BMC Pulmonary Medicine最新文献

{"title":"The effect of bempedoic acid on histopathologic changes associated with natural aging in rat lungs.","authors":"Serap Argun Baris, Ozgur Baris, Huseyin Kaya, Elif Karasal Guliyev, Cenk Anil Olsen, Cigdem Vural, Hasim Boyaci, Ilknur Basyigit","doi":"10.1186/s12890-025-03608-x","DOIUrl":"https://doi.org/10.1186/s12890-025-03608-x","url":null,"abstract":"<p><strong>Background: </strong>The process of aging is characterized by a series of physiological, cellular, and immunological changes in tissues. Bempedoic acid is an antioxidant, anti-inflammatory, and cholesterol-lowering drug that does not belong to the statin class. The objective of this study was to assess the impact of bempedoic acid on age-related histopathological alterations in rat lungs.</p><p><strong>Methods: </strong>A total of 40 Wistar-Albino male rats (275-357 g) were included in the study, with 10 rats in each experimental group [Young control (YC), Young + Bempedoic acid (YD), Elderly control (EC), Elderly + Bempedoic acid (ED)]. Bempedoic acid (30 mg/kg/day) was administered orally for one month. The rats were housed under controlled conditions to minimize external stressors. The Geropathological Grading System (GGP) was used to standardize the evaluation of age-related findings in the lungs. Some lesions were classified as either present or absent, whereas others were evaluated on a scale of 0-4 according to their severity. Composite lesion scores were calculated for each rat. Additionally, the presence and severity of emphysema in the rat lungs were recorded.</p><p><strong>Results: </strong>Although the median composite lesion score was higher in the elderly groups, the difference was not statistically significant (p = 0.7). The distribution of cells associated with passive congestion, heart failure, and atelectasis was higher in the elderly drug group (p = 0.024 and p = 0.015, respectively). The prevalence of perivascular inflammation was significantly higher in the elderly control group compared to the other groups. Moreover, no cases of moderate-to-severe perivascular inflammation were observed in the elderly drug group (p = 0.019). The prevalence of severe emphysema was higher in the elderly control group compared to the other groups, whereas no cases of severe emphysema were observed in the elderly drug group (p = 0.044).</p><p><strong>Conclusion: </strong>It is hypothesized that statins, a class of antihyperlipidemic drugs, exert a protective effect against aging due to their ability to correct oxidative damage. Similarly, bempedoic acid's effect on fat oxidation and cholesterol metabolism may be associated with its protective role in the lungs.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"142"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742193","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":"Automatically titrating oxygen system versus constant flow oxygen system during exercise in patients with COPD: a systematic review and meta-analysis.","authors":"Peijian Wang, Jing Wang, Lijun Ge, Beiyao Gao, Siyuan Wang, Shan Jiang","doi":"10.1186/s12890-025-03594-0","DOIUrl":"https://doi.org/10.1186/s12890-025-03594-0","url":null,"abstract":"<p><strong>Background: </strong>Hypoxemia is a common symptom among patients with chronic obstructive pulmonary disease (COPD). The constant flow oxygen system (CFOS) is often insufficient to correct this symptom. The automatically titrating oxygen system (ATOS), a new oxygen therapy mode, remains undetermined in its ability to improve exercise performance more effectively than CFOS in COPD patients. The main objective of this meta-analysis was to explore this issue.</p><p><strong>Methods: </strong>We conducted a thorough search of randomized controlled trials (RCTs) in PubMed, Embase, Web of Science (from inception to 1 November 2024). Study selection, data extraction, and risk of bias assessment were performed independently by two authors. Data synthesis was conducted using Stata software (Version 17.0). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was utilized to rate evidence quality.</p><p><strong>Results: </strong>Five eligible studies (n = 120) were included. Compared to CFOS, ATOS was more effective in extending the distance (MD = 180.28 m, 95%CI:133.03 to 227.52) and duration (MD = 237.63 s, 95%CI: 181.18 to 294.07) of endurance shuttle walking test (ESWT). Besides, ATOS could better prolong the percentage time of sustaining targeted SpO₂ (92%-96%) (MD = 29.43%,95%CI:21.15 to 37.71) and relieve dyspnea at isotime (MD = -1.65, 95%CI -3.19 to -0.11) during ESWT.</p><p><strong>Discussion: </strong>ATOS may have more advantages in improving exercise tolerance, sustaining targeted SpO₂, and ameliorating dyspnea during exercise in COPD patients.</p><p><strong>Clinical trial registration: </strong>The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prosp ero/, and the ID is CRD 42024574955) and we didn't make a protocol.