Pulmonary Therapy最新文献

{"title":"Dyspnea in Chronic Obstructive Pulmonary Disease: Expert Assessment of Management in Clinical Practice.","authors":"Nirupama Putcha, Diego J Maselli, Jessica Bon, Michael G Lester, M Bradley Drummond","doi":"10.1007/s41030-025-00318-x","DOIUrl":"https://doi.org/10.1007/s41030-025-00318-x","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a multifaceted lung condition characterized by persistent airflow limitation that leads to chronic symptoms, including dyspnea, cough, and exacerbations. To date, a major focus for the assessment and management of COPD has been on mitigating exacerbations. However, dyspnea is the most common symptom of COPD and is responsible for substantial negative effects on patients' quality of life. Dyspnea is also a substantial contributor to the symptoms associated with acute exacerbations in COPD. Though a portion of the current recommendations for the assessment and management of COPD are dedicated to dyspnea treatment intervention strategies, there remains a need for improvement in communication between healthcare practitioners and their patients regarding the understanding of dyspnea and the implementation of key nonpharmacologic and pharmacologic treatment options. This clinical commentary outlines practical considerations and recommendations for the real-world assessment and management of dyspnea in COPD, including underlying causes, patient and healthcare provider dialogue, measurement of severity, and management strategies.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177890","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":"Self-Administered Home Sleep Testing Model in Screening of OSA in Healthcare Workers-Sohew Study: A National Multicenter Study in Vietnam.","authors":"Sy Duong-Quy, Thai Nguyen-Duy, Tran V Hoc, Lien Nguyen-Thi-Hong, Tram Tang-Thi-Thao, Khue Bui-Diem, Diep Nguyen-Thi-Hong, Bang Nguyen-Trong, Anh Nguyen-Tuan, Hoang Nguyen-Huu, Quan Vu-Tran-Thien, Toi Nguyen-Van, Trung Mai-Xuan, Viet Nguyen-Ba, Thu Vo-Pham-Minh-Thu, Thuc Pham-Van, Linh Pham-Van, Giap Vu-Van, Bao Le-Khac, Dung Nguyen-Thi-Thu, Khue Luong-Ngoc, Ngoc Luu-Bich, Thuy Tran-Phan-Chung, Huong Le-Thi-Minh, Vinh Nguyen-Nhu, Nhung Nguyen-Viet, Timothy Craig, Franck Soyez, Francis Martin, Thomas Penzel","doi":"10.1007/s41030-025-00315-0","DOIUrl":"https://doi.org/10.1007/s41030-025-00315-0","url":null,"abstract":"<p><strong>Background: </strong>Sleep disorders, including snoring and obstructive sleep apnea (OSA), are significant health concerns. OSA affects an estimated 4 million (8.5%) individuals in Vietnam, with 2.3 million suffering from moderate-to-severe conditions. Despite the high prevalence, underdiagnosis and limited accessibility to sleep diagnostics remain challenges. This study aims to assess the feasibility and effectiveness of a guided, self-administered home sleep study using a level 3 diagnostic model.</p><p><strong>Methods: </strong>A cross-sectional multicenter survey conducted from September 2023 to March 2024 included healthcare professionals (HCPs) across Vietnam. Participants completed questionnaires (Epworth Sleepiness Scale, STOP-BANG), and high-risk individuals underwent respiratory polygraphy using ApneaLink Air devices. Standardized instructions and technical support were provided remotely by trained technicians.</p><p><strong>Results: </strong>Out of 1721 participants, 21.9% were diagnosed with OSA, comprising mild (32.4%), moderate (19.6%), and severe cases (9.2%). Prevalent symptoms included insomnia (22.2%), daytime sleepiness (40.7%), and memory decline (49.4%). Technical issues were minimal, supporting the feasibility of this approach.</p><p><strong>Conclusion: </strong>A level 3 home sleep study model is effective for large-scale OSA screening. Integrating such approaches into public health initiatives can enhance early diagnosis and treatment access, reducing OSA-related health and economic burdens. Graphical abstract available for this article.