Annals of the American Thoracic Society最新文献

{"title":"Short-term air pollution exposure and hospitalizations in idiopathic pulmonary fibrosis: data from the IPF-PRO Registry.","authors":"Maeve G MacMurdo, Daniel M Wojdyla, Amanda Gassett, Joel D Kaufman, Ganesh Raghu, Carrie A Redlich, Divya C Patel, Megan L Neely, Laurie D Snyder, Mridu Gulati, Coralynn Sack","doi":"10.1093/annalsats/aaoag285","DOIUrl":"10.1093/annalsats/aaoag285","url":null,"abstract":"<p><strong>Rationale: </strong>While long-term exposure to ambient air pollution in patients with idiopathic pulmonary fibrosis (IPF) has been associated with an increased risk of disease progression and mortality, the risks associated with acute exposure are less clear.</p><p><strong>Objective: </strong>To determine whether acute exposure to fine particulate matter (PM2.5) is associated with an increased risk of respiratory hospitalization in patients with IPF.</p><p><strong>Methods: </strong>We performed a case crossover analysis of patients with at least one respiratory hospitalization in the IPF-PRO Registry of individuals with IPF enrolled at 46 sites across the US. Acute exposure to PM2.5 was estimated as the average concentration at the regulatory air quality monitor nearest to the individual's residential address for each day in the week preceding hospitalization. Control days were selected using a time-stratified design. Conditional logistic regression estimated the association between average PM2.5 concentration for each lag day and the odds of respiratory hospitalization, adjusting for time-varying confounders.</p><p><strong>Results: </strong>In adjusted conditional logistic analyses, each 5µg/m3 higher PM2.5 on lag day 0 was associated with a 22% (95% confidence interval, 14% to 47%) higher odds of respiratory-related hospitalization. No significant association was observed for PM2.5 in the other days in the week preceding the hospitalization. There was no significant effect modification by age, sex, Social Vulnerability Index, MUC5B allele status, telomere length, or antifibrotic drug use.</p><p><strong>Conclusion: </strong>Increased exposure to PM2.5 is associated with an increased risk of same-day hospitalization in individuals with IPF, suggesting that efforts to reduce community and individual exposure to air pollutants may improve patient outcomes.</p><p><strong>Clinical trial registration: </strong>Clinical trial registered with www.clinicaltrials.gov (NCT01915511).</p><p><strong>Primary source of funding: </strong>The IPF-PRO Registry is supported by Boehringer Ingelheim Pharmaceuticals, Inc and run in collaboration with the Duke Clinical Research Institute and enrolling centers.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957379","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":"Comment on Pepin et al.: non-invasive ventilation in COPD patients with chronic ventilatory failure-pathophysiologic heterogeneity.","authors":"Marta Kaminska, Mathew Cherian, Bryan Ross, Veronique Adam, Jean Bourbeau","doi":"10.1093/annalsats/aaoag288","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag288","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957387","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":"Reply to Yadav et al.: The Lung Function Score Retains Prognostic Value Under Z-Score-Based Interpretation.","authors":"Kristina Gaietto, Daniel Atwood, Christian Rosas-Salazar, Daniel J Weiner","doi":"10.1093/annalsats/aaoag291","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag291","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932009","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":"Factors Associated with 6-Minute Walk Distance Improvement During Outpatient Pulmonary Rehabilitation After Lung Transplantation.","authors":"Justin M Bachmann, Anil J Trindade, Jeremy K McNatt, Jade M Borden, Katelyn S McCloskey, Ashley P Wright, Melissa J Putnam, Konrad Hoetzenecker, Caitlin T Demarest, David B Erasmus, Shi Huang, Robert A Greevy, David J Kennedy, E Wesley Ely","doi":"10.1093/annalsats/aaoag286","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag286","url":null,"abstract":"<p><strong>Rationale: </strong>Pulmonary rehabilitation (PR) is recommended after lung transplantation to optimize recovery. Prior studies have evaluated intensive or specialized PR protocols rather than the 36-session comprehensive outpatient model specified by Medicare.</p><p><strong>Objectives: </strong>We evaluated 6-minute walk distance (6MWD) improvement and factors associated with rehabilitation response in a Medicare PR program.