CHEST pulmonary最新文献

{"title":"Non-Small Cell Lung Cancer Survival by Race and Ethnicity in California, 2014-2019 Differences by Sex and Smoking History","authors":"Jeffrey B. Velotta MD ,&nbsp;Julie Von Behren MPH ,&nbsp;Rachel A. Allison BS ,&nbsp;Linda Shin BS ,&nbsp;Iona Cheng MPH, PhD ,&nbsp;Scarlett Lin Gomez MPH, PhD","doi":"10.1016/j.chpulm.2025.100190","DOIUrl":"10.1016/j.chpulm.2025.100190","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is currently the leading cause of cancer-related death. There are gaps in knowledge regarding survival patterns according to sex and smoking status across racial and ethnic groups.</div></div><div><h3>Research Question</h3><div>Are there mortality differences according to race/ethnicity among individuals diagnosed with lung cancer in California when stratified by sex and smoking status?</div></div><div><h3>Study Design and Methods</h3><div>Non-small cell lung cancer (NSCLC) cases diagnosed from 2014 through 2019 from the California Cancer Registry, a population-based cancer surveillance system, were analyzed. Using Cox regression models, hazard ratios (HRs) were estimated for NSCLC mortality according to race and ethnicity, stratified by sex and smoking status and adjusted for sociodemographic and clinical variables.</div></div><div><h3>Results</h3><div>Among 28,854 female individuals, every racial and ethnic group had an HR &lt; 1 compared with non-Hispanic White (NHW) individuals, with the exception of Native Hawaiian and Pacific Islander and American Indian and Alaskan Native (AIAN) populations, who had comparable mortality. Non-Hispanic Black, Hispanic, and Chinese female individuals had lower mortality relative to NHW female individuals, with HRs of 0.94 (95% CI, 0.89-0.99), 0.89 (95% CI, 0.85-0.93), and 0.82 (95% CI, 0.76-0.88), respectively. Among 29,499 male individuals, every racial and ethnic group exhibited a lower HR, compared with NHW male individuals, with the exception of Japanese (HR, 1.14; 95% CI, 0.99-1.31) and AIAN (HR, 1.15; 95% CI, 0.96-1.38) male individuals. Vietnamese female individuals who had never smoked had lower mortality (HR, 0.80; 95% CI, 0.69-0.92) relative to NHW female individuals. Chinese male individuals who had never smoked had lower mortality (HR, 0.83; 95% CI, 0.71-0.97) compared with NHW male individuals who had never smoked.</div></div><div><h3>Interpretation</h3><div>In this population-based study of NSCLC, we found mortality differences across racial/ethnic groups when accounting for sex and smoking status. Further research focused on mortality differences in NSCLC stratified according to race and ethnicity should focus on social determinants of health and health care access factors.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747474","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":"Isolated Cystic Lung Disease and Recurrent Pneumothorax in a 50-Year-Old Woman","authors":"Eryn Fox MD ,&nbsp;Kyle Swartz DO ,&nbsp;Sunit Jariwala MD","doi":"10.1016/j.chpulm.2025.100175","DOIUrl":"10.1016/j.chpulm.2025.100175","url":null,"abstract":"<div><h3>Case Presentation</h3><div>A 50-year-old woman with no smoking history and medical history significant for portal vein thrombosis on anticoagulation, hepatic steatosis, and recent admission 3 weeks prior for spontaneous left-sided pneumothorax treated with chest tube insertion and successful lung reexpansion presented to the emergency department with 3 days of pleuritic chest pain and dyspnea on exertion. She denied any fevers, chills, diaphoresis, weakness, cough, hemoptysis, nausea, vomiting, or extremity swelling. She stated the chest pain was similar to what she had experienced 3 weeks prior.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925533","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":"“They Just Don’t Get Around to It”","authors":"Neelima Navuluri MD, MPH ,&nbsp;Govind Krishnan MD ,&nbsp;Tiera Lanford MEd, MPH ,&nbsp;Abigail Shapiro MSPH ,&nbsp;Angela B. Johnson BS ,&nbsp;Isaretta L. Riley MD, MPH ,&nbsp;Leah L. Zullig PhD, MPH ,&nbsp;Christopher E. Cox MD, MPH ,&nbsp;Scott Shofer MD, PhD","doi":"10.1016/j.chpulm.2025.100165","DOIUrl":"10.1016/j.chpulm.2025.100165","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer screening (LCS) rates are low across the United States, with substantial disparities in availability and uptake. This trend is also reflected in the Veterans Affairs Healthcare System. We aimed to understand clinician perspectives on factors leading to low uptake and racial disparities in LCS.</div></div><div><h3>Research Question</h3><div>What are VA primary care providers' and LCS program staff's experiences with the LCS process and their perspectives on ways it could be improved to reduce disparities in LCS rates among Black veterans?