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1.
J Clin Med ; 13(13)2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38999475

RESUMEN

Objective: The objective of this paper is to reconsider the significance of preoperative chest radiography (CXR) before ophthalmic surgery through investigation of imaging findings and usage status. Methods: This retrospective observational clinical study involved 1616 patients who underwent ophthalmic surgery at Saga University Hospital from 1 January 2019 to 31 December 2020. The patients' radiology reports were obtained from the electronic medical records, and their CXR findings, therapeutic interventions, and progress were investigated. Results: Among all patients, 539 (33.4%) had abnormal preoperative CXR findings. Of these patients, 74 (4.6%) had newly identified abnormal findings. In both patient groups, approximately 70% of patients with abnormal findings were aged ≥70 years, and interstitial shadows were the most common finding. Among all patients with abnormal findings, three (0.19%) received preoperative therapeutic interventions, and all surgeries were performed safely. Forty-three patients with abnormal findings were referred to our hospital or other hospitals for further investigation and treatment postoperatively. Among those patients, eight (0.5%) had primary lung cancer, seven underwent surgery, and one received chemoradiation. The other patients were also followed up and received appropriate therapeutic interventions. Conclusions: Before ophthalmic surgery, few patients required actual therapeutic interventions based on their CXR results. However, many abnormal findings were revealed in elderly patients, including some serious diseases. Furthermore, research has suggested that appropriate therapeutic intervention after ophthalmologic surgery may reduce the risk of a poor life prognosis. This study clearly shows that preoperative CXR is not only useful for perioperative systemic management but also ultimately benefits patients. It is also considered particularly meaningful for patients aged ≥70 years.

2.
Arerugi ; 73(4): 329-339, 2024.
Artículo en Japonés | MEDLINE | ID: mdl-38880632

RESUMEN

BACKGROUND: In the enhancement of allergy care involving multidisciplinary and multiple medical departments, there is a perceived need for education that targets not only specialists but also non-specialists. However, research on the need for and methods of such education remains inadequate. OBJECTIVE: To design a remote allergy care education program for all medical practitioners and to validate its necessity and utility. METHODS: The Empowering Next Generation Allergist/immunologist toward Global Excellence Task Force (ENGAGE-TF), supported by the Japanese Society of Allergology, initiated a virtual educational program called 'Outreach Lectures' in collaboration with Keio University and Fukui University. This initiative was widely promoted through social media and various institutions, and a survey was conducted through its mailing list. RESULTS: 1139 responses were obtained. More than half were physicians from non-allergy specialties, representing a diverse range of healthcare professions. Over 70% expressed being 'very satisfied,' and over 60% found the difficulty level 'appropriate.' Free-form feedback revealed differences in learning focus based on profession and learning approach based on years of experience. CONCLUSION: The high participation rate (90%) of non-specialist physicians underscores the demand for addressing allergic conditions in primary care. The effectiveness of virtual / recurrent education, particularly for healthcare professionals with over 11 years of experience, was implied. Further follow-up investigation focusing on quantitative and objective assessment of educational effectiveness is indispensable.


Asunto(s)
Alergia e Inmunología , Hipersensibilidad , Encuestas y Cuestionarios , Humanos , Alergia e Inmunología/educación , Educación a Distancia
3.
Arerugi ; 73(1): 40-51, 2024.
Artículo en Japonés | MEDLINE | ID: mdl-38403700

RESUMEN

BACKGROUND AND AIMS: Bronchial thermoplasty (BT) is a bronchoscopic treatment for adult patients with moderate to severe asthma. A systematic review was conducted to examine the efficacy of this treatment. METHODS: Randomized controlled comparing BT to a control in adult patients with moderate to severe asthma were added to the previously conducted systematic review. Literature published prior to July 2022 was selected. RESULTS: Four trials were included in this study. BT resulted in significant improvement in quality of life. However, no significant difference in asthma control was observed. Moreover, the incidence of severe adverse events during the treatment period was increased by BT. Furthermore, BT did not improve lung function, increase withdrawal from oral corticosteroids, reduce frequency of rescue medication usage, or increase the number of symptom-free days. CONCLUSION: From a risk-benefit perspective, there is insufficient evidence to support a recommendation of BT in adult patients with moderate to severe asthma.


