Respiratory medicine最新文献

{"title":"Perceived cognitive impairment in patients newly diagnosed with lung cancer: a cross-sectional study","authors":"Xiu-zhi Xu ,&nbsp;Xi Chen ,&nbsp;Rong Zheng ,&nbsp;Guo-hong Huang ,&nbsp;Zhu-zhu Wang ,&nbsp;Xiao-qing Lv ,&nbsp;Min Huang ,&nbsp;Jing-fang Hong","doi":"10.1016/j.rmed.2026.108699","DOIUrl":"10.1016/j.rmed.2026.108699","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to identify perceived cognitive impairment and its associated factors in patients newly diagnosed with lung cancer.</div></div><div><h3>Methods</h3><div>This cross-sectional analysis utilized pretreatment data sourced from an ongoing multicenter longitudinal investigation (registration: ChiCTR2300076232). A total of 340 participants were enrolled between September 2023 and March 2024 from two public hospitals in Anhui Province, China. The well-validated Chinese version of the FACT-Cog was used to collect the information of perceived cognitive function. Data on sociodemographic and clinical characteristics, as well as cancer-related symptoms were obtained through structured questionnaires and medical records.</div></div><div><h3>Results</h3><div>170 Patients newly diagnosed with lung cancer and 170 non-cancer controls matched in age and gender. Patients scored significantly lower on the FACT-Cog and four subscales than controls (all <em>P</em> &lt; 0.05). The prevalence of perceived cognitive impairment in patients was 15.3%, which was significantly higher than 6.5% in controls (<em>P</em> = 0.009). Multivariate regression analysis revealed that fatigue [(95% CI: −2.527 ∼ −1.701); <em>P</em> &lt; 0.001], gender [(95% CI: −15.722 ∼ −4.670); <em>P</em> &lt; 0.001], age [(95% CI: −0.711 ∼ −0.082); <em>P</em> = 0.014] and depression [(95% CI: 0.222 ∼ 1.963); <em>P</em> = 0.014] emerged as significant predictors of perceived cognitive impairment, explaining 54.5% of the total variance (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Patients newly diagnosed with lung cancer exhibited a significant decrement in cognitive function compared to controls. Healthcare professionals ought to provide prompt attention and implement early rehabilitative interventions to prevent further cognitive decline subsequent to the initiation of systemic treatment.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108699"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The C-Reactive Protein-Albumin-Lymphocyte (CALLY) index and all-cause mortality in adults with Asthma: A cohort study using NHANES 1999–2010","authors":"Wen Luo ,&nbsp;Zhenzhen Yu ,&nbsp;Yongcai Zhang ,&nbsp;Dingnan Lin ,&nbsp;Wanyu Wang ,&nbsp;Chen Wang","doi":"10.1016/j.rmed.2026.108706","DOIUrl":"10.1016/j.rmed.2026.108706","url":null,"abstract":"<div><h3>Background</h3><div>Systemic inflammation, nutritional depletion, and immune dysregulation are common in asthma, yet no composite indicator has been prospectively linked to long-term survival; accordingly, the association between the C-Reactive Protein-Albumin-Lymphocyte (CALLY) index and all-cause mortality in U.S. adults with asthma was examined.</div></div><div><h3>Methods</h3><div>We analyzed 3887 asthma participants aged ≥18 years from the National Health and Nutrition Examination Survey (NHANES) 1999–2010, linked to the National Death Index (NDI) through December 2019. Cox regression estimated hazard ratios (HR) per CALLY quartile and per one-unit increase in In-transformed CALLY, adjusting for sociodemographic, lifestyle and comorbidity covariates. Non-linearity was assessed with restricted cubic splines; subgroup analyses tested effect consistency.</div></div><div><h3>Results</h3><div>During a median 157 months, 729 deaths occurred (18.8% mortality). Higher CALLY was associated with younger age, lower BMI and fewer comorbidities. After full adjustment, each unit increase in CALLY conferred a 19% lower mortality risk (HR 0.81, 95 % CI 0.76–0.86). The dose-response gradient remained linear across the entire distribution, and the inverse association was consistently observed across all predefined strata.</div></div><div><h3>Conclusion</h3><div>In this cohort, a higher CALLY index was independently associated with lower all-cause mortality among adults with asthma; prospective studies are warranted to confirm this association.