Inhibition of the p38/JNK MAPK pathway mediated by circadian rhythm genes: Study of the mechanism of Linggan Wuwei Jiangxin decoction in the treatment of COPD.

Potential and challenges of natural product inhaled formulations in the treatment of pulmonary diseases.

The suitability of lung transplantation (LTx) in recipients aged ≥70 years remains debated, despite reports of acceptable outcomes in selected elderly patients among othersolid-organ transplantations. We retrospectively analyzed all LTx procedures performed in this age group within the Prague Lung Transplant Program between January 2012 and July 2025. Twelve patients aged ≥70years underwent double (n= 5) or single (n = 7) LTx. The median age was 70.3 years. Indications were interstitial pulmonary disease (n = 7) and chronic obstructive pulmonary disease (n = 5). Median waiting time was 199.5 days. Primary graft dysfunction grade 2 occurred in 2 patients, with no cases of grade 3. Median ICU and hospital lengths of stay were 10 and 21.5 days, respectively. One-month and 1-year survival rates were 91.7% and 73%. These data indicate that LTx in carefully selected septuagenarian recipients can achieve favorable short-term outcomes.

Pharmacological basis of Codonopsis Radix in COPD: Lobetyolin modulates Nrf2/NF-κB-mediated inflammation and oxidative stress.

The evolving science of ventilation heterogeneity: From pathophysiology to personalized therapeutic approaches.

Lung retransplantation after initial single lung transplantation.

Acromioclavicular (AC) joint injuries represent approximately 11% of all shoulder injuries and are managed surgically in severe cases via techniques such as hook-plating, button fixation, and graft-based reconstruction. While much of the existing literature on AC joint surgery points to relatively high rates of long-term complications and reoperations, short-term outcomes are not fully understood. Therefore, this study investigates short-term outcomes following AC joint surgery using a large database to provide comprehensive complication data and elucidate risk factors. The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2010 to 2023. Patients undergoing surgical intervention for AC joint injuries were identified using Current Procedural Terminology 23550, 23552, and 21320, and their 30-day postoperative outcomes were retrieved. Patients with unknown or null values for demographic or complication metrics were excluded. Statistical analyses included multivariate odds-ratio (OR) logistic regression. Operative time threshold analysis was performed to identify the optimal time cut-point associated with increased complication risk. A total of 13,117 patients underwent AC joint surgery (average age 49.6 ± 15.2 years; average body mass index 30.1 ± 6.44 kg/m2; 70.5% male). The overall adverse event rate was 2.7%: surgical site infection (1.2%) and return to operating room (1%) were among the most common. An average operating time of 85 ± 56 minutes was determined, and threshold analysis revealed a significant increase (P < .001) in complications for operations lasting longer than 148 minutes. Operative time (OR = 1.01), history of chronic obstructive pulmonary disease (OR = 2.47), steroids (OR = 3.16), dialysis (OR = 5.57), bleeding disorders (OR = 2.67), and type 1 diabetes (OR = 1.61) were all significant risk factors for complications. AC joint surgery demonstrated relatively low short-term complication rates; however, comorbidities such as type 1 diabetes and chronic obstructive pulmonary disease are linked to a higher risk of experiencing adverse events. Preoperative counseling is recommended for at-risk patients, and future studies should explore surgery-specific operative time and patient management to provide further insights and enhance surgical decision-making.

The incidence and associated factors of pulmonary embolism after cardiac surgery: A retrospective nationwide inpatient sample database study

The influence of dyspnea on social frailty in elderly patients with chronic obstructive pulmonary disease: The mediating effects of social support and depression symptoms.

The purpose of this study is to evaluate whether accelerated registration and reduced acquisition times preserve the robustness of phase-resolved functional lung (PREFUL) MRI, thereby improving clinical feasibility by facilitating integration into tight time slots and enabling faster turnaround of results. PREFUL MRI at 1.5 T was retrospectively analyzed in 28 patients with chronic obstructive pulmonary disease (COPD) and 56 healthy volunteers. Image registration was performed using Advanced Normalization Tools (ANTs) and Forsberg. Time series (TS) were truncated from 55 to 45, 30, and 15 s per slice. The 55-s variant was evaluated twice to assess potential nondeterministic effects; the first served as the reference. PREFUL parameters, including regional ventilation, quantified perfusion (QQ), flow volume loop correlation metric (FVL-CM) and corresponding defect percentages, were compared across registration methods and TS lengths using Wilcoxon tests, Pearson correlations, intraclass correlation coefficients (ICC), and regional overlap analysis. Forsberg reduced computation time by ~20-fold (3 vs. 58 min per slice) while maintaining trends and repeatability. Although functional values were slightly lower and defect scores higher, correlations between registrations exceeded 90% for most parameters, with regional overlap ≥ 97% in healthy volunteers and ≥ 80% in COPD patients. Shortening the TS to 30 s introduced minor deviations but preserved overlap (≥ 79%) and strong correlations (≥ 77%) compared with 55 s, except for QQ. Larger deviations occurred primarily at 15 s. Repeatability remained moderate to high (ICC ≥ 68%) for all parameters, except QQ, down to 30 s, with the FVL-CM, perfusion defect percentage and amount of nondefect regions in COPD being most stable (ICC ≥ 72%). Forsberg provides results comparable to ANTs at a fraction of the processing time, enabling PREFUL analysis within a practical timeframe. Acquisition for each slice may be reduced to 30 s without compromising robustness, supporting more efficient protocols, although caution is warranted for QQ.

