Annals of Thoracic Medicine最新文献

{"title":"The prevalence of rapid eye movement-related obstructive sleep apnea in a sample of Saudi population.","authors":"Sultan Qanash,&nbsp;Hani Mufti,&nbsp;Faris Alhejaili,&nbsp;Faisal Al-Husayni,&nbsp;Ghufran Bukhari,&nbsp;Shatha Bazhair,&nbsp;Ghadi Alansari,&nbsp;Alaa Aldeibani,&nbsp;Dimah Balkhi,&nbsp;Yara Alhjrsy,&nbsp;Shahad Albadani,&nbsp;Malak Alamoudi,&nbsp;Siraj Wali","doi":"10.4103/atm.atm_388_22","DOIUrl":"10.4103/atm.atm_388_22","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to estimate the prevalence of rapid eye movement-related obstructive sleep apnea (REMrOSA) using common definitions.</p><p><strong>Methods: </strong>This was a retrospective cohort study that used three sets of criteria to identify patients with REMrOSA. These criteria were defined as strict, intermediate, and lenient depending on the apnea-hypopnea index (AHI), AHI during REM sleep/(AHI during non-REM sleep [NREM-AHI]), NREM-AHI and REM duration.</p><p><strong>Results: </strong>The study included 609 patients with OSA and full sleep study. The prevalence of REMrOSA was 26%, 33%, and 52% using the strict, intermediate, and lenient criteria, respectively. There were no differences in the patients' general and demographic characteristics between the different groups of the three definitions. REMrOSA patients were more likely to be younger females than non-REMrOSA (NREMrOSA) patients. Comorbidities were more frequent in the REMrOSA group compared to NREMrOSA when using strict and intermediate definitions. In contrast, AHI, mean O2 saturation, and time spent <90% O2 saturation were significantly worse during NREMrOSA compared to REMrOSA, regardless of the criteria used. Our study reported higher AHI, lower mean oxygen saturation, lower minimum oxygen saturation, and longer time of desaturation during REMrOSA when lenient definition was used compared to when strict and intermediate definitions were used.</p><p><strong>Conclusions: </strong>REMrOSA is a common condition with a prevalence ranging between 26% and 52% depending on what definition is applied. Although OSA tends to be more severe with lenient definition, however, the clinical and polysomnographic features were similar among REMrOSA groups regardless of the definition used.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 2","pages":"90-97"},"PeriodicalIF":2.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/35/ATM-18-90.PMC10263078.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9652850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of the COVID-19 pandemic on hospital admissions and outpatient visits in Ontario, Canada.","authors":"Steven Habbous,&nbsp;Anna Lambrinos,&nbsp;Stephen Petersen,&nbsp;Erik Hellsten","doi":"10.4103/atm.atm_376_22","DOIUrl":"10.4103/atm.atm_376_22","url":null,"abstract":"<p><strong>Introduction: </strong>The wave-over-wave effect of the COVID-19 pandemic on hospital visits for non-COVID-19-related diagnoses in Ontario, Canada remains unknown.</p><p><strong>Methods: </strong>We compared the rates of acute care hospitalizations (Discharge Abstract Database), emergency department (ED) visits, and day surgery visits (National Ambulatory Care Reporting System) during the first five \"waves\" of Ontario's COVID-19 pandemic with prepandemic rates (since January 1, 2017) across a spectrum of diagnostic classifications.</p><p><strong>Results: </strong>Patients admitted in the COVID-19 era were less likely to reside in long-term-care facilities (OR 0.68 [0.67-0.69]), more likely to reside in supportive housing (OR 1.66 [1.63-1.68]), arrive by ambulance (OR 1.20 [1.20-1.21]) or be admitted urgently (OR 1.10 [1.09-1.11]). Since the start of the COVID-19 pandemic (February 26, 2020), there were an estimated 124,987 fewer emergency admissions than expected based on prepandemic seasonal trends, representing reductions from baseline of 14% during Wave 1, 10.1% in Wave 2, 4.6% in Wave 3, 2.4% in Wave 4, and 10% in Wave 5. There were 27,616 fewer medical admissions to acute care, 82,193 fewer surgical admissions, 2,018,816 fewer ED visits, and 667,919 fewer day-surgery visits than expected. Volumes declined below expected rates for most diagnosis groups, with emergency admissions and ED visits associated with respiratory disorders exhibiting the greatest reduction; mental health and addictions was a notable exception, where admissions to acute care following Wave 2 increased above prepandemic levels.