Distinct serum metabolic profiles with supportive diagnostic value in differentiating tuberculosis and Mycobacterium avium complex pulmonary disease.

Prostate cancer in Korea: Nationwide trends in prevalence and medication use during 2011-2021.

Flexible bronchoscopy (FBS) is a widely used diagnostic and therapeutic tool in intensive care and pulmonary medicine. However, its role in the emergency department (ED) is less well established, especially in emergency physicians' hands. The aim of this study was to describe the indications, findings, outcomes, and complications of FBS performed by emergency physicians in the ED following structured training, with a specific focus on its feasibility and safety. This was a prospective single-center cohort study at Careggi University Hospital (Florence, Italy), including all patients undergoing FBS in the ED between January 1, 2023, and September 1, 2025. Demographic data, clinical indications, outcomes, and complications were prospectively collected and analyzed. We prospectively enrolled 431 patients (median age 69years, 43.4% female), the majority of whom were non-intubated (86.8%). The main indications were pneumonia or respiratory infection (40.4%), hemoptysis (19.3%), and bronchial toilet for secretion clearance (18.3%). Common bronchoscopic findings included purulent secretions (42.2%), mucus plugs (9.9%), and airway bleeding (12.3%). Bronchoalveolar lavage was performed in 46.6% of cases, and bronchial toilet in 18.3%. A clinical improvement was observed in 24.4% of patients, while 70.8% showed no immediate change. Complications were minor and self-limited, with no major adverse events or procedure-related deaths recorded. Flexible bronchoscopy performed by trained emergency physicians appears safe and feasible.

Silencer-regulated circLSM14A inhibits autophagy of pulmonary artery smooth muscle cells through parental protein LSM14A.

PAWS-net: prior-aware weakly supervised network for pulmonary disease localization and classification in CT scans

Introduction: Non-invasive ventilation (NIV) is frequently employed as a treatment option for Acute Hypercapnic Respiratory Failure (AHRF) resulting from Chronic Obstructive Pulmonary Disease (COPD). Though it is frequently employed there are group of patients who are not tolerant to NIV,few recent studies had shown that High Flow Nasal Cannula (HFNC) can be used to treat hypercapnia. Aim: To compare the outcome of using High Flow Nasal Cannula (HFNC) versus NIV for COPD patients with AHRF. Materials and Methods: The present single centred crosssectional interventional study was performed from September 2022 to March 2024 at the Department of Respiratory Medicine, NRS Medical College and Hospital, Kolkata, West Bengal, India. A total of 30 COPD patients with AHRF were included in this study and they were assigned in consecutive and alternate manner to the HFNC group and NIV group. Data during their hospital stay such as demographic data, vital data, arterial blood gases, mean duration of hospital stays, and treatment failure were recorded and analysed. Results were analysed by unpaired student t-test and p-values were derived using Graph Pad Prism version 10. A p-value of <0.05 was taken as statistically significant. Results: The HFNC group had a mean age of 57.33±9.02 years (range 45-70), while the NIV group had a mean age of 60.93±3.41 years (range: 53-66), with no significant difference (p=0.1291). Both groups had comparable distributions in gender (male: 66.67%, female: 33.33%) and smoking habits (HFNC- smoker: 66.67%, NIV- smoker: 73.33%), ensuring baseline comparability and ABG parameters. PaCO2 after 24 hours of intervention shows that improvement in both the group was similar and the difference was statistically not significant (64.07±9.06 vs 57±9.62; p=0.056). From both groups one patient (6.67%) needs invasive ventilation. The difference in days spent in the hospital and days on device were also statistically not significant (p>0.05) between two groups. Conclusion: HFNC is an effective option to treat hypercapnic respiratory failure in COPD patients. HFNC therapy did not result in increased treatment failure or prolonged hospitalisation when compared to NIV.

Since 1997 the Building Trades National Medical Screening Program (BTMed) has offered medical exams to construction workers employed in US nuclear weapons facilities. The process consists of two steps: (1) a detailed work history interview; and (2) a medical exam. Some participants only completed the work history interview, and we compared their mortality experience to those who also completed medical exams. We compared the mortality of 3470 work-history-only participants to 23,452 participants who completed both the work history interview and medical exams and, of these, 1720 who additionally participated in lung cancer screening. We used Cox proportional hazard and Poisson regression models to estimate hazard ratios and risk ratios while controlling for potential confounders. Medical exam participants experienced a reduction in mortality risk of 28% for all causes combined; 27% for all respiratory diseases combined; 37% for chronic obstructive pulmonary disease; 30% for cardiovascular diseases combined; 32% for all cancers combined; 36% for lung cancer; and 53% for colorectal cancer. The more medical exams they undertook the greater the mortality risk reduction (25%, 29%, and 43% for one, two, and three medical exams, respectively), demonstrating a clear trend. BTMed has prevented approximately 2911 premature deaths among our participants through 2021 and added 35,178 years of life, an average of 1.5 years per participant, at a cost of $2757 per year of life saved. Secondary prevention in occupational high-risk groups is very effective. Continued surveillance beyond retirement age is important to reduce mortality.

