Respiratory medicine最新文献

{"title":"Cone beam CT with integration improves diagnostic yield of bronchoscopic peripheral pulmonary lesion biopsies","authors":"Bryan S. Benn ,&nbsp;James Dugan ,&nbsp;Christian F. Cuvillier Padilla ,&nbsp;Yifan Wang ,&nbsp;Xiaofeng Wang ,&nbsp;See-Wei Low","doi":"10.1016/j.rmed.2026.108666","DOIUrl":"10.1016/j.rmed.2026.108666","url":null,"abstract":"<div><h3>Background</h3><div>Robotic bronchoscopy has improved the ability to biopsy peripheral pulmonary lesions (PPL). Intra-procedure PPL, biopsy tool, and catheter visualization represents another means towards refining procedural outcomes. Recently, the ability to integrate this information in real-time became available through 3D mobile cone beam CT (CBCT) imaging. We analyzed the impact of imaging integration on diagnostic yield of shape sensing robotic assisted bronchoscopy (ssRAB) biopsies compared to procedures done without integration.</div></div><div><h3>Methods</h3><div>Patients undergoing ssRAB (Ion Endoluminal System) with 2D fluoroscopy (03/2023–03/2024) and with 3D CBCT with integration (Cios system) (04/2024–01/2025) were retrospectively identified. The primary outcome was diagnostic yield. Secondary outcomes included diagnostic accuracy and procedural complications.</div></div><div><h3>Results</h3><div>71 PPLs (67 patients) underwent ssRAB without integration and 102 PPLs (95 patients) were biopsied with integration. While demographics were similar, PPLs in the integration group were smaller (2.11 ± 1.26 cm vs 2.46 ± 1.19 cm, p = 0.010) and more frequently located in the peripheral lung third (n = 82 (80.4 %) vs n = 41 (57.7 %), p = 0.003).</div><div>Diagnostic yield without integration was 72 % (51/71) and with integration was 86 % (88/102) (p = 0.019). Diagnostic accuracy without integration was 78 % (55/71) and with integration was 89 % (91/102) (p = 0.036).</div><div>After controlling for other variables, biopsies with integration had a significantly higher diagnostic yield compared to those without integration (OR = 3.34, 95 % CI 1.39–8.44, p = 0.008). Pneumothorax rate (3 without integration vs 1 with integration, p = 0.3) was similar.</div></div><div><h3>Interpretation</h3><div>The use of 3D CBCT for real time integration of PPL location and biopsy tool and catheter relationship improves diagnostic yield of bronchoscopic biopsies performed via ssRAB.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108666"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023210","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":"PA/A ratio >1 detected by CT-scan during acute exacerbation of chronic obstructive pulmonary disease: A novel prognostic factor for long-term mortality based on a cohort study","authors":"Chen Zhou ,&nbsp;Jing Liu ,&nbsp;Qun Yi ,&nbsp;Jiaxin Zeng ,&nbsp;Xueqing Chen ,&nbsp;Xuelian Li ,&nbsp;Liqing Peng ,&nbsp;Haixia Zhou","doi":"10.1016/j.rmed.2026.108665","DOIUrl":"10.1016/j.rmed.2026.108665","url":null,"abstract":"<div><h3>Background</h3><div>The pulmonary artery (PA) to aorta (A) (PA/A) ratio is a prognostic factor of many diseases, but the long-term prognostic value of PA/A during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has never been disclosed.</div></div><div><h3>Aim</h3><div>To investigate the long-term prognostic value of PA/A detected by CT-scan during AE stage of COPD inpatients.</div></div><div><h3>Design</h3><div>A non-interventional cohort study.</div></div><div><h3>Methods</h3><div>Patients surviving from AECOPD were prospectively enrolled from West China Hospital between September 2017 and July 2021 and followed-up till the fifth year after discharge. PA and A diameters were measured based on CT-scan during hospitalization. LASSO-COX analysis was used to identify the independent prognostic factors. Stratified analysis by sex, age groups were performed.</div></div><div><h3>Results</h3><div>Among the 1466 patients involved, 402 (27.4 %) died during follow-up (median follow-up time: 41.0 months). Multivariate LASSO-COX analysis showed that PA/A &gt;1 during exacerbation period was associated with increased long-term mortality risk [HR = 1.498, 95 % CI (1.120–2.004), P = 0.007], especially in male and old subgroups. With the rise of PA/A ratio, mortality rate showed a significant upward trend. Kaplan–Meier analysis showed patients with PA/A &gt;1 had significantly lower survival rate. After exacerbation, PA/A ratio showed a significant reduction in patients with PA/A ≤1 (exacerbation vs. stable stage: 0.79 ± 0.11 vs. 0.76 ± 0.11, P &lt; 0.001), while that remained stagnant in patients with PA/A &gt;1 (1.13 ± 0.12 vs. 1.13 ± 0.16, P = 0.592).