CHEST pulmonary最新文献

{"title":"Prevalence and Impact of Food Insecurity in Patients Undergoing Pulmonary Function Testing","authors":"Dustin L. Norton MD ,&nbsp;Lauren Witek Mstat ,&nbsp;Corey S. Obermiller Mstat ,&nbsp;Sarah E. Maus MD ,&nbsp;Sundus K. Razzaq MD ,&nbsp;Richa Bundy MPH ,&nbsp;Adam Moses MHA, PMP ,&nbsp;Thomas W. Lycan Jr. DO, MHS ,&nbsp;Jessica A. Palakshappa MD ,&nbsp;Deepak Palakshappa MD, MSHP","doi":"10.1016/j.chpulm.2025.100204","DOIUrl":"10.1016/j.chpulm.2025.100204","url":null,"abstract":"<div><h3>Background</h3><div>Food insecurity (FI), the lack of consistent access to food for a healthy life, affected 13.5% of US households in 2023 and is associated with several chronic diseases. Limited data exist on the relationship between FI and lung health.</div></div><div><h3>Research Question</h3><div>In this cross-sectional study of adults presenting for pulmonary function testing (PFT), is FI associated with pulmonary function or respiratory symptom burden?</div></div><div><h3>Study Design and Methods</h3><div>We conducted a cross-sectional study of adults presenting for PFT between March 2018 and January 2023 in a large academic health network in North Carolina. FI was assessed using a validated 2-item questionnaire. Pulmonary function was measured using percent predicted FEV₁ and percent predicted FVC. Respiratory symptoms were assessed using the Modified Medical Research Council dyspnea scale and COPD Assessment Test. Multivariable models adjusting for sociodemographic factors and other covariates were used to evaluate associations between FI, pulmonary function, and symptoms.</div></div><div><h3>Results</h3><div>Of 10,805 patients screened, 17.8% reported FI. Patients with FI were more likely to be younger, female, non-Hispanic Black or Hispanic, to actively smoke, and to reside in socioeconomically disadvantaged areas. FI was associated with lower percent predicted FEV₁ (−2.55%) and percent predicted FVC (−1.04%), and increased odds of moderate to severe dyspnea (OR, 1.97). Among patients with COPD, FI was associated with higher symptom burden (mean COPD Assessment Test score, 23 vs 17) and more frequently reported moderate or severe dyspnea (67.5% vs 51.2%), with similar findings observed in patients with asthma.</div></div><div><h3>Interpretation</h3><div>Our findings suggest that FI is associated with worse pulmonary function and higher respiratory symptom burden in patients undergoing PFT, highlighting the importance of addressing FI as a social determinant of respiratory health. Further research is needed to explore mechanisms and potential interventions to mitigate the impact of FI on lung health.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Function and Safety Outcomes in Patients With Moderate-to-Severe COPD Treated With Ensifentrine","authors":"Diego J. Maselli MD ,&nbsp;Jessica Bon MD ,&nbsp;Tara Rheault PhD, MPH ,&nbsp;Amy Dixon PharmD ,&nbsp;Daniel Reyner DrPH ,&nbsp;Kathleen Rickard MD ,&nbsp;Michael G. Lester MD","doi":"10.1016/j.chpulm.2025.100210","DOIUrl":"10.1016/j.chpulm.2025.100210","url":null,"abstract":"<div><h3>Background</h3><div>Despite the use of maintenance therapies, many patients with COPD continue to experience persistent symptoms and impaired lung function. Ensifentrine is a novel, first-in-class selective dual inhibitor of phosphodiesterase (PDE) 3 and PDE4 with demonstrated nonsteroidal antiinflammatory activity and bronchodilatory effects.</div></div><div><h3>Research Question</h3><div>Does ensifentrine improve lung function among patients with COPD?</div></div><div><h3>Study Design and Methods</h3><div>This prespecified, pooled analysis of the phase 3, multicenter, randomized, double-anonymized, placebo-controlled Ensifentrine as a Novel Inhaled Nebulized COPD Therapy (ENHANCE-1 [NCT04535986] and ENHANCE-2 [NCT04542057]) trials evaluated the effect of ensifentrine on lung function and safety outcomes. The trials included patients 40 to 80 years of age with symptomatic moderate-to-severe COPD who received 3 mg twice-daily ensifentrine or placebo for 24 weeks.