Pulmonology最新文献

{"title":"An acceptance-based healthy lifestyle programme for community-dwelling patients with pneumoconiosis: A waitlist pilot randomised controlled trial.","authors":"Hon Lon Tam, Stanley Kam Ki Lam, Hau Yi Ngan, Leona Yuen Ling Leung, Suzanne Hoi Shan Lo","doi":"10.1080/25310429.2026.2717021","DOIUrl":"10.1080/25310429.2026.2717021","url":null,"abstract":"<p><strong>Background: </strong>Respiratory symptoms such as cough and shortness of breath are prevalent among patients with pneumoconiosis. These symptoms reduce their engagement in daily activities and induce psychological distress.</p><p><strong>Research question: </strong>Did a 6-week acceptance-based healthy lifestyle programme reduce psychological inflexibility (primary outcome) and enhance the health outcomes among community-dwelling patients with pneumoconiosis?</p><p><strong>Study design and methods: </strong>A two-arm, prospective, multicenter, waitlist pilot randomised controlled trial was conducted. Patients with pneumoconiosis were randomly assigned to either an intervention group or waitlist group at a 1:1 ratio, with intervention group receiving the programme first. The intervention consisted of four biweekly interactive sessions on integrating acceptance-based components into pneumoconiosis management. Psychological inflexibility and health outcomes were assessed at baseline, Week 6, and Week 14 by trained research assistants. A generalized estimating equations model was used to examine the effects of the intervention effect between groups.</p><p><strong>Results: </strong>Eighty patients were recruited and randomly assigned to the two groups. Compared to the waitlist group, the participants in the intervention group showed significant reduction in psychological inflexibility (β = -5.83, <i>p</i> = 0.002) and improvement in exercise self-efficacy (β = 11.68, <i>p</i> = 0.007) at Week 6, and reduction in body weight (β = -1.09, <i>p</i> < 0.001) at Week 14. No significant differences were observed for other outcomes. Moderate effect size was noted on the outcomes of psychological inflexibility and exercise self-efficacy at Week 6.</p><p><strong>Conclusion: </strong>The integration of acceptance-based components into pneumoconiosis management may reduce psychological inflexibility and promote engagement in exercise.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2717021"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical insights into catathrenia: A real-world analysis from a tertiary sleep center.","authors":"Laura Lopes, Denny Marques Rodrigues, Teresa Costa","doi":"10.1080/25310429.2026.2720833","DOIUrl":"10.1080/25310429.2026.2720833","url":null,"abstract":"<p><strong>Introduction: </strong>Catathrenia is a rare sleep-related breathing disorder marked by groaning during prolonged expiration, often underrecognized or misdiagnosed as obstructive or central sleep apnoea (OSA or CSA) or parasomnia. Understanding its clinical and polysomnographic features is essential for accurate diagnosis and management.</p><p><strong>Materials and methods: </strong>We performed a retrospective observational study of adult patients diagnosed with catathrenia at Serviço de Medicina do Sono de Coimbra. Diagnosis was established by attended overnight polysomnography (PSG) with synchronised audio-video recording. Demographic data, symptoms, comorbidities, PSG variables, treatment modalities, and outcomes were reviewed. Catathrenia events were defined as deep inhalation followed by prolonged exhalation with monotonous groaning.</p><p><strong>Results: </strong>Ten patients were included. Median age was 46 years (range 27-78), mostly female (70%). Common comorbidities included obesity (<i>n</i> = 4), depression (<i>n</i> = 2), Parkinson's disease (<i>n</i> = 1), and restless legs syndrome (<i>n</i> = 1). Six patients (60%) had concomitant obstructive sleep apnoea (OSA). Seven patients had excessive daytime sleepiness (Epworth Sleepiness Scale > 10). All catathrenia episodes occurred exclusively during REM sleep. Continuous positive airway pressure (CPAP) therapy was the most frequently used treatment and was associated with objective or subjective improvement in most patients. Two patients experienced spontaneous remission.</p><p><strong>Conclusion: </strong>Catathrenia remains underdiagnosed and can mimic other sleep disorders. Recognition of its REM-sleep predominance and PSG pattern is essential. Individualised treatment, often involving PAP therapy, may improve symptoms and patient outcomes.