Therapeutic Advances in Respiratory Disease最新文献

{"title":"A real-world study of quality of life following treatment with xylometazoline hydrochloride in individuals with common cold.","authors":"Martina Hagen, Kim Clark, Pranab Kalita, Gessica Serra, Edwin Sanchez, Gabor Varbiro, Mathieu M Albasser","doi":"10.1177/17534666241228927","DOIUrl":"10.1177/17534666241228927","url":null,"abstract":"<p><strong>Background: </strong>The common cold is a frequent, acute, and mild upper respiratory human disease. Nasal congestion has been considered the most bothersome symptom in the common cold, impacting quality of life (QoL). Topical decongestants containing steroids benefit QoL in allergic rhinitis, but no published research has assessed the impact of topical decongestants on QoL in the common cold.</p><p><strong>Objective: </strong>To evaluate the effects of xylometazoline hydrochloride 0.1% (Otrivin, GSK Consumer Healthcare SARL, Switzerland) for up to 7 days on QoL in participants with nasal congestion associated with the common cold.</p><p><strong>Design: </strong>This was a decentralized, longitudinal, open-label study.</p><p><strong>Methods: </strong>The study enrolled 136 participants (⩾18 years) with early symptoms of the common cold, of which 102 were included in the modified intention-to-treat (mITT) population. Within 24 h of study product receipt, participants confirmed a 'plugged nose' and ⩾1 other common cold symptom. Primary endpoints were Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21) total score, total and individual symptom scores, and total QoL score. Secondary endpoints were additional QoL scores. Exploratory and <i>post hoc</i> analyses included median days to resolution for each QoL factor and analyses of five QoL categories.</p><p><strong>Results: </strong>Consistent improvements in symptoms and QoL were seen in the mITT population. From day 1, improvements were seen in the 'plugged nose' symptom (<i>p</i> = 0.0023), WURSS-21 total QoL score, and all individual QoL scores (<i>p</i> < 0.0001 for all). After the last dose needed, significant improvements were seen in sleep quality (73%), vitality (76%), physical activity (71%), social activity (80%), and sensation (81%). No serious or unexpected adverse events were reported.</p><p><strong>Conclusion: </strong>This study is the first to demonstrate in a real-life setting that treating nasal congestion in adults with xylometazoline hydrochloride 0.1% during the common cold positively impacts QoL factors relevant to daily living [Otrivin: Quality of Life (QoL) Impact in a Real-World Setting; https://clinicaltrials.gov/study/NCT05556148].</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10878222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albuterol-budesonide fixed-dose combination rescue inhaler for asthma: a plain language summary of the MANDALA study.","authors":"Alberto Papi, Bradley E Chipps, Richard Beasley, Reynold A Panettieri, Elliot Israel, Mark Cooper, Lynn Dunsire, Allison Jeynes-Ellis, Robert Rees, Frank C Albers, Christy Cappelletti","doi":"10.1177/17534666241232264","DOIUrl":"10.1177/17534666241232264","url":null,"abstract":"<p><p><b>What is this summary about?</b>This summary describes the results of a clinical study called MANDALA that was published in the <i>New England Journal of Medicine</i> in 2022. In the MANDALA study, researchers looked at a new asthma rescue inhaler that contains both <b>albuterol</b> and <b>budesonide</b> in a single inhaler (known as <b>albuterol-budesonide</b>, AIRSUPRA™). This summary describes the results for people aged 18 yearsand older who took part in the study.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of lumacaftor/ivacaftor on the bacterial and fungal respiratory pathogens in cystic fibrosis: a prospective multicenter cohort study in Sweden.","authors":"Mahasin Al Shakirchi, Kimmo Sorjonen, Lena Hjelte, Lena Klingspor, Peter Bergman, Petrea Ericson, Marcus Svedberg, Ulrika Lindberg, Christine Hansen, Isabelle de Monestrol","doi":"10.1177/17534666241254090","DOIUrl":"10.1177/17534666241254090","url":null,"abstract":"<p><strong>Background: </strong>A significant decline in pulmonary exacerbation rates has been reported in CF patients homozygous for F508del treated with lumacaftor/ivacaftor. However, it is still unclear whether this reduction reflects a diminished microbiological burden.</p><p><strong>Objectives: </strong>The aim of this study was to determine the impact of lumacaftor/ivacaftor on the bacterial and fungal burden.</p><p><strong>Design: </strong>The study is a prospective multicenter cohort study including 132 CF patients homozygous for F508del treated with lumacaftor/ivacaftor.