Respiratory Medicine and Research最新文献

{"title":"Bronchiectasis in France: data on disease characteristics in 630 patients from the European Bronchiectasis registry (EMBARC)","authors":"Pierre-Régis Burgel ,&nbsp;Anne Bergeron ,&nbsp;Bernard Maitre ,&nbsp;Claire Andrejak ,&nbsp;Cristina Audoly ,&nbsp;Jean-François Boitiaux ,&nbsp;Boubou Camara ,&nbsp;Nathalie Coolen-Allou ,&nbsp;Benoit Douvry ,&nbsp;Gérard Chatté ,&nbsp;Annlyse Fanton ,&nbsp;Sylvie Leroy ,&nbsp;Clémence Martin ,&nbsp;Karine Michaux ,&nbsp;Annabelle Payet ,&nbsp;Hervé Pegliasco ,&nbsp;Frédéric Schlemmer ,&nbsp;Guillaume Vignal ,&nbsp;Agnès Duchange ,&nbsp;Espérie Burnet ,&nbsp;Marlène Murris-Espin","doi":"10.1016/j.resmer.2025.101199","DOIUrl":"10.1016/j.resmer.2025.101199","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about the characteristics of adults with bronchiectasis in France.</div></div><div><h3>Methods</h3><div>A descriptive cross-sectional study was conducted to describe the characteristics of adults (≥18 years) with clinically-significant bronchiectasis, diagnosed on a combination of respiratory symptoms and CT scan findings, and followed in 18 participating centers. Data on, etiology, lung function, symptoms, microbiology, treatments and quality of life were collected.</div></div><div><h3>Results</h3><div>Between January 2016 and July 2022, 630 adults (females: 66 %; ≥55 years: 73.8 %) were included. Idiopathic and post-infective causes represented 33.0 % and 37.1 % respectively; COPD and asthma, which were present in 15.6 % and 23.6 % of subjects, were considered as causes of bronchiectasis in only 3.8 % and 2.9 %, respectively. Only 25 % had normal spirometry and 7.3 % required long-term oxygen therapy. Daily sputum production was present in 78.1 % and 29.0 % had a modified Medical Research Council (mMRC) dyspnea score ≥2. Positive bacterial sputum culture was found in 77.8 % of those with sputum samples (<em>n</em> = 455); including 157 (34.5 %) positive for <em>Pseudomonas aeruginosa</em> within the past year. During the year prior to study entry, 75.4 % of patients reported at least one respiratory exacerbation, 33.8 % had at least one hospitalization and 24.5 % received outpatient parenteral antimicrobial therapy (OPAT). Using the bronchiectasis severity index 26.0 %, 36.4 % and 37.6 % were considered as having mild, moderate and severe disease, respectively.</div></div><div><h3>Conclusion</h3><div>In France, adults with bronchiectasis experience significant disease burden. Respiratory exacerbations are responsible for healthcare utilization and their prevention may require specialized multidisciplinary care and the development of novel therapeutic interventions.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101199"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018699","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":"Pulmonary ultrasound versus chest radiography in the diagnosis of community-acquired pneumonia in adults: an updated systematic review and meta-analysis","authors":"Víctor Juan Vera-Ponce ,&nbsp;Jhosmer Ballena-Caicedo ,&nbsp;Juan Carlos Bustamante-Rodríguez ,&nbsp;Fiorella E. Zuzunaga-Montoya ,&nbsp;Luisa Erika Milagros Vásquez-Romero ,&nbsp;Joan A. Loayza-Castro ,&nbsp;Mario J. Valladares-Garrido ,&nbsp;Carmen Inés Gutierrez De Carrillo ,&nbsp;Felix Llanos Tejada","doi":"10.1016/j.resmer.2025.101200","DOIUrl":"10.1016/j.resmer.2025.101200","url":null,"abstract":"<div><h3>Introduction</h3><div>Although chest radiography (CXR) has traditionally been used as the initial diagnostic test, pulmonary ultrasound (US) has emerged in recent years as a radiation-free, portable, and potentially more sensitive and specific alternative.</div></div><div><h3>Objective</h3><div>To evaluate the diagnostic accuracy of US compared to CXR for detecting community-acquired pneumonia (CAP) in adults through a systematic review and meta-analysis.