Tuberculosis and Respiratory Diseases最新文献

{"title":"Relationship between Serum Cadmium Concentration and Lung function: A Study Using KNHANES data.","authors":"Oh Beom Kwon, Eun Ju Lee, Myoung-Nam Lim, Jeeyoung Kim, Woo Jin Kim","doi":"10.4046/trd.2024.0161","DOIUrl":"https://doi.org/10.4046/trd.2024.0161","url":null,"abstract":"<p><strong>Background: </strong>Occupational and environmental exposures to cadmium affects lung. Cadmium accumulation alters intracellular signaling and impairs innate immunity which leads to chronic inflammation. Various factor such as gender, age, smoking status and comorbidities are known to be associated with blood cadmium levels. The objective of this study was to investigate the association between lung function and serum cadmium concentration, adjusting for these factors.</p><p><strong>Methods: </strong>The study population included 7,448 adults who are over 40 years old and participated in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2017, excluding 2014-2015, when there were no measured values for heavy metals. To investigate the relationship between blood cadmium concentration and estimated glomerular filtration rate (eGFR) and FEV1/FVC , weights were applied to the subjects and adjusted linear regression analysis was performed.</p><p><strong>Results: </strong>According to gender, as the blood cadmium concentration increased FEV1/FVC decreased in male smokers with age, BMI, education level, hypertension and diabetes adjusted (estimate: -0.01, 95% confidence interval (CI): -0.02 - 0.003). In female current smoker group, as the blood cadmium concentration increased, FEV1/FVC decreased with age, BMI, education level, hypertension and diabetes adjusted (estimate: -0.02, 95% CI: -0.04 - -0.01).</p><p><strong>Conclusion: </strong>Lung function represented by FEV1/FVC decreased as the blood cadmium concentration increased in the male and female smoker group. The relationship between blood cadmium concentration and kidney function remains controversial and requires future studies. As a result, our study provided insight into the effects of cadmium concentration on lung function.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761468","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 Review of Comorbidities in Chronic Obstructive Pulmonary Disease and Preserved Ratio Impaired Spirometry: Insights from 2024.","authors":"So-Yun Kim, Duk-Ki Kim, Green Hong, Seong-Dae Woo, Da Hyun Kang, Song-I Lee, Chaeuk Chung, Dongil Park","doi":"10.4046/trd.2025.0052","DOIUrl":"10.4046/trd.2025.0052","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly associated with multiple comorbidities, significantly affecting prognosis and clinical management. Systemic inflammation and shared risk factors contribute to the development of these comorbidities. Additionally, Preserved Ratio Impaired Spirometry (PRISm) has been recognized as a high-risk condition for COPD progression; however, its comorbid burden remains insufficiently studied. This review summarizes key findings from clinically relevant studies published in 2024, focusing on cardiovascular diseases (CVD), pulmonary conditions, frailty, and obstructive sleep apnea (OSA) in both COPD and PRISm. CVD risk in COPD varies according to disease phenotype, with exacerbation severity and frequency serving as independent risk factors for myocardial infarction and pulmonary embolism. Bronchiectasis affects up to 69% of COPD patients, leading to higher exacerbation rates and mortality. The recently proposed ROSE criteria (Radiological bronchiectasis, Obstruction, Symptoms, and Exposure) provide an objective framework for characterizing patients with both bronchiectasis and COPD. This classification has shown that patients meeting the ROSE criteria are at increased risk of COPD exacerbations and hospitalization due to exacerbation. Furthermore, recent studies demonstrate a strong association between severe OSA and PRISm, with a significantly higher prevalence in severe OSA cases (12.9%) compared to mild/moderate OSA (6.2%). PRISm and COPD are also linked to accelerated frailty progression, emphasizing the need for early identification and management of comorbidities. These findings highlight the importance of a multidimensional approach to COPD and PRISm, incorporating objective diagnostic criteria and early interventions. Future research should prioritize longitudinal studies and targeted strategies to improve clinical outcomes in these populations.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660390","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 characteristics and impact of Clostridium difficile infection during treatment of rifampicin-susceptible pulmonary tuberculosis.","authors":"Sang Woo Ha, Soohee Hwang","doi":"10.4046/trd.2024.0185","DOIUrl":"https://doi.org/10.4046/trd.2024.0185","url":null,"abstract":"<p><strong>Background: </strong>Anti-tuberculosis (TB) treatment, although infrequently associated with Clostridium difficile infection (CDI), necessitates updated research on the incidence and clinical features of CDI among TB patients, especially as the demographic of older TB patients in South Korea is growing.