Transitions of care are the movement of a patient from one care setting or provider to another. Interprofessional collaboration is critical in ensuring patient safety and satisfactory health outcomes. Each time an interprofessional team transfers a patient, the team performs three important roles: representing the patient, providing patient information for other team members, and coordinating the transition. Poor transitions of care may contribute to negative health outcomes, especially for patients with chronic health conditions, complex medication regimens, and high-risk treatments. We present a case study of a patient with complicated chronic obstructive pulmonary disease that depicts the importance of successful interprofessional collaboration during the transition of care from hospital to home illustrating the unique contributions of the various disciplines involved in the patient's care.

Introduction: Bronchial anthracosis is a chronic respiratory condition characterised by the deposition of carbon particles in the bronchial mucosa. It is frequently associated with prolonged exposure to environmental pollutants, biomass smoke, and occupational dust, particularly in low-resource and rural settings. Aim: To elucidate the clinical and microbiological profile of patients with bronchial anthracosis in the mountainous valley of Kashmir, India. Materials and Methods: This cross-sectional study involved 88 patients diagnosed with bronchial anthracosis who were recruited from a tertiary care hospital. Data were collected on demographics, co-morbidities, exposure history, and microbiological findings through Bronchoalveolar Lavage (BAL). Statistical analysis was performed using percentage distribution and logistic regression analysis. Results: The mean age of the patients was 62.4±8.7 years, with females comprising 59.0% of the study population. Biomass fuel exposure (34.1%) and smoking (39.8%) were identified as significant risk factors. Common co-morbidities included Chronic Obstructive Pulmonary Disease (COPD) and hypertension. The chief complaints were cough (26.1%) and breathlessness (13.6%). BAL analysis revealed various pathogens, with Mycobacterium tuberculosis identified in 10.2% of cases. Logistic regression analysis demonstrated significant associations between bronchial anthracosis and age, smoking, and biomass fuel exposure, emphasising the influence of environmental risk factors. Conclusion: The findings highlight the significant role of environmental and occupational exposures—particularly biomass fuel use and smoking—in the development of bronchial anthracosis. Older adults, especially housewives and farmers, were the most affected groups, emphasising the need for targeted public health interventions. The association of bronchial anthracosis with respiratory infections and comorbidities such as COPD underscores the importance of early detection and appropriate management. Preventive strategies, including reduction of indoor air pollution and implementation of smoking cessation programmes, are essential to mitigate the disease burden in the ethnic population of Kashmir, India.

Purpose To develop a deep learning model for segmenting pectoralis muscle volume (PMV) at CT and evaluate the reproducibility, group differences, and associations of pectoralis muscle area (PMA) and PMV with chronic obstructive pulmonary disease (COPD)-related outcomes. Materials and Methods This study was a secondary analysis of the prospective Canadian Cohort Obstructive Lung Disease study (CanCOLD, data collected from November 2009 to July 2015). Randomly sampled CT scans from CanCOLD were used for model training, validation, and internal testing (n = 96, 16, and 32, respectively) and an external dataset for external testing (n = 32). A U-Net model was trained for PMV segmentation, and performance was assessed using the Dice similarity coefficient (DSC). PMA and PMV values were extracted from paired inspiration and expiration scans to assess segmentation reproducibility. Differences between individuals with or without COPD and associations with forced expiratory volume in 1 second (FEV1), diffusing capacity of the lungs for carbon monoxide (Dlco), and peak oxygen uptake during exercise (VO2) were reported. Results Individuals included those with (n = 634; mean age, 67.3 years ± 10.1 [SD]; 394 male participants) and without (n = 601; mean age, 65.8 years ± 9.6; 327 male participants) COPD. The model yielded DSCs of 0.94 ± 0.04, 0.93 ± 0.03, and 0.92 ± 0.04 in the training and validation, internal testing, and external testing datasets, respectively. Contrary to PMV (bias, 0.1 cm3; P = .77), PMA showed bias between inspiration and expiration (bias, -2.7 cm2; P < .001). Both PMA and PMV were reduced in patients with COPD (P < .05), but PMV was more strongly associated with FEV1 (adjusted R2 [Radj2], 0.609/0.598), Dlco (Radj2, 0.645/0.627), and VO2 (Radj2, 0.680/0.666). Conclusion An accurate and generalizable CT-based deep learning model for pectoralis muscle segmentation was developed. Compared with PMA, PMV showed better reproducibility and stronger associations with COPD outcomes. Keywords: CT, Thorax, Lung, Volume Analysis, Chronic Obstructive Pulmonary Disease, Segmentation ClinicalTrials.gov identifier no. NCT00920348 © RSNA, 2026 Supplemental material is available for this article.

