71), 0.49 (0.30–0.81), and 0.27(0.19–0.39)] and IPF [aHRs: 1.21 (95 % confidence interval, 0.89–1.64), 1.45 (0.96–2.20), 0.83 (0.52–1.33), and 0.25 (0.16–0.38)], compared to never-users.</div></div><div><h3>Conclusions</h3><div>This study found that individuals using CCBs had a significantly lower risk of interstitial lung disease and idiopathic pulmonary fibrosis compared to never-users in a dose-response manner.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107939"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral blood immune cell dynamics associate with growth of incidental indeterminate pulmonary nodules","authors":"Dongyuan Wang ,&nbsp;Lijuan Hua ,&nbsp;Wenxue Bai ,&nbsp;Mengyao Guo ,&nbsp;Yongman Lv ,&nbsp;Dong Kuang ,&nbsp;Hanxiong Guan ,&nbsp;Jun Yu ,&nbsp;Qi Wang ,&nbsp;Zhipeng Hao ,&nbsp;Wei Sun ,&nbsp;Ni Zhang ,&nbsp;Kaiyan Li ,&nbsp;Hui Xu ,&nbsp;Min Xie","doi":"10.1016/j.rmed.2025.107947","DOIUrl":"10.1016/j.rmed.2025.107947","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies suggest peripheral blood immune cells associate with the progression and prognosis of lung cancer. The main purpose of this study was to explore the association of peripheral immune cell and its dynamics with the growth of pulmonary nodules.</div></div><div><h3>Materials and method</h3><div>Of 9280 subjects whom had blood cell counts and chest CT scan in health check-up, 1068 participants were enrolled with the incidental pulmonary nodules of above 5 mm in diameter and subsequently followed up for 2 years. The pulmonary nodules were identified as growth based on the increase of at least 2 mm in the diameters within the two years. The relationships of pulmonary nodules growth with peripheral immune cell dynamics and clinical variables were analyzed using univariable inter-group comparison and multivariable logistic regression analyses.</div></div><div><h3>Results</h3><div>During the two years, 116 (10.9 %) of 1068 participants had the growth pulmonary nodules. Overall, emphysema, nodule diameter and non-solid characteristics associated with the growth of nodules. In the subgroup of pure solid nodules, high baseline eosinophil percentage (OR 1.220; 95 % CI 1.009–1.474; <em>P</em> = 0.040) and the increase of neutrophil count (OR 3.805; 95 % CI 1.027–14.093; <em>P</em> = 0.045) were significant risk factors for the nodule growth. In the subgroup of solid-predominant nodules, the increase of lymphocyte was associated with a lower risk of growth (OR 0.039; 95 % CI 0.002–0.839; <em>P</em> = 0.038).</div></div><div><h3>Conclusions</h3><div>High baseline eosinophil and increase of neutrophil were associated with the growth of pure solid pulmonary nodules. The decrease of lymphocyte related to the growth of solid-predominant nodules.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107947"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-of-the-art narrative review: Mounier–Kuhn syndrome and tracheobronchomegaly","authors":"Shivang Sharma ,&nbsp;Stephen J. Kuperberg","doi":"10.1016/j.rmed.2024.107914","DOIUrl":"10.1016/j.rmed.2024.107914","url":null,"abstract":"<div><div>Mounier–Kuhn syndrome (MKS) or tracheobronchomegaly is an uncommon disease of the central airways. It is characterized by pathological dilatation of the trachea and main bronchi and inevitably leads to recurrent respiratory infections, bronchiectasis, hospitalizations, and results in considerable morbidity and mortality. Despite numerous case reports, there is a shortage of evidence on clinical outcomes and limited data on interventions, thus presenting a significant gap in the literature. Fortunately, new strategies and increasing clinical experience have improved the clinical approach, diagnostic workup, classification, and management of MKS. Articles in English, Spanish, and French were searched from databases, including Pubmed, Google Scholar, Medline, and SCOPUS, using the terms “Mounier–Kuhn syndrome,” “Tracheomegaly,” “Tracheobronchomegaly,” and “Bronchomegaly,” without date restrictions. A total of 360 articles with the aforementioned syntax were indexed on Pubmed. This state-of-the-art review attempts to fill a void in the current literature by summarizing the current scientific knowledge and highlighting novel interventional strategies in the management of Mounier Kuhn Syndrome.