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177886","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":"Dupilumab Versus Mepolizumab for COPD: Evaluating Efficacy Outcomes Using Placebo-Adjusted Indirect Treatment Comparison.","authors":"Surya P Bhatt, Nick Freemantle, Mena Soliman, Jigna Heble, Yann Cabon, Ernesto Mayen Herrera, Joe Yang, Yingxin Xu","doi":"10.1007/s41030-025-00322-1","DOIUrl":"https://doi.org/10.1007/s41030-025-00322-1","url":null,"abstract":"<p><strong>Introduction: </strong>Up to 40% of patients with chronic obstructive pulmonary disease (COPD) exhibit elevated blood eosinophils, reflective of type 2 inflammation. Dupilumab and mepolizumab versus standard of care have demonstrated moderate-to-severe exacerbation reductions of 30-34% and 15-18%, respectively, over 52 weeks. This study compared their relative efficacy using indirect treatment comparison (ITC).</p><p><strong>Methods: </strong>A Bucher ITC was performed on 52-week phase 3 trials of dupilumab (BOREAS/NOTUS) and mepolizumab (MATINEE/METREX/METREO). The primary ITC endpoint was annualized moderate-to-severe exacerbation rates in patients from BOREAS + NOTUS versus MATINEE + METREX (modified intention-to-treat high stratum cohort, representing an eosinophilic phenotype); sensitivity analyses were performed using different combinations of mepolizumab data including MATINEE + METREX + METREO (100-mg arm). Other 52-week endpoints included mean difference in pre-bronchodilator forced expiratory volume in 1 s (FEV₁), proportion of St. George's Respiratory Questionnaire (SGRQ) improvement ≥ 4 points, proportion of Evaluating Respiratory Symptoms in COPD (E-RS:COPD) improvement ≥ 2 points, and annualized severe exacerbation rate. Rate ratios (RRs)/odds ratios (ORs) with 95% confidence intervals (CIs) are reported.</p><p><strong>Results: </strong>The primary ITC resulted in an RR of 0.82 (95% CI 0.66, 1.01), showing a numerical advantage for dupilumab versus mepolizumab in reducing moderate-to-severe exacerbation. Sensitivity analyses confirmed findings from the primary ITC (BOREAS + NOTUS vs. MATINEE + METREX + METREO: RR 0.83 [95% CI 0.68, 1.01]). Dupilumab demonstrated significantly greater FEV₁ improvement (mean difference 83.4 mL [95% CI 36.1, 130.7]) and proportion of E-RS:COPD improvement ≥ 2 points (OR 1.71; [95% CI 1.18, 2.48]), with a numerical difference favoring dupilumab for the proportion of SGRQ improvement ≥ 4 points (OR 1.16; [95% CI 0.86, 1.56]) and for annualized severe exacerbation rate (RR 0.61 [95% CI 0.33, 1.13]) versus mepolizumab.</p><p><strong>Conclusion: </strong>This ITC suggests potential clinical benefits of dupilumab over mepolizumab in reducing exacerbations and improving lung function, respiratory symptoms, and quality of life in patients with COPD and type 2 inflammation. Direct head-to-head trials are necessary to confirm these results and better guide treatment choices.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150649","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 Neutropenia on Clinical Outcomes in Critically Ill Patients with Acute Respiratory Failure.","authors":"Hwan Il Kim, Seong Mi Moon, Hyo Seok Oh, Ryoung-Eun Ko","doi":"10.1007/s41030-025-00317-y","DOIUrl":"https://doi.org/10.1007/s41030-025-00317-y","url":null,"abstract":"<p><strong>Introduction: </strong>Neutropenia is a common clinical condition in critically ill patients and may be associated with poor outcomes, particularly in the context of acute respiratory failure (ARF). However, evidence on its prognostic impact remains inconsistent, and there are a lack of data, particularly in noncancer and immunocompetent populations. This study evaluates the association between neutropenia and mortality in critically ill patients with ARF and identifies risk factors for mortality among patients with neutropenia.</p><p><strong>Methods: </strong>In this retrospective cohort study, 2412 adult patients with ARF admitted to the intensive care unit (ICU) of a tertiary center between January 2019 and December 2023 were analyzed. Neutropenia was defined as an absolute neutrophil count < 1.5 × 10⁹/L at ICU admission. The primary outcome was hospital mortality; secondary outcomes included ICU mortality. Multivariable Cox proportional hazards models were used to assess the association between neutropenia and outcomes. Subgroup analyses and risk factor assessments were conducted among patients with neutropenia.