BMC Pulmonary Medicine最新文献

{"title":"Association between serum perfluoroalkyl substances and COPD risk: population evidence and in vitro validation.","authors":"Yansong Hu, Huanyu Cui, Yakun Wang, Ye Tang, Yuhua Chen, Yanyan Qin, Min Tang, Siying Pang, Yaqin Pang, Zhengbao Zhang, Xiaonian Zhu, Di Li","doi":"10.1186/s12890-026-04490-x","DOIUrl":"10.1186/s12890-026-04490-x","url":null,"abstract":"<p><strong>Background: </strong>Per- and polyfluoroalkyl substances are characterized by environmental persistence, bioaccumulation potential, and multi-organ toxicity. Given their ubiquitous presence in the environment and human serum, concerns regarding respiratory health risks are growing, particularly due to scarce evidence on environmental etiologies of chronic obstructive pulmonary disease in never-smokers. This study aimed to investigate the mechanistic role of these substances in chronic obstructive pulmonary disease through a population-computational-experimental paradigm, with specific focus on lipid-metabolic mediation.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (2007-2018) were analyzed using weighted quantile sum regression and quantile-based g-computation to assess mixture exposure effects. Mediation analysis was performed to evaluate the triglyceride-glucose index as a metabolic intermediate pathway. Network toxicology and molecular docking analyses were conducted to identify core protein targets. Human bronchial epithelial cells were exposed to perfluorooctanoic acid to validate target gene expression and downstream pathway activation.</p><p><strong>Results: </strong>Mixture exposure showed a significant positive association with chronic obstructive pulmonary disease risk. Perfluorooctanesulfonic acid and perfluorooctanoic acid were the primary toxicity contributors. The association remained robust among never-smokers. The triglyceride-glucose index significantly mediated the exposure-disease relationship (mediation proportion: 6.6%-7.8%). SRC, EGFR, PPARG, and MMP9 were identified as core targets. Experimental validation confirmed that perfluorooctanoic acid altered expression of these targets, activating inflammation and remodeling pathways.</p><p><strong>Conclusions: </strong>These substances disrupt pulmonary homeostasis through concurrent molecular activation and lipid-metabolic disturbance, evidenced by triglyceride-glucose index mediation. This dual mechanism provides new evidence for chronic obstructive pulmonary disease prevention in never-smokers and identifies potential metabolic intervention targets.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418743","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 efficacy-invasiveness trade-off: a retrospective cohort comparison of surgical operation and endobronchial valves for refractory lung bullae disease.","authors":"Honghai Li, Zejin Zhang, Haoning Nan, Yanbin Pei, Ming Zhao, Yafei Sun, Siyu Chen, Qiu Yonghui, Yuqi Wang","doi":"10.1186/s12890-026-04488-5","DOIUrl":"10.1186/s12890-026-04488-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The optimal intervention for refractory bullae lung disease remains debated, with a choice between invasive surgical operation (SO) and the minimally invasive endobronchial valve (EBV). A comprehensive comparison of their long-term efficacy, safety, and cost is crucial for clinical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare perioperative outcomes, 1-year efficacy, long-term recurrence-free survival, and economic impact between surgical bullectomy (SO) and endobronchial valve (EBV) placement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this comparative study, 673 patients with refractory bullae disease from two Chinese centers were enrolled (SO: n = 436; EBV: n = 237). This study enrolled patients with refractory bullous disease, defined by HRCT-confirmed bullae &gt; 10 cm in diameter or concomitant symptoms impacting daily life, and an inadequate clinical response to a minimum of 3 months of optimized medical management. After applying propensity score matching (PSM) to control for confounding factors, perioperative outcomes, 1-year efficacy, and long-term recurrence‑free survival were compared between the two groups. Analyses employed analyses of covariance (ANCOVA), mixed-effects models, Kaplan-Meier estimates, Cox regression, and logistic regression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Following PSM, excellent balance in baseline characteristics was achieved between the surgical (SO, n = 237) and endobronchial valve (EBV, n = 237) groups. Regarding perioperative outcomes, EBV was associated with a lower risk of complications (OR = 0.33), shorter