Pulmonary arterial hypertension (PAH) patients with cardiopulmonary comorbidities have been prevalent nowadays. However, there was limited data on clinical characteristics and therapeutic responses in these populations.

Patients diagnosed with right heart catheterization (RHC)-confirmed PAH between October 2021 to March 2023 were included in our study. According to whether they had cardiopulmonary diseases or not, they were classified into two groups: comorbidities group and non-comorbidities group. We aimed to compare the clinical data, PAH-targeted strategies, and therapeutic responses between these two PAH groups. We further analyzed the impact of the numbers and categories of comorbidities on therapeutic responses.

Almost half of the patients co-existed with cardiopulmonary diseases. Compared with non-comorbidities group (n = 40), comorbidities group (n = 36) were senior (p = 0.000) and male predominantly (p = 0.005). Comorbidities group also associated inconsistencies between hemodynamics and 6-min walking distance (6MWD), with a shorter 6MWD (p = 0.000), but a lower mean pulmonary artery pressure (mPAP) (p = 0.008). Non-comorbidities group showed an upturn in the WHO-FC (p = 0.010) and risk assessment (p = 0.033), while the improvement of hemodynamics [decreased mPAP (p = 0.009) and pulmonary vascular resistance (PVR) (p = 0.001), increased cardiac index (p = 0.001)] in comorbidities group did not match the change in clinical severity (no significant improvements in WHO-FC, risk stratification and 6MWD). When categorized by the comorbidities counts, it demonstrated that the more comorbidities, the more severe the clinical conditions, and the worse the therapeutic responses.

PAH patients with cardiopulmonary comorbidities represent a unique phenotype, with different clinical manifestation and treatment responses from typical PAH and inconsistencies between hemodynamics and functional status from baseline to follow-up.

Some patients undergoing pulmonary procedures are on at least one antiplatelet or anticoagulant agent. Discontinuing these treatments can be challenging due to the risk of severe complications, particularly following acute coronary event. While studies indicate that clopidogrel cessation is necessary before transbronchial biopsy, others suggest it may be safely continued for procedures such as endobronchial ultrasound-guided transbronchial needle aspiration. There is limited literature on performing endobronchial biopsies while patients are on clopidogrel (a P2Y12 inhibitor), with only one case report available.

In our three cases, the patients had endobronchial lesions causing partial or complete airway obstruction, leading to severe dyspnea and wheezing. Two of the patients were on dual antiplatelet therapy (DAPT) due to recent coronary artery syndrome treated with coronary stents, while the third was receiving the same treatment for peripheral artery disease managed with a stent. Endobronchial biopsies (EBB) were performed on all three patients without any major complications.

Although it is typically recommended to discontinue clopidogrel 5-7 days prior to the procedure, early diagnosis and treatment are crucial in certain cases. In these situations, where the benefits may outweigh the risks, EBB can be performed with appropriate precautions. Through our case reports, we aim to encourage further prospective studies and the establishment of updated guidelines, particularly concerning EBB in patients receiving DAPT.

In patients with pulmonary tuberculosis (TB), the persistence of the lung cavities leads to opportunistic infections and increases the risk of person-to-person Mycobacterium tuberculosis (Mtb) transmission. However, factors that associated with cavity resorption remain unknown.

In this retrospective study, 588 patients with drug-sensitive pulmonary tuberculosis and cavitary lesions on chest imaging were enrolled. All patients completed a standard 6-month anti-tuberculosis drug treatment regimen. They were randomly divided into a training set (n = 412) and a validation set (n = 176) in a 7:3 ratio. Clinical variables including demographic data, radiological findings, laboratory test results, and anti-tuberculosis drug usage were collected. Univariate and multivariate logistic regression analyses were performed to identify factors associated with cavity absorption.

