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Addressing the inequities in interstitial lung disease care outside specialised centres in Australia 解决澳大利亚专业中心以外间质性肺病护理方面的不平等问题
IF 1.8 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-10-08 DOI: 10.1016/j.resmer.2025.101217
Gabriella Tikellis , Anne E Holland
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引用次数: 0
Assessment of cardiopulmonary risk in COPD patients: Expert opinion formalized using the Delphi method COPD患者心肺风险评估:专家意见采用德尔菲法形式化
IF 1.8 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-08-06 DOI: 10.1016/j.resmer.2025.101187
Nicolas Roche , Maeva Zysman , Victor Aboyans , Gaëtan Deslee , Laurent Fauchier , Serge Kownator , Gilles Montalescot , Christophe Pinet , Bouchra Lamia , Alain Cohen-Solal , Respondents’ group

Background

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.

Study Design and Methods

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 >75 % of respondents.

Results

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.

Interpretation

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.
背景:心血管(CV)合并症在慢性阻塞性肺疾病(COPD)患者中很常见,增加了个体发病率和死亡率。这一观察结果产生了心肺风险的概念。然而,在实践中,COPD患者心血管风险的评估和管理是高度可变的。采用德尔菲共识法分析心脏科医生和肺科医生对COPD患者心肺风险及其评估的认识和理解,以及特殊情况的处理。研究设计和方法一个由10位专家(5位心脏病专家和5位肺科专家)组成的指导委员会制定了一份调查问卷,涵盖73个临床情况,分为31个陈述。该指导委员会推荐了一个由具有临床经验的专家组成的小组。德尔菲共识方法在两轮中得到应用,第一轮74名受访者,第二轮68名受访者。75%的受访者将共识定义为同意或不同意。结果:专家组一致认为COPD患者的心血管风险升高独立于其他危险因素。对于系统评估COPD患者的心血管危险因素以及如果心血管危险评分高,进行心脏科会诊和动脉造影(冠状动脉、主动脉上干)的必要性达成了共识。该小组反对常规动态心电图,但建议在不成比例呼吸困难的病例中进行心脏学和气脏学检查。肺科医生和心脏病科医生在腹主动脉瘤筛查、糖化血红蛋白检测和COPD加重后的特定CV评估方面存在轻微分歧。德尔菲报告总结了心脏病专家和肺科专家对COPD患者心血管疾病风险评估的观点,强调了对呼吸和心血管疾病进行综合管理的必要性。这些发现证明了多学科方法的重要性,并表明虽然COPD患者CV评估的一些实际方面是明确共识的主题,但其他领域需要进一步研究以制定精确的方案。
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引用次数: 0
Anti-Mi-2 positive interstitial lung disease (ILD): A progressive disease comparable to other myositis-ILD 抗mi -2阳性间质性肺病(ILD):一种与其他肌炎相似的进行性疾病
IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-05-13 DOI: 10.1016/j.resmer.2025.101176
Bess M. Flashner , Ryosuke Imai , Andrew J. Synn , Julia K. Munchel , Lida P. Hariri , Fiona K. Gibbons , Sydney B. Montesi , Barry S. Shea , Mary B. Rice , Rene S. Bermea , Robert W. Hallowell

Background

Evaluation for interstitial lung disease (ILD) often involves sending a myositis panel that includes myositis-associated and myositis-specific antibodies (MAA and MSA respectively) such as anti-Mi-2. Little is known about anti-Mi-2 positive ILD. We sought to determine the typical presentation and prognosis of anti-Mi-2 positive ILD.

Methods

We performed a retrospective chart review of patients in two ILD referral centers in Boston, MA with a positive anti-Mi-2 antibody between 2012 and 2024. Patients were identified by query of the medical record for patients with anti-Mi-2, and we included those with ILD on chest computed tomography (CT). We conducted survival analyses for ILD progression-free and overall survival using Kaplan-Meier curves and log-rank tests. Additionally, a Cox proportional-hazards model was employed, adjusting for age, gender, baseline forced vital capacity, and immunosuppressant use to calculate hazard ratios. The comparator group included patients who were followed longitudinally in the ILD clinic who were anti-Mi-2 negative but positive for other MSAs.

