This study analyzes the risk factors of unfavorable treatment outcomes in rifampicin-sensitive pulmonary tuberculosis (PTB) patients. Clinical data of 694 patients with rifampicin-sensitive PTB admitted to Quzhou Hospital Affiliated to Wenzhou Medical University from January 2020 to December 2021 were retrospectively analyzed. Univariate and multivariate logistic regression were used to analyze the related risk factors, and the predictive value was assessed using the receiver operating characteristic curve. Among 66 patients with unfavorable treatment outcomes, 42 died from non-tuberculosis causes, 16 died from tuberculosis, and 8 had failed treatment. Multivariate Logistic regression analysis showed that retreatment of PTB (odds ratio [OR] = 2.750, 95% confidence interval [CI] 1.253-6.033), chronic obstructive pulmonary disease (OR = 3.229, 95% CI 1.678-6.212), respiratory failure (OR = 7.388, 95% CI 2.420-22.560), elevated C-reactive protein (CRP) (OR = 1.006, 95% CI 1.000-1.011), hypoproteinemia (OR = 0.902, 95% CI 0.839-0.969), and low body mass index (BMI) (OR = 0.976, 95% CI 0.959-0.992) were independent risk factors for unfavorable treatment outcomes in rifampicin-sensitive PTB patients (P < .05); retreated of PTB (OR = 5.347, 95% CI 1.355-21.099), respiratory failure (OR = 17.046, 95% CI 3.080-94.354), hypoalbuminemia (OR = 0.795, 95% CI 0.702-0.902), and low BMI (OR = 0.748, 95% CI 0.584-0.959) were independent risk factors for poor prognosis in rifampicin-sensitive PTB patients (P < .05). The area under the curve of CRP, serum albumin, and BMI combined to predict unfavorable treatment outcomes in PTB patients was 0.798 (95% CI 0.749-0.847), with a sensitivity of 92.4% and specificity of 51.4%. The area under the curve of serum albumin and BMI combined to predict the prognosis of PTB patients was 0.923 (95% CI 0.862-0.984), with a sensitivity of 93.8% and a specificity of 89.3%. The low BMI, hypoproteinemia, elevated CRP level, comorbidities, and retreatment are risk factors for unfavorable treatment outcomes and poor prognosis in patients with rifampicin-sensitive PTB. Serum albumin and BMI were good indicators for evaluating unfavorable treatment responses in rifampicin-sensitive PTB patients, and their combination could improve the accuracy of prognostic assessment.

This study evaluates the efficacy and side effects of different doses of erythromycin in patients with stable non-cystic fibrosis bronchiectasis (NCFB).

Altogether, 148 patients diagnosed with stable NCFB were enrolled in this study and randomly assigned to one of the following 4 treatment groups: Group A received erythromycin 250 mg/d; Group B received erythromycin 375 mg/d; Group C received erythromycin 500 mg/d; and Group D received a placebo. Each group consisted of 35 patients. The dataset comprised lung function data and computed tomography, St. George respiratory questionnaire, modified Medical Research Council, bronchiectasis severity index (BSI), and exacerbations, FEV1, age, chronic colonization, extension, dyspnea scores, which were collected before and at 6 months after treatment. These were subjected to a univariate analysis.

Groups C and D exhibited significant differences in forced expiratory volume in 1 second, forced vital capacity, quality of life, and computed tomography Bhalla, BSI, and E-FACED scores (P < .05). Additionally, Groups B and D demonstrated significant differences in forced vital capacity and St. George respiratory questionnaire, BSI, and E-FACED scores (P < .05). Contrarily, Group A exhibited nonsignificant differences.

The oral erythromycin regimen at a dose of 500 mg/d can improve the lung function and quality of life of stable NCFB patients.

