医学最新文献

{"title":"Performance of helmet CPAP using different configurations: Turbine-driven ventilators <i>vs</i> Venturi devices.","authors":"A Noto, A Cortegiani, G Genoese, L Appendini, C Gregoretti, A Carlucci, C Crimi","doi":"10.1016/j.pulmoe.2023.04.009","DOIUrl":"10.1016/j.pulmoe.2023.04.009","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, Venturi-based flow generators have been preferred over mechanical ventilators to provide continuous positive airway pressure (CPAP) through the helmet (h-CPAP). Recently, modern turbine-driven ventilators (TDVs) showed to be safe and effective in delivering h-CPAP. We aimed to compare the pressure stability during h-CPAP delivered by Venturi devices and TDVs and assess the impact of High Efficiency Particulate Air (HEPA) filters on their performance.</p><p><strong>Methods: </strong>We performed a bench study using an artificial lung simulator set in a restrictive respiratory condition, simulating two different levels of patient effort (high and low) with and without the interposition of the HEPA filter. We calculated the average of minimal (Pmin), maximal (Pmax) and mean (Pmean) airway pressure and the time product measured on the airway pressure curve (PTPinsp). We defined the pressure swing (Pswing) as Pmax - Pmin and pressure drop (Pdrop) as End Expiratory Pressure - Pmin.</p><p><strong>Results: </strong>Pswing across CPAP levels varied widely among all the tested devices. During \"low effort\", no difference in Pswing and Pdrop was found between Venturi devices and TDVs; during high effort, Pswing (p<0.001) and Pdrop (p<0.001) were significantly higher in TDVs compared to Venturi devices, but the PTPinsp was lower (1.50 SD 0.54 vs 1.67 SD 0.55, p<0.001). HEPA filter addition almost doubled Pswing and PTPinsp (p<0.001) but left unaltered the differences among Venturi and TDVs systems in favor of the latter (p<0.001).</p><p><strong>Conclusions: </strong>TDVs performed better than Venturi systems in delivering a stable positive pressure level during h-CPAP in a bench setting.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416789"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9542198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can we rely on single use bronchoscopes in central airway obstruction management? A preliminary, open label randomised controlled trial.","authors":"Filip Popovic, Goran Glodic, Denis Baricevic, Viktor Domislovic, Miroslav Samarzija, Sonja Badovinac","doi":"10.1080/25310429.2024.2443218","DOIUrl":"https://doi.org/10.1080/25310429.2024.2443218","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2443218"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Launching a debate: Physical activity in people with chronic respiratory diseases.","authors":"Mara Paneroni, Michele Vitacca, Nicolino Ambrosino","doi":"10.1080/25310429.2024.2445408","DOIUrl":"https://doi.org/10.1080/25310429.2024.2445408","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2445408"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of exercise training on modulating the TH17/TREG imbalance in individuals with severe COPD: A randomized controlled trial.","authors":"Juliana Tiyaki Ito, Luan Henrique Vasconcelos Alves, Luana de Mendonça Oliveira, Rafaella Fagundes Xavier, Regina Maria Carvalho-Pinto, Iolanda de Fátima Lopes Calvo Tibério, Maria Notomi Sato, Celso R F Carvalho, Fernanda Degobbi Tenorio Quirino Dos Santos Lopes","doi":"10.1080/25310429.2024.2441069","DOIUrl":"https://doi.org/10.1080/25310429.2024.2441069","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) induces an imbalance in T helper (Th) 17/regulatory T (Treg) cells that contributes to of the dysregulation of inflammation. Exercise training can modulate the immune response in healthy subjects.</p><p><strong>Objective: </strong>We aimed to evaluate the effects of exercise training on Th17/Treg responses and the differentiation of Treg phenotypes in individuals with COPD.</p><p><strong>Methods: </strong>This randomized controlled trial included 50 individuals with severe or very severe COPD who were allocated to the Exercise or Control groups. The Exercise group underwent eight weeks of aerobic and muscle strength training, whereas the Control group received usual care. The primary outcome was the change in the phenotypic characteristics of Tregs and Th17 profile differentiation in systemic inflammation.</p><p><strong>Results: </strong>Exercise training increased the frequency of total and activated Tregs and decreased the frequency of Th17 cells in between-group comparisons. Additionally, Th17/Treg responses were moderately correlated with improvements in the six-minute walking test, muscle strength of the upper and lower limbs, and daily life physical activity levels.</p><p><strong>Conclusion: </strong>Exercise training improved functional exercise capacity, muscle strength, and physical fitness, which was associated with a decrease in the Th17 inflammatory response and an increase in Treg cell phenotypes immunosuppressive activity.