Annals of the American Thoracic Society最新文献

{"title":"Lung Volumes in Smokers without Chronic Obstructive Pulmonary Disease: A Pointer to Disease Development?","authors":"Peter M A Calverley","doi":"10.1513/AnnalsATS.202502-146ED","DOIUrl":"10.1513/AnnalsATS.202502-146ED","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"478-479"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Applicability of Three-Dimensional Holographic Virtual Bronchoscopy with Mixed Reality.","authors":"Shotaro Okachi, Maki Sugimoto, Takuma Ina, Tomoya Horiguchi, Yasuhiro Goto, Naozumi Hashimoto, Michitaka Fujiwara, Kazuyoshi Imaizumi","doi":"10.1513/AnnalsATS.202407-729CC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202407-729CC","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":"22 4","pages":"609-611"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxygen Saturation Targeting for Infants with Bronchopulmonary Dysplasia: A Pilot Randomized Trial.","authors":"Sara B DeMauro, Erik A Jensen, Molly Passarella, Mary Catherine Gambacorta, Megan Dhawan, James Weimer, Sooyong Jang, Howard Panitch, Haresh Kirpalani","doi":"10.1513/AnnalsATS.202404-443OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202404-443OC","url":null,"abstract":"<p><p><b>Rationale:</b> The optimal target oxygen saturation (Sp_O₂) range in infants with established bronchopulmonary dysplasia (BPD) is unknown. <b>Objectives:</b> To compare the incidence of intermittent hypoxemia (IH), proportion of time with hypoxemia, and secondary clinical outcomes measured up to 6 months corrected age (CA) in infants with established BPD randomized to higher (⩾96%) versus lower (90-94%) Sp_O₂ target ranges. <b>Methods:</b> Fifty infants born at <30 weeks gestational age who received supplemental respiratory support at 36 weeks postmenstrual age (PMA) were randomized before 44 weeks PMA to higher (<i>n</i> = 22) or lower (<i>n</i> = 28) Sp_O₂ target ranges. Continuous pulse oximetry data were analyzed weekly to guide titration of respiratory support until 6 months CA. Primary outcomes were the incidence of IH (Sp_O₂ < 80% for ⩾30 s) and proportion of time with hypoxemia (<80%) over the entire study period. Secondary outcomes were hypoxemia defined using alternative durations (⩾10 and ⩾60 s) and Sp_O₂ thresholds (<90%) and clinical and developmental outcomes assessed through 6 months CA. <i>Post hoc</i> analyses compared rates of hypoxemia between the two study groups from enrollment to 48 weeks PMA among infants with at least 4 weeks of study data. <b>Results:</b> Median duration of monitoring was 19.0 (interquartile range [IQR], 8.5-23.0) weeks, yielding 835 (IQR, 412-1,269) hours of data per participant. Over the entire study period, there was no difference between Sp_O₂ target groups in the primary outcomes of median numbers of IH events <80% for ⩾30 seconds or time with Sp_O₂ < 80%. <i>Post hoc</i> analyses of infants with at least 4 weeks of study data demonstrated higher incidence of IH events <80% and <90% for both ⩾60 and ⩾30 seconds between enrollment and 48 weeks PMA in the lower target group. Infants in the lower Sp_O₂ target group were discharged at later PMA than infants in the higher Sp_O₂ target group (median, 48.0 vs. 45.0 wk; <i>P</i> = 0.05). <b>Conclusions:</b> A higher (⩾96%) compared with lower (90-94%) Sp_O₂ target strategy is unlikely to significantly reduce hypoxemia between 36-44 weeks PMA and 6 months CA. A possible decrease in IH before 48 weeks PMA and modest clinical improvements associated with the higher target range will require confirmation in future studies. Clinical trial registered with www.clinicaltrials.gov (NCT03385330).</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":"22 4","pages":"560-569"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"County Level Social Determinants of Health and Correlation with Chronic Obstructive Pulmonary Disease Prevalence in the United States.","authors":"Benjamin R E Harris, Gustavo A Cortes Puentes, Erin S DeMartino, Alexander R Zheutlin, Eric L Stulberg","doi":"10.1513/AnnalsATS.202406-667RL","DOIUrl":"10.1513/AnnalsATS.202406-667RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"623-627"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race-Specific vs Race-Neutral Pulmonary Function Predicted Values in Operable Lung Cancer Patients.","authors":"Ravi Rajaram, Ajay Sheshadri, Aaron Baugh, Levi N Bonnell, Liang Li, Ara A Vaporciyan, Mark Block, Elizabeth A David, Robert H Habib, David E Ost","doi":"10.1513/AnnalsATS.202408-846OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202408-846OC","url":null,"abstract":"<p><strong>Rationale: </strong>Percent-predicted forced expiratory volume in 1 second (FEV1pp) is used for surgical risk assessment in lung cancer patients. FEV1pp is adjusted for race despite concerns regarding inaccurate estimations of lung health.</p><p><strong>Objectives: </strong>To compare prediction of race-specific versus race-neutral FEV1pp for pulmonary complications following lung cancer resection.