Respiratory medicine最新文献

{"title":"Minimal clinically important difference for quadriceps maximal voluntary contraction following pulmonary rehabilitation in people with interstitial lung disease","authors":"Sara Reina-Gutiérrez ,&nbsp;Cátia Paixão ,&nbsp;Patrícia Rebelo ,&nbsp;Joana Antão ,&nbsp;Vânia Fernandes ,&nbsp;Pedro G. Ferreira ,&nbsp;Alda Marques","doi":"10.1016/j.rmed.2025.108351","DOIUrl":"10.1016/j.rmed.2025.108351","url":null,"abstract":"<div><h3>Background</h3><div>Skeletal muscle loss has a devastating effect on daily lives of people with interstitial lung disease (ILD). Pulmonary rehabilitation (PR) improves muscle strength; however, the lack of cut-off values to define clinical improvement limits the interpretability of the obtained gains.</div></div><div><h3>Objective</h3><div>To estimate the minimal clinically important difference (MCID) for quadriceps maximal voluntary contraction (QMVC) in people with ILD, assessed with hand-held dynamometry as an absolute value in kilogram-force (KgF) and as percentage of the predicted value (% pred), after PR in people with ILD.</div></div><div><h3>Methods</h3><div>A secondary analysis of data from three previous studies was conducted. Participants took part in a 12-week community-based PR programme. The MCIDs were computed using anchor- and distribution-based methods. Anchors explored were the 1-min sit-to-stand (1-min STS) test, the 6-min walking distance, handgrip strength, modified Medical Research Council questionnaire, St. George's Respiratory Questionnaire and Functional Assessment of Chronic Illness Therapy-Fatigue Subscale. The pooled MCIDs were computed using the weighted arithmetic mean (2/3 anchor and 1/3 distribution-based methods).</div></div><div><h3>Results</h3><div>Fifty-nine people with ILD (61 % female, 66 ± 11years) were included in the analysis. The 1-min STS test was the only anchor fitting the criteria. There were significant improvements after PR in the QMVC (mean difference = 3.9 ± 8.2 KgF and median difference = 10.9 [1.6; 22.0] % pred, p &lt; 0.001) and 1-min STS test (mean difference = 6.6 ± 7.1 repetitions, p &lt; 0.001). The pooled MCIDs were 3.2 KgF and 10.6 % pred.</div></div><div><h3>Conclusion</h3><div>An increase of at least 3.2 KgF or 10.6 % pred for QMVC in people with ILD after PR represents clinically relevant improvements.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108351"},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055726","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":"Effectiveness of antifibrotic treatment in real-world patients with progressive pulmonary fibrosis","authors":"Takayuki Niitsu ,&nbsp;Kiyoharu Fukushima ,&nbsp;Sho Komukai ,&nbsp;Ryohei Yamamoto ,&nbsp;Takayuki Shiroyama ,&nbsp;Takuro Nii ,&nbsp;So Takata ,&nbsp;Kazuki Hashimoto ,&nbsp;Yuko Abe ,&nbsp;Haruhiko Hirata ,&nbsp;Kotaro Miyake ,&nbsp;Toshiaki Kataoka ,&nbsp;Koji Okudela ,&nbsp;Shinichi Iwakoshi ,&nbsp;Masahiro Yanagawa ,&nbsp;Noriyuki Takeuchi ,&nbsp;Yoshito Takeda ,&nbsp;Hiroshi Kida ,&nbsp;Atsushi Kumanogoh","doi":"10.1016/j.rmed.2025.108347","DOIUrl":"10.1016/j.rmed.2025.108347","url":null,"abstract":"<div><h3>Purpose</h3><div>The suitability of progressive pulmonary fibrosis (PPF) as a criterion for antifibrotic use remains uncertain. We aimed to evaluate the effectiveness of antifibrotics for patients with different criteria of progressive non-idiopathic pulmonary fibrosis interstitial lung disease (non-IPF ILD).</div></div><div><h3>Material and methods</h3><div>In this multicenter, retrospective cohort study, we estimated the effect of antifibrotic drugs in three cohorts of PF-ILD (progression within 24 months under standard non-antifibrotic therapy, as in the INBUILD trial), PPF (progression within 12 months based on ATS/ERS/JRS/ALAT guidelines), and PPF “despite management” (a subset of PPF with progression despite appropriate non-antifibrotic therapy). Analyses used the parametric G-formula, the time-varying Cox hazard model, and inverse probability weighting (IPW).