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Mental health and transplantation in cystic fibrosis 囊性纤维化患者的心理健康与移植
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-09 DOI: 10.1016/j.rmed.2025.108407
Anna M. Georgiopoulos , Beth A. Smith , Elisabeth P. Dellon , Denis Hadjiliadis , Rebecca Colman , Tara M.D. Mullen , Alexandra L. Quittner , Yelizaveta I. Sher
{"title":"Mental health and transplantation in cystic fibrosis","authors":"Anna M. Georgiopoulos ,&nbsp;Beth A. Smith ,&nbsp;Elisabeth P. Dellon ,&nbsp;Denis Hadjiliadis ,&nbsp;Rebecca Colman ,&nbsp;Tara M.D. Mullen ,&nbsp;Alexandra L. Quittner ,&nbsp;Yelizaveta I. Sher","doi":"10.1016/j.rmed.2025.108407","DOIUrl":"10.1016/j.rmed.2025.108407","url":null,"abstract":"<div><h3>Background</h3><div>People with cystic fibrosis (PWCF) and their caregivers may face the prospect of lung or liver transplantation as cystic fibrosis (CF) progresses. Despite the links between psychological distress, poor adherence and survival outcomes, their mental health needs may not be consistently addressed.</div></div><div><h3>Methods</h3><div>We conducted a narrative review of mental health aspects of transplantation in PWCF, including health-related quality of life (HRQoL), pre-transplant psychosocial evaluation, neuropsychiatric complications, and psychosocial and psychopharmacologic interventions.</div></div><div><h3>Results</h3><div>Depression, anxiety and post-traumatic stress are common in this population, along with neuropsychiatric complications including cognitive impairment, delirium, side effects of immunosuppression, and drug-drug interactions. CF-specific guidelines recommend routine screening for depression, anxiety, and unmet palliative care needs for PWCF throughout the lifespan. Peri-transplantation, systematic monitoring can modify risk factors for and identify and treat delirium. Guidelines recommend screening, evaluation, and referral to care for depression, anxiety, and PTSD within 6 months post-transplant for PWCF and caregivers. Mental health intervention studies indicate there is potential to improve depression, anxiety, HRQoL, and medical outcomes.</div></div><div><h3>Conclusions</h3><div>As CF progresses, patients and caregivers require preparation for the psychosocial aspects of transplant evaluation, including the salience of social support, treatment adherence, and the importance of early interventions for mental health and substance use disorders. Specialists in mental health, palliative care, and pain management can be enlisted to improve symptoms and functioning in PWCF and caregivers at all stages of the transplant process. Psychological and psychopharmacologic interventions may require adaptation to target the specific needs of PWCF with advanced disease.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108407"},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259054","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}
引用次数: 0
Childhood body size and risk of chronic obstructive pulmonary disease in adulthood: a prospective cohort study. 儿童体型与成年后慢性阻塞性肺疾病的风险:一项前瞻性队列研究
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-09 DOI: 10.1016/j.rmed.2025.108416
Frida R Hansen, Dorthe C Pedersen, Flemming Madsen, Helena Backman, Jens-Ulrik S Jensen, Allan Linneberg, Katja B Leth-Møller, Jennifer L Baker
{"title":"Childhood body size and risk of chronic obstructive pulmonary disease in adulthood: a prospective cohort study.","authors":"Frida R Hansen, Dorthe C Pedersen, Flemming Madsen, Helena Backman, Jens-Ulrik S Jensen, Allan Linneberg, Katja B Leth-Møller, Jennifer L Baker","doi":"10.1016/j.rmed.2025.108416","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108416","url":null,"abstract":"<p><strong>Introduction: </strong>Although previous studies have suggested links between childhood body size and lung function and asthma in adolescence and adulthood, the association with COPD is unclear. Therefore, we investigated whether trajectories of body mass index (BMI) in childhood were associated with COPD in adulthood.</p><p><strong>Methods: </strong>In this prospective cohort study, we included 276,747 children born from 1930-1982, with weight and height measurements available at ages 6-15 years from the Copenhagen School Health Records Register. We followed individuals from 1977 to 2022 in national health registers and identified those with a COPD diagnosis from age 40 years onwards. Hazard ratios (HR) and 95% confidence intervals (CI) for the associations between five childhood BMI trajectories and COPD were estimated separately for females and males using Cox proportional hazard regression analyses.