BMC Pulmonary Medicine最新文献

{"title":"3D CT-Based quantification of airway structural changes during asthma exacerbations: a retrospective observational study.","authors":"Ryosuke Ozoe, Kenji Mizumura, Yosuke Nemoto, Michio Kawamura, Shun Yokota, Naho Furusho, Yusuke Kurosawa, Shiho Yamada, Masayuki Nomoto, Yuko Iida, Go Naka, Yutaka Kozu, Yoshiko Nakagawa, Takashi Oki, Tetsuo Shimizu, Motoyasu Iikura, Shuichiro Maruoka, Yasuhiro Gon","doi":"10.1186/s12890-026-04464-z","DOIUrl":"10.1186/s12890-026-04464-z","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, mucus plugs have been evaluated using two-dimensional computed tomography (CT) images through expert visual assessment, a process that requires substantial experience and specialized knowledge of airway anatomy. In the present study, we propose a novel approach employing three-dimensional CT (3D-CT) with semi-automated quantification, which can be performed in routine clinical practice without requiring expert readers. We aimed to demonstrate its feasibility and clinical relevance for assessing mucus plug burden and exacerbation severity in asthma.</p><p><strong>Methods: </strong>This exploratory, single-center, retrospective study included 23 patients with asthma and a history of exacerbations. Using a clinically available 3D-CT application, we semi-automatically quantified bronchial endpoint count and bronchial volume in both stable and exacerbation phases, and calculated their percentage change. We further assessed correlations of these parameters with mucus plug scores and arterial blood gas measurements.</p><p><strong>Results: </strong>The bronchial endpoint count and bronchial volume were significantly lower during exacerbations than during the stable phase; both showed a significant negative correlation with mucus plug scores during exacerbations. The percentage change of bronchial endpoint count and bronchial volume from the stable to exacerbation phase also correlated with mucus plug scores. The bronchial endpoint count and bronchial volume at exacerbation-related admission did not correlate with the PaO₂/FiO₂ (P/F) ratio; however, their percentage change from the stable phase to exacerbation-related admission significantly correlated with the P/F ratio.</p><p><strong>Conclusions: </strong>Clinically available semi-automated 3D-CT analysis enables objective and reproducible quantification of bronchial endpoint count and bronchial volume during asthma exacerbations, eliminating the need for expert readers. Their percentage change from the stable to exacerbation phase not only reflect mucus plug burden but also correlate with oxygenation status. These imaging biomarkers enable objective and quantitative assessment of structural airway abnormalities, including airway narrowing, distal airway obstruction, and mucus impaction. They are not intended to replace conventional clinical or physiological assessment, but rather to provide complementary structural information regarding the underlying causes of physiological abnormalities, such as impaired oxygenation, when detected by physiological evaluation. Furthermore, such quantitative structural assessment may contribute to a better understanding of airway structural changes and airway dynamics during asthma exacerbations.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359469","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 increased the risk of atrial fibrillation: insights from clinical association to genetic and molecular evidence.","authors":"Yan Zheng, Yanzhen Zhu, Jiayi Feng, Jianping Hu, Zhenhong Jiang, Jin Ouyang, Huitian Liao, Hong Deng, Wenfeng He, Yang Shen","doi":"10.1186/s12890-026-04274-3","DOIUrl":"10.1186/s12890-026-04274-3","url":null,"abstract":"<p><strong>Background: </strong>Despite the high global incidence of asthma and atrial fibrillation (AF), the causal relationship between the two conditions remains unclear. Emerging observational evidence suggests a potential association; however, conflicting results and limited mechanistic insights necessitate a comprehensive evaluation. This study aims to determine the causal relationship between asthma and the risk of AF and to explore the underlying molecular mechanisms.</p><p><strong>Methods: </strong>We performed a meta-analysis of observational studies to assess the association between asthma and AF risk, followed by a two-sample Mendelian randomization (MR) analysis to infer causality. Bioinformatics analyses using data from the Gene Expression Omnibus (GEO) were conducted to identify differentially expressed genes (DEGs) and enriched pathways. Potential therapeutic targets were validated through drug-gene interaction screening.