American journal of respiratory and critical care medicine最新文献

{"title":"Effects of Continuous Positive Airway Pressure on Neuroimaging Biomarkers and Cognition in Adult Obstructive Sleep Apnea: A Randomized Controlled Trial.","authors":"Huajun Xu, Yupu Liu, Chenyang Li, Xinyi Li, Li Shen, Hui Wang, Feng Liu, Juanjuan Zou, Yunyan Xia, Weijun Huang, Yuenan Liu, Zhenfei Gao, Yiqun Fu, Fan Wang, Shujian Huang, Zhiyuan Song, Fan Song, Yiqing Gao, Yu Peng, Jianyin Zou, Huaming Zhu, Suru Liu, Linpeng Li, Xiaoyue Zhu, Yuanping Xiong, Yuli Hu, Jiaxin Yang, Yuehua Li, Feng Gao, Qihao Guo, Hengye Huang, Weituo Zhang, Jiping Li, Yanqing Chen, Pin Dong, Jun Yang, Jingrong Lv, Peihua Wang, Yiyuan Sun, Biyun Qian, Kristine Yaffe, Jian Guan, Hongliang Yi, Yue Leng, Shankai Yin","doi":"10.1164/rccm.202406-1170OC","DOIUrl":"10.1164/rccm.202406-1170OC","url":null,"abstract":"<p><p><b>Rationale:</b> Obstructive sleep apnea (OSA) is associated with cognitive impairment. The effects of continuous positive airway pressure (CPAP) on neuroimaging biomarkers and cognitive performance among middle-aged patients with OSA and normal cognition remain unclear. <b>Objectives:</b> To investigate the effects of CPAP therapy over 12 months on neuroimaging biomarkers and cognitive performance. <b>Methods:</b> In this multicenter, randomized clinical trial, we randomly assigned 148 participants with normal cognition and an apnea-hypopnea index ⩾15/h into two groups: patients receiving CPAP with best supportive care (BSC); and patients receiving BSC alone. The primary endpoint was Montreal Cognitive Assessment (MoCA) score at 6 months after enrollment. The secondary endpoints were intranetwork functional connectivity (FC) of default mode network (DMN) and cortical thickness assessed by functional and structural magnetic resonance imaging, other neuroimaging biomarkers, and neurobehavioral tests. <b>Measurements and Main Results:</b> Between 2017 and 2021, 148 patients were recruited from five hospitals. Linear mixed models showed that there was no significant difference in MoCA scores at 6 months between the CPAP and BSC groups (difference, -0.04; 95% confidence interval [CI], -0.72 to 0.65; <i>P</i> = 0.91). However, there were significant differences in the FC of DMN (difference, -13.73; 95% CI, -23.40 to -4.06; <i>P</i> = 0.01) and cortical thickness (difference, -0.06 mm; 95% CI, -0.10 to -0.01 mm; <i>P</i> = 0.02) between CPAP and BSC groups at 6 months after treatment. No serious adverse events occurred. <b>Conclusions:</b> CPAP improved cortical thickness and FC of DMN, suggesting that patients with OSA may recover from brain atrophic processes after CPAP treatment. However, no improvement in MoCA was found. Clinical trial registered with www.clinicaltrials.gov (NCT02886156).</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"628-636"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490144","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":"Electrical Impedance Tomography Changes After Surfactant Administration: Signs to Be Explored.","authors":"Walusa A Gonçalves-Ferri, Felipe S Rossi, Maisa Ribeiro, Thais Iwashita-Lages, Maria A M Nakamura, Letícia C Correa, Eduardo L V Costa, Marcelo B P Amato","doi":"10.1164/rccm.202406-1182RL","DOIUrl":"10.1164/rccm.202406-1182RL","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"644-647"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715038","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":"Effect of Long-Term Fine Particulate Matter Exposure on Lung Cancer Incidence and Mortality in Chinese Nonsmokers.","authors":"Meng Zhu, Yuting Han, Yuanlin Mou, Xia Meng, Chen Ji, Xia Zhu, Canqing Yu, Dianjianyi Sun, Ling Yang, Qiufen Sun, Yiping Chen, Huaidong Du, Juncheng Dai, Zhengming Chen, Zhibin Hu, Jun Lv, Guangfu Jin, Hongxia Ma, Haidong Kan, Liming Li, Hongbing Shen","doi":"10.1164/rccm.202408-1661OC","DOIUrl":"10.1164/rccm.202408-1661OC","url":null,"abstract":"<p><p><b>Rationale:</b> The association between fine particulate matter (particulate matter ⩽2.5 μm in aerodynamic diameter, PM_2.5) and lung cancer incidence in nonsmokers (LCINS) remains inconsistent. <b>Objectives:</b> To investigate the association between long-term PM_2.5 exposure and LCINS in a Chinese population and to assess the modifying effect of genetic factors. <b>Methods:</b> Time-dependent Cox proportional hazard models were used to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) of PM_2.5 with LCINS risk and LCINS-related mortality. The polygenic risk score was constructed to further explore the interactions between genetic risk and PM_2.5 exposure. In addition, the population attributable fraction of PM_2.5 to lung cancer risk and mortality was calculated. <b>Measurements and Main Results:</b> The results demonstrated significant associations between PM_2.5 exposure and LCINS incidence (HR, 1.10 per 10 μg/m³; 95% CI, 1.04-1.17 per 10 μg/m³) and mortality (HR, 1.17 per 10 μg/m³; 95% CI, 1.08-1.27 per 10 μg/m³). Compared with the lowest-risk group, individuals exposed to the high PM_2.5 concentration (⩾50.9 μg/m³) and high genetic risk (top 30%) exhibited the highest LCINS incidence (HR, 2.01; 95% CI, 1.39-2.87) and mortality (HR, 2.30; 95% CI, 1.38-3.82). A significant additive interaction between PM_2.5 and genetic risk on LCINS incidence was observed. Approximately 33.6% of LCINS cases and 48.5% of LCINS-related deaths in China could be prevented if PM_2.5 concentrations were reduced to meet World Health Organization guidelines. <b>Conclusions:</b> Long-term exposure to outdoor PM_2.5 increases LCINS risk and LCINS-related mortality, especially in populations with high genetic risk. Strengthening air pollution control measures in China has the potential to significantly reduce the burden of LCINS.