European Respiratory Review最新文献

{"title":"Physiological signal entropy in patients with chronic respiratory disease: a systematic review.","authors":"Nawal Alotaibi, Maggie Cheung, Amar Shah, John R Hurst, Ali R Mani, Swapna Mandal","doi":"10.1183/16000617.0252-2024","DOIUrl":"https://doi.org/10.1183/16000617.0252-2024","url":null,"abstract":"<p><strong>Background: </strong>Chronic respiratory diseases (CRDs) such as COPD and asthma have a substantial impact on patients and healthcare systems. Recent research on diagnosing and monitoring CRDs highlights the potential of continuous measurement of physiological parameters using nonlinear measures such as entropy analysis. Entropy measures the irregularity and complexity of physiological signals, reflecting the engagement of physiological control mechanisms. This systematic review examines the current evidence on changes in the entropy of physiological signals in CRDs.</p><p><strong>Methods: </strong>The review follows Preferred Reporting in Systematic Reviews and Meta-Analyses (PRISMA) guidelines and includes studies from databases such as Scopus, Medline, CINAHL and Embase. Quality assessment was conducted using the Newcastle-Ottawa Scale. Evidence was qualitatively synthesised, taking into account entropy signals, entropy type and results.</p><p><strong>Results: </strong>11 studies met the inclusion criteria. Entropy in signals including heart rate variability (HRV), airflow, peripheral oxygen saturation (<i>S</i> _pO₂ ), inter-breath interval and tidal volume were evaluated. The findings indicated that patients with COPD and asthma exhibit lower entropy in HRV and airflow compared to healthy controls, with entropy decreasing as disease severity increases. Conversely, <i>S</i> _pO₂ entropy values were increased during an exacerbation compared to stable COPD.</p><p><strong>Conclusion: </strong>The review highlights the potential of entropy analysis of physiological signals for early detection of COPD exacerbations and for differentiating between various levels of disease severity in both COPD and asthma. Additionally, it identifies research gaps, particularly in relation to other CRDs such as bronchiectasis and interstitial lung diseases. Further research is needed to facilitate the development of this approach into a fully effective tool for clinical practice.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the role of quantitative CT in the prognostication and disease monitoring of interstitial lung disease.","authors":"Giles Dixon, Hannah Thould, Matthew Wells, Krasimira Tsaneva-Atanasova, Chris J Scotton, Michael A Gibbons, Shaney L Barratt, Jonathan C L Rodrigues","doi":"10.1183/16000617.0194-2024","DOIUrl":"https://doi.org/10.1183/16000617.0194-2024","url":null,"abstract":"<p><strong>Background: </strong>The unpredictable trajectory and heterogeneity of interstitial lung disease (ILDs) make prognostication challenging. Current prognostic indices and outcome measures have several limitations. Quantitative computed tomography (qCT) provides automated numerical assessment of CT imaging and has shown promise when applied to the prognostication and disease monitoring of ILD. This systematic review aims to highlight the current evidence underpinning the prognostic value of qCT in predicting outcomes in ILD.</p><p><strong>Methods: </strong>A comprehensive search of four databases (Medline, EMCare, Embase and CINAHL (Cumulative Index to Nursing and Allied Health Literature)) was conducted for studies published up to and including 22 November 2024. A modified CHARMS (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies) checklist was used for data extraction. The risk of bias was assessed using a Quality in Prognostic Studies template.</p><p><strong>Results: </strong>The search identified 1134 unique studies, of which 185 studies met inclusion and exclusion criteria. Commonly studied ILD subtypes included idiopathic pulmonary fibrosis (41%, n=75), mixed subtypes (26%, n=48) and systemic sclerosis ILD (16%, n=30). Numerous studies showed significant prognostic signals, even when adjusted for common covariates and/or significant correlation between serial qCT biomarkers and conventional outcome measures. Heterogenous and nonstandardised reporting methods meant that direct comparison or meta-analysis of studies was not possible. Studies were limited by the use of retrospective methodology without prospective validation and significant study attrition.