Advances in respiratory medicine最新文献

{"title":"Biomechanical Phenotyping of Forced Expiration for Precision Pulmonary Rehabilitation: A Machine Learning Approach to Identify Structural and Kinetic Drivers.","authors":"Noppharath Sangkarit, Weerasak Tapanya","doi":"10.3390/arm94020026","DOIUrl":"https://doi.org/10.3390/arm94020026","url":null,"abstract":"<p><strong>Background: </strong>Standard spirometry fundamentally overlooks the mechanical dynamics of forced expiration. This study derived novel biomechanical parameters to establish functional phenotypes and predict clinical respiratory impairments.</p><p><strong>Methods: </strong>Utilizing 16,596 acceptable spirometry records from NHANES (2007 to 2012), parameters reflecting kinetic power, mass constraint, and airway instability were mathematically derived. Principal component analysis, K-means clustering, and a Multilayer Perceptron neural network were sequentially applied.</p><p><strong>Results: </strong>Three distinct biomechanical phenotypes emerged: Load-Constrained (45.4%), Mechanically Efficient (23.5%), and Dynamic Collapse (31.0%). Aging significantly degraded kinetic power, demonstrating a steeper functional decline in males (<i>p</i> < 0.001). The neural network achieved 93.2% testing accuracy in classifying spirometric abnormalities. Crucially, Dynamic Airway Collapse Ratio (100% normalized importance), BMI (89.4%), and kinetic power (86.2%) fundamentally outperformed traditional demographic predictors such as chronological age (20.4%) and biological sex (7.1%).</p><p><strong>Conclusions: </strong>Structural and dynamic kinetic factors drive pulmonary dysfunction far more accurately than conventional demographics. Classifying these mechanical phenotypes facilitates highly targeted precision cardiopulmonary rehabilitation.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Exercise-Based Pulmonary Rehabilitation in Patients with Long COVID: A Systematic Review and Meta-Analysis.","authors":"Janne Marques Silveira, Ana Paula Midori Nakaishi, Marcos Gontijo da Silva, Daniele Oliveira Dos Santos, Ada Clarice Gastaldi","doi":"10.3390/arm94020025","DOIUrl":"https://doi.org/10.3390/arm94020025","url":null,"abstract":"<p><p><b>Background/Objective</b>: A substantial proportion of infected individuals develop persistent symptoms after the acute phase of COVID-19, regardless of initial disease severity. Long COVID (LC) remains a public health challenge characterized by impaired functional exercise capacity (FEC) and quality of life (QoL). We systematically synthesized evidence on the effects of in-person outpatient pulmonary rehabilitation (OPR) with individualized and supervised exercise in adults with LC. <b>Methods</b>: Following PROSPERO (CRD42023389365), this study reviewed randomized controlled trials (RCTs) and observational cohort studies (OCSs) published between November 2019 and January 2026 in MEDLINE/PubMed, Web of Science, PEDro, and EMBASE. <b>Results</b>: Fifteen studies (<i>n</i> = 803) were included. OPR improved FEC (6MWT; MD: 53.72 m, 95% CI 43.69-63.75) and 30″SST (MD: 4.68, 95% CI 3.59-5.77) and reduced exertional dyspnea. RCTs showed benefits in physical (MD: 8.04, 95% CI 3.02-13.05) and mental QoL (MD: 6.60, 95% CI 2.01-11.18) and dyspnea impact, with inconsistent PF findings. Fatigue showed a trend toward improvement but was measured using heterogeneous patient-reported tools in RCTs and OCSs. <b>Conclusions</b>: Supervised PR improves FEC, QoL, and dyspnea in individuals with LC. In patients with fatigue/PEM, systematic assessment and continuous symptom monitoring are essential. High-quality controlled studies are needed to strengthen evidence and clinical guide.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Serum Transthyretin and Sarcopenia on 3-Year Mortality and Respiratory-Related Hospitalizations in Idiopathic Pulmonary Fibrosis: A Prospective Cohort Study.","authors":"Akihito Okada, Akiko Nakano, Kohei Fujita, Yoshitsugu Inoue, Toshiyasu Ito, Fumitaka Hashiba, Masashi Fujikawa, Tatsuya Tanaka, Aya Mukai, Keima Ito, Yuta Mori, Kensuke Fukumitsu, Satoshi Fukuda, Yoshihiro Kanemitsu, Tomoko Tajiri, Tetsuya Oguri, Yoshiyuki Ozawa, Takayuki Murase, Hirotsugu Ohkubo","doi":"10.3390/arm94020024","DOIUrl":"https://doi.org/10.3390/arm94020024","url":null,"abstract":"<p><strong>Background: </strong>Prognostic markers reflecting nutritional vulnerability in idiopathic pulmonary fibrosis (IPF) remain poorly defined.