We aimed to analyze the epidemiological characteristics and pathogen trends of common respiratory infections in a tertiary hospital in Zhangjiakou from 2018 to 2024. We retrospectively studied patients who underwent screening for 11 common respiratory pathogen antibodies at the First Affiliated Hospital of Hebei North University between January 1, 2018, and December 31, 2024. Serum-specific Immunoglobulin M antibodies were detected using indirect immunofluorescence assays, and annual data from 2018 to 2024 were compared. Among 35,665 patients, 10,531 (29.53%) were positive for at least 2 pathogen. The lowest positivity rate was observed in 2020 (23.47%, 841/3584), while the highest was observed in 2023 (38.58%, 3165/8204). Mycoplasma pneumoniae exhibited the highest positivity rate (11.99%, 4278/35,665), followed by influenza B virus (10.83%, 3861/35,665). Influenza A virus, respiratory syncytial virus, parainfluenza virus, Chlamydia pneumoniae, Legionella pneumophila, Coxsackie A virus, Coxsackie B virus, Echovirus, and adenovirus had relatively low positivity rates, ranging from 0.88% to 4.97%. Positive cases were stratified as follows: 0 to <3 years (13.32%, 1403/10,531), 3 to <6 years (17.52%, 1845/10,531), 6 to <12 years (18.35%, 1932/10,531), 12 to <18 years (6.37%, 671/10,531), 18 to <60 years (15.86%, 1670/10,531), and ≥60 years (28.58%, 3010/10,531). The proportion of patients <12 years significantly decreased by 2024 compared to 2018 (P < .001), while the proportion of patients significantly increased in the ≥60 group (P < .001). Single-pathogen infection was the predominant type (68.73%, 7238/10,531), followed by dual-pathogen infections (23.26%, 2450/10,531). The proportion of single-pathogen cases decreased from 75.59% in 2018 to 60.32% in 2023, rebounding to 74.36% in 2024. On the contrary, the number of dual-pathogen cases increased from 18.46% in 2018 to 27.65% in 2023, and then decreased to 21.67% in 2024 (P < .001). From 2018 to 2024, the epidemiological features of common respiratory pathogens exhibited significant temporal variations, with reduced positivity rates during the Coronavirus Disease 2019 pandemic and a sharp resurgence after the pandemic. Routine pathogen screening provides critical data for regional respiratory infection prevention and control.

Although some observational studies have linked circulating cytokine levels to asthma, their exact causal relationship(s) remain elusive. To address this knowledge gap, a Mendelian randomization (MR) study was performed to explore potential causal associations between circulating cytokine levels and asthma susceptibility using genetic instrumental variables. To investigate potential causal associations between circulating cytokines and asthma risk, a 2-sample MR analysis was performed using data from European participants from publicly available genome-wide association study summary statistics. Single nucleotide polymorphisms demonstrating significant associations with cytokine levels in previous studies were selected as instrumental genetic variables. A range of complementary MR approaches, including inverse variance weighted, weighted median, MR-Egger, weighted mode, simple mode, and MR pleiotropy residual sum and outlier (i.e., "MR-PRESSO") methods, were implemented to comprehensively investigate causality. Genetically predicted levels of the chemokines RANTES (regulated on activation, normal T-cell expressed and secreted [CCL5]), monocyte chemoattractant protein-1 (MCP-1), and growth-regulated protein alpha (GRO-α) exhibited significant causal associations with reduced asthma susceptibility, as evidenced by odds ratios (OR) of 0.935 (95% confidence interval [CI] 0.895-0.978; P = .003), 0.951 (95% CI 0.916-0.986; P = .007), and 0.968 (95% CI 0.944-0.992; P = .011), respectively. In contrast, beta-nerve growth factor (β-NGF; OR 1.043 [95% CI 1.000-1.087], P = .048), tumor necrosis factor-alpha (TNF-α; OR 1.040 [95% CI 1.001-1.081], P = .042), and macrophage colony stimulating factor (M-CSF; OR 1.032 [95% CI 1.001-1.064], P = .043) conferred increased causal risks for the development of asthma. These causal inferences remain robust across multiple complementary MR approaches, including MR-Egger, weighted median, weighted mode, and simple mode regressions. Sensitivity analyses excluded bias from horizontal pleiotropy. This MR analysis provides initial genomic evidence supporting genetically predicted causal relationships between circulating levels of RANTES, MCP-1, GRO-α, β-NGF, TNF-α, and M-CSF and altered susceptibility to asthma. These findings highlight the potential immunopathogenic roles of these cytokines in the onset and development of asthma.

