Respiratory investigation最新文献

{"title":"Unfavorable response to capmatinib for MET exon14 skipping after first-line osimertinib in a patient with EGFR-mutated lung adenocarcinoma: A case report and literature review","authors":"Taisuke Araki ,&nbsp;Shintaro Kanda ,&nbsp;Tatsuya Yazaki ,&nbsp;Taro Hirabayashi ,&nbsp;Masamichi Komatsu ,&nbsp;Kei Sonehara ,&nbsp;Kazunari Tateishi ,&nbsp;Masayuki Hanaoka","doi":"10.1016/j.resinv.2024.05.009","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.05.009","url":null,"abstract":"<div><p><em>MET</em> exon14 skipping mutations (<em>MET</em>ex14s) are rarely reported as a potential resistance mechanism to EGFR tyrosine kinase inhibitors (TKIs). The efficacy of targeted therapy against <em>MET</em>ex14s emerging after osimertinib resistance is uncertain. Herein, we report a case of <em>EGFR-</em>mutated metastatic lung adenocarcinoma in which <em>MET</em>ex14 was detected in a re-biopsy upon first-line osimertinib resistance. The patient received capmatinib monotherapy as third-line therapy, which was ineffective, followed by an exceptional response to salvage therapy with afatinib. This report highlights the heterogeneity of EGFR-TKI resistance and that targeting rare resistance mechanisms remains challenging.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 4","pages":"Pages 677-680"},"PeriodicalIF":3.1,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077839","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":"Computed tomography machine learning classifier correlates with mortality in interstitial lung disease","authors":"Onofre Moran-Mendoza ,&nbsp;Abhishek Singla ,&nbsp;Angad Kalra ,&nbsp;Michael Muelly ,&nbsp;Joshua J. Reicher","doi":"10.1016/j.resinv.2024.05.010","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.05.010","url":null,"abstract":"<div><h3>Background</h3><p>A machine learning classifier system, Fibresolve, was designed and validated as an adjunct to non-invasive diagnosis in idiopathic pulmonary fibrosis (IPF). The system uses a deep learning algorithm to analyze chest computed tomography (CT) imaging. We hypothesized that Fibresolve is a useful predictor of mortality in interstitial lung diseases (ILD).</p></div><div><h3>Methods</h3><p>Fibresolve was previously validated in a multi-site &gt;500-patient dataset. In this analysis, we assessed the usefulness of Fibresolve to predict mortality in a subset of 228 patients with IPF and other ILDs in whom follow up data was available. We applied Cox regression analysis adjusting for the Gender, Age, and Physiology (GAP) score and for other known predictors of mortality in IPF. We also analyzed the role of Fibresolve as tertiles adjusting for GAP stages.</p></div><div><h3>Results</h3><p>During a median follow-up of 2.8 years (range 5 to 3434 days), 89 patients died. After adjusting for GAP score and other mortality risk factors, the Fibresolve score significantly predicted the risk of death (HR: 7.14; 95% CI: 1.31–38.85; p = 0.02) during the follow-up period, as did forced vital capacity and history of lung cancer. After adjusting for GAP stages and other variables, Fibresolve score split into tertiles significantly predicted the risk of death (p = 0.027 for the model; HR 1.37 for 2nd tertile; 95% CI: 0.77–2.42. HR 2.19 for 3rd tertile; 95% CI: 1.22–3.93).</p></div><div><h3>Conclusions</h3><p>The machine learning classifier Fibresolve demonstrated to be an independent predictor of mortality in ILDs, with prognostic performance equivalent to GAP based solely on CT images.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 4","pages":"Pages 670-676"},"PeriodicalIF":3.1,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072621","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":"Response to letter to the editor “The current definition, but not scientific criteria of aspiration pneumonia may be important for clinical physicians”","authors":"Akihito Ueda ,&nbsp;Kanji Nohara","doi":"10.1016/j.resinv.2024.05.013","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.05.013","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 4","pages":"Page 669"},"PeriodicalIF":3.1,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141068851","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":"Antibiotic treatment for patients with exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis","authors":"Yasuhito Suzuki ,&nbsp;Kento Sato ,&nbsp;Suguru Sato ,&nbsp;Sumito Inoue ,&nbsp;Yoko Shibata","doi":"10.1016/j.resinv.2024.05.007","DOIUrl":"10.1016/j.resinv.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><p>Although respiratory tract infection is a significant factor that triggers exacerbation of chronic obstructive pulmonary disease (COPD), the benefit of antibiotics for patients with COPD exacerbation remains controversial. It is necessary to evaluate the efficacy and safety of antibiotics versus placebo in such patients.</p></div><div><h3>Methods</h3><p>We conducted a systematic review and meta-analysis of randomized controlled trials of antibiotics versus placebo for the treatment of COPD exacerbation, and compared the frequencies of treatment failure, mortality, and adverse events between patients treated with antibiotics and those treated with placebo.</p></div><div><h3>Results</h3><p>A total of six studies were included in this meta-analysis. The frequency of treatment failure was significantly lower in the antibiotic-treated patients compared to the placebo-treated patients (odds ratios [OR] 0.50, 95% confidence intervals [CI] 0.35–0.71, <em>p</em> = 0.0001). There was no significant difference between the two groups in mortality (OR 0.44, 95% CI 0.05–3.76, <em>p</em> = 0.45) or frequency of adverse events (OR 1.05, 95% CI 0.75–1.48, <em>p</em> = 0.78).