Pulmonary Medicine最新文献

{"title":"Neutrophil-to-Lymphocyte Ratio in Bronchiectasis and Its Association With Disease Severity-A Single-Center Retrospective Study.","authors":"Irfan Shafiq, Ali Saeed Wahla, Mateen Haider Uzbeck, Zaid Zoumot, Mohamed Abuzakouk, Shuayb Elkhalifa, Jahnavi Bodi, Said Isse","doi":"10.1155/pm/9920691","DOIUrl":"https://doi.org/10.1155/pm/9920691","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and has shown promise in assessing disease severity in chronic respiratory conditions including bronchiectasis. This study explores the association between NLR and clinical markers of bronchiectasis severity, including lung function and the Bronchiectasis Severity Index (BSI).</p><p><strong>Objective: </strong>To assess the association between NLR, lung function, and bronchiectasis severity in adults with noncystic fibrosis bronchiectasis.</p><p><strong>Methods: </strong>We performed a retrospective single-center study of adults with HRCT-confirmed bronchiectasis identified from electronic health records. Demographic, spirometric, microbiological, BSI, and blood count data were collected. NLR was calculated from the first available complete blood count obtained during clinical stability. Correlation analyses were performed in an outlier-truncated cohort, whereas multivariate general linear models and ordinal regression assessed independent associations with lung function and BSI severity categories.</p><p><strong>Results: </strong>The cohort included 213 patients; 99 were male and 114 female, with a mean age of 53.9 ± 20.4 years. Most patients had severe bronchiectasis by BSI category. Chronic Pseudomonas aeruginosa colonization was present in 33.8% and was associated with lower FEV₁% predicted. Median NLR was 2.89. NLR showed significant negative correlations with FEV₁% predicted, FVC% predicted, and FEV₁/FVC ratio, but not with continuous BSI score. After adjustment for chronic Pseudomonas colonization, logNLR remained independently associated with FEV₁% predicted and FVC% predicted, but not with BSI score. In ordinal regression, NLR was not independently associated with BSI severity categories. Absolute eosinophil count was the only independent predictor of advanced BSI category.</p><p><strong>Conclusion: </strong>NLR was associated with impaired lung function, but not independently with BSI. NLR may reflect physiological impairment but does not replace established severity tools such as BSI.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e9920691"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799340","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":"Survival and Hemodynamic Effects of Parenteral Prostanoids in High-Altitude Group 1 Pulmonary Hypertension: A Retrospective Cohort Study.","authors":"Rafael Conde-Camacho, Eduardo Tuta-Quintero, Mauricio González, Wendy Rubiano, Emily Rincón, Katherine Diaz, Luis F Giraldo-Cadavid","doi":"10.1155/pm/2867844","DOIUrl":"10.1155/pm/2867844","url":null,"abstract":"<p><strong>Background: </strong>In Latin America, the evidence regarding the use of prostanoids at high altitude in patients with Group 1 pulmonary hypertension (PH-1) is limited. Therefore, it is essential to describe the clinical characteristics and outcomes associated with prostanoid treatment in this population.</p><p><strong>Methods: </strong>This retrospective study involved patients with PH-1. Hemodynamic and clinical variables were compared before the initiation of prostanoids and during clinical follow-up. Overall survival was analyzed using Kaplan-Meier estimation, with survival rates calculated at 3 and 5 years. The strength of the association for each variable concerning the proposed outcomes was estimated by calculating the odds ratio (OR).</p><p><strong>Results: </strong>The study included 55 patients (mean age 34.6 ± 10.3 years), 83.6% women, all receiving triple combination therapy with endothelin receptor antagonists (ERAs), phosphodiesterase Type 5 inhibitors, and parenteral prostacyclin analogues. Idiopathic pulmonary arterial hypertension was present in 62%, and 60% were classified as intermediate risk at baseline. Median time from PH-1 diagnosis to prostacyclin initiation was 8.96 months (IQR 1.88-41.42). At 1 year, complete follow-up data were available for 49 patients. St. George's Respiratory Questionnaire scores improved significantly from 49.0 to 36.5 at 1 year and 31.5 at the last follow-up (p < 0.001). Cardiac index increased from 2.24 to 2.96 L/min/m² at 1 year (p < 0.001), whereas mixed venous oxygen saturation improved significantly. In survivors, the 6-min walk test distance increased by 53.5 m, and pulmonary vascular resistance decreased by 3.8 WU. Diffusing capacity for carbon monoxide (DLCO) < 25% was associated with an OR of 7.35 (95% CI: 1.28-41.92; p = 0.015), and tricuspid annular plane systolic excursion to pulmonary artery systolic pressure ratio (TAPSE/PASP) < 0.10 mm/mmHg had an OR of 5.78 (95% CI: 0.64-52.03; p = 0.088). Female sex had an OR of 0.13 (95% CI: 0.02-0.78; p = 0.016). Three- and five-year survival rates were 87.2% and 78.1%, respectively.