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"140"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742173","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":"FDG-avid pulmonary mucous gland adenoma mimicking lung cancer on 18 F-FDG PET/CT: a rare case report and literature review.","authors":"Chen Xiaomei, Zhou Jiahui, Zhang Fangbiao, Zheng Chunhui","doi":"10.1186/s12890-025-03590-4","DOIUrl":"10.1186/s12890-025-03590-4","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary mucous gland adenoma (MGA) is an exceptionally rare benign tumor. Even with the assistance of 18 F-FDG PET/CT, the accurate diagnosis of MGA as lung cancer remains challenging. Only one case of fluorodeoxyglucose(FDG)-avid pulmonary mucous gland adenoma and two case of low FDG uptake pulmonary mucous gland adenoma have been reported in English literature, while a single case of moderately increased FDG uptake pulmonary mucous gland adenoma has been documented in French literature. To minimize misdiagnosis and select appropriate treatment strategies, it is crucial to comprehensively analyze its 18 F-FDG PET/CT manifestations in conjunction with clinical symptoms and pathological findings.</p><p><strong>Case presentation: </strong>In our study, we present a case involving a 70-year-old woman with clinical manifestations of persistent cough and sputum with an FDG-avid mucous gland adenoma mimicking lung cancer on 18 F-FDG PET/CT imaging. Ultimately, the patient underwent a potentially unnecessary video-assisted thoracoscopic lobectomy, and the pathological diagnosis was determined to be MGA. The patient was discharged and remained clinically well without any complaints for a period of 6 months.</p><p><strong>Conclusions: </strong>The use of 18 F-FDG PET/CT lacks specificity in detecting MGA and may lead to misdiagnosis as a lung malignancy. A comprehensive analysis combining clinical manifestations, bronchoscopy findings, imaging results, and pathological findings is essential for accurate identification of pulmonary mucus gland adenoma.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"137"},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717989","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":"Comparing the clinical characteristics and risk factors of prognosis in pediatric ARDS with and without malignancies: a retrospective cohort study.","authors":"Xi Xiong, Yun Cui, Chunxia Wang, Yiping Zhou, Xiaoxuan Ma, Pin Li, Yucai Zhang","doi":"10.1186/s12890-025-03598-w","DOIUrl":"10.1186/s12890-025-03598-w","url":null,"abstract":"<p><strong>Background: </strong>The number of malignancy patients with respiratory failure is rising in pediatric intensive care units (PICU). Our study aims to compare the clinical characteristics and prognostic risk factors of acute respiratory distress syndrome (ARDS) with or without malignancies.</p><p><strong>Methods: </strong>This retrospective study reviewed medical records of 188 ARDS patients admitted to the PICU between January 2018 and December 2022, including 60 with malignancies and 128 without. Clinical data were collected within 48 h post-ARDS diagnosis. Multivariate logistic regression analysis and receiver operating characteristic curve (ROC) analysis were used to investigate the risk factors for PICU mortality in the malignancy and non-malignancy groups.</p><p><strong>Results: </strong>Compared with pediatric patients without malignancy, the ARDS patients with malignancy presented higher mortality (55.0% vs. 31.3%, P = 0.002), a higher incidence of community-acquired fungal infection (36.1% vs. 6.3%, P < 0.001) and multidrug resistance (MDR) bacteria (65.4% vs. 30.5%, P = 0.003). There were substantial differences in levels of lactate [1.5 (0.8-3.7) vs. 1.0 (0.7-2.0) mmol/L, P = 0.008], C-reactive protein (CRP) [150.0 (83.0-168.0) vs. 31.0 (10.0-108.0) mg/L, P = 0.02], procalcitonin (PCT) [10.4 (2.0-27.5) vs. 1.2 (0.3-6.2) mg/L, P < 0.001], counts of platelet [17.0 (8.0-73.0) vs. 232.0 (152.0-330.0) × 10⁹/µL, P < 0.001], the distribution of CD8 + T [36.9 (26.0-53.6) vs. 21.9 (17.3-29.1) %, P < 0.001], CD19 + T cells [9.9 (0.9-30.2) vs. 33.6 (22-46.6) %, P < 0.001], and higher peak vasoactive-inotropic score (VIS) in ARDS with malignancy [73.0 (20-208) vs. 15.0 (5.0-82.0), P < 0.01]. In multivariable analysis, only VIS independently predicted mortality in ARDS patients with malignancy (OR, 1.011; 95% confidence interval [CI]: 1.003-1.018; P = 0.005). Neither pSOFA scores (OR, 1.249, 95% CI: 0.958-1.628, P = 0.101) nor lactate levels (OR, 1.192, 95% CI: 0.928-1.531, P = 0.170) showed significant associations.</p><p><strong>Conclusion: </strong>ARDS patients with malignancies exhibited poorer outcomes. VIS is only an independent predictor of mortality in pediatric ARDS patients with malignancies.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"136"},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717982","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":"Pulmonary cavity with black sputum in COVID-19-Pneumoconiosis: a case report.","authors":"Wen-Qin Jiang, Yu-Hong Li, Wen-Ming Wang","doi":"10.1186/s12890-025-03586-0","DOIUrl":"10.1186/s12890-025-03586-0","url":null,"abstract":"<p><strong>Background: </strong>Black sputum is scarce in clinical work. Pulmonary cavities with black sputum are more common in fungal infections and inhalation of a large amount of dust rarely.