Respirology最新文献

{"title":"Fly Me to the Moon (or Not).","authors":"Natasha Smallwood","doi":"10.1111/resp.14886","DOIUrl":"10.1111/resp.14886","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"262-263"},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053458","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":"Sputum Metagenomics Reveals Multidrug-Resistant Pseudomonas-Dominant Communities in Severe Asthma.","authors":"Sara K Di Simone, Samuel C Forster","doi":"10.1111/resp.14890","DOIUrl":"10.1111/resp.14890","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"186-187"},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081068","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":"Thoracic Society of Australia and New Zealand (TSANZ) Is Abrogating Its Leadership Role in Asia-Pacific.","authors":"Philip Bardin, Christine McDonald, Debra Sandford, Gregory King, Christine Jenkins, Paul Reynolds","doi":"10.1111/resp.14884","DOIUrl":"10.1111/resp.14884","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"190-191"},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010463","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 digital therapy targeting anxiety in pulmonary fibrosis: A decentralized randomized controlled trial.","authors":"Joshua J Solomon, Robert W Hallowell, Cecilia Ganslandt, Jessica G Shull, Thomas Bengtsson, Jakob Ganslandt, Maureen R Horton","doi":"10.1111/resp.14859","DOIUrl":"10.1111/resp.14859","url":null,"abstract":"<p><strong>Background and objective: </strong>Pulmonary fibrosis, a manifestation of interstitial lung disease, is frequently associated with anxiety. The objective of this study, COMPANION, was to assess the anxiolytic efficacy of Almee, a digital cognitive behavioural therapy for patients with pulmonary fibrosis, compared to treatment as usual.</p><p><strong>Methods: </strong>COMPANION was a randomized, controlled, open-label and partly reader-blinded, decentralized, clinical trial conducted in the United States. Eligible patients had radiology-confirmed pulmonary fibrosis and a Generalized Anxiety Disorder 7-item (GAD-7) score of ≥5 (possible range 0-21). Participants were randomized 1:1 to Almee or no intervention for 9 weeks, with block stratification by anxiety severity. The primary endpoint was change in GAD-7 score from baseline to week 9. Between 20 December 2022 and 14 August 2023, 108 participants were randomized, 54 to Almee and 54 to treatment as usual.</p><p><strong>Results: </strong>In each arm, 46 participants completed the study; 108 cases were analysed as intention-to-treat. By week 9, average GAD-7 score had improved by 1.8 points (SEM = 2.1) in the Almee group (n = 54) and deteriorated by 0.9 points (SEM = 2.2) in the control group (n = 54), a 2.7-point difference (95% confidence interval: 1.2-4.2, p = 0.0006).</p><p><strong>Conclusion: </strong>Treatment with Almee was well-tolerated and showed clinically meaningful improvement in pulmonary fibrosis-related anxiety. Almee shows promise as a personalized intervention for management of the psychological burden related to living with pulmonary fibrosis.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"253-261"},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis: An Update for the Clinician.","authors":"Saskia Janssen, Melissa Murphy, Caryn Upton, Brian Allwood, Andreas H Diacon","doi":"10.1111/resp.14887","DOIUrl":"10.1111/resp.14887","url":null,"abstract":"<p><p>Tuberculosis (TB) remains a significant global health threat with high mortality and efforts to meet WHO End TB Strategy milestones are off-track. It has become clear that TB is not a dichotomous infection with latent and active forms but presents along a disease spectrum. Subclinical TB plays a larger role in transmission than previously thought. Aerosol studies have shown that undiagnosed TB patients, even with paucibacillary disease, can be highly infectious and significantly contribute to TB spread. Encouraging clinical results have been seen with the M72/AS01_E vaccine. If preliminary results can be confirmed in ongoing larger trials, modelling shows the vaccine can positively impact the epidemic. TB preventive therapy (TPT), especially for high-risk groups like people living with HIV and household contacts of drug-resistant TB patients, has shown efficacy but implementation is resource intensive. Treatment options for infectious patients have grown rapidly. New shorter, all-oral treatment regimens represent a breakthrough, but progress is threatened by rising resistance to bedaquiline. Many new chemical entities are entering clinical trials and raise hopes for all-new regimens that could overcome rising resistance rates to conventional agents. More research is needed on the management of complex cases, such as central nervous system TB and severe HIV-associated TB. Post-TB lung disease (PTLD) is an under-recognised but growing concern, affecting millions of survivors with lasting respiratory impairment and increased mortality. Continued investment in development of TB vaccines and therapeutics, treatment shortening, and management of TB sequelae is critical to combat this ongoing public health challenge.