Respiratory investigation最新文献

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

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

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

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

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

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

{"title":"Safety and immunogenicity of an mRNA-based RSV vaccine in Japanese older adults aged ≥60 years: A phase 1, randomized, observer-blind, placebo-controlled trial","authors":"David Fitz-Patrick ,&nbsp;Hanako Mihara ,&nbsp;Anthony Mills ,&nbsp;Runa Mithani ,&nbsp;Archana Kapoor ,&nbsp;Rakesh Dhar ,&nbsp;Lauren Wilson ,&nbsp;Ruiting Guo ,&nbsp;Alana K. Simorellis ,&nbsp;Catherine A. Panozzo ,&nbsp;Caroline Reuter ,&nbsp;Eleanor Wilson ,&nbsp;Grace L. Chen ,&nbsp;Sonia K. Stoszek ,&nbsp;Christine A. Shaw ,&nbsp;Jaya Goswami","doi":"10.1016/j.resinv.2024.08.011","DOIUrl":"10.1016/j.resinv.2024.08.011","url":null,"abstract":"<div><h3>Background</h3><p>Respiratory syncytial virus (RSV) represents a global health concern, including in older adults. This study assessed the safety and immunogenicity of mRNA-1345, an investigational mRNA RSV vaccine, in adults aged ≥60 years of Japanese descent.</p></div><div><h3>Methods</h3><p>In this phase 1, randomized, observer-blind, placebo-controlled study, participants were randomized to receive one injection of mRNA-1345 100 μg or placebo. Solicited local and systemic adverse reactions (ARs) were collected within 7 days following injection. Unsolicited adverse events (AEs) were collected up to 28 days after injection; AEs of special interest, medically attended AEs, and serious AEs were collected through end of study. Immunogenicity was assessed at baseline and months 1, 2, 3, and 6 following injection.</p></div><div><h3>Results</h3><p>Twenty-five adults of Japanese descent aged ≥60 years received one injection of mRNA-1345 100 μg (n = 21) or placebo (n = 4). mRNA-1345 was well-tolerated; the most common local and systemic solicited ARs were injection site pain, and fatigue and myalgia, respectively, which were generally mild to moderate and transient. No serious AEs were reported. Neutralizing (nAb) and binding (bAb) antibodies were detectable at baseline, consistent with prior RSV exposure. mRNA-1345 boosted RSV nAb titers and preF bAb concentrations 1 month post-injection (geometric mean fold rise: RSV-A nAb, 11.2; RSV-B nAb, 6.6; preF bAb, 9.1). Titers among mRNA-1345 recipients remained above baseline through 6 months.</p></div><div><h3>Conclusions</h3><p>mRNA-1345 100 μg was well-tolerated among older adults of Japanese descent and induced nAbs and bAbs which were durable through 6 months, supporting its continued development.</p></div><div><h3>Trial registration</h3><p><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, NCT04528719.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1037-1043"},"PeriodicalIF":2.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142158154","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":"New diagnostic criteria and current issues for pulmonary hypertension","authors":"Kei Kusaka ,&nbsp;Keita Takeda ,&nbsp;Masahiro Kawashima ,&nbsp;Yoshiteru Morio","doi":"10.1016/j.resinv.2024.09.002","DOIUrl":"10.1016/j.resinv.2024.09.002","url":null,"abstract":"<div><p>In 2022, the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) proposed new diagnostic criteria for pulmonary hypertension (PH). These criteria include significant changes to the definitions of pulmonary hemodynamic indices. Specifically, the threshold for mean pulmonary artery pressure (mPAP) has been lowered from ≥25 mmHg to &gt;20 mmHg, and the threshold for pulmonary vascular resistance (PVR) has been adjusted from ≥3 Wood units (WU) to &gt;2 WU. Additionally, the diagnostic criterion for exercise-induced PH has been reintroduced. To differentiate between non-severe and severe PH associated with lung disease, a differential threshold of 5 WU for PVR has been proposed. However, the threshold for mean pulmonary artery wedge pressure (PAWP) remains unchanged. While these new criteria could provide a more refined approach to clinical practice, they may also raise clinical concerns and questions regarding the diagnosis and management of PH.