Respiratory investigation最新文献

{"title":"Epidemiology of chronic pulmonary aspergillosis: A nationwide descriptive study","authors":"Yuya Kimura ,&nbsp;Yusuke Sasabuchi ,&nbsp;Taisuke Jo ,&nbsp;Yohei Hashimoto ,&nbsp;Ryosuke Kumazawa ,&nbsp;Miho Ishimaru ,&nbsp;Hiroki Matsui ,&nbsp;Akira Yokoyama ,&nbsp;Goh Tanaka ,&nbsp;Hideo Yasunaga","doi":"10.1016/j.resinv.2024.09.015","DOIUrl":"10.1016/j.resinv.2024.09.015","url":null,"abstract":"<div><h3>Background</h3><div>Chronic pulmonary aspergillosis (CPA) has recently gained attention owing to its substantial health burden. However, the precise epidemiology and prognosis of the disease are still unclear due to the lack of a nationwide descriptive analysis. This study aimed to elucidate the epidemiology of patients with CPA and to investigate their prognosis.</div></div><div><h3>Methods</h3><div>Using a national administrative database covering &gt;99% of the population in Japan, we calculated the nationwide incidence and prevalence of CPA from 2016 to 2022. Additionally, we clarified the survival rate of patients diagnosed with CPA and identified independent prognostic factors using multivariate Cox proportional hazard analysis.</div></div><div><h3>Results</h3><div>During the study period, while the prevalence of CPA remained stable at 9.0–9.5 per 100,000 persons, its incidence declined to 2.1 from 3.5 per 100,000 person-years. The 1-, 3-, and 5-year survival rates were 65%, 48%, and 41%, respectively. During the year of CPA onset, approximately 50% of patients received oral corticosteroids (OCS) at least once, while about 30% underwent frequent OCS treatment (≥4 times per year) within the same timeframe. Increased mortality was independently associated with older age (&gt;65 years) (hazard ratio [HR], 2.65; 95% confidence interval (CI), 2.54–2.77), males (1.24; 1.20–1.29), a history of chronic obstructive pulmonary disease (1.05; 1.02–1.09), lung cancer (1.12; 1.06–1.18); and ILD (1.19; 1.14–1.24); and frequent OCS use (1.13; 1.09–1.17). Conversely, decreased mortality was associated with a history of tuberculosis (HR, 0.81; 95% CI, 0.76–0.86), non-tuberculous mycobacteria (0.91; 0.86–0.96), and other chronic pulmonary diseases (0.89; 0.85–0.92).</div></div><div><h3>Conclusions</h3><div>The incidence of CPA decreased over the past decade, although the prevalence was stable and much higher than that in European countries. Moreover, the patients’ prognosis was poor. Physicians should be vigilant about CPA onset in patients with specific high-risk underlying pulmonary conditions.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1102-1108"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic obstructive pulmonary disease, asthma, and mechanical ventilation are risk factors for dyspnea in patients with long COVID: A Japanese nationwide cohort study","authors":"Emiko Matsuyama ,&nbsp;Jun Miyata ,&nbsp;Hideki Terai ,&nbsp;Naoki Miyazaki ,&nbsp;Toshiki Iwasaki ,&nbsp;Kengo Nagashima ,&nbsp;Mayuko Watase ,&nbsp;Keeya Sunata ,&nbsp;Ho Namkoong ,&nbsp;Takanori Asakura ,&nbsp;Katsunori Masaki ,&nbsp;Shotaro Chubachi ,&nbsp;Keiko Ohgino ,&nbsp;Ichiro Kawada ,&nbsp;Kazuhiro Minami ,&nbsp;Rie Hagiwara ,&nbsp;Soichiro Ueda ,&nbsp;Takashi Yoshiyama ,&nbsp;Hiroyuki Kokuto ,&nbsp;Tatsuya Kusumoto ,&nbsp;Koichi Fukunaga","doi":"10.1016/j.resinv.2024.09.009","DOIUrl":"10.1016/j.resinv.2024.09.009","url":null,"abstract":"<div><h3>Background</h3><div>Patients often experience multiple prolonged symptoms following acute coronavirus disease 2019 (COVID-19) recovery, defined as long coronavirus disease (COVID). Patients with long COVID may experience dyspnea during acute and post-acute phases. Therefore, this study aimed to identify specific risk factors for dyspnea in patients with long COVID.