Respiratory Medicine and Research最新文献_第7页

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

Respiratory Medicine and Research

Pub 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

Emerging respiratory challenges in space and long-duration missions 太空和长时间任务中新出现的呼吸挑战

IF 2.2 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-07-01 DOI: 10.1016/j.resmer.2025.101188

Benjamin Pequignot , Seamus Thierry , G Kim Prisk , Mickael Lescroart

引用次数: 0

Use of complementary medicines and self-medication practices in cystic fibrosis – MUCAUTOMED study 囊性纤维化患者补充药物和自我药疗的应用MUCAUTOMED研究

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-06-16 DOI: 10.1016/j.resmer.2025.101186

Sophie Lemagner , Isabelle Récoché , Frédéric Eyvrard , Remy Chambault , Marie Mittaine , Marlène Murris

Background

Cystic fibrosis (CF) patients often undergo treatment with CFTR modulators, which have demonstrated high efficacy but also potential involvement in drug interactions. Inquiries regarding the risks of drug interactions with complementary and alternative medicine products (CAMp) and self-medication drugs have become frequent among patients and prescribers at Toulouse University Hospital. Currently, there is lack of literature on these practices within CF patients, particularly in France, and more so since the advent of CFTR modulators.

Methods

This observational monocentric study (MUCAUTOMED) aimed to characterize and quantify the prevalence of CAMp utilization among CF patients under our hospital's care. A secondary objective was to assess and describe the prevalence of self-medication practices. Surveys were administered to outpatients during visits from January 10 to June 6, 2022.

Results

Out of 171 included patients, responses from 64 adults and 69 children were analyzed (response rate 133/171 = 77.8 %). CAMp usage was reported by 56.3 % of adults and 46.4 % of children. Most patients use CAMp for enhancing wellness, addressing digestive concerns, and managing respiratory issues. Remarkably, 71.4 % of participants were unaware of potential drug interactions with CAMp, and 48.9 % initiated such use without consulting healthcare professionals. Notably, a significant correlation between CAMp utilization and self-medication was identified within the pediatric population.

Conclusion

Our investigation underscores a notably high prevalence of CAMp use among the CF population. Given these findings, it is imperative to routinely discuss CAMp utilization and self-medication practices when initiating CFTR modulator therapy. A multidisciplinary approach is recommended to address potential interactions that may impact overdosing and underdosing, ensuring patients and families are informed of associated risks.

Registration number 2021-A02593-38.

囊性纤维化（CF）患者通常接受CFTR调节剂治疗，CFTR调节剂已证明具有较高的疗效，但也可能涉及药物相互作用。图卢兹大学医院的病人和处方者经常询问药物与补充和替代药物产品（CAMp）和自我药疗药物相互作用的风险。目前，在CF患者中缺乏这些实践的文献，特别是在法国，自CFTR调节剂出现以来更是如此。方法本观察性单中心研究（MUCAUTOMED）旨在描述和量化我院CF患者CAMp使用率。第二个目的是评估和描述自我药疗实践的流行程度。对2022年1月10日至6月6日就诊的门诊患者进行调查。结果在171例纳入的患者中，分析了64例成人和69例儿童的反应（有效率133/171 = 77.8%）。56.3%的成年人和46.4%的儿童使用CAMp。大多数患者使用CAMp来增强健康，解决消化问题和管理呼吸问题。值得注意的是，71.4%的参与者不知道潜在的药物与CAMp的相互作用，48.9%的人在没有咨询医疗保健专业人员的情况下开始使用CAMp。值得注意的是，在儿科人群中发现了CAMp使用与自我用药之间的显著相关性。结论：我们的调查强调了CF人群中CAMp使用的显著高流行率。鉴于这些发现，在开始CFTR调节剂治疗时，常规讨论CAMp的使用和自我用药实践是必要的。建议采用多学科方法来解决可能影响过量和剂量不足的潜在相互作用，确保患者和家属了解相关风险。注册号2021-A02593-38。

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引用次数: 0

Use of hemi-cannula in patients with high risk of recannulation in an intermediate respiratory care unit. A descriptive analysis and study of the predictor variables of the use of posterior non-invasive mechanical ventilation 半套管在中级呼吸护理病房中再插管高风险患者中的应用。后路无创机械通气使用预测变量的描述性分析与研究

IF 2.2 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-06-09 DOI: 10.1016/j.resmer.2025.101185

Sergio Lopez-Ruz, Alba Fernández-Boza, Maria Andrea Jaimes-Castaño, Carlos Carrera-Cueva, Belen Muñoz-Sánchez, Emilio Garcia-Díaz, Demetrio González-Vergara, Javier Toral-Marin, Maria Barca-Hernando

Background

Information about the decannulation process in patients with high risk of recannulation is limited. However, devices such as the hemi-cannula, which maintain airway permeability for a controlled period, may enhance the safety of this process.