</p><p><strong>Methods: </strong>Clinical parameters as well as bacterial and fungal outcomes 1 year after initiation of lumacaftor/ivacaftor were compared to data from 2 years prior to initiation of the treatment. Changes in the slope of the outcomes before and after the onset of treatment were assessed.</p><p><strong>Results: </strong>Lung function measured as ppFEV1 (<i>p</i> < 0.001), body mass index (BMI) in adults (<i>p</i> < 0.001), and BMI <i>z</i>-score in children (<i>p</i> = 0.007) were improved after initiation of lumacaftor/ivacaftor. In addition, the slope of the prevalence of <i>Streptococcus pneumoniae</i> (<i>p</i> = 0.007) and <i>Stenotrophomonas maltophilia</i> (<i>p</i> < 0.001) shifted from positive to negative, that is, became less prevalent, 1 year after treatment, while the slope for <i>Candida albicans</i> (<i>p</i> = 0.009), <i>Penicillium</i> spp (<i>p</i> = 0.026), and <i>Scedosporium apiospermum</i> (<i>p</i> < 0.001) shifted from negative to positive.</p><p><strong>Conclusion: </strong>The current study showed a significant improvement in clinical parameters and a reduction of some of CF respiratory microorganisms 1 year after starting with lumacaftor/ivacaftor. However, no significant changes were observed for <i>Pseudomonas aeruginosa, Staphylococcus aureus</i>, or <i>Aspergillus fumigatus</i>, key pathogens in the CF context.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11119492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined medical-interventional approaches for the management of complex fungal balls: a case series as a viable alternative in non-surgical patients.","authors":"Elaine Dumoulin, Christina S Thornton, John H MacGregor, Alain Tremblay, Chrystal Chan, Paul R MacEachern, Margaret M Kelly, Ranjani Somayaji, Michael D Parkins, Christopher H Mody","doi":"10.1177/17534666241255203","DOIUrl":"10.1177/17534666241255203","url":null,"abstract":"<p><p>Intracavitary pulmonary aspergilloma is a persistent and life-threatening infection that carries a mortality rate of up to 15%. It occurs when Aspergillus species gain entry to an existing lung cavity. In the absence of definitive treatment, patients may succumb to severe complications such as massive hemoptysis, cachexia, or secondary infections. Aspergillomas often show limited response to antifungal medications, mainly due to insufficient drug concentrations within the cavities. Surgery is frequently the preferred treatment option, but it poses significant risks, and many individuals are ineligible due to underlying health issues. We present the most extensive non-surgical fungal ball cohort to date, managed using an innovative multimodal strategy that combines antifungal therapy before and after bronchoscopic debulking. This was a cross-sectional observational study. For those who cannot undergo surgery, our medical center has pioneered a multimodal approach to aspergilloma resection. This approach combines bronchoscopic endoscopy with antifungal therapy and has been applied successfully to more than 18 patients that are presented in this series. The median age of the cohort was 58 years (range: 32-73), with an equal sex distribution. The mean percent predicted FEV₁ was 65.3%. The mean follow-up duration was 3.6 years (range: 0.5-10 years). The cohort receiving antifungals systematically prior to debridement showed a reduction of the pre-existing cavity (40.38 mm <i>versus</i> 34.02 mm, <i>p</i> = 0.021). Across the 18 patients during the follow-up period, 94% remained recurrence-free (defined by symptoms and radiology). Our study fills a critical knowledge gap regarding the significance of initiating antifungal treatment before bronchoscopic debulking and presents a viable approach in these cases for which there is a current unmet therapeutic need.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11119499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of asthma and its predictor among patients presetting in Ethiopian public hospitals: systematic review and meta-analysis, 2024.","authors":"Ousman Adal, Sosina Tamire Mamo, Alamirew Eneyew Belay, Yeshimebet Tamir Tsehay, Henok Biresaw Netsere, Sileshi Mulatu, Gebrehiwot Berie Mekonnen, Mengistu Abebe Messelu, Gebremeskel Kibret Abebe, Wubet Tazeb Wondie, Chernet Tafere, Asnake Gashaw Belayneh","doi":"10.1177/17534666241275336","DOIUrl":"10.1177/17534666241275336","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a leading cause of emergency hospital visits and a significant factor in lost productive hours. The lack of a synthesized body of knowledge on bronchial asthma has notable public health implications.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aim to investigate the prevalence of asthma and its predictors among patients presenting in Ethiopian public hospitals.