Respiratory Medicine and Research最新文献

{"title":"The incidence of pleural infections in Finland","authors":"Antti Lehtomäki ,&nbsp;Mika Ukkonen ,&nbsp;Vesa Toikkanen ,&nbsp;Jari Laurikka ,&nbsp;Jahangir Khan","doi":"10.1016/j.resmer.2024.101132","DOIUrl":"10.1016/j.resmer.2024.101132","url":null,"abstract":"<div><h3>Background</h3><p>The incidence of pleural infections appears to be increasing in Western countries for unclear reasons. The aim of the study was to describe the incidence and treatment patterns of pleural infections in Finland over three decades.</p></div><div><h3>Methods</h3><p>Data regarding each treatment episode for pleural infections in the Finnish special medical care between January 1994 and December 2016 was obtained from a national database and compared to the demographics of Finnish residents obtained from the national census bureau. The annual incidence rates, type of treatment given, as well as the lengths of the hospitalization were analyzed.</p></div><div><h3>Results</h3><p>A total of 28,463 episodes were reported, of which 55% were inpatient episodes. Of these, 76% concerned males, and the median age of patients was 60 (interquartile range 49–70) years. The overall incidence of pleural infections was 23.4 per 100.000 patient-years, with a male-to-female -ratio of 3.3:1. The annual incidence rates increased throughout the study period with an average annual percentage change of +11.4% (95% CI ±7.4%). The highest incidence rates (&gt;200 per 100.000 patient-years) were observed in men aged 80 or more. Altogether 88% of patients were treated conservatively. The proportion of patients treated by mini-invasive surgery significantly increased during study period (0–5.9%, <em>p</em> &lt; 0.001) and was associated with shorter hospitalization (median 6 [interquartile range 4–12] days) than open surgery (median 7 [4.5–13] days) (<em>p</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>The incidence of pleural infections has increased significantly over the previous decades in Finland and appears to be higher than previously reported, particularly in elderly men.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101132"},"PeriodicalIF":2.2,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000485/pdfft?md5=86148589ae8c4061d2cfb25f9ad609c8&pid=1-s2.0-S2590041224000485-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An « endo-tracheal customization » of a tracheobronchial silicone stent","authors":"Martin Boussuges,&nbsp;Aurélie Kienlen","doi":"10.1016/j.resmer.2024.101129","DOIUrl":"10.1016/j.resmer.2024.101129","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101129"},"PeriodicalIF":2.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcoidosis Diagnostic Score (SDS) system: Impact of race, sex, organ involvement and duration of symptoms prior to diagnosis","authors":"Ying Zhou ,&nbsp;Florence Jeny ,&nbsp;Violetta Vucinic ,&nbsp;Deepak Talwar ,&nbsp;Ogugua Ndili Obi ,&nbsp;Marc A Judson ,&nbsp;Irina Strambu ,&nbsp;Parathasarathi Bhattacharyya ,&nbsp;Dominique Valeyre ,&nbsp;Alexandra N Bickett ,&nbsp;Elyse E Lower ,&nbsp;Robert P Baughman","doi":"10.1016/j.resmer.2024.101127","DOIUrl":"10.1016/j.resmer.2024.101127","url":null,"abstract":"<div><h3>Background</h3><p>The Sarcoidosis Diagnostic Score (SDS) system has been established for sarcoidosis patients based on the WASOG organ involvement criteria. We evaluated modifications of the SDS system to determine if they improved its the diagnostic accuracy.</p></div><div><h3>Methods</h3><p>Biopsy-confirmed patients with sarcoidosis seen during a 7-month period at 9 sarcoidosis centers across the world. Patients with non-sarcoidosis seen at the same sites were served as control patients. Comparing the SDS-biopsy and SDS-clinical values of five groups: duration of symptoms prior to evaluation (≤1 years vs.&gt;1 years, ≤2 years vs.&gt;2 years), organ involvement (lung, eye, or cardiac), race, and sex.</p></div><div><h3>Results</h3><p>A total of 990 patients with sarcoidosis and 1011 controls were included in this study. The SDS-clinical was significantly more discriminating for those undergoing assessment with symptoms for more than one year (z-statistic=2.570, <em>p</em> = 0.0102) or two years (z-statistic=2.546, <em>p</em> = 0.0109). However, the addition of two points for both &gt;1 years and &gt;2 years since onset of symptoms did not increase sensitivity and specificity of diagnosis with the SDS system. The SDS-clinical cut-off for patients with ocular or cardiac disease was two points higher than that for lung disease. There was no difference in SDS-clinical or biopsy AUC values based on gender or race.