Chronic obstructive pulmonary disease (COPD), a major global health burden linked to smoking, is frequently underdiagnosed due to low awareness and delayed symptom recognition. This study explored the feasibility of non-invasive voice and cough sound analysis for COPD identification.
Methods
In this prospective study, 55 participants (26 with COPD, 29 without) underwent pulmonary function testing and provided sociodemographic and clinical data. Speech and cough sounds were recorded three times per participant and processed using acoustic feature extraction, feature selection via the minimum redundancy maximum relevance algorithm, and logistic regression classification. Model performance was evaluated using four-fold cross-validation. Statistical analysis was conducted with JMP software (p < 0.05).
Results
The vowel sound/u/showed statistically significant discriminatory ability in the mixed-gender cohort, but sensitivity and specificity were both below 80 %, indicating limited diagnostic performance. When restricted to male participants, both metrics exceeded 80 %, suggesting higher discriminatory power. Smartphone recordings yielded comparable accuracy to integrated circuit recorders. Adding COPD assessment test scores and smoking history did not improve classification.
Conclusions
Voice analysis may offer a non-invasive screening approach for COPD. However, this study was limited to male participants and a single disease target, restricting generalizability. Future research will expand to include related respiratory conditions such as bronchiectasis and assess performance across sexes and disease types.
{"title":"Identification of individuals with COPD using biometric voice and cough sound features","authors":"Yasushi Obase , Susumu Fukahori , Jun Iriki , Takahiro Takazono , Yusei Tsukamoto , Shinnosuke Takemoto , Noriho Sakamoto , Yusuke Hamanaka , Hideaki Watanabe , Kazumi Hirano , Chizu Fukushima , Tomoya Nishino , Hiroshi Mukae","doi":"10.1016/j.resinv.2025.101353","DOIUrl":"10.1016/j.resinv.2025.101353","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD), a major global health burden linked to smoking, is frequently underdiagnosed due to low awareness and delayed symptom recognition. This study explored the feasibility of non-invasive voice and cough sound analysis for COPD identification.</div></div><div><h3>Methods</h3><div>In this prospective study, 55 participants (26 with COPD, 29 without) underwent pulmonary function testing and provided sociodemographic and clinical data. Speech and cough sounds were recorded three times per participant and processed using acoustic feature extraction, feature selection via the minimum redundancy maximum relevance algorithm, and logistic regression classification. Model performance was evaluated using four-fold cross-validation. Statistical analysis was conducted with JMP software (p < 0.05).</div></div><div><h3>Results</h3><div>The vowel sound/u/showed statistically significant discriminatory ability in the mixed-gender cohort, but sensitivity and specificity were both below 80 %, indicating limited diagnostic performance. When restricted to male participants, both metrics exceeded 80 %, suggesting higher discriminatory power. Smartphone recordings yielded comparable accuracy to integrated circuit recorders. Adding COPD assessment test scores and smoking history did not improve classification.</div></div><div><h3>Conclusions</h3><div>Voice analysis may offer a non-invasive screening approach for COPD. However, this study was limited to male participants and a single disease target, restricting generalizability. Future research will expand to include related respiratory conditions such as bronchiectasis and assess performance across sexes and disease types.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101353"},"PeriodicalIF":2.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736906","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}
High-intensity inspiratory muscle training (IMT) has been reported to increase diaphragm thickness in healthy adults, but evidence in severe chronic obstructive pulmonary disease (COPD) remains scarce. This prospective pilot study evaluated the effects of high-intensity IMT on diaphragm thickness and functional outcomes in nine patients with severe COPD who had completed standard respiratory rehabilitation. Participants performed 30 breaths per day at 60 % of maximum inspiratory pressure for 12 weeks. Diaphragm thickness at maximum inspiration increased from 4.7 to 5.6 mm, maximum inspiratory pressure from 57.1 to 68.1 cmH2O, 6-min walk distance from 318 to 366 m, and COPD Assessment Test scores from 19 to 12, both exceeding the minimal clinically important difference thresholds (all p < 0.01). These findings suggest that high-intensity IMT may be a feasible and beneficial adjunct for improving inspiratory function and symptoms in patients with severe COPD.
