Respiratory medicine最新文献

{"title":"Real-world comparison of T2-biologics effectiveness in severe allergic asthma with nasal polyps.","authors":"Angelica Tiotiu, Nicolas Migueres, Francisco-Javier Gonzalez-Barcala, Pauline Roux, Jean-Philippe Oster, Natacha Moutard, Frederic de Blay, Philippe Bonniaud","doi":"10.1016/j.rmed.2025.107979","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.107979","url":null,"abstract":"<p><strong>Background: </strong>Patients with severe allergic asthma (SAA) and blood eosinophil count ≥0.3x10⁹/L are eligible for multiple biologics. Several of them showed benefits on nasal polyps (NP), a frequent comorbidity of the severe asthma, but comparative studies on their effectiveness in the association SAA-NP are currently lacking. OUR OBJECTIVE: was to compare the effectiveness of anti-IgE, anti-IL5/R and anti-IL4R in patients with SAA-NP in real-world settings.</p><p><strong>Methods: </strong>A real-world multicentre observational study was realized including patients with SAA-NP treated by anti-IgE, anti-IL5/R or anti-IL4R for 6 months. We analysed the nasal and respiratory symptoms, the number of asthma attacks and salbutamol use/week, acute sinusitis and severe exacerbation rates, the asthma control score, the lung function parameters, the NP endoscopic score, the sinus imaging, and the blood eosinophil count 6 months before and after treatment.</p><p><strong>Results: </strong>One hundred seven patients with SAA-NP were included: 35 treated by anti-IgE, 38 by anti-IL5/R and 34 by anti-IL4R. All the biologics showed similar effectiveness in improving asthma outcomes (symptoms, exacerbation rate, asthma control, lung function). Despite the amelioration of almost all rhinological parameters and sinus imaging in each group, greater benefits were found in the anti-IL4R group in terms of loss of smell (odds ratio OR 3.64[1.3-11.1], p=0.017), nasal obstruction (OR12.00[2.00-23.10], p=0.023), and NP endoscopic score (OR 18.10[4.43-24.50]).</p><p><strong>Conclusion: </strong>All three biological classes improved asthma and sino-nasal outcomes in patients with SAA-NP. However, anti-IL4R was superior in improving the smell, nasal obstruction, and NP endoscopic size. Larger comparative studies are needed to confirm our results.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107979"},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080972","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":"Cystic fibrosis patients' preferences for electronic devices that monitor their inhalation - A qualitative study.","authors":"Lyan Betsema, Mingshi Yang, Adam Bohr, Aitana Herrera, Susanne Kaae","doi":"10.1016/j.rmed.2025.107980","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.107980","url":null,"abstract":"<p><strong>Background: </strong>Patients with cystic fibrosis (CF) use inhaled medicines daily due to respiratory manifestations. However, only 31% of users is inhaling correctly. Digital solutions targeting inhalation could help CF patients improve their technique and thus health outcomes. However, the use of electronic monitoring devices shows a decrease over time. Therefore, the aim of study was to investigate CF patients' preferences for the use of electronic devices on their inhalation technique on a regular basis and reasons behind these preferences.</p><p><strong>Methods: </strong>Semistructured interviews were conducted with 11 CF patients from four European countries to understand their disease history and experiences, daily use of inhaler medication, experiences with digital devices to achieve disease control, and expectations of new devices for monitoring inhalation. A conventional content analysis was applied.</p><p><strong>Results: </strong>CF patients knew their body well due to their lifelong experiences. However, some patients still experienced periods with more symptoms and need for support. Non-app support was preferred. CF patients reported that digital systems should provide high benefits for regular use. Patients differed in their interest in digital systems for inhalation. Such systems were mostly relevant to CF patients starting a new inhaled treatment/inhaler device or during periods in which the disease was out of control.</p><p><strong>Conclusions: </strong>CF patients perceived limited value of digital systems to monitor their inhalation and mostly considered them necessary for specific periods. Extensive experience in using inhalers and existing daily routines to manage a high treatment burden appear involved in limited need of such systems.