Respiratory investigation最新文献

{"title":"Assessment and management of continuous positive airway pressure therapy in patient with obstructive sleep apnea","authors":"Yukio Fujita ,&nbsp;Motoo Yamauchi ,&nbsp;Shigeo Muro","doi":"10.1016/j.resinv.2024.05.004","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.05.004","url":null,"abstract":"<div><p>Obstructive sleep apnea (OSA) causes excessive daytime sleepiness, impaired daytime functioning, and an increased risk of cardiovascular diseases. Continuous positive airway pressure (CPAP) is a highly effective therapy for moderate to severe OSA. Although CPAP adherence is commonly assessed using a 4-hthreshold, determining the optimal usage time based on clinical outcomes is crucial. While subjective sleepiness often improves with ≥4 h of CPAP usage, an extended duration (≥6 h) may be necessary to impact objective sleepiness. CPAP demonstrated a modest yet clinically meaningful dose-dependent effect on lowering blood pressure. For patients seeking antihypertensive benefits from CPAP therapy, the goal should extend beyond 4 h of use to maximize the therapeutic impact. Recognizing individual variations in sleep duration and responses to CPAP therapy is essential. The adoption of 'individualized goals for CPAP use,' outlining target times for specific outcomes, should also consider an individual's total sleep duration, including periods without CPAP. The impact of CPAP on clinical outcomes may vary, even with the same duration of CPAP use, depending on the period without CPAP use, particularly during the first or second half of sleep. Patients who remove or initiate CPAP midway or have a low CPAP usage frequency may require different forms of guidance. Tailoring patient education to address CPAP usage patterns may be necessary to enhanced satisfaction, self-efficacy, and adherence to therapy. Management of CPAP treatment should be personalized to meet individual needs and adapted based on specific response patterns for achieving treatment efficacy.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140951287","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":"Safety and efficacy of airway stent placement following bronchial artery embolization: A retrospective study at a single institute","authors":"Yuki Takigawa ,&nbsp;Ken Sato ,&nbsp;Kenichiro Kudo ,&nbsp;Tomoyoshi Inoue ,&nbsp;Miho Fujiwara ,&nbsp;Suzuka Matsuoka ,&nbsp;Hiromi Watanabe ,&nbsp;Akiko Sato ,&nbsp;Takashi Mukai ,&nbsp;Keiichi Fujiwara","doi":"10.1016/j.resinv.2024.05.003","DOIUrl":"10.1016/j.resinv.2024.05.003","url":null,"abstract":"<div><h3>Background</h3><p>Airway stenting is an established procedure for treating oncological emergencies in patients with airway disorders. In patients with airway hemorrhage, respiratory conditions may worsen during stenting. Bronchial artery embolization (BAE) is useful to prevent bleeding from the bronchus. We aimed to evaluate the efficacy and safety of airway stenting after BAE in patients with malignant airway disorders.</p></div><div><h3>Methods</h3><p>The medical records of all patients who underwent airway stenting following BAE at the National Hospital Organization Okayama Medical Center between 2016 and 2023 were retrospectively reviewed.</p></div><div><h3>Results</h3><p>Thirteen procedures (11 silicone Y stents, one hybrid stent, and one self-expandable metallic stent) were performed. The median duration from BAE to airway stenting was one day (range: 1–5 days). Nine patients experienced tumor shrinkage, and none experienced severe bleeding after BAE during the stent procedure. No other major complications were associated with the stent placement. The median survival time after stenting was 169 days (range; 24–1086). No serious complications caused by BAE, such as spinal cord infarction, were observed.</p></div><div><h3>Conclusions</h3><p>Airway stent placement was safely performed after BAE without severe bleeding or acute respiratory failure. BAE, followed by airway stenting, is useful.