Canadian respiratory journal最新文献

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Thoracic CT Screening in a Population With Unidentified Lung Cancer Risk Factors: Does It Facilitate the Early Diagnosis of Lung Cancer? 肺癌危险因素不明人群的胸部CT筛查:有助于肺癌的早期诊断吗?
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-10-29 eCollection Date: 2025-01-01 DOI: 10.1155/carj/7611259
Aysegul Gencer, Buket Caliskaner Ozturk, Gizem Senkardesler, Ersan Atahan, Bilun Gemicioglu, Sermin Borekci
{"title":"Thoracic CT Screening in a Population With Unidentified Lung Cancer Risk Factors: Does It Facilitate the Early Diagnosis of Lung Cancer?","authors":"Aysegul Gencer, Buket Caliskaner Ozturk, Gizem Senkardesler, Ersan Atahan, Bilun Gemicioglu, Sermin Borekci","doi":"10.1155/carj/7611259","DOIUrl":"10.1155/carj/7611259","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is the predominant cause of cancer-related mortality globally. Computed tomography (CT) scanning is employed to enhance the early diagnosis of lung cancer by screening for risk factors. This study aimed to examine the impact of CT scanning on the incidence of lung cancer detection in a group with unidentified risk factors for the disease.</p><p><strong>Methods: </strong>Data from two patient cohorts were analyzed: the \"study group,\" comprising individuals with a CT-detected pulmonary nodule of ≥ 8 mm and unknown lung cancer risk factors, and the \"control group,\" consisting of individuals with a pulmonary nodule of ≥ 8 mm identified by CT scan due to known lung cancer risk factors.</p><p><strong>Results: </strong>No significant difference was seen between the groups regarding malignancy frequency (<i>p</i>=0.155) and early-stage occurrence (<i>p</i>=0.842).</p><p><strong>Conclusions: </strong>The incidence of lung cancer in pulmonary nodules measuring ≥ 8 mm is not influenced by the presence of lung cancer risk factors.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"7611259"},"PeriodicalIF":2.1,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Diagnostic Value of Transthoracic Echocardiography Parameters Under the New Diagnostic Criteria for Pulmonary Hypertension. 新诊断标准下经胸超声心动图参数对肺动脉高压的诊断价值
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-10-23 eCollection Date: 2025-01-01 DOI: 10.1155/carj/2592204
Yuankun Qi, Junjun Liu, Xiaopei Cui, Yumiao Wang, Mingyuan Ma, Hongyu Zhang, Weida Lu, Min Xiang, Qiushang Ji
{"title":"The Diagnostic Value of Transthoracic Echocardiography Parameters Under the New Diagnostic Criteria for Pulmonary Hypertension.","authors":"Yuankun Qi, Junjun Liu, Xiaopei Cui, Yumiao Wang, Mingyuan Ma, Hongyu Zhang, Weida Lu, Min Xiang, Qiushang Ji","doi":"10.1155/carj/2592204","DOIUrl":"10.1155/carj/2592204","url":null,"abstract":"<p><strong>Background: </strong>In 2022, new guidelines for the diagnosis and treatment of pulmonary hypertension (PH) revised the hemodynamic definition, reducing the mean pulmonary artery pressure threshold from ≥ 25 to > 20 mmHg. The optimal threshold of transthoracic echocardiography (TTE) parameters and the predictive capability require further validation. This study aims to investigate the diagnostic value of TTE parameters under the new hemodynamic criteria.</p><p><strong>Methods: </strong>Retrospective analysis of PH patients who underwent right heart catheterization and TTE examination between 2017 and 2022 in a single center. Logistic regression was employed to ascertain the predictive capacity of parameters across various conditions. Receiver operating characteristic curves were used to determine the optimal cutoff values based on the new criteria.