</p><p><strong>Methods: </strong>We conducted a pragmatic cohort study of 367 lung transplant recipients participating in PR from 2013-2025. The primary outcome was 6MWD. Registry data were linked to obtain pre-transplant demographic, clinical and functional data. Factors associated with 6MWD improvement were evaluated through multivariable regression, inverse probability weighting and machine learning models.</p><p><strong>Results: </strong>Among 367 lung transplant recipients, 286 (78%) completed discharge assessments with median 6MWD improvement of 171 meters (m, 61% relative improvement). Baseline functional capacity was inversely associated with 6MWD improvement (-0.6m per 1m baseline increase [95% CI, -0.7 to -0.5]). Female sex (-44.2m [-64.0 to -24.3]), longer hospital stay (-0.7m/day [-1.3 to -0.1]), and higher BMI (-3.2m per kg/m² [-5.5 to -1.0]) were associated with less improvement. Higher baseline depression scores were paradoxically associated with greater gains (2.4m/PHQ-9 point [0.04 to 4.67], p < 0.05). Neither pre-transplant disease severity (Lung Allocation Score, p = 0.68) nor functional status at transplant (p = 0.33) was associated with rehabilitation response.</p><p><strong>Conclusions: </strong>In this analysis of outpatient PR linked to transplant registry data, lung transplant recipients achieved substantial functional improvements. Post-transplant baseline function was inversely associated with gains while pre-transplant disease severity showed no significant association, suggesting removal of ventilatory constraints creates relatively uniform rehabilitation potential. These findings support the real-world effectiveness of the Medicare outpatient PR model.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922161","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":"The Lung Function Score Retains Prognostic Value Under Z-Score-Based Interpretation.","authors":"Hemang Yadav, Guang-Shing Cheng, Anne Bergeron, Kirsten M Williams, Ajay Sheshadri","doi":"10.1093/annalsats/aaoag290","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag290","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922245","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":"Unmasking the Subset: Neuropsychiatric Monitoring in the Era of CFTR Modulators.","authors":"C Bathgate, A Georgiopoulos","doi":"10.1093/annalsats/aaoag282","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag282","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922208","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":"Perceptions of Incidental Findings on Lung Cancer Screening Exams: A National Survey of Primary Care Clinicians and Radiologists.","authors":"Rahul Bollam, Andie E O'Laughlin, Tanner Caverly, Kristina Crothers, Bhavika Kaul, Nicholas Maurice, Alison S Rustagi, Ammer Saati, Gregory Kicska, Jeffrey Waltz, Nichole Tanner","doi":"10.1093/annalsats/aaoag275","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag275","url":null,"abstract":"<p><strong>Rationale: </strong>Unlike other common cancer screenings, annual lung cancer screening often identifies a spectrum of incidental findings unrelated to lung cancer. While these findings could be actionable, how to best communicate and manage them can be a challenge, often falling upon primary care clinicians.</p><p><strong>Objectives: </strong>Evaluate primary care clinician and radiologist approaches to and preferences for reporting commonly identified incidental findings on lung cancer screening.</p><p><strong>Methods: </strong>In this cross-sectional study, we conducted an electronic survey of primary care clinicians and radiologists practicing in the Veterans Health Administration, which was distributed from August to September 2025. Clinicians' professional data and clinical practice details were captured. Three clinical vignettes reflecting common cardiopulmonary incidental findings (coronary artery calcifications, pulmonary emphysema, and pulmonary fibrosis) were used to identify management approaches and preferences for communicating incidental findings. Additional questions were posed to explore opinions on how artificial intelligence could be used to assist in reporting and management.