Respirology最新文献

{"title":"World Association for Bronchology and Interventional Pulmonology (WABIP) Guidelines on Airway Stenting for Benign Central Airway Obstruction.","authors":"Udit Chaddha, Abhinav Agrawal, Septimiu Murgu, Uzair Ghori, Pere Trias-Sabria, Rosamaria Ortiz-Comino, Herve Dutau, Lutz Freitag, Stefano Gasparini, Pyng Lee, Christophe Dooms, Rocco Trisolini, Maria Lucia L Madariaga, Shuben Li, Lina Zuccatosta, Felix Herth, Hideo Saka, David Fielding, Masahide Oki, Antoni Rosell","doi":"10.1111/resp.70068","DOIUrl":"10.1111/resp.70068","url":null,"abstract":"<p><p>Benign central airway obstruction (BCAO) related strictures include post-intubation tracheal stenosis, post-tracheostomy tracheal stenosis, post-surgical or anastomotic stenosis, stenosis related to inflammatory disorders or infectious disorders, chemical injury or post radiotherapy. Techniques and thresholds for airway stenting for each of these unique conditions vary significantly across centres due to lack of guidance. The management of the airway stents once placed due to scarcity of data also has a similar knowledge void. This document aims to address these knowledge gaps by addressing relevant questions related to airway stenting in BCAO. A multidisciplinary, international group of 20 experts from 19 institutions across 12 countries with extensive experience in airway stenting in BCAO was convened as part of this guideline document through the World Association of Bronchology and Interventional Pulmonology (WABIP). A literature search was performed for reports addressing eight clinically relevant PICO questions. Recommendations addressing these questions were formulated using a systematic process involving the evaluation of published evidence, supplemented with expert experience when necessary. The panel participated in the development of the final recommendations using a modified Delphi technique.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"587-604"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507983","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":"Contemporary Concise Review 2024: Chronic Obstructive Pulmonary Disease.","authors":"Sarita Thawanaphong, Parameswaran Nair","doi":"10.1111/resp.70062","DOIUrl":"10.1111/resp.70062","url":null,"abstract":"<p><p>Non-smoking COPD is common in LMICs, especially in women. Biomass fuel and air pollution are major risk factors with distinct pathophysiology. The 'eosinophilic' endotype in COPD is biologically distinct from asthma. PRISm, FEV₁/FVC Z-scores, and quantitative CT improve early COPD detection. Dupilumab (anti-IL-4/IL-13) improved exacerbations and lung function in COPD with blood eosinophils ≥ 300 cells/μL. Mechanisms are currently being investigated. Smoking cessation remains pivotal. Nicotine metabolite ratio (NMR) can guide pharmacotherapy. Cytisine and varenicline are effective; e-cigarettes pose safety concerns. Mood disorders and dysfunctional breathing are common in COPD. Addressing these can reduce symptom burden and improve quality of life. Comorbidity management, particularly of cardiovascular risk, obesity, and sleep-disordered breathing, is integral to holistic COPD care.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"574-586"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174693","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":"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":"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":"623-632"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231770/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"Fixed CPAP at 10 cmH₂O for OSA: A One-Size-Fits-All Approach?\"","authors":"Yuanming Luo, Lu Wang, Danny J Eckert","doi":"10.1111/resp.70061","DOIUrl":"10.1111/resp.70061","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"682-683"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128465","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":"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":"644-651"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231771/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing COPD Care for Women: A Predictive Tool for Palliative Needs.","authors":"Syed Ahmar Shah","doi":"10.1111/resp.70031","DOIUrl":"10.1111/resp.70031","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"547-549"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693133","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":"Video Killed the Radio Star.","authors":"Philip G Bardin","doi":"10.1111/resp.70064","DOIUrl":"10.1111/resp.70064","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"678-679"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094898","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":"World Bronchiectasis Conference 2025-Inclusive Lungs, Diverse Solutions.","authors":"Rachel Mary Thomson, Lucy