The Experts below are selected from a list of 280320 Experts worldwide ranked by ideXlab platform
Yuji Shiraishi - One of the best experts on this subject based on the ideXlab platform.
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Surgical treatment of nontuberculous mycobacterial Lung Disease
General Thoracic and Cardiovascular Surgery, 2014Co-Authors: Yuji ShiraishiAbstract:While the prevalence of pulmonary tuberculosis has been decreasing, the prevalence of nontuberculous mycobacterial Lung Disease has been increasing. Unlike tuberculosis, nontuberculous mycobacterial Disease is not communicable. However, their indolent nature may result in extensive parenchymal destruction, causing respiratory failure and vulnerability to airway infection. Nontuberculous mycobacterial Lung Disease, therefore, has been becoming a significant health problem. According to the 2007 American Thoracic Society/Infectious Diseases Society of America statement on nontuberculous mycobacterial Diseases, the primary treatment is a multidrug treatment regimen. However, its efficacy is less than satisfactory for Mycobacterium avium complex Lung Disease, which is the most common type of nontuberculous mycobacterial Lung Diseases, and for Mycobacterium abscessus Lung Disease, which is notoriously resistant to chemotherapeutic drugs. The statement, therefore, has proposed a multidisciplinary treatment approach for these types of nontuberculous mycobacterial Lung Diseases: a combination of multidrug treatment regimen and adjuvant resectional surgery. This review covers the rationale, indication, procedure, and outcome of surgical treatment of nontuberculous mycobacterial Lung Disease. The rationale of surgery is to prevent Disease progressing by removing the areas of Lung most affected, harboring the largest amounts of mycobacteria. The indications for surgery include a poor response to drug therapy, the development of macrolide-resistant Disease, or the presence of a significant Disease-related complication such as hemoptysis. The surgical procedures of choice are various types of pulmonary resections, including wedge resection, segmentectomy, lobectomy, or pneumonectomy. The reported series have achieved favorable treatment outcomes in surgically treated patients with acceptable morbidity and mortality rates.
Hiroaki Iijima - One of the best experts on this subject based on the ideXlab platform.
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Clinical risk factors related to treatment failure in Mycobacterium abscessus Lung Disease
European Journal of Clinical Microbiology & Infectious Diseases, 2020Co-Authors: Keiji Fujiwara, Koji Furuuchi, Akio Aono, Fumiko Uesugi, Tatsuya Shirai, Keitaro Nakamoto, Takafumi Shimada, Fumi Mochizuki, Yoshiaki Tanaka, Hiroaki IijimaAbstract:The clinical importance of Mycobacterium abscessus subsp. abscessus ( M. abscessus ) Lung Disease has been increasing, but few studies have assessed the clinical characteristics associated with the treatment outcome. We retrospectively analyzed 75 consecutive patients with M. abscessus Lung Disease diagnosed at a tertiary hospital from January 2004 to April 2018. Among 52 patients with sufficient clinical data, 19 patients (42.2%) achieved treatment success. Compared with 26 (57.8%) patients in the treatment failure group, body mass index (BMI) (19.8 vs 17.5 kg/m^2, P = 0.022), previous nontuberculous mycobacterial (NTM) Lung Disease (26.3% vs 61.5%, P = 0.034), the presence of cavitary lesions (31.6% vs 69.2%, P = 0.017), and the bronchiectasis score (3.0 vs 5.0, P = 0.003) were significantly different in the treatment success group. Multivariate analysis showed that age (adjusted hazard ratio (aHR), 0.94; 95% confidence interval (CI), 0.90 to 0.99; P = 0.010), the presence of cavitary lesions (aHR, 0.34; 95% CI, 0.12 to 0.94; P = 0.039), and previous NTM Lung Disease (aHR, 0.28; 95% CI, 0.09 to 0.86; P = 0.026) were negatively associated with treatment success. This is the first study to show that previous NTM Lung Disease might be a clinically important factor related to unfavorable treatment outcomes in M. abscessus Lung Disease patients. To increase our understanding the characteristics of M. abscessus Lung Disease, this factor should be independently analyzed in future research.
Kevin K Brown - One of the best experts on this subject based on the ideXlab platform.
