Respiration最新文献

{"title":"Age- and Sex-Stratified Population-Based Estimates of Hospitalization-Requiring Asthma Exacerbation in Korea during Prepandemic Period (2002-2019).","authors":"Eun-Ae Yang, Soonchul Lee, Eunkyo Ha, Jeewon Shin, Boeun Han, Man Yong Han, Ju Hee Kim","doi":"10.1159/000551953","DOIUrl":"10.1159/000551953","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma exacerbations vary in prevalence, risk factors, and outcomes according to sex and age. However, large-scale longitudinal studies stratifying the prevalence of asthma exacerbation by age and sex are limited.</p><p><strong>Methods: </strong>This observational national sample cohort study used data from the National Health Insurance database to assess the prevalence of hospitalization requiring asthma exacerbation in Korea in 2002-2019. The study population included 1,137,861 participants, categorized by sex and age. The participants were classified into six age groups: <2 years (infants and toddlers), 2-5 years (preschoolers), 6-12 years (children), 12-18 years (adolescents), 19-59 years (adults), and ≥60 years (older adults). Asthma exacerbation was defined as hospitalization with a primary diagnosis of asthma or status asthmaticus on an annual basis. Trends in annual prevalence were analyzed using joinpoint regression, and the annual average percentage change (AAPC) for each segment was calculated.</p><p><strong>Results: </strong>Over the entire age range, the prevalence of asthma exacerbation increased from 5.65 cases per 10,000 person-years (PY) in 2002 to 11.89 in 2010 and decreased to 5.73 in 2019. This trend was consistent in male and female individuals. Infants and toddlers, preschoolers, and older adults exhibited the highest prevalence, peaking at 87.14, 84.47, and 22.96 cases per 10,000 PY in 2006-2007, respectively, and subsequently declining. In contrast, the peak incidences in adolescents and adults were 4.76 and 3.26 cases per 10,000 PY, respectively, which were delayed until 2013-2014. During the study period, the AAPC decreased in infants and toddlers as well as preschoolers but increased in age groups after school age, with a dominant increase of 10.7 (from 7.02 to 17.1) noted in adolescents. Mortality due to asthma exacerbation increased significantly among the older population. Among individuals aged under 12 years, asthma exacerbations were more prevalent in male individuals; however, this trend was reversed among adults and older adults, with higher rates observed in female individuals.</p><p><strong>Conclusion: </strong>This nationwide longitudinal study highlights trends in asthma exacerbation prevalence that vary by sex and age during an 18-year period, indicating the need to tailor asthma exacerbation prevention strategies in response to these changes.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842156","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":"Worldwide Survey on Interventional Pulmonology Training Programs.","authors":"Lamya Chrif Morand, Lorenzo Corbetta","doi":"10.1159/000552099","DOIUrl":"10.1159/000552099","url":null,"abstract":"<p><strong>Introduction: </strong>Interventional pulmonology (IP) has evolved into a distinct subspecialty driven by advanced technologies, yet the global educational infrastructure to support this growth remains undefined. The shift from traditional training models to competency-based medical education is advocated but inconsistently applied. This study aimed to comprehensively assess the current landscape of IP training, identifying geographic disparities in educational structure, resource availability, and certification requirements.</p><p><strong>Methods: </strong>We conducted a prospective, international, cross-sectional survey in May 2025. A validated 25-item web-based questionnaire was distributed to interventional pulmonologists and thoracic endoscopists across 34 countries via major international respiratory societies and professional digital networks. The instrument evaluated four domains: demographics, institutional setting, local training architecture, and assessment methodologies. Data were analyzed using descriptive statistics to map global training availability and standardization.</p><p><strong>Results: </strong>Analysis of 102 valid responses revealed a profound global training deficit. Seventy percent of respondents reported that no structured IP training program exists in their country. In general pulmonary fellowships, 41% of respondents indicated their training offered no exposure to interventional techniques. Geographic disparities were significant; while 100% of North American respondents reported access to structured programs, respondents from Africa reported 0% availability. Furthermore, certification was not mandatory for operating in an IP unit in 70% of cases. Assessment methods lacked rigor, with 33.3% of general fellowships reporting no formal skills evaluation. Despite these gaps, 96% of respondents expressed agreement with the need for a standardized, global IP training curriculum.