Thoracic research and practice最新文献

{"title":"Non-Small Cell Lung Cancer Patients with Brain Metastases and Limited Access to Systemic Therapy.","authors":"Kyrhatii Trikhirhisthit, Aniwat Berpan, Sunee Neesanun","doi":"10.4274/ThoracResPract.2026.2026-5-5","DOIUrl":"https://doi.org/10.4274/ThoracResPract.2026.2026-5-5","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to identify prognostic factors associated with overall survival in patients with brain metastases from non-small cell lung cancer (BM-NSCLC) who had limited access to systemic therapy.</p><p><strong>Material and methods: </strong>We retrospectively analyzed 83 patients with BM-NSCLC. Data collected included age, sex, performance status, histology, neurologic symptoms, extracranial metastasis (ECM), and receipt of whole-brain radiotherapy (WBRT) and systemic treatment. Associations between these factors and time to death were assessed using Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>The mean age of the patients was 63.1±8.9 years. Approximately 30% of patients had ECM, whereas 14% received systemic treatment. Three-quarters of the cohort underwent WBRT. The median survival time was 2.7 months [95% confidence interval (CI): 2.2-4.1 months]. The 6-month and 1-year survival probabilities were 26.5% (95% CI: 17.6%-36.3%) and 9.6% (95% CI: 4.5%-17.1%), respectively. Multivariable analysis demonstrated that ECM was significantly associated with an increased risk of death [adjusted hazard ratio (aHR): 4.22, 95% CI: 1.27-14.0, <i>P</i> = 0.019, for newly diagnosed lung cancer; aHR: 6.33, 95% CI: 1.62-24.79, <i>P</i> = 0.008, for controlled primary lung cancer with ECM; and aHR: 11.32, 95% CI: 2.89-56.1, <i>P</i> = 0.003, for uncontrolled primary lung cancer and ECM]. Receipt of systemic treatment was significantly associated with a lower risk of death (aHR: 0.39, 95% CI: 0.18-0.80, <i>P</i> = 0.011). WBRT was not significantly associated with improved survival (aHR: 0.79, 95% CI: 0.43-1.44, <i>P</i> = 0.441).</p><p><strong>Conclusion: </strong>The presence of ECM and the absence of systemic treatment were significantly associated with shorter survival in patients with BM-NSCLC.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicians' Knowledge Level, Sources of Information, and Clinical Smoking Cessation Practices Regarding Electronic Cigarettes: A Cross-sectional Study in Adana, Türkiye.","authors":"Çiğdem Erhan, Ayşe Turan","doi":"10.4274/ThoracResPract.2026.2026-7-16","DOIUrl":"https://doi.org/10.4274/ThoracResPract.2026.2026-7-16","url":null,"abstract":"<p><strong>Objective: </strong>Data on physicians' knowledge and clinical practices regarding electronic cigarettes (e-cigarettes) remain limited, particularly among physicians from diverse specialties within the same setting. This study assessed the knowledge level, information sources, and smoking cessation counseling practices regarding e-cigarettes of physicians in Adana province and examined associations with sociodemographic and occupational characteristics.</p><p><strong>Material and methods: </strong>A cross-sectional survey was conducted among 525 physicians in Adana between January 26 and February 16, 2026, using a 12-item e-cigarette knowledge scale (0-12) and a 5-item smoking cessation counseling practice scale (5-25). Between-group comparisons were performed using the Mann-Whitney U and Kruskal-Wallis tests; associations were assessed using Spearman's correlation; independent predictors of practice score were identified using multivariate linear regression.</p><p><strong>Results: </strong>Mean knowledge score was 9.40±2.75 [95% confidence interval (CI): 9.17-9.64] and mean practice score was 20.71±4.07 (95% CI: 20.36-21.06). Knowledge and practice scores were not correlated (ρ = 0.063; 95% CI: -0.022-0.148; <i>P</i> = 0.148). Practice score was associated with specialty, professional title, institution, age, and chronic disease (all <i>P</i> < 0.05). In multivariate regression, age, specialty, and physicians' own tobacco/nicotine use remained independent predictors (B = -0.739; <i>P</i> = 0.041 for tobacco/nicotine users). Social media were the most frequently reported information sources (40.2%; 95% CI: 36.1-44.4%).</p><p><strong>Conclusion: </strong>Physicians' e-cigarette knowledge was moderate to high, but was not associated with general smoking cessation counseling practices, which were not assessed as e-cigarette-specific. Educational interventions should incorporate structured clinical protocols in addition to knowledge transfer.