Respiratory medicine最新文献

{"title":"Clinical impact of pre-determined guideline selection for the diagnosis of fibrotic hypersensitivity pneumonitis","authors":"Pedro Magalhães Ferreira ,&nbsp;Francisco Machado ,&nbsp;David Barros Coelho ,&nbsp;André Terras Alexandre ,&nbsp;Hélder Novais Bastos ,&nbsp;Patrícia Mota ,&nbsp;Natália Melo ,&nbsp;Susana Guimarães ,&nbsp;Conceição Souto-Moura ,&nbsp;André Carvalho ,&nbsp;António Morais","doi":"10.1016/j.rmed.2024.107925","DOIUrl":"10.1016/j.rmed.2024.107925","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>International guidelines for the diagnosis of Hypersensitivity Pneumonitis (HP) have improved the diagnostic standardization of this heterogeneous interstitial lung disease. Our goal was to determine how the final multidisciplinary discussion confidence level for suspected fibrotic HP (fHP) can be impacted by the application of different guidelines validated in this context.</div></div><div><h3>Materials and methods</h3><div>Retrospective study including patients submitted to transbronchial lung cryobiopsy (TBLC) with a final multidisciplinary meeting diagnosis of fHP. Both guidelines were applied to all patients in a stepwise fashion and directly compared according to the level of confidence in a fHP diagnosis.</div></div><div><h3>Results</h3><div>A total of 170 patients were diagnosed with fHP after TBLC and subsequent multidisciplinary discussion. Overall, there was a statistically significant change in proportion towards higher confidence diagnostic levels using the CHEST guideline (p &lt; 0.0001). Changes were significant at three different levels: ATS/JRS/ALAT's “fHP not excluded” subgroup significantly upscaled to CHEST's “provisional low-confidence” subgroup (76.2 % increase; p &lt; 0.001) and the proportion of patients in ATS/JRS/ALAT's “low confidence” subgroup significantly upscaled to both CHEST's “provisional high-confidence” (67.4 % increase; p &lt; 0.001) and “definitive fHP” (50 % increase; p &lt; 0.001) subgroups. The alternative application of the CHEST guideline in multidisciplinary discussion would have resulted in 73 less TBLC (42.9 % decrease versus the ATS/JRS/ALAT-oriented decision).</div></div><div><h3>Conclusions</h3><div>This study suggests a significant increase in definite fHP diagnosis when applying the CHEST versus the ATS/JRS/ALAT guideline, resulting in almost a 43 % decrease in referrals to TBLC when compared with the latter due to a combination of less strict radiological criteria and a more prominent role of BAL.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107925"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922781","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 minimally important difference in the six-minute walk test predicts clinical worsening in pulmonary arterial hypertension","authors":"Arsal Tharwani ,&nbsp;Omar Minai ,&nbsp;Youlan Rao ,&nbsp;Hyoshin Kim ,&nbsp;Gustavo A. Heresi","doi":"10.1016/j.rmed.2024.107919","DOIUrl":"10.1016/j.rmed.2024.107919","url":null,"abstract":"<div><h3>Background</h3><div>The minimally important difference (MID) in the 6-min walk test (6MWT) for pulmonary arterial hypertension (PAH) is estimated to be 33 m using distributional and anchor-based methods. Quality of life was used as the anchor. Here, we sought to determine whether the MID is predictive of clinical worsening.</div></div><div><h3>Methods</h3><div>This was a post hoc analysis of the pivotal clinical trial of tadalafil in PAH (n = 405) and its extension phase (n = 161). The 6MWT was determined at the end of the placebo-controlled phase of 16 weeks and dichotomized as &lt; 33 or ≥33 m. Primary outcome was clinical worsening ascertained at 16 weeks and at 68 weeks of follow up. Cox proportional hazard analysis was used to determine the association between 6MWT and clinical worsening.