</p><p><strong>Results: </strong>The meta-analysis of eight observational studies involving 1,067,774 participants demonstrated that asthma was associated with a 21% increased risk of AF (odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.07-1.36, p = 0.003). Two-sample MR analyses of European populations revealed that genetically predicted asthma was causally associated with increased AF risk (inverse-variance weighted (IVW) OR = 1.001, 95% CI: 1.000-1.002, p = 0.019), whereas no significant association was observed in East Asian cohorts. Transcriptomic analyses identified carboxypeptidase A3 (CPA3) as a shared upregulated gene in both asthma and AF, potentially involved in renin-angiotensin system dysregulation. Drug-gene interaction screening suggested osilodrostat and metyrapone as potential therapeutic candidates targeting CPA3.</p><p><strong>Conclusions: </strong>Our study provides evidence that genetic predisposition to asthma is significantly associated with an increased risk of AF in the European population. Transcriptomic data analyses suggest that CPA3 and its interactions with therapeutic drugs could serve as potential biomarkers, offering new opportunities to improve prognosis in patients with coexisting asthma and AF.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359489","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":"Conservative management of prolonged air leak following tension pneumothorax in cavitary pulmonary tuberculosis: a case report.","authors":"Aows Ahmad, Mohamed Alkhartalak, Lama Alsaoub, Mohammad Berro, Mohammad Abd-Alrahman Saif, Mohammad Shbat, Bassam Darwish","doi":"10.1186/s12890-026-04462-1","DOIUrl":"10.1186/s12890-026-04462-1","url":null,"abstract":"<p><strong>Background: </strong>Secondary spontaneous pneumothorax is a recognized complication of pulmonary tuberculosis; however, presentation with tension physiology followed by prolonged air leak may create diagnostic and management challenges, particularly when tuberculosis is not known at presentation.</p><p><strong>Case presentation: </strong>We report a 20-year-old male with a 3 pack-year smoking history and no known prior lung disease who presented with dyspnea, left-sided pleuritic chest pain, productive cough, and constitutional symptoms. During the initial emergency assessment, unilateral chest findings raised concern for a left-sided pneumothorax. Urgent chest radiography obtained during this process showed a large left-sided pneumothorax with mediastinal shift, and emergency needle decompression was performed as a temporizing maneuver, followed directly by placement of a 28-Fr left chest tube. Persistent incomplete lung re-expansion and continuous air bubbling prompted further evaluation. Chest computed tomography revealed multiple left-sided cavitary lesions with surrounding parenchymal infiltrates, and sputum Ziehl-Neelsen staining was positive for acid-fast bacilli in three samples, supporting active cavitary pulmonary tuberculosis in the clinical and radiographic context. Standard anti-tuberculosis therapy was initiated. Despite early symptomatic improvement and substantial lung re-expansion, air leakage persisted. Because the patient maintained adequate oxygenation, controlled drainage, and no evidence of pleural sepsis or respiratory deterioration, conservative management was continued under thoracic surgical supervision with ambulatory drainage and close follow-up. The air leak resolved 61 days after hospital discharge, and the chest tube was removed without subsequent clinical recurrence.</p><p><strong>Conclusions: </strong>This case highlights that emergency decompression should not preclude continued etiologic evaluation when pneumothorax is accompanied by constitutional symptoms, incomplete lung re-expansion, persistent air leakage, or parenchymal abnormalities. It also illustrates that, in carefully selected clinically stable patients with adequate drainage and close supervision, prolonged air leak in active cavitary tuberculosis may be interpreted within the broader clinical trajectory rather than by duration alone.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359472","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":"Plasma TIM-1 concentration: correlation with cytokines in pulmonary tuberculosis patients and development of a predictive model.","authors":"Wolazihan Madeniyati, Chunyu Wang, Reyila Tuerhong, Dilixiati Tuerdimaimaiti, Gulisitan Aili, Ajiguli Kulaixi, Remilanmu Nizhamuding, Baihetinisha Tuerdi","doi":"10.1186/s12890-026-04435-4","DOIUrl":"10.1186/s12890-026-04435-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the dynamic expression of T-cell immunoglobulin and mucin domain molecule-1 (TIM-1) in pulmonary tuberculosis (PTB) patients at various stages, and examine possible relationships with IFN-γ and IL-17, to elucidate the potential roles in PTB pathogenesis. In addition, we aimed to assess the feasibility of using TIM-1 combined with IFN-γ and IL-17 as a biomarker for PTB diagnosis.