</p><p><strong>Results: </strong>Among the 2412 patients, 411 (17.0%) had neutropenia at ICU admission. Compared with their counterparts without neutropenia, patients with neutropenia had higher ICU mortality (48.0% versus 18.9%, P < 0.001) and hospital mortality (60.1% versus 28.3%, P = 0.007). Neutropenia remained independently associated with increased ICU (adjusted hazard ratio [HR] 1.48; 95% confidence interval [CI], 1.20-1.83) and hospital mortality (adjusted HR 1.27; 95% CI 1.07-1.52). The association was more pronounced in patients without cancer (adjusted HR 3.08) than in patients with cancer (adjusted HR 1.48; P for interaction < 0.001). Among patients with neutropenia, sequential organ failure assessment (SOFA) score was an independent predictor of hospital mortality (adjusted HR 1.15; 95% CI 1.11-1.20; P < 0.001).</p><p><strong>Conclusions: </strong>Neutropenia at ICU admission is independently associated with increased mortality in patients with ARF, particularly among those without cancer. SOFA score is a strong prognostic indicator among patients with neutropenia. These findings highlight the need for improved risk stratification, and suggest that patients with neutropenia may benefit from specific management strategies, which should be investigated in future studies.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081111","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":"Real-world Comparative Effectiveness in Patients with Asthma Newly Initiating Fluticasone Furoate/Vilanterol or Budesonide/Formoterol: A United Kingdom General Practice Cohort Study.","authors":"Ashley Woodcock, John Blakey, Arnaud Bourdin, Giorgio Walter Canonica, Christian Domingo, Alexander Ford, Rosie Hulme, Theo Tritton, Ines Palomares, Sanchayita Sadhu, Arunangshu Biswas, Manish Verma","doi":"10.1007/s41030-025-00313-2","DOIUrl":"https://doi.org/10.1007/s41030-025-00313-2","url":null,"abstract":"<p><strong>Introduction: </strong>It is important that treatment recommendations reflect real-world data when available, as randomised controlled trials have stringent eligibility criteria and do not represent the entire asthma population or their usual ecosystem of care. Limited real-world evidence has compared the effectiveness of fluticasone furoate/vilanterol (FF/VI) and budesonide/formoterol (BUD/FOR) to date in asthma; we explored this in England using patients from general practice.</p><p><strong>Methodology: </strong>We retrospectively compared new FF/VI users and new BUD/FOR users from 1 December 2015 to 28 February 2019, based on de-identified data from the Clinical Practice Research Datalink. The baseline period pre-index was ≥ 1 year; the follow-up period was 1 year. At index, eligible adults (≥ 18 years) with diagnosed asthma had ≥ 1 prescription for FF/VI or BUD/FOR, ≥ 1 years' general practitioner registration and records eligible for linkage to Hospital Episode Statistics. Chronic obstructive pulmonary disease was an exclusion criterion. The primary study outcome assessed the overall asthma exacerbation rate in new FF/VI or BUD/FOR users. Secondary outcomes included oral corticosteroid (OCS) use and medication persistence (analysed using Kaplan-Meier curves). For each treatment comparison, propensity scores were generated and confounding between baseline group characteristics was adjusted via inverse probability of treatment weighting, separately carried out for each study outcome. Intercurrent events (ICEs) were considered for analyses, such as death, loss to follow-up, rescue-medication use, treatment discontinuation or switching.</p><p><strong>Results: </strong>Between groups, baseline attributes were well balanced. Annual per-person rates of exacerbation were numerically similar in the while on-treatment population (measuring outcome until ICE; FF/VI, 0.1356; BUD/FOR, 0.1583 [P = 0.3023]). Patients who continued initiation treatment for 1 year without interruption had significantly lower annual per-person exacerbation rates with FF/VI (0.0722 [n = 425]) versus BUD/FOR (0.2258 [n = 546]) (rate ratio 0.3197 [P = 0.0003]). Patients indexed on FF/VI had significantly fewer OCS prescriptions and lower OCS dosage versus BUD/FOR (respective coefficients: - 0.29 [P = 0.0352]; 0.41 [P = 0.0004]) and improved treatment persistence (hazard ratio: 0.62 [P < 0.0001]).