Thorax最新文献

{"title":"To test or not to test: reassessing the need for drug response assessment before inhaled hypertonic saline","authors":"Hayoung Choi","doi":"10.1136/thorax-2026-225820","DOIUrl":"https://doi.org/10.1136/thorax-2026-225820","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"22 1","pages":"thorax-2026-225820"},"PeriodicalIF":10.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Counting what matters: the collective weight of interstitial lung disease","authors":"Sabina Guler","doi":"10.1136/thorax-2026-225922","DOIUrl":"https://doi.org/10.1136/thorax-2026-225922","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"68 1","pages":"thorax-2026-225922"},"PeriodicalIF":10.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End of rarity: the evolving burden of interstitial lung diseases in England – trends from a national population-based cohort study","authors":"Georgie May Massen,Ann Dorothy Morgan,Peter M George,Jennifer K Quint,Vidya Navaratnam","doi":"10.1136/thorax-2026-224977","DOIUrl":"https://doi.org/10.1136/thorax-2026-224977","url":null,"abstract":"Background The disease burden from interstitial lung diseases (ILDs) is thought to be increasing globally, but there is a paucity of data on epidemiological trends in non-idiopathic pulmonary fibrosis (IPF) ILD. We calculated incidence, prevalence and mortality rates of all ILD, IPF and non-IPF ILD in England from 2005 to 2022 and investigated trends over time. Methods Using linked primary and secondary electronic healthcare records, we used three code-based algorithms to estimate incidence, prevalence and mortality rates of all ILD, IPF and non-IPF ILD subtypes. We additionally stratified our results by sex, age-group and region. Poisson regression was used to investigate changes to trends over time. We used Kaplan-Meier methods to calculate median survival. Results There were 153 975 incident cases of ILD in either primary or secondary care records. Incidence rates of all ILD, IPF and non-IPF ILD were 30% higher in 2022 compared with 2005, with rates plateauing from 2018 onwards. The prevalence of IPF and non-IPF ILD increased by 6% and 7%, respectively, over the study period. Mortality rates adjusted for age and sex in people with all ILD and non-IPF ILD were similar in 2022 compared with 2005 but in people with IPF it was 15% lower. Median survival of our overall ILD cohort was 5.4 years (IQR 1.88–13.03). Conclusions Our population-based study highlights that ILD are no longer rare. Currently, there are 200 000 people living with ILD and 60 000 new cases are diagnosed each year. Healthcare and research funding needs to reflect this growing burden.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"57 1","pages":"thorax-2026-224977"},"PeriodicalIF":10.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholder-informed prioritisation of HealthTech innovation across chronic respiratory disease: the HERON study","authors":"Zhanna Oganesova,Sofya Panchenko,Nia W Roberts,Lindsay Welch,Fiona Mosgrove,Clare Cook,Gillian Richards,Joanne Salmon,Philip J Turner,Gail N Hayward,Marta Wanat,Helen F Ashdown","doi":"10.1136/thorax-2026-225806","DOIUrl":"https://doi.org/10.1136/thorax-2026-225806","url":null,"abstract":"Background Chronic respiratory disease (CRD) is characterised by high symptom burden and frequent emergency admissions, disproportionately affecting disadvantaged populations. Advances in health technology (HealthTech) offer opportunities to improve health outcomes but are most effective when they target the most pressing needs across the CRD pathway. We aimed to develop and apply a stakeholder-informed prioritisation methodology for HealthTech across adult and paediatric CRD. Methods We used a stakeholder-informed prioritisation methodology designed specifically for HealthTech. National surveys and targeted discussions with people living with CRD, individuals at risk, carers and healthcare professionals identified unmet needs and potential HealthTech solutions. Inductive qualitative content analysis generated a longlist of candidate solution areas, which were mapped against a respiratory technology landscape review to produce evidence summaries of current technological capability. These informed a multistakeholder consensus workshop to identify the top 20 priority HealthTech solution areas for CRD. Results A total of 314 patients, carers and healthcare professionals contributed through surveys and targeted discussions. Stakeholders identified 741 challenges and 555 potential HealthTech solutions, which were synthesised into 73 candidate solution areas across 16 priority domains. The technology landscape review found that 52/73 (71.2%) solution areas remained unmet and 21/73 (28.8%) were partially met by existing HealthTech; none were considered fully met. A multistakeholder consensus workshop identified the top 20 priority HealthTech solution areas for CRD. Conclusion This stakeholder-informed HealthTech prioritisation integrates unmet need with current technological capability to inform policy and funding decisions in CRD. The methodology for HealthTech prioritisation can be applied beyond respiratory care.