</div></div><div><h3>Methodology</h3><div>Comprehensive searches were conducted in SCOPUS, Web of Science, PubMed, and EMBASE databases. Observational studies comparing US with CXR in diagnosing CAP were included, using computed tomography as the reference standard for all patients. Random-effect models were used for statistical analysis, calculating sensitivity, specificity, likelihood ratios (LR), and diagnostic odds ratios (DOR). Meta-regression analyses were performed, and SROC curves were constructed to compare diagnostic performance.</div></div><div><h3>Results</h3><div>Eight studies using CT as a reference standard were included. US showed superior performance with sensitivity 90.0 % (95 % CI: 81.3-96.2 %), specificity 90.8 % (95 % CI: 79.9-97.7 %), LR+ 9.45 (95 % CI: 3.73-23.94), LR- 0.12 (95 % CI: 0.06-0.24), and DOR 79.74. CXR demonstrated lower values with sensitivity 72.6 % (95 % CI: 61.7–82.4 %), specificity 82.0 % (95 % CI: 65.5–93.9 %), LR+ 3.98 (95 % CI: 1.87-8.49), LR- 0.36 (95 % CI: 0.23-0.54), and DOR 11.17. Both modalities showed significant heterogeneity, which was not explained by the sample size in meta-regression.</div></div><div><h3>Conclusions</h3><div>Pulmonary US demonstrates substantially higher diagnostic accuracy than CXR for CAP detection, with particularly strong performance in excluding pneumonia as evidenced by its low negative LR. While CXR maintains relevance where US is unavailable or for evaluating specific thoracic conditions, implementing US can optimize pneumonia diagnosis and potentially reduce unnecessary antibiotic use, particularly in emergency and critical care settings.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101200"},"PeriodicalIF":1.8,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026685","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":"French translation and linguistic validation of four questionnaires relevant to psychological interventions targeting persistent dyspnea: The Breathlessness catastrophizing questionnaire, the breathlessness beliefs questionnaire, the COPD self-efficacy scale, and the three-domain interoceptive sensations questionnaire.","authors":"Sophie Lavault ,&nbsp;Nicolas Roche ,&nbsp;Capucine Morélot-Panzini ,&nbsp;Christian Straus ,&nbsp;Thomas Similowski","doi":"10.1016/j.resmer.2025.101202","DOIUrl":"10.1016/j.resmer.2025.101202","url":null,"abstract":"<div><h3>Background</h3><div>Psychological interventions such as medical hypnosis, cognitive-behavioral therapy (CBT), and mindfulness-based techniques are emerging as promising tools in the management of persistent dyspnea. Their integration into clinical practice, however, is limited by the scarcity of validated outcome measures in non-English languages.</div></div><div><h3>Objectives</h3><div>This study aimed to provide linguistically validated French versions of four questionnaires selected for their potential relevance in assessing the psychological and perceptual dimensions of dyspnea: the Breathlessness Catastrophizing Questionnaire (BCQ), the Breathlessness Beliefs Questionnaire (BBQ), the COPD Self-Efficacy Scale (CSES), and the Three-Domain Interoceptive Sensations Questionnaire (THISQ).</div></div><div><h3>Methods</h3><div>Questionnaire selection was based on constructs likely to be modulated by psychological interventions: catastrophic thinking, maladaptive beliefs, self-efficacy, and interoception. Translation and linguistic validation followed internationally accepted forward–backward methodology, in collaboration with a specialized agency. Reconciliation was performed through iterative review by subject-matter experts until full consensus was achieved.</div></div><div><h3>Results</h3><div>French versions of all four questionnaires were successfully produced. Specific challenges arose regarding the translation of key constructs (e.g., “catastrophizing,” “belief,” “self-efficacy”), leading to the proposal of dual titling strategies to balance semantic precision and user acceptability.