</div></div><div><h3>Methods</h3><div>Hospitalized patients with COVID-19, aged ≥18 years, were enrolled in this multicenter cohort study conducted at 26 medical institutions across Japan. Clinical data during hospitalization and patient-reported outcomes after discharge at the 3, 6, and 12-month follow-ups were retrieved from medical records and paper-based or smartphone application-based questionnaires, respectively.</div></div><div><h3>Results</h3><div>Generalized linear mixed model (GLMM) analysis of prolonged dyspnea at each time point during follow-up showed that this symptom was associated with chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.31–5.74), asthma (OR, 2.21; 95%CI, 1.17–4.16), and ventilator management (OR, 3.10; 95%CI, 1.65–5.83). In addition, patients with COPD (44.4%) and ventilator management (25.0%) were more frequently associated with delayed dyspnea onset. The generalized estimating equations analysis results with multiple imputed datasets, conducted as a sensitivity analysis, confirmed the adjusted GLMM analysis results.</div></div><div><h3>Conclusions</h3><div>Prolonged dyspnea was associated with COPD, asthma, and severe infection that required mechanical ventilation in the Japanese population with long COVID. Further investigation is needed to clarify its mechanism and develop prophylactic and therapeutic strategies for dyspnea in patients with long COVID.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1094-1101"},"PeriodicalIF":2.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142326453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responsiveness and minimal clinically important difference of the COPD Assessment Test in fibrotic interstitial lung disease","authors":"Toshiaki Matsuda ,&nbsp;Yasuhiro Kondoh ,&nbsp;Reoto Takei ,&nbsp;Hajime Sasano ,&nbsp;Jun Fukihara ,&nbsp;Yasuhiko Yamano ,&nbsp;Toshiki Yokoyama ,&nbsp;Kensuke Kataoka ,&nbsp;Fumiko Watanabe ,&nbsp;Tomoki Kimura","doi":"10.1016/j.resinv.2024.08.006","DOIUrl":"10.1016/j.resinv.2024.08.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>Patients with fibrotic interstitial lung disease (FILD) have impaired health status. The simple questionnaire in the COPD assessment test (CAT) has been validated for idiopathic pulmonary fibrosis (IPF) and connective tissue disease-related interstitial lung disease (CTD-ILD), but no or limited data exist for patients with FILD as a whole. The aim of this study was to evaluate the reliability, repeatability and responsiveness of the CAT, and estimate the minimal clinically important difference (MCID) in patients with FILD.</div></div><div><h3>Methods</h3><div>This study was a retrospective chart review of 358 consecutive patients with FILD including 131 with IPF, who underwent clinical assessment over 6–12 month intervals. We assessed the cross-sectional and longitudinal validity of the CAT. MCID was estimated using distribution methods and anchor methods with mean change and regression models.</div></div><div><h3>Results</h3><div>Internal consistency (Cronbach's alpha = 0.898) and repeatability (intraclass correlation coefficient [ICC] = 0.865) for the CAT score was acceptable. A cross-sectional study showed constructive validity. Changes in the CAT over 6–12 months were significantly associated with change in anchors including physiological function, exercise capacity, and dyspnea regardless of IPF diagnosis. The estimated MCIDs of the CAT for the deterioration and improvement directions were at least +5 and at least −3 points, respectively.</div></div><div><h3>Conclusions</h3><div>The CAT is a reliable, responsive and clinically relevant instrument for assessing health status in patients with FILD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1088-1093"},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of long-term macrolide therapy for non-cystic fibrosis bronchiectasis: A systematic review and meta-analysis","authors":"Natsuki Nakagawa ,&nbsp;Masashi Ito ,&nbsp;Takanori Asakura ,&nbsp;Nobuyuki Horita ,&nbsp;Yasushi Obase ,&nbsp;Hiroshi Mukae","doi":"10.1016/j.resinv.2024.09.004","DOIUrl":"10.1016/j.resinv.