</p><p><strong>Results: </strong>During follow-up, 18,227 females and 15,789 males had a COPD diagnosis. Compared to females with an average childhood BMI trajectory, a higher hazard of COPD was observed for females who had an above-average (HR=1.10; 95%CI: 1.06-1.15), overweight (HR=1.26; 95%CI: 1.20-1.33) or obesity BMI trajectory (HR=1.65; 95%CI: 1.50-1.83). Results were largely similar for males. Among females, a below average childhood BMI trajectory was associated with a lower hazard of COPD (HR=0.91; 95%CI: 0.87-0.95).</p><p><strong>Conclusion: </strong>We found that a BMI trajectory above average throughout childhood was positively associated with COPD in adulthood. Thus, our results suggest that having overweight or obesity during this early period of life is an indicator of risk for the later development of COPD.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108416"},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275483","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}
引用次数: 0
Outcomes of Introducing Shared Decision-Making for Tracheostomy on Prolonged Intubated Critical Patients. 长期插管危重患者气管切开术引入共同决策的效果分析。
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-09 DOI: 10.1016/j.rmed.2025.108370
Shu-Hung Kuo, Chien-Wei Hsu, Wei-Chun Huang, Chun-Hao Yin, Ying-Chun Li, Tsung-Hsien Lin, Yao-Shen Chen, Jin-Shuen Chen
{"title":"Outcomes of Introducing Shared Decision-Making for Tracheostomy on Prolonged Intubated Critical Patients.","authors":"Shu-Hung Kuo, Chien-Wei Hsu, Wei-Chun Huang, Chun-Hao Yin, Ying-Chun Li, Tsung-Hsien Lin, Yao-Shen Chen, Jin-Shuen Chen","doi":"10.1016/j.rmed.2025.108370","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108370","url":null,"abstract":"<p><strong>Aim: </strong>Tracheostomy has been relatively unpopular in Taiwan. Here, we investigate the impact of shared decision-making (SDM) for tracheostomy on critical patients undergoing prolonged intubation.</p><p><strong>Methods: </strong>We retrospectively enrolled 1464 patients admitted to a tertiary medical centre intensive care unit (ICU) due to respiratory failure between April 2017 and April 2023. A 2-to-1 propensity- score with nearest-neighbour matching was used to balance covariates across SDM and non-SDM groups. Outcomes, including tracheostomy rate, intubation to tracheostomy time, mortality rate, ventilator weaning rate, ICU admission days, length of hospital stay, and 6-month post-discharge readmission rate were collected. Binary outcomes (Tracheostomy rate, in-hospital mortality, and 6-month readmission rate) were analysed using multivariable logistic regression, reported as odds ratios (ORs) with 95% confidence intervals (CIs). Continuous outcomes (Intubation to Tr. T, ICU days, and length of stay) were assessed with generalised linear models, reported as regression coefficients (β) with 95% CIs.</p><p><strong>Results: </strong>We found that SDM introduction was associated with a higher tracheostomy (44.3% vs. 30.9%, p<0.001) and lower in-hospital mortality rates (15.7% vs. 26.5%, p=0.004), but failed to demonstrate significant impacts on the intubation-to-tracheostomy time (25.8±16.8 vs. 28.8±17.6 d, p = 0.05) and the rest of the clinical outcomes. Subgroup analysis showed SDM had the greatest benefit to those with prior respiratory, neuromuscular, and malignant diseases.</p><p><strong>Conclusion: </strong>Introducing SDM for prospective tracheostomy recipients is associated with better clinical outcomes in critical patients undergoing prolonged intubation.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108370"},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275667","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}
引用次数: 0
Comparison of oscillometry ratios between IOS and AOS in patients with asthma and COPD 哮喘和慢性阻塞性肺病患者IOS和AOS的振荡比比较。
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-08 DOI: 10.1016/j.rmed.2025.108402
Philipp Suter, Robert Greig, Chris RuiWen Kuo, Rory Chan, Brian Lipworth
