全部最新文献

{"title":"Influenza's silent toll: A closer look at individuals aged 75 years or older.","authors":"Filipe Froes, Mafalda Carmo, Carlos Robalo Cordeiro","doi":"10.1080/25310429.2024.2411809","DOIUrl":"https://doi.org/10.1080/25310429.2024.2411809","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2411809"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study.","authors":"B Sousa-Pinto, R Louis, J M Anto, R Amaral, A Sá-Sousa, W Czarlewski, L Brussino, G W Canonica, C Chaves Loureiro, A A Cruz, B Gemicioglu, T Haahtela, M Kupczyk, V Kvedariene, D E Larenas-Linnemann, Y Okamoto, M Ollert, O Pfaar, N Pham-Thi, F Puggioni, F S Regateiro, J Romantowski, J Sastre, N Scichilone, L Taborda-Barata, M T Ventura, I Agache, A Bedbrook, S Becker, K C Bergmann, S Bosnic-Anticevich, M Bonini, L-P Boulet, G Brusselle, R Buhl, L Cecchi, D Charpin, F de Blay, S Del Giacco, J C Ivancevich, M Jutel, L Klimek, H Kraxner, P Kuna, D Laune, M Makela, M Morais-Almeida, R Nadif, M Niedoszytko, N G Papadopoulos, A Papi, V Patella, B Pétré, D Rivero Yeverino, C Robalo Cordeiro, N Roche, P W Rouadi, B Samolinski, M Savouré, M H Shamji, A Sheikh, C Suppli Ulrik, O S Usmani, A Valiulis, A Yorgancioglu, T Zuberbier, J A Fonseca, E M Costa, J Bousquet","doi":"10.1016/j.pulmoe.2023.07.004","DOIUrl":"10.1016/j.pulmoe.2023.07.004","url":null,"abstract":"<p><strong>Introduction: </strong>Adherence to controller medication is a major problem in asthma management, being difficult to assess and tackle. mHealth apps can be used to assess adherence. We aimed to assess the adherence to inhaled corticosteroids+long-acting β2-agonists (ICS+LABA) in users of the MASK-air® app, comparing the adherence to ICS+formoterol (ICS+F) with that to ICS+other LABA.</p><p><strong>Materials and methods: </strong>We analysed complete weeks of MASK-air® data (2015-2022; 27 countries) from patients with self-reported asthma and ICS+LABA use. We compared patients reporting ICS+F versus ICS+other LABA on adherence levels, symptoms and symptom-medication scores. We built regression models to assess whether adherence to ICS+LABA was associated with asthma control or short-acting beta-agonist (SABA) use. Sensitivity analyses were performed considering the weeks with no more than one missing day.</p><p><strong>Results: </strong>In 2598 ICS+LABA users, 621 (23.9%) reported 4824 complete weeks and 866 (33.3%) reported weeks with at most one missing day. Higher adherence (use of medication ≥80% of weekly days) was observed for ICS+other LABA (75.1%) when compared to ICS+F (59.3%), despite both groups displaying similar asthma control and work productivity. The ICS+other LABA group was associated with more days of SABA use than the ICS+F group (median=71.4% versus 57.1% days). Each additional weekly day of ICS+F use was associated with a 4.1% less risk in weekly SABA use (95%CI=-6.5;-1.6%;<i>p</i>=0.001). For ICS+other LABA, the percentage was 8.2 (95%CI=-11.6;-5.0%;<i>p</i><0.001).</p><p><strong>Conclusions: </strong>In asthma patients adherent to the MASK-air app, adherence to ICS+LABA was high. ICS+F users reported lower adherence but also a lower SABA use and a similar level of control.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416869"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9941968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic yield and safety of transbronchial lung cryobiopsy for diffuse parenchymal lung diseases diagnosis: Comparison between 1.7-mm and 1.9-mm probes.","authors":"C Ravaglia, F Sultani, S Piciucchi, A Dubini, A J De Grauw, S Martinello, S Oldani, S Maitan, F Stella, V Poletti","doi":"10.1016/j.pulmoe.2023.04.003","DOIUrl":"10.1016/j.pulmoe.2023.04.003","url":null,"abstract":"<p><p><i>Purpose of the research</i>: transbronchial lung cryobiopsy has been recently accepted as a valid and less invasive alternative to surgical lung biopsy. The purpose of this randomized controlled study was to evaluate, for the first time, the quality and safety of biopsy specimens obtained by using the new disposable 1.7-mm cryoprobe compared with the standard re-usable 1.9 mm cryoprobe in the diagnosis of diffuse parenchymal lung diseases. <i>Methods</i>: 60 consecutive patients were prospectively enrolled and randomly assigned to two different groups: 1.9 mm (group A) and 1.7 mm (group B); primary endpoints were pathological