Therapeutic Advances in Respiratory Disease最新文献

{"title":"Improving outcomes in electromagnetic navigation bronchoscopy-guided transbronchial microwave ablation for pulmonary nodules: the role of cone-beam computed tomography.","authors":"Yaochen Huang, Lin Zhou, Yongyong Wang, Jianing Wang, Zhipeng Hao, Xiangning Fu","doi":"10.1177/17534666251333287","DOIUrl":"https://doi.org/10.1177/17534666251333287","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown the potential of electromagnetic navigation bronchoscopy (ENB)-guided transbronchial microwave ablation (MWA) for treating pulmonary nodules. The role of cone-beam computed tomography (CBCT) in the procedure remains unknown.</p><p><strong>Objectives: </strong>To investigate the efficacy and safety of employing CBCT during ENB-guided transbronchial MWA for pulmonary nodules.</p><p><strong>Design: </strong>Retrospective analysis of clinical records.</p><p><strong>Methods: </strong>Patients who underwent ENB-guided transbronchial MWA at the Department of Thoracic Surgery, Tongji Hospital. Patients were categorized into two groups: those who received CBCT during the procedure and those who did not. Technical and ablation success rates, complication rates, and patient characteristics were assessed.</p><p><strong>Results: </strong>A total of 283 patients with 371 nodules were included in the final analysis. The technical success rate was significantly higher in the CBCT group (97.0%) compared to the non-CBCT group (91.5%, <i>p</i> = 0.034). The overall ablation success rate was 88.1%, with the CBCT group demonstrating a higher rate (90.9% vs 81.5%, <i>p</i> = 0.018). Complication rates were similar between the two groups, with no significant differences.</p><p><strong>Conclusion: </strong>The use of CBCT in ENB-guided transbronchial MWA significantly increases the technical and ablation success rates without raising complication rates. These findings underscore the potential advantages of CBCT in enhancing procedural outcomes for patients with pulmonary nodules. Further validation through larger, multi-center studies with longer follow-up is warranted.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251333287"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013641","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":"Perspectives of people with cystic fibrosis considering parenthood surrounding preconception and prenatal genetic counseling and testing.","authors":"Gopika Rajanikanth, Asher Prangley, Olivia M Stransky, Elinor Langfelder-Schwind, Jodie Vento, Elizabeth Felter, Traci M Kazmerski","doi":"10.1177/17534666251340334","DOIUrl":"10.1177/17534666251340334","url":null,"abstract":"<p><strong>Background: </strong>People with cystic fibrosis (pwCF) are increasingly considering their reproductive options. Currently, there are many genetic testing options available for pwCF and their reproductive partners. Healthcare providers, including genetic counselors, can educate pwCF about these options and support them through the decision-making process.</p><p><strong>Objective: </strong>This study explored the role of genetics in the reproductive decisions of pwCF and their perspectives and experiences surrounding prenatal and preconception genetic counseling and testing.</p><p><strong>Design: </strong>We conducted a qualitative study of a national US sample of pwCF age ⩾18 years recruited from the CF Foundation Community Voice platform.</p><p><strong>Methods: </strong>We conducted and recorded semi-structured telephone interviews with participants. We utilized Dedoose software and applied inductive thematic analysis to code the interview transcripts and elicit themes.</p><p><strong>Results: </strong>We interviewed 21 participants (76.2% women, 95.2% White, 4.8% Hispanic, 57.1% parents, 23.8% considering parenthood). Key themes included: (1) pwCF appeared to understand the genetics of CF and were typically first introduced to CF genetics by CF providers, school, or their parents; (2) pwCF had diverse perspectives on having a child with CF; (3) carrier testing was an important consideration for some participants when making decisions about biological parenthood; (4) participants understood the role of genetic counselors and valued their knowledge, but only half previously met with a genetic counselor; (5) pwCF believed genetics information should be presented during childhood/adolescence and reinforced when interested in family planning.</p><p><strong>Conclusion: </strong>pwCF have discrepant views on passing on CF to future offspring, and although there is recognition of the role of genetic counseling and a desire for knowledge from genetic testing, genetic considerations are but one factor involved in parenthood decisions. Future work should develop patient-, provider-, or system-based interventions to best integrate high-quality genetics and genetic counseling care into the CF team for those with CF considering parenthood.