</div></div><div><h3>Conclusion</h3><div>These French-language instruments address a practical need for culturally and linguistically appropriate tools in the assessment of psychological dimensions of dyspnea. While developed with medical hypnosis in mind, they may prove equally valuable in research and clinical practice involving other psychological interventions. Psychometric validation in French-speaking populations is warranted.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101202"},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988546","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":"Increasing sleep apnoea burden in the elderly in Finland from 1996 to 2018: A national registry study","authors":"Hannele Hasala ,&nbsp;Tiina Mattila ,&nbsp;Hanna-Riikka Kreivi ,&nbsp;Heidi Avellan-Hietanen ,&nbsp;Tuula Vasankari ,&nbsp;Fredrik Herse ,&nbsp;Riikka-Leena Leskelä ,&nbsp;Sanna Toppila-Salmi ,&nbsp;Marina Erhola ,&nbsp;Tuija Jääskeläinen ,&nbsp;Tari Haahtela","doi":"10.1016/j.resmer.2025.101201","DOIUrl":"10.1016/j.resmer.2025.101201","url":null,"abstract":"<div><h3>Background</h3><div>In many countries, obstructive sleep apnoea is causing an increased burden on healthcare. In Finland (population 5,5 million), the diagnoses of the condition have raised 7-fold from 1996 to 2018. Here, we present register-based data on sleep apnoea in the elderly Finnish people (aged ≥ 60 years) during the 23-year period.</div></div><div><h3>Methods</h3><div>Two cohorts were explored. The first cohort included all Finns who used public health services during the 23-year period. The data was collected from the Register for Health Care, Statistics Finland. The second cohort consisted of patients treated in the respiratory outpatient clinics from 2010 to 2019 in Tampere and Helsinki University Hospitals with a population of about 1,3 million.</div></div><div><h3>Results</h3><div>In people aged 60–69 years, the diagnoses of sleep apnoea per 100 000 persons have increased 9-fold, from 0.26 % (1996) to 2.3 % (2018). In those aged ≥ 70 years, the increase has been 23-fold, from 0.06 % to 1.4 %. Obesity is a growing risk factor. During the follow up, the direct healthcare costs of sleep apnoea increased from about €1 million (1996) to nearly €16 million (2018). The cost increase was explained by the mounting outpatient care costs with CPAP-treatment (Continuous Positive Airway Pressure).</div></div><div><h3>Conclusions</h3><div>In Finland, the prevalence and costs of diagnosed sleep apnoea and CPAP treatment have been in alarming increase in the elderly. This reflects improved awareness and diagnostics, but a risk of over diagnostics and over treatment is obvious. CPAP-treatment must be better targeted to those in true need.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101201"},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911893","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":"Does size matter: Diagnostic yield and significance of small intrathoracic lymph nodes sampled on EBUS-TBNA","authors":"Lorraine Thong,&nbsp;Mohammed Mitha,&nbsp;David Breen","doi":"10.1016/j.resmer.2025.101198","DOIUrl":"10.1016/j.resmer.2025.101198","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101198"},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922255","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":"Assessment of cardiopulmonary risk in COPD patients: Expert opinion formalized using the Delphi method","authors":"Nicolas Roche ,&nbsp;Maeva Zysman ,&nbsp;Victor Aboyans ,&nbsp;Gaëtan Deslee ,&nbsp;Laurent Fauchier ,&nbsp;Serge Kownator ,&nbsp;Gilles Montalescot ,&nbsp;Christophe Pinet ,&nbsp;Bouchra Lamia ,&nbsp;Alain Cohen-Solal ,&nbsp;Respondents’ group","doi":"10.1016/j.resmer.2025.101187","DOIUrl":"10.1016/j.resmer.2025.101187","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular (CV) comorbidities are frequent in patients with chronic obstructive pulmonary disease (COPD), increasing individual morbidity and mortality. This observation has given rise to the concept of cardiopulmonary risk. However, assessment and management of CV risk in COPD patients is highly variable in practice. Cardiologists' and pulmonologists' knowledge and understanding of cardiopulmonary risk and its assessment in COPD patients, along with the management of special situations, were analyzed using the Delphi consensus methodology.