Advances in respiratory medicine最新文献

{"title":"Prevalence and Clinical Implications of Pulmonary Vein Stenosis in Bronchiectasis: A 3D Reconstruction CT Study.","authors":"Xin Li, Yang Gu, Jinbai Miao, Ying Ji, Mingming Shao, Bin Hu","doi":"10.3390/arm92060046","DOIUrl":"10.3390/arm92060046","url":null,"abstract":"<p><strong>Background: </strong>Recent studies on bronchiectasis have revealed significant structural abnormalities and pathophysiological changes. However, there is limited research focused on pulmonary venous variability and congenital variation. Through our surgical observations, we noted that coarctation of pulmonary veins and atrophied lung volume are relatively common in bronchiectasis patients. Therefore, we conducted a retrospective study to explore pulmonary venous variation and secondary manifestations in bronchiectasis cases, utilizing 3D reconstruction software (Mimics Innovation Suite 21.0, Materialise Dental, Leuven, Belgium) to draw conclusions supported by statistical evidence.</p><p><strong>Method: </strong>This retrospective study included patients with bronchiectasis and healthy individuals who underwent CT examinations at Beijing Chao-Yang Hospital between January 2017 and July 2023. Chest CT data were reconstructed using Materialise Mimics. Pulmonary veins and lung lobes were segmented from surrounding tissue based on an appropriate threshold determined by local grey values and image gradients. Subsequently, venous cross-sectional areas and lung volumes were measured for statistical analysis.</p><p><strong>Result: </strong>CT data from 174 inpatients with bronchiectasis and 75 cases from the health examination center were included. Three-dimensional reconstruction data revealed a significant reduction in cross-sectional areas of pulmonary veins in the left lower lobe (<i>p</i> < 0.001), the right lower lobe (<i>p</i> = 0.030), and the right middle lobe (<i>p</i> = 0.009) of bronchiectasis patients. Subgroup analyses indicated that approximately 73.5% of localized cases of the left lower lobe exhibited pulmonary vein stenosis, while in the diffuse group, this proportion was only 52.6%. Furthermore, the cross-sectional area of pulmonary veins had a gradually decreasing trend, based on a small sample. Lung function tests showed significant reductions in FEV1, FVC, and FEV1% in bronchiectasis patients, attributed to the loss of lung volume in the left lower lobe, which accounted for 60.9% of the included sample.</p><p><strong>Conclusions: </strong>Our recent findings suggest that pulmonary venous stenosis is a common variation in bronchiectasis and is often observed concurrently with reduced lung volume, particularly affecting the left lower lobe. Moreover, localized cases are more likely to suffer from pulmonary venous stenosis, with an ambiguous downtrend as the disease progresses. In conclusion, increased attention to pulmonary venous variation in bronchiectasis is warranted, and exploring new therapies to intervene in the early stages or alleviate obstruction may be beneficial.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 6","pages":"526-537"},"PeriodicalIF":1.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891349","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":"Prospects for Treatment of Lung Cancer Using Activated Lymphocytes Combined with Other Anti-Cancer Modalities.","authors":"Anastasia Ganina, Manarbek Askarov, Larissa Kozina, Madina Karimova, Yerzhan Shayakhmetov, Perizat Mukhamedzhanova, Aigul Brimova, Daulet Berikbol, Elmira Chuvakova, Lina Zaripova, Abay Baigenzhin","doi":"10.3390/arm92060045","DOIUrl":"10.3390/arm92060045","url":null,"abstract":"<p><p>This review explores the significance and prospects of using diverse T-cell variants in the context of combined therapy for lung cancer treatment. Recently, there has been an increase in research focused on understanding the critical role of tumor-specific T lymphocytes and the potential benefits of autologous T-cell-based treatments for individuals with lung cancer. One promising approach involves intravenous administration of ex vivo-activated autologous lymphocytes to improve the immune status of patients with cancer. Investigations are also exploring the factors that influence the success of T-cell therapy and the methods used to stimulate them. Achieving a comprehensive understanding of the characteristics of activated lymphocytes and deciphering the mechanisms underlying their activation of innate anti-tumor immunity will pave the way for numerous clinical trials and the development of innovative strategies for cancer therapy like combined immunotherapy and radiation therapy.