</div></div><div><h3>Results</h3><div>Mean age for patients in the pivotal trial of tadalafil was 54 years old ( ± 15.5 yrs). There were 317 (78.3 %) female patients and 61 % with idiopathic PAH. 53 % of the patients were on background bosentan therapy. A 6MWT &lt;33 m was associated with an increased risk of clinical worsening at 16 and 68 weeks. These results were unchanged after adjusting for age, sex, background therapy with bosentan, and tadalafil dose. There were no PAH hospitalizations during short-term and long-term follow up in patients achieving a 6MWT ≥33 m</div></div><div><h3>Conclusions</h3><div>The 6MWT MID of 33 m is predictive of short- and long-term clinical worsening. These results further validate 33 m as a relevant MID for the 6MWT.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107919"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882769","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":"Serum cholesterol levels predict the survival in patients with idiopathic pulmonary fibrosis: A long-term follow up study","authors":"Ranxun Chen,&nbsp;Guanning Zhong,&nbsp;Tong Ji,&nbsp;Qinghua Xu,&nbsp;Huarui Liu,&nbsp;Qingqing Xu,&nbsp;Lulu Chen,&nbsp;Jinghong Dai","doi":"10.1016/j.rmed.2024.107937","DOIUrl":"10.1016/j.rmed.2024.107937","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between serum lipid with idiopathic pulmonary fibrosis (IPF) required to be explored. We aim to evaluate the association of serum lipid levels with mortality in patients with IPF.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included IPF patients with more than three years follow-up. We collected baseline demographics information, forced vital capacity (FVC)% predicted, carbon monoxide diffusion capacity (DLCO)% predicted, gender-age-physiology (GAP) index, and serum lipid levels, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C). We evaluate the relationship between the serum lipid levels and the disease severity, and the mortality in IPF.</div></div><div><h3>Results</h3><div>This study enrolled 146 patients, with the three-year survival rate of 71.23 %. The median follow-up time was 46.5 months. There was no significant difference in baseline lipid levels between the survival and non-survival group. TG levels were positively correlated with DLCO% predicted (r = 0.189, p = 0.022) and negatively correlated with GAP index (r = −0.186, p = 0.025). After adjusting for GAP index, smoking history, body mass index and the use of antifibrotic and lipid-lowering drug, lower TC levels (HR: 0.74, 95 % CI: 0.58–0.94, p = 0.013) were identified as an independent risk factor for mortality.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that lower TC levels were associated with increased mortality in IPF. More investigations are required to explore the role of lipid metabolism in the pathogenesis of pulmonary fibrosis.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107937"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915541","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":"Clinically significant hemoptysis and all-cause mortality in patients with nontuberculous mycobacterial pulmonary disease","authors":"Kwonhyung Hyung ,&nbsp;Sung A Kim ,&nbsp;Nakwon Kwak ,&nbsp;Jae-Joon Yim ,&nbsp;Joong-Yub Kim","doi":"10.1016/j.rmed.2025.107946","DOIUrl":"10.1016/j.rmed.2025.107946","url":null,"abstract":"<div><h3>Background</h3><div>Hemoptysis is one of the major symptoms in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). However, its prevalence, incidence, and impact on long-term prognosis remain uncertain. We evaluated the incidence of clinically significant hemoptysis, and determined its association with mortality in patients with NTM-PD.</div></div><div><h3>Methods</h3><div>Patients enrolled in a prospective observational cohort (NCT01616745) between July 2011 and May 2023 were analyzed. We evaluated risk factors for clinically significant hemoptysis—defined as hemoptysis events requiring interventions such as bronchial artery embolization or surgical resection—and its association with all-cause mortality.