Respiratory research & clinical practice最新文献

{"title":"Targeted metabolomic analysis of exhaled breath condensate before and after bronchial provocation by eucapnic voluntary hyperventilation in adolescents with asthma: an exploratory study.","authors":"Cláudio Gonçalves de Albuquerque, José Ângelo Rizzo, Edil de Albuquerque Rodrigues, Ricardo Oliveira Silva, Tatiane Priscila Santos Rodrigues da Luz, Marco Aurelio de Valois Correia, Décio Medeiros Peixoto","doi":"10.36416/1806-3756/e20250375","DOIUrl":"10.36416/1806-3756/e20250375","url":null,"abstract":"<p><strong>Objective: </strong>To analyze endogenous metabolites in exhaled breath condensate before and after eucapnic voluntary hyperventilation (EVH) in adolescents with asthma with and without exercise-induced bronchoconstriction (EIB).</p><p><strong>Methods: </strong>This was an exploratory study including 44 adolescents with asthma in the 10- to 20-year age bracket. They were divided into two groups: the group of patients with EIB (n = 25) and that of those without (n = 19). EIB was defined as a ≥ 10% reduction in FEV₁ after a six-minute EVH challenge using 5% carbon dioxide. Ventilation was maintained at 21 times the baseline FEV₁. Exhaled breath condensate was collected before EVH and 15-30 min after EVH by using a validated device. Samples were analyzed by proton nuclear magnetic resonance focusing on the region of d1.60-2.00 parts per million. Data were preprocessed by using sum normalization and autoscaling for orthogonal partial least squares discriminant analysis.</p><p><strong>Results: </strong>All participants completed the protocol without adverse events. The mean reduction in FEV₁ was significantly greater in the group of patients with EIB than in that of those without (-25.13% vs. -4.37%; mean difference, -20.76%; 95% CI, -26.45 to -15.07). In the EIB group, responses were classified as mild (n = 15), moderate (n = 9), or severe (n = 1). Post-EVH orthogonal partial least squares discriminant analysis showed significant separation between pre- and post-EVH metabolic profiles in the group of patients with EIB (p < 0.001) but not in that of those without (p = 0.195). The discriminative response in patients with EIB was associated with a marked increase in acetate signal intensity at 1.76 parts per million.</p><p><strong>Conclusions: </strong>Adolescents with EIB show a distinct metabolic fingerprint that is significantly associated with ventilatory stress. Acetate emerged as a key metabolic differentiator, suggesting a specific biochemical pathway associated with the exercise response and supporting its potential role in precision phenotyping of EIB.</p>","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20250375"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973090","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":"Patient-ventilator asynchrony knowledge, attitudes, and practices among ICU health care professionals: questionnaire development.","authors":"Mayson L A Sousa, Fabia Diniz-Silva, Sandra R Wilson, Juliana C Ferreira","doi":"10.36416/1806-3756/e20260010","DOIUrl":"10.36416/1806-3756/e20260010","url":null,"abstract":"<p><strong>Objective: </strong>To describe the development and validation process of a questionnaire to assess the knowledge, attitudes, and practices of ICU health care professionals regarding patient-ventilator asynchrony.</p><p><strong>Methods: </strong>This was a knowledge, attitudes, and practices questionnaire development study. Item generation was guided by a literature-based conceptual framework, followed by expert review to establish face and content validity. The instrument was refined through specialists in mechanical ventilation and questionnaire design. The tenth version was piloted in Portuguese among ICU health care professionals, including a 30-day test-retest assessment.</p><p><strong>Results: </strong>The final version of the questionnaire comprised 24 items (knowledge, 14 items; attitudes, 4; and practices, 6). Of the 83 ICU health care professionals who consented to participate, 49 completed at least 80% of the questionnaire twice and were included in the analysis. The knowledge section showed acceptable internal consistency (Cronbach's alpha = 0.73) and moderate test-retest reliability (intraclass correlation coefficient = 0.48; 95% CI, 0.24-0.67). Median knowledge scores were 71 [57-79] at test and 64 [50-79] at retest, out of 100 (p = 0.052). Attitude scores also showed good test-retest reliability (intraclass correlation coefficient = 0.68; 95% CI, 0.50-0.81) and a moderate correlation (r = 0.60; p < 0.001), with median scores of 75 (out of 100) in both rounds. Practice item responses were generally consistent between test and retest.