Pub Date : 2026-01-01DOI: 10.1016/j.opresp.2025.100528
Juan Margallo Iribarnegaray, Rodrigo Alonso Moralejo, Carlos Andrés Quezada Loaiza, Lucía Ortega Ruiz, María Ruiz Rodriguez, Alicia De Pablo Gafas
Tacrolimus is an essential immunosuppressive drug in lung transplantation. It is metabolized by cytochrome P450, which can cause interactions with many drugs. We present a case of acute tacrolimus poisoning in a lung transplant patient following administration of nirmaltrevir/ritonavir, as well as treatment with rifampicin, acytochrome inducer, which allowed blood levels of tacrolimus to be reduced to appropriate values.
{"title":"Use of Rifampicin as a Cytochrome Inducer in Acute Tacrolimus Poisoning","authors":"Juan Margallo Iribarnegaray, Rodrigo Alonso Moralejo, Carlos Andrés Quezada Loaiza, Lucía Ortega Ruiz, María Ruiz Rodriguez, Alicia De Pablo Gafas","doi":"10.1016/j.opresp.2025.100528","DOIUrl":"10.1016/j.opresp.2025.100528","url":null,"abstract":"<div><div>Tacrolimus is an essential immunosuppressive drug in lung transplantation. It is metabolized by cytochrome P450, which can cause interactions with many drugs. We present a case of acute tacrolimus poisoning in a lung transplant patient following administration of nirmaltrevir/ritonavir, as well as treatment with rifampicin, acytochrome inducer, which allowed blood levels of tacrolimus to be reduced to appropriate values.</div></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100528"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.opresp.2025.100532
Pablo Lozano Cuesta , Inés Ruiz Álvarez , Ina Guerassimova , Guillermo López-Arranz Monge , Ramón Fernández Álvarez
Pneumoperitoneum secondary to gastrostomy is a rare, usually benign complication, often due to air insufflation. It can occur after both endoscopic and radiological techniques, though less frequently with the latter. Percutaneous radiological gastrostomy is preferred in neuromuscular patients where deep sedation poses respiratory risks. We report a case of a Duchenne muscular dystrophy patient on non-invasive ventilation who developed symptomatic pneumoperitoneum, likely exacerbated by aerophagia. We propose minimally managing this with a semi-permanent percutaneous drain, allowing continued ventilatory support until resolution.
{"title":"Symptomatic Pneumoperitoneum After Percutaneous Radiological Gastrostomy in Patient With Duchenne Disease Dependent on Non-Invasive Mechanical Ventilation","authors":"Pablo Lozano Cuesta , Inés Ruiz Álvarez , Ina Guerassimova , Guillermo López-Arranz Monge , Ramón Fernández Álvarez","doi":"10.1016/j.opresp.2025.100532","DOIUrl":"10.1016/j.opresp.2025.100532","url":null,"abstract":"<div><div>Pneumoperitoneum secondary to gastrostomy is a rare, usually benign complication, often due to air insufflation. It can occur after both endoscopic and radiological techniques, though less frequently with the latter. Percutaneous radiological gastrostomy is preferred in neuromuscular patients where deep sedation poses respiratory risks. We report a case of a Duchenne muscular dystrophy patient on non-invasive ventilation who developed symptomatic pneumoperitoneum, likely exacerbated by aerophagia. We propose minimally managing this with a semi-permanent percutaneous drain, allowing continued ventilatory support until resolution.</div></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100532"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.opresp.2025.100520
Maria Belén Alonso Ortiz , Javier de Miguel Díez
{"title":"COPD With Comorbidities: A Clinical and Organizational Challenge for the 21st Century","authors":"Maria Belén Alonso Ortiz , Javier de Miguel Díez","doi":"10.1016/j.opresp.2025.100520","DOIUrl":"10.1016/j.opresp.2025.100520","url":null,"abstract":"","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100520"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.opresp.2025.100531
Carmen Amezcua Sánchez , Maria Guadalupe Hurtado Gañán , Agustin Valido Morales , Talia Maria García Guerrero , Ruth Ayerbe García , Virginia Almadana Pacheco
This study evaluated the differential characteristics between Chronic Obstructive Pulmonary Disease (COPD) exacerbator patients who accepted or declined participation in a telemonitoring program based on the virtual assistant “Lola” at Virgen Macarena University Hospital (HUVM). Between October 2023 and November 2024, 82 patients were invited to participate, and clinical as well as sociodemographic variables were collected through electronic health record review and telephone interview. Of these, 59.8% agreed to participate, whereas 40.2% refused. Refusal was significantly associated with lower sociocultural level, fewer electronic devices, higher anxiety and depression scores (HADS-A, HADS-D), and lower adherence to inhaled therapy (TAI). These findings suggest that sociotechnological barriers play a determining role in program acceptance and may inform patient selection strategies and implementation approaches aimed at improving adherence and optimizing the effectiveness of telemonitoring interventions.
