Thoracic research and practice最新文献

{"title":"Efficacy of Trikafta (ELX/TEZ/IVA) & Symdeko (TEZ/IVA) in Treating Cystic Fibrosis with F508del Allele: A Systematic Review and Meta-analysis.","authors":"Kainat Hussain, Sonali Karhana, Aakriti Garg, Mohd Ashif Khan","doi":"10.4274/ThoracResPract.2025.2025-1-1","DOIUrl":"https://doi.org/10.4274/ThoracResPract.2025.2025-1-1","url":null,"abstract":"<p><p>The objective of the study was to assess and compare the efficacy of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) treatment with TEZ/IVA treatment in individuals diagnosed with cystic fibrosis (CF) and carrying the F508del allele. An extensive search of relevant literature was conducted using online resources, namely, PubMed, ScienceDirect, and Google Scholar. The initial search identified 248 articles, and after a careful examination of the full text of 18 articles, 7 met the inclusion and exclusion criteria. These selected reports were then thoroughly examined to perform a comparative analysis of the effectiveness of TEZ/IVA versus ELX/TEZ/IVA in CF patients with the F508del allele. The quality of the selected reports was evaluated using the Cochrane risk-of-bias tool for randomized studies, known as RoB 2. ELX/TEZ/IVA has shown significant improvements in key indicators of CF treatment. It has demonstrated a significant increase in forced expiratory volume in one second levels, indicating improved respiratory capacity and airflow. Additionally, ELX/TEZ/IVA successfully reduced sweat chloride levels and positively impacted Cystic Fibrosis Questionnaire-Revised Respiratory Domain scores, reflecting enhanced respiratory function and improved quality of life for patients. Overall, the study concluded that ELX/TEZ/IVA provided a clinically robust benefit compared to TEZ/IVA alone while maintaining a favourable safety profile.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064867","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":"The Prognostic Significance of MELD-XI in Patients Admitted to the Intensive Care Unit for Respiratory Failure","authors":"Fatma Arslan, Yağmur Gizem Timurhan, Deniz Doğan Mülazımoğlu, Miraç Öz, Aslıhan Gürün Kaya, Serhat Erol, Aydın Çiledağ, Akın Kaya","doi":"10.4274/ThoracResPract.2024.24047","DOIUrl":"10.4274/ThoracResPract.2024.24047","url":null,"abstract":"<p><strong>Objective: </strong>Composite Model for End-Stage Liver Disease (MELD), an adapted version of the model score excluding international normalised ratio (MELD-XI), was reported to predict outcomes in patients with organ failure. Aim of study was to evaluate the prognostic significance of the MELD-XI score and compare it with the Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation 2 (APACHE 2) scores in patients admitted to the intensive care unit (ICU) for respiratory failure.</p><p><strong>Material and methods: </strong>Out of 822 patients with respiratory failure between September 2020 and June 2023, a total of 727 patients with etiologies of chronic obstructive pulmonary disease exacerbation, cardiogenic pulmonary edema, pulmonary thromboembolism, pneumonia, bronchiectasis, kyphoscoliosis, neuromuscular diseases, obesity hypoventilation syndrome, and diffuse parenchymal lung disease were included.</p><p><strong>Results: </strong>A statistically significant correlation was found between MELD-XI, SOFA, and APACHE 2 scores. The cutoff value of the MELD-XI score was 11 on receiver operating characteristic analysis, indicating a higher risk of mortality in patients with a score of 11 or above. The APACHE 2 and SOFA scores of the MELD-XI ≥11 group were found to be higher and the Glasgow Coma Scale were lower than the MELD-XI <11 group. MELD-XI ≥11 was associated with an increased risk of mortality in overall [Hazard ratio (HR): 4.1, 95% confidence interval (CI): 2-6.4, <i>P</i> < 0.001] and subgroups with different etiologies in Cox regression analysis. In the multivariate analysis, MELD-XI was the most important independent variable indicating an increased risk of mortality, regardless of etiology (HR: 2.4, 95% CI: 2.0-2.5, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>MELD-XI is an important marker of ICU mortality in patients with respiratory failure due to different etiologies and is as effective as the SOFA and APACHE 2 in predicting mortality.