BMC Pulmonary Medicine最新文献

{"title":"The impact of the triglyceride-glucose index on the risk of respiratory failure in patients with COPD: a study from the MIMIC database and Chinese cohorts.","authors":"Shiyu Hu, Ye Zhang, Zhifang Cui, Ye Zhang, Jiaye Wang, Xiaoli Tan, Wenyu Chen","doi":"10.1186/s12890-025-03597-x","DOIUrl":"https://doi.org/10.1186/s12890-025-03597-x","url":null,"abstract":"<p><strong>Background: </strong>The Triglyceride-Glucose (TyG) index, a reliable marker for insulin resistance, is now employed to assess the onset and prognosis of various conditions like acute coronary syndrome, chronic kidney disease, and ischemic stroke. However, whether the TyG index can be used to assess respiratory failure (RF) risk among Chronic obstructive pulmonary disease (COPD) patients remains uncertain. The present study aims to delve into the link between the TyG index and the risk of RF in COPD patients.</p><p><strong>Methods: </strong>Individuals with COPD were retrospectively acquired from the MIMIC-IV 2.2 (The Medical Information Mart for Intensive Care IV, version 2.2) database. The association between the TyG index and the probability of RF among COPD patients was evaluated using Cox proportional hazards models and restricted cubic spline (RCS) curves. Cumulative incidence curves were generated to appraise the RF risk across the quartile groups. Finally, 1188 patients were recruited from the First Hospital of Jiaxing City to externally validate the Cox modeling results for the primary outcome.</p><p><strong>Results: </strong>This study incorporated a total of 1,232 participants from MIMIC database. Among these individuals, 134 cases (10.9%) experienced RF. According to Cox regression analysis, a one-unit increment in the TyG index was linked to a 1.821-fold elevated risk of RF in the COPD population (HR, 1.821[95% CI 1.349-2.459], P < 0.001). High TyG index levels were significantly linked to a higher RF risk (HR, 3.510 [95% CI 1.885-6.535], P < 0.001). RCS curve analysis also signaled a linear correlation between the TyG index and RF risk (P-Nonlinear = 0.074).</p><p><strong>Conclusion: </strong>There exists a certain correlation between high-level TyG index and the risk of RF occurrence in COPD patients, indicating promising prospects for utilizing the TyG index to assess the severity of COPD patients.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"149"},"PeriodicalIF":2.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771152","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":"Impact of initial ventilation strategies on in-hospital mortality in sepsis patients: insights from the MIMIC-IV database.","authors":"Yuxin Lu, Jingtao Zhang, Wanglin Zhang, Hongwei Shi, Kanlirong Wang, Ziang Li, Liqun Sun","doi":"10.1186/s12890-025-03610-3","DOIUrl":"https://doi.org/10.1186/s12890-025-03610-3","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the impact of different initial ventilation strategies on in-hospital mortality among sepsis patients.</p><p><strong>Methods: </strong>We included hospitalized sepsis patients who underwent mechanical ventilation from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized them into groups based on their initial ventilation strategy: non-invasive ventilation (NIV) and invasive mechanical ventilation (IMV). The main endpoint analyzed was in-hospital mortality. A propensity score matching model was employed to address confounding factors, and Cox survival analysis was performed in the matched cohort. Subgroup analyses were conducted to evaluate population heterogeneity.</p><p><strong>Results: </strong>Among 19,796 patients who received mechanical ventilation, 10,073 (50.8%) initially received NIV. The analysis included 2935 matched pairs. Patients initially receiving NIV exhibited a higher survival rate (P = 0.009) and a 24% lower risk of in-hospital mortality compared to those initially receiving IMV (P < 0.001). Subgroup analysis indicated significant survival benefits with initial NIV for patients without malignant tumor (MT), or lower Sequential Organ Failure Assessment (SOFA) scores and higher PO₂/FiO₂.</p><p><strong>Conclusion: </strong>Among sepsis patients, initial NIV is linked to increased in-hospital survival rates and reduced mortality risk, particularly in patients without concurrent MT, lower SOFA scores, and higher PO₂/FiO₂.