Cox proportional hazards regression analysis of mortality after airway stenting: Multivariate analysis.

<p>Cox proportional hazards regression analysis of mortality after airway stenting: Multivariate analysis.</p

Airway stenting by metallic stent.

<p>(A) Tracheal compression from advanced esophageal cancer producing marked tracheal compression and critical airway stenosis. (B) Palliation by placement of tracheal Spiral Z stent producing immediate resolution of airway symptoms.</p

Weaning from mechanical ventilation after airway stenting for malignant obstruction.

<p>Weaning from mechanical ventilation after airway stenting for malignant obstruction.</p

Outcomes of airway stenting for malignant obstruction.

<p>Outcomes of airway stenting for malignant obstruction.</p

Causative species of nontuberculous mycobacterial lung disease and comparative investigation on clinical features of <i>Mycobacterium abscessus</i> complex disease: A retrospective analysis for two major hospitals in a subtropical region of Japan

<div><p>Nontuberculous mycobacteria (NTM) lung disease is increasing globally. Although the etiological epidemiology of NTM is different across regions, <i>Mycobacterium avium</i> complex (MAC) is the leading cause of NTM lung disease in most countries, including mainland Japan. Okinawa is located in the southernmost region of Japan and is the only prefecture categorized as a subtropical region in Japan, it is therefore likely the etiological epidemiology of NTM lung disease is different from mainland Japan. From 2009 to 2015, the medical records of patients, with respiratory specimens positive for NTMs, visiting or admitted to two Okinawan hospitals, were retrospectively analyzed. NTM lung disease cases were defined according to the American Thoracic Society criteria and patient epidemiology and clinical information were evaluated. Results indicate four hundred sixteen patients had bacterial cultures positive for NTM. The most common NTM was <i>M</i>. <i>abscessus</i> complex (MABC) (n = 127; 30.5%), followed by <i>M</i>. <i>intracellulare</i> (n = 85; 20.4%). NTM lung disease was diagnosed in 114 patients. Of these cases, MABC was most common (n = 41; 36.0%), followed by <i>M</i>. <i>intracellulare</i> (n = 31; 27.2%). Chronic obstructive pulmonary disease (COPD) and tracheostomy patients were more likely to develop MABC than MAC lung disease. Multivariate analysis showed a probable association between COPD and MABC lung disease. Chest computed tomography (CT) evaluation revealed bronchiectasis, nodules, and consolidation were less frequently observed in MABC patients compared with MAC patients. Our data suggests Okinawa may be one of the few places where MABC is the predominant pathogen causing NTM lung disease and our results add new insight to MABC lung disease, which is not yet well understood.</p></div

Patient background.

<p>Patient background.</p

Multivariate analysis to determine clinical charecteristics for MABC.

<p>Multivariate analysis to determine clinical charecteristics for MABC.</p

NTMs cultured from respiratory samples (N = 416).

<p>NTMs isolated from respiratory specimens were retrospectively analyzed. Others category includes: <i>Mycobacterium kansasii</i> (1.0%), <i>M</i>. <i>szulgai</i> (0.7%), <i>M</i>. <i>xenopi</i> (0.7%), <i>M</i>. <i>peregrium</i> (0.5%), <i>M</i>. <i>scrofulaceum</i> (0.5%), <i>M</i>. <i>simiae</i> (0.2%), and <i>M</i>. <i>terrae</i> (0.2%).</p

Clinical spectrum and prognostic factors of possible UIP pattern on high-resolution CT in patients who underwent surgical lung biopsy

<div><p>Background</p><p>Few studies have reported the diagnostic variability in patients with a possible usual interstitial pneumonia (UIP) pattern on high-resolution CT (HRCT) who underwent surgical lung biopsy (SLB), and the prognostic factors for these patients have not been fully evaluated. We retrospectively investigated the frequency of idiopathic pulmonary fibrosis (IPF) and prognostic factors in patients with possible UIP pattern on HRCT.</p><p>Methods</p><p>Consecutive patients who had a possible UIP pattern on HRCT, underwent SLB, and had a diagnosis of IIPs before SLB were retrospectively recruited from 10 hospitals. Diagnoses were made based on multidisciplinary discussion using the criteria for current IPF guidelines and multidisciplinary classification for IIPs in each hospital.</p><p>Results</p><p>179 patients who underwent SLB were enrolled. The diagnoses were IPF in 91 patients (51%), unclassifiable IIPs in 47 (26%), idiopathic NSIP in 18 (10%), and chronic hypersensitivity pneumonia in 17 (9%). One-year FVC changes showed significant differences between IPF and non-IPF (-138.6 mL versus 18.2 mL, p = 0.014). Patients with IPF had a worse mortality than those with non-IPF (Logrank test, p = 0.025). Multivariable Cox regression analysis demonstrated that diagnoses of IPF (HR, 2.961; 95% CI, 1.183–7.410; p = 0.02), high modified MRC score (HR, 1.587; 95% CI, 1.003–2.510; p = 0.049), and low %FVC (HR, 0.972; 95% CI, 0.953–0.992; p = 0.005).</p><p>Conclusions</p><p>About a half of patients with a possible UIP pattern on HRCT had diagnoses other than IPF, and patients with IPF had a worse mortality than those with an alternative diagnosis. We reaffirmed that multidisciplinary discussion is crucial in patients with possible UIP pattern on HRCT.</p></div

Multivariate Cox hazard analysis for all-cause mortality with adjustment for age and gender.

<p>Multivariate Cox hazard analysis for all-cause mortality with adjustment for age and gender.</p