ABSTRACT
PURPOSE: Although the international guidelines for managing bronchiectasis are centred on preventing the exacerbation of bronchiectasis, the medical causes of admissions to hospital among patients with bronchiectasis have not been fully investigated. METHODS: This study targeted patients with bronchiectasis who were admitted to hospitals between April 2018 and March 2020 using the national inpatient database in Japan. The causes of hospitalisation and types of antibiotics used for hospitalised patients were recorded. RESULTS: In total, 21,300 hospitalisations of 16,723 patients with bronchiectasis were analysed. The most common cause was respiratory diseases in 15,145 (71.1%) admissions, including bacterial pneumonia and the exacerbation of bronchiectasis in 6238 (41.2%) and 3151 (20.8%), respectively. Antipseudomonal antibiotics were used in approximately 60% of patients with bacterial pneumonia who were administered antibiotic treatments and in approximately 50% of patients with the exacerbation of bronchiectasis. CONCLUSIONS: Bacterial pneumonia was the most frequent cause of hospitalisation, followed by the exacerbation of bronchiectasis, among patients with bronchiectasis. Physicians need to focus on the prevention of bacterial pneumonia in addition to the exacerbation of bronchiectasis in patients with bronchiectasis.
ABSTRACT
Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection in patients with human immunodeficiency virus (HIV), but it may develop in patients without HIV, whose immune system is suppressed by anticancer or immunosuppressive agents even when indicating normal counts of CD4+ T cells. Mycosis fungoides (MF) is a primary cutaneous T-cell lymphoma, which is believed not to cause immunosuppressive conditions unless it develops leukosis or metastasis or is treated with anticancer drugs or systemic immunosuppressants. Here, we report a case of PCP in a patient with localized MF not receiving immunosuppressive treatment. The patient, a woman in her 70s, presented with persistent dyspnea. High-resolution computed tomography (HRCT) showed diffuse ground-glass opacities in both lungs. Bronchoalveolar lavage fluid was positive for P. jirovecii. Moreover, the cytomegalovirus antigenemia test was positive, whereas tests for anti-HIV and antihuman T-cell lymphotropic virus antibodies were negative. The patient was treated with trimethoprim-sulfamethoxazole, prednisolone, and ganciclovir, which gradually improved the symptoms and diminished diffuse ground-glass opacities on HRCT. This case exemplifies a rare presentation of PCP with mild MF that was not treated with chemotherapy or immunosuppressants. The possible mechanisms for the development of PCP are discussed.
ABSTRACT
BACKGROUND: Individuals with swallowing dysfunction in their 50s and 60s may be at risk for aspiration pneumonia as they age. The association of background and lifestyle with swallowing dysfunction for those in their 50s and 60s has not been fully studied. This study aimed to clarify the relationship between lifestyle and swallowing function in this group. PATIENTS AND METHODS: We targeted physicians in their 50s and 60s as participants. The repetitive saliva swallowing test (RSST) was used to evaluate swallowing function, and self-reported questionnaires about their lifestyle were administered. The associations between RSST scores and participants' backgrounds and lifestyles were analyzed. RESULTS: This study included 310 participants, who were divided into two groups: 162 in the low RSST group and 148 in the high RSST group. The low RSST group had significantly shorter daily conversation times and a lower incidence of hyperlipidemia than the high RSST group. On multivariate analysis, less than three hours of daily conversation time was independently related to lower RSST scores (adjusted odds ratio: 1.863; 95% confidence interval: 1.167-2.974). CONCLUSIONS: Shorter conversation time may serve as a predictor of impaired swallowing function, potentially increasing the risk of aspiration pneumonia in the future.
ABSTRACT
Although studies have investigated the factors associated with psychological post-COVID-19 symptoms, the impact of marital status on symptom development has not been fully determined. This study conducts a questionnaire survey to investigate the association between marital status and the proportion of patients with post-COVID-19 symptoms in 749 cases as valid responses. Depressive state and memory impairment were more frequently seen in the no-spouse group when each symptom was compared according to marital status. Particularly in individuals in the 40s who had minor COVID-19 illness, this trend was noted. Single patients with mild COVID-19 illness may need proactive psychological support.