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"115-124"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392586","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":"A Research on Healthcare Professionals’ Stigma Towards Tuberculosis Patients","authors":"Mehmet Sinan Bodur, Barış Çil","doi":"10.4274/ThoracResPract.2024.24079","DOIUrl":"10.4274/ThoracResPract.2024.24079","url":null,"abstract":"<p><strong>Objective: </strong>Strong collaboration between healthcare professionals and patients is necessary for the control of tuberculosis (TB), a potentially fatal and contagious disease without treatment. Our research aims to evaluate whether healthcare professionals have stigmatizing attitudes and behaviours toward TB patients.</p><p><strong>Material and methods: </strong>A web-based survey of 19 questions covering clinical situations was designed. A total of 528 healthcare professionals working in different healthcare institutions across the country participated in the survey. Stigma scores were recorded on a 5-point Likert response scale ranging from -2 to +2: the extreme points were ‘strongly disagree’ and ‘strongly agree’.</p><p><strong>Results: </strong>The highest stigma scores were observed in non-physician auxiliary healthcare personnel groups such as medical secretaries, social workers, dietitians, pharmacists, midwives, nurses, and nurse assistants, while the lowest scores were detected in specialist physicians and academic physicians. In demographic analyses, it was observed that healthcare workers (HCWs) who more often encounter TB cases have higher stigma scores. In addition, when evaluated according to the type of institution they work in, it was found that stigma levels were higher in pharmacies, clinics, individual medical practices, private and independent healthcare institutions, and workplaces.</p><p><strong>Conclusion: </strong>This study can contribute to reducing the stigma levels of HCWs towards TB patients with effective training programs and appropriate health policies, thus improving the health services provided to patients.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"88-96"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392727","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":"Nationwide Assessment of Pulmonary Function Testing Practices and Safety Compliance During the COVID-19 Pandemic","authors":"Aslı Görek Dilektaşlı, Şermin Börekçi, Öznur Akkoca Yıldız, Bilun Gemicioğlu, Cüneyt Saltürk, Sevgi Behiye Saryal, Gaye Ulubay","doi":"10.4274/ThoracResPract.2025.2025-1-12","DOIUrl":"10.4274/ThoracResPract.2025.2025-1-12","url":null,"abstract":"<p><strong>Objective: </strong>Coronavirus disease-2019 (COVID-19) presented considerable challenges to health services, particularly for a routine assessment method, the pulmonary function tests (PFTs), which can generate aerosols and require sharing common surfaces. Despite these risks, there is a need to continue testing, especially for vulnerable patient groups.</p><p><strong>Material and methods: </strong>An online survey was conducted from June 1 to June 26, 2020, to assess pulmonologists’ practices regarding PFTs before and during the pandemic’s first peak in Türkiye (March 11-May 20, 2020). The survey included 30 anonymized questions and received ethical committee approval. Statistical analysis was performed using the IBM Statistical Package for the Social Sciences statistical package.</p><p><strong>Results: </strong>Two hundred and forty-three respondents across 59 cities participated in the study. 93% were pulmonologists. 77.4% of PFT labs have adequate ventilation by having a window enabling room direct air exchange. 27.2% of the PFT labs continued testing during the first peak of the pandemic. 83.3% of the responding centers applied triage before testing. Ongoing tests included spirometry (100%), bronchodilator reversibility testing (62.1%), and carbon-monoxide diffusion testing (16.7%). 49% of the PFT labs conducted fewer than four tests daily, while 21.2% performed more than eight. PFT technicians used personal protective equipment, with 67.7% using eye protection and 75.3 % wearing FFP3 or FFP2 masks.</p><p><strong>Conclusion: </strong>The survey found that pulmonologists have acted quickly and made moderate success in making preparations in PFT labs for the COVID-19 pandemic. Nevertheless, safer practice in PFT units still needs to be implemented.