</p><p><strong>Case report: </strong>A 58-year-old young man went to the hospital several times because of Black sputum after being infected with COVID-19 and was diagnosed with pulmonary tuberculosis. The chest computerized tomography (CT) showed multiple high-density mass shadows in both lungs, accompanied by cavity formation. Bronchoscopy showed carbon foam was deposited in bilateral bronchial mucosa without new organisms, and the bronchial lavage fluid is medium black mucus, which gene X-PERT/rifampicin resistance test, fungal and pathological examination were negative. According to medical history, the patient has been engaged in underground work in coal mines three times, without any preventive measures. The final diagnosis was pneumoconiosis. The symptoms were relieved after two alveolar lavage treatments within 1 month, and the black sputum disappeared. Chest CT showed lung cavity lesions are stable 3 months later.</p><p><strong>Conclusion: </strong>Occupational dust exposure should not be ignored when treating patients with hollow lungs and black sputum. Pneumoconiosis is always diagnosed at an advanced stage, either as a milia nodular disease in chest imaging, or it progresses to PMF (progressive bulk fibrotic), with or without cavitation. There are currently no reported cases of pneumoconiosis combined with COVID-19 infection. Patients with pneumoconiosis have become susceptible to COVID-19 infection due to pulmonary interstitial fibrosis and low immunity. PMF cases of COVID-19 are atypical, and their clinical symptoms, laboratory examinations, and imaging manifestations are allIt exhibits atypical properties, and because the fungal test is negative, infection with COVID-19 may accelerate the production of unexplained tracheal mucus and black sputum in microbiological examinations.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"133"},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708485","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 respiratory viruses in children with respiratory tract infections during the COVID-19 pandemic era: a systematic review and meta-analysis.","authors":"Pegah Khales, Mohammad Hossein Razizadeh, Saied Ghorbani, Afagh Moattari, Hassan Saadati, Ahmad Tavakoli","doi":"10.1186/s12890-025-03587-z","DOIUrl":"10.1186/s12890-025-03587-z","url":null,"abstract":"<p><strong>Background and aims: </strong>The evaluation of the spread of respiratory viruses in the context of the COVID-19 pandemic is required to understand how SARS-CoV-2 may have impacted the spectrum of respiratory viruses among children. Our study aimed to examine the viral etiology of respiratory infections other than SARS-CoV-2 in children during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Three databases including PubMed, Scopus, and Web of Science were systematically searched from 2020 to 2023 to assess the pooled prevalence of respiratory viruses in different regions, types of patient care, and types of respiratory disease.</p><p><strong>Results: </strong>A total of 68 studies were included in this systematic review and meta-analysis. Rhinovirus/Enterovirus (29.1%) and Respiratory syncytial virus (11.3%) were among the most common viruses among children with respiratory infections during the COVID-19 pandemic. In the case of patients younger than 5 years old, Rhinovirus/Enterovirus (36.2%) were the most prevalent viruses among all types of respiratory diseases. Also, Rhinovirus/Enterovirus were the most common viruses in the case of acute respiratory infection (26.1%), upper respiratory tract infection (21.0%), pneumonia (97.3%), and severe acute respiratory infection (54.7%). The most common viruses detected among inpatient cases were Rhinovirus/Enterovirus (47.4%) and Respiratory syncytial virus (14.9%). The prevalence of Influenza A + B viruses and Metapneumovirus among inpatients was also significantly higher than among outpatients.</p><p><strong>Conclusion: </strong>The high prevalence of viruses such as Rhinovirus/Enterovirus and Respiratory syncytial virus in various respiratory conditions, shows the requirement for enhanced surveillance, vaccination, and treatment strategies. The significance of Influenza viruses and metapneumovirus in inpatient settings delineates the importance of prioritizing them in future preventive measures such as vaccine development to minimize respiratory infection-associated hospitalization.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"135"},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708481","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 value of neutrophil-to-lymphocyte ratio, fibrinogen-to-albumin ratio and red blood cell distribution width in tuberculosis combined with other bacterial infections.","authors":"Haiyang Fu, Haimei Liu, Wenqiang Sun, Haiyun Zhang, Huiming Zhu","doi":"10.1186/s12890-025-03588-y","DOIUrl":"10.1186/s12890-025-03588-y","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical significance of the neutrophil-to-lymphocyte ratio (NLR), fibrinogen-to-albumin ratio (FAR), and red blood cell distribution width (RDW) in pulmonary tuberculosis (PTB) associated with other bacterial lung infections.