Respiratory medicine最新文献

英文中文

Comparing mesh and compressor nebulizers in pulmonary function test in pediatric asthma attacks: A double-blind randomized comparative clinical trial

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-28 DOI: 10.1016/j.rmed.2025.107966

Berker Okay , Halil Ugur Hatipoglu , Zeynep Uze Okay , Kamil Sahin , Adem Yasar

Objective

Asthma is a prevalent global health issue, especially affecting children in numerous countries. Our study aimed to determine the most effective nebulizer type by comparing the effects of mesh nebulizers (MNs) and compressor nebulizers (CNs) on spirometry tests in pediatric asthma attacks.

Methods

The prospective, double-blind, randomized comparative study was conducted with patients aged 7–15 presenting with asthma attacks. The participating patients were divided into two groups by randomization: those using CNs and those using MNs. A pulmonary function test was performed before and after giving the patients three doses of salbutamol inhaler at 20-minute intervals, and changes in the test were recorded.

Results

The increase in peripheral oxygen saturation was higher in the MN group, although this difference was not statistically significant (p = 0.391). However, statistically significant differences were observed in the decrease in respiratory rate (RR;/min; p = 0.002) and the increase in heart rate (/min; p = 0.022). The respiratory function test indicated a higher change in forced vital capacity (FVC) and peak expiratory flow in the MN group than the CN group, although this difference was not statistically significant (p = 0.258 and 0.256). However, statistically significant changes were observed in the forced expiratory volume in 1 second (FEV1) and forced expiratory flow at 25%–75% of FVC (FEF25–75; p = 0.001 and 0.043).

Conclusion

MNs show superior improvement in vital signs and pulmonary function, particularly in RR, FEV1, and FEF25–75. MNs may be preferred for more effective treatment despite heart rate elevation.

{"title":"Comparing mesh and compressor nebulizers in pulmonary function test in pediatric asthma attacks: A double-blind randomized comparative clinical trial","authors":"Berker Okay , Halil Ugur Hatipoglu , Zeynep Uze Okay , Kamil Sahin , Adem Yasar","doi":"10.1016/j.rmed.2025.107966","DOIUrl":"10.1016/j.rmed.2025.107966","url":null,"abstract":"<div><h3>Objective</h3><div>Asthma is a prevalent global health issue, especially affecting children in numerous countries. Our study aimed to determine the most effective nebulizer type by comparing the effects of mesh nebulizers (MNs) and compressor nebulizers (CNs) on spirometry tests in pediatric asthma attacks.</div></div><div><h3>Methods</h3><div>The prospective, double-blind, randomized comparative study was conducted with patients aged 7–15 presenting with asthma attacks. The participating patients were divided into two groups by randomization: those using CNs and those using MNs. A pulmonary function test was performed before and after giving the patients three doses of salbutamol inhaler at 20-minute intervals, and changes in the test were recorded.</div></div><div><h3>Results</h3><div>The increase in peripheral oxygen saturation was higher in the MN group, although this difference was not statistically significant (p = 0.391). However, statistically significant differences were observed in the decrease in respiratory rate (RR;/min; p = 0.002) and the increase in heart rate (/min; p = 0.022). The respiratory function test indicated a higher change in forced vital capacity (FVC) and peak expiratory flow in the MN group than the CN group, although this difference was not statistically significant (p = 0.258 and 0.256). However, statistically significant changes were observed in the forced expiratory volume in 1 second (FEV1) and forced expiratory flow at 25%–75% of FVC (FEF25–75; p = 0.001 and 0.043).</div></div><div><h3>Conclusion</h3><div>MNs show superior improvement in vital signs and pulmonary function, particularly in RR, FEV1, and FEF25–75. MNs may be preferred for more effective treatment despite heart rate elevation.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"238 ","pages":"Article 107966"},"PeriodicalIF":3.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067353","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}

引用次数: 0

Prevalence, incidence, and clinical features of cardiac involvement in patients with pulmonary sarcoidosis

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-27 DOI: 10.1016/j.rmed.2025.107954

Junichi Nakamura , Takahiro Sato , Hiroshi Ohira , Shuhei Yoshikawa , Takeshi Hattori , Osamu Manabe , Noriko Oyama-Manabe , Satonori Tsuneta , Hirokazu Kimura , Sakae Takenaka , Toshiyuki Nagai , Toshihisa Anzai , Masaharu Nishimura , Isao Yokota , Ichizo Tsujino , Satoshi Konnno

Background

The epidemiology and characteristics of cardiac involvement in patients with pulmonary sarcoidosis remain unclear. We aimed to determine the prevalence, incidence, and clinical features of cardiac sarcoidosis in patients with pulmonary sarcoidosis.