</div></div><div><h3>Study Design and Methods</h3><div>A Steering Committee of ten experts (five cardiologists and five pulmonologists) developed a questionnaire covering 73 clinical situations grouped into 31 statements. This Steering Committee recommended a panel of expert respondents with clinical experience. The Delphi consensus methodology was applied in two rounds, with 74 respondents in the first round and 68 in the second. Consensus was defined as agreement or disagreement by &gt;75 % of respondents.</div></div><div><h3>Results</h3><div>The panel agreed that COPD patients face elevated CV risk independently of other risk factors. Consensus was reached on systematically assessing CV risk factors in COPD patients and the necessity for cardiological consultation and arterial imaging (coronary, supra-aortic trunks) if CV risk scores are high. The panel opposed routine Holter EKG use, but recommended both cardiological and pneumological investigations in cases of disproportionate dyspnea. Minor disagreements emerged between pulmonologists and cardiologists about abdominal aortic aneurysm screening, glycated hemoglobin testing, and specific CV assessments post COPD exacerbation.</div></div><div><h3>Interpretation</h3><div>This Delphi report summarizes expert cardiologist and pulmonologist perspectives on CV risk assessment in COPD patients, emphasizing the need for integrated management of respiratory and CV conditions. These findings demonstrate the importance of a multidisciplinary approach and suggest that while some practical aspects of CV assessment in COPD patients are the subject of clear consensus, other areas require further research to develop precise protocols.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101187"},"PeriodicalIF":1.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886205","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":"Association between neutrophil extracellular traps in bronchoalveolar lavage fluid and severity of drug-induced lung injury","authors":"Genki Inui ,&nbsp;Miki Takata ,&nbsp;Yoshihiro Funaki ,&nbsp;Aditya Sri Listyoko ,&nbsp;Miyu Nishigami ,&nbsp;Hiroyuki Tanaka ,&nbsp;Hiroki Ishikawa ,&nbsp;Hiroki Kohno ,&nbsp;Tomoya Harada ,&nbsp;Ryota Okazaki ,&nbsp;Masato Morita ,&nbsp;Akira Yamasaki","doi":"10.1016/j.resmer.2025.101195","DOIUrl":"10.1016/j.resmer.2025.101195","url":null,"abstract":"<div><h3>Background</h3><div>Neutrophil extracellular traps (NETs) play a pivotal role in early immune responses and are implicated in various respiratory diseases, such as acute respiratory distress syndrome (ARDS). A correlation between NETs in bronchoalveolar lavage fluid (BALF) and the severity of ARDS has been reported. NETs are also associated with drug-induced organ disorders. However, the relationship between drug-induced lung injury (DLI) and NETs remains unclear. This study aimed to establish and substantiate this relationship.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study. We extracted DLI cases in which BAL was performed at Tottori university hospital. Based on the need for glucocorticoid treatment, patients were classified into the “moderate severity or above” group (PaO₂ &lt; 80 mmHg) and “mild” group (PaO₂ ≧ 80 mmHg). We examined myeloperoxidase, neutrophil elastase, and double-strand-DNA levels in BALFs, and examined their association with clinical findings and severity, with non-parametric Mann-Whitney U test.</div></div><div><h3>Results</h3><div>We studied 46 patients with DLI. The “moderate severity or above” group had 32 patients, while the “mild” group had 14 patients, and NETs in BALF were significantly higher in the former group. Three cases showed a diffuse alveolar damage (DAD) pattern on high-resolution computed tomography (HRCT), with significantly higher NET levels that those with non-DAD patterns.