Respiratory Medicine and Research最新文献

{"title":"Frailty in COPD hospitalized patients: Associated factors from a multicentre cohort study","authors":"Cristóbal Esteban ,&nbsp;María Gascón ,&nbsp;Eva Tabernero ,&nbsp;Patricia Sobradillo ,&nbsp;Monica Rayón ,&nbsp;Ignacio García-Talavera ,&nbsp;Amaia Aramburu ,&nbsp;Leyre Chasco ,&nbsp;José M. Quintana ,&nbsp;the ReEPOC-REDISSEC group","doi":"10.1016/j.resmer.2025.101239","DOIUrl":"10.1016/j.resmer.2025.101239","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the study was to determine the association between frailty and hospitalizations, mid-term mortality and medical readmissions, and to evaluate the relationship between frailty and other variables, such as dependence, anxiety, depression and health-related quality of life in a cohort of COPD patients after admission due to exacerbation (eCOPD).</div></div><div><h3>Methods</h3><div>Prospective observational cohort study conducted across nine Spanish hospitals. Patients were recruited consecutively. Variables relating to the patients' clinical baseline status were recorded, including the Tilburg Frailty Indicator (TFI), EuroQol EQ-5D, the COPD Assessment Test (CAT), Yale Physical Activity Survey (YPAS); the mMRC Dyspnea Scale, Hospital Anxiety and Depression Scale (HAD), and the Duke-UNC scale.</div></div><div><h3>Results</h3><div>1638 COPD patients were studied, with a mean age of 72.4 (SD 10.3), 77 % male, mean FEV1 49.4 % (SD 19.2), median Charlson index 2; mean CAT 21.3 (SD 9.1). In the multivariate analysis, the variables independently associated with frailty were older age, female sex, comorbidities, health-related quality of life, dyspnea, dependence, anxiety, depression, and physical activity. Multivariable survival regression analysis identified TFI, sex, and previous hospitalizations as predictors of one-year mortality. These variables, together with comorbidities, were associated with the risk of readmission due to any medical condition during the 1-year follow-up.</div></div><div><h3>Conclusions</h3><div>Frailty was associated with admission due to eCOPD and to the number of hospitalizations. In COPD, a single hospitalization should be considered a warning sign for frailty. Variables such as dependence, anxiety, depression and HRQoL were independent predictors of frailty. Additionally, frailty was associated with mortality and medical readmissions in the following year.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101239"},"PeriodicalIF":1.8,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An original story of a coma","authors":"Malo Miquel ,&nbsp;Cécile Devloo ,&nbsp;Alexandre Vasseur ,&nbsp;Jéromine Alessandri ,&nbsp;Jean-Philippe Rigaud ,&nbsp;Pierre-Louis Declercq","doi":"10.1016/j.resmer.2025.101241","DOIUrl":"10.1016/j.resmer.2025.101241","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101241"},"PeriodicalIF":1.8,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of having pulmonary embolism response team (PERT) on outcome of pulmonary embolism: A systematic review and meta-analysis","authors":"Sagun Dawadi ,&nbsp;Dhan Bahadur Shrestha ,&nbsp;Prakash Raj Oli ,&nbsp;Raj Kumar Thapa ,&nbsp;Jurgen Shtembari ,&nbsp;Amit Bhandari ,&nbsp;Daniel H. Katz","doi":"10.1016/j.resmer.2025.101245","DOIUrl":"10.1016/j.resmer.2025.101245","url":null,"abstract":"<div><h3>Introduction</h3><div>Pulmonary embolism (PE) continues to pose a significant challenge in clinical practice. Selecting the optimal management approach is complicated by conflicting societal guidelines, which can hinder the care team's ability to deliver effective therapies in timely fashion. To address this complexity, the Pulmonary Embolism Response Team (PERT) was introduced in 2012. This study evaluates the effectiveness of PERT and explores its integration as a standard of care for PE management.</div></div><div><h3>Methods</h3><div>A systematic search of databases was conducted from inception to April 2024. Relevant references were identified and imported for analysis. Statistical evaluation was performed using RevMan Web, using odds ratios (OR) for dichotomous outcomes and mean differences (MD) for continuous outcomes.