Clinical Respiratory Journal最新文献

{"title":"Differences in Radiological and Pathological Findings by ANCA-Subtype in ANCA-Positive Idiopathic Interstitial Pneumonias","authors":"Tetsuro Sawata,&nbsp;Susumu Sakamoto,&nbsp;Yusuke Usui,&nbsp;Aika Suzuki,&nbsp;Hideya Kitamura,&nbsp;Tae Iwasawa,&nbsp;Shoichiro Matsushita,&nbsp;Yasuhiro Terasaki,&nbsp;Shinobu Kunugi,&nbsp;Kazuma Kishi,&nbsp;Tomoyuki Fujisawa,&nbsp;Takafumi Suda,&nbsp;Sakae Homma","doi":"10.1111/crj.70061","DOIUrl":"https://doi.org/10.1111/crj.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Anti-neutrophil cytoplasmic antibody (ANCA) seropositivity strongly correlates to ANCA-associated vasculitis. Patients with idiopathic interstitial pneumonias (IIPs) without systemic vasculitis are sometimes ANCA-positive. Radiological and pathological differences between patients with myeloperoxidase (MPO)-ANCA-positive and those with proteinase 3 (PR3)-ANCA-positive IIPs remain unclear. To determine whether high-resolution computed tomography (HRCT) features and pathology findings differ by ANCA subtype in ANCA-positive IIP patients in a national database. Clinical, radiological, and pathological data were examined along with a web-based multidisciplinary discussion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed records of 10 MPO-ANCA-positive and 9 PR3-ANCA-positive IIP patients who underwent HRCT and surgical lung biopsy between April 2009 and March 2014. Pulmonologists, chest radiologists, and pathologists evaluated HRCT scans and pathological findings independently. Patterns were classified using ATS/ERS/JRS/ALAT 2011 guidelines for idiopathic pulmonary fibrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HRCT patterns were definite usual interstitial pneumonia (UIP) (<i>n</i> = 8; 42.1%), possible UIP (<i>n</i> = 6; 31.6%), and inconsistent with UIP (<i>n</i> = 5; 26.3%). Pathological patterns were definite UIP (n = 5; 26.3%), probable UIP (n = 8; 42.1%), possible UIP (<i>n</i> = 4; 21.1%), and not UIP (<i>n</i> = 2; 10.5%). HRCT and pathological patterns did not differ between MPO-ANCA-positive and PR3-ANCA-positive IIPs. Radiological features were reticulation (<i>n</i> = 13; 68.4%), nodules (<i>n</i> = 12; 63.1%), honeycombing (<i>n</i> = 10; 52.6%), and increased attenuation around honeycombing (<i>n</i> = 7; 36.8%). Pathological findings were cysts (<i>n</i> = 12; 63.1%), lymphoid follicles with germinal centers (<i>n</i> = 11; 57.9%), and peribronchiolar wall lymphocytic infiltration (<i>n</i> = 11; 57.9%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HRCT and pathological patterns did not differ between MPO-ANCA-positive and PR3-ANCA-positive IIPs. This absence of significant differences suggests a similar mechanism underlying both types of interstitial pneumonia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psittacosis Outbreak in Europe: A Concern for Public Health","authors":"Salomon Izere,&nbsp;Hope Intwari Munyaneza,&nbsp;Faisal Ahmed","doi":"10.1111/crj.70068","DOIUrl":"https://doi.org/10.1111/crj.70068","url":null,"abstract":"&lt;p&gt;Psittacosis, also known as parrot fever or ornithosis, is a zoonotic bacterial infectious disease caused by &lt;i&gt;Chlamydia psittaci&lt;/i&gt;, an obligatory intracellular organism [&lt;span&gt;1&lt;/span&gt;]. The infection is primarily transmitted through contact with infected avian species, leading to a diverse spectrum of clinical manifestations and severity. &lt;i&gt;Chlamydia psittaci&lt;/i&gt; predominantly resides in birds, particularly those within the Psittaciformes order, which includes species such as parakeets, parrots, lorikeets, cockatoos, and budgerigars, as well as birds from the Galliformes order, including chickens, turkeys, and pheasants. Notably, any bird species can potentially harbor the disease [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The primary risk factor for transmission to humans involves direct contact with infected birds or inhalation of aerosolized pathogens resulting from their urine, feces, respiratory secretions, and ocular exudates (Figure 1) [&lt;span&gt;3-5&lt;/span&gt;]. Although there are occasional reports of human-to-human transmission, such occurrences are considered rare. Additionally, humans may contract psittacosis through exposure to &lt;i&gt;C. psittaci&lt;/i&gt; present in aborted products from equine sources, thus underlining the significance of a One Health approach to understanding the disease.