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Redundancy in sarcoidosis granulomas 肉样瘤肉芽肿的重复性。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.05.001
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引用次数: 0
Impact of the 2022 ATS/ERS update criteria on the bronchodilator responsiveness test result 2022 年 ATS/ERS 更新标准对支气管扩张剂反应性测试结果的影响。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.06.003
B. Martins , A. Marinho , P. Amorim
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引用次数: 0
Sclerosing pneumocytoma with rosette structure mimicking carcinoid: A diagnostic pitfall of intraoperative consultation 具有模仿类癌花纹结构的硬化性肺细胞瘤:术中会诊的诊断陷阱。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.03.006
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引用次数: 0
Associations and relative risks of pulmonary hypertension and lung diseases in individuals with methamphetamine use disorder 甲基苯丙胺使用障碍患者肺动脉高压和肺部疾病的相关性和相对风险。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2023.01.003

Objective

Methamphetamine causes considerable short- and long-term adverse health effects. Our aim was to assess the effects of methamphetamine use on pulmonary hypertension and lung diseases at the population level.

Methods

This population-based retrospective study used data from the Taiwan National Health Insurance Research Database between 2000 and 2018 that included 18,118 individuals with methamphetamine use disorder (MUD) and 90,590 matched participants of the same age and sex without substance use disorder as the non-exposed group. A conditional logistic regression model was used to estimate associations of methamphetamine use with pulmonary hypertension and lung diseases such as lung abscess, empyema, pneumonia, emphysema, pleurisy, pneumothorax, or pulmonary hemorrhage. Incidence rate ratios (IRRs) of pulmonary hypertension and hospitalization due to lung diseases were determined between the methamphetamine group and non-methamphetamine group using negative binomial regression models.

Results

During an 8-year observation period, 32 (0.2%) individuals with MUD and 66 (0.1%) non-methamphetamine participants suffered from pulmonary hypertension, and 2652 (14.6%) individuals with MUD and 6157 (6.8%) non-methamphetamine participants suffered from lung diseases. After adjusting for demographic characteristics and comorbidities, individuals with MUD were 1.78 times (95% confidence interval (CI) = 1.07–2.95) more likely to have pulmonary hypertension and 1.98 times (95% CI = 1.88–2.08) more likely to have a lung disease, especially emphysema, lung abscess, and pneumonia in descending order. Furthermore, compared to the non-methamphetamine group, the methamphetamine group was associated with higher risks of hospitalization caused by pulmonary hypertension and lung diseases. The respective IRRs were 2.79 and 1.67. Individuals with polysubstance use disorder were associated with higher risks of empyema, lung abscess, and pneumonia compared to individuals with MUD alone, with respective adjusted odds ratios of 2.96, 2.21, and 1.67. However, pulmonary hypertension and emphysema did not differ significantly between MUD individuals with or without polysubstance use disorder.

