BMC Pulmonary Medicine最新文献

{"title":"A clinical data-driven machine learning approach for predicting the effectiveness of piperacillin-tazobactam in treating lower respiratory tract infections.","authors":"Yemeng Yang, Kun Han, Jiatao Li, Tao Zhang, Zhijing Zhu, Ling Su, Zhaoyong Han, Chunyan Xu, Yi Lu, Likun Pan, Tao Yang","doi":"10.1186/s12890-025-03580-6","DOIUrl":"10.1186/s12890-025-03580-6","url":null,"abstract":"<p><strong>Background: </strong>In hospitalized patients, inadequate antibiotic dosage leading to bacterial resistance and increased antimicrobial use intensity due to overexposure to antibiotics are common problems. In the present study, we constructed a machine learning model based on patients' clinical information to predict the clinical effectiveness of Piperacillin-tazobactam (TZP) (4:1) in treating bacterial lower respiratory tract infections (LRTIs), to assist clinicians in making better clinical decisions.</p><p><strong>Methods: </strong>We collected data from patients diagnosed with LRTIs or equivalent diagnoses admitted to the Department of Pulmonary and Critical Care Medicine at Shanghai Pudong Hospital, Shanghai, between January 1, 2021, and July 31, 2023. A total of 26 relevant clinical features were extracted from this cohort. Following data preprocessing, we trained four models: Logistic Regression, Random Forest, Support Vector Machine, and Gaussian Naive Bayes. The dataset was split into training and test sets using a 7:3 ratio. The top-performing models, as determined by Receiver Operating Characteristic (ROC)-Area Under the Curve (AUC) on the independent test set, were subsequently ensembled. Ensemble model (EL) performance was evaluated using bootstrap resampling on the training set and ROC-AUC, recall, accuracy, precision, F1-score, and log loss on an independent test set. The optimal model was then deployed as a web application for clinical outcome prediction.</p><p><strong>Results: </strong>A total of 1,314 patients primarily treated with TZP as initial empiric antibiotic therapy were enrolled in the analysis. The success group comprised 995 patients (75.7%), while the failure group consisted of 319 patients (24.3%). We constructed an ensemble learning model based on the Logistic Regression, Support Vector Machine and Random Forest models, which showed better overall performance. The EL model demonstrated robust performance on an independent test set, exhibiting a ROC-AUC of 0.69, a recall of 0.69, an accuracy of 0.64, a precision of 0.40, a F1-score of 0.50, and a log loss of 0.66. A corresponding web application was then developed and made available at http://106.12.146.54:1020/ .</p><p><strong>Conclusions: </strong>In this study, we successfully developed and validated an EL model that effectively predicts the clinical effectiveness of TZP (4:1) in treating bacterial LRTIs. The model achieved a balanced performance across key evaluation metrics, demonstrating the model's potential utility in clinical decision-making. The web-based application makes this model readily accessible to clinicians, potentially helping optimize antibiotic dosing decisions and reduce both inadequate treatment and overexposure. While promising, future studies with larger datasets and prospective validation are needed to further improve the model's performance and validate its clinical utility. This work represents a step forward in using machine ","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"123"},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647275","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":"Effect of asthma education intervention on self-management knowledge and control level in Tigray, Northern Ethiopia: a quasi experimental study.","authors":"Tirhas Gebremedhin Gebresilassie, Alemayehu Worku, Ahmed Ali Ahmed, Negussie Deyessa Kabeta","doi":"10.1186/s12890-025-03574-4","DOIUrl":"10.1186/s12890-025-03574-4","url":null,"abstract":"<p><strong>Background: </strong>Asthma self-management education empowers patients to manage their condition effectively. However, evidence on its impact in Ethiopia remains limited. This study evaluated the effect of asthma education on asthma control and self-management knowledge among adult asthma patients in Ethiopia.