Respiratory Medicine and Research最新文献

英文中文

Skin side-effects of elexacaftor-tezacaftor-ivacaftor: a real-world view 皮肤副作用：一个真实世界的观点。

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2026-05-01 Epub Date: 2025-10-27 DOI: 10.1016/j.resmer.2025.101218

Sophie Constantinou , Lucy Webber , Alice Darby , Devika Sunil , Mirain Phillips , Richard Goodwin , Jamie Duckers

Background

Since 2020, ETI (elexacaftor/tezacaftor/ivacaftor) has been used to treat patients with cystic fibrosis. Acne and rash are listed as “common” and “very common” adverse effects in the Summary of Product Characteristics for ETI, affecting between 2-5% and 10% of patients respectively. Patients have, however, shared their experience of developing acne and rashes with clinicians and on social media. This study aimed to describe the real-world impact of rash and acne amongst patients taking ETI and to evaluate the service provided by healthcare practitioners.

Methods

A paper and/or electronic survey was distributed to adult patients taking ETI in two regional CF centres between November 2022 and February 2023.

Results

Of the 268 survey respondents, 20.9% reported new-onset acne and 13.8% reported a rash following the commencement of ETI. 11.9% had a past history of acne and reported an exacerbation/recurrence after starting ETI. ETI-associated acne occurred weeks to months after commencement of ETI, whereas most rashes occurred within the first 2 weeks of treatment. Reassuringly for 2/3 of affected patients, acne and rashes were minor side effects, although 1/3 experienced a greater impact on their quality of life.

Conclusion

This study is the first to specifically report the real-world prevalence of acne and rashes amongst patients taking ETI, which is higher than that reported in clinical trials. These findings could be used to improve counselling of patients commencing ETI. Ensuring access to up-to-date resources and treatments for patients experiencing skin side-effects would be mutually beneficial for both patients and healthcare professionals.

背景：自2020年以来，ETI （elexacaftor/tezacaftor/ivacaftor）已被用于治疗囊性纤维化患者。痤疮和皮疹在ETI产品特性摘要中被列为“常见”和“非常常见”的不良反应，分别影响2-5%和10%的患者。然而，患者与临床医生和社交媒体分享了他们患痤疮和皮疹的经历。本研究旨在描述在接受ETI的患者中皮疹和痤疮的现实影响，并评估医疗保健从业者提供的服务。方法：在2022年11月至2023年2月期间，向两个地区CF中心接受ETI的成年患者分发了一份论文和/或电子调查。结果：在268名受访者中，20.9%报告了新发痤疮，13.8%报告了ETI开始后的皮疹。11.9%的患者既往有痤疮病史，并在开始ETI后出现恶化/复发。与ETI相关的痤疮发生在ETI开始后的几周到几个月，而大多数皮疹发生在治疗的前两周。令人欣慰的是，对于2/3的受影响患者来说，痤疮和皮疹是轻微的副作用，尽管1/3的患者的生活质量受到了更大的影响。结论：本研究首次明确报道了服用ETI的患者中痤疮和皮疹的真实患病率，高于临床试验报告。这些发现可用于改善对开始ETI的患者的咨询。确保有皮肤副作用的患者获得最新的资源和治疗，对患者和医疗保健专业人员都是有利的。

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引用次数: 0

First steps for telemonitoring mechanical cough assistance in people with neuromuscular diseases: The Tele-INEX study 神经肌肉疾病患者远程监测机械咳嗽辅助的第一步：Tele-INEX研究

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2026-05-01 Epub Date: 2025-10-03 DOI: 10.1016/j.resmer.2025.101213

M Lebret , D Zerillo , A Kerfourn , M Mahot , R Abouly , E Fresnel , JC Borel

引用次数: 0

Hit-hard vs step-up therapies in COPD: the Goldilocks dilemma 慢性阻塞性肺病的重击vs强化治疗：金发姑娘困境

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2026-05-01 Epub Date: 2026-01-14 DOI: 10.1016/j.resmer.2026.101246

Belen Muñoz-Sanchez , José Luis Lopez-Campos , Esther Quintana-Gallego

引用次数: 0

Gas embolism during pleural lavage for empyema : potential risk factors from two clinical cases 胸膜灌洗术中气体栓塞：两例临床病例的潜在危险因素。

