{"title":"Predictive value analysis of diaphragmatic ultrasound evaluation for mechanical ventilation outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease.","authors":"Leilei Qu, Wenping Zhao, Wei Zhang, Jiping Li","doi":"10.1186/s12890-025-03567-3","DOIUrl":"10.1186/s12890-025-03567-3","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) exacerbations often necessitate mechanical ventilation. Weaning from ventilation poses challenges, especially due to diaphragmatic dysfunction. We evaluated the predictive value of diaphragmatic ultrasound for mechanical ventilation outcomes in COPD patients during acute exacerbations.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 200 patients experiencing acute COPD exacerbations between June 2020 and September 2023. We identified these patients using the ICD-10 codes for COPD (J44.x) and acute exacerbations from our electronic medical record system.Patients underwent diaphragmatic ultrasound assessments and were then grouped based on weaning success or failure. The study investigated parameters such as the E-T index, diaphragmatic displacement (DD), and diaphragmatic thickening fraction (DTF), correlating them with weaning outcomes. Correlation and receiver operating characteristic (ROC) analyses were employed to ascertain predictive values.</p><p><strong>Results: </strong>The E-T index, DD, and DTF were significantly higher in the success group, indicating these parameters as predictors of successful weaning. The E-T index (rho = -0.254, P < 0.001), DD (rho = -0.269, P < 0.001), and DTF (rho = -0.201, P = 0.004) negatively correlated with weaning failure. Conversely, the diaphragmatic Rapid Shallow Breathing Index (D-RSBI) positively correlated with failure (rho = 0.179, P = 0.011). Higher LUS scores predicted weaning failure (P = 0.029). Combined analysis of ultrasound indicators demonstrated an area under the curve (AUC) of 0.905, highlighting the model's predictive utility.Additional correlations showed that higher PaCO₂ before weaning was linked with lower DD, suggesting an association between impaired diaphragmatic mechanics and elevated CO₂ levels.</p><p><strong>Conclusion: </strong>Diaphragmatic ultrasound was a valuable tool for assessing readiness for mechanical ventilation weaning in COPD exacerbations, enhancing the precision of clinical decisions.Our findings also suggest that a threshold E-T index of ∼ 1.915 and DTF of ∼ 42.475% may have clinical relevance in identifying successful weaners.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"478"},"PeriodicalIF":2.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312328","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}
Christelle M Vandervelde, Jorine E Hartman, Karin Klooster, Wim Janssens, Stephanie Everaerts, Sofian Bouneb, Walter Weder, Dirk-Jan Slebos, Laurens J Ceulemans
{"title":"Surgical lung volume reduction eligibility in an emphysema patient pool referred for endoscopic treatment.","authors":"Christelle M Vandervelde, Jorine E Hartman, Karin Klooster, Wim Janssens, Stephanie Everaerts, Sofian Bouneb, Walter Weder, Dirk-Jan Slebos, Laurens J Ceulemans","doi":"10.1186/s12890-025-03954-w","DOIUrl":"10.1186/s12890-025-03954-w","url":null,"abstract":"","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"479"},"PeriodicalIF":2.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312378","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}
Layal Massara, Anais Ollivier, Romain Dusautoir, Gwenola Kervoaze, Muriel Pichavant, Anne Platel, Jérôme Kluza, Jean-Marc Lo-Guidice, Sebastien Antherieu, Philippe Gosset
{"title":"Vaping versus smoking: a quest for long-term impact in a mouse model.","authors":"Layal Massara, Anais Ollivier, Romain Dusautoir, Gwenola Kervoaze, Muriel Pichavant, Anne Platel, Jérôme Kluza, Jean-Marc Lo-Guidice, Sebastien Antherieu, Philippe Gosset","doi":"10.1186/s12890-025-03943-z","DOIUrl":"10.1186/s12890-025-03943-z","url":null,"abstract":"<p><p>Smokers consider that electronic cigarettes are safer than tobacco and are marketed as safe products. Nevertheless, reports show the exposure to high levels of electronic cigarette aerosols (ECA) activates lung cells and triggers inflammation and structural alterations after chronic exposure. In order to assess the potential harmful long term effect of exposure to ECA, we investigated in mice, its effect on lung and systemic inflammation as well as on lung function. To reproduce closely the situation frequently encountered in human, we exposed mice during 1 h/day during 3 or 6 months with two levels of electronic cigarette power in comparison with mice exposed to cigarette smoke (CS). Lung and systemic inflammation was evaluated by measuring cell recruitment