BMC Pulmonary Medicine最新文献

{"title":"Prevalence of genetic mutations in Alpha-1 antitrypsin in patients with difficult-to-treat asthma in Colombia.","authors":"Abraham Alí-Munive, Jaime Leonardo Chacón, Leidy Prada, Nadia Juliana Proaños, Leslie Vargas, Claudia Diaz-Bossa, Angela Giraldo, John Pedrozo-Pupo","doi":"10.1186/s12890-025-03840-5","DOIUrl":"10.1186/s12890-025-03840-5","url":null,"abstract":"<p><strong>Background: </strong>Alpha-1 antitrypsin (AAT) is a medium-sized globular glycoprotein distributed in serum and tissues. In the lungs, it inhibits serine proteases and has anti-inflammatory properties in different types of cells, protecting lung tissue from damage. Mutations in the SERPINA1 gene that codes for AAT are related to asthma and chronic obstructive pulmonary disease. In Colombia, there are no published data on the prevalence of alpha-1 antitrypsin deficiency (AATD) in adult patients with difficult-to-manage asthma. ​This study aims to determine the prevalence of genetic mutations related to AAT in adult patients with difficult-to-treat asthma in Colombia.</p><p><strong>Methods: </strong>This prospective, multicenter, cross-sectional study included adult patients with difficult-to-treat asthma in five asthma care centers in Colombia. Informed consent was obtained, and gingival mucosa was sampled for genetic diagnosis of AATD using the A1AT Genotyping Test. Data analysis was performed using the Chi² test, Student's t-test, and Mann-Whitney test for group comparison.</p><p><strong>Results: </strong>A total of 449 adult patients with difficult-to-treat asthma were included with a mean age of 56.1 ± 14.9 years; 73.1% (N = 328) were women; and 89.1% were using high-dose inhaled corticosteroid / long-acting B2 agonists. Mutations in the AAT gene were found in 12.5% (N = 56) of patients. Of these, 85.7% had the M/S genotype, 10.7% the M/Z genotype, 1.8% the M/I genotype, and 1.8% the S/S genotype.</p><p><strong>Conclusions: </strong>The study identified a prevalence of AAT mutations in 12.5% of adult patients with difficult-to-treat asthma in Colombia made up of four genotypes: M/S, M/Z, M/I and S/S.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"380"},"PeriodicalIF":2.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803526","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":"Technical evaluation of Turbuhaler^® use in children with bronchial asthma: combination of a checklist and inhalation parameters.","authors":"Lina Liang, Ruogang Huang, Yun Li, Zhufeng Wang, Kang Peng, Junfeng Lin, Feifei Huang, Xiaoyin Yao, Jinping Zheng, Yi Gao","doi":"10.1186/s12890-025-03834-3","DOIUrl":"10.1186/s12890-025-03834-3","url":null,"abstract":"<p><strong>Background: </strong>The Turbuhaler^® is a dry powder inhaler (DPI) that is commonly used in the treatment of asthmatic patients aged 5 years and above. Nevertheless, the technique of using the Turbuhaler^® in the real world remains ambiguous. This study aims to evaluate techniques in using Turbuhaler^® by combining a checklist with inhalation parameters and to investigate the association between the patient characteristics and inhaler technique.</p><p><strong>Methods: </strong>This study recruited asthmatic children aged 4 to 14 years who were using the Turbuhaler^® from The First Affiliated Hospital of Guangzhou Medical University from August 2023 to August 2024. The technique of using Turbuhaler^® was evaluated step by step, and the inhalation parameters of patients were subsequently tested. Influencing factors related to inhaler technique were analyzed by ordered logistic regression analysis.</p><p><strong>Results: </strong>Of the 141 enrolled patients, 50 (35.5%) scored 10 points on the checklist. Overall, 105 (74.4%), 28 (19.9%) and 8 (5.7%) patients performed good, moderate, and poor inhaler technique, respectively. The three common improper steps were ''exhale to residual volume'' (35.5%), \"inhale forcefully and deeply\" (13.5%), \"rinse mouth after inhalation\" (13.5%). The three common inappropriate inhalation parameters were \"Effective inspiratory time(EIT) < 2s\" (90.8%), \"Peak inspiratory flow rate(PIFR) < 60L/min\" (41.8%), and \"Breath-hold time(BHT) < 5s\" (27.0%). In the three groups with good, moderate, poor inhaler techniques, 0, 2 (7.1%), and 2 (25.0%) patients did not reach the minimum PIFR. Meanwhile, 38 (36.2%), 15 (53.6%), and 6 (75.0%) patients did not reach the optimal PIFR, respectively. The results of ordered logistic regression analysis indicated that low medication adherence (P = 0.045), PIFR (P = 0.041), BHT (P = 0.003) and the duration of Turbuhaler^® use (P = 0.009) were the primary factors influencing asthmatic children's inhaler technique.