Clinical Respiratory Journal最新文献

{"title":"Primary Malignant Pulmonary Glomus Tumor: A Case Report and Literature Review","authors":"Shishi Luo,&nbsp;Xiaoyan Lei,&nbsp;Tianxu Fu,&nbsp;Fujin Liu,&nbsp;Zhenping Wang","doi":"10.1111/crj.70183","DOIUrl":"10.1111/crj.70183","url":null,"abstract":"<p>Malignant glomus tumors originating from the lungs are relatively rare. We report a case of primary malignant pulmonary glomus tumor in a 41-year-old female. Chest CT revealed an 8 × 6 cm mass in the upper lobe of the right lung with multiple spotted calcifications, with uneven enhancement on enhanced scans; multiple metastatic nodules can be seen in both lungs; enlarged lymph nodes can be seen in the mediastinum and right hilar lobe. The pathological diagnosis of right lung puncture was malignant pulmonary glomus tumor. Chemotherapy and targeted therapy with arotinib hydrochloride were used, and survival was still observed after 36 months of follow-up. The clinical manifestations of primary malignant pulmonary glomus tumor lack specificity. The imaging manifestations are well-defined nodules or masses, with peripheral enhancement on enhanced scans. The imaging manifestations of benign and malignant pulmonary glomus tumor overlap with other lung tumors, making differential diagnosis difficult. The diagnosis is mainly based on pathology and immunohistochemical.</p>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500807","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":"D-Dimer: A Mediator of the Association Between Lymphocyte and Dissemination of Pulmonary Tuberculosis: A Retrospective Cohort Study","authors":"Yujun Lin,&nbsp;Di Wu,&nbsp;Xiaohong Chen,&nbsp;Lujing Jiang,&nbsp;Yiming Zeng","doi":"10.1111/crj.70175","DOIUrl":"10.1111/crj.70175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to examine whether D-dimer and lymphocyte counts predict the risk of concurrent pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) and to identify critical thresholds for clinical use. We also investigated whether D-dimer mediates the protective effect of lymphocytes against tuberculosis (TB) dissemination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One thousand nine hundred (1318 PTB and 582 PTB + EPTB) patients diagnosed between 2022 and 2024 were analyzed. Multiple regression analysis, smooth curve fitting, threshold effect analysis, and causal mediation analysis were conducted using EasyStat and R software to evaluate the association between lymphocyte counts (exposure), D-dimer (mediator), and PTB + EPTB risk (outcome) and to determine the critical value of lymphocyte counts and D-dimer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PTB + EPTB patients had higher D-dimer and lower lymphocyte counts. Elevated D-dimer increased the risk of PTB + EPTB (adjusted OR = 2.28, 95% CI: 1.99–2.60). High lymphocyte counts reduced the risk (adjusted OR = 0.25, 95% CI: 0.13–0.46). Threshold effects showed increased risk when D-dimer exceeded 0.170 mg/L (OR = 2.35, 95% CI: 2.05–2.70) and reduced risk when lymphocyte counts exceeded 750 cells/μL (OR = 0.15, 95% CI: 0.07–0.32). D-dimer mediated 36.473% (95% CI: 25.469–53.168) of the protective effect of lymphocytes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>D-dimer is an independent risk factor and lymphocyte counts a protective factor for PTB + EPTB, with D-dimer mediating 36.473% of the lymphocyte effect. Clinically actionable thresholds (D-dimer &gt; 0.170 mg/L and lymphocytes &lt; 750 cells/μL) provide concrete targets for early intervention to prevent TB dissemination and improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470273","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":"Therapeutic Targets for Lung Squamous Cell Carcinoma: Proteome-Wide Mendelian Randomization and Potential Drug Prediction","authors":"Tao Xiang,&nbsp;Tingting Hu,&nbsp;Jiantong Sun,&nbsp;Qikun Geng,&nbsp;Jiazun Yang,&nbsp;Zhongyu Jian","doi":"10.1111/crj.70182","DOIUrl":"10.1111/crj.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung squamous cell carcinoma (LUSC) is one of the most prevalent subtypes of lung cancer, accounting for approximately 25%. Mendelian randomization (MR) analysis of plasma proteins can identify potential drug targets for LUSC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We obtained genetic instruments for plasma proteins from a GWAS by Sun BB et al. conducted on 3301 healthy adults. GWAS summary statistics of LUSC were from ILCCO. We conducted a two-sample MR analysis to investigate the causal relationships between plasma proteins and the risk to LUSC. Colocalization analysis was used to test whether two traits share the same causal variables. Survival analysis based on potential proteins was conducted using transcriptomic data from TCGA database to determine whether gene expression levels are associated with the prognosis of LUSC patients. Moreover, predictions of potential drug ligands and molecular dockings were performed to evaluate the pharmaceutical properties