Pub Date : 2025-11-06DOI: 10.1016/s2213-2600(25)00389-3
Miriam J Johnson, Sabrina Bajwah, Nazia Chaudhuri, David C Currow, Marie T Fallon
No Abstract
没有抽象的
{"title":"Further research needed before removal of morphine from the therapeutic armoury for breathlessness","authors":"Miriam J Johnson, Sabrina Bajwah, Nazia Chaudhuri, David C Currow, Marie T Fallon","doi":"10.1016/s2213-2600(25)00389-3","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00389-3","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"33 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/s2213-2600(25)00338-8
For over seven decades, oral corticosteroids have been the cornerstone of sarcoidosis management. Oral corticosteroids suppress sarcoidosis inflammati…
70多年来,口服皮质类固醇一直是结节病治疗的基石。口服糖皮质激素抑制结节病炎症…
{"title":"A paradigm shift in corticosteroid therapy for sarcoidosis: a World Association of Sarcoidosis and Other Granulomatous Disorders Position Paper, endorsed by the Americas Association of Sarcoidosis and Other Granulomatous Disorders","authors":"","doi":"10.1016/s2213-2600(25)00338-8","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00338-8","url":null,"abstract":"For over seven decades, oral corticosteroids have been the cornerstone of sarcoidosis management. Oral corticosteroids suppress sarcoidosis inflammati…","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"28 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145455103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/s2213-2600(25)00402-3
Tony Kirby
No Abstract
没有抽象的
{"title":"US lung cancer report suggests years of encouraging progress under threat from health agency cuts","authors":"Tony Kirby","doi":"10.1016/s2213-2600(25)00402-3","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00402-3","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"39 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145455104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/s2213-2600(25)00391-1
Katie Bechman, James Galloway, Surinder S Birring
No Abstract
没有抽象的
{"title":"Towards a new treatment era in sarcoidosis","authors":"Katie Bechman, James Galloway, Surinder S Birring","doi":"10.1016/s2213-2600(25)00391-1","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00391-1","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"135 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1016/s2213-2600(25)00329-7
Matthew J Saunders, Delia Boccia, Palwasha Y Khan, Lara Goscé, Antonio Gasparrini, Rebecca A Clark, Julia M Pescarini, Salome Charalambous, Lelisa Fekadu, Fernanda Dockhorn da Costa Johansen, Irina Vasilyeva, Gopalan Narendran, Tao Li, Norbert Ndjeka, Richard G White, Rein M G J Houben, Matteo Zignol, Nebiat Gebreselassie, Christopher Finn McQuaid
Climate change is likely to exacerbate a range of determinants that drive tuberculosis, the world's leading cause of death from a single infectious agent. However, tuberculosis is often neglected in wider climate health discussions. Commissioned by WHO, we developed an analytical framework outlining potential causal relationships between climate change and tuberculosis. We drew on existing knowledge of tuberculosis determinants, identified determinants likely to be sensitive to the effects of climate change, and conceptualised the mechanistic pathways through which these effects might occur. We collated evidence for these pathways, but found no studies directly linking climate change and tuberculosis, warranting research to build evidence for action. Nevertheless, the available indirect evidence supports the existence of plausible causal links between climate change and tuberculosis. This evidence highlights the need to consider tuberculosis as a climate-sensitive disease, and include tuberculosis in climate risk adaptation and mitigation programmes, and climate-resilient funding and response mechanisms. Only through urgent research and comprehensive action can we address this overlooked intersection and ensure that climate change does not become a barrier to ending the global tuberculosis epidemic.
