BMC Pulmonary Medicine最新文献

{"title":"Pulmonary function in relation to muscle endurance and functional capacity in children with bronchial asthma.","authors":"Zahera Raafat Zedan, Walaa Abd El-Hakiem Abd El-Nabie, Shimaa AboEldahab Ahmed, Eman Mohamed Tantawy, Mai Mohamed Khalaf","doi":"10.1186/s12890-025-03650-9","DOIUrl":"https://doi.org/10.1186/s12890-025-03650-9","url":null,"abstract":"<p><strong>Background: </strong>Bronchial asthma is a major global health concern among children. It poses a significant global public challenge, causing around 22.8 million years of life lost to disability and 495,100 asthma-related deaths.</p><p><strong>Objective: </strong>The goal of the study was to investigate the relationship between pulmonary function in children with bronchial asthma and both the muscle endurance of the deep cervical flexors and overall functional capacity.</p><p><strong>Methods: </strong>This cross-sectional study involved sixty-four pediatric patients diagnosed with bronchial asthma, aged from 8 to 10 years old from both sexes. Their body mass index was from 5th percentile to less than 85th percentile for age, gender and height. They were evaluated and diagnosed by using spirometry. Pulmonary function (vital capacity(VC), peak expiratory flow (PEF), forced expiratory volume in 1s (FEV1), forced expiratory volume in 1s / forced vital capacity (FEV1/FVC), muscle endurance, and functional capacity were assessed by using spirometry, pressure biofeedback, and 6-minutewalk test respectively.</p><p><strong>Results: </strong>The findings indicated a clear and significant positive association between pulmonary function measures, including (VC, PEF, FEV1 and the FEV1/FVC ratio), with both the cervical flexion test and the six-minute walk test (6MWT). These correlations were statistically significant, with p-values of ≤ 0.05.</p><p><strong>Conclusion: </strong>Pulmonary function is associated with endurance of cervical flexors and functional capacity in pediatric patients with bronchial asthma.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"204"},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of neutrophil-lymphocyte ratio for all-cause mortality in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.","authors":"Li Fang, Jianzhi Zhu, Dandan Fu","doi":"10.1186/s12890-025-03677-y","DOIUrl":"https://doi.org/10.1186/s12890-025-03677-y","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) involves inflammation as a key factor influencing its pathology and progression. This meta-analysis sought to assess the prognostic importance of the neutrophil-to-lymphocyte ratio (NLR) in individuals diagnosed with COPD.</p><p><strong>Methods: </strong>Comprehensive searches were carried out in PubMed, Embase, Web of Science, and the Cochrane Library up to March 2025. All-cause mortality-related data were collected and analyzed. Outcomes were evaluated using odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Following a thorough review of the literature and a rigorous screening process, a total of 24 studies including 18,597 patients were selected for this meta-analysis. The cut-off range of NLR in all included literatures was 1.3 to 16.83. Analysis of categorical variables showed that COPD patients with elevated NLR levels faced a significantly higher all-cause mortality risk compared to those with lower NLR levels (OR: 1.03, 95% CI: 1.01-1.06, P = 0.009, I² = 89%). For continuous variables, deceased COPD patients exhibited significantly elevated NLR levels compared to survivors (SMD: 1.23, 95% CI: 0.90-1.57, P < 0.00001, I² = 97%). The subgroup analysis highlighted study design and the timing of NLR measurement as potential contributors to heterogeneity. Subgroup analysis showed that NLR had a better predictive value for disease in AECOPD subgroups.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates a correlation between increased NLR levels and heightened all-cause mortality risk in COPD patients. Nevertheless, given the inherent limitations of this study, additional multi-center, prospective clinical trials are essential to confirm these findings.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"206"},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of early pulmonary rehabilitation in severe and critically ill COVID-19 patients: a retrospective cohort study.","authors":"Xue Wang, Haomiao Ma, Xiaoya He, Xiaomeng Gu, Yi Ren, Huqin Yang, Zhaohui Tong","doi":"10.1186/s12890-025-03678-x","DOIUrl":"https://doi.org/10.1186/s12890-025-03678-x","url":null,"abstract":"<p><strong>Background: </strong>Respiratory sequelae, induced by lung injury, reduced muscle strength, and nutritional disturbance, are common in hospitalized patients with coronavirus disease 2019 (COVID-19). Therefore, optimal treatment is essential for reducing the mortality in severe forms of the disease and critically ill patients. Pulmonary rehabilitation (PR) has been used in many chronic respiratory diseases, but the role of early PR in severe and critically ill COVID-19 patients remains to be fully understood.