Respiratory investigation最新文献

{"title":"Reassessment of the relevance between microbiological macrolide-induced resistance and diagnosis and treatment outcome of Mycobacterium abscessus-related pulmonary disease","authors":"Shiomi Yoshida ,&nbsp;Kazunari Tsuyuguchi ,&nbsp;Takehiko Kobayashi ,&nbsp;Yu Kurahara ,&nbsp;Yasuaki Shimatani ,&nbsp;Toru Arai","doi":"10.1016/j.resinv.2024.09.012","DOIUrl":"10.1016/j.resinv.2024.09.012","url":null,"abstract":"<div><h3>Background</h3><div>Treatment outcomes for <em>Mycobacterium abscessus</em> species–related pulmonary disease (MABS-PD) are generally poor because of inducible clarithromycin resistance (IR). The clinical management of patients with MABS with different genotypic and phenotypic susceptibility results is also not definitive. Here, we aimed to reassess the characteristics of patients with variant MABS and their association with diagnosis, treatment intervention, and sputum culture conversion.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 119 patients with MABS infection. Clinical characteristics and medical history were obtained via medical chart review. Isolates were tested for clarithromycin susceptibility and classified into <em>erm</em>(41) sequevars.</div></div><div><h3>Results</h3><div>In the IR, non-IR, and acquired resistance groups, the sputum culture conversion rates were 22% (5/23), 80% (40/50), and 8% (1/12), respectively. In contrast, in MAB, MAB T28, MAB C28, and <em>M. abscessus</em> subsp. <em>massiliense</em> (MAM), sputum culture conversion rates were 33% (12/36), 29% (22/31), 60% (3/5), and 70.8% (34/48), respectively. The proportion of patients with non-IR MAB T28 diagnosed and treated for MABS-PD was lower than those of patients with IR or acquired resistant T28 [35.7% (5/14), 80.7% (21/26), 100% (5/5); <em>P</em> &lt; 0.05], whereas the sputum culture conversion rate was high in patients with non-IR MAB T28 [80.0%(4/5), 23.8%(5/21), 0%(0/5); <em>P</em> &lt; 0.01)]. The sputum culture conversion rate in treated patients with MABS-PD with IR MAB C28 or acquired resistant MAM was low [0.0% (0/1) and 14.3% (1/7)].</div></div><div><h3>Conclusions</h3><div>Patients with MABS-PD and non-IR were likely to have sputum culture conversion. Our results indicated that phenotypical properties were associated with MABS-PD diagnosis and treatment.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1142-1148"},"PeriodicalIF":2.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378218","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":"Combined use of serum ferritin and KL-6 levels as biomarkers for predicting COVID-19 severity","authors":"Hiromu Tanaka ,&nbsp;Erika Toya ,&nbsp;Shotaro Chubachi ,&nbsp;Ho Namkoong ,&nbsp;Takanori Asakura ,&nbsp;Shuhei Azekawa ,&nbsp;Shiro Otake ,&nbsp;Kensuke Nakagawara ,&nbsp;Takahiro Fukushima ,&nbsp;Mayuko Watase ,&nbsp;Kaori Sakurai ,&nbsp;Katsunori Masaki ,&nbsp;Hirofumi Kamata ,&nbsp;Makoto Ishii ,&nbsp;Naoki Hasegawa ,&nbsp;Yukinori Okada ,&nbsp;Ryuji Koike ,&nbsp;Yuko Kitagawa ,&nbsp;Akinori Kimura ,&nbsp;Seiya Imoto ,&nbsp;Koichi Fukunaga","doi":"10.1016/j.resinv.2024.09.011","DOIUrl":"10.1016/j.resinv.2024.09.011","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the value of serum ferritin and Krebs von den Lungen-6 (KL-6) levels for predicting severe COVID-19 (death or requirement for invasive mechanical ventilation [IMV]/high-flow oxygen).</div></div><div><h3>Methods</h3><div>Data were analyzed on 2495 patients with COVID-19 from February 2020 to November 2022 using data from a nationwide COVID-19 database.</div></div><div><h3>Results</h3><div>Patients with high KL-6 and low ferritin levels were older with more comorbidities and higher mortality rates, whereas those with high ferritin and low KL-6 levels were younger, predominantly male, and more likely to need IMV. A high level of both markers was strongly associated with critical outcomes (adjusted odds ratio: 13.6, 95% confidence interval: 8.58–21.5). The combination of both markers had higher predictive value than either marker alone (area under the curve: 0.709, 0.745, and 0.781 for KL-6, ferritin, and KL-6 + ferritin, respectively).</div></div><div><h3>Conclusions</h3><div>The combination of both markers accurately predicted COVID-19 severity.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1132-1136"},"PeriodicalIF":2.