The purpose of this study was to estimate the efficacy of traditional Chinese medicine (TCM) prescription in the treatment of coronavirus disease 2019 (COVID-19).

A multicenter prospective cohort study at 7 hospitals was conducted. The COVID-19 inpatients were divided into 2 groups. The control group received conventional treatment, and the TCM group received conventional treatment in combination with TCM prescription (Huashi Xuanfei decoction, Jiedu Xiefei decoction and Jianpi Bufei decoction). The 24 clinical symptoms of each patient were surveyed during 7 periods. The partial least squares discriminant analysis algorithm and Mann-Whitney U test were applied to systematical analyzing the differences in clinical symptoms between the 2 groups.

A total of 38 and 77 cases were included for data analysis in the control and TCM groups, respectively. There were significant differences in scores of fever between the control and TCM groups on days 2 to 4 (1.00 vs 0.29, P = .003) and days 6 to 8 (0.53 vs 0.07, P = .024). The scores of poor appetite had significant differences between the control and TCM groups on days 0 to 1 (0.08 vs 0.51, P = .000), days 2 to 4 (0.05 vs 0.39, P = .001), days 20 to 22 (0.24 vs 0.05, P = .004) and days 27 to 29 (0.14 vs 0.03, P = .044). The scores of expectoration had significant differences on days 0 to 1 (0.32 vs 0.83, P = .000) and days 2 to 4 (0.24 vs 0.59, P = .001).

The superiority of TCM prescription in improving symptoms of fever, poor appetite, and expectoration was demonstrated. The treatment regimen of using conventional treatment in combination with TCM prescription can significantly improve the clinical symptoms of COVID-19.

During the coronavirus disease 2019 (COVID-19), the extent of pulmonary impairment associated with initial clinical parameters remained controversial. The notion is valuable for the recovery and prognosis of COVID-19. This study investigated the long-term pulmonary sequelae of severe acute respiratory syndrome coronavirus 2 infection, focusing on pulmonary function and clinical parameters during the 3 months after diagnosis. This is a retrospective, single-center observational study of 229 patients who tested positive for COVID-19 and made the 3rd-month follow-up visit between June 2020 and May 2021. The demographic and clinical characteristics of patients and treatment outcomes were recorded. The obstructive, restrictive pulmonary dysfunction patterns were analyzed to associate with the radiological findings, disease severity, and clinical parameters. The median age of the patients was 46 years. The most common residual symptoms were dyspnea (38%), dry cough (34.5%), and fatigue (29.4%). The obstructive and restrictive pulmonary dysfunction patterns were observed in 38.9% and 2.2% of the patients, respectively. Two-fifth of patients had some form of pulmonary dysfunction. A significant rate (35.8%) of patients had reduced diffusing capacity for carbon monoxide values. Obstructive pulmonary dysfunction was more common among older patients, whereas hypertension was more common among patients with extended hospital stays. Long-term pulmonary dysfunction was a frequent complication in patients recovering from severe severe acute respiratory syndrome coronavirus 2 infection. Understanding these long-term effects is essential for providing appropriate medical care for COVID-19 survivors. Therefore, further research is needed to elucidate the postinfection changes in the lung.

Although the efficacy of triple therapy in treating chronic obstructive pulmonary disease (COPD) patients with a history of exacerbation is well established in groups with frequent exacerbations, less research has been conducted on its use in group B. Here, we investigated the effects of triple therapy on COPD patients with low eosinophil counts in the context of the current management of group B.

Using data from the Korean COPD Subtype Study (KOCOSS), we selected patients with blood eosinophil count (BEC) less than 300 cells/μL as non-eosinophilic COPD groups. The study evaluated the effect of a triple therapy group (combination of inhaled corticosteroid, a long-acting β2-agonist [LABA] and a long-acting muscarinic antagonist [LAMA]) and a dual therapy group (LABA/LAMA) on moderate-to-severe exacerbations, as well as longitudinal changes in lung function over 3 years in patients categorized as Global Initiative for Chronic Obstructive Lung Disease (GOLD) B.