</p><p><strong>Conclusions: </strong>Hospital visits across all diagnostic categories and visit types were reduced at the onset of the COVID-19 pandemic in Ontario, followed by varying degrees of recovery.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 2","pages":"70-78"},"PeriodicalIF":2.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/c9/ATM-18-70.PMC10263076.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9652852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of pleural effusion due to amyloidosis.","authors":"Cristina Pou, Lucía Ferreiro, Juan Suárez-Antelo, Antonio Golpe, José M Álvarez-Dobaño, María Elena Toubes, Adriana Lama, Nuria Rodríguez-Núñez, Jorge Ricoy, Carlos Rábade, Tamara Lourido, Luis Valdés","doi":"10.4103/atm.atm_433_22","DOIUrl":"10.4103/atm.atm_433_22","url":null,"abstract":"<p><p>The characteristics of patients with pleural amyloidosis (PA) are poorly known. A systematic review was performed of studies reporting clinical findings, pleural fluid (PF) characteristics, and the most effective treatment of PA. Case descriptions and retrospective studies were included. The review included 95 studies with a total sample of 196 patients. The mean age was 63 years, male/female ratio was 1.6:1, and 91.9% of patients were >50 years. The most common symptom was dyspnea (88 patients). PF was generally serious (63%), predominantly lymphocytic, and with the biochemical characteristics of transudates (43.4%) or exudates (42.6%). Pleural effusion was generally bilateral (55%) and <1/3 of the hemithorax (50%), although in 21% pleural effusion (PE) exceeded 2/3. Pleural biopsy was performed in 67 patients (yield: 83.6%; 56/67) and was positive in 54% of exudates and 62.5% of unilateral effusions. Of the 251 treatments prescribed, only 31 were effective (12.4%). The combination of chemotherapy and corticosteroids was effective in 29.6% of cases, whereas talc pleurodesis was effective in 21.4% and indwelling pleural catheter in 75% of patients (only four patients). PA is more frequent in adults from 50 years of age. PF is usually bilateral, serous, and indistinctly a transudate or exudate. A pleural biopsy can aid in diagnosis if effusion is unilateral or an exudate. Treatments are rarely effective and there may be definitive therapeutic options for PE in these patients.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 2","pages":"53-60"},"PeriodicalIF":2.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/97/ATM-18-53.PMC10263077.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The implications of Vitamin E acetate in E-cigarette, or vaping, product use-associated lung injury.","authors":"Brian Soto,&nbsp;Louis Costanzo,&nbsp;Anoop Puskoor,&nbsp;Nada Akkari,&nbsp;Patrick Geraghty","doi":"10.4103/atm.atm_144_22","DOIUrl":"10.4103/atm.atm_144_22","url":null,"abstract":"<p><p>In the summer of 2019, a cluster of cases were observed with users of battery-operated or superheating devices presenting with multiple symptoms, such as dyspnea, cough, fever, constitutional symptoms, gastrointestinal upset, and hemoptysis, that is now termed e-cigarette, or vaping, product use-associated lung injury (EVALI). The Centers for Disease Control and Prevention reported 2807 cases within the USA leading to at least 68 deaths as of February 18, 2020. The heterogeneous presentations of EVALI make diagnosis and treatment difficult; however, treatment focused on identifying and removal of the noxious substance and providing supportive care. Vitamin E acetate (VEA) is a likely cause of this lung injury, and others have reported other components to play a possible role, such as nicotine and vegetable glycerin/propylene glycol. EVALI is usually observed in adolescents, with a history of vaping product usage within 90 days typically containing tetrahydrocannabinol, and presenting on chest radiograph with pulmonary infiltrates or computed tomography scan with ground-glass opacities. Diagnosis requires a high degree of suspicion to diagnose and exclusion of other possible causes of lung disease. Here, we review the current literature to detail the major factors contributing to EVALI and primarily discuss the potential role of VEA in EVALI. We will also briefly discuss other constituents other than just VEA, as a small number of EVALI cases are reported without the detection of VEA, but with the same clinical diagnosis.