{"title":"Artificial Intelligence-Based Interventions in Pulmonology: What Factors Influence Patient Participation in This Type of Study?","authors":"Carmen Amezcua Sánchez , Maria Guadalupe Hurtado Gañán , Agustin Valido Morales , Talia Maria García Guerrero , Ruth Ayerbe García , Virginia Almadana Pacheco","doi":"10.1016/j.opresp.2025.100531","DOIUrl":"10.1016/j.opresp.2025.100531","url":null,"abstract":"<div><div>This study evaluated the differential characteristics between Chronic Obstructive Pulmonary Disease (COPD) exacerbator patients who accepted or declined participation in a telemonitoring program based on the virtual assistant “Lola” at Virgen Macarena University Hospital (HUVM). Between October 2023 and November 2024, 82 patients were invited to participate, and clinical as well as sociodemographic variables were collected through electronic health record review and telephone interview. Of these, 59.8% agreed to participate, whereas 40.2% refused. Refusal was significantly associated with lower sociocultural level, fewer electronic devices, higher anxiety and depression scores (HADS-A, HADS-D), and lower adherence to inhaled therapy (TAI). These findings suggest that sociotechnological barriers play a determining role in program acceptance and may inform patient selection strategies and implementation approaches aimed at improving adherence and optimizing the effectiveness of telemonitoring interventions.</div></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100531"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.opresp.2025.100529
Bernardino Alcázar-Navarrete , Maria Jose Bernabé Barrios , Alberto Caballero Vázquez , Myriam Calle Rubio , Enrique Cases Viedma , Javier de Miguel-Díez , Javier García López , Ingrid Solanes García , Juan Jose Soler Cataluña , Alfons Torrego Fernandez
Endoscopic lung volume reduction (BLVR) has emerged as an evidence-based, minimally invasive therapeutic option for patients with severe pulmonary emphysema who remain highly symptomatic despite optimal medical therapy and pulmonary rehabilitation. This SEPAR Clinical Protocol provides an updated, comprehensive, and standardized framework for the evaluation, selection, treatment, and follow-up of candidates for BLVR in Spain. The document synthesizes current scientific evidence on the efficacy and safety of available bronchoscopic techniques – principally endobronchial valves (EBV), bronchoscopic thermal vapor ablation (BTVA), and coils – highlighting the superiority and robustness of evidence supporting EBV therapy. Randomized controlled trials consistently show clinically meaningful improvements in lung function, hyperinflation, dyspnea, exercise tolerance, and health-related quality of life, particularly in patients without collateral ventilation. The protocol details the structural and organizational requirements for high-complexity BLVR programs, emphasizing the need for multidisciplinary teams, advanced imaging, comprehensive functional testing, and specialized inpatient care. It establishes clear inclusion and exclusion criteria, stressing the importance of radiological fissure assessment, physiological thresholds (FEV1 15–45%, RV >175%, DLCO >20%), smoking cessation, and appropriate symptom burden. Procedural sections describe indications, technical aspects, device characteristics, periprocedural management, and complication handling for EBV and BTVA. Finally, structured follow-up recommendations outline clinical, functional, radiological, and endoscopic monitoring to detect complications, evaluate loss of treatment effect, and guide valve revision or removal when necessary.
