Pulmonology最新文献

{"title":"Prevalence of treatable traits among patients with very severe COPD across STAR and GOLD classification.","authors":"Debarghya Sen, Mousumi Saha, Suman Pradhan","doi":"10.1080/25310429.2026.2630425","DOIUrl":"https://doi.org/10.1080/25310429.2026.2630425","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2630425"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183323","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":"Management of nontuberculous mycobacterial Pulmonary disease refractory to guideline-based therapy: A systematic review.","authors":"Diana Moreira-Sousa, Beatriz Martins, Ana Aguiar, Marina Pinheiro, Onno W Akkerman, Timothy R Aksamit, Stefano Aliberti, Claire Andrejak, Charles L Daley, Jakko van Ingen, Christoph Lange, Marc Lipman, Michael R Loebinger, Mateja Jankovic Makek, Kozo Morimoto, Rachel Thomson, Dirk Wagner, Kevin L Winthrop, Jae-Joon Yim, Raquel Duarte","doi":"10.1080/25310429.2026.2632467","DOIUrl":"https://doi.org/10.1080/25310429.2026.2632467","url":null,"abstract":"<p><strong>Introduction: </strong>Managing patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) unresponsive to guideline-based therapy remains challenging due to limited treatment options and complex disease progression. This study systematically reviewed existing literature on management strategies and emerging therapeutic approaches for refractory NTM-PD.</p><p><strong>Methods: </strong>We systematically reviewed studies on NTM-PD treatment failure published from inception until 31 January 2024, examining associated factors, intensification strategies, and supportive measures. Twenty-five studies met the inclusion criteria, mostly retrospective and observational, focusing on pulmonary disease by <i>Mycobacterium avium</i> complex and <i>Mycobacterium abscessus</i> species. Findings were synthesised qualitatively because of substancial heterogeneity in study design and outcomes.</p><p><strong>Results: </strong>Before treatment intensification or de-escalation, the impact of antibiotics on health-related quality of life and microbiological factors, including acquired resistance and pathogen shifts, should be assessed. Severe baseline radiological findings and multiple prior regimen modifications were associated with lower treatment success. Evidence for supportive interventions-such as nutritional counselling, respiratory rehabilitation, and psychosocial support-remains limited. Intermittent intravenous antibiotics may aid symptom control. Depending on NTM species, additional antibiotics have been explored to intensify treatment, though evidence is largely observational. Surgical resection may be considered for localised disease, but recurrence risk remains substantial, particularly with preoperative positive cultures. Novel therapeutic approaches remain under investigation as potential alternatives.</p><p><strong>Discussion: </strong>This systematic review underscores the complexity of managing refractory NTM-PD, highlighting the role of treatment intensification, symptom control, supportive measures, and knowledge gaps. While no standardised approach exists, individualised strategies incorporating clinical, microbiological, and radiological factors remain essential for optimising patient outcomes.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2632467"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286212","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":"Trajectories of lung recovery following COVID-19 in a prospective multicentric cohort study: Impact of sleep apnea and its treatment by continuous positive airway pressure.","authors":"Sébastien Baillieul, Lucile Sesé, Laurent Boyer, Bruno Chenuel, Philippe Romand, Carole Planes, Geneviève Derumeaux, Sam Bayat, Marie Destors, Thi Hong Van Ngo, François Arbib, Mathias Poussel, Edem Allado, Thomas Gille, Jean-Louis Pépin, Renaud Tamisier","doi":"10.1080/25310429.2026.2641327","DOIUrl":"https://doi.org/10.1080/25310429.2026.2641327","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnoea (OSA) is associated with more severe forms of COVID-19. We investigated the impact of OSA and its treatment on lung recovery trajectories over the year following acute care for different COVID-19 severities.</p><p><strong>Methods: </strong>Prospective multicentric (5 centres) cohort study, recruiting from June 2020 to April 2022. All patients with a non-fatal pulmonary presentation of COVID-19 were eligible. OSA diagnosis (apnoea-hypopnoea index [AHI] >5/h) was performed at inclusion. Pulmonary function tests, including haemoglobin-corrected diffusing capacity of the lung for carbon monoxide (DLCO-Hb, expressed as % predicted), the primary endpoint, were conducted at 3 months and repeated at 6 and 12 months post-COVID-19 diagnosis only for patients with persisting abnormal values (conditional monitoring approach). Mixed models with subjects as a random effect were performed to assess the impact of OSA severity and treatment on DLCO-Hb recovery trajectories.</p><p><strong>Results: </strong>Three hundred and eighteen patients were included in the cohort, 102 (32.1%) requiring outpatient care, and 216 (67.9%) requiring hospitalisation. OSA was not present in 75 (23.6%) patients, newly diagnosed or not treated in 203 (63.8%) and treated by continuous positive airway pressure in 40 (12.6%). 53.3% of tested patients presented a DLCO-Hb ≥80% of predicted values at 3 months. This proportion was significantly lower in non-treated OSA patients at 6 months (<i>p</i> < 0.01), but not at 12 months (<i>p</i> = 0.07), indicating comparable recovery. In multivariable analysis, OSA severity and its treatment but not COVID-19 severity significantly influenced the evolution of DLCO-Hb.</p><p><strong>Conclusion: </strong>OSA severity and treatment affect the initial trajectories of lung recovery following COVID-19.