Respiratory medicine最新文献

{"title":"Network-Based Analysis of Images and Lesions Expressed by Digital Interpretation and Transmission of Bronchoscopy Findings on Social Media (NAILED-IT).","authors":"Christopher R Gilbert, Lonny B Yarmus, Christopher Kapp, A Christine Argento, Jason A Akulian, Jed A Gorden, Jeffrey Thiboutot, Gerard A Silvestri, Fabien Maldonado","doi":"10.1016/j.rmed.2026.108859","DOIUrl":"https://doi.org/10.1016/j.rmed.2026.108859","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnostic bronchoscopy has advanced rapidly over the last two decades with the adoption of novel technologies. Concurrently, social media platforms have proliferated, with some pulmonologists sharing and promoting these new technologies and diagnostic successes. The impact of this content on perceptions of diagnostic yield and utility remains unclear.</p><p><strong>Methods: </strong>A scoring system was developed to evaluate social media posts related to bronchoscopy. The BIASED score ranges from 1-6 points, awarding one point each for the inclusion of: Brand/technology mention, Imaging (diagnostic), Anatomy description, Successful diagnosis, Educational value, and Data on the procedure. Nine participants reviewed and scored bronchoscopy-related posts across multiple social media platforms. Descriptive statistics were used to summarize findings.</p><p><strong>Results: </strong>Social media platforms were reviewed that included Facebook, Instagram, LinkedIn, TikTok, and YouTube. Diagnostic bronchoscopy related posts were identified and scored after visual filtering for the presence of radiographic or bronchoscopic imaging. The mean BIASED score was 4.59. Most posts emphasized positive diagnostic outcomes, with only two social media accounts posting content related to non-diagnostic bronchoscopy results.</p><p><strong>Discussion: </strong>This study represents one of the first attempts at descriptive assessment of bronchoscopy-related content on social media. Many posts demonstrated high BIASED scores, which appear to emphasize favorable outcomes with diagnostic bronchoscopy. The BIASED scoring system provides a feasible method to quantify characteristics of bronchoscopy-related social media content and may serve as a framework for future analyses.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108859"},"PeriodicalIF":3.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857005","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 validation of a nomogram prediction model for prolonged length of hospital stay in patients with AECOPD.","authors":"Shijie Tang, Jinxi Li, Junjie Peng, Xuanfei Xu, Hao Wang, Lei Chen","doi":"10.1016/j.rmed.2026.108879","DOIUrl":"https://doi.org/10.1016/j.rmed.2026.108879","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate risk factors of prolonged length of hospital stay (LOHS) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and to develop a predictive nomogram.</p><p><strong>Approach: </strong>AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine at West China Hospital between January 2010 and December 2019 were retrospectively analyzed and randomly divided into training and validation sets (7:3). Least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression analyses were performed to screen independent predictors, which were incorporated into a nomogram. Model performance was evaluated through receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of 3,146 patients were included, with 2,022 in training set and 944 in validation set. Twelve variables were independently associated with prolonged LOHS and incorporated into the nomogram, including onset seasons, hemoglobin (Hb), white blood cells (WBC), albumin (ALB), sputum cultures, respiratory failure and respiratory support modes, use of anticoagulants, antibiotics and systemic glucocorticoids, heart failure, and malignant tumors. The area under the ROC curve (AUC) was 0.760 (95% CI: 0.737-0.783) in training set and 0.746 (95% CI: 0.710-0.783) in validation set, demonstrating strong discrimination. Calibration curves closely aligned with the diagonal, indicating high consistency between predicted and observed values. DCA showed substantial net benefits, highlighting the model's clinical utility.</p><p><strong>Conclusions: </strong>A nomogram prediction model was developed and validated, facilitating early identification of AECOPD patients at risk for extended LOHS and supporting informed clinical decision-making and optimal resource allocation.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108879"},"PeriodicalIF":3.