Of the 328 non-eosinophilic COPD group B, 145 (44.2%) patients were in triple therapy and 183 (55.8%) patients were in dual therapy. Triple therapy group showed an increased risk of moderate-to-severe exacerbation in multivariate adjusted model (adjusted incidence rate ratio of annual rate, 2.04; 95% confidence interval, 1.45 to 2.84; P < 0.001). Similarly, restricted cubic spline regression analysis of annual rates of moderate-to-severe exacerbations suggested an increased risk associated with the triple therapy over dual therapy in BEC lower than 300 cells/μL. There was no significant difference in the adjusted rate of forced expiratory volume in 1 second decline between triple therapy group and dual therapy group (-10.0 [-39.8 to -19.7] mL/year vs. 22.3 [-4.4 to -49.0] mL/year, P for interaction = 0.888).

In conclusion, our research suggests that triple therapy was associated with a higher risk of moderate-to-severe exacerbations in non-eosinophilic COPD categorized as GOLD B compared with dual therapy.

Despite eligibility of over 90% of people with cystic fibrosis (PwCF) for CFTR modulators, 12% of eligible PwCF are not prescribed these therapies. The CF Foundation CF Learning Network (CFLN) convened a quality improvement (QI) innovation lab (iLab) to investigate gaps in modulator use and identify best practices for modulator initiation, management, and side effect screening.

Thirty-one CF centers used the Model for Improvement to adapt interventions to local context by Plan-Do-Study-Act cycles and approach aims in two phases: (1) increase documented elexacaftor-tezacaftor-ivacaftor or ivacaftor (ETI/I) use or co-produced deferral by 4% by 5/2023 and (2) increase side effect screening rates for PwCF taking ETI to 80% by 8/2024. Interventions included processes to track eligibility and facilitate safety assessments and tools like screener forms. Centers submitted weekly measures. We used control charts and run charts to analyze progress.

Of 4649 PwCF evaluated from 12/2022 to 5/2023, 98.5% on average had documentation of either ETI/I use (89.3%) or deferral (9.2%). The most common reason for deferral was previous side effects (39.0%). Across 3236 visits from 3/2024 to 8/2024, ETI side effect screening rates improved, with the centerline shifting from 67.1% to 80.8%. Potential side effects were identified in 24.5% of screenings, most commonly mood changes, inattention/brain fog, and weight gain.

Application of QI methods resulted in processes and tools for enhancing modulator management and improving side effect screening across multiple CFLN centers. Potential side effects, including those not listed in the prescribing information, were commonly reported, highlighting the importance of side effect screening and management by care teams. Interventions can be reproduced by other centers and applied to novel CF therapies.