</p><p><strong>Conclusion: </strong>A critical \"training divide\" exists in interventional pulmonology, characterized by a lack of structured programs, inconsistent assessment, and severe regional inequities. The current reliance on unregulated training models is insufficient for modern procedural complexity. There is a near-unanimous consensus among practitioners for the implementation of a unified, competency-based international curriculum to ensure patient safety and standard of care worldwide.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex and Gender Differences in Expiratory Central Airway Collapse: A Retrospective Cohort Study.","authors":"Paola Gutierrez-Gallegos, Regina M Murillo-Torres, Alejandra Yu Lee-Mateus, Tatiana A Rojas-Zapata, Deepika Karki, David Abia-Trujillo, Linh H Vu, Bryan C Husta, Sebastian Fernandez-Bussy","doi":"10.1159/000552345","DOIUrl":"10.1159/000552345","url":null,"abstract":"<p><strong>Introduction: </strong>Sex and gender influence the presentation and impact of multiple respiratory disorders, yet their role in expiratory central airway collapse (ECAC) remains poorly understood. To help address this gap, we examined differences in symptom burden, functional status, and quality of life (QOL) between women and men with ECAC.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included adults who underwent dynamic bronchoscopy for suspected ECAC between January 2019 and October 2024. Patients without evidence of ECAC on bronchoscopy were excluded. ECAC severity was quantified using a composite score derived from six airway segments and classified as non-severe or severe. Respiratory symptoms, dyspnea severity (modified Medical Research Council scale), pulmonary function tests, 6-min walk test (6MWT) distance, and health-related QOL (St. George's Respiratory Questionnaire [SGRQ] and Cough-Specific Quality-of-Life Questionnaire [CQLQ]) were compared by sex. Multivariable regression models assessed associations between female sex and patient-centered outcomes, adjusting for age, body mass index, ECAC severity, and comorbidities.</p><p><strong>Results: </strong>A total of 288 patients with ECAC were included, of whom 195 (67.7%) were women. Anatomic ECAC severity was similar between women and men, with severe ECAC present in 62.6% and 62.4%, respectively (p = 1.00). Pulmonary function was also comparable. Women demonstrated lower median 6MWT distance compared with men (344.8 vs. 366.4 m; p = 0.029). Chronic cough was more prevalent among women (91.8% vs. 79.6%; p = 0.006), and women more frequently reported severe dyspnea. Quality-of-life scores were significantly worse in women, with higher median SGRQ (69.4 vs. 58.2; p = 0.008) and CQLQ scores (78.5 vs. 68.0; p = 0.002). In adjusted analyses, female sex was independently associated with higher SGRQ and CQLQ scores, increased dyspnea severity, and greater cough prevalence.</p><p><strong>Conclusion: </strong>In this ECAC cohort, women had higher symptom burden, lower functional capacity, and poorer respiratory QOL than men despite comparable anatomic severity. These findings may reflect sex- and gender-related differences in the clinical presentation of ECAC and could inform more individualized diagnostic and management strategies.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchoscopic Management of Mesh Erosion following Tracheobronchoplasty in Patients with Severe Tracheobronchomalacia: A Case Series.","authors":"Maria C Lopez-Giron, Marta A Diez-Ferrer, Diana Espinoza, Ilana Roberts Krumm, Laith A Ayasa, Mihir Parikh, Jennifer L Wilson, Sidharta Gangadharan, Adnan Majid","doi":"10.1159/000550881","DOIUrl":"10.1159/000550881","url":null,"abstract":"<p><strong>Introduction: </strong>Mesh erosion is an increasingly recognized delayed complication of tracheobronchoplasty (TBP) for severe tracheobronchomalacia (TBM). While historically reported in fewer than 0.5% of cases, recent case series with extended follow-up have identified isolated events, including one erosion among 12 patients (8.3%). This case series illustrates the endoscopic management of mesh erosion in four patients, emphasizing bronchoscopic resection as a viable alternative to surgical removal in select cases.