BMJ Open Respiratory Research

ObjectiveTo demonstrate the association between hospital admissions, health-related quality of life (HRQoL), limitations in daily activities, mortality, and survival in relation to physical activity (PA) and functional capacity (FC), which were used together to classify a cohort of COPD patients. MethodsProspective study. Participants were consecutively recruited from six outpatient respiratory clinics of a single university hospital. Data were recorded on sociodemographic and clinical variable...

BackgroundThough a normal forced vital capacity (FVC) is typically thought to imply the absence of restriction, recent data suggest that restriction may in fact be common among patients with normal spirometry. However, the clinical significance of restriction with normal spirometry is unknown. Research QuestionWhat clinical characteristics and outcomes are associated with restriction with normal spirometry? Study Design and MethodsWe interpreted pulmonary function tests (PFTs) with both static...

Background/ObjectiveBarriers in access to care have prompted development of innovative care delivery models for patients with obstructive sleep apnea (OSA). One such innovation is management of uncomplicated OSA by primary care providers (PCPs), which reserves specialist capacity for more complex patients. We developed a clinical guideline and subsequently, an online clinical pathway to support PCPs in OSA management. We aimed to evaluate the impact of these initiatives on PCP behaviour by asses...

Background and AimsThe prognosis of interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF) has not been studied as extensively as IPF. This study aimed to evaluate baseline factors associated with mortality in non-IPF ILD, including demographic characteristics, respiratory function test (RFT), comorbidities, and ILD subtypes. MethodsThis retrospective cohort study analysed prospectively collected data of patients with non-IPF ILD at a single tertiary centre in Malaysia...

BackgroundBronchiectasis is an increasingly recognized structural complication among patients with chronic obstructive pulmonary disease (COPD), yet evidence from Bangladesh remains limited. This study aimed to determine the prevalence, clinical characteristics, radiological patterns, and associated factors of bronchiectasis among COPD patients in tertiary-level hospitals. MethodsA cross-sectional study was conducted among 129 COPD patients regardless of age distribution, all are met GOLD crite...

Background: Interstitial lung abnormalities (ILA) are radiologic findings of increased lung density or fibrosis in individuals without clinical interstitial lung disease (ILD) and are associated with increased mortality and progression to ILD. Understanding physiologic trajectories of lung function preceding ILA diagnosis may illuminate early mechanisms of lung injury. Methods: We recruited participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Lung Study, a prospective ...

ImportanceChronic obstructive pulmonary disease (COPD) remains a leading cause of morbidity and mortality in the United States (US), largely driven by cigarette smoking and characterized by progressive lung injury. While e-cigarettes are promoted as a less harmful alternative to cigarette smoking, their long-term health effects, including the impact of prolonged use on COPD incidence among adults who have smoked, are not well understood. ObjectiveTo evaluate the prospective association between ...

ObjectiveMyositis-associated interstitial lung disease (myositis-ILD) consists of two predominant radiologic patterns of lung injury--nonspecific interstitial pneumonia (NSIP) and organizing pneumonia (OP)--that oftentimes coexist. However, it remains unclear whether either is associated with clinical outcomes. We aimed to assess the therapeutic response in patients with NSIP-compared to those with OP-predominant myositis-ILD. MethodsThis retrospective, single-center cohort study recruited part...

BackgroundQuality of life (QoL), the highest prioritised outcome by children with bronchiectasis and their parents, is a patient-reported outcome measure increasingly considered essential when evaluating health and interventions. Despite this, there are no validated instruments that specifically measure QoL related to bronchiectasis in children. We aimed to develop and validate a new bronchiectasis child-specific parent-proxy QoL instrument (BC-QoL). MethodsWe developed a draft 44-item BC-QoL a...

BackgroundInterstitial lung diseases (ILDs), including idiopathic pulmonary fibrosis (IPF) and connective tissue disease-associated ILD (CTD-ILD), share similar features that complicate diagnosis. Tumor markers are often elevated in ILD, yet their diagnostic utility remains unclear. MethodsThis retrospective study included ILD patients hospitalized between 2018 and 2025. Serum levels of alpha-fetoprotein, carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 199, CA125, CA153, neuron-specif...

