BMC Pulmonary Medicine最新文献

{"title":"Motivations and experiences of patients with respiratory disease and their caregivers in a multinational trial of mirtazapine for severe breathlessness: a qualitative study (BETTER-B).","authors":"Adejoke O Oluyase, Luca Ghirotto, Harry Watson, Massimo Costantini, Sabrina Bajwah, Charles Normand, Silvia Tanzi, Jeremias Bazata, Karen Ryan, Elena Turola, Irene J Higginson, Matthew Maddocks","doi":"10.1186/s12890-025-03862-z","DOIUrl":"10.1186/s12890-025-03862-z","url":null,"abstract":"<p><strong>Background: </strong>Drug repurposing offers advantages over traditional drug development, such as shorter time and reduced costs. Understanding patient and caregiver perspectives on repurposed medicines is crucial to improving clinical trial design and conduct, especially in advanced disease. We carried out this study in the UK and Italy to explore the experiences and motivations of patients with respiratory diseases and their caregivers who participated in a trial investigating the repurposing of the antidepressant mirtazapine to alleviate severe breathlessness.</p><p><strong>Methods: </strong>Qualitative study nested within a double-blind, placebo-controlled, randomised trial (BETTER-B: BETter TreatmEnts for Refractory Breathlessness). Purposive sampling ensured diversity in age and gender. Framework analysis was applied. Interviewed participants had Chronic Obstructive Pulmonary Disease (COPD) or Interstitial Lung Disease (ILD), experienced limiting breathlessness (grade 3 or 4 of the modified Medical Research Council breathlessness scale) and had participated in the trial.</p><p><strong>Results: </strong>Twenty-three patients (13 men and 10 women) and eight caregivers (4 men and 4 women) were interviewed. Of patients (15 COPD, 8 ILD), 22 had completed the trial and one had withdrawn due to adverse effects. Interviews were conducted at home or via the telephone. Two main themes were derived: (1) 'knowledge and views about antidepressants and its use' and (2) 'experience and views on joining the trial'. The patients' perceived need for relief from severe breathlessness and its impact outweighed any concerns about taking an antidepressant. Motivations for trial participation included the potential for benefit, altruism, trust in the healthcare system, and the strength of relationships between patients and healthcare professionals.</p><p><strong>Conclusions: </strong>Participants willing to accept mirtazapine repurposed for another indication joined this trial regardless of their existing concerns about antidepressants. A clear explanation of trials and possible benefits, plus trust in professionals and the healthcare system, are instrumental in increasing trial participation for repurposed medicines.</p><p><strong>Trial registration: </strong>ISRCTN Registry, ISRCTN10487976. Prospectively Registered on 19 November 2019.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"390"},"PeriodicalIF":2.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854596","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":"Trajectory-based analysis of early mechanical ventilation PEEP levels and physiological parameter trajectories in ARDS patients and their association with the occurrence of gastrointestinal injury events.","authors":"Shi-Tao Huang, Kai-Hua Yu, Xiong-Bin Ma, Yi-Bo Sun, Zhong-Ya Huang, Di Chen, Hong-Lei Li, Li-Ping Liu","doi":"10.1186/s12890-025-03856-x","DOIUrl":"10.1186/s12890-025-03856-x","url":null,"abstract":"<p><strong>Background: </strong>Mechanical ventilation is crucial in the treatment of acute respiratory distress syndrome (ARDS), but is associated with complications, including gastrointestinal injury (GI). This study investigates the association between early mechanical ventilation parameter trajectories and the occurrence of GI events in ARDS patients.</p><p><strong>Methods: </strong>A retrospective cohort study using the MIMIC-IV database employed group-based trajectory modeling (GBTM) to identify trajectory patterns during early mechanical ventilation in ARDS patients. Kaplan-Meier analysis estimated GI events incidence across trajectory groups, and Cox regression models assessed independent risk associations, adjusting for clinical confounders. We evaluated and compared the model in order to enhance its robustness.