Pulmonology最新文献

{"title":"Dyspnoea-referenced minimal clinically important difference in the resting inspiratory capacity response to short-acting bronchodilators in COPD patients.","authors":"Pierantonio Laveneziana, David Hajage, Nicolas Verger, Clara Bianquis, François-Xavier Blanc, Christian Straus, Thomas Similowski","doi":"10.1080/25310429.2025.2611184","DOIUrl":"https://doi.org/10.1080/25310429.2025.2611184","url":null,"abstract":"<p><strong>Background: </strong>In COPD, the clinical significance of bronchodilator-induced changes in inspiratory capacity (IC) at rest remains uncertain. Unlike forced expiratory volume in one second (FEV₁), IC may better reflect symptom improvement, but no minimal clinically important difference (MCID) has been formally established.</p><p><strong>Research question: </strong>To relate short-acting bronchodilator (SABD)-induced dyspnoea relief in stable COPD patients at rest with the concomitant IC changes and determine the MCID of the latter.</p><p><strong>Study design and methods: </strong>In 106 stable COPD outpatients undergoing routine lung function testing, spirometry and plethysmography were performed before and after SABD administration. Dyspnoea was assessed using a visual analogue scale (VAS) and a five-point Likert scale. Three approaches were used to estimate MCID, namely two anchored methods (receiver operating characteristics (ROC)-based and difference-based) and a distribution-based method.</p><p><strong>Results: </strong>Dyspnoea improvement was reported in 64% of patients. IC changes correlated strongly with symptom relief, while FEV₁ changes did not. ROC analysis identified an optimal IC threshold of 0.125 L (5% of baseline) with excellent predictive accuracy. The distribution-based estimate was 0.187 L, and the lowest difference-based estimate was 0.27 L. Averaging the ROC and distribution thresholds yielded a proposed MCID of 0.150 L.</p><p><strong>Conclusion: </strong>IC changes after SABD administration at rest are more closely associated with dyspnoea relief than FEV₁ changes. An IC increase of 0.150 L may serve as a practical benchmark in future large-scale studies aiming at evaluation of the practical utility of IC changes in clinical practice, e.g. to inform therapeutic strategies, such as guiding the use of rescue SABD.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2611184"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960832","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: 'Interpreting exercise's immunomodulatory effects in chronic obstructive pulmonary disease requires methodological scrutiny'.","authors":"Hongjuan Jing, Chao Yuan","doi":"10.1080/25310429.2026.2613997","DOIUrl":"https://doi.org/10.1080/25310429.2026.2613997","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2613997"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960843","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":"Dual-correction robotic bronchoscopy system with ultra-thin catheter for diagnosing challenging peripheral pulmonary nodules: A multi-centre prospective trial.","authors":"Zhending You, Junfeng Huang, Feng Wang, Li Xu, Jing Liu, Hongjia Li, Jiaxin Tang, Wan Li, Zhaohui Li, Yuhua Liu, Yanfei Bai, Shiyue Li, Changhao Zhong","doi":"10.1080/25310429.2026.2621546","DOIUrl":"https://doi.org/10.1080/25310429.2026.2621546","url":null,"abstract":"<p><strong>Background: </strong>Conventional bronchoscopy has imited diagnostic yield for challenging peripheral pulmonary nodules(C-PPNs), particularly for small (≤20 mm), pleural-contact, or reverse-angle (bifurcation angle ≤90°) nodules. This prospective multi-centre study evaluates the novel robotic bronchoscopy system (RBS) with ultra-thin catheters in C-PPNs under radiation-free conditions.</p><p><strong>Methods: </strong>This multi-centre, prospective study enrolled 89 patients with C-PPN (characterised by a diameter ≤20 mm, pleural-contact, or an angle ≤90°) from three centres, who underwent RBS biopsy between 2022 and 2024. Diagnostic yield were conducted based on specific nodule characteristics. Univariate and multivariate logistic regressions were performed to evaluate the association between nodular-related factors and diagnostic yield.</p><p><strong>Results: </strong>The average nodule size was 19.54 mm (53.9%, ≤20 mm). Pleural-contact was observed in 71.9% of nodules, and 64.0% exhibited a reverse-angle (≤90°). The novel system achieved 100% navigation and sampling success. Importantly, the diagnostic yield reached 84.2%, with 88.3% sensitivity for malignancy. Diagnostic performance were comparable across Single-criteria, Dual-criteria, and Triple-criteria groups (<i>p</i> = 0.416). Nodules ≤20 mm had lower yield (75.0%) compared to pleura-contact (90.6%, <i>p</i> = 0.013) or reverse-angle (89.5%, <i>p</i> = 0.028). Logistic regression confirmed nodule size >20 mm as a significant diagnostic yield predictor. Notably, no pneumothorax occurred, and only two patients experienced minor bleeding.</p><p><strong>Conclusion: </strong>This prospective multi-centre study introduced the concept of C-PPN, establishing a valuable reference for subsequent research. Moreover, the novel system featuring ultra-thin catheters demonstrated superior performance, achieving 100% navigation success, 84.2% diagnostic yield and 0 pneumothorax, in such nodules without radiation guidance.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2621546"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115109","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: 'CFTR variants in bronchiectasis'.","authors":"Yuanli Yang","doi":"10.1080/25310429.2026.2632449","DOIUrl":"https://doi.org/10.1080/25310429.2026.2632449","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2632449"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203718","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 'dyspnoea-referenced minimal clinically important difference in the resting inspiratory capacity response to short-acting bronchodilators in COPD patients'.","authors":"Shivi Bajpai, Mousumi Saha, Subhasish Chatterjee, Shanvi Priya","doi":"10.1080/25310429.2026.2630534","DOIUrl":"https://doi.org/10.1080/25310429.2026.2630534","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2630534"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208545","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 the editor: Urinary incontinence