BMC Pulmonary Medicine最新文献

{"title":"Evaluation of comparative efficacy of Umeclidinium/Vilanterol versus other bronchodilators in the management of chronic obstructive pulmonary disease: a systematic review and meta-analysis of RCTs.","authors":"He Zhu, Jiahui Lei, Fan Gao, Yingjie Guo, Limin Zhao","doi":"10.1186/s12890-024-03445-4","DOIUrl":"10.1186/s12890-024-03445-4","url":null,"abstract":"<p><strong>Background: </strong>UMEC/VI administered via a combination inhaler is associated with a clinically significant improvement in lung function and health-related quality of life in patients with mild-to-moderate COPD. However, their efficacy compared to other bronchodilator mono or dual therapies still remains unclear.</p><p><strong>Objective: </strong>The objective of this research was to evaluate the therapeutic efficacy of UMEC/VI dual and UMEC/VI/FF triple therapies versus alternative bronchodilator regimens in COPD patients.</p><p><strong>Methods: </strong>A systematic search was conducted using four electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) to select publications published in peer-reviewed journals written in English. The odds ratio (OR) and risk ratio (RR) was calculated, along with their 95% confidence intervals. We assessed heterogeneity using Cochrane Q and I [2] statistics and the appropriate p-value. The analysis used RevMan 5.4.</p><p><strong>Results: </strong>The current meta-analysis includes 31,814 COPD patients from 17 RCTs. The meta-analysis results demonstrate that the combination of LABA and LAMA provides additive bronchodilation and improved lung function in COPD patients. We found that UMEC/VI dual therapy significantly improved FEV1 (OR 1.98 [95% CI 1.70-2.30]), TDI values (OR 1.97 [95% CI 1.72-2.26]), and reduced SGRQ total scores (OR 1.99 [95% CI 1.71-2.32]), with fewer drug-related adverse events (RR 0.58 [95% CI 0.53-0.64]). Similarly, UMEC/VI/FF triple therapy also showed similar benefits, with significant improvements in FEV1 (OR 1.93 [95% CI 1.73-2.15]), TDI values (OR 2.37 [95% CI 2.15-2.61]), and reduced SGRQ total scores (OR 1.83 [95% CI 1.63-2.05]), and fewer drug-related adverse events (RR 0.53 [95% CI 0.49-0.58]).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis concludes that UMEC and VI combinations are an efficacious treatment option for symptomatic COPD patients.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"609"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852818","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 extracellular CIRP as a predictive marker for the endothelial dysfunction in chronic obstructive pulmonary disease combined with pulmonary hypertension.","authors":"Yun Yao, Haibo Jiang, Dalin Xu, Bing Zhang, Feng Yao, Wei Guo","doi":"10.1186/s12890-024-03416-9","DOIUrl":"10.1186/s12890-024-03416-9","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) is a serious complication of chronic obstructive pulmonary disease (COPD), distinguished by pulmonary endothelial dysfunction. The extracellular cold-inducible RNA-binding protein (eCIRP) is a damage-associated molecular pattern (DAMP) that triggers inflammation and causes vascular endothelial dysfunction in COPD-PH.</p><p><strong>Methods: </strong>The expression levels of CIRP were compared in peripheral lung tissues among 40 individuals. Moreover, A prospective analysis was conducted on serum levels of eCIRP, interleukin (IL) 1β, IL-33, endothelin-1 (ET-1), and nitric oxide (NO) in 150 COPD patients and 50 healthy control individuals at Jiangsu Taizhou Peoples Hospital. The study aimed to compare these serum levels and correlations among COPD-PH group, COPD non-PH group and the normal group.</p><p><strong>Results: </strong>We found higher CIRP levels in COPD-PH compared to COPD non-PH and the normal in lung tissue samples. A prospective analysis showed higher serum levels of eCIRP, IL-1β, IL-33, and ET 1 in COPD-PH, while a noticeable reduction in NO levels. There exists a correlation between the severity of COPD-PH and elevated levels of eCIRP, proinflammatory cytokines like IL-1β and IL-33, along with indicators of endothelial dysfunction like endothelin-1 ET-1 and NO. Moreover, the serum eCIRP level demonstrated a notable positive correlation with the levels of IL-1β, IL-33, PCT, and ET-1, while displaying a negative correlation with NO and Peripheral Oxygen Saturation (SpO₂). Moreover, the serum eCIRP level demonstrated a notable positive correlation with the levels of IL-1β, IL-33, PCT, and ET-1, while displaying a negative correlation with NO and SpO₂. Moreover, an assessment of independent risk factors for COPD-PH with ROC curve analysis, gauged the predictive value of serum eCIRP, IL-1β, IL-33, ET-1, and NO levels in diagnosing COPD-PH. Elevated eCIRP, IL-33, and ET-1 levels significantly correlated with COPD-PH, highlighting eCIRP's strong predictive value for this condition.