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251340334"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161118","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":"Effects of sodium-glucose cotransport-2 inhibitors treatment in patients with pulmonary hypertension.","authors":"Mohammed Obeidat, Aravinthan Vignarajah, Rashid Abdel-Razeq, Ala'eddien Nathir, Nishanthi A Vigneswaramoorthy, Adriano R Tonelli","doi":"10.1177/17534666251351443","DOIUrl":"10.1177/17534666251351443","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) is a complex disorder associated with various underlying conditions, including cardiac and respiratory diseases. PH is classified into five groups based on etiology, disease mechanisms, hemodynamic data, and treatment options. Preliminary data suggest that sodium-glucose cotransport-2 inhibitors (SGLT2-I), known for their benefits in chronic kidney disease, heart failure, and type-2 diabetes mellitus, may have therapeutic implications in PH through their metabolic effects, which include reducing aerobic glycolysis, improving mitochondrial function, and enhancing fatty acid oxidation.</p><p><strong>Objective: </strong>This study aimed to evaluate the clinical effects of SGLT2-I in PH by analyzing a large multicenter database of medical records from the TriNetX Network.</p><p><strong>Design: </strong>The cohort included adult patients with PH diagnosed between January 1, 2012, and January 1, 2023, classified by PH group and treatment with SGLT2-I. Propensity score matching (PSM) was used to balance baseline characteristics between the SGLT2-I and non-SGLT2-I groups.</p><p><strong>Methods: </strong>The primary endpoint was a composite of all-cause mortality, RHF, and hospital admissions over 365 days. Secondary endpoints included the individual components of the primary endpoint, intubations, RHF incidence, IV diuretic use, and NT-Pro-BNP levels. PSM was used to adjust for baseline differences between cohorts.</p><p><strong>Results: </strong>A total of 771,490 patients with PH were identified, with 58,303 treated with SGLT2-I. After PSM, each cohort of treated and untreated patients included 58,302 patients. Patients treated with SGLT inhibitors had a significant reduction in the primary composite endpoint (HR 0.71, 95% CI: 0.707-0.729). Secondary outcomes, including all-cause mortality, hospitalization, and the number of intubations, were also significantly lower in patients treated with SGLT-2 inhibitors. Beneficial effects of SGLT2-I were observed across all PH groups.</p><p><strong>Conclusion: </strong>This study demonstrates that SGLT2-I may be clinically beneficial in patients with PH by reducing all-cause mortality, RHF, and hospital admissions. Our findings support the role of SGLT2-I as a therapeutic option in PH and provide support for future randomized controlled trials using this treatment.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251351443"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529549","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":"Clinical characteristics and prognostic factors of Hermansky-Pudlak syndrome with or without pulmonary fibrosis: a systematic review.","authors":"Dongru Du, Ting Yang, Huajing Wan, Fengming Luo","doi":"10.1177/17534666251374241","DOIUrl":"10.1177/17534666251374241","url":null,"abstract":"<p><strong>Background: </strong>Hermansky-Pudlak syndrome (HPS) is a rare disease characterized by excessive bleeding, oculocutaneous albinism, and pulmonary fibrosis (PF). However, few studies have systematically summarized the clinical characteristics of HPS.</p><p><strong>Objectives: </strong>To summarize the clinical characteristics, risk factors of PF, radiological and pathological presentations, and prognostic factors in patients with HPS.</p><p><strong>Design: </strong>A systematic review.</p><p><strong>Data sources and methods: </strong>We searched PubMed, Embase, Web of Science, and Scopus for eligible studies and extracted patient-level data of clinical characteristics, diagnosis of PF, radiological and pathological features, outcomes, and survival time. Categorial variables were presented as numbers (proportions) and compared using the chi-square test. Univariate and multivariate logistic regression analyses were applied to identify potential risk factors of PF. Kaplan-Meier curve, log-rank test, and Cox regression models were performed for survival analysis and prognostic factors.</p><p><strong>Results: </strong>A total of 186 patients from 112 eligible studies were included. Ocular albinism was associated with increased risk of PF (OR 9.08, 95% CI 2.26, 36.41, <i>p</i> = 0.002), while nystagmus was associated with reduced risk of PF (OR 0.11, 95% CI 0.03, 0.42, <i>p</i> = 0.001). Ground glass opacity (77.9%) was the most common radiological pattern, and ceroid deposition (66.7%) was the most common pathological pattern in HPS-associated PF (HPS-PF). Significant improvements in survival time were observed in patients who received an antifibrotic drug or lung transplantation (<i>p</i> = 0.042). However, no significant prognostic factor was identified in multivariate Cox regression analyses.