</div></div><div><h3>Study Design and Methods</h3><div>Semistructured interviews were conducted at a Southeastern US Veterans Affairs Healthcare System with primary care providers and LCS program staff. Interview questions and notetaking templates were developed using the Consolidated Framework for Implementation Research. Rapid qualitative analysis was used to assess perspectives on barriers, facilitators, and contextual factors leading to low uptake and racial disparities in LCS to help inform future interventions.</div></div><div><h3>Results</h3><div>We interviewed 20 health care providers (17 primary care providers, 3 LCS program staff). Six emergent themes were derived from a combination of Consolidated Framework for Implementation Research domains and constructs. These included the following: (1) primary care providers’ complex experiences with the centralized LCS program, (2) LCS is 1 priority among many, (3) marked clinician variation in LCS shared decision-making and referral decisions, (4) racial biases and structural inequities, (5) limited clinician knowledge of patient-level screening facilitators, and (6) suggested program improvements. Themes underscored that improving the shared decision-making process and streamlining referral and scheduling are key areas for future interventions to improve LCS uptake.</div></div><div><h3>Interpretation</h3><div>Providers reported multiple barriers contributing to LCS disparities and suggested targeting interventions to improve the shared decision-making process and the transition from primary care to LCS visit. Future studies should evaluate such interventions and their impact on LCS uptake and equity.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048710","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":"Understanding Patient Perspectives on Digital Smoking History Data Collection","authors":"Kayla C. Jones MA ,&nbsp;Lauren E. Kearney MD ,&nbsp;Emily Jansen MPH ,&nbsp;Nicholas Cordella MD ,&nbsp;Hasmeena Kathuria MD ,&nbsp;Katrina Steiling MD","doi":"10.1016/j.chpulm.2025.100180","DOIUrl":"10.1016/j.chpulm.2025.100180","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer screening with an annual low-dose CT scan is recommended by the US Preventive Services Task Force for high-risk patients based on age (50-80 years of age) and smoking history (≥ 20 pack-years). Inaccurate smoking history data in the electronic health record (EHR) pose a challenge to identifying eligible patients. Digital strategies to collect patient-generated health data (PGHD) are a potential solution to elicit complete smoking histories directly from patients to then integrate into their EHR.</div></div><div><h3>Research Question</h3><div>How do patients perceive and experience the use of digital outreach strategies to collect smoking history data to determine lung cancer screening eligibility?</div></div><div><h3>Study Design and Methods</h3><div>As part of a quality improvement initiative, semistructured qualitative interviews were completed with a diverse group of patients who had received a request to complete a digital smoking history survey. Rapid analytical methods were used.</div></div><div><h3>Results</h3><div>We completed 20 interviews with patients who did (n = 9) and did not (n = 11) complete the digital smoking history survey. Participants described varied preferences for digitally self-updating their smoking histories. Four themes emerged regarding barriers to uptake including (1) participants prefer to update their health record with a clinician, (2) technologic barriers influence participant engagement with digital PGHD collection strategies, (3) multiple options for collecting smoking frequency are needed to align with a variety of behaviors, and (4) participants have mixed perceptions of the value of accurate and updated EHR smoking data.</div></div><div><h3>Interpretation</h3><div>Our findings highlight the need to address barriers to collection of digital PGHD to optimize reach and uptake. Using PGHD to obtain an updated and accurate smoking history has important implications, and incorporating patient education, strategies to overcome technologic barriers, and multiple metric options to collect smoking history may improve use.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931940","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":"Lymphangioleiomyomatosis Patient Research Priorities Survey (LAM-PREP)","authors":"Marina K. Holz PhD, DrPH ,&nbsp;Andrea D. Slattery BSBA ,&nbsp;Eden J. Pontz BA ,&nbsp;Stephanie R. Dreyer MBA ,&nbsp;Gregory P. Downey MD ,&nbsp;Nishant Gupta MD, MS ,&nbsp;Susan E. Sherman MHA ,&nbsp;Vera P. Krymskaya PhD ,&nbsp;Lyndsay M. Hoy MD","doi":"10.1016/j.chpulm.2025.100184","DOIUrl":"10.1016/j.chpulm.2025.100184","url":null,"abstract":"<div><h3>Background</h3><div>Engaging patients in developing research agendas is recognized as critical in advancing scientific discovery and improving clinical care. There is a scarcity of such studies for respiratory diseases, particularly rare conditions like lymphangioleiomyomatosis (LAM).