BMC Pulmonary Medicine最新文献

{"title":"Association between FEV₁/FVC levels and all-cause mortality in the general population.","authors":"Leheng Tang, Fan Wu, Shiyu Zhang, Jie Ou, Juncheng Liang, Ranxi Peng, Siman Liao, Qiaorui Zhou, Yingtong Chen, Xiaozi Guo, Jingxian Chen, Qi Wan, Zihui Wang, Zhishan Deng, Yumin Zhou","doi":"10.1186/s12890-025-03573-5","DOIUrl":"10.1186/s12890-025-03573-5","url":null,"abstract":"<p><strong>Background: </strong>The ratio of the forced expiratory volume in 1 s (FEV₁) to the forced vital capacity (FVC) is an essential tool for the diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between levels of FEV₁/FVC and mortality in the general population remains unclear, particularly its non-linear relationship. Therefore, we aimed to explore the association between the FEV₁/FVC and all-cause mortality in the general population.</p><p><strong>Methods: </strong>The data of participants included in the National Health and Nutrition Examination Survey (1988-1994 and 2007-2012 cycles) were analyzed. Participants aged ≥20 years, who were not pregnant, who underwent quality-controlled lung function tests, and with follow-up data on mortality status were enrolled. The study outcome was all-cause mortality. The participants were grouped by FEV₁/FVC ratio in 0.10 increments. Cox proportional-hazards models were used to estimate the association between the FEV₁/FVC ratio and all-cause mortality before and after confounder adjustment. Non-linear associations were explored using restricted cubic spline curves.</p><p><strong>Results: </strong>Overall, 25,501 participants were included. During the median follow up of 308 months, 6431 (25.2%) deaths were recorded. Among all participants, the mean age is 46.3 years, and 48.7% of which were male. In unadjusted model, individuals with an FEV₁/FVC ratio < 0.90 had an increased risk of all-cause mortality compared to those with an FEV₁/FVC ratio ≥ 0.90. After adjusting for age, sex, body mass index, race, and smoking status, participants in the 0.60 ≤ FEV₁/FVC < 0.90 group had a lower all-cause mortality risk than those in the FEV₁/FVC ≥ 0.90 group, while the mortality risk of individuals with an FEV₁/FVC ratio < 0.50 was higher. Restricted cubic splines revealed a U-shaped association between the FEV₁/FVC ratio and all-cause mortality. Below and above the inflection point, an inverse trend was observed.</p><p><strong>Conclusion: </strong>Our study first revealed a U-shaped association between the level of FEV₁/FVC and all-cause mortality in general population.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"108"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603912","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 medroxyprogesterone acetate on noninvasive ventilation -treated exacerbated COPD patients: a double-blind randomized clinical trial.","authors":"Mohsen Gholinataj Jelodar, Mohammadreza Malek-Ahmadi, Adeleh Sahebnasagh, Farhad Mohammadi, Fatemeh Saghafi","doi":"10.1186/s12890-024-03462-3","DOIUrl":"10.1186/s12890-024-03462-3","url":null,"abstract":"<p><strong>Background: </strong>In acute exacerbation periods of chronic obstructive pulmonary disease (COPD), patients may experience hypoxemia or hypercapnia. Noninvasive ventilation (NIV) and respiratory stimulant drugs are used to treat this condition. Medroxyprogesterone acetate (MPA) can cross the blood-brain barrier and cause breathing stimulation and hyperventilation. This study was conducted to investigate the effectiveness of MPA in hypercapnic exacerbated COPD patients and the possibility of faster weaning of patients from NIV.</p><p><strong>Materials and methods: </strong>This double-blind clinical trial was conducted on consecutive exacerbated COD patients referred to Shahid Rahnemoun Hospital, Yazd, Iran, from February 2022 to August 2022. Through a block randomized sampling method with a 1:1 allocation ratio, 58 eligible patients with hypercapnic exacerbated COPD on NIV were divided into two study groups: the intervention (treated with MPA 10 mg every 8 h) and the control (treated with placebo). The clinical and arterial blood gas (ABG) parameters were investigated in both groups.