Pulmonology最新文献

{"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":"Accuracy and safety of C-TST for tuberculosis infection: A clinical trial in Brazil.","authors":"Marcela Bhering, Carla Conceição, Martha Oliveira, Ana Paula Razal Dalvi, Marcelo Cordeiro-Santos, Adriana Rezende Moreira, Anna Cristina Calçado Carvalho, Aline Lopes, Rogerio Rufino, Luciana Rodrigues, Eliene Mesquita, Sergian Vianna Cardozo, Sumire Sakabe, Fernanda Mattos, Pedro Almeida da Silva, Anete Trajman, Afrânio Kritski","doi":"10.1080/25310429.2026.2704303","DOIUrl":"10.1080/25310429.2026.2704303","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis infection (TBI) diagnosis in BCG-vaccinated, high-burden settings remains challenging.</p><p><strong>Research question: </strong>We aimed to assess the sensitivity, specificity, and safety of the C-tuberculin skin test (C-TST), compared with PPD RT-23, for tuberculosis infection in BCG-vaccinated adults.</p><p><strong>Study design and methods: </strong>Randomised, double-blind clinical trial in Brazil. Adults with pulmonary tuberculosis (PTB) and asymptomatic controls without known TB exposure or prior TB/TPT underwent C-TST, PPD RT-23, and QuantiFERON-TB Gold Plus (QFT-Plus). Skin tests were read by two strategies: (a) induration only or (b) induration or erythema, at a ≥5-mm cut-off. Sensitivity was assessed in PTB; specificity for C-TST and PPD RT-23 was estimated against QFT-Plus. Adverse events were monitored.</p><p><strong>Results: </strong>Among 446 participants (141 PTB; 305 controls), at the 5-mm cut-off, C-TST showed lower sensitivity but higher specificity than PPD RT-23. With strategy (a) and (b), C-TST sensitivity was 0.67 and 0.68, specificity was 0.92 and 0.9, compared to 0.74 sensitivity and 0.78 specificity for PPD RT-23. Adverse events were more frequent in PTB: 12.1% (C-TST) and 6.4% (PPD RT-23); none were serious.</p><p><strong>Conclusion: </strong>In BCG‑vaccinated adults, C-TST showed a trade-off of higher specificity and lower sensitivity than PPD RT-23 at the 5-mm cut-off; and a favourable safety profile. Adding erythema to readings did not improve accuracy, suggesting that C-TST may be a useful alternative for programmatic TBI screening in high-burden settings.</p><p><strong>Trial registration: </strong>Trial registry number RBR-7tn2ysw (https://ensaiosclinicos.gov.br/ registered on 25 January 2021).</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2704303"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474198","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 regarding \"Mobile cone-beam computed tomography combined with electromagnetic navigation bronchoscopy for the diagnosis of peripheral pulmonary nodules\".","authors":"Deep Shikha, Sunita Sharma","doi":"10.1080/25310429.2026.2737564","DOIUrl":"10.1080/25310429.2026.2737564","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2737564"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018882","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":5.3,"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":"Association between chronotypes and comorbidities in obstructive sleep apnea: The age effect.","authors":"Nikolaos Athanasiou, Vassilios Vlachakos, Asteria Ilektra Karapiperi, Petros Galanis, Paschalis Steiropoulos, Georgia Trakada","doi":"10.1080/25310429.2026.2679351","DOIUrl":"10.1080/25310429.2026.2679351","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnoea (OSA) is associated with increased cardiometabolic risk. Although a chronotype, a phenotypic marker of circadian rhythm, appears to influence this relationship, the influence of age-related differences has not been fully elucidated. This study aims to evaluate chronotypes and their association with age in identifying comorbidity risk among patients with OSA.</p><p><strong>Methods: </strong>In this cross-sectional study of 671 adults from three outpatient sleep clinics (median age 56, interquartile range 47-65; 60.2% men) had a medical history assessment, completed standardised questionnaires, and underwent in-lab polysomnography or home sleep testing. An individual's chronotype was assessed using the Morningness - Eveningness Questionnaire (MEQ), whereas comorbidities were determined based on patients' medical history and/or pharmacological treatment. Multivariable analysis was performed to adjust for potential confounders.</p><p><strong>Results: </strong>The morning chronotype is associated with a higher prevalence of arterial hypertension, dyslipidemia, diabetes mellitus, and cardiovascular disease compared with evening chronotype (all <i>p</i> < 0.05), particularly among participants younger than 60 years. In contrast, depression was more frequently observed among individuals with an evening chronotype, with no significant age-related effect.</p><p><strong>Conclusion: </strong>In newly diagnosed patients with OSA, the morning chronotype was primarily associated with cardiometabolic comorbidities, especially in young and middle-aged adults, but not in older individuals, suggesting that it may represent a potential adjunctive clinical marker.