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2026-05-01 Epub Date: 2025-11-13 DOI: 10.1016/j.resmer.2025.101225

Martin Boussuges , Mathilde Cadic , Aurélie Kienlen , Pierre-Jean Marianne Dit Cassou , Thomas Masseguin , Cyril D’Andrea

引用次数: 0

Chest wall motion symmetry during breathing – a systematic review with meta-analysis providing normative value in healthy subjects 呼吸时胸壁运动对称——一项对健康受试者提供规范价值的系统综述和荟萃分析。

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2026-05-01 Epub Date: 2025-12-10 DOI: 10.1016/j.resmer.2025.101244

Laurent GAILLARD , Laurent STUBBE , Damien RIQUET , Nicolas HOUEL

Background

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.

Objective

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.

Methods

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.

Results

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], p < 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], p < 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], p < 0.05 and 49.33% ([48.34 : 50.32], p < 0.05) respectively.

Conclusion

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.

背景：呼吸系统的体格检查寻找被认为是病理性的呼吸运动不对称的证据。光电容积描记术（OEP）是一种非侵入性技术，它使用动作捕捉来测量呼吸量。目的：本系统综述的目的是研究OEP在病理和健康状态下的进展，该方法可以比较全胸壁和室室胸壁运动的左右部分。方法：采用Pubmed、ScienceDirect、Scopus、Cochrane等数据库进行系统研究。对健康受试者在安静呼吸时右侧对总胸壁运动和室室胸壁运动的相对贡献进行了荟萃分析。结果：20项研究符合纳入标准。OEP准确地诊断了通常通过侵入性手术诊断的病理。OEP适用于评估胸外科手术和肺部康复的效果。meta分析结果显示，全胸壁运动对称，右侧运动占50.00% （[49.24:50.76],p < 0.05）。隔室胸壁运动受到轻微不对称的影响。肺胸腔右段（RCP）占RCP运动的51.02% （[49.56:52.47],p < 0.05）。右侧胸腔和腹部代偿贡献分别为49.25% （[47.74:50.77],p < 0.05）和49.33% （[48.34:50.32],p < 0.05）。结论：OEP比较呼吸时左右胸壁运动的能力与诊断和随访引起呼吸不对称的病理有关。

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引用次数: 0

Translation into English and republication of: Pneumocystis jirovecii prophylaxis in non-HIV infected individuals: risk assessment and modalities1 翻译和再版：非艾滋病毒感染者的乙氏肺囊虫预防：风险评估和方式。

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2026-05-01 Epub Date: 2025-12-10 DOI: 10.1016/j.resmer.2025.101240

Radhika Sood , Marco Marando , Pieter-Jan Gijs , Zisis Balmpouzis , Pre Anne Bergeron , Angela Koutsokera , Gregory Berra

Infections caused by Pneumocystis jirovecii (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 (Pneumocystis 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.

由吉氏肺囊虫（PJ）引起的感染是一种机会性真菌，可在发病率和死亡率方面产生重大后果。这些感染主要发生在免疫功能低下的患者中，并以其肺嗜性（肺囊虫性肺炎，PCP）而闻名。从流行病学上讲，现在在非艾滋病毒（人类免疫缺陷病毒）人群中遇到的PJ感染比在艾滋病毒感染者中遇到的更多。虽然在艾滋病毒感染人群中研究了预防方式，但在非艾滋病毒患者中却缺乏证据。决定处方PJ预防需要评估临床背景，以及现有的风险因素，可能使个人易患PCP。很少有足够敏感和特异性的指标来预测PCP的发生。虽然某些潜在疾病有明确的预防建议，如实体器官移植受者，但证据很少。在决定使用预防措施时，必须考虑到患者的整体情况。

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引用次数: 0

Impact of a pediatric dyspnea clinic management on patients with unexplained exertional dyspnea: cross-sectional assessment at three months 小儿呼吸困难的临床管理对不明原因的用力性呼吸困难患者的影响：三个月的横断面评估

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2026-05-01 Epub Date: 2025-12-10 DOI: 10.1016/j.resmer.2025.101242

Florence Coquelin , Aurélie Bourmaud , Deborah Fuchs-Climent , Artémis Toumazi , Pierre Coste , Nellie Buridans-Travier , Chérine Benzouid , Véronique Houdouin , Christophe Delclaux , Claudine Peiffer , Jade Pautrat

Background

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.