</p><p><strong>Results: </strong>Out of 50 patients, 27 and 23 intervention and control arms cases were analyzed. Although there was a significant difference in the amount of ABG parameters during the study in each group, there was no statistically significant difference between the two groups. Also, There was no significant difference in the total weaning rate of the patients in the two groups. Despite the higher number of early weaning in the MPA group, no significant difference was reported between the two groups in this regard. In addition, there was no difference between the two groups in the rate of ICU hospitalization, the length of stay of hospitalization and ICU, and the mortality rate.</p><p><strong>Conclusion: </strong>The administration of MPA has not improved clinical and laboratory results, and MPA is not superior to placebo in the weaning process of patients undergoing NIV.</p><p><strong>Trial registration: </strong>IRCT20190810044500N21 (01/02/2022), (https//irct.behdasht.gov.ir/user/trial/59402/view).</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"107"},"PeriodicalIF":2.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association and risk of blood urea nitrogen-to-creatinine ratio with congestive heart failure in critically ill COPD patients.","authors":"Jinjun Sun, Weiwei Chen, Hongli Xu","doi":"10.1186/s12890-025-03556-6","DOIUrl":"10.1186/s12890-025-03556-6","url":null,"abstract":"<p><strong>Objective: </strong>Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity and death. The blood urea nitrogen-to-creatinine ratio (BCR) is recognized as a crucial marker to assess renal function and cardiovascular risk. Nevertheless, the effects of BCR on COPD patients suffering comorbid congestive heart failure (CHF) is not clarified. This study aims to elucidate the association between BCR and CHF risk in the COPD population.</p><p><strong>Methods: </strong>Data from COPD patients meeting the eligibility criteria were from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The cumulative incidence curve was utilized for examining the link of BCR to CHF. Kaplan-Meier (KM) analysis was carried out for evaluating the relation of BCR to in-hospital mortality(IHM). Multivariable Cox regression assisted in assessing the correlation of BCR with CHF risk. Restricted cubic splines (RCS) were leveraged for unraveling the association of BCR (as a continuous variable) with CHF.</p><p><strong>Results: </strong>Our study included 2,840 COPD patients in the intensive care unit for the first time, with hospital stays exceeding 24 h. The incidence of CHF was 57.18% among these patients. Cumulative incidence curve analysis demonstrated a notably increased CHF incidence in patients having higher BCR (18.889 < BCR ≤ 92.5) in contrast to those with lower BCR (2.877 ≤ BCR ≤ 18.889) (p < 0.0001). KM survival analysis indicated a markedly elevated IHM risk in patients with higher BCR in comparison to those with lower BCR (p < 0.0001). Multivariable Cox regression and RCS analysis further confirmed that higher BCR was linked to a risen likelihood of CHF [hazard ratio (HR) = 1.28, 95% confidence interval (CI, 1.15-1.44), p < 0.001]. Subgroup analysis revealed a higher risk of CHF [HR = 1.41, 95% CI (1.13-1.76), p = 0.002] in patients with diabetes than those without [HR = 1.24, 95% CI (1.08-1.41), p = 0.002].</p><p><strong>Conclusion: </strong>Elevated BCR is an independent risk factor for CHF in critically ill COPD individuals and strongly related to a risen risk of CHF. The findings prove BCR as a reliable clinical predictor, facilitating risk stratification and personalized treatment for COPD patients with comorbid CHF.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"106"},"PeriodicalIF":2.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584747","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":"Determinative sleep traits associated with dyslipidemia in obstructive sleep apnea patients.","authors":"Longlong Wang, Ping Gao, Xinglin Gao","doi":"10.1186/s12890-025-03480-9","DOIUrl":"10.1186/s12890-025-03480-9","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is recognized to increase the risk of dyslipidemia; however, the specific sleep traits in OSA that influence dyslipidemia are poorly understood. This study sought to determine which sleep traits are independently associated with dyslipidemia and serum lipid profiles in patients with OSA.