Advances in Respiratory Medicine

Haemoptysis arises from diverse respiratory diseases and may involve a broad spectrum of thoracic vessels. Arterial embolisation (AE) is an effective, repeatable, minimally invasive treatment option for life-threatening haemoptysis. This case series included 10 patients (mean age 34 years; six males; five with cystic fibrosis) who underwent 17 AE procedures for life-threatening haemoptysis between January 2018 and September 2025. The study assessed the role of wide-field computed tomography angiography (CTA), extending from the thoracic inlet to L2, in preprocedural planning, bleeding localisation and detection of systemic collaterals. CTA accurately predicted the culprit region in 16 out of 17 procedures. Non-bronchial systemic arteries were identified in 6 out of 10 patients, consistent with previous reports. CTA showed strong concordance with angiography and enabled the detection of uncommon collaterals, including subclavian and phrenic branches. Recurrence of hemoptysis occurred in one patient during follow-up; however, three patients were lost to follow-up. Wide-field CTA enhances the identification of systemic feeders and supports procedural planning, potentially reducing recurrence associated with missed culprit vessels. AE remains a valuable option for haemoptysis control in cystic fibrosis, with outcomes further improved following initiation of CFTR modulators. The small sample size and incomplete follow-up limit generalisability, but findings highlight the importance of CTA in guiding AE and improving clinical outcomes.

Background: Dysfunctional breathing patterns may impair autonomic regulation and increase perceived stress. Breathing-based interventions, particularly those involving guided exercises and supportive tools, have the potential to provide non-pharmacological benefits. Methods: In this parallel two-arm randomized controlled trial, 14 women aged 35–45 years with signs of dysfunctional breathing and no comorbidities were recruited from a fitness club. Participants were randomly assigned (1:1) using a computer-generated sequence to an intervention group (n = 7) or a control group (n = 7). Blinding was not applied. Both groups completed a 6-week program of guided breathing exercises using the iBreathe app, while the intervention group additionally used mouth tape during sleep. The primary outcomes were heart rate variability (HRV) indices—root mean square of successive differences (RMSSD) and the high-frequency (HF) component. Secondary outcomes included respiratory rate, Hencho test performance, and perceived stress measured using the Perceived Stress Scale-10 (PSS-10) and a Visual Analogue Scale (VAS). All participants were included in the final analysis (no loss to follow-up). Results: The intervention group showed a significant increase in the HF component of HRV (p = 0.018) and improved Hencho test performance (p = 0.018). Both groups demonstrated significant reductions in respiratory rate (p < 0.05) and PSS scores (p < 0.05). Between-group differences were not significant for RMSSD or perceived stress. No adverse events were reported. Conclusions: A 6-week breathing intervention improved respiratory efficiency and reduced perceived stress among women with dysfunctional breathing. The additional of night-time mouth taping provided further benefits for HRV and respiratory control. Larger and longer trials are needed to confirm these findings.

During the COVID-19 pandemic, the global focus on SARS-CoV-2 overshadowed the epidemiology of other respiratory pathogens. This study aimed to characterize the circulation of endemic human coronaviruses (HCoVs) in Brazil. We retrospectively analyzed results from 22,472 PCR tests for HCoVs (from 5183 patients) and 601,278 tests for SARS-CoV-2 (from 475,856 patients) between November 2019 and June 2021. HCoVs were detected in 160 patients (3.09%), with HCoV-NL63 as the most frequent species. HCoV circulation was intermittent, with positivity peaks up to 4% but also periods of up to six months with an absence of detections in 2020, contrasting with the sustained high positivity of SARS-CoV-2 (22.37%). Co-infections were frequent: 26.25% of HCoV-positive patients were co-infected with at least one other respiratory pathogen, most commonly Rhinovirus/Enterovirus, and cases involving up to five pathogens were observed, seven patients had co-infections between HCoVs and SARS-CoV-2. These findings reveal the persistent, often cryptic, circulation of HCoVs during the pandemic and highlight their role as key components in complex multi-pathogen infections. This underscores the critical importance of implementing comprehensive molecular diagnostic panels in routine respiratory surveillance to ensure accurate etiology, guide appropriate clinical management, and fully assess the public health burden of non-SARS-CoV-2 coronaviruses.