Aims

Describe and analyze the variables in the decannulation process of patients with high risk of recannulation, who have used a hemi-cannula and correlate these variables with the posterior need for Non-Invasive Mechanical Ventilation (NIMV).

Methods

Unicentric study analyzing a retrospective cohort of consecutive patients admitted to the Intermediate Respiratory Care Unit (IRCU) to continue the decannulation process from April 2022 to April 2024. Sociodemographic and clinical variables were described and analyzed. SPSS software was used to analyze the data with T student for independent data and Chi-square with Fischer correction.

Results

The final cohort included 19 patients, whom most of them had no previous respiratory pathology, but a 47.4 % had some cardiovascular risk factors. All of the patients had polyneuropathy at the admission to the IRCU. No 30-day mortality was observed in any patient. The recannulation rate was 10.5 %. 21 % of the patients required subsequent NIMV. Statistical significance at the analysis of the correlation between the mean number of days of Invasive Mechanical Ventilation (IMV) and the need for subsequent NIMV was found. However, there was not with the remaining variables.

Conclusions

The use of devices such as the hemi-cannula can enhance safety during the complex decannulation process in patients with high risk of recannulation, reducing the likelihood of reintubation or readmission to the Intensive Care Unit (ICU).

背景：关于高危再循环患者的去管过程的信息是有限的。然而，像半插管这样的设备，可以在一段可控的时间内保持气道渗透性，可以提高这一过程的安全性。目的描述和分析使用半插管的高危患者再插管过程中的变量，并将这些变量与后路无创机械通气（NIMV）的需求联系起来。方法对2022年4月至2024年4月期间连续入住中级呼吸护理病房（IRCU）继续行脱脉术的患者进行回顾性队列研究。对社会人口学和临床变量进行描述和分析。采用SPSS软件对数据进行分析，独立数据采用T student，卡方采用Fischer校正。结果最终纳入19例患者，大多数患者既往无呼吸系统病变，但47.4%的患者有心血管危险因素。所有患者在IRCU入院时均有多发性神经病变。无患者30天死亡。再循环率为10.5%。21%的患者需要后续NIMV。有创机械通气（IMV）平均天数与后续需行NIMV的相关性分析有统计学意义。然而，与其他变量没有关系。结论半套管等装置的使用可提高再插管高危患者复杂的脱管过程中的安全性，降低再插管或再次入住重症监护病房（ICU）的可能性。

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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

Respiratory Medicine and Research

Pub 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。

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引用次数: 0

Should segmentectomy indications be extended to NSCLC smaller than 3 cm without lymph node involvement? A retrospective single-center study 节段切除适应症是否应扩展到小于3cm且未累及淋巴结的非小细胞肺癌？回顾性单中心研究

IF 2.2 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-05-29 DOI: 10.1016/j.resmer.2025.101179

Damien Leveque , Soufiane Lebal , Tristan Goudou , Mihaela Giol , Denis Debrosse , Marielle LE Roux , Thérésa Khalife-Hocquemiller , Anna Vayssette , Juliette Camuset , Alexandra Rousseau , Jalal Assouad , Harry Etienne

Introduction

Surgical resection remains the standard treatment for stage IA non-small cell lung cancers (NSCLC). The dual objective of this study is to compare long-term outcomes of lobectomies and segmentectomies for stage IA NSCLC and to identify prognostic factors for resected stage IA NSCLC.