</div></div><div><h3>Results</h3><div>The pooled analysis included 975 patients treated with ensifentrine and 574 patients who received placebo. Ensifentrine significantly improved average FEV₁ area under the curve over 12 hours at week 12 from baseline vs placebo (least squares [LS] mean difference, 90 mL). Rapid improvements in peak FEV₁ were observed with ensifentrine treatment as early as day 1 (LS mean difference, 154 mL), which were sustained through week 24 compared with placebo (LS mean difference, 135 mL) (<em>P</em> &lt; .0001 for all time points). Ensifentrine also demonstrated significant improvements across all other lung function parameters, including average FEV₁ area under the curve from administration time to 4 hours (LS mean difference, 137 mL at week 12; <em>P</em> &lt; .0001 for all time points), FEV₁ area under the curve from 6 hours to 12 hours (LS mean difference, 59 mL at week 12; <em>P</em> &lt; .0001), morning trough FEV₁ (LS mean difference, 42 mL at week 12; <em>P</em> &lt; .001), and evening trough FEV₁ (LS mean difference, 56 mL at week 12; <em>P</em> &lt; .0001). Ensifentrine was well tolerated, with adverse event rates similar to placebo.</div></div><div><h3>Interpretation</h3><div>Ensifentrine demonstrated early, sustained, and clinically significant improvements in lung function in a broad population and across all subgroups of patients with symptomatic moderate-to-severe COPD.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Pulse Dose Corticosteroids With Outcomes Among Patients With Acute Exacerbations of Idiopathic Pulmonary Fibrosis","authors":"Divya A. Shankar MD ,&nbsp;Nicholas A. Bosch MD ,&nbsp;S. Reza Jafarzadeh DVM, MPVM, PhD ,&nbsp;Mari-Lynn Drainoni PhD, MEd ,&nbsp;Renda Soylemez Wiener MD, MPH ,&nbsp;Kevin C. Wilson MD ,&nbsp;Finn J. Hawkins MBBCh ,&nbsp;Konstantinos-Dionysios Alysandratos MD, PhD ,&nbsp;Allan J. Walkey MD ,&nbsp;Anica C. Law MD","doi":"10.1016/j.chpulm.2025.100207","DOIUrl":"10.1016/j.chpulm.2025.100207","url":null,"abstract":"<div><h3>Background</h3><div>Corticosteroids are a mainstay of treatment for acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF), but dosing practices vary. We leveraged between-hospital variation in propensity to administer pulse dose corticosteroids to determine the association between pulse dose corticosteroids and patient outcomes in AE-IPF.</div></div><div><h3>Research Question</h3><div>Do outcomes differ for hospitalized patients who recieve pulse dose corticosteroids vs low dose corticosteroids for AE-IPF?</div></div><div><h3>Study Design and Methods</h3><div>We designed an instrumental variable study informed by a target trial framework using the Premier Healthcare Database (2016-2022). We identified adults ≥ 50 years of age with AE-IPF who received a dose of IV methylprednisolone within 2 days of admission. Our exposure of interest was receipt of pulse dose methylprednisolone (≥ 250 mg); our instrument was admission to a hospital with high use of pulse dosing. We assessed association with in-hospital death/discharge to hospice and discharge home without invasive mechanical ventilation. In subgroup analyses, we tested for interaction with unit of admission (admission to ICU/intermediate care units vs ward units).</div></div><div><h3>Results</h3><div>We identified 3,049 patients with AE-IPF at 177 US hospitals (pulse dose: n = 1,094; low dose: n = 1,955). Patients who received a pulse dose vs low dose had a risk difference for death/hospice of 1.2% (95% CI, −6.0% to 8.5%); for discharge home without invasive mechanical ventilation, this was 5.3% (95% CI, −2.6% to 13.1%). In subgroup analysis, receipt of pulse dosing was associated with differential risk of death/hospice by admission unit (risk difference: ICU/intermediate care: 26.3%; 95% CI, 10.1%-42.6% vs ward units: 0.1%; 95% CI, −11.1% to 11.3%; <em>P</em> interaction = .009), but not with differential risk of discharge home without invasive mechanical ventilation (<em>P</em> interaction = .18).