Open Respiratory Archives最新文献

{"title":"SeparSEPAR (Sociedad Española de Neumologia y Cirugía Torácica) Clinical Protocol on Endoscopic Lung Volume Reduction for Severe Emphysema","authors":"Bernardino Alcázar-Navarrete ,&nbsp;Maria Jose Bernabé Barrios ,&nbsp;Alberto Caballero Vázquez ,&nbsp;Myriam Calle Rubio ,&nbsp;Enrique Cases Viedma ,&nbsp;Javier de Miguel-Díez ,&nbsp;Javier García López ,&nbsp;Ingrid Solanes García ,&nbsp;Juan Jose Soler Cataluña ,&nbsp;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 (FEV₁ 15–45%, RV &gt;175%, DLCO &gt;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}

{"title":"Synthetic Lung-cancer Cohorts Generated by a Large Language Model: Epidemiological Validity Assessment","authors":"Álvaro Fuentes-Martín ,&nbsp;Julio Mayol ,&nbsp;Bárbara Segura Méndez ,&nbsp;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> <!-->&lt;<!--> <!-->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}

{"title":"Use of New Tobacco and Nicotine Products as a Harm Reduction Strategy: A Critical Review of the Evidence","authors":"Carlos Andrés Jimenez-Ruiz ,&nbsp;José Ignacio de Granda-Orive ,&nbsp;Carlos Rábade Castedo ,&nbsp;Harold J. Farber ,&nbsp;Angélica Ocampo ,&nbsp;Susana Luhning ,&nbsp;Beatriz Raboso-Moreno ,&nbsp;Lola del Puerto-Garcia ,&nbsp;Daniel Buljubasich ,&nbsp;Manuel Conrado Pacheco-Gallego ,&nbsp;José Antonio Castillo-Vizueta ,&nbsp;Rosa Mirambeaux-Villalona ,&nbsp;Marcos García-Rueda ,&nbsp;Juan Antonio Riesco-Miranda ,&nbsp;Ángela Ramos-Pinedo ,&nbsp;Jaime Signes-Costa ,&nbsp;Ledys Blanquicett-Barrios ,&nbsp;Eva de Higes-Martinez ,&nbsp;Catalina Casillas-Suarez ,&nbsp;Concepción Rodríguez-García ,&nbsp;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}

{"title":"Do Observational Studies Overestimate the Effectiveness of Cytisinicline?","authors":"Raúl Majo García ,&nbsp;Cristina Díez Flecha ,&nbsp;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}

{"title":"Hemoptysis in a Young Man With Behçet's Disease","authors":"Ana Fernandes ,&nbsp;Nuno Santos ,&nbsp;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}

{"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 ,&nbsp;Pedro Landete ,&nbsp;Enrique Zamora ,&nbsp;Ana Román ,&nbsp;Inés Vergara ,&nbsp;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}

{"title":"Innovative Approach to Early Lung Cancer Detection: Integrating a Comprehensive Screening Program and an Incidental Pulmonary Nodule Clinic","authors":"Anna Sánchez-Cucó ,&nbsp;Sally Santisteve ,&nbsp;Anna Vila ,&nbsp;Carlos Manzano ,&nbsp;Maria Zuil ,&nbsp;Aida Monge ,&nbsp;Clara Sanz ,&nbsp;Esther Gracia-Lavedan ,&nbsp;Nerea Ramírez-Seco ,&nbsp;Marcela Suárez ,&nbsp;Silvia Barril ,&nbsp;Wassim El Arfaoui ,&nbsp;Ivan D. Benítez ,&nbsp;Sonia Gatius ,&nbsp;Carlos A. Rombolá ,&nbsp;Leandre Fernández ,&nbsp;Marina Pardina ,&nbsp;Maria Teresa Esqué ,&nbsp;Virginia Garcia ,&nbsp;José David González ,&nbsp;Jessica González","doi":"10.1016/j.opresp.2025.100527","DOIUrl":"10.1016/j.opresp.2025.100527","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer (LC) is the leading cause of cancer-related death. Early detection strategies include LC screening (LCS) with low-dose computed tomography (LDCT) and incidental pulmonary nodule clinics (IPNCs). This study describes the structure, workflow, and outcomes of an integrated early diagnosis strategy combining LCS and IPNCs.</div></div><div><h3>Material and methods</h3><div>We conducted a descriptive analysis of a prospective observational study (May 2023–June 2025) implementing an integrated IPNC-LCS model. All IPNC patients underwent initial LC-risk assessment: highly suspicious lesions were referred to a fast-track diagnostic pathway, low-risk patients to primary care (PC), and high-risk individuals to the LCS program. Additional referrals to the LCS program were received from pulmonology clinics and PC. The LCS program followed the I-ELCAP protocol, including LDCT, lung function testing, α1-antitrypsin deficiency (AATD) screening, and smoking cessation support.</div></div><div><h3>Results</h3><div>The IPNC evaluated 481 individuals: 30 (6.2%) had suspicious lung lesions, with four stage I LC confirmed; 282 (58.6%) were classified as low-risk; and 150 (31.2%) as high risk of whom 97 were enrolled in LCS. The LCS program also received 199 referrals from PC and 122 from pulmonology clinics, totaling 418 participants at baseline (63.2% male; mean age 63.0<!--> <!-->±<!--> <!-->6.43 years; 52.9% former smokers; 39.7% with COPD; 67.9% with emphysema). New diagnoses included emphysema (<em>n</em> <!-->=<!--> <!-->106), COPD (<em>n</em> <!-->=<!--> <!-->25), and AATD mutations (<em>n</em> <!-->=<!--> <!-->95). Smoking cessation referral was accepted by 74% of smokers. LC was detected in 17 participants (4.07%), 14 (82.4%) at stage I, all receiving curative-intent treatment.</div></div><div><h3>Conclusions</h3><div>This integrated IPNC–LCS model achieved high early-stage LC detection and enabled curative treatment, while uncovering unrecognized respiratory comorbidities and promoting smoking cessation.</div></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100527"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839573","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}