Methods

The characteristics of patients with biopsy-proven pulmonary sarcoidosis were retrospectively evaluated. Cardiac sarcoidosis was diagnosed via evaluations, including ¹⁸F-fluorodeoxyglucose positron emission tomography at the time of diagnosis of pulmonary sarcoidosis and during follow-up. Characteristics of patients with and without cardiac complications were compared.

Results

In total, 438 patients with pulmonary sarcoidosis were included, of which 40 (9.1 %) were diagnosed with cardiac sarcoidosis at the time of diagnosis of pulmonary sarcoidosis. During the follow-up period, 14 patients (4 %) developed cardiac complications (0.0075/person-years). Electrocardiographic abnormalities were the most common findings leading to the diagnosis of cardiac sarcoidosis (85 %).

Compared to patients without cardiac involvement, those with cardiac sarcoidosis had lower serum angiotensin converting enzyme concentration [19.9 (15.5–25.1) vs. 17.4 (12.6–23.8) U/L)], higher rates of kidney complications (3 vs. 13 %), fewer ocular complications (78 vs. 17 %), and lower lymphocyte levels [35.8 (18.6–53) vs. 25.1 (14.2–38.2)%] and CD4/CD8 ratios [4.8 (3.1–7.5)% vs. 3.9 (1.8–6)%] in bronchoalveolar lavage fluid analysis.

Conclusion

At the time of diagnosis of pulmonary sarcoidosis, cardiac complications occurred in approximately 10 % of the patients and developed in 0.0075/person-year during follow-up. Low serum angiotensin converting enzyme concentration, lymphocyte level and CD4/CD8 ratio in the bronchoalveolar lavage fluid may be unique features of patients with cardiac sarcoidosis.

{"title":"Prevalence, incidence, and clinical features of cardiac involvement in patients with pulmonary sarcoidosis","authors":"Junichi Nakamura , Takahiro Sato , Hiroshi Ohira , Shuhei Yoshikawa , Takeshi Hattori , Osamu Manabe , Noriko Oyama-Manabe , Satonori Tsuneta , Hirokazu Kimura , Sakae Takenaka , Toshiyuki Nagai , Toshihisa Anzai , Masaharu Nishimura , Isao Yokota , Ichizo Tsujino , Satoshi Konnno","doi":"10.1016/j.rmed.2025.107954","DOIUrl":"10.1016/j.rmed.2025.107954","url":null,"abstract":"<div><h3>Background</h3><div>The epidemiology and characteristics of cardiac involvement in patients with pulmonary sarcoidosis remain unclear. We aimed to determine the prevalence, incidence, and clinical features of cardiac sarcoidosis in patients with pulmonary sarcoidosis.</div></div><div><h3>Methods</h3><div>The characteristics of patients with biopsy-proven pulmonary sarcoidosis were retrospectively evaluated. Cardiac sarcoidosis was diagnosed via evaluations, including <sup>18</sup>F-fluorodeoxyglucose positron emission tomography at the time of diagnosis of pulmonary sarcoidosis and during follow-up. Characteristics of patients with and without cardiac complications were compared.</div></div><div><h3>Results</h3><div>In total, 438 patients with pulmonary sarcoidosis were included, of which 40 (9.1 %) were diagnosed with cardiac sarcoidosis at the time of diagnosis of pulmonary sarcoidosis. During the follow-up period, 14 patients (4 %) developed cardiac complications (0.0075/person-years). Electrocardiographic abnormalities were the most common findings leading to the diagnosis of cardiac sarcoidosis (85 %).</div><div>Compared to patients without cardiac involvement, those with cardiac sarcoidosis had lower serum angiotensin converting enzyme concentration [19.9 (15.5–25.1) vs. 17.4 (12.6–23.8) U/L)], higher rates of kidney complications (3 vs. 13 %), fewer ocular complications (78 vs. 17 %), and lower lymphocyte levels [35.8 (18.6–53) vs. 25.1 (14.2–38.2)%] and CD4/CD8 ratios [4.8 (3.1–7.5)% vs. 3.9 (1.8–6)%] in bronchoalveolar lavage fluid analysis.</div></div><div><h3>Conclusion</h3><div>At the time of diagnosis of pulmonary sarcoidosis, cardiac complications occurred in approximately 10 % of the patients and developed in 0.0075/person-year during follow-up. Low serum angiotensin converting enzyme concentration, lymphocyte level and CD4/CD8 ratio in the bronchoalveolar lavage fluid may be unique features of patients with cardiac sarcoidosis.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"238 ","pages":"Article 107954"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067440","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}

