Pulmonary Medicine最新文献

{"title":"Pulmonary Cryptococcosis Infection in Non-HIV Patients in a Tertiary Care Center in Taiwan.","authors":"Kuan-Chieh Tu, Ting-Chia Chang, Mei-I Sung, Chung-Han Ho, Kuo-Chen Cheng, Wen-Liang Yu","doi":"10.1155/pm/4389033","DOIUrl":"10.1155/pm/4389033","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary cryptococcosis is an important opportunistic fungal infection in immunocompromised individuals, including those with an infection of the human immunodeficiency virus (HIV) but it can be increasingly seen in non-HIV patients.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 58 non-HIV-infected patients with International Classification of Diseases, Ninth Revision, Clinical Modification Code B45.0 (pulmonary cryptococcosis) who were admitted to the Chi-Mei Hospital, Taiwan from January 2016 to April 2022.</p><p><strong>Results: </strong>Of the enrolled 58 cases, 56 patients had no evidence of disease outside the lungs, and only two patients (3.4%) had disseminated diseases. Thirty-nine patients had pathologically confirmed pulmonary cryptococcosis, and 19 patients had clinically confirmed disease. Pulmonary cryptococcus patients with cancer had a nonsignificant numerically higher rate of ICU use (14.29% vs. 5.13%; <i>p</i> = 0.348). There were similar mortality rates in both cancer and noncancer patients with pulmonary cryptococcosis (4.76% vs. 2.70%; <i>p</i> = 0.581). Patients in the cancer and noncancer groups had a similar duration of hospital stay (7 vs. 6 days, <i>p</i> = 0.799) and low mortality rates (4.76% vs. 2.70%, <i>p</i> = 0.581) on standard antifungal therapy.</p><p><strong>Conclusions: </strong>Cancer and noncancer patients had similar good outcomes after receiving appropriate standard antifungal treatment. Asymptomatic patients with pulmonary cryptococcosis diagnosed incidentally are self-limited and require no antifungal therapy.</p><p><strong>Trial registration: </strong>IRB number: 11111-004.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 ","pages":"4389033"},"PeriodicalIF":2.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12933177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Dyspnea and Chronic Fatigue in Patients With Long COVID: Clinical Characteristics and Associated Laboratory Parameters.","authors":"Maria Eduarda Souza Melo-Oliveira, Roberto Alves Lourenço, Eduardo Buzanovsky Louzada, Marcela Moutinho, Alessandra Ferrarese Barbosa, Virgílio Garcia Moreira, Luís Cristóvão Porto","doi":"10.1155/pm/5426125","DOIUrl":"10.1155/pm/5426125","url":null,"abstract":"<p><strong>Abstract: </strong>Dyspnea and chronic fatigue stand out as prevalent manifestations in the postacute phase of COVID, resulting in substantial adverse effects on patients' quality of life and functional capacity. Although these symptoms have been widely documented, there is no clear consensus on the pathophysiological mechanisms that underlie them. The available literature reveals a dispersion of clinical and laboratory data, and the variability in the methods of assessment of fatigue and dyspnea, as well as in the laboratory variables examined, limits the standardized understanding of this complex condition.</p><p><strong>Objective: </strong>This study was aimed at identifying and synthesizing the evidence on the main clinical and laboratory characteristics related to dyspnea and fatigue in patients during long COVID from 2021 onwards.</p><p><strong>Methods: </strong>The main databases used to select the studies were PubMed and Medline, also using LitCovid and Embase.</p><p><strong>Results: </strong>A total of 42 articles that met the inclusion criteria were included, covering a total population of 30,682 patients diagnosed with COVID-19. The findings underscore the significant impact of long COVID on patients' quality of life, with persistent symptoms such as fatigue and dyspnea affecting a considerable proportion of individuals for durations ranging from 1 to 24 months.