of the target genes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Proteome-wide MR analysis identified three proteins (MICB, SPINK2, TXNDC11) that showed a strong association with decreased risk of LUSC after FDR correction. Increased levels of MICB [OR(95% CI) = 0.72(0.63, 0.83); <i>p</i> = 3.90E−06], SPINK2 [OR (95% CI) = 0.74 (0.66, 0.84); <i>p</i> = 1.25E−06], TXNDC11 [OR (95% CI) = 0.63(0.51, 0.78); <i>p</i> = 2.69E−05] per SD decreased the risk of LUSC specifically. Sensitivity analysis revealed that there was no significant heterogeneity, pleiotropy, or reverse causality between these proteins and LUSC. Colocalization analysis indicated that three proteins shared the same variants with LUSC. Survival analysis showed that upregulation of SPINK2 was associated with a favorable prognosis in LUSC patients, while MICB and TXNDC11 were not. The expression of MICB, SPINK2, TXNDC11 was found to be potentially affected by specific substances, and our molecular docking showed a stable binding between SPINK2 and danazol, suggesting its potential as a drug target.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified SPINK2 causally associated with the risk and prognosis of LUSC, which is a promising target for LUSC. The drug prediction we performed illustrated the medicinal potential of SPINK2, and the high binding activity of molecular docking indicated its strong potential as a drug target.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476292","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":"Safety and Efficacy of Nerandomilast in Patients With Pulmonary Fibrosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Humna Shahzad,&nbsp;Usama Afzaal,&nbsp;Fahad Saleem,&nbsp;Ahmad Hassan Gul,&nbsp;Freya Thummar,&nbsp;Hafiz Nadir Murtaza,&nbsp;Abel Gelan,&nbsp;Maria Ahsan,&nbsp;Rafay Irfan,&nbsp;Ahmad Nawaz,&nbsp;Uzair Jafar,&nbsp;Asma'a Munasar Ali Alsubari,&nbsp;Muhammad Ehsan,&nbsp;Ahmed Nadeem,&nbsp;Praveen Kumar Komminni,&nbsp;Juan Iribarren","doi":"10.1111/crj.70181","DOIUrl":"10.1111/crj.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Nerandomilast, an oral phosphodiesterase-4 (PDE4) inhibitor, has shown potential in slowing the progression of pulmonary fibrosis. This meta-analysis evaluated the efficacy and safety of nerandomilast in preserving lung function among patients with pulmonary fibrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MEDLINE, Embase, the Cochrane Library, and ClinicalTrials.gov were systematically searched for randomized controlled trials (RCTs) comparing nerandomilast with placebo. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool. Analyses were performed in RevMan 5.4 using random-effects models with risk ratios (RR) and mean differences (MD) as effect measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four RCTs (<i>n</i> = 2515) were included. Nerandomilast significantly attenuated the decline in forced vital capacity (FVC) compared with placebo (MD: 69.25 mL, 95% CI: 52.1–86.29), but did not improve diffusing capacity for carbon monoxide (DLCO) (MD: 0.84, 95% CI: −0.56 to 2.24). It was associated with a lower pooled risk of all-cause mortality (RR: 0.68, 95% CI: 0.52–0.88) without increasing adverse events (RR: 1.00, 95% CI: 0.98–1.02) or serious adverse events (RR: 0.93, 95% CI: 0.76–1.14).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nerandomilast appears to slow lung function decline in pulmonary fibrosis without added safety risks. Although a lower pooled risk of mortality was observed, individual trials were not powered for mortality outcomes, and event rates were low; therefore, this finding should be interpreted cautiously. Given the heterogeneity of pulmonary fibrosis phenotypes and trial designs, further large-scale RCTs should explore standardized outcomes, subgroup effects, and combination strategies with nintedanib or pirfenidone.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437702","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":"Small Airway Function as an Indicator for Persistent Airflow Limitation Asthma: A Retrospective Study","authors":"Zhongzhao Wang,&nbsp;Xintong Du,&nbsp;Yang Luo,&nbsp;Heng Gong,&nbsp;Hao Tang","doi":"10.1111/crj.70174","DOIUrl":"10.1111/crj.70174","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;Asthma is a heterogeneous disease characterized by chronic inflammatory changes in the airways and reversible airflow limitation. Persistent airflow limitation (PAL) asthma, as a common phenotype of asthma, is usually defined as forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio lower than 0.7 after bronchodilator in asthmatic patients. Recent research has indicated a correlation between PAL asthma and more frequent asthma exacerbations.