Pulmonology最新文献

{"title":"Recommendations for the implementation of a national lung cancer screening program in Portugal—A consensus statement","authors":"M.G.O. Fernandes ,&nbsp;M. Dias ,&nbsp;R. Santos ,&nbsp;S. Ravara ,&nbsp;P. Fernandes ,&nbsp;J. Firmino-Machado ,&nbsp;J.P. Antunes ,&nbsp;O. Fernandes ,&nbsp;A. Madureira ,&nbsp;V. Hespanhol ,&nbsp;C. Rodrigues ,&nbsp;C.A. Vicente ,&nbsp;S. Alves ,&nbsp;G. Mendes ,&nbsp;R. Ilgenfritz ,&nbsp;B.S. Pinto ,&nbsp;J. Alves ,&nbsp;I. Saraiva ,&nbsp;C. Bárbara ,&nbsp;M.A. Cipriano ,&nbsp;A. Morais","doi":"10.1016/j.pulmoe.2024.04.003","DOIUrl":"10.1016/j.pulmoe.2024.04.003","url":null,"abstract":"<div><div>Lung cancer (LC) is a leading cause of cancer-related mortality worldwide. Lung Cancer Screening (LCS) programs that use low-dose computed tomography (LDCT) have been shown to reduce LC mortality by up to 25 % and are considered cost-effective. The European Health Union has encouraged its Member States to explore the feasibility of LCS implementation in their respective countries.</div><div>The task force conducted a comprehensive literature review and engaged in extensive discussions to provide recommendations.</div><div>These recommendations encompass the essential components required to initiate pilot LCS programs following the guidelines established by the World Health Organization. They were tailored to align with the specific context of the Portuguese healthcare system. The document addresses critical aspects, including the eligible population, methods for issuing invitations, radiological prerequisites, procedures for reporting results, referral processes, diagnostic strategies, program implementation, and ongoing monitoring. Furthermore, the task force emphasized that pairing LCS with evidence-based smoking cessation should be the standard of care for a high-quality screening program. This document also identifies areas for further research.</div><div>These recommendations aim to guarantee that the implementation of a Portuguese LCS program ensures high-quality standards, consistency, and uniformity across centres.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 625-635"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive Sleep Apnoea (OSA) and early atherosclerosis: The role of microbiota and EVs","authors":"","doi":"10.1016/j.pulmoe.2023.11.011","DOIUrl":"10.1016/j.pulmoe.2023.11.011","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 506-508"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139104672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single breath nitrogen test as predictor of lung function decline and COPD over an 8-year follow-up","authors":"","doi":"10.1016/j.pulmoe.2022.09.001","DOIUrl":"10.1016/j.pulmoe.2022.09.001","url":null,"abstract":"<div><h3>Background</h3><div>The single breath nitrogen (SBN₂) test was proposed for early detection of “small airways disease” in the seventies. Few longitudinal studies have subsequently evaluated the relationships between SBN₂ test measurements and lung function decline or COPD incidence.</div></div><div><h3>Aim</h3><div>This study evaluates whether SBN₂ test abnormalities may be significant predictors of lung function decline and COPD incidence over an 8-year follow-up.</div></div><div><h3>Study Design and Methods</h3><div>In this longitudinal study, 907 adults (20+ years old; 56% males) from the prospective Po River Delta epidemiological study underwent SBN₂ test at baseline and spirometry testing at both baseline and follow-up 8-year apart. Multinomial and multiple regression models were used to assess associations of SBN₂ indexes and rates of FEV₁ decline or risk of COPD incidence over time, after adjusting for sex, height and baseline age, FEV₁ and smoking status. COPD was defined according to either GOLD or ATS-ERS criteria.</div></div><div><h3>Results</h3><div>Among SBN₂ indexes, only the slope of alveolar plateau (N₂-slope) was significantly associated with rates of FEV₁ decline (7.93 mL/year for a one-unit change in N₂-slope, p&lt;0.0001), and with an increased risk of developing COPD as defined by GOLD (RR 1.81, 95%CI 1.29-2.52, mild; RR 2.78, 95%CI 1.70-4.53, moderate or severe obstruction) and ATS-ERS criteria (RR 1.62, 95%CI 1.14-2.29, mild; RR 3.40, 95%CI 1.72-6.73, moderate or severe obstruction).</div></div><div><h3>Conclusion</h3><div>In this population-based study, N₂-slope from SBN₂ test is a significant predictor of lung function decline and COPD incidence over an 8-year follow-up, confirming the role of the “small airways disease” in the natural history of COPD.