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856950","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":"Beyond the Lungs: The Role of Extrapulmonary Manifestations in the Quality of Life of Indians with Chronic Airway Diseases.","authors":"Rohini Bhadra, S Sucharita, George D'Souza, Sumithra Selvam, Annemie M W J Schols","doi":"10.1016/j.rmed.2026.108872","DOIUrl":"https://doi.org/10.1016/j.rmed.2026.108872","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic airway diseases (CAD) including Chronic obstructive pulmonary diseases (COPD), persistent asthma (≥2weekly episodes) and bronchiectasis, exhibit overlapping extrapulmonary manifestations potentially affecting health-related quality-of-life (HRQOL). The study objective was to quantify HRQOL of CAD patients and identify impact of associated pulmonary and extrapulmonary manifestations.</p><p><strong>Methodology: </strong>Total 101 established CAD patients were recruited cross-sectionally (COPD, n=61, persistent asthma, n=30 and bronchiectasis, n=10). Patients completed spirometry, body composition (Dual-energy X-ray Absorptiometry), muscle function (isometric and isokinetic dynamometry), exercise capacity (6-minute walking distance,6MWD) and patient reported outcomes including physical activity, sleep and Hospital-Anxiety-and-Depression-Scale. HRQOL was assessed using EuroQol quality-of-life questionnaire and utility score (EQ-5D index) was stratified into tertiles to compare patient characteristics.</p><p><strong>Result: </strong>Mean age of participants was 60.9±12.8y, and 25.7% were female. Mean EQ-5D index was 0.658(95%CI: 0.596, 0.721), significantly lower than population norms and other chronic diseases including diabetes, cardiovascular diseases and rheumatoid heart disease (p<0.01). Participants in lowest EQ-5D tertile were older, had higher depression, lower 6MWD, lower handgrip and quadriceps muscle strength than other two tertiles, whereas anxiety was higher in both lowest and intermediate tertile compared to highest tertile(p<0.01). In adjusted regression model, age (AOR:1.187) depression (AOR:1.438), anxiety (AOR:1.266), and body fat (AOR:1.114) showed increased odds for poor EQ-5D index while in intermediate vs highest EQ-5D tertile, only age (AOR: 1.125) and anxiety (AOR:1.403) showed a significant association.</p><p><strong>Conclusion: </strong>HRQOL is significantly lower in CAD compared to other chronic non-communicable diseases and significantly associated with extrapulmonary manifestations. Interventions targeting modifiable risk factors may aid in improving HRQOL in CAD.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108872"},"PeriodicalIF":3.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856981","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":"The effect of inhaler prescription and comorbidities on the prognosis of COPD in never-smokers: A nationwide population-based study.","authors":"Seung Soo Sheen, Ju Hyun Oh, Won-Il Choi, Kyungjoo Kim, Chin Kook Rhee, Joo Hun Park","doi":"10.1016/j.rmed.2026.108864","DOIUrl":"https://doi.org/10.1016/j.rmed.2026.108864","url":null,"abstract":"<p><strong>Background: </strong>Most clinical trials evaluating inhaler therapy in COPD have been conducted predominantly in smoking populations, and prognostic factors and therapeutic outcomes in COPD without any history of smoking were not well investigated. Therefore, this study was conducted to investigate the effect of inhaler prescription and comorbidities on the prognosis of COPD in never-smokers.</p><p><strong>Methods: </strong>A retrospective observational study was undertaken using data from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) Survival analyses were performed according to inhaler prescriptions and comorbidities from index date to December 31, 2019.</p><p><strong>Results: </strong>Among 2,432 eligible patients, 382 (16.3%) received long-acting muscarinic antagonist(LAMA)/long-acting β₂-agonist(LABA) therapy, 1,780 (73.2%) received inhaled corticosteroid(ICS)/LABA, 187 (7.3%) received LAMA monotherapy, and 83 (3.4%) received LABA monotherapy. In multivariate Cox regression analysis, compared with the LAMA/LABA group, the ICS/LABA group had significantly higher all-cause (HR 1.65; 95% CI 1.22-2.24) and respiratory mortality (HR 1.72; 95% CI 1.07-2.77). Coexisting heart failure, frequent hospitalizations (≥2 times/year vs. none), and emergency room visits along with older age, male sex, and lower body mass index (BMI) were also independently associated with higher respiratory and all-cause mortality (p<0.05).</p><p><strong>Conclusion: </strong>Our data in the cohort of non-smoking COPD suggest that LAMA/LABA therapy was associated with better survival rate compared with ICS/LABA therapy. Moreover, comorbid heart failure, frequent hospitalizations, emergency room visits, older age, male sex, and lower BMI were also independently linked to higher risks of respiratory and all-cause mortality.