</p><p><strong>Methods: </strong>Hospitalized severe to critically ill COVID-19 patients were recruited from Beijing Chaoyang Hospital between December 1, 2022, and June 30, 2023. In all, we recruited 272 patients, with 39 in the PR group and 233 in the control group. The PR intervention consisted of the prone position, airway clearance therapy (ACT), and resistance respiratory training (RRT). The primary outcome was the composite disease progression outcome rate, defined as death or intensive care unit (ICU) admission. Adverse events (AEs) and serious adverse events (SAEs) were recorded in the PR group. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) was used to balance confounding bias, generating weighting cohort and matched cohort.</p><p><strong>Results: </strong>The rate of the primary outcome was lower in the PR group (28.2% [11/39] in the PR group vs. 48.9% [114/233] in the control group). Significant differences were observed in both the original and weighting cohorts. Subgroup analyses showed that receiving ≥ 2 types of PR, receiving RRT, length from admission to intervention ≤ 4 days, and baseline P/F ≤ 150 mmHg were associated with lower rates of progression. Total rates of 2.6% (1/39) for AEs and 10.26% (4/39) for SAEs were reported.</p><p><strong>Conclusions: </strong>Early pulmonary rehabilitation may prevent disease progression and reduce mortality in patients with severe COVID-19. These findings may be helpful for formulating an optimal rehabilitation strategy.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"203"},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954332","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":"Mediastinal lymphangioma and intestinal lymphangiomatosis presenting with chylothorax: a systematic review of therapeutic modalities.","authors":"Marc Assaad, Roshan Acharya, Wasif Shamsi, Elspeth Springsted, Mahtab Foroozesh, Maria Del Mar Cirino-Marcano","doi":"10.1186/s12890-025-03664-3","DOIUrl":"https://doi.org/10.1186/s12890-025-03664-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Chylothorax is defined by the accumulation of chyle in the pleural space, characterized by triglyceride levels exceeding 110 milligrams per deciliter. The clinical presentation of chylothorax varies depending on its acuity and underlying etiology. Mediastinal lymphangiomas are extremely rare and benign lesions that can affect both infants and adults. They may occur independently or in association with other lymphatic disorders and can lead to complications such as chylothorax.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case report: &lt;/strong&gt;A 60-year-old male patient presented with shortness of breath and was diagnosed with left-sided chylothorax secondary to mediastinal lymphangioma, accompanied by intestinal lymphangiomatosis. Conservative approach was unsuccessful, and surgical therapy was needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We conducted a thorough search of the PubMed/MEDLINE, PubMed Central, and Google Scholar databases. The search parameters we used included the following Boolean terms: [(\"lymphangioma\" OR \"mediastinal lymphangioma\" OR \"cavernous lymphangiomas\" OR \"cystic hygromas\" OR \"capillary lymphangioma\" OR \"lymphangioma simplex\") AND (\"chylothorax\" OR \"chylous pleural effusion\" OR \"chylous effusion\" OR \"chylous lung\")]. Our search yielded 166 articles in total, out of which we selected 17 articles for inclusion. We included patients who presented to the hospital with chylothorax secondary to mediastinal lymphangioma and those who developed chylothorax after the removal of mediastinal lymphangioma. The primary outcome was the total number of reported cases of chylothorax secondary to mediastinal lymphangioma. The secondary outcomes included patient characteristics, fluid characteristics, clinical manifestations, and therapeutic modalities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The systematic review encompassed seventeen case reports. Most patients were male, spanning ages from six weeks to 82 years, with an average age of 28.35 years. Most pleural effusions were on the left side. Few cases were asymptomatic, while the most reported symptom was shortness of breath. The mean pleural triglyceride level was 708 mg/dl, with cystic hygroma being the most common subtype. The anterior mediastinum was the most frequent location. The primary treatment involved surgical removal of the lymphangioma along with thoracic duct ligation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Mediastinal lymphangioma is an infrequent etiology of chylothorax and is scarcely documented in the literature. It may be present in isolation or may be associated with extra mediastinal lymphatic anomalies. The management of chylothorax in such cases is challenging with conservative measures often being ineffective, necessitating surgical intervention. The rarity of these conditions complicates the study of potential risk factors and genetic predispositions. Furthermore, there is no established consensus on the therapeutic modalities for patients with similar diagnos","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"202"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976542","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":"Corticosteroids and long-term pulmonary function after critical illness due to COVID-19- a single-center cohort study.","authors":"Mari Roël, Anna Schandl, Sandra Jonmarker, Anders Hedman, Gisela Vogel, Eva Joelsson-Alm, Maria Cronhjort, Pernilla Darlington","doi":"10.1186/s12890-025-03659-0","DOIUrl":"https://doi.org/10.1186/s12890-025-03659-0","url":null,"abstract":"<p><strong>Background: </strong>Early in the pandemic, corticosteroids became standard treatment for patients with critical COVID-19 infections. This study aimed to investigate the possible long-term pulmonary consequences after corticosteroid treatment in patients with critical COVID-19 requiring ventilatory support.