</p><p><strong>Results: </strong>A total of 1,344 ARDS patients were included, with four trajectory groups identified. Patients in Group 1 (low PEEP, moderate VT, lower frequency spontaneous breathing) exhibited the highest GI risk, while Group 2 (high PEEP, low tidal volume, controlled spontaneous breathing) had the lowest risk (HR: 0.606, 95% CI: 0.418-0.879, P = 0.008). Kaplan-Meier curves revealed a consistent pattern with Group 1 showing the highest cumulative incidence of GI events. Aspirin use, heparin therapy, renal replacement therapy, and APACHE II score were identified as independent factors for GI events. Subgroup analysis did not show intergroup differences. Sensitivity analyses confirmed model robustness.</p><p><strong>Conclusions: </strong>Ventilation parameter trajectories are associated with GI injury risk in ARDS patients. Strategies optimizing PEEP levels and spontaneous breathing may mitigate this risk, supporting the need for individualized ventilation approaches.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"388"},"PeriodicalIF":2.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844405","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":"Diabetes mellitus increases the risk of post-COVID-19 pulmonary fibrosis: a meta-analysis of observational studies.","authors":"Fen Tan, Chenyu Li, Jingyi Hu, Shanshan Liu, Weijun Peng, Hong Peng, Can Hou, Chao Wu, Zhiguang Zhou, Yang Xiao","doi":"10.1186/s12890-025-03880-x","DOIUrl":"10.1186/s12890-025-03880-x","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary fibrosis (PF) is a serious respiratory complication observed in coronavirus disease 2019 (COVID-19) patients, and people with diabetes mellitus (DM) are at an increased risk of developing severe COVID-19. However, whether DM is a risk factor for post-COVID-19 pulmonary fibrosis (PCPF) remains unknown.</p><p><strong>Methods: </strong>We conducted a meta-analysis of observational studies to evaluate the association between DM and the development of PCPF. We searched PubMed, EMBASE, and the Cochrane Library for relevant studies published before February 1, 2023, without language or publication type restrictions. We calculated odds ratio (OR) with 95% confidence interval (CI) to compare the prevalence of DM among COVID-19 patients with PCPF with that among non-PCPF controls.</p><p><strong>Results: </strong>This meta-analysis included a total of 5,088 COVID-19 patients. We found a significant association between DM and the development of PCPF (OR = 2.18, 95% CI: 1.15-4.13, P < 0.001), with high heterogeneity among the studies (I² = 82.2%). Subgroup analysis showed that the association between DM and PCPF was consistent across different geographic regions, study designs, sample sizes, mean ages, DM types, assessment times after COVID-19 onset, and NOS quality ratings.</p><p><strong>Conclusions: </strong>This meta-analysis offers evidence supporting a correlation between DM and the development of PCPF among COVID-19 patients. Despite the considerable heterogeneity in this studies, this research retains significant implications for the clinical management of COVID-19 patients. DM is a potential risk factor for PCPF. It is imperative for clinicians to remain vigilant regarding the development of PCPF in COVID-19 patients who complicated with DM.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"386"},"PeriodicalIF":2.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833923","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":"Predicting 30-day in-hospital mortality in ICU asthma patients: a retrospective machine learning study with external validation.","authors":"Yuanshuo Ge, Guangdong Wang, Tingting Liu, Wenwen Ji, Jiaolin Sun, Yaxin Zhang","doi":"10.1186/s12890-025-03881-w","DOIUrl":"10.1186/s12890-025-03881-w","url":null,"abstract":"<p><strong>Background: </strong>Asthma-related mortality in the intensive care unit (ICU) remains poorly characterized, with no existing predictive models specifically designed for this high-risk population. This study aimed to develop and externally validate a machine learning-based model to predict 30-day in-hospital mortality among ICU patients with asthma.