</p><p><strong>Design: </strong>Duplicate studies were removed using EndNote version X9. The Newcastle-Ottawa Scale guided the quality assessment, and data extraction followed the Joanna Briggs Institute format.</p><p><strong>Data source and methods: </strong>The authors used advanced search methods, including databases such as PubMed, Scopus, Embase, Africa Index Medicus, Science Direct, HINARI, Google Scholar, and manual searches. Data presentation adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Publication bias was assessed using Egger's regression test and a funnel plot. Sensitivity analysis was also conducted.</p><p><strong>Results: </strong>The search yielded 352 original articles, with 22 meeting the criteria for inclusion. Using the random-effects DerSimonian-Laird model, the prevalence of bronchial asthma was found to be 9.02% (95% CI: 7.50, 10.53). Several factors were associated with the prevalence of bronchial asthma, including the spring season (AOR 3.7; 95% CI: 2.11, 6.49), childhood age (AOR 4.2; 95% CI: 1.84, 9.55), and urban residence (AOR 1.7; 95% CI: 1.29, 2.31). Other significant factors include family history of asthma (AOR 2.89; 95% CI: 2.22, 3.75), insecticide exposure (AOR 3.3; 95% CI: 2.23, 4.91), and the presence of household insects like cockroaches (AOR 3.33; 95% CI: 2.15, 5.15). Smoking (AOR 3.64; 95% CI: 2.66, 4.98), obstructive sleep apnea (AOR 4.29; 95% CI: 2.37, 7.76), and recurrent upper respiratory tract infections (AOR 4.31; 95% CI: 2.24, 8.32) were also significant.</p><p><strong>Conclusion: </strong>The pooled prevalence of bronchial asthma is notably high in Ethiopia. Key predictors include childhood age, spring season, urban living, family history of asthma, exposure to insecticides, presence of cockroaches, smoking, obstructive sleep apnea, and recurrent upper respiratory infections. Targeted interventions are crucial and should focus on lifestyle improvements, allergen identification, cockroach control, smoking cessation, reducing insecticide exposure, and promoting a safe environment.</p><p><strong>Trial registration: </strong>This review's protocol was pre-registered with the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42023491222).</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of gastro-esophageal reflux disease with asthma control and quality of life: a cross-sectional study from a low-middle income country.","authors":"Nousheen Iqbal, Atiqa Amirali, Ghulam Ullah Lail, Maria Ali Khan, Rabia Sial, Muhammad Irfan","doi":"10.1177/17534666241297879","DOIUrl":"https://doi.org/10.1177/17534666241297879","url":null,"abstract":"<p><strong>Background: </strong>Gastro-esophageal reflux disease (GERD) is a chronic disease that coexists with asthma and is often responsible for repeated exacerbations, as well as has a negative impact on the quality of life (QoL). However, from our continent, there is limited data available on the exact prevalence of GERD in asthma and its association with asthma control and QoL.</p><p><strong>Objective: </strong>To determine the prevalence of GERD in asthma and see its association with asthma control and QoL.</p><p><strong>Design: </strong>A prospective, cross-sectional study was conducted over 8 months from September 2020 to April 2021.</p><p><strong>Methods: </strong>Patients with a confirmed diagnosis of asthma aged 18 years and above were recruited from the outpatient department of pulmonology. Patients' GERD score was calculated using the FSSG SCALE (Frequency Scale for Symptoms of GERD) questionnaire and the Asthma Control Test (ACT) was used to determine asthma control. To assess the QoL, the short form of health survey (SF-36) questionnaire was used. Patients were recruited through a convenience sampling technique.</p><p><strong>Results: </strong>A total of 190 patients were enrolled, the mean age was 33.7 ± 13.3 years and 55.8% were female. Prevalence of GERD was (136) 71.6%. According to the ACT score, 81 (42.6%) patients had very poorly controlled asthma (mean GERD score of 13.73 ± 7.66), compared to 59 (31.1%) asthmatic patients who had well-controlled asthma (mean GERD score of 11.97 ± 7.39, <i>p</i> = 0.43). SF-36 questionnaire was used to measure QoL showed GERD patients had statistically lower scores in the following domains of QoL: \"Role Limitations due to Physical Functioning\" (37.78 vs 57.44, <i>p</i> = 0.003), \"Energy/Fatigue\" (47.47 vs 55.07, <i>p</i> = 0.02), and \"Bodily Pain\" (63.40 vs 72.84, <i>p</i> = 0.01).</p><p><strong>Conclusion: </strong>This study showed a high prevalence of GERD among asthmatic patients with a negative impact on QoL but did not demonstrate a statistically significant relationship between GERD and asthma control.