Respiratory Medicine

BACKGROUND: Tuberculosis (TB) infection screening of high-risk groups is an important strategy for achieving End TB targets. A TB infection screening program was implemented for quarry workers from a Portuguese high-incidence area in 2018-2022. We aimed to calculate the cost-benefit of the screening program from the societal perspective. METHODS: We calculated medical and non-medical direct and indirect screening costs and compared them with the cost savings from averted cases of TB disease...

BACKGROUND AND OBJECTIVE: Lung function abnormality of obstructive sleep apnea (OSA) has not been explored well. Preserved ratio impaired spirometry (PRISm) is known for its association with obesity and cardiovascular morbidity, which are also characteristic features of OSA. This study aims to investigate whether the prevalence of PRISm increases according to apnea-hypopnea index levels among subjects with OSA. METHODS: Conducted as an observational cross-sectional study, the study included 372 patients ≥ 40 years of age with definitive diagnoses of OSA and pulmonary function assessment from 2000 to 2004...

BACKGROUND: Tuberculosis frequently poses diagnostic challenge when it presents as a peripheral pulmonary lesion (TB-PPL). The growing use of radial endobronchial ultrasound (rEBUS) for PPL biopsy highlights the need to identify predictive factors for TB-PPL, which is crucial for procedure safety. METHODS: A six-year retrospective review at our institution on adult patients with TB and malignant-PPL diagnosed from rEBUS procedure from October 1, 2016, to December 31, 2022...

BACKGROUND: The underlying population of patients selected for each respiratory monoclonal antibody might change as other biologics are approved. OBJECTIVE: To evaluate effect modification by calendar time of the effectiveness of each respiratory biologics in asthma. METHODS: The Effectiveness of Respiratory biologics in Asthma (ERA) is a retrospective cohort of severe asthma patients from the Mass General Brigham clinics between January 2013 and September 2023...

BACKGROUND: There is a lack of data on the long-term effect of nintedanib on survival in specific groups of idiopathic pulmonary fibrosis (IPF) patients with different phenotypes. We investigated the outcomes of nintedanib therapy in an observational study of a large multicentre real-world cohort of IPF patients with various initial characteristics. METHODS: The analysis included IPF patients treated with nintedanib (NIN) and IPF patients not receiving antifibrotic treatment (NAF) enrolled for the EMPIRE registry in 2015-2020...

OBJECTIVE: This study aimed to develop and validate a nomogram for predicting 28-day and 90-day mortality in intensive care unit (ICU) patients who have chronic obstructive pulmonary disease (COPD) coexisting with congestive heart failure (CHF). METHODS: An extensive analysis was conducted on clinical data from the Medical Information Mart for Intensive Care IV database, covering patients over 18 years old with both COPD and CHF, who were were first-time ICU admissions between 2008 and 2019...

BACKGROUND: Poor glucose control might deteriorate the impaired pulmonary function, which can ultimately lead to mortality. However, few studies have examined the effect modification of glucose control on the association between pulmonary function and mortality. This study aimed to examine the association of pulmonary function with mortality and determine the effect modification of glycemic level on the association of pulmonary function with mortality in persons with type 2 diabetes (T2DM)...

BACKGROUND: Dyspnea is an important non-motor symptom in Parkinson's disease (PD) that impacts quality of life. The mechanisms underlying dyspnea have been difficult to determine due to challenges separating central respiratory control abnormalities from peripheral respiratory muscle dysfunction and chest wall rigidity. METHODS: A comprehensive literature review was conducted, searching the PubMed database for observational studies on respiratory dysfunction and dyspnea in PD...

BACKGROUND: Whether the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1 /FVC) can be used as a biomarker to predict the risk of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is unclear. METHODS: To investigate the predictive role of FEV1 /FVC for AECOPD, we analyzed data from an observational and multicenter cohort study of 2,043 patients with COPD in KOREA. Exposures were post-bronchodilator FEV1 /FVC and/or percentage predicted FEV1 (FEV1 %pred)...

RATIONALE AND OBJECTIVES: Computed tomography (CT) is commonly used and offers an additional viewpoint for evaluating extrapulmonary symptoms, disease severity, and muscle atrophy. This study assessed whether the pectoralis muscle area (PMA) and pectoralis muscle density (PMD) are lower in patients with chronic obstructive pulmonary disease (COPD) than in healthy controls and elucidated their relationships with these variables. MATERIALS AND METHODS: The participants were enrolled in the hospital outpatient clinic between October 2023 and May 2024...

