UNASSIGNED: The evidence on the association of fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) with pulmonary tuberculosis (PTB) retreatment is limited. There are no data on whether greenness exposure protects air pollution-related PTB retreatment in patients with prior PTB.
UNASSIGNED: In a population-based retrospective study, we aimed to investigate the influence of PM2.5 and residential greenness on the risk of PTB retreatment.
UNASSIGNED: A total of 26,482 patients with incident PTB, registered in a mandatory web-based reporting system between 2012 and 2019 in Zhengzhou, China, were included in the analysis. The exposure to PM2.5 was assessed based on the China High Air Pollutants dataset, and the level of greenness was estimated using the Normalized Difference Vegetation Index (NDVI) values. The associations of PTB retreatment with exposure to PM2.5 and greenness were evaluated, respectively, considering the local socioeconomic level indicated by the nighttime light index.
UNASSIGNED: Among the 26,482 patients (mean age 46.86, SD 19.52 years) with a median follow-up time of 1523 days per patient, 1542 (5.82%) PTB retreatments were observed between 2012 and 2019. Exposure to PM2.5 was observed to be significantly associated with the increased risk of PTB retreatment in fully adjusted models with a hazard ratio of 1.97 (95% CI 1.34-2.83) per 10 μg/m3 increase in PM2.5. Patients living in the regions with relatively high quartiles of NDVI values had a 45% lower risk of PTB retreatment than those living in the regions with the lowest quartile for the 500 m buffers (hazard ratio 0.55, 95% CI 0.40-0.77). Such a protective effect of residential greenness was more pronounced among patients living in lower nighttime light areas. The strength of the association between PM2.5 exposure and the risk of PTB retreatment was attenuated by greenness. No significant association was observed between NDVI and the incidence of drug resistance.
UNASSIGNED: Long-term exposure to PM2.5 might be a risk factor for PTB retreatment, while an increased level of residential greenness was found to be associated with reduced risks of PTB retreatment. Our results suggest strengthening the control of ambient air pollution and improving residential greenness may contribute to the reduction of PTB retreatment.

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Asthma and chronic obstructive pulmonary disease (COPD) represent chronic inflammatory respiratory disorders that, despite having distinct pathophysiological underpinnings, both feature airflow obstruction and respiratory symptoms. A critical component in the pathogenesis of each condition is the transforming growth factor-β (TGF-β), a multifunctional cytokine that exerts varying influences across these diseases. In asthma, TGF-β is significantly involved in airway remodeling, a key aspect marked by subepithelial fibrosis, hypertrophy of the smooth muscle, enhanced mucus production, and suppression of emphysema development. The cytokine facilitates collagen deposition and the proliferation of fibroblasts, which are crucial in the structural modifications within the airways. In contrast, the role of TGF-β in COPD is more ambiguous. It initially acts as a protective agent, fostering tissue repair and curbing inflammation. However, prolonged exposure to environmental factors such as cigarette smoke causes TGF-β signaling malfunction. Such dysregulation leads to abnormal tissue remodeling, marked by excessive collagen deposition, enlargement of airspaces, and, thus, accelerated development of emphysema. Additionally, TGF-β facilitates the epithelial-to-mesenchymal transition (EMT), a process contributing to the phenotypic alterations observed in COPD. A thorough comprehension of the multifaceted role of TGF-β in asthma and COPD is imperative for elaborating precise therapeutic interventions. We review several promising approaches that alter TGF-β signaling. Nevertheless, additional studies are essential to delineate further the specific mechanisms of TGF-β dysregulation and its potential therapeutic impacts in these chronic respiratory diseases.

RSV infection remains a serious threat to the children all over the world, especially, in the low-middle income countries. Vaccine delivery via the mucosa holds great potential for inducing local immune responses in the respiratory tract. Previously, we reported the development of highly immunogenic RSV virus-like-particles (RSV-VLPs) based on the conformationally stable prefusogenic-F protein (preFg), glycoprotein and matrix protein. Here, to explore whether mucosal delivery of RSV-VLPs is an effective strategy to induce RSV-specific mucosal and systemic immunity, RSV-VLPs were administered via the nasal, sublingual and pulmonary routes to BALB/c mice. The results demonstrate that immunization with the VLPs via the mucosal routes induced minimal mucosal response and yet facilitated modest levels of serum IgG antibodies, enhanced T cell responses and the expression of the lung-homing marker CXCR3 on splenocytes. Immunization with VLPs via all three mucosal routes provided protection against RSV challenge with no signs of RSV induced pathology.

