Respiratory medicine最新文献

{"title":"Efficacy and safety of mepolizumab for eosinophilic chronic obstructive pulmonary disease: A systematic review and meta-analysis","authors":"Milene Vitória Sampaio Sobral , Wellgner Fernandes Oliveira Amador , Altair Pereira de Melo Neto , Rafaela da Cunha Pirolla , Rodrigo Bettanim Menechini","doi":"10.1016/j.rmed.2025.108356","DOIUrl":"10.1016/j.rmed.2025.108356","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108356"},"PeriodicalIF":3.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213374","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":"Obstructive sleep apnea and associated mediators with left ventricular remodeling","authors":"Yingying Han ,&nbsp;Li Fu ,&nbsp;Xiaochen Jia ,&nbsp;Yan Wang ,&nbsp;Yanzhong Li ,&nbsp;Juanjuan Zou","doi":"10.1016/j.rmed.2025.108391","DOIUrl":"10.1016/j.rmed.2025.108391","url":null,"abstract":"<div><h3>Background</h3><div>The association between obstructive sleep apnea (OSA) and subclinical cardiac structural changes remains conflicted. This study aimed to investigate the link between OSA and left ventricular remodeling (LVR) and to explore the mediating roles of body mass index (BMI) and blood pressure.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 518 patients with OSA. Regression models were used to assess the independent association of OSA with left ventricular hypertrophy (LVH). Mediation analysis was employed to quantify the proportion of the effect mediated by BMI and systolic blood pressure (SBP).</div></div><div><h3>Results</h3><div>The prevalence of LVH was 12.36 %, and concentric remodeling was the most common geometric pattern (49.42 %). While oxygen desaturation parameters correlated with LVR indicators in univariate analysis, these associations were not independent in multivariate regression. Crucially, mediation analysis revealed that BMI and SBP accounted for 85.2 % and 24.5 % of the association between OSA severity (AHI) and LV mass, respectively.</div></div><div><h3>Conclusions</h3><div>OSA's impact on left ventricular remodeling is not independent but is predominantly mediated through BMI and, to a lesser extent, systemic blood pressure. Our findings underscore the critical importance of weight management and optimal blood pressure control in the future.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108391"},"PeriodicalIF":3.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213408","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":"Comparison of chronic bronchitis definitions in COPD for predicting 10-year all-cause mortality","authors":"Joon Young Choi ,&nbsp;Hyoung Kyu Yoon ,&nbsp;Youlim Kim ,&nbsp;Jong Geol Jang ,&nbsp;Jae Ha Lee ,&nbsp;Yong Bum Park ,&nbsp;Cheon Woong Choi ,&nbsp;Chang-Hoon Lee ,&nbsp;Kwang Ha Yoo ,&nbsp;Chin Kook Rhee","doi":"10.1016/j.rmed.2025.108389","DOIUrl":"10.1016/j.rmed.2025.108389","url":null,"abstract":"<div><h3>Background</h3><div>Chronic bronchitis (CB) is a common phenotype of chronic obstructive pulmonary disease (COPD) associated with poor outcomes. This study aimed to compare the predictive performance of a CB definition based on the COPD Assessment Test (CAT-CB) with that of the classic definition for 10-year all-cause mortality in patients with COPD.</div></div><div><h3>Methods</h3><div>We analyzed 3476 participants in a prospective, multicenter study, namely, the Korea COPD Subgroup Study (KOCOSS). CB was classified using both the classic ATS definition (cough + sputum ≥3 months per year for 2 consecutive years) and the CAT-CB definition (CAT item 1 [cough] &gt; 2 and item 2 [sputum] &gt; 2). CAT-CB was further stratified as mild (any item ≤3) or severe (both items &gt;3). Mortality data were ascertained from national death records; follow-up was truncated at 10 years. Cox proportional hazards models were used to evaluate mortality risk.</div></div><div><h3>Results</h3><div>At baseline, 354 patients (11.0 %) met the classic CB definition and 774 (22.6 %) met the CAT-CB definition. CAT-CB was independently associated with higher all-cause mortality, whereas classic CB was not. Mortality risk was confined to the severe CAT-CB subgroup, whereas patients with mild CAT-CB showed no significant excess risk. Individually, CAT-cough &gt;2 and CAT-sputum &gt;2 each predicted mortality; the classic subcomponents did not.</div></div><div><h3>Conclusions</h3><div>A CAT-based definition of CB better identifies COPD patients with increased risk of long-term mortality relative to the classic definition.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108389"},"PeriodicalIF":3.