</div></div><div><h3>Results</h3><div>Among 1754 patients with non-IPF ILD, 327, 567, and 326 patients were diagnosed with PF-ILD (134 antifibrotics, 193 non-antifibrotics), PPF (149 antifibrotics, 418 non-antifibrotics), and PPF “despite management” (115 antifibrotics, 211 non-antifibrotics), respectively. Using the parametric G-formula, antifibrotic therapy was associated with higher estimated survival in PF-ILD, with statistically significant differences during the first three years, and with a consistent survival advantage in the PPF “despite management” cohort. In contrast, no clear survival benefit was observed in the PPF cohort. These findings were consistent with the time-varying Cox hazard model and IPW analysis results.</div></div><div><h3>Conclusion</h3><div>Our results demonstrate antifibrotic therapy was associated with higher estimated survival in patients with PF-ILD in a real-world setting, suggesting the importance of including “despite management” as a criterion for antifibrotic therapy eligibility in the PPF diagnosis.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108347"},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041222","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":"Frailty in pulmonary hypertension: Establishing the frailty index and impact on survival","authors":"Jan Brand ,&nbsp;Wout de Graaf ,&nbsp;Thomas Geiser ,&nbsp;Michele Martinelli ,&nbsp;Carolin Müller ,&nbsp;Anja Renner ,&nbsp;Bruno Schnegg ,&nbsp;Sabina A. Guler","doi":"10.1016/j.rmed.2025.108346","DOIUrl":"10.1016/j.rmed.2025.108346","url":null,"abstract":"<div><h3>Background</h3><div>Patients with pulmonary hypertension (PH) experience reduced physical capacity, which affects daily life functionality. Frailty signifies increased vulnerability due to diminished physiological reserves and is common in the elderly and those with chronic diseases, but has not been investigated in PH. This study aimed to create a frailty index for PH, to assess the prevalence of frailty, to determine frailty severity and progression over time and to establish a potential association between frailty and mortality in patients with PH.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients with right heart catheter confirmed PH. Frailty was assessed using a cumulative frailty index (FI). Logistic regression, Cox proportional hazard models and causal mediation analyses were used to determine the relationship between frailty and time from FI assessment to death or censoring.</div></div><div><h3>Results</h3><div>After dropping 22 items with item-score correlation &lt;0.7, a 30-item-FI was developed, demonstrating high internal consistency. At baseline 117/189 (62 %) patients were frail (FI &gt; 0.12) and this proportion increased to 71 % at follow-up. Frail patients were older, had lower 6-min walk distance (6MWD), higher NT-proBNP, and lower pulmonary vascular resistance (PVR). Risk of death was significantly higher in patients with frailty after adjustment for age, sex, PVR, and PH treatment (HR 6.4, 95 % CI 2.14–19.1, p = 0.001); only a small proportion of this effect was mediated by 6MWD.</div></div><div><h3>Conclusions</h3><div>Frailty is common in PH and an independent risk factor for mortality beyond confounding/effect modification. Future research should explore underlying mechanisms and the utility of integrating frailty assessment in routine PH patient care.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108346"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027276","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":"Asthma-OSA overlap syndrome: A distinct endophenotype?","authors":"Antonio Fabozzi ,&nbsp;Izolde Bouloukaki ,&nbsp;Matteo Bonini ,&nbsp;Sophia E. Schiza ,&nbsp;Paolo Palange","doi":"10.1016/j.rmed.2025.108344","DOIUrl":"10.1016/j.rmed.2025.108344","url":null,"abstract":"<div><h3>Purpose</h3><div>Asthma and obstructive sleep apnea (OSA) are two respiratory diseases that often may coexist, resulting in Alternative Overlap Syndrome (aOVS), which is still underestimated and underdiagnosed.