Conclusions

Individuals with MUD were associated with higher risks of pulmonary hypertension and lung diseases. Clinicians need to ensure that a methamphetamine exposure history is obtained as part of the workup for these pulmonary diseases and provide timely management for this contributing factor.
目的:甲基苯丙胺会对健康造成很大的短期和长期不利影响。我们的目的是在人群水平上评估吸食甲基苯丙胺对肺动脉高压和肺部疾病的影响:这项基于人群的回顾性研究使用了台湾国民健康保险研究数据库 2000 年至 2018 年间的数据,其中包括 18 118 名甲基苯丙胺使用障碍(MUD)患者和 90 590 名年龄和性别相同、无药物使用障碍的非暴露组匹配参与者。该研究采用条件逻辑回归模型来估算吸食甲基苯丙胺与肺动脉高压和肺部疾病(如肺脓肿、肺水肿、肺炎、肺气肿、胸膜炎、气胸或肺出血)之间的关系。使用负二项回归模型确定了甲基苯丙胺组和非甲基苯丙胺组之间肺动脉高压和肺部疾病住院的发病率比(IRRs):在8年的观察期内,32名(0.2%)甲基苯丙胺感染者和66名(0.1%)非甲基苯丙胺感染者患有肺动脉高压,2652名(14.6%)甲基苯丙胺感染者和6157名(6.8%)非甲基苯丙胺感染者患有肺部疾病。在对人口统计学特征和合并症进行调整后,MUD 患者罹患肺动脉高压的几率是非 MUD 患者的 1.78 倍(95% 置信区间 (CI) = 1.07-2.95),罹患肺部疾病的几率是非 MUD 患者的 1.98 倍(95% 置信区间 (CI) = 1.88-2.08),尤其是肺气肿、肺脓肿和肺炎的几率依次递增。此外,与非甲基苯丙胺组相比,甲基苯丙胺组因肺动脉高压和肺部疾病住院的风险更高。其内部相关系数分别为 2.79 和 1.67。与只吸食甲基苯丙胺的人相比,有多种物质使用障碍的人患肺水肿、肺脓肿和肺炎的风险更高,调整后的几率比分别为 2.96、2.21 和 1.67。然而,肺动脉高压和肺气肿在有或没有多种药物使用障碍的 MUD 患者之间没有显著差异:结论:MUD 患者罹患肺动脉高压和肺部疾病的风险较高。临床医生需要确保获得甲基苯丙胺接触史,作为这些肺部疾病检查的一部分,并对这一诱因进行及时处理。
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引用次数: 0
Complete response to mTOR inhibitor following JAKi failure in severe pulmonary sarcoidosis 严重肺肉样瘤病 JAKi 治疗失败后对 mTOR 抑制剂的完全应答。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.03.002
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引用次数: 0
Pre- and post-COVID practice of interventional pulmonology in adults in Portugal 葡萄牙成人介入性肺病诊疗在 COVID 之前和之后的实践。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2022.02.009

Introduction and objectives

There is a lack of information regarding bronchoscopy practice in adults in Portugal. Our objective was to obtain an overview of the characteristics, resources, techniques and behaviors in national interventional pulmonology (IP) units, before and after SARS-CoV-2 outbreak.

Materials and Methods

An online survey was developed by an expert panel with a total of 46 questions comprising the specifications of each unit, namely physical space, equipment, staff, procedure planning, monitoring, technical differentiation, and numbers pre- and post-COVID-19. Forty-one interventional pulmonology centers were invited to participate between April and May 2021.

Results

37 units (90.2%) responded to the survey. The majority (64.9%) have a fully dedicated space with a weekly presence of ≥3 chest physicians (82.1%) and support of an anesthesiologist on specific days (48.6%). There is marked heterogeneity in the IP unit's equipment, and 56.8% acquired disposable bronchoscopes after COVID-19 pandemics. Pre-bronchoscopy hemogram, platelet count and coagulation tests are regularly asked by more than 90% of the units, even when deep sedation or biopsies are not planned. In 97.3% of cases, topical anesthesia and midazolam are utilized. Propofol (21.6%) and fentanyl (29.7%) are occasionally employed in some institutions. Most units use ancillary sampling techniques to diagnose central or peripheral lesions, with radial EBUS being used for guidance of distal procedures in 37.8% of centers, linear EBUS and EUS-B-FNA for mediastinal diagnosis and/or staging in 45.9% and 27.0% of units, respectively. Cryobiopsies are used by 21.6% of respondents to diagnose diffuse lung diseases. Rigid bronchoscopy is performed in 37.8% of centers. There was a decrease in the number of flexible (p < 0.001) and rigid (p = 0.005) bronchoscopies and an upscale of personal protective equipment (PPE) during the COVID-19 outbreak.

