NPJ Primary Care Respiratory Medicine最新文献

{"title":"Association between maternal asthma and ASD/ADHD in offspring: A meta-analysis based on observational studies.","authors":"Jingfang Zheng, Junyi Chen, Qiufeng Zhang, Liying Ying, Hui Huang, Jingyu Yang, Zhenghao Chen","doi":"10.1038/s41533-025-00440-y","DOIUrl":"10.1038/s41533-025-00440-y","url":null,"abstract":"<p><p>This meta-analysis aims to examine the association between maternal asthma and autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD) in offspring. A literature search was performed in PubMed, Web of Science, Embase, and the Cochrane Library from electronic database inception to October 2024 for studies on the relationship between asthma and ASD/ADHD. The definition of maternal asthma was \"asthma existing prior to childbirth\". The primary outcome was the incidence of ASD/ADHD in the offspring. This meta-analysis incorporated 5 cohort studies and 7 case-control studies. The statistical results suggested that there is a higher incidence of ASD (odds ratio (OR) = 1.36, 95% confidence interval (95%CI) = 1.28-1.44, P < 0.001) and ADHD (OR = 1.43, 95% CI = 1.37-1.51, P < 0.001) in offspring with maternal asthma compared to the control group. The subgroup analysis revealed that there was no difference in ASD incidence between maternal asthma group and control group in subgroup of female (OR = 1.81, 95%CI = 0.72-4.25, P = 0.205). However, in subgroup of male, the incidence of ASD was higher in the maternal asthma group than the control group (OR = 1.28, 95%CI = 1.01-1.61, P = 0.04). Furthermore, an elevated incidence of ADHD was observed in the maternal asthma group compared to the control group, both in male offspring (OR = 1.36, 95%CI = 1.30-1.42, P < 0.001) and female offspring (OR = 1.45, 95%CI = 1.38-1.53, P < 0.001) subgroups. This study indicates that maternal asthma may have a potential association with ASD and ADHD in the offspring.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"32"},"PeriodicalIF":3.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of electronic cigarette use and risk of COPD: a systematic review and meta-analysis.","authors":"Muhammed Shabil, Ajay Malvi, Mahalaqua Nazli Khatib, Subbulakshmi Ganesan, Mandeep Kaur, Manish Srivastava, G V Siva Prasad, Pranchal Rajput, Brijendra Mohan, Diptismitha Jena, Ganesh Bushi, Sanjit Sah, Prakasini Satapathy, Shailesh Kumar Samal, Edward Mawejje","doi":"10.1038/s41533-025-00438-6","DOIUrl":"10.1038/s41533-025-00438-6","url":null,"abstract":"<p><p>Chronic Obstructive Pulmonary Disease (COPD) is a global health concern, primarily linked to cigarette smoking. The potential role of electronic cigarettes (e-cigarettes) in COPD development remains unclear. Despite growing popularity as a smoking alternative, evidence suggests e-cigarettes may have harmful respiratory effects. This systematic review and meta-analysis assess the relationship between e-cigarette use and odds of having COPD. A comprehensive search of Web of Science, Embase, and PubMed was conducted to identify observational studies that assessed the association between e-cigarette use and the risk of COPD, providing risk estimates (hazard ratios, risk ratios, or odds ratios) for current, former, and ever e-cigarette users. Random-effects meta-analysis was performed using R software (V 4.4), and heterogeneity was assessed with the I² statistic. Sensitivity analyses were conducted to test the robustness of the findings. Publication bias was evaluated using Egger's test and funnel plots. Seventeen studies (1087 records screened) were included. E-cigarette use was associated with significantly higher odds of COPD compared to non-use. The pooled odds ratios were 1.48 (95% CI: 1.36-1.61) for current users, 1.84 (95% CI: 1.51-2.23) for former users, and 1.79 (95% CI: 1.42-2.25) for ever users. Sensitivity analysis confirmed the robustness of the findings. E-cigarette use is associated with higher odds of having COPD. Public health efforts should consider raising awareness of the potential respiratory risks associated with e-cigarette use.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"31"},"PeriodicalIF":3.