{"title":"Unusual Bronchoscopic Findings in Endobronchial Sarcoidosis","authors":"Leandro Tapia Barredo,&nbsp;Laura Martínez Vega,&nbsp;Carmen Centeno Clemente","doi":"10.1016/j.opresp.2025.100525","DOIUrl":"10.1016/j.opresp.2025.100525","url":null,"abstract":"","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100525"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839569","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}

{"title":"Pleural Empyema Due to Gemella morbillorum: A Rare Etiology in a High-risk Patient","authors":"Dorian Paola Chaucayanqui ,&nbsp;Laura Castellanos López ,&nbsp;Beatriz Raboso Moreno","doi":"10.1016/j.opresp.2025.100526","DOIUrl":"10.1016/j.opresp.2025.100526","url":null,"abstract":"<div><div>Pleural empyema is a severe complication of pneumonia, tipically caused by <em>Streptococcus pneumoniae</em> or <em>Staphylococcus aureus</em>. We present a rare case of empyema due to <em>Gemella morbillorum</em>, an orophrarynx commensal. Risk factors include alcoholism, immunocompromised state, and poor oral hygiene. Its slow growth and resemblance to <em>Streptococcus viridans</em> complicate diagnosis, often requiring Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry for accurate identification. While beta-lactams (penicilins and most cephalosporins) remain first-line therapy, our case highlights successful treatment in a penicillin-allergic patient using vancomycin and clindamycin, providing an alternative regimen. Other options, including macrolides, fluoroquinolones and tetracyclines, may be considered based on antimicrobial susceptibility testing. Optimal management combines pleural drainage and prolonged antibiotic therapy (≥4 weeks).</div></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100526"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839572","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}

{"title":"Unequal Access, Unequal Outcomes: Analyzing Chronic Obstructive Pulmonary Disease Hospital Admissions Across Clinical Commissioning Groups","authors":"Sushant Sharma","doi":"10.1016/j.opresp.2025.100524","DOIUrl":"10.1016/j.opresp.2025.100524","url":null,"abstract":"<div><div>Chronic obstructive pulmonary disease (COPD) remains a major cause of hospitalisation and mortality in England, with outcomes differing widely across Clinical Commissioning Groups (CCGs). This short communication highlights regional variation in COPD emergency admissions and 30 day readmission patterns using figures from the 2nd Atlas of Variation in Risk Factors and Healthcare for Respiratory Disease by Public Health England. Northern regions show higher rates than southern regions, reflecting variation in access to primary care, respiratory specialists, and pulmonary rehabilitation. These patterns indicate that supply sensitive factors contribute significantly to unequal outcomes. Reducing avoidable hospitalisations will require fairer resource allocation, earlier community based management, and stronger coordination between hospital and primary care services.</div></div>","PeriodicalId":34317,"journal":{"name":"Open Respiratory Archives","volume":"8 1","pages":"Article 100524"},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736044","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}