is common among people attending pulmonary rehabilitation, yet pulmonary rehabilitation has a small effect on urinary symptoms: A multicenter prospective cohort study.","authors":"Trishala Rangare, Shweta Sharma","doi":"10.1080/25310429.2026.2671501","DOIUrl":"https://doi.org/10.1080/25310429.2026.2671501","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2671501"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846009","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":"Blood eosinopenia (≤30/µL) as an early predictor of respiratory failure in community-acquired pneumonia: A prospective multicentre study.","authors":"Barbara Christine Weckler, Roman Martin, Max Kutzinski, Wilhelm Bertrams, Anna Lena Jung, Hendrik Pott, Katrin Laakmann, Leon Schulte, Peter Ahnert, Dominik Heider, Stephan Ringshandl, Christian Seidemann, Norbert Suttorp, Martin Witzenrath, Christian Wildberg, Mareike Lehmann, Gernot Rohde, Timm Greulich, Claus Franz Vogelmeier, Bernd Schmeck","doi":"10.1080/25310429.2025.2611215","DOIUrl":"10.1080/25310429.2025.2611215","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Lower blood eosinophil counts have been associated with increased mechanical ventilation rates in patients with community-acquired pneumonia (CAP). However, the optimal eosinophil count threshold for identifying CAP patients at high risk of respiratory failure remains undefined. This study aimed to establish an optimal admission eosinophil count as a prognostic biomarker for respiratory failure in CAP.</p><p><strong>Methods: </strong>This prospective, multicentre cohort study (PROGRESS) enrolled adult patients (≥18 years) hospitalised with community-acquired pneumonia (CAP). A receiver operating characteristic curve analysis with Youden's index was applied to identify the optimal eosinophil threshold for predicting mechanical ventilation. Associations were adjusted for corticosteroid use using multivariable regression. Additional outcomes - ICU admission and hospital length of stay - were compared between patients above and below the optimal eosinophil count threshold.</p><p><strong>Results: </strong>An eosinophil count threshold of ≤30/µL was optimal for predicting mechanical ventilation. Patients with eosinophil counts ≤30/µL experienced significantly higher mechanical ventilation rates (15.5% versus 7.3%; <i>p</i> < 0.0001; RR 2.12, 95% CI 1.61-2.80), regardless of glucocorticoid treatment. They also exhibited higher ICU admission rates (23.1% versus 10.9%; <i>p</i> < 0.0001; RR 2.11, 95% CI 1.70-2.63) and longer hospital stays among survivors (median 8.0 versus 7.0 days; <i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>Admission eosinopenia (≤30 µL) is a robust, easily measured biomarker that predicts respiratory failure in hospitalised CAP. It supports early risk stratification and may guide timely escalation of care.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2611215"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936319","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: Beyond pulmonary rehabilitation: Can the PICk UP programme fill the gap? A randomised trial in COPD.","authors":"Anchal Thakur, Kanika Bhatia","doi":"10.1080/25310429.2025.2612382","DOIUrl":"https://doi.org/10.1080/25310429.2025.2612382","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2612382"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901578","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":"Effect of anti-tuberculosis drugs on the pharmacokinetics and pharmacodynamics of novel antidiabetic drugs: A scoping review.","authors":"David S Gomes, Joana Lourenço, Maria J Moura, Mariana Vieira, João Pedro Ramos, Marina Pinheiro, Raquel Duarte","doi":"10.1080/25310429.2026.2640663","DOIUrl":"https://doi.org/10.1080/25310429.2026.2640663","url":null,"abstract":"<p><strong>Background: </strong>The co-occurrence of tuberculosis (TB) and diabetes mellitus (DM) presents a growing public global health concern. Managing DM during anti-TB therapy is challenging due to potential drug-drug interactions, especially with rifamycin (RIF).</p><p><strong>Research question: </strong>Assess the effects of anti-TB drugs on the pharmacokinetics and pharmacodynamics of novel antidiabetic agents, including DPP-4 inhibitors (DPP4i), SGLT-2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1a).</p><p><strong>Study design and methods: </strong>A PRISMA-ScR-based scoping review was conducted among four databases.</p><p><strong>Results: </strong>Ten studies involving 307 participants were included. RIF significantly reduced the plasma exposure of DPP4i (saxagliptin, gemigliptin, evogliptin) and canagliflozin, while other SGLT2i (dapagliflozin, empagliflozin, ertugliflozin) were minimally affected. No direct data was available for GLP-1a. Adverse events were rare in healthy participants but more frequent in elderly patients with poorly controlled DM. Linezolid and dapagliflozin co-administration may lead to severe pancytopenia.</p><p><strong>Discussion: </strong>RIF co-administration with gemigliptin, evogliptin and canagliflozin requires caution and potential requiring dose adjustments, while saxagliptin, dapagliflozin, ertugliflozin and empagliflozin appear safer alternatives. Haematologic monitoring is recommended when combining linezolid and dapagliflozin. However, current evidence remains limited by small sample sizes, single-dose designs, inclusion of mainly healthy participants, and lack of data on GLP-1a or other anti-TB agents. The limited inclusion of DM patients with TB, restricted to one study with latent TB infection, further reduces generalisability. We developed a clinical decision algorithm to support co-treatment in TB - DM cases, but further dedicated studies are warranted to guide optimal co-treatment.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2640663"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390466","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":"Optimizing EBUS-Guided mediastinal biopsy strategies: Considerations beyond diagnostic yield.","authors":"Weikai Dong, Qing Shao, Qiang Wang","doi":"10.1080/25310429.2026.2649664","DOIUrl":"https://doi.org/10.1080/25310429.2026.2649664","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2649664"},"PeriodicalIF":6.4,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576532","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}