Annals of Thoracic Medicine最新文献

{"title":"Prevalence and characteristics of rapid eye movement-related sleep apnea in a population-based cohort.","authors":"Omar Kanbr, Siraj Wali, Lina Wasfi, Asim Sharif, Ghadah Batawi, Md Dilshad Manzar, Ranya Alshumrani, Faris Alhejaili","doi":"10.4103/atm.atm_188_24","DOIUrl":"https://doi.org/10.4103/atm.atm_188_24","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to estimate the prevalence and characteristics of rapid eye movement-related obstructive sleep apnea (REMrOSA) in the general Saudi Arabian population, contributing novel data to the field and providing insights into this specific OSA phenotype.</p><p><strong>Methods: </strong>We analyzed data from a previously described Saudi population study targeting school employees aged 30-60 years. The study was conducted in two stages: an initial screening of 2682 participants using screening questionnaires and a confirmatory test of 346 participants using polysomnography (PSG). OSA was defined as an apnea-hypopnea index (AHI) ≥5. REMrOSA was identified on the basis of specific criteria, including a REM-AHI/non-REM (NREM)-AHI ratio ≥2, NREM-AHI <15, and REM duration ≥30 min. An extrapolation method was used to estimate the prevalence of REMrOSA in the general population.</p><p><strong>Results: </strong>Among the 346 subjects who underwent PSG, 235 had OSA. Approximately one-third (30.64%) of these patients had REMrOSA, with a higher prevalence noted in females (38.03%) than in males (27.44%). The estimated prevalence of REMrOSA in the general Saudi population was 2.68%, with males (3.5%) being more affected than females (1.93%). Patients with REMrOSA presented lower AHI, Epworth Sleep Scale score, and arousal index than did those with non-REMrOSA (NREMrOSA). Logistic regression analysis indicated that patients with exclusive positional OSA (e-POSA) were 2.7 times more likely to have REMrOSA.</p><p><strong>Conclusions: </strong>REMrOSA is a common condition among patients with OSA, with an estimated prevalence of 2.68% in the general Saudi population. Patients with REMrOSA tend to have milder disease, are less symptomatic, and are seen more in e-POSA.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 2","pages":"117-124"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057258","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":"Analysis of treatment efficacy, tolerability, and survival of patients receiving antifibrotic therapy for progressive nonidiopathic pulmonary fibrosis.","authors":"Nesrin Ocal, Aykut Cilli, Nesrin Mogulkoc, Funda Coskun, Ahmet Ursavas, Ismail Hanta, Berna Akinci Ozyurek, Kerem Ensarioglu, Alper Ezircan, Esra Yuksel, Beste Arikan, Fatih Uzer, Tugce Sahin Ozdemirel, Salim Misirci, Pelin Pinar Deniz, Ilknur Basyigit, Ozlem Ozdemir Kumbasar","doi":"10.4103/atm.atm_213_24","DOIUrl":"https://doi.org/10.4103/atm.atm_213_24","url":null,"abstract":"<p><strong>Background: </strong>There are still disagreements about diagnostic criteria and treatment of progressive pulmonary fibrosis (PPF). Real-life data and survival analyses have a guiding role in clarifying this issue.</p><p><strong>Methods: </strong>In this multicenter retrospective cohort study, real-life data of adult patients diagnosed with PPF and treated with antifibrotics for at least 6 months were examined.</p><p><strong>Results: </strong>Of the 222 patients, 161 were treated with Nintedanib (N) and 61 with Pirfenidone (P). The most common PPF subtype was connective tissue disease-related interstitial lung disease (CTD-ILD) (53.2%). The progression rate was significantly higher in patients with usual interstitial pneumonia (UIP) (<i>P</i> = 0.003). A -3.1% (-49.2 ml) decrease was detected in forced vital capacity (FVC) in the 6^th month. The 6^th month and overall progression-free survival (PFS) rates were 83.3% and 51.8%. The 6^th month and overall clinical event-free survival (CEFS) rates were 89.6% and 53.6%. The survival rates for 6^th, 12^th, and entire follow-up periods were found to be 98.2%, 89.2%, and 77.5%. CT-ILD had the longest survival time (166.5 ± 9.2 months) and fibrotic hypersensitivity pneumonia had the shortest survival time (87.6 ± 9.2 months) (<i>P</i> = 0.011). N was advantageous in patients with UIP in terms of FVC loss and estimated survival. While PFS during the entire follow-up period was in favor of N, CEFS had no significant difference between drugs.