</p><p><strong>Methods: </strong>Plasma samples were collected from 60 PTB patients, 50 latent tuberculosis infection (LTBI) patients, and 50 healthy controls at the First Affiliated Hospital of Xinjiang Medical University between February and November 2023. The concentrations of TIM- 1, IFN-γ, and IL-17 in plasma were quantified using ELISA. Correlation and Logistic regression analyses were conducted, followed by the construction of a predictive model.</p><p><strong>Results: </strong>Significantly higher plasma concentrations of TIM-1 and IL-17 and reduced levels of IFN-γ were observed in PTB patients compared to LTBI subjects and healthy controls. A positive correlation was found between TIM-1 and IL-17 levels in PTB patients. Receiver operating characteristic (ROC) curve analysis demonstrated that TIM-1 exhibited moderate diagnostic performance, with a cutoff value of 22.3 pg·ml^- 1, whereas the reduction in IFN-γ level was not statistically significant. The constructed predictive model had a C-index of 78.8% and an area under the ROC curve of 0.79.</p><p><strong>Conclusions: </strong>Plasma TIM-1 concentration was significantly elevated in PTB patients and non-significantly raised in LTBI suggesting possible roles in promoting inflammation and modulating Th17 responses, potentially influencing mycobacterial clearance and perhaps disease progression. This highlights the potential importance of TIM-1 in tuberculous inflammatory processes, immune regulation, and its utility in early diagnostics, suggesting it may be a novel therapeutic target in PTB. These findings are preliminary and require further validation in larger, multicenter studies.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359500","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":"Glycemic variability does not provide incremental prognostic value for in-hospital death in community-acquired pneumonia patients: conventional clinical variables dominate.","authors":"Jiaojiao Zhou, Kaiyu Cai, Yinggang Zhu, Yanchun Gong, Haiyan Ge, Hua Sheng","doi":"10.1186/s12890-026-04443-4","DOIUrl":"10.1186/s12890-026-04443-4","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to systematically evaluate whether glycemic variability (GV) could provide independent incremental prognostic value for in-hospital death among patients with community-acquired pneumonia (CAP), beyond conventional clinical variables including the SOFA score.</p><p><strong>Methods: </strong>Data were retrieved from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, with a multicenter intensive care unit (ICU) database used as the external validation set. The coefficient of variation was employed to quantify GV. Feature selection was performed using the Boruta algorithm, and 9 machine learning (ML) models were constructed. The area under the receiver operating characteristic curve (AUC), Brier score, Deviance and other metrics were used to evaluate model performance, and SHapley Additive exPlanations (SHAP) analysis was conducted to reveal feature contributions. The predictive performance of the two models was further compared using the change in the area under the receiver operating characteristic curve (ΔAUC), Net Reclassification Index (NRI), Integrated Discrimination Improvement (IDI), and Decision Curve Analysis (DCA), to assess the incremental contribution of GV to model performance.</p><p><strong>Results: </strong>A total of 5256 patients were included, of whom 1175 (22.36%) experienced in-hospital death. After Boruta feature selection, 15 key features were retained. In the internal validation set, among the 9 ML models, the LR model performed optimally, with the highest AUC of 0.7851 (95% confidence interval [CI]: 0.7587-0.8115), the lowest Brier score (0.138), and the lowest Deviance (0.861). SHAP analysis indicated that Sequential Organ Failure Assessment (SOFA) score, Charlson Comorbidity Index, age, respiratory rate (RR) and weight were the top 5 core predictive factors. The AUC of the LR model without GV was 0.7623, with a ΔAUC of -0.0002; both NRI and IDI were not applicable (NA). The calibration curves and DCA curves of the two models were similar.</p><p><strong>Conclusion: </strong>In the model incorporating conventional clinical variables, GV did not yield independent incremental predictive value, highlighting the necessity of rigorous evaluation for additional biomarkers prior to clinical implementation.