and multidisciplinary diagnostic yield, sample size and complication rate. <i>Principal results</i>: the pathological diagnostic yield of cryobiopsy was 100% in group A and 93.3% in group B (<i>p</i> = 0.718); cryobiopsy median diameter was 6.8 mm in group A and 6.7 mm in group B (<i>p</i> = 0,5241). Pneumothorax occurred in 9 patients in group A and 10 in group B (<i>p</i> = 0.951); mild-to-moderate bleeding in 7 cases and 9 cases in group A and B respectively (<i>p</i> = 0.559). No death or severe adverse events were observed. <i>Conclusions</i>: there was no statistically significant difference between the two groups, regarding diagnostic yield, adverse events and sampling adequacy.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416785"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9491535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High altitudes and partial pressure of arterial oxygen in patients with chronic obstructive pulmonary disease - A systematic review and meta-analysis.","authors":"A Sevik, T Gaisl, A Forrer, L Graf, S Ulrich, K E Bloch, M Lichtblau, M Furian","doi":"10.1016/j.pulmoe.2024.06.002","DOIUrl":"10.1016/j.pulmoe.2024.06.002","url":null,"abstract":"<p><strong>Importance: </strong>Prior study in healthy subjects has shown a reduction of partial pressure of arterial oxygen (PaO₂) by -1.60 kPa/kilometre of altitude gain. However, the association of altitude-related change in PaO₂ and altitude-related adverse health effects (ARAHE) in patients with chronic obstructive pulmonary disease (COPD) remain unknown.</p><p><strong>Objective: </strong>To provide an effect size estimate for the decline in PaO₂ with each kilometre of altitude gain and to identify ARAHE in relation to altitude in patients with COPD. www.crd.york.ac.uk/prospero: CRD42020217938.</p><p><strong>Data sources: </strong>A systematic search of PubMed and Embase was performed from inception to May 30, 2023.</p><p><strong>Study selection: </strong>Peer-reviewed and prospective studies in patients with COPD staying at altitudes >1500 m providing arterial blood gases within the first 3 days at the target altitude.</p><p><strong>Data extraction and synthesis: </strong>Aggregate data (AD) on study characteristics were extracted, and individual patient data (IPD) were requested. Estimates were pooled using random-effects meta-analysis.</p><p><strong>Main outcome and measures: </strong>Relative risk estimates and 95 % confidence intervals for the association between PaO₂ and altitude in patients with COPD.</p><p><strong>Results: </strong>Thirteen studies were included in the AD analysis, of which 6 studies (222 patients, 45.2 % female) provided IPD, thus were included in the quantitative analysis. The estimated effect size of PaO₂ was -0.84 kPa [95 %CI, -0.92 to -0.76] per 1000 m of altitude gain (I²=65.0 %, <i>P</i> < 0.001). In multivariable regression analysis, COPD severity, baseline PaO₂, age and time spent at altitude were predictors for PaO₂ at altitude. Overall, 37.8 % of COPD patients experienced an ARAHE, whereas older age, female sex, COPD severity, baseline PaO_2, and target altitude were predictors for the occurrence of ARAHE (area under ROC curve: 0.9275, <i>P</i> < 0.001).</p><p><strong>Conclusions and relevance: </strong>This meta-analysis, providing altitude-related decrease in PaO₂ and risk of ARAHE in patients with COPD ascending to altitudes >1500 m, revealed a lower altitude-related decrease in PaO₂ in COPD patients compared with healthy. However, these findings might improve patient care and facilitate decisions about initiating preventive measures against hypoxaemia and ARAHE in patients with COPD planning an altitude sojourn or intercontinental flight, i.e. supplemental oxygen or acetazolamide.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416860"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence: Exploring the role of nasal high flow therapy in enhancing exercise tolerance in COPD patients.","authors":"Sudhamoy Maity, Subhasish Chatterjee, Etika Rana","doi":"10.1080/25310429.2025.2454761","DOIUrl":"https://doi.org/10.1080/25310429.2025.2454761","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2454761"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory syncytial virus vaccination in older adults and patients with chronic disorders: A position paper from the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal Medicine.","authors":"Tiago Alfaro, Filipe Froes, Cláudia Vicente, Rui Costa, Cristina Gavina, Rui Baptista, António Maio, Saraiva da Cunha, João Sérgio Neves, Pedro Leuschner, Sofia Duque, Paula Pinto","doi":"10.1080/25310429.2025.2451456","DOIUrl":"https://doi.org/10.1080/25310429.2025.2451456","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infection, hospitalisation and death in adults.