</p><p><strong>Discussion: </strong>qCT has shown efficacy in the prognostication and disease monitoring of a range of ILDs. Hurdles exist to widespread adoption including governance concerns, appropriate algorithm anchoring and standardisation of image acquisition. International collaboration is underway to address these hurdles, paving the way for regulatory approval and ultimately patient benefit.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the utilisation and effectiveness of implementation science strategies by cystic fibrosis registries for healthcare improvement: a systematic review.","authors":"Rob G Stirling, Bhumika Sood, Macken J L Stirling, Tom Kotsimbos, Dominic T Keating, Catherine E Rang, James M Trauer, Alan C Young, Christiaan Yu, Julianna Bailey, Peter Wark, Angela Melder, Paul Dawkins","doi":"10.1183/16000617.0227-2024","DOIUrl":"https://doi.org/10.1183/16000617.0227-2024","url":null,"abstract":"<p><strong>Background: </strong>Cystic fibrosis (CF) registries capture important information in high-burden health domains to support improvement in health outcomes, although a number of unanswered questions persist, as follows. 1) Do CF registries utilise implementation science strategies to improve patient outcomes? 2) Which implementation strategies have been engaged? 3) Has the engagement of these strategies been effective in improving clinical outcomes?</p><p><strong>Methods: </strong>We undertook a systematic review to exploring the use of implementation science strategies by CF registries for healthcare improvement. We searched MEDLINE, Embase, Scopus, Emcare and Web of Science databases for use of Expert Recommendations for Implementing Change (ERIC) implementations and use of the Knowledge to Action framework for improvement. We used the Risk of Bias in Non-randomised Studies - of Interventions tool for risk-of-bias assessment.</p><p><strong>Results: </strong>1974 citations were identified and 12 studies included. Included studies described 45 ERIC implementation strategies from nine categories. Strategies included \"use evaluative and iterative strategies\" (n=9) and \"develop stakeholder interrelationships\" (n=10). Least-used strategies were \"utilise financial strategies\" (n=1), \"support clinicians\" category (n=3) and \"provide interactive assistance\" (n=2). All 12 studies utilised monitoring of knowledge use, and assessing barriers and facilitators of knowledge use. Only seven studies utilised mechanisms to sustain knowledge use.</p><p><strong>Discussion: </strong>Reported studies describe significant benefits in important CF outcomes for people with CF reported at site-specific and population levels. Studies highlighted the importance of governance, leadership, patient and family engagement, multidisciplinary engagement, quality improvement, data and analytics and research. The ready availability of clinical performance data feedback to clinicians and patients by CF registries is likely to strengthen the effectiveness of CF registries in driving healthcare improvement within a learning health system.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting respiratory virus-induced reactive oxygen species in airways diseases.","authors":"Thomas J Adams, Michael Schuliga, Nyoaki Pearce, Nathan W Bartlett, Mingtao Liang","doi":"10.1183/16000617.0169-2024","DOIUrl":"https://doi.org/10.1183/16000617.0169-2024","url":null,"abstract":"<p><p>The immune response to virus infection in the respiratory tract must be carefully balanced to achieve pathogen clearance without excessive immunopathology. For chronic respiratory diseases where there is ongoing inflammation, such as in asthma and COPD, airway immune balance is perturbed, and viral infection frequently worsens (exacerbates) these conditions. Reactive oxygen species (ROS) are critical to the induction and propagation of inflammation, and when appropriately regulated, ROS are vital cell signalling molecules and contribute to innate immunity. However, extended periods of high ROS concentration can cause excessive cellular damage that dysregulates antiviral immunity and promotes inflammation. Traditional antioxidant therapeutics have had limited success treating inflammatory diseases such as viral exacerbations of asthma or COPD, owing to nonspecific pharmacology and poorly understood pharmacokinetic properties. These drawbacks could be addressed with novel drug delivery technologies and pharmacological agents. This review summarises current research on ROS imbalances during virus infection, discusses the commercially available mitochondrial antioxidant drugs that have progressed to clinical trial and assesses novel drug delivery approaches for antioxidant delivery to the airways. Additionally, it provides a perspective on future research into pharmacological targeting of ROS for the treatment of respiratory virus infection and disease.