</p><p><strong>Conclusion: </strong>The heterogeneity in research approaches highlights the urgent need for collaborative initiatives to elucidate the determinants of long COVID symptomatology and create more consistent evaluation protocols.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 ","pages":"5426125"},"PeriodicalIF":2.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12868379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress Echocardiography to Detect Exercise Pulmonary Hypertension in Patients With Chronic Thromboembolic Pulmonary Disease.","authors":"Adam Dhayyat, Knut Stavem, Øyvind Jervan, Janne Mykland Hilde, Diyar Rashid, Jostein Gleditsch, Waleed Ghanima, Kjetil Steine","doi":"10.1155/pm/4127338","DOIUrl":"10.1155/pm/4127338","url":null,"abstract":"<p><strong>Background: </strong>This study was aimed at determining whether stress echocardiography could detect exercise pulmonary hypertension (ePH) in patients with mild chronic thromboembolic pulmonary disease (CTEPD) as compared with right-heart catheterization (RHC).</p><p><strong>Methods: </strong>Thirty-six symptomatic patients with persistent residual perfusion defects detected using ventilation/perfusion scintigraphy underwent a haemodynamic assessment by RHC and echocardiography at rest and during exercise. We compared pulmonary pressures in echocardiography with RHC values using the definitions in current ESC/ERS guidelines for ePH [mean pulmonary artery pressure/cardiac output (mPAP/CO) slope > 3 mmHg/L/min] and PH (mPAP > 20 mmHg).</p><p><strong>Results: </strong>Ten of the 36 patients (28%) exhibited an increase in the invasive mPAP/CO slope of > 3 mmHg/L/min. The correlation between echocardiographic and invasive measures of the mPAP/CO slope and systolic pulmonary pressure (sPAP) during peak exercise was <i>ρ</i> = 0.75 (95<i>%</i> <i>C</i> <i>I</i> = 0.53-0.97) and <i>ρ</i> = 0.75 (95<i>%</i> <i>C</i> <i>I</i> = 0.53-0.96), respectively. In bivariate logistic regression analyses, ePH was associated with the echocardiographic sPAP during peak exercise [<i>o</i> <i>d</i> <i>d</i> <i>s</i>  <i>r</i> <i>a</i> <i>t</i> <i>i</i> <i>o</i> (<i>OR</i>) = 1.13, 95<i>%</i> <i>C</i> <i>I</i> = 1.02-1.24] and with the echocardiographic mPAP/CO slope (<i>OR</i> = 3.86, 95<i>%</i> <i>C</i> <i>I</i> = 1.24-12.03). In ROC analysis, AUC was 0.89 (95<i>%</i> <i>C</i> <i>I</i> = 0.78-1.00) for the optimal exercise sPAP cut-off value of 56 mmHg (<i>s</i> <i>e</i> <i>n</i> <i>s</i> <i>i</i> <i>t</i> <i>i</i> <i>v</i> <i>i</i> <i>t</i> <i>y</i> = 90<i>%</i>, <i>s</i> <i>p</i> <i>e</i> <i>c</i> <i>i</i> <i>f</i> <i>i</i> <i>c</i> <i>i</i> <i>t</i> <i>y</i> = 87<i>%</i>), and 0.84 (95<i>%</i> <i>C</i> <i>I</i> = 0.66-1.00) for the optimal mPAP/CO slope cut-off value of 3.7 mmHg/L/min (<i>s</i> <i>e</i> <i>n</i> <i>s</i> <i>i</i> <i>t</i> <i>i</i> <i>v</i> <i>i</i> <i>t</i> <i>y</i> = 89<i>%</i>, <i>s</i> <i>p</i> <i>e</i> <i>c</i> <i>i</i> <i>f</i> <i>i</i> <i>c</i> <i>i</i> <i>t</i> <i>y</i> = 79<i>%</i>).</p><p><strong>Conclusion: </strong>Stress echocardiographic assessments of the exercise sPAP and mPAP/CO slope predicted ePH as measured using RHC with good discrimination and acceptable calibration, providing promising evidence in diagnosing ePH in patients with CTEPD.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03405480.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 ","pages":"4127338"},"PeriodicalIF":2.1,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Cryptococcosis Infection in Non-HIV Patients in a Tertiary Care Center in Taiwan.","authors":"Kuan-Chieh Tu, Ting-Chia Chang, Mei-I Sung, Chung-Han Ho, Kuo-Chen Cheng, Wen-Liang Yu","doi":"10.1155/pm/4389033","DOIUrl":"https://doi.org/10.1155/pm/4389033","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary cryptococcosis is an important opportunistic fungal infection in immunocompromised individuals, including those with an infection of the human immunodeficiency virus (HIV) but it can be increasingly seen in non-HIV patients.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 58 non-HIV-infected patients with International Classification of Diseases, Ninth Revision, Clinical Modification Code B45.0 (pulmonary cryptococcosis) who were admitted to the Chi-Mei Hospital, Taiwan from January 2016 to April 2022.