Respiratory investigation最新文献

Background: This study evaluated work-functioning impairment (presenteeism) among Japanese workers with asthma or respiratory symptoms.

Methods: This cross-sectional study included 3038 workers who completed respiratory function tests, a routine interview questionnaire regarding disease history and symptoms, and an additional questionnaire, the Work-Functioning Impairment Scale (WFun), during health checkups. Workers were divided by presence of asthma, respiratory symptoms, or treatment. According to the WFun score, outcomes were classified into two groups: no work-functioning impairment (a score of ≦20) and work-functioning impairment (a score of ≧21). Logistic regression analysis was used to assess these associations.

Results: Compared to "workers without asthma or respiratory symptoms" (reference group), "workers with both asthma and respiratory symptoms" had significant work-functioning impairment (odds ratio [OR] = 3.91, 95% CI: 1.92-7.97) and use of sick leave after adjustment. "Workers with asthma but without respiratory symptoms" did not show a significant work-functioning impairment (OR = 1.39, 95% CI: 0.87-2.21). Within the asthma group, work-functioning impairment was significantly associated with "workers with both asthma and respiratory symptoms" compared to "workers with asthma but without respiratory symptoms" after adjustment (OR = 6.53, 95% CI: 2.12-20.14).

Conclusions: Asthma and respiratory symptoms were significantly associated with sick leave use. However, for work-functioning impairment, the presence of respiratory symptoms was significantly associated, whereas with asthma but without respiratory symptoms was not. Thus, our findings indicate that asthma alone does not lead to work-functioning impairment. Our findings suggest that therapeutic interventions should be strengthened.

Background: Patients with Coronavirus Disease 2019 (COVID-19) pneumonia often experienced reduced activities of daily living due to isolation-related inactivity and muscle deconditioning. This study aimed to assess the safety and feasibility of early pulmonary rehabilitation (PR) in isolated patients with COVID-19 pneumonia and to evaluate their functional status and health-related quality of life.

Methods: A bedside PR program-prioritizing early mobilization and ambulation, supplemented with calisthenic and device-based resistance exercises, chest mobilization, and breathing exercises-was delivered in isolation rooms. Assessments included the 1-min sit-to-stand test (1MSTST), COPD Assessment Test (CAT), and Hospital Anxiety and Depression Scale (HADS) at baseline and discharge.

Results: In this single-arm study, 23 hospitalized patients (mean age 61 ± 11 years, 78% male) completed the program with an adherence rate of 71%. No adverse events occurred. 1MSTST repetitions increased (median change 8.0 [3.0, 12.8]; p < 0.002), with increases in oxygen saturation nadir and peak heart rate (p = 0.012 and p < 0.001, respectively). Higher adherence was correlated with greater increase in 1MSTST (r = 0.626, p = 0.010), and lower baseline 1MSTST predicted larger gains (r = -0.662, p = 0.005). CAT total score and items related to cough, phlegm, and chest tightness decreased significantly, whereas HADS depression scores worsened at discharge.

Conclusions: Early bedside PR was safely and feasibly delivered to isolated patients with COVID-19 pneumonia. 1MSTST and CAT were useful tools for functional evaluation during the acute phase.

Trial registration: UMIN Clinical Trials Registry, UMIN000057259. Retrospectively registered on March 11, 2025.

Patients with hemoptysis refractory to conventional treatments and ineligible for surgical intervention often have a poor prognosis. We report a 74-year-old man with intractable hemoptysis deemed inoperable, successfully treated using a novel approach. Initial management included bronchial artery embolization and endobronchial occlusion with Endobronchial Watanabe Spigots (EWSs), which achieved temporary hemostasis. However, hemoptysis recurred following the dislodgement of spigots. Replacement EWSs were then stabilized using fibrin formed by the reaction between fibrinogen in the bloody sputum and endoscopically administered thrombin. To our knowledge, this is the first reported case demonstrating successful control of intractable hemoptysis using this approach.

Background: Airway stent placement is used to manage malignant airway obstruction, but often these patients cannot receive immune checkpoint inhibitors (ICIs) because of poor performance status (PS). We evaluated whether stenting could enable ICI therapy and improve outcomes.

Methods: We retrospectively reviewed patients with lung cancer who received anticancer therapy after airway stent placement from January 2016 to July 2025. Outcomes included 1-year overall survival (OS), median survival time (MST), ECOG PS changes, complications, immune-related adverse events, and stent removal.

Results: Eighteen patients were included (16 non-small cell lung cancer; 2 small cell lung cancer). Median age was 71 years, and 60% had poor PS. MST was 282 days (95% CI, 120-546). MST was longer in stage III than stage IV disease (502 vs 200 days; p = 0.03) and in patients with PS 1 versus 2 after stenting (398 vs 78.5 days; p = 0.007). ECOG PS improved in 13 patients, and oxygen was discontinued in 10. Immune-related adverse events occurred in 7 patients and stent-related complications in 9; stent removal was performed in 8 cases (41%). MST was longer with ICI-containing therapy than with chemotherapy and/or radiotherapy (282 vs 139 days; p = 0.002). Stent removal was more frequent in the ICI group (44.4% vs 13.0%; p = 0.03).

Conclusions: Airway stenting can improve PS, relieve obstruction, and permit safe ICI therapy. Subsequent ICI use may extend survival and increase stent removal rates, supporting stenting as a bridging approach in oncologic airway emergencies.

Background: Although Krebs von den Lungen-6 (KL-6) and surfactant protein D (SP-D) are established as serum biomarkers for interstitial lung disease (ILD), these are rarely measured in bronchoalveolar lavage fluid (BALF). It remains unclear how the biomarker levels in BALF are associated with the presence of pulmonary fibrosis.

Methods: We retrospectively analyzed the data of ILD patients who were measured KL-6 and SP-D in both serum and BALF at our institute from 2021 to 2024. Patients were classified into fibrotic and non-fibrotic groups, which were determined in accordance with radiological and/or histopathological findings, and the levels and BALF/serum ratios of KL-6 and SP-D were compared.

Results: Of the 87 eligible participants, 51 were classified into the fibrotic group. The levels of KL-6 and SP-D in BALF and BALF/serum ratios for both markers were significantly lower in the fibrotic group than in the non-fibrotic group (KL-6: p = 0.012; SP-D: p = 0.001; KL-6 ratio: p = 0.004; SP-D ratio: p = 0.006). Among 26 patients without fibrotic findings on HRCT, histopathological fibrosis was identified in 13, whereas 13 showed no fibrosis. KL-6 levels in BALF (p = 0.043) and the BALF/serum ratio of KL-6 (p = 0.039) were significantly lower in the former group than in the latter.

Conclusions: BALF levels and BALF/serum ratios of KL-6 and SP-D may be negatively correlated with the presence of fibrosis. Even when fibrosis is not evident on HRCT, measurement of these biomarkers in BALF appears to be predictive of fibrosis.