operation time (mean difference: -0.72 h), less blood loss (mean: -48.00 ml), and a reduced hospital stay (mean: -7.61d) compared to SO (all p &lt; 0.001). However, total hospitalization costs were significantly higher for EBV (mean increase: ¥104,502). For secondary outcomes, EBV demonstrated lower rates of radiologic lung re-expansion based on the semi-quantitative imaging assessment used in this study (OR = 0.15, p &lt; 0.001) and bulla volume reduction (mean difference: -29.02%, p &lt; 0.001) at 1 year, and was associated with a higher 1-year readmission risk (OR = 3.21, p &lt; 0.001). For the primary outcomes at 1 year, SO demonstrated superior improvement in both lung function (adjusted mean difference in forced expiratory volume in one second (FEV1)%: -9.71%, p &lt; 0.001) and exercise capacity (adjusted mean difference in 6-minute walk distance (6MWD): -53.04 m, p &lt; 0.001). Mixed-effects models confirmed that SO's advantages in FEV1% were significant at all time points, while its 6MWD benefit became fully apparent only by 1 year. Long-term recurrence-free survival was significantly higher in the SO group (2-year rate: 86.5% vs. 70.0%; HR for EBV: 2.48, p &lt; 0.001). Subgroup analysis revealed this survival advantage was most pronounced for giant bullae (≥ 10 cm), where the recurrence risk with EBV was 3.49-fold higher (HR 3.49, p &lt; 0.001), whereas for smaller bullae (&lt; 10 cm) ","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive accuracy of the Kristersson/Olsen formula after lung resection: a prospective study comparing minimally invasive surgery and thoracotomy.","authors":"Hassan Edward Bakali, Tevfik Ilker Akcam, Ahmet Kayahan Tekneci, Gizem Kececi Ozgur, Ayse Gul Ergonul, Ali Ozdil, Alpaslan Cakan, Ufuk Cagirici","doi":"10.1186/s12890-026-04475-w","DOIUrl":"10.1186/s12890-026-04475-w","url":null,"abstract":"<p><strong>Background: </strong>Surgical resection remains the gold standard for early-stage lung cancer. This study aimed to evaluate the predictive accuracy of the Kristersson/Olsen formula for postoperative lung function in patients undergoing minimally invasive surgery (MIS).</p><p><strong>Methods: </strong>Seventy-five patients who underwent anatomical lung resection for lung cancer between January 2022 and January 2024 were prospectively analyzed. Preoperative, first postoperative week and second postoperative month pulmonary function test values (FEV₁, FVC), surgical approach, postoperative complications, and demographic and clinical variables were recorded.</p><p><strong>Results: </strong>Regardless of surgical approach, the Kristersson/Olsen formula predicted a mean postoperative FEV₁ loss of 571 mL. However, the actual mean loss in the first postoperative week was significantly greater (698 mL; p = 0.013). In the MIS group, the predicted loss was 549 mL, whereas the observed first week loss reached 750 mL (p = 0.025). In contrast, during the second postoperative month, the overall patient cohort demonstrated a significantly smaller FEV₁ loss than predicted (449 mL vs. 571 mL; p = 0.002). Similarly, MIS patients showed an actual loss of 408 mL compared with the expected 549 mL (p = 0.013). When postoperative respiratory function recovery was examined, FEV₁ and FVC losses were significantly greater at the first postoperative week than at the second postoperative month in the MIS group, with a large effect size (p < 0.001, Cohen's d 0.892 and 1.042, respectively). Thoracotomy patients also demonstrated greater early losses, with moderate-to-high effect sizes (Cohen's d: 0.586 and 0.797). Recovery of pulmonary function from the first week to the second month was more pronounced in the MIS group.</p><p><strong>Conclusions: </strong>The Kristersson/Olsen formula demonstrated limited accuracy in predicting postoperative pulmonary function during the early recovery phase (up to the second postoperative month), particularly in patients undergoing minimally invasive surgery. MIS is associated with lower-than-predicted functional loss, fewer complications, and greater pulmonary recovery, suggesting that patients with limited respiratory reserve may still be suitable candidates for surgery.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418869","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 between serum uric acid levels and COPD: a meta-analysis and mendelian randomization study.","authors":"Aiju Su, Yunpeng Xu, Xue Han, Qiuyu Chen, Jian Liu","doi":"10.1186/s12890-026-04477-8","DOIUrl":"10.1186/s12890-026-04477-8","url":null,"abstract":"<p><strong>Objective: </strong>Chronic obstructive pulmonary disease (COPD) poses a major global health burden, but its relationship with serum uric acid (SUA) remains controversial. This study combined meta-analysis and Mendelian randomization (MR) to evaluate the observational association and potential causal relationship between SUA and COPD.