BMJ Open Respiratory Research最新文献

{"title":"Inspiratory muscle training for people with Parkinson's disease: a protocol for a mixed methods randomised controlled trial.","authors":"Juliana Fernandes Barreto de Mendonca, Elisabeth Preston, Allyson Flynn, Bernie Bissett","doi":"10.1136/bmjresp-2024-003120","DOIUrl":"10.1136/bmjresp-2024-003120","url":null,"abstract":"<p><strong>Introduction: </strong>Inspiratory muscle weakness is a known consequence of Parkinson's disease and could be a potential contributor to the dyspnoea experienced by many people living with the condition. Inspiratory muscle training is effective in improving inspiratory muscle strength and reducing dyspnoea in other chronic diseases. However, inspiratory muscle training has received little attention in people with Parkinson's disease, and it is unclear how this training affects inspiratory muscle strength, dyspnoea and quality of life.</p><p><strong>Methods and analysis: </strong>This mixed methods, randomised controlled trial will recruit 50 participants with idiopathic Parkinson's disease who will be randomly allocated to either the experimental group, for 8 weeks, or the control group. Inspiratory muscle strength (maximum inspiratory pressure) will be the primary outcome. The secondary outcomes include motor experience of daily living (Movement Disorder Society-Unified Parkinson's Disease Rating Scale part II), rate of perceived exertion (modified Borg Scale), exercise capacity (6-minute walk test) and quality of life (39-item Parkinson's Disease Questionnaire). Quantitative data will be analysed using descriptive statistics. Semi-structured interviews will be conducted with participants who underwent inspiratory muscle training. Inductive reflexive thematic analysis will be used to explore the participants' experiences of inspiratory muscle training and its impact on dyspnoea, activities of daily living and overall quality of life.</p><p><strong>Trial registration number: </strong>ACTRN12622000097741.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic obstructive pulmonary disease is a risk factor for non-tuberculous mycobacterial pulmonary disease: a population-based matched cohort study.","authors":"Jong Geol Jang, Hyun Lee, Min Gu Kang, Youlim Kim, Kwang Ha Yoo, Kyung Hoon Min, June Hong Ahn, Kyung Soo Hong, Jong Seung Kim, Ji-Yong Moon","doi":"10.1136/bmjresp-2024-002373","DOIUrl":"10.1136/bmjresp-2024-002373","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal studies comprehensively evaluating the direction of the relationship between chronic obstructive pulmonary disease (COPD) and non-tuberculous mycobacterial pulmonary disease (NTM-PD) are scarce. Therefore, this study aimed to evaluate whether COPD influences the development of NTM-PD even after considering various confounders by using a nationwide longitudinal cohort study.</p><p><strong>Methods: </strong>Data from the National Health Insurance Service National Sample Cohort between 2002 and 2019 were analysed. Participants≥20 years of age with COPD and no previous NTM diagnosis were included in the study. The incidence of NTM-PD was compared between participants with COPD (n=8939) and 1:4 fully matched control participants (n=32 355). Participants were followed until the date of NTM-PD incidence, death, or December 2019.</p><p><strong>Results: </strong>During a median follow-up of 9.0 years (IQR, 5.0-12.9 years), participants with COPD (55.5 per 100 000 person-years) had a higher incidence of NTM-PD than matched control cohorts (25.4 per 100 000 person-years), with a HR of 2.16 (95% CI, 1.45 to 3.23). Age, sex, smoking history, asthma, bronchiectasis and corticosteroid use did not affect the association between COPD and the risk of incident NTM-PD (<i>P</i> for interaction >0.05 for all). Among patients with COPD, being underweight and having bronchiectasis were significantly associated with NTM-PD development.</p><p><strong>Conclusions: </strong>Individuals with COPD had approximately a twofold increased risk of developing NTM-PD compared with matched controls. Being underweight and having bronchiectasis were identified as risk factors for developing NTM-PD.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which clinical factors are predictive of outcome in primary spontaneous pneumothorax management?","authors":"Mohammed Zain Raza, Beenish Iqbal, Anand Sundaralingam, Dinesh Addala, Alguili Elsheikh, Rob Hallifax","doi":"10.1136/bmjresp-2024-003089","DOIUrl":"10.1136/bmjresp-2024-003089","url":null,"abstract":"<p><strong>Background: </strong>Primary spontaneous pneumothorax (PSP) occurs when air leaks into the pleural space in patients without known underlying lung disease, causing pain and breathlessness. Optimal management of PSP is not defined and we are unable to predict who will fail medical treatment (ongoing pneumothorax with prolonged air leak). We hypothesised that patients with longer symptom duration and higher symptom scores would be more likely to fail treatment.