</p></div><div><h3>Conclusions</h3><p>The longer the duration of symptoms prior to diagnosis, the more likely the diagnosis of sarcoidosis was correct. For patients presenting with ocular or cardiac symptoms, evidence of multi-organ involved can improve the diagnostic accuracy of the SDS-clinical.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101127"},"PeriodicalIF":2.2,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual inhaled antibiotics for treatment of pulmonary exacerbations in cystic fibrosis – A real life pilot study","authors":"Moshe Heching ,&nbsp;Liora Slomianksy ,&nbsp;Huda Mussaffi ,&nbsp;Dario Prais ,&nbsp;Joel Weinberg ,&nbsp;Mordechai R. Kramer","doi":"10.1016/j.resmer.2024.101128","DOIUrl":"10.1016/j.resmer.2024.101128","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101128"},"PeriodicalIF":2.2,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000448/pdfft?md5=21329279a017f62b30a76be47a37bb3c&pid=1-s2.0-S2590041224000448-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary nodules and the psychological harm they can cause: A scoping review","authors":"Grace C. Hillyer ,&nbsp;Nicole Milano ,&nbsp;William A. Bulman","doi":"10.1016/j.resmer.2024.101121","DOIUrl":"10.1016/j.resmer.2024.101121","url":null,"abstract":"<div><p>More than 1.6 million pulmonary nodules are diagnosed in the United States each year. Although the majority of nodules are found to be benign, nodule detection and the process of ruling out malignancy can cause patients psychological harm to varying degrees. The present study undertakes a scoping review of the literature investigating pulmonary nodule-related psychological harm as a primary or secondary outcome. Online databases were systematically searched to identify papers published through June 30, 2023, from which 19 publications were reviewed. We examined prevalence by type, measurement, associated factors, and behavioral or clinical consequences. Of the 19 studies reviewed, 11 studies investigated distress, anxiety (<em>n</em> = 6), and anxiety and depression (<em>n</em> = 4). Prevalence of distress was 24.0 %-56.7 %; anxiety 9.9 %-42.1 %, and 14.6 %-27.0 % for depression. A wide range of demographic and social characteristics and clinical factors were associated with nodule-related psychological harm. Outcomes of nodule-related harms included experiencing conflict when deciding about treatment or surveillance, decreased adherence to surveillance, adoption of more aggressive treatment, and lower health-related quality of life. Our scoping review demonstrates that nodule-related psychological harm is common. Findings provide evidence that nodule-related psychological harm can influence clinical decisions and adherence to treatment recommendations. Future research should focus on discerning between nodule-related distress and anxiety; identifying patients at risk; ascertaining the extent of psychological harm on patient behavior and clinical decisions; and developing interventions to assist patients in managing psychological harm for better health-related quality of life and treatment outcomes.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101121"},"PeriodicalIF":2.2,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000370/pdfft?md5=e00898e97cc43b0153d798a4860670ad&pid=1-s2.0-S2590041224000370-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world comparison of chemo-immunotherapy and chemotherapy alone in the treatment of extensive-stage small-cell lung cancer","authors":"D. Lamy ,&nbsp;P. Mouillot ,&nbsp;A. Mariet ,&nbsp;R. Barnestein ,&nbsp;F. Quilot ,&nbsp;C. Fraisse ,&nbsp;F. Ghiringhelli ,&nbsp;P. Bonniaud ,&nbsp;A. Zouak ,&nbsp;P. Foucher","doi":"10.1016/j.resmer.2024.101125","DOIUrl":"10.1016/j.resmer.2024.101125","url":null,"abstract":"<div><h3>Introduction</h3><p>Small cell lung cancer (SCLC) is a high-grade neuroendocrine carcinoma responsible for 200,000 deaths per year worldwide. Platinum-etoposide-based chemotherapy has been the standard of treatment for the past 40 years, with an overall survival of 10 months. Since 2019, the addition of immunotherapy (atezolizumab or durvalumab) to chemotherapy has become the standard of care for first-line treatment of extensive-stage SCLC following the demonstration of an improvement in overall survival in phase 3 studies. We aimed to evaluate the efficacy and safety of chemo-immunotherapy compared with chemotherapy alone in a “real-world” setting.