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Stone Silicosis: New Face of an Old Disease.","authors":"Heng Sieh Yen Samantha, Tan Kian Wei Alvin, Koh Soo Quee David","doi":"10.4274/ThoracResPract.2026.2026-6-19","DOIUrl":"https://doi.org/10.4274/ThoracResPract.2026.2026-6-19","url":null,"abstract":"<p><p>Artificial stone (AS) silicosis has emerged as a major global occupational health concern, challenging the perception of silicosis as a disease of the past. Driven by the fabrication of AS products containing high concentrations of crystalline silica (>90%), this rapidly progressive form disproportionately affects younger workers and develops after a much shorter exposure duration (median 7-19 years) than in classic silicosis. As cases continue to emerge worldwide, clinicians and occupational health practitioners are increasingly likely to encounter affected workers in clinical practice. This review provides a clinically focused synthesis of the current evidence on the epidemiology, pathophysiology, clinical manifestations, diagnosis, and management of AS silicosis. Compared with traditional silicosis, the unique physicochemical properties of AS dust may amplify lung toxicity and promote a self-perpetuating inflammatory response. This frequently results in rapid development of progressive massive fibrosis, with disease progression often continuing after exposure cessation. Diagnosis is often delayed because of overlapping clinical features and the limited sensitivity of conventional screening tools, highlighting the importance of early clinical recognition, detailed occupational history-taking, and the use of high-resolution computed tomography where appropriate. Lung transplantation remains the only definitive treatment for advanced disease, underscoring the importance of prevention. Effective prevention requires strong workplace controls, systematic medical surveillance, and appropriate regulatory measures. Clinicians play a key role in early detection, patient education, and mandatory disease reporting. Coordinated action across clinical, occupational, and policy domains is essential to improve recognition, strengthen preventive measures, and avert further cases of this highly preventable occupational disease.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological and Pulmonary Gene Expression Findings Associated with Isoflurane Exposure in a Rat Hydrochloric Acid/Lipopolysaccharide Double-hit Acute Lung Injury Model.","authors":"Feyza Tülek, Baykal Tülek, Zeynep Çelik Kenar, Fatma Balcı, Yusuf Kaplan, Mehmet Tuzcu","doi":"10.4274/ThoracResPract.2026.2026-6-5","DOIUrl":"https://doi.org/10.4274/ThoracResPract.2026.2026-6-5","url":null,"abstract":"<p><strong>Objective: </strong>We examined histopathological injury and pulmonary mRNA expression of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10), and vascular endothelial growth factor (VEGF) associated with isoflurane exposure in a rat hydrochloric acid + lipopolysaccharide (HCl+LPS) double-hit acute lung injury model.</p><p><strong>Material and methods: </strong>Thirty-two male Wistar rats were assigned to control, HCl+LPS, HCl+LPS+isoflurane (6-h), or HCl+LPS+isoflurane (48-h) groups. After intratracheal HCl and LPS, isoflurane groups underwent 4 h of chamber exposure (3% induction, 1.4% maintenance), whereas non-isoflurane groups received matched oxygen exposure. The control, HCl+LPS, and 6-h isoflurane groups were evaluated at 6-h; the 48-h isoflurane group was evaluated at 48-h. No untreated 48-h HCl+LPS group was included.</p><p><strong>Results: </strong>HCl+LPS produced marked histopathological injury. At 6-h, the isoflurane-exposed group had lower injury scores and lower TNF-α and IL-1β mRNA expression than the time-matched untreated group. The 48-h isoflurane group also had lower values than the untreated 6-h group; however, this comparison was not time-matched. IL-6 mRNA expression was markedly higher in both isoflurane groups; IL-10 levels were highest, and VEGF approached the control value at 48-h.</p><p><strong>Conclusion: </strong>Isoflurane exposure was associated with histopathological and transcriptional differences. The absence of the untreated 48-h and isoflurane-only groups precludes drawing conclusions about sustained efficacy, temporal response, or the mechanism underlying the IL-6 increase. The data do not establish a definitive therapeutic effect or a specific molecular mechanism.