Pulmonology最新文献

{"title":"The diagnostic performance and optimal strategy of cone beam CT-assisted bronchoscopy for peripheral pulmonary lesions: A systematic review and meta-analysis.","authors":"Huijie Yang, Junfeng Huang, Yu Zhang, Jiaming Guo, Shuojia Xie, Ziwen Zheng, Yuqin Ma, Qilin Deng, Changhao Zhong, Shiyue Li","doi":"10.1080/25310429.2024.2420562","DOIUrl":"10.1080/25310429.2024.2420562","url":null,"abstract":"<p><p>Cone-beam computed tomography (CBCT) assisted bronchoscopy shows prospective advantages in diagnosing peripheral pulmonary lesions (PPLs), but its diagnostic value and potential influencing factors remain unclear. What is the clinical value and optimal strategy of CBCT-assisted bronchoscopy in diagnosing PPLs? The references were searched from PubMed, EmBase, and Web of Science. Studies reporting diagnostic yield and potential influencing factors of CBCT-assisted bronchoscopy were included. The navigational success rate, diagnostic rate, complication rate, and potential influencing factors were pooled by random-effects model and meta-regression. A total of 1,441 patients with 1,540 lesions from 15 studies were included in our meta-analysis. The pooled navigational success rate (97.0% vs 81.6%; odds ratio [OR] 5.12) and diagnostic rate (78.5% vs 55.7%; OR 2.51) of the CBCT-assisted group were significantly higher than those without CBCT. The complication rate of CBCT-assisted bronchoscopy was 4.4% (95%CI: 0.02-0.07). Cone-beam CT combined with r-EBUS can achieve the highest diagnostic rate. Applying positive end-expiratory pressure could improve the diagnostic rate and reduce the complication rate (p < 0.05). Lesions located in the upper lobe could achieve a higher diagnostic rate and lesions located in the right lobes could get a lower complication rate (p < 0.05). Cone-beam CT combined with r-EBUS seems to be the effective and optimal approach to ameliorate the navigation success rate and diagnostic rate of diagnosing PPLs.<b>Clinical trial registration</b>: This study was registered in PROSPERO (Registration Number: CRD42022378992). URL: PROSPERO (york.ac.uk).</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2420562"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069519","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":"Endobronchial ultrasound-guided cryobiopsy of a rare epicardial tumour.","authors":"Toshiyuki Nakai, Atsushi Miyamoto, Mana Ogawa, Akimasa Morisaki, Nobuhiro Izumi, Sayaka Tanaka","doi":"10.1080/25310429.2025.2458368","DOIUrl":"10.1080/25310429.2025.2458368","url":null,"abstract":"<p><strong>Background: </strong>Cardiac tumors are rare, and a nonsurgical diagnosis is preferred for determining appropriate treatment strategies.</p><p><strong>Research question: </strong>Can Endobronchial ultrasound-guided cryobiopsy (EBUS-cryo) be useful for diagnosing cardiac tumors?</p><p><strong>Study design and methods: </strong>This paper presents a case report on the successful diagnosis of a rare cardiac tumor using EBUS-cryo. A 60-year-old woman was referred to our hospital after echocardiography revealed an epicardial tumor compressing the bilateral atria. Computed tomography revealed a 90-mm cardiac tumor adjacent to the tracheal bifurcation compressing the surrounding large vessels. Endobronchial ultrasound-guided cryobiopsy (EBUS-cryo) was performed, and a histological diagnosis of schwannoma, a type of peripheral nerve sheath tumor (PNST), was made without severe complications. Surgical resection was performed, and the tumor was found to originate from the pericardium on the left atrial wall.</p><p><strong>Results: </strong>The surgical specimens contained small areas of perineurioma in addition to schwannoma, leading to the final diagnosis of extremely rare hybrid PNST.</p><p><strong>Conclusion: </strong>EBUS-cryo can be one of useful biopsy techniques for diagnosing cardiac tumors.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2458368"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191269","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":"High-dose inhaled NO for the prevention of nosocomial pneumonia after cardiac surgery under cardiopulmonary bypass: A proof-of-concept prospective randomised study.","authors":"Tatiana P Kalashnikova, Nikolay O Kamenshchikov, Yulia A Arsenyeva, Yuri K Podoksenov, Igor V Kravchenko, Maxim S Kozulin, Mark A Tyo, Elena A Churilina, Elena B Kim, Yulia S Svirko, Boris N Kozlov, Alla A Boshchenko","doi":"10.1080/25310429.2025.2471706","DOIUrl":"10.1080/25310429.2025.2471706","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the safety and potential efficacy of high-dose inhaled nitric oxide therapy for the prevention of postoperative pneumonia in cardiac surgery patients.