</div></div><div><h3>Conclusion</h3><div>PA/A ratio &gt;1 detected during AE stage was a steady and effective prognostic factor of long-term mortality in COPD patients. Further multicenter is warranted to validate the association.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108665"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023211","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":"Fractional exhaled nitric oxide in monitoring biological treatment for severe asthma in adults: Clinical implications and future perspectives","authors":"Mauro Maniscalco ,&nbsp;Claudio Candia ,&nbsp;Pasquale Ambrosino ,&nbsp;Maria Gabriella Matera ,&nbsp;Mario Cazzola","doi":"10.1016/j.rmed.2026.108647","DOIUrl":"10.1016/j.rmed.2026.108647","url":null,"abstract":"<div><div>Severe asthma (SA) is a heterogeneous disease that remains uncontrolled despite optimized, high-dose inhaled therapy. It is also associated with substantial morbidity, corticosteroid exposure, and a significant healthcare burden. The advent of targeted biologic therapies has transformed SA management, making accurate biomarker-guided phenotyping essential. Fractional exhaled nitric oxide (FeNO), a noninvasive biomarker of IL-4/IL-13–driven airway inflammation, is widely used in asthma; however, interpreting its levels in SA is complex. This narrative review provides a biology-driven analysis of FeNO in SA, focusing on mechanistic foundations, interpretive limitations, and biologic-specific behavior. Chronic exposure to high-dose inhaled or systemic corticosteroids, overlap with reference ranges in healthy populations, and common SA comorbidities, such as obesity, chronic rhinosinusitis with nasal polyps, and bronchiectasis, can substantially modify FeNO levels. This limits the usefulness of fixed cutoffs. We summarize the available evidence on FeNO dynamics across biologic classes, highlighting the rapid and pronounced suppression observed with anti-IL-4Rα and anti-TSLP therapies. This is in contrast to the variable and often modest changes seen with anti-IL-5/IL-5R agents. We also review data linking baseline FeNO values and early FeNO trajectories to clinical outcomes and asthma remission. FeNO should be integrated with blood eosinophils, IgE, sputum cytology, and clinical features to guide biologic selection and longitudinal monitoring, rather tham being used in isolation. Key evidence gaps include the need for prospective FeNO-guided biologic trials, harmonized SA-specific FeNO thresholds, and integration with multi-omics approaches to fully realize the full potential of FeNO as a precision biomarker in SA.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108647"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978760","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":"Exploring the genetic link between obstructive sleep apnea and obesity: A bidirectional Mendelian randomization study","authors":"Fuguo Cai ,&nbsp;Wei Hong ,&nbsp;Chaoliang Xiong ,&nbsp;Ningning She ,&nbsp;Rui Lu ,&nbsp;Yewen Shi ,&nbsp;Xiaoyong Ren","doi":"10.1016/j.rmed.2025.108609","DOIUrl":"10.1016/j.rmed.2025.108609","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) and obesity are interrelated conditions with significant public health implications, but the genetic causal association between them remains unclear. This study investigates their bidirectional causality using Mendelian randomization (MR).</div></div><div><h3>Methods</h3><div>Genetic data for OSA were obtained from the FinnGen consortium, including 38,998 OSA cases and 336,659 controls, as well as a broader sleep-disorder phenotype comprising 44,299 cases and 329,251 controls. Genetic data for obesity-related traits were sourced from large-scale genome-wide association studies from the GIANT consortium, including body mass index (BMI; n = 681,275), waist–hip ratio (WHR; n = 224,459), and WHR adjusted for BMI (WHRadjBMI; n = 694,649). MR analyses were performed using inverse variance weighting (IVW) as the primary method, with weighted median and MR-Egger analyses for sensitivity assessment.</div></div><div><h3>Results</h3><div>OSA was causally associated with increased BMI (IVW: OR = 1.275, 95 % CI = 1.070–1.520, p = 0.0065), trunk fat mass (IVW: OR = 1.323, 95 %CI = 1.166–1.501, p = 1.46e-05), and whole-body fat mass (IVW: OR = 1.327, 95 %CI = 1.164–1.512, p = 2.21e-05). Conversely, obesity measures such as BMI (IVW: OR = 1.929, 95 %CI = 1.808–2.059, p = 3.05e-87), trunk fat mass (IVW: OR = 1.630, 95 %CI = 1.515–1.753, p = 4.21e-39), and leg fat mass (IVW: OR = 1.959, 95 %CI = 1.796–2.137, p = 5.93e-52) were causally linked to OSA. No significant association was found between WHR or WHRadjBMI and OSA (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study provides genetic evidence of a bidirectional causal relationship between OSA and obesity, emphasizing the role of systemic and regional fat distribution. Integrated management strategies targeting weight reduction and OSA treatment may mitigate the mutual burden of these conditions.