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 546-554"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33497589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensity of exercise in people with COPD enrolled in community-based physical activities","authors":"","doi":"10.1016/j.pulmoe.2023.11.001","DOIUrl":"10.1016/j.pulmoe.2023.11.001","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 642-645"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the resurgence of pertussis: Insights into epidemiology and global health strategies","authors":"","doi":"10.1016/j.pulmoe.2024.04.009","DOIUrl":"10.1016/j.pulmoe.2024.04.009","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 503-505"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic obstructive pulmonary disease exacerbations' management in Portuguese hospitals – EvaluateCOPDpt, a multicentre, observational, prospective study","authors":"","doi":"10.1016/j.pulmoe.2022.07.007","DOIUrl":"10.1016/j.pulmoe.2022.07.007","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>In order to improve the quality of chronic obstructive pulmonary disease (COPD) patients' care, better knowledge of clinical practice and the factors associated with patient outcomes are needed. This study aimed to evaluate the relation between clinical practice and the outcomes of patients admitted for COPD exacerbations in Portuguese hospitals.</div></div><div><h3>Materials and Methods</h3><div>Observational, multicentre, prospective study with a 60-days follow-up period, in 11 hospitals, including patients aged ≥ 30 years, admitted to hospital for at least 24 hours due to an acute exacerbation of COPD. Demographic and clinical data were collected, including sex, age, smoking habits, hospitalisations, pulmonary function, comorbidities, COPD symptoms, and treatment. Sixty days after discharge, COPD exacerbations management, outcome measures, and readmission data were evaluated through a structured phone follow-up interview.</div></div><div><h3>Results</h3><div>196 patients were included (85.7% male, mean age 71.2 years), the majority admitted through the emergency service. Ex-smokers and current smokers accounted for 51% and 36%, respectively. On admission, 72.4% were on LAMA, 54.6% on LABA, and 45.5% were on LABA/LAMA. Inhaled corticosteroids (ICS) were used in 37.3% and systemic steroids (SCS) in 10.3%. 35.7 % had had at least one exacerbation, with hospitalisation, in the previous year. There was no spirometry data for 23.2%. On hospitalisation, 98.5% of patients were treated with oxygen and 38.3% with non-invasive ventilation. Additionally, 93.4% used SCS and 60.2% ICS. Antibiotics were administered to 85.2%. 95.4% of patients were discharged; 9 died, 5 of whom had a COPD-related death. The median length of stay was 12 days for discharged patients and 33 days for patients who died. At discharge, 79.1% were prescribed with LAMA, 63.6% SCS, 61.5% LABA and 55.6% LAMA+LABA. 26,2% were prescribed with ICS+LABA+LAMA. At follow-up, 44.4% had a scheduled medical appointment within the 60 days after being discharged, and 28.3% were later readmitted due to exacerbation, of whom 52.8% were hospitalised.</div></div><div><h3>Conclusions</h3><div>The severity of COPD, particularly in exacerbations, is directly related to impaired lung function and quality of life, mortality, and significant health system costs. Knowledge about COPD exacerbations' management in acute hospital admissions in Portugal may help stimulate a national discussion and review of existing data to engage clinicians, policymakers, managers, and patients, raising awareness and promoting action on COPD.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 522-528"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40364433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and validity of the Chester step test in patients with interstitial lung disease","authors":"","doi":"10.1016/j.pulmoe.2022.10.009","DOIUrl":"10.1016/j.pulmoe.2022.10.009","url":null,"abstract":"<div><h3>Background</h3><div>The Chester Step Test (CST) is a simple and inexpensive field test, which requires minimal physical space to assess exercise capacity. Such characteristics make the CST suitable to be used in different settings, however, its measurement properties in patients with interstitial lung diseases (ILD) are unknown.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in patients with ILD. First, a CST-1 and a 6-minute walk test (6MWT) were performed. After 48-72 hours, a CST-2 was repeated. A 2nd rater was present in one of the sessions. Relative reliability was measured using intraclass correlation coefficient (ICC_1,1 and ICC_2,1). Absolute reliability was determined using standard error of measurement (SEM), minimal detectable change at 95% confidence interval (MDC₉₅) and the Bland-Altman method. The values of SEM and MDC₉₅ were also expressed as a percentage of the mean. Construct validity was explored using Spearman correlation coefficient (r_s) between the number of steps taken in the best CST and the distance performed in the 6MWT.</div></div><div><h3>Results</h3><div>Sixty-six patients with ILD (65.5±12.9 years; 48.5%men; FVC 79.4±18.8pp; DL_CO 49.0±18.3pp) participated in the study. Relative (ICC 0.95-1.0) and absolute reliability were excellent without evidence of systematic bias. The SEM and MDC₉₅ were 11.8 (14.7%) and 32.6 steps (40.7%), respectively. The correlation between CST and 6MWT was significant, positive, and high (r_s=0.85, p=0.001).