Archivos De Bronconeumologia最新文献

Introduction: Previous studies have proposed forced expiratory volume in 0.5s (FEV_0.5) to determine health outcomes in infants and young children, but few studies exist in adults. This study aims to investigate the associations between FEV_0.5 and all-cause mortality in adults.

Methods: Participants were enrolled from the National Health and Nutrition Examination Survey (NHANES) (1988-1994 [NHANES III] and 2007-2012 cycles). Participants aged≥20 years, not pregnant with qualifying prebronchodilator FEV_0.5 data, acceptable spirometry, complete body measurements, and follow-up data for mortality were included. The association between FEV_0.5 and all-cause mortality risk was evaluated by multivariable Cox regression. Restricted cubic spline analysis was used to evaluate the non-linear relationship between FEV_0.5 and all-cause mortality. Subgroup analyses were conducted with stratification by sex, age, body mass index, smoking status, and race.

Results: Overall, 25,357 individuals were included, with a median follow-up of 308 months. The mean±standard deviation age was 46.1±7.2 years, and the mean prebronchodilator FEV_0.5 was 2412±699mL. A reduction in FEV_0.5 was associated with an increased all-cause mortality risk. A non-linear relationship was observed between FEV_0.5 and all-cause mortality risk. The results were maintained in subgroups analyses.

Conclusion: FEV_0.5 was inversely associated with all-cause mortality risk in adults, indicating its potential for monitoring respiratory health.

Background: The purpose of this study was to analyze the prevention and control effects of the three-phase global tuberculosis control strategy, and analyze the influencing factors.

Methods: We collected age-standardized incidence, prevalence, and mortality (ASIR, ASPR, and ASDR) data from the Global Burden of Disease Study (GBD 2021) database. Annual percentage change (AAPC) of ASIR, ASPR and ASDR were analyzed by Joinpoint regression. Correlation and decomposition analyses explored related epidemiological factors.

Results: At the global level, in the first phase Directly-Observed Treatment Strategy (DOTS), the annual reduction in incidence was 1.18%, and prevalence was 0.71%. In the second phase Stop TB, the cumulative mortality decrease was 56.44% which met the desired goal. However, the cumulative decrease of prevalence was only 20.45%. In the third phase End TB, annual rate of reduction in mortality was 3.33%, while the annual rate of reduction in incidence was 1.14%. ASPR showed a large decrease in both low socio-demographic index (SDI) and high SDI regions, the decrease in medium SDI region was small, which might be dominated by demographic factors at the DOTS stage, changed to epidemiologic in the Stop TB stage and to aging factors in the End TB stage.

Conclusion: The control of TB morbidity and mortality had a great achievement in all the 3 different phases of the TB control strategy, and a concerted global effort is still needed in phase 3 to reach the END TB goal. TB prevalence control needs to be emphasized, especially in the middle and high SDI areas.

Introduction: Understanding the diverse pathogenetic pathways in obstructive sleep apnea (OSA) is crucial for improving outcomes. microRNA (miRNA) profiling is a promising strategy for elucidating these mechanisms.

Objective: To characterize the pathogenetic pathways linked to OSA through the integration of miRNA profiles, machine learning (ML) and bioinformatics.

Methods: This multicenter study involved 525 patients with suspected OSA who underwent polysomnography. Plasma miRNAs were quantified via RNA sequencing in the discovery phase, with validation in two subsequent phases using RT-qPCR. Supervised ML feature selection methods and comprehensive bioinformatic analyses were employed. The associations among miRNA targets, OSA and OSA treatment were further explored using publicly available external datasets.

Results: Following the discovery and technical validation phases in a subset of patients with and without confirmed OSA (n=53), eleven miRNAs were identified as candidates for the subsequent feature selection process. These miRNAs were then quantified in the remaining population (n=472). Feature selection methods revealed that the miRNAs let-7d-5p, miR-15a-5p and miR-107 were the most informative of OSA. The predominant mechanisms linked to these miRNAs were closely related to cellular events such as cell death, cell differentiation, extracellular remodeling, autophagy and metabolism. One target of let-7d-5p and miR-15a-5p, the TFDP2 gene, exhibited significant differences in gene expression between subjects with and without OSA across three independent databases.

Conclusion: Our study identified three plasma miRNAs that, in conjunction with their target genes, provide new insights into OSA pathogenesis and reveal novel regulators and potential drug targets.

Introduction: Bronchiectasis is a complex lung disease with poorly studied systemic manifestations. Patients with bronchiectasis-associated sarcopenia exhibit a specific differential profile of functional muscle phenotype (vastus lateralis, VL), which may be analyzed using imaging (ultrasound and magnetic resonance imaging, MRI).

Methods: Ultrasound and MRI were used to explore functional imaging parameters in quadriceps of 20 patients with stable bronchiectasis and 10 healthy controls. In muscle specimens (open biopsy procedures), muscle phenotype (fiber morphometry and structural abnormalities, immunohistochemistry) was also evaluated. Patients and controls were clinically and functionally evaluated.

Results: In muscles of patients compared to controls, a significant decline in body composition parameters (BMI and FFMI), muscle function (upper and lower limbs), lung function, and exercise capacity was detected, ultrasonography revealed decreased muscle thickness and area, while MRI demonstrated increased fat infiltration, which positively correlated with the bronchiectasis severity scores. Structural parameters (proportions of hybrid fibers, internal nuclei, abnormal fibers, and apoptotic nuclei) were significantly greater in the VL of patients than in controls and inversely correlated with quadriceps muscle function and exercise capacity in the former.

Conclusions: In patients with stable mild-to-moderate bronchiectasis, sarcopenia was clinically evidenced through the significant reduction in muscle mass and upper and lower limb muscle function. Non-invasive ultrasound and MRI techniques showed that features of muscle quality architecture and fat infiltration are hallmarks of bronchiectasis-associated sarcopenia. Functional radiological tools should be implemented in clinical settings to early diagnose and monitor sarcopenia in these patients.