</p><p><strong>Methods: </strong>This observational single-center cohort study included patients treated for critical COVID-19 requiring ventilatory support between March 1, 2020, and August 1, 2021, with a 6-month follow-up after discharge from the intensive care unit. Corticosteroid treatment was defined according to the RECOVERY trial (6 mg dexamethasone daily or equivalent dose of another corticosteroid, initiated within eight days of hospital admittance and continued for at least one day) Pulmonary function was assessed by diffusion capacity for carbon monoxide. Health-related quality of life was measured with the questionnaire RAND-36. General linear regression was used to present mean score differences with 95% confidence intervals.</p><p><strong>Results: </strong>Among the 456 (69%) critically ill COVID-19 patients who survived at least 90 days after ICU discharge, 286 (63%) attended the follow-up six months later. The groups were balanced regarding invasive ventilation; 47% received invasive ventilation in both groups. Corticosteroid treatment was associated with a lower diffusion capacity for carbon monoxide (MSD - 8.3, 95% CI: -14.2 to -2.4) 6 months after ICU discharge (change > 10% were regarded as clinically significant). There were no differences in health-related quality of life between the groups.</p><p><strong>Conclusions: </strong>Corticosteroids might negatively impact pulmonary function after critical COVID-19. The decrease did not seem to influence health-related quality of life. Future studies are needed to confirm the results.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"201"},"PeriodicalIF":2.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976224","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":"Impact of physician awareness and microbiological examination on incidence of COVID-19-associated pulmonary aspergillosis: a retrospective study.","authors":"Li-Jing Xia, Tong-Tong Hou, Xi-Ling Liu, Xue-Bing Chen, Peng-Cheng Lin, Shan-Shan Su, Li Yang, Ying Zhou, Yu-Ping Li","doi":"10.1186/s12890-025-03671-4","DOIUrl":"https://doi.org/10.1186/s12890-025-03671-4","url":null,"abstract":"<p><strong>Background: </strong>The reported incidence of aspergillosis among COVID-19 patients has varied significantly, which can be partly attributed to differences in diagnostic approaches and levels of physicians' proficiency in diagnosing COVID-19-associated pulmonary aspergillosis (CAPA). Consequently, we conducted a retrospective study to investigate the potential reasons for these discrepancies and analyzed the risk factors for pulmonary aspergillosis in patients with COVID-19.</p><p><strong>Method: </strong>Data were retrospectively collected from December 1, 2022, to September 30, 2023, from patients who were admitted to the First Affiliated Hospital of Wenzhou Medical University. The research platform was used to screen patients with discharge diagnoses of COVID-19 pneumonia. CAPA was defined according to the 2020 ECMM/ISHAM criteria and the Chinese expert consensus. Clinical data that were collected included data about underlying diseases, laboratory examinations and microbiological detection. Analyses were conducted with R software, with continuous variables analyzed with t-tests, categorical variables analyzed with chi-square tests, and logistic regression and ROC curves used to assess risk factors for CAPA.</p><p><strong>Results: </strong>The incidence of CAPA was 13.4% in the general ward, 30.8% in the RICU, and 6.8% in other ICUs. The average time to CAPA diagnosis was 5.6 days in general wards, 3.7 days in the RICU, and 7.4 days in other ICUs. Diagnostic testing revealed the following sensitivities: 78% for BALF galactomannan (GM), 48% for serum GM, 52% for culture tests, and 71% for BALF mNGS. Risk factors for CAPA included chronic respiratory disease, chronic renal insufficiency, and diabetes. The primary Aspergillus species identified was A. fumigatus, followed by A. flavus.</p><p><strong>Conclusion: </strong>Differences in incidence may arise from varying levels of physician awareness, which can influence the rate at which BALF and serum GM samples are submitted for testing. The sensitivity of BALF GM is higher than that of serum GM. Furthermore, BALF mNGS has the potential to enhance the clinical detection sensitivity of CAPA. Risk factors for CAPA include chronic respiratory disease, chronic renal insufficiency, and diabetes, which may aid in identifying at-risk patients. The primary Aspergillus species identified was A. fumigatus, followed by A. flavus, providing a reference for clinical empirical treatment.