</p><p><strong>Conclusions: </strong>Patients who continued initiation treatment for a year without interruption had reduced exacerbation rates with FF/VI versus BUD/FOR. The FF/VI group also had reduced treatment discontinuation and OCS use.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070403","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":"Comparison of Portable Oxygen Concentrators and Inspired Oxygen Levels in a Model of Respiratory Failure.","authors":"Douglas S Gardenhire, Robert B Murray, Robin E Gardenhire, Kyle J Brandenberger, Gerald S Zavorsky","doi":"10.1007/s41030-025-00314-1","DOIUrl":"https://doi.org/10.1007/s41030-025-00314-1","url":null,"abstract":"<p><strong>Introduction: </strong>This bench study evaluated the inspired oxygen fraction (FiO₂) delivered by different portable oxygen concentrators (POCs) compared to wall oxygen and a standalone concentrator (control device) using a respiratory failure-specific lung simulator replicating an adult with chronic respiratory disease at respiratory rates of 15, 20, 30, and 40 breaths per minute.</p><p><strong>Methods: </strong>A lung simulator replicated an adult with chronic lung disease in respiratory failure. POCs and controls were tested at device-specific settings 2, 3, 5, and 6. One-way analysis of variance (ANOVA) assessed FiO₂ differences when more than two groups were compared; independent t tests were used for two-group comparisons.</p><p><strong>Results: </strong>Wall oxygen generally delivered higher FiO₂ across all settings and respiratory rates. At 40 breaths/min and setting 2, however, the CAIRE FreeStyle^® Comfort^® with autoSAT^® delivered a slightly higher FiO₂ than wall oxygen (0.25 vs. 0.24, p < 0.01). Among POCs, the CAIRE FreeStyle^® Comfort^® (with or without autoSAT^®) achieved the highest FiO₂ values at elevated respiratory rates, while devices like the Inogen G4^® and G5^® performed more variably and showed reduced oxygen delivery at higher breathing frequencies.</p><p><strong>Conclusions: </strong>Wall oxygen and standalone concentrators consistently outperformed POCs across most breathing conditions. While the CAIRE FreeStyle^® Comfort^® with autoSAT^® offered relative advantages at high respiratory rates, most POCs may not adequately sustain oxygenation during exertion or stress. These findings inform home oxygen therapy decisions, emphasizing the importance of device selection based on respiratory demand. Clinical validation of these bench findings is warranted.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070484","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 Flow Restrictors on Aerosol Delivery of the Respimat® Soft Mist Inhaler.","authors":"Moritz Fleischhauer, Kai Berkenfeld, David Stadermann, Sitaram Velaga, Igor Gonda, Peter Langguth, Herbert Wachtel","doi":"10.1007/s41030-025-00312-3","DOIUrl":"https://doi.org/10.1007/s41030-025-00312-3","url":null,"abstract":"<p><strong>Introduction: </strong>The modification of an inhaler's air flow resistance influences a patient's inhalation flow profile, thereby affecting the exit velocity of an aerosol leaving the Respimat® mouthpiece. A slower inhalation maneuver results in reduced plume velocity and thus a decreased oropharyngeal deposition due to reduced impaction. This could not only lead to fewer unwanted side effects associated with inhaled therapies, but also enhance lung deposition.</p><p><strong>Methods: </strong>Device prototypes with different air flow resistances were designed using custom-made inserts that can be clipped into the Respimat mouthpiece. The consequences on aerosol characteristics, as well as on in vitro deposition, were analyzed. Computational fluid dynamics simulations contributed to a better understanding of the modified aerodynamic conditions.