Pub Date : 2025-10-30DOI: 10.1136/thorax-2025-223995
Gabriel Navarrete Fernandez, Joao Sakuray Pais, Eduardo Kaiser Ururahy Nunes Fonseca, Rogerio Souza
A 35-year-old female patient presented with a 3-month history of progressive dyspnoea. The patient reported that since the onset of symptoms, she experienced tachycardia, cyanosis and presyncope after light exertion. At that time, the patient underwent a chest CT angiography, which was positive for pulmonary thromboembolism. Following this diagnosis, the patient started anticoagulation with rivaroxaban. However, after 2 months of anticoagulation, she reported no improvement and looked for a second opinion. At our institution, repeat chest CT angiography demonstrated a nodular lesion in the region of the pulmonary valve (figure 1A, B), located along its left lateral aspect, measuring up to 3.2 cm and causing significant obstruction of the right ventricular outflow tract. The lesion extended to the left lateral wall of the pulmonary artery, where a small nodular component was identified at the origin of the left main pulmonary branch, …
{"title":"Pulmonary artery angiosarcoma","authors":"Gabriel Navarrete Fernandez, Joao Sakuray Pais, Eduardo Kaiser Ururahy Nunes Fonseca, Rogerio Souza","doi":"10.1136/thorax-2025-223995","DOIUrl":"https://doi.org/10.1136/thorax-2025-223995","url":null,"abstract":"A 35-year-old female patient presented with a 3-month history of progressive dyspnoea. The patient reported that since the onset of symptoms, she experienced tachycardia, cyanosis and presyncope after light exertion. At that time, the patient underwent a chest CT angiography, which was positive for pulmonary thromboembolism. Following this diagnosis, the patient started anticoagulation with rivaroxaban. However, after 2 months of anticoagulation, she reported no improvement and looked for a second opinion. At our institution, repeat chest CT angiography demonstrated a nodular lesion in the region of the pulmonary valve (figure 1A, B), located along its left lateral aspect, measuring up to 3.2 cm and causing significant obstruction of the right ventricular outflow tract. The lesion extended to the left lateral wall of the pulmonary artery, where a small nodular component was identified at the origin of the left main pulmonary branch, …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"158 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145404720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1136/thorax-2025-223508
Giovanni Viegi,Stefania La Grutta
{"title":"Passive smoke exposure as an intergenerational risk factor for lung health.","authors":"Giovanni Viegi,Stefania La Grutta","doi":"10.1136/thorax-2025-223508","DOIUrl":"https://doi.org/10.1136/thorax-2025-223508","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"80 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1136/thorax-2025-224162
Donald P Tashkin,Kathryn H Melamed
{"title":"Comparative efficacy in smokers with versus without COPD: a new addition of an old drug to approved pharmacotherapy for smoking cessation.","authors":"Donald P Tashkin,Kathryn H Melamed","doi":"10.1136/thorax-2025-224162","DOIUrl":"https://doi.org/10.1136/thorax-2025-224162","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"113 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-29DOI: 10.1136/thorax-2025-223421
Haopu Yang, Jingen Xia, Xu Huang, Yu Bai, Dan Jin, Seyed Mehdi Nouraie, Bryan J McVerry, Alison Morris, Georgios D Kitsios, Chen Wang, Qingyuan Zhan
Purpose Subphenotype classifiers for acute respiratory distress syndrome (ARDS) dichotomise patients into hyperinflammatory versus hypoinflammatory subgroups. These models demonstrated prognostic and predictive values but were developed primarily in Caucasian populations. Generalisability of these models in Asian patients, who experience worse clinical outcomes, has not been established. We aimed to profile host responses in Asian patients with ARDS and evaluate the generalisability of established classifiers in this understudied population compared with a Caucasian cohort. Methods We prospectively enrolled patients with ARDS from medical intensive care units in Beijing, China, and Pittsburgh, Pennsylvania, USA. In the Beijing cohort, 37 protein biomarkers were measured, with 10 overlapping biomarkers measured in the Pittsburgh cohort. Six established subphenotype models were assessed for generalisability and intermodel agreement. Sensitivity analyses, including latent class analysis, were conducted to explore biological heterogeneity within Asians. Results Between 2011 and 2020, a total of 356 patients with ARDS (83% meeting the Berlin Definition; the rest on high-flow nasal cannula (HFNC) meeting the New Global Definition) were enrolled across Beijing (97% Han Asian) and Pittsburgh (90% Caucasian) sites, with comparable baseline hypoxaemia severity but disparate outcome. While the proportion of hyperinflammatory versus hypoinflammatory subphenotypes was predicted to be overall similar across different cohorts per each model, we observed poor intermodel agreement. We observed heightened inflammation in Berlin patients with ARDS compared with HFNC-ARDS within our Asian cohort. Conclusion Established subphenotype classifiers demonstrated similar distribution of subphenotypes in Asian patients with ARDS. However, poor intermodel agreement highlights the need for further investigation into model variability with models coming closer to bedside implementation. Trial registration number [NCT02975908][1]. Data are available upon reasonable request. Desensitised data for Beijing cohort, including demographics, biomarker measurement, as well as code for analyses, are available upon reasonable request (QZ (drzhanqy{at}163.com)). Pittsburgh cohort data availability as previously described. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02975908&atom=%2Fthoraxjnl%2Fearly%2F2025%2F10%2F29%2Fthorax-2025-223421.atom
