Pulmonology最新文献_第10页

Impact of treating obesity hypoventilation syndrome on body mass index. 治疗肥胖低通气综合征对体重指数的影响。

IF 10.4 2区医学

Pulmonology Pub Date : 2025-12-31 Epub Date: 2024-10-24 DOI: 10.1016/j.pulmoe.2023.09.004

R G S Andrade, J F Masa, J-C Borel, L F Drager, P R Genta, B Mokhlesi, G Lorenzi-Filho

{"title":"Impact of treating obesity hypoventilation syndrome on body mass index.","authors":"R G S Andrade, J F Masa, J-C Borel, L F Drager, P R Genta, B Mokhlesi, G Lorenzi-Filho","doi":"10.1016/j.pulmoe.2023.09.004","DOIUrl":"10.1016/j.pulmoe.2023.09.004","url":null,"abstract":"<p><strong>Study objectives: </strong>To evaluate the impact of positive airway pressure (PAP) therapy on body mass index (BMI) in patients with obesity hypoventilation syndrome (OHS) associated with obstructive sleep apnea (OSA). Methods: A systematic review using the following terms: \"obesity hypoventilation syndrome\" AND \"treatment\" AND \"randomized\" using Cochrane Central Register of Controlled Trials, Medline and Web of Science was performed from the first data available until February 10, 2023. The inclusion criteria were: (1) original article; (2) adult OHS with concomitant OSA (apnea-hypopnea index or AHI ≥5 events/h); (3) randomized trial with PAP arm and standard care (control); (4) BMI evaluation at baseline and after the first months. We performed an individual participant data meta-analysis of randomized controlled trials.</p><p><strong>Results: </strong>Our initial search retrieved 32 articles and 3 randomized studies fulfilled study criteria and were included in the final analysis, leading to a total of 342 participants. Patients were predominantly females (62%) and had OHS associated with at least mild OSA. As compared to baseline, a decrease in BMI was observed at study endpoint but this difference was not different intergroups (-0.50 ± 1.49 and -0.50 ±1.83, in control and PAP groups respectively (p=0.939)). Weight change was not associate with PAP adherence, OSA severity or use of supplemental oxygen.</p><p><strong>Conclusions: </strong>In contrast to treatment of eucapnic OSA with PAP that is associated with weight gain, treatment of OSA+OHS patients with or without PAP is associated with weight loss. Future studies are necessary to elucidate the mechanism by which weight loss occurs.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416816"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300594","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}

引用次数: 0

Smoking exposure trajectories and pulmonary function in early adulthood in a Brazilian cohort. 巴西队列中成年早期的吸烟暴露轨迹和肺功能。

IF 10.4 2区医学

Pulmonology Pub Date : 2025-12-31 Epub Date: 2024-10-24 DOI: 10.1016/j.pulmoe.2023.09.005

P Weber, A M B Menezes, H Gonçalves, P D de Oliveira, A Wendt, R Perez-Padilla, F C Wehrmeister

{"title":"Smoking exposure trajectories and pulmonary function in early adulthood in a Brazilian cohort.","authors":"P Weber, A M B Menezes, H Gonçalves, P D de Oliveira, A Wendt, R Perez-Padilla, F C Wehrmeister","doi":"10.1016/j.pulmoe.2023.09.005","DOIUrl":"10.1016/j.pulmoe.2023.09.005","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate smoking trajectories and their association with pulmonary function (PF) and respiratory symptoms at age 22.</p><p><strong>Methods: </strong>Data from a population-based cohort study of 3350 individuals and their spirometries were analysed. The outcomes were: forced expiratory volume in the first second (FEV<sub>1</sub>), forced vital capacity (FVC), forced expiratory flow at the mid expiratory phase (FEF<sub>25-75 %</sub>), FEV<sub>1</sub>/FVC and FEF<sub>25-75</sub>/FVC ratio. Smoking data were collected at perinatal follow-up (gestational exposure) and 15, 18 and 22 years. Group-based trajectory model was applied.</p><p><strong>Results: </strong>Four groups were identified: no exposure (NE), gestational (GE), gestational and adulthood (GAE) and continuous (CE) exposure. Both CE and GAE trajectories were associated with lower values of FEV<sub>1</sub>/FVC (-1.77pp; <i>p</i> = 0.01 and -1.58 pp; <i>p</i><0.001 respectively) and FEF<sub>25-75</sub>/FVC ratio (-7.27pp; <i>p</i> = 0.019 and -6.04pp; <i>p</i><0.001 respectively) compared to the NE trajectory. Lower FEV<sub>1</sub> and FEF<sub>25-75 %</sub> values were also related to the GAE trajectory (-68 ml; <i>p</i> = 0.03 and -253 ml/s<sub>;</sub> <i>p</i><0.001 respectively). Compared to those who never smoked, individuals who smoked 10 or more cigarettes daily presented a reduction in the FEV<sub>1</sub>/FVC ratio by 1.37pp (<i>p</i><0.001), FEF<sub>25-75 %</sub> by 126 ml (<i>p</i> = 0.012) and FEF<sub>25-75 %</sub>/FVC ratio by 3.62pp (<i>p</i> = 0.011). CE trajectory showed higher odds of wheezing (OR 4.14; <i>p</i><0.001) and cough (OR 2.39; <i>p</i> = 0.002) compared to the non-exposed group.</p><p><strong>Conclusions: </strong>The in-uterus exposure to maternal smoking reduces PF later in life. However, the perpetuation of smoking behaviour throughout adolescence and early adulthood is determinant for PF main reduction and the emergence of respiratory-related symptoms.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416818"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415277","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}

