Therapeutic Advances in Respiratory Disease最新文献

{"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":"18 ","pages":"17534666241285606"},"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}

{"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":"18 ","pages":"17534666241282590"},"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":"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":"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":"18 ","pages":"17534666241297879"},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544649/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-reflux swallow-induced peristaltic wave index: a new parameter for the identification of non-acid gastroesophageal reflux-related chronic cough.","authors":"Bingxian Sha, Wanzhen Li, Haodong Bai, Tongyangzi Zhang, Shengyuan Wang, Linyang Wu, Wenbo Shi, Yiqing Zhu, Li Yu, Xianghuai Xu","doi":"10.1177/17534666231220819","DOIUrl":"10.1177/17534666231220819","url":null,"abstract":"<p><strong>Background: </strong>The current available diagnostic criteria for gastroesophageal reflux-related chronic cough (GERC) dominated by non-acid reflux is imperfect. The post-reflux swallow-induced peristaltic wave index (PSPWI) is a parameter reflecting esophageal clearance function.</p><p><strong>Objectives: </strong>This study aims to investigate its diagnostic value for non-acid GERC.</p><p><strong>Design: </strong>This study sought to compare the diagnostic value of PSPWI in different types of GERC, particularly non-acid GERC, and explore the clinical significance of PSPWI in the diagnosis of non-acid GERC through diagnostic experiments.</p><p><strong>Methods: </strong>A retrospective analysis was performed based on 223 patients with suspected GERC who underwent multichannel intraluminal impedance-pH monitoring (MII-pH) in the outpatient clinic of our department from August 2016 to June 2021. Their clinical information, laboratory test results, and treatment responses were assessed and the underlying etiologies of chronic cough were categorized. The predictive value of the PSPWI in diagnosing different types of GERC, especially non-acid GERC, was analyzed and compared.</p><p><strong>Results: </strong>A total of 195 patients with chronic cough who met the inclusion criteria underwent MII-pH monitoring. 143 patients had a definitive diagnosis of GERC, including 98 with acid GERC and 45 with non-acid GERC. The diagnostic value of PSPWI alone was moderate for GERC with an area under the working curve (AUC) 0.760, but poor for non-acid GERC with an AUC of 0.569. However, PSPWI < 39.8% combining with acid exposure time (AET) ⩽ 6.2% demonstrated a moderate diagnostic value for non-acid GERC, with an AUC of 0.722. When PSPWI < 39.8% combined with a non-acid reflux ratio >68.75%, the diagnostic value for non-acid GERC was improved (AUC_ROC = 0.80 <i>versus</i> AUC_ROC = 0.722, <i>p</i> < 0.05), which was significantly superior to non-acid symptom index (AUC_ROC = 0.804 <i>versus</i> AUC_ROC = 0.550, <i>p</i> < 0.05) and non-acid symptom association probability (AUC_ROC = 0.804 <i>versus</i> AUC_ROC = 0.571, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>PSPWI < 39.8% and AET ⩽ 6.2% have demonstrated good diagnostic value for non-acid GERC. The diagnostic value was further improved when combined with non-acid reflux ratio >68.75%.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666231220819"},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106710","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":"Basic assessment of chronic cough in primary care and referral pathways of patients to different specialists: plain language summary of publication.","authors":"Christian Domingo, Jaime Gonzálvez-Rey, Ignacio Dávila, Alfonso Del Cuvillo, Marta Sánchez-Jareño, Luis Cea-Calvo, Karlos Naberan","doi":"10.1177/17534666241257166","DOIUrl":"10.1177/17534666241257166","url":null,"abstract":"<p><p>People with <b>chronic cough</b> (a cough lasting more than 8 weeks) are often referred to different specialists and undergo numerous diagnostic tests, but clear guidance is lacking. This work summarizes a consensus (an agreement) among medical specialists who are involved in managing people with <b>chronic cough</b>: <b>primary care</b> physicians (family doctors), pulmonologists (doctors who specialize in lung conditions), allergists (medical professionals specializing in allergies) and ear, nose and throat (ENT) specialists. They discussed how to perform a basic assessment of people with <b>chronic cough</b> in <b>primary care</b> (day-to-day healthcare given by a general practitioner or family doctor) and how to refer them to different specialists based on clinical findings or test results.