Tuberculosis and Respiratory Diseases最新文献

{"title":"Clinical characteristics of chronic obstructive pulmonary disease according to smoking status.","authors":"Joo Hun Park","doi":"10.4046/trd.2024.0060","DOIUrl":"https://doi.org/10.4046/trd.2024.0060","url":null,"abstract":"<p><p>COPD can be caused by various factors, including lung infections, asthma, air pollution, childhood growth disorders, and genetic factors, although smoking is a predominant risk factor. The main pathological mechanisms in COPD involve small airway disease, emphysema, mucus hypersecretion, and vascular disorders. COPD in non-smokers is characterized by normal FEV1 decline, equal distribution of sex, younger age of onset, fewer comorbidities, milder airflow obstruction, normal diffusing capacity of the lungs for carbon monoxide (DLCO) and radiological features such as more air-trapping and less severe emphysema, compared to COPD in smokers. COPD in non-smokers is still accompanied by a high prevalence of acute exacerbation almost equal to COPD in smokers. Moreover, COPD per se is an independent risk factor for the development of lung cancer, irrespective of smoking status. Considering that COPD coexists with numerous comorbidities, effective management of these comorbidities is essential, and multifaceted efforts are required for the comprehensive treatment of COPD.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547744","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":"Miliary tuberculosis associated with Klebsiella pneumonia: Managing double whammy of antimicrobial resistance.","authors":"Priyavardhan Mishra, Mohit Kondisetti, Anant Patil, Nikhil Sarangdhar, Vijaykumar Gupta","doi":"10.4046/trd.2024.0105","DOIUrl":"https://doi.org/10.4046/trd.2024.0105","url":null,"abstract":"","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547746","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":"Comprehensive strategies for preoperative pulmonary risk evaluation and management.","authors":"Hyo Jin Lee, Hyun Woo Lee","doi":"10.4046/trd.2024.0118","DOIUrl":"https://doi.org/10.4046/trd.2024.0118","url":null,"abstract":"<p><p>Postoperative pulmonary complications (PPCs) significantly increase morbidity and mortality in surgical patients, particularly those with pulmonary conditions. The incidence of PPCs varies widely, influenced by surgery type, patient age, smoking status, and comorbidities like chronic obstructive pulmonary disease (COPD) and congestive heart failure. Preoperative pulmonary function tests and chest radiographs, while critical for lung resection surgery, should be selectively used based on individual risk factors. Effective risk stratification models, including ASA classification, Arozullah Respiratory Failure Index, Gupta Calculators, and ARISCAT model, aid in predicting PPCs. Key strategies to reduce PPCs involve preoperative optimization of pulmonary conditions, smoking cessation, and respiratory rehabilitation. In COPD and asthma patients, maintaining optimal disease control through inhaled therapies, systemic corticosteroids, and preoperative respiratory exercises is crucial. Anemia and hypoalbuminemia are notable predictors of PPCs, warranting careful management. The type and duration of anesthesia significantly impact PPC risk, with regional anesthesia preferred over general anesthesia when feasible. Comprehensive preoperative evaluation and tailored interventions are essential to improve surgical outcomes and reduce PPC incidence. Further study involving domestic patients is needed to refine national guidelines for managing patients at risk of PPCs.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547745","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":"Korean Guidelines for the Management and Antibiotic Therapy in Adult Patients with Hospital-Acquired Pneumonia.","authors":"Hayoung Choi, Kyung Hoon Min, Young Seok Lee, Youjin Chang, Bo Young Lee, Jee Youn Oh, Ae-Rin Baek, Jongmin Lee, Kyeongman Jeon","doi":"10.4046/trd.2024.0135","DOIUrl":"https://doi.org/10.4046/trd.2024.0135","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are correlated with high morbidity and mortality rates. Guidelines that consider local epidemiologic data are fundamental for identifying optimal treatment strategies. However, Korea has no HAP/VAP guidelines.</p><p><strong>Methods: </strong>This study was conducted by a committee of nine experts from the Korean Academy of Tuberculosis and Respiratory Diseases Respiratory Infection Study Group using the results of Korean HAP/VAP epidemiologic studies. Eleven key questions for HAP/VAP diagnosis and treatment were addressed. The Convergence of Opinion on Suggestions and Evidence (CORE) process was used to derive suggestions, and evidence levels and recommendation grades were in accordance with the Grading of Recommendations Assessment Development and Evaluation (GRADE) methodology.</p><p><strong>Results: </strong>Suggestions were made for the 11 key questions pertinent to diagnosis, biomarkers, antibiotics, and treatment strategies for adult patients with HAP/VAP.</p><p><strong>Conclusion: </strong>Using the CORE process and GRADE methodology, the committee generated a series of recommendations for HAP/VAP diagnosis and treatment in the Korean context.