</p><p><strong>Methods: </strong>In this prospective cohort study, 63 stable outpatients with IPF were followed for 3 years. Sarcopenia was defined according to the 2019 Asian Working Group for Sarcopenia criteria. Serum transthyretin levels were measured concurrently. Cox proportional hazards regression, binary logistic regression, and Kaplan-Meier survival analyses were performed.</p><p><strong>Results: </strong>During follow-up, 18 patients (29%) died and 21 (33%) experienced respiratory-related hospitalization. Serum transthyretin was an independent predictor of both 3-year mortality and respiratory-related hospitalization, even after adjusting for the Gender-Age-Physiology index. Conversely, sarcopenia and low appendicular skeletal muscle mass index (ASMI) were not independently associated with either outcome. Kaplan-Meier analysis demonstrated significant differences in both mortality and hospitalization according to serum transthyretin levels. Low ASMI evaluated using sex-specific cutoffs was associated with higher mortality in the unadjusted analysis, but not with hospitalization; sarcopenia was not significantly associated with either endpoint.</p><p><strong>Conclusions: </strong>Serum transthyretin may serve as a practical biomarker of nutritional vulnerability, providing complementary prognostic information beyond muscle mass-based assessment in IPF.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke-Associated Pneumonia and Impaired Functional Recovery After Stroke: The Role of Nutritional-Inflammatory Factors.","authors":"Rongjian Feng, Chonggui Jiang, Yan Yang, Mao Su, Meng Qin, Quan Wei","doi":"10.3390/arm94020023","DOIUrl":"https://doi.org/10.3390/arm94020023","url":null,"abstract":"<p><strong>Background: </strong>Stroke-associated pneumonia (SAP) is a common complication after acute ischemic stroke and contributes to worse recovery and greater resource use. Nutritional and inflammatory dysregulation have been implicated in both SAP susceptibility and adverse prognosis.</p><p><strong>Objective: </strong>To examine whether admission inflammatory and nutritional markers are associated with the development of SAP and with short-term functional prognosis.</p><p><strong>Methods: </strong>We performed a retrospective single-centre cohort study of consecutive patients with acute ischemic stroke admitted between 1 January 2015 and 31 December 2024 (N=303;SAPn=108,non-SAPn=195). Admission laboratory indices (albumin, CRP, fibrinogen, WBC, PCT, and prealbumin) in the first 24 h and clinical variables were analysed. Multivariable logistic regression identified factors independently associated with SAP; the relationship between SAP and early functional recovery was assessed in adjusted outcome models. A nomogram integrating key predictors was developed and its apparent discrimination is reported.</p><p><strong>Results: </strong>SAP occurred in 35.6% of patients. Factors independently associated with SAP included nasogastric tube placement (OR: 7.02, 95% CI: 3.50-14.62), venous thromboembolism (OR: 3.20, 95% CI: 1.62-6.31), cognitive impairment (OR: 2.90, 95% CI: 1.32-6.36), and elevated inflammatory markers (WBC OR: 1.52, 95% CI: 1.28-1.80; fibrinogen OR: 1.37, 95% CI: 1.02-1.84; CRP OR: 1.01, 95% CI: 1.00-1.03). Higher admission serum albumin was associated with lower odds of SAP (OR: 0.92, 95% CI: 0.86-0.98). The nomogram showed strong apparent discrimination (AUC: 0.90, 95% CI: 0.86-0.94). After multivariable adjustment, SAP remained associated with poorer short-term functional improvement (adjusted OR: 6.99, 95% CI: 3.05-17.54) and greater healthcare utilization (median length of stay: 39.6 vs. 30.6 days; median cost: USD 12,836 vs. 6585).</p><p><strong>Conclusion: </strong>In this retrospective cohort, admission markers of nutritional depletion and inflammatory activation were associated not only with increased likelihood of SAP, but also with adverse early functional outcomes. These association-based findings support early risk stratification using routine admission markers; prospective studies and external validation are required before clinical implementation.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Pharmacological Pulmonary Rehabilitation in Patients with Pneumoconiosis: A Systematic Review.","authors":"Madina B Baurzhan, Sayagul A Kairgeldina, Venera M Almatova, Alexandr E Gulyayev, Raushan S Dosmagambetova, Kanat K Tekebayev, Karashash Absatarova, Karlygash S Absattarova","doi":"10.3390/arm94020022","DOIUrl":"https://doi.org/10.3390/arm94020022","url":null,"abstract":"<p><strong>Background: </strong>Pneumoconiosis remains a major occupational lung disease associated with progressive respiratory impairment, reduced functional capacity, and diminished quality of life. Non-pharmacological rehabilitation has been increasingly proposed as a supportive intervention; however, evidence regarding its effectiveness remains heterogeneous.