</p><p><strong>Methods: </strong>A prospective randomised controlled pilot study included 74 patients with moderate risk of postoperative pneumonia after elective cardiac surgery under cardiopulmonary bypass. Patients were randomised into two groups. The main group (NO-group) (<i>n</i> = 37) received inhaled nitric oxide at a dose of 200 ppm for 30 minutes 2 times a day for 5 days or until pneumonia developed. The control group received conventional postoperative care (<i>n</i> = 37). The primary endpoint was the incidence of postoperative pneumonia during in-hospital stay.</p><p><strong>Results: </strong>Preventive nitric oxide inhalations were associated with a reduced incidence of postoperative nosocomial pneumonia (2 (5.4%) cases in the main group (NO-group) vs. 9 (24.3%) cases in the control group, <i>p</i> = 0.046; OR = 0.178, 95% CI = 0.036-0.89)). There was no decrease in either peak expiratory flow, or peak inspiratory flow in comparison with the preoperative values in the NO-group. Inhaled nitric oxide therapy is safe. It did not lead to an increase in the incidence of acute kidney injury.</p><p><strong>Conclusions: </strong>High-dose inhaled nitric oxide therapy is safe and effective for the prevention of postoperative nosocomial pneumonia in cardiac surgery.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2471706"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525137","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":"Quality of life associated with breathlessness in the multinational Burden of Obstructive Lung Disease (BOLD) study: A cross-sectional analysis.","authors":"Alexander Müller, Emiel F M Wouters, Peter Burney, James Potts, Joao Cardoso, Mohammed Al Ghobain, Michael Studnicka, Daniel Obaseki, Asma Elsony, Kevin Mortimer, David Mannino, Rain Jõgi, Rana Ahmed, Asaad Nafees, Maria Fatima Rodrigues, Cristina Bárbara, Rune Nielsen, Thorarinn Gíslason, Hamid Hacene Cherkaski, Karima El Rhazi, Christer Janson, Mahesh Padukudru Anand, Sanjay Juvekar, Herminia Brites Dias, Frits M E Franssen, Dhiraj Agarwal, Sylvia Hartl, Terence Seemungal, Stefanni Nonna Paraguas, Imed Harrabi, Meriam Denguezli, Abdul Rashid, Gregory Erhabor, Mohammed El Biaze, Parvaiz Koul, Daisy J A Janssen, André F S Amaral","doi":"10.1080/25310429.2025.2470566","DOIUrl":"10.1080/25310429.2025.2470566","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence of an association between breathlessness and quality of life from population-based studies is limited. We aimed to investigate the association of both physical and mental quality of life with breathlessness across several low-, middle- and high-income countries.</p><p><strong>Methods: </strong>We analysed data from 19 714 adults (31 sites, 25 countries) from the Burden of Obstructive Lung Disease (BOLD) study. We measured both mental and physical quality of life components using the SF-12 questionnaire, and defined breathlessness as grade ≥2 on the modified Medical Research Council scale. We used multivariable linear regression to assess the association of each quality-of-life component with breathlessness. We pooled site-specific estimates using random-effects meta-analysis.</p><p><strong>Results: </strong>Both physical and mental component scores were lower in participants with breathlessness compared to those without. This association was stronger for the physical component (coefficient = -7.59; 95%CI -8.60, -6.58; I² = 78.5%) than for the mental component (coefficient = -3.50; 95%CI -4.36, -2.63; I² = 71.4%). The association between physical component and breathlessness was stronger in high-income countries (coefficient = -8.82; 95%CI -10.15, -7.50). Heterogeneity across sites was partly explained by sex and tobacco smoking.</p><p><strong>Conclusion: </strong>Quality of life is worse in people with breathlessness, but this association varies widely across the world.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2470566"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765852","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":"Weaning from tracheostomy: Trend of decannulation rate over two decades in a respiratory rehabilitation centre.","authors":"Matteo Vigna, Cinzia Lastoria, Annalisa Carlucci, Serena Cirio, Matteo Prazzoli, Piero Ceriana","doi":"10.1080/25310429.2024.2411814","DOIUrl":"https://doi.org/10.1080/25310429.2024.2411814","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2411814"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069551","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":"Complete response to mTOR inhibitor following JAKi failure in severe pulmonary sarcoidosis: Authors' reply.","authors":"Raphaël Hindré, Valérie Besnard, Fatma Kort, Hilario Nunes, Dominique Valeyre, Florence