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science, CNKI, and Wanfang Data for observational studies comparing SUA levels between COPD patients and healthy controls published up to December 2025. Meta-analysis was performed using a random-effects model to calculate mean differences (MD) and 95% confidence intervals (CI), followed by subgroup analyses. This meta-analysis has been registered with PROSPERO under the registration number CRD420251234511. Two-sample bidirectional MR analysis was conducted using publicly available GWAS summary data, with inverse variance weighting (IVW) as the primary method, supplemented by weighted median, MR-Egger regression, and sensitivity analyses.</p><p><strong>Results: </strong>The meta-analysis included 22 studies, comprising a total of 3739 COPD patients and 2778 healthy controls. Results showed that SUA levels were significantly higher in stable COPD patients compared to healthy controls (MD: 1.19 mg/dL, 95% CI: 0.83-1.55, P < 0.00001). Patients with acute exacerbation of COPD (AECOPD) exhibited even higher uric acid levels (MD: 1.30 mg/dL, 95% CI: 0.36-2.24, P < 0.00001), and SUA levels were significantly higher in severe COPD patients compared to those with mild-to-moderate COPD (MD: 1.18 mg/dL, 95% CI: 0.76-1.60, P = 0.02). Bidirectional MR analysis revealed that genetically predicted higher SUA levels were causally associated with reduced COPD risk (IVW: OR: 0.883, 95% CI: 0.811-0.961, P = 0.004). Reverse MR analysis found no significant causal effect of COPD on uric acid levels (P > 0.05). Sensitivity analyses supported the robustness of the MR findings.</p><p><strong>Conclusion: </strong>Observational evidence indicated elevated SUA in COPD, especially during exacerbations, while genetically predicted higher SUA showed a modest protective effect. These findings suggest a complex, dual role of uric acid. However, observational associations may be confounded by reverse causality, and the MR estimates-derived from East Asian populations-are method-sensitive. Current evidence does not yet support altering uric acid management in COPD, and further prospective and interventional studies across diverse populations are warranted.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418821","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 relationship between swallowing function and clinical parameters in patients with chronic obstructive pulmonary disease.","authors":"Senay Demir Yazici, Ayşe Kübra Söyler, Hatice Arzu Uçar","doi":"10.1186/s12890-026-04487-6","DOIUrl":"10.1186/s12890-026-04487-6","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia is considered an extrapulmonary manifestation of chronic obstructive pulmonary disease (COPD), and its clinical significance has received increasing attention in recent years. However, data on the association between swallowing function and clinical parameters in COPD remain limited. Therefore, this study aimed to evaluate swallowing function using clinical screening tools in patients with COPD and to assess its relationship with demographic and clinical parameters.</p><p><strong>Methods: </strong>This cross-sectional study included 60 COPD patients who were followed jointly at the Chest Diseases and Physical Medicine and Rehabilitation outpatient clinics of a tertiary university hospital between April and July 2025. Patients' swallowing-related parameters were evaluated using the Eating Assessment Tool-10 (EAT-10) and the Repetitive Saliva Swallowing Test (RSST). Physical performance was assessed using the Six-Minute Walk Test (6MWT), respiratory function using spirometric parameters, and symptom severity using the COPD Assessment Test (CAT) and the modified Medical Research Council Dyspnea Scale (mMRC). Data analyses were performed using SPSS.</p><p><strong>Results: </strong>The mean age of patients was 68.75 ± 6.54 years, and 81.7% were male. According to the EAT-10 screening, the prevalence of self-reported dysphagia was 35%. There was a significant difference in EAT-10 scores between GOLD groups, whereas no difference was observed in RSST counts (p = 0.020, p = 0.111). Patients with mMRC ≥ 2 had higher EAT-10 scores and lower RSST counts (p = 0.043, p = 0.024) compared with those with mMRC scores < 2. Patients with CAT scores ≥ 10 had higher EAT-10 scores (p = 0.001). Those with recent weight loss also had higher EAT-10 scores and lower RSST counts (p = 0.010, p = 0.025). No significant correlations were found between swallowing-related parameters and age, BMI, smoking exposure, COPD duration, pulmonary function, or 6-MWT. However, EAT-10 scores showed positive correlations with mMRC (r = 0.356, p = 0.005) and CAT scores (r = 0.530, p < 0.001), while RSST counts showed a weak negative correlation with mMRC scores (r=-0.282, p = 0.029).