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"198"},"PeriodicalIF":2.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969442","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":"Does asthma pay-for-performance program really improve the quality of asthma care: a nationwide retrospective cohort analysis in Taiwan.","authors":"Pin-Kuei Fu, Tsung-Hsien Yu","doi":"10.1186/s12890-025-03673-2","DOIUrl":"https://doi.org/10.1186/s12890-025-03673-2","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a prevalent noncommunicable disease worldwide, imposing significant burdens and diminishing the quality of life for those affected. Pay-for-Performance (P4P) programs are reimbursement models that offer incentives to healthcare providers based on their performance metrics. While P4P initiatives have been implemented across various medical conditions, their specific impact on asthma care remains uncertain. This study aims to compare the characteristics and quality of asthma care between patients enrolled in the P4P program and those who are not. Additionally, we will examine trends in these characteristics and care quality over time.</p><p><strong>Methods: </strong>This study utilized a multiple cross-sectional design to analyze asthma patients diagnosed in 2010 and 2019, drawing data from Taiwan's National Health Insurance claims database. We collected information on demographic characteristics, P4P program enrollment, medication usage, healthcare service utilization, and attributes of both patients and their primary treatment hospitals. To address the study objectives, we employed logistic regression models and applied 1:1 propensity score matching to mitigate selection bias.</p><p><strong>Results: </strong>A total of 811,177 individuals diagnosed with asthma were identified, comprising 317,669 in 2010 and 493,508 in 2019. Our findings indicate that patients enrolled in the P4P program had higher prescription rates for inhaled corticosteroids (ICS) and experienced lower rates of hospital admissions and emergency department visits for acute asthma exacerbations compared to non-enrolled patients. We also observed that demographic characteristics influenced P4P enrollment, with these impacts evolving over time. Furthermore, the effects of the P4P program varied across different levels of hospital accreditation.</p><p><strong>Conclusion: </strong>This study demonstrates that the P4P program positively influences the quality of asthma care. However, variations between P4P and non-P4P enrollers persist and have widened over time. Health authorities should address these disparities to ensure equitable care for all asthma patients.</p><p><strong>Clinical trial number: </strong>Protocol #202203101RINC.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"199"},"PeriodicalIF":2.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973849","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":"Real-time ultrasound-guided laryngeal mask assisted percutaneous dilatational tracheostomy versus bronchoscopy-guided percutaneous dilatational tracheostomy in critically ill patients: a randomized controlled trial.","authors":"Sameh Taha, Jihad Mallat, Mohamed Elsaidi, Ashraf Al-Agami, Ahmed Taha","doi":"10.1186/s12890-025-03645-6","DOIUrl":"https://doi.org/10.1186/s12890-025-03645-6","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous dilatational tracheostomy (PDT) is a common procedure for mechanically ventilated patients in the intensive care unit (ICU). This study compared the real-time ultrasound-guided PDT using a laryngeal mask airway (LMA) with the standard bronchoscopy-guided PDT technique in ICU patients requiring elective tracheostomy.</p><p><strong>Methods: </strong>This randomized controlled study was conducted at Ain Shams University Hospital's Critical Care Department from December 4th, 2021, to December 3rd, 2022. The study population included 60 critically ill patients admitted to the ICU. Thirty patients were randomly assigned to the real-time ultrasound-guided LMA-assisted group, and 30 patients were randomly assigned to the bronchoscopy-guided technique. The primary study outcome was the procedure time, and the secondary outcomes included procedure-related complications rate and cost-effectiveness.</p><p><strong>Results: </strong>The real-time ultrasound-guided LMA-assisted group had significantly shorter procedure time (median 17 [IQR: 15-20] min vs. 35 [IQR: 28-39] min, p < 0.001) and lower equipment damage (0% vs. 20%, p = 0.024) during the procedure compared to the bronchoscopy-guided group. Additionally, the cost of tracheostomy was significantly lower in the real-time ultrasound-guided LMA-assisted group (median: 300 vs. 800 USD, p < 0.001). The real-time ultrasound-guided LMA group had a lower major complications rate than the bronchoscopy-guided group (36.7%) vs. 3.3%, p = 0.002).</p><p><strong>Conclusions: </strong>The study demonstrated that real-time ultrasound-guided LMA-assisted PDT had shorter procedure time, reduced equipment damage, lower costs, and was associated with lower complications when compared to the bronchoscopy-guided technique. These findings suggest that ultrasound guidance can enhance the efficiency and cost-effectiveness of PDT procedures.