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"1-9"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/47/ATM-18-1.PMC10034821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of the awareness of venous thromboembolism in the Saudi population.","authors":"Ali Alaklabi,&nbsp;Shouq Mohammed AlNujaim,&nbsp;Sarah Mohammed Alghaihab,&nbsp;Sadeem Ahmed AlDakhil,&nbsp;Obeid Mohammed AlKethami,&nbsp;Rajkumar Rajendram","doi":"10.4103/atm.atm_147_22","DOIUrl":"10.4103/atm.atm_147_22","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) causes significant morbidity and mortality. International studies have suggested poor public awareness of VTE, with a few data from Saudi Arabia. The aim of this study was to investigate the knowledge and awareness of VTE in the Saudi population. Awareness of other important diseases was also investigated to allow contextualization.</p><p><strong>Methods: </strong>A cross-sectional survey study was conducted throughout Saudi Arabia from April to June 2021. A nonprobability, purposive, social media-driven, snowballing sampling technique was used to distribute a validated online questionnaire to Saudi adults (aged over 18 years) from the general population.</p><p><strong>Results: </strong>Of 1226 respondents, 214 were excluded as they were health-care professionals. The majority of the participants were unaware and unconcerned about VTE. They were more aware of other medical conditions such as hypertension. Immobility and old age were frequently recognized as risk factors for VTE. While less than half of the participants were aware that thrombosis is the cause of VTE, most participants correctly identified leg pain and tenderness as symptoms of deep venous thrombosis. The majority of the participants identified chest pain and breathlessness as symptoms of pulmonary embolism. However, leg paralysis and slow, shallow breathing were frequently identified as symptoms of VTE. The majority of subjects disagreed with the statement, \"having a blood clot is not considered a medical emergency.\" Awareness of VTE varied significantly with age.</p><p><strong>Conclusion: </strong>In Saudi Arabia, the public awareness of VTE is poor. To improve outcomes, public health initiatives must increase awareness, introduce preventive measures, encourage early diagnosis, and ensure compliance with treatment.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"15-22"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/95/ATM-18-15.PMC10034823.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of single-port laparoscopic retrograde gastric mobilization during McKeown esophagectomy for esophageal cancer.","authors":"Bo Liu,&nbsp;Xu Li,&nbsp;Min-Jie Yu,&nbsp;Jin-Bao Xie,&nbsp;Guo-Liang Liao,&nbsp;Ming-Lian Qiu","doi":"10.4103/atm.atm_205_22","DOIUrl":"10.4103/atm.atm_205_22","url":null,"abstract":"<p><strong>Background: </strong>As a novel alternative to the conventional minimally invasive esophagectomy (MIE) to treat esophageal cancer, single-port laparoscopic retrograde three-step gastric mobilization (SLRM) for esophageal reconstruction during MIE to treat esophageal cancer was attempted in our department. The aim of the present study was to explore the preliminary clinical outcomes and feasibility of this innovative surgery.</p><p><strong>Methods: </strong>From March 2020 to November 2021, patients undergoing SLRM combined with four-port thoracoscopic McKeown esophagectomy for their esophageal cancers were reviewed. Gastric mobilization with abdominal lymph node dissection was performed through SLRM. The clinical characteristics and short-term outcomes were analyzed retrospectively.</p><p><strong>Results: </strong>A total of 120 patients underwent R0 resection without conversion to open surgery. The mean times needed for the thoracic part, abdominal part, and total operation were 43 ± 6 min, 60 ± 18 min, and 230 ± 20 min, respectively. The numbers of mediastinal and abdominal lymph nodes harvested were 13.2 ± 2.7 and 10.2 ± 2.5, respectively. Postoperative pneumonia was encountered in 10 (8.3%) patients. Anastomotic leakage occurred in 3 (2.5%) cases. Temporary vocal cord paralysis was reported in 20 (16.6%) cases. The mean length of hospital stay was 8.5 ± 4.6 days.</p><p><strong>Conclusions: </strong>The SLRM is a technically feasible and safe treatment for patients with esophageal cancer. It can be considered an alternative method for patients, especially for the ones with obesity and gastric distension.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"39-44"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/ed/ATM-18-39.PMC10034825.