BMC Pulmonary Medicine最新文献

{"title":"Needs among persons with advanced COPD and their informal caregivers: a multi-perspective qualitative study focusing on the potential role of palliative care.","authors":"Kira Schmidt-Stiedenroth, Julia Salandi, Alexandra Schmidt, Balam Er Dedekarginoglu, Stefanie Paniczek, Manuela Schallenburger, Anette Scholz, Jacqueline Schwartz, Kathrin Fricke, Stefanie Keymel, Achim Mortsiefer, Martin Neukirchen, Adrian Loerbroks","doi":"10.1186/s12890-026-04828-5","DOIUrl":"https://doi.org/10.1186/s12890-026-04828-5","url":null,"abstract":"<p><strong>Objectives: </strong>To explore needs among persons with advanced COPD and informal caregivers, and to explore how palliative care can address those needs.</p><p><strong>Background: </strong>COPD is a common, progressive disease affecting lung function and represents a leading cause of death. Advanced COPD is associated with a high symptom burden and poor quality of life. Persons with advanced COPD may benefit from palliative care, but its use among persons with COPD remains limited, also in Germany.</p><p><strong>Methods: </strong>A qualitative, multi-perspective interview study was conducted with persons suffering from advanced COPD, informal caregivers, and formal caregivers (general practitioners, pulmonologists, and palliative care physicians). A total of 53 interviews were analysed following structuring (Kuckartz') as well as latent content analysis methods using MAXQDA.</p><p><strong>Results: </strong>Key needs were identified in the following domains (1) management of dyspnoea and anxiety, (2) home-based healthcare, (3) emergency planning and support, (4) psychosocial care, (5) organisational support, and (6) timely information about COPD and palliative care. Persons who had previously received PC reported various needs met in the first five areas.</p><p><strong>Conclusions: </strong>Persons with advanced COPD and their informal caregivers reported numerous needs. Persons receiving palliative care reported relief from various needs. Timely information about COPD's progression and palliative care could increase acceptance and thus use of palliative care among these persons and could consequently reduce or curtail the burden of living with advanced COPD.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223418","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":"Who participates in LDCT screening for the early detection of lung cancer after long-term occupational exposure to asbestos dust? Results of the analysis of administrative and medical routine data from the German Social Accident Insurance.","authors":"Nikolas Oubaid, Felix Greiner, Helena Keller, Martin Ansgar Horn, Alexandra Marita Preisser, Volker Harth","doi":"10.1186/s12890-026-04780-4","DOIUrl":"10.1186/s12890-026-04780-4","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is one of the most common cancers in Germany and is predominantly detected at an advanced stage. To ensure early detection, the German Social Accident Insurance (DGUV) offers lung cancer screening including a low-dose computed tomography (LDCT) for individuals with long-term occupational exposure to asbestos dust and a smoking history of at least 30 pack years. However, evidence remains scarce about what encourages this group of people to participate in LDCT screening after medical consultation.</p><p><strong>Methods: </strong>A secondary data analysis using routinely collected medical and administrative data between 2014 and 2024 was conducted in a cross-sectional design. This study aimed to investigate factors that could be used to predict the uptake of LDCT screening following a medical consultation. Exploratory logistic regression analysis was used to identify and assess possible predictors.</p><p><strong>Results: </strong>The sample included n = 14,491 individuals (97% male; average age 67 years; average asbestos dust exposure 21 years; average cigarette consumption 43 pack years). 74% of individuals underwent LDCT screening after medical consultation. 13 predictors were included in the regression model. The model demonstrated a low level of variance explanation (Nagelkerkes R² = 0.026). Younger individuals (OR: 0.96, p < 0.001), individuals with prolonged exposure to asbestos dust (OR: 1.01, p = 0.011) and with a history of pneumonia (OR: 1.16, p = 0.011) were more likely to undergo LDCT screening.</p><p><strong>Conclusion: </strong>The predictors showed only a low explanatory power. Further research should include non-participants and expand the exploratory model to include theoretically grounded predictors.