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375883","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":"Comparison of efficacy of gefitinib and osimertinib for untreated EGFR mutation-positive non-small-cell lung cancer in patients with poor performance status","authors":"Kazuhisa Nakashima ,&nbsp;Hiroaki Kodama ,&nbsp;Haruyasu Murakami ,&nbsp;Toshiaki Takahashi ,&nbsp;Keita Kawakado ,&nbsp;Takashi Yanagawa ,&nbsp;Kashu Kitani ,&nbsp;Takamasa Hottta ,&nbsp;Masaaki Abe ,&nbsp;Kosuke Hamai ,&nbsp;Takuya Tanimoto ,&nbsp;Nobuhisa Ishikawa ,&nbsp;Tomoki Tamura ,&nbsp;Shoichi Kuyama ,&nbsp;Takeshi Isobe ,&nbsp;Yukari Tsubata","doi":"10.1016/j.resinv.2024.09.010","DOIUrl":"10.1016/j.resinv.2024.09.010","url":null,"abstract":"<div><h3>Background</h3><div>There is a dearth of studies on the efficacy and safety of the tyrosine kinase inhibitors osimertinib (OSI) and gefitinib (GEF) in treating epidermal growth factor receptor (<em>EGFR</em>) mutation-positive non-small cell lung cancer (NSCLC), even in patients with poor performance status (PS).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed and compared data of 113 patients with <em>EGFR</em> mutation-positive NSCLC with Eastern Cooperative Oncology Group PS 2–4 who were administered OSI 80 mg/day or GEF 250 mg/day from May 2016 to March 2022.</div></div><div><h3>Results</h3><div>The GEF group (39 patients; median age: 74 years) included 20 patients with a PS of 2, 17 with a PS of 3, and 2 with a PS of 4. The OSI group (74 patients; median age: 76 years) included 48 patients with a PS of 2, 24 with a PS of 3, and 2 with a PS of 4. The overall response rates were 69% and 66% in the GEF and OSI groups, respectively. The disease control and PS improvement rates were 89% and 51% in both groups, respectively. The median progression-free survival in the GEF and OSI groups was 6.9 and 9.2 months, respectively (p = 0.15). The OSI group experienced better overall survival than the GEF group (median: 20.9 vs. 13.0 months, p = 0.0031). The incidence of pneumonitis was 10% and 11% in the GEF and OSI groups, respectively. One treatment-related death owing to pneumonitis occurred in the GEF group.</div></div><div><h3>Conclusions</h3><div>OSI may be a useful treatment for untreated <em>EGFR</em> mutation-positive NSCLC with poor PS.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1137-1141"},"PeriodicalIF":2.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375884","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":"Prevalence and characteristics of minimal pleural fluid on screening chest MRI","authors":"Kensuke Fukuda ,&nbsp;Hirotaka Matsuzaki ,&nbsp;Takuya Kawahara ,&nbsp;Toshihiro Yamaguchi ,&nbsp;Akira Saito ,&nbsp;Nobutake Yamamichi ,&nbsp;Hidenori Kage ,&nbsp;Takeharu Yoshikawa","doi":"10.1016/j.resinv.2024.09.014","DOIUrl":"10.1016/j.resinv.2024.09.014","url":null,"abstract":"<div><h3>Background</h3><div>Minimal pleural fluid is often seen incidentally on chest MRI. However, its prevalence and clinical characteristics remain unknown.</div></div><div><h3>Methods</h3><div>This retrospective observational study included 2726 participants who underwent comprehensive medical check-ups for screening, including chest CT and MRI, and transthoracic echocardiography between March 2018 and February 2019. Pleural fluid on MRI was manually measured for maximum thickness. Its distribution, change over time, and relevance to participant characteristics were analyzed. The pulmonary function data of 82 participants and their associations with fluid were also analyzed.</div></div><div><h3>Results</h3><div>Of the 2726 participants (mean age ± standard deviation, 59 ± 11 years), 2009 (73.7%) had minimal pleural fluid (thickness, 1–9 mm) on either side, with right-sided fluid being more frequent than left-sided fluid (<em>P</em> &lt; 0.001). Negligible changes in fluid thickness were observed one year later. The following parameters were associated with less fluid: age, ≥65 years (<em>P</em> &lt; 0.001); male sex (<em>P</em> = 0.006); current smoking (<em>P</em> &lt; 0.001); body mass index, ≥25 kg/m² (<em>P</em> &lt; 0.001); and mean arterial pressure, ≥100 mmHg (<em>P</em> = 0.01), whereas a ratio between early mitral inflow velocity and mitral annular early diastolic velocity&gt;14 was associated with more fluid (<em>P</em> = 0.01). The presence of fluid was an independent explanatory variable for a higher percentage of predicted vital capacity (<em>P</em> = 0.048).</div></div><div><h3>Conclusions</h3><div>MRI was highly sensitive in detecting minimal pleural fluid. Pleural fluid found on MRI for health screening was assumed to be physiological and fluid thickness at the steady state might be variable among participants depending on age, sex, smoking habits, body shape, blood pressure, and cardiac diastolic capacity.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1109-1116"},"PeriodicalIF":2.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372709","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":"Factors associated with non-intervention of antifibrotic agents in IPF patients","authors":"Maki Asami-Noyama ,&nbsp;Kazuki Hamada ,&nbsp;Yoshiyuki Asai ,&nbsp;Takeshi Abe ,&nbsp;Kosei Yonezawa ,&nbsp;Michiya Watanabe ,&nbsp;Yukari Hisamoto ,&nbsp;Keita Murakawa ,&nbsp;Ayumi Fukatsu ,&nbsp;Kazuki Matsuda ,&nbsp;Shuichiro Ohata ,&nbsp;Ryo Suetake ,&nbsp;Yoriyuki Murata ,&nbsp;Yoshikazu Yamaji ,&nbsp;Keiji Oishi ,&nbsp;Nobutaka Edakuni ,&nbsp;Tsunahiko Hirano ,&nbsp;Tomoyuki Kakugawa ,&nbsp;Kazuto Matsunaga","doi":"10.1016/j.resinv.2024.09.008","DOIUrl":"10.1016/j.resinv.