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2720833"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of supernormal lung function on mortality risk in adults with and without sleep-disordered breathing.","authors":"Yuhan Wang, Hailing Liu, Jiali Xiong, Jingyi Zhang, Yixuan Wang, Ke Hu","doi":"10.1080/25310429.2026.2719425","DOIUrl":"https://doi.org/10.1080/25310429.2026.2719425","url":null,"abstract":"<p><strong>Background: </strong>In the general population, supernormal lung function is associated with a lower risk of all-cause mortality.</p><p><strong>Research question: </strong>It remains unclear whether sleep-disordered breathing (SDB) affects this relationship.</p><p><strong>Methods: </strong>This cohort analysis included 4,839 adults. Lung function was categorised as supernormal (FEV₁ > ULN), normal (LLN ≤ FEV₁ ≤ ULN), and below normal (FEV₁ < LLN). SDB severity was classified using apnoea-hypopnoea index categories: no SDB (<5 events/hour), mild SDB (5-<15 events/hour), moderate SDB (15-<30 events/hour), and severe SDB (≥30 events/hour). The association between lung function and all-cause mortality was assessed using Cox proportional hazards models with subgroup analyses according to SDB severity and formal testing for interaction. Analyses were repeated using FVC-defined lung function groups as an alternative definition of supernormal lung function.</p><p><strong>Results: </strong>Among the included participants, 4,068 (84.1%) had normal lung function, 369 (7.6%) had supernormal lung function, and 402 (8.3%) had below normal lung function. During 52 421.5 person-years of follow-up (median 11.72 years; IQR, 10.46-12.56), 1,188 deaths occurred. Compared with the normal lung function group, the supernormal lung function group had a lower prevalence of baseline hypertension and cardiovascular disease. The association between lung function and all-cause mortality varied across SDB severity strata (P for interaction = 0.034). A lower mortality risk associated with supernormal lung function was observed in participants without SDB (HR: 0.24, 95% CI: 0.06-0.97), whereas this association was not statistically significant in the mild, moderate, or severe SDB strata. Below normal lung function was generally associated with an increased all-cause mortality risk. Sensitivity analyses using FVC-defined lung function groups yielded broadly consistent findings.</p><p><strong>Conclusion: </strong>Supernormal lung function was associated with lower all-cause mortality primarily among individuals without SDB. These findings underscore the importance of considering SDB severity when assessing the health implications of lung function.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2719425"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of prognostic scores and individual predictor variables for short-term mortality after acute pulmonary embolism.","authors":"David Jimenez, Behnood Bikdeli, Victor Tapson, Cecilia Becattini, Lisa Moores, Geoffrey D Barnes, Manuel Monreal, Stavros Konstantinides, Gregory Piazza, Raquel Morillo, Noelia Alvarez-Diaz, Roger D Yusen","doi":"10.1080/25310429.2026.2703889","DOIUrl":"10.1080/25310429.2026.2703889","url":null,"abstract":"<p><strong>Background: </strong>For patients with acute pulmonary embolism (PE), assessment of prognosis helps with risk stratification, triage for level of care, management strategy, and communication among healthcare workers and patients. We sought to identify prognostic models and individual factors associated with short-term outcomes after acute symptomatic PE.</p><p><strong>Methods: </strong>We performed a systematic review of prognostic factors for PE, searching MEDLINE, Embase, and Web of Science for records up to 1 June 2024. Studies of any design evaluating potential prognostic models or individual variables (not contained in the models) associated with short-term mortality after acute PE were included.</p><p><strong>Results: </strong>We identified 314 studies that included 2,495,115 patients. Of these, 225 studies included 2,267,952 patients and evaluated 24 prognostic models for patients with acute PE. The most frequently used validated models were the simplified Pulmonary Embolism Severity Index (<b>sPESI</b>) (127 studies), the original PESI (79 studies), and the European Society of Cardiology risk schema (34 studies). Each model-development study had a c-index ≥ 0.7. Individual factors associated with prognosis included older age, presence of coexisting conditions, abnormal clinical signs and symptoms, clot burden, markers of right‑ventricle dilatation/dysfunction and myocardial injury, altered laboratory results indicating impaired haemodynamics, and tests that assess for systemic inflammation. Pooled odds ratios for variables not contained in any eligible prognostic model ranged from 1.43 (for D-dimer) to 2.65 (for right heart thrombi).