</div></div><div><h3>Results</h3><div>The analysis included 23 studies, comprising 15,621 patients in two groups: patient managed by PERT, n=5,555 and patient managed with standard treatment without PERT, n=10,066. The use of PERT significantly lowered odds of 30-day or in-hospital mortality (OR 0.76, CI 0.59-0.99) but significantly increased the utilization of advanced therapeutic strategies (OR 3.45, CI 1.95-6.09). Although PERT demonstrated favorable odds for reduced major bleeding events and earlier achievement of therapeutic anticoagulation but could not achive statistcal significance. Also, while PERT was associated with higher odds of ICU admission (OR 2.41, CI 1.33-4.34)but significantly reduced the length of ICU stay (MD -0.67, CI -1.28 to -0.05).</div></div><div><h3>Conclusion</h3><div>PERT implementation has been associated with reduced mortality, shorter ICU stays, at cost of higher utilization of advanced therapies. However, given that most studies are observational, these findings should be interpreted cautiously, and higher-quality research is needed to establish definitive benefit.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101245"},"PeriodicalIF":1.8,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apical and basolateral alpha-1 antitrypsin delivery modulate CFTR and STAT3 in human airway epithelia grown at air-liquid interface","authors":"Kokilavani Sivaraman ,&nbsp;Stephanie Tamm ,&nbsp;Elena Korenbaum ,&nbsp;Beata Olejnicka ,&nbsp;Wenzhang Si ,&nbsp;Sabine Wrenger ,&nbsp;Frauke Stanke ,&nbsp;Sabina Janciauskiene","doi":"10.1016/j.resmer.2025.101236","DOIUrl":"10.1016/j.resmer.2025.101236","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101236"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a pulmonary rehabilitation maintenance program on long-term healthcare resource utilization and costs in COPD patients: ancillary analysis from a real-life post-rehabilitation cohort","authors":"Fares Gouzi ,&nbsp;Thomas Espie ,&nbsp;Steven Lopes ,&nbsp;Hélène Forthin ,&nbsp;Elise Galmes ,&nbsp;Léo Blervaque ,&nbsp;Christian Préfaut ,&nbsp;François Carbonnel","doi":"10.1016/j.resmer.2025.101243","DOIUrl":"10.1016/j.resmer.2025.101243","url":null,"abstract":"<div><h3>Rational</h3><div>Chronic Obstructive Pulmonary Disease (COPD) is a major cause of healthcare system use and related cost. While pulmonary rehabilitation (PR) is efficient, maintenance programs (PR-MA) can maintain the benefits over time. Yet, the long-term impact (&gt;36 months) of PR-MA on healthcare resource and cost has never been assessed. Recently, a PR-MA program based on self-help associations has shown a clinical efficacy beyond 36 months, Thus, we aimed to assess the effect of this PR-MA program on long-term hospitalizations and costs versus usual care (PR-UC).</div></div><div><h3>Methods</h3><div>We performed an ancillary analysis of the post-rehabilitation LTAir+R cohort study, which compared a PR-MA group (n=144) to a matched PR-UC group (n=137) of COPD patients. Data were collected in 82 PR-MA and 93 PR-UC patients, from the Montpellier University Hospital database and patient records over 60 months, including hospitalizations, consultations, emergency visits, and associated costs.</div></div><div><h3>Results</h3><div>In PR-AM vs. PR-UC group, the hospitalization probability reduction almost reached significance (hazard ratio: 1.68; p=0.05). The costs of each hospitalization day (867±116 vs. 1213±138 euros/day; p&lt;0.05), emergency visits (8±5 euros/year vs. 12±3 euros/year) and medical consultations (110±3 vs. 174±3 euros/year; p&lt;0.01) were significantly lower in the PR-AM vs. PR-UC group. Last, PR-MA mitigated the increase in total hospitalizations (p&lt;0.001) associated with the follow-up duration.</div></div><div><h3>Conclusion</h3><div>In addition to its long-term clinical efficacy, this PR-MA program showed a positive impact on hospitalization and healthcare use costs. The effect on hospitalization number and costs could be larger in patients with the longest PR-MA adherence.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101243"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world outcomes of patients treated with ≥17 cycles of pembrolizumab monotherapy as first-line therapy and for previously treated advanced NSCLC: multicenter observational study in France","authors":"Maurice Pérol ,&nbsp;Clarisse Audigier-Valette ,&nbsp;Hervé Léna ,&nbsp;Marie-Ange Massiani ,&nbsp;Xavier Quantin ,&nbsp;Melissa Santorelli ,&nbsp;Marion Apert ,&nbsp;Axelle Spampinato ,&nbsp;Thomas Burke ,&nbsp;Christos Chouaid","doi":"10.1016/j.resmer.2025.101238","DOIUrl":"10.1016/j.resmer.2025.101238","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101238"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased delays of care during the COVID-19 pandemic: experience of a lung cancer rapid diagnostic center","authors":"Pascal Wang ,&nbsp;Anthony Canellas ,&nbsp;Floriane Millet ,&nbsp;Constance Météyé ,&nbsp;Christelle Epaud ,&nbsp;Lise Rosencher ,&nbsp;Martine Antoine ,&nbsp;Harry Etienne ,&nbsp;Matthias Barral ,&nbsp;Jacques Cadranel ,&nbsp;Antoine Parrot ,&nbsp;Vincent Fallet ,&nbsp;et Armelle Lavolé","doi":"10.1016/j.resmer.2025.101237","DOIUrl":"10.1016/j.resmer.2025.101237","url":null,"abstract":"<div><h3>Context</h3><div>The COVID-19 pandemic has disrupted hospital organisation and management of chronic pathologies, such as lung cancer. Our objective was to evaluate the impact of COVID-19 on delays in lung cancer care at a French Lung Cancer Rapid Diagnostic Center (RDC).