</p><p><strong>Conclusion: </strong>The improper use of inhalers and inappropriate inhalation parameters are common among asthmatic children. Using checklist and inhalation parameters enables a more comprehensive evaluation of the patients' inhalation maneuvers and inspiratory effort.</p><p><strong>Trial registration: </strong>This study is registered at Chictr.org with the identifier number ChiCTR2200056579.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"381"},"PeriodicalIF":2.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803527","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":"Incidence and prevalence of idiopathic pulmonary fibrosis: a systematic literature review and meta-analysis.","authors":"Negar Golchin, Aditya Patel, Julia Scheuring, Victoria Wan, Kimberly Hofer, Jean-Paul Collet, Brandon Elpers, Tamara Lesperance","doi":"10.1186/s12890-025-03836-1","DOIUrl":"10.1186/s12890-025-03836-1","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a progressive and serious lung disease with a poor prognosis and severe clinical and humanistic burden. This systematic literature review and meta-analysis aimed to summarize and quantify the data on IPF incidence and prevalence among adults within the general population and to compare regional differences.</p><p><strong>Methods: </strong>Comprehensive searches of MEDLINE^®, Embase, and the Cochrane Database of Systematic Reviews were conducted to capture available studies published in English from January 1, 2000, to November 7, 2023, that reported on the incidence or prevalence of IPF. Pooled weighted-mean incidence and prevalence estimates were calculated from studies reporting adequate epidemiological data using a DerSimonian-and-Laird random-effects model.</p><p><strong>Results: </strong>Of 4,077 records identified, 26 studies were included in the meta-analysis (17 reported both prevalence and incidence, 6 reported incidence only, 3 reported prevalence only). Most studies were retrospective, with study periods ranging from 1984 to 2021. Pooled global incidence per 100,000 (95% confidence interval) was 5.8 (4.8, 6.8; 23 studies). Pooled incidence in Asia was 4.4 (1.6, 7.2; 5 studies), 5.1 (3.9, 6.3; 13 studies) in Europe, and 9.0 (6.9, 11.1; 5 studies) in North America. Pooled prevalence (per 100,000) was 17.7 (14.0, 21.5; 20 studies) globally, 14.8 (7.1, 22.6; 6 studies) in Asia, 14.6 (9.4, 19.7; 9 studies) in Europe, and 27.2 (21.0, 33.4; 6 studies) in North America.</p><p><strong>Conclusion: </strong>This analysis confirms that IPF is a rare condition globally, but substantial heterogeneity exists across studies. Incidence and prevalence were notably high in North America compared with Europe and Asia. This finding may be explained by the use of selective source populations in North American studies, in contrast to the more general populations used in European or Asian studies. Additional contributing factors include variations in case identification algorithms, differences in diagnostic definitions and regional differences in occupational and environmental exposures. While recent multi-societal guidelines have advanced the standardization of the IPF diagnostic process, variability in clinical practice remains a challenge that affects comparisons of incidence and prevalence across regions and over time.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"378"},"PeriodicalIF":2.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798091","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 oxygen debt (DEOx) variability over time and clinical outcomes in critically ill COVID-19 patients: an observational study.","authors":"Eduardo Tuta-Quintero, Alirio Bastidas-Goyes, Henry Robayo-Amortegui, Michel Pérez-Garzón, Isacio Serna-Palacios, Cristian Peña-Quimbayo, Julian Espitia, Daniel Pinto, Johan Rincón, Juan Sánchez, Jesus Pérez","doi":"10.1186/s12890-025-03858-9","DOIUrl":"10.1186/s12890-025-03858-9","url":null,"abstract":"<p><strong>Background: </strong>Oxygen debt (DEOx) quantifies oxygen deficit during shock, reflecting the transition to anaerobic metabolism due to decreased oxygen delivery (DO₂). This study aimed to analyze the temporal variation of DEOx values and their association with invasive mechanical ventilation (IMV) requirement and survival in patients with severe COVID-19.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including adult patients admitted to the ICU with confirmed SARS-CoV-2 infection at Clínica Universidad de La Sabana (Colombia) between July 2020 and December 2021. DEOx was calculated using two validated formulas: one based on lactate (DEOx1) and another incorporating lactate and base excess (DEOx2). Variability in DEOx was assessed at different time points (≤6h, 6-12h, 12-24h, >24h) and its association with IMV and survival outcomes was analyzed.