</p><p><strong>Conclusion: </strong>PPF subtypes have significant differences in terms of prognosis and survival. The effect of AF drugs on progression varies, especially among radiological patterns. An individualized approach is required in the diagnosis, follow-up, and treatment of patients with PPF.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 2","pages":"98-107"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020285","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":"Awareness and barriers of adherence to chronic obstructive pulmonary disease guidelines among respiratory therapists.","authors":"Nowaf Y Alobaidi, Abdulelah M Aldhahir, Ahmed H Alasimi, Mohammed A Almeshari, Ali Altoraibili, Aqeel Al-Abdulsalam, Ahmed Almoraihel, Thamer Alabbad, Elyas Alanazi, Rayan A Siraj, Jaber S Alqahtani","doi":"10.4103/atm.atm_227_24","DOIUrl":"https://doi.org/10.4103/atm.atm_227_24","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) significantly contributes to global morbidity and mortality. Despite increasing COPD prevalence in Saudi Arabia, knowledge of and barriers to adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines among respiratory therapists (RTs) remain limited. This study assessed RT awareness and barriers to adherence to the updated 2023 GOLD guidelines for COPD management in Saudi Arabia.</p><p><strong>Methods: </strong>A modified cross-sectional online survey (snowball sampling) was distributed via social media from December 2023 to March 2024. The questionnaire covered eight domains: six assessing knowledge of COPD (overview, diagnosis, stable COPD therapy, pharmacological and nonpharmacological management of COPD and exacerbations, and COPD prevention and comorbidity), one on barriers to guideline adherence, and one on attitudes toward guidelines. A knowledge score (out of 39) was calculated. Descriptive statistics, tests for group differences, and regression analyses were conducted.</p><p><strong>Results: </strong>Three hundred and twenty-six RTs (65.6% of males) participated. The average knowledge score was 18.9 ± 5.75 out of 39 (49.9% correct answers), indicating low COPD knowledge. Higher scores were associated with more COPD cases and bedside RT roles. While 53.1% of RTs expressed positive attitudes toward guideline utilization, only 16.9% of RTs reported recent use and 12.9% reported consistent use over the past 6 months. Key barriers included limited time for professional development (40.8%) and inadequate educational resources (37.7%).</p><p><strong>Conclusion: </strong>This study reveals a knowledge gap and suboptimal COPD guidelines adherence among RTs in Saudi Arabia. Knowledge level correlated with COPD cases and RT role. Targeted interventions are needed to improve guideline adherence and COPD care.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 2","pages":"108-116"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055014","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":"Strategies for preventing ventilator-associated pneumonia in adults in the Middle East and North Africa Region: A systematic review and meta-analysis.","authors":"Omar Abousaad, Aisha Al-Ajji, Noor Abouazab, Adel Aljoaid, Jithin K Sreedharan","doi":"10.4103/atm.atm_237_24","DOIUrl":"https://doi.org/10.4103/atm.atm_237_24","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) is a common complication in intensive care units (ICUs), particularly in patients undergoing prolonged mechanical ventilation. VAP rates vary significantly across regions, with the Middle East and North Africa (MENA) region experiencing relatively high incidences. This study systematically reviews and analyses the efficacy of various VAP prevention strategies in the adult population of the MENA region.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines. Electronic databases (PubMed, Scopus, and CINAHL) were searched for studies from January 2004 to May 2024 that investigated VAP prevention strategies in adult ICU patients in the MENA region. Data extraction and quality assessment were performed by multiple independent reviewers. Meta-analysis was carried out using the DerSimonian and Laird random effect models.