</p><p><strong>Methods: </strong>Patients who underwent lung resection in the Society of Thoracic Surgeons General Thoracic Surgery Database were identified (2002-2008). We used Global Lung Initiative equations to derive race-specific and race-neutral FEV1pp and compared their performance to predict pulmonary complications. Percent predicted postoperative FEV1 (ppoFEV1) was calculated with patients categorized into low (>60%), intermediate (30-60%), and high (<30%) risk groups.</p><p><strong>Measurements and main results: </strong>Of 24,276 patients, most were White (n=21,130; 87.0%) or Black (n=1,912; 7.9%). Race-specific equations reduced the mean FEV1pp by 5.3% for White patients and increased it 6.2% for Black patients compared to race-neutral. Multivariate models using race-neutral FEV1pp performed similarly to race-specific models in predicting pulmonary complications (sublobar resection: C-statistic 0.72; lobectomy: C-statistic 0.65; and bilobectomy/pneumonectomy: C-statistic 0.67; for both models) with similar adjusted odds ratios of FEV1pp for both equation types. In 5,422 patients with calculable ppoFEV1, 617 (11.4%) were recategorized into a higher (n=65) or lower (n=552) risk group when using race-neutral equations. Of those moving into a lower risk group, 98.0% were White. All patients reclassified into higher risk groups were Black.</p><p><strong>Conclusions: </strong>Race-neutral FEV1pp performed equally well as race-specific equations in predicting pulmonary complications and disentangled the effect of respiratory function from race on outcomes.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent versus Daily Therapy for Noncavitary <i>Mycobacterium avium</i> Complex Pulmonary Disease: An Open-label Randomized Trial.","authors":"Taku Nakagawa, Kohei Fujita, Mari Miki, Akihiro Ito, Ho Namkoong, Takanori Asakura, Kozo Morimoto, Naoki Hasegawa, Toshiyuki Kita, Akira Watanabe, Kazunari Tsuyuguchi, Masahiro Kawashima, Ayako Shiozawa, Satoru Watanabe, Atsuo Sato, Tatsuo Kato, Yoshifumi Kimizuka, Hiroaki Harada, Kaori Fujita, Akiko M Saito, Hiroya Hashimoto, Yoshikazu Inoue, Kenji Ogawa","doi":"10.1513/AnnalsATS.202406-626OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202406-626OC","url":null,"abstract":"<p><p><b>Rationale</b>: Patients with noncavitary nodular bronchiectatic (NB) <i>Mycobacterium avium</i> complex pulmonary disease (MAC-PD) are treated intermittently three times a week, although no randomized controlled trials have been conducted comparing three times weekly to daily therapy. <b>Objectives</b>: To assess the tolerability, safety, and efficacy of intermittent versus daily treatment in patients with previously untreated noncavitary NB MAC-PD <b>Methods</b>: In an open-label study, patients were randomly assigned to the intermittent therapy group receiving clarithromycin 1000 mg, rifampicin 600 mg, and ethambutol 25 mg/kg (maximum 1000 mg) three days a week, or the daily therapy group receiving clarithromycin 800 mg, rifampicin 450 mg, and ethambutol 15 mg/kg (maximum 750 mg) daily for one year. The primary endpoint was the proportion of patients requiring modification of the initial treatment regimen. <b>Results</b>: Twenty-one Japanese hospitals participated in the study, enrolling 141 patients between May 2019 and December 2021. The full analysis set included 138 participants (intermittent therapy = 70; daily therapy = 68). There were no significant differences between the intermittent and daily therapy groups in terms of the regimen modification rate (20.0% (14/70) versus 33.8% (23/68); adjusted odds ratio 0.48, 95% confidence interval 0.22 to 1.05; p=0.06) or culture conversion (70.3% vs. 80.0%, p=0.53), time to culture conversion (28.0 vs. 28.5 days, p=0.89), improvement in chest CT findings (60.9% vs. 71.0%, p=0.30), or clarithromycin resistance development (1.4% vs. 0%, p=1.00). Elevated AST (16.9% vs. 41.2%, p=0.003) and ALT (18.3% vs. 44.1%, p=0.002) were more common in the daily treatment group, while elevated bilirubin (11.3% vs. 1.5%, p=0.04) and dysgeusia (14.1% vs. 1.5%, p=0.01) were more common in the intermittent treatment group. The daily treatment group exhibited a greater absolute change in the 36-Item Short Form Survey physical aspect score (-2.5 points) than the intermittent treatment group (2.1 points) (p=0.01). <b>Conclusion</b>: Intermittent treatment was not significantly better tolerated than daily treatment for noncavitary NB MAC-PD. However, further studies with larger numbers of patients are needed. Clinical trial registration available at: https://jrct.niph.go.jp/en-top. ID: jRCTs031190008.