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchiolar disorders in systemic autoimmune rheumatic diseases.","authors":"Yanisa Kluanwan, Nichthida Tangnuntachai, Jay H Ryu, Teng Moua","doi":"10.1183/16000617.0248-2024","DOIUrl":"https://doi.org/10.1183/16000617.0248-2024","url":null,"abstract":"<p><p>Pulmonary manifestations of systemic autoimmune rheumatic diseases (SARDs) may involve the large and small airways, lung parenchyma, pleura, respiratory muscles and thoracic cage. Bronchiolar disorders (BDs) or small airways disease (SAD) are common and may sometimes be the dominant presentation in patients with SARDs. We conducted a literature review using search terms \"bronchiolitis,\" \"small airway diseases\" and the names of individual SARDs and collated relevant articles published between January 1977 and April 2024. A summary of the incidence/prevalence, clinical manifestations, pathogenetic mechanisms, pulmonary function testing, chest imaging, histopathology and treatment options for BDs associated with SARDs is provided in this review. BDs associated with Sjögren syndrome, rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus, idiopathic inflammatory myositis, mixed connective tissue disease and ankylosing spondylitis are specifically highlighted.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of scores used for quantitative lung ultrasound in neonates: a systematic review.","authors":"Victor Sartorius, Stéphanie Brunet, Daniele De Luca","doi":"10.1183/16000617.0232-2024","DOIUrl":"https://doi.org/10.1183/16000617.0232-2024","url":null,"abstract":"<p><strong>Background: </strong>Quantitative lung ultrasound is increasingly being used in neonatology. The aim of this study is to identify the lung ultrasound scores (LUS) available for use in neonates, describe their characteristics and determine which LUS are most used and validated.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted following PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols extension for reporting literature searches in systematic reviews) guidelines. Articles describing LUS in newborn animals and human neonates, published up to March 2024, were searched in the PubMed and Embase databases.</p><p><strong>Results: </strong>Out of 757 identified studies, 121 were included. Most of the articles were published in the past 5 years, predominantly by European investigators. They described 32 different LUS. Only 10 (31.4%) of these LUS had undergone at least one validation attempt and only 15 (48.4%) used the four-step scoring scale (<i>i.e.</i> scored from 0 to 3) based on classical lung ultrasound patterns originally described and well established in adult critical care medicine. The most common (49 (40.5%) of all the articles) neonatal score (published by Brat <i>et al.</i> in 2015) was based on this classical grading system. The most commonly used score was also validated using the greatest number of techniques and applied to all major neonatal respiratory disorders. Its simplified version is used to analyse six chest areas (anterior and lateral) to guide surfactant administration, while its extended version includes 10 areas by adding four posterior ones.</p><p><strong>Conclusions: </strong>The most commonly used and validated score, consistent with adult critical care practice, should be the standard for assessing lung aeration in neonates.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health disparities and associated social determinants of health in interstitial lung disease: a narrative review.","authors":"Gabriella Tikellis, Anne E Holland","doi":"10.1183/16000617.0176-2024","DOIUrl":"10.1183/16000617.0176-2024","url":null,"abstract":"<p><strong>Background: </strong>Health disparities are prevalent across respiratory diseases. Social determinants of health are closely associated with health disparities and account for between 30% and 55% of all health outcomes. In people with interstitial lung disease (ILD), disparities have the potential to significantly impact access to care and health outcomes along many stages of the disease journey.