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149240722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alpha-1 Antitrypsin Gene Variants in Southeastern Türkiye with Identification of Rare Malton Genotypes in a Multicenter Real-world Cohort.","authors":"Barış Çil, Hadice Selimoğlu Şen, Mehmet Sinan Bodur, Mehmet Kabak, Cenk Babayiğit, Ahmet Dündar, Songül Çetik Yıldız","doi":"10.4274/ThoracResPract.2026.2026-5-8","DOIUrl":"https://doi.org/10.4274/ThoracResPract.2026.2026-5-8","url":null,"abstract":"<p><strong>Objective: </strong>Alpha-1 antitrypsin (<i>A1AT</i>) deficiency is a hereditary disorder associated with an increased risk of chronic obstructive pulmonary disease (COPD) and remains underdiagnosed worldwide. Data from Southeastern Türkiye are limited, particularly in geographically and demographically underrepresented regions of the country. This study aimed to investigate the frequency and spectrum of <i>A1AT</i> gene variants in a real-world multicenter cohort from Southeastern Türkiye.</p><p><strong>Material and methods: </strong>This retrospective multicenter study included 1,008 patients who underwent targeted genetic testing for <i>A1AT</i> deficiency between 2022 and 2026 at two tertiary centers. Demographic characteristics, smoking status, pulmonary function parameters, and clinical diagnoses were evaluated. <i>A1AT</i> genotypes were classified as normal or variant, the latter including both common and rare alleles.</p><p><strong>Results: </strong><i>A1AT</i> variants were identified in 6 patients (0.6%), including the MZ, Lowell, and Malton alleles; one patient carried the rare homozygous Malton/Malton genotype. All variant carriers had COPD. Half of the variant-positive patients were never-smokers, and several demonstrated severe airflow limitation corresponding to Global Initiative for Chronic Obstructive Lung Disease stages 3-4 disease. The overall prevalence of <i>A1AT</i> variants was low and consistent with frequencies previously reported in Mediterranean and Middle Eastern populations. However, the detection of rare alleles highlighted the genetic heterogeneity of <i>A1AT</i> deficiency and suggested that sole reliance on common allele screening may contribute to underrecognition.</p><p><strong>Conclusion: </strong>Although the prevalence of <i>A1AT</i> variants was low, their detection among high-risk individuals, including never-smokers and patients with severe COPD, underscores the clinical importance of targeted genetic testing. The identification of rare genotypes such as Malton/Malton supports the need for comprehensive genetic evaluation strategies. This study provides important regional data from Southeastern Türkiye and emphasizes the need for larger multicenter studies to better define the epidemiology and clinical impact of <i>A1AT</i> variants.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149240804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Specialty, Training, and Future Among Pulmonology Residents in Türkiye: A Cross-sectional, Nationwide, Multi-institutional Online Survey.","authors":"Mustafa Ersözlü, Erencan Begiç, Alpercan İlker, Buket Selen Şahin, Samet Samancı, Aytekin İdikut, Barış Çil, Aslıhan Gürün Kaya, Osman Elbek, Çağlar Çuhadaroğlu, Oğuz Kılınç","doi":"10.4274/ThoracResPract.2026.2026-6-9","DOIUrl":"https://doi.org/10.4274/ThoracResPract.2026.2026-6-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate specialty preferences, training environments, working conditions, professional concerns, and perceptions regarding the future of the pulmonology specialty among resident physicians in Türkiye.</p><p><strong>Material and methods: </strong>This cross-sectional, nationwide, multi-institutional online survey was conducted between January 30 and March 30, 2026, with voluntary and anonymous participation. Pulmonology residents were recruited through professional networks using voluntary convenience sampling. Affirmative specialty and institution re-choice were analyzed using prespecified multivariable logistic regression, with multinomial sensitivity analyses performed.</p><p><strong>Results: </strong>Among 158 respondents [median age, 29 years (interquartile range, 27-31); 70.3% women], 63 (39.9%) would choose pulmonology again, 66 (41.8%) would be undecided, and 65 (41.1%) would choose their institution again. A high or very high impact of work hours or night shifts was reported by 88 of 157 respondents (56.1%). First-choice pulmonology was associated with specialty re-choice [adjusted odds ratio (aOR), 2.91; 95% confidence interval (CI), 1.42-5.93], whereas high burden was associated with lower specialty re-choice (aOR, 0.29; 95% CI, 0.14-0.60). For institutional re-choice, high burden (aOR, 0.15; 95% CI, 0.07-0.34) and training/research hospital sector (aOR, 0.39; 95% CI, 0.16-0.95) were associated with lower odds, while resident-reported accreditation was associated with higher odds (aOR, 4.37; 95% CI, 1.23-15.53). Multinomial analyses were consistent.</p><p><strong>Conclusion: </strong>Affirmative specialty and institutional commitment were limited. Work-hours/night-shift burden was the most consistent correlate; however, the imprecise accreditation estimate should not be interpreted causally.