</p><p><strong>Conclusion: </strong>eCIRP levels could serve as a valuable biomarker for predicting endothelial dysfunction in COPD-PH.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"615"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852822","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 predictive effects of adiponectin and irisin hormones on diagnosis and clinical involvement of Sarcoidosis.","authors":"Huseyin Kaya, Hasim Boyaci, Serap Argun Baris, Ilknur Basyigit, Ozgur Doga Ozsoy, Hala Maral Kir","doi":"10.1186/s12890-024-03412-z","DOIUrl":"10.1186/s12890-024-03412-z","url":null,"abstract":"<p><strong>Background: </strong>Sarcoidosis is a chronic disease of unknown etiology characterised by systemic non-caseating granulomas that can affect any organ in the body, especially the lungs and in which genetic and environmental factors are thought to play a role in its pathophysiology. Adipokines and myokines secreted from adipose and muscle tissue play a role in the pathogenesis or protection against many inflammatory and autoimmune diseases in which inflammation and immunity form the basis. In our study, we aimed to investigate the role of the irisin and adiponectin in sarcoidosis.</p><p><strong>Methods: </strong>The study included 90 sarcoidosis patients and 86 healthy subjects. Adiponectin and irisin levels were analysed in addition to standard tests for diagnosis and follow-up of patients with sarcoidosis. The sensitivity and specificity of serum irisin levels for the diagnosis of sarcoidosis were evaluate dusing ROC analysis.</p><p><strong>Results: </strong>Irisin levels were significantly lower in the patient group than in the control group (3.28-5.25, p < 0.001). There was no association between irisin levels and extrapulmonary involvement. The cut-off irisin value for the diagnosis of sarcoidosis was ≤ 4.2662 with 95% confidence interval, and the sensitivity and specificity were calculated as 84% and 55.8%, respectively.</p><p><strong>Conclusions: </strong>To our knowledge, this is the first study to investigate irisin in sarcoidosis patients. Based on the available evidence, anti-inflammatory, anti-oxidant and anti-apoptocic effects of irisin may play a role in the pathophysiology of sarcoidosis. Although no significant difference was found in our study, we believe that a comprehensive evaluation of adiponectin in sarcoidosis is important.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"623"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852823","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":"Analysis of the correlations and inconsistencies between spirometry and impulse oscillometry in the diagnosis of small-airway dysfunction.","authors":"Ting Mou, Yujiao Wang, Yufen Fu, Yuxin Wang, Guoping Li","doi":"10.1186/s12890-024-03420-z","DOIUrl":"10.1186/s12890-024-03420-z","url":null,"abstract":"<p><strong>Objective: </strong>Currently, there has been no gold standard for diagnosing small airway dysfunction (SAdf). This study aimed to evaluate the correlation between small airway parameters derived from spirometry and oscillometry in hospitalized patients, assessing the potential of oscillometry as an alternative diagnostic tool for SAdf. Additionally, this study explored the inconsistencies and influencing factors related to spirometry and oscillometry in diagnosing SAdf, conducting a preliminary assessment of these factors.