</p><p><strong>Methods: </strong>Based on evidence regarding the impact of RSV on adult populations at risk for severe infection and the efficacy and safety of RSV vaccines, the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal Medicine endorses this position paper with recommendations to prevent RSV-associated disease and its complications in adults through vaccination.</p><p><strong>Conclusion: </strong>The RSV vaccine is recommended for people aged ≥50 years with risk factors (chronic obstructive pulmonary disease, asthma, heart failure, coronary artery disease, diabetes, chronic kidney disease, chronic liver disease, immunocompromise, frailty, dementia, and residence in a nursing home) and all persons aged ≥60 years. If it cannot be made available to this population, then the vaccine should be prioritised for individuals aged ≥75 years and those aged ≥50 years with risk factors. The vaccine should preferably be given between September and November and can be co-administered with the influenza vaccine. Ongoing studies on RSV vaccines may justify extending these recommendations in the future.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2451456"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not too much, not too little. Titrating flow rate to minimise inspiratory effort during helmet CPAP: A bench study.","authors":"Andrea Coppadoro, Rosa Fracchia, Alice Nova, Andrea Restivo, Alberto Lucchini, Giacomo Bellani, Emanuele Rezoagli, Giuseppe Foti","doi":"10.1080/25310429.2024.2411804","DOIUrl":"https://doi.org/10.1080/25310429.2024.2411804","url":null,"abstract":"<p><strong>Background: </strong>Non-invasive helmet respiratory support is suitable for several clinical conditions. Continuous-flow helmet CPAP systems equipped with HEPA filters have become popular during the recent Coronavirus pandemic. However, HEPA filters generate an overpressure above the set PEEP.</p><p><strong>Methods: </strong>A lung simulator was used to mimic patient respiratory mechanics and effort. Compared to room air spontaneous breathing, the additional inspiratory effort attributable to helmet CPAP (ΔPmusHelmet) was recorded at different continuous-flow rates (30-150 L/min), PEEP levels (5, 10, 12.5 cmH2O) and respiratory rates (15, 20, 25, 30 breaths/minute), both with and without a HEPA filter at the outlet port.</p><p><strong>Results: </strong>Helmet pressure swings during inspiration largely explained ΔPmusHelmet variations (p<0.001, Spearman's Rho=0.964). The lowest ΔPmusHelmet levels (0.2 [0; 0.4] cmH2O) were frequently recorded (>70%) at a 90 L/min flow rate. Higher ΔPmusHelmet levels were recorded when the continuous-flow was lower than the peak inspiratory flow (3.7 [3.1; 5.6] cmH2O, p<0.001) or when a HEPA filter was used (2.7 [2.2; 3.5], p<0.001). Increasing the flow rate resulted in higher overpressure levels, particularly with a HEPA filter (p<0.001). Overpressure levels correlated with ΔPmusHelmet (p<0.001, Spearman's Rho=0.598).</p><p><strong>Conclusions: </strong>Helmet pressure swings below PEEP lead to additional inspiratory efforts. The HEPA filter acts as a flow resistor, generating an overpressure leading to increased respiratory effort. The continuous-flow rate should be titrated high enough to slightly exceed the peak inspiratory flow; however, further flow increase is not recommended as it leads to an increase in overpressure and helmet pressure swings below PEEP.