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350834","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":"Diagnostic significance of HRCT imaging features in idiopathic inflammatory myopathy-associated interstitial lung disease.","authors":"Qian-Yun Zhang, Cai-Yu Li, Chao-Chao Wang, Dong-Dong Zhang, Hong-Yan Shao, Ying Zhang","doi":"10.1186/s12890-026-04457-y","DOIUrl":"10.1186/s12890-026-04457-y","url":null,"abstract":"<p><strong>Background: </strong>Connective tissue disease-associated interstitial lung disease (CTD-ILD) is an important factor leading to a poor prognosis in connective tissue disease (CTD) patients. To analyze the clinical and imaging data of CTD-ILD patients, summarize their characteristics, and explore the diagnostic value of certain specific High Resolution Computed Tomography (HRCT) manifestations and their distribution patterns for idiopathic inflammatory myopathy-associated interstitial lung disease (IIM-ILD).</p><p><strong>Methods: </strong>This study conducted a retrospective analysis of demographic data and HRCT findings from 384 patients with CTD-ILD. Using multivariable logistic regression, hierarchical analysis, and sensitivity analysis to compare data from the IIM-ILD group and other connective tissue disease-associated interstitial lung disease (OCTD-ILD) group, we summarized the imaging features and distribution of IIM-ILD, providing imaging clues for its recognition.</p><p><strong>Results: </strong>The distribution of different imaging features differed between the IIM-ILD patients and the OCTD-ILD patients. This study found that nonspecific interstitial pneumonia (NSIP) located in the upper lung field, as well as organized pneumonia (OP) located in the middle and lower lung fields, are relatively significant characteristics that distinguish idiopathic inflammatory myopathies (IIM) from other connective tissue disease (OCTD) (the odds ratios (OR) were 2.51, 5.46, and 8.33, respectively, P < 0.001). If both NSIP in the upper lung field and OP in the lower lung field are present, diagnostic performance in differentiating IIM from OCTD will be further enhanced (sensitivity 55.90%, specificity 94.18%, accuracy 74.74%, OR 20.51, P < 0.001).</p><p><strong>Conclusions: </strong>This study indicated that for patients with CTD-ILD, specific HRCT manifestations could be used to distinguish IIM-ILD from OCTD-ILD, thereby assisting in clinical diagnosis. The coexistence of NSIP in the upper lung fields and OP in the lower lung fields would suggest a higher possibility of IIM-ILD.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350781","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":"Prognostic impact of ¹⁸F-fluorodeoxyglucose positron emission tomography and cardiac magnetic resonance-proven cardiac involvement in pulmonary sarcoidosis: a single centre long-term cohort study.","authors":"Shuhei Yoshikawa, Takahiro Sato, Taku Komori, Junichi Nakamura, Osamu Manabe, Noriko Oyama-Manabe, Satonori Tsuneta, Hirokazu Kimura, Sakae Takenaka, Toshiyuki Nagai, Toshihisa Anzai, Isao Yokota, Ichizo Tsujino, Satoshi Konno","doi":"10.1186/s12890-026-04458-x","DOIUrl":"10.1186/s12890-026-04458-x","url":null,"abstract":"<p><strong>Background: </strong>Sarcoidosis is a systemic granulomatous disease, often affecting the lungs, with a generally favourable prognosis. However, some patients experience progressive disease, and cardiac involvement may worsen outcomes. Data on the clinical course and causes of death in pulmonary sarcoidosis (PS), particularly with coexisting cardiac sarcoidosis (CS), remain limited.</p><p><strong>Methods: </strong>We retrospectively analysed patients with histologically confirmed PS. Baseline evaluations included chest X-ray and computed tomography, pulmonary function tests, and echocardiography. CS was diagnosed based on the findings of ¹⁸F-fluorodeoxyglucose positron emission tomography and cardiac magnetic resonance imaging in patients who met the predefined clinical screening criteria.</p><p><strong>Results: </strong>A total of 513 patients met the study criteria. The 3-, 5-, and 10-year survival rates were 98.2%, 97.0%, and 94.6%, respectively (median follow-up: 6.7 years). CS was diagnosed in 48 patients (9.4%), and survival was poorer in those with CS (p = 0.004 by log rank test). Multivariate analysis showed that CS was associated with increased all-cause mortality after adjustment for age or sex (age-adjusted hazard ratio 3.55, 95% CI 1.18-10.6; sex-adjusted hazard ratio 3.79, 95% CI 1.28-11.2). During follow-up, 21 patients (4.6%) died. Malignancy was the leading cause of death (n = 10, 48%), followed by cardiac death (n = 3, 14%) and respiratory failure (n = 3, 14%).