&lt;/p&gt;&lt;p&gt;Symptoms of psittacosis can vary from mild to severe, with complications such as pneumonia occurring frequently and posing a risk of fatality, as evidenced by recent outbreaks documented in Europe [&lt;span&gt;4, 5&lt;/span&gt;]. Typically, symptoms manifest within a timeframe of 5 to 14 days following exposure to the pathogen. The management of psittacosis-related pneumonia necessitates the use of antimicrobial drugs, particularly as pulmonary involvement is prevalent at the time of diagnosis. Currently, antibiotics such as tetracyclines and chloramphenicol are the preferred therapeutic agents. Most patients respond favorably to oral administration of chloramphenicol palmitate, tetracycline hydrochloride, or doxycycline [&lt;span&gt;4&lt;/span&gt;]. For critically ill patients, intravenous administration of doxycycline hyclate may be considered an initial treatment option. Symptoms generally begin to remit within a period of 48 to 72 h. It is imperative that, following the resolution of fever, the course of treatment is maintained for a minimum of 10 to 14 days to mitigate the risk of relapse [&lt;span&gt;1, 4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Psittacosis can affect individuals regardless of age or gender; however, its incidence appears to peak among individuals aged 35 to 55 [&lt;span&gt;4&lt;/span&gt;]. The first documented case of psittacosis was identified in 1879 when seven individuals in Switzerland were diagnosed with pneumonia following exposure to tropical pet finches and parrots [&lt;span&gt;6&lt;/span&gt;], although the infectious agent was not initially recognized. Subsequent pandemics occurred in 1929 and 1930 [&lt;span&gt;6, 7&lt;/span&gt;]. Despite remaining relatively rare, psittacosis is currently regarded as a significant public heal","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial Colonization of Silver-Additive Ventilator Circuit in Patients Receiving Mechanical Ventilation: A Randomized Controlled Trial","authors":"Ke-Yun Chao,&nbsp;Wei-Lun Liu,&nbsp;Chao-Yu Chen,&nbsp;Chia-Hui Su,&nbsp;Shih-Hsing Yang,&nbsp;Yu-Tzu Huang","doi":"10.1111/crj.70058","DOIUrl":"https://doi.org/10.1111/crj.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Mechanical ventilation is a significant risk factor for developing ventilator-associated pneumonia. Although silver-coated endotracheal tubes have been shown to reduce the bacterial burden, the efficacy of silver-based ion additive ventilator circuits in reducing bacterial colonization remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-site, randomized controlled trial compared the incidence of bacterial contamination between a silver-additive ventilator circuit and a ventilator circuit that did not have a silver additive. Bacterial samples were collected from the inspiratory limb and Y-adaptor of the circuit and analyzed using culture and identification methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Bacterial growth was observed in all samples from the control group and in 93.7% and 81.2% of inspiratory limb and Y-adaptor samples, respectively, from the study group. The colony counts in the inspiratory limb samples were significantly different between the groups, with a higher proportion of undesirable colony counts in the control group compared with the study group. No significant difference between the groups was observed in the colony counts in the Y-adaptor samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of a silver-additive ventilator circuit may reduce bacterial circuit colonization. However, further research with larger sample sizes and more diverse patient populations is necessary to confirm these findings.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ClinicalTrial.gov: NCT04927806</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioinformatic Insights and XGBoost Identify Shared Genetics in Chronic Obstructive Pulmonary Disease and Type 2 Diabetes","authors":"Qianqian Ji,&nbsp;Yaxian Meng,&nbsp;Xiaojie Han,&nbsp;Chao Yi,&nbsp;Xiaoliang Chen,&nbsp;Yiqiang Zhan","doi":"10.1111/crj.70057","DOIUrl":"https://doi.org/10.1111/crj.