and activation or cytokine concentrations. Respiratory function and lung transcriptome and structure were also measured. Our data revealed that chronic exposure to moderate levels of ECA increased specifically lung inflammation, these effects being characterized by the mobilization of conventional dendritic cells in the BAL and the recruitment of T cells in the lungs and by the early secretion of IL-22. Surprisingly, there is no strong overlap between the impact of both ECA and CS exposure on lung transcriptome. Modulation of pro-inflammatory pathways are limited to mice exposed to low power e-cigarette. In contrast, alteration of respiratory function is observed in high-power ECA-exposed mice with a different profile than with CS. Subchronic exposure to ECA might alter the respiratory function independently of the inflammatory response and in a different manner than CS.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"477"},"PeriodicalIF":2.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312329","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}
Hang Su, Wen Hua, Wuping Bao, Zichong Xu, Xue Zhang, Lei Zhao, Lei Han, Yishu Xue, Huahao Shen, Min Zhang
{"title":"Trends of asthma mortality in china: a comprehensive analysis by population, region, and sex with future projections.","authors":"Hang Su, Wen Hua, Wuping Bao, Zichong Xu, Xue Zhang, Lei Zhao, Lei Han, Yishu Xue, Huahao Shen, Min Zhang","doi":"10.1186/s12890-025-03930-4","DOIUrl":"10.1186/s12890-025-03930-4","url":null,"abstract":"<p><strong>Background: </strong>Asthma prevalence in China has risen due to rapid industrialization, environmental changes, and improved diagnostics. While efforts in asthma control have expanded nationwide, research on asthma-related mortality remains limited. Understanding death patterns from asthma is important to identify key regions and populations at risk, and to support more effective prevention and treatment strategies suitable for China's population and healthcare system.</p><p><strong>Methods: </strong>We conducted a retrospective study using China CDC's DSPs data, stratifying asthma mortality by sex, region, urban-rural residence, and age. This is a nationwide population and mortality survey study, including data on the total surveyed population and deaths from 2008 to 2021, covering approximately 25% of the total population. Trend analysis was conducted on the total surveyed population stratified by age, sex, and region to explore patterns of mortality changes. Based on mortality trend changes, decomposition analysis of asthma mortality and future trend projections considering population changes were performed to further identify key regions and populations.</p><p><strong>Results: </strong>Asthma mortality in China showed significant regional variation, with higher rates in the southwestern region and lower rates in northern and coastal regions. The crude mortality rate of asthma in China (2008-2021) generally decreased, especially in the older population (33.8% decline), but increased in individuals aged 15-19 in recent years. Mortality rates peaked around 2015 and then declined annually. Geographically, the most substantial decline rate was observed in the eastern region (10.5% decline), followed by the central region (8.1% decline). However, the decline rate in the western region was less pronounced and even displayed an upward trend, particularly in urban areas. Both decomposition analysis and BAPC analysis revealed an unclear mortality trend in urban areas of the western region, while mortality declined in the eastern and central regions.</p><p><strong>Conclusion: </strong>The asthma mortality rate in China has experienced a comprehensive decline over the past decade. However, rates in certain groups, like the older population and those in western China, remained higher than the global average, while in the youth population a slight upward trend was observed. Addressing these disparities is crucial for future efforts.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"475"},"PeriodicalIF":2.