Asunto(s)
Asma , Termoplastia Bronquial , Adulto , Humanos , Calidad de Vida , Asma/cirugía , Asma/tratamiento farmacológico , Corticoesteroides/uso terapéutico
4.
Allergol Int ; 73(1): 48-57, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37659887

RESUMEN

Obesity is one of the factors associated with the severity of asthma. Obesity is associated with aggravation of the pathophysiology of asthma, including exacerbations, airway inflammation, decreased pulmonary function, and airway hyperresponsiveness. The present review addresses the characteristics of asthma with obesity, focusing especially on the heterogeneity caused by the degree of type 2 inflammation, sex differences, the onset of asthma, and race differences. To understand the severity mechanisms in asthma and obesity, such as corticosteroid resistance, fatty acids, gut microbiome, and cytokines, several basic research studies are evaluated. Finally, possible future therapies, including weight reduction, microbiome-targeted therapies, and other molecular targeted therapies are addressed. We believe that the present review will contribute to better understanding of the severity mechanisms and the establishment of novel treatments for severe asthma patients with obesity.


Asunto(s)
Asma , Hipersensibilidad Respiratoria , Humanos , Femenino , Masculino , Asma/epidemiología , Asma/terapia , Asma/etiología , Obesidad/complicaciones , Citocinas , Inflamación
5.
Allergol Int ; 73(2): 313-322, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38145912

RESUMEN

BACKGROUND: Ozone is one of the triggers of asthma, but its impact on the pathophysiology of asthma, such as via airway inflammation and airway hyperresponsiveness (AHR), is not fully understood. Thymic stromal lymphopoietin (TSLP) is increasingly seen as a crucial molecule associated with asthma severity, such as corticosteroid resistance. METHODS: Female BALB/c mice sensitized and challenged with house dust mite (HDM) were exposed to ozone at 2 ppm for 3 h. Airway inflammation was assessed by the presence of inflammatory cells in bronchoalveolar lavage fluid and concentrations of cytokines including TSLP in lung. Anti-TSLP antibody was administered to mice to block the signal. Survival and adhesion of bone marrow-derived eosinophils in response to granulocyte colony-stimulating factor (G-CSF) were evaluated. RESULTS: Ozone exposure increased eosinophilic airway inflammation and AHR in mice sensitized and challenged with HDM. In addition, TSLP, but not IL-33 and IL-25, was increased in lung by ozone exposure. To confirm whether TSLP signaling is associated with airway responses to ozone, an anti-TSLP antibody was administered, and it significantly attenuated eosinophilic airway inflammation, but not AHR. Interestingly, G-CSF, but not type 2 cytokines such as IL-4, IL-5, and IL-13, was regulated by TSLP signaling associated with eosinophilic airway inflammation, and G-CSF prolonged survival and activated eosinophil adhesion. CONCLUSIONS: The present data show that TSLP contributes to ozone-induced exacerbations of eosinophilic airway inflammation and provide greater understanding of ozone-induced severity mechanisms in the pathophysiology of asthma related to TSLP and G-CSF.


Asunto(s)
Asma , Linfopoyetina del Estroma Tímico , Animales , Femenino , Ratones , Citocinas , Factor Estimulante de Colonias de Granulocitos , Inflamación , Ratones Endogámicos BALB C
6.
J Clin Med ; 12(22)2023 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-38002712

RESUMEN

Periostin was investigated as a biomarker for rheumatoid arthritis-associated interstitial lung disease (RA-ILD). This prospective study measured serum monomeric and total periostin, Klebs von den Lungen-6 (KL-6), surfactant protein D (SP-D), and lactate dehydrogenase (LDH) in 19 patients with RA-ILD, 20 RA without ILD, and 137 healthy controls (HC). All biomarkers were higher in RA-ILD than HC or RA without ILD. KL-6 accurately detected ILD in RA patients (area under curve [AUC] = 0.939) and moderately detected SP-D and monomeric and total periostin (AUC = 0.803, =0.767, =0.767, respectively). Monomeric and total periostin were negatively correlated with normal lung area and positively correlated with honeycombing, reticulation, fibrosis score, and the traction bronchiectasis grade but not inflammatory areas. Serum levels of SP-D, KL-6, and LDH did not correlate with the extent of those fibrotic areas on high-resolution CT. Serum monomeric and total periostin were higher in patients with RA-ILD with definite usual interstitial pneumonia pattern compared with other ILD patterns. Immunohistochemical analyses of biopsy or autopsy lung tissues from RA-ILD during the chronic phase and acute exacerbation showed that periostin was expressed in fibroblastic foci but not inflammatory or dense fibrosis lesions. Periostin is a potential biomarker for diagnosis, evaluating fibrosis, and deciding therapeutic strategies for patients with RA-ILD.