Multivariate logistic regression identified several factors independently associated with poor cavity resorption: older age (odds ratio [OR] 1.029, 95% confidence interval [CI]: 1.012-1.047), male sex (OR 2.599, CI: 1.349-5.009), serum total protein (OR 0.963, CI: 0.931-0.997), presence of multiple cavities (OR 1.791, CI: 1.115-2.876) and absence of fever (OR 1.729, CI: 1.032-2.893). The predictive model constructed using these six variables showed good discrimination, with an area under the curve (AUC) of 0.749 (95% CI: 0.699-0.798) in the training set and 0.746 (95% CI: 0.670-0.822) in the validation set (n = 176).

Our findings indicate that older age, male sex, lower serum total protein, presence of multiple cavities, and absence of fever are independently associated with poor cavity resorption in patients with pulmonary tuberculosis. These variables may help identify high-risk patients and guide personalized management. Therefore, for better control of Mtb infection and improved outcomes, greater clinical attention should be paid to these associated factors.

Although the COVID-19 pandemic has demonstrably led to an increase in health inequities, only a few studies have analyzed their underlying mechanisms by taking into account socioeconomic status and sociodemographic differences at the same time. Similarly, only few studies have explored the impact of COVID-19 containment measures on inequities in living conditions, health-related risks, and coping resources. This study aims to address these gaps by exploring the complex associations of socioeconomic and sociodemographic factors with changes in life circumstances, pandemic-related experiences, self-rated health, and well-being among adults living in Germany.

A total of 2,123 adults (women: 49.8%, men: 50.2%) living in Germany participated in the cross-sectional online study ExCo:Well between July and August 2022. The survey included questions on socioeconomic status, sociodemographic factors, social circumstances, resources and burdens, as well as health outcomes. The data were analyzed using bivariate and multivariable logistic regression analyses.

Our results show significant disparities in self-rated health and mental well-being based on socioeconomic status. For sociodemographic differences, the results are mixed, with only women consistently showing worse health outcomes than men. Immigration status played a limited role. Although measures to contain the COVID-19 pandemic more commonly affected the life and work conditions of more privileged participants, socioeconomically disadvantaged participants experienced higher burdens and had fewer coping resources. Logistic regression analyses showed that health inequities decreased when resources and burdens were considered.

By covering the whole period of the COVID-19 pandemic, our data allow for an overall assessment of this critical time as well as a better understanding of mechanisms underlying health inequities. Our findings suggest that more important than the number of government-induced social changes is their quality and their potential to negatively impact material and social livelihoods in the long run. To improve health equity, tailored social security and health promotion interventions need to be systematically integrated in pandemic or crisis response plans.

Due to the impact of COVID-19, telehealth technologies have become crucial for managing the health of community-dwelling older adults with frailty. This study builds upon the Fitness and Nutrition Program for Seniors (FANS), a hybrid course based on the Transtheoretical Model, which integrates both in-person and remote care tailored for this population. This research aimed to investigate the effectiveness of this intervention on physical activity and kinanthropometric measures.

This quasi-experimental research involved 81 older adults from community care centers, with 43 in the experimental group receiving the FANS and 38 in the control group continuing their usual health activities. Outcome measures, evaluated using intention-to-treat analysis, included physical activity (assessed with the Short Physical Performance Battery, grip strength, Timed Up and Go test, and overall activity level) and kinanthropometric measures (body mass index, mid-upper arm circumference, and calf circumference). Changes over 3 and 6 months were analyzed using Generalized Estimating Equations.