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publisher Correction: A practical guide to the diagnosis and management of suspected Non-tuberculous Mycobacterial Pulmonary Disease (NTM-PD) in the United Kingdom.","authors":"D J Dhasmana, P Whitaker, R van der Laan, F Frost","doi":"10.1038/s41533-025-00439-5","DOIUrl":"10.1038/s41533-025-00439-5","url":null,"abstract":"","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"30"},"PeriodicalIF":3.1,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating expert patients: outcomes from a national digital therapeutic approach for people with asthma in Wales.","authors":"Simon M Barry, Julian Forton, Gareth R Davies, Gwyneth A Davies, Katie Pink, Alison Whittaker, Jerome Donagh, Dan Menzies, Mark Andrews, Grace Moore, Chris Davies","doi":"10.1038/s41533-025-00433-x","DOIUrl":"10.1038/s41533-025-00433-x","url":null,"abstract":"<p><p>National applications (apps) for adults with asthma were implemented as part of a respiratory toolkit across Wales from 2020. Data were collected on patient recorded asthma control including the Royal College of Physicians three questions. All general practices in Wales had patients registered on the asthma app and by September 2024, 12,567 (57.8%) of patients who downloaded the app went on to register. Analysis comparing baseline with four or more months of app use demonstrated improvements in the percent of those having a Royal College of Physicians asthma score of 0 (26.5% vs 40.7%, p = 0.0011), together with improvements in those not using a reliever inhaler at all (29.1% vs 39.2%, p = 0.0001). Where we had paired data one year apart, the improvements in asthma control were greater in those from most deprived areas. For those who used the app there were improvements across important metrics of asthma control consistent with better patient self-management.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"29"},"PeriodicalIF":3.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing acute respiratory infections in primary care for better management of viral infections.","authors":"Hortense Petat, Matthieu Schuers, François Le Bas, Xavier Humbert, Andry Rabiaza, Sandrine Corbet, Astrid Vabret, Meriadeg Ar Gouilh, Christophe Marguet","doi":"10.1038/s41533-025-00434-w","DOIUrl":"10.1038/s41533-025-00434-w","url":null,"abstract":"<p><p>Acute respiratory infections (ARI) are the most common infections in the general population and represent an important socio-economic burden. Characterizing ARIs in primary care in patients of all ages in terms of clinical presentation, and virological results. We conducted a prospective multicenter study in primary care: 36 French general practitioners (GPs) included patients from all ages presenting with symptoms of ARI, and performed a nasopharyngeal swab, which was analyzed by Multiplex RT-PCR. 685 patients of all ages were included in the cohort. We found associations between clinical diagnosis and respiratory viruses: influenza was associated with the diagnosis of flu-like syndrome (p < 0.001), HRV with rhinitis (p < 0.05), and RSV with bronchiolitis (p < 0.001) and bronchitis (p < 0.05). Respiratory distress was associated with RSV (p = 0.002), and a cough at the inclusion was significantly not associated with the influenza virus (p = 0.009). Antibiotic prescriptions were not associated with any specific virus. By day 7, persistent cough was significantly associated with active and passive smoking (respectively p = 0.01 and p < 0.001), influenza and RSV-positive samples (p < 0.05) and an age of less than 2 years (p < 0.01). With this prospective cohort performed in primary care including patients of all ages, we characterized viral respiratory infections, to better understand correlations between clinical data and virological results.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"28"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived barriers and facilitators to managing psychological distress in COPD: The perspectives of patients and carers - a qualitative study using the theoretical domains framework (TDF).","authors":"Juliet Wang, Lena Ly, Elizabeth Barson, Natasha Smallwood","doi":"10.1038/s41533-025-00430-0","DOIUrl":"https://doi.org/10.1038/s41533-025-00430-0","url":null,"abstract":"<p><p>Psychological distress is highly prevalent in people with chronic obstructive pulmonary disease (COPD), however, remains under-recognised and under-treated. A qualitative study using semi-structured interviews was undertaken to explore lived experiences of psychological distress of people with COPD and their informal carers, as well as barriers and facilitators to uptake of mental health treatments. Participants were recruited via purposive sampling from respiratory clinics at two Australian tertiary hospitals. Thirteen people with COPD and comorbid mental illnesses and two informal carers participated. Interview transcripts were analysed using the Theoretical Domains Framework (TDF). Barriers to patients' acceptance of structured management for psychological distress in COPD included: limited understanding of overlapping symptoms, high burden of care from physical issues, stigma, and healthcare that did not align with individual preferences. Increased psychoeducation, supported self-management, and individualised care were possible facilitators. Multidisciplinary care integrating mental health services within primary care and pulmonary rehabilitation settings are required to overcome current challenges and improve patient outcomes.