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108706"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137807","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":"Amikacin exposure and its association with ototoxicity and efficacy in nontuberculous mycobacterial pulmonary disease treatment","authors":"Fumiya Watanabe ,&nbsp;Tatsuya Kodama ,&nbsp;Masashi Ito ,&nbsp;Koji Furuuchi ,&nbsp;Keiji Fujiwara ,&nbsp;Keisuke Kamada ,&nbsp;Takashi Ohe ,&nbsp;Eriko Hachikawa ,&nbsp;Kazuhiko Hanada ,&nbsp;Kozo Morimoto","doi":"10.1016/j.rmed.2026.108708","DOIUrl":"10.1016/j.rmed.2026.108708","url":null,"abstract":"<div><h3>Purpose</h3><div>Amikacin (AMK) is a widely used therapeutic drug monitoring (TDM)-recommended treatment for nontuberculous mycobacterial pulmonary disease (NTM-PD). However, its optimal dosage and TDM target remain unclear. In this study, we aimed to clarify the relationship between AMK exposure, ototoxicity, and efficacy.</div></div><div><h3>Methods</h3><div>Patients with NTM-PD treated with AMK at Fukujuji Hospital were retrospectively included in this study. The correlation between AMK exposure, measured by peak and trough levels and the area under the concentration-time curve (AUC), ototoxicity, and culture conversion was analyzed using the Mann–Whitney <em>U</em> test and Cox regression analysis. A population pharmacokinetic/pharmacodynamic (PPK/PD) model was developed to predict ototoxicity using TDM measurements.</div></div><div><h3>Results</h3><div>A total of 185 patients were enrolled. The median AMK dose and observation period were 500 (interquartile range [IQR], 500–600) mg/day and 45.8 (IQR, 31.3–76.5) months, respectively. Ototoxicity and culture conversion were observed in 39% and 54% of the enrolled patients, respectively, after initiating AMK. The median time to the development of ototoxicity was 69 (IQR; 43–97) days. Neither ototoxicity nor culture conversion was associated with pharmacokinetic parameter of AMK exposure, including its minimum inhibitory concentration. However, the cumulative AUC was significantly higher in patients who developed ototoxicity (<em>P</em> &lt; 0.001) than in those without ototoxicity. The developed PPK/PD model enabled calculation of cumulative AUC from TDM data and prediction of ototoxicity onset.</div></div><div><h3>Conclusion</h3><div>Cumulative AMK exposure was associated with ototoxicity, and our findings allow prediction of ototoxicity onset using AMK TDM data.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108708"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143329","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":"Optimizing adherence to inhaled therapy in asthma: Behavioral and digital strategies with insights from the Greek healthcare context","authors":"Christelos Kapatais ,&nbsp;Andriana I. Papaioannou ,&nbsp;Evangelia Fouka ,&nbsp;Konstantinos Samitas ,&nbsp;Stavros Tryfon ,&nbsp;Konstantinos Porpodis ,&nbsp;Katerina M. Antoniou ,&nbsp;Eleftherios Zervas ,&nbsp;Petros Bakakos ,&nbsp;Stylianos Loukides ,&nbsp;Nikoletta Rovina","doi":"10.1016/j.rmed.2026.108709","DOIUrl":"10.1016/j.rmed.2026.108709","url":null,"abstract":"<div><div>Adherence to inhaled therapy remains a persistent challenge in asthma management and continues to compromise disease control in routine clinical practice. Although data from Greece are limited, international evidence indicates that a substantial proportion of patients do not use their inhalers consistently or as prescribed. Suboptimal adherence is associated with avoidable exacerbations, loss of lung function, increased healthcare utilization, and inappropriate escalation of therapy, including early introduction of biologic agents. This narrative review examines recent evidence on behavioral, treatment-related, and healthcare-system factors influencing adherence to inhaled therapy in asthma, with particular attention to the Greek healthcare environment. Findings from clinical trials, meta-analyses, and real-world studies published between 2018 and 2025 are synthesized to identify determinants of adherence, methods of assessment, and strategies that support sustained treatment engagement. Across studies, adherence rates typically range between 30% and 60%, with major barriers including limited understanding of asthma as a chronic condition, concerns about inhaled corticosteroids, complex dosing regimens, and persistent inhaler technique errors. These challenges are often compounded by system-level constraints such as brief consultations and fragmented follow-up. Simplified treatment strategies, particularly once-daily inhaled corticosteroid/long-acting β₂-agonist regimens and single maintenance and reliever therapy approaches, are consistently associated with more regular medication use. Pharmacist-led interventions improve inhaler technique and daily adherence, while digital inhaler technologies support early identification of non-adherence, although their implementation in Greece remains limited. Improving adherence requires coordinated, patient-centered care that integrates behavioral support, appropriate inhaler selection, simplified regimens, and targeted use of digital monitoring within existing healthcare pathways.