Results

Fifty-eight patients were identified. Half (52 %) were female with mean age 67 years (SD 13 years). The majority had dyspnea and/or cough, and a quarter of patients required oxygen upon presentation. Six (10 %) had PM/DM that pre-dated their ILD diagnosis. Other autoantibody positivity was common; one-third-of patients (n = 19, 33 %) were positive for anti-Mi-2 alone without positivity for other MSAs or MAAs. Clinical follow up data were available for 52 patients for a median follow up of 24 months (range <1 month-10 years). PFT progression was seen in 67 % and radiologic progression was seen in over a third. Half received immunosuppression (55 %), with 19 % requiring multiple immunosuppressives. During follow up, 21 % had acute exacerbation of ILD or death. Progression-free and overall survival were not significantly different among anti-Mi-2 positive ILD versus anti-Mi-2 negative, MSA positive ILD patients regardless of anti-Mi-2 positivity alone or in combination with other autoantibodies.

Conclusions

This series of 58 patients is the largest anti-Mi-2 positive ILD cohort to date. Concurrent positivity with other autoantibodies associated with ILD was common. Anti-Mi-2 positive ILD was associated with similar outcomes to those with other MSAs. Larger studies are needed to better characterize patients with Mi-2 positive ILD.
肺间质性疾病(ILD)的诊断通常包括肌炎检查,包括肌炎相关抗体和肌炎特异性抗体(分别为MAA和MSA),如抗mi -2。对抗mi -2阳性ILD知之甚少。我们试图确定抗mi -2阳性ILD的典型表现和预后。方法:我们对2012年至2024年间在马萨诸塞州波士顿的两家ILD转诊中心抗mi -2抗体阳性的患者进行回顾性图表回顾。通过查询抗mi -2患者的医疗记录来确定患者,并在胸部计算机断层扫描(CT)上纳入ILD患者。我们使用Kaplan-Meier曲线和log-rank检验对ILD无进展和总生存率进行了生存分析。此外,采用Cox比例风险模型,调整年龄、性别、基线强制肺活量和免疫抑制剂使用来计算风险比。比较组包括在ILD诊所纵向随访的抗mi -2阴性但其他msa阳性的患者。结果共鉴定出58例患者。一半(52%)为女性,平均年龄67岁(SD 13岁)。大多数患者有呼吸困难和/或咳嗽,四分之一的患者在就诊时需要吸氧。6例(10%)在ILD诊断之前患有PM/DM。其他自身抗体阳性较为常见;三分之一的患者(n = 19, 33%)单抗mi -2阳性,而其他msa或MAAs阳性。52例患者的临床随访数据为中位随访24个月(范围1个月-10年)。67%的患者出现PFT进展,超过三分之一的患者出现放射学进展。一半接受免疫抑制(55%),19%需要多种免疫抑制剂。在随访期间,21%的患者出现ILD急性加重或死亡。抗mi -2阳性ILD患者的无进展期和总生存率与抗mi -2阴性、MSA阳性ILD患者的无进展期和总生存率无显著差异,无论单独抗mi -2阳性还是联合其他自身抗体。该58例患者是迄今为止最大的抗mi -2阳性ILD队列。与ILD相关的其他自身抗体同时呈阳性是常见的。抗- mi -2阳性ILD与其他msa相关的结果相似。需要更大规模的研究来更好地描述Mi-2阳性ILD患者。
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引用次数: 0
Anti-synthetase syndrome: A focus on interstitial lung disease as a diagnostic criteria 抗合成酶综合征:关注间质性肺疾病作为诊断标准
IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-07-09 DOI: 10.1016/j.resmer.2025.101190
Jessica A. Peterson , Caroline Cook , Hanzhi Gao , Raju Reddy , Bruno Hochhegger , Diana Gomez-Manjarres , Faye Pais

Background

Anti-synthetase syndrome (ASyS) is an autoimmune disorder with clinical manifestations that often include interstitial lung disease (ILD), myositis, and arthritis. Although it shares features with other idiopathic inflammatory myopathies, ILD is more prevalent and often more severe in this syndrome. The aim of this study was to compare Connors and Solomon diagnostic criteria for ASyS and investigated whether the presence of no additional symptoms, one additional symptom, or two or more symptoms, in addition to ILD and relevant antibodies, would indicate a worse prognosis.