引用次数: 0

Bronchodilator responsiveness of oscillometry parameters in COPD patients

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-27 DOI: 10.1016/j.rmed.2025.107960

Sajal De, Dibakar Sahu

引用次数: 0

Global prevalence of fatigue in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-27 DOI: 10.1016/j.rmed.2025.107969

Wenting Shi , Tao Li , Yingjie Leng , Qinglu Li , Nan Wang , Guorong Wang

Background

Fatigue is a common symptom in patients with chronic obstructive pulmonary disease (COPD). Published studies of fatigue among patients with COPD have presented diverse findings that may reflect variations in research methods as well as actual population differences.

Objective

To estimate the worldwide prevalence of fatigue in patients with COPD and its associated epidemiological characteristics.

Methods

The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and China Biology Medicine disc (CBM) databases were searched for articles from their inception date through August 2024. The pooled prevalence of fatigue in patients with COPD and 95 % confidence interval (CI) were calculated using a random-effects model with Stata 15.0 software. Agency for Healthcare and Research and Quality (AHRQ) indicators and the Newcastle-Ottawa Scale (NOS) were used to evaluate the quality of the included studies.

Results

The 25 included studies involved 6830 patients. The meta-analysis results showed a 59 % (95 % CI: 52%–66 %) pooled prevalence of fatigue in patients with COPD. Subgroup analysis indicated that the prevalence varied significantly by region, setting, assessment tool, and publication year.

Conclusions

Fatigue is a common symptom among patients with COPD worldwide. To reduce the negative effects of fatigue in these patients, clinicians should actively explore the mechanisms of fatigue occurrence and its risk factors to provide a basis for further research.

{"title":"Global prevalence of fatigue in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis","authors":"Wenting Shi , Tao Li , Yingjie Leng , Qinglu Li , Nan Wang , Guorong Wang","doi":"10.1016/j.rmed.2025.107969","DOIUrl":"10.1016/j.rmed.2025.107969","url":null,"abstract":"<div><h3>Background</h3><div>Fatigue is a common symptom in patients with chronic obstructive pulmonary disease (COPD). Published studies of fatigue among patients with COPD have presented diverse findings that may reflect variations in research methods as well as actual population differences.</div></div><div><h3>Objective</h3><div>To estimate the worldwide prevalence of fatigue in patients with COPD and its associated epidemiological characteristics.</div></div><div><h3>Methods</h3><div>The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and China Biology Medicine disc (CBM) databases were searched for articles from their inception date through August 2024. The pooled prevalence of fatigue in patients with COPD and 95 % confidence interval (CI) were calculated using a random-effects model with Stata 15.0 software. Agency for Healthcare and Research and Quality (AHRQ) indicators and the Newcastle-Ottawa Scale (NOS) were used to evaluate the quality of the included studies.</div></div><div><h3>Results</h3><div>The 25 included studies involved 6830 patients. The meta-analysis results showed a 59 % (95 % CI: 52%–66 %) pooled prevalence of fatigue in patients with COPD. Subgroup analysis indicated that the prevalence varied significantly by region, setting, assessment tool, and publication year.</div></div><div><h3>Conclusions</h3><div>Fatigue is a common symptom among patients with COPD worldwide. To reduce the negative effects of fatigue in these patients, clinicians should actively explore the mechanisms of fatigue occurrence and its risk factors to provide a basis for further research.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"238 ","pages":"Article 107969"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067436","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}