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2641327"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482540","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":"Comment on 'Evolution of hospitalizations of adults for community-acquired pneumonia in Portugal and the impact of pediatric pneumococcal vaccination'.","authors":"Mei Zhaojun, Li Li","doi":"10.1080/25310429.2026.2652163","DOIUrl":"https://doi.org/10.1080/25310429.2026.2652163","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2652163"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576494","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":"Agreement of different reference equations to classify patients with COPD as having reduced or preserved 6MWD.","authors":"Sandhya Saini, Kanika","doi":"10.1080/25310429.2026.2644005","DOIUrl":"https://doi.org/10.1080/25310429.2026.2644005","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2644005"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476356","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":"An overview of respiratory function laboratories in Portugal: Tracing the present to steer the future.","authors":"Nuno Cortesão, Ana Sofia Oliveira, Joana Gomes, Mafalda Silva, Ana Barros, António Morais","doi":"10.1080/25310429.2026.2647676","DOIUrl":"https://doi.org/10.1080/25310429.2026.2647676","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2647676"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500605","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":"Comparative diagnostic performance of advanced endoscopic techniques in suspected sarcoidosis: A systematic review and network meta-analysis.","authors":"Sheng-Ping Li, Yan Luo, Xin-Bin Liu, Zhen-Ming Zhang, Yu Bao","doi":"10.1080/25310429.2026.2647681","DOIUrl":"https://doi.org/10.1080/25310429.2026.2647681","url":null,"abstract":"<p><strong>Background: </strong>While various endoscopic techniques are used for minimally invasive tissue sampling in suspected sarcoidosis, comprehensive evidence comparing their diagnostic efficacy is limited, and the optimal approach remains unclear.</p><p><strong>Research question: </strong>Which endoscopic technique provides the greatest diagnostic advantage for sarcoidosis?</p><p><strong>Study design and methods: </strong>We systematically searched 3 databases for studies published up to 22 April 2025. A network meta-analysis was conducted within a Bayesian framework, with diagnostic yield as the primary outcome.</p><p><strong>Results: </strong>A total of 35 studies were included. Compared to TBLB, both EBUS-guided intranodal forceps biopsy (EBUS-IFB) (RR 3.50, 2.14-5.84) and EBUS-guided transbronchial mediastinal cryobiopsy (EBUS-TMC) (RR 3.52, 1.97-6.48) showed higher diagnostic yield. SUCRA rankings placed EBUS-IFB (0.912) and EBUS-TMC (0.910) at the top, followed by EBUS-guided core needle biopsy (EBUS-CNB) (0.587), EUS-FNA (0.582), and EBUS-TBNA (0.560), EUS-B-FNA (0.498). Conventional techniques, including cTBNA (0.279), TBLB (0.168), and EBB (0.001), ranked lowest. All procedures had a favourable safety profile.</p><p><strong>Conclusions: </strong>In centres with appropriate expertise, EBUS-IFB and EBUS-TMC may offer superior diagnostic performance for sarcoidosis. However, given the low certainty of evidence, these conclusions should be interpreted with caution. Clinical decisions should be individualised, considering the patient's condition when determining the final diagnostic strategy.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2647681"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629390","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":"Longitudinal changes of obstructive sleep apnea and its impact on cardiovascular outcomes: Results from the Sleep Heart Health Study.","authors":"Wenlong Zhao, Jiaqi Du, Yixiang Liu, Yun Zhou, Zekun Zhang, Siyi Li, Yan Yan, Hui Ai, Shaoping Nie, Wei Gong","doi":"10.1080/25310429.2026.2640670","DOIUrl":"10.1080/25310429.2026.2640670","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the longitudinal change in OSA and its impact on cardiovascular outcomes. This study aimed to investigate the association between the OSA changes and cardiovascular outcomes.</p><p><strong>Methods: </strong>In the Sleep Heart Health Study (SHHS), participants who underwent two polysomnograms, approximately five years apart, were included. OSA was defined as apnoea-hypopnoea index (AHI) ≥15 events/hour. Clinical characteristics and outcomes were examined overall and by sex. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE), including cardiovascular death, heart failure, myocardial infarction, revascularization and stroke.</p><p><strong>Findings: </strong>A total of 2653 participants (45.9% men) were included. Of them, 364 (19.6%) participants without OSA developed OSA, and 258 (32.6%) participants with OSA reverted to a non-OSA state. The proportion of women with stable AHI was higher than that of men (59.3% vs. 46.0%, <i>p</i> < 0.001). In men, increased risk of MACCE was observed in the non-OSA to OSA group (absolute risk [AR], 35.5%; hazard ratio [HR], 1.52 [95% CI, 1.00-2.30]), OSA to non-OSA group (AR, 42.3%; HR, 1.54 [95% CI, 1.03-2.38]), and stable OSA group (AR, 44.9%; HR, 1.70 [95% CI, 1.20-2.41]), compared with the stable non-OSA group, but not in women. AHI gain was associated with a higher risk of MACCE and mortality in men.</p><p><strong>Conclusions: </strong>OSA course showed dynamic changes. Increased AHI was associated with higher cardiovascular risk, and a reduction in AHI in patients with OSA may not signify complete remission of cardiovascular risk, particularly among men. No such association was observed in women.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2640670"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576481","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":"Correspondence: Expanding the clinical implications of pectoralis muscle area assessment in COPD.","authors":"Anchal Thakur, Vaishali Rai, Kanika Bhatia","doi":"10.1080/25310429.2026.2615023","DOIUrl":"https://doi.org/10.1080/25310429.2026.2615023","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2615023"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953872","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":"Correspondence: Dyspnoea anchoring and methodological considerations in inspiratory capacity based MCID estimation in COPD.","authors":"Nikita Vaid, Mandeep Kumar Jangra, Rittu Sharma","doi":"10.1080/25310429.2026.2623660","DOIUrl":"https://doi.org/10.1080/25310429.2026.2623660","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2623660"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108038","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}