</p><p><strong>Methods: </strong>A quasi-experimental design was employed, with a total of 204 participants, comprising 102 individuals in the intervention group and 102 in the control group at baseline. After accounting for follow-up losses (20.6% in the intervention group and 23.5% in the control group), 81 participants from the intervention group and 78 from the control group were retained six months after the completion of the education (post-intervention). Pre- and post-intervention assessments were conducted using validated questionnaires to measure asthma control levels and self-management knowledge. The intervention group received a structured, small-group asthma education program comprising three sessions over six months. The intervention's effect was analyzed using linear regression models for difference-in-differences and interaction effects, while heterogeneity analysis was performed using a generalized linear model.</p><p><strong>Results: </strong>10% of the intervention group and 7.8% of the control group reported prior asthma management education, most of which (60%) was over a decade ago. Asthma control levels significantly improved in the intervention group, with a 19.4% increase compared to 0.6% in the control group. The overall increase in the intervention group was 18.8% higher than in the control group (P = 0.03). Similarly, self-management knowledge improved markedly in the intervention group, with a 24.3% increase compared to 0.7% in the control group. The intervention group demonstrated a 23.6% overall improvement relative to the control group (P = 0.000).Participants in the intervention group were six times more likely to achieve well-controlled asthma and 13 times more likely to exhibit good self-management knowledge compared to the comparison group (p < 0.01). The intervention's impact was consistent across subgroups, with no significant variations by socio-demographic and asthma related factors.</p><p><strong>Conclusions: </strong>Asthma self-management education interventions significantly enhance asthma management knowledge and control levels. This study highlights the need to implement and expand asthma education programs during patient follow-ups to empower patients, to reduce medical costs, unscheduled hospital visits, emergency department visits, and premature mortality.</p><p><strong>Trial registration: </strong>Registered retrospectively with TRN PACTR202407741896902.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"120"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633663","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":"CT-Based radiomics nomogram of lung and mediastinal features to identify cardiovascular disease in chronic obstructive pulmonary disease: a multicenter study.","authors":"XiaoQing Lin, TaoHu Zhou, Jiong Ni, XiuXiu Zhou, Yu Guan, Xin'ang Jiang, Yi Xia, FangYi Xu, HongJie Hu, Jie Li, Jin Zhang, Shiyuan Liu, Rozemarijn Vliegenthart, Li Fan","doi":"10.1186/s12890-025-03568-2","DOIUrl":"10.1186/s12890-025-03568-2","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>To investigate the performance of two diagnostic models based on CT-derived lung and mediastinum radiomics nomograms for identifying cardiovascular disease (CVD) in Chronic Obstructive Pulmonary Disease (COPD) patients.</p><p><strong>Materials and methods: </strong>Hospitalized participants with COPD were retrospectively recruited between September 2015 and April 2023. Clinical data and visual coronary artery calcium score (CACS) were collected. Radiomics features of lung and mediastinum were extracted. Least absolute shrinkage and selection operator (LASSO) logistic regression was applied for feature selection and radiomic model construction. We constructed 3 radiomics models, based on lung, mediastinum, and combined lung-and-mediastinum. Multivariate logistic regression model was used to establish radiomics nomograms. The performance of radiomics nomograms was evaluated by area under the ROC curve (AUC) and decision curve analysis (DCA).</p><p><strong>Results: </strong>Of 686 COPD patients, 131 had a history of CVD. Age, neutrophilic granulocyte percentage, hematocrit and GOLD stage were independent clinical factors for CVD. 12 lung, and 6 mediastinum radiomic features were collected to construct the radiomics models. As the lung-and-mediastinum radiomics model included the same 6 features as the mediastinum model, finally 2 radiomics models were studied (lung, mediastinum). The 2 radiomics nomograms showed better discriminatory ability (AUC: 0.79, 95%CI [0.72, 0.86] for lung; 0.86, 95%CI [0.81, 0.92]) for mediastinum) than the clinical factors model (AUC: 0.71, 95%CI [0.64, 0.78]) and visual CACS (AUC: 0.65, 95%CI [0.57, 0.72]). DCA demonstrated the 2 radiomics nomograms outperformed the clinical factors and CACS across the majority of the range of reasonable threshold probabilities.</p><p><strong>Conclusion: </strong>We developed chest CT-based nomograms to identify CVD in COPD patients, in particular based on mediastinum features, had better discriminatory power than clinical factors and visual CACS.