</div></div><div><h3>Interpretation</h3><div>We observed no significant benefit or harm associated with the receipt of pulse dose corticosteroids for patients with AE-IPF. However, in the subgroup of patients admitted to ICU/intermediate care, there was an increased risk of in-hospital death/discharge to hospice. Future studies should explore the use of pulse vs low-dose corticosteroids in critically ill populations with AE-IPF.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication of Lung Cancer Screening Results","authors":"Elena Vlachos DO ,&nbsp;John Dell’Italia PhD ,&nbsp;Kristina Crothers MD ,&nbsp;Nicholas Maurice MD ,&nbsp;Nichole T. Tanner MD, MSCR","doi":"10.1016/j.chpulm.2025.100183","DOIUrl":"10.1016/j.chpulm.2025.100183","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Prognosis of Resected Stage 1 Lung Adenocarcinoma With Radiomics, Regionality, and Histopathologic Correlation","authors":"Abdelmohaymin Abdalla MBBS ,&nbsp;Srinivasan Rajagopalan PhD ,&nbsp;Tobias Peikert MD ,&nbsp;Jennifer M. Boland MD ,&nbsp;Nan Zhang MS ,&nbsp;Brain Bartholmai MD ,&nbsp;Cyril Varghese MD","doi":"10.1016/j.chpulm.2025.100139","DOIUrl":"10.1016/j.chpulm.2025.100139","url":null,"abstract":"<div><h3>Background</h3><div>The discovery of adenocarcinoma (AC) spectrum nodules often leads to a pathway of ongoing radiologic observation, tissue biopsy, ablative therapies, or surgical excision. This complex decision-making process may be aided by machine learning. The Score Indicative of Lung Cancer Aggression was developed and validated as an evolution of previously developed radiomics models to predict the degree of histologic tumor invasion in AC and to predict patient survival. We now investigate if radiomics classification can help predict long-term outcomes after stage I AC resection. Secondarily, we explore if the geographic location of stage 1 AC nodules correlates with local invasion or long-term outcomes.</div></div><div><h3>Research Question</h3><div>Can radiomics predict long-term outcomes in stage 1 lung adenocarcinoma after curative surgical resection?</div></div><div><h3>Study Design and Methods</h3><div>A total of 196 patients with early stage AC who underwent curative surgical resection were studied over a follow-up median period of 12 years. Kaplan-Meier analysis of disease-free survival was performed on patients whose index nodule was categorized by radiomics. Local invasion of tumor was analyzed using radiomics and histopathologic assessment. The correlation of these metrics relating to the nodule’s geographic location was explored. Finally, disease-free survival analysis based on the location of the index nodule was performed.</div></div><div><h3>Results</h3><div>Patients whose stage I AC nodules were classified as poor before resection by our radiomics tool had worse long-term prognosis (&gt; 5 years) than those classified as intermediate or good. AC nodules in lower lung regions were proportionately more invasive than nodules in the upper lung regions, both based on radiomics and histopathologic review. However, that did not translate to a disease-free survival advantage for upper lobe nodules that were resected.</div></div><div><h3>Interpretation</h3><div>Our results indicate that radiomics helps prognosticate long-term outcomes in patients with resected stage I AC. Furthermore, histopathologic invasion detected by radiomics seems to vary depending on geographic location of the nodule in the lung.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Ultrasound for Predicting Resolution of Transient Tachypnea of the Newborn","authors":"Amanjot Kaur MD ,&nbsp;Deeksha Gupta MD, DM ,&nbsp;Mayank Priyadarshi MD, DM ,&nbsp;Suman Chaurasia MD, PhD ,&nbsp;Poonam Singh MD, DNB ,&nbsp;Nowneet Kumar Bhat MD ,&nbsp;Sriparna Basu MD, FRCPCH","doi":"10.1016/j.chpulm.2025.100216","DOIUrl":"10.1016/j.chpulm.2025.100216","url":null,"abstract":"<div><h3>Background</h3><div>Transient tachypnea of the newborn (TTN) is a self-limited condition, but can persist for prolonged durations. None of the existing tools can accurately predict the timing of TTN resolution.