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108709"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181953","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 between Epworth Sleepiness Scores and CPAP compliance in patients with obstructive sleep apnea","authors":"Ziad T. Baki ,&nbsp;Mustafa A. Alameri ,&nbsp;Sushil K. Singhi","doi":"10.1016/j.rmed.2026.108673","DOIUrl":"10.1016/j.rmed.2026.108673","url":null,"abstract":"<div><h3>Purpose</h3><div>Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for obstructive sleep apnea, but adherence remains suboptimal. Subjective symptoms such as excessive daytime sleepiness may influence motivation to maintain therapy. This study examined whether baseline Epworth Sleepiness Scale (ESS) scores predict early CPAP adherence compared with objective measures such as the Apnea-Hypopnea Index (AHI).</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study of 400 adults with Obstructive Sleep Apnea prescribed CPAP between 2021 and 2023. Thirty days of CPAP adherence data was downloaded and categorized into five ordinal groups ranging from very low to very high adherence. Associations between ESS and adherence were assessed using chi-square tests, Goodman and Kruskal's gamma, and ordinal logistic regression adjusted for AHI, age, sex, and body mass index.</div></div><div><h3>Results</h3><div>Higher ESS scores were significantly associated with greater adherence (χ² = 28.7, P = 0.026; gamma = 0.199). Ordinal regression showed each 1-point increase predicted 7.4% higher odds of being in a greater adherence category (OR 1.072, 95% CI 1.027–1.117, P &lt; 0.001). Age modestly predicted adherence (OR 1.010, P = 0.019). AHI, body mass index, and sex were not significant predictors. Patients with severe daytime sleepiness had the highest rates of excellent adherence (&gt;90%).</div></div><div><h3>Conclusion</h3><div>Although causality cannot be inferred from a retrospective design, higher subjective sleepiness, measured by ESS, was associated with higher early adherence. Incorporating ESS into routine evaluation may identify patients at risk for nonadherence and guide targeted interventions.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108673"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100446","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":"Side versus adverse effects of elexacaftor/tezacaftor/ivacaftor therapy in people with CF","authors":"J.B.A. Gorgels,&nbsp;J. Koopman,&nbsp;E.C. van der Hout,&nbsp;R.W. Hofland,&nbsp;H.G.M. Heijerman,&nbsp;I. Bronsveld","doi":"10.1016/j.rmed.2026.108697","DOIUrl":"10.1016/j.rmed.2026.108697","url":null,"abstract":"<div><h3>Background</h3><div>Elexacaftor/Tezacaftor/Ivacaftor (ETI) therapy is highly effective for people with cystic fibrosis (pwCF) carrying at least one <em>F508del</em> mutation. However, clinical trials often include a limited subset of eligible patients, with inclusion rates as low as 31%. Additionally, some adverse effects linked to ETI may stem from restored CFTR function (side effects) rather than drug toxicity (adverse effects). This study evaluates the real-world efficacy and tolerability of ETI in adults with CF, while differentiating side from adverse effects.</div></div><div><h3>Methods</h3><div>In this retrospective single-centre cohort study, 198 adults with CF (46.5% female) initiating ETI between January 2022 and April 2023 were analysed. Clinical data, laboratory results, and adverse events were collected. Subgroup-analyses were performed based on baseline ppFEV1 and genotype.</div></div><div><h3>Results</h3><div>ETI therapy increased mean ppFEV1 by 11.2% (95% CI: 9.7%, 12.7%) and BMI by 0.7 kg/m² (95% CI: 0.5, 0.9), decreased sweat chloride by 43.7 mmol/L (95% CI: 46.7, −40.6), and reduced yearly exacerbation rate (70 vs. 12, p &lt; 0.001). Common side effects included increased sputum, cough, and headache. Headache was more frequent in patients with ppFEV1 &lt;40% (p &lt; 0.001). Increased sputum and cough were most prevalent in F/F and F/MF subgroups. Frequent adverse effects were fatigue, depressed state, and mood swings. Side effects resolved spontaneously more often than adverse effects (89.3% vs. 47.9%).</div></div><div><h3>Conclusion</h3><div>ETI demonstrates robust real-world efficacy in adults with CF. Side effects due to CFTR restoration are generally self-limiting, whereas adverse effects from drug toxicity persist longer and are more frequently cause for permanent discontinuation of ETI.