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298629","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":"Severe central airway obstruction caused by primary endobronchial B-cell lymphoma: three case reports and literature review.","authors":"Cai-Li Li, Wei Zhou, Mo Chen, Shuo Li, Bao-Yuan Chen, Yu-Bao Wang, Hai-Yan Zhao, Jing Feng","doi":"10.1186/s12890-025-03924-2","DOIUrl":"10.1186/s12890-025-03924-2","url":null,"abstract":"<p><p>Central airway obstruction is associated with severe clinical manifestations and a high mortality rate. To our knowledge, there have been very few published reports describing isolated central airway lesions caused by primary lymphoma without extrathoracic or extranodal involvement. This is the first case of malignant tracheal obstruction caused by primary B-cell lymphoma without involvement of the main stem bronchi, lobar bronchi, or mediastinal structures.Case PresentationThree patients were admitted to our hospital with complaints of progressively worsening cough accompanied by wheezing. Chest computed tomography (CT) scans revealed soft-tissue-density masses located in the central trachea. Pathological examination confirmed the diagnosis of lymphoma. Importantly, no significant enlargement of mediastinal or cervical lymph nodes was identified.ConclusionEndobronchial lymphoma should be considered in the differential diagnosis of central airway masses, particularly when clinical and imaging findings are inconclusive.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"473"},"PeriodicalIF":2.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298656","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}
Mohammadreza Shoghli, Juha Sinisalo, A Inkeri Lokki, Mitja Lääperi, Marja-Liisa Lokki, Mika Hilvo, Antti Jylhä, Jaakko Tuomilehto, Reijo Laaksonen
{"title":"Exploring the association between ceramide, phosphatidylcholine, and COPD prevalence and incidence: a FINRISK population-based cohort study.","authors":"Mohammadreza Shoghli, Juha Sinisalo, A Inkeri Lokki, Mitja Lääperi, Marja-Liisa Lokki, Mika Hilvo, Antti Jylhä, Jaakko Tuomilehto, Reijo Laaksonen","doi":"10.1186/s12890-025-03884-7","DOIUrl":"10.1186/s12890-025-03884-7","url":null,"abstract":"<p><strong>Background: </strong>Ceramides (Cers) and phosphatidylcholines (PCs) are potential lipid biomarkers in obstructive pulmonary disease (COPD). Even though they are linked to inflammation and lipid dysregulation, little is known about how these factors affect the prevalence and incidence of COPD in population-based cohorts. This study investigates these associations, addressing knowledge gaps regarding the interplay of Cers, PCs, and COPD risk, focusing on sex-specific differences and smoking.</p><p><strong>Methods: </strong>This observational study analysed data from the population-based FINRISK 2002 cohort, with 7,722 participants for prevalence and 7,662 for incidence analyses. Logistic regression models were used to assess associations between lipid biomarkers and prevalent COPD, while Cox regression models were applied for incident COPD. CERT1 and CERT2 (Cardiovascular Event Risk Test 1 and 2) are lipid-based scores derived from ceramide (Cer) ratios that estimate cardiovascular risk; in this study, they were used to examine their association with COPD. Kaplan-Meier curves were used to evaluate the impact of CERT scores on COPD risk, stratified by smoking status.</p><p><strong>Results: </strong>Elevated CERT1 and CERT2 scores were associated with both prevalent and incident COPD. For CERT1, the association with prevalent COPD was significant (univariable OR = 1.81, 95% CI: 1.41-2.33, p = < 0.001), as was the association with incident COPD (univariable HR = 1.33, 95% CI: 1.16-1.53, p = < 0.001). CERT2 was also significantly associated with prevalent COPD (adjusted OR = 1.57, 95% CI: 1.15-2.16, p = 0.005) and with incident COPD (univariable HR = 1.53, 95% CI: 1.32-1.77, p = < 0.001). PC species (14:0/22:6) was significantly associated with a lower risk of incident COPD (adjusted HR = 0.85, 95% CI: 0.73-0.98, p = 0.023). The Cer(d18:1/18:0)/PC (14:0/22:6) ratio was associated with both prevalent COPD (adjusted OR = 1.37, 95% CI: 1.01-1.86, p = 0.041) and incident COPD (HR = 1.24, 95% CI: 1.07-1.44, p = 0.004). Smokers had an elevated risk of COPD with increasing CERT scores.</p><p><strong>Conclusion: </strong>These findings support the role of lipid biomarkers, particularly Cers and CERT scores, in improving COPD risk prediction and management, with potential implications for targeted interventions in smokers.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"470"},"PeriodicalIF":2.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298658","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}
Nicole M Robertson, Kirsten Koehler, Christian Jenkins, Hema C Ramamurthi, Megan Wilks, Timothy Green, Gregory D Kirk, Meredith C McCormack, Sarath Raju