</div></div><div><h3>Objectives</h3><div>This state-of-art review aims to describe the current evidence on aOVS, including its pathophysiology, clinical, functional and therapeutic implications. A secondary objective is to assess whether aOVS can be identified as a distinct endophenotype needing personalized diagnostic and therapeutic strategies.</div></div><div><h3>Results</h3><div>Asthma and OSA share several common risk factors, including obesity, gastroesophageal reflux disease (GERD) and rhinitis, which contribute to the pathogenesis of aOVS. From a pathophysiological perspective, aOVS has unique characteristics such as a low arousal threshold, nocturnal bronchial hyperresponsiveness and autonomic nervous system (ANS) dysfunction. These features lead to sleep fragmentation, altered ventilatory control, increased upper and lower airway resistance, and airway and systemic inflammation. From a functional perspective, patients with aOVS present lower FEV₁ and increased nocturnal hypoxemia compared to subjects with only asthma or only OSA. From a clinical perspective, aOVS is linked to reduced asthma control, frequent exacerbations, and a lower quality of life. From a therapeutic perspective, continuous positive airway pressure (CPAP) has a positive impact on asthma control, symptom burden and inflammatory response. Weight loss, GERD and rhinitis management, and emerging therapies such as GLP-1 agonists and biological agents may provide additional benefit.</div></div><div><h3>Conclusions</h3><div>Current evidence suggests that aOVS may be considered a distinct clinical endophenotype. Its identification is crucial to ensure timely diagnosis, improve management, and direct future research about long-term outcomes and personalized therapy.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108344"},"PeriodicalIF":3.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010495","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":"Efficacy of dupilumab and mepolizumab in eosinophilic COPD: insights from phase 3 trials","authors":"Philipp Suter,&nbsp;Robert Greig,&nbsp;Rory Chan,&nbsp;Brian Lipworth","doi":"10.1016/j.rmed.2025.108343","DOIUrl":"10.1016/j.rmed.2025.108343","url":null,"abstract":"<div><h3>Background</h3><div>Eosinophilic chronic obstructive pulmonary disease (eCOPD), characterized by type 2 inflammation, is an emerging target for biologic therapies.</div></div><div><h3>Objective</h3><div>To indirectly compare the efficacy of dupilumab and mepolizumab in eCOPD, defined as blood eosinophil counts ≥300 cells/μL, by synthesizing data from phase 3 randomized controlled trials: BOREAS and NOTUS for dupilumab, MATINEE for mepolizumab.</div></div><div><h3>Methods</h3><div>We performed an indirect comparison of trial primary and secondary outcomes including annual exacerbation rates (AER), quality of life (St. George's Respiratory Questionnaire, SGRQ), symptoms (E-RS–COPD), and lung function (FEV₁). Rate ratios and mean differences with crude 95 % CI were evaluated using forest plots.</div></div><div><h3>Results</h3><div>Both dupilumab and mepolizumab significantly reduced AER versus placebo, with comparable magnitude based on overlapping 95 % CI. The time needed to prevent one exacerbation was shorter for dupilumab (2.3–3.1 years) compared to mepolizumab (4.8 years). However, dupilumab but not meplizumab showed significant improvements in quality of life, symptoms, and FEV₁, along with enhanced effects in patients with elevated fractional exhaled nitric oxide (FeNO ≥20 ppb). None of the secondary outcomes reached the minimal clinical important difference.</div></div><div><h3>Conclusion</h3><div>While both biologics reduced AER in eCOPD, dupilumab demonstrated statistically but not clinically relevant improvements on quality of life, symptoms, and lung function. Especially in patients with elevated FeNO, dupilumab demonstrated an improvement. Further direct comparisons and biomarker-driven studies are warranted.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108343"},"PeriodicalIF":3.