</p><p><strong>Conclusion: </strong>Swallowing-related parameters assessed using clinical screening tools were associated with symptom severity (mMRC and CAT) and weight loss in patients with COPD. These findings suggest that screening-based swallowing assessment may provide additional clinical information during clinical follow-up and that screening for dysphagia may be beneficial, particularly in patients with high symptom burden and recent weight loss.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors for mortality in pulmonary mucormycosis among patients with non-hematologic malignancies.","authors":"Renwen Zhang, Yongzhe Liu, Ran Li, Li Gu","doi":"10.1186/s12890-026-04474-x","DOIUrl":"10.1186/s12890-026-04474-x","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary mucormycosis (PM) is a life-threatening fungal infection typically reported in neutropenic patients with hematologic malignancies (HM), but its features in non-hematologic malignancy (NHM) patients remain unclear. This study aimed to characterize the clinical presentation, treatment, and outcomes of PM in NHM patients.</p><p><strong>Methods: </strong>This retrospective study (March 1, 2017-July 31, 2024) at Beijing Chaoyang Hospital included 46 NHM-PM patients, predominantly diabetes mellitus (DM) and solid organ transplantation (SOT). The primary outcome was 90-day all-cause mortality. Survival was analyzed using Kaplan-Meier curves and Cox regression, with adjustment for age, sex, and diabetes mellitus. The proportional hazards assumption was verified (GLOBAL p = 0.515).</p><p><strong>Results: </strong>Among 46 PM patients with NHM, DM was present in 71.7%. The 90-day mortality rate was 37.0% (17/46). Non-survivors had higher rates of respiratory failure, intensive care unit (ICU) admission, and septic shock, along with lower hemoglobin and higher D-dimer and procalcitonin (all P < 0.05). Univariable Cox regression identified solid organ transplantation (HR = 6.97), the use of immunosuppressants (HR = 5.58), elevated D-dimers, and elevated procalcitonin as significant mortality predictors (all P < 0.01), whereas longer hospital stay and longer time to treatment initiation were protective (both P < 0.05). Multivariable Cox regression confirmed the use of immunosuppressants as an independent risk factor (adjusted HR = 7.51, 95% CI: 2.72-20.74, P < 0.001). Kaplan-Meier curves showed significantly worse survival for the use of immunosuppressants and SOT recipients (log-rank P < 0.001 for both).</p><p><strong>Conclusions: </strong>The use of immunosuppressants and SOT are both important factors associated with 90-day mortality in NHM-PM patients. These findings highlight the poor prognosis associated with immunosuppression and support early, aggressive intervention in this high-risk population. Validation in larger cohorts is warranted.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403773","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":"Physical activity, functional capacity, and mental health during the first postoperative month in patients undergoing ambulatory pulmonary wedge resection: a prospective observational study.","authors":"Qiaoling Wang, Zhongxing Bing, Shuai Wei, Xiaojie Wang, Bo Yu, Riwang Wang, Lixia Chen, Lu Zhang","doi":"10.1186/s12890-026-04481-y","DOIUrl":"10.1186/s12890-026-04481-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As a well-established clinical model, ambulatory surgery has been routinely performed in thoracic surgery. Accordingly, this study aimed to investigate home-based physical activity, functional capacity, mental health in patients undergoing ambulatory VATS for lung cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This study prospectively observed the changes in physical activity, functional capacity, mental health and quality of life on 1 month after surgery, with a comparison between the postoperative and preoperative to identify the indicators associated with early postoperative mobility, and further screened out the potential preoperative predictors for postoperative mobility. Among 150 patients assessed for eligibility, 97 were enrolled, 82 underwent day-case VATS wedge resection, and 72 had complete 4-week follow-up data and constituted the complete-case analytic cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;A