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2679351"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058369","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":"ALPHA-1 antitrypsin genotype, sex, and lung cancer: Clinical and molecular characterisation.","authors":"Esmeralda García-Rodríguez, Ramón Antonio Tubío-Pérez, Cristina Candal-Pereira, Laura Villar-Aguilar, Ana Priegue-Carrera, Alberto Fernández-Villar, Alberto Ruano-Raviña, María Torres-Durán","doi":"10.1080/25310429.2026.2735063","DOIUrl":"https://doi.org/10.1080/25310429.2026.2735063","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Alpha-1 antitrypsin deficiency is associated with lung and liver disease, but its role in lung carcinogenesis remains unclear. This study aimed to compare the clinical, functional, and molecular characteristics of lung cancer according to alpha-1 antitrypsin (AAT) genotype and, additionally, to explore differences by sex and the possible influence of environmental exposures.</p><p><strong>Patients and methods: </strong>We conducted a cross-sectional, single-centre study including 407 patients with incident lung cancer diagnosed between 2020 and 2023. Clinical, functional, radiological, molecular, and environmental variables were collected. Comparisons were performed between carriers and non-carriers of altered AAT alleles and between women and men.</p><p><strong>Results: </strong>Of the 394 patients with available genotyping, 24.4% carried at least one altered allele. No significant differences were observed by genotype in smoking status, radon exposure, comorbidities, lung function, or histological subtype. Carriers showed significantly lower serum AAT levels and a higher frequency of values < 116 mg/dL (<i>p</i> < 0.001). PD-L1 expression ≥ 50% was more common in carriers (28.1% vs. 19.4%; <i>p</i> = 0.036). In the multivariable analysis, the altered AAT genotype remained independently associated with a higher probability of PD-L1 expression ≥ 50% (aOR = 2.04; 95% CI: 1.09-3.80; <i>p</i> = 0.026). Women had lower cumulative tobacco exposure, lower prevalence of emphysema and COPD, greater biomass exposure, higher frequency of adenocarcinoma, and more EGFR mutations (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Patients carrying altered AAT alleles did not exhibit a distinctly different clinical profile, although they showed higher PD-L1 expression (≥50%). Furthermore, significant differences were observed between women and men in terms of exposure, histology and molecular alterations.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2735063"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984361","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":"Low-dose theophylline in mild-to-moderate COPD: A physiological signal without clear clinical benefit?","authors":"Yijuan Lin, Feng Li, Yixun Huang","doi":"10.1080/25310429.2026.2730843","DOIUrl":"https://doi.org/10.1080/25310429.2026.2730843","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2730843"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963835","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":"Cost comparison of UniAMP with Truenat for tuberculosis detection in India.","authors":"Malaisamy Muniyandi, Sahil Abdul Salam, Venkateshprabhu Janagaraj, Priya Rajendran, Silla Varghese Thomas, Kavitha Rajsekar, Karikalan Nagarajan","doi":"10.1080/25310429.2026.2733901","DOIUrl":"https://doi.org/10.1080/25310429.2026.2733901","url":null,"abstract":"<p><strong>Background: </strong>The molecular platforms such as Truenat and GeneXpert have enhanced tuberculosis (TB) diagnostic capacity in India. However, these technologies still face challenges related to cost, infrastructure requirements and maintenance. To address these gaps, several newer molecular diagnostic tools are emerging, including UniAMP. However, the cost implications and economic feasibility remain limited in Indian context. We conducted cost comparison of UniAMP with Truenat for TB detection in India.</p><p><strong>Methods: </strong>A decision tree model was developed from a health system perspective to compare UniAMP with Truenat for TB detection. Sensitivity and specificity data were collected from published literature and validation reports. Diagnostic outcomes such as true positives and negatives were estimated for the cohort of 1,000 presumptive TB patients. Costs data were collected from ICMR-NIRT laboratory and average cost per test and per case detection was estimated. The comparison was done between UniAMP and Truenat.</p><p><strong>Results: </strong>The estimated per test cost was ₹483 (US$5.54) for UniAMP and ₹834 (US$9.57) for Truenat. Case detection in a cohort of 1,000 presumptive TB, true positive was 265 and 296; true negatives 647 and 651 in UniAMP and Truenat respectively. UniAMP identified fewer true positive TB cases than Truenat (265 vs 296), resulting in 31 (10.7%) reduction in diagnostic yield.