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004794","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 in adult dialysis patients: A review","authors":"Jacob Sutton,&nbsp;Suzanne El Sayegh","doi":"10.1016/j.rmed.2025.108341","DOIUrl":"10.1016/j.rmed.2025.108341","url":null,"abstract":"<div><div>Obstructive sleep apnea (OSA) is an extremely common but underdiagnosed problem in adults receiving dialysis therapy. Patients with end-stage kidney disease (ESKD) on hemodialysis or peritoneal dialysis have a higher prevalence of OSA compared to the general population (Nicholl et al., 2013; Kimmel et al., 1989; Markou et al., 2006). This condition carries significant clinical implications, contributing to impaired sleep quality, daytime fatigue, and elevated cardiovascular risk if left untreated (Marin et al., 2005; Burkhalter et al., 2024). In fact, untreated OSA is associated with markedly higher rates of hypertension and adverse cardiac events in susceptible patients (Nicholl et al., 2013; Burkhalter et al., 2024). Despite these dangers, OSA often goes unrecognized in dialysis patients, partly because its presentation can be atypical or masked by uremic symptoms.</div><div>This review provides a comprehensive overview of OSA in adult dialysis patients. We discuss how OSA prevalence in dialysis populations is extremely high (often affecting half or more of patients) and examine why conventional screening tools may fail to identify many cases. We also describe the unique pathophysiological contributors in ESKD, such as fluid overload and its redistribution, that predispose patients to OSA. Finally, we review management strategies, including standard therapies like continuous positive airway pressure (CPAP) and dialysis-specific interventions such as intensive volume control and nocturnal dialysis. Improving awareness and treatment of OSA in this vulnerable population is crucial to enhance patient outcomes and quality of life.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108341"},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008430","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":"An analysis of adverse events associated with Mandibular Repositioning Appliances (MRA)- study of the FDA Manufacturer and User Facility Device Experience (MAUDE) database","authors":"Tala Al Khouri ,&nbsp;Issam Halasa ,&nbsp;Boris I. Medarov","doi":"10.1016/j.rmed.2025.108342","DOIUrl":"10.1016/j.rmed.2025.108342","url":null,"abstract":"<div><h3>Study objectives</h3><div>Mandibular repositioning appliances (MRAs) are widely used for obstructive sleep apnea (OSA) and snoring, but their safety profile remains underexplored. This study analyzes adverse events associated with MRAs using the FDA Manufacturer and User Facility Device Experience (MAUDE) database.</div></div><div><h3>Methods</h3><div>A retrospective review of the MAUDE database identified adverse events related to MRAs under the product code “LRK” from January 1, 2015, to February 8, 2025. Reports were categorized into seven groups: allergic reactions, broken parts, loose screws, dental issues, ill-fitted appliances, temporomandibular joint (TMJ) problems, and miscellaneous issues. Duplicate reports and unrelated cases were excluded.</div></div><div><h3>Results</h3><div>A total of 517 reports were analyzed, with allergic reactions (40.3 %) and device breakage (39.4 %) being the most frequently reported issues. Other events included loose screws (6.3 %), dental issues (3.5 %), ill-fitting appliances (3.3 %), TMJ problems (2.9 %), and miscellaneous complaints (3.3 %). Custom-made MRAs were involved in 85 % of cases, while boil-and-bite devices accounted for 15 %.</div></div><div><h3>Conclusion</h3><div>Our analysis of the MAUDE database reveals an increasing number of adverse event reports related to MRAs, reflecting their growing use in treating OSA and snoring. Outcomes and success depend on factors like device type, patient selection, and adherence. Adverse events such as allergic reactions and device breakage highlight the need for proper material selection and maintenance, favoring MRAs made from biocompatible materials over polymethyl methacrylate or metal.