We present the case of a 69-year-old woman with a 25-year history of psychosis, managed with risperidone, who developed refractory tachypnea and alkalosis over 2 weeks. Despite multidisciplinary evaluation, she was initially misdiagnosed with psychogenic hyperventilation. Ultimately, a diagnosis of respiratory dyskinesia (RD) was established, and substantial clinical improvement was achieved after initiation of a vesicular monoamine transporter 2 (VMAT2) inhibitor. The substantial effectiveness of this therapy was confirmed over a 7-month follow-up period, with monitoring of both clinical symptoms and arterial blood gas parameters. This case highlights the diagnostic challenges posed by RD and underscores the potential utility of VMAT2 inhibitor as a novel therapeutic option.

A 44-year-old man, who does not smoke, presented for investigation of a right mediastinum lesion as revealed on a routine radiograph that was performed as a requirement of his life insurance. The patient reported no associated symptoms. He did not report shortness of breath, cough, sputum, fever, chest pain, or hemoptysis. The remaining review of symptoms was also negative for issues such as muscle weakness, weight loss, night sweats, fatigue, skin rash, and visible, palpable, or painful lymphadenopathy. His medical history was unremarkable, and he did not receive any regular medication. The patient's professional occupation was not related to special exposure and he did not report alcohol consumption, illicit drug use, or any recent travel.

Preserved ratio impaired spirometry (PRISm) has emerged as a distinct pulmonary pattern with potential clinical significance, but their 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 (SpO2) and tissue (StO2) oxygenation is routinely performed in clinical practice. Arterial Blood Gas (ABG) analysis, though considered as the gold standard for SpO2 estimation, requires arterial puncture, trained personnel and laboratory back up. Currently, there is a lack of universally accepted and widely used method for StO2 measurement. Available non-invasive 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.