{"title":"Generalisability of ARDS biological subphenotype models in Asians: an international, multicentre, prospective biomarker study","authors":"Haopu Yang, Jingen Xia, Xu Huang, Yu Bai, Dan Jin, Seyed Mehdi Nouraie, Bryan J McVerry, Alison Morris, Georgios D Kitsios, Chen Wang, Qingyuan Zhan","doi":"10.1136/thorax-2025-223421","DOIUrl":"https://doi.org/10.1136/thorax-2025-223421","url":null,"abstract":"Purpose Subphenotype classifiers for acute respiratory distress syndrome (ARDS) dichotomise patients into hyperinflammatory versus hypoinflammatory subgroups. These models demonstrated prognostic and predictive values but were developed primarily in Caucasian populations. Generalisability of these models in Asian patients, who experience worse clinical outcomes, has not been established. We aimed to profile host responses in Asian patients with ARDS and evaluate the generalisability of established classifiers in this understudied population compared with a Caucasian cohort. Methods We prospectively enrolled patients with ARDS from medical intensive care units in Beijing, China, and Pittsburgh, Pennsylvania, USA. In the Beijing cohort, 37 protein biomarkers were measured, with 10 overlapping biomarkers measured in the Pittsburgh cohort. Six established subphenotype models were assessed for generalisability and intermodel agreement. Sensitivity analyses, including latent class analysis, were conducted to explore biological heterogeneity within Asians. Results Between 2011 and 2020, a total of 356 patients with ARDS (83% meeting the Berlin Definition; the rest on high-flow nasal cannula (HFNC) meeting the New Global Definition) were enrolled across Beijing (97% Han Asian) and Pittsburgh (90% Caucasian) sites, with comparable baseline hypoxaemia severity but disparate outcome. While the proportion of hyperinflammatory versus hypoinflammatory subphenotypes was predicted to be overall similar across different cohorts per each model, we observed poor intermodel agreement. We observed heightened inflammation in Berlin patients with ARDS compared with HFNC-ARDS within our Asian cohort. Conclusion Established subphenotype classifiers demonstrated similar distribution of subphenotypes in Asian patients with ARDS. However, poor intermodel agreement highlights the need for further investigation into model variability with models coming closer to bedside implementation. Trial registration number [NCT02975908][1]. Data are available upon reasonable request. Desensitised data for Beijing cohort, including demographics, biomarker measurement, as well as code for analyses, are available upon reasonable request (QZ (drzhanqy{at}163.com)). Pittsburgh cohort data availability as previously described. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02975908&atom=%2Fthoraxjnl%2Fearly%2F2025%2F10%2F29%2Fthorax-2025-223421.atom","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"61 30 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145396916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUNDNumerous studies have found associations between parental socio-economic position (SEP) and offspring asthma. Obesity and tobacco smoking during pregnancy (SDP) are more prevalent in lower SEP groups and have been identified as risk factors for childhood asthma.AIMThe aim of this study was to explore and quantify the role of the modifiable risk factors-obesity, body mass index (BMI) and SDP-in the association between maternal SEP and offspring asthma.METHODSThis Swedish register-based cohort study included n=1 265 933 children born between 2006 and 2018, with information on asthma during the third and sixth years of life obtained from the National Patient Register and the Swedish Prescribed Drug Register. Maternal education was used as a measure of SEP. We used logistic regression to estimate exposure-outcome associations and applied the counterfactual approach to mediation analysis to estimate the proportion of the maternal SEP-offspring asthma association that could be explained by maternal obesity, BMI and SDP, with and without adjustment for birth year.RESULTThe OR was 1.15 (95% CI 1.13 to 1.16) for the association between maternal education and asthma during the third year of life and slightly lower during the sixth year (OR 1.09, 95% CI 1.07 to 1.10). Out of the excess risks, 20%-30% could be explained by obesity or BMI through mediation and mediated interaction, while 15%-20% could be explained by SDP.CONCLUSIONOur results indicate that supporting young women and mothers-to-be to healthy weight and to abstain from tobacco smoking, in particular during pregnancy, could reduce child morbidity and improve health equity in childhood.