</div></div><div><h3>Research Question</h3><div>In term and late preterm neonates (population), can lung ultrasound (LUS) score (index test) predict delayed resolution of TTN, defined as persistence of respiratory distress beyond 6 hours of age (disease), monitored with Downes score (reference test)?</div></div><div><h3>Study Design and Methods</h3><div>In this prospective study, term and late preterm neonates requiring neonatal ICU admission with a diagnosis of TTN were included. Respiratory distress was monitored with hourly Downes score, and resolution was noted when Downes score was 0 in the neonate not requiring any respiratory support. Baseline characteristics, physiological monitoring, respiratory support parameters, and LUS clips were recorded within 2 hours of age and compared between early and delayed resolution groups. LUS findings were neither revealed to the treating team, nor used in the management of neonates. LUS scoring was later performed by blinded assessors.</div></div><div><h3>Results</h3><div>Among 113 enrolled neonates, 37 (32.7%) had delayed resolution of TTN. The mean birth weight and gestation were lower in the delayed resolution group, along with a higher requirement for resuscitation at birth. The median LUS score was significantly higher in the delayed (7; interquartile range, 5.5-9) compared with the early resolution group (4; interquartile range, 2-5.5). The diagnostic accuracy of LUS score was determined by receiver operating characteristic curve analysis (area under the curve, 0.84; 95% CI, 0.76-0.92; <em>P</em> &lt; .01). An LUS score ≥ 6 was considered an optimal cutoff for prediction of delayed TTN resolution (sensitivity, 73%; 95% CI, 56-86; specificity, 80%; 95% CI, 70-89).</div></div><div><h3>Interpretation</h3><div>LUS is a promising tool to predict delayed resolution of TTN. Early prediction of TTN resolution may guide decision for neonatal ICU admission and help avoid unnecessary admissions in cases likely to resolve within 6 hours.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Metagenomic Sequencing of Bronchoalveolar Lavage Fluid for Diagnosis of Infection in Patients With Hematologic Malignancies and Pulmonary Complications","authors":"Matthew K. Hensley MD, MPH,&nbsp;Khaled Sayed PhD,&nbsp;Ghady Haidar MD,&nbsp;Xiaohong Wang RN,&nbsp;Panayiotis V. Benos PhD,&nbsp;Sawa Ito MD, PhD,&nbsp;Annie Im MD,&nbsp;Emily Geramita MD, PhD,&nbsp;Warren Shlomchik MD,&nbsp;Barbara Methé PhD,&nbsp;Charles Dela Cruz MD, PhD,&nbsp;Alison Morris MD, MS,&nbsp;Georgios D. Kitsios MD, PhD","doi":"10.1016/j.chpulm.2025.100173","DOIUrl":"10.1016/j.chpulm.2025.100173","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosing pulmonary complications (PCs) in hematologic malignancies remains challenging due to insensitive conventional microbiologic testing (CMT) and overlapping clinical manifestations of infectious and noninfectious pulmonary complications. For these reasons, empirical antimicrobials and immunosuppression (eg, corticosteroids) are used for prolonged periods.</div></div><div><h3>Research Question</h3><div>How does metagenomic sequencing of the lower respiratory tract compare with conventional microbiologic testing among patients with hematologic malignancy?</div></div><div><h3>Study Design and Methods</h3><div>Prospective proof-of-concept cohort study of 30 adult inpatients with hematologic malignancies and PCs who underwent bronchoscopy for suspected lower respiratory tract infection.</div></div><div><h3>Results</h3><div>CMT identified a pathogen via culture- or polymerase chain reaction-based testing in 53% of patients. 16S sequencing demonstrated 66.7% positive and 42.9% negative concordance with CMT, while also identifying additional plausible respiratory pathogens in 59.3% of patients. Nanopore demonstrated 6.7% positive and 87.5% negative concordance with CMT and identified additional plausible respiratory pathogens in 42.3% of patients.