</p><p><strong>Results: </strong>Different insert geometries resulted in modified device resistances. However, an increased flow resistance does not necessarily result in an improved in vitro performance. The flow restrictors critically determine aerosol characteristics such as plume velocity and spray pattern, thereby altering in vitro deposition patterns. Quantitative data on mouth-throat deposition and aerosol characteristics are reported.</p><p><strong>Conclusions: </strong>Integrating flow restrictors into the Respimat mouthpiece offers a promising approach to enhance patient centricity by promoting slower inhalation, thereby reducing the likelihood of suboptimal use. The use of a porous insert acting as a diffuser demonstrated minimal impact on internal airflow dynamics and in vitro deposition, suggesting that such designs can support correct inhalation technique without compromising aerosol performance. By minimizing the influence of patient-dependent factors, this strategy may help standardize the inhalation process and improve therapeutic outcomes. Video Abstract available for this article. Video Abstract (MP4 85313 KB).</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034065","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":"Real-World Adherence and Persistence of Upfront Therapy in Patients with Pulmonary Arterial Hypertension in the United States.","authors":"Teresa De Marco, Carly J Paoli, Nicole S Croteau, Fei Tang, Harrison W Farber","doi":"10.1007/s41030-025-00311-4","DOIUrl":"https://doi.org/10.1007/s41030-025-00311-4","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary arterial hypertension (PAH) is a rare, progressive disease resulting from elevated pulmonary arterial pressure leading to right ventricular failure and death. Optimal adherence and persistence to medical therapy are necessary to improve outcomes. The objective of this study was to characterize adherence and persistence to first-line PAH therapies in patients newly initiating treatment.</p><p><strong>Methods: </strong>This retrospective cohort study utilized Komodo Research Database claims data. Adults initiating therapy were identified based on ≥ 1 claim for a phosphodiesterase 5 inhibitor (PDE5i) and/or an endothelin receptor antagonist (ERA) from January 1, 2017, to June 30, 2022 (index date), continuous medical and pharmacy health plan enrollment for ≥ 12 months before and including index, ≥ 1 inpatient or ≥ 2 outpatient claims for pulmonary hypertension/PAH, and ≥ 1 claim for right heart catheterization. Adherence was measured by proportion of days covered (PDC); nonadherence was defined as PDC < 80%. Persistence was defined as time from index to treatment discontinuation (gap in therapy > 60 days). Propensity score matching was utilized 1:1:1 across groups.</p><p><strong>Results: </strong>A total of 9176 patients met the study criteria (6989 PDE5i, 1006 ERA, 1181 dual combination). After matching, each cohort included 714 patients. Median (95% confidence interval) persistence was highest for ERA monotherapy (26.5 [19.0-33.0] months), followed by dual combination therapy (19.8 [16.6-23.4] months) and PDE5i monotherapy (12.9 [10.8-17.4] months)-P = 0.019, dual combination versus ERA; P = 0.026, dual combination versus PDE5i. Nonadherence was highest with dual combination therapy (35.4%), followed by PDE5i monotherapy (17.1%) and ERA monotherapy (11.9%)-P < 0.001, dual combination versus each monotherapy.</p><p><strong>Conclusions: </strong>Adherence to initial PAH therapy is suboptimal, especially with upfront dual combination therapy. Persistence was highest for ERA monotherapy, followed by dual combination therapy and PDE5i monotherapy. Strategies to improve adherence and persistence are crucial to optimizing outcomes.