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"147"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762867","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":"Characteristics and sex differences in bronchopulmonary dysplasia-related pulmonary hypertension.","authors":"Dansha Zhou, Ting Wang, Yuqin Chen, Yulin Zheng, Yingzhen Zhou, Mingxiang Zhang, Aofeng Liu, Biao Hu, Shuang Fu, Ruixian Wu, Wei Chen, Xiaoli Jiang, Zehui Ye, Yuan Shi, Zhou Fu, Jian Wang","doi":"10.1186/s12890-025-03585-1","DOIUrl":"https://doi.org/10.1186/s12890-025-03585-1","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) secondary to bronchopulmonary dysplasia (BPD) is associated with increased mortality. This study aims to elucidate the risk factors for BPD-PH development and the long-term prognostic factors in pediatric BPD.</p><p><strong>Methods: </strong>We analyzed 1082 BPD patients under the age of three. Univariate and multivariate regression were performed to determine the final model. Risk stratification was performed based on the predicted risk score, and Kaplan-Meier survival curves were used to compare survival rates.</p><p><strong>Results: </strong>The in-hospital mortality rate of severe BPD was three times than non-severe BPD, and pediatric BPD-PH had twice the mortality compared to BPD without PH. The incidence of BPD was 1.7 times higher in males, but there were no sex-specific differences in BPD severity. However, female children with BPD had a higher likelihood of developing BPD-PH and lower survival rates. Females, severity of BPD, congenital diaphragmatic hernia, ventricular septal defect, patent ductus arteriosus, uric acid, aspartate aminotransferase/alanine transaminase (ALT), and albumin were independent factors of PH in BPD. Severity of BPD, PH, severe pneumonia, budesonide use, use of adrenaline or noradrenaline, ALT, and day of respiratory support were independent factors for overall survival in pediatric BPD. Two web servers were constructed based on these predictive factors for risk prediction of BPD-PH ( https://sex-ph.shinyapps.io/Nomapp1/ ) and overall survival prediction in BPD patients ( https://zds88.shinyapps.io/DynNomapp/ ).</p><p><strong>Conclusion: </strong>This study confirmed sex differences in BPD-PH and emphasized the role of sex in the development and prognosis of the disease. Two web servers predicted personalized PH risk and survival outcomes in BPD.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"148"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762856","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":"The impact of frailty on clinical outcomes among individuals with COPD: a systematic review and meta-analysis.","authors":"Mathew Cherian, Pourya Masoudian, Kednapa Thavorn, Jacqueline Sandoz, Risa Shorr, Sunita Mulpuru","doi":"10.1186/s12890-025-03595-z","DOIUrl":"https://doi.org/10.1186/s12890-025-03595-z","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a prevalent and robust predictor of poor outcomes for older adults and those with chronic disease. We performed a systematic review and meta-analysis of the literature to understand the association between frailty and clinical outcomes for people with COPD.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, Cochrane Central, CINAHL, and Web of Science from inception to February 2022, for observational studies evaluating the association between frailty and clinical outcomes among individuals with COPD. Included studies defined COPD by spirometry, used a validated frailty assessment tool, and compared dyspnea, symptom burden, health related quality of life, exacerbations, hospitalization, or mortality between frail and non-frail individuals. Risk of bias was assessed using the Newcastle Ottawa Scale. Mean differences or hazard ratios were calculated using inverse variance (IV) methods, odds ratios were calculated using Mantel-Haenszel methods, and homogeneity was assessed using I ² statistics. Results were pooled using a random effects model.</p><p><strong>Results: </strong>Of 1385 identified studies, 16 studies were included with 7 studies included in the meta-analyses, representing 5903 individuals. The Fried Frailty Phenotype instrument was used in 50% of included studies. When comparing frail vs. non-frail people with COPD, pooled estimates revealed frail people with COPD had higher dyspnea scores [modified Medical Research Council (mMRC) score standardized mean difference (95% CI): 1.67 (1.40-1.92), I ² = 24%]; higher symptom burden [COPD Assessment Test (CAT) score mean difference (95% CI): 10.24 (8.30-12.17), I ² = 31%]; more COPD exacerbations in the prior year [mean difference (95% CI): 1.09 (0.62-1.56), I ² = 0%), and increased odds of being hospitalized in the previous year [OR (95% CI): 2.94 (1.57-5.50); I ² = 0%]. The largest study with longest follow up period showed increased mortality risk among frail vs. non-frail individuals with COPD, [HR (95% CI): 1.83 (1.24-2.68)].