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108609"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834635","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 role of clinical characteristics, thoracic ultrasonography and pleural fluid parameters in differentiating malignant from benign pleural effusion","authors":"Ayshan Mammadova ,&nbsp;Zeynep Yalçınkaya ,&nbsp;Nilgun Yılmaz Demirci","doi":"10.1016/j.rmed.2026.108637","DOIUrl":"10.1016/j.rmed.2026.108637","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Thoracic ultrasonography (TUS) enhances the success of thoracentesis and reduces complications.Ultrasound elastography is a sensitive imaging technique for the assessment of tissue stiffness. This study evaluates the role of ultrasonographic imaging and elastography, in conjunction with clinical and pleural fluid laboratory parameters, to differentiate malignant from benign, and transudative from exudative pleural effusions.</div></div><div><h3>Materials and methods</h3><div>A total of 95 patients with pleural effusions and 26 control patients were included. All patients underwent B-mode ultrasonography, color intensity analysis in elastography mode, and strain index calculation.</div></div><div><h3>Results</h3><div>Exudative fluid was detected in 62.1 % of patients, while transudative fluid was found in 37.9 %. Pleural nodules were identified in 83.3 % of those with malignant effusions and 3.6 % in benign cases, with a significant difference (p &lt; 0.001). Pleural thickness was greater in the malignant than benign group, and in the exudative compared to the transudative group (p &lt; 0.001). A pleural thickness cutoff of 1.35 mm demonstrated high sensitivity (93 %) and specificity (86 %) for differentiating exudative fluids. However, no significant differences were found in elastogram color distribution or strain index between the malignant and benign, or transudative and exudative groups. The median strain index was significantly higher in the patient group (15.0) than in the control group (0.95)(p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The findings of the present study suggest that TUS can offer significant assistance to clinicians in diagnosing pleural effusion and differentiating malignant from benign, as well as transudative from exudative effusions. More comprehensive studies in the future will further clarify the definitive role of elastogram color distribution and strain index in these differentiations.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108637"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927721","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":"Prevalence and overlap of treatable traits in severe asthma and COPD: A cross-disease comparison in a tertiary care setting","authors":"Vanessa L. Clark ,&nbsp;Joice Mara de Oliveira ,&nbsp;Peter G. Gibson ,&nbsp;Vanessa M. McDonald","doi":"10.1016/j.rmed.2025.108604","DOIUrl":"10.1016/j.rmed.2025.108604","url":null,"abstract":"<div><h3>Introduction/aim</h3><div>Understanding the prevalence and overlap of treatable traits in severe asthma and COPD can guide personalised management. We aimed to determine the prevalence of traits in severe asthma and COPD compared to healthy controls in a tertiary care setting and to compare prevalence by diagnostic label.</div></div><div><h3>Methods</h3><div>Participants with severe asthma, COPD and healthy controls were recruited to a cross-sectional study and underwent multidimensional assessment to characterise their treatable traits.</div></div><div><h3>Results</h3><div>We recruited 140 participants with severe asthma, 45 COPD and 67 healthy controls, mean ± SD age, 56.6 ± 16.2 years, and 57.5 % female. Participants with severe asthma and controls, were younger compared to COPD p &lt; 0.001. Of the 23 possible traits, fewer were identified in severe asthma (9.0 ± 2.8) and controls (2.4 ± 1.4) compared to COPD (10.6 ± 2.4; p &lt; 0.001, with a difference between severe asthma and COPD; p &lt; 0.001). Traits that were less prevalent in severe asthma were dyspnoea; p &lt; 0.01, exertional O₂ desaturation; p &lt; 0.001, mucous-hypersecretion; p &lt; 0.05 and airflow obstruction; p &lt; 0.001. Severe asthma was associated with more daytime-sleepiness; p &lt; 0.01, and obesity; p &lt; 0.05. The prevalence of chest infections, pathogen colonisation, smoking, nonadherence, inhaler-polypharmacy, dysfunctional breathing, anxiety or depression did not differ between disease groups.