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Long-term macrolide therapy for non-cystic fibrosis bronchiectasis (NCFB) can play a significant role. However, such data are insufficient regarding the efficacy against severe exacerbation and adverse effects, including the emergence of macrolide-resistant pathogens and prolonged macrolide use beyond 1 year.</div></div><div><h3>Methods</h3><div>Randomized controlled trials (RCTs) and prospective observational studies comparing the efficacy and safety of macrolides and placebo in adult patients with NCFB were screened on April 10, 2024. The primary outcome was severe exacerbation frequency.</div></div><div><h3>Results</h3><div>Ten RCTs ≤1 year study durations were included. Most studies mainly included patients with a history of &gt;2 exacerbations. Macrolides had a tendency to reduce the frequency of severe exacerbations compared with placebo (odds ratio = 0.54, 95% confidence interval (CI) = 0.25–1.18). Macrolides significantly reduced the frequency of exacerbations (rate ratio = 0.58, 95% CI = 0.48–0.69), prolonged the time to first exacerbation (rate ratio = 0.41, 95% CI = 0.30–0.55), improved the changes in SGRQ scores [mean difference (MD) = -3.99, 95% CI = −4.63–3.44] and percent predicted forced expiratory volume in 1 s (MD = −2.30, 95% CI = 0.26–4.33), and reduced sputum volume (gram) (MD = −7.44, 95% CI = −9.15–5.74). Additionally, macrolides did not increase drug-related adverse events leading to discontinuation. Qualitative SR of pathogens indicated macrolides might increase the number of macrolide-resistant oropharyngeal and sputum pathogens and the emergence of <em>Pseudomonas aeruginosa</em>.</div></div><div><h3>Conclusions</h3><div>Our results support macrolide therapy for patients with NCFB. Studies with an observation period of &gt;1 year or those focusing on patients with/without a minimal exacerbation history are required to determine the long-term effects on patients with NCFB.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1079-1087"},"PeriodicalIF":2.4,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative-predictive value of SUVmax for Ascertaining the efficacy of osimertinib in EGFR mutation-positive non-small cell lung cancer","authors":"Moriyasu Anai ,&nbsp;Hiroki Inoue ,&nbsp;Koichi Saruwatari ,&nbsp;Seitaro Oda ,&nbsp;Shinya Shiraishi ,&nbsp;Kimitaka Akaike ,&nbsp;Kosuke Imamura ,&nbsp;Takayuki Jodai ,&nbsp;Shinya Sakata ,&nbsp;Shinji Iyama ,&nbsp;Yusuke Tomita ,&nbsp;Hidenori Ichiyasu ,&nbsp;Takuro Sakagami","doi":"10.1016/j.resinv.2024.09.001","DOIUrl":"10.1016/j.resinv.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Fluorine-¹⁸ 2-fluoro-2-deoxy<span>-d</span>-glucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) is routinely used to stage non-small cell lung cancer (NSCLC). However, whether ¹⁸F-FDG accumulation in primary tumors affects the efficacy of osimertinib in patients with epidermal growth factor receptor (<em>EGFR</em>) mutation-positive NSCLC remains unclear.</div></div><div><h3>Methods</h3><div>We retrospectively investigated 74 patients with advanced or postoperative recurrent <em>EGFR</em> mutation-positive NSCLC who underwent ¹⁸F-FDG PET/CT and were treated with osimertinib as first-line therapy between September 2018 and March 2023 at Kumamoto University Hospital. The maximum standardized uptake value (SUVmax) of each primary tumor was measured, and the patients were divided into two groups according to the median SUVmax. The effects of SUVmax on progression-free survival (PFS) and overall survival (OS) were assessed using a multivariate Cox proportional hazards model.