BMC Pulmonary Medicine最新文献

{"title":"Association between plasma transfusion and in-hospital mortality in severe pneumonia: a propensity score-matched retrospective cohort study.","authors":"Linyan Wu, Zekui Fang, Xiping Wu, Kunzuo Yu, Ning Jiang, Minhong Su","doi":"10.1186/s12890-026-04497-4","DOIUrl":"10.1186/s12890-026-04497-4","url":null,"abstract":"<p><strong>Background: </strong>Plasma transfusion is used in patients with severe pneumonia who develop coagulopathy or bleeding, but recipients are often sicker than non-recipients. We evaluated the association between plasma transfusion and in-hospital mortality after adjustment for available measured confounders, while recognizing that unmeasured confounding from transfusion indications and illness severity may persist.</p><p><strong>Methods: </strong>This single-center retrospective cohort included 156 adults with severe pneumonia admitted between January 2021 and May 2024; 62 received plasma and 94 did not. The matched mortality comparison using propensity score matching (PSM) and McNemar analysis was prespecified as the primary analysis. Supportive and exploratory analyses included Cox regression, Kaplan-Meier analysis, IPTW, overlap weighting, Fine-Gray modeling, E-value analysis, and exploratory coagulation-enhanced, logistic, microbiological/coagulation, and time-dependent exposure sensitivity analyses.</p><p><strong>Results: </strong>Before matching, mortality was higher among plasma recipients than controls (64.5% vs. 28.0%; crude odds ratio [OR] 4.69, 95% confidence interval [CI] 2.35-9.34; p < 0.001), with substantial baseline imbalance. After matching, mortality remained numerically higher in the plasma group (50.0% vs. 36.1%) but was not statistically significant (matched OR 1.62, 95% CI 0.67-3.92; McNemar p = 0.383). Cox models yielded attenuated HRs after adjustment, but the fully adjusted model violated the global proportional hazards assumption; therefore, Cox estimates were interpreted as time-weighted associations over follow-up rather than constant effects. Exploratory sensitivity estimates varied in direction across estimands: coagulation-enhanced matching yielded OR 1.50 (95% CI 0.53-4.21), full-cohort logistic regression yielded adjusted OR 3.19 (95% CI 1.12-9.11), approximate adjusted time-dependent Cox analysis yielded HR 1.73 (95% CI 0.85-3.51), and strict verified-date adjusted time-dependent Cox analysis yielded HR 2.67 (95% CI 1.38-5.16).</p><p><strong>Conclusions: </strong>The attenuation of the crude mortality difference after propensity score matching is consistent with baseline severity and confounding by indication accounting for a substantial component of the unadjusted association; however, residual confounding cannot be excluded. Because residual confounding, immortal-time bias, related time-dependent exposure bias, and proportional-hazards violations remain important limitations, these data do not establish a definitive beneficial or harmful effect of plasma transfusion. The non-significant matched result reflects limited statistical power (approximately 25% for a paired OR of 2.0) and should not be interpreted as evidence of no effect.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497109","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":"Bayesian network model for identification of factors associated with ventilator-associated pneumonia in mechanically ventilated patients in the ICU: retrospective cohort study.","authors":"Liyu Zhang, Cailing Wang, Jing He, Xiuxiu Li, Wenyan Wang, Yuping Tang, Yinghui Zhang","doi":"10.1186/s12890-026-04485-8","DOIUrl":"10.1186/s12890-026-04485-8","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) represents a complication occurring in patients undergoing mechanical ventilation. This study aimed to develop a Bayesian network model to identify factors associated with the occurrence of VAP.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using data from patients aged ≥ 60 years who underwent mechanical ventilation in the Department of Intensive care unit at the Second Hospital of Shanxi Medical University between June 2018 and June 2022. Collected variables included demographic characteristics, clinical conditions, medication use, catheterization-related data, laboratory findings, nursing-related and mechanical ventilation-related data. The chi-square test and logistic regression analysis were applied to determine factors associated with VAP. A Bayesian network model was subsequently constructed using the max-min hill-climbing algorithm.</p><p><strong>Results: </strong>A total of 502 patients were included, comprising 332 males and 170 females, with a median age of 72 years (range: 60-100 years). The prevalence of VAP was 9.6% (48/502 patients). The constructed Bayesian network included 10 nodes and 17 directed edges. Direct associations with VAP were identified for antibiotic use exceeding three agents, reintubation, mechanical ventilation methods, and an Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 15. Indirect associations were observed for disease category, diabetes mellitus, presence of an indwelling central venous catheter, transfusion, and corticosteroid administration. The area under the receiver operating characteristic curve for the Bayesian network model was 0.84 (95% CI: 0.79-0.90).