</p></div><div><h3>Methods</h3><p>Retrospective observational study including patients undergoing first-line treatment for extensive-stage SCLC between 2014 and 2022. We separated the study population into two arms (chemo-immunotherapy/chemotherapy). For each arm, progression-free survival (PFS), overall survival (OS) and serious side effects were collected. Associations between treatments and survival outcomes were adjusted for potential confounders. Consolidative palliative thoracic radiotherapy was introduced in the models as a time-dependent variable.</p></div><div><h3>Results</h3><p>A total of 118 patients with a median age of 63 years were included. 65.2 % of patients were performance status 0 or 1. In univariate analysis, PFS and OS were not significantly different between the chemo-immunotherapy and chemotherapy alone groups (<em>p</em> = 0.70 and 0.24 respectively). In multivariate analysis, the addition of immunotherapy to chemotherapy was not significantly associated with better PFS (HR 0.76, IC (0.49 – 1.19), <em>p</em> = 0.23), but it was significantly associated with better OS (HR 0.61, IC (0.38 – 0.98), <em>p</em> = 0.04). Consolidative palliative thoracic radiotherapy (time-dependent variable), when applied (almost only in the chemotherapy alone group), was significantly associated with better PFS and OS.</p></div><div><h3>Discussion</h3><p>In this real-world study, chemo-immunotherapy was associated with slightly better OS compared to chemotherapy alone as a first-line treatment in ES-SCLC patients in multivariate analysis, which is not explained by a benefit in PFS. However, consolidative palliative thoracic radiotherapy seems to be significantly associated with better OS and PFS, suggesting that we should also consider using it in patients receiving chemo-immunotherapy.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101125"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000412/pdfft?md5=6163e4bd3e4705c895951a02b4a7c251&pid=1-s2.0-S2590041224000412-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fast pleurodesis combining talc poudrage and indwelling pleural catheter for the management of recurrent malignant pleural effusions","authors":"Jean-Baptiste Lovato ,&nbsp;Sophie Laroumagne ,&nbsp;Julie Tronchetti ,&nbsp;Ngoc Anh Thu Nguyen ,&nbsp;Hervé Dutau ,&nbsp;Philippe Astoul","doi":"10.1016/j.resmer.2024.101124","DOIUrl":"10.1016/j.resmer.2024.101124","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Malignant pleural effusions (MPE) are a frequent and major turning point in neoplastic disease usually leading to poor life expectancy. Improve quality of life and relieve the dyspnea are the main objectives in this palliative care setting. This can be achieved by the placement of an indwelling catheter (IPC) or talc pleurodesis ideally performed by thoracoscopy route (talc poudrage). Beside to misidentify a trapped-lung, the latter requires a prolonged hospital stay and the IPC placement does not allow a high pleurodesis rate. To overcome these drawbacks, a combination of both technique could be proposed for the management of recurrent malignant pleural effusions. Safety and efficacy of this pragmatic approach are reported.</p></div><div><h3>Methods</h3><p>Consecutive patients who have been managed for recurrent MPE by a combination of talc poudrage for pleural symphysis by thoracoscopy route ending with the insertion of IPC using the same thoracic point of entry. Demographic data, hospital length of stay (LOS), procedural-related complications, patients’ quality of life (QoL) and success of pleurodesis were collected. Patients were followed-up for 6 months.</p></div><div><h3>Results</h3><p>The data of twenty-five consecutive patients undergoing the procedure were analyzed. Successful pleurodesis was obtained for 14/25 patients (66 %) at one month, 17/20 patients (85 %) at 3 months and 13/15 patients (86 %) at 6 months respectively. On average, the hospital LOS after the procedure was 3.24 days (IQR 1–4) with a median of 1 day. A prolonged hospitalization (&gt;1 day) was never due to the procedure except for one patient (pneumothorax). No IPC related infection or procedure related deaths were noted.</p></div><div><h3>Conclusion</h3><p>Among patients with recurrent MPE, the combination of talc poudrage symphysis by thoracoscopy route and IPC placement on the same time results in a shortened hospital LOS and higher rate of pleurodesis. Further randomized clinical trials are needed to confirm these results.