</p><p><strong>Results: </strong>A total of 597 patients were included, of whom 150 (25.1%) died. DEOx1 within 6 hours was -6.87 (SD: 23.72) in patients requiring IMV by day 7, compared to -1.2 (SD: 7.83) in patients without IMV (p=0.004). DEOx2 within 6 hours on day 7 was -7.92 (SD: 30.7) vs. -1.57 (SD: 14.65) (p=0.027), and between 6 and 12 hours, it was 1.24 (SD: 14.92) vs. -3.54 (SD: 9.34) (p<0.001). 24 hours (SD: 36.09) in deceased patients on day 7, compared to -2.09 (SD: 14.26) in survivors (p<0.001). Between 6 and 12 hours, DEOx1 was 0.51 (SD: 11.49) vs.-2.27 (SD: 12.32) (p=0.016). At more than 24 hours, it was 3.21 (SD: 9.22) vs. -3.8 (SD: 20.91) (p<0.001). Similar trends were observed on days 14 and 28. DEOx2 within 6 hours on day 7 was -19.02 (SD: 35.3) vs. -1.36 (SD: 14.31) (p<0.001), and between 6 and 12 hours, it was 7.57 (SD: 18.78) vs. -1.94 (SD: 11.73) (p<0.001). At more than 24 hours, it was 2.6 (SD: 10.75) vs. -4.54 (SD: 17.26) (p<0.001). This pattern persisted on days 14 and 28.</p><p><strong>Conclusion: </strong>DEOx variability in critically ill COVID-19 patients was significantly associated with IMV need and mortality. Higher DEOx values at ≤6h and persistent metabolic derangement beyond 24h correlated with worse outcomes.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"379"},"PeriodicalIF":2.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798090","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":"Difference in efficacy between pulmonary endarterectomy and balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension.","authors":"Kenichi Yanaka, Kazuhiko Nakayama, Yu Taniguchi, Hiroyuki Onishi, Yoichiro Matsuoka, Hidekazu Nakai, Kenji Okada, Toshiro Shinke, Noriaki Emoto, Ken-Ichi Hirata","doi":"10.1186/s12890-025-03741-7","DOIUrl":"10.1186/s12890-025-03741-7","url":null,"abstract":"<p><strong>Background: </strong>Both pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA) can be considered for the invasive treatment of chronic thromboembolic pulmonary hypertension (CTEPH). However, the technique applied to treat pulmonary vessels differs between PEA and BPA. While PEA removes lesions with thickened intima and organized thrombus, BPA improves pulmonary arterial flow by dilating stenosis and obstruction without removing the lesions. There have been limited reports on the differential efficacy between PEA and BPA. This study aimed to compare the baseline characteristics and efficacy of both treatments in CTEPH.</p><p><strong>Methods: </strong>Between November 2001 and May 2019, 55 patients underwent PEA and 77 had only BPA performed. We evaluated clinical parameters before performing PEA and BPA, and on follow-up.</p><p><strong>Results: </strong>The patients who underwent BPA were older and had fewer proximal lesions and milder pulmonary hemodynamics compared with those who underwent PEA (mean pulmonary arterial pressure: 34.0 ± 8.6 vs. 43.0 ± 9.9 mm Hg, p < 0.001). Although both groups showed improvement in most of their clinical data, cardiac index was not improved by BPA as opposed to PEA (2.5 ± 0.6 to 2.5 ± 0.6 L/min/m², p = 0.99, 2.0 ± 0.6 to 2.6 ± 0.8 L/min/m², p < 0.001, respectively). Furthermore, RC (resistance-compliance) time was significantly decreased by PEA (0.54 ± 0.16 to 0.45 ± 0.12 s, p < 0.001), but unchanged by BPA (0.54 ± 0.16 to 0.51 ± 0.13 s, p = 0.21).</p><p><strong>Conclusions: </strong>BPA did not change RC time and cardiac index, while PEA reduced RC time and improved cardiac index. The technical approach of removing intra-vascular organized thrombi and thickened intima by PEA could have a more profound impact on pulmonary circulation and cardiac function improvements compared with BPA.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"376"},"PeriodicalIF":2.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793490","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":"Validation of the Distress Thermometer for detecting psychological distress in patients with stable chronic obstructive pulmonary disease: optimal cut-off score and influencing factors.","authors":"Xu Tian, Xiaoling Liu, Xiuni Gan, Maria F Jimenez-Herrera, Hongcai Shang, Yi Ren","doi":"10.1186/s12890-025-03864-x","DOIUrl":"10.1186/s12890-025-03864-x","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic obstructive pulmonary disease (COPD) are at high risk for psychological distress, yet validated screening tools are not routinely used in clinical practice. The Distress Thermometer (DT), originally developed for cancer patients, is a brief screening tool for detecting psychological distress. However, the optimal cut-off in COPD patients remains unclear.