</p><p><strong>Materials and methods: </strong>A total of 168 patients with rifampin-susceptible pulmonary TB were enrolled in this study. Initial clinical features of the CDI-suspected group, risk factors for CDI, the primary outcome of all-cause mortality, and secondary outcomes, including delayed conversion of AFB smear and culture, were analyzed.</p><p><strong>Results: </strong>The incidence rate of CDI among TB patients was 15.0 cases per 10,000 patient-days. Among initial features associated with TB-related CDI, patients exhibiting diarrhea of Bristol Stool Scale type 7 for more than two days were more likely to receive a CDI diagnosis. Old age and hypoalbuminemia were significant risk factors for CDI occurrence. In the primary outcome analysis, CDI was associated with a 4.63-fold increase in all-cause mortality according to the unadjusted analysis. However, this association dissipated in the adjusted analysis. Older age, underlying respiratory disease, and pneumonia at baseline were strong predictors of all-cause mortality. No significant factors were detected in the analysis of delayed AFB smear and culture conversion.</p><p><strong>Conclusions: </strong>Despite the lack of an independent association between CDI and all-cause mortality among TB patients, monitoring older adults with undernutrition and persistent diarrhea for CDI is crucial.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643623","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":"Change in exacerbation rate of asthma patients before and after COVID-19 infection.","authors":"Joon Young Choi, Kyung Joo Kim, Chin Kook Rhee","doi":"10.4046/trd.2024.0201","DOIUrl":"https://doi.org/10.4046/trd.2024.0201","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 had significant impact on healthcare utilization and disease outcomes worldwide. While overall asthma exacerbations reportedly declined during the pandemic, the specific effect of COVID-19 infection on subsequent exacerbation patterns in asthma patients remains unclear.</p><p><strong>Methods: </strong>Using a nationwide health insurance claims database from South Korea, we identified patients who had both asthma and a confirmed COVID-19 diagnosis in 2020. We defined the pre-COVID-19 period as the 12 months immediately preceding the date of each patient's COVID-19 diagnosis, and the post-COVID-19 period as the 12 months following that date. Baseline characteristics, annual exacerbation rates, and direct medical costs were compared between these two time frames.</p><p><strong>Results: </strong>Among 82,825 confirmed COVID-19 cases, 2,965 patients with asthma met the inclusion criteria. Compared to the pre-COVID-19 period, the proportion of patients experiencing moderate and moderate-to-severe exacerbations decreased, whereas severe exacerbations increased after COVID-19 infection. In a binomial mixed model, moderate and moderate-to-severe exacerbations declined significantly (IRR=0.848, p<0.001 and IRR=0.912, p<0.001, respectively), but severe exacerbations increased (IRR=1.220, p<0.001) after COVID-19 infection. Of those who were non-exacerbators prior to COVID-19, 10.8% became exacerbators. This group was older, more frequently male, and had a greater comorbidity burden. Total direct medical costs escalated markedly from USD 2,965.50 to USD 4,850.41 (p<0.001), particularly among those who developed as exacerbators after COVID-19 infection.</p><p><strong>Conclusions: </strong>COVID-19 infection had a paradoxical impact on asthma exacerbations, reducing moderate exacerbations but increasing severe events. The substantial rise in medical costs contributes the economic burden of asthma care.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601663","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 Diagnosis and Management of Interstitial Lung Disease: Cryptogenic Organizing Pneumonia.","authors":"Yong Suk Jo, Jong Sun Park, Sun Hyo Park, Joon Sung Joh, Hye Jin Jang, Hyun-Kyung Lee","doi":"10.4046/trd.2024.0167","DOIUrl":"10.4046/trd.2024.0167","url":null,"abstract":"<p><p>Cryptogenic organizing pneumonia (COP), one of the idiopathic interstitial pneumonias (IIP), exhibits an acute or subacute course. It can be diagnosed after excluding secondary causes or diseases. COP accounts for approximately 5% to 10% of IIPs, with the average age of diagnosis ranging from 50 to 60 years. Patients primarily present with dry cough and dyspnea. They often experience fever, fatigue, and weight loss. Common radiologic findings on high-resolution computed tomography include localized consolidations, which are typically subpleural or located in the lower zones, though they can occur in all regions of the lungs. While treatment can be initiated without histopathological diagnosis, tissue biopsy may be necessary when the diagnosis is unclear. Response to steroid therapy is generally good, with rapid clinical improvement and a favorable prognosis, although relapses are common.