Respiratory medicine最新文献

{"title":"Effect of indoor environmental interventions in the home on asthma in children and adolescents: A systematic review.","authors":"Nina Viskum Hogaard, Torben Sigsgaard, Lone Agertoft, Susanne Halken, Sune Rubak","doi":"10.1016/j.rmed.2025.108299","DOIUrl":"10.1016/j.rmed.2025.108299","url":null,"abstract":"<p><strong>Background: </strong>Asthma is the most frequent chronic respiratory disease in childhood. Children spend much time indoors and are therefore exposed to many indoor allergens and pollutants for several hours during day and night. Many different measures have been investigated in an attempt to reduce the different indoor asthma triggers. The objective of this review was to evaluate the effect on asthma in children and adolescents of home environmental interventions.</p><p><strong>Methods: </strong>A systematic review was conducted by searching five electronic databases and including randomised controlled trials studying the effect of environmental interventions, not aimed at tobacco smoke and smoke alone, on childhood allergic asthma. Data were extracted using a predefined template and quality of the evidence assessed using Cochrane risk-of-bias tool and the GRADE approach.</p><p><strong>Results: </strong>We identified 13,124 studies and included 54 of which 24 intervened on house dust mites, 3 on pet allergen, 4 on pest allergen, 17 on indoor air quality and 6 were multifaceted interventions. There was a high degree of heterogeneity, and only three studies of high quality. A significant effect was found in two high quality studies on mattress covers, four (1 high, 1 moderate, 2 very low quality) studies on nocturnal, temperature-controlled laminar airflow and low evidence for effect of multifaceted interventions. Apart from this no clear effects of other interventions were found.</p><p><strong>Conclusion: </strong>Multifaceted interventions, nocturnal laminar air flow and mitigating HDM exposure by mite-impermeable mattress covers are promising interventions. Future studies should use relevant asthma outcome measures and a rigorous study design based on experience from former studies.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108299"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800112","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":"Morpho-clinical insights into moderate-to-severe obstructive sleep apnea","authors":"Moussa Riachy ,&nbsp;Sophie Riachy ,&nbsp;Albert Riachy ,&nbsp;Farid Mallat ,&nbsp;Nicolas Medawar ,&nbsp;Thalia Hanna ,&nbsp;Kristy Braidy ,&nbsp;Dalia Al Halabi ,&nbsp;Joe Elio El Chaer ,&nbsp;Karl Chammas ,&nbsp;Antoine El Kik ,&nbsp;Hind Eid","doi":"10.1016/j.rmed.2025.108392","DOIUrl":"10.1016/j.rmed.2025.108392","url":null,"abstract":"<div><h3>Introduction</h3><div>Obstructive sleep apnea syndrome results from recurrent upper airway obstruction during sleep. Moderate-to-severe is common in referred sleep clinics and poses significant health risks. We assessed whether a morphotype model, a clinical-complaints model, and a combined morpho-clinical model can predict MS-OSA.</div></div><div><h3>Method</h3><div>In a prospective cohort of referred adults undergoing type I polysomnography (n = 925, 2018–2024), we recorded demographics/anthropometry and two novel dynamic metrics, the cricomental angle (CMA) and inspiratory Mallampati score (I-MS). Logistic regression models were developed and internally validated with 80-20 split and 10-fold cross validation. Pre-specified operating points were chosen for interpretability.</div></div><div><h3>Results</h3><div>Among 925 patients (72.8 % male, average body mass index (BMI) of 30.3 ± 5.6 kg/m², mean AHI 32.7 ± 24.4), daytime drowsiness (75.5 %) and snoring (74.6 %) were prevalent. Significant predictors of MS-OSA included age, male sex, BMI, neck circumference. Higher I-MS classifications and convex CMA were associated with greater odds of MS-OSA. In internal validation the comprehensive morphotype model showed high specificity (0.96) and PPV (0.82) (rule-in). The clinical-complaints model showed higher sensitivity (0.46) and NPV (0.80) (rule-out but does not exclude MS-OSA). Adding clinical features (Berlin category 1 and arterial hypertension) to the morphotype model improved overall fit (lower Akaike information criterion 737) while maintaining high specificity.</div></div><div><h3>Conclusion</h3><div>We propose a simple three step workflow or an alternative on step option to support triage in specialist clinics. Future work should focus on refining and validating these tools across diverse populations. The proposed models are designed for triage and prioritization rather than to replace or restrict diagnostic testing.