Monaldi Archives for Chest Disease最新文献

{"title":"Contribution of small airway disease to dynamic hyperinflation in patients with chronic obstructive pulmonary disease.","authors":"Cristiane Chaves Marcelino Da Costa, Hebert Olímpio Júnior, Paulo Victor Leandro Da Silva Pinto, Milena Alves Da Silva, Laura Franco Pessoa, Laura Lima Da Silva, Jannis Papathanasiou, Arthur De Sá Ferreira, Agnaldo José Lopes","doi":"10.4081/monaldi.2025.3402","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3402","url":null,"abstract":"<p><p>Lung hyperinflation is a treatable trait in chronic obstructive pulmonary disease (COPD) that can often only be detected on exertion. Air trapping in these patients results from the premature closure of the small airways. This study aimed to assess the association between small airway disease (SAD) and dynamic hyperinflation (DH) induced by the Glittre-daily life activities test (TGlittre) in COPD patients. This is a cross-sectional study in which 54 patients with COPD underwent TGlittre coupled with dynamic ventilation measurements. They also underwent the COPD Assessment Test (CAT) questionnaire, the St. George's Respiratory Questionnaire (SGRQ), spirometry, and respiratory oscillometry (RO). In the TGlittre, 30 (55.6%) participants presented DH (DH group), while 24 (44.4%) did not (NDH group). When comparing these two groups, we observed no statistical difference concerning the CAT score, SGRQ score, and spirometric parameters. Respectively, 27 (90%) and 9 (37.5%) participants in the DH and NDH groups presented changes in the RO, with the DH group showing higher values in reactance area [Ax, 24.7 (17-46) vs. 6.1 (4-9) cm H2O/L/s, p<0.0001] and resonance frequency [Fres, (8 (4.3-17.9) vs. 2.8 (2.3-4.7) Hz, p<0.0001]. DH correlated significantly with Fres (rs=-0.604, p<0.0001), Ax (rs=-0.652, p<0.0001), and several domains of the SGRQ and CAT scores. In the multivariate regression analysis, Fres and Ax explained 49% of the variability in DH. In conclusion, our results show that patients with COPD and DH have more altered RO. In these patients, the more pronounced the DH, the worse the RO parameters, the greater the symptom impact, and the more deteriorated the quality of life. Furthermore, SAD is a significant predictor of DH in this patient population.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding adverse drug reactions in respiratory care: a prospective predictive and severity-based analysis at a tertiary care hospital in India.","authors":"Vaishnavi V Gaonkar, Vinay V Shanbhag, Mandati Santhosh Reddy, M S Ganachari","doi":"10.4081/monaldi.2025.3464","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3464","url":null,"abstract":"<p><p>Adverse drug reactions (ADRs) are a major concern in healthcare, including morbidity, longer hospitalization, and increased healthcare expenses. Despite the necessity of ADR monitoring, reporting is poor, particularly in developing countries such as India. This study assessed the severity, predictability, and causality of ADRs in a tertiary care hospital's respiratory department. A prospective observational study was conducted at KLE's Dr. Prabhakar Kore Hospital, Belagavi, Karnataka, from September 2023 to January 2025. Patients aged 45 years and above with chronic respiratory conditions were included. ADRs were assessed using validated scales, including the World Health Organization-Uppsala Monitoring Centre Scale, Modified Hartwig and Siegel Scale, and Predictability Assessment. Descriptive statistics were applied to analyze ADR patterns. Among the 107 patients enrolled, 63.5% were elderly and 59.8% were female. Mild ADRs accounted for 60.7% of cases, while serious responses were reported in 3.7%. Predictability analysis revealed that 77.5% of ADRs were foreseeable. Causality assessment revealed ADRs as probable (51.4%), possible (37.3%), and certain (10.2%). Drug withdrawal was the most popular intervention (55.1%). The most commonly reported ADRs were gastrointestinal disorders (33.6%), followed by respiratory (18.6%) and cardiovascular disorders (16.8%). The study highlighted the need for improved pharmacovigilance programs to reduce ADR-related hazards in respiratory patients. Improving ADR reporting methods and predictive assessments can enhance patient safety and maximize therapeutic outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of herbal medicine related to anxiety and depression in the general population of southeast Iran during the COVID-19 pandemic.","authors":"Hossein Yarmohammadi, Maryam Iranzadasl, Mohammad Mostafa Ansari Ramandi, Mohammad Gholami Fesharaki, Fereshteh Ghorat","doi":"10.4081/monaldi.2025.3066","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3066","url":null,"abstract":"<p><p>The COVID-19 pandemic has led to increased anxiety/depression and changes in people's health behaviors. This study aimed to investigate health beliefs regarding using herbal medicine and its associated factors among Iranians. A cross-sectional study on