</p><p><strong>Results: </strong>In a cohort of 213 patients, the optimal cutoff values identified were a tricuspid annular plane systolic excursion (TAPSE) to systolic pulmonary arterial pressure (sPAP) ratio of < 0.50 mm/mmHg, a right ventricular outflow tract acceleration time (RVOT-AT) of < 93 ms, and a right atrial area (RAA) > of 14.5 cm<sup>2</sup>. Regardless of the inclusion of tricuspid regurgitation velocity (TRV) and related parameters, RVOT-AT < 93 ms manifested as an effective predictive parameter. A combination of RVOT-AT < 93 ms, main pulmonary artery diameter > 25 mm and RAA > 14.5 cm<sup>2</sup> exhibited better specificity.</p><p><strong>Conclusion: </strong>The threshold values for TAPSE/sPAP, RVOT-AT, and RAA should be adjusted to improve the predictive capacity of PH based on revised criteria in this single-center dataset. RVOT-AT was a promising indirect parameter, and the utilization of combined indirect indicators may enhance diagnostic accuracy, particularly in instances where satisfactory TRV measurements are unavailable.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"2592204"},"PeriodicalIF":2.1,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12575021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Notoginsenoside R1 Improved Hypoxic Pulmonary Hypertension by Inhibiting Glycolysis-Mediated Pulmonary Arterial Vascular Remodeling. 三七皂苷R1通过抑制糖酵解介导的肺动脉血管重构改善缺氧性肺动脉高压。
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-10-13 eCollection Date: 2025-01-01 DOI: 10.1155/carj/2884885
Xiaowei Gong, Yanling Sheng, Gaijun Zhang, Shiwei Kang, Xin Liu, Yuming Wang, Tao Zhang, Hanzhou Li, Huan Pei, Yadong Yuan, Feitian Min, Huantian Cui
{"title":"Notoginsenoside R1 Improved Hypoxic Pulmonary Hypertension by Inhibiting Glycolysis-Mediated Pulmonary Arterial Vascular Remodeling.","authors":"Xiaowei Gong, Yanling Sheng, Gaijun Zhang, Shiwei Kang, Xin Liu, Yuming Wang, Tao Zhang, Hanzhou Li, Huan Pei, Yadong Yuan, Feitian Min, Huantian Cui","doi":"10.1155/carj/2884885","DOIUrl":"10.1155/carj/2884885","url":null,"abstract":"<p><p>Hypoxic pulmonary hypertension (HPH) lacks effective treatments. The research is designed to examine the effectiveness of Notoginsenoside R1 (NGR1) in addressing HPH and to explore its molecular mechanisms. Under hypoxic conditions, we created a rat model of HPH and treated the animals with NGR1. We assessed the therapeutic effects of NGR1 on HPH through hemodynamic measurements and pulmonary artery vascular remodeling. We employed transcriptomic analysis to evaluate gene expression changes in HPH rats. We conducted untargeted metabolomics to examine how NGR1 influences the metabolic profile of HPH rats. NGR1 treatment significantly improved hemodynamic parameters and ameliorated pulmonary artery vascular remodeling in HPH rats. Transcriptomic analysis identified <i>Pck1</i> as the most significantly altered gene. NGR1 intervention significantly improved the expression of vascular remodeling-related proteins. NGR1 reversed the expression of glycolysis-related genes. NGR1 reduced the levels of glycolysis-related metabolites. Further analysis revealed that NGR1 treatment decreased PFKL, HK2, and LDHA protein expression and lowered lactate levels in lung tissue. Our findings demonstrate that NGR1 effectively alleviates the pathological features of HPH in rats. NGR1 inhibits hypoxia-induced glycolysis-mediated pulmonary artery remodeling, mitigates vascular endothelial damage, and suppresses the abnormal proliferation of smooth muscle cells and fibroblasts.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"2884885"},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Plasma β-Endorphin and Neuropeptide Y as Candidate Biomarkers for Predicting Obstructive Sleep Apnea Syndrome: A Preliminary Study. 血浆β-内啡肽和神经肽Y作为预测阻塞性睡眠呼吸暂停综合征的候选生物标志物:初步研究