The etiology of vascular problems in beta-thalassemia has been linked to endothelial damage. Antiangiogenic proteins such as soluble fms-like tyrosine kinase-1 (sFLT-1) inhibit the signaling of vascular endothelial growth factor (VEGF) and placental growth factor (PIGF), resulting in a decrease in the development of new blood vessels. Additionally, they promote the maturation of existing blood vessels and lead to endothelial dysfunction. This study aimed to assess the role of sFLT-1 in adult patients with beta-thalassemia major (TM) as a biomarker of endothelial dysfunction and its association with pulmonary hypertension (PHT). A total of 90 subjects were recruited and categorized into two groups: 45 patients with beta-TM, who were further divided based on the presence or absence of PHT, and 45 healthy individuals served as a control group. Serum sFLT-1 was determined using the enzyme-linked immunosorbent assay (ELISA) technique. The results revealed that Beta-TM patients had higher sFLT-1 levels than the control group. In addition, patients with PHT had significantly higher sFLT-1 levels compared to those without PHT. The levels of sFLT-1 were positively correlated with von Willebrand factor (vWF), serum ferritin, and high-sensitivity C-reactive protein (hs-CRP). Regression analyses demonstrated a significant association between high sFLT-1 levels and the occurrence of PHT. Additionally, sFLT-1 (at a cutoff value of 8.84 pg/ml) demonstrated a sensitivity of 83.30% and specificity of 80.0% in diagnosing thalassemic patients with PHT. In conclusion, beta-TM patients with elevated serum levels of sFLT-1 are at risk of developing endothelial dysfunction and subsequent development of PHT.

BACKGROUND: The development of internet technology has greatly increased the ability of patients with chronic obstructive pulmonary disease (COPD) to obtain health information, giving patients more initiative in the patient-physician decision-making process. However, concerns about the quality of website health information will affect the enthusiasm of patients\' website search behavior. Therefore, it is necessary to evaluate the current situation of Chinese internet information on COPD.
OBJECTIVE: This study aims to evaluate the quality of COPD treatment information on the Chinese internet.
METHODS: Using the standard disease name \"\" (\"chronic obstructive pulmonary disease\" in Chinese) and the commonly used public search terms \"\" (\"COPD\") and \"\" (\"emphysema\") combined with the keyword \"\" (\"treatment\"), we searched the PC client web page of Baidu, Sogou, and 360 search engines and screened the first 50 links of the website from July to August 2021. The language was restricted to Chinese for all the websites. The DISCERN tool was used to evaluate the websites.
RESULTS: A total of 96 websites were included and analyzed. The mean overall DISCERN score for all websites was 30.4 (SD 10.3; range 17.3-58.7; low quality), no website reached the maximum DISCERN score of 75, and the mean score for each item was 2.0 (SD 0.7; range 1.2-3.9). There were significant differences in mean DISCERN scores between terms, with \"chronic obstructive pulmonary disease\" having the highest mean score.
CONCLUSIONS: The quality of COPD information on the Chinese internet is poor, which is mainly reflected in the low reliability and relevance of COPD treatment information, which can easily lead consumers to make inappropriate treatment choices. The term \"chronic obstructive pulmonary disease\" has the highest DISCERN score among commonly used disease search terms. It is recommended that consumers use standard disease names when searching for website information, as the information obtained is relatively reliable.

Traumatic pneumatocele (TP) is a rare complication that can develop in the lungs following a traumatic event. These lesions are sometimes mistaken for congenital airway malformations. Multiple theories exist to explain the pathophysiology of this condition. This case study presents the clinical and radiological findings of a seven-year-old patient diagnosed with pneumatocele on thoracic imaging after a motor vehicle accident. A detailed evaluation of the patient\'s medical history and imaging led to the diagnosis of traumatic pneumatocele. This uncommon presentation, if not well understood, may lead to unnecessary interventions and significant anxiety for patients and their families. Given its rarity, awareness and a high index of suspicion are essential for accurate diagnosis and appropriate management.

This report presents the case of an 18-year-old male with cystic fibrosis (CF) who developed septic shock due to methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. He had a history of poor nutritional status and uncontrolled CF-related diabetes, both contributing to his rapidly declining condition. Despite aggressive treatment, including extracorporeal membrane oxygenation, his hospital course continued to deteriorate, including worsening respiratory failure and the need for lower extremity amputation secondary to ischemia. Ultimately, the decision to withdraw life support was made after it was determined the patient had unrecoverable respiratory failure. Our goal in presenting this case is to demonstrate the serious consequences of MRSA infection in patients with CF, who are often severely immunocompromised, and to emphasize the need for early detection and aggressive intervention among patients of this group.