</div></div><div><h3>Research Question</h3><div>Can a comprehensive study inform and guide future LAM research for the benefit of patients, researchers, and clinical providers?</div></div><div><h3>Study Design and Methods</h3><div>We used a mixed-methods analysis consisting of focus groups of patients and caregivers. Participant responses were thematically analyzed and grouped into categories and subcategories using qualitative content analysis to generate a list of health needs, quality of life issues, and research areas. A survey to rank the priorities was then developed and administered electronically to patients with LAM, caregivers, scientists, and clinicians.</div></div><div><h3>Results</h3><div>The LAM Patient Research Priorities Survey (LAM-PREP) revealed a list of priorities centered on health, quality of life, and research needs. Areas of agreement among all respondents were prioritizing awareness of LAM among health care providers, access to comprehensive care, understanding and interpreting symptoms, mental health, managing supplemental oxygen, finding new treatments and a cure, and studying the role of hormones in LAM disease and treatment. Clinicians prioritized needs relating to travel, sexual and women’s health, and childbearing and family planning. Patients prioritized questions regarding LAM and sleep quality, safe exercise, and the impact of diet. Both scientists and clinicians noted a priority in studying disease onset and progression.</div></div><div><h3>Interpretation</h3><div>LAM-PREP integrated diverse perspectives on LAM research and clinical priorities from LAM community stakeholders. These findings should serve as a roadmap for developing and implementing projects and interventions to improve the health outcomes of women living with LAM. Importantly, LAM-PREP can serve as a model for developing patient-focused research agendas for other rare diseases, particularly those affecting women.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920303","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":"Metabolic Medications and Youth Hospitalizations for Asthma","authors":"Sixtus Aguree PhD ,&nbsp;Bowen Jiang MS ,&nbsp;Yash Kalpesh Shah MS ,&nbsp;Arthur H. Owora PhD, MPH ,&nbsp;Erick Forno MD, MPH","doi":"10.1016/j.chpulm.2025.100185","DOIUrl":"10.1016/j.chpulm.2025.100185","url":null,"abstract":"<div><h3>Background</h3><div>Obesity and metabolic dysregulation can lead to adverse outcomes in people with asthma. We hypothesized that pharmacologic treatment of metabolic conditions in youths with asthma is associated with lowered risk of severe asthma exacerbations.</div></div><div><h3>Research Question</h3><div>Is metabolic pharmacotherapy associated with a lower risk of severe asthma exacerbations among children and young adults with metabolic dysregulation?</div></div><div><h3>Study Design and Methods</h3><div>This retrospective, quasi-experimental, longitudinal study examined severe asthma exacerbations (those requiring hospitalization or an emergency department visit) among youths aged 5 to 25 years with asthma and a history of a metabolic condition (obesity, diabetes, or hypertension). Definitions and diagnoses were based on documented International Classification of Diseases codes. We compared the odds of severe asthma exacerbations before and after the initiation of metabolic pharmacotherapy using adjusted piecewise generalized linear mixed models.</div></div><div><h3>Results</h3><div>The cohort consisted of 783 patients, predominantly female (73.7%), White (71.6%), and non-Hispanic (90.4%). Metformin was the most frequently prescribed metabolic medication (75.4%). Before initiating metabolic pharmacotherapy, the odds of severe asthma exacerbations increased by 29% per year (OR, 1.29; 95% CI, 1.12-1.49). Conversely, after the commencement of metabolic pharmacotherapy, the odds of severe asthma exacerbations decreased by 66% per year (OR, 0.34; 95% CI, 0.23-0.50), showing a statistically significant and marked difference between the pretreatment and posttreatment periods.</div></div><div><h3>Interpretation</h3><div>Our findings show that the odds of severe asthma exacerbations are substantially lower after the initiation of metabolic pharmacotherapy, highlighting the positive impact that treatment of metabolic syndromes could have in reducing the risk of severe asthma exacerbations. This underscores the interconnectedness of metabolic and respiratory health and the need for further research into effective treatment strategies for individuals with asthma and obesity-related metabolic conditions.