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241257166"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11186388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421082","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":"Early experience of endobronchial ultrasound-guided transbronchial nodal cryobiopsy: a case series from Sabah, Malaysia.","authors":"Hema Yamini Ramarmuty, Nai-Chien Huan, Larry Ellee Nyanti, Teng Shin Khoo, Tamilarasi Renganathan, Ahmad Zaki Manoh, Nusaibah Azman, Kunji Kannan Sivaraman Kannan","doi":"10.1177/17534666241231122","DOIUrl":"10.1177/17534666241231122","url":null,"abstract":"<p><p>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an established minimally invasive method for the diagnosis of benign and malignant conditions. Continuous efforts are underway to improve the material adequacy of EBUS-TBNA, including the introduction of a new technique called EBUS-guided transbronchial nodal cryobiopsy (EBUS-TBNC). This method allows for the retrieval of larger and well-preserved histologic samples from the mediastinum. We present a case series of four patients who underwent combined EBUS-TBNA and EBUS-TBNC procedures in our centre. All procedures were performed under general anaesthesia using a convex probe EBUS scope (Pentax EB-1970UK). Two patients were diagnosed with malignancy and two with benign disorders (silicosis and tuberculosis). In the malignant cases, both EBUS-TBNA/cell block and cryobiopsy provided a diagnosis but cryobiopsy yielded more material for ancillary tests in one patient. However, in the benign cases, there was discordance between EBUS-TBNA/cell block and cryobiopsy. Only cryobiopsy detected granuloma in the patient with TB (tuberculosis), and in the patient with silicosis, TBNC provided a better overall histological evaluation, leading to a definitive diagnosis. No complications were observed. This case series supports the potential diagnostic value of combining EBUS-TBNA and EBUS-TBNC, particularly in benign mediastinal lesions (granulomatous diseases), and in cases requiring additional molecular tests in cancer diagnosis.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241231122"},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10870810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736243","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":"18 ","pages":"17534666241275336"},"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":"Unlocking the potential of robotic-assisted bronchoscopy: overcoming challenging anatomy and locations.","authors":"Wissam Abouzgheib, Christopher Ambrogi, Michele Chai","doi":"10.1177/17534666241259369","DOIUrl":"10.1177/17534666241259369","url":null,"abstract":"<p><p>Robotic-assisted bronchoscopy (RAB) was recently added to the armamentarium of tools used in sampling peripheral lung nodules. Protocols and guidelines have since been published advocating use of large oral artificial airways, use of confirmatory technologies such as radial endobronchial ultrasound (R-EBUS), and preferably limiting sampling to pulmonary parenchymal lesions. We present three clinical cases where RAB was used unconventionally to sample pulmonary nodules in unusual locations and in patients with challenging airway anatomy. In case 1, we introduced the ion catheter through a nasal airway in a patient with trismus. In case 2, we established a diagnosis by sampling a station 5 lymph node, and in case 3, we sampled a lesion located behind an airway stump from previous thoracic surgery. All three patients would have presented significant challenges for alternative biopsy modalities such as CT-guided needle biopsy or video-assisted thoracic surgery.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241259369"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321697","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":"Liver injury due to endothelin receptor antagonists: a real-world study based on post-marketing drug monitoring data.","authors":"Shichao Dong, Xiaofei Guo, Huayu Wang, Chuan Sun","doi":"10.1177/17534666231223606","DOIUrl":"10.1177/17534666231223606","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Liver injury is the hallmark adverse reaction of endothelin receptor antagonist (ERA). Since the first drug, bosentan has been widely used in clinical practice, hepatotoxicity has been accompanied by the history of ERA. The new ERA has been proven to have a lower liver risk but the current research findings are inconsistent. ERA-based targeted drug combinations are commonly used in the treatment of pulmonary arterial hypertension, where the risk of liver injury is difficult to estimate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to compare the correlation between ERA and different ERA combination regimens with liver injury in the real world.