Respirology最新文献

{"title":"The Case for Case Finding Is Getting Stronger.","authors":"Christine Jenkins","doi":"10.1111/resp.70022","DOIUrl":"https://doi.org/10.1111/resp.70022","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for Causal Inference Studies.","authors":"Rachel E Foong, Don Vicendese","doi":"10.1111/resp.70018","DOIUrl":"https://doi.org/10.1111/resp.70018","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Review of Interstitial Lung Abnormalities.","authors":"Yuben Moodley, John A Mackintosh","doi":"10.1111/resp.70026","DOIUrl":"https://doi.org/10.1111/resp.70026","url":null,"abstract":"<p><p>Interstitial lung abnormalities (ILAs) represent radiological entities that comprise changes compatible with an interstitial process, occurring in individuals not suspected to have interstitial lung disease (ILD). The prevalence of ILAs ranges from 2.5% to 16.7% in lung cancer screening and population-based cohorts. ILAs have consistently been associated with mortality. Risk factors include older age, smoking, and genetic polymorphisms such as MUC5B. Progression of ILAs occurs in 20%-76% of cases over 2-6 years of follow-up. The clinical approach to ILAs involves risk stratification based on radiological features, extent of involvement, and associated clinical and physiological findings. ILAs pose a significant challenge in distinguishing inconsequential radiological findings from early ILD. This review summarises the current understanding of ILAs, including prevalence, risk factors, progression, associated biomarkers, and clinical management strategies.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tackling a Lifetime of Risk for OSA.","authors":"Neeraj Mukesh Shah, Eui-Sik Suh","doi":"10.1111/resp.70025","DOIUrl":"https://doi.org/10.1111/resp.70025","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatable Trait Guided Asthma Management: A Feasibility Study.","authors":"James Fingleton, Rob McLachlan, Jenny Sparks, Richard Beasley, Alvar Agustí, Peter G Gibson, Ian D Pavord, Jo Hardy, Mark Weatherall, Allie Eathorne, Vanessa M McDonald","doi":"10.1111/resp.70016","DOIUrl":"https://doi.org/10.1111/resp.70016","url":null,"abstract":"<p><strong>Background and objectives: </strong>Treatable trait-based personalised medicine improves outcomes in severe asthma clinics. We assessed the feasibility of a randomised controlled trial (RCT) of protocolised treatable trait-guided asthma management in patients not under a severe asthma clinic.</p><p><strong>Methods: </strong>Ten week single-group cohort study. Participants had a doctor's diagnosis of asthma, Asthma Control Questionnaire-5 (ACQ-5) score > 1, and ≥ 1 exacerbation in the last year.</p><p><strong>Intervention: </strong>biomarker-guided asthma medication according to a protocolised algorithm, targeting traits of type-2 inflammation and airflow obstruction. Feasibility outcomes: recruitment rates, acceptability of intervention, willingness to enrol in an RCT, need for 'extended' trait assessment after 10 weeks, and estimation of trait prevalence.</p><p><strong>Results: </strong>Recruitment ceased with 29/50 participants after 14 months due to difficulties associated with COVID-19. Recruitment rate: 29/118 (25%) of those invited to participate (95% CI 17 to 33). 24/26 (92%) participants found the intervention acceptable and were willing to participate in a future study. After 10 weeks, 65% remained not well controlled (ACQ-5 > 1) and would have required the 'extended' assessment. Participants had a mean (SD) 4.8 (2.3) of 13 traits assessed. ACQ-5 improved during the study by -1.0 (0.3 to 1.8) units, and post-bronchodilator airflow limitation reduced from 59% of participants to 35%. 12/29 (41%) participants received continuous oral corticosteroids at some point during the study.</p><p><strong>Conclusion: </strong>Protocolised treatable trait management was acceptable to participants, associated with significant clinical benefit, and a full RCT appears feasible. Targeting type-2 inflammation and airflow obstruction was insufficient to control asthma in the majority of patients, despite marked systemic corticosteroid exposure.</p><p><strong>Trial registration: </strong>ACTRN12620000935932.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective Effects and Patient Preferences for Ambulatory Oxygen in Fibrotic Interstitial Lung Disease With Isolated Exertional Hypoxaemia: A Placebo-Controlled 6-Minute Walk Test Study.","authors":"Giuseppina Ciarleglio, Paolo Cameli, David Bennett, Behar Cekorja, Paola Rottoli, Elisabetta A Renzoni, Piersante Sestini, Elena Bargagli","doi":"10.1111/resp.70020","DOIUrl":"https://doi.org/10.1111/resp.70020","url":null,"abstract":"<p><strong>Background and objective: </strong>The available evidence on the effects of ambulatory oxygen on exercise impairment in patients with fibrotic interstitial lung diseases (F-ILD) is of limited quality.</p><p><strong>Methods: </strong>We conducted a randomised, double-blind, placebo-controlled crossover trial with 32 normoxaemic F-ILD patients, desaturating to ≤ 88% during a baseline 6-minute walk test (6MWT) on ambient air. After determining the oxygen flow needed to prevent desaturation, patients completed two double-blind 6MWTs with either oxygen or placebo (compressed medical air) at the same personalised flow. Objective measures included oxygen saturation, pulse rate, and distance walked. Patient-reported outcomes, assessed via visual analogue scales, included end-of-test dyspnoea, fatigue, and preferences for walking with oxygen or placebo versus each other and ambient air.</p><p><strong>Results: </strong>Ambulatory oxygen, compared to placebo, prevented desaturation, reduced tachycardia, increased walking distance by 37 m (95% CI: 10-74, p = 0.008), and lessened dyspnoea and fatigue. The mean preference score for oxygen over placebo was 2.6 (95% CI: 1.9-3.2, p < 0.0005), significantly greater than equivalence. The preference score for placebo over ambient air was -1.5 (-2.4 to 0.64, p = 0.005), significantly lower than equivalence, while the score for oxygen over ambient air was 0.4 (-0.7 to 1.5), not significantly different from equivalence.