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107914"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nodular-bronchiectatic pattern in pulmonary nocardiosis: Immune status and treatment outcomes in a multicenter retrospective study","authors":"Airi Hasegawa ,&nbsp;Kazuya Tone ,&nbsp;Yuri Baba ,&nbsp;Zenya Saito ,&nbsp;Takuya Akutsu ,&nbsp;Takaaki Kitayama ,&nbsp;Shunsuke Inaki ,&nbsp;Mina Gochi ,&nbsp;Takashi Yaguchi ,&nbsp;Koichi Makimura ,&nbsp;Masamichi Takagi ,&nbsp;Jun Araya","doi":"10.1016/j.rmed.2024.107922","DOIUrl":"10.1016/j.rmed.2024.107922","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary nocardiosis is a rare opportunistic infection, with approximately 15 % of patients being immunocompetent. The isolation rate of <em>Nocardia</em> spp. has recently increased, indicating rising clinical concern. This study aimed to summarize computed tomography (CT) findings, evaluate treatment outcomes, and improve disease recognition.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 12 pulmonary nocardiosis cases recorded over 10 years in three hospitals, excluding two unclear cases. All pathogens were detected on smears and isolated from respiratory specimens.</div></div><div><h3>Results</h3><div>The mean age was 73.0 ± 12.9 years, with 9 men and 6 smokers. Among the included patients, 8 had underlying pulmonary diseases, 4 had non-pulmonary diseases, and 3 were on steroids. The most common species were <em>N. cyriacigeorgica</em> and <em>N. nova</em>. CT findings included cavitary, consolidation/infiltrative, and nodular-bronchiectatic (NB) patterns. The NB pattern, particularly common in immunocompetent patients, was associated with significantly better treatment outcomes than non-NB patterns (Fisher's exact test, <em>p</em> = 0.0476). All isolates were susceptible to trimethoprim/sulfamethoxazole. Eight patients recovered with appropriate antimicrobial therapy, while two patients died.</div></div><div><h3>Conclusions</h3><div>Pulmonary nocardiosis presented three CT patterns, with the NB pattern being the most frequent and showing favorable treatment outcomes, especially in immunocompetent patients. While <em>Nocardia</em> spp. can develop in patients with preexisting bronchiectasis, it may also independently cause bronchiectasis. <em>Nocardia</em> infection should be considered as a differential diagnosis in patients exhibiting the NB pattern, resembling that of nontuberculous mycobacterial pulmonary diseases.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107922"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclophosphamide is not associated with clinically relevant late pulmonary dysfunction in Dutch survivors of childhood cancer – The DCCSS-LATER 2 PULM sub-study","authors":"R.J. van Kalsbeek ,&nbsp;E.A.M. Feijen ,&nbsp;D. Bresters ,&nbsp;L.C.M. Kremer ,&nbsp;S.M.F. Pluijm ,&nbsp;O.A. Asogwa ,&nbsp;E.van Dulmen-den Broeder ,&nbsp;M.M. van den Heuvel-Eibrink ,&nbsp;G.O. Janssens ,&nbsp;W.J. Tissing ,&nbsp;J.J. Loonen ,&nbsp;S.J.C.M.M. Neggers ,&nbsp;H.J.H. van der Pal ,&nbsp;C.M. Ronckers ,&nbsp;J.C. Teepen ,&nbsp;A.C.H. de Vries ,&nbsp;M. Louwerens ,&nbsp;M. van der Heiden-van der Loo ,&nbsp;S.M.P.J. Prevaes ,&nbsp;A.B. Versluys","doi":"10.1016/j.rmed.2025.107948","DOIUrl":"10.1016/j.rmed.2025.107948","url":null,"abstract":"<div><h3>Background</h3><div>Treatment for childhood cancer may increase the risk of long-term pulmonary complications and dysfunction. Pulmonary surveillance is recommended after established pulmonary toxic exposures, including bleomycin, busulfan, carmustine (BCNU), lomustine (CCNU), radiotherapy to a field exposing the lungs, and pulmonary surgery. However, the role of cyclophosphamide as a pulmonary toxic agent is debated.