{"title":"SeparSEPAR (Sociedad Española de Neumologia y Cirugía Torácica) Clinical Protocol on Endoscopic Lung Volume Reduction for Severe Emphysema","authors":"Bernardino Alcázar-Navarrete , Maria Jose Bernabé Barrios , Alberto Caballero Vázquez , Myriam Calle Rubio , Enrique Cases Viedma , Javier de Miguel-Díez , Javier García López , Ingrid Solanes García , Juan Jose Soler Cataluña , Alfons Torrego Fernandez","doi":"10.1016/j.opresp.2025.100529","DOIUrl":"10.1016/j.opresp.2025.100529","url":null,"abstract":"<div><div>Endoscopic lung volume reduction (BLVR) has emerged as an evidence-based, minimally invasive therapeutic option for patients with severe pulmonary emphysema who remain highly symptomatic despite optimal medical therapy and pulmonary rehabilitation. This SEPAR Clinical Protocol provides an updated, comprehensive, and standardized framework for the evaluation, selection, treatment, and follow-up of candidates for BLVR in Spain. The document synthesizes current scientific evidence on the efficacy and safety of available bronchoscopic techniques – principally endobronchial valves (EBV), bronchoscopic thermal vapor ablation (BTVA), and coils – highlighting the superiority and robustness of evidence supporting EBV therapy. Randomized controlled trials consistently show clinically meaningful improvements in lung function, hyperinflation, dyspnea, exercise tolerance, and health-related quality of life, particularly in patients without collateral ventilation. The protocol details the structural and organizational requirements for high-complexity BLVR programs, emphasizing the need for multidisciplinary teams, advanced imaging, comprehensive functional testing, and specialized inpatient care. It establishes clear inclusion and exclusion criteria, stressing the importance of radiological fissure assessment, physiological thresholds (FEV<sub>1</sub> 15–45%, RV >175%, DLCO >20%), smoking cessation, and appropriate symptom burden. Procedural sections describe indications, technical aspects, device characteristics, periprocedural management, and complication handling for EBV and BTVA. Finally, structured follow-up recommendations outline clinical, functional, radiological, and endoscopic monitoring to detect complications, evaluate loss of treatment effect, and guide valve revision or removal when necessary.</div></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100529"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Large language models (LLMs) are increasingly used in medicine for clinical reasoning and educational simulation. This study assessed the epidemiological plausibility of a synthetic lung-cancer cohort generated by ChatGPT-4.0. A total of 102 virtual cases were created in Spanish using structured prompts including demographic, histologic, and molecular variables. When descriptively compared with international datasets (GLOBOCAN 2020, SEER, and biomarker meta-analyses), the cohort reproduced general disease patterns but showed statistically significant deviations (p < 0.05): early-stage disease and EGFR-positive tumors were overrepresented, while advanced stages, ALK rearrangements, and extreme PD-L1 values were underrepresented. These discrepancies likely reflect biases in model training data and the probabilistic nature of generative language models. Despite this quantified generative bias, the utility of these cohorts for non-epidemiological tasks like educational simulation is discussed, provided methodological transparency is maintained.
{"title":"Synthetic Lung-cancer Cohorts Generated by a Large Language Model: Epidemiological Validity Assessment","authors":"Álvaro Fuentes-Martín , Julio Mayol , Bárbara Segura Méndez , Ángel Cilleruelo-Ramos","doi":"10.1016/j.opresp.2025.100533","DOIUrl":"10.1016/j.opresp.2025.100533","url":null,"abstract":"<div><div>Large language models (LLMs) are increasingly used in medicine for clinical reasoning and educational simulation. This study assessed the epidemiological plausibility of a synthetic lung-cancer cohort generated by ChatGPT-4.0. A total of 102 virtual cases were created in Spanish using structured prompts including demographic, histologic, and molecular variables. When descriptively compared with international datasets (GLOBOCAN 2020, SEER, and biomarker meta-analyses), the cohort reproduced general disease patterns but showed statistically significant deviations (<em>p</em> <!--><<!--> <!-->0.05): early-stage disease and EGFR-positive tumors were overrepresented, while advanced stages, ALK rearrangements, and extreme PD-L1 values were underrepresented. These discrepancies likely reflect biases in model training data and the probabilistic nature of generative language models. Despite this quantified generative bias, the utility of these cohorts for non-epidemiological tasks like educational simulation is discussed, provided methodological transparency is maintained.</div></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100533"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-24DOI: 10.1016/j.opresp.2025.100534
Carlos Andrés Jimenez-Ruiz , José Ignacio de Granda-Orive , Carlos Rábade Castedo , Harold J. Farber , Angélica Ocampo , Susana Luhning , Beatriz Raboso-Moreno , Lola del Puerto-Garcia , Daniel Buljubasich , Manuel Conrado Pacheco-Gallego , José Antonio Castillo-Vizueta , Rosa Mirambeaux-Villalona , Marcos García-Rueda , Juan Antonio Riesco-Miranda , Ángela Ramos-Pinedo , Jaime Signes-Costa , Ledys Blanquicett-Barrios , Eva de Higes-Martinez , Catalina Casillas-Suarez , Concepción Rodríguez-García , Maribel Cristóbal-Fernández
The sale, distribution, and indiscriminate use of new tobacco and nicotine products have multiplied. The most relevant products are: electronic cigarettes (ECs), heated tobacco (HT), and nicotine pouches (NPs). From the tobacco industry and its related health sectors, and even from some health institutions with no clear influence from this industry, the use of all these devices is being promoted as an excellent harm reduction strategy for those conventional tobacco smokers who do not want to or cannot quit smoking. This paper reviewed the lack of scientific evidence of this strategy.
