Respirology : official journal of the Asian Pacific Society of Respirology
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Randomized Controlled Trial Multicenter Study
Efficacy of inhaled N-acetylcysteine monotherapy in patients with early stage idiopathic pulmonary fibrosis.
Idiopathic pulmonary fibrosis (IPF) is a fatal disorder for which there are currently no specific or effective medical treatments. A multicentre, prospective, randomized, controlled clinical trial was conducted to assess the efficacy of inhaled N-acetylcysteine (NAC) monotherapy in Japanese patients with early stage IPF. ⋯ These findings indicate that NAC monotherapy may have some beneficial effect in patients with early stage IPF. Further trials in more select IPF populations with progressive disease are required to prove the efficacy of inhaled NAC.
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Limited data suggest that outdoor air pollution (such as ambient air pollution or traffic-related air pollution) and indoor air pollution (such as second-hand smoking and biomass fuel combustion exposure) are associated with the development of chronic obstructive pulmonary disease (COPD), but there is insufficient evidence to prove a causal relationship at this stage. It also appears that outdoor air pollution is a significant environmental trigger for acute exacerbation of COPD, leading to increasing symptoms, emergency department visits, hospital admissions and even mortality. Improving ambient air pollution and decreasing indoor biomass combustion exposure by improving home ventilation are effective measures that may substantially improve the health of the general public.
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Chronic obstructive pulmonary disease (COPD) is considered to be a systemic inflammatory disease, and systemic inflammation has been noted as a factor contributing to cardiovascular disease, which is one of the comorbidities associated with COPD. On the other hand, pleiotropic effects, such as the anti-inflammatory effects of statins, have attracted attention in recent years, and there have been a variety of reports regarding the usefulness of statins for patients with COPD. ⋯ This is the first cross-sectional study from Japan that has demonstrated that statin use has a potential impact on airflow limitation in patients with COPD.
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Exposure to environmental tobacco smoke (ETS) is associated with impaired lung function in childhood, which in turn, is associated with chronic obstructive pulmonary disease (COPD) in adulthood. However, little is known regarding the direct association between childhood exposure to ETS and the development of COPD. The main objective of the present study was to examine the associations between childhood ETS exposure and adult COPD and respiratory symptoms. ⋯ Exposure to ETS during childhood was associated with COPD and respiratory symptoms in adulthood. Although active smoking is still the most important risk factor for COPD, reduction of childhood ETS exposure could contribute to the prevention of COPD and respiratory symptoms.
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In order to survey the current status of the use and complications associated with respiratory endoscopy, the Japan Society for Respiratory Endoscopy conducted a nationwide postal questionnaire survey. ⋯ Respiratory endoscopy was performed safely, but education regarding complications caused by new techniques is necessary.