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 6","pages":"504-525"},"PeriodicalIF":1.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891350","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":"Molecular Pathophysiology of Chronic Thromboembolic Pulmonary Hypertension: A Clinical Update from a Basic Research Perspective.","authors":"Leslie Marisol Gonzalez-Hermosillo, Guillermo Cueto-Robledo, Dulce Iliana Navarro-Vergara, Maria Berenice Torres-Rojas, Marisol García-Cesar, Oscar Pérez-Méndez, Galileo Escobedo","doi":"10.3390/arm92060044","DOIUrl":"10.3390/arm92060044","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but severe condition characterized by persistent obstruction and vascular remodeling in the pulmonary arteries following an acute pulmonary embolism (APE). Although APE is a significant risk factor, up to 25% of CTEPH cases occur without a history of APE or deep vein thrombosis, complicating the understanding of its pathogenesis. Herein, we carried out a narrative review discussing the mechanisms involved in CTEPH development, including fibrotic thrombus formation, pulmonary vascular remodeling, and abnormal angiogenesis, leading to elevated pulmonary vascular resistance and right heart failure. We also outlined how the disease's pathophysiology reveals both proximal and distal pulmonary artery obstruction, contributing to the development of pulmonary hypertension. We depicted the risk factors predicting CTEPH, including thrombotic history, hemostatic disorders, and certain medical conditions. We finally looked at the molecular mechanisms behind the role of endothelial dysfunction, gene expression alterations, and inflammatory processes in CTEPH progression and detection. Despite these insights, there is still a need for improved diagnostic tools, biomarkers, and therapeutic strategies to enhance early detection and management of CTEPH, ultimately aiming to reduce diagnostic delay and improve patient outcomes.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 6","pages":"485-503"},"PeriodicalIF":1.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891348","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":"Association Between Weight-Adjusted Waist Index and Emphysema in Adults in the United States: A Cross-Sectional Study Involving 44,949 Participants.","authors":"Hui Cheng, Ziheng Yang, Jiateng Guo, Yukun Zu, Fan Li, Bo Zhao","doi":"10.3390/arm92060043","DOIUrl":"10.3390/arm92060043","url":null,"abstract":"<p><p><b>Background</b>: The relationship between obesity and respiratory diseases has been widely explored. In this context, the Weight-Adjusted Waist Index (WWI) has emerged as a novel metric for assessing visceral fat. This study aims to evaluate the association between WWI and the risk of emphysema in the U.S. population, by utilizing data from the 2001-2018 National Health and Nutrition Examination Survey (NHANES). <b>Methods</b>: A cross-sectional study was conducted using NHANES data from 2001 to 2018. Logistic regression models were applied to assess the relationship between WWI and emphysema risk. Interaction and subgroup analyses were performed to explore effect modifiers. <b>Results</b>: Our study included a total of 44,949 American adults. The results of the multivariable logistic regression analysis revealed an association between WWI and the incidence of emphysema. In the fully adjusted model, the probability of developing emphysema was 1.5 times higher in the group with WWI > 10.46 compared to those with WWI ≤ 10.46, with an odds ratio of [1.5 (1.1, 1.9), <i>p</i> = 0.003]. Subgroup analysis showed stronger associations among males, non-Hispanic Whites, and individuals with hypertension. Furthermore, we used a two-piece linear regression model and found a nonlinear association between WWI and emphysema, with a breakpoint at 12.5. <b>Conclusions</b>: Our findings indicate a significant association between WWI levels and emphysema. Larger-scale prospective studies are needed to further explore the role of WWI in emphysema.