Respiratory investigation最新文献

{"title":"The JRS guideline for the management of pneumonia in adults 2024","authors":"Hiroshi Mukae ,&nbsp;Naoki Iwanaga ,&nbsp;Nobuyuki Horita ,&nbsp;Kosaku Komiya ,&nbsp;Takaya Maruyama ,&nbsp;Yuichiro Shindo ,&nbsp;Yoshifumi Imamura ,&nbsp;Kazuhiro Yatera ,&nbsp;Yoshihiro Yamamoto ,&nbsp;Katsunori Yanagihara ,&nbsp;Nobuaki Shime ,&nbsp;Kazuyoshi Senda ,&nbsp;Hiroshi Takahashi ,&nbsp;Futoshi Higa ,&nbsp;Tetsuya Matsumoto ,&nbsp;Makoto Miki ,&nbsp;Shinji Teramoto ,&nbsp;Hiroki Tsukada ,&nbsp;Masahiro Yoshida ,&nbsp;Naoyuki Miyashita","doi":"10.1016/j.resinv.2025.06.014","DOIUrl":"10.1016/j.resinv.2025.06.014","url":null,"abstract":"<div><div>The Japanese Respiratory Society published the Adult Pneumonia Practice Guidelines 2024 in April 2024. In Japan, a super-aged society, the disease burden of pneumonia is significant and is expected to grow in the future. Given this historical context, the most important themes in this revision of the guidelines include the appropriate use of antibiotics and measures against pneumonia in older adults. A large portion of these cases involves aspiration pneumonia, making it challenging to achieve fundamental improvement with antibiotic treatment alone and necessitating a comprehensive approach. Preventing pneumonia and maintaining physical function are essential points for improving the prognosis of pneumonia in older adults, with an emphasis on promoting vaccination, rehabilitation, and oral care.</div><div>The treatment of Nursing and Healthcare-Associated Pneumonia (NHCAP), a Japan-specific category adapted from the ATS/IDSA's HCAP guidelines, has been extensively reviewed. Despite international moves away from HCAP due to concerns about the overuse of broad-spectrum antibiotics, Japan has chosen to retain NHCAP for treating pneumonia in older adults while implementing stricter controls on antibiotic use to promote antimicrobial stewardship.</div><div>In cases of repeated aspiration pneumonia or in situations where the patient is in a terminal state of age-related decline or the final stage of comorbidities, all pneumonia patients are recommended to undergo a background assessment, occasionally prioritizing palliative care and respecting the patient's outlook on life. The importance of advanced care planning has also been highlighted to underscore the need for interdisciplinary collaboration with medical doctors and other healthcare professionals.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 811-828"},"PeriodicalIF":2.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536188","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 endobronchial spigot for the management of postoperative fistula, refractory pneumothorax, and hemoptysis: A single-center retrospective study","authors":"Miwa Kamatani,&nbsp;Nobuyasu Awano,&nbsp;Minoru Inomata,&nbsp;Keita Sakamoto,&nbsp;Haruka Fujioka,&nbsp;Takehiro Izumo","doi":"10.1016/j.resinv.2025.06.016","DOIUrl":"10.1016/j.resinv.2025.06.016","url":null,"abstract":"<div><h3>Background</h3><div>Bronchopleural fistula, refractory pneumothorax, and massive hemoptysis pose significant clinical challenges. Endobronchial spigot offers a less invasive alternative to surgical interventions for the management of these conditions. This study aimed to evaluate the efficacy and safety of endobronchial spigot in patients with bronchopleural fistula, refractory pneumothorax, and hemoptysis in whom interventional radiology or surgical intervention was not feasible.</div></div><div><h3>Methods</h3><div>Endobronchial spigot procedures performed at the Japanese Red Cross Medical Center between December 2017 and January 2024 were retrospectively analyzed. Patient demographics, procedural details, methods of target bronchus identification, additional treatments, clinical outcomes, and complications were included in the analysis.</div></div><div><h3>Results</h3><div>A total of 27 procedures were performed in 20 patients, including 16 patients with intractable pneumothorax, 2 with postoperative fistula, and 2 with hemoptysis. The responsible bronchi were identified using balloon occlusion, endobronchial injection of a contrast medium under fluoroscopic guidance, and intrathoracic injection of indigo carmine via thoracic tubes. Of the 20 patients, 15 (75 %) achieved clinical improvements: postoperative fistula 1/2 (50 %), refractory pneumothorax 12/16 (75 %), and hemoptysis 2/2 (100 %). Procedure-related complications, such as endobronchial spigot migration (3 patients) and mediastinal and intra-abdominal emphysema (1 patient), were resolved with conservative managements.