To systematically evaluate the prevalence, clinical characteristics, and clinical outcomes of mucus plugging across chronic respiratory diseases. Two authors searched four databases for eligible studies. Prevalence of mucus plugging was pooled and shown as percentage with a 95
Lung cancer screening guidelines generally recommend imaging surveillance rather than tissue sampling for nodules measuring ≤8 mm. Evidence regarding the feasibility, diagnostic performance, and safety of tissue biopsy in this lesion size remains limited. We evaluated the diagnostic performance and safety of shape-sensing robotic-assisted bronchoscopy (ssRAB) for biopsy of peripheral pulmonary nodules measuring ≤8 mm. We conducted a retrospective single-center study of consecutive patients who underwent ssRAB between June 2020 and December 2025 for biopsy of nodules measuring ≤8 mm on pre-procedural CT imaging. The primary outcome was strict diagnostic yield, as defined by the American Thoracic Society/American College of Chest Physicians. Secondary objectives included intermediate diagnostic yield, diagnostic distribution, procedural outcomes, and complications. Diagnostic performance according to lesion size (≤ 6 mm vs. 6.1–8 mm) was evaluated separately as a subgroup analysis. A total of 195 nodules were included in the study. Median lesions diameter was seven mm (IQR 6–8). Strict diagnostic yield was 70.2
Chronic obstructive pulmonary disease (COPD), asthma, lower respiratory tract infection (LRTI), and lung cancer have been identified as major respiratory diseases. Fine particulate matter (PM2.5) is an important respiratory risk factor, but evidence on life-course exposure to individual constituents and associated biological signatures remains limited. Among 47,737 participants from UK Biobank, birth-to-baseline residential histories were linked to annual concentrations of PM2.5, sulfate (SO42−), nitrate (NO3−), ammonium (NH4+), organic carbon (OC), and elemental carbon (EC) estimated by the Community Multiscale Air Quality model during 1930–2010. Cox regression was used to estimate hazard ratios (HRs) per interquartile range (IQR) increase, and quantile g-computation to estimate mixture effects. Exposure- and disease-associated biomarkers were screened, followed by mediation analyses, protein functional enrichment, and metabolite categorization. During 13–14 years of follow-up, each IQR increase in PM2.5 was associated with higher risks of COPD (HR: 1.138, 95
To assess whether airway pressure release ventilation (APRV) reduces mortality compared with conventional invasive ventilation in adults with established acute respiratory distress syndrome (ARDS), acute lung injury, or conditions considered to confer a high risk of ARDS. We searched PubMed, Embase, and the Cochrane Library from inception through August 15, 2026. We analyzed parallel-group randomized trials using random-effects models. Mortality at trial-defined follow-up was the primary outcome. We used Cochrane RoB 2 to assess risk of bias and GRADE to assess certainty of evidence. PROSPERO: CRD420251170819. Nine trials involving 585 participants were included. No mortality benefit was demonstrated (risk ratio 0.95, 95
Phase 3 evidence for antifibrotic-directed therapies in idiopathic pulmonary fibrosis (IPF) has expanded, but direct head-to-head trials are lacking. Forced vital capacity (FVC) decline remains the principal trial outcome, although it may not fully capture clinically relevant differences among therapies. We systematically reviewed phase 3 randomized placebo-controlled trials of antifibrotic-directed therapies in IPF. FVC effects versus placebo were descriptively summarized using standardized 48–52-week estimates. All-cause treatment discontinuation and all-cause mortality were analyzed using placebo-controlled odds ratios. Sensitivity analyses assessed follow-up duration, background antifibrotic therapy, and trial-level consistency. Ten trials including 5,386 randomized participants were included. Pirfenidone and nintedanib showed consistent reductions in FVC decline versus placebo. Inhaled treprostinil showed a favorable FVC signal in the combined TETON-1/2 evidence, largely as add-on therapy with background antifibrotic treatment. Without background antifibrotic therapy, several therapies showed directionally favorable but imprecise FVC effects, without evidence of equivalence. Nintedanib and inhaled treprostinil were associated with higher odds of all-cause treatment discontinuation versus placebo: OR 1.39 (95