{"title":"Use of New Tobacco and Nicotine Products as a Harm Reduction Strategy: A Critical Review of the Evidence","authors":"Carlos Andrés Jimenez-Ruiz , José Ignacio de Granda-Orive , Carlos Rábade Castedo , Harold J. Farber , Angélica Ocampo , Susana Luhning , Beatriz Raboso-Moreno , Lola del Puerto-Garcia , Daniel Buljubasich , Manuel Conrado Pacheco-Gallego , José Antonio Castillo-Vizueta , Rosa Mirambeaux-Villalona , Marcos García-Rueda , Juan Antonio Riesco-Miranda , Ángela Ramos-Pinedo , Jaime Signes-Costa , Ledys Blanquicett-Barrios , Eva de Higes-Martinez , Catalina Casillas-Suarez , Concepción Rodríguez-García , Maribel Cristóbal-Fernández","doi":"10.1016/j.opresp.2025.100534","DOIUrl":"10.1016/j.opresp.2025.100534","url":null,"abstract":"<div><div>The sale, distribution, and indiscriminate use of new tobacco and nicotine products have multiplied. The most relevant products are: electronic cigarettes (ECs), heated tobacco (HT), and nicotine pouches (NPs). From the tobacco industry and its related health sectors, and even from some health institutions with no clear influence from this industry, the use of all these devices is being promoted as an excellent harm reduction strategy for those conventional tobacco smokers who do not want to or cannot quit smoking. This paper reviewed the lack of scientific evidence of this strategy.</div></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 2","pages":"Article 100534"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-24DOI: 10.1016/j.opresp.2025.100535
Raúl Majo García , Cristina Díez Flecha , Sheila María Martínez Tahoces
{"title":"Do Observational Studies Overestimate the Effectiveness of Cytisinicline?","authors":"Raúl Majo García , Cristina Díez Flecha , Sheila María Martínez Tahoces","doi":"10.1016/j.opresp.2025.100535","DOIUrl":"10.1016/j.opresp.2025.100535","url":null,"abstract":"","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 2","pages":"Article 100535"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-24DOI: 10.1016/j.opresp.2025.100536
Ana Fernandes , Nuno Santos , Miguel Castro
{"title":"Hemoptysis in a Young Man With Behçet's Disease","authors":"Ana Fernandes , Nuno Santos , Miguel Castro","doi":"10.1016/j.opresp.2025.100536","DOIUrl":"10.1016/j.opresp.2025.100536","url":null,"abstract":"","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 2","pages":"Article 100536"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-23DOI: 10.1016/j.opresp.2025.100530
David Rudilla , Pedro Landete , Enrique Zamora , Ana Román , Inés Vergara , Julio Ancochea
{"title":"Erratum to “MEntA Program Based on Motivational Interview to Improve Adherence to Treatment of Obstructive Sleep Apnea With Continuous Positive Airway Pressure (CPAP): A Randomized Controlled Trial” [Open Respiratory Archives. 2021;3(2):100088]","authors":"David Rudilla , Pedro Landete , Enrique Zamora , Ana Román , Inés Vergara , Julio Ancochea","doi":"10.1016/j.opresp.2025.100530","DOIUrl":"10.1016/j.opresp.2025.100530","url":null,"abstract":"","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100530"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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