</p><p><strong>Trial registration: </strong>This retrospective study was approved by the institutional review boards at Second Affiliated Hospital of Naval Medical University, Tongji Hospital of Tongji University and Sir Run Run Shaw Hospital (ChiCTR2300069929 March 29, 2023). Retrospectively registered.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"121"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633662","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":"Risk prediction and early intervention strategies for persistent SARS-CoV-2 infection in patients with non-Hodgkin lymphoma: a retrospective cohort study.","authors":"Wailong Zou, Jia Zhang, Yulin Li, Yuwei Cao, Jiaxin Li, Zhe Zhang, Xin Zhang, Chuan Song, Rui Yang, Yaxin Yan, Yumin Wang, Xinjun Zhang, Zhe Xu, Jichao Chen","doi":"10.1186/s12890-025-03524-0","DOIUrl":"10.1186/s12890-025-03524-0","url":null,"abstract":"<p><strong>Background: </strong>Patients with non-Hodgkin lymphoma (NHL) face heightened mortality and accelerated disease progression when persistently infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This critical situation underscores the urgent need to identify risk factors and establish early intervention strategies tailored to this vulnerable population. The primary aim of this study was to investigate the risk factors associated with persistent SARS-CoV-2 infection in NHL patients during the COVID-19 pandemic.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from January 2020 to June 2024, obtained from the Aerospace Center Hospital's database, electronic health records, and laboratory archives. Inclusion criteria comprised patients with confirmed NHL and SARS-CoV-2 infection, with persistence defined as positive viral test results beyond 14 days after initial diagnosis. Patients with incomplete medical records or loss of follow-up were excluded. Predictive models were developed and refined using logistic regression and random forest algorithms. The models incorporated data on demographics, comorbidities, laboratory findings, and imaging results. Model performance was evaluated using accuracy, precision, and the area under the receiver operating characteristic curve (AUC-ROC). Validation was conducted on an independent dataset to ensure generalizability, and the best-performing model guided the development of a prediction tool for early risk assessment and intervention.</p><p><strong>Results: </strong>Key risk factors for persistent SARS-CoV-2 infection in NHL patients included advanced age, hypertension, diabetes, immunosuppressed status, low lymphocyte count, elevated C-reactive protein, high body mass index, anemia, reduced CD4 + cell count, and the presence of lung lesions. The random forest model demonstrated superior predictive performance, achieving an AUC of 0.93. The study further highlighted that prompt antiviral therapy, adjustments to immunosuppressive regimens, and enhanced monitoring significantly reduced infection persistence.</p><p><strong>Conclusions: </strong>This study identifies critical risk factors for persistent SARS-CoV-2 infection in NHL patients and underscores the importance of early intervention strategies. These findings may guide clinical decision-making to improve outcomes in this high-risk population.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"122"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633669","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":"Rhoifolin improves bleomycin-induced fibrosis in vivo and cell damage in vitro both related to NRF2/HO-1 pathway.","authors":"Xuehua Wang, Qing Wang, Panyu Zhou, Junhong Zhang, Haojie Su, Fanlu Liu, Jingjing Wu, Fengxia Xiao, Liang Liu, Ling Han","doi":"10.1186/s12890-025-03526-y","DOIUrl":"10.1186/s12890-025-03526-y","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary fibrosis (PF) is a chronic interstitial lung illness characterized by its high worldwide prevalence, unknown etiology, and dismal prognosis. Lonicerae Japonicae Flos, a commonly used traditional Chinese medicine for treating PF, is rich in Rhoifolin (ROF). Although numerous studies have demonstrated the anti-inflammatory properties of ROF, its potential anti-fibrotic effects remain uncertain.