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"137-144"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805063","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":"Comment on: Normative Values and Calculation Formulas of Respiratory Muscle Strength of Adults in Turkish Society: A Population-based Study","authors":"Mahmood Dhahir Al-Mendalawi","doi":"10.4274/ThoracResPract.2024.24096","DOIUrl":"10.4274/ThoracResPract.2024.24096","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"152-152"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392422","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":"Artificial Intelligence-guided Total Opacity Scores and Obstructive Sleep Apnea in Adults with COVID-19 Pneumonia","authors":"Zeynep Atçeken, Yeliz Çelik, Çetin Atasoy, Yüksel Peker","doi":"10.4274/ThoracResPract.2024.24090","DOIUrl":"10.4274/ThoracResPract.2024.24090","url":null,"abstract":"<p><strong>Objective: </strong>We previously demonstrated that artificial intelligence (AI)-directed chest computed tomography (CT)-based total opacity scores (TOS) are associated with high-risk obstructive sleep apnea (OSA) based on the Berlin Questionnaire. In the current study, we examined the association between TOS severity and OSA severity based on polysomnography (PSG) recordings among participants with a history of Coronavirus disease-2019 (COVID-19) infection.</p><p><strong>Material and methods: </strong>This was a post-hoc analysis of 56 patients who underwent CT imaging after being diagnosed with COVID-19 pneumonia as well as overnight PSG for a validation study with a median of 406 days after the initial COVID-19 onset. The AI software quantified the overall opacity scores, which included consolidation and ground-glass opacity regions on CT scans. TOS was defined as the volume of high-opacity regions divided by the volume of the entire lung, and severe TOS was defined as the score ≥15. OSA was defined as an apnea-hypopnea index (AHI) of at least 15 events/h.</p><p><strong>Results: </strong>In total, 21 participants had OSA and 35 had no OSA. The median TOS was 10.5 [interquartile range (IQR) 1.6-21.2] in the OSA group and 2.8 (IQR 1.4-9.0) in the non-OSA group (<i>P</i> = 0.047). In a multivariate logistic regression analysis, OSA, AHI, and oxygen desaturation index were associated with severe TOS (<i>P</i> < 0.05 for all, respectively) adjusted for age, sex, body mass index, and hypertension.</p><p><strong>Conclusion: </strong>AI-directed CT-based TOS severity in patients with COVID-19 pneumonia was associated with OSA severity based on PSG recordings. These results support our previous findings suggesting an association between questionnaire-based high-risk OSA and worse outcomes in COVID-19 pneumonia.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"107-114"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392073","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":"Etiologies and Treatment Outcomes of Chronic Cough Diagnosed with a Pathophysiological Diagnostic Procedure: A Single-center Retrospective Observational Cohort Study","authors":"Johsuke Hara, Masaki Fujimura, Masahide Yasui, Reiko Takeda, Noriyuki Ohkura, Seiji Yano","doi":"10.4274/ThoracResPract.2024.24049","DOIUrl":"10.4274/ThoracResPract.2024.24049","url":null,"abstract":"<p><strong>Objective: </strong>We developed a pathophysiological diagnostic procedure to identify etiologies of chronic cough (CC) like cough variant asthma (CVA), atopic cough (AC), cough predominant asthma, sinobronchial syndrome (SBS), and mucoid impaction of small bronchi. After identifying the etiologies of CC through an understanding of its pathophysiological processes, we determined the patient’s management outcomes based on the pathophysiological diagnosis.</p><p><strong>Material and methods: </strong>In this retrospective observational cohort study, the medical records of CC patients from April 2013 to March 2018 was analyzed to assess the etiologies and treatments based on the pathophysiological diagnostic procedure. The capsaicin cough-reflex sensitivity test, methacholine-induced bronchoconstriction cough response test, bronchodilator reversibility test, bronchial responsiveness test, chest and sinus computed tomography, and sputum investigations were used for pathophysiological diagnosis.</p><p><strong>Results: </strong>CC etiologies were diagnosed in 289 of the 298 patients who underwent the diagnostic procedures. The remaining nine patients had normal diagnostic findings. The three most common causes of CC were CVA, AC and SBS. Cough disappeared completely in 278 of the 286 patients who completed treatment. The median time to complete symptom resolution was 5.8 weeks.</p><p><strong>Conclusion: </strong>Pathophysiological evaluation may facilitate prompt and objective diagnosis of the etiologies of CC. Our results suggest that pathophysiological diagnosis is better than the conventional diagnostic method in treatment outcomes.