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The correlation between chronic obstructive pulmonary disease (COPD) and Type 2 diabetes mellitus (T2DM) has long been recognized, but their shared molecular underpinnings remain elusive. This study aims to uncover common genetic markers and pathways in COPD and T2DM, providing insights into their molecular crosstalk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilizing the Gene Expression Omnibus (GEO) database, we analyzed gene expression datasets from six COPD and five T2DM studies. A multifaceted bioinformatics approach, encompassing the limma R package, unified matrix analysis, and weighted gene co-expression network analysis (WGCNA), was deployed to identify differentially expressed genes (DEGs) and hub genes. Functional enrichment and protein–protein interaction (PPI) analyses were conducted, followed by cross-species validation in <i>Mus musculus</i> models. Machine learning techniques, including random forest and LASSO regression, were applied for further validation, culminating in the development of a prognostic model using XGBoost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis revealed shared DEGs such as <i>KIF1C</i>, <i>CSTA</i>, <i>GMNN</i>, and <i>PHGDH</i> in both COPD and T2DM. Cross-species comparison identified common genes including <i>PON1</i> and <i>CD14</i>, exhibiting varying expression patterns. The random forest and LASSO regression identified six critical genes, with our XGBoost model demonstrating significant predictive accuracy (AUC = 0.996 for COPD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identifies key genetic markers shared between COPD and T2DM, providing new insights into their molecular pathways. Our XGBoost model exhibited high predictive accuracy for COPD, highlighting the potential utility of these markers. These findings offer promising biomarkers for early detection and enhance our understanding of the diseases' interplay. Further validation in larger cohorts is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Retinal Nerve Fiber Layer Thickness in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis","authors":"Yunpeng Xu,&nbsp;Peidong Shi,&nbsp;Xiaoying Liu,&nbsp;Ziyi Jiang,&nbsp;Yanru Chen,&nbsp;Jian Liu,&nbsp;Xunwen Lei,&nbsp;Xue Bai,&nbsp;Fanqi Wu","doi":"10.1111/crj.70065","DOIUrl":"https://doi.org/10.1111/crj.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study is to evaluate the relationship between retinal nerve fiber layer (RNFL) thickness and the onset as well as progression of chronic obstructive pulmonary disease (COPD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Database searches were conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP Database, and CBM, covering the period from each database's inception to March 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This meta-analysis included 15 studies from 2016 to 2023, comprising a total of 1455 participants (801 in the COPD group and 654 in the health group). The results showed a significant reduction in RNFL thickness across all quadrants (average, inferior, nasal, superior, and temporal) in the COPD group compared to the health group (MD: −4.46; 95%CI: −7.77 to −1.14; <i>p</i> = 0.008; MD: −8.17; 95%CI: −11.36 to −4.99; <i>p</i> &lt; 0.00001; MD: −4.69; 95%CI: −7.22 to −2.16; <i>p</i> = 0.0003; MD: −4.83; 95%CI: −8.45 to −1.21; <i>p</i> = 0.009; MD: −2.89; 95%CI: −5.35 to −0.43; <i>p</i> = 0.02). In the mild/moderate COPD group, only the inferior RNFL (MD: −2.32; 95%CI: −4.40 to −0.24; <i>p</i> = 0.03) showed a significant reduction. However, in the severe COPD group, all quadrants were significantly reduced (MD: −5.89; 95%CI: −7.40 to −4.38; <i>p</i> &lt; 0.0001; MD: −6.74; 95%CI: −10.71 to −2.77; <i>p</i> = 0.0009; MD: −4.29; 95%CI: −5.95 to −2.64; <i>p</i> &lt; 0.0001; MD: −2.34; 95%CI: −4.30 to −0.37; <i>p</i> = 0.02; MD: −4.84; 95%CI: −8.82 to −0.86; <i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on current evidence, the average RNFL thickness and the thicknesses of various RNFL regions in COPD patients are significantly lower than those in healthy subjects, and these reductions are closely associated with disease severity. The inferior RNFL may be the first to show changes with the onset and progression of COPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nomogram for Predicting Pulmonary Embolism in Silicosis Patients","authors":"Jiaqing Zhou,&nbsp;Wen Du,&nbsp;Jin Liu,&nbsp;Lijun Peng","doi":"10.1111/crj.70059","DOIUrl":"https://doi.org/10.1111/crj.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As one of the most severe occupational diseases that prevention efforts have supported for several decades, silicosis is still a public health issue that lacks a prediction model for pulmonary embolism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 162 patients confirmed to have silicosis were all involved in a training cohort to construct a nomogram with the outcome diagnosed by the CTPA using logistic regression. Univariate and LASSO analyses were used to select variables for the nomogram.