</p><p><strong>Methods: </strong>In this study, we established a PF model in Sprague-Dawley (SD) rats utilizing Bleomycin (BLM). We then assessed the impact of ROF on lung histology and appearance, measured the content level of Superoxide dismutase (SOD) in rat serum, and analyzed changes in α-SMA, TGF-β relative mRNA expression using PCR, measured SMAD Family Member 7 (Smad7), and Heme Oxygenase-1 (HO-1) protein expression in rat lung tissue by Western Blot. Additionally, we induced a cell injury model in A549 cells with BLM. Then after ROF administration, we detected the cell viability by MTT assay, measured N-cadherin, α-SMA, and Vimentin mRNA levels via real-time PCR, and analyzed the expression changes of N-cadherin, Nuclear factor erythroid 2-related factor 2(Nrf2), HO-1, Smad7 proteins by Western Blot.</p><p><strong>Results: </strong>The results indicated that ROF mitigated lung tissue damage and reduced the degree of PF in the lung tissue of rats with PF. Furthermore, In vivo, ROF reduced the expression of N-cadherin protein while increasing the expression of Smad7, and HO-1 proteins and decreasing the relative mRNA expression of α-SMA and TGF-β, and increased the expresson of SOD in rat serum In vitro, cell injury was induced in A549 cells using BLM. After ROF administration, the relative mRNA expression of α-SMA, N-cadherin, and Vimentin decreased significantly, and the protein expression of N-cadherin decreased, while the protein expression of Nrf2, HO-1, and Smad7 increased significantly.</p><p><strong>Conclusion: </strong>This study demonstrates that ROF can mitigate the symptoms of PF to a certain degree, and its mechanism of action is intimately linked to the Nrf2/HO-1 signaling pathway. Therefore, this study indicates that ROF may serve as a potential therapeutic agent for treating PF.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"117"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633668","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":"Evaluation of respiratory muscle dysfunction in patients with idiopathic pulmonary fibrosis: a prospective observational study with magnetic resonance imaging.","authors":"Xiaoyan Yang, Hongyi Wang, Anqi Liu, Yifei Ni, Jianping Wang, Yueyin Han, Bingbing Xie, Jing Geng, Yanhong Ren, Rongguo Zhang, Min Liu, Huaping Dai","doi":"10.1186/s12890-025-03572-6","DOIUrl":"10.1186/s12890-025-03572-6","url":null,"abstract":"<p><strong>Objective: </strong>Respiratory muscle dysfunction in patients with idiopathic pulmonary fibrosis (IPF) is a big challenge for treatment and rehabilitation. To quantitatively assess diaphragm and chest wall dysfunction using dynamic Magnetic Resonance Imaging (Dyn-MRI) in patients with IPF.</p><p><strong>Methods: </strong>Ninety-six patients with IPF and 50 gender- and age-matched controls were prospectively included and underwent D-MRI with a dynamic fast spoiled gradient-recalled echo sequence. Respiratory muscles function were assessed with thoracic anterior-posterior (AP), left-right (LR), cranial-caudal (CC) metrics. Moreover, lung area ratios, height (DH), and area (DA) of diaphragm curvature between end-inspiration and end-expiration during both quiet and deep breathing.</p><p><strong>Results: </strong>During quiet breathing, the functional metrics of the diaphragm and chest wall were comparable between IPF patients and controls. However, during deep breathing, IPF patients exhibited significantly reduced ratios of AP, CC, and lung area compared to controls. Moreover, the median ratios of DH and DA were higher in IPF patients than in controls (DH: 0.96 vs. 0.81, p < 0.001; DA: 1.00 vs. 0.90, p < 0.001). Furthermore, the ratios of AP, CC, and lung area during deep breathing were found to correlate with pulmonary function, total lung volume, and 6-minute walk distance.</p><p><strong>Conclusion: </strong>D-MRI demonstrated dysfunction in the diaphragm and chest wall among IPF patients, with respiratory muscle dysfunction showing a correlation with the severity of disease.</p><p><strong>Trial registration: </strong>This article presents a prospective observational study that does not include the outcomes of any healthcare interventions on human participants. The study was registered on September 11, 2018, under the registration number NCT03666234.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"118"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633665","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":"Overlap and correlation of reperfusion lung injury with postoperative pneumonia following pulmonary thromboendarterectomy: incidence, characteristics, and outcomes in chronic thromboembolic pulmonary hypertension.","authors":"Shardul N Rathod, Pamela Ropski, Jakub Glowala, Charles M Quinn, Alyssa Stamper, Maureen K Bolon, Daniel Schimmel, Stephen F Chiu, S Chris C Malaisrie, Mike J Cuttica, Ruben Mylvaganam","doi":"10.1186/s12890-025-03575-3","DOIUrl":"10.1186/s12890-025-03575-3","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) can