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"600-609"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inbuilt Errors: A Call for Standardized Definitions.","authors":"Aman Pande, Philippe Haouzi","doi":"10.1164/rccm.202411-2183LE","DOIUrl":"10.1164/rccm.202411-2183LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"663-664"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Hypertension Care Delivery in the United States: Is It Time to Get with the Guidelines?","authors":"Kari R Gillmeyer, Shelsey W Johnson","doi":"10.1164/rccm.202501-0107ED","DOIUrl":"10.1164/rccm.202501-0107ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"552-554"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: A New Approach for Identifying Patients with Undiagnosed Chronic Obstructive Pulmonary Disease.","authors":"","doi":"10.1164/rccm.v211erratum2","DOIUrl":"10.1164/rccm.v211erratum2","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"211 4","pages":"664"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal High Flow to Modulate Dyspnea in Orally Intubated Weanable Patients.","authors":"Lara Pisani, Massimo Antonelli","doi":"10.1164/rccm.202412-2574ED","DOIUrl":"10.1164/rccm.202412-2574ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"544-546"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Progression of Chronic Obstructive Pulmonary Disease.","authors":"Carrie Pistenmaa, George R Washko","doi":"10.1164/rccm.202410-2041ED","DOIUrl":"10.1164/rccm.202410-2041ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"543-544"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142976967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting Air Pollution and Reduction in Lung Cancer Incidence and Mortality.","authors":"Samira Shojaee, Patrick Nana-Sinkam","doi":"10.1164/rccm.202501-0061ED","DOIUrl":"10.1164/rccm.202501-0061ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"548-549"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended Continuous Positive Airway Pressure in Preterm Infants Increases Lung Growth at 6 Months: A Randomized Controlled Trial.","authors":"Cindy T McEvoy, Kelvin D MacDonald, Mitzi A Go, Kristin Milner, Julia Harris, Diane Schilling, Matthew Olson, Christina Tiller, James E Slaven, Jeffrey Bjerregaard, Annette Vu, Alec Martin, Rachna Mamidi, Robert L Schelonka, Cynthia D Morris, Robert S Tepper","doi":"10.1164/rccm.202411-2169OC","DOIUrl":"10.1164/rccm.202411-2169OC","url":null,"abstract":"<p><p><b>Rationale:</b> Extended continuous positive airway pressure (eCPAP) in the neonatal ICU (NICU) for stable preterm infants increases lung volumes. Its effect on lung growth after discharge is unknown. <b>Objectives:</b> To assess whether 2 weeks of eCPAP in stable preterm infants is associated with increased alveolar volume (Va) at 6 months corrected age. <b>Methods:</b> This randomized controlled trial was conducted at Oregon Health & Science University. Outpatient assessors were unaware of treatment assignment. One hundred infants were randomized to eCPAP versus CPAP discontinuation (dCPAP) to room air. <b>Measurements and Main Results:</b> The primary outcome was Va by the single breath hold technique at 6 months corrected age. Secondary outcomes included Dl_CO and forced expiratory flows (FEFs). FRC was measured in the NICU. Infants randomized to eCPAP (<i>n</i> = 54) versus dCPAP (<i>n</i> = 46) had the following measurements shown as adjusted mean (SE): Va (500.2 [24.9] vs. 418.1 [23.4] ml; adjusted mean difference, 82.1 [95% confidence interval (CI), 8.3-155.9]; <i>P</i> = 0.033); Dl_CO (3.4 [0.2] vs. 2.8 [0.1] ml/min/mm Hg; adjusted mean difference, 0.6 [95% CI, 0.1-1.1]; <i>P</i> = 0.018); measurement of FEF at 50% of the expired volume (500.6 [18.2] vs. 437.9 [17.9] ml/s; adjusted mean difference, 62.7 [95% CI, 4.5-121.0]; <i>P</i> = 0.039); FEF between 25% and 75% of expired volume (452.0 [17.4] vs. 394.4 [17.4] ml/s; adjusted mean difference, 57.5 [95% CI, 1.3-113.8]; <i>P</i> = 0.046). <b>Conclusions:</b> Infants randomized to eCPAP versus dCPAP had significantly increased Va at 6 months corrected age. Dl_CO and FEFs were also increased. Extending CPAP in stable preterm infants in the NICU may be a nonpharmacologic and safe therapy to promote lung growth. Clinical trial registered with www.clinicaltrials.gov (NCT04295564).</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"610-618"},"PeriodicalIF":19.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}