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"197"},"PeriodicalIF":2.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972605","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":"Tuberculosis in children and adolescents using biological agents: a nationwide cohort study from Turkey.","authors":"Tugba Sismanlar Eyuboglu, Ayse Tana Aslan, Volkan Medeni, Sinem Can, Naim Ata, Mustafa Mahir Ulgu, Suayip Birinci","doi":"10.1186/s12890-025-03616-x","DOIUrl":"https://doi.org/10.1186/s12890-025-03616-x","url":null,"abstract":"<p><strong>Background: </strong>The use of biological agents in various diseases in children has been increasing and the risk of tuberculosis (TB) increases with them. We aimed to investigate the role of biological agents in children diagnosed with TB in a moderate level of TB country where TB screening is mandatory before and during biological agent treatment.</p><p><strong>Study design and methods: </strong>This was a retrospective cohort study. All patients who were 0-18 years old and diagnosed with TB-related ICD-10 in the national health database system between 2018 and 2023 were included in the study. The number of patients, demographic characteristics, treatments used by the patients, underlying diseases, and organ involvement of TB were recorded. Children using and not using biological agents were compared.</p><p><strong>Results: </strong>A total of 4351 children were diagnosed with TB, and 1.9% of them were treated with biological agents. The age of diagnosis was older (p = 0.001), and both pulmonary and extrapulmonary involvement was more frequent in children using biological agents (p = 0.001). Pulmonary involvement was more frequent in rheumatological diseases (p = 0.001), and naproxen usage was higher in children with pulmonary involvement (p = 0.014). Naproxen was found to increase the risk of pulmonary TB in children using biological agents (OR:3.824, p = 0.033).</p><p><strong>Conclusions: </strong>The low frequency of TB may be due to effective TB screening before and during the therapy. The age of diagnosis was older, pulmonary and extrapulmonary TB involvement was more common in children using biological agents, which may be related to the immunosuppressive effects. Children using biological agents who are also using naproxen should be closely followed up in terms of pulmonary TB.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"196"},"PeriodicalIF":2.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966433","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 importance of asking a thorough social history; a case report of aluminum pneumoconiosis.","authors":"Taylor Caton, Jay Pescatore, Gerard Criner","doi":"10.1186/s12890-025-03662-5","DOIUrl":"https://doi.org/10.1186/s12890-025-03662-5","url":null,"abstract":"<p><p>Aluminum induced lung disease is associated with pulmonary fibrosis, granulomatous pneumonia, and pulmonary alveolar proteinosis. Recognizing aluminum pneumoconiosis remains important as demand for aluminum production continues to rise. The case presents a 53-year-old woman with incidentally noted lung nodules and hilar lymphadenopathy on CT imaging. Despite being asymptomatic, imaging findings prompted referral to a pulmonologist with CT chest demonstrating bulky mediastinal lymphadenopathy with dominant right paratracheal mass as well as several lung nodules in the bilateral lungs. The patient underwent PET scan revealing hypermetabolic lymph nodes bilaterally in the neck, bones, mediastinum, bilateral hila, retroperitoneal lymph nodes, and spleen. Transbronchial biopsy with nodal aspiration of the mediastium revealed granulomatous inflammation. Treatment was started with prednisone 40 mg daily for presumed sarcoidosis, however she had steroid induced hyperglycemia necessitating multiple hospital admissions. This therapy was then stopped. After eliciting a detailed history, it was noted she worked for 15 years as a powder metal laborer exposed to fine aluminum dust. The case highlights a rare presentation of aluminum pneumoconiosis with diffuse systemic manifestations. Though the exact mechanism of aluminum pathogenesis that produces a sarcoid-like granulomatous reaction remains unclear, metal elements have been implicated in acting as antigens stimulating the immune system. Imaging appearance varies, and CT findings can include alveolitis, small ill-defined centrilobular opacities, lung nodules, and pulmonary fibrosis. Unfortunately, no definitive treatment exists for aluminum pneumoconiosis and limiting ongoing exposure is paramount. Periodic lung function testing and thorax imaging remain staples for monitoring disease progression. Therefore, obtaining a thorough occupational history and awareness of possible manifestations of aluminum pneumoconiosis remains essential as aluminum production and manufacturing demand increases.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"200"},"PeriodicalIF":2.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972106","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}