AIM: The objective was to evaluate the serum levels of neutrophil gelatinase-associated lipocalin (NGAL), hypoxia-induced factor-1 alpha (HIF-1α), and apelin 13 in patients with acute pulmonary thromboembolism (PE) and to investigate their diagnostic and prognostic role in PE patients with different mortality risk groups. MATERIAL AND METHODS: This study was conducted in a tertiary referral center and included 124 subjects with 94 cases of PE and 30 cases of healthy control group...

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BACKGROUND: Although airway clearance techniques (ACTs) and physical exercise are recommended for adults with bronchiectasis, there is little data on current practice and limited guidance predicting clinical approach. OBJECTIVE: This study aimed to describe current ACT and exercise practice recorded by patients, and identify predictors of regular ACTs, ACT modalities and exercise. METHODS: Physiotherapy-specific interventions, quality of life (Quality-of-Life Bronchiectasis questionnaire, QOL-B), demographics and disease severity were extracted from the Australian Bronchiectasis Registry...

Severe asthma represents a true challenge for clinicians from two basic perspectives, i.e.: a rational assessment of the underlying endo/phenotype and the subsequent selection of the best fitted (personalized) and effective treatment. Even though asthma is a heterogeneous disease, in the majority of therapy-compliant patients, it is possible to achieve (almost) complete disease control or even remission through conventional and quite uniform step-based pharmacotherapy, even without phenotyping. However, the absence of deeper assessment of individual patients revealed its handicap to its fullest extent during the first years of the new millennium upon the launch of biological therapeutics for patients with the most severe forms of asthma...

Mediastinal lymphadenopathy has a broad differential diagnosis which includes lymphoma. The current preferred biopsy technique for mediastinal lymph nodes is transbronchial needle aspiration which has mixed results in terms of sensitivity, specificity and diagnostic yields; there are also limitations with subtyping lymphomas with needle aspiration alone which can be a barrier to determine management strategies. Invasive mediastinal lymph node sampling such was with mediastinoscopy provides higher yields and preserved lymph node architecture for both diagnosis and subtyping of lymphoma but carries a higher risk of morbidity and complications...

BACKGROUND AND OBJECTIVES: Different factors (etiotypes) can lead to persistent airflow obstruction (PAO) across the lifetime, including genetic factors, abnormal lung development, cigarette smoking, traffic pollution exposure, respiratory infections and asthma. Here we explore the prevalence of PAO and associated etiotypes in the general population in different age bins. METHODS: We studied 664 individuals with PAO (FEV1/FVC post bronchodilation (post-BD) below the lower limit of normal (LLN)) and 11,522 with normal lung function (FEV1/FVC, FEV1 and FVC ≥LLN and ≤ upper limit of normal (ULN) post BD) included in the LEAD Study (NCT01727518), a general population cohort in Vienna (Austria)...

BACKGROUND: Factors associated with early-stage frailty (pre-frailty) in patients with chronic obstructive pulmonary disease (COPD) remain unestablished. In addition to skeletal muscle quantity, skeletal muscle dysfunction can be estimated using an angular metric from bioelectrical impedance analyzer (BIA), termed the phase angle, that reflects cell membrane reactance representing the structural stability. This study examined whether the phase angle was more closely associated with pre-frailty compared with skeletal muscle quantity in patients with COPD...

BACKGROUND: To describe the nutritional status of IPF patients, report clinical associations and evaluate the prognostic value of them in IPF. METHODS: 264 IPF patients diagnosed with IPF at the Second Xiangya Hospital of Central South University between January 2011 and January 2021 were recruited. Three different scoring systems, including nutritional risk index (NRI), controlling nutritional status (CONUT) score, and prognostic nutritional index (PNI) were used to describe the nutritional status of IPF patients...

BACKGROUND: Invasive cardiopulmonary exercise testing (iCPET) combines traditional cardiopulmonary exercise testing with invasive hemodynamic measurements to assess exercise intolerance, which can be caused by preload insufficiency (PI), characterized by low ventricular filling pressures and reduced cardiac output during exertion. We hypothesize that plasma catecholamine levels at rest and during exercise correlate with hemodynamic parameters in PI. METHODS: We included adult patients who underwent iCPET for exercise intolerance and had plasma catecholamines measured at rest and peak exercise...

BACKGROUND: To date there are no data on sex aspects evaluating outcomes of interventional pneumology (IP). Our aim was to investigate sex differences in transbronchial lung cryobiopsy (TBLC) outcomes in the diagnosis of interstitial lung disease (ILD). METHODS: All consecutive (TBLC)s performed for ILD evaluation between Nov 17 and Dec 21 at a tertiary referral center for ILDs and IP were analysed. The indication for the procedure was determined by a multidisciplinary discussion (MDD)...