引用次数: 0

Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence. Pembrolizumab联合化疗治疗转移性非鳞状NSCLC患者的结果：真实世界证据

IF 10.4 2区医学

Pulmonology Pub Date : 2025-12-31 Epub Date: 2025-02-05 DOI: 10.1080/25310429.2025.2457856

Irina Surovtsova, Felix J F Herth, Daria B Kokh, Philipp Morakis

{"title":"Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence.","authors":"Irina Surovtsova, Felix J F Herth, Daria B Kokh, Philipp Morakis","doi":"10.1080/25310429.2025.2457856","DOIUrl":"10.1080/25310429.2025.2457856","url":null,"abstract":"<p><strong>Background: </strong>Pembrolizumab with chemotherapy (immunochemotherapy) has shown encouraging overall survival (OS) benefits in non-squamous mNSCLC, as demonstrated by the KEYNOTE-189 trial. However, randomised controlled trials may not fully capture the diversity of real-world patients. This study aims to evaluate immunochemotherapy outcomes in a real-world setting, including subgroups underrepresented in the KEYNOTE-189 trial.</p><p><strong>Methods: </strong>Patients diagnosed with non-squamous mNSCLC 2011-2022 and recorded in Cancer Registry Database of the German Federal State Baden-Württemberg (BWCR), were analysed. OS was assessed using Kaplan-Meier and multivariable Cox models, adjusted for major clinical parameters. Results were compared with KEYNOTE-189.</p><p><strong>Results: </strong>Among 2630 eligible cases, 1314 patients received chemotherapy alone and 1316 received immunochemotherapy. Median OS (mOS) was 14.1 months (95%CI: 13.1-15.4) for immunochemotherapy and 10.4 months (95%CI: 9.7-11.2) for chemotherapy alone, with an HR of 0.7 (95%CI: 0.64-0.77). A significant benefit was seen in M1c stage (HR 0.7, 95%CI: 0.63-0.79). No significant OS improvement was observed in patients with ECOG 2-3 or bone metastases.</p><p><strong>Conclusion: </strong>This real-world evidence suggests that immunochemotherapy generally improves OS in mNSCLC. Subgroup analysis showed no survival benefit for patients with ECOG >1 or bone metastasis, but a benefit for patients with M1c stage.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2457856"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191275","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}

引用次数: 0

Late-onset endobronchial metastasis of oncocytic cell thyroid carcinoma 晚期发生的甲状腺细胞癌支气管内转移。

IF 10.4 2区医学

Pulmonology Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.02.005

引用次数: 0

Disseminated tuberculosis mimicking pleural mesothelioma in a polycythemia vera patient treated with ruxolitinib 一名接受鲁索利替尼治疗的红细胞增多症患者发生了模仿胸膜间皮瘤的播散性结核病。

IF 10.4 2区医学

Pulmonology Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.05.003

引用次数: 0

Oral communications 口头沟通

IF 10.4 2区医学

Pulmonology Pub Date : 2024-11-01 DOI: 10.1016/S2531-0437(24)00120-X

引用次数: 0

What do we know about macrolides immunomodulatory therapeutic potential in respiratory disease in 2023 我们对 2023 年大环内酯类药物在呼吸系统疾病中的免疫调节治疗潜力了解多少？