</p><p><strong>Conclusions: </strong>We developed a questionnaire to assess knowledge, attitudes, and practices related to patient-ventilator asynchrony among ICU health care professionals, with evidence of face and content validity, internal consistency, and test-retest reliability.</p>","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20260010"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973079","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":"Obesity and obstructive sleep apnea: from pathophysiology to current clinical approaches.","authors":"Erika Cristine Treptow, Glaucia Carneiro, Monica Levy Andersen, Luciano F Drager, Pedro Rodrigues Genta","doi":"10.36416/1806-3756/e20250314","DOIUrl":"10.36416/1806-3756/e20250314","url":null,"abstract":"<p><p>The prevalence of obesity and obstructive sleep apnea (OSA) has increased alarmingly over recent decades and is projected to continue to rise. These chronic disorders interact bidirectionally and increase cardiovascular and metabolic risks. OSA is a complex and heterogenous disease in which weight management plays a key role in achieving long-lasting therapeutic success. Multiple mechanisms are associated with the link between obesity and OSA, including enlargement of upper airway soft tissue, pharyngeal lengthening, reduced lung volume, and leptin impairment. In this review, we describe the mechanisms linking obesity and OSA, and examine the impact of CPAP therapy on body weight. We also review current obesity treatment strategies and their effects on reducing OSA severity, comparing the efficacy of lifestyle modifications, surgical approaches, and pharmacological treatments in promoting weight loss. Finally, we explore the potential of recent advances in pharmacological obesity treatments as therapeutic options for OSA, as well as the promise of combination therapy for achieving better short- and long-term weight reduction.</p>","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20250314"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973092","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":"Neurofibromatosis type I with thoracic involvement.","authors":"Felipe Von Ranke, Gláucia Zanetti, Edson Marchiori","doi":"10.36416/1806-3756/e20260131","DOIUrl":"10.36416/1806-3756/e20260131","url":null,"abstract":"","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20260131"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973082","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":"Differences in survival between two cohorts of COPD patients living in Mexico City: a 20-year cohort comparison.","authors":"Gustavo I Centeno-Saenz, Robinson Robles-Hernández, Alejandra Ramírez-Venegas, Sandra P Guinto-Ramirez, Rafael Hernández-Zenteno, Francisco López-Montiel, Abraham Tolentino-de la Mora, Justino Regalado, Rogelio Perez-Padilla","doi":"10.36416/1806-3756/e20250271","DOIUrl":"10.36416/1806-3756/e20250271","url":null,"abstract":"<p><strong>Objective: </strong>To compare the survival rates for two cohorts of COPD patients living in Mexico City and studied 20 years apart at the same referral center, with demographic characteristics, lung function, hypoxemia, type of exposure associated with COPD, and socioeconomic status being analyzed.</p><p><strong>Methods: </strong>Two cohorts of COPD patients were studied and followed at a single referral center for respiratory diseases in Mexico City, at an altitude of 2,240 m above sea level. The first cohort was studied between 1996 and 2003, and the second was studied between 2016 and 2023. Participants were followed for seven years, and a multivariate Cox model was used in order to analyze survival.</p><p><strong>Results: </strong>The first cohort included 434 patients, and the second comprised 416 patients, with a total of 850 patients being analyzed. Of those, 68% had COPD from tobacco smoking and 32% had COPD from biomass smoke exposure. In the multivariate Cox model adjusted for age, sex, smoking status, exposure to biomass smoke, BMI < 21 kg/m², hypoxemia, six-minute walk distance, and lung function as assessed by spirometry, the 2016-2023 cohort showed a significant reduction in the seven-year mortality rate (hazard ratio = 0.59; 95% CI, 0.44-0.81; p = 0.001) when compared with the 1996-2003 cohort.</p><p><strong>Conclusions: </strong>Survival of COPD patients has improved over the past 20 years after accounting for several mortality predictors.