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-09-15 eCollection Date: 2025-01-01 DOI: 10.1155/carj/4316574
Meng-Lin Li, Yi Yang, Qian-Yun Huang, Jian-Yong Liu
{"title":"Plasma β-Endorphin and Neuropeptide Y as Candidate Biomarkers for Predicting Obstructive Sleep Apnea Syndrome: A Preliminary Study.","authors":"Meng-Lin Li, Yi Yang, Qian-Yun Huang, Jian-Yong Liu","doi":"10.1155/carj/4316574","DOIUrl":"10.1155/carj/4316574","url":null,"abstract":"<p><p><b>Background and Objective:</b> Given the involvement of neuropeptides in the pathophysiology of obstructive sleep apnea syndrome (OSAS), this study investigated the associations between plasma levels of β-endorphin (β-EP) and neuropeptide Y (NPY) and OSAS severity and evaluated their potential as predictive biomarkers. <b>Methods:</b> A total of 48 snoring patients undergoing polysomnography (PSG) were categorized into non-OSAS, mild, moderate, and severe OSAS groups (<i>n</i> = 12 per group) based on the apnea-hypopnea index (AHI). Plasma levels of β-EP and NPY were measured using ELISA. Statistical analyses included one-way ANOVA, Spearman's correlation, and receiver operating characteristic (ROC) curve analysis to assess predictive performance. <b>Results:</b> Plasma β-EP levels exhibited significant elevation in moderate (<i>p</i>=0.003) and severe OSAS groups (<i>p</i>=0.032) compared to the non-OSAS group. Notably, NPY levels demonstrated marked differences across all OSAS severity groups (<i>p</i> < 0.01), with significantly higher concentrations observed in mild, moderate, and severe OSAS patients versus non-OSAS controls (<i>p</i> < 0.01). A progressive increase in NPY levels was observed with advancing OSAS severity, accompanied by statistically significant intergroup differences (<i>p</i> < 0.01). Correlation analyses revealed strong positive associations between NPY levels and both BMI (<i>p</i> < 0.0001) and AHI (<i>p</i> < 0.0001). In contrast, β-EP correlated positively with AHI (<i>p</i> < 0.0001) but not with BMI (<i>p</i>=0.0931). ROC curve analysis identified β-EP (cutoff: 9.405 ng/L) as a moderate predictor of OSAS (AUC = 0.7986, <i>p</i> < 0.01; sensitivity: 72.22%, specificity: 83.33%). Strikingly, NPY (cutoff: 19.29 ng/L) exhibited perfect discriminative capacity (AUC = 1, <i>p</i> < 0.0001; sensitivity: 97.22%, specificity: 100%). <b>Conclusions:</b> Plasma β-EP and NPY levels are associated with OSAS severity and may serve as potential biomarkers. However, further validation in larger cohorts is needed to confirm their clinical utility.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"4316574"},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High-Altitude Pulmonary Embolism: Epidemiology, Pathophysiology, Diagnosis, and Management. 高原肺栓塞:流行病学、病理生理学、诊断和管理。
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-09-15 eCollection Date: 2025-01-01 DOI: 10.1155/carj/5519627
Zhen-Zhong Yang, Jing Li, Zhen-Long Chang, Xiao-Xia Liu, Jun-Peng Ran, Lin-Feng Liu
{"title":"High-Altitude Pulmonary Embolism: Epidemiology, Pathophysiology, Diagnosis, and Management.","authors":"Zhen-Zhong Yang, Jing Li, Zhen-Long Chang, Xiao-Xia Liu, Jun-Peng Ran, Lin-Feng Liu","doi":"10.1155/carj/5519627","DOIUrl":"10.1155/carj/5519627","url":null,"abstract":"<p><p>Pulmonary embolism (PE) at high altitude (HA) is a potentially life-threatening but underrecognized condition. Unlike low-altitude PE, high-altitude pulmonary embolism (HA-PE) may result from unique hypoxia-driven mechanisms, including hemoconcentration, endothelial dysfunction, and a hypercoagulable state. In this narrative review, we summarize current evidence on the epidemiology, pathophysiology, diagnosis, management, and prognosis of HA-PE, based on the literature published between 2010 and 2025 retrieved from PubMed and CNKI. This review summarizes the epidemiological profile, clinical features, altitude-related diagnostic challenges, limitations of current therapeutic strategies, and the prognosis of HA-PE. A more comprehensive understanding of HA-PE is crucial for enhancing early detection and developing altitude-adapted management approaches.