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1034-1036"},"PeriodicalIF":2.4,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142148470","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":"Transesophageal ultrasound-guided bronchoscopic Acquire TBNB versus Vizishot2 TBNA needles for neoplastic lesions: A retrospective study","authors":"Toshiyuki Sumi ,&nbsp;Taiki Ishigooka ,&nbsp;Keigo Matsuura ,&nbsp;Takumi Ikeda ,&nbsp;Yuta Koshino ,&nbsp;Keito Suzuki ,&nbsp;Kotomi Arioka ,&nbsp;Yuichi Yamada ,&nbsp;Hirofumi Chiba","doi":"10.1016/j.resinv.2024.08.016","DOIUrl":"10.1016/j.resinv.2024.08.016","url":null,"abstract":"<div><h3>Background</h3><p>Lung cancer is often diagnosed at an advanced stage; however, it has shown improved therapeutic efficacy with the introduction of molecularly targeted drugs and immune checkpoint inhibitors, necessitating accurate molecular diagnosis for effective treatment planning. Traditional sampling techniques, including endobronchial ultrasound-guided transbronchial needle aspiration, frequently require multiple biopsies to obtain sufficient tissues for multiplex testing, highlighting the need for more efficient methods. Therefore, we explored the diagnostic utility of endoscopic ultrasound with bronchoscope-guided fine-needle biopsy (EUS-B-FNB) versus fine-needle aspiration (EUS-B-FNA) in patients with lung cancer, focusing on tissue sample collection for molecular testing. The introduction of the Franseen needle in EUS-B-FNB, characterized by three beveled edges, allows for more tissue collection in cylinder form.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed the data of 97 patients who underwent EUS-B-FNB or EUS-B-FNA at Hakodate Goryoukaku Hospital and evaluated diagnostic yields, safety, and nucleic acid concentrations using collected specimens.</p></div><div><h3>Results</h3><p>The diagnostic yields of EUS-B-FNB and EUS-B-FNA were comparable (92.2% vs. 92.3%), with no significant differences in complications. However, EUS-B-FNB provided significantly higher DNA and RNA concentrations (DNA; 41.05 vs. 10.20 ng/mL; P &lt; 0.0001, RNA; 36.80 vs. 11.80 ng/mL; P = 0.0009), essential for comprehensive molecular testing.</p></div><div><h3>Conclusion</h3><p>This study highlights the potential of EUS-B-FNB for enhancing the molecular diagnosis of lung cancer by ensuring adequate tissue sample collection for multiplex testing, paving the way for personalized medicine. This technique is comparable in safety and efficacy to traditional methods while offering a substantial improvement in the quality of molecular diagnostics.</p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1021-1026"},"PeriodicalIF":2.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142129977","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":"Reevaluating diagnosis in interstitial lung disease with a second multidisciplinary discussion","authors":"Yuki Iijima ,&nbsp;Haruhiko Furusawa ,&nbsp;Takashi Yamana ,&nbsp;Sho Shibata ,&nbsp;Tsuyoshi Shirai ,&nbsp;Tsukasa Okamoto ,&nbsp;Tomoya Tateishi ,&nbsp;Takuya Adachi ,&nbsp;Susumu Kirimura ,&nbsp;Yasunari Miyazaki","doi":"10.1016/j.resinv.2024.08.015","DOIUrl":"10.1016/j.resinv.2024.08.015","url":null,"abstract":"<div><h3>Background</h3><p>The importance of multidisciplinary discussion (MDD) for diagnosing interstitial lung disease (ILD) is emphasized by several international guidelines. While initial diagnoses are often provisional and require periodic re-evaluation, there is a lack of literature regarding the role of follow-up MDD in clinical practice.</p></div><div><h3>Methods</h3><p>From September 2020 to January 2022, patients underwent an initial MDD (MDD1) based on clinical, radiological, and pathological evaluations. Each diagnosis was assigned a confidence level. One year later, a second MDD (MDD2) was conducted for re-evaluation, based on subsequent clinical and radiological information. Changes in diagnosis and confidence levels between MDD1 and MDD2 were assessed.</p></div><div><h3>Results</h3><p>Among 52 patients enrolled in both MDDs, the diagnosis for 13 (25%) was revised at MDD2. Of these, 10 patients were initially diagnosed with unclassifiable ILD, and 3 received a low confidence diagnosis of either idiopathic pulmonary fibrosis or idiopathic nonspecific interstitial pneumonia. The most common diagnostic revision was due to the deterioration after antigen exposure or improvement after antigen avoidance, which resulted in a revised diagnosis of HP at MDD2.</p></div><div><h3>Conclusions</h3><p>Our findings underscore the importance of periodic reassessment of MDD to improve the accuracy of ILD diagnosis. This study highlights the significance of longitudinal clinical and radiological evaluation for diagnostic revision, even in situations when rebiopsy is not feasible<strong>.</strong></p></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1027-1033"},"PeriodicalIF":2.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142137010","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}