</p><p><strong>Methods: </strong>A retrospective study was conducted involving data collection from patients who underwent both spirometry and oscillometry between June 1, 2022, and September 1, 2023, at Chengdu Third People's Hospital was conducted. Initially, 1,771 patients were considered, with 1,446 meeting the inclusion and exclusion criteria. The clinical characteristics and correlations between small airway parameters from the two methods were analyzed based on different lung function data groups. Besides, this study explored the inconsistency between the two pulmonary function tests in diagnosing SAdf in hospitalized patients. Multivariate logistic regression was employed to investigate the factors contributing to these inconsistencies.</p><p><strong>Results: </strong>Significant correlations were identified between parameters (reactance area [AX], resonant frequency [Fres], reactance at 5 Hz [X5], difference between resistance at 5 Hz and R20 [R5-R20]) and the forced expiratory flow (FEF) metrics (FEF25%-75%, FEF50%, and FEF75%). Among these, AX showed the strongest correlation, regardless of the severity of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and the FEV1/FVC ratio. Diagnostic inconsistencies were influenced by factors such as sex, body mass index (BMI), and sputum production. Females, individuals with a high BMI, and those with less sputum were linked to oscillometry-only SAdf, while males, individuals with alow BMI, and those with more sputum were linked to spirometry-only SAdf.</p><p><strong>Conclusion: </strong>In hospitalized patients, oscillometry could serve as an effective alternative or complement to spirometry for diagnosing SAdf. A greater degree of lung function impairment was correlated with small airway parameters between the two tests. The oscillometry might detect SAdf more sensitively in patients with normal pulmonary function as measured by spirometry. Ultimately, we recommend the combined use of spirometry and oscillometry in hospitalized patients based on its comprehensive assessment of small airway function and potential in timely intervention.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"619"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852801","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":"Prevalence and clinical features of interstitial lung disease in patients with psoriasis.","authors":"Nobuhiro Kanaji, Noriyuki Misaki, Makiko Murota, Masashi Iwata, Ryou Ishikawa, Kentaro Yamamura, Hisamu Tanaka, Naoya Yokota, Shuusuke Fujimoto, Toshiki Yajima, Hiroaki Dobashi, Hiromi Shimada, Risa Wakiya, Naoki Watanabe, Takuya Inoue, Hitoshi Mizoguchi, Yuta Komori, Kazuki Kojima, Norimitsu Kadowaki, Teruki Dainichi","doi":"10.1186/s12890-024-03450-7","DOIUrl":"10.1186/s12890-024-03450-7","url":null,"abstract":"<p><strong>Background: </strong>Despite the autoimmune nature of psoriasis, the potential association between psoriasis and interstitial lung disease (ILD) remains underexplored. This study aimed to investigate the frequency and clinical features of ILD in patients with psoriasis and propose a new conceptual framework of \"ILD associated with psoriasis\".</p><p><strong>Methods: </strong>A retrospective analysis of 117 patients with psoriasis was conducted, excluding those without chest imaging prior to methotrexate or biologic use and those with other comorbidities leading to ILD.</p><p><strong>Results: </strong>ILD was identified in 12 (10%) patients with psoriasis; 6/50 with psoriasis vulgaris and 6/65 with psoriatic arthritis. Three of 12 patients had no history of smoking. Serum Krebs von den Lungen-6 (KL-6) levels were elevated in patients with ILD compared to those in patients without ILD. The indeterminate for usual interstitial pneumonia (UIP) pattern was the most prevalent CT finding. A lung biopsy specimen from a representative case revealed equivalent indeterminate for UIP. Over a median 8.9-year observation period, ILD progressed in only 5 patients, with no cases of respiratory failure or death due to ILD progression, suggesting generally favourable prognoses.</p><p><strong>Conclusions: </strong>ILD associated with psoriasis would be present, and its frequency is 10% of patients with psoriasis. We propose that chest radiography and a serum KL-6 test at the initial diagnosis of psoriasis would be useful in screening for the detection of ILD. We also recommend that a physician diagnosing ILD should carefully examine the skin findings, considering if psoriasis could be associated with ILD.