7.
Respir Investig ; 61(6): 698-701, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37708635

RESUMEN

A patient with sarcoidosis was found to have a massive left pleural effusion. Her chest computed tomography showed small nodules in the lung parenchyma and swelling of the hilar lymph nodes, with normal visceral and parietal pleura. Thoracoscopy showed white nodules on the visceral pleura and normal parietal pleura, which were resected. Epithelioid granulomas were seen in the visceral pleura and lung parenchyma. Surprisingly, in the parietal pleura, abnormal cells that were positive for the leukocyte common antigen, CD20, and CD79a were found, leading to the diagnosis of malignant B-cell lymphoma.


Asunto(s)
Linfoma , Derrame Pleural , Neoplasias Pleurales , Sarcoidosis , Femenino , Humanos , Pleura/diagnóstico por imagen , Neoplasias Pleurales/complicaciones , Neoplasias Pleurales/diagnóstico por imagen , Sarcoidosis/complicaciones , Sarcoidosis/diagnóstico por imagen , Linfoma/patología
8.
Chest ; 163(6): e286, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37295890
9.
BMJ Open Respir Res ; 10(1)2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37197795

RESUMEN

INTRODUCTION: Bronchodilators, including long-acting muscarinic antagonists (LAMA) and long-acting beta 2 agonists (LABA), are the main treatments for chronic obstructive pulmonary disease (COPD). The efficacy of triple therapy (inhaled corticosteroids/LAMA/LABA) has also been reported. However, the effect of triple therapy on patients with mild-to-moderate COPD has not yet been clarified. This study aims to investigate the safety and efficacy of triple therapy, compared with LAMA/LABA combination therapy, for lung function and health-related quality of life in patients with mild-to-moderate COPD and identify baseline characteristics and biomarkers to predict responders and non-responders to triple therapy. METHODS AND ANALYSIS: This is a multicentre, prospective, open-label, randomised, parallel-group study. Mild-to-moderate patients with COPD will be randomised to receive fluticasone furoate/umeclidinium/vilanterol or umeclidinium/vilanterol for 24 weeks. A total of 668 patients will be enrolled from March 2022 to September 2023 from 38 sites in Japan. The primary endpoint is the change in the trough forced expiration volume in 1 s after 12 weeks of treatment. Secondary endpoints are responder rates based on the COPD assessment test score and the St. George's Respiratory Questionnaire total score after 24 weeks of treatment. The safety endpoint is the occurrence of any adverse events. We will also investigate safety in terms of changes in microbial colonisation in sputum and antimycobacterium avium complex antibodies. ETHICS AND DISSEMINATION: The study protocol and informed consent documents were approved by the Saga University Clinical Research Review Board (approval number: CRB7180010). Written informed consent will be obtained from all patients. Recruitment of the patients began in March 2022. The results will be disseminated through scientific peer-reviewed publications and domestic and international medical conferences. TRIAL REGISTRATION NUMBERS: UMIN000046812 and jRCTs031190008.


Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica , Calidad de Vida , Humanos , Estudios Prospectivos , Administración por Inhalación , Nebulizadores y Vaporizadores , Antagonistas Muscarínicos/efectos adversos , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Multicéntricos como Asunto
10.
J Clin Med ; 12(4)2023 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-36836165

RESUMEN

Recently, physical activity has increasingly become the focus in patients with chronic obstructive airway disease (COPD) because it is a strong predictor of COPD-related mortality. In addition, sedentary behavior, which is included as a category of physical inactivity including such behaviors as sitting or lying down, has an independent clinical impact on COPD patients. The present review examines clinical data related to physical activity, focusing on the definition, associated factors, beneficial effects, and biological mechanisms in patients with COPD and with respect to human health regardless of COPD. The data related to how sedentary behavior is associated with human health and COPD outcomes are also examined. Lastly, possible interventions to improve physical activity or sedentary behavior, such as bronchodilators and pulmonary rehabilitation with behavior modification, to ameliorate the pathophysiology of COPD patients are described. A better understanding of the clinical impact of physical activity or sedentary behavior may lead to the planning of a future intervention study to establish high-level evidence.

