Pulmonology最新文献

{"title":"Comunicações orais","authors":"","doi":"10.1016/S2531-0437(24)00117-X","DOIUrl":"10.1016/S2531-0437(24)00117-X","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":10.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S253104372400117X/pdfft?md5=55b11bc4a149c2dffe13ec8611e3caf8&pid=1-s2.0-S253104372400117X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230680","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":"Resumos","authors":"","doi":"10.1016/S2531-0437(24)00119-3","DOIUrl":"10.1016/S2531-0437(24)00119-3","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":10.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043724001193/pdfft?md5=e122b941b8eb77a9b1ba3b6bf10a26eb&pid=1-s2.0-S2531043724001193-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230072","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":"Application and internal validation of lung ultrasound score in COVID-19 setting: The ECOVITA observational study.","authors":"L Rinaldi, M Lugarà, V Simeon, F Perrotta, C Romano, C Iadevaia, C Sagnelli, L Monaco, C Altruda, M C Fascione, L Restivo, U Scognamiglio, N Laganà, R Nevola, G Oliva, M G Coppola, C Acierno, F Masini, E Pinotti, E Allegorico, S Tamburrini, G Vitiello, M Niosi, M L Burzo, G Franci, A Perrella, G Signoriello, V Frusci, S Mancarella, G Loche, G F Pellicano, M Berretta, G Calabria, L Pietropaolo, F G Numis, N Coppola, A Corcione, R Marfella, L E Adinolfi, A Bianco, F C Sasso, I de Sio","doi":"10.1016/j.pulmoe.2024.04.012","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.04.012","url":null,"abstract":"<p><strong>Background: </strong>The severe acute respiratory syndrome Coronarovirus-2 associated still causes a significant number of deaths and hospitalizations mainly by the development of respiratory failure. We aim to validate lung ultrasound score in order to predict mortality and the severity of the clinical course related to the need of respiratory support.</p><p><strong>Methods: </strong>In this prospective multicenter hospital-based cohort study, all adult patients with diagnosis of SARS-CoV-2 infection, performed by real-time reverse transcription polymerase chain reaction were included. Upon admission, all patients underwent blood gas analysis and lung ultrasound by expert operators. The acquisition of ultrasound scan was performed on 12 peculiar anatomic landmarks of the chest. Lung ultrasound findings were classified according to a scoring method, ranging 0 to 3: Score 0: normal A-lines. Score 1: multiple separated B-lines. Score 2: coalescent B-lines, alteration of pleural line. Score 3: consolidation area.</p><p><strong>Results: </strong>One thousand and seven patients were included in statistical analysis (male 62.4 %, mean age 66.3). Oxygen support was needed in 811 (80.5 %) patients. The median ultrasound score was 24 and the risk of having more invasive respiratory support increased in relation to higher values score computed. Lung ultrasound score showed negative strong correlation (rho: -0.71) with the P/F ratio and a significant association with in-hospital mortality (OR 1.11, 95 %CI 1.07-1.14; p < 0.001), even after adjustment with the following variables (age, sex, P/F ratio, SpO2, lactate, hypertension, chronic renal failure, diabetes, and obesity).</p><p><strong>Conclusions: </strong>The novelty of this research corroborates and validates the 12-field lung ultrasound score as tool for predicting mortality and severity clinical course in COVID-19 patients. Baseline lung ultrasound score was associated with in-hospital mortality and requirement of intensive respiratory support and predict the risk of IOT among COVID-19 patients.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160498","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":"Development of clinical tools to estimate the breathing effort during high-flow oxygen therapy: A multicenter cohort study.","authors":"A Protti, R Tonelli, F Dalla Corte, D L Grieco, E Spinelli, S Spadaro, D Piovani, L S Menga, G Schifino, M L Vega Pittao, M Umbrello, G Cammarota, C A Volta, S Bonovas, M Cecconi, T Mauri, E Clini","doi":"10.1016/j.pulmoe.2024.04.008","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.04.008","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Quantifying breathing effort in non-intubated patients is important but difficult. We aimed to develop two models to estimate it in patients treated with high-flow oxygen therapy.