the general population in Birjand (southeast Iran) was conducted using a survey questionnaire (an online platform for creating questionnaires, available at https://porsline.ir/) consisting of demographic characteristics and beliefs toward herbal medicine use, as well as a telehealth and hospital anxiety and depression scale questionnaire to address anxiety and depression disorders. All statistical analysis was done with SPSS software version 18, and a p-value of 0.05 or less was considered significant. The study included 619 participants with a mean age of 36.58±10.74 and a female rate of 61%. The overall use of herbal medicine was 385 (62%), 170 (28%) for prevention, 12 (2%) for treatment, 170 (28%) for relaxation, and 191 (31%) for other reasons. Using herbal medicine for relaxation (p=0.010) and prevention (p=0.02) was significantly associated with less anxiety, while using herbs for the treatment of COVID-19 had an association with no family history of Coronavirus infection (p<0.001). The majority of participants used herbal medicine for different purposes for COVID-19, and this health behavior had a relationship with anxiety/depression and family history of COVID-19. This study's findings would be useful to researchers and policymakers in improving health beliefs and behaviors during the other pandemic in Iran.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of conventional laboratory tests and Xpert MTB/RIF in the diagnosis of tuberculosis.","authors":"Natalia Zaporojan, Ramona Hodișan, Andreea Atena Zaha, Claudiu Zaporojan, Dana Carmen Zaha","doi":"10.4081/monaldi.2025.3394","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3394","url":null,"abstract":"<p><p>The laboratory diagnosis of tuberculosis (TB) represents a continuous challenge due to the variability and complexity of the required clinical samples. Although molecular technologies have considerably improved diagnostic accuracy, their combined use with traditional methods like microscopy and bacterial culture remains a subject of debate. This study aims to compare the performance of microscopy, bacterial culture on Löwenstein-Jensen medium, and the molecular Xpert MTB/RIF test in diagnosing pulmonary and extrapulmonary TB. In this retrospective study, conducted over a period from January 2016 to January 2023, data were collected from pulmonary TB and extrapulmonary TB samples of patients hospitalized in the pneumonology departments of the Bihor County Emergency Hospital. The study included 1796 patients, of whom 85.2% had samples collected from the respiratory tract. The variability of sensitivity and specificity depending on the type of sample indicates the need for a differentiated approach in diagnosis. The results show that the Xpert MTB/RIF test detected a higher number of positive cases (16%) compared to microscopy (9%) and bacterial culture (15%). Statistical analysis revealed a high sensitivity and specificity of Xpert MTB/RIF, suggesting superior accuracy compared to traditional methods. Our conclusions underline the importance of the Xpert MTB/RIF as a valuable tool in the diagnosis of TB, but it is recommended to use it in combination with other methods to ensure a complete and efficient diagnosis.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin prick test wheal size: a potential predictor of respiratory allergies?","authors":"Gennaro Liccardi, Matteo Martini, Mauro Maniscalco, Maria Beatrice Bilò, Claudio Candia, Lorenzo Cecchi, Carmen Montera, Annaclaudia Giordano, Manlio Milanese, Fabio De Bartolomeis, Domenico Gargano, Mario Lo Schiavo, Francesco Madonna, Antonio Papa, Alfonso Pedicini, Alfonso Savoia, Paola Rogliani","doi":"10.4081/monaldi.2025.3326","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3326","url":null,"abstract":"<p><p>Dear Editor, The skin prick test is the most commonly used method for diagnosing IgE-mediated sensitizations in conditions like bronchial asthma, allergic rhinitis, and food allergies... ******************************** Promoted by the Italian Association of Hospital and Territorial Allergists and Immunologists (AAIITO - Campania region). *******************************.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of chest ultrasound in the diagnosis of ventilator-associated pneumonia in the critical care unit of a tertiary care center: a prospective observational study.","authors":"Avinash Babu, Aditi Joshi, Amartya Chakraborti, Pradeep Bajad, Ramniwas Jalendra, Nishant Chauhan, Naveen Dutt","doi":"10.4081/monaldi.2025.2974","DOIUrl":"https://doi.org/10.4081/monaldi.2025.2974","url":null,"abstract":"<p><p>Ventilator-associated pneumonia (VAP) is a type of nosocomial pneumonia developing in patients who are mechanically ventilated for ≥48 hours. Lung ultrasound (LUS) has been shown to be useful in evaluating various pathologic pulmonary conditions. We aimed to study the utility of chest ultrasound in the diagnosis of VAP in a critical care unit. This was a monocentric, prospective observational study