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164769","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":"Association between intraprocedural oxygen administration and postprocedural pneumothorax after ct-guided transthoracic lung biopsy.","authors":"Burcu Ozdemir, Deniz Sonmez","doi":"10.1186/s12890-026-04774-2","DOIUrl":"10.1186/s12890-026-04774-2","url":null,"abstract":"<p><strong>Background: </strong>Pneumothorax is the most common complication of computed tomography (CT)-guided transthoracic lung biopsy (TLB). Whether supplemental oxygen administered during the procedure before pneumothorax detection is associated with postprocedural pneumothorax remains unclear. This study evaluated the association between documented intraprocedural oxygen administration and postprocedural pneumothorax.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 442 consecutive patients who underwent CT-guided TLB between January 2022 and June 2025. Patients were grouped according to documented oxygen administration during the biopsy and before pneumothorax detection. Oxygen administration was non-standardized, and the exact dose and timing could not be reliably determined. Clinical, imaging, and procedural variables were evaluated. The primary outcome was postprocedural pneumothorax. Multivariable logistic regression analysis was performed to identify factors independently associated with pneumothorax.</p><p><strong>Results: </strong>Intraprocedural oxygen administration was documented in 118 patients (26.7%), whereas 324 patients (73.3%) received no intraprocedural oxygen. Pneumothorax occurred in 141 patients (31.9%). The pneumothorax rate did not differ significantly between the oxygen and no-oxygen groups [36/118 (30.5%) vs. 105/324 (32.4%); absolute risk difference, - 1.9% points; 95% CI, - 11.6 to 7.8; p = 0.705]. No statistically significant association was identified between documented intraprocedural oxygen administration and postprocedural pneumothorax in the univariable analysis (OR, 0.916; 95% CI, 0.581-1.444; p = 0.705) or after multivariable adjustment (adjusted OR, 0.807; 95% CI, 0.492-1.323; p = 0.395). Non-pleural-based lesion location and CT-detected emphysema were independently associated with pneumothorax, whereas the association with lower subcutaneous tissue thickness should be considered exploratory. Pulmonary hemorrhage and pneumothorax-related intervention rates did not differ significantly between the groups.</p><p><strong>Conclusion: </strong>In this retrospective cohort, no statistically significant association was identified between documented intraprocedural oxygen administration and postprocedural pneumothorax after CT-guided TLB. This finding does not exclude a preventive effect, which should be evaluated in prospective studies using standardized oxygen protocols.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179364","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":"MiR-128-3p serves as a diagnostic biomarker in pediatric Mycoplasma pneumoniae pneumonia.","authors":"Hong Yang, Wanzhen Yang, Dan Li","doi":"10.1186/s12890-026-04553-z","DOIUrl":"10.1186/s12890-026-04553-z","url":null,"abstract":"<p><strong>Background: </strong>Mycoplasma pneumoniae pneumonia (MPP) is a frequent pulmonary infection in children, and severe cases are associated with significant adverse outcomes.</p><p><strong>Purpose: </strong>To investigate the expression, clinical value, and functional mechanism of miR-128-3p in MPP.</p><p><strong>Methods: </strong>Serum samples from children with MPP were collected to measure miR-128-3p expression. ROC curve and logistic analysis were further performed to evaluate the clinical value of miR-128-3p in MPP. An MPP model was established by infecting BEAS-2B cells with Mycoplasma pneumoniae (MP). The functions of miR-128-3p were verified using CCK-8 and ELISA. Potential downstream target genes were predicted and verified by bioinformatics analysis and the dual-luciferase reporter assay.</p><p><strong>Results: </strong>MiR-128-3p was significantly downregulated in the serum of children with MPP and served as an independent predictor of severe MPP (SMPP). Overexpression of miR-128-3p inhibited the secretion of IL-6, IL-8, and TNF-α and alleviated cell injury. ITGA5 is a target gene of miR-128-3p, which was upregulated in MPP. Rescue experiments verified that overexpression of ITGA5 abolished the anti‑inflammatory and protective effects of miR‑128‑3p.