{"title":"High-intensity inspiratory muscle training and diaphragm thickness in severe COPD: a prospective pilot study","authors":"Daisuke Minamishima , Yuko Asato , Kazuhiro Tsuji , Rin Anamizu , Nami Hasegawa , Daisuke Shiihara","doi":"10.1016/j.resinv.2025.101348","DOIUrl":"10.1016/j.resinv.2025.101348","url":null,"abstract":"<div><div>High-intensity inspiratory muscle training (IMT) has been reported to increase diaphragm thickness in healthy adults, but evidence in severe chronic obstructive pulmonary disease (COPD) remains scarce. This prospective pilot study evaluated the effects of high-intensity IMT on diaphragm thickness and functional outcomes in nine patients with severe COPD who had completed standard respiratory rehabilitation. Participants performed 30 breaths per day at 60 % of maximum inspiratory pressure for 12 weeks. Diaphragm thickness at maximum inspiration increased from 4.7 to 5.6 mm, maximum inspiratory pressure from 57.1 to 68.1 cmH<sub>2</sub>O, 6-min walk distance from 318 to 366 m, and COPD Assessment Test scores from 19 to 12, both exceeding the minimal clinically important difference thresholds (all p < 0.01). These findings suggest that high-intensity IMT may be a feasible and beneficial adjunct for improving inspiratory function and symptoms in patients with severe COPD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101348"},"PeriodicalIF":2.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736909","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}
Bendopnea is a recognized symptom in patients with systolic heart failure; however, its clinical relevance in those with chronic obstructive pulmonary disease (COPD) has not been fully elucidated. This study aimed to evaluate the potential impact of bendopnea on the coexistence of comorbid pulmonary hypertension (PH), various metrics of health-related quality of life (HRQoL), chest CT findings, and respiratory function in a cohort of patients with COPD.
Methods
This retrospective study analyzed the medical records of 133 patients with COPD at Shinshu University Hospital (Matsumoto, Japan). Bendopnea was defined as a positive response to a bendopnea-related question based on the corresponding item in the St. George's Respiratory Questionnaire (SGRQ). Pulmonary artery and descending aorta diameters were measured on CT scans. To assess emphysema severity, the percentage of low-attenuation volume (LAV%) was calculated from the same CT scans using specialized image analysis software. Respiratory impedance was evaluated using oscillometry. Indicators of PH, emphysema severity, HRQoL, and pulmonary function were compared between patients who reported bendopnea and those who did not.
Results
Compared to those without bendopnea, patients with the symptom had a significantly higher pulmonary artery-to-descending aorta diameter ratio and LAV%, as well as markedly poorer HRQoL. Regarding oscillometry parameters, reactance at 5 Hz (X5) was significantly decreased in the bendopnea group, while elevated resonant frequency (Fres) and area under the low-frequency reactance curve (ALX) values were also observed.
Conclusions
Bendopnea may serve as a clinical indicator of a more advanced disease state in COPD.