total of 72 patients underwent day-case VATS, were discharged within 23 h postoperatively, and completed the 4-week follow-up. The cohort had a mean age of 50.4 ± 12.0 years, with 88.9% stageⅠA1 and 11.1% stageⅠA2 lung cancer. The compliance of wearing Actigraph accelerometers was satisfactory within 4 weeks after surgery. During the 4-week follow-up, patients showed a significant upward trend in daily step count, mean daily METs, and moderate-intensity physical activity time (all P &lt; 0.05), while light-intensity activity decreased notably from week 1 to week 2 and remained stable thereafter. No significant changes were observed in sedentary time across the 4 weeks. Compared with the preoperative baseline, significant decreases were observed in 6MWD(P = 0.043), MEP(P = 0.001), mMRC grade(P = 0.044) and EQ-VAS score(P = 0.002), whereas SF-12 score(P = 0.003) increased significantly. Correlation analysis showed week 1 step count correlated significantly with preservation of exercise capacity (Δ6MWT) (r = 0.369, P = 0.035). Univariate linear regression identified higher GAD-7 scores were strongly associated with lower activity levels (P = 0.02). Safety outcomes were analyzed in the all-operated cohort (n = 82, primary safety population) and the pathology-confirmed malignant cohort (n = 78, secondary safety population). Two patients (2.44%, 95% CI 0.30-8.53%) experienced postoperative complications requiring 30-day readmission- for pulmonary infection. No 30-day reoperation or mortality was observed (0/82, 95% CI 0-4.40%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients undergoing day-case VATS wedge resection showed a weekly increase in home-based activity, reaching near physical activity levels of normal healthy individuals by week 4 without full recovery of preoperative physical capacity. The mean daily step count at week 1 was correlated with functional performance at week 4. Preoperative anxiety level was inversely associated with physical activity within the first postoperative week, indicating that higher preoperative anxi","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of unexpected rapid regression of diffuse pulmonary lymphangiomatosis mimicking advanced lung cancer.","authors":"Byeong-Kwon Shin, Seung Yong Park, Ae Ri Ahn, Kum Ju Chae","doi":"10.1186/s12890-026-04467-w","DOIUrl":"10.1186/s12890-026-04467-w","url":null,"abstract":"<p><strong>Introduction: </strong>Diffuse pulmonary lymphangiomatosis (DPL) is an extremely rare lymphatic disorder characterized by diffuse proliferation of lymphatic vessels involving the lungs, pleura, and mediastinum. Its radiologic features often overlap with those of malignancy, particularly lymphangitic carcinomatosis, making accurate diagnosis challenging.</p><p><strong>Case presentation: </strong>A 79-year-old man presented with a one-week history of dyspnea and high fever. Chest computed tomography demonstrated an enhancing pulmonary nodule with extensive mediastinal and bilateral hilar lymphadenopathy, pleural effusion, pleural thickening, and diffuse interlobular septal thickening, raising suspicion for advanced lung cancer with lymphangitic metastasis. Endobronchial ultrasound-guided transbronchial needle aspiration and pleural biopsy were nondiagnostic. Subsequently, video-assisted thoracoscopic surgery with wedge resection was performed. Histopathologic examination revealed diffuse proliferation of anastomosing lymphatic channels lined by endothelial cells, with positive immunostaining for D2-40 and CD31, consistent with DPL. Notably, without DPL-directed therapy, the patient's symptoms resolved within three weeks. Follow-up chest CT at two months demonstrated marked regression of lymphadenopathy and complete resolution of interlobular septal thickening. No clinical or radiological recurrence was observed during one year of follow-up.</p><p><strong>Conclusion: </strong>DPL can closely mimic advanced lung cancer with lymphangitic metastasis on imaging while exhibiting a potentially reversible clinical course. Awareness of this entity is essential to avoid misdiagnosis and unnecessary aggressive treatment, particularly in atypical settings and for elderly patients.