</div></div><div><h3>Conclusion</h3><div>This study provides further support for the treatable traits approach, revealing both diverse and overlapping traits in severe asthma and COPD. This advances the treatable traits paradigm and supports its implementation to improve personalised care in severe asthma and COPD.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108604"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811150","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 effect of interval and continuous aerobic training on exercise capacity and health-related quality of life in people with coronary artery DISEASE: A randomized controlled trial","authors":"Gulay Yalcin ,&nbsp;Fatma Mutluay","doi":"10.1016/j.rmed.2026.108634","DOIUrl":"10.1016/j.rmed.2026.108634","url":null,"abstract":"<div><h3>Background</h3><div>Aerobic exercise is a fundamental component of cardiac rehabilitation in individuals with coronary artery disease (CAD). However, the comparative effects of interval and continuous aerobic training on exercise capacity and health-related quality of life (HRQoL) remain under debate.</div></div><div><h3>Methods</h3><div>This randomized controlled trial included 40 patients with clinically stable coronary artery disease. Participants were randomly assigned to either interval aerobic training or continuous aerobic training for six weeks. The 6-min walk test (6MWT) was used to evaluate exercise capacity, and the Short Form-36 (SF-36) questionnaire was used to assess health-related quality of life (HRQoL). All assessments were performed before and after the training program.</div></div><div><h3>Results</h3><div>Both training groups demonstrated significant improvements in exercise capacity and HRQoL following the intervention. Interval aerobic training resulted in greater improvements in 6-min walk distance, exercise test duration, and selected SF-36 domains compared with continuous aerobic training.</div></div><div><h3>Conclusion</h3><div>Both interval and continuous aerobic training improved exercise capacity and health-related quality of life in patients with coronary artery disease. Interval aerobic training was associated with superior improvements in submaximal exercise capacity and selected quality-of-life domains, suggesting that it may be an effective alternative within cardiac rehabilitation programs.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108634"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912629","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":"When the noise exceeds the signal: day-to-day variability in spirometry dominates LLN discordance","authors":"Gerald S. Zavorsky","doi":"10.1016/j.rmed.2025.108632","DOIUrl":"10.1016/j.rmed.2025.108632","url":null,"abstract":"<div><div>Robert A. Rigby, Mikis D. Stasinopoulous, Achim Zeilis, Sanja Stanojevic, Gillian Heller, Fernanda de Bastiani, Thomas Kneib, Andreas Mayr, Reto Stauffer, and Nikolaus Umlauf contend that segmented linear regression (SLR) is inadequate for spirometry reference equations and over-/underdiagnoses abnormality compared with Generalized Additive Models of Location, Scale, and Shape (GAMLSS). Using a refined NHANES 2007-2012 dataset (n=16,596), I reassessed calibration and the lower limit of normal (LLN) discordance with additional analyses. Out-of-sample root mean square error (RMSE) and correlations were essentially identical across approaches, and overall, the prevalence below the LLN differed by &lt;1 percentage point. Ages 5-80 were resampled to the 2020-2024 U.S. Census age structure, and observed below-LLN counts (z&lt;−1.645) were compared with exact 95% binomial bands; most age-sex strata for FEV₁, FVC, and FEV₁/FVC fell within expected sampling variability, with modest departures mainly in older men. Age-stratified concordance showed 93.5-93.8% normal by both methods and 4.0-4.8% abnormal by both; discordance was uncommon (GAMLSS-only 0.20-0.78%, SLR-only 1.23-1.65%). Estimated week-to-week measurement variability produced LLN flip rates of ∼3% (FEV₁), ∼3.5% (FVC), and ∼6% (FEV₁/FVC), exceeding model-driven differences. GAMLSS remains useful, but simpler, transparent regressions can often yield comparable practical interpretation.