Expert review of respiratory medicine最新文献_第10页

A tale as old as time - the importance of accelerated lung aging in chronic obstructive pulmonary disease. 一个和时间一样古老的故事——慢性阻塞性肺病中加速肺老化的重要性。

Expert review of respiratory medicine Pub Date : 2025-06-01 Epub Date: 2025-04-16 DOI: 10.1080/17476348.2025.2492800

Carolyn J Wang, Janice M Leung, Don D Sin

{"title":"A tale as old as time - the importance of accelerated lung aging in chronic obstructive pulmonary disease.","authors":"Carolyn J Wang, Janice M Leung, Don D Sin","doi":"10.1080/17476348.2025.2492800","DOIUrl":"10.1080/17476348.2025.2492800","url":null,"abstract":"Introduction: Chronic obstructive pulmonary disease (COPD) is progressive in nature and predominantly affects older individuals. Lung function decline is a typical part of the aging process, characterized by gradual loss of lung mechanics, airway remodeling, persistent low-grade inflammation of the airways, compromised epithelial barrier function, and impaired immune responses over time.Areas covered: The pathology of the senile lung is advanced in patients with COPD, whereby genomic damages contribute to structural defects and cellular dysfunction. Primary, antagonistic, and integrative hallmarks of aging are accelerated in COPD, potentiated by cumulative injury sustained from repeated environmental exposures and the interaction with comorbidities. Identification of epigenetic profiles in COPD indicates how cellular processes contribute to the advancement of biological age. Epigenetic abnormalities unique to COPD subpopulations occur in individuals who are immunodeficient, and often experience early onset and increased severity of COPD.Expert opinion: Accelerated aging processes indicated by epigenetic and other biomarkers may be a promising avenue for early detection, prevention, and subsequent management of COPD. Understanding risk factors contributing to progressive lung function decline and implementation of mitigation strategies such as cessation of smoking, repurposing existing pharmacotherapeutics and development of novel therapies may slow age-related pathologies in COPD. [Figure: see text].","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"597-608"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003928","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}

引用次数: 0

The impact of the inflammatory pulmonary microenvironment on the behavior and function of mesenchymal stromal cells. 炎性肺微环境对间充质间质细胞行为和功能的影响。

Expert review of respiratory medicine Pub Date : 2025-06-01 Epub Date: 2025-04-16 DOI: 10.1080/17476348.2025.2491715

Abigail Jm Warren, Lanzhi Liu, Daniel P O'Toole, John G Laffey, Claire H Masterson

{"title":"The impact of the inflammatory pulmonary microenvironment on the behavior and function of mesenchymal stromal cells.","authors":"Abigail Jm Warren, Lanzhi Liu, Daniel P O'Toole, John G Laffey, Claire H Masterson","doi":"10.1080/17476348.2025.2491715","DOIUrl":"10.1080/17476348.2025.2491715","url":null,"abstract":"Introduction: Acute respiratory distress syndrome is characterized by the dysregulation and activation of several inflammatory pathways which lead to widespread inflammation in the lungs. Presently, direct therapy is unavailable and the use of mesenchymal stromal cells as a direct therapy has been proposed, as early-phase studies have shown promise.Areas covered: MSCs exert various therapeutic effects on the inflammatory microenvironment, such as anti-microbial effects, restoration of the alveolar-capillary barrier, and exuding various anti-inflammatory effects. However, to exert these effects MSCs need to be submitted to specific external stimuli which can affect their immunomodulation, survival, migration and metabolic state. This review references several articles found through targeted searches in PubMed [Accessed between November 2024 and March 2025], for key terms such as 'mesenchymal stromal cells', 'inflammatory microenvironment', anti-inflammatory', 'metabolism', and 'immunomodulation'.Expert opinion: The advancement of MSCs therapy in the treatment of ARDS has not progressed as effectively as one might have anticipated. Several clinical findings have established patient subgroups based on inflammatory cytokine profiles and severity of ARDS. This variation in patients may influence the clinical efficacy of MSCs and instead of concluding that MSCs therapy is not worth pursuing, more research is needed to develop an appropriate therapy.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"551-562"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055871","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}

引用次数: 0

Ensifentrine vs placebo for chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized clinical trials. 恩西芬汀与安慰剂治疗慢性阻塞性肺疾病：随机临床试验的系统评价和荟萃分析

Expert review of respiratory medicine Pub Date : 2025-06-01 Epub Date: 2025-04-23 DOI: 10.1080/17476348.2025.2493367