&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;A total of 1322 asthma patients were retrospectively assessed, and finally, 441 asthma patients were included in the study. Among them, 217 patients were diagnosed with non-PAL asthma, and 224 patients were PAL asthma. The differences in basic information, clinical manifestations, lung function, and laboratory test indicators between the PAL asthma and non-PAL asthma groups were compared. A clinical prediction model for PAL asthma based on patient demographics was established using logistic regression analysis.&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;Comparing the demographic data of patients with PAL and non-PAL asthma, it was observed that PAL asthma was more common in elderly smoking males. Patients with PAL asthma had a higher severity of asthma, poorer control, and lower life quality compared to non-PAL asthma. In terms of lung function, patients with PAL asthma mainly exhibited obstructive ventilatory impairment, small airway dysfunction, diffusion dysfunction, and increased residual volume. Notably, after bronchodilators, patients with PAL asthma showed a significantly lower rate of improvement in small airway function compared with non-PAL asthma. Logistic regression analysis showed gender, smoking index, and Asthma Control Test (ACT) score were independent risk factors for PAL asthma. Linear regression analysis showed small airway function was closely associated with ACT score.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;PAL asthma was poorly controlled, leading to a diminished quality of life. The limited improvement in small airway function after bronchodilator in PAL asthma suggested that targeting small airway dysfunction may hold significant value in the treatment of PAL asthma.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;This retrospective study (441 asthma patients) found that PAL asthma is more common in elderly males, with smoking index and ACT score as its independent risk factors. PAL patients have poor small airway function and limited improvement after bronchodilators, suggesting targ","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373618","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":"Association Between Unsaturated Fatty Acid Levels and Chronic Obstructive Pulmonary Disease: A Bidirectional Mendelian Randomization Study","authors":"Shuai Jiang,&nbsp;Lili Lu,&nbsp;Xiaojun Wang,&nbsp;Xunxia Zhu,&nbsp;Xiaoyu Chen,&nbsp;Hung-Chen Chang,&nbsp;Xuchao Gu,&nbsp;Fuzhi Yang,&nbsp;Xuanqi Liu,&nbsp;Xuelin Zhang,&nbsp;Xiaoyong Shen","doi":"10.1111/crj.70179","DOIUrl":"10.1111/crj.70179","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Observational studies have revealed that the levels of unsaturated fatty acids (UFAs) may influence the development, progression, and management of chronic obstructive pulmonary disease (COPD). To investigate the association between UFAs and COPD, we performed a bidirectional Mendelian randomization (MR) study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We extracted summary genome-wide association statistics (GWAS) for UFAs (<i>N</i> = 115 082) among population from UK Biobank study by measuring circulating lipoprotein lipid concentrations. The genetic instrument for COPD was derived from the FinnGen, which included 338 303 COPD controls and 20 066 cases of the disease. Measured at the genome-wide significance level, independent genetic variations associated with each characteristic were considered instrumental factors. Two-sample MR analysis was mainly conducted utilizing the inverse-variance-weighted (IVW) approach, complemented by the weighted median method and the MR-Egger regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>IVW MR analysis significantly demonstrated that the level of docosahexaenoic acid (DHA) (OR 0.812, 95% CI 0.719–0.918, <i>p</i> &lt; 0.001), linoleic acid (LA) (OR 0.850, 95% CI 0.781–0.926, <i>p</i> &lt; 0.001), the levels of omega-3 fatty acids (OR 0.884, 95% CI 0.781–0.99, <i>p</i> = 0.049), omega-6 fatty acids (OR 0.878, 95% CI 0.812–0.950, <i>p</i> = 0.001), and polyunsaturated fatty acids (PUFAs) (OR 0.901, 95% CI 0.827–0.982, <i>p</i> = 0.018) all linked to a higher risk of COPD. Moreover, in reverse direction MR analysis, genetic liability to COPD showed associations with higher levels of monounsaturated fatty acids (MUFAs) (OR 1.040, 95% CI 1.010–1.071, <i>p</i> = 0.008). Horizontal pleiotropy is not likely to materially skew the causative estimates from sensitivity analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our research added credence to the current evidence that suggests a bidirectional causal link between UFAs and COPD. It is imperative to comprehend this connection in order to effectively prevent and manage COPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373630","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":"Asthma and Infertility: A Prospective Case–Control Study on Pregnancy and Live Birth Rates in Women With Asthma Undergoing Assisted Reproduction","authors":"Frida E. Lundberg,&nbsp;Amalie H. Sneckenborg,&nbsp;Hanna Nilsson,&nbsp;Kenny A. Rodriguez-Wallberg","doi":"10.1111/crj.70180","DOIUrl":"10.1111/crj.70180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have suggested a negative impact of