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>mMRC, pectoralgia, history of VTE, active tumor, unilateral lower limb pain or edema, hormonotherapy, reduced mobility, and heart failure/respiratory failure were selected for the establishment of the nomogram for silicosis with pulmonary embolism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A novel nomogram was developed to predict pulmonary embolism in silicosis patients. The internal validation indicated that clinicians could utilize this predictive model to help decision-making and patient management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Rescue of Massive Hemoptysis Caused by Vascular-Bronchial Fistula","authors":"Xiangwu Zhang,&nbsp;Rongxian Zhou,&nbsp;Guangqiang Zhao,&nbsp;Wanling Chen,&nbsp;Yunchao Huang,&nbsp;Lianhua Ye","doi":"10.1111/crj.70064","DOIUrl":"https://doi.org/10.1111/crj.70064","url":null,"abstract":"<p>The case reported in this paper is a vascular-bronchial fistula associated with fatal massive hemoptysis. The patient was rescued successfully by experts from a multidisciplinary team. The bronchoscopy physician cleared the accumulated blood in the airway timely and maintained the airway patency, and the anesthesiologist established artificial ventilation quickly; eventually, the thoracic surgeon performed an emergency thoracotomy to control the bleeding. It reflected the significance of multidisciplinary collaborative treatment.</p>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Causes Bilateral Pleural Effusion: A Case Report","authors":"Miaojuan Zhu,&nbsp;Shuaiyu Lin,&nbsp;Yifei Chen,&nbsp;Jiong Yang,&nbsp;Hanxiang Nie","doi":"10.1111/crj.70055","DOIUrl":"https://doi.org/10.1111/crj.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tuberculous pericarditis begins with fibrinous and hemorrhagic pericarditis, followed by pericardial effusion, then pericardial hypertrophy, which may turn into subacute or chronic stage, and partly develop into pericarditis. Early diagnosis and treatment have very important clinical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>We present a case of an 82-year-old man with a known history of hypertension who was admitted for pleural effusion. CT scan of the chest showed findings of pleural effusion. An echocardiographic study during admission revealed a small amount of pericardial effusion (~1.2 cm in thickness). A whole-body positron emission tomography-computer tomography (PET-CT) scan was then performed and showed a slightly increased fluorodeoxyglucose uptake in the entire pericardium considering tuberculosis. He was started on antituberculosis (TB) medications and tolerated them well. Follow-up echocardiographic study showed no re-accumulation of pleural effusion and pericardial fluid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Transudative–exudative pleural effusion may be one of the clinical manifestations of tuberculous pericarditis. (1) Bilateral leaking pleural effusion may be the early clinical manifestation of tuberculous pericarditis; (2) PET/CT in the diagnosis and efficacy evaluation of tuberculous pericarditis is valuable; and (3) the central venous pressure may be an indicator of choice for treatment of tuberculous pericarditis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Risk Factors and Predictors of Chronic Obstructive Pulmonary Disease in Patients With Obstructive Sleep Apnea–Hypopnea Syndrome at Plateau","authors":"Yumei Geng,&nbsp;Yu Hu,&nbsp;Bin Li,&nbsp;Zhuoma Dawa,&nbsp;Fang Zhang","doi":"10.1111/crj.70053","DOIUrl":"https://doi.org/10.1111/crj.70053","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;OSAHS patients with COPD (i.e., overlap syndrome) have a significantly worse prognosis than those with OSAHS alone, and the role of plateau hypoxia in the occurrence of the disease is still unclear. This underscores the urgent need to explore the risk factors for the incidence of COPD in patients with OSAHS and to identify predictors for the occurrence of overlap syndrome at plateau.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Fifty patients with OSAHS and 34 patients with overlap syndrome were enrolled in this study. Demographic, auxiliary examination, and laboratory data were collected.