{"title":"Comparison of oscillometry ratios between IOS and AOS in patients with asthma and COPD","authors":"Philipp Suter,&nbsp;Robert Greig,&nbsp;Chris RuiWen Kuo,&nbsp;Rory Chan,&nbsp;Brian Lipworth","doi":"10.1016/j.rmed.2025.108402","DOIUrl":"10.1016/j.rmed.2025.108402","url":null,"abstract":"<div><div>The forced oscillation technique (FOT) enables effort-independent assessment of small airway dysfunction (SAD) in obstructive lung diseases. We compared resistance and reactance ratios between two FOT modalities—impulse oscillometry (IOS) and airwave oscillometry (AOS), in patients with asthma and COPD. We retrospectively analysed paired pre- and post-bronchodilator IOS and AOS measurements from 82 patients (58 asthma, 24 COPD). Resistance (R5–R20/R5 for IOS; R5–R19/R5 for AOS) and reactance (X5/AX) ratios were compared using correlation and Bland-Altman analyses. Resistance ratios showed significant agreement between devices, with minimal mean differences. Reactance ratios were also significantly correlated but were higher with IOS than AOS. This difference increased at higher X5/AX ratios, likely due to device specific signal characteristics and calibration differences. Post-bronchodilator improvements were observed with both devices, with a greater change in X5/AX using IOS (p &lt; 0.05). In conclusion resistance ratios were comparable between IOS and AOS, supporting their clinical use across devices. In contrast, reactance ratios differed, highlighting the need for device-specific normative values and improved standardization. FOT-derived ratios may offer a practical alternative to absolute values for assessing SAD in asthma and COPD.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108402"},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259032","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}
引用次数: 0
Evaluation of Gene and microRNA Expression Patterns in Idiopathic Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension as Rare Diseases. 特发性肺动脉高压和慢性血栓栓塞性肺动脉高压罕见病的基因和microRNA表达模式评价
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-08 DOI: 10.1016/j.rmed.2025.108415
Ecem Inci, Aybike Sena Ozuynuk-Ertugrul, Berkay Ekici, Pinar Koseoglu-Buyukkaya, Ajar Kocak, Neslihan Coban
{"title":"Evaluation of Gene and microRNA Expression Patterns in Idiopathic Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension as Rare Diseases.","authors":"Ecem Inci, Aybike Sena Ozuynuk-Ertugrul, Berkay Ekici, Pinar Koseoglu-Buyukkaya, Ajar Kocak, Neslihan Coban","doi":"10.1016/j.rmed.2025.108415","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108415","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) is a group of fatal diseases, including idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic PH (CTEPH), which are rare diseases with treatment options. Although there are suggested molecular mechanisms for IPAH, the pathogenesis of CTEPH remains unclear.</p><p><strong>Objectives: </strong>This study hypothesized that PH-related genes and their post-transcriptional regulators, miRNAs, may show specific expression patterns in IPAH and CTEPH patients.</p><p><strong>Methods: </strong>In this study, healthy controls (n=12), IPAH (n=15), and CTEPH (n=12) patients were recruited. The expression levels of PH-related ABCA3, ATP13A3, BMPR1A, BMPR2, KCNK3, NOTCH1, SMAD9, SOX17, and TET2 genes, along with hsa-miR-30a-5p, hsa-miR-210-3p, hsa-miR-155-5p, and hsa-miR-126-3p were determined using qRT-PCR. The associations between expression levels and clinical measurements were assessed.</p><p><strong>Results: </strong>ABCA3 expression was decreased in IPAH (p=0.007) while SMAD9 expression was elevated in CTEPH patients (p=0.012). miR-210-3p and miR-126-3p were increased in IPAH and CTEPH, while miR-30a-5p was increased in IPAH patients (p=0.005). Moreover, systolic pulmonary artery pressure showed significant negative correlation with ATP13A3, BMPR1A, BMPR2, KCNK3, SMAD9, SOX17, and TET2 expression in IPAH patients, while NOTCH1 expression levels were positively correlated with pulmonary artery wedge pressure in CTEPH group.</p><p><strong>Conclusions: </strong>The study identifies distinct gene and miRNA expression profiles in IPAH and CTEPH patients. Specifically, ABCA3 is downregulated in IPAH, while SMAD9 is upregulated in CTEPH, suggesting potential markers. Additionally, dysregulated miRNAs highlight the importance of post-transcriptional regulation. The correlations between gene expression and clinical parameters emphasize their prognostic value. These results represent preliminary findings and need further validation in larger cohorts.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108415"},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275673","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}
引用次数: 0
Non-pharmacological interventions for fatigue in patients with chronic obstructive pulmonary disease: a systematic review and network meta-analysis. 慢性阻塞性肺疾病患者疲劳的非药物干预:系统综述和网络荟萃分析
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-08 DOI: 10.1016/j.rmed.2025.108409
Xiaona Zhang, Jiali Xue, Yan Chang, Rui Zhang, Jie Zhao, Xindan Li, Hongyan Lu, Xirui Jiang, Fang Yu, Pengfei Yang