{"title":"Unraveling the impact of indoor air pollution on respiratory health in people living with HIV within a high-prevalence HIV cohort.","authors":"Nicole M Robertson, Kirsten Koehler, Christian Jenkins, Hema C Ramamurthi, Megan Wilks, Timothy Green, Gregory D Kirk, Meredith C McCormack, Sarath Raju","doi":"10.1186/s12890-025-03937-x","DOIUrl":"10.1186/s12890-025-03937-x","url":null,"abstract":"","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"472"},"PeriodicalIF":2.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298593","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":"Predictive value of bedside lung ultrasound, quantitative chest CT, and frailty assessment for short-term outcomes in elderly patients with severe pneumonia: a pilot study.","authors":"Longjiang Shao, Yongyong Liang","doi":"10.1186/s12890-025-03950-0","DOIUrl":"10.1186/s12890-025-03950-0","url":null,"abstract":"<p><strong>Background: </strong>Elderly patients with severe community-acquired pneumonia (CAP) have high short-term mortality, yet conventional severity scores do not incorporate bedside imaging or physiological frailty. In this study we aim to (1) evaluate the feasibility of obtaining lung ultrasound (LUS), quantitative chest computed tomography (CT), and Clinical Frailty Scale (CFS) assessments during the same admission and (2) explore the predictive potential for 28-day mortality by integrating imaging severity with physiological frailty.</p><p><strong>Methods: </strong>In this prospective, single-center pilot study (February 2022 - February 2025), we consecutively enrolled 60 hospitalized adults ≥ 65 years who met guideline criteria for severe CAP and completed 28-day follow-up. Twelve-zone LUS and CFS assessments were performed ≤ 24 h after admission; chest CT was acquired within 48 h when clinically permissible. Feasibility outcomes were recruitment rate, data completeness, and study-related adverse events. Associations with 28-day mortality were analyzed descriptively and with exploratory multivariable logistic regression.</p><p><strong>Results: </strong>LUS and CFS were completed in 100% and 93.3% of participants, respectively; CT was obtained in 83.3%. No study-related adverse events occurred. Twelve patients (20%) died within 28 days. Compared with survivors, non-survivors had higher median LUS scores (14.1 vs. 12.1), greater CT-defined consolidation (30% vs. 22% of lung volume), and a higher prevalence of severe frailty (58% vs. 25%). In the 50 participants with complete data, both LUS score (odds ratio [OR] 1.09 per point) and severe frailty (OR 3.85) independently predicted mortality. A model combining LUS and frailty improved discrimination relative to CURB-65 alone (area under the receiver-operating characteristic curve 0.75 vs. 0.68).</p><p><strong>Conclusions: </strong>Simultaneous acquisition of LUS, quantitative CT, and frailty metrics is feasible, safe, and well tolerated in elderly patients with severe CAP. Preliminary evidence suggests that integrating imaging severity with physiological frailty enhances short-term risk stratification beyond established clinical scores. These findings merit confirmation in larger, multicenter cohorts.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"474"},"PeriodicalIF":2.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298610","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 effects of diaphragm release on sleep quality: a pilot feasibility study.","authors":"Erkan Erol, Muhammed Kurtboğan","doi":"10.1186/s12890-025-03968-4","DOIUrl":"10.1186/s12890-025-03968-4","url":null,"abstract":"<p><strong>Background: </strong>Poor sleep quality is a common health concern with wide-ranging consequences. Manual diaphragm release, by improving diaphragmatic function and autonomic balance, may help enhance sleep quality. This pilot feasibility study aimed to explore the preliminary effects of diaphragm release on sleep quality in healthy individuals.</p><p><strong>Methods: </strong>35 participants were included in the study. The Pittsburgh Sleep Quality Index (PSQI) and Fitbit smartband were utilized to evaluate individuals' sleep quality. The diaphragm release technique was administered over three sessions, with two days of rest in between each session.</p><p><strong>Results: </strong>Following the intervention, increases in sleep duration and sleep score were observed as per Fitbit measurements (p < 0.05). Post-intervention, statistically significant changes were found in sleep latency, sleep duration, sleep disturbance subscales, and the total score of the PSQI (p < 0.05).</p><p><strong>Conclusions: </strong>As a preliminary investigation, this pilot study suggests that diaphragm release may be a feasible and safe intervention to enhance sleep quality. Further randomized controlled trials using gold-standard sleep assessments are needed to confirm these findings.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov id: </strong>NCT05762913 (Date: 10/03/2023).</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"471"},"PeriodicalIF":2.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298578","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}