</div></div><div><h3>Conclusion</h3><div>In DLI, NETs in BALF were found to be related with disease severity and the presence of DAD patterns in HRCT images. Measuring NETs in BALF offer potential utility in guiding future treatment selection and aiding the differential diagnosis of clinical phenotypes.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101195"},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889664","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 treatment patterns, healthcare resource utilization, and healthcare costs in patients in the United States with metastatic non-small cell cancer receiving second or subsequent line systemic anticancer therapy","authors":"Divyan Chopra ,&nbsp;Ihtisham Sultan ,&nbsp;David M. Waterhouse ,&nbsp;Alexander Lonshteyn ,&nbsp;Thomas E. Delea ,&nbsp;Björn Stollenwerk","doi":"10.1016/j.resmer.2025.101197","DOIUrl":"10.1016/j.resmer.2025.101197","url":null,"abstract":"<div><h3>Background</h3><div>This study assessed real-world treatment patterns, healthcare resource utilization, and healthcare costs in the US adults with metastatic non-small cell lung cancer (NSCLC) receiving second or later line (2L+) treatment for non-actionable alterations.</div></div><div><h3>Methods</h3><div>Adults with metastatic NSCLC who received 2L+ treatment for non-actionable alterations from January 1, 2020, to March 31, 2023, were identified using the US Optum deidentified Clinformatics® database. Patients were continuously enrolled in health plans for ≥180 days before NSCLC diagnosis until ≥30 days after receiving treatment.</div></div><div><h3>Results</h3><div>5310 patients met the inclusion criteria and received 2L+ treatments (7010). Median age was 73 years; 86% were insured by Medicare Advantage. Commonly used 2L+ treatments were mono or dual immunotherapy (IO) without chemotherapy (CT) (43.2%) and IO plus platinum-based CT (PBCT) (13.4%). Median treatment duration and time to next treatment were 3.8 months and 6.0 months respectively and were low for CT without IO. Healthcare resource utilization was mainly attributed to outpatient visits (mean: 5.09 per-patient per-month [PPPM]) and were highest for CT without IO. Patients receiving CT without IOs also had the highest rates of inpatient and emergency utilization. Mean total healthcare costs were $27,105 PPPM with hospitalization costs being highest for CT without IO.</div></div><div><h3>Conclusions</h3><div>In the treatment of 2L+ metastatic NSCLC, chemotherapy without IO was associated with poor treatment duration, high inpatient, emergency care utilization, and substantial economic burden. These results highlight the need for more efficacious, safe and cost-efficient treatment options in the 2L+ setting.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101197"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829713","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":"Diaphragm dysfunction evaluated by electroneuromyography in patients with interstitial lung disease (ILD), risks factors and impact on mortality: a retrospective observational study","authors":"Jules Milesi ,&nbsp;Sophie Ng Wing Tin ,&nbsp;Thomas Gille ,&nbsp;Hilario Nunes ,&nbsp;Simon Chauveau ,&nbsp;Carole Planès ,&nbsp;Guillaume Robbe ,&nbsp;Yurdagül Uzunhan ,&nbsp;Lucile Sesé","doi":"10.1016/j.resmer.2025.101196","DOIUrl":"10.1016/j.resmer.2025.101196","url":null,"abstract":"<div><h3>Introduction</h3><div>Diaphragmatic dysfunction (DD) plays a significant role in dyspnea, quality of life, and prognosis in various respiratory diseases. However, its characterization in Interstitial Lung Diseases (ILDs) remains limited. This study aimed to characterize ILD patients with probable DD using diaphragmatic electroneuromyography (dENMG) and analysis of the diaphragm's compound muscle action potential (CMAP), and to determine predictive factors of DD and its prognostic impact.