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207380","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":"Molecular diagnosis of respiratory viral infections in cystic fibrosis, sputum versus nasopharyngeal samples","authors":"Romain Legros ,&nbsp;Karl Stefic ,&nbsp;Sophie Ramel ,&nbsp;Charlotte Pronier ,&nbsp;Julia Dina ,&nbsp;Emilie Cardot-Martin ,&nbsp;Aurélie Schnuriger ,&nbsp;Catherine Gaudy-Graffin ,&nbsp;Rozenn Le Berre ,&nbsp;Hélène Revillet ,&nbsp;Geneviève Héry-Arnaud ,&nbsp;Sophie Vallet ,&nbsp;Mucovir study group","doi":"10.1016/j.rmed.2025.108374","DOIUrl":"10.1016/j.rmed.2025.108374","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory viral infections in people with Cystic Fibrosis (pwCF) significantly impact disease progression, and their molecular diagnosis should be part of the recommendations. Sputum, the routinely used specimen for bacterial culture, could also be used for viral molecular diagnosis, avoiding an additional invasive nasopharyngeal swab or aspirate. Our primary objective was to evaluate whether invasive nasopharyngeal samples (NP) and non-invasive sputum specimens are equally accurate for the diagnosis of viral infections in pwCF.</div></div><div><h3>Methods</h3><div>We conducted a prospective and multicentre study in 11 French CF centres. A total of 111 pwCF (children or adults, all able to expectorate) presenting with acute respiratory symptoms were included. Each provided paired NP and sputum, which were analysed using multiplex PCR panels detecting a broad spectrum of respiratory viruses, in addition to standard clinical evaluation and microbiological findings.</div></div><div><h3>Results</h3><div>Among 111 paired samples, 69 NP and 64 sputa tested positive for ≥1 virus, with 94 pairs yielding concordant results (58 both positive, 36 both negative). Overall NP–sputum agreement was substantial (Cohen's κ = 0.68 [0.60; 0.75]), and even higher for the most prevalent viruses (enterovirus/rhinovirus, κ = 0.74 [0.65; 0.80] and influenza viruses, κ = 0.95 [0.87; 0.97]). The detection of a virus in one or both specimens was independent of the presence of a bacterial pathogen in sputum culture.</div></div><div><h3>Conclusion</h3><div>These results confirmed the suitability of sputum sampling as an alternative to NP sampling for the diagnosis of viral respiratory infection in pwCF, ensuring patients’ comfort.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108374"},"PeriodicalIF":3.1,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192527","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":"Development of a questionnaire on supportive care needs of patients with COPD combined with respiratory failure on noninvasive ventilators and evaluating its reliability and validity","authors":"HengXu Wang ,&nbsp;Min Fan ,&nbsp;JunQi Wu ,&nbsp;HongMei Liu","doi":"10.1016/j.rmed.2025.108384","DOIUrl":"10.1016/j.rmed.2025.108384","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a supportive care needs questionnaire for patients with COPD and respiratory failure who are on a noninvasive ventilator, and to test its reliability and validity.</div></div><div><h3>Methods</h3><div>The questionnaire was based on the short form of the Supportive Care Needs Scale. Its dimensions and items were formulated through literature analysis, semi-structured interviews, the Delphi method, and group discussions, resulting in the initial draft. The reliability and validity of the questionnaire were then evaluated.</div></div><div><h3>Results</h3><div>The authority coefficients from two rounds of expert consultation were 0.875 and 0.888, with entry variation coefficients ranging from 0.05 to 0.42 and 0.05–0.21. Kendall's W-values were 0.551 and 0.487 (P &lt; 0.05). Exploratory factor analysis identified five factors with 32 items, explaining 82.523 % of the variance. The content validity index S-CVI/Ave was 0.92, while S-CVI was 0.91. The total Cronbach's alpha coefficient was 0.982, with individual dimensions ranging from 0.924 to 0.976, and a test-retest reliability coefficient of 0.912.</div></div><div><h3>Conclusion</h3><div>The developed questionnaire for assessing supportive care needs in COPD patients with respiratory failure using noninvasive ventilation demonstrates good reliability and validity, making it a suitable assessment tool.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108384"},"PeriodicalIF":3.1,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192559","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":"Effect of EBUS timing on delays and survival in non-small cell lung cancer","authors":"José A. Gullón,&nbsp;Lucía Gimeno,&nbsp;Macarena Corrales,&nbsp;Manuel A. Villanueva,&nbsp;Juan Rodríguez,&nbsp;Manuel Ricardo Rodríguez-Seoane,&nbsp;Jesús Allende","doi":"10.1016/j.rmed.2025.108387","DOIUrl":"10.1016/j.rmed.2025.108387","url":null,"abstract":"<div><div>Our aim was to analyse whether the timing of endobronchial ultrasound (EBUS) influenced delay times and survival in patients with non-small cell lung cancer (NSCLC).