</div></div><div><h3>Results</h3><div>Among 506 patients from the ongoing cohort, 43 patients (8.5 %) experienced clinically significant hemoptysis during a median follow-up of 5.1 years. The overall incidence of clinically significant hemoptysis was 2.1 (95 % confidence interval [CI]; 1.5–2.9) cases per 100 person-years. Identified risk factors included a history of tuberculosis (incidence rate ratio [IRR], 1.91; 95 % CI, 1.02–3.60), higher C-reactive protein (CRP) (IRR, 1.20 for 1 mg/dl increase; 95 % CI, 1.01–1.43), and lower % predicted forced vital capacity (FVC) (IRR, 0.81 for 10 % increase; 95 % CI, 0.66–0.98). Clinically significant hemoptysis was independently associated with an increased risk of all-cause mortality (adjusted hazard ratio, 2.39; 95 % CI, 1.31–4.36).</div></div><div><h3>Conclusion</h3><div>In patients with NTM-PD, those with history of tuberculosis, higher CRP levels, and lower % predicted FVC were at a higher risk of subsequent clinically significant hemoptysis. Importantly, clinically significant hemoptysis was associated with an elevated risk of all-cause mortality.</div></div><div><h3>Clinical trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: NCT01616745.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107946"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966303","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 of interstitial lung abnormalities with cytotoxic agent-induced pneumonitis in patients with malignancy","authors":"Kyohei Oishi ,&nbsp;Hironao Hozumi ,&nbsp;Nobuko Yoshizawa ,&nbsp;Shintaro Ichikawa ,&nbsp;Yusuke Inoue ,&nbsp;Hideki Yasui ,&nbsp;Yuzo Suzuki ,&nbsp;Masato Karayama ,&nbsp;Kazuki Furuhashi ,&nbsp;Noriyuki Enomoto ,&nbsp;Tomoyuki Fujisawa ,&nbsp;Satoshi Goshima ,&nbsp;Naoki Inui ,&nbsp;Takafumi Suda","doi":"10.1016/j.rmed.2024.107924","DOIUrl":"10.1016/j.rmed.2024.107924","url":null,"abstract":"<div><h3>Background and objective</h3><div>The association between interstitial lung abnormalities (ILA) and various conditions and diseases, including drug-related pneumonitis (DRP), has been reported. However, the association of the presence of ILA with developing DRP in patients undergoing cytotoxic agent-based chemotherapy, one of the standard treatments for malignancies, remains unclear. This warrants urgent investigation.</div></div><div><h3>Methods</h3><div>We included consecutive patients diagnosed with malignancy and treated with cytotoxic agents with/without immune checkpoint inhibitors (ICIs). We used Gray's method and multivariate Fine-Gray sub-distribution hazards analysis to evaluate the cumulative incidence of DRP (common terminology criteria for adverse events grade of ≥3) and the association between ILA and DRP development, respectively.</div></div><div><h3>Results</h3><div>Among 786 patients, 58 (7.3 %) demonstrated ILA. Patients with ILA were older, predominantly male, and reported a higher smoking history compared to those without ILA. The 90-day cumulative incidence of cytotoxic agent-induced DRP with/without ICIs was significantly higher in patients with ILA than in those without ILA (6.0 % vs. 1.2 %, <em>p</em> = 0.006). Multivariate analysis, adjusted for age, sex, and smoking history, revealed that ILA was associated with an increased risk of developing DRP due to cytotoxic agents with/without ICIs (hazard ratio [HR] 3.11, 95 % confidence interval [CI]: 1.06–9.14, <em>p</em> = 0.039) and cytotoxic agents alone (HR: 5.53, 95 % CI: 1.55–19.7, <em>p</em> = 0.008).</div></div><div><h3>Conclusions</h3><div>The presence of ILA is associated with an increased risk of developing DRP in patients undergoing cytotoxic agent-based chemotherapy. Therefore, evaluating the presence of ILA before determining chemotherapy regimens that include cytotoxic agents is recommended.