11.
Artículo en Inglés | MEDLINE | ID: mdl-36767227

RESUMEN

INTRODUCTION: Obesity is associated with severe asthma, but no specific treatment has been established. The gut microbiome is increasingly recognized as a crucial factor, but specific treatments focused on the gut microbiome have not been established. Recently, azithromycin has been found to have the capacity to attenuate exacerbations, a characteristic of severe asthma. The effect of azithromycin on obesity-induced severe asthma is not understood. METHODS: The purpose of the present study is to clarify the effect of azithromycin on exacerbations in asthmatic patients with obesity. To explore the mechanism, the gut microbiome, metabolites of microbes such as short-chain fatty acids, and blood inflammatory cytokines will be analyzed to evaluate the correlation with the effect of azithromycin on exacerbations in obesity-induced severe asthma. A multi-center, prospective, single-arm intervention study is planned. DISCUSSION: The present study will allow us to evaluate the effect of azithromycin on exacerbations, particularly in asthma patients with obesity, and explore biomarkers, targeting molecules including the gut microbiome, which are correlated with decreased exacerbations. The present results could contribute to identifying new therapeutic prospects and targeted microbes or molecules associated with severe clinical characteristics in asthmatic patients with obesity. TRIAL REGISTRATION: This study has been registered as a prospective study with the University Hospital Medical Information Network (UMIN0000484389) and the Japan Registry of Clinical Trials (jRCTs071220023).


Asunto(s)
Asma , Azitromicina , Humanos , Azitromicina/uso terapéutico , Estudios Prospectivos , Método Doble Ciego , Asma/tratamiento farmacológico , Obesidad/complicaciones , Obesidad/tratamiento farmacológico , Antibacterianos/uso terapéutico , Estudios Multicéntricos como Asunto
12.
Chest ; 163(1): e7-e11, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36628691

RESUMEN

CASE PRESENTATION: A 45-year-old Japanese woman was diagnosed with anemia in a work place medical check-up and came to our hospital for further investigations. She had experienced general fatigue and orthostatic dizziness for 6 months without fever or respiratory symptoms, including cough, sputum, hemoptysis, or dyspnea. She had undergone annual medical check-ups previously, which had shown no abnormalities, including anemia. She had no history of weight loss, epimenorrhagia, hematuria, or melena. She had no significant positive medical history and was not on any regular medication or supplements. She had no history of alcohol abuse or smoking.


Asunto(s)
Anemia Ferropénica , Femenino , Humanos , Persona de Mediana Edad , Anemia Ferropénica/diagnóstico , Anemia Ferropénica/etiología , Hemoptisis , Disnea/diagnóstico , Disnea/etiología , Tos , Esputo , Diagnóstico Diferencial
13.
Thorac Cancer ; 13(24): 3459-3466, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36263938

RESUMEN

BACKGROUND: Transbronchial biopsy (TBB) with endobronchial ultrasonography and a guide sheath (EBUS-GS) is an effective examination tool for the diagnosis of lung cancer. Factors related to making the diagnosis are still not fully understood. METHODS: A total of 367 patients who underwent EBUS-GS and were diagnosed with lung cancer in Saga University Hospital were investigated retrospectively. Clinical characteristics were compared between 244 patients who were diagnosed with lung cancer and 123 patients who were not diagnosed by TBB with EBUS-GS but were diagnosed by other examinations. RESULTS: Size of target lesion, rate of patients with target lesion size ≥20 mm, presence of the bronchus sign, and detection by EBUS imaging were significantly associated with making the diagnosis (all p < 0.01). In patients whose lesion was detected by EBUS imaging, patients with positive findings within the lesion were significantly more often diagnosed by TBB with EBUS-GS than those with positive findings adjacent to the lesion (p < 0.01). The odds ratio (OR) of patients whose lesion was detected by EBUS imaging (OR [95% confidence interval] 14.5 [8.0-26.4]) tended to be higher compared to the ORs of size of lesion ≥20 mm (3.9 [2.2-6.8]) and the bronchus sign (7.5 [4.6-12.2]). CONCLUSION: Targeted lesion diameter ≥20 mm, bronchus sign, and detection by EBUS imaging, especially within the lesion, are important factors for the diagnosis of lung cancer by TBB with EBUS-GS.