</p><p><strong>Results: </strong>Of the enrolled 58 cases, 56 patients had no evidence of disease outside the lungs, and only two patients (3.4%) had disseminated diseases. Thirty-nine patients had pathologically confirmed pulmonary cryptococcosis, and 19 patients had clinically confirmed disease. Pulmonary cryptococcus patients with cancer had a nonsignificant numerically higher rate of ICU use (14.29% vs. 5.13%; p = 0.348). There were similar mortality rates in both cancer and noncancer patients with pulmonary cryptococcosis (4.76% vs. 2.70%; p = 0.581). Patients in the cancer and noncancer groups had a similar duration of hospital stay (7 vs. 6 days, p = 0.799) and low mortality rates (4.76% vs. 2.70%, p = 0.581) on standard antifungal therapy.</p><p><strong>Conclusions: </strong>Cancer and noncancer patients had similar good outcomes after receiving appropriate standard antifungal treatment. Asymptomatic patients with pulmonary cryptococcosis diagnosed incidentally are self-limited and require no antifungal therapy.</p><p><strong>Trial registration: </strong>IRB number: 11111-004.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e4389033"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Safety of 1.1-mm Cryobiopsy for Acute Rejection Surveillance in Lung Transplant Recipients: A Comparative Study and Review of the Literature.","authors":"Alanna Barrios-Ruiz, Alejandra Yu Lee-Mateus, Bryan F Vaca-Cartagena, Paola Gutierrez-Gallegos, Rodrigo Funes-Ferrada, Prasanth Balasubramanian, Andras Khoor, Sadia Z Shah, Francisco G Alvarez, Maher Baz, Tathagat Narula, Remzi Bag, Kelly S Robertson, Sebastian Fernandez-Bussy, David Abia-Trujillo","doi":"10.1155/pm/3558336","DOIUrl":"10.1155/pm/3558336","url":null,"abstract":"<p><strong>Background: </strong>Identifying graft rejection after lung transplantation remains challenging, and no consensus exists on the optimal surveillance strategy. Transbronchial forceps biopsy (FBx) is the conventional method but is limited by small sample size and crush artifacts. Sheath-guided cryobiopsy (CBx) using a novel 1.1-mm probe has emerged as a promising alternative. This study evaluates the feasibility and safety of the 1.1-mm cryoprobe and provides a focused review of current literature.</p><p><strong>Methods: </strong>We conducted a retrospective observational single-center study between October 2022 and January 2023 of adult lung transplant recipients who underwent transbronchial biopsies for surveillance. Procedures were performed using either standard FBx or the 1.1-mm cryoprobe. Descriptive analyses compared feasibility and safety between groups.</p><p><strong>Results: </strong>We identified 72 lung transplant recipients who underwent 109 surveillance biopsies. A total of n = 56 CBx and n = 53 FBx procedures were performed. The median procedure time was 20 min (IQR 17-26) in the CBx group versus 22 min (IQR 15-33) in the FBx group. We found a statistically higher median sample area for CBx compared with FBx (11 vs. 6 mm², p < 0.01). No pneumothorax or postprocedural respiratory failure occurred in either group.</p><p><strong>Conclusion: </strong>CBx with a 1.1-mm probe provides larger histological samples than FBx, with comparable safety and potentially shorter procedural times. These findings support its feasibility for lung transplant surveillance.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e3558336"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Post-COVID Syndrome on Cardiorespiratory Fitness, Psychological Well-Being, and Quality of Life in Adolescents: A Cross-Sectional Study.","authors":"Albane Bertha Rosa Maggio, Ivan Perret, Nuseibah Alramadina, Anne Perrin, Constance Barazzone, Anne Mornand","doi":"10.1155/pm/5599011","DOIUrl":"10.1155/pm/5599011","url":null,"abstract":"<p><strong>Background: </strong>Post-COVID syndrome (PCS) in adolescents, marked by persistent symptoms such as dyspnea and fatigue, remains poorly understood, particularly in those referred for exercise intolerance.