Publications by authors named "Shih-Lung Cheng"

Background: Dual bronchodilator therapy, consisting of a long-acting beta-agonist (LABA) and a long-acting muscarinic antagonist (LAMA), has proven effective for patients with chronic obstructive pulmonary disease (COPD). However, it remains uncertain whether there are efficacy differences between current and former smokers with COPD. This study aims to explore the effectiveness of LABA/LAMA therapies in both these groups.

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Background: Airflow obstruction is a hallmark of disease severity and prognosis in bronchiectasis. The relationship between lung microbiota, airway inflammation, and outcomes in bronchiectasis with fixed airflow obstruction (FAO) remains unclear. This study explores these interactions in bronchiectasis patients, with and without FAO, and compares them to those diagnosed with chronic obstructive pulmonary disease (COPD).

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Article Synopsis
  • This study aimed to validate a simplified radiological scoring system for evaluating clinical symptoms and outcomes in Taiwanese patients with noncystic fibrosis bronchiectasis (NCFB).
  • It involved analyzing data from 2,753 patients, assessing their bronchiectasis type and severity using a modified Reiff score derived from high-resolution CT scans, and correlating these with clinical features such as lung function and hospitalization rates.
  • The findings indicated that as the severity of bronchiectasis increased, patients experienced worse symptoms and lung function, and identified factors like age and pneumonia as independent predictors of mortality, suggesting the scoring system's utility in clinical assessments.
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Background: To revisit the association between vitamin D deficiency (VDD, defined as serum 25(OH)D < 20 ng/ml) and incident active tuberculosis (TB), after two potentially underpowered randomized trials showed statistically non-significant 13%-22% decrease in TB incidence in vitamin D supplementation groups.

Methods: We prospectively conducted an age/sex-matched case-control study that accounting for body-mass index (BMI), smoking, and other confounding factors to examine the association between VDD and active TB among non-HIV people in Taiwan (latitude 24°N), a high-income society which continues to have moderate TB burden.

Results: We enrolled 62 people with incident active TB and 248 people in control group.

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Purpose: The treatment advantage of guideline-based therapy (GBT) in Mycobacterium avium complex lung disease (MAC-LD) is well-known. However, GBT is not always feasible. The aim of the study was to analyze the relationship of treatment regimens and duration with outcomes.

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Article Synopsis
  • Chronic obstructive pulmonary disease (COPD) is a significant global health issue, with around 70-80% of cases undiagnosed, leading to poorer health outcomes and lower quality of life for patients.
  • Early detection of COPD is essential, and while strategies have been developed over the past decade, identifying undiagnosed cases remains challenging.
  • The review provides an overview of current literature on various case-finding strategies and instruments recommended by health organizations, alongside a proposed flowchart to effectively identify individuals at risk for COPD.
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Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by airway limitation and changes in airway structure. It has a high global burden of mortality and morbidity. The etiology of COPD is complex, but exposure to tobacco smoke and other inhaled lung oxidants are major risk factors.

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Background: Molnupiravir (MOL) is an oral antiviral medication that has recently been treated for COVID-19.

Objectively: We perform a prospective and observational study to elucidate the efficacy and safety of MOL in healthcare patients with COVID-19.

Materials And Methods: A observational, non-randomized study of patients diagnosed with COVID-19 in 46 healthcare facilities and treated with MOL started within 5 days after the onset of signs or symptoms.

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Article Synopsis
  • The authors express appreciation for Crimi et al.'s feedback on their work.
  • They acknowledge the insights provided, which could enhance their research.
  • The response indicates a willingness to consider suggestions for improvement in future studies.*
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  • Idiopathic pulmonary fibrosis (IPF) is a serious lung disease that leads to fatal lung scarring and has limited treatment options; this study focused on the first Taiwan-based registry to understand IPF progression.
  • The NICEFIT registry tracked 101 patients over two years, comparing 88 patients treated with antifibrotics (nintedanib or pirfenidone) to 13 untreated patients, finding that treated patients maintained lung functionality.
  • The study indicated that antifibrotic drugs help slow the progression of IPF, reduce acute exacerbations (AE), and delay mortality, with no new safety issues reported in the Taiwanese population.
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  • - During the COVID-19 pandemic, there was a significant shortage of ventilators and ICU beds, leading to a surge in the use of noninvasive respiratory support methods, particularly high-flow nasal cannula (HFNC), which proved beneficial for patients with severe respiratory issues.
  • - This narrative review examines recent findings on the effectiveness of HFNC for patients experiencing acute hypoxemic respiratory failure due to COVID-19, addressing important questions regarding its success, impact of late intubation, and comparison with other support methods.
  • - The study highlights existing limitations in the current research on HFNC application, aiming to identify gaps in knowledge and offer guidance for future investigations to improve treatment strategies and reduce infection risks.
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Management of patients with asthma during the coronavirus disease 2019 (COVID-19) pandemic is a concern, especially since asthma predisposes patients to respiratory problems. Interestingly, asthma characterized by type 2 inflammation, also known as T-helper type 2-high endotype, displays a cellular and molecular profile that may confer protective effects against COVID-19. The results of experimental and clinical studies have established the actions of immunoglobulin E (IgE) in inducing airway hyperreactivity and weakening an interferon-mediated antiviral response following respiratory viral infection.