</p><p><strong>Conclusion: </strong>The Bayesian network model elucidates the interrelationships among multiple factors associated with VAP. The model may provide ancillary information to help clinicians identify patient profiles associated with higher VAP risk and facilitate the implementation of early during mechanical ventilation.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497129","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":"Chronic cough caused by cerebellar tonsillar herniation: a case report.","authors":"Na Li, Jiangying Guo, Yue Hu, Zihan Yi, Guangyu Ying, Huaqiong Huang","doi":"10.1186/s12890-026-04504-8","DOIUrl":"10.1186/s12890-026-04504-8","url":null,"abstract":"<p><strong>Background: </strong>Chronic cough is most commonly associated with respiratory or gastroesophageal disorders, whereas central nervous system etiologies are rare. Cerebellar tonsillar herniation is typically characterized by neurological manifestations, but cough as an isolated symptom is uncommon.</p><p><strong>Case presentation: </strong>A 61-year-old woman presented with a one-year history of recurrent cough that worsened after eating or drinking. Initial respiratory, gastrointestinal, and allergic evaluations, including chest computed tomography (CT), laboratory testing, and bronchial challenge, were unremarkable. Multidisciplinary team assessment prompted a water swallow test, which showed coughing episodes, raising suspicion for central nervous system involvement. Subsequent magnetic resonance imaging revealed cerebellar tonsillar herniation with 10-mm descent below the foramen magnum. The patient underwent posterior fossa decompression with occipital-cervical fusion. Her cough resolved completely postoperatively, with sustained symptom remission at one-year follow-up.</p><p><strong>Conclusions: </strong>Cerebellar tonsillar herniation may present solely with chronic cough, particularly when common etiologies have been excluded. Thorough clinical assessment, including simple bedside tools such as the water swallow test, and multidisciplinary evaluation can promote timely diagnosis. Cerebellar tonsillar herniation should be regarded as a potential etiologic factor in the differential diagnosis of chronic cough.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497143","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":"Beyond single encounters: a mixed methods study of access to continuous asthma care using Levesque's framework.","authors":"Irem Sevik, Meltem Ciceklioglu, Gulistan Karadeniz","doi":"10.1186/s12890-026-04516-4","DOIUrl":"10.1186/s12890-026-04516-4","url":null,"abstract":"<p><strong>Background: </strong>Achieving symptom control in asthma depends on regular follow-up and access to continuous care, and inadequate control is associated with reduced quality of life and increased healthcare utilization. This study aimed to examine access to continuous care and associated factors among adult asthma patients attending tertiary care, and to explore the dynamics of continuity through patient experiences.</p><p><strong>Methods: </strong>This is an explanatory sequential mixed-methods study within a critical realist paradigm, guided by Levesque's framework. The cross-sectional phase involved 312 participants and data were analyzed using SPSS 30.0. Chi-square test, Fisher's exact test, Student's t-test, and univariate and multivariate logistic regression were conducted. In the qualitative phase, semi-structured in-depth interviews were conducted with 12 participants selected through maximum variation sampling. Audio recordings were transcribed verbatim, coded using MAXQDA 24, and analyzed through a critical grounded theory approach.</p><p><strong>Results: </strong>The mean age was 49.62 ± 14.54 years; 72.8% were female, and 17.3% were uninsured. Only 29.2% of participants had access to continuous care. The strongest determinant of continuity was receiving clear explanations about asthma (OR = 3.30). Individuals with well-controlled asthma were more likely to access continuous care than those with uncontrolled asthma (OR = 2.67). Patients reported delayed diagnoses and insufficient involvement of family physicians in asthma management. 28.2% of family physicians were unaware of the asthma diagnosis. Individuals reporting no difficulty in securing appointments were paradoxically more likely to lack continuous care (OR = 1.89). Qualitative findings suggest that difficulties in obtaining appointments with previously consulted physicians may underlie this paradox. Multimorbid patients reported significant care fragmentation due to poor coordination between institutions. Insurance status was not significantly associated, but participants reported a healthcare-related financial burden. Trust in physicians, care quality, and stigma emerged as relational factors associated with access to continuous care. Access to care was experienced as a cyclical and context-dependent process shaped by recurring barriers and facilitators and findings informed a conceptual refinement of Levesque's framework.