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 6","pages":"472-484"},"PeriodicalIF":1.8,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708943","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":"Beneficial Impact of Vaccination Against SARS-CoV-2 on the Mental Health of IPF Patients.","authors":"Ioannis Tomos, Andriana I Papaioannou, Zoe I Daniil, Ilias E Dimeas, Paraskevi Kirgou, Athena Gogali, Konstantinos Tatsis, Ilias Papanikolaou, Vasilios Tzilas, Argyrios Tzouvelekis, Panayiota Tsiri, Paschalis Steiropoulos, Pachalis Ntolios, Areti Xyfteri, Katerina Antoniou, Emmanouil Symvoulakis, Aggeliki Haritou, Maria Maniati, Lykourgos Kolilekas, Elvira-Markella Antonogiannaki, Vasiliki Apollonatou, Maria Kallieri, Kostas Samaras, Stylianos Loukides, Anna Karakatsani, Demosthenes Bouros, Effrosyni Manali, Spyros Papiris","doi":"10.3390/arm92060042","DOIUrl":"10.3390/arm92060042","url":null,"abstract":"<p><p><b>Background</b>: Depression and anxiety represent significant comorbidities in idiopathic pulmonary fibrosis (IPF) patients, affecting their quality of life. The COVID-19 pandemic has had an uneven impact on global mental health. The Hospital Anxiety and Depression Scale (HADS) constitutes a validated tool to identify anxiety disorders and depression. The aim of this multicentre study was to evaluate the effect of COVID-19 vaccination on depression and anxiety in IPF patients. <b>Methods</b>: Consecutive IPF patients (median 73.5 years) who are regularly followed-up with were included in the study. Demographics, functional, and clinical were recorded. The HADS score was calculated before and one month after vaccination against COVID-19 in all participants. A Wilcoxon signed ranks test was conducted. <b>Results</b>: A total of 180 IPF patients (median 73.5 years) were included in the study. Among them, 145 patients (81%) received antifibrotic treatment. A significant reduction in HADS, both in anxiety and depression scales, was observed one month after vaccination against SARS-COV-2), independent of age, smoking, lung function impairment, and prior history of depression (<i>p</i> < 0.01). <b>Conclusions</b>: A higher Hospital Anxiety and Depression Scale score was detected before vaccination against COVID-19. It seems that vaccination also offered a beneficial effect on depression and anxiety in IPF patients, independent of age, smoking, lung function impairment, and prior history of depression.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 6","pages":"466-471"},"PeriodicalIF":1.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708893","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":"2024 Update on Position Statement by Experts from the Polish Society of Allergology and the Polish Respiratory Society on the Evaluation of Efficacy and Effectiveness of Single Inhaler Triple Therapies in Asthma Treatment.","authors":"Paweł Śliwiński, Adam Antczak, Adam Barczyk, Adam J Białas, Małgorzata Czajkowska-Malinowska, Karina Jahnz-Różyk, Marek Kulus, Piotr Kuna, Maciej Kupczyk","doi":"10.3390/arm92060041","DOIUrl":"10.3390/arm92060041","url":null,"abstract":"<p><p>Medication non-adherence remains a substantial obstacle in asthma care, prompting the exploration of novel therapeutic modalities that prioritize rapid symptom relief, anti-inflammatory activity, and facilitate patients' compliance. This task is well-served by the following new form of therapy: inhaled triple-combination medications ICS/LABA/LAMA (inhaled glucocorticosteroid/long-acting beta2-agonist/long-acting muscarinic antagonist). The integration of three medications within a singular inhalation device culminates in the reduction of the effective dose of the principal therapeutic agent for asthma management, namely ICS. This consolidation yields a dual benefit of minimizing the likelihood of adverse effects typically linked with ICS while concurrently optimizing bronchodilator efficacy. The accumulated evidence suggests that adding LAMA to a medium- or high-dose ICS/LABA results in a decrease of asthma exacerbations compared to medium- or high-dose ICS/LABA alone, accompanied by sustained enhancements in lung function parameters. In adult patients experiencing suboptimal asthma control despite medium/high-dose ICS/LABA treatment-regardless of adherence to GINA-recommended strategies, such as MART therapy as a first-line approach, or alternative second-line strategies-we propose that the preferred course for intensifying asthma therapy involves the addition of a LAMA, ideally in the form of SITT.