</p><p><strong>Methods: </strong>Prospectively collected data from the Randomised Ambulatory Management of Primary Pneumothorax randomised controlled trial of ambulatory management were used to determine which clinical factors are associated with treatment failure including symptom scores, time from symptom onset to presentation, treatment allocation, vital signs, history of prior pneumothorax and size of initial pneumothorax.</p><p><strong>Results: </strong>Overall, 63/236 patients (26.7%) failed treatment. On average, symptoms started 1 day before admission. Multivariable analysis found that patients who presented at least 1 day after symptoms began had a lower risk of treatment failure than those presenting on the day symptoms began (ORs 0.39 (0.18 to 0.81)).</p><p><strong>Conclusion: </strong>Further work is required to determine psychological drivers of PSP presentation and risks of prolonged air leak.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma and extrapulmonary comorbidities in a middle-aged general population: results from the SCAPIS study.","authors":"Juan Wang, Anders Blomberg, Magnus Ekström, Hans Lennart Persson, Magnus Sköld, Kjell Torén, Xingwu Zhou, Andrei Malinovschi, Christer Janson","doi":"10.1136/bmjresp-2024-003020","DOIUrl":"10.1136/bmjresp-2024-003020","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma may increase the risk of comorbidities and systemic inflammation, but population data are scarce. This study aimed to compare comorbidities and systemic inflammation between those with and without current asthma and to identify characteristics linked to comorbidities and biomarkers.</p><p><strong>Methods: </strong>In a cross-sectional analysis of 28 828 people aged 50-64 in the Swedish CArdioPulmonary bioImage Study, assessments included postbronchodilator forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), serum levels of C reactive protein (CRP) and haemoglobin A1c (HbA1c). Data on current physician-diagnosed asthma, respiratory symptoms and comorbidities were obtained via a questionnaire.</p><p><strong>Results: </strong>The prevalence of current asthma was 6.3%. Current asthma was independently associated with a higher prevalence of hypertension (OR=1.30; 95% CI 1.16 to 1.46), hyperlipidaemia (OR=1.20; 95% CI 1.04 to 1.39), diabetes (OR=1.42; 95% CI 1.16 to 1.75), coeliac disease (OR=2.52; 95% CI 1.61 to 3.95) and rheumatic disease (OR=1.43; 95% CI 1.16 to 1.78). Asthma was also associated with higher levels of CRP (beta=0.25; 95% CI 0.06 to 0.44) and HbA1c (beta=0.47; 95% CI 0.18 to 0.77). In those with asthma, lower FVC % predicted was associated with a higher likelihood of hypertension (OR=1.10; 95% CI 1.01 to 1.19), diabetes (OR=1.47; 95% CI 1.26 to 1.71) and rheumatic disease (OR=1.22; 95% CI 1.05 to 1.42). Lower FEV₁ % predicted was associated with a higher likelihood of diabetes (OR=1.27; 95% CI 1.12 to 1.44). FVC % and FEV₁ % predicted were negatively associated with CRP and HbA1c.</p><p><strong>Conclusions: </strong>Our findings suggest that in middle-aged people, asthma is independently associated with common comorbidities such as hypertension, diabetes and rheumatic disease, as well as elevated CRP and blood glucose. Our data suggest that some associations are connected with lung function impairment in those with asthma.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional relationship between sleep problems and long COVID: a longitudinal analysis of data from the COVIDENCE UK study.","authors":"Giulia Vivaldi, Mohammad Talaei, John Blaikley, Callum Jackson, Paul E Pfeffer, Seif O Shaheen, Adrian R Martineau","doi":"10.1136/bmjresp-2024-002506","DOIUrl":"10.1136/bmjresp-2024-002506","url":null,"abstract":"<p><strong>Background: </strong>Studies into the bidirectional relationship between sleep and long COVID have been limited by retrospective pre-infection sleep data and infrequent post-infection follow-up. We therefore used prospectively collected monthly data to evaluate how pre-infection sleep characteristics affect risk of long COVID and to track changes in sleep duration during the year after SARS-CoV-2 infection.