</p><p><strong>Conclusions: </strong>Access to continuous care among asthma patients is limited. Strengthening diagnosis, follow-up, and referral processes in primary care, establishing coordination mechanisms between institutions, and expanding guideline-based practices in asthma management are necessary.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468909","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 association between sarcopenia and peak expiratory flow decline in middle-aged and older adults: a nationwide cross-sectional and longitudinal study in China.","authors":"Fengjuan Hu, Gongchang Zhang, Hu Liu, Tingting Huang, Wanyu Zhao, Xiaolei Liu, Ning Huang, Birong Dong, Meiling Ge","doi":"10.1186/s12890-026-04451-4","DOIUrl":"https://doi.org/10.1186/s12890-026-04451-4","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests an association between sarcopenia and impaired respiratory function; however, longitudinal population-based data on the relationship between sarcopenia, its individual components, and peak expiratory flow (PEF) decline remain limited. This study aimed to investigate the cross-sectional and longitudinal associations of sarcopenia and its components with PEF measures among middle-aged and older Chinese adults.</p><p><strong>Methods: </strong>Data were obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Cross-sectional associations between sarcopenia and PEF measures were examined using multivariable logistic and linear regression models. Longitudinal associations between baseline sarcopenia and subsequent PEF decline were evaluated using multivariable logistic regression models.</p><p><strong>Results: </strong>A total of 9452 participants were included in the cross-sectional analysis. Compared with participants without sarcopenia, those with sarcopenia and severe sarcopenia had higher odds of severe airflow limitation (SAL) (OR = 1.41, 95% CI: 1.20-1.65 and OR = 1.56, 95% CI: 1.26-1.94, respectively). Sarcopenia and its individual components were also associated with lower PEF and PEF% predicted. In the longitudinal analysis of 4804 participants, low muscle strength was the strongest and most consistent predictor of subsequent PEF decline. Participants with low muscle strength had a higher risk of new-onset SAL (OR = 1.54, 95% CI: 1.20-1.98) and a 56%-64% greater risk of PEF% predicted decline across different thresholds. Severe sarcopenia and low muscle mass were also associated with greater risks of moderate-to-severe PEF% predicted decline.</p><p><strong>Conclusion: </strong>Sarcopenia was associated with poorer cross-sectional PEF measures, whereas low muscle strength showed the strongest and most consistent longitudinal associations with subsequent PEF decline. These findings highlight the potential importance of muscle strength preservation for maintaining respiratory health in middle-aged and older adults.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' experiences of promoting and hindering factors in daily physical activity with chronic obstructive pulmonary disease: a qualitative systematic review.","authors":"Yongjia Zhang, Ying Xu, Yan Yang, Jingyou Sun","doi":"10.1186/s12890-026-04517-3","DOIUrl":"10.1186/s12890-026-04517-3","url":null,"abstract":"<p><strong>Background and objectives: </strong>Physical activity (PA) is essential for maintaining function and quality of life in patients with chronic obstructive pulmonary disease (COPD). Yet, many return to sedentary behaviors after pulmonary rehabilitation. Identifying facilitators and barriers to daily activity is crucial for developing patient-centered interventions. However, qualitative evidence on patients' experiences and perceptions remains limited.</p><p><strong>Methods: </strong>A qualitative systematic review was conducted following the Joanna Briggs Institute (JBI) Evidence Synthesis Manual. Twelve databases, including Cochrane Library, PubMed, Embase, CINAHL, and major Chinese databases, were searched up to December 5, 2023. Study quality was appraised using the JBI Checklist for Qualitative Research. Data were extracted with the JBI tool and synthesized using a meta-aggregative approach.</p><p><strong>Results: </strong>A total of 1,540 records were screened, and 11 studies were included. Forty findings were aggregated into 13 categories and synthesized into five themes: confronting symptom management and psychological challenges; lacking compliance, behavior change capacity, and autonomy in decision-making; stimulating motivations for engaging in activities; managing activity plans, respiratory aspects during activities, and activity safety; and optimizing family, peer, and medical support systems. Confidence in the synthesized findings ranged from low to high according to the ConQual assessment.