{"title":"Climate change and tuberculosis: an analytical framework","authors":"Matthew J Saunders, Delia Boccia, Palwasha Y Khan, Lara Goscé, Antonio Gasparrini, Rebecca A Clark, Julia M Pescarini, Salome Charalambous, Lelisa Fekadu, Fernanda Dockhorn da Costa Johansen, Irina Vasilyeva, Gopalan Narendran, Tao Li, Norbert Ndjeka, Richard G White, Rein M G J Houben, Matteo Zignol, Nebiat Gebreselassie, Christopher Finn McQuaid","doi":"10.1016/s2213-2600(25)00329-7","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00329-7","url":null,"abstract":"Climate change is likely to exacerbate a range of determinants that drive tuberculosis, the world's leading cause of death from a single infectious agent. However, tuberculosis is often neglected in wider climate health discussions. Commissioned by WHO, we developed an analytical framework outlining potential causal relationships between climate change and tuberculosis. We drew on existing knowledge of tuberculosis determinants, identified determinants likely to be sensitive to the effects of climate change, and conceptualised the mechanistic pathways through which these effects might occur. We collated evidence for these pathways, but found no studies directly linking climate change and tuberculosis, warranting research to build evidence for action. Nevertheless, the available indirect evidence supports the existence of plausible causal links between climate change and tuberculosis. This evidence highlights the need to consider tuberculosis as a climate-sensitive disease, and include tuberculosis in climate risk adaptation and mitigation programmes, and climate-resilient funding and response mechanisms. Only through urgent research and comprehensive action can we address this overlooked intersection and ensure that climate change does not become a barrier to ending the global tuberculosis epidemic.","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"48 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145404680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1016/s2213-2600(25)00361-3
Ewan C Mackay, Peter S P Cho, Surinder S Birring, James H Hull
{"title":"Remission in chronic cough: an achievable target?","authors":"Ewan C Mackay, Peter S P Cho, Surinder S Birring, James H Hull","doi":"10.1016/s2213-2600(25)00361-3","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00361-3","url":null,"abstract":"","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"39 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145382800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1016/s2213-2600(25)00368-6
Huib A M Kerstjens, Maarten van den Berge
{"title":"FeNO or no FeNO in COPD?","authors":"Huib A M Kerstjens, Maarten van den Berge","doi":"10.1016/s2213-2600(25)00368-6","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00368-6","url":null,"abstract":"","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"7 14 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145382793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-11DOI: 10.1016/s2213-2600(25)00322-4
Mark van den Boogaard, Thomas Ottens
No Abstract
没有抽象的
{"title":"Deep sedation in the ICU: at what cost?","authors":"Mark van den Boogaard, Thomas Ottens","doi":"10.1016/s2213-2600(25)00322-4","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00322-4","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"135 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-11DOI: 10.1016/s2213-2600(25)00264-4
Karuna Wongtangman, Felix Borngaesser, Maíra I Rudolph, Flora T Scheffenbichler, Michael E Kiyatkin, Ibraheem M Karaye, William J Sauer
<h3>Background</h3>Deep sedation can be used during invasive mechanical ventilation without proven indication to treat the signs and symptoms of emotional distress or insomnia. However, medication-induced deep sedation is associated with delayed recovery and increased mortality. We tested the hypothesis that medication-induced deep sedation, but not emotional distress, is associated with loss of independent living.<h3>Methods</h3>In this retrospective cohort study, we included adult patients (age ≥18 years) who lived independently before hospital admission and were mechanically ventilated for at least 24 h in any of 20 ICUs at an academic health system in the Bronx, New York (NY, USA), and adjacent counties. The primary exposure was the proportion of time spent in medication-induced deep sedation (defined as a Richmond Agitation Sedation Score of –3 to –5) within the first week of ICU admission. The secondary exposure was the proportion of time with indicators of emotional distress within the first week of ICU admission. The exposures were categorised as none, a low proportion, or a high proportion using the median (42·9% for medication-induced deep sedation and 10·7% for emotional distress) as the cutoff between low and high. The primary outcome was loss of independent living (defined as in-hospital death or postoperative discharge to a long-term skilled nursing facility). Modified Poisson regression with an a priori-defined confounder control model were used to assess the association between exposures and outcomes. Mediation analysis was done to evaluate whether patient mobilisation level during mechanical ventilation contributed to the association between deep sedation and loss of independent living.