</p><p><strong>Aim: </strong>This review aimed to provide an overview of health disparities in ILD, focusing on the determinants of health and access to care from diagnosis to end of life and to report on some approaches being proposed to address these disparities.</p><p><strong>Methods: </strong>A narrative review of the literature was undertaken using three electronic databases (Ovid Embase, Medline and CINAHL) from inception to May 2024. Disparities and social determinants were mapped to the domains of the Dahlgren-Whitehead model of social determinants of health.</p><p><strong>Results: </strong>A total of 31 studies were eligible for inclusion. Common disparities identified included differences in antifibrotic utilisation, representation in clinical trials, access to ILD care and lung transplantation waiting lists. Associated social determinants included race/ethnicity, gender, geography and socioeconomic status. Paradoxically, telehealth technology and utilisation have the potential to improve access to diagnostic and treatment options for marginalised communities but may exacerbate disparities for those with lower digital literacy and access.</p><p><strong>Conclusion: </strong>Reducing health disparities in ILD will require an awareness and understanding of the root cause of the disparities at both the individual and societal level in order to develop effective interventions that improve access to care for all living with ILD.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Diaphragm excursion and diaphragm thickening fraction: commonality and conflict.","authors":"Diego Poddighe, Alexandros Kalkanis, Dries Testelmans, Greet Hermans, Daniel Langer","doi":"10.1183/16000617.0031-2025","DOIUrl":"10.1183/16000617.0031-2025","url":null,"abstract":"","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced imaging techniques and artificial intelligence in pleural diseases: a narrative review.","authors":"Guido Marchi, Mattia Mercier, Jacopo Cefalo, Carmine Salerni, Martina Ferioli, Piero Candoli, Leonardo Gori, Federico Cucchiara, Giovanni Cenerini, Giacomo Guglielmi, Michele Mondoni","doi":"10.1183/16000617.0263-2024","DOIUrl":"10.1183/16000617.0263-2024","url":null,"abstract":"<p><strong>Background: </strong>Pleural diseases represent a significant healthcare burden, affecting over 350 000 patients annually in the US alone and requiring accurate diagnostic approaches for optimal management. Traditional imaging techniques have limitations in differentiating various pleural disorders and invasive procedures are usually required for definitive diagnosis.</p><p><strong>Methods: </strong>We conducted a nonsystematic, narrative literature review aimed at describing the latest advances in imaging techniques and artificial intelligence (AI) applications in pleural diseases.</p><p><strong>Results: </strong>Novel ultrasound-based techniques, such as elastography and contrast-enhanced ultrasound, are described for their promising diagnostic accuracy in differentiating malignant from benign pleural lesions. Quantitative imaging techniques utilising pixel-density measurements to noninvasively distinguish exudative from transudative effusions are highlighted. AI algorithms, which have shown remarkable performance in pleural abnormality detection, malignant effusion characterisation and automated pleural fluid volume quantification, are also described. Finally, the role of deep-learning models in early complication detection and automated analysis of follow-up imaging studies is examined.</p><p><strong>Conclusions: </strong>Advanced imaging techniques and AI applications show promise in the management and follow-up of pleural diseases, improving diagnostic accuracy and reducing the need for invasive procedures. However, larger prospective studies are needed for validation. The integration of AI-driven imaging analysis with molecular and genomic data offers potential for personalised therapeutic strategies, although challenges in data privacy, algorithm transparency and clinical validation persist. This comprehensive approach may revolutionise pleural disease management, enhancing patient outcomes through more accurate, noninvasive diagnostic strategies.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diaphragm excursion and diaphragm thickening fraction: commonality and conflict.","authors":"Haotian Zhao, Kai Liu, Yaru Yan, Yaxiaerjiang Muhetaer, Li Li","doi":"10.1183/16000617.0285-2024","DOIUrl":"10.1183/16000617.0285-2024","url":null,"abstract":"","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}