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"27"},"PeriodicalIF":3.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between sleep duration and hypertension risk in patients with obstructive sleep apnea.","authors":"Yi Wang, Xi Xi Chen, Fang Ying Lu, Ya Ru Yan, Shi Qi Li, Liu Zhang, Ying Ni Lin, Qing Yun Li","doi":"10.1038/s41533-025-00429-7","DOIUrl":"https://doi.org/10.1038/s41533-025-00429-7","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a well-established risk factor for hypertension, with sleep duration being a modifiable factor influencing this risk. However, sleep misperception among OSA patients makes it unclear how subjective and objective sleep duration are associated with the prevalence and incidence of hypertension in this population. This study aims to examine these associations using data from the Sleep Heart Health Study cohort. Participants with OSA (apnea-hypopnea index ≥ 15 events/hour) were categorized based on objective sleep duration from polysomnography (PSGTST) and subjective sleep duration (morning-reported sleep time, AMTST; habitual sleep time, HABTST). Hypertension prevalence was assessed at baseline, while hypertension incidence was evaluated during a five-year follow-up. Multivariable logistic regression and Poisson log-link models were employed to explore the association between sleep duration and hypertension risk, with restricted cubic splines used to assess nonlinear trends. Among 2574 participants with OSA, 1263 had hypertension at baseline. Over 5.25 years, 376 of 1001 patients without baseline hypertension developed hypertension. Shorter PSGTST was linearly associated with higher hypertension prevalence (p = 0.009) and incidence (p = 0.024). HABTST showed a U-shaped relationship with hypertension prevalence, while AMTST was not significantly associated with either outcome. In patients with OSA, objective sleep duration is linearly and inversely associated with both the prevalence and incidence of hypertension, showing stronger and more consistent associations than subjective sleep duration measures. These findings highlight the value of incorporating objective sleep assessment in evaluating hypertension risk in this population.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"26"},"PeriodicalIF":3.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 obesity paradox in chronic respiratory disease: the mediating effect of triglyceride-glucose index on mortality.","authors":"Feng Xu, Yongwen Feng, Jibo Li, Xinlong Liu, Haoda Liang, Zhongsheng Tan, Pan Jiang","doi":"10.1038/s41533-025-00431-z","DOIUrl":"https://doi.org/10.1038/s41533-025-00431-z","url":null,"abstract":"<p><p>Chronic respiratory diseases (CRD) are major contributors to mortality. The \"obesity paradox\" suggests that higher body mass index (BMI) may confer survival benefits in CRD patients. This study investigates the association between BMI and mortality risk in CRD patients, focusing on the mediating role of the triglyceride-glucose (TyG) index. A cross-sectional analysis of 7689 participants with CRD was conducted. Participants were categorized by BMI into <25.0, 25.0-29.9, 30.0-34.9, 35.0-39.9, and ≥40 kg/m². Outcomes included all-cause mortality, cardiovascular disease (CVD) mortality, and non-CVD mortality. Cox regression models assessed associations, and mediation analysis evaluated the role of the TyG index. Among 7689 CRD patients, higher BMI was associated with lower all-cause mortality (HR for BMI 25.0-29.9: 0.81, 95% CI 0.70-0.94; HR for BMI 30.0-34.9: 0.72, 95% CI 0.61-0.85; HR for BMI 35.0-39.9: 0.72, 95% CI 0.59-0.88; HR for BMI ≥ 40: 0.82, 95% CI 0.66-1.02) and non-CVD mortality (HR for BMI 25.0-29.9: 0.77, 95% CI 0.65-0.91; HR for BMI 30.0-34.9: 0.65, 95% CI 0.54-0.79; HR for BMI 35.0-39.9: 0.66, 95% CI 0.52-0.83; HR for BMI ≥ 40: 0.69, 95% CI 0.53-0.89), but not CVD mortality. The TyG index mediated a significant proportion of the association between BMI and mortality (mediation effects: -22.39 to -18.49%). Kaplan-Meier survival curves and restricted cubic spline regression further illustrated the significant associations between BMI and all-cause mortality and non-CVD mortality, while no significant association was observed for CVD mortality. Higher BMI is associated with lower mortality risk in CRD patients, particularly for non-CVD causes, mediated by the TyG index. This highlights the potential role of insulin resistance in the \"obesity paradox\" and suggests that metabolic health interventions may improve outcomes in CRD.