引用次数: 0

Evaluation of online videos and websites on inspiratory muscle training for individuals with chronic lung disease

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-27 DOI: 10.1016/j.rmed.2025.107967

Sahar Sohrabipour , Ahmad Ibrahim , Jillian Dhawan , Omer Ahmad Choudhary , Brandon Luu , Josh Shore , Megha Ibrahim Masthan , Dmitry Rozenberg

Background

Inspiratory muscle training (IMT) is an effective rehabilitation modality for individuals with chronic lung disease. IMT can improve dyspnea, exercise capacity, and health-related quality of life. Online resources are common sources of health information for individuals. This study is the first to: 1) evaluate the content, reliability, quality, and comprehensibility of IMT-related videos and websites for individuals with chronic lung disease, and 2) determine the characteristics of these online resources.

Methods

The search term “(respiratory muscle training) OR (inspiratory muscle training)” was used to evaluate the first 200 consecutive YouTube videos and 200 Google websites on IMT for chronic lung disease management. Online resources were evaluated using validated scoring metrics: modified DISCERN tool, Global Quality Scale (GQS), and Patient Education Materials Assessment Tools (PEMAT) understandability and actionability. Content comprising key IMT components was also scored.

Results

Forty videos and fourteen websites were included, with majority uploaded by for-profit organizations. Content scores (out of 25) were low (videos 7.7 ± 4.4; websites 11.4 ± 5.3, p = 0.01). Benefits of IMT were often highlighted, but safety considerations were infrequently mentioned. Resources scored poorly on modified DISCERN (videos 2/5 IQR[1.0–3.0]; websites 3.5/5 IQR[2.0–4.0], p = 0.001), and GQS scores (videos 2/5 IQR[2.0–3.0]; websites 3/5 IQR[2.8–3.3], p = 0.003). Online resources met the PEMAT threshold (>70 %) for understandability, but not actionability.

Conclusions

Online IMT resources have mainly focused on the benefits of IMT and majority were developed by for-profit organizations. There is a need for high-quality, evidence-based online resources, as IMT is an important rehabilitation modality for chronic lung disease management.

{"title":"Evaluation of online videos and websites on inspiratory muscle training for individuals with chronic lung disease","authors":"Sahar Sohrabipour , Ahmad Ibrahim , Jillian Dhawan , Omer Ahmad Choudhary , Brandon Luu , Josh Shore , Megha Ibrahim Masthan , Dmitry Rozenberg","doi":"10.1016/j.rmed.2025.107967","DOIUrl":"10.1016/j.rmed.2025.107967","url":null,"abstract":"<div><h3>Background</h3><div>Inspiratory muscle training (IMT) is an effective rehabilitation modality for individuals with chronic lung disease. IMT can improve dyspnea, exercise capacity, and health-related quality of life. Online resources are common sources of health information for individuals. This study is the first to: 1) evaluate the content, reliability, quality, and comprehensibility of IMT-related videos and websites for individuals with chronic lung disease, and 2) determine the characteristics of these online resources.</div></div><div><h3>Methods</h3><div>The search term “(respiratory muscle training) OR (inspiratory muscle training)” was used to evaluate the first 200 consecutive YouTube videos and 200 Google websites on IMT for chronic lung disease management. Online resources were evaluated using validated scoring metrics: modified DISCERN tool, Global Quality Scale (GQS), and Patient Education Materials Assessment Tools (PEMAT) understandability and actionability. Content comprising key IMT components was also scored.</div></div><div><h3>Results</h3><div>Forty videos and fourteen websites were included, with majority uploaded by for-profit organizations. Content scores (out of 25) were low (videos 7.7 ± 4.4; websites 11.4 ± 5.3, p = 0.01). Benefits of IMT were often highlighted, but safety considerations were infrequently mentioned. Resources scored poorly on modified DISCERN (videos 2/5 IQR[1.0–3.0]; websites 3.5/5 IQR[2.0–4.0], p = 0.001), and GQS scores (videos 2/5 IQR[2.0–3.0]; websites 3/5 IQR[2.8–3.3], p = 0.003). Online resources met the PEMAT threshold (>70 %) for understandability, but not actionability.</div></div><div><h3>Conclusions</h3><div>Online IMT resources have mainly focused on the benefits of IMT and majority were developed by for-profit organizations. There is a need for high-quality, evidence-based online resources, as IMT is an important rehabilitation modality for chronic lung disease management.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"238 ","pages":"Article 107967"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067429","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}