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"5519627"},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic Evaluation of Automatic Noncontact Ultra-Wideband Radar Combined With Oximeter for Obstructive Sleep Apnea in the South of China. 自动非接触式超宽带雷达联合血氧仪对南方地区阻塞性睡眠呼吸暂停的诊断评价。
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-09-03 eCollection Date: 2025-01-01 DOI: 10.1155/carj/6631384
Shuyue Wang, Jian Wu, Haiyao Zheng, Yan Ruan, Feng Yu, Tao Liao
{"title":"Diagnostic Evaluation of Automatic Noncontact Ultra-Wideband Radar Combined With Oximeter for Obstructive Sleep Apnea in the South of China.","authors":"Shuyue Wang, Jian Wu, Haiyao Zheng, Yan Ruan, Feng Yu, Tao Liao","doi":"10.1155/carj/6631384","DOIUrl":"10.1155/carj/6631384","url":null,"abstract":"<p><p><b>Background:</b> Polysomnography (PSG) is the traditional technique for diagnosing obstructive sleep apnea (OSA) with some limitations. Ultra-wideband radar (UWB) is a new method for diagnosing OSA that combines multiple techniques including radar technology, artificial intelligence (AI), and big data algorithms. The accuracy of UWB in OSA diagnosis needs further scientific verification, especially in southern China. <b>Methods:</b> Fifty patients from southern China wore UWB with oximetry and PSG simultaneously overnight. UWB generated automated reports; PSG was manually interpreted. Lowest oxygen saturation (LSpO2) and apnea-hypopnea index (AHI) from both methods were compared. <b>Results:</b> High correlation was found between UWB and PSG for AHI (<i>r</i> = 0.925, <i>p</i> < 0.001) and LSpO2 (<i>r</i> = 0.990, <i>p</i> < 0.001). The average bias of AHI (-3.09, <i>p</i>=0.98, 95% CI -15.48 - 9.31) and LSpO2 (-0.34, <i>p</i> > 0.99, 95% CI -3.68 - 3.04) between the two methods was small. ROC analysis showed good diagnostic performance of UWB versus PSG (AUC = 0.979, <i>p</i> < 0.001), with 95.8% sensitivity and 100% specificity. <b>Conclusion:</b> The study demonstrated UWB combined with oximetry could be a reliable alternative to PSG for diagnosing OSA in the south of China.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"6631384"},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Delta Neutrophil Index and Other Hematologic Parameters in Acute Exacerbations of COPD: A Retrospective Study. 慢性阻塞性肺病急性加重期δ中性粒细胞指数和其他血液学参数的回顾性研究。
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-08-28 eCollection Date: 2025-01-01 DOI: 10.1155/carj/3647362
Burcu Akkok, Evrim Gulderen Kuscu, Hatice Sahin
{"title":"Delta Neutrophil Index and Other Hematologic Parameters in Acute Exacerbations of COPD: A Retrospective Study.","authors":"Burcu Akkok, Evrim Gulderen Kuscu, Hatice Sahin","doi":"10.1155/carj/3647362","DOIUrl":"10.1155/carj/3647362","url":null,"abstract":"<p><p><b>Background:</b> Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality worldwide, and acute exacerbations are the major health issues in COPD patients. In this study, we aimed to investigate the role of the delta neutrophil index (DNI) with other hematologic parameters in managing and guiding COPD patients admitted with acute exacerbations. <b>Methods:</b> In this retrospective study, COPD patients treated internally in pulmonology clinic, intensive care unit, and anesthesiology and reanimation unit with acute exacerbation between May 2021 and December 2023 