Respiratory medicine最新文献

{"title":"Effect of chronic kidney disease on survival in patients with chronic obstructive pulmonary disease","authors":"Chen-Chuan Hsu ,&nbsp;Pi-Hung Tung ,&nbsp;Ting-Yu Lin ,&nbsp;Shih-Wei Huang ,&nbsp;Tsu-Chuan Li ,&nbsp;Bing-Chen Wu ,&nbsp;Chiung-Hsin Chang ,&nbsp;Hao-Ming Wu ,&nbsp;Chun-Yu Lo ,&nbsp;Chun-Yu Lin ,&nbsp;Horng-Chyuan Lin ,&nbsp;Shu-Min Lin","doi":"10.1016/j.rmed.2025.108181","DOIUrl":"10.1016/j.rmed.2025.108181","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is a common respiratory disease associated with several comorbidities. Although chronic kidney disease (CKD) has been recognized as one such comorbidity, the effect of CKD on survival in patients with COPD remains uncertain. This study investigated the clinical impact of CKD in patients with COPD, accounting for clinically characteristics and 6-min walking test (6MWT) results.</div></div><div><h3>Materials and methods</h3><div>Patients with COPD who completed the 6MWT and a 3-year follow-up were retroactively enrolled in the study. Data on clinical information, 6MWT parameters, and outcomes were collected and analyzed.</div></div><div><h3>Results</h3><div>Among the 141 patients with COPD enrolled, 33 (23.4 %) had comorbid CKD. Patients with CKD were significantly older and more likely to experience heart failure, mortality, and FEV1 decline than patients without CKD. Multivariate analysis revealed that 6-min walking distance &lt;350 m (odds ratio [OR]: 3.65, 95 % confidence interval [CI]: 1.05–12.06, <em>p</em> = 0.041) and CKD (OR: 4.66, 95 % CI: 1.30–16.76, <em>p</em> = 0.018) were independent risk factors for mortality.</div></div><div><h3>Conclusions</h3><div>Comorbid CKD was associated with an increased mortality rate and rapid FEV1 decline in patients with COPD. Patients with COPD and comorbid CKD may require intensive monitoring during treatment.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108181"},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168190","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":"Bronchiectasis: A clinical review of inflammation","authors":"George Doumat ,&nbsp;Timothy R. Aksamit ,&nbsp;Amjad N. Kanj","doi":"10.1016/j.rmed.2025.108179","DOIUrl":"10.1016/j.rmed.2025.108179","url":null,"abstract":"<div><div>Bronchiectasis is a chronic inflammatory airway disease characterized by a self-perpetuating vortex of impaired mucociliary clearance, persistent infection, and progressive structural lung damage. While inflammation is central to disease activity and progression, targeted anti-inflammatory treatments have been limited. Understanding the different types of inflammation involved and their significant overlap is essential for effective management. This review explores key inflammation patterns, biomarkers, and available treatments across the spectrum of inflammation in bronchiectasis, with a particular focus on non-cystic fibrosis bronchiectasis in adults. Neutrophilic inflammation remains the hallmark of bronchiectasis, with promising reversible dipeptidyl peptidase-1 inhibitors reducing the activation of neutrophil serine proteases during neutrophil maturation. Eosinophilic inflammation has also gained attention, with evidence indicating that patients with this endotype may benefit from glucocorticoids and biologic therapies targeting type 2 inflammation. Additional inflammatory mechanisms discussed here include impaired epithelial function and mucociliary abnormalities, immune dysregulation, and airway inflammation triggered by infections, environmental irritants, and autoimmune conditions. Written for general clinicians, this review simplifies complex concepts, underscores key aspects of diagnostic evaluation, and discusses both conventional and emerging treatments for bronchiectasis, providing practical insights for improved personalized patient care.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108179"},"PeriodicalIF":3.5,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147104","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":"Chronic obstructive pulmonary disease is associated with a higher incidence of acute kidney injury in non-cardiac but not in cardiac surgery ICU-patients: a retrospective MIMIC-III database analysis","authors":"Nadine Hochhausen ,&nbsp;Ajay Moza ,&nbsp;Andreas Kroh ,&nbsp;Rolf Rossaint ,&nbsp;Felix Kork","doi":"10.1016/j.rmed.2025.108160","DOIUrl":"10.1016/j.rmed.2025.108160","url":null,"abstract":"<div><h3>Purpose</h3><div>Acute kidney injury (AKI) and chronic obstructive pulmonary disease (COPD) are both associated with high mortality. We hypothesized that COPD impacts the incidence of AKI and the outcome of surgical intensive care unit (ICU)-patients.