</p><p><strong>Methods: </strong>A total of 74 patients with PTB complicated with other bacterial lung infections, who were admitted to the Sixth People's Hospital of Nantong City (Nantong, China) from January 2021 to December 2023, were included in this study as the PTB with infection complication group. A comparison group of 96 patients with uncomplicated PTB, admitted to the same hospital during the same period, was used as the PTB without infection complication group. The NLR, FAR, and RDW values in peripheral blood were determined and compared between the two groups. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of these indicators for early detection of PTB complicated with other bacterial infections.</p><p><strong>Results: </strong>The NLR, FAR, and RDW values were significantly higher in the PTB with infection complication group compared to the PTB without infection complication group, with differences reaching statistical significance (P < 0.05). NLR value showed a positive correlation with white blood cell count, C-reactive protein levels, and D-dimer levels. ROC curve analysis indicated that the area under the curve (AUC) values for diagnosing PTB with bacterial infection using blood NLR, FAR, and RDW were 0.861, 0.818, and 0.799, respectively. The combined AUC value of these three indicators was 0.982. The validation results showed that the diagnostic sensitivity (98.6%) and specificity (89.58%) of the combination of NLR, FAR, and RDW were higher than those of each indicator alone.</p><p><strong>Conclusion: </strong>The combined assessment of blood NLR, FAR, and RDW values has high clinical diagnostic value for diagnosing PTB complicated with other bacterial infections.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"134"},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708473","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":"A case report of monomorphic epitheliotropic intestinal T-cell lymphoma with pulmonary manifestations as the first presentation.","authors":"Bai Dong, Yonglin Chen, Binbin Ding, Nana Li, Zijian Li","doi":"10.1186/s12890-025-03592-2","DOIUrl":"10.1186/s12890-025-03592-2","url":null,"abstract":"<p><p>Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is defined as a type of lymphoma that occurs in the intestine, but may show extra-intestinal involvement, such as in the skin, brain, lungs, stomach, ovaries, and uterus, which have been previously reported. The disease has no specific clinical manifestations and is often diagnosed by pathological examination as a complication of intestinal perforation or obstruction. The difficulty of making a timely diagnosis is further compounded when the disease begins with non-gastrointestinal symptoms. In this paper, We report a case of MEITL with concurrent abdominal and pulmonary involvement on imaging, but only present with respiratory symptoms. The patient was diagnosed as Peripheral T cell lymphoma, Not otherwise specified (PTCL, NOS) initially based on lung biopsy. However, the diagnosis of MEITL was finally established due to complications of intestinal obstruction and perforation during treatment. Therefore, for lymphomas that occur at multisite outside lymph nodes, multiple-site biopsy should be performed to enhance the accuracy of the pathological diagnosis.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"132"},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699623","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":"Clinical characteristics of severe community-acquired pneumonia in children with virus mono-detection versus co-detection with bacteria.","authors":"Qian Chen, Yuejie Zheng, Heping Wang, Xiaonan Li, Jiali Gu, Zihao Liu","doi":"10.1186/s12890-025-03591-3","DOIUrl":"10.1186/s12890-025-03591-3","url":null,"abstract":"<p><strong>Backgroud: </strong>By analyzing the etiological distribution and clinical characteristics of severe community-acquired pneumonia in children with virus mono-detection and co-detection with bacteria and other pathogens, to explore the clinical characteristics that can help identify mixed infections, thereby providing a basis for the more precise use of antimicrobial drugs.</p><p><strong>Methods: </strong>A retrospective study was conducted on hospitalized children aged 1 month to 14 years with severe community-acquired pneumonia who underwent bronchoscopy in Shenzhen Children's Hospital from January to December 2018. The distribution of 19 pathogens detected by nucleic acid detection in bronchoalveolar lavage fluid was analyzed. Clinical data of children were obtained from the hospital electronic patient dossiers. Data were analyzed to describe the difference between viral mono-detection and co-detection.