{"title":"Non-pharmacological interventions for fatigue in patients with chronic obstructive pulmonary disease: a systematic review and network meta-analysis.","authors":"Xiaona Zhang, Jiali Xue, Yan Chang, Rui Zhang, Jie Zhao, Xindan Li, Hongyan Lu, Xirui Jiang, Fang Yu, Pengfei Yang","doi":"10.1016/j.rmed.2025.108409","DOIUrl":"10.1016/j.rmed.2025.108409","url":null,"abstract":"<p><strong>Background: </strong>Fatigue is a common and debilitating symptom in patients with chronic obstructive pulmonary disease (COPD). It limits daily activities, lowers perceived health, and diminishes the overall quality of life. Although several interventions have been demonstrated to alleviate fatigue, the relative effectiveness of these interventions remains unclear.</p><p><strong>Objective: </strong>To assess and compare the efficacy of various non-pharmacological interventions for managing fatigue in patients with COPD, and to provide evidence-based recommendations for the design of intervention programs.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across MEDLINE, Cochrane Library, Web of Science, Embase, CINAHL, CNKI, Wanfang Database, CBM, and the VIP Chinese journal full-text database to identify randomized controlled trials and quasi-experimental studies evaluating non-pharmacological interventions for COPD-related fatigue. The search covered all records from the inception of each database up to August, 2025. The network meta-analysis was conducted using Stata 16.0 and Addis 1.16.8 software.</p><p><strong>Results: </strong>The analysis included 35 studies involving 2565 patients with COPD and examined 12 distinct non-pharmacological interventions. Results from the network meta-analysis demonstrated that acupressure [standardized mean difference (SMD) = -20.58, 95 %CI (-36.35, -5.19), P < 0.05], aerobic exercise [SMD = -12.80, 95 %CI (-22.96, -2.57), P < 0.05], pulmonary rehabilitation [SMD = -20.07, 95 %CI (-32.61, -6.98), P < 0.05], and progressive muscle relaxation [SMD = -16.99, 95 %CI (-28.83, -5.57), P < 0.05] were significantly effective in alleviating COPD-related fatigue. Ranking probability analysis further suggested that acupressure (0.25) was the most effective intervention, followed by pulmonary rehabilitation (0.19) and progressive muscle relaxation (0.15). The sensitivity analysis indicated that the ranking probability of acupressure was influenced by the quasi-experimental studies.</p><p><strong>Conclusion: </strong>Pulmonary rehabilitation and progressive muscle relaxation therapy provide significant therapeutic advantages and should be prioritized as key non-pharmacological strategies for managing fatigue in patients with COPD.</p><p><strong>Trial registration: </strong>INPLASY registration number: 202290072.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108409"},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275670","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}
引用次数: 0
Lymphocyte level is a potential biomarker for the neonatal apnea risk and the length of intensive care unit stay in neonates. 淋巴细胞水平是新生儿呼吸暂停风险和新生儿重症监护病房停留时间的潜在生物标志物。
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-08 DOI: 10.1016/j.rmed.2025.108414
Yi Xie, Xiang-Jin Qiu
{"title":"Lymphocyte level is a potential biomarker for the neonatal apnea risk and the length of intensive care unit stay in neonates.","authors":"Yi Xie, Xiang-Jin Qiu","doi":"10.1016/j.rmed.2025.108414","DOIUrl":"10.1016/j.rmed.2025.108414","url":null,"abstract":"<p><p>This study aimed to investigate the association of lymphocyte levels with the risk of neonatal apnea and the length of intensive care unit (ICU) stay in neonates. The data on neonates were derived from the MIMIC III database. Baseline characteristics and laboratory parameters were compared between the apnea and no-apnea groups. Logistic regression models were used to assess the association between lymphocyte levels and apnea risk. Generalized linear models (GLM) were performed to explore the relationship between lymphocyte levels and ICU stay. Moreover, latent class trajectory models (LCTM) evaluated lymphocyte trajectory changes over time, with subgroup analysis based on treatment types and gestational age. A total of 3408 neonates were finally included: 1121 with apnea and 2287 without apnea. Higher lymphocyte levels were significantly associated with an increased risk of apnea and a shorter ICU stay among neonates with apnea. LCTM identified four lymphocyte trajectory groups: persistently low, low-rise, moderate-rise, and high-rise. Trajectory groups showed no significant association with length of ICU stay. However, among the neonates treated with vancomycin or acetaminophen subgroups, the high-rise trajectory and moderate-rise trajectory had significantly shorter ICU stays compared to persistently low trajectory. In conclusion, elevated lymphocyte levels are associated with a higher risk of neonatal apnea and a shorter ICU stay. Specific treatment types may modulate the association of lymphocyte trajectory with ICU stay duration, suggesting potential for targeted intervention.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108414"},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275686","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}