</p><p><strong>Conclusions: </strong>In this Japanese single-centre cohort of patients with predominantly mild histologically confirmed PS, CS identified through a screening-based diagnostic pathway was associated with increased all-cause mortality.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350852","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":"Candida-associated immune and metabolic rewiring in chronic obstructive pulmonary disease.","authors":"Ran Wang, Zhibin Chen, Yanwei Wang, Niangui Zhao, Kecong Li, Haiyan Gong, Yanna Zhang, Songyin Lai, Zhangqiang Ye, Hui Yang","doi":"10.1186/s12890-026-04415-8","DOIUrl":"10.1186/s12890-026-04415-8","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is characterized by persistent systemic inflammation. Candida colonization is frequently observed in patients with COPD, yet its systemic impact remains poorly understood. This study aimed to identify molecular alterations uniquely induced by Candida under COPD conditions.</p><p><strong>Methods: </strong>An interaction-based model incorporating COPD status, Candida colonization, and their interaction term was used to define COPD-context-dependent Candida-responsive genes and metabolites. Peripheral blood mononuclear cell transcriptomes were analyzed by RNA sequencing, followed by functional enrichment, protein-protein interaction (PPI), and transcription factor (TF) motif analyses. Plasma metabolomics was performed to identify exclusive differential metabolites and enriched pathways. Multi-omic integration was performed to assess coordinated relationships between genes and metabolites, with correlation network construction and Spearman's correlation validation.</p><p><strong>Results: </strong>A subset of differentially expressed genes (DEGs) was exclusively altered in the CA_COPD versus COPD comparison. These genes were primarily enriched in immune regulation and inflammatory signaling pathways. PPI analysis identified limited but biologically meaningful interaction networks, while TF motif analysis implicated the zf-C2H2 family as a potential regulator of context-specific transcriptional remodeling. Metabolomic profiling revealed exclusive differential metabolites in CA_COPD. Upregulated metabolites were marginally associated with amino sugar and nucleotide sugar metabolism, whereas downregulated metabolites were significantly enriched in aminoacyl-tRNA biosynthesis, central carbon metabolism, protein digestion and absorption, and ABC transporter pathways. Integrated multi-omic analysis demonstrated tightly coordinated gene-metabolite networks linking transcriptional and metabolic reprogramming under Candida-COPD interaction conditions.</p><p><strong>Conclusion: </strong>Candida colonization induces distinct COPD-context-dependent transcriptional and metabolic reprogramming, suggesting a specific host response signature that may contribute to disease progression.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326818","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":"Doctor-nurse integrated management is associated with improved clinical outcomes in AECOPD patients with multimorbidity: A propensity score-matched retrospective cohort study.","authors":"Li Wang, Yaping Dou, Kun Li, Yajie Wang, Na Li","doi":"10.1186/s12890-026-04428-3","DOIUrl":"10.1186/s12890-026-04428-3","url":null,"abstract":"<p><strong>Background: </strong>Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are frequently complicated by multimorbidity, particularly cardiovascular and metabolic disorders such as heart failure and diabetes. These coexisting conditions create therapeutic conflicts and increase the risk of poor outcomes. Effective management strategies addressing both pulmonary and associated disorders in this high-risk population are urgently needed. This study aimed to evaluate whether a Doctor-Nurse Integrated Management (DNIM) model is associated with better clinical outcomes compared to routine care in AECOPD patients with multimorbidity.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at a tertiary hospital in China, screening electronic medical records of patients admitted for AECOPD with confirmed multimorbidity (defined as Charlson Comorbidity Index ≥ 2 or documented cardiac/metabolic comorbidities) between January 2022 and January 2025. Patients were allocated to either a DNIM group, receiving structured collaborative care including joint ward rounds, integrated care plans addressing both pulmonary and comorbid conditions, and collaborative discharge planning, or a routine care (RC) group. Propensity score matching (1:1) was employed to balance baseline characteristics. The primary outcome was a composite of all-cause mortality or readmission for cardiopulmonary events within one year. Secondary outcomes included length of stay (LOS), improvement in COPD Assessment Test (CAT) scores, and in-hospital complications.