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988139","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 Effect Modification of Type 2 Inflammation and Sex on Asthma Exacerbation Rates","authors":"Trisha Agarwal BS ,&nbsp;Ryan Peterson PhD ,&nbsp;Guillermo Jimenez MD ,&nbsp;Zachary Taich MD ,&nbsp;Sunita Sharma MD, MPH ,&nbsp;Fernando Holguin MD, MPH ,&nbsp;Meghan D. Althoff MD, PhD","doi":"10.1016/j.chpulm.2024.100123","DOIUrl":"10.1016/j.chpulm.2024.100123","url":null,"abstract":"<div><h3>Background</h3><div>Prior studies have identified predictors of asthma exacerbations; however, most lack integration of type 2 (T2) inflammatory markers.</div></div><div><h3>Research Question</h3><div>In a large electronic health record database, what are predictors of asthma exacerbation rates and is there interaction by T2 inflammation, female sex, and obesity?</div></div><div><h3>Study Design and Methods</h3><div>This is a retrospective cohort study using electronic health record data of patients with asthma followed for at least 1 year in the UCHealth system. The primary outcome was asthma exacerbation rate, defined by the prescription of an oral corticosteroid burst. Predictors of interest included T2 high inflammation, defined as absolute eosinophil count (AEC) ≥ 300 cells/μL, BMI, and sex. Predictors of the numbers of exacerbation and prespecified interactions were identified with negative binomial models. A natural cubic spline was used to model the dose response between AEC and exacerbation rate.</div></div><div><h3>Results</h3><div>The cohort included 70,939 patients with asthma; 52% had T2 high inflammation and 62% were female, with 70% of patients being overweight or obese. Individuals with T2 high inflammation had higher adjusted rates of exacerbation (adjusted incidence rate ratio, 1.13; 95% CI, 1.10-1.16). AEC predicted exacerbation frequency in a dose-dependent manner. There was significant effect modification by sex, with female participants with T2 high inflammation having increased exacerbation rates compared with male participants with T2 high inflammation.</div></div><div><h3>Interpretation</h3><div>This study finds an increase in exacerbation rate among patients with T2 high inflammation with asthma and shows a dose-dependent response to AEC. To our knowledge, this is the first study to find effect modification by sex and T2 status, identifying a group of patients who could potentially benefit from T2-targeted biologic therapy to decrease their exacerbation rate.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100123"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988140","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":"Infant Pulmonary Function Testing in Pediatric Diffuse Parenchymal Lung Disease","authors":"Avigdor Hevroni MD ,&nbsp;Alex Gileles-Hillel MD ,&nbsp;Malena Cohen-Cymberknoh MD ,&nbsp;Joel Reiter MD ,&nbsp;David Shoseyov MD ,&nbsp;Reuven Tsabari MD ,&nbsp;Chaim Springer MD ,&nbsp;Laurice S. Boursheh MD ,&nbsp;Oded Breuer MD","doi":"10.1016/j.chpulm.2025.100140","DOIUrl":"10.1016/j.chpulm.2025.100140","url":null,"abstract":"<div><h3>Topic Importance</h3><div>Diffuse parenchymal lung disease (DPLD) in pediatrics, also known as children’s interstitial lung disease, comprises a diverse group of rare and chronic respiratory disorders affecting the pediatric population. Diagnosing and monitoring these conditions in infants pose significant challenges. Despite advances in genetic diagnostics and imaging technologies, challenges persist, particularly in infants, for whom noninvasive methods are limited, and no optimal technique exists for quantitative follow-up. Although pulmonary function testing (PFT) is an essential tool for evaluating adults and older children, its complexity limits its routine use in infants. In this review, we summarize available data on infant PFT (iPFT) in DPLD, highlight its potential to enhance our understanding of the pathophysiologic features of certain DPLDs, and elucidate its role in disease management.</div></div><div><h3>Review Findings</h3><div>Diverse patterns of iPFT alterations have been observed across different types of DPLD in infants. Specific conditions, such as surfactant dysfunction disorders, neuroendocrine cell hyperplasia of infancy, and congenital heart disease with high pulmonary flow exhibit distinct alteration patterns. These findings enhance our understanding of the pathophysiologic characteristics of these diseases and can aid in their diagnosis and management.