</p><p><strong>Conclusions: </strong>This systematic review identified 24 prognostic models and 18 individual variables distinct from the prognostic models associated with short-term mortality after acute PE.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2703889"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to editor 'Cost comparison of UniAMP with Truenat for tuberculosis detection in India'.","authors":"Deep Shikha, Anish Neupane, Sunita Sharma","doi":"10.1080/25310429.2026.2739160","DOIUrl":"https://doi.org/10.1080/25310429.2026.2739160","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2739160"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hidden burden of AATD: High prevalence of emotional distress and the 'care gap' in mental health support.","authors":"Raffaella Manzo, Giuseppe Fiorentino, Anna Michela Gaeta, Antonietta Coppola, Valentina Di Spirito, Maurizia Lanza, Angela Mirizzi, Ilaria Ferrarotti, Nuccia Gatta, Anna Annunziata","doi":"10.1080/25310429.2026.2737011","DOIUrl":"https://doi.org/10.1080/25310429.2026.2737011","url":null,"abstract":"<p><strong>Background: </strong>:Alpha-1 antitrypsin deficiency (AATD) is a rare genetic disorder mainly affecting the lungs and liver, but its psychological, functional, and relational burden remains insufficiently characterizedcharacterised.</p><p><strong>Objective: </strong>To describe emotional distress, health-related quality of life, interpersonal and sexual difficulties, and daily functional limitations in individuals with AATD.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey in Italy between October and December 2025 among individuals with AATD. Socio-demographic, clinical, and psychosocial data were collected using an ad hoc questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the 12-item Short Form Health Survey (SF-12). HADS subscales were reconstructed from item-level responses, applying reverse scoring where appropriate.</p><p><strong>Results: </strong>The study included 130 participants (mean age 56.3 ± 13.5 years; 53.8% female). Pulmonary involvement was the most frequent manifestation (68.5%). Disease-related limitations were reported in daily functioning by 57.7% and in social participation by 53.1%. Clinically significant symptoms were present in 46.2% for anxiety and 17.7% for depression. The SF-12-derived ad hoc unweighted physical and mental descriptive composites were 56.68 ± 27.47 and 54.53 ± 26.91. Women reported higher anxiety and poorer mental-composite scores, while participants receiving augmentation therapy showed worse depressive and perceived-health burden. Sexual-life changes were reported by 37/96 partnered participants (38.5%). Fifteen of 128 respondents (11.7%; two preferred not to answer) reported current psychological support. In exploratory covariate-adjusted models, functional and perceived-health correlates remained associated with clinically significant anxiety.</p><p><strong>Conclusions: </strong>In this cross-sectional survey, respondents with AATD reported substantial emotional, functional, and relational burden, while few were receiving psychological support. The self-selected sample and absence of a non-AATD comparison group preclude causal or disease-specific inference; the findings support evaluation of brief psychological screening and defined referral pathways in multidisciplinary AATD care.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2737011"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to editor 'Cross-cultural adaptation and construct validity of the Portuguese version of the Bordeaux Sleepiness Scale (BOSS): A cross-sectional study in patients with sleep disorders'.","authors":"Deep Shikha, Anish Neupane, Sunita Sharma","doi":"10.1080/25310429.2026.2742026","DOIUrl":"https://doi.org/10.1080/25310429.2026.2742026","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2742026"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor: Reallocation time of accelerometer-measured movement behaviours, genetic susceptibility, and incident chronic obstructive pulmonary disease.","authors":"Ritu Raj Singh, Sunita Sharma, Aiyesha Khatun","doi":"10.1080/25310429.2026.2666999","DOIUrl":"10.1080/25310429.2026.2666999","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2666999"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment adherence and mental health in people with cystic fibrosis and advanced lung disease treated with elexacaftor/tezacaftor/ivacaftor.","authors":"Vito Terlizzi, Sonia Graziano, Santiago Presti, Marco Andrea Malanima, Cristina Fevola, Alice Castaldo, Caterina Teodori, Silvia Bresci, Angelo Avarello, Alexandra L Quittner, Ersilia Lucenteforte","doi":"10.1080/25310429.2026.2742596","DOIUrl":"https://doi.org/10.1080/25310429.2026.2742596","url":null,"abstract":"<p><strong>Introduction: </strong>Advanced lung disease (ALD) is a leading cause of mortality in cystic fibrosis (CF). Although Elexacaftor/Tezacaftor/Ivacaftor (ETI) provides significant clinical benefits, little is known about long-term adherence, health-related quality of life (HRQoL), and neuropsychological side-effects in people with CF (PWCF) and ALD. This study evaluated adherence, HRQoL, mental health, and ETI-related side-effects.