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2411804"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public Policy and Health System Responses to Diabetes Mellitus in Nigeria: A Call for Reform.","authors":"Friday Okonofua, Lorretta Favour Ntoimo, Rosemary Ogu, Maradona Isikhuemen","doi":"10.1080/23288604.2025.2477941","DOIUrl":"https://doi.org/10.1080/23288604.2025.2477941","url":null,"abstract":"<p><p>Diabetes mellitus, once a rare diagnosis in precolonial and early post-colonial Nigeria, now has the highest prevalence and fatality rates in sub-Saharan Africa. This increased prevalence is attributed to rising population affluence characterized by sedentary lifestyles and higher consumption of processed and ultra-processed foods. The burden is further exacerbated by a poorly responsive healthcare system. Currently, less than 50% of affected individuals are aware of their condition. Factors such as misconceptions about the disease, a preference for unproven traditional herbal treatments, and the high cost of treatment hinder effective secondary responses. Health system challenges in diabetes management in Nigeria include inadequate implementation of existing policies and guidelines, high out-of-pocket payments, poor quality of healthcare, and limited public education about the disease. To address these issues, we recommend a policy focus on:  1) Implementing actionable policies and guidelines for diabetes prevention and care; 2) Improving the pre-paid care system to reduce out-of-pocket payments; 3) Enhancing the quality of services at all healthcare levels, with the establishment of centers of excellence for specialized diabetes management; 4) Continuing the training, retraining, motivation, and expansion of the workforce responsible for diabetes care; and 5) Health promotion and health awareness aimed at the public to address inaccurate beliefs and practices about diabetes. Addressing these multifaceted factors will help to reduce the rising incidence of diabetes in Nigeria.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2477941"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617895","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":"Optimising non-invasive ventilation in acute COPD exacerbations: Beyond pressure and volume settings.","authors":"Claudia Crimi, Annalisa Carlucci, Stefano Nava","doi":"10.1080/25310429.2024.2448080","DOIUrl":"https://doi.org/10.1080/25310429.2024.2448080","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2448080"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"German Asthma Net: Characterisation of responders to anti-IL-5 and anti-IL-5(R) therapy.","authors":"Christina Bal, Slagjana Stoshikj, Andreas Renner, Katrin Milger, Dirk Skowasch, Christian Schulz, Margret Jandl, Olaf Schmidt, Rainer Ehmann, Sonja Zehetmayer, Christian Taube, Eckard Hamelmann, Roland Buhl, Stephanie Korn, Marco Idzko","doi":"10.1080/25310429.2025.2460868","DOIUrl":"https://doi.org/10.1080/25310429.2025.2460868","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies of anti-IL-5/IL-5(R) therapies in severe asthma found that response was mainly predicted by indicators of good baseline disease control. However, long-term response predictors remain unclear.</p><p><strong>Methods: </strong>Responders to anti-IL-5/IL-5(R) therapy in the well-characterised, real-life, international German Asthma Net (GAN) registry were analysed using regression analyses. Response was defined by ≥50% reduction in exacerbations or corticosteroid dose, super-response by a complete stop of both, and remission additionally by controlled asthma (ACT score≥20).</p><p><strong>Results: </strong>Seventy-seven percent of 347 patients (55% female, 56.6±12.3 years, follow-up 20.3±13 months) were responders and showed improved exacerbation rates, asthma control, and corticosteroid treatment reduction. Response was independently predicted by inhaled corticosteroid dose (odds ratio [OR] 1.5; <i>p</i> = 0.014), exacerbation rate (OR 1.2; <i>p</i> = 0.009), and treatment duration (OR 1.05, <i>p</i> = 0.023). Univariately, blood eosinophil counts notably predicted response (OR 12.4; <i>p</i> = 0.004). Super-response was inversely associated with corticosteroid dependence and depression. Remission was associated with the absence of systemic corticosteroids, better asthma control, and FEV1 in litre.</p><p><strong>Conclusions: </strong>These results underscore that long-term anti-IL-5/IL-5(R) therapy reduces exacerbation and corticosteroid burden, especially in patients with severe disease and high type 2 inflammatory burden. Contrastingly, low baseline corticosteroid use and markers of good asthma control predicted remission and super-responder status.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2460868"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}