Conclusions

IP units have variable bronchoscopic practices, but during the COVID-19 pandemic, they complied with most international recommendations, as elective procedures were postponed and PPE levels increased.
引言和目的:葡萄牙缺乏成人支气管镜检查方面的信息。我们的目标是在SARS-CoV-2疫情爆发前后,对国家介入肺科(IP)单位的特点、资源、技术和行为进行全面了解:专家小组编制了一份在线调查表,共有 46 个问题,包括每个科室的具体情况,即物理空间、设备、人员、手术计划、监测、技术差异以及 COVID-19 前后的人数。41 家介入肺科中心应邀在 2021 年 4 月至 5 月间参与了此次调查:37个单位(90.2%)对调查做出了回应。大多数单位(64.9%)拥有完全专用的空间,每周有≥3 名胸科医生(82.1%)在场,并在特定日期有麻醉师(48.6%)提供支持。IP 单位的设备存在明显差异,56.8% 在 COVID-19 大流行后购置了一次性支气管镜。90% 以上的科室会定期要求进行支气管镜检查前的血液造影、血小板计数和凝血功能检查,即使不计划进行深度镇静或活检。97.3%的病例使用局部麻醉和咪达唑仑。一些机构偶尔会使用丙泊酚(21.6%)和芬太尼(29.7%)。大多数单位使用辅助取样技术诊断中央或周边病变,37.8% 的中心使用径向 EBUS 引导远端手术,45.9% 和 27.0% 的单位分别使用线性 EBUS 和 EUS-B-FNA 进行纵隔诊断和/或分期。21.6%的受访者使用冷冻活组织检查诊断弥漫性肺部疾病。37.8%的中心进行硬支气管镜检查。柔性支气管镜检查的数量有所减少(P 结论):IP 单位的支气管镜检查方法不尽相同,但在 COVID-19 大流行期间,它们遵守了大多数国际建议,推迟了选择性手术,并提高了个人防护设备水平。
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引用次数: 0
Perceptions of the Portuguese population on vaccination – The specific view of Chronic Respiratory Disease patients 葡萄牙人对疫苗接种的看法--慢性呼吸道疾病患者的特殊观点。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.05.002
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引用次数: 0
A rare case of pneumocystosis under anti-PD-L1 therapy 抗PD-L1疗法下的一例罕见肺囊肿病例。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.05.004
Maria João Santos , Maria João Cavaco , Fernanda Paula Santos , Filipe Froes
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引用次数: 0
"Alveolar stem cell exhaustion, fibrosis and bronchiolar proliferation" related entities. A narrative review. "肺泡干细胞衰竭、纤维化和支气管增生 "相关实体。叙述性综述。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-09-13 DOI: 10.1016/j.pulmoe.2024.05.005
M Chilosi, S Piciucchi, C Ravaglia, P Spagnolo, N Sverzellati, S Tomassetti, W Wuyts, V Poletti
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引用次数: 0
Prediction of exercise respiratory limitation from pulmonary function tests 通过肺功能测试预测运动呼吸受限。
IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-09-01 DOI: 10.1016/j.pulmoe.2022.12.003

Background

Evaluation of unexplained exercise intolerance is best resolved by cardiopulmonary exercise testing (CPET) which enables the determination of the exercise limiting system in most cases. Traditionally, pulmonary function tests (PFTs) at rest are not used for the prediction of a respiratory limitation on CPET.

Objective

We sought cut-off values on PFTs that might, a priori, rule-in or rule-out a respiratory limitation in CPET.

Methods

Patients who underwent CPET in our institute were divided into two groups according to spirometry: obstructive and non-obstructive. Each group was randomly divided 2:1 into derivation and validation cohorts respectively. We analyzed selected PFTs parameters in the derivation groups in order to establish maximal and minimal cut-off values for which a respiratory limitation could be ruled-in or ruled-out. We then validated these values in the validation cohorts.