be treated with pulmonary thromboendarterectomy (PTE) which may lead to reperfusion lung injury (RPLI) and postoperative pneumonia. We aimed to describe the incidence, diagnostic characteristics, and clinical outcomes of post-PTE pneumonia compared to RPLI. A retrospective study involving CTEPH subjects who underwent PTE at a large referral center was conducted. Data included demographics, hemodynamics, microbiologic diagnostics, and clinical outcomes. Post-PTE pneumonia was diagnosed based on documentation, signs/symptoms, or microbiologic sampling within seven days of surgery. Among 75 PTE subjects, 21 (28%) had RPLI, and 18 (24%) had post-PTE pneumonia. Of those with RPLI, 48% had pneumonia, suggesting overlap. Eight of 75 (11%) subjects underwent bronchoscopic sampling, and five (63%) samples yielded positive results indicative of infection. Subjects with post-PTE pneumonia and RPLI had longer hospital and ICU lengths of stay and mechanical ventilation duration than either group alone. Post-PTE pneumonia is prevalent and overlaps with RPLI in CTEPH subjects. The study highlights the importance of systematic evaluation and early detection of pneumonia in subjects with RPLI post-PTE. Timely diagnosis and management of pneumonia may improve outcomes. Further research is needed to understand risk factors and develop preventive strategies for post-PTE pneumonia.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"119"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633667","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":"Telehealth in sarcoidosis: a scoping review.","authors":"Lida Fadaizadeh, Farnia Velayati, Hassan Shojaee-Mend","doi":"10.1186/s12890-025-03528-w","DOIUrl":"10.1186/s12890-025-03528-w","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcoidosis is an inflammatory disease that causes functional and physical limitations in patients, negatively impacting their quality of life. Telehealth can provide a solution to improve healthcare services for these patients, regardless of their social and economic status. This research explores the various telehealth technologies and their applications for patients with sarcoidosis.</p><p><strong>Material and methods: </strong>This scoping review was conducted in 2024 with a comprehensive search in PubMed, Web of Science, Scopus, and ProQuest databases. Following screening and duplicate removal, relevant data were extracted and analyzed.</p><p><strong>Results: </strong>Out of 821 studies, only 6 studies met the inclusion criteria. The findings showed that mHealth technologies have good acceptance among patients and healthcare providers in managing sarcoidosis symptoms, such as fatigue, stress, and physical activity levels, and improving quality of life. Also, activity tracker technology, alone or in combination with other remote monitoring tools, increases exercise performance, reduces fatigue, and allows for continuous monitoring of the disease status. Hence, it has the potential to be integrated into long-term care programs for patients with sarcoidosis. In addition, telerehabilitation technology could be an acceptable option for patients, but its effectiveness in improving exercise capacity and quality of life in patients with sarcoidosis requires further investigation.</p><p><strong>Conclusion: </strong>mHealth and activity tracker technology showed promising results in improving sarcoidosis management and increasing patients' motivation and adherence to treatment, but further studies are required to assess the effectiveness of telerehabilitation. Overall, telehealth has significant potential to improve the care of sarcoidosis patients, but further research is needed to evaluate the effectiveness of these technologies.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"115"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623357","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 role of low-dose glucocorticoids in preventing bronchopleural fistula after bronchoplasty: a retrospective study.","authors":"Rui He, Teng Zeng, Yuan Ma, Chao Ming, Guang-Qiang Zhao, Yi-Zhou Peng, Bo-Yi Jiang, Xue-Liang Zhou, Guang-Jian Li","doi":"10.1186/s12890-025-03577-1","DOIUrl":"10.1186/s12890-025-03577-1","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to evaluate the clinical significance of early administration of low-dose corticosteroids after bronchoplasty, for the prevention of bronchopleural fistula (BPF).</p><p><strong>Methods: </strong>A total of 356 patients who underwent bronchoplasty in our hospital from 2019 to 2023 were retrospectively included. Univariate and multivariate logistic regression methods were used to determine the factors affecting the occurrence of BPF, and the significant factors were screened for Receiver Operating Characteristics (ROC) curves.