</p><p><strong>Conclusion: </strong>Ocular albinism may serve as a risk factor, while nystagmus may serve as a protective factor of PF in HPS patients. Applying antifibrotic drugs or lung transplantation may improve the outcome and survival time of patients with HPS-PF. Future prospective studies with a large sample size were needed to verify these results and identify potential prognostic factors.</p><p><strong>Trial registration: </strong>This systematic review was registered in PROSPERO (CRD42024623580).</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251374241"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016197","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 comorbidity and chronic obstructive pulmonary disease: a systematic review and meta-analysis of Mendelian randomization studies.","authors":"Huanrong Ruan, Siyuan Lei, Hulei Zhao, Hailong Zhang, Xuezhong Zhou, Jiansheng Li","doi":"10.1177/17534666251348393","DOIUrl":"10.1177/17534666251348393","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) often coexists with various systemic diseases, forming a comorbid condition. The causal evidence from Mendelian randomization (MR) studies on the impact of comorbidities on COPD is accumulating, yet information for comprehensive summary is limited.</p><p><strong>Objectives: </strong>This study aimed to systematically summarize the evidence from MR studies on the impact of comorbidities on COPD.</p><p><strong>Design: </strong>Systematic review and meta-analysis of MR studies.</p><p><strong>Data sources and methods: </strong>Eight electronic databases were searched to identify relevant MR studies about comorbidities associated with COPD from inception to June 3, 2024. Strengthening the Reporting of Observational Studies in Epidemiology-Mendelian Randomization (STROBE-MR) guidelines were used for reporting quality assessment. We used either a random-effects model or a fixed-effects model to estimate pooled causal evidence from MR studies of comorbidities and COPD.</p><p><strong>Results: </strong>A total of 26 studies were included, of which 8, 4, and 3 studies summarized the causal effects of GERD, depression, obesity on the risk of COPD, respectively. Overall, the studies included had high reporting quality. Our meta-analysis using inverse variance weighted (IVW) of main MR analyses revealed positive causal effects of GERD (OR: 1.64; 95% CI: 1.47-1.84), depression (OR: 1.31, 95% CI: 1.01-1.71), and obesity (OR: 1.51; 95% CI: 1.25-1.83) on COPD. Our qualitative analysis also identified multisystem diseases such as asthma, bronchiectasis, peptic ulcers, heart failure, hypertension, rheumatoid arthritis, and osteoarthritis, as well as systemic conditions like anemia and frailty, were related to the risk of COPD.</p><p><strong>Conclusions: </strong>This study revealed the causal effects of comorbidities on COPD, providing new scientific evidence for the prevention and treatment of COPD, and aiding in the guidance of effective clinical strategies.</p><p><strong>Registration: </strong>This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (No CRD42024575341).</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251348393"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498069","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":"Comparative diagnostic performance and safety of radial endobronchial ultrasound versus its combination with electromagnetic or virtual bronchoscopic navigation for peripheral pulmonary lesions: a retrospective study.","authors":"Qi Qi, Wanqin Fang, Linhui Yang, Yi Liu, Rui Xu, Dan Liu","doi":"10.1177/17534666251355130","DOIUrl":"10.1177/17534666251355130","url":null,"abstract":"<p><strong>Background: </strong>Radial endobronchial ultrasound (R-EBUS), virtual bronchoscopic navigation (VBN), and electromagnetic navigation bronchoscopy (ENB) are widely used bronchoscopic techniques for diagnosing peripheral pulmonary lesions (PPLs). However, the applications of their combinations remain unclear.</p><p><strong>Objectives: </strong>This study aimed to investigate the diagnostic performance and safety of R-EBUS versus its combination with ENB or VBN and lesion characteristics.</p><p><strong>Design: </strong>This study is a retrospective, single-center cohort study.</p><p><strong>Methods: </strong>Patients who underwent R-EBUS without and with ENB or VBN (R-EBUS+ENB, R-EBUS+VBN) for peripheral pulmonary. Diagnostic yield, sensitivity, specificity, and complications were compared using inverse probability of treatment weighting (IPTW) for baseline difference adjustment.</p><p><strong>Results: </strong>R-EBUS, R-EBUS+ENB, and R-EBUS+VBN groups had diagnostic yields of 74.6%, 78.2%, and 73.0%, respectively (no significant differences after IPTW adjustment). Multimodal approaches significantly improved diagnostic yield in patients with emphysematous lungs (R-EBUS vs R-EBUS+ENB: odds ratio (OR): 3.51; 95% confidence interval (CI): 1.38-8.95; <i>p</i> = 0.009; R-EBUS vs R-EBUS+VBN: OR: 3.14; 95% CI: 1.05-9.35; <i>p</i> = 0.04). R-EBUS+ENB demonstrated superior diagnostic performance in lesions ⩽20 mm (OR: 3.58; 95% CI: 1.28-9.98; <i>p</i> = 0.015), lesions with positive bronchial signs (OR: 1.98; 95% CI: 1.07-3.67; <i>p</i> = 0.029), and solid lesions with combined positive bronchial signs (OR: 2.67; 95% CI: 1.18-6.07; <i>p</i> = 0.019). Mild bleeding was more frequent in the R-EBUS+ENB group than in the R-EBUS group (OR: 3.21; 95% CI: 1.13-9.13; <i>p</i> = 0.029); severe complications did not significantly differ among groups.