</p><p><strong>Methods: </strong>COVIDENCE UK is a prospective, population-based UK study of COVID-19 in adults. We included non-hospitalised participants with evidence of SARS-CoV-2 infection and used logistic regression to estimate adjusted ORs for the association between preinfection sleep characteristics and long COVID. We assessed post-infection sleep duration using multilevel mixed models. We collected sleep data from participants using a subset of questions from the Pittsburgh Sleep Quality Index. We defined long COVID as unresolved symptoms at least 12 weeks after infection. COVIDENCE UK is registered with ClinicalTrials.gov, NCT04330599.</p><p><strong>Results: </strong>We included 3994 participants in our long COVID risk analysis, of whom 327 (8.2%) reported long COVID. We found an inverse relationship between pre-infection sleep quality and risk of long COVID (medium vs good quality: OR 1.37, 95% CI 1.04 to 1.81; medium-low vs good: 1.55, 1.12 to 2.16; low vs good: 1.94, 1.11 to 3.38). Greater variability in pre-infection sleep efficiency was also associated with long COVID when adjusted for infection severity (OR per percentage-point increase 1.07, 1.02 to 1.12). We assessed post-infection sleep duration in 6860 participants, observing a 0.11 hour (95% CI 0.09 to 0.14) increase in the first month after infection compared with pre-infection, with larger increases for more severe infections. After 1 month, sleep duration largely returned to pre-infection levels, although fluctuations in duration lasted up to 6 months after infection among people reporting long COVID.</p><p><strong>Conclusions: </strong>While poor-quality sleep before SARS-CoV-2 infection associates with increased risk of long COVID thereafter, changes in sleep duration after infection in these non-hospitalised cases were modest and generally quick to resolve.</p><p><strong>Trial registration number: </strong>NCT04330599.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycopyrrolate/formoterol fumarate MDI in mild-to-moderate chronic obstructive pulmonary disease (PIONEER): a protocol for a randomised, double-blind, placebo-controlled trial.","authors":"Feng-Yan Wang, Zi-Hui Wang, Jia-Xuan Xu, Zhen-Yu Liang, Pi-Xin Ran, Yu-Min Zhou, Yi Gao, Wei-Juan Shi, Wan-Yi Jiang, Yu-Qi Li, Dong-Ying Zhang, Rong-Chang Chen, Wei-Jie Guan, Nan-Shan Zhong, Jin-Ping Zheng","doi":"10.1136/bmjresp-2024-002656","DOIUrl":"10.1136/bmjresp-2024-002656","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) often experience rapid declines in lung function but are rarely treated early. The Prospect of early InterventiON in the managEment of chronic obstructivE pulmonaRy disease (PIONEER) study aims to evaluate the efficacy of long-term glycopyrrolate/formoterol fumarate (GFF) metered dose inhaler (MDI) as an initial therapy on lung function and disease progression in individuals with mild-to-moderate COPD.</p><p><strong>Methods and analysis: </strong>This is a multicentre, randomised, double-blind, placebo-controlled, parallel-group study. Approximately 318 patients with COPD in Global Initiative for Chronic Obstructive Lung Disease stages 1 (mild) or 2 (early moderate), with no history of severe exacerbations in the previous year, will be randomised in a 2:1 ratio to receive two times per day GFF MDI (14.4/10 µg) or placebo for 52 weeks. Clinical assessments will include pulmonary function tests, symptom scores, quality-of-life measures, recording of COPD exacerbations and chest CT. The primary endpoint is the between-group difference in the change from baseline in forced expiratory volume in 1 s (FEV₁) after 2 hours of bronchodilator over 24 weeks. Secondary endpoints include the between-group difference in the change from baseline in morning pre-dose trough FEV₁ over 24 weeks, morning post-dose 2 hour FEV₁ over 52 weeks and time to minimal clinically important deterioration. The safety endpoint is the incidence of adverse events. An extension study with rerandomisation will follow the PIONEER study to explore the long-term need for GFF MDI use.</p><p><strong>Trial registration number: </strong>ChiCTR2200064765; Chinese Clinical Trial Registry, www.chictr.org.cn.</p><p><strong>Ethics and dissemination: </strong>The study protocol has been approved by the Ethics Committee of The First Affiliated Hospital, Guangzhou Medical University (2022-23、2024-K-005), and all collaborating centres have obtained approval from their respective ethics committees. Results will be presented at national and international meetings and submitted for publication in peer-reviewed journals within the field.