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a retrospective study using data from the Adverse Event Reporting System (Food and Drug Administration AERS, FAERS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study used proportional imbalance and Bayesian analysis to mine FAERS data from January 2004 to December 2022 to determine the association of three ERAs with liver injury and to further mine the risk of liver injury due to the combination of ERAs with other targeted drugs. In addition, we analyzed the onset time, mortality, and hospitalization rate of liver injury caused by different ERA combination regimens.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We screened out 3581 ERA-related liver injury events, of which bosentan (59.82%) had the largest number of cases. The patients with liver injury were mainly female (60.63%), and the age was concentrated between 61 and 75 years (26.75%). According to different signal mining methods, reporting odds ratio (ROR; 3.38, 95% confidence interval = 3.23-3.53), proportional reporting ratio (PRR; 3.22, &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 37.84), Bayesian confidence propagation neural network (BCPNN; 1.68, 95% confidence interval = 1.61), multi-item gamma Poisson shrinker (MGPS; 3.21, 95% confidence interval = 3.09), bosentan had the strongest association with liver injury compared to ambrisentan and macitentan. Furthermore, bosentan + sildenafil [ROR (2.52, 95% confidence interval = 2.23-2.84), PRR (2.44, &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 15.92), BCPNN (1.29, 95% confidence interval = 1.14), MGPS (2.44, 95% confidence interval = 2.21)], bosentan + epoprostenol [ROR (5.39, 95% confidence interval = 4.29-6.77), PRR (4.94, &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 65.18), BCPNN (2.30, 95% confidence interval = 1.83), MGPS (4.94, 95% confidence interval = 4.08)], bosentan + iloprost [ROR (2.70, 95% confidence interval = 2.11-3.45), PRR (2.61, &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 31.03), BCPNN (1.38, 95% confidence interval = 1.08), MGPS (2.61, 95% confidence interval = 2.12)] had a higher risk of liver injury caused by the three ERA combination regimens. The median time to onset of hepatotoxicity associated with all ERA combination regimens was 259 days (interquartile range: 58-716.5 days). Finally, the hospitalization rate for patients experiencing hepatotoxicity with ERA combination regimens was 47.86% and the mo","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666231223606"},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098657","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":"Referral rates and barriers to lung transplantation based on pulmonary function criteria in interstitial lung diseases: a retrospective cohort study.","authors":"Ofir Deri, David Ovadia, Ella Huszti, Michael Peled, Milton Saute, Tammy Hod, Amir Onn, Lior Seluk, Nadav Furie, Inbal Shafran, Ronen Mass, Sumit Chatterji, Liran Levy","doi":"10.1177/17534666231221750","DOIUrl":"10.1177/17534666231221750","url":null,"abstract":"<p><strong>Background: </strong>Interstitial lung diseases (ILD) unresponsive to medical therapy often require lung transplantation (LTx), which prolongs quality of life and survival. Ideal timing for referral for LTx remains challenging, with late referral associated with significant morbidity and mortality. Among other criteria, patients with ILD should be considered for LTx if forced vital capacity (FVC) is less than 80% or diffusion capacity for carbon monoxide (DLCO) is less than 40%. However, data on referral rates are lacking.</p><p><strong>Objectives: </strong>To evaluate referral rates for LTx based on pulmonary function tests (PFTs) and identify barriers associated with non-referral.</p><p><strong>Design: </strong>A single-center retrospective cohort study.</p><p><strong>Methods: </strong>The study consisted of ILD patients who performed PFT between 2014 and 2020. Patients with FVC < 80% or a DLCO < 40% were included in the study. Patients with absolute contraindications to LTx were excluded. Referral rates were computed, and a comparison was made between referred and non-referred subjects.</p><p><strong>Results: </strong>Out of 114 ILD patients meeting criteria for referral to LTx, 35 were referred (30.7%), and 7 proceeded to undergo LTx. Median time from PFT to referral for assessment was 255 days [interquartile range (IQR) 35-1077]. Median time from referral to LTx was 89 days (IQR 59-143). Referred patients were younger (<i>p</i> = 0.003), had lower FVC (<i>p</i> < 0.001), DLCO (<i>p</i> < 0.001), and a higher rate of pulmonary hypertension (<i>p</i> = 0.04). Relatively better PFT, and older age, were significantly associated with non-referral of patients.</p><p><strong>Conclusion: </strong>There is under-referral of ILD patients who are eligible for LTx, which is associated with severe disease and missed opportunities for LTx. Further research is required to validate these findings.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666231221750"},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098658","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}