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108864"},"PeriodicalIF":3.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856928","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":"Regional Differences in Sensitization Patterns Among Children with Allergic Asthma in China: A Latent Class Analysis and Age-Related Characteristics.","authors":"Yu Guo, Guojing Wang, Chengtao Zhou, Zuer Gan, Kaixin Tan, Zhiman Liang, Jiale Zhang, Yaobin Li, Yuqi Chen, Youpeng Chen, Jiahao Xia, Wenhan Cao, Yuezhi Deng, Ruyan Liao, Xiaolin Xiao, Zhixin Chen, Wenting Luo, Baoqing Sun","doi":"10.1016/j.rmed.2026.108845","DOIUrl":"https://doi.org/10.1016/j.rmed.2026.108845","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize regional and age-dependent sensitization patterns in Chinese children in clinical referral settings with allergic asthma using Latent Class Analysis (LCA).</p><p><strong>Design setting and participants: </strong>This multicenter cross-sectional study (2019-2022) analyzed 580 children (aged 0-14 years) with diagnosed allergic asthma, strictly recruited from 13 tertiary referral centers across Northern and Southern China.</p><p><strong>Methods: </strong>Standardized allergen-specific IgE (sIgE) testing for 18 allergens was performed using a unified platform. LCA was applied to identify distinct sensitization phenotypes, and age-related trajectories were examined.</p><p><strong>Results: </strong>LCA identified four distinct patterns per region with significant distributional differences. Northern children were characterized by a High Pollen/Weed pattern (Class 3), accounting for 38.9% of the cohort, with Artemisia vulgaris (53.0%) and Leucanthemum vulgare (50.0%) as primary sensitizers. In contrast, Southern children were dominated by a High Dust Mite pattern (Class 3), comprising 63.3% of the population. The prevalence of Dermatophagoides farinae sensitization in the South was 72.0%, significantly higher than in the North (). Furthermore, the 3-6-year age group demonstrated the highest sensitization intensity across both regions.</p><p><strong>Conclusion: </strong>Sensitization phenotypes exhibit marked geographic heterogeneity, with plant pollens predominating in the North and dust mites in the South. While these findings support region-specific diagnostic strategies, they reflect patterns in a referral-center cohort and may imply a more severe clinical phenotype than the general population; thus, broader generalization should be approached with caution.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108845"},"PeriodicalIF":3.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723568","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":"Association between urinary metabolites of volatile organic compounds and lung function: A cross-sectional study","authors":"Jian Chen ,&nbsp;Yan Li ,&nbsp;Zhenzong Han ,&nbsp;Jixiang Liu ,&nbsp;Lin Hou","doi":"10.1016/j.rmed.2026.108683","DOIUrl":"10.1016/j.rmed.2026.108683","url":null,"abstract":"<div><h3>Background</h3><div>Volatile organic compounds (VOCs), play a major role in exacerbating air pollution and present a threat to human health. However, the association between specific VOCs and lung function in the general population has not been extensively explored.</div></div><div><h3>Objectives</h3><div>Our study aimed to examine the correlation between urinary VOC metabolites (mVOCs) concentrations and lung function, among a typical sample of the adult population.</div></div><div><h3>Methods</h3><div>The correlation between urinary mVOCs and lung function was analyzed using logistic regression models, QG-C, WQS, and BKMR models were employed.</div></div><div><h3>Results</h3><div>Our study revealed that higher concentrations of certain urinary mVOCs significantly correlated with an increased risk of abnormal lung function, especially URXAMC and URXDHB. A significant nonlinear correlation was observed between URXDHB and FEV1 % pred &lt;80 % (<em>P</em> for overall &lt;0.001, <em>P</em> for nonlinear &lt;0.001), and a nonlinear correlation was noted between URXAMC and the incidence of FEV1 % pred &lt;80 % (<em>P</em> for overall, <em>P</em> for nonlinear = 0.012).</div></div><div><h3>Conclusion</h3><div>VOCs exposure is associated with compromised lung health, and particularly strong correlations exist between URXAMC/URXDHB and abnormal lung function; These findings provide new insights for respiratory disease prevention and control.