The intervention group exhibited significant improvements in all physical activity measures (p < 0.001) and mid-upper arm circumference (p < 0.001) immediately and over time. The study identified significant differences between the two groups in physical activity on the Short Physical Performance Battery, which increased by 0.66 points (p < 0.05), Five Times Sit to Stand test, which was 1.83 s faster (p < 0.05), Timed Up and Go test, which was 2.63 s faster (p < 0.001), and physical activity levels, which increased by 6.47 MET/hr (p < 0.001). Additionally, kinanthropometric measurements, such as mid-upper arm circumference, which increased by 2.28 cm (p < 0.001), and calf circumference, which increased by 1.34 cm (p < 0.01), also showed significant differences. Significant interactions (group × time) were observed between the FTSST (Wald χ² = 5.103, p < 0.05) and PA level (Wald χ² = 4.080, p < 0.05) after three months. Additionally, significant interactions were found for the TUG (Wald χ² = 6.856, p < 0.01), PA level (Wald χ² = 34.888, p < 0.001), MUAC (Wald χ² = 19.695, p < 0.001), and CC (Wald χ² = 10.181, p < 0.01) after six months.

The FANS proved to be a viable and effective health promotion program, significantly enhancing physical function and body measurements among frail older adults, thereby supporting their independence and well-being.

ClinicalTrials.gov Identifier NCT05242549 (16/02/2022).

To investigate the respiratory and related health outcomes at 18 months for extremely preterm (EP) infants diagnosed with bronchopulmonary dysplasia (BPD). This retrospective cohort study aims to investigate the respiratory and related health outcomes at 18 months for extremely preterm (EP) infants diagnosed with bronchopulmonary dysplasia (BPD). Also, rephrase the second sentence to be: We reviewed post-hospital discharge outcomes for EP infants with BPD from Women's Health and Research Centre, Doha, Qatar (January 2018 - December 2019). We compared 86 BPD infants with 102 preterm controls without BPD. EP infants with BPD were more often male (70% vs. 46%, p < 0.001), had lower birth weights (797 g vs. 920 g) and gestational ages (25.3 vs. 25.9 weeks, both p < 0.001). They required more surfactant, longer ventilation, and experienced higher rates of complications. Post-discharge, infants with BPD had significantly higher rates of oxygen dependence, steroid use (both systemic and inhaled), gastric tube feeding, and sleep study evaluations compared to those without BPD. Regression analysis revealed that moderate and severe BPD were significantly associated with increased risk of pediatric intensive care unit admissions, pulmonary hypertension, any patent ductus arteriosus closure procedure, and neurodevelopmental impairment. Specifically, severe BPD was strongly associated with home gastric tube feeding (OR 67.3; 95% CI: 6.48-699.67; p < 0.001), motor delays (OR 6.29; 95% CI: 1.61-24.54; p < 0.001), and expressive language delays (OR 4.39; 95% CI: 1.15-16.77; p = 0.031). BPD infants have significantly poorer respiratory and neurodevelopmental outcomes, highlighting the need for intensive monitoring and follow-up care. While this retrospective study provides valuable insights, further prospective research is warranted to validate these findings and explore targeted interventions.

In light of the growing awareness of the unequal distribution of care work, this study aimed to analyze gender differences in burdens of care work and associations with mental health during the COVID-19 pandemic, with a focus on employment status. Therefore, data from the population-representative Gutenberg COVID-19 cohort, collected between October 2020 and April 2021, in the city of Mainz and the County of Mainz-Bingen, Germany, were used. Out of the whole cohort, people living with children in the household were included (N = 2,043). Feeling burdened by care work and mental health outcomes were assessed by validated self-report questionnaires. Descriptive analyses and multilinear regression analyses were performed. Results showed that feeling burdened by care work was more likely for women than for men. For men, feeling burdened by care work was significantly associated with depressiveness, anxiety, and somatization. For women, difficulties with child raising were associated with depressiveness. Part-time working men and women did not differ with respect to mental health or care work burden, whereas unemployed and full-time working women showed significantly worse mental health and reported more burden of care than unemployed and full-time working men. Hence, this study showed gender inequalities. For women, worsening external conditions for childcare appeared to be a risk factor. Men with care work responsibilities seem to benefit, concerning their mental health, from full-time paid work. The data underscore the importance of mitigating the burden of care work, especially to improve conditions for women and part-time workers.