</p><p><strong>Methods: </strong>In this cohort study, 5239 participants were included from the Sleep Heart Health Study. Further, OSA was diagnosed via polysomnography with an AHI ≥ 5 events/h. Sleep traits were assessed using polysomnographic data and questionnaires. Then, logistic regression was used to identify sleep traits that predict dyslipidemia in OSA patients. Non-linear associations between sleep traits and dyslipidemia were evaluated using restricted cubic splines. The potential mediating effect of body mass index (BMI) was also calculated. Later, linear regression analysis identified sleep traits that were independently linked to lipid levels.</p><p><strong>Results: </strong>After adjusting for confounding factors, logistic regression identified sleep latency (OR: 1.005, 95% CI: 1.002-1.009, P = 0.001), rapid eye movement (REM) stage (OR: 0.987, 95% CI: 0.977-0.998, P = 0.022), REM latency (OR: 1.001, 95% CI: 1.000-1.002, P = 0.027), mean oxygen saturation (meanSpO2) (OR: 0.961, 95% CI: 0.926-0.996, P = 0.031), percentage of time with oxygen saturation below 95% (T95) (OR: 1.003, 95% CI: 1.001-1.005, P = 0.005), and time to fall asleep (OR: 1.004, 95% CI: 1.000-1.007, P = 0.042) as variables independently associated with dyslipidemia. No significant non-linear associations were found (all P >0.05). BMI mediated the association between REM stage, meanSpO2, T95, and dyslipidemia risk. Linear regression analysis identified T95 as a consistent independent determinant of all lipid parameters. Additionally, the meanSpO2 and sleep latency were significant independent determinants of most lipid parameters.</p><p><strong>Conclusions: </strong>Sleep latency, sleep architecture, and nocturnal hypoxemia are key factors in dyslipidemia among patients with OSA. These insights suggest potential biomarkers and targeted interventions for the management of lipid-related complications of OSA.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"105"},"PeriodicalIF":2.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583714","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":"Baseline total lung capacity and all-cause mortality in restrictive pulmonary disorders: a meta-analysis.","authors":"Fei Li, Yifan Chen, Guozhou Zhang, Mengyuan Liu, Huihui Zeng, Huaping Dai","doi":"10.1186/s12890-024-03425-8","DOIUrl":"10.1186/s12890-024-03425-8","url":null,"abstract":"<p><strong>Rationale: </strong>Forced vital capacity (FVC) has been utilized as a surrogate for vital capacity (VC) in monitoring the progression of restrictive pulmonary disorders, particularly in clinical trials of idiopathic pulmonary fibrosis (IPF). A dose-response relationship between decreased FVC and mortality in IPF has also been established. Since 2005, total lung capacity (TLC) has been routinely required to differentiate and diagnose restrictive pulmonary disorders. However, the relationship between changes in TLC change and the risk of mortality remains unclear.</p><p><strong>Objectives: </strong>To investigate and quantify the relationship between changes in TLC and the risk of mortality in patients with restrictive pulmonary disorders.</p><p><strong>Methods: </strong>This study employed a systematic review and meta-analysis following the PRISMA 2020 guidelines.</p><p><strong>Results: </strong>A total of 26 studies were included in the meta-analysis, comprising a combined sample of 16,579 subjects, which included 7,961 females, 4,460 subjects in the relative low TLC group, and 12,119 subjects in the high TLC group. A reduced TLC was associated with an increased risk of all-cause mortality, as indicated by both unadjusted and adjusted hazard ratios. The unadjusted hazard ratio (95% CI) was 1.76 (1.32, 2.35), while the adjusted hazard ratio (95% CI) was 1.70 (1.31, 2.20). The risk ratio (RR) estimated from the studies that reported both the number of participants and deaths was RR (95% CI) = 2.01 (1.56, 2.60). The included studies demonstrated significant heterogeneity.</p><p><strong>Conclusion: </strong>A low TLC at baseline, in comparison to individuals with relatively higher TLC, may increase the risk of all-cause mortality by at least 42-70% in cases of restrictive pulmonary disorders, although this conclusion is primarily based on observational studies, which carry low to moderate certainty.