PulmonologyPub Date : 2024-11-01DOI: 10.1016/j.pulmoe.2024.02.001
{"title":"What do we know about macrolides immunomodulatory therapeutic potential in respiratory disease in 2023","authors":"","doi":"10.1016/j.pulmoe.2024.02.001","DOIUrl":"10.1016/j.pulmoe.2024.02.001","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 509-511"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944694","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}
PulmonologyPub Date : 2024-11-01DOI: 10.1016/j.pulmoe.2024.06.006
Y. Hu , L. Wang , K. Yao , Q. Wang
{"title":"Atypical surge of hospitalized and severe cases of pertussis: A single center 19-years study from China","authors":"Y. Hu , L. Wang , K. Yao , Q. Wang","doi":"10.1016/j.pulmoe.2024.06.006","DOIUrl":"10.1016/j.pulmoe.2024.06.006","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 636-638"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604500","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}
PulmonologyPub Date : 2024-11-01DOI: 10.1016/j.pulmoe.2023.01.005
{"title":"Profile of emergency department overuse in hospitalized patients with pulmonary disease and its impact on mortality","authors":"","doi":"10.1016/j.pulmoe.2023.01.005","DOIUrl":"10.1016/j.pulmoe.2023.01.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Portugal is one of the countries with the highest number of visits to the emergency department (ED), 31% classified as “non-urgent” or “avoidable.” The objectives of our study were to evaluate the size and characteristics of patients with pulmonary disease who overuse the ED, and identify factors associated with mortality.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted, based on the medical records of ED frequent users (ED-FU) with pulmonary disease who attended a university hospital center in the northern inner city of Lisbon from January 1 to December 31, 2019. To evaluate mortality, a follow-up until December 31, 2020 was performed.</div></div><div><h3>Results</h3><div>Over 5,567 (4.3%) patients were identified as ED-FU and 174 (0.14%) had pulmonary disease as the main clinical condition, accounting for 1,030 ED visits. 77.2% of ED visits were categorized as “urgent/very urgent.” A high mean age (67.8 years), male gender, social and economic vulnerability, high burden of chronic disease and comorbidities, with a high degree of dependency, characterized the profile of these patients. A high proportion (33.9%) of patients did not have a family physician assigned and this was the most important factor associated with mortality (<em>p</em><0.001; OR: 24.394; CI 95%: 6.777–87.805). Advanced cancer disease and autonomy deficit were other clinical factors that most determined the prognosis.</div></div><div><h3>Conclusions</h3><div>Pulmonary ED-FU are a small group of ED-FU who constitute an aged and heterogeneous group with a high burden of chronic disease and disability. The lack of an assigned family physician was the most important factor associated with mortality, as well as advanced cancer disease and autonomy deficit.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 586-594"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10739359","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}
PulmonologyPub Date : 2024-11-01DOI: 10.1016/j.pulmoe.2022.08.001
{"title":"Predictors of lung entrapment in malignant pleural effusion","authors":"","doi":"10.1016/j.pulmoe.2022.08.001","DOIUrl":"10.1016/j.pulmoe.2022.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Malignant pleural effusion (MPE) is a common complication in advanced stages of malignancy and is associated with poor prognosis. Non-expandable lung (NEL) often occurs and its presence influences the MPE approach. Our main objective was to assess risk factors for malignant NEL.</div></div><div><h3>Methods</h3><div>Patients diagnosed with pathologically confirmed MPE between January 2012 and December 2018 in our institution were retrospectively analyzed. Demographic and clinical data of patients were reviewed and compared according to the presence or absence of NEL. A univariate and multivariate binary logistic regression analysis were used to determine predictors of the development of NEL.</div></div><div><h3>Results</h3><div>Of 365 patients included, 68 (18.6%) had NEL. After multivariate analysis, we found that loculated MPE (OR 8.63, 95%CI 4.30-17.33, p<0.001), complete hemithorax opacification (OR 2.81, 95%CI 1.17-6.76, p<0.021), lung cancer (OR 2.09, 95%CI 1.01-4.31, p=0.047) and higher effusion-serum LDH ratio (OR 1.09, 95%CI 1.00-1.17, p=0.039) were independent predictors of malignant NEL. There were no significant differences compared with expandable lung group regarding time from primary malignancy diagnosis to MPE diagnosis (3.0, IQR 0.0-75.8 vs 2.0, IQR 0.0-75.5 weeks, p=0.942) or MPE symptoms onset to MPE diagnosis (4.0, IQR 1.0-9.0 vs 3.0, IQR 1.0-9.0 weeks, p=0.497). Patients with NEL had a higher number of therapeutic pleural drainages (3.0, IQR 2.0-6.0 vs 2.0, IQR 1.0-3.0; p<0.001) and longer hospital stay (32.5, IQR 15.5-46.3 vs 21.0, IQR 11.0-36.0, p=0.007), measured in hospitalization days until the end of life, than patients with expandable lung. The rate of recurrence of pleural effusion was not significantly different between groups (p=0.291). Overall survival (OS) was 3.0 (95%CI, 2.3-3.7) months, regardless of lung expandability (p=0.923).</div></div><div><h3>Conclusion</h3><div>Loculated MPE, complete hemithorax opacification, lung cancer and a higher effusion-serum LDH ratio were found to be independent predictors for NEL. These patients underwent thoracocenteses more frequently and had longer hospitalization days, although without significant impact in the OS.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 555-562"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40387650","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}
PulmonologyPub Date : 2024-11-01DOI: 10.1016/j.pulmoe.2022.06.003