</div></div><div><h3>Interpretation</h3><div>Culture-independent sequencing approaches had modest agreement with CMT when considering bacterial PCs and showed poor detection of fungal pathogens. Sequencing frequently identified additional plausible respiratory pathogens, and further validation is needed to determine if such detection represents clinically missed infections or nonpathogenic colonization.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Self-Contained Underwater Breathing Apparatus Diving on French Military Divers’ Lung Function","authors":"Justin Ulm MD, MPH ,&nbsp;Jean-Eric Blatteau MD ,&nbsp;Luc Aigle MD ,&nbsp;Roman Glogowski MD ,&nbsp;Olivier Castagna MD, PhD ,&nbsp;Arnaud Druelle MD","doi":"10.1016/j.chpulm.2025.100158","DOIUrl":"10.1016/j.chpulm.2025.100158","url":null,"abstract":"<div><h3>Background</h3><div>Although acute risks concerning underwater divers are well documented, the literature regarding the long-term impacts on pulmonary function remains inconclusive. Although oxygen toxicity at high partial pressures is established for patients in intensive care, the impact of diving seems limited.</div></div><div><h3>Research Question</h3><div>What are the long-term effects of self-contained underwater breathing apparatus diving on pulmonary function in military divers?</div></div><div><h3>Study Design and Methods</h3><div>This longitudinal study used routinely collected data from Sainte-Anne Military Teaching Hospital, Toulon, France, over a 20-year follow-up period. We expressed spirometric measures as a percentage of predicted values to account for age, height, and ethnicity, and analyzed them using mixed-effects models. The impact of diving is assessed for different gas and diving apparatus. Other included variables were atopy, tobacco use, and BMI.</div></div><div><h3>Results</h3><div>A total of 331 divers were included (2,685 spirometric measurements), with an average follow-up of 23.9 years and 2,491 dives. Only male divers met inclusion criteria. Baseline FEV₁ matched predicted values (100.00%; SD, 11.98). Every 1,000 dives, FEV₁ increased by 3.21% (95% CI, 2.73-3.68; <em>P</em> &lt; .001), regardless of gas or apparatus. FVC (3.02%; 95% CI, 2.52-3.53; <em>P</em> &lt; .001) and forced expiratory flow when 75% of forced expiratory vital capacity has been exhaled (10.12%; 95% CI, 8.29-11.95; <em>P</em> &lt; .001) increased, whereas FEV₁/FVC remained stable. Each BMI point increase was associated with a 0.51% rise in FVC (<em>P</em> = .010) and 0.38% rise in FEV₁ (<em>P</em> = .032), whereas each pack-year was associated with a 1.12% decline in forced expiratory flow when 75% of forced expiratory vital capacity has been exhaled (<em>P</em> = .005).</div></div><div><h3>Interpretation</h3><div>Our results show that self-contained underwater breathing apparatus diving is associated with increased pulmonary flows and volumes in this population of military divers. Prospective studies could explore the role of unmeasured confounding factors and could significantly contribute to health policies for both military and civilian divers.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of Interstitial Lung Disease to Mortality in Patients With Connective Tissue Diseases","authors":"Atefeh Vaezi MD ,&nbsp;Tracy Ashby DO ,&nbsp;Arvind Balavenkataraman MD ,&nbsp;Nadera Sweiss MD ,&nbsp;Mehdi Mirsaeidi MD","doi":"10.1016/j.chpulm.2025.100157","DOIUrl":"10.1016/j.chpulm.2025.100157","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial lung diseases (ILDs) are common in patients with connective tissue diseases (CTDs), but their role in the mortality of patients with CTDs remains unexplored.</div></div><div><h3>Research Question</h3><div>What proportion of mortality in patients with CTDs is due to ILD?</div></div><div><h3>Study Design and Methods</h3><div>In this retrospective, population-based epidemiologic study, we used the Wide-Ranging Online Data for Epidemiologic Research database and extracted mortality data of all deceased US citizens aged ≥ 15 years, from 1999 to 2019. Age-adjusted mortality rate (AAMR) was calculated by sex, racial group, and state of death. The annual trend was examined using the annual percent change and average annual percent change. We identified the rank of ILD as an underlying cause of death compared with the 15 leading causes of death in patients with CTDs.