</div></div><div><h3>Patients and methods</h3><div>We included all patients diagnosed with NSCLC, prospectively collected in an anonymized database, who underwent EBUS and Positron Emission Tomography (PET). Patients were categorized as EBUSpre (EBUS before PET) or EBUSpost (EBUS after PET). Delay time (DT) was defined as the interval from first contact with specialized healthcare to therapeutic decision. Survival was estimated with Kaplan–Meier curves, and factors associated with delay and survival were identified through logistic regression and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>190 patients were included, 66 EBUSpre (TNM stage by CT: 48 I-IIIA, 14 III-B, 4 III-C), six of whom (9.2 %) were classified as stage IV by PET. The mean DT was 61.8 ± 31.8 days, significantly shorter in EBUSpre than in EBUSpost (53.5 ± 27.0 vs. 66.9 ± 33.5 days; p = 0.01). In multivariate analysis, EBUSpre remained independently associated with shorter delays [OR = 0.43; 95 % CI 0.23–0.81; p = 0.009], while outpatient setting was linked to longer delays [OR = 2.45; 95 % CI 1.17–5.11; p = 0.004]. Overall median survival was 90 weeks, with no difference between groups, except in stage IIIA patients, where survival was significantly longer in EBUSpre (124 vs 90 weeks; p = 0.04). In Cox regression, both EBUS timing and treatment were independently associated with survival.</div></div><div><h3>Conclusion</h3><div>In NSCLC, performing EBUS early—without awaiting PET—significantly reduces delays and may improve survival in stage IIIA.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108387"},"PeriodicalIF":3.1,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192495","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":"Clinical characteristics and outcomes of patients undergoing palliative extubation","authors":"James S. Krinsley,&nbsp;Katherine H. Walker,&nbsp;Lilian Zerihun,&nbsp;Farwa Ilyas,&nbsp;Ayara Ehinmisan,&nbsp;Melis Ketenci,&nbsp;Jean-Charles Preiser","doi":"10.1016/j.rmed.2025.108385","DOIUrl":"10.1016/j.rmed.2025.108385","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize clinical features and outcomes of patients undergoing palliative extubation (PalExt) from mechanical ventilation (MV) and to compare these to those patients who died during MV (DMV).</div></div><div><h3>Methods</h3><div>This is a single-center study including all patients undergoing MV in the Stamford Hospital ICU between 4/1/16 and 3/14/2020 and 10/1/2021 and 3/31/23, excluding those admitted during the first and second waves of Covid-19. Data were abstracted from the intensive care unit's (ICU) databases and the hospital's electronic medical record.</div></div><div><h3>Results</h3><div>A total of 1911 patients underwent MV during the study period, including 226 PalExt and 177 DMV. Compared to DMV, PalExt were older, less likely to be functionally independent and more likely to be admitted with a cardiac or neurologic diagnosis. 84.5 % of PalExt were admitted to the ICU with “full code” resuscitation status and the median time to comfort care orders was 2 days. 77.0 % died in the ICU and 98.7 % died before hospital discharge. The median duration from PalExt to death in the ICU was 118 min. Patients receiving consultations from the Palliative Care service had significantly longer ICU length of stay and days of MV.</div></div><div><h3>Conclusions</h3><div>This investigation documents significant differences between patients undergoing PalExt and those who die while undergoing MV.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108385"},"PeriodicalIF":3.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186569","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":"Different respiratory exercise devices on postoperative outcomes in elderly lung lobectomy patients: A retrospective study","authors":"Ayşe Gökce Işıklı ,&nbsp;Zeynep Kızılcık Özkan","doi":"10.1016/j.rmed.2025.108386","DOIUrl":"10.1016/j.rmed.2025.108386","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this study was to determine the effect of preoperative use of different respiratory exercise devices on postoperative outcomes in elderly lung lobectomy patients.</div></div><div><h3>Methods</h3><div>This study was retrospectively conducted between 03.12.2024 and 5.02.2025 in the Thoracic Surgery Clinic of a university with 82 patients using 41 Triflow and 41 Acapella. The information obtained from the online files of the patients was entered into the SPSS program using the Patient Introduction Form and Patient Follow-up Form. Descriptive analyses, independent sample t-tests, Mann-Whitney U tests, and chi-square tests were used to evaluate the data.</div></div><div><h3>Results</h3><div>In the study, the postoperative hospitalisation time of the acapella group was higher than that of the triflow group, and this difference was statistically significant (p: 0.042). In addition, the saturation value on the 3rd postoperative day (p:0.023) was significantly higher in the triflow group than in the acapella group. On postoperative days 4 and 7, the pain score (p:0.012) was significantly lower in the Triflow group than in the Acapella group.</div></div><div><h3>Conclusion</h3><div>In the study, it was determined that the hospitalisation period was shorter, the saturation value was higher on the 3rd postoperative day, and the pain score was lower on the 4th and 7th postoperative days in the Triflow group compared to the Acapella group as a respiratory exercise device in elderly patients with lung lobectomy.