</p><p><strong>Conclusions: </strong>Our data confirm that ambulatory oxygen provides significant benefits beyond a placebo effect; although in some patients it is associated with a negative perception that may hinder treatment acceptance. This strengthens the evidence supporting current recommendations and suggests that incorporating patient preferences recorded at the time of the 6MWT into clinical discussions can aid shared decision making regarding ambulatory oxygen.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT02668029.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Bullous Emphysema With Lung Ultrasound: A Prospective Multicentre Study.","authors":"Kinan El Husseini, Thomas Flament, Sophie Laroumagne, Damien Basille, Mathilde Le Brun, Elise Noël-Savina, Philippe Richard, Gilles Mangiapan, Elise Artaud-Macari","doi":"10.1111/resp.70021","DOIUrl":"https://doi.org/10.1111/resp.70021","url":null,"abstract":"<p><strong>Background and objectives: </strong>Lung ultrasound holds high diagnostic performance for pleural diseases, notably pneumothorax. Bullous emphysema is a potential differential diagnosis of pneumothorax on ultrasound, but its precise semiology is poorly known. This study aimed to delineate the sonographic presentation of bullous emphysema and assess the diagnostic performance of common ultrasound features in identifying bullae.</p><p><strong>Methods: </strong>From June 2019 to June 2021, patients with CT scanner-confirmed bullous emphysema were prospectively included. Investigators performed a standardised 14-region lung ultrasound. Sonographic features of bullous and non-bullous regions were compared. Diagnostic performances for bullae were calculated for each sign, and an additive score was constructed using signs with specificity > 85%. Pearson's correlation was used to examine the relationship between this score, bulla size, and respiratory functional parameters.</p><p><strong>Results: </strong>Thirty-six patients were included, mostly male (n = 33 patients, 91.7%), with an average age of 62 ± 11 years. Bullae mostly affected apical regions (n = 24 patients, 67%). Bullous regions displayed a more frequent absence of lung sliding (34% vs. 11% in non-bullous regions, p < 0.01), barcode sign (15% vs. 3%, p < 0.01), increased A-line visibility (16% vs. 8%, p = 0.048), and absence of Z lines (62% vs. 44%, p = 0.018). A bulla-point sign was visualised in 4% of bullous regions. Absent lung sliding was more frequent in patients with pulmonary distension and in apical regions. Patient bulla score (3 [2-6]) correlated with bulla size (r = 0.53 [0.25;0.73], p < 0.001), FEV₁ (r = -0.38 [-0.60;-0.03], p = 0.022), and forced vital capacity (r = -0.38 [-0.64;-0.08], p = 0.021).</p><p><strong>Conclusion: </strong>Our findings challenge previous data about the specificity of ultrasound signs of pneumothorax in patients with bullous emphysema, highlighting the need for cautious interpretation in clinical practice.</p><p><strong>Trial registration: </strong>NCT04012359.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Form Is Function: Predicting COPD Outcomes With Respiratory Muscle Dysfunction.","authors":"Bartolome R Celli","doi":"10.1111/resp.70019","DOIUrl":"https://doi.org/10.1111/resp.70019","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"My Lungs Have Feelings Too!","authors":"Peter Gerard Gibson","doi":"10.1111/resp.70011","DOIUrl":"https://doi.org/10.1111/resp.70011","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Lymph Node Metastasis in Lung Cancer Using Deep Learning of Endobronchial Ultrasound Images With Size on CT and PET-CT Findings.","authors":"Ji Eun Oh, Hyun Sung Chung, Hye Ran Gwon, Eun Young Park, Hyae Young Kim, Geon Kook Lee, Tae-Sung Kim, Bin Hwangbo","doi":"10.1111/resp.70010","DOIUrl":"https://doi.org/10.1111/resp.70010","url":null,"abstract":"<p><strong>Background and objective: </strong>Echo features of lymph nodes (LNs) influence target selection during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). This study evaluates deep learning's diagnostic capabilities on EBUS images for detecting mediastinal LN metastasis in lung cancer, emphasising the added value of integrating a region of interest (ROI), LN size on CT, and PET-CT findings.</p><p><strong>Methods: </strong>We analysed 2901 EBUS images from 2055 mediastinal LN stations in 1454 lung cancer patients. ResNet18-based deep learning models were developed to classify images of true positive malignant and true negative benign LNs diagnosed by EBUS-TBNA using different inputs: original images, ROI images, and CT size and PET-CT data. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC) and other diagnostic metrics.</p><p><strong>Results: </strong>The model using only original EBUS images showed the lowest AUROC (0.870) and accuracy (80.7%) in classifying LN images. Adding ROI information slightly increased the AUROC (0.896) without a significant difference (p = 0.110). Further adding CT size resulted in a minimal change in AUROC (0.897), while adding PET-CT (original + ROI + PET-CT) showed a significant improvement (0.912, p = 0.008 vs. original; p = 0.002 vs. original + ROI + CT size). The model combining original and ROI EBUS images with CT size and PET-CT findings achieved the highest AUROC (0.914, p = 0.005 vs. original; p = 0.018 vs. original + ROI + PET-CT) and accuracy (82.3%).</p><p><strong>Conclusion: </strong>Integrating an ROI, LN size on CT, and PET-CT findings into the deep learning analysis of EBUS images significantly enhances the diagnostic capability of models for detecting mediastinal LN metastasis in lung cancer, with the integration of PET-CT data having a substantial impact.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}