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"103"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584750","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":"Role of ultrasonography in assessing respiratory muscle loss: insights from a cross-sectional study on neurological patients with long-term bed rest with and without tracheostomy.","authors":"Juchuan Dong, Zihui Xie, Wenyuan Wang, Yongmei Li, Shaofang Li, Fuhou Zhang, Lihua Jin","doi":"10.1186/s12890-024-03451-6","DOIUrl":"10.1186/s12890-024-03451-6","url":null,"abstract":"<p><strong>Objective: </strong>Prolonged immobilization is the main cause of muscle loss, particularly in patients with tracheostomy. The parasternal intercostal muscle (ICM) and diaphragm are commonly evaluated using ultrasonography; however, the importance of the fifth ICM has been overlooked. We compared the thickness and echogenicity of the second and fifth ICMs and diaphragm in patients with and without tracheostomy to determine the associations with onset duration and other factors and to characterize the respiratory muscle loss.</p><p><strong>Patients and methods: </strong>This single-center, cross-sectional study compared the thickness and grayscale of respiratory muscles in patients without tracheostomy admitted to a general rehabilitation ward and in patients with tracheostomy admitted to an intensive care rehabilitation ward and correlated them with onset duration, functional capacity, dyspnea, and other parameters.</p><p><strong>Results: </strong>In patients without tracheostomy, nutritional parameters were associated with delta values of the diaphragm and fifth ICM thickness between the paretic and healthy sides. In contrast, in patients with tracheostomy, the onset duration was associated with grayscale delta values of the second ICM, especially in those with an onset of ≥ 60 days, where the grayscale of the healthy side was significantly lower than that in patients with an onset of <60 days. In patients with and without tracheostomy, the thickness or grayscale of the second or fifth ICMs correlated with the patients' functional independence measure and Borg scores, although this correlation was weak for diaphragm thickness.</p><p><strong>Conclusions: </strong>In comparison to the diaphragm, the ICM provide a more comprehensive understanding of pulmonary function in patients undergoing extended bed rest, irrespective of the presence of a tracheotomy. Notably, the thickness of the second ICM and the grayscale of the fifth ICM are indicative of dyspnea scores, while the grayscale of the second ICM correlates with scores related to activities of daily living. These indices exhibit differential correlations in patients with and without a tracheotomy. It is imperative that these factors be assessed and compared in clinical practice.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"104"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584192","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":"Serum carbohydrate antigen 153 as a predictor of interstitial lung disease associated with rheumatoid arthritis is positively correlated with serum Krebs von den Lungen-6.","authors":"Jiaxi Guo, Heqing Huang, Shaowei Lin, Guangdong Wang, Fengbei Cen, Shenhui Huang, Dehao Liu, Yikai Lin, Xinhua Yu, Sien Shi, Aiping Ma","doi":"10.1186/s12890-025-03558-4","DOIUrl":"10.1186/s12890-025-03558-4","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the clinical significance of carbohydrate antigen (CA) 153 and its correlation with Krebs von den Lungen-6 (KL-6) in the prediction and determination of the severity of interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients.</p><p><strong>Methods: </strong>Data was collected retrospectively on a cohort of 357 RA patients who were admitted to our hospital from January 2018 to December 2020. The classification of patients into subgroups was based on high-resolution computed tomography (HRCT) of the chest, resulting in 135 patients with RA but no ILD, 107 patients with RA and indeterminate ILD, 91 patients with RA and mild ILD, and 24 patients with RA and advanced ILD. The levels of CA153 and KL-6 were determined by chemiluminescence analysis.