IF 10.4 2区医学

Pulmonology Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.02.001

引用次数: 0

Prone position for acute respiratory distress syndrome and the hazards of meta-analysis 急性呼吸窘迫综合征的俯卧位和荟萃分析的危害。

IF 10.4 2区医学

Pulmonology Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2022.12.005

{"title":"Prone position for acute respiratory distress syndrome and the hazards of meta-analysis","authors":"","doi":"10.1016/j.pulmoe.2022.12.005","DOIUrl":"10.1016/j.pulmoe.2022.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Researchers have tried unsuccessfully for many years using randomized controlled trials to show the efficacy of prone ventilation in treating ARDS. These failed attempts were of use in designing the successful PROSEVA trial, published in 2013. However, the evidence provided by meta-analyses in support of prone ventilation for ARDS was too low to be conclusive. The present study shows that meta-analysis is indeed not the best approach for the assessment of evidence as to the efficacy of prone ventilation.</div></div><div><h3>Methods</h3><div>We performed a cumulative meta-analysis to prove that only the PROSEVA trial, due to its strong protective effect, has substantially impacted on the outcome.</div><div>We also replicated nine published meta-analyses including the PROSEVA trial. We performed leave-one-out analyses, removing one trial at a time from each meta-analysis, measuring <em>p</em> values for effect size, and also the Cochran's Q test for heterogeneity assessment. We represented these analyses in a scatter plot to identify outlier studies influencing heterogeneity or overall effect size. We used interaction tests to formally identify and evaluate differences with the PROSEVA trial.</div></div><div><h3>Results</h3><div>The positive effect of the PROSEVA trial accounted for most of the heterogeneity and for the reduction of overall effect size in the meta-analyses. The interaction tests we conducted on the nine meta-analyses formally confirmed the difference in the effectiveness of prone ventilation between the PROSEVA trial the other studies.</div></div><div><h3>Conclusions</h3><div>The clinical lack of homogeneity between the PROSEVA trial design and the other studies should have discouraged the use of meta-analysis. Statistical considerations support this hypothesis, suggesting that the PROSEVA trial is an independent source of evidence.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 529-536"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9187052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Atypical surge of hospitalized and severe cases of pertussis: A single center 19-years study from China 百日咳住院重症病例的非典型激增：来自中国的一项为期 19 年的单一中心研究。

IF 10.4 2区医学

Pulmonology Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2024.06.006

Y. Hu , L. Wang , K. Yao , Q. Wang

引用次数: 0

Profile of emergency department overuse in hospitalized patients with pulmonary disease and its impact on mortality 住院肺病患者过度使用急诊室的概况及其对死亡率的影响。

IF 10.4 2区医学

Pulmonology Pub Date : 2024-11-01 DOI: 10.1016/j.pulmoe.2023.01.005

{"title":"Profile of emergency department overuse in hospitalized patients with pulmonary disease and its impact on mortality","authors":"","doi":"10.1016/j.pulmoe.2023.01.005","DOIUrl":"10.1016/j.pulmoe.2023.01.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Portugal is one of the countries with the highest number of visits to the emergency department (ED), 31% classified as “non-urgent” or “avoidable.” The objectives of our study were to evaluate the size and characteristics of patients with pulmonary disease who overuse the ED, and identify factors associated with mortality.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted, based on the medical records of ED frequent users (ED-FU) with pulmonary disease who attended a university hospital center in the northern inner city of Lisbon from January 1 to December 31, 2019. To evaluate mortality, a follow-up until December 31, 2020 was performed.</div></div><div><h3>Results</h3><div>Over 5,567 (4.3%) patients were identified as ED-FU and 174 (0.14%) had pulmonary disease as the main clinical condition, accounting for 1,030 ED visits. 77.2% of ED visits were categorized as “urgent/very urgent.” A high mean age (67.8 years), male gender, social and economic vulnerability, high burden of chronic disease and comorbidities, with a high degree of dependency, characterized the profile of these patients. A high proportion (33.9%) of patients did not have a family physician assigned and this was the most important factor associated with mortality (<em>p</em><0.001; OR: 24.394; CI 95%: 6.777–87.805). Advanced cancer disease and autonomy deficit were other clinical factors that most determined the prognosis.</div></div><div><h3>Conclusions</h3><div>Pulmonary ED-FU are a small group of ED-FU who constitute an aged and heterogeneous group with a high burden of chronic disease and disability. The lack of an assigned family physician was the most important factor associated with mortality, as well as advanced cancer disease and autonomy deficit.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 586-594"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10739359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0