</p><p><strong>Objective: </strong>The objective of this study is to describe the clinical presentation and cardiorespiratory fitness (CRF) of adolescents with PCS and identify factors distinguishing those with normal versus reduced CRF.</p><p><strong>Study design: </strong>In this cross-sectional study, 31 adolescents (90% female) with PCS underwent cardiopulmonary exercise testing (CPET), pulmonary function tests, and completed validated questionnaires assessing fatigue, depression, hyperventilation, physical activity, and quality of life (QoL). Patients were grouped by CRF status and compared.</p><p><strong>Results: </strong>Symptoms were more prevalent than in general PCS literature, likely due to referral bias. Moderate depression risk was present in 35%, and 75% reported QoL impairment comparable with chronic conditions. Nearly half (48%) had reduced CRF. CRF was not associated with acute infection severity but correlated with orthostatism, reduced O₂ pulse, and increased static air trapping (p < 0.05). Preinfection physical activity was positively associated with CRF (p = 0.014), whereas postinfection activity levels were similar across groups.</p><p><strong>Conclusion: </strong>PCS significantly impacts CRF, QoL, and psychological well-being in adolescents with exercise intolerance. Reduced CRF appears multifactorial, involving autonomic dysfunction, pulmonary limitations, and deconditioning. These findings underscore the need for comprehensive evaluation and targeted management strategies in this vulnerable population.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e5599011"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Predictors of Weaning Failure and Mortality in Individuals With COVID-19 Undergoing Invasive Mechanical Ventilation: A Retrospective Cohort Study.","authors":"Natália Trindade, Larissa Araújo de Castro, Walter Sepúlveda-Loyola, Carrie Chueiri Ramos Galvan, Josiane Marques Felcar, Ercy Mara Cipulo Ramos, Vanessa Suziane Probst","doi":"10.1155/pm/9316439","DOIUrl":"10.1155/pm/9316439","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, a significant number of affected individuals experienced acute respiratory failure requiring invasive mechanical ventilation (IMV). Once IMV becomes necessary, substantial efforts are made to conduct a successful ventilatory weaning process and prevent deleterious effects associated with prolonged positive pressure use. Identifying the clinical characteristics of COVID-19 patients who experienced failure in ventilatory weaning can provide insights to optimize ventilatory management.</p><p><strong>Aim: </strong>This study is aimed at identifying predictors of weaning failure (WF) from IMV in patients with COVID-19 and their association with mortality.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data obtained from medical records, including personal and clinical information, IMV parameters, ventilatory mechanics, IMV duration, hospital and intensive care unit (ICU) length of stay, and discharge or death date. All COVID-19 patients admitted between March 2020 and July 2022, aged ≥ 18 years, and requiring IMV were included. Patients were categorized into three groups: weaning success (WS), WF, and no criteria for weaning (NCW). Success was defined as orotracheal prosthesis removal without reintubation within 48 h or, for tracheostomized patients, disconnection from mechanical ventilation for ≥ 48 h.</p><p><strong>Results: </strong>A total of 2.198 individuals were included, of whom 528 (age 52 [39-61] years, 195 men, and body mass index 29 [26-34] kg/m²) met the criteria for weaning and were analyzed (WS: n = 380, 195 men; WF: n = 148, 89 men). Individuals in the WS group were younger (WS: 52 [39-61] vs. WF: 56 [47-67] years; p < 0.0001) and had shorter ICU stay (WS: 16 [10-27] vs. WF: 29 [14-45] days; p < 0.0001) and IMV duration (WS: 12 [7-20] vs. WF: 25 [14-37] days; p < 0.0001). Independent predictors of WF included age (OR [95% CI]: 1.028 [1.005-1.052]), length of hospital stay (OR [95% CI]: 0.963 [0.937-0.990]), time on IMV (OR [95% CI]: 1.103 [1.059-1.149]), and driving pressure (OR [95% CI]: 3.750 [1.344-10.466]), regardless of gender and comorbidities. Mortality was higher in the WF group (WF: 69% vs. WS: 24%; p < 0.0001).