Asunto(s)
Broncoscopía , Neoplasias Pulmonares , Humanos , Broncoscopía/métodos , Estudios Retrospectivos , Endosonografía/métodos , Biopsia/métodos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/patología
15.
Sci Rep ; 12(1): 16457, 2022 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-36180514

RESUMEN

Obesity is associated with the severity of asthma, which is characterized by airway obstruction. Pulmonary function testing is one of the important examinations for evaluating airway obstruction. However, the impact of obesity on pulmonary function in patients with asthma is not fully understood. A total of 193 patients with asthma and 2159 patients without asthma who visited Saga University Hospital were investigated retrospectively. Obesity was defined as a body mass index (BMI) greater than 25 kg/m2. Pulmonary functions including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were compared between patients with and without asthma, focusing especially on obesity. FVC percent predicted and FEV1 percent predicted were significantly lower in patients with asthma than in those without asthma (p = 0.03, < 0.01 respectively). In patients with asthma, FVC percent predicted and FEV1 percent predicted were significantly lower in patients with obesity than in those without obesity (all p < 0.01). In addition, BMI was negatively correlated with FEV1 (r =- 0.21, p = 0.003) and FVC (r = - 0.15, p = 0.04), along with the percent predicted. On multivariate analysis in patients with asthma, FVC (ß [95% confidence interval] 0.12 [0.02-0.22], p = 0.02) and FEV1 (0.13 [0.05-0.22], p < 0.01) were still significantly different between patients with and without obesity. However, these obesity-associated differences were not observed in patients without asthma. Obesity reduces pulmonary function, including FVC and FEV1, in patients with asthma, but not in those without asthma.


Asunto(s)
Obstrucción de las Vías Aéreas , Asma , Adulto , Asma/complicaciones , Volumen Espiratorio Forzado , Humanos , Japón/epidemiología , Obesidad/complicaciones , Estudios Retrospectivos , Capacidad Vital
16.
J Asthma Allergy ; 15: 169-177, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35177908

RESUMEN

PURPOSE: Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare, chronic respiratory disease. Corticosteroid therapy is effective for ICEP, but relapse is frequent after its tapering, which leads to chronic use and corticosteroid-related adverse effects. Currently, biological agents targeting interleukin 5 (IL-5) are considered alternatives for treating ICEP patients with frequent relapse, but the detailed effects are not fully understood. PATIENTS AND METHODS: The clinical characteristics of 30 patients with ICEP, especially 12 patients with ICEP who experienced relapse after corticosteroid dose tapering, were evaluated retrospectively. In addition, 4 ICEP patients with frequent relapse treated by IL-5-targeted biological agents were reviewed. RESULTS: Of the 30 patients diagnosed with ICEP, 12 patients (40.0%) recurred after corticosteroid dose tapering, and 9 (30.0%) were treated with maintenance doses of corticosteroid. Of ICEP patients who experienced recurrence, 6 (50.0%) had frequent relapses (2 or more times). All 4 patients treated with anti-IL-5 agents had their corticosteroid dose reduced without any relapses; in 3 patients, corticosteroids were withdrawn. CONCLUSION: Anti-IL-5 agents might be alternatives for treating ICEP patients with frequent relapses.

17.
Int J Chron Obstruct Pulmon Dis ; 16: 3297-3307, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34908832

RESUMEN

BACKGROUND: Prolonged sedentary behavior is associated with worse prognosis in patients with chronic obstructive pulmonary disease (COPD). Our previous study found that first-line dual therapy with tiotropium/olodaterol significantly reduces sedentary time compared to tiotropium monotherapy in Japanese patients with treatment-naïve COPD, although the characteristics of responders to dual-therapy versus monotherapy for COPD are still unclear. METHODS: Patients with treatment-naïve COPD were randomized to receive either tiotropium or tiotropium/olodaterol treatment for 12 weeks. Physical activity was assessed using a triaxle accelerometer for 2 weeks before and after treatment. This analysis focused on the change in sedentary time, indicated by physical activity of 1.0-1.5 metabolic equivalents (METs), with stratification for the following factors: age, body mass index (BMI), pulmonary function, COPD assessment test (CAT), the 6-minute walk distance (6MWD), and physical activity level at study entry. RESULTS: Thirty-five patients received tiotropium/olodaterol and 34 patients received tiotropium. In patients with lower inspiratory capacity at study entry, a significant reduction in sedentary time was observed in the tiotropium/olodaterol group compared with the tiotropium group (Tio: -12.8 ± 13.5 min, Tio/Olo: -65.1 ± 21.0 min, mean difference, -52.2 min, 95% CI -103.6 to 0.88, p = 0.046). In patients with a shorter duration of physical activity of ≥2 METs at study entry, a significant reduction of sedentary time was observed in the tiotropium/olodaterol group compared with the tiotropium group (Tio: -3.3 ± 17.5 min, Tio/Olo: -72.9 ± 23.1 min, mean difference, -69.7 min, 95% CI -128.7 to -10.6, p = 0.02). There were no differences in terms of age, BMI, CAT score, 6MWD, FEV1, FVC, VC, and physical activity of 1.0-1.5 METs and ≥3.0 METs. CONCLUSION: This study showed that COPD patients with lower inspiratory capacity or shorter active time of ≥2.0 METs at study entry are likely to exhibit significantly greater reduction in sedentary time with tiotropium/olodaterol treatment.


Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica , Conducta Sedentaria , Administración por Inhalación , Agonistas de Receptores Adrenérgicos beta 2/uso terapéutico , Benzoxazinas/efectos adversos , Broncodilatadores/efectos adversos , Combinación de Medicamentos , Volumen Espiratorio Forzado , Humanos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Bromuro de Tiotropio/efectos adversos , Resultado del Tratamiento
19.
Sci Rep ; 11(1): 15862, 2021 08 05.
Artículo en Inglés | MEDLINE | ID: mdl-34354171

RESUMEN

Decreasing exercise tolerance is one of the key features related to a poor prognosis in patients with chronic obstructive pulmonary disease (COPD). Cardiopulmonary exercise testing (CPET) is useful for evaluating exercise tolerance. The present study was performed to clarify the correlation between exercise tolerance and clinical parameters, focusing especially on the cross-sectional area (CSA) of skeletal muscle. The present study investigated 69 patients with COPD who underwent CPET. The correlations between oxygen uptake ([Formula: see text]) at peak exercise and clinical parameters of COPD, including skeletal muscle area measured using single-section axial computed tomography (CT), were evaluated. The COPD assessment test score (ρ = - 0.35, p = 0.02) was weakly correlated with [Formula: see text] at peak exercise. In addition, forced expiratory volume in one second (FEV1) (ρ = 0.39, p = 0.0009), FEV1/forced vital capacity (ρ = 0.33, p = 0.006), and the CSA of the pectoralis muscles (PMs) (ρ = 0.36, p = 0.007) and erector spinae muscles (ECMs) (ρ = 0.39, p = 0.003) were correlated with [Formula: see text] at peak exercise. Multivariate analysis adjusted by age and FEV1 indicated that PMCSA was weakly correlated after adjustment (ß value [95% confidence interval] 0.175 [0.03-0.319], p = 0.02). In addition, ECMCSA tended to be correlated, but not significantly after adjustment (0.192 [- 0.001-0.385] p = 0.052). The COPD assessment test, FEV1, FEV1/FVC, PMCSA, and ECMCSA were significantly correlated with [Formula: see text] at peak exercise.


Asunto(s)
Tolerancia al Ejercicio/fisiología , Músculo Esquelético/patología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Anciano , Anciano de 80 o más Años , Prueba de Esfuerzo/métodos , Femenino , Volumen Espiratorio Forzado/fisiología , Humanos , Japón , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Oxígeno/metabolismo , Consumo de Oxígeno/fisiología , Músculos Pectorales/patología , Ventilación Pulmonar/fisiología , Respiración , Pruebas de Función Respiratoria , Índice de Severidad de la Enfermedad , Capacidad Vital/fisiología
20.
Respir Med Case Rep ; 33: 101430, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34401274

RESUMEN

A 37-year-old man with fever, cough, and dyspnea with no medical history developed an eosinophilic pleural effusion and blood eosinophilia. No evidence of malignancy or pathogens was detected in the pleural effusion, and the pleural specimen obtained by thoracoscopy showed eosinophilic infiltration with inflammatory granulation tissue without fibrinoid necrosis or malignant cells. Since a myeloproliferative disorder was also excluded, the diagnosis was idiopathic eosinophilic pleurisy. Corticosteroid treatment was started and then slowly tapered, and the eosinophilic pleural effusion resolved. Considering the various etiologies of eosinophilic pleurisy, a practical clinical approach to the investigation and diagnosis of eosinophilic pleurisy is presented.

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