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"402 1","pages":"thorax-2026-225806"},"PeriodicalIF":10.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic chylohemothorax revealed by sequential dual pleural fluid layering.","authors":"Sunil Munakomi","doi":"10.1136/thorax-2026-225688","DOIUrl":"https://doi.org/10.1136/thorax-2026-225688","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary embolism: from diagnosis to prognosis.","authors":"Ken Kuljit S Parhar, Kevin J Solverson","doi":"10.1136/thorax-2026-225031","DOIUrl":"https://doi.org/10.1136/thorax-2026-225031","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PM\u0000 2.5\u0000 , O\u0000 3\u0000 and survival gains from China’s clean air actions among patients with lung cancer: a 20-year registry-based cohort study in Beijing","authors":"Lei Yang,Ning Kang,Tao Xue,Ning Wang,Shuo Liu,Huichao Li,Xi Zhang,Lili Cao,Xiaolin Ma,Shaohua Ma,Jiafu Ji,Tong Zhu","doi":"10.1136/thorax-2026-225199","DOIUrl":"https://doi.org/10.1136/thorax-2026-225199","url":null,"abstract":"Background In recent years, China has experienced declining fine particulate matter (PM 2.5 ) levels but rising ozone (O 3 ) levels. We aimed to examine the independent and joint associations of long-term exposure to PM 2.5 and O 3 with all-cause mortality among patients with lung cancer and to estimate potential survival gains. Methods We included 172 845 lung cancer patients diagnosed in 2003–2022 from the Beijing Cancer Registry. Three-year average pre-diagnosis PM 2.5 and O 3 were assigned using the ChinaHighAirPollutants dataset. Cox proportional hazards models were used to estimate associations of PM 2.5 and O 3 with mortality. Joint exposure-response patterns were examined using a two-dimensional tensor-product spline and quantified by the multiplicative interaction index. Model-estimated avoided deaths and extended expected lifespan (EEL) were calculated using counterfactual simulations based on 2013 exposure levels. Results Both PM 2.5 and O 3 were associated with increased mortality among patients with lung cancer, with HRs of 1.111 for PM 2.5 (95% CI 1.083 to 1.140) and 1.117 for O 3 (95% CI 1.070 to 1.166) per 10 μg/m 3 increase. A significant multiplicative interaction was observed between PM 2.5 and O 3 , with statistically significant positive interactions mainly occurring at higher O 3 concentrations (>105 µg/m 3 ). During 2016–2022, reductions in pre-diagnosis PM 2.5 exposure were associated with 13 229 model-estimated avoided deaths and a 7.8-month increase in 5-year EEL. However, O 3 and the PM 2.5 -O 3 interaction offset approximately 40% of these benefits. Discussion PM 2.5 reduction was associated with substantial survival gains among lung cancer patients, but rising O 3 and pollutant interactions partly offset these benefits, supporting coordinated multipollutant control.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"103 1","pages":"thorax-2026-225199"},"PeriodicalIF":10.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic misclassification of lung function in Indian adolescents using GLI-2012 reference equations: evidence from the multicity APEAL cohort","authors":"Priya Samdarshi,Padukudru Anand Mahesh,Swapnali Patil,Anant Mohan,George D’Souza,Rajesh Thimmulappa,Twinkle Agrawal,Jayaraj Biligere Siddaiah,Harish Chandra Phuleria","doi":"10.1136/thorax-2026-225309","DOIUrl":"https://doi.org/10.1136/thorax-2026-225309","url":null,"abstract":"Background Accurate spirometric interpretation depends on appropriate reference equations. The Global Lung Function Initiative (GLI-2012) equations are widely used internationally, but South Asian populations were sparsely represented in their derivation and their applicability in Indian adolescents remains uncertain. Methods We performed a cross-sectional analysis of baseline data from the multicity Air