</p><p><strong>Methods: </strong>The model was developed using data from MIMIC-IV 2.2 and externally validated on a subset of MIMIC-IV 3.1. Clinical variables from the first 24 h of ICU admission were extracted. Feature selection was conducted using both LASSO regression and the Boruta algorithm. Seven machine learning algorithms were trained and evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis. The best-performing model was identified based on internal and external validation results. SHapley Additive exPlanations (SHAP) were employed to interpret feature importance. The final model was deployed as an interactive web-based tool.</p><p><strong>Results: </strong>A total of 4385 ICU asthma patients were analyzed. The final XGBoost model, using 12 features, achieved the highest AUROC in both internal (0.83) and external (0.80) validation, and demonstrated the best calibration and net clinical benefit. SHAP analysis identified age, respiratory rate, RDW, urine output, and anion gap as top predictors. The model outperformed conventional ICU scores and is available as a web-based tool.</p><p><strong>Conclusions: </strong>We developed and externally validated a robust prediction model for 30-day mortality in ICU patients with asthma. The model offers strong performance, interpretability, and clinical utility, supporting its use for real-time risk stratification and decision-making in critical care settings.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"387"},"PeriodicalIF":2.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833924","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":"Prevalence and risk factors for the development of COPD among workers in stone quarries: a cross-sectional study.","authors":"Sadequr Rahman, Atonu Das, Afm Nazmul Islam, Enayet Hossain, Sahm Mesbahul Islam, Khasruzzaman Rony, Abu Kamran Rahul, Guljar Hossain, Mohammad Romel Bhuia, Md Asaduzzaman","doi":"10.1186/s12890-025-03542-y","DOIUrl":"10.1186/s12890-025-03542-y","url":null,"abstract":"<p><strong>Background: </strong>Employees working in stone quarries are frequently exposed to dust, especially silica particles, which may increase the risk of developing various lung diseases, notably chronic obstructive pulmonary disease (COPD). This study aimed to evaluate pulmonary function and explore the prevalence and potential risk factors associated with COPD among individuals in this occupational category.</p><p><strong>Methods: </strong>This Cross-sectional study recruited 200 workers from multiple stone quarries. Pulmonary function was evaluated through Spirometry, and sociodemographic information, current symptoms, and data on dust exposure were gathered using a prearranged questionnaire. Logistic regression analysis was performed to identify the factors contributing to the development of COPD.</p><p><strong>Results: </strong>The overall prevalence of COPD was 39%. The primary pattern observed in pulmonary function test was non-reversible obstructive. There was a consistent decrease in all spirometric parameters with an increase in years of service. Age (OR = 1.07, 95% CI = 1.04-1.10; p = 0.001), male gender (OR = 2.51, 95% CI = 1.23-5.08; p = 0.0106), smoking status (OR = 2.15, 95% CI = 1.12-4.11; p = 0.02), length of service (10-15 years) (OR = 67.3, 95% CI = 21.35-212.64; p < 0.001), and length of service (> 15 years) (OR = 112.8, 95% CI = 116.28-1095.58; p < 0.001) have been identified as significant risk factors for the development of COPD.</p><p><strong>Conclusions: </strong>The prevalence of COPD is significantly high among stone quarry workers, underscoring the necessity for implementing effective preventive measures to mitigate the impact of occupational lung diseases.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"384"},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820590","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":"Readmission and mortality among children requiring long-term mechanical ventilation via tracheostomy: a systematic review.","authors":"Lindsey Scheller, Karley Mariano, Sandra Staveski, Sandra Weiss, Abbey Alkon, Christopher J Russell, Leia Casey, Yoshimi Fukuoka","doi":"10.1186/s12890-025-03818-3","DOIUrl":"10.1186/s12890-025-03818-3","url":null,"abstract":"<p><strong>Background: </strong>Home environments improve quality of life and reduce infections for children on long-term mechanical ventilation via tracheostomy (LTMV-T). However, unexpected hospital readmissions and death remain significant concerns. Existing systematic reviews have not fully examined risk factors for readmission and mortality. This review examines modifiable and non-modifiable risk factors associated with readmission and mortality in infants, children, and adolescents on LTMV-T.