</div></div><div><h3>Materials and methods</h3><div>We analyzed data of surgical ICU-patients from the Medical-Information-Mart-for-Intensive-Care-III-database. We compared the incidence of AKI, in-hospital-mortality, ICU-and hospital-length-of-stay (ICU-LOS, HLOS) in patients with and without COPD. In a subgroup analysis, we compared the outcomes of patients undergoing cardiac (CS) and non-cardiac surgery (NCS).</div></div><div><h3>Results</h3><div>The data of 21,720 cases were analyzed, 9.7 % suffered from COPD. COPD-patients were younger compared to patients without COPD (64years(52–75)vs.71years(63–78),p &lt; 0.001). Males were more frequently represented in both groups (58.3 %vs.61.2 %,p = 0.009). COPD-patients had a higher incidence of AKI (24.2 %vs.19.7 %,p &lt; 0.001), higher in-hospital-mortality (8.7 % vs.6.4 %,p &lt; 0.001), longer ICU-LOS (3.1days(IQR,1.6–7.0)vs.2.3days(IQR,1.3–5.0),p &lt; 0.001), and HLOS (10days(IQR,6–17)vs.8days(IQR,5–15),p &lt; 0.001). Multivariable analyses could not confirm a higher risk for AKI in surgical COPD-patients but for all other outcomes (in-hospital mortality,OR:1.59,95 %CI:1.24–2.04,p &lt; 0.001; ICU-LOS,beta:1.1, 95 %CI:0.6–2.3,p &lt; 0.001; HLOS,beta:1.7,95 %CI:0.9–2.4,p &lt; 0.001).</div><div>Subgroup analyses revealed that COPD was associated with a higher risk of AKI (OR,1.24,95 %CI:1.01–1.51,p = 0.038), longer ICU-LOS (beta:0.9,95 %CI:0.3–1.5,p = 0.006) and HLOS (beta:1.4,95 %CI:0.2–2.5,p = 0.018) but not with a higher risk for in-hospital mortality in NCS-patients. In CS-patients on the other hand, COPD was associated with a higher risk for in-hospital mortality (OR,1.73,95 %CI:1.02–2.94,p = 0.043) but neither for AKI, longer ICU-LOS or HLOS.</div></div><div><h3>Conclusions</h3><div>COPD has a different impact on outcomes in CS- and NCS-patients. While COPD was associated with a higher risk for in-hospital mortality in CS-patients, COPD was associated with a higher risk of AKI, longer ICU-LOS and HLOS in NCS-patients.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108160"},"PeriodicalIF":3.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151548","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":"Individual factors affecting oxygen saturation under acute hypoxia exposure in air personnel","authors":"Idan Nakdimon ,&nbsp;Daniela Algranati ,&nbsp;Asaf Glass ,&nbsp;Anna Levkovsky ,&nbsp;Uri Eliyahu ,&nbsp;Oded Ben-Ari ,&nbsp;Barak Gordon","doi":"10.1016/j.rmed.2025.108175","DOIUrl":"10.1016/j.rmed.2025.108175","url":null,"abstract":"<div><div>During flight, cabin pressure failure or oxygen system malfunction may lead to an oxygen-deprived environment, which could lead to a physiological state of hypoxia. Personal tolerance will determine cognitive performance level under these conditions. The aim of this study was to examine the influence of different parameters on hypoxia tolerance. As cognitive function was previously found to be associated with oxygen saturation levels (SatO₂), hypoxia tolerance was assessed using this method. A linear mixed models analysis revealed a significant correlation between decreased SatO₂ and BMI, hemoglobin levels, smoking, FEV1/FVC ratio, and age. In a further analysis, higher SatO₂ levels were significantly and independently associated in smokers (p = 0.012) and trainees with BMI above 27.7 kg/m² (p = 0.025 to 0.032). Moreover, non-smoking trainees with hemoglobin value above 15.9 g/dL (p = 0.016), and non-smoking trainees with FEV1/FVC ratio below 0.78 (p = 0.040 to 0.049) were correlated with significantly higher SatO₂. In this analysis, age, sex, and physical activity were not found to be correlated with SatO₂. Higher SatO₂ levels are correlated with higher hypoxia tolerance, hence the aforementioned parameters increase hypoxia tolerance. It is recommended to take these parameters into consideration during dedicated hypoxia trainings.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108175"},"PeriodicalIF":3.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139383","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":"Change in the 6-min walk test among 71 patients with cystic fibrosis treated with elexacaftor/tezacaftor/ivacaftor","authors":"Julien Perrone ,&nbsp;Muriel Rabilloud ,&nbsp;Laurent Mely","doi":"10.1016/j.rmed.2025.108178","DOIUrl":"10.1016/j.rmed.2025.108178","url":null,"abstract":"<div><h3>Background</h3><div>Elexacaftor/tezacaftor/ivacaftor (ETI) has led to substantial improvements in the clinical outcome of people with cystic fibrosis (pwCF). However, its effects on exercise capacity remain uncertain.