</p><p><strong>Conclusions: </strong>COPD patients' engagement in daily physical activity is influenced by a complex interplay of physical, psychological, behavioral, and social factors. These findings may inform the development of multidisciplinary, patient-centered strategies to support daily physical activity engagement among adults with COPD, including integrated symptom management, motivational support, individualized activity planning, safety monitoring, and strengthened social and professional support.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468875","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 alveolar proteinosis diagnosed during leuprorelin acetate therapy for ovarian endometrioma: a case report.","authors":"Xin Gao, Lei Wang, Zhiwei Li, Jing Zhou, Fuqiang Ren","doi":"10.1186/s12890-026-04507-5","DOIUrl":"10.1186/s12890-026-04507-5","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disorder characterized by impaired surfactant clearance due to alveolar macrophage dysfunction. Leuprorelin acetate, a gonadotropin-releasing hormone agonist, is widely used in the treatment of ovarian endometriosis; however, pulmonary findings associated with this therapy have not been well characterized. We report a case of PAP diagnosed during leuprorelin acetate therapy for ovarian endometrioma and describe its temporal relationship with treatment.</p><p><strong>Case presentation: </strong>A 29-year-old woman underwent laparoscopic surgery for an ovarian endometrioma in August 2025 and initiated leuprorelin acetate therapy three days postoperatively. A routine chest computed tomography (CT) performed one month later revealed scattered bilateral ground-glass opacities (GGOs), which persisted on repeat CT in November 2025. Although the patient remained asymptomatic, video-assisted thoracoscopic surgery (VATS) lung biopsy was performed to obtain a histopathological diagnosis and confirmed PAP. Serum anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) antibody testing was negative (3.2 µg/mL; reference range, ≤ 5 µg/mL), not supporting autoimmune PAP. During treatment, the patient developed transient Common Terminology Criteria for Adverse Events (CTCAE) grade 2 leukopenia (white blood cell nadir, 2.94 × 10⁹/L), which resolved spontaneously after completion of leuprorelin acetate therapy without intervention. Hematological evaluation did not suggest an underlying clonal disorder, including myelodysplastic syndrome. Because baseline chest imaging was unavailable, pre-existing subclinical PAP could not be excluded. Follow-up CT performed three months after completion of therapy showed regression of GGOs.</p><p><strong>Conclusion: </strong>This case shows a temporal relationship between leuprorelin acetate therapy and non-autoimmune PAP. However, causality cannot be inferred in the absence of baseline imaging. Only a temporal association can be observed. This observation is hypothesis-generating and highlights a potential rare pulmonary finding observed in the context of gonadotropin-releasing hormone agonist therapy.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468926","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":"Cumulative intraoperative oxygen exposure acts as a predictor for postoperative acute exacerbation of interstitial lung disease: a retrospective cohort study.","authors":"Ryotaro Katsuya, Naoki Ozeki, Tomohito Okubo, Kiichi Tatakawa, Chihiro Furuta, Hideaki Note, Toyofumi Fengshi Chen-Yoshikawa, Takayuki Fukui","doi":"10.1186/s12890-026-04482-x","DOIUrl":"10.1186/s12890-026-04482-x","url":null,"abstract":"<p><strong>Background: </strong>Excessive oxygen administration during surgery may induce lung damage via oxidative stress; however, limited evidence exists on how intraoperative oxygen usage and preoperative pulmonary function predict acute exacerbation (AE) in patients with interstitial lung disease (ILD). This study evaluated whether intraoperative oxygen use and preoperative pulmonary function could predict postoperative AEs in patients with ILD who underwent lung surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed 78 patients with ILD who underwent lung surgery between 2014 and 2022. Clinical variables, including intraoperative oxygen usage and preoperative pulmonary function tests, were assessed for their association with AEs occurring within 1 month (1mAE) and 1 year (1yAE) postoperatively using Firth's bias-reduced logistic regression.</p><p><strong>Results: </strong>Eight patients (10%) had 1mAE, and 14 (18%) had 1yAE. Multivariable analysis showed that lower %vital capacity (%VC) consistently predicted both 1mAE and 1yAE, whereas lower %diffusing capacity for carbon monoxide (%DLCO) significantly predicted only 1yAE. Notably, total oxygen administration > 990 L exhibited a marginal association with 1mAE (OR 2.12, 95% CI: 0.93-4.99, p = 0.071). Even after adjusting for operative and anesthesia durations, total oxygen volume remained a significant independent predictor for 1yAE (OR 2.29, 95% CI: 1.09-4.93, p = 0.029). No significant associations were found between AEs and factors such as the mean fraction of inspired oxygen (FiO₂), forced expiratory volume in 1 s, sex, preoperative steroid use, computed tomography patterns, serum Krebs von den Lungen-6 levels, or surgical procedures.