Pulmonology最新文献

{"title":"EBUS-guided cryobiopsy in the diagnosis of thoracic disorders","authors":"","doi":"10.1016/j.pulmoe.2023.11.008","DOIUrl":"10.1016/j.pulmoe.2023.11.008","url":null,"abstract":"<div><h3>Background</h3><p>Endobronchial Ultrasound (EBUS) has emerged as a crucial tool for diagnosing intrathoracic disorders, particularly in the staging of lung cancer. However, its diagnostic capabilities in the context of benign and rare diseases remain a subject of debate.</p></div><div><h3>Aim</h3><p>to investigate the diagnostic yield and safety of EBUS-transbronchial mediastinal cryobiopsy (EBUS-TMC) in comparison to EBUS-transbronchial needle aspiration (TBNA) for a broad spectrum of intrathoracic diseases.</p></div><div><h3>Methods</h3><p>a single-centre retrospective observational study conducted on 48 patients who underwent both EBUS-TBNA and endobronchial ultrasound-transbronchial mediastinal cryobiopsy (EBUS-TMC) in the same procedure between August 2021 and October 2023.</p></div><div><h3>Results</h3><p>The overall diagnostic yield of EBUS-TMC surpassed that of EBUS-TBNA (95.8% vs 54.1 %), notably excelling in the diagnosis of sarcoidosis (92.8% vs 78.5 %), rare mediastinal disorders (100% vs 0 %), hyperplastic lymphadenopathy (100% vs 0 %), and lymphoproliferative disease (100% vs 0 %). No significant differences were observed in the diagnosis of NSCLC and SCLC. Samples obtained through EBUS-TMC facilitated the acquisition of NGS and immunohistochemical analyses more readily.</p></div><div><h3>Conclusion</h3><p>EBUS-TMC may contribute to the precise diagnosis and subtyping of mediastinal diseases, especially lymphomas and rare mediastinal tumors, thereby reducing the number of non-diagnostic procedures.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 5","pages":"Pages 459-465"},"PeriodicalIF":10.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043723002234/pdfft?md5=ed20865649a730520408bacdf8f59c72&pid=1-s2.0-S2531043723002234-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139104673","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}

{"title":"High altitudes and partial pressure of arterial oxygen in patients with chronic obstructive pulmonary disease - A systematic review and meta-analysis.","authors":"A Sevik, T Gaisl, A Forrer, L Graf, S Ulrich, K E Bloch, M Lichtblau, M Furian","doi":"10.1016/j.pulmoe.2024.06.002","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.06.002","url":null,"abstract":"<p><strong>Importance: </strong>Prior study in healthy subjects has shown a reduction of partial pressure of arterial oxygen (PaO₂) by -1.60 kPa/kilometre of altitude gain. However, the association of altitude-related change in PaO₂ and altitude-related adverse health effects (ARAHE) in patients with chronic obstructive pulmonary disease (COPD) remain unknown.</p><p><strong>Objective: </strong>To provide an effect size estimate for the decline in PaO₂ with each kilometre of altitude gain and to identify ARAHE in relation to altitude in patients with COPD. www.crd.york.ac.uk/prospero: CRD42020217938.</p><p><strong>Data sources: </strong>A systematic search of PubMed and Embase was performed from inception to May 30, 2023.</p><p><strong>Study selection: </strong>Peer-reviewed and prospective studies in patients with COPD staying at altitudes >1500 m providing arterial blood gases within the first 3 days at the target altitude.</p><p><strong>Data extraction and synthesis: </strong>Aggregate data (AD) on study characteristics were extracted, and individual patient data (IPD) were requested. Estimates were pooled using random-effects meta-analysis.</p><p><strong>Main outcome and measures: </strong>Relative risk estimates and 95 % confidence intervals for the association between PaO₂ and altitude in patients with COPD.</p><p><strong>Results: </strong>Thirteen studies were included in the AD analysis, of which 6 studies (222 patients, 45.2 % female) provided IPD, thus were included in the quantitative analysis. The estimated effect size of PaO₂ was -0.84 kPa [95 %CI, -0.92 to -0.76] per 1000 m of altitude gain (I²=65.0 %, P < 0.001). In multivariable regression analysis, COPD severity, baseline PaO₂, age and time spent at altitude were predictors for PaO₂ at altitude. Overall, 37.8 % of COPD patients experienced an ARAHE, whereas older age, female sex, COPD severity, baseline PaO_2, and target altitude were predictors for the occurrence of ARAHE (area under ROC curve: 0.9275, P < 0.001).</p><p><strong>Conclusions and relevance: </strong>This meta-analysis, providing altitude-related decrease in PaO₂ and risk of ARAHE in patients with COPD ascending to altitudes >1500 m, revealed a lower altitude-related decrease in PaO₂ in COPD patients compared with healthy. However, these findings might improve patient care and facilitate decisions about initiating preventive measures against hypoxaemia and ARAHE in patients with COPD planning an altitude sojourn or intercontinental flight, i.e. supplemental oxygen or acetazolamide.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":""},"PeriodicalIF":10.4,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728297","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 of obstructive sleep apnea syndrome (OSAS) with mandibular advancement devices-A statement of the Portuguese society of pulmonology, the Portuguese society of stomatology and dental medicine, the Portuguese dental association, and the Portuguese society of temporomandibular disorders, orofacial pain and sleep.","authors":"Susana Sousa, Sílvia Correia, André Mariz de Almeida, Gabriela Videira, Ricardo Dias, Susana Falardo Ramos, Júlio Fonseca","doi":"10.1016/j.pulmoe.2024.05.006","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.05.006","url":null,"abstract":"<p><p>With the purpose of establishing a consensus around clinical orientations for professionals involved in managing patients with sleep breathing disorders (SBD), an interdisciplinary group of scientific societies involved in this field discussed and reviewed all the published international guidelines from the American Dental Association, American Academy of Sleep Medicine, American Academy of Dental Sleep Medicine and the European counterparts. Treatment of SBD is multidisciplinary and should be made in concert with the patient, the sleep physician, and the qualified dentist to solve the individual, social, and economic burden of the disease,. This consensus document represents the current thinking of a team of Portuguese experts on managing patients with SBD based on the available evidence.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":""},"PeriodicalIF":10.4,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604502","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":"Application and internal validation of lung ultrasound score in COVID-19 setting: Correspondence.","authors":"H Daungsupawong, V Wiwanitkit","doi":"10.1016/j.pulmoe.2024.06.001","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.06.001","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":""},"PeriodicalIF":10.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604498","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":"Application and internal validation of lung ultrasound score in COVID-19 setting: The ECOVITA observational study. Authors' reply.","authors":"L Rinaldi, F Perrotta","doi":"10.1016/j.pulmoe.2024.06.004","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.06.004","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":""},"PeriodicalIF":10.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604499","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":"Methicilin-susceptible Staphylococcus aureus clonal complex 398: An unusual agent of necrotizing pneumonia","authors":"C. Nobre ,&nbsp;P. Moniz ,&nbsp;N.A. Faria","doi":"10.1016/j.pulmoe.2023.10.003","DOIUrl":"10.1016/j.pulmoe.2023.10.003","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 4","pages":"Pages 397-400"},"PeriodicalIF":10.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043723001964/pdfft?md5=ac54245c2ac3ed3e8ad299b51a7b5e84&pid=1-s2.0-S2531043723001964-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138435391","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}