Giulia Carvalhal, Gonzalo Alberto Peralta-Jiménez, Maria Meritxell Roca Mora, Laith Ayasa, Vivian Barrera, Kavita Advani, Antonio Anzueto, Jafar Aljazeeri

{"title":"Ensifentrine vs placebo for chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized clinical trials.","authors":"Giulia Carvalhal, Gonzalo Alberto Peralta-Jiménez, Maria Meritxell Roca Mora, Laith Ayasa, Vivian Barrera, Kavita Advani, Antonio Anzueto, Jafar Aljazeeri","doi":"10.1080/17476348.2025.2493367","DOIUrl":"10.1080/17476348.2025.2493367","url":null,"abstract":"Introduction: To evaluate the efficacy and safety of ensifentrine in chronic obstructive pulmonary disease (COPD).Methods: We searched electronic databases and registries until 25 January 2025, for randomized clinical trials (RCTs) comparing ensifentrine vs placebo in patients with COPD. Primary outcomes include forced expiratory volume in one second (FEV₁) area under the curve (AUC), peak FEV₁, and morning trough FEV₁.Results: Ten RCTs involving 2,589 patients were included. Compared with placebo, ensifentrine improved FEV₁ AUC by 104.24 ml (95% CI, 74.03 to 133.44; moderate certainty) on day 1 and by 90.37 ml (95% CI, 54.94 to 125.81; moderate certainty) at study end. Ensifentrine increased peak FEV₁ by 140.99 ml on day 1 (95% CI, 107.48 to 174.5; moderate certainty) and by 118.98 ml at the final assessment (95% CI, 86.49 to 151.47; moderate certainty). Ensifentrine improved morning trough FEV₁ by 42.15 ml (95% CI, 19.87 to 64.43; high certainty). Dose-response analysis showed a bell-shaped curve for all outcomes. Ensifentrine did not significantly differ from placebo in adverse events or improvements in COPD symptoms and quality of life.Conclusions: Compared with placebo, ensifentrine improved lung function in COPD. Larger RCTs are needed to integrate this bronchodilator benefit with patient-centered outcomes.Prospero registration: CRD42024571928.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"609-618"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061032","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}

引用次数: 0

Ultrathin bronchoscopy versus conventional bronchoscopy in the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis. 超薄支气管镜与常规支气管镜在肺周围病变诊断中的比较：一项系统综述和荟萃分析。

IF 2.7

Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-03-24 DOI: 10.1080/17476348.2025.2481959

Jiaping Liu, Ze Yang, Heng Zou, Lei Li, Longzhao Li, Hongwu Wang

{"title":"Ultrathin bronchoscopy versus conventional bronchoscopy in the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis.","authors":"Jiaping Liu, Ze Yang, Heng Zou, Lei Li, Longzhao Li, Hongwu Wang","doi":"10.1080/17476348.2025.2481959","DOIUrl":"10.1080/17476348.2025.2481959","url":null,"abstract":"Background: Ultrathin bronchoscopy (UTB) is commonly used to diagnose peripheral pulmonary lesions due to its small diameter. However, there is no consensus on its comparison with conventional bronchoscopy (CB) combined with various guiding modalities.Methods: A comprehensive literature search was performed to identify studies comparing UTB and CB, extracting data on diagnostic yield, operating time, complications, pathological diagnoses, and lesion size. Protocol registration: identifier CRD42024554649. PRISMA guidelines were followed.Results: This meta-analysis included 11 studies with 2,640 patients. UTB demonstrated a significantly higher diagnostic yield (70.5% vs. 57.6%, p = 0.005), particularly with rEBUS and fluoroscopy (p = 0.02). UTB had a higher complication rate, but the difference was not significant (p = 0.37). It also had a shorter operative time than CB-GS (p = 0.007). UTB showed a significant advantage in diagnosing malignant tumors, especially adenocarcinoma and metastatic cancer (p = 0.02, p = 0.03). Both techniques were comparable in diagnosing benign conditions, but UTB outperformed CB in all lesion size categories (p < 0.01).Conclusions: UTB's smaller diameter likely provides a diagnostic advantage over CB and CB-GS by enabling deeper and more accurate access to peripheral lung regions.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"461-473"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660072","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}

引用次数: 0

Preoperative frailty as the strongest predictor of postoperative adverse events burden in patients with operable non-small cell lung cancer: a retrospective analysis. 可手术的非小细胞肺癌患者术前虚弱程度是术后不良事件负担的最强预测因素：一项回顾性分析。

Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-04-01 DOI: 10.1080/17476348.2025.2487152

Radu Iacobescu, Lucian Boiculese, Tiberiu Lunguleac, Cristina Grigorescu, Sabina Antoniu