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108386"},"PeriodicalIF":3.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186689","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":"EzPAP therapy versus non-invasive ventilation for hypercapnic chronic obstructive pulmonary disease exacerbation: a randomized clinical trial","authors":"Gökhan Karakurt ,&nbsp;Merve Demireller ,&nbsp;Hikmet Uçgun ,&nbsp;Oya Güven ,&nbsp;Lale Tuna ,&nbsp;Bedriye Feyza Kurt ,&nbsp;Hakan Selçuk","doi":"10.1016/j.rmed.2025.108383","DOIUrl":"10.1016/j.rmed.2025.108383","url":null,"abstract":"<div><h3>Purpose</h3><div>EzPAP positive airway pressure (EzPAP) is an innovative device that enhances positive end-expiratory pressure (PEEP) while improving oxygenation. Our study was conducted to assess the efficacy of EzPAP treatment in the management of mild to moderate hypercapnic exacerbations of chronic obstructive pulmonary disease (COPD)</div></div><div><h3>Material and methods</h3><div>In this prospective controlled study, participants admitted to the emergency department between December 2022 and July 2024 with a diagnosis of hypercapnic COPD exacerbation who were treated with EzPAP or noninvasive ventilation (NIV) were examined. All participants were followed up for 24 h, and blood gas parameters were compared before and after treatment.</div></div><div><h3>Results</h3><div>39 out of 95 patients were enrolled in the study. 19 participants received EzPAP, and 20 participants received NIV treatment. In both groups, SaO₂ and pH values increased significantly at 24 h compared to baseline (p &lt; 0.05). The increase in pH value was significantly higher in the EzPAP group compared to the NIV group (p = 0.003). Only in the EzPAP group did the pH value increase significantly at 1 and 4 h compared to baseline (p &lt; 0.05). Only in the EzPAP group, PaO₂ value increased significantly compared to the baseline level at 24 h (p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>In our study, we found that EzPAP significantly improved oxygen saturation and alleviated respiratory acidosis more rapidly than NIV in participants with mild to moderate hypercapnic COPD exacerbations. Given these results, EzPAP presents itself as a compelling alternative worth considering.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108383"},"PeriodicalIF":3.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186717","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":"Predicting response to inhaled corticosteroid maintenance therapy in patients with chronic obstructive pulmonary disease using machine learning models","authors":"Shan-Chieh Wu ,&nbsp;Chih-Ying Wu ,&nbsp;Jung-Yien Chien ,&nbsp;Yaa-Hui Dong ,&nbsp;Fang-Ju Lin","doi":"10.1016/j.rmed.2025.108378","DOIUrl":"10.1016/j.rmed.2025.108378","url":null,"abstract":"<div><h3>Background</h3><div>Blood eosinophil count and exacerbation history are established predictors of inhaled corticosteroid (ICS) effectiveness in chronic obstructive pulmonary disease (COPD). However, treatment responsiveness is heterogeneous and influenced by additional clinical characteristics. This study aimed to develop a machine learning-based prediction model to identify predictors of response to ICS in COPD patients.</div></div><div><h3>Methods</h3><div>Using a nationwide administrative database linked with individual laboratory results, we identified COPD patients initiating ICS between 2015 and 2019. Patients were stratified into low- and high-exacerbation-risk groups based on prior exacerbation frequency. Prediction models for favorable ICS response were developed using logistic regression, lasso regression, and extreme gradient boosting (XGBoost). Model performance was assessed by receiver operating characteristic (ROC) curves and calibration plots. Key predictors were identified using Shapley Additive exPlanations.</div></div><div><h3>Results</h3><div>Among 23,587 ICS-naïve patients, favorable ICS response rates were 73.7 % in the low-risk group and 59.1 % in the high-risk group. XGBoost model outperformed other models in discriminative ability, achieving an area under the ROC curve of 0.72 (95 % CI, 0.70–0.74) for the low-risk group and 0.67 (95 % CI, 0.64–0.70) for the high-risk group in the validation dataset. Younger age, male sex, comorbid asthma, and lower prior use of COPD-related medications were significant predictors of ICS response. The relationship between prior exacerbations on ICS response varied between risk groups. Elevated blood eosinophil levels demonstrated relatively limited predictive ability.</div></div><div><h3>Conclusions</h3><div>Machine learning identified potential predictors of ICS response in COPD patients, which may inform future efforts to enhance personalized treatment strategies based on risk profile.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108378"},"PeriodicalIF":3.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182261","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}