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108392"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220808","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 aspirin use with mortality in critically ill patients with chronic obstructive pulmonary disease: A retrospective propensity score-matched cohort study.","authors":"Shaolin Cai, Qingcui Huang, Minna Huang, Jinghao Wang, Shasha Li","doi":"10.1016/j.rmed.2025.108300","DOIUrl":"10.1016/j.rmed.2025.108300","url":null,"abstract":"<p><strong>Background: </strong>The impact of aspirin on mortality in patients with chronic obstructive pulmonary disease (COPD) remains unclear, particularly those who are critically ill.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the MIMIC-IV 3.1 database to investigate the correlation between aspirin use and 30-day mortality among critically ill adult patients diagnosed with COPD. Patients who initiated aspirin therapy within the first 24 h of intensive care unit (ICU) admission were included in the analysis. The primary outcome was 30-day mortality. Multivariable analysis, 1:1 propensity score matching, and standardized mortality ratio weighting (SMRW) were employed to adjust for confounding factors.</p><p><strong>Results: </strong>A total of 3184 patients were included in the study. The 30-day mortality rate was 13.0 % in aspirin recipients (140/1074) compared to 22.6 % in non-recipients (476/2110). Analysis using SMRW demonstrated a significant association between aspirin use and reduced 30-day mortality (HR, 0.64; 95 % CI, 0.52-0.77; P < 0.001). Furthermore, aspirin use was associated with decreased in-hospital mortality (OR, 0.69; 95 % CI, 0.50-0.96; P = 0.029), a longer duration without ICU readmission within 28 days (β, 1.13; 95 % CI, 0.30-1.96; P = 0.008), and prolonged time without mechanical ventilation within 28 days (β, 1.27; 95 % CI, 0.41-2.14; P = 0.004). Sensitivity analyses on the complete dataset confirmed a significant association between aspirin use and reduced 30-day mortality, with a hazard ratio of 0.72 (95 % CI, 0.59-0.87; P = 0.001).</p><p><strong>Conclusions: </strong>Aspirin was associated with reduced mortality in critically ill patients with COPD. These findings warrant further prospective studies to confirm the observed benefits of aspirin use in this population.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108300"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804666","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":"Predictors of in-hospital death among patients with COVID-19 aged < 65 who required invasive mechanical ventilation in Japan.","authors":"Yuta Taniguchi, Mariko Hosozawa, Hitomi Kimura, Koji Kitajima, Norio Ohmagari, Hiroyasu Iso","doi":"10.1016/j.rmed.2025.108289","DOIUrl":"10.1016/j.rmed.2025.108289","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the characteristics, prognosis, and predictors of in-hospital death of hospitalized patients with coronavirus disease 2019 (COVID-19) aged <65 years who required invasive mechanical ventilation (IMV).</p><p><strong>Methods: </strong>Data were obtained from the nationwide inpatient registry for COVID-19 in Japan. The data of individuals aged <65 years who received IMV between March 2020 and June 2021 were analyzed. Predictors of in-hospital death were examined using logistic regression analyses, adjusted for age and sex.</p><p><strong>Results: </strong>Among 22,946 participants aged <65 years registered during the study period, 728 patients received IMV (median, 55 years [range; 22-64, interquartile range: 49.5-60]; males, 84.8 %); 10 % (n = 73) died in the hospital and 46.6 % (n = 305/655) of those discharged alive required oxygen therapy at discharge. After adjusting for age and sex, predictors of in-hospital death included congestive heart failure (adjusted odds ratio: 3.59, 95 % confidence interval: 1.23-10.5), chronic respiratory disease excluding chronic obstructive pulmonary disease (7.98, 2.84-22.4), diabetes with complications (3.52, 1.68-7.40), moderate-to-severe renal dysfunction (3.18, 1.36-7.46), Charlson comorbidity index ≥3 (5.16, 2.34-11.4), and complications during hospitalization such as acute respiratory distress syndrome (2.00, 1.12-3.57).</p><p><strong>Conclusions: </strong>A substantial proportion of COVID-19 patients aged <65 with invasive mechanical ventilation died at the hospital or required oxygen at discharge, suggesting the importance of attention to younger patients, especially those with multiple comorbidities.