</p><p><strong>Conclusion: </strong>Parenteral prostanoids in patients with PH-1 demonstrate improvements in hemodynamic variables during clinical follow-up. A DLCO < 25% and a TAPSE/PASP < 0.10 mm/mmHg were associated with an increased risk of mortality, whereas female sex was identified as a protective factor.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e2867844"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976491","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":"Quantification of Immediate Surgical Stress After Major and Minor Thoracic Surgeries Through HRV: A Secondary Post Hoc Analysis of a Randomized Controlled Trial.","authors":"Seyedsadra Miri, Sabina Lähteenmäki, Heidi Mahrberg, Antti Vehkaoja, Jari Laurikka, Jari Viik","doi":"10.1155/pm/3752161","DOIUrl":"10.1155/pm/3752161","url":null,"abstract":"<p><strong>Purpose: </strong>Heart rate variability (HRV) reflects autonomic nervous system activity and is sensitive to physiological stress induced by surgery. This study is a secondary, post hoc analysis of a randomized controlled trial aimed at evaluating changes in HRV following major and minor thoracic surgery, and investigating whether postoperative respiratory physiotherapy can modulate these changes. In a prospective, randomized design, two physiotherapy interventions, including positive expiratory pressure (PEP) and inspiratory muscle training (IMT), were compared to assess their effects on HRV.</p><p><strong>Methods: </strong>Electrocardiogram recordings were analyzed from 75 patients undergoing either minor pulmonary (PM) or pulmonary resection (PR) surgery. HRV data were collected preoperatively and during the first two postoperative days, immediately following physiotherapy sessions. Patients were assigned to one of two intervention groups (PEP or IMT). Time-, frequency-, and nonlinear-domain HRV parameters were analyzed longitudinally and compared between surgical and intervention groups.</p><p><strong>Results: </strong>Most HRV parameters exhibited a postoperative reduction, with more pronounced changes observed in the PR surgery group. In particular, the root mean square of successive RR interval differences (RMSSD) and high-frequency (HF) power, which are commonly associated with parasympathetic modulation, showed marked decreases. Recovery toward baseline values varied across surgical groups, interventions, and HRV parameters; however, no clear signs of recovery were observed in the PR surgery group during the observation period. No statistically significant differences were detected between the PEP and IMT interventions (p ≥ 0.05), with the exception of short-term detrended fluctuation analysis (DFA α₁) in the PM surgery group (p = 0.04).</p><p><strong>Conclusion: </strong>HRV parameters reflected surgery-induced autonomic alterations, with more pronounced and persistent changes observed in patients undergoing PR compared with PM surgery. No clear recovery toward baseline was detected during the 2-day postoperative follow-up, suggesting prolonged autonomic disturbances after thoracic surgery.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT02931617.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e3752161"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082229","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":"Long-Term Oxygen Therapy and Cognitive Function in Chronic Obstructive Pulmonary Disease: A Systematic Review.","authors":"Shaikh Fawwad, Saed S K Makhlouf, Mazen Mahgoub, Roba Sabri Kamel Makhlouf, Sumaiya Monjur, Nandita Thapar","doi":"10.1155/pm/5525054","DOIUrl":"10.1155/pm/5525054","url":null,"abstract":"<p><strong>Objective: </strong>This study is aimed at evaluating the association between long-term oxygen therapy (LTOT) and cognitive function in patients with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>We conducted a systematic literature search across major databases for observational studies comparing cognitive outcomes between COPD patients receiving LTOT (≥ 15 h/day) and those not receiving it. Cognitive performance was evaluated using validated tools like the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Trail Making Tests (TMT-A/B). Due to heterogeneity in study design and outcome measures, a narrative synthesis was performed.