Materials and Methods

This is a retrospective monocentric study including patients diagnosed with NSCLC smaller than 3 cm, without lymph node involvement, from November 2015 to November 2021. The primary endpoint was event-free survival (EFS), defined as time from surgery to recurrence or all-cause death. Secondary endpoints included overall survival, recurrence-free survival, and short-term postoperative outcomes (length of stay, drainage duration, 30-day mortality, and postoperative complications). Prognostic factors were analyzed using multivariate Cox regression adjusted for variables identified in univariate analysis.

Results

A total of 457 patients underwent surgery for stage cIA NSCLC during the 11study period. Of these, 176 (38.5 %) had a segmentectomy, and 281 (61.5 %) underwent lobectomy. Among patients with cT1N0 tumors, the 5-year event-free survival did not significantly differ between the segmentectomy and lobectomy groups (adjusted HR = 0.59 (0.32; 1.08), p = 0.086), with 5-year event-free rates of 75.0 % and 83.0 %, respectively (p = 0.054). Multivariate analysis revealed an association between nodule type (solid vs. ground-glass or mixed) and event-free survival (death and/or recurrence) ([adjusted HR =2.07 (1.17–3.66), p = 0.01)]. Vascular and/or lymphatic invasion is associated with a decrease in event-free survival (recurrence or death) [adjusted HR = 2.25 (1.29; 3.92), p = 0.004]. Conversion from segmentectomy to lobectomy occurred in 6 patients (3.4 %), and they were included in the lobectomy group for analysis.

Conclusion

For patients with clinical stage cIA NSCLC, segmentectomy appears to offer comparable oncologic outcomes to lobectomy. Tumor characteristics, including radiological appearance and histological factors, should be carefully considered when selecting the appropriate surgical strategy. Prospective multicenter studies are needed to confirm these findings.

手术切除仍然是IA期非小细胞肺癌（NSCLC）的标准治疗方法。本研究的双重目的是比较IA期非小细胞肺癌肺叶切除术和节段切除术的长期预后，并确定切除的IA期非小细胞肺癌的预后因素。材料和方法这是一项回顾性单中心研究，包括2015年11月至2021年11月诊断为小于3cm的非小细胞肺癌，无淋巴结累及的患者。主要终点为无事件生存期（EFS），定义为从手术到复发或全因死亡的时间。次要终点包括总生存期、无复发生存期和短期术后结局（住院时间、引流时间、30天死亡率和术后并发症）。预后因素采用多因素Cox回归分析，对单因素分析中确定的变量进行校正。结果在11个研究期间，共有457例患者接受了cIA期NSCLC手术治疗。其中，176例（38.5%）行节段切除术，281例（61.5%）行肺叶切除术。在cT1N0肿瘤患者中，节段切除术组和肺叶切除术组的5年无事件生存率无显著差异(调整后HR = 0.59 (0.32；1.08), p = 0.086)， 5年无事件率分别为75.0%和83.0% （p = 0.054）。多因素分析显示，结节类型（实性、磨玻璃性或混合性）与无事件生存率（死亡和/或复发）之间存在相关性（调整后风险比=2.07 (1.17-3.66),p = 0.01）。血管和/或淋巴浸润与无事件生存率（复发或死亡）降低相关[调整后风险比= 2.25 (1.29；3.92), p = 0.004]。从节段切除术转为肺叶切除术的患者有6例（3.4%），并纳入肺叶切除术组进行分析。结论对于临床分期为cIA期的非小细胞肺癌患者，节段切除术似乎与肺叶切除术具有相当的肿瘤预后。在选择合适的手术策略时，应仔细考虑肿瘤的特征，包括影像学表现和组织学因素。需要前瞻性多中心研究来证实这些发现。

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引用次数: 0

Early mobilization and functional outcomes in cystic fibrosis patients after lung transplantation: A single-center retrospective study 肺移植后囊性纤维化患者的早期活动和功能结局：一项单中心回顾性研究

IF 2.2 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-05-29 DOI: 10.1016/j.resmer.2025.101184

Matthieu Reffienna , Jeremy Roussel , Gabor Kalman , Mathilde Labro , Charles Cerf , François Parquin

Background

Rehabilitation has been shown to enhance patient performance before and after lung transplantation, but limited data exist on its role during the immediate post-transplant phase in critical care units.

Methods

We conducted a single-center retrospective study. All adult patients who underwent bilateral transplantation for cystic fibrosis were included. Patients were followed from admission to discharge from critical care. All rehabilitation sessions were recorded. We aimed to evaluate the relationship between the amount of mobilization performed by the patient in critical care, and functional performance at discharge.