</p><p><strong>Patients and methods: </strong>We analyzed the data of 260 patients from previous studies who received high-flow oxygen therapy. Their breathing effort was measured as the maximal deflection of esophageal pressure (ΔPes). We developed a multivariable linear regression model to estimate ΔPes (in cmH₂O) and a multivariable logistic regression model to predict the risk of ΔPes being >10 cmH₂O. Candidate predictors included age, sex, diagnosis of the coronavirus disease 2019 (COVID-19), respiratory rate, heart rate, mean arterial pressure, the results of arterial blood gas analysis, including base excess concentration (BEa) and the ratio of arterial tension to the inspiratory fraction of oxygen (PaO₂:FiO₂), and the product term between COVID-19 and PaO₂:FiO₂.</p><p><strong>Results: </strong>We found that ΔPes can be estimated from the presence or absence of COVID-19, BEa, respiratory rate, PaO₂:FiO_2, and the product term between COVID-19 and PaO₂:FiO_2. The adjusted R² was 0.39. The risk of ΔPes being >10 cmH₂O can be predicted from BEa, respiratory rate, and PaO₂:FiO₂. The area under the receiver operating characteristic curve was 0.79 (0.73-0.85). We called these two models BREF, where BREF stands for BReathing EFfort and the three common predictors: BEa (B), respiratory rate (RE), and PaO₂:FiO₂ (F).</p><p><strong>Conclusions: </strong>We developed two models to estimate the breathing effort of patients on high-flow oxygen therapy. Our initial findings are promising and suggest that these models merit further evaluation.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960099","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":"Issue 4-Impact of air pollution on COVID-19 mortality and morbidity: An epidemiological and mechanistic review.","authors":"Hasan Bayram, Nur Konyalilar, Muge Akpinar Elci, Hadi Rajabi, G Tuşe Aksoy, Deniz Mortazavi, Özgecan Kayalar, Öner Dikensoy, Luis Taborda-Barata, Giovanni Viegi","doi":"10.1016/j.pulmoe.2024.04.005","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.04.005","url":null,"abstract":"<p><p>Air pollution is a major global environment and health concern. Recent studies have suggested an association between air pollution and COVID-19 mortality and morbidity. In this context, a close association between increased levels of air pollutants such as particulate matter ≤2.5 to 10 µM, ozone and nitrogen dioxide and SARS-CoV-2 infection, hospital admissions and mortality due to COVID 19 has been reported. Air pollutants can make individuals more susceptible to SARS-CoV-2 infection by inducing the expression of proteins such as angiotensin converting enzyme (ACE)2 and transmembrane protease, serine 2 (TMPRSS2) that are required for viral entry into the host cell, while causing impairment in the host defence system by damaging the epithelial barrier, muco-ciliary clearance, inhibiting the antiviral response and causing immune dysregulation. The aim of this review is to report the epidemiological evidence on impact of air pollutants on COVID 19 in an up-to-date manner, as well as to provide insights on in vivo and in vitro mechanisms.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960196","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 extremely rare case of Langerhans cell hyperplasia in the thymus.","authors":"Q Xu, H Tian, L Feng, L Li, J Tang","doi":"10.1016/j.pulmoe.2024.04.002","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.04.002","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960130","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":"Beyond pulmonary rehabilitation: can the PICk UP programme fill the gap? A randomised trial in COPD.","authors":"P Rebelo, D Brooks, J Cravo, M A Mendes, A C Oliveira, A S Rijo, M J Moura, A Marques","doi":"10.1016/j.pulmoe.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.04.001","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Pulmonary rehabilitation (PR) is a fundamental intervention to manage COPD, however, maintaining its benefits is challenging. Engaging in physical activity might help to prolong PR benefits. This study assessed the efficacy and effectiveness of a personalised community-based physical activity programme to sustain physical activity and other health-related PR benefits, in people with COPD.