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 6","pages":"452-465"},"PeriodicalIF":1.8,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708903","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":"Application of Forced Oscillation Technique in Assessing Pulmonary Fibrosis in Hermansky-Pudlak Syndrome.","authors":"Wilfredo De Jesús-Rojas, Luis Reyes-Peña, José Muñiz-Hernandez, Rolando Mena-Ventura, Gabriel Camareno-Soto, Gabriel Rosario-Ortiz, Marcos J Ramos-Benitez, Monica Egozcue-Dionisi, Enid Rivera-Jimenez, Rosa Román-Carlo","doi":"10.3390/arm92060040","DOIUrl":"10.3390/arm92060040","url":null,"abstract":"<p><p>Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder characterized by defects in lysosome-related organelles. Given the high mortality rate associated with HPS pulmonary fibrosis (PF) and the significant risks tied to lung transplantation, it is essential to explore new tools for the early surveillance of PF to monitor its progression before clinical symptoms become apparent. This study evaluates the forced oscillation technique (FOT) for assessing PF in five adult patients with HPS, all homozygous for the <i>HPS-1</i> (c.1472_1487dup p.His497Glnfs*90) founder mutation. Using the Resmon™ Pro V3 device, the FOT measured resistance (Rrs) and reactance (Xrs) at 5, 11, and 19 Hertz (Hz). High-resolution computed tomography (HRCT) scans of the chest were reviewed for radiographic findings. The cohort (<i>n</i> = 5) had a median age of 43 years. All patients exhibited HPS clinical features, including oculocutaneous albinism and respiratory symptoms such as dry cough and dyspnea. Radiographic analysis revealed PF in four patients (80%), with traction bronchiectasis, reticular patterns, honeycombing, and ground-glass opacities. The FOT detected progressive changes in pulmonary resistance and reactance correlating with fibrosis severity. These findings suggest that the FOT is a valuable non-invasive tool for monitoring PF in patients with HPS-1, potentially improving early diagnosis and management.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 6","pages":"444-451"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708933","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":"Utility of Raman Spectroscopy in Pulmonary Medicine.","authors":"Pauls Dzelve, Arta Legzdiņa, Andra Krūmiņa, Madara Tirzīte","doi":"10.3390/arm92050038","DOIUrl":"https://doi.org/10.3390/arm92050038","url":null,"abstract":"<p><p>The Raman effect, or as per its original description, \"modified scattering\", is an observation that the number of scattered light waves shifts after photons make nonelastic contact with a molecule. This effect allows Raman spectroscopy to be very useful in various fields. Although it is well known that Raman spectroscopy could be very beneficial in medicine as a diagnostic tool, there are not many applications of Raman spectroscopy in pulmonary medicine. Mostly tumor tissue, sputum and saliva have been used as material for analysis in respiratory medicine. Raman spectroscopy has shown promising results in malignancy recognition and even tumor staging. Saliva is a biological fluid that could be used as a reliable biomarker of the physiological state of the human body, and is easily acquired. Saliva analysis using Raman spectroscopy has the potential to be a relatively inexpensive and quick tool that could be used for diagnostic, screening and phenotyping purposes. Chronic obstructive pulmonary disease (COPD) is a growing cause of disability and death, and its phenotyping using saliva analysis via Raman spectroscopy has a great potential to be a dependable tool to, among other things, help reduce hospitalizations and disease burden. Although existing methods are effective and generally available, Raman spectroscopy has the benefit of being quick and noninvasive, potentially reducing healthcare costs and workload.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 5","pages":"421-428"},"PeriodicalIF":1.