</p><p><strong>Conclusion: </strong>MiR-128-3p is downregulated in MPP and serves as a predictive biomarker for SMPP, which exerts a protective effect by suppressing inflammatory responses.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147374","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":"Sex-specific patterns of symptom burden, psychological distress, and work productivity impairment in post-acute sequelae of COVID-19: a 10-month dynamic cohort study.","authors":"Andrea Sauer, Lennart Boblitz, Nora Drick, Miriam Wiestler, Michèle Scharbau, Philipp Pries, Benjamin-Alexander Bollmann, Marius M Hoeper, Isabell Pink","doi":"10.1186/s12890-026-04741-x","DOIUrl":"10.1186/s12890-026-04741-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A considerable proportion of patients experience post-acute sequelae of COVID-19 (PASC). Increasing evidence suggests sex-related differences, yet systematic longitudinal analyses remain limited. This study aimed to examine sex-specific differences in symptoms, psychological burden, work productivity and physical activity over ten months following acute COVID-19.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective, dynamically enrolled cohort study, patients with ongoing symptoms after confirmed SARS-CoV-2 infection were followed over a 10-month observation period. Patients conducted at the post-COVID outpatient clinic of the department of respiratory medicine and infectious diseases at Hannover Medical School, Germany. The assessment included patient-reported outcome measures, pulmonary function tests, six-minute walk tests, and capillary blood gas analysis. All outcome comparisons between sexes were adjusted for age, BMI, COVID-19 severity, and comorbidities using generalised linear mixed-effects models, with sex-by-time interaction terms tested to assess whether differences changed over follow-up, and p-values corrected for multiple testing across all outcome comparisons using the Holm method. A sensitivity analysis was performed in the subgroup of patients with complete follow-up at all four visits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Five hundred ninety patients attended to our clinic and a total of 433 patients were eligible and consecutively enrolled. Males were older (56 years vs. 52 years, p = 0.002), had more cardiovascular comorbidities (16% vs. 5%, p &lt; 0.001), and experienced more severe COVID-19 (28% vs. 8%, p &lt; 0.001). After adjustment for age, BMI, COVID-19 severity, and comorbidities, and Holm correction for multiple testing across all 27 outcome comparisons, females showed higher fatigue (Fatigue Assessment Scale, adjusted β = 3.3, Holm-adjusted p = 0.006), higher anxiety (GAD-2, β = 0.5, p = 0.021), lower quality of life (EQ-5D-3L, β = -0.6, p = 0.004), and greater work productivity impairment, both as a continuous score (WPAI-VAS, β = 1.3, p = 0.031) and as a binary indicator of clinically relevant impairment (OR = 3.0, p = 0.020). Females also had higher percent-predicted (pp) total lung capacity (p &lt; 0.0001) and lower pCO&lt;sub&gt;2&lt;/sub&gt; (p &lt; 0.0001), whereas males had higher pp diffusion capacity (p = 0.001). Headache (p &lt; 0.001) and chest tightness (p = 0.011) were reported more frequently by females. None of these differences varied significantly over the 10-month follow-up (all sex-by-time interaction p ≥ 0.41), indicating no evidence that these differences changed over time. No significant sex differences remained after adjustment for depression (PHQ-2), lung function parameters, sex/height-adjusted exercise capacity, post-exercise dyspnoea or oxygen saturation, or most acute-COVID-19 symptoms other than headache and chest tightness. Regression models separately for each sex revealed fever (OR = 2","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008160","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":"Ultrasound assessment of diaphragm thickness and related determinants in healthy female adolescents: a retrospective study.","authors":"Zeliha Celik, Nevin A Guzel, Halit Nahit Sendur","doi":"10.1186/s12890-026-04752-8","DOIUrl":"10.1186/s12890-026-04752-8","url":null,"abstract":"<p><strong>Background: </strong>The diaphragm plays a crucial role in respiration and is influenced by changes in body composition. However, data on the relationship between diaphragm thickness, respiratory muscle strength, and body composition in healthy adolescents are limited. This study aimed to investigate the clinical indicators of diaphragm thickness and their relationships with respiratory muscle performance and body composition in a healthy female adolescent population.