</p><p><strong>Aim: </strong>This study aims to validate the DT for use in stable COPD patients and to explore factors influencing psychological distress.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving 386 stable COPD patients. Data were collected using sociodemographic questionnaires, the DT, and the Hospital Anxiety and Depression scale (HADS). Receiver Operating Characteristics (ROC) analysis was employed to determine the predictive metrics of various DT cut-off scores compared to the HADS. Bivariate binary logistic regression was used to identify factors influencing psychological distress.</p><p><strong>Clinical trial number: </strong>This cross-sectional survey study did not involve experimental interventions and therefore did not require registration in a clinical trials platform. However, the study protocol can be retrieved from https://doi.org/10.17605/OSF.IO/C3N79 .</p><p><strong>Results: </strong>The mean DT reported by patients was 3.77, while the mean total HADS score was 29.68. The DT score showed a high correlation with the total HADS score (r = 0.640). An optimal DT cut-off score of ≥ 5 was identified, yielding a Youden index of 0.815, with sensitivity and specificity of 97.40% and 84.14%, respectively. Using this cut-off score, the incidence of significant psychological distress was found to be 32.1%. Risk factors for psychological distress included gender, number of children, educational level, frequency of exercise, GOLD degree, and number of acute exacerbations.</p><p><strong>Conclusions: </strong>The DT is a valid screening tool for identifying psychological distress among COPD patients. With an optimal cut-off score of ≥ 5, the DT offers high sensitivity and specificity, making it a reliable measure for clinical use. This study also highlights significant factors contributing to psychological distress, emphasizing the importance of integrating routine psychological assessments and care into the routine management of COPD to improve patient outcomes.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"377"},"PeriodicalIF":2.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793429","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":"Venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre-existing stenosis in an adult patient: a case report.","authors":"Xiao Song, Jian Wang, Liang Zong, Hui Jiang, Di Shi, Huadong Zhu","doi":"10.1186/s12890-025-03851-2","DOIUrl":"10.1186/s12890-025-03851-2","url":null,"abstract":"<p><strong>Background: </strong>The use of venovenous extracorporeal membrane oxygenation (VV ECMO) for severe adult respiratory failure is rapidly increasing worldwide. To date, no studies have documented early-onset superior vena cava (SVC) stenosis caused solely by ECMO cannula placement in adults without pre-existing anatomical abnormalities, leading to SVC syndrome.</p><p><strong>Case presentation: </strong>We report the first case of SVC syndrome in an adult patient with pre-existing SVC angulation, exacerbated by cannula placement during VV ECMO therapy. Serial venous-phase chest CT scans (pre-ECMO and during ECMO support) demonstrated progressive luminal narrowing at the cannula tip site, correlating with clinical manifestations of SVC obstruction. The patient was successfully weaned from VV ECMO, achieved complete resolution of SVC syndrome symptoms, and was discharged without neurological sequelae.</p><p><strong>Conclusions: </strong>This case provides definitive imaging evidence that ECMO cannula placement alone can induce acute SVC stenosis in patients with pre-existing vascular tortuosity. Our findings strongly advocate for pre-procedural vascular imaging assessment and real-time monitoring during ECMO support to mitigate this life-threatening complication.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"375"},"PeriodicalIF":2.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793430","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 poly (ADP-ribose) polymerase inhibitor olaparib attenuates established pulmonary fibrosis in a large animal model.","authors":"Habtamu B Derseh, Andrew N Davies, Alarna Young, Sylvie Bischof, Joseph Pelle, David Rudd, Michelle McIntosh, David Piedrafita, Robert J Bischof","doi":"10.1186/s12890-025-03803-w","DOIUrl":"10.1186/s12890-025-03803-w","url":null,"abstract":"","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"374"},"PeriodicalIF":2.