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108289"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776120","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":"Triangulation evidence for the causal effect of monocytes on pulmonary artery hypertension: a Mendelian randomization study and results from NHANES","authors":"Zhekang Liu ,&nbsp;Qingan Fu ,&nbsp;Yijia Shao ,&nbsp;Junda Cao","doi":"10.1016/j.rmed.2025.108388","DOIUrl":"10.1016/j.rmed.2025.108388","url":null,"abstract":"<div><h3>Background</h3><div>Previous research has indicated an association between circulating white blood cell (WBC) counts and the development of pulmonary arterial hypertension (PAH), however a causal relationship is unclear. This study aimed to investigate the causal link between circulating WBC counts and PAH.</div></div><div><h3>Methods</h3><div>We used the genome-wide association study (GWAS) datasets of European ancestry to perform Mendelian randomization to assess the effects of WBC counts on PAH. Summary statistics for WBC subtype counts were obtained from the Blood Cell Consortium, and data for PAH were sourced from FinnGen GWAS results. Furthermore, a cross-sectional observational study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) to explore the relationship between WBC counts and PAH, involving a sample size of 15,835 participants.</div></div><div><h3>Results</h3><div>MR results showed that monocyte count was a risk factor for PAH (OR = 1.21, 95 % CI 1.05–1.40, P = 0.007), which was supported by a meta-analysis of IVW, and sensitivity analyses revealed the reliability of the MR results (OR = 1.21, 95 % CI 1.10–1.36, P = 0.0009). The association between monocyte count and PAH was also supported by a cross-sectional study based on NHANES.</div></div><div><h3>Conclusions</h3><div>This study shows a causal relationship between increased risk of PAH and monocyte counts, providing new insights into the role of monocytes in PAH. However, further studies are needed to validate this finding.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108388"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219586","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":"Non-tuberculous micobacteria in the elderly. Multicentric study.","authors":"I Gonzalez-Munoz, M V Leal Arranz, J A Garcia Fuentes, B Santos Zorrozua, M Zuriarrain Alonso, L Altube Urrengoechea, J Ugedo Urruela, E Tabernero Huguet","doi":"10.1016/j.rmed.2025.108297","DOIUrl":"10.1016/j.rmed.2025.108297","url":null,"abstract":"<p><strong>Background: </strong>Nontuberculous mycobacterial (NTM) pulmonary disease is an increasingly common infectious condition that particularly affects patients with pre-existing lung disease, immunosuppression, and the elderly.</p><p><strong>Objectives: </strong>To determine the incidence of NTM isolation and NTM pulmonary disease (NTM-PD) in older adults and describe their clinical, radiological characteristics, and treatment outcomes.</p><p><strong>Methods: </strong>A multicenter observational study conducted retrospectively (2012-2017) and prospectively (2018-2020) in five tertiary hospitals in northern Spain. All adults aged ≥18 years with NTM isolation from respiratory samples were included and followed for two years.</p><p><strong>Results: </strong>Among 594 patients, 220 (37 %) were aged >75 years. NTM-PD was confirmed in 192 cases, with 32 % occurring in elderly patients. The isolation rate was higher in older adults (13.8/100,000 vs. 2.94/100,000 in younger individuals), as was the disease rate (3.82/100,000 vs. 1.02/100,000). Older patients had fewer cavitated forms (27 vs 10 %), were less often diagnosed by bronchoscopy, and received proportionally less treatment despite meeting disease criteria. However, cure rates did not significantly differ between age groups.</p><p><strong>Conclusions: </strong>Older adults exhibit a higher incidence of NTM isolation and disease but are managed with less aggressive diagnostic and therapeutic approaches, without compromising cure rates.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108297"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800113","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 major COPD triple therapy trials using a structured multi-criteria decision analysis: A deep dive into patient populations and outcomes.","authors":"Mario Cazzola, Mauro Maniscalco, Vincenzo Patella, Luigino Calzetta, Maria Gabriella Matera, Paola Rogliani","doi":"10.1016/j.rmed.2025.108292","DOIUrl":"10.1016/j.rmed.2025.108292","url":null,"abstract":"<p><strong>Background: </strong>Triple inhaled therapy (ICS/LABA/LAMA) is widely recommended for managing COPD in patients with persistent symptoms or frequent exacerbations. However, variability in trial designs, populations, and pharmacologic formulations complicates direct comparison between regimens.</p><p><strong>Objective: </strong>To evaluate the comparative performance of three triple therapies, FF/VI/UMEC, BUD/FOR/GLY, and BDP/FOR/GLY, using a multidimensional comparative decision analysis (MCDA) across key clinical domains.