</p><p><strong>Conclusions: </strong>People with COPD and frailty experience increased dyspnea, symptom burden, exacerbation history, and hospitalizations compared to non-frail patients with COPD. Frailty is a robust predictor of outcomes among people with COPD and should be considered a treatable trait. Additional work is needed to standardize screening methods for frailty, and to understand the optimal timing of non-pharmacologic interventions to treat frailty among people with COPD.</p><p><strong>Prospero registry id: </strong>CRD42022329893.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"146"},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751120","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":"ECMO-assisted bronchoscopic therapy for severe tracheal stenosis: a case report and literature review.","authors":"Hao-Su Zhou, Yu-Xiang Wan, Hao Qin, Jun-Ping Zhou, Xiao-Meng Nie, Qin Wang, Chong Bai, Wei Zhang","doi":"10.1186/s12890-025-03612-1","DOIUrl":"https://doi.org/10.1186/s12890-025-03612-1","url":null,"abstract":"<p><strong>Background: </strong>Severe tracheal stenosis is a life-threatening condition that often requires immediate intervention. Traditional surgical approaches may be challenging in critically ill patients, and bronchoscopic therapies have emerged as a less invasive alternative. However, maintaining adequate oxygenation and ventilation during these procedures can be challenging, especially in patients with near-complete airway obstruction. The manipulation of the already compromised airway during bronchoscopy can exacerbate respiratory insufficiency, leading to hypoxemia, hypercapnia, and even cardiac arrest. To address these challenges, extracorporeal membrane oxygenation (ECMO) has been increasingly utilized as a supportive measure during high-risk airway interventions. The use of ECMO in managing severe tracheal stenosis is a relatively recent development, with growing evidence supporting its role in facilitating complex airway interventions. By ensuring hemodynamic stability and adequate gas exchange, ECMO enables the safe and effective application of bronchoscopic techniques in critically ill patients who would otherwise be deemed unsuitable for such procedures. This approach can improve outcomes and expand treatment options for patients with severe tracheal stenosis.</p><p><strong>Case presentation: </strong>A 49-year-old woman, who underwent metal stent placement in her upper trachea 24 years ago due to tuberculous tracheal stenosis, was hospitalized due to worsening dyspnea. A thorough evaluation showed that the entire tracheal section was narrowed, with the smallest diameter measuring approximately 4-5 mm. Traditional respiratory support was inadequate for maintaining the patient's oxygen levels during bronchoscopy. We conducted bronchoscopic treatment with ECMO support, significantly alleviating the patient's dyspnea symptoms post-treatment. This is the first documented case of ECMO being utilized alongside bronchoscopy for patients with tracheal narrowing caused by tuberculosis.</p><p><strong>Conclusion: </strong>The case study described a patient experiencing severe tracheal scar stenosis due to tuberculosis, who underwent successful treatment that included bronchoscopy supported by ECMO. Our effective handling of this case has provided crucial insights and strategies for managing similar situations in the future.