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107924"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903233","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":"Characteristics of pulmonary rehabilitation programs and their effects on exercise capacity and health related quality of life (HRQoL) in patients with interstitial lung disease: A systematic review and meta-analysis","authors":"Jaime Jiménez Salazar ,&nbsp;Fatim Tahirah Mirza ,&nbsp;Md Nazim Uzzaman ,&nbsp;Ranita Hisham Shunmugam ,&nbsp;Nik Zawani Shazana ,&nbsp;Hilary Pinnock ,&nbsp;Nikhil Hirani ,&nbsp;Roberto A. Rabinovich","doi":"10.1016/j.rmed.2024.107936","DOIUrl":"10.1016/j.rmed.2024.107936","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial Lung Disease (ILD) is characterized by dyspnoea, reduced exercise capacity and poor health related quality of life (HRQoL). The evidence to support the benefits of pulmonary rehabilitation (PR) on exercise capacity (EC) and HRQoL in this population is still limited. We aimed to determine the effect of the different PR components on exercise capacity and HRQoL in patients with ILD.</div></div><div><h3>Methods</h3><div>We searched five databases (January 1990 to August 2024) using Population: ILD patients; Intervention: PR; Comparison: no PR; Outcomes: exercise capacity (e.g., 6-min walk test [6MWT] and HRQoL (e.g., St George's respiratory questionnaire [SGRQ]); Study type: randomised controlled trials (RCT). We used Cochrane risk-of-bias tool and GRADE to rate the quality of the evidence.</div></div><div><h3>Findings</h3><div>We identified 11 RCTs (476 ILD patients; 8 countries). 10 studies provided data for exercise capacity (6MWD) and 7 studies for HRQoL (SGRQ). Both 6MWD and SGRQ improved ≥ their respective mínimum clinically-important difference of 45m and 7 units respectively, in studies where PR programme was i) &gt;8 weeks (n = 5) [6MWD: MD 58m, 95 % CI 37 to 79, p &lt; 0.00001; SGRQ: MD -9.7, 95 % CI -12.6 to −6.7, p &lt; 0.00001], ii) fully supervised [6MWD (n = 5): MD 53.6m, 95 % CI 39 to 68, p &lt; 0.00001; SGRQ (n = 2): MD -9.38, 95 % CI -12.93 to −5.84, p &lt; 0.00001] and iii) incorporated high-intensity interval training (HIIT) (n = 2) [6MWD: MD 77m, 95 % CI 45 to 109, p &lt; 0.00001; SGRQ: MD -10.3, 95 % CI -13.7 to −6.9, p &lt; 0.00001]</div></div><div><h3>Interpretation</h3><div>PR programs of &gt;8 weeks, fully supervised and incorporated HIIT had a better clinical impact on EC and HRQoL.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107936"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932209","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":"Mechanical power density, spontaneous breathing indexes, and weaning readiness following prolonged mechanical ventilation","authors":"Alessandro Ghiani ,&nbsp;Swenja Walcher ,&nbsp;Azal Lutfi ,&nbsp;Lukas Gernhold ,&nbsp;Sven Fabian Feige ,&nbsp;Claus Neurohr","doi":"10.1016/j.rmed.2025.107943","DOIUrl":"10.1016/j.rmed.2025.107943","url":null,"abstract":"<div><h3>Introduction</h3><div>Evidence suggests that mechanical power (MP) normalized to dynamic compliance, which equals power density, may help identify prolonged ventilated patients at risk for spontaneous breathing trial (SBT) failure. This study compared MP density with traditional spontaneous breathing indexes to predict a patient's capacity to sustain a short trial of unassisted breathing.</div></div><div><h3>Methods</h3><div>A prospective observational study on 186 prolonged ventilated, tracheotomized patients. We analyzed the first 30-min SBT upon weaning center admission, comparing MP density with spontaneous breathing indexes (e.g., predicted body weight normalized tidal volume (VT/PBW), rapid shallow breathing index (RSBI), and the integrative weaning index (IWI)) regarding SBT failure prediction, with diagnostic accuracy expressed as the area under the receiver operating characteristic curve (AUROC).