</div></div><div><h3>Methods</h3><div>All patients diagnosed with lung cancer through the RDC at Tenon hospital were included in this retrospective study. The main outcomes were delays (in days) of medical (diagnosis and treatment) care over two periods: period 1 in 2016 (P1, pre-COVID) and period 2 in 2020 (P2, during COVID). Two individualized pathways were considered based on the type of first treatment (surgery or chemo ± immunotherapy).</div></div><div><h3>Results</h3><div>A total of 227 and 293 patients were referred to the RDC during periods P1 and P2, respectively. Lung cancer was diagnosed in 118 patients (52 %) in P1 and 145 patients (49.5 %) in P2 (p=0.29). Patient characteristics were comparable between the two periods, except for TNM stage. A higher proportion of patients with localised stage was diagnosed in P2 compared to P1 (42.1 %¦vs 29.7 %; p=0.02). All delays increased significantly during P2, both pre-hospital steps (e.g. the delay in accessing the first consultation at RDC, which increased from 4 to 13 days, p &lt; 0.0001) and in-hospital steps (e.g. the delay from the first consultation at RDC to the first treatment, which rose from 37.5 to 49 days, p &lt; 0.0001). The surgery pathway was the most impacted, with a significant increase in the overall delay (67 days in P1 vs 109 days in P2, p &lt; 0.0001). The only delay that did not increase between P1 and P2 was the delay in accessing molecular biology.</div></div><div><h3>Conclusions</h3><div>Although the RDC remained open, our delays in lung cancer care increased during the COVID-19 pandemic. These increased delays particularly affected the management of localised lung cancers, which are the most curable. Given the shift toward ambulatory care outlined in the new 2021-2030 National Cancer Plan established by french health authorities, regular evaluations of care delays should be conducted, particularly in the context of health crisis.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101237"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a pediatric dyspnea clinic management on patients with unexplained exertional dyspnea: cross-sectional assessment at three months","authors":"Florence Coquelin ,&nbsp;Aurélie Bourmaud ,&nbsp;Deborah Fuchs-Climent ,&nbsp;Artémis Toumazi ,&nbsp;Pierre Coste ,&nbsp;Nellie Buridans-Travier ,&nbsp;Chérine Benzouid ,&nbsp;Véronique Houdouin ,&nbsp;Christophe Delclaux ,&nbsp;Claudine Peiffer ,&nbsp;Jade Pautrat","doi":"10.1016/j.resmer.2025.101242","DOIUrl":"10.1016/j.resmer.2025.101242","url":null,"abstract":"<div><h3>Background</h3><div>While unexplained exertional dyspnea (ED) is a frequent complaint in children, there is little consensus on its management. Our pediatric dyspnea clinic provides multidisciplinary assessment and management of ED that includes a psychological interview and a breathing retraining. The aim of this study was to determine the evolution of ED 3±1 months after the visit at the dyspnea clinic (day 0) and to identify factors associated with improvement of ED.</div></div><div><h3>Methods</h3><div>This cross-sectional monocentric cohort study included children referred to our dyspnea clinic between March 2018 and January 2021 for unexplained ED. Thereafter, we reassessed patients by a telephone interview. The evolution of ED between day 0 and 3±1 months after dyspnea clinic was assessed with a score ranging from -8 (most important worsening of dyspnea) to +8 (most important improvement of dyspnea). Factors associated with an improvement in ED were identified through a multivariate analysis.</div></div><div><h3>Results</h3><div>We included 74 patients (median age 13.1 years, 44 girls) and reassessed 68 of them. The median of ED evolution score (ESc) between day 0 and 3±1 months after dyspnea clinic was 4.0 [0.0; 8.0]. Improvement in ED (ESc &gt;0) was observed in 46 children (68%) among whom 70% (32) had a near maximal ESc (≥6/8)</div><div>Lower compliance (&lt; 4 days per week) with breathing exercises performed at home was associated with fewer improvement in ED (OR = 0.20 [0.04; 0.87], p = 0.03).