Advances in respiratory medicine最新文献

{"title":"FeNO 350 mL/s: Unlocking the Small Airways to Achieve Clinical Remission in Severe Asthma-A Pilot Study.","authors":"Vitaliano Nicola Quaranta, Andrea Portacci, Leonardo Maselli, Marta Tornesello, Maria Granito, Gennaro Rociola, Silvano Dragonieri, Giovanna Elisiana Carpagnano","doi":"10.3390/arm93050037","DOIUrl":"10.3390/arm93050037","url":null,"abstract":"<p><p><b>Background:</b> Several studies focused on the importance of managing small airways disease in the treatment of severe asthma, whose improvement can improve respiratory symptoms, lung function, and airways inflammation, potentially reaching the objective of clinical remission. <b>Methods:</b> Twenty-five patients with severe asthma and without bronchiectasis were enrolled. They were started on biological therapies with Omalizumab, Dupilumab, Benralizumab or Mepolizumab. Follow-up evaluations were conducted at baseline (T0) and after one year of biological therapy (T1). Assessments included clinical evaluations, spirometry, questionnaires, and inflammatory markers. <b>Results:</b> Predictive analysis identified baseline FeNO 350 mL/s levels as a significant predictor of clinical remission in both univariable and multivariable analysis. Higher FeNO 350 mL/s levels at T0 were associated with an increased likelihood of achieving remission (<i>p</i> = 0.012). The optimal cutoff value for FeNO 350 mL/s was determined to be 18 ppb, based on the Younden Index. <b>Conclusions:</b> Following patients with severe asthma on biological therapy for one year, FeNO 350 mL/s could be used as a predictive factor of clinical remission, highlighting its importance as inflammatory marker not only in small airways disease, but also in predicting clinical remission in severe asthmatic patients.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111649","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":"Detecting Airway Involvement in Non-Asthmatic Eosinophilic Disorders: Diagnostic Utility of Fractional Exhaled Nitric Oxide (FeNO).","authors":"Nicolas Raoul, Lucie Laurent, Ophélie Ritter, Pauline Roux-Claudé, Faraj Al Freijat, Nadine Magy-Bertrand, Virginie Westeel, Cindy Barnig","doi":"10.3390/arm93050036","DOIUrl":"10.3390/arm93050036","url":null,"abstract":"<p><p>Airway involvement in eosinophilic disorders other than asthma is not well-defined, and the symptoms may be overshadowed by other more prominent eosinophilic extra-respiratory manifestations. This study aimed to evaluate the utility of fractional exhaled nitric oxide (FeNO) in diagnosing eosinophilic airway involvement in patients with persistent eosinophilia (>0.5 × 10⁹/L). We conducted a retrospective analysis of adult patients with confirmed peripheral blood eosinophilia (>0.5 × 10⁹/L) on at least two occasions one month apart. Patients with blood eosinophilia associated with known eosinophilic airway inflammatory diseases were excluded from the study. Pulmonary function testing, spirometry, and FeNO measurement were conducted. A total of 14 patients with various eosinophil-related disorders were identified, with a mean age of 65.7 years. Increased FeNO levels were associated with airflow obstruction and clinical symptoms such as coughing and wheezing. Notably, eosinophil levels were not predictive of eosinophilic airway involvement. FeNO could be a useful diagnostic tool for detecting bronchial eosinophilic airway inflammation in non-asthmatic disorders, thereby enabling appropriate treatment. Further studies with larger cohorts are needed to validate these findings.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111689","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":"Bronchial Artery Embolisation in Haemoptysis Management: A Scoping Review with Emphasis on Embolic Materials and Indications.","authors":"Anna Ziętarska, Adam Dobek, Anna Sawina, Piotr Białek, Sebastian Majewski, Ludomir Stefańczyk","doi":"10.3390/arm93050035","DOIUrl":"10.3390/arm93050035","url":null,"abstract":"<p><p>Haemoptysis is an alarming symptom of a wide spectrum of underlying diseases, ranging from indolent chronic conditions to life-threatening states. Among the strategies to manage pulmonary bleeding is bronchial artery embolisation (BAE), an interventional radiology procedure. The objective of this scoping review was to map the current evidence on embolic agents used in BAE for haemoptysis management, with a focus on their clinical applications, and decision-making factors. Studies published between 2019 and 2024 were included if they specified the embolic material used and reported outcomes of BAE in adult patients. Data were extracted from PubMed and charted according to embolic agent type, recurrence rate, and clinical context. Thirty-one studies met the eligibility criteria. Polyvinyl alcohol (PVA) remains the most widely studied agent, comparable in efficacy to more homogeneous microspheres. Gelatin sponges (GS), though biodegradable, are well-documented and affordable, making them a common choice. N-butyl-2-cyanoacrylate (NBCA) is highly effective for small vessels and may offer lower recurrence rates. Coils are valuable in proximal embolisation and severe cases. This review highlights the need for individualised embolisation strategies and updated guidelines for material selection, considering clinical context, vascular anatomy, and recurrence rates. The findings aim to support evidence-based decision-making in interventional radiology practice.