</p><p><strong>Case presentation: </strong>Four patients (ages 49-78) with severe TBM underwent TBP using posterior tracheobronchial mesh. All developed delayed-onset respiratory symptoms including progressive dyspnea, chronic cough, and recurrent infections. Comorbidities included severe COPD, diabetes, GERD, and immunosuppressive conditions. Computed tomography imaging raised concern for airway compromise; diagnostic bronchoscopy confirmed mesh erosion into the airway lumen in all cases, with tracheal and bronchial involvement and varying degrees of obstruction. Therapeutic bronchoscopy was performed using a combined rigid and flexible approach. Mesh segments eroding into the airway were selectively resected using biopsy forceps and laparoscopic scissors under direct visualization. Procedures were well-tolerated, with no intraoperative complications. In two patients, airway patency improved to >90% post-intervention. The remaining patients underwent partial mesh trimming, achieving symptomatic and infectious control. Adjunctive therapies included culture-guided antibiotics, mucociliary clearance optimization, and GERD management. One patient underwent hyperbaric oxygen therapy for mucosal healing. All patients remained clinically stable on follow-up, with improved symptom scores and no need for repeat bronchoscopic resection to date.</p><p><strong>Conclusions: </strong>Bronchoscopic resection of eroded mesh following TBP is a safe, effective, and less invasive option that can relieve airway obstruction, reduce infection burden, improve symptoms and quality of life in carefully selected patients. Timely diagnosis through imaging and endoscopic assessment is essential, and management should be guided by a multidisciplinary approach.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-8"},"PeriodicalIF":3.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Asthma in Women: Clinical Characteristics and Pharmacological Implications for Tailored Management.","authors":"Elena Villamañán, Carlos Carpio, Daniel Laorden, Laura Carrasco, David Romero, Javier Domínguez-Ortega, Leticia De Las Vecillas, Carmen Sobrino, Jose Antonio Guerra, Luis Gallego, Susana De Andrés, Magdalena Lluch, Alicia Herrero, Santiago Quirce, Rodolfo Álvarez-Sala","doi":"10.1159/000552098","DOIUrl":"10.1159/000552098","url":null,"abstract":"<p><strong>Introduction: </strong>Sex-specific differences in severe asthma - particularly those affecting women - remain underexplored, despite their potential impact on disease management and outcomes. A better understanding of these differences is key to advancing personalized and equitable care. Multiple population-based cohorts have reported a higher prevalence of asthma in adult women than in men, underscoring the clinical relevance of sex-based differences. The objective is to describe and compare sex-based clinical and pharmacological profiles among patients with severe asthma managed at a Severe Asthma Clinic (SAC) in a tertiary hospital in Spain.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients with severe asthma followed at the SAC in 2024. Clinical variables (comorbidities, pulmonary function, biomarkers, and asthma control) and pharmacological variables (inhaled therapy prescriptions and adherence, rescue overuse, oral corticosteroid use, biologics, and comorbidity-related treatments) were analyzed using electronic health and pharmacy records.</p><p><strong>Results: </strong>A total of 223 patients were included (157 women and 66 men). Women showed significantly poorer asthma control (Asthma Control Test 18.3 vs. 21.5, p < 0.05), lower fractional exhaled nitric oxide and IgE levels (p < 0.05), and higher rates of depression/anxiety (18.5% vs. 6.1%, p = 0.012). Pulmonary function tests revealed higher forced vital capacity (FVC) but lower forced expiratory volume in 1 s (FEV₁)/FVC ratios in women (p < 0.05). Poor adherence to inhaled therapies (26.0% vs. 15.4%, p < 0.05) and intranasal corticosteroids (59% vs. 34.6%, p = 0.038), as well as higher oral corticosteroid use (20.6% vs. 15.1%, p = 0.031), were more frequent in women. Biologic prescription rates and rescue inhaler overuse were similar between sexes.</p><p><strong>Conclusion: </strong>Women with severe asthma exhibit distinct clinical and pharmacological profiles that warrant sex-specific approaches to improve disease management and outcomes.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779689","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":"Pulmonary Endometriosis Successfully Treated with Percutaneous Radiofrequency Ablation: Report of Two Cases.","authors":"Yue Cheng, Dan Li, Kaige Wang, Weimin Li, Dan Liu","doi":"10.1159/000552095","DOIUrl":"10.1159/000552095","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary endometriosis (PE) is an unusual cause of catamenial hemoptysis, with only a small proportion of endometriosis cases involving the thorax. Standard management often involves surgical resection combined with hormonal therapy; however, recurrence rates remain high and long-term hormonal suppression can be challenging for patients. Multiple thoracic surgical interventions may be required for these patients during their reproductive age. A more minimally interventional alternative to surgery is expected, especially for those who would like to preserve lung function and warrant quality of life.</p><p><strong>Case presentation: </strong>We report two PE cases diagnosed clinically based on periodical hemoptysis and radiological changes relevant to menstrual cycles. Both patients were successfully treated with percutaneous radiofrequency ablation (RFA), with complete resolution of cyclical hemoptysis and an over 3-year symptom-free follow-up.