Pulmonary Medicine最新文献

{"title":"ACE2 Expression and Clinical Biomarkers in COVID-19: Associations With Disease Severity.","authors":"Kazhin Rahim Ali Saeed, Paywast Jamal Jalal","doi":"10.1155/pm/1013605","DOIUrl":"10.1155/pm/1013605","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic, caused by SARS-CoV-2, has led to significant global mortality and morbidity. Angiotensin-converting Enzyme 2 (ACE2) has been identified as the primary receptor for viral entry into host cells and is believed to play a critical role in disease progression and severity. While ACE2 expression has been studied across various populations, data remains limited for underrepresented ethnic groups, such as the Kurdish population.</p><p><strong>Methods: </strong>A prospective pilot study was conducted with 45 participants, divided equally into three groups (n = 15 each): mild cases, severe cases, and healthy controls. Whole blood samples were collected to assess hematological and biochemical parameters. ACE2 mRNA expression was analyzed using quantitative real-time PCR (qRT-PCR). Group comparisons were performed using one-way ANOVA for ΔCq values and nonparametric tests for nonnormally distributed variables.</p><p><strong>Results: </strong>ACE2 expression was significantly upregulated in patients with severe COVID-19, as indicated by lower ΔCq values compared to controls (mean difference = 0.568; adjusted p = 0.032). No significant difference was observed between mild cases and controls (p = 0.138). Furthermore, severe disease was characterized by markedly increased inflammatory markers (CRP, ESR, and ferritin) and hepatic enzymes (AST/GOT and ALP), alongside a decrease in lymphocyte counts. Also, CRP, ESR, and GPT were identified as the most significant predictors of disease severity in a machine learning analysis using XGBoost with SHAP interpretation. Demographic analysis revealed a significant age difference between controls and patients; however, no difference was observed between mild and severe cases. The sex distribution was comparable across all study groups.</p><p><strong>Conclusion: </strong>Reduced lymphocyte counts and systemic inflammatory responses, specifically elevated CRP, ESR, and ferritin levels, were closely associated with disease severity in COVID-19. Although ACE2 expression results provide preliminary evidence that the Kurdish cohort's ACE2 mRNA expression is elevated in cases of severe COVID-19, its contribution to disease classification was minimal, indicating that multiple inflammatory and RAAS-related mechanisms, rather than ACE2 expression alone, drive disease progression.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e1013605"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220059","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":"Rapid Detection of Resistance Mutations in Multidrug-Resistant Tuberculosis With GenoType MTBDRsl Assay.","authors":"Shaina Gaikwad, Antisha Tiwari, Jitendra Singh, Alkesh Kumar Khurana, Sagar Khadanga, Shashank Purwar, Debasis Biswas, Anand Kumar Maurya","doi":"10.1155/pm/6993694","DOIUrl":"10.1155/pm/6993694","url":null,"abstract":"<p><strong>Background: </strong>Multidrug-resistant tuberculosis (MDR-TB) is becoming a major threat to the global control of tuberculosis (TB). The situation worsens when fluoroquinolone (FQ) and second-line injectable (SLID) resistant strains are involved. This study assesses the utility of MTBDRsl V2.0 line probe assay (LPA) in identifying resistance patterns to FQ and SLID in MDR-TB isolates.</p><p><strong>Methods: </strong>A total of 74 MDR-TB isolates were tested for genetic mutations that confer resistance to FQs and against SLIDs by applying the GenoType MTBDRsl V2.0 LPA. This assay targets resistance-associated mutations in the gyrA and gyrB genes for FQ resistance, and in the rrs and eis genes for resistance to aminoglycosides and capreomycin.</p><p><strong>Results: </strong>Of the 74 isolates examined, 14 (18.9%) had FQ resistance. Most of these isolates had mutations in the gyrA gene, most commonly at codon A90V (6.7%), followed by D94G (5.4%), and various D94 variations. No mutations were found in the rrs, gyrB, or eis genes, and no resistance to SLIDs was found. With no discernible contribution from rrs, gyrB, or eis genes, our results emphasize gyrA mutations, particularly A90V and D94G, as important molecular markers of FQ resistance.</p><p><strong>Conclusion: </strong>The MTBDRsl V2.0 assay demonstrated operational utility for rapid detection of resistance-associated mutations related to FQs and SLID drugs in MDR-TB isolates. Its rapid turnaround time expanded mutation coverage, and applicability in routine diagnostic settings make it a useful tool for molecular resistance profiling in high TB-burden settings.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e6993694"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148398543","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":1.9,"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":"Prevalence of Cardiovascular Diseases in COPD-OSA Overlap Syndrome Versus COPD Alone: A Systematic Review.","authors":"Ștefania-Florina Oprea, Ștefan Dumitrache-Rujinski, Camelia Cristina Diaconu","doi":"10.1155/pm/2311043","DOIUrl":"10.1155/pm/2311043","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is frequently associated with cardiovascular comorbidities. Obstructive sleep apnea (OSA) may coexist with COPD, forming the so-called overlap syndrome (OS), and may further increase cardiovascular risk through intermittent hypoxia, systemic inflammation, and sympathetic activation. This systematic review is aimed at synthesizing and comparing the burden of cardiovascular comorbidities in patients with COPD and coexisting OSA versus those with COPD alone, thereby identifying the additional cardiovascular burden associated with OSA and gaps in current knowledge.</p><p><strong>Materials and methods: </strong>A systematic search was conducted in PubMed and Web of Science from inception to 3^rd of January 2026, using predefined search terms related to COPD, OSA, and cardiovascular diseases. Only observational studies in adults were included.</p><p><strong>Results: </strong>Nineteen studies were included in the final analysis. Most studies had a cross-sectional or retrospective cohort design. Cardiovascular disease was reported as a baseline characteristic in nearly all included studies; however, none evaluated the prevalence of cardiovascular disease as a primary outcome; these conditions were reported mainly as associated comorbidities. Overall, most included studies reported a higher prevalence of cardiovascular diseases-particularly systemic arterial hypertension-in patients with overlap syndrome compared with COPD alone, frequently reaching statistical significance; however, this finding derived from unadjusted comparisons of baseline comorbidities, and no study adjusted for confounders such as age, body mass index, or smoking.