大量研究发现父母社会经济地位（SEP）与后代哮喘之间存在关联。妊娠期肥胖和吸烟（SDP）在低SEP组中更为普遍，并已被确定为儿童哮喘的危险因素。目的探讨肥胖、体重指数（BMI）和sdp这三个可改变的危险因素在母亲SEP与后代哮喘的关系中所起的作用。方法：这项以瑞典登记为基础的队列研究纳入了2006年至2018年间出生的n= 1265933名儿童，其生命第3年和第6年的哮喘信息来自国家患者登记和瑞典处方药登记。我们使用母亲受教育程度作为SEP的衡量标准。我们使用逻辑回归来估计暴露与结果的关联，并应用反事实方法进行中介分析，以估计母亲肥胖、BMI和SDP可以解释的母亲SEP与后代哮喘的关联比例，无论是否对出生年份进行调整。结果母亲教育程度与出生后第3年哮喘相关的OR为1.15 (95% CI 1.13 ~ 1.16)，第6年的OR略低（OR 1.09, 95% CI 1.07 ~ 1.10）。在过量风险中，20%-30%可由肥胖或BMI通过中介和介导的相互作用解释，15%-20%可由SDP解释。结论支持年轻妇女和准妈妈保持健康体重和戒烟，特别是在怀孕期间，可以降低儿童发病率，改善儿童健康公平。
{"title":"Maternal BMI and smoking partly explain the association between maternal socio-economic position and offspring asthma.","authors":"Cecilia Lundholm,Emma Caffrey Osvald,Samuel Rhedin,Catarina Almqvist","doi":"10.1136/thorax-2025-223330","DOIUrl":"https://doi.org/10.1136/thorax-2025-223330","url":null,"abstract":"BACKGROUNDNumerous studies have found associations between parental socio-economic position (SEP) and offspring asthma. Obesity and tobacco smoking during pregnancy (SDP) are more prevalent in lower SEP groups and have been identified as risk factors for childhood asthma.AIMThe aim of this study was to explore and quantify the role of the modifiable risk factors-obesity, body mass index (BMI) and SDP-in the association between maternal SEP and offspring asthma.METHODSThis Swedish register-based cohort study included n=1 265 933 children born between 2006 and 2018, with information on asthma during the third and sixth years of life obtained from the National Patient Register and the Swedish Prescribed Drug Register. Maternal education was used as a measure of SEP. We used logistic regression to estimate exposure-outcome associations and applied the counterfactual approach to mediation analysis to estimate the proportion of the maternal SEP-offspring asthma association that could be explained by maternal obesity, BMI and SDP, with and without adjustment for birth year.RESULTThe OR was 1.15 (95% CI 1.13 to 1.16) for the association between maternal education and asthma during the third year of life and slightly lower during the sixth year (OR 1.09, 95% CI 1.07 to 1.10). Out of the excess risks, 20%-30% could be explained by obesity or BMI through mediation and mediated interaction, while 15%-20% could be explained by SDP.CONCLUSIONOur results indicate that supporting young women and mothers-to-be to healthy weight and to abstain from tobacco smoking, in particular during pregnancy, could reduce child morbidity and improve health equity in childhood.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"356 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145381209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-21DOI: 10.1136/thorax-2025-224041
Van Le Hong,C Louise Thwaites
{"title":"Acute breathlessness in resource-limited settings: diagnostic gaps and treatment challenges.","authors":"Van Le Hong,C Louise Thwaites","doi":"10.1136/thorax-2025-224041","DOIUrl":"https://doi.org/10.1136/thorax-2025-224041","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"29 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-21DOI: 10.1136/thorax-2025-223477
Na Wang,Wei Cheng,Yun Long,Huaiwu He,Yan Shi
{"title":"Mycelial growth in the bronchial lumen of a patient with acute promyelocytic leukaemia.","authors":"Na Wang,Wei Cheng,Yun Long,Huaiwu He,Yan Shi","doi":"10.1136/thorax-2025-223477","DOIUrl":"https://doi.org/10.1136/thorax-2025-223477","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"101 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：