asthma on fertility, and it has been hypothesized that the underlying inflammation is playing an important role. However, available data are scarce and mostly refer to women conceiving naturally. With this study, we wished to investigate whether asthma affects the outcomes of medically assisted reproduction or not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective cohort study of 809 women, with (<i>N</i> = 213) or without asthma (<i>N</i> = 596), undergoing fertility treatment between 2009 and 2019 at one academic-based reproductive medicine center. Treatment outcome measures included clinical pregnancy rate (CPR) and live birth rate (LBR) per stimulation cycle, per oocyte pickup, and per embryo transfer, among women undergoing in vitro fertilization treatment, and LBR among women treated by intrauterine insemination. Odds ratios and 95% confidence intervals were estimated using multivariable generalized estimating equation models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were found in CPR or LBR between women with asthma and women without asthma undergoing in vitro fertilization (<i>N</i> = 694) or intrauterine insemination (<i>N</i> = 45). In women with asthma, the adjusted odds ratio of clinical pregnancy per embryo transfer for all cycles was 0.91 (95% CI, 0.71–1.16), and the adjusted odds ratio of live birth per embryo transfer for all cycles was 0.90 (95% CI, 0.70–1.16). The adjusted odds ratio of live birth per performed intrauterine insemination was 1.42 (95% CI, 0.63–3.21) in women with asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Infertile women with asthma undergoing medically assisted reproductive treatment have a similar chance of achieving clinical pregnancy and live childbirth when compared to infertile women without asthma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367225","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":"Development and Validation of Prediction Models for Severe Obstructive Sleep Apnea Based on Periodic Health Examinations","authors":"Kyoka Kanno,&nbsp;Hiromasa Ogawa,&nbsp;Toshiya Irokawa,&nbsp;Shinya Ohkouchi,&nbsp;Masao Tabata,&nbsp;Natsuko Ohko,&nbsp;Hajime Kurosawa","doi":"10.1111/crj.70177","DOIUrl":"10.1111/crj.70177","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Obstructive sleep apnea (OSA) is not only associated with reduced work efficiency and an elevated risk of occupational accidents but also with hypertension, diabetes, and other lifestyle-related diseases, making it an important occupational health concern. Conventional questionnaire–based screening may fail to detect OSA because it frequently lacks subjective symptoms. Herein, we aimed to develop and validate a simple objective, questionnaire-independent prediction model for severe OSA using periodic health examination (PHE) data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD), we analyzed the data of 671 patients who underwent overnight polysomnography (PSG) at Tohoku University Hospital. Eight predictors—age group, sex, obesity, hypertension, diabetes mellitus, dyslipidemia, polycythemia, and liver dysfunction—derived from routine PHE items—were included in logistic regression models to predict severe OSA, defined as an apnea–hypopnea index (AHI) ≥ 30 or a 3% oxygen desaturation index (ODI) ≥ 30. Internal validity was assessed using bootstrap samples. External validation was performed using overnight percutaneous oxygen saturation data of 100 university employees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The areas under the receiver operating characteristic curve were 0.67 and 0.72 for the AHI- and ODI-based models, respectively. The internal validity was generally acceptable. In external validation, the AHI model had a sensitivity and specificity of 1.00 and 0.95, respectively, while the ODI model exhibited values of 0.50 and 0.97, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We developed and validated two predictive models for severe OSA using the PHE data. These models could be used for screening by occupational physicians and clinicians.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367241","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":"Surgical Management of Congenital Lung Malformations in Children—A Single-Center Analysis of 25 Years of Experience","authors":"Patrycja Sosnowska-Sienkiewicz,&nbsp;Alicja Kamińska,&nbsp;Przemysław Mańkowski,&nbsp;Irena Wojsyk-Banaszak,&nbsp;Danuta Januszkiewicz-Lewandowska","doi":"10.1111/crj.70178","DOIUrl":"10.1111/crj.70178","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Congenital lung malformations (CLMs) in pediatric patients encompass various structural abnormalities arising during fetal development, which can range from benign to life-threatening. The most common types include congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim of the Study&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aimed to retrospectively analyze patients treated surgically for CLMs, focusing on indications for surgery, surgical