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"477-487"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617469","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":"The Quality Changes in Intensive Care Units in South Korea since the Initiation of Intensive Care Unit Quality Assessments.","authors":"Su Hwan Lee, Sunghoon Park","doi":"10.4046/trd.2025.0039","DOIUrl":"10.4046/trd.2025.0039","url":null,"abstract":"","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"603-605"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754688","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":"Epidemiology of Severe Acute Respiratory Infection in Korea: 2022 to 2024 Surveillance Data.","authors":"Young Seok Lee, Hye Sun Lee, Jae Young Moon","doi":"10.4046/trd.2025.0043","DOIUrl":"10.4046/trd.2025.0043","url":null,"abstract":"","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"610-613"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029624","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":"Importance of accounting for confounding factors when assessing cardiovascular outcomes of COVID-19: a nationwide cohort study.","authors":"Seung-Hun You, Moon Seong Baek, Tae Wan Kim, Gyungah Kim, Sun-Young Jung, Won-Young Kim","doi":"10.4046/trd.2025.0092","DOIUrl":"https://doi.org/10.4046/trd.2025.0092","url":null,"abstract":"","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529650","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":"Non-pharmacologic Prevention of Acute Exacerbation Chronic Obstructive Pulmonary Disease.","authors":"Joon Young Choi","doi":"10.4046/trd.2024.0155","DOIUrl":"10.4046/trd.2024.0155","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a major global health issue, as acute exacerbation COPD (AECOPD) significantly worsens outcomes and increases healthcare burden. This review explores non-pharmacologic strategies to prevent AECOPD. Pulmonary rehabilitation consistently demonstrates its effectiveness in reducing exacerbations and mortality, while improving exercise capacity and the quality of life. Lung volume reduction, through both surgical and bronchoscopic methods, has shown promise in select patient groups, leading to improved lung function and reduced exacerbation risk. Smoking cessation remains a critical intervention, while the role of electronic cigarettes remains debatable; some evidence suggests they may help patients unable to quit tobacco smoking. Vitamin D supplementation has shown potential in reducing exacerbations, particularly in patients with severe deficiency, though conflicting results warrant further research. Furthermore, shielding measures, like mask-wearing and social distancing, have gained attention during the coronavirus disease 2019 (COVID-19) pandemic for their role in reducing exacerbation risk. Lastly, vaccination, diet and nutrition, and non-invasive ventilation may be important to prevent AECOPD. These non-pharmacologic approaches should be integrated into comprehensive COPD management to improve outcomes and prevent AECOPD.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"419-430"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574275","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":"Maximal Forced Inspiratory Flow Dynamics and Acute Exacerbation in Chronic Obstructive Pulmonary Disease Patients with Exacerbation History.","authors":"Heemoon Park, Jung-Kyu Lee, Eun Young Heo, Deog Kyeom Kim, Hyun Woo Lee","doi":"10.4046/trd.2024.0156","DOIUrl":"10.4046/trd.2024.0156","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD), characterized by progressive airflow obstruction and frequent exacerbations, is a significant global health burden. COPD severity has traditionally been assessed using expiratory flow measurements, like forced expiratory volume in 1 second. However, the role of inspiratory flow, specifically maximal forced inspiratory flow (FIFmax), in predicting exacerbation risk is gaining attention.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated COPD patients with a history of exacerbations who were receiving inhaled therapy. The eligible patients were followed up for 3 years with spirometric assessments. Patients were categorized into quartiles based on the annual change in FIFmax, from the greatest decrease (Q1) to the greatest increase (Q4). Primary outcome was acute exacerbation, stratified by severity as moderate-to-severe and severe exacerbation.</p><p><strong>Results: </strong>In total, 180 patients were followed up for 3 years. A greater increase in FIFmax was linearly associated with lower rates of both moderate-to-severe and severe exacerbations (p-value for trend <0.001 for both), but time-to-event analysis revealed no significant association between FIFmax changes and moderate-to-severe exacerbations. In contrast, a significant association with severe exacerbations was observed (log-rank p=0.005). Even after adjusting for confounders, FIFmax remained an independent predictor of severe exacerbations (Q3: hazard ratio, 0.506 [95% confidence interval, 0.306 to 0.836], p=0.008; Q4: hazard ratio, 0.491 [95% confidence interval, 0.291 to 0.830], p=0.008).</p><p><strong>Conclusion: </strong>Changes in FIFmax were not significantly associated with moderate-to-severe exacerbations, but were related to a reduced risk of severe exacerbations in COPD patients receiving inhaled therapy. These findings indicate that FIFmax may serve as a valuable prognostic marker for severe exacerbations in high-risk COPD patients.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"535-544"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731894","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}