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2441069"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of anxiety and depression with prognosis in chronic obstructive pulmonary disease: A systematic review and meta-analysis.","authors":"Kefan Wu, Lifei Lu, Yubiao Chen, Jieqi Peng, Xiaohui Wu, Gaoying Tang, Ting Ma, Jing Cheng, Pixin Ran, Yumin Zhou","doi":"10.1080/25310429.2024.2438553","DOIUrl":"10.1080/25310429.2024.2438553","url":null,"abstract":"<p><p>The associations between anxiety, depression, and the prognosis of COPD remain uncertain. The present study aims to investigate the associations of anxiety and depression with 30-day readmission rates and acute exacerbations of COPD (AECOPD). Four databases were searched to identify relevant studies published before 13 March 2024. Studies that report on the impact of anxiety and depression on the prognosis of AECOPD were included. The pooled effect size and its 95% confidence interval (CI) were calculated using a random effects model. The primary outcomes were 30-day readmission and AECOPD within the first year after discharge in COPD patients. Of the 5,955 studies screened, 14 studies were included in the analysis. Patients with anxiety had a higher risk of AECOPD within the first year after discharge compared to those without anxiety (HR: 2.10, 95% CI: 1.28-3.45, <i>p</i> = 0.003). Patients with depression also had a higher risk of AECOPD within the first year after discharge (HR: 1.36, 95% CI: 1.10-1.69, <i>p</i> = 0.004). Similar results were observed in the associations of anxiety and depression with 30-day readmission. Our results suggested that anxiety and depression were associated with an increased risk of 30-day readmission and AECOPD in patients with COPD.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2438553"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clustering patients with COVID-19 according to respiratory support requirements, and its impact on short- and long-term outcome (RECOVID study).","authors":"Rosario Menéndez, Raúl Méndez, Ana Latorre, Paula González-Jiménez, Germán Peces-Barba, María Molina-Molina, Pedro Pablo España, Estela García, Angélica Consuegra-Vanegas, Marta María García-Clemente, Carolina Panadero, Juan Marco Figueira-Gonçalves, David De la Rosa-Carrillo, Oriol Sibila, María Dolores Martínez-Pitarch, Nuria Toledo-Pons, Cecilia López-Ramírez, Wanda Almonte-Batista, Abigail Macías-Paredes, Mercedes Villamon, Marisol Domínguez-Álvarez, Eli Nancy Pérez-Rodas, Javier Lázaro, Sarai Quirós, Rosa Cordovilla, Irene Cano-Pumarega, Antoni Torres","doi":"10.1080/25310429.2024.2442175","DOIUrl":"10.1080/25310429.2024.2442175","url":null,"abstract":"<p><strong>Introduction: </strong>The Spanish Society of Pulmonology and Thoracic Surgery created a registry for hospitalised patients with COVID-19 and the different types of respiratory support used (RECOVID). Objectives. To describe the profile of hospitalised patients with COVID-19, comorbidities, respiratory support treatments and setting. In addition, we aimed to identify varying profiles of patients according to outcomes and the complexity of respiratory support needed.</p><p><strong>Methods: </strong>Multicentre, observational study in 49 Spanish hospitals. A protocol collected demographic data, comorbidities, respiratory support, treatment setting and 1-year follow-up. Patients were described using either frequency and percentages or median and interquartile range, as appropriate. A cluster analysis made it possible to identify different types of profile among the patients.</p><p><strong>Results: </strong>In total, 2148 of 2454 hospitalised patients (87.5%) received care in the conventional ward, whilst 126 in IRCU and 180 in ICU. In IRCU, 30% required high-flow nasal oxygen whilst 25%, non-invasive mechanical ventilation and 17%, mechanical ventilation. Four clusters of patients were identified. Two clusters were more likely to require IRCU/ICU admission, although primarily Cluster 2: Cluster (C) 1 consisted of patients without comorbidities and C2, those with comorbidities. Both presented higher inflammatory levels and lower lymphocyte count and SpO2/FiO2; however, C2 showed worse values. Two different clusters identified patients requiring less complex respiratory support. C3 presented higher comorbidities and elevated lymphocyte count, SpO2/FiO2 and low C-reactive protein (CRP). C4 included those without comorbidities except for arterial hypertension, lymphopenia and an intermediate CRP. In-hospital mortality and subsequent 1-year mortality were greater for C2 (28.6% and 7.1%) and C1 (11.1%, 8.3%) than for C4 (3.3%, 1.8%) and C3 (0%, 0%).</p><p><strong>Conclusions: </strong>The cluster analysis identified four clinical phenotypes requiring distinct types of respiratory support, with great differences present per characteristics and outcomes.