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 71 pwCF who started ETI between March 2020 and September 2022. The best performance on the 6-min walk test (6MWT), defined as the peak walking distance achieved, was compared between the 12 months preceding ETI initiation and the first 14 months of treatment. Pulmonary function tests (PFT) and Cystic Fibrosis Questionnaire-Revised (CFQ-R) were analyzed at treatment initiation and after 12 months.</div></div><div><h3>Results</h3><div>After starting ETI, the 6MWT was performed at a median interval of 356 [296–380] days. The mean 6-min walk distance (6MWD) was 641 m ± 85.5 at baseline. After treatment, the 6MWD showed a significant absolute increase of 15.8 m (<em>P</em> = 0.007). Improvement was greater in pwCF with a percent predicted FEV1 (ppFEV1) ≤40, showing a mean increase of 37.8 m (<em>P</em> = 0.009), and in those without prior CFTR modulator therapy with an increase of 21.6 m (<em>P</em> = 0.016). After 12 months, the absolute increase in ppFEV1 was 15.8 (<em>P</em> &lt; 0.001). The absolute changes from baseline in CFQ-R physical and respiratory scores were 17.9 (<em>P</em> &lt; 0.001) and 27 points (<em>P</em> &lt; 0.001), respectively. No correlation was found between changes in 6MWT and changes in PFT results.</div></div><div><h3>Conclusions</h3><div>ETI improved exercise capacity in pwCF, as evidenced by a significant increase in the 6MWD. ETI was also associated with improvements in physical-related quality of life. Changes in PFT results cannot predict changes in 6MWT results after ETI therapy.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108178"},"PeriodicalIF":3.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139333","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":"Relationship between sweat chloride and pulmonary function in healthy young adults – a single-center, pilot study","authors":"Sankaran S. Krishnan ,&nbsp;Alison T. Lennox ,&nbsp;John Welter ,&nbsp;Allen J. Dozor","doi":"10.1016/j.rmed.2025.108177","DOIUrl":"10.1016/j.rmed.2025.108177","url":null,"abstract":"<div><h3>Background</h3><div>The role of Cystic Fibrosis Transmembrane Conductance regulator (CFTR) dysfunction in non-cystic fibrosis lung diseases, including COPD, is not well understood. The objective of this study was to assess the prevalence of intermediate sweat chloride levels, 30–59 mmol/L, in healthy young adults and the relationship between sweat chloride and pulmonary function.</div></div><div><h3>Methods</h3><div>Healthy volunteers &gt;18 years of age were enrolled in this single center, prospective, cross-sectional pilot study. Sweat chloride testing was performed by pilocarpine iontophoresis. Study participants completed the ATS-DLD LHS-III modified general respiratory symptom questionnaire, spirometry pre- and post-inhaled bronchodilator, and Lung Clearance Index.</div></div><div><h3>Results</h3><div>93 subjects were enrolled. 1 subject withdrew and 2 had insufficient sweat volumes collected. Median (IQR) age was 27 years (25, 33) and 40 % were male. Median (IQR) sweat chloride was 21 mmol/L (12, 29). 25/90 subjects (28 %) had intermediate sweat chloride values, median 37 (33, 40) mmol/L. 60 % of individuals with intermediate sweat chloride values were male as compared to 34 % of individuals with normal sweat chloride values, p &lt; 0.001. Median FEV₁ (% predicted) was 100 (90, 109), FEV₁/FVC 0.83 (0.81, 0.86), and LCI was 6.01 (5.38, 6.98). There were no differences in pulmonary function between those with normal and intermediate sweat chloride values.</div></div><div><h3>Conclusions</h3><div>A significant number of healthy young adults have intermediate sweat chloride levels, but no differences in spirometry and LCI were found. Larger studies, including genetic analyses, are needed to determine if mild CFTR dysfunction impacts respiratory health, especially in older individuals with respiratory co-morbidities.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"245 ","pages":"Article 108177"},"PeriodicalIF":3.