<h3>Findings</h3>Among 10 204 patients receiving invasive mechanical ventilation between Jan 30, 2016 and July 11, 2023, 6369 (62·4%) had a loss of independent living. The proportion of patients who received deep sedation was a mean 2·84-fold (SD 1·51) higher than the proportion of patients who had an order for deep sedation. 7289 (71·4%) patients had at least one episode of medication-induced deep sedation within the first week of mechanical ventilation in the ICU. A high proportion of medication-induced deep sedation was associated with an increased risk of loss of independent living (adjusted risk ratio [RR<sub>adj</sub>] 1·18 [95% CI 1·13–1·23], p<0·0001) compared with no medication-induced deep sedation. There were 30 022 documented episodes of emotional distress. Having a high proportion of emotional distress was associated with a decreased risk of loss of independent living (RR<sub>adj</sub> 0·88 [0·84–0·92], p<0·0001) compared with no emotional distress. Clinicians provided deeper sedation in response to emotional distress and during the night (p<0·0001 for both comparisons). Symptom control with antipsychotics or non-opioid analgesics was associated with a decreased risk of loss of independent living compared with no treatment (RR
{"title":"Association of medication-induced deep sedation and emotional distress during mechanical ventilation with loss of independent living: an observational cohort study","authors":"Karuna Wongtangman, Felix Borngaesser, Maíra I Rudolph, Flora T Scheffenbichler, Michael E Kiyatkin, Ibraheem M Karaye, William J Sauer","doi":"10.1016/s2213-2600(25)00264-4","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00264-4","url":null,"abstract":"<h3>Background</h3>Deep sedation can be used during invasive mechanical ventilation without proven indication to treat the signs and symptoms of emotional distress or insomnia. However, medication-induced deep sedation is associated with delayed recovery and increased mortality. We tested the hypothesis that medication-induced deep sedation, but not emotional distress, is associated with loss of independent living.<h3>Methods</h3>In this retrospective cohort study, we included adult patients (age ≥18 years) who lived independently before hospital admission and were mechanically ventilated for at least 24 h in any of 20 ICUs at an academic health system in the Bronx, New York (NY, USA), and adjacent counties. The primary exposure was the proportion of time spent in medication-induced deep sedation (defined as a Richmond Agitation Sedation Score of –3 to –5) within the first week of ICU admission. The secondary exposure was the proportion of time with indicators of emotional distress within the first week of ICU admission. The exposures were categorised as none, a low proportion, or a high proportion using the median (42·9% for medication-induced deep sedation and 10·7% for emotional distress) as the cutoff between low and high. The primary outcome was loss of independent living (defined as in-hospital death or postoperative discharge to a long-term skilled nursing facility). Modified Poisson regression with an a priori-defined confounder control model were used to assess the association between exposures and outcomes. Mediation analysis was done to evaluate whether patient mobilisation level during mechanical ventilation contributed to the association between deep sedation and loss of independent living.<h3>Findings</h3>Among 10 204 patients receiving invasive mechanical ventilation between Jan 30, 2016 and July 11, 2023, 6369 (62·4%) had a loss of independent living. The proportion of patients who received deep sedation was a mean 2·84-fold (SD 1·51) higher than the proportion of patients who had an order for deep sedation. 7289 (71·4%) patients had at least one episode of medication-induced deep sedation within the first week of mechanical ventilation in the ICU. A high proportion of medication-induced deep sedation was associated with an increased risk of loss of independent living (adjusted risk ratio [RR<sub>adj</sub>] 1·18 [95% CI 1·13–1·23], p<0·0001) compared with no medication-induced deep sedation. There were 30 022 documented episodes of emotional distress. Having a high proportion of emotional distress was associated with a decreased risk of loss of independent living (RR<sub>adj</sub> 0·88 [0·84–0·92], p<0·0001) compared with no emotional distress. Clinicians provided deeper sedation in response to emotional distress and during the night (p<0·0001 for both comparisons). Symptom control with antipsychotics or non-opioid analgesics was associated with a decreased risk of loss of independent living compared with no treatment (RR","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"19 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}