BACKGROUND: 18F-Fluorodeoxyglucose (FDG) PET/CT is emerging as a tool in the diagnosis and evaluation of pulmonary sarcoidosis, however, there is limited consensus regarding its diagnostic performance and prognostic value.
METHODS: A meta-analysis was conducted with PubMed, Science Direct, MEDLINE, Scopus, and CENTRAL databases searched up to and including September 2023. 1355 studies were screened, with seventeen (n = 708 patients) suitable based on their assessment of the diagnostic performance or prognostic value of FDG-PET/CT. Study quality was assessed using the QUADAS-2 tool. Forest plots of pooled sensitivity and specificity were generated to assess diagnostic performance. Pooled changes in SUVmax were correlated with changes in pulmonary function tests (PFT).
RESULTS: FDG-PET/CT in diagnosing suspected pulmonary sarcoidosis (six studies, n = 400) had a pooled sensitivity of 0.971 (95%CI 0.909-1.000, p = < 0.001) and specificity of 0.873 (95%CI 0.845-0.920)(one study, n = 169). Eleven studies for prognostic analysis (n = 308) indicated a pooled reduction in pulmonary SUVmax of 4.538 (95%CI 5.653-3.453, p = < 0.001) post-treatment. PFTs displayed improvement post-treatment with a percentage increase in predicted forced vital capacity (FVC) and diffusion capacity of the lung for carbon monoxide (DLCO) of 7.346% (95%CI 2.257-12.436, p = 0.005) and 3.464% (95%CI -0.205-7.132, p = 0.064), respectively. Reduction in SUVmax correlated significantly with FVC (r = 0.644, p < 0.001) and DLCO (r = 0.582, p < 0.001) improvement.
CONCLUSIONS: In cases of suspected pulmonary sarcoidosis, FDG-PET/CT demonstrated good diagnostic performance and correlated with functional health scores. FDG-PET/CT may help to guide immunosuppression in cases of complex sarcoidosis or where treatment rationalisation is needed.
CONCLUSIONS: FDG-PET/CT has demonstrated a high diagnostic performance in the evaluation of suspected pulmonary sarcoidosis with radiologically assessed disease activity correlating strongly with clinically derived pulmonary function tests.
CONCLUSIONS: In diagnosing pulmonary sarcoidosis, FDG-PET/CT had a sensitivity and specificity of 0.971 and 0.873, respectively. Disease activity, as determined by SUVmax, reduced following treatment in all the included studies. Reduction in SUVmax correlated with an improvement in functional vital capacity, Diffusion Capacity of the Lungs for Carbon Monoxide, and subjective health scoring systems.

BACKGROUND: The rapid evolution of ChatGPT has generated substantial interest and led to extensive discussions in both public and academic domains, particularly in the context of medical education.
OBJECTIVE: This study aimed to evaluate ChatGPT\'s performance in a pulmonology examination through a comparative analysis with that of third-year medical students.
METHODS: In this cross-sectional study, we conducted a comparative analysis with 2 distinct groups. The first group comprised 244 third-year medical students who had previously taken our institution\'s 2020 pulmonology examination, which was conducted in French. The second group involved ChatGPT-3.5 in 2 separate sets of conversations: without contextualization (V1) and with contextualization (V2). In both V1 and V2, ChatGPT received the same set of questions administered to the students.
RESULTS: V1 demonstrated exceptional proficiency in radiology, microbiology, and thoracic surgery, surpassing the majority of medical students in these domains. However, it faced challenges in pathology, pharmacology, and clinical pneumology. In contrast, V2 consistently delivered more accurate responses across various question categories, regardless of the specialization. ChatGPT exhibited suboptimal performance in multiple choice questions compared to medical students. V2 excelled in responding to structured open-ended questions. Both ChatGPT conversations, particularly V2, outperformed students in addressing questions of low and intermediate difficulty. Interestingly, students showcased enhanced proficiency when confronted with highly challenging questions. V1 fell short of passing the examination. Conversely, V2 successfully achieved examination success, outperforming 139 (62.1%) medical students.
CONCLUSIONS: While ChatGPT has access to a comprehensive web-based data set, its performance closely mirrors that of an average medical student. Outcomes are influenced by question format, item complexity, and contextual nuances. The model faces challenges in medical contexts requiring information synthesis, advanced analytical aptitude, and clinical judgment, as well as in non-English language assessments and when confronted with data outside mainstream internet sources.