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111646","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":"The Safety and Performance of a Novel Extracorporeal Membrane Oxygenation Device in a Long-Term Ovine Model.","authors":"Yongchao Li, Lei Cai, Jia Huang, Hongbin Gao, Zhongqiang Huang, Yalun Guan, Yunfeng Li, Shuhua Liu, Shi Liang, Summer Xiatian Li, Hongzhou Lu, Ge Li, Yijiang Li, Yu Zhang","doi":"10.3390/arm93050034","DOIUrl":"10.3390/arm93050034","url":null,"abstract":"<p><p>Since extracorporeal membrane oxygenation (ECMO) is primarily used for patients in a high-risk state and is an invasive procedure, its unique application scenarios make it difficult to recruit suitable cases for clinical trials. Therefore, large animal models have become one of the most important models for preclinical evaluation of the safety and effectiveness of ECMO. This study aims to assess the safety and performance of a novel portable ECMO device with Small-tail Han sheep. Fifteen sheep were divided into a test group (LIFEMOTION, Chinabridge, Shenzhen, China) and control group (NOVALUNG XLUNG kit 230, Xonis, Heilbronn, Germany) with veno-venous ECMO (VV-ECMO) and veno-arterial ECMO (VA-ECMO) modes. Tracheal intubation, arteriovenous access, and ECMO support were performed. Vital signs and blood laboratory tests of the subjects were monitored and recorded. The main organs were examined pathologically at the end of day fourteen. The serum protein expression profile was analyzed by protein quantification techniques. All sheep were successfully weaned from ECMO without transfusion or cannula complications. No significant differences were observed between the two groups in terms of vital signs, oxygenation, hemodynamic stability, and physiological function (<i>p</i> > 0.05). According to the serum protein expression profile, no significant biomarkers associated with ECMO clinical complications were identified. The LIFEMOTION ECMO device demonstrated good safety and efficacy.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111706","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":"Test-Retest Reliability and Minimal Detectable Change of the 6-Minute Step Test and 1-Minute Sit-to-Stand Test in Post-COVID-19 Patients.","authors":"Patchareeya Amput, Weerasak Tapanya, Sirima Wongphon, Krittin Naravejsakul, Thanakorn Sritiyot","doi":"10.3390/arm93050033","DOIUrl":"10.3390/arm93050033","url":null,"abstract":"<p><strong>Background: </strong>This study aims to determine test-retest reliability and to calculate minimal detectable change (MDC) scores for the functional capacity of the 6-minute step test (6MST) and 1 min sit-to-stand test (1-min-STST), and compare these outcomes with the 6-minute walk test (6MWT) in post-COVID-19 patients.</p><p><strong>Methods: </strong>A total of 42 post-COVID-19 patients aged 18 years or older were recruited for this study. The post-COVID-19 patients were investigated for cardiovascular response parameters induced by a 6MWT, 6MST, and 1-min-STST on two different days, with a five-day interval between the first and second days.</p><p><strong>Results: </strong>The test-retest reliability obtained between the initial measurement and the measurement recorded five days later in the post-COVID-19 patients was excellent for all three of the 6MWT, 6MST, and 1-min-STST. The ICC of the 6MWT was 0.97 with MDC95 at 5.57%. The ICC of the 6MST was 0.93 with MDC95 at 12.21%, while, the ICC of the 1-min-STST was 0.96 with MDC95 at 3.61%.</p><p><strong>Conclusions: </strong>The 6MST and 1-min-STST were valid and acceptable for the evaluation of functional capacity in post- COVID-19 patients and can be used to investigate whether each post-COVID-19 patient had made significant improvement in a clinical setting.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111670","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":"Machine Learning-Driven Lung Sound Analysis: Novel Methodology for Asthma Diagnosis.","authors":"Ihsan Topaloglu, Gulfem Ozduygu, Cagri Atasoy, Guntug Batıhan, Damla Serce, Gulsah Inanc, Mutlu Onur Güçsav, Arif Metehan Yıldız, Turker Tuncer, Sengul Dogan, Prabal Datta Barua","doi":"10.3390/arm93050032","DOIUrl":"10.3390/arm93050032","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma is a chronic airway inflammatory disease characterized by variable airflow limitation and intermittent symptoms. In well-controlled asthma, auscultation and spirometry often appear normal, making diagnosis challenging. Moreover, bronchial provocation tests carry a risk of inducing acute bronchoconstriction. This study aimed to develop a non-invasive, objective, and reproducible diagnostic method using machine learning-based lung sound analysis for the early detection of asthma, even during stable periods.