{"title":"Impact of bendopnea on indicators of pulmonary hypertension, health-related quality of life, and pulmonary function in patients with chronic obstructive pulmonary disease","authors":"Toshitaka Shomura , Yosuke Wada , Norihiko Goto , Yusuke Suzuki , Yoshiaki Kitaguchi , Atsuhito Ushiki , Taku Osawa , Masanori Yasuo , Masayuki Hanaoka","doi":"10.1016/j.resinv.2025.101346","DOIUrl":"10.1016/j.resinv.2025.101346","url":null,"abstract":"<div><h3>Background</h3><div>Bendopnea is a recognized symptom in patients with systolic heart failure; however, its clinical relevance in those with chronic obstructive pulmonary disease (COPD) has not been fully elucidated. This study aimed to evaluate the potential impact of bendopnea on the coexistence of comorbid pulmonary hypertension (PH), various metrics of health-related quality of life (HRQoL), chest CT findings, and respiratory function in a cohort of patients with COPD.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed the medical records of 133 patients with COPD at Shinshu University Hospital (Matsumoto, Japan). Bendopnea was defined as a positive response to a bendopnea-related question based on the corresponding item in the St. George's Respiratory Questionnaire (SGRQ). Pulmonary artery and descending aorta diameters were measured on CT scans. To assess emphysema severity, the percentage of low-attenuation volume (LAV%) was calculated from the same CT scans using specialized image analysis software. Respiratory impedance was evaluated using oscillometry. Indicators of PH, emphysema severity, HRQoL, and pulmonary function were compared between patients who reported bendopnea and those who did not.</div></div><div><h3>Results</h3><div>Compared to those without bendopnea, patients with the symptom had a significantly higher pulmonary artery-to-descending aorta diameter ratio and LAV%, as well as markedly poorer HRQoL. Regarding oscillometry parameters, reactance at 5 Hz (X5) was significantly decreased in the bendopnea group, while elevated resonant frequency (Fres) and area under the low-frequency reactance curve (ALX) values were also observed.</div></div><div><h3>Conclusions</h3><div>Bendopnea may serve as a clinical indicator of a more advanced disease state in COPD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101346"},"PeriodicalIF":2.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725529","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}
Pub Date : 2025-12-06DOI: 10.1016/j.resinv.2025.101350
Hajime Fujimoto
{"title":"To coexist or not to coexist: The evolutionary paradox of the human-microbe relationship","authors":"Hajime Fujimoto","doi":"10.1016/j.resinv.2025.101350","DOIUrl":"10.1016/j.resinv.2025.101350","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101350"},"PeriodicalIF":2.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681718","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}
Ultrasound (US)-guided percutaneous biopsy is increasingly being used for thoracic lesions abutting the chest wall; however, its comparative safety according to puncture site remains unclear. We assessed the diagnostic yield and complications of bedside US-guided core needle biopsy.
Methods
We retrospectively reviewed the medical records of 168 consecutive patients who underwent pulmonologist-performed bedside core biopsy using an 18-gauge needle under real-time US guidance without a coaxial system between April 2011 and July 2022 at a single center. Typically, two to three passes were performed. Lesions were prospectively classified ultrasonographically as solid or heterogeneous. Diagnostic yield and complications were graded using the Clavien–Dindo system and compared according to puncture site and lesion morphology.
Results
Adequate tissue was obtained in 159 (94.6 %) patients. The final diagnosis was malignancy, infection, and other benign conditions in 81.8 %, 13.8 %, and 4.4 % patients, respectively. Complications occurred in 7.1 % of patients, and pneumothorax was the most frequent complication (4.7 %). All complications were managed conservatively. Grade IV–V adverse events occurred in three (1.5 %) patients undergoing lung parenchymal biopsies. Of these, one patient died during follow-up due to pleural dissemination along the biopsy tract. No adverse events ≥ Grade III occurred after chest-wall, pleural, or mediastinal biopsies. No adverse events occurred in 156 patients.
Conclusions
US-guided percutaneous core biopsy has a high diagnostic accuracy and low complication rate. However, safety varies according to site, with serious adverse events limited to patients with lung parenchymal targets. US-guided core biopsy is a feasible first-line approach for accessible extrapulmonary thoracic lesions; however, careful consideration is required for intrapulmonary targets.