</p><p><strong>Methods: </strong>This study included 87 healthy female adolescents (mean age 17.5 ± 2.5 years) within the 15-24 age range, aligning with the broad definition of adolescence. Pulmonary function and respiratory muscle strength (MIP, MEP) were measured using a spirometer. Diaphragm thickness was evaluated using a single ultrasound device with a linear transducer, and measurements were taken three times during breath-holding at both inspiration and expiration. Body composition was assessed using a bioelectrical impedance analyzer.</p><p><strong>Results: </strong>Diaphragm thickness during inspiration showed positive correlation with fat-free mass (FFM) (r = 0.383, p = 0.006), height (r = 0.292, p = 0.029), and weight (r = 0.323, p = 0.015). Diaphragm thickness during expiration was positively correlated with FFM (r = 0.359, p = 0.010), weight (r = 0.297, p = 0.026), and FVC (r = 0.271, p = 0.045). No significant associations were found between diaphragm thickness and MIP, MEP, or other spirometric measures. Regression analyses demonstrated FFM was the strongest predictor of diaphragm thickness (p < 0.05).</p><p><strong>Conclusions: </strong>Diaphragm thickness in healthy female adolescents is significantly associated with FFM and anthropometric measures. These findings may indicate that diaphragm thickness could provide structural information about general muscle status during growth.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001219","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":"Early change in ventilatory ratio during prone positioning and 28-day mortality in patients with ARDS: a retrospective cohort study with exploratory eICU assessment.","authors":"Hong Li, Xin Xu, Yun Peng, Li Sun, Shujing Li, Yufang Yang","doi":"10.1186/s12890-026-04704-2","DOIUrl":"10.1186/s12890-026-04704-2","url":null,"abstract":"<p><strong>Background: </strong>Prone positioning (PP) improves outcomes in moderate-to-severe acute respiratory distress syndrome (ARDS), but early bedside markers that reliably characterize physiological response remain uncertain. The ventilatory ratio (VR), calculated from minute ventilation, PaCO₂, and predicted body weight, may capture ventilatory efficiency during PP.</p><p><strong>Methods: </strong>MIMIC-IV v3.1 was used as the primary retrospective cohort and eICU-CRD v2.0 as an exploratory cohort. Adult patients with moderate-to-severe ARDS receiving an initial PP session lasting at least 12 h were included. The primary exposure was exploratory VR response, defined as ∆VR% ≤ -20% using the nearest available post-PP VR within the predefined observation window. The minimum post-PP VR within 12 h was analyzed as a sensitivity definition.</p><p><strong>Results: </strong>The primary MIMIC-IV cohort included 177 patients, with 73 deaths within 28 days. Only 6 patients were classified as VR responders under the primary nearest post-PP VR definition. Crude 28-day mortality was 33.3% among responders and 41.5% among non-responders; the unweighted Cox model did not show a statistically significant association (HR 0.79, 95% CI 0.20-3.08; P = 0.737). Adjusted and IPTW-weighted models were considered exploratory and not reliably estimable because the responder group contained only 6 patients and 2 deaths. Sensitivity analyses using the minimum post-PP VR definition produced a stronger but definition-sensitive signal, whereas analyses using absolute VR change or baseline/post-PP VR did not confirm a stable association. In eICU-CRD, 29 patients had complete core VR data and only 3 were responders.</p><p><strong>Conclusions: </strong>Early VR change during PP was not significantly associated with 28-day mortality under the primary nearest post-PP VR definition. This study supports the feasibility of extracting dynamic VR metrics from routinely collected ICU data, but does not establish VR response as a validated prognostic marker or clinical threshold.