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"196-205"},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Muscle Strength as a Predictor of Exacerbations in Patients With Chronic Obstructive Pulmonary Disease.","authors":"Yuichiro Furukawa, Atsushi Miyamoto, Kazuhisa Asai, Masaya Tsutsumi, Kaho Hirai, Takahiro Ueda, Erika Toyokura, Misako Nishimura, Kanako Sato, Kazuhiro Yamada, Tetsuya Watanabe, Tomoya Kawaguchi","doi":"10.1111/resp.70003","DOIUrl":"https://doi.org/10.1111/resp.70003","url":null,"abstract":"<p><strong>Background and objective: </strong>Chronic obstructive pulmonary disease (COPD) is closely related to skeletal muscle dysfunction, and the evaluation of respiratory muscle function has recently been recommended. We aimed to investigate the effects of respiratory muscle dysfunction on clinical outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients with COPD whose respiratory muscle strength was measured between June 2015 and December 2021. We then analysed the effects of respiratory muscle strength on moderate-to-severe exacerbations after adjusting for confounding factors, including sex, age, forced expiratory volume in 1-s percent predicted, hand grip strength, and skeletal muscle mass index. We also compared the temporal relationship between respiratory and systemic skeletal muscle dysfunctions.</p><p><strong>Results: </strong>Respiratory muscle weakness (RMW) was observed in 48.1% (100) of the 208 patients. Low percent predicted maximal inspiratory pressure was an independent risk factor for moderate-to-severe exacerbations within 1 year in the Cox regression analysis (adjusted hazard ratio per 1 standard deviation increase, 0.521; 95% confidence interval, 0.317-0.856). Approximately half of the patients already exhibited RMW at the mild systemic skeletal muscle dysfunction, while those with sarcopenia had higher RMW rates. More patients with RMW experienced progressive systemic skeletal muscle dysfunction within 1 year compared to those without RMW.</p><p><strong>Conclusion: </strong>Lower respiratory muscle strength is associated with an increased risk of exacerbation. Respiratory muscle function could serve as a marker of disease status and early prognosis in COPD.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516598","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":"Assessment of the Risk of Severe COPD Exacerbations: Balancing Between Fat and Muscle.","authors":"Felipe V C Machado, Kenneth Verboven, Frits M E Franssen","doi":"10.1111/resp.70008","DOIUrl":"https://doi.org/10.1111/resp.70008","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449991","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":"Development and Validation of a Risk Prediction Model to Identify Women With Chronic Obstructive Pulmonary Disease for Proactive Palliative Care.","authors":"Begashaw Melaku Gebresillassie, John Attia, Dominic Cavenagh, Melissa L Harris","doi":"10.1111/resp.70005","DOIUrl":"https://doi.org/10.1111/resp.70005","url":null,"abstract":"<p><strong>Background and objective: </strong>Proactive palliative interventions can improve symptom control and quality of life in individuals with chronic obstructive pulmonary disease (COPD); however, they are often underutilised. This study aimed to develop and validate a prediction model to identify women with COPD in their last year of life to facilitate timely palliative care referrals and interventions.</p><p><strong>Methods: </strong>Data from 1236 women diagnosed with COPD from the 1921-1926 Australian Longitudinal Study on Women's Health cohort, linked to administrative health records, were analysed. We employed Lasso regression and multivariable logistic regression to select predictors. To assess the predictive performance of the model, we used the area under the receiver operating characteristic (AUROC) curve, calibration plot, and calibration metrics. The Youden index was used to establish the optimal cutoff point for risk classification. The clinical utility of the model was evaluated using decision curve analysis (DCA).</p><p><strong>Results: </strong>The final model to predict 1-year all-cause mortality included six predictors: smoking status, body mass index, needing regular assistance with daily activities, number of supplied medications, duration of illness, and number of hospital admissions. The model performed well, with AUROC of 0.82 (95% CI: 0.80-0.85) and showed excellent calibration. Using a cutoff of 56.6% predicted risk, the model achieved a sensitivity of 72.3%, specificity of 77.7%, and accuracy of 75.0%. The DCA indicated that the model provided a greater net benefit for clinical decision-making.</p><p><strong>Conclusion: </strong>Our prediction model for identifying women with COPD who may benefit from palliative care has shown robust predictive performance and can be easily applied, but requires external validation.