</p><p><strong>Results: </strong>The survey was completed by 560 primary care clinicians and 55 radiologists. Both groups of clinicians preferred incidental findings be communicated through the radiology report rather than direct communication (95%) with the majority of primary care clinicians preferring incidental findings be included in both the impressions and findings sections of the report. The American College of Radiology Quick Reference Guide for Incidental Findings indicates that only new or previously undocumented incidental findings be reported, however primary care clinicians preferred incidental findings be communicated on both baseline and follow-up screening exams (68% in coronary artery calcification, 68% in emphysema, and 75% in pulmonary fibrosis). The majority of radiologists indicated that they report these incidental findings, but some indicated that they do not use the S-modifier for certain disease states. Using artificial intelligence to review the medical record to indicate which incidental findings had previously been diagnosed was favored by 76% of primary care clinicians and 82% of radiologist respondents.</p><p><strong>Conclusions: </strong>As lung cancer screening uptake continues to increase, incidental findings will continue to pose a reporting and management dilemma. This study provides insight into primary care clinician and radiologist views and provides important data to guide future research.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914757","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":"Mental health safety profile of CFTR modulators in pediatrics and adults: insights from the French pharmacovigilance database and from VigiBase.","authors":"Diane A Merino, Samuel D Cohen, Nouha Ben Othman, Marie-Noëlle Osmont, Tessa Pietri, Sandrine Bergeron, Sophie Gautier, Fanny Rocher, Milou-Daniel Drici, Pierre-Régis Burgel, Isabelle Sermet-Gaudelus, Alexandre O Gérard, Laurent Chouchana","doi":"10.1093/annalsats/aaoag192","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag192","url":null,"abstract":"<p><strong>Rationale: </strong>CFTR modulators (CFTRms) have transformed cystic fibrosis care, yet concern exists regarding their mental health safety profile.</p><p><strong>Objective: </strong>To provide further information, we conducted an analysis of CFTRm-related mental health disorders using two spontaneous pharmacovigilance reporting databases in real-world settings.</p><p><strong>Methods: </strong>We analyzed reports from the French Pharmacovigilance Database (FPD) and VigiBase, the WHO global individual case safety reports database. Reports recorded between 2012 and 2024 involving any CFTRm and psychiatric disorders were included. In VigiBase, we conducted a case-non case, disproportionality analysis using the Reporting Odds Ratio (ROR), overall and stratified by age group (pediatrics vs. adults) and by CFTRm type. This study was conducted in accordance with the STROBE and the READUS-PV guidelines.</p><p><strong>Results: </strong>In the FPD, 116 cases were analyzed. ELX/TEZ/IVA was suspected in 98% of cases and no single case was reported with ivacaftor alone. Sleep (61%), mood (37%), and anxiety disorders (27%) were the most frequently reported, with suicidal behaviors being infrequent, including 6 suicide attempts and no completed suicide. In VigiBase (n = 3,407), sleep disorders predominated in children, whereas mood and suicidality disorders were most frequent in adolescents. The median time to onset was 60 days (Q1-Q3: 12-150 days). Mental health disorders were disproportionately reported with CFTRms, particularly ELX/TEZ/IVA, while they were not with other combination therapies, compared to other drugs in the database. Disproportionality signals were slightly stronger in pediatrics than in adults.</p><p><strong>Conclusions: </strong>CFTRms, especially ELX/TEZ/IVA, are associated with increased reporting of mental health disorders, predominantly sleep and mood disorders. Pediatrics appear to be particularly affected. Prospective observational studies are warranted to confirm these findings and elucidate underlying pathophysiological mechanisms.</p><p><strong>Registration: </strong>OSF: mfyx3.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908342","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":"Reply to Su et al.: Revisiting Risk Estimation in COPD: When Model Outputs Diverge from Clinical Direction.","authors":"Samaneh Salimian, Nathaniel M Hawkins, Mohsen Sadatsafavi, Ricky D Turgeon","doi":"10.1093/annalsats/aaoag280","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag280","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893016","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":"Platelets Beyond Hemostasis: Thromboinflammation as a Target in COPD.","authors":"Mehdi Mirsaeidi","doi":"10.1093/annalsats/aaoag255","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag255","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893096","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}