</p><p><strong>Results: </strong>A total of 10 randomized clinical trials conducted in Iran and Tunisia were included. The studies evaluated various interventions, including respiratory care programs, oral care protocols, and tracheal suction techniques. Significant reductions in VAP incidence were observed with interventions such as aerosolized colistin and comprehensive oral care (e.g., clove mouthwash). However, certain interventions, such as ondansetron and N-acetylcysteine, did not yield significant benefits.</p><p><strong>Conclusion: </strong>This meta-analysis highlights effective VAP prevention strategies in the MENA region, with notable improvements in patient outcomes. These findings can potentially help in developing policies and guidelines to enhance VAP prevention efforts across ICUs in the region. Further research is essential to address existing gaps and refine prevention strategies.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 2","pages":"90-97"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065234","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":"Gastrobronchial fistula after esophageal cancer surgery treated by silicone plug.","authors":"Yun Liu, Shanshan Zhang, Wenwen Guo, Cuixia Bian","doi":"10.4103/atm.atm_259_24","DOIUrl":"https://doi.org/10.4103/atm.atm_259_24","url":null,"abstract":"<p><p>Gastrobronchial fistula (GBF) is a rare but serious complication following esophagectomy, associated with high morbidity and mortality. The use of silicone plugs has proven effective in closing bronchial fistulas in other contexts, but its application in GBF has not been widely described. In this article, we report the successful closure of a GBF using a self-made silicone plug under bronchoscopic guidance in a patient with a history of esophagectomy for esophageal cancer. This approach offers a safe, minimally invasive alternative for managing refractory GBF.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 2","pages":"141-144"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057640","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":"Comparison of perioperative outcomes between hybrid uniportal robotic-assisted and uniportal video-assisted thoracoscopic surgery - A propensity score matching analysis.","authors":"Jun Chen, Yunfei Gao, Yueying Yang, Jianhu Chu, Xiaogang Li, Dongbo Luo","doi":"10.4103/atm.atm_236_24","DOIUrl":"https://doi.org/10.4103/atm.atm_236_24","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the perioperative outcomes of hybrid multi-arm robotic-assisted uniportal thoracoscopic surgery (H-URATS) using a laparoscopic stapling device, assess the safety and feasibility of the procedure, and summarize the surgical experience.</p><p><strong>Methods: </strong>The Department of Thoracic Surgery at Xinjiang Tumor Hospital has performed over 100 H-URATS procedures using endoscopic staplers and the robotic surgery platform. We collected the clinical data and perioperative outcomes from patients undergoing Uniportal Video-assisted Thoracoscopic Surgery (UVATS) and H-URATS between January 2023 and August 2024. Propensity score matching (PSM) was conducted based on clinical characteristics and perioperative outcomes were compared between the two groups after matching.</p><p><strong>Results: </strong>A total of 395 patients were included, with 109 in the H-URATS group and 286 in the UVATS group. After PSM, each group consisted of 92 patients. There were no significant differences between the H-URATS and UVATS groups in terms of chest drainage duration, postoperative hospital stay, conversion to thoracotomy rate, intensive care unit admission rate, postoperative complication rate, postoperative pathological types, or tumor TNM staging (<i>P</i> > 0.05). The H-URATS group had less intraoperative blood loss compared to the UVATS group (<i>P</i> < 0.001), and more lymph nodes (LNs) and LN stations were dissected in the H-URATS group (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>In terms of short-term results, our study confirms the safety and feasibility of H-URATS as a new minimally invasive technique. It combines the advantages of uniportal thoracoscopy and robotic surgery systems and demonstrates potential benefits in oncological outcomes and complex procedures such as segmentectomies.