</p><p><strong>Methods: </strong>We designed a machine learning algorithm to classify controlled asthma patients and healthy individuals using respiratory sounds recorded with a digital stethoscope. We enrolled 120 participants (60 asthmatic, 60 healthy). Controlled asthma was defined according to Global Initiative for Asthma (GINA) criteria and was supported by normal spirometry, no pathological auscultation findings, and no exacerbations in the past three months. A total of 3600 respiratory sound segments (each 3 s long) were obtained by dividing 90 s recordings from 120 participants (60 asthmatic, 60 healthy) into non-overlapping clips. The samples were analyzed using Mel-Frequency Cepstral Coefficients (MFCCs) and Tunable Q-Factor Wavelet Transform (TQWT). Significant features selected with ReliefF were used to train Quadratic Support Vector Machine (SVM) and Narrow Neural Network (NNN) models.</p><p><strong>Results: </strong>In 120 participants, pulmonary function test (PFT) results in the asthma group showed lower FEV1 (86.9 ± 5.7%) and FEV1/FVC ratios (86.1 ± 8.8%) compared to controls, but remained within normal ranges. Quadratic SVM achieved 99.86% accuracy, correctly classifying 99.44% of controls and 99.89% of asthma cases. Narrow Neural Network achieved 99.63% accuracy. Sensitivity, specificity, and F1-scores exceeded 99%.</p><p><strong>Conclusion: </strong>This machine learning-based algorithm provides accurate asthma diagnosis, even in patients with normal spirometry and clinical findings, offering a non-invasive and efficient diagnostic tool.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111719","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":"Concomitant Idiopathic Pulmonary Fibrosis and Lung Cancer: An Updated Narrative Review.","authors":"Bartłomiej Czyżak, Sebastian Majewski","doi":"10.3390/arm93040031","DOIUrl":"https://doi.org/10.3390/arm93040031","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive interstitial lung disease (ILD) with poor prognosis and limited therapeutic options. The introduction of antifibrotic agents has improved survival outcomes in IPF patients, which has led to more frequent recognition of comorbidities, particularly lung cancer (LC). This review summarizes current evidence on the epidemiology and pathogenesis of LC in the context of IPF, with particular emphasis placed on shared molecular, cellular, genetic, and epigenetic alterations. Diagnostic approaches and available treatment modalities, including surgical, systemic, and radiation therapies, are outlined, and their limitations in patients with IPF-LC are discussed. Acute exacerbations (AEs), as a life-threatening complication influencing diagnostic and treatment strategies, are specifically addressed. Moreover, studies indicating a possible protective effect of antifibrotic agents against LC development in IPF are reviewed. Further research is warranted into the shared mechanisms of IPF and LC to identify novel therapeutic targets. Establishing standardized, multidisciplinary clinical guidelines is essential for optimizing patient management, reducing AE risk, and improving patient outcomes.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938585","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":"An Integrated Strategy for Preventing and Rehabilitating Dust-Induced Occupational Bronchopulmonary Diseases: A Scoping Review.","authors":"Alexandr E Gulyayev, Karlygash S Absattarova, Sayagul A Kairgeldina, Raushan S Dosmagambetova, Kanat K Tekebayev, Madina B Baurzhan, Nazym Sagandykova, Gaukhar Sh Dauletova","doi":"10.3390/arm93040030","DOIUrl":"10.3390/arm93040030","url":null,"abstract":"<p><strong>Background: </strong>Occupational bronchopulmonary diseases (OBPDs)-including pneumoconiosis, silicosis, and occupational COPD-remain a pressing public health issue, especially in regions with intensive mining, metallurgy, and construction industries. Caused by chronic inhalation of fibrogenic dusts, these conditions are often diagnosed at late stages, resulting in irreversible lung damage and diminished work capacity.</p><p><strong>Methods: </strong>A scoping review was performed using the Arksey and O'Malley framework, with methodological refinements from the Joanna Briggs Institute. Following PRISMA-ScR guidelines, we searched PubMed, Scopus, and gray literature for publications from 2014 to 2024. After screening 1761 records and full-text review, nine studies were included in the final synthesis, comprising two systematic reviews, two narrative literature reviews, and five observational studies.</p><p><strong>Results: </strong>Key risk factors identified included prolonged exposure to silica and coal dust, tobacco use, and genetic susceptibility. Diagnostic delays were attributed to the underuse of high-resolution CT and exhaled nitric oxide analysis. Several studies highlighted the diagnostic value of oxidative stress and inflammatory markers (e.g., IL-6, TNF-α). Nutritional rehabilitation and polyphenol-enriched herbal therapies were associated with improved respiratory function and quality of life. However, these strategies remain underutilized, particularly in low-resource settings.</p><p><strong>Conclusions: </strong>A coordinated, biomarker-driven approach integrating early diagnosis, dust exposure control, and tailored rehabilitation is urgently needed. Multidisciplinary models may reduce the clinical and socioeconomic burden of OBPDs.