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scleroderma Lung Disease
European Respiratory Review, 2013Co-Authors: Amy L Olson, Aryeh Fischer, Kevin K Brown, Joshua J Solomon, Todd M BullAbstract:Systemic sclerosis (SSc) is a systemic autoimmune Disease that is characterised by endothelial dysfunction resulting in a small-vessel vasculopathy, fibroblast dysfunction with resultant excessive collagen production and fibrosis, and immunological abnormalities. The classification of SSc is subdivided based on the extent of skin involvement into diffuse cutaneous sclerosis (dcSSc), limited cutaneous sclerosis (lcSSc) or SSc sine scleroderma [1]. While virtually any organ system may be involved in the Disease process, fibrotic and vascular pulmonary manifestations of SSc, including interstitial Lung Disease (ILD) and pulmonary hypertension (PH), are the leading cause of death. As new therapies targeting these pulmonary conditions emerge, early recognition of Lung involvement is essential for the care of these patients. In this article we review the direct and indirect pulmonary manifestations of SSc and recent therapeutic trials that have attempted to target these manifestations. When a patient with SSc Disease presents with signs or symptoms referring to the chest, a number of potential disorders must be considered (table 1) for: direct pulmonary involvement (ILD with or without PH or pulmonary arterial hypertension (PAH), airways Disease and pleural involvement); indirect pulmonary complications (aspiration, infection, drug toxicity, malignancy, respiratory muscle weakness, restrictive Lung Disease from chest wall involvement and Lung Disease secondary to cardiac involvement); combinations of direct and indirect pulmonary manifestations; and other Lung Diseases not related to SSc (chronic obstructive pulmonary Disease/emphysema, asthma and Lung nodules). View this table: Table 1. Pulmonary involvement in systemic sclerosis In scleroderma, the two most common types of direct pulmonary involvement are ILD and PH, which together account for 60% of SSc-related deaths [2]. While certain pulmonary manifestations may occur more commonly in a subset of SSc ( i.e. ILD is more common in dcSSc while PH is more common in lcSSc) [3], all of the known pulmonary manifestations reported have been described in each of …
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rheumatoid arthritis interstitial Lung Disease associated mortality
American Journal of Respiratory and Critical Care Medicine, 2011Co-Authors: Amy L Olson, Jeffrey J Swigris, David Sprunger, Aryeh Fischer, Evans R Fernandezperez, Josh Solomon, James R Murphy, Marc Cohen, Ganesh Raghu, Kevin K BrownAbstract:Rationale: Mortality rates from rheumatoid arthritis–associated interstitial Lung Disease (RA-ILD) are largely unknown.Objectives: We sought to determine mortality rates from rheumatoid arthritis–associated interstitial Lung Disease in the United States from 1988 through 2004.Methods: Using data from the National Center for Health Statistics, we calculated age-adjusted mortality rates from the deaths of persons with rheumatoid arthritis–associated interstitial Lung Disease, determined the prevalence of interstitial Lung Disease in all decedents with rheumatoid arthritis, and compared the age and underlying cause of death in these two cohorts of decedents.Measurements and Main Results: From 1988 to 2004, there were 39,138,394 deaths in U.S. residents and 162,032 rheumatoid arthritis–associated deaths. Of these deaths, 10,725 (6.6%) met criteria for rheumatoid arthritis–associated interstitial Lung. Mortality rates from rheumatoid arthritis fell over the course of this study in both women and men. However, ...
Charles L Daley - One of the best experts on this subject based on the ideXlab platform.
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clofazimine containing regimen for the treatment of mycobacterium abscessus Lung Disease
Antimicrobial Agents and Chemotherapy, 2017Co-Authors: Bumhee Yang, Byung Woo Jhun, Seong Mi Moon, Hye Yun Park, Kyeongman Jeon, Sung Jae Shin, Charles L DaleyAbstract:ABSTRACT Patients with Lung Disease caused by Mycobacterium abscessus subsp. abscessus (here M. abscessus) typically have poor treatment outcomes. Although clofazimine (CFZ) has been increasingly used in the treatment of M. abscessus Lung Disease in clinical practice, there are no reported data on its effectiveness for this Disease. This study sought to evaluate the clinical efficacy of a CFZ-containing regimen for the treatment of M. abscessus Lung Disease. We performed a retrospective review of the medical records of 42 patients with M. abscessus Lung Disease who were treated with CFZ-containing regimens between November 2013 and January 2015. CFZ was administered in combination with other antibiotics as an initial antibiotic regimen in 15 (36%) patients (initial treatment group), and it was added to an existing antibiotic regimen for refractory M. abscessus Lung Disease in 27 (64%) patients (salvage treatment group). Overall, there was an 81% treatment response rate based on symptoms and a 31% response rate based on radiographic findings. Conversion to culture-negative sputum samples was achieved in 10 (24%) patients after CFZ-containing antibiotic treatment, and during treatment, there were significant decreases in the positivity of semiquantitative sputum cultures for acid-fast bacilli in both the initial ( P = 0.018) and salvage ( P = 0.001) treatment groups. Our study suggests that CFZ-containing regimens may improve treatment outcomes in patients with M. abscessus Lung Disease and that a prospective evaluation of CFZ in M. abscessus Lung Disease is warranted.
Byung Woo Jhun - One of the best experts on this subject based on the ideXlab platform.
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clofazimine containing regimen for the treatment of mycobacterium abscessus Lung Disease
Antimicrobial Agents and Chemotherapy, 2017Co-Authors: Bumhee Yang, Byung Woo Jhun, Seong Mi Moon, Hye Yun Park, Kyeongman Jeon, Sung Jae Shin, Charles L DaleyAbstract:ABSTRACT Patients with Lung Disease caused by Mycobacterium abscessus subsp. abscessus (here M. abscessus) typically have poor treatment outcomes. Although clofazimine (CFZ) has been increasingly used in the treatment of M. abscessus Lung Disease in clinical practice, there are no reported data on its effectiveness for this Disease. This study sought to evaluate the clinical efficacy of a CFZ-containing regimen for the treatment of M. abscessus Lung Disease. We performed a retrospective review of the medical records of 42 patients with M. abscessus Lung Disease who were treated with CFZ-containing regimens between November 2013 and January 2015. CFZ was administered in combination with other antibiotics as an initial antibiotic regimen in 15 (36%) patients (initial treatment group), and it was added to an existing antibiotic regimen for refractory M. abscessus Lung Disease in 27 (64%) patients (salvage treatment group). Overall, there was an 81% treatment response rate based on symptoms and a 31% response rate based on radiographic findings. Conversion to culture-negative sputum samples was achieved in 10 (24%) patients after CFZ-containing antibiotic treatment, and during treatment, there were significant decreases in the positivity of semiquantitative sputum cultures for acid-fast bacilli in both the initial ( P = 0.018) and salvage ( P = 0.001) treatment groups. Our study suggests that CFZ-containing regimens may improve treatment outcomes in patients with M. abscessus Lung Disease and that a prospective evaluation of CFZ in M. abscessus Lung Disease is warranted.