carried out in the intensive care unit (ICU) of our institution. On clinical suspicion of VAP, patients were subjected to ultrasound chest (lung) examination, which was done in a supine position in six areas of each hemithorax on the same day, and endotracheal aspirate (ETA) for gram stain and aerobic culture was sent within 6 hours. The final diagnosis of VAP was made when ETA culture was positive (>105 CFU/mL). Days of mechanical ventilation, ICU stay, hospital stay, and mortality were separately recorded for monitoring outcomes. Diagnostic performance of risk factors for VAP was analyzed by parameters like sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio (positive and negative). Concerning LUS signs, subpleural consolidations >2 had a sensitivity of 96% and specificity of 63% with an odds ratio of 51.43 in predicting VAP. Dynamic air bronchogram within consolidation was seen in 45% of patients with a sensitivity and specificity of 29% and 73%, respectively. A clinical LUS score >2 had a sensitivity of 100% in predicting VAP. LUS is a robust diagnostic tool with high sensitivity for diagnosing VAP. Clinical trials are needed to study whether LUS can be used as a tool for early diagnosis of VAP, which will help in the timely introduction of antibiotics.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to sputum culture conversion as a predictor of cure in multidrug-resistant tuberculosis patients: a multicenter retrospective cohort study in Pakistan.","authors":"Abdul Wahid, Nafees Ahmad, Fahad Saleem, Amjad Khan, Asad Khan, Faiz Ullah Khan, Farman Ullah Khan","doi":"10.4081/monaldi.2025.3200","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3200","url":null,"abstract":"<p><p>This study aimed to evaluate how the time to sputum culture conversion (SCC) predicts cure and to identify factors associated with delayed SCC and cure among multidrug-resistant tuberculosis (MDR-TB) patients receiving longer treatment regimens of 18-24 months. This multicenter retrospective cohort study was conducted at eight programmatic management units. A total of 462 patients with confirmed pulmonary MDR-TB were enrolled at eight PMDT sites between January 2017 and August 2018 with available treatment outcomes till 30th June, 2020. Survival analysis was done using the Kaplan-Meier curve, and Cox proportional hazards model and binary logistic regression were performed to determine factors associated with time to SCC and cure. Statistical significance was set at p<0.05. A total of 424/462 (91.8%) patients achieved SCC, with a cure rate of 75.5%. The mean time to SCC was 2.4 months (interquartile range = 1-3 months). Factors such as employment [hazard ratio (HR)=0.654, p=0.001], sputum smear grading score +2+3 (HR = 0.638, p=0.014), resistance to first-line drugs HREZ (HR=0.716, p=0.014), and resistance to second-line drugs, fluoroquinolones (HR=0.698, p≤0.001) were significantly associated with SCC. In the current study, the cure rate was 75.5% (349/462). In the binary logistic regression, month 1 [odds ratio (OR)=2.601, p≤0.001), month 2 (OR=3.14, p≤0.001), month 3 (OR=5.219, p≤0.001), month 4 (OR=6.788, p≤0.001), month 5 (OR=21.512, p≤0.001), and month 6 (OR=31.806, p≤0.001) had a statistically significant association with cure. In predicting cure, the overall sensitivities of SCC at 1, 2, 3, 4, 5, and 6 months were 37.2%, 64.1%, 85.9%, 91.1%, 97.4%, and 98.2%, respectively, and the specificities were 81.4%, 63.7%, 46.0%, 39.8%, 36.2%, and 35.3%, respectively. Interestingly, the combined sensitivity and specificity of SCC at 3 and 4 months in predicting cure were similar to those observed at 5 and 6 months.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of vitamin D receptor gene polymorphism on susceptibility to tuberculosis infection in Indonesia.","authors":"Ismail Ismail, Ratnawati Ratnawati, Yulianto Machmud, Harliani Harliani","doi":"10.4081/monaldi.2025.3329","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3329","url":null,"abstract":"<p><p>This study investigated the association between vitamin D receptor (VDR) gene polymorphisms and susceptibility to pulmonary tuberculosis (PTB) in various ethnic groups in Indonesia. The study involved 267 participants divided into three groups: 99 healthy controls, 80 individuals with latent tuberculosis, and 88 with active tuberculosis. Four VDR polymorphisms (FokI, ApaI, BsmI, and TaqI) were analyzed using polymerase chain reaction and restriction fragment length polymorphism. The research comprehensively analyzes sociodemographic and genetic factors associated with PTB in Indonesia, focusing on three ethnic groups-Makassar, Bugis, and Toraja. Sociodemographic data (n=267) revealed a mean age of 34.43±11.81 years, with a higher prevalence of males (55.4%) and significant associations between PTB status and education level (p=0.006). Smoking was notably higher among active PTB patients (48.9%), emphasizing behavioral influences on disease prevalence. The genetic study (n=88 PTB, n=179 controls) highlighted significant associations of VDR gene polymorphisms with PTB. Specifically, the FokI CC genotype (p=0.014) and C allele (p<0.001) were more frequent in PTB patients, alongside the ApaI GT genotype (p<0.001) and BsmI GG genotype (p<0.001). The findings emphasize the multifactorial nature of PTB susceptibility, highlighting the roles of genetic variations, particularly in the VDR gene, and sociodemographic factors in influencing PTB risk in Indonesian populations.