American journal of respiratory and critical care medicine最新文献

{"title":"Clinician Prediction of Hyperinflammatory ARDS Subphenotypes: Overestimated but Prognostic.","authors":"Georgios D Kitsios, Menaal Haque, William G Bain, Charles Dela Cruz, Bryan J McVerry, Faraaz A Shah","doi":"10.1164/rccm.202409-1816RL","DOIUrl":"https://doi.org/10.1164/rccm.202409-1816RL","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, Regional, and National Burden of Pulmonary Fungal Infections 1990-2021.","authors":"Ying Xia, Weiwei Jiang, Xinlin Zhu, Bo Pan, Tianyang Chen, Yan Wang, Wanqing Liao, Weihua Pan","doi":"10.1164/rccm.202410-2076OC","DOIUrl":"https://doi.org/10.1164/rccm.202410-2076OC","url":null,"abstract":"<p><p><b>Rationale:</b> The lungs are the most prevalent site for invasive fungal infections, and the diagnosis and treatment of pulmonary fungal infections pose significant challenges, accompanied by a substantial disease burden. Global factors will likely enhance the risk of it in the future. Assessing the global burden of pulmonary fungal infections is crucial for implementing appropriate measures for prevention and control. <b>Objectives:</b> To evaluate the burden of pulmonary fungal infections at the global, regional, and national levels from 1990 to 2021 and make projections for 2024. <b>Methods:</b> Data on deaths and Disability-Adjusted Life Years due to pulmonary fungal infections were extracted from the Global Burden of Disease database. Linear regression, complex inequality measures, and the Nordpred model were employed for analysis and visualization. <b>Results:</b> In 2021, the global incidence of pulmonary fungal infections was estimated at 5.62 million cases (95% Uncertainty Interval [UI] 4.93-6.40 million), with 45,542 deaths (95% UI 39,299-51,944). The age-standardized mortality rate was 0.56 per 100,000 (95% UI 0.48-0.64). From 1990 to 2021, the estimated annual percentage change was -1.03% (95% Confidence Interval [CI]: -1.13 to -0.93), with an observed increase in mortality rates in low- and middle-income countries. The mortality rate significantly increased among individuals aged 50 and above. By 2044, over 87,000 deaths are expected from pulmonary fungal infections, at a rate of about 0.58 per 100,000. <b>Conclusions:</b> Pulmonary fungal infections represent a significant global challenge that warrants attention and necessitates international collaboration to collectively address this issue. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Guidelines: Asking the Right Questions to Guide Fungal Infection Management.","authors":"Ignacio Martin-Loeches, Alejandro H Rodriguez","doi":"10.1164/rccm.202412-2459LE","DOIUrl":"https://doi.org/10.1164/rccm.202412-2459LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Currow <i>et al.</i> and to Akgün.","authors":"Amy Heinzerling, Robert Harrison, Jennifer Flattery, Jane C Fazio, Sheiphali Gandhi, Kristin J Cummings","doi":"10.1164/rccm.202502-0405LE","DOIUrl":"https://doi.org/10.1164/rccm.202502-0405LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We'll Look Back and Say, \"Why Didn't We Act Sooner on Engineered Stone?''.","authors":"David C Currow, Kate F Cole, Sanchia K Aranda, Malcolm R Sim","doi":"10.1164/rccm.202501-0282LE","DOIUrl":"https://doi.org/10.1164/rccm.202501-0282LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Martin-Loeches and Rodriguez: Clinical Guidelines: Asking the Right Questions to Guide Fungal Infection Management.","authors":"Oleg Epelbaum, Tina Marinelli, Kelly M Pennington, Andrew H Limper, Chadi A Hage","doi":"10.1164/rccm.202501-0152LE","DOIUrl":"https://doi.org/10.1164/rccm.202501-0152LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Presentation of Clear Cell Tumor of the Lung as Irregular Nodules with a Thin-walled Cavity.","authors":"Minli Lv, Qiang Gao, Jianquan Zhong","doi":"10.1164/rccm.202411-2124IM","DOIUrl":"https://doi.org/10.1164/rccm.202411-2124IM","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combating Global Silicosis Epidemics: Can We Alter Sisyphus's Fate?","authors":"Metin Akgün","doi":"10.1164/rccm.202502-0447LE","DOIUrl":"https://doi.org/10.1164/rccm.202502-0447LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oscillometry-defined Small Airway Dysfunction in Tobacco-exposed Adults with Impaired or Preserved Airflow.","authors":"Mustafa Abdo, Henrik Watz, Frederik Trinkmann, Sabine Bohnet, Miriam Annabella Marcella Guess, Johannes Roeben, Katharina May, Martin Reck, Benjamin-Alexander Bollmann, Susanne Stiebeler, Sabine Dettmer, Benjamin Waschki, Klaus F Rabe, Klaas Frederik Franzen, Jens Vogel-Claussen","doi":"10.1164/rccm.202501-0028OC","DOIUrl":"https://doi.org/10.1164/rccm.202501-0028OC","url":null,"abstract":"<p><strong>Rationale: </strong>Small airway dysfunction (SAD) is a key feature of COPD and might present in tobacco-exposed adults with normal spirometry. So far, the role of oscillometry-defined SAD in this population is largely unexplored.</p><p><strong>Objective: </strong>To investigate the prevalence of oscillometry-defined SAD and its associations with airway structural changes, quality of life (QoL), metabolic and cardiovascular disease (CVD) in tobacco-exposed adults with impaired or preserved airflow.</p><p><strong>Methods: </strong>In a sub-cohort (n=1628) nested within a lung cancer screening trial, we assessed airway disease using preBD-spirometry, oscillometry, and AI-powered CT. Impaired airflow included airflow obstruction (AFO) and preserved ratio impaired spirometry (PRISm). Subjects with preserved airflow (PA), defined as FEV1 and FEV1/FVC > LLN, were further stratified as PA with SAD (PA-SAD) or normal lung function. SAD was defined as the frequency dependence of resistance (R_5-19) or reactance area (AX) > ULN. CT biomarkers included airway wall thickness (AWT-Pi10), lumen diameter, branch count, and emphysema. QoL was measured using the EQ-5D-5L.</p><p><strong>Results: </strong>The overall prevalence of SAD was 39%. SAD was present in 26% of subjects with PA and in 60% of those with impaired airflow. The frequency of AFO, PRISm and PA-SAD was 21%, 15% and 16%, respectively. Similar to impaired airflow, subjects with PA-SAD had lower EQ-5D-5L score, greater AWT-Pi10, narrower lumen, lower branch count, and higher rate of metabolic and CVD than those with normal lung function, (all p-values <0.01). However, they had minimal emphysema and significantly higher branch count than those with AFO. Subjects with AFO or PRISm and concurrent SAD had greater structural changes and more frequent CVD than those with AFO or PRISm alone. SAD was associated with CVD, OR: 1.91 (95% CI: 1.55 - 2.36), even after adjusting for confounders and metabolic disease.</p><p><strong>Conclusion: </strong>SAD is highly prevalent among tobacco-exposed adults and is associated with airway structural changes, impaired QoL, and increased rate of CVD, even in those with PA. PA-SAD is distinct from AFO by its preserved airway count and minimal emphysema. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Credible</i> Subgroup Effects in Randomized Clinical Trials.","authors":"Harm-Jan de Grooth, Nadir Yehya, Michael O Harhay","doi":"10.1164/rccm.202502-0411ED","DOIUrl":"https://doi.org/10.1164/rccm.202502-0411ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}