</div></div><div><h3>Conclusions</h3><div>Endobronchial spigot might be a valuable therapeutic option for treating intractable pneumothorax, postoperative fistula, and hemoptysis.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 805-810"},"PeriodicalIF":2.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522765","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":"Expanding the radiological spectrum of Lymphangioleiomyomatosis: A case with Unique imaging findings","authors":"Hinako Kori ,&nbsp;Kazunori Tobino","doi":"10.1016/j.resinv.2025.06.015","DOIUrl":"10.1016/j.resinv.2025.06.015","url":null,"abstract":"<div><div>Lymphangioleiomyomatosis (LAM) is a rare cystic lung disease linked to tuberous sclerosis (TSC) gene mutations and female sex restriction. Pulmonary cysts on high-resolution computed tomography (HRCT) are its hallmark. We report an unusual LAM case with minimal cystic changes, diffuse ground-glass opacities, and randomly distributed nodules. Diagnosis was confirmed by histopathology and elevated serum VEGF-D levels. The patient responded well to sirolimus, later discontinuing it, completing pregnancy without exacerbation, and safely resuming therapy postpartum. This case underscores the diagnostic challenges of atypical LAM and highlights the importance of early diagnosis and individualized management in women of childbearing age.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 800-804"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517385","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 outcomes, safety, and potential prognostic factors of noninvasive respiratory support in patients with COVID-19: A Japanese multicenter observational study","authors":"Jiro Ito ,&nbsp;Toshiki Yokoyama ,&nbsp;Aiko Tanaka ,&nbsp;Ryutaro Seo ,&nbsp;Keisuke Tomii ,&nbsp;Clara So ,&nbsp;Shinyu Izumi ,&nbsp;Yutaka Kozu ,&nbsp;Kazuo Chin ,&nbsp;Yasuhiro Gon ,&nbsp;Naoki Nishimura ,&nbsp;Hajime Sasano ,&nbsp;Kazuko Yamamoto ,&nbsp;Yuichiro Takeshita ,&nbsp;Eriko Hamada ,&nbsp;Motoo Yamauchi ,&nbsp;Tetsuhisa Kitamura ,&nbsp;Yuji Fujino ,&nbsp;Yasuhiro Kondoh","doi":"10.1016/j.resinv.2025.06.013","DOIUrl":"10.1016/j.resinv.2025.06.013","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to explore the clinical practice of noninvasive respiratory support (NIRS) in COVID-19 patients, and assess its clinical outcomes, safety, and prognostic factors.</div></div><div><h3>Methods</h3><div>A multicenter, retrospective observational study was conducted with consecutive adult COVID-19 patients who underwent NIRS at nine Japanese hospitals between January 1 and September 30, 2021. NIRS modalities included high-flow nasal cannula oxygen therapy (HFNC), noninvasive ventilation (NIV), and continuous positive airway pressure (CPAP). NIRS failure, defined as intubation or in-hospital death, intubation rate, in-hospital mortality, and the incidence of SARS-CoV-2 infection in health care workers (HCWs) were evaluated. The respiratory rate-oxygenation (ROX) index was examined as a predictor of NIRS failure.</div></div><div><h3>Results</h3><div>We included 694 patients with a median age of 61 years, of whom 516 (74.4 %) were men. HFNC was the first-line respiratory support for 622 (89.6 %) patients, followed by CPAP in 54 (7.8 %) and NIV in 18 (2.6 %). The NIRS failure rate was 41.5 %, with an intubation rate of 32.0 % and in-hospital mortality of 18.4 %. The ROX index at baseline and 1 and 24 h after NIRS initiation were independent predictors of NIRS failure (odds ratio [95 % CI] 0.89 [0.85–0.94], p &lt; 0.001; 0.84 [0.78–0.89], p &lt; 0.001; 0.84 [0.78–0.90], p &lt; 0.001, respectively). Nine possible NIRS-related HCW infections were reported.</div></div><div><h3>Conclusion</h3><div>The majority of COVID-19 patients in this study were treated with HFNC, with a NIRS failure rate of about 40 %. The ROX index within 24 h effectively predicted NIRS failure. HCW infections were infrequent, indicating the relative safety of NIRS.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 794-799"},"PeriodicalIF":2.