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Background And Aim: Chronic obstructive pulmonary disease (COPD) is frequently underdiagnosed because of the unavailability of spirometers, especially in resource-limited outpatient settings. This study provides real-world evidence to identify optimal approaches for COPD case finding in outpatient settings.

Methods: This retrospective study enrolled individuals who were at risk of COPD (age ≥40 years, ≥10 pack-years, and ≥1 respiratory symptom).

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Background: The incidence of nontuberculous mycobacterial lung disease (NTM-LD) is increasing worldwide. Immune exhaustion has been reported in NTM-LD, but T-cell immunoglobulin and mucin domain-containing protein 3 (TIM3), a co-inhibitory receptor on T cells, has been scarcely studied.

Methods: Patients with NTM-LD and healthy controls were prospectively recruited from July 2014 to August 2019 at three tertiary referral centers in Taiwan.

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Chronic obstructive pulmonary disease (COPD) is a heterogeneous and complex disorder. In this review, we provided a comprehensive overview of biomarkers involved in COPD, and potential novel biological therapies that may provide additional therapeutic options for COPD. The complex characteristics of COPD have made the recommendation of a generalized therapy challenging, suggesting that a tailored, personalized strategy may lead to better outcomes.

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Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. It has also imposed a substantial economic and social burden on the health care system. In Taiwan, a nationwide COPD pay-for-performance (P4P) program was designed to improve the quality of COPD-related care by introducing financial incentives for health care providers and employing a multidisciplinary team to deliver guideline-based, integrated care for patients with COPD, reducing adverse outcomes, especially COPD exacerbation.

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Article Synopsis
  • * A study analyzed emergency department visits related to acute exacerbations of COPD from 2015 to 2019, finding a 3.5% increase in visits for every 10 μg/m³ increase in PM concentration, with the strongest effects observed in the spring season.
  • * The research highlights the urgent need for protective measures against air pollution, as increases in PM exposure can significantly affect the number of ventilators required for patients experiencing acute respiratory failure related to COPD.
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Asthma is a heterogeneous respiratory disease characterized by usually reversible bronchial obstruction, which is clinically expressed by different phenotypes driven by complex pathobiological mechanisms (endotypes). In recent years several molecular effectors and signaling pathways have emerged as suitable targets for biological therapies of severe asthma, refractory to standard treatments. Indeed, various therapeutic mono-clonal antibodies currently allow one to intercept at different levels the chain of pathogenic events leading to type 2 (T2) airway inflammation.

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Purpose: To understand the association between biomarkers and exacerbations of severe asthma in adult patients in Taiwan.

Materials And Methods: Demographic, clinical characteristics and biomarkers were retrospectively collected from the medical charts of severe asthma patients in six hospitals in Taiwan. Exacerbations were defined as those requiring asthma-specific emergency department visits/hospitalizations, or systemic steroids.

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Chronic obstructive pulmonary disease (COPD) has significant contributions to morbidity and mortality world-wide. Early symptoms of COPD are not readily distinguishable, resulting in a low rate of diagnosis and intervention. Different guidelines and recommendatations for the diagnosis and treatment of COPD exist globally.

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The effectiveness and safety of fixed dual long-acting bronchodilators for chronic obstructive pulmonary disease (COPD) patients have been well established; however, there is a paucity of clinical effectiveness comparison in patients with COPD treatment. The aim of the current study was to compare the effectiveness of three once-daily dual bronchodilator agents in patients with COPD. Patients with diagnosed COPD and treated with a long-acting beta-agonist (LABA) + long-acting muscarinic antagonist (LAMA) fixed-dose combination therapy (UME/VIL (umeclidinium and vilanterol inhalation powder), IND/GLY (indacaterol and glycopyrronium), and TIO/OLO (tiotropium and olodaterol)) were enrolled in this retrospective study over a period of 12 months.

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Article Synopsis
  • * The GOLD report is a key resource used globally for managing COPD patients, and this study aims to update local guidelines across the Asia-Pacific region.
  • * This report highlights the commonalities and differences in COPD management strategies, focusing on airflow limitation, severity assessment, and treatment options in stable COPD cases.
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