</p><p><strong>Results: </strong>We included five studies involving 1849 participants (343 LTOT users) in this review. LTOT use was generally associated with a lower prevalence of cognitive impairment (18%-45%) and higher global cognitive scores, particularly in executive functions. MoCA-based assessments also consistently favored LTOT users, particularly in rural populations. However, findings were heterogeneous across studies.</p><p><strong>Conclusion: </strong>LTOT is associated with better cognitive performance in hypoxemic COPD patients. Prospective longitudinal studies are needed to establish causality between LTOT use and reduction in cognitive impairment in COPD.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e5525054"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934470","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":"Combating Drug-Resistant Tuberculosis: Advancements in Diagnostics and Therapeutics.","authors":"Silvi Gautam, Jahanvi Saini, Shabaaz Begum Jameel Pasha, Divakar Sharma, Divya Venugopal","doi":"10.1155/pm/3346306","DOIUrl":"https://doi.org/10.1155/pm/3346306","url":null,"abstract":"<p><p>The increasing prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR)Mycobacterium tuberculosis has emerged as a major global health concern. Advanced molecular diagnostics, including rapid assays, have improved resistance detection; however, resource-limited settings remain underserved. Nanotechnology-based drug delivery systems, including polymeric carriers, solid lipid nanoparticles, and silver nanoparticles, can provide targeted delivery, prolonged release, and improved bioavailability. Drug repurposing strategies using existing drugs like linezolid, celecoxib, and nitazoxanide also show a promising option in combating drug-resistant TB while reducing treatment duration. Host-directed therapies (HDTs) and natural products offer complementary strategies by enhancing host immune responses and providing multitarget antimycobacterial effects. This review emphasizes the drug resistance mechanisms and advancements in novel theranostics. Despite significant progress, challenges related to cost-effective scalability, accessibility of advanced diagnostics, and optimization of therapeutic systems continue to limit clinical translation. Future research must prioritize multidisciplinary collaborations to accelerate drug development, enhance diagnostic capabilities, and expand nanotechnology-based solutions to address the TB epidemic effectively.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e3346306"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799384","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":"Morphological Diversity and Diagnostic Evaluation of Thoracic Amyloidosis: Insights From a Tertiary Referral Center in Vietnam.","authors":"Luong Dinh-Van, Hoang-Anh Nguyen-Cong, Phuong Duong-Minh, Bich-Ngoc T Nguyen","doi":"10.1155/pm/3849443","DOIUrl":"10.1155/pm/3849443","url":null,"abstract":"<p><strong>Background: </strong>Thoracic amyloidosis is a rare disorder that often mimics malignancy or chronic infections. In tuberculosis-endemic regions, diagnostic confusion frequently leads to unnecessary empiric treatments. This study was aimed at describing the clinical and radiological characteristics of thoracic amyloidosis and evaluating the safety profile of diagnostic biopsy procedures.</p><p><strong>Methods: </strong>We retrospectively analyzed 19 patients with histopathologically confirmed thoracic amyloidosis at the National Lung Hospital, Hanoi, Vietnam, between 2022 and 2025. Clinical symptoms, high-resolution computed tomography (CT) features, and biopsy outcomes were recorded.</p><p><strong>Results: </strong>The mean age was 55 ± 16 years. Common symptoms included cough (n = 15, 88.2%) and dyspnea (n = 9, 52.9%). Isolated airway involvement was the most frequent phenotype (n = 6, 31.6%), followed by isolated nodular (n = 3, 15.8%) and diffuse alveolar septal (n = 2, 10.5%) patterns. Mixed radiological patterns were observed in five patients (26.3%), while isolated extrapulmonary thoracic involvement accounted for the remaining three patients (15.8%). Notably, isolated cystic disease was absent. Among the cases with nodular involvement (n = 5), 80.0% (n = 4) exhibited spiculated margins, mimicking malignancy. Calcification was a frequent finding, present in 14/19 cases (73.7%). CT-guided transthoracic needle biopsy (TTNB) and endobronchial biopsy (EBB) achieved diagnostic yields of 87.5% (7/8) and 69.2% (9/13), respectively, with no major complications, suggesting they are generally well-tolerated. All collected specimens were negative for Mycobacterium tuberculosis, reducing the likelihood of active pulmonary tuberculosis.