</p></div><div><h3>Conclusion</h3><p>In the current systematic review and meta-analysis, we found that antibiotics were superior to placebo in patients with exacerbated COPD, as shown by the lower treatment failure rate.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 4","pages":"Pages 663-668"},"PeriodicalIF":3.1,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959396","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":"Effect of mTOR inhibitors on the mortality and safety of patients with lymphangioleiomyomatosis on the lung transplantation waitlist: A retrospective cohort study","authors":"Teiko Sakurai ,&nbsp;Takashi Kanou ,&nbsp;Soichiro Funaki ,&nbsp;Eriko Fukui ,&nbsp;Toru Kimura ,&nbsp;Naoko Ose ,&nbsp;Yoshikazu Inoue ,&nbsp;Yasushi Shintani","doi":"10.1016/j.resinv.2024.05.008","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.05.008","url":null,"abstract":"<div><h3>Background</h3><p>Although lung transplantation (LTx) is the last resort for patients with end-stage lymphangioleiomyomatosis (LAM), the high waitlist mortality is a source of concern in Japan. Discontinuation of mechanistic target of rapamycin (mTOR) inhibitors prior to LTx is recommended due to the incidence of severe adverse events. Therefore, we hypothesized that mTOR inhibitors may affect the mortality of patients with LAM on the LTx waitlist.</p></div><div><h3>Methods</h3><p>We retrospectively compared the characteristics of consecutive patients with LAM on the LTx waitlist who were and were not receiving mTOR inhibitors.</p></div><div><h3>Results</h3><p>Twenty-nine consecutive patients with LAM who listed our center between January 2004 and December 2021 were selected from the database and enrolled in the present study. Seventeen patients (58.6%) were receiving a mTOR inhibitor, sirolimus (treatment group). During a median listing period of 1277 days, 12 patients (41.4%) were hospitalized, six patients (20.7%) died from disease before LTx, and 15 patients underwent LTx. Among the deceased patients, four patients (66.6%) had pneumothoraces. The waitlist mortality in the treatment group was significantly lower than that in the non-treatment group (p = 0.03). Among the six patients who discontinued sirolimus in the treatment group, four patients (66.6%) were hospitalized with respiratory complications after the discontinuation of sirolimus. No mTOR inhibitor-related complications arose in the treatment group undergoing LTx (n = 7), including those on a reduced sirolimus dose.</p></div><div><h3>Conclusions</h3><p>Administration of an mTOR inhibitor until LTx may decrease waitlist mortality. Due to life-threatening events after discontinuing sirolimus pre-LTx, a reduced dose until LTx is permissible.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 4","pages":"Pages 657-662"},"PeriodicalIF":3.1,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140951285","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":"Phase angle as an indicator of sarcopenia and malnutrition in patients with chronic obstructive pulmonary disease","authors":"Tomoyuki Murakami ,&nbsp;Takeshi Kobayashi ,&nbsp;Hiroto Ono ,&nbsp;Hayato Shibuma ,&nbsp;Kazuhiro Tsuji ,&nbsp;Etsuhiro Nikkuni ,&nbsp;Naoki Mori ,&nbsp;Shinya Ohkouchi ,&nbsp;Masao Tabata ,&nbsp;Toshiya Irokawa ,&nbsp;Hiromasa Ogawa ,&nbsp;Tsuneyuki Takahashi ,&nbsp;Hajime Kurosawa","doi":"10.1016/j.resinv.2024.05.012","DOIUrl":"https://doi.org/10.1016/j.resinv.2024.05.012","url":null,"abstract":"<div><h3>Background</h3><p>Phase angle (PhA), which is measured using bioelectrical impedance analysis, is an indicator of muscle quality and malnutrition. PhA has been shown to be correlated with sarcopenia and malnutrition; however, studies on patients with chronic obstructive pulmonary disease (COPD) are limited. In this study, we investigated the correlation between PhA and sarcopenia and malnutrition and determined the cutoff values of PhA for those in patients with COPD.</p></div><div><h3>Methods</h3><p>This study included 105 male patients with COPD (mean age 75.7 ± 7.7 years, mean forced expiratory volume in 1s % predicted [%FEV₁] 57.0 ± 20.1%) and 12 male controls (mean age 74.1 ± 3.8 years) who were outpatients between December 2019 and March 2024. PhA was measured using the InBody S10, and its correlation with sarcopenia and malnutrition was assessed. The cutoff PhA values for sarcopenia and malnutrition were determined using receiver operating characteristic curves.</p></div><div><h3>Results</h3><p>The prevalence rates of sarcopenia and malnutrition were 31% and 22%, respectively, in patients with COPD. PhA significantly correlated with sarcopenia- and malnutrition-related indicators. Multivariate logistic regression analysis independently correlated PhA with sarcopenia and malnutrition. The cutoff values of the PhA for sarcopenia and malnutrition were 4.75° (AUC = 0.78, 95% CI = 0.68–0.88) and 4.25° (AUC = 0.75, 95% CI = 0.63–0.86), respectively.</p></div><div><h3>Conclusions</h3><p>PhA was significantly correlated with sarcopenia and malnutrition in Japanese patients with COPD and may be a useful diagnostic indicator.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 4","pages":"Pages 651-656"},"PeriodicalIF":3.1,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140951286","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":"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":"62 4","pages":"Pages 645-650"},"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":"62 4","pages":"Pages 640-644"},"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":"62 4","pages":"Pages 638-639"},"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":"62 4","pages":"Pages 631-637"},"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}