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143371","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":"Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review","authors":"Patrícia Araújo ,&nbsp;Rita Calé ,&nbsp;Ernesto Pereira ,&nbsp;Filipa Ferreira ,&nbsp;Sofia Alegria ,&nbsp;Hélder Pereira ,&nbsp;André Coelho","doi":"10.1016/j.rmed.2025.108154","DOIUrl":"10.1016/j.rmed.2025.108154","url":null,"abstract":"<div><h3>Background</h3><div>No systematic review has been published comparing the effectiveness and safety of balloon pulmonary angioplasty (BPA) and riociguat in patients with chronic thromboembolic pulmonary hypertension (CTEPH) across studies that evaluate both treatment methods.</div></div><div><h3>Methods</h3><div>A literature search was conducted using PubMed, ScienceDirect, and Elsevier. Clinical, functional, and hemodynamic effectiveness criteria were analysed, as well as complications related to both interventions.</div></div><div><h3>Results</h3><div>Five studies were reviewed, including randomized clinical trials and observational studies, comprising a total of 184 patients who underwent riociguat and BPA, 94 patients who underwent BPA alone, and 79 who underwent riociguat alone. Patients receiving combination therapy demonstrated a more significant improvement in WHO-FC, PVR, and CO (≈1.13 L/min) compared to monotherapy (BPA: ≈0.45 L/min and riociguat: ≈0.84 L/min). Regarding the 6MWD, patients who started with Riociguat before combination therapy showed a greater improvement (≈78 m) than those on monotherapy (BPA: ≈46.9 m and riociguat: ≈38.2 m). The reduction in mPAP was greater in patients treated with BPA alone (≈-17.6 mmHg) compared to riociguat alone (≈-5.4 mmHg) or combination therapy (≈-12.2 mmHg). In the BPA group, the rate of life-threatening complications was very low, with haemoptysis or pulmonary haemorrhage being the most common adverse events (15 %–44 %). In the riociguat group, dizziness, headaches, gastrointestinal reflux, vomiting, and nausea were reported (15 %–23 %). Among patients undergoing both treatments, the vascular injury rate was &lt;11 %, with the most common adverse event being the need for non-invasive ventilation (30 %).</div></div><div><h3>Conclusions</h3><div>Combination therapy appears to be more effective than monotherapy, without being associated to major adverse events in patients diagnosed with CTEPH.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108154"},"PeriodicalIF":3.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143368","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":"Impact of Post-COVID syndrome on quality of life and mental health among COVID-19 survivors: A study from a tertiary care center in Lebanon","authors":"Hisham Bou Fakhreddine ,&nbsp;Salah Zeineldine ,&nbsp;Hassan Itani ,&nbsp;Jawad Abdul Sater ,&nbsp;Pierre BouKhalil ,&nbsp;Bassem Al Harfani ,&nbsp;Imad Bouakl","doi":"10.1016/j.rmed.2025.108173","DOIUrl":"10.1016/j.rmed.2025.108173","url":null,"abstract":"<div><h3>Background and aim</h3><div>Post-COVID Syndrome (PCS) significantly impacts morbidity, impairing quality of life (QoL) and mental health. This study assesses PCS symptom prevalence, the impact of COVID-19 severity on QoL and mental health and identifies predictors of impaired QoL among COVID-19 survivors in Lebanon.</div></div><div><h3>Method</h3><div>ology: The study included adult COVID-19 survivors who recovered at least 4 weeks before enrollment. Participants completed symptom questionnaires, 36-Item Short Form Health Survey (SF-36), and Hospital Anxiety Depression Scale (HADS) at enrollment and during follow-up visits. PCS symptoms prevalence, SF-36 and HADS scores were compared across infection severity groups. Multivariate linear regressions identified predictors of lower SF-36 scores.</div></div><div><h3>Results</h3><div>The study included 417 patients, with 50.1 % being male and an average age of 48 years. Most patients (78 %) had mild COVID-19 and presented within 3 months of recovery (83 %). The most commonly reported symptoms were fatigue (54.3 %), dyspnea (47.5 %), cough (38.8 %), and palpitations (38.4 %). Dyspnea was more prevalent in severe cases (71.4 %) than in mild and moderate ones. Severe COVID-19 patients had significantly lower scores in physical function, role limitations due to physical health, and body pain compared to the mild group. Mild cases had higher abnormal HADS anxiety scores than moderate and severe cases, with no differences in HADS depression scores. The main independent predictors of impaired physical functioning and role limitations were severe COVID-19, fatigue, and dyspnea.</div></div><div><h3>Conclusion</h3><div>PCS severely impacts QoL and mental health, with impairment directly linked to the severity of acute infection and the persistence of symptoms.