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 2","pages":"125-133"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059910","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":"Erratum: Investigating the dynamic relationship of sleep-disordered breathing, orthodontic treatment needs, and dental esthetics in the general population.","authors":"","doi":"10.4103/atm.atm_9_25","DOIUrl":"10.4103/atm.atm_9_25","url":null,"abstract":"<p><p>[This corrects the article on p. 284 in vol. 19, PMID: 39544350.].</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 1","pages":"86"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383786","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":"A case report of pulmonary paragonimiasis diagnosed via the deterioration of pulmonary cavities during high-dose corticosteroid therapy for chronic eosinophilic pneumonia.","authors":"Takehiro Hashimoto, Akira Nishizono, Kazufumi Hiramatsu","doi":"10.4103/atm.atm_146_24","DOIUrl":"10.4103/atm.atm_146_24","url":null,"abstract":"<p><p>A 32-year-old Chinese woman with a cough and bloody sputum was diagnosed with chronic eosinophilic pneumonia. After starting corticosteroid therapy, chest radiography showed improvement in the bilateral infiltrative shadow. However, chest image findings showed worsening of the bilateral infiltrative shadow and pulmonary cavities during the 20 mg/day of oral prednisolone therapy. Transbronchial lung biopsy and bronchoalveolar lavage were repeated, and the patient was diagnosed with pulmonary paragonimiasis. After starting praziquantel treatment, chest radiography findings and clinical symptoms improved. Careful follow-up during corticosteroid therapy is important to judge whether transient improvement and true deterioration of radiological findings.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 1","pages":"74-77"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383761","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":"Asymptomatic neck mass and normal variations of the thymus in children: A report of two cases from a tertiary hospital in Riyadh, Saudi Arabia.","authors":"Maryam Albaqami, Abdulaziz Almonifi, Areej Albelali","doi":"10.4103/atm.atm_91_24","DOIUrl":"10.4103/atm.atm_91_24","url":null,"abstract":"<p><p>The pathogenesis of cervical extension of the thymus has been postulated to be incomplete descent of the thymus in the midline of the neck, which is considered normal in children. The thymus normally extends to the neck in approximately two-thirds of children. Ectopic thymus mainly occurs in 1%-13% of the younger population. In this study, we report two cases of asymptomatic neck swelling, one due to cervical extension of the thymus and the other due to a right submandibular ectopic thymus. None of the patients required any intervention. Recurrent suprasternal swelling in children that becomes more pronounced during coughing/crying or Valsalva maneuvers can be more accurately diagnosed using neck ultrasonography and/or magnetic resonance imaging.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 1","pages":"71-73"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383772","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":"Management of refractory postpneumonectomy empyema with bronchopleural fistula.","authors":"Oleg Shamilevich Kesaev, Dmitry Borisovich Giller, Sergey Sergeevich Saenko, Elham Pahlevani, Lyudmila Petrovna Severova","doi":"10.4103/atm.atm_93_24","DOIUrl":"10.4103/atm.atm_93_24","url":null,"abstract":"<p><p>A 39-year-old female has postoperative empyema with bronchial stump fistula (BSF) after pneumonectomy due to ineffective tuberculosis chemotherapy. Transpleural reamputation of the right main bronchial stump with simultaneous 8-rib thoracoplasty, 6 attempts at endobronchial valve implantation and thoracostomy have failed to cure BSF and empyema. Consequently, an alternative treatment-transsternal transpericardial wedge-shaped resection of the tracheal bifurcation was performed despite its difficulty and was successful. This clinical case demonstrates the complications of BSF with tuberculosis empyema treatment in spite of there existing many alternative therapies. The need for new more effective treatments is highlighted, as well as safe and less technically difficult interventions which could assist patients with BSF.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"20 1","pages":"78-81"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383789","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}