</p><p><strong>Conclusion: </strong>Advanced age, the length of hospitalization, prolonged IMV duration, and compromised respiratory mechanics were the predictors of WF. Furthermore, individuals who experienced WF presented a higher mortality rate compared with those who successfully weaned.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e9316439"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Frailty on Prognosis and Functional Outcome in Patients With Acute Respiratory Deterioration of Interstitial Lung Disease.","authors":"Yuta Takahashi, Mitsutoshi Akiho, Takuya Miyahara, Yasunari Sakai, Shuken Kobayashi, Daisuke Minamishima, Shuichi Nakada, Kanji Yamada","doi":"10.1155/pm/3510542","DOIUrl":"10.1155/pm/3510542","url":null,"abstract":"<p><strong>Background: </strong>Frailty has emerged as an important prognostic factor in patients with interstitial lung disease (ILD), but its impact on hospitalized ILD patients with acute respiratory deterioration (ARD) remains unclear. The objective of this study is to investigate the association between preadmission frailty and clinical outcomes including 180-day mortality and functional decline in ILD patients hospitalized due to ARD.</p><p><strong>Methods: </strong>This multicenter prospective study included ILD patients admitted due to ARD at five acute care hospitals in Japan. Frailty was assessed at admission using the Clinical Frailty Scale (CFS) based on patients' prehospitalization condition. The primary outcome was 180-day mortality from the day of admission. Secondary outcomes included early ambulation and functional decline at discharge. Cox regression and logistic regression analyses were used to assess the impact of frailty on outcomes.</p><p><strong>Results: </strong>Among 205 patients, 37 (18.0%) were classified as frail (CFS 5-9). The frail group had significantly higher 180-day mortality than the nonfrail group (p = 0.002). Frailty remained an independent predictor of 180-day mortality after multivariable adjustment (hazard ratio 2.450, 95% confidence interval [CI]1.327-4.524, p = 0.004). Nonfrailty was an independent predictor of early ambulation (odds ratio [OR] 4.820, 95% CI 1.700-13.600, p = 0.003); however, it was not a significant predictor of functional decline (OR 1.810, 95% CI 0.748-4.380, p = 0.188).</p><p><strong>Conclusions: </strong>Frailty independently predicted mortality and adverse functional outcomes in ILD patients hospitalized due to ARD. Frailty assessment on admission may help identify patients who require early and tailored multidisciplinary interventions.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e3510542"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Intubation Prediction in Pneumonia Patients: A Systematic Review and Meta-Analysis of Machine Learning Algorithms.","authors":"Elham Abdoli, Pooya Eini, Sajjad Farashi, Maryam Farhadian","doi":"10.1155/pm/6670267","DOIUrl":"10.1155/pm/6670267","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia, including influenza, COVID-19, and community-acquired pneumonia, is a major global health burden associated with high morbidity, mortality, and frequent progression to respiratory failure requiring intubation. Early identification of patients at risk of endotracheal intubation is essential to improve outcomes and optimize ICU resource allocation, yet existing prognostic tools remain limited in predicting this need. This study evaluated the performance of machine learning (ML) algorithms in predicting endotracheal intubation among patients with pneumonia during hospital stay.</p><p><strong>Methods: </strong>We systematically searched five databases to evaluate the diagnostic accuracy of ML models. Pooled estimates of area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity were calculated. Subgroup analysis and meta-regression were conducted. Risk of bias was assessed using PROBAST+AI and certainty of evidence with GRADE.