</p><p><strong>Methods: </strong>Data from pivotal trials (IMPACT, FULFIL, TRINITY, TRIBUTE, TRILOGY, ETHOS, and KRONOS) were synthesized using an MCDA framework encompassing lung function, symptom control, and exacerbations. Mortality, safety, and device usability were also assessed. Analyses considered variations in enrolled populations, prior ICS use, and inhaler characteristics.</p><p><strong>Results: </strong>FF/VI/UMEC showed consistent efficacy across multiple domains and populations, particularly in patients at high risk of exacerbations. BUD/FOR/GLY was associated with reductions in exacerbations and mortality, particularly in patients previously treated with LABA/LAMA. BDP/FOR/GLY may be suitable for ICS-maintained patients. Trials like FULFIL and KRONOS showed symptom and lung function gains even in non-exacerbators, although ICS use in this group always warrants caution due to pneumonia risk.</p><p><strong>Limitations: </strong>Findings are based on indirect comparisons across heterogeneous trials. Relative changes from dual therapy comparators were evaluated, and pharmacological and device-related differences between each triple therapy and the comparators may have influenced outcomes.</p><p><strong>Conclusions: </strong>Among the therapies evaluated, FF/VI/UMEC achieved the highest composite MCDA score. However, optimal COPD management requires personalized treatment to be prescribed based on factors such as exacerbation history, previous ICS use, inhaler preference and adherence. This may involve evaluating the use of an alternative triple therapy and emphasizes the importance of aligning the choice of triple therapy with the individual's clinical profile and treatment goals.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108292"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785158","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 (CF) and Modulators Based Therapy (CFTR) in oral and salivary perspectives: A single center cross-sectional study","authors":"Sz. Cofta ,&nbsp;E. Paszynska ,&nbsp;M. Roszak ,&nbsp;D.T. Kopycka-Kedzierawski ,&nbsp;J. Otulakowska-Skrzynska ,&nbsp;A. Hernik ,&nbsp;H. Winiarska ,&nbsp;D. Springer ,&nbsp;M. Rataj ,&nbsp;E. Wysocka ,&nbsp;M. Dworacka ,&nbsp;M. Suchodolski ,&nbsp;M. Dmitrzak-Weglarz","doi":"10.1016/j.rmed.2025.108390","DOIUrl":"10.1016/j.rmed.2025.108390","url":null,"abstract":"<div><h3>Objectives</h3><div>Recently introduced modulators-based therapy for cystic fibrosis (CF), provides new opportunity for better health outcomes and longer life. Single center cross-sectional aim of this study was to determine oral health status of adult CF patients, treated with CFTR modulators (CFTR-T), with no modulators (CFTR-0) in comparison to matched healthy individuals (Ctrl).</div></div><div><h3>Materials and methods</h3><div>Among 52 CF adult outpatients (male n = 24/female n = 28, 18-49y.) 34 were treated with triple-combination CFTR modulators (elexacaftor/tezacaftor/ivacaftor). Oral assessments included caries prevalence (Decayed, Missing, Filled teeth DMFT), dental hygiene (Plaque Control Record PCR), bleeding on probing (BOP), salivary mucins 5B/7, lysozyme, alpha-amylase (ELISA/PCR tests).</div></div><div><h3>Results</h3><div>There was statistically significant difference between CF and Ctrl groups in decayed teeth (respectively median (min-max) 1 (0–12) vs. 0 (0–3) p &lt; 0.001), PCR% (22.5 (0–100) vs. 10 (0–60) p &lt; 0.001), BOP% (0 (0–39) vs. 0 (0–30) p &lt; 0.006). Significantly higher concentrations of mucins 5b,7 and lysozyme (0.9 (0.3–20.9), 2.8 (0.9–12.8), 11.1 (5–31), all p &lt; 0.001). In CFTR-T subgroup significantly higher dental plaque (31.5 (1–100) vs. 10 (0–60), p &lt; 0.001) and lysozyme (8.8 (5–15.5), p &lt; 0.001). Noteworthy, CFTR-T recipients gained weight (p = 0.002).</div></div><div><h3>Conclusions</h3><div>Adult patients with CF showed higher susceptibility to dental caries, poorer oral hygiene and sustain proinflammatory status. However novel modulator therapy reduced the level of salivary mucins and enzymes.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108390"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213121","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 cancer treatment on physical functioning, symptoms and health-related quality of life in patients with non-small cell lung cancer: A longitudinal observational study.","authors":"Kirsten Quadflieg, Eva Arents, Sarah Haesevoets, Francesca Van Hulle, Fien Hermans, Maarten Criel, Marc Daenen, Eric Derom, Martijn A Spruit, Veerle Surmont, Dieter Stevens, David Ruttens, Heleen Demeyer, Chris Burtin","doi":"10.1016/j.rmed.2025.108283","DOIUrl":"10.1016/j.rmed.2025.108283","url":null,"abstract":"<p><strong>Background: </strong>Treatments for non-small cell lung cancer (NSCLC) may negatively affect health status. This study aimed to (i) quantify the impact of different treatments on physical functioning, symptoms, and health-related quality of life (HRQoL) in patients with NSCLC, and (ii) compare these with a one-time assessment in age- and sex-matched healthy individuals.