Thorax最新文献

{"title":"Clinical presentation and prognosis of acute symptomatic pulmonary embolism in patients with concomitant upper-extremity versus lower-extremity deep vein thrombosis","authors":"Álvaro Dubois-Silva, Behnood Bikdeli, David Jiménez, Cristina Barbagelata-López, Carmen Fernández-Capitán, Andris Skride, Khanh Quoc Pham, José Antonio Porras, Nazaret Pacheco-Gómez, Manuel Monreal","doi":"10.1136/thorax-2024-221960","DOIUrl":"https://doi.org/10.1136/thorax-2024-221960","url":null,"abstract":"Background The impact of deep vein thrombosis (DVT) location on acute pulmonary embolism (PE) prognosis remains uncertain. Methods Using the Registro Informatizado de Enfermedad TromboEmbólica registry, we assessed 30-day and 90-day outcomes in patients with acute symptomatic PE and concomitant upper-extremity (UEDVT) versus lower-extremity DVT (LEDVT). Cox regression was employed for analysis, and standardised differences (SRD) were used for reporting clinical characteristics to minimise type I error overinflation. The primary outcome was 30-day all-cause mortality, with secondary outcomes including 90-day mortality, fatal PE, venous thromboembolism (VTE) recurrences, and major bleeding. Results Among 21 617 patients with PE (March 2001–April 2023), 508 had UEDVT, and 21 109 had LEDVT. Patients with UEDVT were younger (SRD: 0.231), more often had cancer (SRD: 0.395) or non-central PEs (SRD: 0.445), but less frequently had raised troponin levels (SRD: 0.376) or right ventricle dysfunction (SRD: 0.249). Thirty-day mortality was higher in UEDVT compared with LEDVT (7.3% vs 3.5%; p<0.001), with similar trends at 90 days (14% vs 6.0%) and in subgroup analysis in patients without cancer. Increased rates of PE-related mortality, VTE recurrences and major bleeding were noted in patients with UEDVT at both 30 and 90 days. UEDVT was associated with a higher risk for 30-day (adjusted HR (aHR): 1.49; 95% CI 1.04 to 2.13) and 90-day (aHR: 1.52; 95% CI 1.15 to 2.00) all-cause mortality on multilevel multivariable analysis. Conclusions Patients with concomitant UEDVT experienced worse short-term outcomes, including higher mortality, despite fewer clinical signs of PE severity compared with LEDVT. These findings suggest that unrecognised patient characteristics might influence prognosis, warranting further research. Data are available upon reasonable request.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"30 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618438","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":"AI-powered evaluation of lung function for diagnosis of interstitial lung disease","authors":"Daniela Gompelmann, Maximilian Robert Gysan, Paul Desbordes, Julie Maes, Karolien Van Orshoven, Maarten De Vos, Markus Steinwender, Erich Helfenstein, Corina Marginean, Nicolas Henzi, Peter Cerkl, Patrick Heeb, Stephan Keusch, Gianluca Calderari, Paul von Boetticher, Bernhard Baumgartner, Daiana Stolz, Marioara Simon, Helmut Prosch, Wim Janssens, Marko Topalovic","doi":"10.1136/thorax-2024-221537","DOIUrl":"https://doi.org/10.1136/thorax-2024-221537","url":null,"abstract":"Background The diagnosis of interstitial lung disease (ILD) can pose a challenge as the pulmonary function test (PFT) is only minimally affected at the onset. To improve early diagnosis, this study aims to explore the potential of artificial intelligence (AI) software in assisting pulmonologists with PFT interpretation for ILD diagnosis. The software provides an automated description of PFT and disease probabilities computed from an AI model. Study methods In study phase 1, a cohort of 60 patients, 30 of whom had ILD, were retrospectively diagnosed by 25 pulmonologists (8 junior physicians and 17 experienced pneumologists) by evaluating a PFT (body plethysmography and diffusion capacity) and a short medical history. The experts screened the cohort twice, without and with the aid of AI (ArtiQ.PFT, V.1.4.0, ArtiQ, BE) software and provided a primary diagnosis and up to three differential diagnoses for each case. In study phase 2, 19 pulmonologists repeated the protocol after using ArtiQ.PFT for 4–6 months. Results Overall, AI increased the diagnostic accuracy for various lung diseases from 41.8% to 62.3% in study phase 1. Focusing on ILD, AI improved the detection of lung fibrosis as the primary diagnosis from 42.8% without AI to 72.1% with AI (p<0.0001). Phase 2 yielded a similar outcome: using AI increased ILD diagnosis based on primary diagnosis (53.2% to 75.1%; p<0.0001). ILD detections without AI support significantly increased between phase 1 and phase 2 (p=0.028) but not with AI (p=0.24). Interpretation This study shows that AI-based decision support on PFT interpretation improves accurate and early ILD diagnosis. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"18 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618422","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":"First impressions matter: early CPAP use predicts future success","authors":"Stephanie K Kim Mansell, Swapna Mandal","doi":"10.1136/thorax-2025-223052","DOIUrl":"https://doi.org/10.1136/thorax-2025-223052","url":null,"abstract":"Obstructive sleep apnoea (OSA) is a highly prevalent condition affecting 2 billion adults globally.1 The economic burden of OSA has been reported to be in the billions.2 Continuous positive airway pressure (CPAP) remains the gold standard treatment for OSA.3 The clinical and cost-effectiveness of CPAP depend on patients’ adherence to treatment.4 As many clinicians will recognise, CPAP is often a difficult treatment for patients to tolerate, and published data demonstrate that more than one-third of patients are, in the long run, non-concordant with CPAP treatment.5 Many interventions to increase concordance with CPAP therapy have been investigated, including behaviour therapies such as motivational interviewing,6 management of side effects with interventions such as humidification or different interfaces7 and more recently telemedicine and mobile applications.8 While these interventions have been potentially beneficial in clinical trials, transferability to real-world clinical practice is variable. More recently, the timing of interventions to mitigate poor use has been considered with guidelines advocating follow-up after 1 week, 4–6 weeks and 12 weeks after treatment initiation.9 Dielesen et al 10 in their paper have conducted a study to investigate associations between early CPAP use behaviours …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"99 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143608017","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":"Effect of time of day and seasonal variation on bronchodilator responsiveness: the SPIRO-TIMETRY study","authors":"Ben Knox-Brown, Fu Chuen Kon, Karl Peter Sylvester, Akhilesh Jha","doi":"10.1136/thorax-2024-222773","DOIUrl":"https://doi.org/10.1136/thorax-2024-222773","url":null,"abstract":"We investigated the association between time of day and season of testing on the level of bronchodilator responsiveness in a hospital-based population. We found that per 1-hour increment in the working day, the odds of a positive bronchodilator response decreased by 8%. A similar effect was seen when time of day was dichotomised into morning and afternoon time periods. When stratifying by referral reason, the impact of time of day was only seen in those referred for asthma/query asthma. We also found that bronchodilator responsiveness was more common in winter months compared with the rest of the year.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"54 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143599110","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":"Early clinical remission and its role in lung function decline and exacerbation in adult Korean patients with asthma","authors":"Eunhye Bae, Hyun-Jun Park, Heemoon Park, Jung-Kyu Lee, Eun Young Heo, Chang Hoon Lee, Deog Kyeom Kim, Hyun Woo Lee","doi":"10.1136/thorax-2024-222679","DOIUrl":"https://doi.org/10.1136/thorax-2024-222679","url":null,"abstract":"Introduction Despite advancements in asthma management, many patients continue to experience poor disease control, lung function decline, and frequent exacerbations. Clinical remission (CR) has been proposed as a novel treatment target and surrogate marker for long-term outcomes. This study evaluates whether early CR at 1 year after inhaled corticosteroid (ICS) initiation influences lung function decline and exacerbation risk in asthma. Methods This retrospective cohort study evaluated 492 asthma patients treated with ICS at two teaching hospitals. Patients were classified into early CR and non-early CR groups. Early CR was defined based on a composite set of criteria, including sustained absence of exacerbations, no systemic corticosteroid use, symptom control and stable or improved lung function in the first year following ICS initiation. Study outcomes were the annual forced expiratory volume in one second (FEV1) decline and the moderate-to-severe exacerbations. Results Early CR was significantly associated with slower annual FEV1 decline (4-component CR, adjusted β=31.6 mL/year, p=0.001; 3-component CR, adjusted β=15.7 mL/year, p=0.043). The benefits of early 4-component CR on attenuating annual FEV1 decline were more pronounced in specific phenotypes, including type-2 high asthma, persistent airflow limitation, severe asthma and patients requiring add-on long-acting muscarinic antagonists. Early 4-component CR had a reduced risk of moderate-to-severe (adjusted HR (aHR)=0.591, p=0.011) and severe exacerbations (aHR=0.508, p=0.025). Conclusions Achieving CR within 1 year of ICS initiation was associated with improved lung function preservation and reduced exacerbation risk. These findings suggest the importance of achieving early CR as a clinical target in asthma management. Data are available on reasonable request. The data that support the findings of this study are not publicly available due to their containing information that could compromise the privacy of research participants but are available from IRB Committee of SNU-SMG Boramae Medical Center on reasonable request.