</p><p><strong>Conclusion: </strong>Percutaneous RFA may be a promising alternative to surgical resection for solitary PE lesions and could serve as part of a multidisciplinary management strategy for endometriosis, especially in young patients at risk of recurrence who wish to preserve lung function and maintain quality of life.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Italian Network for the Management of Severe COVID-19 Disease in Respiratory Intermediate Care Units: The PNEUMO-COV-VEN-IT.","authors":"Martina Turrin, Andrea Francavilla, Elisabetta Balestro, Lucio Michieletto, Silvia Iovino, Paolo Spagnolo, Manuele Nizzetto, Dimitri San Lorenzo, Stefano Calabro, Laura Spillere, Riccardo Drigo, Francesco Menzella, Elisabetta Marcon, Gian Luca Casoni, Claudio Micheletto, Ernesto Crisafulli, Enrico Orzes, Dario Gregori, Micaela Romagnoli","doi":"10.1159/000552275","DOIUrl":"10.1159/000552275","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence on the management of COVID-19 patients with severe acute respiratory failure outside intensive care units (ICUs) is limited. The aim of the study was to assess mortality, outcomes/complications and their risk factors in COVID-19 patients with bilateral interstitial pneumonia and severe respiratory failure treated in respiratory intermediate care units (RICUs) within an Italian pulmonology network.</p><p><strong>Methods: </strong>Retrospective observational multicentre study was performed collecting data regarding severe respiratory failure due to SARS-CoV-2 bilateral interstitial pneumonia in 13 RICU in the Veneto region from February 2020 to May 2023.</p><p><strong>Results: </strong>A total of 1,557 patients were included (median age 69 years; male 71% vs. female 29%, p value = 0.009). The most frequent symptoms at ER admission were fever (78%), dyspnoea (72%), and cough (48%). At RICU admission, patients showed severe hypoxaemia (median PaO₂/FiO₂ = 140, IQR 100-209). Respiratory support included non-invasive ventilation and/or continuous positive airway pressure plus high-flow nasal cannula (HFNC) in 72%, HFNC alone in 12%, and low-flow oxygen in 16%. Overall, in-hospital mortality was 25%; in-RICU mortality was 16%. The 19.7% of patients were transferred to ICU, and 91% of them were intubated. ICU mortality was 51.8%. Independent mortality risk factors included chronic kidney disease (+13%) and diabetes (+7.4%), while mortality decreased significantly during the third pandemic time frame (p < 0.001). Male sex and older age were associated with higher risk of mortality.</p><p><strong>Conclusions: </strong>This large multicentre study across 2020-2023 demonstrates that RICU management provided favourable outcomes in severe COVID-19, even among elderly and comorbid patients.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of the Early Pleurodesis via IPC for Treatment of Malignant Effusion Protocol.","authors":"Deirdre B Fitzgerald, Sanjeevan Muruganandan, Christopher Stanley, Arash Badiei, Cathy Read, Rajesh Thomas, Y C Gary Lee","doi":"10.1159/000551874","DOIUrl":"10.1159/000551874","url":null,"abstract":"<p><strong>Background: </strong>Malignant pleural effusion management often involves multiple procedures that are painful and have risks. Indwelling pleural catheters (IPCs) are associated with reduced re-intervention rates. Recently published trials have focused on optimizing IPC aftercare to improve pleurodesis rates, reduce complications, and expedite catheter removal. We combined available data into one protocol and evaluated it in an unselected cohort, aiming to answer whether initial IPC insertion as first-line intervention for MPE (combined with talc instillation and daily drainage where suitable) is safe, feasible, and effective.</p><p><strong>Methods: </strong>The EPIToME protocol was developed to minimize pleural interventions and was evaluated in a prospective, unselected cohort of MPE patients.</p><p><strong>Results: </strong>The EPIToME protocol managed all symptomatic MPEs (unless contraindicated), with IPC insertion, inpatient talc instillation via the IPC, and daily ambulatory drainage if full lung expansion was achieved. Otherwise, symptom-guided drainage was performed. Of 102 MPE patients, 47 (46.1%) patients underwent talc instillation, of which 74.5% achieved pleurodesis after 20 (median, 95% CI = 6.7-33.3) days. Those unsuitable for pleurodesis (55%) underwent symptom-guided drainage. Fifty-five patients had the IPC removed after fluid cessation. The EPIToME protocol required a hospital stay of 2 to 3 days, similar to standard pleurodesis. Complications (infection 11.8%, symptomatic loculation 10.8%) were within expected ranges, but interpretation of safety is limited in the absence of a comparator group. Only 3 patients (2.9%) required further pleural re-intervention post-IPC removal.