{"title":"Ultrasound-guided percutaneous core biopsy of thoracic lesions: Diagnostic yield and site-specific safety","authors":"Yosuke Murakami, Shota Sogabe, Kazuki Uchida, Takafumi Kawabata, Hiroaki Ota, Yuri Hiramatsu, Mitsukuni Sakabe, Ryuta Yamamoto, Ryunosuke Oi, Akiko Maeda, Kohei Yoshimine, Saori Nishizawa, Hiromi Ide, Minako Hanaka, Kazunori Tobino","doi":"10.1016/j.resinv.2025.101347","DOIUrl":"10.1016/j.resinv.2025.101347","url":null,"abstract":"<div><h3>Background</h3><div>Ultrasound (US)-guided percutaneous biopsy is increasingly being used for thoracic lesions abutting the chest wall; however, its comparative safety according to puncture site remains unclear. We assessed the diagnostic yield and complications of bedside US-guided core needle biopsy.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the medical records of 168 consecutive patients who underwent pulmonologist-performed bedside core biopsy using an 18-gauge needle under real-time US guidance without a coaxial system between April 2011 and July 2022 at a single center. Typically, two to three passes were performed. Lesions were prospectively classified ultrasonographically as solid or heterogeneous. Diagnostic yield and complications were graded using the Clavien–Dindo system and compared according to puncture site and lesion morphology.</div></div><div><h3>Results</h3><div>Adequate tissue was obtained in 159 (94.6 %) patients. The final diagnosis was malignancy, infection, and other benign conditions in 81.8 %, 13.8 %, and 4.4 % patients, respectively. Complications occurred in 7.1 % of patients, and pneumothorax was the most frequent complication (4.7 %). All complications were managed conservatively. Grade IV–V adverse events occurred in three (1.5 %) patients undergoing lung parenchymal biopsies. Of these, one patient died during follow-up due to pleural dissemination along the biopsy tract. No adverse events ≥ Grade III occurred after chest-wall, pleural, or mediastinal biopsies. No adverse events occurred in 156 patients.</div></div><div><h3>Conclusions</h3><div>US-guided percutaneous core biopsy has a high diagnostic accuracy and low complication rate. However, safety varies according to site, with serious adverse events limited to patients with lung parenchymal targets. US-guided core biopsy is a feasible first-line approach for accessible extrapulmonary thoracic lesions; however, careful consideration is required for intrapulmonary targets.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101347"},"PeriodicalIF":2.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681715","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}
Loss of skeletal muscle mass contributes to poor respiratory disease outcomes. We previously developed an easy method for assessing physical activity by measuring erector spinae muscle thickness (ESMT) via routine chest computed tomography (CT). Since chest CT is commonly performed in hospitalized patients with pulmonary diseases, ESMT can be readily evaluated. In this study, we aimed to investigate the association between ESMT and 1-year mortality in such patients.
Methods
We prospectively enrolled patients hospitalized for pulmonary diseases between February 2023 and January 2024. Among the 636 patients included, 162 died within one year (mortality group), and 474 survived (survival group). ESMT was compared between the groups, and its correlations with clinical parameters were examined. Subgroup analyses were conducted for patients with major pulmonary conditions to assess the broader clinical utility of ESMT.
Results
Lower ESMT was significantly associated with higher 1-year mortality risk according to the Cox proportional hazard model (hazard ratio: 0.96, 95 % confidence interval: 0.92–0.99, p = 0.035). An ESMT ≤20.55 mm predicted increased mortality risk. Subgroup analyses confirmed the associations between low ESMT and mortality across pneumonia, interstitial lung disease, chronic obstructive pulmonary disease, and nontuberculous mycobacteria and/or bronchiectasis. ESMT also correlated significantly with age, males, body weight, body mass index, activities of daily living (ADL), pre-admission living place, use of home oxygen therapy, and SARC-F scores.
Conclusion
ESMT is a useful and easy marker for predicting 1-year mortality and impaired ADL status in patients with pulmonary diseases.