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107980"},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080967","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":"Are we giving too much oxygen to patients at risk of hypercapnia? Real world data from a large teaching hospital.","authors":"B Ronan O'Driscoll, Nawar Diar Bakerly","doi":"10.1016/j.rmed.2025.107965","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.107965","url":null,"abstract":"<p><strong>Introduction: </strong>Oxygen guidelines recommend a target saturation range (SpO₂ range) of 88-92% for patients at risk of hypercapnia. Saturations <88% and saturations >92% whilst using supplemental oxygen are associated with increased mortality.</p><p><strong>Methods: </strong>We audited SpO₂ observations of all patients with a prescribed target range of 88-92% at one hospital over a four-year period.</p><p><strong>Results: </strong>Of 1,045,958 observations from patients with an oxygen prescription, 107,724 (10.3%) had a target range of 88-92% (at risk of hypercapnia). 26,668 of these observations (24.8%) involved oxygen use. 89.6% of the SpO₂ observations with target SpO₂ range 88-92% were satisfactory with SpO₂ ≥88% breathing air or SpO₂ 88-92% breathing oxygen. However, 1.2% of SpO₂ observations for these patients were too low (<88%). This was commoner in observations involving use of supplemental oxygen (2.2%) compared with observations on air (0.9%). Of the SpO₂ observations with target SpO₂ range 88-92% which were recorded whilst the patient was receiving supplemental oxygen therapy, 9,870 had SpO₂ >92% (over-oxygenated). This represented 9.2% of all observations for patients with a target range of 88-92% and 37.0% of the 26,668 observations involving use of oxygen for these patients. Compared with nasal cannulae, SpO₂ observations involving use of simple masks, Venturi masks and humidified oxygen were more commonly outside of the target range.</p><p><strong>Summary: </strong>We found that excessive oxygen administration was much commoner than insufficient oxygen therapy for hospital patients at risk of hypercapnia. Excessive oxygen use implies an increased risk of harm to these patients, increased cost, and potentially delayed discharges.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107965"},"PeriodicalIF":3.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075347","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":"Prevalence and Characteristics of Airway Collapse in Non-Specific Patterns of Lung Function.","authors":"Khouloud Kchaou, Balsam Barkous, Chaima Briki, Soumaya Khaldi, Saloua Ben Khamsa Jameleddine","doi":"10.1016/j.rmed.2025.107981","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.107981","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107981"},"PeriodicalIF":3.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075357","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":"Assessment of Online YouTube Videos as a Source of Information and Instruction for Pulmonary Rehabilitation.","authors":"Omer A Choudhary, Jillian Dhawan, Sahar Sohrabipour, Julie Semenchuk, Tania D Silva, Megha I Masthan, Gillian C Goobie, W Darlene Reid, Jolene H Fisher, Christopher J Ryerson, Dmitry Rozenberg","doi":"10.1016/j.rmed.2025.107968","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.107968","url":null,"abstract":"<p><strong>Background/objectives: </strong>Pulmonary rehabilitation (PR) benefits individuals with chronic respiratory conditions beyond COPD; however, the quality of online resources has not been evaluated. The aims of this study were to assess the content, quality, and comprehensibility of YouTube videos that provide PR to individuals with chronic lung diseases other than COPD.</p><p><strong>Methods: </strong>A search was conducted on YouTube for videos related to PR on non-COPD conditions, with the first 350 videos screened for eligibility (2004-2024). Videos were assessed for content based on predefined scoring matrix derived from PR guidelines, evaluated for their quality using the modified DISCERN tool and Global Quality Scale (GQS), and assessed for their understandability and actionability using the Patient Education Materials and Assessment Tool. Engagement metrics including viewing rate and interaction index were also analyzed.</p><p><strong>Results: </strong>Of the 59 videos included, there was significant heterogeneity in PR content (i.e. aerobic, strength training, flexibility, etc.). 83% of the videos were published following the onset of COVID-19 pandemic (March 2020), and 85% of the videos were not directed at specific disease states. Video quality was moderate, with median modified DISCERN and GQS of 3 IQR[3-4] and 3 IQR[2-4] out of 5, respectively. Mean understandability and actionability were above the 70% threshold. Engagement metrics revealed that median video views were 2,857 (IQR[637-10,729]), but engagement was low (1.4% IQR[1.0-2.7]).</p><p><strong>Conclusion: </strong>The study highlights variability in PR content and moderate quality of videos, with reasonable comprehensibility. There is a need for more standardized and disease-specific PR online video resources for non-COPD states.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107968"},"PeriodicalIF":3.