</p><p><strong>Conclusion: </strong>We developed and demonstrated the feasibility of the EPIToME approach, which aims to minimize interventions for all-comers with MPE. Combining IPC, talc pleurodesis and daily drainage may be effective and should be evaluated in randomized trials.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-8"},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gender Gap in Obstructive Sleep Apnea: A Machine Learning Approach to Screening Women for Moderate-to-Severe Disease.","authors":"Theofilos Kanavos, Effrosyni Birbas, Georges Khattar, Chapman Wei, Michel Al Achkar, Alanna Davis, Mohammad Aldalahmeh, Salim Barakat, Zaineb Zubair, Jackson Abou Chehade, Dany Elsayegh, Suzanne El Sayegh, Theodoros P Zanos","doi":"10.1159/000551856","DOIUrl":"10.1159/000551856","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea (OSA) can lead to severe complications if left untreated. Several challenges hinder OSA identification in females, resulting in underdiagnosis and undertreatment in this population. This study aimed to develop a machine learning (ML) approach specifically tailored to screen women for moderate-to-severe OSA.</p><p><strong>Methods: </strong>A retrospective study was conducted using clinical records of 1,210 women who underwent polysomnography at our institution. Collected data included demographics, body metrics, nocturnal oxygen saturation levels, medical conditions, medications, laboratory measurements, and polysomnography results. Four ML algorithms were employed to classify participants into moderate-to-severe and none-to-mild OSA groups.</p><p><strong>Results: </strong>Due to the high missingness of laboratory values in the whole cohort, two sets of models were developed: one utilizing all subjects but excluding lab tests, and another restricted to a subgroup of 383 participants that additionally incorporated hemoglobin and lipid profile alongside the other features. Without laboratory measurements, the best-performing model was adaptive boosting, which achieved an area under the receiver operating characteristic curve and accuracy of 0.811 and 76.03%, respectively. When lab tests were included, gradient boosting machine outperformed its competitors, with the above metrics reaching 0.872 and 84.42%, respectively.</p><p><strong>Conclusion: </strong>The promising performance of our approach underlines the potential of artificial intelligence in refining screening strategies for OSA in women. Nadir oxygen saturation during sleep emerged as a particularly strong predictor, reinforcing the central role of nocturnal hypoxemia in OSA risk stratification. Future research should focus on incorporating broader clinical inputs and using larger, diverse datasets to develop a highly accurate, robust model that meets clinical standards and is suitable for real-world implementation.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-18"},"PeriodicalIF":3.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending the Diagnostic Frontier: Slim Endobronchial Ultrasound in Navigation Bronchoscopy: A Case Series.","authors":"Johannes M A Daniels, Marjolein A Heuvelmans, Peter I Bonta, Jouke T Annema","doi":"10.1159/000551967","DOIUrl":"10.1159/000551967","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional convex endobronchial ultrasound (EBUS) is limited to the central airways, whereas radial EBUS lacks real-time guidance. As navigation bronchoscopy expands into the peripheral lung, a gap persists in the (sub)segmental \"mid-zone,\" where visualization, tool alignment, and vascular anatomy challenge diagnostic sampling.</p><p><strong>Case presentation: </strong>Seven patients with suspected lung cancer in the mid-zone underwent slim EBUS (s-EBUS) with or without cone-beam CT-guided navigation bronchoscopy. Anatomical access, sampling strategy, diagnostic contribution, and safety were evaluated. s-EBUS allowed precise real-time visualization and needle placement in mid-zone targets, including stations 12L and peribronchial lung nodules beyond (sub)segmental bronchi. In two cases, a pulmonary artery branch separated airway and lesion; under ultrasound control, transvascular needle access was feasible without adverse events. In a single case, s-EBUS-guided cryobiopsy was successfully performed using a 1.1-mm probe and yielded diagnostic tissue for histology and molecular analysis. s-EBUS provided clinically relevant diagnosis or staging information in all cases.</p><p><strong>Discussion: </strong>s-EBUS extends ultrasound-guided bronchoscopy beyond the central airways and may close an important anatomical diagnostic gap in navigation bronchoscopy. Advantages include mid-zone access, vascular mapping, selective transvascular sampling, and targeted cryobiopsy. Further studies should assess performance, safety, and clinical impact.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692156","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}