Advances in Respiratory Medicine

Background/Objectives: We examined whether respiratory performance differed among broad stroke lesion-location categories. Methods: This exploratory single-center cross-sectional analysis combined pre-intervention assessments from 20 participants in an earlier trial with 60 subsequently recruited participants. The 80 patients were classified into frontal lobe (n = 27), basal ganglia region (n = 26), or brainstem (n = 27) categories. Peak inspiratory flow (PIF), strength index (S-Index), and five conventional respiratory outcomes were assessed. Holm correction was applied across seven outcomes. Linear models used type 3 heteroscedasticity-consistent (HC3) robust standard errors and the original six clinical covariates. Additional PIF analyses incorporated time since stroke, National Institutes of Health Stroke Scale (NIHSS), or modified Barthel Index (MBI), and restricted the sample to ischemic or first-ever stroke. Results: Only PIF retained an unadjusted group association after Holm correction (adjusted p = 0.008). The adjusted overall lesion-location association also survived correction (adjusted p = 0.009). PIF was 0.625 L/s higher in the basal ganglia region than in the brainstem group (95% confidence interval [CI], 0.282–0.967). This contrast persisted with additional clinical adjustment in the full cohort and in ischemic stroke. Evidence weakened in first-ever stroke; with MBI adjustment, the contrast was 0.381 L/s (95% CI, −0.067–0.829). Conclusions: Broad lesion-location categories were associated with PIF in this selected cohort. The findings remain exploratory and cannot fully separate anatomical associations from stroke severity, disability, unmeasured clinical factors, or measurement limitations.

Population-based lung cancer screening with low-dose computed tomography (LDCT) is expanding across Europe, including a publicly funded Polish programme starting in October 2026. Because screening-eligible individuals share substantial tobacco-related cardiovascular risk, LDCT also offers cardiovascular risk assessment without additional radiation. We conducted a narrative review of the PubMed literature published up to September 2026, prioritising guidelines, lung cancer screening cohorts and systematic reviews. We summarise the cardiovascular findings on non-contrast, non-electrocardiography (ECG)-gated LDCT: coronary artery, aortic valve, mitral annular and thoracic aortic calcification, ascending aortic dilatation, pericardial effusion, and pulmonary artery enlargement, as well as investigational cardiac volumetry, epicardial adipose tissue and artificial intelligence (AI)-assisted quantification. We grade each finding by reportability, defined downstream action and supporting evidence, and align reporting thresholds with the European Respiratory Society/European Society of Thoracic Imaging (ERS/ESTI) statement on incidental findings. LDCT cannot replace dedicated cardiac imaging or establish haemodynamic diagnoses. The prognostic value of coronary and aortic valve calcification and of ascending aortic dilatation is established, whereas the evidence for mitral annular calcification and pulmonary artery enlargement is more limited; observational data indicate that reporting these markers changes preventive management, but whether this improves cardiovascular outcomes has not yet been demonstrated. Standardised reporting, proportionate thresholds, and coordinated pathways linking radiology, pulmonology, primary care and cardiology are needed to translate incidental cardiovascular findings into scalable prevention and should be evaluated in implementation studies.

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic interstitial lung disease with high morbidity and mortality. Inhaled treprostinil showed pulmonary vascular and lung-function signals in pulmonary hypertension associated with Interstitial lung disease (PH-ILD) and was subsequently tested in IPF trials. Objectives: This systematic review and meta-analysis assessed the efficacy and safety of inhaled treprostinil in adults with IPF. Methods: PubMed, Google Scholar and the Cochrane Library/CENTRAL were searched for records published from January 2000 to 2026. A random-effects meta-analysis used the DerSimonian–Laird tau squared and inverse-variance weighting methods. Continuous outcomes were pooled as generic inverse-variance effects from reported estimates and 95% confidence intervals. Hazard ratios were pooled on the log scale. Safety outcomes were pooled as risk ratios from event counts. Results: The searches identified 1552 records. After deduplication, 379 records were screened and 85 full-text reports were assessed. Eleven reports were included in the systematic review. TETON-1 and TETON-2 were the two direct-IPF randomized trials within the coordinated TETON program eligible for primary meta-analysis. Inhaled treprostinil improved absolute forced vital capacity (FVC) change at 52 weeks compared with placebo (MD 111.28 mL, 95% CI 77.61 to 144.95, p < 0.001; I squared 8.5%). Clinical worsening was reduced (HR 0.69, 95% CI 0.57 to 0.84, p < 0.001; I squared 0.0%). Acute exacerbation was lower in pooled analysis (HR 0.52, 95% CI 0.30 to 0.91, p = 0.022), while all-cause mortality did not differ significantly (HR 0.70, 95% CI 0.47 to 1.05, p = 0.086). Adverse-event discontinuation, cough and headache were more frequent with treprostinil. Conclusions: In direct IPF randomized evidence, inhaled treprostinil preserved lung function and reduced clinical worsening at 52 weeks.