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067369","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":"Comparing mesh and compressor nebulizers in pulmonary function test in pediatric asthma attacks: A double-blind randomized comparative clinical trial.","authors":"Berker Okay, Halil Ugur Hatipoglu, Zeynep Uze Okay, Kamil Sahin, Adem Yasar","doi":"10.1016/j.rmed.2025.107966","DOIUrl":"10.1016/j.rmed.2025.107966","url":null,"abstract":"<p><strong>Objective: </strong>Asthma is a prevalent global health issue, especially affecting children in numerous countries. Our study aimed to determine the most effective nebulizer type by comparing the effects of mesh nebulizers (MNs) and compressor nebulizers (CNs) on spirometry tests in pediatric asthma attacks.</p><p><strong>Methods: </strong>The prospective, double-blind, randomized comparative study was conducted with patients aged 7-15 presenting with asthma attacks. The participating patients were divided into two groups by randomization: those using CNs and those using MNs. A pulmonary function test was performed before and after giving the patients three doses of salbutamol inhaler at 20-minute intervals, and changes in the test were recorded.</p><p><strong>Results: </strong>The increase in peripheral oxygen saturation was higher in the MN group, although this difference was not statistically significant (p = 0.391). However, statistically significant differences were observed in the decrease in respiratory rate (RR;/min; p = 0.002) and the increase in heart rate (/min; p = 0.022). The respiratory function test indicated a higher change in forced vital capacity (FVC) and peak expiratory flow in the MN group than the CN group, although this difference was not statistically significant (p = 0.258 and 0.256). However, statistically significant changes were observed in the forced expiratory volume in 1 second (FEV1) and forced expiratory flow at 25%-75% of FVC (FEF25-75; p = 0.001 and 0.043).</p><p><strong>Conclusion: </strong>MNs show superior improvement in vital signs and pulmonary function, particularly in RR, FEV1, and FEF25-75. MNs may be preferred for more effective treatment despite heart rate elevation.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107966"},"PeriodicalIF":3.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067353","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":"Bronchodilator responsiveness of oscillometry parameters in COPD patients.","authors":"Sajal De, Dibakar Sahu","doi":"10.1016/j.rmed.2025.107960","DOIUrl":"10.1016/j.rmed.2025.107960","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107960"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047265","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":"Prevalence, incidence, and clinical features of cardiac involvement in patients with pulmonary sarcoidosis.","authors":"Junichi Nakamura, Takahiro Sato, Hiroshi Ohira, Shuhei Yoshikawa, Takeshi Hattori, Osamu Manabe, Noriko Oyama-Manabe, Satonori Tsuneta, Hirokazu Kimura, Sakae Takenaka, Toshiyuki Nagai, Toshihisa Anzai, Masaharu Nishimura, Isao Yokota, Ichizo Tsujino, Satoshi Konnno","doi":"10.1016/j.rmed.2025.107954","DOIUrl":"10.1016/j.rmed.2025.107954","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology and characteristics of cardiac involvement in patients with pulmonary sarcoidosis remain unclear. We aimed to determine the prevalence, incidence, and clinical features of cardiac sarcoidosis in patients with pulmonary sarcoidosis.</p><p><strong>Methods: </strong>The characteristics of patients with biopsy-proven pulmonary sarcoidosis were retrospectively evaluated. Cardiac sarcoidosis was diagnosed via evaluations, including ¹⁸F-fluorodeoxyglucose positron emission tomography at the time of diagnosis of pulmonary sarcoidosis and during follow-up. Characteristics of patients with and without cardiac complications were compared.</p><p><strong>Results: </strong>In total, 438 patients with pulmonary sarcoidosis were included, of which 40 (9.1 %) were diagnosed with cardiac sarcoidosis at the time of diagnosis of pulmonary sarcoidosis. During the follow-up period, 14 patients (4 %) developed cardiac complications (0.0075/person-years). Electrocardiographic abnormalities were the most common findings leading to the diagnosis of cardiac sarcoidosis (85 %). Compared to patients without cardiac involvement, those with cardiac sarcoidosis had lower serum angiotensin converting enzyme concentration [19.9 (15.5-25.1) vs. 17.4 (12.6-23.8) U/L)], higher rates of kidney complications (3 vs. 13 %), fewer ocular complications (78 vs. 17 %), and lower lymphocyte levels [35.8 (18.6-53) vs. 25.1 (14.2-38.2)%] and CD4/CD8 ratios [4.8 (3.1-7.5)% vs. 3.9 (1.8-6)%] in bronchoalveolar lavage fluid analysis.