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"144"},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751110","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":"The short-term effects of different cold spell definitions on asthma outpatient visits in Lanzhou, China.","authors":"Jianjun Wu, Xizhuoma Zha, Xuelin Ren, Boxi Feng, Ying Zhang, Linghong Wang, Xingmin Wei, Yahui Xie, Jia Zhang, Jie Lu","doi":"10.1186/s12890-025-03605-0","DOIUrl":"https://doi.org/10.1186/s12890-025-03605-0","url":null,"abstract":"<p><strong>Background: </strong>With global warming, most studies have focused on the health impacts of heat waves, while the health effects of cold spells, especially in developing countries, still need to be explored. Additionally, existing research on temperature extremes and asthma primarily targets severe asthma cases requiring hospitalization or emergency care, neglecting outpatients with mild symptoms. This study aimed to identify the optimal definition of cold spells in Lanzhou, China, and examine their association with outpatient asthma visits, identifying potentially vulnerable populations.</p><p><strong>Methods: </strong>This study collected daily asthma outpatient records, along with meteorological and air pollutant data, from January 1, 2017, to December 31, 2020, in Lanzhou, Gansu Province. Twenty-four cold spell definitions were developed using four temperature indices (daily mean, daily minimum, daily mean apparent, and daily minimum apparent temperatures), two thresholds (P₁₀ and P₅), and three durations (2, 3, and 4 days). A time-series fitted poisson generalized linear model (PGLM) and distributed lag nonlinear model (DLNM) were applied to estimate the short-term effects of cold seasons (November to March) on outpatient asthma visits, controlling for confounding factors such as humidity, air pollutants, time trends, holidays, and weekdays. Stratified analyses by sex and age were conducted to identify vulnerable populations and examine the influence of cold spell duration on asthma clinic visits.</p><p><strong>Results: </strong>Various definitions of cold spells influenced asthma outpatient visits, with similar trends observed. The model fit was best when the daily minimum apparent temperature was below the 10th percentile, and the duration was more significant than or equal to 4 days. Based on this optimal definition, for the total population, the main effect of the cold spell on asthma occurred at Lag0, Lag1, Lag6, and Lag7, with Lag7 producing the most significant effect (RR = 1.208, 95% CI: 1.052 ± 1.388). In the subgroup analyses, the cumulative effect of lag 0-7 days (Lag0-7) was higher for females and those in the 0-18 age group than for males and other age groups, respectively. In addition, the longer the duration of the cold spell from lag 3 days (Lag3) onwards, the greater its effect.</p><p><strong>Conclusion: </strong>Cold spells in Lanzhou City can notably increase asthma outpatient visits, with females and individuals aged 0-18 particularly affected. Moreover, the longer a cold spell persists, the greater its impact, especially in the latter days of the event.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"145"},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751121","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":"The importance of uric acid levels in geriatric patients with respiratory failure under noninvasive mechanical ventilation in the respiratory intensive care unit.","authors":"Murat Yıldız, Deniz Çelik, Tarkan Özdemir, Güler Eraslan Doğanay, Melek Doğanci, Mustafa Özgür Cırık, Maşide Arı, Kerem Ensarioğlu, Ayşe Cifci, Derya Kızılgöz","doi":"10.1186/s12890-025-03603-2","DOIUrl":"https://doi.org/10.1186/s12890-025-03603-2","url":null,"abstract":"<p><strong>Introduction: </strong>The respiratory system is critical for gas exchange, with respiratory failure resulting in insufficient oxygen and inadequate removal of carbon dioxide. Serum uric acid (SUA), a byproduct of purine metabolism, rises during hypoxemic conditions and has potential as a prognostic marker in respiratory failure. This study aimed to explore the relationship between SUA levels, mortality, duration of hospital stay, and ICU scores (APACHE II, and SOFA) in geriatric patients receiving non-invasive mechanical ventilation (NIV).</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of 1109 patients with respiratory failure admitted to the Respiratory Intensive Care Unit (RICU) from 2020 to 2022. We excluded minor patients (under 18 years old), patients with incomplete records, known gout, and dialysis-dependent or SRRT required renal failure. We collected demographics, comorbidities, laboratory findings, APACHE II, and SOFA scores. Patients were divided into two age groups (≥ 65 and < 65). Statistical analysis, including chi-square, regression, and correlation tests, was performed to evaluate the association between SUA and clinical outcomes.