</p><p><strong>Results: </strong>The serum levels of CA153 were found to be significantly higher in both the RA-mild ILD group and the RA-advanced ILD group compared to the RA-no ILD group (8.00 vs. 6.40, q = 0.039; 20.30 vs. 6.40, q < 0.001). Multivariate analysis demonstrated that CA153 was an independent risk factor for RA-ILD (RA-mild ILD + RA-advanced ILD) [odds ratio (OR) = 1.124, 95% confidence interval (CI) = (1.060-1.191), p < 0.001] and RA-advanced ILD (OR = 1.583, 95% CI = 1.247-2.010, p < 0.001). Furthermore, the receiver operating characteristic (ROC) analysis indicated that CA153 had diagnostic value for both RA-ILD (RA-mild ILD + RA-advanced ILD) and RA-advanced ILD. The best area under ROC curve (AUC) of CA153 for RA-ILD (RA-mild ILD + RA-advanced ILD) was 0.66 (p < 0.001; sensitivity = 57.27%; specificity = 72.03%). The AUC of CA153 for RA-advanced ILD was 0.95 (p < 0.001; sensitivity = 95.65%; specificity = 83.05%). Moreover, CA153 was negatively correlated with forced vital capacity percent predicted (FVC% pred) (r = -0.383, p = 0.037) but positively related to KL-6 (r = 0.762, p < 0.001).</p><p><strong>Conclusion: </strong>It was concluded that CA153 was positively associated with KL-6 and might be a significant and clinical availably measurable serum marker to predict the diagnosis and severity of ILD in RA patients.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"102"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584563","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":"Heterogeneity in clinical patterns of adult lung abscess patients: an 8-year retrospective study in a tertiary hospital.","authors":"Rongling Zhang, Jiapei Yu, Xiao Shang, Zeyi Wang, Hui Li, Bin Cao","doi":"10.1186/s12890-025-03487-2","DOIUrl":"10.1186/s12890-025-03487-2","url":null,"abstract":"<p><strong>Background: </strong>The widespread use of broad-spectrum antibiotics has led to changes in both the microbiological and clinical characteristics of lung abscesses. It is necessary to re-evaluate the bacterial spectrum associated with these infections. As a novel method for pathogen detection, metagenomic next-generation sequencing (mNGS) is increasingly being applied in clinical practice. There is limited research evaluating the use of mNGS in patients with lung abscesses.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with lung abscess who were hospitalized between July 2015 and July 2023 at a teaching hospital in China. Patients who underwent both computerized tomography (CT) imaging and conventional pathogen testing were included in the study. The efficacy of pathogen detection using conventional methods was compared with that of mNGS. Additionally, the clinical and radiological features were analyzed to provide a comprehensive understanding of the disease patterns.</p><p><strong>Results: </strong>A total of 782 patients with lung abscess were included in the study and hematogenous abscess accounting for 7.16% (56/782) of cases. The overall hospital mortality rate was 1.53%. The mean age of the patients with lung abscess was 60 years, with a male predominance (80.2%). A significant proportion of patients had comorbid conditions, including diabetes (29.7%) and cardiovascular disease (18.2%). Lung abscesses were predominantly located in the right lung, and pleural effusion was more commonly observed in the deceased group. The detection rate of pathogen via conventional test was lower at 41.8% (327/782). Among patients with positive mNGS results, only 51.9% had pathogens identified through conventional testing methods. Klebsiella pneumoniae was the most frequently detected pathogen by conventional culture, while mNGS identified was Parvimonas micra. Infections caused solely by anaerobic bacteria or facultative anaerobes were associated with shorter hospital stays. Patient infected with Gram-negative bacilli (GNB) had a higher proportion of liver abscesses (11.8%).</p><p><strong>Conclusion: </strong>Compared to conventional testing methods, mNGS demonstrates superior performance in detecting anaerobic and facultative anaerobic bacteria. The low detection rate of conventional tests may result in an underestimation of the clinical significance of anaerobic bacteria infections. In patients with lung abscess caused by GNB, hematogenous dissemination, liver abscess and diabetes were more commonly observed and these patients tended to have longer hospital stays.