techniques, and outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Data were collected from the medical records of patients who underwent thoracoscopy (&lt;i&gt;n&lt;/i&gt; = 140) or thoracotomy (&lt;i&gt;n&lt;/i&gt; = 52) between 2000 and 2024. Among these, 50 patients were diagnosed with CLMs, who were taken for further analysis. Study group inclusion criteria were performing a CT/X-ray imaging examination indicating the presence of a defect, surgery, and available pathology results. Exclusion criteria were incomplete data or lack of surgical procedure. Final study group included 37 patients who met inclusion criteria for further analysis. Detailed analysis encompassed demographics, clinical presentation, diagnostic methods, treatment, and follow-up.&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;The cohort included patients diagnosed with CPAM type I (&lt;i&gt;n&lt;/i&gt; = 12), CPAM type II (&lt;i&gt;n&lt;/i&gt; = 7), pulmonary sequestration (&lt;i&gt;n&lt;/i&gt; = 10), and other congenital malformations such as bronchogenic cyst (&lt;i&gt;n&lt;/i&gt; = 2), congenital cystic pulmonary disease (&lt;i&gt;n&lt;/i&gt; = 2), CPAM type IV—pleuropulmonary blastoma type I (PPB) (&lt;i&gt;n&lt;/i&gt; = 1), juvenile emphysema (&lt;i&gt;n&lt;/i&gt; = 2), and mediastinal cyst (&lt;i&gt;n&lt;/i&gt; = 1). The average age at diagnosis was 37.61 months. The cohort consisted of 17 females and 20 males. The right lung was involved in 41.18% of cases, and the left lung in 58.82%. Symptoms at presentation included pneumonia (&lt;i&gt;n&lt;/i&gt; = 9), respiratory failure (&lt;i&gt;n&lt;/i&gt; = 8), emphysema (&lt;i&gt;n&lt;/i&gt; = 3), and pneumothorax (&lt;i&gt;n&lt;/i&gt; = 2). Fifteen patients were asymptomatic, and the diagnosis was incidental. Seven patients had other congenital diseases, such as heart defects. None of the patients other than the child with PPB were offered genetic diagnostics, albeit for DICER1 or KRAS mutations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study underscores the heterogeneity in age and clinical presentation at the time of CLM diagnosis, highli","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277575","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":"Novel Type IV Monitoring Device With Advanced Oximetry Indicators Offers Accurate Diagnosis of Obstructive Sleep Apnea in Adults","authors":"Xu Wu,&nbsp;Hailiang Qin,&nbsp;Huai Huang,&nbsp;Jing Jiang,&nbsp;Xiaodan Wu,&nbsp;Zilong Liu,&nbsp;Min Li,&nbsp;Shanqun Li","doi":"10.1111/crj.70176","DOIUrl":"10.1111/crj.70176","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Type IV sleep monitors offer a low-burden option for obstructive sleep apnea (OSA) screening, yet their accuracy is often limited by motion artifacts and variability in signal-processing methods. The PM50-B is a wrist-worn Type IV device that combines high-sampling-rate (200 Hz) photoplethysmography (PPG)-based oximetry with wrist actigraphy to reduce motion artifacts and employs an adaptive SpO₂ waveform-based desaturation detection algorithm. This study aimed to validate the diagnostic performance of the PM50-B against reference sleep studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective observational study, adults with suspected OSA underwent simultaneous overnight recording with the PM50-B and a reference test: in-laboratory polysomnography (Type I), unattended polysomnography (Type II), or Type III home sleep apnea testing (HSAT). Oximetry and actigraphy signals were processed using a standardized workflow incorporating motion-artifact attenuation, signal stabilization, and sleep–wake estimation. From the SpO₂ signal, hypoxemia metrics were derived, including the oxygen desaturation index ODI2.5_5 (≥ 2.5% desaturation lasting ≥ 5 s/h of total sleep time), cumulative time with SpO₂ &lt; 90% and &lt; 95% (CT90, CT95), and lowest SpO₂. Agreement with the reference apnea–hypopnea index (AHI) was assessed using intraclass correlation coefficients, and diagnostic accuracy was evaluated at clinically relevant AHI thresholds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 475 participants were analysed (Type I, <i>n</i> = 37; Type II, <i>n</i> = 32; Type III, <i>n</i> = 406). ODI2.5_5 showed moderate-to-good agreement with AHI (ICC = 0.710) and good discrimination for moderate-to-severe OSA (AHI ≥ 15 events/h), with an under the curve (AUC) of 0.925 (sensitivity 81.20%, specificity 91.00%). Diagnostic performance was consistent across reference modalities (AUC range, 0.928–0.983).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The PM50-B provides clinically acceptable accuracy for OSA screening when combined with a standardized signal-processing approach, particularly in comparison with Type III HSAT. ODI2.5_5 emerged as the strongest diagnostic metric, while CT90, CT95, and lowest SpO₂ provided complementary characterization of nocturnal hypoxemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215128","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}