</p><p><strong>Results: </strong>Patients aged ≥ 65 had significantly higher SUA, creatinine, and BUN levels, as well as longer hospital stays and higher APACHE II and SOFA scores. Elevated SUA levels correlated with increased mortality and NIV requirements in the elderly. Regression analysis confirmed SUA as a predictor of NIV need.</p><p><strong>Discussion: </strong>SUA levels are positively associated with worse outcomes in elderly patients with respiratory failure. This study supports previous research findings that hyperuricemia correlates with increased ICU admissions and mortality in respiratory conditions, particularly in older adults who need a noninvasive ventilation (NIV).</p><p><strong>Conclusion: </strong>Elevated SUA levels are a valuable prognostic marker for predicting NIV needs and poor outcomes in geriatric patients with respiratory failure. Regular monitoring of SUA could enhance clinical management and improve prognosis in this population.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"143"},"PeriodicalIF":2.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742202","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":"A scoring model based on the pleural effusion adenosine deaminase-to-serum C-reactive protein ratio for differentiating tuberculous pleural effusion from non-tuberculous benign pleural effusion.","authors":"Huan Hou, Jieying Li, Tingting Huang, Zhaohui Ruan, Xinjie Hui, Yilin Huang, Jinming Gao","doi":"10.1186/s12890-025-03593-1","DOIUrl":"https://doi.org/10.1186/s12890-025-03593-1","url":null,"abstract":"<p><strong>Background: </strong>Differentiating tuberculous pleural effusion (TPE) from non-tuberculous benign pleural effusion (non-TB BPE) can be challenging, especially in patients with low levels of pleural effusion adenosine deaminase (pADA) and negative etiological evidence. This study aimed to evaluate the diagnostic performance of the pADA to serum C-reactive protein ratio (pADA/sCRP) and to develop a scoring model for diagnosing TPE.</p><p><strong>Methods: </strong>This retrospective study included 364 patients with pleural effusion, comprising 121 with TPE and 243 with non-TB BPE from Peking Union Medical College Hospital. Clinical, laboratory, and imaging data were collected, and comparisons were made between the two groups. The diagnostic performance of the pADA/sCRP ratio and other statistically significant variables was assessed. Six valuable factors were selected for multivariate regression analysis to establish a predictive model, which was displayed as a nomogram.</p><p><strong>Results: </strong>The pADA/sCRP ratio demonstrated superior diagnostic performance compared to pADA alone, with an area under the curve (AUC), sensitivity, and specificity for identifying TPE of 0.68, 71%, and 64%, respectively. Six variables were selected to develop a nomogram, including night sweats, calcification on chest computed tomography, pleural effusion lymphocyte ratio, pADA/sCRP, hemoglobin, and neutrophil. With a cutoff value of 20 points, the AUC, sensitivity, and specificity for distinguishing TPE from non-TB BPE were 0.836, 83.4%, and 64.9%, respectively. The validation cohort confirmed the model with the AUC, sensitivity, and specificity of 0.815, 61.1%, and 82.4%, respectively.</p><p><strong>Conclusion: </strong>The pADA/sCRP ratio exhibited improved diagnostic performance compared to pADA alone. The novel scoring system based on a nomogram demonstrated good diagnostic efficacy in differentiating TPE from non-TB BPE.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"139"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742162","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":"Distinct risks of exacerbation and lung function decline between never-smokers and ever-smokers with COPD.","authors":"Heemoon Park, Soo Min Jo, Kwang Nam Jin, Hyo Jin Lee, Hyun Woo Lee, Tae Yun Park, Eun Young Heo, Deog Kyeom Kim, Jung-Kyu Lee","doi":"10.1186/s12890-025-03604-1","DOIUrl":"https://doi.org/10.1186/s12890-025-03604-1","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) can occur in patients without a history of smoking, which is a strong risk factor for COPD. However, few studies have focused on the prognosis of never-smokers with COPD. We investigated the difference of the longitudinal clinical outcomes between never-smokers and ever-smokers with COPD.