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401451","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 of Nutritional Intake with Physical Activity and Handgrip Strength in Individuals with Airflow Limitation.","authors":"I Re Heo, Tae Hoon Kim, Jong Hwan Jeong, Manbong Heo, Sun Mi Ju, Jung-Wan Yoo, Seung Jun Lee, Yu Ji Cho, Yi Yeong Jeong, Jong Deog Lee, Ho Cheol Kim","doi":"10.4046/trd.2024.0017","DOIUrl":"https://doi.org/10.4046/trd.2024.0017","url":null,"abstract":"<p><strong>Background: </strong>We investigated whether nutritional intake is associated with physical activity (PA) and handgrip strength (HGS) in individuals with airflow limitation.</p><p><strong>Methods: </strong>This study analyzed data from the 2014 to 2016 Korean National Health and Nutrition Examination Survey. We assessed total protein intake (g/day), caloric intake (kcal/day), and other nutritional intakes using a 24-hour dietary recall questionnaire. HGS was measured three times for each hand using a digital grip strength dynamometer, and PA was assessed as health-enhancing PA. Airflow limitation was defined as a forced expiratory volume/forced vital capacity ratio of 0.7 in individuals over 40 years of age. Participants were categorized into groups based on their PA levels and HGS measurements: active aerobic PA vs. non-active aerobic PA, and normal HGS vs. low HGS.</p><p><strong>Results: </strong>Among the 622 individuals with airflow limitation, those involved in active aerobic PA and those with higher HGS had notably higher total food, calorie, water, protein, and lipid intake. The correlations between protein and caloric intake with HGS were strong (correlation coefficients = 0.344 and 0.346, respectively). The forest plots show that higher intakes of food, water, calories, protein, and lipids are positively associated with active aerobic PA, while higher intakes of these nutrients are inversely associated with low HGS. However, in the multivariate logistic regression analysis, no significant associations were observed between nutritional intake and active aerobic PA or HGS.</p><p><strong>Conclusion: </strong>Nutritional intake was not found to be an independent factor associated with PA and HGS. However, the observed correlations suggest potential indirect effects that warrant further investigation.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401450","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":"Diagnosis and Treatment of latent tuberculosis infection in adults in South Korea","authors":"Kyung-Wook Jo, Young Soon Yoon, Hyung Woo Kim, Joong-Yub Kim, Young Ae Kang","doi":"10.4046/trd.2024.0122","DOIUrl":"https://doi.org/10.4046/trd.2024.0122","url":null,"abstract":"<p><p>Latent tuberculosis infection (LTBI) is characterized by immune responses to Mycobacterium tuberculosis antigens without clinical symptoms or evidence of active tuberculosis. Effective LTBI management is crucial for tuberculosis elimination, requiring accurate diagnosis and treatment. In South Korea, LTBI guidelines have been updated periodically, with the latest in 2024. This review discusses the recent changes in the Korean guideline for the diagnosis and treatment of LTBI in adults.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393707","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":"Pulmonary Function, Functional Capacity, Respiratory, and Locomotor Muscle Strength after Severe to Critically Ill COVID-19: A Long-Term Study.","authors":"Thanunya Ngamsutham, Warawut Chaiwong, Sauwaluk Dacha, Patraporn Sitilertpisan, Chaicharn Pothirat, Pilaiporn Duangjit, Athavudh Deesomchok, Chalerm Liwsrisakun, Chaiwat Bumroongkit, Theerakorn Theerakittikul, Atikun Limsukon, Konlawij Trongtrakul, Nutchanok Niyatiwatchanchai, Pattraporn Tajarernmuang","doi":"10.4046/trd.2024.0044","DOIUrl":"10.4046/trd.2024.0044","url":null,"abstract":"<p><strong>Background: </strong>The sequelae of post-coronavirus disease 2019 (COVID-19) pneumonia on lung function, exercise capacity, and quality of life were observed in both shortterm and long-term. However, the study about the respiratory and locomotor muscle strength in severe and critically ill COVID-19 survivors are still limited. Therefore, we aimed to examine long-term pulmonary function, functional capacities, and respiratory and locomotor body muscle strength in severe to critically ill post-COVID-19 survivors.</p><p><strong>Methods: </strong>A prospective observational study was conducted in 22 post-COVID-19 pneumonia and healthy adults. Clinical characteristics during admission, pulmonary function, functional capacity, respiratory muscles, and locomotor muscles strength were examined at 1, 3, and 6 months after discharge from the hospital.</p><p><strong>Results: </strong>The generalized linear mixed model showed that percent predicted of forced expiratory volume in the 1 second (%FEV1), percent predicted of forced vital capacity (%FVC), maximum inspiratory pressure (MIP), handgrip strength, 6-minute walk distance, and five times sit to stand (5TSTS) were significantly lower in post-COVID-19 pneumonia patients than in healthy subjects during the follow-up period. The percent predicted of maximal voluntary ventilation (%MVV), and locomotor muscle strength were not different between the two groups throughout the follow-up period. Among post-COVID-19 pneumonia patients, %FEV1, %FVC, %MVV, 5TSTS, locomotor muscle strength significantly improved at three months compared to baseline at 1 month.</p><p><strong>Conclusion: </strong>Pulmonary function, functional capacity, respiratory, and locomotor muscle strength of survivors from COVID-19 were impaired and recovery was observed after three to six months. These emphasized the need to evaluate the long-term consequences of COVID-19.