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Background: Identifying positive bronchodilator reversibility (BDR) helps the diagnosis of asthma. However, not all patients can adequately perform the forced expiration during the spirometry test. An alternative test is required. Impulse oscillometry (IOS) is an effort-independent technique that enables the measurement of lung mechanics during quiet tidal breathing. We investigated the potentiality of IOS to evaluate BDR in untreated adult patients with newly diagnosed asthma (UAPNDS). Methods: All UAPNDS (aged 20–80 years) who never smoke and underwent IOS and spirometry before and after salbutamol inhalation at their initial visit to the hospital from March 22, 2017, to December 31, 2019, were identified. A total of 323 patients were enrolled. Data from the medical record, including demographic characteristics, laboratory examination, spirometric data, and IOS parameters, were retrospectively reviewed. The associations of parameters with the positive BDR and the performance of parameters in predicting the positive BDR were evaluated by statistical methods. Results: Patients (n = 323) had a median age of 64 years and were mostly female (67.5%). Several variables, including serum total immunoglobulin level, blood eosinophil counts, blood eosinophil percentage (%), and two IOS parameters, were found to be different between the positive (n = 93) and negative BDR (n = 230) groups. Multivariate logistic regression analyses after adjustment by cofactors revealed that the percentage change of the area under the reactance curve between 5 Hz and resonant frequency [ΔAx (%)] after salbutamol inhalation was the only independent factor for the positive BDR. The area under the receiver operating characteristic curve of ΔAx (%) in predicting the positive BDR was 0.614 (p = 0.0013), and its optimal cutoff value was −53.8% (sensitivity, 39.78% and specificity, 80.43%). Conclusion: In addition to spirometry, ΔAx (%), an IOS parameter, may serve as a novel indicator to evaluate BDR in UAPNDS.

Background To investigate whether whole‐brain radiotherapy (WBRT) decreases lymphocyte counts and evaluate the impact of treatment‐related lymphopenia on survival in patients with brain metastasis. Methods Medical records from 60 small‐cell lung cancer patients treated with WBRT from January 2010 to December 2018 were included in the study. Total lymphocyte count (TLC) was obtained pre and post treatment (within 1 month). We performed linear and logistic regression analyses to identify predictors of lymphopenia. The association between lymphopenia and survival was analyzed using Cox regression analysis. Results Thirty‐nine patients (65%) developed treatment‐related lymphopenia. The median TLC decrease was −374 cells/μL (interquartile range −50 to −722, p < 0.001). Baseline lymphocyte count was a significant predictor of TLC difference and percentage change in TLC. Logistic regression analysis found male sex (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.00–0.79, p = 0.033) and higher baseline lymphocyte count (OR 0.91, 95% CI 0.82–0.99, p = 0.005) were associated with a lower risk of developing ≥grade 2 treatment‐related lymphopenia. Cox regression analysis showed that age at brain metastasis (hazard ratio [HR] 1.03, 95% CI 1.01–1.05, p = 0.013), ≥grade 2 treatment‐related lymphopenia, and percentage change in TLC (per 10%, HR 0.94, 95% CI 0.89–0.99, p = 0.032) were prognostic factors of survival. Conclusions WBRT decreases TLC and the magnitude of treatment‐related lymphopenia is an independent predictor of survival in small‐cell lung cancer patients.