医学最新文献

{"title":"Helmet continuous positive airway pressure for patients' transport using a single oxygen cylinder: A bench study.","authors":"N Capsoni, F Zadek, D Privitera, G Parravicini, G V Zoccali, F Galbiati, M Bombelli, R Fumagalli, T Langer","doi":"10.1016/j.pulmoe.2023.09.007","DOIUrl":"10.1016/j.pulmoe.2023.09.007","url":null,"abstract":"<p><strong>Background: </strong>Continuous positive airway pressure (CPAP) is frequently used to treat patients with acute respiratory failure in out-of-hospital settings. Compared to a facemask, the helmet has many advantages for the patient but requires a minimum gas flow of 60 L/min to avoid CO₂ rebreathing. The aim of the present bench study was to evaluate the performance of four Venturi devices, connected to a single oxygen cylinder, in delivering helmet-CPAP with clinically relevant gas flow, fraction of inspired oxygen (FiO₂)_, and positive end-expiratory pressure (PEEP) values.</p><p><strong>Methods: </strong>Three double-inlet Venturi systems (EasyVent, Ventuplus, Compact-HAR) were connected to full 5-L oxygen cylinders using a double flowmeter, and their oxygen requirements to reach different setups (flow 60-80 L/min; FiO₂ 0.4-0.5-0.6, PEEP 7.5-10-12.5 cmH₂O) were tested. The fourth Venturi system (O2-MAX) was directly attached to the tank, and the flow and FiO₂ delivered at preset FiO₂ 0.3 and 0.6 were recorded. The runtime of the cylinder was assessed.</p><p><strong>Results: </strong>EasyVent, Ventuplus, and O2-MAX were able to deliver helmet-CPAP with clinically useful setups when connected to a single oxygen cylinder, while Compact-HAR did not. The runtime of the cylinders ranged between 28 and 60 minutes according to the preset flow and FiO₂. The delivered gas flow decreased slowly and linearly with the drop in cylinder pressure until its exhaustion.</p><p><strong>Conclusions: </strong>Helmet-CPAP might be provided using portable Venturi systems connected to an oxygen cylinder, but not all of them are able to deliver it. The use of a double flowmeter allows delivery of both high flow and high FiO₂ when double-inlet Venturi systems are used. Due to the flow drop observed during the cylinder consumption, a flow >60 L/min should be set when helmet-CPAP is started. Considering the flow drop phenomenon, the estimated duration of the tank runtime can be used with a margin of safety when planning patient transport.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416826"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415276","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":"Early detection of interstitial lung disease in rheumatic diseases: A joint statement from the Portuguese Pulmonology Society, the Portuguese Rheumatology Society, and the Portuguese Radiology and Nuclear Medicine Society.","authors":"A Morais, A C Duarte, M O Fernandes, A Borba, C Ruano, I D Marques, J Calha, J C Branco, J M Pereira, M J Salvador, M Bernardes, N Khmelinskii, P Pinto, R Pinto-Basto, S Freitas, S Campainha, T Alfaro, A Cordeiro","doi":"10.1016/j.pulmoe.2023.11.007","DOIUrl":"10.1016/j.pulmoe.2023.11.007","url":null,"abstract":"<p><strong>Introduction: </strong>Interstitial lung disease (ILD) contributes significantly to morbidity and mortality in connective tissue disease (CTD). Early detection and accurate diagnosis are essential for informing treatment decisions and prognosis in this setting. Clear guidance on CTD-ILD screening, however, is lacking.</p><p><strong>Objective: </strong>To establish recommendations for CTD-ILD screening based on the current evidence.</p><p><strong>Method: </strong>Following an extensive literature research and evaluation of articles selected for their recency and relevance to the characterization, screening, and management of CTD-ILD, an expert panel formed by six pulmonologists from the Portuguese Society of Pulmonology, six rheumatologists from the Portuguese Society of Rheumatology, and six radiologists from the Portuguese Society of Radiology and Nuclear Medicine participated in a multidisciplinary discussion to produce a joint statement on screening recommendations for ILD in CTD.</p><p><strong>Results: </strong>The expert panel achieved consensus on when and how to screen for ILD in patients with systemic sclerosis, rheumatoid arthritis, mixed connective tissue disease, Sjögren syndrome, idiopathic inflammatory myopathies and systemic lupus erythematous.</p><p><strong>Conclusions: </strong>Despite the lack of data on screening for CTD-ILD, an expert panel of pulmonologists, rheumatologists and radiologists agreed on a series of screening recommendations to support decision-making and enable early diagnosis of ILD to ultimately improve outcomes and prognosis in patients with CTD.