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163713","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":"\"I know a little, but I can't do more\": a COM-B-based qualitative study of CPAP use and sleep behaviour change among hospitalised patients with COMISA in China.","authors":"Yuting Wang, Tong Liu, Rong Hu, Weili Zhao, Bixia Zhao","doi":"10.1186/s12890-026-04571-x","DOIUrl":"10.1186/s12890-026-04571-x","url":null,"abstract":"<p><strong>Background: </strong>Co-morbid insomnia and sleep apnoea (COMISA) is a highly prevalent condition associated with worse health outcomes and greater treatment complexity than either disorder alone. Patients with COMISA demonstrate lower acceptance and use of continuous positive airway pressure (CPAP) therapy compared with those who have obstructive sleep apnoea (OSA) alone, yet the subjective mechanisms underlying this adherence penalty remain poorly understood. Qualitative research on CPAP use and sleep behaviour change in patients with COMISA is scarce, the COM-B (Capability, Opportunity, Motivation-Behaviour) model has rarely been applied to this population, and the influence of non-Western cultural norms on COMISA treatment engagement has received little attention.</p><p><strong>Methods: </strong>A descriptive qualitative study guided by the COM-B model and Theoretical Domains Framework (TDF) was conducted at a tertiary sleep medicine centre in Hunan Province, China. Sixteen hospitalised patients with polysomnography-confirmed moderate-to-severe OSA (AHI ≥ 15) and clinically significant insomnia (ISI ≥ 15) were purposively sampled using a 2 × 2 maximum variation matrix based on inpatient CPAP adherence (good vs. poor) and receipt of a brief nurse-led inpatient CBT-I programme (with vs. without structured CBT-I). Individual semi-structured interviews were analysed using directed content analysis, with reporting following the COREQ checklist.</p><p><strong>Results: </strong>The analysis generated 1,160 reference points across 20 coding nodes, synthesised into three themes and nine sub-themes aligned with the COM-B dimensions. Motivation accounted for the largest share of coded data (589 reference points) and revealed a pattern of \"insomnia dominance\" in which participants systematically prioritised insomnia over OSA, four patterns of fixed causal attribution that led patients to rule out particular treatments, and an emotion-identity complex linking stigma, age-related identity, and treatment rejection. Within the Opportunity dimension, an \"adherence illusion\" was identified: some inpatients with good CPAP adherence had not internalised motivation for post-discharge self-management. Culturally specific barriers extended beyond rural CPAP-related death stigma to include urban obligatory banquet drinking norms.</p><p><strong>Conclusions: </strong>Hospitalised COMISA patients face qualitatively different behavioural barriers from those with OSA alone, requiring COM-B-guided individualised assessment rather than uniform adherence interventions. Nursing practice should incorporate pre-discharge environmental screening, proactive CPAP experience management during the first two to three nights, and culturally sensitive approaches spanning both rural and urban social norms. The Behaviour Change Wheel provides a systematic pathway for translating these behavioural diagnoses into targeted, nurse-led intervention design.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058225","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":"Moving beyond treatment: pulmonary function, autonomous motivation, and physical activity enjoyment in adults with cystic fibrosis.","authors":"Wolfgang Gruber, Matthias Welsner, Florian Stehling, Jin-Sun Schermaul, Jose G Ortiz, Liron Lechtenberg, Christian Taube, Margarete Olivier","doi":"10.1186/s12890-026-04661-w","DOIUrl":"10.1186/s12890-026-04661-w","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) and structured exercise are established cornerstones of cystic fibrosis (CF) management. While CFTR modulators have transformed treatment, the psychological factors affecting sustained PA adherence, particularly motivational regulation and PA enjoyment, require further investigation. This study aimed to determine whether percent predicted forced expiratory volume in one second (ppFEV₁) is independently associated with autonomous motivation and PA enjoyment in adults with CF, after adjusting for CFTR modulator therapy status and sex.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a specialised CF centre (N = 200). Participants completed validated questionnaires assessing motivational regulation (Behavioural Regulation Questionnaire-2, BREQ-2) and PA enjoyment (Physical Activity Enjoyment Scale, PACES). Clinical data, including the ppFEV₁, were obtained from medical records. Multivariate general linear models (GLM), partial correlations, and hierarchical regression analyses were utilised.