</p><p><strong>Conclusions: </strong>Although many of the observed differences were statistically significant, they derived from unadjusted comparisons of baseline characteristics, which limits the ability to draw firm conclusions regarding causality. Future studies including larger populations of patients with COPD and OSA are required to accurately determine the prevalence of cardiovascular disease and better describe the relationship between COPD, OSA, and cardiovascular comorbidities.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e2311043"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956971","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":"Determinants of Bronchiectasis Among Patients Attending Chest Clinic of Teaching Hospital in Ethiopia: Case-Control Study.","authors":"Belay Shewaye Mola, Mengesha Akale Tekle, Wubshet Abraham Alemu","doi":"10.1155/pm/5549973","DOIUrl":"10.1155/pm/5549973","url":null,"abstract":"<p><strong>Background: </strong>Bronchiectasis is a chronic lung disease characterized by cough and purulent sputum, recurrent infections, and airway damage. It affects people of all ages and is associated with considerable morbidity and mortality.</p><p><strong>Objectives and methods: </strong>A case-control study was conducted to assess factors associated with bronchiectasis. Each patient with HRCT-confirmed bronchiectasis who visited the chest clinic was selected as a case, whereas age- and sex-matched patients without bronchiectasis were selected as controls. Data was collected using a chart review and questionnaire from April 1, 2022, to June 30, 2022. Then, data was entered and analyzed using SPSS Version 25. Frequencies and cross-tabulations were used to summarize descriptive statistics of the data. Chi-square tests and logistic regression were done to establish associations for variables.</p><p><strong>Results: </strong>The study included 77 cases and 153 controls, with 49.35% of the cases and 33.99% of the controls being between the ages of 41 and 60. After adjusting for potential confounders, a multivariable logistic regression analysis showed that four variables were independent predictors of bronchiectasis. Bronchiectasis was six times more likely to occur in patients with a history of pulmonary tuberculosis (AOR = 6.182; 95% CI (3.16-12.10), p < 0.001). COPD (AOR = 2.896; 95% CI = 1.460-5.746, p = 0.002), bronchial asthma (AOR = 2.124; 95% CI = 1.086-4.154, p = 0.028), and COVID-19 (AOR = 2.786; 95% CI = 1.454-5.340, p = 0.002) also increased the risk of bronchiectasis by more than twofold. There was no significant association between bronchiectasis and age, sex, or smoking history.</p><p><strong>Conclusion and recommendations: </strong>Pulmonary tuberculosis, COVID-19, chronic obstructive pulmonary disease, and bronchial asthma are associated with the development of bronchiectasis. Attention should be given to early identification of bronchiectasis among patients with these lung diseases.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e5549973"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869875","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":1.9,"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":"Treatment Adherence and Treatment Effectiveness in Stable Chronic Obstructive Pulmonary Disease Among Outpatients at An Giang Province, Vietnam.","authors":"Khanh Duy Dang, Lich Thanh Vu, Si Van Tran","doi":"10.1155/pm/7201063","DOIUrl":"10.1155/pm/7201063","url":null,"abstract":"<p><strong>Background: </strong>Recently, early prevention, treatment, and stabilization of chronic obstructive pulmonary disease (COPD) have become key priorities to reduce exacerbations and improve respiratory function. This study is aimed at evaluating treatment adherence and effectiveness among outpatients with stable COPD in Vietnam.</p><p><strong>Methods: </strong>A cross-sectional descriptive study was conducted on 400 stable COPD outpatients at Kien Giang General Hospital (June 2024-June 2025). Treatment adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Treatment effectiveness was evaluated using three criteria: the number of exacerbations and hospitalizations in the previous 12 months, the modified Medical Research Council (mMRC) dyspnea scale score, and the COPD Assessment Test (CAT) score at two time points: T₀ (baseline) and T (after 3 months of outpatient follow-up).</p><p><strong>Results: </strong>After 3 months of outpatient follow-up, the treatment adherence rate was 76.5%. The chosen treatment regimen was significantly associated with medication adherence (p < 0.001). Patients using regimens (ICS/LABA + LABA [p.o.]), (SABA + ICS/LABA), and (SABA + ICS/LABA + LABA [p.o.]) had higher adherence than those using ICS/LABA alone. The overall treatment effectiveness improvement rate was 70.3%, with improvements in exacerbations/hospitalizations in the previous 12 months (23.0%), mMRC score (32.3%), and CAT score (66.0%). Although the treatment efficacy index showed positive trends for exacerbations/hospitalizations (11.0%, p = 0.076), mMRC score (3.1%, p = 0.375), and CAT score (3.5%, p = 0.088), these changes did not reach statistical significance, indicating only early positive trends over the 3 months. Multivariate logistic regression analysis identified treatment adherence and smoking status as the strongest predictors of treatment effectiveness.</p><p><strong>Conclusion: </strong>Patients with good adherence had substantially higher treatment effectiveness than those with poor adherence. Conversely, smoking status was negatively associated with treatment effectiveness. Further interventional studies targeting these factors are needed to improve medication adherence and treatment effectiveness in patients with stable COPD.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e7201063"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900547","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":1.9,"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":"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":1.9,"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":"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":"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":1.9,"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}