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108683"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093896","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":"Comparative effectiveness and safety of novel antidiabetic agents in the management of obstructive sleep apnea: a systematic review, meta-analysis, and network meta-analysis","authors":"Ying-tian Yang ,&nbsp;Xin-zheng Hou ,&nbsp;Xi-rui Zhang ,&nbsp;Zhen-peng Zhang ,&nbsp;Shi-han Wang","doi":"10.1016/j.rmed.2026.108671","DOIUrl":"10.1016/j.rmed.2026.108671","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) is a prevalent but frequently underdiagnosed type of sleep-disordered breathing. Excessive obesity is a primary reversible risk factor for OSA. A range of novel antidiabetic agents has recently demonstrated promising potential for improving OSA severity through weight loss and metabolic regulation.</div></div><div><h3>Objective</h3><div>This study aimed to examine the effectiveness and safety of novel antidiabetic agents for people with OSA.</div></div><div><h3>Methods</h3><div>We searched PubMed, Web of Science, Cochrane Library, and Embase database from inception to May 18, 2025. Pairwise meta-analysis and Bayesian network meta-analysis (NMA) were conducted to compare relative efficacy.</div></div><div><h3>Results</h3><div>A total of 8 RCTs and 2 non-RCTs involving 1280 OSA participants were enrolled. Compared with the control group, SGLT-2i (MD = −7.73 events/h, 95 % CI [-9.83, −5.64]), GLP-1 RAs (MD = −5.19 events/h, 95 % CI [-6.87, −3.51]), and tirzepatide (−21.89 events/h, 95 % CI [-26.01, −17.77]) could significantly decrease AHI. The NMA results suggested that tirzepatide ranking highest of producing the greatest AHI reduction (MD = −21.85 events/h, 95 % CI [−27.52, −16.34]), along with the most substantial decreases in body weight (MD = −19.41 kg, 95 % CI [-21.00, −17.82]) and blood pressure (MD_SBP = −5.86 mmHg, 95 % CI [-7.97, −3.74]; MD_DBP = −1.96 mmHg, 95 % CI [-3.45, −0.46]).</div></div><div><h3>Conclusion</h3><div>Based on indirect evidence, tirzepatide was associated with the largest estimated magnitude of AHI reduction, presumably mediated by its weight-loss effects. For obesity-related OSA patients intolerant to continuous positive airway pressure therapy, tirzepatide may represent a potential adjunctive or alternative pharmacological option. High-quality studies are still needed to validate these findings further.</div></div><div><h3>Prospero registration number</h3><div>CRD420251165267.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108671"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093931","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":"Adaptive support ventilation with IntelliSync versus pressure support ventilation for non-invasive ventilation in acute exacerbation of COPD: A feasibility randomized trial","authors":"Selva Vijay,&nbsp;Inderpaul Singh Sehgal,&nbsp;Ritesh Agarwal,&nbsp;Valliappan Muthu,&nbsp;Sahajal Dhooria,&nbsp;Kuruswamy Thurai Prasad,&nbsp;Ashutosh Nath Aggarwal","doi":"10.1016/j.rmed.2026.108690","DOIUrl":"10.1016/j.rmed.2026.108690","url":null,"abstract":"<div><h3>Background</h3><div>While non-invasive ventilation (NIV) is recommended for managing acute exacerbations of chronic obstructive pulmonary disease (AECOPD), it has a 30–40% failure rate when delivered using pressure support ventilation (PSV). Adaptive support ventilation with IntelliSync (ASVi) synchronizes breath initiation and cycling to match patient's requirements. We conducted a feasibility study to inform design of a larger trial and compared NIV failure rates using PSV or ASVi in patients with AECOPD.</div></div><div><h3>Materials and methods</h3><div>We conducted a single-center, randomized controlled trial from December 2023 to April 2025 in subjects with AECOPD. Subjects were randomized (1:1) to receive NIV using PSV or ASVi. The primary outcome was NIV failure, defined as the need for airway intubation. Key secondary outcomes included the asynchrony index and 28-day all-cause mortality.</div></div><div><h3>Results</h3><div>We included 55 consecutive subjects with AECOPD (ASVi, n = 26; PSV, n = 29), with a mean age of 63 years. NIV failure occurred in15.4% (4/26) with ASVi versus 31% (9/29) with PSV, representing a 50% relative risk reduction (absolute difference 15.6%, 95% CI: −6.2%–37.5%, P = 0.17). Asynchrony index was similar between groups (22.6 ± 17.8 ASVi vs. 21.5 ± 16.7 PSV, P = 0.83). ASVi was associated with significantly greater patient comfort (P = 0.048) and shorter hospital stay (3.9 ± 2.9 vs 5.8 ± 4.0 days, P = 0.021).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that ASVi is safe, feasible to implement, and associated with improved patient comfort and significantly reduced hospital stay in AECOPD. The observed 50% relative reduction in NIV failure rates, although not statistically significant, represents a clinically meaningful effect that warrants evaluation in a larger trial.