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"53 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143570444","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":"Impact of COPD on cardiovascular risk factors and outcomes in people with established cardiovascular disease","authors":"Eunice Eunae Cho, Laura C Maclagan, Anna Chu, Ruth Croxford, Don D Sin, Jacob A Udell, Douglas Lee, Peter C Austin, Andrea S Gershon","doi":"10.1136/thorax-2023-220991","DOIUrl":"https://doi.org/10.1136/thorax-2023-220991","url":null,"abstract":"Background Little is known about the association between chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) in people with established CVD. Knowing if COPD is associated with a higher risk of cardiovascular events would guide appropriate secondary prevention. Objective To examine the risk of COPD on major adverse cardiac events (MACEs, acute myocardial infarction, stroke and cardiovascular death) in a complete real-world population of a large province, with known CVD. Methods We conducted a retrospective population cohort study using health administration, medication, laboratory, electronic medical record and other data from Ontario, Canada. All people with a history of CVD with and without physician-diagnosed COPD as of 2008 were followed until 2016 and cardiac risk factors, sociodemographic factors, comorbidities and other factors were compared. Sequential cause-specific hazard models adjusting for these factors determined the risk of MACE in people with COPD. Results Of 496 056 individuals with CVD in Ontario on 1 January 2008, 69 161 (13.9%) had COPD. MACE occurred more frequently among those with CVD (45.3 per 1000 person-years) and COPD compared with those with CVD alone (28.6 per 1000 person-years) (HR 1.24, 95% CI 1.21–1.26) after adjustment for cardiac risk factors, comorbidities, socioeconomic status and other factors. People with COPD were less likely to receive preventive CVD medications or see a cardiologist. Conclusion In a large, real-world population of people with established CVD, COPD was associated with a higher rate of cardiovascular events but a lower rate of preventive therapy. Strategies are needed to improve secondary CVD prevention in the COPD population. Data are available upon reasonable request. The dataset from this study is held securely in coded form at ICES. While legal data sharing agreements between ICES and data providers (eg, healthcare organisations and government) prohibit ICES from making the dataset publicly available, access may be granted to those who meet prespecified criteria for confidential access, available at [www.ices.on.ca/DAS][1] (email: das@ices.on.ca). The full dataset creation plan and underlying analytic code are available from the authors upon request, understanding that the computer programs may rely upon coding templates or macros that are unique to ICES and are therefore either inaccessible or may require modification. [1]: http://www.ices.on.ca/DAS","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"1 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539209","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 on endobronchial ultrasound","authors":"Sze Shyang Kho, Swee Kim Chan","doi":"10.1136/thorax-2024-221866","DOIUrl":"https://doi.org/10.1136/thorax-2024-221866","url":null,"abstract":"A 33-year-old ex-smoker, morbidly obese man presented with symptoms of orthopnoea, oedema and blood-tinged sputum. On physical examination, he exhibited signs consistent with acute pulmonary oedema, necessitating oxygen supplementation. He has a history of percutaneous coronary intervention to the left anterior descending coronary artery, performed a few years ago. A clinical diagnosis of congestive heart failure was confirmed after echocardiography showed a left ventricular (LV) ejection fraction of 15%. CT of the thorax performed for blood-tinged sputum showed cardiomegaly and mediastinal lymphadenopathy without suspicious lung lesions. Diuresis was initiated, resulting in symptom improvement, and the patient was discharged without complications. An endobronchial ultrasound (EBUS) performed a month later for investigation of isolated mediastinal lymphadenopathy showed significant regression in lymph node size, with a benign appearance likely related to underlying congestive heart failure. However, on examination at the right hilar region, an intravascular hyperechoic mass was noted within the lumen of the right pulmonary artery ( arrow, figure 1A). The Doppler signal was positive surrounding the mass, raising suspicion of an intravascular thrombus (figure 1B and online supplemental video 1). An urgent CT of the pulmonary artery (CTPA) was arranged, confirming pulmonary embolism (PE) of the right main …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"11 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143518069","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":"Six early CPAP-usage behavioural patterns determine peak CPAP adherence and permit tailored intervention, in patients with obstructive sleep apnoea","authors":"Julia Dielesen, Lesedi J Ledwaba-Chapman, Pragna Kasetti, Noori Fatima Husain, Timothy C Skinner, Martino F Pengo, Teresa Whiteman, Koula Asimakopoulou, Simon Merritt, David Jones, Peter Dickel, Siddiq Pulakal, Neil R Ward, Justin Pepperell, Joerg Steier, S Amanda Sathyapala","doi":"10.1136/thorax-2024-221763","DOIUrl":"https://doi.org/10.1136/thorax-2024-221763","url":null,"abstract":"Background High rates of non-adherence to continuous positive airway pressure (CPAP) in obstructive sleep apnoea hamper good clinical outcomes. Current recommendations assumes two behaviours (adherence and non-adherence) and days 7–90 follow-up post-CPAP initiation mitigates against non-adherence. Objectives To investigate associations between early CPAP-usage behaviours and (1) CPAP adherence at month 3 of treatment and (2) sleep centres’ treatment pathways (the procedures patients undergo that may affect barriers or facilitators of CPAP adherence). Methods We conducted growth mixture modelling (GMM) on retrospective data from 1000 patients at 5 UK sleep centres. Night 1 to month 3 telemonitored CPAP-usage data were downloaded from 200 patients per centre who started CPAP in 2019 (100) or 2020 (100). Adherence was defined using accepted criteria (mean CPAP-usage ≥4 hours/night for ≥70% of nights). Results GMM identified six distinct CPAP-usage behaviour patterns over month 1. In four (54% of patients), CPAP-usage increased or decreased, in two (remaining 46%), CPAP-usage/non-usage was consistent. 