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2442175"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silicosis and tuberculosis: A systematic review and meta-analysis.","authors":"P Jamshidi, B Danaei, M Arbabi, B Mohammadzadeh, F Khelghati, A Akbari Aghababa, A Nayebzade, A H Shahidi Bonjar, R Centis, G Sotgiu, M J Nasiri, G B Migliori","doi":"10.1016/j.pulmoe.2023.05.001","DOIUrl":"10.1016/j.pulmoe.2023.05.001","url":null,"abstract":"<p><strong>Introduction: </strong>Silicosis mostly happens in workers with high silica exposure and may accompany the development of various diseases like tuberculosis, cancer, or autoimmune diseases. The term silico-tuberculosis describes a condition in which an individual is affected by both silicosis and tuberculosis at the same time. This systematic review and meta-analysis study was conducted to evaluate the risk of tuberculosis in silicosis patients and individuals exposed to silica dust.</p><p><strong>Methods: </strong>We performed a systematic search for relevant studies up to 6 September 2022 using PubMed/ Medline, and Embase with the following keywords in titles or abstracts: \"silicosis\" OR \"silicoses\" OR \"pneumoconiosis\" OR \"pneumoconioses\" AND \"tuberculosis\". Cohort and case-control studies containing relevant and original information about tuberculosis infection in silicosis patients were included for further analysis. Pooled estimates and 95% confidence intervals (CI) for the relative risk of tuberculosis in individuals with silicosis compared to those without; these were evaluated using the random effects model due to the estimated heterogeneity of the true effect sizes.</p><p><strong>Results: </strong>Out of 5352 potentially relevant articles, 7 studies were eligible for systematic review, of which 4 cohort studies were included for meta-analysis. The total population of all studies was 5884, and 90.63% were male. The mean age of participants was 47.7 years. Our meta-analysis revealed a pooled risk ratio of 1.35 (95%CI 1.18-1.53, I ²: 94.30%) which means an increased risk of silicosis patients and silica-exposed individuals to tuberculosis infection.</p><p><strong>Conclusion: </strong>Silicosis and silica dust exposure increase the risk of tuberculosis. Therefore, we suggest that individuals with long-time silica exposure, like mine workers, be routinely considered for both silicosis and tuberculosis screening programs.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416791"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9680387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features in patients with severe Alpha-1 antitrypsin deficiency due to rare genotypes.","authors":"Ilaria Ferrarotti, Davide Piloni, Asia Filosa, Stefania Ottaviani, Valentina Barzon, Alice Maria Balderacchi, Luciano Corda, Christine Seebacher, Sara Magni, Francesca Mariani, Paolo Baderna, Paola Confalonieri, Leonardo Iannacci, Silvia Mancinelli, Paola Putignano, Carlo Albera, Giulia Maria Stella, Maria Cristina Monti, Angelo Guido Corsico","doi":"10.1080/25310429.2024.2429911","DOIUrl":"https://doi.org/10.1080/25310429.2024.2429911","url":null,"abstract":"<p><p>Alpha-1 Antitrypsin Deficiency (AATD) is a co-dominant condition associated with an increased risk of lung and liver disease. Since it is commonly thought that 95% of severe cases of AATD have PI*ZZ genotype, most studies about AATD have been focused on the Z variant. Nevertheless, over 500 single nucleotide variations in the <i>SERPINA1</i> gene have been identified. We investigated the clinical presentation of subjects with severe AAT deficiency due to rare genotypes of the <i>SERPINA1</i> gene. We enrolled patients from the Italian Registry for AATD (RIDA1) with the following inclusion criteria: diagnosis of severe AATD; age >18 years; full clinical data available at diagnosis; three years of follow-up respiratory function data. A total of 281 patients were enrolled from the RIDA1 Registry and subdivided into 3 cohorts: PI*ZZ genotype (n = 160), PI*SZ genotype (n = 54), and rare genotypes PI*R (n = 67). We did not observe any statistical differences among the cohorts regarding sex, smoking habits, occupational exposure and age at diagnosis. Patients with severe AATD due to rare genotypes have clinical characteristics and respiratory profiles similar to PI*ZZ subjects, and differed from the PI*SZ patient group. Early and accurate diagnosis of PI*R subjects is therefore important for their appropriate clinical management.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2429911"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign ectopic intrapulmonary thyroid: Further proof of its existence.","authors":"Jeffy Mathew, Nao Hara, Liying Han, Samuel J McCabe, Oleg Epelbaum","doi":"10.1080/25310429.2024.2435092","DOIUrl":"https://doi.org/10.1080/25310429.2024.2435092","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2435092"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary health-care practices for deaf children should include early incorporation of a signed language.","authors":"Wyatte C Hall, Julia L Hecht","doi":"10.1016/S0140-6736(24)01564-2","DOIUrl":"10.1016/S0140-6736(24)01564-2","url":null,"abstract":"","PeriodicalId":18014,"journal":{"name":"The Lancet","volume":" ","pages":"2498-2500"},"PeriodicalIF":98.4,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}