</p><p><strong>Conclusions: </strong>Thoracic amyloidosis presents with diverse and often overlapping radiological patterns. Isolated nodular lesions frequently exhibit spiculated margins, posing a diagnostic challenge. However, the high prevalence of calcification and the acceptable safety profile of EBB and TTNB facilitate definitive diagnosis. In endemic areas, early tissue diagnosis is essential to differentiate amyloidosis from tuberculosis and avoid inappropriate therapy.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e3849443"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844346","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 Molecular Diagnostics of Tuberculosis: What Do We Have, What Do We Need?","authors":"Bruno Luukinen","doi":"10.1155/pm/9947140","DOIUrl":"10.1155/pm/9947140","url":null,"abstract":"<p><p>Smear microscopy and culture are conventional methods of tuberculosis (TB) diagnostics. Microscopy is fast and inexpensive but has low sensitivity, whereas culture is highly sensitive but may take several weeks. Molecular diagnostic (MDx) methods were widely introduced into TB diagnostics much later, in the early 2010s, when the GeneXpert system was launched. MDx methods combine the benefits of the conventional methods. Furthermore, significant developments have occurred in recent years. The current selection of available rapid MDx methods covers the full range of TB diagnostics: detection of pulmonary and extrapulmonary TB, narrow- to broad-range rapid drug susceptibility testing, mycobacterial species identification, and Mycobacterium tuberculosis (MTB) strain typing. Several issues-often focusing on high assay costs-have still prevented the complete roll-out of MDx methods over conventional methods in both low-resource, high-incidence settings and high-resource, low-incidence settings. This review covers topics related to molecular detection of MTB and MTB drug resistance directly from clinical specimens. The aim of the review is to describe currently available methods, how they perform, and what key issues must be addressed for more optimal implementation. Overall, MDx methods currently represent an essential but often accessory tool in the detection of TB and MTB drug resistance. At present, several limitations-including diagnostic equivalence with the reference method, breadth of drug resistance testing, treatment monitoring, and accessibility due to analysis costs and assay complexity-still hinder efficient replacement of the conventional smear microscopy and culture methods. However, new advances in testing methods and strategies are continuously being made.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2026 1","pages":"e9947140"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065062","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":"The Effect of Heated, Humidified High-Flow Air in COPD Patients With Chronic Bronchitis.","authors":"Spyridon Fortis, Eric A Hoffman, Alejandro P Comellas","doi":"10.1155/pm/8350741","DOIUrl":"10.1155/pm/8350741","url":null,"abstract":"<p><strong>Introduction: </strong>Heated, humidified high-flow air (HHHFA) has been shown to reduce exacerbations in patients with COPD or bronchiectasis with significant sputum production. This pilot study evaluated the short-term effects of nocturnal HHHFA in COPD patients with chronic bronchitis.</p><p><strong>Methods: </strong>This was a prospective, single-center, open-label, randomized, placebo-controlled trial. Participants with COPD, chronic bronchitis, and ≥ 2 exacerbations in the prior year were randomized to either nocturnal HHHFA or usual care. Assessments included sleep quality, dyspnea, quality of life, cough, lung function, imaging, and exercise capacity at baseline and 6 weeks.</p><p><strong>Results: </strong>Of 11 eligible participants, seven completed the study (four intervention, three control). Baseline characteristics were generally similar, though the intervention group had a higher BMI and a lower emphysema percentage. No statistically significant differences were observed between groups in primary or secondary outcomes.</p><p><strong>Conclusions: </strong>Nocturnal HHHFA over 6 weeks did not improve clinical or imaging outcomes in this small cohort of COPD patients with chronic bronchitis. The study was likely underpowered due to recruitment challenges. Larger trials are needed to assess the potential of HHHFA in this population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03959982.