Patient-reported substance use in heart failure.

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of healthcare system use and related cost. While pulmonary rehabilitation (PR) is efficient, maintenance programs (PR-MA) can maintain the benefits over time. Yet, the long-term impact (>36 months) of PR-MA on healthcare resource and cost has never been assessed. Recently, a PR-MA program based on self-help associations has shown a clinical efficacy beyond 36 months, Thus, we aimed to assess the effect of this PR-MA program on long-term hospitalizations and costs versus usual care (PR-UC). We performed an ancillary analysis of the post-rehabilitation LTAir+R cohort study, which compared a PR-MA group (n=144) to a matched PR-UC group (n=137) of COPD patients. Data were collected in 82 PR-MA and 93 PR-UC patients, from the Montpellier University Hospital database and patient records over 60 months, including hospitalizations, consultations, emergency visits, and associated costs. In PR-AM vs. PR-UC group, the hospitalization probability reduction almost reached significance (hazard ratio: 1.68; p=0.05). The costs of each hospitalization day (867±116 vs. 1213±138 euros/day; p<0.05), emergency visits (8±5 euros/year vs. 12±3 euros/year) and medical consultations (110±3 vs. 174±3 euros/year; p<0.01) were significantly lower in the PR-AM vs. PR-UC group. Last, PR-MA mitigated the increase in total hospitalizations (p<0.001) associated with the follow-up duration. In addition to its long-term clinical efficacy, this PR-MA program showed a positive impact on hospitalization and healthcare use costs. The effect on hospitalization number and costs could be larger in patients with the longest PR-MA adherence.

The impact of respiratory syncytial virus (RSV) among older adults hospitalized for acute respiratory symptoms was uncertain. We compared the prevalence and clinical outcomes of RSV with those of COVID-19 and influenza in older adults hospitalized for acute respiratory symptoms. We conducted a multicentre prospective cohort study at three community hospitals, which enrolled emergently hospitalized adults aged ≥50 years with acute respiratory symptoms or signs from July 1, 2023, to December 31, 2024. RSV, COVID-19, and influenza A/B were measured using the FilmArray Respiratory panel 2.1 on a nasopharyngeal swab. The primary outcomes were lower respiratory tract infections (LRTIs), defined as presence of ≥2 lower respiratory symptoms/signs for at least 24 hours, including ≥1 lower respiratory sign or presence of ≥3 lower respiratory symptoms for at least 24 hours; modified LRTIs, incorporating chest radiography or computed tomography; and the 30-day all-cause mortality. During the 18-month study period, 3067 patients were included, with a mean age of 81 years (standard deviation: 11), and 55% of whom were male. Comorbidities included chronic pulmonary diseases (28%), chronic heart failure (32%), and diabetes (30%). The vaccination rates for RSV, COVID-19, and influenza were 0%, 62.3%, and 37.9%, respectively. The prevalence of RSV, COVID-19, and influenza A/B was 1.6%, 18.0%, and 2.3%, respectively. The rates of LRTIs were 87.8% (RSV), 82.8% (COVID-19), and 88.4% (influenza A/B). The rates of modified LRTIs exhibited a marginal increase. The 30-day mortality was highest among patients with RSV (14.3%) compared with those with COVID-19 (8.4%) and influenza A/B (2.9%) (p = 0.02). The adjusted odds ratios (95% confidence intervals) of 30-day mortality with RSV and COVID-19 relative to influenza A/B were 5.2 (1.2-36.7) and 2.9 (0.83-17.9), respectively. RSV should be recognized as a risk factor for mortality among older adults emergently hospitalized for acute respiratory symptoms.

Process and Cost Evaluation of a Successful Palliative Telecare Team Intervention in Heart and Lung Disease.