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with COPD who underwent chest computed tomography and longitudinal lung function tests from January 2013 to December 2020. We classified patients according to smoking status and examined their histories of acute exacerbation and long-term changes in lung function.</p><p><strong>Results: </strong>Among 583 patients with COPD, 75 (12.9%) had no smoking history. These never-smokers with COPD were predominantly women; they had a lower forced vital capacity and a higher prevalence of asthma, history of tuberculosis, tuberculosis-destroyed lung, and bronchiectasis, but a lower prevalence of emphysema, relative to ever-smokers with COPD. Never-smokers with COPD had significantly lower risks of subsequent moderate to severe exacerbation (β ± standard error, - 0.4 ± 0.12; P = 0.001), any exacerbation (adjusted odds ratio, 0.46; 95% confidence interval, 0.26 - 0.8; P = 0.006), and frequent exacerbation (adjusted odds ratio, 0.28; 95% confidence interval, 0.09 - 0.89; P = 0.03) than ever-smokers with COPD. Never-smokers with COPD also showed significantly slower annual decline of forced expiratory volume in 1 s than ever-smokers with COPD (- 15.7 ± 4.7 vs. -30.4 ± 2.9 mL, respectively; P = 0.03).</p><p><strong>Conclusions: </strong>Never-smokers with COPD had significantly fewer acute exacerbations and slower decline of lung function than ever-smokers with COPD during longitudinal follow-up.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"138"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742178","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":"The impact of smoked cigarettes' type on the level of reactive oxygen species in physicians with surgical and non-surgical specialization.","authors":"Artur Nowak, Paulina Natalia Kopa-Stojak, Rafał Pawliczak","doi":"10.1186/s12890-025-03606-z","DOIUrl":"https://doi.org/10.1186/s12890-025-03606-z","url":null,"abstract":"<p><strong>Background: </strong>Cigarette smoking remains a pervasive global health concern, contributing to a myriad of debilitating conditions. One critical aspect of its detrimental impact is the induction of oxidative stress (OS). The aim of the study was to identify differences in the level of reactive oxygen species between surgical and non-surgical physicians who smoke different types of cigarettes and their level of nicotine addiction.</p><p><strong>Methods: </strong>The prospective study conducted on surgical and non-surgical physicians who smoke various types of cigarettes worked at the Provincial Multidisciplinary Oncology and Traumatology Centre in Lodz (Poland) and at the Polish Mother's Health Centre Institute in Lodz (Poland). The Fagerström's test for nicotine dependence was used to determine degree of nicotine addiction. The differences in reactive oxygen species level among physicians with surgical and non-surgical specialization who smoke different types of cigarettes was analysed by the Cellular Reactive Oxygen Species Assay Kit.</p><p><strong>Results: </strong>In this study 35.1% of surgical and 40.5% of non-surgical physicians indicated signs of nicotine addiction. The Fagerström score was significantly higher in surgical than non-surgical physician specialties (5.4 ± 1.372 vs. 4.7 ± 1.310; p = 0.001). Significantly higher ROS level was observed in conventional cigarette (CS) smokers, e-cigarette (EC) smokers and tobacco heating products (THP) smokers compared to non-smokers (p < 0.05). In addition, there was a significantly lower ROS level in THP smokers compared to CS smokers (p < 0.05) and EC smokers (p < 0.05). There was a significantly higher ROS level in physicians with surgical specialization who smoke CS (p < 0.001) and EC (p = 0.004) compared to non-surgical physicians.</p><p><strong>Conclusions: </strong>Understanding the influence of the type of smoked cigarettes on oxidative stress in surgical and non-surgical physicians is imperative for targeted interventions and health promotion strategies. The broader goal is mitigating the health risks associated with cigarette smoking, especially within professional domains where stressors may already be heightened. Further investigations are essential for developing tailored approaches to address the nuanced relationships between cigarette types, occupational stress, and oxidative stress in specialized medical fields.</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"141"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742198","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}