{"title":"Erector spinae muscle thickness predicts mortality in patients with pulmonary diseases","authors":"Masafumi Shimoda, Haruka Hamada, Takashi Yoshiyama, Kozo Morimoto, Kozo Yoshimori, Shoji Kudoh","doi":"10.1016/j.resinv.2025.101342","DOIUrl":"10.1016/j.resinv.2025.101342","url":null,"abstract":"<div><h3>Background and objective</h3><div>Loss of skeletal muscle mass contributes to poor respiratory disease outcomes. We previously developed an easy method for assessing physical activity by measuring erector spinae muscle thickness (ESM<sub>T</sub>) via routine chest computed tomography (CT). Since chest CT is commonly performed in hospitalized patients with pulmonary diseases, ESM<sub>T</sub> can be readily evaluated. In this study, we aimed to investigate the association between ESM<sub>T</sub> and 1-year mortality in such patients.</div></div><div><h3>Methods</h3><div>We prospectively enrolled patients hospitalized for pulmonary diseases between February 2023 and January 2024. Among the 636 patients included, 162 died within one year (mortality group), and 474 survived (survival group). ESM<sub>T</sub> was compared between the groups, and its correlations with clinical parameters were examined. Subgroup analyses were conducted for patients with major pulmonary conditions to assess the broader clinical utility of ESM<sub>T</sub>.</div></div><div><h3>Results</h3><div>Lower ESM<sub>T</sub> was significantly associated with higher 1-year mortality risk according to the Cox proportional hazard model (hazard ratio: 0.96, 95 % confidence interval: 0.92–0.99, <em>p</em> = 0.035). An ESM<sub>T</sub> ≤20.55 mm predicted increased mortality risk. Subgroup analyses confirmed the associations between low ESM<sub>T</sub> and mortality across pneumonia, interstitial lung disease, chronic obstructive pulmonary disease, and nontuberculous mycobacteria and/or bronchiectasis. ESM<sub>T</sub> also correlated significantly with age, males, body weight, body mass index, activities of daily living (ADL), pre-admission living place, use of home oxygen therapy, and SARC-F scores.</div></div><div><h3>Conclusion</h3><div>ESM<sub>T</sub> is a useful and easy marker for predicting 1-year mortality and impaired ADL status in patients with pulmonary diseases.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101342"},"PeriodicalIF":2.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681717","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}
Preserved ratio impaired spirometry (PRISm), defined as a forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio ≥0.70 and a predicted FEV1 <80 %, is associated with increased morbidity and mortality. However, determinants of PRISm, particularly in younger populations, remain poorly characterised. We aimed to address this knowledge gap.
Methods
We conducted a cross-sectional analysis of 12,350 participants from a Japanese community-based cohort using data from the Tohoku Medical Megabank Project. Participants underwent spirometry, blood pressure measurement, laboratory testing, and completed standardised questionnaires. Multivariate logistic regression was used to identify factors associated with PRISm across three age groups: 20–39, 40–59, and ≥60 years. Interactions between age groups and other explanatory variables were assessed.
Results
In the 20–39-year group, PRISm was independently associated with being men, diabetes mellitus, hypothyroidism, and low body mass index (BMI <18.5 kg/m2), and inversely associated with age. Among participants aged ≥60 years, PRISm was significantly associated with increasing age, overweight status (BMI ≥25.0–<30.0 kg/m2), being men, current smoking, hypertension, diabetes mellitus, bronchial asthma, elevated eosinophil counts (≥300 cells/μL), and birth weight ≥2000–<2500 g. Significant interactions were observed between age and BMI, bronchial asthma, and thyroid dysfunction.
Conclusions
Our findings indicate that PRISm in younger adults is associated with hypothyroidism and underweight status, whereas in older adults, it is more closely related to constitutional and lifestyle-related factors. These results highlight the heterogeneity of PRISm and indicate that its pathophysiology and optimal management may vary by age group.
{"title":"Age-related factors associated with preserved ratio impaired spirometry: The Tohoku medical Megabank project community-based cohort study","authors":"Chikashi Iwasaki , Kumi Nakaya , Mitsuhiro Yamada , Naoki Nakaya , Mana Kogure , Rieko Hatanaka , Ippei Chiba , Masato Takase , Sayuri Tokioka , Taku Obara , Masatsugu Orui , Naoya Fujino , Akira Koarai , Tomoko Kobayashi , Yohei Hamanaka , Eiichi N Kodama , Satoshi Nagaie , Soichi Ogishima , Nobuo Fuse , Shinichi Kuriyama , Atsushi Hozawa","doi":"10.1016/j.resinv.2025.101343","DOIUrl":"10.1016/j.resinv.2025.101343","url":null,"abstract":"<div><h3>Background</h3><div>Preserved ratio impaired spirometry (PRISm), defined as a forced expiratory volume in 1 s (FEV<sub>1</sub>) to forced vital capacity (FVC) ratio ≥0.70 and a predicted FEV<sub>1</sub> <80 %, is associated with increased morbidity and mortality. However, determinants of PRISm, particularly in younger populations, remain poorly characterised. We aimed to address this knowledge gap.