Jeny","doi":"10.1080/25310429.2024.2422210","DOIUrl":"https://doi.org/10.1080/25310429.2024.2422210","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2422210"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069631","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":"Increased plasma interleukin-1β is associated with accelerated lung function decline in non-smokers.","authors":"Xinru Ran, Haiqing Li, Zihui Wang, Fan Wu, Zhishan Deng, Qiaorui Zhou, Cuiqiong Dai, Jieqi Peng, Lifei Lu, Kunning Zhou, Pixin Ran, Yumin Zhou","doi":"10.1080/25310429.2024.2411811","DOIUrl":"10.1080/25310429.2024.2411811","url":null,"abstract":"<p><p>Interleukin-1β is one of the major cytokines involved in the initiation and persistence of airway inflammation in chronic obstructive pulmonary disease (COPD). However, the association between plasma interleukin-1β and lung function decline remains unclear. We aimed to explore the association between plasma interleukin-1β and lung function decline. This longitudinal evaluation of data from the Early COPD study analysed the association between the plasma interleukin-1β concentration, lung function decline, and COPD exacerbation. Overall, 1,328 participants were included in the baseline analysis, and 1,135 (85%) completed the 1-year follow-up. Increased plasma interleukin-1β was associated with accelerated lung function decline in non-smokers (forced expiratory volume in 1 s: per unit natural log-transformed increase, adjusted unstandardised β [95% confidence interval] 101.46 [16.73-186.18] mL/year, p=0.019; forced vital capacity: per unit natural log-transformed increase, adjusted unstandardised β [95% confidence interval] 146.20 [93.65-198.75] mL/year, p<0.001), but not in smokers. In non-smokers, participants with an interleukin-1β concentration in the top 30% (>5.02 pg/mL) had more respiratory symptoms, more severe emphysema and air trapping, and higher levels of inflammation-related biomarkers. In this study, a subgroup with increased plasma interleukin-1β was identified among non-smokers, and increased plasma interleukin-1β was associated with lung function accelerated decline.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2411811"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068687","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":"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":" ","pages":"2416837"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","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":"Mendelian randomisation studies for causal inference in chronic obstructive pulmonary disease: A narrative review.","authors":"Zizheng Chen, Yuqiong Yang, Chusheng Peng, Zifei Zhou, Fengyan Wang, Chengyu Miao, Xueping Li, Mingdie Wang, Shengchuan Feng, Tingnan Chen, Rongchang Chen, Zhenyu Liang","doi":"10.1080/25310429.2025.2470556","DOIUrl":"10.1080/25310429.2025.2470556","url":null,"abstract":"<p><strong>Background and objective: </strong>Most non-randomised controlled trials are unable to establish clear causal relationships in chronic obstructive pulmonary disease (COPD) due to the presence of confounding factors. This review summarises the evidence that the Mendelian randomisation method can be a powerful tool for performing causal inferences in COPD.</p><p><strong>Methods: </strong>A non-systematic search of English-language scientific literature was performed on PubMed using the following keywords: 'Mendelian randomisation', 'COPD', 'lung function', and 'GWAS'. No date restrictions were applied. The types of articles selected included randomised controlled trials, cohort studies, observational studies, and reviews.</p><p><strong>Results: </strong>Mendelian randomisation is becoming an increasingly popular method for identifying the risk factors of COPD. Recent Mendelian randomisation studies have revealed some risk factors for COPD, such as club cell secretory protein-16, impaired kidney function, air pollutants, asthma, and depression. In addition, Mendelian randomisation results suggest that genetically predicted factors such as PM_2.5, inflammatory cytokines, growth differentiation factor 15, docosahexaenoic acid, and testosterone may have causal relationships with lung function.</p><p><strong>Conclusion: </strong>Mendelian randomisation is a robust method for performing causal inferences in COPD research as it reduces the impact of confounding factors.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2470556"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494329","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":"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":"2416848"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","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}