</div></div><div><h3>Results</h3><div>The median SUVmax was 8.2 (interquartile range: 5.5–11.4). The median PFS in the high SUVmax group (≥8.2) was significantly shorter than that in the low SUVmax group (&lt;8.2). The respective median PFSs were 11.2 months (95% confidence interval [CI]: 3.1–19.3 months) vs. 22.9 months (95% CI: 12.4–33.4 months) (<em>P</em> = 0.015), although the OS values did not differ significantly. Multivariate analysis showed that a high SUVmax was an independent negative predictive factor for PFS in patients treated with osimertinib (hazard ratio, 2.25; 95% CI: 1.15–4.39, <em>P</em> = 0.017).</div></div><div><h3>Conclusions</h3><div>High primary-lesion SUVmax in patients with <em>EGFR</em> mutation-positive NSCLC correlated with shorter PFS with first-line osimertinib therapy, suggesting that SUVmax is a useful predictive marker for the antitumor efficacy of osimertinib.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1072-1078"},"PeriodicalIF":2.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological trends and clinical relevance of nontuberculous mycobacterial pulmonary disease in a referral hospital in Japan, 2017–2021","authors":"Masashi Ito ,&nbsp;Koji Furuuchi ,&nbsp;Keiji Fujiwara ,&nbsp;Tatsuya Kodama ,&nbsp;Yoshiaki Tanaka ,&nbsp;Takashi Yoshiyama ,&nbsp;Hideo Ogata ,&nbsp;Atsuyuki Kurashima ,&nbsp;Ken Ohta ,&nbsp;Kozo Morimoto","doi":"10.1016/j.resinv.2024.09.007","DOIUrl":"10.1016/j.resinv.2024.09.007","url":null,"abstract":"<div><h3>Background</h3><p>Epidemiological trends and clinical relevance of NTM species in Japan following the adoption of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry remain unclear.</p></div><div><h3>Methods</h3><p>We analyzed the results of mycobacterial culture tests of respiratory specimens collected between January 2017 and December 2021. We assessed the clinical relevance of NTM species by analyzing the proportion of patients diagnosed with NTM pulmonary infection (NTM-PI). We illustrated the incidence and clinical relevance of each NTM species using a two-dimensional scatter plot. Medical chart review and radiological analysis were also performed for less common species.</p></div><div><h3>Results</h3><p>Among 65,368 respiratory specimens tested for acid-fast bacilli, NTM were identified in 12,802 specimens from 3177 patients. The number of incident cases with NTM-PI has continued to increase. Notably, the number of incident cases with <em>M. abscessus</em> species (MABS) was continuously increasing and accounted for 10.6% of all incident cases with NTM-PI. The clinical relevance of the common NTM species, <em>M. avium</em> complex, MABS and <em>M. kansasii</em>, ranged from 57 to 72%. Seven other species exhibited a higher clinical relevance than these common NTM species, with <em>M. shinjukuense</em> (100%) having the highest clinical relevance. On the other hand, 11 species, including <em>M. fortuitum</em> (32.4%), <em>M. xenopi</em> (20.0%), and <em>M. gordonae</em> (22.9%), showed clinical relevance below 50%.</p></div><div><h3>Conclusions</h3><p>The present study clarified the incidence and clinical relevance of NTM species using a two-dimensional scatter plot, which could serve as a useful tool for clinical decision-making and future epidemiological research.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1064-1071"},"PeriodicalIF":2.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise intolerance and oxygen dynamics in nontuberculous mycobacteria with bronchiectasis","authors":"Satoshi Miyamoto ,&nbsp;Keisuke Miki ,&nbsp;Seigo Kitada ,&nbsp;Yuka Nagata ,&nbsp;Ryo Kijima ,&nbsp;Yasuhiro Mihashi ,&nbsp;Hisako Hashimoto ,&nbsp;Tomonori Maekura ,&nbsp;Rika Yonezawa ,&nbsp;Shizuka Sakaguchi ,&nbsp;Hiromi Yanagi ,&nbsp;Kazumi Koyama ,&nbsp;Takuro Nii ,&nbsp;Takanori Matsuki ,&nbsp;Kazuyuki Tsujino ,&nbsp;Hiroshi Kida","doi":"10.1016/j.resinv.2024.08.017","DOIUrl":"10.1016/j.resinv.2024.08.017","url":null,"abstract":"<div><h3>Background</h3><p>Nontuberculous