Pollution Exposure on Adolescents’ Lungs cohort. Healthy, non-smoking school-going adolescents aged 11–14 years from Delhi, Mumbai, Bengaluru and Mysuru underwent spirometry using standardised American Thoracic Society/European Respiratory Society procedures. GLI-2012 z-scores for forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC) and FEV 1 /FVC were calculated using the Asian reference category. Fit was assessed using mean z-scores and the proportion below the lower limit of normal (LLN; z<−1.645). Results Among 4175 adolescents (2148 males), mean z-scores were −2.44 (SD 1.27) for FEV 1 , −1.34 (0.93) for FVC and −0.78 (1.11) for FEV 1 /FVC, all well outside the accepted ±0.5 range for adequate fit. Overall, 74.6% were below the LLN for FEV 1 , 36.8% for FVC and 19.3% for FEV 1 /FVC, compared with the expected 5% in a well-calibrated healthy population. The leftward shift in z-score distributions was consistent across sex, city, age, height and body mass index strata. Conclusion GLI-2012 equations, as currently applied in the absence of South Asian-specific references, demonstrated substantial calibration mismatch relative to this cohort of Indian adolescents and risk major overclassification of low lung function. Population-specific validation and recalibration are needed before routine clinical or epidemiological use in this population.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"47 1","pages":"thorax-2026-225309"},"PeriodicalIF":10.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequalities in chronic respiratory disease: working towards policy change?","authors":"Ruth Costello,Rosalind Eggo","doi":"10.1136/thorax-2026-225782","DOIUrl":"https://doi.org/10.1136/thorax-2026-225782","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"18 1","pages":"thorax-2026-225782"},"PeriodicalIF":10.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of obstructive sleep apnoea treatment on cardiovascular and sleep health in bed partners: the sleep partners clinical trial","authors":"Sara Q C Giampá,Sofia F Furlan,Thiago A Macedo,Fernanda CSG Cruz,Mayara L Cabrini,Silvana de Barros,Indira FB Azam,Valéria A Costa-Hong,Paulo HS Fernandes,Luiz A Bortolotto,Geraldo Lorenzi-Filho,Luciano F Drager","doi":"10.1136/thorax-2026-225271","DOIUrl":"https://doi.org/10.1136/thorax-2026-225271","url":null,"abstract":"Background It remains unclear whether obstructive sleep apnoea (OSA) and its treatment influence cardiovascular and sleep health in bed partners. Methods In this placebo-controlled trial, patients with moderate/severe OSA who had bed partners were randomly assigned to receive continuous positive airway pressure (CPAP) or placebo (nasal strips). At baseline and after 3 months, the bed partners underwent clinical evaluation, endothelial function (flow-mediated dilation, FMD), 24-hour ambulatory blood pressure (BP) monitoring, sleep questionnaires and 1-week wrist actigraphy. Results A total of 63 couples were recruited (34 patients randomised to CPAP and 29 to nasal strips). At baseline, bed partners showed impaired FMD and a higher frequency of long sleep latency, fragmented sleep, short sleep duration and poor sleep quality. Mean adherence to CPAP and nasal strips in OSA patients was 5.7±1.7 hours and 93.1%±12.6%, respectively. Compared with placebo, bed partners of patients assigned to CPAP did not change FMD (Δ: −0.94% (6.03%; 2.24%) vs Δ: −3.27% (−6.50%; 1.76%), p=0.67). However, significant differences were observed for 24-hour systolic BP (CPAP: −0.85±5.22 mm Hg; placebo: +3.14±8.00 mm Hg; p=0.03), daytime systolic BP (CPAP: −1.2±5.5 mm Hg; placebo: +3.8±8.8 mm Hg; p=0.01) and night-time heart rate (CPAP: −3±6 bpm; placebo: +2±7 bpm; p=0.01). They improved sleep quality (p=0.02), decreased daytime sleepiness (p=0.01), time awake after sleep onset (CPAP: −4.71±20.32 min; placebo: +7.36±17.51 min; p=0.002) and number of awakenings (CPAP: −0.97±9.42; placebo: +2.83±9.14; p=0.02). In a stratified analysis by CPAP adherence, endothelial function in bed partners was preserved with optimal use (≥6 hours/night), but worsened with lower adherence (p=0.03). Conclusions OSA treatment did not improve endothelial function in bed partners but prevented BP increases, alongside improvements in sleep quality, daytime sleepiness and sleep fragmentation. Trial registration number NCT03011294 .","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"18 1","pages":"thorax-2026-225271"},"PeriodicalIF":10.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}