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"101"},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566138","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":"Assessment of disease severity in hospitalized community-acquired pneumonia by the use of validated scoring systems.","authors":"Sandleen Iftikhar, Bjørn Waagsbø","doi":"10.1186/s12890-025-03550-y","DOIUrl":"10.1186/s12890-025-03550-y","url":null,"abstract":"<p><strong>Background: </strong>Severity assessment of community-acquired pneumonia (CAP) is essential for many purposes. Among these are the microbiological confirmation strategy and choice of empirical antimicrobial therapy. However, many severity assessment systems have been developed to aid clinicians to reach reliable predictions of severe outcomes.</p><p><strong>Methods: </strong>We aimed to apply nine disease severity assessment scoring systems to a large 2016 to 2021 CAP cohort in order to achieve test sensitivity, specificity and predictive values. We used intra-hospital all-cause mortality and the need for intensive care admission as outcomes. The area under the receiver operating characteristic (ROC) curve was used to display test performance.</p><p><strong>Results: </strong>A total of 1.112 CAP episodes were included in the analysis, of which 91.4% were radiologically, and 43.7% were microbiologically confirmed. When intra-hospital all-cause mortality was set as outcome, tests designed for CAP severity assessment, like PSI, and CURB65 outperformed the more generic systems like NEWS2, qSOFA, SIRS and CRB65. Designated tests for CAP (PSI, IDSA/ATS and CURB65) and overall critical illness (SOFA) displayed acceptable performances as compared to non-specific tests. Comparable results were gained when intensive care admission was set as outcome. The area under the receiving operating curve was 0.948, 0.879, 0.855 and 0.726 for the SOFA, PSI, IDSA/ATS and CURB65 scoring systems, respectively.</p><p><strong>Conclusion: </strong>CAP severity assessment remains important. Designated CAP severity assessment tools outperformed generic tests.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"100"},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540180","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":"Predictors of occult lymph node metastasis in clinical T1 lung adenocarcinoma: a retrospective dual-center study.","authors":"Xiaoxin Huang, Xiaoxiao Huang, Kui Wang, Lijuan Liu, Guanqiao Jin","doi":"10.1186/s12890-025-03559-3","DOIUrl":"10.1186/s12890-025-03559-3","url":null,"abstract":"<p><strong>Background: </strong>The optimal surgical strategy for lymph node dissection in lung adenocarcinoma remains controversial. Accurate predicting occult lymph node metastasis (OLNM) in patients with clinical T1 lung adenocarcinoma is essential for optimizing treatment decisions and improving patient outcomes. This study analyzes the relationship between anaplastic lymphoma kinase (ALK) status, clinicopathological characteristics, computed tomography (CT) features, and OLNM in patients with clinical T1 lung adenocarcinoma.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on data from patients with clinical T1 lung adenocarcinoma who showed no lymph node metastasis on preoperative CT and underwent surgical resection with lymph node dissection at two centers from January 2016 to December 2023. Univariate and multivariate logistic regression analyses were performed to identify factors associated with OLNM.</p><p><strong>Results: </strong>Among 1138 patients with clinical T1 lung adenocarcinoma, 167 (14.6%) were found to have OLNM, including 55 (4.8%) with pathological N1 status and 112 (9.8%) with pathological N2 status. Multivariate logistic regression analysis identified lobulation, spiculation, solid density, lymphovascular invasion, spread through air spaces (STAS), micropapillary pattern, solid pattern, and carcinoembryonic antigen (CEA) levels as independent positive predictors of OLNM. Furthermore, lobulation, lymphovascular invasion, STAS, micropapillary pattern, solid pattern, CEA levels, and ALK were independent positive predictors of occult N2 lymph node metastasis. The lepidic pattern, however, was identified as an independent negative predictor for OLNM and occult N2 lymph node metastasis.</p><p><strong>Conclusion: </strong>The identified predictors may assist clinicians in evaluating the risk of OLNM in patients with clinical T1 lung adenocarcinoma, potentially guiding more targeted intervention strategies.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"99"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536625","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}