mycobacterial pulmonary disease (NTM-PD) patients often have exercise intolerance. Pulmonary rehabilitation (PR) to improve such patients' conditions is often not based on its exercise pathophysiology. We have reported that the oxygen consumption (ΔF_O2) by expiratory gas analysis, i.e., the inspired-expired-expiratory mean oxygen concentration difference, is related to the minute ventilation-carbon dioxide output (<em>V</em>′_E-<em>V</em>′_CO2)-slope and oxygen uptake (<em>V</em>′_O2) independent of the <em>V</em>′_E. The aim of this study was to investigate how ΔF_O2 is related to dynamic ventilatory variables, chest computed tomography (CT), and echocardiography findings in NTM-PD patients to understand their pathophysiological conditions.</p></div><div><h3>Methods</h3><p>Clinical data of NTM-PD patients with exertional dyspnea (n = 29) who underwent incremental exercise testing, chest CT, and echocardiography at the same time were compared with those of control participants (n = 12).</p></div><div><h3>Results</h3><p>In the NTM-PD group, 1) peak <em>V</em>′_O2 decreased (NTM-PD: 17.6 vs. controls: 28.7 mL⋅min⁻¹⋅kg⁻¹), and 2) ΔF_O2 at peak exercise was negatively correlated with respiratory frequency at peak exercise (correlation coefficient: r = −0.80, p &lt; 0.0001), <em>V</em>′_E-<em>V</em>′_CO2-slope (r = −0.75, p &lt; 0.0001), bronchiectasis CT score (r = −0.52, p = 0.0042), and the <em>trans</em>-tricuspid pressure gradient (r = −0.39, p = 0.0417), and positively correlated with peak <em>V'</em>_O2 (r = 0.71, p &lt; 0.0001) and the body mass index (r = 0.42, p = 0.0217), but it was not correlated with <em>V</em>′_E at peak exercise and the cavity CT score.</p></div><div><h3>Conclusions</h3><p>Exertional oxygen consumption, independent of ventilatory ability, is associated with exercise tolerance and ventilatory efficiency, while being related to tachypnea and bronchiectasis rather than cavitation in NTM-PD patients. These findings may be useful in considering exercise physiology-based PR for NTM-PD patients with exertional dyspnea.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1058-1063"},"PeriodicalIF":2.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between the use of Shoseiryuto and reduction in intravenous steroid dose among adult inpatients with asthma exacerbation: A national database study in Japan","authors":"Aya Saihara-Yamaguchi ,&nbsp;Hirokazu Urushiyama ,&nbsp;Kosuke Makita ,&nbsp;Shotaro Aso ,&nbsp;Hideaki Watanabe ,&nbsp;Akira Yokoyama ,&nbsp;Takahiro Ando ,&nbsp;Taisuke Jo ,&nbsp;Nobuyasu Awano ,&nbsp;Matsui Hiroki ,&nbsp;Kiyohide Fushimi ,&nbsp;Hidenori Kage ,&nbsp;Hideo Yasunaga","doi":"10.1016/j.resinv.2024.09.005","DOIUrl":"10.1016/j.resinv.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><p><em>Shoseiryuto</em>, a Japanese herbal medicine, is used to treat asthma exacerbation; however, the effect of <em>Shoseiryuto</em> in a clinical setting is yet to be elucidated. We aimed to examine the effect of <em>Shoseiryuto</em> for inpatients with asthma exacerbation and the reduction in the total amount of intravenous steroids administered during hospitalization, in-hospital mortality, and length of hospital stay using a national inpatient database in Japan.</p></div><div><h3>Methods</h3><p>Using data from the Japanese Diagnosis Procedure Combination database (July 2010–March 2022), we identified patients aged ≥18 years who were admitted due to asthma exacerbation. We performed propensity score overlap weighting analyses to estimate the in-hospital outcomes between patients who received <em>Shoseiryuto</em> within 3 days of admission (<em>Shoseiryuto</em> group) and those who did not (control group). The outcomes measured were the dose of intravenous steroids administered, in-hospital mortality, and length of hospital stay for patients alive at discharge.