Respiratory Medicine and Research最新文献

{"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":"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":"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":"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}

{"title":"Screening for an underlying myeloproliferative neoplasm in patients with chronic thromboembolic pulmonary hypertension","authors":"Stephen E. Langabeer","doi":"10.1016/j.resmer.2025.101235","DOIUrl":"10.1016/j.resmer.2025.101235","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101235"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789680","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":"Burden of unexplained dyspnea: a single-center study","authors":"Anissa Reguig ,&nbsp;Clémence Remy ,&nbsp;Lidwine Wemeau ,&nbsp;David Montaigne ,&nbsp;Thierry Perez ,&nbsp;Cécile Chenivesse ,&nbsp;Nathalie Bautin","doi":"10.1016/j.resmer.2025.101234","DOIUrl":"10.1016/j.resmer.2025.101234","url":null,"abstract":"<div><div>Unexplained dyspnea refers to unpleasant breathing sensations without any disorder being diagnosed. We aimed to study the burden of unexplained dyspnea, by assessing health-related quality of life (SF-36 questionnaire), characteristics of dyspnea (mMRC, multidimensional dyspnea profile (MDP) and Borg score at exercise), hyperventilation symptoms (Nijmegen questionnaire), anxiety and depression (HAD scale), exercise capacity (peak V̇O2) and ventilatory response to exercise. Of the 62 patients referred to our Dyspnea center, we included 29 patients with confirmed unexplained dyspnea after a complete systematic evaluation (a cause of dyspnea was found in 29 patients and 4 cases were excluded for missing values)<em>.</em> They were aged 57 years [47;66], including 20 (69 %) women. All SF-36 scores were low: physical functioning 50 [33;75], limitation due to physical health 50 [0;63], limitation due to emotional problems 67 [0;100], fatigue 30 [15;43], emotional well-being 52 [44;66], social functioning 63 [38;75], bodily pain 45 [23;58], general health 50 [30;55]. Most patients (23 (79 %)) had activity-limiting dyspnea (mMRC≥2), 15 (55 %) had a low exercise capacity (peakV’O2&lt;85 %) and 20 (74 %) had either exertional hyperventilation (threshold V̇E/V̇CO2&gt;34) or low Vt expansion (peak Vt/FVC&lt;40 %). Hyperventilation symptoms (Nijmegen&gt;23) were present in 17 (59 %) patients, and associated with lower scores in some domains of the SF-36 questionnaire and higher HAD and MDP anxiety subscores. Our results suggest a heavy burden of unexplained dyspnea on physical and mental health. Expert centers may help in the diagnosis and thus enable earlier symptomatic management.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101234"},"PeriodicalIF":1.8,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829019","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":"Endoscopic liposomal amphotericin B therapy in semi-invasive pulmonary aspergillosis","authors":"Benoit Aguado ,&nbsp;Julia Ballouhey ,&nbsp;Yannick Simonneau ,&nbsp;Thomas Egenod ,&nbsp;Stéphane Moreau ,&nbsp;Elsa Clapaud","doi":"10.1016/j.resmer.2025.101233","DOIUrl":"10.1016/j.resmer.2025.101233","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101233"},"PeriodicalIF":1.8,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783274","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 systemic sclerosis on outcomes of patients hospitalized for influenza: Evidence from the US nationwide inpatient sample","authors":"Ang-Jun Liu ,&nbsp;Hen-Hong Chang ,&nbsp;Hsueh-Ting Chu ,&nbsp;Tai-Hua Yang ,&nbsp;Yu-Pei Chen","doi":"10.1016/j.resmer.2025.101232","DOIUrl":"10.1016/j.resmer.2025.101232","url":null,"abstract":"<div><h3>Background</h3><div>Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by fibrosis and immune dysregulation, often involving pulmonary and cardiovascular systems. Limited data exist regarding its impact on outcomes among patients hospitalized with influenza.</div></div><div><h3>Methods</h3><div>Using the US Nationwide Inpatient Sample (2016–2020), we identified adults hospitalized with a principal diagnosis of influenza using ICD-10 codes. Patients were categorized into SSc and non-SSc groups. Propensity score matching (1:4) was applied to balance baseline characteristics. Logistic and linear regression analyses estimated adjusted odds ratios (aORs) or coefficients with 95% confidence intervals (CIs) for in-hospital mortality, complications, length of stay (LOS), and adverse discharge outcomes.</div></div><div><h3>Results</h3><div>After matching, 1,265 patients (253 with SSc, 1,012 without SSc) were included, representing 6,248 hospitalizations nationwide after weighting. Compared with non-SSc patients, those with SSc had significantly higher risks of secondary bacterial or fungal infections (aOR = 1.42; 95% CI: 1.05–1.92; p = 0.025) and bronchiectasis (aOR = 3.91; 95% CI: 1.77–8.65; p &lt; 0.001). Among patients aged ≥60 years, SSc was associated with increased risks of bronchiectasis (aOR = 4.67; 95% CI: 2.13–10.24) and respiratory failure requiring mechanical ventilation (aOR = 1.47; 95% CI: 1.06–2.02). Smokers with SSc had a higher risk of shock, while non-smokers with SSc remained at elevated risk for secondary infections, bronchiectasis, and respiratory failure.</div></div><div><h3>Conclusions</h3><div>SSc was associated with excess risks of severe in-hospital complications among influenza patients, particularly in older adults and smokers, underscoring the need for targeted prevention and early intervention strategies.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"89 ","pages":"Article 101232"},"PeriodicalIF":1.8,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789681","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}