引用次数: 0
Persistent use of amikacin liposome inhalation suspension associated with lower risk of hospitalizations and emergency room visits in refractory Mycobacterium avium complex lung disease. 持续使用阿米卡星脂质体吸入混悬液与难治性鸟分枝杆菌复杂肺病住院和急诊就诊风险降低相关
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-07 DOI: 10.1016/j.rmed.2025.108406
Kevin L Winthrop, Catherine Waweru, Emily Welch, Ping Wang, Leona E Markson
{"title":"Persistent use of amikacin liposome inhalation suspension associated with lower risk of hospitalizations and emergency room visits in refractory Mycobacterium avium complex lung disease.","authors":"Kevin L Winthrop, Catherine Waweru, Emily Welch, Ping Wang, Leona E Markson","doi":"10.1016/j.rmed.2025.108406","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108406","url":null,"abstract":"<p><strong>Background: </strong>Amikacin liposome inhalation suspension (ALIS) as add-on treatment to a multidrug regimen is the only therapy approved for treatment of adults with refractory Mycobacterium avium complex lung disease (rMACLD). Data on the impact of persistent use of ALIS on patient outcomes may be informative during clinical decision making. We used claims data to examine the association between persistent use of ALIS and healthcare resource use.</p><p><strong>Methods: </strong>This retrospective study used the Merative® MarketScan Commercial and Medicare Supplemental databases. Patients who initiated ALIS between October 2018 and March 2021, with ≥3 months continuous enrollment before and ≥12 months after index (ie, date of first ALIS prescription) were included. ALIS use was stratified into two groups: persistent ALIS use (≥6 months total supply) and less persistent ALIS use (<6 months total supply) over a 12-month post-index period. Hospitalizations and emergency room (ER) visits between ALIS-use groups were assessed using Kaplan-Meier analysis and multivariate Cox proportional hazards models.</p><p><strong>Results: </strong>In total, 103 ALIS-treated patients were included, with 54 (52.4%) and 49 (47.6%) in the persistent and less persistent ALIS-use groups, respectively. Compared with the less persistent ALIS-use group, the persistent ALIS-use group had a lower risk of all-cause (hazard ratio [95% CI], 0.17 [0.07-0.40], p<0.0001), respiratory-related (0.16 [0.06-0.40], p<0.0001), and NTM-related hospitalizations (0.14 [0.05-0.38], p<0.0001), and ER visits (0.41 [0.18-0.92], p=0.03), based on multivariate modeling.</p><p><strong>Conclusions: </strong>Persistent use of ALIS during the first 12 months of treatment was associated with a lower risk of hospitalizations and ER visits.</p><p><strong>Notation of prior abstract publication/presentation: </strong>Part of this study has been presented at CHEST on October 6-9, 2024, in Boston, MA, USA, and AMCP Nexus on October 14-17, 2024, in Las Vegas, NV, USA.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108406"},"PeriodicalIF":3.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258994","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}
引用次数: 0
Effects from Using a Race-Neutral Prediction Equation for Interpreting Spirometry in an Active-Duty Military Population. 使用种族中立预测方程解释现役军人肺活量测定的效果。
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-07 DOI: 10.1016/j.rmed.2025.108400
Aaron B Holley, Emil Oweis, Erann Briggs, Michael J McMahon, Michael J Morris
{"title":"Effects from Using a Race-Neutral Prediction Equation for Interpreting Spirometry in an Active-Duty Military Population.","authors":"Aaron B Holley, Emil Oweis, Erann Briggs, Michael J McMahon, Michael J Morris","doi":"10.1016/j.rmed.2025.108400","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108400","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of our analysis was to study the clinical and occupational consequences from switching to a \"race-neutral\" spirometry reference equation for active-duty service members (ADSMs).