The airway microbiome has been implicated in the pathogenesis of laryngotracheal stenosis (LTS), yet prior studies using 16 S rRNA sequencing have limited sub-genus level resolution. Metagenomic whole genome shotgun sequencing (mWGS) allows for strain-level taxonomic and functional genomic analysis, providing detailed insights into specific organisms and pathways. A pilot study was conducted to explore the advantages and challenges of mWGS in investigating the airway metagenome in LTS. mWGS was conducted on 12 intraoperative swab samples from 8 LTS patients, divided into tracheostomy-dependent (n = 3) and non-tracheostomy (n = 5) groups, and 4 controls. Patient comorbidities, antibiotic use, and medications were documented. Biobakery workflows were used for taxonomic and functional profiling. Species-specific reference databases were constructed for 6 abundant species for strain-level analyses. LTS samples had decreased taxonomic diversity and were dominated by species with previously described roles in other chronic inflammatory processes such as Staphylococcus aureus, Streptococcus parasanguinis, Streptococcus mitis, and Corynebacterium pseudogenitalium. LTS samples were enriched for pathways involved in fatty acid biosynthesis and formaldehyde metabolism. Our results identified tracheostomy as an important potential confounder in airway metagenomics but show mWGS techniques are promising in uncovering microbiota correlates in LTS that could reveal disease-specific biomarkers, comorbidity links, and therapeutic targets.

Physical activity (PA) is a well-established prognostic marker in Chronic Obstructive Pulmonary Disease (COPD). Traditional PA metrics, such as step count, often overlook movement intensity, while energy expenditure (EE) relies on indirect calorimetry assumptions. To address these limitations, we propose a data-driven PA metric that integrates movement frequency and amplitude derived from raw accelerometer data. This retrospective analysis, based on a Dutch COPD database, also evaluates the predictive value of the new score for mortality in COPD patients compared to step count and energy expenditure. Movement data and step counts were collected using McRoberts triaxial accelerometers. Fourier analysis was applied to extract movement frequency and amplitude, which were then used to compute the physical activity (PA) score. Kolmogorov-Smirnov test was conducted to assess whether the distributions of step count and PA score differed, followed by Kruskal-Wallis test to assess day-to-day movement variability. Logistic regression was used to evaluate and compare the predictive performance of the novel PA score against step count and EE. A total of 404 COPD patients (51.5% female; median [IQR] age: 57 [46-66] years) were included. The proposed PA score and step count exhibited similar daily patterns but differed significantly in distribution. Mortality data were available for 165 participants. The PA score achieved 2.8% higher accuracy and 5.6% higher balanced accuracy than step count in mortality prediction, while EE demonstrated the lowest predictive performance. The proposed PA score demonstrates stronger predictive power for mortality in COPD patients, highlighting the importance of integrating movement characteristics beyond simple step count, and offering a more refined metric for PA evaluation in both clinical and research settings.

The impact of SARS-CoV-2 and the COVID-19 pandemic on brain health is recognised, yet specific effects remain understudied. We investigate the pandemic's impact on brain ageing using longitudinal neuroimaging data from the UK Biobank. Brain age prediction models are trained from hundreds of multi-modal imaging features using a cohort of 15,334 healthy participants. These models are then applied to an independent cohort of 996 healthy participants with two magnetic resonance imaging scans: either both collected before the pandemic (Control groups), or one before and one after the pandemic onset (Pandemic group). Our findings reveal that, even with initially matched brain age gaps (predicted brain age vs. chronological age) and matched for a range of health markers, the pandemic significantly accelerates brain ageing. The Pandemic group shows on average 5.5-month higher deviation of brain age gap at the second time point compared with controls. Accelerated brain ageing is more pronounced in males and those from deprived socio-demographic backgrounds and these deviations exist regardless of SARS-CoV-2 infection. However, accelerated brain ageing correlates with reduced cognitive performance only in COVID-infected participants. Our study highlights the pandemic's significant impact on brain health, beyond direct infection effects, emphasising the need to consider broader social and health inequalities.