Methods

This retrospective single-center study examined patients who were previously diagnosed with ASyS based on Connors or Solomon criteria and were further categorized using the 273rd ENMC International workshop criteria and post-hoc. The patients were then stratified based upon how many “defining” signs and symptoms that they had in addition to ILD and antibodies. Demographic characteristics, pulmonary function tests (PFT), chest CT’s—along with clinical outcomes were assessed.

Results

No differences in demographic factors and PFT’s were found between those who were diagnosed using Solomons versus Connors criteria. No differences in demographic, PFT’s and chest CT’s between those with ILD and antibodies only, with 1 additional criteria, and with 2+ additional criteria groups, although those with two or more additional criteria had a longer duration since diagnosis.

Discussion

Key findings from the study suggest that there are no differences in diagnostic outcomes, therapeutic interventions, or mortality rates when using different criteria to diagnose ASyS. This study suggests a reevaluation of diagnostic criteria for ASyS to prioritize ILD and relevant antibodies rather than a focus of additional criteria, supporting the new ASyS defining criteria from 273rd ENMC International Workshop (2024).
抗合成酶综合征(ASyS)是一种自身免疫性疾病,临床表现通常包括间质性肺疾病(ILD)、肌炎和关节炎。虽然它与其他特发性炎症性肌病具有相同的特征,但ILD在该综合征中更为普遍且往往更为严重。本研究的目的是比较Connors和Solomon对ASyS的诊断标准,并研究除了ILD和相关抗体外,是否存在无附加症状、一种附加症状、或两种或两种以上症状表明预后较差。方法本回顾性单中心研究检查了先前根据Connors或Solomon标准诊断为ASyS的患者,并使用第273届ENMC国际研讨会标准和事后标准进一步分类。然后根据患者除了ILD和抗体外还有多少“定义性”体征和症状对患者进行分层。评估人口统计学特征、肺功能检查(PFT)、胸部CT以及临床结果。结果采用Solomons和Connors诊断标准的患者在人口学因素和PFT方面没有差异。在ILD和抗体组、附加1个标准组和附加2+标准组之间,在人口统计学、PFT和胸部CT上没有差异,尽管附加2个或更多标准的患者自诊断以来持续时间更长。本研究的主要发现表明,当使用不同的诊断标准诊断ASyS时,在诊断结果、治疗干预或死亡率方面没有差异。本研究建议重新评估ASyS的诊断标准,优先考虑ILD和相关抗体,而不是关注额外的标准,支持第273届ENMC国际研讨会(2024)的新ASyS定义标准。
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引用次数: 0
Does occupational exposure affect the surgical management of patients with non-small cell lung cancer? A single-center retrospective experience 职业暴露会影响非小细胞肺癌患者的手术治疗吗?单中心回顾性研究
IF 2.2 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-06-04 DOI: 10.1016/j.resmer.2025.101183
Matthieu Thumerel , Camille Carles , Hugues Begueret , Quentin Thomas , Jacques Jougon , Carine Audoin , Jean-François Bernaudin , Patrick Brochard , Yaniss Belaroussi

Objective

Non-small-cell lung cancer (NSCLC) remains a major public health concern, with tobacco and environmental exposures to carcinogens (such as asbestos, radon, and silica) recognized as major risk factors. This study investigates the impact of occupational exposure, particularly to crystalline silica on peri‑ and postoperative outcomes in patients undergoing surgery for NSCLC.

Methods

A retrospective analysis was performed on 251 patients who underwent lobectomy or segmentectomy between 2018 and 2021, with occupational exposure data collected postoperatively.

Results

Our findings suggest that patients with occupational exposure, particularly to silica, asbestos, or multiple carcinogens, have more complex surgical courses, including longer operative times, higher rates of conversion from minimally invasive to open surgery, and increased postoperative complications (Clavien-Dindo grade II or higher). Preoperative lymph node staging was less accurate in exposed patients, in part because of inflammatory changes such as fibro-hyaline lesions, which can cause false-positive PET/CT findings.

