Benign metastasizing leiomyoma (BML) is a rare condition characterized by the proliferation of smooth muscle cells at extrauterine sites, predominantly in the lungs, in women with a history of uterine leiomyomas. We report the case of a 63-year-old postmenopausal former smoker with a previous history of myomectomy for uterine leiomyoma. Multiple bilateral pulmonary nodules were incidentally detected at the age of 50 years. Computed tomography revealed well-defined solid lesions, while positron emission tomography demonstrated low metabolic uptake. Due to the presence of multiple bilateral pulmonary nodules suggestive of metastatic disease, video-assisted thoracoscopic wedge resection was performed, and histopathological examination supported the diagnosis of BML. During follow-up, slow progression of some lesions was observed, despite clinical and functional stability. This case highlights that some BML lesions may show slow radiological progression even after menopause. Factors such as obesity and hormone receptor expression may potentially contribute to disease persistence or progression, although a causal relationship could not be established in our case. These findings underscore the importance of prolonged and individualized radiological follow-up.
Introduction Specialist respiratory care delivered outside the acute hospital is recognised in the Spanish pulmonology training programme but has not been characterised in a multicentre study. We aimed to describe this model of care. Material and methods Cross-sectional REDCap survey of heads of Spanish pulmonology departments, conducted between January 2025 and May 2026. Three operational domains were assessed: intensity of in-person community-based activity, diagnostic and therapeutic capacity, and telemedicine and coordination with primary care (PC). In exploratory analyses, centres were compared according to their community-based outpatient share (<25% vs ≥25%) and the availability of a community-based day hospital. Results The 83 responses yielded 63 analysable centres from 25 provinces; 48 had in-person community-based activity. Of 44 centres with data, 34 (77.3%) saw ≥25% of their outpatients in this setting; these centres had more weekly clinic sessions (10 vs 6; p=0.011) and more often had nurses with respiratory training (66.7% vs 20.0%; p=0.013). Centres with a community-based day hospital had more advanced techniques (6 vs 2; p=0.005) but did not differ significantly in activity volume or in telemedicine and PC coordination. The three operational domains showed weak, non-significant pairwise correlations. Conclusions In this non-probability sample, community-based respiratory care represented a substantial component of outpatient activity and showed heterogeneous patterns across operational domains. These findings provide a baseline for prospective evaluation of accessibility, quality and efficiency.
Oscillometry is a non-invasive method for assessing the impedance (Z) of the respiratory system, which depends on resistance (R) and reactance (X). Currently, it is mainly developed in obstructive diseases and its utility in obstructive sleep apnea (OSA) remains unclear. In a few previous studies it has been explored as a diagnostic tool for OSA with positive findings, but most included obese individuals, making it unclear whether observed changes were due to OSA or obesity. Our study aimed to evaluate oscillometry values specifically in non-obese patients with and without OSA to clarify these relationships without the confounding effect of obesity, as well as to describe these parameters based on disease severity. We conducted a prospective observational study at Getafe University Hospital (Madrid) between January and December 2023. A total of 60 patients, aged 18–75 years, who attended the sleep disorders consultation were recruited: 30 with OSA and 30 without OSA, confirmed by polygraphy. All participants underwent oscillometry to measure respiratory resistance (Rrs) and reactance (Xrs) at different frequencies. Results, adjusted for age, sex, and BMI, revealed no statistically significant differences in resistance or reactance between groups. Furthermore, no correlation was found between oscillometric parameters and OSA severity. In the course of our study, we did not observe significant mechanical alterations, suggesting that in non-obese individuals, basal respiratory mechanics remain preserved during wakefulness. These findings support the need to consider obesity as a potential confounding factor when interpreting oscillometric abnormalities previously reported in patients with OSA. Further studies are needed to confirm these findings.
Introduction Although computed tomography (CT) provides valuable information in severe asthma, its indications and interpretation remain nonstandardized and often undervalued, making consensus between pulmonologists and radiologists crucial to optimize its clinical use. Material and methods An expert panel of 85 pulmonologists specialized in asthma and thoracic radiologists completed a two-round Delphi process, rating 33 statements on a 1–9 Likert scale using the RAND/UCLA appropriateness method. Results Seventy-six experts completed round 1 (89.4%) and 70 completed both rounds (82.3%); 76.3% were pulmonologists and 23.7% thoracic radiologists. Consensus was achieved for 32/33 statements in round 1 and for the three reevaluated statements in round 2, yielding 34 recommendations organized in six thematic blocks. Panelists highly recommended performing high-resolution chest CT (HRCT) in all patients with severe uncontrolled asthma and when complications are suspected to establish differential diagnoses and identify associated entities. Specific recommendations were provided for CT acquisition and interpretation, including parameter-specific guidance for relevant features such as airway wall thickening (wall area percentage, lumen area, total airway count), small-airway disease (air trapping with or without emphysema), mucus plugging (standardized scoring), and comorbidities (e.g., bronchiectasis). They also agreed on the importance of performing HRCT before and after starting biologic therapies to guide drug selection and to assess response, and highlighted future opportunities for radiomultiomics and artificial intelligence. Conclusions Chest CT is a highly valuable objective tool in severe asthma, and CT-derived parameters have the potential to become established imaging biomarkers to support clinical decision-making. This consensus document provides recommendations to guide CT use and interpretation, contributing to improved patient management and personalized care.
Objective Assess the relationships between physical nicotine dependence (FTCD), motivation to quit smoking, perceived self-efficacy, and behavioural and psychosocial smoking-related domains (UISPM) among smokers attending specialized smoking cessation units. Material and methods A baseline cross-sectional analysis was conducted to evaluate the relationships between motivation and self-efficacy, physical dependence, and behavioural and psychosocial dependence, using data from a prospective, observational, multicenter study. Associations were analyzed using between-group comparisons, Spearman correlations, and multivariate logistic regression models. Results A total of 330 smokers were included. High motivation was observed in 84.2% of participants, whereas high self-efficacy was present in 30.9%. FTCD dependence was positively correlated with all UISPM domains, with the strongest correlations observed for sedation (rho=0.331, 95% CI 0.231–0.424), social dependence (rho=0.311, 95% CI 0.210–0.406), and psychological dependence (rho=0.300, 95% CI 0.198–0.396). Motivation showed only a weak positive correlation with FTCD dependence. In multivariable analyses, high motivation was independently associated with lower educational level (OR 2.528, 95% CI 1.118–5.714), higher FTCD score (OR 1.247, 95% CI 1.007–1.543), and higher self-efficacy (OR 1.504, 95% CI 1.217–1.859). High self-efficacy was independently associated with shorter smoking duration (OR 0.923, 95% CI 0.871–0.979), higher baseline CO levels (OR 1.047, 95% CI 1.014–1.082), and higher motivation (OR 1.400, 95% CI 1.091–1.797). Conclusions Physical dependence was consistently associated with behavioural and psychosocial smoking-related domains, but not with lower motivation or self-efficacy. These findings suggest that dependence burden, motivation, and self-efficacy represent complementary dimensions in baseline smoking cessation assessment.