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492815","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":"Expression of Epithelial Alarmin Receptor on Innate Lymphoid Cells Type 2 in Eosinophilic Chronic Obstructive Pulmonary Disease.","authors":"Katarzyna Królak-Nowak, Marta Wierzbińska, Aleksandra Żal, Adam Antczak, Damian Tworek","doi":"10.3390/arm92050039","DOIUrl":"https://doi.org/10.3390/arm92050039","url":null,"abstract":"<p><p>Studies have shown that eosinophilic COPD (eCOPD) is a distinct phenotype of the disease. It is well established that innate lymphoid cells are involved in the development of eosinophilic inflammation. Interleukin(IL)-25, thymic stromal lymphopoietin (TSLP) and IL-33 are a group of cytokines produced by epithelium in response to danger signals, e.g., cigarette smoke, and potent activators of ILC2s. In the present study, we examined circulating and sputum ILC2 numbers and expression of intracellular IL-5 as well as receptors for TSLP, IL-33 and IL-25 by ILC2s in non-atopic COPD patients with and without (neCOPD) airway eosinophilic inflammation and healthy smokers. In addition, we examined the association between ILC2s and clinical indicators of COPD burden (i.e., symptom intensity and risk of exacerbations). ILC2s were enumerated in peripheral blood and induced sputum by means of flow cytometry. We noted significantly greater numbers of airway IL-5⁺ILC2s and TSLPR⁺ILC2s in eCOPD compared with neCOPD (<i>p</i> < 0.05 and <i>p</i> < 0.01, respectively) and HSs (<i>p</i> < 0.001 for both). In addition, we showed that IL-5⁺ILC2s, IL-17RB⁺ILC2s and ST2⁺ILC2s are significantly increased in the sputum of eCOPD patients compared with HSs. In all COPD patients, sputum ILC2s positively correlated with sputum eosinophil percentage (r = 0.48, <i>p</i> = 0.002). We did not find any significant correlations between sputum ILC2s and dyspnea intensity as measured by the modified Medical Research Council scale (mMRC) and symptom intensity measured by the COPD Assessment Test (CAT). These results suggest the involvement of epithelial alarmin-activated ILC2s in the pathobiology of eosinophilic COPD.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 5","pages":"429-443"},"PeriodicalIF":1.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492813","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":"Secure and Transparent Lung and Colon Cancer Classification Using Blockchain and Microsoft Azure.","authors":"Entesar Hamed I Eliwa, Amr Mohamed El Koshiry, Tarek Abd El-Hafeez, Ahmed Omar","doi":"10.3390/arm92050037","DOIUrl":"https://doi.org/10.3390/arm92050037","url":null,"abstract":"<p><strong>Background: </strong>The global healthcare system faces challenges in diagnosing and managing lung and colon cancers, which are significant health burdens. Traditional diagnostic methods are inefficient and prone to errors, while data privacy and security concerns persist.</p><p><strong>Objective: </strong>This study aims to develop a secure and transparent framework for remote consultation and classification of lung and colon cancer, leveraging blockchain technology and Microsoft Azure cloud services. Dataset and Features: The framework utilizes the LC25000 dataset, containing 25,000 histopathological images, for training and evaluating advanced machine learning models. Key features include secure data upload, anonymization, encryption, and controlled access via blockchain and Azure services.</p><p><strong>Methods: </strong>The proposed framework integrates Microsoft Azure's cloud services with a permissioned blockchain network. Patients upload CT scans through a mobile app, which are then preprocessed, anonymized, and stored securely in Azure Blob Storage. Blockchain smart contracts manage data access, ensuring only authorized specialists can retrieve and analyze the scans. Azure Machine Learning is used to train and deploy state-of-the-art machine learning models for cancer classification. Evaluation Metrics: The framework's performance is evaluated using metrics such as accuracy, precision, recall, and <i>F</i>1-<i>score</i>, demonstrating the effectiveness of the integrated approach in enhancing diagnostic accuracy and data security.</p><p><strong>Results: </strong>The proposed framework achieves an impressive accuracy of 100% for lung and colon cancer classification using DenseNet, ResNet50, and MobileNet models with different split ratios (70-30, 80-20, 90-10). The <i>F</i>1-<i>score</i> and k-fold cross-validation accuracy (5-fold and 10-fold) also demonstrate exceptional performance, with values exceeding 99.9%. Real-time notifications and secure remote consultations enhance the efficiency and transparency of the diagnostic process, contributing to better patient outcomes and streamlined cancer care management.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"92 5","pages":"395-420"},"PeriodicalIF":1.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492814","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}