Conclusions

The study highlights the need for tailored surgical strategies and accurate lymph node staging in exposed individuals. Future research should focus on prospective studies to refine perioperative management and explore the biological mechanisms driving these complications.
非小细胞肺癌(NSCLC)仍然是一个主要的公共卫生问题,烟草和环境暴露于致癌物(如石棉、氡和二氧化硅)被认为是主要的危险因素。本研究调查了职业暴露,特别是结晶二氧化硅对非小细胞肺癌手术患者围手术期和术后预后的影响。方法回顾性分析2018年至2021年251例肺叶或节段切除术患者,并收集术后职业暴露数据。结果我们的研究结果表明,职业性暴露的患者,特别是接触二氧化硅、石棉或多种致癌物的患者,手术过程更复杂,包括手术时间更长,从微创到开放手术的转换率更高,术后并发症增加(Clavien-Dindo II级或更高)。暴露患者的术前淋巴结分期不太准确,部分原因是炎症改变,如纤维透明病变,可能导致PET/CT结果假阳性。结论该研究强调了在暴露个体中需要量身定制的手术策略和准确的淋巴结分期。未来的研究应侧重于前瞻性研究,以完善围手术期管理,并探索导致这些并发症的生物学机制。
{"title":"Does occupational exposure affect the surgical management of patients with non-small cell lung cancer? A single-center retrospective experience","authors":"Matthieu Thumerel ,&nbsp;Camille Carles ,&nbsp;Hugues Begueret ,&nbsp;Quentin Thomas ,&nbsp;Jacques Jougon ,&nbsp;Carine Audoin ,&nbsp;Jean-François Bernaudin ,&nbsp;Patrick Brochard ,&nbsp;Yaniss Belaroussi","doi":"10.1016/j.resmer.2025.101183","DOIUrl":"10.1016/j.resmer.2025.101183","url":null,"abstract":"<div><h3>Objective</h3><div>Non-small-cell lung cancer (NSCLC) remains a major public health concern, with tobacco and environmental exposures to carcinogens (such as asbestos, radon, and silica) recognized as major risk factors. This study investigates the impact of occupational exposure, particularly to crystalline silica on peri‑ and postoperative outcomes in patients undergoing surgery for NSCLC.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on 251 patients who underwent lobectomy or segmentectomy between 2018 and 2021, with occupational exposure data collected postoperatively.</div></div><div><h3>Results</h3><div>Our findings suggest that patients with occupational exposure, particularly to silica, asbestos, or multiple carcinogens, have more complex surgical courses, including longer operative times, higher rates of conversion from minimally invasive to open surgery, and increased postoperative complications (Clavien-Dindo grade II or higher). Preoperative lymph node staging was less accurate in exposed patients, in part because of inflammatory changes such as fibro-hyaline lesions, which can cause false-positive PET/CT findings.</div></div><div><h3>Conclusions</h3><div>The study highlights the need for tailored surgical strategies and accurate lymph node staging in exposed individuals. Future research should focus on prospective studies to refine perioperative management and explore the biological mechanisms driving these complications.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101183"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510771","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}
引用次数: 0
Does size matter: Diagnostic yield and significance of small intrathoracic lymph nodes sampled on EBUS-TBNA 大小重要吗? EBUS-TBNA胸内小淋巴结的诊断率和意义
IF 1.8 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-08-15 DOI: 10.1016/j.resmer.2025.101198
Lorraine Thong, Mohammed Mitha, David Breen
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引用次数: 0
Classification of systemic lupus erythematosus in patients with interstitial pneumonia with autoimmune features using two different sets of criteria 两套不同标准对具有自身免疫特征的间质性肺炎患者系统性红斑狼疮的分类
IF 1.8 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-09-17 DOI: 10.1016/j.resmer.2025.101206
Gabriela Martinez-Zayas , David Karp , Traci N. Adams , Elena K. Joerns

Objective

Interstitial pneumonia with autoimmune features (IPAF) describes patients with interstitial lung disease and autoimmunity who do not meet classification criteria for a systemic autoimmune rheumatic disease, including systemic lupus erythematosus (SLE). We aimed to determine whether the criteria developed by the European Alliance of Association of Rheumatology and American College of Rheumatology (EULAR/ACR) would classify more patients with IPAF as SLE, than those developed by the Systemic Lupus International Collaborating Clinics (SLICC). Increasing the recognition of SLE among patients with IPAF may affect therapy.