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"610"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852584","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":"Bortezomib induces Rho-dependent hyperpermeability of endothelial cells synergistically with inflammatory mediators.","authors":"Shunichi Nishima, Takeru Kashiwada, Yoshinobu Saito, Shinya Yuge, Tomohiro Ishii, Kuniko Matsuda, Koichiro Kamio, Masahiro Seike, Shigetomo Fukuhara, Akihiko Gemma","doi":"10.1186/s12890-024-03387-x","DOIUrl":"10.1186/s12890-024-03387-x","url":null,"abstract":"<p><strong>Background: </strong>Bortezomib (BTZ), a selective 26 S proteasome inhibitor, is clinically useful in treating multiple myeloma and mantle cell lymphoma. BTZ exerts its antitumor effect by suppressing nuclear factor-B in myeloma cells, promoting endothelial cell apoptosis, and inhibiting angiogenesis. Despite its success, pulmonary complications, such as capillary leak syndrome of the vascular hyperpermeability type, were reported prior to its approval. Although the incidence of these complications has decreased with the use of steroids, the underlying mechanism remains unclear. This study aims to investigate how BTZ influences endothelial cell permeability.</p><p><strong>Methods: </strong>We examined the impact of BTZ on vascular endothelial cells, focusing on its effects on RhoA and RhoC proteins. Stress fiber formation, a known indicator of increased permeability, was assessed through the Rho/ROCK pathway.</p><p><strong>Results: </strong>BTZ was found to elevate the protein levels of RhoA and RhoC in vascular endothelial cells, leading to stress fiber formation via the Rho/ROCK pathway. This process resulted in enhanced vascular permeability in a Rho-dependent manner. Furthermore, the stress fiber formation induced by BTZ had synergistic effects with the inflammatory mediator histamine.</p><p><strong>Conclusions: </strong>Our findings suggest that BTZ accumulates RhoA and RhoC proteins in endothelial cells, amplifying the inflammatory mediator-induced increase in the active GTP-bound state of Rho, thereby exaggerating vascular permeability during pulmonary inflammation. This study provides novel insights into the molecular mechanism underlying the pulmonary complications of BTZ, suggesting that BTZ may enhance inflammatory responses in pulmonary endothelial cells by increasing RhoA and RhoC protein levels.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"617"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852804","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":"High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients undergoing bronchoscopy: a retrospective study.","authors":"Xiaohui Luo, Fei Xiang","doi":"10.1186/s12890-024-03440-9","DOIUrl":"10.1186/s12890-024-03440-9","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing bronchoscopy, particularly those with pre-existing hypoxemia, face a significant risk of further deterioration in their oxygen saturation levels. This heightened risk necessitates the provision of supplemental oxygen therapy throughout the procedure, rendering it mandatory. High-flow nasal cannula (HFNC) has been widely employed in the management of hypoxemic acute respiratory failure (ARF) in adults. Based on this, HFNC has been used in endoscopic procedures, but there are still few studies on HFNC in fiberoptic bronchoscopy (FOB) patients. The purpose of this study was to evaluate the comparative efficacy of HFNC with nasal cannula oxygen in maintaining adequate oxygen saturation during fiberoptic bronchoscopy in patients with pre-existing hypoxemia.</p><p><strong>Methods: </strong>We retrospectively investigated 232 patients with hypoxemia who underwent bronchoscopy between January 2018 to August 2023 who received either HFNC or nasal cannula oxygen supplementation. The control group received nasal cannula oxygen, and the observation group received HFNC. The changes of oxygen saturation, heart rate, blood pressure and adverse events during the operation were compared between the two groups.