Chronic psychological stress induces pulmonary dysfunction through alveolar macrophage-mediated activation of apoptotic signaling pathways.

Automated administration of medical oxygen using model predictive control incorporating real-time monitoring of breathing parameters.

A Contextual Multimodal Federated Transformer with dual distillation for decentralized chronic obstructive pulmonary disease related lung pathology classification

This data note describes a structured dataset of lung radiomic features derived from thoracic noncontrast computed tomography examinations of 100 subjects (47 males, 53 females; aged 15-74 years). Participants were selected on the basis of the absence of known lung, pleura, and mediastinum diseases in clinical records and radiology reports, as well as systemic diseases affecting the respiratory system. The included computed tomography studies were performed on a single multidetector CT scanner (Siemens Healthineers SOMATOM go. Now), using a uniform protocol (110 kVp; reconstructed slice thickness 0.8 mm; Br60-type lung kernel). For each case, the target thin-slice DICOM series was converted to the NIfTI format. The lung lobes ("raw" masks), vessels and air pathways were segmented automatically with TotalSegmentator. In addition to "raw" lobe masks, vessel/airway-subtracted (parenchyma) masks were generated. Lobe masks (left lung - 2, right lung - 3) were also combined into the left lung, right lung, and both lungs, resulting in eight ROIs per subject for each mask type - with ("raw") and without vessel/air pathways ("parenchyma"). For each SubjectID×ROI, radiomic features (107 "original" features - shape, first-order, and texture families) were extracted via a PyRadiomics-based pipeline with fixed settings (B-spline interpolation; resampling to 1 × 1 × 1 mm; bin width 25 HU; absolute resegmentation) in two attenuation ranges: -1000 to +200 HU and -950 to 0 HU. The dataset is distributed as (i) a CT protocol table, (ii-iii) two feature tables ("raw" and parenchyma masks), (iv) a JSON file with a computational environment description, (v) a Python extraction script, and (vi) a dictionary file. This dataset can serve as a normative reference for lung radiomics, a benchmark for harmonization and robustness studies, and a control cohort for comparative modelling in diffuse lung diseases, as well as region-specific diseases requiring lobar or single-lung-specific radiomic features (such as emphysema, chronic obstructive pulmonary disease, Swyer-James-MacLeod syndrome, asbestosis, and silicosis).

Nebulization with mucolytic and bronchodilator agents is frequently applied in Intensive Care Units (ICUs) for invasively ventilated patients, despite limited evidence for clinical benefit and potential risks associated with routine use. Understanding current practice and rationale behind nebulization is essential to targeted de-implementation strategies. We conducted a nationwide, cross-sectional telephone survey among ICU healthcare professionals in the Netherlands. The survey addressed nebulization practices for mucolytics and bronchodilators, including agents used, administration strategy, clinical indications, evaluation strategies, and local protocols. Open-ended questions explored underlying clinical reasoning and factors influencing nebulization practices. Representatives from 54 of 71 Dutch ICUs (76%) participated. Most respondents were ventilation practitioners (72%, 39/54), supplemented by ICU nurses and intensivists. Nebulization with mucolytics was reported in 47 ICUs (87%) ICUs and with bronchodilators in all ICUs. On-demand nebulization predominated (91.5%, 43/47 for mucolytics; 83.3%, 45/54 for bronchodilators). Thick secretions were the main indication for mucolytics, whereas obstructive pulmonary disease and bronchospasm were leading indications for bronchodilators. Acetylcysteine and salbutamol/ipratropium were most frequently used. Local protocols were present in 41 (76%) ICUs. Active humidification was commonly applied on indication, particularly in prolonged ventilation. Responses to open-ended questions revealed that, beyond clinical triggers, nebulization decisions were frequently shaped by personal preference, habitual practice, and organizational context, rather than by evidence-based reasoning. Nebulization in Dutch ICUs is predominantly on-demand but practice remains variable and partly driven by ingrained habits instead of evidence. Non-indicated nebulization persists and represents potential low-value care. This nationwide survey demonstrates that nebulization practices in Dutch ICUs remain highly variable, often driven by non-standardized protocols and subjective interpretation of indications rather than evidence. To promote more consistent and evidence-based care, implementing a practical decision-support tool could guide clinicians toward indication-based nebulization and support de-implementation of routine, non-indicated use.

Investigating the electrostatics underlying activation of the β2 adrenergic receptor.

BDP/FF/GB single-inhaler triple therapy in COPD: real-world effectiveness, safety, and adherence in a pooled analysis of 5,000 patients.

Effect of complementary therapies on chronic obstructive pulmonary disease patient outcomes treated with noninvasive ventilation: A systematic review.

Sputum proteomics and phosphoproteomics for improving chronic obstructive pulmonary disease knowledge.

Risk factors for sputum smear-positive in COPD patients first diagnosed with active tuberculosis.