</p><p><strong>Methods: </strong>In this longitudinal study, PWCF and ALD enrolled in an ETI compassionate use program were assessed cross-sectionally after approximately 30 months of ETI therapy using the Treatment Adherence Questionnaire-CF (TAQ-CF), CFQ-R, PHQ-9, GAD-7, and an ad-hoc neuropsychological side-effects survey. Clinical parameters (ppFEV1, BMI, sweat chloride) and CFQ-R scores were followed from baseline to 36 months.</p><p><strong>Results: </strong> Thirty-three PWCF and ALD were included. From baseline to 36 months, sweat chloride decreased by 57.4 mmol/L, while ppFEV1 and BMI increased by 19.4% and 1.6 kg/m², respectively. HRQoL improved significantly across most CFQ-R domains. Mean overall adherence was 75.6%; 45.2% of participants reported high and 51.6% moderate adherence. No significant associations were found between adherence and clinical or mental health outcomes. Concentration difficulties and insomnia were reported by 25.8% and 32.3% of participants, respectively. Anxiety was associated with memory and concentration difficulties and insomnia.</p><p><strong>Conclusion: </strong>Approximately 30 months after ETI initiation, PWCF and ALD maintained moderate-to-high adherence, potentially reflecting disease severity and treatment burden. ETI provided sustained pulmonary and HRQoL benefits, although persistent neuropsychological side-effects occurred in a subset of participants and were associated with anxiety. Comprehensive ALD management should address both physical and mental health.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2742596"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exacerbation history as a predictor of future exacerbations and mortality in COPD patients: A real-world study from a Portuguese integrated care health unit 2013-2018.","authors":"Paula Simão, Ana Luísa Fernandes, Carla Ponte, Daniela Sousa Santos, Mário Bibi, Marisa Pardal, Julieta Maciel, Inês Esteves, Carlos Amaral, Hugo Martinho, Rita Amaral, Rita Lopes, Cristina Jácome, Filipa Bernardo","doi":"10.1080/25310429.2026.2629617","DOIUrl":"https://doi.org/10.1080/25310429.2026.2629617","url":null,"abstract":"<p><strong>Background: </strong>This study estimated the risk of exacerbations, cardiovascular (CV) death and all-cause death in COPD patients, according to their exacerbation profile.</p><p><strong>Methods: </strong>A real-world, retrospective study, based on electronic health records from the Unidade Local de Saúde de Matosinhos, was conducted. Individuals ≥40 years, diagnosed with COPD between 2013 and 2018 and with 1 year of history prior to diagnosis were followed for 1 year. Patients were divided based on their exacerbation history: Cohort A: no exacerbations; Cohort B: one moderate exacerbation; Cohort C: ≥2 moderate exacerbations; Cohort D: one severe exacerbation; Cohort E: ≥2 exacerbations, with ≥1 severe. The 1-year risk of exacerbations, CV death and all-cause death were estimated based on Cox proportional hazard models (reference Cohort A).</p><p><strong>Results: </strong>In total, 5696 COPD cases were identified, with median age increasing from Cohort A to E (68 to 74 years). The risk of moderate exacerbations was higher in Cohorts C (hazard ratio, HR = 1.95; 95% CI 1.70-2.25) and D (HR = 1.69; 95% CI 1.51-1.90). For severe exacerbations, cohorts D (HR = 2.95; 95% CI 2.51-3.46) and E (HR = 3.12; 95% CI 2.59-3.77) showed an increased risk. Cohort E also had the highest risk of CV death (HR = 1.65; 95% CI 1.17-2.34). Cohort D had the highest risk of all-cause death (HR = 1.65; 95% CI 1.24-2.18).</p><p><strong>Discussion: </strong>A higher number and severity of prior exacerbations in patients with COPD increase their risk of future exacerbations, all-cause and CV death. These findings highlight the importance of implementing effective strategies to prevent exacerbations and improve disease management.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2629617"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}