</p><p><strong>Conclusion: </strong>Comparable diagnostic performances were observed among R-EBUS, R-EBUS+ENB, and R-EBUS+VBN groups. Multimodal approaches significantly enhanced diagnostic accuracy in subtypes with lesions of small size, positive bronchial signs, or emphysematous lungs. These findings highlight the importance of tailored multimodal strategies to improve diagnostic yield and procedural safety in PPL evaluation.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251355130"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620693","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":"Therapeutic options for patients with pulmonary hypertension and interstitial lung disease.","authors":"John W Swisher, Eric Weaver","doi":"10.1177/17534666251335815","DOIUrl":"10.1177/17534666251335815","url":null,"abstract":"<p><p>Pulmonary hypertensive diseases have been classified by the World Health Organization (WHO) into five groups based on the pathophysiology and characteristics of each disease state. Several targeted therapeutic agents have been developed that combat the vascular remodeling in WHO Group 1 pulmonary arterial hypertension, however, the search for treatment solutions in other WHO Groups has been less fruitful. In this review, we focus on therapeutic options for patients with pulmonary hypertension and interstitial lung disease (PH-ILD). Investigations of targeted WHO Group 1 PAH therapies have largely failed to improve functional capacity, hemodynamics, oxygenation, quality of life, or survival in PH-ILD. In contrast, inhaled treprostinil was shown effective in the INCREASE Trial, a placebo-controlled study in which patients with PH-ILD treated with inhaled treprostinil demonstrated a 31-meter placebo-corrected improvement in the primary endpoint, 6-minute walk distance. Treatment with inhaled treprostinil was also associated with improvement in time to clinical worsening, fewer exacerbations of underlying lung disease, decrease in N-terminal pro-B-type natriuretic protein (NT-proBNP) levels, and improvement in forced vital capacity compared to placebo. In this review, we also elaborate on the current understanding of the pathobiology leading to PH-ILD with emphasis on the role of newer signaling pathways and mediators of vascular biology that may expand treatment options. Strategy and innovations for early detection and diagnosis are highlighted while underscoring the importance of early detection and diagnosis. A holistic and collaborative approach to the treatment of PH-ILD is outlined including a variety of adjunctive measures and the consideration of patient-reported outcome data in order to improve disease management outcomes.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251335815"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340394","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 value of macrolides in the adjuvant treatment of pulmonary fibrosis: maybe a panacea.","authors":"Qingqing Jia, Qian Wang, Qilong Zhou, Hong Fan, Xiang Tong","doi":"10.1177/17534666251346108","DOIUrl":"10.1177/17534666251346108","url":null,"abstract":"<p><p>Pulmonary fibrosis (PF) is a progressive and fatal interstitial lung disease characterized by excessive extracellular matrix deposition and fibroblast activation. Current antifibrotic therapies, such as nintedanib and pirfenidone, slow disease progression but fail to halt fibrosis or significantly improve survival. Macrolides, a class of antibiotics with immunomodulatory and anti-inflammatory properties, have emerged as potential adjunctive therapies for PF. Preclinical studies demonstrate that macrolides attenuate fibrogenesis through multifaceted mechanisms: suppression of TGF-β/Smad and JNK/c-Jun signaling, inhibition of pro-fibrotic cytokine release, modulation of macrophage polarization toward antifibrotic M2 phenotypes, and induction of apoptosis in senescent cells. Clinically, macrolides have shown promise in reducing acute exacerbations in idiopathic pulmonary fibrosis (IPF), mitigating radiation pneumonitis, and attenuating post-infectious fibrotic changes. However, conflicting results from clinical trials and the absence of large-scale randomized studies highlight the need for further validation. This review evaluates the antifibrotic mechanisms and therapeutic potential of macrolides in PF, integrating preclinical and clinical evidence. We aim to inform future research directions by elucidating their role in modulating key pathways and addressing unresolved efficacy questions.