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945747","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 current definition, but not scientific criteria of aspiration pneumonia may be important for clinical physicians","authors":"Shinji Teramoto","doi":"10.1016/j.resinv.2024.04.018","DOIUrl":"10.1016/j.resinv.2024.04.018","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945748","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":"Squamous metaplasia is an indicator of acute exacerbation in patients with usual interstitial pneumonia / idiopathic pulmonary fibrosis","authors":"Yuri Tachibana ,&nbsp;Masatake Hara ,&nbsp;Mikiko Hashisako ,&nbsp;Yasuhiko Yamano ,&nbsp;Kensuke Kataoka ,&nbsp;Yasuhiro Kondoh ,&nbsp;Takeshi Johkoh ,&nbsp;Shimpei Morimoto ,&nbsp;Andrey Bychkov ,&nbsp;Junya Fukuoka","doi":"10.1016/j.resinv.2024.04.021","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.04.021","url":null,"abstract":"<div><h3>Background</h3><p>Acute exacerbation (AE) is a potentially lethal event in patients with usual interstitial pneumonia/idiopathic pulmonary fibrosis (UIP/IPF). However, to date, no pathological predictors of AE have been identified. This retrospective study aimed to elucidate the pathological features that could predict AE in patients with UIP.</p></div><div><h3>Methods</h3><p>We reviewed the pathological findings of 91 patients with UIP/IPF and correlated these findings with AE events. Thirteen histological variables related to acute lung injury were evaluated by three independent observers and classified as positive or negative. The patients’ clinical data during follow-up were collected and reviewed for AE. A recursive partition using the Gini index for the prediction of AE was performed, with each pathological finding as a candidate for branching.</p></div><div><h3>Results</h3><p>Twenty patients (22%) developed AE during the median follow-up duration of 40 months. Thirty-eight patients died (15 due to AE and 23 for other reasons). The median time interval from surgical lung biopsy to AE onset was 497 (interquartile range: 901–1657) days. Histologically, squamous metaplasia was positively associated with AE (odds ratio: 4.7, <em>P</em> = 0.015) and worse event-free survival in patients with UIP (<em>P</em> = 0.04). Leaf scoring based on the Gini index for recursive partition, including five positive findings (squamous metaplasia, neutrophilic infiltration, septal widening, Kuhn's hyaline, and fibrin), showed a sensitivity of 90% with a specificity of 74.7% (area under curve: 0.89).</p></div><div><h3>Conclusions</h3><p>We found that squamous metaplasia is an important histopathological finding that predicts AE events and tends to unfavorable outcome in patients with UIP/IPF.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212534524000728/pdfft?md5=25a9d535535627a0d3431f28cb9b5fab&pid=1-s2.0-S2212534524000728-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140894473","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":"Coffee consumption was associated with a lower prevalence of airflow limitation in postmenopausal women","authors":"Jui-Hung Hsu ,&nbsp;Jia-In Lee ,&nbsp;Shu-Pin Huang ,&nbsp;Szu-Chia Chen ,&nbsp;Jiun-Hung Geng","doi":"10.1016/j.resinv.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.05.002","url":null,"abstract":"<div><h3>Background</h3><p>Several studies have suggested a potential correlation between menopause and airflow limitation. However, the presence of protective factors in postmenopausal women remains uncertain. Therefore, our study seeks to examine potential protective factors associated with a reduced prevalence of airflow limitation among postmenopausal women.</p></div><div><h3>Methods</h3><p>Postmenopausal women were recruited from the Taiwan Biobank for this cross-sectional study. Airflow limitation was defined by a forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) ratio &lt;0.7. The participants were categorized into two groups: non-coffee drinkers and coffee drinkers, and the association between coffee consumption and airflow limitation was examined using binary logistic regression models.