</p><p><strong>Results: </strong>A total of 356 patients who underwent bronchoplasty were included in this study, 12 of whom developed BPF. Univariate and multivariate logistic regression analysis results showed that Preoperative serum albumin level (odds ratio (OR) = 0.64, 95% confidence interval (CI): 0.52-0.78, P < 0.01), low-dose glucocorticoid (OR = 0.11, 95% CI: 0.01-0.89, P = 0.038) were significant factors affecting postoperative BPF. Subsequently, the ROC curves of glucocorticoid and preoperative serum albumin level affecting the occurrence of BPF showed that low-dose glucocorticoids and preoperative albumin level were significantly correlated with the occurrence of BPF [Area Under Curves (AUC) = 0.681, AUC = 0.860], and the model had good prediction accuracy.</p><p><strong>Conclusions: </strong>Early use of low-dose glucocorticoids after bronchoplasty was associated with a reduced incidence of BPF, suggesting a potential role in preventing this complication. Preoperative serum albumin levels were identified as an independent risk factor for BPF, and it is recommended that a comprehensive assessment of the patient's nutritional status, including but not limited to serum albumin levels, be performed during preoperative management to optimize preoperative management and reduce the occurrence of BPF.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"116"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623360","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":"Risk factors of immune-related endocrine toxicities in non-small cell lung cancer patients treated with pembrolizumab and its impact on patient outcomes: a multicenter retrospective study.","authors":"Haoting Zhang, Jing Zheng, Chenyi Ren, Chenlin Ye, Xiaoyu Wu, Xiaodong Lv, Yuping Li, Jianya Zhou, Jianying Zhou","doi":"10.1186/s12890-025-03570-8","DOIUrl":"10.1186/s12890-025-03570-8","url":null,"abstract":"<p><strong>Background: </strong>Pembrolizumab has been approved as a first-line treatment for non-small cell lung cancer (NSCLC) patients. However, a percentage of patients discontinue immunotherapy due to immune-related adverse events (irAE). Among these events, immune-related endocrine toxicities (E-irAE) represents the most common form, though their etiology, risk factors, and impact on patient outcomes remain poorly understood.</p><p><strong>Materials and methods: </strong>This retrospective cohort study was conducted across 5 multiple centers to investigate the outcomes of NSCLC patients who received pembrolizumab treatment between October 1, 2019, and September 30, 2023. E-irAE can occur on the thyroid, pituitary, adrenal glands, pancreas, and parathyroid. So thyroid function, adrenocorticotropic hormone, cortisol, sex hormone and glycaemia were measured at baseline and at regular intervals after the initiation of pembrolizumab treatment.</p><p><strong>Results: </strong>Our study included a total of 380 NSCLC patients treated with pembrolizumab, 114 patients (30.00%) developed E-irAE. Among them, 107 patients (93.86%) developed immune-related thyroid dysfunction (irTD) (5 cases of combined immune-related hypophysitis (IH)), 4 patients (3.51%) only developed IH, and 3 patients (2.63%) developed type 1 diabetes mellitus. IrTD was found to be independently associated only with monocyte-to-lymphocyte ratio (MLR) (odds ratios (OR) = 0.060, 95% CI 0.000-0.375; p = 0.015) and anti-thyroglobulin antibody (TGAb) (OR = 31.898, 95% CI 1.516-671.367; p = 0.026). Kaplan-Meier Survival Analysis showed that the progression-free survival (PFS) was significant longer in stage IV NSCLC patients with irTD than in those who did not (44.72 weeks vs. 27.79 weeks; hazard ratio (HR) = 0.645, 95% CI 0.440-0.946; p = 0.025), particularly in the subgroup of subclinical hypothyroidism (HR = 0.567, 95% CI 0.324-0.994; p = 0.047). We also found that sex (HR = 0.493, 95% CI 0.291-0.834; p = 0.008) was identified as an independent factor associated with better PFS.</p><p><strong>Conclusion: </strong>E-irAE are recognized as prevalent common irAE with various phenotypic manifestations. Low MLR and positive TGAb at baseline have been identified as risk factors that increase the likelihood of developing irTD. Sex and the occurrence of irTD were independently associated with improved PFS.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"111"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623345","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}