Preserved ratio impaired spirometry (PRISm) has emerged as a distinct pulmonary pattern with potential clinical significance, but its association with lung cancer risk remains unclear.

Pulmonary alveolar proteinosis (PAP) is a rare diffuse lung syndrome characterized by impaired surfactant clearance and alveolar filling, most commonly the result of autoimmune neutralization of granulocyte-macrophage colony-stimulating factor (GM-CSF) by autoantibodies. Whole lung lavage (WLL) remains the cornerstone of treatment, yet procedural practices vary widely across institutions. This report presents a reproducible, evidence-aligned protocol for WLL developed across 2 high-volume centers, detailing perioperative management, technical execution, and follow-up. We describe our approach to patient selection, contraindication screening, anesthesia and airway strategy, and the stepwise lavage process using warmed saline instillation and drainage under general anesthesia with single-lung ventilation. Lavage is performed in 2 staged sessions, guided by effluent clarity and clinical tolerance. Intraoperative challenges such as hypoxemia, fluid spillover, or poor return are anticipated and addressed using structured response algorithms. Postprocedural care includes diuresis, lung re-expansion measures, and early mobilization, with discharge typically within 24 to 48 hours for elective outpatients. Most patients experience rapid improvement in symptoms, gas exchange, and functional capacity; however, recurrence is common, with one-third of patients requiring repeat lavage within 2 to 3 years. Inhaled GM-CSF therapy now is considered after WLL in all eligible patients, especially those with incomplete response or high relapse risk, prolonging remission and reducing the need for subsequent procedures. Our experience supports a combined strategy of lavage, adjunctive therapy, and longitudinal surveillance to achieve sustained disease control. By emphasizing multidisciplinary coordination, individualized risk assessment, and protocolized execution, this framework aims to enhance safety, reproducibility, and long-term monitoring to reduce recurrence and improve outcomes in PAP.

Idiopathic pulmonary fibrosis (IPF) is characterized by an increase in proteolytic enzymes, including matrix metalloproteinases that degrade the extracellular matrix and markers of localized inflammation. Protein fragments (neoepitopes) are detectable in the circulation.

Measurement of blood oxygen saturation (Spo2) and tissue oxygenation (Sto2) is routinely performed in clinical practice. Arterial blood gas analysis, although considered the gold standard for Spo2 estimation, requires arterial puncture, trained personnel, and laboratory backup. Currently, there is a lack of universally accepted and widely used methods for Sto2 measurement. Available noninvasive methods for Spo2 and Sto2 estimation have several limitations. Many technologies are under development to address this unmet clinical need.

Nocturnal hypoxemia commonly affects people with pulmonary fibrosis (PF).

Insomnia and OSA, together known as comorbid insomnia and OSA (COMISA), are highly prevalent sleep disorders, each of which has the potential to impair treatment efficacy for the other.

Weight loss in patients with fibrotic interstitial lung disease (F-ILD) is associated with poor prognosis, yet the impact of dietary input is unknown.

A subgroup of patients with obesity exhibits hypoventilation as a result of, among other mechanisms, a narrow, collapsible upper airway (UA), a reduced ventilatory drive during both wakefulness and sleep, and the loss of pharyngeal muscle tone during sleep. These features characterize obesity-hypoventilation syndrome (OHS). If left untreated, OHS is associated with significant morbidity and mortality. Besides lifestyle modifications, positive airway pressure (PAP) is the only available treatment, and it is often not well tolerated. Drugs designed to activate UA muscles such as atomoxetine and to stimulate breathing such as acetazolamide represent a potential novel strategy for treating OHS.

Asthma, the most prevalent respiratory condition in pregnancy, affects up to 12% of pregnant women globally and is associated with adverse perinatal outcomes when poorly controlled. Modern asthma management emphasizes achieving clinical remission through personalized, trait-based approaches targeting modifiable risk factors. Insights into the mechanisms of airway inflammation have led to biomarker-directed therapy and the emergence of biologic agents for severe asthma. An evidence review was conducted to evaluate the applicability of these contemporary principles within the context of pregnancy.

The role of cannabis smoking in lung cancer has long been underexplored due to its historical illegality and frequent co-use with tobacco. As cannabis use increases globally, particularly among younger individuals, understanding its impact on lung cancer is critical.

Severe asthma affects 5% to 10% of patients with asthma but constitutes close to one-half of the medical costs related to asthma due to higher morbidity and health care utilization. Biologic agents have become a standard of care in those unresponsive to standard treatments yet the choice of biologic agent is complex due to the varying mechanisms of action, efficacies, and lack of head-to-head comparisons. Therefore, clinicians need further clinical guidance to optimize their use.

Timely follow-up after PICU hospitalization provides an important opportunity to support recovery following critical illness. However, the limited available data suggest that timely follow-up does not occur regularly.

Atelectasis frequently occurs in patients with impaired consciousness who are being treated with invasive mechanical ventilation. It is mainly caused by secretion accumulation, which can lead to longer durations of ventilation and ICU stay.

Olfaction may be associated with lung health because of the anatomic and functional connections between the upper and lower airways, but empirical evidence is lacking.

Trajectories of pulmonary function across the menopausal transition remain poorly understood.

Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) confers an increased risk of mortality among patients with RA. However, the optimal treatment strategies remain uncertain due to the limited high-quality evidence available.

Diffusing capacity for carbon monoxide (Dlco) is a critical measurement for diagnosing and monitoring cardiorespiratory diseases, but its clinical utility is limited by measurement variability. Clinical guidelines lack evidence-based thresholds for distinguishing significant changes from normal variability.

Usual interstitial pneumonia (UIP) indicates a poor prognosis, and there is significant heterogeneity in the diagnosis of UIP, necessitating an auxiliary diagnostic tool.

Betel quid is a widely consumed substance that has been associated with higher mortality and increased risk of several diseases.