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251346108"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485845","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":"Nocturnal hypoxemia in COPD: the amplifying effect of comorbid OSA and PLMS on oxygen desaturation.","authors":"Viraj Jain, Harshill Modi, Moon Park, Anil Ghimire, Lourdes M DelRosso","doi":"10.1177/17534666251380431","DOIUrl":"10.1177/17534666251380431","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA), and periodic limb movements of sleep (PLMS) frequently co-occur and may exacerbate nocturnal hypoxemia. Still, their combined effects are not well defined.</p><p><strong>Objectives: </strong>To examine the independent and interactive effects of COPD, OSA, and PLMS on nocturnal oxygen desaturation.</p><p><strong>Design: </strong>Cross-sectional analysis of a sleep study cohort.</p><p><strong>Methods: </strong>We analyzed 711 participants (mean age 57.2 ± 17.9 years; 44.4% male), including 48 with COPD. Time with oxygen saturation ⩽88% (ST) and mean SpO₂ were compared across COPD and OSA/PLMS subgroups. Multivariable regression tested the independent and interaction effects of COPD, OSA, PLMS, age, and sex.</p><p><strong>Results: </strong>Participants with COPD had lower mean SpO₂ and longer ST than non-COPD participants (<i>p</i> < 0.005). ST was greatest in those with both OSA and PLMS, particularly in COPD. COPD (+46.4 min, <i>p</i> < 0.001) and OSA (+10.5 min, <i>p</i> = 0.009) independently increased ST. A negative COPD × OSA interaction (<i>p</i> = 0.021) indicated less-than-additive effects, whereas a positive COPD × OSA × PLMS interaction (<i>p</i> = 0.036) identified the highest desaturation burden.</p><p><strong>Conclusion: </strong>COPD and OSA independently worsen nocturnal hypoxemia, while the coexistence of COPD, OSA, and PLMS confers the greatest desaturation burden, underscoring the importance of evaluating overlapping conditions in clinical assessment.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251380431"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081629","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":"How do doctors and patients communicate about the treatment of systemic sclerosis-associated interstitial lung disease? A plain language summary of publication.","authors":"Masataka Kuwana, Aiko Saito, Sue Farrington, Ilaria Galetti, Christopher P Denton, Dinesh Khanna","doi":"10.1177/17534666251371814","DOIUrl":"10.1177/17534666251371814","url":null,"abstract":"<p><p>Summary<b>What is this summary about?</b><b>Systemic sclerosis</b> (SSc) is a condition that affects the immune system (the body's natural defence system) and causes the skin to harden and thicken in large patches. Research shows that 30% to 90% of people with SSc also have <b>interstitial lung disease</b> (ILD), a condition that causes inflammation and scarring of the lungs. When people have SSc and ILD, it is known as SSc-associated ILD or SSc-ILD. The authors of this plain language summary of publication (PLS-P) reviewed different articles to find out what the key issues were in the way doctors and patients with SSc-ILD communicate with each other.<i>What were the results?</i>The key messages from the studies were:Most patients felt uneasy when they were diagnosed with SSc-ILDGood communication between doctors and patients at the first visit is crucial as it sets the tone for future relationshipsBoth doctors and patients avoid talking about how SSc-ILD symptoms may get worse (prognosis) or the subject of death. Patients should be encouraged to ask questions to address important and personal topics that would not be talked about otherwisePatients may feel intimidated by a doctor, which could interfere with communicationDoctors must be able to listen and show empathy to build a relationship with patients and be aware that different communication styles may suit a patient during different stages in their journeyDoctors should avoid using a lot of technical terms. Patients felt metaphors helped them understand their condition betterPatients have different awareness, thoughts, and feelings about SSc-ILD than doctors. If doctors understand this, it may improve the communication between doctors and patientsWays to close the gap between the way doctors and patients communicate include patients having the opportunity to access:Self-learning and patient organizationsPeer-mentoring (patients mentoring other patients)Information technologyShared decision-making, where the doctor and patient work together to come to a decision about treatment and care<i>What do the results mean?</i>The best way to improve the feelings patients have when they are diagnosed with SSc, including SSc-ILD, is to improve the quality of the communication between doctors and patients. The quality of the first meeting between a doctor and patient sets the tone for future checkups, especially if the doctor can listen, show empathy, and allow the patient to ask questions. Improving the patient's knowledge about SSc-ILD, for example by using websites, reading printed materials, or taking part in peer-mentoring schemes, may also contribute to a better conversation.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"19 ","pages":"17534666251371814"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186784","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}