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;All patients enrolled were obstructive sleep apnea–hypopnea syndrome. The apnea–hypopnea index (AHI), the number of hypopnea, and the oxygen desaturation index were higher in the group of patients with overlap syndrome than in the group of patients with OSAHS. The mean pulse oxygen saturation was lower than that in the group of patients with OSAHS (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The right heart structure and function indexes (PASP, right atrial transverse diameter, RVTD, BNP, TNI) in patients with overlap syndrome were worse than those in patients with OSAHS (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), and this worse cardiovascular status was positively correlated with inflammatory factors such as high-sensitivity C-reactive protein, IL-6, and PCT (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Binary logistic regression analysis indicated that PASP, smoking index, and AHI were independent risk factors for OSAHS developing into overlap syndrome. ROC curve showed that the area under the curve of the combination of the three markers for predicting overlap syndrome was 0.908 (95% CI 0.843–0.974, &lt;i&gt;p&lt;/i&gt; = 0.000), with a sensitivity of 0.882 and a specificity of 0.820. The optimal cutoff values for PASP were 42.5 mmHg, 15 for the smoking index, and 25.65 for the AHI based on the Youden index.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our study reveals that overlap syndrome has more frequent nighttime hypopnea and hypoxia than OSAHS alone. The cardiovascular complications of overlapping syndromes at plateau are more pronounced, possibly due to the exacerbation of the systemic inflammatory response. The combination of PASP, smoking index, and AHI can be a powerful tool for predicting and assessing the occurrence of COPD in OSAHS patients from plateau populations in China. These findings have the potential to significantly improve the management and prognosis of patients with overlap syndrome.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Patterns of Patients With Pulmonary Hypertension: A Descriptive Study in Colombia","authors":"Manuel Machado-Duque,&nbsp;Andrés Gaviria-Mendoza,&nbsp;Luis Fernando Valladales-Restrepo,&nbsp;Manuel Pacheco,&nbsp;Juan Sebastián Franco,&nbsp;María del Rosario Forero,&nbsp;Rubiela Suarez,&nbsp;Oscar Peñuela,&nbsp;Jorge E. Machado-Alba","doi":"10.1111/crj.70063","DOIUrl":"https://doi.org/10.1111/crj.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pulmonary hypertension (PH) is a chronic disease characterized by a progressive rise in pulmonary artery blood pressure. The objective was to describe the treatment patterns among ambulatory patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) in a real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a longitudinal cohort follow-up study characterizing the treatment patterns of patients diagnosed with PAH or CTEPH, with secondary data from a population-based drug-dispensing database between 2022 and 2023, which includes sociodemographic, diagnosis, prescribing specialty, and treatment (drugs, persistence of use, and concomitant medications).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 1045 patients with a diagnosis of PH were identified, with mean age of 62.9 ± 18.2 years, and 72.3% of females; of which 947 (90.6%) received monotherapy, and 98 (9.4%) received combination therapy at the beginning of follow-up. The most frequently used drugs for the treatment of PH were calcium channel blockers (58.1%), followed by phosphodiesterase 5 inhibitors (41.1%), endothelin receptor antagonist (32.5%), and guanylate cyclase stimulants (9.7%). The schemes used most frequently were monotherapy with amlodipine (31.0%), sildenafil (19.2%), or nifedipine (10.0%), but the main combination were sildenafil with nifedipine (2.5%). The mean of persistence of use was 161 ± 123 days during 1 year of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This group of patients with PH from Colombia were treated predominantly with monotherapy of calcium channel blockers and phosphodiesterase 5 inhibitors. However, current clinical practice guidelines recommend the use of combined therapy. The average persistence of the use of drugs for treatment for less than 6 months may be associated with difficulties in follow-up, adherence, effectiveness, tolerability, and access.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}