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976668","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":"Liberation from Mechanical Ventilation in Critically Ill Patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines.","authors":"Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park","doi":"10.4046/trd.2024.0039","DOIUrl":"10.4046/trd.2024.0039","url":null,"abstract":"<p><strong>Background: </strong>Successful liberation from mechanical ventilation is one of the most crucial processes in critical care, because it is the first step through which a respiratory failure patient begins to transition out of the intensive care unit, and return to normal life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider scientific and systematic approaches, as well as the individual experiences of healthcare professionals. Recently, numerous studies have investigated methods and tools to identify when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians for liberation from the ventilator.</p><p><strong>Methods: </strong>Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. These evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved the recommendations.</p><p><strong>Results: </strong>Recommendations for nine questions on ventilator liberation about Population, Intervention, Comparator, and Outcome (PICO) are presented in this document. This guideline presents seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation.</p><p><strong>Conclusion: </strong>We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477484","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":"Secondary Immunodeficiency and Non-cystic Fibrosis Bronchiectasis.","authors":"Sungmin Zo, Ji-Yong Moon, Kyung Hoon Min, Hyun Lee","doi":"10.4046/trd.2024.0015","DOIUrl":"10.4046/trd.2024.0015","url":null,"abstract":"<p><p>Bronchiectasis is a chronic respiratory disease characterized by abnormal dilation of the bronchi that causes cough, sputum, and recurrent infections. As it may be associated with various respiratory or systemic diseases, a critical aspect of managing bronchiectasis is to identify the underlying cause. Immunodeficiency is a rare but important cause of bronchiectasis, and its treatability is a significant trait for bronchiectasis management. While primary immunodeficiencies in bronchiectasis are well recognized, secondary immunodeficiencies remain under-reported and under-researched. Secondary immunodeficiencies may result from various diseases and conditions, such as hematologic malignancies, human immunodeficiency virus infection, renal transplantation, or the use of immunosuppressive drugs, and may contribute to the occurrence of bronchiectasis. Recurrent pulmonary and/or extrapulmonary infections in bronchiectasis may indicate the presence of secondary immunodeficiency in patients with these underlying conditions. For treatment, examining the underlying condition, managing bronchiectasis adequately, and prophylactic antibiotics (e.g., macrolide) and/or supplementary immunoglobulin G therapy may provide potential benefits. Considering the projected increase in the prevalence of secondary immunodeficiencies and bronchiectasis, future guidelines and research on the diagnosis and optimized treatment are needed.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976669","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":"Eosinophilia Is a Favorable Marker for Pneumonia in Chronic Obstructive Pulmonary Disease.","authors":"Kang-Mo Gu, Jae-Woo Jung, Min-Jong Kang, Deog Kyeom Kim, Hayoung Choi, Young-Jae Cho, Seung Hun Jang, Chang-Hoon Lee, Yeon Mok Oh, Ji Sook Park, Jae Yeol Kim","doi":"10.4046/trd.2023.0174","DOIUrl":"10.4046/trd.2023.0174","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic obstructive pulmonary disease (COPD) expressing eosinophilia experience slightly fewer episodes of community-acquired pneumonia (CAP), than those without eosinophilia. However, the severity and burden of hospitalized pneumonia patients with COPD involving eosinophilia have not been assessed.</p><p><strong>Methods: </strong>We evaluated the differences in clinical characteristics between patients with CAP and COPD with or without eosinophilia by a post hoc analysis of a prospective, multi-center, cohort study data.</p><p><strong>Results: </strong>Of 349 CAP patients with COPD, 45 (12.9%) had eosinophilia (blood eosinophil ≥300 cells/μL). Patients with eosinophilia had a lower sputum culture percentile (8.1% vs. 23.4%, p&lt;0.05), a lower percentile of neutrophils (70.3% vs. 80.2%, p&lt;0.05), reduced C-reactive protein levels (30.6 mg/L vs. 86.6 mg/L, p&lt;0.05), and a lower pneumonia severity index score (82.5 vs. 90.0, p&lt;0.05), than those without eosinophilia. The duration of antibiotic treatment (8.0 days vs. 10.0 days, p&lt;0.05) and hospitalization (7.0 days vs. 9.0 days, p&lt;0.05) were shorter in eosinophilic patients. The cost of medical care per day (256.4 US$ vs. 291.0 US$, p&lt;0.05), cost for the medication (276.4 US$ vs. 349.9 US$, p&lt;0.05), and cost for examination (685.5 US$ vs. 958.1 US$, p&lt;0.05) were lower in patients with eosinophilia than those without eosinophilia.</p><p><strong>Conclusion: </strong>Eosinophilia serves as a favorable marker for the severity of pneumonia, health-care consumption, and cost of medical care in patients with CAP and COPD.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870102","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}