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410222","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 lactate dehydrogenase-to-albumin ratio predicts frequent exacerbations in COPD patients with coronary heart disease.","authors":"HongXu Zhang, MengYu Lian, Jie Song, JingJing Yang, RuiYan Lin, JinXiang Wang","doi":"10.1186/s12890-026-04450-5","DOIUrl":"https://doi.org/10.1186/s12890-026-04450-5","url":null,"abstract":"<p><strong>Objective: </strong>Patients with chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD) frequently exhibit heightened systemic inflammation, oxidative stress, and cardiopulmonary dysfunction, contributing to an increased risk of recurrent exacerbations. The lactate dehydrogenase-to-albumin ratio (LAR) is a readily available biomarker reflecting inflammatory and metabolic stress; however, its association with the frequent-exacerbator phenotype in patients with COPD and CHD remains unclear. This study aimed to evaluate the relationship between admission LAR levels and frequent exacerbations in this high-risk population.</p><p><strong>Methods: </strong>This retrospective study analyzed 489 hospitalized patients with acute exacerbations of COPD (AECOPD) and comorbid CHD. Patients with two or more exacerbations were classified as frequent exacerbators. Demographic characteristics, comorbidities, and lab parameters were collected. Multivariable logistic regression and restricted cubic spline analyses were performed to evaluate the association between LAR and the frequent-exacerbator phenotype.</p><p><strong>Results: </strong>A total of 489 patients with AECOPD and CHD were included, with a mean age of 76 years, and 66.9% were male. Higher admission LAR levels were significantly associated with the frequent-exacerbator phenotype in the unadjusted analysis (Odds Ratio [OR] 1.23; 95% confidence interval [CI] 1.12 ~ 1.35; p < 0.001). The association remained significant after adjustment for potential confounders (adjusted OR 1.34; 95% CI 1.19 ~ 1.51; p < 0.001). Restricted cubic spline analysis demonstrated a significant nonlinear association (p = 0.004), with an inflection point at a LAR value of approximately 5.1 (OR 4.04, p = 0.001), whereas a more modest increase was observed above this threshold (OR 1.45, p = 0.009).</p><p><strong>Conclusion: </strong>Higher admission LAR levels were independently associated with the frequent-exacerbator phenotype among patients with AECOPD and CHD. This readily available biomarker may improve risk stratification and personalized management in this high-morbidity population.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410426","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":"Pulmonary glue embolism mimicking thrombotic pulmonary embolism after varicocele embolization: a case report.","authors":"İpek Çalık","doi":"10.1186/s12890-026-04491-w","DOIUrl":"10.1186/s12890-026-04491-w","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary glue/iodized oil embolism is an uncommon form of non-thrombotic pulmonary embolism caused by migration of cyanoacrylate-based embolic agents. Although most cases have been reported after endoscopic treatment of gastric varices, cases after varicocele embolization are exceptionally rare, and longitudinal data on clinically stable patients remain limited.</p><p><strong>Case presentation: </strong>We report a 35-year-old man who developed acute dyspnea, chest pain, and palpitations immediately after varicocele embolization, mimicking thrombotic pulmonary embolism. Computed tomography pulmonary angiography demonstrated bilateral radiopaque intravascular material within the pulmonary arterial circulation, consistent with migrated glue/iodized oil material, with associated right-dominant consolidation, ground-glass opacities, and minimal pleural effusion. The patient remained hemodynamically stable, with no sustained hypoxemia, right ventricular dysfunction, or pulmonary hypertension, and was managed with individualized conservative/supportive treatment without surgical or endovascular intervention. Follow-up CT at 1 month showed marked regression of parenchymal abnormalities and an apparent partial decrease in the visible radiopaque embolic material. At 6 months, pulmonary function, including DLCO, normalized, echocardiography showed no pulmonary hypertension, and CT findings remained stable. At 1 year, the patient was asymptomatic, and chest radiography showed no clinically significant residual or new parenchymal or pleural abnormality.</p><p><strong>Conclusions: </strong>This case adds to the limited literature on pulmonary glue/iodized oil embolism after varicocele embolization by documenting a hemodynamically stable course with favorable longitudinal clinical, radiological, and functional follow-up. In carefully selected patients without right ventricular dysfunction or clinical deterioration, conservative/supportive management may be reasonable, but treatment decisions should remain individualized and multidisciplinary.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410428","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}