</p></div><div><h3>Results</h3><p>Among 51,459 eligible patients, 131 received <em>Shoseiryuto</em>. In the propensity score overlap weighting analyses, the use of <em>Shoseiryuto</em> was significantly associated with reduced amount of intravenous steroid during hospitalization (67 mg versus 149 mg, 95% confidence interval [CI]: −68 to −92), but was not associated with reduced in-hospital mortality (1.9% versus 3.5%, 95% CI: −28 to 25) or length of hospital stay (17.3 days versus 18.3 days, 95% CI: −4.2 to 2.4).</p></div><div><h3>Conclusions</h3><p>The use <em>Shoseiryuto</em> in inpatients with asthma exacerbation was significantly associated with reduced steroid use. Our results elucidated the potential role of <em>Shoseiryuto</em> in the treatment of asthma exacerbation.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1053-1057"},"PeriodicalIF":2.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Endoscopic reflux esophagitis and decline in pulmonary function in nonsmokers: A retrospective cohort study","authors":"Ahmad Furqan Anjum,&nbsp;Muhammad Burhan Anjum,&nbsp;Rahmeen Nauman","doi":"10.1016/j.resinv.2024.08.018","DOIUrl":"10.1016/j.resinv.2024.08.018","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1051-1052"},"PeriodicalIF":2.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of anticholinergic drugs associated with aspiration pneumonia using the Japanese adverse drug event report database: Supplementary insights from a scoping review","authors":"Akihito Ueda ,&nbsp;Kanji Nohara ,&nbsp;Michiko Obara ,&nbsp;Shinichi Watanabe","doi":"10.1016/j.resinv.2024.09.003","DOIUrl":"10.1016/j.resinv.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><p>Japan's super-aged society presents significant challenges, particularly with regard to managing aspiration pneumonia among older adults. We aimed to investigate the link between anticholinergic drug use and the incidence of aspiration pneumonia, primarily utilizing data from the Japanese Adverse Drug Event Report (JADER) database.</p></div><div><h3>Methods</h3><p>The primarily analysis included JADER data from the first quarter of 2004 through the third quarter of 2023, focusing on 2367 cases of aspiration pneumonia in individuals aged ≥60 years. The study examined the association of aspiration pneumonia with 49 drugs listed in the Anticholinergic Risk Scale, using the Reporting Odds Ratio for signal detection. A scoping review incorporating findings from MEDLINE and the Cochrane Library was conducted to validate these associations.</p></div><div><h3>Results</h3><p>The primary analysis identified an increased risk of aspiration pneumonia associated with specific drugs, including clozapine, haloperidol, risperidone, quetiapine, and olanzapine. A total of 20 drugs were significantly associated with an increased risk of aspiration pneumonia. Our results emphasize the importance of considering the dopamine-blocking effects of these drugs, particularly in at-risk populations, such as older adults, and those with conditions, such as schizophrenia or Parkinson's disease.</p></div><div><h3>Conclusions</h3><p>The study highlights the importance of careful monitoring of anticholinergic drugs with potent dopamine-blocking effects, such as clozapine, haloperidol, risperidone, quetiapine, and olanzapine, to reduce the risk of aspiration pneumonia. Future research should include observational and interventional studies to further investigate these findings.</p></div><div><h3>Ethics and dissemination</h3><p>As this study utilized pre-existing anonymized information, approval from an ethics committee was not required.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1044-1050"},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212534524001394/pdfft?md5=9cdd20d0490ef1b6bc68285cea71a4d1&pid=1-s2.0-S2212534524001394-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}