</p><p><strong>Materials and methods: </strong>This was a multicentre, assessor blinded, randomised controlled trial. Following 12-weeks of PR, people with COPD were assigned to a six-months personalised community-based physical activity programme (experimental group), or to standard care (control group). Physical activity was assessed via: time spent in moderate to vigorous physical activities per day (primary outcome measure), steps/day and the brief physical activity assessment tool. Secondary outcomes included sedentary behaviour, functional status, peripheral muscle strength, balance, symptoms, emotional state, health-related quality of life, exacerbations and healthcare utilization. Assessments were performed immediately post-PR and after three- and six-months. Efficacy and effectiveness were evaluated using intention-to-treat and per-protocol analysis with linear mixed models.</p><p><strong>Results: </strong>Sixty-one participants (experimental group: n = 32; control group: n = 29), with balanced baseline characteristics between groups (69.6 ± 8.5 years old, 84 % male, FEV₁ 57.1 ± 16.7 %predicted) were included. Changes in all physical activity outcomes and in one-minute sit-to-stand were significantly different (P < 0.05) between groups at the six-month follow-up. In the remaining outcomes there were no differences between groups.</p><p><strong>Conclusions: </strong>The community-based physical activity programme resulted in better physical activity levels and sit-to-stand performance, six-months after completing PR, in COPD. No additional benefits were observed for other secondary outcomes.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908898","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":"Issue 3-The occupational burden of respiratory diseases, an update.","authors":"N Murgia, M Akgun, P D Blanc, J T Costa, S Moitra, X Muñoz, K Toren, A J Ferreira","doi":"10.1016/j.pulmoe.2024.03.004","DOIUrl":"https://doi.org/10.1016/j.pulmoe.2024.03.004","url":null,"abstract":"<p><strong>Introduction and aims: </strong>Workplace exposures are widely known to cause specific occupational diseases such as silicosis and asbestosis, but they also can contribute substantially to causation of common respiratory diseases. In 2019, the American Thoracic Society (ATS) and the European Respiratory Society (ERS) published a joint statement on the occupational burden of respiratory diseases. Our aim on this narrative review is to summarise the most recent evidence published after the ATS/ERS statement as well as to provide information on traditional occupational lung diseases that can be useful for clinicians and researchers.</p><p><strong>Results: </strong>Newer publications confirm the findings of the ATS/ERS statement on the role of workplace exposure in contributing to the aetiology of the respiratory diseases considered in this review (asthma, COPD, chronic bronchitis, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, infectious pneumonia). Except for COPD, chronic bronchitis and infectious pneumonia, the number of publications in the last 5 years for the other diseases is limited. For traditional occupational lung diseases such as silicosis and asbestosis, there are old as well as novel sources of exposure and their burden continues to be relevant, especially in developing countries.</p><p><strong>Conclusions: </strong>Occupational exposure remains an important risk factor for airways and interstitial lung diseases, causing occupational lung diseases and contributing substantially in the aetiology of common respiratory diseases. This information is critical for public health professionals formulating effective preventive strategies but also for clinicians in patient care. Effective action requires shared knowledge among clinicians, researchers, public health professionals, and policy makers.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869547","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":"Hyperoxemia in invasively ventilated COVID–19 patients–Insights from the PRoVENT–COVID study","authors":"A.M. Tsonas ,&nbsp;D.M. van Meenen ,&nbsp;M. Botta ,&nbsp;G.S. Shrestha ,&nbsp;O. Roca ,&nbsp;F. Paulus ,&nbsp;A.S. Neto ,&nbsp;M.J. Schultz ,&nbsp;PRoVENT–COVID Collaborative Group","doi":"10.1016/j.pulmoe.2022.09.003","DOIUrl":"10.1016/j.pulmoe.2022.09.003","url":null,"abstract":"<div><h3>Objective</h3><p>We determined the prevalences of hyperoxemia and excessive oxygen use, and the epidemiology, ventilation characteristics and outcomes associated with hyperoxemia in invasively ventilated patients with coronavirus disease 2019 (COVID–19).