</p><p><strong>Methods: </strong>Five databases (PubMed, CINAHL, Web of Science, Embase, and Epistemonikos) were searched from inception to 2024. All quantitative study designs examining risk factors associated with readmission and/or mortality in children less than 21 years of age on LTMV-T were included. Articles were limited to peer-reviewed journals and the English language. Covidence software was used for data management, study screening, and data extraction. Each abstract was reviewed by two independent reviewers and discrepancies were resolved by a third. The Joanna Briggs Institute critical appraisal tools were used to assess risk of bias in individual studies.</p><p><strong>Results: </strong>Twenty-six studies examined cohorts of children on LTMV-T from 1980 to 2023. Studies were primarily retrospective cohorts, with sample sizes ranging from 27 to 8,009 children. Most studies reported that at least 50% of readmissions occurred within the first two years post-discharge and respiratory-related issues accounted for 30-75% of readmissions. Mortality within the first-year post-discharge varied as low as 0% to as high as 16%. Few studies examined socioenvironmental risk factors or those specific to LTMV-T populations, conducting analyses primarily on tracheostomy-only and/or LTMV-T cohorts. Risk factors for readmission and mortality included age, lower income, discharge disposition, chronic conditions, lack of respiratory physiotherapy (cough assist, percussions), gastrostomy tube, and lower birth weight. Risk of bias ranged from low to moderate due to unclear outcome measures and analyses that did not address potential confounders.</p><p><strong>Conclusions: </strong>Readmissions are common occurrences among children on LTMV-T with considerable risk of mortality, especially within the first two-years post-discharge. Risk factors identified were predominately clinical and demographic characteristics that can inform risk assessments and targeted interventions. Future studies should further explore socioenvironmental factors such as social determinants of health among LTMV-T specific populations.</p><p><strong>Trial registration: </strong>International Prospective Register of Systematic Reviews ID: CRD42024492773.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"385"},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820591","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 relationship between the triglyceride-glucose index and lung function in healthy individuals: a cross-sectional study of 89,809 participants from Kangbuk Samsung health study.","authors":"Hyun-Il Gil, Sungwon Lim, Min-Jung Kwon, Soo-Youn Ham, Jonghoo Lee, Jae-Uk Song","doi":"10.1186/s12890-025-03869-6","DOIUrl":"10.1186/s12890-025-03869-6","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose index (TyG) has emerged as a reliable proxy for insulin resistance and metabolic dysfunction, showing associations with various health outcomes. While the relationship between metabolic health and respiratory function has been established, the association between TyG and lung function remains unclear, particularly in Asian populations. Therefore, we investigated whether TyG is associated with decreased lung function in a large sample of healthy Koreans.</p><p><strong>Methods: </strong>We analyzed data from 89,809 healthy Korean adults (46,739 men, mean age: 38.5 years) who underwent health examinations in 2019, stratifying participants into quartiles based on their TyG index. Lung function impairment was defined using the lower limit of normal (LLN) derived from spirometric values at the fifth percentile of our population. We calculated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for lung function impairment, using the lowest TyG quartile as the reference group.