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Bookmarking to Reveal Dyspnea Severity Categorizations According to Patients with ILD and the Physicians Who Treat Them.","authors":"Jeffrey J Swigris, Joseph B Pryor, Kerri I Aronson, Taylor A Guess, Joshua J Solomon","doi":"10.1513/AnnalsATS.202411-1215OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202411-1215OC","url":null,"abstract":"<p><strong>Rationale: </strong>Dyspnea impairs the quality of life of patients with interstitial lung disease (ILD). To deliver the best care to patients with ILD, practitioners must understand how patients view and categorize dyspnea severity. Item response theory analyses use a probabilistic model to explain the association between an abstract construct (here, dyspnea severity) and observed data (e.g., responses to a dyspnea questionnaire). Bookmarking is a method for establishing cut-points along the range of a questionnaire's score to define severity categories.</p><p><strong>Methods: </strong>We performed an IRT analysis on response data from the University of California San Diego Shortness of Breath questionnaire administered at the time of enrollment into the Pulmonary Fibrosis Foundation Patient Registry (PFF-PR). Results of the IRT were used to generate a book of hypothetical patient vignettes which were ordered from no dyspnea (first page) to most severe dyspnea (last page). Convenience samples of patients with ILD and ILD physicians were recruited to work in groups to decide where bookmarks should be placed to divide the vignette book into categories of overall dyspnea severity.</p><p><strong>Results: </strong>Data from 1760 patients in the PFF-PR were used in the IRT analysis. Twenty-one vignettes were generated to cover the full spectrum of dyspnea severity. There appeared to be no differences in bookmark positions between female and male ILD physicians or between patient groups based on supplemental oxygen use. Patients and physicians bookmarked dyspnea similarly at the mild end of the dyspnea severity spectrum, but at the severe end, patients rated dyspnea more severely than physicians. When applied back to the registrants in the PFF-PR, patients' bookmarks categorized 177 (10%) registrants with more severe dyspnea than physicians' bookmarks, including 159 (9%) registrants who would be classified with \"severe\" dyspnea according to patients but only \"moderate\" dyspnea according to the physicians.</p><p><strong>Conclusions: </strong>Patients and ILD physicians categorize dyspnea similarly at the milder end of the severity spectrum, but patients view dyspnea more severely than physicians at the higher end. Remaining aware of this in clinical encounters could improve understanding of patients' experiences living with ILD and enhance empathy in the patient-physician relationship.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary for Clinicians: Clinical Practice Guideline on Interventional Strategies for Children with Progressive Pulmonary Hypertension Despite Optimal Therapy.","authors":"Ryan D Coleman, Sarah P Cohen, Pirooz Eghtesady, R Mark Grady, David L S Morales, Don Hayes, Joseph K Ruminjo, W Graham Carlos","doi":"10.1513/AnnalsATS.202501-132AG","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202501-132AG","url":null,"abstract":"<p><p>This guideline provides evidence-based recommendations for managing pediatric patients with progressive pulmonary hypertension (PH) despite optimal medical therapy1. Key interventions systematically reviewed include atrial septal defect (ASD) intervention/atrial septostomy (creation and/or enlargement), pulmonary-to-systemic shunt (reverse Pott's shunt) creation, lung transplantation, and the use of extracorporeal membrane oxygenation (ECMO) support as bridge to other treatments (Table 1). These recommendations aim to guide clinicians managing this fragile patient population, with the strength of recommendation and evidence quality specifically annotated (Table 2). Also of note, these recommendations are primarily focused on patients with progressive pulmonary arterial hypertension despite use of multi-pathway pharmacotherapy; under certain circumstances, however, these recommendations may also apply to children with other types of progressive PH as discussed. As the literature discussing these interventions is only continuing to grow, clinicians are encouraged to consider individual patient circumstances. This summary is intended to provide practicing physicians with key points from the guideline.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protecting the Future of Medical Innovation: Balancing Fiscal Responsibility with the Need for National Institutes of Health and Federal Health Funding.","authors":"Irina Petrache, Raed A Dweik, Michelle Ng Gong, Jesse Roman, M Patricia Rivera, Karen J Collishaw","doi":"10.1513/AnnalsATS.202503-286ED","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202503-286ED","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Incidence Leads to Precedence: A Call for Early Detection Protocols for Pulmonary Hypertension in Heart Failure and COPD.","authors":"Stephen C Mathai, Monica Mukherjee","doi":"10.1513/AnnalsATS.202503-254ED","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202503-254ED","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}