Results

We included 36 patients (21 males) with a median age of 29 years (IQR: 24.5–35.0) and a median critical care length of stay of 15 days (12.5–20). Patients performed a total of 388 sessions of rehabilitation. Out-of-bed mobilization started at a median of post-operative day 2.5 (IQR: 1.0–4.5), with the first walking session at day 3 (IQR: 2.0–4.5). A strong correlation was found between daily walking distance and functional performance, as measured by the 6-minute walk test, with a Pearson correlation coefficient of 0.70 (95 % CI: 0.48–0.84).

Conclusions

After lung transplantation for cystic fibrosis, early initiated rehabilitation in critical care is feasible and can improve patients' functional performance. These findings are promising, but require validation in other lung transplant populations.

康复已被证明可以提高患者在肺移植前后的表现，但关于其在重症监护病房移植后立即阶段的作用的数据有限。方法采用单中心回顾性研究。所有因囊性纤维化而接受双侧移植的成年患者均被纳入研究。随访患者从入院到出院。所有的康复疗程都被记录下来。我们的目的是评估重症监护患者的活动量与出院时的功能表现之间的关系。结果纳入36例患者（男性21例），中位年龄29岁（IQR: 24.5-35.0），中位重症监护住院时间15天（12.5-20）。患者总共进行了388次康复治疗。术后中位2.5天开始床下活动（IQR: 1.0-4.5），第3天开始第一次行走（IQR: 2.0-4.5）。通过6分钟步行测试，发现每日步行距离与功能表现之间存在很强的相关性，Pearson相关系数为0.70 （95% CI: 0.48-0.84）。结论囊性纤维化肺移植术后危重监护早期康复是可行的，可提高患者的功能表现。这些发现很有希望，但需要在其他肺移植人群中进行验证。

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引用次数: 0

Endobronchial valve (EBV) insertion for severe emphysema does not improve skeletal muscle mass or function: A pilot study on 19 patients 支气管内瓣膜（EBV）插入治疗严重肺气肿不能改善骨骼肌质量或功能：一项19例患者的初步研究

IF 2.2 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-05-22 DOI: 10.1016/j.resmer.2025.101178

Julia Rubenstein , Ilyès Benlala , Emilie Mesa , Anne-Claire Toublanc , Marina Gueçamburu , Arnaud Maurac , Claire Bon , Charlotte Vergnenegre , Léo Grassion , Geoffroy Moucheboeuf , Patrick Dehail , Gaël Dournes , Maéva Zysman , Pauline Henrot

Endobronchial valve (EBV) insertion for severe emphysema allows to reduce hyperinflation and alleviates respiratory symptoms in patients with chronic obstructive pulmonary disease (COPD). However, few studies investigate its effect on extra-pulmonary manifestations. We sought to assess the effect of EBV insertion on skeletal muscle mass and function, as well as determine if skeletal muscle parameters could represent a prognostic factor for response to EBV insertion.

We conducted a monocentric prospective pilot study including 19 patients. Exhaustive evaluation of lung & skeletal muscle parameters was performed at baseline and 3 and 6 months after EBV insertion. Our primary aim was to assess the 6-month change in skeletal muscle parameters i.e. assessment of body composition with bioimpedance analysis (appendicular skeletal muscle mass index, fat mass, phase angle), evaluation of thoracic muscles (pectoralis, erector spinal, 5th intercostalis, psoas) surfaces and densities on CT-scans, and of upper limb force with handgrip test.

EBV insertion led to a significant improvement of lung function after 3 months and persisting at 6 months. In contrast, no significant improvement was observed in skeletal muscle parameters. In addition, no muscle parameter nor sarcopenic status was found to predict response to EBV insertion.

These results suggest that EBV insertion is not associated with strong systemic effects in our study, as well as emphasize the need to find bottom-up drug strategies for COPD-associated sarcopenia.