Methods

This observational, retrospective, single-center cohort study included consecutive patients initially classified as having IPAF between December 2005-August 2019. We reviewed patients’ charts to assess whether more patients met SLE criteria by SLICC or EULAR/ACR methodology. Fisher’s exact test assessed the significance of the difference in the proportion of patients classified by the two criteria.

Results

We included 201 patients initially classified as IPAF. Twelve were identified as SLE by SLICC criteria and 23 by EULAR/ACR criteria. All but three patients with lymphopenia who met SLE criteria by SLICC also met it by EULAR/ACR. The difference in the proportion of IPAF patients meeting SLE criteria by the two methods was statistically significant (p < 0.001).

Conclusions

Patients with IPAF were classified as SLE more frequently using EULAR/ACR criteria than by SLICC criteria. The EULAR/ACR criteria may be superior for SLE classification in patients with ILD. Patients with IPAF and SLE features should undergo full work-up to evaluate for SLE classification as it may affect therapy.
目的:具有自身免疫性特征的间质性肺炎(IPAF)描述了不符合系统性自身免疫性风湿病(包括系统性红斑狼疮(SLE))分类标准的间质性肺疾病和自身免疫患者。我们的目的是确定由欧洲风湿病协会联盟和美国风湿病学会(EULAR/ACR)制定的标准是否会比由系统性狼疮国际合作诊所(SLICC)制定的标准将更多的IPAF患者分类为SLE。提高IPAF患者对SLE的认识可能会影响治疗。方法:这项观察性、回顾性、单中心队列研究纳入了2005年12月至2019年8月期间最初被分类为IPAF的连续患者。我们回顾了患者的图表,以评估是否有更多的患者符合SLICC或EULAR/ACR方法的SLE标准。Fisher的精确检验评估了按两种标准分类的患者比例差异的显著性。结果:我们纳入了201例初始分类为IPAF的患者。12例根据SLICC标准确诊为SLE, 23例根据EULAR/ACR标准确诊为SLE。除3例淋巴细胞减少患者外,所有通过SLICC达到SLE标准的患者也通过EULAR/ACR达到SLE标准。两种方法IPAF患者符合SLE标准的比例差异有统计学意义(p < 0.001)。结论:与SLICC标准相比,EULAR/ACR标准更频繁地将IPAF患者分类为SLE。对于ILD患者的SLE分类,EULAR/ACR标准可能更优。具有IPAF和SLE特征的患者应进行全面检查以评估SLE的分类,因为它可能影响治疗。
{"title":"Classification of systemic lupus erythematosus in patients with interstitial pneumonia with autoimmune features using two different sets of criteria","authors":"Gabriela Martinez-Zayas ,&nbsp;David Karp ,&nbsp;Traci N. Adams ,&nbsp;Elena K. Joerns","doi":"10.1016/j.resmer.2025.101206","DOIUrl":"10.1016/j.resmer.2025.101206","url":null,"abstract":"<div><h3>Objective</h3><div>Interstitial pneumonia with autoimmune features (IPAF) describes patients with interstitial lung disease and autoimmunity who do not meet classification criteria for a systemic autoimmune rheumatic disease, including systemic lupus erythematosus (SLE). We aimed to determine whether the criteria developed by the European Alliance of Association of Rheumatology and American College of Rheumatology (EULAR/ACR) would classify more patients with IPAF as SLE, than those developed by the Systemic Lupus International Collaborating Clinics (SLICC). Increasing the recognition of SLE among patients with IPAF may affect therapy.</div></div><div><h3>Methods</h3><div>This observational, retrospective, single-center cohort study included consecutive patients initially classified as having IPAF between December 2005-August 2019. We reviewed patients’ charts to assess whether more patients met SLE criteria by SLICC or EULAR/ACR methodology. Fisher’s exact test assessed the significance of the difference in the proportion of patients classified by the two criteria.</div></div><div><h3>Results</h3><div>We included 201 patients initially classified as IPAF. Twelve were identified as SLE by SLICC criteria and 23 by EULAR/ACR criteria. All but three patients with lymphopenia who met SLE criteria by SLICC also met it by EULAR/ACR. The difference in the proportion of IPAF patients meeting SLE criteria by the two methods was statistically significant (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Patients with IPAF were classified as SLE more frequently using EULAR/ACR criteria than by SLICC criteria. The EULAR/ACR criteria may be superior for SLE classification in patients with ILD. Patients with IPAF and SLE features should undergo full work-up to evaluate for SLE classification as it may affect therapy.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101206"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245547","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}
引用次数: 0
Bronchiectasis in France: data on disease characteristics in 630 patients from the European Bronchiectasis registry (EMBARC) 法国支气管扩张:来自欧洲支气管扩张登记(EMBARC) 630例患者的疾病特征数据
IF 1.8 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-08-27 DOI: 10.1016/j.resmer.2025.101199
Pierre-Régis Burgel , Anne Bergeron , Bernard Maitre , Claire Andrejak , Cristina Audoly , Jean-François Boitiaux , Boubou Camara , Nathalie Coolen-Allou , Benoit Douvry , Gérard Chatté , Annlyse Fanton , Sylvie Leroy , Clémence Martin , Karine Michaux , Annabelle Payet , Hervé Pegliasco , Frédéric Schlemmer , Guillaume Vignal , Agnès Duchange , Espérie Burnet , Marlène Murris-Espin