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101124"},"PeriodicalIF":2.2,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000400/pdfft?md5=8a539327bdc3737de1953cd936680db1&pid=1-s2.0-S2590041224000400-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence and unresolved questions in pulmonary hypertension: Insights from the 5th French Pulmonary Hypertension Network Meeting","authors":"Athénaïs Boucly ,&nbsp;Laurent Bertoletti ,&nbsp;Charles Fauvel ,&nbsp;Mélanie Gallant Dewavrin ,&nbsp;Christian Gerges ,&nbsp;Julien Grynblat ,&nbsp;Christophe Guignabert ,&nbsp;Sébastien Hascoet ,&nbsp;Xavier Jaïs ,&nbsp;Etienne-Marie Jutant ,&nbsp;Nicolas Lamblin ,&nbsp;Olivier Meyrignac ,&nbsp;Marianne Riou ,&nbsp;Laurent Savale ,&nbsp;Cécile Tromeur ,&nbsp;Ségolène Turquier ,&nbsp;Simon Valentin ,&nbsp;Gérald Simonneau ,&nbsp;Marc Humbert ,&nbsp;Olivier Sitbon ,&nbsp;David Montani","doi":"10.1016/j.resmer.2024.101123","DOIUrl":"10.1016/j.resmer.2024.101123","url":null,"abstract":"<div><p>Pulmonary hypertension (PH) continues to present significant challenges to the medical community, both in terms of diagnosis and treatment. The advent of the updated 2022 European Society of Cardiology (ESC) and European Respiratory Society (ERS) guidelines has introduced pivotal changes that reflect the rapidly advancing understanding of this complex disease. These changes include a revised definition of PH, updates to the classification system, and treatment algorithm. While these guidelines offer a critical framework for the management of PH, they have also sparked new discussions and questions. The 5th French Pulmonary Hypertension Network Meeting (Le Kremlin-Bicêtre, France, 2023), addressed these emergent questions and fostering a deeper understanding of the disease's multifaceted nature. These discussions were not limited to theoretical advancements but extended into the practical realms of patient management, highlighting the challenges and opportunities in applying the latest guidelines to clinical practice.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101123"},"PeriodicalIF":2.2,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The challenges of identifying pulmonary embolism in patients hospitalized for exacerbations of COPD","authors":"Rufang Li ,&nbsp;Jie Zeng ,&nbsp;DanXiong Sun,&nbsp;Dengyuan Li","doi":"10.1016/j.resmer.2024.101122","DOIUrl":"10.1016/j.resmer.2024.101122","url":null,"abstract":"<div><h3>Background</h3><p>Chronic obstructive pulmonary disease (COPD) is associated with airflow obstruction that threatens global health. During the hospitalization of patients with acute exacerbations of COPD (AECOPD), the high prevalence of pulmonary embolism (PE) seriously affects the prognosis of disease. This study aims to assess the differences in clinical data between patients with AECOPD and patients with AECOPD-PE, and to identify the relevant factors of PE.</p></div><div><h3>Methods</h3><p>We performed a retrospective case-control study in AECOPD patients between January 2018 and December 2021. Due to suspected PE, all patients underwent radiological examination. Patients without PE were included as controls. Clinical data and laboratory tests were recorded. Univariate analysis and multivariate logistic regression analysis were used to investigate the independent predictors of PE. Receiver operating characteristics (ROC) curves was performed to evaluate the effect of risk factors on PE prediction.</p></div><div><h3>Results</h3><p>A total of 191 patients were included for analysis, divided into the AECOPD group (96 cases) and AECOPD-PE group (95 cases). No statistic differences were detected in demographic characteristics between patients with AECOPD and patients with AECOPD and PE. Average PO₂ and PCO₂ levels, lung function, and Echocardiographic indicator were not associated with PE. The concentration of D-dimer, the proportion of simplified wells score ≥ 2, and the incidence rate of lower extremity deep vein thrombosis (DVT) remarkably increased in AECOPD-PE group than AECOPD individuals. At multivariate analysis, the above three indicators were closely relevant to the occurrence of PE. The AUC value for D-dimer combined with lower extremity DVT and Simplified Wells Score was 0.729.</p></div><div><h3>Conclusions</h3><p>D-dimer, lower extremity DVT, and simplified wells score ≥ 2 were relevant to higher risks of PE, which will help to improve clinicians’ understanding of PE secondary to AECOPD.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101122"},"PeriodicalIF":2.2,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial pneumonia with auto-immune features (IPAF): Is a change of criteria necessary?","authors":"Raphael Borie,&nbsp;Joshua J Solomon","doi":"10.1016/j.resmer.2024.101120","DOIUrl":"10.1016/j.resmer.2024.101120","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101120"},"PeriodicalIF":2.3,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141405396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}