</p><p><strong>Conclusions: </strong>UniAMP may support decentralised TB testing in resource limited settings because of its lower cost and minimal infrastructure requirements. UniAMP may therefore be more suitable as a supplementary diagnostic option rather than a replacement for established molecular tests such as Truenat.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2733901"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992468","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":"Defining lung function in asthma remission: Results of an international Delphi study.","authors":"Angelica Tiotiu, Jonathan A Bernstein, David Price, Juan Carlos Ivancevich, Paschalis Steiropoulos, Giorgio Walter Canonica, Fulvio Braido, Pierachille Santus, Silviya Novakova, Plamena Novakova, Stefan Frent, Francisco-Javier Gonzalez-Barcala, Andras Bikov, Herberto Jose Chong-Neto, Krzysztof Kowal, Giuseppe Liistro","doi":"10.1080/25310429.2026.2732616","DOIUrl":"https://doi.org/10.1080/25310429.2026.2732616","url":null,"abstract":"<p><strong>Background: </strong>A consensual criterion regarding lung function (LF) assessment that could be included in the definition of asthma remission on treatment (tAR) is currently lacking.</p><p><strong>Research question: </strong>This work aimed to identify a criterion concerning LF evaluation corresponding to this concept.</p><p><strong>Methods: </strong>A survey was conducted using the Delphi method. The scientific board established 16 candidate statements to be included in the questionnaire. A 5-point Likert scale was used to measure agreement for each statement. The predefined conditions for statement selection were a median score ≥ 4 and >60% of responses indicating agreement. The survey included four rounds: three including the board members and one - 177 participants through the Interasma Scientific Network platform.</p><p><strong>Results: </strong>Following the first two rounds, six statements reaching consensus were included in the large survey. They incorporated various definitions used for 'normal' and 'stable' LF together with elimination of airway hyperresponsiveness and variability during bronchodilator testing. Three statements gained consensus during the third round. The final selected criterion associates 'stable LF' over time with a 'negative reversibility test' or 'negative challenge test'.</p><p><strong>Conclusion: </strong>This Delphi process identified a criterion based on LF assessment that may serve as support for future consensual definition of _tAR after prospective validation.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2732616"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971890","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":"Supranormal lung function and incident atrial fibrillation.","authors":"Xiu Shi, Jinyan Ke, Xiaofeng Wu, Yuhan Wang, Yixuan Wang","doi":"10.1080/25310429.2026.2737513","DOIUrl":"10.1080/25310429.2026.2737513","url":null,"abstract":"<p><strong>Background: </strong>Whether supranormal lung function is associated with incident atrial fibrillation (AF), and whether obstructive sleep apnoea (OSA) modifies this association, remain to be determined.</p><p><strong>Methods: </strong>We analysed 2,408 participants from the Sleep Heart Health Study who were free of AF at baseline and had no spirometric airflow obstruction. The primary analysis classified forced expiratory volume in 1 second (FEV₁) as below normal, normal, or supranormal using race-neutral Global Lung Function Initiative (GLI) Global (2022) reference equations. Categories defined by forced vital capacity (FVC) were examined in a secondary analysis. Associations with incident AF were evaluated using multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Firth penalised logistic regression and sensitivity analyses were used to assess the robustness of the findings. Interaction with OSA was explored.</p><p><strong>Results: </strong>Among 2,408 participants, 282 developed AF. Compared with normal FEV₁, supranormal FEV₁ was associated with lower odds of incident AF in the primary adjusted model (OR, 0.420; 95% CI, 0.198-0.888). The corresponding Firth estimate was 0.443 (95% CI, 0.199-0.869). Supranormal FVC showed a similar association in standard logistic regression (OR, 0.351; 95% CI, 0.167-0.736) and Firth penalised logistic regression (OR, 0.371; 95% CI, 0.168-0.721). The direction of the associations was generally consistent across sensitivity analyses. There was no statistically significant evidence of effect modification by OSA.</p><p><strong>Conclusions: </strong>Supranormal lung function was associated with lower odds of incident AF. These findings support supranormal spirometry as a potential marker of favourable systemic and cardiopulmonary physiology.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"32 1","pages":"2737513"},"PeriodicalIF":5.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041983","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}