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517386","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":"Long-term safety and effectiveness of dupilumab in patients with severe asthma: data from post-marketing surveillance in Japan","authors":"Makoto Nagata ,&nbsp;Ryo Yamaguchi ,&nbsp;Makiko Usami ,&nbsp;Mami Orimo ,&nbsp;Masato Ishida","doi":"10.1016/j.resinv.2025.05.015","DOIUrl":"10.1016/j.resinv.2025.05.015","url":null,"abstract":"<div><h3>Background</h3><div>In Japan, dupilumab, an anti-interleukin-4Rα monoclonal antibody, is approved and recommended as add-on therapy for patients with moderate-to-severe asthma uncontrolled with conventional therapies. This post-marketing surveillance (PMS) aimed to evaluate the long-term safety and clinical effectiveness of dupilumab in Japanese patients with moderate-to-severe asthma.</div></div><div><h3>Methods</h3><div>Patients who initiated dupilumab for moderate-to-severe asthma between June 2019 and July 2021 were included. Safety and effectiveness outcomes were monitored for 1 year following dupilumab initiation or until treatment discontinuation. Safety was assessed by evaluating the incidence and severity of adverse drug reactions (ADRs). Effectiveness was assessed through the incidence and frequency of severe asthma exacerbations.</div></div><div><h3>Results</h3><div>Overall, 390 patients were registered from 129 clinical sites in Japan. In the safety analysis population (N = 376), ADRs were reported in 37 patients (9.8 %), including five (1.3 %) with serious ADRs. When stratified by baseline age, ADRs were reported in 22 patients aged &lt;65 years (10.7 %) and in 15 patients aged ≥65 years (8.8 %). In the effectiveness analysis population (n = 373), the frequency of severe asthma exacerbations in the year following dupilumab initiation was significantly lower than the year before treatment (least squares mean [95 % confidence interval] 0.25 [0.20–0.31] vs 1.48 [1.26–1.73] events/year; incidence rate ratio 0.17 [0.14–0.20]; <em>P&lt;</em>0.001). Subgroup analyses found that safety and effectiveness outcomes were similar between patients aged &lt;65 and ≥65 years at baseline.</div></div><div><h3>Conclusion</h3><div>Consistent with previous clinical trials and real-world studies, this PMS confirmed the long-term safety and effectiveness of dupilumab for patients with moderate-to-severe asthma in Japan.</div></div><div><h3>Clinical trial registration number</h3><div>UMIN Clinical Trials Registry (UMIN000036992)</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 787-793"},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491728","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":"Exploration of plasma factor profiles involved in tumor growth factors in non-small cell carcinoma patients with interstitial pneumonia","authors":"Goushi Matama ,&nbsp;Koichi Azuma ,&nbsp;Akimasa Sekine ,&nbsp;Norikazu Matsuo ,&nbsp;Koji Okudela ,&nbsp;Kenta Murotani ,&nbsp;Akihiko Kawahara ,&nbsp;Masaki Tominaga ,&nbsp;Yoshiaki Zaizen ,&nbsp;Daiki Murata ,&nbsp;Tetsuro Sasada ,&nbsp;Takashi Ogura","doi":"10.1016/j.resinv.2025.06.012","DOIUrl":"10.1016/j.resinv.2025.06.012","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial pneumonia (IP) is a known complication of lung cancer (LC), but the mechanisms that trigger development of LC are not fully understood. In this study, we aimed to identify factors that promote development of LC in patients with IP by comprehensively measuring levels of inflammatory cytokines and chemokines in stored plasma samples from patients who were diagnosed with IP and who developed LC during follow-up.</div></div><div><h3>Methods</h3><div>We used a bead-based multiplex assay to comprehensively measure the levels of 87 soluble immune mediators in plasma stored at the time of IP diagnosis in the groups of patients with IP that did (LC-IP, n = 25) and did not (IP, n = 45) develop LC, and used a logistic regression analysis to examine the correlation between plasma factors and LC development. The LC-IP group included 25 patients, who were matched with patients with IP without LC for several factors to increase comparability as much as possible.</div></div><div><h3>Results</h3><div>In IP patients, the following soluble immune mediators were significantly associated with LC development: GM-CSF, IL-4, IL-1ra, PDGF-BB, IFN-a2, MMP1, CXCL1, TGF-β2, CXCL16, CCL11, IL-2, CCL2, IFN-γ, and IL-16. Meanwhile, PDGF-BB, CXCL2, and TGF-β1 were identified as being associated with LC development in patients with idiopathic pulmonary fibrosis (IPF).</div></div><div><h3>Conclusion</h3><div>PDGF-BB, CXCL2, and TGF-β1 may be factors in the development of LC in patients with IPF. Further elucidation of the mechanism and prospective follow-up of patients with IPF are needed for validation of these findings.