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' experiences of, and psychological responses to, surveillance for pulmonary nodules detected through lung cancer screening.","authors":"Evangelos Katsampouris, Andrew W Creamer, Ruth Prendecki, Elizabeth Clark, Jennifer L Dickson, Richard Lee, Samuel M Janes, Stephen W Duffy, Samantha L Quaife","doi":"10.1136/bmjresp-2024-002498","DOIUrl":"10.1136/bmjresp-2024-002498","url":null,"abstract":"<p><strong>Introduction: </strong>Low-dose CT screening reduces lung cancer mortality among high-risk populations, and detects indeterminate pulmonary nodules that require subsequent surveillance. This period of uncertainty could result in patients experiencing lung cancer-related distress, anxiety and worry. This multicentre qualitative study explored patients' experiences and psychological responses to disclosing and communicating nodule surveillance.</p><p><strong>Methods: </strong>Eligible participants were purposively sampled from four lung cancer screening sites in England to ensure diversity with respect to region, service setting, individual characteristics and surveillance pathways. Thirty-nine patients (23 females), aged 55-80 years, who had undergone their first nodule surveillance scan, participated in one-to-one remote semi-structured interviews. Audio-recorded interviews were transcribed verbatim and analysed using applied thematic analysis.</p><p><strong>Results: </strong>Participants reported a broad spectrum of psychological responses to the way their nodule finding was communicated and their experiences of undergoing surveillance. Understanding what a nodule is and what a surveillance process entails was important for explaining patient psychological reactions and behavioural outcomes. Perceived support and effective communication with healthcare professionals were instrumental in decreasing patients' distress, uncertainty and concern, and increasing reassurance, knowledge about nodules and psychological preparation for the possibility of surveillance.</p><p><strong>Conclusions: </strong>While current letter-based means of nodule disclosure and communication were acceptable to patients, there is a need to improve the way nodules are communicated using lay language. Brief verbal consultations with healthcare professionals could provide clearer guidance to patients undergoing surveillance and increase their understanding about the surveillance process and subsequent scans, resulting in improved affective, behavioural and cognitive outcomes.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term multidimensional patient-centred outcomes after hospitalisation for COVID-19: do not only focus on disease severity.","authors":"Martine Bek, Yasemin Türk, Matthijs L Janssen, Gemma Weijsters, Julia C Berentschot, Rita J G van den Berg-Emons, Majanka H Heijenbrok-Kal, Gerard M Ribbers, Joachim Aerts, Wessel E J J Hanselaar, Henrik Endeman, Merel E Hellemons, Evert-Jan Wils","doi":"10.1136/bmjresp-2024-002789","DOIUrl":"10.1136/bmjresp-2024-002789","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between COVID-19 disease severity during hospitalisation for COVID-19 and long-term multidimensional patient-centred outcomes up to 12 months post-hospitalisation. The secondary objective was to identify other risk factors for these long-term outcomes.</p><p><strong>Methods: </strong>In this multicentre prospective cohort study, we categorised COVID-19 disease severity using the maximal level of respiratory support as proxy into (1) conventional oxygen therapy (COT), (2) high-flow nasal oxygen (HFNO) and (3) invasive mechanical ventilation (IMV). The primary outcome health-related quality of life (HRQoL), and the secondary outcomes self-reported symptoms and recovery were collected at 6 and 12 months post-hospitalisation.</p><p><strong>Results: </strong>Data from 777 patients were analysed, with 226 (29%) receiving COT, 273 (35%) HFNO and 278 (36%) IMV. Patients reported impaired HRQoL, persistence of symptoms and poor recovery. Multivariable generalised estimating equations analysis showed that COVID-19 disease severity was not associated with HRQoL and inconsistently with symptoms; the HFNO group reported poorer recovery. Overall, female sex, younger age and pulmonary history were independent risk factors for outcomes.</p><p><strong>Conclusions: </strong>COVID-19 disease severity was associated with self-perceived recovery, but not with HRQoL and inconsistently with symptoms. Our findings suggest that age, sex and pulmonary history are more consistent risk factors for long-term multidimensional outcomes and offer better guidance for aftercare strategies.