</div><div>MRAs also present limitations such as dental contraindications and occlusal changes, stressing the importance of patient monitoring. Future research should focus on prospective studies to better assess outcomes.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108342"},"PeriodicalIF":3.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006590","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":"Mepolizumab treatment and reduced oral corticosteroid exposure improves symptoms of depression and anxiety in severe eosinophilic asthma: data from the Australian Mepolizumab Registry","authors":"Erin S. Harvey ,&nbsp;Yuto Hamada ,&nbsp;Sarah A. Hiles ,&nbsp;David Langton ,&nbsp;Dennis Thomas ,&nbsp;Vanessa M. McDonald ,&nbsp;Philip Bardin ,&nbsp;Matthew Peters ,&nbsp;Paul N. Reynolds ,&nbsp;John W. Upham ,&nbsp;John Blakey ,&nbsp;Simon Bowler ,&nbsp;Jimmy Chien ,&nbsp;Li Ping Chung ,&nbsp;Claude S. Farah ,&nbsp;Andrew Gillman ,&nbsp;John Harrington ,&nbsp;Mark Hew ,&nbsp;Christine Jenkins ,&nbsp;Constance H. Katelaris ,&nbsp;Peter G. Gibson","doi":"10.1016/j.rmed.2025.108340","DOIUrl":"10.1016/j.rmed.2025.108340","url":null,"abstract":"<div><h3>Background</h3><div>The benefits of oral corticosteroid (OCS) stewardship approaches -including monoclonal antibody treatments for severe asthma- on reducing toxic OCS exposure and related comorbidities such as depression and anxiety require real-world evaluation.</div></div><div><h3>Methods</h3><div>This real-world observational study investigated OCS exposure and associated complications over 24 months in patients enrolled in the Australian Mepolizumab Registry (n = 412).</div></div><div><h3>Results</h3><div>Patients were median age 59 years, 58 % were female. The proportion of patients receiving OCS burst in the year prior to commencement was 95 % (44 % during second year of treatment, p &lt; 0.001). In the year prior to baseline, 64 % received toxic level OCS exposure (≥1000 mg), with more disease burden and doctor diagnosed depression (27 % v 15 %, p = 0.020). Ongoing toxic level exposure was reduced to 25 % of patients in the second year of mepolizumab treatment (p &lt; 0.001). At baseline, 42 % required maintenance OCS which reduced to 18 % after two years of treatment (p &lt; 0.001). Hospital Anxiety and Depression Scale (HADS)-Depression score ≥8 was evident in 37 % of patients at baseline and reduced to 15 % after two years (p &lt; 0.001). HADS-Anxiety score ≥8 was reduced from 44 % of patients to 25 % after two years (p &lt; 0.001). Improvements in HADS scores correlated with improvement in Asthma Quality of Life Questionnaire score.</div></div><div><h3>Conclusion</h3><div>Mepolizumab treatment reduces exposure to toxic levels of OCS in severe eosinophilic asthma, with reduction in associated complications, confirming the importance of OCS stewardship initiatives. Improvements in both asthma outcomes, and clinically relevant treatable traits including depression and anxiety, further highlights the role of biologics within the OCS stewardship framework.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108340"},"PeriodicalIF":3.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004795","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":"Pulmonary mucosa-associated lymphoid tissue lymphoma (MALToma): Clinico-radiologic features, diagnosis, and outcomes","authors":"Vasilios Tzilas ,&nbsp;Anne-Marie G. Sykes ,&nbsp;Rebecca M. Lindell ,&nbsp;Eunhee S. Yi ,&nbsp;Jay H. Ryu","doi":"10.1016/j.rmed.2025.108339","DOIUrl":"10.1016/j.rmed.2025.108339","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALToma) is the most common form of primary pulmonary lymphoma. Data on clinic-radiologic presentation, diagnostic methods, and clinical outcome are relatively sparse.</div></div><div><h3>Methods</h3><div>Retrospective study of 71 patients with biopsy-proven pulmonary MALToma encountered at Mayo Clinic from 1998 to 2022.