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605210","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":"Optimizing the safety and efficacy of the awake venovenous extracorporeal membrane oxygenation in patients with COVID-19-related ARDS.","authors":"Peter Sklienka, Filip Burša, Michal Frelich, Jan Máca, Vojtech Vodička, Hana Straková, Markéta Bílená, Tereza Romanová, Hana Tomášková","doi":"10.1177/17534666241282590","DOIUrl":"https://doi.org/10.1177/17534666241282590","url":null,"abstract":"<p><strong>Background: </strong>Maintaining the patient awake and not intubated during the venovenous extracorporeal membrane oxygenation (VV ECMO) reduces the risk of ventilation-induced lung injury in patients with ARDS. Currently, there is a lack of data on outcomes and complications associated with the awake ECMO approach.</p><p><strong>Objectives: </strong>To evaluate outcomes and the occurrence of complications of awake ECMO approach guided by local safety protocol comprising ultrasound-guided cannulation, argatroban-based anticoagulation, respiratory support, and routine sedation targeted to reduce respiratory effort and keeping nurse-to-patient ratio of 1:1.</p><p><strong>Design: </strong>A single-center retrospective case series analysis.</p><p><strong>Methods: </strong>Consecutive patients with COVID-19-related acute respiratory distress syndrome (ARDS) (CARDS) treated by full awake VV ECMO approach from April 2019 to December 2023 were eligible.</p><p><strong>Results: </strong>Our center treated 10 patients (mean age 54.7 ± 11.6 years) with CARDS with an awake ECMO approach. The reasons for awake ECMO included the presence of barotrauma in six patients, a team consensus to prefer awake ECMO instead of mechanical ventilation in three patients, and the patient's refusal to be intubated in one case. Before ECMO, patients were severely hypoxemic, with a mean value of Horowitz index of 48.9 ± 9.1 mmHg and a mean respiratory rate of 28.8 ± 7.3 breaths per minute on high-flow nasal cannula or noninvasive ventilation support. The mean duration of awake VV ECMO was 558.0 ± 173.6 h. Seven patients (70%) were successfully disconnected from ECMO and fully recovered. Intubation from respiratory causes was needed in three patients (30%), all of whom died eventually. In total, three episodes of delirium, two episodes of significant bleeding, one pneumothorax requiring chest tube insertion, and one oxygenator acute exchange occurred throughout the 5580 h of awake ECMO. No complications related to cannula displacement or malposition occurred.</p><p><strong>Conclusion: </strong>The awake ECMO strategy guided by safety protocol appears to be a safe approach in conscious, severely hypoxemic, non-intubated patients with COVID-19-related ARDS.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-acting muscarinic antagonist and long-acting β₂-agonist combination for the treatment of maintenance therapy-naïve patients with chronic obstructive pulmonary disease: a narrative review.","authors":"Roland Buhl, Marc Miravitlles, Antonio Anzueto, Stephen Brunton","doi":"10.1177/17534666241279115","DOIUrl":"10.1177/17534666241279115","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Faster lung function impairment occurs earlier in the disease, particularly in mild-to-moderate COPD, highlighting the need for early and effective targeted interventions. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024 report recommends initial pharmacologic treatment with a long-acting muscarinic antagonist (LAMA) and long-acting β₂-agonist (LABA) combination in group B (0 or 1 moderate exacerbation not leading to hospitalization, modified Medical Research Council score of ⩾2, and COPD Assessment Test™ score of ⩾10) and E (⩾2 moderate exacerbations or ⩾1 exacerbation leading to hospitalization and blood eosinophil count <300 cells/µL) patients. In randomized controlled trials (RCTs), LAMA/LABA combination therapy improved lung function, St. George's Respiratory Questionnaire (SGRQ) total score, and Transitional Dyspnea Index (TDI) focal score and reduced the use of rescue medications, exacerbation risk, and risk of first clinically important deterioration (CID), compared with LAMA or LABA monotherapy. However, there is limited evidence regarding the efficacy and safety of LAMA/LABA combination therapy versus LAMA or LABA monotherapy in maintenance therapy-naïve patients. This review discusses the rationale for the early initiation of LAMA/LABA combination therapy in maintenance therapy-naïve patients with COPD. In post hoc analyses of pooled data from RCTs, compared with LAMA or LABA monotherapy, LAMA/LABA combination therapy improved lung function and quality of life and reduced COPD symptoms, risk of first moderate/severe exacerbation, risk of first CID, and use of rescue medication, with no new safety signals. In a real-world study, patients initiating LAMA/LABA had significantly reduced risk of COPD-related inpatient admissions and rate of on-treatment COPD-related inpatient admissions over 12 months than those initiating LAMA. Consequently, LAMA/LABA combination therapy could be considered the treatment of choice in maintenance therapy-naïve patients with COPD, as recommended by the GOLD 2024 report.