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of antifibrotic agents in idiopathic pulmonary fibrosis (IPF) has been demonstrated and early introduction is recommended, especially in patients with preserved performance status (PS). We aimed to determine the proportion of untreated IPF cases using real-world data and to assess the factors associated with non-intervention.</div></div><div><h3>Methods</h3><div>A prospective observational study using questionnaires was performed on 518 patients with interstitial lung disease (ILD) and their attending physicians who visited a clinic, general hospital, or tertiary respiratory center between December 2019 and October 2020. Patients responded with subjective symptoms and PS, whereas physicians responded with diagnosis, treatment, and reasons for their treatment choices. Principal component analysis (PCA) was performed using age, sex, BMI, medical facility, specialized tests, and symptom severity.</div></div><div><h3>Results</h3><div>We included 207 patients with IPF. Among them, 168 has a good PS (≤2), which could be indicative of treatment; 130 (77.4%) were not treated with antifibrotic agents. The PCA revealed a trend consistent with that of antifibrotic agent therapy and the distribution of medical facilities, with a treatment intervention rate of 16% in general hospitals and 62% in tertiary respiratory centers. In general hospitals, low symptom severity (PS, mMRC, and no use of long-term oxygen therapy) was a relevant factor for non-intervention with antifibrotic agents (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Antifibrotic treatment interventions varied by facility in cases with good PS. Patients with milder symptoms are not being treated early in general hospitals and more collaboration between general hospitals and specialized facilities is necessary.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1124-1131"},"PeriodicalIF":2.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372725","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":"Feasibility of a problem-solving exercise program based on short physical performance battery for older patients with chronic respiratory diseases: A multicenter, pilot clinical trial","authors":"Masatoshi Hanada ,&nbsp;Tadayoshi Nonoyama ,&nbsp;Tomoyuki Ikeuchi ,&nbsp;Koki Sasaki ,&nbsp;Kazuaki Suyama ,&nbsp;Masaki Nakashita ,&nbsp;Ryota Shiroishi ,&nbsp;Ryosuke Segawa ,&nbsp;Kengo Tanaka ,&nbsp;Hideki Aoki ,&nbsp;Chika Kitagawa ,&nbsp;Yuichi Hori ,&nbsp;Shuhei Hashimoto ,&nbsp;Toshiro Matsuzaki ,&nbsp;Shuntaro Sato ,&nbsp;Shinichi Arizono ,&nbsp;Takako Tanaka ,&nbsp;Ryo Kozu","doi":"10.1016/j.resinv.2024.09.016","DOIUrl":"10.1016/j.resinv.2024.09.016","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to assess the feasibility and safety of a problem-solving exercise program based on the items in the short physical performance battery (SPPB) for older patients with chronic respiratory diseases (CRDs) to inform future randomized controlled trials.</div></div><div><h3>Methods</h3><div>This was a multicenter, prospective, non-randomized feasibility study. Participants with CRD received an enhancement program based on the SPPB decline items (balance, walk, and/or chair stand) for 4 weeks. The feasibility, safety, and efficacy of the problem-solving exercise program in improving the SPPB score, physical function, and step count (measured using a pedometer) were assessed.</div></div><div><h3>Results</h3><div>Overall, 36 patients were enrolled in this study, and adherence to the exercise program was high (100%). No exercise program-related adverse events were observed. The implementation of the exercise program ranged from 70 to 100%. The mean daily step count increased from 2152 ± 1498 steps during the first week to 2899 ± 1865 steps in the last week (p&lt;0.01). Additionally, the SPPB total score increased from 8.9 ± 1.8 points to 10.7 ± 1.3 points at the end of the program (p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>The problem-solving exercise program based on SPPB is feasible and safe for older patients with CRDs. However, the effectiveness of this exercise program should be validated in large-scale, randomized-controlled trials in the future.</div></div><div><h3>Trial registration</h3><div>University Hospital Medical Information Network Center (UMIN-CTR) UMIN: approval number: UMIN000048761.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1117-1123"},"PeriodicalIF":2.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372726","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":"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}