</p><p><strong>Results: </strong>This systematic review of 34 studies (26 in meta-analysis) included 195,214 pneumonia patients. The pooled AUROC was 0.79 (95% CI: 0.75-0.82), with sensitivity of 0.74 (95% CI: 0.61-0.84), specificity of 0.71 (95% CI: 0.50-0.86), and a DOR of 7 (95% CI: 2-20), indicating moderate diagnostic accuracy. Heterogeneity was substantial across analyses (I² = 90.45% for sensitivity and 94.58% for specificity). Risk of bias was lowest in development (59%) and highest in application domains (41% high risk). Despite a nonsignificant Deeks' test (p = 0.252), the funnel plot suggests selective publication of positive results, likely inflating the pooled AUROC. GRADE rated the evidence as moderate to low due to heterogeneity and imprecision.</p><p><strong>Conclusion: </strong>ML algorithms demonstrate a modest and highly variable accuracy in predicting the need for endotracheal intubation among pneumonia patients. High heterogeneity and methodological variability highlight the need for standardized ML approaches before clinical adoption.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e6670267"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Macrophage Migration Inhibitory Factor-794 CATT Microsatellite Polymorphism With Tuberculosis Risk: A Systematic Review and Meta-Analysis.","authors":"Anand Kumar Maurya, Sabir Ali, Shaina Gaikwad","doi":"10.1155/pm/8413702","DOIUrl":"https://doi.org/10.1155/pm/8413702","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a major infectious cause of morbidity and mortality worldwide and is influenced by both environmental exposures and host genetic factors. Macrophage migration inhibitory factor (MIF), a proinflammatory cytokine, plays an important role in immune and inflammatory responses. The MIF-794 CATT microsatellite polymorphism (rs5844572) in the promoter region may affect gene transcription and thereby influence susceptibility to TB. This systematic review and meta-analysis are aimed at evaluating the association between the MIF-794 CATT polymorphism and TB risk across different populations.</p><p><strong>Methods: </strong>A comprehensive literature search was performed in PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar up to the latest available date. Case-control studies evaluating the association between the MIF-794 CATT polymorphism and TB susceptibility were included in accordance with PRISMA guidelines. Data from seven high-quality studies (Newcastle-Ottawa Scale score ≥ 8), comprising 1063 TB cases and 957 controls, were pooled. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated under allelic, dominant, and recessive genetic models using fixed- or random-effects models according to heterogeneity.</p><p><strong>Results: </strong>The pooled analysis suggested a possible association between longer CATT repeat alleles (CATT₇ or CATT₈) and increased TB susceptibility compared with shorter repeats (CATT₅ or CATT₆), although the effect size was modest and not fully consistent across all populations. A stronger trend was observed in some East Asian cohorts, whereas African and Latin American studies showed variable results. All included studies were of high methodological quality, and control groups were reported to be in Hardy-Weinberg equilibrium (HWE). Visual assessment of funnel plots did not indicate marked publication bias, although the small number of studies limits definitive interpretation.</p><p><strong>Conclusions: </strong>The available evidence suggests that the MIF-794 CATT polymorphism may contribute to TB susceptibility, but the association remains modest, heterogeneous, and inconclusive overall. This variant should be regarded as a possible component of a broader immunogenetic framework rather than an established standalone biomarker. Further large-scale, multicentric, and functionally integrated studies are needed to clarify its role in TB risk.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e8413702"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}