</div></div><div><h3>Results</h3><div>From 1999 to 2019, CTDs were mentioned in the death certificates of 286,643 US citizens, with 26,406 (7.12%) of them having ILDs simultaneously. The ILD-CTD-related AAMR per 1 million population decreased from 4.26 in 1999 to 3.37 in 2015 and further increased to 4.03 in 2019. The ILD-CTD-related AAMRs during 1999 to 2019 for female individuals and male individuals were 4.53 and 2.80 per 1 million, respectively. In the list of 15 leading causes of mortality, ILD could be ranked as the seventh, 11th, third, fourth, and fourth cause of death in patients with rheumatoid arthritis, systemic lupus erythematosus, polymyositis/dermatomyositis, systemic sclerosis, and Sjögren syndrome, respectively.</div></div><div><h3>Interpretation</h3><div>Our findings underscore the necessity for developing screening protocols and targeted interventions aimed at reducing ILD-related mortality in patients with CTD. This could significantly improve outcomes and quality of life for these patients.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Approach to Lung Volume Reduction Encompassing Surgical and Endobronchial Treatment of Severe Emphysema","authors":"Wim Janssens MD, PhD ,&nbsp;S. Everaerts MD, PhD ,&nbsp;N. Filipow MD, PhD ,&nbsp;C. Vandervelde MD ,&nbsp;J. Coolen MD, PhD ,&nbsp;H. Geysen PhD ,&nbsp;A. Blondeel PhD ,&nbsp;I. Gyselinck MD, PhD ,&nbsp;D. Stylemans MD ,&nbsp;I. Niesten MD ,&nbsp;F. Janssens MD ,&nbsp;S. Bouneb MD ,&nbsp;A. Neyrinck MD, PhD ,&nbsp;G. Verleden MD, PhD ,&nbsp;D. Van Raemdonck MD, PhD ,&nbsp;C. Dooms MD, PhD ,&nbsp;L. Ceulemans MD, PhD","doi":"10.1016/j.chpulm.2025.100194","DOIUrl":"10.1016/j.chpulm.2025.100194","url":null,"abstract":"<div><h3>Background</h3><div>Randomized controlled trials with lung volume reduction surgery (LVRS) or endobronchial valves (EBVs) have shown clinically significant benefits for specific patients with emphysema.</div></div><div><h3>Research Question</h3><div>What is the impact of a comprehensive lung volume reduction (LVR) program, with both LVRS and EBVs as treatment options, on patient selection and short- and long-term outcomes in real life?</div></div><div><h3>Study Design and Methods</h3><div>This study summarizes the results of a prospective comprehensive LVR program in tertiary care, based on 5-year inclusions and follow-up over 1 to 3 years.</div></div><div><h3>Results</h3><div>A total of 429 cases were discussed at a multidisciplinary emphysema board; of these, 131 (30%) were referred for LVRS, 73 (17%) were referred for EBV, 25 (6%) were referred for lung transplantation, and 200 (47%) were referred for usual care. A total of 38 (52%) of the EBV interventions were followed by a second to fourth intervention, including LVRS in 25 (34%). For LVRS first, 72 (55%) and 37 (38%) of patients had a single 1-stage bilateral or unilateral LVRS procedure, and 22 (17%) had a staged procedure. Clinically significant improvements between baseline and follow-up visits were obtained on all outcome dimensions in all LVRS and EBV groups for most of the visits. Responder rates varied between 50% and 80% at 3 months to 1 year and slowly declined in the second year. Transplant-free survival over 2.5 years, adjusted for age and BODE Index at baseline, was significantly better for the EBV intervention (hazard ratio, 0.14; 95% CI, 0.04-0.44) and borderline significant for LVRS (hazard ratio, 0.7; 95% CI, 0.45-1.2) compared with the nonintervention group.</div></div><div><h3>Interpretation</h3><div>LVR programs should cover both surgical and bronchoscopic interventions to maximize eligibility and to improve outcome and prognosis of highly symptomatic patients with severe emphysema.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}