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 780-786"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471699","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":"Association between nonrestorative sleep status and sleep apnea syndrome: A cross-sectional and longitudinal study using health check-up and health insurance claims data in Japan","authors":"Naomi Takahashi ,&nbsp;Yoshimitsu Takahashi ,&nbsp;Kimihiko Murase ,&nbsp;Kazuma Nagata ,&nbsp;Yuka Nakatani ,&nbsp;Satoshi Hamada ,&nbsp;Hironobu Sunadome ,&nbsp;Jumpei Togawa ,&nbsp;Toyohiro Hirai ,&nbsp;Kazuo Chin ,&nbsp;Takeo Nakayama ,&nbsp;Susumu Sato","doi":"10.1016/j.resinv.2025.06.010","DOIUrl":"10.1016/j.resinv.2025.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Nonrestorative sleep (NRS) refers to the subjective experience of feeling unrefreshed upon awakening that is not attributed to lack of sleep; NRS is also observed in patients with sleep apnea syndrome (SAS). We investigated the prevalence of NRS among health check-up participants using a single item and further investigated the relationship between NRS status and newly diagnosed SAS using health insurance claims data.</div></div><div><h3>Methods</h3><div>We extracted data associated with 93215 participants who underwent health check-ups in 2014 and answered a sleep-related question from a health insurance claims and health check-up database. Patients with SAS were identified via confirmation of the diagnosis and their use of continuous positive airway pressure (CPAP) therapy. Participants without a diagnosis of SAS were followed up for up to 6 years. A Cox proportional hazard model was used to determine whether NRS status was significantly associated with SAS.</div></div><div><h3>Results</h3><div>The mean age of the participants was 52.3 ± 16.7 years (men: 58.4 %, women: 41.6 %); 32.0 % had NRS status, and 0.8 % had SAS. During the 6-year observation period, among 92050 people, 2.2 % of the patients in the NRS group and 1.3 % of the patients in the non-NRS group were newly diagnosed with SAS. Even after adjusting for other factors, NRS status was a significant risk factor for newly diagnosed SAS (hazard ratio: 1.62, 95 % CI: 1.46–1.81).</div></div><div><h3>Conclusions</h3><div>NRS status was a significant risk factor for newly diagnosed SAS. NRS status might be useful as a health check-up screening tool for undiagnosed or subclinical SAS.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 771-779"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471705","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":"Prognosis and prognostic factors for chronic fibrosing idiopathic interstitial pneumonias","authors":"Hirotaka Nishikiori,&nbsp;Hirofumi Chiba","doi":"10.1016/j.resinv.2025.06.005","DOIUrl":"10.1016/j.resinv.2025.06.005","url":null,"abstract":"<div><div>Progressive lung fibrosis is frequently observed in patients with idiopathic interstitial pneumonias (IIPs), especially in those with idiopathic pulmonary fibrosis (IPF) being a representative form of IIPs characterized by a poor prognosis, even in the era of antifibrotic therapy. Predicting prognosis is essential for informing patients and determining future treatment strategies. Multiple prognostic factors have been reported for these diseases. The international clinical practice guidelines for IPF were repeatedly revised in 2010, 2018, and 2022, and the multidisciplinary classification of IIPs was updated in 2013. These updates have led to changes in how patients are classified under various IIP subtypes. Recent advances in the areas of genetic polymorphisms, radiological image analysis, and deep learning technology have helped identify multiple prognosis predictive factors for IPF and other forms of IIPs. This review provides an updated summary of the prognosis and prognostic predictors of IPF and other chronic fibrotic IIPs, incorporating recent reports published since antifibrotic therapy became the standard treatment for IPF and other forms of progressive pulmonary fibrosis, and covers other latest advancements and technologies as well.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 762-770"},"PeriodicalIF":2.