</p><p><strong>Results: </strong>The patients were divided into the HFNC (n = 78) and nasal cannula oxygen (n = 154) groups. During FOB, although the lowest oxygen saturation (SpO₂) was similar in both groups (intraoperative minimum SpO₂ was defined as the lowest value of SpO₂ occurring between the start of anesthesia and the end of the operation), the occurrence of the lowest SpO₂ < 90% was significantly lower in the HFNC group (3.8% vs. 17.5%, p = 0.003). No serious complications were reported in either group, however, the overall incidence of general adverse events was 7.7% and 20.1% in the HFNC and conventional oxygen therapy (COT) groups, respectively (p = 0.015). Multifactorial analysis showed that higher arterial partial pressure of oxygen versus the fraction of inspired oxygen (PaO₂/FiO₂; P/F) was a protective factor against desaturation events (p = 0.032, OR = 0.990, 95% CI: 0.982-0.999). In patients with baseline PaO₂/FiO₂ ≥ 200 mmHg, the HFNC group exhibited smoother vital sign changes from pre-procedure to the end of bronchoscopy, although there were no significant differences between the two groups regarding the rates of deoxygenation events as well as adverse events.</p><p><strong>Conclusion: </strong>The use of HFNC therapy can effectively reduce the incidence of SpO₂ < 90% during bronchoscopy in patients with hypoxemia. Additionally, HFNC significantly reduces the overall incidence of adverse events compared to COT. In patients with milder hypoxemia, its advantages in maintaining operational stability during bronchoscopy should not be overlooked.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"614"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852819","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 implications of the SERPINA1 variant, M_Palermo, and alpha-1 antitrypsin deficiency in Türkiye.","authors":"Dilek Karadoğan, Bettina Dreger, Lourdes Osaba, Enes Ahmetoğlu, Songül Özyurt, Bilge Yılmaz Kara, Nur Hürsoy, Tahsin Gökhan Telatar, Ünal Şahin","doi":"10.1186/s12890-024-03421-y","DOIUrl":"10.1186/s12890-024-03421-y","url":null,"abstract":"<p><strong>Background: </strong>Alpha-1 antitrypsin deficiency (AATD) is associated with increased susceptibility to chronic obstructive pulmonary disease (COPD). AATD results from mutations in the SERPINA1 gene and over 500 rare mutations have been identified. Despite these findings and recommendations from major healthcare organizations, testing of COPD patients and their family members for AATD remains inadequate.</p><p><strong>Methods: </strong>We examined genotypes and clinical characteristics of COPD patients (index cases; n = 14) treated at Recep Tayyip Erdoğan University Chest Diseases Department and their relatives (n = 17).</p><p><strong>Results: </strong>When index cases were compared with screened relatives positive for AATD (n = 14), index cases were older and more predominantly male than screened relatives. Both groups had extensive smoking histories. All of the index cases and one of the screened relatives had been diagnosed with COPD. Clinical characterization of the COPD cases (14 index cases; 1 screened relative) showed that they had moderate to severe COPD with pre-treatment AAT levels of 0.59 ± 0.40 g/L (mean ± SD) and a COPD Assessment Test (CAT) score of 16.0 ± 8.12. The majority of these patients (73.3%) had panlobular emphysema. Five of the patients were treated with AAT augmentation which led to a decrease in the number of COPD exacerbations. Genotyping revealed that the most common rare allele identified in this population was M_Palermo (c.227_229delTCT mutation on the M1(Val²¹³) allelic background).</p><p><strong>Conclusions: </strong>More testing and research need to be done to identify the relative prevalence of rare AATD variants. Earlier identification could lead to more effective treatment of affected individuals and improvement in their quality of life.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"622"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for readmission within one year after acute exacerbations of bronchiectasis in a Chinese tertiary hospital: a retrospective cohort study.","authors":"Yaxin Fan, Ben Su, Huiyong Zhang, Xiaoyu Yang, Zhengyi Zhang, Shaoyan Zhang, Shunxian Zhang, Dingzhong Wu, Peiyong Zheng, Zhenhui Lu, Lei Qiu","doi":"10.1186/s12890-024-03402-1","DOIUrl":"10.1186/s12890-024-03402-1","url":null,"abstract":"<p><strong>Background: </strong>Frequent exacerbations of bronchiectasis lead to poor quality of life, impaired lung function, and higher mortality rates. This study aims to evaluate the risk factors associated with readmission within one year due to acute exacerbation of bronchiectasis (AEB).