</p></div><div><h3>Results</h3><p>A total of 8149 women with available information were enrolled. Compared to the non-coffee drinkers, the coffee drinkers had a significantly lower prevalence of airflow limitation (7% vs. 5%). The odds ratio (OR) for airflow limitation was lower in the coffee drinkers than in the non-coffee drinkers (OR = 0.77; 95% confidence interval [CI] = 0.63 to 0.94) after adjusting for confounding factors. We also examined the association between daily coffee consumption in cups and airflow limitation. The women who consumed ≥2 cups of coffee per day had an OR of 0.74 (95% CI = 0.59 to 0.94) compared to those who did not consume coffee.</p></div><div><h3>Conclusions</h3><p>Our results suggest that habitual coffee consumption is associated with a reduction in the prevalence of airflow limitation in postmenopausal women, warranting further prospective studies to explore possible causal effects and mechanisms.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878517","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":"Diagnostic yields and safety of thoracoscopic cryobiopsies in Japan: A single-center retrospective observational study","authors":"Miwa Kamatani ,&nbsp;Nobuyasu Awano ,&nbsp;Minoru Inomata ,&nbsp;Naoyuki Kuse ,&nbsp;Keita Sakamoto ,&nbsp;Toshio Kumasaka ,&nbsp;Takehiro Izumo","doi":"10.1016/j.resinv.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Thoracoscopy is useful for diagnosing unexplained pleural effusions. A sufficient specimen volume is often difficult to obtain using forceps biopsies (FBs) but can be obtained with pleural cryobiopsies (CBs). This study aimed to assess the utility and safety of CB during thoracoscopy in the Japanese population.</p></div><div><h3>Methods</h3><p>Patients who underwent thoracoscopic CBs at the Japanese Red Cross Medical Center between January 2017 and August 2023 were included in the study. Data were retrospectively analyzed, including clinical data, thoracoscopic findings, specimen size, diagnostic yield, and complications. The number of collected specimens and the freezing time were left to the discretion of the attending physician.</p></div><div><h3>Results</h3><p>Twenty-six patients underwent thoracoscopic CB. Specimens obtained by CB were larger than those obtained by FB. Primary lung cancer was the most common cause of pleural effusion, followed by malignant pleural mesothelioma. CB contributed to the diagnosis in 24 of 26 cases (92.3%) and FB contributed to the diagnosis in 11 of 18 cases (61.1%). Severe fibrosis could be diagnosed in all 3 cases by CB, but not by FB. The common complications of CB included bleeding at the biopsy site and atelectasis, but no severe complications occurred.</p></div><div><h3>Conclusions</h3><p>The utility and safety of thoracoscopic CB for diagnosing pleural effusions in Japan were verified. The diagnostic yield, specimen size, and safety profile of CB support the diagnostic utility of this method.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878518","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":"Cytokine profiles associated with disease severity and prognosis of autoimmune pulmonary alveolar proteinosis","authors":"Keiichi Akasaka ,&nbsp;Masako Amano ,&nbsp;Tomohiko Nakamura ,&nbsp;Tomotaka Nishizawa ,&nbsp;Hideaki Yamakawa ,&nbsp;Shintaro Sato ,&nbsp;Ami Aoki ,&nbsp;Kenjiro Shima ,&nbsp;Hidekazu Matsushima ,&nbsp;Toshinori Takada","doi":"10.1016/j.resinv.2024.04.019","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.04.019","url":null,"abstract":"<div><h3>Background</h3><p>Pulmonary alveolar proteinosis (PAP) is characterized by an abnormal accumulation of surfactants in the alveoli. Most cases are classified as autoimmune PAP (APAP) because they are associated with autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF). However, GM-CSF autoantibody levels are unlikely to correlate with the disease severity or prognosis of APAP.</p></div><div><h3>Methods</h3><p>We collected clinical records and measured 38 serum cytokine concentrations for consecutive patients with APAP. After exclusion of 21 cytokines because of undetectable levels, 17 cytokine levels were compared between low and high disease severity scores (DSSs). We also compared whole lung lavage (WLL)-free survival with cut-off values defined by receiver operating characteristic (ROC) curves of cytokine levels and WLL administration at 11 months.