</div></div><div><h3>Results</h3><div>Median age was 63 years (range: 41–87) and included 42 females (59 %). Most patients (60.6 %) were asymptomatic; most common symptoms were cough (23.9 %), dyspnea (19.7 %), chest pain (5.6 %) and fatigue (5.6 %). Predisposing systemic disorder was present in 23 (32.4 %) patients, most commonly primary Sjogren syndrome (19.7 %). Diagnosis was achieved by surgical lung biopsy, core needle biopsy, transbronchial biopsy, and fine needle aspirate in 42 (60 %), 21 (29.6 %), 7 (10 %), 1 (1.4 %) patient, respectively; diagnostic rates were 100 %, 72.4 %, 41.2 % and 33 %, respectively. On chest CT scan, the most common type of abnormality was consolidation in 62 (87 %) and nodular/mass-like lesions in 62 (87 %) cases; air-bronchogram was present in 50 (70.4 %) cases. These findings were multilobar and bilateral in 45 (63.4 %) and 43 (60.6 %) cases, respectively, with no predominant distribution. Over one-third did not need treatment and pulmonary MALToma was an uncommon cause of death.</div></div><div><h3>Conclusions</h3><div>Pulmonary MALToma most commonly manifests during the 7th decade of life with more than half of patients being asymptomatic at presentation. Most frequent imaging findings include bilateral areas of consolidation and/or nodular/mass-like lesions commonly associated with air-bronchogram. Pulmonary MALToma is typically indolent and uncommonly causes death.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108339"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144997427","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":"Two-week heart rate variability measurements and lung health: a cross-sectional analysis in the ARIC study","authors":"David M. MacDonald ,&nbsp;Selcuk Adabag ,&nbsp;Lin Yee Chen ,&nbsp;Wendy Wang ,&nbsp;Stephen Juraschek ,&nbsp;Sarath Raju ,&nbsp;Jennifer A. Schrack ,&nbsp;Elsayed Z. Soliman ,&nbsp;Hau-Tieng Wu ,&nbsp;Ken M. Kunisaki ,&nbsp;Pamela L. Lutsey","doi":"10.1016/j.rmed.2025.108338","DOIUrl":"10.1016/j.rmed.2025.108338","url":null,"abstract":"<div><h3>Background</h3><div>Heart rate variability (HRV) is a measure of autonomic function that has been associated with worse lung function and worse respiratory health. Using data from a community-based cohort, we aimed to test if HRV is associated with lung function and self-reported chronic lung disease (CLD).</div></div><div><h3>Methods</h3><div>The Atherosclerosis Risk in Communities (ARIC) study is a community-based cohort that collected HRV measurements from 14-day continuous ECG patches and self-reported CLD at visit 6 (2016–2017). Pulmonary function testing was performed a prior visit (visit 5; 2011–2013). We used multivariate linear regression to test cross-sectional associations between HRV and lung function, and logistic regression to test associations between HRV and self-reported CLD. All analyses were adjusted for important confounders including smoking, demographics, and medications.</div></div><div><h3>Results</h3><div>HRV and lung function measurements were available for 1456 participants. Included participants had a mean ± standard deviation (SD) age of 78.7 ± 4.5 years, 59.6 % were female, and 30.1 % were African American. Higher HRV reflective of overall HRV (standard deviation of normal RR intervals) and sympathetic activity [low frequency (LF) to high frequency (HF) ratio (LF/HF)] were associated with better lung function and lower odds of self-reported CLD. Higher HRV reflective of parasympathetic function (HF) was associated with worse lung function and higher odds of self-reported CLD.</div></div><div><h3>Conclusions</h3><div>We confirmed associations between HRV and respiratory health outcomes. Our data from a community-based cohort demonstrate the importance of utilizing several HRV measurements to capture multiple components of autonomic function when analyzing respiratory health outcomes.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108338"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001469","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}