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416840"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040902","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":"Treatment of obstructive sleep apnea syndrome (OSAS) with mandibular advancement devices-A statement of the Portuguese Society of Pulmonology, the Portuguese Society of Stomatology and Dental Medicine, the Portuguese Dental Association, and the Portuguese Society of Temporomandibular Disorders, Orofacial Pain and Sleep.","authors":"Susana Sousa, Sílvia Correia, André Mariz de Almeida, Gabriela Videira, Ricardo Dias, Susana Falardo Ramos, Júlio Fonseca","doi":"10.1016/j.pulmoe.2024.05.006","DOIUrl":"10.1016/j.pulmoe.2024.05.006","url":null,"abstract":"<p><p>With the purpose of establishing a consensus around clinical orientations for professionals involved in managing patients with sleep breathing disorders (SBD), an interdisciplinary group of scientific societies involved in this field discussed and reviewed all the published international guidelines from the American Dental Association, American Academy of Sleep Medicine, American Academy of Dental Sleep Medicine and the European counterparts. Treatment of SBD is multidisciplinary and should be made in concert with the patient, the sleep physician, and the qualified dentist to solve the individual, social, and economic burden of the disease. This consensus document represents the current thinking of a team of Portuguese experts on managing patients with SBD based on the available evidence.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416848"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604502","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":"Smoking exposure trajectories and pulmonary function in early adulthood in a Brazilian cohort.","authors":"P Weber, A M B Menezes, H Gonçalves, P D de Oliveira, A Wendt, R Perez-Padilla, F C Wehrmeister","doi":"10.1016/j.pulmoe.2023.09.005","DOIUrl":"10.1016/j.pulmoe.2023.09.005","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate smoking trajectories and their association with pulmonary function (PF) and respiratory symptoms at age 22.</p><p><strong>Methods: </strong>Data from a population-based cohort study of 3350 individuals and their spirometries were analysed. The outcomes were: forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), forced expiratory flow at the mid expiratory phase (FEF_25-75 %), FEV₁/FVC and FEF_25-75/FVC ratio. Smoking data were collected at perinatal follow-up (gestational exposure) and 15, 18 and 22 years. Group-based trajectory model was applied.</p><p><strong>Results: </strong>Four groups were identified: no exposure (NE), gestational (GE), gestational and adulthood (GAE) and continuous (CE) exposure. Both CE and GAE trajectories were associated with lower values of FEV₁/FVC (-1.77pp; <i>p</i> = 0.01 and -1.58 pp; <i>p</i><0.001 respectively) and FEF_25-75/FVC ratio (-7.27pp; <i>p</i> = 0.019 and -6.04pp; <i>p</i><0.001 respectively) compared to the NE trajectory. Lower FEV₁ and FEF_25-75 % values were also related to the GAE trajectory (-68 ml; <i>p</i> = 0.03 and -253 ml/s_; <i>p</i><0.001 respectively). Compared to those who never smoked, individuals who smoked 10 or more cigarettes daily presented a reduction in the FEV₁/FVC ratio by 1.37pp (<i>p</i><0.001), FEF_25-75 % by 126 ml (<i>p</i> = 0.012) and FEF_25-75 %/FVC ratio by 3.62pp (<i>p</i> = 0.011). CE trajectory showed higher odds of wheezing (OR 4.14; <i>p</i><0.001) and cough (OR 2.39; <i>p</i> = 0.002) compared to the non-exposed group.</p><p><strong>Conclusions: </strong>The in-uterus exposure to maternal smoking reduces PF later in life. However, the perpetuation of smoking behaviour throughout adolescence and early adulthood is determinant for PF main reduction and the emergence of respiratory-related symptoms.