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433434","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":"Early-to-Midlife Body Mass Index Trajectories and Obstructive Sleep Apnoea Risk 10 Years Later.","authors":"Yaoyao Qian, Jennifer L Perret, Garun S Hamilton, Michael J Abramson, Caroline J Lodge, Dinh S Bui, Gulshan B Ali, Anurika P De Silva, Robert J Adams, Bruce R Thompson, Bircan Erbas, Eugene H Walters, Chamara V Senaratna, Shyamali C Dharmage","doi":"10.1111/resp.70002","DOIUrl":"https://doi.org/10.1111/resp.70002","url":null,"abstract":"<p><strong>Background and objective: </strong>While short-term weight changes are known to influence obstructive sleep apnoea (OSA), the impact of body mass index (BMI) changes over the life course has been poorly documented. We examined the association between BMI trajectories from childhood to middle age and adult OSA, 10 years later.</p><p><strong>Methods: </strong>Five BMI trajectories were previously identified in the population-based cohort Tasmanian Longitudinal Health Study (TAHS), using eight time-point BMI from age 5 to 43 years. The primary outcome was probable OSA at 53 years, defined using STOP-Bang questionnaire, with Berlin and OSA-50 questionnaires used to ensure consistency of findings. Clinically significant diagnosed OSA was defined as self-reported medical diagnosis or mild OSA with symptoms or moderate-to-severe OSA, using type-4 sleep studies. Associations were examined using multivariable logistic regression.</p><p><strong>Results: </strong>Compared with the average BMI trajectory, the child average-increasing (aOR = 5.28, 95% CI 3.38-8.27) and persistently high trajectories (aOR = 3.73, 2.06-6.74) were associated with increased risk of probable OSA. These associations were consistent when using clinically significant diagnosed OSA (child average-increasing trajectory: aOR = 2.95, 1.30-6.72; high trajectory: aOR = 2.23, 0.82-6.09). Individuals belonging to the low trajectory were less likely than the average trajectory to have OSA. Notably, the child high-decreasing trajectory was not associated with OSA.</p><p><strong>Conclusion: </strong>Physicians and the public should be aware of the potential risk of OSA in middle-aged adults when BMI is high or continuously increasing from childhood to mid-40s. Obese children who subsequently lose weight were not at higher risk of OSA in middle age-a novel and key finding.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391659","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 Two-Staged, Risk-Stratified Strategy Combining FEV₁/FEV₆ and COPD Diagnostic Questionnaire Acts as an Accurate and Cost-Effective COPD Case-Finding Method.","authors":"Po-Chun Lo, Hsin-Kuo Ko, Kun-Ta Chou, Yi-Han Hsiao, Diahn-Warng Perng, Kang-Cheng Su","doi":"10.1111/resp.70000","DOIUrl":"https://doi.org/10.1111/resp.70000","url":null,"abstract":"<p><strong>Background and objective: </strong>Symptom-based questionnaires and handheld lung function devices are widely used for COPD case finding, but the optimal combination remains unclear. This study aimed to compare the diagnostic accuracy (DA) of various combinations of handheld lung function devices and questionnaires and develop a COPD case-finding strategy.</p><p><strong>Methods: </strong>This cross-sectional, prospective, observational study enrolled participants aged ≥ 40 years with respiratory symptoms and ≥ 10 smoking pack-years. Participants completed three questionnaires (COPD diagnostic questionnaire [CDQ], lung function questionnaire; COPD Population Screener) and 2 handheld lung function devices (peak flow meter, microspirometer), followed by spirometry to confirm COPD (post-bronchodilation FEV₁/FVC < 0.7). DA is assessed using the area under the ROC curve (AUROC).</p><p><strong>Results: </strong>Among 224 participants, COPD incidence was 29%. Individually, handheld devices showed significantly higher DA than questionnaires (AUROC 0.678-0.69 for questionnaires vs. 0.807 for peak expiratory flow rate [PEFR] and 0.888 for FEV₁/FEV₆; all pairwise p < 0.05). FEV₁/FEV₆-based combinations outperformed PEFR-based combinations (all n = 224; AUROC 0.897-0.903 vs. 0.810-0.818; p < 0.05). The CDQ and FEV₁/FEV₆ combination reached the highest DA (AUROC 0.903). FEV₁/FEV₆ < 0.76 was the optimal cutoff value. A two-staged strategy (sensitivity/specificity 0.82/0.84) was proposed: low-risk participants (CDQ ≤ 13) need no further testing; middle-risk (CDQ 14-26) should undergo FEV₁/FEV₆; and high-risk (CDQ ≥ 27) and middle-risk with FEV₁/FEV₆ < 0.76 require confirmatory spirometry. This approach would reduce misdiagnoses and save costs and time compared to FEV₁/FEV₆ alone.</p><p><strong>Conclusion: </strong>FEV₁/FEV₆ and CDQ combination achieves the highest DA. A two-staged, risk-stratified strategy combining CDQ and FEV₁/FEV₆ can be accurate and cost-effective to detect at-risk, undiagnosed COPD subjects. External validation is required.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399883","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}