</p><p><strong>Results: </strong>After propensity score matching, 104 patients (52 pairs) with well-balanced baseline characteristics were included. The DNIM group demonstrated a significantly lower associated risk of the one-year composite endpoint compared to the RC group (Hazard Ratio [HR] 0.58, 95% Confidence Interval [CI] 0.35-0.96, P = 0.034). Patients in the DNIM group also had a shorter mean length of stay (8.4 ± 2.1 vs. 11.2 ± 3.4 days, P < 0.001) and greater improvement in CAT scores (ΔCAT - 6.2 ± 2.5 vs. -4.1 ± 2.2, P < 0.01). Furthermore, the DNIM model was linked to fewer in-hospital complications (11.5% vs. 28.8%, P = 0.028), particularly hyperglycemia and acute heart failure.</p><p><strong>Conclusion: </strong>The Doctor-Nurse Integrated Management model was associated with a better one-year prognosis, reduced length of stay, and decreased in-hospital complications in AECOPD patients with multimorbidity. This integrated approach addresses the complex interplay between COPD and its associated comorbidities, supporting its implementation in respiratory clinical practice to enhance patient-centered outcomes.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338004","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 association of household conditions with the development of active pulmonary TB among in households with a previous TB patient: a community-based case-control study.","authors":"Ringga Rahmi Prima, Alan F Geater, Defriman Djafri, Virasakdi Chongsuvivatwong","doi":"10.1186/s12890-026-04434-5","DOIUrl":"10.1186/s12890-026-04434-5","url":null,"abstract":"<p><strong>Background: </strong>Poor housing has been linked to tuberculosis (TB), yet details of living conditions are less well studied.</p><p><strong>Methods: </strong>This community-based case-control study examined household and individual factors associated with active pulmonary TB among households with a prior TB patient in Padang City, West Sumatra, Indonesia. Confirmed TB cases (CS, 105), symptomatic confirmed non-TB controls (CN1, 104), and asymptomatic controls (CN2, 102) were recruited at primary health centres from August to December 2024. Inclusion criteria were informed consent and ability to communicate; controls with a history of active TB were excluded from analysis. Participants were interviewed regarding individual characteristics, and a home visit made to record household conditions (temperature, humidity, carbon dioxide content and wind speed of living room air, house dimensions and construction materials). Multivariable multinomial logistic regression identified associations (relative probability ratios) of individual and household variables between cases and each control group.</p><p><strong>Results: </strong>Case status was associated with small bedroom volume (< 12m³), compared with CN2 (3.74 [1.25, 11.20]), and with gypsum/plaster ceilings compared with CN1 (11.24 [2.52, 50.10]. In both comparisons, case status was associated with outdoor occupation (10.13, [1.69, 60.61] and 18.60, [2.53, 137.0]), frequent coffee shop visits (10.17 [1.32, 78.55] and 24.06 [2.22, 261.0]), and time elapsed of > 1 year since the prior TB patient (21.64 [8.73, 53.64] and 13.91 [5.82, 33.24]). Compared with CN1, case status was associated with the prior patient being a sibling (8.72 [2.33, 32.57]), grandparent/parent (5.31 [1.51, 18.70]) or other relative (4.23 [1.16, 15.45]) rather than spouse. The relative probability of outdoor activity was lower among cases (0.25, [0.10, 0.62] compared with CN2), and that of being underweight higher (4.71 [1.77, 12.53] and 6.35 [2.35, 17.18]), possibly consequences of ill-health.</p><p><strong>Conclusion: </strong>Among this population, small bedroom volume, gypsum/plaster ceiling, frequent coffee shop visits, outdoor occupation, non-spousal relationship with the prior TB patient and elapsed time of > 1 year increased the relative probability of being a TB patient. These findings suggest interventions such as improving bedroom space and targeted screening in households with prior TB, especially after one year. Housing improvements, though long-term, may usefully complement behavioural interventions for sustainable TB control.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326856","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}