Methods

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.

Results

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 >0) was observed in 46 children (68%) among whom 70% (32) had a near maximal ESc (≥6/8)

Lower compliance (< 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).

Conclusion

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.

背景：虽然不明原因的用力性呼吸困难（ED）是儿童常见的主诉，但对其治疗却鲜有共识。我们的儿科呼吸困难门诊提供多学科评估和ED管理，包括心理访谈和呼吸再训练。本研究的目的是确定在呼吸困难门诊就诊后3±1个月（第0天）ED的演变，并确定ED改善的相关因素。方法本横断面单中心队列研究纳入了2018年3月至2021年1月期间因不明原因ED转至我们的呼吸困难门诊的儿童。此后，我们通过电话访谈对患者进行重新评估。以-8分（最重要的呼吸困难加重）到+8分（最重要的呼吸困难改善）的评分评估患者在呼吸困难门诊后第0天至3±1个月之间ED的演变情况。通过多变量分析确定与ED改善相关的因素。结果我们纳入74例患者（中位年龄13.1岁，44例女孩），并对其中68例进行了重新评估。呼吸困难临床后第0天至3±1个月ED进化评分（ESc）中位数为4.0 [0.0；8.0]。46名儿童（68%）的ED （ESc >0）得到改善，其中70%（32）的ESc接近最大值（≥6/8）。在家进行呼吸练习的依从性较低（每周4天）与ED改善较少相关（OR = 0.20 [0.04; 0.87], p = 0.03）。结论到我院呼吸困难门诊就诊3个月后，大多数患者的ED得到改善，几乎一半患者的ED得到了最大程度的改善。遵守呼吸练习对取得更好的结果至关重要。

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引用次数: 0

Impact of systemic sclerosis on outcomes of patients hospitalized for influenza: Evidence from the US nationwide inpatient sample 系统性硬化症对流感住院患者预后的影响：来自美国全国住院患者样本的证据

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2026-05-01 Epub Date: 2025-11-28 DOI: 10.1016/j.resmer.2025.101232

Ang-Jun Liu , Hen-Hong Chang , Hsueh-Ting Chu , Tai-Hua Yang , Yu-Pei Chen

Background

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.

Methods

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.

Results

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 < 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.

Conclusions

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.

系统性硬化症（SSc）是一种以纤维化和免疫失调为特征的慢性自身免疫性疾病，常累及肺和心血管系统。关于其对流感住院患者预后影响的数据有限。方法使用美国全国住院患者样本（2016-2020），使用ICD-10代码确定主要诊断为流感的住院成年人。患者分为SSc组和非SSc组。采用倾向评分匹配（1:4）来平衡基线特征。Logistic和线性回归分析估计了住院死亡率、并发症、住院时间（LOS）和不良出院结局的调整优势比（aORs）或95%置信区间（CIs）系数。结果匹配后，纳入1265例患者（253例SSc， 1012例非SSc），加权后代表全国6248例住院患者。与非SSc患者相比，SSc患者继发细菌或真菌感染（aOR = 1.42; 95% CI: 1.05-1.92; p = 0.025）和支气管扩张（aOR = 3.91; 95% CI: 1.77-8.65; p < 0.001）的风险明显更高。在年龄≥60岁的患者中，SSc与支气管扩张（aOR = 4.67; 95% CI: 2.13-10.24）和需要机械通气的呼吸衰竭（aOR = 1.47; 95% CI: 1.06-2.02）的风险增加相关。患有SSc的吸烟者有较高的休克风险，而患有SSc的非吸烟者继发感染、支气管扩张和呼吸衰竭的风险仍然较高。结论sssc与流感患者，特别是老年人和吸烟者发生严重住院并发症的风险过高相关，强调有针对性的预防和早期干预策略的必要性。

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