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"97-106"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392459","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 Nasal and Oral Breathing on Respiratory Muscle and Brain Function: A Review","authors":"Ömer Bayrak, Massimiliano Polastri, Esra Pehlivan","doi":"10.4274/ThoracResPract.2024.24061","DOIUrl":"10.4274/ThoracResPract.2024.24061","url":null,"abstract":"<p><p>Nasal breathing (NB) and oral breathing (OB) are two modes of respiration, and the extent to which they affect respiratory muscles and brain function. The primary objective of this study was to explore the impact of NB versus OB on respiratory muscle and brain function. A literature review was conducted by searching the National Library of Medicine (PubMed) and Scopus databases from January 2000 and May 2024. One hundred twenty-six articles were retrieved from the databases searched, and at the end of the selection process, 11 articles were included in the present review. Most studies (91%) were experimental and had adult healthy volunteers; 64% of the included studies focused on the effects of NB and OB on brain function, while the remaining 36% focused on respiratory muscles. A total of 313 participants comprised the population, most of whom were women (63%). Although most studies were conducted on adults, a percentage of participants (15%) were children. NB and OB elicit different brain areas and heterogeneously influence respiratory muscle function. Knowledge of the underlying mechanisms could be beneficial for, for example, personalizing respiratory and manual techniques when rehabilitating individuals with neurological or respiratory impairments.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"145-151"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392455","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":"Scoring Pulmonary Fibrosis Following COVID-19 Pneumonia with Quantitative HRCT: Relationship with Clinical Parameters, Mean Platelet Volume and Lymphocyte/Monocyte Ratio","authors":"Ceren Değirmenci, Göksu Şahin Kalkan, Hakan Ertürk, Pınar Ergün","doi":"10.4274/ThoracResPract.2025.24067","DOIUrl":"10.4274/ThoracResPract.2025.24067","url":null,"abstract":"<p><strong>Objective: </strong>Our study aims to quantify post-Coronavirus disease-2019 (COVID-19) pneumonia-related pulmonary fibrosis using high resolution computed tomography (HRCT) scoring and assess its correlation with clinical parameters, lymphocytes, mean platelet volume (MPV), and lymphocyte/monocyte ratio (LMR). Early detection and understanding of fibrosis progression in patient subsets are essential for enhancing post-COVID-19 patient outcomes.</p><p><strong>Material and methods: </strong>This retrospective, single-center study aims to quantify post-COVID-19 pneumonia pulmonary fibrosis using HRCT scoring and explore its associations with clinical parameters, lymphocytes, MPV, and LMR. From March 1, 2020, to December 31, 2021, HRCT reports of patients diagnosed with COVID-19 within 14 days of symptom onset were reviewed. Those with COVID-19 pneumonia were identified, and subsequent HRCTs performed 2 months or later post-infection were analyzed for fibrosis. Data on demographics, hospitalization details, and laboratory findings were collected. Fibrosis scores were determined using quantitative HRCT.</p><p><strong>Results: </strong>A total of 133 patients (60.2% male, mean age 57.3) were included. Of these patients, 50.4% were hospitalized. Quantitative HRCT analysis indicated average fibrosis of 2.7% (range: 0.9-28.7%). Lower lymphocyte counts correlated significantly with increased fibrosis (<i>P</i> = 0.002). No significant correlations were found between fibrosis development and hospitalization duration, age, or gender.</p><p><strong>Conclusion: </strong>This study underscores the importance of monitoring lymphocyte counts in COVID-19 patients for early detection of pulmonary fibrosis. The findings suggest a need for screening and prompt diagnosis of fibrosis post-COVID-19, particularly in patients with lymphopenia. Further research using quantitative HRCT could enhance understanding and management of progressive interstitial lung diseases, especially in the context of future pandemics.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"125-131"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392584","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":"Response to: Normative Values and Calculation Formulas of Respiratory Muscle Strength of Adults in Turkish Society: A Population-based Study","authors":"Esra Pehlivan, Halit Çınarka","doi":"10.4274/ThoracResPract.2024.240962","DOIUrl":"10.4274/ThoracResPract.2024.240962","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"153-154"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392449","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}