</p><p><strong>Objective: </strong>This study aimed to systematically review and synthesize the available evidence on the effects of non-pharmacological rehabilitation interventions on functional capacity, quality of life, and psychological outcomes in patients with pneumoconiosis.</p><p><strong>Methods: </strong>A systematic literature search was conducted in major electronic databases and grey literature sources in accordance with PRISMA 2020 guidelines. Studies evaluating non-pharmacological rehabilitation interventions in adults with pneumoconiosis were eligible for inclusion. Outcomes of interest included functional capacity, health-related quality of life, and psychological well-being. Due to methodological heterogeneity across studies, a qualitative synthesis was performed.</p><p><strong>Results: </strong>Six studies met the predefined inclusion criteria and were included in the qualitative synthesis. The reviewed evidence suggests that structured rehabilitation interventions were associated with clinically meaningful improvements in functional capacity, particularly in structured rehabilitation programs, most consistently reflected by increases in six-minute walk distance exceeding established minimal clinically important differences in three studies. Improvements in health-related quality of life and selected psychological outcomes were also reported, although outcome measures and intervention protocols varied across studies. Significant improvements in exercise capacity, dyspnea severity, and health-related quality of life were reported.</p><p><strong>Conclusions: </strong>Non-pharmacological rehabilitation may provide clinically meaningful benefits for patients with pneumoconiosis, based on limited and heterogeneous evidence, particularly in terms of functional capacity and quality of life. Nevertheless, the current evidence base is limited by heterogeneity in study design and outcome reporting. Further high-quality, standardized trials are needed to strengthen the evidence and guide the clinical implementation of rehabilitation programs for occupational lung diseases.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Flow Nasal Cannula in Patients Awaiting Lung Transplant: Evidence, Clinical Applications, and Outcomes.","authors":"Salah M Zeineldine, Rami Hallak, Antonio Esquinas, Mohamad F El-Khatib","doi":"10.3390/arm94020021","DOIUrl":"https://doi.org/10.3390/arm94020021","url":null,"abstract":"<p><p>Patients with end-stage lung diseases awaiting lung transplant frequently experience severe hypoxemia, dyspnea, and functional limitations that may compromise survival and transplant eligibility. Optimizing noninvasive respiratory support during the waiting period is crucial to preserve oxygenation, maintain physical conditioning, and avoid escalation to invasive mechanical ventilation, which is associated with poorer transplant outcomes. High-flow nasal cannula therapy has emerged as an important noninvasive respiratory support modality capable of providing physiological and clinical benefits such as precise fractions of inspired oxygen, a low level of positive end-expiratory pressure, dead-space washout, and reduced work of breathing. This review summarizes the pathophysiology of hypoxemia in lung transplant candidates, the mechanisms of action of high-flow nasal cannulas, and the current clinical evidence supporting its use in this population during the pre-transplant period. Available evidence suggests that the use of high-flow nasal cannulas improves oxygenation, relieves dyspnea, enhances exercise tolerance, facilitates participation in pulmonary rehabilitation programs, and may reduce the need for endotracheal intubation, thereby improving the likelihood of survival to transplantation. The review also discusses patient selection, the practical implementation of high-flow nasal cannula therapy, and comparisons with other respiratory support modalities. Although the current evidence is largely observational and heterogenous, high flow appears to be a valuable supportive and bridging therapy for selected patients awaiting lung transplant. Future prospective studies are needed to define standardized protocols and evaluate transplant-specific outcomes.