</p><p><strong>Results: </strong>Mean TyG index was 8.34 ± 0.57. Subjects in the highest TyG quartile exhibited the lowest predicted forced expiratory volume in one second (FEV1%) and forced vital capacity (FVC%) after adjusting for covariates (P < 0.001). Also, FEV1(L) /FVC(L) ratio significantly differ among the four quartiles (P < 0.001). Compared to the lowest quartile (Q1), the aORs with 95% CI for FEV1% below the LLN across increasing quartiles (Q2 to Q4) were 1.150 (1.002-1.320), 1.272 (1.103-1.466), and 1.535 (1.310-1.799), respectively. For FVC% below the LLN, aORs were 1.233 (1.065-1.428), 1.334 (1.159-1.536), and 1.745 (1.506-2.021), respectively. Both trends were statistically significant (all P for trend < 0.001). In contrast, the aORs for FEV1/FVC below the LLN showed no significant differences among groups (P for trend = 0.186).</p><p><strong>Conclusions: </strong>We found a significant association between higher TyG index values and decreased lung function in a large sample of healthy Koreans. Longitudinal studies are needed to establish causality and explore the long-term implications of this relationship on respiratory health.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"383"},"PeriodicalIF":2.8,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811796","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":"Efficacy and safety of inhaled ambroxol solution in improving sputum of lower respiratory tract infection in children: a multicenter, randomized, double-blind, placebo-controlled trial.","authors":"Baoping Xu, Peng Han, Yunxiao Shang, Huanji Cheng, Zhiying Han, Lin Zhao, Shaoru He, Min Lu, Enmei Liu, Kunling Shen","doi":"10.1186/s12890-025-03845-0","DOIUrl":"10.1186/s12890-025-03845-0","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of inhaled ambroxol solution in improving sputum of lower respiratory tract infections (LRTIs) in children.</p><p><strong>Study design: </strong>This study was a randomized, double-blind, parallel-group, placebo-controlled, multicenter trial. The patients were administered inhaled ambroxol or a placebo twice a day for 7 days. And researchers collected efficacy and (or) safety indicators every day during the course.</p><p><strong>Results: </strong>A total of 236 children were randomly assigned to receive ambroxol or placebo (1:1). At all visit points after the medication, the mean difference of cough score with the baseline between the two groups was statistically significant (P < 0.05). Compared with the baseline, the phlegm-sound scores in the throat of the experimental group decreased more on the 1st, 2nd, and 3rd days after administration (P < 0.05). But there was no difference in pulmonary rale scores. The occurrence of adverse events in the experimental group was lower (21.37% vs. 35.59%, P = 0.021), and the incidence of adverse reactions was similar between the two groups (2.56% vs. 5.08%, P = 0.499).</p><p><strong>Conclusion: </strong>Inhaled ambroxol solution could improve the sticky sputum symptoms in children with LRTIs and is safe in clinical application. Further research is needed to confirm these findings.</p><p><strong>Trial registration: </strong>The study was retrospectively registered on June 14, 2023, at https://www.chictr.org.cn/ under the number ChiCTR2300072466.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"382"},"PeriodicalIF":2.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803525","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":"Prevalence of genetic mutations in Alpha-1 antitrypsin in patients with difficult-to-treat asthma in Colombia.","authors":"Abraham Alí-Munive, Jaime Leonardo Chacón, Leidy Prada, Nadia Juliana Proaños, Leslie Vargas, Claudia Diaz-Bossa, Angela Giraldo, John Pedrozo-Pupo","doi":"10.1186/s12890-025-03840-5","DOIUrl":"10.1186/s12890-025-03840-5","url":null,"abstract":"<p><strong>Background: </strong>Alpha-1 antitrypsin (AAT) is a medium-sized globular glycoprotein distributed in serum and tissues. In the lungs, it inhibits serine proteases and has anti-inflammatory properties in different types of cells, protecting lung tissue from damage. Mutations in the SERPINA1 gene that codes for AAT are related to asthma and chronic obstructive pulmonary disease. In Colombia, there are no published data on the prevalence of alpha-1 antitrypsin deficiency (AATD) in adult patients with difficult-to-manage asthma. ​This study aims to determine the prevalence of genetic mutations related to AAT in adult patients with difficult-to-treat asthma in Colombia.