Objective: To assess the optimal timing and short-term clinical efficacy of sinus drug-eluting stent placement in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: The minimum sample size was calculated using G-power 3.1.9.7 software. From March 2021 and May 2023, a total of 114 eligible patients with CRSwNP were recruited in this study at the Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University. The patients were randomly assigned to three groups: the control group, the intraoperative stent group, and the postoperative stent group. In the intraoperative stent group, drug-eluting stents were implanted during endoscopic sinus surgery (ESS), while patients in the postoperative stent group received drug-eluting stent 2 weeks after ESS, following routine debridement of the surgical cavity. Bilateral ethmoid sinus stenting was performed for both stent groups, while the control group only underwent ESS with standard postoperative cavity debridement. All subjects were followed up at 2, 4, 8, and 12 weeks postoperatively. Nasal symptom Visual Analog Scale (VAS) scores and endoscopic evaluations of the ethmoid cavity-assessing obstruction, crusting, polypoid mucosal changes, epithelialization of ethmoid cavity, need for intervention, and complications such as middle turbinate lateralization and adhesions-were collected to evaluate the treatment efficacy of three groups. Statistical analyses were performed using GraphPad Prism 9. Analysis of variance (ANOVA) was applied to analyze continuous variables among the three groups, and chi-square tests were used for categorical variables. Results: Among 114 CRSwNP patients, 21 lost follow-up patients and 7 postoperative oral corticosteroid intervention patients were excluded. Finally, 86 patients were included in the analysis, including 45 males and 41 females, aged 18-65 years. The cohort comprised 29 in the control group, 29 in the intraoperative stent group, and 28 in the postoperative stent group. Successful bilateral ethmoid sinus stent implantation was achieved in both stent groups. At 4 weeks postoperatively, compared with the control group, both stent groups showed significant improvements in nasal congestion and rhinorrhea scores (P<0.05). At 8 weeks, the postoperative group continued to demonstrate superior outcomes in these two symptoms (both P<0.05), while the intraoperative group only showed significant improvement in nasal congestion (P<0.05). No significant differences were observed in facial pressure, olfactory loss, or nasal dryness scores among the three groups (all P>0.05). Endoscopic evaluation revealed that both stent groups had significant improvements in ethmoid sinus obstruction scores at 4 weeks compared with the control group, with the postoperative group maintaining this advantage at 8 weeks (P<0.05). At 2 weeks, the intraoperative stent group had higher crusting scores than other groups (P<0.05). At 2 weeks after stent implantation, the postoperative stent group had significantly lower crusting scores than the intraoperative stent group (P<0.001). The intraoperative group had a significantly lower incidence of ethmoid sinus edema and polypoid changes at 4 weeks compared with the control group (P<0.05), while the postoperative group showed reduced rates of these pathological changes at 4, 8, and 12 weeks (all P<0.05). The postoperative stent group had significantly higher rates of ethmoid sinus mucosal epithelialization at 8 and 12 weeks postoperatively compared with the control group. The intraoperative stent group required fewer interventions than the control group at both 8 and 12 weeks, while the postoperative stent group maintained lower interventions rates at all follow-up points after implantation (all P<0.05). Additionally, the incidence of complications was significantly lower in both stent groups compared with the control group (P<0.05). Overall, stent implantation at different time points showed similar efficacy, with the postoperative group demonstrating more stable outcomes and less crusting/coagulation formation compared with the intraoperative group. Conclusions: The implantation of corticosteroid sinus stents in the ethmoid sinuses effectively controls postoperative inflammation, promotes mucosal epithelialization, and reduces postoperative intervention rates. Stent implantation two weeks after surgery is feasible. Adjusting the timing of stent placement can minimize crust formation and maximize the corticosteroid effect, thereby facilitating a benign course of the surgical site.

In North Dakota (ND), American Indian (AI) women face a persistent disparity in prenatal care (PNC) access compared to other women. During the COVID pandemic, the expansion of telehealth emerged as a potential solution to disparate access to health care. We examined whether telehealth use mitigated disparities in PNC in ND.

Data were drawn from the 2020 to 2021 ND Pregnancy Risk Assessment Monitoring System (weighted n = 10,189). PNC initiation >13 weeks gestation or not receiving PNC was considered "late/no PNC." Maternal race/ethnicity was self-reported. Use of telehealth for prenatal visits was self-reported and categorized as "any telehealth use" versus "no telehealth use." Those not using telehealth self-reported eight barriers to telehealth (e.g., lacking internet, no appointments). Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for late/no PNC among AI and other race/ethnicity women compared to White women. Models included maternal sociodemographic and health factors. Chi-square was used to examine prevalence of telehealth barriers by race/ethnicity.

Compared to White women, AI/AN women were twice as likely to receive late/no PNC (OR: 2.40; 95% CI, 1.08, 5.35). When telehealth was accounted for, the AI-White disparity was lowered by only 2% (OR: 2.35; 95% CI, 1.05, 5.26). Compared to White and other race/ethnicity women, a higher prevalence of AI/AN women reported a lack of telehealth appointments (p < 0.01), no computers (p < 0.01), no phones (p < 0.01), and no physical space (p < 0.01) as barriers to telehealth.

The use of telehealth did not mitigate PNC disparities in ND. Infrastructure investments and culturally safe initiatives are needed to improve PNC access for AI/AN women.