62% of the cohort were non-adherent by month 3, despite pathways following current recommendations. 98% of patients who were non-adherent by month 3 were already non-adherent by month 1. Regression analysis with a separate dataset demonstrated that early CPAP-usage behaviour explained 86% of the variance in CPAP non-adherence at month 3. Conclusions These data, supported by previous work, indicate that recommended day 30–90 follow-up is too late to prevent CPAP non-adherence. Determining CPAP-usage behavioural pattern in week 2 identifies risk of CPAP non-adherence at month 3 and permits the possibility of tailored interventions. Data are available on reasonable request.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"35 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143518019","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":"Vasodilator-induced selective pulmonary oedema in sarcoidosis-associated pulmonary hypertension with pulmonary venous stenosis","authors":"Takatoyo Kiko, Akihiro Tsuji, Jin Ueda, Keiko Ohta-Ogo, Takeshi Ogo","doi":"10.1136/thorax-2024-222190","DOIUrl":"https://doi.org/10.1136/thorax-2024-222190","url":null,"abstract":"A 43-year-old woman was diagnosed with sarcoidosis-associated pulmonary hypertension (SAPH) based on transbronchial lymph node and lung biopsy (figure 1A) and right heart catheterisation. Contrast-enhanced CT revealed no signs of pulmonary embolism. Based on the medical history, laboratory examination and imaging modalities, other potential causes of pulmonary hypertension (PH) were excluded. The diffusion capacity of carbon monoxide was 81% of the predicted value; arterial haemoglobin oxygen saturation was 92% on room air. First, she was prescribed prednisolone (15 mg daily) for 6 months, after which a phosphodiesterase type 5 inhibitor (tadalafil; 40 mg daily) was initiated. Despite treatment, her PH persisted, exhibiting a mean pulmonary artery pressure, 39 mm Hg; cardiac index, 1.9 L/min/m2; pulmonary artery wedge pressure, 4 mm Hg; and pulmonary vascular resistance, 13.0 Wood units. Consequently, an endothelin receptor antagonist (macitentan; 10 mg daily), was added to her regimen. After 4 days of macitentan initiation, her shortness of breath worsened with increased body weight, leading to heart failure. Chest radiography (figure 2A) and CT (figure 2B) revealed selective pulmonary oedema. Contrast-enhanced CT showed pulmonary venous stenosis due to sarcoidosis lesions (figure 2C). Pulmonary angiography confirmed severely localised pulmonary venous stenosis and occlusion (figure …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"30 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143518018","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":"Preserved ratio impaired spirometry (PRISm): prognostic, preventable and treatable?","authors":"Guy G Brusselle, Sebastian G Riemann","doi":"10.1136/thorax-2024-222923","DOIUrl":"https://doi.org/10.1136/thorax-2024-222923","url":null,"abstract":"Spirometry is a crucial lung function test, which is primarily aimed at identifying airway obstruction in subjects with chronic symptoms of shortness of breath or cough. An obstructive pattern is defined as an impaired ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) (ie, FEV1/FVC less than the lower limit of normal (LLN)) (figure 1). It may be caused by asthma and/or chronic obstructive pulmonary disease (COPD) and warrants further testing including bronchodilator responsiveness. Spirometry is essential for diagnosing asthma and COPD, but also for monitoring the course of these highly prevalent chronic airway diseases, including the response to treatment, the level of short-term asthma control and the occurrence of long-term clinical remission. However, there is a second spirometric pattern which is important to discern in clinical practice: preserved ratio impaired spirometry (PRISm), defined as a preserved FEV1/FVC ratio but impaired FEV1 (ie, FEV1 less than 80% predicted). Only recently, PRISm has attracted more attention. Figure 1 The main spirometric patterns encompass an obstructive pattern, a normal spirometry and preserved ratio impaired spirometry (PRISm). BMI, body mass index; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 s; FVC, forced vital capacity; HDL, high-density lipoprotein; LE8: Life’s Essential 8; LLN, lower limit of normal. PRISm, affecting approximately 6%–18% of the adult general population and elicited by multiple conditions, is associated with …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":"50 1","pages":""},"PeriodicalIF":10.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143462610","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}