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like Peptide-1 Receptor Agonist Therapy and Risk of Pulmonary and Systemic Infections in Diabetic Gastroparesis: A Propensity-Matched Cohort Study.","authors":"Muhammad Ali Ibrahim Kazi, Hasan Kamal, Syed Musa Mufarrih, Imran Qureshi, Sanmeet Singh, Adrien Mazer","doi":"10.3390/arm94020020","DOIUrl":"https://doi.org/10.3390/arm94020020","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic gastroparesis increases the risk of aspiration, pneumonia, and sepsis, yet the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on these outcomes is uncertain because of their gastric-emptying effects.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the TriNetX Global Research Network. Adults (≥18 years) with diabetes mellitus and gastroparesis were identified and divided into two cohorts based on GLP-1 RA exposure. Propensity score matching (1:1) balanced demographics, comorbidities, and antidiabetic medications, yielding 23,371 patients per cohort. Outcomes, assessed from 180 days after index, included pneumonia, pneumonitis, mechanical ventilation, ventilator-associated pneumonia, sepsis, bacteremia, empyema, lung abscess, acute respiratory distress syndrome (ARDS), and need for enteral feeding. Risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated.</p><p><strong>Results: </strong>Compared with GLP-1 users, non-GLP-1 patients had higher incidences of pneumonitis (3.6% vs. 2.5%; HR 1.76, 95% CI 1.58-1.95), pneumonia (13.2% vs. 12.2%; HR 1.34, 95% CI 1.27-1.41), mechanical ventilation (4.4% vs. 3.3%; HR 1.63, 95% CI 1.49-1.79), sepsis (12.8% vs. 11.1%; HR 1.44, 95% CI 1.37-1.52), and bacteremia (5.2% vs. 4.4%; HR 1.46, 95% CI 1.35-1.59) (all <i>p</i> < 0.001). Empyema and ARDS were also numerically lower among GLP-1 users, while ventilator-associated pneumonia and lung abscess were rare and similar between groups. No patients required percutaneous endoscopic gastrostomy or nasal enteral feeding.</p><p><strong>Conclusions: </strong>In patients with diabetes and gastroparesis, GLP-1 RA therapy was associated with significantly fewer pulmonary and systemic infectious complications. These data suggest that the systemic benefits of GLP-1 RAs may outweigh concerns regarding delayed gastric emptying in this high-risk population.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Factors Associated with Sarcoidosis in Patients Referred for EBUS-TBNA Due to Mediastinal Lymphadenopathy.","authors":"Paweł Zając, Monika Zając, Wojciech Kądziołka, Andrzej Sokołowski, Ewa Kaznowska","doi":"10.3390/arm94020019","DOIUrl":"10.3390/arm94020019","url":null,"abstract":"<p><p>Sarcoidosis is a multisystem granulomatous disease of unknown aetiology that frequently presents with mediastinal lymphadenopathy and often requires invasive diagnostic procedures. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is widely used in this setting; however, a definitive diagnosis cannot always be established at first attempt. This study aimed to identify clinical, laboratory, and radiological factors associated with a definitive diagnosis of sarcoidosis in patients referred for EBUS-TBNA. A retrospective analysis was performed including patients undergoing first-time ever EBUS-TBNA for mediastinal lymphadenopathy over a 12-month period. Demographic data, clinical features suggestive of sarcoidosis, chest computed tomography findings, and white blood cell count, were analysed, and definitive diagnoses were established based on cytological results and available follow-up data. Younger age (≤55 years), female sex, the absence of a pulmonary mass >10 mm on imaging, normal white blood cell count, and the presence of clinical features typical of sarcoidosis were significantly associated with a definitive diagnosis of sarcoidosis. Based on these variables, two point-based diagnostic scoring models were developed, demonstrating clinically relevant discriminatory performance. Readily available pre-procedural clinical and radiological factors may assist in estimating the probability of sarcoidosis in patients undergoing EBUS-TBNA for mediastinal lymphadenopathy and may support risk stratification and clinical decision-making.