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of 12,350 participants from a Japanese community-based cohort using data from the Tohoku Medical Megabank Project. Participants underwent spirometry, blood pressure measurement, laboratory testing, and completed standardised questionnaires. Multivariate logistic regression was used to identify factors associated with PRISm across three age groups: 20–39, 40–59, and ≥60 years. Interactions between age groups and other explanatory variables were assessed.</div></div><div><h3>Results</h3><div>In the 20–39-year group, PRISm was independently associated with being men, diabetes mellitus, hypothyroidism, and low body mass index (BMI <18.5 kg/m<sup>2</sup>), and inversely associated with age. Among participants aged ≥60 years, PRISm was significantly associated with increasing age, overweight status (BMI ≥25.0–<30.0 kg/m<sup>2</sup>), being men, current smoking, hypertension, diabetes mellitus, bronchial asthma, elevated eosinophil counts (≥300 cells/μL), and birth weight ≥2000–<2500 g. Significant interactions were observed between age and BMI, bronchial asthma, and thyroid dysfunction.</div></div><div><h3>Conclusions</h3><div>Our findings indicate that PRISm in younger adults is associated with hypothyroidism and underweight status, whereas in older adults, it is more closely related to constitutional and lifestyle-related factors. These results highlight the heterogeneity of PRISm and indicate that its pathophysiology and optimal management may vary by age group.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101343"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681716","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}
There is limited data on BRAF V600E-mutant squamous cell carcinoma (SCC). We report three cases of SCC of the lung with a history of resected papillary thyroid carcinoma (PTC), showing p40 positivity, TTF-1 negativity, and PAX8 expression. While treated as lung SCC, metastatic thyroid carcinoma was unconfirmed due to absence of PTC recurrence, clinicopathologic features consistent with primary lung origin, and unavailable archival PTC pathology. BRAF inhibitors yielded only transient responses, and outcomes were poor. These cases underscore the diagnostic and therapeutic value of multigene testing in SCC, highlighting the need to integrate detailed clinical history into precision oncology strategies.
{"title":"BRAF V600E-mutant squamous cell carcinoma of the lung in patients with a history of papillary thyroid carcinoma: A three-case series","authors":"Naozumi Hashimoto , Ryoma Moriya , Ken Akao , Hisashi Kako , Yasuhiro Goto , Tomohide Souma , Yuko Oya , Yuka Kondo , Tetsuya Tsukamoto , Sumito Isogai , Masashi Kondo , Kazuyoshi Imaizumi","doi":"10.1016/j.resinv.2025.101344","DOIUrl":"10.1016/j.resinv.2025.101344","url":null,"abstract":"<div><div>There is limited data on BRAF V600E-mutant squamous cell carcinoma (SCC). We report three cases of SCC of the lung with a history of resected papillary thyroid carcinoma (PTC), showing p40 positivity, TTF-1 negativity, and PAX8 expression. While treated as lung SCC, metastatic thyroid carcinoma was unconfirmed due to absence of PTC recurrence, clinicopathologic features consistent with primary lung origin, and unavailable archival PTC pathology. BRAF inhibitors yielded only transient responses, and outcomes were poor. These cases underscore the diagnostic and therapeutic value of multigene testing in SCC, highlighting the need to integrate detailed clinical history into precision oncology strategies.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101344"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661782","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}
The 6-min walk test (6MWT) is a widely used functional test that assesses desaturation on exercise. However, the clinical impact of desaturation on progressive pulmonary fibrosis (PPF) has been insufficiently studied. We aimed to evaluate the association between desaturation and future progression in patients with fibrotic interstitial lung disease (FILD).
Methods
We retrospectively analysed consecutive patients with FILD from 2008 to 2015. Desaturation was defined as oxygen saturation measured by pulse oximetry (SpO2) at the end of the 6MWT being less than 90 %. It was divided into two groups: mild (SpO2 was 89 %) and moderate desaturation (SpO2 was 88 % or less).
Results
Among 810 patients, 498 (61.5 %) had desaturation (45 mild and 453 moderate). Multivariable Cox proportional hazard analysis showed desaturation was associated with a higher mortality (HR: 1.69, 95 % CI: 1.37–2.08, p < 0.0001). Both mild and moderate desaturation were also associated with a higher mortality compared with no desaturation, although there was no significant difference between them. Multivariable logistic regression analysis showed that desaturation was associated with PPF in the overall cohort (OR: 2.20, 95 % CI: 1.59–3.05, p < 0.0001), in patients with idiopathic pulmonary fibrosis (IPF) (OR: 2.59, 95 % CI: 1.56–4.29, p = 0.0002), and in patients with non-IPF FILD (OR: 1.86, 95 % CI: 1.17–2.96, p = 0.0091).