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108697"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132673","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":"Severity and phenotype of sleep-disordered breathing in Prader-Willi syndrome compared to obstructive sleep apnea syndrome in children","authors":"Xueyun Xu ,&nbsp;Yanyu He ,&nbsp;Meng Lv ,&nbsp;Jiapeng Ji ,&nbsp;Bolin Chen ,&nbsp;Zhiqing Liu ,&nbsp;Jun Han ,&nbsp;Qianqian Tong ,&nbsp;Rongrong Xie ,&nbsp;Yuqing Wang","doi":"10.1016/j.rmed.2026.108694","DOIUrl":"10.1016/j.rmed.2026.108694","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disordered breathing (SDB) is prevalent in individuals with Prader-Willi syndrome (PWS). However, its clinical characteristics, risk factors, and impact on sleep architecture remain incompletely understood. This retrospective case-control study aims to <em>characterize respiratory events in PWS; asses body mass index (BMI)-SDB severity association; and quantify sleep architectural changes to inform PWS screening and management</em>.</div></div><div><h3>Methods</h3><div>Children with PWS who underwent PSG in the Department of Respiratory Medicine, Children's Hospital of Soochow University from December 2020 to January 2025 were enrolled in this study. Age- and gender-matched control subjects of children diagnosed with obstructive sleep apnea-hypopnea syndrome (OSAS) without underlying comorbidities, evaluated using identical PSG equipment. SPSS30.0 was used to perform 1:2 matching according to age and gender. The clinical characteristics and PSG results were compared between groups. Correlations between BMI, adenoid/tonsil hypertrophy and the severity of SDB were analyzed.</div></div><div><h3>Results</h3><div>19 children with PWS underwent sleep monitoring, of whom 16 completed PSG. The PWS cohort (n = 16) included 9 males (56.3 %) and 7 females (43.8 %), ranging in age from 3.4 to 14.7 years (mean age: 8.4 ± 3.5 years), with a median BMI of 24.5 kg/m² (IQR: 21.6–35.1). All 16 PWS children were diagnosed with OSAS, 75 % presenting moderate-to-severe OSAS (P &lt; 0.001). Compared with the OSAS control group, the PWS group exhibited significantly higher BMI values (P &lt; 0.001),fewer awakenings (P = 0.007) and a reduced proportion of NREM3 sleep (P = 0.040). While OSA predominates in the SDB spectrum of PWS, central sleep apnea (CSA), mixed apnea, and hypoventilation events were also observed, with all respiratory event indices significantly higher in PWS than controls (all P &lt; 0.05). PWS children demonstrated significantly lower mean oxygen saturation and lowest oxygen saturation (LSaO₂) (all P &lt; 0.001), as well as higher oxygen desaturation index (ODI) and obstructive apnea-hypopnea index (OAHI) (all P &lt; 0.005). BMI was positively correlated with obstructive apnea‐hypopnea index (OAHI) (r = 0.558, P = 0.025) and Hypopnea index (HI) (r = 0.639, P = 0.008), and negatively correlated with LSaO2 (r = −0.551, P = 0.027).</div></div><div><h3>Conclusion</h3><div>PWS children exhibit a diverse spectrum of SDB, with OSA as the dominant respiratory event type with abnormal arousal responses to respiratory events<strong>.</strong> The severity of SDB in PWS is strongly related to BMI. These findings highlight the critical role of obesity in exacerbating respiratory compromise and emphasize the necessity of routine PSG screening and targeted BMI management in PWS care.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108694"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090294","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":"Ultra-short term Heart Rate Variability in moderate and severe Obstructive Sleep Apnea","authors":"Karthik Nagaraju ,&nbsp;Kavitha Venkatnarayan ,&nbsp;Rahul Venugopal ,&nbsp;Ravindra P. Nagendra ,&nbsp;Chitra Veluthat ,&nbsp;Priya Ramachandran ,&nbsp;Uma Devaraj ,&nbsp;Uma Maheswari Krishnaswamy","doi":"10.1016/j.rmed.2026.108654","DOIUrl":"10.1016/j.rmed.2026.108654","url":null,"abstract":"<div><h3>Introduction</h3><div>Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia and recurrent arousals, leading to sympathetic overactivity and adverse cardiometabolic consequences. Heart rate variability (HRV), which reflects beat-to-beat fluctuations in heart rate, serves as a non-invasive marker of cardiac autonomic regulation. Although reduced long-term HRV has been described in OSA, literature on short- and ultra-short-term HRV (uST-HRV) is sparse.