</div></div><div><h3>Summary</h3><div>Understanding the nature of iPFT alterations can provide insights into the pathophysiologic features, diagnosis, and management of DPLD in infants. However, the complexity of performing comprehensive PFT in infants restricts its routine use. Advancing the development of precise and accessible techniques for evaluating pulmonary function in infants is crucial to improving management. Given the rarity of DPLD in infants, international collaboration is imperative.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988141","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":"Detection of SARS-CoV-2 RNA and Biomarkers in Device-Captured Droplets From the Lung","authors":"Rebecca S. Steinberg MD ,&nbsp;Tzu-Chun Chu MPH ,&nbsp;Denny Shin MD ,&nbsp;Binh Ha PhD ,&nbsp;He-Ying Sun PhD ,&nbsp;Samadhan J. Jadhao DVM ,&nbsp;David N. Ku MD ,&nbsp;Blaine R. Roberts PhD ,&nbsp;Evan J. Anderson MD ,&nbsp;Laila Hussaini MPH ,&nbsp;Larry J. Anderson MD ,&nbsp;Blake Anderson MD","doi":"10.1016/j.chpulm.2025.100137","DOIUrl":"10.1016/j.chpulm.2025.100137","url":null,"abstract":"<div><h3>Background</h3><div>SARS-CoV-2 remains a global health issue since its discovery in 2019, and long-term noninvasive clinical testing methods are required. The current preferred method of detection is nasopharyngeal swab, which reflects sampling of the upper respiratory tract alone.</div></div><div><h3>Research Question</h3><div>Can we noninvasively assess detection of SARS-CoV-2 RNA and biomarkers in patients’ cough droplets captured with the PneumoniaCheck device?</div></div><div><h3>Study Design and Methods</h3><div>We enrolled adult patients with a recent nasopharyngeal swab that was positive for COVID-19 by polymerase chain reaction (PCR) who were receiving monoclonal antibody infusion therapy. After consent and instruction, patients coughed 5 sets of 10 coughs into the PneumoniaCheck device. Material captured on the device filter was eluted and tested for biomarkers (interferon gamma, tumor necrosis factor alpha [TNF-α], IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, and IL-13) and amylase by an enzyme activity assay, and SARS-CoV-2 RNA by PCR (3 different primer sets).</div></div><div><h3>Results</h3><div>A total of 44 case patients out of 50 cases and 17 control patients with adequate specimen and accompanying clinical data were included in the analysis. Thirty case patient cough specimens (68%) tested PCR positive for SARS-CoV-2 RNA, 10 (23%) tested negative, and 4 (9%) tested indeterminate. IL-13 and TNF-α levels were significantly higher, whereas IL-2 levels were significantly lower in case specimens than in control cough specimens. In the multivariable analysis of biomarkers and reported symptoms, higher IL-10 levels were associated with reduced fatigue (OR, 0.41; 95% CI, 0.15-0.87; <em>P</em> = .039), whereas higher IL-12p70 (OR, 2.74; 95% CI, 1.15-8.51; <em>P</em> = .043), IL-4 (OR, 3.56; 95% CI, 1.56-11.20; <em>P</em> = .008), and TNF-α (OR, 4.36; 95% CI, 1.79-14.60; <em>P</em> = .004) levels were associated with fever.</div></div><div><h3>Interpretation</h3><div>Our results show that the PneumoniaCheck device is a noninvasive method for successfully detecting SARS-CoV-2 and inflammatory cytokines in specimens from the lower respiratory tract in patients with COVID-19 and likely in patients with other lung diseases.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048712","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":"Cutting for Stone","authors":"Matthew Federbush MD ,&nbsp;Alain Borczuk MD ,&nbsp;Arunabh Talwar MD ,&nbsp;Julissa Jurado MD ,&nbsp;Abhinav Agrawal MD","doi":"10.1016/j.chpulm.2025.100188","DOIUrl":"10.1016/j.chpulm.2025.100188","url":null,"abstract":"<div><div>Silicosis typically presents with parenchymal lung disease in workers exposed to silica. We present a rare case of isolated pleural and lymph node silicosis without parenchymal involvement in a stone fabrication worker. A 49-year-old man with extensive occupational exposure to stone materials, including engineered stone without consistent use of personal protective equipment, was found to have mediastinal and hilar lymphadenopathy. Initial bronchoscopic and radiology evaluations were nondiagnostic. Video-assisted thoracoscopic surgery revealed pleural nodules, and pathologic examination demonstrated silicotic changes in both pleura and lymph nodes but without parenchymal involvement. This case demonstrates an unusual presentation of silicosis confined to the pleura and lymph nodes, highlighting the importance of thorough evaluation of thoracic pathology in workers with silica exposure. It adds to growing evidence regarding health risks in the engineered stone fabrication industry and emphasizes the need for improved occupational safety measures and medical surveillance.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048714","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}