Pulmonology最新文献

{"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":"Association between smoking and prognosis in idiopathic pulmonary fibrosis: A systematic review and meta-analysis.","authors":"Kyeongmin Kim, Jinwoo Seok, Hee-Young Yoon","doi":"10.1080/25310429.2026.2693393","DOIUrl":"10.1080/25310429.2026.2693393","url":null,"abstract":"<p><strong>Background: </strong>Although smoking is a well-established risk factor for idiopathic pulmonary fibrosis (IPF) development, its impact on clinical outcomes remains unclear.</p><p><strong>Research question: </strong>Is smoking associated with clinical outcomes of IPF?</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and the Cochrane Library was conducted to identify studies reporting associations between smoking status and IPF outcomes, including mortality, acute exacerbation (AE), lung cancer development, and baseline lung function. Summary estimates with 95% confidence intervals (CIs) were pooled using random-effects model. Subgroup analyses were conducted by study region.</p><p><strong>Results: </strong>Forty-nine studies comprising 32 974 patients were included. Overall mortality did not differ by smoking status. However, significant regional differences were observed, with ever smokers demonstrating higher mortality in non - East Asian studies (Hazard ratio [HR] 1.17, 95% CI: 1.03-1.33) but lower mortality in East Asian studies (HR 0.75, 95% CI: 0.62-0.91, p-for-interaction < 0.001) compared with never smokers. Current smokers had a higher risk of developing lung cancer compared with non-current smokers (HR 1.88, 95% CI: 1.24-2.87). No significant associations were observed between smoking and the risk of AEs or baseline forced vital capacity.</p><p><strong>Conclusion: </strong>Smoking was not associated with overall mortality in IPF, although significant regional differences were observed.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2693393"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310447","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":"Occupational category, job type, and sarcoidosis: Findings from a French multicenter study.","authors":"Raphael Lhote, Fleur Cohen Aubart, Hilario Nunes, David Launay, Raphael Borie, Karim Sacré, Nicolas Schleinitz, Antoine Néel, Mohamed Hamidou, Julien Haroche, Matthieu Mahevas, Herve Devilliers, Philippe Bonniaud, François Lhote, Lucile Sesé, Bruno Crestani, Dominique Valeyre, Zahir Amoura, Isabella Annesi-Maesano","doi":"10.1080/25310429.2026.2653434","DOIUrl":"10.1080/25310429.2026.2653434","url":null,"abstract":"<p><strong>Objectives: </strong>Evidence supporting an occupational hypothesis for sarcoidosis remains limited. The hypothesis of the present study was that some occupational exposures might be more prevalent among sarcoidosis patients than in the French population.</p><p><strong>Methods: </strong>A cross-sectional observational study design was used to collect occupational data from patients enrolled in the Epidemiology ofSarcoidosis (EpiSarc) cohort study with documented sarcoidosis. The data were initiallyclassified according to the occupational classification of the French National Institute ofStatistics and Economic Studies and then compared to employment data fromthe French population for the reference year 2016.</p><p><strong>Results: </strong>Among the 1,512 sarcoidosis patients included, occupational data were avail- able for 1,177 patients (78%). Of these, 1,086 (92%) were employed at time of sarcoidosis diagnosis. Notably, manual workers were significantly overrepresented compared to the general French population (40% versus 20%, p < 0.0001). Among the 471 manual workers, the distribution of occupations was as follows: construction workers (n = 165, 35%), domestic helpers and cleaners (n = 109, 23%), transportation and handling workers (n = 82, 17.5%), manufacturing labourers and industrial operators (n = 67, 14%), textile indus- try workers (n = 25, 5.5%), and other occupations (n = 23, 5%). The frequency of patients with manual working occupations varied depending on the organ involvement, being the highest in patients with lung involvement.</p><p><strong>Conclusion: </strong>We found that manual workers occupations with exposure to various environmental hazards that may trigger inflammation promoting an abnormal granulomatous immune response, including dust, were associated with sarcoidosis.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2653434"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310438","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":"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":5.3,"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":"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":5.3,"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":"Impact of an early follow-up visit on adherence and adherence trajectories after initiation of continuous positive airway pressure therapy for obstructive sleep apnea.","authors":"Jérémy Duval, Joëlle Texereau, Sébastien Bailly, Jean Louis Pépin","doi":"10.1080/25310429.2026.2641311","DOIUrl":"10.1080/25310429.2026.2641311","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Continuous positive airway pressure (CPAP) outcomes depends on adherence, yet the effect of different patient support strategies on adherence is poorly studied. This study assessed whether an early home visit improves CPAP adherence and trajectories in obstructive sleep apnoea, and which patients benefit most.