</div></div><div><h3>Conclusion</h3><div>Three months after the visit to our dyspnea clinic, most patients had improved their ED with a near maximal improvement in almost half of all patients. Compliance with breathing exercises is essential for a better outcome.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101242"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest wall motion symmetry during breathing – a systematic review with meta-analysis providing normative value in healthy subjects","authors":"Laurent GAILLARD ,&nbsp;Laurent STUBBE ,&nbsp;Damien RIQUET ,&nbsp;Nicolas HOUEL","doi":"10.1016/j.resmer.2025.101244","DOIUrl":"10.1016/j.resmer.2025.101244","url":null,"abstract":"<div><h3>Background</h3><div>The physical examination of the respiratory system looks for evidence of asymmetrical breathing motion that is considered as pathologic. Optoelectronic plethysmography (OEP) is a non-invasive technic that uses motion capture to measure breathing volumes.</div></div><div><h3>Objective</h3><div>The aim of this systematic review is to research the progress made using OEP with a segmentation allowing the comparison of left and right parts of total and compartmental chest wall motion both in pathology and healthy condition.</div></div><div><h3>Methods</h3><div>Systematic research was conducted using Pubmed, ScienceDirect, Scopus and Cochrane databases. A meta-analysis was performed on the relative contribution of the right side to the total and compartmental chest wall motion in healthy subjects during quiet breathing.</div></div><div><h3>Results</h3><div>Twenty studies met the inclusion criteria. OEP accurately diagnosed pathologies that would typically be diagnosed through invasive procedures. OEP is suitable for the assessment of the effects of thoracic surgeries and pulmonary rehabilitation. The meta-analysis results show that the total chest wall motion is symmetrical with the right side contributing 50.00% ([49.24: 50.76], <em>p</em> &lt; 0.05). Compartmental chest wall motion is affected by slight asymmetries. The right part of the pulmonary rib cage (RCP) accounts for 51.02% ([49.56 : 52.47], <em>p</em> &lt; 0.05) of the RCP motion. The right part of the abdominal rib cage and the abdomen compensate with a contribution of 49.25% ([47.74 : 50.77], <em>p</em> &lt; 0.05 and 49.33% ([48.34 : 50.32], <em>p</em> &lt; 0.05) respectively.</div></div><div><h3>Conclusion</h3><div>OEP’s ability to compare left and right sides of chest wall motion during breathing is relevant to diagnose and to follow-up pathologies causing breathing asymmetries.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101244"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation into English and republication of: Pneumocystis jirovecii prophylaxis in non-HIV infected individuals: risk assessment and modalities1","authors":"Radhika Sood ,&nbsp;Marco Marando ,&nbsp;Pieter-Jan Gijs ,&nbsp;Zisis Balmpouzis ,&nbsp;Pre Anne Bergeron ,&nbsp;Angela Koutsokera ,&nbsp;Gregory Berra","doi":"10.1016/j.resmer.2025.101240","DOIUrl":"10.1016/j.resmer.2025.101240","url":null,"abstract":"<div><div>Infections caused by <em>Pneumocystis jirovecii</em> (PJ), an opportunistic fungus, can have major consequences in terms of morbidity and mortality. These infections occur mainly in immunocompromised patients and are known for their pulmonary tropism (<em>Pneumocystis</em> pneumonia, PCP). Epidemiologically, more PJ infections are now encountered in the non-HIV (human immunodeficiency virus) population than in HIV-infected individuals. While prevention modalities have been studied in HIV-infected populations, evidence is scarce in non-HIV patients. The decision to prescribe prophylaxis for PJ requires assessment of the clinical context, as well as existing risk factors that may predispose an individual to develop PCP. Few indicators exist that are sufficiently sensitive and specific to predict the occurrence of PCP. While certain underlying conditions have clear recommendations for prophylaxis such as solid organ transplant recipients, evidence is scarce. The decision to use prophylaxis must be made while taking into consideration the overall context of the patient.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101240"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}