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between handgrip strength and small airway disease in patients with stable chronic obstructive pulmonary disease.","authors":"Thanapon Keawon, Narongkorn Saiphoklang","doi":"10.1177/17534666241281675","DOIUrl":"10.1177/17534666241281675","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is associated with airflow limitation resulting from a combination of small airway disease (SAD) and parenchymal destruction. Although various diagnostic methods for SAD exist, access to these tools can be limited.</p><p><strong>Objectives: </strong>This study aimed to explore the correlation between handgrip strength (HGS) and SAD in COPD patients.</p><p><strong>Design: </strong>Cross-sectional prospective study.</p><p><strong>Methods: </strong>HGS was measured using a hand dynamometer. SAD was evaluated using impulse oscillometry, with results reported as the difference between respiratory resistance at 5 and 20 Hz (R5-R20). SAD was defined as R5-R20 ⩾0.07 kPa/L/s. The receiver operator characteristic (ROC) curves, sensitivity, and specificity values were calculated to determine the optimal cutoff value of HGS for predicting SAD.</p><p><strong>Results: </strong>Sixty-four patients (90.6% male) were included. The average age was 72.1 ± 8.3 years, and body mass index was 23.4 ± 4.2 kg/m². FEV₁ was 71.6 ± 21.3%, and HGS was 30.2 ± 8.1 kg. R5-R20 was 0.11 ± 0.08 kPa/L/s. SAD was found in 64.1% of patients. A negative correlation between HGS and R5-R20 was observed (<i>r</i> = -0.332, <i>p</i> = 0.007). The best cutoff value for HGS in detecting SAD was determined to be 28.25 kg, with a sensitivity of 73.9%, specificity of 65.9%, and an area under ROC curve of 0.685 (95% CI 0.550-0.819, <i>p</i> = 0.015).</p><p><strong>Conclusion: </strong>SAD is common in COPD patients, and HGS is significantly negatively correlated with SAD. This tool might serve as an alternative or adjunctive assessment for small airway dysfunction in COPD patients.</p><p><strong>Registration: </strong>This study was registered with ClinicalTrials.gov with number NCT06223139.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk analysis of visceral pleural invasion in malignant solitary pulmonary nodules that appear touching the pleural surface.","authors":"Ziwen Zhu, Weizhen Jiang, Danhong Zhou, Weidong Zhu, Cheng Chen","doi":"10.1177/17534666241285606","DOIUrl":"10.1177/17534666241285606","url":null,"abstract":"<p><strong>Background: </strong>The preoperative determination of visceral pleural invasion (VPI) in patients with malignant solitary pulmonary nodules (SPNs) is essential for determining the surgical range and selecting adjuvant chemotherapy.</p><p><strong>Objectives: </strong>This study aimed to systematically investigate risk factors of VPI in patients with SPN and construct a preoperative predictive model for such patients.</p><p><strong>Design: </strong>This is a retrospective study. The clinical, radiological, and pathological characteristics of study subjects were reviewed, and the groups with and without VPI were compared.</p><p><strong>Methods: </strong>Multivariate logistic analysis was utilized to identify independent risk factors for VPI. Moreover, a predictive nomogram was constructed to assess the likelihood of VPI occurrence.</p><p><strong>Results: </strong>Of the 364 enrolled cases, SPNs adjacent to the pleura with VPI were found in 110 (30.2%) patients. By incorporating four preoperative variables, including tumor diameter (>2 cm), maximum computed tomography value (>200 Hu), air bronchogram sign, and age, a preoperative predictive nomogram was constructed. The nomogram demonstrated good discriminative ability, with a C-index of 0.736 (95% CI (0.662-0.790)). Furthermore, our data indicated that the air bronchogram sign (odd ratio (OR) 1.81, 95% CI (0.99-3.89), <i>p</i> = 0.048), a maximum diameter >2 cm (OR 24.48, 95% CI (8.43-71.07), <i>p</i> < 0.001), pathological type (OR 5.01, 95% CI (2.61-9.64), <i>p</i> < 0.001), and Ki-67 >30% (OR 2.95, 95% CI (1.40-6.21), <i>p</i> = 0.004) were overall independent risk factors for VPI.</p><p><strong>Conclusion: </strong>This study investigated the risk factors for VPI in malignant SPNs touching the pleural surface. Additionally, a nomogram was developed to predict the likelihood of VPI in such patients, facilitating informed decision-making regarding surgical approaches and treatment protocols.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}