</div></div><div><h3>Results</h3><div>SBT failure occurred in 51 out of 186 patients (27 %), who demonstrated significantly lower dynamic compliance (median 29 mL/cmH₂O [IQR 26–37] vs. 39 mL/cmH₂O [33–45]) and higher MP density (5837 cmH₂O²/min [4512–7758] vs. 2922 cmH₂O²/min [2001–4094]) before SBT, as well as lower spontaneous VT/PBW (5.7 mL∗kg⁻¹ [5.0–6.7] vs. 6.6 mL∗kg⁻¹ [5.9–7.8]), higher RSBI (73 min⁻¹∗L⁻¹ [57–100] vs. 59 min⁻¹∗L⁻¹ [45–76]), and lower IWI (40 L²/cmH₂O∗%∗min∗10⁻³ [27–50] vs. 63 L²/cmH₂O∗%∗min∗10⁻³ [46–91]) after 5 min of unassisted breathing. MP density was more accurate at predicting SBT failures (AUROC 0.86 [95%CI 0.80–0.91]) than VT/PBW (0.58 [0.50–0.65]), RSBI (0.54 [0.47–0.61]), or IWI (0.66 [0.58–0.73])).</div></div><div><h3>Conclusions</h3><div>MP density as a readiness criterion was more accurate at predicting weaning trial failures in prolonged ventilated, tracheotomized patients than traditional indexes assessed during unassisted breathing.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107943"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954110","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 impact of blood eosinophil count and FeNO on benralizumab effectiveness in clinical practice: An ORBE II subanalysis","authors":"Ismael García-Moguel ,&nbsp;Álvaro Martínez-Mesa ,&nbsp;Rubén Andújar-Espinosa ,&nbsp;Rocío Díaz-Campos ,&nbsp;José Luis Velasco-Garrido ,&nbsp;Jose Luis Sanchez-Trincado ,&nbsp;Elisa Luzon ,&nbsp;Javier Nuevo ,&nbsp;Carlos Alconada ,&nbsp;Miguel Ángel Gutiérrez ,&nbsp;Gabriel Niza ,&nbsp;Alicia Padilla-Galo ,&nbsp;ORBE II study group","doi":"10.1016/j.rmed.2025.107940","DOIUrl":"10.1016/j.rmed.2025.107940","url":null,"abstract":"<div><h3>Background</h3><div>The ORBE II study showed the real-world effectiveness of benralizumab in severe eosinophilic asthma (SEA). This subgroup analysis aimed to characterize patients and outcomes based on baseline blood eosinophil count (BEC) and/or fractional exhaled nitric oxide (FeNO) levels.</div></div><div><h3>Methods</h3><div>In this analysis of the ORBE II retrospective study, SEA patients receiving benralizumab were categorized into subgroups based on individual or combined BEC/FeNO levels, according to the following thresholds: high BEC (hiBEC): ≥300 cells/μL; low BEC (loBEC): &lt;300 cells/μL; high FeNO (hiFeNO): ≥50 ppb; low FeNO (loFeNO): &lt;50 ppb. Baseline and up to 1 year of follow-up data are described.</div></div><div><h3>Results</h3><div>Most patients with available data were classified as hiBEC (72.6 %) and 38.3 % as hiFeNO. The distribution according to combined baseline BEC and FeNO levels revealed a heterogeneous patient population. Although common SEA features were shared among subgroups, some distinct characteristics were observed, including elevated allergic asthma prevalence in hiBEC/loFeNO patients, high obesity prevalence and fewer non-smokers in loBEC/loFeNO patients, remarkable severe exacerbation rates in loBEC/hiFeNO patients [5.5 SD (6.0)], and more severe symptoms in the hiBEC/loBEC subgroup. All subgroups showed benefits following benralizumab treatment, with super-responder rates ranging from 68.2 % to 83.3 % and clinical remission rates reaching 70.0 %. Particularly good responses were noted in hiBEC/hiFeNO patients.</div></div><div><h3>Conclusions</h3><div>This study shows the variability of T2 biomarkers in ORBE II SEA patients, emphasizing the prevalence of high BEC values. While benralizumab benefits were important regardless of BEC, high BEC predicted good outcomes and FeNO had less influence on treatment effectiveness.