The ERS/ATS22 interpretative flowchart classifies diffusing capacity (DLco) into 5 scenarios with associated pathophysiology, and has not been tested on large patient groups. We aimed to obtain a more layered DLco interpretation, by interrogating DLco components Kco and VA, and by estimating lung inflation during the DLco test to identify the presence of restriction, which crucially impacts Kco interpretation. By assessing a "low VA" against lung inflation, a novel 9-scenario DLco classification...

BackgroundBronchiectasis is a debilitating respiratory condition characterized by chronic cough with expectoration of thick sputum. It accounts for significant morbidity and mortality, especially when associated with exacerbations. Assessing the health-related quality of life (HR-QoL) of patients with bronchiectasis is important to ascertain the impact of the disease on day-to-day life, as well as to gauge the effect of targeted interventions. Conventionally used methods for assessing HR-QoL suc...

BackgroundObstructive Sleep Apnoea (OSA) increases motor vehicle collision risk, and while Continuous Positive Airway Pressure (CPAP) considerably reduces this risk, it remains unclear how much CPAP use is required to fully normalise driving behaviour, and whether baseline (Pre-CPAP) driving style influences treatment response. MethodsIn a prospective observational study embedded within routine clinical care, real-world driving behaviour was recorded using a smartphone telematics application in...

IntroductionUnilateral hypoglossal nerve stimulation (HGNS) is an approved surgical therapy for obstructive sleep apnea (OSA), but its efficacy is limited by obesity and unfavorable (laterally directed) pharyngeal collapse patterns. This study tested whether the effect of body mass index (BMI) on HGNS efficacy differs by pharyngeal collapse pattern, specifically comparing laterally directed and anteroposterior (AP) collapse. MethodsWe pooled data from two independent HGNS cohorts (n=760) to eva...

ObjectivesTo evaluate the efficacy and safety of sitafloxacin-containing regimens versus non-sitafloxacin therapy in patients with nontuberculous mycobacterial (NTM) pulmonary disease, focusing on sputum/BALF conversion rate, time of sputum/BALF culture conversion and radiographic improvement. MethodsThis retrospective cohort study analyzed 149 adults (76 control group vs. 73 sitafloxacin group) with NTM pulmonary disease treated between 2021 to 2024. Inclusion criteria: (1) Sitafloxacin group:...

IntroductionObstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction during sleep, leading to intermittent hypoxia, sleep fragmentation, and autonomic dysregulation. These disturbances contribute to nocturnal blood pressure (BP) surges and increased cardiovascular risk. While sleep-stage-dependent BP modulation is well established, high-resolution data on sleep-stage- specific systolic BP variability (BPV) in OSA are limited. This study examined beat-to-beat systolic ...

BackgroundReliable detection of latent Mycobacterium tuberculosis (Mtb) infection (LTBI) remains challenging, particularly in TB contacts and immunocompromised individuals, where interferon-{gamma} release assays (IGRAs) demonstrate variable sensitivity. IP-10, a chemokine produced at substantially higher concentrations than IFN-{gamma}, represents a promising immune marker. This study aimed to evaluate the diagnostic performance of two IP-10 based assays RIDA(R)QUICK TB (lateral flow) and RIDA...

BackgroundThe maintenance of wakefulness test (MWT) measures the ability of an individual to maintain wakefulness in soporific conditions and despite limitations remains the mainstay of vigilance testing. Wake and sleep states are traditionally characterised by oscillatory activity on electroencephalogram (EEG) but there is a less utilised non-oscillatory component of background neural aperiodic activity which can be derived from EEG raw data and represented as an exponent or a gradient (1/f slo...

BackgroundDeep learning algorithms for tuberculosis (TB) screening frequently achieve radiologist-level performance during internal evaluation, yet their reliability often degrades when deployed to populations differing from the training domain. Such degradation is clinically consequential for screening tools, where the World Health Organization (WHO) emphasizes high sensitivity to minimize missed infectious cases. MethodsA DenseNet-121 convolutional neural network was trained using transfer le...

RationaleSevere SARS-CoV-2 infection induces disrupted oropharyngeal and gut microbiota during acute disease which may persist and contribute to the development of post-acute pulmonary sequelae. To date, it is unclear whether dysbiosis following severe disease is linked to long-term pulmonary function impairment. ObjectivesTo determine associations between oropharyngeal and gut microbiota composition with lung function after severe COVID-19. Methods16S and internal transcribed spacer (ITS) rRN...