{"title":"Associations of serum sclerostin levels with body composition, pulmonary function, and exacerbations in COPD patients","authors":"","doi":"10.1016/j.pulmoe.2022.06.003","DOIUrl":"10.1016/j.pulmoe.2022.06.003","url":null,"abstract":"<div><h3>Background</h3><div>In COPD, the bronchial epithelium shows a pathologically activated Wnt pathway. Sclerostin (SOST) is a secreted glycoprotein that is associated with bone metabolism and blocks the Wnt pathway. We hypothesized that low sclerostin levels might be associated with lung function and COPD exacerbations in patients.</div></div><div><h3>Methods</h3><div>We studied 139 outpatients with stable COPD and normal kidney function. We assessed the serum levels of SOST and bone metabolism parameters, body composition, clinical characteristics and lung function at baseline. We followed the patients prospectively for 12 months after enrolment. Moderate exacerbations and hospital admissions were recorded during follow-up.</div></div><div><h3>Results</h3><div>The serum SOST levels were 23.98±7.6 pmol/l (men: 25.5±7.7 pmol/l, women: 20.3±5.9 pmol/l (<em>p</em> < 0.001)). SOST showed correlations with age (<em>r</em> = 0.36), FFMI (<em>r</em> = 0.38), FEV1 (<em>r</em> = 0.27), DLCO (<em>r</em> = 0.39), 6MWD (<em>r</em> = 0.19) and CAT (<em>r</em> = -0.24). In multivariate linear regression analysis, only age (beta=0.264) and FFMI (beta=1.241) remained significant. SOST showed a significant negative correlation with serum phosphorus (<em>r</em> = -0.29). Cox proportional risk analysis indicated that patients in the lower tertile of SOST levels were at higher risk of moderate COPD exacerbation (HR 2.015, CI95% 1.136–3.577, <em>p</em> = 0.017) and hospital admission due to COPD (HR 5.142, CI95% 1.380–19.158, <em>p</em> = 0.015) than the rest of the patients.</div></div><div><h3>Conclusions</h3><div>SOST levels are associated with body composition and lung function in patients with COPD. Furthermore, lower SOST levels predict a higher risk of exacerbations and hospitalization.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 512-521"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40611190","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}
PulmonologyPub Date : 2024-11-01DOI: 10.1016/j.pulmoe.2024.04.007
{"title":"Malignant pulmonary epithelioid hemangioendothelioma masquerading as lung adenocarcinoma: A possible radiological and pathological diagnostic pitfall","authors":"","doi":"10.1016/j.pulmoe.2024.04.007","DOIUrl":"10.1016/j.pulmoe.2024.04.007","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 681-684"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855530","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}
PulmonologyPub Date : 2024-11-01DOI: 10.1016/j.pulmoe.2024.04.002
{"title":"An extremely rare case of Langerhans cell hyperplasia in the thymus","authors":"","doi":"10.1016/j.pulmoe.2024.04.002","DOIUrl":"10.1016/j.pulmoe.2024.04.002","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 679-680"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141050196","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}
PulmonologyPub Date : 2024-11-01DOI: 10.1016/j.pulmoe.2024.02.006
{"title":"Delays have dangerous ends: Tuberculosis diagnosis delay in Portugal, a qualitative study","authors":"","doi":"10.1016/j.pulmoe.2024.02.006","DOIUrl":"10.1016/j.pulmoe.2024.02.006","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 653-658"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974561","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}
PulmonologyPub Date : 2024-11-01DOI: 10.1016/j.pulmoe.2024.04.003
M.G.O. Fernandes , M. Dias , R. Santos , S. Ravara , P. Fernandes , J. Firmino-Machado , J.P. Antunes , O. Fernandes , A. Madureira , V. Hespanhol , C. Rodrigues , C.A. Vicente , S. Alves , G. Mendes , R. Ilgenfritz , B.S. Pinto , J. Alves , I. Saraiva , C. Bárbara , M.A. Cipriano , A. Morais
{"title":"Recommendations for the implementation of a national lung cancer screening program in Portugal—A consensus statement","authors":"M.G.O. Fernandes , M. Dias , R. Santos , S. Ravara , P. Fernandes , J. Firmino-Machado , J.P. Antunes , O. Fernandes , A. Madureira , V. Hespanhol , C. Rodrigues , C.A. Vicente , S. Alves , G. Mendes , R. Ilgenfritz , B.S. Pinto , J. Alves , I. Saraiva , C. Bárbara , M.A. Cipriano , A. Morais","doi":"10.1016/j.pulmoe.2024.04.003","DOIUrl":"10.1016/j.pulmoe.2024.04.003","url":null,"abstract":"<div><div>Lung cancer (LC) is a leading cause of cancer-related mortality worldwide. Lung Cancer Screening (LCS) programs that use low-dose computed tomography (LDCT) have been shown to reduce LC mortality by up to 25 % and are considered cost-effective. The European Health Union has encouraged its Member States to explore the feasibility of LCS implementation in their respective countries.</div><div>The task force conducted a comprehensive literature review and engaged in extensive discussions to provide recommendations.</div><div>These recommendations encompass the essential components required to initiate pilot LCS programs following the guidelines established by the World Health Organization. They were tailored to align with the specific context of the Portuguese healthcare system. The document addresses critical aspects, including the eligible population, methods for issuing invitations, radiological prerequisites, procedures for reporting results, referral processes, diagnostic strategies, program implementation, and ongoing monitoring. Furthermore, the task force emphasized that pairing LCS with evidence-based smoking cessation should be the standard of care for a high-quality screening program. This document also identifies areas for further research.</div><div>These recommendations aim to guarantee that the implementation of a Portuguese LCS program ensures high-quality standards, consistency, and uniformity across centres.</div></div>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 6","pages":"Pages 625-635"},"PeriodicalIF":10.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903524","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}