引用次数: 0

Bleeding risk assessment with thromboelastography in interventional pulmonology procedures

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-27 DOI: 10.1016/j.rmed.2025.107964

David Abia-Trujillo, Rodrigo Funes-Ferrada, Bryan F. Vaca-Cartagena, Alejandra Yu Lee-Mateus, Alanna Barrios-Ruiz, Sofia Valdes-Camacho, Kelly S. Robertson, Sebastian Fernandez-Bussy

Objective

Thromboelastography (TEG) offers a point-of-care and comprehensive evaluation of the coagulation cascade, but its utility in predicting bleeding risk in Interventional Pulmonology (IP) procedures has not been thoroughly investigated. This study aims to evaluate the effectiveness of TEG in assessing bleeding risk in patients undergoing elective IP procedures.

Material and methods

Retrospective study of patients who underwent elective IP procedures at Mayo Clinic (Jacksonville, FL, USA) from November 2022 to May 2024. Patients had TEG performed within a day before the procedure and met standard coagulation criteria (INR<2, platelets>50,000/mm³). The primary outcome was the incidence of bleeding, defined by validated scales. The association between TEG results and bleeding was analyzed using Fisher's Exact test and binary logistic regression.

Results

76 patients were included, 13 (17.1 %) experienced bleeding despite “normal” coagulation panel. Of these, 10 (14.93 %) had a non-hypocoagulant TEG (p = 0.082) suggesting no statistical association of TEG results and bleeding. TEG showed high specificity (94 %) but low sensitivity (23 %) for predicting bleeding risk. Hypocoagulant TEG provided a 5.1-fold increase in the odds of bleeding in our study (OR 5.1, 95%CI: 0.84–31.29, p = 0.066). Notably, TEG results identified 8.9 % (n = 6) of patients as hypocoagulable and 50 % experienced bleeding, highlighting the potential value of TEG in identifying patients at higher risk.

Conclusion

TEG may offer additional value in pre-procedural bleeding risk assessment in IP procedures, particularly due to its high specificity. However, larger-scale studies are needed to confirm these findings and to better understand TEG's role in this context.

{"title":"Bleeding risk assessment with thromboelastography in interventional pulmonology procedures","authors":"David Abia-Trujillo, Rodrigo Funes-Ferrada, Bryan F. Vaca-Cartagena, Alejandra Yu Lee-Mateus, Alanna Barrios-Ruiz, Sofia Valdes-Camacho, Kelly S. Robertson, Sebastian Fernandez-Bussy","doi":"10.1016/j.rmed.2025.107964","DOIUrl":"10.1016/j.rmed.2025.107964","url":null,"abstract":"<div><h3>Objective</h3><div>Thromboelastography (TEG) offers a point-of-care and comprehensive evaluation of the coagulation cascade, but its utility in predicting bleeding risk in Interventional Pulmonology (IP) procedures has not been thoroughly investigated. This study aims to evaluate the effectiveness of TEG in assessing bleeding risk in patients undergoing elective IP procedures.</div></div><div><h3>Material and methods</h3><div>Retrospective study of patients who underwent elective IP procedures at Mayo Clinic (Jacksonville, FL, USA) from November 2022 to May 2024. Patients had TEG performed within a day before the procedure and met standard coagulation criteria (INR<2, platelets>50,000/mm³). The primary outcome was the incidence of bleeding, defined by validated scales. The association between TEG results and bleeding was analyzed using Fisher's Exact test and binary logistic regression.</div></div><div><h3>Results</h3><div>76 patients were included, 13 (17.1 %) experienced bleeding despite “normal” coagulation panel. Of these, 10 (14.93 %) had a non-hypocoagulant TEG (<em>p = 0.082</em>) suggesting no statistical association of TEG results and bleeding. TEG showed high specificity (94 %) but low sensitivity (23 %) for predicting bleeding risk. Hypocoagulant TEG provided a 5.1-fold increase in the odds of bleeding in our study (OR 5.1, 95%CI: 0.84–31.29, <em>p</em> = 0.066). Notably, TEG results identified 8.9 % (n = 6) of patients as hypocoagulable and 50 % experienced bleeding, highlighting the potential value of TEG in identifying patients at higher risk.</div></div><div><h3>Conclusion</h3><div>TEG may offer additional value in pre-procedural bleeding risk assessment in IP procedures, particularly due to its high specificity. However, larger-scale studies are needed to confirm these findings and to better understand TEG's role in this context.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"238 ","pages":"Article 107964"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067340","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}