Background

Little is known about the characteristics of adults with bronchiectasis in France.

Methods

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.

Results

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 (n = 455); including 157 (34.5 %) positive for Pseudomonas aeruginosa 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.

Conclusion

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.
背景:在法国,人们对成人支气管扩张的特点知之甚少。方法采用一项描述性横断面研究,对18个参与研究的中心中诊断为呼吸道症状和CT扫描结果相结合的具有临床意义的支气管扩张的成人(≥18岁)的特征进行描述。收集了病因学、肺功能、症状、微生物学、治疗和生活质量等方面的数据。结果2016年1月至2022年7月共纳入成人630人(女性66%,55岁以上73.8%)。特发性病因和感染后病因分别占33.0%和37.1%;COPD和哮喘分别在15.6%和23.6%的受试者中存在,分别只有3.8%和2.9%的受试者被认为是支气管扩张的原因。只有25%的肺活量正常,7.3%需要长期氧疗。78.1%的患者存在每日咳痰,29.0%的患者经修订的医学研究委员会(mMRC)呼吸困难评分≥2。痰液标本细菌培养阳性率为77.8% (n = 455);其中157例(34.5%)在过去一年感染铜绿假单胞菌。在研究开始前的一年中,75.4%的患者报告至少一次呼吸恶化,33.8%的患者至少住院一次,24.5%的患者接受门诊肠外抗菌药物治疗(OPAT)。支气管扩张严重程度指数分别为26.0%、36.4%、37.6%为轻、中、重度。结论在法国,成人支气管扩张患者有显著的疾病负担。呼吸恶化是医疗保健利用的原因,其预防可能需要专门的多学科护理和开发新的治疗干预措施。
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引用次数: 0
Impact of Remdesivir on long-term outcomes in lung transplant recipients with SARS-CoV-2 infection: a retrospective cohort analysis. 瑞德西韦对SARS-CoV-2感染肺移植受者长期预后的影响:回顾性队列分析
IF 1.8 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-07-19 DOI: 10.1016/j.resmer.2025.101192
Damiana-Maria Vulturar, Gaëlle Dauriat, Anne Gigandon, Pauline Pradère, Pierre Gazengel, Samuel Dolidon, Chahine Medraoui, Amir Hanna, Adrian Crutu, Liviu-Stefan Moaca, Laurène Cachera, Delphine Mitilian, Dominique Fabre, Elie Fadel, Olaf Mercier, Alban Le Monnier, Jérôme Le Pavec, Benoît Pilmis

Background: The COVID-19 pandemic has presented considerable challenges for lung transplant (LTx) recipients, a population inherently at high risk for severe complications. Although early data from the pandemic indicated worrisome outcomes for these patients, understanding the current context of SARS-CoV-2 infections is essential to inform ongoing management strategies. The efficacy of anti-viral treatments, including Remdesivir (RDV), remains uncertain. This study aims to evaluate the effect of RDV on clinical outcomes in LTx recipients infected with SARS CoV-2, primarily those with a clinically significant disease course.