</div></div><div><h3>Methodology</h3><div>In this cross-sectional study, adults with moderate and severe OSA were included. Stable, artifact-free 30-s electrocardiographic segments were extracted using a dedicated algorithm during rapid eye movement (REM) and non-REM (NREM) sleep, as well as during respiratory events (apneas and hypopneas). These segments were assessed for ultra-short term HRV comprising time domain and nonlinear indices.</div></div><div><h3>Results</h3><div>A total of 88 patients (44 moderate and 44 severe OSA) were studied. The mean (SD) age was 49.7 (14) years, with a male predominance (64.7 %). Mean (SD) AHI was 16.8 (4.3) in moderate and 61.5 (23.1) in severe OSA respectively. HRV indices were significantly lower in female participants and among diabetics and hypertensives compared to their non-diabetic and non-hypertensive counterparts. Time-domain and non-linear HRV indices were also lower in severe OSA, NREM sleep and during hypopneic events compared to moderate OSA, REM sleep and apneic events respectively.</div></div><div><h3>Conclusions</h3><div>Ultra-short-term HRV varies with OSA severity, sleep stage, and type of respiratory event, with reduced HRV observed in severe OSA, NREM sleep, and during hypopneic events. The exclusion of mild OSA and the focus on 30-s respiratory events limit the generalisability of these findings.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108654"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The EUFOREA pocket guide on paediatric asthma: A step forward in patient care","authors":"Milos Jesenak ,&nbsp;Zuzana Diamant ,&nbsp;Diego Conti ,&nbsp;Dario Antolin-Amerigo ,&nbsp;Vibeke Backer ,&nbsp;Leif Bjermer ,&nbsp;Wojciech Feleszko ,&nbsp;Peter Hellings ,&nbsp;Outi Jauhola ,&nbsp;Katerina Khaleva ,&nbsp;Mika Mäkela ,&nbsp;Nikolaos Papadopoulos ,&nbsp;Helena Pite ,&nbsp;Petr Pohunek ,&nbsp;Santiago Quirce ,&nbsp;Zuzana Rennerova ,&nbsp;Glenis Scadding ,&nbsp;Boony Thio ,&nbsp;Susanne Lau","doi":"10.1016/j.rmed.2025.108631","DOIUrl":"10.1016/j.rmed.2025.108631","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108631"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934703","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":"Risk factors of sepsis-associated encephalopathy in sepsis patients with pulmonary infection: from the secondary analysis of a cluster‐randomized controlled trial","authors":"Lijun Meng ,&nbsp;Jialing Liu ,&nbsp;Panpan Wang ,&nbsp;Ling Yin ,&nbsp;Xingjie Ma ,&nbsp;Xingxing Yang ,&nbsp;Yucheng Li ,&nbsp;Kaizheng Gong ,&nbsp;Weili Liu","doi":"10.1016/j.rmed.2026.108658","DOIUrl":"10.1016/j.rmed.2026.108658","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The risk factors for sepsis-associated encephalopathy (SAE) secondary to pulmonary infection remain unclear. This study aimed to determine the prevalence and identify the risk factors of SAE in this specific sepsis population.</div></div><div><h3>Methods</h3><div>In this secondary analysis of the cluster-randomized controlled trial. We screened 603 sepsis patients with pulmonary infection. Least absolute shrinkage and selection operator (LASSO) regression was used for potential variables selection. Selected variables were then included in a multivariable logistic regression model to identify the potential independent risk factors for SAE. Cox proportional hazard models were used to assess its impact on 28‐day mortality.</div></div><div><h3>Results</h3><div>A total of 603 sepsis patients with pulmonary infection at ICU admission, of whom 411 (68 %) had SAE, were included in this study. LASSO regression identified 19 potential variables, and the following factors remained independently associated with SAE: <strong>acute gastrointestinal injury (AGI)-II</strong> (OR = 1.86, 95 % CI: 1.18–2.98, <em>P</em> = 0.008)<strong>, elevated serum lactate</strong> (OR = 1.25, 95 % CI: 1.10–1.44, <em>P</em> = 0.001)<strong>, hypernatremia</strong> (OR = 1.93, 95 % CI: 1.07–3.62, <em>P</em> = 0.034), and BUN (OR = 1.03, 95 %CI:1.0–1.05, <em>P</em> = 0.025). SAE was associated with higher mortality, with an adjusted HR of 1.61 (95 % CI: 1.04–2.47, <em>P</em> = 0.031).</div></div><div><h3>Conclusion</h3><div>These findings indicate that SAE is closely associated with prognosis in sepsis induced by pulmonary infection. The primary independent risk factors identified were acute gastrointestinal injury (AGI) severity, elevated serum lactate, hypernatremia, and increased blood urea nitrogen (BUN).</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108658"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023212","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}