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788291","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":"Rapid, season-specific PCR testing versus traditional diagnostics for pneumonia in the emergency department.","authors":"Yangxiu Yu, Qiuping Li","doi":"10.1186/s12890-025-03843-2","DOIUrl":"10.1186/s12890-025-03843-2","url":null,"abstract":"<p><strong>Background: </strong>Traditional culture-based diagnostics for emergency-department (ED) pneumonia are slow and season-agnostic, delaying targeted therapy. We evaluated whether season-tailored multiplex PCR panels accelerate pathogen identification and improve antibiotic stewardship.</p><p><strong>Methods: </strong>In a single-center, prospective study, adults with radiographically confirmed pneumonia were enrolled consecutively and allocated by a rotating week-on/week-off schedule to either a seasonal PCR panel or conventional diagnostics. Primary outcomes were (i) time to final pathogen report and (ii) diagnostic yield (≥ 1 pathogen detected). Secondary outcomes included empiric-antibiotic appropriateness within 24 h, regimen changes ≤ 72 h, antibiotic duration, length of stay (LOS) and 30-day mortality.</p><p><strong>Results: </strong>Among 282 analyzable patients (spring = 140; autumn-winter = 142), PCR slashed turnaround time from 48 h to 12 h in spring and from 50 h to 14 h in autumn-winter (median difference - 36 h, 95% CI: - 42 to - 30; p < 0.001). Diagnostic yield rose from 61.6 to 80.6% in spring and from 56.8 to 80.0% in winter (risk differences 19.0 pp and 22.3 pp, respectively; both p < 0.01). In the winter cohort, guideline-concordant empiric therapy increased (78.7% vs. 64.9%; +13.8 pp) and antibiotic changes ≤ 72 h fell (14.7% vs. 28.4%; - 13.7 pp). Mean antibiotic courses shortened by 1.5-1.7 days across seasons, while LOS showed a non-significant 1-2-day reduction. Thirty-day mortality did not differ. Effects were consistent in older adults (≥ 65 y) and patients with COPD.</p><p><strong>Conclusions: </strong>Locally adapted, season-specific multiplex PCR panels deliver near-four-fold faster, higher-yield pathogen detection and support measurable stewardship gains without compromising safety. Implementation in other settings should consider local pathogen seasonality, workflow, and cost structures.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"372"},"PeriodicalIF":2.8,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum metabolomics in pulmonary sarcoidosis: metabolic signatures across prognoses.","authors":"Dafu Zhu, Jianglong Chen, Li Zhang, Hongxu Li, Jingyi Wang, Jiacui Song, Dong Weng, Pengcheng Zhang, Qiuhong Li, Yuan Zhang, Mengmeng Zhao","doi":"10.1186/s12890-025-03863-y","DOIUrl":"10.1186/s12890-025-03863-y","url":null,"abstract":"<p><strong>Background: </strong>Sarcoidosis is a systemic inflammatory disease, primarily affecting the lungs, with a prognosis that varies widely among patients. While some patients recover spontaneously after diagnosis, others experience disease progression. Currently, the metabolomic profile associated with pulmonary sarcoidosis and its different clinical outcomes remains poorly understood.</p><p><strong>Methods: </strong>Serum samples from 29 pulmonary sarcoidosis patients and 10 healthy controls were analyzed using untargeted UPLC-MS/MS metabolomics. Univariate and multivariate analyses identified differentially expressed metabolites, followed by pathway enrichment to evaluate their biological relevance. Patients were further stratified into self-healing (n = 11) and progressive (n = 18) subgroups based on prognosis. Differential metabolites between subgroups were compared, potential biomarkers were selected, and their diagnostic performance assessed. Correlations with clinical parameters were also analyzed to explore associations with disease progression.</p><p><strong>Results: </strong>Sarcoidosis patients showed distinct serum metabolic profiles compared to healthy controls, with 10 upregulated and 199 downregulated metabolites. Pathway analysis indicated enrichment in amino acid, lipid, and immune-related pathways. Between prognostic subgroups, 25 differential metabolites were identified. Uric acid, testosterone sulfate, allopregnanolone sulfate, and 24,25-dihydroxyvitamin D₃ emerged as key metabolites with prognostic value and moderate correlations with clinical parameters.</p><p><strong>Conclusions: </strong>This study highlights distinct serum metabolic profiles associated with sarcoidosis prognosis, suggesting that specific metabolic alterations may aid in monitoring and predicting disease outcomes. These findings offer a foundation for future research into personalized treatment and management strategies.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"373"},"PeriodicalIF":2.8,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768413","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}