</div></div><div><h3>Aim</h3><div>To establish whether cyclophosphamide is associated with late pulmonary dysfunction among survivors of childhood cancer.</div></div><div><h3>Methods</h3><div>In this multicenter Dutch Childhood Cancer Survivor Study (DCCSS)-LATER 2 PULM sub-study, we included 828 survivors with a median follow-up of 26.6 years, treated with cyclophosphamide and/or established pulmonary toxic treatment, or neither. Pulmonary function tests were used to measure the primary outcomes of diffusion impairment (diffusing capacity for carbon monoxide (DLCO) z-score), restriction (total lung capacity (TLC) z-score), and obstruction (forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) z-score). Secondary outcomes comprised chronic cough, recurrent respiratory tract infections, shortness of breath, and supplemental oxygen need.</div></div><div><h3>Results</h3><div>Diffusion and restrictive abnormalities were highly prevalent among those treated with established pulmonary toxic treatment, with cyclophosphamide (41.0 % and 50.4 %, respectively) and without (34.3 % and 41.9 %, respectively), and occurred less frequently in survivors treated with cyclophosphamide only (12.9 % and 7.3 %, respectively) or in survivor controls (9.9 % and 12.4 %, respectively). In multivariable analyses, cyclophosphamide did not have a clinically relevant effect on the primary or secondary outcomes.</div></div><div><h3>Conclusions</h3><div>This study suggests that cyclophosphamide is not associated with clinically relevant pulmonary dysfunction in long-term childhood cancer survivors.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107948"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Background therapy in severe asthma on monoclonal antibody treatment in real life","authors":"Filippo F. Cosini ,&nbsp;Diego Bagnasco ,&nbsp;Fulvio Braido ,&nbsp;G. Walter Canonica ,&nbsp;Giovanni Passalacqua ,&nbsp;Elisa Testino ,&nbsp;Manlio Milanese","doi":"10.1016/j.rmed.2025.107944","DOIUrl":"10.1016/j.rmed.2025.107944","url":null,"abstract":"<div><h3>Background</h3><div>Global Initiative for Asthma (GINA) recently recommends clinicians to reduce inhaled corticosteroid doses in patients with severe asthma who respond positively to monoclonal antibodies (MAbs).</div></div><div><h3>Objective</h3><div>As we operated this reduction even before the document, we analysed our cohort of subjects on treatment with a MAbs for at least 24 months.</div></div><div><h3>Methods</h3><div>Data stored in our electronic archive and at the 6-month follow-up (FU) were registered and patients’ adherence to asthma therapy was derived by electronic pharmacy claim database.</div></div><div><h3>Results</h3><div>Sixty-three subjects were enrolled. A complete asthma remission and reduction to GINA Step 3 was obtained in 41 % and 61 % of them, respectively. Non-adherent subjects to inhaled and oral asthma therapy were 45 % of them, with a higher percentage among those in complete remission (59 % vs 33 %).</div></div><div><h3>Conclusion</h3><div>In our cohort<strong>,</strong> stepping down asthma therapy from 5 to 3 level in severe asthmatic patients on Mabs is without any negative consequences on asthma control, even in the case of non-adherence.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107944"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}