Methods: A single-center retrospective cohort study was conducted, including LTx recipients with confirmed SARS-CoV-2 infection diagnosed between January 2022 and December 2023. Patients were classified as treated with RDV if they received at least three consecutive days of therapy, typically initiated in the context of symptomatic infection with increased oxygen requirements (RDV group). The primary outcome was all-cause mortality. Secondary outcomes were ICU admission, longitudinal changes in lung function, at 3-, 6-, and 12-months post-infection, incidence of COVID-19-associated pulmonary aspergillosis (CAPA) and bacterial co-infections. A multivariable logistic regression model was used to control for cofounding factors.

Results: Among the 130 LTx infected with SARS CoV-2, 61% (80/130) received at least 3 days of RDV. All cause of mortality was lower in the RDV group (4% 2/50) compared to the non-RDV group (15%, 12/80) (p= 0.05). Non-RDV group experienced a significant decline in forced expiratory volume in 1 second (FEV1) at 3 months post-infection compared to those in the RDV group (6% vs 3%, p = 0.04). ICU admission rates, bacterial coinfection, and CAPA were similar between groups.

Conclusion: RDV treatment appears to improve survival and may mitigate the long-term deterioration of lung function in lung transplant recipients infected with SARS CoV-2. These findings underscore the potential of RDV as a beneficial therapy in this high-risk population and highlight the need for further investigation in larger studies.

背景:COVID-19大流行给肺移植(LTx)受者带来了相当大的挑战,这一人群本身就是严重并发症的高风险人群。尽管大流行的早期数据表明这些患者的结局令人担忧,但了解SARS-CoV-2感染的当前背景对于为持续的管理策略提供信息至关重要。包括Remdesivir (RDV)在内的抗病毒治疗的疗效仍不确定。本研究旨在评估RDV对SARS CoV-2感染LTx受体临床结局的影响,主要是那些有临床显著病程的患者。方法:采用单中心回顾性队列研究,纳入2022年1月至2023年12月诊断为确诊的SARS-CoV-2感染的LTx接受者。如果患者接受了至少连续三天的治疗,通常是在有症状的感染和氧气需求增加的情况下开始的(RDV组),则将其归类为RDV治疗。主要结局为全因死亡率。次要结局是ICU住院情况、感染后3、6、12个月肺功能的纵向变化、covid -19相关肺曲霉病(CAPA)和细菌合并感染的发生率。采用多变量logistic回归模型控制共同影响因素。结果:在感染SARS CoV-2的130例LTx中,61%(80/130)接受了至少3 d的RDV。RDV组的全因死亡率(4% 2/50)低于非RDV组(15%,12/80)(p= 0.05)。与RDV组相比,非RDV组在感染后3个月的1秒用力呼气量(FEV1)显著下降(6%对3%,p = 0.04)。ICU住院率、细菌合并感染及CAPA组间比较相似。结论:RDV治疗可提高SARS CoV-2感染肺移植受者的生存率,并可能减轻肺功能的长期恶化。这些发现强调了RDV在这一高危人群中作为一种有益疗法的潜力,并强调了在更大规模研究中进一步调查的必要性。
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引用次数: 0
Acute hemodynamic response to inhaled treprostinil in pulmonary hypertension associated with interstitial lung disease: a case highlighting unresolved questions 肺高血压合并间质性肺疾病患者吸入曲前列替尼的急性血流动力学反应:一个突出未解决问题的病例
IF 1.8 4区 医学 Q3 RESPIRATORY SYSTEM Pub Date : 2025-11-01 Epub Date: 2025-09-25 DOI: 10.1016/j.resmer.2025.101210
Marianne Riou , Matthieu Canuet , Sandrine Hirschi , Ségolène Turquier , David Montani
{"title":"Acute hemodynamic response to inhaled treprostinil in pulmonary hypertension associated with interstitial lung disease: a case highlighting unresolved questions","authors":"Marianne Riou ,&nbsp;Matthieu Canuet ,&nbsp;Sandrine Hirschi ,&nbsp;Ségolène Turquier ,&nbsp;David Montani","doi":"10.1016/j.resmer.2025.101210","DOIUrl":"10.1016/j.resmer.2025.101210","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101210"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265263","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}
引用次数: 0
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Respiratory Medicine and Research
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