</p>","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20250271"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972914","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":"Brazilian guidelines for the pharmacological treatment of pulmonary hypertension. Official document of the Brazilian Thoracic Society based on the Grading of Recommendations Assessment, Development, and Evaluation methodology.","authors":"Veronica Moreira Amado, Mônica Corso Pereira, Ricardo Amorim Correa, Frederico A F Thadeu Campos, Caio Fernandes, Eloara V M Ferreira, Marcelo B Gazzana, Marcelo Jorge Jacó Rocha, Carlos Jardim, Jose Leonidas Alves-Jr, Rudolf K F Oliveira, Virginia Pacheco, William Salibe-Filho, Suzana Tanni, Daniel Waetge, Jaquelina S Ota-Arakaki, Rogerio Souza","doi":"10.36416/1806-3756/e20250528","DOIUrl":"10.36416/1806-3756/e20250528","url":null,"abstract":"<p><p>Pulmonary hypertension (PH) is a complex and heterogeneous clinical condition associated with high morbidity and mortality and can occur in the context of various diseases. It is characterized by increased pulmonary arterial pressure and progressive right ventricular overload. The current classification of the different forms of PH presentation comprises five groups, based on pathophysiological similarities and available therapeutic options. In recent decades, significant advances in pathophysiological understanding and the development of specific therapies have significantly modified the prognosis of patients with PH. This guideline aims to define updated Brazilian recommendations for the treatment of PH, with an emphasis on pulmonary arterial hypertension, considering the available scientific evidence and the particularities of the Brazilian health system. Four structured questions in the PICO format (patients, intervention, comparator group, and outcome) were developed by a multidisciplinary panel of Brazilian experts. Systematic literature reviews were conducted for each question, based on randomized clinical trials. Meta-analyses were conducted where methodologically feasible. The quality of evidence and the strength of recommendations were defined according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The guideline was complemented by a comprehensive narrative review of the literature on clinical management of patients with PH, especially patients with pulmonary arterial hypertension, addressing general measures, specific therapeutic strategies, risk stratification, and treatment algorithm, always based on the best available scientific evidence and with the aim of contributing to the improvement of care for patients with PH in Brazil.</p>","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20250528"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972958","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":"Beyond the human eye: the role of deep learning in the diagnosis of pneumonia in infants.","authors":"Raí Silva Gomes, Leonardo Araujo Pinto","doi":"10.36416/1806-3756/e20260286","DOIUrl":"10.36416/1806-3756/e20260286","url":null,"abstract":"","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20260286"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972917","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":"Linezolid in the era of bedaquiline-pretomanid-linezolid-based regimens: an indispensable challenge.","authors":"Ana Paula Santos, Fernanda Carvalho de Queiroz Mello","doi":"10.36416/1806-3756/e20260324","DOIUrl":"10.36416/1806-3756/e20260324","url":null,"abstract":"","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20260324"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972987","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":"Diffuse aspiration bronchiolitis associated with oropharyngeal carcinoma: an underrecognized condition-a case report.","authors":"Guilherme das Posses Bridi, Ellen Caroline Toledo do Nascimento, Eduardo Kaiser Ururahy Nunes Fonseca, Alexandre Franco Amaral, Bruno Guedes Baldi, Ronaldo Adib Kairalla","doi":"10.36416/1806-3756/e20260025","DOIUrl":"10.36416/1806-3756/e20260025","url":null,"abstract":"","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20260025"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972903","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":"Exercise testing in the assessment of patients with bronchiectasis.","authors":"Danilo C Berton, Carla Tatiana Martins de Oliveira, Denis E O'Donnell, José Alberto Neder","doi":"10.36416/1806-3756/e20260267","DOIUrl":"10.36416/1806-3756/e20260267","url":null,"abstract":"","PeriodicalId":524203,"journal":{"name":"Respiratory research & clinical practice","volume":"52 3","pages":"e20260267"},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973046","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}