Conclusions
Desaturation in the 6MWT was associated with future risk of progression in patients with newly diagnosed FILD.
6分钟步行测试（6MWT）是一种广泛使用的功能测试，用于评估运动时的去饱和。然而，去饱和对进行性肺纤维化（PPF）的临床影响尚未得到充分研究。我们旨在评估纤维化间质性肺疾病（field）患者去饱和与未来进展之间的关系。方法回顾性分析2008 - 2015年连续发生的field患者。去饱和定义为在6MWT结束时通过脉搏血氧仪（SpO2）测量的氧饱和度小于90%。分为轻度（SpO2为89%）和中度（SpO2为88%或以下）两组。结果810例患者中有498例（61.5%）发生过血饱和度过低，其中轻度45例，中度453例。多变量Cox比例风险分析显示，去饱和与较高的死亡率相关（HR: 1.69, 95% CI: 1.37-2.08, p < 0.0001）。与不去饱和相比，轻度和中度去饱和也与更高的死亡率相关，尽管两者之间没有显著差异。多变量logistic回归分析显示，在整个队列（OR: 2.20, 95% CI: 1.59-3.05, p < 0.0001）、特发性肺纤维化（IPF）患者（OR: 2.59, 95% CI: 1.56-4.29, p = 0.0002）和非IPF field患者（OR: 1.86, 95% CI: 1.17-2.96, p = 0.0091）中，去饱和与PPF相关。结论：6MWT的去饱和与新诊断的field患者未来的进展风险相关。
{"title":"Desaturation in the six-minute walk test predicts progressive pulmonary fibrosis in fibrotic interstitial lung disease","authors":"Reoto Takei , Jun Fukihara , Yasuhiko Yamano , Kensuke Kataoka , Tomoki Kimura , Fumiko Watanabe , Taiki Furukawa , Junya Fukuoka , Takeshi Johkoh , Yasuhiro Kondoh","doi":"10.1016/j.resinv.2025.11.013","DOIUrl":"10.1016/j.resinv.2025.11.013","url":null,"abstract":"<div><h3>Background</h3><div>The 6-min walk test (6MWT) is a widely used functional test that assesses desaturation on exercise. However, the clinical impact of desaturation on progressive pulmonary fibrosis (PPF) has been insufficiently studied. We aimed to evaluate the association between desaturation and future progression in patients with fibrotic interstitial lung disease (FILD).</div></div><div><h3>Methods</h3><div>We retrospectively analysed consecutive patients with FILD from 2008 to 2015. Desaturation was defined as oxygen saturation measured by pulse oximetry (SpO<sub>2</sub>) at the end of the 6MWT being less than 90 %. It was divided into two groups: mild (SpO<sub>2</sub> was 89 %) and moderate desaturation (SpO<sub>2</sub> was 88 % or less).</div></div><div><h3>Results</h3><div>Among 810 patients, 498 (61.5 %) had desaturation (45 mild and 453 moderate). Multivariable Cox proportional hazard analysis showed desaturation was associated with a higher mortality (HR: 1.69, 95 % CI: 1.37–2.08, p < 0.0001). Both mild and moderate desaturation were also associated with a higher mortality compared with no desaturation, although there was no significant difference between them. Multivariable logistic regression analysis showed that desaturation was associated with PPF in the overall cohort (OR: 2.20, 95 % CI: 1.59–3.05, p < 0.0001), in patients with idiopathic pulmonary fibrosis (IPF) (OR: 2.59, 95 % CI: 1.56–4.29, p = 0.0002), and in patients with non-IPF FILD (OR: 1.86, 95 % CI: 1.17–2.96, p = 0.0091).</div></div><div><h3>Conclusions</h3><div>Desaturation in the 6MWT was associated with future risk of progression in patients with newly diagnosed FILD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101334"},"PeriodicalIF":2.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616017","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}
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