</p><p><strong>Methods: </strong>We hypothesized that switching to a \"race-neutral\" equation would affect eligibility for deployment and improve clinical accuracy. We tested this hypothesis using data from a prospective cohort study (STAMPEDE II) of ADSMs screened using spirometry pre-deployment. Prevalence of abnormality and z-scores were compared using the \"race-neutral\" GLI-Global (GLI-G) versus the original GLI 2012 (GLI-R) equations. The relationship between spirometry and deployment respiratory symptoms was modeled using ordinal logistic regression.</p><p><strong>Results: </strong>Among the 1,632 subjects enrolled in STAMPEDE II, moving to GLI-G decreased z-scores and increased the prevalence of abnormality for Black ADSMs. For White and Hispanic ADSMs, z-scores increased and resulting abnormalities decreased. Among those referred for pre-deployment spirometry per current military protocols (n=155), using GLI-G increased abnormal spirometry from 9.8% to 11.6% (p<0.01), with a significant increase (5 (16.7%) to 14 (46.7%); p=0.01) and decrease (6 (6.5%) to 3 (3.2%); p=0.01) in abnormal spirometry in Black and White subjects, respectively. After adjustment for other factors, the presence of abnormal spirometry, whether defined by GLI-G or GLI-R, did not increase the odds for an increase in respiratory symptoms during or after deployment.</p><p><strong>Discussion: </strong>Among Black ADSMs, GLI-G decreases z-scores and results in an increase in abnormalities that will affect eligibility for deployment. Moving to a \"race-neutral\" equation did not improve clinical accuracy for predicting respiratory symptoms during or after deployment.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108400"},"PeriodicalIF":3.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259057","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}
引用次数: 0
Real-world effectiveness and Lung Abnormalities Associated with Amikacin Liposome Inhalation Suspension. 阿米卡星脂质体吸入悬浮液的实际疗效和肺部异常。
IF 3.1 3区 医学
Respiratory medicine Pub Date : 2025-10-07 DOI: 10.1016/j.rmed.2025.108408
Nozomi Tokita, Masashi Ito, Naohisa Urabe, Keiji Fujiwara, Koji Furuuchi, Tatsuya Kodama, Takashi Ohe, Atsuko Kurosaki, Yoshiaki Tanaka, Takashi Yoshiyama, Kazuma Kishi, Ken Ohta, Kozo Morimoto
{"title":"Real-world effectiveness and Lung Abnormalities Associated with Amikacin Liposome Inhalation Suspension.","authors":"Nozomi Tokita, Masashi Ito, Naohisa Urabe, Keiji Fujiwara, Koji Furuuchi, Tatsuya Kodama, Takashi Ohe, Atsuko Kurosaki, Yoshiaki Tanaka, Takashi Yoshiyama, Kazuma Kishi, Ken Ohta, Kozo Morimoto","doi":"10.1016/j.rmed.2025.108408","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108408","url":null,"abstract":"<p><strong>Background: </strong>The guideline recommends the addition of amikacin liposome inhalation suspension (ALIS) for patients with refractory Mycobacterium avium complex pulmonary disease (MAC-PD). However, factors influencing culture conversion and managing ALIS-related adverse events, particularly ALIS-related lung abnormalities (ALIS-RLAs) remain insufficient.</p><p><strong>Methods: </strong>This was a two-center retrospective cohort study involving 87 patients with refractory MAC-PD who received ALIS from August 2021 to September 2023. Refractory MAC-PD was defined as failure to achieve sputum culture conversion after six months or more of guideline-based therapy. On the basis of data obtained from medical records, adverse events were assessed in 76 patients, whereas treatment outcomes were evaluated in 49 patients.</p><p><strong>Results: </strong>The sputum culture conversion rate was 28.6%. Prognostic factors associated with a negative impact included a body mass index below 18.5 kg/m<sup>2</sup> (adjusted odds ratio [aOR], 0.07, 95% confidence interval [CI], 0.02-0.35) and the presence of cavities (aOR 0.02, 95% CI 0.002-0.18). Patients achieved culture conversion had a shorter interval from MAC-PD treatment initiation to ALIS administration. The most frequent adverse event was dysphonia, which occurred in 53.9%. ALIS-RLAs were observed in 82.1%: 53 patients (79.1%) had multiple nodular patterns, 18 patients (26.9%) had organizing pneumonia patterns, one patient (1.5%) had a diffuse alveolar pattern, and another (1.5%) had a hypersensitivity pneumonitis pattern. Among patients with ALIS-RLAs, 92.7% were asymptomatic, and 85.5% were able to continue ALIS.</p><p><strong>Conclusion: </strong>Initiating ALIS before significant progression is important. Although ALIS-RLAs were observed in 82.1% of patients, discontinuation of ALIS appeared unnecessary in asymptomatic cases.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108408"},"PeriodicalIF":3.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259067","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}
引用次数: 0
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