引用次数: 0

Efficacy and safety of long-acting muscarinic antagonists in COPD: A meta-analysis and meta-regression with a focus on aging

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-25 DOI: 10.1016/j.rmed.2025.107956

Luigino Calzetta , Elena Pistocchini , Rossella Laitano , Shima Gholamalishahi , Mario Cazzola , Paola Rogliani

The increasing global elderly population, projected to reach 20 % of individuals aged 65 and over by 2030, faces significant pulmonary challenges, including chronic obstructive pulmonary disease (COPD). Aging is associated with a natural decline in lung function and structural changes that exacerbate respiratory issues. COPD, characterized by chronic respiratory symptoms and airflow obstruction, presents a unique challenge in older patients due to the accelerated decline in lung function. Acetylcholine plays a pivotal role in airway dynamics through muscarinic acetylcholine receptors, particularly M₃ subtype, which mediates bronchoconstriction. The efficacy of long-acting muscarinic antagonists (LAMA) may differ in older adults, with evidence suggesting that these patients can respond favorably to LAMA treatment. This study utilized meta-analysis and meta-regression to explore the efficacy and safety of LAMA in treating COPD, while considering aging as a potential modifier. A meta-analysis of Phase III randomized controlled trials highlighted significant improvements in trough forced expiratory volume in the 1st second when LAMA were compared to placebo (PCB). Furthermore, the meta-regression revealed a trend suggesting older adults may experience enhanced benefits from LAMA therapy, particularly with once-daily regimens. Safety outcomes, including serious adverse events (SAE), cardiovascular SAE, and mortality, were not modulated by age when comparing LABA to PCB. Overall, these findings support the use of LAMA in elderly COPD patients and underscore the need for tailored treatment strategies to improve clinical outcomes in this vulnerable population.

{"title":"Efficacy and safety of long-acting muscarinic antagonists in COPD: A meta-analysis and meta-regression with a focus on aging","authors":"Luigino Calzetta , Elena Pistocchini , Rossella Laitano , Shima Gholamalishahi , Mario Cazzola , Paola Rogliani","doi":"10.1016/j.rmed.2025.107956","DOIUrl":"10.1016/j.rmed.2025.107956","url":null,"abstract":"<div><div>The increasing global elderly population, projected to reach 20 % of individuals aged 65 and over by 2030, faces significant pulmonary challenges, including chronic obstructive pulmonary disease (COPD). Aging is associated with a natural decline in lung function and structural changes that exacerbate respiratory issues. COPD, characterized by chronic respiratory symptoms and airflow obstruction, presents a unique challenge in older patients due to the accelerated decline in lung function. Acetylcholine plays a pivotal role in airway dynamics through muscarinic acetylcholine receptors, particularly M<sub>3</sub> subtype, which mediates bronchoconstriction. The efficacy of long-acting muscarinic antagonists (LAMA) may differ in older adults, with evidence suggesting that these patients can respond favorably to LAMA treatment. This study utilized meta-analysis and meta-regression to explore the efficacy and safety of LAMA in treating COPD, while considering aging as a potential modifier. A meta-analysis of Phase III randomized controlled trials highlighted significant improvements in trough forced expiratory volume in the 1st second when LAMA were compared to placebo (PCB). Furthermore, the meta-regression revealed a trend suggesting older adults may experience enhanced benefits from LAMA therapy, particularly with once-daily regimens. Safety outcomes, including serious adverse events (SAE), cardiovascular SAE, and mortality, were not modulated by age when comparing LABA to PCB. Overall, these findings support the use of LAMA in elderly COPD patients and underscore the need for tailored treatment strategies to improve clinical outcomes in this vulnerable population.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"238 ","pages":"Article 107956"},"PeriodicalIF":3.5,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053449","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}