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9191290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicodemographic characteristics and prognostic role of myasthenia gravis in thymoma: Experience from a Saudi population","authors":"Abdullah Al Shammari, Aida Saad, Lama Tareq Saif, Safy A. Othman, Mohammad J. Ghosheh, Ghadir M. Khdeir, Omniyah Alashgar, Mohammed A. Abu-Rayya, Mohamed Hussein Ahmed, Khaled AlKattan, Waleed Saleh","doi":"10.4103/atm.atm_61_23","DOIUrl":"https://doi.org/10.4103/atm.atm_61_23","url":null,"abstract":"Abstract: OBJECTIVES: The objectives of the study were to determine the clinicodemographic characteristics and the prognostic role of myasthenia gravis (MG) in thymoma. METHODS: The records of patients who underwent surgical resection of thymoma at King Faisal Specialist Hospital and Research Center in the past 23 years were reviewed. Seventy thymoma patients were finally included and were then categorized based on MG status into the MG group (39 patients) and the non-MG group (31 patients). Collected data included patients’ demographic characteristics, tumor characteristics, and postoperative clinical outcomes. All analyses were conducted using SPSS. The comparison between both groups was tested using the Student t -test and Chi-square test for continuous and categorical variables, respectively. A P = 0.05 or less indicated statistical significance. RESULTS: Patients’ age ranged from 11 to 76 years, and female predominance was observed (55.7%). Compared to the non-MG group, no difference in patients’ gender was observed ( P = 0.058); however, MG patients had a younger age (39.30 vs. 48.77, P = 0.0095). No difference was noted between both groups based on the World Health Organization classification ( P = 0.398), but MG patients tended to present with less-advanced tumors based on the TNM classification ( P = 0.039) and lower stage based on the MASAOKA staging system ( P = 0.017). No significant change in tumor size ( P = 0.077), resectability ( P = 0.507), and adjuvant therapy ( P = 0.075) were observed. MG was not significantly associated with postoperative complications, morbidity, or mortality. However, it exhibited a prognostic protective role in terms of lower recurrence (2.56% vs. 35.48%, P = 0.0001) and longer survival duration (18.62 vs. 10.21 years, P < 0.001) as compared to non-MG patients. CONCLUSIONS: MG occurrence in thymoma patients is more likely to occur at a younger age, higher TNM classification, and advanced MASAOKA stage. Although no significant association was noted between MG and complications and mortality, MG exhibited a protective role in thymoma by providing a lower recurrence rate and longer survival duration.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135009506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General rehabilitation for the Post-COVID-19 condition: A narrative review.","authors":"Dian Marta Sari,&nbsp;Laurentia Cindy Gani Wijaya","doi":"10.4103/atm.atm_286_22","DOIUrl":"10.4103/atm.atm_286_22","url":null,"abstract":"COVID-19 significantly impacts the acute phase or the period after being infected by severe acute respiratory syndrome coronavirus-2. Studies have shown it has affected multiorgan and needs continuous care by a multidisciplinary team. Nowadays, guidance is required to assist the recovery process of survivors who reported at least one symptom as a residual effect. This study aims to describe the rehabilitation management of post-COVID-19 conditions. As the number of survivors seems to be increasing, it is expected that COVID-19 survivors will recover through a holistic approach by all physicians. Comprehensive rehabilitation for long COVID or COVID-19-related illnesses includes exercising, nutrition, education, managing voice, breathlessness, neurocognitive problems, mental health, feeding problems, and daily activities. Specific recommendations have already been published to support rehabilitation for survivors in every targeted organ. Supportive care, especially rehabilitation programs, is recently an urgent knowledge in this pandemic.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"10-14"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/fe/ATM-18-10.PMC10034826.