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416818"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415277","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":"Impact of treating obesity hypoventilation syndrome on body mass index.","authors":"R G S Andrade, J F Masa, J-C Borel, L F Drager, P R Genta, B Mokhlesi, G Lorenzi-Filho","doi":"10.1016/j.pulmoe.2023.09.004","DOIUrl":"10.1016/j.pulmoe.2023.09.004","url":null,"abstract":"<p><strong>Study objectives: </strong>To evaluate the impact of positive airway pressure (PAP) therapy on body mass index (BMI) in patients with obesity hypoventilation syndrome (OHS) associated with obstructive sleep apnea (OSA). Methods: A systematic review using the following terms: \"obesity hypoventilation syndrome\" AND \"treatment\" AND \"randomized\" using Cochrane Central Register of Controlled Trials, Medline and Web of Science was performed from the first data available until February 10, 2023. The inclusion criteria were: (1) original article; (2) adult OHS with concomitant OSA (apnea-hypopnea index or AHI ≥5 events/h); (3) randomized trial with PAP arm and standard care (control); (4) BMI evaluation at baseline and after the first months. We performed an individual participant data meta-analysis of randomized controlled trials.</p><p><strong>Results: </strong>Our initial search retrieved 32 articles and 3 randomized studies fulfilled study criteria and were included in the final analysis, leading to a total of 342 participants. Patients were predominantly females (62%) and had OHS associated with at least mild OSA. As compared to baseline, a decrease in BMI was observed at study endpoint but this difference was not different intergroups (-0.50 ± 1.49 and -0.50 ±1.83, in control and PAP groups respectively (p=0.939)). Weight change was not associate with PAP adherence, OSA severity or use of supplemental oxygen.</p><p><strong>Conclusions: </strong>In contrast to treatment of eucapnic OSA with PAP that is associated with weight gain, treatment of OSA+OHS patients with or without PAP is associated with weight loss. Future studies are necessary to elucidate the mechanism by which weight loss occurs.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416816"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300594","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":"Application and internal validation of lung ultrasound score in COVID-19 setting: The ECOVITA observational study. Authors' reply.","authors":"L Rinaldi, F Perrotta","doi":"10.1016/j.pulmoe.2024.06.004","DOIUrl":"10.1016/j.pulmoe.2024.06.004","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416781"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604499","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":"Hip Adduction and Abduction Strength Reference Values of Gaelic Football and Rugby Union Players: A Cross-Sectional Study.","authors":"Ciaran O'Connor, Martin McIntyre, Eamonn Delahunt, Kristian Thorborg","doi":"10.1123/ijspp.2024-0116","DOIUrl":"10.1123/ijspp.2024-0116","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this research was to report isometric hip adduction and abduction strength reference values of men's and women's Gaelic football and rugby union players and compare values between sexes and between sports.</p><p><strong>Methods: </strong>This cross-sectional cohort study consisted of 331 club-level athletes. Maximum isometric hip adduction squeeze and abduction press strength values were measured with a ForceFrame across several testing positions.</p><p><strong>Results: </strong>Hip adduction squeeze and abduction press strength reference values for men's and women's Gaelic and rugby union footballers were provided with mean and 1 SD. A 2-way analysis of variance demonstrated significant sport × sex interaction main effects for hip adduction squeeze (η2 = .159-.228), abduction press (η2 = .099-.144), and adduction:abduction ratio (η2 = .120). Men demonstrated significantly greater relative (Newtons per kilogram) maximum isometric hip adduction squeeze (15.5%-26.4%, 0.48-1.00 N/kg) and hip abduction press (9.6%-19.6%, 0.20-0.67 N/kg) strength across all testing positions when compared with women of the same sport. Male Gaelic football players demonstrated significantly greater hip adduction (8.7%-14.0%, 0.30-0.52 N/kg) and abduction (6.1%-8.6%, 0.16-0.31 N/kg) strength (Newtons per kilogram) than their rugby counterparts, while no significant between-sports differences in strength were observed between female athletes.</p><p><strong>Conclusion: </strong>Reference values are provided with mean and 1 SD. Sport and sex interaction had significant main effects for hip adduction, abduction, and adduction:abduction ratio, with medium to large effect sizes. Male athletes demonstrate significantly greater hip strength than female athletes of the same sport, and male Gaelic players demonstrate greater hip strength than male rugby players.</p>","PeriodicalId":14295,"journal":{"name":"International journal of sports physiology and performance","volume":" ","pages":"282-291"},"PeriodicalIF":3.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909668","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}