Catriona Morgan","doi":"10.1111/resp.70063","DOIUrl":"10.1111/resp.70063","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"552-554"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110848","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":"Quantitative Assessment of Systemic Sclerosis-Related Interstitial Lung Disease via 3D-Imaging.","authors":"Hiromasa Nakayasu, Yuzo Suzuki, Masato Kono, Dai Hashimoto, Shinpei Kato, Koshi Yokomura, Yusuke Inoue, Hideki Yasui, Hironao Hozumi, Masato Karayama, Kazuki Furuhashi, Noriyuki Enomoto, Tomoyuki Fujisawa, Naoki Inui, Takafumi Suda","doi":"10.1111/resp.70024","DOIUrl":"10.1111/resp.70024","url":null,"abstract":"<p><strong>Background and objective: </strong>Interstitial lung disease (ILD) is a leading cause of morbidity and mortality in patients with systemic sclerosis (SSc). The disease course of SSc-related ILD (SSc-ILD) is heterogeneous, and several risk-based models have been developed. This study aimed to quantitatively measure volume loss and disease extent and subsequently evaluate their associations with the development of end-stage lung disease (ESLD).</p><p><strong>Methods: </strong>Lung volume (LV) and disease extent were retrospectively and quantitatively evaluated in two cohorts (exploratory: n = 70; validation: n = 42) using high-resolution computed tomography at the time of SSc-ILD diagnosis, compared to controls (n = 70). LV was quantitatively measured using three-dimensional imaging (3D-image) and standardised by predicted forced vital capacity (standardised LV). The ratio of the normally attenuated LV (range, -950 to -750 Hounsfield units) to the whole-LV (NL%) was also measured using 3D-image. The associations of these variables with ESLD were evaluated.</p><p><strong>Results: </strong>Volume loss and normal lung area loss were noted in patients with SSc-ILD compared with controls, especially in the lower lobes. Meanwhile, extended ILD lesions without volume reduction were observed in the upper lobes. Both decreased standardised LV and NL% were associated with ESLD development, and age and NL% were significant risk factors for ESLD independent of pulmonary function test parameters and standardised LV. A composite model consisting of age and NL% successfully stratified patients with SSc-ILD based on the risk of ESLD.</p><p><strong>Conclusion: </strong>3D-image may be a useful technique for assessing disease severity and predicting the risk for ESLD in patients with SSc-ILD.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"652-661"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650090","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":"Clinical Presentation and Diagnostic Evaluation of Vaping Related Lung Injury in Youth.","authors":"Eleanor D Muise, Rachel Gordon, Jacqueline Steiding, Keri Sullivan, Catherine A Sheils, Alicia M Casey","doi":"10.1111/resp.70034","DOIUrl":"10.1111/resp.70034","url":null,"abstract":"<p><strong>Background and objectives: </strong>The vaping epidemic is a public health crisis worldwide. E-cigarette, or vaping product, use-associated lung injury (EVALI) was recognised in the summer of 2019 and resulted in more than 2800 hospitalizations and 60 deaths per the Centres for Disease Control and Prevention (CDC). Vaping refers to the use of E-cigarettes, which are electronic nicotine delivery systems (ENDS) and mimic smoking without combustion. Over 40 million people in the United States vape, of which youth and young adults represent over half. We describe the evaluation and pulmonary complications in a large cohort of adolescents and young adults referred to a Pulmonary Complications of Vaping Clinic.</p><p><strong>Methods: </strong>Youth ages 10-35 with a vaping history and respiratory symptoms underwent a comprehensive diagnostic evaluation. All patients were counselled for vaping cessation. Patients who met criteria for EVALI or probable EVALI with concurrent infection were reported to the Department of Health.</p><p><strong>Results: </strong>One hundred and thirty patients were referred, and 103 patients underwent comprehensive diagnostic evaluation. Eighty-four percent of patients reported vaping both marijuana and nicotine products. Forty-six percent of patients were diagnosed with EVALI or probable EVALI.</p><p><strong>Conclusions: </strong>The evolving vaping epidemic demonstrates a need for subject matter expertise in the evaluation and diagnosis of youth with vaping-related lung injury, including EVALI. We report a higher number of youth who met criteria for EVALI with the implementation of a standardised vaping questionnaire and evaluation inclusive of outpatients.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"671-677"},"PeriodicalIF":6.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711167","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}