</p><p><strong>Material and methods: </strong>This multicenter cohort study analysed home service provider data from adults starting CPAP in 2019-2022 who had >90 days of telemonitoring data. Adherence was compared before and after the early visit, overall and in subgroups based on adherence over the 15 days after starting CPAP (<2 [low], 2-<4 [intermediate] or ≥4 [high] h/night). Adherence trajectories were also determined.</p><p><strong>Results: </strong>A total of 4,924 patients were included (62.3% male, mean age 59 ± 13 years, apnoea-hypopnoea index 40 ± 17/h). The early follow-up visit took place 16 ± 5 days after CPAP initiation. Change in adherence in the week after versus week before the early visit was 14 ± 3 min/night overall, and -7 ± 2, 60 ± 4, 102 ± 5 min/night in the high, intermediate, and low adherence subgroups, respectively (<i>p</i> < 0.01). Adherence gradually decreased after therapy initiation, increased in the 1-2 days before the visit, then declined. Cluster analysis identified two profiles across all early adherence subgroups: responders and non-responders (those with or without better CPAP usage after the early visit, respectively). Responders were slightly older and had higher CPAP motivation than non-responders; higher leak and higher residual AHI predicted improved adherence after the early visit in the intermediate and low adherence subgroups, respectively.</p><p><strong>Conclusions: </strong>An early home visit intervention significantly improved short-term adherence for low and intermediate CPAP adherers. Cluster analysis revealed two distinct adherence trajectories supporting the need for personalised follow-up.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2641311"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437824","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":"Drivers of delay in tuberculosis diagnosis among underserved groups in Portugal: An exploratory convergent parallel mixed-methods study.","authors":"Mariana Vieira, João Pedro Ramos, Ana Aguiar, Teresa Silva, Marta Pinto, Raquel Duarte","doi":"10.1080/25310429.2026.2720832","DOIUrl":"https://doi.org/10.1080/25310429.2026.2720832","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains the leading infectious cause of death globally, disproportionately affecting people living with HIV and those with drug-resistant TB. In Portugal, TB incidence and notification rates exceed the European average, with diagnostic delays affecting underserved populations.</p><p><strong>Research question: </strong>This study investigated factors contributing to total diagnostic delay among people with TB in Portugal, particularly underserved groups, and identified strategies to reduce these delays.</p><p><strong>Study design and methods: </strong>A convergent-parallel mixed-methods approach was used. Quantitative data came from 55 surveys, and qualitative data through 27 semi-structured interviews and two focus group discussions. Descriptive statistics and thematic analysis identified patterns of total diagnostic delay, contributing factors, and potential interventions.</p><p><strong>Results: </strong>Median total diagnostic delay was 45 days (IQR 21-60 days). In exploratory comparisons, underserved groups reported longer total diagnostic delay than the general population. Key person-related barriers included symptom normalisation, financial and logistical constraints, stigma, and fragmented referral pathways. System-level obstacles such as complex paperwork, limited clinic hours, staff indifference, and language barriers compounded delays. Proposed solutions included clear and non-judgemental communication, mobile screening units, integrated electronic records, anti-stigma campaigns, and social support teams for healthcare navigation.</p><p><strong>Conclusion: </strong>Diagnostic delays remain a major challenge in TB control in Portugal, especially among underserved populations. Reducing these delays requires multi-level interventions, including enhanced primary care awareness, stigma reduction, compensation for indirect costs, and simpler administrative procedures. Addressing these barriers is essential to reduce preventable morbidity, limit ongoing transmission, and tackle health inequities, while supporting progress towards national and global TB targets.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2720832"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907680","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 urinary incontinence outcomes following pulmonary rehabilitation requires further methodological scrutiny'.","authors":"Nikita Vaid, Kanika Bhatia, Rittu Sharma","doi":"10.1080/25310429.2026.2623659","DOIUrl":"10.1080/25310429.2026.2623659","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2623659"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108041","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":"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":5.3,"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":"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}