{"title":"Preoperative frailty as the strongest predictor of postoperative adverse events burden in patients with operable non-small cell lung cancer: a retrospective analysis.","authors":"Radu Iacobescu, Lucian Boiculese, Tiberiu Lunguleac, Cristina Grigorescu, Sabina Antoniu","doi":"10.1080/17476348.2025.2487152","DOIUrl":"10.1080/17476348.2025.2487152","url":null,"abstract":"Background: non-small cell lung cancer (NSCLC) is the most prevalent malignancy worldwide despite versatile screening programs. Therapy-related adverse events can be predicted with various tools including frailty. Frailty predictive power is less well studied in operable NSCLC.Research design and methods: Retrospective analysis performed in NSCLC patients undergoing surgery in which ability of two preoperative frailty indexes mFI-5 and mFI-11 to predict the postoperative burden of adverse events was compared against conventional risk assessment tools such as American Society of Anesthesiologists (ASA), or the Revised Cardiac Risk Index (Lee score). Adverse events burden was categorized as any adverse event, any patient-related adverse event, any surgery-related adverse event, any administrative adverse event.Results: In a sample of 98 patients with surgery for NSCLC, mFI-5 was the best predictor of adverse events burden (OR 36.34, p = 0.006 for any adverse event, 45.2, p = 0.002 for any patient- related adverse event, 23.1, p = 0.01 for any surgery-related adverse event, 12.26, p = 0.03 for any administrative adverse event.Conclusions: Despite its sporadic use in this setting, preoperative frailty might be a more versatile predictor for postoperative adverse events in patients undergoing open surgery for NSCLC. Further studies with more complex approach for frailty are needed.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"475-481"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756903","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}

引用次数: 0

Longitudinal trajectories of tobacco and alcohol use following first or consecutive admissions for respiratory diseases. 首次或连续因呼吸系统疾病入院后烟酒使用的纵向轨迹

Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-03-30 DOI: 10.1080/17476348.2025.2484286

Elsa Caballeria, Maria Teresa Pons-Cabrera, Lourdes Navarro-Cortés, Clara Oliveras, Laura Bueno, Roger Borràs, Pilar Martínez-Olondris, Rosanel Amaro, Néstor Soler, Luis Pintor, Mercè Balcells, Hugo López-Pelayo

{"title":"Longitudinal trajectories of tobacco and alcohol use following first or consecutive admissions for respiratory diseases.","authors":"Elsa Caballeria, Maria Teresa Pons-Cabrera, Lourdes Navarro-Cortés, Clara Oliveras, Laura Bueno, Roger Borràs, Pilar Martínez-Olondris, Rosanel Amaro, Néstor Soler, Luis Pintor, Mercè Balcells, Hugo López-Pelayo","doi":"10.1080/17476348.2025.2484286","DOIUrl":"10.1080/17476348.2025.2484286","url":null,"abstract":"Background: Smoking and alcohol use worsen Chronic Respiratory Diseases (CRD). Smoking cessation is a cornerstone of treatment. We aim to describe the trajectories of alcohol and tobacco use in patients admitted due to first (FE) or consecutive episodes (CE) of CRD.Methods: This prospective study assessed tobacco and alcohol use in 219 patients upon admission for CRD and one year later. Generalized multilevel mixed-effect models analyzed changes within and between groups.Results: Significant differences between groups were observed in tobacco use prevalence (p = 0.001) and quantity (p = 0.009). Although overall tobacco use prevalence remained stable over time (p = 0.08) and no significant group-by-time interaction was found, weekly cigarette consumption decreased over time (from 32.1 to 19.7 in FE, 15.5 to 4.9 in CE) (p = 0.009). Alcohol use prevalence remained at approximately 50% in both groups and time points. The number of standard drink units per week (SDU)/week showed significant group effects (p = 0.03).Conclusions: Admission for a respiratory event alone is not sufficient to induce smoking cessation in many patients. Alcohol use prevalence remains high without significant changes. This gap could be reversed by implementing integrated brief interventions based on motivational interviewing for these patients.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"509-515"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702557","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}

引用次数: 0

The airway hyperresponsiveness prediction value of digitalized lung sound collected during forced expiration in bronchial provocation test. 支气管激发试验中强迫呼气时采集的数字化肺音对气道高反应性的预测价值。

Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-04-03 DOI: 10.1080/17476348.2025.2487690

Mengting Zhu, Qianwen Wang, Shibo Zhu, Limin Zhu, Dongyang Xu, Nan Hu, Like You, Shengsheng Cai, Yonghuai Li

