Breathe最新文献

TB-IRIS is a rare complication of antitubercular therapy, particularly in immunocompetent patients. Timely recognition and initiation of corticosteroid therapy are crucial for effective management. https://bit.ly/4qH4RXB.

Preschool spirometry thrives on empathy: greet at eye level, link devices to familiar cues, gamify each blow, and coach with a gentle rise-fall voice. This playful standards-based script boosts success and slashes distress, preserving autonomy for all. https://bit.ly/4nGTOvs.

Pleural effusion represents a frequent and diagnostically challenging condition across multiple clinical settings. Conventional characterisation relies on invasive thoracentesis and biochemical analysis, with Light's criteria offering high sensitivity but limited specificity. Procedural risks and patient factors may limit fluid sampling, highlighting the need for complementary, noninvasive approaches. Recent advances in thoracic ultrasound (TUS) suggest that quantitative assessment of pleural fluid (PF) echogenicity, particularly pixel density analysis and hypoechogenicity index, may represent an investigational approach for objective and reproducible evaluation. Preliminary studies using standardised image analysis platforms, such as ImageJ, indicate that exudative effusions more frequently exhibit higher pixel density than transudates, in association with markers of cellularity, protein content, and inflammation. Hybrid scoring systems combining quantitative metrics with morphological sonographic features, such as septations, fibrin strands, and debris, have been explored and may enhance diagnostic specificity, although validation remains limited. However, methodological constraints, operator- and device-dependent variability and small sample sizes continue to restrict their applicability in routine clinical practice. Emerging approaches, including artificial intelligence, may be able to mitigate these limitations by standardising measurements, harmonising grayscale output, and integrating clinical, laboratory and imaging data to generate real-time risk scores. In the absence of robustly validated evidence, quantitative TUS should be regarded as an investigational adjunct, with potential to refine PF characterisation, support clinical decision-making, and inform future research on noninvasive diagnostic strategies.

An overview of the ERS early career members' committee (ECMC), the role of the Chair and co-Chair of the ECMC, what the outgoing Chair and co-Chair achieved during their mandate and what they think the next steps should be https://bit.ly/48IghDF.

COPD is a progressive respiratory condition characterised by persistent airflow limitation and chronic inflammation. Despite advances in bronchodilator and corticosteroid therapy, many patients, particularly those with eosinophilic inflammation, remain inadequately managed. This review highlights two recently approved therapies, ensifentrine and dupilumab, which represent a shift toward precision medicine in COPD management. Ensifentrine, a dual phosphodiesterase 3 and 4 inhibitor, offers both bronchodilatory and anti-inflammatory effects, improving lung function and reducing exacerbations. Dupilumab targets interleukin-4 and interleukin-13 signalling, addressing type 2 inflammatory pathways prominent in eosinophilic COPD. Key clinical trials (ENHANCE, BOREAS, NOTUS) demonstrate the efficacy of these agents in improving forced expiratory volume in 1 s, reducing exacerbation rates, and enhancing quality of life in select patient subgroups. By focusing on disease endotypes, these novel therapies underscore the growing role of personalised treatment approaches in COPD. Continued investigation into biomarkers and long-term outcomes will be essential for integrating these therapies into routine clinical practice.

The implementation of lung cancer screening with low-dose computed tomography has significantly increased the detection of pulmonary nodules, most of which are peripherally located and difficult to access. Effectively addressing these findings remains a clinical challenge, particularly in balancing diagnostic accuracy with procedural risk. Advances in interventional pulmonology have enabled minimally invasive approaches that may support both diagnosis and treatment, especially in selected patients with peripherally located nodules or limited surgical options. However, evidence on their effectiveness, accessibility and integration into screening workflows remains variable. In this review, we discuss the current role of interventional pulmonology in the context of lung cancer screening, outlining its potential benefits, limitations, and areas requiring further research to define its place within multidisciplinary care.

Pulmonary function testing is a pillar of respiratory medicine, contributing to the diagnosis and monitoring of respiratory diseases and supporting therapeutic decisions. The aim of this review is to summarise advances in the field of lung function monitoring, presenting both innovation in current everyday lung function testing, as well as newer physiological and functional imaging techniques. We highlight the potential clinical utility of novel digital tools, such as smart inhalers, wearables and sensors, that enable continuous real-time monitoring of lung physiological parameters and assessment of therapeutic interventions. Finally, current evidence for the application of artificial intelligence tools, such as machine- and deep-learning algorithms, in lung function interpretation is discussed.

Pleural effusion induces an increase in pleural pressure, resulting in a cascade of changes in the physiological parameters of the thoracic cavity. These changes include increased volume of the rib cage, abnormal gas exchange, impaired respiratory mechanics, and abnormal diaphragmatic movements. Such alterations have a significant clinical impact, including the development of specific symptoms such as dyspnoea. Dyspnoea secondary to pleural effusion has a complex physiopathology. Notably, the severity of dyspnoea often shows a poor correlation with effusion size and may not improve after fluid drainage. The symptomatic relief experienced by patients after fluid drainage is largely attributed to improvements in the length-tension relationship of the respiratory muscles. Importantly, dyspnoea in these cases results from the abnormal shape and restricted motion of the ipsilateral hemidiaphragm, coupled with an increased compensatory respiratory drive aimed at preserving adequate ventilation. Fluid drainage reduces diaphragmatic distension, restoring diaphragmatic mobility, reducing inspiratory neural drive, and enhancing the neuromechanical coupling of the diaphragm, all of which contribute to dyspnoea relief. This review explores current evidence regarding the pathophysiological mechanisms underlying dyspnoea in pleural effusion and the therapeutic effects of thoracentesis.

The 2025 Sleep and Breathing Conference, co-hosted by the European Respiratory Society (ERS) and the European Sleep Research Society (ESRS), presented the latest advances in sleep disordered breathing and related fields. This comprehensive overview, written by Early Career Members of ERS Assembly 4, highlights the key scientific and clinical takeaways from the event. Symposia were dedicated to the pathophysiology of obstructive sleep apnoea (OSA), the role of intermittent hypoxia and autonomic dysregulation, diagnostic work-up, and treatment approaches for OSA, including the perspective of patients. Updates on central sleep apnoea, comorbid insomnia and sleep apnoea, obesity hypoventilation syndrome and sleep disordered breathing in neuromuscular disease were also presented. The event emphasised the importance of phenotyping, individualised treatment approaches and the integration of physiology into clinical decision-making in sleep disordered breathing.

Psychosis is a potential side-effect of isoniazid therapy that clinicians involved in the care of patients with tuberculosis should be aware of. https://bit.ly/4n2gXrX.