</p><p><strong>Methods: </strong>A retrospective cohort study was performed on 260 patients with bronchiectasis who were hospitalized in the respiratory and critical care department of a tertiary hospital in China. Univariate and multivariate Cox analyses were used to evaluate the risk factors for readmission within one year.</p><p><strong>Results: </strong>Readmission within one year was found in 44.6% of 260 patients hospitalized with acute exacerbation of bronchiectasis. The risk factors associated with readmission included age over 65 years (HR = 3.66; 95% CI: 2.30 to 5.85), BMI < 18.5 kg/m² (HR = 1.71; 95% CI: 1.16 to 2.51), respiratory intensive care unit (RICU) stay during admission (HR = 2.06, 95% CI: 1.16-3.67), involvement of 3 or more lobes on chest high-resolution computed tomography (HRCT) (HR = 1.85; 95% CI, 1.22 to 2.80), chronic Pseudomonas aeruginosa (PA) colonization (HR = 2.29; 95% CI: 1.54 to 3.38), and positive sputum culture results within 24 h after admission (HR = 1.93; 95% CI: 1.27 to 2.94). Long-term oral antibiotics use after discharge was associated with decreased hazard of readmission (HR = 0.34; 95% CI: 0.20 to 0.59).</p><p><strong>Conclusions: </strong>Patients with bronchiectasis have a high rate of readmission, which is linked to varieties of risk factors, and identifying these risk factors is importance for effectively managing patients with bronchiectasis.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"616"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852820","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":"Integrating genetic and clinical data to predict lung cancer in patients with chronic obstructive pulmonary disease.","authors":"Zhan Gu, Yonghui Wu, Fengzhi Yu, Jijia Sun, Lixin Wang","doi":"10.1186/s12890-024-03444-5","DOIUrl":"10.1186/s12890-024-03444-5","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is closely linked to lung cancer (LC) development. The aim of this study is to identify the genetic and clinical risk factors for LC risk in COPD, according to which the prediction model for LC in COPD was constructed.</p><p><strong>Methods: </strong>This is a case-control study in which patientis with COPD + LC as the case group, patientis with only COPD as the control group, and patientis with only LC as the second control group. A panel of clinical variables including demographic, environmental and lifestyle factors were collected. A total of 20 single nucleotide polymorphisms (SNPs) were genotyped. The univariate analysis, candidate gene study and multivariate analysis were applied to identify the independent risk factors, as well as the prediction model was constructed. The ROC analysis was used to evaluate the predictive ability of the model.</p><p><strong>Results: </strong>A total of 503 patients were finally enrolled in this study, with 188 patients for COPD + LC group, 162 patients for COPD group and 153 patients for LC group. The univariate analysis of clincial data showed compared with the patients with COPD, the patients with COPD + LC tended to have significantly lower BMI, higher smoking pack-years, and higher prevalence of emphysema. The results of the candidate gene study showed the rs1489759 in HHIP and rs56113850 in CYP2A6 demonstrated significant differences between COPD and COPD + LC groups. By using multivariate logistic regression analysis, four variables including BMI, pack-years, emphysema and rs56113850 were identified as independent risk factors for LC in COPD and the prediction model integrating genetic and clinical data was constructed. The AUC of the prediction model for LC in COPD reached 0.712, and the AUC of the model for predicting LC in serious COPD reached up to 0.836.</p><p><strong>Conclusion: </strong>The rs56113850 (risk allele C) in CYP2A6, decrease in BMI, increase in pack-years and emphysema presence were independent risk factors for LC in COPD. Integrating genetic and clinical data for predicting LC in COPD demonstrated favorable predictive performance.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"618"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851948","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}