{"title":"The airway hyperresponsiveness prediction value of digitalized lung sound collected during forced expiration in bronchial provocation test.","authors":"Mengting Zhu, Qianwen Wang, Shibo Zhu, Limin Zhu, Dongyang Xu, Nan Hu, Like You, Shengsheng Cai, Yonghuai Li","doi":"10.1080/17476348.2025.2487690","DOIUrl":"10.1080/17476348.2025.2487690","url":null,"abstract":"Background: This study investigated the acoustic characteristics of forced expiratory lung sounds during bronchial provocation tests and their predictive value for airway hyperresponsiveness (AHR).Research design and methods: Participants underwent a bronchial provocation test with incremental methacholine doses (0.072-1.25 mg). Forced expiratory volume in the first second (FEV1) was measured using spirometry, with pre-saline FEV1 as the baseline. AHR was defined as a ≥ 20% decline in FEV1%Ref (FEV1 relative to baseline). Simultaneously, lung sounds were recorded from the right lower lung field. Thirty-five acoustic features were extracted from the first-second forced expiratory lung sound, including 24 spectral parameters, 5 mel-frequency cepstral coefficients (MFCCs), and 6 entropy parameters. Correlation analysis, group comparisons, and logistic regression were conducted to assess the relationship between acoustic features and AHR.Results: Seventeen patients tested positive for AHR. AHR was associated with decreased spectral parameters (A1-A3, MFCC2-MFCC5) and increased spectral entropy (p < 0.05). Logistic regression identified effective power (PT) and MFCC5 as independent predictors, yielding an AUC of 0.856 (95% CI: 0.769-0.944).Conclusions: Acoustic features of breath sounds can predict AHR, offering a potential noninvasive alternative to bronchial challenge tests.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"483-491"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756845","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}

引用次数: 0

Evaluation of exacerbation severity in patients with COPD exacerbations according to the GOLD 2023 report. 根据 GOLD 2023 报告评估慢性阻塞性肺病患者病情加重的严重程度。

Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-04-08 DOI: 10.1080/17476348.2025.2488967

Halil İbrahim Yakar, Gülistan Karadeniz, Tevfik Özlü, Akın Kaya, Erdoğan Çetinkaya, Tarkan Özdemir, Ümran Erbay, Özlem Şengören Dikiş, Dildar Duman, Osman Demir, Gökhan Aykun, Sedef Şule Bozkır, Şebnem Emine Parspur, Melike Demir, Murat Kavas, Utku Tapan, Handan İnönü Köseoğlu, Ahmet Cemal Pazarlı, Burcu Babaoğlu Elkhatroushi, Hüseyin Yıldırım, Deniz Doğan Mülazimoğlu, Ensar Cihat, Zeynep Betül Özcan, İrem Aras

{"title":"Evaluation of exacerbation severity in patients with COPD exacerbations according to the GOLD 2023 report.","authors":"Halil İbrahim Yakar, Gülistan Karadeniz, Tevfik Özlü, Akın Kaya, Erdoğan Çetinkaya, Tarkan Özdemir, Ümran Erbay, Özlem Şengören Dikiş, Dildar Duman, Osman Demir, Gökhan Aykun, Sedef Şule Bozkır, Şebnem Emine Parspur, Melike Demir, Murat Kavas, Utku Tapan, Handan İnönü Köseoğlu, Ahmet Cemal Pazarlı, Burcu Babaoğlu Elkhatroushi, Hüseyin Yıldırım, Deniz Doğan Mülazimoğlu, Ensar Cihat, Zeynep Betül Özcan, İrem Aras","doi":"10.1080/17476348.2025.2488967","DOIUrl":"10.1080/17476348.2025.2488967","url":null,"abstract":"Background: The criteria for COPD exacerbation were redefined in the GOLD 2023 report. This study aimed to evaluate and compare the severity of exacerbations in patients hospitalized with COPD exacerbations [ECOPD] based on the new severity classification defined in the GOLD 2023 report.Research design and methods: A prospective, cross-sectional, and observational study included a total of 513 ECOPD patients from nine university hospitals. Patients were classified into three groups according to the GOLD 2023 COPD exacerbation severity criteria.Results: The mean age of the total patients was 68.9 ± 8.8 years, with 83.4% being male. The distribution of exacerbation severity was as follows: mild [24.4%], moderate [50.8%], and severe [24.8%]. The rate of ICU admission [0.8%-4.2%-27.5%] and in-hospital mortality [1.6%-3.9%-9.2%] increased progressively from the mild to the severe exacerbation group [p < 0.001; p = 0.012, respectively]. Factors affecting 180-day mortality included age, smoking pack-years, mMRC score, hypoxemia, elevated CRP, low HCT, low eosinophil, CCI, and experiencing moderate to severe exacerbations. Severe exacerbations were associated with COPD duration, smoking pack-years, mMRC score, hypoxemia, low eosinophil, reduced FEV1%, and treatment non-adherence.Conclusions: Our study demonstrates that the new ECOPD severity classification is a distinctive and objective tool for predicting ICU admission and in-hospital mortality.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"499-508"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775138","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}