</p><p><strong>Methods: </strong>A retrospective study was conducted on hospitalized children aged 1 month to 14 years with severe community-acquired pneumonia who underwent bronchoscopy in Shenzhen Children's Hospital from January to December 2018. The distribution of 19 pathogens detected by nucleic acid detection in bronchoalveolar lavage fluid was analyzed. Clinical data of children were obtained from the hospital electronic patient dossiers. Data were analyzed to describe the difference between viral mono-detection and co-detection.</p><p><strong>Results: </strong>A total of 479 children with severe community-acquired pneumonia were enrolled from January to December 2018, at least one pathogen was detected in 375 cases (78.3%), including 247 cases (51.6%) of viruses, 111 cases (23.2%) of atypical pathogens, and 98 cases (20.5%) of bacteria. Among all positive cases, 274 cases (73.1%) had a single pathogen detected, and 101 cases (26.9%) had co-detection (≥ 2 pathogens). Among these co-detection, 51 cases (50.5%) were virus-bacteria co-detection, and 20 cases (19.8%) were virus-atypical pathogens co-detection. There was no significant difference in the detection rates of different types of pathogens between male and female patients (p > 0.05). There were no significant differences in clinical presentation, signs, inflammation and organ function indicators, pulmonary complications, antibiotic use, glucocorticoid use, intravenous immunoglobulin use, PICU admission rate, need for mechanical ventilation, and length of hospital stay among children with virus-bacteria co-detection, virus-atypical pathogens co-detection, and virus mono-detection (p > 0.05).</p><p><strong>Conclusion: </strong>Virus-bacteria co-detection or virus-atypical pathogens co-detection are common in children with severe community-acquired pneumonia. Clinical features alone cannot distinguish between viral mono-infection and mixed bacterial or atypical pathogen infections.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"130"},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676820","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":"Younger severe asthma patients with interleukin 4 (CC variant) and dupilumab treatment are more likely to achieve clinical remission.","authors":"Mona Al-Ahmad, Asmaa Ali, Wafaa Talat","doi":"10.1186/s12890-025-03578-0","DOIUrl":"10.1186/s12890-025-03578-0","url":null,"abstract":"<p><strong>Background and objectives: </strong>Asthma is a complex condition characterized by variable respiratory symptoms and chronic inflammation. In recent years, the use of biologics in severe asthma patients led to significant improvements in symptom control and disease outcomes. This has prompted healthcare providers to explore the possibility of achieving clinical remission (CR). This study aimed to evaluate the prevalence of clinical remission in severe asthma patients treated with biologics. Additionally, to identify factors associated with achieving clinical remission.</p><p><strong>Methods: </strong>The study recruited 116 patients from a national severe asthma registry in Kuwait, focusing on patients who had been treated with biologic therapy for at least 12 months. CR was defined as the absence of exacerbations and oral corticosteroids (OCS) use, an Asthma Control Test (ACT) score of ≥ 20, Asthma Control Questionnaire (ACQ-6) score of ≤ 0.75 and forced expiratory volume in one second (FEV1) ≥ 80% predicted. Data were collected on demographics, clinical, and functional parameters; including biomarkers such as blood eosinophils count (BEC), total immunoglobulin E (IgE), and fractional exhaled nitric oxide (FeNO), as well as the polymorphism patterns of the interleukin-4 (IL-4) and tumor necrosis factor-alpha (TNF-α) genes.</p><p><strong>Results: </strong>Patients with severe asthma were predominantly female (68.9%) with an average age of 54.09 years. Most had adult-onset asthma (67.3%), comorbid allergic rhinitis (AR) (81.03%), and experienced frequent exacerbations, with a median of four corticosteroids-requiring flare-ups per year. The allergic eosinophilic phenotype was common (74.14%), and a significant portion carried the CC genotype of the IL-4 gene (51.72%) or the GG genotype of the TNFα gene (57.76%). Biologic therapy significantly improved asthma control, reduced exacerbations and OCS use while improved lung function (p = 0.001 for all). About 18.1% of patients achieved CR after at least 12 months of biologic therapy, with dupilumab being the most effective, especially in biologic-naive patients. A multiple logistic regression analysis found that increasing age was negatively associated with CR (OR 0.95, p = 0.02), while the CC genotype of the IL-4 gene (OR 4.57, p = 0.008) and the use of dupilumab (OR 3.63, p = 0.001) were strong positive predictors of CR.</p><p><strong>Conclusion: </strong>This study suggested that CR can be achieved in patients with severe asthma. However, biologic therapy, particularly dupilumab, offers a promising avenue for achieving CR in comparison to other biologics, especially in younger patients with specific genetic profiles (CC genotype of the IL-4 gene).</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"131"},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676821","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}