</p></div><div><h3>Methods</h3><p>Post hoc analysis of a national, multicentre, observational study in 22 ICUs. Patients were classified in the first two days of invasive ventilation as ‘hyperoxemic’ or ‘normoxemic’. The co–primary endpoints were prevalence of hyperoxemia (PaO₂ &gt; 90 mmHg) and prevalence of excessive oxygen use (FiO₂ ≥ 60% while PaO₂ &gt; 90 mmHg or SpO₂ &gt; 92%). Secondary endpoints included ventilator settings and ventilation parameters, duration of ventilation, length of stay (LOS) in ICU and hospital, and mortality in ICU, hospital, and at day 28 and 90. We used propensity matching to control for observed confounding factors that may influence endpoints.</p></div><div><h3>Results</h3><p>Of 851 COVID–19 patients, 225 (26.4%) were classified as hyperoxemic. Excessive oxygen use occurred in 385 (45.2%) patients. Acute respiratory distress syndrome (ARDS) severity was lowest in hyperoxemic patients. Hyperoxemic patients were ventilated with higher positive end–expiratory pressure (PEEP), while rescue therapies for hypoxemia were applied more often in normoxemic patients. Neither in the unmatched nor in the matched analysis were there differences between hyperoxemic and normoxemic patients with regard to any of the clinical outcomes.</p></div><div><h3>Conclusion</h3><p>In this cohort of invasively ventilated COVID–19 patients, hyperoxemia occurred often and so did excessive oxygen use. The main differences between hyperoxemic and normoxemic patients were ARDS severity and use of PEEP. Clinical outcomes were not different between hyperoxemic and normoxemic patients.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9550012","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":"Prevalence of pulmonary hypertension in COPD patients living at high altitude","authors":"C. Aguirre-Franco ,&nbsp;CA. Torres-Duque ,&nbsp;G. Salazar ,&nbsp;A. Casas ,&nbsp;C. Jaramillo ,&nbsp;M. Gonzalez-Garcia","doi":"10.1016/j.pulmoe.2021.12.006","DOIUrl":"10.1016/j.pulmoe.2021.12.006","url":null,"abstract":"<div><h3>Background</h3><p>Pulmonary hypertension (PH) is associated with poor prognosis for patients with chronic obstructive pulmonary disease (COPD). Most of the knowledge about PH in COPD has been generated at sea level, with limited information associated with high altitude (HA).</p></div><div><h3>Objectives</h3><p>To assess the prevalence and severity of PH in COPD patients living in a HA city (2,640 m).</p></div><div><h3>Methods</h3><p>Cross-sectional study in COPD patients with forced expiratory volume in the first second / forced vital capacity ratio (FEV₁/FVC) post-bronchodilator &lt;0,7. Transthoracic echocardiography (TTE), spirometry, carbon monoxide diffusing capacity, and arterial blood gasses tests were performed. Patients were classified according to the severity of airflow limitation. PH was defined by TTE as an estimated systolic pulmonary artery pressure (sPAP) &gt; 36 mmHg or indirect PH signs; severe PH as sPAP &gt; 60 mmHg; and disproportionate PH as an sPAP &gt; 60 mmHg with non-severe airflow limitation (FEV₁ &gt; 50% predicted).</p></div><div><h3>Results</h3><p>We included 176 COPD patients. The overall estimated prevalence of PH was 56.3% and the likelihood of having PH increased according to airflow-limitation severity: mild (31.6%), moderate (54.9%), severe (59.6%) and very severe (77.8%) (<em>p</em> = 0.038). The PH was severe in 7.3% and disproportionate in 3.4% of patients.</p></div><div><h3>Conclusions</h3><p>The estimated prevalence of PH in patients with COPD at HA is high, particularly in patients with mild to moderate airflow limitation, and greater than that described for COPD patients at low altitude. These results suggest a higher risk of developing PH for COPD patients living at HA compared to COPD patients with similar airflow limitation living at low altitude.</p></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043722000046/pdfft?md5=685dbc48802c7fba0677dc8269435514&pid=1-s2.0-S2531043722000046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609294","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}