引用次数: 0

Effectiveness of drugs employed in the treatment of COVID-19: real-world evidence. 治疗COVID-19所用药物的有效性：真实世界的证据。

Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-04-13 DOI: 10.1080/17476348.2025.2488966

Jose M Quintana, Nere Larrea, Lara Menéndez, Maria J Legarreta, Maria Gascon, Julia Garcia-Asensio, Pedro-Pablo España

{"title":"Effectiveness of drugs employed in the treatment of COVID-19: real-world evidence.","authors":"Jose M Quintana, Nere Larrea, Lara Menéndez, Maria J Legarreta, Maria Gascon, Julia Garcia-Asensio, Pedro-Pablo España","doi":"10.1080/17476348.2025.2488966","DOIUrl":"10.1080/17476348.2025.2488966","url":null,"abstract":"Background: Drugs used to treat patients with SARS-CoV-2 infection have been tested in different clinical trials but less in real-life studies. Our goal was to assess the effectiveness of several specific COVID-19 drugs.Research design and methods: Retrospective study of all patients testing positive for SARS-CoV-2 infection between 1 March 2020 and 9 January 2022. We extracted sociodemographic, basal comorbidities, specific medication for their COVID-19, COVID-19 vaccination data, and outcomes such as death and admission to hospital and intensive care unit (ICU) during the different periods of the pandemic.Results: The prescription of corticosteroids to out-of-hospital patients was related to a higher likelihood of hospital admission. Among the hospitalized patients, all of the drugs studied (dexamethasone, prednisone, methylprednisolone, remdesivir, ritonavir/lopinavir, and tocilizumab) were related to a higher likelihood of dying at 90 days or being admitted to an ICU. In patients admitted to an ICU, corticosteroids prevented intrahospital mortality (Odds ratio: 0.73; 95% confident intervals: 0.554-0.969). All drugs were related to longer length of hospital admission and ICU stays.Conclusions: Most drugs used for COVID-19 patients had no clear benefit except in the case of corticosteroids, associated with a reduced risk of intrahospital mortality among ICU patients.Trial registration: The study is registered at ClinicalTrials.gov (CT.gov identifier: NCT04463706).","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"493-498"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789458","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}

引用次数: 0

An update on the role of endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer management. 超声引导下支气管针吸在肺癌治疗中的作用的最新进展。

Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-03-30 DOI: 10.1080/17476348.2025.2486349

Takahiro Nakajima

{"title":"An update on the role of endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer management.","authors":"Takahiro Nakajima","doi":"10.1080/17476348.2025.2486349","DOIUrl":"10.1080/17476348.2025.2486349","url":null,"abstract":"Introduction: Accurate diagnosis and staging are essential for optimizing lung cancer management. The 9th edition of the TNM classification emphasizes distinguishing between single-station and multi-station N2 disease, highlighting the necessity of comprehensive mediastinal node assessment for clinical staging. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality used for nodal staging and diagnosis of lung cancer, offering a diagnostic yield comparable to that of mediastinoscopy when performed by experts. Additionally, EBUS-TBNA facilitates essential ancillary testing, including next-generation sequencing (NGS)-based biomarker panels and PD-L1 immunohistochemistry, which are critical for evaluating the suitability of targeted therapies and immune checkpoint inhibitors. Notably, advancements in perioperative management, such as neoadjuvant and adjuvant therapies with immunotherapy and targeted agents, have improved the outcomes of locally advanced diseases. EBUS-TBNA helps identify patients with early-stage lung cancer who are candidates for perioperative therapy.Areas covered: This review discusses lung cancer diagnosis, nodal staging, the 9th TNM classification, biomarker testing, PD-L1 immunohistochemistry, and precision medicine.Expert opinion: Lung cancer management requires pathological diagnosis, including histological subtyping, accurate nodal staging of the hilum and mediastinum, and NGS-based biomarker and PD-L1 testing. EBUS-TBNA achieves all three in a single session, making it indispensable in modern lung cancer care.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"423-434"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756894","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}

引用次数: 0