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108632"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900964","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 home transcutaneous capnography on the assessment of patients with nocturnal hypoxemia","authors":"Claudia Mañana Valdés ,&nbsp;Ramon Fernandez Alvarez ,&nbsp;Laura Abad Chamorro ,&nbsp;Patricia Rodríguez Menéndez ,&nbsp;Ines Ruiz Alvarez ,&nbsp;Irene Fernandez Suarez ,&nbsp;Maria Jose Vazquez Lopez ,&nbsp;Pablo Lozano Cuesta ,&nbsp;Ina Guerassimova ,&nbsp;Guillermo López-Arranz Monge ,&nbsp;Claudia Madrid Carbajal ,&nbsp;Gemma Rubinos Cuadrado","doi":"10.1016/j.rmed.2026.108643","DOIUrl":"10.1016/j.rmed.2026.108643","url":null,"abstract":"<div><h3>Background</h3><div>Sleep studies sometimes identify varying levels of hypoxemia through pulse oximetry; however, this does not distinguish between isolated hypoxemia and coexisting hypoventilation with hypercapnia. Transcutaneous capnography (TcCO2) correlates well with blood gas analysis and would be useful in these cases; however, there is limited information on its use at home in normocapnic patients with nocturnal hypoxemia. Our goal was to assess the impact of adding nocturnal TcCO2 measurement in this group of patients and to compare the measurement differences across different devices used.</div></div><div><h3>Methods</h3><div>A cross-sectional design was used to study normocapnic subjects with nocturnal hypoxemia detected during a sleep study. Home transcutaneous capnography and simultaneous pulse oximetry were performed. The study analyzed the detection of nocturnal hypoventilation, potential measurement differences between devices, and the impact on treatment decisions.</div></div><div><h3>Results</h3><div>Sixty-three subjects (64 ± 13 years; 54 % women) were included. Capnography was abnormal in 30 cases (48 %): 20 (32 %) with hypercapnia and 10 (16 %) with isolated hypoxemia. Specific treatment was recommended for 25 of the cases (83 %): 13 with CPAP and 12 with noninvasive ventilation. Differences between devices were observed in oxygenation data, as capnography measurements did not show hypoxemia in 52 % of the included cases.</div></div><div><h3>Conclusions</h3><div>Nocturnal TcCO2 monitoring at home can identify hypoventilation in patients without daytime hypercapnia and help guide suitable therapies. The differences in measurements compared to traditional pulse oximetry require further investigation.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108643"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952844","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":"Apnea-hypopnea index, blood pressure, daytime sleepiness, and sleeping quality in obstructive sleep apnea: randomized-controlled responses to Shitali respiratory training","authors":"Ali Mohamed Ali Ismail ,&nbsp;Naglaa Gadallah Mohammed Gadallah ,&nbsp;Ahmed Mohamed Abdelhalim Elfahl","doi":"10.1016/j.rmed.2025.108608","DOIUrl":"10.1016/j.rmed.2025.108608","url":null,"abstract":"<div><h3>Background</h3><div>Shitali respiratory or pranayamic yogic training might help to improve OSA symptoms but no study investigated the response of OSA to Shitali respiratory training (SRT).</div></div><div><h3>Aim</h3><div>This pranayama study aimed to investigate the response of OSA patients to SRT.</div></div><div><h3>Methods</h3><div>Forty from-both-sex OSA patients with polysomnography-based apnea-hypopnea-index (AHI) evidence were included. Patients – aged 35–58 years old - with mild and moderate OSA (5 &lt; AHI &lt;30 events/hour) were included. The closed envelope procedure was used to randomize and assign the OSA patients into the SRT group (received a 12-week daily SRT, n = 20) or control group (served as a waitlist OSA group, n = 20). Outcome measures were blood systole (BS), respiratory rate (RR), visual analogue scale (VAS) that detected partner rating of sleep disturbance by the participants’ snoring, AHI, blood diastole (BD), daytime sleepiness which was assessed by Epworth questionnaire (EQ), and sleeping quality which was assessed Pittsburgh quality of sleep index questionnaire (PQSIQ).</div></div><div><h3>Results</h3><div>After the 12-week SRT, the within-SRT group comparison of RR, AHI, BS, PQSIQ, BD, EQ, and VAS showed significant improvements. The waitlist OSA group did not show any significant improvement in all measures.</div></div><div><h3>Conclusion</h3><div>The course of a 12-week SRT is a good treatment to improve RR, AHI, BS, PQSIQ, BD, EQ, and VAS of partner rating of sleep disturbance in patients with OSA.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108608"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834677","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}