Expert review of respiratory medicine最新文献_第3页

Longitudinal trajectories of tobacco and alcohol use following first or consecutive admissions for respiratory diseases.

Expert review of respiratory medicine Pub 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":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-30","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

An update on the role of endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer management.

Expert review of respiratory medicine Pub 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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-30","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

The risk of stroke-related pneumonia: a systematic review of peripheral immunodepression markers.

Expert review of respiratory medicine Pub Date : 2025-03-30 DOI: 10.1080/17476348.2025.2481956

Maria Eduarda Lopez de Mello, Scarleth Andreghetto, Maiara de Aguiar da Costa, Victória Linden de Rezende, Cinara Ludvig Gonçalves, Amanda Della Giustina, Fabricia Petronilho

{"title":"The risk of stroke-related pneumonia: a systematic review of peripheral immunodepression markers.","authors":"Maria Eduarda Lopez de Mello, Scarleth Andreghetto, Maiara de Aguiar da Costa, Victória Linden de Rezende, Cinara Ludvig Gonçalves, Amanda Della Giustina, Fabricia Petronilho","doi":"10.1080/17476348.2025.2481956","DOIUrl":"10.1080/17476348.2025.2481956","url":null,"abstract":"Introduction: Ischemic stroke (IS)-associated pneumonia is a leading cause of mortality after stroke, driven by peripheral immune imbalance. This systematic review evaluates immunosuppression markers associated with pneumonia following IS in clinical studies.Methods: Following PRISMA guidelines, we searched PubMed/MEDLINE, EMBASE, and LILACS databases until March 2024. Inclusion criteria comprised clinical studies assessing IS-related immunosuppression and pneumonia, excluding in vitro and animal studies. Study quality was assessed using the Newcastle-Ottawa Scale.Results: A total of 32 studies met the inclusion criteria, analyzing 1,833 post-stroke patients. Findings indicate that increased interleukin-6 (IL-6), interleukin-10 (IL-10), and C-reactive protein (CRP) levels, alongside decreased repulsive guidance molecule A (RGM-A), are early indicators of post-stroke pneumonia. Meta-analysis was not conducted due to heterogeneity in study methodologies and populations.Conclusions: Elevated IL-6, IL-10, and CRP levels, along with reduced RGM-A, are associated with post-stroke pneumonia, emphasizing the role of immune dysregulation in its pathophysiology. Despite promising findings, further studies with standardized detection techniques are needed to enhance diagnostic accuracy and improve patient prognosis. The variability in study methodologies presents a limitation to drawing definitive conclusions.Registration: PROSPERO CRD42024543108.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665768","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 long-acting muscarinic agents for asthma therapy.

Expert review of respiratory medicine Pub Date : 2025-03-28 DOI: 10.1080/17476348.2025.2484289

Maria Gabriella Matera, Mario Cazzola, Paola Rogliani, Vincenzo Patella

{"title":"An update on long-acting muscarinic agents for asthma therapy.","authors":"Maria Gabriella Matera, Mario Cazzola, Paola Rogliani, Vincenzo Patella","doi":"10.1080/17476348.2025.2484289","DOIUrl":"10.1080/17476348.2025.2484289","url":null,"abstract":"Introduction: The manifestations of asthma are influenced by the dysfunction of the autonomic nervous system, which results in elevated vagal tone within the airways. Acetylcholine (ACh) plays a pivotal role in the pathophysiology of asthma through its interaction with muscarinic acetylcholine receptors (mAChRs). Consequently, using mAChR antagonists to counteract the actions of ACh is scientifically sound.Areas covered: This narrative review methodically examines the latest information on the mechanisms and evidence supporting the use of long-acting muscarinic antagonists (LAMAs) in asthma.Expert opinion: Adding a LAMA to existing asthma treatments involving an ICS and a LABA, within a single inhaler triple therapy (SITT), improves lung function regulating airflow limitation, reduces exacerbations, and eosinophilic inflammation and offers a more comprehensive approach to managing inflammation and tissue remodeling, which are linked to ACh. Additionally, it disrupts the vicious cycle of ACh release that contributes to neuronal plasticity and dysfunction of small airways. Identifying treatable traits is key to using SITT in a customized way that aligns with patients' needs. The 5T (Triple Therapy Targeting Treatable Traits) approach proposes the utilization of SITT for all asthma cases, not solely severe ones, and involves using LAMAs in ICS/LABA combinations earlier than current guidelines recommend.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694943","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.

Expert review of respiratory medicine Pub 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":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","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

Genetic underpinning of idiopathic pulmonary fibrosis: the role of mucin.

Expert review of respiratory medicine Pub Date : 2025-02-25 DOI: 10.1080/17476348.2025.2464035

Seyedeh Zahra Fotook Kiaei, David A Schwartz

{"title":"Genetic underpinning of idiopathic pulmonary fibrosis: the role of mucin.","authors":"Seyedeh Zahra Fotook Kiaei, David A Schwartz","doi":"10.1080/17476348.2025.2464035","DOIUrl":"10.1080/17476348.2025.2464035","url":null,"abstract":"Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease characterized by progressive scarring and reduced survival. The development of IPF is influenced by rare and common genetic variants, cigarette smoking, aging, and environmental exposures. Among the two dozen genetic contributors, the MUC5B promoter variant (rs35705950) is the dominant risk factor, increasing the risk of both familial and sporadic IPF and accounting for nearly 50% of the genetic predisposition to the disease.Areas covered: This review provides an expert perspective on the genetic underpinnings of IPF rather than a systematic analysis, emphasizing key insights into its genetic basis. The articles referenced in this review were identified through targeted searches in PubMed, Scopus, and Web of Science for studies published between 2000 and 2023, prioritizing influential research on the genetic factors contributing to IPF. Search terms included 'idiopathic pulmonary fibrosis,' 'genetics,' 'MUC5B,' 'telomere dysfunction,' and 'surfactant proteins.' The selection of studies was guided by the authors' expertise, focusing on the most relevant publications.Expert opinion: The identification of genetic variants not only highlights the complexity of IPF but also offers potential for earlier diagnosis and personalized treatment strategies targeting specific genetic pathways, ultimately aiming to improve patient outcomes.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257365","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 emerging role of anticoagulants targeting Factor XI in thromboembolism management.