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006558","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":"Assessment of Small Airways Function in Eosinophilic Preserved Ratio Impaired Spirometry.","authors":"Tianran Zhou, Hongyu Gao, Xingxing Sun, Jianhua Xu, Hanqing Zhu, Mian He, Wenlan Yang, Jinming Liu, Jian Guo","doi":"10.1007/s41030-025-00309-y","DOIUrl":"10.1007/s41030-025-00309-y","url":null,"abstract":"<p><strong>Introduction: </strong>Preserved ratio impaired spirometry (PRISm) is an important phenotype of pulmonary function in clinical and public health practice. It is possible for some patients to have chronic obstructive pulmonary disease (COPD) at an early stage. At present there is little research on the association of PRISm with type 2 (T2) inflammation biomarkers. The blood eosinophilia and impairment of small airway function in PRISm have not been fully assessed. This study investigated the eosinophilic phenotype in PRISm.</p><p><strong>Methods: </strong>Between January 2019 and September 2022, a retrospective assessment was conducted in a single pulmonary function unit in China. PRISm was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥ 70% and FEV1 < 80% predicted. Two groups were formed among the PRISm participants: eosinophilic PRISm, blood eosinophil count (BEC) ≥ 150/µL; non-eosinophilic PRISm, BEC < 150/µL. Differences were analyzed between eosinophilic and non-eosinophilic PRISm.</p><p><strong>Results: </strong>The study included 313 participants, of whom 135 were assigned to the eosinophilic PRISm group. After adjusting for potential confounders, compared to non-eosinophilic PRISm, eosinophilic PRISm remained correlated with lower natural logarithm (ln) MEF25% predicted (- 0.161 [- 0.267, - 0.054], P = 0.003) and elevated fractional exhaled nitric oxide (FeNO) (10.616 [6.384, 14.849], P < 0.001).</p><p><strong>Conclusion: </strong>Eosinophilic phenotype was common in individuals with PRISm. Compared to participants with non-eosinophilic PRISm, those with eosinophilic PRISm tended to have impaired MEF25% predicted and elevated FeNO.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"11 3","pages":"461-473"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive Sleep Apnea and Sleep Disorders in Children with Attention Deficit Hyperactivity Disorder.","authors":"Mai Nguyen-Thi-Phuong, Mai Nguyen-Thi-Thanh, Robert Joel Goldberg, Hoa L Nguyen, An Dao-Thi-Minh, Sy Duong-Quy","doi":"10.1007/s41030-025-00299-x","DOIUrl":"10.1007/s41030-025-00299-x","url":null,"abstract":"<p><strong>Introduction: </strong>Sleep disorders are common yet often underdiagnosed in children with attention deficit/hyperactivity disorder (ADHD). These disturbances can exacerbate ADHD symptoms and negatively affect cognitive, emotional, and behavioral functioning. This study aimed to describe the prevalence of obstructive sleep apnea (OSA) and other sleep disorders in children with ADHD using standardized diagnostic criteria and to identify associated clinical and behavioral factors.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 629 children aged 6-12 years (mean age: 7.8 ± 1.5 years) who were diagnosed with ADHD. Sleep disturbances were assessed using the Children's Sleep Habits Questionnaire (CSHQ), the Pediatric Sleep Questionnaire (PSQ), and respiratory polygraphy. Sleep disorders were classified on the basis of the International Classification of Sleep Disorders, Third Edition (ICSD-3). Multivariate logistic regression was used to identify associated risk factors.</p><p><strong>Results: </strong>Sleep disorders were diagnosed in 70.0% of children with ADHD. The most common disorders were insomnia (40.2%), OSA (23.4%), parasomnias (27.8%), restless legs syndrome (10.5%), and delayed sleep-wake phase disorder (4.8%). The inattentive ADHD subtype, psychiatric comorbidities, tonsil and adenoid hypertrophy, iron-deficiency anemia, and sleep-related behaviors in children with ADHD were significantly associated with sleep disturbances.</p><p><strong>Conclusions: </strong>Sleep disorders are highly prevalent and diverse in children with ADHD. Early identification and targeted management of sleep disturbances, particularly OSA and insomnia, are essential to improving sleep quality and optimizing ADHD outcomes. Routine sleep screening should be integrated into clinical ADHD evaluations. Graphical abstract available for this article.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"423-441"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}