引用次数: 0

Robotic-assisted bronchoscopy for the diagnosis of benign pulmonary tumors

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-25 DOI: 10.1016/j.rmed.2025.107963

Tejaswi R. Nadig , Jaanki R. Dave , Prasad S. Adusumilli , Matthew J. Bott , Mohit Chawla , Katherine D. Gray , Bryan C. Husta , Robert P. Lee , Catherine L. Oberg , Bernard J. Park , Gaetano Rocco , Marina K. Baine , Or Kalchiem-Dekel

引用次数: 0

Development and internal validation of a nomogram for predicting recurrent respiratory tract infections in children

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-23 DOI: 10.1016/j.rmed.2025.107961

Fei Xia , Xi Zhou , Yan Xiong , Chenghui Yin , Minhua Wang , Ling Li

Objective

This study aimed to develop and internally validate a nomogram in predicting the risk of recurrent respiratory tract infection (RRTI) in children.

Methods

A retrospective analysis was performed, involving 150 children with RRTI and 151 healthy controls, aged 0–14 years, admitted to or selected from the Pediatric Department of Yixing Hospital of Traditional Chinese Medicine between June 2022 and June 2023. Data were gathered through a comprehensive questionnaire survey on risk factors associated with RRTI. The dataset was randomly divided into a training cohort (n = 211) and a validation cohort (n = 90) in a 7:3 ratio. Significant variables were selected using LASSO regression in the training cohort to construct the nomogram, the performance of which was evaluated through Receiver Operating Characteristic (ROC) curves, calibration plots, and Decision Curve Analysis (DCA).

Results

The LASSO regression identified five predictors in the training cohort: picky eating, age at first antibiotic use, antibiotic use within the previous year, allergic conditions, secondhand smoke exposure. Based on them, the nomogram exhibited an excellent discriminative ability, with an AUC of 0.902 (95 % CI: 0.860–0.944) and a C-index of 0.902 in the training cohort. The validation cohort showed an AUC of 0.826 (95 % CI: 0.742–0.909) and a C-index of 0.826, confirming a high predictive accuracy. Calibration plots showed close alignment with the ideal reference line, and DCA indicated a significant clinical net benefit.

Conclusion

Our nomogram can efficiently predict RRTI risk in children, thereby providing a personalized and graphical tool for early identification and intervention.

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引用次数: 0

Antinuclear antibodies and progression of quantitative interstitial lung changes: The Multi-Ethnic Study of Atherosclerosis (MESA)-Lung Study

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine

Pub Date : 2025-01-23 DOI: 10.1016/j.rmed.2025.107955

Kathryn Friedman Flack , Michael D. George , John S. Kim , Jesse Y. Hsu , Anna J. Podolanczuk , Eric A. Hoffman , Cheilonda Johnson , Claire F. McGroder , Benjamin M. Smith , Maryl Kreider , Steven M. Kawut , R. Graham Barr , Michaela R. Anderson , Elana J. Bernstein

Antinuclear antibodies (ANA) are often found in ILD; whether ANA is associated with radiographic progression of quantitive interstitial lung changes is unknown. We performed longitudinal analyses of adults in the Multi-Ethnic Study of Atherosclerosis using linear mixed effects models with random intercept and slope to evaluate whether baseline ANA was associated with change in the amount of lung with high attenuation areas on CT (HAAs, percentage of imaged lung with −600 to −250 HU). In 6,638 subjects with 17,293 CT scans over 18 years, 741 (11 %) were ANA positive. ANA was not associated with HAA progression with ANA as a dichotomous variable (0.13 % less progression per year for ANA positive vs negative, 95%CI -0.33 %–0.07 %, p = 0.19) or as a continuous variable (0.004 % less progression per year per 10 % increase in ANA, 95%CI -0.01 %–0.005 %, p = 0.37). ANA was not associated with progression of HAA in community dwelling adults.

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引用次数: 0

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