{"title":"Predictors of immune-related adverse events and outcomes in patients with NSCLC treated with immune-checkpoint inhibitors","authors":"M. Serino ,&nbsp;C. Freitas ,&nbsp;M. Martins ,&nbsp;P. Ferreira ,&nbsp;C. Cardoso ,&nbsp;F. Veiga ,&nbsp;V. Santos ,&nbsp;D. Araújo ,&nbsp;H. Novais-Bastos ,&nbsp;A. Magalhães ,&nbsp;H. Queiroga ,&nbsp;G. Fernandes ,&nbsp;V. Hespanhol","doi":"10.1016/j.pulmoe.2022.03.003","DOIUrl":"10.1016/j.pulmoe.2022.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>To identify predictors of immune-related adverse events (IRAEs) in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). Assess associations between outcomes and the development of IRAEs.</p></div><div><h3>Methods</h3><p>Retrospective analysis of patients with NSCLC treated with ICIs between 2016 and 2020 in the Pulmonology Department of our hospital. Patients with and without IRAEs were compared. A logistic regression analysis was performed to determine predictors of IRAEs. Progression-free survival (PFS) and overall survival (OS) curves were calculated using the Kaplan-Meier method, and the long-rank test was used to assess survival differences between groups. Univariate and multivariate Cox proportional-hazards regression models were used to identify factors associated with PFS and OS. The value considered statistically significant was p≤0.05.</p></div><div><h3>Results</h3><p>A total of 184 patients (77.7% men, mean age 66.9±9.5 years) treated with ICIs were analyzed. During follow-up, 49 (26.6%) patients developed IRAEs and 149 (81.0%) died. According to the multivariate logistic regression analysis, treatment with statins (OR:3.15; <em>p</em> = 0.007), previous systemic corticosteroid therapy (OR:3.99; <em>p</em> = 0.001), disease controlled as response to ICI (OR:5.93; <em>p</em> &lt; 0.001) and higher hemoglobin values (OR:1.28; <em>p</em> = 0.040) were independent predictors for the development of IRAEs. Patients who developed IRAEs had significantly longer medians of PFS (41.0 vs 9.0 weeks, <em>p</em> &lt; 0.001) and OS (89.0 vs 28.0 weeks; <em>p</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Patients treated with statins, pre-ICI systemic corticosteroids, higher baseline hemoglobin value and controlled disease as initial response to ICI had a higher risk of developing IRAEs. The development of IRAEs was associated with better outcomes.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 4","pages":"Pages 352-361"},"PeriodicalIF":10.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043722000769/pdfft?md5=f68e9ab9cfdaae86cb0d8b61009aa97b&pid=1-s2.0-S2531043722000769-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76640049","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}