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2025 ","pages":"8350741"},"PeriodicalIF":1.9,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913464","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":"Highly Effective Modulator Therapy in Cystic Fibrosis: Addressing Unusual Variants in the Middle East.","authors":"Said Isse, Ali Saeed Wahla, Mateen Haider Uzbeck, Zaid Zoumot, Mohamed Abuzakouk, Irfan Shafiq","doi":"10.1155/pm/3622052","DOIUrl":"10.1155/pm/3622052","url":null,"abstract":"<p><strong>Background: </strong>Cystic fibrosis (CF) is an autosomal recessive disorder caused by variants in the CFTR gene. Although the F508del mutation is common globally, the Middle East exhibits a higher prevalence of rare, region-specific variants. The triple-combination therapy elexacaftor/tezacaftor/ivacaftor (ETI) has revolutionized CF management; however, its efficacy in individuals with rare variants, often underrepresented in clinical trials, remains less certain. This study is aimed at evaluating the real-world outcomes of ETI therapy in CF patients with rare CFTR variants predominantly found in the Middle East.</p><p><strong>Methods: </strong>This retrospective, single-center study included 12 patients with CF carrying rare Middle Eastern variants. Data on percent predicted Forced Expiratory Volume in 1 second (ppFEV1), body mass index (BMI), and annual exacerbation frequency were collected before and after 12 months of ETI treatment. Nine of these patients were previously on ivacaftor and were switched to ETI. Changes in clinical outcomes were analyzed using Wilcoxon signed-rank tests due to nonnormally distributed data.</p><p><strong>Results: </strong>Following 12 months of ETI therapy, significant improvements were observed. The median ppFEV1 increased by 9.5% (range: 2-15). The median annual frequency of exacerbations decreased by two events (range: 0-4). BMI showed a modest median improvement of 1.5 kg/m², which was not statistically significant. The cohort comprised nine females (75%) and three males (25%), with a median age of 24.3 years (range: 18.5-35.2 years) at the time of ETI initiation or transition.</p><p><strong>Conclusion: </strong>ETI therapy led to statistically significant improvements in lung function and a reduction in pulmonary exacerbations in CF patients with rare Middle Eastern variants. These findings, from the first report of its kind in this region, support the expansion of ETI access to individuals with rare CFTR variants, particularly in underserved populations, based on functional response. This underscores the benefit of ETI beyond the common F508del mutation.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2025 ","pages":"3622052"},"PeriodicalIF":1.9,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913472","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":"Diagnostic Performance of Quantitative Computed Tomography Pulmonary Angiography Parameters in Patients With Pulmonary Embolism.","authors":"Shahab Abdi, Negar Naderi, Seyed Salman Zakariaee","doi":"10.1155/pm/9038741","DOIUrl":"10.1155/pm/9038741","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary embolism (PE) is the third leading cause of cardiovascular death after stroke and myocardial infarction. Accurate and timely identification of patients could have a significant impact on reducing the mortality rate and better patient management.</p><p><strong>Aim: </strong>The purpose of this study was to evaluate the diagnostic performance of quantitative parameters measured based on CTPA images to determine the most important and relevant imaging parameters for diagnosing patients with PE.</p><p><strong>Methods and materials: </strong>In this cross-sectional, multicenter study, the electronic files of 1428 cases suspected of PE were reviewed from 2021 to 2023. The diagnostic performances of anthropometric parameters, right ventricle-to-left ventricle (LV) diameter ratio, and CT obstruction index measured based on CTPA images were evaluated for the diagnosis of PTE.</p><p><strong>Results: </strong>Radiological manifestations associated with PE were IV septum deviation, RV/LV diameter ratio, CT obstruction score, and pulmonary infarction with OR values of 10.53, 38.71, 6.59, and 78.16, respectively (<i>p</i> < 0.001). CT obstruction index with a threshold of 1 was the best parameter for the diagnosis of PE. Accuracy, sensitivity, specificity, and AUC of the CT obstruction index were 96.10%, 98.68%, 94.84%, and 0.96%, respectively. Pulmonary infarction with multifocal involvement as the second strongest parameter had a sensitivity of 81.58%, specificity of 98.76%, accuracy of 93.25%, kappa coefficient of 0.93, and an AUC of 0.90.</p><p><strong>Conclusion: </strong>CT obstruction index and pulmonary infarction with multifocal involvement perform better than the reports of the presence of disease in CTPA images. Therefore, these two parameters must be reported by radiologists and implemented as the primary criteria for diagnosing PE.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2025 ","pages":"9038741"},"PeriodicalIF":1.9,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758067","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}