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clues to Long COVID Linked to Virulence and Infectivity Found in Shell Proteins.","authors":"Gerard Kian-Meng Goh, James A Foster, Vladimir N Uversky","doi":"10.3390/arm94020018","DOIUrl":"10.3390/arm94020018","url":null,"abstract":"<p><p>Clinical, experimental, and computational evidence of COVID-19 virulence and infectivity has been linked to SARS-CoV-2 shell disorder. A strong link was first discovered using an AI disorder-predicting tool, which detected an unusually hard (low disorder) outer shell among all SARS-CoV-2-related viruses but not in the 2003 SARS-CoV-1. This could account for the high infectivity found in SARS-CoV-2-but not in SARS-CoV-1-as it is believed that hard shells protect viral particles from the onslaught of the antimicrobial enzymes present in the respiratory system and saliva. As a result, much larger quantities of particles are shed by COVID-19 patients. Abnormally hard outer shells (M) are associated with burrowing animals, e.g., pangolins, and SARS-CoV-2 likely acquired these shells due to its long-term evolutionary interactions with pangolins. As for virulence, the inner shell of SARS-CoV-2 (N) has been found to exhibit lower disorder than that of SARS-CoV-1. This lower disorder is consistent with the fact that SARS-CoV-2 is less virulent than SARS-CoV-1, as higher disorder in the inner shell is associated with more efficient protein-protein binding during replication. The link between N/M disorder and virulence or infectivity falls under the umbrella of shell disorder models (SDMs), which can connect virulence, infectivity, and long COVID under one coherent concept. Evidence of the reliability and reproducibility of SDMs as applied to COVID-19 is examined. The hard M that is resisting the antimicrobial enzymes in the respiratory system can be extended to immunological enzymes, especially those found in phagocytes such as macrophages, which can therefore become a reservoir for the virus.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Performing Spirometry During Pregnancy: A Systematic Review.","authors":"Zofia Potocka, Katarzyna Górska, Radosław Ciesielski, Dorota Bomba-Opoń, Mirosław Wielgoś, Piotr Korczyński","doi":"10.3390/arm94020017","DOIUrl":"10.3390/arm94020017","url":null,"abstract":"<p><p><b>Introduction</b>: It is estimated that up to 75% of pregnant women complain of dyspnea at some point during pregnancy. Asthma is the most common chronic pulmonary disease complicating pregnancy. Well controlled asthma does not affect pregnancy negatively. However, asthma exacerbations are linked with several adverse perinatal outcomes. As diligent treatment of asthma significantly reduces the number of asthma exacerbations, it is important to properly detect asthmatic patients among pregnant women in order to provide them with better care. The most efficient way to diagnose asthma is to perform spirometry with a reversibility test. There are no studies that have examined the safety of performing spirometry and, more specifically, a reversibility test, during pregnancy. <b>Objectives</b>: In this systematic review we aimed to review current available data regarding the safety of performing spirometry and a reversibility test during pregnancy. <b>Patients and methods</b>: For this systematic review, we searched PubMed, Scopus and Cochrane databases. We used the following search terms: (pregnancy); (spirometry); (lung function test); (pulmonary function test); (reversibility test); (post-bronchodilator challenge); (safety). <b>Results</b>: We collected reports of spirometry performed on pregnant women and analyzed them for complications that occurred during the procedure. Out of 13,594 records identified for the aforementioned search words, we included 78 documents that met the inclusion criteria. In total, the studies consisted of over 33,405 spirometry attempts performed by 10,617 pregnant women. Additionally, the reversibility test was conducted in nine studies. In all of the selected articles, there were no reports of adverse events occurring while performing spirometry. <b>Conclusions</b>: In this systematic review we aimed to summarize the current available data about the safety of performing spirometry during pregnancy. Several studies have investigated pulmonary function tests during pregnancy. No studies reported any adverse events that occurred while performing the procedure. In order to better characterize the safety profile of spirometry, including during pregnancy, further prospective studies systematically reporting on adverse symptoms during spirometry are required.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"94 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}