</p><p><strong>Methods: </strong>This prospective, multicenter, cross-sectional study included adult patients with difficult-to-treat asthma in five asthma care centers in Colombia. Informed consent was obtained, and gingival mucosa was sampled for genetic diagnosis of AATD using the A1AT Genotyping Test. Data analysis was performed using the Chi² test, Student's t-test, and Mann-Whitney test for group comparison.</p><p><strong>Results: </strong>A total of 449 adult patients with difficult-to-treat asthma were included with a mean age of 56.1 ± 14.9 years; 73.1% (N = 328) were women; and 89.1% were using high-dose inhaled corticosteroid / long-acting B2 agonists. Mutations in the AAT gene were found in 12.5% (N = 56) of patients. Of these, 85.7% had the M/S genotype, 10.7% the M/Z genotype, 1.8% the M/I genotype, and 1.8% the S/S genotype.</p><p><strong>Conclusions: </strong>The study identified a prevalence of AAT mutations in 12.5% of adult patients with difficult-to-treat asthma in Colombia made up of four genotypes: M/S, M/Z, M/I and S/S.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"380"},"PeriodicalIF":2.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803526","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":"Technical evaluation of Turbuhaler^® use in children with bronchial asthma: combination of a checklist and inhalation parameters.","authors":"Lina Liang, Ruogang Huang, Yun Li, Zhufeng Wang, Kang Peng, Junfeng Lin, Feifei Huang, Xiaoyin Yao, Jinping Zheng, Yi Gao","doi":"10.1186/s12890-025-03834-3","DOIUrl":"10.1186/s12890-025-03834-3","url":null,"abstract":"<p><strong>Background: </strong>The Turbuhaler^® is a dry powder inhaler (DPI) that is commonly used in the treatment of asthmatic patients aged 5 years and above. Nevertheless, the technique of using the Turbuhaler^® in the real world remains ambiguous. This study aims to evaluate techniques in using Turbuhaler^® by combining a checklist with inhalation parameters and to investigate the association between the patient characteristics and inhaler technique.</p><p><strong>Methods: </strong>This study recruited asthmatic children aged 4 to 14 years who were using the Turbuhaler^® from The First Affiliated Hospital of Guangzhou Medical University from August 2023 to August 2024. The technique of using Turbuhaler^® was evaluated step by step, and the inhalation parameters of patients were subsequently tested. Influencing factors related to inhaler technique were analyzed by ordered logistic regression analysis.</p><p><strong>Results: </strong>Of the 141 enrolled patients, 50 (35.5%) scored 10 points on the checklist. Overall, 105 (74.4%), 28 (19.9%) and 8 (5.7%) patients performed good, moderate, and poor inhaler technique, respectively. The three common improper steps were ''exhale to residual volume'' (35.5%), \"inhale forcefully and deeply\" (13.5%), \"rinse mouth after inhalation\" (13.5%). The three common inappropriate inhalation parameters were \"Effective inspiratory time(EIT) < 2s\" (90.8%), \"Peak inspiratory flow rate(PIFR) < 60L/min\" (41.8%), and \"Breath-hold time(BHT) < 5s\" (27.0%). In the three groups with good, moderate, poor inhaler techniques, 0, 2 (7.1%), and 2 (25.0%) patients did not reach the minimum PIFR. Meanwhile, 38 (36.2%), 15 (53.6%), and 6 (75.0%) patients did not reach the optimal PIFR, respectively. The results of ordered logistic regression analysis indicated that low medication adherence (P = 0.045), PIFR (P = 0.041), BHT (P = 0.003) and the duration of Turbuhaler^® use (P = 0.009) were the primary factors influencing asthmatic children's inhaler technique.</p><p><strong>Conclusion: </strong>The improper use of inhalers and inappropriate inhalation parameters are common among asthmatic children. Using checklist and inhalation parameters enables a more comprehensive evaluation of the patients' inhalation maneuvers and inspiratory effort.</p><p><strong>Trial registration: </strong>This study is registered at Chictr.org with the identifier number ChiCTR2200056579.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"381"},"PeriodicalIF":2.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803527","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}