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107940"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010780","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":"Health-related quality of life and symptom concordance between patients and physicians in pulmonary arterial hypertension in the United States, Europe, and Japan","authors":"R. James White ,&nbsp;Dario Vizza ,&nbsp;Rogier Klok ,&nbsp;Julia Harley ,&nbsp;Mark Small ,&nbsp;Dominik Lautsch","doi":"10.1016/j.rmed.2024.107869","DOIUrl":"10.1016/j.rmed.2024.107869","url":null,"abstract":"<div><div>This study involved analyses of a real world, cross-sectional survey of physicians and their patients with pulmonary arterial hypertension (PAH). Physician and patient symptom concordance was assessed, and patients self-reported Health-Related Quality of Life (HRQoL). Data were drawn from the Adelphi PAH Disease Specific Programme (DSP)™ in the United States, France, Germany, Italy, Spain, United Kingdom, and Japan, between March and August 2022. EQ-5D 5L utility, EQ-5D Visual Analogue Scale (VAS) scores, and emPHasis-10 (e10) HRQoL scores were reported by patients. Physician-patient symptom concordance was analyzed with Cohen's Weighted Kappa (κ) analysis. Of 628 PAH patients, the mean (SD) EQ-5D VAS and e10 scores were 66 (17) and 23 (11). Data was stratified by World Health Organization Functional Class (WHO-FC). As WHO-FC increased, EQ-5D utility and VAS scores decreased and e10 scores increased, indicating poorer patient-reported HRQoL. Symptom concordance varied, ranging from κ = 0.11–0.57 (slight-moderate agreement), and physicians frequently underestimated the presence and severity of patient-reported symptoms. Future research should aim to bridge this gap between patient and physician understanding of HRQoL and the symptom burden associated with PAH.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107869"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682478","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":"The psychological disorder and personality traits of individuals with pulmonary nodules","authors":"Xianping Guo ,&nbsp;Xiaoli Zhu","doi":"10.1016/j.rmed.2024.107938","DOIUrl":"10.1016/j.rmed.2024.107938","url":null,"abstract":"<div><h3>Introduction</h3><div>With the widespread use of Low-dose computed tomography (LDCT) in the chest, more and more people will be detected with pulmonary nodules. The presence of uncertainty following the detection of these nodules can impose significant psychological distress. This study aimed to investigate personality traits, psychological distress, and their impact on pulmonary nodule patients in China.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional survey of adults with pulmonary nodules accidently discovered by LDCT in the chest from the respiratory outpatient department.</div></div><div><h3>Results</h3><div>A total of 224 patients with pulmonary nodules were included in this study.</div><div>The prevalence of anxiety among patients with pulmonary nodules was found to be 47.8 %, while the prevalence of depression was reported to be 44.2 %. The present study also demonstrated a higher prevalence of anxiety among female patients with pulmonary nodules compared to their male counterparts, with mild anxiety being the predominant manifestation. The multivariate logistic regression analysis revealed that age (OR = 0.926, P &lt; 0.01), gender (OR = 3.24, P &lt; 0.01), number of pulmonary nodules (OR = 0.586, P &lt; 0.05), lung cancer-related characteristics (OR = 5.423, P &lt; 0.01), PTSD (OR = 5.715, P &lt; 0.01), and Extroversion personality traits (OR = 1.087, P &lt; 0.05) were significant factors contributing to anxiety in patients with pulmonary nodules. Similarly, (OR = 0.891, P &lt; 0.01), gender (OR = 2.981, P &lt; 0.05), duration (OR = 0.663, P &lt; 0.05), lung cancer-related characteristics (OR = 5.707, P &lt; 0.01), PTSD (OR = 4.420, P &lt; 0.01)emerged as key factors associated with depression in this patient population.</div></div><div><h3>Conclusion</h3><div>Approximately 50 % of patients with pulmonary nodules exhibit negative affective states. Furthermore, as time progresses, the negative emotional burden of anxiety and depression in individuals with pulmonary nodules tends to alleviate.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107938"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922785","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}