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac arrhythmia following acute myocardial infarction: a retrospective analysis of 27,648 hospitalized patients in a tertiary heart hospital.","authors":"Nidal Asaad, Ayman El-Menyar, Rajvir Singh, Betsy Varughese, Shahul Hameed Khan, Hajar AlBinali, Jassim Al Suwaidi","doi":"10.4081/monaldi.2025.3286","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3286","url":null,"abstract":"<p><p>Arrhythmia frequently complicates acute myocardial infarction (AMI) and contributes to high morbidity and mortality. We aimed to investigate the prevalence, risk factors, and impact of cardiac arrhythmias in AMI patients at a tertiary heart hospital. This retrospective observational study included AMI patients who were admitted between January 1991 and May 2022. Patients' data were analyzed and compared according to the absence or presence of cardiac arrhythmias post-AMI. We hypothesized that arrhythmias are associated with higher mortality following AMI. During the study, 27,648 patients were hospitalized with AMI, of whom 2118 (7.7%) developed arrhythmia. Patients who developed arrhythmia had a higher average age compared to those without arrhythmia (57.2 vs. 54.8 years, p=0.001), and a larger proportion were male compared to female patients (85.2% vs. 14.8%, p=0.001). Atrial fibrillation was observed in 383 patients (18.1%). Ventricular tachycardia was found in 461 (21.8%), and ventricular fibrillation occurred in 526 patients (24.8%). Complete heart block was developed in 286 (13.5%) patients, 1st-degree atrioventricular (AV) block in 36 (1.7%), 2nd-degree AV block in 138 (6.5%), left bundle branch block in 81 (3.8%), and right bundle branch block in 118 (5.6%). The rate of β-blocker use has increased in the arrhythmias group at discharge compared to the on-admission rate (55.7% vs. 32.5%). However, it remained sub-optimal. Arrhythmias were associated with longer hospital stays and five times higher hospital mortality than the non-arrhythmia group. Multivariable logistic regression analysis indicated that arrhythmia was associated with increased mortality risk three times following AMI (adjusted odds ratio 3.01; 95% confidence interval 2.42-3.75, p=0.001). Almost one-tenth of patients hospitalized with AMI in Qatar developed arrhythmia with variable outcomes; however, the in-hospital mortality remained high. Addressing the risk factors and optimizing the prevention and treatment of AMI and arrhythmias is crucial to improving clinical outcomes. This study may underestimate the incidence of arrhythmias post-AMI as it did not report all types.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of patient counseling on medication adherence in respiratory tract infection patients in a tertiary care teaching hospital.","authors":"Sai Phalguna Prakash Chitralu, Princy Domnic Dsouza, Chandrashekhar Mallikarjun Patil, Sanatkumar Bharamu Nyamagoud, Vinod Ashok Koujalagi, Agadi Hiremath Viswanatha Swamy","doi":"10.4081/monaldi.2025.3336","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3336","url":null,"abstract":"<p><p>Respiratory tract infections (RTIs) significantly impact public health in India, with high morbidity and mortality rates. Effective management of RTIs relies on medication adherence (MA), which is often challenged by factors like forgetfulness, side effects, and socioeconomic barriers. This study aimed to evaluate the impact of patient counseling on MA among RTI patients and to assess the influence of demographic, socioeconomic, and clinical factors on adherence. A cross-sectional observational study was conducted at Vivekananda General Hospital Hubballi, India, from August 2023 to January 2024, involving 200 RTI patients. MA was measured using the Medication Adherence Report Scale (MARS) before and after patient counseling. Statistical analysis assessed the effect of age, gender, comorbidities, and socioeconomic status on adherence. MA significantly improved following patient counseling, with mean MARS scores increasing from 4.13±1.601 to 6.80±1.592 (p<0.05). Age was positively correlated with adherence, while factors like gender, infection type, and socioeconomic status had varied effects. Overall, patient counseling effectively enhanced adherence across all groups. The study underscores the importance of patient counseling in improving MA among RTI patients. Personalized interventions and addressing socioeconomic barriers are crucial for optimizing treatment outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}