Expert review of respiratory medicine Pub Date : 2025-02-20 DOI: 10.1080/17476348.2025.2467463

Laurent Bertoletti, Jean Escal, Lutfi Ozturk, Margaux Geier, Géraldine Poenou

引用次数: 0

Amivantamab plus lazertinib vs. osimertinib in first-line EGFR-mutant advanced non-small cell lung cancer.

Expert review of respiratory medicine Pub Date : 2025-02-20 DOI: 10.1080/17476348.2025.2467338

Nazmul Hasan, Misako Nagasaka

引用次数: 0

The prognostic value of NT-proBNP in 28-day mortality and post-discharge survival in pneumonia: a retrospective cohort study from Taiwan.

Expert review of respiratory medicine Pub Date : 2025-02-18 DOI: 10.1080/17476348.2025.2467339

Van-Dong Nguyen, Hsien-Chun Lin, Wen-Chen Lee, Ke-Shiuan Ju, Jing-En Dai, Pei-Ni Hsieh, Chun-You Chen, Chih-Hsin Lee

{"title":"The prognostic value of NT-proBNP in 28-day mortality and post-discharge survival in pneumonia: a retrospective cohort study from Taiwan.","authors":"Van-Dong Nguyen, Hsien-Chun Lin, Wen-Chen Lee, Ke-Shiuan Ju, Jing-En Dai, Pei-Ni Hsieh, Chun-You Chen, Chih-Hsin Lee","doi":"10.1080/17476348.2025.2467339","DOIUrl":"10.1080/17476348.2025.2467339","url":null,"abstract":"Background: NT-proBNP, traditionally used to assess heart failure, is increasingly recognized for its prognostic value in other diseases. This study evaluates its value in pneumonia.Research design and methods: We conducted a retrospective cohort study of adult patients hospitalized for pneumonia at Wan Fang Hospital (2017-2021) to investigate whether elevated NT-proBNP levels predicted poorer outcomes. Logistic regression identified risk factors for 28-day mortality, while the Cox regression model identified predictors of post-discharge survival.Results: Among 2,805 patients (79.6 ± 13.4 years, female 45%), the 28-day mortality rate was 18.2%, and the median post-discharge follow-up time was 359 days. Moderately (increased but < 10000 pg/mL) and severely (>10000 pg/mL) elevated NT-proBNP levels had higher 28-day mortality compared to normal NT-proBNP; adjusted odds ratios: 2.24 (1.34-3.75, p = 0.002) and 3.57 (2.03-6.27, p < 0.001). Moderately and severely elevated NT-proBNP levels related to shorter survival time than normal NT-proBNP levels; adjusted hazard ratios 1.60 (1.28-2.00, p < 0.001) and 2.03 (1.56-2.63, p < 0.001). All ratios were adjusted with comorbidities, sex, age, and clinical and laboratory tests.Conclusions: Elevated NT-proBNP levels predict higher 28-day mortality and shorter survival time in patients with pneumonia across most subpopulations. This marker holds potential as a prognostic biomarker for pneumonia, especially in high-risk patients.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411988","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

Pathophysiology of small airways in idiopathic pulmonary fibrosis (IPF): the silent zone.

Expert review of respiratory medicine Pub Date : 2025-02-17 DOI: 10.1080/17476348.2025.2467341

Wenying Lu, Affan Mahmood Shahzad, Athul Antony Simon, Greg Haug, Maddison Waters, Sukhwinder Singh Sohal

{"title":"Pathophysiology of small airways in idiopathic pulmonary fibrosis (IPF): the silent zone.","authors":"Wenying Lu, Affan Mahmood Shahzad, Athul Antony Simon, Greg Haug, Maddison Waters, Sukhwinder Singh Sohal","doi":"10.1080/17476348.2025.2467341","DOIUrl":"10.1080/17476348.2025.2467341","url":null,"abstract":"Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease characterized by distorted alveolar structure and reduced lung compliance, and impaired ventilation-perfusion. Small airway disease (SAD) is often termed a 'quietzone' due to its asymptomatic nature. Around 30-40% of IPF patients exhibit SAD, which is associated with worse prognosis, higher fibrosis and emphysema scores, and elevated mortality risk. We used PubMed and Google Scholar for literature search.Areas covered: This review explores the pathophysiology of small airways in IPF, focusing on 1. Risk factors, including age, gender, smoking and occupational dust exposure, and ozone. 2. Diagnostic challenges: SAD is difficult to detect through traditional spirometry or high-resolution computed tomography imaging due to resolution limitations. 3. Early physiological changes of small airways include airway wall thickening, lumen distortion, and reduced terminal bronchioles, preceding microscopic fibrosis, occurs in the early process of IPF. 4. Pathological mechanisms: The review examines the underlying mechanisms driving small airway disease in IPF.Expert opinion: A comprehensive approach is essential to improve the understanding and management of SAD in IPF. Priorities include identifying therapeutic targets, advanced imaging and functional assessments. Forced oscillation technique should be introduced for early detection for small airway abnormalities in IPF.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411966","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