Results

Of 593 patients who underwent a CPET, 126 were in the obstructive and 467 in the non-obstructive group. In patients with obstructive lung disease, forced expiratory volume in 1 second (FEV1) ≥ 61% predicted could rule out a respiratory limitation, while FEV1 ≤ 33% predicted was always associated with a respiratory limitation. For patients with non-obstructive spirometry, FEV1 of ≥ 73% predicted could rule-out a respiratory limitation. Application of this algorithm might have saved up to 47% and 71% of CPETs in our obstructive and non-obstructive groups, respectively.

Conclusion

Presence or absence of a respiratory limitation on CPET can be predicted in some cases based on a PFTs performed at rest.

背景:对不明原因的运动不耐受的评估最好通过心肺运动测试(CPET)来解决,在大多数情况下,心肺运动测试可确定运动受限系统。传统上,静息状态下的肺功能测试(PFT)并不用于预测 CPET 的呼吸限制:目的:我们寻找可以预先判断或排除 CPET 呼吸受限的 PFT 临界值:在我院接受 CPET 的患者根据肺活量分为两组:阻塞性和非阻塞性。每组按 2:1 的比例随机分为推导组和验证组。我们分析了推导组的部分 PFTs 参数,以确定可排除或排除呼吸受限的最大和最小临界值。然后,我们在验证组中对这些数值进行了验证:在接受 CPET 的 593 名患者中,阻塞性肺病组有 126 人,非阻塞性肺病组有 467 人。在阻塞性肺病患者中,1 秒用力呼气容积(FEV1)≥ 61% 预测值可排除呼吸受限,而 FEV1 ≤ 33% 预测值总是与呼吸受限有关。对于肺活量无阻塞的患者,FEV1 ≥ 73% 预测值可排除呼吸受限。在我们的阻塞性和非阻塞性组别中,应用这种算法可分别节省多达 47% 和 71% 的 CPET:结论:在某些情况下,根据静息状态下的 PFT 可以预测 CPET 是否存在呼吸受限。
{"title":"Prediction of exercise respiratory limitation from pulmonary function tests","authors":"","doi":"10.1016/j.pulmoe.2022.12.003","DOIUrl":"10.1016/j.pulmoe.2022.12.003","url":null,"abstract":"<div><h3>Background</h3><p>Evaluation of unexplained exercise intolerance is best resolved by cardiopulmonary exercise testing (CPET) which enables the determination of the exercise limiting system in most cases. Traditionally, pulmonary function tests (PFTs) at rest are not used for the prediction of a respiratory limitation on CPET.</p></div><div><h3>Objective</h3><p>We sought cut-off values on PFTs that might, <em>a priori</em>, rule-in or rule-out a respiratory limitation in CPET.</p></div><div><h3>Methods</h3><p>Patients who underwent CPET in our institute were divided into two groups according to spirometry: obstructive and non-obstructive. Each group was randomly divided 2:1 into derivation and validation cohorts respectively. We analyzed selected PFTs parameters in the derivation groups in order to establish maximal and minimal cut-off values for which a respiratory limitation could be ruled-in or ruled-out. We then validated these values in the validation cohorts.</p></div><div><h3>Results</h3><p>Of 593 patients who underwent a CPET, 126 were in the obstructive and 467 in the non-obstructive group. In patients with obstructive lung disease, forced expiratory volume in 1 second (FEV<sub>1</sub>) ≥ 61% predicted could rule out a respiratory limitation, while FEV<sub>1</sub> ≤ 33% predicted was always associated with a respiratory limitation. For patients with non-obstructive spirometry, FEV<sub>1</sub> of ≥ 73% predicted could rule-out a respiratory limitation. Application of this algorithm might have saved up to 47% and 71% of CPETs in our obstructive and non-obstructive groups, respectively.</p></div><div><h3>Conclusion</h3><p>Presence or absence of a respiratory limitation on CPET can be predicted in some cases based on a PFTs performed at rest.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 5","pages":"Pages 452-458"},"PeriodicalIF":10.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043723000016/pdfft?md5=1ff4d9adf371592749df33b9cd7b6948&pid=1-s2.0-S2531043723000016-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10577847","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}
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Pulmonology
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