</p><p><strong>Conclusion: </strong>At the time of diagnosis of pulmonary sarcoidosis, cardiac complications occurred in approximately 10 % of the patients and developed in 0.0075/person-year during follow-up. Low serum angiotensin converting enzyme concentration, lymphocyte level and CD4/CD8 ratio in the bronchoalveolar lavage fluid may be unique features of patients with cardiac sarcoidosis.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107954"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067440","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":"Global prevalence of fatigue in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis.","authors":"Wenting Shi, Tao Li, Yingjie Leng, Qinglu Li, Nan Wang, Guorong Wang","doi":"10.1016/j.rmed.2025.107969","DOIUrl":"10.1016/j.rmed.2025.107969","url":null,"abstract":"<p><strong>Background: </strong>Fatigue is a common symptom in patients with chronic obstructive pulmonary disease (COPD). Published studies of fatigue among patients with COPD have presented diverse findings that may reflect variations in research methods as well as actual population differences.</p><p><strong>Objective: </strong>To estimate the worldwide prevalence of fatigue in patients with COPD and its associated epidemiological characteristics.</p><p><strong>Methods: </strong>The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and China Biology Medicine disc (CBM) databases were searched for articles from their inception date through August 2024. The pooled prevalence of fatigue in patients with COPD and 95 % confidence interval (CI) were calculated using a random-effects model with Stata 15.0 software. Agency for Healthcare and Research and Quality (AHRQ) indicators and the Newcastle-Ottawa Scale (NOS) were used to evaluate the quality of the included studies.</p><p><strong>Results: </strong>The 25 included studies involved 6830 patients. The meta-analysis results showed a 59 % (95 % CI: 52%-66 %) pooled prevalence of fatigue in patients with COPD. Subgroup analysis indicated that the prevalence varied significantly by region, setting, assessment tool, and publication year.</p><p><strong>Conclusions: </strong>Fatigue is a common symptom among patients with COPD worldwide. To reduce the negative effects of fatigue in these patients, clinicians should actively explore the mechanisms of fatigue occurrence and its risk factors to provide a basis for further research.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107969"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067436","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":"Bleeding risk assessment with thromboelastography in interventional pulmonology procedures.","authors":"David Abia-Trujillo, Rodrigo Funes-Ferrada, Bryan F Vaca-Cartagena, Alejandra Yu Lee-Mateus, Alanna Barrios-Ruiz, Sofia Valdes-Camacho, Kelly S Robertson, Sebastian Fernandez-Bussy","doi":"10.1016/j.rmed.2025.107964","DOIUrl":"10.1016/j.rmed.2025.107964","url":null,"abstract":"<p><strong>Objective: </strong>Thromboelastography (TEG) offers a point-of-care and comprehensive evaluation of the coagulation cascade, but its utility in predicting bleeding risk in Interventional Pulmonology (IP) procedures has not been thoroughly investigated. This study aims to evaluate the effectiveness of TEG in assessing bleeding risk in patients undergoing elective IP procedures.</p><p><strong>Material and methods: </strong>Retrospective study of patients who underwent elective IP procedures at Mayo Clinic (Jacksonville, FL, USA) from November 2022 to May 2024. Patients had TEG performed within a day before the procedure and met standard coagulation criteria (INR<2, platelets>50,000/mm³). The primary outcome was the incidence of bleeding, defined by validated scales. The association between TEG results and bleeding was analyzed using Fisher's Exact test and binary logistic regression.</p><p><strong>Results: </strong>76 patients were included, 13 (17.1 %) experienced bleeding despite \"normal\" coagulation panel. Of these, 10 (14.93 %) had a non-hypocoagulant TEG (p = 0.082) suggesting no statistical association of TEG results and bleeding. TEG showed high specificity (94 %) but low sensitivity (23 %) for predicting bleeding risk. Hypocoagulant TEG provided a 5.1-fold increase in the odds of bleeding in our study (OR 5.1, 95%CI: 0.84-31.29, p = 0.066). Notably, TEG results identified 8.9 % (n = 6) of patients as hypocoagulable and 50 % experienced bleeding, highlighting the potential value of TEG in identifying patients at higher risk.</p><p><strong>Conclusion: </strong>TEG may offer additional value in pre-procedural bleeding risk assessment in IP procedures, particularly due to its high specificity. However, larger-scale studies are needed to confirm these findings and to better understand TEG's role in this context.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"107964"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067340","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}