</div></div><div><h3>Methods</h3><div>A retrospective monocentric study was conducted in our center, including all consecutive ILD patients who underwent diaphragm evaluation with ENMG between May 2018 and September 2023. Clinical data, dENMG, and other assessments were collected. Association between abnormal diaphragm’s CMAP and ILD characteristics were analyzed using logistic regression. Survival was analyzed using Kaplan-Meier curves and cox model adjusted for age and sex.</div></div><div><h3>Results</h3><div>Between May 2018 and September 2023, thirty-seven ILD patients underwent an dENMG for suspected DD. Connective Tissue Disease-associated ILD (CTD-ILD) [28 (76 %)] was the most common ILD-subtype. Thirteen (35 %) had a DD according to dENMG. Patients with DD were predominantly older males, had a higher prevalence of coronary artery disease (CAD), and had less non-specific interstitial pneumonia (NSIP) pattern compared to patients without DD. The prognosis appeared to be worse in the DD group, with reduced survival [mean 29.3 (± 17.2) <em>p</em> = 0.04 vs 31.3 months (± 18.3)].</div></div><div><h3>Discussion</h3><div>In a French referral center for ILDs, suspicion of associated DD concerned only a small proportion of ILD patients, mainly with CTD-ILD. Among those, only a third had DD suspected by a dENMG and abnormal diaphragm’s CMAP. DD appears to be associated with unfavorable outcomes, although further research with larger cohorts is warranted.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101196"},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889663","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 mechanics after endoscopic lung volume reduction: Comparison between responders and non-responders based on dynamic hyperinflation","authors":"Olivier Taton ,&nbsp;Silvia Perez-Bogerd ,&nbsp;Alain Van Muylem ,&nbsp;Pierre Alain Gevenois ,&nbsp;Olivier Van Hove ,&nbsp;Benjamin Bondue ,&nbsp;Emmeline Brenard ,&nbsp;Dimitri Leduc","doi":"10.1016/j.resmer.2025.101194","DOIUrl":"10.1016/j.resmer.2025.101194","url":null,"abstract":"<div><h3>Background</h3><div>Endobronchial lung volume reduction (ELVR) improves lung function, exercise capacity, and quality of life in case of severe emphysema. Nevertheless, not all patients are improved by ELVR including those with substantially decreased lung volume. We tested the hypothesis that unilateral volume loss could impact differently both responders and non-responders.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on 20 patients, classified as 13 responders and 7 non-responders based on inspiratory capacity increase ≥200 ml at isotime. We compared changes in lung volume, diaphragm shape and strength, mediastinal shift, lung function, exercise capacity, and quality of life before and three months after ELVR.</div></div><div><h3>Results</h3><div>Compared to non-responders, responders showed a more improved diaphragm strength (4 vs<em>.</em> 2 cmH₂O, <em>p</em> = 0.0318) and shape in both sides (non-treated side total area: +42 (7–54) cm², <em>p</em> = 0.0079, non-treated side zone of apposition: +26 (18–52) cm², <em>p</em> = 0.0270). Responders had a larger mediastinal shift than non-responders (13 vs<em>.</em> 3 degrees, <em>p</em> = 0.0039) with significant positive correlations between mediastinal shift and improvements in lung function (FEV₁: <em>r</em> = 0.48, <em>p</em> = 0.0365), exercise capacity (6MWD: <em>r</em> = 0.78, <em>p</em> &lt; 0.0001, inspiratory capacity: <em>r</em> = 0.48, <em>p</em> = 0.0365), and quality of life (CAT: <em>r</em>=-0.58, <em>p</em> = 0.0096).</div></div><div><h3>Conclusions</h3><div>Dynamic hyperinflation responders present a larger mediastinal shift than non-responders. This shift could be a marker of improved diaphragm shape and strength in both treated and non-treated sides.</div></div><div><h3>Clinical trial registration</h3><div>NCT05799352</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101194"},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767071","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}