</p></div><div><h3>Results</h3><p>Nineteen patients with APAP were enrolled in the study. Five were classified as DSS 1 or 2, while the others were classified as DSS 4 or 5. Comparison between DSS 1−2 and 4−5 revealed that the concentrations of IP-10 and GRO increased in the latter groups (p &lt; 0.05). Fifteen patients underwent WLL. Comparison between those who underwent WLL within 11 months and the others showed that IP-10 and TNF-α were tended to be elevated in the former group (p = 0.082 and 0.057, respectively). The cut-off values of IP-10, 308.8 pg/mL and TNF-α, 19.1 pg/mL, defined by the ROC curves, significantly separated WLL-free survivals with log-rank analyses (p = 0.005).</p></div><div><h3>Conclusions</h3><p>The concentrations of IP-10 and GRO may reflect the DSSs of APAP. A combination of IP-10 and TNF-α levels could be a biomarker to predict WLL-free survival.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140823117","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":"A collaborative step forward in hemoptysis research","authors":"Hideo Ishikawa,&nbsp;Yu Yamaguchi","doi":"10.1016/j.resinv.2024.04.013","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.04.013","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140823118","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":"Clinical inertia in chronic obstructive pulmonary disease","authors":"Sumito Inoue","doi":"10.1016/j.resinv.2024.04.007","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.04.007","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140823116","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":"Endoscopic reflux esophagitis and decline in pulmonary function in nonsmokers: A retrospective cohort study","authors":"Takayoshi Enokido ,&nbsp;Yoshihisa Hiraishi ,&nbsp;Taisuke Jo ,&nbsp;Hirokazu Urushiyama ,&nbsp;Akira Saito ,&nbsp;Satoshi Noguchi ,&nbsp;Keisuke Hosoki ,&nbsp;Takashi Ishii ,&nbsp;Naoya Miyashita ,&nbsp;Kensuke Fukuda ,&nbsp;Rei Matsuki ,&nbsp;Chihiro Minatsuki ,&nbsp;Takeshi Shimamoto ,&nbsp;Hidenori Kage ,&nbsp;Nobutake Yamamichi ,&nbsp;Hirotaka Matsuzaki","doi":"10.1016/j.resinv.2024.04.017","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.04.017","url":null,"abstract":"<div><h3>Background</h3><p>The association between reflux esophagitis and pulmonary function remains controversial. Thus, evaluating the relationship between endoscopic reflux esophagitis and changes in pulmonary function over time in a nonsmoking population is an important clinical issue.</p></div><div><h3>Methods</h3><p>In this single-center retrospective cohort study, a medical examination database at Kameda Medical Center Makuhari was employed to identify nonsmokers who underwent upper gastrointestinal endoscopy and spirometry in 2010 and were followed up in 2015. Gastroenterologists carefully double-checked the diagnosis of reflux esophagitis. Multiple linear regression analyses were performed to compare the decline in the percentage of predicted vital capacity (%VC), forced vital capacity (%FVC), and forced expiratory volume in 1 s (%FEV₁) between participants with reflux esophagitis and those without. Furthermore, using multivariable logistic regression analyses, we evaluated the factors associated with rapid decline in %VC, %FVC, and %FEV₁, which is defined as a decrease of &gt;10% in each parameter over the 5-year observation period.</p></div><div><h3>Results</h3><p>We identified 3098 eligible subjects, including 72 and 44 participants who had a Los Angeles classification grade A and B–C (severe) reflux esophagitis in 2010, respectively. The decline in %VC was significantly larger in the participants with severe reflux esophagitis than in the control subjects (standardized coefficient, −0.037; 95% confidence interval, −0.071 to −0.004). Moreover, reflux esophagitis was significantly associated with a rapid decline in %VC and %FVC but not in %FEV₁ (P for trend: 0.009, 0.009, and 0.276, respectively).</p></div><div><h3>Conclusions</h3><p>Severe reflux esophagitis among nonsmokers had clinical disadvantages in terms of a decline in %VC.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212534524000704/pdfft?md5=5c696c4260c627cddd4845192bb96ae0&pid=1-s2.0-S2212534524000704-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140816394","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}