</div></div><div><h3>Conclusion</h3><div>The CST is a reliable and valid test and might be especially useful to assess exercise capacity in patients with ILD in limited space environments.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 570-576"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35349722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic cough in patients with obstructive sleep apnoea: A prospective cohort study","authors":"","doi":"10.1016/j.pulmoe.2024.04.010","DOIUrl":"10.1016/j.pulmoe.2024.04.010","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 659-662"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue 2 - “Update on adverse respiratory effects of indoor air pollution”. Part 2): Indoor air pollution and respiratory diseases: Perspectives from Italy and some other GARD countries","authors":"","doi":"10.1016/j.pulmoe.2023.03.007","DOIUrl":"10.1016/j.pulmoe.2023.03.007","url":null,"abstract":"<div><h3>Objective</h3><div>to synthesize the Italian epidemiological contribution to knowledge on indoor pollution respiratory impact, and to analyze the perspective of some GARD countries on the health effects of indoor air pollution.</div></div><div><h3>Results</h3><div>Italian epidemiological analytical studies confirmed a strong relationship between indoor air pollution and health in general population. Environmental tobacco smoke, biomass (wood/coal) fuel for cooking/heating and indoor allergens (house dust mites, cat and dog dander, mold/damp) are the most relevant indoor pollution sources and are related to respiratory and allergic symptoms/diseases in Italy and in other GARD countries such as Mexico, Brazil, Vietnam, India, Nepal and Kyrgyzstan.</div><div>Community-based global health collaborations are working to improve prevention, diagnosis and care of respiratory diseases around the world, specially in low- and middle-income countries, through research and education.</div></div><div><h3>Conclusions</h3><div>in the last thirty years, the scientific evidence produced on respiratory health effects of indoor air pollution has been extensive, but the necessity to empower the synergies between scientific community and local administrations remains a challenge to address in order to implement effective interventions.</div><div>Based on abundant evidence of indoor pollution health effect, WHO, scientific societies, patient organizations and other members of the health community should work together to pursue the GARD vision of “a world where all people breathe freely” and encourage policy makers to increase their engagement in advocacy for clean air.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 595-624"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9853324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of maximal exercise capacity through the incremental shuttle walking test in lymphangioleiomyomatosis","authors":"","doi":"10.1016/j.pulmoe.2022.04.009","DOIUrl":"10.1016/j.pulmoe.2022.04.009","url":null,"abstract":"<div><h3>Background</h3><div>The cardiopulmonary exercise test (CPET) is the gold standard for assessing aerobic fitness; however, it is expensive, not widely available, and requires specialized equipment and staff. The incremental shuttle walking test (ISWT) is an exercise field test used to evaluate exercise capacity and may be an alternative to CPET in patients with lymphangioleiomyomatosis (LAM).</div></div><div><h3>Objective</h3><div>To investigate whether the ISWT can be used to assess maximal aerobic capacity in patients with LAM.</div></div><div><h3>Methods</h3><div>Forty-five women were evaluated on two days, and they randomly performed the CPET and ISWT. The maximum oxygen uptake (peak VO₂) was evaluated using gas analyzers in both tests. The carbon dioxide production (VCO₂), respiratory exchange ratio (RER), and heart rate (HR) were compared during peak exercise. Pearson's correlation and Bland-Altman assessed the association and agreement, respectively. The intraclass correlation coefficient (ICC) was used to assess the reliability of the data.</div></div><div><h3>Results</h3><div>All patients (46.1 ± 10.2 years) presented similar peak VO₂, RER, and peak HR during the CPET and ISWT (15.6 ± 4.6 vs. 15.7 ± 4.4 ml·kg⁻¹·min⁻¹; 1.15±0.09 vs. 1.17±0.12; and 142.2 ± 18.6 vs. 141.5 ± 22.2 bpm, respectively; <em>p</em>&gt;0.05). A good linear correlation (<em>r</em> = 0.79; <em>p</em>&lt;0.001) and ICC (0.86; 95%CI 0.74−0.93) were observed between the peak VO₂ in both tests. Predictive peak VO₂ equations based on the ISWT performance are also presented.</div></div><div><h3>Conclusion</h3><div>Our results suggest that the ISWT can be used to assess maximal exercise performance in patients with LAM, and it is a valuable option to be used as an alternative to the CPET and predict maximal exercise capacity.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 563-569"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40615980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}