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Function Test Abnormalities in Subacute Cough: A Neglected Tool.","authors":"Aycan Yüksel, Ceren İlgar Akelma","doi":"10.4274/ThoracResPract.2026.2026-1-11","DOIUrl":"10.4274/ThoracResPract.2026.2026-1-11","url":null,"abstract":"<p><strong>Objective: </strong>Subacute cough is often considered a benign and self-limiting condition, and pulmonary function tests (PFTs) are not routinely performed during this period. This study aimed to evaluate PFT findings in patients with subacute cough compared with those in healthy controls.</p><p><strong>Material and methods: </strong>This retrospective, cross-sectional study included adults with subacute cough who underwent standardized spirometry, along with age- and sex-frequency matched healthy controls. Forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and forced expiratory flow at 25-75% of the pulmonary volume (FEF_25-75) were recorded as absolute values and z-scores. Between-group comparisons were performed using analysis of covariance to adjust for age, sex, and height.</p><p><strong>Results: </strong>A total of 156 patients with subacute cough and 156 controls were analyzed. Patients with subacute cough demonstrated significantly lower FEV₁ and FVC z-scores, and lower FEF_25-75 values and z-scores (all P < 0.001). After adjustment, group differences remained significant for FVC, FEV₁ z-score, and FEF_25-75 (both absolute and z-score). Post-infectious cough was the most common diagnosis (37.8%), followed by asthma (25%); interstitial lung diseases (ILD) were also detected. FVC z-scores, absolute FEF_25-75, and FEF_25-75 z-scores were lower in the obstructive airway disease and ILD subgroups than in the post-infectious cough group. FEF_25-75 z-scores showed the greatest discriminatory ability across diagnostic categories.</p><p><strong>Conclusion: </strong>Subacute cough encompasses a heterogeneous group of underlying diseases and should not be considered solely post-infectious. Patients with subacute cough may exhibit impaired PFTs, especially FEF_25-75 z-scores. PFTs may provide additional information for the evaluation of subacute cough.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"4-10"},"PeriodicalIF":0.8,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152401","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":"Small Airway Dysfunction in Asthma: Associations with Control and Quality of Life.","authors":"Demet Polat Yuluğ, Sibel Naycı, Bahar Taşdelen, Eylem Sercan Özgür, Cengiz Özge","doi":"10.4274/ThoracResPract.2026.2026-1-7","DOIUrl":"10.4274/ThoracResPract.2026.2026-1-7","url":null,"abstract":"<p><strong>Objective: </strong>Small airway dysfunction (SAD) is an important but frequently underrecognized component of asthma. This study aimed to determine the prevalence of SAD in asthma, as assessed by impulse oscillometry (IOS), and to evaluate its association with clinical outcomes.</p><p><strong>Material and methods: </strong>This cross-sectional study, with a 12-month prospective follow-up, included adult patients with asthma. SAD was defined by IOS as R5-R20 ≥0.07 kPa·s·L-¹. The asthma control test (ACT) and the asthma quality of life questionnaire (AQLQ) were administered. Exacerbations were prospectively recorded during the 12 months after enrollment. Patients were stratified according to the presence of SAD. Clinical and functional parameters were compared between groups.</p><p><strong>Results: </strong>SAD was identified in 63 of 98 participants (64.3%). SAD prevalence differed significantly across the five Global Initiative for Asthma treatment steps (<i>P</i> < 0.001). Patients with SAD had significantly lower ACT scores (<i>P</i> = 0.021), poorer quality of life (AQLQ, <i>P</i> = 0.002), and more frequent exacerbations (<i>P</i> < 0.001) than those without SAD. In multivariable regression analyses, higher R5-R20 was independently associated with a lower AQLQ score (β = -0.18, 95% confidence interval -0.30 to -0.07; <i>P</i> = 0.002) and higher odds of being in a worse asthma control category (odds ratio 1.33, <i>P</i> = 0.010).</p><p><strong>Conclusion: </strong>SAD is common among patients with asthma and is associated with poorer asthma control, lower quality of life, and an increased exacerbation burden. Higher R5-R20 remained associated with poorer quality of life after adjustment for spirometry, whereas its association with asthma control was attenuated and became non-significant after adjustment for forced expiratory volume in the first second. These findings support further evaluation of IOS-defined SAD as a potentially clinically relevant trait in asthma.