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between cancer survivorship and subsequent respiratory disease: a systematic literature review.","authors":"Kirsty Andresen, Helena Carreira, Ruchika Jain, Harriet Forbes, Elizabeth Williamson, Jennifer K Quint, Krishnan Bhaskaran","doi":"10.1136/bmjresp-2024-002681","DOIUrl":"10.1136/bmjresp-2024-002681","url":null,"abstract":"<p><strong>Background: </strong>The population of cancer survivors is growing. Some cancers and their treatments may lead to long-term adverse respiratory issues. This systematic review aims to summarise the evidence on the association between cancer survivorship and long-term respiratory health, across a range of cancer types.</p><p><strong>Methods: </strong>We searched Cochrane, Embase and MEDLINE up until 23 February 2025 for cohort or nested case-control studies comparing incident respiratory outcomes in people with a history of cancer versus population-based cancer-free controls. We required studies to include follow-up time beyond the period of active cancer treatment. Outcomes included acute respiratory infections and chronic respiratory conditions. Study quality was assessed using The Scottish Intercollegiate Guidelines Network methodology checklists.</p><p><strong>Results: </strong>We identified 34 eligible cohort studies. Cancer survivors' cohort sizes ranged from 1325 to >8 million. Only 4 out of 34 studies adjusted for smoking, leading to most studies being rated as low quality. Four of the 21 studies of acute respiratory infections were rated as acceptable/high quality, and of these, all observed raised risks, notably among survivors of haematological, head and neck, lung and oesophageal cancers. Of 19 studies of chronic respiratory conditions, 1 was rated as high quality, finding increased risks of chronic obstructive pulmonary disease (COPD) and pneumonitis in survivors of head and neck cancer. The remaining studies found increased risks of adverse outcomes from acute respiratory infections in 17 of 21 cancer types for which data were available, and of COPD in cervical, head and neck, lung, oesophageal, oral, stomach, thyroid and vulva cancers.</p><p><strong>Discussion: </strong>These findings suggest increased risks of a range of respiratory conditions in survivors of some cancers. Much of the evidence is compromised by a lack of control for key potential confounders, like smoking. Future studies should address this limitation and investigate the drivers of respiratory risks in cancer survivors. Improved evidence could inform mitigation strategies and lead to better survivorship care plans.</p><p><strong>Prospero registration number: </strong>CRD42022311557.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of sleep-disordered breathing and chronic hypoventilation in obese women and men: a cross-sectional observational study.","authors":"Michelle Mollet, Lara Benning, Joel J Herzig, Matteo Bradicich, Zoe Bousraou, Silvia Ulrich, Esther Irene Schwarz","doi":"10.1136/bmjresp-2024-002632","DOIUrl":"10.1136/bmjresp-2024-002632","url":null,"abstract":"<p><strong>Background and aim: </strong>Obesity is associated with an increased risk of sleep-disordered breathing (SDB)-obstructive sleep apnoea (OSA) and sleep hypoventilation-and obesity hypoventilation syndrome (OHS). The aim was to assess the impact of obesity on lung volumes and the prevalence of SDB and OHS and to identify predictors of these.</p><p><strong>Methods: </strong>In a cross-sectional analysis, obese patients (body mass index ≥30 kg/m²) who underwent an in-laboratory sleep study, arterial blood gas analysis and pulmonary function tests between 2018 and 2023 were included. Analysis of variance and multivariate regression analysis were used to compare obesity groups and identify predictors of SDB and OHS.</p><p><strong>Results: </strong>In 1065 obese adults (39% female; 48% obesity WHO I, 24% WHO II, 28% WHO III), the prevalence of OSA (apnoea hypopnoea index (AHI) ≥5/hour), severe OSA (AHI ≥30/hour), sleep hypoventilation and OHS was 77%, 29%, 21% and 8%, respectively. The likelihood of OSA, severe OSA and sleep hypoventilation increased with obesity class, while the presence of OHS did not differ between groups. In multivariate regression models including body mass index, neck circumference, age, sex, AHI, bicarbonate and expiratory reserve volume, bicarbonate and forced vital capacity were independent predictors of both sleep hypoventilation and OHS and neck circumference of severe OSA. The area under the receiver operating characteristics curve of bicarbonate for OHS and sleep hypoventilation was 0.92 and 0.72, respectively.</p><p><strong>Conclusions: </strong>Three quarter of obese patients have OSA, and the likelihood of OSA, severe OSA and sleep hypoventilation increase across obesity severity groups. Bicarbonate has a high diagnostic accuracy for OHS.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}