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108690"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106945","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":"Influence of chronic obstructive pulmonary disease on cardiovascular outcomes and mortality benefits of sodium glucose co-transporter inhibitors in heart failure patients: A systematic review and meta-analysis","authors":"Rohab Sohail ,&nbsp;Zaraq Ahmad Khan ,&nbsp;Ridda Khattak ,&nbsp;Prakhar Anand ,&nbsp;Vyom Patel ,&nbsp;Marcos Alberto ,&nbsp;Mark Georgy ,&nbsp;Karan Dhand ,&nbsp;Andrei Feldiorean ,&nbsp;Seemab Fatima ,&nbsp;Sana Murtaza ,&nbsp;Manjeet Singh ,&nbsp;Syed Nazeer Mehmood","doi":"10.1016/j.rmed.2026.108685","DOIUrl":"10.1016/j.rmed.2026.108685","url":null,"abstract":"<div><h3>Background</h3><div>By 2030, healthcare expenditures related to congestive heart failure (CHF) in the United States are projected to surpass $70 billion. Despite substantial advances in guideline-directed medical therapy, morbidity and mortality remain unacceptably high, particularly among patients with concomitant chronic obstructive pulmonary disease (COPD), a comorbidity reported in approximately 5%–41% of individuals with CHF. Although COPD is independently associated with worse CHF outcomes, its influence on the mortality benefit conferred by sodium–glucose cotransporter-2 (SGLT-2) inhibitors remains poorly defined.</div></div><div><h3>Objective</h3><div>To evaluate whether COPD alters the cardiovascular and mortality benefit of SGLT-2 inhibitors in CHF patients.</div></div><div><h3>Methods</h3><div>PubMed, Cochrane and Google Scholar were searched from inception to February 2025 to identify studies meeting inclusion criteria. Review Manager was employed to calculate results in the form of relative risk (RR) with 95% confidence interval.</div></div><div><h3>Results</h3><div>Our analysis of 15,058 patients (1725 (11%) COPD patients) showed that COPD was associated with significantly higher risks of composite outcomes (RR = 1.63; 95% CI: 1.49–1.79; p &lt; 0.00001), CV mortality (RR = 1.62; 95% CI: 1.39–1.88; p &lt; 0.0001), heart failure hospitalization (RR = 1.84; 95% CI: 1.40–2.40; p &lt; 0.00001), and all-cause mortality (RR = 1.59; 95% CI: 1.42–1.78; p &lt; 0.00001). Additionally, adverse outcomes were more frequent in COPD patients, including volume depletion (RR = 1.34; 95% CI: 1.25–1.51; p &lt; 0.00001), and adverse renal events (RR = 1.46, 95% CI: 1.17–1.82; P = 0.0007).</div></div><div><h3>Conclusion</h3><div>Our analysis indicates that heart failure (HF) patients with COPD may drive a somewhat attenuated benefit from SGLT-2 inhibitors, underscoring a clinical profile that merits careful consideration.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108685"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126364","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":"Monitoring home mechanical ventilation: Polysomnography or built-in ventilator software?","authors":"Jean-Michel Arnal ,&nbsp;Sonia Khirani","doi":"10.1016/j.rmed.2026.108713","DOIUrl":"10.1016/j.rmed.2026.108713","url":null,"abstract":"<div><div>Monitoring of home mechanical ventilation (HMV) and continuous positive airway pressure (CPAP) is essential to guarantee an efficient ventilation. Hospital attended polysomnography (PSG), or at least respiratory polygraphy, remains the gold standard for the monitoring of HMV/CPAP. However, it is time-consuming, costly and not practical. Built-in ventilator software data represent a good alternative, but some limitations have to be acknowledged. Adherence, leaks and patient-ventilator asynchrony (PVA) are among the main data to monitor, and the analysis of these data can be easily done using built-in ventilator software. Residual respiratory events can also be monitored using built-in ventilator software, with the limitation that their identification and characterization are not always optimal. PSG may be indicated when the analysis of breath-by-breath waveforms of built-in ventilator software is not conclusive. PSG or thoraco-abdominal belts connected to a ventilator may also be useful to identify PVA related to an insufficient pressure support. This review summarizes the information available when using built-in ventilator software data, highlighting their advantages and drawbacks as compared to PSG for the monitoring of HMV/CPAP, and addresses the situations where one approach may be more appropriate than the other. The availability of thoraco-abdominal belts for additional ventilators may represent a valuable development, enabling an improved monitoring of HMV/CPAP, particularly in settings with limited resources.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108713"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202578","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}