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"25"},"PeriodicalIF":3.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a machine learning risk prediction model for asthma attacks in adults in primary care.","authors":"Holly Tibble, Aziz Sheikh, Athanasios Tsanas","doi":"10.1038/s41533-025-00428-8","DOIUrl":"https://doi.org/10.1038/s41533-025-00428-8","url":null,"abstract":"<p><p>Primary care consultations provide an opportunity for patients and clinicians to assess asthma attack risk. Using a data-driven risk prediction tool with routinely collected health records may be an efficient way to aid promotion of effective self-management, and support clinical decision making. Longitudinal Scottish primary care data for 21,250 asthma patients were used to predict the risk of asthma attacks in the following year. A selection of machine learning algorithms (i.e., Naïve Bayes Classifier, Logistic Regression, Random Forests, and Extreme Gradient Boosting), hyperparameters, training data enrichment methods were explored, and validated in a random unseen data partition. Our final Logistic Regression model achieved the best performance when no training data enrichment was applied. Around 1 in 3 (36.2%) predicted high-risk patients had an attack within one year of consultation, compared to approximately 1 in 16 in the predicted low-risk group (6.7%). The model was well calibrated, with a calibration slope of 1.02 and an intercept of 0.004, and the Area under the Curve was 0.75. This model has the potential to increase the efficiency of routine asthma care by creating new personalized care pathways mapped to predicted risk of asthma attacks, such as priority ranking patients for scheduled consultations and interventions. Furthermore, it could be used to educate patients about their individual risk and risk factors, and promote healthier lifestyle changes, use of self-management plans, and early emergency care seeking following rapid symptom deterioration.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"24"},"PeriodicalIF":3.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma control and opportunities to optimize management and the healthcare provider experience using the AsthmaOptimiser online tool in Dutch general practice: the CAPTURE study.","authors":"Marika T Leving, Yoran H Gerritsma, David J Jackson, Erik W M A Bischoff, Jiska M Meijer, Hans Wouters, Bertine Flokstra-de Blok, Janwillem W H Kocks","doi":"10.1038/s41533-025-00427-9","DOIUrl":"https://doi.org/10.1038/s41533-025-00427-9","url":null,"abstract":"<p><p>Patients seen in general practices can achieve improved asthma control with better identification of factors that contribute to uncontrolled asthma. Information is lacking on the proportion of patients with uncontrolled asthma, associated patient characteristics, and opportunities to improve management. The objectives of this study were to determine the proportion of general practice patients with uncontrolled asthma, as assessed during a regular consultation with the AsthmaOptimiser digital tool, identify the opportunities for improved management, and to evaluate the usability of this tool which is based on treatment recommendations from GINA. The CAPTURE study was a non-interventional, prospective, observational study of the AsthmaOptimiser in general practice settings in the Netherlands. Patients were at least 18 years of age with an asthma diagnosis. A total of 34 Dutch general practitioners or nurse practitioners participated in the study and planned to use the AsthmaOptimiser with 5 to 10 adult patients per practice. Interviews were conducted to gather information from practitioners about the tool's usability, its content, and areas for improvement. Of the 220 patients enrolled, 60% had uncontrolled asthma, of whom 64% had opportunities for management improvement that could be initiated during a primary care visit. Specialist referrals were advisable according to the AsthmaOptimiser in 45 patients with uncontrolled asthma. Practitioners reported that the AsthmaOptimiser was an added value and had suggestions on how to improve the tool. In Dutch general practices, the AsthmaOptimiser helped general practitioners identify opportunities for improved disease management by addressing poor disease control. Overall, the general practitioners found the AsthmaOptimiser easy to use and a good addition to asthma consultations.</p>","PeriodicalId":19470,"journal":{"name":"NPJ Primary Care Respiratory Medicine","volume":"35 1","pages":"23"},"PeriodicalIF":3.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}