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"11-19"},"PeriodicalIF":0.8,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119964","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":"Pretransplant Small-airway Dysfunction is Associated with Posttransplant Complications in Adult HSCT Recipients.","authors":"Caner Çınar, Ahmet Mert Yanık, Zeynep Mercancı, Cansu Yıldız, Tayfur Toptaş, Işık Atagündüz, Semiha Emel Eryüksel, Sait Karakurt","doi":"10.4274/ThoracResPract.2026.2026-5-9","DOIUrl":"10.4274/ThoracResPract.2026.2026-5-9","url":null,"abstract":"<p><strong>Objective: </strong>Pulmonary function testing is routinely performed before hematopoietic stem cell transplantation (HSCT), but conventional parameters may not capture subtle airway abnormalities. This study evaluated the association of pretransplant forced expiratory flow between 25% and 75% of forced vital capacity (FEF_25-75) with post-HSCT complications in adults.</p><p><strong>Material and methods: </strong>This retrospective single-center cohort included 83 adults who underwent HSCT between 2016 and 2023. Reduced FEF_25-75 was defined as <75% predicted. The primary outcome was a composite of post-HSCT complications. Multivariable logistic regression models were adjusted for age, sex, ever-smoking status, HSCT type, and reduced forced expiratory volume in 1 second (FEV₁). Discrimination was assessed using receiver operating characteristic analysis.</p><p><strong>Results: </strong>Overall, 32 patients (38.6%) experienced post-HSCT complications. Complications occurred in 50.0% of patients with reduced FEF_25-75 versus 28.9% of those with FEF_25-75 ≥75% predicted (<i>P</i> = 0.049). Reduced FEF_25-75 was independently associated with higher odds of complications [odds ratio (OR): 3.58, 95% confidence interval (CI): 1.28-10.04; <i>P</i> = 0.015]. Reduced FEV₁ showed an inverse association (OR: 0.12, 95% CI: 0.02-0.71; <i>P</i> = 0.019). FEF_25-75 showed poor standalone discrimination (area under the curve: 0.578, 95% CI: 0.450-0.705).</p><p><strong>Conclusion: </strong>Reduced pretransplant FEF_25-75 was independently associated with post-HSCT complications, but showed poor standalone discrimination. These hypothesis-generating findings suggest that FEF_25-75 may provide information complementary to FEV₁, but they do not support its use as an independent predictive test. Larger prospective studies are required.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"20-26"},"PeriodicalIF":0.8,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119923","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":"Clinical Significance of Age and Coexisting Lifestyle-related Diseases in ILD Patients with Acute Exacerbation.","authors":"Masahiro Uchiyama, Kunihiko Miyazaki, Yosuke Maezawa, Naomi Kayauchi, Shinichiro Okauchi, Hiroaki Satoh, Ryuichi Hasegawa","doi":"10.4274/ThoracResPract.2026.2026-1-15","DOIUrl":"10.4274/ThoracResPract.2026.2026-1-15","url":null,"abstract":"<p><strong>Objective: </strong>As the population ages, the impact of aging and comorbid lifestyle-related diseases on the prognosis of interstitial lung disease (ILD) has not been fully investigated. Therefore, we investigated the impact of age and comorbidities on the prognosis of patients with ILD who experienced acute exacerbations (AEs).</p><p><strong>Material and methods: </strong>We retrospectively reviewed the medical records and chest computed tomography scans of all consecutive ILD patients, with or without AE, between May 2015 and July 2025. The survival times of cases with and without AE were investigated.</p><p><strong>Results: </strong>Median survival time (MST) for 443 ILD cases was 10 years, while the MST for the 158 cases who developed AE was 2 months. The prognosis of cases who developed AE at age 80 years or older was significantly poorer than that of cases younger than 80 years. Among cases younger than 80 years, the survival curve for those who survived 3 months after the onset of AE plateaued. Favorable factors among cases who developed AE were age younger than 80 years and absence of comorbidities such as hypertension, diabetes mellitus, and malignancy.</p><p><strong>Conclusion: </strong>For ILD patients who developed AE, \"80 years of age\" was the threshold age distinguishing good from poor prognosis. Some patients, particularly those with ILD who were diagnosed early, appeared likely to have an improved prognosis. Some AE patients, particularly younger patients, could be expected to have a good long-term prognosis if they survive a certain period of time.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"53-60"},"PeriodicalIF":0.8,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581623","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}