{"title":"Nontuberculous Mycobacteria in Portugal: Trends from the last decade","authors":"A. Santos ,&nbsp;S. Carneiro ,&nbsp;A. Silva ,&nbsp;J.P. Gomes ,&nbsp;R. Macedo","doi":"10.1016/j.pulmoe.2022.01.011","DOIUrl":"10.1016/j.pulmoe.2022.01.011","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Nontuberculous mycobacteria (NTM) are opportunistic human pathogens found in the environment. The transmission seems to be associated with inhalation of aerosol droplets, ingestion or trauma events. Recent studies indicate that NTM disease is increasing worldwide, however, the true clinical impact of NTM infections is difficult to determine due to challenges in discriminating between disease and colonization as they are ubiquitous in the environment. In addition, understanding the epidemiology of NTM is difficult and has not yet been established. In this work, we used a country NTM representative collection from the National Reference Laboratory for Tuberculosis (NRL-TB) of the National Institute of Health (INSA), to characterize the circulation trends of NTM species in Portugal and the most affected regions, contributing to a better understanding of the NTM epidemiology.</p></div><div><h3>Material and methods</h3><p>We conducted a nationwide retrospective study where all individuals with positive NTM cultures at the NRL-TB of the INSA from 2014 to December 2020 were included. Positive cultures were identified using GenoType Mycobacterium CM/AS® (Hain Lifescience) according to manufacturer's instructions, or hsp65 DNA sequencing as previously described. Social-demographic data from patients were also analyzed and patients classified into 3 groups according only to microbiological data, “definite NTM disease”, “NTM colonization” and, “possible NTM disease”.</p></div><div><h3>Results</h3><p>In the period 2014-2020, the NRL-TB performed 50397 cultures. Among these, 1118 cultures were NTM positive retrieved from 944. Most of our cases were in patients whose mean age was 64±15.9 years, and no significant differences between gender was observed, although more frequent in male patients. Overall, from the 944 cases, we were able to identified 93 “definite NTM disease” cases and 79 “possible NTM disease”. Mycobacterium avium complex (MAC) (40,8%), Mycobacterium abscessus-chelonae complex (MABC) (9,6%) and Mycobacterium fortuitum (6,3%) were responsible for most of the infections. The geographical distribution of NTM cases varied significantly and was possible to observe that was independent of population density. The region were most cases occurred was Lisbon Metropolitan Area (31,9%), followed by North (25,3%) and Centre (24,4%), however North region has the highest number of “definite NTM disease” cases (n=33).</p></div><div><h3>Conclusions</h3><p>This is the first national wide epidemiological study on this subject, contributing to a better understanding of NTM dynamics in Portugal. MAC was the NTM species responsible for the majority of infections and, LMA the region with the highest number of cases. It was also possible to conclude that the number of NTM isolates is independent of the demography of the region.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 4","pages":"Pages 337-343"},"PeriodicalIF":10.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S253104372200023X/pdfft?md5=9db3e296903f176f3c592a4a113499d6&pid=1-s2.0-S253104372200023X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83335370","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}

{"title":"Use of automatic 6-minute walking test recording system in patients with chronic respiratory diseases","authors":"R. Torres-Castro ,&nbsp;H. Pascual ,&nbsp;A. Alonso ,&nbsp;E. Gimeno-Santos ,&nbsp;M. Palomo ,&nbsp;J.A. Barberà ,&nbsp;J. Bigorra ,&nbsp;J. Batlle ,&nbsp;X. Masip-Bruin ,&nbsp;I. Blanco","doi":"10.1016/j.pulmoe.2023.08.011","DOIUrl":"10.1016/j.pulmoe.2023.08.011","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 4","pages":"Pages 390-392"},"PeriodicalIF":10.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043723001666/pdfft?md5=1b8ace6f12e41e16584a2e2750835bc5&pid=1-s2.0-S2531043723001666-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159327","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}

{"title":"Association between sputum myeloperoxidase concentration and acute exacerbation of bronchiectasis","authors":"B. Yang ,&nbsp;H. Lee ,&nbsp;H. Yun ,&nbsp;C. Seong ,&nbsp;E.-G. Kim ,&nbsp;J.‑K. Choi","doi":"10.1016/j.pulmoe.2023.10.006","DOIUrl":"10.1016/j.pulmoe.2023.10.006","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 4","pages":"Pages 401-405"},"PeriodicalIF":10.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043723001976/pdfft?md5=32e497ab4fdd7d16e63a1765309bb6f6&pid=1-s2.0-S2531043723001976-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500160","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}