</p><p><strong>Conclusions: </strong>Cumulative intraoperative oxygen administration (rather than mean FiO2) serves as an independent predictor of long-term postoperative AEs in patients with ILD. These findings suggest that cumulative oxygen exposure may contribute to long-term postoperative risk through mechanisms related to oxidative stress.</p><p><strong>Trial registration: </strong>Aichi Medical University 2025-011.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468865","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":"Trends in mortality involving coexisting lung cancer and sepsis in the United States: a CDC WONDER analysis, 1999-2024.","authors":"Rasheeda Shehroz","doi":"10.1186/s12890-026-04470-1","DOIUrl":"10.1186/s12890-026-04470-1","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer and sepsis are major contributors to morbidity and mortality worldwide. Their coexistence represents a significant clinical challenge, as patients with lung cancer may be at increased risk of developing sepsis because of cancer-related immune dysfunction, treatment-related immunosuppression, and frequent healthcare exposure. Sepsis in these patients is associated with poor outcomes, increased health care utilization, and higher mortality rates.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of death certificates from the Centers for Disease Control and Prevention (CDC) WONDER database to evaluate mortality associated with the co-occurrence of lung cancer and sepsis among adults aged ≥ 45 years in the United States from 1999 to 2024. Age-adjusted mortality rates (AAMRs) and annual percent changes (APCs) were calculated and stratified by year, sex, race/ethnicity, census region, state, and metropolitan status.</p><p><strong>Results: </strong>AAMR increased from 1.6 to 2.0 per 100,000 population between 1999 and 2024. Among males, the AAMR increased from 2.3 in 1999 to 2.4 in 2024, while among females, it rose from 1.1 to 1.6 over the same period. Racial disparities were evident, with non-Hispanic Black or African American adults experiencing the highest AAMR (2.6). Regionally, the South had the highest mortality burden (AAMR 2.2), while Kentucky and Mississippi reported the highest state-level rates (3.98 and 3.14, respectively). Mortality rates were higher in non-metropolitan areas (AAMR 1.9) compared with metropolitan areas (1.7).</p><p><strong>Conclusions: </strong>Mortality associated with coexisting lung cancer and sepsis has increased over time, with notable disparities across demographic and geographic groups. These findings highlight the need for targeted public health strategies and improved access to care to reduce mortality in high-risk populations.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454614","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":"Sequential Talaromyces marneffei and Legionella pneumophila infections leading to the diagnosis of anti-interferon-γ autoantibody-associated immunodeficiency: a case report.","authors":"MingJing Yu, YuLing Xiao, Ya Liu, ZhongHao Wang, Haixia Zhou, YongJiang Tang","doi":"10.1186/s12890-026-04455-0","DOIUrl":"10.1186/s12890-026-04455-0","url":null,"abstract":"<p><strong>Background: </strong>Opportunistic infections caused by uncommon intracellular pathogens can serve as important clues to underlying immune dysfunction.</p><p><strong>Case presentation: </strong>We report a 57-year-old male who presented with chronic cough, dyspnea, fever, and weight loss. Chest imaging revealed diffuse pulmonary infiltrates and mediastinal lymphadenopathy, mimicking tuberculosis or lymphoma. Despite empirical anti-tuberculosis and broad-spectrum antibiotic therapy, his condition deteriorated. Metagenomic next-generation sequencing (mNGS) and culture confirmed Talaromyces marneffei infection. During antifungal therapy, he developed Legionella pneumophila pneumonia-an unusual sequential infection that raised suspicion of an immune defect. Comprehensive immunological evaluation revealed anti-interferon-γ (anti-IFN-γ) autoantibodies, supporting the diagnosis of AIGA-associated immunodeficiency. The patient had also shown repeatedly indeterminate interferon-γ release assay (IGRA) results, retrospectively suggesting impairment of the IFN-γ pathway.</p><p><strong>Conclusions: </strong>This case illustrates that recurrent or sequential infections with intracellular pathogens, particularly Talaromyces marneffei and Legionella pneumophila, should prompt evaluation for cell-mediated immunodeficiency such as AIGA syndrome. Early recognition may facilitate tailored antimicrobial therapy, immunological follow-up, and consideration of immunomodulatory treatment in selected patients.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468952","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}