were investigated. Records from daily visits were evaluated retrospectively. Patients were divided into two groups according to the causative organism: bacterial or nonbacterial. <b>Results:</b> Patients with cardiac failure were found to have significantly higher median DNI values (<i>p</i> : 0.026), whereas patients with other comorbidities that were not individually recorded have substantially lower median DNI values (<i>p</i> : 0.026). White blood cell (WBC), neutrophil, immature granulocyte values (both absolute value and percent), thrombocyte, platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin, positive blood culture, positive systemic inflammatory response syndrome (SIRS) criteria, and sepsis were significantly higher in patients with bacterial acute exacerbation. Hospitalization duration was also significantly longer in the same group (<i>p</i> :  0.006). No statistically significant correlation was found between median DNI values and early mortality rate (within 28 days), readmission within 30 days and 6 months. <b>Conclusion:</b> In this study, we have shown that the serum procalcitonin level, WBC, NLR, and PLR measurement can be used to distinguish bacterial and nonbacterial COPD exacerbations. The DNI revealed no prognostic predictive value regarding early mortality, mechanic ventilation need, or readmission in 30 days and 6 months.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"3647362"},"PeriodicalIF":2.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improved Etiological Diagnosis of Nonresolving or Slowly Resolving Pneumonia Through Combined Endobronchial Ultrasound-Guided Biopsy and Metagenomic Sequencing. 超声引导下支气管内活检和宏基因组测序联合应用于非溶解性或缓慢溶解性肺炎的病因学诊断。
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-08-28 eCollection Date: 2025-01-01 DOI: 10.1155/carj/7651699
Qiang Li, Li Jian, Qiquan Zhao
{"title":"Improved Etiological Diagnosis of Nonresolving or Slowly Resolving Pneumonia Through Combined Endobronchial Ultrasound-Guided Biopsy and Metagenomic Sequencing.","authors":"Qiang Li, Li Jian, Qiquan Zhao","doi":"10.1155/carj/7651699","DOIUrl":"10.1155/carj/7651699","url":null,"abstract":"<p><p><b>Background:</b> Nonresolving or slowly resolving pneumonia (NRP) poses a diagnostic challenge because infectious and noninfectious etiologies often mimic community-acquired pneumonia on imaging. Endobronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) improves tissue acquisition for peripheral lesions, whereas metagenomic next-generation sequencing (mNGS) offers culture-independent pathogen detection. Whether their combination enhances etiological clarification of NRP remains uncertain. <b>Methods:</b> A total of 109 consecutive adults with NRP unresponsive to standard antimicrobial therapy were randomized to EBUS-TBLB alone (<i>n</i> = 66) or EBUS-TBLB + mNGS (<i>n</i> = 43). Baseline characteristics, diagnostic yield, and procedure-related complications were recorded. Diagnostic positivity, sensitivity for infectious agents, and safety profiles were compared using <i>χ</i> <sup>2</sup> or Fisher's exact tests, with <i>p</i> < 0.05 considered significant. <b>Results:</b> Overall diagnostic yield increased from 50.0% with EBUS-TBLB to 72.1% with the combined approach (<i>χ</i> <sup>2</sup> = 4.37, <i>p</i> < 0.05). mNGS significantly improved detection of bacterial/fungal pneumonia (0% vs. 13.9%; <i>p</i> < 0.05) and pulmonary <i>tuberculosis</i> (0% vs. 20.9%; <i>p</i> < 0.05). Malignancy remained the predominant diagnosis (57.8% of all cases); yields for most tumor subtypes were comparable between groups. Complication rates did not differ between the two groups: minor bleeding (19.7% vs. 23.3%), hypoxia (50.0% vs. 48.8%), pneumothorax (4.5% vs. 0%), and delayed recovery (4.5% vs. 7.0%) (<i>p</i> > 0.05). No severe adverse events occurred. <b>Conclusions:</b> EBUS-TBLB + mNGS represents a paradigm shift in the diagnosis of complex respiratory cases, integrating imaging with advanced genomics to enhance precision medicine. In practice, early implementation of the EBUS-TBLB + mNGS diagnostic protocol in patients with NRP can help exclude malignancy or confirm an infectious etiology.