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365563","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":"Benefit of antifibrotic therapy initiated during acute exacerbation of interstitial lung disease: A systematic review","authors":"Narat Srivali ,&nbsp;Federica De Giacomi","doi":"10.1016/j.resinv.2025.06.011","DOIUrl":"10.1016/j.resinv.2025.06.011","url":null,"abstract":"<div><h3>Background</h3><div>Acute exacerbations of interstitial lung disease (AE-ILD) are associated with significant morbidity and mortality. While corticosteroids are commonly used in the treatment, their optimal dose, duration, and overall benefit remain unclear. This systematic review evaluates the efficacy of antifibrotic medications (nintedanib and pirfenidone) when initiated during or immediately after AE-ILD.</div></div><div><h3>Methods</h3><div>We conducted a systematic search across MEDLINE, EMBASE, and Cochrane databases through January 2025. Studies comparing antifibrotic medications to standard care in AE-ILD were included. Primary outcomes were survival rates, hospitalization duration, and AE-ILD recurrence. Quality assessment was performed using the Newcastle-Ottawa Scale.</div></div><div><h3>Results</h3><div>Four observational studies from Japan comprising 6321 patients met the inclusion criteria. Nintedanib was associated with significantly reduced in-hospital mortality (7.1 % vs. 15.1 %, p &lt; 0.001) and shorter hospitalization duration (30.7 ± 13.7 vs. 37.5 ± 19.0 days, p &lt; 0.001) in one large study (n = 6235). A second nintedanib study demonstrated lower 90-day mortality (36.36 % vs. 54.55 %, p = 0.048) and delayed time to subsequent exacerbations. Two smaller studies evaluating pirfenidone showed trends toward improved 90-day survival that did not reach statistical significance (64.3 % vs. 52.9 %, p = 0.72; 44 % vs. 34 %, p = 0.391). Reported adverse events were consistent with known safety profiles of these medications.</div></div><div><h3>Conclusion</h3><div>Current evidence suggests nintedanib may reduce mortality and hospitalization duration in AE-ILD, while pirfenidone's benefits remain inconclusive. These findings are limited by the observational nature of the studies, variability in AE-ILD definitions, and limited geographical representation. Well-designed randomized controlled trials are needed to confirm these preliminary findings and establish optimal treatment protocols for AE-ILD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 755-761"},"PeriodicalIF":2.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365562","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":"Risk factors for the onset of pneumothorax in idiopathic pulmonary fibrosis","authors":"Ryoju Sato,&nbsp;Machiko Arita,&nbsp;Hiroshi Takahashi,&nbsp;Akihiko Amano,&nbsp;Ayaka Tanaka,&nbsp;Masamitsu Hamakawa,&nbsp;Tadashi Ishida","doi":"10.1016/j.resinv.2025.06.007","DOIUrl":"10.1016/j.resinv.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Pneumothorax is a serious complication in patients with idiopathic pulmonary fibrosis (IPF). This study aimed to clarify the clinical course of and risk factors for pneumothorax in patients with IPF.</div></div><div><h3>Methods</h3><div>This was a retrospective, cohort study of 164 patients with IPF diagnosed based on relevant guideline criteria. The clinical course of patients with pneumothorax was summarized, and risk factors for pneumothorax were assessed using Fine-Gray proportional hazards model analysis with time-dependent covariates.</div></div><div><h3>Results</h3><div>Of the 164 patients, 30 (18.3 %) developed pneumothorax. Of the 30 patients with pneumothorax, 4 (13.3 %) died in hospital, and the median duration of chest tube insertion was 11 (6–17.5) days. Low body mass index (BMI) and upper lobe pleuroparenchymal thickening on high-resolution computed tomography (HRCT) were significantly associated with pneumothorax onset (hazard ratio [HR] = 0.85 and 2.55; 95 % confidence interval [CI]: 0.73–0.98 and 1.14–5.73; <em>P</em> = 0.031 and 0.023, respectively). In patients who had repeat pulmonary function tests 6–18 months after diagnosis, annual reduction rates of forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO) were significantly associated with pneumothorax onset (HR = 0.97 and 0.97; 95 % CI: 0.93–1.00 and 0.94–0.99; <em>P</em> = 0.034 and 0.013, respectively).</div></div><div><h3>Conclusion</h3><div>Pneumothorax is a serious event having a poor prognosis and requiring long-term treatment in patients with IPF. Low BMI, upper lobe pleuroparenchymal thickening on HRCT, annual FVC reduction rates, and annual DLCO reduction rates are associated with the onset of pneumothorax in patients with IPF.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 5","pages":"Pages 744-748"},"PeriodicalIF":2.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321798","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}