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pulmonary rehabilitation program reduces hospitalizations in chronic obstructive pulmonary disease patients: A cost-effectiveness study","authors":"Maria Elena Toubes-Navarro, Francisco Gude-Sampedro, José Manuel Álvarez-Dobaño, Francisco Reyes-Santias, Carlos Rábade-Castedo, Carlota Rodríguez-García, Óscar Lado-Baleato, Raquel Lago-Fidalgo, Noelia Sánchez-Martínez, Jorge Ricoy-Gabaldón, Ana Casal-Mouriño, Romina Abelleira-Paris, Vanessa Riveiro-Blanco, Carlos Zamarrón-Sanz, Nuria Rodríguez-Núñez, Adriana Lama-López, Lucía Ferreiro-Fernández, Luis Valdés-Cuadrado","doi":"10.4103/atm.atm_70_23","DOIUrl":"https://doi.org/10.4103/atm.atm_70_23","url":null,"abstract":"Abstract: BACKGROUND: Although pulmonary rehabilitation (PR) is recommended in patients with chronic obstructive pulmonary disease (COPD), there is a scarcity of data demonstrating the cost-effectiveness and effectiveness of PR in reducing exacerbations. METHODS: A quasi-experimental study in 200 patients with COPD was conducted to determine the number of exacerbations 1 year before and after their participation in a PR program. Quality of life was measured using the COPD assessment test and EuroQol-5D. The costs of the program and exacerbations were assessed the year before and after participation in the PR program. The incremental cost-effectiveness ratio (ICER) was estimated in terms of quality-adjusted life years (QALYs). RESULTS: The number of admissions, length of hospital stay, and admissions to the emergency department decreased after participation in the PR program by 48.2%, 46.6%, and 42.5%, respectively ( P < 0.001 for all). Results on quality of life tests improved significantly ( P < 0.001 for the two tests). The cost of PR per patient and the cost of pre-PR and post-PR exacerbations were €1867.7 and €7895.2 and €4201.9, respectively. The PR resulted in a cost saving of €1826 (total, €365,200) per patient/year, and the gain in QALYs was+0.107. ICER was −€17,056. The total cost was <€20,000/QALY in 78% of patients. CONCLUSIONS: PR contributes to reducing the number of exacerbations in patients with COPD, thereby slowing clinical deterioration. In addition, it is cost-effective in terms of QALYs.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nintedanib and pirfenidone for idiopathic pulmonary fibrosis in King Abdulaziz Medical City, Riyadh: Real-life data.","authors":"Mohammed Ayaz Khan,&nbsp;Nahed Sherbini,&nbsp;Sami Alyami,&nbsp;Abdullah Al-Harbi,&nbsp;Majed Al-Ghamdi,&nbsp;Suliman Alrajhi,&nbsp;Rajkumar Rajendram,&nbsp;Hamdan Al-Jahdali","doi":"10.4103/atm.atm_206_22","DOIUrl":"10.4103/atm.atm_206_22","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a chronic progressive age-related lung disease causing relentless fibrosis of the lung parenchyma. Currently, pirfenidone and nintedanib are the two antifibrotic drugs, approved for the treatment of IPF. Both are shown to slow progression by preserving lung functions from rapid decline compared to a placebo. We are reporting a real-life patient experience using these two antifibrotic medications (AFMs) in our tertiary care hospital.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted for all IPF cases diagnosed in multidisciplinary meetings between 2015 and 2020 at KAMC, Riyadh (Saudi Arabia). We are reporting patients' demographics, lung function, survival, tolerance, side effects, or death in patients taking AFMs.</p><p><strong>Results: </strong>A total of 81 cases were identified. The majority of patients aged 67 years (68%) were men with a median age of 68 years. Late presentation, severe disease, and definite usual interstitial pneumonia patterns were reported in 60% of our patients. The average number of hospital admissions before starting treatment was 1 (range: 0-3) in the nintedanib group and 1.4 (range: 1.2-5) in the pirfenidone group. There was an increase in the number of hospital admissions in the group started on pirfenidone 1.7 (range: 1.9-8) compared to nintedanib 0.5 (range: 0-3), <i>P</i> = 0.001. The observed mortality outcome in this cohort was 4 (11%) and 12 (27%) for nintedanib and pirfenidone, respectively. The predominant side effects were gastrointestinal symptoms for both the groups 18 (22%).</p><p><strong>Conclusions: </strong>Pirfenidone and nintedanib are the available approved antifibrotic agents used for many years to treat IPF patients. Real-life data showed better tolerability than reported in the West, good compliance, and a manageable side effect profile in this group of elderly and severe IPF patients.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"45-51"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/2f/ATM-18-45.PMC10034822.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}