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938594","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":"Tobacco-Free Schools in Practice: Policy Presence and Enforcement in Baltimore Schools.","authors":"Chidubem Egboluche, Rifath Ara Alam Barsha, Shervin Assari, Michelle Mercure, Marc Laveau, Oluwatosin Olateju, Payam Sheikhattari","doi":"10.3390/arm93040028","DOIUrl":"https://doi.org/10.3390/arm93040028","url":null,"abstract":"<p><p><b>Background:</b> School-based tobacco control policies are critical for preventing youth tobacco use. While many districts adopt formal policies to create smoke- and vape-free environments, the degree to which these policies are enforced at the school level may vary, influencing their effectiveness. Little is known about how consistently such policies are implemented across schools within urban school districts. Objectives: This study aimed to examine the existence and enforcement of school-level tobacco control policies in an urban public school system, using Baltimore City schools as a case example. <b>Methods:</b> We conducted a survey of school personnel from 20 high schools in Baltimore City in 2024. The survey instrument assessed the presence and enforcement of policies related to tobacco use prevention, communication, signage, disciplinary actions, and institutional support. Descriptive statistics (frequencies and percentages) were used to summarize responses. Spearman correlations were also used for bivariate correlations. Additional school-level and neighborhood-level contextual data were collected from the internet (neighborhood socioeconomic status and school performance). <b>Results:</b> While many policies existed across the 20 participating schools, their enforcement was widely inconsistent. Most schools reported the existence of policies prohibiting tobacco use in school buildings (60%) and vehicles (55%). However, few schools had visible tobacco-free signage (35%) or offered cessation programs (15%). Communication of policies to students (70%) and staff (65%) was the most commonly enforced aspect of tobacco control policies. <b>Conclusions:</b> Findings suggest that while tobacco control policies may be adopted across urban school systems, their enforcement at the school level remains uneven. Greater attention may be needed to support policy implementation and to reduce variability in school-level practices. Baltimore City serves as a useful case study to understand these challenges and identify opportunities for strengthening school-based tobacco prevention efforts.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12383167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938720","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 Efficacy of C-Reactive Protein in Differentiating Various Causes of Exudative Pleural Effusion: Disease Research Should Not Be Exclusive to the Wealthy.","authors":"Majed Odeh, Yana Kogan, Edmond Sabo","doi":"10.3390/arm93040029","DOIUrl":"https://doi.org/10.3390/arm93040029","url":null,"abstract":"<p><p><b>Background and Objectives</b>: Discrimination between various causes of exudative pleural effusion (PE) remains a major clinical challenge, and to date, definitive biochemical markers for this discrimination remain lacking. An increasing number of studies have reported that serum C-reactive protein (CRPs), pleural fluid CRP (CRPpf), and CRPpf/CRPs ratio (CRPr) are useful for the differential diagnosis of exudative PE; however, their efficacy rate is not similar in these studies. The majority of these studies were conducted on small groups of subjects, and the efficacy of the gradient between CRPs and CRPpf (CRPg-calculated as CRPs-CRPpf) in this differentiation has not been previously investigated. This study aims to evaluate the efficacy rate of CRPs, CRPpf, CRPg, and CRPr in the differential diagnoses of various causes of exudative PE in a relatively large cohort of patients. <b>Materials and Methods</b>: The research group included 282 subjects with exudative PE-146 had parapneumonic effusion (PPE), 126 had malignant pleural effusion (MPE), and 10 had tuberculous pleural effusion (TPE). The values are presented as mean ± SD. <b>Results</b>: The mean CRPs level was significantly higher in the PPE group compared to the MPE group (<i>p</i> < 0.0001) and the TPE group (<i>p</i> < 0.001), and also significantly higher in the TPE group than in the MPE group (<i>p</i> = 0.0009). Similarly, the mean CRPpf level was significantly higher in the PPE group than in the MPE group (<i>p</i> < 0.0001) and the TPE group (<i>p</i> = 0.04), and also significantly higher in the TPE group than in the MPE group (<i>p</i> < 0.0001). The mean CRPg level was significantly higher in the PPE group than in both the MPE group (<i>p</i> < 0.0001) and the TPE group (<i>p</i> < 0.002). The mean CRPr level did not differ significantly among these groups of exudate. <b>Conclusions</b>: CRPs, CRPpf, and CRPg are effective in the differential diagnosis of exudative PE, while CRPr was not effective in this regard. The main limitation of this study is that the sample size of the TPE group is very small.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"93 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12383173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938662","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}