</p><p><strong>Results: </strong>Cross-sectional analyses showed that ppFEV₁ was independently associated with intrinsic motivation (β = .233, p < .001), the relative autonomy index (RAI) (β = .203, p = .004) and the PACES total score (β = .201, p = .004). After CFTR modulator therapy status and sex were accounted for, the additional variance explained by the ppFEV₁ was statistically significant but modest (ΔR² = .054, .041, and .040, respectively). Neither the CFTR modulator therapy status nor sex was significantly associated with the assessed motivational or enjoyment outcomes.</p><p><strong>Conclusions: </strong>Although ppFEV₁ showed small, independent associations with autonomous motivational regulation and PA enjoyment in adults with CF, lung function should not be used as a proxy for motivational support needs. To provide person-centred, SDT-informed support that encourages sustained participation in PA, the motivational regulation and enjoyment of PA should be assessed directly in adults with CF.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905111","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":"Post-transplant trajectories of the CRP-to-albumin ratio identify a late-emerging high-risk phenotype in interstitial lung disease.","authors":"Ekaterina Krauss, Silke Tello, Luise Wilke, Janine Sommerlad, Gani Oruqaj, Natascha Sommer, Martin Reichert, Andreas Hecker, Anita Windhorst, Matthias Hecker, Andreas Guenther, Sabina A Guler, Stefan Kuhnert","doi":"10.1186/s12890-026-04648-7","DOIUrl":"10.1186/s12890-026-04648-7","url":null,"abstract":"<p><strong>Background: </strong>After bilateral lung transplantation for interstitial lung disease (ILD), most recipients recover well, but some deteriorate over the following years. The C-reactive protein-to-albumin ratio (CAR) combines a marker of systemic inflammation (CRP) with one of nutritional and hepatic-synthetic reserve (albumin); a rising ratio reflects worsening inflammation against falling reserve. We assessed whether tracking CAR over time identifies the subgroup at risk.</p><p><strong>Methods: </strong>We studied 138 consecutive adult ILD recipients of bilateral lung transplants (Giessen, 2000 to 2026), with a median of 13 paired CRP and albumin measurements each. Using group-based trajectory modelling, we grouped patients by the trajectory of their CAR from the first routine follow-up visit (month 4) to year 5, then related the groups to five-year survival and the Clinical Frailty Scale (CFS).</p><p><strong>Results: </strong>Three CAR trajectories emerged. Most patients were stable-low (39%, CAR near zero throughout) or resolving (38%, initially high then falling). The key group was CAR-rising (23%): at four months these patients were indistinguishable from the best-recovering stable-low group but then climbed steadily over the following years. Five-year survival was 92%, 61% and 69% in the stable-low, rising and resolving groups (log-rank p = 0.029; rising versus stable-low hazard ratio 4.5, 95% CI 1.2 to 17.1). A landmark analysis among patients alive at year 2 confirmed this late risk: 33% of the rising group died over the next three years versus 5% of the stable-low group (p = 0.005). In the pre-specified model, phenotype membership was not predicted by ILD subtype or LAS at listing (likelihood-ratio p = 0.16); pre-transplant CAR itself differed modestly across the groups (p = 0.049) but was not prognostic for survival. The CFS trajectory, scored independently of CRP and albumin, showed the same pattern: groups were equally frail before transplant (p = 0.83) but separated afterwards (p = 0.01 at 4 months, p = 0.001 at 5 years), the adverse groups drifting back toward frailty.</p><p><strong>Conclusions: </strong>A simple test already measured at every post-transplant visit, the CRP-to-albumin ratio, can be read as a trajectory to identify the ILD recipients who enter an inflammatory and nutritional decline associated with worse five-year survival. These findings are hypothesis-generating, and further work is needed to establish what drives the CAR trajectory before any clinical application.</p><p><strong>Trial registration: </strong>The analysis draws on two registries: the European IPF Registry and Biobank (eurIPFreg; ClinicalTrials.gov NCT02951416, registered 1 November 2016) and the European ILD Registry and Biobank (eurILDreg; German Clinical Trials Register DRKS00028968, registered 26 July 2022).</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872768","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}