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108173"},"PeriodicalIF":3.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124790","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":"Spirometric pattern transitions in a World Trade Center occupational cohort on longitudinal surveillance","authors":"Jonathan Weber ,&nbsp;Zitong Zhang ,&nbsp;John T. Doucette ,&nbsp;Akshay Sood ,&nbsp;Juan C. Celedón ,&nbsp;Rafael E. de la Hoz","doi":"10.1016/j.rmed.2025.108170","DOIUrl":"10.1016/j.rmed.2025.108170","url":null,"abstract":"<div><h3>Background</h3><div>Many workers and volunteers who participated in the rescue and recovery of the World Trade Center (WTC) disaster site in 2001–2002 manifest a heterogeneous group of chronic lower airway diseases, with variable spirometric patterns on longitudinal surveillance. We examined systematically the observed transitions among those spirometric patterns and assessed their association with BMI and occupational WTC exposure intensity.</div></div><div><h3>Methods</h3><div>We selected 10,810 Mount Sinai WTC General Responders’ Cohort members with at least three acceptable quality periodic spirometries (n = 56,312) performed between July 2002 and November 2019. We defined three spirometric patterns: (1) normal: prebronchodilator first-second forced expiratory volume (FEV₁), forced vital capacity (FVC), and FEV₁/FVC ratio &gt; lower limit of normal (LLN); (2) obstruction: pre-bronchodilator FEV₁/FVC ratio&lt;LLN; (3) low FVC: FVC &lt; LLN and FEV₁/FVC &gt; LLN. We built a multi-state Markov-like model to analyze probabilities of transition between those three spirometric patterns.</div></div><div><h3>Results</h3><div>Low FVC is the most frequent abnormal spirometric pattern in the WTC workers. Substantial stationary probabilities of stability (0.88) were observed for normal, and less so for low FVC (0.73) and obstructive (0.65) pattern. At least 80 % of the observed transitions involved the normal and low FVC patterns, and both higher WTC exposure intensity (early arrival at the site), and body mass index (BMI) were predictors of transitions to low FVC in this cohort.</div></div><div><h3>Conclusion</h3><div>Low FVC is relatively stable, and both WTC exposure intensity and BMI are independently and significantly associated with transitions to it. Transitions to obstruction are generally infrequent among the WTC workers and have greater instability.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"244 ","pages":"Article 108170"},"PeriodicalIF":3.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124789","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":"Impact of availability of a highly effective Cystic Fibrosis treatment (elexacaftor/tezacaftor/ivacaftor) on lung transplant waitlist and lung transplantation trends in the US.","authors":"Christian Merlo, Jessica Morlando Geiger, Zailong Wang, Grace R Lyden, David P Schladt, Lisa McGarry","doi":"10.1016/j.rmed.2025.108171","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108171","url":null,"abstract":"<p><p>Cystic fibrosis (CF) is a genetic disease that often leads to progressive lung disease and lung transplantation. CF transmembrane conductance regulator modulators (CFTRm) improve lung function in people with CF. The US Scientific Registry of Transplant Recipients (SRTR) data were used to assess rates of lung transplant waitlisting, waitlist removal, pre-transplant mortality, and lung transplantation in people with CF (CF cohort) compared to those with other respiratory conditions (non-CF cohort) across three time periods: (i) prior to approval of any CFTRm (Pre-CFTRm era); (ii) from approval of ivacaftor to pre-approval of elexacaftor/tezacaftor/ivacaftor (Pre-ETI CFTRm era); and (iii) after approval of ETI (ETI era). Among the CF cohort, new waitlistings decreased by 78% in ETI era compared to Pre-ETI CFTRm era while rates increased in the non-CF cohort. Among the CF cohort, waitlist removal for improving condition increased 18-fold in ETI era compared to Pre-ETI CFTRm era; rates remained stable among the non-CF cohort. Lung transplants decreased by 72% in ETI era compared to pre-ETI CFTRm era; rates increased among the non-CF cohort. These results suggest the availability of ETI is associated with reductions in demand for lung transplants for people with CF, increasing availability of donor lungs for non-CF candidates.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108171"},"PeriodicalIF":3.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132929","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}