Cigarette smoking is a well-recognized risk factor for chronic obstructive pulmonary disease (COPD) and lung cancer, but the underlying molecular mechanisms remain the subject of intense investigation. A large body of evidence has shown the role of long noncoding RNAs (lncRNAs) in the pathogenesis of smoke-related diseases. LncRNAs are > 200 nt-long functional transcripts with limited protein-coding potential, which are emerging as critical regulators of gene expression in a variety of biological processes. Exposure to cigarette smoke (CS) is known to cause widespread dysregulation of lncRNAs in lung tissues and immune cells, thus leading to disruption of cell homeostasis, and induction of oxidative stress and chronic inflammation. This review article discusses the interplay of lncRNAs, smoking, oxidative stress, immune response, and lung disease. First, we provide an overview of the functions and modes of action of lncRNAs in the regulation of gene expression at the epigenetic, transcriptional, and post-transcriptional levels. We then examine the different mechanisms by which tobacco-induced dysregulation of lncRNAs contributes to oxidative stress, chronic inflammation, and disease pathogenesis, while focusing on COPD and lung cancer. Finally, we highlight the importance of extending lncRNA research to new and emerging tobacco products and discuss the promises and pitfalls of lncRNAs as predictive biomarkers and prognostic targets. Understanding the intricate roles of lncRNAs in the pathogenesis of COPD and lung cancer can provide new avenues for advancing diagnostic tools and therapeutic strategies in the fight against these devastating smoke-associated diseases.

Vibrating mesh nebulization increases tidal volume relative to jet nebulization during NIV in COPD exacerbation.

Exploring AI and ML in managing overlap between cardiovascular disease and asthma or COPD: a scoping review.

Chronic obstructive pulmonary disease (COPD) increases surgical morbidity and mortality, but its effect on paraesophageal hernia repair (PEHR) is unknown. This study aimed to evaluate the associations between COPD and PEHR outcomes, hypothesizing an increased risk of hernia recurrence in patients with COPD. A retrospective cohort study (2011-2022) was conducted on elective patients with PEHR, stratified into COPD and high-risk non-COPD groups (American Society of Anesthesiologists [ASA] class 3 or 4). The primary outcome was early recurrence (<6 months). Propensity score matching (1:1) was used to control for age, gender, and body mass index (BMI). The chi-squared and Mann-Whitney U tests were used to compare demographics and outcomes. Kaplan-Meier curves were used to analyze the recurrence timing, and multivariate logistic regression was used to assess COPD as an independent risk factor, adjusting for age, BMI, ASA class, and smoking status. Among 537 patients, 62 matched pairs were analyzed. COPD was not linked to increased respiratory complications but was associated with higher discharge to advanced care (12.9% vs 1.6%; P =.038) and earlier recurrence (160 vs 652 days; P =.01). Kaplan-Meier curves showed increased early recurrence in patients with COPD (P =.02), although recurrence rates converged later. COPD independently predicted early recurrence (odds ratio, 4.4; P <.001). COPD is an independent risk factor for early recurrence after PEHR, although it does not increase the risk of respiratory complications or overall recurrence. Patients with COPD more frequently required higher-level care and experienced earlier recurrence. Our findings may guide shared decision-making and suggest strategies to mitigate recurrence risk, such as routine mesh placement.

Diaphragmatic ultrasound in guiding weaning from invasive mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease.

Unintentional weight loss (UWL) is an important clinical indicator of malnutrition risk. Risk factors for UWL may differ by body size, measured by body mass index (BMI), and identifying at-risk individuals can be challenging in those with overweight/obesity. Data from ∼125 000 adults (≥18 y) in the Dutch Lifelines cohort were analyzed to examine whether associations between 21 potential risk factors spanning sociodemographic, psychological stress, disease, dietary, and quality-of-life domains and UWL differ by BMI group. Participants were classified as having a healthy weight (45.8%) or overweight/obesity (54.2%). Multivariable Poisson regression models estimated prevalence ratios for UWL, with sensitivity analyses to test robustness. Statistical significance was set at P < 0.05. UWL was reported by 4.9% of participants with a healthy weight and 2.7% of those with overweight/obesity. Positive associations with UWL were observed for female sex, (healthy-weight group only), absence from work due to disease, psychological stress in the past year, chronic obstructive pulmonary disease, depression, and poor quality-of-life indicators (physical functioning, perceived health, emotional well-being, vitality, and social functioning). Effect modification by BMI was suggested for 10 risk factors (P < 0.1), with associations generally more pronounced in the healthy-weight group. After sensitivity analyses, only higher educational attainment, psychological stress in the past year, and poor physical functioning retained significant modification. Most risk factors for UWL were consistent between BMI groups. Differences in higher educational attainment, psychological stress in the past year, and physical functioning suggest that although the factors are similar, their impact may differ by BMI.