支气管内瓣膜（EBV）插入治疗严重肺气肿可以减少慢性阻塞性肺疾病（COPD）患者的恶性膨胀并缓解呼吸道症状。然而，很少有研究探讨其对肺外表现的影响。我们试图评估EBV插入对骨骼肌质量和功能的影响，并确定骨骼肌参数是否可以代表EBV插入反应的预后因素。我们进行了一项包括19名患者的单中心前瞻性先导研究。肺的详尽评估；骨骼肌参数在基线和EBV植入后3个月和6个月进行。我们的主要目的是评估6个月骨骼肌参数的变化，即通过生物阻抗分析评估身体成分（阑尾骨骼肌质量指数、脂肪质量、相位角），通过ct扫描评估胸肌（胸肌、竖脊肌、第五肋间肌、腰肌）的表面和密度，以及通过握力测试评估上肢力量。EBV植入3个月后肺功能显著改善，并持续到6个月。相比之下，骨骼肌参数没有明显改善。此外，没有发现肌肉参数或肌肉减少状态可以预测EBV插入的反应。这些结果表明，在我们的研究中，EBV插入与强烈的全身效应无关，并强调需要寻找自下而上的药物策略来治疗copd相关的肌肉减少症。

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引用次数: 0

Acute effects of fan therapy on exercise-induced breathlessness in healthy adults and people living with chronic respiratory disease: A systematic review 风扇疗法对健康成人和慢性呼吸系统疾病患者运动诱导呼吸困难的急性影响：一项系统综述

IF 2.2 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-05-14 DOI: 10.1016/j.resmer.2025.101172

Julien Da Purificaçao , Clémence Pierret , Tristan Bonnevie , William Poncin

Background

Exercise-induced breathlessness is a common complaint in the general population and a highly prevalent symptom in adults living with chronic diseases, often acting as an important barrier to engaging in physical activity. Fan therapy can reduce breathlessness at rest, yet its acute effects during exercise have not been systematically explored.

Methods

A literature search encompassing three electronic databases (PubMed, Scopus, Embase) from inception to January 2025 was conducted to identify randomized controlled trials comparing fan therapy during and after an acute exercise bout to a control condition, on dyspnea and exercise capacity. Relevant conference abstracts were considered. Risk of bias was assessed via the Physiotherapy Evidence Database scale. The PRISMA guidelines were followed.

Results

A total of six studies, including one conference abstract, met eligibility criteria. Five records involved 79 adults with chronic respiratory disease, all presenting a respiratory disease, and the remaining record included 10 healthy individuals. The results were generally consistent, showing that fan therapy significantly reduces exercise-induced breathlessness (n = 2 studies), decreases breathlessness during recovery (n = 5), and enhances exercise capacity (n = 2). The methodological quality was good for half or retrieved studies and poor-to-fair in the other half.

Conclusion

Fan therapy might relieve dyspnea and improve exercise capacity during and after an acute bout of exercise in patients with chronic respiratory disease. Future high-quality research should confirm these findings and consider assessing fan therapy effects in other populations. PROSPERO number: CRD42023475117

背景：运动引起的呼吸困难是普通人群中一种常见的主诉，也是成人慢性疾病患者中一种非常普遍的症状，经常成为参与体育活动的重要障碍。风扇疗法可以减少休息时的呼吸困难，但其在运动中的急性效果尚未得到系统的探索。方法检索PubMed、Scopus、Embase三个电子数据库从成立到2025年1月的文献，以确定随机对照试验，比较风扇治疗在急性运动期间和之后对呼吸困难和运动能力的影响。审议了有关的会议摘要。通过物理治疗证据数据库量表评估偏倚风险。遵循了PRISMA准则。结果共有6项研究符合入选标准，其中包括1项会议摘要。5项记录涉及79名患有慢性呼吸道疾病的成年人，他们都表现出呼吸道疾病，其余记录包括10名健康个体。结果基本一致，显示风扇疗法显著减少运动引起的呼吸困难（n = 2项研究），减少恢复期间的呼吸困难（n = 5），并增强运动能力（n = 2）。一半或检索研究的方法学质量良好，另一半研究的方法学质量较差。结论风扇疗法可缓解慢性呼吸系统疾病患者急性发作时及发作后的呼吸困难，提高运动能力。未来的高质量研究应该证实这些发现，并考虑评估风扇治疗在其他人群中的效果。普洛斯彼罗号码：CRD42023475117

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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

Respiratory Medicine and Research

Pub 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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