</p><p><strong>Methods: </strong>A multicenter longitudinal observational study assessed patients at diagnosis and 12-15 weeks after treatment initiation. Healthy individuals underwent the same assessments, including peripheral and respiratory muscle strength, functional exercise capacity (6-min walk distance (6MWD), 1-min sit-to-stand (1MSTS)), objectively measured physical activity (PA), and patient-reported outcomes on symptoms and HRQoL.</p><p><strong>Results: </strong>Seventy-six patients (66 ± 9 years; 65 % male) and 46 healthy individuals (64 ± 10 years; 59 % male) were included. At diagnosis, patients scored significantly worse than healthy individuals across most outcomes. Twelve weeks, post-surgery (n = 41), patients showed significant worsening of 1MSTS (-2±4 reps, p = 0.03), 6MWD (-24 ± 59 m, p = 0.008), self-efficacy for PA, dyspnea, physical wellbeing, and lung cancer-specific symptoms (p < 0.05). Declines were more pronounced with (neo-)adjuvant therapy. Systemic chemotherapy (n = 16) worsened self-efficacy to perform PA (p = 0.03), while radiotherapy (n = 5) reduced self-reported PA (p < 0.05) and increased fatigue (p = 0.04), but improved mental wellbeing (p = 0.03). All treatment groups showed significantly lower PA post-treatment compared to healthy individuals.</p><p><strong>Conclusion: </strong>At diagnosis, patients with NSCLC had worse physical functioning, symptoms, and HRQoL than healthy individuals. Treatment for NSCLC further deteriorated these outcomes, with patients exhibiting significantly lower physical activity compared to healthy individuals. These findings highlight the need for implementation of rehabilitation programs in NSCLC care.</p><p><strong>Trial registration: </strong>registered on ClinicalTrials.gov (NCT02493114).</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108283"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768997","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":"Diagnostic performance and safety of endobronchial ultrasound-guided transbronchial cryobiopsies in the diagnosis of mediastinal lesions.","authors":"Sabina Perelló Roselló, Alberto Alonso-Fernández, Marcos Becerra Anieto, Ana Forteza Valades, Cristina Gómez Bellvert, Borja G Cosío, Belén Núñez Sánchez, Ruth Engonga, María Díaz Busto, Meritxell López, Jaume Sauleda Roig","doi":"10.1016/j.rmed.2025.108294","DOIUrl":"10.1016/j.rmed.2025.108294","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial cryobiopsy (Cryo-EBUS) is an emerging technique for diagnosing mediastinal lesions, offering larger and better-preserved tissue samples compared to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). However, its diagnostic performance, safety, and role in clinical practice remain under investigation.</p><p><strong>Methods: </strong>We conducted a prospective observational study including 100 consecutive patients with mediastinal/hilar lymphadenopathies or masses who underwent both Cryo-EBUS and EBUS-TBNA in the same procedure. The diagnostic yields, their ability to provide adequate tissue for molecular testing, safety outcomes, and the learning curve were analyzed.</p><p><strong>Results: </strong>Cryo-EBUS demonstrated a significantly higher diagnostic yield (80 %, 95 %CI:72-88 %) compared to EBUS-TBNA (72 %, 95 %CI:63-81 %), with a further increase when both techniques were combined, especially in cancer lesions (93.3 %, 95 %CI:87.6-99.1 %). The technique was particularly effective in PET-CT positive lesions. Additionally, Cryo-EBUS provided high-quality tissue samples, allowing biomarker analysis in 91 % of cases. A learning curve effect was observed, with diagnostic yield improving from 53 % in the first 15 cases to 84.7 % thereafter (p = 0.001). Cryo-EBUS had a favorable safety profile, with only three minor complications (pneumothorax and pneumomediastinum), all conservatively resolved.</p><p><strong>Conclusion: </strong>Cryo-EBUS is a safe and effective technique for mediastinal lesion diagnosis, particularly when combined with EBUS-TBNA. It enhances diagnostic accuracy, improves molecular testing capabilities, and remains minimally invasive. The integration of PET findings may further optimize its application. Standardized protocols are needed to refine its clinical use and establish its role in routine practice.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108294"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804667","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}