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"7651699"},"PeriodicalIF":2.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cryobiopsy as a Salvage Technique Following Negative Flexible Forceps Biopsy of the Pleura Under Rapid On-Site Evaluation Guidance: A Prospective Study. 在快速现场评估指导下,低温活检作为胸膜负性柔性钳活检后的抢救技术:一项前瞻性研究。
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-08-12 eCollection Date: 2025-01-01 DOI: 10.1155/carj/6641774
Jianlong Tan, Cuihua Zhang, Bing Liu, Yun Li, Zhiguang Liu, Weidong Zhang
{"title":"Cryobiopsy as a Salvage Technique Following Negative Flexible Forceps Biopsy of the Pleura Under Rapid On-Site Evaluation Guidance: A Prospective Study.","authors":"Jianlong Tan, Cuihua Zhang, Bing Liu, Yun Li, Zhiguang Liu, Weidong Zhang","doi":"10.1155/carj/6641774","DOIUrl":"10.1155/carj/6641774","url":null,"abstract":"<p><p>A diffusely thickened or hard pleura is a special type of macroscopic appearance associated with benign or malignant conditions. Medical thoracoscopy (MT) is the gold standard for pleural pathology, but its diagnostic yield is imperfect. Although cryobiopsy may provide greater and deeper tissue, its impact on the diagnostic yield remains uncertain, and safety concerns persist. We evaluated the efficacy and safety of cryoprobe biopsy as a salvage technique following negative or inconclusive flexible forceps biopsy during MT under the guidance of rapid on-site evaluation (ROSE). This prospective study enrolled 280 patients with undiagnosed exudative pleural effusion who underwent MT. After the initial flexible forceps biopsy and ROSE, 37 patients with negative ROSE results underwent cryoprobe biopsy. A total of 37 (21 males and 16 females) patients, aged 56.43 ± 16.09 (range: 22-78) years with negative ROSE results, underwent cryoprobe biopsy. CB established a definitive histopathological diagnosis in 33/37 (89.2%) patients, which was significantly higher than that achieved with FFB, i.e., 21/37 (56.8%; <i>p</i>=0.002). CB resulted in significantly larger pleural specimens (9.86 ± 2.69 mm) in comparison to FFB (2.89 ± 1.15 mm, 95% confidence interval [CI]: 6.01-7.93; <i>p</i> < 0.001). Furthermore, CB was faster than FFB (median durations of 15 and 31 min, respectively; <i>p</i> < 0.001). CB had improved tissue quality for CGP testing in 20 NSCLC patients compared to FFB (18/20 versus 8/15, <i>p</i>=0.036). No significant complications were noted. Cryoprobe biopsy is a safe and effective salvage technique for patients with undiagnosed pleural effusion who show negative results on flexible forceps biopsy during MT. It provides larger, higher-quality specimens with a higher positivity rate, potentially avoiding the need for repeat procedures and facilitating timely diagnosis and treatment.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"6641774"},"PeriodicalIF":2.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Harnessing AI for Improved Detection and Classification of Pleural Effusion: Insights and Innovations. 利用人工智能改进胸腔积液的检测和分类:见解和创新。
IF 2.1 4区 医学
Canadian respiratory journal Pub Date : 2025-08-06 eCollection Date: 2025-01-01 DOI: 10.1155/carj/2882255
Geran Maule, Ahmad Alomari, Abdallah Rayyan, Ogbeide Aghahowa, Mohammad Khraisat, Luis Javier
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